This week, dentist Jimmy Palahey takes time out from his busy chain of Midlands practices to talk about the current state of play in COVID-era dentistry.
He shares some of his experiences as urgent dental care (UDC) provider throughout the worst days of the crisis and lets us in on how his mixed practice is balancing UDC with the demands of general post-lockdown operations.
Jimmy also lets us in on his thoughts about what’s next for the profession.
“We’re a pretty adaptable profession. And I think that we can adapt to whatever that gets thrown out…I think you just got to adapt to what’s there.” – Jimmy Palahey
In This Episode
00.37 – The mixed model
04.52 – Urgent care
11.55 – Managing the new normal
20.12 – Thoughts on the future
32.24 – Silver linings
About Jimmy Palahey
Jimmy graduated from Leeds Dental Institute in 2004 and went on to practice in and around the East Midlands. He is currently clinical director of the JDSP group of clinics – an urgent dental care provider during the COVID crisis.
Jimmy is a Foundation trainer and member of the Royal College of Surgeons (England) and the British Dental Association. He is also chairman of Nottingham Local Dental Committee.
Payman: Called from me, the CEO, to my top users. I should’ve been doing more. I’ve learned that now. A simple thing like that. Of course, there’s all the financial side. Luckily, I’ve got a partner who takes care of that stuff as you know, so.
Intro Voice: This is Dental Leaders. The podcast, where you get to go one on one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.
Payman: So, today we are going to talk to Jimmy Palahey, who’s got four practises in around Lincolnshire and Nottinghamshire. Jimmy, is that right?
Jimmy: That’s correct. Yeah.
Payman: Yeah. Nice to have you Jimmy. So Jimmy, just tell us firstly, pre-COVID, what your practises were like. The size of them, the number of people, the buildings, the kind of dentistry you were doing in those four. And then, three of those became urgent care centres, urgent dental centres. So really, what I’d like to know is what it’s like, first of all, how did you do that? Why did you do that? Why didn’t you barbecue like the rest of us? And then, what it’s like working in that environment.
Jimmy: Okay. So, let’s take a question at a time. The initial group of practises that we had, we always run a mix model, so we’ve always run a mix model. I’ve always felt the most suitable model for us.
Jimmy: I think it works well for us. I have a background doing NHS dentistry. Did most of my career doing that. And then, obviously always had one eye on private as well. But we’ve always approached it as a Pizza Express of dentistry, toward that sort of model. So, not high-end Michelin star and not McDonald’s, so kind of sitting in the middle. And we’ve always sat at that sort of position. So we’ve always built the practises, all four of them really, into that sort of position where we have a steady NHS income, and then also have the private on top.
Payman: When did you have your first one? How old were you when you started that? And then, when did you add the next three?
Jimmy: So we bought the first practise about 10 years ago [inaudible 00:02:15], and we bought a pretty standard setup sort of buy a practise offer, offered the practise owner. And then they were, they sort of ran it as much more of an NHS type practise.
Jimmy: And then, we sort of added in more services and expanded the practise and so on. And then, we sort of went through the tendering process, for new NHS contracts. And, that’s how we sort of expanded over the years. So, we expanded over the last few years into more sites in order to sort of just essentially able to treat more patients. And just to have a bit more activity going on. And then, obviously taking that original philosophy into the new practise to create that sort of mixed model.
Prav: And Jimmy, as a practise owner… And I see a lot of practise owners who have mixed practises and then grow. Personally, from a clinical point of view. Did you adjust your splits? Did you start doing more private work, or move, or at any point shift towards being exclusively private? And then, get the associate centre do the NHS. How has that been during the whole period of time that you’ve grown from say, your first practise up to four?
Jimmy: So, yeah, obviously I was doing a lot more NHS work at the beginning. Because, young couple buying a practise. You essentially got to put the graphic that you’ve got to have that grit and determination to sort of…
Jimmy: Get ahead a few years. I’m sure everybody will say the same thing. And then, as we, as we have more conversations with patients and we stabilise our base, we can start talking to them about private work. And then, obviously introducing various clinical systems into the practise. So, whitening being one, for example. And then, implants and handles. So, sort of endodontics and oral surgery and just expanding into all the different stairs. And then, just making sure that, we cater for all needs really. We try to keep everything under one roof. I think that’s probably what the majority of practises are doing or aiming to do.
Jimmy: And, that gives you a natural platform to then expand on. And that’s what we’ve done.
Prav: And so, you as a clinician personally, do you do any NHS work now? If you shifted to be primarily working on the business plus private, or do you do still do a little bit of NHS? How does the structure work now?
Jimmy: So yeah, I probably do more private work now. As you said, work on the business. So, I do problem solving and all the other aspects of running a business. But I still do a little bit of NHS because there’s where my roots are. And, I don’t mind doing a little of that. I think in certain circumstances, NHS is very suitable. Private is obviously suitable in other circumstances. So, it’s just about giving people choice and then… I’m not pretty prejudice against one or the other. I’m quite happy to do both.
Payman: How did the UDC thing happen?
Jimmy: So, UDC thing happened. I also work with the LDC in Nottingham and we were approached as an LDC about UDC. Because the thing about LDCs is that no one’s ever heard of it. And quite frankly, in most of your [inaudible] different games with them very much. And we have many years where there was not much engagement.
Jimmy: And then, we were then mentioned in the documentation that came out from the CEO of the NHS about utilising the LDCs to create either UDC or to impart on the CBC. So from the outset, we were inputting on this, how we wanted our UDC to be sort of designed in our area. And I think as a group of LDCs, we did that. And obviously, as a provider of services, we actually provide an eight to eight service. And we provide seven days a week at most of our practises. So, we already have that sort of platform. And we are already quite happy to see NHS patients.
Jimmy: So it seems like a natural progression to then extend that out towards that UDC model. And ultimately, we were approached by the NHS to become a UDC.
Payman: So, you were running eight to eight, seven days a week before.
Jimmy: We were, that’s right. And, in a few of our sites we’re eight to eight, seven days a week. So, we find that works quite well. And we find it’s quite a good model for our employees as well. [inaudible]
Prav: Jimmy, quick question about that. In my own practises, sometimes I talk to my associates and support team about possibly opening a Saturday clinic or doing a late evening and stuff like that. You’ve obviously got something in you that we haven’t, that enables you to get team members to be able to come in late or, or do the weekend shift and stuff. How have you managed to sort of set that up? So, you’re able to operate on them hours. And then, how do the shifts work? Just, just give me an overview of that. I’m really curious about that.
Jimmy: So, probably a combination of wit and charm, let’s say that. Hey, that’s from me, that’s from my wife. This is not really my doing now. I’m not that charming really, to be honest. Yeah, it’s just talking to people, and exploring the fact that this is not a bad option for many people. They can turn their weekend into a weekday. They can do a lot more work in that weekday. Then as more things open up, there is more opportunity, it gets busy. So it’s just really, trying to spell out the advantages of working in this whole flexible way. And I think that, if people have children, that they can do the school run. And one way or the other, so they could drop in the morning or pick up in the afternoon. I think there’s an appetite for it. And it works, it’s a very productive way of working I think.
Jimmy: Yeah. I think that it does have its challenges. But then, all practise have their challenge to problem solving, as you said before.
Payman: So is it an eight to two, two to eight model?
Jimmy: Yeah. We run it more of an eight to two, two to eight. I think it’s reasonable, six hours and then their work is over, usually. Some people like to work more and that’s their choice. But, we’ve encouraged that sort of working.
Payman: But then, how about the manager? Are there two managers or just one?
Jimmy: So we’ve been through different scenarios. I think early on we had multiple managers, a manager per site. And, I think that now we sort of have a bit more of a dual practise manager role. We also have a team of about, let’s say five or six to look after all the sites. So, we all chip in and do a bit each. And, we all have our different roles. I think they’re quite role specific. We tend to spell those roles out quite early on. So, everybody knows what they’ve got to do. And, I think we sort of… And, then we can dip into other parts of the business as well. So we have a loose managerial structure. But, we tend to just allocate the roles accordingly.
Prav: Jimmy, how does it work for you as a practise owner? Because, I certainly know that during the times of operation, there are certain team members that are on call too, if that makes sense. And then, when the practise shuts, obviously I’m probably going to get a little less feedback and stuff like that. What does your work life balance look like? And, are you on call from eight to eight most times. Or, have you got that sort of covered, so there’s a layer below you. How, how does that work in terms of your life and how you manage something that’s running seven days. Eight to eight.
Jimmy: Yeah. Good question. I think it was a bit more challenging at first. But then, you get into a flow don’t you? And, if you have a good team and you can allocate work, you feel that the team are picking up that work and you get good feedback.
Jimmy: I think at that point you can start taking your foot off the pedal a bit. And maybe, just concentrate on the more complicated work with more complicated problem solving. I think more of the operational type aspects of the business, I would leave to other team members. Our clinical leads, for example, practise managers and so on. I think that would be where I would try to just actively take a step away and say, that’s your role? And if you have any issues and come and see me. But, essentially I’ll expect you to fulfil that role.
Jimmy: And if it’s clearly defined from the outset, and if that means you can dip in and dip out accordingly. And then, make those time for your kids and everything else, you’ve got to make time for as well. It’s just juggling time. Isn’t it really?
Payman: Yeah. So tell us about what it’s like working within a UDC environment. Like, whole PPE thing. Especially, when the virus was peaking. Did you have members of staff scared to go in and that sort of thing?
Jimmy: That’s interesting. Yeah, I think we’ve seen the whole evolution of this really. Because, from the outset we were sort of sitting with the NHS saying, this is how we think it should be delivered.
Jimmy: And, everybody didn’t have the level of sort of guidance as we have now. More documentations coming out on a weekly basis, daily basis almost. But, early on, we didn’t have that level of guidance. So, we would do things like fit testing. And then, the person that was fit tested would say, look, there’s literally no guidance in the healthcare space. Most of my guidance comes from asbestos and from solvents and so on. So, there really isn’t. So we’ve asked him a question like, how about we try this. And he’d be, oh, there isn’t any evidence for it again. So, essentially become a guinea pig. And I think, that we kind of guinea pigged our way through from the early days. From PPE testing, patient flow, everything. They created softs quite early on and they did a good job in explaining this.
Jimmy: I think that their team that created the standard operating procedure to do a good job, based on the evidence they have. And obviously, more has just flooded the market and opinions have changed over time.
Jimmy: So, where we started and where we are now is quite different, actually, I would say. A bit more clarity on what you can and can’t do.
Payman: And you were doing AGPs as well. Right?
Jimmy: We were doing AGPs from quite long time now. Yeah, we sort of embraced all of the PPE requirements, and obviously patient flow requirements. And adjusting the practise to accommodate donning and doffing areas. All that sort of stuff. We did that early on. Yeah. And we’ve been doing it for a while, so we feel quite right doing it. So, we’ve continued on. And yeah, we’re happy to share any sort of information. We’ve done that through the LTC networks. We’ve always shared any kind of learning.
Payman: Yeah. What are some tips how to manage in this new normal. In this bit? H Hopefully it’s going to change again. But, to me it seems like patient communication is an issue, right?
Jimmy: I think so. The conversation, there’s going to be an issue because of the mixed messages that they’re probably getting from the wider sphere. So, if the tell everyone they’re opening on the eighth. And they don’t give you any indication as to what to expect. And it becomes a bit of a… You almost have to work backwards. Certainly, they give you all of the information later. So we’ve had a big comms bundle that’s come from the NHS. But practises are already open. So, you’re kind of retrospectively trying to get that all out to patients. So, it’s kind of almost doing things in reverse. And that hasn’t really helped the situation. But in practises that are proactive and people are quite sort of willing to get on with it. I think that’s, we’re a pretty adaptable profession. And I think that we can adapt to whatever that gets thrown out. So, I’m not hugely downbeat about it. I think you just got to adapt to what’s there.
Payman: When I said communication, I meant actually patient-dentist communication. Under all that stuff, do they not find it difficult talking?
Jimmy: Yeah. So we’ll have a conversation with the patient prior to getting them through. So yeah, we learned quite early on that we needed to triage prior to them coming into the practise. So, trying to get conversations done and dusted. And we’ve been using things like video conferencing and things like that to at least liaise with the patient beforehand. And just kind of give them an idea. And post-treatment as well, essentially when you’ve treated them, you want them out of the door and out of the practise. So that you can start preparing the practise for the next patient and cleaning down and so on. So, we can always have a debrief post the appointment. So, using tech has been a big help and has allowed us to sort of contact patient outside of the room, sitting in the chair. I think, it is going to be a useful thing to use. I think going forward, I think the whole profession will embrace it, wouldn’t they?
Prav: I think something that keeps coming up with a lot of my dental clients and friends is it’s fallow times and how long to leave between AGP, non AGP procedures. And, what was that when you first kicked off? Has that changed and what advice can you give? And it’s different. We speak to everyone. It’s different.
Jimmy: Yeah. In the early as standard operating procedures that we’ve got from the UDC, the real first incarnation of that. At that time, it’s about 60 minutes and we used to leave about an hour and a half some for the AGPs. And about 60 minutes for anybody non-AGP. But, that was what was written down. Because, I think that, that position was evolving. And obviously again, through the LDC network, we would always ask the questions about this type of thing directly to the NHS. And sit there and wait for an answer from PHE, would eventually come down the line. Things like air conditioning, for example. We had a lot of our teams sweating away in FFP3s and their gowns. And, we’ve kept asking the question, yeah, can we use air conditioning? And then, we got the responsible for a few weeks later.
Jimmy: So, it hasn’t always been that quick, getting the response. But, obviously the PAT position is that equal position. So, I think that you have to follow that. The FGEP guidance has been very useful in my mind. I thought that was a good document. And again, some of our East [inaudible] colleagues were involved in creating that document. But, it’s not always in tune with the NHS documentation. It’s kind of explained in a slightly different way. And, I think that ultimately from what I’ve heard anyway, the NHS document has to trump that in terms of that being a legal position that you must take.
Jimmy: So, I think the final time issue is going to be something that sort of ranges on and on. Isn’t it? Especially, when we move into the sort of level three type alert status, and people start to think about going a bit more towards routine care or going a bit more back to routine practise. I think those questions will be asked a lot more about fallow time and how, how it could be potentially mitigated.
Prav: So what are the fallow times today? Are they similar, or have they changed now?
Jimmy: Well, the FGEP thing to see… I’m not an expert on this, but they tend to sort of, from my understanding of their documentation, that the non AGP, they didn’t really mention having a fallow time. And for AGP, they gave a range of mitigation for how long the fallow time should be. But the baseline is 60 minutes based on six air changes, I believe. After which we are opening a window. So, and I think they’ve taken out from hospital theatre design and air movements in the hospital sector, how they design it.
Jimmy: So whether more information will come out about mitigation, for example, air exchanges, ventilation systems, and so on. If more evidence comes up, maybe they’ll tweak that slightly. And obviously, you can use rubber down in the suction. And there some very good papers, that talk about the experiences of other countries and how they’ve tried to mitigate that sort of circumstance. I think, certainly the Germans and the South Koreans and so on have certainly released some good information about how they dealt with the issue. And what the actual risk is. I think this is an evolving thing. I think that as their profession demands, more thorough investigation, more thorough explanation of what they can and can’t do. This will only widen the debate further, I believe.
Prav: And, just excuse my ignorance here. But, am I right in understanding as an NHS practise, there’s certain things that you have to stick to. And payment, you might know this better than me. Where this is solely private practise, you can be a little bit more discretionary and go towards, let’s say the SGDP guidelines, or what the BAPD are doing. Because, I’m having conversations every day. Obviously I’m not going to mention any names. And some people are saying, look, I’m using fallow times of 10, 15, 20 minutes. And, I know those are going down the more rigid sort of 60 and longer fallow time routes. And, and is this a sort of, well, this is what independent practises do. This is what NHS guidelines, they have to stick to these. And then, there’s the conundrum of, well, if you’re a mixed practise, how does that pan out?
Jimmy: That’s a good point. I’m not a big… Essentially, people are people and patients are patients.
Prav: Of course.
Jimmy: Everybody is an NHS patient, quite frankly, because everybody pays tax. So everybody’s an NHS patient. Some people choose to have their private perk, healthcare provided privately. But, they have the option of accessing secondary care, also other things on the NHS. And we have lots of patients that maybe have a bit of both. So, I think fundamentally making that divide between NHS and private, probably isn’t going to hold well, if you get scrutinised on your prep. On the way that you decide to interpret rules and regulations. I think, I’m going to give a personal opinion there. I’m not that strong on this. But, I suppose in my opinion, if you’re dealing with a sort of that level four. It’s there for a reason and we should really be dealing with urgent care or maybe tinkering on essential care. People that are having problems that you know, will get worse. And, really sticking to more of a non AGP based model.
Jimmy: I think if you start mitigating fallow times at level four, alert level, I think, maybe in my opinion, that’s a bit premature. I think, as the alert level reduces and the outside risk reduces, then maybe there’s more scope. But again, that’s why I’ve mentioned, that there’s lots of guidance. And, I think that if the PAT position is really the legal position as far as I’m led to believe. So, I think the GDC have also acknowledged that. But, in terms of health and safety, which is essentially what this would fall into. Then, you’d have to follow a legal position in the past, been defined by the department of public health England. I think even as a private practise, I think you’d be hard pushed to defy that regulation.
Jimmy: I think the issue is whether having robust stays and if it’s challenged and so on. And, how much evidence is there to back it up. I think ultimately, you can have an opinion on these things. But my own opinion is that you probably have to follow that regulation if it was in black and white. I think you’d be hard pushed to have your own interpretation of it, unless you had some senior figures, or senior think tanks. Or, people that were in a position that they could rewrite legislation on your side.
Payman: Obviously, you’re quite a focused person. You’re obviously looking into the future and from the business perspective, what do you see happening with your contract. And what do you think you’re going to do? What are going to be your tactics going forward, your strategy going forward?
Jimmy: That’s a pretty broad question. Does anybody know? I mean, ultimately it depends on a number of things. If the GDP figures are what they are in terms of the tanking economy, that is going to be a mitigating factor. And all that will go back on what’s happened in the past. And I guess 2008, we do remember 2008. And I think that, it was when the profession took a hit. And I think that, my gut instinct is that it’s probably going to take a hit again. By how much we don’t know. I think that a furlough is probably giving a false sense of security at this stage. And then, they are going to affect cost and mitigate. And, it might be that the appetite is maybe not as great as it was. It’s a very difficult question to ask.
Jimmy: I think that the NHS side of what we do will continue because the demand will always be there. And we’re quite happy to serve those people that have issues and need dental care. We’re quite happy to do that.
Payman: Do you think the contract’s going to change?
Jimmy: This is the million dollar question, right? I mean, from everything I was reading, it seemed to hint that the contract would change. What happened in Wales, and then the CDO. Sort of reading between the lines. It seemed to hint that change was in the air and that the appetite was there. I know that they’d be piloting for 10 years since the [inaudible] report. They’ve been piloting other options. I’m unsure about the… I think the pilots have become generally unstuck too, to their financial modelling. And, I think that’s always been a hurdle that they’ve never been able to get over. And possibly, there’s an appetite in the profession to change the NHS system. But it’s, whatever… It could be appropriately costly I suppose. That’s again, my personal opinion. It’s probably something to do with…
Payman: If I were to say that you were the King of the… You were the CDO? How would you structure NHS and private?
Jimmy: Well, I think that you could look at other models. The French are quite sort of, have a huge NHS. But then, they remunerate very well for their NHS care. I think about 95% of their MTs are on the NHS. And then, certain aspects they take out of the NHS, like prosthesis, like dentures and so on. So, there are various models around Europe that people could look to. And I think that a prevention based approach has got to be the way forward. If you really, you’ve got to remunerate of prevention. You’ve got to look after kids. You’ve got to. That has to be your baseline. As a national health service, that’s what you got to do. I think at the moment, it’s been skewed towards activity. And really got to go down the prevention route. It just depends on whether they’re in the position to afford it really, I think. As that’s going to be…
Payman: I don’t think they’re going to spend any more money, are they? That seems clear. And we were talking to Ian Wilson and he was saying, look, it’s 2.5% of healthcare spending is for teeth. So, what’s the best way of spending that. And I know, by the way, it’s not even worth saying if you were King of the world, what would you do? Because you’re not. And, the world doesn’t change like that. The world changes incrementally. But it’s been sick for a long time, the system. And I think, the timeline… This is a good time to reflect on what we can change.
Payman: And by the way, also the stuff that Dominic’s been talking about where… I see you’ve really managed well in this period, right? You’ve moved quickly. And you’re the kind of guy who doesn’t complain and takes care of business, but you know, we’ve been let down overall. We’ve been let down by the regulator, we’ve been let down by, over our own defence organisations, I thought were pretty poor as well. Don’t you think it’s a time for the profession viewing the LDC system? Are you guys not having these conversations?
Jimmy: Yeah, we’ve been having these conversations a lot. That’s a part of what we do in terms of discussing these issues. But yeah, it’s a very difficult question to answer. I think that you’ve got to put people’s healthcare at the forefront, because that’s essentially why you do the job. I hope so. That’s why we do it. So, people’s health has to be at the forefront. So, any system you design has to be based around patient care and making sure that the service that we deliver is in line with the demand. What we should be doing to prevent problems going forward.
Jimmy: So, as I said, prevention has got to be the key. I would agree with you, there has been some disjointed comments from various aspects of the profession over this period of time. But, you’ve had to just sort of piece it together.
Jimmy: I think that’d be fair to the LDC network. Again, I keep going on about this, because I’m sort of part of this network. But, they’ve had to provide a lot of information for practitioners. In terms of trying to decipher through sort of a plethora of information and guidance that is coming through. Certainly, we’ve tried to sort of kick through the relevant bits of information and get them sent out to practitioners. So, our levy pays to constituents are receiving that information in a timely fashion. But it doesn’t help. If the information, as I said, it’s sometimes a bit backward. Open the practise and then tell you how to do it afterwards. I think that kind of position has been a bit tricky.
Jimmy: And also, trying to extract a position statement from a lot of organisations has taken time, as well. As I said, that starts at the UDCs. We didn’t have this guidance. We were just kind of winging it a little bit based on some guidance. But then, that was evolving. I was reading constantly reading weekly, trying to work out if anything new had come about. And do we need to change the way we practise.
Jimmy: And I think that’s the experience of most of the practitioners now. So I think the frustration maybe has come about from just having to go back to your business model constantly. And have to make adjustments because new guidance come out and then that would supersede other guidance. And then you trying to decide which one trumps, which. Because, you might get two different opinions and you’re not an expert to decide which trumps which. So you’re waiting for someone else to come out and tell you. For example, that the public health England position is the law and the other positions are not.
Jimmy: So, you needed that guidance from the GDC to actually spell that out. So then, you know that if you’re going to be scrutinised, which guidance you’ve got to follow. So, I think that this is where it’s very… It’s been a huge learning curve and a huge challenge for not only practises. But practise owners especially, but also associates and so on have had to adjust to a different style of working and so on. So, I think any kind of change often breeds fear, doesn’t it? So I think that we are fearful about these changes. But, I think the way to deal with it, it’s just to be level headed and just try to see it in and around and…
Payman: Where do you sit on the conspiracy versus incompetence kind of debate.
Jimmy: As I said, I’d like to think that I’ve gotten a bit of an idea about where I think of how is it we, want to go with dentistry. But then, everybody throws their 2 cents in. And that’s why, again, as you said, would be sort of this redesign of the whole NHS system. I thought that was on the cards. I really… My initial thought was that will never happen because it’s simply too expensive to do it. Or, it would involve additional funding. But then, you started to get trickles of the fact that obviously they were thinking about this in the background. And, there was an opportunity. As you said, everything’s up in the air and an opportunity to rethink it all. But then again, they came back with, we’re probably going to go back to activity again. So then, my hopes were dashed somewhat.
Jimmy: So basically, that letter it’s just quite generic and said, we’re going back to activity again. So, I don’t know what goes on in those conversations. I get a bit of an inkling from people that possibly are negotiating on our behalf as a profession. And giving you sort of snippets and possibly eyeballing the opposition or the other side and the negotiations. And, they can give you their thoughts. But ultimately, unless you’re in that position, sitting around that table, you haven’t really bothered how to make that decision. So, all we can do from the grass or our level, which is the ground level, is just make our opinion known. And then keep our fingers crossed that it doesn’t fall on deaf ears and that somebody does something about it.
Payman: You’ve read a book, it’s called The Shock Doctrine? There’s a new idea as well. It’s all about, when there is a crisis, that’s a good time to make a massive social change.
Payman: Again, by the way, whether it’s a pre thought out thing. Or these plans are already… Of course, there’s loads of plans in place. And there must be people saying, well, now’s a good time to put it in. I can see that happening. I thought the opening, the sudden decision to open. I think that had as much to do with Dominic Cummings’ problems as anything else. Because they announced a bunch of stuff that day on the ticker and on the class. That’s how government tends to work, the news flow management and so on. Right?
Payman: Yeah. But not conspiracy theorist are you?
Prav: No, I am not. I think know for me, I hear lots of things from lots of dentists, right? And, I’ve listened a lot to Dominic. I’ve listened a lot to Tiff. A lot of my clients as well. And they’re all saying different things. My approach has always been that everything that we do in all actions we take, we should be following guidance and law. But at the same time, I truly believe that we should be following science as well. I think that’s key for me, is when, when you look at… And I don’t know if you guys have been following stuff that Ross Hobson has been putting out. He’s been filming smoke bombs in his clinic and stuff like that to see how quickly the air clears. And I think, one of the things that’s really clear to me is one thing that we’re doing with every single patient that walks through the door is we’re doing this screening. But, we’re treating every single patient like they’re walking COVID time-bomb.
Prav: And so, while we’ve got these clean down, leaving it so long for the dust to clear and everything. While we’ve got the temperature check, we’ve got the questionnaires, we’ve got all of this. And, I am not at the front line either. So, I can say what I want, right? And I can say, well, do you know what? The fallow time should be 10 minutes. Or, I think it should be less than that. And I think personally, things will move in that direction. I think, as the evidence comes out and more and more comes out, I think things will shift over back to normality. But, I think the people who are making these decisions have also got a lot on there, a big weight on their shoulders. What if they were to make a decision tomorrow and somebody contracted COVID, that was tough.
Payman: We have been having these conversations with super people who’ve been through. President of GDC, president of BDS. None of them seem to know where the answers were, until we finally got to this point of the chief dental officer. Yeah.
Payman: So, the system’s broken and this is not the last time we’re going to have a problem. There’s going to be other types of problems, whether it’s again, one of these pandemic type. Or some sort of crash or financial crash or whatever it is. Jimmy, what are you thinking going forward? What were your plans? Are you the kind of guy who thinks 10 years ahead. Or, are you thinking of adding more than four practises? What you’re doing?
Jimmy: I don’t know. I think this has been a bit of a chance to reflect, this kind of problem. Knowing that the advice that we get is like throwing a pack of cards in the air and seeing how they fall. I haven’t got. I’m not sort of. Just get a good balance in life basically. Isn’t that, just [inaudible 00:32:17].
Payman: Just seven days a week, eight to eight.
Prav: Jimmy, can I ask you one question? Yeah. And it’s a question I’ve been asking a lot of my friends, colleagues and stuff is, what has been your biggest silver lining of COVID?
Prav: Mine has been focused around family life, appreciating the kids And getting some time and moments in life that 100% I would have missed.
Prav: And, you couldn’t have paid me any amount of money to take this time off work and do that. So, a lot of blessings there. Have you got any silver linings personally, or professionally that have come out of this that you could share with us?
Jimmy: I’m probably on your page there. I think just basically spending some time with the kids. Actually they have been off, we’d been off a little bit. So, it’s been nice to actually just be spending that quality time. Just doing mundane stuff with them was quite fun actually. And also, I think from a professional point of view, I’ve had to really look at the business. And, I’ve never looked at it that much before. And I’m talking, looking at the numbers, really focusing, crunching down those numbers and making projections.
Jimmy: And I think, sometimes we all get a bit complacent and you just kind of like talk… When it comes in, you see that there’s a margin there, you kind of just fill up the gaps, you just get a bit complacent about it. And I think, something like this makes you really focus and sit down in front of that computer screen. And keep looking at those Excel spreadsheets and just trying to work the numbers and work out what’s going on. I think that’s just been a good thing. And I think I’ll make some permanent changes within the practise. It’s definitely off the charts. I think those changes would be for the benefit factor. And when all of this sort of mess goes away, eventually, when things start to go back to normality more, I think that those will be positive changes. I think that making you focus so intensely is a good thing. It’s something that I probably wouldn’t have done.
Prav: Yeah. I agree with you there in terms of, when the train’s moving. And you’ve got this business and it’s moving, there’s always those ideas you have. One day I’ll get around to this, one day I’ll look at this, one day I’ll look at that. And all of a sudden, the train stops moving. You get off there and you’re able to walk around it and analyse what was wrong and say, I’ll change this, these systems, these processes, this, that, and the other. And then, you jump on, it starts moving. And you think, I’m so glad I’ve had that breathing space. So I think for me, definitely systems and processes. And yeah, it’s been good. It’s been good in many ways, it counteracts a lot in the negatives.
Payman: Well certainly, the family stuff. I’m enjoying working from home. It’s a nice mix. For professionally… But the reason why Jimmy’s on this podcast right now is because I called him as an enlightened centre. And said, how’s it going? And so on. And, I wasn’t doing that before. You know, those calls, from me, the CEO to my top users. I should have been doing more of those. I’ve learned that and there are some simple things like that.
Payman: Of course, there’s all the financial side. Luckily I’ve got a partner who takes care of that stuff as you know.
Prav: You too want to leash me.
Payman: Yeah. I’m more the spender. He’s more the controller.
Payman: Anyway, mate. Thanks a lot for taking the time. It’s been a real education. I think you’ve got a very bright future. I don’t know if you’re looking at the whole politics side of dentistry. But you should. Because, you’ve provided more clarity than some of the big guns that I’ve spoken to. It’s really refreshing to see that. Thank you mate.
Prav: Thanks to you actually, really appreciate it. Take care. Bye bye.
Outro Voice: This is dental leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts, Payman Langroudi, and Prav Solanki.
Prav: Thanks for listening guys. If you’ve got this volume, 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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