Payman Langroudi: This podcast comes to you from Enlighten Enlightens, an advanced teeth whitening system [00:00:05] that guarantees results on every single patient. We’ve treated hundreds of thousands of patients [00:00:10] now and have a really clear understanding of what it takes to get every patient to that delighted [00:00:15] state that we want to get to. If you want to understand teeth whitening in much further detail, join [00:00:20] us for online training only takes an hour completely free. Even if you never use [00:00:25] enlighten as a whitening system, you’ll learn loads and loads about whitening, how to talk about it, [00:00:30] how to involve your teams. Join us enlighten online training comm.

[VOICE]: This [00:00:35] is Dental Leaders. The [00:00:40] podcast where you get to go one on one with emerging [00:00:45] leaders in dentistry. Your [00:00:50] hosts Payman, Langroudi and Prav Solanki.

Richard Porter: Feelings [00:00:55] are the currency of human existence. And so when somebody comes [00:01:00] into a learning environment or a patient turns up to or I come to your podcast, I have feelings. And [00:01:05] if you can understand how those feelings are and you can empathise with [00:01:10] that person, you can create the most optimal outcome for them. And so I’m very [00:01:15] into the soft skills side of things. Um, I do think you need to be able to do dentistry. [00:01:20] I don’t know about you what your experience was. Can I ask you a question before we even get really into it? Rate [00:01:25] your dental school experience out of ten with you. Bear in mind all [00:01:30] of your amazing knowledge, skills, experience, incredible setup.

Payman Langroudi: I [00:01:35] mean, I like to separate that into, you know, the educational side and the, you know, because I had the best [00:01:40] five years of my life. A lot.

Richard Porter: Of you had fun.

Payman Langroudi: And a lot of people don’t. I’ve noticed that. I thought everyone [00:01:45] had that, but but a lot of people find that some of the hardest times of their life. Yeah, I didn’t realise [00:01:50] that. But from the educational perspective, one benefit I had was I did [00:01:55] in Kent.

Richard Porter: Okay.

Payman Langroudi: And, uh, all [00:02:00] the groups were made up of everyone from the three London schools back then. [00:02:05] Okay. And me and you could see from the different subjects that were coming up, the things that we were taught [00:02:10] better than them. And then there were quite a few things that they were taught better than, better than [00:02:15] we were in Cardiff. I was in Cardiff, I guess.

Richard Porter: I guess the question is when someone spat out of dental school, are [00:02:20] are they have we treated them fairly? Are they, are they competent to not [00:02:25] quite stand alone, but very nearly stand alone and face all the trials and tribulations of being a GDP? I’m [00:02:30] not convinced.

Payman Langroudi: No, of course not.

Richard Porter: I’m not convinced. So I’m not sure.

Payman Langroudi: It’s a very minimum. Right. [00:02:35]

Richard Porter: Yeah. And I yeah, I was one of those who I didn’t like dental school in year one at [00:02:40] all. And I was in London and I just everyone was just so rude.

Payman Langroudi: Guys.

Richard Porter: Guys [00:02:45] back in. Yeah. Old school guys. I don’t know what I’m doing with my hand there, but something like that. [00:02:50]

Payman Langroudi: Wolfson House.

Richard Porter: Floor 14. Wolfson house.

Payman Langroudi: You. This [00:02:55] is a.

Richard Porter: Man who’s.

Payman Langroudi: Travelled. My brother. Yeah. Oh. Did he? Yeah. Okay.

Richard Porter: Yeah. [00:03:00] So? So I was at, uh. Guys. Yeah. And I thought when I went there, everyone [00:03:05] seemed more confident. Everyone seemed so sure of themselves. Everyone seems so certain [00:03:10] about their purpose, direction, what the right social behaviour was. And I just found not [00:03:15] the students so much. But like London’s this busy [00:03:20] cold. It has a million people in London. But it’s easy to feel lonely [00:03:25] in London.

Payman Langroudi: Where had you grown up?

Richard Porter: In rural Kent, in a village in Kent. Very [00:03:30] simple place.

Payman Langroudi: Which one was.

Richard Porter: Your, uh. So if you’ve heard. If you’ve heard of the village, I’m going to buy [00:03:35] you a horse. Uh, it’s a village called Hunton. The nearest town is Maidstone. And, [00:03:40] you know, I went through a a very simple education system. Nothing posh, nothing fancy. [00:03:45] And, uh, I, I loved school, and I loved [00:03:50] being around other people who said please and thank [00:03:55] you. It’s that important. It felt important. And you come to London and it was. I guess it’s just the [00:04:00] big bad city. And maybe it just toughened me up a little bit. But year one, I found it very.

Payman Langroudi: And then year [00:04:05] two, three. Four, five. Did you enjoy it much more?

Richard Porter: Do you know, I. I don’t know about you. You [00:04:10] know what’s important to you with your your education. I found it, I found [00:04:15] it difficult to. I don’t know if we’d talk about personality psychology today, [00:04:20] but I study personality psychology a lot. And if you were to, I can show you my scores. And one of my scores [00:04:25] relates to who I like in terms of authority. And I’m very, very selective [00:04:30] over who will have authority over me. I’m very choosy and I’m very judgemental on that. I can’t I’m [00:04:35] not saying it’s a bad thing, it’s just and I found it difficult to be inspired. Mhm. And [00:04:40] then I remember sitting there thinking I’m here to dental school and someone’s saying this [00:04:45] is foramen of Ali and this is Kreb’s cycle. And, and [00:04:50] I remember thinking am I in the wrong room? You know, fatty acid synthesis. How [00:04:55] many times have you used it in your career? No no no no, I’m on a zero as well. I know it’s important. [00:05:00] I know it’s really.

Payman Langroudi: If you were the king of dentistry and you could change the course because the course doesn’t [00:05:05] change. This is one thing. I mean, I know it’s changed, but it’s just [00:05:10] in our little world of bleaching. Yeah, it was illegal. So that was the reason they [00:05:15] weren’t teaching it. But it’s been legal. Fully legal now for 13 years.

Richard Porter: Yeah. [00:05:20]

Payman Langroudi: And they’re still not teaching it.

Richard Porter: Is that right?

Payman Langroudi: Yeah. They’re teaching internal whitening. That’s [00:05:25] still on the course. There’s half an hour or something on internal whitening. But but bleaching, which is, you know, [00:05:30] fully legal. And the thing that everyone wants the most in practice isn’t taught in dental school.

Richard Porter: And how does [00:05:35] it make you feel as someone who’s right in the middle of it?

Payman Langroudi: Well, it’s ridiculous. It makes [00:05:40] me realise that things don’t change. Things don’t change much in dental school. So if you could change [00:05:45] them, what would you change? I mean, what would we take out? Because once you take out that kreb’s cycle bit. [00:05:50] Some guy who later on goes on to become a max factor doesn’t know that and [00:05:55] doesn’t become an oral medicine guy. True, but you could. There’s lots of things we don’t teach. [00:06:00] So what would you do?

Richard Porter: You know. I mean, what a question. I, I think I look [00:06:05] at first of all, I think you have to the outcome has to be the outcome for me has [00:06:10] to be patients get better care. So if we do root cause analysis from that, if you’re going to get a patient getting better [00:06:15] care, you can’t say I’m going to capture 100%, but most of them. So if we’re going to do that then you [00:06:20] need good dentists. So the question then is what makes a good dentist. [00:06:25] And to make a good dentist I would really break that into six [00:06:30] big areas. And we’ve got to give them the knowledge and clinical skill set that’s most applicable [00:06:35] to them. And that would definitely include bleaching. I definitely include bleaching. And if [00:06:40] we say I mean you could almost do a like for like you could say if you need the knowledge and clinical skill set, [00:06:45] do you need to spend ages learning Krebs cycle, or how to give an ID block as painlessly [00:06:50] and as comfortably as comfortably as something like that can be. I would compare those two and say if it’s one [00:06:55] or the other, it’s a very easy choice because I have delegates who come onto our courses and we talk to [00:07:00] them.

Richard Porter: You know, if there’s a group of 20, I’ll say, let one of you in this room is nervous about every single ID block, and you’re [00:07:05] running at 50% success and failure. I know you are, because I was one of them, and I was nervous [00:07:10] every time I had to give an ID block the night before. And if that’s you, come and talk to me [00:07:15] and we will sort that out. Let’s take that little anxiety away. So so I would be very selective on knowledge and clinical [00:07:20] skill set. They, I think they I think the second thing you need is time. [00:07:25] And I would say to them this this means you’re going to need to allocate this much time to do [00:07:30] your job this well. And people say really well. So one of the great [00:07:35] people I had admired, I admired, who was a colleague of mine at Saint George’s, is Henry Marsh, one of the world’s [00:07:40] most famous neurosurgeons, and he wrote a couple of incredible books. I wish I brought you one And [00:07:45] imagine Henry is going to cut a tumour out of your brain. And he says it’ll [00:07:50] take me eight hours, Payman. And you go, no, no, no, mate, you got three and a half years, [00:07:55] you know, and as a patient you would find that abhorrent.

Richard Porter: It’s just no [00:08:00] way it’s going to happen. So you need knowledge and clinical skill set. You need time. You need the [00:08:05] right equipment and materials. You know, and I’ve seen I worked in a practice where the light cure was like [00:08:10] a little blue candle out of Oliver Twist. You know, it didn’t do anything. Um, [00:08:15] you need tactical emotional intelligence, which I’m very [00:08:20] big on. And that’s a soft skill thing you and I are talking about. You need to understand that feelings are the currency of [00:08:25] human existence and the currency of Dental experience, and you really need to build that up. You need [00:08:30] systems in delivery, and you need to build a good team around it. So you need those six things and if you can do that. So I would build a [00:08:35] curriculum around those and anything that didn’t fit in that curriculum or like we keep [00:08:40] talking about Krebs cycle. But I would add that as a bolt on if you chose to diverge your career towards max factor or [00:08:45] something with a more medical slant. That’s what I would do.

Payman Langroudi: So look, do [00:08:50] you recognise what I’m saying when I say that sometimes the knowledge itself isn’t [00:08:55] enough? Insomuch as I know if I wanted to look like you, big [00:09:00] arms. I needed to go to the gym every day and not eat crap. Right. But. But I’m not doing [00:09:05] that. Yeah. So the sort of the mindset to change that [00:09:10] change behaviour change, you know, it should be behaviour change should be like for hygiene, it should [00:09:15] be like a third of their course. Right. Because you know.

Richard Porter: I, I [00:09:20] could have say more.

Payman Langroudi: Yeah, yeah.

Richard Porter: Do you mind if we dwell on that example. So. So I’m [00:09:25] supposedly a specialist as well. But the I work with a hygienist who’s very [00:09:30] good at getting people to change their behaviour. Mhm. And I [00:09:35] would make the case that if someone has perio the mainstay is to remove [00:09:40] the bacterial insult. Yeah. You can change the host response and you can modulate their immune system and things like that. But it’s [00:09:45] to remove the plaque insult to their body. How often does that [00:09:50] need to be done every day. So you’re talking specifically about behaviour change. So I think perio [00:09:55] is primarily treated with psychology. I don’t think it’s treated with modified widman flaps [00:10:00] and debridement. I think it is if you can take someone and say, right, motivate. So you and I talk about [00:10:05] motivation there and dental schools have motivation, but the motivation [00:10:10] might be to sit still and do nothing. It might be protective over a sense of ego [00:10:15] or tradition or conformity or rules and regulations from [00:10:20] an external source. I don’t know, but they are certainly motivated. You and I are motivated [00:10:25] right now to sit down. If someone sits at home and watches TV and eats cookies, [00:10:30] they are motivated. If you go to the gym, you’re motivated. It’s [00:10:35] stimulus and response. Everything is stimulus and response.

Payman Langroudi: So with that in mind, [00:10:40] do you? I mean, I watched a piece that [00:10:45] you did that you were walking in the countryside talking about this.

Richard Porter: The motivations of big subjects.

Payman Langroudi: And I [00:10:50] found it very excellent. I found it brilliant. Thanks. Because because I really did think there was motivated [00:10:55] people in one, one side of the room, and [00:11:00] then unmotivated people on the other side of the room. And it made a very nice thing that we’re all motivated, but [00:11:05] we’re motivated in different directions. We are it’s useful, it’s a useful.

Richard Porter: And [00:11:10] and some motivations come with social reward and academic reward and financial reward and other ones [00:11:15] come with other rewards. And yeah, I mean, to break that down, we I would think of [00:11:20] motivation as a mixture of internal and external. External [00:11:25] is really, you know, fame, accolades, status, applause. [00:11:30] The more your.

Payman Langroudi: Ego kind of.

Richard Porter: Yeah, yeah. And acquisition of trinkets, [00:11:35] you know, posh watches and Birkin bags. I’ve found out. Or a thing. And if you if you [00:11:40] if you’re motivated externally, then the external world has control over [00:11:45] the volume on your motivation centre. And it’s and you’re going to be in a reactive state and then internal [00:11:50] motivation which is beautiful. Motivation is based around curiosity purpose and passion. [00:11:55] And that is your self reinforcing rocket fuel to become whatever you [00:12:00] want to be. But it starts with curiosity and everyone needs a bit of that. Like we’re doing your podcast now [00:12:05] and I’m not. I try and be very internally motivated, but people’s opinions [00:12:10] of me matter to me. What you think of me matters to me. And what your audience will think is is [00:12:15] important to me. So no one’s immune to it.

Payman Langroudi: No completely.

Richard Porter: Only psychopaths genuinely [00:12:20] are entirely internally motivated. Other people’s opinions of them are irrelevant. [00:12:25]

Payman Langroudi: Oh, interesting.

Richard Porter: So I’m definitely not one of them.

Payman Langroudi: Yeah yeah yeah yeah yeah.

Richard Porter: Yeah.

Payman Langroudi: Yeah. So, so in the, [00:12:30] in the sort of self-development realm. Yeah. Do you, Were [00:12:35] you someone who wasn’t so motivated in that sense and [00:12:40] now are like, where did that journey start for you?

Richard Porter: You know, I, I’m not trying to be falsely [00:12:45] modest. It’s just luck. Payman. It’s who you meet. And if you meet people, I mean, I’m lucky to [00:12:50] be here, but if you meet people who inspire you and teach you and you can connect with them, [00:12:55] I think you get ideas. And and I’ve been incredibly lucky to [00:13:00] meet people on the way who I found inspiring. And I’m always [00:13:05] shocked if you ask someone for help who’s in a position above you? [00:13:10] Yeah. How willing people are to help you. It just it’s just incredible. That’s why I love [00:13:15] humans. I think we’re awesome. And and people will help. And so [00:13:20] I was always motivated. Not always for the best things in life. [00:13:25] None of us are perfect. I’ve got as many flaws as anyone. And I have plenty [00:13:30] of dental school. And I’ve got enough points on my license now to prove I’m. But [00:13:35] I. I started studying psychology. The reason I started studying how people think and [00:13:40] feel was I recognised that every single patient, even at dental school, like we were sitting on the [00:13:45] floor and someone would come in and no matter what you did, they wouldn’t be happy with their denture. And [00:13:50] that can’t be that. It’s just not technically made. Well, it has [00:13:55] to be something internal.

Richard Porter: And I’ll tell you another brief story. I was walking through. One [00:14:00] of the pieces of architecture is in, um, the cloisters at Gloucester [00:14:05] Cathedral, where they filmed quite a lot of the Harry Potter scenes. And there’s a time of day [00:14:10] you can go there, and a time of year when the sunlight is literally golden and the stained [00:14:15] glass windows come through this light. And no matter who you are, you walk through [00:14:20] there and you go, this is just there’s a there’s a feeling, and it makes the hair on the back [00:14:25] of your neck stand up. You can feel it. And that is light and stone. It [00:14:30] is light and stone because it’s glass. And and I had this thought. Yeah, I just think like [00:14:35] so you’ll see it a million times on Instagram. The first thing you give a patient is a mirror. [00:14:40] Once you’ve done their rehab I see people doing this all the time. Light comes from the ceiling, comes from the windows. [00:14:45] It hits the stone. It hits the mirror. Just photons of light. It [00:14:50] goes through that little hole in their eyes, their pupils. And what does it turn into? Feelings [00:14:55] and emotions. So light and stone equals emotions. And I [00:15:00] just got captivated by this idea. And that’s.

Payman Langroudi: Beautiful.

Richard Porter: Man. Well I, well [00:15:05] I’ve been.

Payman Langroudi: I.

Richard Porter: I’ve been on the receiving end of you put it up [00:15:10] and you’re thinking, I’m not sure that light and stone is going to create the right feelings. And the patient goes, is this a joke? You [00:15:15] know, and you go, no, no, no, this is just a giant. But but it’s it’s that. And [00:15:20] again, it proves the point. Feelings are the currency of our existence. And you know, what you want on [00:15:25] Instagram is that moment where everyone claps and it’s like, oh my God, I’m crying. And so light. Light [00:15:30] is emotion. And I got interested in that. So I started studying that [00:15:35] with fever. Fever and energy. And that led me to meet loads of other inspiring [00:15:40] psychologists. So people who understand human motivation and [00:15:45] understand concepts like future self orientation rather than being in a reactive state which [00:15:50] could expand.

Payman Langroudi: Expand on that.

Richard Porter: I can rant.

Payman Langroudi: All day how I want to be when I’m 70.

Richard Porter: Do [00:15:55] you know, do you know? So that’s that’s I mean, that’s a, that’s a that’s a big stretch. If [00:16:00] you think about your. First of all, let me make the case [00:16:05] that your, your brain doesn’t care that you’re happy. It cares that you’re alive. [00:16:10] It’s predisposed to make you worried and miserable for a number [00:16:15] of reasons. Because if you and I are walking through the woods a thousand years ago and I’m happy go lucky, [00:16:20] and like the rustling of the side is probably nothing. And you go, which I think is danger, you [00:16:25] leg it and I don’t, I get eaten. So all that genetic code saying, don’t worry about it, it’s dead. It’s all inside [00:16:30] animals, whereas yours is alive. So now we have this group of people on Earth called humans, and we’re predisposed [00:16:35] to worry and anxiety and negative emotions. And it’s not a bad thing. It keeps us safe. So [00:16:40] we have that. We then have concepts of good emotions, [00:16:45] happiness, joy, fulfilment. But they all have to be earned and you [00:16:50] really do have to earn them apart from pleasure, which is, you know, we will [00:16:55] reach for our phones far too much. So we’ve got positive and negative emotion. And [00:17:00] if you have a terrible [00:17:05] life to date, like imagine you were unloved as a child, perhaps, and [00:17:10] you grew up in poverty and you were worried about food and you were worried about X, Y, and Z.

Richard Porter: But from this moment [00:17:15] on, you are now feeling connected, loved, opulent, full of hope, [00:17:20] opportunities and freedom for the rest of your life right now, in the moment. How do [00:17:25] you feel? I bet you feel quite good. So people don’t. They think their past [00:17:30] defines them. It’s not your past. It’s actually your future. Because your brain isn’t a happiness [00:17:35] machine. It’s a prediction machine. And it is making predictions for the very near [00:17:40] the mid and the long term future. And the more good predictions it can make, the better you feel in the [00:17:45] moment. If I switch that around and let’s say you had a wonderful childhood, loving family, [00:17:50] incredible educational opportunities, abundant food, travel opportunities, all [00:17:55] of that. Now it stops. Now you’re living in a skip, eating out of second hand crisp [00:18:00] packets. You’re alone, cold, worried. How do you feel in the moment? Don’t tell me your [00:18:05] past defines you. Because it doesn’t. It’s your future. So conceptually, what I [00:18:10] encourage dentists to do, people to do, anyone to do is to say there’s two things we really, really [00:18:15] need. We need clarity on our future like and that clarity on our future. [00:18:20] I would call your identity. It’s who Payman is going to become. It’s who Rich is going to become.

Richard Porter: And [00:18:25] then we need crystal clarity on it and then emotional attachment to it. [00:18:30] So if you can create a future. I know we’re on camera here, but if you imagine there’s a compass 360 [00:18:35] degrees and I can move in that direction, one particular direction, but I’m not emotionally attached [00:18:40] to it and it’s not clear. I’m just a leaf blowing in the wind. And we’ll be reactive, you know, and [00:18:45] I’ll get an invite to this and then a nasty patient, and then something happens and then my staff leave me and, you know, X, Y [00:18:50] and Z, you’re entirely reactive. If I then focus that down and I think that’s my future [00:18:55] that over there. Oh my God, I love that. Every little step [00:19:00] feels amazing. Every. You don’t even need to reach it. So what we need is [00:19:05] a future we love that we’re crystal clear about and to take steps towards it. And that’s how we get to feel good in the moment. [00:19:10] And to answer your earlier question, were there times in my life I wasn’t as motivated? I didn’t have a clear future, [00:19:15] and it’s a blessing to be able to do that because and [00:19:20] you can measure the personality characteristics that enable us to do this, but being able to think and [00:19:25] lay out a future you love for a given time period, you talk about 70, [00:19:30] but let’s say six months or let’s say next week, or let’s say two years, and [00:19:35] you can lay out a future.

Richard Porter: So it might be spending more time with your parents. It might be, you know, we did [00:19:40] it for someone recently and they just said, like I said, what do you want your average Tuesday to be like? Just tell me. And [00:19:45] they give wishy washy answers. And I said, well, tell me about your parents. Well, my mom’s alone. And I said, [00:19:50] well, how often do you see your mom? Once every month. Would you like to do that more often? Yeah, yeah I would. I said, [00:19:55] well, tell me a dream. It’s like, well, I want to have lunch with my mom every Tuesday from 11 till [00:20:00] three. And I said, okay, how do you feel when you think about that? And they’re like, I like that [00:20:05] a lot. Like they smile. I like it a lot. Well, let’s help you build a life where that’s real. Let’s [00:20:10] let’s just create it and that positive motion comes your way. So I’m very into [00:20:15] creating sense of identity. Um, we start with personality on that [00:20:20] personality side, so people can understand who they are and how they interact with the world. But becoming future orientated [00:20:25] is one of the biggest gifts you can give someone.

Payman Langroudi: Yeah, I like that. I like that. It’s fun [00:20:30] to do that with all the all the delegates.

Richard Porter: Anyone who wants to I, I think [00:20:35] like positive psychology or any form of psychology. You’re a bit like a vampire. You’ve [00:20:40] got to be invited in. I don’t think you can foist yourself onto people. [00:20:45] And so I will often try and extol [00:20:50] the virtues of tactical emotional intelligence and say that you could be incredibly [00:20:55] technically great, like the world’s best endodontists. But if your nurse [00:21:00] doesn’t like your receptionist doesn’t like you, and patients don’t like you, you’re going to be a very lonely, poor expert. If [00:21:05] you are likeable and there’s a skill to that [00:21:10] and, um, amicable and you get on well with your team and they advocate for you and your [00:21:15] patients like you, you’re better off being a good, competent dentist than an [00:21:20] absolute expert than that. So. So we offer that and we offer certainly [00:21:25] training in that across the board because it’s just an essential if people want to go further [00:21:30] then if they engage then for sure.

Payman Langroudi: And there must be a patient version of that [00:21:35] too, right. When you’re presenting a treatment plan, that’s the future and attaching [00:21:40] a patient’s emotions to that future.

Richard Porter: Yeah. Well, absolutely. [00:21:45] I mean, from from a whole point of view. I mean, I’ve heard some of your, your previous [00:21:50] work. So I think you’re pretty expert at this. You ask good questions, but I think you’re expert at this from the subject [00:21:55] as well. The, the I mean, I will often say to a patient, the reason I’m asking you these [00:22:00] questions is because what’s important to you is what’s important to me. So is there anything that’s particularly important [00:22:05] to you, not just in the procedure, but when it’s finished? I’m trying to work out [00:22:10] how you want to feel. So it’s nearly November. If you’ve got any big [00:22:15] events between now and Christmas? Or have you got a Christmas party? How do you want to feel when you smile [00:22:20] at that event? Talk to me about it. Who’s going to be there? What’s important? Got a wedding coming up. You [00:22:25] know what’s important to you is what’s important to me and build that in. And once. [00:22:30] I mean, it’s that classic Maya Angelou quote, isn’t it? Is. People don’t remember what you say. Or do they remember how [00:22:35] you made them feel? Or words to that effect. And it’s that and and if you can show [00:22:40] people that that to me Payman is is a crucible [00:22:45] and it’s where two people meet. So you and I haven’t met before, but we’re meeting today, and [00:22:50] that crucible is where your mind and my mind [00:22:55] that live in our brains, that are full of emotions, which we can’t really control [00:23:00] much, and they’ve become thoughts and feelings, and your thoughts and feelings are [00:23:05] your behaviours, and we call that personality. So this is the meeting point [00:23:10] of that whole process all the way down. It’s it’s all the way down. And you have this meeting point [00:23:15] of personalities. This is why understanding behavioural science and personality me is [00:23:20] key. And I think it’s personally super key for dentists because [00:23:25] if you’re a librarian, you know you don’t. But you and I, for a living work [00:23:30] like inside someone’s head.

Payman Langroudi: Yeah.

Richard Porter: It’s crazy. So you [00:23:35] have this meeting of personalities and if that’s where you meet, understanding that crucible, that interaction [00:23:40] is fundamental to you having any form of success, whatever success may look like to [00:23:45] you. So, yeah, I try and show that we do run specific like courses [00:23:50] on that.

Payman Langroudi: I mean, listen, the one thing I’ve learned by stopping being a dentist is, [00:23:55] is that the people’s side of it is [00:24:00] even more important than I realised it was when when I was a dentist. [00:24:05]

Richard Porter: How so?

Payman Langroudi: Because it’s definitely the thing I miss the most. Okay. From being a dentist, [00:24:10] right? And yeah, I know that. Maybe that’s why I have a pod now or [00:24:15] whatever to make up for that. But as a dentist, you you don’t realise [00:24:20] the privileged situation you’re in that you’re sitting talking [00:24:25] to people in society or all different levels, and at a [00:24:30] moment when they’re at their most vulnerable and that vulnerable side [00:24:35] of it. You know, I used to have a boss who used to say, you young guys, none of you know what [00:24:40] it’s like to be a patient anymore. And how I had an inlay fit. [00:24:45] Yeah, three days ago. How right this guy was. Yeah. Because how [00:24:50] much we like to say how pleasant it is in a dental surgery and all the bits and pieces. It’s [00:24:55] horrible.

Richard Porter: It is.

Payman Langroudi: It’s horrible. I would my wife was fitting. I was negotiating with not [00:25:00] to numb me up for the fit. I love it, yeah, because I didn’t want to be numb for four [00:25:05] hours. I love that. And you forget, you know, like imagine as a dentist, you the number of times [00:25:10] you numb someone up thinking nothing of it at all. It’s four hours of bullshit. Yeah. [00:25:15] It is. Yeah. I was pulling my own moustache out. Why [00:25:20] the hell am I still numb? Yeah.

Richard Porter: Is it going to stay forever?

Payman Langroudi: Such a simple thing, right? Such a simple. [00:25:25]

Richard Porter: Did you check your occlusion as well?

Payman Langroudi: Were you doing this?

Richard Porter: Were you giving a lot of that off?

Payman Langroudi: I’m a terrible patient. I’m [00:25:30] a terrible. But. But what I’m saying is, it’s a horrible experience. And so what you said about painless [00:25:35] injections. 100% agree with you on that.

Richard Porter: Do you know, I think I think I should I [00:25:40] should not contradict myself. But is it possible to give a painless injection? Nearly. [00:25:45] But what’s important is you showing the intent to do it painlessly, because you [00:25:50] don’t have to do dentistry with complete comfort. It’s not like having [00:25:55] a foot rub, you know? It can’t be. Now we’ve got that out, the out, the out [00:26:00] in the open. But it’s you can show the intent to do it with kindness. [00:26:05] You can show that you have the intent to be compassionate and God [00:26:10] forbid. You know, I’m sure you’ve taken out teeth where you’ve given them a cauldron full of local anaesthetic, [00:26:15] and at the moment of delivery, they still wince because they’ve got this horrible infection there or something. And [00:26:20] but it’s the intent to get that over and done with and say, I’m so sorry. That last bit was uncomfortable. [00:26:25] That’s what matters. That’s the key to it. I know. I think one of the, the, [00:26:30] the caveats here is, and I spent a lot of your listeners, they will have probably [00:26:35] met a difficult patient. And I think that can leave scars and wounds [00:26:40] in people, um, that can take away that [00:26:45] compassion.

Richard Porter: And so I’d encourage anyone listening to this to I tell every group [00:26:50] I ever treat, it’s a room full of strangers. And I say, look, you’ve known me ten minutes. If [00:26:55] I go like this and I grab my heart and I collapse on the floor unconscious, I bet you’re all going to rush [00:27:00] over. And I bet if you and I go for a walk out in the street here and we both collapse on the floor, [00:27:05] strangers will rush over. Human solidarity is the norm. Humans being compassionate [00:27:10] and kind and helping each other is the norm. You are going to meet outliers and [00:27:15] let’s train you to detect them because they’re actually easy to detect once you know how. But [00:27:20] the norm is that nearly everyone you meet is a is a kind, reasonable, [00:27:25] compassionate person and you just need to connect with them. And once you’re connected with them, like they’ve got friends [00:27:30] and they’ve got family who connect with them, you just become the professional version. And as you say, it’s a privilege [00:27:35] to slot into that person’s life.

Payman Langroudi: And it’s sad when kind of what you’re alluding to. It’s [00:27:40] sad when my brother went for an examination, he’s had a full mouth rehab because he had okay, amelogenesis [00:27:45] imperfecta. And I said, hey, how was it? What happened? And he said it was [00:27:50] more like being a lawyer than at the dentist. Wow. And it’s sad, you know, that [00:27:55] that’s how the guy came across.

Richard Porter: Yeah.

Payman Langroudi: Because he’s being so defensive with his whatever it [00:28:00] was.

Richard Porter: Because. Because the best advert you can have is that guy going back to work? [00:28:05] Your brother is going back to his job or going wherever and say, well, I need some dentistry. [00:28:10] And him saying, I’ve solved. I know exactly who you need to see. Not only is this person [00:28:15] precise, and they give me exactly what I want, the way they delivered it, it was just so kind, [00:28:20] so compassionate. You know, I really felt involved in the process and like, I was in control [00:28:25] of the decisions and, you know, really.

Payman Langroudi: And, you know, all the all the research shows anyway, that people don’t [00:28:30] sue people they like, right? So yeah. Yeah, being liked is so much more important than having the right [00:28:35] signatures in the right places.

Richard Porter: 100% 100% 100% people, people, [00:28:40] people complain and sue through an emotional response to how they feel more than anything [00:28:45] else. It’s not your high energy. You can’t see your wife.

Payman Langroudi: You know this question [00:28:50] of, you know, the the people stuck to the teeth. You know, it’s [00:28:55] a big issue in enlightened. I’m always constantly dealing with my team on this subject of [00:29:00] look, how lucky are we that our product is on something that stuck to humans teeth, right? Stuck [00:29:05] to humans? That means we can tell all sorts of human stories around our product. And it’s not like [00:29:10] we’re selling a microphone stand. By the way, there to do with humans, too. But, [00:29:15] you know, human stories are what we should be focusing on. And then we make another advert with a [00:29:20] toothpaste spinning around or whatever. It does my head and I’m going berserk saying, [00:29:25] why is there a picture of toothpaste?

Richard Porter: Storytelling is key to it.

Payman Langroudi: Yeah yeah yeah. And [00:29:30] and then from a, from a patient perspective, they’re going to tell you their stories. Um. What [00:29:35] think that with you. I’m really interested to know is at what point [00:29:40] did you decide I’m going to be the best?

Richard Porter: Uh, well, that’s a deep question. I [00:29:45] don’t I don’t think I have made that decision, and I don’t think I’m the best.

Payman Langroudi: I’m trying [00:29:50] to be.

Richard Porter: I’m trying to I so that comes down to motivation. And you [00:29:55] can look at motivation internal or external, but you could also classify it as approach or [00:30:00] avoid. And I think I’m more avoiding not being the [00:30:05] worst a failure than having a determination to be the best. [00:30:10] Um, I actually mean that. I do think that I think a lot of those things come from people’s childhoods, [00:30:15] from how you got validation from your parents, from how [00:30:20] you.

Payman Langroudi: Would you call yourself competitive?

Richard Porter: Yes, yes, I am [00:30:25] yeah. I am a competitive.

Payman Langroudi: And like and but.

Richard Porter: I don’t let [00:30:30] anyone see me coming.

Payman Langroudi: Oh I see yeah. So so so so for instance, are you the type of person. [00:30:35] If I said, listen you definitely can’t do this. You’ll do reverse.

Richard Porter: Psychology.

Payman Langroudi: You’ll you’ll [00:30:40] do whatever it takes to prove me wrong.

Richard Porter: I so I’ll tell you, I’ll tell [00:30:45] you, I’ll tell you a couple of stories. So I, I was I have I was competitive, I went to [00:30:50] a boys school. It’s a state school, but it was a boys school and it was a.

Payman Langroudi: Sports and. [00:30:55]

Richard Porter: Sports.

Payman Langroudi: Punch ups.

Richard Porter: Uh, plenty of those. And, you know, it was very sporty [00:31:00] and I loved competitive sport. And [00:31:05] I’m always I’m, you know, I love seeing human excellence. [00:31:10] And I guess I do like to be part of that. So a sane bolt Leonardo [00:31:15] da Vinci, Florence Nightingale, anyone who’s just excellent, pick [00:31:20] a world class pianist and just just take a moment to look at this person [00:31:25] and take all the inspiration you need from it. Mozart. Like, when did he start composing symphonies? When he’s younger [00:31:30] than my kids, you know, failures. The. So from that point [00:31:35] of view, I do love excellence. And I love the the awe inspiring [00:31:40] nature of what humans can achieve. And you just live in a world of wonder. So that [00:31:45] fascinates me. And if you can create something that contributes to that, then I definitely like that. I [00:31:50] find that inspiring. Equally, I remember being a vocational trainee and [00:31:55] thinking to myself, I don’t feel necessarily ready to do this. [00:32:00] People call that imposter syndrome. And so this is going back a way. Payman. And this is in the very [00:32:05] early days of the UFC. And I had, um, I wasn’t in the UFC, but I had a patient who was a British [00:32:10] contender in the early days of the UFC, the Ultimate Fighting competition, and that’s [00:32:15] where. And there were no weight classes back then, and he needed an endo, and [00:32:20] it was my first endo in it. And I said to the nurse, could I have a rubber dam? And [00:32:25] I got this blank look.

Richard Porter: And they said, I don’t know what that is. And I said, well, what [00:32:30] can we have? The endodontic equipment said, oh, you mean one of those little files? Yeah, I’ll get one out of the autoclave [00:32:35] because they weren’t single use. And I said, how do I stop this going down the [00:32:40] patient’s throat? And how do we use bleach and, and things like that. And it had a ring that [00:32:45] you’d put on your finger and it had a little chain that would clip on the end and it was rusted. So it was covered in [00:32:50] rust. And I was trying to do endo on this guy as best I could in this the situation with good intentions, [00:32:55] you know forgive me. And he he ended up with a big [00:33:00] swollen face and he couldn’t compete. And I just remember thinking, ah, what the [00:33:05] hell? You know, if there’s 40,000 dentists in the country, I’m ranked 39,998. [00:33:10] I reckon I’m better than two. I’m not. I’m not having a career of doing [00:33:15] this. And so pretty early on, and again, I’ve met some people who inspired me. I [00:33:20] thought, well, the only way I knew to get good back then was to go back into hospital. [00:33:25] So I actually took I applied for a job at the Royal London Hospital, and I made sure I got it as [00:33:30] best I could, and and I stayed in hospitals then for the next 25 years.

Payman Langroudi: Wow. [00:33:35] So that was the catalyst.

Richard Porter: It was it was fear of failure. I think it’s true for a lot of people, [00:33:40] you know, it’s it’s fear of not being enough. And, you know, I see if you [00:33:45] pick the average undergraduate now, they’ve gone through school and they’ve never failed at anything. They’d probably get [00:33:50] A’s in everything. If A’s even a thing. Now Nines. And then they go [00:33:55] to dental school and they get through dental school as well. And then they qualify. And you remember that moment? You qualify. [00:34:00] Suddenly you’re in practice, and suddenly someone like you and me, who’s not a dentist, [00:34:05] comes in and goes, that bit of work you did. It’s not good enough. You know, it might be your first ever failure as [00:34:10] a dentist, and it might be the first person who hasn’t told you your great have a pass, [00:34:15] but says, I’m not too happy about that. Mm. You know, and it’s I think that’s brutal. [00:34:20]

Payman Langroudi: It is. Yeah.

Richard Porter: It is brutal. And so we try I try and guide people through that [00:34:25] and understand it and get them a bead on mental resilience and then who they want [00:34:30] to become and tie that in with their identity, make them future orientated, help [00:34:35] people define what version of success is to them.

Payman Langroudi: So you went off and did [00:34:40] all the specialist training. I did the post [00:34:45] specialist training. I guess what I mean, what does it take to become a consultant? [00:34:50] You have to write papers and raise money, all that sort of thing.

Richard Porter: I think the goalposts [00:34:55] change. I’ll be very frank with you. I hope no one’s watching this get me into trouble. Um, so [00:35:00] you have to have done a certain amount of, um, training beforehand. [00:35:05] So a few hospital jobs. And I think there was still quite a lot of phone calls behind [00:35:10] hidden doors back then, and I worked hard. I’ll be honest, I did work hard, and, [00:35:15] um, I was pretty good at just getting in. And I’d look at consultants. If you were my consultant, I could say, right, [00:35:20] how do I make this guy happy? You know, where his stresses or his stresses are on the ward round. This isn’t [00:35:25] done. This isn’t done, this isn’t done. You watch what happens tomorrow. So tomorrow morning, I’d say the chest physio [00:35:30] is booked. This is done. He’s admitted overnight. I think you need an ultrasound before you make a decision. That’s happening in 20 [00:35:35] minutes. I’ll bring it to your desk later on. And they were like, okay, so I was quite good at things like [00:35:40] that. And, and and. Yes. And then I will answer your question. And then I applied [00:35:45] to do specialist registrar training and restorative, and [00:35:50] I’d visited the units beforehand and met the consultants, and I was very lucky. I do believe [00:35:55] I’m not being humble. I believe there was a lot of luck involved in that. And I was appointed and I worked very, very hard at that. [00:36:00] I was a registrar and back then you could sit a multidisciplinary exam, [00:36:05] which is Days of Vivas, where I’d sit in a room like you with 3 or [00:36:10] 4 other consultants, and they would cross-examine you on cases and statistics and literature, and [00:36:15] you would pass or fail.

Richard Porter: And theoretically, you got, you know, a few chances [00:36:20] to pass. And if you didn’t, the last 5 or 6 years would have been a waste. I was lucky to get through all [00:36:25] of that. And then you get appointed as a consultant. Um, and you would if you’d [00:36:30] passed the right bits, you would go on a few specialist lists. Um, and [00:36:35] so I managed to do that. I was very lucky, I was, I, I again, I keep [00:36:40] saying I’m not being humble or falsely humble. I was and I loved being a consultant, I really [00:36:45] did, I loved, I loved helping people. There is an element of status to it. [00:36:50] You get the right colour. Scrubs. Yeah, but someone will come in with terribly [00:36:55] worn teeth, hit by a car, a tumour, and [00:37:00] you’d be part of a team with incredible people who would sit down and would plan how [00:37:05] to put this person back together and give them as much quality of life as we could. And that’s, [00:37:10] that’s that’s a great, great privilege. I loved every second of that. I miss that [00:37:15] now. I’m not a consultant anymore. I do, I miss it a lot. I get to see some of [00:37:20] my consultant colleagues, a facial aesthetics event in a few weeks time, actually, and [00:37:25] I can’t wait to see them just to reconnect with them.

Payman Langroudi: So. Okay, so became a consultant. [00:37:30]

Richard Porter: Yeah. Became a consultant.

Payman Langroudi: And went into private practice.

Richard Porter: So yeah, I was a consultant. Um, [00:37:35] I started as a full time consultant. Then I just do 1 or 2 private patients in the evening, and I would do that in [00:37:40] either on a Saturday or at my friend’s Friends practice, or I would see 1 [00:37:45] or 2, like on a Monday or Tuesday and just one patient for a couple of things, and then I reduce [00:37:50] my timetable as time went on and I did a little more private practice. Um, [00:37:55] I think it’s important to do both. I think it’s important for senior NHS staff [00:38:00] to do both.

Payman Langroudi: Yeah.

Richard Porter: So you know what it’s like to say if I do my job well enough, you pay [00:38:05] me this. And if I don’t, you don’t. You know that. Get off the salary assurance [00:38:10] train and really understand what it’s like to do. Do something that that that comes [00:38:15] at a potential risk of not getting paid for it if you don’t do it well enough. Um, and I [00:38:20] did that for a lot of years. Yeah, I did.

Payman Langroudi: Was there a particular area that you were particularly expert at?

Richard Porter: Um, [00:38:25] okay. That’s a bold question for me to answer. [00:38:30] Um, I’m good at endo. I’m good at prose. Um, I’m good at [00:38:35] talking to people. I perio bores [00:38:40] the life out of me in terms of a it doesn’t and there’s some great periodontists around there. But [00:38:45] perio for me was about behavioural change. It wasn’t about perio and [00:38:50] restorative kind of encompasses it all. So if you’re on those four specialist lists, um, I’ll [00:38:55] be honest, I, you know, I’m like so many people now. I love doing implants. It’s [00:39:00] just great.

Payman Langroudi: What you love about doing implants.

Richard Porter: Um, I [00:39:05] love the fact that it’s quite serious.

Payman Langroudi: It is serious. [00:39:10]

Richard Porter: It’s like, I don’t know if you ever have these moments. Payman tell me this. Say yes. Whatever the answer, real answer [00:39:15] is just to make me feel good. Yeah. Is I sometimes look at being [00:39:20] a sort of fully fledged professional and I think, oh my God, you’re an actual adult.

Payman Langroudi: You [00:39:25] know, like.

Richard Porter: You look at your children and you think, oh my goodness, you know, and [00:39:30] they call you dad. And I’m like, oh my God. Yeah, I’m one of those people. And [00:39:35] um, and implants have that. So they’re very serious. [00:39:40] You know, you have to cut someone open. Yeah, you’ve got to put this bit of metal in their skull. Screw [00:39:45] it in.

Payman Langroudi: So, for instance, you know, the serious thing is happening [00:39:50] tomorrow morning at 9 a.m. or 830, whatever. Yeah. For instance, the night before, [00:39:55] you’re like, get a good night’s sleep. Yeah.

Richard Porter: Within reason.

Payman Langroudi: Because this is what I’m saying, [00:40:00] that, you know, however many implants you’ve put in.

Richard Porter: Yeah, yeah.

Payman Langroudi: It’s so serious that [00:40:05] you’re cutting this guy open and sticking a screw in his jaw that, you [00:40:10] know, at the moment you become nonchalant about it. You’re making a big error, right?

Richard Porter: Oh, no. Put beautifully. [00:40:15] I think you answered that better than I ever could. The. I think you should always, always be slightly [00:40:20] nervous. Yeah, I think you should always be slightly anxious about. I’m afraid [00:40:25] every day at work, the day you think. Don’t worry about it. This will be easy. Is [00:40:30] the day something’s going to go.

Payman Langroudi: It’s a feature of a professional, you know, like even a lawyer.

Richard Porter: Anxiety. [00:40:35] Yeah, I.

Payman Langroudi: Agree. Even, you know when you say Do you think a professional a professional? [00:40:40] Yeah. And the image comes to your head of what that is? Yeah. There’s a worried look on [00:40:45] that guy’s face. Yeah. Yeah. It’s not. It’s not a big, big fat. You must have noticed my frown [00:40:50] line here. Yeah. So, so.

Richard Porter: And sleep is all relative, isn’t it? Yeah. I will think about the case. [00:40:55] No doubt at all. Mhm. Um, and, and I think about how [00:41:00] you can assure that person’s well-being as much as you can. That’s why I like transparent [00:41:05] operating, you know. So like if I was going to put an implant in and you said, Rich, we’re bringing the [00:41:10] podcast team down and we’re going to watch and film.

Payman Langroudi: You.

Richard Porter: That to me, I like because [00:41:15] that means, okay, a game on. Just get your A-game on. And this [00:41:20] is going to you know it’s a it’s like a layer of quality assurance. Yeah.

Payman Langroudi: Rich what do you think [00:41:25] is kind of rich. Yeah. What do you think is the hallmark of an expert? Because [00:41:30] I’m just trying to distil it down myself. Right. Of all the experts I’ve come across. [00:41:35] And if it’s a funny thing I’m now [00:41:40] coming down to doesn’t take shortcuts.

Richard Porter: Yeah, I think it’s true.

Payman Langroudi: Like basics, the basics are [00:41:45] exactly correct.

Richard Porter: I think a lot of it. Yeah, there’s different ways. It’s a very good question. I mean, first [00:41:50] of all, everything is comparative. So if you’re an expert, it’s compared to who. Yeah. Yeah yeah. So [00:41:55] you know I can run but at the same bolt is an expert runner compared [00:42:00] to me. Or is he just faster. But it’s all comparative. Yeah, I think I [00:42:05] think an expert, if you’re going to use that word expert in your identity, it [00:42:10] has to be the standards below which you refuse to fall. And that’s the [00:42:15] same thing as you just said. It’s what are the standards below which you, you you can’t operate [00:42:20] and like rubber. No rubber dam for that endo with a rusty keychain. [00:42:25]

Payman Langroudi: Yeah.

Richard Porter: I couldn’t do it. I just couldn’t do it. That wouldn’t be for me. And [00:42:30] an expert is someone who is is not willing to do that. And is then [00:42:35] socratically the eternal student because being an expert has [00:42:40] to you. I think you have to say, yeah, but I could be better. And I think that’s [00:42:45] that sense of dissatisfaction you should always have. Because [00:42:50] if you’ve got that sense of dissatisfaction when you’re being honest, like, if anyone’s ever [00:42:55] says to me, I did the perfect Dental case.

Payman Langroudi: Mhm.

Richard Porter: I did it perfectly. [00:43:00] I know I’m talking to a psychopath or a liar.

Payman Langroudi: Yeah.

Richard Porter: Because you’ve never [00:43:05] done it perfect. There’s always something, however trivial or small it might be. And [00:43:10] so we can always learn. And that that’s staying humble staying curious. So I think part of [00:43:15] being an expert is you still think yeah, but I’ll be better. You think in 200 years, mate. How are they going [00:43:20] to. They’re going to say right to do an implant. You get this steel spike and [00:43:25] you load it up with cocaine, and you shove it in their face and you [00:43:30] know, there’ll be a way of anaesthetising patients then, which will be a button you press on your phone or you know [00:43:35] something. And they’re going to. So so you’ve got to be humble as well.

Payman Langroudi: So [00:43:40] on that subject of, you know, you’re forced to be at the tip of the spear in so many different [00:43:45] areas, insomuch as when a delegate asks you a question. By [00:43:50] the way, some of the people I respect the most say, I don’t know more [00:43:55] than you think they would. Yeah, but you’re going to have to stay on top of what’s [00:44:00] going on. And what’s the latest thing? Yeah, I think there’s a tension [00:44:05] in, if you are the tip of the spear in anything and, you know, I’m sure there’s some, [00:44:10] some researcher somewhere right at the tip of the spear on one specific subject, you [00:44:15] have to try stuff out. You do and then [00:44:20] trying stuff out. The very nature of that, the, the, the definition of that is sometimes [00:44:25] that thing’s going to fail. Yeah. And it’s incumbent on you as an expert [00:44:30] to try stuff out, rather than someone who’s not an expert to try stuff out. Yeah, yeah yeah, [00:44:35] yeah. But it’s attention. It’s attention and I see attention. Also, I’d [00:44:40] really like your answer to this one because I’m struggling with this one myself.

Richard Porter: I hope I can help.

Payman Langroudi: You [00:44:45] know, around those words that you said, the difference in contentment and progress on [00:44:50] a string. Why are those two things on a string? And we understand the reasons why [00:44:55] they are right. But is it possible to live being content and continuing to progress [00:45:00] at the same time, because they seem in opposition with each other?

Richard Porter: Yeah, I you know, I mean, [00:45:05] that’s a beautiful philosophical question. And, you know, the Buddha said life is dissatisfaction or life is [00:45:10] discomfort, and the word is actually is dukkha. And it actually means the [00:45:15] sense of tension that as soon as you’ve achieved something and you think, well, I’ve done that job [00:45:20] really, really well, and I do have a sense of fulfilment, it’s now what next? You’ve built [00:45:25] an enlightened smile on a podcast unit. Now what? Payman. You know, because what? This is it forever. [00:45:30] And there’s always this sense of I can do more and I can become more. And so I think [00:45:35] that what you’re talking about there really is, is people, you know, let’s take a dentist [00:45:40] who says, I want to be successful. And I think there’s two layers to this. [00:45:45] The first thing is it’s not about being successful because that’s your destination. And people I think level [00:45:50] one say it’s the journey. And I don’t think it is the journey either. I [00:45:55] don’t think it is the journey. I think it’s who you become to keep going on that journey and the sense [00:46:00] of growth inside your mind as you progress along your journey. That’s why you [00:46:05] and I move the goalposts, because here’s our destination and we want to move towards it, and we love moving towards [00:46:10] it. But as soon as we get there, we’re going to have that intense dissatisfaction. You know, I came, I saw, [00:46:15] I conquered, and then Alexander cried because there was no worlds left to conquer. And so as we get [00:46:20] close, you move the goalposts so you and I can keep becoming. And that comes down [00:46:25] to feelings, because you become someone new. As Payman becomes more and his [00:46:30] social skills become more and you become more of a wonderful parent interviewer, whatever you do, [00:46:35] that sense of becoming is what makes life feel completely fulfilling. I [00:46:40] think if you sit back and say, right, I’m content. That, to me is [00:46:45] Aldous Huxley’s Brave New World. It’s like hiding from from that progress [00:46:50] or the fear of failure overwhelming you so you become apathetic. You know, there are philosophers. [00:46:55]

Payman Langroudi: So you’re saying contentment shouldn’t be the goal?

Richard Porter: I think I.

Payman Langroudi: Think.

Richard Porter: No, contentment, [00:47:00] I think, is it’s going to be part of your life, but don’t expect to be [00:47:05] content forever. And you know, what are you going to do? Sit on a sofa and watch.

Payman Langroudi: It all so transient like pleasure [00:47:10] is.

Richard Porter: Yeah, yeah, I mean pleasures.

Payman Langroudi: Totally.

Richard Porter: 12 minutes and it’s gone, [00:47:15] isn’t it? You know, whereas misery, you can be happy. Like I’m enjoying your conversation. [00:47:20] And when we leave here, I’ll have a sense of satisfaction. And by the time I get home and [00:47:25] after travelling on the tube it will start to wane. If you were a patient complaining of [00:47:30] me, I can worry about that for weeks. And that’s that negative emotion thing. So I think you should be content. I want people [00:47:35] to be content. Martin Seligman’s work on this is incredible.

Payman Langroudi: Martin.

Richard Porter: Martin Seligman, [00:47:40] so he’s a the the godfather of positive psychology. And [00:47:45] he would talk about positive psychology really in three areas, which is pleasure, joy [00:47:50] and satisfaction or fulfilment, which probably leads to.

Payman Langroudi: I’ve got to read this. [00:47:55]

Richard Porter: Yeah. For me he’s he has written his latest book is [00:48:00] fabulous. Um, I think it’s just called The Good Life. And that might be his original, but. So [00:48:05] pleasure is used to be the hardest to achieve because [00:48:10] you really had to earn things to bring you pleasure. Like even a hundred years ago, 200 years ago, pleasure [00:48:15] was incredibly rare. Did you have a warm shower this morning? [00:48:20] Yep. I bet it felt good. Did you have a moment where you thought, oh, wow, this is so nice? [00:48:25] Yeah. And, you know, we should be grateful for that, but we take it for granted. And I wanted to connect with you. So [00:48:30] I just send you a text, and then I wonder what you’re doing. And we get. Pleasure is now abundant. The [00:48:35] other forms of joy. So connecting with someone else, connecting with your patients, connecting with [00:48:40] your family, creating value in their lives through your behaviour to [00:48:45] your patients, your family, your friends. That’s joy. That’s human to human. And that’s the big one [00:48:50] we really should concentrate on. And then fulfilment and satisfaction is [00:48:55] looking back and thinking, do you know what I was? I finished my career as a consultant [00:49:00] or whatever. I gave it the best I possibly could. I really helped thousands [00:49:05] of people.

Richard Porter: I didn’t save everyone, but I saved a lot of lives. I rehabbed a lot of people. [00:49:10] I think I did my job pretty well, that sense of fulfilment. So he would break it down into [00:49:15] those three. And joy and fulfilment are what make us have high self-esteem, [00:49:20] our or self-concept grows and we get that sense of the [00:49:25] value of my life is not determined by what I think it is, it’s how much I contribute to other people. That’s [00:49:30] all it is. And we get swamped by the pleasure, the pleasure [00:49:35] dome that’s everywhere around us now, you know, abundant calories. [00:49:40] Like, if I want some pleasure on the tube, I can go and buy a pack of hobnobs and eat them all. And [00:49:45] every single one is just impossibly delicious. You know, it’s a food like you couldn’t have dreamt of 200 [00:49:50] years ago. And it’s just a £50 pack of hobnobs. So? So I’m not saying [00:49:55] deny self pleasure, but revel in the joy and fulfilment. Yeah, do be content and [00:50:00] then accept that part of human nature is depending on your disposition. What [00:50:05] next? What next? What can I do next? Where’s my next contribution I think I think [00:50:10] it’s that. And I think that’s what makes it well put.

Payman Langroudi: That’s well put. Thanks. Yeah. [00:50:15] And my other question regarding New things that come out. Digital [00:50:20] new. New materials, new techniques. I mean, you can’t be the first to [00:50:25] jump on something like that. I guess, in your position. But you certainly can’t be the last. I mean, you’ve got [00:50:30] to be pretty an early adopter.

Richard Porter: You have you have got to be an early adopter. And [00:50:35] you, you do get you do have to sit on the cutting edge. So materials and equipment, you [00:50:40] know, I have good relationships with a lot of good companies and they will often bring them to my attention, [00:50:45] which I’m very, very grateful for. So in our new centre we [00:50:50] have a seven metre by three metre screen, and it’s a really high density LED [00:50:55] screen and I’ll be doing live prep through that. So there’s nowhere to hide. And so we’re speaking with [00:51:00] canon at the moment. And there’s a new camera, for example, on your subject that isn’t even released in Europe [00:51:05] yet called the C50. And that records [00:51:10] in true seven K. So it can come on the screen and they let me know that exists. So [00:51:15] I affiliate with a lot of companies and people I really, really trust on techniques. [00:51:20] I’ll be honest, I think you have to. It’s part of life is dissatisfaction. You have to accept everything you’re doing [00:51:25] is going to become obsolete. And the good news is social media. If people come up with a good technique. [00:51:30] I remember when mylar pull, you know, the mylar pool when the Mylapore first came out and I’d never seen [00:51:35] mylar pull before. I think I was a reg a specialist trainee. And looking at that and thinking, that’s amazing. And [00:51:40] I take it to other people and say, look, when people are doing this interproximal technique and there’ll [00:51:45] be two responses. Someone saying it’s rubbish, not interested. And other people who are the eternal students [00:51:50] saying they’re on to something, there’s something on that. So I think social media helps [00:51:55] with dissemination of new techniques. Definitely. And you just have to have a thick [00:52:00] enough or malleable enough ego to say everything I’m, [00:52:05] I know and I’m good at will be superseded by someone probably younger [00:52:10] and smarter than me in due course. Yeah, we just do the best you can.

Payman Langroudi: Add one [00:52:15] of the. One of the nicest things about being a teacher is sometimes that person is one of your students. You [00:52:20] know who who, who you know who’s now coming back and teaching you something.

Richard Porter: Couldn’t agree.

Payman Langroudi: More. It’s a [00:52:25] wonderful thing. Lewis Mackenzie used to tell me that that was the thing that made him the happiest. You [00:52:30] know, as a teacher.

Richard Porter: I’m going to do more philosophy on you. Payman. Do you mind? Sure. So imagine you’re here. [00:52:35] Yeah, well, imagine I’m here and I’m the teacher. And this is my student.

Payman Langroudi: Below.

Richard Porter: You. Yeah, [00:52:40] they’re below me. Yeah, yeah. And they come up here if my goal is to lock them there, and then they have the [00:52:45] same goal, then the same goal. Five generations as a species. We’ve gone backwards. [00:52:50] Yeah. My goal is here. And my this is my level. And my goal is to get you here. [00:52:55] And then your goal is the same. This is how we learn as a species. So the goal [00:53:00] of any teacher has to be that the students outgrow them. And I could show you WhatsApp [00:53:05] messages now of tens and tens and tens of our students or on on our app [00:53:10] who will come up and say, look, I’ve tried this thing, even if it’s something small. Like if you look [00:53:15] at the number one complaint dentists dental technicians have about Crown preps is [00:53:20] under preparation on the occlusal surface. So how do we eliminate that? We’ll [00:53:25] put that out there to a load of people. You know we’ve got 2500 alumni. How do you ensure [00:53:30] you don’t do this? We taught you techniques. Has anyone got other ideas? And they go, yeah, I do it like this, this, this and this. And you [00:53:35] think that’s brilliant? That’s brilliant. And that collective learning experience. You have to be humble enough [00:53:40] to say someone is going to do it better than me. There’ll be a new burr, a new technique, a [00:53:45] new system, a new augmented digital thing. Yeah, yeah. [00:53:50] Some overlay that shows when you’ve done it perfectly, it’s going to happen. You’ve got to enjoy it.

Payman Langroudi: Enjoy [00:53:55] the fact that things are changing. Yeah.

Richard Porter: And people can teach you. Yeah, yeah. You’ve got a responsibility. [00:54:00] But you’ve got you’ve got to enjoy the fact that if you’ve got 200 students every year, some [00:54:05] of them are going to say, I think I can do it better than you. Oh, I think I can. Do you mind [00:54:10] if I show you? And You’ve got to say if you can, you’re going to get nothing but gratitude of me. Nothing but gratitude. [00:54:15] One of one of the aspire philosophies is it’s much better that we have questions [00:54:20] we can’t answer than answers you can’t question. So you can question anything. And if you think [00:54:25] it’s not clear, the burden of understanding is on on me. It’s on us. But [00:54:30] equally, if you have a better technique, you’re going to get nothing but gratitude 100%. [00:54:35] Show us what you got. It’ll be awesome.

Payman Langroudi: Tell me. [00:54:40] Tell me about the evolution of how you met Raheel. And whose [00:54:45] idea was it to do a, like a training course or whatever? And how? How did [00:54:50] it start? And where? Where are you now?

Richard Porter: I will, I’ll, I’ll give you the brief version. [00:54:55] I’m sure he will see this. The the, um, the. So, [00:55:00] so I, uh, we first met when I was giving a talk at an event, [00:55:05] and they used to go to Centre Parcs a lot, and I was there.

Payman Langroudi: I have to give one of those. Yeah.

Richard Porter: And it was, you know, they had [00:55:10] they had a lot of sort of socialising going on. Yeah. And there was and I was doing day two. So there [00:55:15] was a lot of.

Payman Langroudi: Hangover.

Richard Porter: Hangover from the socialising. And he was very lucid. Uh, [00:55:20] you know wouldn’t drink alcohol. And I gave a talk on some [00:55:25] of the things you and I talked about earlier on this morning. I was like, does anyone know how to really take an alginate [00:55:30] impression? Well, like a really good. Let’s do something very, very simple. And I said, so I’m going [00:55:35] to give you a ten minute talk on how to take a really good alginate impression. And he woke [00:55:40] a couple of people up and said, this guy knows what he’s talking about. He’s making it crystal clear. So I then [00:55:45] I’d become quite frustrated with ineffective education at that stage. And I’d [00:55:50] seen I’d been at talks, which I’m sure you have. And you sit thinking, My God, I’m just learning nothing. [00:55:55] This is just either an advert or just ineffective learning. So I ran [00:56:00] a I hired Lundbeck, the London Dental Education Centre, and I ran a three day crown and bridge [00:56:05] course, and Raheel had to beg, steal and borrow money. Literally [00:56:10] not steal, but to come on the course. And he came on the course and he was the most determined delegate on the course. [00:56:15]

Richard Porter: And he and I got on very well. Um, [00:56:20] I have two sisters. He’s the brother I never had. And we got [00:56:25] on very, very well. And he was there’s one thing that I admire in someone is dogged [00:56:30] determination. And he has dogged determination. And he said, look, you, [00:56:35] you’ve you’re good at teaching, you’re good at this. I think we need to formalise this. And he’s just presented [00:56:40] ideas. And he was relentless in his pursuit of it. And I became [00:56:45] ever more full of admiration for his drive, his clarity, how [00:56:50] much structure he brings. So I’m inherently quite a disorganised person, and he is incredibly [00:56:55] well organised. And we met and we said, well, let’s see if we can make this work. [00:57:00] We had a lot of blowback, had loads of people saying like, postgraduate education doesn’t work, It won’t be. [00:57:05] And these are people who tried it and it hadn’t gone well. Um, protecting, you know, their own [00:57:10] psychological outcomes. And we thought we’d give it a go. And [00:57:15] so we launched our first course, and we had one group.

Payman Langroudi: Was it a year course from [00:57:20] the get go?

Richard Porter: It was. It was a 12 day course. And we hired hotel rooms [00:57:25] and we hired Lundak. And we we managed to make that work with a small [00:57:30] group.

Payman Langroudi: The first cohort.

Richard Porter: First cohort, year one. Yeah, that’s 15 years ago. Yeah. [00:57:35] Um, and just word of mouth grew it from there. Um, [00:57:40] and, um, so we, we were [00:57:45] always fairly good at saying, what can we do better? And [00:57:50] we ask for honest feedback. And if someone writes feedback and they’re being honest with [00:57:55] you, it’s a compliment. Even if they’re criticising you. Criticism from someone who cares about [00:58:00] you as a compliment. And we would act on that. And then we’d we would have the philosophy [00:58:05] that if we give a presentation and there are questions, we haven’t given the presentation well enough, we [00:58:10] should always be self-critical and try and say if there are questions which people can [00:58:15] ask questions till midnight with us if they want, but that [00:58:20] means we haven’t landed the important message well enough. So we try to evolve [00:58:25] the course and improve the course every time.

Payman Langroudi: Um, but it went I mean, from that first cohort, [00:58:30] did you then the second year have two?

Richard Porter: We did. Yeah, we had two [00:58:35] groups. And then we had people complaining, saying, I tried to get into the groups and I didn’t. And so [00:58:40] we said, well, let’s go to three. And we did a couple of years with three groups. [00:58:45] And then um, this at that stage, it meant I had to change my consultant [00:58:50] contract.

Payman Langroudi: Um.

Richard Porter: Because I didn’t have time. And so I said, we can go to Group [00:58:55] four.

Payman Langroudi: So I guess around that point and you probably thought, we’ve really got something [00:59:00] here, like, like, you know, you’re changing your your career. Yeah.

Richard Porter: Because you’ve got [00:59:05] to have the self doubt as well.

Payman Langroudi: Well yeah yeah yeah yeah.

Richard Porter: You know so so you asked earlier on about um [00:59:10] confidence. Confidence is is a combination of two things. It’s calmness and expectation of a positive [00:59:15] outcome. So have the calmness. But I always wanted to be assured of the positive outcome. [00:59:20] And you never really are. And you know, there’s a million courses out there now. So it’s [00:59:25] it’s a fierce environment. But but yes, I started to think this is [00:59:30] we’re gaining traction here. We’re getting more support from big [00:59:35] companies. People are starting to resonate with us, and our delegates are starting [00:59:40] to say, when’s your next course? Are you going to do something with endodontics? Are you going to do something [00:59:45] on communication? And it was them lobbying us that let us build the various [00:59:50] other facets outside. Just the first course was just the aesthetic restorative course. And then we during [00:59:55] that course, for example, we had delegates who say, I’ve had a complaint. We’d have a Q&A [01:00:00] session at the end of the day, and it’s this. And we would give a response and they would start recording [01:00:05] my responses and writing it down. And we said, do you want more on communication? And [01:00:10] they said, yes. And we started building those courses and it just evolved from there.

Payman Langroudi: And so [01:00:15] what are the headlines now like? How many people do you train a year. And so we have how many how [01:00:20] many courses are there. All of that.

Richard Porter: So it’s uh, so we have we have our [01:00:25] aesthetic restorative course. Uh, we have an endodontic course, we have a [01:00:30] removable pros course, which Farhan teaches. Um, we have uh, uh, [01:00:35] I’ll get this Janjua. Yeah. And he’s a very much [01:00:40] nicer person than me. Yeah, he’s a wonderful human being. And he, um.

Payman Langroudi: You [01:00:45] teach the other bits? The endo.

Richard Porter: I teach endo and aesthetic restorative. We have a spa conversations, [01:00:50] which is pure communication for dentists. Oh, really? Um, we have, [01:00:55] um, an implant course. So we teach a lot [01:01:00] of implants. Um, and we have an occlusion course. [01:01:05] Um, I’m trying to make sure I don’t miss anything.

Payman Langroudi: Each of these are multi-day. [01:01:10]

Richard Porter: Uh, well, occlusion is two days. Implant communication is two days. That’s 20 days over [01:01:15] two years.

Payman Langroudi: 20 days over two years.

Richard Porter: Over two years.

Payman Langroudi: Yeah yeah yeah yeah yeah.

Richard Porter: Implants. [01:01:20] You know, it’s different teaching on implants. Just because if we said it’s I’m a different teacher on implants [01:01:25] because the delegates on that when they go out their risk of litigation [01:01:30] isn’t higher. But the values involved in implant based litigation, the numbers [01:01:35] in the cases are higher. And I need to make sure these people are safe and happy. So so but yeah, [01:01:40] those are our courses. We run non Dental courses because I study personality psychology now. So [01:01:45] we run a lot of personal development.

Payman Langroudi: And so first on the implant one are you then their mentor going [01:01:50] forward.

Richard Porter: Yeah. So we have a faculty team. So I’m involved in that. But [01:01:55] for Hans, involved in that, we have other teachers and our faculty team mentor [01:02:00] them on site. We have a lot of ongoing support, and the way we structure it is [01:02:05] they get so much clinical hands on with us that the mentoring is kind of with them. [01:02:10] It’s very individual because what I don’t want is someone who lives in a remote [01:02:15] part of the country, who hasn’t got a mentor to think, well, I can’t do that. And unless I relocate [01:02:20] my family, other people, so I can think of someone off the top of my head who’s working [01:02:25] in a big implant practice with experienced mentors left, right and centre. [01:02:30] And so their educational delivery is slightly different. That’s [01:02:35] why I never thought one size fits all. It doesn’t. You’ve got to tailor the course slightly [01:02:40] to people’s individual needs. And we’ve got people on there who’ve placed 100 implants, signed up for an implant course. And you’ve [01:02:45] got other people who say, I haven’t taken a tooth out in six years, you know. So they need very different [01:02:50] things.

Payman Langroudi: So look, the as you said, the sort of market for education [01:02:55] is gigantic now. I mean, we have real problems with staff, like [01:03:00] many events going on at the same time. We can’t go to everything at the same time. [01:03:05] There’s so much going on all the time in different places. Yeah. Um, do you [01:03:10] get that annoying call that I get sometimes where the guy could sell it to me? I’m considering [01:03:15] you and Chris or and Monica and and elevate. Sell me on [01:03:20] you.

Richard Porter: Yeah.

Payman Langroudi: So do you get that? Yeah.

Richard Porter: I mean, we.

Payman Langroudi: Definitely.

Richard Porter: I we get that a lot. We get [01:03:25] a lot of people saying I’m not sure what to do next.

Payman Langroudi: Yeah.

Richard Porter: Yeah. And my response always be, well, listen I can tell you [01:03:30] what we can what we can offer. Yeah. But I want you to make the right choice for you. And [01:03:35] out of all the names you’ve mentioned there, you know, we respect all these other people. So I will never badmouth another [01:03:40] course. I’ll never speak ill of another course. Um, and I think [01:03:45] a lot of those delegates need to find what fits with them best. I’ll be [01:03:50] honest, Payman, once you speak to someone, I think they judge you on how connected they are with you as a teacher. [01:03:55] So if you can give them that and they can connect with you. If somebody rings up [01:04:00] and says, I’m interested and they’re sent a brochure, you know, if people [01:04:05] can’t judge you on feelings, they’ll judge you on price and convenience. Whereas if you can create feelings [01:04:10] in people and they connect with you and they feel that connection, then I think [01:04:15] they make decisions on that. But yeah, there are a lot of courses out there, but it’s good. You know, competition [01:04:20] drives innovation.

Payman Langroudi: Yeah. And also a lot better than back in the day. I remember graduating [01:04:25] in 96 and looking for a cosmetic [01:04:30] course was. Yeah. And basically [01:04:35] it was one. There was one, there was one. There was a guy he used to sort of test stuff. Adapt. [01:04:40] Do you remember him? Uh.

Richard Porter: I remember do you remember Larry Rosenthal used to come to [01:04:45] the UK a lot.

Payman Langroudi: Yeah, yeah. So I went to Larry’s. Oh. Did you? But there was, There was one guy. There was one UK [01:04:50] based guy who did a course. It was. It was called Aesthetic Dentistry and Professional [01:04:55] Testing. Okay. And he used to test stuff and he used to have a course. That was it. That was the choice. [01:05:00] Those two things. Yeah. You know, so it was nice that there’s a lot of choice. Um, [01:05:05] at the same time, you think that a lot of times people are having to do these courses [01:05:10] to just get their own CVS going so that they can move to [01:05:15] private, um, as quickly as possible? You know, there’s a sort of strange feeling from [01:05:20] younger dentists. None of them want to do NHS anymore. Right.

Richard Porter: I think that’s true. I do. Increasingly [01:05:25] so. I mean, I hope it doesn’t die entirely, but I think that’s probably true.

Payman Langroudi: It’s [01:05:30] maybe one of the main drivers, isn’t it?

Richard Porter: Of it is.

Payman Langroudi: Doing so much education.

Richard Porter: Now. And, you know, if [01:05:35] I came here with ten CVS, I could open up on my laptop now and show them all to you. They’re all there’s [01:05:40] there’s a uniformity to it. You know, I did an audit on Bitewings and I am a kind, compassionate, driven dentist [01:05:45] who likes patient care the forefront. You know, how do you stand out? And so I [01:05:50] think some form of post-grad sign off has [01:05:55] become part of a standard, almost for the type of practice that you [01:06:00] and I might want to choose to work in if we were young associates looking for it. Yeah, I think that’s probably true. [01:06:05] I think it is. And I think it’s good that there’s choice. Um, I think, [01:06:10] you know, it does drive innovation. It drives it gives people the options for what’s most convenient [01:06:15] for them, where they get the best connection. And I think you’re right that I [01:06:20] don’t I don’t know. I mean, the NHS has a place, but it’s [01:06:25] just become such a difficult employer. Yeah. And it’s so anonymous. [01:06:30] Whereas at least if you come and work in my private practice, I’m accountable [01:06:35] to you on some level. Like if you’re my.

Payman Langroudi: It’s just Richard. I think luckily [01:06:40] I can say things like this because I haven’t got like a anything to worry about [01:06:45] in this respect. Right.

Richard Porter: Lucky you.

Payman Langroudi: But yeah, not everyone can can say what I’m [01:06:50] about to say. Yeah. Overall, the NHS in medicine, I think is a blessing. It’s [01:06:55] a blessing that anyone could get ill and end up being taken care of. [01:07:00] Some. Some of the best medicine in the world.

Richard Porter: I agree.

Payman Langroudi: As you said, a lot of goodwill involved [01:07:05] in that. Huge. But overall the net net, I would say it’s a massive positive thing [01:07:10] about Britain. And it was correct that it was during the Olympics. They pushed [01:07:15] some beds around and said the NHS, it was, it was correct. Yeah. Intensity. I don’t think it’s [01:07:20] the same. I do not think it’s the same thing.

Richard Porter: They’re fundamentally different things. And politicians get away with [01:07:25] conflating dentistry in the NHS. So you don’t pay when you go to your GP. [01:07:30] If you say I’ve got a chest infection, could I see my GP and they see you or you go to A&E, they don’t say you’ve got [01:07:35] to pay. Even on an NHS contract at the dentist, unless you’re exempt, you’re paying. [01:07:40] There’s fundamentally a difference.

Payman Langroudi: But you know, if if your grandmother, [01:07:45] God forbid, gets cancer, you know, the NHS will look after her. Yeah. The equivalent [01:07:50] of that in dentistry should be if your grandmother, God forbid, gets massive toothache, the [01:07:55] NHS will look after you. That should be the equivalent.

Richard Porter: Yes it.

Payman Langroudi: Should. Yeah. The minimum [01:08:00] standard should be around emergencies and so forth. Yeah. Because as [01:08:05] much as it does some good in the other area, I think it [01:08:10] does just as much harm as well, you know, in, in restorative dentistry, [01:08:15] if the dentist hasn’t got time to do the job right. Yeah. You know, we know even [01:08:20] quite meticulous dentistry fails. So I.

Richard Porter: I [01:08:25] think it’s true. You know, I yeah, I think you’re touching on a number of really interesting subjects there, I really do. There’s, [01:08:30] there’s perception of longevity. So if you have a knee replacement and you go running marathons, you [01:08:35] know your knees are going to fail after 2 or 3 years. You have a crown and you’re parafunctional and [01:08:40] it falls off. There’s grounds. You know, it’s it’s how dentistry is perceived from the top down and [01:08:45] bottom up by the public, by the profession and by politicians as a political tool. That’s all it is. [01:08:50] Yeah, I think the NHS is primarily a political tool. I agree with you entirely, though. I think [01:08:55] the NHS, if I step outside of your office today and break a leg, I don’t need to give a credit [01:09:00] card for the ambulance and and an orthopaedic surgeon will fix my leg and [01:09:05] God bless that person. And nurses will look after me and, you know, be kind to you and [01:09:10] it is a blessing. I agree with you.

Payman Langroudi: Imagine the number of people in the US or whatever who aren’t going to see [01:09:15] their doctor about a particular niggle, because just to say hello to a doctor [01:09:20] is so expensive and and they don’t have insurance. You know, I think it’s 65 million Americans don’t [01:09:25] have insurance. Yeah. And some guy’s got throat ache that might be some cancer. [01:09:30]

Richard Porter: Can’t swallow.

Payman Langroudi: But isn’t going to see anyone because he thinks hopefully he’ll get better by itself. You know.

Richard Porter: Yeah. My insurance [01:09:35] is.

Payman Langroudi: You know we don’t have that problem in here. No. But in dentistry, [01:09:40] if, you know, my grandmother had toothache in America, I think I’d be happier for her [01:09:45] than if she has toothache here. Yeah, I see a big difference.

Richard Porter: The service provision of it. Yeah, [01:09:50] I agree with that. I think you’re right. I think you’re I think it’s a very insightful way of looking at it. And [01:09:55] so do you think that means the public then perceive they need to go more privately like they just. [01:10:00] Yeah. Has that changed?

Payman Langroudi: It’s very good for private dentistry in.

Richard Porter: That.

Payman Langroudi: Sense. In that sense. Right.

Richard Porter: But then [01:10:05] I. So I don’t believe that happens by chance. I think that is conspiracy theorist. [01:10:10] I am a conspiracy theorist. Listen, the NHS, I believe the [01:10:15] primary function of the NHS to you and me is healthcare. But let me make my case. [01:10:20] If the primary function of the NHS, NHS is healthcare, if [01:10:25] you look at the number one reason children are admitted to hospital is through an entirely preventable disease. So that’s fulminant [01:10:30] failure at about around 50% of people. So so the number one killer of [01:10:35] people in the world, the four big killers in the world And number one by a mile is cardiovascular disease, then dementia, cancer [01:10:40] and metabolic syndrome. And for men, particularly cardiovascular disease, it’s probably what will [01:10:45] hasten our demise. 50% of people presenting their first sign [01:10:50] or symptom of cardiovascular disease is death. That’s their presenting symptom. [01:10:55] Don’t tell me you’re into preventative medicine. If you allow 50% of the biggest killer to [01:11:00] be that. So why? So if the NHS is into preventative [01:11:05] medicine, then none of that is happening. Look at the children with decay. Look at that. And [01:11:10] I can pick a million other diseases from that point of view. Then you look at the cost of the NHS, which is over [01:11:15] £360 million a day to fund. Now that may be money [01:11:20] well spent, but a lot is wasted. So this, this sort of utopian idea of how [01:11:25] it should be for medicine, how it should be for dentistry is muddied by the [01:11:30] point I’m trying to make, which is, I believe that you and me as patients [01:11:35] and consumers and providers. The NHS is a healthcare service. I [01:11:40] think for politicians on both sides of the House or however many sides of the House, it’s [01:11:45] a political tool. I have seen 24 hours to save the NHS through every political party [01:11:50] since I was a child.

Payman Langroudi: Yeah, well, you could be both things could be true at the same time, though. [01:11:55] You know, like.

Richard Porter: Oh yeah. Absolutely.

Payman Langroudi: Because it’s such an emotive subject in the UK that it ends up being a political [01:12:00] subject. Um, and, you know, you’ve got the right wing who are constantly being blamed [01:12:05] for trying to turn it private, and then you’ve got the left wing who waste too much. The reality, though, is [01:12:10] financially we’re spending more on it than ever before.

Richard Porter: Oh yeah.

Payman Langroudi: As even [01:12:15] as a proportion of I mean, it’s more it’s a bigger dollar number and a bigger proportion number [01:12:20] than we’ve ever spent before. And yet it’s on its knees. Yeah. So so the answer, [01:12:25] you know, I think there’s a lot of conversations in politics now around what you’re saying that actually changing [01:12:30] to a true preventative model using AI and data to, you know, that’s [01:12:35] the sort of the headline, right?

Richard Porter: Um, I’m very into preventative health. [01:12:40] We, I try and bring a lot of that to people’s lives. And the psychology part of it is [01:12:45] the emotional aspect of that, you know, and people will be familiar with the work like Outlived by Peter Attia. And, you [01:12:50] know, there’s lots of great authors out there, great functional, integrative preventative medicine experts. [01:12:55] And you can look at all of that. So we I look at it from the point of view of your four big killers, but then you [01:13:00] have your six angels of, of life, which is, you know, your big ones are [01:13:05] sleep, nutrition, exercise. And if we’re ever trying to outside of dentistry, but with [01:13:10] our delegates or anyone involved, um, with our faculty to try and help them enhance their [01:13:15] health, is those three big which sleep, exercise, nutrition, just [01:13:20] energy balance. But then building on to that, there’s circadian biology. [01:13:25] I’m a big believer in light. Your light environment really makes a difference. Your emotional wellbeing and [01:13:30] then medications and supplementation. And, um, I mean, we run I run lecture [01:13:35] courses on this and, uh, I, I think.

Payman Langroudi: Are you a longevity expert?

Richard Porter: I’m [01:13:40] not an expert at anything, but I am a longevity.

Payman Langroudi: Enthusiast.

Richard Porter: Passionate [01:13:45] acolyte. I’ll give you an example. Yeah. So and [01:13:50] it’s a cliched example, but the three big deficiencies we have as a [01:13:55] population in the UK with racial disparity vitamin [01:14:00] D, magnesium and omega three. And a lot of your listeners will be very familiar with that. [01:14:05] So there is no sunlight containing UVB in the UK right [01:14:10] now until like late March. And it stopped a couple of weeks ago. So you’re vitamin [01:14:15] D deficient unless you manage that or live a lifestyle according to that. [01:14:20] Now, people who are vitamin D deficient, you know, we send delegates for blood testing, to be honest, if [01:14:25] they really get into this and we’ll look at them. And I was writing to a guy is one [01:14:30] of our delegates yesterday. And I said to him, what do I have to say? Because he sent me his vitamin D and he says, [01:14:35] wow, I’m so severely deficient. Is this accounting for my symptoms? And I said, how many times have I told you [01:14:40] he’s a friend, you know, so I can speak to him like that? And I’m very into people living an [01:14:45] optimised life.

Payman Langroudi: I guess you supplement with vitamin D.

Richard Porter: So there is nuance to it. Yes. [01:14:50] Yeah. And if you’re going to supplement you, the point I’m trying to make is if you’ve got darker skin, [01:14:55] you’re far more at risk of vitamin D deficiency. Deficiency. Far, far more.

Payman Langroudi: Yeah. But what I was [01:15:00] going to, you know, my kids go to French school. Okay. The French take two vitamin tablets [01:15:05] a year.

Richard Porter: Okay?

Payman Langroudi: And it’s a super all year. Yeah. All year, every every year. So it’s [01:15:10] a super high dose vitamin D. Yeah. It’s delicious actually. Yeah. It’s beautiful.

Richard Porter: It’s [01:15:15] so easy to do.

Payman Langroudi: So it makes it a lot easier right.

Richard Porter: So I do supplement vitamin D. Yeah. But you’re going [01:15:20] to supplement with vitamin D if we’re giving you it has to be with K2. And it can’t be activated if you take it orally. [01:15:25] It’s not through your skin unless you’ve got adequate magnesium and most people are deficient in magnesium as well. [01:15:30] And then to absorb that you need some fat in you. So how you take it.

Payman Langroudi: Has a type of magnesium as well. [01:15:35]

Richard Porter: Anything except oxide but magnesium bisglycinate, magnesium citrate. [01:15:40] Any of those things will work very, very well. From. Yeah. So I’m very into this side of it. [01:15:45]

Payman Langroudi: And the omega three, is there a nuance there?

Richard Porter: Uh, there’s nuance in that. [01:15:50] Most omega three supplements you really need omega three. So if you’re deficient in omega [01:15:55] three in terms of all cause mortality, it’s comparable with smoking 10 to 20 cigarettes a day. [01:16:00] Yeah. If you look at the Framingham Heart Study and it compares these deficiencies and all cause [01:16:05] mortality. Most supplements have rancid oil. It [01:16:10] won’t make you ill, but it’s not effective. So the fish oil and, uh, [01:16:15] is rancid. So you really need there’s believe it or not, Payman, there is an international fish oil [01:16:20] standards group, IFAs, and rank them for you. So if you’re really into [01:16:25] visuals, you can look at a global ranking and you obviously want high potency, low rancidity. [01:16:30] And then you can take a very effective omega three. I would have bought you some if I’d known. I think I [01:16:35] know where you live now, so I’m going to come back.

Payman Langroudi: My friend Dan Dan Murray, um, he’s got [01:16:40] a company called Heights. Okay. And he’s very much into apparently very good [01:16:45] for your brain.

Richard Porter: Very good for brain health.

Payman Langroudi: But, you know, he was talking about the type of fish [01:16:50] oil is the key point.

Richard Porter: Yeah. I don’t know if you talk about that. I have a very particular brand I’m very into. So [01:16:55] the best brand I’ve come across is Nordic Naturals. They do halal version for people who want [01:17:00] that as well. And it’s. But Nordic Naturals is just a really, really high quality omega [01:17:05] three brand. They’re very good and they do kids versions as well.

Payman Langroudi: I’ll look that up.

Richard Porter: Yeah, yeah, I would have brought you [01:17:10] some.

Payman Langroudi: I’ll find it. Let’s get on to darker part. Okay.

Richard Porter: I’m ready.

Payman Langroudi: It’s [01:17:15] around mistakes.

Richard Porter: Okay.

Payman Langroudi: Clinical errors.

Richard Porter: Dan that.

Payman Langroudi: What [01:17:20] comes to mind if I say what would have been some of your biggest clinical [01:17:25] errors?

Richard Porter: Biggest clinical error I’ve made, um, is taking on patients who [01:17:30] was impossible to please. Um, and if you speak to I will talk [01:17:35] about actual clinical errors. Um. First of all, I think it’s [01:17:40] inevitable. I think if you put in a million implants or you do 20,000 endos, you’re going to [01:17:45] have a clinical error, you’re going to have an adverse outcome. And I have had [01:17:50] adverse outcomes. But if I look at anyone who’s in a regretful situation, [01:17:55] a delegate, an associate, whomever, I will say to them, did you know this patient was [01:18:00] troubled before you took them on? And they said, yes, I did. So patient selection. And [01:18:05] I’m going to qualify that with patient rejection. Not enforcing your boundaries, [01:18:10] I think is one of the most underrated and important skills we can teach any dentist [01:18:15] in 1978. There’s a paper by a guy called Groves in the New [01:18:20] England Journal of Medicine, and he wrote How to Understand and Deal with [01:18:25] Hateful Patients. And he didn’t have any psychological classifications. We [01:18:30] now know the personality characteristics to look for how to detect them. He didn’t know them, but he came up with this [01:18:35] subject and have been medical publications on that subject many, many, every [01:18:40] year since 1978. There’s none in dentistry, almost none. Whereas [01:18:45] patient personality is the biggest determinant in outcome in challenging cases. So the biggest [01:18:50] mistake I’ve ever made is having I. It’s not a mistake to have compassion, [01:18:55] but if you’ve got high ish compassion and you want to help people, difficult [01:19:00] people can sneak through the net.

Richard Porter: So if you ask a group of people what percentage of the [01:19:05] British population are psychopathic diagnosed, they don’t know. But it’s like 1 in [01:19:10] 50 people. It’s 1 in 50 to 1 or 1 in hundred. If you look at surgeons, it goes up to about 8%. [01:19:15] In prison it’s 20%. So 1 in 5, you know, it’s these are big numbers and [01:19:20] there’s narcissism and Machiavellianism and part of what we call the dark triad of personalities [01:19:25] from a clinical point of view. I have [01:19:30] done everything from so I have seen wrong site surgery. I’m going to touch [01:19:35] wood if you don’t mind. I’ve never done wrong site surgery, which is for dentists taking out the wrong tooth, [01:19:40] but I have seen the wrong ovary removed and I’ve seen the wrong kidney [01:19:45] operated on and things like that. And the fourth leading cause of death in the world is medical [01:19:50] error. Mhm. Um, so so these things happen. I’ve seen prescription [01:19:55] errors. I’ve seen someone prescribed 30g of paracetamol for [01:20:00] post op pain and had to go to that patient’s house. Not, not me to [01:20:05] stop that happening. Um, the worst clinical thing I’ve ever done, I [01:20:10] Payman I think it ranges everything from putting an implant in and thinking it’s perfect [01:20:15] and looking at it, and they’re all parallel. And then this one’s got a wonk on it. And you think, how, how, [01:20:20] how, how did I do that? From looking at your post op radiograph [01:20:25] on an endo, I mean these aren’t common things and I can remember them.

Richard Porter: So yeah I think you’ll [01:20:30] beat yourself up forever thinking oh this endo is absolutely going to be brilliant. And there’s a huge hook. And [01:20:35] I’ve been instrumenting around this apex getting around here. And you look at it and your observations like that and [01:20:40] you think what would I do differently. You know, I will tell you the worst one. [01:20:45] Not many people know this Payman you’ve got secret agent skills. [01:20:50] I was I was a max show and a guy who’d come in, who’d been glassed, and it [01:20:55] was probably two in the morning. There’s my excuse. And I spent all the time getting this glass out of his lip. [01:21:00] And I took you take a soft tissue x ray, and his lip was, like, full thickness. And I got all the glass out, [01:21:05] and it had taken me hours and hours and hours, and I checked it, and I closed it back up and [01:21:10] it was fine. And he came in about a week later to the Max unit, and he was like, I can feel the sharp thing in here. And [01:21:15] I’d I sewed a bit of glass inside his his lip, so we had to open him back up and things like that. [01:21:20] And I remember thinking, if you go back and do that again, would I do it any differently? And I don’t know if [01:21:25] I would, I, you know, I’m not trying to.

Payman Langroudi: I’ve, I’ve been I’ve done that job [01:21:30] and it’s terrible. It’s horrible because in Cardiff you can imagine the rugby [01:21:35] games. Yeah. England, Wales don’t go. There was a lot of that [01:21:40] going on.

Richard Porter: Yeah.

Payman Langroudi: Yeah. Not not not the Wales Scotland Scotland match. No, no. The England [01:21:45] Wales.

Richard Porter: Hostility to England fans in Cardiff is very real.

Payman Langroudi: Yeah. Um and and [01:21:50] you know, 3 a.m. and you’re not in your normal environment. You’re [01:21:55] a dentist at the end of the day and you just become a dentist. Yeah. [01:22:00] Yeah. As well. Yeah.

Richard Porter: Um, and you’ve got to get a bed manager and you’ve got.

Payman Langroudi: To.

Richard Porter: Take IVs [01:22:05] and you’re like, I’ve never done that in my life.

Payman Langroudi: It bloody well makes a man of you doing that job.

Richard Porter: If you. It’s [01:22:10] what doesn’t kill you might make you stronger. Yeah. So I made mistakes. I’m not very good when I’m tired Payman either past 8:00 [01:22:15] at night, I’m basically useless to everything.

Payman Langroudi: What about a Dental one? Like, did you do a lot? [01:22:20] I’m not even looking for one occasion. Uh, is there [01:22:25] a treatment modality that you are very keen on? And then over the years realised [01:22:30] that was incorrect? It’s happening all the time. You’re tweaking all the time. Right. But there’s something [01:22:35] come to mind when I say that. I mean, in my world, like classically ten veneers, Rosenthal style. You [01:22:40] know, even in my short career, I saw some ugly staining, you [01:22:45] know? Yeah, that I thought to myself, I shouldn’t have done that or I did that wrong.

Richard Porter: I think it’s I think [01:22:50] that’s a tight line to walk between. You know, it’s a very good point and it might not it might sound a bit [01:22:55] of a bland answer, but, um, he won’t mind me mentioning it, but Martin Keller was one of my consultants, and he [01:23:00] was like, if you pick up a drill, you know, you you should do everything Adhesively don’t drill the teeth, don’t [01:23:05] drill the teeth. And you do get influenced down that way. And I was certainly influenced that way. [01:23:10] And then you start doing prose where you’ve got to go in direct. You can’t do it all with composite. [01:23:15] You’re going indirect and you’re being so minimal. And I now teach [01:23:20] people, if you’re going to prep a tooth, don’t prep it minimally, prep it properly. [01:23:25] And that might mean one and a half miles off the occlusal surface. So prep one and a half [01:23:30] miles and people you know. So I, I have changed in that regard in [01:23:35] that I was extremely minimal. And if someone said you need 1.5 I would speak to [01:23:40] the technician. Can you get away with like 0.9. And they’re like, well, really not. And so you give them, you know, [01:23:45] 0.91 not that you can prep that accurately, but you know what I mean? I was too minimal. [01:23:50]

Richard Porter: And actually I believed that prepping a tooth. Let [01:23:55] me give you this analogy I use prepping a tooth would kill it. Like [01:24:00] if you prep a tooth, it’s going to kill it. So what’s a spec pulpotomy? [01:24:05] A pulpotomy is where there’s caries in a tooth that’s got an incomplete root. And [01:24:10] what you do is you drill away the caries and then you drill Payman the pulp. And [01:24:15] the intention of drilling the pulp is to preserve the health of the pulp. So [01:24:20] don’t tell me the act of prepping a tooth is going to devitalise the tooth. [01:24:25] You can devitalise a tooth with excess heat and bacterial leakage. It’s those two things. [01:24:30] So actually, I’m very happy. So I have gone around in a circle on that and contradicted myself. I was [01:24:35] very minimalist. Now, if you’re going to prep a tooth and the technician says, I need 1.2, you’re going to get 1.2, I’ll use [01:24:40] a bur that’s 1.2 wide. We’ll measure it with whatever technique we’ll be. Ensure we get you [01:24:45] the enough space to put your ceramic in enough thickness to do the job it’s designed to do. I will do my job [01:24:50] properly, I’ll keep it cool, and I won’t let it get buggy and dirty and leaky. But [01:24:55] that is the key.

Payman Langroudi: So I think this of material, direct or indirect thickness [01:25:00] of material is so important. Minimum thickness for a long lasting restoration [01:25:05] is so key. And interestingly, I had this only, uh, three [01:25:10] days ago. Yeah, it could easily have been a composite. Yeah. Okay. But I’ve gone off composite. I’ve gone off. [01:25:15] We teach composite. Right. We’ve got a full composite hands on course.

Richard Porter: Yeah. You have? Yeah. Very good. [01:25:20]

Payman Langroudi: One. Yeah, but we we I personally have gone off it. Okay. Insomuch as [01:25:25] it’s so technique sensitive and even in the best hands. How [01:25:30] long is it going to last? As long as my porcelain. Only thing that I just spoke about. There’s no [01:25:35] way. There’s no way at all.

Richard Porter: No. A good bit of Emacs press.

Payman Langroudi: Done.

Richard Porter: Really well. It’s just. Yeah, I agree [01:25:40] with you. I think it’s a better product. And I think that’s very, very true. And yeah, it’s interesting. Your question [01:25:45] is really stimulating actually, because I’ve probably gone a bit more towards indirect [01:25:50] at the anterior as well. You know, I’ve done a million cases with composite build ups, Dahl concept, [01:25:55] etc. but I tend to, you know, if you really get to know the patient and I say, look, there’s these two approaches, [01:26:00] what’s important to you is what’s important to me. Like I need it to look amazing [01:26:05] And really, for I don’t want to come back for ten years. Can I get away with [01:26:10] this for ten years? And you do it in porcelain, you know, Emacs or whatever, some form of ceramic. [01:26:15] And they’re happy for a very, very long time. I agree with you.

Payman Langroudi: I mean, listen, I [01:26:20] don’t know how much exposure you’ve had to American dentistry. Um, but my, [01:26:25] my feeling on it is that they’re more drill happy than we are, right. In Europe. Call it. Um, [01:26:30] and I agree with that. And and tiffs, you know that a line bleach bond [01:26:35] was an absolutely important thing. An important thing, you know, compared [01:26:40] to what was going on before. Yeah, there’s no doubt about that. But now I [01:26:45] see a lot of line bleach veneer cases. Yeah. And you know, I used to think [01:26:50] that’s incorrect. Like why would you do that? Why wouldn’t you? But now I kind of get it. I do get why would.

Richard Porter: You think the [01:26:55] shift is. Do you think that’s.

Payman Langroudi: Well, it’s it’s composite and.

Richard Porter: Its failings.

Payman Langroudi: Failing composite. [01:27:00] Composite fails aesthetically. Not only you know, chips. Right. The [01:27:05] stains.

Richard Porter: And it’s never fully cured. Yeah. Like, you take composite and you cure it as much as you possibly, [01:27:10] possibly can. Still, 20% of that is uncured. Yeah. And that’s a liquid which would be displaced by the [01:27:15] liquids. Yeah.

Payman Langroudi: I mean, we really do teach over curing and curing again and long, you know, two minutes per tooth. [01:27:20] But you’re right. You’re right. The reason we do that is because of what you said. Yeah. Um, polishes [01:27:25] a lot better, too when you do that. Um.

Richard Porter: Yeah, I like it.

Payman Langroudi: Yeah.

Richard Porter: Always teaching me, I love [01:27:30] that. It’s very good.

Payman Langroudi: I want to get from you. Um, since you said endo is [01:27:35] your favourite subject, is it?

Richard Porter: No.

Payman Langroudi: Psychology outside, like clinically. What’s your [01:27:40] favourite subject? What do you like doing?

Richard Porter: I it’s it’s implants and pros. Yeah. Implants [01:27:45] and pros.

Payman Langroudi: What is it about them like you said. Right. You know, it’s serious. Is it the sort of the [01:27:50] patient side? The Meccano side? The.

Richard Porter: Yeah, I love that. You know, I mean, you mentioned [01:27:55] materials. I love the fact that these things have been engineered so incredibly well. So if you look at a really [01:28:00] good implant brand, it’s been engineered and the precision is so, so good. You know, I’m at an implant [01:28:05] HQ tomorrow morning and I love their innovations. I love the fact that that’s quite competitive. [01:28:10] So they’re always trying to stay ahead. And then you you put this thing into someone’s skull. You do. You drill [01:28:15] a hole in their skull and you get that roughly in the right place if you can. And then you have these attachments. [01:28:20] Go on it and then you start taking scans and impressions of it and a dual registration [01:28:25] of it. And, and to us, you and I are really I love the paradox that you and I [01:28:30] are excited by that. And it’s like we’ve done this. The patient doesn’t care. They didn’t care. And [01:28:35] then they say, give me a mirror and give me a carrot.

Payman Langroudi: Yeah.

Richard Porter: You know, and I love [01:28:40] that the ultimate acid test of all the things that are important to us are actually not [01:28:45] necessarily what’s important to them, that I just find part of the beautiful part of what we [01:28:50] do, and we get to enjoy our precision. It’s so precise, you know? I mean, let’s talk about another [01:28:55] mistake. I’ve taken hundreds of impressions of crowns and bridges. This is a good one, actually. And the [01:29:00] lab sends me a photo of my model and says, is this the impression you took? And you look at it go, oh [01:29:05] my God, I need to redo my impression. And I’ve learned that the hard way. With implants, you [01:29:10] don’t have that nearly as much, because the precision is built into the system in terms of [01:29:15] an internal locking mechanism inside your implant. So you’ve still got to take a good impression, but it’s a different level [01:29:20] of precision, different parameter you’re looking for. So I love that. [01:29:25] I love the fact that we get to do this. And you can give someone a whole smile back.

Payman Langroudi: Change their lives, [01:29:30] right?

Richard Porter: Change. Change how they feel about themselves and then change how they present themselves [01:29:35] to the world. And when you do that, you change the health. So [01:29:40] there’s a recent study actually, which came out in March 25th and [01:29:45] it measured salivary cortisol. So cortisol is a stress hormone. And when your hypothalamic pituitary [01:29:50] adrenal axis is firing up, great. Unless it’s firing up too much all the time and [01:29:55] you’re producing too much cortisol, and cortisol ages you, it inflames you, it stops you. [01:30:00] You know, you you stop your immune system from functioning well. It’s just a whole multitude of things. [01:30:05] And this measured salivary cortisol in patients pre and post [01:30:10] dental rehab for anterior teeth. And not surprising you give people [01:30:15] their front teeth back. In a way they look good and function well. And the systemic cortisol [01:30:20] drops to a level back where you’re back in that state of peace, [01:30:25] you’re parasympathetically activated. So your sleep improves, your joy improves. The things we [01:30:30] talked about earlier on your interactions. And with all of that, your health improves. You’re probably [01:30:35] going to make that patient live longer and live better until they do eventually [01:30:40] get too sick to survive. So that to me is I think that’s something you aspirational. Well, [01:30:45] you and I could be proud of that you can really hang your hat on that and say, like people say, [01:30:50] how many times you met a patient, say, I know it’s vain, but I’d like this. And I said, it’s not vain, [01:30:55] is not vain. It’s absolutely part of human nature to love [01:31:00] beauty. May I ask you a question?

Payman Langroudi: Vanity is seen as a as a sin in older [01:31:05] British people, their culture.

Richard Porter: Culturally, I do think that labelling it as [01:31:10] a sin. Yeah, but if you look at a morning sunrise, do you find it beautiful? Sure. So [01:31:15] does 8 billion other people. Do you think that’s by chance? No, it can’t be. So [01:31:20] the things that we find beautiful like that are just incredibly good for us. Like seeing the morning wave. Like change [01:31:25] in in the sky is very good for setting your internal clock for every hormone. These [01:31:30] things that we find beautiful. You look at a rose and it’s beautiful. You look at a smile and it’s beautiful. [01:31:35] And the more surrounded by beauty you are, the better your physiology. And if you’re part of that [01:31:40] beauty because you love your smile and you get confidence from it, those joyful emotions, that hormonal [01:31:45] neurotransmitter expression in your body is just, you know, we’re part of that as dentists.

Payman Langroudi: You [01:31:50] know what I noticed in teeth whitening? We’re constantly saying ask everyone. [01:31:55]

Richard Porter: Yeah, I love your message on that.

Payman Langroudi: But then. But then some people, I get loads [01:32:00] of practice, right? There’s many excuses for why not. Right. And one of them is my patients are older. Yeah. [01:32:05] And you know, we developed the first version of this in Folkestone. [01:32:10] Yeah I know, I know.

Richard Porter: I’m from Kent.

Payman Langroudi: I know everyone was over 70, and [01:32:15] they wanted white teeth more than everyone else. You know, they so so so then it’s an interesting [01:32:20] thing. I’ve realised that, um, when a patient says I’m too old [01:32:25] for that, the response you might think might be to be to tell them something around [01:32:30] the age is just a number and whatever. But but it’s not. The best response to that is [01:32:35] to throw in a health benefit of teeth whitening. Um, and it’s [01:32:40] funny because the health benefits of teeth whitening, we never really discuss those are good for the gums. And, you know, [01:32:45] placation and I think.

Richard Porter: They feel clean when I use enlightened.

Payman Langroudi: You said [01:32:50] something about root caries.

Richard Porter: Yeah, absolutely.

Payman Langroudi: But the interesting thing is you throw that out to to an older [01:32:55] patient and you say, oh, by the way, it’s really good for you. And and they’ll say, oh, if it’s good for me then [01:33:00] I should we should go ahead. Right now they’re not even saying that, that what they’re saying is vanity. [01:33:05] I don’t want to admit to wanting a whiter smile because culturally, [01:33:10] at my age, one mustn’t. You know, maybe it was the war or whatever, whatever [01:33:15] it was. Yeah. Vanity is a new disease in the UK, you know. Yeah, I agree.

Richard Porter: So [01:33:20] do you think when they say I’m too old, they don’t mean it?

Payman Langroudi: Not quite. Yeah.

Richard Porter: So, so [01:33:25] one of the analogies we use to see if this resonates with you, we talk about life [01:33:30] is unfair. And, um, if you’re going to have a kid, you want them to be clever or stupid. [01:33:35] Everyone says clever. Do you want them to be good looking or. I want it to be good looking. And we call this [01:33:40] the green button. So if I gave a room full of delegates, the option, you press a green [01:33:45] button. I don’t care how old you are, what ratio or gender you are, any of those things at all. And when you wake up in the morning, you [01:33:50] are noticeably, demonstrably better looking. However that looks for you younger, [01:33:55] whatever you know. Would you press the green button and normally [01:34:00] three quarters of the room go? Yeah I would. I’ll be honest. And the people you’re saying who say I’m too old, [01:34:05] say no, I wouldn’t do it. You know, you’re being callous and shallow. I say, okay, well, you can press the red button if you’re [01:34:10] so indifferent. And when you wake up in the morning, you are noticeably, demonstrably uglier, older, less [01:34:15] attractive. You could just press it. No one would press the red button. And I think green button dentistry [01:34:20] is a universal. I think everybody like you can’t buy skin yellowing toothpaste. [01:34:25] You can’t go to Selfridges or Harrods and say, do you have any skin cream that will make me wrinkly and old [01:34:30] because no one wants it? So I think I think you’re right. The market is always there, but you’re having to [01:34:35] cloak it in a health benefit. Is that true?

Payman Langroudi: Yeah. Listen, when [01:34:40] it when it came, the idea of saying that came to me was I sat in on [01:34:45] someone selling Invisalign to a patient. Okay. Based on its health benefits. Okay. And I thought, [01:34:50] wait a minute. My daughter has just been through two years of ortho. No way would I have put her through [01:34:55] two years of ortho for the health benefits of straighter teeth. You can brush better. [01:35:00] Was what the dentist was selling to the patient. But then I thought, wait a minute. If [01:35:05] he’s saying that, why shouldn’t we throw the health benefits of whitening in? But. But [01:35:10] I noticed all the patients are the ones it resonates with.

Richard Porter: Okay, so let me ask you this then. Do you think those [01:35:15] patients then go and look in the mirror in the morning at their bright white teeth [01:35:20] and go, I’m so glad I’ve got these health benefits. Or do you think they sit there going, I love my [01:35:25] white teeth. I love my.

Payman Langroudi: Every time you’ve made a denture for a for an older patient, they’re picking the whitest [01:35:30] teeth. Absolutely. Yeah.

Richard Porter: Yes. You absolutely nailed it. So it’s it’s that it’s [01:35:35] stated preferences and real preferences, isn’t it? It’s the difference between those two. Yeah. Perception of [01:35:40] it.

Payman Langroudi: Where are we going? Where are you going next? I mean, you’re you’re you’ve [01:35:45] you’ve achieved a lot. Um, I guess you’ve just done the new centre. So does that [01:35:50] has that increased your your number of people you can handle for a year?

Richard Porter: It’s, um. I mean, the centre’s not finished. [01:35:55] We’re in the last few weeks.

Payman Langroudi: Are you in the process?

Richard Porter: Yeah. And it’s been. It’s been an incredible journey. Do you know, the one thing [01:36:00] I’d say about having the centre is, is or building it is working with other [01:36:05] people, not within our beautiful profession. I, I’m [01:36:10] not advocating for the GDC or saying they’re good or bad. Whatever. I [01:36:15] tell you, we need them because having a regulator, the behaviour of professions outside [01:36:20] medicine, dentistry is extraordinary. It’s extraordinary.

Payman Langroudi: Are you having [01:36:25] difficulty with your builders? Is that we’ve had we’ve had.

Richard Porter: Plenty of difficulties with people along the [01:36:30] way. In your who’s doing his Instagram Stories, where he talks about it and just, you know, in terms of people [01:36:35] not reaching a standard, we can be proud as dentists that we have that standard. [01:36:40] So once this place is up and running. Yes, it’s a world of opportunities there, to be honest, because we’ve got our [01:36:45] own training centre. It’s got a six surgery, dental practice and facial aesthetics practice, [01:36:50] and we have a wellness and longevity spa built on it as well. So we’ve got thermal medicine, [01:36:55] cryo chambers, IV drips. We’ve got an infrared sauna, hyperbaric oxygen [01:37:00] treatment rooms. So it’s a beautiful obviously.

Payman Langroudi: Where is it?

Richard Porter: Uh, just off Regent Street. [01:37:05]

Payman Langroudi: Wow.

Richard Porter: Yeah. So about three minutes from Oxford Circus.

Payman Langroudi: I’m coming to the opening of that.

Richard Porter: Please do [01:37:10] come for the pre-opening, I would argue. I mean, a lot of people have heard me say this, but [01:37:15] I don’t know if you’ve ever had a proper infrared sauna. You’ll leave thinking. [01:37:20] I haven’t felt this good in years.

Payman Langroudi: Really?

Richard Porter: It’s so strange. I’m an ice bath addict. [01:37:25]

Payman Langroudi: Yeah, I like ice baths. Do you? Yeah.

Richard Porter: Yeah, mate, we’ll have to. Let’s get you on camera. We’ll do the ice bath. [01:37:30]

Payman Langroudi: The ice bath twin thing.

Richard Porter: And. And then go from there straight into an infrared sauna. You just [01:37:35] literally sit at home, think I just feel strangely good. And like [01:37:40] when your body feels good, your mind feels good.

Payman Langroudi: Yes.

Richard Porter: Everything’s linked like that. So. Yeah, that’s that’s the big project. [01:37:45] And we’re very lucky to have a number of plans for different forms of education once we’re [01:37:50] there. You know, the AV infrastructure is really something we’re proud of. And, um, we affiliate with [01:37:55] some other people who want to run their educational opportunities there as well. And I’m doing a big project on [01:38:00] dementia prevention. I’m involved in the psychology on dementia prevention on a global level.

Payman Langroudi: The [01:38:05] psychology of it.

Richard Porter: Yes. Yeah. So if you look at dementia risk, like twice as many women [01:38:10] have dementia as men. Um, and if you can stop dementia [01:38:15] in women, you’re pretty much by default stop it in men. So everyone benefits. [01:38:20] And we are looking at all the risk factors for dementia, which [01:38:25] are partially genetic and epigenetic. Um, [01:38:30] but a lot of them are lifestyle and many of them are also personality [01:38:35] and emotion related. So chronic stress, chronic inflammation, things like that. And so I’m very involved [01:38:40] in that. And, uh, that’s my going to be my life’s mission. I believe dementia [01:38:45] is not entirely, but almost entirely preventable. Preventable. Yeah. [01:38:50] So I’m going to die on that hill. I might die alone, but I will. I will die on the hill of [01:38:55] thinking I will go down fighting dementia. I think.

Payman Langroudi: What’s your, um, [01:39:00] family situation? Do you have kids or.

Richard Porter: Yeah. I’ve got two sons.

Payman Langroudi: How old are they?

Richard Porter: They are [01:39:05] 14 and 16. So GCSEs this year? Oh. For my oldest, [01:39:10] George. Yeah. Um, they they are my reason. They are. [01:39:15]

Payman Langroudi: I would would you like them to be dentists?

Richard Porter: Do you know that is the question, [01:39:20] mate? The answer to the question is when they’re a little bit [01:39:25] older. I know the decisions are coming sooner. Sooner than I’d like. Genuinely. If [01:39:30] they’ve got the emotional intelligence, the answer is yes. If they haven’t, the answer is no. I [01:39:35] believe that is how interesting. I think that is an almost dichotomous choice [01:39:40] that if you can and maybe they can learn it. But I [01:39:45] think if you can deal with people, I don’t think there are many jobs where [01:39:50] dealing with people is more important skill to have than [01:39:55] tactical emotional intelligence. I guess I just want them to be happy. [01:40:00] And my great friend Matt Clover, who’s, you know, an incredible father, said [01:40:05] to me, you’ll only ever be as happy as your least happy child. And so whatever [01:40:10] they want to do and, and I’ll be honest, I’m not trying to sound, but I would be [01:40:15] miserable for the rest of my life if it means my kids are happy.

Payman Langroudi: Oh. Nice man. [01:40:20] I mean, it’s a funny thing because it’s easy to say, you want to want the kid to do whatever he wants to do, [01:40:25] but often they don’t know what they want.

Richard Porter: Of course you don’t. I mean, especially young boys. I mean, they’re just idiots who just play [01:40:30] rugby.

Payman Langroudi: And.

Richard Porter: And throw fruit at each other’s heads. And what about you? Your kids? Dentists.

Payman Langroudi: My. [01:40:35] My son kind of did want to know. He’s just gone to university for the first time. He’s doing aerospace engineering.

Richard Porter: Yeah, [01:40:40] that sounds cool.

Payman Langroudi: Yeah, it sounds cool, but it’s a lot of it’s defence, unfortunately. I didn’t [01:40:45] even realise that when he told me. I thought it was like Formula One cars and helicopters. But.

Richard Porter: But [01:40:50] it’s like aeronautical defence mechanisms.

Payman Langroudi: Defence is like 90% of it. Wow. You know, [01:40:55] the funny thing is, anyway, you know, as you’d expect. Okay. You know, he went on like a, like a work [01:41:00] experience. And it was all like, I don’t know, the helmet for this bomber. [01:41:05] That’s incredible. Yeah, it’s incredible stuff. Incredible stuff.

Richard Porter: Did you. He [01:41:10] loves engineering.

Payman Langroudi: Yeah. Yeah, yeah. And you know, he expressed his interest and I thought, well, I [01:41:15] said I’d say to him, I said, listen, every boy likes rockets and planes, right? Are you sure? Yeah. It’s very difficult [01:41:20] to get in and do right. And he said no and he did it. And now he’s in bath. So great. My daughter, [01:41:25] we’re kind of trying to push her into dentistry. Not push, not push, not push. But [01:41:30] she’s like easily she’s saying she doesn’t know. Right. So. Path of least resistance. Kind of. We’re trying to [01:41:35] make the path.

Richard Porter: It’s a massive commitment. If you don’t know.

Payman Langroudi: Yeah.

Richard Porter: Did you always want to do it? [01:41:40]

Payman Langroudi: No, but. But I really think it suits a girl very well. Like, you know, in terms of flexibility, [01:41:45] right? You know, you can stop, start one day, five days. Um, God [01:41:50] forbid she gets divorced and and needs to feed her kids. She can. Yeah. [01:41:55] Um, or let’s say she marries Elon Musk and needs to buy handbags. Now she can. [01:42:00] Yeah. I think in that sense is very good, you know.

Richard Porter: And particular areas [01:42:05] within dentistry, I think, you know, subsections within dentistry do give you that flexibility to move in and [01:42:10] out. Yeah. I agree with you. I think our profession gets a bad rap. Yeah, I do, [01:42:15] and I think it’s a good profession. I think it’s a.

Payman Langroudi: Profession as well. Right.

Richard Porter: Yeah I think from within.

Payman Langroudi: Yeah.

Richard Porter: Um, [01:42:20] and, and you know, some of it’s completely justified, but I think, I think we can be more proud of [01:42:25] what we do. Yeah. And I think we can have a more positive spin on it. I think we’re a little isolated. [01:42:30] I think dentists are a little bit alone.

Payman Langroudi: Why do you think dentists kill themselves?

Richard Porter: Um, I [01:42:35] know, so men [01:42:40] and women kill each kill themselves for slightly different reasons. But [01:42:45] for men, it’s particularly like it’s much higher in men. And so I’m not excluding women from the answer. [01:42:50] But if you look at your negative emotion lists, when your brain predicts there [01:42:55] is nothing of value in you to anyone else or any future experience [01:43:00] that makes it worthwhile. We call that emotion hopelessness. So people kill themselves because [01:43:05] they feel completely hopeless. Now, to give someone hope, it has to be hope [01:43:10] for something that is valuable to them. So what’s valuable to you might be different to what’s valuable to your [01:43:15] wife. For you, it’s going to be a sense of purpose. I’m not saying a sense of purpose isn’t important to [01:43:20] your wife, but for you, that might be prime, that you are value to the people who love you and need you. I [01:43:25] just said I’ll be miserable for my kids if it meant they were happy. That sense of being [01:43:30] needed is absolutely key. Dentistry strongly [01:43:35] predisposes people to burnout, and [01:43:40] burnout, in its simplest definition, is being asked to give from an account of which is already [01:43:45] empty. You’re asked to give something you don’t have anymore, and it manifests as [01:43:50] your lack of enthusiasm. Exhaustion, depersonalisation to patients [01:43:55] become a risk rather than a human. What you and I have been talking about all this time, and then a [01:44:00] decrease in your ability to do your job so you get rubbish at your job, you get really unfriendly around [01:44:05] patients and you’re just exhausted all the time. And I was I was actually invited to give a talk about [01:44:10] that at the British Society of Prosthodontics recently.

Richard Porter: I always wanted to go there because [01:44:15] it’s the Royal Institute and it’s where like Newton spoke and stuff. [01:44:20] Not that I’m comparing myself to him, but it was nice to be in the same halls and and so [01:44:25] then you can look at the risk factors for it. And a lot of the there are internal and external risk factors [01:44:30] for burnout. And that sense of hopelessness and the external ones are very [01:44:35] prevalent in dentistry, which is a demanding workload, social and sort [01:44:40] of professional isolation. Like you sit in a room, you don’t get to move around much. You’re often working [01:44:45] without much natural light. The ability to move your body produce myokines from your muscles. Um, [01:44:50] a sense of, uh, apathy and no hope for the future. You’re not going to develop anymore. [01:44:55] You’re on this routine. The risk of patients complaints, they loom over us a lot. Regulatory [01:45:00] overregulation. So the external risk factors are huge. There’s the big one that people don’t [01:45:05] talk about is emotional. We call it emotional instability, which [01:45:10] in personality psychology has the term neuroticism. We call it an end score. [01:45:15] So you have an end score out of 100 and so do I. And so does [01:45:20] everyone else you meet. And the higher your end score, the more internally predisposed to [01:45:25] burnout and sensations of negativity and indeed, God forbid, hopelessness. Everyone is. [01:45:30] So I’m very passionate about saying to someone the [01:45:35] the Temple of Delphi, you know, Apollo’s temple was know thyself, understand [01:45:40] what you’re like. Understand if you do feel stressed and you bring it into [01:45:45] your body and you ruminate, and how predisposed to anxiety and depression and sadness and negative emotion are you [01:45:50] because it’s different for everyone, literally on a range from 0 to 100.

Richard Porter: And if you’re very, very high, [01:45:55] you need to be aware of that. You don’t. It doesn’t make you a bad person. It makes you incredibly good at detecting tigers [01:46:00] in the forest, which I ignored, which is why I’m dead. So your threat sensor is really good, but if it’s [01:46:05] too good and you’re predicting misery, and you have a bad thing because you will have bad things in dentistry, [01:46:10] you will have bad days and it destroys. You know yourself and you’ve got two options [01:46:15] one, change your end score. You can definitely do that. So if somebody is really heavily [01:46:20] predisposed and they’ve got very high end score, very high neuroticism, like 96, 97. [01:46:25] You can bring that down. There’s evidence based things of things you can do to bring it down. Doesn’t [01:46:30] change you, just enhances your experience of life. Or you need to build a life [01:46:35] where you’re less exposed to it. And that might be niching. So that might be you do do a a [01:46:40] line bleach and bond. And that’s you’re not trying to do Indo and prose and perio and everything. [01:46:45] You just say, I’m just, I’m just or I’m just going to set up a whitening practice and I’m gonna do whitening and bonding [01:46:50] or I’m just going to do, you know, you either structure the external world or alter your internal world. [01:46:55] And I’m very and that’s why I if someone kills themselves [01:47:00] because of their profession, it angers me. I, I don’t like that at all. [01:47:05] I don’t think I that that shouldn’t happen.

Payman Langroudi: You know, we’re treating life [01:47:10] patients who are scared as well. You know, my my cousin’s an ophthalmic surgeon. He says his [01:47:15] GA days are relaxed. Yeah. His LA days are much, much more stressful. You [01:47:20] know, they’re having to stick needles in people’s emotional.

Richard Porter: Emotional mirroring is.

Payman Langroudi: Real. Yeah. Yeah, yeah. You know, there’s a very [01:47:25] tense person and you’re there all day looking after this very tense person. [01:47:30] Yeah. You know, it brings on a lot of stress to you.

Richard Porter: And we work inside one of their orifices. [01:47:35] I’m not being crude, but you’ve got a few orifices on your body. But there’s only one [01:47:40] that’s involved in eating speech and gets decorated every day. And you put lipstick on. [01:47:45] It’s like maybe you put earrings on that’s decorating this orifice. You know, but that’s it. [01:47:50]

Payman Langroudi: Yeah.

Richard Porter: And it’s it’s an awful, you know, it’s so important. And that emotional mirroring [01:47:55] is brutal. I’ll be honest. You know, if you give an example of that Payman, you’re you’ve got a really [01:48:00] calm manner about you. So you and I haven’t met today before today. But [01:48:05] you have helped me here just because you’re relaxed and chill and kind [01:48:10] and, you know, emotional mirroring is absolutely real. And you would have known if I turned up here and, [01:48:15] you know, it was absolutely terrifying. And you would have you would have turned it on even more and [01:48:20] you would have given me more emotional support. But how much would that cost you? And if you do that 20 times [01:48:25] in a row, you.

Payman Langroudi: Think.

Richard Porter: It’s this podcast going anyway?

Payman Langroudi: Did you have delegates who [01:48:30] are paralysed by fear of litigation?

Richard Porter: Yes.

Payman Langroudi: It’s a much more common thing these days.

Richard Porter: Yes [01:48:35] it is.

Payman Langroudi: And what do you do for them? Do you, do you sort of. Is it like, is it the same as being phobic [01:48:40] of spiders or something. You have to.

Richard Porter: So I mean, so if somebody’s got [01:48:45] a real, um, the only thing about a spider [01:48:50] in the UK isn’t really going to hurt you. So a phobia is when it’s probably [01:48:55] not justified. Yeah. I think you should be aware of litigation. [01:49:00]

Payman Langroudi: No, but paralysed by it. You know, I’m not trying anything new. I’m. But hate every day [01:49:05] because I’m worried. Every patients.

Richard Porter: That happens all the time. Yeah, that happens not all the time, but at least once [01:49:10] a year.

Payman Langroudi: It’s kind of common, isn’t it?

Richard Porter: I’ll have 5 or 6 people like that.

Payman Langroudi: Really?

Richard Porter: Really. And I think you can go down [01:49:15] the rational route. But then I would ask that. So you can that’s cognitive behaviour [01:49:20] therapy. And then partial exposure to risk at the titrated dose. That’s right [01:49:25] for them. Yeah. But if if you’ve got two people who are both really bright, they’re both dentists [01:49:30] and they’ve got the same level of risk, but one is paralysed and one isn’t, then the difference is in the external [01:49:35] world is the internal. So it comes back to that end score. And I would say to that person, let’s [01:49:40] talk about ice baths. Bear with me for a second. Yeah. One [01:49:45] of the when you’re talking about the mind, you have to say it with humility because [01:49:50] it’s infinite. 729 trillion synapses. So [01:49:55] all we can do with the mind is use models. And if I’m going to use a model for the mind in this situation, I would [01:50:00] say you’ve got a coach voice in your head and a critic voice, and the critic voice [01:50:05] is your paralysing voice. It’s the one. Don’t start a whitening company. [01:50:10] Don’t, don’t do this. Don’t go into aeronautics. Don’t do this. Don’t put your ideas [01:50:15] forward. Don’t invite this stranger into your podcast. You might be drunk or whatever, you know. Don’t [01:50:20] take chances. It’s the same voice that says, don’t get in an ice bath. It’s the same [01:50:25] voice. And so if I have an ice bath, it’s extremely cold. The weather’s turning [01:50:30] now and there’s not once I look at it and go, oh, get me in there. Every single time I look at it and I [01:50:35] think, oh God, this is going to be horrible.

Richard Porter: I’ve chosen my music, I’ve got some Viking chant going on, and [01:50:40] I think, right. What kind of person, Richard, are you? Are you going to become. Where’s your identity? Get in the ice bath. Shut up and get on with it. [01:50:45] But I still hear the critic voice. So what I would do for those people is say [01:50:50] externally, what can we control? What can we mitigate? What are the systems? What are the level of assurances [01:50:55] and what’s actually rational. And then internally, let’s have a look at how you look at life. [01:51:00] Because the same voice that says I’m paralysed, stay safe, [01:51:05] don’t go into work is the same one who says don’t have the ice bath. So it’s [01:51:10] a small, trivial example, but we try and change that threat sensor, [01:51:15] that amygdala response to perceived or even real threats. And [01:51:20] I think the harshness of it is that there are real threats. Yeah, there are difficult patients [01:51:25] and there are problems and there are procedures that can go awry. But most of them won’t. And [01:51:30] it’s you being resilient enough by changing your internal architecture. [01:51:35] So you become the sort of person who can say, listen, I’m never going to silence my critic [01:51:40] voice. I’m never going to silence it, because we can measure this over time, measure it in score over time. But [01:51:45] I can at least dampen it down so I can have the life that I want, that that I love helping [01:51:50] people become.

Payman Langroudi: Can I ask you some quick fire questions?

Richard Porter: Oh, this is a scary.

Payman Langroudi: But [01:51:55] what’s what’s what comes to mind if I say, what’s the best lecture you’ve ever been to?

Richard Porter: Uh, best [01:52:00] lecture I’ve ever been to. Dental. Not not non Dental. Um, [01:52:05] I would say the the the best lecture I’ve ever seen was, [01:52:10] uh, TJ power, who is a neuroscientist. He’s got a book out called [01:52:15] dose I recommend everyone to. And I’ve seen him online give a lecture. He gave a live lecture I couldn’t [01:52:20] attend just recently at a big health event. Jay Powell I know, ridiculous name. And [01:52:25] and you think you’re going to see some David Goggins like warrior and you’ll see this small, [01:52:30] diminutive, nerdy looking, really lovely, super smart. And if he watches this. [01:52:35] Hi, TJ, uh, um, neuroscientist, and he’s wrote a book called dopamine. [01:52:40] Dopamine, which is, which is, uh, sorry, called dose, which is dopamine. Oxytocin. Serotonin, endorphins. [01:52:45]

Payman Langroudi: Oh, I think I’ve heard him. Yeah.

Richard Porter: I’m going to come back with all these books.

Payman Langroudi: I’ve heard him I’ve [01:52:50] heard him on a on a podcast.

Richard Porter: Yeah.

Payman Langroudi: Brilliant. Excellent, excellent. Yeah, yeah. And Dental. [01:52:55]

Richard Porter: Dental. Um, I, I going to do, you know, [01:53:00] I’ve in terms of content, I’ve heard Daniel Hoff when he was [01:53:05] first talking about Emacs, I’ve heard, um, the lecture I was most blown [01:53:10] away with was Marcus Hertzler, and Marcus Hertzler was showing how to [01:53:15] do the tunnel technique when it was first pioneered with a connective tissue graft from the palate. Not [01:53:20] raising a flat but undermining everything. Plumbing it in, using composite to close your contacts [01:53:25] and suturing this position. And I remember I was at the British site of restorative dentistry, sitting next to Sian and my consultant [01:53:30] colleague. Just thinking blown my mind venini the first time I ever saw him years [01:53:35] ago, showing lots of and thinking my composites are A3 and yours are [01:53:40] like nine shades of composite and they’re thinking that’s absolutely brilliant. I’m going to put a shout out for Martin [01:53:45] Keller because, uh, Martin is [01:53:50] is afraid to stick his head above the parapet and say, this is what I think [01:53:55] is right. You can agree or disagree. I’m just here to talk to you about it. This is what I think is the right [01:54:00] thing to do by your fellow human being.

Payman Langroudi: Do you mean the the water test and all of that?

Richard Porter: Yeah, yeah, I do, [01:54:05] I do.

Payman Langroudi: I think, by the way, one of the most important sort of things that he did manage to [01:54:10] get that into the narrative.

Richard Porter: Just just to make it and to get your foot in the door. Yeah. With the conversation, [01:54:15] you’ve got to.

Payman Langroudi: Yeah, yeah.

Richard Porter: And it’s brave.

Payman Langroudi: Yeah. Yeah. I [01:54:20] don’t know. I mean, it’s we should be able to agree and disagree with each other [01:54:25] in dentistry without it becoming toxic, although it does often become [01:54:30] toxic. And I always think about that, you know, why is that?

Richard Porter: And why do you think it is?

Payman Langroudi: Well, I think [01:54:35] there’s a couple of things here. One is you get a bunch of egos because, you [01:54:40] know, they’ve they’ve done something a certain way. They’ve been successful. It’s quite easy [01:54:45] to be successful as a dentist compared to as a marketeer, let’s say. So the guy’s been successful. [01:54:50] He’s done something a certain way. Now someone’s saying that was the wrong thing to do. It almost gets [01:54:55] at your identity, you know? But then you can hide behind the patient, and [01:55:00] then you can do the most awful things to each other under cover of of patient [01:55:05] care. You know, is my concern. Yeah. You can, you know, it gives it gives you license to say [01:55:10] anything about you. As long as there’s a patient. We’re talking.

Richard Porter: Yeah, yeah. The benevolence.

Payman Langroudi: Of healthcare. Yeah.

Richard Porter: Yeah, [01:55:15] yeah. I’m that’s we call that moral spiralling. You know, I’m sitting I’m [01:55:20] ever higher. My moral. And once you’re morally superior to everyone, you can cast aspersions.

Payman Langroudi: Wherever [01:55:25] you want. More spiral. Spiralling.

Richard Porter: Spiralling. Yeah. You just sit on your moral spiral. And if if [01:55:30] I think if you, you know, you can gossip about another dentist and I do, I think you’re right. I think it [01:55:35] does happen in dentistry more you get to feel morally superior without doing anything.

Payman Langroudi: Yeah.

Richard Porter: You know, without [01:55:40] doing anything moral.

Payman Langroudi: We could all do with a bit of moral superiority. Do you do you think.

Richard Porter: The, um. [01:55:45] Do you think there is more envy in dentistry than in other professions?

Payman Langroudi: No, [01:55:50] I doubt it, I doubt it, although I’ve spoken to people, you know, um, people who come from banking [01:55:55] into dentistry and, uh, you know, they own corporates and all that, but but they actually saying [01:56:00] that people in dentistry are much more horrible to each other than bankers are should try builders. I’m [01:56:05] surprised. I was surprised when he said that the guy, [01:56:10] um, Kunal from Tooth Club, he’s got 15 practices or something, I think. [01:56:15]

Richard Porter: I think he’s right.

Payman Langroudi: Yeah, yeah, he must be. I mean, he’s seen both sides, right? I just thought bankers were, [01:56:20] like, real, you know, do each other’s in, do each other in. No morals and all that.

Richard Porter: Yeah. Yeah. Well, [01:56:25] I mean, they’re in it for one reason and that’s to make money.

Payman Langroudi: Although although I noticed my buddies who [01:56:30] are in corporate, you know, banks and things, they’re so politically sort of [01:56:35] aware, you know, of what they can and can’t say and do and you know, that corporate speak and.

Richard Porter: Oh, yeah.

Payman Langroudi: For [01:56:40] sure, it’s part of working in a big company. Whereas the dentists, many of us are mavericks, you know, like [01:56:45] we haven’t worked anywhere other than our own place. Yeah, it’s true, it’s true, [01:56:50] it’s true.

Richard Porter: But there is. And you know, dentists we don’t get trained to do we.

Payman Langroudi: Don’t get trained to talk.

Richard Porter: To [01:56:55] a dentist.

Payman Langroudi: Exactly.

Richard Porter: But not to run a business.

Payman Langroudi: But but even, you know, I personally I’m terrible [01:57:00] at meetings. But, you know, in a meeting, there’s a certain way of carrying yourself, and you know.

Richard Porter: You’re not good.

Payman Langroudi: At [01:57:05] listening to people, and I love that. I hate meetings. So do I don’t like meetings.

Richard Porter: So do I. It’s [01:57:10] all performative.

Payman Langroudi: I don’t know, but I, you know, I know how little I like it when it’s [01:57:15] in my own company, on my own subject, with my own people. And [01:57:20] half an hour in, I’m going crazy. Yeah. You know, like, it couldn’t be more about me [01:57:25] than that. Yeah, yeah. Okay. Okay.

Richard Porter: So where’s your discomfort come from, do you think? [01:57:30]

Payman Langroudi: I don’t know, I just don’t like it. I don’t know. Adhd, whatever. I don’t know, something like that. [01:57:35]

Richard Porter: Yeah. Yeah I love it though I you’re seeing from him she I want to listen to so. [01:57:40] Yeah. Yeah. Yeah very very much. Yeah. You know the reason I hate meetings is because [01:57:45] they take take too bloody long. Yeah. You know, and if you schedule, let’s say you and I had to talk [01:57:50] about a particular subject and we schedule an hour for it. It’ll take an hour if we schedule. It’s called Peterson’s. Yeah, yeah. If you say [01:57:55] we’ve got ten minutes, we’ve got to bang this out.

Payman Langroudi: Ten minutes. So, so, so true. I try and keep it very short.

Richard Porter: Yeah. When I go to a meeting, [01:58:00] I say, right, this is the agenda. If you waffle, I’m going to silence you. You know I will. Yeah. [01:58:05] Somehow I’m going to move on. No waffling. Point one. Let’s do it. A [01:58:10] well-run meeting. Yeah.

Payman Langroudi: What’s your favourite Dental book?

Richard Porter: Uh, you know, I’ve got an easy [01:58:15] answer for that. An easy answer. Mike Wise no, it’s not, but I want I want [01:58:20] to say this slowly. I want to say it slowly. Because this book to me and [01:58:25] again, goodness me, I wish I bought you one. The author is a man called Farhad Naini, and [01:58:30] Farhad Naini is an orthodontist I was blessed to work with. I think he’s the most [01:58:35] published, scientifically published dentist in the UK, probably Europe. I [01:58:40] swear to you, this man is a genius. And he wrote a book on [01:58:45] aesthetics and orthodontics, facial aesthetics and orthodontics. And you [01:58:50] can read this book like a novel. He is an exquisite genius. [01:58:55] He is one of the kindest, most eloquent, [01:59:00] brilliant people you could ever work with. I am biased because I’ve worked with him and he’s helped me so many times.

Payman Langroudi: The name of the book [01:59:05] I.

Richard Porter: Yeah, yeah, let me get it. Word for word. Do you mind if I look it up on my phone? Let me get it. Absolutely. [01:59:10] 100%. And, um.

Payman Langroudi: His name is Farhad Naini. Yeah.

Richard Porter: Farhad [01:59:15] Naini.

Payman Langroudi: Naini.

Richard Porter: Farhad Naini. And, um, he, [01:59:20] um, I remember he’s a very, very interesting guy in that he, um. [01:59:25] He’s like a fourth Dan black belt.

Payman Langroudi: Of [01:59:30] course. Of course. You meet him and you think. You think you’re talking to the most.

Richard Porter: Gentle, [01:59:35] kind person you could ever meet in your entire life. And, uh, but he’s obviously a [01:59:40] very, uh, very, very impressive guy. He’s talking at an event I’m going to soon. And [01:59:45] so there’s a there’s a guy called Daniel Hamermesh who wrote a book called Beauty [01:59:50] Pays. And he talks essentially about the halo effect and how, you know, bond [01:59:55] looks like bond looks, and Danny DeVito is never going to be Batman. And you know, I’m afraid [02:00:00] what the stuff you and I were talking about aesthetics matter. And, um, he lectures [02:00:05] often with him.

Payman Langroudi: Okay.

Richard Porter: Farhad lectures on like, a level that is just [02:00:10] sort of stratospheric.

Payman Langroudi: To how cool.

Richard Porter: But, you know, a lot of people, he’s so humble, [02:00:15] you won’t know him. Um, let me get it absolutely correct here. Um, [02:00:20] and obviously, I’m searching him up and it’s buried, buried, [02:00:25] buried, buried. Although book. Maybe we get a screenshot and I’ll put [02:00:30] it up. Um, facial aesthetics and Concepts by clinical [02:00:35] diagnosis by Farhad Naini.

Payman Langroudi: Nice.

Richard Porter: Nice facial aesthetics concepts [02:00:40] and clinical diagnosis. But, you know, when you read that book, I’m sorry. I’m staring at it because [02:00:45] it’s so.

Payman Langroudi: Beautiful when.

Richard Porter: When he when you read that book, it goes into the history and [02:00:50] all the symbolic history and concepts of beauty. And I just remember thinking, wow, I’m [02:00:55] blessed to be close to your mind. Have I sold it enough?

Payman Langroudi: You have? Yeah. [02:01:00] What’s a course you’re desperate to go on? Like if I. If if there were no time constraints, [02:01:05] no money constraints, no constraints, you could click your finger and get get yourself through [02:01:10] a course or a program or whatever. What would you do?

Richard Porter: Dental. Um, do you know, you [02:01:15] always had this sense of inadequacy? And, you know, I’m reasonably well known for doing implants and things like [02:01:20] that, but working in Maxfacts, if there’s anything zygomatic or or further back in the pterygoids, [02:01:25] that would always fall to our maxfacts consultants. So if somebody could say, right, Rich, I would give you these [02:01:30] skills, it would be deeper surgical skills where you could do that dissection yourself. I think from a clinical [02:01:35] point of view, from a non-dental point of view, I, I do study, uh, like [02:01:40] behavioural cognition and psychology now, but I would do that forever. And if [02:01:45] I could.

Payman Langroudi: Avoid fascinated.

Richard Porter: If I could do it. Yeah. If I could avoid sleeping to not waste time [02:01:50] with sleep, I would study it forever. Like understanding for me. Sorry. I know you’re doing [02:01:55] quickfire questions, but you invited me. It’s your mistake. The. I think the [02:02:00] internal motivation, remember, starts with curiosity. Two universities. We can be endlessly [02:02:05] curious about the cosmos, nature, flora, fauna, the incredible natural world. [02:02:10] There’s always something to study. And the internal. There’s two infinite universes. External, internal. [02:02:15] And I will study the internal University of human psychology forever.

Payman Langroudi: Love [02:02:20] that.

Richard Porter: Thanks. Love that.

Payman Langroudi: Final questions. I will be.

Richard Porter: Quick, [02:02:25] I promise.

Payman Langroudi: No, no, you don’t need to be quick. Um. Fantasy dinner party. Oh, three guests, [02:02:30] dead or alive.

Richard Porter: I’ve got to have Friedrich Nietzsche.

Payman Langroudi: Okay. [02:02:35]

Richard Porter: I have apparently he was miserable and sad all the time, but I think [02:02:40] he was the brightest man who ever lived. Probably, um, Scarlett [02:02:45] Johansson, for obvious reasons. I’m still human, Um, [02:02:50] who else do [02:02:55] you know? Uh, another living Naval Ravikant, I think, is navel. [02:03:00]

Payman Langroudi: Navel? Yeah.

Richard Porter: Yeah, I just think he’s, you know, he’s he’s wicked. Yeah, he is absolutely wicked. [02:03:05] My, there’s essential reading. And, uh, you know, when breath becomes air. [02:03:10] I don’t know if you read it. No, it’s just an incredible book. And, uh, the guy that [02:03:15] wrote it died. And it’s the story of his death. Actually, I would love to meet him. I [02:03:20] forget his name so much. But when breath becomes air. If anyone wants a book recommendation, [02:03:25] just.

Payman Langroudi: You can have. You can have breath.

Richard Porter: And when I die, that’s [02:03:30] it.

Payman Langroudi: And it’s that.

Richard Porter: He’s a cardiologist. Genius cardiologist. Yeah. Incredible.

Payman Langroudi: Absolutely [02:03:35] incredible. The final, final question is a deathbed question. Okay. Um, I [02:03:40] should ask you one more. Um, three pieces of advice for your deathbed, for your loved ones, without [02:03:45] doubt.

Richard Porter: Number one. And I’d make it two and three if you’d allow me, is know thyself. Self-awareness [02:03:50] and understanding.

Payman Langroudi: Why do you think self-awareness, though [02:03:55] is is is something you can train?

Richard Porter: Yes. I didn’t used to, but I [02:04:00] do.

Payman Langroudi: Really.

Richard Porter: I do. I think you can create metacognition in people. I think you can say to them I [02:04:05] being trivial. I use the example of. So it’s [02:04:10] Monday night, Tuesday next week you’re going to dream. Your [02:04:15] brain is extremely active at night. Massively. You’re going to have emotions in your [02:04:20] dream events going to happen in your dream. You have no control of what’s going to happen. So don’t tell me you’re in [02:04:25] charge of your own mind or you get to do is observe it. Your conscious mind can observe your unconscious [02:04:30] mind. So all we do with metacognition is to say, let’s have a look at your your unconscious [02:04:35] mind. Let’s see why you think. Why do I like Payman like, don’t [02:04:40] just say I like him. That’s that’s pretend world. Why? What [02:04:45] are the reasons, You know, go into it. It’s because he makes you feel this and he was this way and just [02:04:50] understand the reasoning. And as soon as you do that, you realise that that crucible we talked about, you know, [02:04:55] your your mind, your soul, whatever it is you lives in, your brain, gives you emotion, thoughts, feelings, your [02:05:00] personality. You need to understand that this personality contends with all the [02:05:05] 7 billion other personalities and how you behave towards them, how you behave. [02:05:10] Understanding how you behave determines how they react now. How they react is [02:05:15] your entire life. From the minute you’re four years old and you become self-aware up [02:05:20] until your last breath, if you know that how the world presents itself [02:05:25] to you is determined by how you behave. So I think as soon as you can get [02:05:30] that click in people’s head, they go, wow, it’s difficult sell because it means accountability and responsibility. [02:05:35] And you know, you’ve got to be humble about it. But if you can make people self aware, um, [02:05:40] I think it’s the biggest asset you can ever give them.

Richard Porter: It’s just a harsh lesson. [02:05:45] Beautiful two would be stay curious and [02:05:50] appreciate beauty and awe and seek it in all things. And with that, [02:05:55] I sneaking in 2.5 because it gives you gratitude. You should be grateful. Like if I say [02:06:00] to you, now we’re in a room without natural light. If I say to you, hey, it’s a beautiful day outside, [02:06:05] I’m using that. You know exactly what day I’m talking about. You know it. So appreciate [02:06:10] it. Feel the kiss of the scan on your skin. And think about how that feels when it’s May and [02:06:15] that first spring day. Just cherish those all filled moments because they [02:06:20] will end. Um, it will come to an end. And I guess my third piece would be just don’t quit. [02:06:25] Just don’t ever quit. Don’t give up. Find your future self. Find that [02:06:30] orientation and just even small steps toward it. Feel amazing no matter what situation [02:06:35] you’re in, even if you’re close to hopelessness, I’d actually say if anyone watched them, they’re close. Give you a call, give [02:06:40] me a call. We’ll go out for dinner for sure. Whatever happens, you [02:06:45] are of value. Every human has a value. Every single one. And [02:06:50] you will have duties that I need you for. So don’t quit. [02:06:55] And wherever you are in life now, you can. You can go again. And you [02:07:00] can build from whatever position you’re in. And next, the next day can be better than yesterday, no matter where [02:07:05] you are. So don’t quit. And then when you you get to a position, you think, okay, I’m in a stronger position [02:07:10] now to help other people watch the joy that follows him from that. It’s just unbelievable.

Payman Langroudi: I mean, the way [02:07:15] you answered those three were very much along the lines of, I’m trying to be like this myself, so you should [02:07:20] too. But what about the opposite? Like, what if the if the thing was, I [02:07:25] wish I had been more what what would more of a risk taker, more [02:07:30] of a.

Richard Porter: Oh, you know, I think I think that’s so hard. I think that’s such a hard question to answer because [02:07:35] I certainly don’t want to come across. I’m saying people like, be like me. I wouldn’t do that, but I would. I [02:07:40] would say that, um.

Payman Langroudi: You know what I mean? I don’t go to the gym. I might give that piece of [02:07:45] advice, though. I might say, go to the gym. Yeah. So, so, so from thinking [02:07:50] of it that way. What? What do you wish you were more like that? You’re not.

Richard Porter: Oh, [02:07:55] God. I mean, I’ll tell you something. I wish I was better at finding [02:08:00] peace in my own mind. I wish I was better at that. Um. And [02:08:05] I’m not very good at that. And, you know, I’m not comparing myself to Elon Musk. But Elon [02:08:10] Musk said many people think they want to be me, but they wouldn’t.

Payman Langroudi: Yeah. [02:08:15]

Richard Porter: My mind is a storm and you don’t understand. And so I think it’s [02:08:20] that. So I guess what would what advice would I give more? I mean, I [02:08:25] should have been more compassionate to people in the past. I think if you’re very able [02:08:30] to create positive emotions with tactical intelligence, you can be hurtful. I regret hurting people. [02:08:35] Um, I, um, I’ve [02:08:40] wasted time. I stopped drinking years ago. Most of [02:08:45] my regrets and stupid things. I’ve done nothing terrible, but was [02:08:50] being drunk. I wish I’d never. I wish I’d never been drunk in my [02:08:55] life. I do. Yeah. And, uh, I guess, you know, a lot of this is. What [02:09:00] would you say to your kids to not go wrong?

Payman Langroudi: Yeah, yeah.

Richard Porter: You know, and I, um. Yeah, just [02:09:05] just understand that every choice and action and behaviour you present to the world will have a reaction.

Payman Langroudi: A [02:09:10] massive pleasure, man. It’s been. I’ve kept you here longer than you probably want to be. I [02:09:15] have no.

Richard Porter: Idea.

Payman Langroudi: I feel like I can’t let this opportunity.

Richard Porter: I feel I feel awful because you’re [02:09:20] you’re you’re very good at asking questions, and I, I feel uncomfortable being this. I [02:09:25] want to, you know, I, I was walking in here and I was thinking, I want to find out about you. [02:09:30] I want it to be like a conversation.

Payman Langroudi: You have a podcast studio in the building. We do. We call it [02:09:35] studio. Yeah, yeah.

Richard Porter: What will happen with that? I mean, I want to do a lot of psychology work in there. Yeah, yeah. You know, [02:09:40] because because if you can teach people, we call it the algorithm of life. And if you can teach that and [02:09:45] personality science around it. So that’s very good from that point of view. Yeah. Yeah. We do have a podcast. You know, [02:09:50] all about me.

Payman Langroudi: It’s a, it’s a brilliant um, I don’t know with you, man. It’s like, you know, the, the, the [02:09:55] wonder of a child that gets squeezed out of us the older we get. You [02:10:00] seem to have that in abundance. And and yet, obviously, children don’t talk about interesting subjects, [02:10:05] a subject as interesting as yours. So the combination is brilliant. Yeah, well, you’re very. [02:10:10]

Richard Porter: Kind, mate.

Payman Langroudi: It’s nice to.

Richard Porter: See. I’ve been curious. Do you let me ask you a question. Do you enjoy podcasting? Do [02:10:15] you enjoy.

Payman Langroudi: Interviewing? Yeah.

Richard Porter: So I’m going to ask you more questions briefly. Yeah. Enjoying [02:10:20] someone as a skill. And I was with a guy called Andy Galpin recently who’s [02:10:25] been he did six episodes on Huberman. Yeah. I’ll drop a name for you. And, um, so he’s an [02:10:30] incredible neuroscientist. Unbelievable. And, uh, I was asking [02:10:35] him about being interviewed because he’s done so many podcasts. And I said, it’s a real skill, isn’t [02:10:40] it? And he said, yeah. He said, it’s an absolute skill to be sitting where you are and do it really, [02:10:45] really well. And I said, have you had good and bad? He said, yeah, I’ve had some terrible interviews and [02:10:50] and other ones that have gone really, really well. I’m not trying to blow sunshine up your arse. You’re you’re amazingly [02:10:55] good at it. Thank you. You’re incredible. Did you practice?

Payman Langroudi: Well, it’s been, you know, 320. [02:11:00]

Richard Porter: I was I was looking through the last 50 or 120, you know. Was he going to ask? But [02:11:05] yeah, I was looking through it all. Do you think you’re better than you were then? Do you mind me asking?

Payman Langroudi: Uh, bit. Not [02:11:10] a lot. Not a lot. You know, I listened to episode three yesterday, and, um, I like [02:11:15] that. Um, it was harder back then because there was two hosts, um, with Prav now, [02:11:20] Prav does it whenever he feels like. Okay, but one, 1 to 1 is very easy.

Richard Porter: Yeah, it’s different, isn’t it, I [02:11:25] find. Were you always good at talking, though?

Payman Langroudi: I don’t know.

Richard Porter: You’re too modest.

Payman Langroudi: But you [02:11:30] know, I don’t. People. People tell me they like listening and that’s just an amazing thing.

Richard Porter: I think you can build [02:11:35] this empire without being good at it, I think. You know, so much comes down to connection. It [02:11:40] really does. I think you’re going to.

Payman Langroudi: Connect you to say so, man. So, so lovely to meet you. [02:11:45]

Richard Porter: It’s really good to meet you. I’ve really enjoyed our time.

[VOICE]: This is [02:11:50] Dental Leaders, the podcast where you get to go one on one with emerging [02:11:55] leaders in dentistry. Your [02:12:00] hosts Payman Langroudi and Prav Solanki.

Prav Solanki: Thanks [02:12:05] for listening, guys. If you got this far, you must have listened to the whole thing. And just a huge [02:12:10] thank you both from me and pay for actually sticking through and listening to what we’ve had to say and [02:12:15] what our guest has had to say, because I’m assuming you got some value out of it.

Payman Langroudi: If you did get some [02:12:20] value out of it, think about subscribing. And if you would share this with a [02:12:25] friend who you think might get some value out of it too. Thank you so so so much for listening. Thanks.

Prav Solanki: And [02:12:30] don’t forget our six star rating.