Month: October 2024

Payman Langroudi: You must have had the conversation about sort of rebranding all of them in the same brand, [00:00:05] because they’re all in the same area, same area. And when there’s that concentration in [00:00:10] the same area that the branding thing actually makes a lot more sense. Yes. Have you have you thought about [00:00:15] that?

Polly Bhambra: So we we thought about rebranding under Dental. Yeah. Payman. [00:00:20] We learned very quickly, very early, very quickly that each practice has their own [00:00:25] idiosyncrasies. Yeah. And if you are a little practice, two surgeries in a little [00:00:30] village in Codsall, and then all of a sudden you’ve been bought out by Dental. Oh, my [00:00:35] God, it’s gone all corporate. Yeah.

[VOICE]: This [00:00:40] is Dental Leaders, the [00:00:45] podcast where you get to go one on one with emerging leaders in dentistry. [00:00:50] Your hosts Payman Langroudi [00:00:55] and Prav Solanki.

Payman Langroudi: It gives me great pleasure to welcome [00:01:00] Polly Bambera onto the podcast. Polly is a owner [00:01:05] of a group of dental practices, a part owner of one of three. I guess [00:01:10] that’s why they’re called Tri Dental, because there’s three of you, um, a group of ten dental practices [00:01:15] in the West Midlands. Polly’s own history is very interesting. Started as a dental nurse, [00:01:20] um, and with your brother and a dentist. Started [00:01:25] this group. They’re not branded, are they?

Polly Bhambra: They’re all individual, um, under [00:01:30] their own names that we bought the practices under.

Payman Langroudi: So you bought all of them? Existing?

Polly Bhambra: Existing? Yes. [00:01:35] All existing retiring dentists. So we thought we could purchase these practices [00:01:40] and add value to them.

Payman Langroudi: So we’ll get we’ll get to your backstory because I’m very [00:01:45] interested in your backstory, but I like to start with the burning question in my head. And the burning [00:01:50] question is, as a nurse, someone who’s done nursing. Yeah. How [00:01:55] different is it for someone who works as a nurse in the group now. [00:02:00] What have you done differently? You know. What were the. What are the frustrations that itch that you scratched? [00:02:05] Do you are your nurses in a different situation than everyone else’s nurses?

Polly Bhambra: Yeah. I remember [00:02:10] being, um, when I was nursing Payman. You know, the dentist on the spot would do [00:02:15] treatment, and, you know, patients come in for a check-up and they’ll just do a treatment, [00:02:20] run into lunch. You’d work through your lunch and you didn’t say anything, and you just got on with it. [00:02:25] And we’ve tried to really change that, instil that in our dentists that we’re a team. Everybody’s [00:02:30] equal. Running into lunch is not acceptable. The long days as it is. And [00:02:35] nurses, dental nurses, it’s quite challenging in the fact that you want everything [00:02:40] to run smoothly. So, um, we’ve changed. I’m really restricted. Dentists running into [00:02:45] lunch hours, running late. Um, and if you are wanting to run late [00:02:50] or you want to do a patient after work, it’s not just a given. A nurse will be available. You’ve got to [00:02:55] ask your nurse. Are you happy for that? If you can’t do it tonight. Can it be another night? So it’s a mutual respect [00:03:00] for each other. I ensure that our equipment and materials are readily available. [00:03:05] There’s nothing worse. As a dental nurse, you’re running in and out of surgery because you haven’t got the stock [00:03:10] or your suction stop working or something’s not right. So we really try hard as [00:03:15] as a group to ensure that our equipment is up to date. No surgeries have got air con, [00:03:20] you’ve got intraoral cameras. So there’s other ways of having conversations. And nurses [00:03:25] are involved in that patient’s journey. We love for our nurses to scan all our patients. [00:03:30] We’ve got itero scanners and other scanners within the group. We want them to [00:03:35] excel, to carry on, to do other roles as TCO front [00:03:40] of house marketing. So it just doesn’t stop. As a dental nurse, there’s no such thing as I’m [00:03:45] just a dental nurse that’s gone for me. There’s no such thing as [00:03:50] I’m just a nurse.

Payman Langroudi: It’s a big issue in our profession. Yes, that is difficult. [00:03:55] Not impossible as you’re showing. Right. But it’s difficult to organise career progression [00:04:00] within practices. You get lots of breaks. I’ve been to thousands of practices. [00:04:05] Where? Yes, you’ve got a receptionist who’s been there for 22 years. Yes. Doing the same job for 22 [00:04:10] years. Or a nurse who’s been there for years and years. What are you doing about progression, or do you have stories? [00:04:15] Do you have stories of someone who joined you at 17 and is now regional manager or something like that? [00:04:20]

Polly Bhambra: So we’ve got, um, our success stories, I would say. So [00:04:25] it just goes back from recruitment. When we recruit, we look at can they do the job? [00:04:30] Have they got the qualifications? Will they do the job, the mindsets or the attitude? The [00:04:35] skill set? Will they fit in? And the fourth element [00:04:40] of that recruitment policy is can we help them develop. So can we help them develop this. [00:04:45] You know, you’re a trainee nurse. You’ve become qualified right. Get onto the radiography course. [00:04:50] What else can you do. Suture removal, impression taking, scanning the TCO role. [00:04:55] And I’ve got one of my nurses who started back with me about 15 years ago at [00:05:00] one of my practices. She started off as a trainee straight from school. She’s our lead nurse [00:05:05] and as we are developing, she will probably become sort of my clinic [00:05:10] manager, the ops manager for this particular practice, which is nine surgeries and she’s [00:05:15] got all of her post qualifications. We’ve supported her. She went on to the implant training course. [00:05:20] So she’s implant trained, she’s radiographer. She’s done, you know, all the other [00:05:25] post-operative qualifications that you possibly can. So there is room for development. But it also [00:05:30] comes back to the nurses that they want to develop.

Polly Bhambra: Some are happy just coming in, doing [00:05:35] the job, going home. But it’s important that there’s a process that they [00:05:40] follow when you are on site. You know, one of our other receptionists, she was a receptionist, non [00:05:45] dental non-clinical from retail and now she’s our head receptionist. And [00:05:50] when I mean she’s got reception on lockdown, she is amazing and [00:05:55] everything has a process, so it negates the whole blame. Like she didn’t do this or [00:06:00] he didn’t do that. That’s why it’s gone wrong. So it negates all that blame culture moving [00:06:05] away from that, where people were too scared to speak up if they’d made a mistake [00:06:10] or they’d broken something and they obviously I don’t have poker face, [00:06:15] but they can say, Polly, your face gives it away when somebody comes and tells you that, oh, I’ve broken [00:06:20] the apex hook and I’m trying to be, oh, it’s okay, accidents happen. But my face [00:06:25] is saying something else. So we’ve moved that blame culture away. So speak up. Have [00:06:30] a voice, you’ll be heard. But let’s move together. We all make mistakes. Let’s move together [00:06:35] and we can resolve them.

Payman Langroudi: And look, these. You’ve become ten practices by acquisition. [00:06:40] Yes, yes. Do you sometimes buy a practice? And then once you once [00:06:45] you’ve bought it, the staff are just amazed at your approach compared to the previous [00:06:50] owner’s approach, because there’s a massive problem with hierarchy and lack of [00:06:55] respect in our profession. I mean, there’s been a lot of talk recently about women in dentistry [00:07:00] and why more women don’t lecture and so on. But I’ve been banging on about this. The biggest [00:07:05] issue with women in dentistry is the way that dentists treat nurses, hygienist, receptionists sometimes. [00:07:10]

Polly Bhambra: Yeah, I think it’s just it’s such a shame because they have there is this element of arrogance with [00:07:15] dentists that dentists are, you know.

Payman Langroudi: Some dentists, right.

Polly Bhambra: Some, [00:07:20] some, some not all because we have got some fantastic dentists in our group. We did have some [00:07:25] dentists who thought equals dentist equals God, but they’re no longer part [00:07:30] of our organisation. And it’s such a shame. Payman because the dental [00:07:35] nurses, the hygienist reception team are so valuable and sometimes they [00:07:40] fail to see, you know, we use this analogy of the jigsaw puzzle. Every piece [00:07:45] is equal to each other to have the full picture to work as a team. One piece is not [00:07:50] aligned. Your values are not aligned. You haven’t got the full picture. The patient. [00:07:55] What we say the patient first ethos that is not applied because they have got their own agenda, [00:08:00] they don’t abide by, say abide, but they don’t follow the same values as what we want them [00:08:05] to do. So yes, there is that. Nurses are not fairly treated or hygienists [00:08:10] aren’t. But we try and have these open forums within our teams. We have [00:08:15] our Training and skills day where we train together, where you learn and you train together. You connect [00:08:20] and you learn from each other. Where we share our practices down for a day and [00:08:25] we’ll have a hands on session for the clinicians. The practice managers will have their own session [00:08:30] regarding anything from handling patient complaints, mental capacity, and [00:08:35] nurses will have theirs.

Polly Bhambra: Anything from, um, you know, cross-infection to nursing [00:08:40] skills, how they can apply that. And then they come together in the afternoon and we have, [00:08:45] um, like a motivational speaker. Last year was managing change [00:08:50] with motivation, and it was, um, a young lady who from a [00:08:55] from a young lady to a male transgender and how they manage their change [00:09:00] and how they manage that. And it was amazing. So if you if that person had asked me, could you [00:09:05] show me where the toilets are, I would be directing them to the men’s toilets. That’s how fantastic [00:09:10] the journey had been for them. And they talked about their whole journey from from a young lady [00:09:15] to a male transgender. And so it’s getting them to understand things can be difficult. Yes, [00:09:20] we have to what we call flex ourselves when we’re at work and you have to go with the flow. We’re [00:09:25] not rigid. And yes, things happen and things go wrong from time to time. But as [00:09:30] a team, as a collective, we have to be supportive of each other and not have [00:09:35] that blame. It’s a process. Hence, all these processes are in place that [00:09:40] you have a process, you follow it if you don’t follow the process and [00:09:45] you feel it’s broken, let’s have a conversation.

Payman Langroudi: Yeah, but my question do you get resistance [00:09:50] to that change sometimes?

Polly Bhambra: Oh, yes.

Payman Langroudi: When you buy a practice.

Polly Bhambra: Oh, yes. You [00:09:55] must do right. Yes. So when first practice, 2010. I bought the practice [00:10:00] in July. First Christmas I said, okay, let’s get the Christmas tree out. Let’s see [00:10:05] what it’s, you know, let’s spruce the place up. And the tree looked a bit haggard. So I thought, you know [00:10:10] what, I’ll nip into town, order it. In those days, Amazon wasn’t as active that you could [00:10:15] pick up the phone and, you know, online book something so nipped in town, bought a Christmas tree and I [00:10:20] bought I think it was pink baubles and pink, you know, all the decorations. And [00:10:25] I got told by one of the receptionist, we don’t have pink baubles, we only have green and red baubles. [00:10:30] So I suggest you return the tree because we’re a traditional family practice and [00:10:35] we only have traditional Christmas tree with green and red.

Payman Langroudi: How interesting.

Polly Bhambra: How interesting. How [00:10:40] did you handle that? Guess what? The pink baubles went up and everything turned [00:10:45] pink in that waiting room and they were not impressed. Even to the silliest things. Payman [00:10:50] one practice we bought the practice and I purchased like you buy the the shopping [00:10:55] and you know the tea and coffee. I bought a different brand coffee. Yeah. And I [00:11:00] was told we only drink Nescafé here, so I suggest you go and buy Nescafé. I [00:11:05] mean, that’s how petty some of the change that we’ve had to handle. Change from answering [00:11:10] the phone. They’d leave the phone ringing. I’m like, guys, answer the phone. Answer it with a [00:11:15] smile. It’s not dental surgery. Can I help? No. You know, it was little [00:11:20] things. So resistance has been there. So therefore external sort of mentors [00:11:25] have had to come in and support reception teams, the nursing team, the clinicians. And [00:11:30] yes.

Payman Langroudi: I mean, it’s a fine line, isn’t it, between, you know, you come in, you might be there’s a lot of [00:11:35] first of all, people worried, you know, the new boss, right. Yeah. Change Change is going to change [00:11:40] or not? Yes. And I don’t know what you know. You’ve done this enough times. Now that you can [00:11:45] tell me what’s the best advice is the best advice not to immediately change [00:11:50] stuff and just reassure everyone that everything’s going to be okay. And then evolution [00:11:55] or, you know, Dev Patel’s angle is like, rip the place down [00:12:00] so that no one could even recognise it and start.

Polly Bhambra: Yeah, I get that. We [00:12:05] I think we tried that one the, the whole Dev Patel strategy. But for us, I think [00:12:10] because we’ve kept the same names of the practices, obviously they needed a spruce [00:12:15] up because by the time the retiring dentist is.

Payman Langroudi: The reason you were buying them. Right? Because they had [00:12:20] some potential potential.

Polly Bhambra: So we’re buying practices that needed add value. So they were not computerised. [00:12:25] No digital X-rays. They were still using, you know, wash dry, fix [00:12:30] dry. You know those liquids. Well let’s go.

Payman Langroudi: To let’s go into it. So are you looking for I mean are you [00:12:35] looking to buy any more? At the moment.

Polly Bhambra: We have ten in our group. So we’ve been consolidating and [00:12:40] making sure that everything is absolutely watertight. And yes, if a practice comes [00:12:45] on the market and we get approached saying, okay, this is a situation for your.

Payman Langroudi: Target [00:12:50] kind of practice, what’s your ideal target practice? How many chairs NHS private. What’s the story? [00:12:55]

Polly Bhambra: Definitely three plus like four chairs which is great. You could have three clinicians [00:13:00] and a hygienist. Stroke therapist. That works really well. Yeah. Plan which is really, [00:13:05] really important in.

Payman Langroudi: Place in.

Polly Bhambra: Place because I feel we are very plan [00:13:10] heavy and that saved us during Covid. Yeah. If we had been fully private we would be having a [00:13:15] different conversation now. We are heavy on plan. We we have a plan [00:13:20] and we have practice plan. And honestly, we made a point of ringing every [00:13:25] patient over the age of 70 vulnerable basically, and had a call with them during Covid. [00:13:30] We sent out every plan patient, some interdental brushes with a letter saying, I [00:13:35] know we’re closed, but we’re here for you. We’re on a phone call away, so that helped. So definitely [00:13:40] our strategy is three plus chairs plan and where we can add value [00:13:45] or not necessarily. We have some mixed. But again it’s back to yes [00:13:50] it’s back to because then you have a certain way what patients expect from you from a private practice. [00:13:55] And the clinicians expect a certain way of materials, equipment, the look, [00:14:00] the feel of the practice of private. So and and it works. So then you are [00:14:05] setting your patient journey what they expect from the minute they even land on your website or they land [00:14:10] on your car park, what they will expect. Not that we’re saying NHS should be treated any differently, because [00:14:15] if you went into any of our practices, NHS patient is treated the same as [00:14:20] well as a private patient as in the journey, but the clinicians are refusing to [00:14:25] treat NHS. I’ve got a lovely, lovely clinician, probably about three years in [00:14:30] from university and served a couple of weeks ago. Polly, I’m really struggling.

Polly Bhambra: I can’t do this NHS [00:14:35] list anymore. If you can offer me a list private, which obviously we can. I’d love [00:14:40] to stay. Otherwise I’m going to have a look elsewhere. All my friends are private. Only [00:14:45] you know they’re doing this and I’m not. And I feel I’m limiting myself to my [00:14:50] skill set, which I can’t deliver on the NHS. These are the sort of barriers that we’re coming. I [00:14:55] can’t understand it. Yes, absolutely can understand. And he is a fantastic clinician, what [00:15:00] we call safe pair of hands when we you know, once a clinician has been in a few months we do [00:15:05] these 360 reviews and we have the lab involved as well. So where they send the work obviously [00:15:10] I’m a dental nurse. I don’t know what happens in the mouth. I know between right and wrong, but [00:15:15] we need the lab, their feedback, peer to peer reviews. If another clinician has seen their [00:15:20] patients as an emergency, what the mouth is, how healthy they are. So we get [00:15:25] feedback in that sense. But yeah, I get it. You know, associates are [00:15:30] moving away from NHS dentistry. So we’re trying a different avenue with dental [00:15:35] therapists. So seeing how that works. And yet we’re getting resistance from the clinicians [00:15:40] saying, well, what happens if the filling doesn’t work out? Who’s going to go? Am I liable [00:15:45] for litigation? How are we going to claim the udas? So it’s having those reassuring conversations [00:15:50] saying, look, this is how it will work. So yeah, let’s see. Let’s see what [00:15:55] happens with that.

Payman Langroudi: And what are the like the headline numbers I mean so okay ten practices, how many [00:16:00] staff in total.

Polly Bhambra: So approximately about 130 staff.

Payman Langroudi: Including. [00:16:05]

Polly Bhambra: Everyone. That’s yeah the nurses.

Payman Langroudi: Salaried and the self-employed.

Polly Bhambra: So we’ve got employed [00:16:10] there’s about 130, there’s 40 about 37 clinicians [00:16:15] and then about ten hygienists. So 47 clinicians, but around 8090 [00:16:20] odd nurses, some part time, some full time. So and a lab technician and [00:16:25] a technician and our prosthetics lab. Yeah, we have a prosthetics lab at one of our sites. He’s been with us 39 [00:16:30] years.

Payman Langroudi: That’s a lot of humans. It’s a lot of humans to worry about, especially operations. That’s you. Right? [00:16:35]

Polly Bhambra: Yes. Well, my day starts around 6:00 in the morning with phone calls of [00:16:40] can’t make it and I’ve moved away. I don’t want to text. I want to speak to you for [00:16:45] a reason for not coming to work. And nine times out of ten, it is genuine that they are poorly. We [00:16:50] have really good staff who are committed because they see the [00:16:55] impact it has on the team if they don’t come to work. So when they do fall insecurities [00:17:00] genuinely, they are poorly or they will come into work. And we have to say, you’ve got to go home, [00:17:05] you’re really seriously not well, go home. Yeah. So managing the team, it’s [00:17:10] the personalities. Payman you have these conversations or we’ll have meetings. Great. [00:17:15] We agree. Something perfect. I will write an email to confirm [00:17:20] that we’ve had this conversation. I get response and I’m thinking, hang on, we didn’t agree [00:17:25] that I’m sure we agreed something else because I’m a sucker for writing everything down. I have a book, obviously. [00:17:30] I bought it and tagged it along with me today. I write everything down so the goalpost changes. So it’s [00:17:35] managing those kind of personalities and conversations.

Payman Langroudi: And how deep do you get [00:17:40] into the sort of characters and the. Because you can I mean, I remember when [00:17:45] we were seven people. Yes. And I remember going home in the evening and talking deep [00:17:50] with my wife about these seven humans, you know, like, oh, all about their lives and everything. Yeah. And [00:17:55] now we’re like 38 people or whatever it is now. Yeah, yeah, yeah. And you’ve got 138 people. [00:18:00] Yeah. So how do you keep. I mean, it sounds it sounds like you’re very touchy [00:18:05] feely with.

Polly Bhambra: With terrible.

Payman Langroudi: With these teams.

Polly Bhambra: Yes, I am.

Payman Langroudi: So are you taking on a lot of [00:18:10] their problems and, you know, like, sort of. It’s a bit it’s a bit difficult, [00:18:15] isn’t it? Because what if it was 4000 people? You couldn’t you. Yes.

Polly Bhambra: My [00:18:20] my, um. Problem maybe. I don’t know what it is. The word problem. I’m [00:18:25] so emotionally invested in these people? Yeah. So their problem sort of. Somehow becomes [00:18:30] my problem. And I feel I have to. I’m solution driven. So find a solution. [00:18:35] What’s the problem? Let’s work together. Let’s sort it out. And it could be anything from, [00:18:40] you know, like somebody said, I can’t, you know, I haven’t got money to pay for the taxi to get to another site. [00:18:45] Okay, let’s book your Uber for you. She texts it, you know, 7:00. Polly. I’m struggling. Um, [00:18:50] haven’t got money on my phone for the Uber. Fine. Don’t worry. I’m booking your Uber. It’s done. It’s dealt [00:18:55] with. Obviously, they put the receipts in. They claim their petrol back. Yeah, so it’s that kind of stuff. A conversation [00:19:00] with a nurse whilst I’m on the train coming down here about how she’s struggling with her course. [00:19:05] Polly, can you help me with the charting? I said, look, I’m on site Thursday. Grab me for five minutes. [00:19:10] I’ll go through it with you. Not a problem. Because of my Dental teaching background. Yeah, you know, it’s different [00:19:15] on charting on paper than it is on the computer and understanding. So yes, [00:19:20] and same with the clinicians. But I think equally they are because we we treat everybody [00:19:25] as a person who they are, we get to know them. Our onboarding is quite robust, [00:19:30] so we get to know them as people. We.

Payman Langroudi: What do you mean? Our onboarding is robust. What [00:19:35] is it.

Polly Bhambra: So. So dental nurse for example are an associate comes on board. Um [00:19:40] they will have the induction of who’s they buddy up with somebody then [00:19:45] um like a nurse would go in. They’re not just brought in on the first day and thrown into surgery. They’ll [00:19:50] have a week with another nurse shadowing her or another practice. Then they have [00:19:55] the training on our software. So from R4 to Ergilio to Dem plan, having [00:20:00] the conversations, how we speak to patients, how we do things here. And [00:20:05] it’s always like, oh, but we’ve always done it like this at our other practice. Exactly. So leave that at the door. [00:20:10] This is our process. This is how we work. This is how we answer the phone. This is what we [00:20:15] do when the patient walks in. This is what we do whilst the patient is in the surgery. This is what we do when the [00:20:20] patient leaves. This is how we follow up with an email texts. A Google review. We [00:20:25] ask everybody. So these are all processes. That’s onboarding. And it’s managing [00:20:30] expectations. So people say oh I don’t know how to do that. Nobody told me it negates [00:20:35] all of that nonsense conversation after oh, I don’t know when you ask the question [00:20:40] or there’s white space, how come there’s white space in the diary? You know the process. [00:20:45] You know what you need to do to fill the white space so it stops that. Oh, I didn’t know. Oh, I didn’t [00:20:50] know. I thought somebody else was doing it. Everybody has a role and a responsibility and they’re held [00:20:55] accountable. You can’t, you know, expect somebody to do something if you’re not going to hold them to [00:21:00] account.

Payman Langroudi: How did you learn all of this?

Polly Bhambra: I’m [00:21:05] a sucker for reading books, podcasts and just as you as you grow. [00:21:10] Because I’ve got as the.

Payman Langroudi: Business grows, you grow as an operator. Yes. [00:21:15] Yeah. That’s true. Yes. But but nonetheless. Yeah, it’s not a joke. [00:21:20] What? You know, it’s a, it’s a big beast to to to to to [00:21:25] systemise.

Polly Bhambra: You learn very quickly. Yeah. When mistakes happen, when people say stuff [00:21:30] or things happen and you see stuff and you get told Prime [00:21:35] example, we had a clinician about five, six years ago was doing something that I didn’t [00:21:40] approve of when I pulled him up and said, look, I don’t like what you’re doing. It’s [00:21:45] wrong. What’s he doing? He, you know, claiming something [00:21:50] that he shouldn’t be claiming. Chrome charging the patient privately for a bit of Chrome, but, [00:21:55] uh, you know, putting these dudes through and a lab bill. And when my lab technician [00:22:00] said, look, you know what, poly? I’m sending you the lab bills. I just want you to be aware of what’s happening. [00:22:05] And this is the thing that is brilliant. It’s the open door policy allowing [00:22:10] people to speak up when they see something’s not right. Ten practices. You’re not in them every [00:22:15] single day. So when something gets told to you and if you don’t action it or you don’t address [00:22:20] it. You are the bigger fool. Because somebody said, look, I’ve told you something’s happening [00:22:25] and you’ve turned a blind eye. That’s worse because you know something’s not right and you’ve done nothing [00:22:30] about it. So when somebody gives me an inkling, something’s just not right. I just want you to know. [00:22:35] So. Okay. You know, leave it with me. I know what’s happening. So I addressed it with the associate. I said, look, this [00:22:40] is not right, and I don’t like what you’re doing. It’s unacceptable. It needs to stop and literally Payman. [00:22:45] You know what he said? He said, what do you know? You’re a dental nurse.

Polly Bhambra: You’re a. His words, [00:22:50] quote unquote. You’re a jumped up dental nurse with a silver spoon in your mouth and walked [00:22:55] out the door. I’m like, wow. Wow. I come from a working class background. [00:23:00] My parents are immigrants from India, from the 60s. You know, my mom was 16. [00:23:05] My dad was 18 when my dad was 14 when he arrived. He married my mom when he [00:23:10] was 18, and he worked in a foundry. And my mom was, you know, a housewife. [00:23:15] And they had these shops and they built their little empire together. And he [00:23:20] walked out and literally I was like, jumped up Dental nurse with a [00:23:25] silver spoon in your mouth. And literally I and he walked out the practice. It was an evening, so I [00:23:30] thought I’d wait till everybody’s gone and then I will speak with him. It was awful. And I just emailed him that night [00:23:35] and said, please do not return back to this building. You’re not welcome. You’ll be able to come. You’ll be escorted into [00:23:40] your surgery to collect your belongings, and that will be it. And I’ve never seen [00:23:45] him since. Or heard of him. Yeah. Sometimes you have to make decisions and [00:23:50] you have to. The harsh? Yes, they’re harsh, but it also sets the precedence [00:23:55] for everybody else that it’s not accepted when you’re doing something which is wrong because it opens [00:24:00] you up to lots of different things, not just NHS litigation, but fraud. People [00:24:05] think, oh, it’s okay. They allow this kind of behaviour, but it’s not, it’s not acceptable. [00:24:10]

Payman Langroudi: So let’s talk about hiring and firing. [00:24:15]

Polly Bhambra: Yeah.

Payman Langroudi: Let’s talk about hiring.

Polly Bhambra: First hire slow. Fire fast. [00:24:20] Yeah. Hire slow. I went through my learning, my own learning. When [00:24:25] you make mistakes and you’re desperate to just fill the Dental nurses gap or need [00:24:30] a receptionist. So you hire somebody quick, get them in, get them and get them trained. Get them on reception. And [00:24:35] when they arrive and you think, oh God, they’re making it’s worse than having [00:24:40] the empty chair because they’re booking them patients where they shouldn’t be, not [00:24:45] charging, not, um, following up. Those processes are not being [00:24:50] followed. So the sooner you find you have those conversations with the person and you say, [00:24:55] look, it’s not working. Either you adapt your style and you follow the process or this practice [00:25:00] is not for you. And if it’s not for them and you quickly realise it’s not for them, [00:25:05] when you ask somebody to contact a patient and say, could you call the patient, do this, [00:25:10] do this, do that, and they don’t, and they send a text instead. So my question is like [00:25:15] I’ve asked you to call the patient, have that conversation and explain what’s going on. [00:25:20] Why would you share with me? For what reason would you send a text called it’s [00:25:25] not personal. It’s you know, what is going on here. I don’t like making phone calls. [00:25:30] I don’t like speaking to patients. Then you’re in the wrong profession if you’re sitting on reception [00:25:35] doesn’t work. So you need to exit.

Payman Langroudi: And is that always you [00:25:40] doing the firing?

Polly Bhambra: Nine times out of ten, myself and Gulu, who is [00:25:45] the other partner? It’s between us two. We do it. And jazz is great and [00:25:50] but it’s usually left to us to to do the firing and the hiring we do together [00:25:55] as a three. The three of us we do together. Because again, we need to make sure that [00:26:00] not only, you know, the clinical values fit, but the personal values [00:26:05] fit. Not just professional, but they are. They’re coming on board for a reason to develop, to grow, [00:26:10] to, um, put the patients first.

Payman Langroudi: The top tips. What are your top tips for hiring? Well. [00:26:15]

Polly Bhambra: Hiring? Well, I would say, um. Get the get [00:26:20] the person in. Let them come and do a trial day. See them in action. See [00:26:25] how they speak to their peers. See how they speak to patients, how they are around you when they’re [00:26:30] not working at lunchtime, at coffee time, when they’re standing in the kitchen or grabbing ten [00:26:35] minutes, you’ve got a gap. Let’s grab a coffee, how they are, and you’ll get to see that quite quickly if [00:26:40] they are for us, if they’re our team. Yes, you’re nervous and so you’re a bit shy and your first day. [00:26:45] But one of the top tips is get get them in, have a phone [00:26:50] call first. Understand exactly what they’re looking for. And what is it that they’re not looking [00:26:55] for. Yes, we can list all the things I want somebody who’s, you know, got [00:27:00] knowledge of dem plan and R4 and this and the other, but it’s equally as important to ask [00:27:05] them what kind of practice are they looking for. Are they looking for career development? Are they looking [00:27:10] for a family practice a little practice where there’s only two chairs and they don’t like a huge practice [00:27:15] because we’ve got hygienist who’s amazing. And probably about a month ago she came in. Polly. I [00:27:20] love working for you, but this practice is too big. I want I’ll carry on working, but [00:27:25] can you find me an opening in one of your other practices? So, of course, two days at a smaller practice [00:27:30] where it’s one chair for the dentist, one for the hygienist, and she loves it. So [00:27:35] it’s knowing the needs of the individual. It’s all very well saying, we want this, we want that. They’ve got to [00:27:40] be doing this and they have to have this and these post qualifications. But it’s what do they want and [00:27:45] what kind of practice are they looking for. So um, telephone conversation first [00:27:50] face to face interview trial day. And then it’s, you know, it’s references [00:27:55] and get them in.

Payman Langroudi: But I mean, what I’m saying about that is, you know, I know people [00:28:00] who’ve got really brilliant, very exhaustive hiring procedures. You know, [00:28:05] they make people fill out forms and do trial days and presentations. [00:28:10]

Polly Bhambra: Yes, we got PMS do.

Payman Langroudi: And yet, yes, the person ends up being a turkey. [00:28:15] Um, it’s it’s not an exact science, is [00:28:20] it?

Polly Bhambra: It’s it’s funny you say that because we hired two PMS at the same time. [00:28:25] One we call was our racehorse and the other was our donkey. Same [00:28:30] training, same induction, same everything. Different person and different person. [00:28:35] It’s a mindset. The mindset was, well, I’m a PM. I’m sitting in my back office, this door shut. [00:28:40] Don’t disturb me, don’t call me if you need me, I will come out. The other one [00:28:45] is like I am the face and the eyes and the ears of the practice. I want to sit at the front desk. I want to have, yes, [00:28:50] my office. But I want to be here, there and everywhere. Totally different. So [00:28:55] what jobs.

Payman Langroudi: Did you do yourself in a dental practice? Were you practice manager at any practice? [00:29:00]

Polly Bhambra: I was never a practice manager, so I started off as a trainee dental nurse at Birmingham Dental Hospital [00:29:05] back in 1990. And then I went into practice [00:29:10] and I worked as a dental nurse. Loved it. I did on call at a local [00:29:15] practice where I worked in the evenings, so I did that. Um, and [00:29:20] then I went back to the hospital, worked on the oral medicine department, which I absolutely loved, [00:29:25] I loved it. Interesting. Yeah, oral med, oral surgery, ortho, oral med, all of those kind of stuffs. [00:29:30] Endo. Not my cup of tea. I’m not one for smelling bar broaches, but, um. Yeah. [00:29:35] Ortho. Endo. Ortho an oral med was great. Worked at the hospital [00:29:40] and then my parents moved in 1995 to [00:29:45] Preston. They bought a residential care home. So with that came [00:29:50] this shift. But my father, my elder brother and myself, we moved together [00:29:55] up north. So I gave up dental nursing for a short period, kept my GDC registration [00:30:00] and worked in a care home and managed a care home.

Payman Langroudi: I bet that was invaluable. [00:30:05]

Polly Bhambra: Horrible that was. That was invaluable in those days. It wasn’t cold and sexy, [00:30:10] which is now didn’t exist.

Payman Langroudi: Yeah.

Polly Bhambra: Yes. And, um, and that’s 24 [00:30:15] hour care. So that again was wow. And again stop [00:30:20] some form of patient care. But it’s 24 hour care and worked as on [00:30:25] on the, you know, shop floor with as a care assistant. So one minute you’re [00:30:30] feeding somebody, the next minute you’re wiping their bum, you know. So that was um, very [00:30:35] a very steep learning curve, which was great. And then um, and [00:30:40] then.

Payman Langroudi: I guess some someone doesn’t turn up who’s supposed to do the night shift.

Polly Bhambra: Oh, Polly. [00:30:45] You’re on. Yeah. And literally Payman I’d do from 7:00 [00:30:50] in the morning till 10:00 at night, and then they’re like, oh, um, and it’s always a Friday [00:30:55] or a Saturday evening that somebody wouldn’t turn up, and then you’d be back [00:31:00] on shift until the following day. I mean, at one, one week, I think we recounted. I did about 100 and [00:31:05] something odd hours, which is wrong for you both. And I and I found myself. I remember [00:31:10] I’d get to about 70 hours, 80 hours, and my dad would say, oh, I think she needs a [00:31:15] break. She’s getting a bit crabby. I’m like, thanks, dad. I’ve only been on the go constantly. So [00:31:20] but it was brilliant because that gave me an opportunity to work really closely with my dad. My dad again, [00:31:25] like I said, an immigrant from the 60s who built his business over time. And there was a time [00:31:30] back in the 80s and, and where he had a row of shops and he [00:31:35] would like open one and, um, it’d be a grocery store. The next one was a hardware [00:31:40] store, the next one was a a fish and chip shop. He’d closed the grocery store, opened the fish and chip shop. [00:31:45] We’d come back from school and he’d be saying, right, you stand behind the counter, you get yourself down to the [00:31:50] cash and carry on one of five siblings. So we all had an input in our family upbringing. [00:31:55] What an.

Payman Langroudi: Entrepreneur.

Polly Bhambra: Yes. And even the siblings. Yeah. All my siblings had, you know, [00:32:00] entrepreneurial older brother. It’s property. The other ones. It’s like nurseries. [00:32:05] As in plant nurseries. My sister day nurseries. She got to a point last [00:32:10] year. She had five day nurseries and we sadly lost our [00:32:15] mum. Two years ago she woke up and said right, enough’s enough. Sold within [00:32:20] six weeks of making a decision Payman she said no, I’m not doing this. I’m [00:32:25] selling look what mum, what happened with mum? So she sold and she’s [00:32:30] retired and she’s not even 50. And then obviously there’s myself, my younger brother as well. He’s [00:32:35] got their care homes and rest homes and property portfolio. Yeah. So we’ve got this five [00:32:40] siblings of us.

Payman Langroudi: I think it’s an interesting thing, you know, where I speak to a lot of women [00:32:45] and they, for a start, got like a perfection thing going [00:32:50] on. They want everything to be perfect. And that’s self-imposed kind of, I don’t know, society imposed [00:32:55] whatever it is. Um, and but then when you’re someone running a [00:33:00] business, in your case, a complicated business. Write ten practices with [00:33:05] kids. Yes. Yeah. And the question of, you know, I feel [00:33:10] guilty that I’m not spending time with the kids. Yeah, that whole thing. Yeah.

Polly Bhambra: That’s been [00:33:15] huge.

Payman Langroudi: Yeah. But. But I’m sure your dad was busy. Yeah. And [00:33:20] your mum? Yeah. Busy? Busy? Yeah. Didn’t spend time doing quality touchy feely things with [00:33:25] you? No, but my point is, they learned by osmosis. Yes. Yeah. [00:33:30] Like when they see you. Yeah. They see you doing what you’re doing. It’s not only the number of hours. [00:33:35] Yeah. Like you can do hours of work not making a massive impact. Yeah. Or [00:33:40] you can do hours of work making you. Look, my mum made that impact [00:33:45] on the world that inspires them to do the same. Right. And you were telling me, you know, your kids [00:33:50] are really high achievers and all that. Yeah. It didn’t happen by. By mistake. Like. Like, you know, you [00:33:55] weren’t there looking over their homework every day. No, you didn’t have time to do that.

Polly Bhambra: I [00:34:00] mean, my, um. I’d bought tree Tops in July 2010. [00:34:05]

Payman Langroudi: What’s that, a practice?

Polly Bhambra: That’s one of our practices. And, um, I [00:34:10] think I was six months pregnant. Probably. So Gumare came in December and [00:34:15] the 13th, and our Christmas party was like the 21st. He came to the Christmas party and [00:34:20] he was in his car seat underneath the table. And literally I’d be like, oh, it’s time to go and [00:34:25] breastfeed him. Quick ten minutes in the toilet, back again under the table and you carry on. So [00:34:30] and I think the kids know they don’t know anything different. So they’ve been they’ve they’re [00:34:35] part of that sort of, you know, cycle that I’m in. They come to work with me. [00:34:40] School holidays. Yes. They would be booked into every possible club. Yes. Tennis dance, [00:34:45] this that and the other. But they’d come back and they’d come back and sit in the office and like, right, you’re here now. You can do the [00:34:50] shredding. You need to do that. You can start franking these letters so they they have that work ethic [00:34:55] in them.

Payman Langroudi: With Chris Barrett don’t you. Yes. Yeah. And he says something about hiring practice managers who come [00:35:00] from families where their parents had businesses. Yes. So they understand [00:35:05] the work ethic.

Polly Bhambra: The work ethic is so important. And it’s having that can do attitude. [00:35:10] You might not know what you’re doing, but you know what? Let me have a go. Let me see if I can make it work. [00:35:15] So let me see if I can, you know, sort of work my way around it. So it’s that attitude and mindset [00:35:20] is above all. So when it comes back to recruitment, can they do the job? Will they [00:35:25] do the job? It’s the skill set. Yes, you can teach the skills, but you can’t teach the attitude and [00:35:30] the attitude comes from having that. Okay, you know what? Let me have a go. So the kids, they [00:35:35] don’t have a choice. They’ve been part of that journey with with me. And you’re [00:35:40] just going to have to crack on guys. Mummy’s busy. I’ve got CQC inspection at one of the sites, so [00:35:45] you need to come and make sure so they have their little checklist. Can you make sure that everything in this surgery has got this, this, [00:35:50] this, this, this and um, but yeah, it’s been fun and they’ve learnt along the way and they, they’ve [00:35:55] learned that you you work hard or you work smart, but then you also have a nice [00:36:00] life. They go to good schools. They’ve got nice stuff around them. But that doesn’t come just by sitting on your bum. You have [00:36:05] to do something. And it’s it’s not easy. As I was saying earlier, it’s not. It’s not [00:36:10] classed as old money. This is money that we’re working hard to make sure that you have got these nice things [00:36:15] around you, but you also get opportunities to be around good people. I’ve got [00:36:20] a great team and they learn the kids learn from them, how they work and how we do things. [00:36:25] So it’s important.

Payman Langroudi: What’s the org chart like? There’s you three at the [00:36:30] top. Yes. Who’s next.

Polly Bhambra: And then we have obviously we have our own individual PA [00:36:35] who do our little admin stuff behind. Then we have ten practice managers. [00:36:40]

Payman Langroudi: Then any area managers.

Polly Bhambra: See we used to have an area manager. [00:36:45] We’ve had a couple of area managers Payman. And what we found that it was just another [00:36:50] layer and our message, what we wanted to portray to our teams. It just [00:36:55] got muddled up and the message the.

Payman Langroudi: Other way round as well.

Polly Bhambra: And the other way round. And the area manager [00:37:00] would always come with, oh my God, there’s a problem. Oh my God, there’s a problem. I’d be like, okay, I get [00:37:05] it, there’s a problem. We’ll come with a solution. If I’m going to you’re telling me the problem, [00:37:10] I can work that out for myself. There’s a problem. But how are you going to help me solve it? So you know, the whole [00:37:15] that layer of area, the the other layer after us, we’ve got it. Practice [00:37:20] practice managers and and what also happened these we bought brilliant area managers on [00:37:25] board. But as we grew their skill set was limited. Yes 2 or 3 at a push. But [00:37:30] ten practices, ten PM’s managing them. The whatsapps going crazy over morning looking [00:37:35] for staff and you know, authorisation for agency staff. And so it’s [00:37:40] just easier now.

Payman Langroudi: Do you see your primary role yourself. Yes. As managing those ten [00:37:45] practice managers.

Polly Bhambra: Practice managers.

Payman Langroudi: Yes. So how often are you in touch with them? Each every day. [00:37:50]

Polly Bhambra: Every day? Every day. Whatsapp is literally every day, if not 100 [00:37:55] times a day on that WhatsApp chat. And it could be anything from, you know, staffing. I haven’t got a nurse.

Payman Langroudi: You know, [00:38:00] there’s stuff. Stuff will come up day by day. But what about like meetings or.

Polly Bhambra: So three days [00:38:05] I’m at. So the Thursday we have two admin days a week. So that’s when I’m [00:38:10] going on site. So because our practice is in Stourbridge are all walking distance from each other. [00:38:15] You could be one day and you’ve done those three sites. There’s only one practice which [00:38:20] you have to devote the full day to, which is in Barwell, Leicestershire and Carlton [00:38:25] House. So if you’re going from Wolverhampton, you know you’ve got to wipe. The whole day is dedicated [00:38:30] to that practice. But if you’re in Wolverhampton you could be at treetops, you know, 9:00 [00:38:35] in the morning, but by 11 you could go to Codsall, which is around the corner. Larch home every day. So [00:38:40] it’s it’s easily commutable and contact is there every day conversations that [00:38:45] we can have.

Payman Langroudi: So you’re doing that as well. You’re doing that journey. You’re visiting every practice [00:38:50] every month. So at least.

Polly Bhambra: Weekly, weekly, every Thursdays, Thursdays [00:38:55] and Fridays is what we call our Stourbridge days, because we’ve got three practices [00:39:00] and Stourbridge and a couple of the practices are the ones where we are really struggling [00:39:05] with recruitment, so we have to be seen to be supportive of the [00:39:10] PM. She’s like, Polly, I’ve got I’ve spent 17 grand on agency and I’m having palpitations [00:39:15] over the last quarter and I’m sharing these figures because they’re coming from our bookkeeper, Clarence, saying, [00:39:20] you’ve spent 17 grand, what the hell’s going on on agency staff? So I’m [00:39:25] speaking to the PM saying, look, what’s happening with your recruitment. Are you what are what are the ads saying? What [00:39:30] can we change? What is the wording that we need to change? What who do we need to be contacting. So [00:39:35] and then we have staff who have left and come back through that revolving door. So [00:39:40] yeah we are.

Payman Langroudi: The PM or the PM’s incentivised with regards to the bottom [00:39:45] line of their particular practice.

Polly Bhambra: Pm’s PMS are we’ve we’ve not done it as incentivises [00:39:50] the PMS. We incentivise the whole team because it’s a team effort. The PM [00:39:55] yes, is the orchestrator of getting the team together to achieve get X amount of Google [00:40:00] reviews, grow our plant patients by 10%. You know, whatever the incentives are [00:40:05] or the KPIs that we’ve set for each practice. So when they get something.

Payman Langroudi: The same right.

Polly Bhambra: There, [00:40:10] same for the other team. Yes. That each practice the three that we are struggling with [00:40:15] staffing and recruitment. Therefore, if we’re struggling with staffing and recruitment, the [00:40:20] decline in taking on plant patients because the conversations are not happening when we’re our own [00:40:25] team in front of house, it’s a natural patient comes in. Yes. Right. You know your plan. [00:40:30] The dentist has already done that. The CEO would have had the paperwork completed already and the [00:40:35] receptionist having those conversations. So not only would decline in recruitment, it’s a decline in plant patients. [00:40:40] It’s a decline in Google reviews. It’s a decline in this. So that’s where either myself or [00:40:45] the other two partners have to go in and say, right, how can we support you? What can we do to help you? [00:40:50] Yeah. So we we’re very much hands on. And to be fair, Payman, [00:40:55] we’ve always been we had the hiring manager. We tried that for about five years. [00:41:00] And for the last I’d say 3 or 4 years we’ve been.

Payman Langroudi: So is there a [00:41:05] head office and head office roles or not?

Polly Bhambra: So back office roles we have marketing [00:41:10] a lady.

Payman Langroudi: Centrally.

Polly Bhambra: Centrally looks after the sites, and we have an accountant [00:41:15] bookkeeper who does all the dentist salaries and payrolls payroll. So that’s [00:41:20] all sort of back office roles. So HR back office. And even though the [00:41:25] managers do the recruitment and all their personal files, but there’s a separate [00:41:30] HR, separate accounts and separate marketing, those functionalities are all from home. [00:41:35] There is.

Payman Langroudi: There is there a central place to all go to.

Polly Bhambra: Stourbridge? [00:41:40] Yes, it’s one of the practices. One of the practices upstairs has got a boardroom, so they all live out of that. Clarence [00:41:45] lives in Preston, so, um, everything’s there because we really. We don’t want it [00:41:50] to be. Oh, I’ll just work from home and I’ll just do it from there. It needs to be on site. You can’t do marketing. [00:41:55] Yes. You possibly say, well, I can get stock images and I can do that. You can’t do marketing [00:42:00] sitting at home. You need to be on site. You need to get your collateral, those patient testimonials. You have to be [00:42:05] the face on the forefront asking for Google reviews, that team engagement. You know, nowadays [00:42:10] somebody I recruited and they said, oh, I see you don’t have a TikTok page. So [00:42:15] it’s frowned upon. So, you know, guys, we need to stay above and beyond the trends. We need a [00:42:20] TikTok page. So getting staff who’ve been there for 15 years, asking them to do a TikTok, they’re like, [00:42:25] I’m not doing that. That’s not part of my job. I’m a dental nurse. I’m not. I’m not making TikTok. So [00:42:30] it’s a case of guys, come on, if we want to stay, you and they say, well, I’ll work somewhere else. But [00:42:35] and I remind them, yes, you might leave and go somewhere else, but eventually that practice will [00:42:40] then catch up as well and saying, well, that is the trend. We have to be visual on social media. [00:42:45] We need to be doing all the stuff that need to be to recruit younger patients, [00:42:50] because that’s what they want. That’s, you know, that’s the norm nowadays.

Payman Langroudi: Yeah, plus [00:42:55] TikTok would give it another year and it won’t be younger people.

Polly Bhambra: It’s like aunties [00:43:00] like me on it.

Payman Langroudi: Yeah, I’m on it. I’m on I’m on TikTok more than I’m on Instagram now.

Polly Bhambra: Yeah, yeah, yeah. [00:43:05] So it’s like my kids don’t Google. They don’t use Google. They’re on TikTok. That’s where they get their like [00:43:10] if.

Payman Langroudi: I, if I, if I was in I don’t know I was in Italy. Yeah. Or in Istanbul looking for whatever [00:43:15] it was, whatever it was I guess. Tiktok.

Polly Bhambra: Tiktok. Absolutely. Yes.

Payman Langroudi: Obviously talk [00:43:20] to locals, but but but TikTok is where I go for that kind of information.

Polly Bhambra: Information? Absolutely. [00:43:25]

Payman Langroudi: Yeah. And so that’s where our patients are going to go to. There’s no doubt about it.

Polly Bhambra: Especially the younger ones. [00:43:30] If you’re trying to recruit Gen Z, Gen X and millennials are probably not on Facebook but Instagram. [00:43:35] But TikTok is where they all sort of hang out. I see from my own children.

Payman Langroudi: Yeah yeah [00:43:40] yeah yeah, exactly. Yeah. So I mean, I’m very interested. [00:43:45] I mean, you seem to take to all of this so naturally. And [00:43:50] did you always have that sort of organiser mentality? [00:43:55] Um, you sort of give off this very positive vibe. [00:44:00] And I think it’s really important. Right. To, to have to have your staff morale. [00:44:05] Yes. High enough. It takes a positive person. Yeah. And what [00:44:10] you said about bad news and keeping a straight face when there’s bad news. And you [00:44:15] know what I think a lot of people should understand. I’ve worked in practices. Yeah. Where the guy would blow up [00:44:20] when something went wrong. Yeah. Guess what? No one ever told him when stuff went wrong. Yeah, because. [00:44:25]

Polly Bhambra: Exactly.

Payman Langroudi: No, because he was going to blow up. He’s going to lose his. He’s going to lose it. Yeah. Yeah. So? So [00:44:30] everyone was just hide everything from this guy. And so this guy didn’t know anything about his own practice [00:44:35] because he was. And maybe there’s that ego thing the dentist game was a. By the [00:44:40] way, dentistry is a highly stress job.

Polly Bhambra: It is very.

Payman Langroudi: Stressful.

Polly Bhambra: I see it so stressful and it’s very lonely as well. [00:44:45] Payman it’s very lonely. I see the clinicians. Yes, we’re a big team. We’re huge. But when they’re in that surgery, [00:44:50] yeah, it is stressful and it’s lonely. So I understand when associates are you [00:44:55] know, we say, oh, he’s being a diva or she’s being a diva. She’s being a diva because she’s she’s [00:45:00] demanding. It’s stressful, but she’s demanding certain, um, things for her patients. [00:45:05] She wants to do things right. So if she’s expecting a certain type of composite or a certain material [00:45:10] or equipment because she wants to do.

Payman Langroudi: Right, you’ve got Polly. You’ve got the numbers in front of you. Yeah, [00:45:15] you can see the numbers. Yes. The cost of materials is not. Yeah. The make [00:45:20] or break for a practice or for even the bottom line. It’s not because of the if [00:45:25] you go berserk on materials. Berserk. Yeah. It might end up being 5% of your [00:45:30] turnover if you save to the, you know, cut to the bone, you might end up being 3%. [00:45:35] Yeah, but that’s not what’s causing. But people focus in because it’s almost the only thing they can [00:45:40] see.

Polly Bhambra: Yes, absolutely. But um, but yeah, like.

Payman Langroudi: Keeping your associate happy because [00:45:45] they’re using what you said, right? He’s trying to do the best for his patient.

Polly Bhambra: That’s what he does.

Payman Langroudi: So that’s what you [00:45:50] want, right? You want that’s the associate you want.

Polly Bhambra: So why not support them if they. And you know, sometimes [00:45:55] you’ll get the manager. Oh, she’s being a diva. She’s asked for this and I’m over my budget. And it’s [00:46:00] like there’s a reason she’s asking for that because the patient is paying for it. So if the patient [00:46:05] is paying for the time and the material, her expertise, you’ve got to get that stock in. Yes, [00:46:10] you’re over budget. It’s fine. But you know she needs it. So it’s so important that [00:46:15] those associates are supported who do right by their patients. But you talk about, [00:46:20] um.

Payman Langroudi: It’s funny, I get associates come to me, they say, oh, I really want to use enlightened, but I can’t persuade my [00:46:25] boss. Yeah. What’s the answer to that? Sell some enlightened, right. Sell some the [00:46:30] moment it’s sold. Yeah. The boss isn’t going to say no. Exactly. There’s a [00:46:35] patient waiting. Pay. Exactly.

Polly Bhambra: And, you know, I move away from the word selling to our associates. [00:46:40] It’s giving patients a choice. Sure, it’s a choice. And it’s allowing them to make [00:46:45] that informed decision. Saying these are the choices. Mrs. Smith. You can have this, or you can have this. [00:46:50] These are the choices, and these are the price points. You decide what you would. You know, it’s very well [00:46:55] I can recommend what I think would be great for you, but it’s giving back to the patient the choice again [00:47:00] about that patient experience. And patients value the clinician’s decision because [00:47:05] it’s back to like what do you think would be better for me. Yes, I think it would be this. But these are the options. So it’s [00:47:10] back to that. So patient dentist clinicians should have that choice of what is available. [00:47:15]

Payman Langroudi: What’s what’s your finance model? I mean when I say that people [00:47:20] think people hear ten practices and they think you’re a multi-millionaire. Yeah. But [00:47:25] what people don’t understand is you do not get to ten practices by spending the [00:47:30] profits, right. You get to ten practices by reinvesting, reinvesting, reinvest, reinvesting. So what’s your [00:47:35] plan? Is it who funds it? Is it bank funded?

Polly Bhambra: Is it bank funded and private? Ah, [00:47:40] our self self-funded. There’s no private equity. There’s no other third party, would [00:47:45] you? I don’t think we would. Because then it takes away the control. [00:47:50] Being the control freak that I am. It takes away the control and then the targets [00:47:55] and, um, the demands. What we then have to keep. It’s like a, [00:48:00] you know, hamster wheel that we’ve got to produce for the private equity firms. This is what you’re.

Payman Langroudi: Working for, someone else.

Polly Bhambra: You’re [00:48:05] working for somebody else? Yeah. So it’s self-funded. We met.

Payman Langroudi: We met in Alicante. Yes. [00:48:10] Yeah. And in Alicante, there was a definite. Well, just to explain to the [00:48:15] audience. It was where they bought a bunch of corporates together to meet up with a bunch of.

Polly Bhambra: Speed dating. [00:48:20]

Payman Langroudi: Flyers.

Polly Bhambra: Dental corporates.

Payman Langroudi: Yeah. But there was a clear difference between the private equity backed [00:48:25] ones and then the non private equity.

Polly Bhambra: Funded or bank funded. Yes.

Payman Langroudi: And that question of do [00:48:30] I go for private equity. Deputy. Um, it’s an interesting question, right? Because [00:48:35] have you got ambitions of more more [00:48:40] and more and more like.

Polly Bhambra: I think there would be, because at the moment we’re consolidating our practices. One of our practices [00:48:45] is having a huge renovation to the point where it’s gone from nine surgeries to 15 surgeries. [00:48:50] This is the one where I’m based at, and I call it my baby because it’s one of our first. And [00:48:55] it is about ensuring that each practice offers something [00:49:00] to everyone. So this particular practice, treetops I’m talking about, it’s it [00:49:05] will at the end of it. This literally the spade goes into the ground on the 1st of October. It [00:49:10] will have a gym for our staff. It’s got a boardroom, training facilities. We’ve got our own dental [00:49:15] nurse training academy, so training will be done there, additional surgeries and [00:49:20] more of a wellness centre where you’re offering these IV, um, vitamins and [00:49:25] hair loss and fat freezing and all this fancy stuff that you can do now Because [00:49:30] clinics are not CQC registered. So they’re coming to us and saying, look, we’d love to have [00:49:35] some space if you’ve got your practice to offer because ideal location. [00:49:40] So yes, we would potentially grow, but again it has to be the right practices. [00:49:45] And for us, what we’ve got. We want to make them better before we move out and [00:49:50] say, right, okay. Because we when we set off back in 2015, we [00:49:55] said, you know, let’s see how we go at ten years, we’ll have a rethink. Where are we at. That’s next year [00:50:00] we’ll be having conversations about, okay, are we selling, are we moving, are we buying more? Are [00:50:05] we consolidating? Are the three of us going our separate ways. And we, you know, selling [00:50:10] the goodwill and just meet every couple of years to pick up the rent check and say hi or [00:50:15] what are we doing. So those conversations will be happening next year or do we grow? And [00:50:20] then we buy another ten and we grow the portfolio. So let’s see. You don’t know. [00:50:25] Not yet. For me, I, um.

Payman Langroudi: It sounds like you’re having fun.

Polly Bhambra: I’m [00:50:30] enjoying it. I love going to work. You know, I walk in and they’re like, oh, she’s arrived because I’m like, morning. [00:50:35] They’re like, oh God, she’s here. But I enjoy going to work. And Payman, I don’t [00:50:40] feel I actually go to work because that sadly I have no friends, I don’t have a social life, I don’t drink, [00:50:45] I don’t smoke. So yeah, work is my social life and I love [00:50:50] work. I love what we do. The teams are amazing. The people that we surround ourselves with, they’re [00:50:55] brilliant. And again, you know, it comes from the top. If you’re walking in with [00:51:00] a face on the team, are like, oh God, she’s here again. But if you’re positive [00:51:05] and you have that, you know, it’s okay. Stuff happens, but we’ll work through it. Yes, you get patient complaints, [00:51:10] yes, you get staff leaving, you get grumbles. But you know we will deal [00:51:15] with it together, collectively. And again, back to the values. If there’s a problem, [00:51:20] we address it straight away. We don’t let it linger and it’s dealt with [00:51:25] there and then. My motto in life is an everlasting [00:51:30] positivity. Whatever it is, we will find a positive out of it. Something’s [00:51:35] gone wrong. Somebody left, somebody handed. They’re noticing, you know, at one practice, we’ve got five [00:51:40] nurses leaving five.

Payman Langroudi: So same time, same time.

Polly Bhambra: So [00:51:45] from anything from maternity leave to, um, our success stories, what we call [00:51:50] when we go, can we help them develop. One went is working for the GDC full time on [00:51:55] the fitness to practice board. She’s heading that. So wow. I’m like how amazing. [00:52:00] And the other nurses leaving to do general nursing. So again another success [00:52:05] story. So those kind of stories you’re proud okay. It’s hitting the business because we’ve got five leaving [00:52:10] maternity leave to this and one is leaving to go to moving back down south and [00:52:15] the other to move to just a must be.

Payman Langroudi: Constantly recruiting, right. Constantly, constantly, constantly [00:52:20] looking for for staff. Always of all types.

Polly Bhambra: Of all types. Yeah. From reception to nurses. [00:52:25] To therapists. Dental associates. Yep. Nhs associates to even come [00:52:30] on board. There is no conversation. There’s nobody. Nothing. Even if you say. Right. Okay. [00:52:35] Let’s negotiate. Uda. Uda rate. No.

Payman Langroudi: It’s up to that rate.

Polly Bhambra: It’s got [00:52:40] to that. Yeah. Honestly, it’s so sad. It is so sad. And then you’ve got. Yes. Overseas [00:52:45] dentists. Some are absolutely amazing, some where we’ve learned the hard way because the [00:52:50] thinking is different, the cross-infection is different, the standards are different. So there’s a lot [00:52:55] of mentoring. And when all of our all of our practices are associate led, it’s [00:53:00] hard to find a mentor because, well, okay, what’s in it for me then? What?

Payman Langroudi: Is there a lead [00:53:05] associate in every practice?

Polly Bhambra: Yes, I would say so. Definitely. Definitely there. Is that what we call our linchpin [00:53:10] at each practice? And a couple of them are the ex principals.

Payman Langroudi: The [00:53:15] previous which.

Polly Bhambra: Are brilliant. Yeah. Um, some were ex owners, but they forget [00:53:20] they have sold the practice and they no longer call the shots and they forget that you have to be reminded you’ve [00:53:25] had your bag of silver. Now, please let us let the practice move on. Because when there’s an issue, [00:53:30] they’d go back to the ex principal. And so those have been the tricky you know, when managing [00:53:35] change. We talked earlier. It’s that kind of change. I bet there’s an issue. Why are you going back [00:53:40] to the ex principal? If he wanted to make that change he should have done that under his leadership.

Payman Langroudi: But [00:53:45] you but you encouraged the ex principal staying on.

Polly Bhambra: Generally, yes, because they are the goodwill if you think [00:53:50] about it. Patients. We yes. You can buy a massive plan. You know a list of [00:53:55] goodwill. But patients stay because of the name of the ex principal. [00:54:00] Yeah they stay. We’ve had principals stay ex principals tied in so-called [00:54:05] between 3 to 5 years. After the five years they still stayed. Said, you know what? [00:54:10] I’m loving it. Why would I want to give up this position that I’m in all [00:54:15] the air, CQC, the logistics, the staffing is taken off me. I’m [00:54:20] coming in. I’m delivering good ethical dentistry and I’m going home with, you know, [00:54:25] a lovely little package tied in.

Payman Langroudi: Is it like an earnout?

Polly Bhambra: We haven’t done any earnouts. Obviously [00:54:30] the usual retention, but there’s no earnout. It’s always been amicably that they [00:54:35] stayed three years. Minimum. Agreement. Agreement. Three years. We’d like you to stay on until [00:54:40] we get, you know, the practice stability. New dentist comes in and then, you know a couple of our [00:54:45] dentists who the the practice we bought in 2010, the principal, the ex principal [00:54:50] only left what, a couple of years ago and then sadly passed away last year. And [00:54:55] two of the other principals are still with us. And they were bought back in 2015. Yeah. [00:55:00] So they’re still with us. So that’s that’s really good. That’s positive. And you.

Payman Langroudi: Must have had the conversation [00:55:05] about sort of rebranding all of them in the same brand because they’re all in the same area, [00:55:10] same.

Polly Bhambra: Area.

Payman Langroudi: And when there’s that concentration in the same area that the branding [00:55:15] thing actually makes a lot more sense. Yes. Have you have you thought about that?

Polly Bhambra: So we we thought about [00:55:20] rebranding under Dental. Yeah. Payman. We learned very quickly, [00:55:25] very early, very quickly that each practice has their own idiosyncrasies. Yeah. And [00:55:30] if you are a little practice, two surgeries in a little village in Codsall and then [00:55:35] all of a sudden you’ve been bought out, try Dental. Oh my God, it’s gone all corporate. Yeah. And [00:55:40] it was the case of the conversations and again, putting it out there. Oh the Asians, [00:55:45] it’s Asians. It’s going to be you know I don’t know this horrible connotation of Asians. It’s [00:55:50] a group of bought it or will it be a they turned it into a care home. Is it going to be a restaurant. [00:55:55] No, it’s a dental practice and it will stay as a dental practice. And yes, it will be [00:56:00] the same principle and the same staff. Nothing’s changing. So we kept the same [00:56:05] names and yes, we have like the back office type of thing is under Dental. But [00:56:10] front facing for patients, for staff is the name of the practice that we purchased. [00:56:15]

Payman Langroudi: So there’s no dream or sort of plans to ever know.

Polly Bhambra: I ran them at the same at all. [00:56:20] No, I think it’s individuality, and I think that stays with the practices because they’ve been long [00:56:25] established. 1930s, 19, you know, 20s, they’ve been established and under that [00:56:30] name. So we’ve kept them under under the same name. I think my.

Payman Langroudi: Dentist was like that. And then one [00:56:35] day they decided, yes, to change all of them to my identity. Well, they weren’t called my dentists at [00:56:40] that point. They h h yes. When the when the name change came in. Yes. You [00:56:45] know, in this journey, building this this, you know, business. You. There must [00:56:50] have been some dark days. Mhm.

Polly Bhambra: Yeah. Covid was one of them. What comes to [00:56:55] mind.

Payman Langroudi: Yeah. What comes to mind when I say dark.

Polly Bhambra: I think just [00:57:00] comments that you hear from people about um, [00:57:05] you as a nurse, that you’re just a nurse. What do you know. It won’t last long. Her [00:57:10] business will fail. She doesn’t know. So those kind of comments. And I suffer hugely [00:57:15] with imposter syndrome. Believe it or not. Massively. I [00:57:20] pull up onto the drive and I’m like, oh my God, somebody’s going to come and tap me on the shoulder and say, excuse [00:57:25] me, you need to be aspirating. And, you know, instruments need doing in decon. What are you doing sitting in [00:57:30] the boardroom? You know, doing this you need to somebody’s going to tap me on the shoulder and say, wrong office. You need to be in the surgery. [00:57:35]

Payman Langroudi: Imposter syndrome is a feature of of growing quickly, though. It’s whatever you’re [00:57:40] doing.

Polly Bhambra: Yeah, but I’ve always had it, even as a younger person, that should I be doing what I’m doing? [00:57:45] When I went for my dental nursing to working for Procter and Gamble, I worked for Procter and Gamble for 1012 [00:57:50] years, heading oral care in Western Europe. I’m like, oh my God. I’m sitting in a boardroom [00:57:55] with Procter and Gamble, and then I’m in Cincinnati. When Oral-B had the acquisition [00:58:00] with P&G back in 2006. And I’m in a boardroom thinking, am I meant to be [00:58:05] here? Oh my God, what is happening? So that has always stayed with me. And the dark days [00:58:10] are very much about, um, you know, sadly, comments from not very [00:58:15] nice people about you’re just a nurse, what do you know? But when they see stuff and [00:58:20] things happening, Covid was horrible. Covid was not nice because it took some [00:58:25] of our practices out of the ten to bounce back longer than we anticipated. [00:58:30] Patient loss was huge at some of our sites. Um, and again, it came [00:58:35] back to how our managers and how our clinicians engaged some of our practices, [00:58:40] our managers and clinicians like I get we’re going to have an on call phone. I’m [00:58:45] taking all the calls, I will triage, I will do the prescriptions, I will fax it or email it [00:58:50] to, um, the chemist, the pharmacy. And I will do all of that. And with the others like, [00:58:55] well, hello, I’m I’m off. It’s Covid. I’m not doing anything. Call me when you open [00:59:00] it. Was that so? Those were really horrible days. And you actually saw from [00:59:05] your own clinicians who were with you and who were like, well, sorry, mate, it’s [00:59:10] Covid. Call me when you your practice opens and I’ll be back. Otherwise I’m off.

Payman Langroudi: Did you feel [00:59:15] like a sort of existential crisis? Like you might. The whole business might. Might shut down. [00:59:20] We we did, we did.

Polly Bhambra: Yeah, I can imagine. But some of our sites, [00:59:25] we thought, especially two of our sites which are drained, you know. Were draining patients, literally [00:59:30] draining patients. I think we’ve got to turn this ship around. We’ve got to do something and do it. It’s a [00:59:35] case of right communication, communication. Get the teams back in talking to patients, [00:59:40] ringing patients. We did the first batch, you know, back in March. It was March [00:59:45] the 23rd or whatever it was 20 and 2020. Every patient right. Get [00:59:50] their teams get them access to our system and then get them talking [00:59:55] to all the patients. And then we thought, fine, we’re back in June. Then we had the other lockdown. [01:00:00] So we thought and some of the practices didn’t quite open till August. September time with [01:00:05] the others were open June the 8th, I think it was. And we’re like, right, come on, we’re on it, we’re on it. Bang on. [01:00:10] I was literally right. Get these signs up. Get everything up. Let the world know that [01:00:15] we have arrived. Oh, literally. Gulu had sourced these ffp3 masks from three [01:00:20] M literally, you couldn’t get them and how he got them. It’s contact [01:00:25] of a contact and everybody. I went on a testing course. [01:00:30] Right. We’re going to I’m going to do all the fit testing myself. And that’s what I did.

Payman Langroudi: Imagine all [01:00:35] these.

Polly Bhambra: New words I.

Payman Langroudi: Know all.

Polly Bhambra: New words furloughed. But [01:00:40] yeah, we’ve got a huge garden, one of our practices. And literally that’s where we had all of our fit tests. And it was [01:00:45] like getting the cue, get fit, tested. Get your mask back on site Monday morning over [01:00:50] a weekend. We did it. Yeah. The gowns or this, that or the other. Yeah. [01:00:55]

Payman Langroudi: And then that crazy period after Covid [01:01:00] where, I mean, our business went through the roof [01:01:05] and like all Dental businesses did. Yes. It’s interesting. I was talking to a colleague from Lithuania. [01:01:10] She was saying same thing happened there. Yeah. And then I looked into. I [01:01:15] wanted to find out. Did that happen after that Spanish flu? Yeah. And it did. [01:01:20] It was like when, you know, like, spending is a funny thing. Like, if you can’t spend them, it [01:01:25] comes out in one go.

Polly Bhambra: To spend and literally.

Payman Langroudi: So you must have seen the growth [01:01:30] go berserk at that point, right.

Polly Bhambra: Crazy new patient appointment because it was all everything was on zoom. [01:01:35] All of a sudden you started analysing your cheekbones, your jowls, your lips, your [01:01:40] teeth, your forehead, the amount of inquiries for street Invisalign. [01:01:45]

Payman Langroudi: People had money, they.

Polly Bhambra: Had money, they had money they had not been spending. They had money. But [01:01:50] we also found it was they wanted it instant. They weren’t waiting. They want it now. [01:01:55] And obviously the younger folks like that total instant gratification. [01:02:00] They want it. They want it now. I’ll pay for it later. Get me finance. I’ll finance rocketed [01:02:05] how much we were providing. It was amazing. It was amazing. It tailed off. Now we’re [01:02:10] at a steady ship again. Yeah, yeah. It’s interesting. Yeah.

Payman Langroudi: Your your story [01:02:15] with your dad. Your mum. Yeah. The care homes.

Polly Bhambra: Yes. [01:02:20]

Payman Langroudi: Shops working shops, working in dental practices. [01:02:25] Yeah. Procter and gamble. Yes. You know Procter and gamble. Another big bit of [01:02:30] your career.

Polly Bhambra: Massive. Yeah.

Payman Langroudi: Um, how much of it how much [01:02:35] of how much of your skills do you attribute to each of those things? I know it’s a silly it’s a silly question. [01:02:40] Right. Because it’s it’s a really good question. It’s a blend of those. Right. But but but but what did you learn [01:02:45] from your dad that you put in place in Procter and Gamble. Yes.

Polly Bhambra: Yeah. Really [01:02:50] really good question. It’s such a fantastic question. So for my dad was a work ethic. You [01:02:55] carry on, you work, you do things right and you do things properly. And it was very much of [01:03:00] you don’t give up. It’s that can do attitude. I definitely learnt from my mum and my dad. [01:03:05] My mom would take a risk. Take a risk? The risk versus the value and the outcome. [01:03:10] The reward. Definitely. He would risk something. And, you know, you’d think, how [01:03:15] is he going to turn this around? And you know what? He he would. And at one time Payman in [01:03:20] Birmingham. I grew up in inner city Birmingham. We had a row of shops, and [01:03:25] my dad owned all of those shops. And then, um, he would literally go and deliver [01:03:30] the food. He’d send myself and my brother to go and deliver food to, um, the elderly round [01:03:35] on that street. And when those people would sadly, um, pass away, they would write [01:03:40] in their will to give Mr.. He was known as Mr. Singh. Give Mr.. Singh the opportunity to buy [01:03:45] my house first before you put it on the market. And he was one of these cash deal? Yes. Fine. Put the deposit. [01:03:50] Cash done. And he had a row of houses, the whole street, the Broadway. Mr. Singh, and even [01:03:55] to this day, you know, he’s still well known in that area. So it was definitely the skill set of [01:04:00] can do, work hard and do things properly.

Polly Bhambra: Have an honest and true [01:04:05] living PNG was the networking. How to engage. [01:04:10] How to talk to professionally. Professionally? Totally. Listen. [01:04:15] I’m a girl from Perry Barr, Birmingham and then talking to professors in [01:04:20] you know Geneva. We that was our European head office. I [01:04:25] learnt a lot and that really helped me with the practices. So when I would be at conferences or [01:04:30] it was one of my managers, when we were still Oral-B back in 2006, and [01:04:35] then we came over to Proctor and Gamble. Before that, she I [01:04:40] was taken on as a territory manager or be where you’d go to each practice, sell your range of [01:04:45] power brushes and your manual brushes. And we, the managers would come out [01:04:50] and do a field visit. And she came out with me once and she said, oh my goodness, Polly, by I [01:04:55] think 1:00 she said, stop, you are doing what we call in the business, the milk [01:05:00] round. You’re going in. You know everybody. They buy from you. You know the practices. Sadly, [01:05:05] I asked you a question. You know, the phone number and you know the post code. Stop. Go home. [01:05:10] Turn your phone off. Turn your laptop off. Make me a business plan where you think we need to be. [01:05:15] Go away and come back and we’ll have a conversation. And she obviously saw something in me [01:05:20] and I back from my dental nursing at the dental hospital.

Polly Bhambra: I thought we never had the reps coming in. They [01:05:25] never spoke to the students, they never spoke to the nurses. So I went back and I said, Penny, we [01:05:30] need to do grab them at grassroot level at the hospital. So they leave the dental [01:05:35] hospital with our power toothbrush. And so that’s all they know the hygienist, what [01:05:40] do they have? So our usage and recommendation are U and R for power brushes skyrocketed [01:05:45] when we targeted hospitals. So I did all the hospitals. That was my best dental schools. [01:05:50] Dental schools grabbed the students at that work with the key associations [01:05:55] like the BSP. So the BSP guidelines, let’s sponsor that. [01:06:00] Obviously they were like, well, sponsorship, we don’t want to be exclusive to one, but if we could [01:06:05] devise the BSP guidelines and we will print all your merchandise. They were happy [01:06:10] with that. I brought that to the table. That was great. Stephen Hancox, let’s do presentations, [01:06:15] but let’s get CPD. I worked with him and we had our own CPD, um, [01:06:20] presentation that we gave out to students and then in practices. So it was that and [01:06:25] I learned so much from there, which now in business I replicate that. So when we [01:06:30] have our training and skills day CPD, you’re doing the dentist do something else. The nurses do something [01:06:35] else, you know.

Payman Langroudi: But so you were in the professional relations for.

Polly Bhambra: Yes. For them it was called [01:06:40] Pearson Professional Scientific Relations Organisation. What was the.

Payman Langroudi: Size [01:06:45] of the bill? I mean like how how much were they selling in toothbrushes.

Polly Bhambra: Oh, huge. Ah.

Payman Langroudi: Did [01:06:50] you get did you get anything on, on the consumer side like numbers.

Polly Bhambra: Huge. [01:06:55] I mean we were very because we were more the science and the professional relations. We [01:07:00] never got to. I mean, sometimes we would go to the factories and see how super floss is made, and [01:07:05] we’d do we. I’d take the hygienist from, um, the Hygiene and Therapy [01:07:10] Association and do like a weekend visit for them to have CPD and go and see our, um, [01:07:15] factories in Ireland. How super Floss was made. And you’d sort of discreetly look at the numbers. You’re [01:07:20] like, oh my God, it’s only costing them £0.04 to make. And you know, it’s they’re selling it for [01:07:25] £2.50 or whatever it was in those days. So it was 2 or 300% mark up [01:07:30] mark of what it was. Manufacturing is like manufacturing.

Payman Langroudi: Factories like that. It’s huge. But, you know, I [01:07:35] would imagine the whole professional side is only there to support the consumer.

Polly Bhambra: Consumer. Yes, [01:07:40] absolutely.

Payman Langroudi: You didn’t get any figure like how many toothbrushes were they selling a year to the public? [01:07:45]

Polly Bhambra: Oh, huge. I can’t even think back how much it was. And we were talking, um, it [01:07:50] was huge. I can’t even think that was back. I started there [01:07:55] in 2002, and I left in 2010 when I bought the practice, so. [01:08:00] Oh, wow. So it’s a it’s a while, but yeah, huge. And at that time there was transition [01:08:05] from manual to power was huge. Yeah. Because the manual power, our sort of [01:08:10] goal was to get as many power brushes in people’s hands and away from [01:08:15] manual, manual, manual, manual. And the Cochrane report really supported us because it’s it said. [01:08:20]

Payman Langroudi: Toothpaste and toothpaste really a thing.

Polly Bhambra: In your day? The launch I think they launched [01:08:25] paste in places like India First because that was 2008 [01:08:30] or 9. They launched paste because in India, obviously, [01:08:35] you know, like we say, oh, I’ll just do the Hoover. It was the brand name rather than [01:08:40] it was all Colgate, Colgate. And that was their biggest competitor market. So we look I [01:08:45] say we P&G launched um toothpaste in India. The big sort of markets [01:08:50] that they had to.

Payman Langroudi: Crest was P&G wasn’t it. Yes.

Polly Bhambra: Crest was P&G. Yes.

Payman Langroudi: But Oral-B To Crest [01:08:55] Press doesn’t exist anymore, does it?

Polly Bhambra: Not in England. I think it’s in Europe still, but not in [01:09:00] the UK or probably, you know, B&M and pound shop type of things that they are there, but [01:09:05] not mainly in supermarkets, but Oral-B, paste, Colgate was our sort of brand competitor. [01:09:10] That was their target audience where they needed to target and get market share. Yeah, [01:09:15] so I learned a lot from P&G. So when it came, came to skill set, P&G taught me [01:09:20] a lot. And the contacts, you know, I could pick up the phone to somebody and say, I [01:09:25] need a perio specialist. You know, one, I need somebody. Do you know anybody in the area.

Payman Langroudi: Visited hundreds of practices, [01:09:30] hundreds of practices, practice. A good practice was. Yes. I mean, you know, you must resonate [01:09:35] with this idea, right? That sometimes I walk into a practice and the [01:09:40] receptionist looks up, comes, opens the door for me. Doctor Langroudi, we’ve been [01:09:45] expecting you. Yes. Coffee. And sometimes the opposite. Right. Yeah, sometimes the opposite. [01:09:50] And I’ve always been very careful about who’s at [01:09:55] blame in that. I don’t think it’s the receptionist. No, it’s not the receptionist.

Polly Bhambra: It’s [01:10:00] the culture. It’s the culture. It’s the.

Payman Langroudi: Practice. Sometimes it’s not enough people. Yeah, it’s all fast paced. [01:10:05]

Polly Bhambra: I haven’t got the time. I haven’t got the time. We’re short staffed. Yeah, and it’s always something I remember. [01:10:10] And the practice that I bought walked in and the receptionist [01:10:15] was sitting on reception, eating pot noodle with a hoodie on [01:10:20] and UGG boots and leggings or something. Okay. Front desk. Front desk. Oh, nice. And I’m like, [01:10:25] wow. And if you go back to that same practice now, 15 years later, all black. [01:10:30]

Payman Langroudi: She’s still sitting there.

Polly Bhambra: She’s still sitting there. Minus the pot noodle, minus the leggings, but all black. [01:10:35] Like red bowl, like scarf. And you know, the clinician used to say, oh my God, they look like air [01:10:40] hostesses now on reception. And they have a certain way they and it’s they’re all [01:10:45] presentable. So. And again that again is back down to the culture how you look, how you [01:10:50] feel, how the patients are made to feel, because if you’re rushing and the patient walks in and you don’t even [01:10:55] look up to them or acknowledge them, you might be on the phone, but give them eye contact, let them know. And if [01:11:00] they’re running late, offer them a coffee. But again, it’s back to the staffing, the culture, [01:11:05] what we expect. So managing staff expectations that they know what [01:11:10] we expect from them at recruitment and what they will expect from us and how we want them to make our [01:11:15] patients feel because they represent try Dental or tree tops or whatever it [01:11:20] might be. They are the faces of the practice, but they represent me. So when a visitor comes and you give them a [01:11:25] mug, that’s not me. Where’s a cup and saucer? You know, the process of visitors, they [01:11:30] sign in, they get the lanyard, they get seated, they offer tea and coffee. It comes in a [01:11:35] cup and saucer, not a builder’s mug, you know. So it’s little detail like that. That. [01:11:40] Yeah. I can’t help myself being getting twitchy. Yeah. [01:11:45]

Payman Langroudi: What was it like growing up? I mean, did you feel? I mean, [01:11:50] I don’t want to cliché it. Your family might have been a totally different thing, but, [01:11:55] you know, a girl in a in a Sikh house. Did [01:12:00] you feel like the expectation on you was that you were going to be this [01:12:05] super successful person, or did you not? Like what? Tell me. Just give me some remarks [01:12:10] about what it was like then. And what do they think about you now? Like, what do your family think about you?

Polly Bhambra: Oh, they just [01:12:15] laugh at me. That. Oh, she’s just honestly growing up, I’m one of five, so I’ve got two older [01:12:20] brothers who were literally two older brothers. You the. [01:12:25] And then I’ve got a younger sister and a younger brother.

Payman Langroudi: Are you the middle? [01:12:30]

Polly Bhambra: I’m right. Middle child syndrome. So. And being the girl. Yeah. So my parents. And [01:12:35] quite because my parents were immigrants from India. They weren’t educated, they weren’t westernised. [01:12:40] They came from little villages back home in Punjab. And so when they came here, they [01:12:45] quite quickly, you know, they got married. My dad worked in a foundry. He had. He bought [01:12:50] his first shop. My mom would sew. It was massive back in the 70s and 80s. Asian [01:12:55] women would sew from home and jackets and wax jackets and stuff. So she would sew and then serve customers [01:13:00] in in the shop. Yeah. And so she’d be backwards and we would be doing the same. So growing [01:13:05] up, you were never sort of allowed to be seen to be sitting doing nothing. [01:13:10] You weren’t Payman. Honestly, I think it’s actually scarred me. I come back, I [01:13:15] say to my dad, I was like, dad. And he’ll say to me, Will you just sit down for five minutes? Just sit down, Polly. [01:13:20] I was like, dad, you’ve been. You’ve so innate in me. I can’t sit down. So if you’re not, [01:13:25] you know, if you’re not serving customers, you were helping your mum and my sister would be in the kitchen. She [01:13:30] would be cooking. From the age of ten, she’d be preparing a full meal for the family. And I would be helping [01:13:35] my mum. So. And if I wasn’t sewing, I was serving customers. So there was that [01:13:40] and it was expected. You are having an arranged marriage. You will get married where we ask you to.

[TRANSITION]: We? [01:13:45] You will.

Polly Bhambra: Um, you know. Yes. You’ll have an education.

Payman Langroudi: It was fully arranged. [01:13:50]

Polly Bhambra: Fully arranged.

Payman Langroudi: When was the first time you met him?

Polly Bhambra: Oh, um.

Payman Langroudi: Are you telling me you had no choice [01:13:55] in the matter? No, no.

Polly Bhambra: They were very good. Because. Oh, you had a variety of boys that you that you were.

Payman Langroudi: Introduced [01:14:00] to a few, and you’re introduced to a few?

Polly Bhambra: Yes. So, um, because my parents lived in Preston, [01:14:05] there wasn’t very much a big Sikh community. The Sikh temple only opened on [01:14:10] a Sunday, and there wasn’t very much. So back in 1995 when my parents moved [01:14:15] up north, it was a very small Sikh community, so my parents would commute backwards [01:14:20] and forwards to Birmingham. And, um, one of our Sikh temples had like a matrimonial, [01:14:25] um, book. Book. Yeah. Pages. My mother would have [01:14:30] that posted out, and then she’d spend the evenings ringing each line. Well, she’d highlight [01:14:35] the ones that she’d want to call. She’d call, find out. And it would say something like, um, you [01:14:40] know, Sikh girl required. Must be at least five [01:14:45] foot something fair skinned. It’s like you can tick that off, mom, because I’m not fair. Must be [01:14:50] this must be that. You know, it was. It was really bizarre. And, um, so my [01:14:55] parents had this list. They highlighted a few. And one Sunday afternoon off the top totalled [01:15:00] my mom, my dad and my brothers. So five of them off they go [01:15:05] to Birmingham and go visit these families who had sons, eligible bachelors. [01:15:10] And I remember them coming back and I’m like, okay, how did you get on? And my brother’s [01:15:15] like, yep, think we’ve got the guy for you, Polly. Absolutely amazing. I think we’re sorted. [01:15:20] We’ve invited them back to come and see you, you know, in a couple of weeks. Okay. So do you want to tell me a little [01:15:25] bit about him? Yes. His name’s A-grade. Amol. He doesn’t go out. He doesn’t smoke, he doesn’t [01:15:30] drink. He’s got no friends. Perfect. I was like, oh great. So totally the [01:15:35] opposite.

Polly Bhambra: Not that I drink or smoke, but you know any other personality like, no, no, it’ll be fine. And literally [01:15:40] two weeks. I obviously met a few, but nothing sort of came of it. But [01:15:45] I met Emma and do you know what? He was genuinely lovely and nice [01:15:50] guy. Met a couple of times. So we met in the September of 98, [01:15:55] and we were married on the 4th of July 1999. So within [01:16:00] a year, your so-called allegedly dating in those days, we didn’t have [01:16:05] mobile phones and I lived in Preston. He lived in Wolverhampton. So it was. And then if [01:16:10] we were meeting, we were chaperoned. Oh, it was chaperones. I’m like, great. You’re sitting there having [01:16:15] a conversation. And then he’d come up on the weekend to with his mum and dad to visit me, and we’d sit in the, [01:16:20] you know, the front room having a cup of tea. I’m like, should we just go for a walk? And we’d walk round the grounds [01:16:25] and of my like, my mum and dad’s the rest home and have [01:16:30] a chat. I’m like, fine, see you in a couple of weeks then. And then I got married. First time I’d been to Wolverhampton. [01:16:35] I’d never been to Wolverhampton before I got married. That was some shock. Cultural? [01:16:40] Yes. Like what is that erected out of the roundabout? And it’s, you know, because it’s [01:16:45] industry and steel and whatever else. And it’s like, oh, that’s culture, that’s culture. But [01:16:50] yeah, 25 years later, we’re still going strong. Somebody asked me, [01:16:55] what’s the secret of a long married life? I said, I’m always at work, I’m never at home. [01:17:00] So it works.

Payman Langroudi: But he’s not involved in your business at all?

Polly Bhambra: Not at all. He’s [01:17:05] in it. And he’s got his own property portfolio. He works from home. My mother in law [01:17:10] is quite poorly, so he’s more or less her full time carer. Yeah. [01:17:15] So. And we live with my mother in law lives with us. So again [01:17:20] it’s so.

Payman Langroudi: Interesting within, within two, three generations. Yeah. You could your, [01:17:25] your kid could marry a Swedish person, [01:17:30] correct.

Polly Bhambra: Yes. Yeah. Yeah.

Payman Langroudi: Whereas with you you [01:17:35] couldn’t even marry a different cast of person, let alone a religion or country.

Polly Bhambra: Country know [01:17:40] how times have changed, and I think this is the difference now with our children. And [01:17:45] maybe that’s why they’re so driven. It’s everything that you weren’t allowed to do or have. So [01:17:50] you’re giving those kids the opportunity. My oldest daughter, she’s 22, finished [01:17:55] the law degree. I would I mean, you weren’t allowed to go off and off to university. [01:18:00] My daughter’s had a year in Singapore, part of a university, which would have been unheard of. I [01:18:05] would be too scared to come home to say to my dad, oh, dad, I’m going to university and it’s abroad. It would [01:18:10] not have happened. Yeah, as a girl, it would not have happened. All my brothers would have. They would have been fine. Oh, [01:18:15] yes. Go. And they would be really proud. But as a girl. No no no no.

Payman Langroudi: I think Sikh men [01:18:20] are men. Oh, yeah. And women are, you know, women are women.

Polly Bhambra: Yeah, but there is that shift, I think. Yeah. [01:18:25] Sikh women are like, come, bring it on.

Payman Langroudi: I know loads of women who are amazing businesspeople. [01:18:30] Yes, loads. I mean, you guys are good at business generally, yes. Yeah, I know loads of Sikh women. [01:18:35]

Polly Bhambra: Strong Sikh women. Yes. Yeah.

Payman Langroudi: And so as a society, we seek society. [01:18:40] A matriarchal society. The women are in charge of the men.

[TRANSITION]: I would say it’s shifted.

Polly Bhambra: The women [01:18:45] are now the matriarchs of, I would say, of society. Yes, there’s I would say Sikh [01:18:50] men are still very, you know, manly, strong, manly, affluent Sikh [01:18:55] turban and, you know, the beard, the presence. Obviously, a Sikh man walks in with [01:19:00] a turban into a room. He has a presence. I’ve got three brothers. One of them wears a [01:19:05] turban out of the three. But when he walks in the room to be taller, big, tall, broader beard, [01:19:10] there is a presence. There is a certain thing about him that, um, he [01:19:15] he has compared to my other two brothers, they’re equally as charming. However, there’s something more spectacular [01:19:20] about him because he wears his turban with pride. That’s his crown. And his beard. [01:19:25] He dresses very vibrant. Orange is his colour. So that kind of thing. Yeah, [01:19:30] but women, I think Sikh women are definitely, definitely holding their own and [01:19:35] standing shoulder to shoulder to Sikh men, in business, in family, in [01:19:40] entrepreneurship. Definitely.

Payman Langroudi: And, you know, we were talking [01:19:45] I was talking to one of my other friends. He was saying having a daughter, when [01:19:50] he tells his parents there’s a disappointment.

Polly Bhambra: Yeah.

Payman Langroudi: How [01:19:55] long do you think that’s going to go on? I’m hopeful. Are we at the end of that now?

Polly Bhambra: My, [01:20:00] um. My experience with that. You’ve touched a nerve. I have two daughters. [01:20:05] Yeah. And I’ve had two miscarriages in between. And one being [01:20:10] was a miscarriage. Was a daughter because I was literally six months pregnant. And [01:20:15] then the the baby died. It still had to deliver, still had to have the funeral. [01:20:20] And the reaction from my family members was, it’s okay, it was a girl. It’s fine. Don’t [01:20:25] worry. And you think it’s my child? It’s my child. Doesn’t matter if it’s a boy or a [01:20:30] girl. I’ve still lost a child. And even after I’ve had my first daughter. Yeah. Fine. It’s [01:20:35] a girl. The second daughter. Oh, it’s a girl. Oh, and I remember going [01:20:40] to the Sikh temple. So we leave the hospital. I’ve got discharged. I go to the Sikh temple and [01:20:45] like an aunty asks, oh, is it a boy or a girl? I said, it’s a girl. And she went, never [01:20:50] mind, she’ll bring her brother. Her brother will follow, don’t worry. And literally you think what [01:20:55] you know, this has got to stop. But even with my own experience. Payman, I had two [01:21:00] girls and after I had my son, my. Who’s my third child? Only [01:21:05] then you felt that you’ve been accepted in society, in your own [01:21:10] family, that you’ve had your son. Now you’re good, you’re fine. And I’m hoping that stops [01:21:15] with my generation. So my children don’t have to feel that, because they won’t. [01:21:20] They won’t accept it. And the children coming forward now, my daughters, they would probably want [01:21:25] daughters because they see the relationship they have with their own mother. They would want that. So [01:21:30] I’m hoping that is he’s stopping. You still hear some stories of the [01:21:35] grown women who are lawyers and.

Payman Langroudi: In your culture, the daughters then goes, yeah, that’s [01:21:40] not the same in our culture, for instance. Yes. And maybe that’s that’s that’s element of it.

Polly Bhambra: It’s the [01:21:45] family name. It’s the daughter is they always say the daughter is somebody belongs to somebody [01:21:50] else. They have to leave their.

Payman Langroudi: Yes.

Polly Bhambra: Isn’t it. It’s mad. They have to leave their family name. They changed [01:21:55] their name. They change their their identity. They’ve given to another somebody else. That’s their [01:22:00] daughter. They leave. They’re never really their families. And that’s where the issue is. I don’t belong [01:22:05] to my my own family because I’ve got to leave. I go to my in-laws. I don’t really belong there or [01:22:10] fully accepted until I’ve had the son. Where am I, you know, felt wanted [01:22:15] or it’s mine in your own home. So yeah, it is. I’m hoping that [01:22:20] that cultural sounds awful nonsense will stop. It will stop with [01:22:25] our generation. You know, I’m 50. I’m hoping it stops with us. And it doesn’t [01:22:30] go on for generations. And again, it comes back to seeing our girls, [01:22:35] like, thrive and how well they’re doing and looking at Asian women. It [01:22:40] makes me proud when you see Sikh girls, girls doing so well in society, [01:22:45] in business, in law, you know, you think, wow, that’s amazing. Yeah. [01:22:50]

Payman Langroudi: But, you know, there was Indira Gandhi was president of India. Yes. Way before there [01:22:55] were women, women in charge of many other countries.

Polly Bhambra: Bhutto for Pakistan, Benazir Bhutto.

Payman Langroudi: Yes, [01:23:00] exactly. Yeah, exactly. So it’s it’s time. It’s time, it’s time.

Polly Bhambra: Absolutely. It’s time. [01:23:05] Yes.

Payman Langroudi: And you know, as much as it’s nice, it’s a nice thing for your daughter to marry a Sikh. Yeah. [01:23:10] Because the traditions and all that, as much as that is nice, it would be nice as well [01:23:15] if more people married out. Yeah. You know.

Polly Bhambra: And I think it’s coming.

Payman Langroudi: Societies, [01:23:20] you know, it’s coming. Do you see it more?

Polly Bhambra: Yes. But however, there is an issues [01:23:25] with our Sikh temples, the gurdwaras, As if it’s a mixed marriage.

Payman Langroudi: They’re not allowed to [01:23:30] have it.

Polly Bhambra: It’s frowned upon. You’re not allowed. So does a.

Payman Langroudi: Person have to sign a piece of paper saying they [01:23:35] are now a Sikh or.

Polly Bhambra: Something? Yeah, I’m assuming people.

Payman Langroudi: Don’t want to do that.

Polly Bhambra: They don’t want to do that. They don’t want to do that. And you’re [01:23:40] not allowed to take our equivalent of our, um, of our Bible out [01:23:45] of the Sikh temple now, because if there’s alcohol being served or meat is being served in big [01:23:50] stately homes and you think, well, I’ll have my wedding at a, you know, a lovely venue that that’s [01:23:55] frowned upon. I mean, even to the point where you can where now girls are not allowed to wear a certain dress. [01:24:00] Um, in the Sikh temple that stopped. It’s got to be fully covered trousers. [01:24:05] And, I mean.

Payman Langroudi: It’s gone backwards.

Polly Bhambra: It’s slightly. Yes. With that, because I think, [01:24:10] um, the Western cultural dress and combined with like the [01:24:15] Sikh langar that’s gone to westernised where they’re saying it’s too much [01:24:20] exposure of skin, you can’t just have, you know, your cleavage out and think you’re in a place of worship. Please [01:24:25] have some decorum for them. Respect. Yes. So that’s where that is. [01:24:30] I don’t think it’s gone back. It’s just setting the sort of values again. Yeah. What you mentioned [01:24:35] not meant to do in a Sikh temple. Yeah.

Payman Langroudi: It’s been a massive pleasure having you. It really has. [01:24:40] Let’s get to our final questions. It’s been fascinating conversation. Thank you. Payman really [01:24:45] learnt a lot from you. Oh.

Polly Bhambra: Bless you.

Payman Langroudi: Thank you. The final question is always the same. Fantasy [01:24:50] dinner party. Three guests, dead or alive.

Polly Bhambra: Oh, [01:24:55] definitely my mum. My mum. Honestly, it’s been two years [01:25:00] in August since my mum’s passed and Payman. Honestly, there’s not a day that goes by that [01:25:05] I don’t miss her or don’t think of her. Having her now sitting at this [01:25:10] table, it would be I would learn something from her every day. I’d learn something and even, [01:25:15] you know, silly things. I would be cooking, I would drink. It’s like, mum, what do I do next? [01:25:20] I’m going to FaceTime you. Tell me what I’m missing from this. Why does this not? Curry does not. Look how you make it. So [01:25:25] having my mom back just to have another conversation, hear her voice, the touch [01:25:30] that you speak.

Payman Langroudi: To her every day before.

Polly Bhambra: Oh goodness. On my. Honestly, it [01:25:35] was my routine. And when she passed, my friends sort of tried to fill that gap. My dad tried. It’s [01:25:40] not the same. So I would drop the kids off. That was my duty in the morning, drop the kids off, pull up at Costa, [01:25:45] grab my coffee, drive to work, and my mom would be my call from my Costa to [01:25:50] work and we would be having a chit chat. Chit chat. I’d get to work. I was like, mom, I’m at work now, call [01:25:55] you on my way home. And that would be twice a day, morning and night.

Payman Langroudi: Twice a day.

Polly Bhambra: Twice. [01:26:00] And because she lived in Preston, I tried to do that with my dad. Payman. It’s lovely [01:26:05] as it is. I love my dad to bits. It’s not the.

Payman Langroudi: Same. But imagine, imagine if you didn’t have those, you know, like there’s plenty [01:26:10] of people who don’t have that conversation.

Polly Bhambra: And then.

Payman Langroudi: Some, and then the person passes away. [01:26:15] Yeah, I’ve.

Polly Bhambra: Had some fantastic conversations. At least.

Payman Langroudi: At least you have the conversations. You know, you [01:26:20] have beautiful conversations.

Polly Bhambra: So many.

Payman Langroudi: People don’t. Know.

Polly Bhambra: I know why. I mean, I see it myself with [01:26:25] my own friends circle. They don’t have a relationship or a bond with their parents. [01:26:30] And it’s. And yeah, it’s very sad. So my mom would definitely be at the top of that list. [01:26:35] Yeah, she would be there and she and if I’d cooked, she’d be telling me off. That meal’s not good enough. This is missing. [01:26:40] Not enough salt or too much chilli or you’ve made it wrong. So definitely my mom. [01:26:45] Definitely. Um, another sort of powerful person because my mom has [01:26:50] a the traits of these other two women, as in Margaret Thatcher, the Iron Lady. [01:26:55] My mom had an element of her in her because she was resilient. [01:27:00] She had the grit. She came to England at the age of 16, couldn’t speak English, [01:27:05] and between her and my dad, they had their own little empire, five kids, [01:27:10] nursing homes, Preston restaurants.

Payman Langroudi: And she was like the the driving force. [01:27:15]

Polly Bhambra: She was the driving force. And as much as my dad might say, he wears the trousers and he’s [01:27:20] the man. My mom. He couldn’t.

Payman Langroudi: He couldn’t have done it without her.

Polly Bhambra: You’re saying she told him what colour trousers to wear? That’s [01:27:25] what it was. That’s what it was. He might wore the trousers, but she told him what colour. But she [01:27:30] was the matriarch of our family, as are the even within, you know, our [01:27:35] wider family. She was definitely. So Margaret Thatcher comes to mind. I think they would both have [01:27:40] great conversations because the 80s we had our shops and the Cold War and, you know, Margaret [01:27:45] Thatcher put herself on the map. And even till the end, Margaret Thatcher, she was self-sufficient. [01:27:50] She didn’t allow anybody to look after her. She booked herself into the Ritz, died at the [01:27:55] Ritz and my mum was very much the same. She passed away with a massive [01:28:00] pulmonary embolism in Antigua, sipping a cocktail, sitting on the beach. I [01:28:05] spoke to her in the morning. She was fine. Next thing, I get a phone call from my brother that my mum’s [01:28:10] passed. I said, that can’t be possible. He went. She was. She’s just been on the beach. [01:28:15] Um, had she’d been in the like, had a spa, came back sat, [01:28:20] had a massive pulmonary embolism and died in Antigua. I was actually in Singapore when that happened. [01:28:25]

Polly Bhambra: So then to bring her back to the UK, then do the funeral, then take her ashes back to India. [01:28:30] So traumatic, so traumatic. So Margaret Thatcher and my mom have [01:28:35] great traits in between that the Iron Lady and the [01:28:40] other trait of my mom had very much about sisterhood and about women and nurturing [01:28:45] and caring would be Mother Theresa. So the three, the four of us would have great conversations [01:28:50] about women, sisterhood, how to leave [01:28:55] a legacy behind, how to, you know, stand up for adversity. [01:29:00] And my mom was very much about that. Yeah. So those are my and if we’re going [01:29:05] to add a male to the combination, go on. Alexander [01:29:10] Bell. The guy who invented the the phone and saying, come on, did [01:29:15] you ever think that we were going to have You were going to invent something that we can’t live without. It’s glued to [01:29:20] our ears. It’s it, you know. Did you ever think that he was a Scotsman? [01:29:25] I think because my pa goes on about this Alexander Bell, how great he was. [01:29:30] And she’s Scottish. She’s Scottish. Yeah. Yeah, they’re very proud. Yeah. They’re very proud. Yes. Yeah.

Payman Langroudi: Final [01:29:35] question. Yes. There’s a deathbed question.

Polly Bhambra: Yeah.

Payman Langroudi: It’s all supposed [01:29:40] to be horrible. It’s like it could be. It could be a different question. But it’s a deathbed question. You’re on your deathbed in many, [01:29:45] many, many years from now surrounded by your grandchildren’s grandchildren. If [01:29:50] you had to leave them three pieces of advice, what would they be? [01:29:55] Mm.

Polly Bhambra: You know, simple, simple things that we [01:30:00] just take for granted. We say, oh, it’s nothing. Sometimes those simple things are the big things. [01:30:05] Just simple. Be kind, be nice. You know, being you might [01:30:10] not have an education, you might not have money. But being kind and being nice will get you so far in life [01:30:15] you don’t realise and really treasure those moments. And you know [01:30:20] what? Don’t live to somebody else’s expectations. Don’t live to somebody [01:30:25] else’s. What they think you should be like or what they expect you to be like. Live for yourself [01:30:30] and do right by yourself what your heart says and the you know. And it’s the usual [01:30:35] work hard, be a kind person. But it is those. Be kind. Live to [01:30:40] your own expectations. Have a voice and always strive to be better. Thrive to do something [01:30:45] more. Don’t just give up at your first hurdle and it’s back to that. In [01:30:50] our Sikh culture, we have a state and it’s a state of mind which is called chardi [01:30:55] kala, which means everlasting positivity. No matter what throws at you have [01:31:00] that everlasting positivity. It will get you through anything. You know, the death of my mother [01:31:05] was so sudden, so traumatic. But I find every day that piece [01:31:10] of positivity that she left behind us. And you.

[TRANSITION]: Know, I.

Polly Bhambra: Still talk to her, say something. And lo and behold, [01:31:15] I get some. You know, the universe gives me that message. I’m like, thanks, mom. I get it, you [01:31:20] know? So it’s that so just. Yeah, that that would be my advice to my [01:31:25] young family behind.

Payman Langroudi: That’s going to be I reckon that’s going to be the name [01:31:30] of the episode.

Polly Bhambra: Everlasting positivity. Chardi Kala, my practice manager, [01:31:35] has that tattooed on her leg. [01:31:40] Can you believe it? She sent.

Payman Langroudi: Me a Sikh at.

Polly Bhambra: Least. No, she’s.

Payman Langroudi: Not.

Polly Bhambra: She’s not. [01:31:45] She’s white as they come. She’s amazing. She’s left. Actually, she again, that’s another [01:31:50] success story. Started off as a PM, did really well. And now she’s heading some [01:31:55] part of Portman somewhere and she’s got it on her thigh. Because that would be my mantra. Keisha [01:32:00] will get through anything. Just be positive. We’ll find a way. And she’s had that tattooed on her leg. Chardi [01:32:05] Kala.

Payman Langroudi: I’d like to have you back. You know, like in five years. Time to see what’s happened. [01:32:10] It’s one of the I can see. It’s a beautiful story so far, so I really, really, really enjoyed that. [01:32:15] Thank you so much for coming all this way.

Polly Bhambra: Thank you so much for your kindness. It’s been lovely. Honestly, I feel so humbled to be invited [01:32:20] to be in the same room as you and to be having this conversation. It’s lovely. So thank you. [01:32:25] Honestly, thank you so much.

[VOICE]: This is Dental Leaders, [01:32:30] the podcast where you get to go one on one with emerging leaders [01:32:35] in dentistry. Your hosts Payman [01:32:40] Langroudi and Prav Solanki.

Prav Solanki: Thanks for listening guys. [01:32:45] If you got this far, you must have listened to the whole thing. And just a huge thank you both from [01:32:50] me and pay for actually sticking through and listening to what we’ve had to say and what our guest has [01:32:55] had to say, because I’m assuming you got some value out of it.

Payman Langroudi: If you did get some value out of it, think [01:33:00] about subscribing. And if you would share this with a friend who you think [01:33:05] 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 [01:33:10] star rating.

James Morrison: I had this one girl who’s had a bit of a strange request where she wanted goofy teeth. [00:00:05] She wanted big teeth. Like she didn’t want square. [00:00:10] She wanted, like, the front two to be a lot longer. And she was showing me all these pictures and I was like, [00:00:15] this is random. And I’m like, it’s not normally what I would do. But, you know, me being like Mr. [00:00:20] Nice People Pleaser, I’m like, well, you know, cosmetic dentistry is subjective. It’s [00:00:25] her opinion. At the end of the day, why? Who am I to judge and say that’s wrong? Yeah. But then [00:00:30] it kind of evolved because she was doing Invisalign anyway because the teeth are crowded. But then she was showing [00:00:35] me pictures of her teeth, the teeth that she liked. And I’m like, they’re a lot bigger than your teeth. So the only way to go get teeth that big [00:00:40] is to open up spaces with Invisalign, to then close those spaces with bigger teeth. [00:00:45] So we went through all that. I started opening up space.

[VOICE]: This [00:00:50] is Dental Leaders, [00:00:55] the podcast where you get to go one on one with [00:01:00] emerging leaders in dentistry. Your [00:01:05] hosts Payman Langroudi and Prav Solanki.

Payman Langroudi: It [00:01:10] gives me great pleasure to welcome James Morrison onto the podcast. [00:01:15] James is a long time friend of mine, a massive enlightened user. [00:01:20] Been on many small make over a couple of times too. Yeah. Uh, cosmetic [00:01:25] dentist in Bristol. Um, James, it’s good to have you. [00:01:30] I kind of want to sometimes. I’ve got, like, a burning question. I want to get out straight away. Of course. Yeah, go [00:01:35] for it. Um, but when did you switched over to being just cosmetic? Recently. [00:01:40] Right?

James Morrison: Yeah, around Covid time, just after Covid.

Payman Langroudi: The mindset [00:01:45] of a cosmetic patient is obviously more difficult than [00:01:50] a non cosmetic patient.

James Morrison: Yeah, definitely.

Payman Langroudi: What’s your top tip around managing [00:01:55] patients I’m not talking about the teeth Patient management of a cosmetic patient. [00:02:00]

James Morrison: It’s difficult for sure. And firstly, I want to say thank you for inviting me on, by the way. I’ve been a [00:02:05] huge fan of this podcast. I switch between this and diary of a CEO and like [00:02:10] every commute to work. And with the cosmetic patient, especially nowadays [00:02:15] with Instagram, they’re seeing these perfect teeth and the expectations [00:02:20] are just going up and up. And I’d say the hardest thing when you first [00:02:25] get into cosmetic dentistry is the fact that obviously you’re learning, right? You’re [00:02:30] not that good yet. It takes quite a lot of courage to get [00:02:35] through those. I would say at least the first year of doing this kind of work, because [00:02:40] you have to accept that there are going to be some revisions. [00:02:45] It might not be perfect, you might not meet that patient’s expectation, because I think that’s less demoralising [00:02:50] on you as the dentist. If you’re already prepared that you may have to tweak things, you don’t necessarily [00:02:55] see it as a failure. It’s more just like a first try.

Payman Langroudi: You prepare them for the fact that there might be revisions. [00:03:00]

James Morrison: Yeah, yeah, yeah. That’s what I learned early on. When you get that patient that’s [00:03:05] like, oh, it’s not quite what I wanted. Obviously over time that happens less and less. And therefore you’ve [00:03:10] become far more confident. And quite often you nail it first time actually. Often [00:03:15] cosmetic dentistry is subjective. There is no right or wrong. So, you know, you [00:03:20] do one thing on one patient, do the same thing on the next patient, and then the next patient is actually like, no, no, that’s not what [00:03:25] I wanted.

Payman Langroudi: But type of cosmetic patient is the type that you’ve come across [00:03:30] that’s been the most difficult. Like in your head.

James Morrison: Have them like in your head.

Payman Langroudi: Have them separated [00:03:35] into different types. Because I speak to Matty Parsons about this. Yeah. And he says the kind [00:03:40] of patient who comes in very exacting, knowing exactly what they want is actually [00:03:45] easier than the type that says, I’ll leave it up to you. That’s true, because the ones who leave it up to you [00:03:50] sometimes, you know, they’ve still got something in their head. Yeah, yeah. You’re just.

James Morrison: Not. Yeah.

Payman Langroudi: Confident [00:03:55] enough to say it. And the demo of your patients are generally younger. Yeah.

James Morrison: Younger patients I’d [00:04:00] say 18 to 35 because of all the Instagram promotion. So again, a.

Payman Langroudi: Different mindset with them [00:04:05] than I used to treat a lot of older patients. Cosmetically another different mindset. Yeah. [00:04:10] So tell me what comes to mind when I say which type of just.

James Morrison: The divas, you know, they come in [00:04:15] and they’ve got the lips and they’ve got the boobs done and they come in the early days.

Payman Langroudi: Body [00:04:20] dysmorphia.

James Morrison: Yeah, that kind of vibe. I haven’t done it often. [00:04:25] I would say in the early days when I realised, you know, some patients [00:04:30] can be difficult. There’s probably about a handful of patients I have written to to say that [00:04:35] I do not think I’m going to meet their expectations before you even start. Before I even start. Yeah. Yeah. And [00:04:40] they would be best. But the problem ones tend.

Payman Langroudi: To be the ones where you don’t spot it.

James Morrison: And [00:04:45] that actually happens a lot. Like a lot of people are nice in the, in the consultation. And [00:04:50] then once you’ve started treatment they kind of turn a bit and seem a bit [00:04:55] difficult, or you’ve run like ten, 15 minutes late and they’re like really angry about it. Yeah. [00:05:00] Causing a scene. To be honest, I haven’t had too many difficult, difficult [00:05:05] patients. I would say in a way, having social media advertising, because you’re kind [00:05:10] of presenting yourself and I try and actually keep my page quite personal. You actually do get a lot of people [00:05:15] who have kind of picked you out because they feel like they gel with you. So I actually [00:05:20] find I have less overall difficulty with [00:05:25] patients now that I’m this cosmetic dentist that has these patients come in through Instagram than I did [00:05:30] when I used to run like an NHS, you know, have an NHS list with varying ages because [00:05:35] it just gets easier and easier.

Payman Langroudi: On the first visit. They already think they know you, [00:05:40] so there’s an element of that.

James Morrison: Quite big on the patient journey and gelling with the patient. Anyway, [00:05:45] I do like to make sure I’m building rapport and all of that is in place before I start doing any work. [00:05:50] I would say it’s just easier when they’re coming in already with a similar mindset to you. Compared [00:05:55] to when I used to do the NHS work, or a patient in their maybe in their 60s, and you’ve [00:06:00] done a crown and they’re quite nervous. They’ve had all this history of bad dentists and [00:06:05] everything and they’ve.

Payman Langroudi: Come in with baggage already.

James Morrison: Yeah, they kind of see me in a way as this cool [00:06:10] Instagram dentist. So they often want to keep me on side, I find, and they [00:06:15] want to get on with me as much as I want to get on with them.

Payman Langroudi: So look what comes to mind. I used [00:06:20] to do cosmetic dentistry in the 90s when I was a dentist. I was a proper five days a week [00:06:25] dentist, and back then it was porcelain veneers. Yeah. And back then, the temporaries weren’t even. [00:06:30] You know what they’re going to get in the end. The temporaries were what they have right now. Yeah. That [00:06:35] way of doing it. And, um, I remember one case in particular where [00:06:40] the the patient was always very happy. She’d go home and then [00:06:45] come back with problems that are I can’t remember. But daughter [00:06:50] was saying they don’t look good. And it was a nightmare, man, because we [00:06:55] fit the veneers. I thought they were great. The nurse was like amazing hugs and kisses. It’s [00:07:00] all brilliant. Everyone’s happy. Go home. My daughter doesn’t like them.

James Morrison: Yeah, [00:07:05] that’s that’s the worry.

Payman Langroudi: Yeah. And then. And then adjust. Oh I’m happy again. Go home daughter. Something [00:07:10] else. Yeah. And I realised you know there’s a few things going on there. Number [00:07:15] one you know you, you put ten veneers on someone you’re talking about sometimes 15 [00:07:20] grand of work or something. So that £15,000 is an amount [00:07:25] that could change people’s lives sort of thing. You know, that, you know, maybe the daughter wants [00:07:30] a new car or whatever it is. There’s that aspect of it. Yeah. So we’re not talking small amounts of money [00:07:35] sometimes, of course. And number two, interestingly, I fitted some veneers on my own dad. [00:07:40] Right. I fitted them everything. He got up, nursed over the moon. [00:07:45] He looked at them and he went, I’m so proud of you. I looked at him and thought, that’s not my [00:07:50] dad. Yeah, yeah yeah, yeah. And what it is is that, you know, the gaps had gone. And [00:07:55] sometimes you you love someone for their weaknesses rather than their strengths, you know. [00:08:00] And so managing all of the, you know that that third party sort of side of [00:08:05] things. Yeah. Yeah.

James Morrison: It’s complex when it comes to porcelain veneers. I’m [00:08:10] quite big on doing the trial smile and actually doing it while polishing them up, putting the [00:08:15] glaze on like making them actually feel nice and are very close to what the real [00:08:20] final result is going to be, and then sending them away, letting them have those like [00:08:25] opinions from other people. Get them back in for review. What do you think this [00:08:30] is.

Payman Langroudi: Going to do that.

James Morrison: With composite? It’s very much like I just like to do it. And then if [00:08:35] the patient wants to change it, I’ll get them back and I’ll just like revise it at that point. My worst [00:08:40] nightmare would be fitting porcelain veneers. And then yeah, the patient turning around and saying, [00:08:45] I hate these or someone doesn’t like them and we need to change them.

Payman Langroudi: Now they’re fitted, right?

James Morrison: That is a worry. Yeah, [00:08:50] that is a worry. Yeah. I haven’t had that, luckily.

Payman Langroudi: So you you alluded to [00:08:55] being hot on patient journey. Go on. What does that mean to you?

James Morrison: You know you [00:09:00] get a lot of practices doing, you know, the whole treatment coordinator thing. Like, I like to just [00:09:05] be in full control from the outset. So I like to be doing the whole consultation [00:09:10] and everything. The workflow is very much like my wife does all my admin. Yeah. So she’s [00:09:15] answering all the DMs. Only because I was doing that once upon a time. But when Covid hit, it was [00:09:20] getting too much. And also you get patient on a Saturday night saying, oh, something’s chipped and you’re just a bit like, [00:09:25] oh God. Like just that anxiety it would create for me knowing that someone’s having an issue was [00:09:30] too much. Yeah. My wife does all the DMs so that I don’t really see that. And it’s very. [00:09:35]

Payman Langroudi: Percentage of your patients come from Instagram 100%. Pretty much word of mouth right from those [00:09:40] same patients. Yeah.

James Morrison: Yeah. I’m getting a lot of the mum mums coming in from a lot of my patients now. [00:09:45] So it started off a younger generation and now it’s a lot of older patients coming through as well.

Payman Langroudi: So [00:09:50] we’ll have to go into the Instagram thing too. But go on. Yeah. Go on. Let’s talk about the patient journey, the.

James Morrison: Message, the Instagram page. [00:09:55] My wife has a pretty much one template that covers all angles. She’ll essentially say [00:10:00] to book a consultation email info at Doctor Morrison. Co.uk. That then goes [00:10:05] to Rosie, my receptionist, and then she just goes to a little back and forth. Patient [00:10:10] pays for consultation, gets booked in with me. Interestingly, during Covid, [00:10:15] I actually started doing some video consultations only because [00:10:20] during Covid the Instagram page boomed and I couldn’t see anyone because obviously we [00:10:25] couldn’t go into the practice. So I designed this presentation with all the different [00:10:30] treatments before and after pictures, all of that, and I’d just do it on zoom where I do [00:10:35] a screen share go through the presentation. The patient patient would have sent me four photos [00:10:40] of their teeth from different angles. Occasionally, if it’s a complex case, I might say we need to confirm this in [00:10:45] person, say nowadays especially I can diagnose from pictures alone pretty [00:10:50] easily, you know? During Covid, I sort of polished that aspect out. So now what? [00:10:55] Because I still get quite a few patients travelling in from from far away I do every [00:11:00] other Friday I’m working from home just still doing them video consultations. I do like clean [00:11:05] checks for Invisalign as well, and just some simple reviews after bonding or whatever. So [00:11:10] I do like a work from home day, which is pretty cool. Like there’s not many dentists that can do that. And then I also do consultations [00:11:15] in the practice as well. But it’s very much like in the practice. For example, I go out, greet the patient, [00:11:20] bring them in, find out where they’ve travelled in from and what they’re up to today. All of them kind [00:11:25] of questions like, how long do you.

Payman Langroudi: Talk to them before even starting to look in the in the mouth?

James Morrison: Not long, maybe [00:11:30] five minutes. You know, it doesn’t need to be that long. It just needs to be a few questions. And I [00:11:35] find, you know, where have you travelled in from to to? Today is a nice one also. How did you hear about [00:11:40] it? Was it through the Instagram page or did you come through a friend? I like that one. Just for my own knowledge. Finding [00:11:45] out how many people are really coming through Instagram and how much is word of mouth. They asked us a few questions [00:11:50] just to chill them out. You can tell instantly they’re quite happy then, because you maybe had a little bit of a joke in [00:11:55] there. Trying to get them to laugh is actually priceless. I find if you can actually have a [00:12:00] bit of banter with the patient. Yeah, that’s like amazing. So and you can tell they’re almost [00:12:05] instantly on board at that point. Then I’ll take just a few brief photos because I get them [00:12:10] back for an examination after that anyway, so once they’ve booked in, they’ll get the proper photos. If I take a few brief photos [00:12:15] just to let them know I’ve got some, like, cool equipment basically.

James Morrison: Yeah. And then lying back [00:12:20] in the chair, scan the teeth to scan everyone, sit them back up and get the teeth up on [00:12:25] the screen. And then I’ll go through my presentation on a screen as well. It’s the ABC [00:12:30] presentation Align Brighton Contour. And you can tell the patient likes that [00:12:35] they’re on board at that point because they think, oh wow, he’s actually educating me. And I’m starting to actually understand [00:12:40] what these treatments are about the align Brighton contour align obviously is Invisalign Brighton [00:12:45] mainly enlighten and then contours either composite bonding porcelain veneers [00:12:50] and I’m very open with the fact that they can do it all. Or we could phase the treatment and do part of the [00:12:55] treatment. I’m not a pushy dentist in the fact that this is your one price and that’s [00:13:00] it. Interestingly, I find when you give people a few options, maybe [00:13:05] if you give them three options or at least two, go for the middle one, they’ll go for the most expensive every time. [00:13:10] Yeah. It’s interesting.

Payman Langroudi: So there’s a big element in that first meeting of rapport [00:13:15] and trust and all that because you kind of know what you’re up against clinically. Yeah. [00:13:20] Kind of already. Yeah. But right now you give them the three different plans. You get them to agree [00:13:25] or not if possible there and then to you most of the.

James Morrison: Time, to be honest, the patient has decided [00:13:30] what plan they want because it’s quite clear. You know, I talk through the payment options as well. At that point [00:13:35] I’m very clear about the financial aspect. You can do finance, they can part pay each visit all of [00:13:40] this. So I’m very clear about the money. I think that’s quite a big drawback for patients when when [00:13:45] that’s not clear they sometimes won’t go ahead with treatments. Yeah. They’ll go out to reception. And I would have said [00:13:50] either you can look at appointments in the diary today with Rosie and then it’s normally 500 minimum [00:13:55] deposit to book in or set up finance. So they could either do that or if they want some time [00:14:00] to think about it, which I do say, I’m constantly very adamant. I don’t want to seem [00:14:05] pressurising. Yeah, yeah, yeah, we can email them the information, which is very much like [00:14:10] their treatment plan. And the great thing about my software actually at work now that I use is [00:14:15] you can send them the treatment plan and all the consent for each treatment option. So [00:14:20] they literally just have one document that has all the all the benefits, all the risks for each treatment [00:14:25] software. Is it um, I smile, have you heard of this one? Each treatment [00:14:30] option has its designated consent and you just click the tick and it would be on [00:14:35] that consent form.

James Morrison: So it’s all in just in one place and then they’ll get another email booking, [00:14:40] treatment and payment options. I’ll normally email them all my nurse. Essentially, [00:14:45] it will be the timeline of their appointments, whatever the time intervals are. And these are all templated, [00:14:50] so it’s all clear on there. The total fee payment options and then the patient could respond. [00:14:55] This is my availability. This is what payment option I want. And then Rosie will already have in that [00:15:00] email the timeline so she’ll know what to book. So I’ve streamlined that so that [00:15:05] it just seems quite slick and quick. So after the consultation, whether it’s in person [00:15:10] or on zoom, they will have all that information within five minutes of [00:15:15] essentially what their appointments are total fee payment options, a [00:15:20] treatment plan with all the consent. I don’t I’m a kind of dentist. I don’t like to have any kind of [00:15:25] admin outside of just being in the surgery. So I’m quite efficient [00:15:30] with just getting it done and like having it ticked off occasionally. Obviously I might run [00:15:35] late. And what’s your.

Payman Langroudi: Kind of positioning? Are you expensive? Cheap? [00:15:40] The same price as other dentists. The weird thing.

James Morrison: At the moment is I’m [00:15:45] getting to a point where my loops are higher. Mag, and I’m now 8.8 times [00:15:50] my skills are getting better, so I’m just. I’m seeing more detail and I’m actually [00:15:55] slowing down, right? Yeah, I would say just after Covid I was like a machine just smashing it out. [00:16:00] But it was almost like what you can’t see. You don’t know. Yeah, I could work very [00:16:05] fast at that point, but now I can’t really compromise on the quality. [00:16:10] So it’s getting to a point where I’ve done some price increases, but I probably should be [00:16:15] doing more given the quality that the patients are now getting and the time that I’m now spending. But [00:16:20] it’s £350 for composite bonding. You know, I know a lot of the London and guys [00:16:25] up north are sort of charging 400 at some point. I probably would go up to that. But [00:16:30] in Bristol the demand for cosmetic isn’t as high. So I don’t I don’t want to. And [00:16:35] are there.

Payman Langroudi: Other possible price objections? Or do I mean, is there, for instance, [00:16:40] I mean, in this sort of touchy feely environment that you’ve set up, it kind of would ruin [00:16:45] the conversation if someone said, oh, I’ve been somewhere else, and they do it for 300. Yeah. Is [00:16:50] that is that a red flag? When that happens.

James Morrison: That probably would be a red flag. And I’m like, well, no. Most of the time they’re charging [00:16:55] cheaper because it’s not as good a product. But I rarely ever have anyone say, oh, I can get [00:17:00] it cheaper somewhere else.

Payman Langroudi: Even with the brands like they say, Invisalign and Lighten, they look [00:17:05] it up. None of that. I think.

James Morrison: It’s because, you.

Payman Langroudi: Know, they’re sold on you from your page.

James Morrison: Yeah, I think in [00:17:10] London and up north, you know, there’s there’s so many dentists on Instagram, there’s so much choice. Whereas [00:17:15] it just seems in Bristol there isn’t many people doing what I’m doing. So they kind of see [00:17:20] it as I want to go to James because I’ve seen his work. So that’s [00:17:25] just the price and they don’t really bat an eyelid. Did you put the price up? I know at some [00:17:30] point I should. Yeah I did, and you said the.

Payman Langroudi: Ones that come from far and wide, is that a lot [00:17:35] or a few or um.

James Morrison: Ten, 20% maybe come from sort of [00:17:40] like Devon Cornwall area. So that side of the country, even.

Payman Langroudi: Fewer dentists down there. Yeah, even. [00:17:45]

James Morrison: Fewer down there. And they obviously don’t want to travel all the way to London. So I do get quite a lot of Devon, Cornwall, Dorset [00:17:50] that sort of areas. But majority are Bristol and Weston-super-Mare, [00:17:55] which is where I used to work. So yeah. But some you know, I did do a price increase with when Invisalign [00:18:00] put their prices up. I did the exact same increase. Yeah. But and I did a few just, you know, [00:18:05] a check-ups now £65 rather than 50. You know, little ones like that. It’s always it’s always a tough [00:18:10] one because you don’t want to like, do it and then see your numbers drop. And it’s always harder to reduce your price once [00:18:15] you’ve gone up. But yeah, the composite bonding one I you know, that’s one I’m looking at at the moment as how much [00:18:20] could I creep that up by. Because it’s the thing that I’m. Yeah. I’d say spending longer [00:18:25] on.

Payman Langroudi: You do a lot of them right. You’re good at them. It’s your price should reflect that. But [00:18:30] I think one other thing like let’s not even talk about dentistry. Let’s talk about any other business. Let’s [00:18:35] say you’ve got a restaurant. Yeah. One thing we don’t sort of get our head around [00:18:40] is that. And just to keep it simple, let’s imagine the restaurant doubles its price [00:18:45] for the sake of the argument, doubles its quality. Um, and [00:18:50] let’s imagine half the the people who go to that restaurant, the [00:18:55] customers don’t come back. Yeah, that restaurant is better off [00:19:00] with half the customers, of course, at double the price, of course. Yeah, because he’s doing half the amount [00:19:05] of work. Mhm. And making the same amount of money. Yeah. Yeah. Yeah. Yeah. That, that, that [00:19:10] double.

James Morrison: The price of composite.

Payman Langroudi: Bonds. No no no. But but it’s not about doubling right. It’s about you increase [00:19:15] it by a 20%. Yeah. Yeah. Let’s imagine there’s a 20% [00:19:20] drop off. You’re better off. Yeah of course. Yeah. Yeah. And but it’s not it’s not an equation we [00:19:25] get clear in our head. Now of course you don’t want to increase it so much that you’re not working. [00:19:30] Yeah. That chair needs to be busy. But but but understand that that if there is a [00:19:35] drop off. I used to have a boss here. He was like. Unless everyone’s completely complaining about price, we’re [00:19:40] not charging enough. And he used to constantly put the prices up. Yeah. This guy. Yeah. You should have [00:19:45] seen that. Patients loved him as well. You know, so there isn’t that relationship [00:19:50] between price and volume, you know. Yeah.

James Morrison: I think like my efficiency [00:19:55] I’ve managed to kind of nail down over time. And I feel like, you know, when you [00:20:00] just feel like you’re comfortable enough, you know, you’ve got a nice house and you know, you’re not really worried about paying bills. So [00:20:05] it’s sort of not like front of mind for me at the moment. But yeah, I do know at some [00:20:10] point I should because because ultimately I’m trying to reduce my days, if anything, [00:20:15] because, yeah, I’ve done the five days, six days work in the past. And, you know, I want to spend more time [00:20:20] with my son. And yeah, so, you know, it’s more it more be about that really like raising [00:20:25] the price so I don’t have to work quite so much. How many days.

Payman Langroudi: Do you work now?

James Morrison: Um, so it’s. Yeah. [00:20:30] Four. So four days a week in practice and then every other Friday, working from [00:20:35] home, then every other Friday off. So, um, that seems to work quite nice. I think [00:20:40] five days in practice is a lot. Yeah.

Payman Langroudi: At the, at the kind of work you’re doing as well.

James Morrison: Yeah. It’s a lot. [00:20:45]

Payman Langroudi: I can’t do it well over five days I think. I mean some people can. Yeah some people can. Yeah. But but [00:20:50] I think four days as a practice owner, I’d say even three days. [00:20:55] Yeah. Yeah. Okay. As a dentist. Because as practice, I mean, you’re kind of you’re I mean, you’re renting a room now. Yeah, [00:21:00] I’m renting a room. You’re not quite an associate. It’s a kind of different situation. Yeah. You’re kind of in an in-between as [00:21:05] a practice owner. There’s so many things that have to be done. Questions have to be asked, staff that aren’t getting on with each [00:21:10] other. So many things like that on top of the dentistry. Yeah, yeah. That I for [00:21:15] me, I’d say three days is enough for the practice. Yeah yeah, yeah.

James Morrison: 100%.

Payman Langroudi: You know, I’m not going to be popular with [00:21:20] people for saying that. Let’s get back to the way we normally start. Okay. Yeah. Where [00:21:25] did you grow up?

James Morrison: So I was actually born in America. Erica. So, yeah, I was born in Florida, a place [00:21:30] called Fort Walton Beach, Florida. My dad’s American. All our all his side of the family from Miami. [00:21:35] And. Yeah, but I only was there for about three years. And then my my mom missed her [00:21:40] family. She’s she’s from Liverpool. Uh, so, yeah, she, we we decided to fly back [00:21:45] and there was an American Air Force base in Alconbury, sort of East Anglia area, and my dad could [00:21:50] work. So we kind of resided in that area. And then. Yeah, I grew up in, grew up in Peterborough, [00:21:55] basically.

Payman Langroudi: And your dad did what?

James Morrison: American Air Force. What did he do with the [00:22:00] military? He was just fixing planes, basically.

Payman Langroudi: Actually fixing planes.

James Morrison: Yeah. Um, yeah. My dad’s. My [00:22:05] dad’s an interesting one. There was something about him and the fact that he just never really got anything done, like [00:22:10] the ultimate procrastinator. So I think growing up, me seeing that and seeing the [00:22:15] stress that used to cause, especially for my mum, has always been the big driver for me to be like, [00:22:20] okay, I need to work hard and be productive to actually like get anywhere [00:22:25] in this world. So I think in a way, like my dad, it was [00:22:30] sort of a reverse role model in the sense that I was like, I wanted to do what not to do. Yeah, [00:22:35] for sure, for sure.

Payman Langroudi: Although do you have any, like, thoughts that maybe he had like a severe ADHD [00:22:40] or something that we didn’t have a name?

James Morrison: He definitely has some sort of mental health. [00:22:45] 100% because I mean, he would be late for everything. And like, I’m [00:22:50] talking like he’d he’d be picking us up all the whole family up from the shops and he’d be [00:22:55] like, four hours late. Can we be, like, sat there, like, where have you been? And he’d be like, he wouldn’t really have a reason. [00:23:00] He misses every single flight he’s ever tried to get. Yeah. So like, every time he’s like, messages. I’ve missed [00:23:05] the flight. He just he just doesn’t really get around to to doing anything. But he’s [00:23:10] kind of innocent about it, you know, it’s like, I don’t, like, have any hard feelings towards him. I’ve [00:23:15] just learned not to rely on him for anything anymore. So I do think that was a driver for me, because my mum would always [00:23:20] say, oh, you’re nothing like your dad. Like you’re so like, I’d be in the gym and I’d be, like, working hard at school. [00:23:25] I feel like that was the big part that played was just seeing him not really achieving [00:23:30] anything. And ultimately he retired from the Air Force and now he actually lives back in America. [00:23:35] Do you still see him? Not much like my brother moved over to America as well. My brother is teaching out [00:23:40] there as well, so I don’t get to see my brother much either. Were you a very studious kid? Not really. [00:23:45] I mean, growing up, it was all about sport. I used to play a lot of football, so it was very much [00:23:50] like that was my life.

James Morrison: So yeah, I would say from the age of like eight, [00:23:55] up until the age of like 14, like my whole life was, was football. And I didn’t really care too [00:24:00] much about school. Yeah, I used to play for Leicester Academy. That was going to be the career. And [00:24:05] then yeah, unfortunately like overnight around about 14 years old, sort of started losing all my athleticism. [00:24:10] Got a lot slower and I had to quit basically, which was was really hard. And then yeah, I would say [00:24:15] just before GCSEs, that’s when I kind of knuckled down a bit more with school because I realised, okay, football’s [00:24:20] not going to happen. That’s when I started actually revising, I’d say GCSEs. I kind of winged it a little [00:24:25] bit. Got got through with I think it was like three stars, five A’s and three B’s [00:24:30] without any revision. But then when I went into A-levels, obviously I [00:24:35] got a, I got a U in my first biology exam, and that was when my [00:24:40] mum was like, right when you really need to knuckle down. And then I actually made the decision to do dentistry and [00:24:45] that’s when I. Why is that? That’s a random one. So yeah, I haven’t got any [00:24:50] sort of dentistry in the family in any way. It was literally my mate’s dad who was just one [00:24:55] of these like really knowledgeable guys who just seems to just have so much wisdom. He [00:25:00] was just like, after a night out, I just sat on his lounge floor and he was like, you [00:25:05] know what? I really want Andrew, who’s my mate.

James Morrison: I really want Andrew to be a dentist. And I was like, oh, right. [00:25:10] Why? He’s like, oh, well, you know, my brother’s a dentist. He’s got, you know, works whatever hours he wants. [00:25:15] Really comfortable life, nice house, nice car. And I was like, oh right. Okay. And he was [00:25:20] like, what do you want to be? And at the time, because I’d come from football background and I was doing [00:25:25] sciences. I was like, oh, maybe physiotherapy. He was like, there’s no jobs. You’re like, you’re going to get out there. [00:25:30] There’s it’s so competitive. You want to do a degree where you’re definitely going to get a job. So medicine, [00:25:35] dentistry, that’s what you need to do. And I was like, right, I never thought. And he was like, you really [00:25:40] need to think about not just the job. Everyone’s like, oh, do what? What you like. You know, do what you [00:25:45] love. Do what you’re passionate about. He was like, what you really need to think about is what life you want to live like [00:25:50] outside. Because that’s what’s going to make you happy. Like a job is a job at the end of the day. If you want to be going [00:25:55] on a certain amount of holidays a year or living in a certain standard of house, you need the job to supply [00:26:00] that. And that was like a light bulb moment. Something clicked in.

Payman Langroudi: Your little 17 [00:26:05] year old head. You know, it’s sort of.

James Morrison: Like, I want all of those things. So [00:26:10] and I think growing up where my parents didn’t have a lot of money and, and I saw the stress that [00:26:15] that can bring it, it literally just overnight was like, I’ll be a dentist. Then that was it. I [00:26:20] kind of booked on to do some work experience and that was it. You know, when I was there, the [00:26:25] funniest bit about the work experience was on day one, it got cancelled because the dentist decided [00:26:30] to go on a golf trip, which I was like, sold. I [00:26:35] want to do this job where I can cancel my day last minute to go play golf. And [00:26:40] yeah, the dentist that I did work experience with was really, really nice guy. And yeah, just [00:26:45] yeah, that opened up my eyes to it. And I just thought I’m just going to go for it and sort of knuckled down with, [00:26:50] with revision and, and to be honest, once I put my mind to something like even the teachers, it was overnight, [00:26:55] they were like, I went from dozing around really in class to suddenly knowing everything and answering all [00:27:00] the questions, and they were like, wow, okay, an A-levels. It got to the point where the Aqa, the [00:27:05] guys who run the exam used to just ask the same questions over and over. So I used to do all the past papers [00:27:10] and I’d know literally the whole mark scheme. I remember the teachers being like, are you cheating? [00:27:15] You know, it got to the point of getting 100% in exams and getting all A’s and a level. [00:27:20] And yeah, it was a sudden turn in me becoming a bit [00:27:25] more serious when it came to the academic side. So yeah, in Peterborough.

Payman Langroudi: At this point.

James Morrison: Yeah. Still in Peterborough. Yeah. [00:27:30] I mean the school I went to wasn’t great. It got very little help. So it was all very much like me just at home [00:27:35] self-teaching myself. It was just a very average state school. Most people don’t go [00:27:40] on to do dentistry or medicine. So it was a little bit outside of the box. And [00:27:45] then when you.

Payman Langroudi: Got when you got to Bristol, what was the feeling?

James Morrison: Oh, amazing.

Payman Langroudi: It’s a wicked [00:27:50] city Bristol. I love Bristol. I love Bristol.

James Morrison: It’s so, so good. And the years I had there at [00:27:55] uni, because I had a lot of them, I had did a six year degree because I did pre-dentistry, so I didn’t actually [00:28:00] do chemistry A-levels, ended up having to do pre-dentistry, which I don’t do anymore. So yeah, I did six year [00:28:05] degree, plus I took two years out because I had to have operation on my shoulders. So I ended up start to finish [00:28:10] being essentially a student in Bristol for eight years. So, you know, [00:28:15] it very much became like my home. Yeah for sure. And yeah, now I live there. I live there [00:28:20] now. I don’t see myself moving anywhere else.

Payman Langroudi: But what kind of a kid were you? I mean, were you, like, first [00:28:25] time out of the house, go crazy party kid? Or were you serious? Study? Yeah, [00:28:30] the first year, like first year?

James Morrison: Oh, yeah. I was very much not going to any lectures, getting [00:28:35] people to bring the handouts home so I could like.

Payman Langroudi: Was there a moment where in university [00:28:40] became serious as well?

James Morrison: Um, I think firstly because it was pre Dental, it wasn’t like quite [00:28:45] as serious, which I’m quite glad it went that way around. Yeah. I was very much like partying. [00:28:50] Yeah. Towards the end of the dentistry degree. Yeah I would say I knuckled down more [00:28:55] but I mean yeah, it got to the point. In my second year I started running all the club nights for, for the students. [00:29:00] You know, I started I started being a fully fledged event organiser, which was a lot of [00:29:05] late nights. Sometimes I’d have a few events on a week.

Payman Langroudi: So yeah.

James Morrison: Yeah, [00:29:10] yeah. I mean it’s not it’s not cheap being a student, especially in Bristol, but [00:29:15] so like that.

Payman Langroudi: Was kind of a mini business.

James Morrison: That was a mini business. Yeah, that was my first introduction, really to to [00:29:20] entrepreneurship and and business because it’s.

Payman Langroudi: Like, oh, go on, go on, tell me, tell me about the club nights, [00:29:25] funding, DJs and venues, all of it. How big was the biggest one?

James Morrison: Uh, [00:29:30] I’d say 3000 people. Maybe 3000 people. Yeah, one, one event actually [00:29:35] got shut down because so many people turned up. There were stampedes outside, you know, prism, you know, the, [00:29:40] the big used to be Oceana in Bristol. Yeah. Um, yeah. We had the police shut an event down [00:29:45] because so many people turned up and were trying to, you know, stampede to get in. And was it just. [00:29:50]

Payman Langroudi: You or did you have a partner?

James Morrison: So, so to start with, it was just me. So in my first [00:29:55] year, there was a guy going around selling tickets and I was like, why are you doing this? He’s like, oh, you sell the tickets. We keep the profit and the [00:30:00] venue get the money from the drinks. I’m like, what? I presume the club took everything. They’re like, [00:30:05] no, no, no. If you if you do it, especially on a midweek night where you’re bringing students to the door, you keep the promoter, you keep the promoter. [00:30:10] Yeah, yeah. So that was like a light bulb moment. And I was like, hang on a minute, because I was already struggling because my [00:30:15] parents weren’t giving me any help with with money and it wasn’t cheap living in Bristol. [00:30:20] So I had to do something in my second year. That was when Facebook just came out, so [00:30:25] I started. What year.

Payman Langroudi: Was it?

James Morrison: Uh, 2007. Oh yeah. So yeah, Facebook just [00:30:30] come out and people do it all the time now. But at the time I started creating profile like for like the Hall, for [00:30:35] example, Hiatt Baker Hall and I’d be adding people and like then they didn’t have all these like, you know, [00:30:40] systems to stop it. So I’d put up an event up, invite everyone they at [00:30:45] that time I was the only person doing it. And then, yeah, I just did a lot of my own events like and [00:30:50] I’d do maybe 3 or 4 a year. And then I kind of teamed up with another guy and [00:30:55] we did more like weekly club nights, you know, the more I got kind of like into it. But that was [00:31:00] another part I feel like I’ve learned a lot is when you spread yourself thin [00:31:05] and think, oh, more events. And that’s going to be like more money, actually, you, [00:31:10] because I wasn’t putting so much love and attention into each event it actually [00:31:15] the effort we were putting in and profit was, was starting to become less, less. Hence why [00:31:20] the first event I ever did was the highest profit, because the amount of love and attention that [00:31:25] I put into that was so much. So that was quite interesting. Now that in in [00:31:30] respect of with dentistry, I think I just want one good practice. I don’t want like 20 [00:31:35] okay practices, I like I want one good practice like quality over quantity. So [00:31:40] that was a big learning.

Payman Langroudi: It’s an interesting discussion. That particular discussion you know, because [00:31:45] you know I’ve got a lot of respect for like I don’t know Gail’s the [00:31:50] the bakery. Oh yeah. It’s quality product. It’s the [00:31:55] same everywhere around the country wherever you get it. You know Gail’s. Yeah [00:32:00] yeah yeah yeah yeah yeah. There’s a lot of them in London. Yeah, it. Deal with it. Mcdonald’s? Yeah. It’s [00:32:05] not such a quality product, but it’s. The quality is the same every time. Yeah yeah, yeah. [00:32:10] And then you’re right. You’re right. There’s a type of practice. The amount of love [00:32:15] that you, the dentist, can give to that patient that isn’t something you can [00:32:20] replicate over 100 practices or whatever. Yeah, yeah, it’s very interesting. [00:32:25] As far as events go, I met the guy who did the manumission, Johnny Manumission, [00:32:30] whatever his name is. Okay. Yeah. And we were talking and he said, yeah, it never made a penny. [00:32:35] Yeah, yeah. And I said, what do you mean? And do you remember, did you ever go to the. Was it before your time. [00:32:40] It was, it was a gigantic. It was the biggest club in the world in Ibiza. Yeah. And, um, [00:32:45] gigantic amazing nights. Amazing nights. One of the most amazing nights I’ve ever seen. And this guy [00:32:50] did it for six, seven years. Was trending as, like, the best night in Ibiza. Mhm. And he said I’d [00:32:55] never made a dollar. And I’m like how could that be. Yeah. And he said I just reinvested [00:33:00] everything. Yeah yeah yeah yeah. And you know events are a funny thing. I do events right. Mini spas. [00:33:05] Yeah. And then there’s loads of Dental events here. The the better you make the event, [00:33:10] the less money you make. Yeah, yeah, yeah. It’s true. It’s a funny thing. Yeah. [00:33:15] Like, even for a Dental event, right? You get an amazing AV setup. Yeah, yeah, yeah, [00:33:20] that’s less money right now, but you could take the one that from the hotel. Yeah, it’s interesting, [00:33:25] but I.

James Morrison: I’d say that gave me the spark of, like, marketing social media, like [00:33:30] the hype where, like, you get all the comments, the likes. Yeah. All these people attending events [00:33:35] and, like, it was like a drug, you know. I was gonna say.

Payman Langroudi: Did you take to it like a duck to water? I mean, how come [00:33:40] in 2007, you.

James Morrison: I just loved it. I loved the the risk [00:33:45] of, like, how is it going to go? Is it going to be a flop? Is it going to be a success? And I would say I’ve only ever [00:33:50] lost money once on an event. Like majority of the time it was normally a it was [00:33:55] an event. It was a buzz. Yeah, yeah. And then yeah, over time I then started working with another guy, [00:34:00] just because it gets a bit lonely doing these things on your own. You know, we started doing crazy stuff like hide, [00:34:05] hide out Kings Weston House in Bristol, which is this big like, like manor [00:34:10] House did a Halloween event. Oh, yeah. Everyone trashed the place, and obviously we never got [00:34:15] invited back, but, um. But, yeah, we did, like, a lot.

Payman Langroudi: I bet you were doctor popular at that point, right? Did [00:34:20] everyone know your name? And you were like, yeah, I mean, life of the party.

James Morrison: Yeah, exactly. It was, like, all about [00:34:25] who you knew and, like, you know, you know, I was always the guy. I knew a lot of people out and about. [00:34:30] And it was more about that. The money aspect helped, but it was quite good, just sort [00:34:35] of being known and connected. I’d say I’m less like that now. Like when you’re when you’re a bit younger, you want [00:34:40] to be the cool kid that everyone knows. But yeah, I’m a bit more of a recluse these days. Yeah, I would say [00:34:45] at that point it was a fun thing to be involved with for sure.

Payman Langroudi: And then you said you had two years out for [00:34:50] operations.

James Morrison: Yeah, yeah, yeah. So that’s a bit of a crazy story, really. I mentioned [00:34:55] I did a lot of football growing up, and about 14, I had to stop playing because I lost my athleticism and I had no [00:35:00] clue what it was like. It was random and it almost felt overnight. And then I just quit football because it [00:35:05] became almost difficult to run. And so I went on to uni, did dentistry, and my second year [00:35:10] when I got on to clinic, it was the first time seeing a patient and I and I went to lift my arm up to [00:35:15] the light and I couldn’t lift my arm and I knew this thing was going on. I was like, my arm’s here. And [00:35:20] I just thought, oh, I need to go gym. I’ve sprained something or whatever. But I realised, yeah, this is a problem [00:35:25] like so I had to stand up to grab the light and pull it down. And I was like, [00:35:30] whoa, this, I need to talk to someone about this. So I just once I went back to see my mum one of the holidays, [00:35:35] I was just like, mum, I can’t lift my arms above my head.

James Morrison: She’s like, were you on about? I’m like, no, honestly. [00:35:40] Like, look. And I go to lift my arm and it’s like, there I’m like, wow, the shoulder blade [00:35:45] wing right out. Now I can get like decent, decent movement. She was like straight away, something’s [00:35:50] wrong. You know? She’s like, get you into the doctors. And even they didn’t know. They had no clue. They did some blood tests, [00:35:55] but they were like, I don’t know. And I was at home googling. I was like, what is going on with me? And I came across on Wikipedia [00:36:00] the type of muscular dystrophy that can affect your scapular stabiliser [00:36:05] muscles. So the shoulder blades start winging out. It’s called scapular winging. So as you go to lift your arm, the shoulder [00:36:10] blade like wings right out, puts loads of pressure on the skin. But interestingly, the biomechanics of that, [00:36:15] once it wings out the arm can’t go up. So and then it also set about can’t blow up balloons. So [00:36:20] I was like whoa. Like that’s true. I can’t blow up balloons like Jesus. So you actually figured.

Payman Langroudi: It out yourself. [00:36:25]

James Morrison: Facial weakness. Yeah, I was like and the difficulty in working with arms raised and all this. And I was like, this is [00:36:30] it. So I went back to the doctor. I was like, you need to do genetic tests for this because I’ve got all these [00:36:35] symptoms. They did it. And yeah, diagnosed with facial Scapulohumeral [00:36:40] muscular dystrophy, which is only about 1500 people in the [00:36:45] UK that have it.

Payman Langroudi: Oh my goodness.

James Morrison: At the time didn’t think we had any family history, so [00:36:50] it was just completely random. I always thought I was like the first mutation. It turns [00:36:55] out now since doing IVF with my wife so that we don’t pass on this condition, that actually my dad [00:37:00] has it. So we managed to find out that I got it from my dad. But yeah, essentially at that point. [00:37:05] I went into the dean of the dental school at the time, and I said to him, look like they can do an operation [00:37:10] where they fuse my scapula to the back of my rib cage, and it will allow me to lift my arms, [00:37:15] not fully, but much better. And it should help with like dentistry long term. [00:37:20] And they were amazing. Like Bristol Uni were like so supportive. I was worried actually, you know how people [00:37:25] got struck off. But you know label label like oh you know, fitness to practice all this [00:37:30] stuff. And I was like, they were really good about it. And yeah, there’s one surgeon in Oswestry [00:37:35] in Shropshire that’s done it like five times. And he’s like the most experienced because most people [00:37:40] just get on with it, to be honest. But yeah, I just thought I’m going to go for it and get it done. All done on the NHS. [00:37:45] He knew I was taking time out of dentistry and and yeah, he got me [00:37:50] in within a month or two for the first. They did do one at a time. They fused one side [00:37:55] upper body Spyker cast like your arms fused like this, right? This full [00:38:00] body cast with a bar going across it. And yeah, I had had to wear that for two [00:38:05] months. Sat at home with my mum. Interesting. Still kept the club nights going. [00:38:10]

James Morrison: So I was just there on Facebook. Yeah, I remember being in hospital at one point on the phone, like, [00:38:15] yeah, I had another guy, like being there at the event, like sorting things. So I still actually kept [00:38:20] paying my rent with my student mates because I didn’t really want to lose that. So. So yeah, I still [00:38:25] kept that kind of ticking over. Then I did the left side. It was a shame the first side got lots of complications [00:38:30] because I’m type one diabetic, so I got all these complications like infections, all this stuff. He [00:38:35] actually didn’t want to do the second, the second one because he was like, look, you went through hell and back by persuading him. I was [00:38:40] like, look, you can’t keep one side. You know? I’m like this like one side. Yeah, yeah. So yeah, [00:38:45] he did did the other side. Luckily that all went fine. And then I was hoping to only have a year [00:38:50] out, but it ended up being two years because of just the time it all took. And then yeah, interesting. [00:38:55] I then dropped down two years and rejoined second year and started second year again. [00:39:00] And the silver lining is I met my wife in that year. So yeah, she was in that year. [00:39:05] So I kind of see that as a, as a meant to be sort of thing in a way. Like even though it was [00:39:10] a crazy time, it gave me quite a lot of clarity because all my teenage years I [00:39:15] was like, why didn’t football work? What was that about? It was a huge question mark there. Yeah. Knowing [00:39:20] that was was quite important for me because I could sort of start to understand what was going on with [00:39:25] my body at the time.

Payman Langroudi: And muscular dystrophy. Does it only affect your scapula [00:39:30] or does it affect the rest of your body?

James Morrison: The fascia scapulohumeral sort of means fate is supposed to affect fate. I [00:39:35] do have difficulty blowing up a balloon, but I generally have pretty good facial function. Most [00:39:40] people with the condition can’t smile and have very limited facial expression, and [00:39:45] then scapulas the shoulder blades and then humerus upper arms. But since [00:39:50] like when I was first diagnosed, it’s evolved the diagnosis where it’s pretty random actually. [00:39:55] Like it affects like my left hamstring is shot. Like it’s really, really bad. I can’t run [00:40:00] anymore. Core muscles are really badly affected. So essentially if I don’t if I don’t [00:40:05] exercise, I waste like quick. So I’m quite big now on like prioritising [00:40:10] swimming gym but not from a like getting hench point of view. Just more from a physiotherapy [00:40:15] point of view. Yeah, I mean luckily it hasn’t impacted dentistry. And you know I do. [00:40:20] I have met other people with the condition and it’s affected their hands and things like that. Luckily my hand [00:40:25] strength is like abnormal. It’s almost gone the other way I think to compensate. So yeah, I’m [00:40:30] touchwood. I haven’t had many issues with dentistry other than occasional back pain, but that [00:40:35] is more when I just am not exercising. When I am exercising, the back pain [00:40:40] goes away. But I’ve tried to do all the things you know, like the saddle chair. I’ve got the loops [00:40:45] like the refractive, so I stay upright trying to change my position, things like that. So but [00:40:50] I think because of the core weakness, I’m always going to be prone to back pain.

Payman Langroudi: I think even more reason to do [00:40:55] fewer days, right? Yeah.

James Morrison: I mean, to be honest. Yeah. I mean, I’ve done it all like eight till eight, [00:41:00] five, six days a week. I’ve pushed myself to the extreme even with having muscular dystrophy. [00:41:05] And I know deep down it’s never it never ends well for me because I’m [00:41:10] like a cripple, basically. So yeah, I think if I could reduce the days not only for for my [00:41:15] health, but also just spend more time with my son. Really?

Payman Langroudi: So do you. You were [00:41:20] kind of. I class you as like a super associate. The kind of associate who had your own [00:41:25] following on social media and one of the biggest practices in the country. [00:41:30] The biggest practice in the country was in Weston super mare. Yeah. Um, how soon [00:41:35] did you get on to Instagram and figure out how to use that? Uh, [00:41:40] was it as soon as it came on it?

James Morrison: Interestingly, you remember the minimalist, the series of lectures you did and you [00:41:45] filmed.

Payman Langroudi: I forget the minimalist, the minimalist.

James Morrison: Like I was on a flight to America to go see my dad. [00:41:50] I bought it, it wasn’t a lot, £50 or whatever for the lecture series, and I just sat and watched [00:41:55] it and I was like, slim McGrath talking about Instagram. And you know you had Chris Moore on there. Depeche. [00:42:00] You were on there and I was like, Prav Prav was on there. And I was like, [00:42:05] this is good. Especially with the Instagram stuff. Yeah, that.

Payman Langroudi: Was my favourite lecture.

James Morrison: Yeah. You know, [00:42:10] when like I remember like Steve Jobs always said about his like creativity, he’s all about connecting [00:42:15] things and like it was like that, like dentistry fused with all the club nights [00:42:20] and the promotion. I was like, whoa, like that could work. And I was like, okay. [00:42:25] So yeah, when I got home, I was like, you know, I booked onto the Mini Smile makeover course, and and that [00:42:30] was another big light bulb moment for me in terms of just like, yeah, cosmetic dentistry and composite bonding. And [00:42:35] then, yeah, I just started doing it on like NHS patients and yeah, it just it just grew from there really. But I [00:42:40] would say like the transition like, you know, I was in that big Weston-super-Mare practice. Houston’s for [00:42:45] seven, seven years. I started off NHS, but it was very much like I was the [00:42:50] big UDA guy, very efficient. I was doing like 11,000 udas and [00:42:55] still doing quite a lot of lot private, but interestingly, you get that reaches a point where [00:43:00] you’re like, I can’t really get any quicker. I would say the transition from going from NHS to private was [00:43:05] just one day where BSA, you know, business service authority, instead of being like, oh, this guy’s hardworking. [00:43:10] This guy’s like putting in the hours.

James Morrison: It’s like full investigation as to why [00:43:15] I’m doing so many uda’s. They didn’t find anything. They were actually just like, this guy’s doing the normal [00:43:20] amount of dentistry that everyone else does, but just on a bigger scale. He’s not doing like a million night [00:43:25] guards or whatever, but it just made me think, like, do you know what? Like, there’s this. This is what you [00:43:30] get when you work hard in the NHS. Because I would be the guy if David was like, look, we’re behind [00:43:35] on Uda’s. I’d be doing like evenings and weekends and all this, but I was like, this [00:43:40] is the only kind of contribution that the NHS have shown me in terms of like what they think of my [00:43:45] work. And I was like, I don’t want this anymore. So I was like, I need to get into private, I need to go, I need to get [00:43:50] out of this. And and yeah, I got quite lucky break because David Houston [00:43:55] retired and because I was the big, you know, the big earner. He asked me [00:44:00] to take over his patient list, which I think was was a huge honour because then I went fully private. [00:44:05] And that really got me kind of in the private mindset. [00:44:10] The more quality over over speed for someone.

Payman Langroudi: For someone who doesn’t know about [00:44:15] that practice, just just tell, tell, tell some of the headlines [00:44:20] because I’ve been there like a little university, like the size of the place. How many chairs? [00:44:25]

James Morrison: 25. Maybe 25. I think it’s the biggest patients. I wouldn’t even know. Thousands. [00:44:30] I mean, it’s the biggest single site practice in the UK.

Payman Langroudi: It actually is. [00:44:35]

James Morrison: Yeah. Yeah.

Payman Langroudi: How many hundreds or hundreds?

James Morrison: Yeah. Yeah. He just bought each [00:44:40] building on the road. So the houses there’s like one house in the middle who just were like just so, like [00:44:45] adamant they weren’t going to sell to him. So there’s just like one house in the middle that he’s been trying to buy for years. But [00:44:50] I think they’ve put in their will that he can’t like buy it or something. Um, but yeah, he’s got like, [00:44:55] I think 5 or 6 houses along the road. He’s bought the, the lab across the road and turned that [00:45:00] to a lecture theatre. I mean, it gets a bit of a bad rep. Houston’s in the southwest, but I think it’s more of a jealousy thing. But [00:45:05] actually, when I was there, David couldn’t have been a better boss. He asked me to take over [00:45:10] his patient list, and that was a huge break for me. And then, yeah, I started doing the Instagram. [00:45:15] You know, people like, you know, afan seguir. I went on his course. I was like a course junkie, [00:45:20] like I was like, once I got the inspiration from the minimalist, I was like, I’m just [00:45:25] going to go on loads of courses and just feel confident. So yeah, I went on like an Invisalign restorative [00:45:30] course. The mini smile makeover obviously did the Invisalign course. I think I did like 260 [00:45:35] hours of CPD that year. And then I started doing the Instagram [00:45:40] as well, posting some of my work. But I mean, it wasn’t like anything crazy at that time. [00:45:45] It wasn’t great. Amazing work. You just have to treat the right people like there’s like a one guy [00:45:50] who’s like a model in Weston-super-Mare who was luckily already my patient, and [00:45:55] he was like, look, I’m trying to why want composite bonding? I was like, oh, I’m trying to do Instagram.

James Morrison: He had 15 000 followers [00:46:00] and they’re the best ones, I think, like the real local influencers. Yeah, yeah, they can [00:46:05] put you on the map if you go for like big scale ones. I had one girl that’s like 350, 000 followers. [00:46:10] Nothing, got nothing back from it. And she was I ended up redoing her work seven times. Like that was [00:46:15] a big learning curve for me, and I got nothing out of it because all the all her followers are like, [00:46:20] international. Yeah, yeah. Whereas Ethan, this Ethan Smith guy, he’d post [00:46:25] instantly 20 people in and then literally just grew from there. Got to the point [00:46:30] where the Instagram was so busy that I had to pass all of David [00:46:35] Houston’s patients onto someone else. And I would say that was just after [00:46:40] Covid, because what happened while everyone else was like having a break from dentistry, I [00:46:45] was doing my consultations, video consultations. I think I did about 300, [00:46:50] right? And then when I went back to work, I had 300 [00:46:55] patients who were like, hadn’t spent any money on anything, who all ready to go, all [00:47:00] wanted to book in. And that was when I realised if you streamline [00:47:05] your business into something that people want, it can just explode. The [00:47:10] figures were ridiculous that first month when I went back after it was like 145 K revenue [00:47:15] month, and I was like, whoa, you know, [00:47:20] when you’re like, this is my wife. Look at this. Did you go.

Payman Langroudi: To the Porsche [00:47:25] garage?

James Morrison: We were like, jumping around. I was like, what has happened? But [00:47:30] it was just crazy. It was a crazy.

Payman Langroudi: Time, man. It was a.

James Morrison: Crazy. And then my boss was like. Right. David’s [00:47:35] patients, they need to go to someone else. You need to just do this. And that was it. And then I just. That was when [00:47:40] I decided to go fully cosmetic. Maybe a bit of the history of doing the club nights [00:47:45] meant I was a bit more savvy with making things look good and you know, to give.

Payman Langroudi: Some tips, [00:47:50] some top tips regarding Instagram.

James Morrison: It’s obviously harder nowadays, I would say.

Payman Langroudi: Are you on TikTok [00:47:55] by the way? No no no.

James Morrison: No I I’m not like one for like dancing [00:48:00] around.

Payman Langroudi: It’s not TikTok’s not dancing.

James Morrison: Oh I know if I do actually [00:48:05] set up my own practice and have associates, I need to fill chairs and I need the business. [00:48:10] I probably would do it right. At the moment I am like fully saturated [00:48:15] as a one man team. It’s a bit like, do I need it? Like if anything? Because I would say just after [00:48:20] Covid, I had a six month waiting list and I had about 50 [00:48:25] new patient inquiries a week. It was too much like I was like trying to [00:48:30] get patients in. The patient’s not happy because they have to wait. All of this stuff go on. The top.

Payman Langroudi: Tips, top [00:48:35] tips, top.

James Morrison: Tips. Competitions are good. Free smile makeover. Yeah, all [00:48:40] of that. Each time I’ve got a big increase of followers. It’s mainly because of the competition.

Payman Langroudi: Matty did [00:48:45] that too, I remember.

James Morrison: Yeah, that was crazy.

Payman Langroudi: Episode 107. For anyone who wants to listen to that, I’ve [00:48:50] recommended that episode to so many people.

James Morrison: Oh, mate, that was crazy. Competitions. [00:48:55] All of us were just sat eating popcorn watching this competition. Yeah, the competition still work. Not [00:49:00] as well, but they do. Still. They generate more. They generate followers, [00:49:05] but more so they just generate enquiries. So you just get more and more business really, when you do [00:49:10] competitions. Suddenly you’re just getting all these new patient enquiries because your page is hot and Instagram are putting [00:49:15] it like on everyone’s profiles. I think getting people to obviously share your before and after. So there are lots [00:49:20] of people are like your promoters because they’re kind of getting their friends to see the story and [00:49:25] then someone’s like oh right, okay. Who’s this? What’s this picture?

Payman Langroudi: Well, run us quickly through. What is it? What [00:49:30] is it? How does the competition work? Competition?

James Morrison: I mean, very much like, get someone to like, a picture, [00:49:35] comment and tag three friends. Matty, when he [00:49:40] really blew up, did it cleverly because it was like all three friends. You tag have to be following the page as well. [00:49:45] So that’s why he went up to like 100 K followers or 4000 or 4000. [00:49:50] I haven’t, like, blown up like that. You know, I think maybe the most I’ve got out of the competition is maybe like [00:49:55] 10,000 followers or something. Pretty good. It’s not bad. And then yeah, getting people to share your before [00:50:00] and afters helps because then they’re just spreading it amongst their friends. So your [00:50:05] friends, their friends are visibly seeing your work and then they end up inquiring [00:50:10] or maybe entering the competition themselves. I would say that’s important. Trying not to have like, [00:50:15] you know, just the blanket kind of stock image type stuff where it’s just like a random [00:50:20] person, like with like smiles saying, brush your teeth twice a day. And I think, I think [00:50:25] having like, authentic real life footage with whether it’s you, [00:50:30] whether it’s patients, whether it’s your own work, I think is is key.

Payman Langroudi: How often [00:50:35] do you post?

James Morrison: Oh, I’m so bad now. Like, I, I used to be more into it, I think since having [00:50:40] a child and then, I don’t know, just you just become, like, less often. [00:50:45]

Payman Langroudi: Did you post?

James Morrison: I’d probably. I did post, I still didn’t. Wasn’t posting enough, but [00:50:50] maybe 2 or 3 times a week I would say. Whereas now I’m like once a week. Yeah, [00:50:55] just because you kind of run out of ideas as well, right? With dentistry, it’s quite like limited, you know, just, you know, [00:51:00] teeth and like how really creative can you be with it. If I had a need there in [00:51:05] terms of I needed to put bums on chairs, probably would be posting more. But at the moment, because [00:51:10] I’m like mainly going through word of mouth, that’s enough. I’d say engagement now is a lot harder. [00:51:15] They’re obviously trying to go down the TikTok route, trying to get more like virality. So yeah, they’re [00:51:20] the kind of videos and pictures that are really blow up the big ones. I kind of see it as I try [00:51:25] not to read too much into the engagement, and I try and just think it’s essentially more like a portfolio, [00:51:30] like a patient of mine will say to a friend or, you know, go see James’s Instagram. I’ve had [00:51:35] work done with him. If you want to go see him, go on his Instagram. They go on my Instagram, they see my work, and [00:51:40] then they inquire. So that for me is the function of of the Instagram [00:51:45] page, more so now than necessarily getting loads of likes and loads of comments.

Payman Langroudi: It’s been in Mini Smile [00:51:50] Makeover a couple of times, where we asked that question about who here has a Dental page, and [00:51:55] out of the 30 delegates generally it’s like five have [00:52:00] a Dental page. I think it’s weird with dentistry there’s a lot.

James Morrison: Of like judgement, I think, [00:52:05] between dentists. Yeah. So so it’s like, I think it’s quite a scary [00:52:10] place.

Payman Langroudi: And we ask the question why not. Right. And people say, oh, I’m worried what other dentists [00:52:15] will say. I don’t want my auntie to be exposed to teeth the whole time. [00:52:20] And we get the reasons why. But if someone was going to start and, you know, there’s [00:52:25] people listen to this, they’re in dental school. Some of them are end of their careers. The whole [00:52:30] the whole spectrum of the profession is listening sometimes. Yeah. It’s always going to [00:52:35] start. How long would you say? I mean, now yours has built momentum to the point where you can post [00:52:40] once a week and you can still pay your kids school fees, right? You know, if you want to compare [00:52:45] it like that. Yeah. How long would you say you’d have to stick at it before seeing results? Because, I mean, you’ve [00:52:50] done so many small makeovers now that the critical mass builds of word of [00:52:55] mouth, you know, word of mouth is an exponential kind of thing.

James Morrison: Yeah. Of course.

Payman Langroudi: But if you were just starting out, [00:53:00] like I think that you have to, my advice is stick at it for a year.

James Morrison: I’d [00:53:05] say, yeah, six, six months or a year. I think if you want to elevate it in terms of your exposure, just treating [00:53:10] the right people and doing some kind of deals here or there, I really because I really wanted to do cosmetic [00:53:15] dentistry, I wanted to get more patients through the door. So I was doing things like giving [00:53:20] you even, not even big followers, but just giving people some free whitening, and then they just like [00:53:25] post about their free whitening on Instagram and tag my page. You know, I was doing quite a few things [00:53:30] like that just to get some exposure. I would say like really try [00:53:35] not to fear the judgement of others because ultimately we all start somewhere and you have [00:53:40] to obviously improve over time. So if I look back on some of my first posts, I’m like, oh my God, I can’t believe I posted [00:53:45] that. But actually, patients aren’t as critical as you think. And also dentists aren’t [00:53:50] as as critical as you think. People are actually quite supportive. And I think getting over that fear factor initially [00:53:55] and sticking at it. And then I’d say nowadays it’s harder to get your page out [00:54:00] there. So just getting patients to do that for you is is key.

Payman Langroudi: Let’s [00:54:05] get to the darker part of the pod. The darker part. [00:54:10] We like to talk about mistakes. Okay. Yeah. What comes to mind when I say clinical errors or [00:54:15] it doesn’t have to be clinical error? It could be a management error like that. That patient you said you repeated seven times. [00:54:20] That sounds like a juicy story. Yeah.

James Morrison: Like I had only really started doing cosmetic [00:54:25] dentistry and she had like 400,000 followers. And I thought it would be a good idea just to do three. It was supposed [00:54:30] to start with just free whitening, but then she wanted composite bonding and I thought, oh yeah, no, that’s fine. [00:54:35] So I did a little bit of bonding, didn’t like it. I had to redo it, Didn’t like it again. And then you [00:54:40] realise I actually got pro clean teeth and that’s the problem. I’ve done a wax up just to show her what [00:54:45] it could look like. If I do it a different way, then I’m now doing composite bonding on six teeth to compensate for [00:54:50] the fact that these pro clined incisors aren’t great. I don’t want to do Invisalign [00:54:55] because that’s going to be a massive lab bill. So I kind of it kind of escalated [00:55:00] and I would say, yeah, it got to the point where I think I was like, yeah, on my seventh time of revising [00:55:05] this work that I’ve done.

Payman Langroudi: Completely charged to a dollar.

James Morrison: I haven’t charged her a.

Payman Langroudi: Dollar, and she’s. [00:55:10]

James Morrison: Done like one post and I got nothing from it. That was like [00:55:15] a real lesson where I’m like, okay, do I need the like [00:55:20] the big influencers? Because most of the time they are the hardest work. You know, they [00:55:25] often are the bigger egos and the more perfectionist OCD [00:55:30] patients. So I would say nowadays, unless I had to say if I bought a practice [00:55:35] and needed more, more exposure. I would say now I wouldn’t give any freebies [00:55:40] to to an influencer because just because I’m busy enough, because I also think when you give stuff for free, [00:55:45] you do run this risk of them not really appreciating it. Yeah. Um, what about technical [00:55:50] error? I had this one girl who’s had a bit of a strange request [00:55:55] where she wanted goofy teeth. She wanted big teeth. Like [00:56:00] she didn’t want square. She wanted, like, the front two to be a lot longer. And she [00:56:05] was showing me all these pictures, and I was like, this is random. And I’m like, it’s not normally what I would do. But, [00:56:10] you know, me being like Mr. Nice People pleaser, I’m like, well, you know, cosmetic [00:56:15] dentistry is subjective. It’s her opinion. At the end of the day, why? Who am I to judge and say that’s wrong? [00:56:20] Yeah.

James Morrison: But then it kind of evolved because she was doing Invisalign anyway because the teeth were crowded. [00:56:25] But then she was showing me pictures of her teeth, the teeth that she liked. And I’m like, they’re a lot bigger than your [00:56:30] teeth. So the only way to go get teeth that big is to open up spaces with Invisalign, to then [00:56:35] close those faces with bigger teeth. So we went through all that. I started opening up spaces. [00:56:40] Yeah. This is how adamant she was. She wanted big [00:56:45] teeth, right? So I open up spaces to then give her these massive teeth. Obviously, [00:56:50] she had a breakdown because she said she looked like a donkey, right? It was like [00:56:55] the first time where I was, like, being really led by the patient, where it’s a bit like, [00:57:00] oh, yeah, we’ll do that because you’ve asked for that rather than me put my foot down and say, look, I don’t I don’t think [00:57:05] that’s a good idea. So I then was then reversing what we’d done. So I was then like, well, the only [00:57:10] way to get these much smaller now is to open up the spaces again and then take the composite [00:57:15] away, close the gaps again.

Payman Langroudi: What a nightmare.

James Morrison: So yeah. So [00:57:20] we did like multiple invisaligns opening the spaces to then close the spaces. And yeah, I revised [00:57:25] her bonding 3 or 4 times. But yeah, we got the final [00:57:30] result in the end. Like she was really happy and and because she was on board with the fact that [00:57:35] what she was requesting wasn’t normal, and because she liked the fact that I was happy to do the [00:57:40] revisions at no extra charge, and I was generally just a nice guy about it, she she actually [00:57:45] was on board with the whole thing. She she didn’t complain or anything. Um, but she learned a lesson. [00:57:50] There was a lot of time, a lot of time wasted in that. The [00:57:55] patient has now moved to Australia, so we should be okay. We should be okay [00:58:00] now. Although she’s now sending me pictures of Doctor Duval’s porcelain veneers and [00:58:05] like, what do you think to these porcelain veneers? Do you reckon I should do this? I’m like, yeah, that guy’s like two grand a tooth. [00:58:10]

Payman Langroudi: Yeah, they are beautiful.

James Morrison: I’m like, yeah, it works. It works for Nicolas. I don’t know, I guess [00:58:15] maybe just when I do my revisions, I’m doing it for free. I’m not charging the patient. [00:58:20] I probably do waste a lot of clinical time revising things at no charge, [00:58:25] but I don’t ever get any complaints. And people are happy and people recommend me. [00:58:30] But I would say I do Compromise myself. Like, well, actually, you [00:58:35] decided that shade and therefore it’s going to be X figure.

Payman Langroudi: It’s a feature of cosmetic dentistry, man. [00:58:40] It’s a feature of it. I mean, that’s why you need to charge properly for it in the first place. Well yeah.

James Morrison: That’s it. And [00:58:45] and I do think it doesn’t happen that often, especially now I’m more proficient with it. When it does happen. You are [00:58:50] like more clinical time, more you know, the priority.

Payman Langroudi: The priority is the patient recommends [00:58:55] another patient. Yeah. And you know, as long as there’s lots of new patients coming in, most [00:59:00] practices are going to be most problems will be solved by new patients [00:59:05] coming in. Yeah. Yeah. And it looks like you’ve you’ve taken care of that. Your your patients [00:59:10] are leaving delighted enough that they’re telling other people to come in a difficult city. Bristol isn’t [00:59:15] a cosmetically orientated. It’s not it’s not a Manchester or a London. No it’s not or [00:59:20] even a I’d say Glasgow or a Leeds even, you know, I mean even Leeds has become like this cosmetic [00:59:25] town. Yeah, crazy. But Bristol isn’t like that.

James Morrison: It’s not.

Payman Langroudi: Bristol isn’t, as you know, culturally, [00:59:30] not like that though difficult, in a town where it’s not so cosmetically orientated to to make [00:59:35] such a success of it. So, you know, my hat’s off to you. You’ve done this. Let’s [00:59:40] move on to the future. Um, what [00:59:45] do you reckon? If I had you here in five years time, what would be your sort of [00:59:50] ideal situation that you’ve got in five years time? I mean.

James Morrison: Yeah, my ambition. [00:59:55] Yeah, would definitely be to own a building. At the moment, I’m just renting a room. I’m very much [01:00:00] like a one man team. I’ve got employ my own nurse, my own receptionist. It’s nice. [01:00:05] It’s comfortable. Patients are happy. So if I lived like this for the rest of my life, actually, you know, [01:00:10] it wouldn’t be the worst thing in the world. But I think I am getting to a point where I’m getting itchy feet [01:00:15] to, like, for a new challenge. And I do feel like my dream has always been to own [01:00:20] my own practice. So, yeah, I mean, you know, there’s talks at the moment of potentially buying the building that [01:00:25] I’m working in at the moment, but not nothing too big, you know, I think 3 or [01:00:30] 4 dentists, each with their own speciality. My wife’s a dentist as well, so us two running [01:00:35] the practice, her doing all the behind the scenes admin stuff. She wants to do a bit of facial aesthetics so [01:00:40] she could do that as well. But yeah, just getting that really nice, high quality family feel practice, [01:00:45] which also kind of runs itself in the fact that we’ve got a good practice manager in there. [01:00:50] If I go on holiday at the moment, the business sort of just dies because I’m I am the business. [01:00:55] So it’s like that’s the business is still ticking over. I could actually reduce my [01:01:00] days and have passive income coming in. So I feel, yeah, that [01:01:05] that would be my dream. I think in the next hopefully in the next couple of years we’d have [01:01:10] have that I guess, see where it goes from there. You can’t say no to like, multiple practices, but I feel like I’m at the moment, I [01:01:15] feel like one practice would be enough.

Payman Langroudi: Nothing wrong with.

James Morrison: That for for me. And then, yeah, me [01:01:20] and my wife doing IVF at the moment and it’s been a long journey that. So hopefully [01:01:25] baby number two will be on the horizon. But if not, like we’ve got a two [01:01:30] and a half year old at the moment who’s like such an awesome little dude. I think just yeah, spending time with family. [01:01:35] We’ve just put an offer in for a house, which we’ll be moving into in the next few months. Definitely the [01:01:40] forever ever home, the big plot, just like, yeah, enjoying family life [01:01:45] and and yeah, hopefully having our own own practice as well.

Payman Langroudi: What if you [01:01:50] had an afternoon without any family work. [01:01:55] Nothing. No responsibilities. Mhm. That’s that seems like hasn’t happened [01:02:00] in a while. Yeah. What would you do really.

James Morrison: That really hasn’t happened for a while I really [01:02:05] just, I really, I really quite like a spa day you know, just like.

Payman Langroudi: You need a break. You [01:02:10] were like.

James Morrison: A little heated outdoor pool massage and just [01:02:15] yeah, read a magazine or a book, that kind of thing, which I like. Me and my wife were [01:02:20] talking about that at the moment. We’re like, yeah, we really need to book something. It’s all been like, [01:02:25] go, go, go for what feels like 3 or 4 years. Really, [01:02:30] I think just something super chilled. Maybe I maybe I’ll book a spa day.

Payman Langroudi: Let’s [01:02:35] finish with the usual questions. Fantasy dinner party. [01:02:40] Three guests, dead or alive? Who would you pick?

James Morrison: I’m [01:02:45] obsessed with the iPhone and Apple, so Steve Jobs is [01:02:50] like, yeah, an incredible human being. His ability [01:02:55] to create and his vision is just like, so inspiring. I remember reading [01:03:00] in his autobiography about how he used to spend ages designing the inside of the iPhone. You know, [01:03:05] the actual mechanics, how that looked, knowing no one would see it, that attention to detail [01:03:10] about beauty, even when no one will even see it, I felt like has [01:03:15] stuck with me. So there’s times I’m doing my dentistry and I’m like spending ages on the back of [01:03:20] the tooth, which the patients are never going to see, and you just get to the point where you just become such a perfectionist [01:03:25] is that those little things matter.

Payman Langroudi: Listen, man, and most of dentistry. No one’s looking. [01:03:30] Yeah. That’s true. And that does come down to your professionalism as a dentist, right? Of [01:03:35] course. Yeah. And, you know, we said that what you alluded to it the the more you [01:03:40] you do it. Well the longer it takes. Yeah. And, you know, that’s [01:03:45] the sort of the way people pay you and all that needs to reflect that. Of course. Yeah. Go [01:03:50] on, Steve Jobs. He’s he’s been invited before. Yeah. Yeah. Let’s see who else you got. [01:03:55]

James Morrison: I’m a massive fan of of Michael Jackson, even though [01:04:00] I know strange character, especially towards the end with all his drama. But his [01:04:05] his work the the again, his creativity. I wouldn’t necessarily [01:04:10] even sit and necessarily listen to his music, but just his whole aura, his you know, I love watching his, [01:04:15] like, stage performances. Like if I’m like on a day where I just want a bit of inspiration, just watching [01:04:20] him like live at Wembley during like the.

Payman Langroudi: So you don’t talk about Michael having dinner with you? He’s just in the corner dancing. [01:04:25] He’s dancing away.

James Morrison: It’s [01:04:30] just like there’s something about that he’s.

Payman Langroudi: Come up before to go [01:04:35] on for.

James Morrison: Um. Oh, God. Who else? Who else do I have? [01:04:40] Maybe a sports person. Like, maybe. Yeah. Like, obviously football was a huge thing for football. Cristiano.

Payman Langroudi: Cristiano [01:04:45] Ronaldo.

James Morrison: Yeah. Cristiano. I’m a Manchester United fan. Yeah. Cristiano. Just. Yeah. His [01:04:50] his ability and just seeing what he can do even he’s an artist. You know the way he [01:04:55] plays and yeah how successful he’s been. Probably say Cristiano. [01:05:00] Yeah. Amazing for sure.

Payman Langroudi: I mean because like Michael Jackson [01:05:05] dancing in the corner. You, Cristiano and Steve Jobs chatting. [01:05:10] Final question. It’s the deathbed question. Mhm. If [01:05:15] you had to leave three pieces of advice for your loved ones on [01:05:20] your deathbed, what would they be.

James Morrison: A big thing that I’ve learned, which actually happens with, [01:05:25] I guess, with age, is you sort of just just to care a lot less about sort of the judgement [01:05:30] of other people just not having that fear of judgement because [01:05:35] I feel that holds so many people back. I feel like just being confident with who you are, with your [01:05:40] flaws and warts and all, good at, yeah, whatever you’re good at, whatever you’re bad at just just staying true [01:05:45] to yourself and being confident with that because we’re all just we’re all individuals. We all have our own unique [01:05:50] things. But yeah, I think as soon as you start trying to, like, change yourself to try and suit other people, [01:05:55] I don’t think that’s a healthy way to live. And I think since having Quinn like my son, that’s really [01:06:00] I think that’s really important. I think just generally like, do whatever makes you happy. [01:06:05] Life’s far too short. And yeah, you don’t want to live with any regrets. So just, just do [01:06:10] what’s going to make you happy. You know, they say like money can’t buy happiness, but that definitely [01:06:15] helps, you know, maybe get a good job in there as well. Because because I’ve lived growing up without a lot of money, it can be [01:06:20] stressful.

Payman Langroudi: It’s been brilliant. It’s brilliant. It’s been lovely to have you. [01:06:25] Yeah.

James Morrison: No, I’ve enjoyed it.

Payman Langroudi: Finally. Finally. Yeah. Yeah. Yeah. Thanks [01:06:30] a lot for taking the time to come all the way down here. Really appreciate it.

James Morrison: I really appreciate it. It’s been a lot of fun.

Payman Langroudi: Enjoyed [01:06:35] that. Thank you.

[VOICE]: This is Dental Leaders, [01:06:40] the podcast where you get to go one on one with emerging leaders in dentistry. [01:06:45] Your hosts, Payman [01:06:50] Langroudi and Prav Solanki.

Prav Solanki: Thanks for listening, guys. If [01:06:55] you got this far, you must have listened to the whole thing. And just a huge thank you both from me and [01:07:00] pay for actually sticking through and listening to what we had to say and what our guest has had to say, [01:07:05] because I’m assuming you got some value out of it.

Payman Langroudi: If you did get some value out of it, think about [01:07:10] subscribing. And if you would share this with a friend who you think might get [01:07:15] 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. [01:07:20]

Angus Pringle: And this is the thing, if you’ve ever got someone who is suffering, that’s a mental distress. Even [00:00:05] if you don’t know who they are, it’s just, listen, we spent the time, we spent 30 [00:00:10] or 40 minutes and she could tell me about her journey, [00:00:15] what she’s been through, how she felt worthless and hopeless. There’s [00:00:20] nothing I can say to make it feel better. But the fact is we were there to [00:00:25] listen. And I think that’s something we can all do. We don’t know. Don’t have to give solutions. [00:00:30] And then we followed up with the person. Um, [00:00:35] two days later, I phoned them up and chatted to it, and they were just very grateful. [00:00:40] The fact that we spent the time. I mean, you.

Payman Langroudi: Said yourself something as simple as tomorrow might be different. [00:00:45]

Angus Pringle: Yeah, tomorrow might feel better. You might.

Payman Langroudi: Feel better. Change the way you think about you [00:00:50] thought about your own mental health. Something as simple as that.

[VOICE]: This [00:01:00] is mind movers moving [00:01:05] the conversation forward on mental health and optimisation for dental professionals. [00:01:10] Your hosts Rhona Eskander and Payman [00:01:15] Langroudi.

Payman Langroudi: It gives me great pleasure to welcome [00:01:20] Angus Pringle onto Mind Movers. Angus is a specialist orthodontist [00:01:25] who became a consultant orthodontist and is now working [00:01:30] in a specialist dental practice where six dental specialists. One of the top practices [00:01:35] around Angus has an interest in suicide and [00:01:40] mental health, particularly as it pertains to dentists and to [00:01:45] others. And wearing a jersey from your [00:01:50] cycling. Just what the jersey is. Welcome, welcome. Yeah, thank you very much.

Angus Pringle: And I really appreciate [00:01:55] being invited on to this because it’s such an important issue for all of us, not only [00:02:00] in dentistry but in the general population. So my friend and I just recently [00:02:05] completed our cycle challenge in Belgium called the Flandrian Challenge, and it was to raise awareness [00:02:10] of suicide prevention. And the reason we chose the challenge was it’s [00:02:15] not a race. Just like our mental health isn’t a race. There’s no end point. But it [00:02:20] was an attritional ride where we’re having to ride over cobbles and I’ve [00:02:25] never ridden on cobbles. Neither is my friend. And on day one, after the first set [00:02:30] of cobbles we rolled on, we were shocked how difficult it was and it was an [00:02:35] all encompassing mental battle to keep going. [00:02:40] And that’s like someone who might be struggling with their thoughts, particularly suicidal thoughts. So [00:02:45] we documented our journey on social media, talking through the wellbeing [00:02:50] that we can use to get through these difficult times. And we both had difficult times [00:02:55] with our mental health and those three days. As we were going through, [00:03:00] we had horrendous weather. It was wet. I broke my back wheel, I [00:03:05] got punctures, I had times that this was the last place in the world I wanted to be. [00:03:10] Um, but we were talking about two charities that were really close to my heart, which [00:03:15] is the baton of Hope and the Baton of Hope’s relatively new charities focussed [00:03:20] on suicide prevention. And I took part in the tour last year [00:03:25] in London, where we were walking through London with the baton, [00:03:30] and we’re talking to the general public raising awareness of suicide prevention, and it was [00:03:35] an incredibly powerful and emotional thing for me to do, because I was doing [00:03:40] it on behalf of my brother, who had sadly lost to suicide and had taken a long [00:03:45] time for me to be able to stand up and say, look, we need to do something about it.

Angus Pringle: I want to talk [00:03:50] about it. I want to share our journey and the things that we’ve learned. But [00:03:55] most importantly, show that there’s recovery and that there’s hope. Um, [00:04:00] the other charity that I’m deeply passionate about is the Kanwar Trust, [00:04:05] which isn’t that well known, possibly down in England, but is based in Scotland. [00:04:10] Um, and it’s a dear friend of mine, John Gibson. Tragically, [00:04:15] his son died by suicide. And John Gibson is a professor of oral [00:04:20] medicine who happened to teach me when I was at Glasgow Dental School. And [00:04:25] John’s son was a vet. Um, he had no mental health conditions [00:04:30] and all that John and the family knew was a knock on the door from the police. [00:04:35] And, um, subsequent to that, it was had a devastating effect on their lives [00:04:40] and everything they’ve been through. They then went on [00:04:45] to form the Kanwar Trust. And the point of the Kanwar Trust is creating [00:04:50] safe spaces for lives impacted by suicide. And they’re deeply involved [00:04:55] with dentists, medics and vets because they’ve got a higher [00:05:00] risk of suicide compared to the general population.

Angus Pringle: And I was recently speaking with John [00:05:05] and he they’re involved with supporting people, going through the fitness to practice at the GDC, [00:05:10] which is obviously very important. And there’s a lot [00:05:15] of things that we need to talk about and really move forward with our compassion [00:05:20] when it comes to regulation, not only in dentistry, but medicine and veterinary [00:05:25] surgery. Um, but they also do something that’s incredibly unique [00:05:30] and something that we never have to. We lost my brother Andy, which is Postvention, [00:05:35] which is support to families and individuals who have been bereaved [00:05:40] by suicide because one of the tragic things, when you lose someone to suicide, it’s [00:05:45] very isolating. I didn’t really know anyone who’s ever died by suicide. [00:05:50] I never thought it was going to happen to me. That’s probably where the stigma comes from. [00:05:55] Somehow I thought that we were immune. We were a good family, in inverted commas. [00:06:00] Um, and in that devastation, you know, life changes. It’s never [00:06:05] the same again. But how do you find purpose? And we’ve [00:06:10] had so many impactful conversations, John and I. And I’ve [00:06:15] got purpose certainly in my family and my work. But there was kind of that itch. My [00:06:20] purpose really outwith that protected environment is really discussing [00:06:25] mental health, breaking the taboos, breaking the stigmas, but [00:06:30] also really looking at suicide prevention. It’s such an important thing. We can’t keep [00:06:35] losing our men and women to something where the researchers [00:06:40] will say is preventable. And unless we talk about it, we [00:06:45] can’t stop losing people.

Rhona Eskander: Thank you so much for sharing that. Honestly, you’ve moved [00:06:50] me so much. The whole reason why I started Mind Movers was to open up the conversations. [00:06:55] I think Payman thought I was a little bit crazy a few years ago, and he said, you know, I don’t think anyone wants to be heavy [00:07:00] right now. And then obviously mental health was something that was, I don’t want to use the word trending, [00:07:05] but I think people were opening up to the conversation. Healthcare professionals definitely [00:07:10] feel that it is their duty to show some kind of self-preservation. [00:07:15] I think maybe because we view ourselves as healers in society. So to show vulnerability [00:07:20] is to show weakness. But I would argue and say that to show vulnerability is actually a superpower. [00:07:25] And the more that I’ve opened up the conversations, not only do I feel better, but [00:07:30] I also feel connected to a wider community. So I’m really grateful there are [00:07:35] people like you out there and someone that’s been able to come onto this podcast. I [00:07:40] want to know, though, how old were you when the event actually happened [00:07:45] to your family and yourself?

Angus Pringle: Gosh. So I lost my brother in 2005, [00:07:50] which was that 19 years ago. Okay. And it feels actually like yesterday. And [00:07:55] it just happened to be it was Andy’s birthday on the 10th of September. So [00:08:00] there’s a couple of days ago, which also now is World Suicide Prevention Day. [00:08:05] Wow. And that has it’s got so many mixed emotions, you know, in some way [00:08:10] it’s ironic and cruel, but I’ve started to think it’s actually quite motivating. [00:08:15] You know what is Andrew’s legacy is like we don’t want someone to be [00:08:20] in the position where they feel they need to take their life. And I don’t want people to, [00:08:25] um, uh, have that loss, that [00:08:30] tragic devastation. Um, and after [00:08:35] we lost Andy, you know, I certainly would talk to people and say, you know, Andrew died by [00:08:40] suicide. And for a while, uh, that was fine, but [00:08:45] quite quickly, unfortunately, we quite quickly realised the stigma [00:08:50] surrounding it and there was quite a lot of negativity and not very nice [00:08:55] comments that were being made, and for actually a very long.

Rhona Eskander: Period of the 80s then.

Angus Pringle: No, this [00:09:00] was 2005, 2005. Okay. Yeah, yeah. Uh, and we are kind [00:09:05] of in a slightly more modern time now, but still the thing it’s it’s the people that [00:09:10] you might speak to and actually having the right people around you. And for a very long period of time, [00:09:15] I actually didn’t talk about it. I’m really ashamed to say that we had some [00:09:20] circumstances where I might meet new people, and they ask about family, and I wouldn’t acknowledge that I had a [00:09:25] brother because I just didn’t want to get into that conversation. It’s like, what are they going to bring up? [00:09:30] Uh, and for me, it was the end of 2018. [00:09:35] I had a really unpleasant incident with comments about Andrew and also [00:09:40] myself. I then made the decision, you know, I’m going to talk about [00:09:45] it. And if people don’t like it, That’s their problem. But we can’t keep going [00:09:50] on where we’re losing people and also the people who are bereaved. They can’t be [00:09:55] in this isolation because there’s too many people who are in this difficult [00:10:00] position. We’ve got to talk out. We’ve got to support people. Um, yeah. [00:10:05]

Payman Langroudi: Would you say the the grief that a family feels after [00:10:10] someone takes their life by suicide has its own particular [00:10:15] characteristic that’s different to someone passes [00:10:20] away a different way. I think that guilt, a bigger part of it.

Angus Pringle: In the in the [00:10:25] greater scheme of grief, it’s important to acknowledge everyone has a different experience. [00:10:30] And I think what I went through was very different to what Andrew’s, um, [00:10:35] uh, fiancee went through to what was different to what my parents went through. But [00:10:40] there’s two big areas, which is guilt and shame. The [00:10:45] guilt of thinking, what could I have done? And that could really torture [00:10:50] you? Um, and the shame really surrounding the stigma of whether it’s our own [00:10:55] internal stigma or the stigma that other place on you, uh, [00:11:00] and the consequences of living in a family [00:11:05] after a suicide. It can do devastating things to the family network. And the [00:11:10] statistics on marriages that break down after suicide. Uh, it’s [00:11:15] certainly affected my relationships with people. It would put a massive strain [00:11:20] on my own marriage. Um, but, you know, we we [00:11:25] were the fortunate ones that we battled through these difficult times. And [00:11:30] Kevin Hines is a medical mental health campaigner in [00:11:35] America. He’s very famous for surviving a suicide attempt. And one of his expressions is [00:11:40] he’s cracked, but he’s not broken. And I would certainly say that, you know, I’ve [00:11:45] of. I’ve got the scars of what I’ve been through before. I’ve come through it. But because [00:11:50] of what we’ve been through and what we’ve learned, we can certainly talk about [00:11:55] it and help others to avoid these situations happening again. And in the tragic [00:12:00] situation, if someone does lose someone to suicide, being in a better place to [00:12:05] really offer support. Really.

Rhona Eskander: So I got a book in the post [00:12:10] a few months ago when it’s darkest. Me too. And uh, [00:12:15] I didn’t know who it was from and I was really touched. It was very personal to me because I’m very vocal [00:12:20] about my mental health and being gone through those really, really dark times. So I thought maybe a [00:12:25] patient sent it to me, or one of my friends messaged my therapist, my coach, [00:12:30] and I was like, no. And then, lo and behold, we found out today it’s [00:12:35] from you. So. Yeah. And I really, you know, I’m, I’m a very slow reader ad [00:12:40] diagnosed now. So I, I take a long time to read things and I [00:12:45] have found it an incredibly compassionate book. But I think that it’s I’ve [00:12:50] known two people to lose their lives via suicide. So the first one [00:12:55] was a boy at university who was very good looking, very popular, [00:13:00] had a beautiful girlfriend. I think he’d always struggled, had gone on a holiday [00:13:05] in Ibiza with a group of friends, came back to university and [00:13:10] took his own life. He couldn’t cope anymore and I remember we all went [00:13:15] to the funeral. I think one of the most difficult things was as well. He was Jewish and there was a lot of stigma [00:13:20] within religion, and I became very aware of the religious narrative around [00:13:25] his death, and that made me feel a certain way. I had also [00:13:30] gone to school with a girl who became a very famous Bollywood actress, and, [00:13:35] um, she was best friends with my best friend and again led a troubled life [00:13:40] in the limelight, as it were, And had also died by suicide. [00:13:45] But unfortunately, as you’ve already alluded to, her [00:13:50] mother tried to pinpoint it as murder. And I think there was definitely [00:13:55] an element of cognitive dissonance because, as you said, the the people around [00:14:00] you bear this responsibility and guilt and shame. So it’s almost easier to blame [00:14:05] something else, you know. Yeah. And I remember that being extremely heavy because things turned [00:14:10] quite ugly from a legal point of view as well.

Payman Langroudi: Yeah. I mean, it’s crazy that the stigma [00:14:15] of suicide was more than the stigma of murder. Correct? Of course, of course. Well, [00:14:20] it’s mad that there’s a mad situation.

Rhona Eskander: I think that’s that’s the whole problem I have [00:14:25] around the narrative of mental health, and why I’m so grateful that our people like Angus and our industry. [00:14:30] I went to go watch Gabor mate on Monday, and it was I [00:14:35] was it was amazing. But I think what really struck me the most in [00:14:40] the talk was, I mean, he didn’t say anything. That was completely blowing my mind because I’ve read so much of his work, and there were [00:14:45] a lot of people in the audience that had felt very impacted by his life. But what really struck [00:14:50] me about what he said about mental health was he said that a lot of health care professionals will [00:14:55] say that someone that doesn’t suffer from mental health is the absence of disease, [00:15:00] but they don’t actually state what being mentally healthy is. So be not [00:15:05] depressed. Not anxious. Do you see what I mean? But okay. But then what is what is actually [00:15:10] being healthy in mental health terms? And for me, I was really thinking about [00:15:15] that. And we don’t actually know because it’s the absence of some kind of medical disease, but that doesn’t really [00:15:20] mean anything. And for me, I was trying to explain this [00:15:25] to my father yesterday, who was an old school gynaecologist who is [00:15:30] almost 80 years old. And I was also trying to explain to him how so many autoimmune [00:15:35] diseases have now been linked to mental health and so forth. My dad was like, I think [00:15:40] this is rubbish. You know, like he recognises that stress can happen, but he, he [00:15:45] recognises that stress can impact. But he also, you know, [00:15:50] is very much you have an autoimmune disease. You treat it this way, you know, this is the [00:15:55] medical route etc.. And I think that’s a huge problem. I really think it’s a huge problem [00:16:00] in our profession because we are so used to seeing symptoms, giving a diagnosis [00:16:05] and then like trying to alleviate it with a treatment or medicine and not going [00:16:10] back to the body. And I want to say, are we really going to claim that the mind and the body are totally [00:16:15] separate entities? It’s practically impossible.

Angus Pringle: You know, you’ve actually you’ve you’ve [00:16:20] really described it well. And, you know, the, the concept we need to think of is mental fitness, [00:16:25] not mental health, just like physical fitness. And that’s something I’ve worked [00:16:30] out over the years is physical fitness with cycling. And that comes on, [00:16:35] um, it’s on a sliding scale, really. I’m not fit or I’m very fit, but there’s no kind of middle [00:16:40] ground of what is average fitness. And I also think in my own mental health on [00:16:45] that is my where am I mentally fit. And I’ve had better times with mental fitness [00:16:50] and worse times of mental fitness, and changing the rhetoric [00:16:55] around it is probably a better way of understanding it. But you’ve just really described it better than I have, [00:17:00] really.

Rhona Eskander: So I want to ask you, there’s a few things I always claim [00:17:05] this, claim this. And people say back it up with lots of stats and there’s a bit of airy fairy [00:17:10] stats. But does dentistry have one of the highest suicide rates of any profession? My [00:17:15] husband will argue with me and say finance is really up there, etc.. I mean, I don’t know about the finance bros, but [00:17:20] but what are the stats out there, Angus, regarding dentists and doctors and so [00:17:25] forth?

Angus Pringle: Well, it’s the when you actually think about statistics, it’s actually quite difficult. [00:17:30] We know that we’ve had a very sad increase in the number of people who’ve died by [00:17:35] suicide in the UK. We’re about 6600, but we know there’s [00:17:40] certain professions that are higher risk, such as dentistry, medicine, veterinary and nursing, [00:17:45] and medicine is actually slightly higher than dentistry. But [00:17:50] it’s still tragic. But you can also look at the construction industry. They also [00:17:55] have similar issues with a higher suicide rate. Marginalised [00:18:00] people in society like refugees, LGBTQ community, neurodiverse. [00:18:05] Um, but I don’t have the figures on hand. Um, but. [00:18:10] And also, unfortunately, people who have been bereaved by suicide have a higher risk. [00:18:15] So I sadly have a double whammy being a dentist and someone who’s been bereaved. [00:18:20] But just because someone has a higher risk, it’s not a fait accompli. Um, [00:18:25] but I’m just a little bit more mindful of my own wellbeing and understanding how [00:18:30] my own emotions work to make sure that we are [00:18:35] staying as mentally fit as I can. Yeah.

Rhona Eskander: So you talked about prevention. [00:18:40] And in the book they talk about prevention as well. Yeah. So how [00:18:45] in your experience, your view and understanding, do you think it can be prevented? [00:18:50]

Angus Pringle: When we talk about prevention in general [00:18:55] there’s some good concepts. But to prevent just one suicide is very more complicated. [00:19:00] And you’re starting on a societal level of reducing [00:19:05] inequalities, breaking down taboos and stigma around mental health so people [00:19:10] can access the care. Can they then access care over a good long [00:19:15] period of time? Um, I think the other the factors [00:19:20] around prevention is if you think about dentistry as well, [00:19:25] it’s the environment that we’re working in. Uh, if you think about the NHS and [00:19:30] what that’s gone through, and I used to work in the NHS and I knew that it wasn’t good for my mental [00:19:35] health. And I know you’ve talked about the same thing as well, but I’m interested in your [00:19:40] both of your opinions on this, because I appreciate that this isn’t always necessarily [00:19:45] me talking about it, but it’s your feelings and understandings about where we can go with prevention. [00:19:50]

Payman Langroudi: It’s difficult. So off off mic, we were talking about the sort of escalator [00:19:55] of, you know, kind of conversation like this stops someone [00:20:00] who’s decided to take their own lives to not take their own lives. And [00:20:05] I was saying I was a bit sceptical about that. And do you remember we were saying, what do we call this pod? [00:20:10] And we said, call it mind movers as in movement. Yeah. Not just [00:20:15] talking if you remember. But then I spoke to my cousin who’s a psychiatrist, [00:20:20] and she said, well, before someone gets to that point, they’re at a lower point, and at that [00:20:25] lower point you can intervene before someone’s fully decided to take their own lives [00:20:30] and they can find a way out.

Angus Pringle: You know, you’ve just brought something to my mind and [00:20:35] it’s something. And this is actually to do with the media. But also some of this should be [00:20:40] today, which is and I might pronounce this wrong, it’s called the Papageno effect. [00:20:45] Uh, Papageno was in The Magic Flute, uh, one of Mozart’s operas, [00:20:50] and he was feeling suicidal. But his. There’s three characters [00:20:55] that helped to find and give him hope to be able to realise he [00:21:00] could be here tomorrow. So a lot about prevention is the embracing of lived experience. [00:21:05] So people like Kevin Hines, if you ever read his book and he talks [00:21:10] about his experience of his suicide attempts and how the fact he he is [00:21:15] glad that he’s survived and that’s giving hope to others, even in their darkest hour, there might be [00:21:20] hope. Um, and just before we went on camera, I was talking about something [00:21:25] that happened in my life that I didn’t realise had such a massive effect. Um, [00:21:30] After Andy died. There was obviously it was it felt like chaos [00:21:35] and the world was turned upside down. I felt like I was living on [00:21:40] a different planet. Um, and with everything that had gone on, there was naturally there was media [00:21:45] attention, there was police, there was lawyers. And when you’re, you feel [00:21:50] you’re at your lowest. We were kicked down. We’re kicked down again. We kept getting kicked down. [00:21:55] And you think how how low can I go. And I recognised [00:22:00] in myself that I wasn’t in a very good place. So I’d gone to have some [00:22:05] treatment with a psychologist. And having never been to anything [00:22:10] like that and maybe being a man as well, I felt that it was actually quite challenging. [00:22:15]

Angus Pringle: But gradually, as I gained more confidence and opened up, there was one day [00:22:20] where we just had some more bad news coming through, and I, um, and [00:22:25] I was saying to the psychologist, you know, I just don’t feel fulfilled. I don’t feel [00:22:30] happy. I don’t feel like I really need to be here. There’s nothing in life that I’m [00:22:35] gaining from. And the psychologist said to me, you might feel [00:22:40] better tomorrow. And it was. I didn’t really realise the significance of that [00:22:45] comment, but it was very much like a crossroads in my life where there was [00:22:50] actually hope. And someone described hope as hold on, pain ends [00:22:55] just like we’re doing in the cycle, right? As even in the absolute [00:23:00] chaos, it was not going to be forever. And we talked about that a lot. And [00:23:05] even where I was in a really miserable place, I could think, perhaps [00:23:10] this isn’t going to be like the rest of my life like this. Perhaps tomorrow might be something [00:23:15] better. Perhaps tomorrow I might wake up and actually look out the window and think, [00:23:20] do you know what? It’s a nice day. It’s these little glimmers. And the longer [00:23:25] it’s been since then, I realise how important that’s been in my life and [00:23:30] sharing, you know, how different my life could have been if I’d not had [00:23:35] that support and treatment, how different my life had been if I’d not had that [00:23:40] little bit of advice. Which for me was really profound, actually.

Rhona Eskander: I [00:23:45] think that’s really important. And like Payman said, we’re lucky. I mean, I often [00:23:50] seek refuge in podcasts, which is one of the reasons why I brought it up to you. You know, since [00:23:55] the ADHD diagnosis as well, and having a better understanding because I chose [00:24:00] not to medicate it hasn’t affected my professional life, I would say, because I think I’ve always been [00:24:05] able to cope, especially as a high functioning woman, which is quite common for women [00:24:10] to hide neurodivergence behaviour. But I think that my mental health [00:24:15] is like literally up and down. It’s like a constant. It’s a constant up and down. And podcasts [00:24:20] have been a really good way. And as I said, as you had quite correctly described stories [00:24:25] like stories of people making out like, you know, they say the only [00:24:30] way out is through. And I just think, oh my gosh, like, this person’s been through this. [00:24:35] And, you know, it’s really important that we find [00:24:40] help. I think we’re in a more privileged position. Right. Because at the back of my mind, I think sometimes [00:24:45] when I see I live in Notting Hill and it’s super diverse, multicultural area, and sometimes [00:24:50] I see just like Camden, you know, you see drug addicts, crack addicts at like, you know, [00:24:55] 1 p.m. and since reading Gabor Mate’s work, my narrative and my compassionate inquiry [00:25:00] towards those people has completely changed because I’m like, how did they end up that way? We had somebody that was a previous [00:25:05] addict that had come out, you know, he’d been using since he was 12 years old.

Rhona Eskander: Yeah. And but [00:25:10] I think it was it’s also the recognition that a lot of these people don’t have the tools and support. [00:25:15] You know, a lot of them don’t have that. And I think that’s, you know, where the difficulty lies. Dentists [00:25:20] do. And medics will generally have lots of tools available to them. One [00:25:25] thing that you said at the beginning of this talk, which I’m keen to delve into is the GDC [00:25:30] and our governing body, because I think since I graduated, I’m going to go as far [00:25:35] as to say the thought of being ever investigated by the GDC, [00:25:40] which might happen, makes me feel suicidal. And even when I’ve had a patient who’s [00:25:45] who’s complained and wants some kind of, like, financial, um, she has a financial [00:25:50] incentive, they will threaten with the GDC, right? Because they know how scared [00:25:55] it makes us. And that really makes me feel sick to the stomach. You know, whether or [00:26:00] not the GDC finds you guilty is irrelevant. It’s the fact that you have to go through that for [00:26:05] several months and years that for me, I find terrifying. And I don’t know what the answer is. Yeah. [00:26:10]

Angus Pringle: And you’ve raised a very good point where the Cancer Trusts are running a wellbeing conference [00:26:15] in November to address this particular issue with the GDC, the GMC, the [00:26:20] veterinary college, and they’ve invited representatives to speak at that. [00:26:25]

Rhona Eskander: Thing.

Angus Pringle: The thing is like, how do we move to compassionate regulation [00:26:30] whereby we aren’t just shamed? Well, yeah. And the thing [00:26:35] is, if you went through the legal system, even the criminal system, you probably would be dealt with in [00:26:40] a more of a compassionate way. Um, and if when I graduated in dentistry, [00:26:45] I think I paid my first year’s registration was like £40. It’s ridiculous. [00:26:50] And the worst thing you’d be doing is if your brass plaque outside the practice was [00:26:55] of a wrong size. And I absolutely agree that patients need [00:27:00] to be protected, but we also have to be compassionate to our healthcare providers [00:27:05] because we are human. And I’ve seen some devastating effects of [00:27:10] people who’ve been through the GDC. Even if they’re cleared, it’s feeling like that. Mud [00:27:15] sticks and it’s it’s there for everyone to see. Um, [00:27:20] and I think that there’s definitely needs to be engagement of understanding the proportionality [00:27:25] of the charges, the proportionality of how they’re dealing with [00:27:30] people and as well as the support, especially now they’re moving to remote [00:27:35] hearings in an attempt to reduce costs. If that happened to me and I’m [00:27:40] sitting at home, they keep my laptop listening to legal terminology [00:27:45] I might not understand, you know, I’d know that would have a devastating effect to my own mental [00:27:50] health. And who’s sitting there to support me, um, and [00:27:55] get me through this difficult time. Because ultimately, the GDC may not have the our [00:28:00] interests at heart. It’s about protecting the public, but we’re still human at the end of the day [00:28:05] and where we spend our time caring for people, we also need to be cared for, too. [00:28:10]

Payman Langroudi: Look, it’s no consolation for someone going through it now, [00:28:15] but one thing that is becoming clear I had a ten day cruise on [00:28:20] the legal That Dental legal expert, and [00:28:25] he said the pendulum is definitely swinging back towards us, really from the [00:28:30] GDC side in that there they may be about to start a [00:28:35] program whereby it’s impossible for a first offence to be struck [00:28:40] off, for instance. Really? Yeah.

Rhona Eskander: That’s so interesting. Yeah.

Payman Langroudi: And, and [00:28:45] and, you know, I guess.

Rhona Eskander: That’s dependent because if it would be something like, of course, MeToo or.

Payman Langroudi: Something. But if [00:28:50] you’ve never had a complaint before and it’s not going to get even get to the GDC. He was telling me about a few [00:28:55] things, and what he was saying was that definitely 2014 to 2015 was sort [00:29:00] of like peak GDC. Yeah. Where where the GDC itself was getting [00:29:05] bigger and it was it was almost like an industry, you know, to to get Dental [00:29:10] they put ads out saying, has the dentist hurt you and all that? Um, but [00:29:15] you know, what I’m trying to say is the fear of the GDC, particularly we get it with younger [00:29:20] dentists That is, it’s it’s it’s not as bad as it was [00:29:25] number one. Yeah. Um, and number two, [00:29:30] as I say, it’s no consolation for someone going through it now. Um, it’s we’re [00:29:35] much less likely to be put in that position. Yeah. Much less likely. Um. [00:29:40]

Angus Pringle: But I think what you’re talking about is the, the expectation versus [00:29:45] the reality. And yeah, there certainly is the catastrophizing of the fear of the GDC. [00:29:50] And that’s affected a lot of people’s careers where, um, all you [00:29:55] have to do is read the GDC Gazette and you see this whole myriad there’s still [00:30:00] names.

Payman Langroudi: Yeah.

Angus Pringle: Um, and that that fear is enough to put off ruining someone’s enjoyment [00:30:05] of their job. And I’ve certainly been fearful, following some complaints, wondering if it’s going [00:30:10] to go to the GDC. Yeah.

Rhona Eskander: Every complaint, if I’m honest with you, every complaint, I’m like, is this going [00:30:15] to end up? And patients know now because they’ll threaten you with it whether they just want money. [00:30:20] They’ll go, well, if you don’t give me money, I’m going to report you to the GDC and it’s going through your head.

Payman Langroudi: What’s going through your head when [00:30:25] you’re when you’re worried about it? It’s shame, the primary emotion.

Rhona Eskander: I think shame is [00:30:30] the primary emotion, because I’ve also had fellow colleagues and healthcare professionals [00:30:35] been through it. And what I find also so disturbing is that the patient is [00:30:40] patient A, and the dentist or doctor has their name dragged through the mud. I find it incredibly [00:30:45] unfair, you know, and I find that is unbelievable. And the fact that people can go just on [00:30:50] the internet and have a look and, you know, people can ridicule you. [00:30:55] And, you know, I just think that since I’ll never forget a year before I graduated, or [00:31:00] was it during, you know, they sat us down Dental protection, came to give us a chat and was like, you will get [00:31:05] sued at least like X times in your life.

Payman Langroudi: Yeah. So Linda Cruz also talked about that, and he said it used to be an opener [00:31:10] that they all used to work at Dental protection, and it used to be an eye opener to every lecture that they [00:31:15] all used to use, and they realised that opener was causing massive [00:31:20] anxiety because they were going around all the dental schools. Yeah, starting with that opener. [00:31:25]

Rhona Eskander: Massive anxiety. And the fact is, look, I’ve been long enough in this game, in the cosmetic game [00:31:30] to actually realise it’s actually part of the job. You know, people some people are going to sue [00:31:35] you whether or not you did your job right. Anika talks about this. You know, Anika in the podcast was like you [00:31:40] put X amount of your money away per year and accept that that’s [00:31:45] going to go like to compensate and something legal or giving the patient money back. You know what I mean? And it’s part [00:31:50] of the game. But they make us operate from a place of fear. And what I don’t [00:31:55] like is in our profession, we are constantly operating from a place of fear. And [00:32:00] I don’t talk about just the GDC or our indemnity. What I [00:32:05] talk about as well is like we operate from fear in the sense that you are here to serve. [00:32:10] You should do X number of years on in a hospital. You should do this in general [00:32:15] practice. You should do this. It’s always this should that is like looming over us. And I think my father’s generation [00:32:20] had it much worse when he talks about his years as well in hospital. So I’ve been operating [00:32:25] from a place of fear for so long, fear that something’s going to go wrong. From the day I was in university. [00:32:30]

Payman Langroudi: And, and, and the other sort of side effect of it is you’re communicating with your patients [00:32:35] from a position of defence.

Rhona Eskander: And you’re almost manifesting things happening. [00:32:40] I know it sounds crazy.

Payman Langroudi: My brother went for a dental check-up. He hadn’t been for a while. Yeah. And [00:32:45] he said it was more like talking to a lawyer than a doctor. Yeah. Yeah. He said the guy was making [00:32:50] me sign stuff left, right and centre. He was saying, did you understand that? Did you understand that? And [00:32:55] I really something. It really hurts when he said that. Yeah. Because you almost [00:33:00] feel like the lawyers have won. Yeah. You know, the legal system has won, and.

Angus Pringle: It’s [00:33:05] taken the human element out of healthcare, and it’s making more risk averse, and [00:33:10] we’re all.

Payman Langroudi: Acting defensively.

Angus Pringle: It’s interesting. I was listening to you speak there, Rona. And, [00:33:15] um, something I was talking about actually, on World Suicide [00:33:20] Prevention Day is listening to understand and then listening to respond. [00:33:25] And you’ve really hit the nail on the head again, in terms of one of the challenges we have [00:33:30] in dentistry, but also medicine is a lot of us have these perfectionism [00:33:35] traits in our personality. And the thing biggest thing around the GDC [00:33:40] is the fear of not only what it’s going [00:33:45] to affect us, but how might we be judged by our colleagues, not just our patients? It’s [00:33:50] like, are we going to be hauled over the coals? Are we going to lose friends? [00:33:55] And unfortunately, the perfectionism trait is one of the contributing factors [00:34:00] to potentially bad mental health and suicide. Sadly, um, [00:34:05] but it’s something that we all kind of have to be mindful of, um, and [00:34:10] be working towards to help to keep our mental fitness as good as [00:34:15] possible.

Rhona Eskander: That goes back to vulnerability. When I was talking to my therapist about my own mental [00:34:20] state and she said that I suffered from something called toxic perfectionism. Yeah. Do you know about it? Yeah. [00:34:25] Yeah. So toxic for section is, you know, the the the self-perpetuating belief [00:34:30] that you’re just never good enough. I might even get my description out that she sent me. And [00:34:35] I constantly live in this, and it’s always like, you know, this thing is going to make me happy [00:34:40] or this or this or this and then this constant, and, you know, it can serve you well, right? Because [00:34:45] if you think about part’s work, I don’t know if you’ve ever done part’s work. So there’s something [00:34:50] called internal family systems. Um, I don’t know if you’re familiar with it, but again, it’s something [00:34:55] I’ve worked on with my therapist and my coach. And, you know, we’re all made up of parts. So if [00:35:00] Payman says, like today, I’m feeling anxious. No part of you is feeling anxious. That’s [00:35:05] just a part of you. It’s not you. Your identity is not anxiety. And it’s really important. And then [00:35:10] when you start to recognise all the different parts of yourself, they can all be in a boardroom together and you’re like, hey, [00:35:15] anxiety.

Rhona Eskander: Hey, this and sometimes certain parts of you have actually served you well in life. So instead of [00:35:20] shaming it because I think for a lot of dentists, that part of you, that toxic professional perfectionism [00:35:25] part has actually made you be a high achiever. Yeah. Made you do well in your exams, [00:35:30] you know, made you be a provider, organise whatever it is. So actually some parts of us have served [00:35:35] us well, but it doesn’t mean they will continue to serve us well for the rest of our lives. Yeah, I think that [00:35:40] that’s really, really important to recognise because it goes back to the vulnerability vulnerability [00:35:45] argument as well. So many dentists and healthcare professionals are not willing to be vulnerable. [00:35:50] They’re just not willing to have these conversations and be like, do you know what? I feel like [00:35:55] I’ve got imposter syndrome, or I feel like my work’s rubbish, you know, compared to X, Y, and Z online. [00:36:00] Because if we were having these conversations, we’d recognise we’re all in the same boat and we’re actually all connected, [00:36:05] you know?

Angus Pringle: Yeah, yeah. And I often think back to when I started my career, a [00:36:10] lot of the interactions we would have is in person, where you could actually have these heart to hearts [00:36:15] about maybe not feeling so good about things, but things that weren’t going so well. And as we become [00:36:20] a bit more online, especially during Covid, and mindful of the changes [00:36:25] I’ve seen online, and I kind of am mindful of the things that I post about my patients, [00:36:30] whether it’s testimonials or befores and afters and think, am I doing this for me? [00:36:35] And could this have a negative effect because someone might be having a bad day and look at it and think, you [00:36:40] know, I just or in a, in a as an orthodontist thinking I’ve just done a D bond today [00:36:45] and I didn’t really like the occlusion at the end, but Angus has posted something that’s better and [00:36:50] vice versa. I could look at it like that, but we’re not having that discussion to resolve that, [00:36:55] as in to understand the balance in how we’re feeling.

Rhona Eskander: So yeah, I [00:37:00] think also we’ve got to be active in the types of people that we follow online. [00:37:05] And that goes back to the same thing, because comparison is the thief of joy. We know that our [00:37:10] whole social media ecosystem is based on everybody feeling insecure. [00:37:15] Even the people that look like they’re like living their best life. The system would not work unless [00:37:20] every single person felt insecure. That’s the fact.

Payman Langroudi: That you feel insecure just [00:37:25] blows me away. You know, it’s it’s it’s it’s it’s madness to me that someone [00:37:30] like you would feel like you’re not you’re not good enough. But but having been sat [00:37:35] with you through all these conversations that, that that’s an issue you have with you. [00:37:40] You’ve been through so many different parts of our profession. So the hospital system climbing [00:37:45] up to become a consultant now in general? Well, not specialist [00:37:50] practice. You’ve had corporates involved. I [00:37:55] mean, the way we we were introduced was through the people at Bupa. What parts of [00:38:00] our profession can we talked about the GDC part, but what parts of our profession do you think [00:38:05] are the parts that you’ve seen have raised your anxiety levels or [00:38:10] that we could do better.

Angus Pringle: Uh, that’s [00:38:15] a really good question. I think it’s actually a combination of self-compassion, [00:38:20] being aware we’re not superhuman. Uh, and I think unfortunately [00:38:25] in orthodontics, getting in was so competitive. You’re and it’s not being [00:38:30] big headed, but your top of your top of the pile. But to get there, it’s [00:38:35] blood, sweat and tears. You’ve been really going at it. It really is. And then during the training [00:38:40] you’re constantly being pushed to excel, which it is, is admirable, as we should be. [00:38:45] But where’s the kind of middle ground? Where is the enough [00:38:50] is enough? And I remember Annika talking as well on the podcast. I think she’d [00:38:55] had some challenges when she was applying to get into specialist training and also during [00:39:00] specialist training. I think there was an issue in one year. Um, and [00:39:05] I put my hands up when I was a registrar because that’s when I lost my brother Andy and I [00:39:10] said, I’m having a really bad time. I need to have help. And hats [00:39:15] off to the people there, you know. Sue Cunningham, you know, Prof. Cunningham at Eastman. [00:39:20] Lovely lady. A brilliant orthodontist and an academic. You know, [00:39:25] I told her everything that was going on, and she’s hugely supportive. And without [00:39:30] that, you know, where would I have been? They didn’t necessarily always agree with my decisions [00:39:35] because I delayed doing my exams by a period of time, and it didn’t fit [00:39:40] necessarily their schedule. But I did get through my exams. Um, but [00:39:45] I think the hard thing in these training environments is [00:39:50] what do you do when someone struggles? Because the conveyor belt of training continues, [00:39:55] but someone is lagging behind or someone has stepped off. And unfortunately, [00:40:00] more often than not, people leave training. Um, and there has been [00:40:05] some flexibility on a very separate thing about, um, from sort [00:40:10] of, uh, doing part time training, which can help. But [00:40:15] yeah, I, I was lucky I got through it. It was, there was a, [00:40:20] I was bruised and battered, but I got my qualifications. Um, what about what. [00:40:25]

Payman Langroudi: About politics, hospital politics? Like, did that wear you down? Because that’s a big [00:40:30] part of. Well, I.

Angus Pringle: Think there’s politics everywhere. I think that, uh, even [00:40:35] politics where I work. Not in a bad way, I think in a good way. Constructive way. Certainly, [00:40:40] when I left my consultant post, the. It was a period of time when management [00:40:45] were really not very pleasant. And it was a lot of pressure, uh, to see more [00:40:50] patients, to do more hours, to change our contracts, uh, [00:40:55] cutting costs. I was thinking, you know, I trained all these years because I maybe [00:41:00] it was quite naive. I wanted to provide the best possible care. Uh, I [00:41:05] A kid in some respects, but I realise this isn’t for me. I actually want to care for [00:41:10] people. I wasn’t interested really on sitting on committees. Um, I got [00:41:15] the most out of interacting with families, patients, seeing them grow [00:41:20] and develop as I do with staff. And that’s what I’m really fortunate to be able to see now in [00:41:25] the practices that I work in. Um, but I didn’t really get to be heavily [00:41:30] involved in the politics. And you can get sucked in and you have the [00:41:35] different camps for people who’ve got beliefs for this and that. When I always kind of thought [00:41:40] what the big picture is, um, which is looking after people because health care is [00:41:45] just not just about health, it’s actually about caring. And sadly, there’s a lot of people who don’t [00:41:50] actually forget that.

Payman Langroudi: Now that you’re more tuned in [00:41:55] to mental health victims of suicide, families [00:42:00] of victims of suicide, do you think there’s a role for dentists in [00:42:05] intervening, maybe, but in helping in helping, helping [00:42:10] people with their mental health.

Angus Pringle: Yeah, absolutely.

Payman Langroudi: Patients.

Angus Pringle: That’s what we’re doing.

Rhona Eskander: With this as well. [00:42:15]

Payman Langroudi: No, no. But for our patients, I mean, you see the patient every six months, you know, we’re perfectly [00:42:20] placed to spot. But someone like me, I’m not tuned in enough to [00:42:25] to well, I’m not a dentist anymore, but, you know, you’re very sort of empathic [00:42:30] with your patients, and you can tell if they’re going up or down. Have you had a thought about that or have [00:42:35] you noticed with your own patients?

Angus Pringle: Absolutely. And even I think one of the things I’ve loved [00:42:40] in my job is people feeling comfortable to speak to me. Me too. Um, and it’s [00:42:45] like they’re comfortable telling when they’re not happy. And I always say, like, as soon as something doesn’t feel right, [00:42:50] tell me so it doesn’t snowball. So over time, and I think it’s [00:42:55] a privilege that I’ve had parents tell me about the struggles their children are having or their own [00:43:00] struggles. Um, And an orthodontist isn’t really [00:43:05] about moving teeth. It’s about psychology. It’s about coaching people. And that’s something [00:43:10] I’ve really enjoyed.

Rhona Eskander: I had all parts of dentistry, to be fair.

Angus Pringle: If you’ve got the [00:43:15] time, and I think that’s a struggle in the NHS, is you can do a technically good [00:43:20] job on the NHS. But does the patient feel happy? Does they feel listened to? Have you manage their anxiety? [00:43:25] If you’ve not got enough time and that leads to patient dissatisfaction and also dentist dissatisfaction. [00:43:30] And I had a patient last year uh, which [00:43:35] really has stuck in my mind. They just they’d been referred to me to replace a bonded [00:43:40] retainer, which is not a big deal. And I don’t often go into the waiting room, but this time [00:43:45] I thought, I’ll go down. It’s a new patient. It’s nice to get to meet new people. [00:43:50] And as soon as I walk into the waiting room and I said their name, I knew something wasn’t right. They didn’t look [00:43:55] me in the eye. They looked distracted, like the thousand mile stairs. [00:44:00] And so we walked up the stairs. I was making small talk, but they weren’t really saying anything. [00:44:05] And they sat in the chair and I started talking to them and I knew something wasn’t [00:44:10] up. And this is something that’s very important in preventing [00:44:15] suicide is listen to your gut feeling. Something doesn’t feel right. [00:44:20] You generally are on to something. So we forget the bonded [00:44:25] retainer.

Angus Pringle: And I started asking her, you know, how are you feeling? She says, I’m not doing so good. Says, [00:44:30] do you want to talk about it? She says, I don’t really want to talk about it. And do you have any [00:44:35] support at the moment? She says, yeah, I’ve been to a therapist, but it’s not worth it. You [00:44:40] know, I don’t feel like I need to be here, and there’s all these alarm bells that kind of [00:44:45] came up and we just kind of chatted and I let her talk. [00:44:50] Um, and this is the thing. If you’ve ever got someone who is suffering, [00:44:55] that’s a mental distress. Even if you don’t know who they are, it’s just. Listen. We [00:45:00] spent the time, we spent 30 or 40 minutes and she could tell me [00:45:05] about her journey, what she’s been through, how she felt worthless and [00:45:10] hopeless. There’s nothing I can say to make it feel better, but the [00:45:15] fact is we were there to listen, and I think that’s something we can all do. We don’t [00:45:20] know, don’t have to give solutions. And then we followed up [00:45:25] with the person. Um, two days later, I phoned them up and chatted to it, and [00:45:30] they were just very grateful. The fact that we spent the time. I mean, you said.

Payman Langroudi: Yourself something as [00:45:35] simple as tomorrow might be different.

Angus Pringle: Yeah, tomorrow might feel better. You might feel.

Payman Langroudi: Better. Change [00:45:40] the way you think about you thought about your own mental health. Something as simple as that. [00:45:45]

Angus Pringle: But it is. It is. The thing I’ve been talking about is the compassion. And there’s a [00:45:50] lot of fear around about talking about suicide. And if you’re worried about [00:45:55] someone and you’ve got a gut feeling that something isn’t right, A key thing [00:46:00] we know is if you ask someone, are you thinking about taking your own [00:46:05] life? That doesn’t mean you’re seeding the idea. It doesn’t mean that [00:46:10] they’re more likely to die by suicide. They actually might find it’s a way that they [00:46:15] can actually say yes, and it can actually be a huge relief in a lot of respects. [00:46:20] And from that, we can then look to see if we can get them support. Yeah. [00:46:25] But this is where because there’s not been enough of a discussion around suicide prevention, [00:46:30] it’s these conversations that are incredibly important. And I certainly had no skills [00:46:35] in that previously. And I’ve been through some training. I’m certainly not an expert in it, but [00:46:40] I feel in a better place. If I were in the unfortunate situation where I was [00:46:45] to have someone who was worried about, I feel I could possibly handle it slightly better than [00:46:50] I used to.

Rhona Eskander: Yeah, I think it’s really there’s two things based on what you were saying. [00:46:55] First of all, I want to say the listening piece is really important. One of the best questions that [00:47:00] I got asked was, or one of the best proposals that I was given, [00:47:05] was, do you want to be heard or do you want advice? And I think that’s [00:47:10] really important because sometimes when people come to you with a problem, you start giving them a number of [00:47:15] solutions and it actually makes them feel worse. Like there’s definitely times where I’m like, this is overwhelming me and making me feel worse. [00:47:20] Whereas actually, sometimes you just want to be seen, and being seen is incredibly powerful [00:47:25] and you feel that you are not being judged [00:47:30] for what’s being said, and you just need to kind of have that release and that vent. Yeah. So I [00:47:35] think that that’s one of the most important questions I started to ask people, do you want to [00:47:40] be listened to? Or do you want advice? And I think that’s where we really need to start thinking [00:47:45] about that way. The other thing that I wanted to say was, is also the [00:47:50] stigma thing is just so big, because I think that people relate [00:47:55] death by suicide as being mentally unwell. And when I went through a [00:48:00] really dark period of my life, I remember going to quite an old school psychiatrist [00:48:05] telling him about like the suicidal ideation, and [00:48:10] he wanted to put a diagnosis on me straight away for a mental health disorder and put me on, [00:48:15] you know, quetiapine, which is a very strong, um, medication. [00:48:20] And I just said no. And I was like, no, actually, listen to me. I mean, I saw him a few times, but I listened to my [00:48:25] gut and was like, I don’t think he’s the right kind of person because the conversation around those feelings is [00:48:30] something’s wrong with you, and that makes you feel even worse.

Angus Pringle: Yeah, yeah. But you brought up the thing [00:48:35] about stigma. Um, and it’s one of the things how we can change the conversation [00:48:40] is how we use the language around suicide. And something that is [00:48:45] I particularly don’t like was after Andrew died by suicide, people talked about [00:48:50] him committing suicide. And that just it just makes the hair go up on the back of my neck. [00:48:55] And it harks back to really when suicide was a crime implicating, [00:49:00] like there’s a crime where there was a sin that happened. So by it’s nothing to do [00:49:05] with political correctness, but by changing our language about how we talk about [00:49:10] it, it’s so that other people who might be struggling with those thoughts can feel more [00:49:15] able to reach out for help. But if we’re using terminology that is reinforcing [00:49:20] stigma, then they’re the ones who may not be seeking help. And then [00:49:25] we’ve got another tragic death. So there’s a lot that we can do in terms of talking about [00:49:30] it, that we can help others.

Rhona Eskander: I think we have to make them like the media, have to be held accountable. We’ve talked about Caroline [00:49:35] Flack off camera. I’ve talked about her on camera a lot. Uh, you [00:49:40] know, the media’s narrative towards her. And again, it reminds me a little bit of the GDC. [00:49:45] You know, you are like, you are on trial. This person is on trial. It was the same with [00:49:50] Caroline Flack. She was on trial for her behaviour, you know, so that is responsibility. [00:49:55] Like these people, these these institutions, the.

Payman Langroudi: Gdc by design [00:50:00] is a court. Yeah it is. It’s by design. It’s not it’s not like it feels [00:50:05] like it’s a court. It actually it is a court.

Angus Pringle: Yeah.

Payman Langroudi: Yeah. But I think maybe that’s.

Rhona Eskander: Almost medieval to be [00:50:10] different. That’s medieval.

Payman Langroudi: Maybe that needs to be different. Yeah. For sure. I mean, [00:50:15] what should someone do if they have [00:50:20] suicidal ideation?

Angus Pringle: That’s a difficult one. [00:50:25] I think from our point of view, I think that.

Payman Langroudi: Talk [00:50:30] to someone. Right.

Angus Pringle: Well, you know, we’re thinking about men and women here. I think [00:50:35] that anyone who is struggling with their thoughts to begin with, I think [00:50:40] it’s most important for anyone who’s listening today know that help is available. Sometimes [00:50:45] those thoughts can be scary. And this is the issue of if someone had thoughts [00:50:50] of taking their own life, it can be scary if they’ve never had anything like this before, or [00:50:55] heard about it before, or heard that recovery can happen. Yeah, um. [00:51:00] And reach out for help, but reach out for support as well. We’ve [00:51:05] got obviously great charities like Samaritans. We’ve got papyrus, we’ve [00:51:10] Got Minds and Confidential, which is confidential, which is.

Payman Langroudi: Anonymous [00:51:15] for dentists.

Angus Pringle: But don’t think you have to go through it alone. Um, there. [00:51:20] It’s always amazing to think of the people who are compassionate that can support [00:51:25] you through this journey. And I think that’s what’s really important. And I think that’s the thing for [00:51:30] us. On the other side of things, if you’re worried about someone is having the confidence [00:51:35] to have that chat, and if it’s particularly if it’s a man, if he sees he’s okay, [00:51:40] ask him twice, you know, are you really okay? And if you’re still [00:51:45] getting a no or you say coming back and say, you know, I’m doing fine, if you then say, [00:51:50] well, I’ve have observed this about you like you’ve been a bit withdrawn. [00:51:55] You don’t look yourself. You look quite distant. Um. I’m worried about you. [00:52:00] It’s trying to really extract that information, um, and be persistent. [00:52:05] And we often don’t want to interfere with someone’s private life. Um, but [00:52:10] it’s important in these their life saving conversations. And if you are [00:52:15] worried about changes in their behaviour, that could be that they’re worried that they [00:52:20] might take their own life. Ask the question because it has been shown to be life [00:52:25] saving. It’s not seeding the idea.

Rhona Eskander: Have you seen that, um, amazing [00:52:30] advert? I don’t know which charity it is. Remember it made you cry. There was two older men that were at the football. [00:52:35] And then there’s one that’s really. Yeah. And then there’s one that’s really happy. And the one that looks a bit [00:52:40] more miserable. And the happy ones always trying to make sure the miserable ones are having a really good time. And then, [00:52:45] you know, it says like, mental health doesn’t always look like it. Yeah. And then it was the really happy one [00:52:50] that ended up taking his own life, which I think really labours the point that, you know, you [00:52:55] never know what people are going through, what mask they might be wearing, and [00:53:00] educate like we need to educate ourselves like, don’t shy away [00:53:05] from it. You know, I know it’s not the happiest topic in the world, but when I got the book, I [00:53:10] started reading it, you know, and I think maybe it’s because I’ve been I’ve been I’ve been in dark places. I really, [00:53:15] really have. So for me it was like, oh my God, I feel seen. Someone’s seeing my mental health. [00:53:20] Like that’s what I felt like. And I wanted to understand more. And I think it’s that education that’s really key. [00:53:25] And for some people, particularly in medicine and dentistry, I think it’s really challenging because of cultural and religious, [00:53:30] um, taboos and stigmas around the conversation. And it’s also not [00:53:35] a topic of conversation, which they feel maybe would propel them in their career. But you know, your [00:53:40] mind, you know, mind over matter. That’s what I think.

Payman Langroudi: Something you’ve taught me, Rhona, [00:53:45] and you brought it up today is that, you know, there’s a there’s a spectrum [00:53:50] all the way from mental fitness and optimisation, all [00:53:55] that good stuff, you know, being at the top of your game all [00:54:00] the way to feeling suicidal and you can move along that spectrum and somehow [00:54:05] talking about optimisation is everyone wants to talk about optimisation, but [00:54:10] when we get to the to the suicide side of it, now stigma creeps in. Yeah, it’s just not sexy, [00:54:15] is it? But it’s the same subject we’re talking about is how are you feeling? How is how is your mental health? [00:54:20]

Angus Pringle: Yeah, you’ve just triggered something in my mind. I’ve just remembered. So Mike McCarthy, who’s [00:54:25] the founder of the Baton of Hope, I have had some amazing conversations with him. And he [00:54:30] lives in Sheffield and they’re they’ve got a men’s club called Talk Club, which is very [00:54:35] simple. And when you go to talk club as a man, you’re asked, how [00:54:40] are you feeling out of ten? And can you tell me why? And I’ve used these kind of [00:54:45] skills with patients in terms of how they’re feeling about their smile or their well-being. It’s incredibly [00:54:50] effective. But I actually had the conversations with my kids. So my oldest [00:54:55] boy, Fraser, he is probably a bit like me, a bit introverted, not necessarily [00:55:00] going to volunteer information, whereas Hugo, he’s [00:55:05] amazing. The conversations we have, he will volunteer information, everything. Yeah. So [00:55:10] it was I saw I spoke to Fraser and I said, Fraser, can you tell me how you’re feeling out of [00:55:15] ten? And he gave me a number and then says, can you tell me why? He then talked to me for 20 [00:55:20] minutes and all these things I could hear about. He says, oh, I’m a bit worried about GCSEs, [00:55:25] what subjects are going to do, what the teachers are going to be like, but that’s a few years away. But I [00:55:30] didn’t know that. But sometimes by asking a different question, it opens [00:55:35] up huge, um, avenues of discussion [00:55:40] because it’s in a non-threatening way, rather than how is your day to day? [00:55:45] And it’s a, it’s fine but think it on a different way. And we use [00:55:50] that a lot with our teenage patients in terms of how they’re feeling, how they’re getting on. Because if [00:55:55] you’re asked something directly, it can feel quite threatening. Whereas if you’re having to reflect [00:56:00] upon your thoughts and your feelings, the answers you get are, as [00:56:05] an.

Payman Langroudi: Orthodontist, you get to see a kid go through. I mean, one of my kids went through two and a half years [00:56:10] of ortho, and then right at the end, we sat with the authorities and said, let’s look at the pictures right at the beginning [00:56:15] and right at the end, and the pictures right at the beginning. To hell with the teeth. He was he [00:56:20] was a child at the beginning. And at the end. He’s a teenager, you know, he’s and so you [00:56:25] see a family go through that period and a teenager. I [00:56:30] mean, it’s a difficult time being a teenager. Oh, gosh.

Angus Pringle: Yeah. Yeah.

Payman Langroudi: It’s [00:56:35] kind of a privileged position as an orthodontist. You get to see them. [00:56:40]

Angus Pringle: They’re so different. Yeah, I absolutely love it. And one of the most important [00:56:45] lessons I learned when I was training at the Eastman wasn’t the technical bit, but we had a psychologist who [00:56:50] came in, uh, Sarah Portnoy. I think that’s right. And [00:56:55] she said, when you’re talking to teenagers, don’t just criticise the toothbrushing. Don’t just criticise [00:57:00] their appliance wear because they’re going to switch off. This is where I learned the scale out [00:57:05] of 1 to 10. If you ask them, how are you getting on with your toothbrushing? And [00:57:10] I say to my patients, a ten is I win a gold medal at the Toothbrush Olympics. And [00:57:15] one is I lost it two weeks ago. So there’s no no judgement in that. [00:57:20] And then 99.9% of the time they’re right. They’ll say I’m a five out of ten. And you say, well, [00:57:25] can you tell me why? And they say, well, I brush one time a day and that’s probably for about a minute. [00:57:30] Um, and I don’t say, well, which end of the toothbrush are you using? But [00:57:35] it’s much more engaging. You’re bringing the patient along with you because it can [00:57:40] be so easy to just slap someone down and say, you’re bad at this.

Rhona Eskander: But dentists are really [00:57:45] bad at that, by the way. I’m really shocked because I did a video on TikTok that, [00:57:50] um, got 8 million views. It went really viral, and it was come along with [00:57:55] me as I watched this girl and this girl, uh, basically expressed that she hadn’t brushed her teeth. [00:58:00] Well, she calls it a hot minute. And she says, because every time she brushes her teeth, um, [00:58:05] her teeth crumble and fall apart. And basically you watch her. There’s [00:58:10] a three minute video. Every single tooth is covered in gross calculus. Um, [00:58:15] the girl is panicking. And I did a really compassionate review of the video, [00:58:20] and the amount of positive feedback that I got back was, thank you [00:58:25] so much. Not for judging her. Yeah, you don’t know what people are going through. There have been loads of dentists [00:58:30] that have been really mean to her on this video. There have um, you know, my dentist speaks to [00:58:35] me like I’m trash, but I was actually going through depression. I couldn’t get out of bed. My bodily and [00:58:40] oral hygiene completely Suffered. And I was like, you know, it’s so basic, but I’ve [00:58:45] heard so many patients that have actually been shamed by their own dentist or healthcare [00:58:50] professionals about not brushing their teeth, having good oral hygiene. We don’t know what [00:58:55] people are going through. I’m not saying that I’m giving people a free card to just do what they [00:59:00] want. I’m not telling you to go and like, have a pack of fags for breakfast.

Payman Langroudi: But you’re right, you’re right. You’re [00:59:05] absolutely right that there are some dentists like that. I think number one are dental [00:59:10] education. We’ve talked about this a million times. Right. What bits of the course would you take out and what new [00:59:15] bits would you add in. And definitely something around mental health of yourself [00:59:20] and of your patients.

Rhona Eskander: 100% should be on the curriculum.

Payman Langroudi: And then and then what you’re saying here empathy. Not sure if it’s [00:59:25] teachable as much, but something you should bear in mind here is that some people [00:59:30] were treated by a dentist who told them off. Yeah. And [00:59:35] they see that’s the dentists job to tell you off. Yeah. And it’s so interesting because [00:59:40] what the dentistry that you had as yourself as a child kind of defines [00:59:45] what you think is normal. Yeah. As dentistry, whatever that was. So [00:59:50] I was treated by the guy. Same guy who treated us in Iran before we came. And he [00:59:55] he happened to go to Harley Street. So I thought Harley Street was normal. [01:00:00] Then I go into my practice saying, what the hell is this? Yeah. The next person had a bossy [01:00:05] dentist. He thinks that’s the normal.

Rhona Eskander: I think it’s I think it’s different. I mean, I had a horrible orthodontist. [01:00:10] Horrible. And it was the worst experience ever. But also, I [01:00:15] wasn’t super compliant, but also, like, my parents couldn’t afford to be around and make [01:00:20] sure that I could go to appointments. So there was complexity in my social environment at the time, [01:00:25] which meant that I was in braces for six and a half years and my six and a half years. So [01:00:30] my orthodontist was like, not great. And he obviously was resentful of being on the [01:00:35] NHS. I still wanted to be a dentist, and I was like, I want to be a very different dentist to him. Do you see what I mean?

Payman Langroudi: So [01:00:40] sometimes you want to be the.

Rhona Eskander: Opposite, but it’s the same as when you look at people that grow up in abused homes or [01:00:45] addict homes. Either they follow in the footsteps or they become the complete opposite. You know, that’s quite [01:00:50] common. So I think that’s. But I think that what’s lacking in the education system and perhaps [01:00:55] in the selection process, a lot of people will choose dentists [01:01:00] based on certain accolades without actually assessing whether they are [01:01:05] right to be a healthcare professional. I was deemed to be not [01:01:10] desirable to get into dental school, and pretty much rejected from every [01:01:15] part of my dental education, not the A-level GCSE part because [01:01:20] I was deemed to be too airy fairy to this, to that because the character I am, and actually [01:01:25] that’s served me. That’s my superpower. My patients are my superpower because I have [01:01:30] that understanding. But in dental school, they didn’t see that.

Payman Langroudi: People misjudge you. [01:01:35]

Rhona Eskander: They do, they do, they do misjudge.

Payman Langroudi: It’s part of it’s part, it’s it’s part of the feature of of [01:01:40] being loud and proud that people get get you wrong. It’s one it’s one of the it’s [01:01:45] your biggest it’s your biggest strength and your biggest weakness at the same time.

Rhona Eskander: But why? But why? Why is dental [01:01:50] care professionals, health care professionals? Do we want somebody to be quiet in the corner and slaving [01:01:55] around? And just like writing academic papers or doing research studies, why is that [01:02:00] considered within the community? Not my patient community. Within the medical health care professional [01:02:05] community, the more quiet you are, but doing research and ticking those academic boxes, [01:02:10] the more we’re going to look up to you.

Angus Pringle: People like us do things like us, [01:02:15] and no one wants anyone to rock the boat and change things.

Payman Langroudi: It’s a conservative.

Angus Pringle: Profession. [01:02:20] And, uh, and I think even in orthodontics is a very small [01:02:25] world. And you think of everything I had to do. I was a kind of a chameleon. I, I changed [01:02:30] myself to be the person they’re looking for rather than the person who I am. So I did, [01:02:35] and hence why I’m in a much better place myself, because I’m doing [01:02:40] my authentic self now in terms of caring for my patients and [01:02:45] feeling fulfilled. But to come back to when we think how we speak to our patients, [01:02:50] this perfectionism trait that is detrimental to our own mental health is [01:02:55] why we sometimes struggle with relationships with patients or with staff members. [01:03:00] If I think of staff members, um, who when [01:03:05] I was younger because of my drive and determination, if they weren’t as driven [01:03:10] and determined and hard working as me, I would kind of judge them internally. I might not [01:03:15] express that, but they’re still doing their job. But at the same with our patients. A [01:03:20] really difficult thing with orthodontics is compliance. But no one is a perfectionist [01:03:25] like the orthodontist might be. How do you get them through wearing their aligners? [01:03:30] It’s a very good point. Their elastics are wearing are brushing their teeth. Not everyone [01:03:35] can be at the very top end of that curve. And how do you handle that and still maintain a good relationship? [01:03:40]

Payman Langroudi: Yeah, yeah. By the way, you think we have egos and dentistry orthodontists. [01:03:45] I was going to sell a product to orthodontists and looking to sell [01:03:50] a product to orthodontists. And I wanted just to talk to some orthodontists, just to see what they thought of the [01:03:55] idea before going ahead with it. So I called Tracy and Tracy Posner. Yeah, yeah. She used to run the [01:04:00] British Orthodontics Boss event. Yeah. So I said to her, look, who are the top 3040 orthodontists [01:04:05] in the country? Let me just go see all of them. My God, the egos, my God, the egos. [01:04:10] It surprised me having, you know, having been with dentists continuously. [01:04:15] There were egos and disagreements. You know, that old thing [01:04:20] about six orthodontists? Seven opinions. It was like six orthodontists, [01:04:25] 23 opinions. You know that so many different ways. And it’s so weird because [01:04:30] as a dentist, you think you kind of know what’s going on in that world. Yeah, yeah. But so many different [01:04:35] ways of moving teeth and different opinions and strong opinions. Strong opinions on [01:04:40] how things should be done.

Angus Pringle: But yeah, this orthodontics is science, but also art. Yeah, yeah. [01:04:45] And it’s the art that we really there’s there’s huge arguments [01:04:50] about, you know, what’s right and wrong. And, and I often say to patients, there’s so many different ways I [01:04:55] can get you to the end point of treatment, but what is going to be the right thing for you? And often they’re [01:05:00] more of the judge than I am. Um, and I’ve sat in the periphery of a lot of online [01:05:05] debates regarding things like Myofunctional appliances, [01:05:10] six month smiles, GDPR, GDPR. So et cetera, et cetera. [01:05:15] And it can get incredibly toxic. But if you step back and say, look, [01:05:20] at the end of the day, we just want to look after our patients. A lot of it is kind of semantics between [01:05:25] different things, but it is about caring about people. But there’s a the [01:05:30] keyboard warriors can really oh my.

Rhona Eskander: God, they’re terrible. They’re literally I mean, they create pages about [01:05:35] colleagues.

Payman Langroudi: Like, I had a guy here sitting where you’re sitting. Uh ex-goldman. [01:05:40] Sachs. He’s now owns 14 dental practices. And and I said to him, what [01:05:45] surprised you the most about dentistry? And he said, the egos. And I was really I was like, I said, what the bigger [01:05:50] egos in dentistry than in banking. And he was like 100%. Yeah. Yeah. It was really surprised [01:05:55] me.

Rhona Eskander: I think it is really difficult. Um, Angus, [01:06:00] it’s.

Payman Langroudi: Been a massive pleasure.

Rhona Eskander: Yeah. You are amazing. And thank you so much for the work that you’re doing and coming [01:06:05] on here and talking about a topic that’s incredibly close to my heart. Uh, I [01:06:10] would love people to be able to connect. If they need more help, could you perhaps give some [01:06:15] information about where they can find any more information with regards to all of this?

Angus Pringle: So I think the [01:06:20] first place is like education. And just like when I gave you the book that in what’s [01:06:25] the when it is darkest like I my I’m really someone [01:06:30] talking through lived experience. I’m not a therapist. I’m not a psychologist. But to actually [01:06:35] understand the backgrounds to mental health and suicide awareness is incredibly [01:06:40] important. I think, in the Dental community, engaging with the charities, [01:06:45] particularly the Canmore Trust, where they’re doing a huge amount of work supporting dentists [01:06:50] in difficulties, but also looking to see can we get a more compassionate regulation. [01:06:55] Um, and there’s a lot of stuff that’s going on online. And if you look at my Instagram, [01:07:00] I’ve done a lot of posts regarding mental health, different wellbeing things, but [01:07:05] I think it’s the collective voice that we all speak together as most important. Um, [01:07:10] from that point of view.

Payman Langroudi: What’s your Instagram? Yes.

Angus Pringle: Uh, Angus Pringle Orthodontics [01:07:15] and or Angus Pringle as well. So. Perfect.

Rhona Eskander: Thank you so much Angus. That’s amazing.

Angus Pringle: Well [01:07:20] thank you for having this conversation. It’s it’s it can be life changing for people and life saving. [01:07:25] So thank you for taking the opportunity to invite me.

Rhona Eskander: Thank you so much.

Payman Langroudi / Andrew Chandrapal: None of us like failure. Yeah. That’s universal. Yeah. Um, but failure is inevitable. [00:00:05] It’s just when it happens. And so the reality. Are you less likely to go and try [00:00:10] and fix, be a hero and fix something that you really, you know, something that hasn’t got much there [00:00:15] nowadays? Um, I wouldn’t say that, but I’m less likely to do it on someone who [00:00:20] I feel. Um, personality wise is going to, is going to then say, well, the treatment [00:00:25] that you did hasn’t worked out. Now, what are you going to do about it? Yeah. So it really is the personality type [00:00:30] and the dynamic or the ideology of that patient that will drive me the right patient. You would do that? [00:00:35] Absolutely. Um, and notwithstanding the fact that I’ve learned from other people [00:00:40] how to then try and do forms of heroic antics that actually I would have [00:00:45] never have tried before.

[VOICE]: This [00:00:50] is Dental Leaders, the [00:00:55] podcast where you get to go one on one with emerging leaders in dentistry. [00:01:00] Your hosts Payman Langroudi [00:01:05] and Prav Solanki.

Payman Langroudi / Andrew Chandrapal: It gives me great pleasure to [00:01:10] welcome Andrew Chandrapal onto the podcast. Andrew is a all [00:01:15] round good guy musician. Um, for me, the [00:01:20] when I think about you, Andrew, I think about like almost the bridge between single tooth and [00:01:25] full mouth dentistry. If I wanted to understand that [00:01:30] point of difference, you’d be the person I’d go to. And [00:01:35] also the kind of dentist for me, the kind of dentist you refer family and friends to. And I [00:01:40] can’t think of a sort of a bigger thing that you could say about someone, right? Because that, [00:01:45] you know, there are there are dentists who do lots of different things, but then there are some who you feel like have [00:01:50] got the holistic knowledge of what’s going on. Um, pleasure to have you. [00:01:55] Thank you for inviting me. Yeah. Finally. Yeah. I’m not going to say anything. [00:02:00] 250. Wow. That’s all good. We first met. If I [00:02:05] want to guess around 2005 or 6, I want [00:02:10] to say something like that. When did you call the fire? 2001. Yeah. You [00:02:15] were like, a 4 or 5 year qualified. It was even then. Very talented. Well, I’m [00:02:20] not sure. Yeah. Yeah. You were. The first question really is, were you always [00:02:25] driven work wise, or was there a moment that you became [00:02:30] driven? Were you driven like in university as well? Yeah, that’s an interesting question. [00:02:35] Um, no. No. And I think, I think if you referred [00:02:40] to the musician element and I suppose for the first three years, [00:02:45] my gigging and musical performance stuff was the forefront [00:02:50] of my head and heart at Birmingham.

Payman Langroudi / Andrew Chandrapal: Yeah. At Birmingham. And so unbeknown to my parents. [00:02:55] I’d be travelling down most weekends into London. Oh, really? And from Brum [00:03:00] and doing some gigs with some band mates, buddies and what have you. And then [00:03:05] travelling back on Sunday night. And I actually found, I found the cheapest tickets [00:03:10] on National Rail. It was a £12.50 ticket. I’d missed the end of my lectures on the Friday [00:03:15] afternoon bus down and come back on Sunday night for £12.50. I was like Bob on, unbeknown [00:03:20] to me, losing out on some of the social affairs at university [00:03:25] and not really feeling the vibe of dentistry at all. So it’s a very functional, kind [00:03:30] of purposeful thing up until year three. And at that point there was a tutor at [00:03:35] Birmingham, a lovely fella. His name is Don Spence, and he [00:03:40] sat me down and said, Andy, you know, you’ve got [00:03:45] some potential. And there I was, you know, like long haired kind of and, and [00:03:50] he said, but you need to change your Anyways, and because [00:03:55] you’re not going to get through it otherwise. And so I kind of set up for a night or two trying [00:04:00] to think about where I was, where I was going, where I potentially could go. And [00:04:05] um, two days later, I cut my hair, stopped gigging, told roommates [00:04:10] that’s it, and got into it, and, and I and [00:04:15] I realised at that point I have a fairly obsessional methodology in life.

Payman Langroudi / Andrew Chandrapal: So I kind [00:04:20] of delve in fairly deeply, and that was the first poignant moment. I ended up [00:04:25] doing okay at uni as a result of that in those last two years. The other poignant moment, I guess, was [00:04:30] what I presented at BCD one time, which was my [00:04:35] father passed in 2005, and I kind of adopted a bit of a head down approach [00:04:40] in dealing with that. And grief does funny things to you. Yeah. And I think at that [00:04:45] point in time, I kind of just went head down into my work and never really came up. And [00:04:50] so that’s really adopted my work to life ratio, to a point [00:04:55] where I felt adapting that obsessional mentality early on, [00:05:00] and then that almost traumatic point in life took me to [00:05:05] a point where I have to go headfirst into everything that I do. And was it to do with your [00:05:10] relationship with your dad and so much? I mean, was your dad saying be the best [00:05:15] or whatever? No. Was he that kind of. He wasn’t at all. It was how I dealt with my grief [00:05:20] of losing him when I wasn’t expecting to. Yeah. And I think [00:05:25] that’s how I dealt with it by busying myself. And [00:05:30] because my music had taken a bit of a sideline, I was then thrust into, I’m the eldest, [00:05:35] one of my family, of my generation.

Payman Langroudi / Andrew Chandrapal: And so it was a responsibility issue [00:05:40] as it was. Then all of a sudden you go from kid to I was in my mid to late 20s at that point, [00:05:45] and all of a sudden, you know, you’re thrust into in an Asian family to be [00:05:50] the head of your family. So it was very much a caring thing that I had done for my for my mum. And my [00:05:55] brother was here. He was only young, but then actually a few years later he emigrated to Sydney. So [00:06:00] from that point, it’s then been a very kind of insular [00:06:05] relationship with my mum and I. And that configuration, that dynamic changed. [00:06:10] And so all of a sudden I had my work. I was fortunate enough to have what will end up to be [00:06:15] my family at that point. And um, yeah, it’s it’s been go, go, go since. [00:06:20] And the music, how deep were you into that? Like when you say coming down to London [00:06:25] gigging, were you in a band like, did you ever consider music as [00:06:30] a career? Yeah, 100%. So 100%. So. So was dentistry sort of just [00:06:35] an insurance policy? How what was going through your head? So I wanted to I was given opportunities [00:06:40] to, to become part of studios or to do, um, international session [00:06:45] performing. Oh, really? Um, prior to uni. And it was a conversation that I had with [00:06:50] my folks and they never really beat me into submission. [00:06:55] I wouldn’t say that, but they certainly made their opinions known.

Payman Langroudi / Andrew Chandrapal: Um, you [00:07:00] know, having come to the UK in the early 70s and, um, and, [00:07:05] and fought tooth and nail, you know, what it’s like to get here and to, to, to make [00:07:10] a living and to raise a family. And then you’ve got your, your eldest son saying, no, I want to do music, [00:07:15] you know. Um, I don’t think it’s sat well with them. It’s not like it would be now. And [00:07:20] so I think. But then you say that, right? But, you know, your kids are [00:07:25] getting to that point of A-levels and things soon. Yeah. If one of them [00:07:30] says I want to write movies. Yeah. Are you cool or were you or what? [00:07:35] What’s your advice? Yeah. You know, actually, my advice or actually both [00:07:40] of our advice to the kids is not really about if you if you [00:07:45] want to be a hairdresser, be a hairdresser. But don’t just be a hairdresser. Own your business. Own a salon. [00:07:50] Think about teaching others. Think about influencing others. Think about aspiring others, [00:07:55] then own another salon and then become a group. So it it [00:08:00] just be the best you can in what you do. Yeah. Or attain to be the best you can. [00:08:05] Uh, whether they want to be writers, poets, musicians, whatever, that’s cool. But [00:08:10] I think the mentality is the important thing. And without getting too deep into it, I think that’s what’s [00:08:15] led me to to a stable point in my career.

Payman Langroudi / Andrew Chandrapal: Um, dentistry. We’re lucky we [00:08:20] have the ability to do several things. Yeah. But I think the mindset is the same whatever [00:08:25] industry you might be in and the sort of the age old question about dentistry for your [00:08:30] kids, would you encourage them to become dentists or are you the opposite? [00:08:35] Because I get both sides. Yeah. You know, when people ask, well, [00:08:40] let me flip it. When people answer that question, they base based their own rhetoric and the [00:08:45] rhetoric of others that they know to answer that question. And I’m like, you know what? We [00:08:50] will make the best of whatever we do. And the [00:08:55] generation before you and I treated dentistry in a different way to we do the way [00:09:00] we do and have done and the generation ahead of us the same. And so you make the best [00:09:05] of your generational kind of culture and dynamic. And so if they chose to do want to do dentistry [00:09:10] or any other vocation like medicine, I wouldn’t discourage them, but I’d encourage them to make the best [00:09:15] of it. Um, I don’t like the idea of basing our decisions based [00:09:20] upon legacy, because actually, the older you get, you realise how times must and [00:09:25] do change. So I if they choose to want to go [00:09:30] into dentistry, let them do it. But don’t give them expectations based upon what you’ve achieved, [00:09:35] or don’t have expectations upon what you’ve achieved, because your kids are different to you. [00:09:40] True. But look.

Payman Langroudi: What I’ve done.

Payman Langroudi / Andrew Chandrapal: A lot.

Payman Langroudi: Maybe. Maybe I’ve done this wrong. I’ve. [00:09:45] When people have said they want to do medicine, I have tried to discourage them. And [00:09:50] anyway, you can’t discourage someone who wants to be a doctor. That’s one of those things that happens [00:09:55] when you’re, I don’t know, 11 years old. You decide you want to become a doctor and you can’t stop that guy [00:10:00] becoming a doctor. But my brother’s a doctor. And, um, I’d much [00:10:05] rather my kid became a dentist than a doctor for. For his own well-being. [00:10:10] Tell me why. For his own well-being, you know. For his own well-being. Okay. In this country. In this country. [00:10:15] Yeah. Might be a different story somewhere else.

Payman Langroudi / Andrew Chandrapal: So let’s look at that. Let’s look at that. I mean, like, you’ve got [00:10:20] young doctors, right? Who have always been beaten into submission. That’s what being a young medic is like. [00:10:25] You are the bottom of, of your sort of professional tree. And that’s what grows [00:10:30] you to be humble within your team. And hopefully most people remain that way. And I [00:10:35] just wonder, and this may be kind of a little cutting what I’m going to [00:10:40] say, but I just think people’s expectations about what they demand from their career [00:10:45] is changing. Yeah. People’s expectation about how much or how little they want to work [00:10:50] is changing. Yeah. So that eternal balance upon what we do is changing. And [00:10:55] so with that, when you then find yourself in a situation where actually the realisation is that these [00:11:00] poor junior doctors have had the experience that they’ve had, I feel for them, [00:11:05] I really do. I genuinely do because the NHS now is different from 20 or 30 years [00:11:10] ago. Yeah. Um, but there, there [00:11:15] is a way forward. So expect less from your life at that stage [00:11:20] to get to a better part. I know it’s not that simple, [00:11:25] but I think that, you know, there’s a way [00:11:30] through this. There’s a way through it for sure.

Payman Langroudi: For sure. Look, we still need doctors, right? Right. There’s no doubt about [00:11:35] that. My brother’s a senior consultant, though, And, um, so it’s not only the junior [00:11:40] experience that I’m talking about. And hey, by the way, that’s just my brother’s experience, right? I’ve [00:11:45] got lots of friends who are happy doctors, too. Yeah, but with your own kids, what [00:11:50] ends up happening is a lot of the. What? I find a lot of the nice talk about let them do what [00:11:55] they like comes out from a lot of us. Yeah. Then most [00:12:00] kids don’t have a passion like you had. Yeah.

Payman Langroudi / Andrew Chandrapal: You know, it’s funny. That’s. I [00:12:05] forced myself to love dentistry. Low pay, you know.

Payman Langroudi: But a passion for music is what I’m [00:12:10] saying. Yeah. Most kids, you say, hey, what do you want to do? And they’re like, I don’t know. Yeah. Most [00:12:15] kids. So then. So then they in a way, they’re looking to you for, for for advice. And and the advice [00:12:20] you end up giving, I end up giving, strangely, is very similar to my parents [00:12:25] advice. And I never thought that would be the case.

Payman Langroudi / Andrew Chandrapal: You turn into your parents.

Payman Langroudi: Yeah, yeah, yeah yeah, yeah. [00:12:30] So tell me about dental school. Straight. You decided [00:12:35] you wanted to be good. What was your first job?

Payman Langroudi / Andrew Chandrapal: So, [00:12:40] interestingly, I, um, I qualified. [00:12:45] I got, you know, pretty well, um, in my grades at [00:12:50] qualification from Birmingham. And I don’t know what happened. I must have done a really [00:12:55] poor CV or put my face on it or something ridiculous like that. I [00:13:00] didn’t get, um, any any immediate offers where it might. The [00:13:05] rest of my housemates were getting offers and and I was thinking to myself, what’s going [00:13:10] on? You know, have I put something wrong in my CV? Did my personal statement not read well? Um. Is my report [00:13:15] bad? Should I not put my face on the TV? Um. And I got this one offer. [00:13:20] I met this guy in West Brom, West Bromwich, which is about 20 [00:13:25] 20 minutes from central Birmingham. His name was Dai Gyngell and [00:13:30] he, uh, he’s a Welsh, um based GDP [00:13:35] trainer for a number of years. And he said to me, I don’t understand why [00:13:40] you haven’t had a job offer before. And I said, well, that’s really kind, but could I have a job, please? And [00:13:45] he goes, yeah, sure. And he probably influenced [00:13:50] me the most at that time and since.

Payman Langroudi / Andrew Chandrapal: And [00:13:55] he was the most humble, adorned [00:14:00] dentist I to this day have ever met by his team and his [00:14:05] patients. But he just sat in his hole and did what he did for years. [00:14:10] And he and his wife, his wife was the PM. Um, she’s no longer with us. Um, sadly. [00:14:15] And, um, he lived in the same house that he practised in. So he was never late for work. [00:14:20] Obviously, he just had to go from the landing from one side to the other side of the landing. But at the same time, [00:14:25] if there was someone that needed some help, um, they’d be knocking on the door all hours of night and [00:14:30] day, and he would see them. Yeah. And it wasn’t about the quality or the scale of his dentistry. [00:14:35] He wasn’t aiming to be something that he wasn’t. He’s just his mindset. His attitude [00:14:40] was, we are just dentists and we are here to help. We’ll be benevolent when we [00:14:45] can and we’ll do what we can. And it was just amazing.

Payman Langroudi: I [00:14:50] know exactly what you mean. That set up, that’s that was a very common setup. Living in the house with [00:14:55] your wife as the as the practice manager. A pillar of the community? Yeah, 100%. And and [00:15:00] within that being a pillar of the community, if someone was in pain after [00:15:05] hours, those dentists would see them.

Payman Langroudi / Andrew Chandrapal: You’d open up.

Payman Langroudi: You know, and and I [00:15:10] mean, it’s a funny thing, I think a lot about what does it mean to be a professional. [00:15:15] Right. There’s so many different aspects to that. Right? Yeah. Um, [00:15:20] I think one one important part of it is, and [00:15:25] dentistry really lends itself to this, right, is what is it you do when no one’s watching? [00:15:30] You know, um. And no one’s watching. Yeah. Even [00:15:35] your nurse can’t see what the hell you’re doing. Yeah, yeah. No one’s watching. Yeah. Um, [00:15:40] but then these things that you’re talking about here, being there for people, putting [00:15:45] other people in front of yourself, right. That’s in the end. That’s. That’s the important thing. Um, [00:15:50] we’re losing that a bit in in that way of [00:15:55] working, that pillar of community way of working, we’re losing a little bit. [00:16:00]

Payman Langroudi / Andrew Chandrapal: I’m glad you say that.

Payman Langroudi: Well, yeah, we are, we are. But but but you know, you said society is evolving [00:16:05] here and society is evolving. You know, that there was a time when the local policeman used [00:16:10] to slap the kid, and the father would thank him for it, [00:16:15] you know. You know, there was. Society is changing. Yeah. Um, but you know [00:16:20] where it changes. And don’t worry, one of my, one of my quickfire questions is going to be what [00:16:25] grinds your gears?

Payman Langroudi / Andrew Chandrapal: Yeah, yeah yeah yeah yeah yeah.

Payman Langroudi: F. All right, so, look, I think [00:16:30] the first boss is just a massive influence, a massive, massive influence. It just sets the trajectory [00:16:35] for where you’re going on this issue of ego. Why [00:16:40] do you think we see some super talented [00:16:45] dentists who don’t have it? Didier. Dc would come to mind [00:16:50] one of your degrees, right?

Payman Langroudi / Andrew Chandrapal: Agreed.

Payman Langroudi: And then some [00:16:55] dentists who just ruled by it. And I always find [00:17:00] that it’s almost like there’s acceptable cover in in. [00:17:05] I’m thinking about the patient’s best interest. So I’m going to destroy what you just said [00:17:10] on social media because I’m thinking about the patient’s best interests. You know, you [00:17:15] can you can cover yourself with that cover, and then you can be as vindictive as [00:17:20] you like. What are your thoughts?

Payman Langroudi / Andrew Chandrapal: I think dentistry, as [00:17:25] I’ve observed it over the years gives us all the opportunity [00:17:30] for self, Lord, adulation [00:17:35] and opinion.

Payman Langroudi: Opinion write strong opinion.

Payman Langroudi / Andrew Chandrapal: Well when you’re [00:17:40] when you’re when you’re when you’re congratulated many, many times by both your patients, [00:17:45] your your team, you. There is a temptation [00:17:50] within your practice to become bigger than actually what and who you are. Yeah. [00:17:55] Add social media into that. Adds maybe a presentation or two into that. [00:18:00] You become bigger in the region or nationally or internationally. And I think that [00:18:05] sometimes it’s very, very easy to lose sight of your place, your position [00:18:10] in this world. And, and I see that happening because dentistry is so [00:18:15] visual, it’s so creative. And the net effect on the patients [00:18:20] to which we serve has the potential to be life changing In [00:18:25] such a small part of the body. Where else does that happen? And I think where [00:18:30] where you get that adulation, particularly on social media, you become you become [00:18:35] maniacal sometimes. Or I see people that do so and [00:18:40] then they go around the full circle and that maniacal nature becomes more humble, um, [00:18:45] because they realise their position or actually they become humble, but they’re really in the background. They are egotistical. [00:18:50] Uh, but then you have, as you say, other members of the [00:18:55] community and within our profession who are just benevolent, [00:19:00] continually trusting and giving, [00:19:05] constantly will admit their fears, will admit their failures, and [00:19:10] just be there to up the game to raise [00:19:15] the bar.

Payman Langroudi / Andrew Chandrapal: Yeah. And I have tried to seek those out. [00:19:20] And in the journey you find the egotistical ones and you learn what you need to [00:19:25] for them from them, and then you disregard the rest. And [00:19:30] when you’re or if you’re fortunate enough to become a responsible person within your profession, [00:19:35] which I think if you become high profile, whatever that means, you have a responsibility, [00:19:40] then you must self-reflect an awful [00:19:45] lot. That’s one of your responsibilities to self-reflect and realise actually what it is you [00:19:50] are achieving and what effect you have upon the people around you and your community. To realise [00:19:55] that actually I am just but a dentist, I just might be [00:20:00] more intense than other people. I’m just might spend longer doing things in terms of getting better or [00:20:05] what have you, or looking at my results and self-critiquing myself. But [00:20:10] you are just a dentist.

Payman Langroudi: Is it a muscle? Humility.

Payman Langroudi / Andrew Chandrapal: I [00:20:15] think it’s becoming one that we need to flex a little more.

Payman Langroudi: But you can train [00:20:20] yourself to become because you you for me. You really are that guy, right? Like someone who knows [00:20:25] so much and yet so humble with it.

Payman Langroudi / Andrew Chandrapal: I, [00:20:30] I don’t like anybody who.

Payman Langroudi: It’s [00:20:35] weird being revered for being humble. It’s a weird. It’s a weird paradigm.

Payman Langroudi / Andrew Chandrapal: Well, [00:20:40] I’m not sure. I’m not sure that I would see myself [00:20:45] as humble. I mean, it’s it’s it’s cool that you say that.

Payman Langroudi: That’s your humility saying [00:20:50] that.

Payman Langroudi / Andrew Chandrapal: But, but but at the same way, I can see those who brag. Yeah. And [00:20:55] every time I see some form of brag going on and I see it on social [00:21:00] media such a lot, I, I detach. Further and further away. If [00:21:05] I look at some of the memories that come up on, on Facebook, I call it the University of Facebook. [00:21:10] We can go into that one later. Yeah. But if I look at that, the memories that [00:21:15] I used to comment on things a lot more back then. I mean, you remember. Yeah. And now [00:21:20] I detach a lot more. You know, it’s not because I resent social media. It’s just [00:21:25] that I take it for what it is and and detach from the parts I don’t want to be part of.

Payman Langroudi: I [00:21:30] think all of us have been like that. Right? We. Social media is evolving. [00:21:35] I mean, there was a time, wasn’t there, that there were massive, huge arguments [00:21:40] on social media that you didn’t see them so much anymore?

Payman Langroudi / Andrew Chandrapal: Not so.

Payman Langroudi: Maybe I’m not on Facebook anymore. Maybe that’s [00:21:45] the reason I’m not seeing them.

Payman Langroudi / Andrew Chandrapal: It’s awesome. You’re right. I don’t think there’s as much [00:21:50] going on. Yeah. But I think instead, I mean, if you look on sort of TikTok and my my nurse, [00:21:55] she’s all of 19. She’s she’s great. But she asked me to then set up a TikTok [00:22:00] account, or rather more. She did it for me. Yeah. And I went through [00:22:05] on the feeds and it will obviously attract towards the Dental kind of profession. And I see [00:22:10] you know what’s on there. I see the level of promotion going on or information. Some of them are great because I want [00:22:15] to provide information to their to their audiences, or hygiene and [00:22:20] health and promotion, that type of thing. But others are doing crazy ass dances in their [00:22:25] surgeries. Do you not agree with that? Just for shits and giggles, maybe I don’t. Do you not agree with that? Oh, [00:22:30] should you not be professional? Well, should you [00:22:35] not be professional or should you? I mean, I get it. I love the bit of having fun and keeping the [00:22:40] vibrancy for your profession. Get it? But at the same time, [00:22:45] professional standards are what builds the the profession [00:22:50] to be what it is. Uh, to a degree. And I think standards [00:22:55] need to be maintained. And I wonder whether the time spent on academia [00:23:00] or improving your skill or your art could be equally as committed [00:23:05] to as the time some people spend on social media because, as I understand it, it’s a big commitment when [00:23:10] you do social media properly, right? Yes. I mean, some people spend hours on it per week, right?

Payman Langroudi: For [00:23:15] some people it’s it’s their source of patience, right. You know.

Payman Langroudi / Andrew Chandrapal: That’s an interesting dynamic [00:23:20] too. That’s a real change from back in the day.

Payman Langroudi: Yeah. But look, I remember someone, [00:23:25] you know, an older lady dentist telling me once that, [00:23:30] you know, dentists shouldn’t be in bikinis on social media. Mhm. [00:23:35] And now it’s like par for the course.

Payman Langroudi / Andrew Chandrapal: Have [00:23:40] you seen me in one.

Payman Langroudi: I’m looking for.

Payman Langroudi / Andrew Chandrapal: I’m sorry.

Payman Langroudi: I’m looking forward to see. [00:23:45] So you know the evolution of that. I mean yeah the it’s a funny thing. It’s [00:23:50] a funny thing I don’t know man. I, I’m, I’m pretty addicted to TikTok myself. Yeah. [00:23:55] Yeah. I’m not seeing anyone dancing. Right. The algorithm figures out what you want, [00:24:00] right?

Payman Langroudi / Andrew Chandrapal: I don’t know.

Payman Langroudi: No, it does sometimes. So, like, I’ve been [00:24:05] watching some some dude getting his ears waxed for hours. It [00:24:10] was. It was some dude cleaning the horse horseshoe or something. Yeah yeah yeah yeah, [00:24:15] yeah, stuff like that seems to get you. Yeah. Um, but I don’t think it’s clear yet where [00:24:20] dentistry and TikTok, for instance, is. And Instagram, it’s become very clear [00:24:25] before and after is beautiful things. Yeah. Tiktoks. No [00:24:30] one’s really worked it out. No one’s really succeeded on it.

Payman Langroudi / Andrew Chandrapal: Were in this really new era, though, because of our [00:24:35] regulators and say what we will about them, but they’re just not used to this type [00:24:40] of, um, dynamic. And, and we’ve always had [00:24:45] blurred lines of what it is to be professional. We take an implied Hippocratic oath [00:24:50] in terms of what we do. We have more social responsibilities as healthcare professionals, [00:24:55] whether we like it or not, just like the police do, just like medics do. So that limits [00:25:00] us because of our profession. And I’m not sure you can resent that. It just is. [00:25:05] So when it just is, you kind of have to draw the line at a point. [00:25:10] But I don’t want to sound old and cranky about that. I want to be dynamic to it. [00:25:15] And so I understand the need that patients are attracted to what [00:25:20] they see and what they hear on social media, and that’s a mode of how dentists get [00:25:25] their patients. Sometimes I worry for younger dentists getting patients on that medium because are [00:25:30] they limiting themselves to a personality? Typing that, for example, isn’t in [00:25:35] anybody’s best interests, but it seems to work. What does that [00:25:40] mean? Well, the whole aspect of attracting [00:25:45] patients via social media can work really successfully for many [00:25:50] individuals, and I applaud that. And I think that in this dynamic era, it [00:25:55] needs to be done for many, and it should be done for many. Um, but on [00:26:00] the very, very few patients that that I have had, [00:26:05] and when I talk to friends and colleagues about this, the type [00:26:10] of patient that you sometimes get through on social media or via social media, sometimes [00:26:15] don’t have the, um, the values. I’m being really [00:26:20] generalistic here, but, uh, the, the values that maybe your [00:26:25] general patient might. So let me give you an example. Yeah. [00:26:30] Instant gratification. They want an instant result and they want it to last for the summer. Right. [00:26:35] So if you then provide that service for it to last [00:26:40] the summer and your your mantra for that is because the patient wanted it, does [00:26:45] it mean we should provide it? I don’t know.

Payman Langroudi: Well, we come down to sort of informed [00:26:50] consent and all that. Right. Um, right. But I hear you, I [00:26:55] definitely hear the fact that patient comes in saying, I want composite bonding. Yeah, maybe [00:27:00] composite bonding is not the right treatment, right? Yeah. Um, but social media [00:27:05] has a way of sort of getting people into a particular [00:27:10] treatment, and that in itself is unhealthy. You know, people come in saying, I want [00:27:15] something just because they saw it on social media. Right. Um, but but then I guess that’s, [00:27:20] you know, that’s part of our job, right? Communication has always been part of our job to to make them understand. But the question [00:27:25] of, you know, would the daughter test sort of that you’re alluding to? I [00:27:30] guess it’s your daughter’s choice. It’s not your choice. It’s your daughter’s choice. [00:27:35] What she wants to do. Yeah. Yeah. And although, you know, informed consent isn’t [00:27:40] so black and white as as I’m portraying it, but informed consent [00:27:45] is informed.

Payman Langroudi / Andrew Chandrapal: Yeah.

Payman Langroudi: Yeah. So if this adult [00:27:50] is informed, it’s not our job to say yes or no. [00:27:55] It is our job to say, I’m not going to do this for whatever reason. [00:28:00] Yeah. I’m not comfortable with this. Yeah. But that sort of agency of the [00:28:05] patient is important. Yeah. So as [00:28:10] an example, would I drill a 19 year old’s teeth for veneers [00:28:15] today? Probably not. Yeah, but if the 19 year [00:28:20] old was some model who thought that that was the right thing for her career and understood [00:28:25] because I informed her of the risks, then [00:28:30] it’s not my decision. It’s her decision. Right. Otherwise, I didn’t inform her [00:28:35] properly. Right. And that’s the key. That’s the key, right?

Payman Langroudi / Andrew Chandrapal: That is the key.

Payman Langroudi: And you’re right. There’s [00:28:40] financial incentive not to fully inform. Yeah. And that now we’re getting into what [00:28:45] is it to be a professional?

Payman Langroudi / Andrew Chandrapal: Yeah. And it goes full circle, doesn’t it? Because we’re also dealing with cultural values. [00:28:50] If I look to my friends in the Middle East, if I look to my friends in South America, there’s [00:28:55] a much more there’s a far greater sort of trend towards indirect dentistry. Yeah. Irrespective [00:29:00] of the age to some degree. And if I, if, if we look at Europe [00:29:05] and if we look at here, perhaps we are sort of evolving to a minimally [00:29:10] invasive sort of, um, level of dentistry that is probably [00:29:15] greater than it should or needs to be, because minimally invasive doesn’t mean no prep. We know this, [00:29:20] right? Minimally invasive means that you do what you need to do and no more to get the desired [00:29:25] result. So if you need to prep, you prep. But at the same time, um, [00:29:30] I think that sometimes the additive, um, element of what we [00:29:35] are doing in conservative dentistry is probably used and abused, which is influenced [00:29:40] by some of the trends that are followed. So this becomes then a service that’s provided because [00:29:45] it is a trend and because you get healthily remunerated, dare I say it becomes a trend [00:29:50] even more. And we go back then to the ego. Yeah. So then to then post [00:29:55] or illustrate cases where we don’t really consider the, [00:30:00] the, the, the, the results of what will happen and what it will look like in years to come. [00:30:05] Are we doing that patient a disservice? Is that patient fully informed from the word go? [00:30:10]

Payman Langroudi: By the way, is the dentist fully informed?

Payman Langroudi / Andrew Chandrapal: Is the dentist fully informed?

Payman Langroudi: That’s maybe the.

Payman Langroudi / Andrew Chandrapal: Key, right. As [00:30:15] a as a result of that, where is this consent element. Yeah. You know, where is the professionalism. [00:30:20] And that worries me because I see beautiful work being done by a number of our colleagues [00:30:25] worldwide. And I’m talking about additive dentistry. I also see an absolute shit [00:30:30] tip of work that’s taking place as well. And I a little bit of me just gets firstly upset, [00:30:35] um, and concerned for that individual because I work with some of the defence companies [00:30:40] as well. And I see what happens. And then part of me gets a bit [00:30:45] bit cross bit what bit cross cross.

Payman Langroudi: Yeah.

Payman Langroudi / Andrew Chandrapal: And [00:30:50] I think we can do better guys. Yeah. We can do better. Let’s do better because [00:30:55] we, we are part of the influence as well.

Payman Langroudi: Well sure man. Look, if incorrect work [00:31:00] is being done or incorrect consent is is all of that’s true? All [00:31:05] of that is true. There’s no there’s no doubt about that. And we all see crappy dentistry breath left, [00:31:10] right and centre.

Payman Langroudi / Andrew Chandrapal: We see me. We see mediocrity. That’s functionally correct. [00:31:15] And that’s what I learned at an early point. And that’s what has built a [00:31:20] lot of functional dentistry in the UK and abroad for many, many years. And for the majority [00:31:25] of the population, it serves them perfectly fine.

Payman Langroudi: But then looping back to the social [00:31:30] media thing, um, you’re absolutely right in that it’s easy. [00:31:35] Social media is kind of like a like an echo chamber, right? Yeah. So [00:31:40] it’s easy to flick through your Instagram and think [00:31:45] that the majority of dentistry that’s happening is what’s happening on [00:31:50] your screen, right, because of that echo chamber. In the same way as if I’m a BNP [00:31:55] guy, I keep getting fed the same stuff now, I think. Oh, there’s [00:32:00] loads of us right here thinking that. And, you [00:32:05] know, this notion of the amount of dentistry that’s happening [00:32:10] in the country. 95% of it. Isn’t this right? Maybe 5% [00:32:15] of it is that. But who’s warning who on that subject? [00:32:20] Yeah, I think me and you are in trouble understanding this [00:32:25] much more than the younger generation. I mean, they’re native, and they know. [00:32:30] They know the guy sitting on this private jet does not own a private jet. Yeah. [00:32:35] Me and you are like, wow.

Payman Langroudi / Andrew Chandrapal: Maybe, [00:32:40] maybe. And you’re right about, you know, because social media brings [00:32:45] you in it. It makes your world smaller. Yeah. And it surrounds, um, you. [00:32:50] It’s surrounded by you. So it makes you feel special because social media [00:32:55] designed. You know it to surround you and you become the centre of that [00:33:00] universe. That’s why all of a sudden you become bigger than you think you are. Yeah, a lot of the time. [00:33:05] Um, but at the same time, uh, [00:33:10] like you rightly say, um, it’s really important to be able to then see through what we see. [00:33:15] So I can now at the point where I can say what type of lighting, what type of photography, what type [00:33:20] of bounces are being used. Yeah. To then hide the things that we clearly see [00:33:25] that actually are there, you know, both in direct and indirect. And because it’s so visual, a lot [00:33:30] of the time it’s aesthetic based work, you know, and, and and that’s before [00:33:35] any form of modulation or modification has come into play. So when you can start [00:33:40] to see through that, you start to just think it’s a real bit of a shame, because what you’re not emulating [00:33:45] is the is the reality of the situation for the patient rather than the [00:33:50] the trying to concentrate on the applaud of the end result that [00:33:55] you want to perceive you’ve achieved. Yeah, there’s a big difference between the two.

Payman Langroudi: Yeah, but what is it? What [00:34:00] is social media? Yeah. In the end, yeah. It’s I mean, [00:34:05] I’d say a marketing tool when it’s being used in dentistry. [00:34:10] Now you post. Right. Yeah.

Payman Langroudi / Andrew Chandrapal: Every [00:34:15] now and again.

Payman Langroudi: Not a lot. Yeah. You don’t post a lot. Um, neither do I when.

Payman Langroudi / Andrew Chandrapal: I know how to. [00:34:20] Neither do I. Look at the instruction manual. Neither do I.

Payman Langroudi: But. But your market, if [00:34:25] you like inverted commas. Here is dentists. Right. So it’s super important. Like someone like [00:34:30] you must not use the right, the wrong balances and and the wrong lighting [00:34:35] and all of that. Someone like you needs to do things exactly correctly, as [00:34:40] per what a dentist needs to see in that photo. But the majority [00:34:45] of people are on there trying to attract patients, right? And listen, I totally get it. [00:34:50] There’s no point seeing a before and after without seeing the prep, right? But patients don’t want to see [00:34:55] the prep. Know they have to bear that in mind.

Payman Langroudi / Andrew Chandrapal: 100%. And and you know, [00:35:00] there’s a term that’s been coined, I suppose, over the last ten years, like this whole emotional dentistry thing. [00:35:05] Yeah. And, you know, where you have sort of beautiful videography and production. Yeah. Haunting music [00:35:10] and all the rest of it come into play. And I think the production and the work taken to do some of the stuff that some [00:35:15] people are doing is phenomenal. It really is. I mean, I’m like, I’m sitting there with my iPhone going, [00:35:20] oh my God, it’s the wrong way up, you know? So I feel completely primitive in that world. And [00:35:25] I absolutely applaud the efforts that some are going to to produce that. You just [00:35:30] want to make sure that the quality of what’s coming out, when it comes down to ground level. Yeah. Is [00:35:35] just, um, is safe, predictable and has a longevity to it that we would expect [00:35:40] for our kids or for our partners.

Payman Langroudi: Let’s get on to some clinical stuff. [00:35:45] Um, I asked this question. I know it’s bloody unfair question. [00:35:50] Yeah, yeah. But I love it. And you [00:35:55] do a lot of full mouth stuff. Yeah. And you know, you teach [00:36:00] a lot of single tooth stuff as well, right? You do both. You cross both. Give [00:36:05] me. Is this a ha moment I’m interested in an aha [00:36:10] moment for you around occlusion. The biggest subject in [00:36:15] the world. Yeah. Okay. Yeah, yeah. But what comes to mind? I don’t know, doesn’t need to be the crux [00:36:20] of it, but what for you. I mean, you did the whole voice continuum. [00:36:25] Where was it in that in that continuum that something grabbed [00:36:30] you and thought, oh, I get that more now.

Payman Langroudi / Andrew Chandrapal: Yeah. So I think [00:36:35] when I started, um, Voices Continuum, it was about [00:36:40] 2007, 2008, something like that. And I had questions over [00:36:45] the huge amounts of confusion that was given [00:36:50] to me by the courses and the continuums I had attended as a as a young graduate. To that point, [00:36:55] I was only out of out of school for for 6 or 7 years. Um, but I had done enough [00:37:00] to realise I wasn’t getting the binary answers that are needed with the results that I was getting. And, [00:37:05] um, the the beauty, of course, [00:37:10] continuum was the fact that everything was manifested in a checklist type methodology. [00:37:15] And I love that. I think as dentists, we love that, right? We like recipes. And, [00:37:20] uh, Ronaldo Hirata does a similar type of thing. Yeah. And [00:37:25] when I got this kind of checklist, this cookbook of recipes, [00:37:30] it was all based around valid science, where John had then gone [00:37:35] through scientific papers from the last 50 years, sieved out the tripe [00:37:40] and kept the the good stuff, and built this continuum around that. Not [00:37:45] to improve your hands, but to improve your thinking, to make yourself more methodical, [00:37:50] and to then categorise things where possible to give [00:37:55] you the answers about the outcome and thus the predictability of what it is you’re doing.

Payman Langroudi / Andrew Chandrapal: And [00:38:00] that has really structured. That was a game changer for me. Um, and [00:38:05] that really structured my restorative pathway from single tooth dentistry to, to multiple [00:38:10] tooth dentistry. And I think that has really changed things and remains to, to this [00:38:15] day. And it’s amazing that when you learn implant dentistry, [00:38:20] for example, your oral orthodontics, you are taught from the word go from the get go to have [00:38:25] the treatment plan to have to walk skeletal base there. In what incisal [00:38:30] relationship are they in and all the rest of it? What’s the bone type like? Type one, type four, blah blah blah. But [00:38:35] when it comes down to the replacement of an incisor or composite, when it comes down to the replacement [00:38:40] of a class two um amalgam restoration on [00:38:45] a lower six. You’re never taught to treatment plan. Why it failed, what you’d do [00:38:50] differently and how long you’d expect that to then last. And then if you then multiply [00:38:55] that by a number by quadrant, or then by an arch or by two arches, what [00:39:00] the net effect of that is the effect of reducing ovd upon, um, [00:39:05] anterior guidance, the effect of a constricted envelope of function, which still to this day [00:39:10] isn’t really it’s misunderstood. It’s misunderstood, and it’s not represented enough in this [00:39:15] country.

Payman Langroudi: Yeah, not in undergrad at all. Right? No. And it’s a simple concept. In the end. It’s simple. [00:39:20] In the end, it’s a simple concept.

Payman Langroudi / Andrew Chandrapal: Concept?

Payman Langroudi: Yeah, it did a bit for that.

Payman Langroudi / Andrew Chandrapal: Tiff [00:39:25] has really helped that I think in his in his own way. He’s sort of, um, [00:39:30] you know, uh, aided the, the concept to be [00:39:35] more exposed as it needed to be in this country. And, and, but John [00:39:40] has been talking about this since the early 80s, as has have as have [00:39:45] many others. Um. It’s just that I felt that John’s approach, [00:39:50] again, his humility has is something that’s really attracted me about him [00:39:55] to, um, to his the way he delivers the message and the way that I absorb it. [00:40:00] Yeah.

Payman Langroudi: Tell me about Chris. Yeah. Not not John, but [00:40:05] Chris. Yeah.

Payman Langroudi / Andrew Chandrapal: So the course continuum is is, um, Seattle is [00:40:10] based in Seattle, where John has been located for decades. He started [00:40:15] a really, really small, intimate study club with his buddies, um, sort of back in the 70s. [00:40:20] Um, and it or it could even be the early 80s. Um, and [00:40:25] this grew, um, to kind of a more regional thing. And then he [00:40:30] took a leap of faith and began a centre in the early 90s that nearly ruined him because [00:40:35] he put a lot of money and time and resource into it. Um, and he’s grown it into this [00:40:40] sort of, um. Comfortably kind of large sort [00:40:45] of study, um, arena where he has his own office there. He conducts [00:40:50] the majority of the teaching still to this day, over nine modules, has people [00:40:55] from around the world come along. And he split it up into restorative modules of occlusion treatment [00:41:00] planning, um, periodontal interface biomechanics and implants and things, and [00:41:05] basically updates it every single year with all of the literature, literature that comes [00:41:10] through. And he himself pushes himself, um, as is now entered into the digital arena [00:41:15] and has probably one one of the most prolific, um, individuals, research [00:41:20] fellows who is who is with him producing some amazing research in [00:41:25] the quality of digital. Um, and he’s just a continual innovator. [00:41:30] So he’s a really inspiring character. Um, and [00:41:35] still to this day is going strong. Um, what is a module?

Payman Langroudi: How many days does [00:41:40] a module?

Payman Langroudi / Andrew Chandrapal: Typically it’s about three days. But what he did is that for international [00:41:45] people who obviously have to fly in, he’s then sort of done a track course where you do two [00:41:50] of the modules longer hours for five days. So you’re there by half, six in the morning [00:41:55] and you’re not leaving till about seven, half seven in the evening, which is kind of what I’ve tried to base my [00:42:00] courses on. Sometimes it works, sometimes it doesn’t. Yeah.

Payman Langroudi: Depeche likes that [00:42:05] to get people running off to the toilet twice, three times during lecture. [00:42:10] Well, the culture.

Payman Langroudi / Andrew Chandrapal: Of learning, and also an interesting thing because as [00:42:15] I went over to the States and started doing that, I mean, my first exposure was with Pascal [00:42:20] Meunier in 2005. I went over to Foster City to Ideo, [00:42:25] and I met him and Michel at that point, and I hadn’t you know, that was the last time I effectively [00:42:30] prepped for a crown in over a decade, you know, and and that style [00:42:35] of learning, that intensity of learning stuck with me. Yeah. And culturally, [00:42:40] we’re not used to it here even now.

Payman Langroudi: What is it about manure [00:42:45] or cows or spear that you know, so many people say [00:42:50] it changed the way I practice. Is it the content or is it the delivery, [00:42:55] or is it both?

Payman Langroudi / Andrew Chandrapal: I think you see the content. You see the passion [00:43:00] more than anything. You see the consistency. I mean, I have my own views about [00:43:05] many of the educators that have inspired me. Pascal has to a point. [00:43:10] Pascal is different now to how Pascal used to be, but John is [00:43:15] consistent and I love consistency. I think that that stands [00:43:20] for a lot. I think you can base your legacy on being consistent. Um, and be [00:43:25] that good or bad, I might add. And um, when, um, [00:43:30] you look at these people over the years, they have been researchers, [00:43:35] they have been clinicians, they have been educators, and all of that’s [00:43:40] difficult. I mean, now that I’ve lived some level of that in [00:43:45] my own boots now for the last 15 years, I understand how tough that is.

Payman Langroudi: Yeah.

Payman Langroudi / Andrew Chandrapal: Um, and [00:43:50] so I applaud these individuals.

Payman Langroudi: So, you know, there’s an element of [00:43:55] simplifying the complicated, but my personal bugbear [00:44:00] is the opposite, right? Someone’s trying to complicate the simple. Right. And [00:44:05] almost it’s like to fill a lecture up or something to pad it out or something. Yeah. [00:44:10] Yeah. That that’s my personal bugbear. I mean, it’s one of the reasons I really like Chris Hall. Yeah. [00:44:15] He just tends to simplify things. Yeah. And, but but then, you know, it’s simplifying [00:44:20] isn’t simplicity. Like, it shouldn’t be simplistic. Right. [00:44:25] Simplistic. There’s a there’s a, there’s almost like a breadth and depth discussion. [00:44:30] Right. That you need to cover the breadth and then at the right point do the depth bit. [00:44:35] Um, but you’re right, I mean, Pascal, I [00:44:40] got the same feeling from him. Just the passion, you know, but.

Payman Langroudi / Andrew Chandrapal: Also that’s [00:44:45] where education then has its commerciality, and that’s where education starts to be, starts [00:44:50] to get a little bit soured, I feel anyway, you know, because actually to catch [00:44:55] an edge, if you are an aspiring educator, um, um, or [00:45:00] an established educator aiming to keep relevance in the market, [00:45:05] sometimes I see that people start overcomplicating what [00:45:10] never needed to be complicated. And as a result of that, they become inspirational [00:45:15] in that overcomplicated thing, and it starts [00:45:20] to trend and all of a sudden, oh, I’ve got to know a bit about that. And then all of a sudden they raise a court, they [00:45:25] start a course, all of a sudden they have a load of feedback, and then all of a sudden that feedback turns [00:45:30] viral. All of a sudden it becomes a thing. How is it a thing? It never needed to be a thing. What [00:45:35] was working before worked perfectly fine. Don’t make it a thing.

Payman Langroudi: We’re [00:45:40] going to get to the. What grinds the gears. Yeah. Do [00:45:45] you want to give an example of that or.

Payman Langroudi / Andrew Chandrapal: No. Um.

Payman Langroudi: No.

Payman Langroudi / Andrew Chandrapal: We [00:45:50] could do. I mean, look, I think I think the people that are at the forefront [00:45:55] of our research and our education, um, have a responsibility [00:46:00] to find simplification where it’s appropriate and to [00:46:05] define complicated or complex procedures where they are appropriate. But [00:46:10] to simplify something, um, you have to then be bringing [00:46:15] a solution to the people’s problems, to find [00:46:20] a solution to the people’s problems, the problems have to be generalised and big enough in the [00:46:25] first place. So when you’re doing a class two restoration or an Mod [00:46:30] restoration. If you are not looking at how you isolate, how you selectively [00:46:35] etch when you’re using a self adhesive, how you then incrementally layer how you look at morphology [00:46:40] as a point of occlusal contacts and stressing of the um, of the buccal, lingual and [00:46:45] axial walls. If you’re not looking at all of that, but instead putting a bit of fibre in the base of the cavity, [00:46:50] I have a problem with that. Yeah, I get it. I [00:46:55] get it. So I think more overly let’s stick to the basics [00:47:00] and concentrate on those, because generation after generation, I’m fortunate enough to now be [00:47:05] teaching two generations of clinicians. The problems are the same.

Payman Langroudi: Yeah. You know, [00:47:10] the older I get, the more I realise expertise is just doing the basics [00:47:15] very well.

Payman Langroudi / Andrew Chandrapal: Right? It’s no more complex than that. And that will work for 80%, [00:47:20] if not 90% of your results.

Payman Langroudi: Yeah. Agreed? Agreed. On [00:47:25] this pod, we like to talk about mistakes. Yeah. Um, [00:47:30] I. You can look at it how you like. I’d like to buck [00:47:35] the trend of sort of, you know, the, you know, that black box thinking idea, um, [00:47:40] where we can learn from each other’s mistakes. Right. What comes to mind when [00:47:45] I say clinical errors? What clinical errors have you made that you think someone else [00:47:50] can learn from?

Payman Langroudi / Andrew Chandrapal: I make clinical errors all the [00:47:55] time, and and I think I want to be [00:48:00] my own worst critic on that, and I am I [00:48:05] don’t want I am my own. Um, my biggest critique, uh, if I look [00:48:10] at some of the common errors that I make, I [00:48:15] would say. If I look at [00:48:20] something like digital scanning, um, I, I’ve gone full [00:48:25] circle with digital scanning and realise what it can do very well and realise what it [00:48:30] currently cannot do very well. So for minimal prep stuff, let’s say like [00:48:35] a rooftop on lay prep that doesn’t um, um, cross [00:48:40] the contacts, I realised that taking a good, sharp impression is [00:48:45] often more accurate and more useful to the lab than a digital impression. Um, [00:48:50] and that may be sending people wild when I say that. And equally minimal prep veneers, [00:48:55] um, where you don’t cross the contacts, particularly in lower interiors, that [00:49:00] for me is served better with a really crisp, accurate impression, uh, [00:49:05] than a digital scan. Um, and again, I see results that are wonderful [00:49:10] using both techniques in my hands. I’ve learned that by making mistakes and [00:49:15] having things that don’t fit quite as well. Yeah. Um, you know, a lower right one that could probably fit [00:49:20] on lower left one if it really wanted to, you know, and that type of thing.

Payman Langroudi / Andrew Chandrapal: So that’s one of the big things. [00:49:25] And as far as direct restorations is concerned, where I will happily have all my hand [00:49:30] up and say I make errors all the time. I think it is errors of, [00:49:35] um, how I layer material down, how I see porosities, [00:49:40] how I deal with voids. Um, and actually, it’s not how I deal with voids, [00:49:45] it’s how I get past not creating them in the first place. [00:49:50] And a lot of that is just I sometimes don’t [00:49:55] pay attention to how I’m putting the material down, how the material needs to be treated, the pressure [00:50:00] that I put down. Um, and, and as a result, I create [00:50:05] problems for myself when I’m doing my finishing and polishing. So I make that [00:50:10] error a lot. Um, and then I suppose the last one [00:50:15] is then forgetting about when I’m doing sort of something that’s occlusal based, [00:50:20] forgetting the fact that, you know, you set someone up in centric relation if that’s what’s required, [00:50:25] and then you let them go on that and but then you forget that there’s emotional elements [00:50:30] that cause the occlusal issues as well.

Payman Langroudi / Andrew Chandrapal: And those are the non-quantifiable [00:50:35] values when you’re doing full mouth dentistry, the psychological, the [00:50:40] psycho psychosomatic elements of that to which sometimes you have to then [00:50:45] build in insurance policies. What do I mean by that? I mean technicalities like not making [00:50:50] indirect restorations massively morphologically. Correct. I [00:50:55] see beautiful morphologically primary, secondary, tertiary anatomy on posterior teeth a lot of the time [00:51:00] by these amazing technicians. But for locking people into a set pattern, a [00:51:05] lot of the time life isn’t like that. So again, I’ve learned that from John, making sort [00:51:10] of inclinations that are more forgiving to allow patients to glide a little bit [00:51:15] more, to not lock them in posterior anteriorly so that, you know, things like guards, for example, [00:51:20] aren’t staple, um, uh, diets that patients [00:51:25] have to commit to for the rest of their days after being rehabilitated. Would you? I’m not sure I would. [00:51:30] So I think that you have to you have to reconsider [00:51:35] all of the elements of what makes a patient, um, come to you [00:51:40] for occlusal or tooth wear problems. Um, is more than just the mechanics of [00:51:45] what we’re trying to look at. Um, so I have been guilty of making that mistake on many occasions. [00:51:50]

Payman Langroudi: And 18 years in the same practice, [00:51:55] nearly 20, 20 years in the same practice. You must have seen a lot of your [00:52:00] own work fail, right?

Payman Langroudi / Andrew Chandrapal: Absolutely.

Payman Langroudi: Is that the kind of thing that you’ve [00:52:05] these these examples that you’re giving? Is that is that where it’s come from, seeing your own work?

Payman Langroudi / Andrew Chandrapal: 100%. [00:52:10] I mean, I think, um, I’m massively fortunate. Uh, [00:52:15] very lucky to have been in the same practice for nearly 20 years. [00:52:20] It’s the.

Payman Langroudi: Best education.

Payman Langroudi / Andrew Chandrapal: Yeah, 100% the best education. Hands down. Because [00:52:25] you totally see the results. Um, not only clinically, but also emotionally in [00:52:30] your patients. And and if anything ever humbles you in terms [00:52:35] of the work that we are enabled to carry out by the people [00:52:40] that we stand on the shoulders of it, is that 100%? Yeah. [00:52:45] And and also in the same time, seeing how things don’t work, reflecting [00:52:50] on that, giving yourself a little whip on the on the back, not a pat a whip and saying, I need [00:52:55] to do this better. And then actually the ability to be transparent to your patient and say, you [00:53:00] know, Mrs. Smith, this didn’t go so well. I’m going to do this again for you. When [00:53:05] can you do it? Yeah. When can you make the appointment? Because I’ll fix it.

Payman Langroudi: I [00:53:10] think look, we’re in the we’re in the trust business more than any other business. Yeah. Mhm. We [00:53:15] are. And When a patient trusts you. If something goes wrong, [00:53:20] you can be upfront and fully transparent because you know you’ve [00:53:25] got that trust. And it’s a it’s a funny business in that sense, right? Because [00:53:30] the patient knows nothing about what’s really going on. There’s dentists [00:53:35] who treat patients like that. I worked in a place [00:53:40] that the principal was the most charming, one of the most charming people I’ve ever [00:53:45] come across. Like charming guy, man. But his work was behind. It was, [00:53:50] you know, he was stuck in the 60s or whatever it was. His patients [00:53:55] had no idea. His patients adored him. Adored him. And then sometimes you [00:54:00] get the opposite, which is that that’s a really heartbreaking.

Payman Langroudi / Andrew Chandrapal: Someone who’s technically excellently.

Payman Langroudi: Brilliant, [00:54:05] almost on the on the spectrum.

Payman Langroudi / Andrew Chandrapal: But has the social skills of a dead [00:54:10] end. Yeah, yeah.

Payman Langroudi: Yeah, yeah. And, you know, and how much of dentistry is the technical brilliance and how much [00:54:15] is I mean, one of my family members had a massive operation [00:54:20] and we picked the surgeon based on his, like, what a nice guy he was. [00:54:25] Yeah. And and you know, we know all about I mean, we knew what was [00:54:30] what, you know, who was who and so on. But the nice guy was a six [00:54:35] hour operation. Right. You imagine you want to look at the technical part of it? [00:54:40] Yeah. Um, so it’s a really interesting point. [00:54:45] Right. How much of the speed of trust [00:54:50] with patients? Yeah. Like when you’ve been somewhere for 20 years. Hopefully you’ve [00:54:55] done the right thing for long enough that people trust you. Yeah.

Payman Langroudi / Andrew Chandrapal: I see two patients [00:55:00] a month. It’s fine.

Payman Langroudi: Yeah. But some some people, when I say speed of trust, some people just [00:55:05] have a way about them that people trust them immediately. Um, [00:55:10] I see your alarm signs going off again. And some people don’t, you know. [00:55:15]

Payman Langroudi / Andrew Chandrapal: Well, I think I think again, we go full circle because this is the worry I have, particularly for younger dentists [00:55:20] and social media attraction, because with a lot of these patients, they [00:55:25] will self refer themselves because of what they see or hear. And as a result, they are [00:55:30] requesting, demanding um, a particular service or technique. [00:55:35] So a lot of the time the recall, the, the longevity [00:55:40] of establishing or the genuine nature of establishing that professional rapport [00:55:45] with that patient. So trust is then established is then very, [00:55:50] very challenging. Yeah. And it creates a hot lead that can sometimes not be [00:55:55] as genuine as a patient. That’s been recommended by a friend or a family member [00:56:00] or established over years of let’s do this now. Mrs. Smith, I think this is the [00:56:05] time where we should then do these few crowns for you, for example. Sure. Um, and I worry for that. [00:56:10] But what I do see, however, is these individuals create an environment [00:56:15] within their practice that looks second to none. You know, they have, um, they [00:56:20] have marketing designs, they have design, they have team members that are, um, you [00:56:25] know, sort of all saying and doing the same thing. A reception team that is second to none. Um, a [00:56:30] TCO that that is phenomenal. And I think this is how we have [00:56:35] really started to revolt, because actually the team approach, the team [00:56:40] creates the legacy and that rapport.

Payman Langroudi / Andrew Chandrapal: So the dentist is doing the carpentry [00:56:45] is one part of that. Yeah. And I think that’s really changed because go back back [00:56:50] in the day, the dentist was a really focal element, um, of that [00:56:55] um, of that practice. But now the team are much, much bigger within that. And I think that’s the [00:57:00] right thing to do. That’s the right way to be. So I think the dynamic has changed. [00:57:05] Um, but I, I still think that we need we are in the game of trust, [00:57:10] in the business of trust. And I think when you have that, you are able to then [00:57:15] sort of be transparent with your patients, be transparent with the treatment that’s that’s [00:57:20] being proposed, the risks inherent within that, the talking about [00:57:25] money, which is a stickler for many of us. And then also talking about patient responsibilities, [00:57:30] what they have to do to keep to keep things going. Because a lot of the time we don’t like [00:57:35] talking about that either. Yeah, yeah. And then how we deal and how we talk about failure, how [00:57:40] we how we can then sort of build the patient’s expectations [00:57:45] so that if there is a bump in the road, the reaction to that isn’t reactive. [00:57:50] Yeah. It is instead pragmatic.

Payman Langroudi: How do you see a big difference [00:57:55] between your patients in Bourne End and your patients at Dashwood and Tanner? [00:58:00]

Payman Langroudi / Andrew Chandrapal: Um, because.

Payman Langroudi: That that dynamic must be there, right? I mean, you’re meeting those [00:58:05] central London specialist patients almost bought for the first time [00:58:10] before you treat them.

Payman Langroudi / Andrew Chandrapal: Yeah. Um. Yes and no. I mean, because in Bourne [00:58:15] End these days, I’m fortunate enough to just see referral patients anyway. Oh, really? So they are tending [00:58:20] to be hot leads that that that know that they require something that’s another clinician [00:58:25] has recommended I treat. Yeah. Yeah. So in in Darwin Tanner it’s a similar type of [00:58:30] affair. However having said and done all that the the general patient [00:58:35] at Darwin Tanner is of a slightly different ilk. Um, but on the basis of geographical [00:58:40] location, reputation and legacy and what have you. So, um, but having [00:58:45] said and done all that, be it celebrity, be it anyone else or person of notoriety, let’s call [00:58:50] it that. They’re all treated exactly the same. And I’ve, I’ve sort [00:58:55] of developed over the years just to not be starstruck by anyone or anything. [00:59:00] Um, and to just have a very level head about who you’re treating, because at the end of the day, their teeth are the same [00:59:05] as the next person. And and I actually think sometimes there’s [00:59:10] a little bit of a binary response to that. So certain patients will expect to be treated [00:59:15] a certain way that is dictated by themselves, whereas I’m trying to then get [00:59:20] them around to be dictated by the mechanism of their dentition or their aesthetic needs. [00:59:25] And so a dentist can easily fall prey to the sway, if that makes [00:59:30] sense. Yeah. Um, whereas I try and build them around. And actually many patients, [00:59:35] particularly the alphas, respond really well to that, because if you say, what do you do?

Payman Langroudi: How [00:59:40] do you give me an example? You get some some high, high powered businessman who [00:59:45] comes in telling you what he wants done. Yeah. How do you handle him?

Payman Langroudi / Andrew Chandrapal: So [00:59:50] the power of communication, the power of spending time with that individual, the power of body language [00:59:55] and non-verbal communication, and the power of actually speaking to someone at their [01:00:00] same level, looking into their eyes when you speak. And then the power of also showing [01:00:05] some of the illustrations of cases that you’ve treated before and how this didn’t work out, but how this did work [01:00:10] out. You know, I find I have a fairly good level of conversion [01:00:15] with patients who are offered, um, with that. Not [01:00:20] everybody, but most. And and I used to be really [01:00:25] affected by those who didn’t take up the treatment that I was recommended, because this is how I [01:00:30] was taught to be predictable to, to to to be mechanistic in my, in my methodology. But [01:00:35] actually now I’ve seen it in a way that, okay, if you didn’t value the [01:00:40] things that I was saying or the way I was saying it, that’s okay. I will certainly reflect on [01:00:45] how I could have done that better. But on the other side of the coin, maybe I just [01:00:50] wasn’t the approach that you needed at that time. Yeah. And that’s okay.

Payman Langroudi: You don’t need to be everything [01:00:55] to everyone. Absolutely not.

Payman Langroudi / Andrew Chandrapal: You can’t. Yeah. You can’t be. Yeah. And and particularly [01:01:00] when you’re, uh, doing performing a type or a standard [01:01:05] of dentistry? Um, that is inherently higher in risk, let’s put it that way. [01:01:10] You need to be a little more binary. You need to be able to then say, no, [01:01:15] this isn’t going to work if we do it this way. And I don’t want that for you. And I actually [01:01:20] don’t want that for me either. That’s okay to say.

Payman Langroudi: Have you had to replace [01:01:25] failed full mouth rehabilitations a [01:01:30] lot? Yeah. Is that the most challenging thing you do?

Payman Langroudi / Andrew Chandrapal: It is. It is because [01:01:35] and I’ve had to do it from very, very eminent people that I respect hugely. Not because [01:01:40] things have gone wrong. It’s just time has fatigued the situation. I [01:01:45] might add that um, but um, but yeah. And they are difficult. I mean, in some [01:01:50] respects patients know what they have gone through in the past, or they have forgotten what they went through to get [01:01:55] to that point. Yeah. But also the level of restorative, um, breakdown of some [01:02:00] of those teeth is.

Payman Langroudi: Yeah. Once you get under there, it’s very complex.

Payman Langroudi / Andrew Chandrapal: And so you have an additional [01:02:05] layer of having to put that patient into provisionals, which are lab based and all sorts. And that pushes up costs, [01:02:10] that pushes up time. Um, and that actually reduces predictability to, to a [01:02:15] point. So you have to be then ever more binary with some of those cases where there’s a post crown [01:02:20] on a dodgy upper left lateral, you just don’t know where the crossover is going to then flex [01:02:25] that tooth so it pings. So how can you predict that for five years time? Yeah. [01:02:30] So is it that you run for the point of actually saying, do you know what, we probably need to then think about [01:02:35] where your mindset on this. If you’re happy for this to last for a few years, let’s run with it. If [01:02:40] you’re not, let’s run with something like a dental implant.

Payman Langroudi: And the let’s [01:02:45] call it hero Don ticks side. It’s a funny it’s a funny sort [01:02:50] of, uh, thing. You have to sort of you got on one side, you’ve got bonding, [01:02:55] getting better, the technology getting better. On the other side, you’ve got someone who wants to pay his 50 [01:03:00] grand or whatever it is, and get something that lasts some years.

Payman Langroudi / Andrew Chandrapal: Yeah, none [01:03:05] of us like failure. Yeah. That’s universal. Yeah. Um. But failure is [01:03:10] inevitable. It’s just when it happens. And so the reality. Are you less.

Payman Langroudi: Likely to go and [01:03:15] try and fix, be a hero and fix something that you really, you know, something that hasn’t got much [01:03:20] there nowadays?

Payman Langroudi / Andrew Chandrapal: Um, I wouldn’t say that, but I’m less likely to do it on someone who [01:03:25] I feel. Um, personality wise is going to, is going to then say, well, the [01:03:30] treatment that you did hasn’t worked out. Now, what are you going to do about it? Yeah. So it really is the personality [01:03:35] type and the dynamic or the ideology of that patient that will drive me the right patient.

Payman Langroudi: You would [01:03:40] do.

Payman Langroudi / Andrew Chandrapal: That? Absolutely. Um, and notwithstanding the fact that I’ve learned from other [01:03:45] people how to then try and do forms of Herod’s antics that actually [01:03:50] I would have never have tried before, such as partial extraction. What does that mean? So [01:03:55] effectively.

Payman Langroudi: The teeth and take half of it up.

Payman Langroudi / Andrew Chandrapal: Um, well, no, actually partially. Extract the tooth. [01:04:00] Splint it into position. Oh, so you’ve got greater coronal tissue to work with than.

Payman Langroudi: You know. [01:04:05]

Payman Langroudi / Andrew Chandrapal: I mean, very, very circumstantially led. But that’s the thing. [01:04:10] I learned that from an Italian prosthodontist. I mean phenomenal. It’s so simple [01:04:15] as well. But it’s like instant crown lengthening without having a higher gingival point than [01:04:20] the adjacent teeth.

Payman Langroudi: Wow, what an idea.

Payman Langroudi / Andrew Chandrapal: And so, [01:04:25] um, as an example, but that’s high risk treatment. I wouldn’t do it on someone who has an expectation [01:04:30] that this is going to work for years on end. You’re doing this because you have no other [01:04:35] choice, and because the only other choice is extraction.

Payman Langroudi: Take me through a case in terms [01:04:40] of, let’s say it’s one of these where you’re having to redo a full mouth rehabilitation in [01:04:45] terms of how many times are you seeing that patient before you actually start treatment? [01:04:50] What kind of costs does it run to? And you might find that distasteful. But [01:04:55] how long does it take? How much does it cost? All of that sort of [01:05:00] stuff. How many visits? What are we talking?

Payman Langroudi / Andrew Chandrapal: So I meet a patient initially for [01:05:05] a relatively short period of time, to work out and ascertain the nature of their needs. We have tcos [01:05:10] that will then brief me, but I need to meet that patient. I need to psychologically profile them, and they do [01:05:15] me. And I’ll also listen intently to my assistant at that time because I value [01:05:20] their opinion. Yeah. Um, especially the more experienced ones. And [01:05:25] and after that, they will have an expectation the patients will by, by means of the, [01:05:30] the TCO, that they will have to come back for a diagnostics visit where [01:05:35] we will spend another hour together, where we’ll take as much, extrapolate as much clinical data from the [01:05:40] patient as possible. In the meantime, I’ll have had some communication upon what I would like them to do. So [01:05:45] I have some forms that I have the patient complete in between that if they’re keen, they’ll do [01:05:50] it. If they’re not, they won’t. And that tells me something. Yeah. So I’ll carry on the conversation [01:05:55] at the second visit, and I’ll do all the work that we need to do. They’ll have an expectation at the end of that that there’s going to be [01:06:00] a letter provided for them in no more than two weeks. I [01:06:05] make it a point to deliver it in two weeks. If for any reason I can’t. I will be personally on the phone [01:06:10] to them to explain why and to apologise for it. Upon that, I’ll then have another [01:06:15] meeting with that individual. Now that instantly filters out a lot of people, because from the point of [01:06:20] you’ve made them jump through.

Payman Langroudi: Quite a lot of hoops, I.

Payman Langroudi / Andrew Chandrapal: Have. I have, and the people that are committed, [01:06:25] serious about it will all go through that. The ones that won’t, don’t value it. And that’s [01:06:30] okay. Yeah. They just I’m saving people. I’m filtering people through that process. [01:06:35] And so to the point to where we’re then having another conversation, be it virtually [01:06:40] on zoom, be it in person or on the phone, we then have given that patient [01:06:45] probably a week to go through their treatment plan, take all the parts through it, then I meet with them in person. [01:06:50] They’ll sign off and consent to all the key points that I’ve summarised in that treatment [01:06:55] plan. So the treatment plan, you know as well as I do, if I give someone a treatment plan of 5 or [01:07:00] 6 pages, they’re going to jump straight to the treatment fees. Yeah. And they’re going to look at [01:07:05] that and say, I can’t do that or I can do that. Yeah. Or some [01:07:10] of them will go through every element. But what I do, I then have what I want to put [01:07:15] down in the treatment plan, fees, etc., etc. I’ll annotate photos. Takes me a long [01:07:20] time to do. I charge well for it, but I’ll have a key summary points. Summary of [01:07:25] key points on one side of A4 that say all the pertinent points that that patient needs to [01:07:30] know. They’ll have to tick an initial every single point. Well, that I’ll go through them with.

Payman Langroudi: Oh, with [01:07:35] you.

Payman Langroudi / Andrew Chandrapal: Okay. Yeah. Upon doing that, then we sign consent and then we move. So that’s [01:07:40] three appointments down the way for the most complex case, for the ones that have the highest [01:07:45] risk and probably the highest financial value.

Payman Langroudi: How much are we talking?

Payman Langroudi / Andrew Chandrapal: So for the most [01:07:50] complex patient I’m treating currently, I’ve got a value of about 85 grand.

Payman Langroudi: And [01:07:55] how long will it take to deliver?

Payman Langroudi / Andrew Chandrapal: Probably 12 [01:08:00] months minimum.

Payman Langroudi: And where do you start?

Payman Langroudi / Andrew Chandrapal: Um, [01:08:05] a lot of the time. Phase one is stabilisation. Yeah. So [01:08:10] we’re trying to then unearth teeth of guarded prognosis. So we’re taking [01:08:15] disassembling restorations, having a look at what’s underneath, doing a degree of re prep rebuilding, [01:08:20] stabilising the the soft tissues around them and what have you. So we’ll do that on every [01:08:25] native tooth in the in the background. We’re then trying to find out a [01:08:30] little bit of detective work on the implants that are present, trying to make sure that we can find out each and every implant [01:08:35] specification. There’s a lot of background work that needs doing. Not every patient has that. I mean, that’s a minefield [01:08:40] in itself. And so once we’ve done that, I’ll put the patient into, um, [01:08:45] um, chairside temps and then lab made temps will then make sure [01:08:50] they’re aesthetically and functional, functionally stably stable for a matter of [01:08:55] no less than about three months. In that time, periodontist or myself will do [01:09:00] any soft tissue work grafting, crown lengthening, whatever is needed. And then we’ll get to [01:09:05] do that.

Payman Langroudi: Work yourself as well. I do. Oh, really?

Payman Langroudi / Andrew Chandrapal: Yeah. Um, and then we’ll get to a point where, [01:09:10] um, everything is stable. Patients are completely made up with everything, as am I. [01:09:15] And then we we transfer, um, upper and lower interiors, posteriors. [01:09:20] Off we.

Payman Langroudi: Go. And is that sort of fit day? Your what what [01:09:25] drives you in that? Like where do you get your buzz in all of this process. Do you get your buzz from [01:09:30] the planning stage, the prepping stage, the fitting stage or the social [01:09:35] side, the talking to the patient and solving their problem? Where’s your real buzz?

Payman Langroudi / Andrew Chandrapal: Uh, solving [01:09:40] the problem. I like the mechanistic of solving the problem. I [01:09:45] mean, once you’re actually delivering the treatment, it’s carpentry. You can either do it or you can’t. [01:09:50] Yeah. If you can’t do it, then you can train to do it if you want. If you can do it, then do it. But it’s [01:09:55] the it’s the it’s the strategy. I’m quite the strategist. Yeah. So I love that bit. [01:10:00] And actually when the patient sees that as well and gets it I’m like, wow this is amazing. [01:10:05] That’s really cool. And the and the buzz actually is provisionals. I get [01:10:10] those lab made provisionals on and everything. Everything goes and then they bite together. [01:10:15] And you’ve got one single when they bite together. I’m like, wow. Even [01:10:20] now, love that Basil.

Payman Langroudi: Loves the Provisionals.

Payman Langroudi / Andrew Chandrapal: Yes he does. Yeah. [01:10:25] I want to.

Payman Langroudi: Talk about teaching. Yeah. And within [01:10:30] teaching, I’d like to discuss you. I should have I should have, uh, introduced you as the past [01:10:35] president of the BCD as well. Um, teaching. I [01:10:40] mean, we do teaching. Is it’s high risk. Low [01:10:45] reward is really where I see it in.

Payman Langroudi / Andrew Chandrapal: What’s [01:10:50] happened to you? No, no.

Payman Langroudi: It is, it is. It’s high risk. Low reward. It is. It’s high [01:10:55] work. A lot of work in it. Yeah, it’s a lot of work, especially hands on. Right. Yeah. And maybe you don’t [01:11:00] handle the hands on side. No, I don’t do everything. No. It’s in the, the the the setup, [01:11:05] the cleanup for me. Is that you? I thought maybe the company, um. [01:11:10] It’s a pain in the ass. It’s difficult. Difficult work. Um, but [01:11:15] on the flip side of it, for me, the there’s, like, a [01:11:20] light bulb moment from the delegate somehow makes everything worth it. It’s [01:11:25] almost like, you know, the patient, this this full mouth rehab patient that we’re talking [01:11:30] about. Maybe she at the end of it all, she gives you a massive hug. [01:11:35] And truly, from the bottom of her heart. Thanks you. Yeah. Is worth more than the [01:11:40] 85 grand that she gave you. And it’s like, what drives us? Yeah, for me, it’s when a delegate [01:11:45] gets a light bulb moment. It just feels good to watch it. I’m [01:11:50] not normally the teacher, to tell the truth, but watch, watch that and then see the delegate doing something. [01:11:55] Yeah. How about you? What?

Payman Langroudi / Andrew Chandrapal: You’re right. Teaching [01:12:00] is a huge responsibility. I take it really seriously. [01:12:05] I put a lot of pressure on myself, um, to to to perform, [01:12:10] um, and to watch what I’m saying and to deliver how it needs to be said and to reflect off [01:12:15] of others that I have learned from. Um, there’s a huge amount of preparation that goes into [01:12:20] it. Um, and I reflect back on every course and [01:12:25] think, how could I have done that better? Could I have had more delegates or less delegates to [01:12:30] strengthen the message? And I think I see [01:12:35] the change in most delegates as we go along that journey, which [01:12:40] is at least two days. And the change is both in terms of body language [01:12:45] involvement. So you see, you get the passion level start to come up, but also [01:12:50] in attainment. But it’s not only that. I find [01:12:55] that many delegates come back to me on the support side of things, and [01:13:00] they’ll send me a message showing me a case when they didn’t have to do that because they’re busy with life [01:13:05] and what have you. And just to give me an example of what they achieved and how it’s [01:13:10] changed things. And I just love that. I’m like, whoa, that that’s [01:13:15] just quite something. And I think when you can have that impact and it need [01:13:20] be only something that’s just little, then it just I think that that really drives you. [01:13:25]

Payman Langroudi / Andrew Chandrapal: Um, I finished my courses and I am goosed. [01:13:30] Yeah. And I have done stupid [01:13:35] things in the past that I shouldn’t do and probably admit inasmuch as [01:13:40] I’ve okay, I. I am Indigo Dent. I am [01:13:45] Batman. I am Indigo Dent. Inasmuch as I’m the administrator, I’m. I keep [01:13:50] all the stock. I order the stock. I set up all yourself. Yeah. Wow. And then I [01:13:55] set down. I have support, um, mainly with Kolser who are amazing, [01:14:00] um, with. And for me and, um, they, they, they really help me. [01:14:05] Um, but they are my courses. So, [01:14:10] for example, when I do a course in Glasgow, I’ll drive up [01:14:15] on the Thursday. Um, sometimes I’ll do a morning session in the clinic [01:14:20] and then I’ll drive up. I’ll get there either at midday or at the end of [01:14:25] the day, about five hours set up for the course. Deliver the course Friday, Saturday, [01:14:30] Sunday. Take the delegates out for a meal. Sunday night, pack [01:14:35] up, drive home, get back about 4 a.m., wake up at six to [01:14:40] go to work the next day. Why’d you drive? Uh, because I’ve got so much kit and. [01:14:45]

Payman Langroudi: I send it.

Payman Langroudi / Andrew Chandrapal: I don’t send it because I can’t trust something to not turn up or something to get [01:14:50] delivered and damaged. You know, I’ve got usually 25 sets of hand pieces. I’ve got [01:14:55] all sorts of things. Um. Et cetera. Et cetera. So. And I guess, am I a control [01:15:00] freak or am I a micromanager? Probably.

Payman Langroudi: Yeah, probably. That’s harder than it needs to be, [01:15:05] isn’t it? But I get you, [01:15:10] I get you. Look, once, once we forgot mandrels. Right. There was a [01:15:15] good reason as well, right? We’d taken our drills to BCD, and there they didn’t [01:15:20] want them. And then someone in the warehouse forgot that or didn’t realise we’d taken them to BCD. And then [01:15:25] we didn’t have mandrels. Yeah. Yeah. Ruined the course. Ruined the course. I mean, bless his heart. [01:15:30] Lewis McKenzie. Yeah. Pulled out the stops. We were in Birmingham in the new hospital. [01:15:35] Yeah. Um, bless him, he he had, you know, he’s the kind of guy [01:15:40] who had 40 mandrels. So. Yeah. So, you know, he [01:15:45] brought out every polishing system he had or whatever. But but what I’m saying is something as small as that, something as tiny [01:15:50] as that can ruin a course. And so you can’t have you can’t miss anything. [01:15:55]

Payman Langroudi / Andrew Chandrapal: And that’s the thing.

Payman Langroudi: And stuff does go missing and stuff doesn’t arrive. And but to [01:16:00] put it in the car and drive. Jesus.

Payman Langroudi / Andrew Chandrapal: Yeah. And I [01:16:05] store my, my, my stuff at Darwood and Tanner. And so I, when I’m, when I teach elsewhere. [01:16:10] Yeah. I have to go there to take the car there and unload it and then do it. And I have a storage facility near my, [01:16:15] near my house, you know, so it the legwork is is mega. Um, [01:16:20] but that’s again why I only teach small groups. Yeah. You know, because [01:16:25] I have to make it logistically work. But I have to have the content for the delegate [01:16:30] to be, uh, concentrated enough to apply to them.

Payman Langroudi: And is there [01:16:35] not a member of staff that’s, like, fully on it? No.

Payman Langroudi / Andrew Chandrapal: I mean, one of [01:16:40] my nurses.

Payman Langroudi: For Cpds or they they cancel courses or. It’s me. Oh, [01:16:45] man. That hurts.

Payman Langroudi / Andrew Chandrapal: I sleep like Maggie Thatcher. That’s [01:16:50] the key. You don’t sleep.

Payman Langroudi: Do you not? Do you not sleep enough? [01:16:55]

Payman Langroudi / Andrew Chandrapal: I actually, I wouldn’t say I don’t sleep enough, I just don’t. I [01:17:00] probably need sleep, but I don’t. I’m. I’ll work till 1 [01:17:05] or 2:00 and that’s that’s back from the bad days. That’s back from seeking stage. Do you remember?

Payman Langroudi: Oh, [01:17:10] yeah. Yeah, yeah, yeah.

Payman Langroudi / Andrew Chandrapal: Um, so it’s back from those days and then wake up at six and crack [01:17:15] on. So if I, if I get four hours sleep, I’m good with it.

Payman Langroudi: Wow. What about [01:17:20] on the institutional level of education? Bcd well, sort of leading them. I’m [01:17:25] not going to call it a behemoth. It’s not. It’s not that big. But but leading an educational [01:17:30] institution. What are your reflections on that? Because everyone I [01:17:35] have asked about that almost says in a year’s not enough time to make any big change. [01:17:40] I think.

Payman Langroudi / Andrew Chandrapal: That’s fair. I think, um, Bacd is um, [01:17:45] is very close to my heart and has been incredibly influential and given opportunity [01:17:50] for many clinicians in the UK and beyond. And it [01:17:55] deserves to do well. It deserves to be directed and driven in the right [01:18:00] way. It deserves to to grow and to continue that influential [01:18:05] pathway. But to do that, um, we have been talking at board level when I was part of [01:18:10] the board, um, that the leadership probably does need a longer, a longer [01:18:15] term of service. However, um, constitutionally, you [01:18:20] already serve a very long term of service to get to that point in the first [01:18:25] place. And I think that that, influences your decision, [01:18:30] um, as to how much you can give. It’s largely a thankless task. [01:18:35] Um, and a lot of what goes on in the background isn’t really, um, [01:18:40] you know, uh, talked about or it doesn’t need to be talked about, but it is [01:18:45] a lot. Um, and I think. What do you mean?

Payman Langroudi: There’s a lot of work. [01:18:50]

Payman Langroudi / Andrew Chandrapal: There’s an awful lot of work in the background.

Payman Langroudi: Unpaid.

Payman Langroudi / Andrew Chandrapal: Oh, yeah. Yeah, absolutely. Yeah. [01:18:55] You do it, you know, to. Well, you do it to what I hope to be to improve [01:19:00] the face of, um, aesthetic dentistry within the UK and to drive the [01:19:05] academy forwards. Um, that’s what I hope you do it for. Um, and so as a consequence [01:19:10] of that, you give it your all like you do anything and, um, two years worth [01:19:15] terms of service as a, as a, as a ah.

Payman Langroudi: You think too much.

Payman Langroudi / Andrew Chandrapal: Is is a big [01:19:20] ask. I’m not saying it’s too much. It’s probably what’s needed. But it is a lot to ask when you’ve [01:19:25] already said.

Payman Langroudi: Individual’s going to have to put his life on hold for for two years.

Payman Langroudi / Andrew Chandrapal: Yeah, well, you’ve already [01:19:30] sat on the executive committee for two years before that. You’ve probably been a chair [01:19:35] of one of the boards. Yeah, but what.

Payman Langroudi: Does it mean? What’s what’s the commitment on the executive committee? Is it [01:19:40] that you’re having to answer questions throughout the week, or how many times do you have to meet. And so [01:19:45] what is it as vice president?

Payman Langroudi / Andrew Chandrapal: Historically, I’d be unsure as to it still being the way. But [01:19:50] as vice president you are effectively the treasurer. Mhm. Um, you [01:19:55] take care of the financial affairs, you become an officer, um, registered under companies House. [01:20:00] Um, and you have to take care of all the financial dealings, um, of, [01:20:05] of uh, of the BCD as. And you’re also flying the flag. [01:20:10] You’re probably educating at a point. Yeah. Um, and you’re meeting [01:20:15] with all the other, um, chairs of all the other committees. As president [01:20:20] elect, you are flying the flag and doing an awful lot of the running around that’s required [01:20:25] for the courses to work, for conference and all the rest of it. And as president, [01:20:30] the framework for that should be that you simply fly the flag. [01:20:35] Um, it depends upon what era of the bacd you have been part of. As to whether or not [01:20:40] that’s all you do. It wasn’t in my time, and it wasn’t for many of the other presidents, but, um, [01:20:45] you fly the flag, you send the message forwards, you present at the conference and such [01:20:50] the like. So within that, um, there’s a lot there’s a lot. I probably [01:20:55] didn’t see my kids the most during that point.

Payman Langroudi: I also saw [01:21:00] you at the Dental update. Yeah. Thing. How long have you been working.

Payman Langroudi / Andrew Chandrapal: For Dental [01:21:05] update? I think I’ve been with them for five years. 4 or 5 years, something [01:21:10] like that.

Payman Langroudi: Good group of people there.

Payman Langroudi / Andrew Chandrapal: I mean, immense I mean, if I [01:21:15] ever look to the group of people that influenced me as an undergraduate, where you [01:21:20] see their names on as the authors of the textbooks have been revising for the end of year [01:21:25] or end of term exams, and then you’re sitting on a committee with these individuals. [01:21:30] You’re like, my goodness. Uh, I mean, the first time I met Edwina, [01:21:35] I was like, whoa, what a kid. Yeah. I mean, it was just phenomenal. [01:21:40] And it puts you in your place. Yeah. Rightly so. And and it kind [01:21:45] of goes back to our initial conversation. Um, these people have, have grafted and [01:21:50] and tirelessly, tirelessly worked for the profession. Most [01:21:55] of them are deans of various Dental schools. Yeah. They they also know how to party pretty hard. Yeah. [01:22:00] Um, harder than I can. Uh, but. Yeah. Amazing. [01:22:05] Um, quite an experience. And obviously to work with, um, [01:22:10] with who you’ve mentioned before. Someone who’s dear to my heart. Louis. Yeah. [01:22:15] Uh, it was amazing.

Payman Langroudi: We’ve come to the end of our time. [01:22:20] I want to do a little quick fire round. It’s a new thing we’re doing. Um, [01:22:25] and then we’ll finish off with the usual questions. Yeah. What’s [01:22:30] a course that affected you the [01:22:35] most for your career?

Payman Langroudi / Andrew Chandrapal: The course continuum.

Payman Langroudi: What’s a course you’re desperate to go [01:22:40] on?

Payman Langroudi / Andrew Chandrapal: I’d [01:22:45] probably like to do Esteban Urban’s course [01:22:50] on, um, bone augmentation for. [01:22:55]

Payman Langroudi: For.

Payman Langroudi / Andrew Chandrapal: Uh, for bone grafting, for surgical [01:23:00] dentistry. Implants.

Payman Langroudi: Do you place implants?

Payman Langroudi / Andrew Chandrapal: I have done for 15 years.

Payman Langroudi: Oh, really? [01:23:05]

Payman Langroudi / Andrew Chandrapal: Yeah.

Payman Langroudi: So, David and Tanner, would you place the implants?

Payman Langroudi / Andrew Chandrapal: No. Um, Andrew places [01:23:10] the majority. Fiona, who’s a periodontist. Um, places some. I do all [01:23:15] restoration of the implants and what have you. Soft tissue work and things, but he would place them.

Payman Langroudi: Favourite [01:23:20] bit of kit?

Payman Langroudi / Andrew Chandrapal: Probably [01:23:25] my sable brush.

Payman Langroudi: Oh, that’s a nice composite brush. That’s [01:23:30] a nice answer. That’s a brilliant answer. What [01:23:35] grinds your gears the most about dentistry?

Payman Langroudi / Andrew Chandrapal: Uh, I [01:23:40] think that the need to feel lauded and applauded constantly. [01:23:45] Um, and the, the, perhaps the artificial [01:23:50] growth that that gives you. I think that we need to remember where we are [01:23:55] in life, where we what we do appreciate the changes that we’re able to make. But [01:24:00] let your growth be in perspective.

Payman Langroudi: What’s your favourite practice [01:24:05] in the UK? No self-nominations allowed.

Payman Langroudi / Andrew Chandrapal: Uh, my [01:24:10] favourite practice. Well. [01:24:15] Let me give you a hypothetical answer. The practice where [01:24:20] there’s a group of like minded clinicians that have been in the same place for a number of years who [01:24:25] have.

Payman Langroudi: Yeah, I’m not going to accept that. Oh my God.

Payman Langroudi / Andrew Chandrapal: Are [01:24:30] you asking me about a practice?

Payman Langroudi: Yeah, it’s your favourite practice. [01:24:35]

Payman Langroudi / Andrew Chandrapal: Man. Because [01:24:40] I have to think of individuals.

Payman Langroudi: Then what is one of your many favourite [01:24:45] practices? Because it’s a big ask to say your favourite. The best. Yeah. [01:24:50] Name for whatever.

Payman Langroudi / Andrew Chandrapal: Okay. You have to give me a minute. Um, [01:24:55] you know, I, I’m only a very, very small cog in it, but [01:25:00] I love what Andrew and Sue have done.

Payman Langroudi: A self norm.

Payman Langroudi / Andrew Chandrapal: Okay. Wow. [01:25:05]

Payman Langroudi: Yeah. I mean, listen, I hero worship David. [01:25:10] I really do, but you work there. You’re not allowed to say that. Okay. [01:25:15]

Payman Langroudi / Andrew Chandrapal: Okay. Can I. Mhm. [01:25:20]

Payman Langroudi: I really didn’t think this one would stump you so badly.

Payman Langroudi / Andrew Chandrapal: Yeah [01:25:25] it’s a tough one. Okay. I [01:25:30] think if I look at someone like Robert. Yeah. Who’s [01:25:35] a good buddy of mine. But also having gone round his practice has organised it in such [01:25:40] a way where the ethos is the same consistently the place [01:25:45] and positioning and the longevity and legacy of that practice has remained. I [01:25:50] love his energy. I love his technical, um, skills, and I love what the practice [01:25:55] achieves. I think probably more Park is a fantastic example of [01:26:00] how I would love, love to have owned a practice like that over the years. [01:26:05]

Payman Langroudi: Where is it.

Payman Langroudi / Andrew Chandrapal: In Moor Park? Where’s that? It’s not too far from kind of harrow. [01:26:10] Okay.

Payman Langroudi: Okay. Yeah. Books that changed your life. [01:26:15]

Payman Langroudi / Andrew Chandrapal: Okay. Uh, outliers to [01:26:20] prove to me that.

Payman Langroudi: Gladwell.

Payman Langroudi / Andrew Chandrapal: Yeah. By Malcolm Gladwell. [01:26:25] To prove that practice and repetition is everything. And that sheer, unadulterated, [01:26:30] unadulterated talent is maybe a touch overrated. Uh, [01:26:35] black box thinking. Uh huh. Um, to then make sure that [01:26:40] you look at all of the points of your of your journey [01:26:45] to make sure that you take care and care for each part of that to create an [01:26:50] overall improved result, and probably clinically. [01:26:55] Yeah.

Payman Langroudi: Favourite. Favourite Dental book? Yeah. Yeah. That’s going to be the next question. Yeah.

Payman Langroudi / Andrew Chandrapal: Um. [01:27:00] Probably. Oof! [01:27:05] I’d [01:27:10] say Mike Weiss’s management [01:27:15] of the failing dentition.

Payman Langroudi: Yeah. I thought for you that would be the right move. Yeah. [01:27:20] Amazing. So the final question is a fantasy dinner party. Three [01:27:25] guests. Right? Dead or alive, who would you have? Okay.

Payman Langroudi / Andrew Chandrapal: I [01:27:30] would go. I [01:27:35] would go, Jemmy Page, LED Zeppelin’s nice guitarist. [01:27:40] I would probably [01:27:45] go with. Someone [01:27:50] like. Uh. [01:27:55] Someone [01:28:10] like Marie Curie. And [01:28:15] my dad.

[TRANSITION]: Oh.

Payman Langroudi: Nice. It’s been [01:28:20] a massive pleasure, man. Thank you. It’s been a pleasure. Thank you so much for coming.

[VOICE]: This [01:28:25] is Dental. Leaders the podcast where you get to go [01:28:30] one on one with emerging leaders in dentistry. Your [01:28:35] hosts, Payman Langroudi and Prav Solanki. [01:28:40]

Prav Solanki: Thanks for listening, guys. If you got this far, you must have listened to the whole thing. [01:28:45] And just a huge thank you both from me and pay for actually sticking through and listening to what [01:28:50] we had to say and what our guest has had to say, because I’m assuming you got some value out of it. [01:28:55]

Payman Langroudi: If you did get some value out of it, think about subscribing. And if you would [01:29:00] share this with a friend who you think might get some value out of it too. Thank you so, so, so much for [01:29:05] listening. Thanks.

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

[VOICE]: This [00:00:05] is Dental Leaders the podcast where you get to go [00:00:10] one on one with emerging leaders in dentistry. Your [00:00:15] hosts Payman Langroudi and Prav Solanki. [00:00:20]

Payman Langroudi: It gives me great pleasure to welcome Zohaib Ali [00:00:25] Zhu to his buddies onto the podcast. So is a specialist [00:00:30] prosthodontist one of the dentists leading the whole bio emulation [00:00:35] movement in the UK. And I was first introduced to by emulation [00:00:40] ten years, eight, nine years ago. And I went to one of the events [00:00:45] in Berlin and it blew me away.

Zohaib Ali: That was about [00:00:50] ten years ago now. Yeah, something like that. Yeah.

Payman Langroudi: Blew me away. And it wasn’t the [00:00:55] only the content because the content was very good, but it was the production value [00:01:00] of some of the lectures at McLaren. Pascal Magnier was there. [00:01:05] Some of the screen that and I and I up [00:01:10] to that point, I was always sort of annoyed every time I went to an event and I’d say, you know, you [00:01:15] come to an event, at least make the AV brilliant. You know, something as simple as that. And [00:01:20] the AV was beyond brilliant. And then there was a party and there was, it [00:01:25] was it was just it was just I came out of it thinking, no way did anyone make any money [00:01:30] out of this event, you know? And it kind of instilled in me this idea that [00:01:35] it’s a weird thing. It’s a bit like being an NHS dentist. The more you pay attention, [00:01:40] the more you take care, the less money you make. Yeah, [00:01:45] um.

Zohaib Ali: You’re right. And thank you for having me on. It’s a pleasure. [00:01:50] Yeah. Um. So. Yeah, Berlin actually was ten years ago, [00:01:55] and. No, no, I wasn’t there, I wasn’t there, I was in my infancy. Um. 2014. [00:02:00]

Payman Langroudi: I don’t think it was the first event, though. I think it was maybe the second.

Zohaib Ali: Maybe. Perhaps? Perhaps. [00:02:05] Um, but this year is the ten year anniversary symposium which we are hosting [00:02:10] in London.

Payman Langroudi: For the first time, right?

Zohaib Ali: In the UK for the very, very first time.

Payman Langroudi: It’s not going to come again for a while, let’s face [00:02:15] that.

Zohaib Ali: No, I don’t think I have the energy to do this again for a long, long time. Um, [00:02:20] it’s been demanding, to say the least. And there’s a group of us. Um, [00:02:25] but how do you.

Payman Langroudi: Characterised by immolation?

Zohaib Ali: I think by immolation, [00:02:30] what you have to remember is that at the core of our profession is patient care [00:02:35] and doing what’s best for the patient at all times. And within that realm, [00:02:40] if you like, there’s there’s that thought process or idea [00:02:45] of of biomimetic or imitating what was there by [00:02:50] design, by God or by nature, whoever you believe in that what was there [00:02:55] by natural design is the best thing possible. That’s our gold standard. That’s the bar. [00:03:00] So by Emulative dentistry aims to recreate that. And [00:03:05] if you think back to my initial statement of patient care, it’s [00:03:10] about recreating nature so that you are treating the patient in the most [00:03:15] conservative way possible by by preserving as [00:03:20] much natural anatomy be that enamel, dentine, soft tissue, [00:03:25] bone, whatever it is, you preserve as much as possible so that whatever [00:03:30] the patient has left at the end of your care, they are in the best possible position for [00:03:35] the rest of their remaining life. And that’s the whole premise of it. Now there’s a much stronger [00:03:40] emphasis historically within by Malaysian on, let’s say, enamel and dentine. [00:03:45] That’s that’s where it all really started. But as time has gone on, we understand that, that [00:03:50] there’s a much bigger role or a much bigger perspective you can have [00:03:55] and on the interplay between teeth and the surrounding tissues. And that’s where we [00:04:00] are with it today. And really.

Payman Langroudi: For me, the tip of the spear when it comes to adhesive [00:04:05] restorative modalities, things of colour. [00:04:10] I mean, some of the some of the stuff I saw, and it’s not like I hadn’t seen stuff. I’d seen a lot of stuff. It’s it’s mind blowing. [00:04:15] I saw blew me away, man. It blew me away.

Zohaib Ali: It’s just nuts. And, you know, let’s say the father of all [00:04:20] this is Pascal Magnan, who is a Swiss clinician now based in the States. [00:04:25] Yeah. In LA. And if you read his original book from 25 [00:04:30] odd years ago, something like that, now you would swear that it [00:04:35] was just printed yesterday. Really? It was so far ahead of its time, really. And [00:04:40] there’s a newer version now, a lot of it, but it.

Payman Langroudi: Stood the test of time. Absolutely.

Zohaib Ali: If [00:04:45] I mean, you could, you could read it today and it would still be valid for another 10 or 15 years. It’s absolutely [00:04:50] incredible. And that’s the whole ethos of this group. It’s collaborative, [00:04:55] it’s looking forward all the time. It’s trying to understand what are [00:05:00] we lacking in our current concepts and our knowledge. How do we, [00:05:05] you know, gain that knowledge through clinical procedures, through technicians [00:05:10] in the lab, through researchers? It’s a global think tank of 100, 120 [00:05:15] clinicians all working together in a collaborative way and 120. That’s all. [00:05:20] It’s a tiny number.

Payman Langroudi: I remember at the time when I went there was like 12.

Zohaib Ali: Oh, I see, I mean.

Payman Langroudi: I think you’re probably.

Zohaib Ali: That [00:05:25] was that was the original very, very the core. And um, you know, it was set up by, by three [00:05:30] phenomenal clinicians.

Payman Langroudi: So who are they? Panos.

Zohaib Ali: Panos, who is. Yes, [00:05:35] Panos Bezos, who is one of the one of the founding members, Javier Tapia, who is based out of Spain. [00:05:40] Um, and unfortunately, Gianfranco, who actually just when I say unfortunate, [00:05:45] I mean he passed away very, very, very recently. Um, so [00:05:50] Yeah. Um, we had.

Payman Langroudi: Gianfranco Politano, uh, do a hands on with us. Really? [00:05:55] Um, about, I don’t know, eight years ago. Wow. And such a [00:06:00] gentleman. He would have.

Zohaib Ali: Been in his prime in terms of his Dental knowledge and his skill and everything.

Payman Langroudi: A gentle [00:06:05] guy, though. Such a gentle guy. And I, I found him just a really special [00:06:10] human being. Yeah. Um, as well as as well as the stuff that he’d done at the time. It was [00:06:15] posteriors. Yeah. If he moved on from there.

Zohaib Ali: You know, there’s when you speak to Panos, [00:06:20] he’s he’s quite passionate about people’s personalities. And [00:06:25] one of the things within being Malaysian is that you’ve got to have your head in the right place. Meaning, [00:06:30] have I got the knowledge that I need? And if I don’t have, is my head screwed on right to go [00:06:35] and search for that knowledge and be thirsty for it and be gritty about it. Second [00:06:40] is, you know, the hand skills have to then be developed. But then the third thing [00:06:45] is your heart. Is your heart in the right place at all times when it comes to dealing with the patient, [00:06:50] number one, but also dealing with your colleagues, your nurses, your, you know, your [00:06:55] team of clinicians that you work with. Your heart always has to be in the right place. And I think that’s one [00:07:00] thing that really resonated with me personally about by emulation was, was that specific [00:07:05] comment that there’s no room for ego, there’s no room [00:07:10] for, you know, aristocracy. It’s a meritocracy. And [00:07:15] you and you got to be playing, playing things in the right way on all fronts. Well, I’m.

Payman Langroudi: Glad to hear that. I’m glad [00:07:20] to hear that, because from my memory of it, it seemed a little bit exclusive back then. [00:07:25] Like you said, it was like invitation only. And, um, by the way, sometimes [00:07:30] at the beginning of something, it kind of serves it to have that sort of scarcity mentality. [00:07:35] But I’m glad to hear what you’re saying, that that’s that’s the way, you know, that’s what got you [00:07:40] into it. Um, I always found Panos. Just his eye. What an eye that guy [00:07:45] has.

Zohaib Ali: You know, he’s a specialist orthodontist, actually, by training. [00:07:50] But he’s now he’s now.

Payman Langroudi: He wasn’t back then.

Zohaib Ali: No, he, he, you know, and actually he trained in the UK in in [00:07:55] Edinburgh I think. But his background is restorative. But he does have an eye for stuff and he’s [00:08:00] somebody who just knows how to get shit done. Uh, which, which I admire massively. Um, [00:08:05] and one of the things he, he is doing is, you know, as a group, we’ve [00:08:10] put together the, let’s say, the educational wing or [00:08:15] part of simulation, which is called core. Um, and that is designed [00:08:20] for clinicians at various stages of their career because there’s always there’s [00:08:25] always so much to learn. Whenever you think that you, you know everything, it’s time to hang up your [00:08:30] boots. Yeah. So, you know, if I listen to another clinician within the simulation group [00:08:35] or even outside, there’s always at least one thing that they’re doing better than me. It doesn’t matter [00:08:40] who that person is, how young they are, or how old they are, there will always be one thing [00:08:45] that they know better than I do, so there’s always something to learn. But in [00:08:50] the core, the curriculum is basically, you know, three days times three. [00:08:55]

Zohaib Ali: So I think there’s nine or 9 or 10 days of teaching, you know, split up into direct [00:09:00] restorations, understanding composites and anatomy and that kind of thing, and then [00:09:05] branching into ceramics and so on and so forth. And that is going to be a pathway [00:09:10] for other people to join the group to understand what’s lacking in their [00:09:15] own practice and how they can apply themselves, and a way and a structured way to improve that [00:09:20] isn’t just based on pure experience or someone’s own personal opinion [00:09:25] on on everything. There’s a science to it, and it’s been proven again and again and again [00:09:30] and all the courses we see, whether it’s UK based in the States, in Europe, [00:09:35] a huge, huge number of them within the realm of adhesive [00:09:40] dentistry, they are, let’s say, or [00:09:45] they have taken a vast amount of inspiration from the teachings [00:09:50] of this group. So my advice always to people is just go to the source, [00:09:55] go to the original source. If you want to learn about veneers, go and see Pascal Mann and do his [00:10:00] course. Or maybe Ghalib Grill in Turkey.

Payman Langroudi: Yeah, great. Course.

Zohaib Ali: You know, if you want to learn [00:10:05] about Verti preps, go to Italy and there’s a couple of absolute [00:10:10] masters of their trade over there. So whatever it is, you know, find the [00:10:15] best person, find the class leader best in class. Go and learn from [00:10:20] them. Don’t don’t cheap out on it. It’s not worth it. Don’t go [00:10:25] locally because it’s convenient for you if you actually want to practice really [00:10:30] good dentistry. And by that I mean doing what’s actually best for your patient all [00:10:35] the time. Then arm yourself with the correct tools and knowledge to do that. You can’t do [00:10:40] it if you’ve if you’ve cheaped out on your education and you’ve cheated yourself out of that. If you’ve done [00:10:45] that, you’re cheating your patience out of it. So it’s a it’s a really big [00:10:50] splash. Hopefully that that that core will make its coming to the UK. Fingers crossed next year. [00:10:55] Um and is.

Payman Langroudi: It going to be other than UK as well. Yes.

Zohaib Ali: So it’s [00:11:00] one cohort is already running Greece and they’re going to run a second one soon [00:11:05] Bulgaria, Spain and UK. These are the four locations at the moment.

Payman Langroudi: Different teachers or. [00:11:10]

Zohaib Ali: Um it’s going to be there will be some crossover. There will be some crossover [00:11:15] because some people are so good at what they do, you can’t replicate it. Yeah. You can’t. You know, if I could present [00:11:20] their slides, but I’m not going to present it the way they present it with their experience and their knowledge. And, [00:11:25] you know, I work with Costa, who is my, my, uh, unfortunately, [00:11:30] a friend and, and business partner. And we have our teaching platform across [00:11:35] the works, across the works. And, you know, we have multiple teaching courses and we and we’ve [00:11:40] taught talked together some of those slides Costas made a few years ago or I made. [00:11:45] And whenever one of us has to present the other person’s slides, even though we know the material, [00:11:50] we just know it’s uncomfortable and you’re sort of scratching your head a little bit thinking, what did what did Zoe mean? [00:11:55] Or what did Costas mean on this slide? I you know, I can’t really put my finger on it. So [00:12:00] much so that now there’s a couple of slides that that I always have to present, and I have no idea [00:12:05] what they mean, but instead of deleting them, I just leave them in there for, for emotional emotional value. [00:12:10] Now it just reminds me of where I am and and where we came from.

Payman Langroudi: Um, Costas, we had on [00:12:15] this podcast episode 213. Um, a bit of like a mentor to you as well, [00:12:20] in a way.

Zohaib Ali: I don’t say that in public. I don’t like to.

Payman Langroudi: Because he was [00:12:25] he was one of your teachers in your he was in your specialising education in kings [00:12:30] and a well known as a consultant in Kings but recently stopped. Yeah, yeah. And [00:12:35] we’ve had your brother, your twin brother. People might think they’re seeing double. Um. Uh. [00:12:40] Episode 217. Hisham, who is an orthodontist?

Zohaib Ali: Yes, [00:12:45] he’s a consultant orthodontist.

Payman Langroudi: Yeah. So I’m really interested in this.

Zohaib Ali: Why am I the last one to be invited? [00:12:50]

Payman Langroudi: I don’t know. It’s a good question. Um, I’m [00:12:55] interested in your outlook. I mean, I spoke to your brother. Mhm. Um, [00:13:00] but for someone who hasn’t listened to that episode. Mhm. Um, I’m interested [00:13:05] in the situation of, you know, why is it one dentist ends up wanting to specialise [00:13:10] and wanting to get better, and another dentist is happy to [00:13:15] stay at the same level. And another dentist who I had in this chair who was once 50 [00:13:20] practices like what is it? What is it about the way you guys were [00:13:25] brought up that made you want to become specialists? Was there was there something [00:13:30] that that your parents did? Was it, you know, where did it come from?

Zohaib Ali: I [00:13:35] think probably for my parents, um, were I mean, we’re, you know, we’re [00:13:40] Pakistani. I was I’m actually, let’s say first generation immigrant. I was born in Pakistan. Yeah. I [00:13:45] wasn’t born in the UK or in the West. I was born there, and we and we immigrated here [00:13:50] when I was 4 or 5 to Ireland. So, you know, our roots [00:13:55] are to, let’s say, quite conservative and, and our thought process is similar. So, [00:14:00] you know, if you’re Middle Eastern, probably if you’re Jewish, if you’re South Asian, like like [00:14:05] we are. Education was always at the forefront of all of our parents mind. That’s just how you were raised, [00:14:10] that, you know, you go and get a good education. You get straight A’s at school, you [00:14:15] absolutely smash it at A-levels or in Ireland, it was called the Leaving Certificate, which is the equivalent [00:14:20] to the International Baccalaureate. And then you go to university, you do a professional degree, [00:14:25] not arts. You don’t do humanities or geography. You do medicine, law, [00:14:30] dentistry, engineering. Yeah, whatever. And you become one of those professions. [00:14:35] You have a stable income and a stable salary, and off you go. And then in that [00:14:40] same line was, well, how far if I’m going to be a healthcare professional, whether [00:14:45] it’s medicine or dentistry or whatever, you know, what’s the most stability that you can have? And it was [00:14:50] always drummed into me that the more specialised you are, the deeper your knowledge, [00:14:55] the more valuable you’re always going to be. Yeah. Um, and it is actually true. I’ve only I’ve only [00:15:00] come to appreciate that now I’m 30, I’m going to be 38in November, and I’ve [00:15:05] only really come to appreciate that now, in the last couple of years, where we’ve seen a downturn [00:15:10] in the financial situation of the state, of the country and [00:15:15] people’s wallets.

Zohaib Ali: Everyone everyone’s being pinched. You know, Covid savings have dried up. [00:15:20] Petrol prices are are through the roof. Energy costs are through the roof. Yeah. Um, [00:15:25] milk costs are through the roof. And people, you know are not spending so much on [00:15:30] luxury goods. And that’s the same with in dentistry. People are not spending so much on pure [00:15:35] aesthetic or cosmetic upgrades like they were 5 or 6 years ago, or even 3 or 4 years ago. [00:15:40] All of that money is gone and, you know, everyone’s going back to work. People have real, real troubles. [00:15:45] Even dentists. I think we don’t talk about it. But I think it’s I think it’s real. Not everywhere. [00:15:50] I’m in a privileged position. I really consider myself privileged, but I think a lot of dentists [00:15:55] are struggling much more than they would like to admit, especially principles, actually, of [00:16:00] smaller practices. And if you are the kind of dentist or [00:16:05] you have the kind of practice that relied heavily on the Instagram generation on [00:16:10] on volume, on lots and lots of cosmetic output, [00:16:15] then you might find it that you have, that you have a difficult time at the moment because [00:16:20] people are spending less on that. And that’s a market that’s relatively easy to get into. [00:16:25] If you have a bit of cash behind you, you know, if you have wealthy parents and I didn’t. But if you have wealthy [00:16:30] parents or you have some capital and you can set up a practice and dump a load of money into marketing. Well, [00:16:35] you can you can bully your way in and fight for some elbow room [00:16:40] in a crowded marketplace if you have the capital to spend on the marketing. It’s as simple as that. [00:16:45]

Payman Langroudi: Whereas I don’t think I wouldn’t say it’s as simple as that. I don’t. I mean, because you can waste [00:16:50] a lot of money on marketing. Of course you can. You can make a massive mistake and ruin it all. [00:16:55] I hear what? I hear what you’re saying. Where were you in 2008?

Zohaib Ali: I was in my last [00:17:00] year of university. Yeah. And it was a hard time to qualify.

Payman Langroudi: 2008 was [00:17:05] where it was a proper recession, by the way. It could still happen. [00:17:10] It could still happen.

Zohaib Ali: No, I mean, I qualified in oh nine.

Payman Langroudi: Yeah. So a difficult time in [00:17:15] Ireland. The thing that dried up the most was, was finance. Yes. Yeah. And you [00:17:20] mean.

Zohaib Ali: Like, easy to access finance? Cheap finance?

Payman Langroudi: Yeah. For patients. Patient finance? Yes. Yes. And where [00:17:25] I think I agree with you is if, if your practice is based on patient finance for [00:17:30] Invisalign and cosmetics and that, you know, the way you’re characterising it is Instagram. [00:17:35] Yeah, but but if patient finance is a big part of your practice, then what [00:17:40] I would do now is to rejig the situation a little bit, maybe offer [00:17:45] patients to pay as they go rather than have to be approved for finance. Um, [00:17:50] because it’s you know, I talk to lots of dentists and, and finance is a big part [00:17:55] of some practices. It’s massive outlook. Right. And you [00:18:00] know, when you say luxury items you’re a luxury item, right?

Zohaib Ali: Yes [00:18:05] and no. Yes and no. Um, I [00:18:10] have two major groups of patients. I have sort [00:18:15] of, you know, I work in a in a rural part of the country just north of Preston. That’s my mainstay [00:18:20] and a little town called Garstang. It’s called Garstang Dental Referral Practice, and it’s a very wellness practice. [00:18:25] Very well known referral practice. And we get patients travelling hours to So we’re blessed [00:18:30] that way. And I mean blessed.

Payman Langroudi: So that’s Finley Sutton. [00:18:35]

Zohaib Ali: That’s Finley Sutton. Yeah. He set up the practice 15 odd years ago. Something like that. Um, and [00:18:40] he just does the removals, and I do the implants and the fixed bras and and some removals as well. [00:18:45] Now, most of our patients, I would say I don’t have the numbers, but [00:18:50] I would say 99% of our patients are referral patients. Um, there’s maybe [00:18:55] half a percent or a word or maybe 1 or 2% or word of mouth, and 1 or 2 are [00:19:00] just direct access. They don’t know who we are. They don’t know the reputation. They just called up. Now, out of all [00:19:05] my patients, the majority of them need actual rehabilitations. [00:19:10] They have had failed dentistry or neglected dentitions [00:19:15] supervised neglect, whatever you want to call it. They are in need of major overhauls. [00:19:20] For me, that’s not a luxury for me to do it. You can argue [00:19:25] for me to do it for them might be a luxury. Yeah, maybe they can find someone cheaper. Yeah. [00:19:30] Um, to to do to do it to a lesser standard. I don’t want to even [00:19:35] say lesser standard, but, you know, spend less time on it. Maybe the aesthetics aren’t quite as good or things aren’t [00:19:40] quite as refined. So that element of it, you could argue, is a luxury. But [00:19:45] if I try and find dentists within a 50 mile [00:19:50] radius or 25 mile radius of where I work, who can provide what I [00:19:55] can provide, not to the same aesthetic level, even to the same functional level. [00:20:00]

Zohaib Ali: I think you’d be hard to find people there aren’t. And that’s not an arrogance thing. I think [00:20:05] it’s just I think that’s a reflection based on how far the patients travel to come [00:20:10] and see us. I don’t think it’s I don’t think that that in itself is a luxury, that I think [00:20:15] that skill level doesn’t exist or that knowledge, it doesn’t exist. Um, so, [00:20:20] yes, in some ways you can [00:20:25] argue that, but there’s a real need, and I think it’s only once you’re in that position [00:20:30] those patients are in that position. They understand that dentistry done really well is not [00:20:35] a luxury. It just isn’t. It’s a basic need for life, for basic quality of life. [00:20:40] And if you look, if you look quite simply at the World Health Organisation definition [00:20:45] of health, it includes mental health. Okay. Now dentistry falls within [00:20:50] physical health. But let me ask you a question. And you know, if you lose your front tooth, [00:20:55] if you walk outside of here and you fall down the stairs and you knock your front tooth out. Yeah, okay. [00:21:00] It’s traumatic. It’s sore. You can you can get a tooth, but it might take you six months, 12 [00:21:05] months to have a final definitive restoration in place. How are you going to feel [00:21:10] for those 12 months without a front tooth?

Payman Langroudi: Well, I have something right.

Zohaib Ali: Yeah, but probably [00:21:15] it will look pretty. Shit.

Payman Langroudi: Well, it depends what I do, right?

Zohaib Ali: It depends [00:21:20] on who you see. It depends on who you see. But how would you feel now? Now, now, let’s blow that up [00:21:25] by six. You’re missing six teeth. Or you’ve got loose teeth, or you’ve got horrible [00:21:30] recession and you’ve got visible margins and all that kind of stuff. How does that impact [00:21:35] you in your life?

Payman Langroudi: Listen, you don’t need to convince me that dentistry is health.

Zohaib Ali: I know I’m not trying to convince you that [00:21:40] what I’m. What I’m saying is that that it has a massive impact on the psychological well-being of [00:21:45] patients as well.

Payman Langroudi: Yeah. I’m sure, I’m sure you don’t need to convince me of that either. 100% agree with that. [00:21:50] Okay. Um, how do you end up in Manchester [00:21:55] or Preston or Bolton or. God. God. God. Garstang. [00:22:00] Garstang. Garstang. Because you guys grew up in Saudi?

Zohaib Ali: Partly, [00:22:05] yes. So born in Saudi? No. Born in Pakistan? Yeah. Spent some time in Ireland. [00:22:10] Spent some time in the Middle East and Saudi, which is where the accent comes from. I was speaking to one [00:22:15] of your American schools. Yes, well, we went to a British school, actually, but all of our friends in the compound, [00:22:20] everyone lives in compounds. Or they used to. Yeah, yeah, yeah. They all went to the American school, so we soaked that up heavily. And then we [00:22:25] moved to Ireland, which is a pretty neutral accent overall. You didn’t pick that. We don’t all say 33. [00:22:30] You know, that’s you know, we’re not all chasing rainbows and but it’s a relatively [00:22:35] neutral accent. So we soak some of that up and.

Payman Langroudi: Studied dentistry in Ireland, in Ireland, in Ireland. Both of you. Yes. [00:22:40]

Zohaib Ali: Both of us in separate universities. So I was in Dublin because I was a little bit more clever [00:22:45] than my brother. So I got into it and he was in Cork. They were both excellent schools. Yeah. And I mean [00:22:50] excellent. When I look at where I was when I qualified, compared to the average, [00:22:55] uh, graduate, even in Europe, even in England, I [00:23:00] think we were miles ahead and we were again, just blessed. And, I mean, I [00:23:05] went there because that was a school down the road. Yeah. And I got the grades to get in. It [00:23:10] was as simple. That’s the only reason I went there. And it was cheaper to go there than it was to go anywhere else. Yeah, they were my reasons. [00:23:15] But we had international students coming from abroad saying, this is one of the best schools that we could identify [00:23:20] internationally. So we were really, really lucky. Um, but, [00:23:25] you know, going back to 2008, which is when the global financial crisis hit, I graduated [00:23:30] the following year in 2009. And in Ireland, all of dentistry virtually is private. [00:23:35] There is a small equivalent NHS element, but it’s virtually private.

Payman Langroudi: And [00:23:40] and Ireland suffered more than most countries.

Zohaib Ali: There were suicides and everything over there were massive, [00:23:45] massive problems over there. It really, really suffered. It’s doing okay now, but at the time it was tough, [00:23:50] which meant that there were no jobs for new graduates because people didn’t have the money to spend [00:23:55] on private dentistry. I did a year of and then Hisham had already moved over to Manchester, um, [00:24:00] with my mother. And so it was seemed like the natural thing to do was go to the UK, [00:24:05] have a stable income. Why Manchester for a couple? I don’t know why I chose Manchester, he just did. I [00:24:10] think maybe, I don’t know. I think we had a family friend that was already in Manchester and [00:24:15] that seemed like, well, I know someone there as well. I mean, it’s like we’re talking about the 60s when like [00:24:20] people emigrated for the 50s or 40s when people emigrated from Pakistan, India to England. Well, let’s [00:24:25] just all go to Bradford or whatever. We’ll set up mills there. Yeah, yeah, yeah. You know, it’s [00:24:30] almost that mentality all over again. It’s weird.

Payman Langroudi: How many years did you work as a regular dentist [00:24:35] before you thought, I’m going to specialise?

Zohaib Ali: I didn’t. I had [00:24:40] specialised specialisation in my mind from the day I started dentistry. Yeah. I’m sure. Um, [00:24:45] because. Because that that thought process that was, that was ingratiated into us. Yeah. But, [00:24:50] um, so you didn’t work.

Payman Langroudi: You went straight into a specialist.

Zohaib Ali: No, no, I didn’t, I wanted to, but but [00:24:55] the thought of of going into speciality training was, was it was always there. It was just a cloud hanging over you. You knew that you had to do [00:25:00] it. Um, so anyway, when we moved to the UK, I found this job, um, in [00:25:05] Stockport. I don’t mind, my boss will know and [00:25:10] I don’t mind divulging a little bit. And, um, I spent two years there, and it was [00:25:15] hard. It was a difficult crowd, a difficult patient base. [00:25:20] Was it NHS? Oh, almost. Almost 100% NHS. I [00:25:25] wasn’t getting paid. Let’s say a very favourable UDA rate. Um, the [00:25:30] patients were non-cooperative. And I think, quite frankly, looking back on my time there, I was [00:25:35] physically I think I was actually depressed. Um, and I think if I’d seen a psychiatrist [00:25:40] at that stage, they would have actually diagnosed me with depression. But I didn’t have that awareness. I graduated when I was [00:25:45] 22 and I was a qualified dentist, you know, licensed to do whatever. I didn’t have the maturity [00:25:50] to understand what I was going through at that time. And I still remember thinking back now, some days [00:25:55] I would head out the back of the practice with the car park was and I had an old Honda Civic hand-me-down [00:26:00] and it was really clunky door on it. But I remember that the that that sound [00:26:05] the door used to make when I closed, when I closed it, it was like a switch would go off in my head where I would just [00:26:10] disconnect from everything that had happened during the day and just go home and try and have a nice evening.

Zohaib Ali: But [00:26:15] I think I was actually depressed about about my work situation, about my patience, about my [00:26:20] finances. Um, and, you know, this was 15 years ago. I [00:26:25] think people are a lot more open to talking about this stuff now. And mental health is a much [00:26:30] more important issue now. Yeah, thankfully. But back then there was really nothing. Nobody [00:26:35] talked about it and you were just left to your own devices with with your nurse or dealing with business [00:26:40] side of things, dealing with your principal. There was no real support. Yeah, I moved to the UK. We didn’t. I didn’t know [00:26:45] anybody other than my brother, but didn’t know anyone. So not having that support, not having [00:26:50] a business mentor, not having a clinical mentor, a, you know, a life mentor, [00:26:55] let’s say a much older brother or anybody like that. It was difficult for sure, [00:27:00] and I needed a way out. I literally just needed a way out. So I jumped into doing Max factor for [00:27:05] a year, did show max factor for a year. Convinced myself. Right. Tough but [00:27:10] awesome.

Payman Langroudi: You liked it.

Zohaib Ali: Oh, what a time, what a time. Honestly, I’d still [00:27:15] recommend people. And you know what makes a.

Payman Langroudi: Man of you? Makes a man of you. That’s it. Was that in Manchester? [00:27:20] Manchester.

Zohaib Ali: And to anyone, any young dentist who’s listening, don’t. Don’t do it in central [00:27:25] London. Don’t do a max job in in a big, massive central hospital. [00:27:30] In a big teaching hospital. Go and do it in the outskirts somewhere where you get your hands dirty. You take out [00:27:35] teeth. You’ll do surgeries. Go and do it somewhere like that. Because it really. Especially now, if you’re graduating [00:27:40] with with almost zero exposure to surgical stuff, it you know, it would, [00:27:45] it would, it would really.

Payman Langroudi: Take teeth out for sure. Yeah.

Zohaib Ali: Yeah. Take teeth out. But [00:27:50] you know what? It gave me a perspective on life. You know, you would see we would see [00:27:55] drug dealers coming in with after machete attacks and slashes on their face, hands [00:28:00] cut lacerations with the least, least or least of their problems. Atas [00:28:05] atas, you know, cancer, cancer operations, life [00:28:10] changing stuff, really. And it makes you, you know, it really put a perspective on dentistry as a whole that [00:28:15] there’s a much bigger world out there. Yeah. And, you know, we’re not really going to kill people in dentistry. It’s very difficult [00:28:20] to kill someone doing dentistry. It’s possible, but you’d have to really be trying. Um, [00:28:25] did you did you.

Payman Langroudi: Think maybe I want to go into Max first?

Zohaib Ali: Yeah, I did. I did.

Payman Langroudi: So do [00:28:30] medicine and all of that as well I did.

Zohaib Ali: Yeah, I did a ukcat. I remember finishing an on call, [00:28:35] and I decided very late in the day that I wanted to to do Max FACs. [00:28:40] Um, I put my, my application in and I went to the Ukcat. I booked it really late. So it was the last [00:28:45] possible day that I could do it, and it was the morning after I’d finished a week of of on call nights. [00:28:50] So I finished in Manchester. I drove to Huddersfield.

Payman Langroudi: I’m getting PTSD, just listening, listening [00:28:55] to it, you.

Zohaib Ali: Know, drove an hour and a half or whatever it was to Huddersfield at some ukcat [00:29:00] centre after doing God knows how many hours at the hospital did my ukcat drove home. [00:29:05] Um, and then decided after all that, actually, it probably wasn’t for me. [00:29:10]

Payman Langroudi: Um, something some some bit of sanity clicked into you, you know?

Zohaib Ali: You [00:29:15] know, have you read, have you read? Um, there’s a famous book by by Paulo [00:29:20] Coelho, the alchemist. The alchemist? Yeah. The name. That’s my favourite book.

Payman Langroudi: It wasn’t [00:29:25] in your fate or something. Is that what you mean?

Zohaib Ali: I think I think what I learned. Have you. Have you read the book? Yeah. So, [00:29:30] you know, it’s been translated into a hundred different languages or whatever. Phenomenal book. And what I got [00:29:35] from that book was just following the path of least resistance, or following the door [00:29:40] that opens to you that thing, um, and being aware of. Well, that just seems, [00:29:45] you know, that route seems really hard right now. That seems like a really difficult mountain to climb. And that [00:29:50] seems like an easier road. Maybe I should go that way. And at that time, going [00:29:55] into back into medicine would have put huge physical strain on me moving house, [00:30:00] relocating again, financial pressures and all that stuff. I was looking after we were looking after [00:30:05] both my brother and I. We were looking after my mum as well. She’s not well. Um. No, no, she [00:30:10] was well, but we’d gone through. Yeah, we’d gone through a family. Family Break-Up. [00:30:15] And, uh, financially, we were completely self reliant.

Payman Langroudi: Was that. [00:30:20]

Zohaib Ali: Uh, these things, unfortunately, tend to drag out for many years. [00:30:25] Um. But what how.

Payman Langroudi: Old were you when when your dad actually left? Um. [00:30:30]

Zohaib Ali: He didn’t. Oh. He stayed. He didn’t. We left, uh, at the point of graduating. [00:30:35] So at the.

Payman Langroudi: Point of graduating.

Zohaib Ali: Yeah. I mean, literally a week, a few weeks later, that [00:30:40] was it. So we just cut the cord at that stage. Um, but these things drag on for years. [00:30:45] Yeah. And it means unhappy houses, unhappy families, you know, all kinds [00:30:50] of all kinds of issues. And they stay with you and you don’t realise for many, many years [00:30:55] until you start making the same mistakes in your own life. Mhm. Um, and I’m [00:31:00] very open about this stuff now. I have a therapist that I see on and off for the last seven years. [00:31:05] Um, and I don’t have.

Payman Langroudi: Does it.

Zohaib Ali: Help you? Massively. It’s just a reminder of, [00:31:10] you know, I went a couple of years recently and I didn’t really speak to him at all because I [00:31:15] thought, I’m doing okay. And then actually, just a few weeks ago, I gave him a call and made him made another appointment. [00:31:20] And it just reminded me of all the little things I’ve learned over the years of therapy, [00:31:25] of managing my own psychology and the people around me and how I behave and self-awareness, all these things [00:31:30] that actually come from good parenting. When you’re a [00:31:35] child, being in a stable, happy environment, they just come through [00:31:40] that. And if you don’t have that, you’re going to struggle later on in life at some point. At some point [00:31:45] it will affect you and hopefully for other people listening, if they’ve been through that, go and speak to someone. [00:31:50] It’s so easy these days. You can do it online. I started it when I was in London when [00:31:55] I was doing my speciality training, because that was hard. That was really especially training is not easy for anyone who’s [00:32:00] done it. They’ll tell you it’s one of the hardest things they’ve done. Yeah.

Payman Langroudi: Did you have in your head some [00:32:05] sort of taboo around therapy and [00:32:10] no at all. No. So many people do. Right? Yeah. So you never [00:32:15] had that problem? No.

Zohaib Ali: So the reason I didn’t do it is because I didn’t know what the fuck I [00:32:20] was doing. Yeah. I didn’t realise I was walking around, you know, burning bridges and [00:32:25] pissing people off left, right and centre. I had no idea that I was doing it. Mhm. It’s that self-awareness. [00:32:30] Mhm. Uh, and actually sometimes you have to go through a really, really rocky [00:32:35] patch to realise, um, to.

Payman Langroudi: Recognise the pattern.

Zohaib Ali: Right here. [00:32:40] Yeah. Um, and you know sometimes that means hurting yourself or others around you where you realise, [00:32:45] okay, something’s not quite adding. There’s something amiss here. Someone will just tell you, hopefully [00:32:50] you love them. They’ll tell you, listen, you need help, and then you have to be open to it and recognise that actually, I’m going [00:32:55] to need some help here. Um. And. Yeah, so I still.

Payman Langroudi: And what about talking [00:33:00] about. I mean, you seem to be talking about it without any problems. Did you have any issue in your head about that? [00:33:05] Did you openly tell everyone you were in therapy or did you not?

Zohaib Ali: No, I didn’t, I didn’t. [00:33:10] Um, but now you are.

Payman Langroudi: So yeah, I mean, if someone over that even.

Zohaib Ali: 100%, if someone wants [00:33:15] to ask me about it or if it comes up in a conversation, I wouldn’t shy away from it. Yeah. At the time when [00:33:20] you’re going through a really difficult period, you know, if you’re let’s say you’re in a [00:33:25] workspace and you’re having a reasonably good day, the last thing you want to do is talk about the shit parts of your life. You just want to [00:33:30] get through it and have a good day. I think the.

Payman Langroudi: Interesting difference between the US and here [00:33:35] regarding I mean, it’s changing very quickly, right. But regarding therapists, it’s almost like a, [00:33:40] like a badge of honour having a therapist. It’s it’s almost like, you know, I can afford a therapist. [00:33:45] Yeah. Like, why wouldn’t I? Yeah. Or like a private private trainer in the gym [00:33:50] or something. You know, they they see it that way.

Zohaib Ali: It’s good.

Payman Langroudi: It’s the right way to look at [00:33:55] it.

Zohaib Ali: I don’t think, you know, I don’t think personal training. You know, [00:34:00] I think everyone who needs it or feels like they might benefit benefit [00:34:05] from it should do it. I don’t think it should become a fad. You know that. Oh, I’ll go see my therapist [00:34:10] or I had an appointment with my therapist. I don’t think it should become one of those things. That’s a status symbol, because [00:34:15] it’s a serious thing, you know? Yeah, yeah. I think if anybody has a slight inkling [00:34:20] that that they may benefit from, from that kind of approach, just [00:34:25] do it. It’s not it’s not that expensive. Um, you know, just.

Payman Langroudi: To to give you a Dental [00:34:30] example of that thing that you’re talking about here is in cosmetic dentistry, you [00:34:35] get some people who they might, you might me, and you might look at their [00:34:40] smile and say, that’s a six out of ten smile. Um, and [00:34:45] fixing that for them in a way, from the cosmetic perspective [00:34:50] is easy. Yes. And then sometimes you get a eight and a half out of ten in [00:34:55] central London. Yes. Who wants to be an 11 out of ten? Yeah. Yeah. Um, that’s [00:35:00] a much harder fix from the from the Dental perspective. Yes. So [00:35:05] therapy is similar in the sense that some people go to the therapist for optimisation. [00:35:10] Mhm. Yeah. And so yes it’s a serious thing but but it’s optimisation. [00:35:15] Yes. Thereafter you know it’s like I don’t know CEO training or something like [00:35:20] that.

Zohaib Ali: That’s awesome.

Payman Langroudi: I think it’s a good way of looking at it because, because to get over the taboo [00:35:25] of therapy, which you’ve clearly gotten over, is to think of all those people who go purely [00:35:30] to be the best they can be, like, they’ve got no problem at all. Not like a want rather than a need, you know? Yeah. [00:35:35]

Zohaib Ali: That’s awesome. I mean, if you’re in that echelon of society. Yeah. That that, [00:35:40] you know, you’re performing so well and you just want more. You’re, you know, you’re floating through your [00:35:45] day. You’re, you know, you’re the type. You’re not even touching the ground.

Payman Langroudi: Yeah. Right. I mean, it’s the same. It’s [00:35:50] the same with braces, braces, braces. Although yeah, in the US, the kids kind of feel like [00:35:55] it’s a badge of honour. Yeah. Yeah. Here. Still, we’re not there. I think.

Zohaib Ali: I think now it’s okay. [00:36:00] When I think when I was growing up, it probably you still wanted to try and avoid it. It [00:36:05] was still a bit of a thing, but it was it was, it was getting to that stage of being, let’s say, more acceptable. [00:36:10] Yeah. Now you’ve got 5060 year olds with fixed appliances. Yeah. I don’t think it’s [00:36:15] a problem at all anymore. Um, and but on that, on that point [00:36:20] of, let’s say someone comes to you with an eight out of ten smile. Yeah. I think it’s [00:36:25] okay if they want to go to ten out of ten. But I think what we’re seeing now is [00:36:30] lots of people who are sevens eights out of ten, which is a very crude way of looking at it. But, [00:36:35] you know, objectively, you can objectify it and actually almost put a value on it. Yeah. But [00:36:40] I think what we’re seeing is a wave of dentistry now, which is overkill. [00:36:45] And, and I mean, you know, extreme level of, of composite bonding and [00:36:50] that kind of thing that we’re seeing now is, is going above [00:36:55] and beyond just trying to take someone from an eight to a ten.

Payman Langroudi: What is it then?

Zohaib Ali: I think [00:37:00] patients need more counselling. And let me let me put this. Let me put it from a different angle. [00:37:05] I used to do a lot of injectables, Botox, fillers. I used to teach you. Yeah. Massive [00:37:10] amount. It used to be a third of my week. Really? Yeah. Yeah. And a significant portion [00:37:15] of my income.

Payman Langroudi: After you became a specialist.

Zohaib Ali: Before I became a specialist. Okay. You see, more sense. [00:37:20] Makes more sense. No. And, um, and, you [00:37:25] know.

Payman Langroudi: As in the body dysmorphia kind of kind of reason people want to solve their problem. Life problems [00:37:30] with an injectable.

Zohaib Ali: Yeah. I mean, that’s one element of it, but another element is is [00:37:35] actually, again, it goes back to keeping your patients interests at [00:37:40] heart. And it’s one of the reasons they say you should never treat or inject yourself. Because how you see yourself Payman is [00:37:45] different to how I see you. Yeah. Okay. And what you think is a flaw and you keep working on. Maybe [00:37:50] nobody else even notices it. So if you come and see me, or if you went and see to see anybody [00:37:55] for for injectable treatment or facial aesthetic work, they should be able to give you an [00:38:00] honest and objective assessment of what they think you would actually benefit from, as opposed to what [00:38:05] you want. And that comes down to it’s really important. I hear.

Payman Langroudi: You, but I [00:38:10] kind of disagree as well because.

Zohaib Ali: Because asking the patient what [00:38:15] they want to achieve rather than what treatment would you like, is [00:38:20] the crux of this. And it’s the same in dentistry. You know, a patient comes, oh, I want bonding [00:38:25] 5 to 510 teeth. Okay. Slow down, slow down. What [00:38:30] do you what are you hoping to achieve? What? You know why that those those questions of why do you want [00:38:35] to, you know, have you heard those five whys or four wives or whatever they are? Five. Yeah. Five whys. Keep saying why until [00:38:40] you get down to the crux of it. Because I’m I’m actually lucky I don’t get those patients. [00:38:45] I don’t want those patients because it’s too it’s too it’s too taxing for me. But I see a lot [00:38:50] of the work and I see a lot of it at point of failure. And when you [00:38:55] strip all the composite back and you get back to the natural enamel, you think, why [00:39:00] was this ever done in the first place? They needed one one tenth of this level of treatment to [00:39:05] achieve an optimum result.

Payman Langroudi: But look, of course it makes a lot of sense what [00:39:10] you’re saying. Of course I understand that. Yes, of course I understand it. But you know the famous [00:39:15] daughter test? Yes. For anyone who doesn’t know. I mean, everyone knows about daughter test, right? [00:39:20] Only treat the patient the way you would treat your daughter. Yes. Yeah. I’m a little bit uncomfortable [00:39:25] with it. Okay. Insomuch as it’s not my choice. [00:39:30] It’s my daughter’s choice. Mhm. What she wants to do. Yes. Yeah. So [00:39:35] this thing about I would only treat my daughter this way. It goes back to that old [00:39:40] way of being a doctor, where the doctor knows best and tells you what’s what. And [00:39:45] I know in practice things are different in theory. Yeah. But in theory [00:39:50] you’ve consented this. This patient has, has has informed [00:39:55] consent before you went ahead with whatever you did in theory. I know often [00:40:00] that’s a blurry line, but let’s just talk theory. Okay. So in theory, this this [00:40:05] this this composite that you stripped off.

Zohaib Ali: Yes.

Payman Langroudi: The dentist told the patient it would only [00:40:10] last however long it lasted. Yeah. Let’s just talk in theory for a moment. Um, he told him how long it would [00:40:15] last. He told him what to expect. And the patient with [00:40:20] that information decided to go ahead. Mhm. Yeah. Mhm. Now [00:40:25] I get what you’re saying. That’s not always the way it works out. Yeah. But, but it’s important to bear [00:40:30] that in mind. Right. What the patient’s thinks looks good is [00:40:35] the important question not what you think looks good. Yeah. So if the patient comes to me and says, I want my teeth to be four [00:40:40] shades whiter than B1. Yeah. Yeah. Yeah. That’s what he wants. Yeah. I [00:40:45] can say I wouldn’t want that for me. Mhm. But if he wants that for [00:40:50] himself. Yeah. And the reason is, look what you want for you or what you would do to your daughter is different to [00:40:55] what I want for my daughter. So these are all different positions anyway, right?

Zohaib Ali: I [00:41:00] agree with you. I agree that, you know, the patient has their right to autonomy. Yeah, totally.

Payman Langroudi: Agency [00:41:05] sort of thing.

Zohaib Ali: Totally agree with that. My problem is, [00:41:10] is twofold. One, I don’t believe that these patients are being consented. Agree. Fully [00:41:15] agree. I don’t agree, you know. No, I.

Payman Langroudi: Agree with you. Patients? Definitely not every time. Right.

Zohaib Ali: No way. A [00:41:20] patients come to me thinking that composite work is reversible, number one. And it just isn’t. It just [00:41:25] is not. You can’t etch a tooth and call it reversible. You just can’t. Never mind removing loads of old [00:41:30] composite. Etching isn’t a reversible process. It’s not. Etching is not a bluff. Okay, [00:41:35] okay. You can remineralize the teeth. Yeah. Fair enough. Okay. But as soon as you put a soft flex disc on something, [00:41:40] you’re trying to remove old composite. It’s not a reversible process. It just isn’t. Okay. [00:41:45] Um, number one. Number two. Have you told the patient how much it’s going to cost to remove [00:41:50] that composite in 3 or 4 years time? Have you considered them for that? Because they’re just going to think I’ll [00:41:55] pay another 2 or 3 grand in another 4 or 5 years. But it’s not. It’s going to be double because the time to remove that [00:42:00] composite.

Payman Langroudi: That’s a good point is huge.

Zohaib Ali: It’s massive. Um, [00:42:05] the third thing is that have you told them that [00:42:10] by doing this composite later on, it is going to damage [00:42:15] their teeth to remove it? Have you told them that? How many dentists say that?

Payman Langroudi: Your [00:42:20] first point, right? Yeah.

Zohaib Ali: As in.

Payman Langroudi: The non-reversible.

Zohaib Ali: Non-reversible is different is [00:42:25] different to actually, it’s going to damage my teeth if I want to get rid of it. There’s a difference there, you [00:42:30] know. Non-reversible. What patients think if I don’t like it, I can just strip it off. No, you can’t [00:42:35] quite strip it off. But we can get you very close to where you were. That’s still different to. Actually, I have [00:42:40] to damage your enamel to get all this composite off, you know. Our patient’s aware of that. I don’t [00:42:45] I don’t think they are. Because my patients, they definitely are not. They come to me expecting [00:42:50] it to be a reversible procedure. And I tell them it’s not. It’s not going to be. And it all goes [00:42:55] back to, you know, trying to keep in what’s naturally, naturally there and trying [00:43:00] to prolong the patient’s dentition and do as little invasion as possible [00:43:05] for maximum longevity. So if you’re going to treat patients in that way, [00:43:10] how does that fit in with, with with our ethos of [00:43:15] minimal invasion, maximum longevity. It’s just it [00:43:20] doesn’t quite work. Do you see do you see how I’m coming, where I’m [00:43:25] coming from I.

Payman Langroudi: Understand that, but.

Zohaib Ali: So so and so and so and so in dentistry, if we if you look [00:43:30] at it at an industry level or at a profession wide level, yeah, if we don’t start [00:43:35] consenting our patients and speaking to them in terms of health rather [00:43:40] than commerce and patient finance, we’re never going to change our [00:43:45] position in society, which is look at that dentist driving their Ferrari. And [00:43:50] again, speaking about Bisimulation, which is where we started this conversation, doing [00:43:55] what’s best for your patients. Excuse me. Doing what’s best for your patients [00:44:00] and having their core interests at heart at all times. I think we would [00:44:05] see a lot less bonding than we see today if everyone [00:44:10] had those frank conversations. Invisalign, which is the other, the other part of that. I [00:44:15] have no problem with aligning people’s teeth. Put them in a stable position.

Payman Langroudi: Well, you know, don’t [00:44:20] don’t pretend there’s no complications to orthodontics.

Zohaib Ali: Of course there is.

Payman Langroudi: And don’t pretend. Don’t [00:44:25] pretend like a lot of dentists do. Yeah. That orthodontics is mainly a health based, um, [00:44:30] treatment. Yeah, I see. I see Invisalign being sold as a health treatment. [00:44:35] I know much more than it should be. I would call it. Of course. Depends [00:44:40] what you’re doing. Yes. But. But I would call it 80% aesthetics. 20%. I mean, you would never [00:44:45] take the risks you take with orthodontics purely to fix [00:44:50] the occlusion.

Zohaib Ali: No, I don’t think orthodontists worry that much about occlusion or that [00:44:55] risks are huge. It’s huge. Orthodontics is primarily aesthetics. Let’s put it that way. [00:45:00] Yeah.

Payman Langroudi: So, like, it’s a funny thing. You know, orthodontics is a branch of dentistry and [00:45:05] has all the hierarchies of dentistry and so forth. So somehow it’s a it’s a [00:45:10] more sort of acceptable thing to take a child and a child and [00:45:15] mess with the growth of his jaws and put wires on and stick things [00:45:20] to it. Let’s face it, mainly for the way that that child’s going to look. Look. Yes, yes, [00:45:25] that’s somehow acceptable. Um, but cosmetic dentistry for an adult [00:45:30] who comes in and says, hey, I’d like things to look better, that’s somehow less acceptable. You know, and [00:45:35] we know the reasons why, right? We know the reasons why. But but we have to also kind of process [00:45:40] That fact that much of what we believe [00:45:45] was taught to us in uni. So. So where I think of it is around [00:45:50] fluoride. Yeah. Today. Yeah. There’s a big [00:45:55] bit of evidence coming out here that says hydroxyapatite toothpaste is as effective as fluoride toothpaste. [00:46:00] Yeah. As effective. Yeah. Um, we brought out hydroxyapatite [00:46:05] toothpaste, I think, 14 years ago. Yeah. And we, when we were [00:46:10] talking to the chemists here, they were like, putting fluoride into this will make your life a hundred times [00:46:15] harder, because fluoride and hydroxyapatite like to become fluorapatite. And applying fluorapatite [00:46:20] to your teeth isn’t as useful as applying fluoride or hydroxyapatite. So [00:46:25] you only have to get a nano version of it. Have A22 walled tube like [00:46:30] massive nightmare. Yeah. Only because we couldn’t put something out to the dental profession [00:46:35] and say it doesn’t have fluoride in it. Yeah. 14 years later. Now. Oh, I don’t know. [00:46:40] I get it accepted.

Zohaib Ali: I get it, but I mean, I think that’s [00:46:45] slightly different. Okay. When when you look at child orthodontics versus adult cosmetic work [00:46:50] non-reversible, they’re both irreversible. Okay. A child is going to go through that treatment. [00:46:55] Okay. It’s going to take a couple of years or however long it takes. They may even lose some teeth if it’s an [00:47:00] extraction case. And a lot of them are you are going to you are going to modify their growth [00:47:05] through functional appliances. They are then going to wear retainers for the rest of their life, or that’s that’s [00:47:10] what they should do. And we know that now we didn’t 25 years ago, but we know now retention for life. [00:47:15] They’re going to see that benefit for the rest of their life. And there will [00:47:20] be no comeback from that as long as they as long as they comply [00:47:25] with your retention protocols. So you wear your retainers, your teeth are going to stay where [00:47:30] they are. Please keep enjoying this smile for the rest of your life. Thank you very much. You’re welcome. That [00:47:35] is a completely different ball game To not consenting a patient [00:47:40] fully not being completely honest about what’s going to happen to their teeth when the composite fails in three, four, five years [00:47:45] time, it all stains and then having to repeat that. I accept that every few [00:47:50] years for the rest of your life. If you want to maintain that, I accept that it’s a so I don’t think it’s quite [00:47:55] it’s not the same. You can’t compare them and say, well, why is that always? Why is one okay in the child’s case but [00:48:00] not okay in the adults? It’s about the conversation that’s had with these patients. Look, [00:48:05] I went to a previous employer a few years ago when I was looking for some work and, um, [00:48:10] they said, oh, we have got these we’ve got these composite cases coming in, but [00:48:15] you can’t charge what you charge. Why? Well, we only charge [00:48:20] whatever.

Payman Langroudi: The price is too high.

Zohaib Ali: Yeah, you’re. They said so. You know what? You charge is just too much. I said, well, [00:48:25] I spend this much time. How much time do you spend doing your work? And there’s a fifth of the time. And I said, well, actually, you’re [00:48:30] making more money per hour than I am, you know, and we had you mentioned this at the start. The more care [00:48:35] you take, it seemed like the less money you make. And there is some truth in that. Um, and [00:48:40] I didn’t end up taking the job because they wanted me to work in a very particular way, [00:48:45] seeing volume. And I said, well, why do you want to work this way? Because it’s only going to last a [00:48:50] couple of years and see those, you know, those incisal edges that you squared off and now you’ve got [00:48:55] lovely square teeth. They’re going to be the first bits that fracture. And she said, well our patients [00:49:00] you know, they’re happy if it lasts a couple of years. Mhm. And I thought [00:49:05] what other realm of, of your life or [00:49:10] in any industry, in any part or in any facet of our life, are we happy [00:49:15] when our dentist tells us you can, you can do it this way, but only last a couple of years.

Zohaib Ali: If [00:49:20] you do it the other way, it will last much longer, have a better polish, better aesthetics. Et cetera, [00:49:25] et cetera, et cetera. So I think we are to blame as a profession for thinking that, [00:49:30] you know, trying to run our businesses in a way which is based out of pure volume. I think it’s our own fault [00:49:35] as an industry. It’s not the patient’s fault. We’re not educating them properly. We’re not speaking to them in the right [00:49:40] terms. We’re just speaking to them about about really. [00:49:45] We’re letting we’re letting customers and the media and social media [00:49:50] influence us as a profession rather than us taking, taking, [00:49:55] taking it by the scruff of the neck and saying, this is where we want to position dentistry in [00:50:00] the UK and this is how we see ourselves as a profession. I think that’s a much, much bigger problem [00:50:05] than patients asking for certain things or, you know, [00:50:10] the pressures of American influence or whatever. In America, they don’t do things this way. Well, number one, they just [00:50:15] do ceramics. So things actually last much longer. Yeah, because they’re more durable. It’s as simple as that. Um, [00:50:20] yeah.

Payman Langroudi: Our partner, our suppliers for our composites in the US, they, [00:50:25] they pretty much, um, pioneered composite bonding. Um, [00:50:30] and, you know, back in the late 60s. Yeah. So, [00:50:35] um, even even though that’s the case, that a lot of the [00:50:40] times when they use it, they use it as a transitional. Yes. Thing. Yeah. Now, all of that [00:50:45] said, you’re very involved with injection moulding. Yes. And with Costas. Yeah. And, [00:50:50] um, that’s composite bonding, right? It is. Um.

Zohaib Ali: It is.

Payman Langroudi: Absolutely. And I take [00:50:55] my hat off to both of you. Uh, you know, he’s more the developer than you are or. [00:51:00] But you both. You’ve done bits together. Right.

Zohaib Ali: Well, it’s been a for me personally. [00:51:05] It’s been it’s been a bit of a journey. And I first started using clear stents, [00:51:10] which is how injection moulding works. You know, you have a clear stent that you inject. Um, in [00:51:15] 2017. Um, that was my first case before injectable [00:51:20] resins were actually available on the market. We didn’t have injectable resins back then. Yeah. Um, [00:51:25] at least not available to me. And, you know, my first case of, let’s [00:51:30] say, using a clear stent was getting regular paste composite out of a computer and a composite [00:51:35] gun, and fitting it inside a stent and doing it tooth by tooth, and just [00:51:40] heating it and placing it into the mouth. That was my first go at it in 2017, [00:51:45] and that was in private practice and a practice in London. Um, well.

Payman Langroudi: Off [00:51:50] your own back. Off my own back.

Zohaib Ali: Yeah. In 2017, this was when I.

Payman Langroudi: Had you not seen someone else do that? [00:51:55]

Zohaib Ali: Listen, people have been doing this for 25 years. Let’s not pretend that that using a clear [00:52:00] stent or some sort of clear matrix plus composite inside it is a new [00:52:05] concept. It’s not a new concept. You can go on YouTube and find a video from 99 2001. [00:52:10] Yeah, yeah. It’s not a new concept. No, what’s changed is the materials we have available [00:52:15] to us. So at the end of 2017 and I never did it again, I have the photos for [00:52:20] it. I can show them to you. And in fact, in fact, in fact in fact, I we teach it. I use those [00:52:25] photographs on our tooth pro course to show to show to people. Um, so [00:52:30] that was my that was the first iteration of it. And the reason I did that off my own back was [00:52:35] because I was aware that it can be done. Um, I was in the middle of my [00:52:40] speciality training, so I was working, you know, I had I had access to a full lab in at Guy’s [00:52:45] Hospital in London Bridge so I could spend time messing and [00:52:50] toying and just, you know, being the evil genius in the lab and just figuring out how am [00:52:55] I going to do this? So. And I would spend hours and hours and hours in the lab, more than any of my classmates, [00:53:00] I would say exponentially much more time in the lab than any of my classmates.

Zohaib Ali: Um, figuring [00:53:05] stuff out. And that’s why I was able to then transfer that into practice. Um, [00:53:10] and then, you know, GC general chemicals from from Japan, they brought out [00:53:15] their general universal injectable in 2020 somewhere around there. Um, [00:53:20] and then they brought out Exit Clear, which is the actual clear silicone. And [00:53:25] that really changed the game because we now had a highly filled resin, which could [00:53:30] be injected into a preformed super clear silicone [00:53:35] matrix, which was dimensionally stable with a phenomenal surface detail. And [00:53:40] we could do that all down with Chairside. So that was the next step. And I remember the first time Costa [00:53:45] showed it to me and she was actually on a WhatsApp message and I said, get the fuck out of here. This is never going [00:53:50] to replace traditional layered composites. And again, that was a good few years [00:53:55] ago. So I was a sceptic at that stage because I hadn’t played with the injectable [00:54:00] resin and that was that was the jump. Then that said, hey, listen, you’ve done [00:54:05] it this way, try it this way now. Um, so that was that was the the little jump, [00:54:10] if you like, a few years ago. And since then we’ve gone on to do lots of other things [00:54:15] and really refined the technique more and more. And it’s gone from a place where it used to be fully analogue [00:54:20] to now it can be fully digital, and people are still saying, oh, you can’t, you can’t use digital workflows for this. [00:54:25]

Zohaib Ali: And we actually exclusively use. I think they haven’t quite spent the they think [00:54:30] there’s a problem with with model printing. They think there’s a problem with honing [00:54:35] your wax up in the right way. And if you don’t get those two things right, then you stand. You stand can’t [00:54:40] be produced correctly, which means when you inject, it’s a mess. And the real [00:54:45] problem is that people haven’t spent enough time doing it like I have. And I have [00:54:50] my own printer at home. I’ve got exocad, I have my own, you know, gaming laptop that [00:54:55] I work with to refine this process all the time. Every week, every month [00:55:00] there’s a new little some some. Advent comes along, I think, oh yeah, that’s [00:55:05] going to refine that process a little bit more. And that’s what I’ve spent the last few years doing. So we’re now [00:55:10] at the stage where we can do fully guided layered injectable [00:55:15] composites, which for me is the holy grail because you end up with [00:55:20] all the benefits of layering aesthetically. And [00:55:25] you get the benefit of finishing it with an injectable technique, meaning you’re not spending [00:55:30] hours and hours and hours on that final facial layer, getting your line angles, polishing [00:55:35] it all, all of the anatomy. That’s all done.

Payman Langroudi: That’s all polishing.

Zohaib Ali: Either. Barely. [00:55:40] I mean, I spend per tooth 15 to 30s per tooth [00:55:45] of polishing because if you wax up is honed correctly and your stent is made properly, [00:55:50] the exit clear is such a fine material. It’s like light body silicone. You know, when you do dentistry [00:55:55] all those years ago.

Payman Langroudi: I have a lab around the corner.

Zohaib Ali: But when you [00:56:00] use light body silicone, you get that surface detail. Exit clear has [00:56:05] the surface detail of light body silicone. But the rigidity of type [00:56:10] zero silicone, which is like a hard putty. So you can get incredible surface reproduction [00:56:15] without warping with excellent support [00:56:20] while you’re injecting. So if you have a good wax up, You have a good stint, which hopefully [00:56:25] made you have an excellent finish. When UV light cured, you don’t need to spend hours on polishing.

Payman Langroudi: I [00:56:30] mean, it’s a testament to the development of it that I remember talking to [00:56:35] Kostas whenever it was and then six [00:56:40] months later, which isn’t very long, talking to him again. Yeah. And [00:56:45] he and he pretty much told me I know everything I told you last time has changed. Yeah. And [00:56:50] I was like, what do you mean, man? Like and and and I couldn’t believe it. Right. And the things [00:56:55] that he was talking about at the time, at the time he was grappling with, you know, the circular fingerprint [00:57:00] marks on the, the stent.

Zohaib Ali: The printing lines, printing.

Payman Langroudi: Lines, printing lines.

Zohaib Ali: Yeah. [00:57:05] So we resolved that. Yeah.

Payman Langroudi: Resolved resolved that.

Zohaib Ali: And then actually taking it one step further now we have now [00:57:10] I have I mean we haven’t I haven’t shared it with people but especially commercially. Yeah. But I now [00:57:15] have printed models with texture like, like a, like a veneer wood.

Payman Langroudi: He told me, he told me.

Zohaib Ali: And [00:57:20] so now I’m at that level that I’ve worked on this for the last six months and it’s [00:57:25] it’s at the point of execution now, so why not? Why can’t, you know, just even.

Payman Langroudi: Even [00:57:30] the layering? The first time I spoke to him, layering wasn’t on the cards. No. And I remember asking, [00:57:35] well, what about layering? And then and then six months later, layering was on the cards. Yeah. Um, so [00:57:40] it’s a testament to the development. And the nice thing is you guys are specialists, both of you. [00:57:45] And that specialist led development is always a good thing. Do you, [00:57:50] when you use it for wear cases and use it, I guess using the same technique at the back? [00:57:55] No, no.

Zohaib Ali: Yes and no. It can be done at the back, but it’s more tricky. [00:58:00] Yeah, it’s more tricky because of access and things like that. And rubber damn clamps getting in the way. I was going. [00:58:05]

Payman Langroudi: To say about the material, it’s the do you can you rely on flowable material for the back? [00:58:10]

Zohaib Ali: So I’m going to stop you there because it’s not a flowable material.

Payman Langroudi: Yeah, but you know [00:58:15] what I mean.

Zohaib Ali: No, no, no, no, it’s not a flowable material. It’s not. If you take it out of a syringe and pop [00:58:20] it into a cavity. It does not move flowable materials. They flow. They [00:58:25] are fluid. This is not fluid in that sense of the word. It’s thixotropic. [00:58:30] Yeah. Sorry to get you. Remember that old dental science. Ringing a bell but [00:58:35] undergoes something called shear thinning, which is when [00:58:40] it’s driven through a syringe out of the tiny nozzle. You know, the needle at the end. [00:58:45] It’s forced from a wide space into a narrow space. Simplistically. And? [00:58:50] And that forces it to flow. Yeah. Okay. It only flows for that [00:58:55] instant that you’re giving it energy.

Payman Langroudi: Okay.

Zohaib Ali: Hang on, hang on. [00:59:00] Fair enough. Right. So. So that’s the only time it flows. The rest of the time [00:59:05] it doesn’t. If you if you make a little column of it, it stays put on the table. It won’t [00:59:10] move. Yeah. So it’s not a flowable material. It’s an injectable material. Fair enough. But [00:59:15] it’s not flowable. And we do now have 2 or 3. [00:59:20] We might have a four year follow ups now, plus possibly of where cases and I mean pure [00:59:25] attrition cases that I have treated probably a 2 or 3 years Costa, maybe four years. [00:59:30]

Payman Langroudi: Posterior is treated with a.

Zohaib Ali: Full mouth. Yeah. Full mouth it does. Where like [00:59:35] all composites. Like all composites. So what’s the problem? [00:59:40] I just don’t see the problem with it. It’s I think there is an issue with us as a profession [00:59:45] thinking that this is a, it’s a terminology problem, that this is a flowable. It’s a flowable. [00:59:50] It’s a.

Payman Langroudi: Flowable. Well, listen, I’ve seen I’ve seen a lot of the work. No, I know, but of of the Flowable, it’s [00:59:55] the strongest one. Yeah. Yeah. It’s not I know you’re not calling it a float. I know it’s an injectable. I know you’re not calling it flowable. [01:00:00] Yeah, but but, you know, you must know. Is it as strong as micro hybrid? Composite? Like proper? Proper [01:00:05] composite.

Zohaib Ali: So I hesitate from using if you want to say. If you want to say [01:00:10] is it is it stronger than or is it stronger, I’m going to say no.

Payman Langroudi: But that’s not the key you’re saying.

Zohaib Ali: But [01:00:15] that’s the wrong way to look at it. There are far more important parameters to look at. Like [01:00:20] like how does it wear? How perishable is it? And when it does wear, [01:00:25] how do the little bits of composite, how do they break off, and how do they then interact [01:00:30] with the composite that’s left behind and teeth that’s left behind. They’re way more important. And [01:00:35] um, uh, I’d love to say that I did the study, but I didn’t. But Kostas was part of [01:00:40] it. Um, published just an article just last week. [01:00:45] Um, which I which is available on our Instagrams or whatever, but it’s a peer reviewed [01:00:50] journal, um, characterising the wear of GSK’s [01:00:55] injectable, which is what we use and what we teach because that’s our material of choice, [01:01:00] not because we’re paid to or we’re sponsored by, and we’re definitely not. In fact, if anything, it’s the other way we [01:01:05] pay for all our materials, um, and comparing it to others [01:01:10] on the market, and although it’s not the most heavily filled with GC, won’t thank me for saying, [01:01:15] but it isn’t. You’re not paying me, so next time I won’t say it, but, [01:01:20] um, it it performed remarkably [01:01:25] well. Like remarkably.

Payman Langroudi: Well. The ones the study I saw, the Japanese ones, all of them were [01:01:30] performed better. They’re really, really good. It’s something to do with the styling. So.

Zohaib Ali: Yeah. So, I [01:01:35] mean, I don’t want to bore people too much, but yeah, all the, all the particles are pre-coated [01:01:40] in silane. And, and that means when you go and polymerise it or bond it, there’s [01:01:45] just far more cohesion within that material than there would be otherwise. And in a very simplistic [01:01:50] way, it’s less likely to break away. And the other way.

Payman Langroudi: Wait, wait, are you or Costas [01:01:55] presenting this at the symposium? The simulation symposium? Because I didn’t see your [01:02:00] pretty faces in those in those circles. Why? Because you’re too busy. Too busy organising. [01:02:05]

Zohaib Ali: We’re too busy organising. So you’re not presenting? So we’re not presenting? No. And it was a question that [01:02:10] was asked of us to say, does someone local not going to present at the local conference. And we just thought, [01:02:15] you know, you know, there’s so many people within that group who are phenomenal at [01:02:20] what they do really like far, far better than what I am or what I could hope to be. [01:02:25] That, and this is the first.

Payman Langroudi: Time this thing.

Zohaib Ali: Though I know, I know, I know, I.

Payman Langroudi: Know this thing. I’d say [01:02:30] you guys are at the tip of the spear, right?

Zohaib Ali: Yeah. Thank you. I feel like we are, but [01:02:35] I feel like this is the first time buyer Malaysian has come to the UK. Yeah. And, um, [01:02:40] I want I want to.

Payman Langroudi: Be ultra.

Zohaib Ali: Modest. I want the, I [01:02:45] want the local Brits to see what’s out there. [01:02:50] I feel like they know us already. They know what Prosperworks is. Hopefully they do. Um, [01:02:55] and because it takes up enough bloody time and, you know, they know Costa, [01:03:00] they know me and they know what we do. They know a little bit about injection moulding, but I don’t think they know [01:03:05] what else is out there and what else is out there. And, you know, in the universe is, is, [01:03:10] is supernova. It’s it’s it’s incredible. So we want to give those people [01:03:15] an opportunity to show what they do and open, open the eyes of, of UK dentists [01:03:20] to what’s actually out there. Because the education that you can receive overseas [01:03:25] is incredible. It’s incredible. Go to Japan, go to Italy. [01:03:30] Go to go to Switzerland. Go to the States, go to Brazil. These people are masters of what [01:03:35] they do. And actually, quite frankly, there are some clinicians in the UK who are phenomenal. But [01:03:40] as an industry here, we’re behind the times. We really are behind the times in our academic institutions [01:03:45] in practice, how we how we treat patients on all aspects.

Zohaib Ali: Our artistry [01:03:50] here overall is lacking compared to what’s going on in Europe. And I think [01:03:55] if we can show that, showcase that here, hopefully it will inspire that younger generation [01:04:00] to, to to travel in a different way. Um, [01:04:05] and I think, I mean, I’m 15 years qualified. I’m not a spring chicken anymore, [01:04:10] but I’m not 2035 years. I’m not at the end of my career. I’m somewhere in the middle. [01:04:15] Um, so one of the things that that, that I’d like to do is [01:04:20] help curate, uh, you know, a group in the UK [01:04:25] that is a proponent of this way of thinking. [01:04:30] So one way of doing that is, is having biosimulation and having that presence [01:04:35] in the UK. The other thing I’m doing is that’s a bit more personal to me. And I guess individual [01:04:40] to me is, um, I’ve, you know, when I moved to the UK, I found people weren’t very open. They [01:04:45] weren’t very, very helpful. Maybe it’s because I was an idiot and I didn’t know how to speak to people. I’m sure that had a had a role to play. [01:04:50]

Payman Langroudi: Dentists weren’t sharing their knowledge with you as much as you.

Zohaib Ali: Expand your knowledge sharing, [01:04:55] but it goes from everything from sharing the knowledge to, um, how to speak to [01:05:00] patients, to clinical knowledge, to techniques, to networking. And I think networking [01:05:05] is a is a big side of things. So I recently set up a very, very small group, um, [01:05:10] which aims I’m Pakistani and there’s lots of British Pakistani [01:05:15] dentists who have had qualified here or qualified from abroad and have come back. And [01:05:20] um, historically, I think our people don’t have a very good attitude towards helping [01:05:25] others of the same background as us. I think we’re really, really bad at that as, as a, as a race or [01:05:30] as a country. We just are, um.

Payman Langroudi: Because of the classic situation where the brother [01:05:35] in law sets up a pizza shop across the road from.

Zohaib Ali: I don’t know.

Payman Langroudi: What. [01:05:40]

Zohaib Ali: We run takeaways. Okay. Yeah.

Payman Langroudi: Sorry. Pizza shops are Iranians. [01:05:45]

Zohaib Ali: Yeah, yeah. Oh, you guys are pizza shops. Yeah. Yeah.

Payman Langroudi: So some Iranian with an Italian [01:05:50] accent. Yeah.

Zohaib Ali: Um, so, so.

Payman Langroudi: Helping [01:05:55] helping collaboration between.

Zohaib Ali: So I set up a small group. It’s called link. The link. [01:06:00] It’s just, you know.

Payman Langroudi: A WhatsApp group.

Zohaib Ali: Yeah. 10 or 15 dentists that [01:06:05] I sort of knew or was able to contact um, of, of British Pakistani [01:06:10] origin, say, listen, if you guys need help, I’m 15 years out now. Let’s just go. And we just went for [01:06:15] a game of mini golf and a Nando’s or something afterwards. And it was just. And I was surprised. [01:06:20] I mean, people were messaging me once, once the word got out a little bit from, I mean, this was in Manchester that [01:06:25] I, that I’m based people messaging me from Glasgow to say, oh, I can’t make it this [01:06:30] weekend, but will you let me know for the next one? One girl came from Sheffield like an hour and a half away on a Friday [01:06:35] evening, just to connect with people from Liverpool. I mean, didn’t they just come from [01:06:40] 10 or 15 minutes away? People come from hours away. Um, so I think we should all [01:06:45] take some responsibility in ensuring the future of the profession by helping [01:06:50] to guide people in the right way. And the most common questions were were things [01:06:55] like, I was the most senior person there, and I’m not an old guy, but I was the eldest there where, [01:07:00] you know, what course should I go on? Um, oh, I wanted to be a specialist, You know, [01:07:05] what are my options? How do I go about doing this? Or I want to get involved in such and such, [01:07:10] or I’m stuck in this job. How do I get out? I want to do this level of dentistry. I think. I think [01:07:15] that’s really, really missing. One of the problems I think that Covid created was [01:07:20] an overflow of webinars, an overflow of online teaching. And [01:07:25] I think educators are partly to blame because they see money in it and it’s not authentic anymore [01:07:30] that teaching isn’t authentic. I think it’s a cash cow for people, quite frankly. I think it is a [01:07:35] bit of a cash cow.

Payman Langroudi: Why do you say that, though?

Zohaib Ali: Because what you what you get online is a very, very diluted [01:07:40] version of of of of of what teaching [01:07:45] should be. And I think teaching should. I think it’s a generalisation.

Payman Langroudi: No, [01:07:50] I don’t think.

Zohaib Ali: It’s a generalisation. Well I don’t think it’s a generalisation.

Payman Langroudi: Spare online. Yeah. Yeah. Fantastic value [01:07:55] for money. Fantastic. Fantastic. The amount of resources you get from that.

Zohaib Ali: Absolutely.

Payman Langroudi: I agree with that. [01:08:00]

Zohaib Ali: I’m quite a polarising individual as you may have gathered in a few weeks.

Payman Langroudi: What I’m saying [01:08:05] is, you know that the profit motive is there. Yeah. For us, for some, I’m an educator. [01:08:10] For some educators. But. But if someone said to me. And by by the way, you might notice [01:08:15] this. A lot of the youngsters want to teach. Yes. Yeah, absolutely. And and you [01:08:20] say, hey, why? Why teach? But but anyway, um, if someone came to me and said, I [01:08:25] want to teach because I want to get rich. Yeah. I mean, there’s there’s not much money in education [01:08:30] unless you’re really at the top of your game. The vast majority of education is a massive [01:08:35] money loser, right? Because if you spend the time that it takes to make presentations [01:08:40] and. Absolutely. Now, I agree with you that there’s there’s the odd people who’ve hacked [01:08:45] the whole sort of I’d call it sort of this sort of coaching [01:08:50] kind of thing. Yeah. Where they’re making a lot of money out of that education. Yeah. But [01:08:55] education is not a great way. I mean, if I was if I was giving advice to a dentist, right, I’d say, hey, [01:09:00] spend time becoming a more expensive dentist than trying to become a more expensive teacher, because that’s [01:09:05] a difficult way of making money. No, it is, it is.

Zohaib Ali: So [01:09:10] I mean, I, I always had this vision for myself personally. I always had a vision that I wanted variety [01:09:15] in my week. I think I have a little bit of undiagnosed ADHD somewhere lurking around in there.

Payman Langroudi: But it sounds [01:09:20] like you put this group together because you didn’t have that information. Yeah, absolutely. So, so so [01:09:25] I’m let’s, let’s, let’s try and like, work together on this. Yeah, I love that. Yeah I love [01:09:30] that. Now, now the prosperworks. Yes. Yeah. Are you saying, [01:09:35] are you saying here that at Prosperworks. You’re you’re you’re supplying a [01:09:40] form of education that, again, you didn’t have access to when you were younger? Yeah. Yes. [01:09:45]

Zohaib Ali: Yeah, I think so. Yeah, I think so. It’s genuine and honest. It’s [01:09:50] how we practice. Yeah.

Payman Langroudi: So, so. But but you’re implying there’s plenty of dishonest information [01:09:55] out there.

Zohaib Ali: That’s exactly what I’m implying.

Payman Langroudi: Go on.

Zohaib Ali: I’m not. I’m not implying it. I’m saying it outright.

Payman Langroudi: Okay, say it [01:10:00] then.

Zohaib Ali: Yeah, I think, I think.

Payman Langroudi: Do you mean dishonest, or do you mean just people who don’t know what they’re talking?

Zohaib Ali: I think [01:10:05] there’s I think there’s two types. Yeah. Okay. And I’m going to get slated for this. Just say.

Payman Langroudi: It. Say it. I’m really enjoying. [01:10:10]

Zohaib Ali: It. But. But we might have to edit this out later. You’re going to send me the. [01:10:15] You’re going to send me this before you edit it, right before you publish it. Sure. Okay, fine. I think there’s two types of educators out [01:10:20] there, or three types of educators out there. There’s there’s the first type that know what they’re talking about, and [01:10:25] they teach it really well. Okay. And to teach it really well, you’re gonna have to let me speak. You speak for a [01:10:30] few minutes now. Okay. To teach it really well, you need to make things simple. [01:10:35] Now, dentistry isn’t simple, especially restorative dentistry. Adhesive dentistry. It’s super sensitive. You need to know [01:10:40] your chemicals, your materials, blah blah blah. Simple. For me, [01:10:45] simplicity means clarity of thought. If you have clarity of thought, [01:10:50] you can explain something to somebody very quickly in a sentence. You [01:10:55] can explain it to them and and they may not understand it immediately, but you can say to them in a very simple [01:11:00] way. It may not be a simple concept, but you can explain it quickly, efficiently, [01:11:05] using easy words.

Payman Langroudi: And to your point. To your point. E equals MC squared. Yes, [01:11:10] is a pretty simple equation, but it took massive knowledge in the background to get to that. [01:11:15] I love that.

Zohaib Ali: I love that metaphor. So so there’s the first type of of [01:11:20] educator who knows what they’re talking about and.

Payman Langroudi: Can communicate.

Zohaib Ali: Can communicate it. [01:11:25] Okay, there’s the next type of educator who knows what they’re talking about [01:11:30] and can’t communicate it. Yeah. Okay.

Payman Langroudi: We’ve all come across those.

Zohaib Ali: Yes. And and [01:11:35] you know what? Universities are full of them. Universities are absolutely full of them. But [01:11:40] so are private courses. And today the [01:11:45] UK market, as in general, UK society is much more susceptible to marketing than [01:11:50] we were 25 years ago. I think that’s coming from the States and very good marketing. So [01:11:55] if you are an average. If you are an average educator, you might be an excellent clinician, but [01:12:00] you might only be an average educator. But if you if you if you’re very good at marketing, [01:12:05] you can sell your courses. But the people coming on your courses, they’re not going to take that much away, [01:12:10] away from you, from being there, because you can’t convey your message in a simple [01:12:15] way, but you’re not going.

Payman Langroudi: To be very successful, are you? You’re not going to. I mean, it depends on word of mouth. Yes. [01:12:20] It depends on word of mouth. Yes. But if you’re getting word of mouth, but the but.

Zohaib Ali: The people who are [01:12:25] coming on your courses, they know even less than you do. Yeah. So they they may go away thinking [01:12:30] I’ve learned something here. Right. And they may feel like on the day they’ve learned something. But [01:12:35] actually to apply that and when you go deeper into do they actually have an understanding [01:12:40] of what they’ve been taught is a completely different ballgame? Because if you take someone who knows one out of ten [01:12:45] and you teach them five out of ten, five out of 10th May not be sufficient, but they think they’ve learned something. Yeah. Are [01:12:50] you doing them a service? Are you doing them a good service.

Payman Langroudi: Well you got them to five.

Zohaib Ali: You got [01:12:55] them five. But is that what they need to actually go and apply? What what what [01:13:00] what their intention is. No it’s not. So that’s the second type of educator. The third [01:13:05] type of educator is more sinister. The third type of educator is who [01:13:10] understands their side, um, [01:13:15] but doesn’t communicate everything to them, to their delegates effectively. [01:13:20]

Payman Langroudi: On purpose.

Zohaib Ali: Either on purpose or by mistake [01:13:25] or through ignorance.

Payman Langroudi: Okay. Why? On purpose?

Zohaib Ali: I think there’s a certain amount of I mean, I [01:13:30] went for a job interview, uh, a while ago, and [01:13:35] I was speaking to a specialist practitioner there. And, um, he said, you know, you know, we [01:13:40] run some open evenings and, you know, we train people how to, to do this, that and the other. [01:13:45] Um, but there’s a limit because you don’t want to train yourself out of a job. You know, you don’t [01:13:50] want to educate people out of a job. And I just thought, hang on, [01:13:55] you’re bringing people in for education, but you’re worried about [01:14:00] how much you teach them in case in case they don’t. [01:14:05]

Payman Langroudi: Want to be for you, not to teach it so that you get the referral. Yes, yes, [01:14:10] I see exactly.

Zohaib Ali: And that’s still happening today. And unfortunately it happens [01:14:15] on paid courses. And I’ve sat in there and I’ve been there and I’ve seen it. Um, [01:14:20] and the last one is that presents everything. Then, you know, the educator that presents everything, [01:14:25] they know everything. They present it, but they present it in such a [01:14:30] complicated way, which is similar to the first one, that the average general dentist cannot grasp it. It’s [01:14:35] too much. It’s information overload. It’s not applicable in everyday practice. It just can’t be applied [01:14:40] in a general practice environment. So I think, you know, [01:14:45] based on my experiences of that in the last 15 years, um, I think [01:14:50] there’s lots of money to be made from poorly delivered education. If [01:14:55] that means that you record, spend a few days recording a two hour webinar [01:15:00] and sell it for £70 and 5000 people buy it. So a lot of money. [01:15:05] It’s quite a bit of money, you know, £70. Yeah. [01:15:10] It doesn’t matter if it’s £70. You’re delivering a message which is diluted. Why [01:15:15] is the money? You know why. So what if it’s £70? You’re delivering a message to people. [01:15:20] It could be. It could be £0.70. But you’re delivering a message to people. That is not the clear. [01:15:25] A clear and complete message. It’s diluted down. Is [01:15:30] that what we should be doing? As. As an industry? As a profession? Yeah.

Payman Langroudi: Look, I think the one [01:15:35] one place where I certainly agree with you is that when you qualified, [01:15:40] there was almost when I qualified, my goodness, there was there was no [01:15:45] volume of education.

Zohaib Ali: You hardly had you didn’t have a YouTube in the 60s. Payman. You know. [01:15:50]

Payman Langroudi: I remember we had the Rosenthal course. [01:15:55] Oh, yeah. Yeah. And there was the Rosenstiel.

Zohaib Ali: Rosenstiel.

Payman Langroudi: Rosenthal. Larry. [01:16:00] Larry. Larry. Rosenthal. Course. And then that used to eventually [01:16:05] came to the UK. Right. But you had to originally. You had to go to New York to get there.

Zohaib Ali: Mike Lappas [01:16:10] boss, let’s say. Yeah.

Payman Langroudi: Yeah. And then. And then there was a there was a guy called Stein [01:16:15] here. He had a he had a I’m doing cosmetic dentistry. He had a, he had a group called adapt. [01:16:20] Okay. Where he would test he would test stuff. Okay. And he was [01:16:25] he was the only choice. That’s all there was. Now go back ten, 15 years from now. [01:16:30] Backwards. There were some. Yes. Now there’s massive overload. [01:16:35] Yes. Yeah. And you’re right. Covid had a lot to do with that. Yeah. Yeah. Massive. And now [01:16:40] it’s almost like curation is the most important thing. Yeah. It is. Um, it’s [01:16:45] a very. It’s a very interesting idea. Right. And so many people have [01:16:50] tried to fix that problem I’ve had. I can’t tell you the number of people who’ve told me. I’m setting up a website that rates courses [01:16:55] and.

Zohaib Ali: Oh.

Payman Langroudi: Yeah.

Zohaib Ali: That’ll jam.

Payman Langroudi: Have they called you as [01:17:00] well? Yeah.

Zohaib Ali: I mean, we get approached. Oh, can you write a chapter in my book that’s aimed at [01:17:05] general dentists and like, for example, you know, there are courses out there entitled, you [01:17:10] know, I don’t know, composite bonding or, you know, [01:17:15] aligners for the general dental practitioner. Yeah. Rehabilitation for the general dental practitioner. [01:17:20] Yeah. Whatever. For the for the GDP. Yeah. I’m sorry. Why the fuck should rehabilitation [01:17:25] or composite bonding or aligners for the GDP be any different [01:17:30] to composite or aligners or rehabilitation for the specialist? Why [01:17:35] should it be any different? Why should it be dumbed down?

Payman Langroudi: It doesn’t mean it’s just dumbed [01:17:40] down. How can you teach a course? It’s branding right? It’s it’s.

Zohaib Ali: Branding. Is that is [01:17:45] is that good for the profession? Is it good to say, hey, come [01:17:50] and learn this? It’s fine for general dentists. I mean, what the. I [01:17:55] just I just feel like there’s a there’s a thought [01:18:00] process out there and it all comes back to money. Why do you need to brand it [01:18:05] for the general dentist? Why? Because more people will buy your course. Because it says [01:18:10] for the general dentist afterwards.

Payman Langroudi: It’s branding.

Zohaib Ali: Is that branding? Is that what it is?

Payman Langroudi: I [01:18:15] mean, what am I going to tell you? Is it I don’t know. No. But why do you call Prosperworks Prosperworks? Why? Because. [01:18:20] Because more people are going to buy courses. You know what I mean? You could say anything [01:18:25] like that.

Zohaib Ali: Can you? I think I think it’s a very specific thing. You know, you [01:18:30] know, you wouldn’t have a course called tooth whitening for the general dentist and then [01:18:35] and then tooth whitening for the prosthodontists. It’s exactly the same. It’s exactly why [01:18:40] should that not be extrapolated to rehabilitation, to endodontics, to [01:18:45] rubber dam isolation. Why should it be different for general dentists?

Payman Langroudi: It’s different, insomuch as you know [01:18:50] that running a general practice is different to running a specialist practice. Agreed. So? [01:18:55] So if the if the teacher is saying in a general practice setting, this is how you [01:19:00] do very high level endo. Yes. For the sake of the argument. Yeah. Yeah. Endodontics for the general practitioner. [01:19:05] If that was the name of the course, the conversation would include [01:19:10] how to get the best of that in a general practice setting where time is limited, [01:19:15] sometimes where patients are coming in for dentures instead of for, for, you [01:19:20] know, and so as well as calling out the audience. Right. Yeah. [01:19:25] But there’s nothing wrong with marketing to do. I feel like you’ve got in your head the marketing [01:19:30] is this disgusting game. No, I love marketing.

Zohaib Ali: I think I think, no, [01:19:35] I think, yeah, maybe because I’m crap at it. So I’m calling everybody out who’s good at it? [01:19:40] Um, no, no, I think I think marketing is good. I just I just think that if you look [01:19:45] at dentistry in the UK, where it’s gone in terms of litigation and why that is and [01:19:50] the sources of those problems, there are a lot of it is based around [01:19:55] poor cosmetic work, poorly executed orthodontics, um, and the consenting [01:20:00] around that. And, you know, we went through a phase. I’m not sure if it’s better now, but I remember [01:20:05] going to dental protection lecture a few years ago and they were saying, we’re, you know, we’re four times as likely now to [01:20:10] get litigated against in the UK compared to the US. [01:20:15] Yeah. You know, which is, which is just.

Payman Langroudi: It’s a lot better.

Zohaib Ali: It’s it is a lot better now. But that’s just staggering. [01:20:20] Why is that.

Payman Langroudi: Well there’s a company called Dental Law Partnership. That was it really [01:20:25] was a big difference. I know.

Zohaib Ali: Listen I was I was a victim.

Payman Langroudi: Oh. Are you. I’ve experienced [01:20:30] what they did. What then the law partnership did was number one, they lobbied um, uh, [01:20:35] politicians. Yeah. Number two, they bought all the dental negligence cases [01:20:40] of the other companies? Yeah. Yeah. And super specialised on how to maximise them. The [01:20:45] funny thing I went on this trip on dental law partnership. Yeah. I wanted to see how the hell can one law firm [01:20:50] ruin a whole profession? Yeah. Insomuch as definitely the lawyers of one. Yeah.

Zohaib Ali: Yeah, [01:20:55] 100%.

Payman Langroudi: 100%. You know, like, we sound more like lawyers than clinicians these days. You know, getting people to [01:21:00] sign things and and, you know, and I looked into them and, you know, what I found in the legal [01:21:05] world here, they’re like the award winning DLP. Yeah. Really? [01:21:10] Yeah. Because they’ve had a great, fantastic growing business. Right. Wow. Wow. It’s [01:21:15] such a it felt horrible. Yeah. It felt horrible to read that. Yeah.

Zohaib Ali: Yeah. I just yeah, [01:21:20] I just, I mean, you know, but they had a field day because. Because to a point we allowed it [01:21:25] to a point, you know, if you have good notes, if you, if you, if you stick together as an industry, you’ll, [01:21:30] you’ll, you’ll do better. You just will. And I think we need more of that. Hence by [01:21:35] emulation, hence the link which I’m going to plug again. Um, I.

Payman Langroudi: Want to. [01:21:40]

Zohaib Ali: Collaborative efforts.

Payman Langroudi: I asked you before we switched on the microphone here that what’s your sort [01:21:45] of micro specialisation? What’s your super specialisation in process. [01:21:50] And you said the failing dentition. Yeah.

Zohaib Ali: Managing the failing [01:21:55] dentition specifically. Yeah. Um.

Payman Langroudi: I think like so [01:22:00] what I’m what I’m thinking my my question is you must get yourself in some [01:22:05] situations like, um, you know, if by the time [01:22:10] the thing about pros is a funny thing because every dentist thinks they can do pros.

Zohaib Ali: Everybody’s a.

Payman Langroudi: Dentist. It’s not. It’s [01:22:15] not like these days everyone’s.

Zohaib Ali: An orthodontist as well.

Payman Langroudi: Yeah. That too, that too. But it’s not like endo. So? [01:22:20] So you must now be getting sent harder cases [01:22:25] than before.

Zohaib Ali: It’s really hard. Yeah. Ah, you only get sent stuff. That’s. I mean, [01:22:30] it takes. You think orthodontics takes time? Yeah. But replacement of teeth. I mean, my patients 18 [01:22:35] months, two years under restorative care or of Prosthodontic care. Yeah. It’s just mega. It’s [01:22:40] mega expensive. And it’s mega mega on their psychology. And I always tell patients [01:22:45] about for costs. Every patient has four costs that they have to pay. The first [01:22:50] one is obviously the financial cost. Yeah. The second is the time cost. Not just [01:22:55] in the chair but travelling. How far are you travelling from you know, effect on work, annual leave, [01:23:00] um, downtime if you’re having surgical work done, that kind of thing. The next [01:23:05] is biological costs. So everything we do has a reaction. Doesn’t matter how small it is. If I [01:23:10] give you anaesthetic, you might bruise. There’s a reaction to everything. Um, and the long [01:23:15] term complications are sequelae of that. And the final and the most important one, [01:23:20] which I didn’t appreciate for the first four years [01:23:25] of, of my practising career, the psychological cost and [01:23:30] the emotional side of dealing with patients. And that’s the one that I speak to patients [01:23:35] about the most now with the demographic that I have, and I think largely the way [01:23:40] you. If I’m, if I’m a subspecialist prosthodontist in the failing dentition, it’s [01:23:45] because that’s what my demographic needs. So all the learning that I do now is based [01:23:50] around their needs, because I want to offer them the best for what they need. I don’t sit there crying that [01:23:55] I don’t have 25 year old models who just want perfect white teeth, you know?

Payman Langroudi: So the older patients [01:24:00] with.

Zohaib Ali: My average age is probably 60 something in my patient demographic. [01:24:05]

Payman Langroudi: The best patients.

Zohaib Ali: I love them, I love I love the Wendy’s and the Pat’s and [01:24:10] the you know.

Payman Langroudi: I used to I used to work in a practice where everyone was over 60 or 70. That would love it. I love it, [01:24:15] and I used to think I’m such a brilliant dentist. You know, I was this young guy.

Zohaib Ali: Nobody complains.

Payman Langroudi: No one complains. [01:24:20] No one has, like, undue sensitivity or or pain after deep fillings.

Zohaib Ali: They all [01:24:25] just feel so philosophical about their approach. They know. You know what? Life ain’t perfect. Yeah, [01:24:30] yeah, shit’s gonna happen. They just accept that at that age they have that wisdom.

Payman Langroudi: They’re part of that generation [01:24:35] that lucked out with the finances? They bought a house for £62,000 [01:24:40] and sold it for 1.3 million. And so that combination [01:24:45] just makes them the best demographic to treat.

Zohaib Ali: I’m blessed that way. I’m truly blessed. And [01:24:50] I remember thinking again about ten years ago. I remember thinking as I’m speaking to my nurse at the time and I said, Carl, you know, [01:24:55] I’d love to just work somewhere. Not like in the sticks sticks out, you know, but somewhere [01:25:00] pretty rural with a slightly older clientele. I think I think that would be my. That would [01:25:05] just be my home. It’s a good.

Payman Langroudi: Way of working.

Zohaib Ali: And I just again, life just happened [01:25:10] to me rather than me happening to life. Yeah. Uh, you know, the Alchemist and and [01:25:15] it just, you know, it fell in my lap when things were really hard. That job just fell into my lap. Um, [01:25:20] but I think I think I think things fall into your lap once you’ve done the hard work [01:25:25] that that job wouldn’t have come my way, or it wouldn’t have been approached about that opportunity if [01:25:30] I wasn’t in specialist practice trying to write articles. If I wasn’t a specialist, if I wasn’t trying to be out there [01:25:35] and make myself known, if I hadn’t done the graft, the luck wouldn’t have come. And I think that’s I [01:25:40] think that’s what young dentists remember these days is the, you know, the money will come, the [01:25:45] fame will come, the riches will come. But you have to put the graft in first. [01:25:50] And and, you know, Rome wasn’t built in a day. Just take your time. It will come [01:25:55] to you. I think people just. They want everything too quickly nowadays.

Payman Langroudi: And do [01:26:00] you share my view that like you said, you said from undergrad, you [01:26:05] knew you were going to be a specialist?

Zohaib Ali: I didn’t know, but I wanted it. Yeah, I wanted it. Yeah yeah yeah.

Payman Langroudi: Yeah. But [01:26:10] but you know I had the Anushka Brogan on and she was saying [01:26:15] she knew before she bought her first practice that she wanted at least ten, you know. Well, [01:26:20] my, my assertion here that it’s better to pick something and run [01:26:25] than, than the traditional advice of take your time, sit, do [01:26:30] a bit of everything. See what you like. Of course, that makes some sense. I get that. [01:26:35] Yeah, but what I’m saying, I find it a third year dental student. [01:26:40] I tell them, look, pick endo right now. Yeah, and just like, look for [01:26:45] endo from now. Yeah. Get books. Go, go to go to Endo courses for Postgrads [01:26:50] in the third year of dental school. Yeah. By the time they qualify, get yourself onto an endo MSC [01:26:55] straight away in the US and then come back as a specialist dentist without having done [01:27:00] any other dentistry, and you’re done.

Zohaib Ali: And you’re set.

Payman Langroudi: Insomuch as, insomuch as you [01:27:05] by by setting your task, your your sights early.

Zohaib Ali: You optimise your you optimise. [01:27:10]

Payman Langroudi: Your journey. Yeah. Like super quickly if, if patience is the issue which [01:27:15] is the disease of the young, you know like yeah everyone’s impatient. Like you said.

Zohaib Ali: There’s [01:27:20] a virtue in that because you optimise your journey. Yeah.

Payman Langroudi: Does [01:27:25] the patient get the best out of you. Well in the US yeah. The US, They really do encourage [01:27:30] that.

Zohaib Ali: Like, I mean, again, the US market is different because it’s, you know, education [01:27:35] is so costly in the UK or in the US as it is in the UK now as well, increasingly. But it’s [01:27:40] a very different way of practising in the US. And the remuneration for dentists is [01:27:45] also really, really different. So it’s hard to draw a total parallels. [01:27:50] But I get what you’re saying in terms of getting to your end point or what you see as your end point [01:27:55] as quickly as possible, so then you can optimise the rest of it.

Payman Langroudi: And what I’m saying, rather than wait to find [01:28:00] your passion, your passion is whatever you’re good at.

Zohaib Ali: I’ll tell you my [01:28:05] story very quickly.

Payman Langroudi: Bloody passionate about hydrogen peroxide, man. You know I am. Yeah. [01:28:10] Go on.

Zohaib Ali: I mean, so I failed at multiple times [01:28:15] of trying to access a speciality training multiple times. Um, [01:28:20] and I think people don’t probably see that side. If you’re. I still don’t [01:28:25] consider myself a success or successful, I still don’t I just don’t, um, [01:28:30] I don’t really have a definition of it, which is maybe why I don’t. I consider myself [01:28:35] privileged to be in my position, and I do consider it a privilege. I still don’t consider myself [01:28:40] successful. I don’t know why, but, um, I [01:28:45] failed 3 or 4 times.

Payman Langroudi: Would you put it down to trying to? [01:28:50]

Zohaib Ali: I don’t know. I just don’t know.

Payman Langroudi: I mean.

Zohaib Ali: So two years in a row, I applied [01:28:55] for orthodontics out of one of those years.

Payman Langroudi: Super competitive. [01:29:00] Right?

Zohaib Ali: Oh. Come on. Fuck that. It is though. Okay, but listen, out of one of those years, I was [01:29:05] I think I was the top graded applicant on paper, one out of whatever [01:29:10] it was. I was number one. Yeah. I’d spent years working on my CV at that stage. Something [01:29:15] happened at Interview stage, which I still don’t quite understand, because that was my second [01:29:20] year of applying. I had the experience, I knew my answers. And these things are you have to prepare. [01:29:25] You have to know exactly what you’re going to say. You know what questions are going to come. You can prepare for it. You can get [01:29:30] you can get coaching from other orthodontists or whatever. Yeah, yeah. Um, something happened, and [01:29:35] and I didn’t get in. I just got pissed off with the whole thing. Then I applied for [01:29:40] the five year restorative NHS training pathway. So it’s five years to.

Payman Langroudi: Become a consultant? [01:29:45] Yes.

Zohaib Ali: Yeah. And again, with that one I had [01:29:50] I knew somebody on the inside. So I knew I had a very good chance. But something [01:29:55] happened. I don’t know. I never really got to the bottom of it. First time I applied for pros, [01:30:00] I got in. And in the years that I’d spent applying for orthodontics, [01:30:05] I spent in general practice after Max FACs in those years, [01:30:10] again, I was trying to do the best for my patients, and my patients needed good restorative work, mostly on their [01:30:15] back teeth. So I spent years working with rubber dam, with cerec, with posterior composites, and [01:30:20] learning how to make money that way. There’s nothing wrong with that, and I still encourage people now [01:30:25] just do really good general dentistry. You’ll make an absolute packet and it’s [01:30:30] so rewarding. It’s so rewarding without any stress, without trying to sell veneers, without [01:30:35] trying to sell aesthetic work. It’s just it’s such a good way to live. Um, but my, my, [01:30:40] you know, my, my thought process is all the CPD and all the courses that I did, they were geared towards restorative [01:30:45] and eventually I thought, I’m okay at this. I kind of enjoy it. I want [01:30:50] to do specialist training because I saw that as my way out of the NHS treadmill. Fuck it. [01:30:55] I’ll apply for pros and I’ll fund it. I’ve been saving up and I got in first time and then [01:31:00] I just flew with it. Once I got in, then it was pedal to the metal and I was all in. That’s just my personality. [01:31:05] I’m either all or nothing. So I went a very roundabout way into specialist [01:31:10] training. Again. I sort of fell into, what’s your.

Payman Langroudi: Point, that it’s a struggle to know. [01:31:15] It doesn’t. Things don’t look as wonderful as my point is.

Zohaib Ali: Sorry. Yeah. Sorry. Payman.

Payman Langroudi: No, no. [01:31:20]

Zohaib Ali: What’s the point? Are we running out of tape? Sorry. So I’m only [01:31:25] saying my point is that my point is that, you know, you can be very [01:31:30] direct with it at the start, as you said, say, I’m going to be an endodontist and fly with it. And [01:31:35] there are merits to that. There’s also, for me personally, if I’d gone into [01:31:40] specialist training straight out of out of uni, dental school or whatever, I would have been shocking [01:31:45] because I wouldn’t have had the time to mature as a person, to see my failures, to improve [01:31:50] my personality, to improve my patient communication. I didn’t go for courses on this stuff. [01:31:55] I just realised how stupid I was. As the years went by [01:32:00] and I had problems and I encountered those problems, whether it’s communication or failures or whatever. So [01:32:05] I think it’s down to the individual. Yeah. And if you are determined, if you’re going to be [01:32:10] gritty, um, there’s that book by Angela Duckworth. If you’re going to be gritty, [01:32:15] um, that everyone should read and that it takes some grit to get through that book. Let me be honest. Have you read it? No. [01:32:20] Oh, fuck. It’s a grind. I did it as an audiobook, and it’s a grind. Just getting through that book takes [01:32:25] a serious amount of dedication because it’s very difficult to listen to. Um, [01:32:30] if you if you want it badly enough, it doesn’t matter. I think when you do it, [01:32:35] you just do it. You know, Apple, Amazon, Microsoft, Microsoft, [01:32:40] not so much. But a lot of these companies weren’t founded until their founders were 30, 40, [01:32:45] 50, 50 years old. So I don’t think that there’s a late point or I think your [01:32:50] journey is your journey. You just got to enjoy it and maximise it along the way. It’s as simple as that. [01:32:55] Um, that’s that’s at least that’s my approach. And I think I’ve been through enough ups and downs to [01:33:00] to appreciate that. Now it sounds like a bit of an old man, but.

Payman Langroudi: On this [01:33:05] pod we like to talk about mistakes. Um, clinical errors. [01:33:10] Yeah. So that you can share an error so [01:33:15] that someone else doesn’t make the same error. Um, and mean in medical. We don’t [01:33:20] like to talk about it very much, but it comes from black box thinking in a way that pilots [01:33:25] share their. What comes to mind when I say clinical errors? What’s an error [01:33:30] you’ve made and what you learned from it?

Zohaib Ali: Not taking X-rays.

Payman Langroudi: Not taking X-rays. And [01:33:35] before putting a crown on something, I.

Zohaib Ali: Did much more than put a crown on. Oh, um, it was a rare case [01:33:40] before I did my speciality training. So for any referrers out there, this is a long time ago. Yeah. [01:33:45] Um, before I had the awareness and before I had a mentor and all that kind of stuff. Anyway, um, [01:33:50] where case I treated it with some composites in a denture. I increased the vertical dimension because [01:33:55] it was where, um, I didn’t take x rays of of [01:34:00] the upper anterior teeth, and it was class two div two case, which means deep overbite, [01:34:05] high forces in unfavourable ways. Patient came back two weeks later after I’d done the [01:34:10] composite work. And her upper anterior incisors. So the maxillary incisors were mobile. [01:34:15] Gums were all flappy I mean, pulling away from the tissues. And I just looked at it and [01:34:20] I just thought, what? What is going on? Took an x ray [01:34:25] and the roots were so short. She had massive root resorption, which I hadn’t [01:34:30] identified, and I should have. The teeth were asymptomatic. They were outside of the where they were, you know, otherwise [01:34:35] intact, unrestored. No carry. So I thought, I don’t need to take an x ray here. These are just healthy teeth. I’ll [01:34:40] just restore them and they’ll be fine. Of course, as soon as I changed the occlusion, I changed the status [01:34:45] quo of the force around those teeth. They started getting pushed forward. They basically were suffering from occlusal trauma. [01:34:50] Wow. Occlusal overload. Mobility. You must.

Payman Langroudi: You must have got scared. [01:34:55]

Zohaib Ali: Honestly? Honestly, I had to go change my pants immediately. Yeah, I bet. And, um, what did [01:35:00] you do? Do you know what? I just adjusted the occlusion. I took all the load off. I [01:35:05] transferred it a bit more posteriorly because it just made sense to me. It just.

Payman Langroudi: Went back and.

Zohaib Ali: Settled. I think [01:35:10] I saw a couple of weeks later, things had settled down again because the load had gone off those teeth, [01:35:15] and eventually they actually that patient this was in Manchester. That patient tracked me down. [01:35:20] Five years later I’d moved to London and she came to see me [01:35:25] at my new job in London five years later and, you know, touch wood. [01:35:30] Everything was still intact. She’d replaced the denture with an implant she’d had done elsewhere, [01:35:35] and the composites were failing a little bit, a bit of staining and that kind of thing.

Payman Langroudi: Did she take it well, [01:35:40] though, when initially, when that happened, or did she take it badly? Um.

Zohaib Ali: She just she just wanted. [01:35:45] I’d seen her husband for some dentures and she’d absolutely lovely Jewish lady. And [01:35:50] she absolutely loved what I had done for him. So I had some credit in the bank. Yeah, yeah, yeah. And that was really [01:35:55] important to manage her. I just said, um, I can’t even remember. I don’t want to say her name. I just said, [01:36:00] look, it’s a little bit inflamed. I’ve just adjusted your bite. I think it’s a bite [01:36:05] problem. That’s the best I could say to her at the time. Um, let’s see you back in a few weeks [01:36:10] and see how things are going. And she went with that and she came back. Everything had settled down because occlusal trauma does shift pretty [01:36:15] quickly. I saw a few years, a few years later, and all she needed was a polish up of the composites, [01:36:20] and they are still going, so thankfully it ended well. The only time [01:36:25] I’ve really gotten into trouble in my career has been endo related. Um, I [01:36:30] was never good at Endo.

Payman Langroudi: Like all of us.

Zohaib Ali: Like all of us. And those are the one. I think endo [01:36:35] is a speciality. I think it’s the hidden gem. Specialist care, single tooth dentistry. [01:36:40]

Payman Langroudi: Tell me, tell me about as a as a specialist. Something that you’ve seen an error, [01:36:45] not an error. Like a failure of your own work that you learned from and thought. [01:36:50] Ah.

Zohaib Ali: As a specialist. Yeah.

Payman Langroudi: Or do you not get to see your patients [01:36:55] long term as a specialist? It’s a.

Zohaib Ali: Problem. Follow up is a problem because patients don’t want to come back and pay [01:37:00] for pay for a consultation fee or whatever, because it’s £100.

Payman Langroudi: You must have had someone you treated, I don’t know. Yeah. [01:37:05] Five years ago. Yeah.

Zohaib Ali: I’m I’m [01:37:10] I’m not arrogant at all, but I have had touch wood very, very few [01:37:15] failures. And even as a general dentist, exquisitely rare for me to [01:37:20] have outright failure. Not outright I’ve had. I’ve had stainless steel and composite in a few [01:37:25] a couple of years down the road, that kind of thing. Yeah. Um, but I’ve [01:37:30] never really had, you know, a crown come off or a fractured crown [01:37:35] or a tooth dechlorinating have you never.

Payman Langroudi: Have you never had a situation where you’ve [01:37:40] pushed the boundaries of of what is possible? I mean, you’re doing it all [01:37:45] the time with injection moulding, right? Yeah. Yeah. And then there’s no way you can get to the very edge [01:37:50] of what’s possible without something falling over the edge.

Zohaib Ali: Yeah.

Payman Langroudi: I mean.

Zohaib Ali: The nature [01:37:55] of what? Of what we do is, is fraught with danger and [01:38:00] frailty at all times. So the patients are consented for that. But if you look at what’s the worst that can [01:38:05] happen here, what’s the worst that could happen? Oh. I’m sorry. You know, a bit of your of your buccal [01:38:10] composite chipped away because I left it a bit thin there.

Payman Langroudi: Okay, okay. [01:38:15] I’m going to say it in a different way. I’m going to ask you a different way. I’m going to ask you a different. Okay.

Zohaib Ali: Go on. Sorry. No, go for [01:38:20] it.

Payman Langroudi: It’s really, really unfair. But I like to ask it.

Zohaib Ali: Do it.

Payman Langroudi: What was your aha moment? [01:38:25]

Zohaib Ali: My aha moment. Yeah. As in I shouldn’t have done that.

Payman Langroudi: No no no. Aha. Like [01:38:30] something. Click click click. What what clicked. It’s a stupid question [01:38:35] right. Because it’s pros. Right. Yeah. But but I’ve what comes [01:38:40] to mind when I say that like. Oh for me. Yeah.

Zohaib Ali: Um, facially [01:38:45] generated treatment planning.

Payman Langroudi: Oh, as in the shape of the smile. Based on the shape [01:38:50] of the face, the.

Zohaib Ali: The position of the maxillary occlusal plane in relation [01:38:55] to the peripheral tissues and the face and facial harmony. Once you understand that, [01:39:00] everything else just falls into place. And that’s literally how I teach it. [01:39:05] You remember complete dentures? Yeah. Remember setting up the teeth? That is prose in its purest [01:39:10] form. So interesting.

Payman Langroudi: I had another specialist and I asked him that question and he said [01:39:15] almost, almost, he said. He said that complete dentures are where it’s all [01:39:20] at. That’s it. That’s it.

Zohaib Ali: If you can. Because imagine complete dentures, right? You don’t [01:39:25] have any zeniths to work with. You don’t have other teeth to use as a guide. You just have soft tissue [01:39:30] and you have lips and you have eyes. You have facial landmarks. If you can use [01:39:35] those to position teeth. That’s all of pros planning. Basically, that [01:39:40] tells you everything. And it’s and it’s so simple. You know, that’s and that’s what I meant about [01:39:45] simplicity and clarity of thought earlier. Yeah. Yeah. Every case I [01:39:50] do, I visualise it as a complete denture. Well what are the problems here? And [01:39:55] you can almost picture a smile and think, if I could just shift these things around this [01:40:00] way and imagine those teeth were in wax, what would I do to correct this problem [01:40:05] that that’s bras. It’s so clear. It’s it’s not rocket science. It’s really simple. So that was my moment [01:40:10] of all right. Now I know where the teeth need to be.

Payman Langroudi: I kind of put everything in it. [01:40:15]

Zohaib Ali: How do I get them there? What are the patience options from here? Whether it’s perio, surgery, intrusion, extrusion, [01:40:20] laparoscopy, whatever it is. These are the options. This this this is this [01:40:25] is your diagnosis. Here’s your options. What do you want to do? That was that for me. That was [01:40:30] the moment. And I think that’s the crux of it.

Payman Langroudi: We’re at this stage in technology now where [01:40:35] it’s almost like a I mean, you see, I’ll take you downstairs to the lab. We’ve got [01:40:40] half the lab with analogue, half the lab with digital. Digital. Yeah. And the time [01:40:45] that you qualified and you’ve sort of seen both sides of this, and I guess [01:40:50] you’ve got to take a decision in a way. Are you going to be the first to jump on a new digital [01:40:55] trend? Trend? I mean, I know you don’t like that word trend, but on a new digital [01:41:00] technology. Yeah. Or are you going to stick with tried and tested? And [01:41:05] I remember the first cerec that I did was, you know, it was before [01:41:10] your time. It was like a powder that wasn’t before. Red cam with the powder. Do you know it?

Zohaib Ali: I’ve used [01:41:15] it.

Payman Langroudi: Oh. So I, I, I did two cases and [01:41:20] I thought, why, why would you take something so fully predictable as [01:41:25] an only, you know, done, done with gum. Yeah. And turn [01:41:30] it into something so unpredictable as the cerec situation.

Zohaib Ali: And look at it [01:41:35] now.

Payman Langroudi: And look at it now. And by the way, even back then, people invested the time and the learning [01:41:40] curve. And of course, you know, they were you know, I was at the time R&D at the time, I was doing one [01:41:45] day a week, you know, so, so, you know, the amount of time it took me, I wasn’t serious. Yeah. [01:41:50] Yeah. Um, so, so based on that, do you find these areas [01:41:55] that you’re still doing analogue? Do you find are you the type [01:42:00] of person who jumps straight in at first early adopter, To. Would you wait for others to be [01:42:05] that?

Zohaib Ali: I’m again, I’m a little bit on the fence, so there are certain things. So let’s take injection [01:42:10] moulding at that.

Payman Langroudi: Well, you’re right at the tip of the spear there.

Zohaib Ali: Yeah, I’m at the head of the curve. Yeah. I’m not even [01:42:15] an adopter. I’m. I feel like I’m innovating it all the time. Yeah, yeah, yeah. Um, but I’m [01:42:20] doing it in very small steps. Yeah. And in, in very safe ways. Yeah. [01:42:25] So that’s easy to do. If you said so, are you going to start doing, [01:42:30] um, you know, fully guided robot robotic implants for me [01:42:35] that the risk profile is really, really important. That’s my point. Um, [01:42:40] so we’ll take a technology. We’ll see how we can train ourselves on it [01:42:45] in a safe, methodical, stepwise manner and work up to the more [01:42:50] complex way of using it to jump into it with, with, you know, head first on the [01:42:55] outset is just mindless. It’s a bit stupid. So whilst you’d like to take [01:43:00] on new technology, you have to do it in a thoughtful way. And I think [01:43:05] that’s that’s just my approach to life, to just keep going with it. Keep. Because if you’re not [01:43:10] learning, it gets boring after a while. Yeah.

Payman Langroudi: Look, sometimes the dentist gets themselves in hot water. [01:43:15] Yeah. And refers to you. Yeah. What do you do when you get into hot water?

Zohaib Ali: What [01:43:20] do I do when I get into hot water? Yeah.

Payman Langroudi: Is there someone you refer to? No, there is not what [01:43:25] you refer to, you know, in different situations.

Zohaib Ali: No, no there isn’t. I mean, [01:43:30] in specialist practice, you find that that the buck stops with you, [01:43:35] you know?

Payman Langroudi: Basil Mizrahi referral. No no no.

Zohaib Ali: No there [01:43:40] isn’t. And maybe it’s because also maybe I haven’t been in that kind [01:43:45] of hot water before.

Payman Langroudi: It hasn’t happened.

Zohaib Ali: Yet. Yeah. Maybe I need another few years of practice for it to really hit the fan. And [01:43:50] then and then and then you can have me back and we’ll talk about it, you know? Um, [01:43:55] so maybe it’s because that hasn’t happened yet, but I find that [01:44:00] you need to need to take responsibility for if something has gone wrong. I’ve never been in a situation [01:44:05] where something has gone wrong. I’ve told the patient about it. I’ve said, just be patient. [01:44:10] We’ll fix this. And I’ve this. As long as you [01:44:15] discuss that problem before it actually, it manifests itself to the patient. [01:44:20] You’re always clear. And and again, it’s about your heart being in the right place [01:44:25] and having the correct ethos at all times. If it’s not right, tell the [01:44:30] patient. Hey, listen, Jenny, I fucked up. Come back next week. I’m sorry. [01:44:35] You have to take an extra day off work. I’ll give you your money back. We’ll do it for free. Don’t worry about it. I’m [01:44:40] really sorry. I’ve never had a patient complain. Someone said, oh no, my [01:44:45] kids or whatever, or it’s a bit of a headache or, you know, umming and aahing a little bit. I’ve never had anyone [01:44:50] complain if you’ve just said I fucked up. I’m human. I’m sorry. I’ve just never had [01:44:55] that problem. And you know, we do big rehabs, massive grafting and implants [01:45:00] and fixed removable work on difficult cases. Patients. Do you do. [01:45:05]

Payman Langroudi: All the placement yourself? I do a.

Zohaib Ali: Lot of the places myself. Yeah. Yeah. And and you [01:45:10] know, a lot of the patients, even at our level, as if it’s some sort of godly level. [01:45:15] A lot of it is compromised treatment. Patients don’t want the orthodontics. They’ve got difficult occlusions, [01:45:20] but they’re 65. And, you know, they make cakes like other patients. She’s [01:45:25] like she’s honestly she’s like 68 years old. She’s like Britain baking champion. Her brownies [01:45:30] are fucking amazing. And she’s like, I don’t have time for orthodontics. I go on TV and I show people recipes [01:45:35] and I don’t have time for orthodontics. Just fix my teeth the way they are. Just do what you can in the way they are, and [01:45:40] you’ve got to find a way around it. For those cases. You can’t pass that to Basil Mizrahi, because what’s [01:45:45] he going to do? He’s going to say, you know, orthodontics. He’s not going to say anything different. Yeah. So, [01:45:50] you know, you just have to find ways of clever ways of doing it. And then finally [01:45:55] consenting the patient to say, look. And I think that’s where patient autonomy is really important. And, you know, we go back to [01:46:00] that conversation to say this is what I’m recommending. Option A is orthodontics [01:46:05] plus restorative at a grand cost of £5 million or whatever it is. Or we can leave out the orthodontics [01:46:10] and it’ll cost you £4.9 million. Um, but these are the compromises. [01:46:15] I think that’s where autonomy is really important.

Payman Langroudi: I think also also when you’re an expert, even [01:46:20] when you’re in hot water, do you know that you’re you’re doing everything [01:46:25] that is possible to be done? Yeah. So you don’t the hot water doesn’t feel as hot. No.

Zohaib Ali: Then [01:46:30] no. Because, you know.

Payman Langroudi: You’ve done everything the right way. Everything that is possible, you know, up to. Yeah, [01:46:35] absolutely.

Zohaib Ali: Up to the standard. So you speak with confidence and I think touching on [01:46:40] that speaking with confidence and patient communication. I’m not I’m really not [01:46:45] a big fan of, of communication courses which teach you how to sell to patients. [01:46:50] Can we can we get. Here we go again. Because because listen, if a patient needs, needs a crown [01:46:55] or they want aesthetic or whatever they need, right? Just tell them that they need it. Just say, hey, listen. Your [01:47:00] teeth. Your teeth are big amalgams. At some point your teeth are a bit worn. It’s going to it’s going to crack. [01:47:05] So you’ve got to.

Payman Langroudi: It’s going to maybe you’ve forgotten what it was to be a generalist. To be a generalist. [01:47:10] I haven’t I know, I know you haven’t, I.

Zohaib Ali: Know I really haven’t.

Payman Langroudi: But I’m saying what I’m saying is from a position of authority, [01:47:15] of a specialist who’s been pre-sold by the referrer, by the way. Yeah. Patient [01:47:20] walks in already. The referrer sold you.

Zohaib Ali: They have to a point.

Payman Langroudi: Yeah. Now, [01:47:25] now the patient comes in thinking I’m seeing the expert. That’s that’s a whole different position [01:47:30] you say this needs you need this. That patient fully accepts that. [01:47:35] They need that. Now it’s just a case of have they got the money or not? Yeah. The generalist. [01:47:40]

Zohaib Ali: It’s a different ball game because.

Payman Langroudi: They have to open.

Zohaib Ali: The conversation at source like so I know what [01:47:45] you’re saying. But my patients generally are not referred for full mouth rehabilitations. [01:47:50] They’re referred because they’ve got a failing bridge somewhere or.

Payman Langroudi: Well, they can’t [01:47:55] see their smile. Something’s happened like that.

Zohaib Ali: And? And so they haven’t been told. Listen, you’ve got [01:48:00] six molars with mod B’s that all need crowns. They’ve just [01:48:05] been told. Oh, you got tooth wear because you can’t see your teeth and you want and you want an aesthetic upgrade. I [01:48:10] can’t do it. Go see them. I have to open that conversation of, well, you know, you want [01:48:15] this, but to make it stable, you also need that. I have to have that conversation [01:48:20] with the general dentist isn’t in their ten minute consultation if they’re an NHS [01:48:25] patient or whatever. Having that conversation, I have to broach that subject. And what I found [01:48:30] is, and this is speaking to somebody who had awful communication with patients and I [01:48:35] mean really fucking awful, really awful. I take that as a compliment that [01:48:40] you’re surprised by that. I really take that as a compliment. I’m surprised. It was awful. Really [01:48:45] horrendous. Clinically, technically I didn’t I never had a huge problem, but communication [01:48:50] was terrible. I’m so tired. So, so coming [01:48:55] from somebody who had that in their past to to what I do now, I can [01:49:00] tell you the biggest difference between now and then one, I’m more [01:49:05] emotionally aware of patients.

Zohaib Ali: That’s a big part of it. It’s huge. But the second is [01:49:10] that let’s say I’m a so-called expert in my field. I understand [01:49:15] what I’m talking about in a very, very detailed way, [01:49:20] but also in a very simplistic way that can be communicated to patients. I [01:49:25] can simply say, hey, did you see this picture? This mould is cracked. What do you think’s [01:49:30] going to happen to it next? You know. Yeah. Yeah. And [01:49:35] it’s that simple. It doesn’t it doesn’t need any more than that. You don’t need [01:49:40] to tell them about the benefits of ceramic coverage versus amalgam expansion. You don’t you [01:49:45] don’t need to tell them that they don’t. And they don’t care. They don’t actually care. Yeah. So I find that the [01:49:50] biggest barrier to actually patients accepting care is us not being able to communicate effectively. [01:49:55] I agree, and that’s the only bit of miscommunication. Just dumb it down for them. That’s that’s it. You [01:50:00] don’t need a sales sales course for that. You need to understand it better yourself and present it with [01:50:05] clarity. Yeah, I’m a bastard. I know I’m a bastard, I know. [01:50:10] No.

Payman Langroudi: I wasn’t thinking that. Um. You’re absolutely right. You’re absolutely right. I mean, number [01:50:15] one. Listen. Yeah. So important. Yeah. Um, but you’re right in that [01:50:20] I see young dentists. Sometimes they make the mistake of putting everything in their head, telling the patient everything. [01:50:25] Yes. Yeah. That’s not our job. No. Yeah. Our job is not to tell them everything. Yeah. [01:50:30] Um. You’re right. I hear people talking about porcelain rather [01:50:35] than talking about the benefits of the treatment. Mhm. Mhm. Big big mistakes [01:50:40] of of of of inexperience you know.

Zohaib Ali: That’s right. It’s inexperience which [01:50:45] is hard to tell someone who is inexperienced. It’s hard to get that through to them. [01:50:50] And, you know, people that I mentor and someone came to me with a basically a full arch rehabilitation [01:50:55] recently. And I know they’re not ready for the case, but they’re not going to listen to me. They’re [01:51:00] not going to listen to me about it. The clinician. Yeah. Yeah. Lovely person. Really nice person. [01:51:05] But they’re definitely not going to listen to me about it. And either I make the decision [01:51:10] to just cut the cord and say, I’m not going to help you with it, or and they’ll [01:51:15] go and do it anyway, or go to somebody who doesn’t know what they’re talking about and get bad mentorship, or [01:51:20] they’ll do it without any mentorship whatsoever. So it’s [01:51:25] a difficult situation. It’s a difficult because medical legally, if you’re advising someone, it’s I, [01:51:30] you know, there is some element of liability there as well. But I [01:51:35] feel like at some point you’ve got to you got to just stop worrying about yourself and help others as well. [01:51:40] If I, if I don’t help that person, that clinician who’s going to suffer, they’re going to suffer and [01:51:45] the patient is going to suffer. So at some point, I think you’ve got to take your own personal hat off and then be [01:51:50] a human and just think, think about others for a while. It’s really important. [01:51:55] Really, really important.

Payman Langroudi: It’s been a lovely conversation. I really enjoyed it. [01:52:00]

Zohaib Ali: Me too. Thank you for having me. I hope, uh.

Payman Langroudi: The simulations, the dates 20, [01:52:05] 29th, ninth and 30th.

Zohaib Ali: 30th. You should know because we’re we are hosting a party. [01:52:10]

Payman Langroudi: On the 29th.

Zohaib Ali: On the 29th.

Payman Langroudi: On the 29th. Um, and [01:52:15] the website by malaysian-symposium.com.com. [01:52:20]

Zohaib Ali: Yes. All the information is there. The lectures, the venues, the party information [01:52:25] will be there very, very soon, I promise. Payman. Um, there’s a link to the ticketing [01:52:30] website. It’s getting very full and I’m really, [01:52:35] really looking forward to which lecture are.

Payman Langroudi: You looking forward to the most? It’s unfair. Is [01:52:40] that unfair? Is that unfair to ask?

Zohaib Ali: You know what? They’re all such wonderful clinicians. Payman.

Payman Langroudi: Uh. Name one, [01:52:45] name one.

Zohaib Ali: I think if you. I think if you haven’t seen these lectures before, um, [01:52:50] probably Javier Tapia. His work is phenomenal. And also his lectures [01:52:55] and his slides are absolutely stunning. So that would be the one for me.

Payman Langroudi: Amazing.

Zohaib Ali: Absolutely. [01:53:00]

Payman Langroudi: It’s been a massive pleasure to have you, but I’m going to finish with the usual questions. Fantasy [01:53:05] dinner party. Okay. Three guests. Ooh. Dead [01:53:10] or alive?

Zohaib Ali: Dead or alive. Um, is it just me and the three guests? Yeah. [01:53:15] Dead or alive? Yeah. Oh, [01:53:20] fuck. I should have been prepared for this payment.

Payman Langroudi: Did I not send you these?

Zohaib Ali: No. Yeah. Um, [01:53:25] okay.

Payman Langroudi: Well, the next one you’re going to answer more easily. [01:53:30] So then the other one will marinate. Yeah. Deathbed question. On your deathbed. [01:53:35] Three pieces of advice you’d leave to your loved ones. [01:53:40]

Zohaib Ali: Work [01:53:45] hard. Always [01:53:50] be true to yourself. [01:53:55] And then always be true to your loved ones.

Payman Langroudi: True [01:54:00] to your loved ones. Yeah. Yeah. Explain that one. [01:54:05] Be yourself. Be yourself. Not [01:54:10] so much.

Zohaib Ali: That I think. I think sometimes in order to protect loved ones, you [01:54:15] might go around certain subjects or hide certain things. Oh, I [01:54:20] see. And just be upfront about it.

Payman Langroudi: Oh, I see.

Zohaib Ali: Communication and relationships. [01:54:25]

Payman Langroudi: Yeah yeah yeah yeah yeah yeah. Work hard. Yeah. [01:54:30] They’re good. They’re good ones.

Zohaib Ali: Work hard. Be true to yourself. And be true to your. [01:54:35] To your loved ones.

Payman Langroudi: Yeah. And the dinner party.

Zohaib Ali: The dinner party, I [01:54:40] think. I’m really, really [01:54:45] stuck. I think I need to work on my on on my idols a little bit.

Payman Langroudi: Clearly it doesn’t [01:54:50] have to be idols. It could be, but. But your grandfather.

Zohaib Ali: You [01:54:55] know, my grandfather passed away, and I didn’t really know him very well. So I’m going to go.

Payman Langroudi: Would be a good candidate.

Zohaib Ali: For that reason. [01:55:00] Actually, he was a he was a famous scientist in in agriculture. Yeah. Was he. Yeah. Yeah. [01:55:05] He pioneered a genetically modified cotton strain, which was resistant to [01:55:10] a virus that was sweeping through Pakistan. Wow. And single handedly saved the cotton [01:55:15] industry in Pakistan. Wow. He was a clever guy. Yeah.

Payman Langroudi: Is that your mom’s dad or your dad’s dad?

Zohaib Ali: My dad’s [01:55:20] dad.

Payman Langroudi: What did your dad do?

Zohaib Ali: He’s a doctor. Yeah, he is a doctor. Yeah. Yeah. But I [01:55:25] don’t really speak with him too much, so. Um. Scientific family for sure. So. Probably. [01:55:30] Yeah. My my my. Do you know what? My my. Three [01:55:35] out of my four grandparents. Because I never got to spend [01:55:40] much time with them. They will be my three guests.

Payman Langroudi: And one you did.

Zohaib Ali: One I remember [01:55:45] more of. So the other three.

Payman Langroudi: Well, you can have all four, man. All right.

Zohaib Ali: I’ll take all four.

Payman Langroudi: You can have all but [01:55:50] but in fact, you can have all four. And one other person can give me one more.

Zohaib Ali: If I had one more. [01:55:55] Probably [01:56:00] Muhammad Ali. Probably [01:56:05] Muhammad Ali. You probably get that one a lot. Do you?

Payman Langroudi: I think I’ve had him before. I [01:56:10] think I’ve had him before. Probably Muhammad Ali. What did you love so much about him?

Zohaib Ali: You know, [01:56:15] there’s so many facets to his life. Yeah. So many stages of it. Yeah. [01:56:20] Um, I mean, and it’s almost like there’s a continuous theme running throughout his life of [01:56:25] racism and all that kind of stuff. Yeah. And then the religious aspect. But there’s there were so many [01:56:30] facets to the sport, the race side, the political side at that time. [01:56:35] How do you how does one person deal with all of that and still come through it. [01:56:40] I’d love. I mean, imagine how resilient he is. I’d love to know where he gets that [01:56:45] strength from. That’s incredible.

Payman Langroudi: Yeah. It’s been a massive pleasure, man. Really, really enjoyed it.

Zohaib Ali: Thank [01:56:50] you. Payman. It’s been a pleasure. It’s been a pleasure.

Payman Langroudi: Talking to you, man.

[VOICE]: This [01:56:55] is Dental Leaders, the podcast where you get to go [01:57:00] one on one with emerging leaders in dentistry. Your [01:57:05] hosts, Payman Langroudi and Prav Solanki. [01:57:10]

Prav Solanki: Thanks for listening, guys. If you got this far, you must have listened to the whole thing. [01:57:15] And just a huge thank you both from me and pay for actually sticking through and listening to what [01:57:20] we’ve had to say and what our guest has had to say, because I’m assuming you got some value out of it. [01:57:25]

Payman Langroudi: If you did get some value out of it, think about subscribing. And if you would [01:57:30] share this with a friend who you think might get some value out of it too. Thank you so, so, so much for [01:57:35] listening. Thanks.

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

Payman Langroudi: Were you this person before the abuse? And then you found I lost [00:00:05] myself, I lost me.

Devina Lavan-Iswaran (Coco): Yeah. Yeah. And this is what I said to my life coach. [00:00:10] I need to find myself back again. I need to find that girl [00:00:15] who, at eight years old, believed in herself. I need to find her [00:00:20] back again. And so one day, he did this thing where he said [00:00:25] to me, think back to when you were eight years old, and remember that girl. [00:00:30] Remember how she wasn’t afraid of anything. Remember how she dared do things. [00:00:35] Remember. Remember that girl? Oh my gosh. I cried for like two weeks [00:00:40] because I remembered that girl who was [00:00:45] like, not afraid, who was positive. Yeah. And I thought, I’ve got to get [00:00:50] that girl back.

[VOICE]: This [00:00:55] is Dental Leaders The podcast [00:01:00] where you get to go one on one with emerging leaders in dentistry. Your [00:01:05] hosts Payman Langroudi [00:01:10] and Prav Solanki.

Payman Langroudi: It gives me great pleasure to welcome Davinia [00:01:15] Laverne Iswaran onto the podcast, otherwise known as Coco, to the wider [00:01:20] dental community, someone who’s had a tumultuous career, [00:01:25] if you want to look at it that way. But for me, someone who’s come out the other end of it, [00:01:30] one of the most positive people I’ve come across, and so you’re a real enigma to me. So [00:01:35] that’s that’s why that’s why I asked you to come onto the pod. Lovely to have you.

Devina Lavan-Iswaran (Coco): Thank you for having [00:01:40] me here. Payman.

Payman Langroudi: I tend to with these things. I [00:01:45] tend to go into the backstory and all that. But [00:01:50] I do want to ask a question first, because if I don’t ask it, then I’ll be waiting to ask the [00:01:55] question throughout and it’ll just put me off here that this this [00:02:00] positivity that you’ve got. Right. That you project. Is [00:02:05] the projection of positivity as important to you [00:02:10] as self-care that comes from it? Because I feel like you really [00:02:15] do. Like you’re on a mission to change other people.

Devina Lavan-Iswaran (Coco): It is absolutely hand on [00:02:20] my heart. My mission is to want to look [00:02:25] at my own life in a positive light, and you can always find positivity [00:02:30] in a negative situation. Yeah. Um, and also to spread happiness [00:02:35] and to spread that joy, you know, like, just imagine you go into the [00:02:40] surgery, um, and you’re grumpy, and then you pass on your grumpiness [00:02:45] to the next person, and then they go home, then they like, let’s say it’s your nurse. She goes [00:02:50] out, she shouts at the receptionist, and the receptionist shouts at the patient. And then it’s kind of snowballed.

Payman Langroudi: It’s infectious [00:02:55] in the same way as positivity is.

Devina Lavan-Iswaran (Coco): That’s right. So it’s so important to [00:03:00] pass on that. It’s it’s like, you know, light a candle and pass it on. That’s [00:03:05] how I think of it. Um, and it it’s like it helps [00:03:10] you like your light and happiness will [00:03:15] reflect on other people. And then when they come into your aura, they then [00:03:20] take that on and pass it on. And is it a muscle?

Payman Langroudi: Like, is it something that [00:03:25] because some people are very good at being negative. Yeah. That’s that’s their skill. [00:03:30] Almost like they can find what they don’t like about something and, and talk about that in [00:03:35] a, I don’t know, call it a funny way for the sake of the argument. And then if you say to that person, listen, you’re spreading [00:03:40] negativity, which she is or he is, yeah, well be positive. That person’s not very [00:03:45] good at being positive. They’re good at being negative. So so do you find that being positive [00:03:50] itself is a is a muscle that can be trained?

Devina Lavan-Iswaran (Coco): It can be. It can be. So [00:03:55] for example, if I say to you, Payman spot the red cars on the street, [00:04:00] right?

Payman Langroudi: Look out for those.

Devina Lavan-Iswaran (Coco): So you’ll be looking out for the red cars. Yeah. Whereas if I say to you. Okay. Payman [00:04:05] spot the yellow cards on the street, and then you’re suddenly looking at all sunshine and happiness. [00:04:10] Yeah. Right. So that’s how I think of as positivity in life. I’m looking [00:04:15] for the gems every day, and at the end of every day I sit there and I think, right, what [00:04:20] were my gems today? And then just, you know, and.

Payman Langroudi: In a bad [00:04:25] situation you’re thinking, what’s the positive that I can get from this?

Devina Lavan-Iswaran (Coco): What have I learnt from this? What are [00:04:30] the good things that I’ve learnt from this? You know, and life has thrown me some big curveballs, [00:04:35] but yet I still I’ve kind of turned it around. I don’t want [00:04:40] to let myself be dragged down by that, um, you [00:04:45] know, by my past, my whatever has happened to me, I just [00:04:50] want to just move on and, um, you know, just [00:04:55] take the lessons I’ve learned from that and then just.

Payman Langroudi: Spread the joy. Yeah. [00:05:00] Let’s get to your backstory. You grew up in Singapore?

Devina Lavan-Iswaran (Coco): Yes, I [00:05:05] did. So I had a lovely childhood growing up in Singapore. And at the age of [00:05:10] eight, my dad said to me, write if you can top the school year, I’ll [00:05:15] let you go to England on a school holiday. And so I was like, right, I’m [00:05:20] going to do this. So we had 50 kids in a class. So this is, you [00:05:25] know, far eastern culture, loads of kids packed in a classroom. And there were [00:05:30] two classrooms. And I thought, okay, I’m seriously going to get down to this and do it [00:05:35] every year. I’d be sort of like in the top 5 to 10 kids, [00:05:40] but never, never the top kid.

Payman Langroudi: Must be tough in Singapore.

Devina Lavan-Iswaran (Coco): It is.

Payman Langroudi: It [00:05:45] is tough in Singapore.

Devina Lavan-Iswaran (Coco): Especially Asian parents. Exactly right. So [00:05:50] I put my head down to it and I came second and I [00:05:55] thought, why did I become second? Why did I not get the top spot? And I thought, now my [00:06:00] dad’s not going to let me go, whatever. And he said, let me see your papers. Let me see where [00:06:05] you lost this mark from in my Mandarin. Top marks in my English, top [00:06:10] marks in my maths. I got 49 out of 50. And the kid who got the [00:06:15] top spot got 50 out of 50. And I thought, what did I do wrong? And my dad’s looking [00:06:20] at this paper and I’m like, dad, she’s marked this thing wrong. And it was like, join the [00:06:25] dots, for example, from 0 to 100, right? So I joined the dots from 0 [00:06:30] to 100 and made, let’s say. And they said, what is this picture? What’s this picture you’ve [00:06:35] drawn? So I said what it was, let’s say it was a spaceship. Yeah. And then I [00:06:40] got 49 out of 50 and I thought, what’s wrong with it? Because I didn’t join [00:06:45] the 100 to the zero. And I was like, dad, they didn’t tell me to join the 100 to the zero, [00:06:50] did they?

Payman Langroudi: You mean you followed the instructions to.

Devina Lavan-Iswaran (Coco): Follow the instructions? It said. Because [00:06:55] I did toy with it and think the picture looks incomplete. Should I go from there? But have you.

Payman Langroudi: Not seen [00:07:00] the Richard Branson version of The Apprentice? Have you seen that one? No. There’s [00:07:05] a Branson version. It’s not The Apprentice. It’s called, like, Rebel Billionaire or something. [00:07:10] Maybe it didn’t work and they didn’t do many episodes of it. But I watched this thing, and he’s got this. When it gets [00:07:15] down to the last three, he puts them all in this boat thing and [00:07:20] they buckle up and he says, we’re going to go over the Niagara Falls together. And so [00:07:25] they all do it. And then just just before they sort of count down, just before they count down, [00:07:30] that one of the ladies says, I can’t do this, I’m not doing this. And she gets up and walks out [00:07:35] and Branson fires the other two who are sitting in the boat for not questioning, [00:07:40] like he was never going to go over the over the, you know, questioning, [00:07:45] not questioning a bad command. Oh, why am I bringing that up? Oh. Following [00:07:50] instructions. Right. Yeah, yeah. So? So what happens? So what happens?

Devina Lavan-Iswaran (Coco): So then my [00:07:55] dad said, you know what? You deserve to go because you followed the instructions, right? [00:08:00] They didn’t ask you to join the 100 to the zero. Yeah. So I then came to England. [00:08:05] Loved it. Oh, so he took that.

Payman Langroudi: Your dad took that on?

Devina Lavan-Iswaran (Coco): That’s it. Like he was like he goes, you know [00:08:10] what? He goes, they didn’t ask you to do that. So off you go. So I came here on a trip [00:08:15] because I.

Payman Langroudi: Was going to say I’d rather figure out how to kill the other kid than try and beat [00:08:20] the top kid in maths in Singapore, like. [00:08:25]

Devina Lavan-Iswaran (Coco): Sabotage the others so you can get to the top. It would be.

Payman Langroudi: Easier to get [00:08:30] rid of that kid. So? So you. So how old were you when you came? Eight. [00:08:35]

Devina Lavan-Iswaran (Coco): So then I came here at eight for a holiday, and I stayed with my dad’s sister, went to [00:08:40] watch these theatre shows, everything. And my dad had been to boarding school when he was young. [00:08:45] So no, in um, in Malaysia. And [00:08:50] then in Sri Lanka during the Japanese occupation. So he was [00:08:55] like, you know. He loved boarding school. He loved the idea to tell us stories. And then he was here at [00:09:00] university in Oxford.

Payman Langroudi: So can you just remind me, is your dad a diplomat?

Devina Lavan-Iswaran (Coco): No, he’s [00:09:05] an obstetrician and gynaecologist. The other end. Okay, so [00:09:10] in our family, we have this this joke that goes around. So my granddad was [00:09:15] a professor in pathology, so he’s a doctor, but dealt with all the dead bodies. Yeah. And [00:09:20] then my dad then dealt with life. And then I then dealt with the other end. So [00:09:25] it’s like.

Payman Langroudi: Are there loads and loads of doctors and dentists in your family?

Devina Lavan-Iswaran (Coco): I’m the first [00:09:30] dentist. Oh, really? There are lots of doctors. Yeah. Always wanted to [00:09:35] kind of do medicine, but then also had that artistic side from my mum [00:09:40] and then thought, okay, there’s that pool. And then I said, oh, I’m, [00:09:45] I might consider going to art school and becoming a fashion designer. [00:09:50] Well, in an Asian family that went down like a bomb. That didn’t.

Payman Langroudi: Work out.

Devina Lavan-Iswaran (Coco): So [00:09:55] then I thought, I actually, if I do dentistry, it’s that combination of art [00:10:00] and science. Yeah. So actually, that’s a good career to do.

Payman Langroudi: Do you know Andrew Dawood?

Devina Lavan-Iswaran (Coco): No. [00:10:05]

Payman Langroudi: He’s he’s a top implantology artist. And he was saying he said [00:10:10] to his Jewish parents he wants to be a potter make pots. And [00:10:15] he was saying that didn’t go down very well at all. So he did dentistry [00:10:20] instead.

Devina Lavan-Iswaran (Coco): Yeah. So I thought, well, in dentistry I sit there and I blend shades and everything. [00:10:25] So, you know, that’s. And even today, one of my patients, she said to me, I can tell you love [00:10:30] what you’re doing. Look at what you’ve done to my smile. And she goes, how you’ve sat there and [00:10:35] you’ve, like, carefully done everything. Then you’re looking at the front of me, the side of me, everything. [00:10:40] And I said, yeah, I love what I do.

Payman Langroudi: So I do want to delve into what drives you as a dentist. [00:10:45] But before we move on, I’d like to know how you felt in Singapore. [00:10:50] Did you feel like it was your country?

Devina Lavan-Iswaran (Coco): Oh, I love home. Oh [00:10:55] my God.

Payman Langroudi: Did you. Were you made to feel like you were a native? Someone from there?

Devina Lavan-Iswaran (Coco): It’s a very multicultural [00:11:00] island. Yeah. So everybody celebrates [00:11:05] everyone’s festivals. So we celebrate Eid. We celebrate Diwali, Chinese New Year. [00:11:10] You know, it’s all like one big party. Through the years. So imagine you get [00:11:15] all their bank holidays as well, and you get to go to your friends houses to celebrate all [00:11:20] these great festivities. Christmas, you know, Diwali, eat whatever else.

Payman Langroudi: And [00:11:25] as a as a place to live. Is it that utopia that we’re kind of told it is here [00:11:30] or or is it that sort of state strong state that sometimes feels overpowering, [00:11:35] like what’s the biggest misconception people have about it.

Devina Lavan-Iswaran (Coco): I never felt that [00:11:40] kind of thing. But then there was like a little bit there was a [00:11:45] tinge of racism in terms of, you know, the Chinese always got the better jobs, etc., [00:11:50] all those things. And then sometimes you’d get like in any country where you get all kinds of [00:11:55] races and everything in. So as in a pool. And this Chinese kid said to me, why are you so dirty? [00:12:00] And I thought, hello, I’m chocolate. Don’t be telling me I’m dirty. You like chocolate, [00:12:05] right?

Payman Langroudi: The kid meant it, though. You know, the kid wasn’t being racist. No, the kid was just being a kid. [00:12:10] Yeah. That’s it.

Devina Lavan-Iswaran (Coco): You know, because kids like that, they don’t [00:12:15] know racism, do they?

Payman Langroudi: So your first impressions when you saw the UK, were [00:12:20] you, I imagine an element of excitement or nervousness, but but what [00:12:25] were the first few things that you noticed that sort of stuck with you?

Devina Lavan-Iswaran (Coco): The first thing that [00:12:30] stuck with me was that the cats were so big that in our neighbourhood we had loads [00:12:35] of stray cats and, you know, you see them on the Asian streets. They’re skinny, scrawny [00:12:40] little things. And then I saw these fat cats here and I thought, and they’re big. They’re giant. [00:12:45] They look like dogs.

Payman Langroudi: That’s funny, isn’t it?

Devina Lavan-Iswaran (Coco): So that stuck with me. And then [00:12:50] I loved the theatre. Oh my gosh. I went to see Annie. I went to see the [00:12:55] King.

Payman Langroudi: And what year was it?

Devina Lavan-Iswaran (Coco): It was in 78. Something like that. 70 [00:13:00] Winter.

Payman Langroudi: Of discontent. Right. There was a general strike all around [00:13:05] the UK like.

Devina Lavan-Iswaran (Coco): But I came and I went to. Oh my gosh, I went to the Tower of London. [00:13:10] I couldn’t believe they chop people’s heads off. You know, they’re the king or queen could decide.

Payman Langroudi: So [00:13:15] then you spent a summer enjoying. But then did they leave you in boarding school and.

Devina Lavan-Iswaran (Coco): No, no, no. So then I went [00:13:20] back up and my dad said, well, did you like England? Would you like to go there to boarding school? And I said, [00:13:25] oh my gosh, yes, because I read Malory Towers, all those Enid Blyton books. And [00:13:30] then so he said, yeah, okay, I’ll send your sister first to boarding school since she’s older. [00:13:35] And I was like, please, I want to go. She’s a bit like not so sure whether she wants [00:13:40] to go or not. And so I used to go degree of.

Payman Langroudi: Confidence in a, in an 11 year old or [00:13:45] eight year old, whatever you were. That’s a degree of confidence, isn’t it?

Devina Lavan-Iswaran (Coco): There is. But then [00:13:50] it’s like when I actually came, right? [00:13:55] When I actually got to the.

Payman Langroudi: Reality.

Devina Lavan-Iswaran (Coco): The reality hit. Not [00:14:00] when I was there because I thought, great, I have a massive sleepover with all these girls [00:14:05] every day, you know, get to go to school, do all these other different things. I get to [00:14:10] play hockey, I get to play netball. They we played different games and things as well. So [00:14:15] the excitement then at the end of the first term when my mum came to pick me up with [00:14:20] my grandmother, imagine Christmas really, really cold, everything. But I kind [00:14:25] of absorbed everything in. And then I looked at her and I cried [00:14:30] because then I suddenly realised, oh my God, I’ve missed my mum. And [00:14:35] then she, she as a parent now when I think if my kid [00:14:40] did that, oh my gosh, my heart would break. And our heart broke. We were supposed to spend Christmas [00:14:45] here. She phoned my dad in Singapore. She’s like, babe, we’re coming back home. And then [00:14:50] we went back home for the holidays. But I never even [00:14:55] missed my parents.

Payman Langroudi: You’re too busy to miss your parents.

Devina Lavan-Iswaran (Coco): It [00:15:00] was just the sheer joy of yes, I’ve come. I love this place. You know, I met your. [00:15:05]

Payman Langroudi: Daughter and you’ve started the charity with your daughter. But, um. Would [00:15:10] you put your own kids in boarding school? Yes.

Devina Lavan-Iswaran (Coco): Did you? I would, my son, [00:15:15] probably. He wouldn’t have liked it because he’s kind of like, um. [00:15:20] I don’t think he would have liked it. He’s. But he’s in the British Army. He loves that. [00:15:25] Yeah, he he’s great at doing, um, going out there [00:15:30] Sitting while camping, doing all those things. Yeah, my [00:15:35] daughter would have thrived in boarding school, but at the point when I would have liked [00:15:40] to have sent her was the time when I was getting divorced and things. And so it was a really hard time. [00:15:45] There were too many things happening in one go, and I thought, you know, I can’t really do [00:15:50] this to her, though in a way, you sometimes think, maybe if I put her there, there may have been some kind [00:15:55] of stability, but then it was the affordability as well. So I absolutely could not have afforded [00:16:00] to send her. That’s why I said to her, your university life, go away. Please [00:16:05] do not stay in London. Go enjoy it. Oh my gosh, she’s had the best time ever and she’s just [00:16:10] graduated. But that girl in camping. Let me tell you a story. When your kids say they want to go [00:16:15] to these festivals, whatever you say to them, go. Go with my blessing. Have the best time [00:16:20] ever. Enjoy yourself. And I said to her, there’ll be loads of drugs there. Whatever. Please, please be [00:16:25] careful. Do not touch those things. They’re laced with all kinds of things. She goes, mummy, I am sensible, [00:16:30] don’t worry. So off she went. She came back on Monday. I was so happy because she [00:16:35] said never will I go again. So sometimes you have to let your kids go and do things because [00:16:40] you know they will hate it. Because if you stop them going then they never get to experience it [00:16:45] and say she was.

Payman Langroudi: At the wrong festival. Which festival did she go to?

Devina Lavan-Iswaran (Coco): So she went to Boomtown.

Payman Langroudi: I told [00:16:50] her.

Devina Lavan-Iswaran (Coco): She was like, no, no, never again. She goes, I don’t know how people do all these things. The portaloos. [00:16:55] So excited. This is what she said. She said she went to the portaloo. [00:17:00] She said I made a mistake. I looked inside and I started heaving and [00:17:05] she goes, my friend next door was like, Anoushka, you haven’t even drunk. Why are you heaving? [00:17:10] And she goes, I’ve looked in the loo, I can’t do this. She goes, we’ve got four more days. So [00:17:15] I said, well, there you go. I said, you went on Duke of Edinburgh when you were at school and you didn’t [00:17:20] like it. And she goes, I thought this might be different. I thought it would be a little bit more glamorous. [00:17:25] She goes, but it was worse. So she will in a boarding [00:17:30] school situation. English boarding schools now. My goodness me, they have all kinds of things [00:17:35] there. Golf? Yeah. Rock climbing. This, that and the other. Yeah. When [00:17:40] I went to boarding school, my first boarding school was, um, convent school. Wow. [00:17:45] Um, run by nuns. Because I went to a convent school in Singapore. Even though we’re Hindus, my parents [00:17:50] believed that, like the Catholics.

Devina Lavan-Iswaran (Coco): And the nuns knew what to do and would make sure [00:17:55] that you didn’t run riot. Um, my second boarding school was very much your [00:18:00] Malory Towers boarding school. Laura Ashley curtains, beautiful bedding [00:18:05] in Oxford. So it was lovely, really, really lovely. And then my third boarding [00:18:10] school was a very international boarding school. But in between that my mum said to me, okay, for sixth form, [00:18:15] why don’t you go to boarding school where your brother is in Scotland? So I said, okay, [00:18:20] I’ll go and see that because she said he’s alone there. All you girls are here. Go up there. They’re going to offer you a scholarship [00:18:25] and everything. They’ve seen your grades. They think you’re amazing. I went up there. The rain [00:18:30] came sidewards bare floors, traditional Scottish boarding school. Freezing [00:18:35] cold, the wind running through the boarding school. I was like, mum, I’m not going to be here. This is not [00:18:40] my kind of life. So like boarding schools have [00:18:45] changed from that rugged bear thing nowadays. Imagine if you sent your child to a school [00:18:50] that was like that. The the school would be shut down very soon, right? [00:18:55] Well, listen.

Payman Langroudi: I’ve got friends with kids in boarding school who are very happy with the situation. Um, [00:19:00] I went to a school that had boarding. I wasn’t boarding there, but I saw [00:19:05] enough people who were having a terrible time. Oh, there are.

Devina Lavan-Iswaran (Coco): Lots of kids who have a bad time that I.

Payman Langroudi: At [00:19:10] the time decided I wouldn’t do that. But then the interesting. I don’t [00:19:15] know, man. The time with your kids is so short. It is short to shorten it further. [00:19:20] It just seems like so difficult. And maybe it’s like the, you know, they say the ultimate expression of [00:19:25] love is to let go or whatever. Yeah. It is. If you’re thinking of the kid, maybe the best [00:19:30] thing for that kid is boarding school in Switzerland or whatever. Yeah, but but sometimes you selfishly want to [00:19:35] keep the kid. And I think.

Devina Lavan-Iswaran (Coco): We shouldn’t kind of like, almost I am. [00:19:40] I will fully admit, I helicopter parented my kids. He truly hovered over them [00:19:45] and were like, you will do this, you will do, lets help you with this, that and the other. But you have [00:19:50] to let them go. You have to let them make mistakes. And boarding school actually [00:19:55] gave me a backbone, a core, a core of strength, [00:20:00] which is your self-reliance. Together your and you know, we’d have things like competitions, [00:20:05] right. In boarding school. And you’re going to laugh at this whereby sports day you’d [00:20:10] be like you’ve got to pick the best of everybody to run, etc.. Where did they give me to [00:20:15] run the place by the woods, because they thought I’d be so scared that, you know, you’d always have these [00:20:20] dodgy people hanging out in the woods, etc.. Oh my god, we won that race because they knew [00:20:25] I would run so fast in the relay down that stretch then, you know. So we [00:20:30] did things like that where our boarding house was the smallest boarding house and you’d have inter-house competitions, [00:20:35] so it made you realise what competition is about. You know, these days when they tell kids [00:20:40] no one’s the winner, you know, I mean, sorry, everybody’s a winner.

Payman Langroudi: Prize winner.

Devina Lavan-Iswaran (Coco): I’m like, no, [00:20:45] no, no, you win or nothing. That’s what I say to my kids. You’re in it [00:20:50] to win it, right? Don’t come back home and be telling me, oh yeah, we all want this. But I said, [00:20:55] no, no, you got to realise that and carry this through because you’re going to apply for [00:21:00] a job. What? You haven’t got the job, so you’re still a winner. No you’re not right. So you’ve got [00:21:05] to let them have that competitive edge. You’ve got to let them have that drive, that ambition. [00:21:10] Because I like I was given that ability in boarding school to [00:21:15] do all those things. I think that kind of like set me up for life [00:21:20] and thought, you know, if you fail, you will pick yourself up. You will. And you [00:21:25] had friends around you. And it made me realise the importance of having a village as well, you [00:21:30] know, and from boarding school. And I have to say this when you say, you know, you selfishly want to [00:21:35] keep your kids to yourself, they need friends, they need you’re not going [00:21:40] to be around forever. They need a.

Payman Langroudi: Community.

Devina Lavan-Iswaran (Coco): And I’m not going to be around forever. Um, [00:21:45] but maybe our lights will be around forever, right? [00:21:50] If we if we do the right thing. But, um, we’re not going to be there [00:21:55] for them, so they need their friends. Like, I have friends from kindergarten [00:22:00] who are still my friends and I. I’ll be seeing them in a few months. Actually, [00:22:05] in September, we’re going to, um, Italy together. Friends [00:22:10] that I can call upon at different times, you know, and [00:22:15] you grow up, you get married, you have your husband or your wife and [00:22:20] they’re not. My big belief is that they’re not your everything. You have [00:22:25] to realise that, that they are maybe 30% of your everything. [00:22:30] That’s all I would give them. Yeah. Um, you know, and that your [00:22:35] friends are there to support you through different things. Your family are there to support you through [00:22:40] different things, your children, etc..

Payman Langroudi: Basing your happiness on someone else [00:22:45] or something else. You know, something sometimes, you know, the guy could be [00:22:50] a straight A student and go to Oxford and whatever, [00:22:55] but be miserable. Well, if you base your happiness on something like that, misery [00:23:00] will come because it’s an external thing. And let’s say you go to Oxford, then I’ve [00:23:05] got a friend who’s his dad killed himself because he didn’t win the Nobel Prize. [00:23:10] Oh, yeah. Like, imagine at what point he’d gotten to, you [00:23:15] know, it will. It will come and get you. You could be the top of your class. [00:23:20] Then you could be top of your university. Then you could be whatever you want to do. If [00:23:25] you base your happiness on these sort of external things, it will come. And it’s a weird [00:23:30] thing to say. An external thing. Being your husband or wife or your kid. Yeah, but [00:23:35] you’re right. Yeah.

Devina Lavan-Iswaran (Coco): You can’t live vicariously through them.

Payman Langroudi: 80, 90% of your life through them. [00:23:40] Because they’ll go and they’ll do things. And then. And then you’re left with nothing. Yeah.

Devina Lavan-Iswaran (Coco): But my [00:23:45] thing is, it’s that journey to get there that you pick your happiness as you go [00:23:50] along. It’s not that end point that I will be happy when I get my Nobel Peace Prize. [00:23:55] No, I will enjoy the journey as I go along. Yeah. Um, and, you know, that’s [00:24:00] really, really important.

Payman Langroudi: Where did you study dentistry?

Devina Lavan-Iswaran (Coco): At, um, Barts and the Royal [00:24:05] London. So we were the first year that were the, that amalgamated year with Kings [00:24:10] and started at Queen Mary. So it.

Payman Langroudi: Was. So how was Whitechapel when you, when you got there from your [00:24:15] leafy boarding school.

Devina Lavan-Iswaran (Coco): So I had my leafy boarding school [00:24:20] and I lived in Kensington. Right. And aristocrat in, [00:24:25] in Chelsea and before that in Paddington. So I lived in lovely areas [00:24:30] in London. And then my mum said to me, come on, you know, we’ll go like I’ll come with [00:24:35] you for your interviews, etc.. My mum is you’ve met her. Yeah. She’s one of those [00:24:40] that’s like, okay, come on, we’re going on this like trip together almost. So [00:24:45] she’s like, yeah, I’ll come with you. I’ll sit out there and wait for you. I’m like, mum, we’re going to Whitechapel. [00:24:50] She’s like, yeah, yeah, come on, let’s go. So then we get there. Oh my gosh, you know Whitechapel [00:24:55] Market is there right in front. Yeah, yeah. There’s rubbish all over the streets. It’s [00:25:00] amazing. This is not, this is not my boarding school Payman. This is we come from [00:25:05] Singapore. The streets are clean. You could literally sleep on the streets. So [00:25:10] she’s looking at it and she’s like, wow. She goes, look at this place. [00:25:15] She goes back home, she phones my dad. She’s like, guess what? She goes, [00:25:20] we’ve been to Whitechapel. The streets are filthy, really dirty. There was [00:25:25] rubbish all over and everything. This is the place she has to go to university because [00:25:30] she will see the most amount of disease here. She goes. You better get that place there. Oh, [00:25:35] wow. So I wasn’t expecting that.

Payman Langroudi: That’s excellent.

Devina Lavan-Iswaran (Coco): If you. So when you grow [00:25:40] up with a mum like that as well. So it’s not just my boarding school with a mum like that who sees, like, the [00:25:45] gem in something, right. You’re then like, yeah, I’m going here like her. [00:25:50] And I were, like, excited that there was so much to see there.

Payman Langroudi: Did you have a good time?

Devina Lavan-Iswaran (Coco): I [00:25:55] had a great time. But, you know, I don’t know what it is. Like you, [00:26:00] every day I travel in from Kensington to there, so [00:26:05] it was like a huge contrast. And then sometimes my friends [00:26:10] there would say to me like, Coco, you’re almost like this princess, [00:26:15] right? It’s 11:00. The last tube is going to go. [00:26:20] We’re going to walk you to the station and you better get the tube and go home. Maybe we’ll ride with [00:26:25] you part way through till we get to this point. You know, like so funny. I [00:26:30] have so many people can relate to this.

Payman Langroudi: There’s a princess in every year, right? Or [00:26:35] two. But it’s like love.

Devina Lavan-Iswaran (Coco): That, you know, you [00:26:40] kind of like. Not the situation that happened to me with my job. You know, [00:26:45] when we used to. You qualified around the same time in the last century, as I say. [00:26:50] So you go for your interviews in all these different places. So [00:26:55] I went to Brixton, um, to this practice. And my ex-husband used to work there, [00:27:00] and I thought, yeah, you know. Hi. How are you? Whatever. Did you meet him.

Payman Langroudi: At dental school?

Devina Lavan-Iswaran (Coco): I met [00:27:05] him when I was at dental school, but he was already qualified, So, um, I [00:27:10] went to this practice to meet them, and they’re like, hi, Koko, how are you? [00:27:15] Etc. and you have bars on reception [00:27:20] before trying to connect the front doors locked and bars on reception, and then they kind [00:27:25] of let you in and there’s like glass coverings etc.. And [00:27:30] then the principal then phoned me up. He goes, you’re so lovely. He goes, but he goes, you’ve [00:27:35] come with your like manicured nails, your lipstick, your everything. [00:27:40] He goes, you’re not. He goes, this is not going to be a safe place for you. That’s [00:27:45] funny. So, like, leave all your jewellery at home. That’s funny. And [00:27:50] like, he goes, I don’t think you’re going to survive here. He goes, I would love for you to work [00:27:55] with me because he goes, you just bring joy. But he goes, I just can’t do this to you. Especially [00:28:00] knowing, you know, your boyfriend. I just cannot let you come here and work. [00:28:05]

Payman Langroudi: How funny.

Devina Lavan-Iswaran (Coco): Yeah. So.

Payman Langroudi: So what was your first job?

Devina Lavan-Iswaran (Coco): So that’s another interesting [00:28:10] thing in that. No, actually when I first qualified he had already owned practices. [00:28:15] So I came out of dental school already owning your ex-husband? Yeah. [00:28:20] Yeah. So we were we had set up, um, in, [00:28:25] um, Surrey Quays area. So there was that contrast [00:28:30] between the Docklands and then the sort of really, [00:28:35] really rundown, um, housing estates there. And then [00:28:40] our second practice was a squat in Whitechapel. Um, so I used to, like, leave the surgery, [00:28:45] go kind of help do reception, etc. and at weekends I’d kind of do [00:28:50] the forms and all those kind of things. So before I’d qualified, I really kind of was like, much older than you. [00:28:55] Um, seven years older than me. So I already knew kind of how to run a practice, etc.. [00:29:00] Um, because I was already doing it. Um, and then left [00:29:05] the left. Dental school worked for a year as an assistant in [00:29:10] the Surrey Docks practice, but goodness me, they were like gangsters [00:29:15] in things there. And they’d come in and they’d say, oh, you know, you saw Alan. Do you know why [00:29:20] he’s limping? Because I shot him in the foot. Oh my God. And I’d be like, okay, [00:29:25] that’s I understand, you know, and think, oh my goodness me, [00:29:30] we’re so safe in Singapore. And here am I working in this like gangland. [00:29:35]

Payman Langroudi: Was there any was there no idea of specialising with your, you know, with your [00:29:40] parents being the gynaecologists and all that?

Devina Lavan-Iswaran (Coco): I had always [00:29:45] wanted to, um, specialise. Um, [00:29:50] but I suppose.

Payman Langroudi: You fell into this practice thing that was going.

Devina Lavan-Iswaran (Coco): On. Yeah. I’d also, [00:29:55] because I grew up in practice life, because my dad was a gynaecologist. He had his own private [00:30:00] practice, and so we would all go at the weekends in [00:30:05] our school holidays. Help draw blood. Answer the phone, do all these things. So you [00:30:10] kind of grew up in that environment. So owning a practice was a [00:30:15] natural kind of step in to do things. Um, and I enjoyed it. [00:30:20] Absolutely enjoyed running a practice, you know, doing all the background stuff, [00:30:25] etc. but then it became tough because, like, things got harder, you [00:30:30] know, in our early days, easy to own a practice. Nowadays you’ve got CQC, [00:30:35] you need an HR team. You need, you know, you need to do what do they call it, black [00:30:40] box thinking. Yeah. Each one has a role, you know, trying to you [00:30:45] have to you can’t as a principal be wet fingered easily.

Payman Langroudi: And [00:30:50] businesses the businesses themselves as they grow there’s growing pains. That’s right. [00:30:55] You have to hire more people. Yeah. It’s exactly.

Devina Lavan-Iswaran (Coco): Manpower. Everything. It’s, you.

Payman Langroudi: Know, when there’s six [00:31:00] of you and you’re all working in the same direction because it’s a new thing, and then if there’s 60 of you, [00:31:05] it’s a whole different story. Yeah. So. So go on.

Devina Lavan-Iswaran (Coco): So then, um, [00:31:10] then I had kids really early on because I thought, I’m not going to be an old mum. [00:31:15] There’s absolutely no way. Um, and then kind of worked [00:31:20] part time, um, alongside, kind of like running the [00:31:25] practice so that it was like three days dentistry, the other two days doing [00:31:30] the paperwork, etc.. Um, and I also thought, I don’t want [00:31:35] to be that mum who is never really around for her kids. I tried [00:31:40] to be the kind of best working mum. There’s no formula that this is right or that is [00:31:45] right or the other is right. One. I knew that I wanted to be at work [00:31:50] because I had, what, three months maternity leave or something. [00:31:55] In those days, nobody had a year’s maternity leave or whatever it is. You just went [00:32:00] back to work and.

Payman Langroudi: Tell me, look, the juggle. I’ve had many women sitting [00:32:05] exactly where you’re sitting. And when we talk about women in dentistry, [00:32:10] it comes down to the juggle somehow. [00:32:15] I mean, it’s a funny thing. Women pressure themselves on [00:32:20] perfection in this area and punish themselves [00:32:25] over it. I don’t get men sitting here telling me to juggle [00:32:30] like my every minute of my day is taken. But I’ve got, you know, some very accomplished men. I’ve [00:32:35] got men who own 60 dental practices sitting here. They don’t worry themselves with [00:32:40] wanting to be perfect. And yet women who sit here [00:32:45] punish themselves over this.

Devina Lavan-Iswaran (Coco): I think we need to realise that 80% [00:32:50] is to perfect, right? And that’s what I do now. I’m like [00:32:55] more and you’re more.

Payman Langroudi: Forgiving of yourself over.

Devina Lavan-Iswaran (Coco): That 80%. I, I don’t think [00:33:00] I ever was about perfect. And I always realised you can drop balls [00:33:05] and it’s okay. Yeah. So it was always that case and I always would kind [00:33:10] of also maybe sing to my own tune, think [00:33:15] in a little way. Um, okay. I know I cannot [00:33:20] sit at home with that baby that doesn’t really say very much or engage [00:33:25] with me. I’m very much a people person. I knew that.

Payman Langroudi: You’re a scientist. It’s super [00:33:30] important that you continue your career, right? It’s. Yeah, but then some.

Devina Lavan-Iswaran (Coco): People give it up. [00:33:35] Sure, sure, sure, sure. But for me, it was like I always believed. To each [00:33:40] his own. There are some people who think, okay, I want to have kids. I want to stay at home. Great. [00:33:45] That’s for you. You be you. You do you. So for me, it was that kind of like, [00:33:50] um, I will go back to work, but part time. But at the same [00:33:55] time, I will bring my kids up at the. And there were things that I really did [00:34:00] really wanted to do. So I would say to my kids, okay, [00:34:05] I will sit on the PTA of your school for one year. So that’s what I did. Um, [00:34:10] made sure that because I committed to that, I would do it well. Um, [00:34:15] and I would say to them, I will come every year, um, [00:34:20] for your matches and everything, because dentistry is that career where you [00:34:25] can leave your surgery partway in the day, go watch your kid in a match and then come back. Right? Yeah. [00:34:30] So I did that. That was great. I also said to the kids that I would go [00:34:35] on one school trip a year. Those school trips, they really do [00:34:40] your head in because you got to remember which kids are in your group and sometimes they swap and everything. Thank [00:34:45] goodness we have mobile phones. So I take a picture of the kids in my group and I’m like.

Payman Langroudi: My own [00:34:50] kids do my head and let alone other people’s children. I don’t know how I would handle that.

Devina Lavan-Iswaran (Coco): So every year I’d do [00:34:55] that. I’d also go into school and help the kids read. So I kind of [00:35:00] said like did things to kind of make it work. But the best thing that I did, and I’ll [00:35:05] give this tip to every like, man and woman out there. Your kids will call [00:35:10] you up at the surgery and go, mommy, mommy, daddy, daddy, I’ve forgotten my homework at home. I’ve forgotten [00:35:15] my kit. Whatever. I said, every time you’re allowed one phone [00:35:20] call to ask me to bring something. One phone call. Right. So [00:35:25] you better think carefully what that one phone call is that you’ve forgotten something. [00:35:30] So initially it was. They’d do the one phone call, like, literally [00:35:35] on their first time. They’ve forgotten something. And then I think then when they called [00:35:40] me the second time, I’d be like, you’ve used up your phone call, right? So you can’t use it again. Then [00:35:45] as terms went by, you’d find that they wouldn’t even use it because. [00:35:50]

Payman Langroudi: It’s more self reliant.

Devina Lavan-Iswaran (Coco): Yeah. That’s it. I made them realise you’ve got to pack everything. You’ve got to get ready, [00:35:55] you’ve got to get going. Um, and if you haven’t brought it in, guess what? You’re [00:36:00] staying in detention, right? Life lessons for them. I [00:36:05] mean, you have to be. I know it’s a it’s some people will look at it and think, [00:36:10] oh my gosh, you’re so mean. But it’s not. It’s like, you know, I want you [00:36:15] to like, figure things out for yourself.

Payman Langroudi: It’s what I mean. [00:36:20] Parenting is a funny thing. You’ve got to play to your own self [00:36:25] regarding I mean, it’s not I would love to be the kind of parent who does teach lessons [00:36:30] like that, but I’m not very good at.

Devina Lavan-Iswaran (Coco): But then they make us go soft and gooey, right? [00:36:35] Yeah, yeah.

Payman Langroudi: Yeah, I’m just not very good at that. So if I try and do that, it’s a bit like, I don’t know, I used to have a [00:36:40] hygienist used to sell whitening all day. She used to say, treat yourself, go on, treat yourself, [00:36:45] treat yourself. It’s just she just saw loads of whitening like loads and loads and loads of whitening. And I [00:36:50] was like, that’s what she’s saying. Yeah. So let me try it. And it just did not work for me [00:36:55] to say. Treat yourself to the patient. You know, it just wasn’t correct coming from my [00:37:00] mouth. So what I’m saying is, around parenting, it’s there’s no right or wrong. I’m [00:37:05] interested in sort of the stick and carrot kind of dynamic here. Were your parents quite strict [00:37:10] or not?

Devina Lavan-Iswaran (Coco): So my dad, because he worked, he was never [00:37:15] really like around so much. Um, you know, especially with being [00:37:20] a gynaecologist, like we’d go off somewhere and he’d be called off. So he was not [00:37:25] really there as such. Your mum was cool. My mum, like, was strict. [00:37:30] Um, we had, we had people around us that would like. So [00:37:35] we weren’t just. You didn’t get discipline. I’m sure for you yourself, you didn’t get discipline by just [00:37:40] your mum or dad or whatever. Um, the school.

Payman Langroudi: Itself, it was. I went to a Catholic school.

Devina Lavan-Iswaran (Coco): Oh, my [00:37:45] gosh, you’d be the first school.

Payman Langroudi: I went to in the UK was Catholic. That was, you know, it was hard.

Devina Lavan-Iswaran (Coco): We had [00:37:50] respect for teachers.

Payman Langroudi: Yeah, yeah, yeah. There was no doubt about stuff like that. I [00:37:55] remember then I went to a normal school. There was a it was a Church of England school and [00:38:00] it was just a totally different situation. I remember being shocked at the disrespect. Yeah. That’s [00:38:05] it. Stuff like that you get.

Devina Lavan-Iswaran (Coco): Yeah. So like, I try and make my kids to learn [00:38:10] respect, but then you learn the eye, right? When they look at you, you think, [00:38:15] that’s it, I’m going to bury my head. And. But my brother and I got up to a lot of mischief. [00:38:20] Right. But we were the two middle kids, and then we had my older sister and younger [00:38:25] sister, but we’d planned the mischief, get up to it, etc. so it was a fun life. But, [00:38:30] um, and I think, like when you look at kids, you want your kids to be [00:38:35] a little bit naughty. Right. Have that little bit of spark in them because, you know, that will [00:38:40] set them up for life. Right. Um, so, yeah, they gave us, like a [00:38:45] little bit of bandwidth. But then my mum also brought music into our lives. Like she [00:38:50] would like go and get like, take us to the record shop by Motown, [00:38:55] by, um, Julio, by all these things. And my parents would have these [00:39:00] parties at home. I don’t know if you had it growing up where they’d, like, roll up the Persian rug [00:39:05] and then play music like, you know, have friends over for a dinner party, play music, and [00:39:10] we’d just dance. Sure. And I remember every.

Payman Langroudi: Single Iranian dinner party ends up like [00:39:15] that.

Devina Lavan-Iswaran (Coco): I remember those parties and I think, wow. And because of that, I’ve [00:39:20] loved, like, dancing. Like, if I go somewhere and the kids will always say, if we go out [00:39:25] on a holiday or somewhere and there’s some music playing, they’ll find me standing up there, I don’t care, I’ll [00:39:30] dance by myself, you know? So like, they gave us the love for those [00:39:35] kind of things. Just being spontaneous and just dancing, doing whatever. [00:39:40]

Payman Langroudi: You said the marriage failed. What was the first [00:39:45] sign of that? Did it go from what to what? In what period [00:39:50] of time?

Devina Lavan-Iswaran (Coco): Literally. You know what? There are red flags [00:39:55] and green flags in relationships. Yeah. And I have this thing [00:40:00] whereby now I realise things a lot more. Um, when I went [00:40:05] to school, um, university, it was all about study, study, [00:40:10] study. Um, my IQ was high, so was my EQ, but I think [00:40:15] my, um, realising that there are some bad things out [00:40:20] there in the world. Yeah, I knew things about like drugs and gangs and whatever, but [00:40:25] I didn’t realise that there were like, these little, little things that you had to kind of like, look [00:40:30] out for. Um, in terms of red flags. Um, [00:40:35] so I never realised what a narcissist was, and I [00:40:40] had actually met a narcissist and I [00:40:45] was gaslighted.

Payman Langroudi: Back then, we didn’t have these words, by the way.

Devina Lavan-Iswaran (Coco): No, we never [00:40:50] realised what they were.

Payman Langroudi: Narcissist gaslighting did not exist in the.

Devina Lavan-Iswaran (Coco): So he put me on [00:40:55] a pedestal, right? And said I like it [00:41:00] said the most loveliest things about me. You are gorgeous, you dress so well, you [00:41:05] are so intelligent, etc. all these things. Um, so I fell under his spell [00:41:10] and I was I dated him for three and a half years before we got married, so you [00:41:15] would think I would see some flags, etc., but, you know, you’re kind [00:41:20] of like, brush a few things aside, slight little things here and there. But we [00:41:25] when we had got married and come back from honeymoon a few days [00:41:30] after we returned from honeymoon, he slapped me over [00:41:35] something very, very minor and [00:41:40] I told his parents and they brushed it aside. They were like, no, no, [00:41:45] no, you know, it’s like he just like touched your shoulder or whatever. I was like, uh, [00:41:50] no. It was a slap across the face. Three and a.

Payman Langroudi: Half years in, this is.

Devina Lavan-Iswaran (Coco): Three and a half years [00:41:55] in. Yeah. And he never laid a hand on me before [00:42:00] that. I would see him get angry over things, but [00:42:05] I never realised that he would hit me. And then [00:42:10] he was then given the carte blanche because his parents, who lived in the same house as [00:42:15] us, because we lived in an Asian family system. So there was this independent girl, [00:42:20] like, who lived in her flat in Kensington, to suddenly going to live in an Asian family [00:42:25] system and then to this happening. And it was [00:42:30] like before I’d got married to him, I’d kind of, um, thought, I really want to [00:42:35] marry into my culture, into all this stuff. And I met this guy and he was like, [00:42:40] brilliant. He was, you know, he loved me to bits. He we would, [00:42:45] you know, host like nice dinner parties for our friends, everything. It was all very civilised. [00:42:50] We’d go on lovely holidays together, and suddenly I married him. And then [00:42:55] he turned into this monster. And it then became worse and worse. And [00:43:00] initially it was like, you know, here and there it’d be words and [00:43:05] words can hurt. You don’t realise how much words can hurt.

Payman Langroudi: More than [00:43:10] hands.

Devina Lavan-Iswaran (Coco): Exactly. Um, and it was like the putdowns and everything. [00:43:15] Um, and he just got braver and braver with things. [00:43:20] Um, but.

Payman Langroudi: You went ahead and had kids and all of that because nonetheless, [00:43:25] you.

Devina Lavan-Iswaran (Coco): Know, um, I’m going to learn to make him happy. [00:43:30] Fix it, you know? Yeah. You know, change him. Yes. You know, and [00:43:35] I can, like I can make him happy. We’re going to have a great life, etc. [00:43:40] we had a beautiful home. We would go on lovely holidays. [00:43:45] We had six cars parked up in the front driveway. We had at 1.3 [00:43:50] practices and you’d think to yourself, you have these things, [00:43:55] you have two beautiful kids, you know, you live in a nice neighbourhood, your kids go [00:44:00] to private school. What more does somebody want? Right? We [00:44:05] were blessed.

Payman Langroudi: You were completely happy three and a half years earlier. So. Yeah. [00:44:10] Did it get worse physically and mentally?

Devina Lavan-Iswaran (Coco): It did get worse. [00:44:15] It did get worse. But. And in all this time, I did not tell my parents [00:44:20] because I thought, I don’t want them to know that I failed. And also, [00:44:25] it’s like you don’t want to fail at something, right? You’re so used [00:44:30] to in dental school doing really well, in school doing well. Right. And then [00:44:35] suddenly to be like, oh my gosh, I don’t know what [00:44:40] to do. So I was like battling within myself and every day. So my, my mom had [00:44:45] this saying to all of us kids, dress up, show up. Right? So every day [00:44:50] I would put game face on, you know, like now we have the Olympic Olympics, the Olympians, [00:44:55] they call that the Olympian effect. You turn up performing at 100%. [00:45:00] So I turned up to the surgery. Nobody would know what went on behind my closed doors. [00:45:05] Nobody would know that, you know, I was, like, so traumatised [00:45:10] by certain things. Like I had miscarriages. I had gone into [00:45:15] hospital, stretchered in an ambulance. You know, all these things that you would never [00:45:20] want your mother, your sister, your cousin, your best friend, your [00:45:25] anybody to go through, be it a man or a woman, right? You would never want them [00:45:30] to be abused in that way. And it was, you [00:45:35] know, when you hear of people being kidnapped or whatever and being in a situation and they [00:45:40] identify with their perpetrator and they don’t dare kind of put that Stockholm effect. They don’t [00:45:45] they? Yeah. They don’t dare say anything about them. So to the outside world, [00:45:50] we looked blessed and had a great lifestyle. But the moment I stepped inside my house, [00:45:55] I never knew what was waiting for me. Doctor Jekyll or Mr. Hyde? Right. [00:46:00]

Payman Langroudi: And was it substance abuse or drinking or any of that? Yeah. [00:46:05]

Devina Lavan-Iswaran (Coco): Okay. He would go out for football matches, get really drunk. Whatever. [00:46:10] Um. He would. There was also substance abuse in terms [00:46:15] of drugs. Right. And I actually found cocaine inside [00:46:20] his pocket. I actually, one day we were having a party at home. I go in the garage, I’m like, [00:46:25] what is this white stuff here or laid up in line? Oh, no, no, no, this is nothing. I was [00:46:30] pregnant with my second child and I thought, oh my God, I’m [00:46:35] going to have another kid. And this is what I’m seeing. And then I found the drugs in his pocket. [00:46:40] I’m like, what is? Oh no, I’m hiding it for a friend. Well, what was the stuff in there? I don’t know what you saw. [00:46:45] That’s dust. Right. And I thought, how does piles of dust look like white [00:46:50] and drawn up in lines? Right. Um, I know I wasn’t born yesterday. [00:46:55] Um, for me, I feel drugs ruin relationships [00:47:00] and things. They ruin families. It’s. I see it. I’ve seen it now in my [00:47:05] own family. I grew up in Singapore, whereby drugs are an absolute no no. You know, you [00:47:10] will land in the Bangkok Hilton, as we call it, if you take drugs. That’s a huge [00:47:15] crime there. Um, and I thought, here is my husband doing this. [00:47:20] Like, what do I do, you know, um, so that was really, really hard, [00:47:25] and I just didn’t know, kind of like, what to do, where to turn. And I [00:47:30] was dealing with this really angry man and those drugs and things. Obviously [00:47:35] they alter his personality and things become worse and worse. I mean, I knew before I [00:47:40] married him that he’d go out to the Ministry of Sound and be taking E’s, um, [00:47:45] but I never understood the effect that that would have. [00:47:50]

Payman Langroudi: Although, you know, dependency can be to anything. I mean, [00:47:55] it can, you know, people get dependent on gambling on. Yeah, on [00:48:00] women on.

Devina Lavan-Iswaran (Coco): Whatever. Yeah.

Payman Langroudi: Food. And I of [00:48:05] course, I hear where you’re coming from on drugs. Of course I hear that. But, um, I’m going [00:48:10] to obviously ask you how you got out of it, but before we do that, [00:48:15] did you ever find sort of empathy for the reason why he [00:48:20] ended up this person, or did you never go there? I [00:48:25] mean, when you said his parents weren’t surprised And.

Devina Lavan-Iswaran (Coco): I don’t know, you [00:48:30] know, I think they because he was the only son and they [00:48:35] had I know in their history they’d like kind of like lost a son [00:48:40] as well. So everything was upon this kid to like, you know, [00:48:45] he’s our only son. We’ve got two daughters. He’s the youngest. He’s like, they [00:48:50] wanted him to shine bright to, you know, like in, in within your own culture [00:48:55] itself. The only son is like the.

Payman Langroudi: Apple of their eyes.

Devina Lavan-Iswaran (Coco): Yeah. Whereas in my family, [00:49:00] my brother’s the only son with the three of us girls. My mum and us girls will be ready to pull [00:49:05] him down if anything. Right. There’s no sunshine out of his butt, [00:49:10] you know. So we’re always reminding him that, you know, you’ve got [00:49:15] to pull your weight, keeping him grounded. Yeah. That’s it, you know? But.

Payman Langroudi: So how did you get out of it? What [00:49:20] happened? What was the turning point?

Devina Lavan-Iswaran (Coco): So one day I thought to myself, [00:49:25] If he does this again, I’m going to go to the lawyers and I’m just going to [00:49:30] get this sorted out.

Payman Langroudi: So why though? What happened? Was it.

Devina Lavan-Iswaran (Coco): Something? So [00:49:35] it was me thinking, how do I deal with an angry man? So I looked it up, as [00:49:40] you do when? Like how we look up, you know, Perrier or something, right? [00:49:45] You think? Okay, I’ll look it up. And then I saw this word narcissist, [00:49:50] and I thought, I’ve done, um, for my, um, [00:49:55] ib um, in my lower subjects, I’d done classics and things, and [00:50:00] I thought, I know who the God is, but I didn’t realise this is an actual [00:50:05] thing, that somebody can sort of love themselves to that extent and kind [00:50:10] of like destroy everything else around them. And the more I read into it, I thought, oh [00:50:15] my gosh, how am I going to get myself out of this? And I really have to plan my [00:50:20] exit because this is actually a dangerous person. Um, And with Narcissus, [00:50:25] you have to realise that even therapists like, [00:50:30] you know, are very careful with how they deal with them. So [00:50:35] I then said, okay, the next time he attacks me, that’s [00:50:40] it. So he did attack me and I then called [00:50:45] in for a non-molestation order, etc. he was so [00:50:50] angry with me, so angry, and he realised that he was at risk [00:50:55] of going into prison.

Devina Lavan-Iswaran (Coco): And so then he thought, [00:51:00] I will get smart and I will charm her because those people [00:51:05] are very charming. Oh my gosh, he could charm the birds off the tree when [00:51:10] he’s like that little girl in the corner. When she’s good, she’s really good. And when she’s bad, [00:51:15] she’s naughty. Right. Um, but he was, oh, my god awful when he was bad. [00:51:20] Um. So he managed to charm me and say, oh, I’ll go to counselling, I’ll [00:51:25] do this, I’ll do that. So we went to counselling. Then he’d take me out for dates, [00:51:30] everything. So he really laid on the charm for six months and then after [00:51:35] that went back to his ways. So I then, then the order had then kind [00:51:40] of like lapsed. And he was then like, okay, I’ve now got her back [00:51:45] into this place. So he then he can’t help but get on with [00:51:50] it. So for a little while he found another supply to be abusive to whatever, [00:51:55] then came back to me and started that again. Um, [00:52:00] but it wouldn’t be as bad. So I’d be like, you know, we’re trying to work through this, etc.. [00:52:05] Um, and then did.

Payman Langroudi: You tell anyone?

Devina Lavan-Iswaran (Coco): So [00:52:10] at that point, the, um, I’d told a [00:52:15] few of my friends and, you know, you have this [00:52:20] village and you have these like certain friends you tell certain things to. You don’t necessarily [00:52:25] tell everybody like, oh my gosh, you know, this is happening. So I had a few very close [00:52:30] friends who would like, you know, they call your do or die friends your ride or die friends who [00:52:35] if you say, we’re going to get in a car and we’re going to fly off a mountain, they’d be like, yeah, we’re going [00:52:40] to do that. Yeah. Yeah. So I had a few friends like that who’d be like, no, [00:52:45] Coco, we’re going to come. We’re going to sit outside your house and we’re going to make sure you’re okay. I [00:52:50] mean, one of them, bless her. She sat outside in the freezing cold of winter and was like, [00:52:55] I will have blankets in my cars, I will have this, etc. if you need to leave, you leave [00:53:00] at work. They knew. So they said to me, um, you need to [00:53:05] leave a bag here with your clothes and everything and your kids clothes, because if you’re [00:53:10] not going to leave, because it was like planning to leave. So I [00:53:15] in my head was like things. Stupid things. Like if I left [00:53:20] in the middle of the night, the kids won’t have uniform. They won’t be able to as a dentist, they won’t be able [00:53:25] to brush their teeth. Imagine that. You think you cannot leave because your kids can’t brush their [00:53:30] teeth the next morning.

Devina Lavan-Iswaran (Coco): Well, you can’t think beyond your like [00:53:35] you have a block. So at work, one of my colleagues said to me, Coco, leave [00:53:40] a bag in here with your kids uniform, right? One set of uniform, one set [00:53:45] of clothes, a set of pyjamas and their toothbrush and toothpaste. A spare, as simple as [00:53:50] that. And that actually then changed things for me, because then I thought, [00:53:55] okay, at any point I’m going to do the walkout and it will be [00:54:00] fine. But it’s getting brave and knowing that only [00:54:05] if you jump your parachute will open. Yeah, right. It’s not going to open if you [00:54:10] stand there and be, like, quivering. You’re still on that plane ride? Yeah. Yeah, yeah. And so [00:54:15] I then, um, one day, actually, what happened [00:54:20] was, um, my daughter pulled me aside and he’d gone off to [00:54:25] the supermarket and she said, mummy, mummy, I need you to see something. She was 12 years old [00:54:30] and she said, look at this. So she showed me his laptop [00:54:35] and he was dating all these other women, meeting them in Mayfair [00:54:40] and things like that, taking them on all these dates. And I thought, oh my gosh, here [00:54:45] am I at the weekends, running into the surgery, doing all like all the paperwork, everything [00:54:50] into. So he worked in a two man practice. By then we’d sold the Whitechapel practice. [00:54:55] Um, so we just had the Surrey Docks one and the eight man practice [00:55:00] in Holborn.

Devina Lavan-Iswaran (Coco): So I was in the Holborn practice, fully private practice, running it, doing [00:55:05] everything. Plus I’d have to go and run into the other surgery to do things. Um, [00:55:10] and it was mental. He’d do things like if one of his staff didn’t come in, he’d call me and be screaming [00:55:15] down the phone, you need to come here and you need to sort it out. Well, I’ve got patience. No, [00:55:20] you need to come immediately. So my receptionist was like, Coco, why are you [00:55:25] doing this? She didn’t understand. If I didn’t go, I would get beaten or something, you know? [00:55:30] I wouldn’t know what would greet me when I got home. So it was a really hard [00:55:35] life to deal with that. But then obviously, my daughter showed me these things and she said, mummy, [00:55:40] she goes, if you’re not going to go now, when are you going to go? And like, [00:55:45] look at what he’s doing? And I said, how did you even know, like how [00:55:50] to get into his computer. That kid, she can work for MI5. I’m telling you, she [00:55:55] knows how to break into things. She said, I just kept lying down there and seeing he’s [00:56:00] doing these things and thinking, oh, maybe this is what adults do. And [00:56:05] she said, then I looked at your phone and looked at all your stuff on your phone, and I thought, I don’t find [00:56:10] this year. And then she goes, I talk to my school friends and I thought, [00:56:15] oh my God, this is oversharing.

Devina Lavan-Iswaran (Coco): Like, I was like, that’s not good. And [00:56:20] she said, and my friend said, that’s not normal. And so [00:56:25] she then said, you need to go. We need to go. Let’s just [00:56:30] leave. And I thought, you know, if I don’t go at this moment, this girl [00:56:35] is going to carry that through for the rest of her life. Yeah, right. And then [00:56:40] I then called back the lawyers put a non-molestation or an [00:56:45] order in that he didn’t come within a certain distance of us. Et cetera. Then they were like, [00:56:50] no, we can’t put that order back in. He hasn’t actually touched you. And I thought, oh my gosh, what [00:56:55] am I going to do? So I said, get the divorce going. So then they started that process. [00:57:00] Then one day I came home and he’d attacked my son and [00:57:05] my daughter standing on the doorstep going, dad’s attacked Aaron. His [00:57:10] parents were like, no, no, no, this never happened. I was like, Non-mall ordering for [00:57:15] him. Get us all protected, get him arrested, get him taken out of the house. I was like, [00:57:20] I can’t deal with this anymore. It was like I had got to that point [00:57:25] when you can touch me but don’t touch my kids. And [00:57:30] so it was. I don’t know you. [00:57:35] You think you can cope when it’s happening to you, but suddenly you become like mother hen when it happens [00:57:40] to your kids, you’re like, no, no, no, it’s a different thing and.

Payman Langroudi: Everyone’s got [00:57:45] a limit, right? I mean, it’s interesting.

Devina Lavan-Iswaran (Coco): You limit helpless.

Payman Langroudi: Know your limit [00:57:50] only only got there when both kids, you know were involved. But [00:57:55] when your daughter told you.

Devina Lavan-Iswaran (Coco): Value myself more.

Payman Langroudi: Well, you know.

Devina Lavan-Iswaran (Coco): Was it [00:58:00] that I was chipped and chipped and chipped and chipped till like, you [00:58:05] know, I don’t know. So I just got him arrested. Got him taken out. His dad [00:58:10] called me all kinds of names under the sun. They said I was lying. They said I [00:58:15] was the one having affairs. Everything. Oh, my gosh, it was horrible. Really, really [00:58:20] horrible. And then his staff then also told me, oh, yeah, he’s on these sites [00:58:25] at lunchtime. We see him on all these things. And I thought, oh my gosh, I come [00:58:30] in here, you guys don’t even say anything. But then, you know, that’s the Dental [00:58:35] world, right? Nobody’s going to turn around and say, oh yeah. By the way, your husband’s doing [00:58:40] this to you. Um, and I thought, where does he have the time to [00:58:45] be doing this? Running a dental practice takes up. It’s all consuming, right? [00:58:50] Um, I.

Payman Langroudi: Mean, the mad thing is that physical and and [00:58:55] mental abuse on its own wasn’t enough [00:59:00] to to make you want to go. It was. That was that was the last the last straw.

Devina Lavan-Iswaran (Coco): The last [00:59:05] straw was my daughter telling me. Yeah, yeah. Because I thought, what am I going to do to her? [00:59:10] Yeah, yeah. And also she had told her friends as well, and what am I going to do to her [00:59:15] and her friends. And this is the future of these females. And so [00:59:20] I was like, I’ve got to walk.

Payman Langroudi: So you hit like a rock bottom, right? Is [00:59:25] that is that was that moment. The moment that was.

Devina Lavan-Iswaran (Coco): Not rock bottom. What was he told [00:59:30] me I will make sure you suffer. So I had no access [00:59:35] to like, um, like in taking him to court and everything. I [00:59:40] had to then, you know, lawyers, they expect you to put the money up front, etc.. I [00:59:45] maxed my cards. I took out a loan, I did everything, he was not [00:59:50] paying, child maintenance, etc. school even asked if [00:59:55] they should put my children on school meals, to growing up in a decent [01:00:00] family, to having a decent life right? More [01:00:05] than decent life to then being at this place the day [01:00:10] my the financial agreements and everything were going through. I was £30,000 [01:00:15] in debt payment. Right? And [01:00:20] I was literally terrified of walking the streets because he said to me, [01:00:25] I will find you and I will kill you, right? If you leave this [01:00:30] marriage, I will find you and I will kill you. You hear these stories of people being buried in the back patio? [01:00:35] That was what I thought was going to happen. You believed him, right? Because, yeah, like he [01:00:40] would say to me, I will break your nose. He would like, you know, right. The marriage. [01:00:45] But every day I’d think I have to come back, because otherwise he’s going to find me and [01:00:50] kill me. And until that moment when my daughter was like, mommy, you [01:00:55] need to leave. Like, how long are you going to wait for? And like you said earlier, your kids [01:01:00] go off to university. Then you’re left there with a the monster. And then what? Right. [01:01:05] So I was like, shit, I got to pick myself up.

Payman Langroudi: What about the psychological [01:01:10] turning point between not telling anyone and [01:01:15] now where you’re telling everyone that it’s [01:01:20] that? When did you feel like I need to tell this story for others to.

Devina Lavan-Iswaran (Coco): It [01:01:25] wasn’t at that point because I felt shame. A huge amount [01:01:30] of shame. Yeah, yeah, yeah. Like I failed in my marriage. I’m so embarrassed [01:01:35] that here are my like, you know, you.

Payman Langroudi: Speak to that perfection thing, doesn’t [01:01:40] it? On one side, you’ve got perfection and then.

Devina Lavan-Iswaran (Coco): It does on.

Payman Langroudi: The other side, it’s [01:01:45] not, it’s not.

Devina Lavan-Iswaran (Coco): It’s a house of cards.

Payman Langroudi: Lots of things have fallen. Yeah, yeah.

Devina Lavan-Iswaran (Coco): And it [01:01:50] was like, what do I how do I get out of this? You know, being [01:01:55] in debt is a shame in itself as well. Not being able to like, [01:02:00] afford school uniform for your children. You know, my daughter’s going in school. She’s growing, [01:02:05] and her school uniform is tight on her. It’s short. Um, [01:02:10] those kind of things. I can’t pay my son’s school fees. What do you do? [01:02:15] But you. Somehow that core strength [01:02:20] of survival from boarding school days, like, kicked in, and I was [01:02:25] like, okay, so you have said to me that you’re going to make sure I fail and [01:02:30] you’re going to laugh about this. I will show you. So I was [01:02:35] like, what am I going to do to turn this around? Right? And we are lucky as dentists [01:02:40] that we can you can step up right. Your [01:02:45] earnings and things. There’s no other job out there that I think anyway where you can think to [01:02:50] yourself, Come Monday morning, I’m going to hit the ground running solidly for [01:02:55] six months and I’m going to make X, right. So I thought, what am [01:03:00] I going to do dentistry wise that is going to help me kind [01:03:05] of like make money to bring this family of mine up, make [01:03:10] sure that I get myself out of this situation. So I thought, [01:03:15] shall I go do implants? And then I thought, that’s like one of those things [01:03:20] where it’s going to take me a long time, right? Should I do [01:03:25] endo that’s miserable and like give you those glabella lines when you concentrate [01:03:30] trying to do your root canal.

Devina Lavan-Iswaran (Coco): And I was like no, no, no. Got to make [01:03:35] sure there are no lines there. And then I thought, okay, why don’t I do a [01:03:40] little bit like, you know, of like clear, clear step or whatever was around [01:03:45] then. So why don’t I go and do Invisalign, right. Because we were doing a little bit [01:03:50] of that in the practice and I thought, I’ll go do that. So I then decided to up [01:03:55] my Invisalign game, knowing that the ROI would have been greater [01:04:00] in terms of like in a short term. Yeah. And [01:04:05] so I went and thought, okay, there’s this diploma out there for [01:04:10] clear aligner therapy. Let me go and do that. Which one? Um, the one that Ramon and Andy [01:04:15] run. Oh, okay. So, um, the first lot of people that were in there. So when I spoke [01:04:20] to Andy, I said, okay, who’s in this thing? And I thought, there are all these, like, Instagram famous people. [01:04:25] Yeah. I don’t fit into that world. Um, let me just see whether this is actually [01:04:30] a course that is going to take on or not.

Payman Langroudi: Is it part of Ilona? They’ve [01:04:35] changed the name now. Yeah, yeah. What’s it called?

Devina Lavan-Iswaran (Coco): Um, Ilona consulting it was. But now it’s the Ilona Dental [01:04:40] Academy. Yeah, yeah.

Payman Langroudi: So it’s part of. It’s a course from there.

Devina Lavan-Iswaran (Coco): So it’s a course? Yeah. So I spoke to Andy, [01:04:45] and then I said, maybe I’ll come into the second cohort. Yeah. So I joined the second cohort at [01:04:50] the time when my life was falling apart, like divorce going on, like the police [01:04:55] saying to me, you need to go make a different life for yourself. Go set up somewhere else. I thought, no, I [01:05:00] have my village here. My village are there to support me. If I leave and start [01:05:05] a life somewhere else, go to the borders of Wales or Scotland or wherever.

Payman Langroudi: What happened [01:05:10] to him in this period? What was?

Devina Lavan-Iswaran (Coco): So we had a case going on where [01:05:15] it was the. So that was, uh, a case going on [01:05:20] for the, a separate one for the kids, for the abuse over my son. [01:05:25] Then there was my case, um, for his abuse to [01:05:30] me. Then there was obviously the divorce case going on. So there was a lot going [01:05:35] on and a lot of money being poured into it. Um, and so [01:05:40] my case got thrown out of court on the day we went in to the [01:05:45] court because they said, um, it’s historical abuse. It’s more than six [01:05:50] months old, so we can’t do anything about it. And, um, [01:05:55] I thought, goodness me, how is that possible? First, you [01:06:00] have to get brave enough to put that forward. Right?

Payman Langroudi: It’s a very long six months, [01:06:05] right?

Devina Lavan-Iswaran (Coco): It is. And, you know, it takes a lot out of you to actually step up and [01:06:10] say, this is happening to me. And so he got away. [01:06:15] And then I thought, okay, the kids have their case going on. And my daughter thought [01:06:20] it was wholly unfair that the, um, his barrister stood [01:06:25] up and said, here is a man, a professional, and if you think [01:06:30] there’s any iota of doubt in you, you need to let this go, because [01:06:35] let this man go, because it’s his career that is on [01:06:40] hold, you know, put it before you. And so then they let him go. [01:06:45] And his mum stood up in court too and said, oh no, my son’s innocent. She’s [01:06:50] a bitter wife. She’s making all this up, she put her kids up to it, etc.. Wow. So, [01:06:55] you know, all this stuff goes on and you never realise [01:07:00] to yourself what happens in courts, etc. [01:07:05] here in this country, it’s who tells the better story, who tells the [01:07:10] most believable story. So you have this charming man in front of you telling this story, [01:07:15] and then you have this woman who’s, like, destroyed and trying to halt her kids together, trying [01:07:20] to take them to school every day, trying to go to work, trying to deal with all the traumas [01:07:25] of everything, the traumas of the kids, etc., trying to deal with her own traumas and [01:07:30] trying to make a life and trying to say, I can do this, I am going to do this. [01:07:35] I’m going to make this work. Right. I did not.

Payman Langroudi: You think, you know, if you haven’t been [01:07:40] involved with the law, you there’s a feeling that you have that the truth will out. [01:07:45] It’s just a very like from the movies.

Devina Lavan-Iswaran (Coco): Always.

Payman Langroudi: Exactly. And it’s nothing to [01:07:50] do with.

Devina Lavan-Iswaran (Coco): Live in this fairy tale world where you think that will happen and it won’t. [01:07:55]

Payman Langroudi: Yeah, it’s its own little world. And, you know, they say, get get a bigger [01:08:00] lawyer than your opposition. It’s like that’s that’s the most important thing. It [01:08:05] is not what happened.

Devina Lavan-Iswaran (Coco): And and you have to get trained. So now [01:08:10] what I’ve done is gone and trained my own self to then [01:08:15] speak to other people who are going through, be it divorce, separation, whatever. [01:08:20] How to make yourself strong, right. And how to [01:08:25] you got to stand up there. You got to be that Olympian when you turn up [01:08:30] right? No matter what shit is going on behind, you have to be strong and realise [01:08:35] you’ve got to talk the talk, walk the walk and get shit done. Because [01:08:40] on that day, that’s showtime, right? Yeah. And I never realised [01:08:45] that I was broken. I was like I [01:08:50] was not on my A-game. I was like, maybe on 10%. [01:08:55] And it was hard. It was really, really hard. Um, but [01:09:00] on the day when I went into court to kind [01:09:05] of like sort out the financial things that day, I realised I was sitting [01:09:10] at rock bottom, a place below rock bottom, that I was not worth. [01:09:15] I had no sense of self-worth, even because I was broken [01:09:20] by the whole process, but yet at the same time trying to hold my family together. [01:09:25] I don’t know how I did it, but then, as they say, I [01:09:30] went find that course and thought, I’m going to do that. I’m going to up my game. So [01:09:35] did the clear aligner therapy diploma. [01:09:40] Then, um, found some great friends. They’re friends [01:09:45] for life, Literally. We’d all, you know, at the end of the course, every day, [01:09:50] we’d go out to a restaurant stand singing Disney songs, um, and [01:09:55] got to be great friends with Ramon and Andy.

Devina Lavan-Iswaran (Coco): I have to say, they like, [01:10:00] you know, when they say you are the sum of the people you hang around with. I’m a big believer [01:10:05] of having that core of people who will pull you up and say, what [01:10:10] are you doing? Step up. Right. Yeah. So I have that core of people [01:10:15] around me. Um, but I also at that point decided as [01:10:20] I was earning the money and putting the money into the kids, bringing them up, I thought I [01:10:25] have to. Also, not only was I investing in myself in that course, I have to invest [01:10:30] in myself in terms of my strength, in terms of building [01:10:35] a better me. So this is another thing that I speak to people about. Make [01:10:40] sure you invest in your own self and in your worth, etc. because you cannot [01:10:45] go and help anybody out until you are strong. So how was I going to be a better [01:10:50] mother, a better clinician, a better person, you know, in being that [01:10:55] better person first, I can then be a better mom, a better clinician and serve others [01:11:00] better. So I then thought, I need to find a coach who [01:11:05] is going to understand family dentistry. You know, all these, [01:11:10] you have all these different coaches, but do they understand that you’re having to like juggle dentistry, [01:11:15] juggle your home life, try and be 100% or for me, 80% [01:11:20] perfect and you will drop balls and what to do? So then [01:11:25] I did find a life coach, and I said to him, this is what [01:11:30] I want out of this, right? Can you do this? And he [01:11:35] was like, yep, Coco, we will get you there.

Devina Lavan-Iswaran (Coco): And I was like, with this. [01:11:40] I said, I’m coming into this And I don’t want another man, another woman [01:11:45] to go through this. I will stand up and I will speak. [01:11:50] I will raise my head above my castle walls, and I will let people know it’s okay. [01:11:55] Right. I am no longer going to carry this around like shame. Yeah, [01:12:00] right. I’m going to wear this like a badge and say, guess what? Okay. It [01:12:05] can happen to anybody. You can come from a low class family, a high class family, [01:12:10] a middle income family or whatever. Abuse does not pick [01:12:15] like what background you come from or anything. It doesn’t [01:12:20] pick black, white, Chinese, whatever. It’s like, it happens. And [01:12:25] I want people to realise what narcissism is because [01:12:30] we didn’t know. As you yourself clearly said, we had no idea. [01:12:35] Um, and so. Yeah. So I [01:12:40] found this coach. He, like, literally shot a bullet at me and said, get [01:12:45] on your your career.

Payman Langroudi: Then going forward in autumn, it ended [01:12:50] up you’re right. Now you’re teaching. Did you find did you find [01:12:55] a line of therapy to be something that you didn’t expect, something you loved more than the rest of [01:13:00] dentistry? The reason I say it is because Millie Morrison, who you know. [01:13:05] Yeah. You do know. Yeah. Um, she she was. I was grooming her [01:13:10] to to be the next composite person, um, teacher in I [01:13:15] mean, a massively talented with composite, massively talented, massively [01:13:20] talented teacher. Yeah. Um, and then one day, she said, I never want to do composites again. I’m going down [01:13:25] aligners forever. Yeah. And she’s a massively talented teacher in that. Well, [01:13:30] how do you feel about aligners? Have you got that feeling about them that she does?

Devina Lavan-Iswaran (Coco): So it’s for [01:13:35] me it’s a combination of things. So it’s that the aloneness. [01:13:40] Right? So I’m aligning your teeth. Yeah. Then it’s the whitening. Yeah. And [01:13:45] then it’s the bonding. Yeah. And then on top of that, it’s that facial aesthetics. [01:13:50] Yeah. So. And it’s all those.

Payman Langroudi: It’s all one to 1 to 1.

Devina Lavan-Iswaran (Coco): That’s right. So it’s [01:13:55] that happiness centred thing. Yeah. So I’m not sitting there doing endo. [01:14:00]

Payman Langroudi: Although I hear from some dentists that, [01:14:05] you know, a lime bleach bond isn’t dentistry. Yeah. Um, and they’re always [01:14:10] looking down on it a little bit or or maybe they’re looking down on, for instance, [01:14:15] a young dentist saying they want to get into that and they’re like, [01:14:20] well, why don’t you just become a dentist first or, you know, this sort of language. Whereas I [01:14:25] just love the want side of dentistry so much because in intrinsic [01:14:30] in our profession is a trust dynamic. [01:14:35] Yeah. A bit like taking your car for service. I [01:14:40] don’t know anything about my car. Yeah, yeah, I’ve got no idea. Yeah. It’s intrinsic [01:14:45] in our profession. The guy’s got no idea what’s going on in his mouth. He’s got [01:14:50] no idea what you’ve done to him either. Yeah. No idea. Um. And he has [01:14:55] to fully trust you. Whereas in the wants area, I don’t have to say you [01:15:00] need. I’m like, do you want? Yeah. And it’s one of the biggest problems [01:15:05] in in enlightened with, with dentists. They don’t say, do you want your teeth whitened? [01:15:10] Have you ever thought about teeth whitening? Because we’re so used to saying if you don’t have the crown, you’ll [01:15:15] you’ll break your tooth. If you don’t have the filling, you’ll need a crown. If you don’t brush your teeth, all the needs. But [01:15:20] if you don’t do X, terrible thing, Y will happen. Whereas with the wants, [01:15:25] it’s that if you do do X, amazing thing y will happen. [01:15:30] And I was so much more attracted to that side. That part of if I was a garage [01:15:35] guy, it’d be selling, I don’t know, satnavs and stereo units. Rather than saying [01:15:40] blackout windows. Yeah, rather than saying your brakes need changing. Yeah. Because that inherent trust [01:15:45] problem.

Devina Lavan-Iswaran (Coco): So for me, right, I now [01:15:50] work my dentistry into. What brings me joy? Yeah, [01:15:55] right. And it’s a.

Payman Langroudi: Joyous thing, right?

Devina Lavan-Iswaran (Coco): I’ve let go of the things that don’t bring me joy. [01:16:00] Yeah, right. And people buy from happiness, right? [01:16:05] True. People will buy from you if you [01:16:10] exude that. Happiness. You actually genuinely love what you do. [01:16:15] And they come in. They see the joy in you. They’re like, no matter what, they’re like, whatever [01:16:20] it is, I want some of that. It’s like when Harry met Sally. When she. When they go, [01:16:25] I’m having some. Yeah, yeah, yeah. So it’s [01:16:30] it’s a case of, um, you know, I want [01:16:35] I want my life to be sort of. I [01:16:40] want that happiness there. Right. And have you listened to that [01:16:45] podcast? I or I don’t know who spoke about this, what the name of [01:16:50] the person is, but they say, um, how you sell, right? So [01:16:55] you have the five senses and you’ve got to make sure you tick all the five senses. [01:17:00] So I try and kind of like, get my room, my practice into that kind of thing. So [01:17:05] you have to hit the five senses. So it has to be taste, smell all these different things. For [01:17:10] example, you ride a motorbike, right? The thrill of riding [01:17:15] a motorbike is the feel of the bike, the smell of the petrol, the, you know, all [01:17:20] those kind of things. So you hit many of those five senses. [01:17:25] So they have a graph and it goes from 0 to 10. So sense of taste [01:17:30] not a huge maybe you can taste, I suppose, to somebody who is a right petrolhead [01:17:35] right. Maybe that will come to a 3 or 4 or whatever. Then [01:17:40] the, um, the actual feel of the bike that like vibration.

Payman Langroudi: Dentistry, how do [01:17:45] you intend to translate.

Devina Lavan-Iswaran (Coco): It? Okay. So then so you come into a practice. Yeah. Right. So [01:17:50] the the look of everything. So when you see everything is so neatly set [01:17:55] up and it looks beautiful, etc., then you think taste [01:18:00] of things right, smell you come in to a does it smell of bleach. Does [01:18:05] it smell I love I travel the world buying all these different [01:18:10] scents for the practice. Like last year when Millie got married, I went to Italy and [01:18:15] there I went to they have these lovely little boutique shops with these amazing [01:18:20] smells. So I bought these really nice diffusers and everything from there [01:18:25] for the practice. When I went to Sweden recently, I bought some things from there to [01:18:30] smell. Yeah. Right then. And how you smell as well? Yeah. Right. [01:18:35] And then there is the touch in terms of I, I shake [01:18:40] my patient’s hand, but even more I hug my patients. I’m a big hugger. Yeah. Um, [01:18:45] so that’s important in how you make them feel. So. Taste the mouthwash. [01:18:50] You know all those things, right? You don’t give your patients coffee, do you? [01:18:55] And then coffee in one hand, then. Then whitening in the other.

Payman Langroudi: Do you not offer them coffee? [01:19:00]

Devina Lavan-Iswaran (Coco): No. I offer them water. Hot water, cold water. But I don’t offer them [01:19:05] coffee. It’s funny, isn’t it?

Payman Langroudi: Our own prejudices around drinks.

Devina Lavan-Iswaran (Coco): I don’t drink any tea or.

Payman Langroudi: Coffee.

Devina Lavan-Iswaran (Coco): Because [01:19:10] I like to keep my teeth white. So. Um, [01:19:15] okay.

Payman Langroudi: So when you. When you hit the five.

Devina Lavan-Iswaran (Coco): Senses, when you hit the five senses, so.

Payman Langroudi: They have their attention.

Devina Lavan-Iswaran (Coco): Something [01:19:20] like sex, you hit all the five senses, right? So you [01:19:25] have to think, how am I going to hit all those five senses in a dental practice. For me, that’s, [01:19:30] like, so important to have that thing. Your uniform, what that looks like, you know. And [01:19:35] it’s those also those touch points. So let’s say, for example, [01:19:40] yourself when I come here, I’ve seen enlightened like from when I start [01:19:45] at the door, then I come in, then I see enlightened and enlightened there. So then I’m like, Payman, [01:19:50] let’s say I didn’t know anything about enlightened. What is enlightened, right? [01:19:55] So I have signs of Invisalign outside on the A board. When [01:20:00] they come in, there’s Invisalign on my uniform. It says doctor DaVinci and Invisalign [01:20:05] under it. Right. So I’ve got that put on my uniform. So one of [01:20:10] the staff said to me, Invisalign is not your surname. And I said, well, [01:20:15] you know, we actually we supply.

Payman Langroudi: We supply enlightened badges to all our users. [01:20:20]

Devina Lavan-Iswaran (Coco): Yeah. So there you go. So it’s it’s.

Payman Langroudi: I feel like [01:20:25] with you there’s a. The speed of trust is [01:20:30] the way I’d put it. Yeah, the speed of trust with you is faster [01:20:35] than the average person. Much faster. Yeah. So you can talk about all of this stuff here. But [01:20:40] if it was a grubby old surgery, there’s something about you that there’s an authenticity [01:20:45] about you and a joy and a joy. You’re right. Joy is a big part of it. That, [01:20:50] and I’d say that’s the most important thing in dentistry because of this trust [01:20:55] dynamic that we were talking about. Yeah.

Devina Lavan-Iswaran (Coco): It is. Um, I don’t [01:21:00] I don’t know where it comes naturally to you or how it came, but I will sit at [01:21:05] a bus stop, and this is what my friends would laugh at me about. They’re like, Coco, you sit at a bus [01:21:10] stop and somebody will talk to you. You sit in a like this weekend [01:21:15] I was sitting in the bus and this old man and old lady sitting next [01:21:20] to me, they they were looking at me and they were smiling. Ling, so I [01:21:25] don’t know. Maybe they recognise me from. Were you.

Payman Langroudi: This person? Were you this person before [01:21:30] the abuse? And then you found I lost myself, I.

Devina Lavan-Iswaran (Coco): Lost [01:21:35] me, yeah, yeah. And this is what I said to my life coach. I need to find myself [01:21:40] back again. I need to find that girl who, at [01:21:45] eight years old, believed in herself. I need to find her back again. And [01:21:50] so one day, he did this thing where he said to me, think back [01:21:55] to when you were eight years old, and remember that girl. Remember how she [01:22:00] wasn’t afraid of anything. Remember how she dared do things. Remember. Remember [01:22:05] that girl? Oh my gosh. I cried for like two weeks because [01:22:10] I remembered that girl who was like, not afraid, [01:22:15] who was positive. Yeah. And I thought, I’ve got to get that girl back. There [01:22:20] were there were like bits of that where I would leave the house and [01:22:25] have my A game on. But it was, it was [01:22:30] literally like my mum saying to me, dress up, show up. Yeah. [01:22:35] And it was a veneer.

Payman Langroudi: Rather than the actuality of.

Devina Lavan-Iswaran (Coco): It. Whereas now it’s like [01:22:40] it’s it’s back, it’s there. It’s like, that’s my [01:22:45] every molecule in me, every atom in me is like, that’s me.

Payman Langroudi: That’s [01:22:50] on this pod. We like to talk about mistakes. Have [01:22:55] you listened to any. We like we like to talk about mistakes and black box thinking. You mentioned [01:23:00] where you know, where when a plane crashes, they find out what went [01:23:05] wrong, and then they don’t blame anyone. And they just tell all the pilot community [01:23:10] what happened to try and make sure everyone learns from what happened. But [01:23:15] in clinical medical situations, when something goes wrong, we blame [01:23:20] tends to be the main thing. And so we try and hide it [01:23:25] and we and we make sure we get embarrassed. We don’t talk about it. None of us learn from [01:23:30] each other’s mistakes because of that. So to buck that trend on this pod, everyone [01:23:35] who comes on this pod tells me what they think. You can choose [01:23:40] your biggest clinical error that you made your most difficult patient. [01:23:45] I like those stories quite a lot too. What comes to mind? [01:23:50]

Devina Lavan-Iswaran (Coco): I would say biggest clinical mistake and I learned this very, very early on [01:23:55] was, you know, in dental school when they they [01:24:00] say to you, here’s your patient. You take ages, you set everything up and you look [01:24:05] at the tooth, you get it right, etc.. So I had to prep a crown and [01:24:10] it was in a lower seven. So I prepped [01:24:15] the buccal surface of the seven and the lingual surface of the six. I [01:24:20] don’t know how.

Payman Langroudi: To love.

Devina Lavan-Iswaran (Coco): That one. [01:24:25] I don’t know how, but I realised just as I was halfway through prepping the lingual [01:24:30] surface of the six.

Payman Langroudi: I love that one.

Devina Lavan-Iswaran (Coco): And then I said, I call my tutor. I was [01:24:35] like, Frank. I said, I don’t know what I’ve done. And then he’s like, well, [01:24:40] the six maybe needs an inlay. So and [01:24:45] the filling is quite large. It’s borderline inlay.

Payman Langroudi: Well done Frank.

Devina Lavan-Iswaran (Coco): And he’s [01:24:50] like, did you tell.

Payman Langroudi: The patient.

Devina Lavan-Iswaran (Coco): You. Yeah, yeah.

Payman Langroudi: So I told the.

Devina Lavan-Iswaran (Coco): Patient, I said what had.

Payman Langroudi: Happened. [01:24:55] Yeah, yeah, the whole thing. And exactly what had happened.

Devina Lavan-Iswaran (Coco): Yeah. And the patient, his [01:25:00] name is Michael. He said, well, he said Frank [01:25:05] says that it needs an online. So he goes, why don’t you do both of them today? [01:25:10] I said, I haven’t got time to do both of them. He goes, you’re going to qualify very soon. He goes, you may as well [01:25:15] do both of them together at the same time. What a great album. And then Frank is, Frank said, yeah, that’s a good idea. [01:25:20] Do them both at the same time. And so I was like, oh my gosh. So then [01:25:25] I did them both. But guess what? 25 years later, this guy comes [01:25:30] to my practice. Michael. He has found me in Holborn and [01:25:35] he came in and he said to me, you’re the best dentist I ever had. My [01:25:40] work is still in my mouth. Those those things that you prepared for me. Look at them. [01:25:45] And he showed them to me. And I said, you know what? For all my life, I have always [01:25:50] thought I really need to find you. But I [01:25:55] said, you’ve come to me and there is something I need to tell you. I [01:26:00] said, because you gave me a lesson in life. So he had little kids [01:26:05] and a boy and a girl. And one day when I was doing his teeth.

Devina Lavan-Iswaran (Coco): Not the day when I, when [01:26:10] I prepped the buccal lingual, he said, you know what? He goes. Tomorrow I’m [01:26:15] going to take the day off. It’s it was a weekday. And he said, it’s a school day. [01:26:20] It’s a sunny day. I’m going to take my kids. We’re going to go off to the seaside and have [01:26:25] a great time, and then we’re going to go back home. And I said, but then at school they’ll find them [01:26:30] missing and everything. And he’s like, so what? He goes, how many sunny days do we have here in [01:26:35] this country? I’m going to live life. I’m just going to go. I don’t care what they say to me. Whatever. [01:26:40] Yeah. And since that time I always thought I’m going to do that. So guess [01:26:45] what I did like when the kids were at school, you know, they say you can’t leave school before the term [01:26:50] finishes because you can’t go away on holiday, etc.. You just so I think [01:26:55] you know what? That man did it. And he taught me a lesson that life is only so short and you’ve got [01:27:00] to enjoy it. Just grab opportunity and just go do it. So I said [01:27:05] thank you for that lesson. He goes, I’ve come here to thank you and you’re thanking me.

Payman Langroudi: It’s funny, I don’t normally [01:27:10] accept Dental school errors. I like to listen to them just [01:27:15] to hear exactly what happened, but I don’t normally accept those.

Devina Lavan-Iswaran (Coco): So what are you waiting.

Payman Langroudi: In this in this particular [01:27:20] case? I mean, I also don’t accept happy endings either. That [01:27:25] was a very happy ending. I kind of want to hear a difficult, patient story.

Devina Lavan-Iswaran (Coco): You [01:27:30] know, when you say yes to somebody you [01:27:35] shouldn’t say yes to. Yeah, yeah.

Payman Langroudi: Go on.

Devina Lavan-Iswaran (Coco): Right.

Payman Langroudi: So that spider sense, [01:27:40] right where you feel something’s off here, and then your ego kind of takes over and says, [01:27:45] I know the last guy didn’t manage, but I will because I do things differently, that sort of thing. [01:27:50]

Devina Lavan-Iswaran (Coco): It’s like it’s my thing whereby I will only do happy treatments. So somebody [01:27:55] comes in like desperate for an endo and going, please, please do it for me. I [01:28:00] can’t wait for the specialist. Whatever. Yeah. And I’m like, no, it’s not my thing. [01:28:05] I would rather you go and see a specialist. Oh no no no no no, please, please do [01:28:10] it for me, you know. And I said, these are the risks, right? And they’re like, no, no, no, [01:28:15] please, please. And then guess what? It comes back to bite me in the backside because you’re [01:28:20] only as good as your worst piece of work. Yeah, yeah. So then she was like, I need [01:28:25] to see my notes. I need to do this. I need often the.

Payman Langroudi: Cases where you really go out of your way end up [01:28:30] being the ones. It’s so weird, isn’t it? And then she’d.

Devina Lavan-Iswaran (Coco): Come late every time she had an appointment. She would come [01:28:35] in late and I’d be like, you haven’t given me enough time to do this. So everything compounded [01:28:40] on top of that. And I just thought, why did I say yes to this? [01:28:45] So nowadays I’m much more strict about things. [01:28:50] I’m like, no, you may stand there, you may be crying, you may be doing whatever, but [01:28:55] I will not do this because I will not be doing it to my mother, my sister, my [01:29:00] brother. I would send them to the specialist. Yeah. So, you know, [01:29:05] you ought to go as well.

Payman Langroudi: So tell me about the charity [01:29:10] that you’re doing with your daughter?

Devina Lavan-Iswaran (Coco): So this. How did it.

Payman Langroudi: Start?

Devina Lavan-Iswaran (Coco): Well, [01:29:15] we’re thinking to ourselves, what are we going to do to kind of, like, almost [01:29:20] like celebrate ten years of, like, walking away from something where [01:29:25] I could have been living a different life. Um, so she said, [01:29:30] you know, Anushka and I thought, okay, we will go. Maybe, um, give [01:29:35] something to, uh, like a women’s refuge. [01:29:40] Um, and then we thought maybe we’ll spend some time there over Christmas, etc.. [01:29:45] And then my daughter just graduated this year and [01:29:50] I thought, wow, nobody could take away her education and [01:29:55] nobody could take away mine. Yeah, because because I was educated, I [01:30:00] could then turn my life back around. Yeah. And because I [01:30:05] could read, I could then escape into a world of books. So [01:30:10] we then thought, why don’t we actually give books [01:30:15] to an inner city school where kids can then [01:30:20] use those books, study, learn whatever, and push themselves [01:30:25] ahead in life? You know, why don’t we give to, you [01:30:30] know, a school out in Africa or something, or India and [01:30:35] give them that chance in life? So what we’re going to do [01:30:40] come to October is domestic Violence Month. And [01:30:45] December is a time for giving here in England, it being Christmas. So [01:30:50] we thought, okay, what we’re going to do this year, come October time, [01:30:55] we’ll get other practices to either give books in [01:31:00] for inner city schools or for us to send abroad, or [01:31:05] we will get people to give into a GoFundMe page [01:31:10] that we can then fund actually sending these books out, because it’s one thing gathering [01:31:15] the books, but it’s another thing having to actually pay to send them abroad. [01:31:20] Um, yeah. So we just thought that is [01:31:25] a much, much more important thing and it has a bigger impact if you think [01:31:30] about it. Yeah, right. You read this book and then this other child reads [01:31:35] it, then this other child and this, and then they get different things out of it, [01:31:40] not just the education from reading it. It’s the escapism. It’s the, [01:31:45] you know, building on their language because some of these kids don’t even speak [01:31:50] English very well, etc.. So there’s a massive ripple effect that that can [01:31:55] have.

Payman Langroudi: Is there a page you can go to now or not?

Devina Lavan-Iswaran (Coco): We’re going to set that up soon because [01:32:00] I’m in the process of um, so there is a lady who sends things out at the moment [01:32:05] to a school in Africa, and she [01:32:10] has. I actually met her at a book launch for a patient of mine, [01:32:15] and she said to me, oh, look, you know, this is what I do, and [01:32:20] you know how people are put in. There is some bigger being [01:32:25] that puts people in your path to kind of like, help you at different points in your life, [01:32:30] or if you have something that you want to do, you suddenly meet somebody who is [01:32:35] that conduit to you doing something? I know when I was getting divorced, there [01:32:40] were people who somehow came into my life who kind of helped me along the way. And so this lady [01:32:45] was there like, this is what I do. And I said, great, this is what Anushka and I want to [01:32:50] do. Um, can we help you in any way? Um, and she’s [01:32:55] like, brilliant, if you can, that would be really, really great. So, um, I [01:33:00] will be, she said at the moment. Away. So she comes back in two weeks time. So I’ll be speaking [01:33:05] to her a little bit more. And yeah, then Josephine, Anushka and myself will [01:33:10] set this up and get it going.

Payman Langroudi: Keep us informed of that. I will try and put it in the show notes. [01:33:15] If you have something. By the time this comes out, we’ll do. So it’s been a massive pleasure to [01:33:20] have you.

Devina Lavan-Iswaran (Coco): Um, thank you for.

Payman Langroudi: We could keep talking forever. We [01:33:25] do end it on the same questions every time. And [01:33:30] the first one is that fantasy dinner party. Ooh. Okay. [01:33:35] Three guests, dead or alive. Who would you have? [01:33:40]

Devina Lavan-Iswaran (Coco): I would say if it was, um, [01:33:45] celebrity guests kind of thing. Um, or even family or whatever. Three [01:33:50] guests that I would have. Probably Michelle Obama. [01:33:55] Oh, yeah. Right. Very inspirational woman. Um, even [01:34:00] when, you know, she had to give up her own role when her husband was president, the [01:34:05] kind of initiatives she took up. Et cetera. Um. I love [01:34:10] the way she’s brought up her family. Um, it’s a.

Payman Langroudi: Shame she doesn’t want to be president. [01:34:15]

Devina Lavan-Iswaran (Coco): That’s exactly what I think.

Payman Langroudi: She would win, for sure.

Devina Lavan-Iswaran (Coco): Make a great president.

Payman Langroudi: Although, although. [01:34:20] Although I don’t know about that, I’ve always been against sort of, uh, familial lines in, in, [01:34:25] in politics. Um, because why should it be? Why should it be Hillary Clinton? [01:34:30] And, you know, the Kennedys and the. Yeah. Uh, and so many other countries as well. But [01:34:35] she definitely would win. She definitely would win.

Devina Lavan-Iswaran (Coco): She would make a great president. [01:34:40] So her. Yeah. And I think she would be game [01:34:45] for things. So I’ve watched her on like the Ellen Show. I’ve watched her with. Yeah. She’s cool. You [01:34:50] know. And and she would like we would play games. Right. [01:34:55] We would have like.

Payman Langroudi: And the dinner party, you mean? Yeah.

Devina Lavan-Iswaran (Coco): Yeah. Why not? And she would enjoy [01:35:00] that. And I think she would tell me about some games that we could play. By the way, do you cook? Yes [01:35:05] I do. Which, which.

Payman Langroudi: Which cuisine do you cook?

Devina Lavan-Iswaran (Coco): Everything.

Payman Langroudi: But is it like I love [01:35:10] cooking? Is it Sri Lanka or is it Chinese?

Devina Lavan-Iswaran (Coco): No, no. So I will cook like Singapore [01:35:15] crab.

Payman Langroudi: Yeah. Just just.

Devina Lavan-Iswaran (Coco): You know, just.

Payman Langroudi: Cook Italian.

Devina Lavan-Iswaran (Coco): Food. I would make a good [01:35:20] Sunday roast, I bake, I. Yeah, yeah. Like food, like [01:35:25] feeds you. What would you.

Payman Langroudi: Serve on this? We’ll get to the other two guests.

Devina Lavan-Iswaran (Coco): I would get to that later. Right. [01:35:30]

Payman Langroudi: Let’s go to the second skill.

Devina Lavan-Iswaran (Coco): So James Corden. Oh yeah. So we could [01:35:35] do karaoke and he would be entertaining to. He’d be up for a I. [01:35:40] I love it when people like enjoy life. They love to sing. They love to dance a little [01:35:45] bit. You know, he’d be up for playing some games, he’d be up for dress up, etc.. Um, [01:35:50] and then so recently I have been [01:35:55] listening to a lot and reading a lot of Paul [01:36:00] Brunson’s books and things. So he [01:36:05] is the guy who’s on Married at First sight. He like, does all the interviewing, etc. [01:36:10] he also, um, uh, his part [01:36:15] does quite a bit of research on, um, is it, [01:36:20] uh, one of these dating websites? And [01:36:25] um, also does celebrity do dating. And recently he did a book [01:36:30] called finding uh, Find Love. And it’s about the dating world [01:36:35] and kind of like the he’s done huge amount of research [01:36:40] behind all this thing and how you should go about dating, how you should go about [01:36:45] it.

Payman Langroudi: Must be fascinating.

Devina Lavan-Iswaran (Coco): So it is absolutely fascinating. Some of the things that he [01:36:50] says, like, you know, your first date should not be that you should go like, [01:36:55] you know, we hype up a first date, right? Oh my gosh. Go to a fancy restaurant, get [01:37:00] new clothes. This, that or the other. What you should actually do is go for a walk. Because imagine [01:37:05] you come back right from going to a fancy restaurant, this, that and the other. And this person is like, [01:37:10] not your cup of tea. Or they turned up like badly dressed or in there, and you think I made this [01:37:15] effort or I paid for this meal and look what she did or look what he did. So [01:37:20] it so just talking about those things and talking about like people’s love languages, [01:37:25] people’s negotiation languages, right. All those kind of things. Fascinating. What’s the.

Payman Langroudi: Surname [01:37:30] Paul.

Devina Lavan-Iswaran (Coco): Paul Brunson.

Payman Langroudi: Brunson. Yeah.

Devina Lavan-Iswaran (Coco): Paul. Carrick Brunson um, and he’s [01:37:35] done a few podcasts with the diary of the CEO Guy as well. Okay. So [01:37:40] yeah, very interesting kind of things. Um, and right now [01:37:45] I’m in the process of kind of like dating. So I thought, yeah, I’ll have [01:37:50] him at a dinner table and then he can say, Coco, you’re going about this wrong.

Payman Langroudi: Nice. Nice combination. [01:37:55]

Devina Lavan-Iswaran (Coco): This is what you need to do. So like, I, I went to his book launch and I [01:38:00] thought. And before that, I was like, I’m not going to date anybody. I’m not going to do anything. I’m going to get myself [01:38:05] like, all set already know what it is I want, etc.. [01:38:10] So it’s like a shopping list, right? You draw up your list and you think, these are my [01:38:15] negotiables, these are my non-negotiables. This is how I’m going to go about it. So it’s [01:38:20] it’s almost like studying for dentistry, right?

Payman Langroudi: So put it down to science [01:38:25] rather than art.

Devina Lavan-Iswaran (Coco): No, no, no. And there is a science behind it, right. And you’ve [01:38:30] got to like it’s amazing when you delve into it. You think, wow, I did [01:38:35] not know these things. This is where I’ve been going wrong, right? And you’ve also got to realise [01:38:40] that, okay, you’re going to date somebody who, um, [01:38:45] like has a job, right? And works like long hours [01:38:50] etc. don’t then expect them to change for that. Yeah, right. You’re going to date [01:38:55] somebody who comes really well dressed up and has her nails done, [01:39:00] you know, has a wardrobe of great clothes, etc. loves handbags. Don’t [01:39:05] expect her to.

Payman Langroudi: Suddenly stop doing those things.

Devina Lavan-Iswaran (Coco): Yeah, don’t expect to not buy her some [01:39:10] nice jewellery or whatever. Right. So no, the person you’re dating know what you’re going [01:39:15] in for that kind of stuff. So him definitely. I’d have to look [01:39:20] him up if it was, um, who’s going to cook at that party? I [01:39:25] would love Yotam Ottolenghi to cook. Yeah, right. I love his food, everything. [01:39:30] But I would have to set him aside and have my mum cook. [01:39:35] Everybody loves their mum’s cooking, right? But my mum is a great chef. She’s actually, [01:39:40] like, written like she’s on TV doing cooking programmes. She actually [01:39:45] has written a book about at the age of 70. Oh my goodness. She [01:39:50] always had this dream of writing a book. And so then she wrote [01:39:55] this book about how our family had gone from Sri Lanka to Malaysia. Her side of the family [01:40:00] to Malaysia. And how different cuisines [01:40:05] got kind of like intermingled with the family recipes. So the Chinese, the Malay, [01:40:10] the. And you use different spices and everything. So her book is a beautiful, [01:40:15] beautiful book. And she actually won an award at the World Gourmet Awards for her book. [01:40:20] So yeah. So I will have my mom cook. Amazing. And [01:40:25] if it’s like dead people, people who’ve gone by, I would say [01:40:30] I would have my grandparents to say to them, thank you for believing in me. My grandmother [01:40:35] always said, Coco, you always dress so lovely. You look great. You are [01:40:40] such a hard worker. I love everything about you. You’re going to do big things. [01:40:45] You know parents, grandparents believing in their kids, the things it can [01:40:50] do to them. That’s why my thing was going back to that eight year old kid who believed she could do [01:40:55] everything because her family believed in her.

Devina Lavan-Iswaran (Coco): The support network around her, the teachers, [01:41:00] the everything. Um, and I’d have these two friends of mine who [01:41:05] passed away from breast cancer just to come back alive for me to say to them, look [01:41:10] at your families. They are thriving. And I just want them to kind of [01:41:15] come back and see that. And one of them actually said to me, both of them were like around [01:41:20] in that group whereby they were like, we’re [01:41:25] going to be here. We’re going to support you. Those do or die friends. But one, two weeks before she [01:41:30] died, she called me in to her hospital room and she said, Coco, [01:41:35] she goes, please leave your husband. She goes, [01:41:40] I don’t want more of our friends dying. And then you get left there and [01:41:45] this guy kill you off or something? Or something worse than [01:41:50] that happened to you. Please leave. You know, don’t fret about the little things in life. They [01:41:55] will. You will find a way. You know, she believed in me. And [01:42:00] literally one day I had this dream. Like she told me all this. She passed [01:42:05] away. And then when things had got sorted out with my divorce, whatever, [01:42:10] and I was more on an even keel, I’d had this dream of her in Holborn tube station. [01:42:15] Like walking down the stairs like, you know, we have a massive long escalator and waving [01:42:20] bye to me, like, as though I’ve watched over you and now you’re okay and I’m going. [01:42:25] And I thought, oh my gosh, like, what an amazing woman, you know? Um, [01:42:30] yeah. So if it’s like people I could bring back, I would bring them back. [01:42:35] But definitely that Paul Brunson guy. I need some advice from him. [01:42:40] Payman and mum would cook.

Payman Langroudi: It’s [01:42:45] been a massive, massive pleasure. I really, really enjoyed that. Thank you. Thank you for being so open and coming [01:42:50] all the way here as well.

Devina Lavan-Iswaran (Coco): It wasn’t far to come, but thank you for your time. [01:42:55] It’s been a pleasure.

Payman Langroudi: Thanks a lot.

[VOICE]: This is [01:43:00] Dental. Leaders the podcast where you get to go one on one with emerging [01:43:05] leaders in dentistry. Your [01:43:10] hosts, Payman Langroudi and Prav Solanki.

Prav Solanki: Thanks [01:43:15] for listening, guys. If you got this far, you must have listened to the whole thing. And just a huge [01:43:20] thank you both from me and pay for actually sticking through and listening to what we had to say and [01:43:25] what our guest has had to say, because I’m assuming you got some value out of it.

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