This week, we welcome British Association of Private Dentistry (BAPD) co-founder and British Association Cosmetic Dentistry (BACD) past president Dr Bertie Napier.
Bertie talks about his early years and dental training in apartheid-era South Africa, and the contrasts with life and practice in London.
Bertie also takes us through his involvement with the BACD and newly-formed BAPD.
He talks about his daughter’s decision to enter practice dentistry – how that has informed his views on women in the profession – and much more besides.
“Do the right thing as though everyone is watching you, even when no one is watching you. You sleep better. The rewards follow.” – Bertie Napier
In This Episode
01.22 – Early years
15.26 – UK and SA
33.03 – Cosmetic dentistry
35.53 – On diplomacy and fairness
42.52 – Associations and ambition
53.09 – BAPD
01.07.01 – Looking back
01.10.17 – Women (and daughters) in dentistry
01.19.05 – Advice for future generations
About Bertie Napier
Dr Bertie Napier graduated from the University of Witwatersrand (Wits), South Africa in 1988 and moved to London in 1998.
With business partner Odette Lazarus, Bertie took over 19 Bell Street dental practice in Hertfordshire in 2002, where he continues to practice today.
Bertie has been closely involved with the BACD since its inception, serving as president and on the board of directors. He has recently been instrumental in the formation of the BAPD.
Bertie is also editor of the International Journal of Cosmetic Dentistry (IJDC).
Bertie: From when she was three years old, the joke was always, when she was three and a half, they said to her, “What are you going to do when you’re big?” And she says, “I want to be a doctor, but I want to be a real doctor, not a dentist.”
Speaker 2: This is Dental Leaders, the podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.
Payman: It gives me great pleasure to welcome one of the people I call in dentistry the voice of reason, is the way I would characterise Bertie Napier. Someone who’s come from his native South Africa to the UK, and has got a wonderful private practise in Hertfordshire. And for me, Bertie’s not just been of massive service to his patients, but of massive service to the profession itself, culminating with being the president of the BACD and one of the founding members of the BAPD. And right now at the cutting edge of where we’re all going to go post-COVID. So, thanks for joining us, Bertie.
Bertie: Thank you. Thank you for giving the opportunity.
Payman: Bertie, give us a little quick run-down of your childhood. The 30-second version.
Bertie: Yeah. Great up on a farm in South Africa. Pretty much Afrikaans-speaking area, so having the English language meant I needed to go to a boarding school. So that’s the way I spent most of my school life, was from age six all the way through to finishing school, was at a boarding school. Yeah, and I suppose that pretty much led me to be quite independent and easy with staying away from home.
Prav: Any siblings, Bertie?
Bertie: Yep, I’m actually one of five boys.
Bertie: The last two were twins. My mum said she always wanted girls, but when the boys started arriving in twos, she decided that’s it. Yeah, so I’ve got another brother who’s, one of the twin brothers is a dentist as well, and then the others range from motor mechanic through to panel beater, teacher. No longer a teacher. Was a headteacher, is now involved in HR in education. All in South Africa, still.
Bertie: Dad was also from farming stock. He farmed for a little while, then he was a motor mechanic. That’s where my brother got into it. And then he was a Member of Parliament for a while in South Africa. I think he served two terms in Parliament. It’s through the time that things were moving from the Apartheid era into the new democracy in South Africa. So those heavy years, that’s when my dad was in Parliament.
Payman: As a child, Bertie, what are your memories? What are your memories of the Apartheid regime?
Bertie: One of the things is, I always look at a Wimpy and I can clearly remember that we were not allowed to go into a Wimpy restaurant in South Africa. There was a little window on the side for non-whites, and if you were white, you could go into the restaurant and sit down and eat. If you were not white, you had to go to the side of the restaurant to go and get a takeaway. So that’s the one thing. Every time I see a Wimpy, I always remember that experience. I mean, it’s all changed now of course. It’s completely different. But as far as Apartheid, that’s the first memory.
Bertie: And then at university it was a friend of mine that I stayed, in a Catholic residence run by Catholic priests. And there was a French guy. We both were 19 years old. “Let’s go to the cinema,” one day. And of course, I’d never been to a cinema in my life. I grew up on a farm. I went to a boarding school in the middle of nowhere. And of course, we get there and the woman looks and says, “No, he can’t come in.” And of course both of us were dumbfounded. “Well, why not?” And she explained to us, “No, this cinema’s for whites only.” The French guy is saying, “No, we just want to watch the movie. That’s all. We’re not coming here for anything else.” And she’s saying, “No, you still can’t come in.”
Bertie: And then, of course, I suppose you’d call it the troubled times in South Africa, which was more or less when I was at university, when there was all the bombings going on, and the ANC was very active as a freedom fighting force at the time. And being told by my parents, “Don’t…” Well, it wasn’t my parents, but my uncle, actually. “Don’t get involved. You’re not there for politics. You’re there to get an education. When you’ve got your education, then you can make a difference. But while you’re there just stay out of things.” Didn’t quite work that way. You got involved. That was the end of that, I think.
Bertie: But university was, I think, Linda Greenwall was one of your guests on a previous podcast, and she mentioned that of all the universities, actually that is where things were happening as far as the politics and the anti-Apartheid side of it. And yeah, dental school of course. And I can remember what Linda said was, “You were told you’re here for dental school, you’re here to become a dentist, you’re not here for politics.” They did try and drum that into us.
Payman: She was mentioning Steve Biko was a medical student.
Bertie: Well, he was down in, I think it was Port Elizabeth area. That’s where that happened, yeah.
Payman: Which is a bit earlier, eh?
Bertie: Yeah, yeah. That was much earlier. Yeah.
Payman: So which year were you in university?
Bertie: I was at Wits from 1983 to 1988.
Payman: Okay. So right in the middle of it all.
Bertie: Right in the middle of all of it. Yeah. We had some hairy times.
Payman: So did you actually get involved in politics? Did you go and demonstrate?
Bertie: Yeah. We all did. We all demonstrated. We all ran for our lives when the police fired tear gas and rubber bullets. It was part of life. It’s what you went out and what you did. And not everyone looks at it as black and white. It wasn’t quite like that. There were lots of my friends who I still regard as very good friends, and I have a lot of respect for, who were white South Africans who were with me at uni, and amazing people, really, really good people. They don’t even realise the impact that they’ve had, some of the things they said or did. So I’m not going to mention names, but some of them will stay, the memories of the things they said and did, and when they stood up for things, will remain with me for a very long time. Yeah.
Payman: You were from a privileged background, definitely, right? Because your dad being a-
Bertie: Was I?
Payman: Well, your dad ended up as a Member of Parliament. That didn’t happen by mistake, did it?
Bertie: Well, no. Well, okay. Let’s go back.
Payman: Tell us the story. Tell us the story.
Bertie: Take a step back. Childhood memories, we didn’t own a house. We always rented. And we usually rented… Most farmers would have had one or two houses on their farm, and we usually rented a house from a farmer. And I can remember, when it rained it was exciting times, because you never knew where the rain was going to be coming through the roof. And we had a collection of buckets and bowls for the times it rained.
Bertie: I mean, my dad was a motor mechanic. He didn’t earn much. Mum was a teacher. She didn’t earn much either. Very low paid. And of course, they just couldn’t afford the deposit to buy a house. It was as simple as that. And then of course you have five children, and you got the kids at boarding school, so there’s even less money because you’re paying school fees. But for my parents it was the education that was probably the most important thing for them. I mean, my dad was always involved… I suppose that’s where I’ve got it from, is to not just sit back and let other people do things. You need to step up and get involved in your community, and get involved in your profession. My dad was a union rep as a motor mechanic. My dad was involved in lots of clubs and things, very similar to Rotary. Very involved in-
Payman: Was he a left wing politician or right wing?
Bertie: No. I suppose I’d class him as, if anything, he’d be more conservative than anything else. If you’re looking at conservative versus left wing, he’d be more conservative. But in South Africa, if you were anti the establishment, you were automatically regarded as left wing. So I guess at that time-
Payman: Everything was a bit more to the right.
Bertie: Yeah. Right wing meant you were more to maintaining Apartheid. Left wing meant you were anti-Apartheid. So slightly different to here. Left wing here is more socialist, and right wing is more capitalist. So as far as thing side of things, it would have been fairly balanced. My dad has always been someone who’s been, you need to look after everyone. There needs to be a fairness to people. It can’t be capitalism at the expense of walking all over the average person.
Payman: Was politics part of dinner conversation in your house?
Bertie: No. Strangely not. We grew up on a farm. We didn’t have electricity in the house. It was paraffin lamps. I remember when my dad wired the first house to put electric lights in the house. We had a diesel generator, and you had to go outside and start the generator when it got too dark. And then he’d run it for a certain amount of time, and then the lights would go out and we’d be back to candles, basically. So if you got up during the night, you need to reach over for the matches and light a candle.
Prav: When the interview started with, “I went to boarding school,” I didn’t imagine this conversation was coming next. So it obviously came at the sacrifice of other things?
Bertie: Oh, my parents sacrificed a lot. And I think with my mum being a teacher, that’s where education was absolutely paramount. School-wise, my mum went up to the equivalent of GCSE, and then she went and did a teacher training diploma. And it was only after I had qualified as a dentist that my mum went back and finished, because she couldn’t get above a certain pay grade without having the equivalent of A levels, which in South Africa is called matric. So she went back to school and basically did the extra night classes. Even though she’s a qualified teacher, she had to do the night classes to get that matric certificate so that she would move onto a different pay grade. In the end, she was a headteacher as well. That’s what she retired from. Yeah.
Payman: How many years did you practise as a dentist in South Africa before you decided to move?
Bertie: So dental school was what, five and a half years? It was a six-year course that had been condensed down to five and a half years, and I practised from, qualified in June ’88 all the way through to the end of 1997. That was in South Africa. And then I started here in the UK in January ’98.
Payman: Did you have a patient base that was diverse or not?
Bertie: In South Africa?
Bertie: I would say not. Also, this is where I got interesting as well. I lived illegally in a white suburb in Johannesburg. It was illegal. You weren’t allowed to. I mean, it was Apartheid when I’d qualified. It only switched in ’94. So from ’88 all the way through to ’94, if you lived in a white area, it was pretty much illegal still. Or just before ’94 when they cancelled the Group Areas Act. I can’t remember the exact year. It might have been ’93 or ’94.
Prav: And it is so recent, isn’t it? ’94.
Bertie: Oh, yeah. Yeah. So worked in Kliptown, which was where the Freedom Charter was written, the ANC Freedom Charter, that’s where they wrote the Freedom Charter in South Africa was in Kliptown, which is Soweto. And obviously, I would say, 90% of our patients were black. I had two white patients who ventured into the township to come and see me, and that is only because of where I lived, and because of my friends. And that was just those people who… One was an Afrikaner lady, Sonya. I’ll never forget Sonya. What a lovely person. And she just said straight out, “I’m coming to see you and that’s it.” I said, “Oh, it’s a bit dangerous, Sonya.” She says, “I don’t care.” And she’d drive out into the middle of a black township, which is not something that a white person did in those years, and she came to me as a patient. Then a few of my other friends as well would have done the same. But yeah.
Payman: And in your year, how many whites were there and how many blacks were there at university?
Bertie: We had a quota system at university at the time.
Payman: Oh, really?
Bertie: Our class, there were 62 of us in our class, and it was very obviously quota. So we had two black ladies, two black men, both of them, I think, had been therapists or technicians, I think. Jerry is now here in the UK as well with his family. So there were two of them. They had a quota then for Muslim Indian and then for Hindu Indian. So the girls, I think there were two. Honestly, that’s the way it was done. And then even, you knew that there were a certain number of Greek girls, there were a certain number of Jewish girls. Men. They had a system which the university had to comply with, otherwise the government wouldn’t fund. The government funded it on the basis of race.
Bertie: But then, Wits eventually were the ones to kick up against it, and they stopped complying with the quota system after a while. I was the only so-called coloured person, which I suppose, yeah, would be called mixed race. And yeah, that was it. I think that was the quota, was one a year. So there was usually either just one male and one female and that was it. And we got to know each other, whichever year we were in, and supported each other. It was an eye-opener, actually, getting to Wits university, because for the first time, talking to people of different races and realising that everyone actually wanted the same thing. That we all had the same insecurities, that we all had the same dreams, that we all had the same wishes for ourselves and our families. And that we all knew absolutely nothing about each others’ struggles and the way we’d gone through things in our lives.
Prav: So fast-forwarding to coming to the UK and practise ownership, what’s the story there?
Bertie: I had got to 10 years after, qualified in ’88, by the end of ’97, I was quite disillusioned with the industry because it was mostly fixing pain and sepsis, and most people couldn’t afford it. Things like root canal treatments, you might do one in two or three months because people just couldn’t afford it. And it was a case of, just take the tooth out. And I’d got to the stage, I thought, “I’ve had enough. I need to do something. While I’m young enough, let me go and do something different.”
Bertie: Spoke to a couple of colleagues, one was an orthodontist, one was a maxillofacial surgeon that was in Durban, and the guys basically said, “Ah, so you’re registered in the UK?” And, “Yes, I am registered in the UK.” And they said, “Why don’t you get rid of your practise, go to the UK, work for a while and see if you want to actually do something else?” So off we came to the UK, and the intention was to stay for a couple of years and just try and discern where to next. So while working on the NHS to travel around a bit, and yeah. But that didn’t quite work out because my daughter was four years old at the time, and when we landed, we were told she actually needs to start school. In South Africa you started school at six. To send them to school before then was a matter of choice.
Bertie: So we’d had her in a Montessori school over there, and we thought, “Oh, we’ll just do the same here.” Then realised that she’s got to start school officially. She started school, and I was here for the two years. Came towards the end of the two years, and the guys I was working for, it was a corporate, and they said, “Do you want to stay for a bit longer?” It was a massive emotional upheaval, moving from one country to another. Probably took us about 18 months to settle down, and just starting to make friends, to enjoy being here and getting used to life, the way things worked in the UK. Then we thought, “Well, we’ve been through the tough part, let’s give ourselves another two years and actually enjoy it.”
Bertie: Which we did. And then along came a letter saying, “You may apply for permanent residency if you wish,” which we thought, “Oh, well, we might as well do that. If we go back to South Africa and we are not happy, then we can always come back again.” Within six months of the permanent residence, they said we could apply for citizenship. So that’s what we did, and became British citizens. And I’ve never really looked back. I mean, now when I look at it, and I think my kids were four and a half and two and a half when we got here, and where they are now, it’s just chalk and cheese. My children have had an absolutely amazing opportunity to grow up in the UK.
Bertie: I know we look at things and we say things that are really tough, and they are. The UK has its problems. I’m not saying that they’re not there. But I just really count ourselves as so blessed to have landed here, to have had the experience we’ve had. For the children to have grown up in a society where race is not a big deal. And in South Africa it still is, unfortunately. It’s going to be a hangover for a very long time. And they are just such well-balanced people, when I look at them.
Prav: So they’re not running around with buckets and hooking the house up to diesel generators-
Prav: … or anything like that. And I think me and Payman have spoken to each other and guests about, how do you keep it real?
Prav: With your kids, right? I didn’t have the most privileged of upbringings, and my kids certainly are a step up in that sense, in terms of the opportunities available to them, because we can afford it, and perhaps we’re a little bit more forward-thinking in terms of value in certain things. But there’s always that, wanting to hold back and say, “No,” whilst wanting to give them everything, because you love them, right? And finding that balance. Do you have that?
Bertie: Oh yeah. Oh yeah.
Prav: Have you had that dynamic?
Bertie: You do.
Prav: What’s your take on it?
Bertie: You do have moments where you think, “You guys haven’t had it tough enough. You need to experience what poverty is so that you can appreciate what you’ve got.” But then you look at them again, and the awareness they have for other people’s situations, and you think to yourself, “You don’t necessarily always have to go through tough times to appreciate what tough times are, and to appreciate where other people have come from and the difficulties they might have had.”
Bertie: I do have this thing that you should try to walk in other people’s shoes. You should experience what poverty looks like. When you talk about things, even the Wimpy experience, and just people will look at you and say, “You can’t come in here because of what you look like,” not how you behave, not the fact that you are-
Prav: Education or anything.
Bertie: Nothing. Nothing. It’s just they just look at you and say, “No, you can’t come in here and that’s the end of that.” Yeah. When you felt you were taking your life in your hands. I mean, South Africa, because I lived in a white area, and all my friends around me were predominantly white, when weekends came around and you went off to, there was a big lake called the… Well, the Vaal Dam. We’d call it a lake here, there we called it a dam. It was massive. I mean, it supplied the water for the whole of the Transvaal Province. And we’d go away for a weekend, and there’d be boating and all of that.
Bertie: I’ve never been to the non-white part of the Vaal Dam resort. I’d only been to the white areas. And of course, you are on tenterhooks because you are very aware that you stick out like a sore thumb. You look completely different to everyone around you. But then of course you’ve got a group of 20 people who are with you, so you’re there, but you are on edge all the way through.
Bertie: And then the same thing happened later on. I did a lot of motorcycling, so a few of us would go out on our bikes regularly, and we’d go to bike rallies. Now, if you’ve seen the typical bikers, big hairy white guys, and there I am. And I was like, “Do I take my helmet off? What do I do?” I mean, until the helmet comes off they think I’m the same as everybody else. But then the helmet would come off and nobody took a second glance, which was a real shock for me.
Bertie: Nobody objected. Nobody looked at you different. They just accepted you there. It was just bizarre.
Payman: Culture shock.
Bertie: Yeah. Yeah.
Payman: Bertie, was there not an element… I understand what you said about moving to the UK and the opportunities that gave to your children and everything. But was there not an element of, at that very moment when South Africa switched, would have been an amazing time for someone of your talents to build something there?
Bertie: Do you know what, Payman? I think I was probably thinking very selfishly at the time. And very focused on what I wanted and what was not happening for me, and the unhappiness of what I was doing within my profession. What I had trained for versus what I was actually able to do. And that was the reason for moving. It had nothing to do with looking for a better opportunity for the kids. That is somebody up above who is looking down on us, and there’s a bigger plan.
Bertie: I genuinely believe that was God above looking after us. I look at my nieces and nephews, and I mean, they’re growing up in a very different South Africa to what we grew up in. And they’ve also got different opportunities and things. But my children’s relationship, or perspective, of other races, is completely different to my nieces and nephews in South Africa, because of the hangover of Apartheid. Because people live in communities based on race still. And you’ve got the more affluent areas which will be far more mixed. But the average person is going to be living really based in suburbs that are still very, very racially segregated, still, even though people are allowed to buy and move and do whatever they want to wherever they want to. The reality is that people will probably stay in the home that they’ve grown up in.
Payman: Yeah. I mean, I adored South Africa when I went there, but one thing I did notice at the time, I think probably right now as well, the pound is pretty strong there, right? At the time, the pound was pretty strong there and so we could afford to do things. So we took a helicopter over Cape Town, and what a wonderful city. But seeing the townships and the swimming pools and the tennis courts, and the geography of it from above, really showed you there’s a bunch of people having a fantastic time, and then a bunch of people not having a fantastic… You could see it from above so much more, because as tourists, you don’t dwell in the townships.
Bertie: That’s still the worry, though. That’s still the worry. For me, whenever I go, and looking and seeing that difference, and I’m sure people in other countries have the same experience where you see the big difference between the haves and the have nots. And you look and you think, “How does a country survive that in the longer term?” Because it can’t. You can’t. You just cannot. Something has got to give at some point if you think that that’s just going to keep going.
Bertie: Although you look at a country like Brazil, and it’s a very similar situation going on there. And they didn’t have the Apartheid problem. The socioeconomic problem is very much there. What is the solution? How do you fix the problem? Is it even fixable, or do we have to accept that that’s always going to be the situation?
Payman: Tell us about when you transitioned from associate to practise owner. When was it?
Bertie: 2002. Yeah. Actually, so this has happened twice for me. In South Africa as a new graduate I went and worked for someone. I worked as an associate probably from June, maybe for about a year. Let’s just see. 1990 I bought it, so a couple of years maybe worked as an associate, and then I was offered to buy into the practise, which I did. And on very, very favourable terms. A deposit, and the rest of the money I worked it off, basically. So I had a fixed salary which was a very generous salary, and whatever else I earned as my share as a one-third partner in the practise, went to the other two partners to pay off what I owed them.
Bertie: If I needed any extra money for anything they would let me have it. And I mean, honestly, you could not get a more generous way of buying into a practise.
Bertie: It was absolutely superb. Perhaps that’s something, I always look at that and think, “If I had a young dentist in my practise and they eventually wanted to buy into the practise, that’s what I would love to do for them, is pay a deposit and then work it off as you go.” Because that actually demonstrates that you’ve got faith in your business being a good business as well.
Bertie: So that was my first transition from associate to practise owner, and then came to the UK, so worked on the NHS from January ’98, and then in October 2002 was when we discovered this practise for sale, about three and a half, four miles in the next village from the town we were working in. And two of us, Odette and myself, decided we’re going to take the plunge.
Bertie: So two things were going to happen. One was getting away from the NHS, because as an associate coming in from South Africa, I didn’t have an NHS number and neither did… Did Odette? No, I think she didn’t have one either. So we both decided, “This is an opportunity to really just go for it.” And the practise we bought was totally private anyway. So that’s October 2002, bought into it, 300 active patients, 600 on the list. There’s about 5,000 on the list now, and I’d say about 2,500 active. Yeah.
Payman: So I remember once you told me before, I think maybe the last time we spoke on this thing, you said coming over from South Africa to the UK, that feeling the respect for dentistry over there was more than it was here.
Bertie: Oh, much, much, much higher. I think for me it starts at GDC level here. I think seriously, people will behave in the way you treat them. If you show someone respect, people will behave in a certain way, generally. When you, not belittle, but when you reduce the level of respect for a profession, so that you’re expecting a profession to behave in one way, but a simple thing like the title Doctor takes a lot away from a profession. And I know some people love the idea that it’s Mr. because it’s a surgeon, but come on, let’s not kid ourselves. The Mr. that surgeons are afforded is slightly above where we are, because they will have done a medical degree, and they’d have done a specialist degree on top of that. So there’s a slight difference in the definition of surgeon there.
Bertie: So that’s the first thing. And we have patients from Europe, for example, the Portuguese and the Spanish, dentists are called Doctor, and they treat you with so much respect. And as much as I say, “Please call me Bertie,” it’s, “No, no, you’re Dr. Napier.” And yet you see them outside in a social setting and then they will call you Bertie. But in the practise setting they insist, especially the older patients, insist on that level of respect. Now, it makes you want to behave completely differently and live up to what the people’s expectation is of you.
Payman: Tell me about the difference between the practise in South Africa, the last one that you were part owning, and the NHS practise you walked into, standards-wise.
Bertie: Oh, Lord.
Payman: Was it lower here?
Bertie: When I got here, right? And they showed me the surgery I had to work in, I think if Harry Potter had been around, I’d have thought I’d ended up in the cupboard under the stairs. I have never seen. It was a small room, and I actually thought to myself, “What the heck have I done?” I really did. I thought, “Wow. Now I’ve really gone and made a huge mistake.” But fortunately the practise had just been bought by the corporate, and they improved things fairly rapidly after that.
Bertie: But there was an experience I had where the first day, I had 52 patients for check ups.
Bertie: 52. That was my list. It was like, five minutes, five minutes, five minutes, five minutes.
Payman: How many were you seeing in South Africa?
Bertie: Much less. In South Africa it was much less. But we worked very differently there. Almost, you didn’t work during… It was very rare that you would do just a check up. Usually somebody would be coming in for something. If they came in for a check up, it was a check up and hygiene. So you would do a really quick check up, and you’d only write down what the problems were. If there was no problem, there were no notes. You just wrote, “Check up, all okay.” Done. You’ve done your oral cancer screening. You’ve done your dental check. You’ve done your perio check. You’ve done all of those things. And all the notes basically said was, you just said, “Check up done, all okay.” Finished. That was the end of that. If there were problems, then obviously you’d list the problems, and then off they went and saw the hygienist.
Bertie: Then here, the initial experience was very similar, because they had those brown envelopes, I forget what they were called, where you did your notes. And it was fairly similar. It was exam SNP. Done. That was it. You’ve done it. You didn’t have to say what you looked at or what you saw. Yeah, now it’s about five pages of A4 for a check up. So it was five minutes to do this. And if it wasn’t something glaringly obvious, that was it. And then the X-rays were… I mean, the quality of the stuff was actually really poor because it was going through a Velopex, probably the oldest Velopex that was there, that existed in the country, almost. So yeah, this old Velopex X-ray machine. So it went through. It might have come out the other end, it might not have come out the other end.
Bertie: The X-rays were either developed properly or not fixed properly, so you’d be able to see it that day. If you went back a few days later, it might have been so dark that you could hardly see what was going on. But again, a lot of that changed very, very quickly as the corporate brought their effect to bear on the way the practise was run. I remember my principal at the time, [Jerry 00:32:32], he couldn’t understand how come the turnover was so low. So I said, “I’ve got no time to do treatment.” 52 check ups in a day, you’re going to earn nothing. It was a fiver or something like that at the time so the whole day you’re turning over £250. It’s just a silly joke.
Bertie: He came in and he said, “Right, that’s it. No more of this. I don’t want you seeing any more than 15 patients a day.” And from that moment things changed in the practise, when he put his foot down that that was the way it was going to be.
Payman: When did you start looking at cosmetic dentistry?
Bertie: We bought the practise, where we are now, October 2002, and looking at growing the practise, we started looking at all sorts of things. I ended up at a seminar at the RSM, and one of the speakers was Raj Rayan, the one who always makes the joke that when people see his name they think he’s Irish, and they see him and wonder what’s going on here.
Bertie: I remember him saying about growing your practise and marketing. That’s what he was talking about. He said simple things like joining an academy. Join the American Academy of Cosmetic Dentistry. All you have to do is pay your membership and you’re allowed to say you’re a member of the American Academy of Cosmetic Dentistry. And patients will look at it and it brings some idea that you do cosmetic dentistry. So I thought, “Oh, okay, let’s have a look at this AACD thing.” Went online, looked at it and thought, “This looks pretty damn good. This is just up my alley. I like what these guys are doing. I want to learn how to do that.”
Bertie: So joined the AACD purely as one of those chequebook members, and then they sent out the conference programme. That was me hooked. First conference, Vancouver 2004, and I’ve never looked back since then. And it started off as, the cosmetic dentist side of it, the beautiful dentistry side of it, was what catches the eye, and you want to do that kind of dentistry. Looks good, it’s functional. I mean, their emphasis… Everybody looked at cosmetic dentistry in the UK at the time as a dirty word. If you did cosmetic dentistry you were one of those people who was just cutting teeth to blazes, just to put veneers on, and make teeth look nice. I’m not trying to say I’m better than anybody else, but I am so pleased that I have never, ever never, ever cut down six, or eight, or 10 healthy teeth to put veneers onto them. I’ve never done that.
Payman: Me neither. No.
Bertie: I’ve never done it. I’ve never done it. Right? So as much as I’ve loved cosmetic dentistry, I’ve always been of the opinion of pushing patients for ortho. I remember a young girl, 22 years old, came to see me in our practise, and she wanted veneers. And I said to her, “You need to have braces.” And she said, “No, no, no, I don’t want braces. I want to have veneers.” She’d been to a practise, I’m not going to mention the group in London at the time, because there are certain people connected with it, who had told her she can have 10 veneers on the front. I explained to her, “You know what? You’re going to end up with the root canal treatments and it’s going to damage the nerves of the teeth.”
Bertie: So she disappeared. Didn’t see her. She came back a year later. I did the first three endos on her anterior teeth. At that time she was 23 years old. She was a model. Saw her again probably about five years later. She’s now [inaudible] and could not afford to have the veneers redone because there’s been general recession, things have changed, and now we are stuck with a mouth that does not look very good at all. Which is really sad. Very, very sad.
Bertie: So yeah. And that’s the sort of stuff that we’ve seen fairly often. Most of the work that we’ve done is replacing work that’s been there 10 years or longer. So that is a lot of what I do. And tooth work cases is a lot of what I do. So yeah, yeah. And as I say, I’m not saying it to say that I’m better than anyone else, it was just something that didn’t sit easy with me, and I just… Yeah.
Payman: One thing I’ve always admired about you, Bertie, is you’ve managed to balance this diplomat, on the one side, with standing up and saying what you believe on the other side. And those time things tend to be, for me, in tension, because if I say what I really think, sometimes I’m not being a diplomat. But you manage to really do that. You carry that off very, very well. I’ve seen it many times where you feel strongly about something and you stand up and say it. But on the most contentious issue, you’re the diplomat. Where does this come from? Is this from your dad?
Bertie: I don’t know. I don’t know.
Payman: I mean, that fairness thing you were saying.
Bertie: I suppose, yeah, you do pick up values. You pick up values from your parents. It’s from, I would say, mum and dad. I’d say my grandfather on my mum’s side, who is much younger than my paternal grandfather, so was a big influence on all of us and an amazing man. Watched him, and his sense of-
Payman: Was he a farmer too?
Bertie: No, he wasn’t. He was in the Second World War. He was a sergeant major. He was in Eighth Army under Montgomery in North Africa. But he was a driver in convoys. He was at the battle of El Alamein. I remember him talking about that. Was absolutely fascinated when the first Gulf War happened because he said, “I can’t believe I’m watching war on television. I never thought I’d see anything like that.”
Bertie: But he was a manager of a dairy, it was a company that sold milk and dairy products. They got the milk in from the farmers, they processed it, they bottled it, milk, all the dairy products, cream, yoghourt, fresh fruit, all those sorts of things. It’s not a dairy product, but they did all that sort of stuff as well. And he was the manager of that. And very respectful of the boss, the owner of the business. I suppose his military side is what got him that sort of job and that he was able to handle it as well as he did.
Bertie: But the fairness, the way in which he treated the people who worked for him, black or white, was just unbelievable. You watched him, and this man was a rock solid man. Absolutely. As well, he and my dad got on extremely well. The two of them. Yeah. And my mum was very close to her father as well. So yeah, heavily influenced by all of them.
Payman: I think it’s one thing to appreciate fairness but it’s another thing to lead in that way.
Bertie: But Payman, is it something that you can teach? Is it something that you’re born with?
Payman: I don’t know.
Bertie: I look at the generation of young people today, I look at my kids, and especially my son, there’s a sense of fairness. I mean, he’s 25, but there’s a sense of fairness amongst young people that-
Payman: Yeah. Kindness.
Payman: I’ve noticed that with the Millennials.
Bertie: That’s it. It’s the Millennials, isn’t it? And there’s that sense of, when something is unjust, it hits them. You can see. They take a step back and think, “But why are you doing that? Why are you treating someone like that?” And even amongst our team, that’s one thing I love about all of them, and it goes beyond the Millennials, is if they feel something’s unfair, they’ll actually speak up and say it.
Prav: Question it.
Bertie: Yeah. They will say something. Is that something that you’re just born with? Have I seen things through my growing up at boarding school that I’ve thought, “No, come on, this is not right”? I don’t know. But somewhere along the line things have influenced you. Maybe it’s through personal experience, that you’ve been unhappy the way you’ve been treated. I don’t know.
Payman: Did you send your kids to boarding school?
Bertie: I would have loved to, but my wife, no way. I was listening to when Zacky was talking about it as well. For me, boarding school wasn’t a bad experience. In the beginning, I think as a young child, it’s a tough experience. I mean, I was seven years old. My brothers were all six years old when they went to boarding school. And it was tough. But when you look back now, the level of education… Because they were Catholic schools. So the level of education was a standard higher, and it was the nuns who were teaching. So they were there because they wanted to be there. It wasn’t just a job for them. They took it to another level, which was absolutely superb.
Bertie: Yeah. So we got a really, really good education. So I would have wanted my children to go to boarding school. But then I spoke to the local Catholic priest here about a private school not far from us, and he said, “Why would you? You’ve got such good schools in the town. You don’t need to spend money on sending your children to a private school.” And he was right. We’re very fortunate, the town that we’re in. We’ve got some really, really good schools. And if you look at St. Mary’s, which is the local Catholic school that my kids went to, people that have come out of there become doctors. I know somebody, Dominique, my daughter’s friends who, she’s becoming a specialist and she’ll be a consultant one day, and comes from a difficult background as well. But what a lovely, lovely girl.
Bertie: And you see how people can get to different places just by the fact that somebody believes in them, that somebody has told them, “You can do it.” And nobody’s telling you that no you can’t, because you come from a particular background, you’re a particular race or whatever. There’s none of that. And that is the opportunity they’ve got here.
Bertie: But yeah, boarding school, I wanted it, because I thought it was pretty good and I thought there’s a lot of discipline and all the rest of it. Gillian also went to boarding school. I mean, we were at school together all our lives almost. She was, “No, I don’t think we should send them. We can live close to school and they can go to school from home.”
Payman: The thing about boarding school, people who’ve enjoyed it themselves want to give that opportunity to their kids-
Bertie: That’s it.
Payman: … to enjoy it too. It’s good for sport and all that, right?
Bertie: Yeah, yeah.
Payman: You know, Bertie, when I think about your practise and your situation at BACD, I can see someone like you’s a great asset to have in both of those situations. Is that a piece of advice you would give to ambitious young dentists, to get involved in these organisations and to give service back? I mean, is it for everyone?
Bertie: Okay, the word ambition I think is my problem.
Bertie: I can never say that I’ve been ambitious. I’ve never looked and said, “I want to do that.” When it came to the BACD, for example, it was Chris Orr, who I didn’t even know, who approached me, I don’t know why he approached me, but he approached me and said, “Do you want to consider getting involved with the board for the BACD?” It was probably because we met over at ASCD-
Bertie: … was the first very informal hello, and just knew each other by face and name, possibly. And then, the first BACD meeting that was here, that was the first time I saw Tif Qureshi, Tim Bradstock-Smith, Elaine Halley, David Bloom, Chris Orr, I remember Mike Zybutz. That was the first time I had met a lot of these people.
Bertie: And then both Odette and I went to every single BACD meeting from there, and it was a few years in that Chris Orr approached me and said, “Do you want to stand for board?” Which I did, and became the longest-serving board member. And then realised you need an exit strategy, and the best exit strategy was to become president and then past president and then out.
Payman: When you say you have a problem with the ambition part, are you saying that you don’t see it as an ambitious step? You see it as a service step?
Bertie: No, no, it wasn’t. When somebody approaches you and says, “Do you want to get involved?” You look at it and you think, “Actually, I can see why this is a good thing.” And what I could see the BACD doing, I thought, was probably the best thing that’s happened to dentistry in the UK. But suddenly this move to raise standards, it wasn’t purely about making smiles look pretty. That was the great part, that there was a visible side to what you were doing, but there was a lot more going on behind the scenes. The functional side of dentistry was a big thing, and Chris Orr has been one of those people that’s always pushed that.
Bertie: So ambition-wise, I wouldn’t say I did it because I saw myself as one day becoming president. I remember when I gave my little, call it an elevator speech, for the elections… It was such a small group of people at the time. There must have been only about 30 people that were the voting members of the BACD at the time. I remember saying, “I mean, I’ve got nothing to offer. I’m just a general practitioner with a huge interest in cosmetic dentistry, but I can promise you that you will get my blood, my sweat, my tears. You will get 100% commitment.”
Payman: I think I was there.
Bertie: I mean, I paraphrased Winston Churchill, I think. That was the quote that I used. And then I got elected onto the board. And what an opportunity for growth, because I’d never done anything like it. I’d been involved in dental organisations in South Africa, but very political, in uniting the whole dental community in South Africa. We had a non-white dental organisation, and then we had a white dental organisation. We got that together. So that was my experience. I was the general secretary for that, and involved in negotiations with the South African, the white dental association or what was perceived as the white dental association at the time.
Bertie: So coming onto the board at the BACD was a huge learning experience, and being asked to do a role. I think membership was the first one that I got involved in. And then each year, the board of directors would change. You had a new chairman of the board, which was the new president, and he would rearrange his cabinet, so to speak, to try and put people in different positions. And I was moved around a lot. But in the end you realise, it’s actually the best way to prepare yourself for leading an organisation, is to actually have full experience of the whole organisation, of what the membership side is like, of running… Comms was our big area, and between myself and with Andrew Chandrapal following up, and seeing how we started looking at things like budgets.
Bertie: In the beginning, I mean, money was not an object with the BACD. There was a lot of money thrown at it by a lot of people, and we were able to do a lot as far as publicity and PR and all the rest of it. And a lot of money was made from the conferences, because it was a very unique concept. And then the copycatting started, and everybody started having conferences very much like the BACD’s conference. And that starts diluting the effect, and you’re competing with other people, and of course numbers dwindle and that’s when the challenges come in. So I learned how to work with budgets, I learned how to be focused. I learned how to plan the year.
Bertie: I mean, there was so much that I learned at BACD and could take back to my practise. So where somebody might be ambitious and think they want to just rocket to the top of an organisation, I don’t think it’s the right thing. I think it’s like the practise. You should focus on doing the right things, and the other things follow. The financial reward follows in your practise, the personal reward follows at organisation level. It’s going to happen for you, but what you need to do is to do what the organisation needs you to do. That for me is key.
Payman: What a lovely speech, man. I love that. So beautiful.
Prav: Bertie, even as a practise owner, I speak to a lot of practise owners on a regular basis. It doesn’t seem like you’ve got an ambition or an exit strategy or anything like that, but it’s more like just doing the right thing for your patients and your team.
Prav: Is there an overarching business goal or ambition? Do you feel like, “In five years time, I want to get out and sell this?”
Bertie: I think yeah. I think the reality is biting that you need to at some point have something that’s sellable. And of course the conversation starts happening now. I mean, my financial planning in South Africa was to retire at 55. So what’s happening at the moment is, all my endowment policies, my retirement annuities, I’m getting all these letters from South Africa saying policies have matured and suddenly I’m like, “Oh, no. This is when I was supposed to retire. Age 55 was shutdown time and go and enjoy yourself.” I just can’t imagine doing that now.
Bertie: But what I’m doing now is saying to myself, “You’ve got 10 years.” And in five years time I need to start winding down. So I need another four years of really working for myself and doing what I want to do, and then allow an extra five years of transition for whoever it is that wants to buy the practise, that I still want to be able to input and make sure that this practise is a good return on investment for the next person, and prove that it is worth what I think it’s worth.
Bertie: So, yes, the mind is starting to stray in that direction, but there’s still a lot of, just keep doing the right thing and things will just… Yeah.
Prav: So between now and the next however many years it is, have you got a plan to maximise value? Maximise turnover? Maximise profitability so you can increase that saleable value?
Bertie: Oh, absolutely.
Prav: Is there a set-out strategy for that?
Bertie: We started last year, and the first thing we thought is, “We need to start getting specialists into the practise.” We’d like to get the associate position for a full-time. So hygienists first. Five days of hygiene. We’re up to four at the moment. We need it to be five. So the only way we could do that was by extending the practise and having another surgery. So that is what we thought we would do. We have a staff room, yeah? Payman, you’ve been to the practise. The old staff room-
Payman: I like your practise. It’s beautiful.
Bertie: Whereas the old staff room would become another surgery. And we had some sheds out at the back, and we thought, “Right, the sheds will become the staff area.” And that was the plan.
Bertie: And then, we started planning and looking at building. We thought, “Well, we need to link these two buildings.” So what started out as converting a staff room into surgery number four turned into extending the building, having surgery number four, while we’re at it, do you know what? My surgery downstairs, I need a little bit of extra room. So we’ll just extend out to the back another four feet or so.
Bertie: The four feet became a 12-foot extension of another room onto the back of the practise, on the back of my surgery. So what’s happened now, we have essentially two buildings that are merged together. If we needed to, we could actually separate off the back section and it could turn into a complete residential unit on its own, if it had to. But it’s actually working very nicely as part of a bigger practise. So we’ve got lots of room now. We’ve got four surgeries.
Payman: It’s a very South African trait, to be building out and up.
Bertie: Yeah. That’s it. So we’ve got four surgeries now, and potential for a fifth one. Again, knowing that some of the corporates, when they look, they look for at least four surgeries, and plus, they’re looking for potential for expansion. And we are in a good area for private patients. So yeah, that’s what we’re looking at, is building the practise but also not over-capitalising at this stage. Which was going well until COVID came along. And that put the brakes on a lot of things. Yeah. But if we could keep going in our recovery the way we are now, then we’ll be okay.
Prav: We’ll be all right.
Prav: I think we’ll definitely be all right.
Payman: Tell us about the BAPD. When was the first time… You were one of the original-
Bertie: Well, so BAPD came about from two groups. There was a group, which I think Neel Jaiswal, and I think Zacky, were pretty much instrumental in this. And a lot of guys who were, I’d say, in a new mainly friendship group, so a lot of us knew each other from that, and in chatting we were already formed these groups on Facebook. There was the turbine dentist group, there was a couple of other groups. We garden and enjoy nice cars and things like that. Not necessarily our own but other people who have them and go to car shows and things. So there’s a lot of common interest outside of dentistry.
Bertie: So when this happened, there were conversations going on, and people said, “We need to do something, so let’s start sorting out…” And what was the catalyst was, 3rd of April was the webinar by the CDO, and where the question was asked, and I’ve realised it was Wayne Williams that actually asked that question, about the involvement of private practises and the CDO saying, “I don’t speak for private dentists, yeah? I only speak for NHS.”
Bertie: And the sudden realisation, “Hey, we’re in limbo, yeah? There’s nobody going to help us.” And of course, practises then being told… Well, we were told to close down on, it was 22nd of March, 23rd of March, by the BDA first. That was the first time I had heard about it. But by that time, we’d already said to our older patients, “You know what? Just stay home until we know what’s going on.” So first call to close I heard was from the BDA, and then of course the next one was the NHS basically saying, “NHS practises should close.” I think that was 24th or 25th of March, somewhere there.
Bertie: And then the first webinar from the CDO was the 3rd of April, and her saying that she didn’t speak for private. Of course, there you are, you’ve closed your practise and you don’t know what on Earth is going to happen next. So we got together, and then we started a Facebook group, and then realised there was another Facebook group that had just been started with Jason and Luke Thorley. I think Simon Thackeray was involved in that one as well. And then we decided, “Guys, rather than launching two separate organisations, let’s talk to these guys and see what we can do.”
Bertie: And of course, people get together because you’re in groups of trust. You’re with people you know and people you trust. So there’s one group of trust, which was Jason and Simon and these guys, sort of knew each other, and Luke, but I don’t think Luke knew them as well as they knew each other, but there was this group who felt they could trust each other, and then there was our group who felt we could trust each other. And then bringing the two together. So there was a bit of, I would call it, what do they call it, forming, storming and norming when it comes to any organisation. So there was the forming, “Everybody, yeah, we’re going to come together.” And then there’s the storming when you don’t know who you can trust, you don’t know people’s motivations. And then the norming where we’ve now established what we’re about, and people can see by people’s actions that these are genuine people. These are people who have dentistry at heart, and where dentistry is going at heart.
Bertie: And from not knowing people to suddenly defending people from criticism from others, because there’s a lot of social media issues where dentists look at other dentists and think, “Oh, these people just want social media fame,” and yet when you get to know people, there’s a slight, “No, actually, yes they’re social media savvy but it doesn’t mean that they’re there just for the sake of being famous.” Which is, I think, that’s the realisation, that we’ve got to know people at a deeper level now, working with people. It’s just been amazing. Yeah. So it’s been a really good experience of getting to know people at a completely different level.
Payman: So we won’t know for sure exactly when this one goes out, Bertie, but we’re at that early August. Right now, today, are we looking at fallow time? What’s the APD’s current agenda?
Bertie: We’d like to see it gone. No, seriously. And the science… I can see the argument that for the danger of what might be in the air from an infected patient, we can see that there’s an argument. We can see the argument, the point of view of the precautionary principle. And I will say this to their faces, the way PHE have gone about this is just treating us like a bunch of idiots. Because you cannot say one hour fallow time on the basis of that’s how long it takes to turn over air in a room. Excuse me? How big is the window in that room? How big is the door in that room? What is the air flow in that room?
Bertie: These are people who are highly qualified. These are dentists who, we’ve got years of studying behind us, of studying science behind us. We’ve all done physics as part of our courses. We would know how to calculate on the basis of what our rooms have. Surely, say, let’s get a scientific basis of calculating how to ensure that there’s fresh air in your room, before you allow the next person into your room. But no. We’ve just been treated like a bunch of mushrooms and told, “One hour, that’s it, you can’t mitigate for it. You can’t do this. You can’t do that.” I’m sorry, but of course people are going to kick back.
Bertie: I think it was again Churchill who said something about, the more regulations you make, the more people lose total respect for the law. So when you start throwing regulations out left, right and centre like that, with no explanation, no justification, no consultation with the profession, or consulting with people who are non-clinical and allowing them to make regulations… I mean, I looked at the stuff from the beginning. It said aerosol generating procedure, and it says what these things are, and then it says evidence. So each thing that PHE had done, they would say what the evidence was, that there was a potential for transmission of this virus.
Bertie: And, when it came to aerosol-generating procedures, evidence, none. There was nothing there. So it’s been taken from other situations and just put into, because it’s happened for, let’s just say, with EMTs and that in the emergency where they’ve been treating these patients under emergency and it’s been just transposed to dentistry, now, why is it that orthopaedic surgeons have managed to get this changed for them and yet it’s taking forever for dentistry? Where people have been presenting science and saying, “Come on, we need to look at this, we need to look at this,” and countries all over the world have been doing very similar things, and yet here we are in the UK, still trying to battle with it.
Payman: What’s the answer to that, buddy? Why?
Bertie: They’ve got to get their act together. I have no idea. I’m a cynic. I’m a cynic. I’m a cynic. So I’d rather not answer that.
Payman: Where do you sit on that balance between conspiracy and just lack of attention to detail?
Bertie: I don’t-
Payman: We can see there’s definitely some NHS angles going down. Right? We can see that.
Bertie: I think the NHS are using the opportunity. And I think because they’re using the opportunity, that has lessened the urgency. Because if the NHS had wanted to get back to work quickly, there would have been a greater urgency to get this thing sorted. 100%, that’s what I feel.
Payman: I agree with that.
Bertie: But because the NHS have decided that they will use government funding, which is my taxes and your taxes, to support NHS… I don’t want to call them NHS dentists, because I don’t believe there’s such a thing. I believe that we are all dentists, and I believe some of us are working with a system that’s funded by the NHS and some of us are working with a system that’s funded by the patient. So I don’t believe in saying it’s an NHS dentist or it’s a private dentist, because that starts conjuring up that the dentistry is different and there should only be one standard of dentistry, and that’s the end of that.
Bertie: But I think the NHS is using, or those in charge of the NHS, are not in a hurry to get rid of fallow time, but may become in a hurry now because their plans may have moved on, and they need to start seeing people get back to work. And while they’ve got the Urgent Care Centres running, supposedly picking up the emergencies… I know it’s not the case in my area, I’m seeing a lot of emergencies who are NHS patients and who want to see someone local to them. So I’m sure that’s what’s happening in the other areas.
Bertie: So while there may be claims that the Urgent Care Centres are actually working really well, the reality is probably that private practises are picking up the slack in a massive way.
Payman: Yeah. Talking to private dentists, that’s what I’m hearing, too.
Prav: Bertie, me speaking to a lot of private dentists about fallow time at the moment, many people are looking at it differently, and there’s this so-called one-hour statement that’s been made. People are treating it completely differently, and it’s a sliding scale, as I see it. Naturally, I’d never mention any names because people have spoken to me in confidence, but it’s everything from nothing, right up to the whole one-hour thing, and panicking and stressing, despite having the large windows, despite having the suction and all the rest of it. Where do you sit on that scale?
Bertie: I think where people are looking at it is looking at the FGDP. What the GDC says, basically, if you are shown to be following a body of opinion and you have done your risk assessments, and you’ve taken the precautions to make sure that you’re not going to harm patients, and you’re doing things safely, and I think it’s that body of opinion. So you don’t have to be following one particular thing.
Bertie: The PHE stuff, as far as I’m concerned, is guidance. It’s guidance. And when you read it, it does leave itself open to, because they explain what it’s about, and there’s a few more documents and things which I’ve had sight of. And you see, there’s an explanation behind how the fallow time works and the number of… It’s based on number of air changes. Now, if I can prove that the air changes are happening to a higher rate in my room, then surely, I have evidence that I’m achieving the air change. It may be taking me a lot less than an hour. Is there some argument to say that I’m not allowed to do that? Because if it’s based on an air change, then that’s what we’re doing.
Prav: How much air change does the one hour assume.
Prav: Six. So if you did 12 in an hour, then you could drop it to half an hour, theory would dictate.
Bertie: Well, this is what the…
Prav: It’s very simple… Yeah.
Bertie: Well, no, it won’t quite work like that, because it’s like taking a cup of tea and pouring clean water into it. It’s not going to take six cups to clear out that water-
Bertie: It’s dilution, but how long is it going to take? It’s not saying that you can cut it to half an hour because you’re getting 12. But there is a system of calculating it, and it is out there somewhere. If you can calculate the size of your room and how many air changes it takes to change that air completely, and how quickly you’re going to do it because of extraction systems, negative air pressure, whatever it is that you’re doing, yeah. It just comes down to calculating it for your particular room.
Prav: Yeah. Yeah. The number of questions I’ve had that are mathematical, from dentists, is unreal. “I’ve got six air changes in my practise and I’ve just put a fan in that does six air changes in that thing. Does that mean I’m getting 12?” I feel like I’m doing maths with my kids.
Bertie: Do you know what? The safest is actually to get a ventilation company in and get them to actually say to you, “So if you’re installing a massive extraction system,” which some people have done. They have actually got professional companies in to come and do it.
Prav: Certify you.
Bertie: The company says, “This is the number of air changes that this is achieving and it’s going to take so much time to achieve it, based on the size of your room,” and that is the safest way to do it. Otherwise, we’re no better than the PHE, which is based on whatever non-evidence that it’s based on. But the argument comes back to, does the virus actually exist in the aerosol that we are generating?
Payman: It’s not the same aerosol as the surgeons [crosstalk]
Payman: Yeah, I agree with that, I agree with that.
Payman: It’s all about nuance, isn’t it? You know, that question of nuance. I heard a lovely quote, the guy was saying, “Tyranny is the deliberate removal of nuance from an argument.” The deliberate removal. The removal of nuance itself, we can see, messes stuff up. Doing it on purpose, that’s-
Bertie: Well, we have an organisation that does that on a regular basis, don’t we?
Payman: Yes. So, Bertie, when you look back on your career, are there parts of it that were dark and difficult? What was a failure in your career that you learnt from later on, that at the time seemed like a disaster, but then actually turned out to be formative?
Bertie: Wow. Okay. What seemed like a disaster was working on the NHS.
Payman: That was a disaster.
Bertie: No, it did. I really thought, “You’ve done it now.” I suppose the turning point was in attitude, and it was someone from the Pankey Institute who said, “You see the opportunity in the situation that you’re in and use it to get you to where you want to be.” Richard Branson, I always remember one of his quotes when he talks about making a mistake, and he says, “I’ve never made a wrong decision. The decisions I’ve made have always been the right decision based on the evidence or the information that I’ve had at that time.” As you’ve got more information, you may have realised that you should have made a different decision.
Bertie: So do we ever really make a wrong decision? Mistakes happen, I think, when you go against your gut instinct. And gut instinct is that amazing computer that’s your brain, that is seeing things faster than you can humanly recognise that you’re seeing these things. And then you’re going to use the logical side of your brain in ignoring the other half, and that’s when we make mistakes, because we think we’re smart.
Payman: Are you one of these guys who really trusts your instincts fully? Are you good with your instincts? Do you get sudden feelings about people that you like them or not?
Bertie: I always say to myself, you meet someone and you think to yourself, for some reason you just don’t feel comfortable. And then you get to know the person, and you think, “Oh, wow, this guy’s actually not so bad.” And then you’re proven later why your instinct was what it was. So my thing now is I always try and recognise what my first instinct is when meeting someone new, and also, when getting into a situation. I always say, “What’s your gut saying? Recognise it.”
Bertie: I can accuse myself very successfully of analysis paralysis at times, where I will sit and analyse something, and take forever to come to a decision, and then come to a decision based on the logic and the evidence and all the rest of it, and I keep saying to myself, “What was your initial reaction?” If that need to analyse is based on a gut instinct that said, “Hold on, something’s not quite right here,” then something is generally not quite right. And then just say no.
Bertie: I’ve taught myself, when somebody says, “It’s an excellent offer but it’s only available until 5:00,” I don’t wait until 5:00 to say no, I just say, “Well, the answer’s no.” Because I’m not going to put myself under pressure and make a mistake. So if somebody’s putting you under pressure, I always say, “Just say no.” An offer of a job. If somebody says, “I need to know by 5:00,” okay, if I’m not certain at that point, the answer is no.
Payman: Love that.
Bertie: You get cheekier.
Payman: So your daughter’s-
Bertie: You get cheekier as you get older though.
Payman: Yeah. Your daughter’s finished dental school now.
Bertie: Yeah. Yeah. She has done-
Payman: Did you encourage her to go to dental-
Bertie: I didn’t, actually.
Prav: Did you discourage-
Bertie: I didn’t discourage her either. From when she was three years old, the joke was always, when she was three and a half, they said to her, “What are you going to do when you’re big?” And she says, “I want to be a doctor, but I want to be a real doctor, not a dentist.” So we used to always laugh about that as she got older. And then she decided she didn’t want to do medicine, but she still wanted to be involved in the medical sciences field, and she did a biomed degree first because she wasn’t sure what she wanted to do.
Bertie: It was medicine all along. Went on a work experience at the local private hospital and got to see all the different aspects, the physio, the radiology, the pharmacy, in the operating theatres with the surgeons. Really, really enjoyed it and decided, “Medicine is not for me.” That was when she made the decision, but she still wanted to be involved in the sphere and did a biomed degree at St. George’s, and then during her final year is when she decided she wanted to do the dentistry.
Bertie: A lot of her colleagues did medicine. I think there’s one who’s doing veterinary science. Others have gone on and done a Master’s, and then she-
Payman: Secretly you were happy, then?
Bertie: I’ll tell you why I was pleased, because I thought she’s got the attributes to do it. She’s got good hands. She’s OCD. She’s meticulous about things. So yeah, I just felt she’s got all the attributes.
Payman: Good people person.
Bertie: And that’s it. And Dominique loves people. Yeah. And I actually thought, she needs to do this on her own. I didn’t encourage her. I’m happy that she’s done it. Obviously, you’re advising, “Do this now, do that now.” Looking at specialising, I’m like, “Do ortho, do ortho, do ortho.” Yeah. But the girl likes the surgery. And this is another thing. Having a daughter-
Payman: Oh, is she doing maxillo?
Bertie: Well, I think she’s done a restorative… What is it when they go into the hospital? She’s worked at year at the Royal London.
Payman: After VT?
Bertie: After VT, or after foundation year. What do they call it? What do they call it? DF1 or something like than.
Payman: I forget. DF2?
Bertie: She’s now going to be working at Whipps Cross, and she’s going to be doing surgery, I think is the field that she’s more going to be focused on. Obviously COVID has thrown a massive spoke into the restorative side of things, because she has not done as much as she would have liked to, but she’s done the sedation thing. So that’s been good as well.
Bertie: But having a daughter, and looking at the experience of women in dentistry, it opens your eyes. Actually, having a daughter first opens your eyes to realising the amount of… It’s not intentional discrimination, but people almost can’t help themselves. We go to the trade shows, for example. I remember being with a lady dentist, and both of us, we hadn’t seen each other for a while. We met on a occlusion course. Walked up to the same trade stand, and someone turns to me and starts speaking to me as a dentist, and then speaks to her as, “So are you practise manager? Or are you head nurse?” And she was absolutely livid.
Bertie: That was the first time it actually hit home, that people automatically assume that because you’re dressed very ordinary, I mean, I was dressed ordinary, I wasn’t in a suit and tie, she wasn’t in a business suit or anything like that, she was dressed ordinary. But the assumption was I was a dentist because I was male, and the assumption was that she was what’s now called DCP because she was female. And you realise, “Hold on, this is not quite right.” And this is still happening in dentistry.
Bertie: It’s like when people say, “I’m not racist.” It’s one thing to be non-racist and it’s another thing to be anti-racist. So I think the challenge is there for us now, and it’s not only because my daughter is a dentist, but the challenge is there for us now to stand with women in dentistry and actually help where we can to be aware of where these things can creep in.
Payman: We talked about this before, you were the one who pointed out to me, you said, “There should be a minimum number of speakers at your event,” at my conference, women speakers.
Bertie: Yeah. Yeah.
Payman: Do you still believe that?
Bertie: Oh, absolutely. Absolutely. There’s two arguments to this thing. There’s one where you look at it and you say, “Surely people should be getting in there on the basis of merit, and that should be it.” Now, there’s another argument that says, when it comes to your friendship groups, very often it’s easy for guys, for us as men, to socialise with each other and it’s easy for women to socialise with each other. And the reality is, even though there are more women dentists graduating today than men, and I seriously think, I’m sure there are more qualified female dentists than there are male dentists, the reality is that the male dentists are in the profession and in the profession from Day One you’re there as a dentist. You’re never leaving for a few years to go and have a family. You’re never leaving for a few years to look after your family. You’re never going part-time because of your family. Which means women are always looked at, possibly, as not going to be there all the time, whereas the male dentists are looked at as, yes, they are. They are bankers, almost.
Payman: This is true in every field, right?
Bertie: It is, it is. And it’s happening in our profession as well. But I don’t know what-
Payman: But shall we take it to there? Shall we say the next prime minister should be a woman, then the next one should be a man?
Bertie: Payman, you see, I don’t like all of that as well.
Payman: I’m not being facetious on purpose.
Bertie: Yeah, no, I hear what you’re saying and I feel the same way. I don’t like that as well. But how wonderful that you can recognise women dentists who have actually achieved and then invite them to come forward? But we also need to encourage them to show themselves. They need to show themselves. It’s no use the shouting going on from the side saying, “There are no women representatives on your organisation. Why is it all male?” Well, I know in the case of the BAPD, I can say it straight out, it happens to be all male because these are the people who stood up and made a noise.
Bertie: Yes, there were women dentists invited to get involved as well. It didn’t quite work out for various reasons. And it would be wonderful if we had women dentists with the same sort of passion and characteristics of the men who are there already saying, “Right, we’re going to fight this battle for private dentistry.” But how do you find those people? How do we encourage those people to step forward? We’ve got one or two really, really good people involved at the moment, but it would be great if there were more.
Bertie: Now, what do you do? Do you say to the male dentists who are involved in, let’s just say, various organisations, say, “Right, we need you to step down because we want a woman dentist to be in your place”? You can’t do that. It’s just wrong. So what needs to happen is looking at how things go forward, is to encourage women to step up and stand forward, put themselves forward, for example, for election on organisations, to put themselves forward for doing presentations. The opportunities are there, but it means people need to be connected, whether it’s on Facebook groups, whether it’s in organisations where the questions are being asked. Women dentists need to be there.
Payman: I think, you know Bertie, my issue with it is women definitely get a really raw deal in dentistry. But I’m not thinking of the dentists, I’m thinking of the nurses, the hygienists, those types. The stories you hear about the way some staff are treated by dentists, men and women. Terrible, terrible stories. Our profession is dominated by women if you count everyone up. Men are the absolute minority.
Payman: For me, if you want to address something, that’s the one that needs addressing. The career prospects of women in dentistry, rather than women dentists. But from that post I saw, there was quite a lot of heavy feeling about it. So I guess that needs addressing too. Prav, what’s your question?
Prav: Bertie, you’ve obviously shared a lot of your values with us today during this short time we’ve been speaking, both from your upbringing, your folks, and then passing on to your kids as well. Imagine it’s your last day on the planet and you’ve got three pieces of advice that you’re going to leave your children, the world, with. What would those three pieces of advice be? And how would you like to be remembered? What would your legacy be?
Bertie: I think the first piece of advice is always try to tell the truth, because then you don’t have to remember what the story was, you actually remember what the facts of the event were. So always try to tell the truth.
Bertie: The second one is always try to talk about people as though they are there with you. That’s a very difficult one to remember at times, because emotions can creep into things. And the third one is always do the right thing. Do the right thing as though everyone is watching you even when no one is watching you. You sleep better. The rewards follow. The rewards follow. Never chase titles. Never chase recognition. Never chase money. Just keep doing the right thing.
Bertie: What would I like to be remembered for? Gee whiz. For being a good father. For being a good father. For being a good husband. For being there for people who need me, whether it’s my colleagues, whether it’s personal things that happen. For being there for my team when they need me. For being fair to people. For just being a really good human being. I think that’s more important than anything else.
Prav: Bertie, that’s beautiful. And I think the one word that comes out of that that resonates with me is integrity. It really does resonate with me based on what we’ve discussed today.
Payman: It’s always such a nicest pleasure to speak with you, Bertie.
Bertie: Thank you. Thanks, guys. Yeah.
Payman: Whether it’s in the practise, or in a bar at the conference, or on-
Payman: … a podcast, it’s always a massive pleasure. I always finish off speaking with you feeling enriched by it.
Bertie: Thank you very much.
Payman: So thanks a lot for doing this, buddy. Thank you.
Bertie: Thanks Payman, and thanks, Prav.
Speaker 2: This is Dental Leaders, the podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.
Prav: Thanks for listening, guys, if you got this far you must have listened to the whole thing, and just a huge thank you, both from me and Pay, for actually sticking through and listening to what we had to say, and what our guest has had to say, because I’m assuming you got some value out of it.
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