If anyone was born to be a dentist, it’s this week’s guest. Avi Sachdev is a surgeon with Croydon’s Gentle Dental Group, which he co-owns and runs with dad Kam, brother Mish and other family members. The eight-clinic group is the very definition of a family-owned business.
Avi lets us in on what working with family, talks us through life under lockdown and shares ideas about how UK dentistry could benefit from a more unified approach.
“Always use Enlighten.” – Avi Sachdev
In This Episode
29.00 – Family business
11.52 – Running the group
16.42 – Avi in lockdown
21.40 – New whys
24.20 – Acquisitions
28.06 – Family, roles and recruitment
31.54 – Advice to associates
37.49 – Clinical tips
41.25 – CEREC
43.34 – Blackbox thinking
54.18 – Croydon Dental Seminars
57.14 – In an ideal world
01.05.20 – No-fear mentality
01.07.40 – Avi’s plans
01.13.34 – Last day and posterity
About Avi Sachdev
Avi Sachdev graduated from King’s College London and gained his MFDS from the Royal College of Surgeon in Edinburgh.
He went on to complete a master’s degree with the University of Kent. He is a surgeon at Gentle Dental, a family-owned group of eight clinics based in Croydon.
Avi: I think one of the things that we don’t really acknowledge is, the team behind us are so important. They work so hard. I’m really, really proud of our team.
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 great pleasure to welcome Avi Sachdev to the podcast. Avi comes from a family full of dentists. Welcome, Avi.
Avi: Thanks, Payman. That’s quite an intro.
Payman: Yeah. I met your dad… You were probably in school when I met your dad the first time, how old are you bud?
Avi: I’m 32.
Payman: Yeah. I was thinking about it this morning. I think I met him 15, 16 years ago.
Avi: Yeah. Probably. Yeah.
Payman: Correct me if I’m wrong, I think it was a mixed practise in Croydon?
Avi: Yeah, yeah.
Payman: A very average-looking practise, nothing out of the ordinary, but there was something about your dad. For a start, 16 years ago, he was asking for Enlighten in his mixed practise in Croydon. Even today, mixed practises have difficulty beginning. He had a glint in his eye and he said to me, “I’m going to build something.” And I said, “Wow. Okay,” and then he did. He built up the spaceship of a practise, the Gentle Dental in Croydon around the corner. And now you guys are up to how many practises?
Avi: Last year we picked up our eighth.
Payman: Eighth. Wow.
Avi: We picked up our eighth, yeah.
Payman: What was it like?
Avi: Dad had a plan.
Payman: What was it like as a kid? I mean, were you totally immersed in dentistry as a family? How was it that all of you went into dentistry? Was that a plan? Or how was it? Tell me about your childhood.
Avi: I think as kids, it was fairly normal. I think we had a really happy childhood. I think we were in our little bubble, every kid is. We don’t really know what’s going on around us. We used to have dad do the school run in the morning. Mom sometimes picked us up, always running a few minutes late, but whenever dad picked us up, it was always on time, dead on time.
Avi: He always used to leave at like 3:00, if he was having to pick us up. So he was around a lot and took really good care of us, but I also think it was a case of… They never let us know how hard they actually worked for us. They used to take us on holidays and trips and things that we just take for granted, but you see them pulling weekends, you see them working on the books late at night. You saw an idea of just how hard they actually worked to keep everything kind of going and to keep our lives really, really good. We were lucky. We went to private schools all of us.
Payman: Did you live around Croydon?
Avi: Yeah. So they’re still in our family home. So I think that they moved into that when I was two. Shiv, my older sister was three, and Mish was six at the time. I don’t really have many memories of the first home that we had, but I’ve got the memory of the home where we lived down in South Croydon. It was really, really good. There was a lot of fun growing up there.
Payman: So you’re the youngest?
Avi: I’m the youngest. Yeah. I’m the youngest.
Payman: So you watched Mish and Shiv become dentists?
Avi: Shiv took a year out, and so we were in the same year at King’s.
Payman: Oh, is Shiv not much older than you?
Avi: She is a year older than me. She is what? 15 months or so. Mish is four years older so I saw him become a dentist, I saw how close my dad and him were. I never really wanted to do dentistry. Shiv was much more keen to do dentistry, but kind of we were spoonfed our grades. So we got kind of our 11 GCCEs. We got five As at A-level. It was very perfunctory to just sit there and achieve things because of the schools we went to.
Avi: I remember getting my grades and thinking I did okay. And I remember my friends, my year group saying, “Actually, you know what? Out of the 600,” or whatever UMS it was, I remember out of that, the guys that I was with used to get 580, 590 out of the 600. And when I kind of still got my A, they would be just like, “How did you not get 100 out of 100 on this and this and this?” So we were really, really lucky. Our schools really pushed us and our parents worked tirelessly for us. So it was pretty amazing as a kid.
Payman: Was there the propaganda of, become a dentist take care of the family business or not?
Avi: There wasn’t that at all. I think dad really enjoyed Mish becoming a dentist. I think I was too young to really understand what that looked like and that closeness definitely no cush… I mean, it’s funny. I think I wanted to do something in economics or in medicine. My dad arranged my work experience at St Helier’s, the hospital, but he arranged it on the renal unit. So I was surrounded for my two week stint I want to become a doctor, by dialysis patients. I don’t know if you know the smell there. I don’t know if you know how-
Payman: I can imagine.
Avi: Yeah. So I don’t know if there was a little bit of subterfuge going where he’s actually seeding, “Oh, this is what your life could look like, or you could become a dentist.” But no, I didn’t really want to do dentistry even throughout dental school. Kind of I remember year one was mostly sciences, it wasn’t great. So-
Payman: Did you all [inaudible] the dental school as well?
Avi: So dad went to Guy’s back in the day, Mish went there, and then my sister and myself. Yeah. We’re all kind of [inaudible 00:05:45]-
Payman: Family tradition, man.
Avi: Yeah. I know. I think that there was Prof. Hutchinson, I want to say, who taught my dad and then also taught us, which was a weird one.
Payman: So, did your dad come here before university? Where was he before?
Avi: Yeah. So my dad came to university. He was from originally from Kenya, both my parents are from Kenya. Came here before university. Dad worked incredibly hard. He worked in a sweet shop. He worked in a whole bunch of jobs to try and put him and then his brothers, he’s got three younger brothers, through school, through university. The reason he became a dentist was actually to put his youngest brother through kind of school [crosstalk 00:06:23]-
Payman: I hear this story from Kenyans specifically. I don’t know if you’ve listened to the other podcasts here. That same story from Vishal, Bru, from Anup [inaudible] Mani about his dad. I think he’s from Uganda or was it Kenya? But that, it’s a Kenyan thing. It’s like, “Come struggle, put your family through.” And well it’s borne fruit, so that’s nice. So you’re saying you didn’t enjoy being a dental student?
Avi: I don’t know. I enjoyed the student aspect, but I never wanted to do dentistry. I think it was, I remember, halfway through my third year. You know the aesthetic advantage course? You had Larry on?
Payman: Larry. Yeah.
Avi: And the aesthetic advantage course we did. So my brother did that and he kind of did his level one and dad was doing his level three at the time with Larry and Mike. And I think I was Misha’s nurse, which was great over there. So in third year of dental school, we took a trip to New York and I think it was my third or fourth time. It’s one of my favourite cities.
Avi: I sat in the audience, bored out of my head because I didn’t want to be there because I don’t like dentistry. I remember sitting in the audience and I couldn’t really relate to anything because it was all really super cosmetic, high level, higher-end dentistry. This little, young 30 something, 20 something came on, and I was listening, I was captivated by it and I had a chat with him afterwards and-
Payman: [crosstalk 00:07:57]?
Avi: … he was talking to me about the colour of his background and how he’d spent ages picking out and selecting the exact colour. When I was chatting with him, there was something about that conversation, his persona, his kind of, not arrogance, but just confidence, that really resonated, and I think it was off the back of that. I remember walking back to the hotel and thinking, “Actually that’s the kind of dentist I want to be.”
Payman: That the penny dropped?
Avi: That was it. Yeah. And I think actually we have that on tape somewhere. The old recorders with a little mini-
Payman: Yes. Yeah. [inaudible 00:08:36].
Avi: Yeah. So we have those. We actually have that lecture on tape and I saw it, I want to say, last Christmas? I remember looking at myself and I remember looking at a young Mike [Epper] and Larry and the team there, and Jay and even Kathy. It was one of those things where I was like, “That was the moment.” It was a very clear in my head where I was like, “I don’t want to do dentistry, I want to do that.”
Avi: Then kind of we’ve been really, really lucky. We exchanged numbers and actually over lockdown, I actually shot him a few messages and he’s doing really, really well.
Payman: Mike. Yeah.
Avi: He’s doing quite well.
Payman: Mike’s doing pretty well.
Avi: Very, very well. It’s great that he’s so successful yet he’ll still turn around and pick up a message. He’ll still turn around and help. It’s a really good trait, a really good characteristic.
Payman: And so at that time, Mish wasn’t a specialist?
Avi: Mm-mm (negative). Yeah. [crosstalk 00:09:27].
Payman: So when did he decide to do that? How many years was he… ?
Avi: Okay, that was dad. That was that dad.
Payman: Oh, really.
Avi: That was dad for sure. So dad didn’t love perio. So he was like, “Oh, you know what? I think you should do this. I think you should do this.” That was dad. That was all dad. So he qualified and then had a couple of years. I think he did his VT, which is not allowed now. I think he did his VT with dad, which was great. Then a couple of years, I think he did a house job, and then went into perio at [Easton 00:09:53].
Payman: So now, I mean, we’ll go through the story of how it happened, but if we fast forward now, is Mish more the clinical kind of director and you’re more like an operationals guy? How’d you guys split? I mean, managing this sort of eight practise beast, how does it split as far as responsibilities? What does your dad do? What does Mish do? What do you do? What does Shivani do? And you said Shivani’s husband is also a part of [crosstalk 00:10:23]?
Avi: Yeah. So Soro is-
Payman: Soro. Sorry.
Avi: We have a story around Soro. He’s my brother-in-law. So I remember he met everyone in the family except me and I came home and I met him by chance and he was lying down. I think my sister was kind of was sitting there and he was lying down and I think their shoulders were touching. I remember walking in and then suddenly he jumped up. So, Soro and I, we didn’t start off on the best grounds, but actually he’s like a second brother to me. He’s amazing. So Soro is one of the directors now, Mish is one of [crosstalk 00:10:55]-
Payman: So who does what? Who does what?
Avi: Soro does a lot of the clinical. So he works probably the hardest clinically out of all of us. Mish does his specialist work three and a half four days a week, and dad works clinically. I mean, last week I was struggling with a case and I didn’t have the space to see the patient myself. So dad came and did four hours of really high-end cosmetic, smile, makeover stuff to help me out. It was amazing. So dad still does very much [inaudible] dentistry and I work on the operations and the management. Still do two or three days a week, but that’s kind of how we split our time. So, really not-
Payman: So you’re the main sort of operator of the business, is that right?
Avi: I don’t think I’m the main operator. I think I’m really supported well clinically by the other guys, but a lot of the management decisions, a lot of the planning decisions, we kind of sit down and we have a chat and then a lot of the time I’m executing some of the stuff behind it, but it’s really good. It’s a lot of fun.
Payman: But okay, so I was looking at the list of practises. You’ve got a practise in Kent somewhere, Orpington.
Avi: Mm-hmm (affirmative). [inaudible 00:11:59].
Payman: There’s a manager there?
Avi: So that practise at the moment is part-time, so it’s three days a week. It’s kind of [crosstalk 00:12:08]-
Payman: What are the other ones? What are other ones that is working? You’re not there. You’re not there.
Avi: We have quite a lot of really great staff. We have Head of Finance, we have Head of Marketing, we have a group PM. We have some senior receptionists, nurses that really help and support us. We’re not as corporate as maybe we should be, or we could be, but I think we’re really, really lucky. I mean, I’m looking over, I’ve got a couple of whiteboards just literally behind you. Here’s the majority of my work. So we’re just planning management structures now. We’re rejigging things. We’re planning to go into a bit more of a flattened pyramid, so try and promote internally and recruit newbies for some other positions, but it should be good. It should be fun.
Payman: So, that Head of Marketing and Head of Finance are centralised? They’re like head office people?
Avi: Mm-hmm (affirmative).
Payman: Are they the only two?
Avi: So I think our PM is somebody who does travel between sites, but she’s usually based out of one, but we only have three kind of what we call potentially management people. We’re really lucky we have…. So the nurse that I work with, she does a lot of our ordering, a lot of our stock control, helps me with a lot of my admin support. We have Mish’s nurse again that helps Soro’s team that really helps. So we really share the responsibility. So we don’t have a huge management team, a lot of our… If there’s a problem, they’ll just come and speak to me directly, and the team will message me directly. So we don’t really have a hierarchy.
Avi: We don’t really have a structure where they feel removed from us, not too dissimilar from where you’re at, where the team can just walk up to you and say, “I have a problem.” And then you kind of empower them to fix their own problem rather than saying, “Actually that’s not my bag. Go and speak to X, Y, Z.” Because otherwise I think the team doesn’t really grow. They don’t feel the pain of, “Oh, I need to learn some more information. I need to do something new.” That’s what we found works well. I’ve heard a lot of the other podcasts and it’s [crosstalk 00:14:03]-
Payman: There are different ways of doing it.
Avi: Yeah, there are very different ways of doing it.
Payman: What’s the head count? So how many people work for Gentle Dental Group?
Avi: Dentists and-
Payman: All in.
Payman: It’s a lot of people there. It’s [inaudible 00:14:15].
Avi: We’re really lucky. We’re really lucky. We’re really lucky. Again, my mom’s very much involved in the business. She married dad, got involved. She used to be an accountant, married dad, got involved and does everything from sedation so she’s a sedationist through to PM roles. So again, we’re very much family run. We don’t have this massive corporate mentality. We should. We should, yeah.
Payman: I know what you mean, dude. I mean, like you say, we’re similar at Enlighten. Yeah, it does feel more like a family. I mean, you guys actually are a family, but it depends on what the plans are, right?
Payman: If the plans are to triple by 24 practises, then it does make sense to systemize everything and have extra people, but if the plans aren’t to do that, then it doesn’t make sense. But [crosstalk 00:15:05]-
Avi: You know like you’re asking me what the plans are there?
Payman: Yep. Well, what are the plans?
Avi: So, I think pre-lockdown, all of this pre-pandemic stuff, I think I had a plan of a number of practises. I had a plan of what I wanted to achieve. We had goals, we had visions we had set. I think the lockdown has kind of allowed us to take a minute and ask really why we’re doing that, and I think that’s happened for a lot of people.
Avi: I’ve spoken to a lot of the dentists from some of the courses. I’m sure have run into you and said, “Life’s different. Life’s changed.” A lot of it is in a good way, but I think one of the things that we’re kind of taking stock of is actually, why are we doing a lot of this expansion? Why are we doing a lot of this growth? Because if we’re doing it for the sake of saying we’ve got a number of practises we’re trying to turn over X, Y, and Z, but actually that’s taking [inaudible 00:15:58]-
Payman: Vanity metric.
Avi: Yeah. I mean, we’re probably not that well-known in the industry. We try and just keep our head down and do our own thing and keep a low profile. I know a lot of people who have kind of even not put the fact that we’re running the National Dental Seminars and the Croydon Dental Seminars together. We are very, very… We try and be quite humble and we try and be quite quiet.
Payman: Yeah, there isn’t one of you who is a social media gangster, right?
Avi: No. [inaudible 00:16:28]. It’s strange. I think I’ve got like six or 7,000 followers, but it’s not something that we use a huge amount and it’s something we need to do, for sure. It’s not something that was a choice. It was something that we just need to get around to do it.
Payman: Well, go on. Explain to me what was it with… I mean, let’s go through lockdown because I think it’s valuable. You’re absolutely right. To me it seems, I don’t know, like a light was shone on your world from a different angle and you see things differently, don’t you? You’ve seen first of all, what’s truly important, right? Health. Health. Health. And you’ve realised, that’s it. That’s the number one most important thing.
Payman: But then as a business, how did it feel on that first day when you were locking down? What did you tell your people? What were you thinking? And then take me through what… You’re saying it changed the priorities of why you’re doing your why. What did the why feel like before, and what does it feel like now?
Avi: Okay. So you’re asking some really good questions there. It’s going to take me a minute to just go order by order, question by question. I think where we first started with this kind of process, this journey years ago, we wanted to grow ourselves. We wanted to grow our footprint in Croydon, in Bromley and Sutton. It makes sense for market share. It makes sense for our CEO. It makes sense for how we’re known.
Avi: Our patients are predominantly from certain areas. If we have practises there, it’s more convenient for them. Actually, to us the fact that they travel 30 minutes is lovely, but if they didn’t have to, it’d be better for them. So our philosophy, our mentality was more, we’re getting patients travelling quite far. It would be lovely to have sites that they could visit locally that are called [inaudible] dentistry locally for them.
Avi: Then I think as lockdown happened, kind of my immediate reactions, emotions were actually that, I don’t know how other people were doing, but we were setting up to acquire sites, so we had cash resource to actually fuel growth, which then went into being sustainable. We were really lucky our bank, NatWest supported us. We’re really lucky that we got some loans. Again, this is all a question of timing and luck that we managed to do all of this. But I think immediately, we kind of were telling our people, “It’s okay. Your jobs are safe.” Whether we had the job retention scheme, or we didn’t, we were saying, “Your jobs are safe. Don’t worry.”
Avi: And I think it was much more reassuring them and our dentists than actually thinking about what I was thinking or feeling. I think it was probably three or four weeks in where we started realising, this is going to be with us for some time. That’s when I started being a bit more introspective.
Avi: You said health is the most important thing. I think over lockdown, we’ve lost some really good people through kind of mental health. It’s really, really important and we’ve lost some really good people through suicide. I think it’s something that Lauren, I think in your earlier podcasts, she kind of touched on, she kind of spoke about. I think that that was kind of a wake-up call. Because you think that you’re about to call that person, you think you’re about to think that that person’s going to turn up to your seminars next week? So that was tough. That was tough.
Avi: I think it’s sitting there and communicating that with your team, saying that things will be okay. I remember doing runs to drop off toilet roll. You know there was that shortage?
Avi: I remember doing runs to drop off toilet roll to some of our nurses, some of our receptionists. Just making sure that everyone was okay, touching base with them. We did Teams calls, maybe not enough, maybe not as much as we could have. We tried really hard not to lay anyone off, or to let anyone go, but I think for the overall business, we decided we wanted to make sure that we prioritised the happiness and wellness of our team. And we didn’t really want to keep growing and expanding and putting more strain on our system and then…
Avi: Because I think one of the things that maybe isn’t mentioned with growth is, you can have your idea, you can have your vision, and although you’re working phenomenally hard for your vision and your plan, it’s kind of yours at the end of it. I think one of the things that we don’t really acknowledge is, the team behind us are so important. They work so hard. I’m really, really proud of our team. And it’s one of those things that I think changed over lockdown, where we said, “Actually, you know what? We want to try and stabilise where we are. We want to try and improve our systems.” So, all of these mindless errors or issues that are happening internally, whether it’s… I don’t know, just simple things, running out stock or something taking two days to fix rather than a day, we want to try and optimise that. We want to try and be slicker.
Avi: We want to try and communicate more with our team and take better care of them if we can. Not only just from a financial, we pay you a bit more, but actually let’s look at their workload. Let’s see actually, are they snowed under? Is it something where actually Monday morning, everyone hates their job? So, we took a minute to do that.
Payman: Go on then. From the perspective of, what was your why before? It was, you’re telling me you were thinking growth, growth, growth. Now, if you had to summarise what you just said with going forward, what is your why now? Creating a happy environment for people to work?
Avi: Yeah, I think creating a happy environment for patients to come in and see us. Really creating the environment for them to be happy and treated by a team that’s happy to see them and not just a social media, five minutes like, “Oh, check it out. Our receptionists are so cool. They’re so happy to be… ” I mean genuinely happy.
Payman: Yeah, you’re right.
Avi: We have some… I mean, there’s a receptionist I’m thinking of, and they turn up to work and they are funny and they are energetic and they are enthusiastic, but I would show you this person years ago and you’d be like, “Oh, you’ve got to get rid of this person. They’re terrible,” but this person has grown and transformed. Their life is happier as a direct result of coming in. You look at actually their purpose, their being, their friendships. Obviously pre-coroner, they meet up outside of work. Even old people that have left us are still in touch with our staff. It’s still-
Payman: I think that’s one of the loveliest things about being in business because there’s quite a lot about it, which is difficult as well. You’ve got all the responsibility, you’ve got the risks, you’ve got so many things, but one of the loveliest things is watching people grow and facilitating people’s growth. It really is. And it’s not often thought about as one of the benefits of being in business.
Avi: Even Georgiana with yourself from where she started to where she is now, it’s [inaudible 00:23:22].
Payman: Exactly. Exactly. On your point about happiness, I’ve say to my people that when one of our users calls Enlighten, I want them to feel like that was a much better call than they made to any other company, not any other dental company, but any other company. By the way, I don’t know if we’re achieving that, but for that to happen, the person has to be happy to start with. There’s no doubt about it. I mean you can’t put on that happiness if you’re pressured and overrun and snowed under in your job. You’re absolutely [crosstalk 00:24:03]-
Avi: I mean, I still think, I don’t think we’re doing it. I mean, I think we do well-
Payman: No, but [inaudible 00:24:08]-
Avi: … but I think if you ask my team, “How does he look?” They’ll say, “Oh, he looks tired. He looks stressed. He doesn’t…” You ask my team, they’re going to say something completely different. But that-
Payman: That’s the goal.
Avi: Yeah, that’s what we want to try and get to.
Payman: What about acquisitions? I mean, are you constantly on the lookout or have you been? How does that work? And is that you? Who is it in the business who does that?
Avi: So a couple of… I think it’s led by our finance guy. So that goes into… The finance guys sees if the numbers make sense, if the cash runs make sense, then we get the first part of the postcode, it comes into me. We have a look. Is it something that we want?
Avi: Went to see a practise about three weeks ago? Had my-owner practise since… I don’t know, since I was a kid? Drove past it on my way when we went to play football as kids and we’ll see how that pans out. We got another one that we went on the weekend. And it’s trying to find the right practise and find the right person behind it. A lot of the time, these people who are selling, it’s not just about, “I want to buy, or I want to sell a practise.” It’s about trying to find the right buyer to take care of the patients because you start building that rapport, you start building that relationship with the patients and actually-
Payman: [inaudible 00:25:18].
Avi: … and you know quite a lot about your patients. I mean, a lot of the patients I’ve seen… So I graduated 2011? So a lot of patients I’ve been seeing after VT, so I’ve been seeing them for eight years? Seven years? Eight years? I know enough to make sure that actually whomever is treating them as the associate, you want to make sure that they’re in a good, safe pair of hands.
Payman: Of course. So, are you always looking for the same type of practise? Would you buy an NHS practise?
Avi: So, last year we had the acquisition of a mixed site. The year before was private practise, the year before that was private practise. So we’re happy with mixed. We’re happy with the private practises, we’re happy with predominantly NHS practises. As I said, it’s the location, it’s the right fit. [crosstalk 00:26:06]-
Payman: Are you expecting the outgoing guy to stay on a bit?
Avi: To be honest, we’re pretty flexible. We have a few dentists in the family that are happy to kind of help out, but I think we want to try and make sure that whomever we’re partnering with, if they want to stay on, they’ve got a job for life. If they don’t want to stay on, then we transition to a clean exit. That’s fine. As long as we communicate well, and I think that’s the big thing here-
Payman: I guess you would prefer it, right? I mean, it’s funny I’m asking you these questions. I’ve never bought a practise before. I’m not really clear, but would you pay more for a practise if the guy was going to stay on and run it essentially?
Avi: I think, without trying to get into practise valuations, which are a little crazy, sometimes, you look at the [crosstalk 00:26:54]-
Payman: Personally, I’m talking about you. You. You’re looking at this practise, the same practise the guy’s going to stay on for 3, 4, 5, 6, 10 years, or the guy says, “I want out.”
Avi: Yeah, I mean, if you’re buying a 7, 8, 9, 10 surgery practise actually it’s less important if they stay on. It’s much more important if you’re buying a short, the kind of one and two-man band practise that you’re trying to hold and keep hold of and so on and so forth. It’s much harder for us to try and build an entire ship around one and two-man bands if the associate doesn’t want to stay on. Yeah. Nina has literally just walked in. So I moved out for a lockdown and she’s literally wandering over.
Payman: Hi, hi.
Avi: Yeah, I know. Well, I moved out for a lockdown and we’ve got our grandma at home. So Nina very, very kind managed to drop off some [inaudible] sweets. We’ve got Diwali on the weekend.
Payman: Congratulations, man, congratulations.
Avi: Yeah. Sorry. I forgot [crosstalk 00:27:58]-
Payman: Were you-
Avi: … but I think it would be great if they can stay on it. It’d be great. That’s the idea.
Payman: Were you all living together before?
Avi: So, my brother and sister married, a couple of kids now, so they live in their own houses. My brother lives about five minutes from mum. My sister originally got married and moved to Leicester and then she managed to find a practise just up the road from us in Sutton, so moved with Soro back and now they found a house that’s less than five minutes from home as well.
Avi: Then I moved out just for the lockdown kind of phase and period because my grandma’s at home. She’s 50 years older than me, so she’s 82. So just because we’re still seeing patients and there’s a small chance of anything-
Avi: … we’re just being hypervigilant with her.
Payman: Tell me about associates, getting them, retaining them, getting the most from them, for them. What do you look for? Do you think you’re good? Do you do the interviews yourself?
Avi: Our structure’s changed, I would say, over the last year. One of the things about growing is, before I used to try and do as much as I could. So I used to do everything from first interviews through to hiring, through to contracts, through to everything. Now, we have, Shiv, my sister’s involved quite heavily in recruitment and one of our finance guys that help and they support that recruiting pathway.
Avi: For the associates, it’s more my sister. So it’s more Shiv that does a lot of that kind of recruitment side of things. It’s funny, we actually had a call this morning because one of our associates is moving up to Liverpool, I think-
Payman: Yeah. You told me.
Avi: Yeah. So in terms of recruitment, in terms of… A lot of the time… Actually I think you’ve found two or three of our associates for us. So a lot of the time it’s reaching out to our professional network. And those guys they stay, you treat them well. And again, Millie, who I think you introduced us to, fantastic associate. Fantastic. It’s actually a great pair of hands, great mind, really affable.
Avi: But again, you don’t really know that in an interview. So you really do rely on those recommendations. If someone says, “Oh, I think this person’s good,” you really do put some weight behind that.
Avi: In terms of retaining them, most of our associates, I would say, probably stay with us for three to four years. There’s a few that have stayed significantly longer. We had one Chinese guy who stayed with us 12, 13 years. We take really good care of him, but we’re aware that also we’re in Croydon. There’s sometimes the allure of actually working in Wimpole Street, Harley Street, Central London. Because also their life moves on. A couple of them, they get married and move away. And as much as you want them to commute an hour and a half for your nine to five, nine to six job and wonderful is that relationship is, and that we can support them and help them, there’s also their family. It’s one of those things where we’re aware that a lot of them will go with our blessing, with all of the support we can give them and we still keep in touch with them. We still kind of have regular chats and regular catch-ups with most of them.
Payman: Imagine if this young associate, who’s never done any private dentistry before and you guys, a lot of your chairs are private, aren’t they?
Payman: So, for someone who lives, I don’t know, anywhere south of the river at all, then you’ve got… There is a Gentle Dental… By the way, are they all branded the same or are they not?
Avi: So, there’s seven sites that are same. My brother-in-law’s is the denture and implant clinic in Sutton. So they just do dentures, full-on-full implants. Really, really good. Really, really good quality dentures with a lab on site. So it makes a massive Difference.
Payman: But the rest are all called Gentle Dental?
Avi: Yeah, the rest are all branded the same.
Payman: So, look, let’s say I’m, I don’t know, two years out. I’ve done VT. I’ve done a year of NHS and I don’t like doing NHS dentistry. I want to do private and you’ve got… Let’s say I introduced this kid to you. He’s a good kid. He came on my composite course and he’s all right. What do you want to see from, I don’t know, a portfolio perspective? And what’s your advice to someone like that? If they’re trying to leave the state system, the mix system and get into the private system, what are the key strengths?
Avi: So, for us, I think that’s a really good question again. So for us, we look at people that are really affable and really, really [crosstalk 00:32:39]-
Payman: The soft skills?
Avi: … day, like from minute one, they need to be affable and they need to be incredibly, incredibly persistent. I think that we’re very aware that there’s somebody who will send around their CV, and then that’s the only contact we’ll have from them. We’ve had people reach out on social media saying, “Hey, I know you may not be looking for an associate. Here’s my CV.” And that’s the last we hear of them.
Avi: But there’s… I think someone comes to mind that reached out on social media saying, “Hey, how are you?” And started talking to me and saying, “I’m a dentist. I need some advice.” And about three months later, they’re like, “Actually, do you have a job going?” And at that point, you’ve kind of got to know them a little bit. So I think they need to be affable, because again, you want that quality. You want that rapport-building quality in that dentist.
Avi: So, when you’re saying, what do we look for? We look for that person to be relatively persistent with us, actually tried to get to know us, get to know the business. I mean Ashley [inaudible] had something on Facebook actually the other day, where he said he wanted to buy a product and the person hadn’t researched him, hadn’t looked at his website, hadn’t said anything about him. So again, you need someone to know a little bit about you, before they’re trying to interview.
Payman: Agreed, but this-
Avi: I mean if we [crosstalk 00:33:56]-
Payman: … this question of soft skills. So you’re telling me you can’t teach those. You can’t learn those?
Avi: Oh, no. Not at all. No, no. For sure. No, actually, sorry, let me correct. Sorry. You can learn those. I’m naming Ashley because actually we did… I think I’ve done this course, like, I don’t know, six times or something? Ridiculous.
Payman: You’re kidding.
Avi: [inaudible 00:34:17]. And we actually caught up a couple of weeks back. Again, Ashley taught me a lot about communications as he’s, I’m imagining, teaching a lot of the listeners and so on a lot about communication skills, a lot about soft skills. It’s being able to actually do that in a pattern.
Avi: I was fine talking to people before from a social perspective, but actually to get to know a patient, you want to be able to build that rapport within 5 to 10 minutes. You want them to really be interested in you and you to be interested in them. That’s, I think… I don’t think that’s a skill you can just wake up and have. I think that is a hundred percent a taught skill or experience skill.
Payman: Yeah. Look, I agree with you. Some people have just got that X-factor. Look at Larry or Mike or with other… There’s several here as well. They’ve just got something that they’re just… When they see another human being, they make instant rapport. But my question is like-
Avi: And you think Mike has that?
Avi: I think Mike didn’t have.
Payman: Yeah, maybe you’re right.
Avi: I think that he’s grown.
Payman: Maybe you’re right.
Avi: I think Larry-
Avi: Well, I certainly… I think-
Payman: Larry came out singing. But my point is this, that as the advice to this junior is, “Okay, go on Ashley’s course. That’s nice.” But I see it all the time, where people give people jobs because they just get on with them and you feel like, “If I get on with this person, they’re going to get on my patients and the clinical will come one way or the other.”
Payman: And I understand why it happens, but I’m surprised how easy it is to get a job, a quite a good job if you’re kind of a good-looking, cool dentists. I’m surprised at that. I’m surprised at that.
Avi: I think that there’s a nepotism angle there, there’s a contact, there’s networking angle, but actually we’ve got some really good dentists that have been introduced to us through reps or through people like yourselves. Actually, it’s not just about the courses they’ve been on because you’ll never get the chance to show your clinical ability if you can’t communicate to the patient the benefits of what you’re doing, how it’s going to change their lives. So actually, I think communication has to be there as the number one skill to have.
Avi: Of course, you’ve got to back up with your clinical ability, but if there was a young dentist that wanted to apply to work with us, it would be reaching out whether it’s on social media, whether it’s by email, whether it’s anything, coming down obviously not with COVID at the minute, but coming down and even saying, “I just want to watch how you work.” The number of people I’ve reached out to, and that have watched us do, whether it’s a CEREC or whether it’s scanning with invisalign, whether it’s seeing what kind of ortho cases I do, seeing what kind of implant cases Mish does, visiting the laboratory over at Sutton. Even just sitting down and grabbing lunch together, we’ve probably, I don’t know, I’ve lost count of how many times that’s happened. We’ve helped a lot of people and guided them into opening doors, I’d say.
Avi: Whether it’s this guy who maybe move up to local and take a job with your colleague, whether it’s you even introducing us to Millie, it’s about making that initial connection and seeing what you can do to help them. So if there’s anyone who actually wanted to do that, just reach out.
Payman: Let’s get into the clinical a little bit.
Avi: Mm-hmm (affirmative).
Payman: Clinically, what are you doing? You’re doing ortho?
Avi: So, I would say about 70% of my work is kind of small ortho, so invisalign. I, again, I do a lot of my own GDP work. So again, I’ll still see a lot of my own recall examinations years later. I used to do a lot more veneers and smile makeover work partly because of the influences from when I was younger. Still, as I said, I’m just… There’s a 10-unit case on a South London footballer we’re doing. Again, it’s that kind of smile makeover, really cosmetic work, which I really enjoy.
Payman: Give me some tips, some Avi tips, clinicals Avi tips.
Avi: Clinical Avi tips?
Payman: Yeah, and listen man, it doesn’t have to be groundbreaking.
Avi: So, what would you like it on? Ortho or would you like it on-
Avi: … [inaudible 00:38:40]?
Payman: Whatever, yeah. Cosmetics.
Avi: Always use Enlighten.
Payman: of course. Of course, but outside of that.
Avi: So, I think a lot of the time, especially with some veneers and smile makeover work that we, do a lot of the time our preps can be excellent, our preps can be average, our preps can be good, you’re going to have good days and bad days. We always use [expansol 00:39:07]. So really, really good product for… instead of [crosstalk 00:39:10]-
Payman: So, the paste, the [inaudible] paste that [inaudible 00:39:11]-
Avi: Yeah, yeah. Always use Expansol. Again, work with a really good laboratory. So we’re quite lucky we have a few laboratories we work with. Work with a really high-end laboratory. They will always make you look good.
Payman: Yeah, that’s so very true, isn’t it?
Avi: And they’ll also give you the feedback.
Avi: They’ll say to you, “Actually, you know what?” I had actually, I took a digital scan with iTero a couple of weeks back and we took a physical impression as well. They kind of said, “Actually, you know what? When you were scanning, you couldn’t see this and this. Actually thanks for taking the physical things.” They’ll give you feedback.
Payman: Yeah, you learn a lot from a good tech. I mean, I remember I had a technician when I was a dentist, I had a technician who I didn’t know was one of the top technicians in the country, but he was. He was super, super good. The amount of stuff that… I basically thought I was an amazing dentist, that’s what I thought. I thought, “My God, I’m good. Everything fits. Nothing’s got to be [occlusally] ground in as much.” I was only one year after VT, and I thought I was amazing. I had older patients as well, and as a tip to anyone, if you go for an interview and the patients are, let’s say where there a seaside town, or something ,older patients. As a young dentist, sometimes you think, “Oh, I don’t want to be treating all these older people,” but they are by far the best patients, by far. They’re respectful, they don’t suffer from the sensitivity or whatever. And they tend to take things more easily than… They handle pain more, they tend to be able to pay for things.
Payman: So, I had a patient base who were older and this amazing technician and I convinced myself I was a brilliant dentist. And then the next job, I went to Central London in the city with these city guys. And I thought, “That’s it, I’m a brilliant… I’m going to have these city guys down. Everything’s going to be all right.” With a different technician, this guy retired, and boy did I realise, “Nah.”
Avi: No, as I said, we’re really blessed. We work with a couple of labs. We’re really, really blessed. And we got really good feedback as well. But in saying that they also call us on our stuff when it’s not that level.
Payman: Do you like CEREC?
Avi: So, you kind of brought it back with… Do you remember Hannah? Hannah Newell? From Shine, she was the rep at the time and Rob?
Avi: So, I kind of bought it. We bought two units back in 2013? Yeah. 2013? 2014? As the CAMs at the when they were, I think they were relatively new. I really enjoyed them at the time. I really got into it, and I still do, I would say, maybe a couple a month, but actually I think that as my role in the business has evolved, the number of hours I’m doing clinical dentistry has changed.
Avi: So, I used to do five days a week. I used to work the occasional Saturday. And as my role has changed in the business, I’m doing less and less. So actually where I’m not doing as much routine crown and bridge, the associates are very comfortable scanning now with iTeros and Omnicams and sending it. It’s now, I think, something that is more specialist almost, it’s not something that we would do routinely. It’s something where a patient would come in.
Avi: So, we had a patient come in from Poland who requested a CEREC because that’s what she had had in the past. You sit there and you do it, and it’s really enjoyable. You kind of closed an hour and a half. I know there’s people that book exams over things and try and manage that. I don’t do that. I feel like I want to enjoy the dentistry. So I’m sitting there and I’m enjoying the dentistry that I’m doing with CEREC and I’m enjoying the staining, the glazing. You get to go back to being a little artist and sitting there and painting. Something therapeutic about it. Even when I came down to do the a mini smile makeover course, and you’re sitting there and you’re just working with composites, it’s just something really [crosstalk 00:43:18]-
Payman: I used to stick on classical music and pretend I’m really an artist, and with the brush [crosstalk 00:43:24]-
Avi: Have you been to see [inaudible 00:43:24]? Are you going to see the class [inaudible 00:43:27]? Again, [inaudible 00:43:28]? Very, very good. Very, very good.
Payman: Is it?
Avi: Definitely [inaudible 00:43:33].
Payman: So, go on. Sticking on the clinical then, we’ve been asking everyone. It sounds like you listened to the podcast, but based on the blackbox thinking, the idea that we can all learn from each other’s mistakes. In medicine, that’s true. We don’t tend to talk about our mistakes enough. Take us through your clinical errors that you’ve made.
Avi: I think I was saying, you mean this week, this month? Yeah, I think there’s an element where we all make mistakes, whether it’s something simple in terms of getting an extra piece of, I think it was listening to Andrew, whether it’s an extra piece of paper signed in terms of consent.
Payman: Andrew Darwood, yeah.
Avi: Yeah, again, it’s listening to these guys and sharing those mistakes because I think for us, we make mistakes all the time, whether it’s non-clinical or clinical. The thing is, it’s the impact of those mistakes.
Avi: So, there was a patient where we needed to do a gingivectomy. It’s a surgical gingivectomy, cut and dry. So certainly we don’t get involved. Took a scan to work out actually how much we needed to pull up and looking at it, actually, a lot of it was actually just very thick, soft tissue. So we came up with a treatment plan. You’re talking three and a half, four ml worth of gingiva here from dodgy restorations. We sat down and we tried to do that with a laser across 10 teeth.
Avi: And then prep on the same day and then fit temps and so on. And maybe we bit off more than we could chew there, but again, when I say that was a mistake, I think that’s definitely something I can learn from. And when the patient really backed me into a corner and I tried to do something nice for them, backfired a little bit and had some swelling, had some issues, but that’s just one. I mean, I think we’d run out of time if I went through the mistakes I’ve made.
Payman: Was the mistake that you didn’t leave that one to Mish?
Avi: So, actually, we had a really good chat with Mish, but again, a lot of the work that these periodontists do, a lot of the surgical stuff they do, they’re brilliant with a scalpel. They are so talented. So, we’re lucky to have Victoria, and I think one of your guests, Simon? I think there’s Simon Short? Victoria works with him. So we have Victoria that works with us. So she’s very, very, very skilled.
Payman: Victoria who?
Avi: Rincon. She’s very, very skilled. Lovely girl as well. But it’s these people that say, “Actually, you know what? I think that we should do this surgically.” The patient couldn’t afford to have four weeks of downtime. Patient’s extremely active. They were going to get on flights. They were going to run around and do things. So again, we couldn’t afford to take that surgical approach.
Avi: Again, that’s just on. Another one is again, where we sometime-
Payman: Go on. I’m quite enjoying this. Go on.
Avi: Another one is just [inaudible 00:46:26]-
Payman: Because you seem very open with these. It’s a refreshing change, man.
Avi: No, I think we’ve all made mistakes. I was speaking to one of my friends. She’s in hospital. She took out a tooth. Patient was under GA. Tooth was sitting on top of the airway. The tooth poked… This is a kind of baby teeth. They pop, they don’t just come out straight. They just pop and fly. So she’s popped that tooth now. That’s again, it’s a mistake, but what would she do massively differently? There was a throat pack there. There’s more experienced colleagues. It’s hard to get around it. So you’re always going to make mistakes. We don’t work in a job where it’s going to be perfect every time. It’s why we call it dental practise. Right?
Payman: Yeah, I agree. I [crosstalk] I think-
Avi: [inaudible 00:47:08].
Payman: I mean, the kind of mistake where you drop an endo file or whatever it is, I mean, bearing in mind, you’ve put some rubber down there, but that type of mistake, you’re not going to beat yourself up about hopefully, but even in my short dental career, there were some times where I felt like I let that patient down.
Avi: Oh yeah, for sure.
Payman: You know?
Avi: There’s times where you… Especially if there’s lab work delays or there’s something where you’ve consented a patient-
Payman: No, no. My decisions. My decisions.
Avi: No, so what I’m saying, there’s time where I’ve-
Payman: During the Larry period, for instance, there was some eight veneers that I did that I saw three short years later. They didn’t look great.
Avi: I’m really, really lucky that some of those veneer cases that I’ve done when I was slightly younger, they seem to have stuck. I’m not saying that they’re all going to stick. Some of them may have come away and they’ve just not come back and see me, but I’m quite lucky that we’ve got quite a good stable patient base so we see a lot of our reviews, seven, eight years down. I have photos, despite the fact I only qualified relatively recently, I have photos eight years post-op, which you really would expect them to still be in, but I still have photos from when I first fitted them.
Avi: I think there’s been a few times where maybe I’ve over promised and not been able to deliver. There’s a few consent issues where I’ve brought the consent form, and I’ve added every risk under the sun, and I’ve spoken to the patients and there’s one tiny risk. Like I’ve put some… You know a trial smile?
Payman: Mm-hmm (affirmative).
Avi: So, done a really nice trial smile where I’ve taken a kind of a still tech putty index, gone over with lots, attempt to preview and consent the patient to make sure we’re all on the same page, disappeared for four months, came back and said, “Oh, I’m going to get married. Can I leave these on before?” “Sure.” Eight months go by, and she just comes back in having paid, I don’t know, 200 pounds for the trial smile and she says, “Oh, I want to take them off, and I don’t want to go ahead with treatment.” And then very gently removing, I nicked her upper central. I made a dent that’s less than half a millimetre by a quarter of a millimetre, and that was one where I just looked at that and thought, if she’d told me she was getting married, would I have done the case? Probably. I still may have actually done that, but I would have warned her to say, “Instead of coming back in four months, you’ve got to make sure you turn up in two weeks.” It’s not something where I’m now going to turn around and leave that in the patient’s mouth. I’ll take it out straight away. We’ll get some therapies, we’ll get some photos.
Avi: But again, as I said, it could be a denture case. It could be being more prescriptive on my lab docket. I think every mistake I’ve… I haven’t taken out the wrong tooth or dropped an endo file yet-
Payman: [inaudible] it is.
Avi: … but I’m sure I will do these things. it’s not wrong to make mistakes. It’s wrong probably just not to learn from them.
Payman: I mean, on to your point about over promising, I think it’s a young dentist’s error because you think that if you over-promise, then you’ll get case acceptance. But firstly, that statement itself isn’t necessarily true.
Avi: I think I’ve over promised on… My worst ones were actually ortho cases. So I’m getting married in December next year. Will I be done by then? You look at the case and you think this is kind of straightforward. It should be okay. Three months on, and you realise the patient’s not wearing their alignments. And then you think, “Okay, what I’m going to do is put some brackets on.” You finally put brackets on, four months later… it was despite you’ve been doing all of this and all of this, you realise actually the patient hasn’t turned up to two reviews. So you’ve seen them bond up and then you’ve seen them four months later. You’ve chased them, and they’ve said they’ve been busy. And that’s where actually I feel really bad. I know that maybe I couldn’t have done more, maybe I could have, I don’t know what I could have done differently [crosstalk 00:51:08]-
Payman: But then what happened? There was like two days before the wedding and it was wrong?
Avi: So, actually like that case, no… So that was the Saturday, Sunday, Monday case. So we came in Saturday, Sunday, Monday to correct and fix everything that we was trying to do all of the… Instead of going for ortho, we actually ended up doing a restorative solution, but that was so much stress. My nurse at the time was just like, “Never again. Never are we working a weekend and a bank holiday Monday.” The lab weren’t happy and it was one of those things that’s a mess. Yeah, you’re right. It is maybe a young person’s but that’s also experience, right?
Payman: Of course.
Avi: Like, the teeth don’t move like they’re meant to move.
Payman: What have you learned? What about errors you’ve made in management that you’ve learned from?
Avi: Again, plenty. I’m sure there’s plenty.
Payman: Oh, I’ve made loads.
Avi: I think… Sorry?
Payman: I’ve made loads of mistakes.
Avi: I think don’t be scared to fail and don’t be scared to make a bad decision. You can sometimes be strangled by the lack of inertia. Sometimes you can feel that actually where you’re at, there is no kind of panacea where you’re going to be that, and that’s the only good decision. Sometimes you just need to take a step forward. Even during this lockdown is a great example, there is no management handbook for a pandemic. You communicate as much as you can. And again, some of the team I know, they said to me afterwards they didn’t feel like this happened or this happened, and this happened. It’s one of those things you’re always learning.
Avi: I’ve let some really good people go. In management, I maybe could have handled that better. I’ve lost some staff that I’ve wanted to retain. I’ve probably not paid as much attention to certain members of the team, not maybe rewarded them as much, but, Payman, we’re incredibly hard on ourselves, we really are. Or I think that’s one of… We always talk about what’s your worst quality, but it’s not even being a perfectionist. We are incredibly hard on ourselves.
Avi: All of the good that we do, we still think, “Oh, I could have done that.” I mean over lockdown is a great example. I picked up the phone and spoke to, I don’t know, 60 or 70 dentists. Some people got in touch and just said they weren’t feeling great. It happened to be that one of the dentists that I didn’t speak to was one actually that was quite unwell. So do your thing.
Payman: You’re right. You’re right. I mean, I was pretty hard on myself, but it took me two months to even think about, “Hey, let’s use this time to train the team.” Or online courses… It was just like rabbit-in-headlights sort of situation for a bit there. When you’ve got 70 people to worry about, as well as yourselves and family and health and all that, it’s not easy. On the other hand-
Avi: [crosstalk] think there’s also… We have, I don’t know. So I’m just looking at the board behind you. We have about six projects on the go that I’m not directly involved in running the dental practises as well. There’s a lot of stuff that we do behind the scenes. The seminars, for example, so we’ve got that.
Payman: Yeah, tell me about that. When did that start? So Croydon Dental Seminar’s been going a long time, right?
Avi: Yes, that was Mish. We’re really, really proud of him. He started it as a referral kind of system and to get busier, that was the original kind of idea we put on free-to-attend seminars and the food was crap and it was out of a golf course, a kind of bar or something. I didn’t even go to the first three. I was terrible at supporting him early on. As kind of I got more involved, I was like, “Look, the reason we’re not getting people is we need to be [inaudible] Croydon.” So, Mish kind of moved us over to Hampton by Hilton, over in Croydon. We put on some decent food, numbers picked up and he’s done a phenomenal job from back in 2013, 2014, when it first started. I think for the November course that we’ve running, it’s about 460 people. [crosstalk 00:55:11]-
Payman: Yeah, it’s amazing. The one that I went to was pretty packed, man, pretty packed.
Avi: Which one was that?
Payman: One of the ones in Croydon. [crosstalk] speaker-
Avi: We’re very-
Payman: Who was the speaker?
Avi: Minesh, or… ? We’re really lucky. We’ve had some really great speakers come.
Payman: So then you turned into national.
Avi: Yeah. We tried to go with Barry Alton, went to Leicester. Again, we’ve got, I mean, Birmingham on our radar, we’ve got a few other bits that we wanted to do again. Over lockdown, we’ve been doing some kind of more casual conversation stuff that we did. We’re really lucky with Raoul, with Ian Gordon. We got the guys from the BDA kind of Eddie Crouch involved. We got some other guys in, so we were really, really lucky, but it’s allowed us to connect with dentists.
Avi: And one of the things that, I think kind of alluding to the point you were saying earlier, as the young dentists, we’re in our little bubble and dentistry is quite isolated. Hearing Lender [Cruise] say, “I don’t really know what I’m going to speak to my staff about. I don’t know how I’m going to describe what we’re doing.” Just hearing someone with that much skill and ability, and he’s an absolute diplomat. The guy is so poised. He’s just so elegant when he speaks, and just to hear him say, “Yeah, I don’t know what to do,” it’s lovely.
Payman: It’s almost that if you look at experts, a lot of being an expert is about knowing the basics very, very, very well. And what I’ve found is, that if you know the basics very well, you can say, I don’t know with authority, because it’s not the basics, whereas on another subject, like me and you, if we’re not experts at something, we’ll say, I don’t know, without authority, is a totally different I-don’t-know.
Avi: So, we had [Tiff] have a really lively debate. There were a few subjects where just went into break and you could just hear, “Actually, you know what? I’m going to pop back. I don’t know about this.” These guys are mega. These guys are big in the industry. So I think it was probably to get to know them. So that was cool. That was really, really good, but that’s been going now for seven or eight years kind of in one way or another. Next year, again, trying to work out what we want to do with it, how we want to take it forward. It’s good.
Payman: If you could change something about dentistry in the UK, what would you change?
Avi: That’s a good question, actually. Couldn’t prep this one. I don’t think you’ve asked that many people this one.
Payman: Normally I’ve got perhaps interrupting me, asking you about your children.
Avi: You can go into that. I think in what I would change, I think that we need to be more aligned as the community. I think lockdown’s helped with the rise of kind of BAPD. We need to be more aligned as a community. We can’t have so much… Whether it’s the LDC or BDA or BAPD even, we need to be more aligned. We need to have our vision more aligned in dentistry, whether it’s when we go to government and try and negotiate. Even now, I know there’s contract negotiations happening from friends and colleagues, I’ve heard about what’s going on and listening to some of the largest groups in dentistry, asking for different things to the paymaster. The paymaster just says, “Actually I can always negotiate with whomever I want here because-
Payman: Divide and rule, right?
Avi: Yeah, and so sometimes you have these massive focus groups or you have these big organisations that mean so well, but they aren’t sometimes aligned with other organisations. So if there was, I’m not saying one voice or one body, but if there was more alignment in dentistry, still [inaudible] and how that is an internal conversation.
Payman: You’re completely right. You’re completely right about that. I remember worrying a lot about these same issue, but it seems so obvious isn’t it? It just seems obvious. But the reason why it happens is because… Let’s just take the example of BAPD and the BDA, which, by the way, I hear they’re talking. But the BAPD came about because the BDA wasn’t addressing private dentists concerns. And because of that fact, that’s where it came from. Then you get that sort of clique mentality sort of starts coming into it. But you’re absolutely right. That’s a good one. You’ve picked a good one, if you could change something.
Avi: I don’t know about the BDA not representing anyone or of the BAPD doing this. I’m very aware that I have friends in both organisations. I’m very aware that no organisation starts off to isolate any organisation. I think that it would be lovely… I know they’re talking, I know there’s the ADG involved. I know there’s other groups involved. It’d be lovely for them to sit down and say, “Look we’ve got 15 points, we’ve agreed 10. We’re not going to bring up the other five.”
Payman: And you know that there’s only two questions that need answering, maybe/. What’s best for patients? What’s best for dentists? And aligning those. That’s kind of the whole game.
Avi: Let me tell you something that maybe I shouldn’t be saying on this kind of-
Payman: No, we’ll dit it out if you decide.
Avi: I mean, [inaudible] because you’ve also got so much commercial opportunity. I’m going to give you an example, okay?
Payman: Go on.
Avi: If I say that the… We were told about the vaccine on Wednesday last week. Okay? Markets obviously picked up yesterday with Pfizer’s nuts. So, let’s assume we were told on Wednesday. Actually, if we were told on Wednesday, we should broadcast that news. Right? We should tell everyone we were told about, but actually there’s so much commercial gain in not saying anything and positioning yourselves in such a way. So even now with some of the contract reform conversations, I can see some people who’ve been in that higher level chambers, I’m going to call them, speaking to CEOs and speaking to people in the NHS kind of set-up, and beginning to position things. And it’s really strange because you think, “Surely, if you’re having those levels of conversation, surely if you’re saying, ‘Oh, the contract reform’s going this way or that way,'” you’d want to tell everyone, you know? But actually there’s, especially organisations that can pivot and move with massive resource, I’m talking massive resource-
Payman: Go on. Go on.
Avi: … [inaudible] positions.
Payman: Spell it out, man. Go on.
Avi: I mean, massive resources should be enough, but they can pivot and position quickly. So if I said that, let’s say you need to have therapists or you need to have othotherapists or X, Y, and Z. If you know that now, guess what? Tomorrow you’re placing an advert for othotherapists, or therapists, or-
Payman: Yeah, yeah, yeah.
Avi: … specialists or level two, whatever and whatever. It’s things that… Again, if I vocalised and said, “Okay, so there’s this,” to everyone, everyone would be like, “Okay, let’s collectively make a pathway where we all can succeed.” But commercially, there’s some organisations and some people in those organisations that have to account to other people. They’re not just family-run organisations. They have to account to-
Payman: They call it stakeholders.
Avi: Yeah. It’s that kind of stuff, which I think if we were more aligned on, that would be a lot better for the profession.
Payman: I hear what you’re saying. So you’re saying it would be great if we were aligned, but to get us aligned, information would have to be open-
Avi: That’s it.
Payman: … and business isn’t always about open information, and often it’s about… it’s [inaudible 01:03:16]. You’re quite right.
Avi: If you look at inequalities, whether it comes to education. I mean, I told you I was super privileged in the schools that I went to, right? I was [inaudible 01:03:24]… My parents worked their butt off to get us, whatever it was, like eight a grand a term fees. It was stupid, but-
Payman: Where did you go?
Avi: I went to Whitgift, in South… To give you an idea of this, we have peacocks in our school, we have a zoo. It’s crazy. It’s a crazy place, a crazy school, but we were so lucky to be there. Again, the way that we were taught, if I say this to anyone who’s done A-levels, you’re taught the mark scheme. You’re not really taught the information. You’re taught how to get an A.
Payman: How to get an A, yeah.
Avi: Yeah, but actually, if that information was disseminated to everyone, it would be really hard for people to not get good quality grades. It’s the same thing, and it starts from that. It starts from your education. You look at the inequality. If information was disseminated quicker and faster in a better form, it would be so much better overall. But yeah, you’re right.
Payman: Do you think where we are today, I often think about this myself, but let’s say I want to get into something or I want to find out about something. Today, I’ve got more information available to me than anyone in history ever had. When I think about our parents, when they had to set up businesses, or whatever, I mean, this is a silly… Let’s say, I said to you, “Listen, Avi. You’ve got to get yourself a metal, what do you call it? A brass name thing outside one of your practises.” Obviously they don’t do them in brass anymore, but you would have to wait for the BDJ to arrive, go to the back of the BDJ and find the one guy who’d paid for that, and you wouldn’t know who’s gone and used that. Whereas, today you can go straight on reviews and so… ” so, my basic point is, we’ve got more information than anyone’s ever had before.
Avi: Yeah, sure.
Payman: So, I guess there’s optimism in that, right?
Avi: Oh for sure. I mean, I’ve met a lot of my dental friends. I’ve met a lot more people during a lockdown. I’ve kind of got introduced. I think you were on [Shadi’s] podcast?
Avi: And then just listening in some of my friends are doing these weird and wonderful things. And the way that we’re connecting right now is great. I think what I’m saying is, that there’s people still in those conversations that may be on 32, 34-
Avi: Now, again, I’m speaking really positively with Sanjay from Together Dental. Again, Smile Over with [Gene] and then kind of his troop. It’s lovely to see right now these guys at that sort of level, the way that they’re communicating with me, because I look up to them and I think that that’s what needs to happen more. I feel like, again, we were talking about young dentists earlier, but if you need advice or you need help, it’s a case of actually just looking up to that person and reaching out and not being scared.
Avi: I mean, there was a story around Steve Jobs going to pick up… When he was actually trying to get a job, he went and picked up the phone to the guy who ran HP, Bill Hewlett, sorry. He actually picked up the phone to him in a phone book and said, “Do you have any spare parts?” He actually came down and worked on the assembly line. If you just think about that, Steve Jobs working in the assembly line of that massive company. And that’s how he got to learn parts of the system, parts of the process. Obviously, you’ve seen what he’s done like and then what he did, but you need to have that kind of no-fear mentality. Those people with this, if they’re wanting to do something, what’s the worst that’s going to happen? Somebody’s going to say no.
Avi: I’m lucky with this NDS stuff, that the people that we wanted to really get, we approach, we didn’t turn around and say, “Actually [inaudible] too big for us.” Actually, we turned around and said, “We really want Raoul Dhoshi on this. We really want Tiff [inaudible 01:07:19]. We really want these people.” All they say no. They’re going to feel flattered. Os, I think that’s been quite good, but if we can, as a profession, get those people to speak to these people, it would be lovely. I don’t know if it’s going to happen because as I said, there’s too much commercial gamer. That sounds cynical, but it’s also realistic.
Payman: Why did I ask you what you want to change? So I think we’re coming to the end of our time, but I want to ask a couple of questions about your personal plans. I mean, what are your personal plans? Are you thinking of-
Avi: [crosstalk] where I am right now.
Payman: Are you thinking of settling down?
Avi: Yeah, I think everyone has that journey and has that progression, right?
Payman: Not everyone. Not everyone, buddy.
Avi: I think sometimes though, they’ll have that thought, I’ll say. Maybe not journey, but I think everyone has that thought. I think probably being a little too honest right now, and it is because it’s you-
Payman: Cheers me.
Avi: I think when I’ve been younger, I’ve probably had my heart broken a few times, and I [inaudible 01:08:22]-
Payman: Oh, well done then.
Avi: [crosstalk 01:08:24]-
Payman: Well-done for bringing that out, man.
Avi: … I’ll wait for some… As in, you do. You go through these things, and I’ve probably done it to a few people as well, but I think it’s trying to find someone to settle down with and is trying to find that part of your life. I’ve seen my brother and my sister do it, and it’s definitely something that’s on my mind. But I think more personally, I’m very much focused on trying to work and get that balance right, right now. Right now, I haven’t maybe exercised as much as I want to. You can see the gym on, just like in the background.
Payman: Yeah, I did, yeah.
Avi: I want to try and take good care of myself and to be at a point where I’m able to balance that commitment. That’s probably the most honest you’re going to get out of me.
Payman: I like that, I like that. What about for the business? What will be like the dream with the business?
Avi: I think for the business, it would be, I hate using the word consolidating. It somehow means we’re settling, but it would be running in a slicker operation so that the team who are pulling crazy hours right now, they’re doing such an amazing job. They are able to do a nine to five, nine to six, be really enthusiastic and passionate and then switch off their laptops and switch off their computers and spend time with their family. I think a lot of that has been brought into light with lockdown. A lot of that has happened as a result of the past few months. So I really feel that if we want ourselves and our business to do well, we’ve got to take excellent care of our team, excellent care of ourselves as well, for sure. Really, really work hard with the team around us.
Payman: Yeah, but what about the business?
Avi: The business, I think, will continue to grow. I think the business will continue to expand. As I said, we’ve seen some practises in the last month we’ve been expanding and we’ve been growing. So we’re still looking at opportunity. Those practises that we’re seeing kind of in Croydon, in Sutton, in Bromley. We’re still in regular contact with these guys-
Payman: Dude, [inaudible] how much do you love your job? If I gave you the proverbial 100 million, what would you do? What would you do if you were a dentist. Perhaps let’s go straight there.
Avi: Probably something in economics. I really enjoy… So you know when we were talking about how the internet has changed things?
Avi: So, I got into trading maybe 2013 and actively trade. So really it’s one of our side projects, I actively trade. I really enjoy that part of my life. That’s that’s not just for the money, it’s actually the [inaudible 01:11:10]-
Payman: The game, [inaudible 01:11:11].
Avi: Yeah, and it’s enjoyable there. I think something in economics, again something in… I really enjoy that, and I’m really passionate about that. I think when we’re saying, if I wasn’t a dentist, it’s quite hard to imagine. I think a dentist can mean so much. So right now, I’m doing three or four days clinical, and then a lot of admin, a lot of management, a lot of other side projects, having a good balance. So I think that that’s probably what I would do for if I wasn’t a dentist, but I really enjoy what I do. I just sometimes feel like in any profession, in any walk of life, even in personal professional relationships, you can feel a little overwhelmed.
Payman: Yeah, of course.
Avi: [inaudible] really got to keep that in check, but I love what I do. And if I didn’t [crosstalk 01:11:54]-
Payman: Well you look pretty happy at work, man. I mean we’re in contact quite a lot, but it’s nice to say, you didn’t really want to become a dentist, you didn’t really enjoy dental school, but now you’re really enjoying your career, you know?
Avi: [inaudible 01:12:09]. I really am blessed. I’m really lucky, like family around me, like you’ve seen dad in his bow ties and you’ve seen my mom and you see how they interact, but I’m just, I’m really honestly, really, really lucky.
Payman: Yeah, it’s a special atmosphere at Gentle Dental. I don’t want you to be overrun with people, but you won’t be, it’s corona. But if someone hasn’t seen that practise, it’s one of the most beautiful practises I’ve been to, and I’ve been to a lot of practises. So it’s-
Avi: I remember when you came down and you said that, “What’s the plan?” and you said, well, build Mecca and they’ll come. I think that was your phrasing. I think we’re really lucky. Dad’s got great vision and-
Payman: I’m a sucker for your architect anyway because my other favourite practise is Andy Moore’s. I haven’t been to Robert [inaudible] but I’ve seen pictures and they look [inaudible 01:12:59], but I really do like the way yours pops out of the end of that building.
Avi: [inaudible] is lovely. Been down there because i think Dad [inaudible] kind of the implants cost and he still would like an implant tutor. Andy is a lovely guy. I haven’t spoken to him in a long, long time, but he is, he’s so hard working [crosstalk 01:13:18]-
Payman: Great guy. Great guy.
Avi: I think he does this… He’s had this line of, every four or five weeks. I need to take a a week [inaudible 01:13:26]. That’s [inaudible] style. That’s really [inaudible] style.
Payman: [inaudible 01:13:27].
Avi: [inaudible 01:13:27]. Yep.
Payman: All right man, because Prav’s not here, I’m going to have to ask his final question. Prav doesn’t like asking his final question when the guest is young, but I quite like it because, we should never take anything for granted as far as health and life and crossing the road. So, Prav’s final question is, you’re surrounded by your family. It’s your last day on the planet. What three pieces of advice would you give them. Your future kids and your family and your family. And finally, how would you like to be remembered?
Avi: That’s a good question. I think, firstly, without sounding too cheesy, I think you have to be kind. You have to be kind because you have no idea what other people are going through. So always, always, always be kind, whether it’s grabbing a donut and giving a quarter or a half of it away to the homeless person, just outside the shop or whether it’s picking up the phone when you don’t want to do it, whether it’s dropping someone or picking someone up at the airport, just be kind as much as you can do good things. If you’re still treating the waiter differently to how you treat someone like yourself, to me it’s not ideal. So try and be kind, [inaudible] no idea what other people are going through.
Avi: Trying maybe to accept praise or my second piece would be the best version of yourself. You can always try and copy someone, but you got to be authentic and original to you. Be the best version of you. Your best might not be someone else’s best. That’s okay. If you wake up and do your best, 9 times out of 10, maybe 99 out of 100, you will be successful. You’ve got to get up. You’ve got to put the hours in.
Avi: We were privileged to get where we were. We were very, very lucky to be born into the families we were, and speaking from where I am, I acknowledge that privilege, but I’m very aware of how many hours I’ve put in. So I think if that’s maybe the only thing to take, just to be the best version and say, just to try your best at all times.
Avi: Maybe touching on that point from earlier to always give back, to always try and pay it forward. So from Lauren’s kind of podcast, that was one thing which I picked up. I think I actually emailed I think I actually emailed and reached out on Facebook actually pretty quickly, to the mental events when I was like, “Look, what about this? And what about this?” And try and help out where you can. Always-
Payman: I’m going to say that with all of your events as element of giving in all of them. And that’s always been a lovely thing to see.
Avi: You’ve been amazing and supported us. And it’s really good to have people like you to lean on and to bounce ideas off, but also, we were talking about the younger generation that will really transform the way we do dentistry. I think it’s trying to help them always remembering that actually you’re never too big to help somebody. You’re never too big to answer a phone or an email or a WhatsApp message. So I think those are maybe my three.
Payman: How would you like to be remembered?
Avi: This is a hard one. This is a hard one. So probably as someone who always had time for people, no matter how busy, always wanting to help. Again, probably the worst quality I have is trying to help someone to a fault, even if they’re not particularly the best person for me to help, but always wanting to give and always wanting to help. And I suppose someone maybe that was successful or otherwise, but I don’t really think about how I want to be remembered. I focus much more on just what I’m doing every day, because I feel like your every day could end tomorrow. If you focus on trying to be remembered and building this massive thing, then you can forget about the person’s life that you can change.
Payman: Yeah, but you could say, “I want to be remembered for being a nice guy,” end of story. But beautiful, man, beautiful. I know it’s a difficult question to ask for a modest person. So, I know that was harder for you than most people.
Payman: Lovely to speak to you and hopefully we’ll have a chance to speak to Cam as well, but I know it didn’t work out this time.
Avi: Yeah, I mean, we’ve been-
Payman: Cam and Mish.
Avi: Yeah, right, we’ve been-
Payman: Yeah, I know-
Avi: [inaudible 01:17:53], and I think again, it’s where they are. They’re lucky to be practising and working hard and enjoying themselves. But thank you so much, Payman. It was lovely.
Payman: Thanks for doing it, bud.
Payman: Take care then.
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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