Nilesh Parmar combines a love of implants with a passion for all things business, and his unabashed celebration of success has made him a divisive figure.
Nilesh recounts the transition from working as a ‘shed boy’ in his father’s practice to dental school before settling upon a career in implantology.
He also talks about his new indemnity venture, the intricacies of practice design and his other loves – fast cars and racing.
“The full arch cases I like because there’s lots of blood. And the nurses like it!” – Nilesh Parmar
In This Episode
02.14 – Backstory and university
11.23 – Postgrad
18.36 – Offering something different
22.25 – Same-day philosophy
23.59 – Pathways to greatness
27.22 – Practice design
32.05 – Fast cars
35.14 – Marriage and children
39.12 – Being Marmite
46.07 – MBA
54.00 – KOIs, DDS and indemnity
01.00.41 – A letter from the GDC
01.04.57 – Black box thinking
01.10.05 – The five-year plan
01.11.51 – Last days and legacy
About Nilesh Parmar
Nilesh Parmar graduated youngest in his class at the Barts and London Dental School in 2004.
Following VT, he secured a role as senior house officer at Guy’s and King’s Hospital in Central London and later undertook an MSc in prosthetic dentistry at the Eastman Institute.
This was followed by a masters in clinical implant dentistry at Guy’s Hospital and an MBA from Imperial College Business School.
Nilesh practices at Parmar Dental and Sparkly Smile, and recently founded Dental Defence Society providing indemnity cover to dentists.
[00:00:00] One VTE lecturer called me a cowboy because I turned up in a fancy car that I’d managed to pay for by doing day trading in the stock market in the 4th and 5th, it used to bunk lectures and go do day trading. And then he called me a cowboy and I was like, why? And that was the thing that really annoyed me was why should I hide success? Why? What’s the reason? Or if you want it, you don’t need to hide it. And it took me a long time to get that into my head. And I think that’s what you touched on before. To me, if you’re successful and you worked for it and if you like X, Y, Z, there’s no harm in having what you want and being happy for yourself. I think rewarding yourself and setting goals are really, really important, especially in the profession that we’re in.
[00:00:53] This is Dental Leaders, the podcast where you get to go one on one with emerging Leaders Dental Street. Your host, Payman, Langroudi and Prav Solanki.
[00:01:11] It’s my pleasure to welcome one of dentistry, sort of more prominent characters that have been around Nilus Palmer, who kind of for me, I remember UNILAG coming onto the scene around 10 years ago or something. And I mean, you’ve become a highly accomplished implant surgeon now. But back then, I mean, I know you were doing implants, but you were kind of famous for being famous back then. It was an interesting thing that you started and really turned on its head. The thing that I obviously visit a lot of them to see in order to talk to a lot of dentists turned on its head. That thing that you see with dentists where, you know, he’s driving a Ford to work. But but. Whispers You know, I’ve got a nice car home or something. You turn that completely on its head, not only not hiding the nice car from the staff, but telling the whole world about it. Lovely to have you on. But so this podcast generally starts with where were you born? Why did you become a dentist? All of that
[00:02:14] High. I pay high Prav. Thanks for having me on. I’ve seen this advertised for you guys. I’ve been doing it for a really long time. It’s a great original idea. So I’m really pleased I’ve made the cut to be asked to be on the famous podcast, you know. So I was born in Essex in South L.A. and I never wanted to become a dentist, as you guys have. I know you’ve met my dad, Prav, I think you might have and maybe my dad did. He is a dentist, an orthodontist, general dentist, studied in India and then came over here to this country many, many moons ago. And I had a paper round when I was, I think, 13, 14. And I see a Saturday morning paper around. And I wanted to become a detective because he’s such a Miami vice. And Don Johnson had a white Ferrari and he used to wear suits and things. And I thought, you know, that’s a bit of me. I’d like to do that. And then I went from that to watching E.R. and I wanted to be like Benton, the cardiothoracic surgeon. I wanted to be a doctor because he was really cool. People listen to him. And I used to get all the girls as well. So you can see my priorities were pretty clear when I was young guys.
[00:03:29] Exactly what do you what are you watching right now? But later are
[00:03:38] So my dad said to me and my mother wasn’t happy with me doing a paper and she said, you know, my son will get kidnapped or whatever is quite dramatic to the Indian series that mothers watch. So my dad was like, look, I’ll give you a job in the Dental practise. You can be like the odd job kid. I was getting like three pound fifty for Pat Brown and he would give me five pounds to work on Saturday morning. Plus we started at nine and finished that one. Plus I would get driven to the practise and driven home. I didn’t have to walk around in the rain to win win, so I started out being the shed boy. I remember Dad being an orthodontist used to keep loads of study models and he had a huge shed at the back of the practise. And my job for like the first six months was to organise all these models. And you had like spiders and you had these moths and all this stuff in the shed. And I went from that to being the tea boy to developing the x rays in the darkroom, where I’m sure probably carcinogenic material into my eyes. And then I used to work on reception. I was like the main receptionist on the Saturday, did a bit of nursing, wasn’t very good at nursing. And then it was through that that I thought maybe this is the profession for me. So it was a slow burner. But then once I decided to do it and that was it, I was pretty much committed.
[00:04:53] How old were you?
[00:04:56] Well, back then, teenager, 13, 14, minimum wage.
[00:05:03] And then you went to London Hospital to study?
[00:05:07] Yeah. So my my pathway was always very difficult. So I wasn’t very bright at school. I was never in the top set of anything then. It was real hard to even be allowed to apply for dentistry. I didn’t get any offers. Nothing took my levels, got the bare minimum and then got in through clearing to the London and I got declined from every other university it was. And ironically, I’ve got a degree from every university that declined me in the beginning. I got declined from everyone
[00:05:37] I didn’t feel we had. I mean, I don’t mean being rejected. I mean being a small town guy from South End and turning up in London. Did you know London quite well at that point?
[00:05:47] Oh, no, no, no. I remember going on the tube and being really terrified of being being like an Asian kid. You had fairly sheltered upbringing, right? You’d be home at a certain time. You could go out on the weekends, but, you know, come like ten, eleven. Your mum was finding you. I mean, my mum would stay up. Until I came back home, so coming to London was a real shock, but I really enjoyed university, I think it was great. What a good bunch of friends. I’m still very close with and I think it was a big, big turning point. Gave me a lot of confidence actually getting into university.
[00:06:20] So did you go nuts when you went to uni having that sort of I think your upbringing was probably similar to mine. You know, there’s that protective Indian instinct of your parents. You said obviously your mom didn’t want you to go in the paper because my kidnap, you get an automatic. And then when you had your freedom, did you go nuts at uni?
[00:06:40] No, not really. I was always I’ve always been quite a calculated individual. And I would never it’s very rare that I mean, we’ve got we guys have been out together. We hold it together. I don’t think you’ve ever seen me exceptionally intoxicated. So I’m always a very calculated individual. I mean, I had fun. Don’t get me wrong, but never went to crazy.
[00:07:00] So as a Dental student, did you find that you were then good and you know, you said you weren’t the top kid in your class as a as a as a student, as a Dental student. Did you pick it up or not yet?
[00:07:14] You know, I found the practical stuff easy. Practically the work with the hands was easy. I could see something once and it wasn’t a problem. The academic side. I had to work hard. I would say I was working harder than my peers to get the same results. I don’t think I excelled, but I think I did enough to go under the radar. Basically, that was my thing. Just getting get the degree, get out. And and that’s the advice I give to all the young Dental is listening is you don’t need to be the best of the best. You just need to get in. I get out, get that beats nobody cares if you go first or on honours or a gold medal or whatever. I mean well done if you do. But I don’t think it has any impact in your long term career.
[00:07:55] I mean, you’re quite right. Some of the some of the guys we’ve spoken to in a bathroom is right. He said he wasn’t great and Dental School and Darwiche that he was almost almost didn’t get through Dental schooling. So it sounds like all of you cats become in-plant guys, pretty much all competition. That’s what it is,
[00:08:17] A hole whole other way.
[00:08:19] Like you had Milada New Years.
[00:08:20] Ah, yes, I did. Yes, I did.
[00:08:23] And you were close then as well.
[00:08:25] You know, Millette and I weren’t that close at university. He was it wasn’t around a lot because he was deejaying and emceeing and he’d come in and do this bit and then he disappeared. So socially he wasn’t there. He he was well known for being the Joker. He was well known for being the guy. He dressed up as Aleg a lot and came to like events and stuff. And and then he’s probably got to kill me. And then I we we became very close when a good friend of our John Paul, who also qualified with us, was getting married in Malta and then Milan and I went together with a room and all that sort of stuff. And then we just got along really well. And then since then, I’d say he’s one of my closest friends, then closest, closest friend.
[00:09:07] So did you start thinking at that point planning out what kind of career you were going to have? I mean, we’ve spoken to other people who have parents who are dentists and, you know, how much of an advantage that is when you’ve got someone to go to with a question, for instance, just from that very basic position. But, you know, what were you thinking back then when you think you’re going to take over your dad’s place? Were you thinking you’re going to do something different?
[00:09:31] Implant’s so my thinking was I would qualify. I’ll take over Dad’s place. I would work three days a week. I would play tennis and golf and go skiing, have an easy life. I would drive a Mercedes. Being Indian, I wanted a Mercedes and that would be it. That would be me done. And but I never intended to do any postgraduate. Never, never intended because I didn’t like being examined. I didn’t enjoy the university sort of regulated learning that we had to have, you know, because I’d question everything and they’d say, do X and Y and I’ll say, why? Why don’t we just do X, Y, Z? It’s easier, it’s quicker, it’s smarter. And I always had a financial edge. I would always say, why are we doing this? How much are we charging for this? How would we do this? What’s the hourly rate? I was the one who was asking in the lectures. So if I do this procedure, what kind of hourly rate should I be charging? What do I need? The lecturers used to look at me like I was a nut case on at VTI. I remember one VTE lecturer called me a cowboy because I turned up in a fancy car that I’d managed to pay for by doing day trading in the stock market in the fourth and fifth. It used to bunk lectures and go do day trading. And then he called me a cowboy and I was like, why? And that was the thing that really annoyed me was why should I hide success? Why? What’s the reason for? If you want it, you don’t need to hide it. And it took me a long time to get that into my head. And I think that’s what you touched on before to me. If you’re successful and you worked for it and if you like X, Y, Z, there’s no harm in having what you want and being happy for yourself. I think rewarding yourself and setting goals are really, really important, especially in the profession that we’re in. What was what was the
[00:11:20] First and second of that?
[00:11:23] So I qualified and I had about 40 grand. And then I worked as a vet for six months and I saved up about 50 K being a complete moron, I thought, I’m going to buy a Porsche 911 is what you do. So I walked into the Porsche dealership and I and I look I mean, I look quite young, maybe not anymore, but back then I looked like a kid. I walked into a Porsche sent to East London. And I remember the sales guy called Brian Jones. I still talk to now and I’m poking around the 9/11. And then you had, like, you know, the little paper brochure of the cars and you’d looked at it and you’d highlighted what you want and you’d read and you knew every option. And I walked in and he said, Can I help you, young man? Is your father with you? And I was like, no, I’d like to buy Porche. And he looked at me and he goes, What do you do? And I said, Oh, I just recently qualified as a dentist is I step into my office and talk to them. And and I remember I turned up everyone in VTE was turning up in three or six and all that sort of stuff. And I used to rock up in the nine eleven and being a complete douchebag, I used to park it right out the front of the lecture theatre because I thought I was a clever guy. And that’s when I understood that if you are successful Asian guy as well, let’s not beat around the bush. You will get flak for it. And I’ve been used to that ever since. Ever since I’ve been used to it.
[00:12:48] So interesting. We’ll get back onto that because, you know, we’ll talk about social and all of that. When did it switch from being, you know, the guy who used to do just enough to get through to the guy who’s done more degrees than Brixham? I mean, it’s like you’re constantly getting a degree and, you know, always looking for excellence. And when did that switch happen?
[00:13:16] I tell you what happened was I did my VTE. I find it hard to get a spot because my dad was a vet trainer and he’d stopped being a vet, trying to. But all the other trainers around Essex knew him and none of them wanted me because I thought I’d be a bit of a problem. If your father’s a vet trainer, they couldn’t pull the wool over my eyes and I got a vet position and I wasn’t very good at taking time. I mean, I couldn’t take teeth out to save my life. So on a Saturday morning, I used to work for my dad and he would book in the most horrendous teeth Tiko. And I’d be hacking away, trying to get these to about half an hour. Forty five minutes now, you know what it’s like. And my dad would walk in after about an hour with some old cria from my 1987 flick The Tooth Out and be like, oh they don’t teach you properly anymore and then walk out. And it really used to piss me off not because he he said that what I could do it. So I was like, right, I’m going to Max Fox job. I need to a job for a year. I need to learn how to take teeth out because this is ridiculous. And I applied for my local district hospital and I didn’t get in and I was really surprised I didn’t get in. But I managed to get into the Kings College six month rotation programme, which was like six months of surgery and then six months of restorative. And then I worked with Richard Porter and I was Martin Kelleher’s.
[00:14:43] And at the end of the six months with Martin Kealoha, Mr Kaye, who was the best guy ever? Best. Best, the two mentors I have, mentors I’ve always had with my father. And after the six month rotation, he sits down and does the interview. And people used to crap themselves because you’d sit down and he’d say, what do you want to do? And somebody says, I’d like to end the downticks. And he’d say, No, you can’t. You can’t do up. Sorry, just become a general dentist. Or somebody would say, I want to be president. He’d say, no, you don’t have the talent for that. I’m very sorry. You can’t do it. Just don’t even bother. So I sat down and I was like, he’s like, what do you want to do now? It’s not all going to get Jack here. It’s I was like, I would like to go into dental implants. And he said to me, good, because I think you need to specialise and do some postgraduate, your your you have a good set of hands. OK, fine. So I phoned up these two men and I was too late to get in to the Eastman post graduate programme. They only offered me a masters in prosthetics for a year. So dentures for a year, like the least sexy part of dentistry for a whole year in the property, not the CPD and the hard core. And multicolour, my dad were like, you know, just do it. You don’t have a job after this. You might as well just get on with it. So I went on and I did that and it was the best thing I ever did.
[00:15:58] What was that? Was it like a full time programme? Hello?
[00:16:02] Yes. So we yes. Basically, they they call it the The Widowmaker because you’re there seven days a week. You don’t work. You never leave. I sleep in the lab and all sorts of crazy stuff there. Seven days a week. You see patients you would have like a ham journal club. Right. And you’d have like seven PM journal club. Then you’d have to do a master’s thesis at the same time. It was the most hardcore year I’ve ever had. But you learn so much from it, like so, so much.
[00:16:33] But you rose to it didn’t it didn’t break you you like it made you you decided that’s what you like now. Education.
[00:16:40] Yeah. Yeah. So for me it was a question of I’ve decided to do it and my dad’s famous quote was like, just get on with it, just do it, stop procrastinating, just do it, don’t complain. Why are you complaining? Just do it. Get on with it. Don’t say to me you’ve got so much work to do, you’ve got so many lectures to read or whatever he goes by the time you’ve complained, you could have actually started doing it. So that was it. Just gone with it. Head down, carry on. And that’s such a fantastic team, these men. And unfortunately, a lot of the consultants and people who we worked with have now retired. But yeah, it was a real special place. I really, really enjoyed my time there. I wouldn’t want to do it again at this stage of my life. But it was it was impressive. And once I did that, I applied for the machine implants that guys now guys only took four people every two years and they must have had like a thousand applicants or two thousand applicants. The reason why it was so popular this was the Masters and Implant Dentistry guys was they provided all the patients.
[00:17:43] So you turned up you had restorative cases, employment cases, not like the implant causes, which we run now where dentists have to bring their own patients. You know, they have to ferry them over here. It’s really hard to get those cases here. It’s all paid for by the trust. So you additional implant patients, you know, so, so good. So I didn’t get into that programme. I go in because somebody flunked it. Somebody couldn’t get the visa to come over or somebody comes the phone me and said, look, you’re the first person on the list. Do you want to do this degree? So I was like, oh, God, I’ve just done one master’s. Am I going to go and do another master’s straight after? I must be insane. So again, with advice from everyone else, I will just do it as a two year part time programme. So I just jumped in and did it and that kind of made my life. If I wasn’t doing implant work, I wouldn’t be where I was today. No chance in hell, never.
[00:18:36] So we’ve had the Paul Palmer on the podcast. He teaches on that, right? Yeah. Yeah. And he says it’s not running anymore. That’s a damn shame because several of you guys I know Zachy, too, came from that programme. But so what would you say to a youngster who wants to get into implants? Would you now say MASC or would you say go find some courses, long courses, short courses?
[00:19:06] It’s it’s a hard one, isn’t it? What I’d say is, where are you in your career path? Can you do surgical? Can you take teeth out? If you can take teeth out, then consider implant work. If you can’t if you got that whole in your repertoire, you need to plug it restrictively. Are you competent? And then it’s a question of doing a course and then finding a mentor the mouthes that are out there. I don’t have enough experience of them to comment on whether or not they’re good or whether or not they’re bad. But I know that there’s nothing as good as the guys programme anymore. I mean, you have people getting messages from certain universities only doing like five implants or something, and we must have done twenty, thirty loads. But you need a good mentor. So some of the guys who I work with now did my course mind. And of course I still mentor them. And it’s nice to see that they’ve progressed. But he’s taken three, four, five years. So it’s a really slow burn. But you have to be all it. You can’t be doing implants and then also be doing this and that. And that implant is the one where you just need to dive in and really go gung ho into it. It’s it’s a hard discipline, but the rewards are very good because there’s not enough dentistry. And to me, to any youngster, I wish I would only be a youngster to any like young younger dentist. And this is from the financial side, if you want to learn, if you can open up a shop, right, let’s say you open up a shop and the shop next to you is selling coke and the shop on the other side is selling Coke.
[00:20:35] Why are you going to open up a shop selling coke? Only going to do is be a price war. You’re going to have to sell the cheapest Coke Pakhtun if you are a dentist. Why are you learning Invisalign, Botox, lip filler composite restorations when every other dentist is doing the same thing? Why don’t you offer a different service? So who’s not offering anything? And it’s hard to come by nowadays and implants. So if you differentiate yourself from the early days, your market share by default would be bigger. Because if you’re in a town and there’s 10 dentists incompetence in one dentist implants, guess who’s going to be the busiest guy? And then you can almost set his price, right? So that’s what I would say is the speciality that is the least service in your area. And then go and implants, I think, is is an amazingly rewarding area of dentistry to do it. And I would like more youngsters. And I think definitely we need more women in dental implant surgery because those even women and Implant Dentistry Foundation and we had a female president of the Aidi. And I think it would be great to have some more diversity in implant industry. I’m sick of going to implant conferences and just seeing bald heads in the audience and present company excepted. Is this all you get is another go
[00:21:56] And this your room? Is your practise now limited to implant dentistry? Hello. Do you do all the bits and pieces?
[00:22:03] I’m I’m getting there very limited. So I have a few other bits and pieces that I like to do. Just because I’ve had training in various stages, about 80 percent of my work is implants. I’m looking for another dentist, fully private to work with me to just do the basic restorative stuff so I can just do the the surgery. Basically, that’s the plan at the moment.
[00:22:25] And then on the implant side of things, are you sort of a same day kind of guy? I hear that this is like quite a big trend or, you know, some dentists to believe in that philosophy and then some dentists or surgeons who sort of believe more on a on sort of the longer sort of delayed loading protocol. What would you say to that?
[00:22:46] It depends upon the case, depends on the patient. I mean, to put a patient through a same DLT is quite an ordeal. They’re pretty messed up by the end of it. I know on on the shows and everything, they get their little glass of champagne and they are trying to drink it. It’s it’s not it’s not all roses. Right, is you need a pretty hard patient for my default is delayed. But now with the implants that are getting better and better, do we have an onsite lab as well? We do do the same that it it’s also patients needing to pay for it. Well, because it does jack up the cost a fair amount. And if we get patients who are paid DONTAE compromised, etc., sometimes it’s just not we’ve been there, have been burned by it. You pick your battles, you know, so some people, you do it and some people you don’t. It is variable. But I’m I’m open to anything.
[00:23:34] But it’s funny. Paul Thomas said exactly the same thing. All depends on the patient.
[00:23:40] Depends on the patient, and I think when you have those patients, you keep for life. As for large implant patients, the ones you do one, two or two to three pretty, they can go elsewhere, etc. But the four large cases, you keep them for very, very long time. So they’re sussing you out. And I also them out.
[00:23:59] Now, what would you say is what does it take to be a great implant surgeon
[00:24:05] Need to suture properly? That’s the one thing we struggle to teach is how to suture properly. And I’ve worked with Specialist Periodontist. I’ve worked with Allsorts, and they couldn’t suture properly. You’ve got to practise, practise, practise. Aside from that, it’s having a good restorative background, having good surgical skills and just being competent. Planning things properly and having really good patient communication is the main thing which is so hard to teach. Right? Talking well to a patient and getting a patient on the side who’s right. Right. And you said that, you know, I just don’t care what you do here. I just care how you make them feel. Very true. And we’ve all seen work where we’ve thought, oh my God, that work looks so crap. And they put it on Instagram and you think, oh, my God, these teeth look horrendous, but the patients love it. Why do they love it? Because they love the dentist and the dentist giving them what they want. So it’s the whole experience. And for me, it’s always just sussing them out of the consultation process. And do you exude confidence and do they believe that you can give them what they want? And that’s the key thing, which is so hard to teach. Some people just have it and some people don’t know
[00:25:19] What’s what’s the outlook. Maybe forgive me for not knowing the answer to this question yet, but we’ll see what’s the pathway? I guess you start with maybe a couple of, like, single lower tooth, then eventually an A.. And the soft tissue situation, when does it get to grafting sinus lift for all and for what’s the other one? The long one that goes in the. Terrible, terrible, terrible. Yeah.
[00:25:49] Yes, zygomatic Østergaard, is there a
[00:25:51] Pathway set in that sense? I mean, like how far how far along are you on that path?
[00:25:57] I think we’re all still learning. I was on a surgical crout soft tissue grafting course on Friday with Hatam. I think you’re always learning. You know what I really like. And my niece is a.. Cosmetic implant, doing single central incisors, doing a few teeth. So getting it to look so that people can’t tell it’s a fake, too. That’s where I get my soft
[00:26:20] Tissue around that. The fall of the eye.
[00:26:24] Exactly. So my thinking is putting a picture up on screen and saying to dentists, which one is the implant? And if some of them get it wrong, then is very real. I’m on cloud nine. Right. I’m loving life. Right. My ego goes through the roof. But the four large cases I like because it’s proper surgery and there’s lots of blood and the nurses like it’s a big challenge to the patient, but the pathway is so variable. I mean, most upper molars that you do usually need an internal sinuses or L.A. cases. In my opinion, most of them will need some form of guided bone generation. So you can get the simple primally cases where you just put the implant in and there’s nothing else to do. But a lot of times they need a bit of extra work, an extra bit of Build-Up, or they need sedation or they want to one or they need to do this. We need to whip out wisdom tooth at the same time is you don’t always get that one in that one implant case, you say I need this one lower molar tooth sorted and then that’s it. You don’t get those very often,
[00:27:22] You know, about the practise. Well, what did you bring to the practise? I mean, I noticed you did the massive sort of overhaul of it kind of soon after. Well, when was it? When I came when I came to the practise, I was amazed at the size of that thing. I mean, it’s it’s the size of maybe Prav used to be the size of maybe three practises stuck together just keeps on going.
[00:27:48] So we were really lucky that the building next door came up for sale. And I was I was treating somebody in the council. I was doing a mayor or something. And I said, you did. The building next door was coming up for sale. And so we bought it and it was really dilapidated. And we spent over a year just joining the two buildings together and had this vision. And we had some really good designers. And I said, if Iron Man had a Dental practise, what would it look like? And that’s kind of what we went for.
[00:28:18] Iron Man, Iron Man, the cartoon, the the Disney Love.
[00:28:23] Tony Stark. Yeah. See, Prav knows what he did.
[00:28:28] I’m telling you the other.
[00:28:30] I am sorry, but I thought you meant Iron Man running Iron Man. That thing, the traffic stress. Then we got go. Sorry. Oh right.
[00:28:43] So yeah. So, so we got that bill and yeah we learn a lot and it was nice because in that clinic I have everything I could possibly one of every toy. The surgeries are set up for me. And you know, interesting. Before Prav came online I was looking at dental practise that I just had a bit of being renovated, etc. And I always look at these dental practises and the waiting rooms are beautiful. They’ve got all the lights and the greys and the gold trim and all that. But then they show the surgeries and the surgery, the sheet, because they’ve not been designed by a proper clinician, there’s not enough room the too small. I can see that there’s not enough room between the chair going back and the wet top behind the dentist. This is where all these companies, when they design it, they give like one point two metre5s behind the head of the chair to the countertop. And it should be one point eight, one point nine metres. I look at, my God, guys, these people are not clinicians, right? They don’t know how to design the surgery properly. So when I did mine, I made sure that it was designed by a clinician so that it was efficient. The workflow was there. It was just so that’s why I’m so in love with my clinic, because it just works properly. And it’s something where I think maybe I should do like a design consultancy, just design and say, guys, look, you can’t have that there. You’ve got to move this here. When you turn around to get your excavator, you’ve got to do a 180 degree turn. You should just be doing a thirty degree turn right. And the other thing is that it rose and the trio says, no, these dangerous as we keep buying the damn things take up so much space, we’re going to park them. Right. It’s like having five cars in the driveway. You go park them somewhere. Right. So I think said you design is something where we are lacking at the moment. You know, I think there’s a real opening for a disrupter into the market.
[00:30:31] Yeah. Although, you know, space is at a premium sometimes. Isn’t that I mean, those are the practise in Bristol last week. And, you know, they’ve just got spaceman. The rooms are so huge that that building in London with. Been like a six million pound at this. There’s no way you’ve got the space is a problem.
[00:30:52] Yeah, true. But then when you look at these this and you can be a bit more ingenious about the design.
[00:30:57] So I’m sure you see it sometimes.
[00:30:59] Yeah. See all the time. But yeah, it is what it is.
[00:31:02] I mean what you said interests me because a lot of times people used to ignore the waiting room and it seems like now it’s kind of gone full circle with the everyone understands the waiting room is very important. The the back in my day, people used to just get this funky chair. And the way to me was to look terrible, like, yeah,
[00:31:20] It’s the whole aesthetic Instagram generation right now. You see, Dentists’, you’ve actually got a banner and they take pictures of all the patients with the little Invisalign back and they stand in front of the back in the banner. Right. How things have changed. Yeah, it just like before they GP now they have like those flower wars that these girls take pictures of when they go to, like the fancy London restaurant. And we have like neon lights and all this. And then the dentist takes a photo with the patient in it. So it’s changed completely the way we design it. And I think it’s great that we’re becoming a lot more aesthetically driven. And as a result, the design of the surgeries has changed. But I don’t want people to lose the importance of the clinical aspect of it. So.
[00:32:05] So when did you start switching from Mr Mercedes’s to Mr Racecar Driver? When did when did the whole car things become costing?
[00:32:15] So I’ve always been mad on cars when I was a kid. You can ask my parents. I just had like toy cars and I still have the toy cars and now my nephew plays with the toy cars that I used to play with. As always, into Porsche was my dream car. And I remember watching Bad Boys when I was younger, like when I was doing my level. And Will Smith was just the coolest guy. You had that 9/11 turbo. I thought, wow, one day. And that was my dream. And it just kind of developed from that as I was doing better and better. And I always wanted to raise my goals. I was also taught to say, look, just because you have this, you need to go after this. Once you get this, you go for this in suits. When Harvey Spectre goes like this, like this, I like this. That probably spoke to me. So I’ve always tried to develop. And the whole thing came about when I used to watch Formula One with my dad, used to watch Michael Schumacher just win. Everything in this red Ferrari would go without only wheels, just used to win everything. And it just kind of got ingrained in my head.
[00:33:13] And my dream was to become a racing car driver. And I had a patient. I’m a very wealthy patient. He used to race customs and he said, you know, why don’t you come along and try to try to out really loved it. And then financially it was viable. So I just took the plunge and. All right, well, become a racing car driver. We start racing. I got my backside handed to me in the first year because I just thought, yeah, well, I’ve done track days, I’ve got fancy car. I’ll be amazing. I’m really could drive. I play Red Racer and Cicarelli as a kid. I’m wicked. Right? Go to the race. Got destroyed and then it took me two and a half years and I don’t know how many hours of training, simulator training, personal training, having a similar home walking race tracks, learning the cars, having a full team around me. And then we started to do well. Then I was in the top ten, then in the top five, then I was on the podium. Then I got asked to race with other teams, did endurance racing. Twenty four hour racing raced all over Europe. It was amazing. Was actually amazing. What’s the what’s
[00:34:15] The process of getting involved in in racing in terms of, you know, somebody wanted to stop, start and get involved in it? What’s the process?
[00:34:23] You just need loads of money. It’s such a money pit. It’s the it’s a scary. So there’s so many race theories out there. The Katrín race series is very good because I came from cause I just unstable. There’s no way there’s no power steering. It’s all manual. You don’t even get a limited death in the first cause. So the car itself is about 30 grand. And then if you really want to comment for the whole year with full team support, you’re probably looking at about another 30, 40 grand on top of that to cover it since about, what, 60, 70 grand for the for the year. And then obviously in the second year in the third is a bit cheaper because you’ve got the helmet, you’ve got the gear. You don’t need to buy the car, but the car gets upgraded every year. So it is it’s like having two kids going through private school, which is what I’m told. I would have not. I’m you guys do that’s a cost implication behind it.
[00:35:14] Which brings us brings us neatly to the why is it you’re not like every other good Indian boy when it comes to getting married early and having kids? Whoa. Oh, that’s what what is it? What happened? It was about you because I’ve come across a fair number of of of of young boys who just almost programmed to follow the parent’s position. Something kicks in.
[00:35:41] I’m a black sheep the of our black sheep. So I would. Say, you know, in your sort of mid to late 20s is when that sort of magic happens, you meet the girl of your dreams and you settle down or see your you’re both happily married. And in my thing, I was doing NMC. Then I did another MASC. Then I was doing an also programme, then I did an MBA and I think really hard degrees. These were not degrees where I would give it everything. So some of my friends wouldn’t see me for a year because I was a study. And I would say to people, you know, I sacrificed a lot for the academic credentials. And I think part of that was probably relationships. I think they all probably struggled. I mean, if you don’t, you’re going to see me for an hour on a Sunday and I’m falling asleep. That’s not really a sustainable relationship. Right. And then plus, I was pretty much not broke. I mean, my father was made sure I had a roof over my head and etc., but I didn’t have any money, really. I was I was working I was doing out of hours emergency service for Essex and I would get 400 quid on a Saturday to do it. And I do like two days a month or something. So I didn’t have boiler money or anything. So it was it was hard. And yeah, I sacrificed all of that just to get to where I am now. And I think now, you know, things have changed. And I am in the position where, yes, I think settling down is something where I’m able to joke about it. And I know my dad active on Facebook with everyone likes to take the Mickey, etc.. But yeah, it is it is something which let’s say it’s a work in progress. So what do you what do you
[00:37:26] Look for in a woman? No one’s listening.
[00:37:33] You know, what I look for now is somebody who’s kind of a good person and who understands that if you’re with somebody who’s very much committed to their career, there’s always going to be allowances made on my side and on her side as well. So you need somebody who’s who’s got some understanding. I mean, we treat a lot of older patients, right? Implant dentistry, just old patients. All my patients are all none of them use Facebook, Instagram. They’re all 50, 60, 70. Whereas if you look at the cosmetic guys, if you look at Rhona Simon, all those guys, all their patients are young. So we have a complete dichotomy of who we treat. And I see them and a lot of them coming together and say, look, you’ve been married for 34 years. What’s the secret of a happy marriage? And they all say compromise, it’s compromise. You have to work at it and it’s always compromise. And I think once you get close to 40, your habits and your patterns are pretty much ingrained in you. And it’s quite hard to become to adjust your life a little bit. So I think for me, I’m looking for somebody who would have that ability to compromise by want to travel and do the things I do and also take into account that I do do crazy stuff every night. I wake up soon to be a racing car driver, wake up. So I want to become a pilot. I want to do everything. I want to do this. I want to be go to space with Mr Branson. It would be nice for somebody who can humour me and take all my craziness into account is what I’m looking for. You guys know anyone mean I
[00:39:09] Tell you,
[00:39:10] This year in
[00:39:12] The studio we discussed a bit before about being out there with the Ferrari’s and the watches. And you know that I see you know, you’re kind of a bit like what’s that thing Chris Burrows, as MA might do to the Dental audience, that there are these people who love you and then there are people who don’t love you. And I break it down. I was thinking about it this morning. There must be a young group of dentists who want to be like you. Right, because who would want to fly planes and drive Ferraris and all of that. And then there’s this other group and I guess a small group of older than this generally, correct me if who don’t want younger dentists to want to be like you. What’s going on? What’s what’s what’s the story? And tell me about that. I mean, we discussed it with Ronan as well. So the trolling side of it. And it’s difficult to manage, right? Difficult to manage.
[00:40:10] Yeah. I think, you know, I started to experience it from VTE days. It’s always a question of the more successful you become, the more people who will dislike you for it. It’s because not because of what you’ve achieved. It’s because you achieving that reminds them of what they haven’t achieved. Right. I like to think and one of the key things for me is when I usually the icewind parties or will be doing another one soon, hopefully. One of the things was if I was really disliked for being who I am, they wouldn’t be three hundred and fifty people turning up to an event that I run on my. But you’re right, it’s a very small area of clinicians, older clinicians, not younger, older, who troll anyone who is a bit of a maverick. And I know I have had it. Rhona’s had it. Simons had it. Sheraz has had it. We’ve all had it. But I like to think I was the first pioneer of the original trolley, trolley and trolley. And then why is it is it is it because I’m brown and I do. Well maybe. But some of the trolls are Asian as well. Is it because I never respond to them? I never give them the satisfaction. They’ve never got anything out of you.
[00:41:27] Sometimes you sometimes take something on your stories, though. I seen that.
[00:41:31] Yeah. I think sometimes I might get the odd kind of when when I don’t get any trolling, I think, well, maybe I’m not significant anymore. I need to do something else to wipe them off the right actually. Exactly. Upsets me. I feel, I feel insignificant but it’s ok.
[00:41:46] Ok. Do I hear you. I hear you. But I just, I just see it as my duty to put this, this idea over here that I think anyone who listens to this will think of you as this is why I wanted you as a sort of a thoughtful, intelligent, considered person. But if I flick through your Instagram or whatever, whatever it is, you could come across as the do to keep showing me Lugo’s Jeremy Ferrari, Rolex, Richard Millais, whatever. And so, by the way, by the way, by the way, I don’t know how I come across and what we don’t know how we come across. But what I’m saying is one of the way you come across is different to who you are. Yeah. So are we going to. Is that the reason for it, that the polarising content.
[00:42:36] You know, the the thing is, I like cars, I like watches, I like all those things and I run to social media accounts. I’ve won Dental one, which is all teeth and all that sort of stuff. And then I have one personal one. And over the years, the personal one has matured slightly. Right. But we all have goals. And when you achieve those goals, you share that goals. And the great thing is my parents, my mom, my dad, my friends, my family was very proud of everything. And to me, I would like to think from if you if you rewind it the short if you said to the 12 year old she was very chubby, had no muscle mass, got bullied when he was younger, had a stammer that, you know, in your late 30s, you’d be doing this, this and this and you’d be going and you’d be doing the Gumble Carelli and you’d be being on this TV and all that sort of stuff. I wouldn’t believe you. I’d say you’re lying. There’s no way you could have it. So if I share all of that, what I’d like to say is to the young guys, gerente guys and the Indian guys, so you can achieve anything you want as long as you’re willing to work really, really hard for nothing comes easy. But you work your arse off. And if you want to buy a Ferrari, you but if you wanna buy a four million pound house, you buy four million pounds, it’s entirely up to you. So for me, if it helps one kid believe in himself, then I don’t give a shit or these heightism because they’re insignificant to me. And as I get older, the more my thing is to mentor and help the younger generation be the younger Asian generation achieve and not be ashamed of their achievements. Because when people meet me, you know, when you meet me, I don’t get high on the list I asked you for. That doesn’t even come into the question right now.
[00:44:31] When you meet me online. That’s how it feels.
[00:44:34] That’s the that’s how it is online, right? Yeah, that is on luff. And I think also, listen, you
[00:44:41] Don’t have to justify it. You don’t have to justify it to me. Look, we’ve got Prav sitting here. Yeah. His own brother was was brought up in the same house as him. Yeah. The same parents, the same situation. And Kailash is more like you and Prav is nothing like you guys give the exact opposite.
[00:45:00] If if if you flick it around to Kailash. Right. Kailash was somebody who did all that before me and I used to see Kailash. I just think, wow, look at this guy. He must be really good. And then he was only once I met him and he came to one of the practises I went to and he gave a course and I saw him do a prayer. And I think he’s actually really good. Not easy or fancy. Fancy, but the guy can cut teeth, you know, he’s really shrink. And then I partied with him once and we got we got really drunk. And I think I had is like really fancy jacket, took it by mistake or something. But these really sound gone and it just goes to show that even I can have preconceptions about someone. But until you meet them, you don’t realise. And for me the amazing thing was just how good he was at dentistry. I mean, a really skilled set of hands. So for me, it was almost like a benchmark, I guess. Is that never much anymore? Yeah, it was almost like a bell.
[00:46:00] He’s too busy sticking implants.
[00:46:03] Yeah, I know. Yeah, you’re too busy.
[00:46:07] Tell us about your MBA. Do tell me. Tell me. Tell me where it came from. We didn’t cut a lot of the people we’re talking to saying I want to do an MBA,
[00:46:14] You know, is the hardest thing I’ve ever done was an MBA. If I fall, Eastman was hard, MBA was hard to another level. And I got into it because I always had the financial side of things right. You draw the financial side, would always look at profit loss accounts, etc.. And then my dad, we read the F.T. and see what he does is he reads it on a Sunday when I’m not at home because I’m getting home in my parent’s place of two nights a week. On the time I’m in London, he put like the paper on my desk. I need highlighted like some NBA fare. And he said, you know, you talk about doing an NBA is an NBA face. You go to it. So I went to this NBA and got chatting to them and Harvard University were there. You could do like a distance. Of course. I remember sitting down with the Harvard University women, and before I even sat down, she said, our programme is one hundred and twenty thousand pounds. If you can’t afford it, I suggest you throw it is like nothing, not even a hello and nothing. Just one twenty grand. You can’t afford it. Magariaf, you look poor you capital. So then I went to the. OK, fine. Yeah. I’m really glad that because go that. So I went to the Imperial College people and the guy and the girl was so nice and they were talking about my dentistry and this that and they said look we really want you on our programme. You need to send in a video recording of.
[00:47:35] Yourself as to why you want to do it, so I did this video recording, which is really cheesy centre in and I’m still in two minds sent in. And then they they accepted me and offered me a scholarship for it is about 40 grand to do an MBA and it was subsidised. So then you can’t really say no, you kind of got to do it to two executive MBA started it and then see Sharma was on it with me as well. Totally out of the blue coincidence. And then we did this MBA. And I tell you what, the problem with dentists is we’re so obsessed with this, so obsessed. We don’t think about the big picture. And the MBA gave me an understanding of the bigger picture of the world. And we looked at innovation. We looked at how to be an entrepreneur. And also so interesting looking at profit and loss accounts, understanding what the corporate world is about, understanding how the credit crunch happened. It just kind of changed my mindset. And it was hard. It was really we had really difficult corporate finance and accountancy modules. I had to get a tutor to come in on the weekend and go through with me because I was so dumb I couldn’t do the maths properly. I could count the money. But you can’t do the maths. It was so hot. So, so but to this day, again, it was an amazing thing to do and I’m so, so grateful for having the opportunity to do it. And I’d recommend it to any contacts.
[00:48:56] Did you did you make contacts in the world outside of the world of dentistry?
[00:49:03] Yeah, loads, loads and loads and loads, because everyone was from a different aspect. You had people from oil and gas, people from the media, people from all sorts of contact wise. It was fantastic. And also when you go to like an event or a dinner party or whatever, and you meet someone and he goes, Oh, I work in MNM before Eminem, he makes chocolate sauce or whatever. And then, you know, he doesn’t mean Eminem means Eminem. He was seven, eight. And then now I’m like, wow, you work in him and tell me about this. And it just kind of broadens your horizons a little bit. And I think it makes you a better dentist because your brain sort of works in a slightly different level. Some people can do that without having to go through the didactic teaching. The good thing about the Imperial College one is we had so many hands on and practical experiences. It was amazing. We do negotiation. We see all sorts. And I excelled at negotiation. Apparently that was like my thing about I was really underhanded and lethal in negotiation and get told off. But everything I’ve come across respect, if you’ve had to see
[00:50:13] I would say, is to be in a place in your life. I mean, for me, I could do all this stuff because I don’t have a life. I don’t have a kids. I come back to my place. There’s no one here is dead quiet. I can Sunday’s is my day of study is Jim what’s the Formula One? And studied the whole day. I have that benefit. If I had a wife and a kid and everything would be really difficult to compartmentalise the time. It’s if you are going to consider it, just be aware.
[00:50:41] What are the key takeaways from you from the MBA? Anything changed in the practise conversations with patients? Was it just sort of more organic and holistic? I mean, can you can you step back now and say, actually, you know what, the business has changed because of this, this and this, for example? And are there any sort of key tangibles?
[00:51:01] Yeah, a few things were don’t be afraid to talk about money. Right, so many dentists that would be like, well, it’s going to cost them 13000 and then put their head down, some dentist won’t even talk the money. They get the t shirt for me. More now. Now that we went through, the whole negotiation module changed. It’s so easy for me to talk about the money side of things with patients. And we all have our own way of doing the way about what’s your USP as a dental clinic? What’s your USB? For me, it was always a question of if I was doing implants, I’d say, look, and I’ll intro myself. I’d say, my name is PAMA. I qualified from the U.K. I’m a dentist by master’s degree in prosthetics and implant dentistry. This is my practise and I’m planning on being here for a very long time. So if you have any problems with your implant work in 10 years time, I’m still going to be right. And it was just trying to put yourself in the patient mindset. What are they concerned about? They’re not concerned about that one point, two mil margin when you’re not they’re just concerned about what’s going to happen in the future. Are you going to guarantee stuff with them? We’re going to be the ones that fixes. But the other thing was analytics, looking at data. So working out how much we spend in the practise, working out who comes to the website, who leaves the website. If I make a post about implants on my Instagram, how many more consultations do I get? If I put a surgical case on my Instagram, which is aimed at dentists, how many more referrals do I get the next week? I’m just looking at data and understanding that data is key for any sort of business and there’s loads of other things that that we don’t. But those are probably my two main takeaways from.
[00:52:43] Did you do your MBA thesis on something social media as well?
[00:52:47] Yeah, so mine was the industry and social media. I was lucky because because I’m one of the admin for for D was able to capture a lot of data from dentists. And it was a questionnaire based thesis looking at how do dentists see social media. And then we flipped it to patients. How do patients perceive dentists, social media? How many patients search for their dentist on social media? How many patients search for your private Facebook profile on social media? And the numbers are pretty impressive. I’m giving a talk on it with Philips and FMC next week. Tuesday. It’s my little plug.
[00:53:27] Let’s go. Let’s go. You must get approached all the time by manufacturers, implant companies and toothpaste people. And especially I mean, I don’t know if to going a little bit more quiet, I’d say now. But back when you were peaking, when you were Peking Duck a couple of years ago on Social, but you didn’t get involved with that many different companies, but now you’ve got yourself involved with this indemnity thing. Does that us about the whole thing? And and.
[00:54:00] Yeah, yeah, I was doing a lot. I think my programme was, first of all, to become known, to become known in the industry. And I went through a period where early on in my career I got in trouble with the GDC, had some disciplinary issues. That was about 16 years ago, I think. And then I went quiet for a little while. And then after that, I thought, you know, well, we’ll make mistakes, let’s bring ourselves back up. Started developing, Louise, from Mannan, who, you know, we still work together, and she helped build some brand recognition for me. And over lockdown, I set up a health care consultancy firm. And the idea behind that was to try and leverage what I know about health care with the MBA, to do work with certain Dental companies or health care companies, be it pension funds, be new products coming to the market, the Internet offerings, et cetera. And through that, I go approach to be on the executive committee of a new indemnity product, and it’s called the Dental Defence Society. And you’ve got big names. You’ve got Professor Stephen Dunn, Lauren Birnbaum. And we basically designed because obviously on defo on for. And despite that, this is one of the biggest questions we get is who’s your endowment, which indemnity Friday used to after moderating that forum for about twelve years. I know every question everybody wants to ask. I know what people are worried about. So using that knowledge, we designed a product for dentists and it’s a really exciting offering which aims to provide reasonably priced indemnity covers all aspects. And most importantly, every case is serviced by practising or former practising dentists. And we have a really aggressive legal team. So the idea is we’re not just there to settle for the time. We’re trying to take the dentists side. And I’ve learnt a lot about indemnity through developing that package. And it’s just being launched now and it’s going to be quite an exciting few years. I think we’ll be up there in the top four or top five quite quickly. I would have thought
[00:56:09] That was a bit more about indemnity, because I speak to a lot of dentists to probably similar to, you know, do sort of high end maybe what’s considered to be higher risk work and volume of that. And the clothes that come back just to keep them protected are insane. And they’ve gone up a lot. So first of all, I guess there’s a couple of questions about the are the right standard across the board about who you go to. You’re going to pay similar. And then what about the level of protection of that?
[00:56:41] Yeah, so the rates vary immensely, immensely. And a lot of it is if you claw it back to an underwriter. Right. So if you approach and underwriter as an indemnity company, you’d say, right, we’ve got five hundred dentists and we would classify half of them as doing high risk procedures and the other half is low risk procedures. But we’ve got four thousand cases ongoing that underwriters are going to say, well, here’s your premium. Right, is if you approach the underwriter and you say we’re going to only provide cover to dentists who we prevent. So we interviewed the dentists, we talked to them. We assess their risk profile and then will apply a fee to their indemnity and we will educate them with X, Y and Z. The underwriters say, OK, that’s a better offering increase. They’ll offer you a lower rate for that person. That’s why the prices are so different, which is why the newer companies tend to be able to offer a lower level of premium than, say, Dental protection or you’ve got. Are claims going back a long, long time and the other thing is having indemnity, which is not always settling right. You need a legal team which look at Dental Law Partnership. They single handedly increased premiums for every dentist in the country because of the things that were doing. But if you look at them now, they’re quite disorganised in the papers that they submit in the allegations that they put forward. A lot of the companies are settling these claims just to get them off the books, just to clear them off. Whereas if you’re a younger, more agile company, you’ve got the benefit of actually being able to fight and look at these claims very carefully. One of the thing that shocked me is one indemnity provider was asking the dentist to write their own letters. That’s not me going to pizza, ordering a pizza. And I go go in the kitchen and make it yourself. Right. So I think there’s there’s an area for a new competitor to enter the market, which is what we’re doing. And Touchwood, it’ll go very well.
[00:58:42] Name one more time to.
[00:58:44] Dental Defence Society, yes.
[00:58:48] And what was the name USPI then? Is it that you’re preventing the dentists? And almost like I guess the way I’m thinking about my daughter’s just started driving and the insurance company put a little box in the car, so a premium comes down. So if she drives like a wolly, they’ll know about it. And so is that your version of what courses have you done, how many failures that you have, cetera, et, and you’re doing that pre-screening and then that is the right thing. Is it the fact that you’ve got a young team of lawyers who want to fight and not settle? What’s the difference? Correct.
[00:59:24] Yeah. So we have quite an aggressive legal team very keen on fighting and not settling. The organisation actually also started out by covering GPS, which I think was twenty seventeen. It was started out by some GPS who wanted to provide indemnity for GPS and now it’s just sort of evolved into dentists. And one of the things was when you have a conversation with somebody on the phone, I mean, we’re all dentists. We can we can figure out what dentist is like after talking to them for me. Let’s say if I’m with dental protection and my indemnity to do implants was twelve thousand pounds or ten thousand pounds a year, how much of my indemnity premium is going towards backing up the dentist who doesn’t write notes properly or is backing up the dentist who’s done no interest in the dental clinic? And it’s then the am I subsidising those clinicians? I don’t want to subsidise those clinicians. So our idea was we’d we’d have a chat with you and we’d say, right, tell us about how you work, what you do, where have you trained so we can get a feel for it. And then we’d say, OK, this is your premium and move from that. So I think it’s a clever way of doing it. And also we’ll run the Dental forms. We know what everyone’s dentistry is like, right? You kind of get a feel for me after talking to them. So I’m excited to see how it how it develops.
[01:00:41] Interesting. Now, let’s take us back to the GDC case. I’ve spoken to quite a few dentists who had that letter, that moment it lands my brother, many of my clients, and there’s nothing quite like it. You know, the sleepless nights tearing the world upside down, all those years of study and all hanging on a thread. Right. Terrible, terrible feeling of just just talk me through the feeling that you went through and how you dealt with it.
[01:01:10] You know, from a from a mental health perspective. I think if you are not mentally strong or don’t have a good support base, I think it could ruin you completely. I think that’s something that you need to understand, because if they’re trying to protect the public, I think they’re also mentally hurting the dentist that they investigate. And it’s almost like you feel like you’re being done for murder, right? You feel as if you’ve done your criminal when you get that letter. Yeah, it’s and it comes to these beautiful brown envelopes, brown envelopes and never see the parking. Fine, speeding fine. Inland Revenue GDC. When I see a brown envelope in the thing, I’m not know what is it. Great TV licence. Fine happy thing. So I messed up many, many years ago and got into trouble with them and had all the letters and all the stuff. And I think it, it makes you question where your life is going to go. Let’s say you can’t work as a dentist. You’ve trained for so long. You’ve done I mean, I haven’t done any postgrad at that time, but everything you planned in your life. Right. Would would shatter and is really, really scary. But I think at the time I saw Dental protection. You were excellent, you know, and I think you need that support network, which is why I think being on a on a legal team, on executive committee now will eventually be helping dentists. Having that insight into what the dentist is going to I think is really important mentally. I think it can be you can go into depression, to be honest with you.
[01:02:49] You can just become depressed and you can not want to do dentistry anymore. But I think the way the market is now or the profession is now, I think many of us will have that letter at least one point in your life. Now, for me, if I got another letter, touchwood, I won’t. I don’t think it would freak me out as much because you’ve been through it already. Right. But it’s something where I would and I’m always so cautious on, especially with social media and the younger dentists, you qualify and you think you’re untouchable. And the one thing I was warned that especially in the social media lecture, I don’t swear on social media. Don’t throw on any platform where your patients to be. You can’t be doing this. You can’t be doing that. You need to be careful as to what you say. If you have any strong viewpoints which divert diverse from the normal, need to be very careful as to how you share them, where you share them. Because Big Brother is always watching and it’s something I wouldn’t want anyone to go through, but interesting you talk about the trolls and the Mai Mai fan club, as I like to call them. Imagine 14 years later, Payman. I’m on the executive committee of a new indemnity organisation, somebody anonymously emails the organisation saying, do you know Neelesh Palmer had an issue with the GDC 14 years ago? Well, imagine imagine what level of human being you have to be to do.
[01:04:17] That’s a special kind of thing.
[01:04:20] And and the thing is, they already knew I’m not hiding anything. They already knew. They think it’s good. They think it means I know what to do. And the thing is, when you haven’t met these people who just have it in for you, no matter what you do, you kind of just get used to it. It doesn’t really bother me anymore. I think my friends, some of my friends get even more excited than I do because I think we know who it is. It’s quite easy to tell by something. You just have to live your life and just carry on. And the higher you fly, the more people will try and bring you down. But you just have to try and fly so high that they can’t even see you anymore. And that’s the ultimate test.
[01:04:57] Takes us nicely onto other errors. We ask everyone about clinical errors and Prav seems to like the one about, oh, I drilled the wrong to my hand slipped. But but I’m not interested in that one. I’m interested in something, you know, decision you made that was incorrect or after reflection, you would have done it differently. Something we can all learn from the market, can learn from the people listening to learn from touchwood.
[01:05:28] I’m not had to drill the wrong tooth to count a wrong to moment touchwood. It’s all been OK. There’s a few patients whom I wish I hadn’t treated right because my ego said and that when you say ego is the worst thing in the world. And those a few, the dentist, X, Y, Z has tried it, I’m better than them. I’m going to fix your problems because I’m the top dog. Woof, woof. And then you try and fix it and then you cook it up even more than the other guy did. And then this patient becomes your problem. And not only does it take time, it gives you a bit of anxiety. And when you see that name on your list, you think, oh, God, no, not this past. And to me, it was always a question of select your page. Don’t be afraid to say I’m sorry, Mr. Patel. Oh, Mrs. Battal, I can’t fix this problem for you, but I’ll refer you to my friend X, Y, Z up the road just to somebody you don’t like. He will look into it for you. And I don’t think there’s anything wrong just to put your hand up. That’s too complicated for me. I can’t do it. And that’s a key thing to understand.
[01:06:42] But your instinct told you not to treat this patient. But your ego,
[01:06:47] My ego, my ego said I can’t do this. You can do it. You’re the man. You can do it.
[01:06:53] Some on the buttocks. Expand a little bit on it. Don’t just a little bit. As far as you know, what was it was it was that the patient was never going to be happy, whatever you did. Personal.
[01:07:02] Yeah. So it was a TMJ case. Had had Crown’s done the occlusion was off one of the crowns to be redone. Fairly straightforward, but there’s something about her that was an edge to her that now it would the alarm bells would be going off. So I did it. And then she would talk and talk and talk about 20 minute appointment to become a forty five minute appointment. I think she would just be and she’d be telling you what she wants you to do. Right. So she will
[01:07:31] See you
[01:07:32] Always a time. And I was like, yeah, I’ve got fancy scanning machine. You know, we can digitally articulate your jaw and do this and do that. And then as soon as I put my fancy restorations into it, it’s wrong. Just it it’s absolutely wrong. It is very bad and so, so bad. And I was like, where do I go from here? Like, what do I do now? Right. Where do I go? And is one of the ones where as soon as that moment happens, your brain, your ego just goes into his little hole and then the other side your brain goes, I told you and now you’re in the the crap. Right? So that’s something that you learn. And now I think maybe every couple of months I’ll turn a patient away. I just say, look, I can’t help you go see a specialist or whatever because I can’t do it. I’m just a kid. I don’t know. I don’t know a very simple man. I don’t want to do that. So you kind of have to play to your strengths. I think that’s the key thing.
[01:08:32] Any influence is.
[01:08:34] Yeah, loads, loads. If you do enough, you get loads. I do about three hundred a year now and I’d say I probably get recently we’ve had a lot more failures on the implant groups and stuff we think is vitamin D. We think it’s cortisol levels. Stress levels are all having effects on implant success rates. Sent a few patients out for blood tests off. The implants have failed for no reason whatsoever. And we found that vitamin D problems have had high cholesterol. Lockdown has affected. I mean, we not really touched on it, but lockdown has has affected the health of our patients in a way that we don’t know and they don’t. And for implant Dental. Yeah, big, big issues, I think. And we are seeing clusters of failures where five, six years ago, no issue whatsoever
[01:09:20] On what you do as a clinician in that situation.
[01:09:25] Take it out. Send them off for bloods and then try again and nine times out of ten second time round, about one patient at the moment who we’ve tried three times, had these bloods done, had everything done, still doesn’t look, I’ve noticed an increased failure rate in penicillin, allergic patients, penicillin, allergic patients. The biology seems to be somewhat different. The oral microflora because they’ve never had amoxicillin or penicillin is different to somebody who’s had penicillin in the past. And they have a high incidence of dry socket and a high incidence of implant failure. And there is some literature coming out to support it now.
[01:10:05] Where’s the less PAMA going to be in five years time? We’re talking retired to two kids and a Tesla and then forget that that figure for career wise, career wise
[01:10:20] And career wise, buying buying another clinic at the moment. Oh, in London, expanding now in Essex and Essex nearby. There’s there’s two more in Essex I’ve got my eye on. And the owners are coming close to retirement. So one hopefully soon and the other one maybe in the next three to four years. And then basically between the three, I’ve got Essex kind of cornered. I’ve got no interest in central London. There’s too many sharks in that tank. For me, Essex is my area. I like it works well for me and to me, I think it would be less clinical because at one point I was in six days a week, six days a week clinic,
[01:10:59] Non-stop NHS and everything. I don’t remember
[01:11:02] And NHS employment. I remember you saying to me, you’ve got Kameda, this is too much. You’re stressing me out by what I’m about. You know, I had, I had a figure I wanted to achieve. I wanted to get to a level and then ease off a bit. I think I want to cut down to maybe three, three days a week I think, and have and also just concentrate on the consultancy business and more on some of the charity charitable endeavours that I’ve been involved with I think have been right. I think you’re
[01:11:30] Always blessed when you’re doing charity, but you’re always best when you’re doing charity really suits you. And it’s interesting, isn’t it? On one side, you’ve got the trolls saying, you know, Ferrari, and then on the other side, your best friend, you’re doing charity. We’ve got it. We’ve got to shut it down. But Prav always ends it with the same question.
[01:11:51] Somebody, as I know, is a long, long way away because you still spring chicken, but imagine it was your last day on the planet and you were surrounded by your nearest and dearest, your loved ones and those who you hope to inspire. What three pieces of wisdom would you like to leave them with?
[01:12:13] For life alone, no one would be you can achieve anything you want as long as you’re willing to put the working. Number two from an uncle of mine, he said to me, the more you have in life, the more humble you must become. A number three was whenever anyone asks you for help, even if you don’t know them but you think it’s justifiable, do what you can to help them. So help people where you can. And those be my three final words before.
[01:12:53] And how would you like to be remembered? There was. Dot, dot, dot.
[01:13:01] And dentistry, just it just
[01:13:03] In general, whatever
[01:13:06] I would say, he lived to his full potential because I think not exploring your full potential is a crime. I think you need to do everything you’re capable of doing and push yourself to the limit.
[01:13:22] We didn’t we didn’t we didn’t get to the bottom of it, you know, but you are that confident, dude, you do what you want to do. But that’s not the picture you drew of when you were a kid. Something clicked. We didn’t get to the bottom of party. Going, go.
[01:13:40] Finally, we have 30 days left and you had all your house intact. What would you do for those 30 days?
[01:13:48] And I’ll spend I think I’d probably have to liquidate every asset so I could set up some trust funds for my two nephews and spend as much time as a kind of my family and friends. Lovely.
[01:14:02] Yeah. Yeah. Where how would. Holidays, what’s your favourite place you’ve been to
[01:14:14] It’s all over any part of Italy I love, it is great. And in Venice, I really liked by Italy, Milan around there with the driving ideology, driving trips, and each year I got to Europe and then we drive around and I do them, but do them as a drivers club. We have about 10, 12 cars. But I’m in the car on my own. I don’t I really don’t bring anyone with me. And that’s my time. That’s my time to think and reflect and then decide what goes I have for the next six months. So that time is really important to me. I love Italy and Payman to what clicked. What changed was getting into Dental school when all the odds were against me and then getting my implant masters and realising there’s a moment in every dentist’s life where you think, you know what, I’m actually good at what I do. There’s no ego. It’s not cockiness. You just think, you know, I’ve done this and it works. And I think that gives you that confidence. And for me, I always had my biggest fan club was always my parents. So as parents yourselves, if your dad says you can do it.
[01:15:19] You go and you do it lovely, really lovely. Thanks so much for doing this. Thank you.
[01:15:26] My pleasure. Thanks for having me.
[01:15:29] This is Dental Leaders, the podcast where you get to go one on one with emerging Leaders Dental Street. Your house, Payman, Langroudi and Prav Solanki.
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