Talk about a work ethic – this week’s guest redefines the term.

Facebook users may recognise Lauren ‘Sparkle’ Harrhy as the founding member of Mental Dental – a forum set up to support dentists with all aspects of mental health.

But that’s just one of many hats. Lauren tells us all about Mental Dental and her helpline charity Confidential. She lets us in on how her family background has shaped her philanthropic outlook and reveals how her own professional burnout inspired her to help others.

Lauren also tells us about her work within the BDA – and why it’s important to maintain a local outlook.

Enjoy!

“I like to be on the go. I like to help. If there’s an opportunity, then I’ll take it. Because I think that if we’ve got the option to help, if we’ve got the ability to help people, then we should.” – Lauren Harrhy

In This Episode

00.59 – Family and backstory

13.08 – Lockdown and being in the thick of it

18.58 – Mental Dental

22.08 – Burnouts and breakdowns

27.45 – Confidential

35.11 – Switching off

37.33 – BDA

46.05 – Cardiff

50.31 – Contributing

54.34 – Lauren’s last day

About Lauren Harrhy

Lauren Harrhy graduated from Cardiff University in 2009 and is now the owner of Sparkle Dental Centre in Pontypool, South Wales.

Lauren has helped to set up and run the Mental Dental Facebook group and Confidential charity helpline – both of which support dental professionals with mental health concerns.

Lauren is vice-chair of the British Dental Association’s (BDA’s) Young Dentists Committee and South East Wales representative of the BDA’s General Dentistry Practice Committee (GDPC). She also sits on the Welsh Dental Council.

Lauren Harrhy: When you look at fossils and bones and you look at humans like early Homo sapiens, nearly all Neanderthals and stuff, the things that set us apart and make us human is because we care for those who need help.

Intro Voice: This is Dental Leaders. A podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi & Prav Solanki.

Payman Langroud…: It gives me great pleasure to welcome Lauren Sparkle to the podcast. Lauren’s one of the list of wonderful ladies that we’ve had who seem to be able to juggle family life, practise ownership, and a bunch of other things. Lauren started the Mental Dental Group For Dentists In Crisis and has a bunch of BDA roles. Welcome to the show, Lauren.

Lauren Harrhy: Hi. Thanks for having me on.

Payman Langroud…: Absolute pleasure. Lauren, let’s just start with the backstory. Where did you grow up? Why did you become a dentist?

Lauren Harrhy: I grew up in the South Wales Valleys. I’m the first person in my family to go to uni. I suppose when I was growing up I was quite interested in sciences but also art. Then when I was doing my A-levels, I fell in with probably the wrong crowd who encouraged me to get into dentistry. I thought that it was a perfect mix of art and science. Enabled me to be able to chat to people. I had originally thought about doing genetic engineering or something lab-based.

Payman Langroud…: Were you like a brain box in school?

Lauren Harrhy: Kind of. Oh, God.

Payman Langroud…: What do your parents do?

Lauren Harrhy: As I was growing up, my dad had a loft conversion business. Then latterly then he sold that and opened a load of nursing homes for people with mental health problems and learning disabilities. Yeah. He did that in response to the fact that my younger brother has several learning impairments and is on the autistic spectrum. As he was growing up, we were looking at if we needed it, what would we do for respite care? Or should the worst happen, where could he go?

Lauren Harrhy: We didn’t find anywhere that was satisfactory. Nowhere that we felt would be suitable for him to live. Dad decided to start a business to be able to fill that gap, really, for people who wanted their loved ones to go and live somewhere that really felt like a home and a family. He’s got several of these small nursing homes which of an excellent standard. Yeah. That’s what dad does.

Lauren Harrhy: My Mum, she passed away a couple of years ago. She was a director of a charity. She advised the Welsh Assembly on quite a lot of issues surrounding people who have learning disabilities and also speech and language impairment. Yeah. She was a really, really clever lady. They had me too young. Yeah. My mother was just 18 and my dad was just 20 when I came along.

Payman Langroud…: Wow.

Lauren Harrhy: Yeah. They didn’t really have the opportunity to go to uni because they started a family really young. They all said, “Don’t do it backwards. Make sure you go and get your degree and put everything in place before you start having a family and just making life harder.”

Payman Langroud…: You studied in Cardiff?

Lauren Harrhy: I did.

Payman Langroud…: Best dental school in the world?

Lauren Harrhy: It is.

Prav Solanki: Yeah, yeah.

Lauren Harrhy: Swimming pool and all. Yeah. I didn’t want to move too far away. My parents had recently divorced. My mother was having a bit of a tough time. I’m really, really close with my younger brother. I wanted to stay a little bit closer so I could nip home on weekends a little bit easier. Or if there were any major disasters, I could be home in half an hour or so. I just wanted to stay a little bit closer really, to be around.

Lauren Harrhy: It suited me well. Because I’ve managed to keep my group of friends that I was in school with. I still see them regularly. I’ve managed to stay really close to my grandparents. Which has really, really helped since my mother passed away. Because we were extremely close. We were best friends. When she passed away, it’s been really, really important to have my grandparents around. Because we’ve all just supported each other, really.

Prav Solanki: Lauren, tell us a little bit more about your brother. You mentioned obviously he’s got a few issues and disabilities as growing up. I just want to learn a little bit more about how that manifested itself in day-to-day life.

Prav Solanki: You mentioned that you wanted to stay close because you’re close to him and perhaps if something happened you could rush back or whatever. That you may need some respite where he could go and spend some time and whatnot. Just paint the picture of what the reality was day-to-day in that situation.

Lauren Harrhy: Well, when he was young, very young, we started noticing that Tom was a little bit different when he was about two. Which is around about the time when you have the MMR vaccine. This is where the link between autism and MMR really was… We all know the tenuous link and the awful destruction that’s been brought by that ridiculous link that… Is that Andrew Waterman connected? This is the age where if you have autism spectrum disorder, you start to display differences.

Lauren Harrhy: Tom was just… Well, we used to call him the Tom Moilian devil because our last name is Moil. He used to just act like Taz. He’d be really, he couldn’t talk very well. He was super just frustrated and aggressive. Would headbutt the walls and headbutt the radiator taps. Would pull… My hair was just out in clumps all the time. He was in his own private little world.

Prav Solanki: What’s the age gap? What’s the age gap between you two?

Lauren Harrhy: It was just under four years between us. My parents, they were young. Very young. They were 22 when Tom came along. My mother had some… She’d had two very, very awful births. We nearly lost her. Certainly the second time. Tom was really, really difficult for the first few years.

Lauren Harrhy: Then we discovered Patrick [Corman] sign language. Which enabled us to open his speech out. He’s skyrocketed ever since because he’s really, really clever. Yeah. His speech, if you were to talk to him now, you can still tell that there’s a speech and language issue.

Lauren Harrhy: As time’s gone on, he’s grown up into this wonderful, caring, clever man. He’s got a job. He drives. He’s into martial arts. He’s just working towards his fourth [dam 00:08:07]-

Prav Solanki: Wow.

Lauren Harrhy: … in boxing. He’s black belt in karate and the sword fighting and all that sort of thing. The social issues are still there. He doesn’t really know how to hold conversations particularly well. He can manage around the family and things. Just about manage at work and stuff. He’s unfortunately never managed to find a partner.

Lauren Harrhy: He’s doing his thing. He’s doing actually much better than we ever thought he would at two or three. He’s made us all really, really proud. His whole world just imploded when my mother passed away because she was his everything. His rock. She would speak for him when he was struggling and organised his whole life. He can’t manage money at all. He would go to a shop and pay 15 quid for a pack of chewing gums if that’s what they asked.

Lauren Harrhy: In those ways he is vulnerable. Yeah. He’s come on leaps and bounds. As a kid, it was difficult. He had some health problems as well, just to go along with it. When he was about nine, we noticed he had a rash. We were worrying because we thought it looked like meningitis. We did the glass test. The rash wasn’t blemishing.

Lauren Harrhy: Rushed him straight to the GP. No meningitis. Couldn’t figure out what it was for ages. It was HSP. Which then affected his kidneys. The treatment for HSP left him with two pulmonary emboli. Four centimetres and four and a half centimetres in size. Huge.

Lauren Harrhy: In fact, I think there’s been a paper written about him by the registrar who treated him. Because they hadn’t seen that in a child before. They decided to inject [inaudible] directly into his heart. To see if they could break this clot up. They did, thankfully. He came through it. He came through the other side. He spent a year in hospital being treated. It’s been a bit of a rough ride with him. Bless him.

Payman Langroud…: Now that your mother’s unfortunately passed away, are you taking up that mantel a little bit?

Lauren Harrhy: Yes. Yeah. My dad’s lived in a granny flat since my mother’s passed away. Because he did try and stay in the house with my mother’s husband for about two years. They didn’t get along. We decided it was better for him to come and live near us. My dad just lives around the corner from me actually.

Lauren Harrhy: We live in the middle of nowhere. I’ve got one house in the middle of nowhere. My dad’s got the other house in the middle of nowhere. My dad’s lived in a granny flat which is actually a really nice flat above my dad’s garage.

Lauren Harrhy: Yeah. He comes to see me every day. We talk about anything he’s got going on. I bought him a budgie for his birthday. Which is keeping him busy. It was my birthday yesterday. He sent me a card and he signed it from him and the bird.

Payman Langroud…: Lovely.

Lauren Harrhy: Yeah. It’s keeping him busy and keeping him company. Because it’s been difficult through COVID. See some, obviously where he had HSP and it’s completely ravaged his kidneys. He’s not on dialysis. We’d like to keep him that way.

Lauren Harrhy: He’s only got about 30% of his kidneys functioning. Yeah. We decided throughout COVID that he needed to self-isolate. Looking at the fact that COVID seems to be affecting people with kidney issues more. With the cases rising, we’ll probably need to have this discussion again, really.

Lauren Harrhy: He works for a CO-OP. They were absolutely amazing. They followed him 100%. They’ve really looked after him and taken care of him and checked that he was ready to come back to work and things. They’ve made work really safe for him as well. We’ve been really pleased and grateful about that. Everyone’s for CO-OP because they’re a great company.

Prav Solanki: What’s the dynamic of lockdown been like for you guys with obviously your brother self-isolating? We’ve spoken to loads of people who have got various silver linings of lockdown in terms of what happened. How we’re getting to spend more time with the family away from… Obviously you’ve got your own business as well. You have those stresses as well. Can you just summarise what happened for yourself?

Lauren Harrhy: Yeah. Well, at the beginning it was very frantic. Because obviously we were concerned about patients. Concerned about closing down and halting treatment and things like that. I’ve got quite a lot of older patients. We’re in quite a deprived socioeconomic area.

Lauren Harrhy: I was really, really concerned because I’ve got lots and lots of patients with quite extensive medical histories. I was really concerned we were going to lose a lot of patients. Also the staff were fearful. I was fearful. We didn’t know really what to expect. Add to that, the fact that I do hold several BDA roles.

Lauren Harrhy: Frantically trying to figure out what to advise members as well. Yeah. I think the first six weeks or so I was averaging about four, five hours sleep a night. Just trying to keep on top of meetings. It was constant concern WhatsApp messages flying around and things.

Payman Langroud…: Lauren, you’ve got your practise. You’ve got your kids. How many kids have you got?

Lauren Harrhy: Three.

Payman Langroud…: Three kids. You’ve got your brother and your dad. Now, you’ve got Mental Dental. Now you’ve got all these BDA roles. Are you the type of person who just says yes to everything and then works it out later? Or do you love being in the middle of it? Do you know what I mean? It’s a lot to do.

Lauren Harrhy: Yeah. We’ve got Confidental as well.

Payman Langroud…: Confidental as well. Yeah. We’re getting to that.

Lauren Harrhy: Yeah. My dad at my wedding, when my dad gave his speech, he called me perpetual motion. I think that probably is right. I like to be on the go. I like to help. If there’s an opportunity, then I’ll take it. Because I think that if we’ve got the option to help, if we’ve got the ability to help people, then we should. Yeah. If there’s an opportunity to help, then I will.

Prav Solanki: Lauren, how do you squeeze it all in? What’s a day or a week in the life of your activities like? With running the practise and-

Payman Langroud…: Just run us through your day.

Prav Solanki: … looking after your brother. Then running all of these organisations and WhatsApp messages and stuff like that. What’s it like for you typical day, typical week?

Lauren Harrhy: I will wake up at half 6:00, 7:00. Just immediately check my phone. As unhealthy as that is. I’ll immediately check my phone. Scroll through messages. Reply to anything that has come while I’ve been asleep.

Prav Solanki: While you’re in bed?

Lauren Harrhy: Pardon?

Prav Solanki: While you’re in bed?

Lauren Harrhy: While lying in bed.

Prav Solanki: While in bed. Yeah.

Lauren Harrhy: It’s [inaudible] when I open. Scrolling through. I’ll reply to any immediate messages. Then get up. Get my kids up. Ready for school, nursery. Sort the dog out. Sort the cats out. Sort the chickens and the ducks out. I’ll get the girls on to their school bus. Sonny comes with me because he goes to nursery just opposite the practise.

Payman Langroud…: How old are they?

Lauren Harrhy: Brooke is nine. Grace is six. Sonny is three.

Payman Langroud…: Wow.

Lauren Harrhy: Yeah. I’ve managed to evenly space them out. My husband was joking a little while ago, he was like, “Oh, come on now. It’s time for the next one.” They will lead the more. We’re done at three. We’re both really tired all the time.

Lauren Harrhy: Sonny still tries to come into bed with us every night. Yeah. This is the reason I’ve got so much time. It’s because Sonny actually has never slept very well. I’m usually up so I can manage a lot from my phone. That’s what happens.

Lauren Harrhy: Yeah. On a typical day, non-COVID, I’ll go in and see patients and reply to messages lunchtimes. Then usually zip from the practise to get Sonny to get home. Get tea on. Sort kids out. That sort of thing. Then in between times I’ll be replying to messages, doing emails and that sort of thing. Yeah. If.

Payman Langroud…: Is it a mixed practise?

Lauren Harrhy: It’s a mixed practise, yeah. We’re about 80% NHS. Obviously we’ve been really, really fortunate to get some NHS funding. In Wales, we’ve had 80% of our contract value at initially. We’ve just recently gone up to 90%. That has been helpful.

Lauren Harrhy: Obviously, the private side has died off, really. Because the priority has been NHS patients. Because we’re still restricted about what we can do. We’ve really just tried to focus on getting everybody healthy. A lot of the private stuff I was doing was aesthetic. I got a small amount of Denplan patients who I’ve been looking after as well. We’ve just mainly been focusing on keeping everybody healthy through this time.

Payman Langroud…: How many rooms is it? How many dentists is it in the practise?

Lauren Harrhy: We were two surgeries. Then this year, I was appointed as an FD trainer. I just put in a third surgery.

Payman Langroud…: Oh, my goodness. You are busy, aren’t you? Tell us about Mental Dental. How did it come about? First of all, for someone who doesn’t know, what is it?

Lauren Harrhy: Mental Dental is a Facebook forum for UK dentists. We’ve allowed a couple of Irish dentists to join. Because there wasn’t something similar for Irish dentists. We thought that we would still have some crossover between our problems. It’s mostly UK dentists. We have close to 6,000 members now. It was started really as a support group.

Lauren Harrhy: I mentioned earlier that my mother was the director of a charity when she was alive. She worked her way up to become the director of that charity but initially was just a volunteer. She used to help to run support groups for people whose children had speech and language problems.

Lauren Harrhy: I remember that the support groups were super useful. Because it meant that people with the same issues and the same problems and the same fears could come together and share them and get advice and support. Just hints and tips without judgement . Because everyone was going through the same thing.

Lauren Harrhy: I thought we’re really, really isolated as dentists. We all say it all the time. We’re really isolated as dentists. It’s slightly better if you work in a practise with more dentists but not always. Because you don’t always feel that you can talk to your colleagues. Some people are very private.

Lauren Harrhy: I just thought that a Facebook forum would give that space quite nicely to dentists who are all over the country. I’d seen on some other forums that people were really suffering. Burnout is something that is really prevalent in dentistry. I’ve suffered from it myself. I had a breakdown in 2015 myself. I just didn’t want anyone to have to face that alone anymore. I just wanted to make a space where we could come together and we could help each other.

Payman Langroud…: When you went through it yourself, did you find there was no one to talk to?

Lauren Harrhy: I didn’t want to talk to anyone.

Payman Langroud…: You didn’t want to?

Lauren Harrhy: This was the problem. Is that I had hidden this part of myself for so long that nobody had any idea that I was suffering. No idea at all. Until it all completely fell apart. It was manifesting even physically. Because I spent about two weeks with just… I was just shaking and vomiting and could barely move. It was really, really… It had affected me not just mentally but physically also.

Prav Solanki: Lauren, on the outside, if I knew you passing by and all the rest of it, I wouldn’t have a clue?

Lauren Harrhy: Yeah.

Prav Solanki: I’d be blind to this. Something was going on inside. You exploded and it all fell apart. Would you mind just sharing what it was and what led to that, if you’re comfortable doing so obviously? Then perhaps just sharing, not necessarily mentioning names, the typical things that you see in your group that perhaps somebody listening to this is experiencing similar problems would feel comfortable reaching out and knowing that there’s help?

Lauren Harrhy: Okay. Well, for me I think it was a combination of things. It’s never just one thing in isolation that causes us these issues. I mentioned that there were problems in my childhood with my brother. My parents had a really tumultuous marriage.

Lauren Harrhy: Yeah. For me, I felt it was better when they split. It had been 17 years of lots and lots and lots of arguments. Growing uncertainty. Also when I was about 14, my mother had been attacked by a Rottweiler and a Bullmastiff. She was left for dead.

Prav Solanki: Oh, God.

Lauren Harrhy: Suffered horrendous PTSD afterwards. Which she didn’t feel able to get help for that. Instead of doing what these days people would… They would just automatically probably go on to meds and get help. She just didn’t want to do that. She was still in the mindset that she could cope with this herself.

Lauren Harrhy: She started drinking instead. Was self-medicating with alcohol. That was always a worry. It was really tough to see somebody go from being so bright and vivacious and loved and kind, to somebody who was less than that. Yeah. I think that stuff contributes. Then you go into a profession which is high pressure. You want to do the best for your patients. You want to do the best job you possibly can.

Lauren Harrhy: I think that in that first few years at dental school, initially you think, “Oh, yeah. I can do this.” Then you start. Your mistakes start coming back. Your failures start popping up. You realise that you’re not as good as you thought you were. You realise that there’s a lot of learning to do.

Lauren Harrhy: I was feeling just that I was failing at everything. I think I had been suffering from some postnatal depression also. I think it was just all a bit of a perfect storm. Yeah.

Payman Langroud…: How did you get out of it?

Lauren Harrhy: Well, I eventually went to the GP. I see a private GP in Cardiff. Dr. Longstaffe. She put me in for 20 minute consultations. Spent an hour and a half with me. She’s amazing. She just broke it all down and said, “Look, we need to just get you on some meds.” She started me off on [Stelaprom 00:25:49]. I was on Stelaprom for about three months. Which just helped me clear everything. Helped me think clearly again.

Lauren Harrhy: I came off work for a month or so while I was feeling poorly. Then after that, I was feeling well enough to go back to work and to see patients and everything again. Then, I think just now I know my triggers. I know what it feels when I’m starting to feel it’s all going downhill. I’ve never, ever got to that state again. Now I know what to do to help myself if I’m feeling low. No, I’ve-

Payman Langroud…: When you hear the stories of dentists who come to you, you do these anonymous posts.

Lauren Harrhy: Yes.

Payman Langroud…: How does that work? The dentist literally reaches out to you. You know who they are, but we don’t.

Lauren Harrhy: Yeah.

Payman Langroud…: Do you find there’s lots of parallels to what you were going through with them?

Lauren Harrhy: [crosstalk 00:26:46].

Payman Langroud…: Who do you hear the most? It’s funny because it’s a bit difficult. I used to read every single post on Mental Dental back when you started. Because I used to find it fascinating and interesting. It felt so authentic compared to everything else on social media. Now, I feel there’s so much more anxiety out there than I realised.

Lauren Harrhy: Yes.

Payman Langroud…: It’s almost like, well, I’ve read this before. I’ve read… It’s a much, much bigger issue than you might imagine.

Lauren Harrhy: Yeah. [inaudible] actually. I think that lots of us don’t know where to go to access help. There are avenues these days. There were few avenues. These days there are many more avenues to go down for help. We’ve always had the Dentists’ Health Support Trust. They are amazing.

Lauren Harrhy: They were initially set up to deal with addiction. They can now help those suffering with their mental health in general. In England, there’s the Practitioner Health programme. We’ve got something similar now in Wales. Also there’s BDA Health Assured and Confidental. Quick plug for Confidental. We’re a helpline if you ask [inaudible 00:28:12].

Payman Langroud…: How did it come about and how do you run it? Confidental.

Lauren Harrhy: Well, Confidental, well, when I started Mental Dental, I always wanted it to be a helpline. Because I thought that the forum was great and it does have its place. Sometimes you do feel you need to speak to someone one-on-one. I just had no idea how to go about it. No idea how to get it off the ground.

Lauren Harrhy: Then about two years ago, Jeremy Cooper put a post out saying that he’d been really affected by a suicide in his area. A dentist. He said that enough is enough. We need to help each other. Somebody connected us. Jeremy was absolutely tenacious.

Lauren Harrhy: He’s gone and found sponsors. Found all the right people to come together to get his project off the ground. It’s actually fairly… The system is simple to use. We use a phone company which allows us to have three people in a cascade at any one time. We’ve trained some volunteers who can take calls. It’s dentists who recently retired. Dentists that are taking our calls.

Lauren Harrhy: We would like more volunteers. Because it’s quite at the moment, the shift pattern is a bit onerous. Just you have to be on for seven days or seven nights, depending on what shift you do. It doesn’t mean that you’re on the phone constantly for all that time. Sometimes you won’t get a call at all. Then other times you might get three calls in a shift.

Lauren Harrhy: Obviously, these calls are not quick calls. Generally, you need to be on the phone for some time. It’s a bit of a commitment when you’re on a call or when you’re on a shift. We’ve had, I think somewhere… Keith Hayes, who is one of the trustees and one of the founding members, he keeps a log of the calls. Not who’s calling, but how many. Keith would be able to tell us a bit more. I think we’ve had over about 400 calls since we started and-

Payman Langroud…: [inaudible 00:30:29].

Lauren Harrhy: … it was fully launched. We launched just… It was the 27th of May 2019. We did a soft launch until we knew that we would be able to deal with the call volume coming through. Yeah. It’s been an amazingly inspiring project to be part of.

Lauren Harrhy: We’ve recently registered as a charity. Keith put an awful lot of work into getting us registered with the Charity Commission. Now we’re just looking for sponsors. We’re looking at whether or not we can extend this help to other members of professions. Dentists and therapists and things like that. We’re just about to survey… Sorry. Hygienists and therapists. Just about to survey hygienists and therapists to see if they think that they would also benefit from a phone line like this.

Payman Langroud…: Yeah. I don’t know. On that hygiene forum, there’s plenty of pain going on there. Plenty of problems. You need volunteers. You need sponsors.

Lauren Harrhy: Yes.

Payman Langroud…: Is that it? How else if someone wants to contribute?

Lauren Harrhy: Well, we could take donations. We’ve had donations from a couple of LDCs. People are more than welcome to donate as well. It doesn’t actually cost an awful lot to run the phone line. It just cost quite a lot to train the volunteers. That’s where the money goes at the moment. The phone line cost is very little. The training is very expensive.

Payman Langroud…: Let’s say I want to volunteer, what’s the process? How long does it take to train? Then-

Lauren Harrhy: Initially we would ask you to make contact. Then we would put you on the waiting list for the next time we’ve got training available. Training usually takes place over two days. We have various different training providers. Invariably we will have training about how to handle calls and personality types and things like that.

Lauren Harrhy: Then we will usually have some training on mental health and suicide prevention. Yeah. It’s quite an intense two days. Then we look at doing top of training and things like that. We haven’t been running that long. Most of the volunteers are pretty fresh. Yeah. The plan is that we’ll do to up training. A bit like CPD [inaudible 00:33:07].

Lauren Harrhy: Prior to COVID, these two days were face-to-face. We did have a cohort of volunteers because [inaudible] were going there. We needed people on day route. We did train a cohort of volunteers earlier this year so that we could get more people on the day route through COVID.

Payman Langroud…: Lauren, you just mentioned suicide prevention there as this part of the training. Is that something that comes up quite a lot as part of the types of calls that are received in terms of different, the range of calls? Is that quite a common thing?

Lauren Harrhy: Thankfully not.

Payman Langroud…: No? Okay.

Lauren Harrhy: Thankfully not. A lot of the time, it’s similar stuff to what we see on Mental Dental. There was dispute within a practise, bullying, harassment, concerns about patient complaints, concerns about GDC hearings. Or just general life stuff, really. Personal problems and things like that.

Lauren Harrhy: We are there if somebody is feeling that they are feeling suicidal. Then we are there to take those calls. Generally somebody is at risk of suicide for about 20 minutes. If you can keep them going during that 20 minutes, you can often change their minds.

Payman Langroud…: Wow.

Lauren Harrhy: Persistently changing somebody’s mind. They might feel suicidal today but not tomorrow. Then they might feel suicidal again in a few months time. It’s hoping that you can always catch somebody and make them realise that they are worth something and that life is worth living and things will change.

Prav Solanki: It’s clear to me from right at the beginning with your dad wanting to set the homes to help people and you’ve been brought in this environment helping, helping, helping. Your practise is predominantly NHS and you’re looking to help people who need the care.

Prav Solanki: Just in terms of the problems that you see and listen to all the time, do you ever get to switch off from those problems of helping all these people or listening to the doom and gloom and everything? Then when you get home, we didn’t really get to the end of your day when you come home from the practise and whatnot. What does that end of your day look like? Do you have strategies for switching off? Or do you want to?

Lauren Harrhy: Do you know what? I do find it difficult to switch off. My husband’s really good at chatting things through with me. He’s really, really supportive. Sometimes if I get myself down a rabbit hole, he’ll pull me up back out. Yeah. I don’t drink very much. Deliberately. Because I think that could send me down the wrong path. Particularly when I’m feeling stressed.

Lauren Harrhy: I do things like walk the dog. Or just, well, no. I don’t know how I switch off really fast. I don’t switch off enough. Yeah. I got the dog. I got the cats and the chickens and the ducks. They keep me busy in a different way. That’s probably how I get away from thinking too much.

Prav Solanki: Does that phone ever go away? You mentioned that you wake up in the morning and you’re flicking through messages in bed. Then are you doing that last thing at night before you go to bed or is there a point where-

Lauren Harrhy: Oh, yeah.

Prav Solanki: …. you actually [inaudible 00:36:51]?

Lauren Harrhy: Often during the night when the littlest one wakes me up during the night as well. No.

Prav Solanki: You don’t switch off?

Lauren Harrhy: Yeah. It’s probably quite unhealthy. I do try to set it aside and I keep an eye on my screen in time. I’ve stopped using the phone so much for just stupid things now. I tend to be on the phone if I need to support somebody or to do my emails or whatever. I’m trying to keep my screen time down as much as possible. Yeah. The phone is glued to me most of the time.

Payman Langroud…: Tell us about your BDA role. The BDA has had a bad rep from a lot of people. You seem to be getting more involved in it. Sum it up for us.

Lauren Harrhy: A couple of years ago, around about time I was starting Mental Dental, I decided that… I could see that there were problems in the profession. Then as we talked about… I do like helping. I just thought that it’s not good sitting around and whinging about problems unless you’re willing to go out and do something about them.

Lauren Harrhy: I’ve always been a BD member since I was a student. I just thought that I could help to enact change. I could help to make working conditions better for dentists. I stood for a couple of positions. Now I’m the Vice Chair of the Young Dentist Committee. Which I’m probably getting a bit too old for now. They’ll probably kick me off soon.

Lauren Harrhy: I’m the Vice Chair of the Welsh General Practise Committee. I also sit on the UK General Practise Committee [inaudible] Council. All these roles give me a good insight into what’s happening in dentistry and the problems that arise. It’s not just NHS dentistry. Although until COVID, NHS dentistry was probably more of a focus because there was more going on.

Lauren Harrhy: Obviously since COVID, we’ve seen the private dentists have really, really needed support. Yeah. The BDA, I think because it is a big organisation, it often draws focus for negativity. I’ve seen this. I think we get lumped in sometimes by some people. We get lumped in with the GDC and the NHS. We just seem lumped in. We are actually the union for dentists.

Payman Langroud…: It does seem very focused on NHS though, isn’t it?

Lauren Harrhy: I think it has been. Purely because, I think prior to COVID, what did private dentists need us for?

Payman Langroud…: Well, lots of things. Private dentist have many issues, don’t they?

Lauren Harrhy: Yeah. We’ve been there. We have looked at… We’ve been there for all dentists. I think that certain parts of the BDA is being very NHS focused. Necessarily so. Yeah. We’ve got the private practise group that’s been set up. Which I think has been welcomed and needed, really.

Lauren Harrhy: I know that BAPD is doing excellent work as well. We’ve been collaborating with them. Because I’m not on the private practise group. I stood in on that meeting a couple of weeks ago. Yeah. I think that it’s about time we all put our heads together really to just [inaudible 00:40:48].

Payman Langroud…: Now you’re going for the [PECK] as well?

Lauren Harrhy: Yes, I am. Well, I stood twice previously. Was narrowly edged out by Tony [Kokoi] last year. Yeah. I’m standing again. The Welsh seat is a… I’m not standing against Tim Harker because I think Tim does an excellent job. I’d like to be on the PECK alongside him rather than instead of him. I’m going to be standing for the UK seat.

Payman Langroud…: I just can’t get my head around the number of things you’re doing. It’s a lot of things. You just came out with four or five different committees that you’re… Each of these takes time.

Lauren Harrhy: Yeah. They do. They [inaudible] other. A lot of the papers and things overlap. It’s good to be a conduit between those committees.

Payman Langroud…: It’s the theme that we’re seeing with some of our lady guests. Linda Greenwall and Vicki Holden. I’m thinking of even Zainab. It’s almost like that famous cliche about, if you’ve got something to give to someone, give it to a busy person or whatever it is. I take my hat off to you.

Payman Langroud…: [inaudible] so much. Do you feel your practise suffers? If let’s imagine you didn’t have all of this and you focused all that energy on practise life, do you feel you’d have a different practise or more practises or whatever it is?

Lauren Harrhy: Might have more practises. No. My practise is, I got a really, really good team. I call them team Sparkle. I’m actually Lauren Harrhy. I put Sparkle in my professional profile on Facebook.

Payman Langroud…: Oh, I’m sorry. I’m sorry.

Lauren Harrhy: That’s all right.

Payman Langroud…: I thought it was part of your name.

Lauren Harrhy: It was just because I’ve got two Facebook profiles. One is my personal one and the other is my dental one. Because I just didn’t want to be spamming all my friends and family with dental stuff all the time. Yeah. I call my team, team Sparkle.

Lauren Harrhy: I’ve got some excellent associates. My practise manager is great and all my nurses are fab. Yeah. The practise is good and runs well. Perhaps we would have more practises. I look at my friends who’ve got more than one practise and it puts me off a little bit. It seems super hard work.

Lauren Harrhy: I know that sounds crazy to say. Because I’m doing a lot of that. It seems hard work in a different way. The pressure is different, I think. Yeah. I think maybe one day I could channel some more energy into another practise. At the moment, I don’t want to spread myself too thin for patients. I still work full time. Clinically I’m still full time.

Prav Solanki: Wow.

Lauren Harrhy: I love my patients. I don’t want it to sound tripe but I really do. I’ve been treating these patients for six years. I know them all really well. I know about their families. I know about their lives. For me, I would feel I was being a bit disloyal spreading myself around a lot of different practises.

Payman Langroud…: Did you grow up in the same town in [inaudible 00:44:25]?

Lauren Harrhy: Well, a couple of times over. Yeah. They’re all the people that I grew up with. Yeah. We’ll get on and we understand each other well and all the rest of it. No. That’s not to say that my friends and colleagues who’ve got [inaudible] one practise are doing that. It’s just for me, I just would feel I was spreading myself a bit too thin.

Lauren Harrhy: I want to be with these guys all the time. I really do. I look forward to seeing my patients. I look at my day list every day and see the names that I recognise. All of us have a couple of patients that give us a bit heart sync. Most of them, I look forward to seeing them. Yeah. I suppose if I had another practise, I would feel like that about the new cohort of patients eventually. I’m just not ready for it yet.

Payman Langroud…: I think we break down dentists into the type like you listen to the people. Then there’s the other type who are into the [mechano 00:45:26]. The fitting bits together type. Of course, there’s some crossover. I’m sure you’re one of those too.

Payman Langroud…: For someone like me, I gave up dentistry 10 years ago. Certainly, that element of it I do miss. I miss people. It was never my own practise in the town I grew up. Having spent six, seven years in Wales myself, I know exactly what you mean about the communities. It is somehow more of a community than we’re used to down here anyway. I’m sure up there Prav, you’ve got some-

Prav Solanki: Of course we have Pay. The best people in Manchester mate.

Payman Langroud…: No. The Wales are amazing.

Prav Solanki: [crosstalk 00:46:05].

Payman Langroud…: They really are amazing. I spent some time in the Valleys after heavy nights in Cardiff as well. Tell us about your Cardiff experience. Did you enjoy it? Did you enjoy being a dental student? Or did you find it hard or?

Lauren Harrhy: Well, for me-

Payman Langroud…: Which years were you there?

Lauren Harrhy: I qualified in 2009.

Payman Langroud…: Oh, it’s way of [crosstalk 00:46:27].

Lauren Harrhy: 2004 to 2009. Yeah. I did enjoy being a dentist student. I met my husband in the first year. He’s not a dentist. He’s a firefighter. I met him in the first year. I had quite a separate life.

Prav Solanki: How did you meet?

Lauren Harrhy: On my out. In [inaudible 00:46:50]. Which is not there anymore. I don’t think. Yeah. We just met on a night out. Stuck together. Yeah. 15, 16 years later we’re still going. Yeah. This is how a lot of the time he keeps me sane. Because he’s got a different perspective. We can talk about firefighter stuff, not dentist stuff and things like that. I bought my first house when I was 20.

Prav Solanki: Wow.

Lauren Harrhy: We lived in [Pamprani] which is just out of Cardiff a little bit.

Payman Langroud…: Was it in dental school you bought your first house?

Lauren Harrhy: Yeah. I was 20 nearly 21. That would put me in second, third year. Then got married six weeks after I qualified.

Payman Langroud…: Wow.

Lauren Harrhy: Yeah. We started having kids pretty young as well. I had Brooke when I was 25. Between having number one and number two, we knocked the house down and built another one. We lived in a caravan for a little while. Although I did enjoy dental school, I wasn’t… Well, the first year I was. The other years I wasn’t out every night or anything. I was settling already. That’s why I didn’t want to go too far for [VT] or I wanted to stay in Wales because I needed life.

Prav Solanki: The way you need, did you have a mixture of friends of obviously your dental colleagues and then… Because I had a similar situation when I was at uni. Not because I met my wife there or anything. Part of the time I’d be hanging out with what they referred to as the townies. The other part of the time I’d be hanging out with my uni mates. Was it similar for you?

Lauren Harrhy: Yeah. I had a group of really lovely friends in uni. We tossed house parties and we [inaudible 00:49:01]. Things like that. Yeah. I would still like to spend time with my family and my friends from home. Also my friends that I met through my husband as well.

Prav Solanki: [inaudible 00:49:12].

Lauren Harrhy: His friends. Yeah. I had a good mix. We were always busy. Yeah. It was a mix between uni friends and home friends. It’s good. It keeps you balanced.

Prav Solanki: I think it is good. I think it just keeps you grounded always. In fact, when I was at uni, I felt I was in a bit of a bubble. I came out of that bubble when I hung out with my local friends, if that made sense. Who weren’t at uni. Weren’t necessarily as educated. Thought it just… It kept everything nice and bubbly [crosstalk 00:49:44].

Payman Langroud…: Were these your bodybuilder buddies?

Prav Solanki: Yeah. I met them in this bodybuilding gym that I joined. That I got thoroughly addicted to and met some really, really good friends for life. I’ve probably got six, seven friends that I would consider to be real friends who would jump if I needed them. Two of them are from the people who I met in that gym. Still till today.

Prav Solanki: Yeah. If I was looking at my uni days, I might be going out on a Friday and a Saturday. Friday might be with the townies, as the students would refer to them as. Then the others would be with my uni mates. It was nice to have that mix. [inaudible 00:50:29].

Payman Langroud…: I’m hearing from you that every single thing you say in the end for me comes out as contribution, contribution, contribution. You’re constantly contributing. Then we’ve had all sorts of people on this show. We’ve got the other type who constantly… It’s wrong to say taking. You’ll forgive me, I’m not saying that.

Payman Langroud…: This level of contribution that you seem to be onto, would you put that down to your parents? Is that it? Were you that kid who used to always try to help people as a kid? What made you Lauren?

Lauren Harrhy: Yeah. I think we’re all shaped by our experiences, aren’t we?

Payman Langroud…: Yeah.

Lauren Harrhy: And the people that come in and out of our lives. Yeah. I think my parents, my grandparents as well, really just taught me that, as I said earlier, you should help where you can. It’s good to help people because not everybody’s in the position to help someone and not everybody’s in a fortunate position. They desperately need help from the Valleys. It’s a big labour area. It’s all a bit socialist.

Lauren Harrhy: Perhaps that where that then comes from a little bit. I just think it’s important to be kind. I think it’s, I couldn’t stand the thought of somebody really struggling and having nobody to lean on. Because I’m really fortunate that with all the issues that have happened over the years, I still always have that call of family and friends that were there. That cared for me.

Lauren Harrhy: I just would hate to feel that there’s somebody out there who felt they didn’t have anybody. That would absolutely break my heart. If somebody feels that they’ve got nobody, then maybe they could feel they’ve got me.

Prav Solanki: It’s incredibly admirable what you’ve just said there. I work with a lot of practise owners. A lot of people are a 100% business-focused. Or ambition-focused. Or clinically they want to be the best and do all this postgraduate education. Blah, blah, blah. All the rest of it.

Prav Solanki: Whereas what’s very, very, very clear from what you’re saying is a big part of your driver is, just about being there for people who need help. Well, it feels as though if there is someone out there who does need help but doesn’t get it, it upsets you?

Lauren Harrhy: Yes, it does. Because, I think as human beings, we’re social animals.

Prav Solanki: [inaudible 00:53:16].

Lauren Harrhy: If look right back into history, we’ve always been tribal. Part of what makes us human is caring for others. When you look at fossils and bones and you look at humans like early Homo sapiens, nearly all the Neanderthals and stuff, the things that set us apart and make us human is because we care for those who need help.

Lauren Harrhy: In anthropology, you can see that with these early humans, they’d see that somebody had a really awful fracture that would have resulted in them not being mobile. The fractures healed and they continued to live a life after that. That’s because the tribe has gathered around and helped them. Well, really that is what makes us human. That’s what we should be nurturing and continuing to this day.

Payman Langroud…: Defines us.

Lauren Harrhy: Yeah. Well, I think so. Then, it’s all very well. Sometimes we need to be selfish and sometimes we need to just do things for us. That’s really important too for our mental health. I think that it’s a much more fulfilling life if we can look after each other as well.

Payman Langroud…: Absolutely.

Prav Solanki: Lauren, let’s imagine this is your last day on the planet. You’ve got your children around you and your chickens. What three pieces of advice would you want to leave the world with and your loved ones with and how would you like to be remembered?

Lauren Harrhy: My three bits of advice would be number one, be kind and help where you can. Number two is be brave and stand up for what’s right even when it’s hard. Number three would be that it’s okay to sometimes just be and not have to be something. Sometimes it’s all right just to sit and be and just take everything in.

Lauren Harrhy: I would like to be remembered as somebody who tried to help. Or just tried. I might not be the best clinician. I might not be the best at anything. At least I tried.

Payman Langroud…: That’s lovely.

Prav Solanki: It’ really nice. Thank you so much.

Payman Langroud…: For me, there’s probably thousands of dentists out there doing the things that you’re saying. Contributing. People we’ve never heard of.

Lauren Harrhy: [inaudible 00:56:02].

Payman Langroud…: You’ve embodied it. You’ve embodied it. It has been just lovely. I knew it would be lovely to have you on the show. Thanks a lot for taking the time Lauren.

Lauren Harrhy: Well, thanks-

Prav Solanki: Thank you.

Lauren Harrhy: … for having [inaudible] guys. I really appreciate the chance to have a chat. It’s been lovely therapy this morning. That’s [crosstalk 00:56:22].

Payman Langroud…: A bit different to Larry [Resental] last week, I have to say.

Prav Solanki: [inaudible] you did too much.

Lauren Harrhy: Oh, gosh. All right. [inaudible] thank you so much. I honestly, I really, really do appreciate taking time to speak to me this morning. I hope that anyone who’s listening now knows that there are plenty of ways to reach out for help with [crosstalk 00:56:44].

Payman Langroud…: What the number for Confidental finally?

Lauren Harrhy: It’s 036.

Payman Langroud…: Look it up.

Lauren Harrhy: Yeah. I know. Let’s look it in [inaudible] site. 0333 9875158. It’s not free to call yet. Eventually we do hope that it will be a free phone number. I think it’s just charged at local rate. I think it might be free for most [nobales]

Payman Langroud…: If someone wants to get involved, they message you on Facebook?

Lauren Harrhy: Yeah. Or get in touch with Keith Hayes. I think you can probably get hold of Keith via Facebook [inaudible] as well. Yeah. You can directly message me on Facebook for any of your mental health needs.

Payman Langroud…: If anyone’s not on it… I’m sure 6,000 dentists is a lot. The group is called Mental Dental-A Group For Dentists-

Lauren Harrhy: A Group-

Payman Langroud…: … In Crisis.

Lauren Harrhy: … In Crisis. Yes.

Payman Langroud…: Yeah. All right Lauren. Thanks a lot for taking the time Lauren.

Prav Solanki: Lauren, thank you.

Payman Langroud…: lovely.

Payman Langroud…: Thank you.

Prav Solanki: Thank you so much.

Outro Voice: This is Dental Leaders. A podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi & Prav Solanki.

Prav Solanki: Thanks for listening guys. If you’ve got this far, you must have listened to the whole thing. Just a huge thank you both from me and Pay for actually sticking through and listening to what we’ve had to say and what our guest has had to say. Because, I’m assuming you’ve got some value out of it.

Payman Langroud…: If you did get some value out of it, think about subscribing. If you would share this with a friend who you think might get some value out of it too. Thank you so much for listening. Thanks.

Prav Solanki: Don’t forget our six star rating.

In this week’s extra special episode, previous guest Druh Shah turns the tables on Prav and Payman, playing host while they take the hot seat. 

And it turns out this isn’t the first time the pair have switched.

Before finding success as dental entrepreneurs and podcast hosts, Payman was all set for a career in general practice, while Prav seemed destined for great things in the world of research science.

Here they talk about making the switch, early days, inspiration and their respective journeys to becoming dental leaders in their own right.

Enjoy! 

 

“This is a proper switch because [Prav] did a switch from pharmacology to marketing and Payman did the switch from dentistry to building a business and you guys have switched me into a host…” – Druh Shah

 

In This Episode

02.31 – Backstories

24.36 – Down to business

39.32 – Influence and inspiration

48.23 – Starting Dental Leaders

57.19 – On fatherhood

01.00.26 – A peek into the future

 

About Prav and Payman

Payman Langroudi started his early career as a dentist before creating leading whitening brand Enlighten. 

Former research scientist Prav Solanki is the director of a national dental chain, a successful health and fitness brand and IAS Academy dental training institute. He is also director of The Fresh marketing and growth consultancy.

Prav and Payman are hosts of the Dental Leaders podcast.

Prav Solanki: I thought his name was Payman, because he was this super rich guy, who just pays for… just a high-roller man, just a super high-roller and Payman is like, “What the hell is that?” Right? But honestly, and I was totally in awe of this guy. Owner of a big dental company, he’s got this massive stand, blah, blah, blah, whatever.

Prav Solanki: But you know what? One of the things is that, you kind of levitate towards people who… I don’t know, your like, you like people who you are like, or whatever people say about that, but, very, very quickly it became apparent, if I was going to be in London, he’s the first person I’d pick up the phone to and call, because I want to hang out with him. I want to spend time with him.

Drew: And he’s always available as well.

Prav Solanki: And he’s always mucking about.

Intro Voice: This is Dental Leaders. A podcast, where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Drew: Welcome to the Dental Leaders Podcast. They always say great leaders are the people who find other leaders. Well, for this podcast, it’s time to switch. Basically the boot’s on the other foot, the host becomes the guest. The guest becomes the host. The goalkeepers just become the striker. The strikers both gone in goal. Well, hell I don’t know which way this is going to turn around, but this time I’m turning this upside down, on it’s head with the two people who started the Dental Leaders Podcast. Prav, welcome to today’s show and Payman, welcome to today’s show. How are you guys doing?

Prav Solanki: I’m very well, mate. Thanks for having us on the show, mate. Really appreciate the invite and…

Payman Langroud…: A big difference, it’s a big difference, isn’t it? This one. I like that. I like that, Drew. I like little intro you gave because then neither me or Prav know anything about football, but go on. Go ahead. You’re the boss. You’re the interviewer.

Drew: Well, okay Pay, cricket, right? Pay’s been throwing all the balls and we’ve been platting away. Well, this time I’ll put him on the crease with Prav.

Prav Solanki: Well, we hope that one works. I know nothing about cricket, mate.

Drew: Right, sports is out of the question Pay, that means-

Prav Solanki: Well, out of the question.

Drew: … you probably didn’t do much. Now, Payman, it’s really funny, but everyone meets you the first time and they say this guy Payman, he must be the guy who pays. But let’s do this one, how, tell me Pay, you’ve always been in and around London growing up. Is that right?

Payman Langroud…: No, no, I was born in Iran. We had a little revolution in Iran when I was six years old and we came… We were really lucky my dad, some employees, some British employees in his company in Iran. And when their embassy said, “Listen, time to go back.” That day me, my brother and my mum got on the same plane with those British employees and good thing we did too, because he couldn’t come out then after that for two more years. So no, I was six years old when I got here.

Drew: Wow, brilliant man. How did it feel? You were six, you were discovering yourself and you must’ve sort of ended up in some random school with people’s British English, but it could be butter instead of butter?

Prav Solanki: Just one thing here mate, Payman told me he started discovering himself when he was 13, but maybe that’s a different story.

Payman Langroud…: 11 actually, when the two ones came in the lion and leopard…

Drew: But how did you get into dentistry Pay? Was that something you kind of just decided to do or someone inspired you to get into dental school?

Payman Langroud…: I’ve got a couple of uncles who are dentists. So one on either side, my mom’s brother and my dad’s brother and my mum’s brother actually used to live with us. He’s actually a periodontist like you. And he came and lived with us and he went and did perio in Cardiff. And that’s actually why I went to Cardiff as well. I studied dentistry in Cardiff because we used to go visit him and ended up having Cardiff on the map. But he was my favourite uncle when it got down to it Drew, I didn’t really know what I wanted to do at all, aged 17. And my parents said, “What are you thinking?” And I said, “I don’t know, maybe accountant, like my dad.” But-

Drew: So you were still discovering yourself basically.

Prav Solanki: Yeah. Yeah.

Payman Langroud…: And my dad said, “Listen, maybe.” I said, “I don’t know, accountant or dentist.” Basically I had no idea to tell you the truth. And my dad said, “Look, what about try dentistry? And if you don’t get in then do accountancy after that.” It was one of those… I wasn’t one of those who wanted to be a dentist since I was 12 types.

Drew: That’s amazing and after dentistry, you kind of did do VT, but somewhere in the way you got into Enlighten and you got into what you’re doing now, how did that happen?

Payman Langroud…: I was quite an ambitious associate. Like you see quite a lot of young, ambitious associates when they’re… And I was in a practise, a private practise I’d come from VT to a private practise. And it was a massive achievement for me at the time. I had an amazing VT boss, Nick Mahindra, have you heard of him?

Drew: Yeah.

Payman Langroud…: He used to do this thing where he used to increase vertical dimension by like 30 millimetres, when the rule said two millimetres that’s the dimension and a real outside the box thinker. And he was just one of those guys that, whatever you said, he used to say, “Why not?” A Kenyan actually, like you and he opened up the books to me.

Payman Langroud…: He was just a great, great guy, still a good friend of mine. And I started then to talk about bleaching. And so I went to my private job and I ended up doing a lot of bleaching in that private job. Mainly because the associate before me was such a brilliant dentist himself and nothing was going wrong, Drew, everything he did was going, right. So the only thing he wasn’t taking care of was bleaching. And I had all these rich patients, relatively rich compared to the ones that I’d known before in VT.

Payman Langroud…: And, there were like company directors and things walking around with a stained composite, and he wasn’t fixing stained composites because there was nothing wrong with them. So I was saying, “Hey, this filling doesn’t need changing, but do you want to change it because it doesn’t look great?” And then, “Do you want to bleach your teeth?” And to my surprise, everyone was saying yes, to bleaching. And so bleaching became a thing in my head very, very early on. And then we came to opening a practise and we said, “Why don’t we open a bleaching centred practise.” With my partners who are now the partners at Enlighten.

Payman Langroud…: And, we went looking for the technology and there wasn’t the people who had the technology didn’t have an office in Europe. And they said, “Maybe if you were a distributor, maybe, but you’re not, you’re a dentist. So we can’t really go any further.” And so then this idea of distribution got into our heads and didn’t really know what that meant Drew, but I went and asked my brother-in-law who’s one of these McKinsey guys. And he said, “Look, it’s just a different idea, different business plan.” And he basically wrote me this business plan. We took it back to them and that’s how it started but by accident really.

Drew: So you’re still another discovering thing.

Payman Langroud…: Yeah. Yeah.

Drew: And at what point did you discover Prav then? At what point did you find him?

Payman Langroud…: Prav was very early on in his career. So Kailash, his brother was one of our biggest users and Prav came up through Kailash. And I remember he came to our office. Do you remember Prav?

Prav Solanki: Yeah.

Payman Langroud…: He came to our office and we had one of these offices.

Drew: you right?

Payman Langroud…: So you say, man, now you say, I can’t believe it.

Prav Solanki: Yeah.

Payman Langroud…: But he came, he came to our office and it was a single room, just me and Sanj and one girl in this room. And he said to me, “If you pay me £500 a month, I’ll get you on the first page of Google.” And he left and I said to Sanj, I said, “This guy’s talking about getting on the first page of Google.” And then Sanj being a Gujarati like [crosstalk] like you too. He said, “Don’t think of it like that. Think of it as six grand he’s asked for.”

Payman Langroud…: And then he says that, “Oh, yeah, I guess so, multiply that by 12.” I don’t think whether… I don’t think we did go with it. But he ended up being just a friend and a confidant and just a super, super, super special buddy of mine since then. And we ended up being me in private and not being much closer than I am even to Kailash even though Kailash is a dear friend too.

Drew: That’s amazing because Prav, you have bounds of energy Prav. Where did you generate this energy from Tell us your story?

Prav Solanki: I think for me, if we take you right back to the beginning, grew up born and bred in Manchester. And I think from a very, very early age, we always saw dad grafting, from working in the factories, 16, 17 hour shifts. We didn’t really see him much growing up. And it was my… My granddad spent a lot of time with us essentially bringing us up. I remember him making his omelettes for us and things like that and that’s such fond memories of my granddad growing up but dad wasn’t really around, but there was one overriding message from him for all of us growing up.

Prav Solanki: And it was, “The reason I’m working so hard is because I don’t want you to. I don’t want you to have to go through what I’m going through.” And that still resonates to today. And so that drive that energy and everything, for me, I think comes from my dad. And it comes from the fact of seeing him not only from factory to taxi driver, through to running a corner shop, he went and got some kind of qualification and ended up doing TV and video engineering and then going and fixing TVs in people’s houses and stuff like that, real wheeler and a dealer, but always grafting, never making loads of money.

Prav Solanki: And I remember growing up and it was probably just before I started high school, mum and dad split up and always remember them having not a great relationship, always arguing and, we were brought up in that environment and then a bit strange, right? But the day she left and they decided to split, they said, “Who do you want to go with? Do you want to stay with dad? Do you want to go with mom?” And me and my brother just said, “We’ll stay with dad.” And then we signed our life away to working in the corner shop. So whether it was on weekends, evenings, bagging SPADs, or serving customers and dealing with all of that growing up, dad looked after us then, he learned to cook.

Prav Solanki: So he makes meat curries and everything, he was writing down recipes, speaking to his sister on the phone, and he learned all of that whilst he was still working and education, education, education was drummed into us growing up. And that was all about being a typical Asian, Indian, whatever you want to call it. There’s only a couple of professions that carry any sort of respect and in that sort of household, and it was either medicine, dentistry, or accountancy/finance, that sort of thing. And the old fashioned guy that my dad was and still is to some respects, but he’s a little bit more straight now is, “My son is a doctor.”

Prav Solanki: That was the pride that he wanted and so that was always the dream. And I remember applying for university at the time, and we were looking at all different kinds of medical schools. And just the thought that I could get into a medical school would have been a dream, an absolute dream come true. And we looked to Oxford, my dad said, “Give this a go.” And I was like, “Nah, that’s not good enough.” And then he in the Sunday Times, in the back of the Sunday Times, it was a little cut out where someone was advertising to help you with your personal statement to get you into Oxford.

Prav Solanki: And so this guy helped with my personal, I can’t remember, I think it was like 50 quid back then. Which to my dad was maybe a day and a bit of income. It was a lot of money, and so he paid it and we got this guy to do my personal statement. And back then, I didn’t know anything about writing or copy or anything like that. What eventually ended up happening is I applied, threw my hat in the ring, so to speak and attended, got an interview. And when I was skipping all over the place, thinking, “How the hell did this just happen?”

Prav Solanki: I got shortlisted, I’ve got an interview. And then I had the old conversation that, “Hey, if I get offered a place, I’m not going to take it anyway, too cool for that place.” Yeah. And deep down, that was just a coping mechanism to deal with rejection, because deep down as well, I wasn’t going to get in. And so when I attended, I threw my hat in the ring and I thought, “Do you know what? If I get in, I get in. And if I don’t, I’ve got an offer from Manchester anyway. So what?” And so I knew I had a place. So, when I attended the interview, there was some tests, some exams, some elimination tests and stuff.

Prav Solanki: So got through that bit. And then a really surreal experience. I met one of my, sort of lifelong mentors, a guy called Professor Tom Kinane, who interviewed me along with a panel of a couple of other people. And it was a strange interview. I don’t think they asked me, “Why medicine?” Or any of sort of stuff in it. It was really off the wall questions about going through the jungle and somebody, throws a poison dart at a hog, and then the hog dies instantly and ingests the poison, and then you eat the hog and then why don’t you die? And so you say, “Oh, the poison has been digested by the thingy and been made inactive.” “Oh, no, no, no, no, no. What happened? Did you ate the skin with the poison still intact in the skin. Why don’t you die?” And so it was all this and loads of questions like that. And what I realised-

Drew: What’s the answer to that?

Prav Solanki: There wasn’t one, because every answer you gave and in between that, they’d throw in a what’s a 22 times 64 question in the middle of answering the question. So it was a really… So we went through several rounds. I think I was there for like three days got through to the finals. And as I left that interview, I knew I’d got a place. I just somehow knew I’d got a place.

Prav Solanki: He said to me, Tom said to me, “It’s your birthday on the 24th of December, wouldn’t it be an amazing birthday present?” Okay. And it was actually, I think it was the day before my birthday, I found out and it was probably still to today, some of the best news I’ve ever received getting in there. And so shortly after that, uni, studying and I entered this world where I’d gone from being the cleverest kid in school by a long stretch, by a huge stretch, to being surrounded by people who were far more intelligent than me, much cleverer had got X number of more A levels than me, spoke in a different way. Do you know what I mean?

Prav Solanki: All these different things. And you end up in this foreign world but going back to your energy question, I really, really do believe that you are the sum total of the people you surround yourself with. So by surrounding myself with whether I’m forced into that situation or not by really, really smart people, you raise your game. And that’s what I did, I studied really hard, did well in my exams. And then it was-

Drew: It was quite intense I would have assumed at that point there in Oxford? The competition, the people sort of wanting to get to the top?

Prav Solanki: Yeah, egos, end of year exams, every eight weeks exams, all the rest of it. And, we have this chart on the wall of all the medics in your year. Little black and white photograph sort of yay size.

Drew: Yeah.

Prav Solanki: And I used to look at that and say, “I’ll beat him in the exam. And I’ll beat that person in the exam. I’ll beat that person there, that person’s really good at anatomy and physio. I need to up my anatomy and physiology game, that person…”

Drew: We never had that in dentistry I think Pay. I think as long as we got 50.5%, I was very happy with it.

Payman Langroud…: I certainly did it, but I think there were some who were like that. But Prav, I was going to say to you, why were you the only one in your school to go to Oxbridge?

Prav Solanki: Yeah. One of a few. I actually went to university, right?

Payman Langroud…: Yeah. Yeah. So, I’m thinking back to school, myself. There was the Oxbridge classes that they were specialised at getting people into Oxbridge from my school. I don’t know, they used to count the number that got in every year and then boast about it. That was one of the measures of the school. So the achievement of getting in from yours was something else, mate.

Prav Solanki: The measure of our school was the number of people who didn’t get expelled. But yeah, and funnily enough, turning that background, I actually spent a bit of time when I post medicine when I started doing my PhD in pharmacology. I was still under the guidance of Tom Kinane and he was my PhD supervisor. And he was still interviewing candidates. So I was fortunate enough to, first of all, be invited by Tom to teach pharmacology to undergraduates. I was teaching first and second year medics. I was running some of the lectures for pharmacology. I was running the practical classes.

Prav Solanki: And I remember having a conversation with him saying, “I’d love to…” Because we did a one-year route where we did a bit of research and it was in pharmacology and I loved it. I loved the experiment. I loved the science, the uncertainty, trying to figure this stuff out and pharmacology was my thing. So he also invited me to be a part of the interview panel for entry into Oxford for medicine. And that was an interesting time because you had these young kids coming in and I’d be sat there with a stack of UCAS forms. They were called UCAS forms and personal statements. Right?

Payman Langroud…: That’s right.

Prav Solanki: And you’re just literally reading through them. And the one thing Tom taught me is that if the first couple of sentences doesn’t excite you move on, we’ve got far too many to get through. And so we have this huge stack and it was really, we’d filter through and everyone that had been shortlisted either by me, Tom and other guy called Martin Bracewell and a guy called Steve Racavich, who we were all interviewing with together. We’d put them together in this stack. And it just seems so surreal that I was being interviewed then I was interviewing.

Prav Solanki: Today at my kid’s school, they do have the Oxbridge club and I’m the guy who does the mock interviews with them. I’m the guy who reviews their personal statements and so far so good. Narrows down 100% success rate in getting these kids in.

Drew: Wow.

Prav Solanki: They’ve obviously got the academic ability, but when they stick a personal statement on my lap, that’s when I tear it to shreds. I think like a marketer. You’re selling yourself to somebody who’s reading this statement. You want to go in with a big punch from the start. You want them to pick that up and say, “Whoever’s read this, whoever’s reading a hundred they’ve never read a first sentence that sounds like this.”

Drew: But that’s something to remember, isn’t it for everything. Pay, do you remember your interview at Cardiff?

Payman Langroud…: I do.

Drew: And how the experience was, how did it feel?

Payman Langroud…: What I particularly remember I had an interview at the London Hospital that went very, very well. And then I had an interview at Guy’s that went very, very badly and I answered the same question in the same way in both interviews thinking, “If it went so well over there, it’s going to well over here.” But it was a massive error.

Payman Langroud…: I said something political and I think as it turned out, one was a very left leaning institution and one wasn’t. And at the time I was a bit lefty myself. So I think in Guy’s when I said something about the government, I just saw fear in all their faces. All their eyes as they opened up and said, “We don’t want this troublemaker.” So then I realised, the thing is though guys, you’re 18 when you’re having these conversations.

Drew: Yeah.

Payman Langroud…: I was an absolute child, Drew, we heard your story, you went through so much to get to that point. You were ahead of me for sure and Pravin is a corner shop and experiences he’s talked to the public. My parents forced me to get a job on Oxford Street for a week and-

Drew: Well, tell you what? That worked because your sales ability is absolutely brilliant Pay, I can tell you that.

Payman Langroud…: Well, actually, I hated them for making me get this job because they said, “You’re getting a job. You’re working.” And it was a clothes shop and I learned more in that week about why the previous five years, by the way, I still took a taxi in and took a taxi out and had a steak at lunch as I spent more every day that I was earning. But I think one thing I’ve thought about that for my kids as well. They’re not getting that live experience bit right now. And it’s important. It’s important. I think both of you guys had a lot more of it than I did. I had a very sheltered experience in a public school.

Drew: But I think still think about the challenge, the challenge of starting a business, you were dentily trained. You and I were taught how to cut teeth and I’m going to ask Prav, that in a bit, but you and I were taught how to cut teeth and stick a crown on and you kind of thought one step ahead and thought, “Let me make these teeth whiter.” But business was a challenge. You were kicked right into it, starting that business. Go on. Tell me about some of the challenges you had Prav, because it can’t have been that easy just to get going like this.

Prav Solanki: No, it’s not easy. The first thing is my dear friends from school who are still my dear friends now, several of them their dads had these gigantic conglomerate businesses, the multinational manufacturing businesses. And so the idea of business to me seemed like this beautiful thing. And Sanj and I used to joke about it in university. Me and Sanj and Janine did used to live together for five years in university. We used to joke about having this business in dentistry. When it came down to it Drew, I think when you’re young you do things that you don’t realise what the challenges are going to be. But yeah, it was very tough, dude. It was very tough.

Prav Solanki: I think we’ve got a loan for 80 grand and it was all personal guarantees on the loan. We had to put houses and all of that, and you don’t have, totally clueless, man. I think I spent 40 grand in the first two weeks on adverts. Yeah, because I had no idea that it was two weeks before the dental show. We thought, “Well, let’s do some ads.” And I said, “Well, where should we do ads?” I thought, “Well, everywhere.” Well, I wasn’t thinking like, the way you do the business. So I called every single magazine and said, “How much is an ad?” And just took the price they gave me and bought double page spreads in every single magazine, 40 grand went.

Payman Langroud…: Just like roll the food in a restaurant, buddy.

Drew: I’ve been saying that since then, perhaps Payman only spent four grand in advertising, I think, which is good news. I think he learned his lesson realistically.

Prav Solanki: Yeah.

Drew: And you weren’t full-time at that point, I suppose you were still doing dentistry and doing this at the same time.

Prav Solanki: No, we were working-

Drew: Did you take the lunch?

Prav Solanki: What happened was on that first day that we launched at dental showcase I don’t know whether it was the advertising or the market was right for it or whatever it was.

Drew: What year was it?

Prav Solanki: 2001, 2001 just after 9/11, I think. We had queues of people trying to talk to us maybe part of the thing was it was light activated back then, and we were giving the machine for free. And then we were charging people to turn it on with this credit card that Fardy, you know Fardy from a Quickwipe?

Drew: Yes.

Prav Solanki: He organised retrofitting these machines for me with card readers. And so we used to sell because we were saying… It’s funny because Sanj is the finance guy to this day and Sanj managed to buy 12 machines, we only had 12. And so there was queues of people wanting to talk to us, but we only had 12 machines.

Prav Solanki: So we were doing this apply to become an Enlighten Centre thing. And we were saying no to people. And the more we were saying no, to people, the more people wanted to know. So, these are the funny mistakes you make. But it started, it suddenly became clear that I needed to stop being a dentist and start working. And I had in my head, I was going to give it five years and I did, I worked on Enlighten for five years before my wife when she got pregnant, I went back and did her job as a dentist.

Drew: Do you miss it?

Prav Solanki: Yeah. Yeah. A little bit, man.

Drew: I’m very convinced with that.

Prav Solanki: No, no, I do. I miss people. I miss people. Yeah.

Drew: Yeah.

Prav Solanki: I don’t meet as many people now. On the odd occasion I miss teeth. I’ve said this before when I’d watch a lecture and I feel like doing that work, then I know that’s a great lecture. I felt that way with Dipesh. I felt that way with Jason Smithson. I felt that way with Galip Gurel. When I’m thinking, “God, I want to do that.” Then I know that’s a great, great, great lecture. But Drew, I didn’t really dig having to be there at 9:00 AM, I didn’t dig that. I do like that aspect of business that you can fit it around your particular lifestyle. We’ve had so many guests and Prav likes to wake up at 4:30 AM and go to bed at 4:30 in the afternoon so that he can put his work around that. I’m more of a night owl. And then you said you’re like both of us, right?

Drew: Yeah.

Prav Solanki: You go to bed late, wake up early. But I love that. That’s one thing I really do like about business is that you can fit it around yourself. And we had Safina. I don’t know if you listened to that one, Drew.

Drew: I have not finished that one, yes.

Prav Solanki: Safina, three kids and a kitchen table, and she’s building an empire, building an absolute empire. And she works at nighttime [inaudible 00:28:55]. That’s this one aspect of business I really do like.

Drew: You can fit it around life, you can fit around-

Prav Solanki: You can fit it around your own particular situation.

Drew: Yeah, and it’s amazing that… And going back to Prav now, I’m going to kind of re un-pause your story here, where you were doing your pharmacology PhD. You had Mr. Kinane, Professor Kinane sort of doing this. You were doing the interviews, you were still in Oxford. How many years on was that now? That must’ve been eight, nine years?

Prav Solanki: Yeah. I was there for a total of just around nine years. And I remember I was in the final year of my PhD and the reason I got the PhD, there is no way on this planet that we had the means or the funds to even live for me to do another three years and to fund a PhD. So I applied, Tom Kinane said, “Look, there’s a Welcome Trust Scholarship.” And these were his words, “Throw your hat in the ring kid. If you don’t apply, you’ll never know.”

Prav Solanki: So there were 200 applicants open to Oxford and Cambridge for this Welcome Trust Scholarship, one place. And you have to put a research proposal together, turn up at the Welcome Trust in London, have your interview by these panel of whoevers they were and then they choose one person. And then I got it. So my PhD was fully funded. My accommodation was fully funded and I received what was called a stipend. It was referred to as a stipend at the time, a salary, a tax-free salary of 3K a month as a student, as well.

Drew: As well.

Prav Solanki: As well. They paid for a research grant. So hundreds of thousands in research chemicals, microscopes, this, that, and the other covered it all, it was a really, really prestigious scholarship and high value and I was getting towards the end of that. And I remember speaking to Tom and I loved the research. I loved the travel that came with it as well. I loved the academia. Yeah. Lazy life. Yeah. Wake up and I was a gym bunny then as well. So go to the gym, rock up at the lab, teach a few students, flake my microscope on, do some experiments, record the results, and then some weeks you might be analysing whatever teaching.

Prav Solanki: It was such a relaxed compared to today, such a really relaxed life. For me what was written in my career plan was this junior research fellow, work my way up to head of lab in academia. That was my dream, okay? In the final year, my brother had just launched Kids Dental. And I remember having a conversation with him and saying, “How’s the practise going, blah, blah, blah.” And our conversations weren’t about business. We were both so wet behind the ears, even though we’d been brought up in a business environment, the shop, I think gave us our foundation in that. And he goes, “Listen up kid.” he goes, “I’m having three hour lunch breaks. We’ve not got any patients come in through the door. And if I don’t do something about this, we’re just going to go pop?”

Prav Solanki: So I went to the practise, we sat down, we had a chat and he had a PR company who were in at that time and they were spending somewhere between 20 to… And in one particular month, 60, 70 grand in marketing. That was national PR, local, this that I knew that. They were charging a king’s ransom, and that was back in 2005/6 and he just said to me, “Listen, bro, I can’t afford to do this. Can you just research the crap out of this, figure out how to do this marketing thing and get me busy?”

Prav Solanki: And so in my mind, I thought, “I pretty much know the roots of every single blood vessel and nerve in the body. I know about how transmission occurs at the chemical level. I know all about drug interactions, volume of distribution, blah, blah, blah, all this sort of stuff. How difficult can this marketing game be?”

Prav Solanki: So I sat and studied and I went back to uni and whilst having the flexibility of doing the PhD was that I could sit there and study and study and study. So what did we do? We launched some radio ads. We launched some newspaper ads. Google PPC came into the mix, search engine optimization and constantly learning my craft. But I would say within-

Drew: Did you spend the 40 grand in ads anywhere did you?

Prav Solanki: We spent a lot of money. So these were the words my brother said to me is, ‘`I’ve only got 50K left, and you can just spend it.’ And he said to me that, “Listen, I got 110% loan to buy this business. It’s not my money. Just spend it.” And he pulls on the map. So he put his trust in me, someone who wasn’t a marketer but ultimately someone who felt he had ownership and I don’t mean ownership as in shares or anything like that but we’re talking family here, right? So my heart was one in that to succeed. Okay. And very, very shortly within six to eight weeks, boom, boom, boom, boom, boom. Patients are coming through the door. Brother, no longer had room for a lunch break.

Prav Solanki: Next thing you know he is refurbishing the practise. And next thing you know, we applied for the Private Dentistry Awards, first practise to win outside of London. And then it just became this business that was booming and then sort of fast forward a couple of months, Kailesh was on the politics and cause and he had loads of friends and colleagues who were on the politics and cause with him and they asked him, “So how have you got your practise so busy, who’s doing your marketing for you.” He’s like, “You want to speak to The Fresh, speak to this guy called Prav, he is amazing.”

Prav Solanki: He didn’t tell them we were related, and wanted to keep that distance. And so he rang me, he goes, “Listen, mate, this guy called and the staff it’s going to call you, he’s opening a practise in New Castle, cosmetic dental clinic, go and see him. He lives in Liverpool. And he’ll get you to do a website. You’ll get a few quid out of him.” So I thought, “All right, okay.” And then that snowballed. And so Andy and Darrell were some of my earliest, first clients and have a massive-

Drew: They’re still your clients.

Prav Solanki: Still my clients today. And I remember I drove to Liverpool in my Ford Ka at the time a car that my dad bought me brand new, about 5,000 quid, the windows that you wind down with your hands. But I was incredibly proud of that car. And I drove to meet the guys and we talked about things and then you dream the new vision, the new practise. And to be honest it was from there onwards my business snowballed because in a short period of time, I had maybe a dozen clients and I was winging it guys. I was figuring out this marketing game. I was learning about it, but I was generating success. And this one client of mine, Dr. Rattan Patel.

Drew: Nottingham.

Prav Solanki: No, sorry.

Prav Solanki: He rang me and he said, “Listen Prav, you’re doing amazing things for my practise. Well, let me tell you something, you’re not charging me anywhere near what you should be charging me.” And I think this is one of my earliest lessons in value and business that I’d ever had. And it was from my own customer. I’m sure everyone else had the same opinion, but just for the milky for one account, why not? There’s been no negotiation this happened. And he said to me, “Listen, Prav, write to all your customers increase your prices by four times and you’ll still be a bargain. And I’ll be the first one to pay you. But until you do that, I’m going to carry on paying you what I’m paying you now and I’m stealing from you, Prav.”

Prav Solanki: And I went away and left it for 12 months. And then he rang me up and he said, “Listen Prav, if you lose three quarters of your customers, you’ll be doing a quarter of the work. You’ll be earning the same money and you’ve just got to do it.” So I did. I drew up and I lost one customer. That was it. I just lost one customer. And then that then sort of helps me realise that, “Hold on a minute? This could be a real business.” Because off the back of that, I could hire people and blah, blah, blah, and, then it all came-

Payman Langroud…: I’ll tell you a story about Prav and his customers. We had our top user, Enlighten top user for a couple of years, was Anthony Quinn in Liverpool, great guy, wonderful.

Prav Solanki: Amazing guy.

Payman Langroud…: And he did a lot of bleaching man and he came to sell his practise. He was retiring and we were at a BACD thing. And it was me and Prav and Anthony and we were having beers and all that. And he was reflecting, we were saying, “Good job, well done. You deserve it. What are your plans going forward?” and all that. And he said, “Payman, you’ve supported me so well, we’ve done this.” And I said, “Actually, you supported me and my top customer… Really happy about it.” Then he turned around to Prav and he put his hand on his shoulder and then no tear came to his eye, literally no tear came to his eye and he went, “There’s no way I could have done what I’ve done without you.”

Drew: Well, it sounds like a good movie line there.

Payman Langroud…: Yeah.

Drew: That’s amazing.

Payman Langroud…: I felt a little bit small at that point, but, yes, he’s a lot more to his customers than the marketing guy, man. All of them have been with you for a decade.

Prav Solanki: Yeah. And I think what’s happened is we’ve evolved together. We started on this journey what? 15 years ago, whatever it is. My business has evolved. They’ve evolved.

Drew: We used to… This is proper switch because you did a switch from pharmacology to marketing and Payman did the switch from dentistry to building a business and you guys have switched me into a host. And your dad had a massive influence on you, Prav.

Prav Solanki: Still does.

Drew: I think that when I listened to your story, his entrepreneurial spirit. His love of cooking. I follow your Facebook recipes, from head to tail, but he must have had all that.

Prav Solanki: Yeah.

Drew: Pay, who do you feel had influence? You’ll tell me about your dad in a minute, Prav, but I want to hear Pay’s who had a massive influence on you that you kind of turn back and go, “That person really shadowed me.”

Payman Langroud…: It’s strange but if we’re talking work and we’re talking Enlighten, I’d have to say Sanj, my partner because Sanj, he’s a low-profile kind of guy, you know him Drew.

Drew: Yeah, yeah.

Payman Langroud…: He’s low profile. He doesn’t like being out there. But the reason why Enlighten is a quality product is because of Sanj. He’s one of those guys, he just wants things done absolutely right. But not in an annoying way. He just wants things done the best. And I was a little bit guilty of being the just good enough type of person but, and if you look at Enlighten, people think it’s me because I’m on the front end, but I’d say three quarters of the backend is Sanj. He’s all of operations, he’s all of finance. He is the beating… I wouldn’t say like the heart. I think maybe I’m the heart, he’s the head of the company.

Payman Langroud…: But growing up with him through university, he was the first guy I met in Cardiff. I borrowed a tin opener from him and just a lovely, one of the sweetest guys you’ll meet, a clever, clever guy, but from this perspective of influence to standards, standards let’s do it right. Do it right. Do it right. And I read Good to Great months, years after I met Sanj, but one of the things in that book was, “Even if it hurts you, do it right.”

Payman Langroud…: And he’s one of those, man. He just wants things done right. That’s it, that’s all he wants. And that’s been a massive… Enlighten may not have been, or probably wouldn’t have been a high end player, we are a high end player because we do everything absolutely right. That’s what defines us now.

Drew: And he’s a grafter, man. He’s a grafter, and I’m not saying you’re not Payman, but-

Payman Langroud…: No, he is.

Drew: He’s a man of few words, but a man of multiple actions from what I’ve gathered.

Prav Solanki: For sure. And I turn up, so on my London days, I often plan it like this. I’ll have a couple of morning meetings or I may have a full day board meeting at the IAS Academy or something like that, but always book a late train, or I finish early and I call Payman in the morning on my way to London. I don’t give him any notice. And I say, “Buddy, I’m free from 3:00.” And he’s like, “Yeah, cool.” So he knows I’m rocking up at 3:00 takes the rest of the day off and we hang out. And he can just do that. Sanj is there sat at his desk. He’ll take 10 minutes to chat to me and he’s straight back on his computer.

Drew: Yeah. [crosstalk] difference really. Well, it is like that but you were telling me about your dad because he was a man of few words, a lot of action from the sounds of it as well. Huge influence there for you.

Prav Solanki: For me. Yeah, massive, massive influence. Very old-fashioned, quite strict and growing up we didn’t really go out that much, hangout that much. For me it was all about studying. For my brother he was a bit of a Jack the lad but we all both worked really hard in the shop. The shift used to be from 6:00 in the morning, stocking the shelves and we go to school, come home, study, study, study.

Prav Solanki: In the evening, mopping the kitchen floor, bagging the tables. At the end of the day, we’d sweep the shop. We’d mop the shop with hot steaming kettle water. Yeah. We’d restock the shelves. Weekend was all about cash and carry. Stocking the shelves, blah, blah, blah, so on and so forth. And it was constant. It was a seven day a week, 6:00 AM to 10:00 PM and our house was above and at the back of the shop. So you walk from the shop, open the back door and you’re in our living room.

Drew: Into the house, yeah.

Prav Solanki: Into the living room from the shop. And then you go upstairs above the shop are our bedrooms. So yeah. I think he taught us the art of graft. He taught us hard work. He taught us the value of money. And as you were saying Drew, it’s hard now trying to pass those values onto your own kids because as a dad, I want what’s best for them. I want to give them everything. I don’t want them to be without anything but at the same time, you don’t know whether you’re destroying them or actually doing the right thing. It’s always a tough balance.

Drew: It’s always a tough balance.

Prav Solanki: Always, always a tough balance. So, treat them mean, keep them keen and or what you can afford to give them what maybe we didn’t have, but then do they learn the value of going without and still till today, my dad is involved in helping me with my personal finances, my business, all of my like car insurance, all that sort of stuff. All that admin just gets handled. And I also, as you guys have said with Sanj, I don’t think my business would be where it is today without him, his influence, his backing, his support when I’m down, when a customer for whatever reason is not happy or leaves or whatever he’s there, he’s got my back and that’s really important.

Drew: It’s so amazing because Payman, was saying when you first saw him, he saw you as the £500 a month guy. What was your impression when you first saw Pay? Is that why you said £500 a month because he’s called Payman or was this your first impression different?

Prav Solanki: You know what? There’s a story behind this. So Kailash would, I remember there were a few people I met around that time. One was Payman, another guy called Ferbert, who’s a dear friend. I don’t know that you remember Payman.

Payman Langroud…: Mm-hmm.

Prav Solanki: And so around that time we were going to like Dental showcase this, that, and the other, I just got, “Payman, Payman, Payman.” Someone said, “Payman.” I didn’t actually believe that was his real name. And if you listen to the first episode of this podcast all will become apparent. But basically, I thought his name was Payman, because he was this super rich guy, who just pays for… just a high-roller man, just a super high-roller and Payman is like, “What the hell is that?” Right? But honestly, and I was totally in awe of this guy.

Prav Solanki: Owner of a big dental company, he’s got this massive stand, blah, blah, blah, whatever. But you know what? One of the things is that, you kind of levitate towards people who… I don’t know, you are like, you like people who you are like, or whatever people say about that, but, very, very quickly it became apparent, if I was going to be in London, he’s the first person I’d pick up the phone to and call, because I want to hang out with him. I want to spend time with him.

Drew: And he’s always available as well.

Prav Solanki: And he’s always mucking about.

Drew: He gives that impression away isn’t it? And you guys have been working for how many years together now, has it been sort of three, four, five years. You’ve known each other for ages.

Payman Langroud…: We actually just started working together last week for the first time.

Prav Solanki: Yeah.

Drew: That’s amazing.

Payman Langroud…: Finally, I said to Prav, “Listen dude, you’ve done so much for me over these years, but you’ve never charged me a penny and it’s getting…” It was starting to get ridiculous. All my team were contacting him continuously and I said, “Listen, can we just not organise it so that I pay you?” And it’s finally, finally happened after 10 years of work for me, he’s finally being paid for it.

Drew: Yeah. You finally realised Payman, but importantly, how did Dental Leaders Podcast come around? I suppose all the listeners want to know, because this Dental Leaders Podcast it’s seriously captured people’s hearts, it’s captured their minds. And some of the stories you’ve unravelled. I honestly to God, even I didn’t know a lot of things and they’re just inspiring. What enabled it, whose idea was it?

Prav Solanki: We were always talking about content creation, ideas and just marketing. We have these conversations, we listen to marketing podcasts all the time. We’re both avid podcast listeners Payman, more so than me actually. What do you remember about the conversation Pay?

Payman Langroud…: Yeah, on the podcast point you know how they… Do remember guys when it went from if you’re searching for a subject where’d you go? Google, but then at one point it became some YouTube. Some group of younger people started looking in YouTube, or if you want to learn how to do something, YouTube. I got to the point where I realised for me if I wanted to learn about something, a podcast would be the one that would engage me the most.

Payman Langroud…: And so whatever the subject was, whether it was, I don’t know, Facebook ads or whether it was whatever, whether it was entertainment or learning, I found podcasts were the ones that was what was really engaging me the most. So I realised I want to do a podcast, that’s it. And who do I go with to with this sort of thing? Prav, and then he said, “Yeah, I want to do a podcast too.” And we weren’t thinking of doing one together to start with.

Prav Solanki: Not at all.

Payman Langroud…: But then he made kind of sense as well because perhaps the kind of executer type, if he wants something to happen, he’ll make it happen. And then for me, I’m probably the Dental side of this Dental Leaders Podcast. But I was thinking about it Prav actually, if I had ever gone on to do it by myself, I would never have followed through in the end. I probably would have one of my team would have made me whatever but you know what I mean. But what’s made me really an amazing thing about it is we’ve had 50 episodes so far.

Drew: That many.

Payman Langroud…: Yeah. The last one was episode 50.

Drew: Wow! Jeez.

Payman Langroud…: And then there’s so many more, I’m talking to people every day who have got these brilliant stories.

Prav Solanki: Yeah.

Payman Langroud…: And dentists are interesting bunch because I don’t know man, maybe it’s the time you’re waiting for that curing light to… I love the medium. I really do and I don’t know, maybe I am a curious person if I’m sitting on a train and there’s two people talking kind of this thing in on them. So I definitely want to know what dentists are thinking. And we started off by saying that we want it to be about people’s lives, not about teeth, because that’s what we’re interested in.

Payman Langroud…: But I think there’s even with all the podcasts that there are now, I think there’s room for another 10 on top of the ones that there are now, but I’m an avid listener I listen to all of the dental ones, the American ones as well. I don’t watch TV or anything like that though.

Drew: No, that’s a good thing actually, your eyes are intact. Your ears will keep going as well. Isn’t it? And you’ve unravelled some seriously awesome stories. It’s hard to point out, I suppose you’ll tell me all 50, but which one for either of you really kind of drove a thing at a personal level, go on Prav.

Prav Solanki: For me, just going back to the whole, first of all, the doing this together, let me just tailor off before I answer your next question.

Drew: Yeah.

Prav Solanki: Is that had I gone out and tried to execute this, I think I’d have ended up getting lazy, and it’s the combination of actually is fun and it’s my favourite working day of the month.

Payman Langroud…: Yeah, me too.

Prav Solanki: Especially when we were doing it in person.

Payman Langroud…: Yeah.

Prav Solanki: Now we’re doing this whole socially distance thing, just doesn’t quite have the same energy. It doesn’t feel the same. But I remember like in my diary, I’ve got podcast day and I know that day I’m going to eat some good food because me and Payman are going to go out for dinner. And we’re going to have some really cool conversations. We’re going to bounce off each other. The vibe in the Enlighten office is always just positive. The team is so happy. So I’ll go in and connect with a few of the team, chat with them. It’s just a great, it doesn’t feel like work. And so yeah, I think the combination of us coming together and doing this is what’s created this podcast.

Drew: You know that they say the ying and the yang, the two parts of the circle, make it up. You guys decide who wants to be ying and yang, but that’s worked really well I think. Absolutely brilliantly.

Payman Langroud…: My favourite one’s Andrew Dawood for me. He was just a massive hero of mine for years and years and years just to meet the guy for me was special. But then to be the one to ask him questions and get answers from him and all that, and in his story, so much about his story, I didn’t even realise, even though I used to follow him. I loved Anil Shrestha, really did, and then stumbled on yours and some of the struggle ones guys, your story Drew.

Drew: You don’t say it. I’m just interviewing you.

Payman Langroud…: What a story man, what a story?

Drew: It left me wounded, man. I walked out of there just feeling like you sort of imparted your pain on us, man.

Payman Langroud…: Sorry.

Drew: And I don’t mean that in a negative-

Payman Langroud…: What’s the name of that shopping centre in Sheffield, man. The going and working and then going to college and then going to the shopping centre every day.

Drew: Meadowhall everyday.

Payman Langroud…: Meadowhall.

Drew: Brilliant, which other ones really Prav, got you because Meadowhall was brilliant by the way. I’ve learned like you, I learned sales there. I worked in Ravel, at a shoe shop selling shoes.

Prav Solanki: Vishal’s, did you listen to Vishal?

Payman Langroud…: Yeah.

Drew: I’ve learnt we have listened to Vishal’s as well. And his story, he’s a flamboyant character and to kind of get to what you guys got to, I’ve got to give it to you. I think he must’ve cried after that if you didn’t.

Prav Solanki: He’s one of my favourite people, Vishal. Robbie Hughes, I liked a lot.

Payman Langroud…: Yeah.

Prav Solanki: Of course, I mean it goes without saying Anup.

Payman Langroud…: And for me that was my favourite episode. Anup, once again one of my early customers very quickly became a friend and a confidant and almost like my ear to the ground, my voice in dentistry. If I produced a piece of content and put it out there, Anup would be texting me about it, asking me about it and et cetera. But he was you say it now, but such a special guy. And we only realised actually how special he was when we lost him.

Prav Solanki: He did it all very quietly to be honest.

Payman Langroud…: With the outpouring but the life lessons in that podcast, the conversations about him being distracted by his computer and his son glueing his laptop, the resonation of the love he had for his dad and when he lost his dad shortly, before he passed. And then how he ended his podcast as well incredibly, incredibly valuable, so many business life and lessons in that podcast, for sure. Definitely, definitely one of my favourites. Another one-

Prav Solanki: I didn’t know Anup as well as you obviously Prav, I used to meet him at a conference, shake hands and have a quick joke. But I’m so glad we did that interview because on that day, at least I felt like I’d met him really properly. And a real gentlemen, real fun loving gentlemen.

Payman Langroud…: Yeah.

Drew: Anup, few months before what happened unfortunately he told me something very nicely he said, “Drew, all these tubule lines may find another tubules if you, whatever, but your son will never find another dad.” And so that was a joke, a joke for me, where I started spending every Sunday with my dad. But as a dad, I know Prav, you’ve got three little ones.

Prav Solanki: Four, four kids mate, four kids.

Drew: You’ve got your hands full. Payman, have you got little ones-

Payman Langroud…: Two.

Drew: … or slightly bigger than little? Two of them. Tell me as a dad, what’s your approach in life when you’re with your kids, how do you want your kids to see yourselves? Go on Payman, you tell me.

Payman Langroud…: I don’t know if it’s the right thing or not. What I’ve found is kids are a bit like, at work with the best intentions you do something and then you get an unintended consequence comes out of it as well. It’s almost like something good and bad comes from every action you make. I’m very lucky though, I’ve been with my wife just about since university. She’s very connected to the kids, to school and all of that.

Payman Langroud…: I think I suffer Prav, with the same issue with my kids as I do with my people at Enlighten. The line between wanting to be their friend and wanting to be their dad, and I don’t know whether it’s a problem or not, but obviously that’s what I’m into, so I don’t want to artificially change the thing, but I’m very close friends with both my kids.

Prav Solanki: Can I just butt in there just for a second Pay, and he talks about this line between being the friend and the dad. Me and Pay was in one of these, his boutiquey coffee shops that he likes to take me to. And we were sat there and this little girl walks in the shop and goes, “Hey, Pay?” And, I just thought, “I wonder who that is.” His daughter, she spoke to him like a mate. I was like, “She calls you Pay?” He was like, “Yeah, carry on Payman.”

Drew: Carry on Pay.

Payman Langroud…: Yeah, I’ve got one of my friends here who gets very offended about that. One of my good friends. He doesn’t like that idea, “You’re her dad. She mustn’t call you Pay.” But I don’t how it came about, but yeah, they both call me Pay.

Drew: That’s really awesome. Isn’t it? I think from after listening to this is when everyone finds you across anywhere, they’re going to go there and, “Hey Pay. How you doing, Pay?” That’s the way it’s going to go, isn’t it? How old are yours Prav? How old are yours now? There’s a wide range.

Prav Solanki: So we’ve got 17, 15, five and three.

Drew: Wow, so you’ve got the absolute independent minded teenager to the absolutely following you, learning from you three year old with every question on the planet. How old are yours Pay?

Prav Solanki: Yeah.

Payman Langroud…: 13 and 10.

Drew: Wow. He’s entering that stage of rebel thing. That’s amazing. Where do you guys see dentistry going? You’ve interviewed so many people. You’ve spoken to a lot of them. You’ve got insight, you work within the business field of dentistry. You see different faces. Do you want to play Nostradamus’ game and look into a Crystal Ball?

Prav Solanki: I think direct to consumer is going to be huge. I do think that obviously what’s happening in the market now is shaking things up. So we’re talking direct to consumer orthodontics. I’m a director of the IAS Academy and I work with the likes of Tif Qureshi, Ross Hobson, Anup when he was around and very much about teaching how to do things right ethically in the right way. And I don’t think that it’s there yet, but I do believe that the power of machine learning that can second guess your next move. And I see this when we’re optimising Google AdWords campaigns, right?

Prav Solanki: So before you had all these switches to optimise and you can change things like your bid strategies, time of day, blah, blah, blah, blah, blah. Or now today, once you’ve got enough conversions, you can leave the machine to it. And it’s got so much more data in hands than we have, and it does a better job than you, but you’ve got to get it to that place. And ultimately, I think machine learning will come into a place where actually it will outsmart the human, but you will still need the human to drive it. We’re seeing things like, look I’m not a clinician, but things like injection moulded teeth. Yeah.

Prav Solanki: Now, even though I’m not a dentist, I challenge anyone to injection mould and produce teeth as beautiful as Dipesh Palmer does, it ain’t going to happen today, but maybe it will happen tomorrow. Yeah. And so that’s where I see the future of dentistry going and just like you can order your groceries from [inaudible] and whatever I think you’ll probably one day be able to ask Alexa for a new set of teeth.

Drew: Yeah, I agree mate.

Payman Langroud…: Look, the digital side is definitely going to change everything. There’s no doubt about that. And a dentist isn’t going to have to hold a drill. Why should a dentist hold a drill? Why can’t the thing go in there and take care of business if drilling is still part of the game? It doesn’t mean there’s no role for a dentist. I’m sure there will be. But I think in shorter term in the UK, I don’t know how you feel Drew, because with your experience internationally yeah, but in the UK, the NHS has held us back.

Drew: 100%.

Payman Langroud…: Yeah. It’s held us back big time and so what happens next to the NHS will make a massive difference to what happens next in dentistry in the UK. But we can see on the private side that when the NHS isn’t holding people back then wonderful things can happen in UK dentistry, but the NHS has held us back. And, I’m not trying to put a downer on it, but in dentistry, even in medicine, I’ve got a love-hate relationship with it. When you’ve had family who’ve needed medical care, there’s definitely a side of it that you love because you know that NHS will save your life.

Payman Langroud…: On the other hand, you try and get a diagnosis quicker. Sometimes I’ve been in third world countries where you get better medical care then you do in the NHS and cleaner medical care. So even though I think as a net, the country’s better off with an NHS, in dentistry I don’t think that. I think in dentistry, if we could switch it off tomorrow, I think life would be better for patients and dentists.

Drew: I think quality would definitely go up and I’ll tell you a very interesting story. Here is a friend of mine moved to another country. And from there, she started in practise and she said to me, “Drew, I’m not getting any patients.” And I said, “What marketing have you done?” She said, “Marketing? What’s that?” Because in the UK, there’s this big board, blue board that says NHS so you never have to do it. But when she did learn marketing, patients came in and then she said, “Drew, a lot of them come in, but when I refer them for some complex stuff, they never come back.”

Drew: I said, “That’s because you refer them. And you’re not in the UK where the system is referral. You’ve got to have every skill under your belt.” So she had to learn implants, orthodontics. But the biggest thing she said is, “I can’t believe it, but it had curtailed my growth and not just growth as a clinician. It had curtailed my growth.” And I think that’s probably where we come in because the fundamentals of why the NHS existed was right until the value got lost somewhere, which is an interesting story. I stick in there, but I think growth is really big.

Drew: Now, you’re both contributing towards that growth. We’re not talking financial growth only but contributing towards whether it’s mental, physical, spiritual, the whole professional, vocational growth, social growth Leaders Podcast has pretty much connected people together. You must feel proud. There must be a sense of pride in what you guys have achieved at what level. At what point do you sit down and go, “Yeah, I’m proud of this.” And at what point do you say, “Huh, life carries on let’s push the barriers further?” Are you those kind of people? Well you look like it.

Prav Solanki: I’ve never really thought about it, but one thing that I do think about is it goes back to Anup’s story. That what we’re doing is we’re putting a stamp of legacy down for every individual that we interview and that’s there forever. That story there is solid. And so had we not interviewed Anup, all those thousands of people that have listened to his episode, wouldn’t still be able to connect to him now he’s no longer here. And that’s what I see is that. The other side of it is actually bringing that true human being to the surface, and I’m sure people like Simon or Rona won’t mind what I’m about to say.

Prav Solanki: So before I met Simon, I thought he was this super perfect made out of plastic canon Barbie doll ask type guy, because that’s what social media depicts him as. Since I’ve got to know Simon. I met him at the podcast in person and stuff, a truly humble, genuine human being who is actually a bit of a perfectionist, self-limiting because of that paralysed by perfection.

Prav Solanki: And I’ve since been fortunate enough to work with him on a couple of different projects, just a really nice guy to chat with. But social media can put you and reflect you in a way that you truly are not as a human being, and the same goes for Rona.

Prav Solanki: The way she puts herself out there, the way she talks and everything is her. It’s just the way she’s not putting on an act or anything like that. And once again, somebody who I’ve worked with, and I think if we hadn’t put these podcasts together, I don’t think you’d have got into the inner workings of a person. Dominica Holland is another one who once again, he’s has been known to be quite abrasive on social media. Let’s be honest.

Prav Solanki: But he’s been the hero of lockdown. His intelligence and then the backstory behind that intelligence and then his vulnerability that, the stuff about his son and all the rest of it, bringing that story to the surface, do you know what? I’m proud of us together, being able to bring that out, publish it. And it be there as an archive for people to listen to. Pay, what about you?

Payman Langroud…: I think it’s one of… It’s like the UN, if it didn’t exist, you’d have to invent it. You know what I mean? These are valuable stories. I get contacted all the time by like first year dental student. I never had any idea that first year dental student would even have access to the Dental Leaders Podcast, lots of students saying how much it’s inspired them, how much they’ve learned from it. And then interestingly, different people find different episodes valuable, different episodes get different numbers of people actually tuning in as well.

Payman Langroud…: I guess they get shared and all of that, but yeah, it’s valuable. Like you said Prav, it’s there forever and it’s a resource and getting to understand how people got to where they got to. And I think we’re going to try and bring out some stories from people who aren’t famous as well, because to start with, when you start something like this, you try to find all your friends who are well-known like, “Get Drew, get Drew.” Two years later it might mean getting new space.

Payman Langroud…: But both me and Prav, we’ve got customers, we have friends, customers, users who no one’s ever heard of because they’re not out there, but they’re amazing business people. They’ve got wonderful stories of their own. People who we know because we’d been working with them for such a long time, and going forward, I want to expose some of those as well, because dude, the day-to-day for dentists is as much about relationships with their patients, relationships with their teams and relationships with each other. And we’re in this wonderful situation now where we were talking to Lauren Harrhy, do you know her?

Drew: Yeah.

Payman Langroud…: And we were told her, she’s sitting in the Welsh Valleys. I know that the Welsh Valleys well. She’s sitting in Pontypool and she’s able to have this massive impact nationally on mental health. And she’s going into the BDA-

Drew: It’s amazing.

Payman Langroud…: … elections and all this. We like to denigrate social media and all that. We are at a point where we’re connected and the best stories will resonate. And so having a platform where we can talk to people, I just love it, dude. I love it. It’s definitely, this is a mini smarmy for all my favourite two days of my month, my least profitable two days.

Prav Solanki: I think they’re profitable. They’re just not financially profitable, but they might provide spiritual wellness.

Drew: Not yet. Not yet, the spiritual wealth and the mental wealth they put into you is amazing. And I suppose, Pay you’re very good at jokes. And my one advice to you is please teach Dipesh Palmer, how to get good at jokes. If he’s listening to this, he’ll think I’m very nice. And I think what you guys capture is that very human spirit. End of the day, whatever social media portrays, as you say Prav, what is most important is every single dentist has good intentions for other human beings.

Drew: It’s just the way they go about it is different. They skin the cat in different ways but that’s what I find most enjoyable about this profession. And everyone takes a different project. They want to impact another human being. You guys have picked up a project that I think is phenomenal, and you’re not impacting another human being. You’re impacting a shit load of, pardon my French, human beings. How many views has these podcasts had? Have you got any idea on the numbers?

Prav Solanki: Pay, handles that better than me.

Payman Langroud…: Yeah. Prav, doesn’t care much about this stuff, man. He doesn’t care.

Prav Solanki: For me, once we’ve done the thing, we’ve recorded the episode, and we’ve got the story out. The way I look at it is we’ve done our bit, right? I’m not looking at performance or anything like that but Payman is so into the numbers.

Payman Langroud…: I look at it every day, dude. It’s like my shares or something every single day I look at it. There’s been around 50,000 downloads so far but-

Drew: Brilliant. That’s amazing actually. And I think you have the ability to capture a global audience as well. Isn’t it? You can now. Well, I know you don’t see them in person, but now you can go out and grab your hands as far to Australia, America, Fiji, wherever they are. So where do you see it going? What’s the future? What’s the future for not the podcast? What’s the future for Prav and Pay.

Prav Solanki: Jeez.

Payman Langroud…: Look, the most important takeaway needs to be, and I know it’s a cliché, but the journey rather than the destination because Drew, we could say, “Hey, what’s your destination.” I don’t know. You’ve got such massive goals. But that might as well be something, ultimately, I want to sell Enlighten for a hundred million dollars or something like that. What am I going to do? Be unhappy until whether that day comes or doesn’t come. Absolutely not, we have to enjoy the journey. And for me, I’m going to carry on doing the things that make me enjoy it. So, we’re going to work on Enlighten. We’re going to develop products and all of that. But I find real joy in connecting Drew, which I know you do as well.

Drew: Yeah.

Payman Langroud…: And for me, watching new generations come through is always exciting. You mentioned Dipesh, and meeting Dipesh in VT and seeing him as a global lecturer, probably one of the best teachers in the world right now on his subject. That just looked, feels good to watch that journey, it really does.

Drew: Fulfilling, rewarding and-

Payman Langroud…: Yeah, yeah, yeah, and you can’t always spot the people, but you can as well, you can see them, you can see them coming. I remember Simon. Talking to Simon as a student rep at the BACD. He was a fourth year dental student and Richard Field as well. And you could see that the ambition of the guy, even at that point, you could see it and watching him becoming this, it feels like he’s been around for 30 years.

Drew: He doesn’t look it.

Payman Langroud…: Or even Jason. Jason’s first ever lecture was with us. And proper household name, the guys themselves are amazing. They’re amazing, amazing people, but what I’m saying about UK-wise is we’ve got the potential to be doing things like that. And yet a large proportion of our workforce has sat there working out UDA rules. What can they and can’t they do, minimising outgoings and like the way it’s all set up and you know what? For me, the real painful part of what you said about not having to look for patients is that it’s like something comes in your psyche that’s like, “I’m doing the patient a massive favour by seeing them.”

Drew: Yeah.

Payman Langroud…: And whenever that comes into your psyche, it’s just wrong. It’s just wrong. You’re not doing the patient a favour. The patient is doing you a massive favour, it’s an honour to treat that patient. And the NHS has somehow kind of skews that. Which [crosstalk 01:16:33].

Prav Solanki: I think you’re right.

Drew: I can see it’s an important point, but it is important to realise that there’s a benefit both ways in that. And that’s why I always tell people, maximise your potential to thrive. Prav, go on.

Payman Langroud…: Opened up the future to us.

Drew: What’s the future Prav?

Prav Solanki: Yeah. So for me, it’s about always learning and being better tomorrow, than I was today or yesterday or whatever. And so be that in different elements or aspects of my life, whether it’s health, whether it’s relationships with family, whether it’s business and taking on new challenges. So, for me, I only really understood dentistry, even though I was in it for a decade beforehand, until I became a practise owner. And then I understood the struggles and the strengths of what reception team members go through, management, people taking a day off sick, dentists not turning up today, patients left waiting, how do we deal with that problem?

Prav Solanki: Emails going unanswered, et cetera, et cetera. All of that pain and struggle. So, from the business side, just taking on more responsibilities and more challenges to improve myself all round. And that may not necessarily result in financial reward, but I really do get my kicks out of learning, trying to apply some kind of scientific methodology to it and rolling that out. That I love, on the business side and on the family side, I just want to be a superhero to my kids.

Drew: Amazing.

Prav Solanki: I just want to be that role model, that somebody who can influence them, guide them when they need that support. So for example, my daughter’s applying for university now. Too bloody right, I wrote her personal statement.

Drew: Throw your hat in the ring girl.

Prav Solanki: And it’s the best personal statement that anyone will ever read, and I can guarantee you that, buddy.

Drew: I think so.

Prav Solanki: And it’s those little things, you want to be the superhero to your kids that’s and with the younger ones, I’m definitely that in their eyes, whilst they’re little kids. I just want to carry on doing that. Nurture my relationship with my wife. You’ve got to work on that stuff. Just like you, Drew. I’m a workaholic, given half the chance, I’ll sit here for 18 hours a day in front of my computer. No question, no question.

Drew: I noticed.

Prav Solanki: But you’ve got to really, really work on that and make time and just segment, it’s hard. The balance is hard. The kid, the wife, the work, the ambition, the drive, and you’re juggling, spinning plates, call it whatever you want. But if any, one of those goes out of whack, it can affect everything else. It can mess-

Drew: It can mess.

Prav Solanki: And Zuber said this the other day,

Payman Langroud…: Zuber Bagasi.

Drew: Yeah. I speak to Zuber all the time.

Payman Langroud…: Synergy Dental.

Drew: I love that man’s drive, another [crosstalk] guy.

Payman Langroud…: Loved it.

Prav Solanki: We haven’t put the episode out yet, but it was a very good.

Drew: I’m going to wait for that, what did he say Prav? Tell me.

Prav Solanki: He said that life is like driving a car with all four tyres inflated. And one of them could be like life, wealth, health, business whatever. And if one of those isn’t fully inflated, then everything goes to pop. So his focus was on driving his car with all four tyres, inflated.

Drew: I mean, that’s brilliant. Zuber always says car analogies as well. I’ve realised when I first met him-

Prav Solanki: Is that right.

Drew: He gave me three car analogies. I’ve just realised he’s got a fourth one, something interesting there, but with car analogies, I’m just going to say I’ve enjoyed being the driver of the Dental Leaders Podcast. I’m moving back to the back seat. So you guys can choose who’s going to drive and navigate again into the future. The sports didn’t make sense. That made sense.

Prav Solanki: Absolutely buddy, absolutely.

Payman Langroud…: That’s brilliant. Guys, I’ve loved sharing this actually. I think [crosstalk 01:20:55].

Drew: Thank you so much for that, I’ve loved it, man.

Prav Solanki: Thanks Drew. When you first suggested the switch, both me and Payman, I think we were just a little bit like, “Well, that’s a bit weird. Let’s do it anyway.” And it’s been great. I’ve enjoyed it.

Drew: I hope you’ve enjoyed it. And I hope you kind of got a bit of a feel of what we’ve been on the hot seat.

Payman Langroud…: It’s difficult on this side, much easier on the other.

Drew: The other side, you ask the questions, but you know what it was, I’m going to finish it with this book worth the read because I know, especially Pay likes reading the Thinking Effect, and I’ll send you this kid’s TED Talk that’s what somehow triggered it in my head. It created a thinking effect, but the switch has been fun. Dental Leaders Podcast is inspiring, it’s positive. It’s energising.

Drew: It’s bringing people of different backgrounds, different experiences, different knowledge, different beliefs, different values, different faiths, and making us all the same. We look after humans. This is Mr. Payman, and now you say, “Hey, Pay.” Who has really told us about his passion for creating, connecting, and really collaborating and watching Prav, whose passion is all about learning and creating systems that just maximise everyone’s potential to thrive together. I’ve enjoyed this Dental Leaders Podcast. The hot seat is back to Prav and Pay. Thanks guys.

Prav Solanki: Thanks Drew.

Payman Langroud…: Awesome man.

Prav Solanki: Thank you so much.

Payman Langroud…: That’s brilliant.

Outro Voice: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Prav Solanki: Thanks for listening guys. If you’ve got this far, you must have listened to the whole thing and just a huge thank you both from me and Pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you’ve got some value out of it.

Payman Langroud…: If you did get some value out of it, think about subscribing. And if you would share this with a friend who you think might get some value out of it too. Thank you so, so, so much for listening. Thanks.

Prav Solanki: And don’t forget our six star rating.

The description of dynamo doesn’t quite do justice to this week’s guest, Zuber ‘Zubz’ Bagasi.

Bolton born and bred Zuber has already opened eight practices – all before age 40 and without ever borrowing a single penny.

And Zuber’s not about to stop.

He fills us in on future plans, lets us in on his inspiration and gives an insight into what it’s like being one of dentistry’s most driven.

Enjoy! 

 

“If you have that structure, then you as a person, you’ve got a life. And what’s more important in your life, is to make sure that you are enjoying it, that’s the first thing. Otherwise, life’s not worth living.” – Zuber Bagasi

 

In This Episode

01.17 – Backstory

07.56 – Mentors

13.41 – Expanding the empire

20.50 – Systems and processes

29.27  – Work/life balance

37.10 – A scratch of the nose

40.34 – Get up and go

46.41- Higher purpose

52.00 – Future plans

58.50 – Advice for the next generation

 

About Zuber Bagasi

Zuber Bagasi graduated from Birmingham University in 2005 and went on to found the Synergy dental group of practices.

He also developed the dental training platform SynTrain.

Zuber is a Member of the Joint Dental Faculty and holds PG Certs in implantology, restorative dentistry and facilitated learning in healthcare practice.

He continues to practice in his hometown of Bolton with the Synergy group.  

Zuber: If I have nothing tomorrow it wouldn’t bother me. It would not bother me. Honest to God, it would not bother me because I can drive a Micro or I can drive a whatever it is, or I can have good clothes or bad clothes so long as I’m healthy, I’m sane and I’ve got a lovely family around me, that’s everything for me.

Intro Voice: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav solanki.

Payman: It gives me great pleasure to welcome Zuber Bagasi on the podcast. Zuber’s a guy I’ve known for a few years and always been super, super impressed with what he’s achieved in what timeframe. And really for me not that because you can look at someone’s achievements on their own, but the mindset of this dentist has been always so impressive for me and I thought we’ve just got to have him on the podcast to try and spread that love amongst the audience. Thanks for coming on, Zuber.

Zuber: Well, it’s a great pleasure and it’s great to see you gents as well.

Payman: Tell us the backstory a bit, buddy. Where did you grow up? Why did you become a dentist?

Zuber: Yeah, so born and bred in Bolton. I’ve lived here all my life, studied in Birmingham to be a dentist. Bolton has been my birthplace, I’ve got my friends here, my family here, everything around me. It’s just so convenient, my support structure is here.

Zuber: Generally from a working class background. My parents were both factory workers putting in shifts from 7AM to 11PM, my father did. It was good. My childhood was exciting, weekends were great when used to see my father on a Saturday and a Sunday. Weekdays we couldn’t see him because by the time we’d wake up he’d be gone to work and by the time that we’d go to sleep he’d still be at work and then he’ll come back. So weekdays, generally, we never used to see him, but weekends was family time.

Zuber: But yeah, loads of great memories of childhood. We had everything. We felt we had everything. We had so much fun. The little things that we don’t appreciate nowadays for our own children, we had so little but you see it felt like we had so much. Two up, two down house, two brothers and a sister. So in one room there was two bunk beds and our parents had their own bedroom. It was great. It was cosy, it was great. Cobbled streets of Bolton, memories to cherish.

Prav: And sort of growing up, it kind of reminds me of my upbringing, although not the cobbled streets of Bolton. We definitely didn’t have a lot and when dad came to this country he was working in a factory, I think making knickers or underpants at the time, doing long, long hours. Then it was taxis, and then it was …

Prav: But my memories were he was rarely there but it was just he was working so God damn hard for us, for a better future for us. Any kind of similar stories or analogies there from your upbringing in terms of the influence from your father, and any messages?

Zuber: Yeah, absolutely. So my father was and is still my mentor. I can talk to him. Every decision I make, every single business decision or personal decision when it comes to it I go and speak to my father. He’s always been very levelheaded, he’s always been a very hardworking character.

Zuber: So I guess what the things that he’s instilled in the siblings is, look, work hard, never borrow any money, and he’s instilled a lot of values in us. So, things like being honest and trustworthy, being there for the community, being there for your friends, being there for your family. He’s developed a reputation within the Bolton community as being very trustworthy. If he’s going to get something from someone to keep or to … Whatever it is, he’ll protect it with his life. I guess that is something that’s been instilled in all our siblings, the hardworking part of it, the long hours.

Zuber: He was a keen sportsman so he used to play a lot of cricket on the weekends. We used to tag along with him. We never used to watch cricket but we used to tag along and be mischievous within the wherever we used to go, in the forest, jumping on trees, jumping on rooftops, whatever it is, as kids do. We were only sort of seven, eight years old. I’m the third child in the family. I’ve got a younger brother, an elder brother and an elder sister. It was great, great memories. You’d never think that we used to do the stuff that we used to do.

Zuber: But a sort of take home message from my father is be honest, be hardworking, live within your means and that’s enough. And it’s exactly that which is what I instil in my children as well.

Prav: So the never borrow thing. My dad’s a big believer in live within your means, what you just said, right? If you can’t afford it don’t touch it kind of thing.

Zuber: Absolutely, yeah.

Prav: And so obviously you’ve built this empire that you have and whatnot. Have some of those values carried across? And I’m sure we’ll talk more about it, but in terms of your business ethos and how you’ve built this have you had to raise money, raise finance, or have you … ?

Zuber: Okay, so the first clinic that I set up was in Sunny Blackpool. We used to go to Blackpool as kids as your twice yearly holidays, for the lights in the winter and for the beach in the summer. So I ended up in Blackpool.

Zuber: In terms of my first squat practise, it was just before the new contract came out in 2006. I used to work during my vocational training year, for Amrik Bhandal in Coventry, in his big fortress in Coventry. So I’ve been mentored through him.

Zuber: The first clinic that I launched was a squat practise. I managed to secure a contract with the PCT at the time, the area team equivalence of nowadays. So it was very little investment and most of that came from my own savings. I like to save to make sure that I’ve got enough and what I need. So I remember investing about 150,000, 170,000 in those days, 2007. I bought the property, kitted it out, I secured a contract, and there’s a story behind that as well in how I managed to secure a contract during a vocational training.

Zuber: Yeah, it was happy days. But I’ve never borrowed money for any goodwill purchases I’ve had. It’s always been organic growth, so each year as we become more successful in each clinic I’ll reinvest that into the next clinic and the next clinic, et cetera. So all of Our equipment, everything like that, it’s all paid for.

Payman: Am I hearing that right, Zuber? You’ve opened eight practises without borrowing any money?

Zuber: That’s right, yes.

Payman: Bloody hell, man. Amazing. Go on, bro.

Prav: Talk to us about your mentor. You mentioned Amrik Bhandal. I guess, if you want to talk NHS contracts in that part of the country he’s got to [crosstalk] right?

Zuber: Yeah, absolutely.

Prav: Did he mentor you in business, dentistry, everything?

Zuber: Yeah, yeah. So, being an undergraduate from the University of Birmingham, we used to have Baaz which is the second brother from the three Bandal brothers in dentistry. And Baaz used to come into clinics and he used to teach us for [inaudible] restorative clinics used to come in. He used to pick out the best surgeons from the ward and I used to see them working for the Bandals later on in their career, so after their VT years.

Zuber: So I knew of the Bandals. Obvious people talk in the West Midlands and they were successful in the West Midlands. Amrik came along once I applied for my VT. I never got a VT place first of all. So I think probably one of the only ones that never got a VT place straight after university. So I started applying to as an assistant post in certain places in Birmingham. I got offered a place with Baaz Bandal in Cranleigh Heath. About a week later he sort of shipped me across to FiveWays, fresh out of university, a week into my clinical practise and he put me into his clinic, a single surgery clinic on Fiveways.

Zuber: At that time, again, when Baaz was on clinic, at the same time I had an interest as one of clinicians. And Anil was such a super duper guy. The inspiration that he instilled. At that time I think I was a fourth year then. He said to me, “Look, Zubs, you’ve got the hands, you’ve got the drive, just make sure that you are achieving clinical finesse.” So he made me think, right?

Zuber: He used to come and check my work on my preps. I used to do a lot of porcelain onlays as an undergraduate, a lot of stuff that some of the undergraduates weren’t doing. I used to go and pick out the more difficult OCC cases, et cetera, just for clinical experience. And Anil just said to me, “Look, that’s what you need to do.” He said, “Get as much experience as you can. Don’t let money be a driver, let clinical excellence be a driver.”

Zuber: So that resonated whilst on the other side I’ve got the Bandals. So I’ve got the Bandals and the empire, and I’ve got Anil on one side, right? So I really sort of started thinking about this in how dentistry can be led through a business model which is corporately managed, the quality of care transfers from one clinic to another clinic, and how do you maintain those high levels of standards?

Zuber: I kept in touch with Anil. I used to go and see him when he was in the Priory in Birminghan for James Hull. I used to go and see him quite regularly for direct supervision, et cetera. He drove me. Anil was one of my biggest mentors, I’d say. So, when I went into an assistant position, Obviously it’s something that I had to do in the period until I got my vocational training post, Baaz transferred me along. He said, “Look, if you work for me for six months I’ll get you into one of my clinics for VT,” which started in February. From June, till July till February I did an assistant post and then moved to Coventry with Amrik.

Zuber: I’ve never met this guy before. I went for an interview, he said, “Look, you’ve got the job. You seem like a great guy.” Great. So I started with him and I sort of learnt how super intelligent Amrik was, how hardworking he was. That was the biggest thing for me. You’ve got so many practises, you don’t need to come to work. It’s not greed, it’s [crosstalk] and that hardworking ethos-

Payman: zuber, I know you take it for granted because you were brought up in the Midlands seeing the Bandals, but for someone who doesn’t know who they are, do you want to just talk about the empire. How big was the empire? What are we talking?

Zuber: When I started my training with the Bandals I think they had about 80 practises across the West Midlands with three brothers. These practises were not sort of small practises, they were huge, humongous. The one that I worked at in Cranleigh Heath for the first week of my post-graduation, that was, I think it was a 12 surgery practise. The one in Coventry, that was a 14 surgery practise.

Payman: I’ve been to that one.

Zuber: It was like a fortress. It was like a mini hospital. All cable chairs all kitted out. So they had a huge empire. Their dad used to come along when I was in the FiveWays, and he used to come in every week with a little car, used to park in the back and used to come and collect the cash. It was so cute. I asked him, “Why do you have to work?” He said, “Every day is Christmas for me.” He said, “Every day is Christmas.” And it was amazing.

Zuber: The work ethos resonates. There’s more purpose to life than just to earn a good living. And yeah, Amrik was with me. I was in the next surgery with him. I was with some great clinicians in Coventry. Yeah, it was a great time. It was a great time.

Payman: So how long after you opened Synergy, your first one in Blackpool, did you look at the second one?

Zuber: So it was 2010. If you bear in mind I had these concepts of corporate dentistry.

Payman: Yeah.

Zuber: And you always hear that corporate, the bigger you are the worst you become. And then you’ve got the boutique practises, especially like the James Hull group, some of the practises, especially the one that Anil used to work at.

Zuber: What I did was, even before I applied for the contract in Blackpool, I was a VT, I had my vision set. The vision was, look, you’ve got to work together. In our profession, there is associate dentists, self-employed. You’ve got the local practitioners within their own clinics. You’ve got the nurses, you’ve got the practise managers, you’ve got the receptionists, so it’s not just a simple retail model.

Payman: Yeah.

Zuber: I had a friend in optometry and, again, he was going through all this, all these different models in his mind at the time. Since when I was an undergraduate we used to talk about this. We looked at the Specsavers model and how we can have clinical leadership with a corporate structure that supports each clinic, ensuring that each clinic operates to a high standard allowing clinical [inaudible 00:15:12]. We looked at IDH and ADP Dental, can you remember them?

Payman: Yeah.

Zuber: And the bigger became the worse the reputation got. We didn’t want to end up like that. So, my optometry friend who was about two years my senior, he developed a similar model to Specsavers where independent opticians are reinvented through a joint venture partnership model.

Zuber: We looked at how we can develop this joint venture partnership model. He’s now got 150 optical practises through a joint venture partnership programme, born and bred in Bolton, went to same school, et cetera, upbringing was the same. So, he then went onto audiology, over nine million turnover through joint venture partnerships. I went into hair transplant surgery myself through our JV model. 50 clinics worldwide this franchise. I was a franchisee a few years ago.

Zuber: We looked at all these models, Vets4Pets for example, and how this model could be brought into dentistry. At that time, when I launched my first clinic, I thought I’ve got to align the Bandals, I’ve got to align Anil Fester through a joint venture partnership model. And therefore I called it Synergy, synergy meaning working together for better results, yeah?

Zuber: The answer to your question, which is how long after the second practise. All this had to be set in my own clinic from a single surgery to a four surgery practise I built in three years. And then in that time I made sure that all the governance systems are absolutely nailed. I’m very OCD in systems and processes, so all the governance systems, number one, had to be absolutely nailed. Second is training, so when we have dental nurses, dentists, receptionists, practise manager starting, what would the training model look like if I was to acquire more practises because I love dentistry. If I had to I would stay in surgery five days a week, and that’s what I’ve been trained to do.

Zuber: So I had to model the training pathways to ensure that I’m hands-off with the training as much as I can and let the systems do the talking. So that, for the first three or four years, I was developing. I became a vocational trainer to understand the actual structure behind the training. So then in 2010 an opportunity came. I had some friends in Birmingham. I said, “Look, we’ll go into a joint venture partnership. I’ll do some of the management and we’ll be equal partners.” We applied for some tenders, we won two tenders in the West Midlands. One of them got pulled back for whatever reason, and one is still operational in the Midlands.

Zuber: So in 2010 we launched our second squat practise, minimal investments again. It was a tender that we won.

Payman: Are you specifically going after squats rather than buying practise?

Zuber: No, no, no, no. So firstly it was the 2010 practise was a tender, a national tender, across the West Midlands booster in Birmingham. It was the time when, I think, Rodric Stencil had a lot of the contracts down south. We managed to secure the one in Birmingham. Again, at that time, I had to evaluate whether partnership was for me. So let alone the systems and processes and how can I make a practise flourish, whether partnerships is going to work for me.

Zuber: So we’re still there and the partners are still very loyal to each other and we’re doing well. And then from there on the vision was how do I now develop the joint venture partnership model just like my close friend had in optometry and in audiology? How can we develop that into dentistry? If you think about it, the systems and the processes, a lot of it are manual, so checklists, paper. Some of it is on Excel, et cetera. But that’s not good, right? In a scalable model that’s not good. So what I had to do is to create software applications to capture HR, capture governance, capture marketing, capture accounts, et cetera.

Zuber: So from since 2010 to now we’ve been developing these systems. It’s taken such a long time. Not saying that it’s took us 10 years, but I had to make sure that every time we develop systems I had to trial it in my own practises. So, every year thereon I had a plan to purchase a practise year on year with my own cash, which I did. So in 2011 I purchased a practise, tested the models out there, pressed the green button, the system works. The staffing model centrally was finally knitted together. Some central management staff have been developed over the years, some have been recruited in, but it’s a very fine balance. Who wants to work in Bolton? Right.

Prav: We can get life from 3:00 for lunch, mate.

Zuber: Get licence degree[crosstalk 00:20:26] who wants to work in Bolton. But Bolton is my birthplace and it has to be Bolton. So the management staff was sort of intricately put together and supporting this the systems, the software’s that we bespoke developed, have been developed and been then trialled and tested on each one of our practises. And it works amazingly well.

Prav: Zuber, You said you’re OCD about systems and processes, right? Have you hold these together yourself? Have you gone in and mapped out every single interaction system process and then launch that and tested it? Or have you hired in someone to do that for you?

Zuber: Oh, absolutely not. I think of myself as Alex Ferguson.

Prav: Nice.

Zuber: Right? I like to create things, nurture things and make it flourish, Okay. so just like, you Ryan gigs and the Neville brothers and Scholes, et cetera. What I like to do I like to get my hands in, develop the systems and processes. I used to read the 200 page documents on the standards for better health. If you remember that in 2005, 2006, it was launch and as an undergraduate, I was reading that. And just to understand the NHS system just to understand the processes.

Zuber: I autopsied as much as I can in the public domain IDH. I autopsied virgin. I autopsied Apple. I autopsied Google. And I looked at why these great companies, some of these great companies, the latter ones, especially, are successful. And it boil down to one main thing. It boiled down to look after your staff, look after your people, and they look after you, Right? So all this was sort of cross industry thinking, and then how we could get this back into dentistry. The answer to your question is, yeah, I did develop a lot of these systems myself, I never hired anyone in and from every little details for what a nurse does in surgery, to what the practise managers role is on a daily, weekly or monthly basis to how the governance structure is created to comply with the currency QC standards, how that’s bolted into the BDA good practise scheme, how that bolts with the Health Education England’s Practise inspection plan, all of that encompassed in and is exciting. So it’s all bespoken and it’s all very dentist driven.

Prav: Zuber, how many people work for you now?

Zuber: Probably, about 100, something like that.

Prav: You know that’s quite a beast to manage. Right? As far as human beings, right?

Zuber: No, no, no. So it’s about systems, right. So it’s about systems, right. So you have to have all the different departments. So you have HR, a crucial role. You have governance, a crucial role. You have accounts team, you have a marketing team, you have an IT team, you have the operational team that includes your regionals. Your regional headedness that support[crosstalk 00:23:50]

Prav: what is the sort of the corporate structure? As far as you know people who work outside of the practises themselves. I can see behind you, you’ve got like the office there. Got an account, some marketing operations team. But then what do you have, you have regional managers?

Zuber: So you’ve got underneath myself and my good wife, we have head of HR, and there’s two people in the HR team. There’s governance team who is responsible for any compliance, any changes in policy, implementation, et cetera. You have an accounts team, there’s four people in accounts. And I mean, this is from verification of your cashing up to invoices to whatever else you need, in accounts, your monthly p&l, you’re ensuring your balance sheets are up to date. You’ve then got a marketing team. So in the marketing team, I’ve got an SEO guy, I’ve got some social media experts. I’ve got a graphics designer videographer, content writer, the whole team there.

Zuber: I’ve got an operations team which is the regionals, which is the area manager supporting the practise managers at each practise level. I’ve got two regional head nurses, which support the head nurses at each clinic through support and appraisal. I’ve got two regional receptionist, which again supports the receptionist that practise level through appraisal, et cetera. I’ve then got a centralised treatment team. There’s six girls in there, all GDC registered treatment coordinators, all our new private patient inquiries come through all the funnels that we have both digitally and offline, they get diverted, it’s a seamless system. So patients don’t know that they are

Payman: Super important, right? Super important.[crosstalk 00:25:56]

Zuber: Centralised hundred percent so the way that we’ve trained them up is that you’ve talked to them and the knowledge that they have is almost that the talking to a dentist. Yeah. So, the training systems that we’ve implemented for our team is so robust. And so we’ve got the team centrally here. And then a practise level, the structure as clinicians you’ve got to understand as clinicians and we all clinicians here, so what we want to do you want to go to work.

Zuber: And we want to make sure that we put our gloves on and between the patients and we take off gloves if we go home. And everything else around us, we want organised. So how does that happen? And the systems and processes that’s been created, allows exactly that. It allows associate dentists to come into work, enjoy the dentistry, go out on courses and develop their career pathways, have internal mentorship, but it’s all clinically focused. And then everything else around that is managed by the team. So we’ve got treatment coordinators at each clinic, you’ve got practise manager at each clinic, we’ve got one or two receptionist each can depending on the size of the clinics, a head nurse each clinic, an assistant head nurse, an assistant head receptionist and then you’ve got some clinics have a therapist, some don’t. And then you’ve got the associate dentists there as well. So the system is such that allows us clinicians to be able to flourish.

Payman: So how many days a week do you actually drill? Do you do still do that?

Zuber: Three days? Yeah. So this is what I’ve been trained to do me. And, I can’t see myself being out of clinic. It allows me to be in touch with dentistry. I spend three days in clinic and two days in the office. Again, just working on the business dipping systems further, I regularly have contacts with the different departments on a weekly basis. And we have a board meeting every month, where the law managers potential board meets up for KPIs practise.

Zuber: And yeah, I think structure is in place. I’m a great believer of Bruce Lee, right. And as a child, Bruce Lee was my like, My God, right, I had to get six packs because of that. And Bruce Lee’s philosophy was this that to be successful, you have to have structure and all see the structure, but at the same time, you have to have emotion, and spirituality, right. So to have a synergy between the two, and mechanical approach, and spirituality and emotion and understanding as human beings involved. That’s where the fusion comes. That’s where the synergy comes in. I think that’s resonated all throughout my life. And everything I’ve done has been a mixture of a professional approach, a structured system in place, as well as just have lots of fun. Make sure that stuff enjoy themselves a little coming to work, I believe in a motto. Less stress, more success. And it’s something that resonates across the group.

Payman: perhaps Do you see what I mean? But [crosstalk]

Prav: Listen, and so, the one thing that sort of is screaming out of me at the moment, right, is you’ve put all these systems and processes together. You’re OCD, okay? And you’ve got a family, you’ve got multiple practises you’re acquiring, okay? And you’re having fun at the same time. That there must have been points during this journey where you were putting in and you probably, I don’t know whether you still are ridiculous hours, right? 16, 17, 18 hour days.

Zuber: No, no, no, no.

Prav: Never.

Zuber: Never. I feed children. Never. I love to eat, I love to get out of the house and I love to do the school pickups and I love to do all of that. But yeah, my kid is nine, four and two year old, so very demanding. But my nine year old, he’s memorising the Quran. So in the morning killer, he’s got to wake up in the morning 6 am I’ve got a supervising for two hours in the morning before I go to work. In the evening, I spend another hour with him. So that’s my time after five o’clock off. That’s it, done.

Prav: Always been the case.

Zuber: I think 90% of the times. When I first started, you know working in practise. In when I first set up my squat in Blackpool, I used to come home, but I feel so tired and ready to go to sleep. Before I had my children. I used to say to my wife, do you want to go to your mom’s today? She put up your mom’s house say sorry, not seen him all week. Why don’t you go? I decided that time that I used to get time for myself to develop systems and processes. So, I used to have a hook on one side and I used to develop my systems on the other. But yeah, I put that trust to my associates. Now as well saying that nine to five you clock out you switch off you go home.

Zuber: Sport is another big thing in my life. You have to balance it out. I’m a big believer, again, the Bruce Lee’s story. We still have Chuck Norris and Arnold Schwarzenegger and Sylvester Stallone. And then were the days when the sport used to I felt the value of sports are probably you know all about this, I think. I’ve been following your fasting journey. Sport is integral, I think it’s integral part of your life. And if you don’t have this balance in life, something’s going to give whether it’s internal, or whether you’re going to explore somewhere else or in your mind, right. So this balance of sports, professional life and personal life is key. I mean, one of the analogies I gave is that life should be like driving a car, each wheel should be fully inflated equally. So work is one of the wheels. And the other three is exercise and sports. The other one is your personal life, your family and the other one is spirituality, Right? So if you use mind, body and soul. If balance yourself well, then I think you’ll do.

Prav: Well talk to me about how this balance features in your life and makes it through maybe a typical day stroke week or couple of days in the life of where spirituality features health and wellness how that fits in, whether it’s a workout, whether it’s whatever it is you do and just give us an insight into that, Mate.

Zuber: Okay, so my day starts at 6 am and I spend about two hours in the morning with my elder child. He’s memorising the Quran takes about five years or so he’s probably about a quarter of his way through now started last year. So eight o’clock when I’m in surgery. I’ll start off at eight o’clock get to Blackpool for about quarter nine, I’ll have a full day a clinic finished at the four o’clock. Spend some time when I finished my clinical work to write my reports up that what the TCM was developed for me, sign them all off, send them out to patients and come home drop my kids offs to the evening mosque.

Zuber: My wife does the school pickup I do the evening pickup and drop offs. And then I’ll fit once in the Mosque, I’ll fit in. I’m a triathlete. So swim, bike or run. I don’t do any heavy weights, I don’t do any weights at all. I just follow these three disciplines. I’m with a triathlon group. So the biggest one in the country, in fact, very lucky to have that in Bolton. And, we have training schedules planned during the week and the weekends. So I spend about an hour or so in the pool, 1500 metres to 2000 metres, whatever it is, or I go for a run for an hour. The weather’s good. I’ll go out for a bike.

Zuber: It takes me one hour, 20 minutes normally the route that I do. And so that’s been a week, so I have two or three of them sessions in the week. Evening wise, spirituality wise, I pray over five prayers during the day, in the morning, afternoon throughout the day. And so I always get them in and that keeps me grounded. I’ve got a really naughty streak in me and I think all this keeps me really grounded. And I’ve got a very supportive wife, Hitler, I call her sometimes!

Zuber: I found but her she’s a little lovely and there’s a story behind that as well. And it’s the way we met but It’s great and then on the weekends, I’ll spend. We go some swimming lessons with my children. So I’ll say come on to swimming, once they having the swimming lessons, I’ll jump in the pool myself. And I’ll do my laps, I need to, again 1000 metres to 1500 metres. Something like that I’ll do. On a Sunday, every Sunday, every morning, half to seven or eight o’clock, depending on the time of the year is. We’ll go for a long ride so 50, 60 miles with my triathlon group and straight after that swimming again with the kids and then we’ll go for our family walk or family adventure in the afternoon and up till evening. So it’s great. Is this a structured life it’s a very nice structured life.

Prav: You’ve definitely got all four tyres equally inflated, they’re made that’s for sure.[crosstalk 00:35:45]

Payman: Did you get during the day when you’re doing patients, so if you’ve got constant messages coming on your phone, things going on?

Zuber: No, no, no, no, no, because one of the things that I’ve… the way that I’ve stitched up the management team. Think of it as Richard Branson sitting in his office, he’s not going to get operational problems, is he? He’s going to have a layer and a layer underneath him was going to take it. I’ll give an example of some friends of mine, the Euro Garages brothers are very close friends of mine. They’ve just took over as in a big stake. Right? So I was with them last week. And I said, Look, how do you manage? And we will speak about this is. How do you manage it? Thousands and thousands of Euro galleries across the world? Australia, America, all over Europe, right? Two brothers sound level headed. And so how do you how do you manage it, they’ve been part of my business mentors. So I said, Look, it’s simple, you have to have a structure in place.

Zuber: And if you have that structure, then you as a person, you’ve got a life. And what’s more important in your life, is to make sure that you are enjoying it, that’s the first thing. Otherwise, life’s not worth living. You spending time with your family. Okay, and everything else is the secondary. So if you’ve got a structure in place then that should take care of itself.

Prav: Tell us about Hitler.

Zuber: See us every time I have an argument, my wife, I say, the biggest mistake I’ve made is scratch my nose. And I remind her of that and said, the story behind values. I met this girl in college. So, I’ve probably spoken to about three times in college. Never give her the time of the day. She used to hate my guts. I used to have curtains, you know the curtains styles in the days.

Prav: Believe it or not, so did I, mate.

Zuber: Really? Oh my goodness. Right. Peter Andre? Right.[crosstalk 00:37:48]

Payman: Is she a dentist?

Zuber: No, she’s a solicitor. Right? So she works for us now. And she has been for the last decade or so. But in terms of our method, So, imagine this girl I knew of, I never really spoke to her. I went to university she went on and she didn’t care what I did or what, vice versa, et cetera. And then I came back from university that said, you know Rich Dad time. It’s time that you got married. And proposals came, we through the community, you meet one girl and she hates you or you don’t like her or whatever it is, right? And so this proposal came so I think I know this girl, and I confirmed it was her. And I said, Okay, we exchanged numbers, parents exchanged numbers, and we met in Starbucks in Bolton first day.

Zuber: I said, Oh, shit, I don’t know what this girl looks like now. Not seen it for over a decade. What if you got it? Couldn’t it be awkward? You know, her friend circle. I know it crosses over. So I went into Starbucks and I went in with a big bouquet of red roses, right? And I went behind the tail and I said, I slipped to 20 pounds, no sin. And I said, Look, guys, I want you to keep this behind the counter. And if I scratch my nose, I want you to bring it out. Okay?

Zuber: I sat down and ordered my coffee, ordered my tea. She hates coffee. So ordered, everything’s planned, right. She came along, sat down, anxious as hell. And on the back then I also arranged with my sister to say look, call me at this time and if I say Oh, shit seriously, I’m coming home now. Okay. So I had it all planned, right? So just in case to make it a bit more.

Prav: Had your escape route sorted. Did you?

Zuber: Everything sorted, right? Everything sorted, right? So I’m talking to this girl and we’re talking a way about college and you know, blah, blah, blah. And then I had a scratch on my nose. And I forgot all about I told these guys that bring the flower out. They bring the bloody flowers up, right? That’s it, I am going to have to marry her now. That’s it done deal. Right? Can’t go back right, flowers are out. Right? My sister call. oh case is too late.[crosstalk 00:40:17] All right guys, so every time we have an argument, I see. No scratch.

Prav: such a lovely story.

Zuber: You know, you’ve been a lovely lady, she’s a rock of my life.

Payman: The thing I find about Zuber, I mean, you meet a lot of dentists right? Me and Prav me a lot of dentists all the time. And a lot of people it’s kind of fashionable now to say I’m opening a chain. Yeah. But the way you executed, for me, how effortless it looks? I know it’s not bad. I know it’s not. There’s a lot of planning and execution. But you are definitely enjoying your life. It’s just it’s obvious. You’re enjoying your life. And it looks like you’ve managed to balance this out really well. Would you say obviously, what you said about Neil Shrestha who’s a great friend of this podcast and the Bandals and that massive structure, we said that, but would you say there’s something about you that’s like, more ambitious than the next man, more structured than the next man? Parents who work in a factory now you’re talking about opening 100 practises out of the blue? Where did it come from? As a kid were you like that with these guys? The Bandals with no stress to sort of open your eyes?

Zuber: No, no. So I’ve been brought up in a community where 90% of the children never had the opportunity to go to university. And even if they did, their parents, probably discourage them all working class. And you know the ethos at the time in the 80s and the early 90s was you go to school and you go to work after that. I started working at the age of 12, something like that. Alarm factory to Nappy factory to Socks factory to Morrison’s earning 2.14 an hour. Sainsbury’s, I’ve always worked. And I’ve always earned for myself, and I’ve always lived within that means.

Zuber: I never got a penny of my parents, anyone. Okay. And the same with my siblings. And same with my friends around, it was just the ethos in the community. So one of the things that resonated when I was a child is actually seeing so many intelligent, really, really intelligent. Guys, I’m not the most intelligent, I can assure you really intelligent guys, but they’ve had to go into work and they’ve lost that ability to progress. And then, I mean, what I’m talking about is you would know from on one hand, the guys that went to university in the communities that we live in, right, so you know that that kid has gone to university that kid has gone to university, you know that, okay.

Zuber: So that to me was this has to change. I need to inspire. I need to do something that you can do this and you can do that. And you don’t need to just to go to work, you don’t need to drop everything else, you can balance it and life is a balance. So I guess one of the biggest drivers for me is to inspire. Remember, I’m the only… I’ve not mentioned this earlier, the only kid in my entire family, my first cousins have never gone to university. None of my first cousins have gone to university. We’ve got a big family, we’ve got a huge family, right. So the first thing is I’m not going to be able to inspire them because I’m one of the younger guys in the generation. So yeah, but I’d be able to inspire the next generation and I’ll be able to inspire the generation that’s coming up, right.

Zuber: And how do you do this? You got to do it yourself. So through school. I did well, I put my head down, I was not a child, I got into trouble loads because of the life that we were living. Naughtily, we were very naughty, very mischievous. Whenever we had a complaint at home. Father used to say, what do you do outside stays outside, never bring it at home, right? So, went through school, in 12, straight A’s, straight A stars, et cetera. Again, a big, big drive was motivating others went to college sixth form, and actually wasn’t going to do dentistry in the first place was going to do law. And I don’t know how I ended up in dentistry. But the people around me those that were very ambitious. They’re all around me.

Zuber: So like I said, for example, my friend who’s in the optical field is over 150 practises, my very close friend, online pharmacies in America, Europe, UK, another very good friend of mine. These guys have been both up together. We’ve got chain of pharmacies, and then you’ve got the the Euro garage brothers. And there’s other stories. There’s very successful stories and us guys were the mindset that we had was how do we inspire the community. Drugs, mental condition, suicide rates, all this was very prevalent and it still is, and we have to do something which allows people to focus on an end goal, and we have to do it ourselves, for us to inspire others, so be inspired and inspire others.

Zuber: And I guess Anil and amrik were sort of boosters to that same philosophy. That’s why I love these guys, but Anil was my mentor for my four implants when I first started in 2007. He used to come all the way from Birmingham used to live there. And we’ve been snowboarding together in Worcester and I’ve invited him across, we’ve been to the campsite a lot.

Zuber: Anil comes from Boston again never sportsman, I’ve seen him grow up if you remember Sajid Mahmood, the cricketer, the fast bowler for England crickets. He was in my year in school and all very sort of successful in your own rights. But the work that goes behind it, no one sees that. So no one sees what it takes to get there. And everyone just wants a shortcut. And it’s not the first, right. It’s not the culture that we tried to share.

Prav: Zuber, you spoke a little bit about, well, quite a bit about religion or touched upon it. Keeping you grounded, coaching your son through this five year programme of reciting the Quran? How important is religion to you? How does it feature in your life? And how does it keep you grounded? Talk to me about[crosstalk 00:47:03] what are your belief systems just tell you a bit about your beliefs.

Zuber: My beliefs, I’m a Muslim. And I believe in a higher creator. And it goes a lot deeper than that. Because wherever religion you’re in, my belief, is that the ultimate end goal is one, which is how you treat others. So you might be praying 20 hours a day and you might be given so much in a community, whatever it is that you you do for your religion, ultimately, it comes down to your inner self, and your inner weaknesses and strengths.

Zuber: So you’ve got the, again, one of the things that I love about Bruce Lee is that he’s not just a fighter, he had this higher purpose, which is you got to fight these inner demons. And the inner demons for Bruce Lee was things like fear, anger and hatred. So, wherever he taught him did, he was to fight these inner demons, you must have watched return to the dragon, Enter the Dragon sorry and this is based around this.

Zuber: Taking that a step further. When it comes to spirituality. It’s inside you look at you don’t look at the outside you look at the inward world, which is things like greed, jealousy, eating too much or less than. All these spiritual sicknesses that we all have, we all human beings. And it’s religion allows me to focus on that and work on the inequality so if I have nothing tomorrow, you wouldn’t bother me. It would not bother me. Honestly, it would not bother me, because I can drive a micro or I can drive a whatever it is or I can have good clothes or bad clothes so long as I’m healthy, I’m sane and I’ve got a lovely family around me that’s everything for me.

Zuber: And that’s my route. And it’s something that’s been serious whatever it brings, what’s my vision? Like, sky’s the limit. What if I spoke to a man I was with Zuber Issa from the Euro garages. Just two years ago, they were venturing out into America. And I said, Why are you going to stop? Why are you going to take this. You’re supplying the amount of fuel that you’re supplying it’s one fifth of the whole country. Right? So where are you going to take this? Right? So we don’t know, we just take as it comes. We don’t know. And yesterday, they were the preferred bidder to buy us there. Now, who would have thought that two years ago, would they have thought that themselves? No, they wouldn’t have. So long as you’ve got this balance, so long as you’ve got an opportunity, and if it fits within your life, and within your lifestyle, and it’s not affecting your time that you spend with your family or friends. It’s not affecting your health then yeah go for it. I studied the high purpose to inspire others. It’s inspire, be an inspiration. Because life is more than that.

Prav: Just taking that question, just to touch further, what you believe is on the other side, when this life is over, at the end of it all? What, what do you think happens? Or what do you believe happens?

Zuber: There’s a hell and heaven and I don’t judge who’s going go to hell, and who’s going go to heaven, I think I’m going to go to hell. There’s so there’s so many bad traits I still have, and I could do so much better. What I believe is that you’ll be judged on your character. So if your character whatever religion, I think religion is a means for you to focus on yourself, right? And whether it’s today’s on Christianity, Hinduism, Sikhism, Islam, whatever it is, the higher purpose of this is to focus on your inner self. That’s where Sufiism comes in. That’s what spirituality comes in. That’s where cleansing your spiritual sicknesses come in. If you having one day, you might not have it the next. That’s the bigger battle that you have. And if you have that you’ll be judged on that. And if you don’t, well, you’ll have an eternal life in heaven. And if you haven’t, then unfortunately, you see red.

Payman: You do really believe it, but really believe it’s the burning like, you really believe in it?

Zuber: I don’t know maybe. I don’t know. Honestly. It’s a common thought there is fire and snake whatever it is. But let’s not focus on that. I’ve got phobia against wasp. Wasps in the hell of it. Right. Wasps and spiders two things, right. Honest to God. Right.

Payman: So you are saying that if I’m hearing you, right, you are saying that if everything carries on and you feel like you’re happy, you will just keep growing this and you’re looking at the 150 mantises, whatever you’re not looking to exit. Yeah.

Zuber: I’m only 38 pal. No, no, I’m only 38. You know, I get bored really, really easily. I have to do new things. So dentistry wise, clinically, I see children that are on the NHS, requiring routine exams, to simple restorations to full arch implants and sedation, and Invisalign, and composite bonding and the whole spectrum. Because if I just did one thing, I’d be out of my mind. So I mixed it up.

Payman: But for me, if I was running the Empire, you’re running. I probably would lower my clinical days. But it looks like you’ve managed to get that thing running itself almost, and still managed to get the clinical hours it. I think the Bandals are like that too. Right. They will practise. They kept practising.

Zuber: They do? Yeah, I don’t know the practises right now. I think his sons have probably taken over. But the ethos is, I mean, there’s different types of dentistry. There’s an NHS dentistry world as a high end private dentistry. Well, there’s something in the middle. There’s a mix practise economy, whatever works for you, and with regards to staying in practise, again, it’s what I love to do, this is my main job. I don’t see as a job in fact. I like using my hands. In management, you can’t do that.

Payman: It was an insight into what I’ve seen a couple of your practises and you know that I like what you’ve done with them for a second perspective and all that. Yeah. But give us an insight, what is it that makes your practises so successful? For instance, with enlightened, when I look at your practise where it is, and I see the number of enlightens going through that practise, it’s more than it should be. [crosstalk] So it was known that the treatment coordinator thing, what is it?

Zuber: No, No, no. It’s a very finely stitched system. So currently effects right, so enlightened, you’ve said, enlightened with the highest provider of straumann implants in the whole of the Northwest, with the highest provider of Invisalign in Greater Manchester and Lancashire, enlightened is another big brand that we use and promote. And all this, you can’t just pay someone and expect results, right. So Prav, right. So in terms of Google SEO, Google pay per pay per clicks, you can’t just put a shedload of money in and expect results, it doesn’t look like that.

Zuber: So the way that it works is, there’s a sales funnel, right? And whatever the sales funnel that you use, whether it’s social media, Google, whether it’s PR that we do wherever it is, you’re ultimately, the endpoint is patients sat in your chair and then the conversion of that.

Zuber: So that’s one part of the bigger picture, right. So the patients have now come into your chair, however, whatever way that you’ve done that, through your central human coordination team, to your key tools, in practise, whatever way is, you’ve got a patient in the chair, the second challenge is allowing the associate dentist to be trained enough sufficiently to be able to manage that case, within the scope of practise. So that is a big, big area. So that’s training and mentorship. So we have a system that we’ve developed, probably took about four or five years to develop a digital platform where everything’s recorded step by step using high resolution videography. It’s a platform that’s an accredited platform. You got the AAIDD award last year for digital dentistry. And it allows each clinician to be able to go through a training programme. And then at the end of that they have mentorship, and direct and indirect supervision.

Zuber: So the second part of the puzzle is, once you’ve got the patients into your chair, how do you develop your dentist, particularly your dentist to be able to offer that treatment, you can have a dentist that comes in fully trained, fully skilled, and then they can implement themselves into the system, or you take the fresh dentist who are very motivated, who are enthusiastic and a willingness to learn. Those are majority of our dentists. So most of our dentists come straight after the f1 or within the training ourselves. And then we’ve allowed them to flourish. Okay. And that’s the second part. Okay.

Zuber: The third part is the management system that goes around, it’s all the administration, all the governance, making sure that everything’s working, making sure that you’re stocked in full Nick, making sure that the equipment that you use you’ve invested properly in it, all everything that goes around it, the infrastructure that’s around it. So if you were just to pay for footfall in marketing, you’re not going to get the results. So it’s the whole system. And that’s what we’ve developed, and that we’ve developed this through looking at the bigger brands that I mentioned earlier.

Payman: Socially present, but they’re going to tell you every time I speak to you, I’m just super, super, super impressed with you, man. Perhaps Go for it, buddy.

Prav: And just just before I go for it, I’m just blown away by the balance that you’ve got here, right? I know a lot of people who do well in business, right, but you’ve got the health, you’ve got the family, you’ve got the wellness, you’ve got the switch off at five o’clock, you’ve got the time in the pool on the bike running, blah, blah, blah on his face.

Payman: picks smile on his face.

Prav: Huge smile on his face, right. I’m a good judge of character as well. And it’s very clear to me that every single word that’s come out of your mouth today has come with a high degree of authenticity.

Zuber: Thank you.

Prav: And I feel like I’ve been having a session with my business coach. I’m genuinely inspired. But all that to one side. Yeah. Imagine it’s your last day on the planet.

Zuber: Okay.

Prav: And the kids sat around you and you need to leave them with three pieces of advice.

Zuber: Okay.

Prav: So question number one, what would those three pieces of advice be? Question number two, how would you like to be remembered?

Zuber: Okay, so three piece of advice is number one is what I’ve been always is don’t be afraid to ask a question. Okay. So that question could be reaching out to a mentor. That question could be reaching out to the authorities, whatever it is, regulators, whatever it is, don’t be afraid to ask a question. Okay. That’s number one.

Zuber: Number two is be the best version of yourself, Right? So don’t compete. Let yourself, create yourself to be the best version of yourself. So I was taught, I engage. I was 100 metre sprinter in school. And one of the pieces of advice that someone gave me is never look to the left, look to the right, you just focus on the end goal and you just go for it and give it your best shot. And the chances are if you do that without distraction, you’ll probably win the race. It’s not about winning, and somebody competing, it’s about giving your best shot. So the second piece of advice I would give is, focus on yourself, and make the best version of yourself. Okay.

Zuber: And the third is, I think is the most important is this, have fun whatever you do. Otherwise life’s not worth living. So whatever you do have fun, enjoy life. Spend time quality time with your family, friends, work. And I think that’s the third, probably the most important piece of advice.

Prav: Beautiful. And how would you like to be remembered?

Zuber: What I’ve always done is to aim to be an inspiration, whether professionally or personally. And so yes, so the guy that inspired me, whether that’s to take up a nine month challenge, which I did a couple of years ago or a to open a squat practise or become a partner within the joint venture partnership programme or to excel clinically . I would remember an ancestor as one of the guys that inspired me to develop clinical finesse and that’s one of the guys that remember him as. So that motivation that inspiration is so value.

Prav: You certainly inspire me to buddy.

Payman: Yeah, me too buddy. Go kick some ass. Thank you so much, buddy. Thank you so much. Thank you. I knew it was going to be good but it was even better than I thought it was going to be. So thank you so much to take your time.

Outro Voice: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your host, Payman Langroudi and Prav solanki.

Prav: Thanks for listening guys. If you got this far, you must have listened to the whole thing. And just a huge thank you both for me and pay for actually sticking through and listening to what we had to say and what our guests had to say because I’m assuming you got some value out of it.

Payman: If you did get some value out of it. Think about subscribing. And if you would share this with a friend who you think might get some value out of it, too. Thank you so so much for listening. Thanks. And don’t forget our six star rating.absolutely.

Dentistry was always in the stars for today’s guest, Rob Jacobs. 

Rob’s father Tony is a prominent dentist and founder of the GDPUK website and forum, so you could say dentistry was destiny.

In this episode, Rob gets geeky about his passion and specialism – endodontics. He also talks family and lets us in on what happened during hid dad’s recent brush with COVID. 

Enjoy!

 

In This Episode

01.02 – COVID life and lockdown

02.17 – On dad and growing up

10.49 – What makes a great endodontologist?

15.21 – Insta-endo

19.01 – Heroics, referrals and day-to-day endo

25.42 – On pricing

32.17 – COVID and family values

46.30 – Future and practice ownership

51.03 – Rob’s black box moment

56.09 – To specialise or not to specialise?

01.02.15 – One thing you need to know about endo

01.07.16 – Rob’s last day on earth

 

About Rob Jacobs

Mancunian Rob Jacobs gained his bachelor of dental surgery from Newcastle University in 2012 and went on to work in Manchester as a general dentist.

In 2015, Rob embarked on specialist training in endodontics at Liverpool University, where he also completed a doctorate-level research project on patient-reported outcomes.

Rob currently practices in Garstang, Lancashire.

 

Rob Jacobs: Yeah, and I think we want to make it a smoother journey for the patient. If they can have an endo in an hour and 20 minutes instead of an hour and 50, I think every single person in the world would go for the hour 20.

Prav: And your hourly rate goes up, mate.

Rob Jacobs: Yeah. Well, you sounded like Sanjeev now.

Intro Voice: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki.

Payman Langroud…: It gives me great pleasure to welcome Rob Jacobs onto the podcast. Rob’s a specialist endodontist and we thought it would be good to speak a specialist, especially an endodontist to get their position and particularly Rob’s own position on where everything’s going in endo. Rob, welcome to the show.

Rob Jacobs: Thank you. Great to be here.

Payman Langroud…: It’s been a long time coming. We started talking about this pre-COVID and all of that, but how’s COVID been for endodontists? You guys must be busy as hell right now, right?

Rob Jacobs: Well, it’s a bit of an unknown because we’ve come back. Obviously, we had three months of patients to sort out, and then we’ve had a lot of new referrals because obviously there’s been people in pain and I think, if there’s any time a GDP doesn’t want to do endo, it’s right now with all the additional difficulties in terms of PPE and heat and stress. So, we’ve had a really busy July in both practises. August looks busy as well, but we know there’s uncertainty around the corner because we don’t know how much patients are going to value endo in the coming months. Especially as furloughing finishes and we’ll just have to see which direction things go.

Rob Jacobs: I think your patient who can afford endo, who wanted endo before COVID will still come along, but we don’t know about the other people who were managing but maybe now their job situation’s changed, et cetera.

Payman Langroud…: Rob, let’s start with your dad. You’ve a prominent dad in dentistry, Tony Jacobs, who started GDPUK. Did you know what that meant, the magnitude of that before you became a dentist? He’s been going a long time with that, right?

Rob Jacobs: Yeah. He started that in 1997. So, 10 years old I definitely had no idea. I thought he just spent a lot of time in his office. Wasn’t quite sure what he was up to really, and I think I was much more interested in football and not much else, but it grew and grew. It started out pretty small, just an email [inaudible] between four people. And then it outgrew that to the point where they then set up a website, and it grew and grew and grew, but I think by the time I was in my late teenage years, that was probably where it was at its height, and dad was doing a lot of work along normal dentistry.

Rob Jacobs: He then cut down from five days a week to four so that he had time for GDPUK. So, it’s been a big part of his life. Latter years, it’s become more a hobby again because it’s still doing really well, but obviously Facebook has changed everything. Well, he still sits in the office for hours, but I think that’s just to get away from my mom maybe. I don’t know.

Payman Langroud…: And do you remember conversations with your dad when you were deciding on dentistry? What was he saying about it?

Rob Jacobs: Yeah, so my dad never pushed me towards dentistry at all. I mean, I had a really good upbringing in terms of opportunities I got, but dad never said, “You’re going to be a dentist,” and I never said… I wasn’t one of these who at 12 years old was destined to be a dentist. It was more I got towards looking at the UCAS brochure in the careers room at school, and I kind of ticked through and I thought, “Accounting, no. Lawyer, no. Dentistry looks all right.” It was more of that. And obviously, I’d always had a good experience going to my dad’s. I didn’t mind dentistry, but I can’t say I loved before that.

Rob Jacobs: You get some people that turn up at undergrad and say, “When I was 9 I knew I wanted to be a dentist.” Definitely wasn’t me, but when I did want to do dentistry, my dad was really happy about it, and we’ve had endless hours of chats on the phone since then, which has been amazing for me. But he never pushed me in towards it.

Payman Langroud…: And did you grow up in North Manchester where the practise is?

Rob Jacobs: Yeah. So, we grew up in Prestwich, a little suburb in Manchester. My mom and dad still in the same house since where I was born. My dad’s practise is exactly a mile from the house. He’s never walked there, or he claims he’s walked there once, but he had the luxury of going home for lunch every day, and my mom would have lunch on the table every day even if she was at work. So, he’s had a very nice work life there. And I still live just down the road. We’re actually moving. We’re currently about 10 minutes from my parents’ house, and we’re moving to about 5 minutes away. So, we’re not far away from them, and family’s a big part of our life. Yeah.

Payman Langroud…: And did you used to visit the practise as a kid?

Rob Jacobs: Yeah. So, I think I had a very relaxed dental experience because I didn’t really have any dentistry. I just used to kind of mess around and go in the drawers and annoy my dad, but I’ve always been comfortable in the practise and I suppose I didn’t ever work in the practise. I did do work as a teenager, but we never mixed my relationship with my dad and the practise, but yeah, we’ve always gone there for our dentistry.

Payman Langroud…: When you finally decided to go to dentistry, did you study at Manchester?

Rob Jacobs: No, so I got into Newcastle and Liverpool. They were my two options, and honest reasoning was I just hated Liverpool Football Club at that age. I was a United fan. So, I was like, “No. Not going to Liverpool. Going to Newcastle,” but I did end up there for my post-grad, so it got me eventually. But no, I wanted to get away. I know that dentistry was a bit of a late decision because I suddenly thought, “I need to show that I’ve got hand skills.” Because people bring along musical instruments or different bits and pieces.

Rob Jacobs: So, I decided to build a model aeroplane, but I only ever built one. That was the one I took to my interview. So, I know it was all pretty late in the day, and I was like, “Oh yeah. I love model aeroplanes .” And it got me through. And Newcastle was just a brilliant experience. Absolutely loved it up there.

Payman Langroud…: Good town.

Rob Jacobs: Yeah, really good. And just got away from Manchester and my culture. Just threw myself into something new.

Payman Langroud…: And a lot of dentists hate endo, and then a lot of dentists love endo. Was there a mentor? Was there a something? What happened that made you look at endo? Was your dad saying, “Be a specialist?”

Rob Jacobs: So, my relationship with endo… I can vividly remember phoning my dad in my first week of undergrad training, basic endo skills in the lab or wherever we were. And I just phoned him and I was like, “I can’t do endo. I’m either perforating or I can’t find the canals. This is a nightmare.” And my dad was just laughing down the phone at me and saying, “You’ll be fine. Keep going.” So, it definitely didn’t start as immediately I was just blessed with skills in endo, but as I got out of undergrad, I started realising I quite enjoy the long appointments. I realised at the end of the appointment, “Well, I’ve actually found that quite relaxing.” And I found I wasn’t too bad at it.

Rob Jacobs: I definitely realised early on I wanted to specialise. I felt like I wanted to separate myself from that rat run of being an associate chasing UDAs. I just really didn’t enjoy UDAs from the outset, and I always felt I wasn’t in a very strong position job-wise because I’ve always felt there’s too many associates and it’s not a strong job position. I wanted to kind of separate myself and really get good at something. I don’t think I enjoyed being average at dentistry. I think I wanted to get good at something. And my dad never pushed me to do dentistry, but he did think it was a great idea to specialise. He didn’t push me, but he was very happy when I said that.

Rob Jacobs: But then in terms of mentor, I think really Sanjeev Bhanderi. My dad referred all his endo to Sanjeev. My dad didn’t love doing endo. And I started going to see Sanj I think in… I qualified in 2012. I think in 2014 or 13, I started going to see him for the dad and just spending a day there watching what he did, seeing all his gadgets and asking him lots of questions. And I then started building a portfolio of cases and things just snowballed from there. So, I think Sanj has been a massive part of my endo journey. I don’t tell him too often, but he’s a really good guy and he’s really helped me along the way.

Payman Langroud…: I think Sanj just got this sort of legendary status in endo, isn’t he? I don’t know. Why is that? We hear his name. He’s president of whatever, the Endodontic Society. What is it, BES, yeah?

Rob Jacobs: Yeah. Well, he’s been around in endo for a long time. Since the early ’90s, and he’s well-travelled. So, he qualified in London, then he did his endo bit and pieces in Manchester. So I think he already had a bit of a following in two places, and then in the North West, he’s done thousands of thousands of endo. So, pretty much every GDP knows him. He does really good endo, and he’s also still involved in quite a lot of teaching. Still teaches at Liverpool. He did teach at Manchester and UCLan. So, he’s just come across a lot of people. Got his fingers in many pies.

Rob Jacobs: And I think he does great endo, and he’s got really good standards, which he passed on to… He was one of our supervisors in the post-grad programme at Liverpool as well. And now working for him, which is great and I’m still learning from him. Even now it’s great, I can go up to his room five minutes before a patient comes in, throw a case over his eyes and say, “What do you think? This is what I’m thinking of doing. Would you do anything differently?” And it’s great to have that mentor still there as I’m still developing as a specialist.

Payman Langroud…: What would you say is the difference between a great endodontist and an average one?

Rob Jacobs: Well look, as an endodontist, you’ve got to get good results in terms of… The dentist judges you by the white lines on the x-ray, but I think endo’s moved on a lot from that, and looking at the whole picture of the tooth. I think endodontists are in a great position to make decisions on tooth restorability and how that tooth’s going to be restored. It’s moving on so much at the moment in terms of constellation, changing the way we access teeth, being a lot less destructive. We’ve got amazing files that help us do that in a much more predictable way.

Rob Jacobs: But I think a good endodontist is someone who’s staying up with the times and following all these modern developments, and not just thinking about the white lines, but thinking about the restoration, how that tooth is actually going to last a long time in the mouth, but on a basic level. Periapical lesions have got to heal up, and teeth have got to not be in pain and get better. Otherwise, you’re not going to be busy for long as an endodontist if your patients aren’t getting better.

Payman Langroud…: My sense of it working with endodontists was that there’s one lovely part about it. It’s that you don’t have to really sell anything to anyone, and that’s wonderful, isn’t it, not to have that problem?

Rob Jacobs: Yeah, the patient is usually… I mean, they’re not usually in acute pain because to refer to the dentist, they usually have to deal with the really acute pain, and we see them when they’re all in the chronic pain phase. But they’ve usually got their head around the fact that they’re spending money. It’s one of the most unenjoyable spends of money. It’s like a car puncture. There’s no joy when your car has a puncture or you need a new tyre, and you need to get back on the road. And in the same way, patients know they want to keep the tooth. If they didn’t want to keep the tooth, they wouldn’t be here. It’s as you said, there isn’t really a sale. It’s just this is the price. You do still get people trying to haggle.

Payman Langroud…: How often do you, Rob, hit a clinical wall where you’re not sure where to go and what to do? I mean, how of it is very routine and then how much of it is where you’re coming across something… I don’t know. Broken instruments, perforations, whatever it is. How much of it is that?

Rob Jacobs: I’m still really young in my journey. I only did my specialists training in 2015, qualified in 2018. So, I’ve only been in specialist practise for coming up to two years, but you can feel the change month by month. Coming home, I’m less stressed about things that have gone on in the day. I’m more and more satisfied with outcomes. I’ve got less stress on the way to work about what’s in for the day. I’m less worried about knowing what’s in the book coming up in the day. And more and more cases are going smoothly and kind of autopilot. I think the restorative part of endo sometimes can be more challenging. Obviously, really curved canals, ledges, broken instruments, calcified canals are all really difficult parts of endo, but I just try and follow processes and mental tick boxes.

Rob Jacobs: So, access the tooth, found the canals, have a little celebration in your head. Then get down the canals, little celebration in your head. Irrigate and everything’s gone fine. Operated, everything’s gone fine. And you break down each patient journey, and these things get more and more routine. But yeah, there’s still cases where we can’t get patency, we can’t get down the end of the canals, we can’t remove fracture instruments or everything goes perfectly but the lesion doesn’t heal. And any endodontist that says this doesn’t happen is lying.

Rob Jacobs: I’m really enjoying using Instagram to talk about endo, and there’s a really, really good endo community there, but one of the big things there is a lot of talk about recalls, failures. That wouldn’t explain cases of what is everyone else thinking. All the endodontists pile in from America, UK, Middle East, Australia. It’s great. So yeah, those challenges still exist and they don’t go away.

Prav: Is there any Instagram sort of audience patient-focuses, or is it all dental?

Rob Jacobs: We’re not in it for the patients. It’s not patient-focused. There’s no nice, shiny pictures. It’s nitty-gritty. My aim is to pick up followers that are interested in endo. So, my audience is primarily other endodontists and then there’s the audience of undergrads who I’ve taught and other people in the North West who have either sent a patient to me or come across me.

Prav: Referring GDPs?

Rob Jacobs: Yeah. And then I’ve still got about 50 friends who haven’t realised they really don’t need to be on this Instagram page because they’re never going to find that’s interesting because they’re not a dentist. So, I get a message every now and then saying, “I didn’t want to see that.” It’s not sexy dentistry, 5 out of 5 composite veneers and all that kind of thing targeted solely and younger patients. It’s completely different, but it’s still a thriving community. I’ve not got that many followers, but some of the guys have got between 15 and 30,000 followers, which for endo, it’s a niche environment, it’s pretty good. It’s not general population.

Prav: And just out of curiosity, does that Instagram dentist-specific content generate referrals for you?

Rob Jacobs: Yeah, I’ve had some referrals from it. To be honest, if I had one referral from it, I’d say it’s worth it. I do it on the couch in the evening. My wife finds it a bit annoying, but it takes probably five to 10 minutes to make a post. I think I probably find it quite relaxing in some ways. It’s like a good way to just round up your day, and have another think about it. Or if I get a gap in the day, maybe I’ll post something. I usually have a few things ready, and then when I get time I’ll post them. Can’t actually remember what you asked me now, Prav.

Prav: You answered my question. Do you get referrals, because a lot of people refer to Instagram as this business generator for them. They put some content out there, as you refer to sexy dentistry, and then that generates patients wanting that sort of dentistry. And just out of curiosity more than anything else, as a specialist in the field that’s not dental patient driven, but more referral driven, does it still work for you?

Rob Jacobs: Yeah, I mean last week I had a referral from a dentist, and I always find it really difficult when you need to get hold of the dentist. You phone then and the receptionist says he’s busy. Then they phone you, and you’re busy. I had a look and I saw he’s on Instagram, and I thought, “I’m just going to message him and say, ‘I just want to ask about this case. Do you want me to do the post or do you want to do the post?'” And we then followed each other, and I’ve actually tagged him today because I reviewed another tooth of that patient I’d already done, and he’s restored it really nicely.

Rob Jacobs: So, I’ve tagged him and said, “Lovely restoration.” And he’s really happy that I’ve done that, and we’ve probably kind of cemented a relationship there. He’s only referred this one patient who’s needed two teeth, but I suspect he’ll probably refer to me again now because we’ve opened up a communication-

Prav: A relationship. And I guess that you don’t have the issue of getting patient consent to show an x-ray and some white lines on Instagram, or do you?

Rob Jacobs: We do get consent for everything like that, just because why not? Yeah, we get it in advance. Every patient signs photographic consent. I don’t use them all, but it’s…

Prav: It’s still the same. Yeah.

Rob Jacobs: Yeah, it’s there in case.

Payman Langroud…: Rob, where are we with regards to is endo able to save more broken down teeth than it was 10 years ago? And the question of, “Do we save this tooth or not?” Bearing in mind implants are getting better. Where’s that heading? Are you doing more heroics or less?

Rob Jacobs: I think we went to a position probably just before I qualified where implants were replacing everything, and why bother with a tooth that has a poor prognosis? Let’s just whip it out and do an implant, but then I think we started to find implants weren’t the saviour of everything and they weren’t miracle workers, and they encountered problems as we got more and more follow-up on implants. I think dentists who place implants are getting much better at saying, “Actually, this tooth can be retreated. This is a good tooth. There’s still life in this tooth. You shouldn’t have the implant. Actually, you’ll get another 10 years out of the tooth.”

Rob Jacobs: And I always say to patients, “It’s all about delaying the next bit of dentistry.” So, if you have an implant at 40, you’re probably going to need to have another implant at 60 and it’s going to be more complicated. Whereas if we can get you to 55 before you have that first implant and you have another one at 75, you’re probably not going to be too bothered at 95 if you got some bone loss around that implant. And I think patients are very aware of that. They’re still very keen to keep their teeth, but I think we still have principles.

Rob Jacobs: If a tooth’s got a fracture then usually that’s done for, and I think we still know that if there isn’t a decent amount of tooth structure in ferrule, then we know we’re pushing the boundaries. It’s all about consenting the patients and giving them a prognosis and giving them an outcome. Every single patient I give a percentage, like 1-in-5 risk of this not working, 80% of it being successful, and try and tailor that to every patient. It goes in their letter before they come to see me, based on the radiograph from the dentist and the bit information we have. And then we I see them for the kind of consultation, if I see anything different then we’ll have a chat about that and adapt that.

Payman Langroud…: And Rob, are you having to nurture the referral relationship, the referring dentist relationship as a thing?

Rob Jacobs: In terms of getting referrals or…

Payman Langroud…: Yeah, as in you’ve got the dentist who’s referred you a couple of patients. Sure, you want to do that work really well. I don’t know. Do you guys sometimes send the patient back and say, “This could do with a crown,” and make sure you give that specialist seal?

Rob Jacobs: Every patient who comes, a letter goes back to the dentist and the patient detailing what we’ve done, what’s next. At the minute, we’re putting calls in all our teeth in terms of COVID because the guidelines are saying get as much done as you can when you’re doing an AGP. Max out on the AGP. But at Endo 61, we want to do good work every single time because that’s how you build your referral base. But at Endo 61, I really am piggybacking off Sanj because 90% or 95% of the referrals come to Sanj, and then he basically divvies them out between us based on who’s got space.

Rob Jacobs: There are some referrals that come directed to me and he then passes them on to me, but majority go to him. So really, we’re working on that together and we do open evenings. We do different things to keep that flowing. At Garstang, that practise was kind of… There was an orthodontist, Rachel, who’s married to Finlay Sutton who does the dentures, and there’s a periodontist. They haven’t had an endodontist for four or five years when I got there. So, we were kind of starting from scratch, but we had a really good catchment area.

Rob Jacobs: Garstang’s just north of Preston. It’s far enough away from Manchester, but it kind of captures the west coast like Southport, Blackpool, Lytham down towards north of Liverpool, because Liverpool’s quite busy with endodontists. And then there’s a late district in Lancashire. So, there’s a lot of people living in that area, and there’s many endodontists. So, it picked up really quickly and we’ve got not that many referrers, but a loyal band. And I started out there one day, and now I do two days and it’s busy. And the same with Sanjeev. I think with Sanj, I did one day and he said after my first day he went, “Can you do a second day if it’s not too much work?”

Rob Jacobs: He said, “We’ll review it soon.” And then after one day he was like, “Yeah. I think if you can do another day in a week, that would be good.” So, that just picked up from the get-go.

Payman Langroud…: So, how many patients do you see in a day?

Rob Jacobs: Pre-COVID, if we were just having a day of endo, I would usually see 4 and then there might be a consult or a review, that kind of thing. At Endo 61, I really just do the endo. It’s an endo practise. At Garstang, I’m doing a bit more restorative work alongside that, so I might place a call or call or restore the tooth if the dentists want me to, which is quite an interesting thing. My dad can never get his head around this because he can’t understand why a dentist would want the endodontist to restore the tooth in terms of a financial side of things, and just why wouldn’t the dentist do it?

Rob Jacobs: But we do get people that say, “Can you restore this tooth? Can you crown it?” Maybe they don’t like the patient, had a communication breakdown, trust issues, or they just don’t really want the hassle. They just want the whole tooth-

Prav: Job done.

Rob Jacobs: Yeah, and for us, that’s great. I mean, I think endodontists are in a brilliant position to restore. We see exactly what the tooth looks under a microscope and we’re in a great position to do it. And the training I had at Liverpool was very restoratively-driven. I mean, we can get onto that as we chat, but I think it was a brilliant programme for driving us to think like restorative dentists, not just to think about white lines.

Payman Langroud…: You treat four patients beginning to end, single visit endo, yeah?

Rob Jacobs: Yeah. Well, single visit endo, that’s a topic that’s been going on for 20 years or more about whether that’s a good idea or not, but most of us will do single visit endo if we finish the endo, there’s no leakage and we got time to obturate it. There’s some cases where… I mean, today I’ve had a case that I plan to do two-visit because it look like it was a fractured file, there was a big abscess. So we definitely wanted to do it over two visits. So, some cases we plan. Another case is you open them, planning to do it in one, but you get puss or you get leakage and you need to do it over two.

Payman Langroud…: What do you charge for a molar endo?

Rob Jacobs: So, at Sanj’s practise we charge 745 for every endo whether it’s primary or retreat or whichever tooth because if we get anterior teeth, there’s always a problem. Either there’s a perf, there’s a post or there’s a calcified canal. We don’t get the easy anteriors. So, even though they’re front teeth, there’s usually a reason to charge the same kind of fee, and then £100 more if they need a second visit.

Rob Jacobs: Garstang, very similar. Charge a little bit more for retreat. So, we’re probably going to go to the same model as Sanj. It’s easier for my brain to have the same thing every day and not have to change what I’m thinking on different days. I mean, I’ve now got the same microscope all four days, which is great. We want to streamline things.

Prav: Everyone knows what they’re getting as well, don’t they, when they refer a patient. They know how much it is. They know there’s no flexing the price or anything. It’s just…

Rob Jacobs: There’s other charges that come into things in terms of cores, taking off crowns because a quite a lot of the time, we have to dismantle things and investigate them. Consults, we do consults quite a lot. Wherever there’s any uncertainty, I’ll do a consult. I’ll only go straight to treatment if I don’t have missing information on the referral, or got enough information, but anything where you think there’s a bit of a guided prognosis or you need a chat with the patient. Then I have to give them a phone call or get them in for a consultation, which is another 100 quid or 145 at Sanjeeve’s.

Rob Jacobs: So, it does start to add up, but I think patients who want to keep the tooth, again as we’ve said, they accept that. It costs money. It’s expensive, business, isn’t it? So, I try and plan everything to an hourly rate that I’m trying to hit, and obviously, you don’t hit that hourly rate or that’s something that Fin’s really taught me in terms of valuing yourself and not underselling yourself. I still struggle with that a bit sometimes where I think, “Oh, it feels a bit expensive for the patient,” where actually, I should charge what is needed for the… Yeah. Yeah. Done a hell of a lot of training and it’s cost me a lot. So, I should .

Prav: A lot of dentists struggle with that, undervaluing themselves, and that comes across in their teams as well. So, let’s say it was one of the reception team or nurses, someone talking about you, but you didn’t feel comfortable with the price that you were charging for example, it’s reflected so much further down the line. Obviously, luckily in Sanjeeve’s practise and stuff, that’s probably all taken care of, but I think sometimes it just comes with confidence over time and experience that you can actually say, “Do you know what, I am worth this and I’m worth this hourly rate, and I’m exceptional value for money.”

Prav: I think we interviewed one of the most expensive implant dentists in the UK, and I asked him the question, “Obviously you are at the top premium end of the market, and you’re one of the most expensive, aren’t you? And how’d you deal with that?” And he goes, “No. I think we’re exceptionally good value,” and even though… It’s a mindset thing, isn’t it?

Rob Jacobs: It’s still something that I’m working on in terms of just… Sometimes I put together a treatment plan and it’s kind of edging up towards 1200 quid for if there’s other bits and pieces, and if they have say, an endo onlay at Garstang, then they pay 800 quid for the onlay and a 145 quid lab fee and the patient pays the lab fee. So, it then becomes kind of 1700, £1800 treatment for that tooth. And then you’re very near to an implant, but they get a really high level of treatment. Everything done properly, and a lot of time in the chair. So, I think it’s a fair price to get the job done well.

Payman Langroud…: And what about the way the system’s affected all of this with the NHS stent as being scared of GDC referrals, all of that. Are you getting people coming to you who can’t afford to give you £1000 and finance it, and all of that? Is there finance?

Rob Jacobs: We don’t really get that. I think I’ve had one patient in 2020 do it through finance. It was two teeth that she needed doing and she wanted to do finance. We really don’t get asked to do it. I think it’s probably a clientele thing if I’m honest. I think we get more middle-class patients that have just got a little bit more spare cash.

Prav: Is finance actively promoted?

Rob Jacobs: Not really because we don’t need to, so we don’t. Yeah, we don’t mention it because cooks into the fear in terms of someone’s got to pay that 8 or 9% fee that you generally got attached to it. A lot of our treatment plans are around about the £1000 mark, so most people don’t ask for it. It wouldn’t a barrier, but we don’t actively promote it because we’re busy enough without it.

Prav: And I guess they’re coming in pre-sold, aren’t they? It’s a recommendation from another healthcare professional.

Rob Jacobs: Yeah, and they get their treatment plan and all their information before they come, so they know the price before they arrive at the front door. So, there’s no surprises when they get here. Especially with COVID, we’re really just getting on with the jobs, so they kind of come in, do their mouth rinse and then we crack on because we’re trying to limit all the other bits and pieces that happen.

Rob Jacobs: Yeah, and I think we want to make it a smoother journey for the patient. If they can have an endo in an hour and 20 minutes instead of an hour and 50, I think every single person in the world would go for the hour 20.

Prav: And your hourly rate goes up, mate.

Rob Jacobs: Yeah. Well, you sounded like Sanjeev now.

Prav: You were just talking about hitting your hourly rate, that’s all.

Rob Jacobs: No, you’re absolutely right.

Prav: You’ve got to look at it that way, don’t you?

Rob Jacobs: I think part of that is as you gain more experience, you can pick exactly which case is going to take an hour and 15, an hour 30, an hour 45. Earlier in your career, you book your standard time because you’ve not got that experience to know what challenges are ahead and you don’t want to be running late. Whereas when you’ve done enough kind of sitting on your bum for 40 minutes, you think, “Next time I get this one, I’m going to book an hour and 20 because there’s no need to book two hours anymore.” So, that’s just part of the experience and learning.

Prav: Rob, moving on from saving teeth. Sort of personally how COVID has affected you and obviously your family as well. Do you want to just give us a rundown on that?

Rob Jacobs: Yeah, so like everyone else, COVID didn’t massively touch us early on. Me and my wife went on a pre-baby holiday to Tenerife at the end of February and we were two hotels down from the… If you remember the first hotel that got coronavirus. I don’t know why that none of us in the UK actually realised it was coming for us next, but we felt, “Bloody hell. It’s kind of interrupted our holiday. I’m not quite as relaxed on my sunbed,” and we didn’t really realise what was coming. But then a few weeks later, my dad got ill and we don’t know where, we don’t know if he got it from a patient or… He did go to a wedding the week before and quite a few people at the wedding got ill, but basically, my mom and dad both got coronavirus and we were getting more and more ill.

Rob Jacobs: As my mom was getting better, my dad was getting worse, and he was pretty stubborn. Pretty hard to get him to listen. We felt he needed to go to hospital, but he was adamant that he needs to follow the guidance, phone 111. I mean he was on the phone to 111 for an hour and a half one night and then it cut off. He was like, “Well, it’s cut off. There’s nothing I can do.” And then basically, eventually his doctor said, “You need to go to A&E.” And he went to A&E at about 1:00 on the Friday, and he was on a ventilator by about 6:00 PM. So, it was very, very intense.

Rob Jacobs: So, they did let my mom go in and see him that day because she… Well, they hadn’t tested her. It was in March, so they weren’t up to speed with testing at that stage, but they hadn’t tested her but my mom had all the classic symptoms, and they let her go in and see him. We were able to FaceTime him, and then we didn’t know what was coming next.

Prav: I mean, in terms of the severity of his symptoms and your take on everything in terms of how bad it was, what’s the reality of it all in terms of how things felt at the time when you were FaceTiming?

Rob Jacobs: I mean, we really didn’t know if he was going to make it. My wife’s a doctor as well, and we were both really reading a lot about coronavirus and as well informed as you could be. If you remember at that time in March, there really wasn’t that much information, and it was so early we didn’t know what was what really, but that was when there was that real rush for ventilators and that belief that ventilators are the only way you’re going to survive this if you get it bad. And so, to hear that he was going on a ventilator was just crazy.

Rob Jacobs: I mean, he went in at about 1:00 and he was texting us, and he was saying, “Oh, I’m actually feeling a bit better. I’m on oxygen. Doing okay.” I mean, his oxygen stats were like 80-odd, they were really low. And he did bounce back a bit, and they kind of said, “We think he’s going to need to go on a ventilator.” Then they said, “He doesn’t. We’re going to hold off.” And then you get that relief, and then about an hour later they’re like, “No. He does actually.” Because he’s needing more and more oxygen, and he’s not responding.

Prav: And who was communicating with who at this time, Rob? Were you speaking with the hospital staff? Was it through your mom?

Rob Jacobs: My dad. My dad was like, “I might be going on a ventilator. I might not.” He doesn’t remember anything from March now at all, but he was remarkably with it that day, and he knew exactly what was happening that day. He knew he was going on a ventilator, he was having a tube down his troat and he was getting into a deep sleep, and he knew everything that was happening. My dad was really well-read on it as well, and he knew how serious it was. So yeah, it was awful and we really didn’t know if he was going to make it. He did have quite a lot of the risk factors in terms of being over 60, male, overweight. We say a bit of high blood pressure, but hypertension.

Rob Jacobs: And yeah, it was so unknown we didn’t… I read every study there was to read in March from China about everything. I said to my programme director for my endo specialty programme, I said, “Think I’ve read more papers in the last week than I did in the last three years,” but I really just wanted to know as much as I could. I don’t know if it did me good, but for me, that felt like the only thing I could really do. And then it was just a case of phoning the hospital. That took over life. So it was wake up, my mom would call in the morning. My mom’s not medical, my mom would just get the kind of, “He’s okay.” Kind of job, and then we’d call in the middle of the day, and then later in the day, but you’re have this guilt phoning because it was so clearly overrun. They were in all this PPE. It was a big effort to come to the phone, so we had this constant battle of…

Rob Jacobs: Two hours after a phone call, you were desperate to phone again, but you didn’t want to interrupt the staff. About 10 days in, they requested that every visitor stops calling and they were going to start calling us instead because they couldn’t keep up with it, but that didn’t work out too well because they were too busy to do that as well. So then communication dropped for about a day, and then every family thought, “Screw this! I’m phoning up because you didn’t actually keep your end of the bargain,” which was because they were so overrun. But yeah, every day we got as much information as we could. We had a lot of help because my wife’s medical friends… We had doctors in ICU in other parts of the country. They were amazing. They gave a lot of information of what to ask because it’s really hard to know what to ask.

Rob Jacobs: You would jump on things. They’d say, “His oxygen requirements are a little bit lower,” and you think, “Oh, that’s good.” Then you’d phone up three hours later and, “So, he’s oxygen requirement’s have gone up a bit.” Oh, shit. That’s not good. So, everything was just-

Payman Langroud…: You realise when you get involved with hospitals and doctors that even when you’ve got all the connections that you’ve got all. Prav is a doctor himself, or my brother’s a doctor and all my best friends are doctors. Even with all our connections, you’re left in the dark and it makes you helpless. Someone who hasn’t got any of this. It’s almost like ignorance is bliss in a way, but just a member of the public who doesn’t know any doctors, where do they stand?

Rob Jacobs: If it was my mom, she would have just phoned up for 21 days, saying, “How’s he doing? Is he okay?” But all they ever said was, “He’s very poorly, but he’s stable.” That was all we really ever got.

Payman Langroud…: So was he on the ventilator for 21 days?

Rob Jacobs: Yeah. He was on a ventilator for 21 days, and I saw him about a week in because they were talking about getting iPads so that we could see him, because obviously we couldn’t visit, but then eventually one of the nurses said, “Do you know what, I’ve actually got my phone on me now. You can FaceTime my phone number,” which was amazing. It was awful seeing him on the ventilator, but I don’t know if I regret it or not, but anyway, we got a happy ending. I think my brain needed to see what was actually going on, what he look like, but then we got to FaceTime him when he was on coming off the ventilator, which was amazing in a different way.

Rob Jacobs: When I knew my dad was coming off the ventilator, I was just waiting for him to come on his phone because he loves his phone as much as me. And the WhatsApp was saying, “Last seen: 27th of March,” and it was April the 19th or something. And then he just came on one night, and when it said, “Online,”.

Payman Langroud…: The blue ticks, eh?

Rob Jacobs: Yeah, though he came back to WhatsApp in a funny… He came on and said, “Yo. Yo y’all,” which is not the way my dad speaks. He had a lot of hallucinations coming out of it, but he’s now doing really, really well.

Payman Langroud…: What’s he left with? Is he left with some…

Rob Jacobs: Well, he went for a follow-up last week to ICU, which was really good for him, I think. His lungs are completely fine by the looks of it. Well, we don’t know the long terms, but everything’s been okay. He was the ninth person to go on ICU in North Manchester, which is a big hospital in Manchester, and he was the first one not to have kidney failure. And they said they based a lot of their treatments off what worked on him. So, I think he feels quite happy about that. We found out that they were experimenting a bit on him, which is fine, and they also ran out of sedation drugs. So, thankfully we didn’t know this in April.

Rob Jacobs: So, there was quite a lot of challenges, but his main issues he’s got now is he’s got neuropathy in his legs. So, both of his legs are not feeling right, which is a consequence of a long stay in ICU rather than coronavirus. It’s a post-ICU complication, but it’s effecting his walking. He’s not back at work. He’s not ready to go back at work, but he’s walking more and more, and he’s walking quicker and quicker. He’s really determined. He did a 20 minute mile a few days, which he was happy with. I think he would have been doing four miles an hour before this, and now he’s struggling to do that. He’s not played golf all year. He tried to go to the driving range yesterday. I mean, he was crap before coronavirus. I think he’s done for now, but he’s due to be captain next year at the gold club, so he wants to get back to playing golf.

Payman Langroud…: Do you find it’s redefined your relationship with your parents in any way?

Rob Jacobs: Well, in the middle of that, we’ve also had a baby.

Payman Langroud…: Of course.

Rob Jacobs: So, we had a baby on May the 20th, so dad was home for that, which was just amazing because that was obviously weighing heavy.

Payman Langroud…: God. Difficult time for you. You have a pregnant wife. Both parents, corona. Difficult time. Sanj.

Rob Jacobs: Yeah, but no. You appreciate your parents and we’ve had an incredible kind of summer in the garden, really. I mean, even when my dad was in ICU, we did break the rules. We went down to see my mom every day in the garden because she was by herself. We had an incredible time. I’ve never seen my mom so much, and she saw my wife every day more and more pregnant. My sister and my sister-in-law are also pregnant. So, we’ve got three babies… They’re due in about two weeks. So, we’ve got three babies arriving in three months, and my dad is now loving it, and he’s

Payman Langroud…: So, wow. 2020 is going to be defined in your family as such a crazy, interesting year overall.

Rob Jacobs: Yeah, a lot has happened. But no, my relationship with my dad has just kind of gone back to normal. We had that week of absolute euphoria that he was here, and then I got my first telling-off. I think I was pulling leaves off his plants in the garden. “What are you doing?! What are you doing that for?!” And I was like, “Oh, good. Dad’s back.”

Prav: Dad’s winding you up.

Payman Langroud…: How many brothers and sisters are you?

Rob Jacobs: I’m the youngest. I’ve got an older brother, five years older, and a sister in the middle. My brothers got a three year old and another one on the way in three weeks. My sister’s got two and another one on the way in a week, and we’ve just had a baby. So, there’s a nice busy family developing. And we all live within about five minute walk, the three siblings. So, we see a hell of a lot of each other.

Payman Langroud…: So, I know Jonny. He was involved with GDPUK for a while.

Rob Jacobs: Yeah, so my brother, he was doing the advertising with my dad, but he’s moved on and he’s now working in sales, kind of a different world. And my sister, she’s trained in law, but she does HR now in a smaller company, but she’s been in maternity leave for years, so on and off.

Payman Langroud…: So, did you kind of think, “Do you think one of us could be a dentist?”

Rob Jacobs: Well, it wasn’t going to be my brother. He’ll admit that himself. I think he’s just smoking weed when he was 16 or 17.

Payman Langroud…: Good on him.

Rob Jacobs: He still denies that, but we all know it’s true. My sister was kind of very academically driven, but not in any way interested in being a dentist or anything medical. Didn’t like blood or giving local. It just wasn’t for her. I think it just suited me, suited my brain, but it was never like an ongoing joke, “One of you needs to be a dentist,” or “One of you needs to follow in the dentist.”

Prav: Footsteps.

Rob Jacobs: Yeah, and even becoming a dentist, there was never really any talk about working at my dad’s practise or taking over, which some people find crazy. In summer, I wouldn’t take over my dad’s practise, but I’ve always thought my dad’s worked hard for that practise. He deserves to get a good price for it in the end that he’s done all that graft for. And then if I was going to buy a practise, it wouldn’t be the one to buy for me because I’m going in a different direction. So, we had a very brief talk about it, about could we convert this into an endo practise, but the whole goodwill of the practise is based on the general practise. So, it never really made sense to us.

Prav: Is practise ownership in the sort of peripheral vision for you in the future? Is that where your ambition is? Have you got that in your blood in terms of where you want to go, do you think?

Rob Jacobs: I think it’s something that everyone thinks about. It’s not something I’m in a rush to do at all. There’s so many other things going on in life. As an associate, obviously you don’t take as much of the fee home, but you don’t take all the stress, all the other stuff that comes with being a practise owner. And I look at the job, and I think it looks stressful. I think Sanj always said, “Get good at your endo, and when you get bored of endo because it’s kind of subconsciously happening and you’re on autopilot in 10 years times.” I think that’s when he thought, “I’ll buy a practise now just for a fresh challenge.” Reinvigorate your career.

Rob Jacobs: But right now I don’t feel the gain financially would be worth it for the loss of quality of life, for what I have because I have a great quality of life at the moment. I do my paperwork at work. I dictate my letters, they go to a friend’s mom on Dropbox, then she gets them back to me within about four hours. She’s awesome. And I usually read them the next morning, and then they get sent off, and that’s that day gone, consigned to history. On a Friday when I finish that, that’s it. I leave and I come back to work Tuesday.

Rob Jacobs: So, I love that element of it. I really want to make sure I spend loads of time with Sammy and also with kids in the future. We’re looking to move house at the moment. So, there’s just other stuff going on in life, and I’m really happy with the jobs that I’ve got and just continuing my development. Right now, I think it’ll come when I need a fresh challenge in my career maybe, but right now, and of course Sanj keeps me busy during the day, still thinking.

Prav: And it’s very, very easy from the outside looking in to sort of maybe think about how lucrative it is, practise ownership, but you’re right, there’s so much stress that comes with it, but also losses. Let’s say you go from now to practise ownership, there’s the investment. You’ve got so much positive time to spend with your little one, and other new ones coming into the family, right?

Rob Jacobs: Yeah, and doing specialists training was a massive investment. I done three years of dentistry after dental school, and then my wife took a little bit of time to get onboard because the course was £17,000 a year at Liverpool and that was without a job. So, three years times that without a job. I think it was at least £300,000 investment and when I told my in-laws, they thought I was a bit crazy at first, but everyone came around to it very quickly and saw why it was going to be a good career move.

Rob Jacobs: At my wedding day, my brother said, “What Monica got, she got engaged to a dentist and she’s marrying a student.” It’s worked out in the end. It was a tough few years though. We made a lot of life changes to do the specialist training. We moved house. I had got myself an A-Class. I had a Corsa, got myself an A-Class and I was happy, then I went back to a Corsa, which was really shit. Well, I eventually managed to get back in a car that I enjoyed driving, but we made life changes to make it work. And Monica’s work kept us going. Managed to do a bit of endo along the way and did a bit of teaching at Liverpool, which I would have just not got by without those extra bits alongside it, but it was tough.

Rob Jacobs: So now, I’m earning well now, but I’m not having that pressure. I get to leave the work behind. I’ve got a good relationship with all the staff because I’m not the boss. I’m the person they can have a laugh and a joke with, and tomorrow we’ve got an early start, early finish. Finish at 2:00 and I’m playing golf at 3:30. Not told the wife yet, but… It means I get some quality of life. Work takes over too much anyway, so I think with that it would take me over the edge. I am looking at it. I’m reading about endo, looking at stuff too much in the evening and that’s something I still need to work on, but I think I’ve got the balance as good as I could at the moment.

Payman Langroud…: Rob, we’re asking everyone about clinical errors, like a Black Box Thinking, to try and learn from them.

Rob Jacobs: From an endo perspective, I’ve done everything.

Payman Langroud…: Everything wrong?

Rob Jacobs: From missed canals, perforations, fractured files. Touch wood, I’ve not had a hypo accident yet, but I will have one.

Payman Langroud…: That’s always a nightmare, isn’t it, that.

Rob Jacobs: And it terrifies me for the day that it happens, and every endodontist-

Payman Langroud…: Prav, you know what that means, Prav?

Prav: Got no idea.

Rob Jacobs: Sorry, Prav.

Payman Langroud…: The bleach they put in the tooth, sometimes it comes out the end and then you’ve got Domestos in the…

Rob Jacobs: Yeah, you get a severe kind of immediate reaction. It’s very painful, very unpleasant. And the problem is as well as the patient shitting themselves, the dentist would also shit themselves, and every endodontist admits that it’s the one thing you really don’t want to happen because it’s really unpleasant for the patient. It’s usually resolved in a few weeks, but it’s a lot of bruising, bleeding, lot of pain.

Prav: So, just explain that again. You clean the teeth out with some pretty powerful stuff, and what-

Payman Langroud…: Bleach.

Prav: Bleach, and that leaks into the oral cavity basically?

Payman Langroud…: No, into the bone.

Prav: Oh, into the bone?

Rob Jacobs: Yeah, so if you extrude that irrigant out of the end of the tooth, you get a very big reaction immediately. So, we use the irrigant really safely. The difficulty is you want to get that bleach as close to the end as you can, because you want to get the end of the tooth clean but without having any instances. So, there’s a lot of things that you do to make things safer. You do those every day and it’s something that I’m always very careful of how I use the irrigant, but you have to also make sure you’re not just tickling it up at the top of the tooth or you won’t.

Prav: Got to be thorough, right?

Rob Jacobs: Yeah, you got to be thorough.

Payman Langroud…: Have irrigants not moved on? Is it still hypochlorite?

Rob Jacobs: Still hypochlorite, yeah. Other things have come in the market, but hypochlorite’s tried and tested. No one has moved away from that. Different things come along the way in terms of activating that, but at the end of the day, bleach is what fixes the problems.

Prav: And you know that’s going to happen one day, don’t you?

Rob Jacobs: Yeah, it will. It’s like a car crash. If you do enough driving, you probably will have a car crash.

Prav: So, is that something that’s happened… Obviously you speak to people like Sanj. Has it happened to Sanj before? Or you can’t speak on his behalf?

Rob Jacobs: I can’t be sure. Any endodontist that work a long time, it will have happened. There’s a really great Instagram endo podcast, another podcast.

Prav: Flipping heck. That’s niche.

Rob Jacobs: Last week they did… Yeah. They did endo mishaps and it was two guys in America. Really, really prominent endodontists talking about their hypochlorite accidents and how much it stress it was. It’s something that I think any endodontist isn’t secretive about it. It’s something that will happen. It’s like some kind of implant-

Prav: Implant failure.

Rob Jacobs: It’s like implant. Yeah. I think if you do enough implants, you’ll have that catastrophic failure that’s just really stressful and awful, but for me, dentistry is all about being open and not… I think maybe in the past, people hid behind these things and say, “Oh, no. Nothing bad’s ever happened to me,” but we’ve become a lot better at one, having open disclosure with the patients, and when you have something go wrong, tell the patient straight away. I’ve learnt that myself. Whenever something happened and I didn’t disclose it, it caused me much more stress when I got home, if something hadn’t gone as perfectly to plan.

Rob Jacobs: And then my wife would say to me, “Why don’t you just tell the patient and you won’t be talking about it on the couch. You’ll just tell them. They’ll accept it because procedural errors happen. It’s difficult sometimes. And then you’ll carry on with your night.” And I’ve learnt that it’s much better to be open and then move on, and also tell patients before. If you tell a patient before, it’s part of a plan. If you tell them after, it’s just an excuse.

Payman Langroud…: Yeah. Look, hopefully you’re going to have a long career. In that long career there’s going to be a few disasters, and there’s going to be a few mistakes and things outside your control even.

Rob Jacobs: There’s stuff that happens that you can’t prevent. I mean, I did an endo in my second year of practise. Everything went well. Two years later, a bit of his tooth broke off and he made a complaint against me. It was in my first week of my specialists training, and it was just like, “What the hell?” So, just at the start of endo specialist training, someone made a complaint about an endo. And then it turned out that we just gave him back whatever I was charging at that time, 400 quid I think it was and said… It wasn’t really my fault that a bit of his tooth broke off two years later, but I think I was still at my training and I thought, “Move that problem away and carry on.”

Payman Langroud…: If I was a young dentist and I wanted to specialise, give me the case for specialising in endo number one, and number two, your best advice after that. I’ve decided I want to be an endo specialist, I’m two years out. Or even before that. Let’s say I decided I want to be a specialist in uni. Are you one of those that believes that you should have a few years of generalist and then move on, or get as quickly as you can into the specialist like the Americans do?

Rob Jacobs: I think in terms of why to do endo, well, there’s many questions there, Prav. But why to specialise I think, as I said at the start, separating yourself, having a niche. I think in 2012, the kind of cosmetic dentist hadn’t really come around as a… We saw implants as the kind of specialty that wasn’t officially a specialty. We now have really the kind of cosmetic dentistry as almost a specialty now. So many people, that’s what they drive towards from an early part of their career and the whole kind of Instagram dentistry didn’t exist. That wasn’t really an option, and that’s what’s really enticing people at the moment.

Rob Jacobs: But for me, I love endo because you fix people, you get a kind of immeasurable improvement very, very quickly. They’ll phone you the next day and say, “That tooth has been hurting me for a long time and it’s better today,” which I love. If you do ortho, you don’t really find out if they’re happy for two years. Perio never really interested me at all. I wasn’t set out for implants. So, endo was just the thing that suited me. You have a nice relationship with the patient, but you also have in some ways quite a nice in that you see them. Then you put the rubber dam on, you get on with your work and then you move on.

Rob Jacobs: And also, I’m a bit OCD. I like the protocol, the procedural steps. It suits my brain and I suppose I liked being spoon-fed. I went to school where you got told, “Do this. Do this. Do this and you’ll have success.” I love with endo, if you’re a good rule-follower and you can follow steps you get good success as well. So it suits my brain.

Rob Jacobs: In terms of specialising, I think most unis want at least 2 to 3 years experience. They want varied portfolios, did some hospital jobs, maybe some MaxFax. You’re going to try and get to do an audit or some kind of paper. If you can get your name on a publication, that helps you massively. But for me, Liverpool started that programme in 2014 just as I was gaining interest in it. London was the only other place really to do endo training, and that was just not viable financially for us. Moving to London would have just been a step too far, and so that Liverpool programme just came at the perfect time, but I didn’t really have the CV that you should’ve had.

Rob Jacobs: But basically, I went to Liverpool and met the programme director Fadi Jarad, who’s been another massive influence on my career, and we just got on really well. And that was probably what got me into the programme, to be honest. We just clicked and then I survived the interview, it went okay, and I think because I was an early adopter there wasn’t so many people applying. Whereas now, six, seven years later, everyone knows about it. You need a lot more on your portfolio.

Payman Langroud…: And on the imaging side, is it something… Back in my day, there was no talk of doing these CBCTs on teeth for endo.

Rob Jacobs: Yeah, so CBCTs are coming more and more into endo and probably-

Payman Langroud…: Just explain that to me. You sort of take a volume and then sort of visualise the canal as you go up and down it, is that what it is?

Rob Jacobs: Yeah, so traditionally, we only had a 2D image of the tooth. So we just had an image that you sometimes didn’t know exactly what was going on with the tooth. You were left with answers. You try and take multiple radiographs to get as much information as you could. The CBCT gives you way more information about… For example resorption, it’s becoming pretty much a must resorption because you can picture so much better where that lesion is, what it’s involving, whether it’s treatable, finding canals, lesions in terms of how big they are, which teeth they’re involving.

Rob Jacobs: So, I’m probably doing a few scans a week that I’m sending off. Currently, I send to a place in Altrincham and the patient goes there and comes back, and then the scan gets reported by a radiologist, but ideally, you’d want to have a scanner in your practise. I think the cost of them is coming down and-

Payman Langroud…: Is it the same scanner as they use for implants?

Rob Jacobs: Well, you want very, very good resolution for an endodontic scan, whereas for an implant you don’t need as much fine detail, but the scanners are getting better all the time. The endo scanners are expensive, but the best of the market for endo you’re looking at 70 to 100,000 quid. So, it’s big money.

Prav: It’s a lot of 750 quids that, isn’t it?

Rob Jacobs: Yeah, but I think they work best in practises that have a lot going on. But I think they’ll get cheaper and they’ll become more mainstream. The place in Altrincham’s a bit of a conveyor belt. They’ve got quite a few scanners. They’ve got appointments every 10 minutes. You book it online, the patient gets an email. It’s very slick. And they’ve got parking there. The patient goes, they have the scan, they leave. So, it works pretty well, but obviously it would be a lot better if we could have it onsite.

Rob Jacobs: The Americans use it. They use it like sweets. They do a CBCT at the start of the case and they do another one at the end just to see how nice the white lines are, but the UK, we’re a lot more… In terms of radiation, we’re a lot more careful. We really justify its use because it is a bit of a higher dose of radiation, but the more you use it, the more… It’s like a microscope. It gives you eyes into a new world of information, and the more you use it, the more you think, “I need this on my next case.” So, it’s going to become bigger and bigger, and eventually it will be a routine thing in endo. Probably by the end of my career or even earlier.

Payman Langroud…: What’s one thing that general dentists don’t know about endo that you wish they did?

Rob Jacobs: So much. I mean, I did a lot of teaching on the undergrad clinic, which is the closest I could come to kind of working with GDPs. In some ways, they’re probably in a better position than GDPs because the teaching’s fresh in a mind. They’re not taking shortcuts, and they loved having… The endo programme at Liverpool, it just had general dentists coming in to supervise it and the general dentists… I remember from my own undergrad days, the general dentists is kind of hanging it on with you during the endo because they don’t probably love endo either, whereas having us looking after them, they loved it, and we give them a lot of tips.

Rob Jacobs: But I think the key things, rubber dam is not difficult to put on. You can learn how to do rubber dam in a few hours. I think COVID has had a great impact on people finally getting more routine with rubber dam because it keeping them safe from saliva, but it’s an essential. I think it’s crazy when people don’t use rubber dam because you do drop files, and with a rubber dam it just goes onto the sheet and you pick it up. I had a mate in fourth year uni, my housemate dropped an F tooth hand file, which Prav, it’s a big file for a non-dentist and it went down the patient’s throat, into his chest and he was with the patient till 11:00 PM on a Friday night. He won’t mind me talking about this. He took it well.

Prav: Just give me an order of magnitude of this thing in terms of… Can you compare it to something?

Rob Jacobs: It’s about an inch long. It’s got a big handle. You wouldn’t want it in your left or right lung.

Prav: Right, okay.

Payman Langroud…: Like a serrated edge.

Rob Jacobs: And I think he needed surgery to get it out. Surgical procedures to remove it from his lung. Actually, the funny thing was he had rubber dam on, but he’d left a gap just between the patient’s upper lip and the rubber dam, and then it slipped out his hand and got through the gap. When you put rubber dam on, make sure you cover the whole mouth. That’s the other thing. It also allows you to use hypochlorite. Without rubber dam, you can’t use hypochlorite and you can’t get the tooth clean. One thing I would say is up skill in your rubber dam. It makes your life so much easier. And not having tongues, saliva, or the patient chatting to you makes your life easier as well.

Payman Langroud…: But what about regarding the endo itself?

Rob Jacobs: Regarding the endo itself, I think again, so many steps, but magnification. You’re not going to have a microscope, but having loops of a light gives you a much better chance of success. Just investing in some decent equipment, going on courses, up skilling and being confident to actually tackle the kind of simpler cases in endo because a lot of people have been scared off by the litigation. They just don’t really to touch endo and it is something that everyone can do. There’s a lot of good courses you can do just for refreshers, and it’s not a kind of dark arts that people see it as that they don’t ever want to go near.

Payman Langroud…: Is there an endodontist that teaches GDPs, like a Tif Qureshi of endodontics, a Hatem Agathy, Ian Dundith, someone who’s ruining it for the rest of you.

Rob Jacobs: There’s a few of them. There’s a few of them. I mean, Sanjeev is one of them.

Payman Langroud…: Sanj is one of them, yeah.

Rob Jacobs: In the North West, there’s Sanj. James Darcey is a younger guy who’s really doing well. Kreena Patel down in London, she’s doing great. So yeah, there’s quite a lot of us who are doing stuff and there’s a lot of weekend courses for the dentist, and they’re brilliant. You can pick up a lot of tips and get a lot more comfortable doing endo just from a weekend course. Everyone just wants to go on the composite courses or the implant courses, but there’s a lot to be said for going on your more everyday-dentistry courses. Especially earlier in your career. I did them and that’s part of where I get my interest in endo.

Payman Langroud…: Do we look forward to the Rob Jacobs year course?

Rob Jacobs: Yeah. Definitely something that’s in my plans.

Payman Langroud…: Is it?

Rob Jacobs: Yeah, there’s also kind of Jon Cowie down in Bath, they do a brilliant programme, and Massimo. Yeah, Massimo Giovarruscio.

Prav: I know Massimo.

Payman Langroud…: Is that in Bristol?

Prav: Yeah.

Rob Jacobs: So, Massimo’s got a great programme, Delta Dental Academy. So these things are happening, and yeah, there’s no reason not to have that up in the North West as well. Just waiting for Sanj to retire.

Payman Langroud…: Does he work with Alfonso?

Prav: Yeah, he’s a character and a half, Payman.

Rob Jacobs: Yeah, he’s a great guy.

Payman Langroud…: Same as Alfonso. What Prav, do you think he’s too young? He’s too young for your final question.

Prav: Far too young, mate.

Payman Langroud…: No, mate. No, mate. No, mate. Corona.

Prav: All right. So Rob, it’s your last day on the planet and just as you were in that situation where you thought maybe it would have been the last time you saw your dad on a nurse’s iPhone, imagine it being the last time somebody sees you, whether it’s your kids, your future kids, your parents. What three pieces of advice would you want to leave them with?

Rob Jacobs: I’d say put your family first because we all get drawn into the work, work, work part of life, but your family is the most important bit when it all comes down to it.

Prav: For sure.

Rob Jacobs: Be kind and generous, and just be a good person. Be compassionate. Care about other people. And I think third lesson for Sammy would just be be a big United fan. I’m encouraging him already, started brainwashing and very important part of life.

Prav: Brilliant. Brilliant.

Payman Langroud…: It’s been lovely having you, mate.

Prav: It’s been great, Rob, and me walking away from this conversation what is truly, truly clear to me is obviously the first thing that you mentioned is family is everything, right? Well, the second thing which is without question, you are a rising star in dentistry and you are so fricking passionate about endo, so geeky about it that you will make a name in this industry. I know you will, whether it’s as an educator or practise owner and stuff, because you are so driven and passionate about it. Whether it’s sitting on the couch reading about it or-

Payman Langroud…: I’ve been on his Instagram. You should have a look at that. That’s a little endo on there.

Prav: I’ll check his x-rays out, mate.

Payman Langroud…: It’s actually impressive. It’s actually impressive.

Rob Jacobs: Yeah, I am an endo geek and I’m proud of it.

Prav: Good. Good.

Payman Langroud…: Thank you so much for doing this, Rob.

Prav: Thanks for your time, mate. Really appreciate it.

Rob Jacobs: Thanks very much.

Payman Langroud…: And really, the next time you see dad, do certainly send him my regards.

Prav: Likewise.

Rob Jacobs: I will do. He’s got time to listen to this, so I’ll make sure he does.

Prav: Brilliant.

Payman Langroud…: Brilliant. I hope you tell him that.

Rob Jacobs: Cheers, guys.

Prav: Bye.

Outro Voice: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki.

Prav: Thanks for listening, guys. If you got this far, you must have listened to the whole thing and just a huge thank you both from me and Pay for actually sticking through and listening to what we’ve had to say and what our guest has had to say because I’m assuming you got some value out of it.

Payman Langroud…: If you did get some value out of it, think about subscribing and if you would share this with a friend who you think might get some value too, thank you so, so, so much for listening. Thanks.

Prav: And don’t forget our six star rating.