The second part of our conversation with Len D’ Cruz delves into the emotional impact of clinical errors and explores the role of the BDA in supporting dental professionals when things go wrong.

Len also discusses his practice-growth journey so far and reveals why he still feels an affinity for NHS practice and patients.


In This Episode

01:30 – BDA—role and challenges

14.16 – Stress, errors and impact

24:25 – Blackbox thinking

37:00 – Practice growth

45.46 – NHS practice

48.37 – Fantasy exit

53.03 – Practice management

55.06 – Getting involved

59.04 – Identity

01.00.52 – Fantasy dinner party

01.10.01 – Last days and legacy


About Len D’Cruz

Len D’Cruz is the head of indemnity at the British Dental Association. He heads a mixed NHS/private practice consisting of seven surgeries in Woodford Green, North East London. He also teaches the MA in Dental Law and Ethics program at the University of Bedfordshire.

Speaker1: We often talk about this concept of of the the third victim or the second victim. The third, [00:00:05] the third victim is probably going to be you. You know, you suffer as a direct result of [00:00:10] that complaint or that error. And even if they don’t complain, you know, you walk home and you think, oh my [00:00:15] God, that’s me. I can’t believe I did this. I can’t believe I missed that. And every one of us, anybody [00:00:20] who’s doing dentistry will have done that, have that sinking feeling of I’ve done something wrong. And even if [00:00:25] the patient doesn’t complain, even if nobody finds out about it, you have that sinking feeling. And I think [00:00:30] that a that makes you a professional, it makes you a caring professional. You’re not burnt out. It means you still care, which [00:00:35] is great in itself, but it is one of the the real challenges of being a clinician and [00:00:40] dealing directly with patients, and also the fact that it happens in real time, you know, the [00:00:45] patient is not anaesthetised. You’re they’re, you know, they’re not under general anaesthetic. You can do what you like in the general [00:00:50] anaesthetic. Something goes wrong. Well, there’s no panic. There’s no stress here. You know, instantly something [00:00:55] goes wrong. They know you know it. And I think that’s why it’s it’s so challenging as a profession [00:01:00] when something goes wrong. Because. Because it is ever so personal.

Speaker2: This [00:01:05] is Dental Leaders [00:01:10] the podcast where you get to go one on [00:01:15] one with emerging leaders in dentistry. Your [00:01:20] hosts Payman Langroudi and Prav Solanki. [00:01:25]

Speaker3: So let’s talk about the BDA brand. I [00:01:30] mean, you grew up in the BDA system, sort of the pack and all that. [00:01:35] It’s one of those love hate things the profession’s got with the BDA. I’m 100% [00:01:40] sure if it didn’t exist, you’d have to invent it. It’s a bit like the UN or something. You have [00:01:45] to we need one, right? And I know it must be a nightmare [00:01:50] to keep so many different types of people happy. And I know it’s ridiculous to [00:01:55] ask you to defend or or stand for an organisation [00:02:00] as giant as the BDA, but just for the sake of the argument, you and your skills. [00:02:05] You could have done this privately. You could, you could, you could have you could have gone and done another [00:02:10] one of these, um, you know, my, my, my good friend Neil has done his own one or whatever, [00:02:15] you know, one of those. But but you chose to go down the, the BDA route is that do you [00:02:20] feel like an element of sort of service to the profession?

Speaker1: Yeah. It’s interesting. I mean, I think [00:02:25] the, the two reasons we went to the BDA indemnity setup or indemnity [00:02:30] setup of the BDA was two reasons. The the first reason essentially was there were lots and lots of [00:02:35] BDA members complaining that the mutuals and insurance companies were not serving them well. [00:02:40] Basically, they discretionary companies would pull their cover at the last minute or subsequently, [00:02:45] at least they wouldn’t be there, etc. etc.. So we think this is very odd. So [00:02:50] we approached our sort of had a at that time, Peter Walsh was uh, head of the BDA [00:02:55] and we approached the organisation, said, you know, we can either work with you or, you know, let’s [00:03:00] sort this out. And we couldn’t get a straightforward answer with them. We said we might go into collaboration with them. Couldn’t get a real, [00:03:05] uh, sort of landing on that. So he said, okay, you know what, we’re going to do this ourselves because it’s not really our business. [00:03:10] We’ve been around this at trade union and professional association for over 100 years, and DMP is not our business. We shouldn’t [00:03:15] be our business at all. So for us to get into, we had to have a very good reason. The reason we [00:03:20] got into it was we wanted to be dentists for dentists, and we wanted to deliver a product [00:03:25] that was actually going to going to be the best for the patient, but also for the dentist. [00:03:30] So, so the difference between us, the biggest differences were, were contractual. [00:03:35] Um, so it’s not mutual. So you have a contract with us for insurance as opposed to mutual [00:03:40] discretionary relationship.

Speaker1: And we are all dentist for dentists and [00:03:45] we are occurrence based. So which is again what the mutuals are. But unlike an insurance company [00:03:50] which has claims made, if you left us an occurrence basis and a claim came in 510 [00:03:55] years down the line, you won’t need to be paying, run off, cover, etc. etc.. So. So we thought that was the [00:04:00] best model. And there was insurers RSA were the insurers that we went with. They [00:04:05] gave us a fantastic policy. We spent a long time costing it and getting getting it to where we want [00:04:10] it to be. And and that the rationale for why I think it’s the best thing is because it’s [00:04:15] a one stop shop, because you now have a professional association, you have a trade union, [00:04:20] you have every service that you could possibly have, including indemnity. So one of the frustrations [00:04:25] I had when I was a dental advisor, Dental protection was somebody had thrown up. We give them advice and they say, [00:04:30] oh, by the way, I’ve also my practice is stitching me up for the money. There’s a complaint, but [00:04:35] he’s holding the money back and there’s a relation, I think, well, I can’t help you with that. That’s a contractual issue. It’s a business [00:04:40] issue. You need to go to the BDA and they say, well, not a BDA member to give you [00:04:45] some advice, but I can’t I can’t really do much for you. Basically you need to be a member. Now we can simply say [00:04:50] you are a BDA member. Um, we’ve got a huge amount of advisory services, we’ve got compliance, [00:04:55] we’ve got health and safety, we’ve got a whole range of things.

Speaker1: And the beauty about. And [00:05:00] what is sad is that it’s only when I started actually working [00:05:05] the BDA that I realised just how much gets done. I was a committee member at Young Dentist on PEC [00:05:10] and I knew what was going on to greater or less extent, but I didn’t realise just how much goes on. There’s [00:05:15] nothing in dentistry. The BDA doesn’t know about every single aspect of [00:05:20] every British professional life they know about, and the stuff that people don’t know about, they know about. Whether [00:05:25] it’s related to the GDC, the NHS or whatever, and we deal with them every single day. There’s new stuff coming across [00:05:30] the desk every single day. Policy decisions by the NHS, by NHS England, by the GDC, [00:05:35] by, uh, CQC. These guys are on it every day and I could pick up the phone to anybody [00:05:40] in this organisation and they’ll know about every single thing that’s going on. And if they don’t know about it, [00:05:45] they’ll soon find out about it. That is unique because there’s no matter no matter what organisation, there’s no [00:05:50] way that they’d have that amount of knowledge and expertise bang up to date. And I think the [00:05:55] frustration is that it’s seen as a trade union, which it is, and it’s badged [00:06:00] as NHS. You’re just an NHS organisation and you really don’t care. You, uh, care [00:06:05] a hoot about private dentistry. And I think we recognise that, that it’s been branded [00:06:10] as that.

Speaker1: But when we, we looked at this recently and said actually everything we’ve got on our [00:06:15] website actually is not specifically NHS. There is, there is some NHS stuff, but [00:06:20] most of it’s private stuff. How you run your practice, how you take payments, uh, all [00:06:25] the every bit of advice that applies to private entity as well. And I think the, the difficulty [00:06:30] we have is and it’s a mantra from my colleague Russell Russell, he says we [00:06:35] aren’t NHS dental private, we are just dentists. Okay. Simple, straightforward dentistry. And [00:06:40] we happen to earn our income either privately or from an NHS contract or from [00:06:45] both. Okay, we are not. And the badge ourselves as an NHS dentist or [00:06:50] as a private dentist is actually a is actually a fallacy because we are just dentists. We’re full stop [00:06:55] clinically, we’re dentists with private dental treatment and it just happens to be the contract we’re working under, [00:07:00] the payment method that that we get. And I think we forget that when when the BDA [00:07:05] representing people, they represent the NHS for pay and rations to the to the government, but they’re also representing [00:07:10] them as a profession. And we’re in there fighting with them for against [00:07:15] the GDC. We’re the ones who came up with who challenged the, the GDC with, with their own money, [00:07:20] with the annual retention fee years ago. One, the one the, the ruling [00:07:25] that the, the, uh, judicial review and, [00:07:30] you know, we did it thinking actually we might get more members if we do this. [00:07:35] We didn’t just kind of set people kind of just for.

Speaker3: The benefit.

Speaker1: You [00:07:40] get benefit. Yeah, exactly. Exactly. So yeah, it happened then.

Speaker3: Correct me if I’m wrong. If [00:07:45] you had to make the case against the BDA, incredibly unfair of me to make you do this. It would be [00:07:50] that would it that it or is it something else.

Speaker1: But no I think I think the [00:07:55] case against them would be we’ve probably haven’t served the private [00:08:00] dentists as much as we should. And and it was it was the reason why bapd British private dentistry [00:08:05] set up in the middle of Covid, because it looked like we were just an organisation that supported dentists [00:08:10] through Covid. We we wanted the support of them. We we fought [00:08:15] tooth and nail to, to get that. And we kind of ignored, ignored the plight of private entities. We weren’t getting the support that NHS [00:08:20] dentists did. And I think we sort of took a hard look at ourselves and said, yeah, you’re probably right. We we [00:08:25] weren’t as aware of it and I think we were probably going to get to, uh, we’re going [00:08:30] to get to the situation very soon, where as a policy, the BDA will just be saying, you know what, NHS [00:08:35] is dead, dead in the water. You may as well just bail out and start looking for another form of income. And I think we’re very [00:08:40] close to that. We’re pretty well there now. Um, because nobody, nobody knows [00:08:45] the NHS better than us. We literally have meetings on a weekly basis with NHS England. [00:08:50] There’s no chance of contract reform. There’s no chance of of getting the the udas. So [00:08:55] we’ll be there for many years to come. And that’s a broken system. It’s been broken since 2006. [00:09:00] And this is the second health select committee that said it [00:09:05] said as much as broken. And we’re still and nobody’s the government’s making no attempt [00:09:10] to change it. So so I think the answer is going to be that the the criticism might be we weren’t. [00:09:15]

Speaker1: And I think one of the criticisms might also be we don’t tell people enough about [00:09:20] what we do. You know, we do a lot, but sometimes we do things behind [00:09:25] the scenes because when an organisation makes an [00:09:30] incorrect decision and we challenge it and they say, yeah, okay, you know, you’re right. If we went to the press or went [00:09:35] to the members every time and said, guess what, the GDC were going to do this. We told them not to or NHS [00:09:40] England was going to do this. We changed their mind. They said, oh, right, well, fantastic. We’re not going to talk to us ever again because, [00:09:45] because all we’re going to do is, is, is spill the beans on them. So, so I, you know, we work behind the [00:09:50] scenes an awful lot and things that we, we have lots of little victories or changes [00:09:55] of minds because we because of that approach, because they recognise that we’re not going to go and. Gladstone [00:10:00] undermine people’s confidence in them because we had a minor victory or a major [00:10:05] victory. So don’t shout from the rooftops. So. So I think that’s in a sense it’s the frustration [00:10:10] of how this this organisation operates. And I see that on a daily basis, thinking we [00:10:15] do so much for everybody. And, and, and it’s just, you know, a few members who recognise [00:10:20] it because they use the services, other people don’t use the services. They actually what did I get from my membership? [00:10:25] I think that’s that’s the problem.

Speaker3: I mean, talking about bringing [00:10:30] the two areas together, we’re talking about blame when things go wrong in, in, [00:10:35] in dentistry. And we talk about shame when that happens. And [00:10:40] then the question of sort of representation within BDA [00:10:45] is, is it something particular to dentistry that do you think is something particular [00:10:50] to dentistry. That means that we, number one, are not united. And [00:10:55] number two, when something goes wrong, we we’re [00:11:00] scared of it. You know, we’ve got black box thinking, um, and, you know, the [00:11:05] way that we run away from errors. Is there something specific to dentistry, [00:11:10] or do you think this is just professions in general?

Speaker1: I think it’s professions in general. I mean, I think there’s probably [00:11:15] a slight there’s well, not I mean the, the, the competitive, the [00:11:20] representation. And I think, um, interesting I don’t think that’s the same amongst lawyers. [00:11:25] Um, you know, my son’s a lawyer. I’ve obviously got, um, people who [00:11:30] are lawyers. Uh, my other son’s an actuary. They don’t have that sort of, uh, [00:11:35] because they don’t have that sort of split nature about them. Because [00:11:40] we are partly because we are competitive, because we’re competing with each other in [00:11:45] one sense, a dentist, uh, you know, from one, one street across to the next, you kind of competing [00:11:50] for business. So there may be an element of we’re kind of divided ourselves artificially because somebody, [00:11:55] probably somebody NHS. There is almost a dismissive approach to an [00:12:00] NHS dentist. To stays in the NHS will surely, surely be bright enough to see that the NHS [00:12:05] is dead. You should be leaving. So there’s there’s almost a pejorative sense of [00:12:10] being an NHS dentist. So there’s kind of competition between dentists, but it’s also division because [00:12:15] you have dcp’s, you have different groups in the profession [00:12:20] wanting different things at different times. And I think that that also leads to that sort [00:12:25] of sense of division. And so I think that that’s a particular problem. But but the feeling of [00:12:30] making mistakes and errors and shame is probably not unique to dentistry. I [00:12:35] think everybody will find that every profession will have a have a every [00:12:40] professional person will have a sense of doing wrong and being ashamed about it basically in [00:12:45] every sort of profession. So I think that that’s just the nature of it.

Speaker1: But the problem with the problem with dentistry [00:12:50] per se, unlike, say, being a lawyer, is it’s personal because you’re actually doing [00:12:55] this treatment on this particular person and you’ve caused them this, or they accuse you of causing them this [00:13:00] particular harm. So it’s very direct. And you don’t have the the sort of corporate [00:13:05] response as you would, you know, you make a complaint to a hotel or a restaurant [00:13:10] or a, or an airline. Well, it doesn’t really matter who the pilot was, who the air hostess was, who’s [00:13:15] surging behind the counter. It’s a corporate response. So you don’t never feel that it’s you [00:13:20] directly, whereas here it’s you personally. It’s directly you. They’ll they’ll use your name in the complaint [00:13:25] and it’s going to be your treatment, your action, your words that they’re challenging. And I think that’s why it’s it’s [00:13:30] so personal. That’s why it gets to people so much as a, as a dentist. Because [00:13:35] on a human level, you go into work to do the best you can. Nobody goes into work saying, [00:13:40] you know, today I’m going to have a I’m just going to treat everybody badly. You go in, you know, with [00:13:45] that diligence that that feeling of wanting to do good. And, and I think [00:13:50] in a sense, the one of the, the joys of, [00:13:55] of that is the flip side of it because, because you, you want to go to do work [00:14:00] and do the best you can. But when it goes wrong, you take it very personally, um, because [00:14:05] you didn’t want to do wrong, you didn’t want it to go wrong, and it has gone wrong. So you take it very, very personally in a way [00:14:10] that probably I don’t even think even the medical professionals will, will take it as badly [00:14:15] as we do.

Speaker1: And we often talk about this concept of, of the the third [00:14:20] victim or the second victim. The third, the third victim is probably going to be you, you know, you, [00:14:25] you, you suffer as a direct result of that complaint or that error. And even if they don’t complain, [00:14:30] you know, you walk home and you’re thinking, oh my God, that’s me. I can’t believe I did this. I can’t [00:14:35] believe I missed that. And and every one of us, anybody who’s doing dentistry will have done that and have that [00:14:40] sinking feeling of, I’ve done something wrong. And even if the patient doesn’t complain, even if anybody [00:14:45] finds out about it, you have that sinking feeling. And I think that’s that. A that makes you a professional. [00:14:50] It makes you a caring professional. You’re not burnt out. It means you still care, which is great in itself. But [00:14:55] it’s but it is one of the the real challenges of being a clinician and dealing [00:15:00] directly with patients, and also the fact that it happens in real time, you know, it’s [00:15:05] the patient is not anaesthetised. Um, you’re they’re, you know, they’re not under general anaesthetic. [00:15:10] You can do what you like in the general anaesthetic and it goes wrong. Well, there’s no panic. There’s no stress here. You know, [00:15:15] instantly something goes wrong. They know you know it. And I think that’s that’s why it’s [00:15:20] it’s so challenging as a, as a profession when something goes wrong. Because, because it is [00:15:25] ever so personal.

Speaker3: I mean, it’s very interesting because I do another podcast at mental health [00:15:30] podcast around dentistry and um, this question of, [00:15:35] you know, suicide. Why? Why dentists? Why, why not brain surgeons? [00:15:40] And I was talking to my, um, my cousin, he’s a he’s an eye surgeon. [00:15:45] And we were talking about this question of the live patient, and [00:15:50] he was saying how much more tired he is, how much more drained he is. And [00:15:55] the patient said it’s an LA compared to if it’s a GA situation [00:16:00] and it’s something that we take for granted. But the cumulative stress [00:16:05] of that live patient and the thing you’re saying about taking things personally, I [00:16:10] probably the the best legal advice of Dental legal advice [00:16:15] I’ve heard in my whatever years is not to take complaints [00:16:20] personally, but it’s inevitable. I mean, what you just described is inevitable, [00:16:25] and in fact, even worse than the situation that you described is when you really feel like you did your very [00:16:30] best and the patient thinks you didn’t, and your patient, you know, the patient’s got it [00:16:35] wrong, but you did your very best. And and now your livelihood is on the line and all those things. Right? [00:16:40] Yeah. Um, I think, on the other hand, the question of why are we not sort of more [00:16:45] united? Do you agree with me that sometimes under the guise of patient’s [00:16:50] best interests, we’re particularly nasty to each other, you know, because [00:16:55] we’ve got that sort of that cover of we’re doing this, we’re talking we’re having this conversation for the patient. It’s [00:17:00] not, you know, that’s the cover that we’re under. And so we can just be as nasty as we like because [00:17:05] because we’re caring so much for our patients. Yeah.

Speaker1: It’s a concept. Yeah I think so. And [00:17:10] yeah. And yeah, you could do because you’re saying, well, the reason you put [00:17:15] something up on our Instagram and somebody criticised it and you say, well, the reason I’m saying [00:17:20] this is because I don’t think you’ve done the best for that patient. And you’re not asking the patient’s best interests, which [00:17:25] is which is interesting because I’m not quite sure whose best interest some of these things are founded [00:17:30] in, you know, but but, but picking up this thing about stress and one of the other things I find what I, [00:17:35] what I, what I think is also particularly challenging is something my, my son mentioned the other day. [00:17:40] He says, how is it that you can be? He says, it’s really tiring [00:17:45] being nice to people all day. Yeah, okay. And I thought, actually there’s an interesting concept, he says, because I [00:17:50] just go to work, you know, if I have a bad day or a bad day, you know, I can sit behind my [00:17:55] computer, whatever. But you, dad, you’ve got to be nice to every single person. And if you’ve had if you’ve [00:18:00] done something bad, if something’s not gone quite right, you’ve got an ex patient’s coming, you know, do come in. [00:18:05] Have a seat. It’s a wonderful. And or you’re running late and you have to you have to slow [00:18:10] down even more.

Speaker1: So uh, you know, you’re running 15 minutes late. They know that that you’re [00:18:15] trying to rush them and you say, no, have a seat. How’s your grandchildren? How are the kids? How was your holiday? And you, [00:18:20] you’re an actor. You’re playing this game. And it’s hard. It’s hard work particularly, [00:18:25] you know, we talk about this thing about mental stress and and, you know, having time out because we [00:18:30] say you should be doing two things. One, celebrate the success. So when something goes really well, you fitted [00:18:35] the crowd patients really happy. And they walk out and you’re fantastic and you think, right, next, next patient [00:18:40] come in, you’re thinking, no chance to even absorb that and enjoy that moment. Basically with with [00:18:45] the staff or the flip side when something doesn’t go quite, quite right. Not catastrophic, but [00:18:50] it’s difficult. It’s difficult extraction. You’re stressed, you’re anxious, and you’re now running late and the next patient comes in, you [00:18:55] just got a big smile on your face, and you’ve got to do it all over again. And it’s I was talking to [00:19:00] somebody. They say the doctors that the medical students are now looking [00:19:05] at seeing has anybody done their A level has done acting okay. And [00:19:10] I thought that was an interesting concept because actually you’re going to be a pretty good actor. Yeah. You know as a, as a clinician [00:19:15] because it because you’ve got to you’ve almost got to subjugate your own personality, [00:19:20] your own your own views because you know, you know, somebody says, oh, I [00:19:25] hate the Tories.

Speaker1: Yeah. The Tories are terrible. Next patient comes in I hate the Labour Party. Yeah, yeah. The Labour Party is terrible [00:19:30] basically. And you’re thinking, right, okay. I don’t want to have an argument with you. We’re just we’re just going to run this particular [00:19:35] thing. And people have very strong views. They don’t know what our views are yet. They’ll, they’ll they’ll express their [00:19:40] views and you’ve got to stay up. Yeah yeah, yeah that’s fine. That’s fine. So I think it’s, it is, [00:19:45] it’s and I think it’s that challenging nature we started at the beginning talking about, you know, what makes [00:19:50] a good dentist. What makes a good dentist is that ability to be a good actor, but also be [00:19:55] empathetic. But you know, but but have that those communication skills and it’s not necessarily about [00:20:00] and actually being being able to cope with that, that that sort of constant [00:20:05] being in the limelight. Um, with those patients, uh, you’re almost being a, being [00:20:10] an actor on a stage, but the stage is just you in that patient and also your nurse, your [00:20:15] nurse is also privy to all your errors and all your your mishaps as well. [00:20:20]

Speaker3: I think, you know, having having left dentistry that or clinical dentistry, I think now [00:20:25] for me, it’s 12 years ago. It’s the thing I miss the most is those conversations. [00:20:30] I mean, it could be a big part of the reason why I do a pod is because [00:20:35] I want to have conversations with people in my office. I’m in my office right now in my office. It’s [00:20:40] it’s the same. It’s the same group of people. Much as I love them, it’s the same group of people [00:20:45] continuously. And it’s so weird because when you when you’re a dentist, [00:20:50] humans are kind of in the way of you doing doing the work. Yeah, [00:20:55] but it’s only when you stop that you realise the bits that you really miss. [00:21:00]

Speaker1: It’s spot on. Absolutely. I mean, there was, there was. I think it was, uh. Must have been [00:21:05] two years ago now. I had a diagnosed neuralgic amyotrophy, basically. So my [00:21:10] hand basically just froze. Uh, one Monday and that that hand was slipping out of my hand and, [00:21:15] and basically as a, as a neuralgic amyotrophy of of [00:21:20] of of a nerve, basically. So, um, so I had to stop work and I’d stopped work [00:21:25] for in the end, it was about 7 or 8 weeks, and there was a possibility that I wouldn’t be able to go back to work [00:21:30] again. And it was a catastrophic not not for any other reason that actually it [00:21:35] wasn’t about the money because because the practice was running perfectly well. Um, there’s no issue necessarily I could [00:21:40] carry on working at the indemnity, so. But I’d be stopping till then. So the two things that affect me [00:21:45] most was the potentially the forced retirement of suddenly saying, right, you’re not working anymore. [00:21:50] And that wasn’t your decision. It was nature’s way of saying stop. And the other thing was actually a conversation. [00:21:55] I, I, my, my wife had come back. First of all, she’d say, I saw your patient, which is always a bad thing to say when you [00:22:00] say, well, so what, what did I do wrong then? And she said, well, why were you doing x, Y and z? And, and [00:22:05] and what I missed most was the conversation.

Speaker1: She was chatting about the patients. Um, started by the [00:22:10] practice. And I thought, you know what? I missed that. What I miss most was actually this conversation with the patient, [00:22:15] the chat, the interaction. And I’m stuck at home here, basically just looking at the four walls. [00:22:20] And that’s what, you know. And it was just like with Covid and people stuck and thinking, actually, when all our staff [00:22:25] came back after Covid, they said, I’m so glad to be back. Back here working. My husband [00:22:30] or wife is is still at home, but I love coming in. And it was just it’s the conversation. It’s a human contact. [00:22:35] And and yes, it may be stressful, but one thing and I think people probably [00:22:40] underestimate just how powerful that a human interaction is [00:22:45] to your own wellbeing. Because, you know, I come home and I say to my wife, oh, guess what? You know, I was chatting to [00:22:50] this person about this, this and said, oh, you know, be a good place to go on holiday. They’ve mentioned this place to that place. [00:22:55] You’re thinking, oh my goodness me, or such and such is happened and you’re thinking, right, and that’s, that’s a conversation. [00:23:00] And that’s the beauty of that human interaction. I think we, we underestimated our peril.

Speaker3: I [00:23:05] it’s interesting, I’ve had that situation too, where I treated my wife’s [00:23:10] list of patients when she took maternity. And what I found really interesting was the [00:23:15] conversations I was having with her patients were completely different to the ones she was having. [00:23:20] And you take it for granted that, you know, you get the same thing from the same [00:23:25] patient. So Mr. Smith, he’s a lovely man or whatever it is, [00:23:30] but totally different. Like she’d been seeing these patients for eight years, and I was talking [00:23:35] to them about questions she’d never asked before. Yeah, it really is. I [00:23:40] don’t know, I don’t want to say it’s the best bit of dentistry because there’s there’s loads of dentists who love the other part. [00:23:45] Right. The Meccano piece, uh, bless him, Lewis McKenzie always used to tell me about [00:23:50] the pleasure he used to get from just matrixing something correctly, [00:23:55] you know, just just doing that and, you know, just doing a very simple mo composite [00:24:00] and how much pleasure he would get from that. So, you know, there’s different areas of dentistry. [00:24:05] Um, but for me, definitely that, that social side, definitely the most important one. Let’s get let’s [00:24:10] get to um, darker questions. I’ve really been looking forward [00:24:15] to asking you about clinical errors, legal problems that you’ve [00:24:20] had. What’s been your most difficult patient?

Speaker1: Me personally.

Speaker3: As a dentist.

Speaker1: Yeah. [00:24:25] Yeah I the, the clinic I have I had I’ve had a claim [00:24:30] and I’ve actually used it in a couple of presentations basically. And the [00:24:35] what it was, was basically was a, I prescribed penicillin to [00:24:40] an allergic patient. Penicillin. Uh, Perkins alleged penicillin, basically. And, you know, I’ve [00:24:45] gone through it so many times in the past, but essentially in my own head, what happened? But it [00:24:50] was a classic. Patients in pain squeezed in and gave some antibiotics. [00:24:55] You needed a bit of swelling, gave some antibiotics, prescribed it on a Wednesday. And [00:25:00] I get it. I go in on Saturday morning for my for my clinic and it’s [00:25:05] 8:45. And the receptionist says to me, oh, you need to phone [00:25:10] up Mr. Smith. You saw Mrs. Smith on Wednesday. You, Mr. Smith, wants to talk to you. Uh, his wife’s [00:25:15] in hospital. She’s in ICU. Um, he wants to know, uh, what [00:25:20] you’ve given him. He’s not going to sue you, but he wants to know. And I’m thinking this is a great line. At [00:25:25] 8:45 on a Saturday morning, I haven’t seen any [00:25:30] patients. And I’m thinking. Right, uh, that’s just what I need to hear, basically. So so I said, right, [00:25:35] okay, what’s the patient? Let me have a good look. And I think I did good mathematics, actually. Hang on a sec. [00:25:40] Uh, they’re allergic, so why why I didn’t give them penicillin. So. [00:25:45] So anyway, they so I sent the patient back up, uh, looked at it and said, right. Okay. Really [00:25:50] sorry to hear about your wife.

Speaker1: What? It’s gone. She’s nice to you. Um, so she so sorry [00:25:55] I gave it on the Monday. So? So she says she had a rash, came out with a rash. They [00:26:00] thought it was meningitis, so they. They’d give. They’d been treating it as meningitis. And I said, okay, it’s fine. [00:26:05] And I said, so I said yes, I did give her a penicillin. She’s obviously alleged penicillin. And I’ve [00:26:10] looked at the records and she did tell me she’s allergic to penicillin on our notes, so I don’t know why I did it. I’m really, really sorry. [00:26:15] It’s my fault. Okay. Um. And he says, well, not really your fault. I just it’s probably my [00:26:20] fault. I said, why is your fault? He said, well, because I know she’s allergic. Penicillin. So when you gave it, I should have checked it. I said, well, [00:26:25] not your problem, it’s my problem. So I said, well, uh, and he says, well, I said [00:26:30] possibly, you know, the, the pharmacist, but it’s, you know, I wrote the prescriptions is my problem. Is that okay? That’s fine, [00:26:35] I said, but you know, he said, but also he said, but he says interestingly, he says the um, we [00:26:40] knew she was allegedly penicillin, that the, um, the hospital’s given a penicillin. I said, sorry, [00:26:45] well, they’ve given a penicillin because they think it’s meningitis. I said, well, what are they doing? Will they be giving [00:26:50] a I.V. penicillin? I’m thinking, hang on a second. I said, I’m gonna check this. This is so. [00:26:55]

Speaker1: I said, don’t they know she’s alleged penicillin? He said, well, it is on the records, but I don’t think [00:27:00] so. I’m thinking, right. Okay. So this is this is interesting. I said, well, I’ll, I’ll take full responsibility for it. And [00:27:05] so, so on the Monday we’ve changed our system. So it’s [00:27:10] on all the records. If anybody’s on penicillin or water or anything else, there’s a pop up note. Whatever. We [00:27:15] had a meeting, we discussed it. Um, we had a we had a incident report, [00:27:20] you know, twice around the the practice meeting, etc., etc. so fine, I’m not going to happen again. [00:27:25] And that was the last. So then about two months, about uh, [00:27:30] 4 or 5 weeks later, I wrote to him, explained everything, explained what we’ve done, explained why it had happened, [00:27:35] um, why it wasn’t gonna happen in the future, etc., etc. and about it was all silent. About a month later he wrote back [00:27:40] and said, it’s a thank you for your letters. Been a bit of a bit of a nightmare journey. She’s okay. She’s better [00:27:45] now. Thank you very much. But if you hadn’t admitted, if you hadn’t said, if you hadn’t taken responsibility [00:27:50] for it, I would have taken it further. Okay. So. Okay. Interesting. Fantastic. Uh, so that [00:27:55] was fine. And, you know, you know, and I think somebody said to me, did you contact your defence [00:28:00] organisation said, well, not really, because I knew what I was going to do. And the answer was I had to be open, I had to be open.

Speaker1: I’d be honest, [00:28:05] had to be truthful, told the patient, and there’s no point hiding out, going to admit it without any shadow of a doubt [00:28:10] that I’d made the error. But the and they said, oh, well, he says, well, the GDC [00:28:15] would also want you to do exactly what I’ve done, because and in the end, if [00:28:20] it ever came to GDC case, would they would my fitness to practice be impaired? The answer is no, because I’ve [00:28:25] learned from it. It won’t happen again. Repetition is very unlikely. Your current fitness practice will be impaired. [00:28:30] So I was worried about the GDC. Was I worried about it saying possibly as it happened, nothing [00:28:35] happened. Four months later I did get a claim. Okay from that, from the from the parents, [00:28:40] from the wife. Basically claim for whatever made a claim of about well [00:28:45] started at 20 grand basically and um for hospitalisation. And I thought actually, you know what, what’s [00:28:50] happened here? They’ve been at a dinner party. Somebody mentioned, you know what? I was [00:28:55] in hospital. She’s quite ill. Why? Because the dentist gave her penicillin. But what did you do about [00:29:00] it or nothing? He apologised. I wouldn’t do that. Hang on a sec. You better sue him. He’s already [00:29:05] admitted it. Go and sue him. So they did. Basically they. They sued. But. But interestingly enough, I [00:29:10] was a dental practice at the time and said, you know this is very interesting. I. Before we settle this claim, [00:29:15] I need to see the hospital records.

Speaker1: Get this close to the records. We’ll see what’s going on. And they had. They’d actually given [00:29:20] her IV penicillin. Okay. When she was. When she was. The reason [00:29:25] why she ended up in it was because they’d given her the, the the penicillin. Obviously, I’d given her penicillin [00:29:30] as well, but but they’d given it to our IV. So. So she’s critically ill as a result of [00:29:35] them and, and I think and and I said, right. Okay. We do need to point out to them we’ll [00:29:40] settle the case because I triggered the whole thing. She wouldn’t be in hospital in the first place. It wasn’t for me, but [00:29:45] but it was compounded subsequently by what the hospital did. So we said, okay, [00:29:50] we reduce the claim down. She she got £10,000 for it. She was just happy and that was the end of it. But but but [00:29:55] the the abiding memory for me is, is obviously making that mistake. And one of the [00:30:00] things I’m really passionate about is, is a we’ve got to learn from the mistakes, these things going to happen. [00:30:05] People make mistakes. People don’t do these things deliberately, but also the fact that I’d like [00:30:10] to be able to still be working in practice, to still have that connection with [00:30:15] our members, to say, you know, because often people say, well, it’s okay for you to talk about record keeping and [00:30:20] how good it should be. Well, you’re not you’re not in practice. Well, if I’m in practice, I’m still working [00:30:25] in a practice.

Speaker1: I still do NHS work. So I’m with you and I understand what’s going on. So I can be pragmatic with you, [00:30:30] but equally so I can be equally critical when you’ve done something really stupid because [00:30:35] it’s not really something that’s a reasonable dentist would do. So I think [00:30:40] it’s that that connection that allows me to to do that and hopefully [00:30:45] be a bit more empathetic to people’s situation, because I know I’ve been there and lots [00:30:50] of people will say, actually, you know what? I wouldn’t, I wouldn’t knowing what you do, [00:30:55] I wouldn’t I would have given up ages ago. And actually, I think because, you know, [00:31:00] you often can see the whole thing rolling out in front of you. You think, I know, I know where this is going [00:31:05] to end. You know, when that happened, I think, right, this is what I need to do to stop it going any further. Because because [00:31:10] this is going to if, unless, unless I do something now, it’s going to roll on and roll on, roll on. If I, if I’m [00:31:15] if I’m not honest, if I’m not open, if I’m not truthful, it’s just going to get worse. [00:31:20] Um, let me suffer the consequences ultimately. But let me just do something now. And I think when [00:31:25] people are because they don’t know the potential consequence, they get really fearful [00:31:30] and very closed and then and then get more trapped in [00:31:35] their way of thinking. Because thinking, oh, if I do this or I say this and I apologise, it’s just going to get worse, it’s going to get worse, going [00:31:40] to get worse.

Speaker1: I’m not going to do it. And I remember, you know, even in our own practice, um, a [00:31:45] patient was she was irrigating her pocket. Periodontal pocket, but was [00:31:50] given was given hypochlorite instead of instead of corsodyl because the [00:31:55] nurse is the nurse wasn’t wasn’t used to that surgery. Walked in and handed a prefilled syringe [00:32:00] which would normally prefilled syringes anymore. A prefilled syringe, which is actually hypochlorite she injected [00:32:05] into the pocket burning sensation and the dentist realised what had gone wrong. [00:32:10] And then the patient’s. What did he do? Said, well, yeah, don’t worry about it. It’ll be okay. What have you done? What [00:32:15] have you checked so well, if I tell you, you’d be more upset thinking, why did you say that? You should. [00:32:20] You should have just said it’s. You know, we picked up the wrong syringe. It’s it’s it’s hypochlorites [00:32:25] the bleaching agent. But, you know, it’ll be okay. Don’t worry. And the mystery and the subterfuge [00:32:30] made even worse because she was terrified as a as a young dentist, you think, oh my God, whatever I’ve [00:32:35] done, I’ve made a mistake. I can’t admit to the mistake. The answer is it is a terrible thing. It’s very [00:32:40] hard to admit to a mistake. But, you know, if you’re going to have to, you’re going to have [00:32:45] to fess up at some point. You may as well just do it now, basically. So I think that’s that’s the challenge, I.

Speaker3: Think, to your [00:32:50] earlier point about, you know, patients who have had injury [00:32:55] needing compensation, I think in your case there that that that’s fine. Right? [00:33:00] That £10,000, you know, there was there was injury there. But before you realise about [00:33:05] the hospital. Hiv and, uh, penicillin. [00:33:10] Did you suffer with shame?

Speaker1: I did, I [00:33:15] did because even more shame.

Speaker3: Because of who you are or or not.

Speaker1: Absolutely, absolutely. Yeah. Because, [00:33:20] you know, it’s you know, you see those things all the time. You’re thinking, right, I shouldn’t make a mistake. [00:33:25] And then you go home to your wife, who’s also a dentist, thinking, so why did you do that? Okay, [00:33:30] okay, I don’t I don’t I don’t need you to criticise me as well. And you say, right, okay. [00:33:35] So did you not look at your notes? Did you not look at the medical street, you know. Yeah, yeah, yeah I know I should have done all that. And [00:33:40] it’s, it’s even more obviously easy to stop. Um, so which makes it makes the [00:33:45] mistake so much more stupid. And you see. So why did I do that? And it’s just things [00:33:50] in a rush. You don’t check it. And, you know, we don’t have a proper process. And so, so some of [00:33:55] this some a lot of the errors in this is a classic. Atul Gawande talked about this checklist [00:34:00] manifesto where you actually you actually have checklist processes. So so [00:34:05] most of what we, we talk about at PD is, you know, if [00:34:10] you have the right process in place, you will risk manage a lot of these things out.

Speaker1: So if we actually had [00:34:15] a pop up note that said, you know, pink pop up little pink pop up notes now for medical, [00:34:20] uh, medical interactions, you’d see that and you’re thinking, right, I’d see it. Uh, the [00:34:25] nurse would see it and he’d say, are you sure you’re going to prescribe this or whatever? So there wasn’t a system. So [00:34:30] there is a system now, and every time something goes wrong, we respond, [00:34:35] or the profession ought to be responding to actually make sure we learn from [00:34:40] our errors. And that’s kind of this, this whole thing, you know, NHS are interred. Jason Wong’s interred about, [00:34:45] um, about, uh, safety, culture and learning from mistakes. We try desperately [00:34:50] to, as a profession, health care profession, to try and collate all these different problems [00:34:55] and errors, to create solutions which the airline industry does very well and we just do very badly. [00:35:00] So, you know, every one of the mistakes that, that, uh, that has happened [00:35:05] in my practice, I’ve seen over is all possible happen could be happening again and again and again. And people just [00:35:10] don’t put the systems in place, um, to stop it happening. Pretty true.

Speaker3: So I [00:35:15] want to get on to your practice, the story of that. So is [00:35:20] this. Am I right in thinking that? Did I read that this is the only practice you’ve ever worked at?

Speaker1: Yeah, [00:35:25] well, I pretty well I mean, I did, I worked as an associate in other [00:35:30] practice, belonged to the same guy. So when I, when I qualified, I was working as a foundation [00:35:35] dentist in his practice and he owned three practices. So I worked in all three [00:35:40] practice as, as as a VTE and then worked as an associate [00:35:45] at the end of the year, worked as an associate in his practice. And then in that literary [00:35:50] year later he worked in practice. In the year I was doing VTE, he wanted to sell it and he said, did you want to buy [00:35:55] it? Not in my year. So it was literally a couple of years later, so qualified [00:36:00] in finished my in 1990 and then bought it in January [00:36:05] of 93. Um, so were you.

Speaker3: Already married at this [00:36:10] point or. No.

Speaker1: Uh, we, uh, no, I was married in, uh, 1992, [00:36:15] and, and so we bought the well, uh, Anne was [00:36:20] working at the at that actually, she was working at the practice as well, basically at, uh, the, [00:36:25] uh, his practice basically. So the so but we bought the practice, [00:36:30] so bought the practice. Um, we exchanged on the practice on the same day we exchanged on our house. [00:36:35] So it’s a pretty stressful week basically. But but it was um, uh, but at that time it was. [00:36:40] So he sold his share, uh, to me. And there was an existing partner there, Melanie [00:36:45] Wainwright and Shadow Practice in Chelmsford. Eventually she sold that to me. So yeah. So [00:36:50] start off as a as a two therapy practice. But yeah. And funny enough, we celebrated [00:36:55] our 30th anniversary of buying the practice this year earlier this year. So we bought [00:37:00] this 92 not last year. Um, and 93. So last year we was [00:37:05] 30 years and I, and I was saying to somebody saying to somebody, I said, well, if I’d known, [00:37:10] uh, if somebody said to me, you’re going to leave, uh, dental school and you’re going to [00:37:15] stay in the same four walls for the next 30 years, uh, what do you think? [00:37:20] I’d say that’s completely mad. I’m not going to do that. Um, and there I am, standing in those same four walls, [00:37:25] look out the window onto, uh, onto the Woodford tube station. So, yeah, it’s, uh, it’s a it’s a strange, [00:37:30] strange sensation. Strange sensation.

Speaker3: But, uh, you know, I think Cliff talks about it a lot about [00:37:35] being in the same practice for years where you see your own mistakes. Um, and, [00:37:40] I mean, in 30 years, you’ve seen same family, grandchildren and so [00:37:45] forth. Yeah. Um, but but what I’m more interested in is the sort [00:37:50] of the business story, um, okay. What two, two surgery, NHS [00:37:55] practice, was it?

Speaker1: Yeah. Yeah, yeah.

Speaker3: And now it’s the same site. Is it [00:38:00] that the same surgery. So what have you done built out and under and up. No African [00:38:05] thinking. Absolutely. Exactly.

Speaker1: So we were on the first floor, [00:38:10] um, and we were renting, paying rent to HSBC. Uh, so [00:38:15] HSBC were downstairs, uh, they had downstairs and they had, they had the basement, which [00:38:20] is the, uh, the safes and the safe deposit boxes. And so we rented off them and then [00:38:25] eventually they, they sold up, um, and then leased it [00:38:30] back off us. So all the banks at that time were, were going, coming off the high street. So [00:38:35] Barclays, NatWest, they’ve all left, they’ve all left. And so what they did was they basically went [00:38:40] to auction, went to a terrifying auction and got the property, [00:38:45] and then they leased it back basically off us. So so they carried on it. So we [00:38:50] got the rent from them. And then eventually three, about four years ago now they [00:38:55] said, right, we’re out here. Basically gave us three months notice and just left. Um, so we end this in this situation [00:39:00] of should we, should we rent out somebody else, uh, and just stay up on [00:39:05] the first? We’re now in the first and second floor. So what we’ve done was so interestingly. So we’re in the first floor, [00:39:10] but we, we, uh, classic, you know, uh, except by stealth, [00:39:15] uh, moved up to the first floor, which is, which was, which was a flat, which is the flat I lived in when [00:39:20] I first moved it, when I joined the practice, which is also one of the main attractions [00:39:25] of the practice, when I applied there, because it meant I didn’t have to go home again after university. [00:39:30] So that was the main attraction. So lived there, moved in with all my mates and then [00:39:35] um, eventually we got married and moved in there and stayed there for about 3 or 4 months before [00:39:40] we bought the house.

Speaker1: But uh, so then eventually converted that into more [00:39:45] surgeries and then so the first and second floor surgeries. And so we had this situation of, you know, [00:39:50] we’re now got this massive building. What are we going to do with it? Do we? [00:39:55] And so in the end we said, okay, there’s nothing more to do. We’re going to have to just go downstairs, gut [00:40:00] the gut downstairs, gut the basement. Uh, and we just have to work out of that. So it [00:40:05] went from four surgeries to seven surgeries in literally one fell swoop, basically. [00:40:10] So it was, um, a big, a big undertaking in terms of [00:40:15] what we do in terms of business, because one of the discussions that I had with the accountants. Uh, was [00:40:20] basically said it’s just going to be a higher growth but more hassle [00:40:25] and probably not much more profit, I think. Okay, well that’s interesting. That’s that. And he’s [00:40:30] absolutely right. But it wasn’t it wasn’t right about the profit because because obviously it worked out okay. Once you’ve [00:40:35] made the investment to to by the by the by the building, you’ve got obviously no rent and [00:40:40] no rent, rent issues. And you can now do exactly what you want to do. So we’ll put central heating in. [00:40:45] We put the whole lot air conditioning, which we would never have done if it wasn’t our building. So it is a [00:40:50] very high respect in terms of the comfort of the place.

Speaker1: And you have control over that. [00:40:55] And I think so. So you know, and then over the but what is what is becoming [00:41:00] more difficult is we then after or during Covid we, we switched [00:41:05] to um, the sessions basically to. So we’ve now so the practice is now open [00:41:10] from seven in the morning till eight in the evening. Um, so it’s now very busy. But [00:41:15] you to matter to, to staff that number of that, that hours [00:41:20] of surgery. You we now have 65 members of staff okay. On one site. So [00:41:25] it’s it is astronomically difficult. So my wife so Ann does an awful lot [00:41:30] basically. So the success of that practice is, is entirely down to for the last ten years because [00:41:35] it you know, it’s not something she spent a huge amount of time. She is the detailed person and [00:41:40] does a huge amount of work to keep that place or keep that place going. We’ve got got two practice managers, [00:41:45] and that’s still not enough because you still need sort of, you know, oversight of all the different people. [00:41:50] And we’ve now sort of moved into sort of specialists and etc., etc., which is kind of the next big thing [00:41:55] we’re trying to do, make sure we’ve got some specialists, um, or got a specialist, um, [00:42:00] evening in a few weeks time. We’ve got a CT scan, we’ve got itero, intraoral [00:42:05] scanners and stuff like so, so, so that, you know, it’s it’s an undertaking in itself, [00:42:10] but it’s worked out because it’s a family practice. You know, people come back again and [00:42:15] again and again. Um, how.

Speaker3: Did you feel these other chairs?

Speaker1: Um, [00:42:20] it’s just organically because because, you know, we we’ve done it [00:42:25] for 20 years, and often the foundation dentist would [00:42:30] stay. If we like them, we keep them on and then we build another, put them into another surgery [00:42:35] and off we go again. And so one of the beauties of the practice largely is built [00:42:40] by built on the backs of people who understand the values, the [00:42:45] what we believe in. So the PhDs arrive, they understand the system, [00:42:50] they understand how we operate, and they stay because they like it. And and sometimes people coming [00:42:55] from a different practice just don’t get the ethos. And it takes them some time to understand what we’re up to while [00:43:00] we’re doing things. We’re not actually about generating shedloads of money off patients because our views very much, [00:43:05] they’re going to be for the long terme. We want to work with you for the next ten, 15, 20 years. We don’t need to [00:43:10] sell you a shedload of stuff in the first first visit. And sometimes dentists don’t get that. [00:43:15] And there’s a there’s a bit of frustration for us and for them to say it’s not how we work. Basically [00:43:20] it’s a different, different mode of operation here. So and, you know, they, they uh, the [00:43:25] practice is built up on, you know, I think for most practices, every single practice in the [00:43:30] country, it’s reputation, every business, it’s reputation, it’s trust. Uh, those are sort of two words [00:43:35] that most companies, businesses, it’s all about trust and reputations. And as long as you [00:43:40] you do your best to maintain that trust, the reputation will follow.

Speaker3: Basically, I think [00:43:45] look, the the model that you’re doing is I’ve seen some of the most successful [00:43:50] practices I’ve ever come across are that model because 65 [00:43:55] humans I mean there’s that could have been you could have been [00:44:00] it could have been a vanity metric here of eight practices. Yeah, [00:44:05] could have been. I mean, there’s many practices with 7 or 8 people [00:44:10] and running it 7 to 8. I accept that that’s [00:44:15] a HR nightmare, because you’ve got to persuade one whole [00:44:20] group of people to work till 8 p.m.. Yeah, but which actually I think that would be one of those [00:44:25] times personally. Um, but I hear often young dentists, I say I want a chain [00:44:30] of practices or something. Actually, if I, if I was going to do it myself, [00:44:35] this building that you can expand, it seems like a much more [00:44:40] efficient way of delivering volume.

Speaker1: Yeah. Because you’ve just got [00:44:45] because all you’re going to do is you’re going to you’re going to replicate those same systems [00:44:50] again and again and again. And actually that doesn’t necessarily generate more profit because because the profit [00:44:55] comes from the, uh, from the from the people doing the treatment. Basically, [00:45:00] it doesn’t have to be in a different site. And because and all you’ve got is more hassle, um, with these different sites, with the [00:45:05] different, um, managers, uh, different managers, different configuration, different type of patients. And so [00:45:10] we know the type of patients we attract, the sort of patients we want to want to keep. And, and [00:45:15] I you know, we often say you get the patients you deserve because if the patients are like [00:45:20] you and they trust you, they’ll refer their friends. And their friends are probably nice people, too. So you [00:45:25] get that build up of patients basically. And and I think, you know, that’s that’s probably [00:45:30] the most exciting thing about it is actually seeing that that grow. And, you know, somebody said, oh, you know, [00:45:35] you know, when are you going to retire? When are you going to sell the practice? And I’m thinking, actually, I’m not so sure I do want to [00:45:40] retire. I’m not sure what I could do with my time retiring, basically, but also the fact that we’ve [00:45:45] still got more to do.

Speaker1: I mean, we’d love to, you know, build up that the specialists and [00:45:50] and take referrals and stuff and, and I know that’s the most challenging thing to do now. Ten years [00:45:55] ago wouldn’t have been because nobody had specialists. Now everybody’s got a specialist operating [00:46:00] out of their practice, their part time. So so having a even a referral practice is challenging. But [00:46:05] because everybody now has a specialist coming to their practice, so us trying to attract [00:46:10] business from elsewhere is not is not going to be straightforward. But we’ve got enough patients of our [00:46:15] own to generate what we need to do. So our orthodontist is busy. He’s booked up 3 or 4 months. [00:46:20] The endodontist is busy, periodontist is busy. So so they are busy in their own right, [00:46:25] and you’d like them to be more busy. But you know, it’s it’s working off the back of our own patients. So [00:46:30] yeah. So you know as a model and the, the other concept for us is it’s, it is still [00:46:35] a mixed NHS and private practice. Um, and we’ve survived probably the best [00:46:40] part of 3 or 4 recessions over the last 30 years because we’re an NHS practice and people still [00:46:45] need their teeth doing.

Speaker1: And and for me it’s just a personal thing I do want to [00:46:50] give. I do want to give back to to the NHS that it has provided me with a great living [00:46:55] and great income, but and a good lifestyle. But, you know, and when I talk [00:47:00] to, uh, lots of people in our practice plan, they’ll be on various panels and they say, you’ve got [00:47:05] to you’ve got to move, you’ve got to move them. You know, it’s all over and thinking, yeah, I know I’m maybe [00:47:10] a bit of a dinosaur in still thinking the NHS is it’s not, it’s not functional, [00:47:15] basically. But in a sense there is. I just feel a sense of duty towards those [00:47:20] patients and some of our dentists, some of our staff members also think that actually we [00:47:25] do owe to those people. There’s lots of people that can’t afford private dentistry. They can just about afford NHS dentistry, let alone private [00:47:30] dentistry and what we can do with those patients. So and they’ve been with us for many, many years. So [00:47:35] I think there is some sense of community and wanting to be, to be part of that, that, [00:47:40] um, that, that service, that community, not just dump them all as they’re very private. [00:47:45]

Speaker3: I understand it. Um, of course I do. But [00:47:50] at the same time. I hated the third party involvement, [00:47:55] you know. Hated it. It is. I did my feet [00:48:00] and just like never again. Never do I want a third party to tell me anything. Yeah, [00:48:05] and I think the patient.

Speaker1: Yeah. And I think that’s that’s true. You know, increasingly, [00:48:10] you know, it’s the it’s the tail wagging the dog because we have so much, um, restrictions [00:48:15] because of the NHS and we’re, you know, we’re chasing udhas for the sake of chasing us. And [00:48:20] it takes up an inordinate amount of time to do those gdas to get to that, to hit that delivery, thinking, [00:48:25] why am I wasting my time doing this? So for, you know, a we can [00:48:30] spend our time seeing the seeing private patients. Um, so yeah, I think there’s, there’s a conflict in our, [00:48:35] in our own heads. Let’s.

Speaker3: Let’s imagine, for the sake of the argument that the friendly [00:48:40] Russian billionaire came and gave you $1 billion for your practice, what would [00:48:45] you do? What do you do next?

Speaker1: Uh, yeah, I’d probably. Yeah, I’d [00:48:50] what I would. I still see patients possibly, but but I mean I well, [00:48:55] the two things I’d like to carry on doing is, is this job, uh, the indemnity as this, [00:49:00] there’s so much more still to be done to get this, to get the policy wording, to get everything [00:49:05] as good as I possibly could. I’d like to, uh, I’ve been doing got back into photography [00:49:10] quite a bit, and I’ve done I’m in the middle of doing a photography diploma, um, and, [00:49:15] um, and I and I and I’ve, I’ve just been, I’ve just literally [00:49:20] taken two weeks time going to Scotland on a landscape photography workshop. I’ve just done the [00:49:25] last couple of months down to Dorset to Land’s End, Peak District, basically. [00:49:30] So, um, there’s a couple of people that follow. They do some workshops, which is great fun. Um, [00:49:35] and then and then up to Scotland, the freezing cold and north, uh, in Inverness. Yeah. [00:49:40] So I and I’d love to do that sort of stuff. I’ve trying to persuade my wife that, [00:49:45] you know, to get converting downstairs to a, to a dental surgery. So we’re not just dental studio, which [00:49:50] is. Are you. Are you kidding me? Well, how much money do you think you’re going to earn out of a out of a studio [00:49:55] in comparison to a dental chair? Okay. Fair enough. Um, so. Yeah. So that would be a [00:50:00] fun, a fun thing to do. But yeah, I think I think for me.

Speaker3: How many days do you actually, [00:50:05] uh, clinical do clinical?

Speaker1: Clinical. Two days a week. Two days. So, so the Wednesday Thursday. [00:50:10] Seven till seven. One till two in the afternoon. So seven hour days and the Wednesday seven hour days and [00:50:15] Thursday. Um, so it gives me sort of free time in three days and indemnity [00:50:20] and.

Speaker3: Clinically what’s your sort of treatments that you like to do and don’t like to do.

Speaker1: Um [00:50:25] I so increasingly I’m doing less and less invasive treatment basically. So [00:50:30] if, if somebody I could specialise in uh, lower right six buccal [00:50:35] composites quite easily basically because, because it’s going to be the simplest straightforward sort of thing. So, [00:50:40] so I, so, you know, we now have, uh, dentists who do, uh, you know, [00:50:45] difficult extraction spaces. I’m thinking. Right, what you know, and doing endo and thinking, why am I going to do [00:50:50] an endo for you privately or even on the NHS when there’s somebody in this room who could do this far [00:50:55] better? In fact, sitting over there is a microscope, you know, why am I going to? Why am I going to if I can, [00:51:00] if I can do if you can, if you allow me, if you allow this density [00:51:05] to, to work, you’d be better off. And they’ll say to me, oh, you’ve done the work before. I said, yeah, but I now have a specialist [00:51:10] in the practice who can do a far better job. You want some predictability? That’s great. So. So I’m happy to do endo [00:51:15] crowns. Bridges. Um, uh, I used to do a lot of. I [00:51:20] used to do a lot of ortho. Um, we now have an orthodontist in the practice, and so I’ve stopped doing that [00:51:25] and don’t do implants or do all surgery. And so [00:51:30] we’ve got the hygienist element of the practice is, is, is bizarre [00:51:35] because we’ve actually got we actually got I mean, we’ve got we’ve got eight hygienists in the practice. [00:51:40] Um, and there’s basically two days, there’s two, two [00:51:45] in every single day basically.

Speaker1: Um, maybe more. And it just it just worked out that way. You know, the, the [00:51:50] hygienist, uh, is a great part of the, um, the [00:51:55] health environment delivering that for the, for the patients. Patients love it. It’s working very well. [00:52:00] And and so, so building building on those foundations is, is really nice to [00:52:05] be able to work in that environment. So the hygienist services is, is is worked very well. [00:52:10] So yeah. So it’s and I think the difficulty and what that then generates [00:52:15] is you actually have specific hygienist meetings. You have specific dentist [00:52:20] meetings, you have specific nurses meetings. And so the hygienist feel as though they’re part of the [00:52:25] team. And because often the hygiene say I work in another practice, I’m on my own now. I come [00:52:30] in, I do, I do my hygiene work, I go upstairs, I do my own, uh, decontamination, [00:52:35] come downstairs and I go home. I don’t see anybody else. There is another hygienist, but we [00:52:40] never cross paths and I think so. So for them, it’s actually quite a really good, lively [00:52:45] sort of atmosphere to, for us to have hygienist meetings. Uh, and, you know, every quarter [00:52:50] and they, they get then you know, they as a, as a, as a cartel [00:52:55] if you want, they get what they want. If you tell us what you want, we’ll do it. You know, you are clinicians, [00:53:00] and you’re right. Uh, we’re more than happy to support you because you’re doing a fantastic job.

Speaker3: And what’s your involvement [00:53:05] with the practice other than the clinical? Do you do anything else or do you act more like an associate? [00:53:10]

Speaker1: Yeah. It’s. Yeah. What if I was [00:53:15] if I was generating money for myself as a as a as an associate, I’d probably just be able to afford [00:53:20] a kebab on the way home basically. Because. Because it’s not it’s not a huge because because the two [00:53:25] things. One is I end up, um, so a lot of regular patients who’ve been seeing. So there’s not a huge we’re [00:53:30] not doing a huge amount of treatment on these patients. And also, yeah, also having to pick up every so often [00:53:35] the patients who uh, the one you know not to be each attempt [00:53:40] is refused to see the patients. So inevitably they end up with me saying, right, okay, fine, I’ll see this patient. Um, and [00:53:45] so that that’s fine. And, and for me, you know, and it’s something I, I [00:53:50] never chased the money. The money, just money just came basically. So, so I kind of act as an associate, and [00:53:55] my wife does an awful lot of the and as an awful lot of the sort of the, the [00:54:00] oversight of it. Um, so I used to do that around when the kids were young. She was at home, [00:54:05] but she’s kind of taken over, uh, the vast majority. And I think that’s that is actually quite stressful for [00:54:10] her.

Speaker1: Um, because she kind of does, obviously, she does her own two days of, of clinical work. [00:54:15] Uh, and she’s also running the practice the rest of the time. She does pretty well. A lot of the stuff she’s [00:54:20] doing, she does all the wages for the associates, the other wage for the for the staff, which is a, you know, literally [00:54:25] four days every month is, is, is doing just that, basically, uh, in addition to organising [00:54:30] all the meetings and stuff. So, so I think she’s, um, you know, and I think that’s probably [00:54:35] more tiring. She actually enjoys the clinical dentistry. She’s she doesn’t want to give it up because she enjoys it so much. Um, [00:54:40] that’s the relief from, from the, the hard admin work and the running the practice. So [00:54:45] she’s really made a huge contribution that the practice wouldn’t be what it is with without her basically. So I’m kind of [00:54:50] dropping it out there and it when she says, well, you’re a useful figurehead in the practice. [00:54:55] Um, uh, but but it allows, you know, and we, we have different sort of styles [00:55:00] of managing the practice and managing those meetings. It’s also, uh, quite useful. Um, [00:55:05] so, so yeah.

Speaker3: We’re coming to the end of our time, but I want to touch on one other thing [00:55:10] before we move on to the final questions. Is this question of sort of getting involved? Yeah. [00:55:15] With stuff.

Speaker1: Yeah, it’s an.

Speaker3: Active process, right? It’s not. It doesn’t [00:55:20] happen by mistake that you do all the list of things that that I listed at the beginning. It’s [00:55:25] an active process of seeking out, wanting to get your hands dirty and and I don’t know, maybe [00:55:30] maybe I’m being a bit like, uh, characterising it incorrectly, but I feel like [00:55:35] I, I’ve noticed this with, with, uh, Kenyans in particular. Um, [00:55:40] there’s a sense of community or something that everyone, you know, I’ve had several. [00:55:45] I mean, we talk about true and um, one one of my favourite episodes we’ve [00:55:50] ever done on this pod is, uh, Vishal Vishal Shah. But but tell me about that. You know, [00:55:55] because I feel like I do the opposite. I actively try and get away from boards [00:56:00] of things and.

Speaker1: Yeah, it’s. Yeah, it’s funny. I mean, I think [00:56:05] the, I suppose one of the drivers when I was a kid [00:56:10] wasn’t, it was actually it was actually the A level that did it because I realised that I had [00:56:15] to do physics, uh, for A level. But I was actually hopeless at it. And, and it was [00:56:20] this classic thing where you’d be sitting in a physics class, uh, the guy would put up the problem, basically, [00:56:25] and I’d just be reading it and somebody put their hand up and they said, they know the answer. I’m thinking, I haven’t even [00:56:30] read the question. What are you doing? Okay, so people just exceptionally bright and very good at what they do. And [00:56:35] I and I vowed, I said, all I want to do is to be good at something, to be to be good at that [00:56:40] and be known for being good at it. And my my wife is always winding me up about that because you just [00:56:45] want to be famous and I don’t want to be famous. I just want to be good at something so I can feel that actually I’ve achieved [00:56:50] something because. Because for the whole of those two years, um, uh, in those classes, [00:56:55] I just felt like a complete idiot, basically thinking, right, you know, I’m just useless. I know I’m going to fail [00:57:00] no matter how many times I’m up past papers that I know. I feel like.

Speaker3: You’re quite black and white. Like, [00:57:05] I feel like if you don’t know 100% of it, you feel like. You know none of it. Yeah, something like [00:57:10] that.

Speaker1: Yeah, that is true. Absolutely. Because because when I, when I do it, I want to be sure I’ve [00:57:15] done it well and, and get involved in it. So which is why the law degree when I did it [00:57:20] um, all these other sort of post-grad qualification, the teaching, I just have to make sure I know enough about [00:57:25] this to be confident that I can do it. But did mentoring did a whole lot, of course. Because because because [00:57:30] I didn’t want to. Part of is also thinking, I’m not going to know this unless I study about it. [00:57:35] I don’t I don’t have the discipline to just read around the subject. I know people will now rely on YouTube’s [00:57:40] and YouTube and TikTok and stuff like that, thinking it’s the same as photography. I mean, I could [00:57:45] quite easily just download a shedload of YouTube videos and watch it and learn myself [00:57:50] and teach myself. And yes, I could, but actually what I’ve what I’ve got from this formal [00:57:55] education of things diploma is actually I would never have learnt about the history of photography and [00:58:00] learnt about the origins of it and what these particular photographers have done, because it wouldn’t be part [00:58:05] of, uh, anything I undertook on YouTube.

Speaker1: But actually I’ve learnt an awful lot from it and actually got [00:58:10] there’s a discipline about learning in a sort of structured way, and that’s, that’s probably just me. In [00:58:15] order to learn those things and be confident about it, there has to be a sort of structure, structured approach to it, [00:58:20] and it’s postgraduate certificate, diploma, masters, whatever. That’s that’s just the way [00:58:25] I learn, because I can’t rely on myself to say, all right, okay, I’m going to do this and I’m just going to do this without, [00:58:30] without, without sort of, sort of some sort of formal thing. I did it, you know, rather being able [00:58:35] to did an Open University course, um, an Arts Foundation course, because I think I actually want to [00:58:40] know about this stuff, but I wanted to do in a formal way. So there’s something probably controlling it. [00:58:45] May be it may be a maybe a go and maybe a Kenyan mentality, but it certainly is something that I think, you [00:58:50] know, driven partly by my dad saying, you know, you need a bit of courtesy, you need you a bit of [00:58:55] paper. And that’s kind of probably prompted most of my sort of driving my [00:59:00] what I describe as my drive, basically.

Speaker3: How much of your identity [00:59:05] is going to feel going?

Speaker1: Yeah. Interestingly, [00:59:10] it’s because obviously I’ve married an Irish girl. Um, you’re both Catholics, [00:59:15] you were telling me, but yeah, both Catholics, um, um, you know, my [00:59:20] fairly religious sort of background, my, my, my mum’s side, there was three [00:59:25] nuns and three priests. So it’s pretty religious. On Anne’s side [00:59:30] there is, there is one nun. So it’s fairly sort of it’s not it’s not [00:59:35] rammed down our kids throats and they go to church up until they were sort of got, you know, [00:59:40] baptised commune till they were younger. And it’s up to you if you want to go to church now, we’ve set it out for you. So, so [00:59:45] there is um, in terms of being going, I think, I think I’m [00:59:50] the problem with the diaspora to go and diaspora is it’s not [00:59:55] as embedded as, say, any other sort of parts of India or Pakistan [01:00:00] or Southeast Asia, because there is a language, we hardly ever use the language. Um, so [01:00:05] there’s no sort of Konkani is the common language, but it’s never used as much as it could have been used, basically. [01:00:10] Um, so, so yeah, I think it’s I do feel I [01:00:15] could be more and the kids are obviously, you know, half Irish, half going, um, but [01:00:20] they understand both sides of it. Do they.

Speaker3: Um, to. [01:00:25] Well I’m doing.

Speaker1: She is going.

Speaker3: Go, go in Kenya. [01:00:30]

Speaker1: Uh, I think she is. And then there is, there’s a lucky for you.

Speaker3: Yeah. [01:00:35]

Speaker1: Yeah, there is. I know there is. It’s not not not a good look. Exactly. Not a good look. Exactly, [01:00:40] exactly. Yeah, yeah.

Speaker3: Let’s get on to our final questions. Yeah. [01:00:45] Let’s start with the fantasy dinner party. Yeah. Three guests, [01:00:50] dead or alive. Three guests. Who would you have? Okay.

Speaker1: Okay. Uh, this might sound a bit left field. [01:00:55] Um, but it’s it’s going to be Madhur Jaffrey. Okay. The the Indian [01:01:00] cook. And I’m not sure anybody else has mentioned there before. No. She’s dead. She’s dead. [01:01:05] Okay, so it’s sounds like and I think, um, partly because, well, she’s [01:01:10] going to make the dinner. It’s going to be a great dinner party because she’s great.

Speaker3: Okay. She’s gonna she’s gonna [01:01:15] cook.

Speaker1: The dinner for us, basically. Um, but there are a couple of reasons for that. One is, [01:01:20] um, my mother was an amazing cook. She’s still around, but she’s, uh, [01:01:25] she’s an she’s an amazing cook. When we, um, we arrived in England. What is interesting [01:01:30] is that. And she could turn her hand to to most things to Indian, Chinese, modern [01:01:35] European. And I kind of watched her cook, um, as she grew up. And it was I. My [01:01:40] passion for cooking comes from her, and I love cooking. Now I really well, now I do most of the sort [01:01:45] of cooking at home basically. But but but the interesting thing about, uh, Madhur [01:01:50] Jaffrey was that she was she did a BBC book back in the, [01:01:55] you know, back in the early 80s when you wouldn’t be able to find you wouldn’t find coriander, [01:02:00] you wouldn’t find any spices at all, anywhere, anywhere, anywhere in England. [01:02:05] And she actually created this sort of this whole culture of Indian food. Bbc television [01:02:10] had a book, um, called Madhur Jaffrey Indian Cooking, and then their classic [01:02:15] was Flavours of India and India. Actually, there’s, there’s funny enough was looking at it the other day [01:02:20] and there’s a huge amount of go and cooking in there, which again, you know, there’s [01:02:25] a couple of dishes, um, which are sort of pork dishes which, which was handed down from my [01:02:30] mum to me, um, which was used basically. And there’s some fantastic recipes in there. So, so that [01:02:35] was, you know, and for me, you know, this, this being an immigrant family being brought up [01:02:40] on Indian cooking is just, just great. Um, uh, she kind of made it popular. And, [01:02:45] you know, you’re now you can walk into any store and you’ll find pretty well, you can [01:02:50] find go and pastes basically go and go and food in there, which you would never have done, you know, 20, [01:02:55] 25 years ago. So, so, so, so she’s, she’s in there for partly because of my mum, [01:03:00] but partly because she’s going to make a good, good meal for us when we get there.

Speaker3: Who’s [01:03:05] your second guest?

Speaker1: Second guest. Uh, would be Frederick Forsyth. Uh, [01:03:10] he’s an author. He’s not exactly high brow, but he was kind of the the first [01:03:15] author, uh, first book that I read or first? First real book I read when [01:03:20] I was a kid. Uh, probably, uh, you know what, 11, 12 years old? He wrote that. So the the Odessa [01:03:25] file, which was this story about this guy chasing Nazi war criminals, then got me interested in [01:03:30] in the whole thing about the Holocaust was about death, a jackal. The assassination attempts on Charles [01:03:35] de Gaulle, uh, dogs of war, all these sort of classic books. And I sort of read and so I so [01:03:40] it’s a classic sort of thing. And probably one of the few authors that I’ve read 2 or 3 times who read the book a couple [01:03:45] of times when I was a kid, I probably wouldn’t have time to read books twice again, but I did then, [01:03:50] and that sort of got me into. So he his his genre was very much weaving [01:03:55] fiction through real life people. So the whole thing about The Day of the Jackal was Charles [01:04:00] de Gaulle had had several assassination attempts on him, and he just weaved this sort of fictional [01:04:05] character that was going to attempt an assassination on him, again, based on sort of meticulous research. And [01:04:10] I kind of got. So the writing is fantastic. It’s not a, you know, it’s not a high [01:04:15] brow author. But actually, that got me into reading, got me into, uh, into writing, wanting to write myself. [01:04:20] Um, and that’s kind of in a sense, the that whole connection with, [01:04:25] um, with English came from that. And, and obviously obviously they [01:04:30] were O-levels and A-levels and did Thomas Hardy and all the other stuff.

Speaker1: But but of course I it would be a good guess. [01:04:35] And, and for me, the, the reason why I ended up at Dental protection was because [01:04:40] I wrote an awful lot when I, as soon as I, um, was out in the out [01:04:45] of dental school, I was writing a lot, got got 2 or 3 articles published in the age. I had written [01:04:50] stuff in in as it was the probe magazine thing. And people want [01:04:55] people who could write, uh, and I was and I was therefore high profile. And the interesting thing you [01:05:00] can get to be high profile now very quickly, um, without doing much, without much effort, because [01:05:05] of Instagram, because the social media, back in those days to be noticed in the profession, you had to work really [01:05:10] hard. It wasn’t an easy thing to be recognised. You did, you know, you did the lecture circuit. You did, [01:05:15] uh, you know, six, three, six, three courses. You did a whole lot of stuff before anybody recognised you. And in [01:05:20] a sense that’s, you know, when I talk to we talk about garage writing about this a lot. The thing, [01:05:25] you know, where do these people come from? Suddenly out of the blue, they’re. They become really famous for thinking, where’s your hard [01:05:30] rock? Where’s all the hard grind that you and I had to do? I think, yeah, that’s that’s life kind of thing. But [01:05:35] I think that’s that’s kind of, uh, this idea that, um, it’s, you know, I [01:05:40] got the interesting writing and that’s kind of got me where I, where I got to for various reasons, basically [01:05:45] of the English to dentistry and then and then writing for the dental protection. [01:05:50] It’s a.

Speaker3: Brilliant point. It’s a brilliant point. I mean, people forget even Pre-social, I think, [01:05:55] I think FMC had a lot to do with it. Yeah. If you remember [01:06:00] pre FMC, do you remember pre FMC? I did yeah yeah I was very early but [01:06:05] I mean when FMC that that do you remember it was called independent seminars [01:06:10] or something. Yeah. Yeah that had a big part in in in making people [01:06:15] famous. And then, and then they weaved it into the magazines. Yeah. [01:06:20] But before that you’re quite right. I mean, you had to be a professor or something. [01:06:25] You had to be. You had to really work hard to bring it up and down the country. Well, [01:06:30] it’s interesting, you see.

Speaker1: Funny because I remember I used to write for the probe. Yeah. Um, and [01:06:35] there was, there was it’s called basically it was a called a stringer. Basically, if you wanted to, [01:06:40] uh, if there was a course on, they would send you along to it for free and you’d [01:06:45] write it up in the probe. Okay. And I remember and then Ken Finlayson turned up [01:06:50] and I actually met him in my surgery. He came to meet me and he said, you know, you’re obviously a bit of a writer. [01:06:55] You don’t want to do this. You want to join that. And I remember being on the editorial board of the early, uh, [01:07:00] early magazines for Ken and getting to him quite well. And then obviously he’s [01:07:05] obviously done various other things basically. And, and, and I think that sort of celebrity [01:07:10] you have to celebrity stuff came out of that. And then obviously then social media came along. And you know, [01:07:15] it is interesting that the but people still will remember, you know, Roger [01:07:20] and Kevin Lewis, but the older generation will the younger people never heard of these [01:07:25] people at all. And I could walk into a room now and I’d look around thinking, nobody knows me, um, [01:07:30] I don’t know them. And whereas whereas an older generation would know me, would [01:07:35] know Raj, would know Kevin, etc., etc. so it is, it’s it’s a it’s a different world. Definitely a different world. [01:07:40]

Speaker3: The third guest.

Speaker1: Third guest, um, guy called Martin [01:07:45] Seligman. Uh, Martin Seligman is a an American psychologist. [01:07:50] Um, he was he was at Princeton. Uh, and he’s a University of Pennsylvania. His book [01:07:55] is called Authentic Happiness and is probably the most influential book I’ve ever read. [01:08:00] Probably, uh, quite a few years ago, about 2002. And I read about 12 years [01:08:05] ago, and it kind of changed my whole whole perspective on what he [01:08:10] described as what’s called positive psychology. And it talked about happiness when people [01:08:15] weren’t talking about happiness. And the whole concept of positive psychology is he he is a psychologist [01:08:20] himself. And he said, why are psychologists spending all their time looking after ill people [01:08:25] when they are trying to make them better? So surely they must know what’s good for people. And [01:08:30] while we spend our time using the the same stories and the same [01:08:35] techniques to get people to be happy. And so he was kind of [01:08:40] use this scientific method to explore happiness in his book. And authentic happiness is just a classic [01:08:45] in terms of the science, the literature behind it and the creating [01:08:50] this meaning and purpose and and the whole concept, pleasure and gratification, I thought. And one of the things [01:08:55] that that stuck in my mind from that book was that happiness is a choice, and [01:09:00] that 50% of your happiness is actually determined by your DNA. It’s from your parents. [01:09:05] Okay, so if your parents were pretty grumpy and pretty miserable, well, you’d like to be pretty grumpy [01:09:10] and miserable yourself. Uh, 10% by circumstance and 40%, uh, is [01:09:15] your internal state of mind basically how you how you perceive things? Uh, that’s um, and how [01:09:20] you manage your, your everyday life. And I thought for me, that was a pretty seminal book in terms [01:09:25] of how I looked at how you’d approach things. And I remember reading it and just [01:09:30] literally, uh, reading it that that one I did read 2 or 3 times, and I remember just quoting [01:09:35] stuff to my kids left, right and centre, bored, rigid, basically. Uh, but yeah, it’s that [01:09:40] that certainly was, uh, I think it’d be a very interesting guest at our party.

Speaker3: Excellent, [01:09:45] excellent. Positive psychology. What’s what’s it called?

Speaker1: It’s [01:09:50] called authentic happiness.

Speaker3: Authentic positive.

Speaker1: Psychology. Yeah. Fields positive psychology. His [01:09:55] book is called Authentic Happiness. Um. Martin Seligman. Yeah. It’s interesting [01:10:00] guy.

Speaker3: And the final question. Yeah. Deathbed question. [01:10:05] On your deathbed, surrounded by your loved ones, [01:10:10] friends and family. By that time, hopefully grandchildren. Great grandchildren. [01:10:15] Yeah. She had to give him three pieces of wisdom, three pieces of advice. What [01:10:20] would they be?

Speaker1: Um, we kind of alluded to this. The first one would be [01:10:25] to say yes, when somebody asks you to do something as part of your job, your career, [01:10:30] you just say yes, because and that’s kind of in answer to your question, why did you get involved [01:10:35] in all those things? Because somebody said, why don’t you join the LDC? Why don’t you join the young dentist committee? [01:10:40] Why don’t you do this? And you’re thinking, yeah, okay, you know, I’ll do that. And, you know, I said yes. And [01:10:45] I was saying yes in my early parts of my career, when lots of people were just getting [01:10:50] their head down and doing a lot of dentistry and being an associate. And I said, so I was working on [01:10:55] local LDC young Dentist committee and then set up the first National Young Dentist [01:11:00] committee, the BDA, and spent literally a year going backwards and forwards, trying to convince, as it was the [01:11:05] board of directors, that the usefulness, as they said, well, we shouldn’t split young dentists up, etc., etc. [01:11:10] and I spent a whole year so I was going backwards and forwards. So that year I probably lost a lot of [01:11:15] income going backwards and forwards to the BDA. And you know, my wife would say, why are you [01:11:20] doing this? You know, less and less than I am. What are you doing? And actually all [01:11:25] those investments and time and effort saying yes will pay dividends in your [01:11:30] profession, your career. So that would be my first bit of advice.

Speaker3: Then say yes. Do you think, though, that it [01:11:35] goes back one one step earlier than that and, [01:11:40] you know, to be asked to do x, y and Z, you have to be a particular [01:11:45] cat.

Speaker1: Um, because. Yeah.

Speaker3: Because I’m being asked to do [01:11:50] x, Y and Z. Do you see. Okay, okay. Yeah, yeah I agree, I agree.

Speaker1: Yeah yeah yeah I agree I agree there [01:11:55] is. Yeah there is some of course. Yeah yeah there is some element to that because you’re, [01:12:00] you’re right. Because there are some people that I wouldn’t ask I wouldn’t ask basically. Yeah. Yeah you’re right. Yeah [01:12:05] you’re right. And so if they say yes, I don’t want them to say yes. No I yeah there, [01:12:10] there is that point. That’s why I didn’t take that. Yeah.

Speaker3: What’s the second piece of advice.

Speaker1: Second [01:12:15] piece of advice is again something related to the Leaders who tried to be an expert in something. [01:12:20] Uh, it might be your career. It might be your hobby. It might be a period of of history [01:12:25] literature. If it’s your job and you’re good at it, the money will come. And I [01:12:30] think this, this, this idea of, uh, you know, this, this idea of happiness comes from, you know, you being [01:12:35] fulfilled. And so if you’re enjoying it, you know, be an expert at it. And it happens to be you’re an expert in your [01:12:40] job, great. You’ll enjoy it even more. You get a huge amount of self-fulfilment from it. And [01:12:45] it’s just that, you know, that bit of that carrot is talking about, you’ve got your bit of character that proves [01:12:50] your expert, proves it to yourself and proves it to other people. Um, so my advice, advice already [01:12:55] to my kids is, you know, try and be an expert, get you a bit of paper, nobody can take it away from you. And we’ll [01:13:00] always have that with you. The, the last bit of advice in all of that, despite all [01:13:05] that saying, be humble because you know about your achievements and be kind to others. So [01:13:10] I think it sounds like a bit of a cliche, but but actually and to a certain [01:13:15] extent, my, my disadvantage is, is is not [01:13:20] shouting from the rooftops and being humble, and often it goes against the grain of social media. [01:13:25] It goes against the grain of Instagram when people are shouting from the rooftops about [01:13:30] their wards, about this, that and the other and and finally I, Faraj and I regret and I [01:13:35] were talking about this the other day.

Speaker1: You know what? What do I what do you and what is he and what do I put on your [01:13:40] title slide of your PowerPoint presentation? Do you put landcruisin [01:13:45] all your qualifications? Do you put Rajaratnam, etc., etc.? No, [01:13:50] I don’t and I don’t either. So he says, well, everybody else does. So why aren’t we? I’m thinking [01:13:55] I feel a bit uncomfortable. And he said, well, the point is that unless people know who we [01:14:00] are, unless we tell them who we are, they’re not going to think we’re credible. Okay. So so I thought it was [01:14:05] an interesting, interesting concept where where actually self promotion [01:14:10] is not something I do particularly well or comfortable with. But actually in this [01:14:15] world of social media and Instagram and all the other things, [01:14:20] actually being humble doesn’t necessarily cut it in that sense. So, [01:14:25] so actually it’s, it’s, it’s a, it’s a double edged sword. But I think people would respect you [01:14:30] more if you are humble and you are you don’t boast about your achievements. Just crack on. [01:14:35] And there’s lots of things about other people I don’t know about because they don’t tell me about it. And then suddenly you discover, you think, oh God, [01:14:40] okay, well that’s amazing. I didn’t know that. Why didn’t you? Why didn’t you tell me that? So, yeah. There. [01:14:45] Is that so? So those are the three bits that I give.

Speaker3: Uh, then [01:14:50] I see you as a bit of a, like a, like a enigma, [01:14:55] right? Because much of what you’ve said has been around [01:15:00] sort of. Or having met you as well. Yeah. Much of much of what you do is around [01:15:05] wanting to know the full story. Right. That 100% has sort of and I would characterise [01:15:10] that as as kind of a black and white kind of person, someone who’d have strong views. [01:15:15] And yet when you talk about things, you talk about them with such nuance [01:15:20] and with with so much humbleness that, you know, humility or humility, [01:15:25] it’s just it’s surprising. It’s surprising, you know, you it’s [01:15:30] a nice thing. It’s a nice thing to see. And it goes to the to the point that, you know, things are [01:15:35] not as simple as one plus one equals two when it comes to human beings. You know, [01:15:40] we’re nuanced. We’ve got lots of different angles about us. It’s [01:15:45] been a fantastic course. I really, really enjoyed it. Thank you so much for doing this. It’s been a massive honour to have [01:15:50] you here.

Speaker2: This is Dental Leaders, [01:15:55] the podcast where you get to go one on one with emerging leaders [01:16:00] in dentistry. Your hosts. [01:16:05] Payman Langroudi and Prav Solanki.

Speaker4: Thanks for listening, guys. [01:16:10] If you got this far, you must have listened to the whole thing. And just a huge thank you both [01:16:15] from me and pay for actually sticking through and listening to what we’ve had to say and what our guest [01:16:20] has had to say, because I’m assuming you got some value out of it.

Speaker3: If you did get some value out of it, [01:16:25] think about subscribing. And if you would share this with a friend who you [01:16:30] think might get some value out of it too. Thank you so so, so much for listening. Thanks.

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