Dr Elaine Halley has been involved with the BACD since its inception. She was not only an early president but also the association’s first accredited female member.
Elaine was also among the first UK dentists to offer patients an enhanced experience with her early adoption of spa dentistry.
She talks about setting precedents; the highs and lows of being a female in the profession; and practice ownership.
Elaine also reveals some of the books and lectures which have inspired her journey – and much more.
“I remember people saying most new businesses fold within the first 12 months, so I’d get to 12 months saying, “Right, phew.” And then it would be, but most businesses fold within the first three years, and then most don’t make it to five years. I remember each of those milestones, thinking, “Oh my God, when can I feel like I’ve made it?” – Elaine Halley
In This Episode
00.45 – Women in dentistry
06.58 – Backstory
10.55 – Going cosmetic
14.50 – Practice ownership
34.03 – Books and lectures
38.45 – BACD
43.51 – Black box thinking
50.46 – Teaching
53.17 – Pain-Free Dentistry
55.01 – Last day and legacy
About Elaine Halley
Dr Elaine Halley graduated from the University of Edinburgh in 1992. She was president of the BACD in 2008-09 and went on to become the association’s first female accredited dentist in 2010.
Elaine serves on the editorial board of Private Dentistry and Aesthetic Dentistry Today magazines and a judge of the Scottish Dental Awards.
Since 2012, Elaine has worked with Christian Coachman as a Digital Smile Design (DSD) instructor. She is a prolific author whose published works includes articles on DSD, practice management and clinical case studies.
She is also a prominent dental lecturer and educator.
Elaine Halley: And realised very quickly I wasn’t going to survive in an NHS environment, because I wanted to be able to offer my patients the best that dentistry had to offer. That’s always been, I want my patients to have the choice of the best. Not to say that I’m the best, clinically, that was never my goal, but to make sure that I understood all the different options and to be sure that people had choice, that’s what was important to me.
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’s my great pleasure to welcome Elaine Halley on to the podcast, one of the pioneers of cosmetic dentistry in the UK and definitely one from Scotland. Were you the first lady to be accredited by the BACD as well?
Elaine Halley: Yes, I was. First, and so far only president and yeah. I’m the first female, yeah.
Payman: Welcome to the show, Elaine, you’ve been teaching all over the world, I think, the recent DSD thing that you’ve been doing as well, right? Shall we just get this lady thing out of the way before we go any further? Because it grates with me a little bit that we have to talk about it, but what’s your position on this balancing the boards, is it harder for women? You’ve been there. You’ve been the one on the boards, president of the board. Was it harder?
Elaine Halley: It’s such a complex question, this. I think in my younger days, I didn’t pay much attention to it, so I think in my younger days I considered myself a dentist, the same as my colleagues. I’ve got two brothers, I’ve always been pretty comfortable in male company. And I was fortunate, I think, when we were starting the BACD, my good friends David Bloom and Chris Orr, we all were equal. Certainly in my eyes, we were peers, colleagues, friends. So, I didn’t feel that being female was either up nor down, at that time.
Elaine Halley: I think, as I’ve got older, and certainly maybe in the last five or 10 years, I have reflected on why are there not more versions of me? I mean, there are some brilliant females in the teaching of dentistry, but not many. And actually, when I think back now, I’ve been in this practise for over 25 years. I have been around for a while and nothing has really changed in that perspective, I would say. And it was at one of the anniversary talks at the BACD, a young female dentist came up to me and said, “Are you going to say anything about the fact that you’re the only female president of the BACD in all of this time?” And I suddenly felt that uncomfortable shift of responsibility, which I’d never really… I never felt it was my job to campaign on behalf of women, I was just me doing what I did.
Elaine Halley: But then I did think yeah, you know what? Maybe I do have to say something here. And so, a few times in my career I’ve felt that the balance and the representation is uneven. That’s the bit that frustrates me, is if the audience are 50/50 male, female or in some countries where I’ve been to conferences, it’s mostly women in the audience. And if the people talking to those women are all male, then there’s something out of balance. You are not representing your audience. And the more I’ve looked in to this, I think that’s the imbalance in dentistry. I think that for all sorts of deep rooted cultural, circumstantial reasons, there just is a tendency for men to ask their friends, for it to become almost without intention, but for some of the boards and the panels to become male dominated. And I think that doesn’t represent the profession.
Elaine Halley: I think any time you have an imbalance in representation, there will be blind spots and there will be bias, you can’t help it.
Payman: What do you reckon should happen about it?
Elaine Halley: I think we need more conversations about it, and I think women can’t do it. I think it is very difficult for the minority to elbow their way in. I think men need to turn around and go, “Wait a minute, we are missing the other side of the conversation,” and need to talk about my colleagues that invited me and stood aside to let me come through. And that’s how I think about it, is stand beside us, not in front of us. Let us in, give us a hand up, men and women. I try to do the same thing myself, and I don’t know that I necessarily did when I was younger, because I didn’t particularly recognise that there was an issue. But I think there obviously are issues.
Elaine Halley: I also get a bit frustrated when people ask me what should be done, like when men say, “Well, Elaine, you’re a female that’s speaking. What should we do to try and get more females?” And I get a bit frustrated with that, because I don’t know any more than anyone else does. I think we all have to look around and it’s not the women’s responsibility only.
Payman: Yeah, one side says… I mean, I don’t want to put it in to a side debate like that, but one side says, “You should do nothing,” and then you’re saying, “There’s misrepresentation and we have to do something.” And so the something, what should we do question is really the problem, because it’s that sort of… No one wants to really give positive discrimination, no one wants to feel like they’ve got a role that they didn’t deserve, and that’s always going to be level, that way of working. And so, maybe, you’re right, thinking about it does help, because since this conversation’s come up, now I’m thinking about it more and so next time I have an event I’ll be thinking about it.
Payman: It’s just strange, man. Yesterday I interviewed Basil [Misrahay]. I didn’t start by saying, “Hey, you’re a man, what’s it like being a man?” And yet today, I’m feeling like I have to ask that question. And I wouldn’t have felt that I would have to ask that question before this debate came up, but there we are.
Payman: Let’s move on. We normally start with this thing with, where were you born? How did you grow up? When did you decide to become a dentist? Why?
Elaine Halley: So I was born in St. Andrews in Fife, which is the home of golf. So, I was born there. My parents had a shop, so they were in retail. My father was quite entrepreneurial. He did a degree in physics at St. Andrews University and then he had an exchange to MIT in Boston, worked as a consultant in the States for a while, which kind of gave me my love of travel to the States. He then came back to London and then saw an opportunity to open a shop on… Well, he was taking tartan scarves from Scotland to the States, and selling them to students at MIT in Boston, and that gave him that insight that there’s a tourist market for Scottish goods. He opened a shop on the 18th green of the golf course in St. Andrews, selling cashmere jumpers, tartan golf balls, kilts… And so, that was the business that I was born in to. So, self employed, he used to give away free tea and coffee when nobody did that, to encourage coach loads of people. So, a very quirky entrepreneurial business.
Elaine Halley: My mother was from London, he’d met her when he was working in London. We were a self employed household, I guess. I’ve got two younger brothers. I was a good student, a good girl at school, did well and enjoyed studying and actually, it probably is a cliché, but wanted to be a vet. That was my absolute ambition. I get annoyed when people say, “Dentists are failed medics and vets.” We used to get that at uni all the time, but the truth was, I wanted to be a vet. Of course, It was really difficult to get in to veterinary school, that was in the 80s, and I just didn’t get the grade in [physics]. I needed an A and I got a C, and I had tried, that was my best.
Elaine Halley: So, I started off doing biology at university because I didn’t know what else to do when I couldn’t get in to be a vet. I had a thought in my mind of trying to get in in second year and I tried really hard, but there was no way in for me. And then I met some dental students. So, while we were just sitting in the student union I met some dental students and I’d always known I didn’t want to do medicine. I don’t know why, but I just knew, for sure, that medicine wasn’t for me, but I was a little bit lost with biology because I was so, had in my mind to be a… And I think again, that was a sign of the times in the 80s, to be a thing, like an accountant or a lawyer… So there was an expectation you were going to be a something.
Elaine Halley: So, I met dental students and then was hearing about them actually doing the dissection on the head, neck and I thought, “Oh, that sounds actually really interesting,” and sort of a half way to medicine but still fulfilling my interest in biological sciences. I applied to transfer after first year at uni, I did a bit of shadowing with my own dentist at home, applied to transfer and that was me.
Payman: Did you enjoy dental school? Were you one of the top in your class?
Elaine Halley: No, I was painfully shy growing up, painfully shy at dental school. Because I hadn’t come in in first year, most of my friends at uni were not studying dentistry, so I quite enjoyed that. Dentistry is, as you know, can become quite insular. I never shared flats predominately with dentists, and those guys are still my friends to this day, those first year friends that I made. I just kept my head down, did the work and got through dental school. I made some great friends, but I wouldn’t say it was the most comfortable experience for me.
Payman: So then Elaine, most people who qualify in dentistry, go and do a regular job. Back in the day, when me and you qualified, a lot of that being NHS practise. When did it switch from being a regular dentist to looking into this cosmetic world? What was the moment? Do you remember the moment when you kind of switched your thinking? Or were you always a bit different?
Elaine Halley: I think, looking back, the fact that my parents were self employed and ran their own business and had to bend with the economic situations and come up with new ideas, I think that was a big influence. So, I already knew as I was graduating from dental school, that I was going to go into general practise. I had no interest in playing the political house officer game. And I also had had, as lots of people had, had a bad experience as a child, where my dentist tried to extract a lower molar I was having taken out for ortho reasons, and I now know that the [ID] block hadn’t worked. But my tongue was numb, my lip was numb, but the tooth was not numb, and she didn’t believe me and carried on trying to extract a lower seven.
Elaine Halley: So, I had been… I kind of bounced back from that no problem, but it was in my head that people can be very nervous for good reason, and believe people, whether you think they can feel it or not feel it, if they think they can feel it, believe them. So, I had those two things in my head. I also travelled to the States, as we had to do our elective period of study, which myself and my two girlfriends, we travelled to California and had a beach/elective experience. But when I was there, I actually heard Larry [Rosenthold] speaking. We got invited to a conference of students, we didn’t know anything about anything, we were fourth year dental students, but I don’t remember anyone else at that conference, but I remember him. And we also visited various different dental practises and they had Nintendo’s, in those days, in the waiting rooms and they had coffee in the… Again, I graduated in 1992, in the early 90s, in this country, there was very little in the way of customer service going on with dentistry.
Elaine Halley: So I had that idea that there’s a different way to be, and that to really help work with nervous patients, that there’s a way of making dentistry not as clinical and not as regimental as it was. I already had that in my head when I graduated, that I had a vision of… It wasn’t particularly on the cosmetic, it was more on the looking after nervous patients. And then, in my first job, I worked in a big NHS practise in Cambridgeshire when I first graduated, and a lady there had spaces between her front teeth and pretty misshapen front teeth, and she came and asked for veneers which, again, I hadn’t done any real training, other than what I’d learned at uni. But I remember her saying she’d been asking for years and all she’d kept being told was that there’s nothing wrong with her teeth and it was character, she should just get on without, her teeth were healthy, it was character.
Elaine Halley: And I can remember thinking, “Well, if my teeth looked like that, I would certainly want something done about it.” So, that kind of put a switch in my head. But cosmetic is, it can be life changing for people and it’s not for us to judge what is character and what isn’t. If you don’t like the way your teeth are, you should be able to explore the pros and cons of doing something about it. So, those two things, I think, are what inspired me at that time.
Prav: And so, moving from that job to owning your business, obviously your father was entrepreneurial and I guess, it was probably written in your life or in your blood, so to speak, that you were going to own your own business. At what point did you say, “Well, I’m going to create my own practise, have my own patient journey and my own vision.” Because I remember when I first got in to dentistry, probably 13 years ago, 14 years ago now, Cherrybank was that practise that you just looked up at and everyone spoke about the experience there, the service there. To me, I don’t know whether they did speak about the actual dentistry itself, but the one big stand out thing that was on everyone’s radar, was the service and the level of service, and people who went there to visit… And I think, at the time, you were doing some kind of training programme with Jameson Management, going round practises and almost injecting Cherrybank in to multiple practises.
Prav: How did that evolution come about? From obviously working as a dentist for someone else, to saying, “I want to own my business and create this experience for patients.”
Elaine Halley: Yeah, I didn’t last very long working for anyone else. I think I have learned that about myself, that there’s a certain… would you say control freak? I don’t know what it is, but there’s a certain… I have ideas and for me, freedom is really, really important. The freedom to be able to put my own ideas in to practise. I was very young when I started my practise, and my first job as an associate was great. Big NHS practise. I learned a lot, but I went on a course and I can’t even remember the name of the course, and there’s a few key dentists that we all know that were on that as well. But it was basically an accountant, but he was almost running a course for associates, saying, “You can do this by yourself.” And I hadn’t actually considered, at that time, that I would be able to open a practise of my own. I was just kind of going with the flow.
Elaine Halley: There wasn’t VT, I was just ahead of the VT curve. My first two, two and a half years in practise, I was self taught. I realised very quickly, I didn’t know enough, so I immediately enrolled in the FGDP programme. I went on a lot of courses and then I was working down south in England, and decided I wanted to come back to Scotland and I just couldn’t face the thought of signing on as an associate, again, for another practise. Fortunately, I had the support of my parents, but I just decided to open a squat practise. I did a fair amount of research into where would I want to live, and where did I think there would be space at that time, but yeah, I was only two and a half years out of uni and I opened a squat practise.
Payman: Is that your Edinburgh one?
Elaine Halley: Perth, that’s where I’m setting up [crosstalk].
Payman: Oh Perth was your first one.
Elaine Halley: Yeah, this is my [crosstalk].
Payman: The one you’re sitting in right now.
Elaine Halley: Yeah.
Payman: Amazing. So, take us through… Opening a squat was quite an innovative thing to do back then. People didn’t really open squats. I mean, of course some did, but take us through that. Are you the kind of person who jumps into things with full confidence? Or did you have anxiety about it? Were you using your parents money? That must have been stressful.
Elaine Halley: No, I didn’t use my parents money, not that they offered, but what they did have to do was guarantee. They guaranteed, they had to act as the guarantee for the loans from the bank. Do I jump in to things? I think I logically look at the pros and cons. I had a plan and I just took it step by step and I’ve never particularly worried too much about what other people think, although then sometimes it comes as a shock when I realise people do think things. So, I got a lot of stick for opening a practise in a city where I wasn’t known, and I actually got some quite nasty letters from some of the dentists. I was quite naïve, I suppose. I did write to everyone saying I was opening a practise, single handed squat practise, I was going to be charging privately for the first examination. It was just, the contracts all changed the year that I graduated, so there was a big move in England, where I had worked initially, for dentists coming out of the NHS. Scotland wasn’t moving in that way.
Elaine Halley: Before that, you weren’t allowed to mix private and NHS, and I started by charging for the full examination and then giving people options, and that was practically… I really angered a lot of people by doing that, but I just kept my head down and stuck to my guns and realised very quickly I wasn’t going to survive in an NHS environment, because I wanted to be able to offer my patients the best that dentistry had to offer. That’s always been, I want my patients to have the choice of the best, not to say that I’m the best clinically, that was never my goal, but to make sure that I understood all the different options and to be sure that people had choice, that’s what was important to me.
Prav: Do you know back then, I mean, you spoke about your dad having this shop and it was unheard of back then to offer tea and coffee. Did you sit down and map out your patient journey and what that would look like? Was there some inspiration in there, in terms of trying to be different and it being about the experience, or did that evolve over time?
Elaine Halley: A bit of both. I used to dream about how could you make the environment not like a dentist. I think I was a bit influenced by not enjoying my childhood experience of dentistry. I used to think, how could you make it more friendly? Could you have yellow paint on the walls instead of white? And then I was very influenced by what I saw in the States, in terms of customer service. And then more and more influenced, because right at that time, spa dentistry, which has probably been done to death now, right at the time I think we were the first in the UK and that was influenced by the States, what we saw in the States.
Payman: What did spa dentistry mean back then, and what does it mean now?
Elaine Halley: Spa dentistry back then absolutely was about making everyone around the dentistry as comfortable as possible, so that people forgot that they were somewhere where they didn’t want to be. That’s what it was about. I think that’s still what it’s about, it’s just like everything, the term’s been overused and it’s easy to call yourself something that doesn’t mean you actually follow through with the ethos behind it. To start with, I was Cherrybank Family Dental Health Centre, that’s what I was for years, and then as my interest in aesthetic cosmetic dentistry grew, I decided that yeah, I’m not really a family dental health centre, that’s not really my market anymore, so we decided to change the name. But definitely influenced by just trying to be different. What can we do that’s different? Why would people come to see us? We need to have something different that we can offer. There’s no point being the same as everybody else.
Prav: Elaine, when you first opened your practise, I remember having conversations with my brother when he first opened his in 2005, he was having two to three hour lunch breaks and I remember getting a phone call from him, saying, “Can you help me sort this out?” Did you have any moments like that at the beginning? What were the earlier marketing campaigns? What were the things… You’ve got this building, nobody knows about you, you’re offering a service that’s totally alien, especially other dentists saying they’re angry about what you’re doing. What did you do to get the initial people through the door? And just talk me through the progression of how it was, say, in the first year, and how you grew the business, and what were the key things that you… strategies you used to get patients through the door.
Elaine Halley: So, it was different times, Prav. One of the biggest things that we did was Yellow Pages, if you remember that.
Prav: Oh yeah.
Elaine Halley: At the time, Yellow Pages was lists, and the dentists were called Mr. Smith and Associates. I’d start with the Yellow Pages and I thought, right, this I guess is where my family helped, because my dad had been a big advert print advertiser with his shop, he had a famous sale every new year and he used newspaper, Yellow Pages, TV ads… And my brother, one of my brothers got involved with advertising. So, we were the first in our area to put an ad in the Yellow Pages that actually… we had a logo, which Pronto Printers came up with our cherries, Cherrybank Family Dental Health Centre and my strap line was, “Caring dentistry with a gentle touch.” And I guess we built a story, at a time when people were just putting lists and their names and numbers. We started off with a box ad, and then we moved to a column, and then we got bigger. And then other practises started to follow suit, so we had to do other things.
Elaine Halley: We also did leaflet. I mean, I went round with leaflets, myself, and put them through doors. I joined the Chamber of Commerce. I joined the business network. I made myself, and as I said, I explained… I talk and teach now, but that never came easily to me, so I made myself join business networking groups and have to stand up and vouch for what I was doing. I remember people saying most new businesses fold within the first 12 months, so I’d get to 12 months saying, “Right, phew.” And then it would be, but most businesses fold within the first three years, and then most don’t make it to five years. I remember each of those milestones, thinking, “Oh my God, when can I feel like I’ve made it?” And then you learn.
Payman: You have three practises now, Elaine, right?
Elaine Halley: No, not quite. So, I did open a second practise in Edinburgh, and I have sold the majority stake in that practise to a group of practises in Scotland, the Pain Free Dentistry Group, and I work for them as a clinical director, so helping to mentor the associates. I still have some ownership of Edinburgh, but I don’t work there anymore.
Elaine Halley: I had a brief dalliance with corporate, which didn’t go well, which I could have probably… A bit like, I need to work for myself. I realised this isn’t going to work, managed to get myself out of that by then selling to a dentist, who understands what it is to be a dentist. I really enjoy balance in my working life, so I work clinically part of the time in my own practise in Perth, which is now back to being just mine, which is brilliant, and then I work mentoring associates for Pain Free Dentistry Group, and then I also teach as well. I love the balance.
Payman: You said you’re a bit of a control freak. What are you like as a boss? Are you a touchy feely, caring, sharing boss? Or are you a bit stricter than that?
Elaine Halley: I’m probably not the one to ask. I have three team members who worked with me for over 20 years, so I can’t-
Payman: That’s a good sign.
Elaine Halley: I can’t be that bad. Yeah, I think, I don’t know. I try and be kind, I try and respect my colleagues but I also know how I want things to be, and I think, sometimes, I have to remember to do the touchy feely stuff. I think most business owners have a mindset of getting the job done and making decisions, and sometimes you have to remember that people aren’t just… they can’t read your mind and they’re not necessarily just going to come with you, you might have to check on them occasionally.
Elaine Halley: But my core team, my team here in Perth, as I say, most of them have been with me for a long time, so they’ve figured out how to manage me, probably, more than-
Payman: You must have had some periods of overwhelm, though, because before you had more practises, more associates, more staff, the whole BACD commitment, you’ve got how many kids?
Elaine Halley: Three.
Payman: Three kids. There must have been moments where it was just too much. What’s your darkest days in your professional life?
Elaine Halley: I’ve had lots of moments where it’s been too much. I mean, I don’t think you get through life without ups and downs. I think that I’m very fortunate that I’ve been able to maintain ownership of my first practise, and I think anyone who’s started a squat practise, not anyone, because some people are very good at starting businesses and selling them and letting them go. But for me, this building, these people, these patients I’ve been looking after for 25 years have been my rock, throughout some of the other ups and downs of life, absolutely.
Elaine Halley: I mean, starting Edinburgh was an ambitious move. I try not to have regrets in life, but there were some pretty big moments where I really did regret stretching myself financially and emotionally, and I have massive respect for people that can manage multi-site practises. I struggled with two, so I don’t know how these people do it that have multiple sites. I realised that that’s not… That was possibly an ego driven situation, I’m doing so well in Perth, I can certainly do it somewhere else. I think what I learnt about myself was, I’m good at what I do, but growing, scaling, that’s not what drives me.
Elaine Halley: So yeah, I have three children. My first pregnancy, I had appendicitis in the middle of that pregnancy and was suddenly off, like suddenly off, for six weeks with a new practise and no associates. Lots of ups and downs that life throws at you. I certainly don’t take any of it for granted, that’s for sure.
Prav: Elaine, what are your strengths, when it comes to running or managing owning a practise? As business owners, we all have different strengths and then there’s probably areas which you absolutely hate. Can you just run us through, during this time, what do you absolutely love about being a practise owner and what do you not like so much?
Elaine Halley: What I love about it, is that ability to think through the patient journey and make that better and better and better. So, what I absolutely love is meeting a new patient for the time, who’s nervous, often here we have people who haven’t been to the dentist for a long time, or they have been but they’ve been made to feel bad for whatever reasons. So, I absolutely love that, “What can we do for you?” Let’s gather the information. Let me analyse it and think about it and let me work out how to best tell that story back to the patient in a way that they can engage with. That’s what I love to do.
Elaine Halley: And part of that is that constant learning about psychology of people, psychology of decision making, psychology of our own biases, how we analyse what’s happened to somebody’s mouth, how we figure out what their options are. In terms of delivery of dentistry, I love that journey, the problem solving, solution finding. And so, I guess my strengths are just always making that better and always being flexible. Always thinking, like introducing the DSD workflow, okay, I like some of what’s being said there by Christian, let’s think about it, let’s bring it back, let’s put it in to practise, let’s try it, let’s adapt it. What else, what’s anyone else doing? Let’s see, is that going to fit with the way that we work.
Elaine Halley: I think sometimes for my team, that’s very frustrating, because we don’t do things the same for very long. So, I think, for some of those personalities that don’t like change, they don’t last long working for me because we’re always trying to change and innovate and do things differently. I think the areas that I hate are financial management, and I’m lucky I’ve got two brothers. One works with me and does the marketing, business development, the other one has taken control of speaking to the banks, doing the cashflow, managing the stock. I’m not a numbers person, I’m an experience, creative person, not a numbers person.
Prav: What about the people side of things? You just mentioned that, obviously those that don’t like change, don’t last. Is it you that does the hiring and firing?
Elaine Halley: No, not particularly. I’m quite a good delegator. I have a brilliant practise manager, she’s one of the members that’s been with me for over 20 years. She started with me as a dental nurse when she was 19, so we’ve been through a lot together. I leave a lot of the hiring, I get involved but my team, our culture here is so well established after all this time, that it’s usually obvious pretty quickly, who fits and who doesn’t. I like the… done a lot of reading, as we all have, on business books and how to develop culture, and that was the hardest thing I felt when trying to replicate, that’s the bit that was hard. But in a small, contained area where I’m here most of the time, it’s easier to influence. Blame a system, not a person. Treat your team members how you want them to treat your best customers, making sure you say, “Please,” and, “Thank you,” and treat everybody with respect.
Elaine Halley: And I do believe, and always have believed, that every member of the team is as important as every other member, so I don’t believe in the sort of hierarchy. I think we’re a team, and we all need each other.
Payman: Elaine, give me one book you’ve read on the personal development business side, that really resonated with you, that you keep referring back to.
Elaine Halley: The Seven Habits of Highly Effective People, Stephen Covey. And that habit four, and I drive my kids mad trying to teach them these habits, but that habit four, seek first to understand and then to be understood. I think that, in itself, if we can just go through life trying to understand and ask questions before we jump to judgements and assumptions. I think the world would be a happier place when we can all remember to try and see things from someone else’s perspective before jumping in with our own thoughts.
Payman: [inaudible] but first principles man, you can’t beat first principles. And then what about, as far as dentistry lectures, you said early on that Rosenthal lecture grabbed you. What about later, when you’ve had the opportunity to meet a lot of these guys and from the lecture perspective, which lecture do you think, you sat in it and it blew you away more recently? Would it be [inaudible]?
Elaine Halley: Yeah, well obviously I think Christian is an amazing visionary, thinker and I’ve really embraced the digital workflow. I think before that, one of the key moments was going to the States, and the very first AACD that I went to after a group of us had got together in the UK and thought, “Right, let’s go.”
Payman: Which one was that? Where was it?
Elaine Halley: Orlando. [Carinda Hundel] was there, Chris Orr, David Bloom, few dental technicians that I know from London. And sitting in those lectures and just thinking, “I don’t know how to do dentistry like this, I’ve never seen composite dentistry that looks like that. I haven’t been taught how to do that.” That kind of wow, there is a whole other world that exists outside of Section 63, that existed at the time. So, that, and then I think, I’ve also always been interested in the clinical, chemical side of things.
Elaine Halley: So, [Pascal Manieu] was another huge influence, and Newton Fall was the other one. I went to [inaudible] and did his-
Payman: Oh did you?
Elaine Halley: Yeah, that really was life changing. And then Pascal Manieu, I followed around like a little groupie for a while. Just that merge of the science and the evidence. And then, the art and Michelle Manieu, his brother, as well, was the first, I guess, insight for me that art is related to dentistry. I hadn’t got that before, but I used to just sit in his lectures and not write a single note down and think that was amazing, and other dentists would be complaining that they hadn’t written a single note down. He was saying, “Go to art galleries, study form, open your eyes to that aesthetic world.” And I think dentists often were science based, that’s how we managed to get in to dental school, we’re very heavily influenced by science and I think it’s so important to be able to open that other side of your…
Payman: You know what, my kids are in french school now, and the system there, you don’t shut art out when you go into science. But the system here, we do. In a way, you’re taught, all three of us, we’re zoomed in on, I don’t know, you guys probably did biology, I did maths, physics, chemistry. Zoomed in on those and there wasn’t even a question of a, what about design and art and these sort of… those subjects, in our world, were considered just bullshit. Don’t go near those subjects. And then now, I don’t know about you, Elaine, but for me, I’m thinking my natural position might be in art. Not drawing art, but the arts rather than the sciences.
Elaine Halley: And interestingly, my son, my eldest, is studying fine art, fine art with history of art, and I have so encouraged him because from an early age it was obviously his thing. But I have learned so much from him because like you, art was shut down. If you couldn’t do science, you could do art. My knowledge in art was so limited and so, yeah, you experience the world again through your children, often, don’t you?
Elaine Halley: I’ve really-
Payman: Tell me about the world of, I don’t want to call it politics, because BACD’s not really like that, but that world, the world of getting… starting an organisation. You were really there, right at the beginning, and then getting members and meetings and who’s the president and that whole world.
Elaine Halley: Yeah, so BACD came about from that first AACD meeting that we were at, and we were sitting there, David, Chris and [Surrendra] and actually myself, at the time, and we were saying, “Do you know what? For all of the versions of us that have come here, and travelled to the States, there must be so many people back home that wouldn’t make this journey.” And again, it was before internet learning, there was none. The only way, in those days, to find out was to travel. So, we decided to come back and invite all of the Britain members of the AACD to a meeting, to see would they be interested in a British version.
Elaine Halley: And we held that meeting in London, and there was me, Chris and David, because we’d literally written it down on the back of an envelope what we thought a good organisation would be. We were blown away at that first meeting. I was the secretary, of course, naturally [inaudible]. Delegated, David and Chris. [inaudible]. Yeah, so we signed up, I think something like 70 odd members on that first meeting, not knowing what we were doing. And Chris, luckily, was a natural. He knew about constitutions and he knew about-
Payman: As a student, he’d done something, didn’t he? European dental student.
Elaine Halley: Yeah, he’d been heavily involved with the [IFID], the international student thing, so he knew, he understood. David and I had not been able to get in to another aesthetic organisation. That was-
Payman: Because it was at the golf club, wasn’t it, back then?
Elaine Halley: Yeah. So, I didn’t know anybody in it, and you had to be nominated, and I didn’t know anybody. We very much from the beginning wanted BACD to be inclusive, because I never was any good at playing the boys network thing, surprisingly. It didn’t interest me and I wasn’t going to know anybody.
Payman: But then when you fast forward to, I don’t know, the 15th meeting, where you’ve got 400 people turn up and you’ve got international speakers, there must have been some satisfaction, seeing that thing that it become, how big it came.
Elaine Halley: Massively proud of that, I mean I think we did a good thing. When I look back at my career, what is the thing you’re most proud of, being there, it was the three of us, that we did that. And these things then rely on everybody else, and there are amazing members and the people that came after us. We didn’t do it perfectly, by any means. We were finding our way, but the buzz and the camaraderie and the, I think, the education, the benchmarking of standards, all of those things that came with the BACD is a good thing. So yeah, I mean, at the time it was quite overwhelming. We didn’t know it was going to be such a success when we started it.
Payman: Yeah, you never do, do you?
Elaine Halley: But very proud, very proud to have been part of that.
Payman: And what about the accreditation process? I mean, if I’m a young dentist, ambitious, whatever, would you recommend that to someone?
Elaine Halley: Yeah, so the accreditation is about benchmarking yourself, so the point of having an accreditation process is to say, these are examples of doing dentistry to a high standard. It’s not… We can all study and pass academic qualifications, but accreditation is about practical. Here’s your cases, your justification, but it’s actually your clinical dentistry. So, nobody has to do accreditation, but I think if you’re brave and you want to benchmark your clinical dentistry against a high standard that’s not easy to attain, there’s massive professional growth and personal satisfaction from doing that.
Elaine Halley: It’s also a very vulnerable thing to do, because you might not pass every case first time. Anything that’s judged by your peers, you have to put your ego to one side and you have to go, “Here’s the best that I did, can I have feedback? How could I do it better?” But that’s how you grow, isn’t it? That’s how… You have to tuck your ego away and go, “Okay, this is it.” Bare your soul and learn.
Payman: It’s a good time to talk about our ego breaking moment of our podcast, that we ask every guest about mistakes. In medical dental, we don’t tend to talk about them enough, but we’ve decided to try and buck that trend and discuss clinical errors or different people answer in different ways. Answer any way you like. What have been your biggest mistakes?
Elaine Halley: Yeah, I think, I mean that book, Black Box Thinking, Matthew Syed, I think we should be talking about our mistakes, because to pretend that we don’t make any is ridiculous. We’re humans, often working under time pressure stresses, and one thing about being in the same practise for the length of time that I have, is you see the things that go right as well as the things that go wrong. I’ve made… I’ve drilled the wrong tooth once. When I had a visiting oral surgeon, and I looked at him and he looked at me, and it was taking off a crown. I had drilled through the wrong crown and because we were both there together, I had to say to the patient, I just had to say, “I’m so sorry, I was looking at the wrong side and I drilled through the wrong crown, and I will replace it.” She wasn’t very happy at all, I think she did write and complain and luckily the oral surgeon backed me up with the… You know, we were doing a difficult procedure and these mistakes can happen. That wasn’t very comfortable.
Elaine Halley: I’ve had a complaint against me to the GDC, like most of us have, when you’ve been around for as long as I have. It wasn’t my patient, it was a patient of one of my associates that I saw for one appointment. But what that highlighted was that I hadn’t re-consented the patient to be treated by me, and as usual, what she was complaining about was not the thing that we all then got in to trouble with from the GDC, it was record [inaudible]. And so, I had thought that I was taking photos of everything, I thought I had a very well documented consent process, but it didn’t conform to the GDC’s idea. Taking a photograph isn’t enough, you have to write down what’s in the photograph, even although my thinking was, you can see, the photograph’s there.
Payman: We can talk about what you learned from that was, whatever, write more notes, but what can you tell someone who’s going through that, or has never been through that process and has just got their first letter?
Elaine Halley: I think, as everyone says, it’s awful. It’s horrible. It certainly made me really close to wanting to say, “Enough.” And I think it’s partly the fitness to practise, is those words, because if it’s fitness to practise then you’re unfit. If you’re found to be wrong, that means you’re unfit to practise and if you really are trying to do your best, which most of us are at all times, but as we’ve said, we are also humans. We won’t do it right all of the time, but our intention is to do it right. I think the thing to do is talk about it. I’m a great believer in talking, and talking probably sometimes to my detriment, sharing too much, but I’m great believer in if you talk something through, a, you feel better because you’ve put it in words and got it out of your head, but also you’ll find that there are other people who’ve been through the same situations. I think, as a profession, we’re getting slightly better. It used to be a thing to be ashamed of, didn’t it? And you would dread that anyone found out that you’d had anything go anywhere near the GDC.
Elaine Halley: And I think there’s been some good, prominent… Colin Campbell and the likes that have really spoken up about a, the fact that it happens to most of us. I think that is just a given, it will happen, and the fact that it happens to good people. It doesn’t mean you did anything wrong, but you do have to take it seriously and reflect. You do have to take it seriously. There’s no point getting angry about the injustice of it, you’re in the system that we’re in. I do think there’s some reform that could be made to that whole process.
Payman: There’s been some reform, hopefully, and they say it’s getting better. When we qualified, it really was the bad people, wasn’t it? It was about fraud and stuff like that. That’s why it was shameful, because it was a bad-
Elaine Halley: It was the people that’d done something wrong.
Payman: Yeah, you put your fear on it. Before I said to you, what’s the thing that drives you the most, and you were like, “Solving a problem for my patient,” is what drives you the most, and then you see this things that says you’re not fit to practise, that’s the question. And those two things, the thing that drives you the most is being put in question. I see you getting some flashbacks there. What about in your personal life, if you had half a day to yourself, what would you do? I know you don’t.
Elaine Halley: I go walking with my dogs up in the hills. My friends and my dogs. Nature, looking away from your hands, like looking…
Payman: And your kids, I know you said you don’t want to tell them what to do, but one of them should be a dentist, right?
Elaine Halley: No.
Payman: It makes sense, doesn’t it?
Elaine Halley: Well, I would be very delighted if any of them wanted to be a dentist. I’ve still got, one of my youngest is 13, so there’s still hope. So, I would be delighted but my son was so obviously art, I mean it just was going to be art or musical theatre. And what I want for all three of my children is for them to study the thing that interests them, not necessarily the… Whereas my generation, I think it was about the job and the career, whereas I think if you’ve got any creative bone in you, follow that because that will serve you well in later life. And all the business books you read, find what you’re passionate about and follow that. Yeah, my son’s fine art, my next daughter, she’s at uni doing animal sciences but she’s probably going to do some type of farming, horses, something like that. And the little one, who knows? She’s only 13.
Payman: What about teaching, Elaine. I’ve watched one of your lectures that really actually turned my idea of potential smile design. I studied [inaudible]. I thought I could smile design myself, and the people that didn’t know how to do it had to digitally smile design, until I watched your lecture and you really explained it well, especially the video before and after that really resonated with me. And it suddenly makes you realise, out of all these years we’ve been doing the [inaudible] for them, there’s no video on this podcast, but [crosstalk].
Elaine Halley: Perfect smile.
Payman: Yeah, why [inaudible] that’s not how we see each other? But with the teaching, do you prefer the practise side, the management side of the practise, the treatment planning like you were saying, the empathy side with your patients? Or do you prefer the teaching side?
Elaine Halley: Do you know, I really love the balance. I’ve asked myself that question a lot. I think I wouldn’t be as good a teacher if I wasn’t working with live patients and facing the same challenges that people do in practise. But what I’ve always loved is sharing. “Look, I’ve tried this out and I’ve been through this sequence and I’m putting it in practise and it’s working. I’m getting good results, so let me explain how I’m doing that.” That’s the bit of teaching that I’ve always loved. “This is how I do it, and I know it’s worth telling you about because it’s working well for us.”
Elaine Halley: I really love the clinical director job that I’m doing with Pain Free Dentistry Group, because I’m there as a sounding board for all of the… they’re all associate run practises, and so I really love… They send me their difficult treatment plans and we look at things together and I’m trying to tell them to slow down, you don’t have to have all that answers, and when the patient’s in the chair, gather the information and then take your time. And then when I hear them coming back with my words, it’s like your children, coming back saying, “You’ve always said, I did this.” And you think, “Oh, that’s great, that’s making a difference.” And ultimately, for patients, that’s making a difference. Everyone’s winning out of that scenario.
Elaine Halley: I enjoy the teaching from a, not look at me, this is how great I am, but from a let’s all get better together, this is a collaborative process.
Prav: Because Pain Free Dentistry, how big is that group?
Elaine Halley: They’ve got seven practises now.
Payman: It’s a bold name, isn’t it?
Elaine Halley: Yeah, very bold, very, very clever. Very clever dentists. Again, not frightened about what people think, just set a value and going for it.
Payman: What are they like? Are they all private?
Elaine Halley: Some of them are a mix, but with an emphasis on private. Again, it’s a bit like the dental spa, but just taken to another extreme. It’s about doing everything we can. If you’re going to say you’re going to be pain free, you better make sure that you’re doing everything you can to make that patient journey as comfortable as possible. It’s again, speaking to the patient rather than-
Payman: Do they have all those sort of machines to give [inaudible] and stuff?
Elaine Halley: Yeah, the electronic anaesthetic, yeah. [crosstalk]
Prav: Is the whole pain free group around, is a big part of it focused around emergency dentistry? Is the whole point is it’s focused around dental phobia, is what you spoke about earlier, just providing the whole range of treatments but attracting those patients who are more anxious and concerned about pain.
Elaine Halley: Yeah, it’s about what are the barriers to patients seeking dental care? We’ve known those four barriers forever, haven’t we? And fear of pain is still one of the major-
Payman: It’s number one.
Elaine Halley: Yeah, fear of pain, fear of cost, no perceived need, and lack of time. So, pain free is about, let’s break down that barrier, let’s do everything that we can to make dentistry accessible. That’s the value set behind that.
Payman: I don’t know if you’re a fan of this podcast, Elaine, but Prav always ends it with the same question.
Prav: Do you know what you’re about to let yourself in for, Elaine?
Elaine Halley: I listened to [inaudible] one last night.
Prav: So, Elaine, imagine it’s your last day on the planet. You’ve got your kids around you, your loved ones around you and you need to part, leaving them with three pieces of wisdom, advice. What would they be?
Elaine Halley: So, my children, we do talk about this some times. My number one thing is be kind, that’s always my number one bit of advice. Just be kind to each other, be kind to yourself, just be kind. The second thing I always say, is get a good nights sleep. Whatever is going wrong, whatever you’re worrying about, just try and get a good nights sleep and things always feel better in the morning. I guess the last one is, just be open to new experiences. Say, “Yes,” to things. It’s okay to be afraid, it’s okay, it’s that feel the fear and do it anyway. It’s okay to be nervous, but say, “Yes.” Experience life. Don’t not do things, take the opportunities.
Payman: Good ones.
Prav: Excellent. And what would you like your legacy to be, Elaine? Elaine was, complete the sentence. How would you like to be remembered?
Elaine Halley: That’s a tough one, isn’t it? I guess, that I lived, I said, “Yes,” to opportunities, I made the most of life. I think that’s all any of us can do, isn’t it? But appreciate every day that you have and be happy.
Prav: And imagine you were given the news that you had a month to live, so you’ve got 30 days. What would you do for those 30 days? Let’s say you had your health and everything all intact, not 30 days in bed and ill or whatnot, but you had 30 days to do whatever you wanted. How would you spend them?
Elaine Halley: The thing that comes to mind is stand on top of mountains and walk on beaches, just get out into nature with friends, with people that you love. Laugh, just really enjoy the physical being. I think I would very quickly hand my practise over to my associate. I don’t think I would spend 30 days treatment planning.
Payman: What’s your favourite place you’ve been to, Elaine?
Elaine Halley: I love the north west of Scotland. There’s a beach, [Clachtoll] Bay, up in the north west of Scotland. White sands, clear water, freezing cold but stunning. And yeah. I’m more drawn towards the north, also the Lofoten islands off Norway, I loved it up there, beautiful. So, I’m more a cold person than I sun seeker. The sea, but yeah.
Payman: The cold sea.
Elaine Halley: The cold sea.
Prav: Ice baths and cold showers, Elaine?
Elaine Halley: No, not quite, I’m not that [crosstalk]. I know that’s good for you, but no.
Payman: Well, it’s been a lovely conversation. Thank you so much for doing it, Elaine.
Prav: Thank you, Elaine.
Elaine Halley: You’re welcome.
Payman: So nice for someone listening to this, to see that someone who has gone as far as you have, can be so open and honest. There’s no magic answer, is there? Behind work hard. [inaudible]. Thank you so much, Elaine. We loved it.
Elaine Halley: Thanks for having me, I appreciate it, thank you, bye.
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’ve had to say and what our guest has had to say, because I’m assuming you’ve got some value out of it.
Payman: If you did get some value out of it, think about subscribing and, if you would, share this with a friend who you think might get some value out of it, too. Thank you so, so, so much for listening. Thanks.
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