Payman Langroudi: One of the most common questions I get is how do I do more teeth whitening? The basis of that is to really [00:00:05] believe in it, and the basis of that is to fully understand it. Join us for enlightened online training on [00:00:10] Enlightened Online Training.com to understand how to assess a case quickly, how to deliver [00:00:15] brilliant results every time. Next time whitening Underwhelms try and lighten. Now let’s get to the [00:00:20] pod.

[VOICE]: This [00:00:25] is Dental Leaders. The podcast where you [00:00:30] get to go one on one with emerging leaders in dentistry. Your [00:00:35] hosts Payman Langroudi and Prav [00:00:40] Solanki.

Payman Langroudi: It gives me great pleasure to welcome Doctor Andrew [00:00:45] Alcantara to the podcast. Andrew’s a young dentist who is, uh, [00:00:50] doing good work. I’ve enjoyed your work, Andrew. Looking at your work lately, for someone who’s [00:00:55] only been out, what, five years now? Um, and also the founder of Mobile [00:01:00] Smiles, which is a charity that’s doing lots of work all over the world. Massive pleasure to have [00:01:05] you.

Andrew El-Khanagry: Thank you very much for having me. It’s a as I said, it was a it’s an honour to be here. And also [00:01:10] I’ve got a bit of imposter syndrome. It’s called the Dental Leaders podcast. But I don’t feel like I’m [00:01:15] anywhere near that yet. But thank you for having me on.

Payman Langroudi: Um, and you said you’re [00:01:20] a listener as well.

Andrew El-Khanagry: Yeah. Yeah, I’ve listened to a lot of podcasts. Um.

Payman Langroudi: When do you listen?

Andrew El-Khanagry: Driving. [00:01:25] Driving? That’s when I tend to stick a podcast on. That’s the time where.

Payman Langroudi: Because [00:01:30] you work in different towns, right?

Andrew El-Khanagry: Yeah, yeah. So when I’m driving to Birmingham, it’s about an hour away. [00:01:35] So I’ll listen on that hour there and back. Probably get [00:01:40] through a podcast every single, every single journey. So I get through quite a bit really.

Payman Langroudi: What [00:01:45] other do you only listen to? Dental or do you listen to other podcasts?

Andrew El-Khanagry: No no, no. Um, there’s also one, [00:01:50] uh, a few different ones. Uh, diary of a CEO listened to quite a bit. Yeah. Um, there’s [00:01:55] one also by Jay Shetty. Yeah. Have you listened to listen to his podcast at all. Yeah. He’s he’s he’s done quite [00:02:00] a few also good books. I think like a monk all that kind of stuff. He’s a yeah he’s got, he’s [00:02:05] got some good podcasts. So yeah I listen to a variety of things. Dentists who invest listen to that sometimes. Um. [00:02:10] Jazz Galati. He also does a really great cast. Great. No, no, no. And yours is great. Yours [00:02:15] is really good as well.

Payman Langroudi: But, you know, it’s kind of interesting because a book, a talking book is 6 or [00:02:20] 7 hours. Most like small ones. Yeah, yeah. That means like you’re doing, I don’t know, eight [00:02:25] hours a week of driving. Yeah, literally, you could listen to one book a week if you wanted to. So it’s a very interesting [00:02:30] idea, man.

Andrew El-Khanagry: I guess it’s I guess without realising you absorb so much knowledge. Yeah. Um, [00:02:35] it’s one of those things where I feel like in conversation, I would remember [00:02:40] something from a podcast, and I’d be able to bring it in without realising, because you’re just absorbing [00:02:45] knowledge all the time through different podcasts, through investing, or through some random, uh, [00:02:50] interview with, uh, someone who does something in science and you remember some scientific facts. So, yeah, it’s a [00:02:55] good way just to absorb knowledge, but to be honest, it’s just for me. I pass time with it rather than listen to music. I’m into [00:03:00] my music. But after a while it’s. I feel like, you know, you listen to a conversation. [00:03:05] The journey just goes a lot quicker when you listen to a really good conversation.

Payman Langroudi: So you grew [00:03:10] up in Derby?

Andrew El-Khanagry: Yeah. So I was born in Egypt. Um, I’m [00:03:15] part of the Coptic Egyptian community, and, um, I moved to England [00:03:20] when I was four. Um, I lived here in a small town called Burton on Trent.

Payman Langroudi: I’ve been [00:03:25] there.

Andrew El-Khanagry: Have you been there? There’s not much going on in Burton. Um, and. Yeah, that’s next to Derby. [00:03:30]

Payman Langroudi: So you’ve always been there?

Andrew El-Khanagry: Well, yeah, I’ve been. I’ve been based there. Went [00:03:35] to schools in Burton. My secondary school was in Derby. Um, and then, uh, [00:03:40] yeah.

Payman Langroudi: Do you remember arriving in the UK or not?

Andrew El-Khanagry: Yeah. So I remember, [00:03:45] I remember because it was such a big difference. Cairo I was born in Cairo, and England [00:03:50] is such a big difference. I do remember exactly the point when I arrived, and I’ve got some [00:03:55] recollections of some times when I was in Egypt as well. Um, but the [00:04:00] the main thing was, is that I couldn’t speak any English.

Payman Langroudi: Yeah.

Andrew El-Khanagry: Me too. When I got [00:04:05] here. Yeah. Um, so I remember my first time I went to school, I think [00:04:10] went into reception year, and I was just, I [00:04:15] would go to school and not make any friends, not be able to communicate with anyone. And then one day I [00:04:20] went home and my apparently I told my parents, so they tell me, um, apparently [00:04:25] I said, oh, everyone can speak Arabic now. I think that’s when they realised that I was starting to speak English, because [00:04:30] everyone thought then that I was able to communicate with everyone. So, uh, so yeah, that was probably the biggest challenge [00:04:35] to begin with.

Payman Langroudi: Do you know why your parents moved for work?

Andrew El-Khanagry: Mainly. My dad. My dad’s a [00:04:40] doctor. He, um. The idea was he. He got his. He’s a he’s an obs [00:04:45] in Gynae. So he went to Royal College here, finished, uh, his hospital [00:04:50] career and everything, and then went back to Egypt to open a clinic, got married, [00:04:55] and the plan was to settle down and open his own private practice and everything. Um, and then just [00:05:00] didn’t like it. Couldn’t couldn’t get back to the Egyptian system. Um, it’s [00:05:05] a bit haphazard. There’s a lot of it’s not as ethical as the UK system. So [00:05:10] he decided to come back to the UK. Then, you know, got a good job here. Then told [00:05:15] my mum, meet myself and my younger sister to come to England and we joined them from there onwards. [00:05:20] Yeah.

Payman Langroudi: So then were you walking a kid? Were you?

Andrew El-Khanagry: Um, it’s [00:05:25] an interesting one because I’d say as a younger kid [00:05:30] who couldn’t speak any English, I was [00:05:35] probably quite an introvert to begin with because [00:05:40] I couldn’t communicate. And that was my biggest barrier at the start, and [00:05:45] I didn’t really have many friends. I then I think some people [00:05:50] probably felt sorry for me. Started making friends with me and then I had little friendship group when I went into [00:05:55] primary school. So I wasn’t, you know, the most popular kid. But I just had a few little friends and was probably [00:06:00] a bit of an introvert to begin with. Um, and, uh, and then I think as I was able to [00:06:05] be a bit more confident and communicate, I kind of came out of my shell a little bit more and, you [00:06:10] know, took it from there. Really. Um, but yeah, that’s probably how it began, was just [00:06:15] just quite an introvert to begin with.

Payman Langroudi: And did your parents say [00:06:20] anything about dentistry, or did your dad want you to be a doctor or what was what was that [00:06:25] journey like?

Andrew El-Khanagry: Um, so, so I always wanted to be in something scientific, like doctor, that [00:06:30] was probably my goal. Um, and I said to my dad, from a young age, you [00:06:35] know, I want to be like you. I want to be a doctor. And he was all my parents were very supportive about that. But [00:06:40] they’re not. My parents aren’t the typical, you know, Egyptian parents who are very pushy into a certain direction. They’re [00:06:45] very happy for me to do anything. My sister, she’s a fashion designer in Sydney, so they’re [00:06:50] very happy to do whatever, whatever we want, really. But then I did my work experience in medicine [00:06:55] and it was in my dad’s hospital, and I’m pretty sure my dad, [00:07:00] um, told all his colleagues that he wants me not to do [00:07:05] medicine because of the anxiousness. So every time I go to a hospital placement, they’ll be like, oh, what do you [00:07:10] want to do? Medicine. And I’d just be like, no, thanks. Uh, they’ll be like, no, no, don’t do [00:07:15] medicine. Do dentistry instead. So they were kind of trying to point me towards dentistry [00:07:20] as a career and, um, yeah. So I started looking about dentistry more. [00:07:25] Did some work experience in dentistry? Didn’t really like it, to be honest. And then one [00:07:30] of my friends was a surgeon and did some work experience and I [00:07:35] loved it. I thought it was incredible.

Payman Langroudi: So before even applying.

Andrew El-Khanagry: Before applying, I loved [00:07:40] Max. I thought it was just incredible operations that they did. And it was just I loved it. Um, [00:07:45] and I then went to dentistry with the intention of doing max packs, and [00:07:50] then eventually just loved dentistry. And that’s why I’m doing it, is because I just [00:07:55] realised that I really like dentistry as I was doing it. And you were in Birmingham? Yeah, I’m in [00:08:00] Birmingham now.

Payman Langroudi: No. You studied in Birmingham?

Andrew El-Khanagry: Yeah, studied in Birmingham. Studied in Birmingham. Um, and then. [00:08:05]

Payman Langroudi: Did you not, did you not think, hey, I’ll go a bit further away than Birmingham.

Andrew El-Khanagry: Um yeah [00:08:10] I did, I did, I applied to a few dental schools, uh, Bristol, Liverpool, [00:08:15] Leeds. Um, and then at [00:08:20] the time, I think the selling point was Birmingham had a brand new dental school that was being opened.

Payman Langroudi: I remember.

Andrew El-Khanagry: So. [00:08:25]

Payman Langroudi: We used to do a composite course. There were the first hands on course in the whole building.

Andrew El-Khanagry: Yeah, it’s a beautiful [00:08:30] dental school. So that was probably the biggest selling point, I thought.

Payman Langroudi: So you never saw the old one. [00:08:35]

Andrew El-Khanagry: So we were the last cohort to see the old one. So we were the last to be in the old one and then go [00:08:40] to the new one afterwards. Oh, really? Um. And, uh. Yeah. No, it’s the old one. Yeah, it’s [00:08:45] an interesting building.

Payman Langroudi: Lift.

Andrew El-Khanagry: Right? Yeah, yeah. Um, and then the new one is [00:08:50] just a massive difference. So it was mainly just because I thought it was a new facilities. It looked good. I didn’t really know much of what I [00:08:55] was getting into, to be honest.

Payman Langroudi: Did you find it challenging or like when you got to the course?

Andrew El-Khanagry: Yeah. [00:09:00] Dentistry. Dentistry is difficult. Um, first year we didn’t really know what we [00:09:05] were doing, to be honest. And I remember first, my first set of exams, I failed [00:09:10] and I was it was a bit of a wake up call. I was like, okay, I actually need to need [00:09:15] to actually do some work. But luckily I lived with one of my good friends and he had some [00:09:20] brilliant set of notes and just managed to. He gave me all his notes and survived [00:09:25] with his set of notes. Really? Um, so yeah, we had luckily in dental [00:09:30] school, we had a really good group of friends who we’d all support each other, give each other notes, [00:09:35] help each other out, and we all got through eventually. But yeah, dental school wasn’t wasn’t a breeze. [00:09:40]

Payman Langroudi: That’s not the usual story you hear about dental school, is it?

Andrew El-Khanagry: No, I guess it’s not. And yeah, I [00:09:45] think I’m very lucky. We had a great group of guys. We’re all. We’re all still very close.

Payman Langroudi: Um, [00:09:50] you were all in the same trouble.

Andrew El-Khanagry: Yeah, yeah, we got up [00:09:55] to a bit of mischief, but at the same time, it was, uh, we all support each other and got through as well, [00:10:00] so. Yeah. No, it was good. It was good. A good group of lads. And, uh, one of them just got married in the summer. [00:10:05] Uh, we’re all his best men and stuff. Yeah. No, it’s a it’s a good group. And we got we got through. [00:10:10] We got through. But it wasn’t easy. I’m very practical hands on. So Birmingham is. I think [00:10:15] at the time I’m not sure if it is now, but it had the most exams out of any dental [00:10:20] school in the country. So it wasn’t my kind of learning. But [00:10:25] we just got through like like everyone else. Really. Yeah, yeah.

Payman Langroudi: And your first job.

Andrew El-Khanagry: So, [00:10:30] um, I went to Manchester. It was, uh, [00:10:35] North Manchester area called Middleton. Um, and. Yeah, just wanted to go [00:10:40] see a different city for a year. And yeah, it was good. I had a great PhD. Yeah. [00:10:45] For PhD, yeah, for PhD I had a great. Is Matthew Whittingham he owns a few practices up [00:10:50] in up in the north north Manchester area. And he just got me stuck in. He [00:10:55] he does implants. He’s really good at surgery. And he just said you know feel free to [00:11:00] to tackle whatever you want. And I’m in the room next to you. So I’ll, I’ll [00:11:05] be there to help you out. So it just got me really focussed on hands on. At the time when I graduated, [00:11:10] it was the middle of Covid. So yeah, it was the times where [00:11:15] like an hour long.

Payman Langroudi: Yeah.

Andrew El-Khanagry: Um, but for me that was a good thing because it just gave me time to sit [00:11:20] down and and do every everything step by step. Really.

Payman Langroudi: So your final year [00:11:25] was Covid year?

Andrew El-Khanagry: Yeah, we we graduated at the literally we did our written [00:11:30] finals and then they told us COVID’s about to there was rumours of [00:11:35] this Covid thing.

Payman Langroudi: So we’ve done everything.

Andrew El-Khanagry: We’ve not done the seen and unseen exams? [00:11:40]

Payman Langroudi: No, but the clinical part.

Andrew El-Khanagry: We’ve done the written finals. Yeah, we’ve done most of the clinical. Yeah. [00:11:45] So we didn’t really get affected by the clinicals as much. And then we took us all into a room and they were like, [00:11:50] look, you’re all gonna have to leave tomorrow. Um, we’ll don’t know what’s gonna happen with your seen and unseen [00:11:55] exams, but we’ll take it from there. And to be honest, at the time, we just thought it would be a two week holiday, so we were all like, great, we’ll [00:12:00] see you guys in two weeks. We’re off. You know, everyone’s off on holidays and stuff. Um, and we all went [00:12:05] and had a year photo and after that year photo everyone went [00:12:10] home. And I think someone must have had Covid the whole year got wiped out with Covid. So it was that [00:12:15] year photo I think destroyed probably half the year. But it was it was good. At least we got there because [00:12:20] that was the last opportunity we’d had. Eventually we wouldn’t have had another opportunity otherwise. But yeah, [00:12:25] we graduated in the middle of Covid. Yeah.

Payman Langroudi: And then.

Andrew El-Khanagry: Um, so yeah, [00:12:30] I did my PhD year, um, and then worked there for, uh, [00:12:35] one year, stayed on. Yeah. So after. Yeah. So after, um, I did [00:12:40] my Ph.D. year, they offered me a job. Um, and I was in a really nice, supportive [00:12:45] practice. Um, just your typical NHS practice. Um, but [00:12:50] very supportive man. North Manchester is quite high. Needs area. So doing a lot of treatment. [00:12:55]

Payman Langroudi: It’s actually an interesting question, right. Should you or shouldn’t you stay on in your PhD practice. [00:13:00] Because I remember as a child, like not you’re at [00:13:05] PhD. Yeah. And I specifically wanted to switch practices. [00:13:10] Okay. To see another way of doing things. Yeah. And my boss was this [00:13:15] wonderful guy, Nick Mahindra. Still a still a friend of mine. And I remember him telling me that [00:13:20] you’re making a mistake actually makes a lot more sense to stay on so you can see your [00:13:25] own work and all that. And I remember being this sort of silly boy thinking, no, no, [00:13:30] no, he just wants me because I’m so brilliant. So but I want to see something else and then deciding [00:13:35] to move on. Yeah. Um, that said, I moved on to a fully private practice [00:13:40] then after that. So. But the question of should you or shouldn’t you stay on? I’ve changed my mind on it now. [00:13:45] I think you should stay on.

Andrew El-Khanagry: It’s. Yeah, it’s it’s a really good point. I don’t know if there’s a right or [00:13:50] wrong answer. I mean, I, I stayed on because I thought it was really supportive and I [00:13:55] didn’t I didn’t feel like I was good enough to to go anywhere else. And I’d be embarrassed to have gone [00:14:00] to another practice at that stage.

Payman Langroudi: As in, you owed him, like that sort of feeling.

Andrew El-Khanagry: No, as in [00:14:05] as in, no, I don’t think.

Payman Langroudi: You know, if you were good enough, I.

Andrew El-Khanagry: Don’t think I was good enough to go nowhere else. So at least they knew my abilities [00:14:10] at the time. And, um, and they were like, yeah, we [00:14:15] know where he’s at. We can carry on with him kind of thing. But then I think as the year went, I became [00:14:20] more confident. I to be honest, I got myself a camera really early on and because of the whole [00:14:25] Covid situation, I had time to take photographs and take it really helped, really do things step by [00:14:30] step because we had the our AGP appointment at the time. Yeah, yeah. And it just meant that [00:14:35] even if I had a simple occlusal filling or something, I would be able to [00:14:40] make proper dams, take photos, just take my time with everything. So that helped. Just. [00:14:45] Yeah. So for me it was great. And then by the time I went into my first year associate, the [00:14:50] world was going back to normal. So things sped up naturally. So [00:14:55] yeah, to be honest, I thought, I thought for me, for me it was it was really good until kind of something [00:15:00] happened and then it kind of was a bit of a wake up call to move [00:15:05] into, move into private practice. Um, just had like a bad experience with the patient and then. [00:15:10]

Payman Langroudi: Yeah. No.

Andrew El-Khanagry: Go on. Um, it was just it was just a situation where I [00:15:15] had a lady come to me. It was a new patient, and [00:15:20] the first thing she opened up with was, I’m in the middle of a lawsuit, and. [00:15:25] And I got knocked over from my bike. There was a problem with the bike that she [00:15:30] was riding, and she smashed her front two teeth. And that was pretty much the situation. [00:15:35] So she’d come to me to fix her teeth, and she wanted to know how much it costs, because she wants to do it privately [00:15:40] so that she can, you know, charge.

Payman Langroudi: The insurance company.

Andrew El-Khanagry: As part of the lawsuit that she was doing as well against [00:15:45] the company that did the bike.

Payman Langroudi: The company that made the bike?

Andrew El-Khanagry: Yeah, apparently it was some sort of bike fault or something. [00:15:50]

Payman Langroudi: Yeah.

Andrew El-Khanagry: So I had obviously I was just out of pretty much just out of PhD [00:15:55] year and I had my alarm bells already ringing, but I just had to tackle it on as, [00:16:00] as you.

Payman Langroudi: Did your treatment plan.

Andrew El-Khanagry: Yeah, I did my treatment plan. She needed a root canal, one tooth [00:16:05] and some composite fillings. That was pretty much it, but I was I was nervous, [00:16:10] I was really nervous. You know, when you have that patient and they’re coming in and you’re just.

Payman Langroudi: Alarm [00:16:15] bells are ringing.

Andrew El-Khanagry: Yeah. And you don’t feel comfortable. Some patients you can you feel comfortable treating some [00:16:20] patients I feel like you’re it can be a bit on edge. Yeah. So she was one of those where [00:16:25] I felt like I was I was on edge, and, um. Yeah. So I [00:16:30] brought her in for the root canal, and the canals were slightly sclerotised because [00:16:35] of the trauma, but to be honest, I ended up perforating the [00:16:40] root. The root canal. And then that made it more of a problem, because then I had [00:16:45] obviously told her what had happened and it was my mistake. We had to refer on. But my [00:16:50] yes and the team were really supportive. But that whole period was really it. Anyone [00:16:55] that knows me knows I’m quite a laid back, but it made me quite anxious. [00:17:00] And for the first time in my life, I’d probably say I had anxiety and I didn’t really [00:17:05] know. I’ve heard people say I have anxiety and you.

Payman Langroudi: Didn’t [00:17:10] know what it meant.

Andrew El-Khanagry: I didn’t know, I didn’t know what it was. I really didn’t know, I didn’t understand. I understand if you have an exam, you [00:17:15] can be a bit anxious for the exam, but I didn’t know. It’s like a constant [00:17:20] state. You wake up, you sleep, you’re anxious. So that was probably the first time.

Payman Langroudi: What [00:17:25] happened? What happened?

Andrew El-Khanagry: Um. Nothing really. I thought she’d end up suing me and my career would be over. [00:17:30] But we referred her on. We paid for her private endodontist. [00:17:35] And, um, he did a really good job. [00:17:40] Sealed it up. Did the root canal and everything was. She was cool. Yeah. I’ve heard nothing [00:17:45] back since Touchwood, so?

Payman Langroudi: Well, even so, you had anxiety like that?

Andrew El-Khanagry: No, no. So that [00:17:50] at that point, yeah, I think you.

Payman Langroudi: Weren’t sure what was going to happen.

Andrew El-Khanagry: I think I realised at that point as well because [00:17:55] I, I was there was a lot going on. I was, I had a target, I was [00:18:00] on 6000 UDA straight out of PhD year, and I just felt [00:18:05] like there was a lot happening every single day. And I, I couldn’t the [00:18:10] workload and the pressure of doing things really quickly.

Payman Langroudi: You couldn’t do everything exactly as you wanted. [00:18:15]

Andrew El-Khanagry: Exactly. And I’m a bit of a perfectionist as part of my nature. So I then thought, [00:18:20] I need to I need to switch up in some way. I didn’t really know what to do, but I [00:18:25] knew one of my colleagues. He Was in a salaried position in a private practice. So [00:18:30] I basically just said, picked up the phone, called him and told him I’m like, [00:18:35] mate, what’s what’s going on? How have you got this job? And he said, this [00:18:40] is how the job works. You. It’s it’s two owners. They own a few private practices [00:18:45] and the salary for a year. And they they send you to loads of courses. And then [00:18:50] eventually after that year, they’ll offer you an associate position in the practice. But they want to train their associates [00:18:55] in a certain way, take them to certain communication courses. Uh, certain [00:19:00] clinical courses just make so you can understand what it’s like to work in a private practice and be of a certain [00:19:05] standard, and then they’ll offer you the job. And I was like, okay, great. And he’s like, actually the actually [00:19:10] got position right now they’re looking for. So yeah. Look [00:19:15] it I said I was like, okay, sign me up. Where is this. And then took it from there. Really luckily got the job and and [00:19:20] ended up in how.

Payman Langroudi: Was it, how was that year. Was it a year or two.

Andrew El-Khanagry: It was one. It was one year. It was. It [00:19:25] was a big for me. I’m a firm believer that you have to invest [00:19:30] in yourself. So I took a big cut in terms of my just what I was earning. [00:19:35] Yeah.

Payman Langroudi: How much was how much were they paying?

Andrew El-Khanagry: Uh, it was 40 K. 40 K for the year.

Payman Langroudi: Okay. Yeah. [00:19:40] And they were paying for your courses.

Andrew El-Khanagry: Yeah. So that’s the thing. So this was they were paying for a course and probably the courses altogether [00:19:45] probably worth about 15 K. So they’ll send you out.

Payman Langroudi: Which could go and list them, list the courses that they [00:19:50] sent you.

Andrew El-Khanagry: It was the Tipton, the Tipton Restorative course.

Payman Langroudi: Tipton.

Andrew El-Khanagry: Um, [00:19:55] it was the Invisalign course.

Payman Langroudi: Yeah.

Andrew El-Khanagry: Ashley. Letter. The communication [00:20:00] ones. Uh, someone’s in, like, cerec all this kind of stuff. So just the selection of courses [00:20:05] that they used to do. Um, and then they would, we’d have almost like weekly tutorials [00:20:10] as well go through cases. So you’d work as a normal dentist, but anything that’s more difficult or more complex, they’ll sit [00:20:15] down with you, give you tutorials and stuff. And yeah, it was a good year. Um.

Payman Langroudi: You feel like you [00:20:20] upskilled, though?

Andrew El-Khanagry: Yeah, I think I think the biggest thing upskilled was probably [00:20:25] communication. I, uh, I went to Ashley later in my PhD [00:20:30] year and to be honest, I, my es took me there because he had like a free [00:20:35] ticket and I went with him. And I at the time I was a bit just [00:20:40] like naive. I didn’t really see the importance of communication and all these things [00:20:45] and even working in the practice afterwards. My associate job in in Manchester, [00:20:50] I’ll bring a patient in and probably have like a two minute chat. Just. Hi, [00:20:55] how you doing? The weather looks nice and take from there. And then [00:21:00] when I went into private practice, they told me that there’s a the, [00:21:05] the check-ups should be half an hour and at least ten minutes should be just getting [00:21:10] to know the patient.

Payman Langroudi: Yeah.

Andrew El-Khanagry: And I really struggle with that. I didn’t know what to say for ten minutes. Um, [00:21:15] and that and then I remember looking at one of the older associates, I [00:21:20] sometimes go and see what he’s doing, and he was doing a lot of implant work at the time, and [00:21:25] his communication skills were incredible. And he would and every patient would [00:21:30] sign up to a pretty big treatment plan, and all he would do would [00:21:35] just get to know the patient. And at the end he’d be like, you know, this is what we need to do. The patient would be like, okay, cool, let’s [00:21:40] that sounds great. I trust you. And they were happy to go for it. Really. So I think that’s. [00:21:45]

Payman Langroudi: Such an important thing here because look, first of all, number one, the difference between a [00:21:50] good endodontist and a great endodontist is communication 100%. Yeah. [00:21:55] So even if we’re talking something super specialised like endo. Yeah. So there’s definitely [00:22:00] and I’ve told this story before but we’ve, I’ve picked surgeons for my wife based [00:22:05] on their communication skills. Yeah. For major operation. You know because of the communication [00:22:10] skills it’s that important. Yeah. Like you’d imagine what you do is you look at the surgeons, you [00:22:15] know, like track record or whatever. Of course we looked at that. But but the final [00:22:20] decision came to the guy who was just the nicest. Yeah, that’s the first. But [00:22:25] the second thing is I left dentistry in 2012 and only [00:22:30] when you stop do you realise the bits you loved and the bits you hated. Yeah. And it turned out the [00:22:35] bits I love were those conversations, you know. So like, the most important [00:22:40] thing from my perspective was the conversations with the patient. You know, that was the [00:22:45] thing that gave me the most value in my life that I don’t have right now. That’s why I got a podcast. Yeah, [00:22:50] but it’s.

Andrew El-Khanagry: True, though. It’s amazing how much you learn.

Payman Langroudi: Yeah.

Andrew El-Khanagry: When you talk [00:22:55] to someone. Yeah, I, you know, patients that I’ve talked to some patients. And once [00:23:00] you get to know them and they get more comfortable with you. Yeah. They come out with some incredible stories [00:23:05] that you you wouldn’t have otherwise heard unless you took the time to get to know them. And I [00:23:10] sometimes and.

Payman Langroudi: The diversity though, that diversity, the important thing is right now I speak to loads [00:23:15] of dentists. Yeah. Of course. But the diversity I remember my last private job. There was this guy [00:23:20] who’d started a bank in Switzerland. Yeah. Yeah. So there was the conversation with that guy. Yeah. [00:23:25] Or some guy was the top journalist in the feet for, you [00:23:30] know, like a particular part of the world, you know, emerging markets. Wow. Yeah. Conversation with that guy. And [00:23:35] then the conversation with some lady who just had her second kid and had to leave her banking [00:23:40] job for the sake of the argument. Yeah. And what was really interesting to me was I took over my wife’s list [00:23:45] at one point. Okay. And I used to come home from work and say, oh, Mr. So-and-so, isn’t it crazy [00:23:50] that he’s head of Brazil for the ft. And she was his dentist for [00:23:55] like, years and didn’t know that. Didn’t know that. Yeah. But she was having other conversations [00:24:00] with him. Yeah. Yeah. And so what you learn from patients is beautiful. Watching [00:24:05] families come through and kids grow up, and all of that stuff is [00:24:10] super beautiful. And you do go through the trials and tribulations with them as well. Families divorce, [00:24:15] marry, you know, all sorts of things go on.

Andrew El-Khanagry: I think I think that’s actually that [00:24:20] doesn’t happen enough where I feel like my generation, the younger generation of dentists, [00:24:25] we do jump around quite a bit. Yeah. And there isn’t a lot of dentists. [00:24:30] Exactly. You know, for example, I remember my. Yes. And I’m sure he’ll stay [00:24:35] on. He’s been in that area from when he pretty much graduated and I’m sure he’s [00:24:40] got two practices there. So he’ll he’ll stay there till he retires. And he’s well known he’s [00:24:45] the dentist in the area. Whereas now the practice I’ve been to recently, there’s been so much jumping [00:24:50] around. A lot of patients come to me like, oh, you know, the third person I’ve seen in a space of two years [00:24:55] before, I used to see so-and-so, and they were my they were my dentists for [00:25:00] 30 plus years. So I feel like patients are starting to also it’s also starting to impact patient [00:25:05] care as well.

Payman Langroudi: Of course.

Andrew El-Khanagry: You know, it takes a while for them to build trust with the dentists especially, I feel. [00:25:10]

Payman Langroudi: Plus those, you know, those, uh, porcelain veneers you cut three years ago that look so amazing. Yeah. [00:25:15] Yeah. In nine years time, it won’t look so amazing and so interesting to see your own [00:25:20] work over the long term. Like, you know, people like Tiff Qureshi’s only only worked in one practice [00:25:25] the whole of his career. 30 years. Yeah. To to see, you know, even that [00:25:30] mod that you thought you did so well. Yeah. Yeah. Fail. It really shows you what [00:25:35] works and what doesn’t in the same way as when you look at photos of your own work. Yeah, but this is over a period of time [00:25:40] as well.

Andrew El-Khanagry: Well, it’s a test of time. Yeah. You’ll be able to see your failures, and I’m [00:25:45] just. I’ve jumped around a fair bit, but I’m trying to. I’m. I’ve [00:25:50] come to realise the importance of staying in somewhere long enough to realise your, [00:25:55] you know, your your where you’re failing and where you can improve. So that that [00:26:00] for me is the main thing. But photography helps me appreciate these little things on a, on a, on a, on a [00:26:05] more of a nuances. Um, so.

Payman Langroudi: I’ve got a question.

Andrew El-Khanagry: For.

Payman Langroudi: You from the associate [00:26:10] perspective. Yeah. Yeah. Well you’ve you’ve worked in how many practices [00:26:15] now do you think?

Andrew El-Khanagry: So um, so I’ve [00:26:20] worked in two practices before my current jobs.

Payman Langroudi: So three. [00:26:25]

Andrew El-Khanagry: So, so I mean for for practice altogether. I work, work between two practices now. So when [00:26:30] I left my, my other job, I’m now kind of split between two practices. [00:26:35]

Payman Langroudi: But I have worked in four practices altogether.

Andrew El-Khanagry: Four practices in yeah, five, four, five [00:26:40] years.

Payman Langroudi: So quite interesting question. Right. Of of the the management [00:26:45] of those four businesses and what the way those people manage [00:26:50] their businesses mean to you the associate. Yeah. And and [00:26:55] the question of like what was really good practice. Something like if you ever opened your own practice, you’d [00:27:00] definitely put in place and what wasn’t and what’s, what’s what important things. You know, from [00:27:05] the associates perspective, is it as obvious as I need a nurse and I need to buy my [00:27:10] materials? Or have you got like more nuanced? Because what really interests me [00:27:15] is a dental practice should be a very similar thing everywhere you go. But it’s not very, very different. The [00:27:20] way people run their practices.

Andrew El-Khanagry: It’s not it’s really hard to gauge. I feel I feel like I’ve been I’m [00:27:25] the idea was when I left my PhD practice to go into my practice in Birmingham, one that was [00:27:30] salaried. I’d be there for enough time to know what I’m doing. And then at that point, you [00:27:35] know, five, six years, then by practice myself or see what I want to do with my career at that stage. But [00:27:40] I they ended up selling that practice. So those owners, they, [00:27:45] they originally began as part of the practice and were dentists in the practice and [00:27:50] then they became purely business side of things. So I was exposed, exposed to that side of dentistry [00:27:55] where you had a practice owner who just saw it as a business. [00:28:00] And as a young associate, I, I didn’t [00:28:05] particularly I didn’t like that because I felt like I was just a number. And if you weren’t performing, [00:28:10] then, you know, you just have to. You’d be replaceable with another associate [00:28:15] who can come in and bring in higher earnings than yourself. Um, then [00:28:20] I, I’m now working in another practice where the owner is also he is [00:28:25] very active part of the dental community. He’s a very good [00:28:30] dentist himself. He used to work on Harley Street and he’s, you know, very nurturing, [00:28:35] you know, mentors me quite a lot. So I would for as as a young [00:28:40] associate, that’s the kind of practice I would want to go into, especially in the private world. Someone [00:28:45] I don’t need someone to babysit me. I might go for the odd bit of advice here and there, [00:28:50] but it’s someone in the in, you know, in the clinic next door. We can go and pop your [00:28:55] head in and they can give you some advice or help treatment planning a complex case or, you know, tell you, oh, this [00:29:00] material is really nice. We recommend that. Or what materials do you like? Do you want us to buy it for [00:29:05] you? So those are the main.

Payman Langroudi: Things happen that last piece. What materials do [00:29:10] you want?

Andrew El-Khanagry: Yeah, yeah. So I remember.

Payman Langroudi: When you want something new, do you have to, like, worry that they’re not going to get it for [00:29:15] you?

Andrew El-Khanagry: Well, there was always that worry, especially if you’re asking for some expensive piece of kit. I [00:29:20] like to just get something expensive I’ve seen on Instagram or something because I want to try it out. [00:29:25] I don’t always get yes, they’re happy to buy it, but in a lot of cases, if I can justify [00:29:30] the reason or if I’ve got a case in, then they’re more than happy to buy it. I don’t feel I’m [00:29:35] not the sort of person to go and be like, look, I want all this equipment on my shelf and then [00:29:40] I’m not going to use it. If I’ve got the case, and I think then it’s fine to ask for a certain piece of equipment. [00:29:45]

Payman Langroudi: I agree, and I think that really is the hack, isn’t it? Like if you’re an associate and by the [00:29:50] way we do it, we have it on our mini smile makeover course. Yeah, we get one set of associates who come in and say, [00:29:55] I am not going to buy anything. The practice has to buy it for me. Yeah, yeah. All right. [00:30:00] Fine. One way of thinking about things. We’ve got another associate who immediately just buys everything and doesn’t [00:30:05] even consider what the practice is or isn’t doing, what’s the best material for himself. And and [00:30:10] then you get one type. The advice I always give is that one that, you [00:30:15] know, if you want your boss to buy it for you, get a case. And no [00:30:20] boss is going to say no when there’s a patient waiting for the treatment or, you know, potential [00:30:25] more patients waiting for the treatment. Although some bosses still say no in that [00:30:30] situation. And so that’s what I’m asking about, you know, best and worst practice. Um, [00:30:35] what’s your bugbear? Let me let me give you my example. My bugbear. Yeah. When I was an associate [00:30:40] was the notion of I couldn’t treat friends and family for free. Okay. In [00:30:45] some practices, it was fully my decision. I could do whatever I wanted. I used to treat my nurses [00:30:50] dad for free. Yeah. And no one, no one had a problem with that? Yeah. Other practices. [00:30:55] There was rules and regulations around who you could or couldn’t treat for free. That [00:31:00] was my bugbear. What was your. What’s yours? Like? What’s a peeve of yours [00:31:05] in these jobs that you’ve done?

Andrew El-Khanagry: I guess it’s the my, my I [00:31:10] guess my pet peeve is so a lot of these practices, they want to keep everything in-house. [00:31:15]

Payman Langroudi: So labs.

Andrew El-Khanagry: This sort of thing. Oh referral referral to treatment. Referral [00:31:20] pathways. Yeah.

Payman Langroudi: So so you want to refer to a particular guy. [00:31:25]

Andrew El-Khanagry: So say for example, I want to refer to a particular guy because I know him. I know they’re good. Of [00:31:30] course they’re a specialist. In some cases I would refer that patient out [00:31:35] and I might get a call or a text being like, why didn’t you refer it to one of our associates who’s, [00:31:40] you know, got a specialist interest or something in this? Why did you send that case out? They might poach [00:31:45] that patient from us. So I think in private practice, which was, again, something [00:31:50] I didn’t really understand when I was just going into that private practice world. You know, some practices do, [00:31:55] I guess, poach patients and all this. I don’t I don’t know how much that goes on, but I, [00:32:00] I never came across that all the patients are referred out. There were to really experience great dentists [00:32:05] who would do the treatment that I referred out for, and then send the patient back to me. Well, I.

Payman Langroudi: Think it’s less the [00:32:10] poaching, more that I’ve hired this endodontist to come in two days a month to fill him up, kind of. Yeah, [00:32:15] that kind of potential angle. There’s a there’s an existing associate who’s got interest in endo or [00:32:20] whatever potentially.

Andrew El-Khanagry: Yeah. And and it was, it was I’d have a lot of things [00:32:25] I’d want to refer out get blocked because, because, [00:32:30] because.

Payman Langroudi: That.

Andrew El-Khanagry: Would hurt in-house.

Payman Langroudi: Yeah.

Andrew El-Khanagry: And that for me after a while it did kind [00:32:35] of frustrate me because I couldn’t do the things I wanted to do with this, with this dentist I wanted to do with, for [00:32:40] example, if I wanted to do more cosmetic case and I wanted to send it to a periodontist [00:32:45] for some gingival surgery before beforehand, I wouldn’t be able to. I’d have to keep [00:32:50] it in-house. So yeah, it did. It did impact me. And also I feel sometimes patient care [00:32:55] as well. Yeah. Yeah. Um, but yeah, I guess that’s probably my biggest pet peeve generally speaking [00:33:00] wise. Apart from that, everything. They were happy for me to treat friends, family and things like that.

Payman Langroudi: Free [00:33:05] of charge.

Andrew El-Khanagry: Um, I did. No one came anything to say. [00:33:10] No one said anything to me, so I assumed they were okay with it. But I [00:33:15] did, I did. So. Yeah. Yeah.

Payman Langroudi: Nice. So then [00:33:20] at what point in this journey did the charity thoughts come up?

Andrew El-Khanagry: I’ll [00:33:25] be completely honest. It was never intended to be a charity. Um, we [00:33:30] I had it was kind of coming towards the end of Covid and again, [00:33:35] I was thinking about potentially going to the private dentistry and things. I knew there was a lot of a lot of friends, [00:33:40] um, in the Egyptian community who were also, uh, dentists and could support each [00:33:45] other through things. So I contacted one of my mates and I was like, let’s make a group chat and [00:33:50] just put in all the people that we know, all the Egyptian dentists that we know, and we can [00:33:55] all help each other out. See? Just see if we can help each other, you know, get contacts and, [00:34:00] you know, just network in that sense. And he just said, great, great [00:34:05] idea. We made a group chat and then someone, an older dentist, he’s he’s [00:34:10] called Rafiq. He works in London. He’s got two practices in London. Um, he contacted us and he [00:34:15] said to us that he does a project in Egypt. He goes every year, does some volunteering work, [00:34:20] and it would be nice if we can get some more dentists involved. And obviously [00:34:25] I was I’m originally Egyptian and I’ve always wanted to go back at some point [00:34:30] and do some work over there. My dad, he always used to do charity work in Egypt. [00:34:35] My granddad, he was also a big businessman in Egypt, and I remember [00:34:40] going down the streets when I was younger with him, and everyone would know him because everyone in the streets would come [00:34:45] and say hi, because he’d helped lots of local businesses.

Andrew El-Khanagry: So it was always kind of part of my kind of upbringing [00:34:50] is to to do some charity work because it’s really kind of fulfilling. Um, so I thought it was a great idea. [00:34:55] And then we ended up trying to raise money for a mobile dental unit in Egypt. So [00:35:00] we raised. I think it was about £50,000. We raised that money. How? [00:35:05] Just through, like GoFundMe and word of mouth. Literally. [00:35:10] We didn’t do any fundraising events at the time. Just we spread the word out throughout, [00:35:15] you know, all the Egyptian community. And money just came in. Um, we didn’t [00:35:20] really put I’ll be honest. We didn’t really put much effort apart from just a few things on Instagram at the time. We [00:35:25] had a like a charity page set up for just for the, for the, uh, mobile [00:35:30] unit. We didn’t have a charity at the time. And then, yeah, we raised the money and then we had [00:35:35] we ended up forming a charity afterwards because we were like, we can do this in other countries and help out other places. [00:35:40] And then the charity grew. More people came in who supported us. Um, [00:35:45] we have in our trustees now just going to. So we got Raffi and John, who we [00:35:50] started off with, and then Cristine, Mariam who came in afterwards. And now we’ve got a social [00:35:55] media app. Um, Georgina and Robbie as well. So the team’s growing [00:36:00] more and more, and we’re going to more locations now. So.

Payman Langroudi: So tell [00:36:05] me about that then. The a typical location. [00:36:10] Like what happens. How long does it last. What’s the story? You buy one [00:36:15] of these vans. Does the van keep on working the whole year?

Andrew El-Khanagry: Yeah, it’s a good question. So for example, [00:36:20] we we obviously we’re not based in Egypt, so we need to find some partners in Egypt [00:36:25] who can look after the van and also use it when we’re not there. So we’re linked with a charity in Egypt for example, called [00:36:30] we’ve got also basically means Egypt without disease. It’s an Egyptian [00:36:35] charity. And in Namibia we’ve got another big project. In Namibia we’re part we’re also working with [00:36:40] the health ministry in Namibia. We’ve got contacts with the chief dental officer there. And when we go to Namibia, we’re [00:36:45] part of the Ministry of Health kind of group going out to different areas and they’ve got their own van. So we’ve [00:36:50] not bought a van there, but we they basically ask for money to just [00:36:55] for maintenance of the van to buy equipment for the van. So we tried to go to location and see what [00:37:00] they already have and support them in either building it up or if [00:37:05] they need just money for equipment and things like that. And then we can [00:37:10] once they’re once they’ve got the money, we’re ready. We can send out groups to volunteer when we’re [00:37:15] not, when we’re not using the van. For example, in Egypt, they then take it out for missions [00:37:20] all the time just for Egyptian people. Christian, Muslim, everyone.

Payman Langroudi: Yeah, but so go on, [00:37:25] explain to me you bought the van.

Andrew El-Khanagry: Yeah, we bought.

Payman Langroudi: The group that goes from here. Yeah. [00:37:30] Is that. Was that like a distinct two week thing, or is that. Yeah.

Andrew El-Khanagry: So for the group from here, for example, it’ll [00:37:35] be ten days. We do.

Payman Langroudi: Who pays for them. They do themselves.

Andrew El-Khanagry: So yeah. All so all these missions [00:37:40] are paid for themselves.

Payman Langroudi: By the dentists.

Andrew El-Khanagry: The dentists and the we [00:37:45] then ask for donations for the maintenance of the van. So every time we go on a charity mission, we have to self. [00:37:50] It’s almost like a double hit on the dentist. So they’re not earning income when they’re there, and also they’re [00:37:55] paying for the mission themselves. So hats off to all them. And yeah, they’ll go and do.

Payman Langroudi: They do a money [00:38:00] raising effort. Each dentist themselves or do they just pay it out of their pocket or how does [00:38:05] it work?

Andrew El-Khanagry: I’m not sure if they do individually.

Payman Langroudi: We are not involved with that side.

Andrew El-Khanagry: No, we mean we’ve [00:38:10] the volunteers just seem to be happy. I mean, we’ve got we’ve got a volunteer list on our charity website. We’ve got hundreds [00:38:15] of dentists in the country who want to get involved. So we just send out an invite to a group, [00:38:20] whoever first signed up, and then everyone just seems to be happy to pay for it [00:38:25] out of their pocket. I think maybe some of them do, maybe within their own communities do a little fundraising project. But [00:38:30] generally speaking, I think everyone just pays. It pays for it themselves.

Payman Langroudi: And typically how much is the cost?

Andrew El-Khanagry: So [00:38:35] around I’d say typically around 2000 1000 to £2000. So for example Egypt [00:38:40] costs about 1000. Namibia is a bit further away. And after we do the mission stuff we try and do a few [00:38:45] fun things in the country. We’ll do safari, we’ll go visit a few different areas. So between [00:38:50] 1 to £2000 for for a mission.

Payman Langroudi: And how many people turn up.

Andrew El-Khanagry: Um, [00:38:55] so around I’d say around ten. Ten. Usually enough for a minivan of people. [00:39:00]

Payman Langroudi: So kind of fun.

Andrew El-Khanagry: It is. It’s good fun. It’s really good fun.

Payman Langroudi: And and then for how many days [00:39:05] is the thing?

Andrew El-Khanagry: Ten days.

Payman Langroudi: Roughly how many of those days are actually treating patients?

Andrew El-Khanagry: I’d say half [00:39:10] the days. So for example, in Namibia, we did about four and a half, five days of treating patients one day there and back, three, [00:39:15] three days of just leisure and evenings after you finish a day of work, evenings you’re [00:39:20] going out for a meal, getting to know everyone. It’s it’s it’s good fun. You know, a lot of our [00:39:25] volunteers, as soon as they finish the mission, they sign themselves up for the next mission because they want to come [00:39:30] back more and more because they find it rewarding. But also they just enjoy doing dentistry [00:39:35] because you’re just doing raw dentistry. You don’t have to worry [00:39:40] about litigation and all the stresses of working in the English system. You’re [00:39:45] going and helping people and there’s something quite, you know, uplifting about the fact that you can just [00:39:50] go in and you can actually come back and you feel invigorated in the job. You enjoy the job more because you’re [00:39:55] just going and helping people, which is at the end of the day, what what we’re what we’re about. So, [00:40:00] yeah, a lot of people enjoy the work purely because it’s not stress [00:40:05] and enjoy the dentistry.

Payman Langroudi: And the work itself is what more extractions. So [00:40:10] yes.

Andrew El-Khanagry: Our focus is two things. Um, prevention and [00:40:15] urgent care at the moment. So we, we normally with the children we do things like [00:40:20] oral hygiene, fluoride varnish and things like that. And then with the adults we [00:40:25] again do with oral hygiene. And if they need any emergency treatment, we’ll, we’ll, we’ll do a lot. We do a [00:40:30] lot of extractions, extirpations fillings, things like that. Most of the work is extractions [00:40:35] because of the we’ve only got one van and that’s two dentists that [00:40:40] can work in the van. But we can set up chairs everywhere really, and help as [00:40:45] many people that need teeth taken out as possible.

Payman Langroudi: I mean, look, it’s an interesting thing. [00:40:50] I’ve been to Egypt and some of the guys I’m hanging out with, Egypt, they’re living [00:40:55] seven star lives in Egypt. So you look at countries like Egypt, yours and mine, there [00:41:00] does tend to be a big difference between the rich and the poor and massive discrepancy. Yeah, massive. I mean, [00:41:05] some of the stuff I’ve seen in Egypt, it was like it could have been in Hollywood, man. Yeah. Amazing. Amazing [00:41:10] things. Yeah. Um, have you heard of, like, the idea of, like, giving [00:41:15] directly that? I mean, let me give you an example. My my son, uh, was [00:41:20] on a long flight from Malaysia, and suddenly we thought, oh, he might have DVT [00:41:25] because he had a swollen ankle or whatever. And then he had to fly to Egypt the next day. [00:41:30] Yeah. So we said, oh, we better do a Doppler ultrasound [00:41:35] thing on him. Took him to the Wellington Hospital down the road from here. We paid [00:41:40] £550 for the Doppler. Yeah. And they said, um, maybe whatever they said. [00:41:45] Oh, if it happens again, if he gets pain when he’s in Egypt, just go and do another one of those, okay? He [00:41:50] went played football, got pain. And so we better take him to hospital. They took him to Egypt, [00:41:55] did another Doppler ultrasound in Cairo.

Payman Langroudi: And we were like calling the parents, [00:42:00] saying, oh, listen, we want to pay for this. And they were saying, no, it’s okay, don’t worry. We were [00:42:05] like, no, no, no, we want to pay for it. In the end, she turned around. She said, look, it was £12, right? That’s all it was. [00:42:10] That’s how much it cost. Yeah, yeah. So now with all of that in mind. Yeah. An [00:42:15] extraction in Egypt. The cost of that? Yeah. If money is the problem, might be [00:42:20] £12. Yeah. The cost of flying this dentist over. [00:42:25] I know he’s self-funding. I know he’s self-funding. Yeah. It’s £2,000. Yeah. [00:42:30] For that 2000, you could have done 200 extractions for the sake [00:42:35] of the argument. Do these thoughts come into play like that? Because I definitely understand [00:42:40] it from the dentists perspective. Right. From the dentist perspective, it’s nice to keep it real. [00:42:45] It’s nice to do charity work. There’s pleasure in giving. It’s like giving a present [00:42:50] is nicer than getting a present. I get it from the dentist perspective, but from you now you’re. This thing [00:42:55] is growing. And almost, if you think of it from a pain perspective, [00:43:00] how can I alleviate the maximum amount of pain? Have you had thoughts on the way [00:43:05] that I’ve just described?

Andrew El-Khanagry: I think yeah, definitely. And it’s a really good thought. And also I’ll answer [00:43:10] that. But also another thought comes into my head is it’s all well and good doing all this stuff in different countries and travelling, [00:43:15] but we’ve got a lot of need in England as well. Very true. And we’re a UK based charity. Very [00:43:20] true. So why don’t we also put the money here and use it here in regards to [00:43:25] the you know you’re right. Obviously it makes more sense [00:43:30] to give that money to, you know, the people directly and they can use it. But [00:43:35] I feel like there’s in a lot of countries when you go there, there’s [00:43:40] a lot of miseducation.

Payman Langroudi: Yeah.

Andrew El-Khanagry: In terms of the people themselves, [00:43:45] they they don’t want to go to an Egyptian dentist. And I’ve worked a lot of Egyptian dentists. [00:43:50] They’ve trained to a really high standard. They’re great dentists, but they they will literally just [00:43:55] suffer. And they know that there’s a group going out from the UK, and there will be inundated with people coming [00:44:00] in for, for treatment because it’s free.

Payman Langroudi: Right.

Andrew El-Khanagry: Because because it’s.

Payman Langroudi: Free. So you’re saying it’s Western. [00:44:05]

Andrew El-Khanagry: But also, you know, relative. Exactly. I think it’s more due to the fact that there are a lot of people, [00:44:10] you know, they have enough money to do the dentistry, for example, had this really interesting [00:44:15] conversation. Well, I was in Egypt. I was in Aswan, which is south Egypt, [00:44:20] about three weeks ago now doing another mission. We just we just came back and [00:44:25] we’ve got a very good dentist who works with us on these missions [00:44:30] to help translate and help settle the stuff before we get there. And I was just having [00:44:35] a conversation, quite frankly, with him about money. And I said to him, how much do you charge for [00:44:40] a root canal? And this is bearing in mind this is. He’s telling me in Egyptian pounds. I [00:44:45] think the conversion rate at the moment is like one to 1 to 60 ish, roughly. So one, [00:44:50] one stone to 60 Egyptian. And he said it’s about 400 Egyptian [00:44:55] pounds.

Payman Langroudi: A fiver.

Andrew El-Khanagry: For a root canal.

Payman Langroudi: £5 roughly, [00:45:00] roughly speaking.

Andrew El-Khanagry: So it.

Payman Langroudi: Is canal.

Andrew El-Khanagry: For root canal. I’m like.

Payman Langroudi: My goodness.

Andrew El-Khanagry: I didn’t want to say it [00:45:05] to him, but I was thinking in my head, obviously I didn’t say it because I felt really bad, but I was thinking in my head, that’s [00:45:10] how much I charge. Probably more. Well, I definitely I know I charge more for a mole render in [00:45:15] Sterling.

Payman Langroudi: So yeah, yeah.

Andrew El-Khanagry: The discrepancies is massive. But again, [00:45:20] these patients don’t don’t don’t go to them. They’ll they’ll wait till a group from abroad [00:45:25] come. And for some reason they’ll trust your judgement more. And he might tell the patient, [00:45:30] look, you’ve got a massive infection in extraction. And they’ll just keep taking antibiotics until I [00:45:35] go over and say the same thing, and they’ll be like, okay, take the tooth out. So there is a benefit to us for us coming [00:45:40] in and also for prevention. We’re also they don’t the Egyptian dentists there, they [00:45:45] haven’t been taught prevention like we’re taught here, how an [00:45:50] Egyptian patient would go to dentist when they when they have pain, but they don’t have the six month [00:45:55] recall of check-ups.

Payman Langroudi: Yeah.

Andrew El-Khanagry: So us trying to introduce [00:46:00] that preventative system in Egypt on a it’s a [00:46:05] it’s a microcosm really. It’s a small in a very small kind of way in these little communities. [00:46:10] I think over time I think that will help. I hope it will help.

Payman Langroudi: Yeah. [00:46:15] But then again, you could pay people on the ground to go into 100 schools. [00:46:20] Yeah, we could, we.

Andrew El-Khanagry: Could 100% could. It’s there’s definitely an element of, you know, [00:46:25] it’s it’s good fun when we’re there to help. And there’s an element of self gratification [00:46:30] that comes with it 100%.

Payman Langroudi: Um, I mean, listen, I’m not judging. I think it’s beautiful. [00:46:35] It’s better to do this than go to a week to Ibiza and party from, [00:46:40] I guess from the energy perspective. Yeah, but by the way, make sure you get to a [00:46:45] birthday party as well. Yeah, I’m not discounting.

Andrew El-Khanagry: I’ve not been to Ibiza.

Payman Langroudi: Actually.

Andrew El-Khanagry: I [00:46:50] need to go there at some point.

Payman Langroudi: How many of these trips have you personally been on?

Andrew El-Khanagry: I’ve been on on [00:46:55] four trips so far.

Payman Langroudi: Go on, tell me the places.

Andrew El-Khanagry: Three Egypt, one.

Payman Langroudi: Namibia to [00:47:00] Namibia. Because Namibia sounds like a brilliant place for a holiday.

Andrew El-Khanagry: It is. It is great for a place [00:47:05] for holiday. I every time I come, when I come back and tell everyone about it, I was like, just go for a holiday. Don’t. Don’t you know [00:47:10] if you want to go for the charity, great. But if you don’t go for the charity, just go explore the moon. It’s a beautiful country. [00:47:15]

Payman Langroudi: And is there a big, rich, poor divide there? There are a lot of poor people there.

Andrew El-Khanagry: Just generally a lot more poor people. [00:47:20] I mean, you go to the capital, Windhoek, you’re expecting a capital [00:47:25] city, you know, it’s just a few homes. Maybe it’s [00:47:30] a very unpopulated country. It is.

Payman Langroudi: You know, like.

Andrew El-Khanagry: It’s a beautiful country, [00:47:35] very clean country.

Payman Langroudi: Yeah.

Andrew El-Khanagry: That’s what it’s it’s, you know, they’re really they [00:47:40] have a lot of they look after themselves. Right. Yeah. A lot of pride in the country. And [00:47:45] yeah, we had a great time. We went and explored the dunes. They’ve got some of the highest dunes in the world. Um, but [00:47:50] the, the thing, the one, they’ve used it for a few film locations where the sand meets the sea. And we [00:47:55] had a safari. We did a lot of charity in between. Um, but. Yeah. No, it’s a it’s a beautiful mission, [00:48:00] beautiful mission. And people want to go for charity or just go for a holiday. It’s a great it’s a great country. [00:48:05] But going back to that point about the UK, I feel like obviously [00:48:10] everyone in our charity, we’re doing this, we don’t get any [00:48:15] money out. We’re all dentists. So for example, I’m just an associate dentist. We’ve got one of the trustees as a consultant oral [00:48:20] surgeon. We’ve got practice owners, you know, everyone just giving their time to try and grow the [00:48:25] charity, help out as many people as possible independent of race, culture, anything. Um, [00:48:30] but Recently, I personally I’ve started saying, you know, I [00:48:35] think it’s all it’s all well and good doing something.

Andrew El-Khanagry: And it looks really good on social media and [00:48:40] everything. And I think we are helping out a lot of people, but it’s also nice to do something in the country. Yeah. So [00:48:45] I’ve we’re it’s right in the beginning of the talks. But you know charity called crisis. They do a lot of homeless [00:48:50] work. And I feel like in our in in the UK right now, there’s a massive problem with just [00:48:55] access to healthcare to homeless people. So we’re in the early stages [00:49:00] of talking, but we’re trying to sort out preventative program for them. And that’s something in the UK, and that’s something [00:49:05] where the money can easily access and we can divert our funds there and help out as many people as possible right here [00:49:10] in the UK. And a lot of our volunteers, they they want to help, but they don’t want to pay £2,000 [00:49:15] and go abroad. They might want to get in the car and just go help someone you know nearby. [00:49:20] So that’ll give us the opportunity to help out a lot of people in in the country, which which I think is [00:49:25] really important as a UK based charity.

Payman Langroudi: That’s a good idea. Crisis to Christmas thing don’t they. Where [00:49:30] Dentists can.

Andrew El-Khanagry: They do. They do a lot. They do already work with dentistry.

Payman Langroudi: Yeah.

Andrew El-Khanagry: We’re hoping we can. [00:49:35] We can support a lot more, a lot.

Payman Langroudi: More. So and what are the other locations that you haven’t [00:49:40] been to yourself but the organisation has.

Andrew El-Khanagry: So we’ve got also [00:49:45] Nigeria opening up as well. We’ve had one mission there so far really, um, really remote community, which [00:49:50] is only accessible by car certain times of the year because there’s a floodplain that goes [00:49:55] across it. So between I think it’s October to February, you can access that that region. [00:50:00] And they have there’s like poverty and there’s like poverty [00:50:05] this this is the super poverty where they’ve never seen a brush [00:50:10] or they’re the kind of communities which are so remote. They they don’t know anything about dentistry [00:50:15] or dental care. So that’s that kind of level of poverty where they, they need [00:50:20] just access to anything. And they’re, they’re, you know, they have the sugar cane there and they just kind of like [00:50:25] chew it and things. So the need for dentistry. There is high, [00:50:30] but they have no education. They no knowledge of dentistry [00:50:35] at all. So that’s one of the areas. And we’re hopefully going to buy a mobile [00:50:40] unit and try and access that area more often. And then we got contacted by [00:50:45] some dentists in America who wanted to be involved in the charity. And then they’ve told us they [00:50:50] have contacts in South America. So Peru and Bolivia, and we’ve had a mission in Bolivia [00:50:55] and hopefully in December, it’s still in talks, but we might be able to do a mission in Peru as well. [00:51:00] So a few different locations are starting. But I wanted just to make sure we’re established in these locations [00:51:05] that we’re in to begin with, to make sure that the prevention work stays, [00:51:10] because again, it’s all well and good doing the urgent care and and helping these people out. But the prevention [00:51:15] is what lasts. And I want the charity to be really focussed on that as well.

Payman Langroudi: I [00:51:20] mean, are there several of you that are like day to day running [00:51:25] it? Yet.

Andrew El-Khanagry: Um, as in, we’re all dentists. We all chip in like [00:51:30] I’m. To be honest, I probably don’t do very much. We’ve got a great team, and they do a lot. So there’s [00:51:35] the day to day running. We have we have an accountant. Apart from that, [00:51:40] we’re all dentists. We don’t have. I think we need to start hiring people, to be honest.

Payman Langroudi: So yeah, but how many dentists are [00:51:45] actually doing work like outside of the turning up and treating like, I don’t know, you get [00:51:50] a call from Nigeria saying we need X. How many dentists are involved [00:51:55] on the trustees?

Andrew El-Khanagry: There’s uh, 6 or 7 of us actively [00:52:00] involved.

Payman Langroudi: Um it’s interesting dude. Yeah, because anything that’s purpose led [00:52:05] like this, the results, the return on the work is so much bigger [00:52:10] than when it’s not purpose led. And that’s a lovely thing, right? Yeah. And [00:52:15] but I think it’s amazing if whatever endeavour you do, you [00:52:20] switch it in your head as your purpose led? [00:52:25] Yeah, because I’ve got a friend. He sells, uh, beef. Yeah. [00:52:30] Yeah. He could say I sell cows, I sell beef. He could think I feed [00:52:35] people. You know, like these bigger sort of. I’ve always. I’ve always had trouble with it. With the teeth [00:52:40] whitening. I’ve always in my head thought. Yeah, making rich people’s teeth whiter is just not very inspirational. [00:52:45] Yeah, but but you could you could say, hey, I bring joy and happiness and love to people [00:52:50] and confidence like you could.

Andrew El-Khanagry: There’s always two ways to look at something, isn’t it?

Payman Langroudi: Yeah, but my point is it’s actually quite a good [00:52:55] thing because purpose is such a powerful thing. It’s true. It brings people together. Like these guys are [00:53:00] all dentists. Yeah, they’re busy doing their own things and yet organising such so many [00:53:05] things. It’s not an easy thing to organise something across the world with dental equipment. [00:53:10] It’s not an easy thing to do, but you’ve done it.

Andrew El-Khanagry: I think it’s true. I think it works with anything really. I feel as soon as money [00:53:15] becomes a factor in the decision making, I mean, even in even dentistry [00:53:20] like that one year I was salaried in the private job. I was enjoying my dentistry so much, so much [00:53:25] more. And as soon.

Payman Langroudi: As I sell anything.

Andrew El-Khanagry: Exactly. And then I would just. I’d love it. And [00:53:30] then as soon as the money came into it, then you. I feel like the enjoyment always gets knocked down [00:53:35] a little bit because it’s less purpose, it’s more money orientated. But obviously, you know, it’s something [00:53:40] you need. Every dentist needs to think about at the end of the day. But I think it’s having that balance of purpose. [00:53:45] And, you know, also, you know, trying to earn a living as well.

Payman Langroudi: Looking at your [00:53:50] Instagram, you’re quite like good at sort of the minimally invasive adhesive stuff.

Andrew El-Khanagry: I’m [00:53:55] okay. I’m all right. I mean, it’s just yeah, [00:54:00] I, I think my I’ve said I’ve done the courses, but I’ll be honest, [00:54:05] the best course I’ve ever done is the course of Instagram. I got access to the [00:54:10] best dentists in the world, and it’s like I’ve got, you know, a chairside [00:54:15] view of what they’re up to. The amount of things I’ve learned from these dentists, [00:54:20] you know, people like you’ve had in like, like George. Um, and so [00:54:25] many other dentists in America are the ones that do all the, the biomimetic type things. I’ve [00:54:30] learned so much. My biggest source of education has been Instagram since graduating.

Payman Langroudi: Interesting. [00:54:35]

Andrew El-Khanagry: Yeah, and I think I was part of that community from really early on. So I as [00:54:40] soon as I pretty much got left PhD, I started my Instagram and, you know, just [00:54:45] put my face out there. I was producing pretty crap work, but I was happy posting it. [00:54:50] And I think when, you know, a dentist who’s well established sees that a younger person is trying [00:54:55] to put the effort in, they will they’re more than happy to help out. So I would always, you know, pop [00:55:00] a question to to one of the dentists and I’d always be surprised when the answer. But the [00:55:05] amount of help I got with along the way of, you know what? How do you do in this situation? How do you treatment plan this or what material [00:55:10] do you use? You know, I got helped so much by some of these bigger dentists. And [00:55:15] you know, it’s got me to my position now, but, you know, it’s nowhere where I need [00:55:20] to be. You know, there’s still so much more improvement and things that I can make. But it’s been my biggest source of education more [00:55:25] than any course.

Payman Langroudi: Where do you see yourself going clinically? Because [00:55:30] five years out is a funny time. You’ve sort of figured out the basics. [00:55:35]

Andrew El-Khanagry: Yeah.

Payman Langroudi: And then you’ve got the whole next level. And, you know, definitely [00:55:40] enjoying dentistry is about getting better at dentistry. It’s hard [00:55:45] to enjoy it when you don’t get better at it. Yeah. Where do you think you’re going to go next? I mean, are [00:55:50] you are you thinking clinically you’re going to go more indirect, more full mouth, [00:55:55] more? Are you going are you going to specialise? Maybe. Any thoughts around that or do you want to open a practice. [00:56:00] Like what are you thinking?

Andrew El-Khanagry: Um, it’s it’s a difficult one. I, I struggle, [00:56:05] I struggle with this. To be honest, it’s I, I don’t think I’ll specialise. I did [00:56:10] my old college exams because I thought when I graduated dental school, I need to specialise. I was taught by, you [00:56:15] know, Professor Ian Chappell, who’s He’s a really, really good guy. Yeah, really [00:56:20] good guy. And, um. Yeah, I thought I’d definitely specialise in perio. And [00:56:25] then I’m now in a position where I’ve done more prosthetics because of my training. Prosthodontics. [00:56:30] So I think I’m going to focus more on I’m enjoying at the moment the more [00:56:35] prosthodontics type treatment. So I feel like my focus is kind of going towards towards that. [00:56:40] But at the moment I’m I do pretty much all aspects of dentistry apart from, you know, [00:56:45] I do restorative endo.

Payman Langroudi: Do do do.

Andrew El-Khanagry: Do I do endo. Yeah.

Payman Langroudi: The perforation [00:56:50] didn’t put you off.

Andrew El-Khanagry: No, I still managed to do it. Still managed to do it. I do, I do end and it’s [00:56:55] got better a little bit better since then. Um, but obviously you still refer the things that are [00:57:00] crazy, but I’m more than happy to tackle anything. I love oral surgery, so [00:57:05] at the moment I’d say I’m a bit of a general restorative dentist, but I’m starting to [00:57:10] slowly focus more on the prosthodontic side of things, the fixed prosthodontics. But [00:57:15] we’ll see. We’ll see where my career takes me. I mean, again, also like business. [00:57:20] I’m thinking, you know, practice ownership at some stage and things like you. Are you at some stage? I’m nowhere. [00:57:25] I don’t know where I’m going to be based yet, but when I’m when I know at that point I’ll probably [00:57:30] reassess. But it’s nice being an associate where you can go and do good quality dentistry [00:57:35] and not worry about the stresses of practice ownership, which have, you know, I’ve seen firsthand [00:57:40] from some of the owners how stressful it can be.

Payman Langroudi: I think it’s a funny thing because you end up becoming [00:57:45] an associate after maybe five years like you, you find [00:57:50] places where you are happy. Yeah. Um, there’s not much in life which is [00:57:55] a better job than, uh, a happy associate. Yeah. But happy associates [00:58:00] make good money. You can, um, do the work you want to do and all that. But [00:58:05] there does end up coming a point for most people where whether it’s because we’re just all programmed [00:58:10] that way or whether there’s a niggle. Yeah. Yeah, let’s imagine [00:58:15] me. My niggle might have been I want to do free work on whoever I want to do free work on, and my boss [00:58:20] wasn’t letting me. And then eventually you think, oh, I want this patient journey and I want that, and then say, [00:58:25] I want to open a practice. I want to open a practice. Yeah. Have you, have you got views on like [00:58:30] what that practice would be like already or not?

Andrew El-Khanagry: Um, [00:58:35] it’s a difficult one. I mean, I I’ve got an idea. [00:58:40] I’m. I’m not. I’m not certain. I know I’d want [00:58:45] to have it like an upscale type practice, because that’s the sort of treatment I enjoy [00:58:50] doing the most. Um, similar to maybe, like Ash Palmer’s type practice. That’s the kind [00:58:55] of practice.

Payman Langroudi: What an Essex.

Andrew El-Khanagry: That one. Yeah. That that that kind of practice. And he’s you [00:59:00] know Ash Palmer is, you know, a great dentist top of his game. And you know, he, he actually came [00:59:05] and spoke in our charity ball last time. He’s a great he’s a great a really great guy. But yeah that [00:59:10] kind of that kind of dentistry is probably.

Payman Langroudi: What do you mean by that? I think I’ve been there. Very [00:59:15] cosmetic. Yeah, very veneer based.

Andrew El-Khanagry: It is, it is it’s [00:59:20] it’s almost like, you know, I’ve not been to the practice myself. From what he’s told me, it’s more like it’s. [00:59:25] You’re entering more like a spa. Almost.

Payman Langroudi: It’s from the decor perspective. [00:59:30]

Andrew El-Khanagry: Yeah. From from the decor. From the patient experience. The patient journey. It’s just [00:59:35] it’s not just about the dentistry. It’s the whole feel of the practice. But [00:59:40] I think the question is, is, you know, at what stage is [00:59:45] enough? Enough as a dentist. You know, like I said, being an associate, it’s great. You’re [00:59:50] earning a good living and you’re doing well. Yeah. Why push it? Why [00:59:55] do you need to keep going and have that? Why? Why do a lot of us as [01:00:00] dentists have that niggle where we want to just keep pushing to have more and more and more when [01:00:05] we’re perfectly comfortable earning quite a good living as being an associate. It’s a difficult one. What? What [01:00:10] stage is enough.

Payman Langroudi: I think the most sort of inspirational answer to that is [01:00:15] to live up to your potential.

Andrew El-Khanagry: Yeah.

Payman Langroudi: Because it definitely isn’t inspirational [01:00:20] to think the next watch, the next car, the next holiday. Yeah, that’s not very inspirational. No. [01:00:25] Um, but to live up to your potential is like, for instance, just on this charity thing. What [01:00:30] is the potential of this? Yeah. And if you really lived up to your potential, what [01:00:35] could you make of this as just talking about the charity thing could be this giant thing. [01:00:40] It could be. It could be that, you know, every dentist does a week and imagine the [01:00:45] size of that. You know, like if every single dentist did that amazing thing. Same [01:00:50] thing with practice, right? Yeah. But then what’s correct and what isn’t and [01:00:55] what metrics make you happy? Like, my absolute hero dentist is Andrew [01:01:00] Darwood. Okay. Yeah, I’ve had him here, I’ve had him here. And he had one extra [01:01:05] ordinary practice and several other businesses, you [01:01:10] know, imaging business and so on. But one extraordinary practice. Yeah, I think he had one other [01:01:15] but but one extraordinary one. That was his one. Yeah. And then I’ve had people sitting here with, [01:01:20] you know, mother of 342 practices. Yeah. And, you know, still [01:01:25] still still going, you know, wants to get to 5050. Her number. Yeah. [01:01:30] Yeah, yeah. It’s interesting to know what it is. You know.

Andrew El-Khanagry: I think I think that’s a great point. I’ve [01:01:35] never thought about that, but I think that’s what’s going on in the back of my head. You don’t want to have unfulfilled [01:01:40] potential or you feel like you can give more. Do more. Yeah. I think it’s part of our [01:01:45] wiring is is, you know, dentists in general. You have to be of a certain character [01:01:50] to be a dentist to, to push for more.

Payman Langroudi: But then also at what cost? That’s the other interesting [01:01:55] thing. Yeah, yeah. Because, you know, there’s, there’s sacrifice in anything [01:02:00] worthwhile. Yeah. Generally, you know, almost like for me, it’s [01:02:05] almost like they go together Sacrifice and worthwhile stuff. Yeah. [01:02:10] And so what? Sacrifice? What level of sacrifice? You know, like, I, I’ve [01:02:15] been in situations where I have missed a best friend’s birthday because I was at the dentistry [01:02:20] show. Yeah. For the sake of the argument, or because I was on a plane somewhere or didn’t. [01:02:25] So that’s one level of sacrifice. Yeah. Someone else wants to, you know, take his kids to school [01:02:30] every day and bring them back every day and be the, you know, present father. And, you [01:02:35] know, someone else wants to be an international lecturer. Yeah. Yeah. And and, you know, I [01:02:40] was talking to Jason Smithson. He was saying. He was saying if you want to be an international lecturer [01:02:45] and you want to keep a wife and family, you can’t have a practice. You [01:02:50] know, you always say and look after yourself, your own health and all of that. You can’t you can’t [01:02:55] have a practice. But that’s the limitations he’s put on it. Yeah. Yeah. It’s very interesting [01:03:00] to to sort of figure out what in life, you know, live up to your potential as a [01:03:05] thinker. Yeah, that means you might not want to work five days a week. You might want [01:03:10] to work three days a week because you want to think for two days a week. It’s an interesting thing.

Andrew El-Khanagry: It’s an [01:03:15] interesting one. And I feel like everyone’s got their own balance. And I’m in a position now where I’m [01:03:20] five years out and I’m. Those kind of questions are starting to come in. Come into my head. Yeah. [01:03:25] So I’m I’m trying to figure it out. And I’ve had a lot of these conversations with my friends and [01:03:30] very different answers. Some want to just be an associate. They never want to buy a practice. [01:03:35] Some are really interested in the business and they want to buy it. Some want to leave dentistry. So yeah. [01:03:40] Yeah.

Payman Langroudi: How many like that?

Andrew El-Khanagry: Um, I’d say minority. Minority. But there are a few who, [01:03:45] you know, they’ve said, yeah, I want to leave dentistry or I want to open my own business or [01:03:50] do something else, like.

Payman Langroudi: What do you do?

Andrew El-Khanagry: Um, one of.

Payman Langroudi: Them. I haven’t decided yet.

Andrew El-Khanagry: One of [01:03:55] them? Yeah. It’s just there’s nothing in particular they’re doing. I mean, a few of them, like scrubs [01:04:00] companies, and they’re just doing scrubs, and they’re just something still Dental related, [01:04:05] but they just want to find a way to to get out of the clinical dentistry, [01:04:10] I guess. They don’t they enjoy. They enjoy being in the field, but not doing the clinical [01:04:15] day to day side of things because of a bad experience, or because they just wanted [01:04:20] to be able to work away from home, things like that. So yeah, that’s, that’s [01:04:25] that’s the main, the main reasons I’ve come across.

Payman Langroudi: Let’s get to the darker [01:04:30] part of the pod. Okay. You kind of already told me. You already told [01:04:35] me one situation that that that caused a problem for you with that patient. The, [01:04:40] um, endo that went wrong. But we like to talk about mistakes so [01:04:45] that we can all learn from each other’s mistakes. What [01:04:50] comes to mind when I say clinical error? What what clinical errors have you been through and which [01:04:55] ones sort of did you learn from and what can we learn from it?

Andrew El-Khanagry: So [01:05:00] I mean, I’ve done I’ve done a fair share of my clinical errors, but that one [01:05:05] was definitely up there. I’ve had.

Payman Langroudi: Well, let’s go to that one then. What [01:05:10] was the error? The perforation itself. The the.

Andrew El-Khanagry: The perforation. And I feel like [01:05:15] that perforation is the is the practical error. But I feel like the error [01:05:20] on like myself is the pressure put myself under. And [01:05:25] I think that’s what it affected me the most is not really [01:05:30] the perforation because the patient ended up being fine. I was in a really good, you know, really supportive practice. [01:05:35] It was my PhD practice and they helped me get through it, but it was the pressure put myself under [01:05:40] to be in this position where I was so anxious all the time. I mean, it only [01:05:45] lasted about a month, but I it I remember that tough month. I remember [01:05:50] that month, you know, it was it wasn’t like people have been through a lot tougher things. You know, the bigger scale things. No [01:05:55] one’s going to die. Dentistry and the day. We’re lucky to be in a profession where it’s very hard to do things [01:06:00] that could go seriously wrong. But it was. It affected me because [01:06:05] I thought I could potentially lose my job. And it really it really bothered me that, you know, she was already going through a [01:06:10] lawsuit. She’s that kind of person who can, you know, will happily put a lawsuit against, [01:06:15] you know, bike company. So she could easily do one on me for doing a mistake, [01:06:20] which is fair enough.

Payman Langroudi: So on reflection, what was the error going ahead at all? Or so what? [01:06:25] When you think about it.

Andrew El-Khanagry: Yeah, I guess I guess the right thing I should’ve done is probably referred that on to a specialist. [01:06:30] The root canal was closed. And, um, then after they’ve done the root canal, just do the composites at [01:06:35] the end. That probably would have been a better approach, especially I was in my first year as an associate, but I was so used [01:06:40] to just cracking on and getting my ES to help me if I needed help, [01:06:45] that I guess I probably got a bit too confident.

Payman Langroudi: I think if you don’t know what you don’t know, right?

Andrew El-Khanagry: You don’t. [01:06:50]

Payman Langroudi: You know, the first time you do anything. So maybe that was the first time you were up against the Sclerosis Canal. [01:06:55] You know, you don’t know. You just say, okay, that’s what it is. Let’s [01:07:00] start working.

Andrew El-Khanagry: Yeah. Yeah. And it’s a beauty to that because again, you can you’ll end [01:07:05] up tackling some things where, you know, and you might get lucky and get.

Payman Langroudi: You’ll never learn if you don’t push [01:07:10] a little bit outside. That’s the thing.

Andrew El-Khanagry: Where the lines. It’s hard to know. It’s hard to know. [01:07:15]

Payman Langroudi: But another one.

Andrew El-Khanagry: Um, I mean, the one most recent I could think of was. [01:07:20] The thing is, since working in private, I’ve had the luxury of doing things, taking my time. So there’s nothing. [01:07:25] I wouldn’t say there’s anything crazy that happened recently, but the. Where [01:07:30] I’ve had a patient who’s come in again, a red flag should have been ringing complaining of his old dentist. [01:07:35] Things like that. Wanted a bridge on his, uh, on his lower tooth. Yeah. Um, we did the [01:07:40] bridge. He then, uh, then devitalised he had to have [01:07:45] a surgery straight after, like a surgery on his arm. Oh. Um, and basically, he [01:07:50] was in pain for a lot of the post-op period and definitely, [01:07:55] definitely felt when he was by the time he saw me, he was, you know, angry to say [01:08:00] the least. So that was quite a difficult patient management situation. But [01:08:05] like you said, you have to put yourself in the patient’s position. They’ve come in for a procedure. [01:08:10] Yeah. Obviously you’re warned of the risk of loss of vitality. But [01:08:15] as a patient who’s had that treatment, you got to see it from their point of view. So we [01:08:20] dealt with appropriately. We did the root canal everything. It’s all sorted now. But at the time that was quite a difficult [01:08:25] patient management situation. It’s about trying to keep it was difficult for me to keep composed [01:08:30] and calm when someone’s clearly very angry and they’ve got a lot to say. Like shouting yeah, well [01:08:35] this emails, phone calls, even to the receptionist shouting at the receptionists. Obviously [01:08:40] we got him. I got him in. I call my identity. Got him in literally as soon as I can. I think on the same day as one of [01:08:45] the calls we managed to get him in, you know, extirpated as soon as we can, then brought him back in for the rest of Root Canal. [01:08:50] And we could have. So we dealt with it patient management wise, actually really well. But it’s more [01:08:55] the communication.

Payman Langroudi: So the error there was the communication in not telling him that. That was one of the possible.

Andrew El-Khanagry: I [01:09:00] guess not making it. Yeah. Not making it clear enough to him. Again. We do the [01:09:05] forms, they sign it. But you need to be I’ve since that point I’ve been extra [01:09:10] clear with the risks.

Payman Langroudi: But it’s so interesting isn’t it? Because you are, [01:09:15] you are. But the next man who that hasn’t happened to isn’t right. Hopefully. That’s. [01:09:20] I guess that’s why we’re asking the question on the pod.

Andrew El-Khanagry: Yeah. And and again [01:09:25] again younger dentists, they get a bit of a pet peeve is I feel like a lot of [01:09:30] us will just go through every single risk to cover ourselves. And a patient come in for some, simple [01:09:35] treatment might end up being put off by going through ridiculous risks that the chances [01:09:40] are will never happen. Yeah. At what stage do you go, uh, you know what? [01:09:45]

Payman Langroudi: That’s the art. The art of dentistry instead of the science.

Andrew El-Khanagry: The intricacies of how to [01:09:50] communicate properly. Yeah. And you just learn that by, I by, I guess just.

Payman Langroudi: Have you ever had toothache? [01:09:55]

Andrew El-Khanagry: Myself, luckily, no.

Payman Langroudi: But it’s. I can’t tell you how awful [01:10:00] it is. I mean, it is awful. It’s much worse than you. They. We [01:10:05] think, as dentists. I had toothache once, and I was walking down the street. [01:10:10] The pain I could see it was about to come again. It was about to come. The pain was so [01:10:15] severe that I had to just go into, like, this shopfront and just. Just because it comes [01:10:20] in waves of massive pain, like awful pain. The worst pain you’ve ever. You know, we [01:10:25] haven’t had children yet, but you know what I mean? The worst. So imagine this guy was in hospital [01:10:30] and his tooth was hurting more than his arm.

Andrew El-Khanagry: He’s recovering from surgery as well.

Payman Langroudi: Yeah, yeah, yeah. [01:10:35]

Andrew El-Khanagry: I understand the frustration.

Payman Langroudi: So mad.

Andrew El-Khanagry: It is. It’s difficult.

Payman Langroudi: It’s a good story. I like that one. [01:10:40]

Andrew El-Khanagry: But we got through. We got through. It’s. It’s one of those where you just got to try your best [01:10:45] and get through. It definitely didn’t help much, to be honest. But it’s one of those.

Payman Langroudi: Indemnity comes [01:10:50] in when when there’s a major situation. I don’t think either of these two were a major situation. [01:10:55] Um, I’m asking some new questions. Let’s [01:11:00] see where you go with these.

Andrew El-Khanagry: Okay.

Payman Langroudi: What’s the best lecture you’ve ever been to? Best [01:11:05] moment of, like, what comes to mind when I say.

Andrew El-Khanagry: So [01:11:10] it’s part of my undergrad [01:11:15] training. Uh, professor Ian Chappell, he did this. He [01:11:20] would get a few select students, and we’d do, like a special study module where he would [01:11:25] teach us basically microsurgery and regenerative dentistry with dogs and things like that. [01:11:30] Yeah, yeah, yeah. Um, and we’d start off each session where he’d give us a tutorial, then we’d go out and [01:11:35] do the actual treatment on patients. And seeing someone like himself [01:11:40] at the top of his game, he gave us some of the in those small group tutorials. He gave us some of [01:11:45] the most incredible lectures about perio and about his cases [01:11:50] and, you know, to the stage where I left wanting to specialise in Perry [01:11:55] after that. So, you know, he, you know, some seeing someone like himself who’s an [01:12:00] incredible dentist, really at the top of his game was the most, probably the most inspirational, [01:12:05] inspirational, inspirational things I’ve seen.

Payman Langroudi: So an interesting thing, that special study module they do at Birmingham, [01:12:10] I’m not sure if they do it other places, but Depeche, who does our mini smile makeover, he [01:12:15] he he was on the special study module with the late, great Louis Lewis.

Andrew El-Khanagry: Exactly. [01:12:20] Yeah.

Payman Langroudi: Mckenzie. And that’s where it all came from. You know, I.

Andrew El-Khanagry: Was lucky enough to get trained by [01:12:25] by Lewis McKenzie. Were you? Yeah. And. Yeah.

Payman Langroudi: What a great guy.

Andrew El-Khanagry: Great great man. And, um. [01:12:30] Yeah, his legacy lives on. He’s he’s a lot of us who went to Birmingham [01:12:35] would have come across him at some point, because even if you didn’t get taught by him, he would lecture as well. [01:12:40] And, um, yeah, he inspired a generation of us. Really?

Payman Langroudi: Next [01:12:45] question. What’s the course you’re desperate to do.

Andrew El-Khanagry: A [01:12:50] lot of courses out there, isn’t it?

Payman Langroudi: You don’t have [01:12:55] to even name the course. It could be the course on something like that. Like what’s the. Where’s your next training?

Andrew El-Khanagry: Probably [01:13:00] the direction I’m heading is in my kind of [01:13:05] the prosthodontics kind of field is probably more towards full mouth rehab type courses. So I know there’s a lot of [01:13:10] good courses. Doctor Devin Patel does one as well.

Payman Langroudi: There’s a good one. Devin [01:13:15] does a good one.

Andrew El-Khanagry: I’ve not, I’ve not.

Payman Langroudi: It’s like a two year, um, [01:13:20] fully mentored. And he’ll look at your cases and everything. Um, [01:13:25] and I think considering it’s two years, it’s actually a good price as well. [01:13:30] Yeah. Yeah. But then your other choices are things like spear and choice.

Andrew El-Khanagry: Yeah. [01:13:35] Yeah. I mean, they’re the big OGs. Commitment, right? Yeah, yeah.

Payman Langroudi: Uh, but people who’ve [01:13:40] done those courses love them. Yeah. Love them. There’s the Pankey Institute. [01:13:45]

Andrew El-Khanagry: The the one the the the the ones on the East coast. Is it or the Florida? [01:13:50] Florida?

Payman Langroudi: Yeah, yeah, it is the East Coast.

Andrew El-Khanagry: Yeah.

Payman Langroudi: Florida.

Andrew El-Khanagry: Yeah.

Payman Langroudi: Um, there [01:13:55] was. Yeah, there’s I mean, there’s so many there’s so many.

Andrew El-Khanagry: There are, there are and [01:14:00] and again, it’s I tend to I’ve done quite a lot I’ve done my fair share [01:14:05] of courses now. So again I’ve got a lot of room to improve. But [01:14:10] I don’t want to be forced out. I want to actually do a bit of the stuff I’ve learned, and then we’ve.

Payman Langroudi: Got to put into practice and. [01:14:15]

Andrew El-Khanagry: Then take it from there. But yeah, at the moment, doing more full mouth rehab type stuff would be learning [01:14:20] any, uh, I’m, I’m, I’m, I’m in the middle of, you know, [01:14:25] some cases where I’m doing some joint cases with some implant surgeons and things like that. So I’m in the middle of [01:14:30] a few. Um, but they’re they’re difficult. I know I’ve, [01:14:35] we’ve I’ve done my diploma in prosthodontics, so I know how to do it. It’s [01:14:40] just having the confidence to do that. That’s that’s what, that’s what with tips and training.

Payman Langroudi: Oh, that was tips. [01:14:45]

Andrew El-Khanagry: Yeah, that was tips. Yeah.

Payman Langroudi: And if, if I was to put like a, an AI through [01:14:50] all your cases, what would be the most typical case that you treat. Like what. What are [01:14:55] we talking. What kind of thing.

Andrew El-Khanagry: I [01:15:00] mean I’ll be completely honest. I’m not going to sit here and be like, I’ll do the the composite bonding and all this. I [01:15:05] probably it’s probably the general restorative case. So, you know, a patient would come in and they need [01:15:10] quadrant. Yeah. Like they need some sort of treatment. So like yeah quadrant or maybe a non [01:15:15] lay a few fillings scale and polish and then some whitening or something. [01:15:20] If, if.

Payman Langroudi: There’s whitening get in there.

Andrew El-Khanagry: Yeah. Whitening for me it’s the it’s the pathway into I [01:15:25] do I tend to do a reasonable whitening because it’s the pathway into any uh cosmetic [01:15:30] dentistry. So I personally don’t see any I know Linda [01:15:35] Greene was a big, big, big fan of whitening as well. We we it’s a pathway [01:15:40] to anything. So Uh, any treatment plan. I’ll try and discuss the shape of the teeth [01:15:45] and try and do the whitening as well. But. But normally it’s maybe an inlay on a heavily restored tooth or [01:15:50] two, some fillings and some Perry.

Payman Langroudi: Keep it simple.

Andrew El-Khanagry: Keep [01:15:55] it simple.

Payman Langroudi: How much does that treatment end up costing?

Andrew El-Khanagry: So if we’re saying what one [01:16:00] only one one filling some maybe like 1.2, [01:16:05] 1.3 K.

Payman Langroudi: And do you think that that that cost [01:16:10] part of it is actually the reason that, you know, like I don’t know, in your population, [01:16:15] most people who trust you have access to £1,200. [01:16:20] Hence that ends up being the treatment. Like I’m sure that’s a thing, man.

Andrew El-Khanagry: I mean, [01:16:25] 100%, 100% after when you work in a surgery for a while, you know what people [01:16:30] are happy to sign up for and what people aren’t. I mean, we had so [01:16:35] we had actually a prosthodontist specialist who came into one of my practice [01:16:40] and he came in wanting to do big 3040 [01:16:45] K treatment plans. Yeah, I think he came for quite a few months [01:16:50] and didn’t do one treatment plan because people weren’t going. He was, I think [01:16:55] he was driving up from South London and he didn’t do one treatment plan because that wasn’t [01:17:00] the demographic of the area. You know, and I think personally speaking, I’ve [01:17:05] done the bigger treatment plans as well. People need to trust you before you get to that [01:17:10] stage. So, you know, doing the fillings and the inlay, you’ve built rapport.

Payman Langroudi: People trust. [01:17:15]

Andrew El-Khanagry: Exactly. So it’s I’m not a specialist. I’m [01:17:20] just, you know, a young a young associate dentist. But for me, the pathway and also [01:17:25] you can gauge a patient if they’re a decent person, you want, you want to work on and [01:17:30] do the more complex things with is to do the small treatment plan, do a few things that need to be done and on [01:17:35] and on. The tooth that’s got a big filling or a few cracks, and then you can assess the patient, [01:17:40] see what they like and take it from there if they need.

Payman Langroudi: Do you say, do you say from the [01:17:45] let’s say it’s the first time you’re meeting a patient? Yeah. Do you. Quite early on say [01:17:50] this is green, green, amber red. Like as in stuff that needs doing immediately. [01:17:55] Stuff that’s nice to have and, like long term stuff. Do you say that quite quickly [01:18:00] or do you just start with the very basic stuff and then next year say something [01:18:05] about that?

Andrew El-Khanagry: It’s a really good question. I’ve done a bit of both, to be honest. I think [01:18:10] I think the best thing to do would be to to say everything from the start. So just [01:18:15] it’s difficult when when you’re an associate becoming [01:18:20] an associate in a practice and they’ve had a dentist for 20, 30 years and they’ve been coming [01:18:25] and saying, yeah, your teeth are fine, off you go. And then you’re coming in and be like, you’ve got all these problems. And then if [01:18:30] you’re going in too hard in that sense, you’ve got, for example, advanced wear [01:18:35] and you can see that, give it a few more years and they might need root canals or teeth. May devitalise. [01:18:40] It’s all they’ve got. Undiagnosed severe perio, you know. Grade four period or something. [01:18:45] And you’re coming in hard saying you’ve got this and this and this. We need to spend, you know, ten K sorting [01:18:50] everything out or else you can lose all your teeth. They won’t trust you. They’ll go somewhere else. So I think you need [01:18:55] to kind of like, gauge it a little bit on a patient by patient basis. So [01:19:00] with some I will I will explain, you know, you need a few things. And then in the future [01:19:05] there’s a crack here not only on this tooth. Another is if they need treatment. [01:19:10] You just got to be frank with them. You’ve had primary treatment and you’ve not had your [01:19:15] treatment in some some practices have gone to, you know, a [01:19:20] lot of the the older generation, they there’s just a lot [01:19:25] of undiagnosed Perrier and things going around. We’ve had to go in as new associates, for example, a dental practice [01:19:30] who’s been inherited by new associates. A lot of these patients, I feel like have [01:19:35] been you know, they’ve not they’ve not had treatment properly [01:19:40] done.

Payman Langroudi: Supervised neglect sort of thing.

Andrew El-Khanagry: Yeah. I’m always sceptical about, you know, saying things [01:19:45] badly you know.

Payman Langroudi: That’s what we’re talking here.

Andrew El-Khanagry: To be frank. Yeah, yeah, yeah. A lot of, you [01:19:50] know, stage four perio that’s not been treated. And you’re coming in as a as a young [01:19:55] new associate and.

Payman Langroudi: Having to to now break the news.

Andrew El-Khanagry: Break the news. But [01:20:00] then all you hear is, you know, they were the best dentists in the world. They because [01:20:05] they’ve known them for years and they have the best communication skills which, which, which that’s [01:20:10] probably the biggest lesson is that it taught me the importance of good communication, because you can be a pretty [01:20:15] bad dentist, but if you’ve got great communication skills, the patient will love you. But it’s [01:20:20] about marrying the two also being clinically good as well. So yeah, it’s it’s [01:20:25] so shocking to me being in private practice and seeing quite a lot of supervisors neglect [01:20:30] to a certain extent.

Payman Langroudi: Yeah. Listen, there’s always going to be good [01:20:35] and bad in every area, right? Whether it’s private or NHS. But you’re 100% [01:20:40] right. Insomuch as we deal in trust much more than most [01:20:45] professions. Much more, I think us and car mechanics. Yeah. [01:20:50] Deal in trust. Yeah.

Andrew El-Khanagry: Honestly? Yeah.

Payman Langroudi: And so then it comes down to [01:20:55] how can you accelerate trust so that you can, you know, get to those conversations [01:21:00] in time? Yeah. And people will be surprised, [01:21:05] man. I mean, the how clean your toilet is is [01:21:10] a big factor in, in in what a [01:21:15] good dentist you are. Yeah. And these days people are more on to it. But [01:21:20] the point is the patient has nowhere to check how good you are as a dentist. I mean, [01:21:25] Google reviews maybe, but even everyone’s on to the fact that they get managed.

Andrew El-Khanagry: 100%. [01:21:30]

Payman Langroudi: As well. Um, you know, it’s like you go to a restaurant with amazing [01:21:35] decor and then the food is awful. You know, the food’s awful because you’re eating it. Yeah. [01:21:40] But when you go to a dental practice, you have no idea whether you had amazing dentistry or poor [01:21:45] dentistry for a few years, right?

Andrew El-Khanagry: Yeah. Yeah. What do you think? What do you think you should do as [01:21:50] a as a young associate? How would you kind of accelerate trust? Yeah. Yeah. Deal with that. [01:21:55]

Payman Langroudi: I’m really. I’m really into the notion of number one. At the very beginning, before you’ve even met the patient. [01:22:00] Phoned the patient. Okay. Yeah. So you’ve got a patient coming in on Tuesday. New [01:22:05] patient. Phone the patient on Monday yourself. Okay. This [01:22:10] is, um, doctor. Your dentist calling? Yeah. Yeah. Yeah. Um, just want to know if there’s any questions [01:22:15] you want me to to ask me before you come for your first visit? That’s great. Yeah. [01:22:20] So? So sometimes there is. Yeah, sometimes, you know, that actually talks about [01:22:25] why now? Yeah. The why now is such a powerful thing. It is that that The guy [01:22:30] can literally in that moment tell you the why now? Yeah, but generally it’s just [01:22:35] a touch point here that wow, I’ve never had the dentist himself call me before. I’ve even visited the practice. [01:22:40] Yeah, it brings things.

Andrew El-Khanagry: Breaks the anxiety. Because the patient.

Payman Langroudi: Yeah.

Andrew El-Khanagry: The first time they’ve had any communication [01:22:45] with you is when they see you in clinic. But just giving them a call. At least they’ve talked to you on the phone. They know you’re [01:22:50] a normal human being because they build this picture up. You’re going to the dentist. But yeah, you know, we’re humans, and.

Payman Langroudi: If [01:22:55] we have so many new patients that that’s hard to do, that’s a great problem to have, right? Most don’t. [01:23:00] Right. Most. You could do this. Yeah. And then right at the end after it’s all over [01:23:05] that call. Yeah. Yeah. Or after any appointment where it’s even slightly a problem. [01:23:10] That call I used to outsource that second call to my nurse. Okay. Yeah. [01:23:15] Um, mainly because she loved it so much herself. Yeah. And I think how [01:23:20] much your nurse, how happy your nurses at work is such an important point to how happy you [01:23:25] are at work. Yeah. So when I noticed my nurse the next day saying Mrs. whatever was so happy that I called. [01:23:30] I just used to leave that to her, you know, and I always found with nurses, the good thing is to give [01:23:35] them more and more important jobs. Yeah. Yeah. So for instance, when I figured [01:23:40] a nurse, I used to teach a nurse shade taking and then tell her she’s better [01:23:45] at it than I am and then let her be the shade taker. Yeah. Yeah. That thing for [01:23:50] nurses is huge, right? Because now they’re really involved in the treatment itself. Yeah. [01:23:55] Um, but then with the patient, like you said, with private dentistry, man, painless private [01:24:00] dentistry is so important, man. So important. Like, [01:24:05] that’s the injection. Like painless. Um.

Andrew El-Khanagry: Completely painless.

Payman Langroudi: Completely painless. [01:24:10] The ten minute conversation that you mentioned. Yeah, I’d say that while [01:24:15] the topical is in place. Not after the injection, the topical for ten minutes, [01:24:20] then the injection or the topical for six minutes, then the injection, [01:24:25] then five more minutes of conversation after the injection until it goes numb. That’s [01:24:30] like 11 minutes of conversation. That conversation pays off. Pays [01:24:35] off not only not only for patient, but for you as well. You enjoy that conversation. Um, [01:24:40] those.

Andrew El-Khanagry: Are three very valuable lessons, you know, I’ll let you know. I’ll call them and I’ll let you know if [01:24:45] that. If that’s.

Payman Langroudi: Anything. It will, it will. The. You’ll see what I [01:24:50] mean. Um, and then, man, you know, what is the difference between great service and good service. [01:24:55] Yeah. We we have our event in Manchester at the Edwardian [01:25:00] Hotel. Yeah. And the people in this place, man, they are just amazing [01:25:05] every time we go there. Me and my team are like, these guys are just brilliant. [01:25:10] And you know, some they’ve done something in that place. Yeah. That people [01:25:15] constantly are trying to help. And whatever you say, they [01:25:20] make it happen without any drama at all. You know, like, you might ask for a burger [01:25:25] in this place, that this place doesn’t do a burger, but they’ll take it upon themselves to go to the other [01:25:30] restaurant and bring a burger here for you. Stuff like that, you know.

Andrew El-Khanagry: It’s the staff [01:25:35] training. I mean, it’s like if you go to a really nice hotel, I remember that was probably one of the first things they I [01:25:40] think the first year, my mentor year, I think one of the first questions they asked me like, tell me about [01:25:45] a holiday you went to, where you went to a great hotel. And what a [01:25:50] weird question. I answered it, I went to, you know, this and this place, and I was at this really nice hotel and [01:25:55] the service was amazing. They were like, this is what we’re trying to do in our dentistry. Yeah. And it really stuck with me. You know, [01:26:00] unfortunately, you know, I feel I feel guilty saying all this [01:26:05] when I know there’s a lot of my colleagues who are still in the NHS. And it’s really [01:26:10] hard to deliver that in the NHS system and trying to earn money.

Payman Langroudi: Yeah. Of course. Impossible. [01:26:15] So it’s possible to deliver it but not. And earn money.

Andrew El-Khanagry: Yeah. [01:26:20] And that’s and that’s the majority. The majority. So it’s it’s [01:26:25] difficult. It’s difficult for me saying all this and and it’s all well [01:26:30] and good, but it’s it’s really hard to put this into action if you’re working in NHS, you know, being in private, [01:26:35] I have the luxury where I can take the lessons you’ve taught me and put it straight into practice. [01:26:40] Yeah, but I always think about some of my colleagues in a similar position. They’ll be [01:26:45] listening to this and they’ll be like, well, it sounds great.

Payman Langroudi: Although although although in the [01:26:50] NHS you’re not so much selling trust.

Andrew El-Khanagry: Yeah.

Payman Langroudi: In private. Look, this is an interesting [01:26:55] question, right. When I, when you go to Starbucks, what are you buying my coffee. [01:27:00] No. You’re not buying coffee.

Andrew El-Khanagry: Oh you’re not okay.

Payman Langroudi: Because, look, the cost of a flat [01:27:05] bike, flat white in Starbucks is maybe, I don’t know, I haven’t done the sums. Shall [01:27:10] we just say 50 times the price of a Nescafé at home?

Andrew El-Khanagry: I see, okay.

Payman Langroudi: 50 times the price. [01:27:15] Like, how much is a cup of coffee at home? Like if. Yeah, I’m sure if you’ve got Nespresso [01:27:20] at home, Nespresso. It starts costing a bit more, but you know what I mean? Yeah. So is it 50 [01:27:25] times better coffee? No. At Starbucks, you’re buying convenience. [01:27:30] Maybe if it’s on your journey, you’re buying self-care. The most. I find the reason why I buy [01:27:35] this coffee from from that shop is this this little moment of me self self-soothing [01:27:40] myself, making doing something for me. Yeah. I mean, I can get the similar [01:27:45] coffee in my in my. But I just so there’s that there’s some [01:27:50] people use it as their office. Right. They literally go there and work there and you know. [01:27:55] Yeah. So there’s that side of it. Um, so by the time when you think about it, [01:28:00] when you’re buying a Starbucks, you’re buying all of those things. You’re buying convenience, self-care. It happens [01:28:05] to be coffee is the routine. That’s true. Yeah. Now, when you’re doing a crown, [01:28:10] what are you buying? What are you selling? What’s the patient buying? Yeah. [01:28:15] Most dentists start banging on about the zirconia. Yeah, but [01:28:20] the patient is actually buying an insurance product, right?

Andrew El-Khanagry: Investment long term on their teeth.

Payman Langroudi: Peace of mind. [01:28:25] Patients buying. Peace of mind. Yeah. And we all know it, right? We say if you don’t buy this crowd, [01:28:30] this awful thing will happen. You’ll break your tooth. And all the needs are in that if you don’t do, this, [01:28:35] terrible thing will happen. And we’re kind of good at that. But with the wants, [01:28:40] it’s a whole other thing, right? If you do whiten your teeth, you will be [01:28:45] confident. Yeah. Yeah. And and so that’s a that’s not a if you don’t something [01:28:50] terrible will happen. It’s that if you do something great will happen. Yeah. And it’s understanding [01:28:55] those things. Yeah. And in private dentistry we’re selling trust [01:29:00] first and foremost. It’s why it’s not like price sensitive. [01:29:05] Yeah. Like, if if you charge £1,400 for your crown, um, [01:29:10] and the next guy charges £700 for his crown, it doesn’t mean that you’ll do half the [01:29:15] number of crowns. Yeah. It doesn’t. It’s about if I trust you to 700, I’ll trust you [01:29:20] to 2900. You know, the trust is the key point. Um, in NHS [01:29:25] dentistry, it’s more access, isn’t it? Access?

Andrew El-Khanagry: That’s that’s [01:29:30] completely true. And and that’s how it felt it just. If that patient left, I’ll get another one through the door straight [01:29:35] away. Whereas in private, you really have to look after your patients. And it’s [01:29:40] all about the slow build up. They’ll they’ll tell their friends and family, yeah, I had this treatment. [01:29:45] They’ll bring them along. And it’s it’s rewarding in that sense because you’re building real relationships.

Payman Langroudi: Yeah. [01:29:50] You know, every time in any situation where there’s just another, another customer [01:29:55] waiting service tends to drop 100%. So I wouldn’t call it 100%. [01:30:00] I’d say 98% because, because, because there are there are some NHS places where they’re really doing managing [01:30:05] to pull it off. Um, and they’re pulling it off based on the private sales on the NHS [01:30:10] patients. And that’s that hybrid situation.

Andrew El-Khanagry: I’ve seen, I’ve seen those type of practices as well [01:30:15] where they will get they almost choose their patients to select getting in. Yeah, exactly. [01:30:20] And then the treatment will be private. Yeah, but the NHS would be the check would be NHS. Yeah. [01:30:25] It’s a it’s a different business model but.

Payman Langroudi: And a great one as well. Yeah. Because you can sell that practice [01:30:30] based on the NHS. Yeah. You can get finance based on the NHS contract. [01:30:35] Okay. What you’ll find is when we go we go to these things where we meet up with the corporates. A lot of the [01:30:40] corporates, the one I was telling you about 42 practices, they get all their finance based on the NHS [01:30:45] contract that they they buy. Banks don’t see that as a solid thing.

Andrew El-Khanagry: The [01:30:50] gas is sold in private. A lot of it depends on the dentist.

Payman Langroudi: Anything could happen. Yeah. [01:30:55] The marketing, the dentist, the area, the competition and all of that.

Andrew El-Khanagry: I’ve heard I’ve heard some [01:31:00] dentists. They will purposely work a lot more a few months before they sell it. Just so that. Yeah, on paper, it [01:31:05] looks like this is a whole field I have no idea about.

Payman Langroudi: Well, you’re on the other side of it. Yeah.

Andrew El-Khanagry: I’ve [01:31:10] heard the stories, so I know. Yeah. I can’t imagine how difficult it is buying a practice and all these [01:31:15] things. It’s a different a different, a different type of different stage in life, but.

Payman Langroudi: It can take a whole [01:31:20] year or so. The other important question is competition. Yeah. Like here we are, me and [01:31:25] you talking. Yeah. Someone is listening to this. Yeah. What is in competition [01:31:30] with this? Yeah. It’s a very important question. Yeah. Because I don’t think it’s [01:31:35] Jazz Gulati. Like, I don’t think there’s a guy sitting there thinking, I’m going to either [01:31:40] listen to jazz or I’m going to listen to pay. I think it’s like something totally different. [01:31:45] Like it could be. Are you listening on your drive? Someone else could watch TV instead [01:31:50] of listen to a podcast, right? And so the competition for your work as a private dentist [01:31:55] sometimes is nothing to do with dentistry. Like something totally different. You know, like it’s true. If it’s want stuff, [01:32:00] it might be, you know, a holiday or whatever, you know, flight to Sydney. Yeah. [01:32:05] Yeah.

Andrew El-Khanagry: And everyone’s got their own interests. Yeah. It’s it’s it’s completely different. I mean, I [01:32:10] personally, I would it just depends on, you know, sometimes. [01:32:15] And the good thing is I feel like you’ve all got your different niches, like, you know, jazz is very clinical, whereas.

Payman Langroudi: Is great. [01:32:20]

Andrew El-Khanagry: Whereas yours is, is more. I feel like I’ve learned a lot more about being a [01:32:25] dentist as a whole from from your podcast, because you get some incredible dentists [01:32:30] on who just I’ve learned so much about just life skills or how to deal with certain situations. So [01:32:35] as a young dentist, it’s it’s important to to hear that advice. And to [01:32:40] be honest, that’s one of those things I’ve come to appreciate again in this time of life is, you know, I [01:32:45] like I like to make I don’t like to make mistakes, but I used to hear a lot [01:32:50] of advice and disregard it until I made that mistake. And then I would be like, [01:32:55] okay, you know, I should have listened to the advice, but now I’m realising I don’t need to make that mistake. I can listen to someone [01:33:00] and, you know, if they’re older and they’re giving you the opinion, that’s probably they’ve been through [01:33:05] that themselves. So that’s probably a little bit of wisdom I’m starting to gain where I’m just trying to listen [01:33:10] to people’s opinions more and actually do it without being, you know, naive and thinking [01:33:15] I know best.

Payman Langroudi: The only thing in life is sometimes you have to learn the lesson before you. Yeah. Life [01:33:20] keeps on teaching you the lesson until you learn it as a bitch. Yeah, it is.

Andrew El-Khanagry: It is.

Payman Langroudi: It is. It’s [01:33:25] been a massive, massive pleasure having you, man. We’re going to end with the usual questions.

Andrew El-Khanagry: Okay.

Payman Langroudi: Fancy [01:33:30] dinner party? Three guests, dead or alive. Who you [01:33:35] having?

Andrew El-Khanagry: Um, so, I [01:33:40] mean, I wouldn’t. I’m not going to give you this answer because I don’t think you’ll accept it, but [01:33:45] probably I’d say first one has to be Jesus. But I probably won’t accept that.

Payman Langroudi: But why not Jesus 100%? [01:33:50]

Andrew El-Khanagry: I mean, Jesus is like, you know, a cop to Christian say that because to spend a [01:33:55] dinner party with him and ask, I’ve got a million questions to ask.

Payman Langroudi: I’ve got no problem with Jesus, Buddha and Muhammad. I’ve got a [01:34:00] problem when people say, my wife.

Andrew El-Khanagry: Well, no, no, I don’t have that problem yet, so I [01:34:05] can’t say that. Um, probably what?

Payman Langroudi: We’re on Jesus. While we’re on Jesus. I’ve had a revelation [01:34:10] of my own. I’ve been really, like, worried about does God exist or doesn’t God exist? Did [01:34:15] God? Did Jesus exist or didn’t? Did he or didn’t he? Yeah. That one. The belief point here. [01:34:20]

Andrew El-Khanagry: Yeah. Can I ask you a question? Yeah. Reply. I know you’ve told me before. You [01:34:25] know your wife’s Lebanese and she’s and she’s she’s Christian. What does she think about it is she is. She believes. [01:34:30] She believes. What conversations do you have together with her about about this topic?

Payman Langroudi: She takes [01:34:35] the kids to church. I’m like, you’re indoctrinating them?

Andrew El-Khanagry: Okay.

Payman Langroudi: Okay. Um. As a joke? [01:34:40] Yeah. Of course, of course. But the revelation I’ve had, it’s an interesting idea of not. [01:34:45] Is there a God or isn’t there a God? But the. Should there be a God question? [01:34:50] Yeah. Okay. Is is is one and almost like a should there be oversight? [01:34:55] Yeah. Is oversight. If we knew there was oversight, I mean, we could arrange it. By the way, [01:35:00] cameras everywhere. Yeah. That’s one point. And the other point is, you know, like I went to a Catholic [01:35:05] school. I know the Jesus story better than I know the the Muhammad story. Um, whether [01:35:10] or not Jesus existed. Yeah. The characteristics [01:35:15] of Jesus, that philosophy of Jesus on its own, stands up as [01:35:20] a as a beautiful thing. Yeah. So while here I am busy. Did he or didn’t he exist? [01:35:25] Yeah. Like, was he or wasn’t he the Son of God? Question [01:35:30] is really an irrelevant question because the the philosophy itself is the beautiful [01:35:35] thing that that we need to examine. Let’s be fair. Took me 45 years [01:35:40] to figure that one out.

Andrew El-Khanagry: It’s. Yeah. I mean, it’s true. I mean, [01:35:45] even even if you’re not religious, it’s it’s a good philosophy to to.

Payman Langroudi: To look.

Andrew El-Khanagry: At to look at and [01:35:50] it’s I listened to a podcast talking about religion. [01:35:55] Must have been a few weeks ago. And I think the guy I think the guy was religious, but he answered [01:36:00] it. He’s like, I would rather die being religious [01:36:05] and there not being a God, then die being not being [01:36:10] religious. And there is being there. There is a God. I don’t know if that’s a good reason, if that’s a [01:36:15] good reason, but that’s what it came down to in the end. Obviously, you know what? If I’m wrong, everyone’s [01:36:20] everyone’s got their own journey. And I also have had that thought. [01:36:25] You know, I was born into a Christian family.

Payman Langroudi: Um.

Andrew El-Khanagry: You know, if I, if I wasn’t born to Christian family, [01:36:30] would I be Christian? I don’t know, especially I don’t.

Payman Langroudi: Know from your part of the world [01:36:35] and my wife’s part of the world that that identity is so super important because Christians [01:36:40] have been in that area since year dot. And and the identity itself [01:36:45] is so key, you know.

Andrew El-Khanagry: Yeah, I mean, I’ve had [01:36:50] I’ve had my own kind of journey to get where I am. And obviously I choose to be Christian [01:36:55] because that’s the way I am.

Payman Langroudi: But you pray.

Andrew El-Khanagry: Yeah I do.

Payman Langroudi: Yeah, yeah. Outside of like, let’s say [01:37:00] the Lord’s Prayer. Like, what do you pray for?

Andrew El-Khanagry: Um.

Payman Langroudi: You don’t have to answer it, [01:37:05] by the way.

Andrew El-Khanagry: That’s right. It’s IV. Anything that comes to mind [01:37:10] for me, prayer is like a conversation. So I, I guess it’s a bit of [01:37:15] a monologue, but sometimes I feel like I get an answer in some, in some form.

Payman Langroudi: So is it more like you’re [01:37:20] reporting back? You’re saying I had a good day?

Andrew El-Khanagry: No, not a report, a conversation. Like like, [01:37:25] you know, when, you know, I’ve. This has happened my day. You know, I’m not sure about this or this, [01:37:30] you know, hope hopefully.

Payman Langroudi: It works out.

Andrew El-Khanagry: Hopefully it works out. Hope, hope I can get some guidance on this or, you know, [01:37:35] or or certain things happen that day and you want to get it off your chest. So [01:37:40] there is a certain element of, um, meditation to it, but [01:37:45] it’s not like a, like a strict formal thing, even though Orthodox is quite a [01:37:50] strict formal, you know, prayer, especially when you go to church. For me, prayer [01:37:55] is like a conversation and I just get everything off my chest. And, [01:38:00] you know, personally, I feel like sometimes they get answers in some form or another, but [01:38:05] that’s the best way I could say what my prayers are like. I was like, I guess, like me and you, except, [01:38:10] you know, God’s out there giving me answers in some form rather than they’d be directly [01:38:15] talking back.

Payman Langroudi: And when was your faith most tested?

Andrew El-Khanagry: Oh. [01:38:20] I had a period in [01:38:25] dental school where one of my good mates, [01:38:30] he was born into a Christian family, and he then decided [01:38:35] to leave Christianity. Leave, you know, leave everything and just [01:38:40] explore different religions and ended up being, you know, an atheist. And to be honest, [01:38:45] I had a lot of self-reflection that period, because me and him had a lot of in-depth conversations [01:38:50] about, you know, he’s a very simple person, born into very strict Christian family. Um, [01:38:55] and, you know, that’s what he’s done all his life. And the reasons why he’s decided [01:39:00] to leave Christianity. You know, he makes a lot of valid points. You know, there’s a lot of [01:39:05] valid reasons why you might not be a Christian. And to be honest, at the end of the day, we came to a point [01:39:10] where we, um, we we came to the conclusion where [01:39:15] it’s just a spiritual thing, where at times he felt like he was [01:39:20] spiritually connected in some form. And then at that point now he’s kind of felt [01:39:25] like he’s he’s not. And there is no there is no kind of scientific [01:39:30] reason to there being a god. There’s a lot of kind of theological conversations. [01:39:35]

Payman Langroudi: We’re not talking scientifically, but did it test your own faith when he was going through?

Andrew El-Khanagry: 100%? [01:39:40] Yeah. Yeah.

Payman Langroudi: Because you started taking his points on. Well.

Andrew El-Khanagry: I’m not I’m. My parents [01:39:45] aren’t indoctrinating me. I’m free to do what I want. And if I don’t want to be Christian, I don’t have to be. Um.

Payman Langroudi: What [01:39:50] about what about in the like in the in the plight of people like in the charity, you see, like [01:39:55] you must have seen or heard some terrible stories. Do stories. Do not reflect on why does God let [01:40:00] that even happen? Sort of.

Andrew El-Khanagry: Yeah.

Payman Langroudi: That method of.

Andrew El-Khanagry: Yeah, definitely. Of course you do. Of course you do. But [01:40:05] for every answer you. A lot of people have said to me, you know, I don’t know how you do it. I don’t know how [01:40:10] you go to these missions and see all these things, but I’ve seen a lot more beautiful things come out of these missions, [01:40:15] and I’ve had a lot more incredible, even religious conversations [01:40:20] with some of these people who’ve said to me, you know, I was praying about someone coming and [01:40:25] I needed someone to be there. And you’ve come out of nowhere and you’ve got me out of pain. So [01:40:30] if anything, I feel like, you know, a lot of people go, you know, I think it’s great to [01:40:35] go strengthened. Yeah, it’s a great thing to go on these missions anyway and help people. But for me personally, it does strengthen [01:40:40] my, my faith and and my religion. And, you know, in [01:40:45] that in that sense of my relationship with, with Jesus and God. So it’s yeah, for me it’s [01:40:50] a good it’s actually a positive. Yeah, yeah.

Payman Langroudi: Second guest we’ve got Jesus.

Andrew El-Khanagry: Oh, [01:40:55] gosh. I forgot the question. Um, probably my granddad, um, he’s passed away [01:41:00] and he’s for me. He’s always been like a hero of mine. He’s, uh. He’s the first role. That’s [01:41:05] my mum’s dad. I never met my dad’s dad, but my mum’s dad, he from a I remember literally holding [01:41:10] his hand as a young age. And he’d be taking me around the streets of Cairo.

Payman Langroudi: Is this the businessman? Who?

Andrew El-Khanagry: Businessman? Yeah, he [01:41:15] used to own, like, a big rubber factory in Egypt. And he’d do, like, the rubber, uh, frames [01:41:20] on all the doors and like, all the mercs, BMWs. You just do that rubber kind of frame. Just a little, little [01:41:25] thing.

Payman Langroudi: What things people do, right?

Andrew El-Khanagry: Little thing. But again, massive, massive rubber business. Yeah, yeah. Um, [01:41:30] plastic business. So yeah, he. Yeah, he just lived in Lockerbie to help loads of people. And he was my [01:41:35] first kind of exposure to that, kind of that kind of.

Payman Langroudi: How old were you when he passed away?

Andrew El-Khanagry: Oh, he only passed away like 4 [01:41:40] or 5 years ago. Oh, I’m sorry, but he he passed away just as we were starting the charity stuff. So [01:41:45] it would have been good for him to kind of. It would be obviously we’re nowhere near where we can be, but it [01:41:50] would be good to kind of it’d be nice to have seen where where we’re at now and have that conversation and see [01:41:55] what advice he can give and from his own experience. Um, and then.

Payman Langroudi: It’s nice [01:42:00] it’s nice to hear that you have like, a story of, like an industrialist who’s kind. [01:42:05] Yeah. Because almost the archetype is you’ve got to be a bastard to be in business. [01:42:10] You know, this sort of weird things that, that, that narratives that, that we hear.

Andrew El-Khanagry: And [01:42:15] he had that side of him. He was, you know, he was pretty. I’ve heard some stories where he.

Payman Langroudi: Had.

Andrew El-Khanagry: The hard [01:42:20] time. Yeah, he had the hard side. But, you know, you have I think you have to be if you’re in business, you have to have [01:42:25] both elements. You can’t. You’re never going to progress if you don’t have that kind of side to you as well. [01:42:30]

Payman Langroudi: I don’t know about that.

Andrew El-Khanagry: I’m not sure you do. I mean, I’m happy. Yeah, I’m not sure.

Payman Langroudi: I don’t know.

Andrew El-Khanagry: It’s [01:42:35] difficult to negotiate. I don’t, but he had that side to him. And, [01:42:40] you know, I’ve heard stories, but of some really high people in Parliament try and do some [01:42:45] things to him. Egypt’s a bit. There’s a bit more corruption in Egypt. So yeah. And when you see successful businessmen, a [01:42:50] lot of government trying to impose a lot of things on you, which basically [01:42:55] try and take money from you. Really. So you have to have that almost.

Payman Langroudi: My Egyptian friend [01:43:00] was saying the road. The road from Cairo to wherever it was has been resurfaced four times in the last four [01:43:05] years because of some corruption scandal, some.

Andrew El-Khanagry: Contract deal they have with the company, I’m sure. Yeah, [01:43:10] a lot of corruption. Um, and.

Payman Langroudi: The third person.

Andrew El-Khanagry: So the third person [01:43:15] I’m really fascinated with, like ancient Egyptology and things like that. Oh, yeah. I love going [01:43:20] to temples and seeing all that kind of stuff. So probably like, uh, like Ramses the second or Khufu [01:43:25] or something, like some sort of Egyptian pharaoh and asking them, you know, how did you build the pyramids? [01:43:30]

Payman Langroudi: Yeah, yeah, yeah, yeah. Have you seen this new stuff about it going under for two kilometres?

Andrew El-Khanagry: I’ve read. I’m not [01:43:35] sure if it’s fake. I think.

Payman Langroudi: It’s fake news.

Andrew El-Khanagry: But. But yeah, it’s.

Payman Langroudi: That would be a good one.

Andrew El-Khanagry: It would be a good story. It would be a good story. [01:43:40] But yeah. No, that probably might be my three random guests. Really amazing.

Payman Langroudi: Amazing. [01:43:45] And the final question is deathbed. I know it’s a bit early for you, but deathbed. Three pieces [01:43:50] of advice for your friends and family.

Andrew El-Khanagry: Um, so probably first [01:43:55] bit of advice. Take people’s advice from early on. Um, [01:44:00] you don’t have to go through the problem yourself and do the mistake yourself. Just, [01:44:05] just, you know, listen to the advice and take it on. Uh, second thing [01:44:10] is. Don’t let the little things [01:44:15] kind of keep you up at night. You know, I’m quite in my [01:44:20] dentistry, in my life in general. I’m very much a perfectionist. And, um, [01:44:25] that can impact me sometimes. So, you know, just letting [01:44:30] things go and knowing what’s worth worrying about or not. And [01:44:35] third bit of advice. Just, I [01:44:40] guess, I guess just have understand the importance of keeping your, your family and friends close, [01:44:45] you know. For me again, that’s Well, most of my enjoyment comes [01:44:50] is from my family and friends, and most of my happiness is so having having them around [01:44:55] and uh, and relying on them when the, when the [01:45:00] going gets tough. It’s important as well. So that’s.

Payman Langroudi: Good advice. Yeah. But you know, you answered that. Well [01:45:05] most people answer that question. And this is the way I am. This is the way I am. This is who [01:45:10] I am. So you should be too. But your first two responses were kind of I wish I was more like this, [01:45:15] I wish I was more like that. Yeah, which is a good way of answering that question. I’m just.

Andrew El-Khanagry: Learning. Yeah.

Payman Langroudi: Yeah. [01:45:20] No, but you know what it is that in you’ll find like, I don’t know if you think back to a friend [01:45:25] you have from childhood. Yeah. And if you’re thinking of him, you’re thinking what’s his biggest [01:45:30] strength? That guy. And it might be he’s a perfectionist. Yeah. And then if you really [01:45:35] look at his life. Yeah. And you figure out what’s his biggest weakness ends up being [01:45:40] he’s a perfectionist. Your biggest strength does end up being your biggest weakness. You know, [01:45:45] like on that one. It’s great to be a perfectionist, but you don’t trust anyone to. You [01:45:50] can’t delegate. You know, things like that. Um, life is like that. It’s been a pleasure [01:45:55] having you, man. It’s been a pleasure.

Andrew El-Khanagry: Honestly.

Payman Langroudi: Thank you so much for coming all the way as well. Driving all that way.

Andrew El-Khanagry: No, no. Thank you.

Payman Langroudi: Good [01:46:00] to have.

Andrew El-Khanagry: You. Thank you very much.

[VOICE]: This is Dental [01:46:05] Leaders, the podcast where you get to go one on one with emerging leaders [01:46:10] in dentistry. Your hosts, [01:46:15] Payman Langroudi and Prav Solanki.

Prav Solanki: Thanks for listening, [01:46:20] guys. If you got this far, you must have listened to the whole thing. And just a huge thank you [01:46:25] both from me and pay for actually sticking through and listening to what we had to say and what our guest [01:46:30] has had to say, because I’m assuming you got some value out of it.

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