About Anup Ladva

 

Talent is overrated. So says today’s guest, Dr Anup Ladva.

 

In this week’s episode, Anup talks us through turning around his bad-boy beginnings in Palmers Green to become owner of several successful clinics. 

 

He also tells us about his love of tech, which he satisfies by helping clinics get started in digital dentistry – and by steering some exciting dental-tech startups.

 

Along the way, you’ll hear plenty of words of wisdom on management, motivation, running a practice and much more.

 

Enjoy!    

 

In This Episode

0.58 – Mischief in Palmers Green

03:12 – Getting into dentistry

09.38 – Into practice

13.07 – Anud’s biggest influences

17:18 – Efficiency hacks

15:41 – Selecting practices and partners

33.10 – Getting kicked out of Tescos

37.57 – What’s important to Anup Ladva?

42.37 – Boards, bosses, buddies & bonuses

50.11 – Anup’s biggest mistake

58.37 – Digital dentistry

1.08.58 – Egg distribution

1.10.19 – Anup’s words of wisdom

 

About Dr Anup Ladva

Since graduating from Kings College London in 2002, Anup has focused mainly on primary care dentistry. 

 

He has developed special interests in occlusal rehabilitation and cosmetic dentistry and has trained in the US with MJDF and the Royal College of Surgeons. He is an examiner and clinical teacher at Kings College and a trainer for the eastern deanery.

 

Anup is a digital dentistry consultant who supports clinics to integrate new digital workflows. He is also an entrepreneur with involvement in new dental tech startups.

Connect with Prav and Payman:

Website

Prav on Instagram

Payman on Instagram

Transcript

Anup Ladva:
The worst type of investment you can have is buy something that you don’t use. Start that gym membership I bought.

Intro Voice:
This is dental leaders, the podcast where you get to go one on one with emerging leaders in dentistry, your hosts, Payman Langroudi and Prav Solanki.

Payman L:
I guess today is someone I’ve known for coming on to 10 years now, I think, a general dentist, a teacher, someone who’s set up several practises and in dentistry one of the people who I consider as one of the good guys. Doctor Anup Ladva. Good to have you on here.

Anup Ladva:
Hi. Thanks for having us.

Payman L:
Prav I don’t think you’ve met before, have you?

Prav Solanki:
We haven’t. No. No. We haven’t met before.

Anup Ladva:
No, I’ve heard a lot about Prav but we’ve never met.

Payman L:
Anud, maybe just start off by telling us about your early life. I mean, where were you born? How did you grow up? How was your childhood like?

Anup Ladva:
So I was born in North London, Palmers Green. I’ve got a brother and my mom and dad, we’ve got big family. So we were all together in a Palmers Green. So we went to comprehensive school, studied hard. To be honest I used to do a lot of things that was not what we would expect to do for our kids. We used to play the game back then.

Payman L:
Like what?

Prav Solanki:
What does that mean?

Anup Ladva:
What does that mean? It means not do the good boy stuff is like go out… naughty sometimes, miss school sometimes, be havoc in school.

Payman L:
And yet you were getting the grades?

Anup Ladva:
Yeah. That was the problem, to be honest, that that was the problem. I was getting the grades and I think I had this opportunity where I was reading and I was able to retain information and very strategically, I think, at the point.

Prav Solanki:
So you were naturally talented, gifted student. Would you say?

Anup Ladva:
No. I think talent is overrated. I think where we came from was hard work. But the thing is for me to achieve that, it just took less time than other people, this is what I felt. So my granny used to say to me, “You’re the only kid that I know that I’ve seen… And my granny used to live with us… Who sits in front of the TV, has the car…” She used to call it car racing, which was the Grand Prix. It was like every Sunday Grand Prix. And I’d have a book on my lap and that was how I would study and I’d do GCSC’s, A Levels and everything else that went with it. And I remember when I got my grades for my history, you do a mock or some sort of exam to say, this is what you’re going to do when you do your choices is the teacher just thought I cheated, straight up cheated. She was like, no, you cheated. And I was like, call my dad. My dad was like, “What’s going on?”. And I didn’t, I just read the book the day before, literally. I read the textbook they gave me the day before, went in and did the exam. I didn’t do it amazingly bad. Passed the exam.

Prav Solanki:
I’d call that talent mate.

Anup Ladva:
I don’t know.

Payman L:
Do you remember when you first decided to be a dentist? What was it your parents to-

Anup Ladva:
No. It wasn’t. It was my mum, basically my mum passed away. She was the Staff Nurse at A&E, so she saw it all right? And I was unsure what I wanted to do and she was like, “Come in and speak to some of the doctors, come in to the Chase Farm A&E. And I went in and there was a lot of blood and a lot of craziness in the accident emergency and I was speaking to one of the doctors and his name was Dr. Chen, and this guy he was a really nice guy. And my mom had a few of those guys around her, they really respected her because they came from East Africa and some of them trained at the same places. So, and he sat down with me and said, “So what do you want to do?” And I said, “I’m not sure.” And I was very computer art orientated as well at the time.

Anup Ladva:
So I had that option and so I’d done my GCSE’s, I was coming up to doing them and I was unsure what I wanted to do. And he said to me, “You can do medicine or you can do dentistry.” “Dentistry, they get paid a lot more money”. That’s what he said to me. I remember you said they get paid a lot more money and in 10 years the life is less demanding. You don’t have to travel to different hospitals and get moved here and there and I thought, I don’t want to do that.

Anup Ladva:
So yeah, let’s do dentistry. And what actually happened was when it came time and I did my A levels and we came time to apply to do dentistry, I applied for optometry and dentistry. I was like one of the only cats who did that. I did like two places for optometry. Obviously I go into those and then did three for dentistry and out of the three I got into two and one they were like, “No”. And it was, I think it was Guys & Kings at the time they were separate. So I’d go into Kings and I got into Birmingham.

Payman L:
And where did you end up?

Anup Ladva:
Ended up at Kings.

Payman L:
Kings.

Anup Ladva:
Yeah.

Payman L:
And then what were you like as a dental student? Were you also fun loving criminal?

Anup Ladva:
Yeah. Big time. Big time, fun loving criminal. I don’t have a lot of like friends, you know they’re like 200 friends guys. I’m like the guy who has like five-

Prav Solanki:
Close friends.

Anup Ladva:
Yeah, five friends and we turn up no matter what. And that was it was Mehul Patel. Mehul Patel was my clinical partner.

Prav Solanki:
Really?

Anup Ladva:
Yeah, and he’s a phenomenal dentist now, but we used to be on clinic together and do crazy things. So Mehul was with me and dentistry don’t get me wrong the first three years was difficult. My first year I nearly dropped out just because I didn’t do biology-

Payman L:
Neither did I by the way.

Anup Ladva:
I did chemistry, physics, maths, further maths. I didn’t do biology. So I went in and the first year literally I was reading out of a dictionary because every word they were putting up I was like, “I have no idea. I have no idea. I have no idea.” And that was difficult. It was draining, for me from sitting in front of a TV, reading a book and getting an A, A* I was like suddenly this is the real world. And that’s why I said, talent is overrated. That’s when I realised-

Prav Solanki:
Graft.

Anup Ladva:
… that this is graft. Forget what everyone else is doing. I go up a thousand I got to graft.

Prav Solanki:
You grew up in a typical Asian family. Was there for that pressure to do medicine, dentistry? Sort of-

Anup Ladva:
No. So listen, this is what happened year one, I had to do some three-week… At King’s you had to do a three makeup biology course. So you go in and I’m like, “Yeah, I can do this.” Come out-

Prav Solanki:
Was it like a foundation course?

Anup Ladva:
Yeah. A foundation. So I had to do that before we went into dentistry, week three I was broken. That was horrific for me. That was the worst university experience I’ve ever, ever come across. It was so bad. I had no idea what they’re talking about. Pathways-

Payman L:
I know exactly the feeling.

Anup Ladva:
I had no idea. I came home literally and I came home and I cried and my gran and my mum were in… I was in my gran’s room. My mom came and she was like, “Why are you crying?” And I was like, “This thing’s crazy. I don’t think I can do this.” And that’s when my mom and my gran, they sat me down. They were like, “Listen…” That’s when she told me that story. She said, “I never seen no one study like you. Whatever you apply yourself to, you can do it. But the thing is, you’re not applying yourself. You’re in this state of where you’re like, this is so difficult because you’ve had it easy because you are able to be in that position. Now it’s time to turn it up.” And then, so they obviously talked to my dad, so my dad comes home and he sits down with me and these are the things that I’ll never forget till I die. And that day he sat with me and he said to me, “You know, you can do whatever you want.

Anup Ladva:
No one’s making you do this. You chose to do this. So you can be a mechanic, you can go and be a computer guide, like engineer.” My dad was an architect by trade and he was into CAD/CAM back in the day in architectural world. So Autodesk and all that kind of stuff. And he says to me, “You could do whatever you like, but the thing is you can’t just do it for the sake of it. You’ve got to be the best as you can when you do it. So I don’t care what you do, I don’t care if you drop out, the choice is yours, but just do it to the best of your ability.”

Prav Solanki:
So you didn’t have that pressure at that time that you must do this.

Anup Ladva:
No. I think they didn’t-

Prav Solanki:
Your dad was quite supportive in that sense, in terms of…

Anup Ladva:
No. I didn’t have pressure. That was the, the difference. The pressure was like, I think my brother had more pressure than me from-

Payman L:
What did he end up doing?

Anup Ladva:
He did chemical engineering in UMIST and then went on and did some other bits. Now he’s into teaching and learning and he’s in a corporate that does big corporate teaching for big companies and he’s doing really well. But I think he had the pressure and I think they from him, they were like, they looked at me and they were like, “Well, he’s doing things different and he’s getting the grade. So maybe we just leave him the way he is.” And I think that worked for me. I learned a lot from that. Hopefully I’ll have that ability to do that with my children.

Payman L:
So then you qualified and how long did you associate before you thought about opening a practise?

Anup Ladva:
So I qualified. It didn’t get VT job, a DF job I went to… So my days you had to apply. I applied and I didn’t like the places when I actually went there. So three interviews I left before I had the interview.

Prav Solanki:
Oh, you just didn’t turn up?

Anup Ladva:
I went to the practise and they were like, “Hello. How are you doing?” And I was like, “Can I have a look around?” They were like, “Yeah, sure.” While you’re waiting for some places in London. So I’m close to here. I was in North London, so I was applying-

Prav Solanki:
Locally.

Anup Ladva:
Yeah, locally. And I didn’t even like the practise. It was like I was under the stairs and it was like-

Payman L:
So you walked out?

Anup Ladva:
I just left. I just left. Just said to them-

Payman L:
How rude.

Anup Ladva:
This practise is not for me. No, I was honest. I didn’t study-

Payman L:
Honest is often rude.

Anup Ladva:
The problem is that’s me all over. My patients say that to me, “The most honest dentist I know. You just tell me exactly how it is good or bad.” That gets me into a lot of trouble along the way. But it also builds that reputation that “Listen, he’s going to tell you how it is he’s not going to mess around.” I left a few of the practises. I applied to 10 I think I’ve got six interviews, three I left and three I did and one of them I wanted and I didn’t get it. So then I went to Cuba, I went to Cuba for eight weeks.

Prav Solanki:
To a holiday party or-

Anup Ladva:
Just switch off and go and do whatever. A few of pals, a few of my friends who had jobs, they were coming back to jobs and I didn’t have one. So I went, I just took the summer, I went to Cuba and when I was in Cuba, my brother, the legend that he is was like, “I’ve got you four interviews. They’re in these places, which are not in London.”

Prav Solanki:
The chemical engineer.

Anup Ladva:
Yeah. So my brother, who was at the time, he was doing some sales work and he was like, he could talk to people, he could communicate really well in the sales arena. And he was like, “I’ve got you four interviews. One’s in Scotland, one’s in Birmingham somewhere, one’s in Colchester and this.” And then I came back and I was like I don’t know if I want to do this, I’m not sure. And he got me an interview with a place in Colchester, Essex and I went to it and it was a beautiful practise. Beautiful.

Prav Solanki:
Was the name of the practise?

Anup Ladva:
Is called Crawford lodge Dental practise. Beautiful practise. Really nice small NHS contract and the DF and it’s a good quality work.

Payman L:
What a legend your brother is.

Anup Ladva:
Yeah. Legend.

Payman L:
Absolutely. So then, okay, was that VT?

Anup Ladva:
So, that was DF. Yeah. So that was DF and then I did a little stint before I started that DF, cause I’d been away, I came back and I stayed late because they had someone who had dropped out. So, that was essentially what happened. They had someone who didn’t pass their exams. So then the timeframes were going to be a little bit further away. So I went and did a stint in UCLA with Ed McLaren doing some aesthetic dentistry.

Payman L:
Ah, nice.

Anup Ladva:
And that just opened my eyes to the real… I thought if we’re going to do this-

Payman L:
Pascal Manua was there?

Anup Ladva:
Yeah. So I was like, those were the golden days guys who wrote the books now. That was some of the privilege that I’ve had now is… And that is actual privilege is the guys that wrote the books were the people that taught us. Like in my year, me, Mes as you know they are the Kings, all the books. They were our tutors, our personal tutors. We had that. And then in the aesthetic arena is like being in those kinds of environments. You take on a lot of knowledge and you learn and also you realise how hard it is. Because them guys they work you hard.

Prav Solanki:
Who do you think had the biggest influence on you in dentistry? In terms of way… We spoke to a lot of people who say that it was their first boss or tutor or someone they ended up being mentored by. Was there anyone who had the biggest influence on the direction that you’ve taken today?

Anup Ladva:
The direction that the biggest influence direction. So in, there’s three arenas there we’re talking about, one is what gave me the opportunity to really think right. This is it. And there’s a guy called Brett Robinson at Kings and he was my personal tutor and anyone who knows Brett would be, if you go into the day and you’re like, today’s gonna be a tough day. He’ll stand on the table and be like, there is no such thing as a tough day. It’s only what we make of it. Come on, we can do this. Like, that was Brett. Right. But it was hard as nails, hard as nails and me and Mes spent a lot of time in his office getting either bollocked or getting told like, you know guys, you’re doing good. But he did clinical skills with us-

Payman L:
Who’s Mes? Mahul?

Anup Ladva:
Mahul Patel, sorry. So, and he sat down with me and he was like, “You can do this and you’re going to be exceptional.” It’s just that you have to work out the hand skills you’ve got like we were way ahead of our group in terms of the clinical side of things. And it was the other stuff that the all medicine, all surgery, the actual learning, like the being able to piece things together. We hadn’t worked that out because we were too busy messing around and doing other things and he did that and he’s the guy who influenced me because his hand skills were phenomenal and he was a big guy, six foot six…

Payman L:
Is he’s still there?

Anup Ladva:
He does. He teaches the hygiene therapy now. So, but he was an endodontist and he just had phenomenal clinical skills. And when we went through that process and we started getting good, that’s where we worked out, why he’d have these plasta teeth or styrofoam teeth made that were this big like foot by foot, like molar. And he’ll give us hand tools like carpentry tools and be like, “Prep it.” So we’re covered in this styrofoam with a mask on like glasses, like top, and he’ll be like, “All right, so now you could see what things are wrong, what is right, what things do we need to change?” And that’s what we used to do. We used to do a lot of that. And then, he was phenomenal. Then obviously after that it was my second boss actually. So I left the DF and I joined a practise, a really big practise.

Prav Solanki:
And did you leave the DF before time or-

Anup Ladva:
No. I did complete the DF and I did it with a guy Jason, who was my TPD and he’s still the TPD now and now I teach under Jason, we teach DF’s. And that’s a crazy like cycle, like he was my TPD and now I’m teaching under him.

Payman L:
Jason who?

Anup Ladva:
Jason Stokes in Ipswich Deanery.

Payman L:
Is he your second mentor?

Anup Ladva:
No. No. Jason was always a good person to have, like to be solidly put you on the right track. He’s such a nice guy and he was very, very tell you the way is. And I like that. That worked for me. That really worked for me at the time and it still does now. I like that. I take a lot of advice from Jason. He’s a nice guy. So there was a practise that I joined it was a big practise and that’s where I learned about the business of dentistry.

Prav Solanki:
And that practise was-

Anup Ladva:
Howard and St John’s dental practise. Colin Brody.

Prav Solanki:
Okay. And was it him who taught you about business or just absorbing to see how the team was together? What was the biggest business lesson you took away from that practise?

Anup Ladva:
Is how to be efficient, how to be efficient. The practise was efficient, like coming from the DF practise, small contract. This was a huge contract. How to be efficient in or in the areas of your book, how to be efficient in the stock ordering, how to be efficient in staffing. We never had those kinds of issues and we all know that staffing is a big issue inside of healthcare. Especially when you get further away from London, you put an ad out you get five people rather than 50 you know those kinds of scenarios. And he had that and he taught me a lot.

Prav Solanki:
So what’s your biggest efficiency hack? Let’s talk from whether it’s clinical business, if you… lot of people out there who are wet behind the ears when it comes to business. Maybe 10 plus years ago from where you used to, you are today. What’s the biggest tip you can give somebody in terms of being more efficient in business for any aspect?

Anup Ladva:
Any aspect?

Payman L:
Any aspect.

Anup Ladva:
Any aspect is the key for, I think in dentistry that we see now, is everyone is… Even if they’ve got a little bit experience. They really want to be running because of the social media. Social media has a big impact on our mindset, our culture the way our kids… Every everything around us. But the thing with dentistry is it has a huge impact in our self confidence, our motivation, our belief and the thing is they want to run really before they can walk. So the biggest hack I’d have for them is get your fundamentals locked down. Get them locked down in a way that you’re not changing six variables.

Anup Ladva:
If you’re doing a procedure and you’re going to extend or get better or get quicker at what you’re doing, choose two variables, work on them master them, then add the next one, then add the other one. We see these guys suddenly, they never use DAN, they never done really complex intricate type of layering and they’re doing this all at the same time. Then it’s a recipe for failure. When you change too many variables, and this the same throughout the industry. You want to make your reception team more efficient, choose two variables, implement them work and get them nailed down. Then move on.

Prav Solanki:
Earn your stripes, do the graft and focus on one or two things at a time.

Anup Ladva:
Yeah. So when I opened my first practise and as a squat and as a video shop, we went in, converted it, my dad sat down with me and we’re obviously from a background where we’re business smart. It’s just, I don’t know how we described that, but that’s what our culture is, it’s in our blood. And so he sat down and we said everything top-down, if you can’t do it yourself, don’t expect someone else to do it better than you. It can’t happen. Everything top-down, cleaning. We grafted and my lovely wife and we got married in that process and she helped me like changing floors and doing things. Because it was a single surgery, we added another surgery and we would like… and we were growing and we were trying to work out like how to do it. But everything, cashing up, the works. Now I look at the books, I know that if there’s from the day’s cash up, I know if we’re two or three hundred pound down, something’s wrong. Something’s right.

Payman L:
Because you know the business inside out.

Anup Ladva:
Because I know the business and I’ve done it, I’ve done it. And they’re like, “Oh I’ve got this cashing up issue.” Like you know, sometimes you have that and you know they’re spending 25 minutes and then they know they don’t want to call me, but you get the call and you’re like, “Okay, I’ll do it on the way out. Let’s go.” So we go sit down and you just look at it and you’re like, “This is where it is. Someone’s not tilled this into this PDQ or the PDQ numbers out or something.” And to this day because of that, I come across, I do a lot of consultancy for practises and trying to make them more efficient. Marketing is difficult. I know Prav is a genius at that. That’s my most difficult thing is marking the practise.

Anup Ladva:
And I think social media plays a big role in that. Now, my wife’s been telling me that for five years and now I know that she was right. But we’re lucky that we’ve never been in a position where we’ve had people steal money from us, you know, and I come across loads of practises they’re like-

Prav Solanki:
That happens a lot.

Anup Ladva:
It’s like I see them crazy ways as well. They take money, then they hit a refund in the system and then that, and I’m like, you’re by the end of the day, don’t you, who’s looking at what refunds were hit on the day and they’re like, no one. And I am like well that’s the issue.

Payman L:
I get exactly what you’re saying about understanding every part of the business and what that’s done for you. But there are other ways of doing it.

Anup Ladva:
Yeah. Of course.

Payman L:
Some of them include taking on partners. Which I know you’ve done as well.

Anup Ladva:
Yes we have.

Payman L:
So was that first practise that you mentioned, not the one that you’re in a partnership?

Anup Ladva:
No. No. No. We bought partnerships after that when we had a bit of money and then we went in and we did some bits for-

Payman L:
And the first one was I was a squat. Tell me this was the biggest lesson you can say to someone who’s about to open a squat with regards to how did you go from no one knowing about you to one patient a day coming in, what do you do? And what’s the biggest things to look out for and some of the hacks some of the things that you learnt along the way so that someone else doesn’t have to make the same mistakes as you?

Anup Ladva:
So when we did this, we did this manually. Right now it’s a digital game. So you got to have a really good digital presence now. But it doesn’t mean you forget about the manual. We did it old school, we had balloons every day. We’d blow up a hundred balloons and we’re in a Tesco’s car park, so there’s lots of people, kids or families coming and we’d give, you know, a logo name we’d give kids, give fam, give mums, even if it was a mum and we knew that, you know, they had kids or they’d be like, have you got children here? Take some balloons for them, you know, constant. We were doing it every day.

Prav Solanki:
Any messages on those balloons or-

Anup Ladva:
We’ll be like, come give us a call. One of the biggest messages we used at the time was while you do your shopping list, let’s have a look at your family’s teeth. It was like, the dad can come with the kids and the mom can do the shopping and then they could swap over and-

Prav Solanki:
Real old school guerrilla marketing.

Anup Ladva:
Guerrilla marketing.

Prav Solanki:
You were going out there.

Anup Ladva:
Tactics.

Prav Solanki:
Literally.

Anup Ladva:
Literally.

Payman L:
Did you try and partner with Tesco’s?

Anup Ladva:
We had trouble with Tesco’s loads of times. No they didn’t want us to do it, but we did it anyway. That was the part of guerrilla marketing. Every car that was in the car park would get a voucher. I think it was a voucher for something off whitening. I think it was something like that-

Prav Solanki:
Under the windscreen wiper.

Anup Ladva:
Yeah. Yeah. It was that kind of thing.

Payman L:
Then a few patients start coming in, I guess.

Anup Ladva:
No. We’re a mixed practise. So we had a small NHS contract, so we made it aware in the press we took a press advert, full page, new practise opening, NHS space available. That was it really done is we had a table. So while they were building the practise in the Tesco car park, we had a table outside and a lovely lady who still works for me now, she sat outside and we registered patients and we had a queue that they’ve never seen before.

Prav Solanki:
Prelaunch.

Anup Ladva:
Prelaunch. NHS is going to do that. It was going to do that back in the day. There was no other NHS when we won the contract, but then from there, that’s when we realised that we’re onto something. There’s 3000 homes here. This is their Tesco. Let’s go at this guerrilla style. And that was the… The aim was to keep me busy two and a half days a week, like mornings and then go to the other practise mornings go to the other practise mornings and from there, suddenly within two months we were like, I can’t work at the other place. I need to be here.

Prav Solanki:
Chock-a-block.

Anup Ladva:
It’s just… and it grew.

Prav Solanki:
Could you talk about about the other practises, these were the ones you already had-

Anup Ladva:
There was associates. I was still an associate at the other place at Howard and St John’s, Colin Brody, and he’s the one who sat down with me and said, “Listen, I know you’re going to leave, so why don’t we go and look at some places and I’ll help you set up.”

Prav Solanki:
So he became your first partner?

Anup Ladva:
No. He just became a person. He was like my mentor.

Payman L:
A mentor. What a lovely guy.

Anup Ladva:
Top bloke, top bloke. No one would take that time, effort and energy. And don’t get me wrong, we paid him some money for it. That was part of the deal was like, “Look I help you every step of the way. Just give me like little consultancy fee.” And that’s when my eyes opened to consultancy. Because then you have another aspect of what I’d… so I took that, we did it, we paid him his consultancy fee. For me it was a no brainer. And then that’s where we’ve started our consultancy business was taking that and developing that mentality in that thought process into… that was 12 years ago. So from there we’ve kind of gone along the way.

Prav Solanki:
What’s a chronological order of things that happened next, you opened your practise, launch day, boom in, left your associate job. And then how many more practises did you-

Anup Ladva:
So from there then we went and got a partnership.

Prav Solanki:
What does getting a partnership mean?

Anup Ladva:
So bought into a practise in Kent with the aim was to increase the turnover and sell it. Went well exited early, earlier than I would like.

Prav Solanki:
Just rewind that a little bit. How does that take place? How do you find a practise-

Anup Ladva:
You go on the hunt.

Prav Solanki:
… that wants you to buy in, do you go and hand select? Do you think that’s a good practise.

Anup Ladva:
Well it was friends of friends, so friends of friends… Met… Guy was like struggling. So as it is a good value prop, value is difficult in dentistry, especially in this market.

Prav Solanki:
Yeah at the moment.

Anup Ladva:
Yeah. And so at the time it was a good value proposition and there was scope and I knew because as grown minds so recently I knew the things we could do and marking is really throwing money at the wall unless you know what you’re doing. And a lot of people do do that. They throw money at the wall and that’s what this guy was doing. There’s no way of monitoring what you’re spending money on. Are you making any money back from it? Your book, how it’s run, that, why do we not have like basic things like slots, dedicated to private. It was a no brainer.

Prav Solanki:
It’s a partnership. Just to sort rewinding that number one in Kent, what percentage did you buy? Did you have an independent valuation done exchange money and then-

Anup Ladva:
No independent bank valuation. Just quick, done, easy. It was dead easy.

Prav Solanki:
Scrap of paper. What percentage did you buy?

Anup Ladva:
50%.

Payman L:
You trusted him because he was a friend of a friend.

Anup Ladva:
Yeah. And there was a lot of trust both ways and that was actually the Kent one was okay. Then there was like other-

Prav Solanki:
You exited from that, right?

Anup Ladva:
Yeah.

Prav Solanki:
Did okay?

Anup Ladva:
Yeah. The exit was okay on all of them. It was okay. It’s just that I think… the thing is in dentistry is I think having now… is buying a partnership is good, but you have to know the people and that’s the difference. A lot of people now are saying to me, “Why don’t you do this again, set up another one.” I would do it, but I couldn’t do it by myself. One, because I’ve got family, kids and everything else and time. I’ve learned a lot at this last three, four years. Payman will tell you in my life we’ll get there. No doubt.

Anup Ladva:
But the partnerships were good. They gave me what we wanted to do. The downsides of them was being in partnership with people that I didn’t know as well as what I would want to know because what happens is your dynamic is different. It’s their baby, you’re buying into it and they think they know best. Even when you can see from an outside strategy that maybe, you need to change things here, we need to drive it a little bit this way and even the little bit was difficult to get. Then it’s like-

Payman L:
I’m not sure it’s to do with whether you know the person or not. Of course it helps to know someone, but you can be in a partnership with someone you know really well and just not share the same risk profile.

Anup Ladva:
Risk is… That’s the big thing.

Payman L:
For me in partnership, that’s the key point.

Anup Ladva:
Yeah, I think you’re right.

Payman L:
If you have the same risk profile and be two totally different people. It’s very important that you are different people. Otherwise, why would you bother getting the partnership?

Anup Ladva:
Sure.

Payman L:
You need two different skillset.

Anup Ladva:
Agreed, but for me, I’m talking 10 years ago, my risk profile then was so different to it is now-

Payman L:
And he was older, was he?

Anup Ladva:
Yeah, yeah, yeah.

Payman L:
That’s where his risk was right now.

Anup Ladva:
Yeah, so if you actually think about in that mechanic it’s very true, is like my risk profile now is so different to what it was then. I’ve got kids-

Prav Solanki:
Different life goals, things change.

Anup Ladva:
Yeah. And my life goals are hugely different compared to three years ago.

Prav Solanki:
Of course. Just as a summary, it sounds like you’ve had some partnerships that have been a booming success.

Anup Ladva:
Yeah.

Prav Solanki:
Some that haven’t worked. What advice would you give somebody who’s thinking of going into partnership? I’m sure there’s a lot of people listening now having conversations. I myself have been involved in partnerships. What advice would you give to someone who is thinking of going into partnership in a joint venture, buying into a practise, what are the things to look out for as what you would consider to be the recipe for a successful partnership?

Anup Ladva:
Okay, so one is trust. You have to trust the person, they have to trust you.

Prav Solanki:
Mm-hmm.

Anup Ladva:
Two is having the ability to be able to take ownership for certain parts because realistically what we find in partnerships is, and now still, is they want to do the same thing and they both want input into the same thing and there’s just not time, effort, energy, efficiency. So your efficiency goes out the window when you start doing that. So being able to take ownership for certain parts of the business. And not being involved in that part because you know that you trust that person and they have ownership for it.

Prav Solanki:
They’ve got your back.

Anup Ladva:
They’ve got your back. Whether you’re going to be doing that or not, that’s huge. And the third thing is being able to be lean. A lot of people still go into this, I really don’t want to say it, but they come in with loaded pockets, they’re setting up a squat, they’ve got loaded pockets and lean is not in business is not a thing I’ve come across. It’s just taking a loan, signing a check or paying for it. Because we’ve got the-

Payman L:
What would you say is the advantage of being lean?

Anup Ladva:
It means you show profit early. The leaner you are, the three years in, you’re already showing some black. That’s a good thing.

Payman L:
Of course that but have you read that lean startup?

Anup Ladva:
Yeah.

Payman L:
Great book. But for me, the fact that you can try things in a small way-

Anup Ladva:
Well the benefit of being lean, like Seth Rogan talks about. So what we’re talking about is benefit of being lean is your exposure to your thought making process is minimised. So you have this idea and you want to do it, but you do it as lean as you can, as long as you can measure it, then go all in. Then be like, “Okay, we’ll sell three extra surgeries, we’ll set up four extra surgeries,” you know, no problem. We’ve got the space, but why go in and fit seven rooms when you’re a squat.

Prav Solanki:
If it doesn’t work ditch it, right?

Anup Ladva:
Yeah.

Payman L:
Prav, your probably in more-

Anup Ladva:
Your most probably the master of this.

Payman L:
He’s in more partnerships than I’ve had breakfast. I mean, he’s in a lot of different partnerships. What would you say is your top tip?

Prav Solanki:
I think my top tip for anyone going into a partnership is have the same personal values as that person. And that’s something you learn over time. And so for me, I’m a family orientated individual. You have family first, above and beyond anyone else, anything else. Risk profiles, those being different. I’m happy with that. Trust, absolutely. You need to know that you can implicitly trust that person. And the other thing is that when you go into a partnership with somebody for me, I want that partner to be bloody awesome at what they do. Be the best of the best at what they do.

Prav Solanki:
So take one partnership for example, the IAS Academy. I know without question that Tif Qureshi is the world’s best teacher and educator when it comes to educating GDPs about minimally invasive ortho restorative dentistry. Knowing that gives me so much confidence that I can market him and the rest of the team who he’s mentored, people like professor Ross Hobson who’s come on board as a master of his own game. And our other mentors, we know they are exceptional. Knowing that I think is key really that people are really good. But, Anud, similar to what you said, unless you can blindly trust the people you’re in business with.

Anup Ladva:
Has to be blind.

Prav Solanki:
It’ll fall to pieces.

Anup Ladva:
Yeah.

Payman L:
The one thing I didn’t appreciate, I’m in a partnership, was one thing you were telling me about in your marketing business, you’re the sole owner and sometimes that’s lonely. The loneliness-

Anup Ladva:
No, it is. I’m there now, right?

Payman L:
Yeah, you’re there now.

Anup Ladva:
And this is 10 years in and I-

Payman L:
You don’t realise this when you’re in a partnership, you don’t really appreciate, you don’t internalise how that feels because you have all this-

Anup Ladva:
And you know the thing is the buck stops with me right? So like everything stops with me. And in our staff meetings we’re like, “Okay, we’re having a quiet month or is quieter because I’ve got two dentists on holiday. I got this happening now”. My wage bill is still £26,000.

Prav Solanki:
You’re isolated though, right?

Anup Ladva:
It’s got to be done. And the thing is the only person who gives me that support and strength is my family, is my wife. And she’s been a legend like along the way she’s been a legend. We went to Sydney. This is where I got the extra study or the bug to really work hard. We’re a qualified practise set up, Tesco’s kicked me out in 2008 of the building we were in, because they wanted it, it was joined to the store. They’re like, “We’re going to build you a unit over. There you go move to that building.” I was like, “Okay, yeah that can be done”. “By the way. You got three months to do it.” So start the NHS paperwork. Think about say, “Tesco, come on golden handshake, let’s work something out.” We managed to do that. Obviously negotiate. But the difficulty was is stress man, like huge stress. Like moving the whole business. And that was the point. That’s when we fitted one surgery and another surgery and we kept the other four rooms and be like, we’ll work out as we go. Let’s just get it open and get in there. But the problem was no-one wanting to lend me no money at the time, that is the 2008 recession. My bank was like, “What? What do you mean you want… What?” We have a small NHS contract. “No, no thanks. We can’t give you no money.”

Payman L:
So how did you fund it?

Anup Ladva:
Self funded it, begged, borrowed and stole.

Payman L:
And it’s beautiful. I guess you saw it as an opportunity to rebrand and make it beautiful.

Anup Ladva:
Yes it was. And that was the hardest and lowest things like of my career in that period was though that was hard work.

Prav Solanki:
What was the hardest thing about it… What was the lowest moment during that time mean? I’m assuming in the chronology of things. You were married at the time?

Anup Ladva:
Yes. It was man hours. The true-

Prav Solanki:
Any kids?

Anup Ladva:
No, not at that stage.

Prav Solanki:
So, it was just you and the wife.

Anup Ladva:
Yeah. And it was actual man hours. Like every time we’ll come home. My wife would sit down with me, she would help me some bits and then like going in doing man hours doing dentistry as well. Trying to liaise with contractors while I’m working in this site. Like literally it was a stone’s throw away but I have to leave there, go there and that’s where my patients just, you worked out whether they loved you or they hated you.

Anup Ladva:
Because my patients were like, it’s fine, no problem. Like I’ll sit in the chair, you can go over there and put builder’s hat on and go like… They’ll come in the surgery on the back of the chair, it would be a builder’s hat and a vest like HiVis vest in case I had to go. There’ll be like, “Okay, I get it.” Like you know they bought into the picture and I was lucky there. They’re still with me. Those patients, the ones that’s went through that are still my patients. They’re not going… I wouldn’t let them go anywhere. Let’s put it like that because they’re like family.

Prav Solanki:
They wouldn’t want to go anywhere else.

Anup Ladva:
No, no, no, they’re like family, those ones are like family.

Prav Solanki:
You know when you hit that point in business, and I think we’ve all been there it’s rock bottom, you go home, you’re in tears. You have conversations with your partner, your wife whoever it is at the time. And sometimes there’s a conflict. So I know myself, when I’d been working so hard, my wife just wants Prav. She doesn’t want business. She doesn’t want that. And you hit those really, really low points. Did you ever have that conflict between you and your wife and, and the work life balance because in a partnership your wife’s going to help you with your business. No question. But she wants Anud, right?

Anup Ladva:
Yeah, of course. That was the worst bits was that, she wanted just to spend time with me and we still see that now. Even now, we’re set up we’re doing what we want, which is why I like my game plans changed over the last five years or three years. Like, literally since… we’ve been in this process where after my mum passed away and opened my eyes to what really is happening and we’re at that age now like look, a good friend of mine like mentoring my digital world. Like what happened last two weeks go-

Payman L:
It made you.

Prav Solanki:
And it made you.

Anup Ladva:
Yeah it’s like, no one’s winning this race. That’s the one thing I take away from this process. And I went through that mindset journey and I’m not shy, I went and did the Tony Robbins and sat down with… and really worked on ourselves and myself and what was important to me and my interactions are better now.

Prav Solanki:
What is important to you?

Anup Ladva:
What’s important to me is time, time with family, time with people you love and you care about because tomorrow they might not be there. Everything else will still be there, right? Sure. When I go, everything else is going to be there.

Payman L:
Did your mum pass away suddenly?

Anup Ladva:
She was ill for a while and then… So let’s just take a step back. So I open the practise grafted, built it, working really well. Vanessa was a legend in that process. She really helped me out and kept me straight. And yeah we did have conflict but it worked well. And then two years ago now, mum got ill. And so I found myself and I’ve got two kids and I found myself going backwards and forwards, backwards and forwards to the hospital. And spending time with her and Vanessa encouraged me to do that. Like she was like, “It is something you’ve got to do”, and it wasn’t about something you’ve got to do because you got to do it is because I had a lot of guilt that I wasn’t able to spend time and I never knew what that felt like. For me, I never knew what guilt was. Like my default was irritation angry. Like that was my pathway.

Anup Ladva:
So like most Indian people, most Indian men especially, and so I started to look at what I was feeling and it was that. It was like, and so it wasn’t because of that, she just said to me, “You’ve got to do this. Like I know it’s difficult for you. Go and do it and spend as much time as you need with them.” So I was there. My mum and dad used to call me the midnight stalker because I’d rock up at when the kids go to sleep I’ll go there, turn up. Because I knew my mum would be awake. She wasn’t well she did some time in hospital and then she passed away.

Anup Ladva:
And those last few weeks, moments me and my mum had fabulous and amazing conversations and that’s when I worked out like no one’s winning this race man. We’re all in it together.

Prav Solanki:
What was the biggest lesson that you took away from your mum? When someone passes away, the only thing we have left is our memories, right?

Anup Ladva:
Yeah.

Prav Solanki:
What’s the best memory you’ve got? And what is the biggest lesson you took away from your mum that you can pass on to your children?

Anup Ladva:
Is the thing is this, is everyone that we meet is going through a battle that we know nothing about. So be kind, dead simple. And the reason that that’s important is, I’d see her and I’d be upset about something and she could tell from our time, we were spending so much time together, she was like, “Why are you being sad or upset about something that you have no control over? The only person who’s making upset is you. The other people don’t give a damn. They’re doing their thing. So who’s it affecting? Who does it actually affect? Affects me because you’re here with me. When you see Vanessa it’s going to affect her because you’re going to be with her, when your kids see that it’s going to infect-”

Anup Ladva:
So realistically, the interactions that are closest to me that I care and value the most about, other people who are going to suffer because of some other interaction I had with someone that has put me in that state. That doesn’t mean you can always be good, but I’m trying. I’m trying to always self-correct. But I’m learning that and that’s what’s changed three years and that was the hardest thing, man. For me I was broken like for me, I was so broken.

Payman L:
Does your dad live with you?

Anup Ladva:
My dad. No. He lives at home. He’s a stubborn old mule, isn’t he? The best of the best. My dad showed me his true colours in these last two years. Man, he can cook. My dad never used to be able to cook, you know, he used to do nothing. Now with mum gone, my old man he can cook. He can everything. I’ll go to his house he makes me food now. He’s like, listen, let me put some kitchen heat on. I’m like, What? You got this. The other day you made me some puff pastries with some vegetable mix inside. I was like, it’s blows my mind he’s, serious. So yeah, my best friend is my dad. He always has been always will be and that’s the way it is.

Anup Ladva:
So you know it’s been good. But along the way like you’re talking about partnerships, it’s like that’s when I learned like partnerships is important and you got to choose the right things. We have a tech company and we’re in a partnership. Obviously we’ve taken funding, we have a board now that’s something totally new to me. Totally new to me. Is like answering to a board.

Payman L:
Go on, tell us a little about that.

Anup Ladva:
Never been in that scenario… Never been in that place like I’m the boss or me and this person is the boss, now you think you’re the boss. And that’s basically that my end goal to working out ways like to deal with a board is you think you’re the boss, but you’re not.

Payman L:
Yeah, me and Prav were talking about this, this division.

Anup Ladva:
Because mate… and it’s like this believable.

Payman L:
Just before you get into that, I’ve been at your practise and I’ve seen the way you interact with your team and I mean love is a big word, but they kind of love you. I feel like they like you a lot-

Anup Ladva:
Know why? Because over the last five years, it’s about honesty.

Payman L:
Yeah, but how’d you draw that balance between being their friend and being their boss? Is it better to be feared or loved or whatever? It seems like you’ve got both sides.

Anup Ladva:
So the fear comes from this is from if they have to sit down and sit in the room with me, they know there’s an issue. That’s number one.

Prav Solanki:
They’ve gone too far.

Anup Ladva:
Yeah, yeah, yeah. That’s it. Okay, there’s X amount of steps before it gets to that. But if they have to come and sit with me and we’ve got to have a direct conversation about why this is happening this way repeatedly.

Payman L:
Does it come naturally to you? It comes naturally to me to act that way with my kids. They love me. I love them. Then if they go past a certain line, I stamp down and-

Prav Solanki:
I cannot imagine you doing that Pay.

Payman L:
I think with adults… What if they do something wrong. Like if your kid doesn’t say thank you to a waiter or something, I’m not going to let that go.

Payman L:
But with adults I find it a little bit harder. I know you don’t.

Anup Ladva:
No, I don’t. I genuinely don’t because like that interaction is important, especially when it comes to patients it comes to each other. And when you’re dealing with 22 staff, 30 staff and there’s women or young, not actually women, youngsters involved, there’s a lot of that which we have to try and control. And thank God I don’t have to do it. We built a mechanism where my team are able to work on that generically with each other in some stern words, some good words, you know that process. But the thing is the other side of that is if it goes wrong, they sit down and they have to say to me, “No one wants to do that really.”

Anup Ladva:
But the other thing is if they do something amazing, I get told they did something amazing, I’ll stop and go and tell them that was amazing. And I’m really like that. That exceeded my expectation.

Prav Solanki:
That is better than any pay rise buddy. That is so-

Anup Ladva:
You know more than me.

Prav Solanki:
I think from my perspective, one of the things I’ve learned and, and look only over the last 18 months to two years. Is that all your team want, touch him on the shoulder and say, “Do you know what? You smashed it. Well done.”

Anup Ladva:
Yeah. We came in to work the other week and I get caught I’m pulling up in the car park and they’re like, “We’ve got flood.” And I’m like that does not sound good. So I’m like, I’m coming upstairs. I get upstairs and I can just hear water shh. Someone’s hit the stopcock and switched off. Well done. Good thinking. But they have rolled up their trousers up to their knees. They’ve got no shoes on rolled up to there and they are just soaking up water. Anything they can they’ve gone to the dry cleaners, got like duvets. The old duvets that people don’t collect, they’ve gone and got them. They’re throwing them down. Mate that day. I was proud of them. “I was like, you all crushed it. You crushed it at another level,” they really did. Because that could have been like a hundred grand of damage done. Headache here we go. Like back in the mix and we didn’t.

Prav Solanki:
Any other team may have just gone home and taken a day off. But they took ownership of that because of your leadership.

Anup Ladva:
And I was in there with them though don’t get me wrong. I was soaked head to toe. I was like, “Oh my God, this is it.” But the thing is, I think that’s the problem is a lot of other… My team call me the governor or the boss. They wouldn’t do that. It would be like, “Oh, can we just get someone to come and clean this?” By then you’re in that, the water’s affecting downstairs, not only upstairs. We might as well shut up shop. Then it is like, “Okay, shut, let’s close for the day, get someone in to deal with it. Like you have to do it with them 100%. You have to.

Payman L:
I totally agree with Prav that pay is probably nowhere near the top of what people want from work. But do you have a performance related bonus?

Anup Ladva:
Yeah and a bonus and an outing or whatever they do for Christmas.

Payman L:
I’m surprised at how few practises actually do, I mean when you come across back to-

Anup Ladva:
You know the thing is we have to… we’re in Essex like it’s not London. London is different. Ten per penny. You have 10 like even for dentist interview you get-

Payman L:
In any business you’d expect some element of-

Prav Solanki:
I think it revolves around… for the practises that I’m involved in, but also those that I work with they all do bonuses in different ways. Right? Some of them are structured, some of them are less structured. Some of them are like, “You went above and beyond, you cleaned up the flood. You know what we’re doing, we’re going out for dinner.” Or some of them are a bit more, “You stayed behind on the weekend. You know what, take Monday morning off.” Or “I’m going to treat you to lunch.” It doesn’t have to be huge. And then others are structured around things like turnover, monthly targets, Google reviews, Facebook reviews. It could be any little micro goals that they’re targeted around. And I think having those little incentives in place work really well. But I think what works better than anything else is having stuff in place that they’re not expected to be like customer service.

Payman L:
That it surprise and delights them.

Prav Solanki:
It’s a surprise for your team.

Payman L:
Give me an example of that then.

Prav Solanki:
So for example, a certain team member had gone above and beyond and what I mean is stayed behind Saturday and Sunday. And booked them a lovely meal out at the Hilton for him and his partner, totally unexpected. Didn’t even want it, but surprise and delight. Or just things like going out of the way and creating in a nice sort of having a bespoke birthday cake made for somebody with their own figurines or their own theme or something like that, rather than just nipping it into Marks and Spencer’s and getting one. Just tiny little things like that I think help people emotionally connect to your cause and it’s the same or marketing as well, or customer onboarding.

Payman L:
Yeah. I think he noticed that we were talking about it in a previous episode-

Anup Ladva:
This all comes to the emotional intelligence. And that’s possibly what I’m learning still along the way.

Payman L:
Expecting your team to be really, really go above and beyond for your customers. It means that you have to go above and beyond for your team to show them what that means. It’s a simple thing. We’ve been doing a little series from black box thinking of asking different guests about clinical mistakes. And the idea is, in medicine we try and hide them all the time as a profession because it’s so blame orientated and in that book it’s all about plane crashes and how blame is taken out of the equation. What can we all learn from the mistake? Are you happy to talk about your clinical errors?

Anup Ladva:
Sure man. Yeah. Yeah. Yeah.

Payman L:
What would you say?

Anup Ladva:
So in this process, is after we were in Sydney. This can come back to this. We were in Sydney and I was helping teach them, clean them, I was there on holiday the MCLinDent from Kings college, Prof Miller and his team were there and they started talking. We had went out for dinner and they were talking to my wife and it basically came to the light that I should do the MCLinDent and that’s how it happened. Prof was a good convincer to Vanessa. So I came back, did the MCLinDent and in this process I have to present cases, right? The big cases and so on this digital journey we are new into the game and we were like talking to labs and they’re like we can do digital. So one of my cases, big case, all of it ironed out, all the steps along the way. We know we’ve got to do, doing it final fit and so this patients come in for a beautiful smile and we go and we fit certain units, we’d work front backwards, you know the Cranham approach and we set the bite up incisor, gums, everything.

Anup Ladva:
And because you’re doing over stages, you don’t really see things the way that you would do as if you’re doing 10 unit veneer fit. Okay, because you see this, this. So at the end I take photos, videos, sit down with the patient and this is the week after I fitted it and I’m looking at him and I’m like, something’s out here. And I couldn’t quite put my finger on it, have I done everything correctly? Like my experience was not as, you know what it should be in that rehab kind of arena. I was doing big rehab cases but not like at this level. So I was like, what’s going on? And it turns out that the material thickness and the digital approach that the lab had used was hybridise some things and come back. And so rather than being able to adjust and have the correct thickness on certain units, I was getting different refraction in the work and it looked horrible. In my eyes, it looked horrible.

Prav Solanki:
What did the patient think?

Anup Ladva:
The patient was like, “Why do some of the teeth look different colours. Like straight up?” He said it to me and I was like, “Yeah, this is a problem.” Years worth of work end goal, occlusion’s beautiful? Everything’s beautiful.

Payman L:
Even though there were all the same shade? Because of the different thickness they’re coming out different colours.

Anup Ladva:
It was in the shade and it was the actual, the way that… so what happened was it still the layering right-

Payman L:
Had you cemented it in?

Anup Ladva:
Yeah, it was cemented. And the beauty is now we don’t even cement what do we do? We are adhesively bond. Because we’re using porcelain. So back in the day cement, yeah, still get it off. No problem. Like end of the crown. But there, now I have to cut these off. And that was… But the thing is, is being honest and learning and I still used it as my case by the way, still used as my case still put it in and I just reflected on it.

Anup Ladva:
And that’s what you’re saying, black book sinking is looking at him and being like why did these things happen? If we had done this in a pure digital environment, monolithic CAD cam, we would have seen less of it. Because I could have tailored from the loo but when you add layering to that mix, the layering is out my hands. It’s out of the digital-

Payman L:
It’s another thing that can go wrong.

Anup Ladva:
There’s another play there. So there’s so much play in this arena, which is why now there is a few labs that do work really well in this and a few concepts that work really well. Skin concept, DSD, they’re all much of the same. But the differences is that when you use a workflow start to finish and the lab knows that workflow start to finish, they’re not going to play intermediary with it. And most labs will tell us, “Yeah, we work in indigenous environment,” so how do we get a fine… Look, how many times have we been in this situation in the same situation I was in? You do a beautiful work and it’s not exactly what you designed on the waxer like 110% not the same. It’s 90% the same.

Anup Ladva:
So what do we do? We become the convincer, right? We said to the patient “Oh, yeah, it’s lovely.” There’s a slight change there, but no one’s going to say that… that bit we had to change that because of… That’s what happens. It happens routinely in traditional dentistry because mimicking at that level is difficult. And it’s only a few labs that can do it, but with digital it’s a lot easier. As long as they’re workflow is there and they understand the dentistry, that convincing theory is going like, this is what we got planned, this is what we designed, this is the 3d flow and this is what we end up with.

Anup Ladva:
And that was horrific for me to cut off eight units on a patient that had spent so much time in the chair and go through and literally have to go through it. Meaning that, how much trauma is there to the teeth? How much trauma is there to the biological cost? The patient’s time, my time, like that was my biggest boo boo. I never done any… and obviously everyone’s done it dropping a screw, implant screw in a patient’s mouth that I’ve done that and luckily… that that was another one. So I’ve done that one. That’s my worst. Like I just went white, sat the patient up, told her what happened and said, look, we got to go to the hospital. Let’s go. I’ll come with you-

Payman L:
For an x-ray.

Anup Ladva:
For an x-ray. You’ve got to do it. I don’t know where it’s gone. It was a healing. It wasn’t even a screw. Did it? Went with it with her to the hospital. Two weeks later she comes and you know what she says to my patient? To my nurse. She goes, “I love coming to this practise.” And Melissa is like, “Why we just dropped a screw down your throat?” She was like, but you know what? He was 100% confident. He knew what he had done. He knew how to fix. He knew the steps we had to take. Like he wasn’t scared. He just said, right, we’re going on the way out. He told the girls at the desk, “Speak to Jessica. Sort out my day I’m going to A&E… He was 100% confident and that made me confident”. Like, “I’m the one who’s got the problem, but I was like, all right, he knows what he’s doing, let’s go.”

Anup Ladva:
We put steps in place for that, but correct that mistake. But you have to learn. I haven’t done any really big horrible things. I’ve had to fix a lot of big, horrible things. That’s what happens when you do a lot of teaching in your training practise and you see that, but that’s part and parcel.

Prav Solanki:
And the eight unit patient that you have to drill off and start all that. How did that patient take it? Similar sort of way? We’re still a fan of yours.

Anup Ladva:
Yeah, he was. The thing is, that patient had come see me three years ago and I told him what was wrong. Like you’ve worn your teeth, there’s nothing as strong as your teeth. You have to do this, you have to do that. And he wasn’t happy. He didn’t want to do what we suggested, which is fine, no problem. Then he went away saw some other people came back. Was still seen routine checkups in the practise somewhere. Then it was his 60th birthday. So he was like, no, we’re going to do this. Like, and he came back to see us and when he came back to see us he was like… I told him, “This is what it is.” And he was like, “You know I’ve been to a few other places and they don’t seem to understand the things you’re telling me no one else has talked about. They’re just like, we put some veneers on and it’ll be all right and you’re talking to me about my bite, this is worn down. Why that’s and they weren’t even looking at my bottom teeth. They just wanted to give me veneers”, and I’m like, “Well unfortunately it’s not what we do. We get referred a lot of patients as well for this kind of work and this is it.”

Payman L:
And is that terrible thinking feeling in your stomach when you feel like you’ve let someone down. Even though none of us are trying to let people down, you do your best.

Anup Ladva:
Got to have a lot of trust.

Payman L:
You feel like you’ve betrayed someone’s trust, if something goes wrong like that.

Anup Ladva:
Yeah, of course. It does. So you know that process does happen.

Payman L:
Again, you were honest, you were completely upfront about it and-

Anup Ladva:
Got to be. Got to be. Got to be.

Payman L:
Yeah.

Anup Ladva:
Got to be and in thing is in this day and age, I don’t think, especially all of my workflow is digital now, which is why we consult on how that… to make it work at different practises, but there’s no hiding. Because you can see it.

Prav Solanki:
It’s all there.

Anup Ladva:
You just show it to him on the screen and most of the time they get emailed it for the trails communicate. They’ve got it themselves. They’re like, “Oh that looks beautiful. I love that.” And then you know the smile design and all the process and then you was not the same as you can see it. There’s no hiding.

Payman L:
What are some of the things you see when you go consulting for the digital? I guess there are people who are really into it and understand a lot of it. And then there’s absolute beginners who’ve gone and bought a scanner.

Anup Ladva:
It’s isn’t… the scanner is never the issue. It doesn’t matter what system you buy it’s not actually the issue.

Payman L:
What’s your advice? If I want to get into digital dentistry in the lab, I’m not really there. I kind of understand some of the words. So what’s your advice?

Anup Ladva:
My advice would be is do you think you need to go and do some digital training in the digital world and get a diploma certificate in that? No. I think if you’re very worse versed in dentistry. Two is workflow. It’s all about workflow. It’s about making it work in your workflow, not the other way around. That’s the problem where a lot of these… Where we go and you know it’s a corporate even and they’ve bought a scanner for the practise and no-one is using it because it doesn’t… That particular unit it needs wires to plugin or it’s on a trolley and a cart and there’s three story surgery and the upstairs guy, he can’t get to it. So then what did they do? They just don’t use it.

Anup Ladva:
Workflow. It’s got fit in with your workflow. The practises workflow, not the other way around. You shouldn’t in this day and age, and how developed the digital systems are, we should need to change 180 on how we work to make the digital work for us. Should be the other way around. And whoever sells it to you, they just want to sell it to you.

Payman L:
Exactly. There is an area vacuum which you’re trying to fill, which is basically the onboarding side.

Anup Ladva:
The onboarding is huge, right? But even when you onboard, what do you onboard? You onboard clinicians. So, when I walk in the room. Am I going to be like, “Okay, get the TRIOS, get it. Can we have it connected here? Can we get it from the other room?” Hell no. I walk in the room up on my bum on the chair. Patients in let’s go. Yeah. We start talking to the patient. My most important person in the room. It’s not me. It’s the patient. So who did they actually onboard? They onboard me. I couldn’t give a damn about it. I’m going to use it. Yeah. I need to get trained in how to use it. What you need to onboard is the team and actually make it workable for the team. So now we have this thing, TRIOS ultra mobile, which me and Anoop talked about many years ago and he was like this is going to come and it’s going to work and now we do that.

Anup Ladva:
We walk into the room with the scanner. That’s it. Just the handheld scanner. Yeah. Sit down and scan. The thing is it’s so usable. So ultra-usable. The nurse is never going to tell you the scan is not being used because in three minutes whoever’s using it is finished their scan. It’s there. So you don’t have to bring a laptop plug in, whatever. Well what does it need? It needs infrastructure. Your IT infrastructure needs to be robust. The computers need to be like what I see out there, Z workstation beasts, like being able to deliver that kind of front, to be able to use the scanner in the surgery. What does that mean? You got to pay two grand for a computer in every surgery and people want to do that? Now they’d rather put £300 computer in every surgery. And then spend a hundred grand on a car or where are we spending our money? What are we doing here? Like come on.

Prav Solanki:
When you talk about workflow it’s quite interesting what you said there about workflow because different dentists will have different workflows and their team as well.

Anup Ladva:
Sure, yeah.

Prav Solanki:
So when you go in and do the training-

Anup Ladva:
So we do a date, we send out a form, we ask them loads of questions about IT, loads of this like how many surgeries you’ve got, where do you want to-

Payman L:
What is the name of the company?

Anup Ladva:
I CAD Academy.

Payman L:
I CAD.

Anup Ladva:
We don’t even advertise it. We just take it on referral because once you get one corporate you’ve got 10 sites that you need to work with and things like that. And so we send it out and then we go and I’ll go and have a little look around, couple of hours or get the practise manager to video what’s happening with their scanners. Most of these guys have already got scanners they’ve already bought them. That’s the crazy shocking thing is they already have it they just don’t know what they’re doing with them and then we have to go and upgrade the IT to make it better or change certain things in where it’s stored or how it’s kept, et cetera.

Prav Solanki:
So I’m a practise, bought scanner, probably not doing things efficiently or making mistakes. I reach out to you and your team, what’s the process? How long does it take, what sort of investment am I looking at?

Anup Ladva:
So process is send us an email, you can send it to me directly. Anud@ICAD.Academy, no problem. And we will send you out form. Thank you for choosing us and get some information. We need some-

Prav Solanki:
Onboarding.

Anup Ladva:
… information. We need some information. What are we dealing with? What have you got? Are you buying one? Have you bought one? Do you want us to help you buy one? Do you want us to help you tailor it to you ,or have you already got it and no one’s using it, which is a lot of what we see in the corporates. Then we’ll get person to liaise with, speak to them, go have a look around, see what’s going on. So they will either send us videos or we’ll go to the practise of is commutable for us and then we’ll book a day where we can go and if there’s no IT infrastructure and needs changing, if it is, we’ll make recommendations or when we go up we’ll be able to see depending on, it’s very tailored, bespoke. So if you need infrastructure change, IT change, then there’s changes.

Prav Solanki:
You support that.

Anup Ladva:
Then we’re going to help you support and we’re going to show you the IT you need to make it work. If you don’t and we just want to buy a scanner, we’re going to help you choose the right scanner that fits your workflow as opposed to you need a CEREC.

Prav Solanki:
You’re not married to a brand or a scanner or-

Anup Ladva:
No, I work a lot with TRIOS just because in my opinion is one of the best scanners out there. But that doesn’t mean that CEREC Prime scanner is amazing. If you’re on a ground floor and you’ve got three surgeries that you can wheel a cart in between, why not? It’s amazing. The head’s big each have got pros and cons. If you’re doing a lot of ortho work then the iTero is the one for you because if you’re doing a lot of Invisalign, there’s scope for it. The head’s big and the tips are chargeable. So you’ve got to build that in. Why not? If you’re a restorative, you want to do design smiles, bang and you want it to be 100% point on for restorative then TRIOS is the one.

Anup Ladva:
If you’re a traditional CEREC user, then Prime Scan works and there’s a lot of cheaper ones coming on the market now, Medit i500. We know all of them and we work with all of them, we have three-

Prav Solanki:
It’s your business-to know them all right?

Anup Ladva:
We have three of them and we play with them regularly. And the one I have in my surgery, which I’m 110% super comfortable with is the TRIOS. Just because it works well in my hands.

Payman L:
Back to the process, I’ve got that practise. Do I need you and your team in my practise for a day, two days?

Anup Ladva:
A day is usually enough. If we’re doing infrastructure and IT change then it needs more because there’ll be one day when the IT guys come in and then one day for me to come in and just work with you.

Payman L:
Do you get the computers cheaper than I can get them myself?

Anup Ladva:
No. We just buy them direct from HP. We have an account with them. We’ve done enough with them. Now that we have a guy at HP and I just say do I want… I don’t want to make no money on computers. It’s not for me. I want you to buy-

Payman L:
I know and it’s different every situation, but what’s the kind of the ballpark cost of that?

Anup Ladva:
So, if you’re doing a four surgery and you want to go ultra mobile the IT will cost you £15 the Trios will cost you £30, if we’re doing Trios.

Payman L:
And your bit?

Anup Ladva:
And my bit will cost you £5. Which is if you’re financing it all, rolling it all up it’s not a lot.

Payman L:
Are people finance that piece too?

Anup Ladva:
Yeah, you can finance the whole lot and just roll it up. And choose your own finance company. I don’t want to sell anything to anyone apart from my time and expertise. That’s it.

Prav Solanki:
You could blow five grand messing about-

Anup Ladva:
Oh, easy. Easy.

Prav Solanki:
Making mistakes.

Anup Ladva:
The biggest corporate in the world that they’ve got 27 scanners in the UK, they’ve got 27 scanners sitting in a cupboard. That’s like 200 grand, 300 grand’s worth of equipment and then no one knows what they’re doing with them. Not because the clinicians don’t, the engagement is high but they can’t make it work for them.

Prav Solanki:
One more question on that relates to the training and you mentioned it’s not just about the dentists. Who are the other team members you get involved in the training?

Anup Ladva:
So we try and involve all the auxiliary stuff. So whether it be hygienists, therapist, dentist receptionist as well. And the reason why is because then they get what’s happening and they get the process. So you know the certain practises where they, if they are using prime scan, the reception need to know like this is how long it took.

Anup Ladva:
So we can’t book at the same patient across two, three books and your nurse isn’t going to know that their nurse isn’t… Because they’re not looking at all the books. The actual reception team is the people who need to know that they’re like, he’s got prep and it says scan. So right, we need to get some time available elsewhere so that the other dentists can use it in scan. Because again, it’s workflow, it’s just workflow.

Anup Ladva:
So the last bit we do is obviously digital fly notes. Just I know we’re going to wrap, but I need to talk about this. This is something amazing. So fly notes is a consenting platform that we were working on.

Prav Solanki:
Consenting?

Anup Ladva:
Consenting because consent is a huge issue. With the things that have happened, Montgomery and all of the bits that we’ve seen, it’s not bespoke so it’s not individualised to the patient. So we have an algorithm that we’ve taken a long time building and also a process where it understands your medical history and then links it to the procedure we are carrying out, or intend to, and tailors the risks and benefits to that process. And it runs off an iPad.

Payman L:
How long did it take you to code that? Have you got people? People abroad?

Anup Ladva:
We’ve got people working abroad. We’ve got a lovely team, great team.

Payman L:
How long did it take you to-

Anup Ladva:
Two years, start to finish.

Payman L:
It’s a very important thing actually.

Anup Ladva:
Yeah. But the beauty is now it’s snow med linked. So essentially if you have high blood pressure you right up HBP or down HPP, it knows. We can pick that up and say right, high blood pressure or low blood pressure. Everyone’s notes are different. That’s the problem. And some people write no HBP so what does that mean?

Anup Ladva:
They used to have high blood pressure, now they don’t. So the system’s intelligent enough to work and pull things out and also take the drugs-

Prav Solanki:
Medication all that?

Payman L:
Drug interactions.

Anup Ladva:
Drug interactions, the works.

Payman L:
What a nightmare to set that up man.

Anup Ladva:
Well, it was hard work but it is stunning. Trust me when you see… we’re coming to market now.

Prav Solanki:
Integrates with?

Anup Ladva:
SOE and non-integrated with other versions. We’re trialling now, so yeah.

Prav Solanki:
And launch is?

Anup Ladva:
Fly notes dot… hopefully we should be launching in the biggest way at the October showcase.

Prav Solanki:
Okay. So October 2019.

Payman L:
Anud what is it about you that means you’re not just opening a practise and growing that practise. Why did you go from one practise to the next, to the next and then doing this and doing the other thing all at the same time.

Anup Ladva:
We’re not having all your eggs in one basket.

Payman L:
But is it a strategic or is it that you-

Anup Ladva:
And plus I love it. You know I love the game.

Payman L:
Love computers.

Anup Ladva:
I love the game. I love computers. I love IT. I love digital. I love technology. But more importantly is I like the process. If you love the process, you can never get bored of the game.

Payman L:
Because there’s five grand that you’re taking for the consult. You could make that as a dentist easily easy.

Anup Ladva:
Oh easy, yeah, yeah.

Payman L:
Probably even more work traipsing up to someone’s practise.

Anup Ladva:
Yeah.

Payman L:
But you love it.

Anup Ladva:
It’s helping people as well. And the thing that I really gets me is like when people get just stiffed over, I hate that. Companies are companies, what do they want to do? Sell things, right? Simple. They want to sell things, hook or crook, they want to sell it and it’s got to work. Some people just don’t see that it works. And other people were like, “Well I bought it…” The worst type of investment you can have is buy something that you don’t use. Start that gym membership I bought.

Prav Solanki:
So earlier on you alluded to, you know, we’ve talked about your success as a serial entrepreneur, multiple businesses, failed partnerships, successful partnerships. But the one thing that really stood out for me and it’s because it resonates with me as well, is the most important thing, your purpose, your cause, is to spend quality time with your family. And obviously recently your mum passed away and you told us about how lessons were passed on. Imagine it’s your last day on the planet and it’s your funeral and you left three pieces of advice for your family and the world. What would those be?

Anup Ladva:
Oh, Prav. This a tough one.

Prav Solanki:
So we’ve just met your little boy outside. What are you going to tell him?

Anup Ladva:
I would tell him that your longterm relationships with whoever they are need work. You need to work at them. Number one is you need to work at the people you care about.

Prav Solanki:
It doesn’t come easy, right?

Anup Ladva:
No way. No way. Number two, and that’s whether it’s your children. Whether it’s your partner, whether it’s your… People change, everything is dynamic. Gone are the days when it just used to be static with… Two is take time and work on yourself because-

Prav Solanki:
What does that mean?

Anup Ladva:
Work. In this day and age, mental health is so… And for them for like my kid’s age or our kids’ ages is you see kids committing suicide 10, 11, 12 like crazy things happening. A kid got thrown off the Tate the other day by another kid and dead calm when he did it. Didn’t try and run away. So it wasn’t intentional like crazy. I’m going to hurt this kid and run away. Just something to do with going through that kid’s head. Because if that was the opposite I’d be going crazy. I’ll be going mad. Like the kid was dead calm, like he didn’t care who came… You see it more and more and more.

Anup Ladva:
Work on yourself, work on your brain, work on your mind. If you want to learn how to draw someone will teach you how to draw, if you want to learn how to paint, paint. If you’re going to drive, drive. But who teaches you how to work on yourself? You, right? You’ve got take those steps.

Prav Solanki:
Personal development.

Anup Ladva:
Personal development. Yeah, and that doesn’t mean in your field of expertise or your work. It means, You mental awareness stuff. That’s fine.

Prav Solanki:
Number three?

Anup Ladva:
Number three is change your expectation for appreciation and your world will change man.

Payman L:
Meaning? Don’t look for thank you.

Anup Ladva:
Don’t expect anything but expect from anyone.

Payman L:
Don’t expect from anyone.

Anup Ladva:
Don’t expect anything from anyone and when it happens, appreciate it.

Payman L:
Rather than the other way round.

Anup Ladva:
You change your world. That will change your world.

Payman L:
That’s nice.

Prav Solanki:
And if your son was to say, my dad was… How would you finish that sentence? How you love to be remembered.

Anup Ladva:
If my sons came and said my dad was… I would love for them to say my best friend.

Prav Solanki:
Beautiful.

Payman L:
Thank you very much.

Payman L:
Thank you. It’s been a lovely conversation.

Prav Solanki:
Thank you.

Payman L:
Thanks for coming in buddy.

Anup Ladva:
Oh man. It’s been a pleasure.

Outro Voice:
This is dental leaders, the podcast where you get to go one on one with emerging leaders in dentistry, your hosts, Payman Langroudi and Prav Solanki.

Prav Solanki:
Thanks for listening guys. Hope you enjoyed today’s episode. Make sure you tune in for future episodes. Hit subscribe in iTunes or Google play or whatever platform it is, and you know, we really, really appreciate it. If you would…

Payman L:
Give us a six star rating.

Payman L:
Six star rating. That’s what I always leave my Uber driver.

Prav Solanki:
Thanks a lot guys.

Payman L:
Bye.

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