In this episode, we welcome insight into growing business values from Sandeep Kumar. Sandeep discusses his successes with Invisalign, House of Fraser and his multiple practices up and down the country.

Sandeep also tells us about his journey from Punjab to the UK, setting up MiSmile and prioritising health and family.

Enjoy!

 

“And I remember after year 12, me and my dad and my brother were sitting, and we couldn’t get our head around – what shall we do? Do I want to do engineering? Do I want to do medicine? Or want to do dentistry? And I still remember that day I called my mum while I was there and I said, “Mum, we don’t know what to do.” And mum said, “I always wanted one son to be an engineer and one to be a doctor, but the rest is up to you. It’s up to you.”  – Sandeep Kumar

 

In This Episode

 

01.48 – Growing up in Punjab

08.15 – Learning the trade

10.28 – Coming to the UK

14.15 – Adjusting to the UK

16:08 – Starting in dentistry

20:38 – Birmingham Dental Hospital

26:55 – Setting up your practice

32:09 – Adding value to your practice

33:12 – Opening a second practice

36:22 – Invisalign

40:43 – House of Fraser

43:19 – Finding the confidence to be ambitious

46:36 – Managing multi-sites

50:50 – MiSmile

58:41 – MiSmile Academy

1:04:20 – Quitting clinical dentistry

1:08:49 – A day in the life

1:13:43 Legacy & last days on Earth

 

About Sandeep Kumar

 

Sandeep qualified as a dentist in India and moved to the UK in 1999. He gained his GDC registration in 2000 and bought his first dental practice in 2003.

Thirteen years later, he now works in both the Private and NHS sectors. He runs one of Birmingham’s largest NHS practices and owns the brand Smile Stylist, which has multiple locations across the UK and MiSmile. He also runs the UK’s first Invisalign only clinic and the MiSmile Invisalign Network, comprising independent dental clinics across the country.

Sandeep became certified with Invisalign in 2007 and is now one of Invisalign’s leading providers in the UK, submitting over 400 cases per year. He’s also one of the UK’s only Diamond Providers.

Highly regarded by Align Technology, he often speaks in clinical on marketing roles and shares his Invisalign journey and experience with fellow practitioners.

[00:00:00] And I remember laughter during the trial, me and my dad and my brother were sitting in my last year and we couldn’t let it get a happier than what we do don’t want to do anything to they want to do medicine or want to do dentistry. And I still remember that day I called my mom while I was there and I said, Mom, we don’t know what to do. And it’s your mom that is wanted by one sort be engineer and part of it. But the rest is up to you. It’s up to you. You know what?

[00:00:33] No pressure.

[00:00:38] This is Dental Leaders, the podcast where you get to go one on one with emerging Leaders Dental Street. Your heist’s Payman Langroudi and Prav Solanki

[00:00:56] Is my absolute pleasure to welcome Sandeep Kumar onto the Dental Leaders podcast. Sandeep’s the guy I’ve known for a long time. And if you look at his empire that he’s built up now, you can see that he’s definitely got the bug for scaling businesses. But this podcast is all about, you know, your origin story. What drives you. Welcome to the show.

[00:01:20] Thanks. Thanks. Pleasure to be here. And good to see you. Prav after a long time.

[00:01:24] Likewise, Sandeep. Likewise. Do you mind just taking us back to your origin, your roots, where you grew up, and then moving on to how dentistry featured in your life? At what point?

[00:01:37] Just to cover that, you’re asking my 23 as in like and like to summarise in two minutes, but I’ll do my best. But you don’t

[00:01:44] Look a day older than 24 Sandeep.

[00:01:48] Well, that’s good to know. But I was born in India, in Punjab, in this small town, small family. I have one older brother and my mom and dad, both the teacher in the school, even though we are a small family. But I’ve been brought up in a big family, you know, cultures in India, how their uncles and aunties. So my dad had four brothers, so it was like a gated entrance. And behind there there was a four families, four uncles and then grandma and lots of cousins. So, yeah, it was it was not a lot of fun living living together.

[00:02:31] And then what was schooling like,

[00:02:33] Our schooling is a very, very strange and it’s a very deep cost, but I’ll try and get you there and tell you where it all started. So I did my up to year 10 in in the town where I was born. And I think my dad was a teacher and my mom was a teacher. And they could see that the signs are not looking very good. This guy is not good at studies. God knows what we’re going to do with him. And so, my God, that very he was very well connected. He was very social, so he started speaking to people and stuff. So a couple of years before my brother went to do engineering in Maharastra, they have me remember. So my dad used to go and drop Payman lot of stuff and all that. So somehow he found that out and master that stuff. In those days, there was lots of Dental private schools are opening a lot of stuff, not only in Lancaster. So my dad figured it out that if you do, you’re 11 and 12 and you can get into a Dental school or engineering school in a private school without paying any donation. So one day he went to see my brother and he came back and I was 14 years old at that time. And he sat me down with my with my mom and he said, I’ve got something to discuss with you. And he said, how do you feel that if you have to go where your brother is doing it? And that was like thirty six hours plane Germany. And I said, what options do you do? I said, you know, you can do this, the band BSE or whatever, but if you want to go in dentistry or medicine or law, then that that’s the only option you have. So here I go. You’re not at the age of 14. Pack my bags in the train. Thirty six hours billion with my dad. And he dropped me last. But luckily, my brother was there, so I did my year level in year 12 of that time.

[00:04:30] So I bet that made you very independent, very young,

[00:04:34] You know, looking back, you always find strength from from, you know, where you have come from and and leaving home at such a young age was not easy, but it did work

[00:04:46] Well. As a 14 year old, what was your day to day? As you know, that’s completely foreign to me. You know, it would be looking after you. Who’d be cooking for you? Where where would you be living? What was the secret that led Sunday?

[00:05:00] Yes, the script was my brother was as I said, he was doing engineering in Maharashtra in that time. And he was as if he was living at somebody’s house as a paying guest and they had an extra room. So I went and lived with them and I was a paying guest. So they were cooking for us and we were paying them a pandemic. But that’s how it was. That’s how it all started.

[00:05:24] And then from there on to Dental school.

[00:05:27] Yes, so I did my year 11 and 12 and I did both maths and biology, so if you want to go in medical field, you do biology. If you take you take maths by I took both of those days, you could take both. And I remember after doing 12. Me and my dad and my brother were sitting in my raza and we couldn’t really get it on. But we do not want to do anything. They want to do medicine or want to do dentistry. And I still remember that day I called my mom while I was there and I said, Mom, we don’t know what to do. And mother was wanted by one sort of engineer and part of it. But the rest is up to you. It’s up to you. You know what?

[00:06:15] No pressure

[00:06:16] Or something. You know, I never, never enjoyed medicine. Dentistry is not a bad idea. And that was really never preplanned. I think the only thing I can say is what persuaded me towards that was when I was really young, I had a massive accident and I broke a couple of my front pages and I had to visit the dentist quite a few times with my dad and the way he looked after me and, you know, put some sort of teeth in it so I could live my day to day life. I think that was back of my mind and that was the turning point for me. So I decided to go into dentistry.

[00:06:56] What’s the education like?

[00:06:58] Education, so that was a that was a private school, so first couple of years, we had a lot of the anatomy and physiology and yuzo usable stuff. And then I think the the the syllabus was pretty, pretty similar to what you do here, but not probably in as much depth. And then in the final year, we had a lot of clinical work. And, you know, you can imagine in rural areas in India, the demand for Dental, Solanki is very high. So there was a queues outside the clinical sessions. So, yeah.

[00:07:37] So did you get a lot of hands on experience as a Dental student right from the early days? Were you getting through a lot of volume and and building up those clinical skills?

[00:07:49] But let’s be honest, but if people want to do it, then there was plenty of work to do. But I wasn’t in one of those. I was lucky to get away from it as soon as I could. Yes, I did. Had enough. But yeah.

[00:08:05] What type of student were you? The sort that tries to get away with the least possible work your way through and just just Skyview way through. Get your qualification and move on to the next step

[00:08:15] And you have to nail on the head. Explain to me exactly the people who are close to me. It was like, how can I get away with minimum possible that that’s how it was. And, you know, my my dad always used to come home twice a year during my during my dentistry days. And, you know, living in Maharastra so far away, my expenses were pretty quite a bit and all the time I used to come home and I used to ask Dad, Hey, Dad, I did some more money. And he will say, you know, I give you so much last time all that go on. And by the time I explain to people that maybe Dad’s right, it never, never let me deprive from anything. It gave me an opportunity to say me one thing before I go back to my uni son. Never come home with you know, it’s very hard earned money just about managing that. What we are doing is half of our salary is going into your education to whatever you need to do, but do not come out of the field. And you know, that always, always stuck with me. So I studied enough so I can just possibly

[00:09:28] Just suck it right to the edge. Actually didn’t quite fail, right?

[00:09:31] Yeah, that’s

[00:09:33] What she did. You come to the UK Sunday,

[00:09:35] So I came to the UK in nineteen ninety eight.

[00:09:41] So what was the story as far as dentistry.

[00:09:44] Yeah. So you know when I finished my Bettina’s OK, this is what it was about. You know, I never said how I got into dentistry in that school. There was a 50 students, there was a twenty five of them were local who was born in Maharashtra who live in a lot of stuff, like literally half an hour away. And twenty four of them came from Punjab, who came from a wealthy family who had money, the son of doctors and gynaecologists and all that sort of money. And there was a me ventrilo. So now I have to manage my lifestyle working with these guys who come from a very, very large family. So I managed to get through dentistry, found my money wherever I could from that time, and came back to Punjab after doing my videos. And I came back to my town. And now I have seen the life of Mumbai and life of big city, and there’s no way I’m going to settle down in my time. So that that is that what you want to do now? You’ve just finished exams, now the next step. So there was the college open in my time, not too far away from my town. And I went there as a teacher. So I started teaching one of the Dental subjects. And I think it was a couple of months after I have this thing in my head, I said, this is not for me. And I literally decided to give up their job and I went to China. I’m sure you guys must have heard about it.

[00:11:12] So my brother used to live there and I told my dad, like, there’s no way I can settle in the city. Can I go and try and do MBA? Sounds like a postgraduation and knowing I was not very good at education, that was another challenge on the song. But I left that job, went and studied for the whole year, like literally every day. That’s what I did. No work at all. And guess what? After one year I sent about nine exams for different states, different countries, and I failed all of them miserably. I know in me. And I could get an envious. Came back to town and came back to town again. Their dad was and that’s about it not look. And I said, you know what? The job which I chucked away, that I left and I went to. Let’s go to that college and get me that job. And I’ll because I’ll live happily ever after. So we went back to college and there was a principal, the guy who gave me that job. And as soon as he saw me and he said, you know what, buddy? You chuck that job on me and I, I have not forgotten that nobody’s ever done that to me. I am not giving you this job. And that was the only Dental college I had in town. So the situation was, you know, kinda envious clinic because I don’t have enough money to college, which was nearby, was not willing to have me back as a teacher. Where did you go? And honest to God, that was like the time that I was very, very lost, didn’t know what to do.

[00:12:47] But, you know, Dad was very supportive. Mom was very supportive. But Dad will always ask me so, you know, you can’t live your life just walking around and sitting in this shop and sitting in that store. What do you want to do with it? And I was just getting in that not not depression, but a stage where I don’t know what to. But, you know, that would be bad, and he has said to you earlier, he was very social and he had his own connexions. So he was speaking to his friends and this and that, and then he said, if nothing else, why don’t you go and get married? And I said that let me just build something, you know, have got nothing at all. And then through one of his friend, he introduced me to this girl. And that girl now is my wife, and later that time was Dad’s friend’s daughter and visiting India. That time she had no plans. I had no plans leaving India. We met once and there was there were some issues on my Punjabi family that was from originally from Punjab amongst us from Punjab. We met once and then thought nothing of it. And then we met a couple of times again. And it was, you know, yeah, there is something in there. And that’s what that’s how it went, really. So we decided to get married and a couple of months after that, I mean, you can.

[00:14:07] Sundeep, how many days did you go on before you agreed to get married or you decided to get married? But that, I

[00:14:14] Think was around two months.

[00:14:15] Three months. Yeah. And then so you started your new life together in the UK? Yeah. What happened, what was the. I remember having a really I think it was a jaw dropping conversation really with you and you can fill us in on the Sunday book. There was conversations I had about your role in the Dental practise and what you were doing, not as a Dental practitioner. And we had that conversation. I think it was in your practise when it was booming and it was jaw dropping from where you came from to where you were then and where you are now. So I won’t spoil it. Tell us a story.

[00:14:56] Well, first of all, Prav well done. Don’t you even remember that?

[00:15:01] How could I forget? How could I forget?

[00:15:04] Yeah. You know, it’s it’s landed in the U.K. The biggest thing was I could not speak English. Turned up. As I said, it was not like you had been planning for six months before or trying to find out what the dentistry systems are going to be in that country. It just happened to be the very word of English. But you know what? I will have to get a lot a lot of credit to my amazing wife. She was like a rock, and she still is. She supported me like, you know, it’s OK, it’ll take time. You’ll get there. I could not even pick up a phone and call a Dental Prav is to find out, you know, how the system works. And I couldn’t pick up the phone and call GDC to find out to work. What do I need to do? So the pull of those days, you had to go to work and then I will get a chance. We’ll call the disease and hospitals and this and that to try and find out, you know, what do I have to do to, you know, start working as a dentist here? So we tried that for about a couple of months and I was not getting any of it. And I thought, you know what? I had enough.

[00:16:08] There’s no way I’m going to sit around a bloody hole and keep calling ten practises. And I couldn’t speak a word of English. They couldn’t understand what the fuck I was talking about. And I came home one day and I said, Do you know what? I’m going to get a job. I don’t give a shit. What shall I get? So I’ll go to the job centre near where we used to go to the job centre. And there was a job available in a factory and in the factory, they used to print like a cardboard boxes, they used to print labels on them. I applied for I got the job. And two months after I came to you, OK, that was my that was my first job. So then they said they will be about three pound twenty an hour at that time. I said, just give me whatever money I just need to get out of the house and do something. So I started that and I did that for about six months or so. But, you know, I was so happy I was meeting people, couldn’t really speak to them or communicate much, but I had somewhere to go. I get up in the morning, shower, dress up somewhere to go, and that carried on for a bit.

[00:17:14] And after a couple of months, I remember one day my wife went to see her GP just for a normal, normal routine, Check-Up or whatever, and she told him that, you know, I got married and he was a family doctor. He knew everybody very well. So he just asked us about your husband, too. And she said he’s a dentist from India, but obviously he can’t get a job at the moment. And he said what he asked us, what he is doing now is that he’s working in a factory nearby. And he got so angry on my wife. Why didn’t you tell me? You know, I’ve got Connexions. I could have done this come that for you. So he gave her this business card and he said, go home and call this a symptom of the look out for you. So if I came home, we sat down and she said, you know, that’s what Dr. Venugopal. That was his name. And Dr. Vinegar gave me a card, which my wife called. And that guy was the guy who was a dentist. And he is still very good friend and is still my mentor. And we still stay connected. So I called him and, you know, obviously and she just told you that you asked me to give you a call.

[00:18:23] That’s the situation. Can you have. So he gave my wife somebody else’s number and he said, call this guy and will have. And that guy’s name was Sam. And my wife called them and we then turned up at the practise, went to see him and he said, Are you OK? OK, yeah, that’s fine. So he just explained to me everything he said. This is very common. Lots of people come from abroad and only processes you have to do and you get to do that. Yeah, I said, yeah, that’s fine. And so I said, when can I start? Actually, my wife was talking on behalf of me and start whenever you want and he said, yeah, come tomorrow. And honest to God, guys, you know, I can still looking back that day, that was the happiest moment since I landed in UK just because I was in a an apartment, which I know I know dentistry. I know the smell of the drill and the materials. So I don’t have to go to that factory and print that stuff there. So that was it. And I started working as a as a Dental said that practise and some other some people unfortunately passed away a few years ago. He was the legend. And my feeling was that.

[00:19:40] So then what, you were studying exams as well.

[00:19:44] So from then on, this is what happened. So I used to work as they used to go there as a work, as a Dental from nine to five thirty six. But there was a guy, there was a dentist and who came through the same group as I did. So he came from Pakistan, he worked as a dental nurse and he qualified as a dentist. And that gave me a light at the end of the tunnel. Now I can follow his footsteps and if I do the same thing, then one day I’ll be dentist as well. So. So this is my routine. Like, literally every day was mine to catch a bus, come to city centre Dental Hospital Library used to be up until eleven o’clock. So from six o’clock, eleven o’clock I sit in the library because I couldn’t afford books that time. Library used to close at eleven. I was the last one there always to pick me up every time, so took time to go home.

[00:20:37] And I saw Birmingham.

[00:20:38] Yeah, yeah. All in Birmingham, Birmingham, Dental Hospital. So we had to come back home and go to bed and stuff the same, same to again. So there was those days called statutory exams and nowadays it’s called a lorry or something. After that it takes to like an old lady. So MIT is used to be called the exam. So I passed my first century exam and guys hospital after about a year and I was getting more and more excited. It’s just one step away from the dream. And then I carried on the same. I carried on my nursing. I carried on my studying in the library on the way. For the second part, you have to do a lot of practical work. So I was collecting those expected, mounting them in the plaster of Paris. And then after the clinic was closed, I have some balls and just starting to do the cavities. And that’s what I did that I think it took me about six months or so. And then somebody told me that if you really want to pass this exam, you have to give up this job about at least a couple of months and focus on the central studies. That’s what I did. I spoke to that guy some time and I said, you know what, I’m going to have to stop now because my exams are still months away and I’m going to go and take that exam.

[00:21:53] So I went off event and I took that exam and unfortunately, I failed. The part that was that was tough. That was the that was the lowest of life. Sometimes it can take, given the game myself. And to see someone said this is a situation I failed, unfortunately. And he said, yeah, don’t worry, man. Come on, let’s get back to this thing tomorrow. And that’s what I did, you know, with my pride, with everything. And that started the process again. And then it was, OK, this is what what happened that time. There was statutory time. He was only allowed to take twice. If you failed seven time, that is it. You’re not allowed to do. And just plain you. OK, well what pressure chase about pressure. Yeah. You know, came home and spoke to my wife, discussed about what shall we do. She said it’s entirely up to you. There’s no pressure on me. She was working, she was earning enough to support both of us that time. And then in the year 2000, my wife was pregnant and she was successful. And I said, I cannot wait for another year or two years for my exam. I’m just going to go for it and see what happens. So I applied for the part and the part of that time was in Manchester. And I knew this is the only the only time to have if I fail, that’s a Dental those things for life.

[00:23:20] And that was a calculated decision I had to make. Part of the process was you do it on Monday, Tuesday and Wednesday and you examined Thursday and your result was on Friday. Compared to what they did was exam was on Monday, Tuesday, Wednesday, and your results was on Thursday. So I knew this is my only attempt I’ve got left. I knew my wife is pregnant and I knew this is this is this is it. So I did not tell anybody and my wife did not know that this time my result is going to be on Thursday. So on Monday morning, I went to Manchester, did my three exams first and only took a train from Manchester, came to Birmingham. I that is the day I started. No, nobody in this world knew that my result is coming today. So I came back to the Langroudi came in a taxi well, somewhere where I had a bit of a pop and I took that. But I made a brave go to GDC. And after a couple of minutes of going around in circles, you know, you did well in this. You did well in that, but you didn’t good in this and you didn’t get in that. And I and then this lady said, you passed your exams, resolutions, talking to you. That is back

[00:24:38] The most have been the second happiest moment of your life and coming to the UK, right?

[00:24:43] Yeah. Yeah, absolutely. Yep. And then, you know, that just took a taxi and went straight to me and my wife was working on that day.

[00:24:56] Did you have a plan? Do you have a plan in case you failed? What were you going to do?

[00:25:00] Filled with hundreds of things I have planned, and I honestly do not want to tell on this platform, but could I have those things from anything to anything to anything? God knows what I would have done on that day. I don’t know if. So then I got my mother took a taxi and a little event took place, I was working at that time and I literally went and that’s what she was know. Like I said, we’re doing my best to make all the good luck and everything on Thursday morning, expecting that I’ve got another exam today and. Yeah, that. There you go. And then we left from there and came home. And, you know, what I learnt during these two years is a really spend time understanding the ins and outs of dentistry, even though it was tough for me to sit on the other side of the Dental. And this little boy, I was speaking to the dentist, trying to really understand how this works, how this works. How can you do this? How can you do that? How do you do this? How do you do that? And, you know, that happened in 2000. And we get the guy who I met first time he gave me a job as a assistant. So you have to work as an assistant after that year. And he was a great mentor, great teacher, taught me everything, which I didn’t learn before. He was just such a smooth operator, you know, mother. And I was like, yeah, and I’m doing it. I thought a very fine but cannot come up with a way to go. But he taught me all that and it was it was good. And that was it. That’s how the dentistry started.

[00:26:46] And so from there, when did it practise ownership or business ownership featured in that journey

[00:26:55] That you did you buy your first practise?

[00:26:58] So I qualified in 2000. Then I had to work one year in the system. So that brought me to two thousand. One time my mentor, my principal and I decided to move from where he was to a new new premises. So in 2002, we moved from his old premises to the new premises, and during that time he started a private practise in Birmingham and he was spending a lot of time there. And I was literally working six days a week in December just like this. And then as he was focussing more and more, building his his private practise is just, you know, there was a conversation one day. What do you think? If I buy this and we had a couple of discussions and he said, yeah, why not? But he said, why not? No, but none of the bloody banks are ready to give me a loan. I think you know what? You’ve already passed two years ago, Yanofsky, for a couple of hundred grand. How are you going to pay you to just finish your Dental system? And I remember that time there was a guy called Roger Upton. He used to run these courses called Setting Up Your Own Practise.

[00:28:08] So I turned to one of his calls and I just told him to rise and say, hey, if I introduce myself and say, you know, this is this I am, what should I do? And it happened to be people just like you who, you know, in this world isn’t that’s how it’s done in life, is all about who you know, not what you know, larger than give me this business card. And he said, speak to this guy. And he was a manager at NatWest, called him and he looked at my account and he said, Are you serious that you want to buy this practise is expensive practise from where you are. And I think about it all this these progenies probably gave a good recommendation. And I still remember his word. You know, he said sometime very early and we put the money on the jockey, not on the horse. And he said, I’m going to put money on you. And he gave me every single penny to buy that practise, bought two thousand pound. Well, and that’s it. So, you know, came back, bought the practise in 2003.

[00:29:09] But why didn’t you just associate for like three years? Why what were you in such a hurry? Because because of the time you’d wasted or your entrepreneur. You knew you were that guy.

[00:29:20] I think it’s a good very good question. You know, the reason I can say that, you know, I think I was getting to about 30 years old, you know, not a penny to my name

[00:29:29] Kid on the way.

[00:29:30] You don’t have a wife done enough of supporting me for a couple of years. You never said a bad word. But she’s looking at me and say, you know, look, come on now. And not a house, not a car to fly. You know, sometimes you get to look on your face, look in the mirror and think, you know what, that’s enough. I think I’ve faced enough shit in my life. Let me go out there and really express myself. Without worrying about will I be able to pay those bills, will I be able to pay those loans, let me just go out there. What I’ve got to lose. Let me just go out there and try it and see where I end up and do how did it go? I was I was it so I bought that first practise in 2003. And then we had our second child and we had a daughter in 2004. And at that time, I still remember. I think that’s a very significant event. My daughter was born with living in a very tiny house. And initially then I then I qualified. So obviously I wanted a bigger house. So we bought a bigger house and we got a dental practise. And the loan is like, I’ve never heard of hundreds of thousand.

[00:30:42] How the hell are we going to pay for it? Because I haven’t got a penny. And I sat down with my wife and I said, you know what? We’ve got to think this will buy you this house from here on. Let’s sit down and make an argument. And that argument is you will never, ever stop me going off of. If I say I’m doing 20 hours, I am doing 20 hours, if I turn up at home at 11 o’clock. I won’t go out clubbing and I want to go out dancing. But if it’s work, then please don’t question me because we are taking on a huge responsibility. And us. It’s been a partnership is equally part of I’m responsible for where we are. She played her side of the cards and I did bloody hell. And I did some of those days as well. The 2007 I bought this 2003 about this practise literally every month I was adding a soldier and I was adding a staff and I was adding a dentist. And two and three is up to two thousand six. I call triple the size of that business and then we turn the contract change into Yoda’s. I had a solid and this today’s date is one of the biggest entities practise in Birmingham.

[00:31:55] So how are you how are you adding value to that? And it just blacks back then, could you do it?

[00:32:01] So back then it was a fee for service, like there was no Yoda’s or anything. Like you just do you just do the work. And I was became a workaholic even at that time. So it was literally my principal and my philosophy those days was same and even today is the same. Do not say no to the patient. If somebody turns up in a practise in Payman, my simple instructions to my team was to not say to the patient that we can see you as long as they’re willing to wait. We will see them before the end of the day what time they cannot promise and pay. I still remember before we opened for lunch, there was a 220 people standing outside sometime. And in 2003, I was the only one dentist. In 2006, there were six dentists in the face just to you still learn that practise. So how many? That is my background.

[00:32:54] Is that now? Is that the same six six

[00:32:56] Six six six surgery and it runs beautifully. I still take a lot of pride. I go there every week, I feel home and I go there.

[00:33:07] Ok, so let’s talk about when did you decide to go for number two?

[00:33:12] So number two was 2006, the contract changed to UDS. So from 2000 to 2006, for me it was you know, I never came out one day, but I’m going to do this, this, this and this. It just happened. But 2006 contract, the growth was literally stopped. You can’t go out of business. And I’m sitting there thinking, that’s no, I’m used to what I’m doing. Anybody can come into. And that’s when I started exploding, you know what’s happening outside in the dentistry dentistry board instead of that, my boastful dental practise, let me just go out and explore what’s going on. So I still remember I joined this battle programme that time. I think he used to run some clubs or something. And I speaking to Chris and I said, you know, I’m thinking about to open another practise, but I don’t know what to do. And they have to go. And I still remember he connected me with Zach. And I Kanzaki and Chris was good friends, so I think Chris called, Zacchaeus said, you know, this guy going to you want to have a look at what’s happening in private industry. Can you can you have a quick chat? Cause I went to London one day and I thought, you know, I’m going to go to his practise.

[00:34:28] It’s going to set me in his office and he’s going to tell me a little bit about private practise. That was a compliment. I still remember that day I turned up. He said something. Give me half an hour. Just wait here. Let me just finish what a fun little thing was around lunchtime. And that guy has taken the rest of the day off for me. And he said, let me show you how the private flexes, Bob. So they took me to Dental, where he used to work. It took me to London smiles, took me to blame. And I’m thinking, wow, this is another side of dentistry, you know, which I never, never leave. All I know is. All I know about is about is that it’s so Suzuki spent literally or five hours with me on that day and told me everything introduced with these guys. That’s the first time I met a new and a couple of other guys that time, and that was it. So I came back and I got a bug and I said, you know what? I’m going to need to find a dentist who can do what I do.

[00:35:35] So it wasn’t that first practise is your only NHS one.

[00:35:39] Yeah, it still is. Is it just not we don’t do anything with that.

[00:35:45] Number two, was that small stylist or wasn’t it? Wasn’t it Branden’s that now?

[00:35:50] So in 2007, we started a practise called New Street Dental. It was the central centre of Birmingham. It was one sided like this and again took old ideas from the practises in London to set up a single solitary practise, went on lots and lots of courses, just learnt about smiled Makos and let it all. Some days I’m talking about here sixth, I

[00:36:18] Think I’ve been there that become your my small office.

[00:36:22] That’s been very nice. So that was that was a cyclical factors which I started in in 2007. And then that’s when really these things started to skyrocket. Business was doing well and the businesses started doing well because of Invisalign. That was the first time I introduce Invisalign. So this is how it happened. I opened the practise waiting for the phone to ring, waiting for people to turn, started from zero, started on spot. I had no knowledge about anything. This guy turned up. So somebody called. He wanted to arrange a meeting. So I’m not going to mention his name, but that just came from London. And he wanted to share. He wanted to have a surgery in my clinic and he was happy to pay me about five, six and defence. And I said, what do you want to do? And he said, I want to do Invisalign first time ever. And he said, I’ll bring everything in a suitcase, I’ll come with my nurse. I don’t need anything from you. And I want to do Invisalign. I said, let me have a think about this. Let me get back to you on that. He left those days. I had plenty of time, nothing to do. I just spent on the computer and type work that Invisalign got onto the website. And just looking through the process, there was of course, a couple of next week.

[00:37:39] And oddly enough, the Dental that cause. So let’s give it a go. What’s there to lose? I took a couple of cases with me to show these clinical guys and they said they can be treated, came back, started my starter two or three cases in 2007, still, when they are convinced that this plastic is going to move. But I thought, you know, I don’t have any other patients anymore. So let’s be let’s let’s try and see how this works. And, you know, but then I started seeing those patients and they were coming back and telling us about quitting and they were tracking really well. And I said, you know what? I’m not good at anything else, but let me see if I can be good at this. And just for whatever reason, it just that literally clicked. And in 2008, I end up going and next year literally nearly a hundred cases and just love everything about Invisalign, love everything about the workload blown everything about the happy, the patients. And obviously that was the revenue in the business because everything was worth three, four thousand those days instead of the feelings in the general dentistry. So things started to work really, really well that at that time. And that’s where we started.

[00:38:56] So then what about then when when we met was maybe a year or two after that, when you done the deal with all the House of Fraser’s, how did that come about?

[00:39:08] Yeah, so House of Fraser was literally across the road from the nearest clinic is like one hundred metres of a house, a place that had this. A medical company called Clearwire started doing teeth whitening and like a pool table, teeth whitening centres and all house of places. So one week and they were in Birmingham one week and they were in Manchester, one in Glasgow. So they were in Birmingham one weekend and they did lots and lots of things. But determining whether that time, like you can know, back to the dead, lots and lots of data. I mean, and one of my patients, both her sister and she said, can you have a look what’s wrong with her teeth and her teeth looked like it’s been patched. You know, there was no mama was completely damaged. And I said, what happened? And she said, you know, we’re going to have to pay that. We paid nine pounds and they had teeth whitening. But so the same thing went completely wrong on that one with her. And I treated her as a teacher, her sisters. And we had a very good rapport. And she said, can you fix it? I don’t know if I can fix it, but I’m definitely going to find out a way if I can, so those days I used to do a fair bit of it. We’ve discussed the Dental and all that. So I reached out to those guys on the set and I’ve got a case like this, what to do. So they got me in touch with a couple of people in USA, speak to them, and then they all, you know, they all said to me that we need to bring that back to where it was and slowly the nominee will start to recover.

[00:40:43] But it can take up to six months or 12 months, six, six, six, six, six or 12 months. I have no idea. But I had a bit of idea. Just make the phrase give these jobs and slowly they will recover. So I told the patient, you know, I can fix it, but it’s going to cost you about six grand and it might take about 12 months because I didn’t know what I’m but I’m getting into. And she said, yep, that’s absolutely fine with me. I’ll come back to you. She went to House of Fraser, spoke to herself as a manager and said, give this guy six grand or I am going to slaughter house appraiser anyway. And she was a journalist. And what there. But is that either I put six thousand pound or I’m going to talk about what you have done. And the next thing I know is also business store manager calling me at my clinic and say something. What’s the deal here? And I said, you know, this is what it is and I can give my best. And he said, please, I take full guarantee that I will pay you all the money. Please look after that lady. And that was it. And so I fixed her teeth. Everything went well. And I stayed in touch with the store manager and everything was fine. And then I have a coffee in my shortly before and after this, a bloody hell. He said we need to do something about a little something here with us. And that was it. So in two thousand nine, we opened the first house of Fraser store in Birmingham,

[00:42:07] Which was a beautiful, beautiful place.

[00:42:09] Absolutely. But that’s not a first time, isn’t it?

[00:42:13] What a beautiful thing. You make it sound like it’s all sort of sliding doors, you know, like you bumped into Zachy. And I’m sure there are other points in life where these sort of inflexion points happen. But at the same time, you could have just been an associate in the NHS and you’ve gone and done taking that one surgery place turned into sexology place. You’ve come down. I mean, you know, the next man might have gone and seen poulain in London Smile’s clinic and, you know, just just just started doing some private on the NHS. But you’ve taken these big steps forward, and I’m sure we’ll get to the next ambition. Was that come from that that confidence studio? I wouldn’t like get up. I mean, forget me, but I to get up, go to another country one year after qualifying, go buy a practise there and then it’s a big thing to do by itself. Was the ambition and confidence come from is that from that 14 year old story.

[00:43:19] You know, looking back, I think, you know. I just don’t want to be poor again. I know how that feels like at the age of 30 years old and you can’t fucking afford a McDonald’s for yourself that bloody hard. And you know what I said to you before that when I qualified, I thought it’s time for me to go and play and see where life takes me. And, you know, bullshit. Once I told you about this practise that became the backbone I was not worried about. And you know how I’m going to feed my family, how I’m going to pay my mortgage, I’m going to pay my rent and everything else just became a playground. I was just, you know, bring it on. Bring it on, bring it on. That’s save it then. You know, I didn’t get up one day and say, you know what? And even today, if you ask me something about your dream, I don’t have any dreams. I don’t get up and say I’m going to take over the world and I’m not going to fix it. My dream is I want to enjoy each day and let me see where this takes us. And that’s always been the attitude attitude since then.

[00:44:25] So when did my smile come along Sunday.

[00:44:28] What was the jump in you jumping them and your jumping? Because because that one one practised in the House of Fraser became seven or something, right?

[00:44:37] Yes, that’s right. So I started in the place. Then there was a couple of pandas going on in and adjust just that time in 2009, 2008, 2009 time. And I want to tender’s. So in 2010, I was building three Dental practises at the same time. One man’s house place on the hill and to those tenders, one. So by that time I had a fight and then we opened another one in Manchester in 2012 because we had a system. You know, I still remember people talk about, you know, it takes two years before you make a profit on this and that. I had a formula. I worked out that formula and then Birmingham and in year one month, three months just did a huge open day due to retirement in year one. We did me the hundred plus cases of Invisalign so that a lot of love and have that. So yeah, it was it was the coming to a stage where outside London I was becoming the go to guy for the misalign.

[00:45:50] And what what were you personally doing at this time, were you running around all these clinics as a practitioner? Would you step back from clinical before? What was your role in all of this, the NHS practise you were telling your wife? I’ll see you next week. And I’m working. So.

[00:46:10] So I think, you know, the one thing I’ve done after all this is I so those days are working seven days a week, then down to six, then down to five and down to four. So by this time I think I was working about three days a week and two days a week managing, managing the business. And yes, that that that that’s where that’s where it was. And then a couple of years after, I’m sure we’ll get there. And then I decided to quit dentistry.

[00:46:36] Sometimes some tips for managing multisite practises. You said you said systems, but for me, that must be it must be people

[00:46:47] Must be key leaders. Just only one one thing I run my business based on, and that is it’s all about people. I manage people. People manage the business. It’s as simple as that. I am not good for them. And I know that I can’t put the associate together. Have you ever seen an email from me? More than half a paragraph. I know what I’m good at, but I surround myself with some amazing people who get these things done. And it’s it’s all about people.

[00:47:20] So do you think you’re a good judge when when you meet someone, you’re a good judge of character was

[00:47:25] Fucked it up many times you can imagine. But overall, overall, I think I managed to get it right. I’ve made so many mistakes, made so many wrong judgements, but I don’t beat myself up for it, you know? You know, sometimes you have a bad day. I just to get somebody handed in a notice and they want to leave and somebody made a complaint. I used to get really worked up about those things. Now it’s just part of the business. That’s what business is. And I remember this scene from Richard Branson. I went to one of his life lessons. I would just pick one thing. And I still remember that, you know, when you’re running a multi size, get comfortable being uncomfortable. You know, I honestly don’t get up every day in the morning where everything is smooth sailing. There’s always something going wrong somewhere. But what I do is I backed myself and I back. My family supported me and back the people I have with me that no matter what happens, we’ll find it. And it’s just it’s just that confidence, you know, it’s OK. Things will go wrong. But look.

[00:48:39] When did the digital marketing start sending

[00:48:42] Digital marketing, so I’m sure Prav Prav know much better that better than I do on this subject. You know, when I started on the estate like this. Now, believe me, this note, guys. I can see the bullshit because I know inside out about Edwards, I spent like months and months understanding about this Google AdWords and my first account on the street Dental I set up myself personally and I ran that. And I used to have these, you know, the bits and pieces you want to show, you know, Dental that I used to manage all that about myself. Obviously, you know, things have changed and it’s a lot more algorithm driven and all that. But I had a very, very good, good understanding because, you know, I got to the stage where I started to think, you know, there’s a lots of good then disappear, lots and lots of good dentist. And I employ more than 20 dentists plus across the business. Can somebody do what I’m doing? And this is a way of bringing people in. The clinic is the art and science on its own. And Prav Prav knows that better than anybody else. If clinical dentist is allowed on science, I’ll tell you, man, this bringing these people and setting these systems and patient journeys is an art and science on its own. It’s just about what what you what we do and what you what you like to do, really.

[00:50:14] And so Sunday, what what was it that moving on from there inspired you to sort of create the Invisalign beast that you have to the day? Was there a was there a turning point in what you were doing where you thought, you know what, I can I can take this turnkey operation that I’ve developed, a smile stylist or whatever and apply that elsewhere. And let me see. Did you I’m assuming you didn’t have this huge vision because you just said that you take one day at a time and you just want to enjoy yourself. Right. So how did it all come about?

[00:50:48] Maybe start by telling

[00:50:50] Someone who doesn’t know what my mom is. Yep, I think I’ll finish it what my smile one, let’s start with a journey started from 2014, as I said, a new clinic. I was doing more and more of Invisalign by 2014. So my overall revenue of the business was more fun than everything else. And when I looked at those papers, I said, guys, this just speaking by itself, why don’t we focus on what we got? And that was the time I made a decision that nobody has done that before. Lots of people were talking about it. And I said, you know what, I’m going to turn this into an Invisalign on the clinic because consumer demand at that time and consumer brand awareness was getting to a stage where people were calling and say, hey, can I look at the phone company misalign instead of going to book? And what is frightening and that was the level I spoke to. And I don’t think there was a single person who said to me, that is a good idea, except one. I still remember that. And yeah, I went ahead. I just called it a Invisalign on the clinic. So that started in 2014, obviously in aligning technologies. Eco-System, they must have heard or, you know, some DEPREZ took a plunge and started in the clinic so that somebody from Aline’s head office in Amsterdam that time came to visit and came to see the clinic. And we went out for lunch and we just having a discussion. And those days I was doing like, you know, outside London.

[00:52:18] I think over the last ten years, I’ve been the biggest provider by and by long, long mile. I was doing those days about three or four hundred cases every year. And, you know, we sat down at lunch and he asked me, you know, what do you do differently compared to everybody else? And I still remember I said, yeah, but that’s my mostly what you find is that, you know, there must be something we can do. Right. And this is where this idea of my social network came, that why don’t we create a platform where I can openly share all my years of learning, all my years of understanding this Invisalign business and help people to grow there in this business. And that’s where this idea came from in 2014 and 2015, in April. So I remember from January, you know it now it looks easy. Everybody looks at it in my mind is a big beast now. It is a beast. It is, you know, with nearly 80 prospectuses. Now, what I remember can you imagine going out and telling people about the this never been done before. You’re going to have to pay five grand just to be part of this. And then on top of that, you’re going to have to pay a grand a month and we will try and grow your investment business. So they’re competing for 17 grand. So, you know, I went up and down the country, travel up and down that lots and lots of people.

[00:53:45] Did a line help you with that? That they say, you know, give us some perspective.

[00:53:50] One hundred percent, 100 percent. So whatever I have done, I’m not going to take all the credit for it. And where I am today, it is in collaboration with the line technology from day one. I had to put a business plan together. I have to show them the concept. I have to show them what it could potentially become and how we could support people. So they dedicated somebody alongside and me. We used to travel together. So one day I will be Newcastle, one day in London, one day in Manchester, trying to introduce the concept to these guys. And in April 2015, we had about 12 people who placed their hand up and say, yeah, we will we will start and see. See, that goes no. We started at twenty people at that time and twelve out of those twenty are still part of the most fun network.

[00:54:43] And the, you know, it’s a it’s a beast of a company to work with. There must be loads of others who’ve tried something like that or are trying something like that. You just really get on with that dude from Amsterdam.

[00:54:58] No, not on. Not only in.

[00:55:00] And I guess I guess you know your priority to them as one of their biggest users. Yeah. But still, you know, dealing as a as a as a dentist dealing with this slow machine. Did you did you find it easy working with them or was it too challenging?

[00:55:18] To be honest, the simplest way I can explain to you explain to you this is there’s a one thing about me. I am a very, very people person. I work with Payman. I don’t work in my team. I work with my accountant. I don’t care about company. There’s about 200 accountants. I have one lawyer. If there’s any question, I pick up the phone and talk to him. And same thing with a line, even though, you know, even at that time the line was a big company and now it’s a massive, massive company. It’s all about people. And because I was. Lots of cases that time they felt it was important. So they did whatever they had to do to look after me and I’ve been hand on heart, I’ve been 100 percent loyal. Lots of people have tried and say they’ve come and do this to us. And that’s how it’s it’s been it’s been it’s been about people. And even to this day, I still speak to all the lying team from a territory manager to the senior vice president. And we work together. It’s a collaboration. I can’t do this by myself. And obviously they see the benefit of it. So you asked me, can I explain to people what my smile is? This is a way to look at this like this is a win win win.

[00:56:36] There’s a three stakeholders in this business, there’s a dentist who joined the Misbah and there’s a spot and then there’s a of technology. Until this doctor or the dentist joins us, does the case, I don’t get anything, the line technology don’t get anything. So it’s in our interest to make sure that we send them as many leads as we can. It’s in our interest to make sure we train them really well so they know how to set the patient journey in the clinics and they can come out those. Customers into treatment. It’s in our interest to make sure that we set up the plate checks in the best possible way so they can treat more and more cases confidently. And finally, we help them to become a commercially viable model by giving them extra discounts. So if they are willing, they are happy, allowing technology is getting more and more cases, you know, now we are doing like the record currently a record month after month after month and the start of this year, I think this month we are on target to do so. Nearly 700 cases, one. So the bogus adopters do have beelined technologies. And then I have a commercial relationship that the more they do, the more the better it is for my smile. So it’s it is a win win strategy for everybody with.

[00:58:01] That’s beautiful, man.

[00:58:03] And so having grown the My Smile network to, what is it, 80 around 80 practises

[00:58:11] And the 80 plus nalliah.

[00:58:13] Was the academy all about the only reason I learnt about that is I saw a video of you on Facebook talking about sort of handing over the keys to your success. And then I came across the academy. So is that a is a training and education sort of platform? Is that centred around Invisalign only or general business development? Just tell us a little bit more about this and where that idea came from.

[00:58:41] Yeah, absolutely. It’s a good question. So part of my small network is everybody who joins us, they get the exclusive. And that is if the contract and my guarantee to those guys is as long as they stay in the NFL, I will not have anybody in those territories. Now, we dropped this contract in 2015 and those days, I think a line used to do about five thousand cases a month to nearly a hundred thousand now. But the contract is still the same. So say take an example of knowledge. So not if there’s a guy called somebody. He’s been part of my contract for the last six years under the contract with him that as long as you stay with the network, I won’t have anybody else in your area. And he’s still there. But there’s a lot of other people who are doing Invisalign now who want to join my mom, but they can’t because their territory is locked down. So the whole thing about Academy is I said, why did I started my school network so I can go properly, go out and share my knowledge, my experience and help people to grow their business. So my small academy is purely Invisalign. It’s done in collaboration with them as a nine. It is about teaching people. Why they should focus on this line and what they should do. We won’t be doing anything for them, we won’t be doing the things we want to be doing, the treatment planning. So this we won’t be going into their practises to do their training. But this is an online education programme so that I can share, you know, does it not only mean I think there’s a lots of other people who are doing exceptionally well in the network so we can collect additional knowledge with these guys to help them more.

[01:00:35] So today it’s all online, is it not? It’s not liveable

[01:00:39] At the moment, it’s all online because of the current current status, things may change. And if they do change, you know, we will look at changing those labels and the platform, how we do it. But right now, well, this quarter is starting on 1st of April. We are going online.

[01:00:57] Is it open to my small packages or they already getting all of this?

[01:01:00] So my small practises, you know, it’s it’s all about you. I have a relationship with them. They will get a free access to this because of our relation with them. So everybody else is not part of my spine that they are paying for this. But my network members will get free access to us.

[01:01:19] Was a costed.

[01:01:20] It’s seven thousand pound for three months.

[01:01:24] Or and so is it an on demand platform so so everything is pre-recorded and you can just access it back, or is it like things are released at certain times and live webinars and things like that? What’s the what’s the former.

[01:01:39] So the formula is 12 weeks, like one hour sessions with different industry experts at the back of that, we will have a WhatsApp and a online platform where people can ask us any questions they want and they can reach out to me directly. And we will be preparing them to do them every day at the end of three months so they can feel they can implement all the strategies which they love and as they go along and implement that and do the things and this is this is this is this will be a rolling Kodaly programme moving forward. So the first one is first of April and then into Q3 and Q4. So, yeah.

[01:02:30] We ask everyone this question, Sandy is around clinical errors,

[01:02:39] If you remember which one

[01:02:44] Look, we did another search to cover those errors,

[01:02:52] Errors funny because in medicine we tend to hide them. Whereas if we can learn from each other, can you think of any mistakes you made,

[01:03:02] Your life changing and life changing? I’m going to say with you asked to ask me it. So it was somewhere around in twenty, seventeen, forty six, twenty, sixteen, twenty six to business was crazy busy. My school network was growing phenomenally practice’s was doing well and I was doing clinical dentistry. But I was mainly focussing on two big cases in the news and stuff like that. One Friday, I have this patient walked in and was on the chair of those, they are supposed to fit them and but on the back of my mind, my laptop was open. My phone was there because I was expecting a very important goal. And by four o’clock, I have to transfer some money to my lawyer so we can get that deal done. So the patient is on the chair. I can’t say no because I booked all afternoon on the back. I’m keeping an eye on my phone and my laptop and that email is going to the phone is going to ring. So I started prepping this case and then was just about to put those videos on and the phone rang and my half of the focus was there. The focus is the finish the case. Ask the patient to set up just before I give up Amida. And I want the. Dos Santos about just nowhere near where they’re supposed to be.

[01:04:20] There was a count in the red line and I was absolutely speechless. So what I have done the. And you know what? I was very honest with the patient and I said, you know, something has not gone right. You need this. Let me fix it for you. Your appointment next Saturday. I’ve booked a whole day off. I’ll get my life to redo this business and sincerely apologise. And, you know, with time, I built a good rapport with the lady and she said, you know, it’s not ideal. I am a little bit upset about it, but I completely understand this and that, blah, blah, blah. So she came told us that Saturday we have 10 minutes to give us some discounts, give us some freebies. And that was the time I sat down. I think, you know what that’s enough clinical dentistry for. I am not giving my patient. So they come to me, they put a lot of trust and they pay me a lot of money and they expect a service, and at that time was the crunch time I decided I’ll focus on running the business. And that was it. So since twenty seventeen, I have not picked up a girl. So it’s going into four years. And that was a very tough decision, you know,

[01:05:36] Even Invisalign as well. But not everyone either.

[01:05:39] I don’t do anything for them.

[01:05:42] Welcome. Welcome to you

[01:05:48] Both. Now, both of us,

[01:05:50] Both of us, a failed clinician.

[01:05:53] This was your defining moment, quite similar.

[01:05:59] Yeah. Yeah, it was. But it was. I took these two these two temporary crowns off and both of them had the cause inside them both. There’s a horrible moment

[01:06:14] Right after that.

[01:06:18] So how many employees do you have now? I mean, as we’ve mentioned, all your businesses or is there a couple of Indian takeaways?

[01:06:26] You have a couple of Indian takeaways and a couple of partnerships and this and that.

[01:06:32] But the employees, if you go in.

[01:06:35] I think including everybody, I think we are close to 80,

[01:06:38] All the people that a lot of people,

[01:06:42] But, you know, the business is all about people. We touched on that before. And I’ll be very easy for me to take a pride and do take care of everything. It’s not my it’s not it’s nowhere near that for people.

[01:06:56] And so how much do you enjoy it, Sandy? I mean, like, if I was your friendly corporate who said, you know, Sandy, I’m going to take this off your hands, you know what I mean? Like, if we could value the thing, whatever you want to walk away from. But how much do you love it? I mean, would you do something? What would you do? This is to say I came along, gave you your father, how much you value. This is

[01:07:22] Enough

[01:07:22] Money, enough money to walk away. What would you do next? I mean, is that a plan is a plan. You think five years. What do you think? What do you think?

[01:07:32] Good question. So this is what I can tell everybody right now, I am loving it. You know, considering that I was 20 years ago from today, like every day is a living bonus, I never, ever, ever dreamed in my life that what I’m doing right now. Right now, I love so, you know, people talk about hobbies, but you enjoy it. I love work. You know, you’ll give me a problem for fact. I’m going to go out for a walk and I’m going to mull over it most often. I’ll get an answer. I get on my meditation routine in the morning. And I’ll think over it after that and see if I can find it also, if I don’t, it’s OK, I’ll do that next day. So I find this a very challenging I have got lots of ambitions, but what I’m enjoying is in the process, what I am becoming. And the first thing is, I can barely speak English now.

[01:08:29] I know I’ve noticed with you, too, that since I’ve known you a good 10 years now, your smile just gets bigger and bigger and bigger.

[01:08:37] And we enjoy what you do, man. I think it’s a it’s a it’s tough out there. You got to enjoy what you do for those sun.

[01:08:49] Give us a typical week of how your week pans out day in the life week in the life. What are you doing?

[01:08:58] And day in the life, I am probably the most autopilot person you’ll ever meet, and I really mean. Five days a week, my alarm is set to for 30. I am the bed by nine, nine thirty, get a professional, I was looking at my app this morning, I use this app called Mieux. Two hundred fifty fifty three days of running straight on meditation. Never miss a day. I’d like to grab a cup of coffee after that and just mull over something that is bothering me. What is the big decision I need to make? And I have a really, really, really easy start of the day. My son’s going to uni now, and I told my daughter to come home, go to the gym, spend some time with the wife together, and then she’s working as well. So she’s managing, managing quite a quite a bit of the business. So she goes out a couple of times. And you know what? Every day is dependent. Who needs me there and what needs to be done. I have if I if you ask me what I have owned on freedom of time and I want freedom of choices, I can sit there and decide what my next week need to look like. And I’m there for people, there for my team, then I believe the meeting and I don’t have total responsibility of any of the department. There’s somebody else looking after them. Think that somebody is looking after that, that somebody is looking after the operations. Yes. Ultimately, I have a helicopter view of everything, but I don’t the business does not run because

[01:10:41] You haven’t got any deliverables.

[01:10:44] Looking at me and said, you know, Friday, five o’clock, it is that stuff with is supposed to deliver.

[01:10:52] Have you always woken up at four thirty in the morning since 2013? What happened? It just read a book.

[01:11:06] So I’m thinking about that time of 2013 at the of the work. And I think one day I was just walking out in a very cold, sunny day, cold day minus temperature, and I was sweating like a pig. What the hell is what the hell is going on? And by that time I would drink every night and eat whatever comes in front of me was about thirty six, wasted that time and never really looked after myself. And it was all about business, business, business. So I went to see a doctor and I did all the tests and they said there’s nothing wrong, you’re fine. But I knew deep down that you know what? I pushed and pushed the board bit too far this time to rein it in. And that was it. Since then, to change the lifestyle, I started cycling, started doing gym, started doing little and not eating consciously. I still have you know, we still have a pizza on the weekend and I have a bottle of wine some time. But being conscious of what you watch it on Sunday.

[01:12:06] I speak to a lot of people, a lot of successful individuals who start off life sacrificing healthful career or health, wealth or whatever you want to call it. And then there’s often a turning point in their life where something happens and events or they start thinking about their own mortality. Right. And then health starts featuring this as a priority. Is is that that event for you when you take a

[01:12:37] Million percent health and family is right at the top and everything else is is there but is far below that close to party’s? No compromise on those two things.

[01:12:52] And it is such an inspiration really

[01:12:56] Coming from you, that means a lot.

[01:13:00] So we tend to finish this podcast with the same questions like legacy based questions. We call it Prav. Final questions.

[01:13:12] I mean, I’m just sat here pretty much like I was when when

[01:13:16] I met you in in Birmingham, jaw on the floor, listening to your journey from where you’ve come, where you are today. So still the same person. You know, it’s bloody hell, it’s inspiring you really that that means a lot coming from successful guys. And, you know, you have you both have done phenomenally well. And I’ve got a lot of respect for you guys coming from you that that really means a lot to you.

[01:13:43] And it’s amazing to, you know, when we sit back and you say, right, well, what’s important to you is family and health. Right. And everything else is second best. It’s it’s lovely to hear that. Really, really lovely to hear that. And so moving on from that sun connexion, we’re not all immortal. And that day is going to there’s one thing that’s guaranteed in life, and it’s our last day on this planet. Right. And imagine it was your last day on the planet and you had the important ones around you, your loved ones around you. And you had to leave them with three pieces of wisdom. What would they be?

[01:14:21] Yeah, it’s it’s a very deep question, but it’s you got to really think about this, so this is what of my mind both. I spent a fair bit of my life feeling unnecessary things. Which didn’t really mean a lot. And my first piece of advice would be face your fears. There is a beautiful, amazing life on the other side. And so I think what would be wrong, you’re always. What I do, nobody else is doing. I have no competition. I’m not looking ahead and I’m not looking backward. I’m running my own race. And I think that that is that means a lot when we start to compete and compare and this is where we start cutting corners. This is a bit of a service of both. You know, we are all individuals and do what you what you enjoy doing. And, you know, you have to as you mentioned earlier, that you saw my video recently until December 20, 20, I’ve never done a video. And now I’m doing it like literally every big. And that’s the third message is express yourself. We all got a story to tell. We all maybe one or two people can learn from this, you know, what we’re doing today or what I have done only to inspire one or two people. You know what? If this guy can do it. Let me give a. And, you know, we can change one or two people’s life by doing that. It’s been.

[01:15:56] Racing and Sundeep, how would you like to be remembered so if you were to repeat and complete the following sentence, Sundeep, was that well, how would that read?

[01:16:07] But I will complete that and I’ll come back to that in a second. But here’s the reality. As I said before, I don’t get up in the morning and I’m how I’m going to change the world. I’m going to buy 20 practises. I’m going to do this. None of that. I want to be remembered. Somebody was a great dad, a great husband, a good boss, a good son and a good friend. Beautiful, but that’s about it, you know, it’s not it’s not changing the world, it’s about small, small, small changes and just making sure be kind to yourself, but be kind to the world. Lovely. And Sunday, if you had 30 days today

[01:16:52] And you knew that in 30 days time it was your last day on the planet, what would you do in those 30 days?

[01:17:00] I think what was I’ll probably carry on what I’m doing, probably about 20 percent of what I’m doing, and I will spend a lot of time with my family, with my kids and my wife. And I will make sure that I leave everything in good hands. I’m very, very confident if I’m not here in 30 days, the businesses will carry on. Kids will be look after. I won’t be happy, but I’m sure she will get used to because kids will be there to look after. It’s about leaving the world and my my little place at a better place than being is today. That’s what I’ll focus on the next 30 days, Sunday.

[01:17:48] Thank you so much. It’s Saturday with my jaw on the floor and I’m inspired and in the same respect, so many values that we share that revolve around family and health and that sort of happiness. It’s been such a lovely conversation.

[01:18:06] Thank you so much.

[01:18:07] We thank you. Thanks for having me, guys. Really appreciate that. And there’s nothing else you got to go to catch up with. You guys got to this fast paced world of sit down and talk about for an hour. What we have done these days means a lot.

[01:18:23] The funny thing, you know, did you know each other all these years? And then you realise

[01:18:26] There’s so much you don’t know, so much you don’t know about the lovely times. I think I should ask you for interviews next time on your inbox. I may reach out to you guys

[01:18:39] In three years time. He’s going to have a podcast network

[01:18:48] That makes a lot of money. All right, guys, thank you. Thanks for your time. Really appreciate the

[01:18:54] This is Dental Leaders, the podcast where you get to go one on one with emerging Leaders history. Your house, Payman, Langroudi and Prav Solanki.

[01:19:10] Thanks for listening, guys. If you got this far, you must have listened to the whole thing and just a huge thank you both from me and pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you got some value out of it if

[01:19:25] 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.

[01:19:35] And don’t forget our six star rating.

In this episode, we welcome insight into the world of business in dentistry from Sameer Patel. Sameer is the Clinical Director of renowned Elleven Dental Wellness Clinic in London and shares his views on company ethos and being successful in the business of dentistry.

Sameer also tells us about his love of cricket, how to chose the right associates and runs us through how he approaches managing patient experience.

Enjoy!

 

Stick to your protocol, stick to the system, stick to what you do and try not to go out of that too much, because actually, that’s when you produce the best clinical dentistry.”  – Sameer Patel

 

In This Episode

 

01.14 – Dentistry vs cricket

08.40 – Parenting

12.00 – Race

20.50 – Australia

17:55 – The business of dentistry

26:32 – Running a practice

32:37 – The patient experience

39:09 – True north

41:20 – Book recommendations

46:43 – Treating everybody

50:41 – Sticking to protocols

52:44 – Dental Entrepreneurial Programme

1:00:32 – Daily life

1:04:16 – Choosing associates

1:06:59 – Company culture

1:08:26 – Legacy & last days on Earth

 

About Sameer Patel

 

After qualifying from the University of Birmingham, Sameer was awarded the Centenary Prize and was nominated for the Clinical Excellence Award. Whilst working in practice, he continued his postgraduate education at Oxford University before moving to Guy’s Hospital, London. Sameer was awarded, by examination, Membership of the Faculty of Dental Surgery at the Royal College of Surgeons in London.

He worked in Sydney, Australia, both in practice and in hospital, before returning to the UK to become a partner at Blandy House Dental Practice. He’s completed training in Implantology at the Eastman Hospital and is a member of the International Team for Implantology.

Sameer enjoys comprehensive dentistry for all ages and is a certified Invisalign practitioner, providing invisible orthodontics for teenagers and adults. He enables a more conservative smile makeover.

Sameer was the recent Chairman of the Reading Section of the British Dental Association and is the current official dentist for the PCA, Professional Cricketers Association.

[00:00:00] Stick to your protocol, stick to the way you do stuff, and again, all of these are just learning lessons. You know, when you’re in it, you feel, oh, God, what a helmet, why do I do that? But then you realise actually stick to your protocol, stick to the system, stick to what you do and try not to go out of that too much, because actually that’s when you produce the best clinical dentistry.

[00:00:26] This is Dental Leaders the podcast where you get to go one on one with emerging Leaders and dentistry. Your heist’s Payman, Langroudi and Prav Solanki.

[00:00:43] It’s my great pleasure to welcome Sameer Patel onto the podcast. Samir is now principal of one of the highest profile prices in the country, 11 Dental with his wife, Sheibani. But to me, it’s great to have you. This podcast is about trying to get to the person behind the persona, and we tend to sort of start with the same question and the same question. But the first question generally is how did you grow up? What kind of kid were you? How did you get Stenstrom?

[00:01:14] Yesterday, she was not even on the horizon, I’m from a family of doctors and some dentists in there, and it just grew up with a passion for cricket. And everything I did was about being out there, being playing sport. And that’s all I wanted to do. And so that’s what I did. I just remember growing up playing cricket almost every single day and fortunately I was OK at it. So I then got into the county teams and had some great coaches and mentors that then took it to a level where it became quite serious. But growing up, everything was driven just all about cricket. And I remember I was I went to private school as a young boy and then went to Selective Grammar School. And I was struggling academically in this year of one hundred. And I was like between nineteen ninety five. And we had our headmaster meetings and he said and I said, he said, if you’ve got anything to say, I said, I think I’m struggling. And he said, but no one else plays for the first team in cricket, hockey and rugby and captains them. And so I think you’re doing OK. Keep going. And for me, for the first time growing up, that was the first affirmation that I had had because I’d grown up in a household where, you know, Dad would work, mum would be at home.

[00:02:32] And often, you know, I think Indian or all across the board, but we’re just not given many compliments. And I remember also winning a game. I was forty five out. We’d be in this really tough school and again dropped into the car is like, why did you get up? You could have. I mean, I was like, so I grew up with very few affirmations and my sister was really bright and she was academically driven. And so I just think that I was a really happy child, don’t get me wrong. But what I look back there was never that much well done. Well done. There was a lot of love and there was a lot of love because we had a huge family and that was amazing. But I grew up in a very happy household and I was told that it was okay to play cricket and do some stuff. I suppose as I got older, there was a little bit more pressure from parents to do some studying is I think a lot of Indian parents do. But it wasn’t until the age of 15, I think I had a self realisation and I walked into a pharmacy again, Dad had picked me up from school and we were driving back home and he had to go pick up some medicine from from the chemist.

[00:03:38] And the pharmacist sat me down and he was OK as a bloke. So we used to see him a lot because I used to go and pick up the medicines with Dad and he just said, where are you going to end up? And I said, I just want to play cricket. And he said, What happens if that doesn’t happen? And for that, I mean, I don’t know where it came from, but I just knew at some stage I wanted to be successful not in cricket, but have to be able to do stuff that I want to do. And I knew that I had to study. And thankfully, I was in a school that was so academically driven that actually just to turn that on. And when I turned my mindset, I just naturally had affinity to maths, chemistry, biology, and I was being successful. And then again, it felt good to be successful and like anything. And the thing I learnt with my children is they will do what they enjoy. So let them enjoy stuff and let them be good at it and they will then be successful. So I then did my GCSE and did my A-levels. And as I was doing my A-levels, it was then what am I going to do still? And I still want to just play cricket because at this stage I was now playing for Berkshire.

[00:04:40] I was playing the first team at Redding and I still knew I had to do a degree and must do a degree. You got to just go play cricket. So then I was playing, I was playing cricket and biology was the quickest way I could get in and out of university quickly. And then I started doing some. They set us up for work experience and solicitors and dentistry. And actually dentistry was OK. It was it was a complete there was a game for every single patient. You have to win the game every time. It was great feeling, great import, whatever. And just in the side where I did my work experience in early and reading what a great bloke just set me on as a mentor to say you will be great at this, you are great with people. You love all your handi stuff. This is all we do. This is what you should do. And that gave me the impetus to change my whole UCAS form at the age of 17 from biology through to dentistry. And I would say that would be my childhood. In a nutshell.

[00:05:40] It was Jackson who convinced you that dentistry was the right career. You were going into Solicitors’ wherever, doing a bit of work experience here and there. And what was it during that work experience that made you think this is really what I want to do? Was it was it that parallel to the games in cricket that, you know, you’re winning at this, you winning at that? Or what was it about that work experience that made you think what this is what I’m going to focus my UCAS problem?

[00:06:05] You know, probably it was very much the people you were with people the whole time, and it didn’t feel like an office and it felt like it was practical. And, you know, dentists have this sort of feeling when you’re looking at them. They’re always on holiday. They drove nice cars and and it all just seemed about right. But the fact that I was with people and this list of three holidays a year minimum and I was like, oh, that sounds OK as a profession to go into. And in those days you needed BBC or BBC. I definitely won’t get into dentistry now, but I mean, thank goodness, you know, we could get in and then start our undergraduate.

[00:06:47] And so what school were you what sort of student? Where were you? Swati Smart kid. Top of the class somewhere in the middle.

[00:06:54] No, I definitely started. I was OK in primary school and we were all doing our stuff. And then as soon as I hit, I would say a medium to large pond. I became a very small fish and I knew I was a small fish and that was OK because in the sports world I was OK and everything sort of balanced. And I sort of felt I was I was appreciated and I had my place and sport kept me afloat, I would say at that time, because, you know, to be in that sort of percentile the whole time through your school thinking not that clever, not that clever. And then when the headmaster says, you know, what is the point, one percent in the country that go to these type of schools and you just so happen to be in the 90 percent, it’s OK. So I don’t think I was. I just think I had potential, but I just wasn’t interested in exploring that. But then when I did and I found some sort of form and some sort of rhythm in terms of studying, and then you got rewarded for it, it felt pretty good. And therefore, I would say I’m very much driven on target driven and rewards. And I would say that that hasn’t changed to some degree. I love applying for these awards that are there in dentistry and things have now sort to calm down a little bit because Shivani is now a judge within the private industry awards. That’s my life. So I just feel like, you know, achieving something. And now it’s now in the business world. It’s just that I would say I’m a achiever and I like setting myself my own goals. I definitely wasn’t a swoll. I didn’t spend much time studying, but I did enjoy learning at that stage when I then found out it was interesting. And you honed in to maths, chemistry, biology, A-levels, and I say that’s when it changed. I enjoyed learning

[00:08:40] Something. You said, you know, you were talking about Asian parents not giving compliments. And I can relate to that obviously was a different time back then, but you turned out really well from it. So then with your own kids, did you feel the need to be the same or did you feel the pain of that and want to address that? Because I remembered the first time my dad telling me he was proud of me was when I fitted eight veneers on him twenty twenty seven years old or something. But because he’d never said it before, I really felt it. But then as a reaction to that, now I tell my kids I’m proud of them all the time. And my feeling is maybe, maybe I’m overstating it and. Well, how do you handle your kids?

[00:09:28] Yes. And so, look, I have three kids, 11 year old, and my twins are five. And I think the biggest thing I try and do is provide a home with a lot of love because I think life is hard. And that’s the bit I figured out. Life is hard. And actually to come back to a loving environment is so important. And so that just allows your child to then be who they want to be. But when it comes to disciplining, definitely I have discipline and I think that’s part of growing up and understanding rules and pushing boundaries. And I am very much I’m proud of you, but I sometimes do feel a bit like you, I would say, because I knew now I would have perhaps had not got to where I am today if I hadn’t wanted my parents adoration. And so I think there is a fine balance between giving them love and telling them I’m proud of them. And I don’t think I’ve found that, by the way, because I’m a big softy with my three girls. And but I just think there is that line and there’s that line of making them feel their loved, but actually understanding this discipline and wanting them to be the best they can be. And I think that’s what our parents wanted. You know, there was no mollycoddling. We just had to get on with it. We never saw our parents. They never helped us with our homework we just sat at, whereas now it’s so different. We’re so involved in our children’s lives. And is that a good thing or a bad thing? Again, I don’t know. I don’t know

[00:10:58] If it’s it’s funny. When you when you were speaking about your dad, it just reminded me of mine, the accident, everything made Be Gone book. But the interesting thing is, you know, I’ve come home and say I’ve got ninety seven percent in a maths test. And he said, what happened to the three.

[00:11:14] Yeah, I mean, we’ll all about first.

[00:11:21] So I do really resonate there. And I do think that that for me growing up I had a point to prove right. And it was well how do I get that extra three percent, how do I make my dad proud, etc., etc.. And there wasn’t a great deal of confidence back then. But I do think to me it was a driving force. But in answer to your Payman question question, I’m the total opposite. So loads of loads of hugs, loads of well done, proud of you. Compliments, blah, blah, blah. But you do you do kind of sit back and sometimes think, are you overdoing it? Is everything an achievement? You know, it’s hard to know what the right thing to do is, right?

[00:12:00] Yeah. Prav I just come one other thing. I mean, I was one of three Asian people in my school. You know, I’m born and brought up in Redding and the other two were brothers of half growing. So they were really English actually. So, you know, there were very few ethnic people in my school and then there was somebody that they enjoyed. And actually I look back on it and I think, well, that was quite tough. But I think sport cut through everything. And I never had an issue with any of that. And I then look, here are the stories. But I think it’s harder for me to know that actually I’m comfortable in my own skin and I felt I had to. Through just because I had to prove and I think there’s no hardship in a difficulty that you go through as a child because that hardship allows you to become the character you’re going to become. And actually, I’ll share with you, my daughter has some difficulty at school from a couple of the other girls. And I sort of dealt with in a way that what have you learn rather than I’m so sorry.

[00:13:05] I was like, I’m so sorry you went through that, obviously. But tell me what you’ve learnt and how you’re feeling and how would you do that next time. And I didn’t make it a big issue. And my parents definitely didn’t make race a big issue for me growing up. And it was never a big thing. And I would say, as I tell you a little bit more about me into cricket and then becoming a member of the AMCC and then a committee member, I would say all of that background of any all of that is to do with the fact that race was never a thing and I never saw me as a colour. And I think that more that we can make our children feel multicultural from whatever background you’re from. I think that would be a great thing. And I think there’s too much emphasis put on race and the differences that have been achieved. That’s not looking at a thing going forward, which actually then makes the child feel like he’s got to act like something or somebody some.

[00:14:00] You may be lucky in that where you were in reading, there were so few Asians that you were a curiosity. You know, if there were loads of Asians taking the jobs of people, you might have felt it more. Maybe, but but let’s move on from from race, because we talk about that too much, like you just said. Tell me this to me. You sound like a proper competitive person. And, you know, competitiveness has its massive advantages because you set goals. You get that dopamine rush when you win and all that. But I want to hear about the downside of being a competitive person. I mean, do you end up sometimes comparing yourself with others too much or or being really down when you don’t win, when you get in cricket or whatever?

[00:14:46] Yeah, look, I do self isolate if I wasn’t to win, but that’s more just retrospection of what I could have done better. And again, that works on a day to day basis in dentistry. You know, you can have a great day, but you know that you could have done that implant a bit better or finish those veneers a bit better. And so, again, the photography, such an amazing thing, because that’s my teacher on a day to day basis, when I’m doing my dentistry, the patient will walk out saying, well, thanks so much. But actually my will to want to get better is inbuilt advantage.

[00:15:25] Again, I’m sure that was a disadvantage.

[00:15:27] Yeah, but I don’t see us disadvantage at all because actually if I’m competitive, I’m just trying to self improve myself the whole time. And I’m not one to compare from a very young age. My dad being the doctor, he was set one thing straight, really early. Don’t compare yourself to anybody. It just make you unhappy. And actually that’s where my line is actually. For me, it’s just it’s about me and it’s about me and my family. And so obviously we all were different hats at different times. Once as a dentist. One’s a husband, one’s a father, one’s is a friend. And all of these things, it’s I’m wishing well. And so when you wish well for people, I believe that people wish well for me. And that’s karma. So I actually, you know, you asked me, is there anything downside about this? Well, I’ve been trained that there isn’t a downside to being competitive. It just means I know myself and I just would self isolate for a period, make sure I understand. Maybe it might be the drive back home, maybe cricket. I’d probably go in my room for a little bit. I was never a tantrum person. And those that, you know, I don’t shout don’t get angry like I’m not an ant, that is. So there’s no angst in me and I’m wishing well. And so there’ll be times that you actually say, God, that team played really well. And I would then draw on how that team played so well to improve myself.

[00:16:46] So an advantage.

[00:16:49] I hope that I’m not a question, but I don’t see is that.

[00:16:53] Yeah. So tell us about then why did you come work for Jackson as well, or does that just work experience.

[00:17:01] No, like he stayed in my mentor. Even today we speak and we meet and and we. What a great guy. Yeah, exactly. And he I would say he’s firmly one of my mentors that seeing me to my point now in my journey hasn’t finished. But I think that everybody needs mentors in every shape or form through through their life. And I love the fact that clubhouse has been able to access everybody. Now, you can access all these people, you know, these podcasts. You can access people and understand them better. When we were growing up, there was none of this and everybody was seen as an isolated entity. And I think the community. Dentistry and the difficulties we face in isolation in our surgeries, as well as the mental stresses that we take. I would definitely say all of this is positive. If you could keep the barrier of comparison to yourself, to others is a wonderful place because we get isolated. And the fact that you’ve had so many great people on your series so far. And thank you so much, by the way, guys, for having me. That’s really amazing. But I feel honoured to be on here because the people you’ve had on before. But all of this leads to it’s it’s individual, your journeys individual. But I still believe that you’ve got to find your own true north. So tell us about your first practise.

[00:18:24] I’ll tell you quickly, my dad was quite funny. So I went straight from there into VTE from university and VTE was brilliant. I had a mentor again called Pip Gary while in the high street of Slough. I would see everybody in anything and everything was OK if I got it wrong, it was OK. It was all about numbers, except he never came in to teach me dentistry. It never came in. We would have a meeting once a week and it would be on the business of dentistry. He loved the business of dentistry and I’d have to go to the associates to find out how I did that. Could I improve on that? What material using for that. And again, we’ve talk about mentors and people have influenced you. Massive influence on me. He made me understand from an outset the business of dentistry is a business as well as the dentistry. And so therefore, you’ve got in my life two great dentists or business people giving me advice. And therefore my shortfall was very much. Now the clinical side of it. And I felt at the end of that year I wanted to learn more about dentistry and I went to become a house officer, guys. And that’s an interesting story in itself, because they hadn’t had any non graduates. And I’m a Birmingham graduate, be a House officer in the hundred twenty years or whatever at guys.

[00:19:42] And because of this Europe and now they’re becoming kings, they had to invite other people from outside. So they said, OK, the first 12 generally get selected in the year guys to be house offices. So the first 10 did. And they offered to sell and they didn’t even apply for it. Just somebody on my VTE just said, listen, you might want to apply. I know this is going on. It won’t go to the market. And I applied and Nigel Fisher, who was selecting who got it, who got out, I went to see him speak and I said I sent my application and there’s my name, Samir Patel. And he said, Yeah, you’re the cricketer. And I said, Yeah, I’d love to come and be on that team. And then that was the end of that. And I met Shivani, that guy. She was in my group of house officers. And so we had such a phenomenal group that year. We were out a lot and we had a lot of fun. And then dentistry from there was I was still playing a lot of cricket. I was playing England amateurs. I was playing Minor County Cricket Worcester for a little bit with when I was at university and I wanted to go and do a season in Australia playing cricket. And Fraser McDonald, who’s a guy’s in charge of orthodontics, sounded a bit like that.

[00:20:50] Don’t be silly. You can’t go and just give up that issue and go and play cricket because you’ll get crap on your CV. So the next day turned up with a fax, with a job interview and and so what a great bloke. He sort of piece it altogether, new someone out there and had this job for me. So I rang this dinner at 12:00 midnight, say, look, Frasers said I should ring you. I’m coming out to play cricket. I’d love to come and work. She said, just come out and we’ll give you a job. I said, Don’t you have to sponsor me on that? I just come out and give you a job. So did my MSDS at the end of that House of the year and I flew to Australia and I went the next day to go and see Donna. I should I got a job for you. Like, okay, so what do you recommend we do? She goes, Well, I’ve got somebody finishing two and a half weeks. Maybe I could offer you that post, but you’ve got lots to do with registration. And anyway, it all worked out really well. I worked at United Dental Hospital for six months, played cricket for University of New South Wales. And again, we won the great championships out there.

[00:21:58] So we had a phenomenal group of players. And I came back and by that time I met Shivani and we’d got married and I landed a job with Oasis in Twyford, which is again near where I live, near Redding. And again, there was a lot of emphasis on understanding the business. So again, I was just trying to find my form and I did Krystle’s course. I did the stuff of implants. Eastman again, I was thriving knowledge because I feel I was being given business of dentistry, knowledge and understanding how that was. But I was still thriving of now having to understand dentistry. And the one thing I would say that we talk about children earlier, the one thing I’ve learnt from that journey to that point was don’t put your kid out. I was so not burnt out the age of twenty three that I was so thirsty to educate myself at that stage on what I wanted to educate myself on. And I would say that would be a big thing that I’ve learnt from my experiences and I’m passing on to my children, that let’s have a lot of fun. Let’s find out what it is that you’re good at. And as a dad, my job is to get the best out of you and for you to enjoy your life. So, yeah, that’s that’s my point to the oasis.

[00:23:19] It seems to me that your your education is almost like back to from when it comes to practise owners. So a lot of practise owners dive into a practise or a squat. They don’t know what they’re getting themselves into. And by default, they have to learn the business of dentistry. It’s, you know, live or die. Whereas for you it seems like your first job, it was all about the business of dentistry. And the clinical thing was a side thing that you have to find, seek help from other people. And then once again, to Oasis. Do you think that’s the secret to how you’ve been so successful in business with your practise? And also moving on to you’re going to tell us a little bit later on about your business courses. Do you think do you think that has been the key? And do you think dentistry should include a bit of business as part of the curriculum?

[00:24:10] Yeah, I mean, the course is really an understanding of that. We’re not taught it. And I think in dentistry, it’s very much your training, your time for money. And so when we move forward, if there’s anything I could teach younger dentists is invest early and if you invest early, the compound effect of your investing early will mean that you can make the decision whether you work or not when you’re older. And understanding that, as well as the right investments, obviously, I think takes a lot of pressure. And I speak to a few dentists about ethical fighting and making sure we stay on the right side of dentistry and doing it properly. Payman knows me very well in the way that I work in my practise as one of the most clinical awards for any practise. For me, that is the most important 11. So, you know, we have Richard Fields, Shiraz Rollcast, Shibani Patel and Antilla, all these superb clinicians, and it’s all about the quality of dentistry. And therefore, if you’re doing quality dentistry, you will be looked after and it will look after itself. But if you can augment here with investment and the understanding of financial intelligence, I believe that you can make clearer decisions on your life, on how you treat the patient and having them at the primary interest of what you’re doing. And it all comes together and your energy will flow a bit better and your karma will be a bit more relaxed as well, because I think it’s a very stressful environment otherwise piecing it all together.

[00:25:50] So what you’ve what you’ve just said there really makes sense in terms of everything that you’ve put together. But you came from this cricket playing dentist who’s worked in a few practises, has been given a bit business knowledge. What was the actual journey to get from an associate oasis to having this multi award winning practise with super talented clinicians? If you just put that out there and you think about another dentist out there listening to this is such a lofty goal, how do you how do you recruit these super talented people? What is it that you attract them with? And then how do you get to that point? What was your journey from the point that you were an associate to where you are now?

[00:26:32] So from Twyford, again, I believe networking is so important and thankfully I enjoy networking. I said to you earlier, you know, the people side of things I really enjoy. And I went to the PTA local committees and would listen to the lectures in the evenings and ended up being the chairman and the chairman for the GDP. A guy called Steve reduced our practise in Henley and he approached me and he said, look, you’ve got a good reputation. I’m looking for somebody to take over my practise and the partnership. And so I went to see him. And it’s this wonderful Georgian building in the middle of Hanalei High Street. It’s a beautiful building, great you listed. And I was just blown away by it. And then I walked in and it was just, do I belong here? This is so nice. And my two partners were 10 and 12 years older than me respectively. And I thought, well, this is going to be a great training ground for me to to work and and now go to the next step. And I was so excited to own a practise. And I remember Shivani, who always so supportive. It’s like, how are we going to pay for that monthly expenditure that we have to put in the fall? And I said, you know, I think you’ll be OK and you have to take that leap of faith. And then I joined it.

[00:27:47] But interestingly, when I joined it, it was actually very difficult because the vision of my partners was not my vision. And so finding true North had not been found at this stage. It was a tough and quite a few years where I was in this place. The vision of where bit, how they were working, where I was working, the way I wanted to work, the way I want the practise looked like I was I was a little bit claustrophobic. And at that stage, I had now given up playing county cricket and I was just playing club cricket for Ealing, which was great, but I was training quite hard still. And then Anthony, who’s my partner up in London, and he’s an orthodontist. I really respect the way that you talk and the way you work and the way you’re doing stuff. And I’m an orthodontist. Would you I’ve got this. Would you like to do something together? I said I loved doing something to the because I don’t feel I’ve really found what it is that I want to find here. And it was I hadn’t found my true north. And at that stage I didn’t know what it was. And he had found an orthodontic practise in the West End. And when we did all our due diligence, it was very clear that 90 percent was coming from the Internet and 10 percent was referral.

[00:28:57] And so I said, come on, let’s give it a go. So we remortgaged our houses, we put all our savings and we put it into eleven. And we were both had our own practises and we started. So Shravani nice and Anstee started that two days a week and so. Well that’s grown now. Then it was then I brought the then this building blocks, this is all building blocks. So then it was about general dentistry in and then we brought another orthodontist. Since they were busy I brought Peter in who’s my first associate. I brought in there’s a general dentist and now were eighteen of us. But that’s grown just three blocks of getting busier. And if I can share with you how we started at again, it started Prav. As you said, it didn’t start with clinical dentistry. It started with Accenture coming in to come and tell us how a business should run before we started it, so we had capabilities and the orthodontics was divide, it was they were given three options. You can have a match at that stage with metal, metal, metal, ceramic, ceramic, ceramic. And that was their option. And he said, Starbucks, do it. You give them three options. They’ll pick the middle one 80 percent, pick the middle one. So now what you want is 80 percent. Pick that middle one. So we were like, OK, that’s what we’re going to do.

[00:30:10] And then we built in what our overheads were and then we built in how many patients we want to see how we were going to market, how we had to increase our marketing to get those numbers in. And then we achieved the target. And, you know, a lot of it is knowing your numbers as a leader. And from the beginning, I knew my numbers and so happy to say we’ve grown that business 600 percent since we’ve owned it. But it was from understanding that my staff this is my numbers, this is what we’re doing. And then having a plan and having a name. And every year we would have an aim of this is what we want to try and do. It doesn’t mean that we’re selling more stuff. It just means we need to open the top on marketing a little bit more now because that’s not happening. And again, talking about where that comes from, it comes from us being stable and having incomes from our other associates, our other partner jobs, basically. And so therefore, there’s never drive to make 11 a money spinning machine or it was just about having dentistry. And we tore down the whole of dentistry and made it the most remarkable customer experience that we we thought was possible. And we did that with Accenture. To start with

[00:31:22] A couple of questions. When you say CPI’s OK, we’ve got, I don’t know, top line. Bottom line. Did you focus on one of those two? Firstly, no. Well, which one of those two?

[00:31:34] We basically had KPIs. Just understand what our aim was as a

[00:31:38] Company backing key KPIs that you were looking at a

[00:31:41] Large number of bonders, for example, because it was all it was just orthodontics at that stage and that’s all it was. And then we got the lease for upstairs. So at the same time of our profits were trying to refurbish upstairs. And you’ve been upstairs to my room and that space there. And again, it’s it’s an environment where it’s conducive to people wanting to have dentistry and opening their mind of seeing what is possible. So CPI’s a number of bonds, number of new patients seen. And it was very simple. No leads, number of new patients booked in. A number of people went ahead with treatment. That was the journey at that stage.

[00:32:19] And what about what about that sort of, you know, looking at your place and the way you’re discussing it, you’re trying to create sort of raving fans out of your patients instead of just patients. So what are the things you do to to make that happen with a few tips you can give us?

[00:32:37] Yeah, I’d love to share that with you. The first is all receptionists are trained. If somebody asks for money, just ask them about where are they travelling from and if they’ve got if they need a crown and they’ve got a broken tooth. I’m so sorry about that. Are you in any pain at the moment? It’s the whole deflection is not money, because I don’t want to trade money. I want to trade a feeling. So the journey will start from the beginning of somebody feeling well, they’re a bit different. They might make three calls and they’ll say four hundred pounds. Six hundred pounds. And I’m so sorry that you’ve got this problem. Can we get you in today or tomorrow? Is it sharp? How do you know which I mean regarding the Crown I can’t tell because we’ve got a variety of crowns. But let Sameer make the decision which is best for you because that’s, that’s his job. And that would be my job. Your job.

[00:33:31] So the interesting thing is a simple thing, you’re absolutely right. I’ve got a broken tooth that I’m so sorry from the from the receptionist is actually the first thing I’d like to hear is

[00:33:45] How can I help this, my name. And so and then at the end, when you were 11, if any of you want to call calling. I would want your feedback. They should say, is there anything more I can do for you at the end of the call, even with me when I ring? Is there anything more I can do to me? So therefore, you’ve got a concierge at the end of the line for you. So therefore, now, really, money is not the number, it’s oh my God, I’ve got somebody looking after me. And then it’s about when they turn up and the feel of the place and the balance of what the website looks like and the aura and the colour of your surgeries and your waiting room. And the trust starts from there of like you’ve walked from your website into the waiting room and they’re feeling this is OK. This is exactly what I thought it would be. And trust starts there. And then they come and see you and you just want to know about them. And we use photographs, we discuss what their concerns are. But when we do it, I always say that if Henry and Henry Ford did market research, they wanted faster horses and he built a car. So when you come and see somebody who feels they can look after you and who’s done all these years of training, it shouldn’t be the passion that drives the treatment plan. It should be the dentist to educate the patient. And this is what it is. And at that stage, we then click how we make the plan and then taken away by a treatment coordinator. And I don’t really talk about money at that stage because my job’s health care driven and therefore often we didn’t have the treatment coordinator and sometimes we still don’t.

[00:35:22] But I think that’s a really important side of it. If you want to convert large treatment plans and make people have comprehensive care dentistry. So a lot of what we do is at 11:00 is when people have that single to dentistry for many years and they’re now looking for somebody who can take care of them for comprehensive care, they often see us. But actually, in your own practises, I would love you guys to be saying what I’ve been doing, single tooth dentistry. A lot of it’s going on. Let me take some photos and let me show you what I think we should be doing to take care of your mouth, to make sure you have less emergencies. And that style of dentistry takes a lot of pressure off your staff yourself. Everybody has a role. One of the I mean, I have so many mantras, but one of the thing is leave your jersey in a better place. And I don’t understand why people work for somebody for 20 years. I mean, like, what are you doing? That’s funny, but I’ve had four CEO roles of eleven Dental. I don’t want the same people working for me. You know, my receptionist who’s now my practise manager. I have a dream coordinator who is my receptionist. And it’s like we want everybody to keep getting better, learn more, learn more. It’s just not me. It’s not my clinical team. It’s everybody. So when I started in the practise managers I had, they would not be my practise manager. I want today. My treatment is not the same treatment coordinates and how

[00:36:39] Much training do you do for your team? What’s the what’s the sort of you know, because these are Prav knows this better than anyone else. Right? You can you can talk to a team about phone manner once, and they might do it for a couple of months, but it needs constant training. So what would you do? What sort of training regime for these people?

[00:36:59] Yeah, I think I just trying to get them passionate about their job and passion about their job means that they will over deliver to you as your principal and macro manager. Don’t micromanage at all. I said you earlier, I’ve got very relaxed demeanour about myself. I tell them I’m there, but I’m not interested in micromanaging. And there are just a few ground rules and don’t come to me with a problem. Come up to me with a solution because I’m employing good people to have the solutions. And it might be I change those, but then you will understand what it is that we want to try and achieve after a few times. You’ve got it wrong. And I would say meeting after meeting after meeting, you know, there’s a lot of meetings and there’s an understanding of culture. That’s the thing I set within the practise. So then when somebody joins, they’re totally understanding. So at the moment, the reception was just taken on a buyer for River Island and she’s got no experience in dentistry. However, she’s a buyer for River Island, who is great at customer service and the ability to understand finance and tracking and following up and all the rest of it.

[00:38:05] So I think trying to identify really amazing people who have a growth mindset similar to you. And I’ll give you an example of my practise manager. She came as a receptionist with a bit of accountancy background, and now she’s my practise manager. So everybody will grow and you want them to grow. And Richard Branson’s thing is we want my I want my staff to grow because they are looking after my business. And, you know, I’m only there one and a half days a week in London. So they represent me the whole time. And sometimes that’s a disadvantage because I would love to get more time and more training and and more influence. But actually, I think sometimes it works as a positive because they can just get on, not have the pressure of the boss. And I think the way that one leads in is a reflection of you. If you are comfortable, you will let them be comfortable. And I think that’s the place that we want to try and make Dental take them to a lot more and put them in a place that they feel more comfortable.

[00:39:09] Now, you keep referring back to True North. Just tell us a little bit more about what that means to you and what your true north is.

[00:39:18] True north is when you you’re doing something and you just go to sleep to refresh and go again. And so that’s true north, that’s where we all need to be, that’s where everybody wants to be, where you just go, you’re doing something. So I got a nice bedtime. There we go to sleep, go to bed and then wake up next morning. And I’d have no alarm clock for four years. I’d wake up at five, 30, do my yoga meditation, write down my list of stuff I got to do, play with the kids. I’m out the door. Go again. So true north is when you find something you’re so passionate about that it’s not a work. It’s not a job. Of course, everybody has days that they don’t feel the need or it’s a job. But actually, once you find something that you’re so passionate about, actually it doesn’t become a job and therefore life becomes very easy. And all the energies within you flowing and your energy level and your and your the whole movement of you is feeling great. It’s not feeling tense. It’s not feeling stress. It’s not feeling worried. And a bit of it’s finance in today’s world. I’d love for people to understand how to invest better as an example and books they should read and all of this education. I generally have three or four books on the go the whole time. You know, wherever I get a chance like that or even if I’m having a massage, I’ve got an audio book on like it’s going in in the car. It just clicks in. There’s no second that we’re not listening to an audio book or thirsty for knowledge or understanding. Now, not everybody is going to be is wired like me, but thirsty for knowledge means you’re growing yourself. And I suppose that comes through Payman to earlier my staff. I want them to feel that as well. I my job is to make them the best they can be, not hold onto them for ten or fifteen years in a practise because my practise then becomes stale.

[00:41:16] What are some of your favourite books, books that changed your

[00:41:20] Books that changed me? I think the telomere effect fairly recently is a wonderful book about health and it’s written by Nobel Prise winner. And it makes you understand how you can change yourself very quickly. The telomere effect. So that’s health. I love legacy. And it’s all about why the All Blacks have a success rate of 80 percent and the next best team is in the 60 percent. And it’s because they have a great culture and it me and it’s the most to most experienced team members will clean down the dressing room and leave it as they found it, regardless of wherever they play. So, again, that’s a great book for culture. I think Richard Khordad, to make people understand money and being financially free and just simple sort of understanding of finance, I think that’s a great book. I could keep going. I missed a great book, Just Understanding Business. And again, I love Simon Sinek and his mentality to infinite business mentality. Same in myself. It doesn’t stop. Why should it stop? Why should we finish? Nothing should finish. Everything should be infinite

[00:42:32] And do so in all of this. What you’ve been talking about, it sounds super successful. You’ve started off this journey. We mentioned in business from day one as an associate right through to having probably one of the most successful practises in the UK. And what really rings true there is you spend one and a half days there. So it really is a true business, right? It operates without you. What have been some of the darkest moments during that journey where you’ve really hit rock bottom? Can you share some of those with us? Because there must have been, even despite having all these advantages of being tuned into business from job number one, it must have been some big mistakes or some dark moments that you can share with us where it just it wasn’t quite going to fun.

[00:43:17] Yeah. First of all, I have made a lot of mistakes, and I think you speak to anybody that’s successful, they’ll say that they made a lot of mistakes and therefore I am happy to try them. And if you’re happy to try stuff, of course, you fall over. So I would say I think I probably would have made more mistakes than most, but that’s part of just giving it a go and then having that confidence. I hope it works and put my energy into that. And I would say constantly we sort of get it wrong and we’ve got to readjust it. Even the other day with one of my reception team, I sort of said we’re going to change things around. And then she came to see me and told me her point of view and I realised now I got it wrong. Absolutely, I got it wrong. But I would say my hardest days were definitely when I became a principal in a practise and I knew there was no direction, which was similar to where I wanted to take the practise. And I was being told that my style of Dental was different to theirs. And the comprehensive approach is not the right way.

[00:44:20] So I would say that that was very difficult because I was going through a period of playing cricket three or four times a week and working three times a week and then going to working five days a week, as well as being an owner, being a principle, being aligned with my partners that weren’t aligned with me. And they are great people, by the way. They’re really lovely people. It’s just they weren’t aligned with me. And I’m still here. I’m here in Henley giving this interview and I’m great friends with them. We are now a lot of water under the bridge with no recourse of what happened then, because I’ve learnt from it and often my tormentors have become my mentor. So I love the fact that it was so difficult then and I became even thirstier to become better as a dentist. So I would say they were definitely my hardest days. And also when we took over 11, when we had sort of roll the dice of Prav putting everything in and I will still go back to none of the three partners got paid for one year and only Shivani got paid the second year. And then we started drawing in the year three.

[00:45:28] So again, there were times where we had our principles in place and we weren’t drawing any money, but we were fortunate that we had other businesses where we could live from. But they were not easy days because you’ve taken over this massive seven, four, seven business in central London and you’re young and everybody’s older than you and everybody appears very established and very confident. And I haven’t even got any grey hairs. And and it was just tough. But I suppose my network at that stage, they were all entrepreneurs and they were going through the same thing. And I would say that I had a lot of solace in hanging out with friends that were going through the same as what I was at that stage, especially when we took over 11. And it was really struggling to get off the ground with this big jumbo jet. And I just think it was great having people around me going through the same stuff. So I would say they would be my darkest or hardest days. But but saying that Prav, as you know me, a very positive, they became the most important days for me to be who I am today

[00:46:36] While we’re on it. What’s been your biggest clinical mistakes and what have you learnt from those?

[00:46:43] Yeah, I think the biggest clinical mistake is to treat anybody. And actually, I’m such a big believer in treating people that you want to treat and have the same values and have come to see you. And so I’m lucky enough now. A bit more experience that often happens as it comes to recommendation, but when you start, you want to treat everybody and if I can make a big sort of shout out to people starting their careers or starting their practise, I would say just make sure you’re comfortable with everybody, Yewtree and some you might not get right. And you can sort of get through it, but don’t treat everybody because they’re going to be some people you can never, ever satisfy. Even if you did the best dentistry that you could do and you can get you know, you could get the ball out the ground six out of six and they would still not be happy. And I think preparation of having a good team

[00:47:37] Is a particular episode that you can

[00:47:42] Tell the wrong to perforate the canal, that sort of thing.

[00:47:45] No, I go back to when I think guys, we used to drink so much like it used to be a concern to these students, these White House officers. And I remember who I used on PEDs and this boy, 16 year old boy, came in for an extraction of a lower left six. And I had had a skinful the night before and I was wearing my mask and I said to my nurse, can you call the patient and sign the consent? He’s 16 from the parents. And please don’t bring the parents in because I stink of booze. And he came in and I stop giving the local on the opposite side, just put the needle in and I came out straight away, going up the wrong side, put it in the other side, gave the local and the poor kid said to me, why don’t you put it in both sovereigns? I said, sometimes as we cross over nodes. And I said, from that day, I am not. So that was the end of me boozing or having more than a couple of glasses before I work. And so that was it. I would say that that was not a good place to be. And I learnt my lesson very quickly.

[00:48:55] That lesson is kind of obvious. What the previous thing you talked about, was there a patient that you couldn’t please or you didn’t judge them? Right. We had Paul Pomerol and he said the lesson he had a massive situation with his brother, with being sued and all that. And he said the lesson you learnt from that was that even the people you really, really, really get on with could turn. So you advised that you don’t treat everyone. So he was saying sometimes you think the person is absolutely right and it could turn ugly. So did you have one of those episodes

[00:49:33] You saw the lady of 11, about 20 percent fly in to see us. And there was one time a lady had come in from Jersey and she was a lovely Indian lady. And I think I even said, I’m going to treat you like I would treat my mama. I think I said that she brought up later on and she had some concerns and we got along so well and it was orthodontics followed by four a.m. and it would seem like that was the plan. And at the end of orthodontics, she was super happy. And the Provisionals, she was super happy. And always after I was on, I see everybody for a review to check the colour, to control everything. And that’s my protocol. And I went against that protocol because I rang her and said, how is everything? She said, everything’s fine about this one. Maybe we can make that bit short and rotate it. And I said, okay. And she came back and she wasn’t she wasn’t the phone. And she signed the disclaimer after we call them, and she was happy. And in the end she went to five consults to see if it was OK.

[00:50:41] And I paid for those consults and all those all the Dental said it was absolutely superb. Yeah, she wasn’t happy. And in the end, she came back and said, actually, I’ve now had some time. I think it looks really good, but I want half my money, otherwise I’m going to kick up a stink. So what do you do? You then manage it to say actually, well, you’ve reached it and I won’t tell you what I did because I don’t think it’s relevant to the whole thing. But what it means is stick to your protocol, stick to the way you do stuff. And again, all of these are just learning lessons. You know, when you’re in it, you think, oh, God, what a helmet, why do I do that? But then you realise actually stick to your protocol, stick to the system, stick to what you do and try not to go out of that too much, because actually that’s when you produce the best clinical dentistry and the most effective.

[00:51:34] And I mean, look, you put the final videos on. You said you liked it, then you cemented it on his face. You didn’t like it. Is that what happened?

[00:51:43] Yeah, pretty pretty much. I came back for the review and then said, no, I’m not that happy with it,

[00:51:48] Because if you had followed your protocol, you still would have probably ended up in the same situation in a way.

[00:51:53] Perhaps, perhaps. But again, when I look back at myself and said, where did I go wrong? Because I. And again, you know, the sports mentality is you could try to control the bulls. That’s what happened. But then you do. I gave the money back. That’s not the right thing to do because I didn’t want the hassle. But I don’t I know you so well.

[00:52:14] And this is supposed driven person. Let’s talk about the courts. Well, it’s interesting, man. It’s interesting. Sometimes you have to buy your way out of this sort of problem, even if it’s a good idea, it’s your principles. Yeah, you’re right. You’re right. Tell us about the course. But because it’s a very interesting idea, it’s a year course for purely non-clinical stuff, including some clinical as well.

[00:52:44] Yeah. And so, look, it came from lock down.

[00:52:47] And I mean, it’s got a name.

[00:52:50] Yeah, it’s called the Dental Entrepreneurial Programme. And you’ll find on a Dental Leaders dotcom elite Dental Leaders dot com. And the programme is called Dental Entrepreneurs Programme. And it’s very much for people who are interested in the non-clinical side of things, but also how to marry that up into the clinical side. And the whole of the first. It’s a module, it’s over one year. So so we’re all together. It’s only a small cohort of limited numbers. And we then go on this journey together like an MBA style. And so the first two days will be all about finding your true north, understanding what good leadership looks like, because leadership varies for everybody. It’s not the same leadership for everybody and understanding yourself. And we’re so lucky. We’ve got a Harvard Business School graduate and an educator coming to run that Hassan Khan. I mean, obviously, I’ll be sharing a lot of my stories in dentistry, but almost he is going to take care of that and say what they learn at Harvard Business School about running a business and what tips that they can give. The second module is about brand and team and culture and so on, brand, again, I’ll share with the delegates exactly what we have done at 11 and why the brand is so important rather than the individual.

[00:54:16] Obviously, you’ve got to have a brand yourself as a dentist, but the brand individual is very important. And we have the GM of Nike UK coming to tell us about how they have literally pivoted from being a consumer business into a virtual business, but also what Nyaka doing to maintain their presence as a high performer. So I’m trying to bring the elite of both in business and in sport together to allow us to all understand where we’re headed because our journeys are all different. And then the team and ship is going to be run by the Clive Woodward who won, who was the leader when England won the World Cup and how he put his whole team together and the mantra of being together and how he dealt with difficult individuals and how he put them within the team and how the team planned and how they did it all together. And it’s the DNA of a champion is his lecture.

[00:55:12] And this is what all these guys will patients

[00:55:14] Know they’re either friends or people that I now know well. So, again, I’d ask them to be involved with this and so lucky that they’re open to helping people go to the next level of the third module. It becomes a little bit more clinical and understanding how we do on new patient appointments at all, the way from the phone calls, how we answer them to treatment planning and how to change single tooth dentistry to comprehensive to Dental, which is what we do every day as dentists.

[00:55:43] So that if it is, I guess maybe from the clinical aspect, most valuable piece is that

[00:55:50] I mean I mean, it’s going to it’s so exciting because that’s when we’ve now found what you’re all about. You found it. Identify where you’re going to go. But actually the clinical side is what we connect us. And so I will share with you how we convert those single tooth dentistry patients into comprehensive how we do a new patient appointment and how important photography is. And Menasche Patel from Focus is going to come and do the whole photography side of things to me on that. And then finally, it will be the fourth module is about financial intelligence, how to understand your business, but also to create wealth. And my mantra on that is most dentists are one step away from being wealthy and it’s this financial intelligence module that’s going to help you to do it.

[00:56:38] Well, of course, so it’s eight days,

[00:56:41] It’s eight clinical days, obviously, there’s a lot of reading that goes alongside the this of Harvard Business School myself, we’ve put together during these three months times your way. But there will be meetings for the cohorts through that period on their commitments through that phase. It’s going to be held at Lord’s Cricket Ground, which is the home of cricket, which is, you know, and so that really brings it home for me as well. And if you want to know more, go to Dental, Leaders dot com. And we have sold half of the course at the moment and there’s an application form on there at the moment. But I’m sure if it’s successful, we will run it another cohort in the year to come.

[00:57:19] And just what’s the investment for that programme?

[00:57:22] It’s twelve thousand pounds for the full year.

[00:57:26] So moving forward, what’s the plan for whether you’ve grown sevenfold, six fold, six fold, you’ve grown six fold. Is there an exit strategy here? Is it now a business that just sort of looks after itself? You there are one and a half days away. Is there another practise in the pipeline?

[00:57:45] And there’s a whole chain coming. Isn’t going to go now.

[00:57:49] Look, I think it’s a very boutique practise. And the people we found that work within it, we work really well. We love creating high quality dentistry. And I get a lot of joy from my dentistry there. And so there’s no plan at the moment. We there is still space to grow. And so, as always, there will be a three month board meeting with action plans in place and we will hopefully just continue growing that

[00:58:20] The practise looks. Did you change that or did it look like that when you when you bought it?

[00:58:26] I’d love to share with you those pictures of before and somehow try and get them to you. It used to be reception. There was a there was a chair in there that had no spittoon and no sink. The lounge was blue carpet with four yellow stools. The bathroom had a baby changing area. And the ladies, it was horrific. There was one nice room at the back and upstairs was just a derelict shell where a paediatric doctor used to work.

[00:58:56] Oh, so you did all of that yourself. And so did you have an interior designer and architect? And so we had an architect.

[00:59:05] And I have to say, Shivani has been instrumental in the way that we have managed that. And so I would say the architect with Shivani, because, you know, your practise is an is an extension of you and we always wanted it to be asked that was doing that. And I would say that that is one of the whole things we say. We build trust as dentists. It’s got to go from websites to the way it looks, to the way you talk and the way you present and all your literature and everything. It’s got to be on

[00:59:33] Point because stunning building. Tell me about Shibani 11. Does she have only a clinical role or does she have a management role? And how many days is she there? And where are you the rest of the week?

[00:59:46] Yes. So Shivani is a clinical partner at eleven and she said two days a week and she comes from a background of being a hospital consultant. So she very much is in charge of the day to day the systems that are put in place and the way we run the practise from a clinical side, almost bringing that that from the hospital environment. This is how it was done, this how it should be done. These are the standards. So we all have very different roles as partners at the practise and we don’t try and overlap. I don’t try and get involved with that. Yes, I’ll have input. I’m obviously running the business marketing and I’m in charge of recruiting and actually looks for technologies and how we can become more efficient in the practise. So we all have very different roles and I think that’s symbiotic relationship is is is one of the success.

[01:00:32] What you do? The rest is on the one half days you’re there, where are you?

[01:00:35] The rest from two and a half days clinical in Henley and I have Fridays nonclinical and I try and get all my letters, all of the things that you need to run a practise. But I have a lot of people around me that help me run this. So I’m a firm believer of having the right people. You can delegate to that you can trust, which allows you to then to take stuff to the next level, because if you’re in the weeds, you really can’t then start planning for the rest of it. So having good team around you to start taking stuff off of you is a critical thing I would recommend to any leader out there as well.

[01:01:11] Good questions. I go to a lot of practises where there’s no element of performance related incentivization. Do you believe in that or.

[01:01:20] No, we have never performance driven our staff because we’re a health care business. But what what they do know is that there is a target in place at the end of each month that they are not privy to. And I believe they don’t need to know it, because if they do their role right, the practise will achieve that. And so once we achieve that, we do things that I think quite extraordinary, like we have closed down June shoes and gone in and allowed the girls to pick any shoe that they want with champagne in their shop. We Nike have given us vouchers that we can pick any shoe that the girls want if they achieve that target cocktail making evenings at a local place in Mayfair around the corner. So I believe in bringing the team together on a deeper level than a financial level is actually keeps your staff and keeps them loyal. But I believe paying good staff the right amount from the beginning. So therefore, that’s not the issue.

[01:02:26] If I was an associate and I want to be ambitious, I want to work in the West and I want to maybe work at your place. Would you look for would you look for an associates? You look more for the attitude than for the skills, because I’ve talked to a lot of associates and they go, well, I’ve been on this course. I’ve been on that course. Of course. Then I talk to you cats, the owners of these big private places. And a lot of times you guys aren’t looking for that. You’re looking for the patient management more than the clinical.

[01:02:55] Yeah. I mean, we’ve never gone to market for any of the associates. They’ve all been referral recommendation to date. Yeah. So that for me is a really important part of bringing culture in, because then they’ve got they’ve got I’ve just sort of said this is how we work, this is the way we want stuff. And then I totally get it. I want to be on board. And so when you set a culture from the beginning, people then will then align to that. But I think the big thing that I look for is people are a bit like myself, absolutely committed to excellence in clinical dentistry. And so they’re always self improving the keeping going. They’re keeping learning. And I think more than ever, the quality of their photography and perhaps an Instagram account allows me to see how good they are. It’s not that Instagram is important, because if they showed me a good quality photographs of what they do, I can understand that that’s the type of person I want. So I would say clinical photography and good records and a good story book of who you are as well as well presented and the ability to be able to educate patients and speak to them and communicate with them and and engage with them. All of that is what I would be looking for. And if you’re not able to engage or be able to be with anybody like that, you’ve got to learn how to go and understand how to put yourself on, not Dental course on how to how to read course.

[01:04:16] But it’s interesting, you know, I mean, look, I don’t really practise Prav you do that. If two associates present and one has fifty thousand followers and the other doesn’t, you’re going to go for the one with fifty thousand followers on you. Why? Because he’s going to bring in patients

[01:04:32] If that’s what you want. Patients. Yeah. Or the right type of patients. Right.

[01:04:37] Do you. Well do you think so.

[01:04:41] Yeah. I think you want both of those actually I think are still on the fence that you want the right type of quality patients, you want a lot of them. But I think somebody that could that’s going to do the wrong type of dentistry is going to ruin your brand as well. At the same time, you want to feel that trust and perhaps a few meetings and getting them to spend time with you or everybody will spend the day with me before they would start anyway. So again, they know the way the practise works, that it should be as much they choose you as you choose then.

[01:05:10] Yeah, but I could imagine, for instance, if you have one or two years out of university or even five or six years out of university, coming to work at yours is one of those things that a lot of people would like to do. I mean, it’s a great position, I guess I’m saying that right. But what I need to do, it’s interesting. You know, I’d I’d say to a young guy, you know, learn Instagram and learn digital marketing before doing that. MSE Yeah. Because in our world there’s loads of people with messages. Yeah. That’s not the thing that’s going to actually put you above. It’s an interesting world we live in. I mean, I find it amazing that I’m even saying this, but things are moving quickly now. The real

[01:05:51] Issue for sure, I mean, Prav you made the point earlier that it’s that all roundedness that you want,

[01:05:56] Right.

[01:05:57] Erm actually I think there’s some practise will be dying for that and there’ll be other principles that will stay clear of that. And so that would be definitely driven by the principle and the way that that practise was run. Mm.

[01:06:11] Who does the firing. Does that.

[01:06:13] You me talk to me about that night because I do it, it never gets easier and I have that conversation with myself probably ten, fifteen times, probably more. The words I’m going to say how I’m going to do it. My heart rate’s pounding and then you just get it out of your system and it’s like a massive weight off your shoulders. But you just talk us through that, the whole process of fine and maybe an experience where you’ve had. To do it, and it’s been a little bit easier.

[01:06:39] Yeah, I’m just really open on this. It’s not quite working. These are the reasons you’re a great person. If they are, and I wish you all the best, that’s it.

[01:06:49] And it is your approach to it in the build up of it. Is it totally unemotional, just facts driven. And this is what it is. Or just you get

[01:06:59] A little bit if you got to when you know you’re I mean, you guys know me, but it’s the businesses first. It’s not me. So therefore, for the business, this is the right thing to do and therefore it’s not difficult. Yeah. And also, I’ll give you one example. We had four staff, 11 this, this. And I say this was this was D-Day for us. And I went in I fired three on one day and we had one staff because the culture that was being created was wrong. And we’re going to rebuild from here. So don’t be frightened to do that, because if the culture is wrong and somebody being the bad, get rid of them soon. I mean, I generally I would say now with experience, I would get rid of them sooner rather than later. So therefore it doesn’t become difficult.

[01:07:45] And thus I like I like that because on the one side, you’re coming across all soft and touchy feely, but on the other side, you know, you’re strong on the things you believe in. You’re strong for doing it. It’s been lovely having you know, we’re pushed for time now to Prav Joona.

[01:08:07] Yeah. Yeah. So, Semir, imagine it’s your last day on the planet and you’ve got your loved ones around you and you’ve got you’ve got to leave them with three pieces of life wisdom or they’d be.

[01:08:26] Three pieces of life wisdom have infinite spirit, don’t think it’s ever going to end. Just keep going, keep going and have that infinite spirit, I think treat life like a game. And actually, it becomes really fun. Everything is like a small game. And you either win some, you lose some. And it’s OK. Don’t be hard on yourself. Worked hard enough out there. So don’t be hard on yourself and love and not hate, because actually, you know, that’s what’s going to come back to you. And if you’re somebody that enjoys love, then love back and it will come back to you.

[01:09:03] Worked love game for you guys.

[01:09:07] And how would you like to remember you spoke about legacy? What would you like your legacy to be? Samir was finished the sentence.

[01:09:18] Semir was very keen to help and was there when I needed him. I believe there’s lots of friendships out there, but I also know that we all go through ups and downs and great friends turn up when you need them the most, not when they’re superficial.

[01:09:37] So true. And if you had a month left, what would you do with your time? Play loads of cricket.

[01:09:43] Now I’m done playing cricket off now, so I’d probably be playing golf. But I would say with this infinite spirit, I would still I love travelling. I would continue to travel and go to somewhere where I hadn’t seen and explore that area and find a coffee shop and write about that in that area.

[01:10:04] Where’s your favourite place that you have been?

[01:10:07] I would say Australia is very close to my heart with with the stuff I did, but we were very fortunate. We got away before lockdown at Christmas and we probably had our best family holiday in Antigua just this Christmas. Yeah. And the girls are growing up and we would never go away for too long. Obviously, the business and the rest of it and Foreston said we’re going to lock down. So our original 10 day holiday turned into three and a half weeks out there. And that was a wonderful break and a wonderful time with the family with no agenda because we knew very little was happening when we came back.

[01:10:42] I love that, I love that. Thank you so much for having me. Thank you. Thank you so much on the show.

[01:10:50] Thanks, guys. Appreciate you having me on

[01:10:53] The course at Lord’s, you know, our offices around the corner. So they pop in and say, hey, I would love that. Thank you so much, but thank you. Well, yes,

[01:11:07] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders history. Your house, Payman, Langroudi and Prav Solanki.

[01:11:23] Thanks for listening, guys. If you got this far, you must have listened to the whole thing and just a huge thank you both from me and pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you got some value out of it

[01:11:37] 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.

[01:11:48] And don’t forget our six star rating.

In this episode, we welcome insight into implantology from Fazeela Khan-Osborne. Fazeela discusses her successful work from hospitals to private practices on Harley Street.

Fazeela also tells us about her experiences of racism, sexism and divorce as well as the uplifting legacies of her parents.

Enjoy!

 

“And I would say to my students, this is a service in our culture, to bow your head and serve someone is not to demean yourself. It’s like the highest form of love. And so I believe that I really believe that. And so for me, that’s what the ethos of this clinic is about.”  – Fazeela Khan-Osborne

 

In This Episode

 

01.06 – West Indies to the UK

07.35 – Why dentistry?

12.37 – Hospital politics

14.50 – Women in dentistry

17:55 – Business in the West End

23:47 – Getting motivated

26:03 – The patient experience

32:13 – Changing lives

37:40 – Failures club

40:39 – Treatment processes

45:39 – Daily life

52:35 – Children & personal life

57:31 – Dentistry on social media

1:02:10 – Dealing with loss

1:05:02 – The next five years

1:07:19 – Legacy & last days on Earth

 

About Fazeela Khan-Osborne

 

Fazeela’s extensive career has gained her an admirable reputation among some of Harley Street’s best. After qualifying from the Royal London in 1994, she continued her training in Oral Surgery and completed her Master’s degree in Restorative Dentistry with Distinction.

Fazeela writes for numerous journals, lectures on Implant Dentistry worldwide and is positioned on several editorial boards. Fazeela is also a Fellow of the International Congress of Oral Implantology as well as being a tutor on the Diploma of Implant Dentistry at The Royal College of Surgeons of England.

She is a member of the Association of Dental Implantology and the British Association of Aesthetic Dentistry. Fazeela currently works at The One-To-One Dental Clinic on Harley Street – a multidisciplinary aesthetic and implant dental clinic with a full dental team.

[00:00:00] And I would say to my students, this is a service in our culture, to bow your head and serve someone is not to demean yourself. It’s like the highest form of love. And so I believe that I really believe them. And so for me, that’s what the ethos of this clinic is about.

[00:00:22] This is dental leaders, the podcast where you get to go one on one with emerging leaders in dentistry.

[00:00:34] Your hosts Payman Langroudi and Prav Solanki, it gives me great pleasure to welcome Fazeela Khan-Osborne to the podcast because he has become a household name in the area of employment policy and teaching of Implantology. It’s lovely to have you on the on the show Fazeela. This podcast really about getting to the person behind the persona. And we always kind of start with the same question. Where were you born? How did you end up in dentistry? What kind of childhood did you have?

[00:01:06] Thanks for having me, guys. Real pleasure and privilege. I’m a West Indian kid. I was born in Guyana, in Georgetown in the 60s, mid 60s, and I was born to two parents that were human rights judges. And we traveled around based on wherever that was predominantly sent to. So we were a British Empire. Kids really in that sense, grew up in the sunshine, walked on the seawall every day after work. You can imagine mum and dad in the front and the rest of us trailing behind. Really happy childhood, as I was saying, to prevail here. I’ve got five brothers, so I’m No. Five of six and technically I’m the shortest. So, you know, I’m not the youngest, but I’m the shortest. So, you know, we just grew up with very simple, no TV, no phones, nothing like that. If we if we were having a birthday and we were having a movie that we’d fire the projector and the Disney movie would come out. It was that kind of thing, very outdoor life. So we’re really happy. Life came here, came here every year, actually, because when you were in that service, my parents were diplomats. You had to come to the UK as well as somewhere else, wherever you wanted to go. So we came here a lot. And then we finally my father was very British, obviously, and was educated here as well as my mum. So we came here in the late seventies. Seventy five, seventy six. And we came here for education. The political situation at home had got to the point where it was very dangerous for us. My dad was chief justice at the time our mail was opened. Every other phone call was a bit hard for one. And when you’re 10, 12 year old kids, that’s quiet. You look out the window and you see kids walking around and you you wonder what made you be behind the door and they’d be the other side of it. So, you know, I was very grateful, but my parents really came here to give us a better life.

[00:03:12] You remember actually the moment of arriving in New York, I remember.

[00:03:17] Yeah, absolutely. And I remember you. I was just coming up to 12. But what I remembered more was because National Service was becoming a conscription for women as well as men.

[00:03:30] I was coming up to 11 was the age and I was coming up to 12. So I was even past my sell by date on that one. And I remember being woken up one morning and bundled into a car with my brothers and looking out the window at the help, because obviously in that part of the world, you have a cook and a gardener people to help you. And then just part of your family, really. And I remember looking at them and thinking, I’m never going to see you again, but I didn’t know where we were going and I didn’t know if we were ever coming back.

[00:04:00] So I remember that vividly arriving arriving in the late 70s. You came, right? That was the winter of discontent. Yeah. So from all the bright colors to that sort of gray ju ju ju ju ju remember thinking you’ve downgraded.

[00:04:18] I remember thinking was the sun you know, why people why don’t people understand my English with my twang. And it was very it was, it was still the days of all the signage where you were the only colored kid in school. You were the only. I grew up in Richmond, so it was a very white middle class area. Very nice, but very, you know, a lonely place. If you didn’t have people that were like nice school. But, you know, it was tough. It was tough in the first days. And people would say, you know, when you go in home or, you know, that was when I was first introduced to the word walk, which I didn’t really know what that meant. I remember going home and saying to my mom, what’s the word she was? And she would say, oh, was that started already? But it sounds silly to say, but I didn’t really realize that I was a color till I got here. We were just kids. We just loved life. And that didn’t really come into our consciousness at all.

[00:05:20] So it was a bit of a rough start from that point of view due to the name calling and the and the the racism, so to speak. How did that manifest on you?

[00:05:31] At the beginning? It was just, you know, a little bit of it was a lot of names and it was a little I was the kid with long hair, pigtails and glasses, so, you know. Mm. Not fun. I got to five foot five when I was about twelve and didn’t go much after that. So I mean, you know, it was just and the thing is because I always had a brother in the school, it helped. But you did feel it was something you had to get used to and you did get used to it because the signs were still out in restaurants saying that you couldn’t go in or whatever, it was getting better, but it wasn’t done yet. And you were very aware of being in the minority in that society, let’s put it that way. But you were also very aware that your parents are working, but don’t, you know, work, working all day and you got to pull together. And and we just we’re very tight because apparently the lawyers my dad was was a human rights judge and my mum was appointed as a first female human rights judge, literally three months before we left. And so she didn’t take up post, but they were both barristers, essentially what they were doing here as well. Yeah, yeah. Although when we when we came here, you see my dad was fifty three when I was born well so but he was like forty, he was running around like baby and very, very active with his kids and my mum was sixteen years younger than him so we wouldn’t have to, I mean he was definitely, she was definitely the, the cool, calm, collected one. So we were really lucky. But he was already semi retired and still putting three kids through school because the kids had gone, but the bottom kids weren’t so. So it was tough for them because we had when you left a situation like that, all your money was there. So you kind of had to start again a little bit. So, yeah.

[00:07:31] When did dentistry come on to you? Oh, not for radar.

[00:07:35] I mean, why dentistry when you have both parents and in the US, I often wonder that I was the kid that brought the dog with the label like home with the kids that brought the kid home who who didn’t have didn’t have a nice home to go home to and they’d sit and eat with us. I’ve always been a caring person. I’ve always loved looking after people. I’ve always wanted to look after people. So I always knew that I would be interested or want to spend a decent part of my life doing that. So obviously, medicine would be. The thing that we turn to and I had also a member of my family who is a radiologist, so that was kind of going that way and I actually ended up starting there and then deciding, funnily enough, now that I’m out of surgery, funnily enough, deciding I don’t want to do medicine because I don’t want to do surgery. So I ended up with a medical biochemistry physiology degree and it kind of got very interested in genetics and that kind of thing. And I ended up working for Paul Nurse actually ICRA for a year to do my PhD and then decided I didn’t really want to kill animals for a living. So I fell into it really because I went to do my PhD at the Royal London with a guy who you guys are probably too young to know is a guy called Spears, who was a professor of physiology in relation to saliva.

[00:09:01] And I started my study with him and he said, why are you here? Why why are you in this lab when you should be out with people? And and it was you know, research is a hard taskmaster, really. And he said to me, go to dentistry. You love people, you’re good with your hands, go to the tree and you’ve only got to do anatomy. It’s only a term. And that was the time when you could do that and go straight into clinical, you know, the three, the full year. And so that’s what I did. What was your deal? It was on the saliva and there were a couple of genes in saliva and couple of proteins that we were looking at. The what how did that give you protection against dental disease? And I only did it for six months. So it didn’t amount to a lot. But it taught me to be really focused and to be really disciplined about what I did. And that, you know, I come from a very science background. So that that helped me a lot with dentistry, because dentistry for me is apart from the lovely bit of actually caring about someone, it’s really about the protocol and making sure that you do it in the right way. And I sort of get that quite easily.

[00:10:20] So I’m from there. Obviously, you went through dental school, and how did you find that? Were you sort of somebody who was sort of top of your class and all that sort of thing?

[00:10:31] No, I had a great time in dental school, so I wasn’t. But I was kind of in the middle. We had thirty three in my year and I was always around number eight, nine, that kind of thing. And I wasn’t I could do it. But there was nothing special on the hospital. Yeah, it was when it was actually the London hospital. So there was a big and I was really lucky because I had a great year and you know, we had a laugh and we had a good social life and and we worked hard, too, but we played hard as well.

[00:11:08] So which did you qualify as a dentist? Nineteen ninety four. OK, same same time. Yeah.

[00:11:16] I mean what did you think then would you did you go like did you have it in those days?

[00:11:22] Yeah, it was just coming in and I basically decided to run for you. Yeah. And I didn’t, I didn’t really want to do it and I really didn’t because I didn’t want to be sent to Colchester to do it. And I really got that year, the final year the Royal London or the London was really good at, you know, different hospitals are good at stuff. We were good at oral surgery. We wanted to get a tons of conservation, but guys were. So I really started to to to go towards oral surgeon because it was something I was really barbershops, basically, and I wanted to be better. And then I won the surgical prize and something happened that year because normally you’d get housetop when you’re in hospital, you know, and if you didn’t get it, then you wouldn’t get it anywhere else. And I remember walking past the the staff room of the oral surgeon room and overhearing a member of staff saying, well, I’m not giving her the job. And it really pissed me off. And I thought, right. And I’ve done a really good rotation and everybody was fine and I had a good time and did the job well. And the remarks that came back were really good. And I thought, I’m not going to give you the satisfaction of turning me down.

[00:12:37] So I didn’t apply. And I applied instead with John Langdon, who had done a bit of research with and I got an interview and I got a house job at Jorges instead, which was great. So I left and I just thought, I’m not doing that, not playing that game. And I just found that there was a little bit of that kind of thing going on in hospital. Even though I loved hospital, I didn’t like the politics at all. So I went to Georgia, do my husband job, and then I went to Keen’s to do the second bit. And then I decided to go back to London now on my own terms. But this time I was seeing one of the staff members married to him. So that was a bit awkward. But he was in restorative and I was in surgery, so it didn’t matter. And I spent another 12 to 18 months there doing right up to locum registrar. And then I went and did great woman straight in Newcastle. So I did the whole law in about six years, had a great time. But it kind of kills your life when because in those days we didn’t have you know, there was no contract. You worked 90 hours a week for duty.

[00:13:47] Did you have a plan from the career perspective that you were going to be a surgeon?

[00:13:51] Yes, I but I did. The one thing I didn’t want to do after having done all of that time was I didn’t know. I didn’t you could have got away with not doing it at that point. Just about, actually. But I didn’t want to do cancer patients because they all died. And that really hurt me. I mean, despite my tough appearance, I’m actually a bit soft and I get to know these people and then we would dehumanize the hell out of them and then they die. And that really bothered me. So I kind of made this decision that I wasn’t doing my space. And the other thing that happened was I looked at the list of consultants at the time and they were six hundred of them and two were women and both were unmarried and both were miserable sods. And I thought, I don’t want to be like you. I want a family, I want a life, but I want to do my surgery, you know? So I made a choice to bring surgery into practice and do it my own way.

[00:14:50] I mean, even even surgery at practice wasn’t really done much by women time.

[00:14:55] No, not at all. I think I know. I know. Well, that’s part of the problem. And I think, you know, in those days and it’s our own fault a little bit, you know, it’s funny. Lately, women in dentistry, she’s become a real topic again. Again. Right. And I tried to almost distance myself from that because I don’t think that we we are a special case. I think if you want to do something, you get you get off your arse, you do it. And if it takes you 10 years, it takes 10 years. And it’s persistence to actually get to where you want to go. And I had listened I when I built my practice that week, I had a kid, I bought my practice and I sent my master’s exam by myself at the time. I remember getting I’m in the breast feeding my son and giving that kid to my husband and saying, can I just go in the pub for a quick bite with the boys just before I go home again? And he said, Yeah, OK, no problem. And you know what? I’ve always been one of the boys because I grew up with boys, go out with boys. There was no concern about, you know, if you’re going to do it on your own, you know what I mean? So it was tough, but it was. All right.

[00:16:10] So then let’s let’s get this out of the way right now. So the women in dentistry thing that’s come back now, do you have some sort of sympathy with why that happened?

[00:16:22] I don’t genuinely I find I think there are a lot of talented women around, but I think they’re talented because they’re talented, not because the women. So that’s one thing. I think this the one about what we’ve got kids. But I had two kids. I had two kids. I have parents to look after, to practice, to look after the education to do you know, it’s about being well organized. It’s about my moms. I was very lucky. I moved back to West London so my mom could help me help us. I also had to even though we’re divorced now, you know, my ex-husband was the most supportive, fantastic person on the planet. And frankly, any education I wanted to do, he would say, you go do it and I’ll stay home and look after the kids. So I was super lucky. So between that, my nanny and my parents, I got it done. And it was just a question of organizing. And for a while, for about three or four years, I took, took, took, took, took the whole time. And because that’s what it required. But, you know, I was just very lucky. But they were supportive 100 percent. And of course, I got in with people like Koroit with Zacky, and I’ve been friends for twenty three years. He’s one of my best mates.

[00:17:39] So at what point do you remember it’s switching from, you know, you qualified as a dentist, you did this all surgery route and bought a practice. At what point did that change to West End high end teaching and all?

[00:17:55] Ok, well, I go to the University London practice, so that was based in Gower Street anyway. So it was already in slightly Western. But when I was a kid, we used to walk up and down High Street and you’d see all the little prince, typical immigrant story. And my dad would point out all these little gold plates. And I thought to myself, if I ever get good enough, I would love to have a plate. And for me, it was about achieving being good enough, not just arriving there, because you can. So it was an important thing for me. And the reason I wanted to be there was because if you go anywhere in the world and you say that you practiced there, there is an understanding or at least a belief that some of the best people in the world practiced there, that there is this collection of knowledge and expertise. And I wanted to be at least part of something that meant something. I think certainly when I was twenty five years old, I’m not sure I feel the same way right now, but because it is a very hard task.

[00:18:58] Master the West Westend could expand on that a little bit for me. Well, there’s the obvious things, right? You haven’t got walk by traffic. Yeah.

[00:19:08] You know, you have you know, there’s no really business in the West and it’s a it’s a boys club. There’s no question about that. When I, I still get mail saying, Mr. Osborne there, it makes me laugh. Actually, the whole the whole thing makes me laugh. But when I up in practice, I had done my and restorative and I done the top, my special area was Dehradun it and I think because my parents were a bit older, certainly my dad, I was really interested in this concept that, oh, they’re old, so they really deserve dentures. Why would they want nice teeth? And that whole thing disturbed me a lot because I have treated people who are ninety six years old with implants because they say in my chair, I want to eat my steak just like you, and why shouldn’t they. And I feel really strongly about that. And I think your ability to be the best part of yourself, to look in the mirror and think I’m still here, I’m still, I’m still great, I can still eat, I can still socialise with my friends. All of those things is what keeps you living. And so I wanted to create a place that wanted to look after everyone. And the whole idea of one to one was the care that I give you one to one is custom. It’s between me and you. And so that’s how the idea came. And in fact, the one to one name came because just before my dad passed away, he gave me a sculpture with a man and a woman looking at each other. And for me that was one to one. And so I used that as my logo. And I you know, I signed my lease on the 14th of November, the year my dad passed away.

[00:20:53] You never saw it, but he knew about it. And the ethos has always been when you come in this clinic, we sit down with you and we listen to you. And we we we look and we examine I really believe in the concept of sitting down for an hour and a half trying to gather as much info as I can. And also for me, I always say to people, how can I help? You know, for me, it’s and I always say to my students, this is a. In our culture, to bow your head and serve someone is not to demean yourself, it’s like the highest form of love. And so I believe that. I really believe that. And so for me, that’s what the ethos of this clinic is about. And when I did my education, I have to say, and this is where I think it’s changed massively for women, you know, most of the time that I went to a course, most people thought I was there to make coffee or I was going to clean the premises because they actually suggested it to me a few times. And that was just how it was, you know, and the day my life changed was a damn upsetting. So I said this was my first real mentor. I mean, I was with him for 15 years, very long time. And the day I spent that day and I remember coming back out of thirty three Harley Street and opening the front door, the sun was shining and I walked out into the street and I thought, now I know what I’m going to do. So that was my one of my moments of grace, I think.

[00:22:25] Do you see the kind of person to rise out of the witness, you know, like the next person when they thought when they heard that overheard the person in the corridor saying, I’m not giving the job to her, would have melted under or you felt you like you enjoy being mistaken for the cleaner because you’re going to teach them what is known.

[00:22:49] But I think when I was younger, you get used to being you get used to people expecting a little bit. And in my family, it was totally the opposite. My father was very pro women. I’m a Muslim girl. And he he expected more from me than even said to the boys, No, it’s not that I find that quite sad. I find it sad that people don’t have good expectations of you, you know, and I think that’s something I’ve tried to change when I teach because I really, really believe that anybody can be taught anything. And I think that teaching is about the acquisition of skills. It’s about change. And I really think if you believe in something, anything’s possible. And I was and that’s what my parents gave us. They gave us that belief. And it’s not so much the I I respect it. I certainly when I was younger, I expected it and I got it. And I just thought, OK, here we go. Here we go again.

[00:23:47] Does that drive you and motivate you? Does it does it make you think, you know what that person thinks I’m the lady. This person is not going to give me the job. I’ll show. And that give you more drive.

[00:24:00] Yeah, it does. It did at the time. Without question. I definitely had a much more feisty I think it mellow with age. I definitely had a much more feisty. Well, you put the barrier down. You know, I’m I’m a great believer. When people talk to me about barriers, I say to them that barriers in reality and the barriers in your head and I think more barriers of it sometimes than reality. And I am a person that if I want to do something, I’m either going through it, around it or over it, but I’m not going to go under it. And I fall down all the time. I fall down all the time. But the thing is, I am surrounded by a family that loved me. Come what may. They are unconditionally at my side. I’m supported in by my friends. You know, I said about even Asher and I have friends I’ve had for thirty years. And even when I fell down in the sense that I don’t know whether you will bring this up, so I’ll bring it up. When I got my letter right, that was four years of hell. Hell, because you suddenly feel that everything has been swept from under you and you suddenly start to believe that you’ve done something terrible. You’ve really that you’ve hurt someone. And it’s appalling. And I remember Corey and Zachy coming to my practice of the day and they sat down and read the letter and said, write, what are we going to do? And it was always we it was always the Three Musketeers, you know. And and I and I hugely remember Corey saying, if they come for you, they’ll come for me, too. And so I was always really lucky because loyalty to my friends is any of my friends call me anytime of the day or night. I will get in my car or walk there if I have to to get to them, because that’s what friendship means to me. And I think that’s why I’ve survived this long, really fiscella.

[00:26:03] Tell me about your patient experience, because from what I’m hearing right now, your whole life and everything is about loyalty, love, care and all of that. And so how do you how do you wrap that up in your in your patient experience? It seems to me you’re less of a businesswoman and more of someone. Is that, as you mentioned, to serve to give that ninety six year old the ability to bite into a steak for the first time in 20, 30 years solely through your patient experience, what happens? A walk through the door? Who do I meet if I pick up the phone? Who do I speak to? What is the experience like in your clinic?

[00:26:41] So usually a lot of my work is referrals, so it’s not the referral from in-house patients. So I think that’s a big plus for us and also a lot of my students and work. But although we’re doing that work together a lot of the time or is just direct referrals. So for example, I have referrals from each other and of the people in the area that I work with. So they will ring and we will have normally had a letter before. So we’ll be aware some white front of House will know straight away that someone’s called and they will be welcomed and say, yes, we’ve got the referral. We’re going to send you an email. Would you like to send us back to your availability? And we would normally say to them, we’ll call you by the end of today to get this sorted for you. Then they’ll come to me and show me that. And if I don’t know about it already, we’ll try to find the appropriate time. So, for example, if the patient is 90, I’m not going to offer them a nine o’clock appointment. I’m going to offer them at 11:00 to do a fourth appointment because they’re not going to get out of bed at 7:00. So things like that I’m fairly attuned to then depending on what it is, they will be called by my head nurse who looks after my patients and she will get to know them. She will ask them if there’s anything they’re particularly concerned about. She’ll ask them how they’re getting to us, you know, just in case there’s any delays, all that kind of thing. And then she’ll follow up on an email saying, I’ll call you the day before your appointment. If you have any concerns, please contact me before.

[00:28:14] So that happens when you walk in. We’re ready. We know you’re coming. So my head nurse will welcome you three covid. We would have known. We will have you a cup of coffee, whatever you want. You will sit down and then they’ll tell me straight away and I will go to to the waiting room or the waiting area and pick up the patient myself. I’ll then take them through and we sit in like a little coffee an area and sit down and have a chat. So the first thing I do with my patient in that scenario is to sit down and learn something about them, learn what makes them tick, why they’re there, what their experience has been, what worries them, what makes them happy. What they’re concerned about today is that away from the dental chair? Yeah. So we have a couple of armchairs. We have a coffee table, that kind of thing. Very simple. They might have a cup of coffee still in their hand. And then we’ll move towards the dental chair and I’ll say to them, this is what I’d like to achieve in the next forty five minutes. We’re going to go through it in this way so they know exactly what’s going to happen before we move to the chair and then we get to the chair. So I will do a full exam photographs. I tend to ask them what are the three or four things that they want to achieve? And I write them down in their own words. And I say to the if you decide that I’m the person who’s going to help you, we’re going to come back and look at this at the end when I fit. So I know whether I did this right.

[00:29:43] You look at just what’s really important about what you just said there is. You’ll know this payment because there’s so many people on Facebook who will advise you during a consultation to say, you know, you’ve just said if you decide that you’re the right way, I’m the right person for you, which is far more humble than some of the advice put out there, which they say, if I think you’re the right patient today and I decide. And so that puts that idea of scarcity in the patient to make them more likely to convert. Yeah. Or as you’ve just flipped that on its head and actually put the choice in the patient’s hands.

[00:30:25] Well, I think it is their choice. I think it’s also our choice. Yeah. I think, you know, if I feel and I’m I’m wrong sometimes about this, but I feel that most of the time I have some connection to people. And I think you have to have an alignment or a connection with the person you’re going to serve in that way, because it’s going to take 12 months sometimes. And it’s not just about the technical. Let’s get through the technical bit of the work that you’re doing. My area is is full mastery, but I don’t do all I’m for. I tend to do all on eight. So I’m actually trying to do the bone grafting of the gum grafting and put everything back so I don’t make units bigger than three. The biggest unit I’ve got is a three unit bridge. So I’m actually spending a lot of time, maybe 12, 18 months doing this. But make and the other thing I don’t do is I don’t do dentures ever. So for me, adventure is like in my hand of. Do you immediately load about 90 percent of what I do is immediately like, yeah, so obviously we have all the fancy stuff now with all the planning, the digital planning. We’ve got a lab here now and all of that and all the city and all of that. But for me, I want the technical side of things to be behind the patient care. And for me, that’s really important. I don’t want the patients, so I’m just going to have a impulsivity. I want them to feel that they’re coming here and we’re going to change one set of teeth to work for another set of teeth to do. And that’s a real responsibility because you can’t really afford to get that wrong, not to mention the financial investment they’re making. But it’s the fact that once you’ve taken all that away, you can’t put it back if you like. So you have to take that really seriously.

[00:32:13] What I find about the whole teeth in a day process procedure, out of all the treatments that we provide in our own clinic is the one that has, I would say, the biggest life impact. Absolutely. Above and beyond that is cosmetic dentistry, teeth whitening, even payment and orthodontics. Right. Is that you’re actually giving these patients back, Cruickshank’s and yeah. The ability to not worry about something falling out of their mouth. Absolutely. Or just a whole new menu of food, right? Yeah. Have you got any stories you can share with those of patients whose lives have changed? And what is the one that sticks out that’s had the biggest impact on you?

[00:33:00] I remember the first one I did, the first one I did was a lady who came and everything was moving to the point where she brought her models and said, you can’t take an impression because everything will come out. So I was already shit scared about what I was going to be doing if I was going to be doing it. So. So that was a big thing. And she was only sixty seven. So for me that wasn’t that old. And I sat down and I remember saying to her, and I’ve done lots of versions of this a lot, but I’d never actually done it all in one go. And I always made sure I surrounded myself with people that were a bit better or a lot better. So that wasn’t very difficult. And I made sure and I said to her, OK, so we used these two models, which were OK, and we kind of guesstimated what we were going to do. And I had everybody there on the day and I knew I could do the surgery. And my ex-husband was a prosthodontics, so I knew I had him as a backup. And he we did this as a double act for nearly two years.

[00:34:01] And at the end of it and I’m not joking, have we finished a 10 to one in the morning? It was about ten hours apart. A whole lot. And I remember her daughter coming to get her and everything was fine. I did it under sedation, so everything was cool. She went home and the next day she sent me a photo of her eating and she said, today is the beginning of the rest of my life. And I still have the photo and I still have the text to remind me of how fallible I am and how, yes, this can go well, but how lucky I am and how grateful I am to be surrounded by all those people to pick me up. And they do. They operate for eight hours is no joke. And I was really lucky. And I and I said to myself, I’m going to do five hundred and then I’m going to go and I’ve done five hundred and three. But but I also decided the last one I’m going to do for free because that would be my best one. Nice.

[00:35:06] Do you remember your first implant fame if.

[00:35:08] Oh yeah. I’ll tell you something, it’s funny, we were talking about it yesterday. I have it in my drawer because I do have it to look at. So every time I open the door, the surgery is looking at me. Yeah, it happened after 18 months. And I remember saying to me, I’m so glad because I was beginning to worry that you’d think they weren’t. Yeah. I remember every single day, every time I pick up an infant, I remember that you’re only as good as the last one. Really? Really. And, you know, I learned a lot from that. And I don’t worry that the implants will fail because after twenty six years later, you know what to do, because you’ve actually made all the mistakes and you’ve mostly made all the corrections. So by now, you should you should know something.

[00:35:58] If we ask if you want to say this question about mistakes. Because from from I don’t know if you’ve seen black black box thinking. Yeah, yeah. It’s about it’s about we can learn from mistakes and how in medicine we don’t sort of learn from our mistakes. What we don’t learn from each other’s mistakes because everyone hides their mistakes.

[00:36:20] If you had to think back, what would you say is your biggest mistake and what have you learned from it?

[00:36:25] My first big mistake was I was doing a placement with an oral surgeon, actually, and she put this implant in and I said, is it sound? And I wiggled it and it went into sinus. All right. And I remember thinking, holy bleep, what am I going to do now? And so my choice was right. Well, let’s go back to oral surgeon, open it up. We take it out. I remember saying to us that when it happened to him that you’re fishing around in this sinus doing this Cordella procedure, you’re fishing around. And then he literally set up the patient and the implant fell out onto the floor. And I remember thinking, yeah, OK, so after an hour of fishing around, I suddenly wised up and I said to the patient, can we just sit you up for a sec? And it fell on the floor. And in that moment, I literally looked up at the sky at the window and said, thank you so much. So there’s that. I’ve learnt a lot from that. I think putting implants in the wrong place, I think almost every kind of mistake you can imagine, nothing life threatening, nothing major, but every kind of thing that is not perfect.

[00:37:40] I have at least done once, if not more than that. And I think the difference is that when I go to surgery now, I don’t go with a plan. I go with 10 plans. So I always assume, well, if it goes to plan, we don’t need to talk about it and nobody does. You don’t learn anything either. But if it doesn’t go to plan, what are you going to do? What happens if this happens and this happens and this happens? And if I’m nervous, I will have spoken to cry about it or I will have spoken to six or seven of my colleagues and we have a club for failures. You can’t bring successes to this club. You only bring failures. And that is the best seminar we have. And there’s only four of us. But we bring the failures because we’ve all got the two, three cases that if you touch it, it goes wrong. And I still have a couple of those.

[00:38:30] Yeah, I mean, it’s it’s nice. It’s become much more fashionable to talk about in lectures. So you’ve been surrounded by some of the you know, the great looks at the flea and Koroit. What would you say? We just we just did a podcast with Paul Polman. Yeah. And the question of does it take to be a great implant surgeon because it’s not about drilling the hole, is it?

[00:38:57] No, it’s about knowing where to drill it. No. For me, the people my mentors are people like the two people you’ve mentioned, but also how Goodman, the Christian I went abroad and the thing that I learned the most was plan, plan, plan, collect as much information plan. Listen, go back, check it again and try to get some skills. You know, what I find hard is that you tend to sell what you do. And the problem is that if you when you’re younger, you’ve only got a few skills. So you’re trying to push those. And I keep saying to my students, life is this tool box of us every month, get a skill, get a tip, get a break and put it in there, because you might not use it more than once a year, but at least it’s in there. And I think for me, I have been on every major course going. I’m still learning. I’m still excited about what I don’t know, although it can be frustrating. But I find it for me it’s about trying to learn what I don’t know so I can do more and do better because I can always do better.

[00:40:07] So typically, this patient that you mentioned, the one that the new patient comes in my referral, let’s call it a full mouth rehab, how much time is spent away from that patient planning the case?

[00:40:20] If it’s a full full, I’ll spend an hour to one and a half hour sessions with them and then I’ll spend probably four or five hours writing the treatment plan and another three or four hours planning on the scan with the lab. Looking at the the stuff that comes is probably a good 15 hours of work before you get to the surgery.

[00:40:39] Well, easily. And the process of presenting your plan to the patient. Yes. They construe that by now we’ve got a lot of rapport. Yeah. No way we’re all going. Yeah, but I take it your prices are on the upper end.

[00:40:57] I think I’m in the middle. I remember once somebody said I was the most reasonable dentist in Piss Me Off that way.

[00:41:04] But I mean, I guess sometimes it runs to tens of thousands of pounds.

[00:41:08] I mean, a full month rehab is is definitely in the in the rebate of 50 plus years.

[00:41:14] So you’ve got to break that news to the patients because. Sixty thousand pound plan take us through it and the follow up process as well. I mean, so everyone’s straight away.

[00:41:25] No, but the thing is, when I do my consultation, the first one we measure, how many people come I don’t have 20 consults a month. I have three or four. So when you sit with me, there’s a good chance you want to be there. I’m not as expensive as Karibe, but, you know, I charge two fifty three hundred quid to sit in my chair. And it’s really for me to listen to what you want, what you want and also what you think you need. We’re very good at telling people what they need, and I’m not one of those people. I remember somebody saying people buy what they want, not what you tell them they need. So I’m very mindful of that. I sit down and I also learned a long time ago that people hold this notion of what they want in their heads for five days. And after that they’re off somewhere else, buying a car, buying a diamond, whatever it is. So we have a rule in the clinic, certainly for me, that when I see a consult from implant dentistry, you get by email and post a full treatment plan within five days, you’re then invited to come and talk to me. If it’s a simple single, most people will do that, but they will come to consult to do the rest of the investigations and then we would go to surgery.

[00:42:40] And if they need to see the therapist or the hygienist or or if they need to have a workup, some of the boys that I work with, they will I will segment the case into if they need. We can work that I do right now. I will send it to Tomko for Clark or somebody like that who’s been in my practice, and he will do all of that.

[00:42:58] They’ll remove all the carries the build the tools and we will set up the occlusal scag because that patient is having a fixed provision or whether it’s a rocket or whatever it is, even if they had a dentist to start with, because I find it a bit crazy that you’re selling this. And if it is not was 50 quid, we wouldn’t be talking about it by the crew. So you’re selling the most expensive thing in dentistry and you’re taking it to thousand and the first thing you do is put a disgusting flipper in their mouth. Well, what I what a great guy. What a great girl you are. So for me, that is the work you have just dehumanised that person. So for me, I would say to my students, if you do that, please let me know and please don’t ever come back, because it is the exact opposite of what I’m about. So the patient will come, we’ll talk it through at the end of the first ponza. I say to the patient, you have two decisions to make. One, are we doing this together? And two, how are we going to pay for it? And they are two distinct decisions. And in a sense, it’s like the jargony word is the call to action, if you like. So then I repeat that in my email and I say to them, if you want to do this, but you haven’t worked, it might be finance, it might be stage payments, it might be some of it’s on the course. Some of it is there are lots of ways to skin the cat. But if you decided that we are the people who you want to help you, then we can help you with the other side as well. And that’s really important to me. I don’t want to treat people who just have a stack of cash in the boot. I want to treat people who we’re going to make a difference to.

[00:44:40] But you tell the guy fifty thousand pounds, I bet you get a few shocked people, right?

[00:44:45] Yeah. But to be honest, maybe years ago. But I think nowadays people who are at the terminal dentition stage and they do not want dentures. And to be honest, I don’t have a single dental care in my practice because our practice demographic is from 18 to about, well, ninety six. But the point is the majority of people are within working age. So I’m going to get the middle ranking.

[00:45:11] I used to get a lot of everyday people that have just saved up and you just feel a huge responsibility for taking their savings, you know, so they know it’s going to be a fair amount. The one thing about media nowadays, find out whatever you want to find out so they know this already if they’re being referred. And a lot of my work is referred to the person. It’s a warm leave, isn’t it? Because the person sending Bulatovic.

[00:45:39] Tell me about the practice and you said you mentioned Tomko footlong. Yeah. How many associates are there? What’s the setup?

[00:45:46] Well, I don’t do associates, you know, so I kind of do I’m a pretend associate. So what I like to do, what I’ve always wanted to do is for each one of these guys to have their own little practice. OK, so they do do some associate work for me, but each one of them has their own bank of patients that belongs to them.

[00:46:10] So they rent the space, they take their own money, they do their own shit. And slowly over the time they are building their own little practices. And we essentially they pay a flat rate because obviously they’re young and they and they want to keep their expenses down. And I send the work on an associate 50 50 basis as well.

[00:46:29] But each one of them has their own little practice. And the idea is that eventually, hopefully three or four of them will get together and they’ll do it together as an expense share, but they’ll take their own money, have their own independence, have their own philosophy. But they will also have an ethos that is together. So how many of them are that? There’s four of them. And and obviously I have a therapist as well who looks after all of us. So so they all do a day, two days, three days. That is a full surgery practice. And they have gone through all of the courses that I’ve done. So I’ve kind of picked them based on I haven’t just picked on skill, actually. I’ve picked on that headspace, how kind they are, how honest they are, because I think if you have the right person, you know, me and Alphons are pretty cool friends. I love the guys. I love the way he does things. I believe in the same thing as he does. I think if you pick the right person, you can change anything. So same thing.

[00:47:31] A lot of time for our fans of such a lovely guy. And tell me about the vibe if you practice, Fazeela, what’s it like when you go there in terms of just the environment, the general buzz, the feel that you get when you walk in there with your team?

[00:47:47] Laughter I’m saying to the girls today, we love too much. There’s always we we were family. We’re not that big. Everybody’s part time except me. We look out for each other. We know what’s going on in each other’s lives. We care about each other. We also believe work is work. So when that switch flips, it’s time to put your game face on, you know? But the other thing is, I’ve been looking after probably 70 percent of my patients for at least 20 plus years. So they’re friends now. They’re people that we very sociable with quite often before pandemic. If a patient had said, oh, I’m not going to my husband’s not picking me up for another hour, I said, what? Don’t you pop upstairs with me, sit down and have a cup of coffee, have a chat. You know, it’s a very sociable place. It’s a very warm place. It’s very Western kind of feel. I love that vibe. There’s always fruit on the table. There’s always food in the fridge. You know, on a Friday night, we sit down. Even now, we try to have our practice meetings around, you know, an Indian takeout round, the one on the conference table. And I think I would like that family. I hope the big family I had at home, I brought to work. So from that point of view, it’s a warm, happy place. I’m not saying we don’t have moments when we’re I’m a grumpy soldier or somebody else else’s, but by and large, people are really great at their jobs. They love what they do. They believe in what they do. And I’m really proud of them.

[00:49:18] Sort so bossy. You so imagine. Well, first of all, what sort of bossy you when when you need to sort of batten down the hatches and tell someone they’ve done something wrong or really straight talking pain in the ass, you know?

[00:49:33] Well, if somebody comes to me, it depends on the mood. But I’m a very kind, caring person. If you need me, I’ll be there and I will help you. If you come and say it and say to me, can we have a coffee? And I sit down with you and I say, what’s the problem? I’m really don’t. OK, let’s do it. Let’s do it again. And I will be there and I will help and all the rest of it. But I’m also the person if I’m really stressed about something. Yeah, I’ll have a little swear occasionally. And I think I’m, I’m not tough, but I’m very straight talking. I don’t get what you say. Yeah. What you see is what you get and I don’t change. And the thing is but when I’ve said it, I’ve said it. I’m not somebody who doesn’t talk to you for days and all that kind of nonsense. I’ll say it and I’ll go. Are we good? Yeah, right. Should put the kettle on then. That’s kind of who I am. Mood everybody makes mistakes.

[00:50:30] What about your teaching? So you teach them on the course. Does that Crucell going with and.

[00:50:37] We suspended it. We did a couple of years, part of the reason we did that course was that we kind of grew up in an industry together and we actually wanted to share what we knew. So we did a couple of years and I was still at the royal colleges that as the lead to to. Yes, it. Yeah. And I had it. I’m not anymore. But I had a gig. I was associate professor at Stony Brook, so I had a gig there and I was just traveling a lot. And I was also running my own year courses, my own advanced courses for when I go. Yeah. So I’ve got a connection with how equipment in South Africa. I’ve got one question in Romania and all the rest of it. And so what I decided in the pandemic was to bring it all together under one umbrella and to just open it up. So now we’ve got an 18 month program which allows you to say diploma. We cover the curriculum, but we’ve got speakers and tutors. So the guys who have been through the course, taking the time and now tutors and they look after the general practices that come in and obviously the speakers like each other come and speak. And Alphons is one of my speakers as well, actually. But but what I wanted to do with the education is I wanted to create a place where people, young people could come see you in town and you got an hour to kill and you just want to come in almost like a like in the old common room school, you know, and you come in, make a coffee, sit down, somebody looking at a case and you just take part and it’s an open door policy and it’s a place where you can feel at home and welcome. And there’s always something going on. And the ones who are slightly older are teaching, the ones that are slightly younger, that kind of thing. And we’re doing that. We’re doing that. And we’re loving it, actually.

[00:52:24] And I just want to touch upon you, really, Fazeela and just sort of you mentioned ex husband. You happy to talk about that and.

[00:52:35] Oh yeah, he’s one of my best friends, actually. So I was married to a Welshman called David Osborne, who’s a senior lecturer at the Royal London and Restorative kind of came about a couple of weeks before I graduated and left. So when I came back, he was there and we eventually got married 18 months later. So he was still teaching in hospital, partly in practice. We had a couple of kids. And, you know, I think the stresses of life, we bought a free held in holosuite, bought 50 to that, nearly killed us. I’ve lived in Harley Street for about eight years. And I think, you know, I really knew where I wanted to go. And he was incredibly supportive. And I think maybe sometimes I wonder if I’m pushy. When I’m ready to go, I’m going, you know? And I think it was just the tough it was a tough we went through. So, you know, 2010 was a great recession even before that. And we ended up thinking that we were better separate than we were together. But we had one thing in common, other than the fact that we were both decent people.

[00:53:46] I was very, very lucky in that we both absolutely adored our children and we didn’t want to hurt them. So we had a very amicable divorce. I mean, obviously there were days where we wanted to kill each other, but very few. And even to this day, our kids say we didn’t really feel like you were divorced because you were just so nice to each other. And I worked with David three or four years after we were divorced because I’d worked with him all the way through before. So I was very fortunate. And I have happy children. And even though David is in Singapore, remarried to a very nice lady, you know, he is one person. If I needed some advice, if I was selling tomorrow and I wanted a really straight up, loyal, decent guy to give me a really good opinion, he would be the one I would go to. Mason. How old are your kids, Fazil? My daughter is twenty three to be twenty four this year and my son is twenty two this year.

[00:54:49] To either of them. Look at dentistry to be daft.

[00:54:52] One of them is, one of them is an architect in the making. So she’s going back to Cambridge to do her master’s in real estate, finance and architecture. So she’s fine, she’s fine if you like, of that seven, eight year road. And my son went into the family business of politics, philosophy and law. So so. Yeah. So I did one go to Cambridge and one go to Oxford, know what he’s thinking about going to do. His master’s there, but he went to work and he’s now in Austria this year just doing philosophy. He’s another one that wants to bring all the animals home and mend them. But I think he wants to do that with humans. So yeah.

[00:55:34] Did you guys not one of them to be a dentist?

[00:55:36] No, we didn’t. You know what we did? We kind of said when they’re ready for the career, we’ll open the door and have the chat with them. And they came to us and said, we want to do this. So we said, fine, off you go. And we basically said our job was to open all the opportunities to them and let them decide. But I can’t say I wouldn’t. I think dentistry is really amazing and exciting in twenty, twenty one, but really hard. I think the people, the the generation, the are the social media generation are much faster with each other than my generation was. You know, I’m fifty five years old. If I don’t like someone I just don’t go to the pub with them. It’s really simple. I feel the need to slag everywhere that I can find. And I think that harshness and the lack of grace is something that I’m glad that my kids would never be part of in my profession. And it’s this I’m better than you syndrome that I find really hard. And I say to the I treat the guys on my courses, the guys and the girls, they’re all twenty five to thirty five or even older. And I just say to them, you know, if everyone makes a mistake, everybody has got skills and everybody is learning skills and we need to be a bit kinder to each other.

[00:57:00] I think physically, you know, sometimes under the guise of what’s best for the patient, we can be quite cruel to each other. Yeah. And it’s it’s one of those things. It’s almost like you have licence when you’re talking about the patient. You’ve got licence to be cruel to each other. And and I see that quite a lot, you know, at the same time. Do you think Forstchen. The reason that they’ve been brought up on social media got massive advantages over huge.

[00:57:31] Yeah, but you know what I find, you know, for me, I would much rather pick up the phone and have a conversation with you about the fact that it saves all the twenty seven texts. And I’m Tony and you and you misunderstand me. And then we fall at the end of it anyway, whereas you pick up the phone and get what I mean is this and that’s the end of that conversation. So for me, what I find sad is it feels sometimes like the art of conversation is going all right. And I have to say, we grew up, especially on a Friday night, where we all sat around the table together. I lived with five boys through uni. Half of them would come home to mum and dad and we’d sit there, eat endless amounts of food, having a whisky and a cigar at the end of the night and just put it in the whole world to write, you know, that that conversation, that banter. And we still have it in the practice. But that notion of why don’t we just have a conversation? And in fact, when people come to me and say, how is it you get the conversion on your consults? And I say to the just have a channel for me when I consult a patient, if they buy, they buy. If they don’t, they don’t.

[00:58:42] I’m just having a conversation like I don’t know why, but I get the feeling I want to come to a party hosted by you. Why? I just feel like you’re one of those hostess with the most this kind of I love the food will definitely be good.

[00:59:00] You know, I’m not crazy, but I get on the summer. But you know what? There’s only like one or two things I really do. Well, everything else I just try hard. But, you know, I think. Well, you must kind. Thank you. Know what my dinner parties are like. You come, you have loads to drink at the beginning. We have really lovely food. And then I put some lovely Spotify and start singing or gets his guitar. That’s it. That’s what happens.

[00:59:32] It’s all downhill from there because I wanted to touch base on you if you were speaking about your dad in the sculpture earlier. Yeah. You mentioned to me before this podcast that your mom passed away not too long ago. Tell us a little bit about your mom and the daily conversations you used to have to have with you. Say your routine would be at some point during the day she was on speed dial, right?

[00:59:59] Yeah, always. You know what I loved about her? I wish I was anything like as like my dad, but crazy. She was calm and cool. And when she had something to say, you didn’t speak. But her entire life was her family, even though she was a very, very well respected senior lawyer. But she found the humor in everything. So if I was going out for dinner with anybody, I would get on the phone. I said, I’m going to need to tell you I’m not ringing you, but we’re going here and we’re going we’re going to do that. She knew everybody. She knew all my friends because she always encouraged us to bring our friends home. She always said, show me show me your company and I’ll tell you who you are. You know, it’s really old fashioned, but it is what it is. We had a bar in our house and, you know, my parents were you want to you want to have your your your cocktails till 3:00 in the morning. No problem at all of you come in the garden, whatever. And we’re just off to bed.

[01:00:50] So I was really lucky that I didn’t have to hide. I didn’t have to be the girl that had to put her face on in the in the bathroom before I went to school. I could do that at home. You know, I was very lucky. But my mom was the glue. She was the one who showed us how to love and and she loved us every single day. And she was our best friend. And she loved to laugh with us and at us at all the silly things we did. And now we miss we I miss her every day. I miss my dad every day. And with mom, it’s food. So even yesterday I said to my daughter, yes, let’s just cook that one thing that mom did. And, you know, we remember her story thinking about her every day and and just remembering the humor. But it’s something that is still very, very it’ll be there at my father’s been dead twenty years. It’s the first person I think of when I wake up in the morning. It is just one of those things.

[01:01:52] I’m fortunate not to be in that position. Right. But I know Songe lost both his parents. Yes. I mean, you were saying that it almost felt like the ground from under his feet disappeared, right. When when you’ve got that support, as you spoke to it, spoke about it like glue.

[01:02:10] And how did you cope initially when?

[01:02:14] Well, with mom, it was really difficult because she came home to pass away, you know, this old West Indian. And it’s not even. What’s the old saying? My mom was like.

[01:02:23] Four years old, she wanted to die at home and we managed to do that, and it was all of us, the grandchildren, everything. And I thought to myself, you just passed away, passed on with everybody that’s nearest and dearest, close to you, who love you quietly, not in pain. And we will remember you every single day. It was hard. It was hell, because both funnily enough, both my parents died on the same day, 17 years apart, which is weird. And they were buried on Christmas Eve. So Christmas is a tough time for us, but now that it’s getting less painful. I choose to you know, I’m I have both my parents photos of my surgery and my patients always say we’ve got the level they like here. And I say that’s to protect me against you. And we have a bit of a laugh about that. But is it cute because it makes you face your own mortality? Yeah, it does. And it’s a very good question that you ask that, because when your parents passed away, certainly for me, you suddenly feel like that golden cloak isn’t there anymore and you’re kind of on your own, even though I’m not on my own. And you will next year, the next generation. So even though I’m fifty five, I’m not seventy five. You think hang on a minute. I’m going to make the next X number of years count. So you start to. It’s not so much the exiting but is what am I going to do in the next five years because I don’t really want to do much more than that. I want to go back to it is a walk on the beach every day. But what am I going to do that’s going to make the last five years be the best five years in your life? So it does make you a bit nervous, but I’m not frightened in the middle of my career.

[01:04:12] It’s not something that I particularly talk about, but it’s not a secret either. I was very, very ill. I had a very good cancer when I was thirty eight and I lost two children and went through 12 years of surgeries and chemo and and a lot of people didn’t know. I just got on with it. And you know, it was quite nice just getting on with it. But when I needed them they were there and and my kids were there particularly. So I know what it’s like to wonder if I’m going to survive because they gave me three and I go, I’m already 13. And so, you know, I’m going to die when I’m good and ready.

[01:04:47] But again, a little bit of bloody mindedness. Yeah, I’m not ready. I’ve got still things I don’t want to do. But it does make you think every day is going to count, even if it’s just to have a coffee with a man.

[01:05:03] So what are you thinking for the next five years?

[01:05:06] Well, I want to grow this education thing that’s been going on for twenty odd years into something solid. So finally, I’ve put it into a company and I’m going to I would like the course to be less about me and more about them, more about the boys that are going to be the payments, Barney’s and the Toms and the Scott Phillips and all those guys trip and all the people that are going to take it forward. And, you know, I want to leave it to them. I want to leave that to them so that they can look after it and carry it. I want to do my best five years. I want to learn all the things I still can’t do and be a bit better. And I want to spend I promised myself before lockdown that I would work for six weeks and go home to or work for eight to go home for three. And it hasn’t happened because of this. But I’m definitely going to do that. I’m going to take the time to look at the way some more and to trek some more and to spend the time with the people that are getting old, because I don’t want to be that guy who says I wish I had because a lot of my family were in the seventies and I want to be there to live with the because dentistry can wait, you know, and the young ones can do it. And, you know, I want to have more balance in that sense.

[01:06:30] What would you do if you had half a day to yourself would be Fazeela? Sort of?

[01:06:36] Well, it depends who I could do it with. If I had the kids, we’d probably go for a really cool breakfast and then go for a long walk in Box Hill and just chat away. You live around there? No, but we go there quite often. I live in I live in music. Oh, well, we it depends. If I was in the Caribbean, it would be a different thing, but I would spend it with people I love. I would cook if it was not an activity, I would or I’d be on a horse somewhere or something like that. They would always be food around. But for me, life is people. Life is my family, my friends and the people I work with predominantly.

[01:07:19] Fazeela, that sort of takes us on too nicely on Suazo. Final question. Going back to what your mom and dad passed on to you, the sculpture and the daily conversations with mom. I imagine it’s your last day on the planet and you’ve got your kids around you. What would be the things that you pass on to them? Three pieces of advice that you’d want to leave them with the equivalent of the sculpture or whatever it is. What would you say to them?

[01:07:56] I would say to my kids, don’t forget where we come from so that you know where you’re going. That’s really important to me that we keep our food and our culture and all the things that glue us together from the from the elders to the to the next, I think I would say in everything you do look for a win win. Don’t do deals of any kind where someone has to lose, look for a win because it’s a much better deal. It makes you sleep at night. And the final thing is live every day, live every day as if it’s your last laugh, cry, love, do whatever you do and do it really well. And if you mess up when you put your head on your pillow, tomorrow is a better day. Always. It’s just simple stuff, you know, simple stuff. Look out for each other and be true to what you believe in, you know. And if it doesn’t work, if people don’t like that, well, keep quiet about it then.

[01:08:56] And if you could finish the following sentence and the topic is legacy write Fazila was dot, dot, dot a crazy, but he was kind, tough, loyal, persistent.

[01:09:15] And who never gave up?

[01:09:17] If I don’t to want a more positive one, imagine you’ve got a month left. Oh.

[01:09:25] Are you going to do your time, I would pretty much give up work if I had a month, I do a week of work. You lost three case, yeah. Yep. I can’t finish at the month.

[01:09:39] I do as much as I could do a week of work if you had a month.

[01:09:43] Yeah, I do a week of work. I love. I love. I love knowing the. Somewhere down the line, it might make a difference or might help. I know that sounds a bit. It sounds a bit highfalutin, but it’s not so I do a do a few days at work, I would try to I have a bucket list of one hundred and fourteen things. I’ve only got 12 left. So what do they want it? I can’t tell you that it was everything from. I still have to do Machu Picchu. I haven’t done that. It’s simple stuff. It’s like I have a walk on Nelson Mandela did that, you know, simple things. I would spend most of it with my kids in the bush in Guyana, in the Amazon, trekking for at least two weeks. And then I’d probably have my five favorite foods in the world and just chill with the people I love. I won’t do anything too fancy for me.

[01:10:42] That’s fancy, will you? Five favorite foods. Well, you probably should. Did you what’s your final meal? Yes, just to keep things really positive.

[01:10:56] Curry the execution meal from Kenya. I want to bring and aubergine curry with some callaloo which is like a spinach and some roti and some doel. Nice. Nice.

[01:11:13] It’s been absolutely lovely. Oh, it’s been a joy to continue. I really enjoyed it.

[01:11:17] Yeah, me too. I really, really enjoyed that. And I think the thanks a lot for being so open. Really well.

[01:11:25] I’ll probably come across as a lunatic, but it is really enjoyable when you are in the West then. I have listened to a few of them actually. And you know, I trained Sanjay and I, Sanjay and I, I taught Sanjay on his first the kidney. So I know I know Nick. I know them. All right. That’s the problem. We’ve been around so long and we eat again. That’s what we did.

[01:11:54] So whenever you’re in the in the West End number eight, the door’s always open.

[01:11:58] Thank you for food.

[01:12:02] It’s been lovely to see. Definitely. Definitely. Thank you so much for having me. I really appreciate it.

[01:12:09] Thank you for doing this. Acento leaders the podcast where you get to go one on one with emerging leaders and dentistry.

[01:12:23] Your house payment, then Groody and perhaps Celenk. Thanks for listening, guys. If you got this far, you must have listened to the whole thing and just a huge thank you both from me and pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you got some value out of it if you did get some value out of it.

[01:12:44] 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. And don’t forget our six star rating.

In this episode, we welcome the industry insight of Paul Palmer. Paul covers his successful work in academia while juggling Guys Hospital, consultancy and private practice as well as explaining how he spots the potential in promising students.

Paul also covers the evolution of his experience from dealing with failed implants to selecting the right patients and what happens when routine cases spiral into court cases.

Enjoy!

 

“At the end of the day, you’ve got to be able to be confident in your own ability and working within your own ability. That is what we try and instil in our students and the people we work with. Because once you lose that insight, life gets difficult and dangerous for all of us.”  – Paul Palmer

 

In This Episode

01.15 – The Fur Trade Legacy

05.20 – Paul’s Introduction to Implants

12.26 – Dealing with Failure

19.17 – Spiralling Cases

26:44 – Advice for Young Implantologists

31:34 – Spotting Talent

37:24 – Efficacy in Procedures

49:36 – Balancing Workload

55:26 – Zygomatic Implants

57:31 – Legacy & Last Day on Earth

 

About Paul Palmer

Paul graduated with his BDS from the London Dental Hospital in 1986. From there, he gained his MSc in Periodontology at UMDS Guys Hospital and has since been working in part-time private periodontal practice.

He has a membership in Restorative Dentistry from the Royal College of Surgeons of England. He is an examiner for the Diploma in Implant Dentistry for the Royal College of Surgeons of Edinburgh and was on the Specialist Advisory Board for the Royal College of Surgeons of Edinburgh.

He currently provides implant treatment for complex cases and teaches implant dentistry to post-grad students. Having worked with various implant systems, he lectures nationally and internationally on the topic.

Paul has a particular interest in bone augmentation and non-invasive sinus grafting techniques.

Dental Leaders – Paul Palmer.mp3

[00:00:00] We always try and not treat patients to a budget. So if it means not treating a patient, I know it sounds mean, but we’d rather not treat a patient than try and treat them on the cheap.

[00:00:17] This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Paymen Langroudi and Prav Solanki, it gives me great pleasure to welcome Paul Palmer onto the podcast.

[00:00:40] Paul is a consultant periodontist from Guys Hospital, works in the West and has many papers and a book on employment policy and works in the South End practice. Pleasure to have you, Paul.

[00:00:58] Thank you very much. Nice to be on this podcast.

[00:01:01] It’s about kind of the person behind the persona. And we kind of we tend to start with the same question and end with the same question. So the first question always is, where were you born? How do you sort of grow up? What kind of childhood did you have?

[00:01:15] When did dentistry come onto your agenda? OK, so that’s what leads to her. You actually confused me with my brother in a setting up of the expected third year and one of a family of five boys, and our father was a furrier. Grandmother was in the fur trade as well. So a lot of my extended family were in the fur trade, which is obviously quite a high, highly technical manual job. Now, that’s partly where we go now, dexterity from so two my brothers, when it’s the fur trade we’re actually dying and they went on to other things. So one of them became a paramedic, another one which I went into a sale loft because we’re sort of major family sporting activity growing up with society. And then one, the middle one’s an accountant. And then so my eldest brother, Richard, who is a twin, he had the closest relationship and the five of us. So we were very close, all my three brothers, nine years between us. So he had a big influence on my choices, I suppose. So the classic story I tell is where my teacher at the age of nine asked me what I wanted to be and I was proud when I got home to tell my mother I’d had this conversation. And the answer I gave is all I want to be a gynaecologist. And she just basically just raised your eyebrows and just sort of took it as why would that be a surprise when he’s got four older brothers just influencing him.

[00:02:53] And so they had a massive influence. You know, when you got brothers who were that much older than you, they influence you. But then it’s always had a sort of medical balance, I suppose. But medicine saved a bit of a a far stretch. So rich nobody I who went to grammar school after eleven plus our middle brother joined us. So I went to grammar school on the same day he went to sixth form and I went into the first one. Did you grow up in Essex? Yeah. So we’re all born and bred in Essex by three of us live in our own lives and cultures. London, so by the time I was of deciding what to do, Richard was already just about to qualify as a dentist. And so then when I was at school, I nursed him a couple of times when you say periodontal surgery. So he started the practice we’re in now that started on Saturday mornings in our small surgery a mile away from me now. Well, what year did you start, though? So he started that a little bit, about nineteen seventy seven, something like that. Well, that’s that’s the one you just sold. Yeah. So that they evolved from. So that went from a Saturday morning to by the time I qualified and a year and a half in, in hospitals.

[00:04:21] So I thought that time I was about eighty nine and then joined Richard. So Richard basically phoned me up and said, do you want a job. But if you want a job you need to do a masters. So I joined him as his apprentice really went to work. So I said Friday night I got to work at Food Drive to Essex and then Friday evening I could work day surgery. So goddamn 10 o’clock at night people would come along and have it done. And then so that was he was doing Saturdays, as I was saying Friday evenings and now. It’s through surgery, nearly a five day a week practice, that’s those built on perio. And they very much built on implants because implants became a large part of perio activity and we were right at the beginning of that, but and that is a big thing.

[00:05:20] I started implants before he did. All right. So I was really fortunate. My second job was in Pecking, so I’d say more than anything. So we had fantastic consultants there and we had a brilliant senior registrar called Brian Littler, and he was putting in the implants for John Basford and the London. So we were taking pictures out of the London hospital and putting implanted in. And then John Basford was in the process. So that was we were really early on the activity that was in 1988. Well, so I go back along along with the prime system. And are you still using the wrong system now? So. So the thing to do, the things you learn as you go through life, at one point we were running five implant systems and partly that was because we were running a program at guys and we thought there were benefits to immersing people in a lot of systems. And what you learn from that is you actually confuse people a bit in some respects. It’s like, you know, you’re going to play golf, play with one set of clubs, don’t keep giving someone a different set of clubs every day as they were. Just just get confused. So we condensed it down, guys, and we also then condensed it down in our practice because we were running we’re running a mirror image so that we we were doing things in practice that we were then teaching in the hospital.

[00:06:57] And we’re familiar with all those systems. But then you have all the trials and tribulations of trying to run different kids, different spare’s different implants, and then as patients then come back to you for problems, which they always do, you’re trying to remember what went in or what the components were.

[00:07:17] Screwdrivers were what the top levels were just becomes a whole complete nightmare.

[00:07:23] So now actually we’ve basically use Astra and we use the Astra TX, so I’ve been resistant to changing that. So they evolved for the last five years, I suppose, introducing some of the research on the bone loss around Astraea implants.

[00:07:43] So we were very early on. We were very lucky that we were looking for people to run trials for the Astra ST. Once I remember the first I met Michael, nor have you interviewed him yet?

[00:07:55] No one to as a recommendation, say he’s a good raconteur and you know that he he sold the system incredibly well. So it was a very good system. It was very innovative and it’s in the way you could handle it. It’s quite user friendly.

[00:08:13] But then we were given the the early trial of the assay, which was the first Astra implants that had a.. Rotation indexing. So we did a small trial and they asked us to play and restoration, and that was with Brian Smith, who was the prosthodontics they got guys and what was it was to do up to that point?

[00:08:35] It was sort of standard thinking that you would always lose some bone up to the first thread.

[00:08:40] Yeah, that’s that’s a pretty. So we can literally print them out. And it has its good things and its bad things. But what we knew was that it would always lose power to the first strike and that’s part of the design of it. And it’s probably largely relates to it being a peripheral fit implant with an external fit. So where the implant meets you have a big biological insult coming through the stack of componentry. So it’s almost like a biological waste of that implant. And that’s why it goes to the first side is largely, I think, of, well, health there. And then so the Astra by almost by accident, was one of the early platforms, which is a platform switching implant with a really good seal. It’s called the conical. So it’s not it’s not a perfect seal, but it’s it just reduces that biological insult from the implant abutment junction. And so that really did hold the bone very well. And also the other component of that system at that point was the. So we’re using a single teeth. So that’s a sealed system. You’ve got a semantic crown. There’s not much leakage. And then their abutments were solid and they certainly are a lot of them still all. So the uniform is a solid column of titanium. So you don’t get a biological leak from the stack of componentry, so you don’t get a insole bone level. So it delivered on two levels. So it was platform switching and there wasn’t much in the way of biofilm within the stack of components. And that’s what made the big difference. So they always thought or promoted the concept of the micro threading and in the Corona portion of that implant, but that’s probably not the most important thing and it’s also one of the early surface traceroute implants. Yeah, it was. And that was really making a difference of.

[00:10:53] What’s changed in that period of time when it comes to implant dentistry? My involvement with dentists is primarily having conversations with them about the type of patients that are coming through the door, but also the interaction. And I’ll just give you my take on things. There’s this whole new and I know it’s not new people. There’s been this upsurge in the market of people promoting and offering immediate loaded S.A.T. solutions. And I’ve come across clinicians who are for or against that and various various arguments. And then there’s been, I would say, a growth of the interaction between the clinical dental technician and the implant dentist. And that how many of those two types of clinicians and I don’t know if you if you worked in that sort of collaboration before and if you got any thoughts on that, the answer would come to this as well.

[00:11:45] So the most important thing that the golden thing to remember in whatever you do, it’s all about case selection and in case selection, the first thing is patient selection. And the next thing is what are you going to do in that patient? So it’s the case selection within the patient selection. If you can stack up or you’ll get all your ducks in a row, then you’re going to have a quiet time. And I think our philosophy has always been to keep it simple. But obviously over decades of working, you inevitably have to take up certain new techniques and certain new philosophies.

[00:12:26] So as we spoke about earlier, there isn’t anything we haven’t done or tried in the past. And I always say with so logic, my philosophy, I suppose because I’m the one who is doing most of it, is you don’t push the envelope too far. So we don’t actively promote our business based on taking a day or immediate loading. But again, I’m not averse to it in the right situation. And the best example I could suggest is that immediate placement is that easy. If you got a small route and a big employer, an immediate load is that easy. If you’ve got a big problem and the occlusion is you just stack up all the right base to enable you to get to the end result. But our philosophy and that it’s not an uncommon one is that every time you lose an employer, it might be a small percentage of your activity, but it’s one hundred percent of the patient. And you’ve you’ve got to be very brave to actually put yourself in a position where you will either encouraging or allowing a patient to take your choice, where they’re taking out and then ultimately high risk for what effectively is a great gain in the scheme of things.

[00:13:50] If you can just delay things for a few months and be much nearer to one hundred percent, why would you make life so much more complicated for everyone and the added expense of it as well? So it’s always and obviously not always. So I always say always, but by and large, you add expense and complexity to the whole situation. And if you add expense and complexity and it fails, you failed on a higher level. Yeah, and that’s where you can really struggle with patients happy so that our overall philosophy really is that we still do immediate loading. We’ve done some really quite significant cases of patients walking in with periodontal involved, not particularly well kept teeth, but for their psychological well-being to actually give them a clearance and then give them full foot bridges in a day. Don’t don’t enjoy. I don’t I don’t feel any kudo’s doing it. I’ve done it to help the patient more than anything.

[00:15:10] So are there any, shall we say, sort of clinical biological benefits and in certain cases of giving, e.g. Lodin or if you were given choice and is the always patient driven in the sense that it’s more lifestyle? And if you would say, I don’t know, extrapolate out one year, two years, five years down the line, are there any benefits of immediate loading versus delayed loading apart from the inconvenience to the patient during the integration side?

[00:15:41] I think that most the evidence would suggest that other than the old millimeter of bone here or there, the differences aren’t great. So that it helps you argue it both ways, doesn’t it, that there’s no harm in doing it, but that the risks can be a little bit higher?

[00:15:59] Is there any any evidence pointing towards sort of failure rates and things like that with respect to immediate verses and then the whole argument that some people say, well, you only need four implants and some clinicians I speak to say, you know what, even if I’m immediately then I’m not going I’m not going to let it all hang on or I’ll put in five or six for the amount of time it takes me to stick in another one or two. It’s not worth the risk. But just on that front, is there any evidence that the risk of failure is higher with immediate loading?

[00:16:32] Yeah, there’s definitely slightly higher risk, but there’s there’s evidence to show it both ways. But overall, you have to accept there is a slightly higher risk. And again, because we grew up with Branum and we grew up with that in the back of our minds, that it was in the maxilla like a 15 percent failure rate over 10 years will be. When you look at all the stocks that you look at now, that’s that’s a completely different way of looking at implants. So we were we were in early and we had to accept that we were having to build a quite a high failure rate. And part of the reason the implants were so expensive from the get go wasn’t so much that it was expensive to actually start at the start up costs was significant. So the kids were really expensive. The drone attacks were expensive, but also in the background, the the fees were building in a degree of failure because we thought we were going to have to retreat more patients than we ever did. Not never got a refund. But that was it was a it was a philosophy and it was it was the right philosophy.

[00:17:40] And so we also had a protocol where we’ve never. Never say never, never say never, but we always try and not treat patients on to a budget. So if it means not treating a patient, I know it sounds mean, but we’d rather not treat a patient than try and treat them on the cheap and compromise what you do. So the other way looking that is when we when we had significant say about it that would accommodate three implants.

[00:18:17] You’d rather it’s in the early days, put three in and expect one of them to fail rather than put two in for the same things and then hope and pray that you didn’t lose one because then that’s catastrophic. So we fail. Team failure in lots and lots of our case is still part of our philosophy now that you should try and accommodate some degree of failure within within what you’re trying to do.

[00:18:47] We also know that we are really, really bad at predicting failure of a person’s dentition, whether it’s restorative. We operate on flavor. You know, anything. You’re probably a bit more certain we’ll treat you well by time period. But, you know, some of the bigger classes, you try and choose a path where you’ve got a parachute at some point down the line, but the truth will out and they never fight in the way you think.

[00:19:17] You remember any cases where either failure had a big impact on you clinically or just emotionally or perhaps the first time an implant failed. And how that felt and how you how you dealt with it obviously happens to everyone. And many implant surgeons I’ve spoken to, it’s you know, it’s like getting a letter from the GDC, not quite as bad as that is. That’s heart sinking feeling where they feel like, you know, what could have they done differently?

[00:19:47] And have there been any situations like that for you with patients know again, we’ve had it, there isn’t anything we are thinking we’ve not experienced. So with a failure to say so. We had a big legal case years ago where someone sued both Richard and I. Well, I filed a case back that went all the way. So we were ten days out of court. Wow, and that was stressing to the point where you would not believe. And so I think the end is very, you know, this this kind of stuff, it’s good to let people know that you share in the same experiences. And I was very lucky in that case in the rich and I were being so together. And he’s a man who is very driven and he’s classic. Is OneTouch a piece of paper once. So something comes in, lands on his desk. He comes out the next day.

[00:20:56] And I very much try and do that because if you want a quiet life to do so, that litigation was, I think, quite remarkable because what I had in the two of us was two people actually willing to take the fight and get stuff back super fast. So the other side never really had a chance to have anything over on us because every time they said something, it was back delivered robust defense and it was you know, we had more control of it because what did you learn from that process?

[00:21:41] You learn something that’s not the nicest places. The ones you get on best with can still bite you.

[00:21:48] And so you never assume that your relationship with a patient is always going to go the right way because we have a very good relationship with him and it just turned what was what do you think you must have reflected on?

[00:22:03] What was the pivotal moment when it turned? Why did it turn?

[00:22:09] You got a second opinion that probably wasn’t. Completely supportive of us. We didn’t expect it to be here. We had some kind of an implant that was that was the big problem that can be very, very difficult to manage. And so the management of him became someone else’s problem, and then that became our problem. And then when he decided to litigate, the expert was not impartial. So they forgot their duty to the call and they just felt I had a duty to the patient and they weren’t particularly careful.

[00:22:53] But so they had an axe to grind with at least one of us. And it wasn’t until very late in the day where our side said to the other side, if you got any idea who you’re trying to say, and I said, you don’t know what you mean, because the experts said that Richard and I were actually not trained fully what we provided. And then what? Well. He’s the first professor of implant industry in this country and I was a specialist associate, and so at that point they had to then go back to their expert and say, you know, why have you said? So he lost his credibility very, very quickly.

[00:23:44] Do you feel do you feel the weight of being at the leading edge?

[00:23:51] You know what I mean by that?

[00:23:53] I mean, I’ve talked to some dentists who say, you know, they’re well known lecturers or whatever. And when they’re doing the work, yes, they’re doing it for the patient. Yes, they’re doing it for their own self-respect and all of that. But the idea that at any point in the future, that patient could be seen by another dentist who then says, I was treated by Paul Palmer.

[00:24:12] And, you know, your reputation is is up there. So you can’t you feel the weight of that.

[00:24:18] I think we all feel the way I think I think that’s dentistry that, you know, I think my wife has always said that, you know, whenever you say a patient, a scene that someone else is going to say this.

[00:24:30] And I think that’s I suppose I suppose that a lot of your work has been by referral by for such a long time that that’s like just second nature to you.

[00:24:38] Yeah, I think that that’s implicit in a lot of our activity, that’s for sure. But I think it has I think that’s part of the stress of dentistry anyway, is that inevitably someone else will actually say your work is sort it’s almost a given and that should be your driving force to do your best, obviously. But it’s a good thing to remember that. And we’ve always tried to do our best by our patients. Sometimes it doesn’t you know, it’s not always going to go 100 percent, only if you’ve trained so many implant.

[00:25:16] So, I mean, you did you trained most of the people who went through that guy’s M.S. right now.

[00:25:21] And you’ve come at it yourself from the perio angle. But the plenty of people go go with implants from the restorative and then some come in from the oral surgery kind of angle for today. Now, I know that M.S. is not running anymore. Right.

[00:25:36] So we we them Clinton now. So that basically what happened was that in running a masters in implant industry, you get through a lot of clinical cases. So for four people on that course can just get through so much clinical activity on their own that it was not really allowing a good throughput into programs that were perio pros that were leading to a specialist certification. So it just made sense to come back from the the MSA and implants, which wasn’t it was delivering a very, very good degree and fantastic that they had an awful lot of clinical input on their clinical surgeries. But we had a lot of parents and students who were not benefiting so much. So it was better to drive a bigger and better implant.

[00:26:44] So those two degrees than if someone was thinking of if a young young dentist was thinking of going into implants now, what would be your advice as the best pathway to follow?

[00:27:00] Not not only from the educational perspective, but what to do, you know, get a mentor before I think that every now and again are some of the mentoring is good.

[00:27:13] But if, you know, all the programs will be driven by someone with more than one aspect or another. So getting a broad base I think can be difficult. But within an academic environment, I think you’re more likely to get a broader base. So, again, I think programs and certainly we’re very proud of because they get an input from and consultants or surgery and restorative. So they’re both broad based. So I think you’d still have to say that they are probably the gold standard. So an intern program. But the commitment that is is massive and you can’t deny that.

[00:28:02] How long does that take? How much does it cost? How hard is it to get onto these four years?

[00:28:07] The cost? Now there are about 20 grand a year. I think people would have to just check that. And the commitment is three days away. So it’s massive. And I feel really sorry for this. Last year has just been too painful for every one of our undergrads postgrads. It’s just been inconceivable. But is it hard to get on to that program? I think it’s really hard. It’s probably got a little bit easier. I think the numbers of the.

[00:28:43] Probably number of it might have gone down a bit, but I’ll pay you 20 grand and then you stay out of all the students you’ve told. Is it quite easy to spot talent I know Payman always talks about refers back to Dipesh and says when he first saw the passion to his work on the composite side of things, you could spot the talent straight away. And he was it was leagues ahead when you were teaching students. Can you pick the talent out pretty quickly? And if so, what are those what are those key indicators you look at and say, this guy’s going to be a good surgeon, he knows how to treatment plan, case selection, etc., etc. all of the skills of a good implant ologist because it’s not about drilling.

[00:29:33] The implant is not the key point now.

[00:29:36] So I thought we sort of drifted off a bit early because I was I was incredibly lucky that I had our training is undergraduate’s was very, very, very good. So we had a big surgical program. So we had probably at the London and the old surgery department that was actually amazing. So we took hundreds of teeth out. We could load the search crews out finals. You could end up doing an impacted wisdom, tooth surgical removal as part of your final exam rather than just doing something in concert. And then I did a house job and then a schedule, and that gave me a really good grounding in surgery. And then the NSA guys is obviously very surgically orientated. But I had a big restorative component to it. So we were it wasn’t just about perio. There was considerable process input. So that then gives you a really good basis to start your influence with an obviously, again, been exposed very early on to the Brenham protocol, which was so based on dictum that you can yeah, he’s a bit like playing golf.

[00:30:55] There’s a point where putting the implant in, as you say, is just the drilling the whole bit and when you can forget worrying about that.

[00:31:03] But that’s the point at which you raise your bit where you are trying to point where you’re going to be optimizing all the other bits, because all the stress for the students is, oh, God, I’ve got to drill this hole. But actually. It’s not quite that, but it’s the bit around it so is being restored to be driven and being able to think about all those facets rather than getting the implanted.

[00:31:34] So just going back to that question, when it comes to spotting talent, we’ve spoke to numerous educators, Payman himself, when he spotted Dipesh’s talent from a mile away. Do you spot that talent? I mean, is it obvious to you when you’ve got a cohort of students who’s going to be flying ahead? And if so, why?

[00:31:55] I think it’s you also have some that are academically very good and some are potentially very good with their hands. Yeah. And that’s obviously a bit like the most obviously is the practical side of things. So when you get someone who’s very confident in their soft tissue handling, that’s the point at which, you know, you’ve got someone who is probably going to excel. But there are plenty of times in the rough where you start and you think we’re going to have some problems here. But again, their exposure at that point just hasn’t been enough. And it’s part of the problem with undergraduates now and the reliance on what appears to be a lot in practice. Learning in practice is your exposure to enough surgery as an undergraduate and as a as a trainee that gets you to a point where you’re able to do that. So that’s how I was learning implants. The soft tissue handling and bone manipulation was sort of second nature. And that makes a big, big difference. But you can certainly take the good ones and you get most most students a very good standard.

[00:33:11] You must I mean, I said you must do you do charge more than an average guy for an implant?

[00:33:20] No, you do not know how much how much is a single unit restored in the back of the mouth if you’re in two thousand five hundred.

[00:33:30] For us, and that’s that would be standard. And that’s how you just got to. So things I remember about myself, my brother, is that we are quite good at what we do and we’re very efficient. So if you look to our hourly rate, it’s probably better by virtue of the fact that we are incredibly efficient at what we do.

[00:33:53] So how fast, how fast are you how how fast you can go and you are still the still actually mostly a few minutes.

[00:34:04] Well, he’s about 15 minutes. But that so it’s all the stuff around isn’t it. So it’s patient, a local analgesics also stuff.

[00:34:15] So I still largely book out an alpha for one between one and four implants will probably still be an hour. And if it’s a single then I’m going to finish well within the hour if it’s full and it’s going to be a little bit of time.

[00:34:32] But that that makes me, you know, I think a highly efficient individual. Whereas other people that’s a classic, you know, some of the most expensive things, they’re are being used to spend an entire afternoon putting one in on it now. Yeah, that’s fine. I don’t know how you do that.

[00:34:55] It reminds you that they’re not making any more money.

[00:34:59] That’s not something, isn’t it? It’s what charges it is. We want wanted to be comfortable with what we charge as well. So, you know, we hate proctoring. So we try and sort of apply a middle line in the West and we’re not wildly expensive either. We can always kept at a reasonable level.

[00:35:21] I was right here on the show and I was saying to him that every time he’s in the mouth, he’s probably doing something outside of the ordinary. And, you know, dentists know him as a sort of top restorative guy. But every time he meets a patient, he has to sort of justify himself to the patient because the patient doesn’t know who he is. And he said there’s an element of the referral then to sort of saying it.

[00:35:49] But do you find that problem? I mean, amongst dentists, you’re so highly regarded, but you have to keep telling yourself to patients every time you meet them and if you become good at that as well.

[00:35:59] No, don’t know if you even bother with that, you know, because I trust the dentist in all good faith and I think that is that’s the biggest thing that’s going to put you in the right place for the patient. So we’re quite straight talking.

[00:36:21] We don’t we don’t try to promote ourselves massively. We try to talk to patients on their level. So I think I hope we come over as trustworthy and we thrown back as many as we come through the door. There’s lots of places we won’t treat or don’t treat. Also to have something else we give them. We try to give them all the options they have.

[00:36:42] So I don’t I don’t sell implants. I don’t I don’t need to. And I often say to patients that I’m busy enough. I don’t need to trade you. So if I take it or leave it with us, I don’t mind patients. Some patients won’t like won’t like me. And that’s the way some patients will either gel with you or they won’t. I think we’re very lucky in Essex where you have a broad church of patients coming in, but you’re all on the same sort of level.

[00:37:20] Yeah, I like that. About a 16.

[00:37:24] Yeah, but they all live in the place that we have a very, very high tech, smart practice and it was purpose-built and we’re very proud of it and our staff are very proud of it. And they all they’re not driving it to create an income for their driving it. So you give patients the treatment and that comes over so we don’t have to sell anything. The site has been done. If someone sits in our chair, the chances of me not being you know, if I had the mind to do it, I could probably put an implant in just about every patient to walk through the door. But that’s not never been our philosophy. It’s always be that they need it to explode all the other possibilities.

[00:38:09] You know, is there something else that I could have done just just on that conversation of budget? Because if we look at implant, dentistry is probably one of the most expensive treatments that you can invest in, especially if you’re going for so full natural mouthfeel, need full mouth to sort of implant dentistry. And you mentioned earlier that one of your philosophies is you don’t let budget drive the treatment plan because that that could compromise your treatment plan, I guess. Do you ever speak to patients about the replacement of so how long this bridge is going to last, what the future cost of that could be? You know, when you when you get patients in clinics and a bridge is going to be several thousand pounds, and when we know it’s not going to last forever, is that a conversation that comes up or that you ask if we have with your patients?

[00:39:00] Yes. So I try and I try and impress on our students as well.

[00:39:05] So it’s quite good with being in practice and in the academic environment because you’re trying to teach people, but you’re also trying to teach them how to behave in practice and how best to look after their patients and how best to keep yourself out of court and out of the way of the GDC, and that he’s about giving them the information they need. So one of my go to things is looking at ten year data, which is the pool data. So it doesn’t have to be specific to your own activity necessarily. But if you pull data and tell them about ten year data that usually they can cope with that and get their heads around that.

[00:39:51] And what I often say to patients is if I didn’t think this would last ten years, I would be telling you not to have it done. It doesn’t mean it’s going to last ten years. But on balance and on average, I would expect this to be that in ten years time. And if I don’t believe that, then I shouldn’t do it. And I shouldn’t be encouraging you to have it done. And your patients, fortunately, do see ten years as a reasonable time frame and a good time frame for things to last. But that’s I think that’s the best way in the fairest way to do that as pool.

[00:40:30] How much of your work is classic perio work?

[00:40:35] How much is implant or none? But there’s not none. But it’s tiny so. But do we implant itis? Is that something you’re looking at? Someone’s accused of being a one trick pony. You had some while ago, which was stuck in my craw for a long time. So I’ve never given up perio and I’m happy to hear. But I’m surrounded by. Some very, very good periodontist in our practices, so unfortunate that they pick up that stuff, I’ll pick up on items, the take up on that is not quite so, so good. So I tend to do a reasonable amount. But again, I don’t dress it up in any great way.

[00:41:19] I don’t make it too technical. But overall, we have fairly good results with that, actually. So I’m very pleased that today they’re not they’re not great today. So it’s not it’s not a good place to start your relationship with a patient or in your relationship with a patient, because obviously things are going awry and we are looking at an avalanche of very important items that’s going to hit us.

[00:41:45] What’s your position like? What do you think is going to happen?

[00:41:48] I think we all agree that it is an inevitability, I’m afraid, fortunately out and we don’t have a huge amount of coming in that is of our doing. But obviously there is some I think we probably become a bit more cautious as well. So, again, in that case, selection. So where patients don’t have a great deal of attached Sokoya and stuff like that, again, you’re trying to do your best to not pay yourself to corner some point down the line. So I hope in our activities we’re reducing the chances of it happening, but we’re also more aggressive. And so when we identify it, we tend to be more aggressive early on.

[00:42:30] So it’s like a like a flat procedure.

[00:42:33] Yeah, definitely. So if you see it as an active, I’d say he’s only saying time to openly debride it. And I I’m one of the people who doesn’t I’m not concerned about using state instruments on implants, but I think they’re still the best. You’ve got contaminated surface. It’s a wrecked surface. There’s nothing you can do that’s going to preserve the surface. So you might as well get in debride aggressive way as you can. Again, your respective. So you’ll mostly effectively. Are you repositioning as much as you dare? Or you can give the aesthetic, though using adjectives like azithromycin seems to have an effect. But fortunately, overall, I think I get some good, good results. But they are the expensive, sometimes showing more metal, having more space on them. Is this going back to good old fashioned perio surgery? Unfortunately.

[00:43:36] Who are frustrated? I mean, I’m frustrated by how little perio has moved. Well, I don’t know if it’s partly partly periodontist or whatever the new thing comes along I’ll miss. So many fans have come and gone. The periodontist are so anti anything other than debridement.

[00:43:55] No, like is renaming everything from reclassifying it.

[00:44:02] I mean, every dentist must lie, lie back and try and try and invent the cure. It’s just amazing.

[00:44:10] Maybe it’s just I find it totally frustrating that a lot of people are out there.

[00:44:18] You’re just trying to muck around with it on an academic level where in some respects know for the most part the patients is actually a simple disease to treat.

[00:44:30] But it has complexities because you are evolving so often, so many take. And with Ruggie support, so, you know, that’s frustrating. They’re all places that do appear from nowhere, obviously, but I think one of the good things about her is that if you do actually deployed and so what is it now? Some changeable professional mechanical platform is the pmrp.

[00:45:07] Penalty is nearly palmitate fire, so it’s. That’s why they’re coming down and it’s just it’s good to realize that that is the number perio, but it’s also the biggest thing. And that is often the is the home care.

[00:45:25] So if you can’t drive very early on into the patient, but the bulk of periodontal treatment is home care, if you don’t get that message through early on, you’re probably onto a loser.

[00:45:40] I won’t be frustrated by that. I think some of the techniques are fantastic. And unfortunately, some of the most widely propagated and promoted techniques are actually all about recession that no one sees or cares about as far as I’m concerned, for the most part. And I find that frustrating. But, you know, that’s that’s the world we live in.

[00:45:59] So a couple of things when it comes to the peril that I see shopped around, one of the mizin repeated treatment with whatever laser it is for several thousand, if not tens of thousands of pounds marketed as the as the sort of cure. I’d like to get your take on that.

[00:46:19] And then and then the stuff you talking about propagates. And he talked about stuff like pinhole, surgical technique and stuff like that.

[00:46:25] Yes, I see techniques that recession and things like that. But for the most part of the country now he’s proper perio, but largely is is not required. Yeah. Cosmetic, which is truly cosmetic. And that’s a great thing. But yes, around four fives and sixes, that’s where I start to struggle. So I think again, after a little bit careful.

[00:46:52] But the last time I saw it shown in a lecture and shown as this is laser therapy, it was the closest thing to subdural Curatola and I mean curtilage, which is now with the new classification, an obsolete term because you shouldn’t do it unless it’s a periodontal lateral prophylaxis. It was the closest thing to that I have seen in 20 years being shown as this is laser therapy and it blatantly isn’t. So I think some of the people who try and promote it are not actually delivering it, as you would describe it. So if it was waving a laser down a pocket and it worked well, you know, who wouldn’t want that and who wouldn’t love that to be the case? And if it was that, why isn’t it really cheap? But they obviously isn’t.

[00:47:43] And it’s there’s no research or evidence that points to that being the trouble is there is there is supporting evidence.

[00:47:53] But the problem is then when you look at you’re not looking at like for like so if do laser treatment and you’ll know mechanically removing plaque, then you’re probably not going to get much of a result. But the minute you start to mechanically remove plaque professionally, then the level of what you do that is very much under the control of the operator. And it’s to set up a controlled study which is truly blind. And where you truly deliver an equivalent treatment can also be very difficult. What are your memories of the surgery and the data that came from that? The level of scaling root plating that the Swedes did in the good old days was phenomenal. Now, like over an hour on a one motivated to just heart such high end intervention that it doesn’t even compare to what you can deliver. And so if you introduce that into a study where you’re introducing a laser and you have the ability to manipulate the tissues outside of that, then there’s an opening to show more effect than maybe there is in the true world. But that’s the biggest problem.

[00:49:16] Would you do such a sort of variation of different things that you teach you research?

[00:49:25] And then you treat patients and and you know this on the patient side, this kind of mccolm on every side, and there’s the sort of treatment planning side and you write books and all that.

[00:49:36] What’s your favorite of those? Is it the mix? You like what you like the most? I mean, the university environment.

[00:49:44] So I have been blessed with with my career because once I started working in a practice that gave me another home outside of general practice and then very quickly became exclusively in perio practice, privately and in the academia. I’ve had a great mix of places I work. So for the last 20 years I worked in three practices and that guys. And that gives you a really nice it’s a complex world, but it’s also really nice because you’re in a different room every day. You have a different nurse. Most days often say, if I got into practice, I’ll probably be dead by now. I don’t think I could have coped with it. One room, one nurse. It wouldn’t have been good for me. So I had been really fortunate. So, you know, I think you can love and hate them equally, but a bad day in practice just, you know, can be really, really bad on be a good day. Practice, it’s very fulfilling, but having the mix and having a good group of colleagues and a network of friends are probably the reason I’m talking to you, was one of our students and he’s now my boss. And we have a great network of friends, colleagues who work for a lot of the time. We all like minded, but we all have different opinions and we have different ways of working, but we all bounce off each other as well. So when we get frustrated or we’re a bad case, we have a WhatsApp group and we share stuff online. So I think we’re lucky. And now it’s a different world, isn’t it? Twenty years ago, you could have been in practice and never you might never speak to another dentist, let alone a whole group of them.

[00:51:52] So are you on Instagram?

[00:51:54] No, I’m not. Tell us to go on Instagram. I’ll choose my hat or choose my hairdresser, my optician. My this is on the Instagram is a map top up on top of an idea on my way.

[00:52:16] And Paul’s outside would go so out of hand to us.

[00:52:20] The same question. Go for me. Yeah. So your favorite at eBay, you mentioned outside of work, what do you do for fun? So when you mentioned comparing golf clubs to implement tools, it’s I’m guessing not that features somewhere and.

[00:52:36] But tell us what tell us what you do outside of academia and practice to relax.

[00:52:44] If you Times is watching this game, you play golf and it’s not pretty. Basically once a year and it’s usually a charity thing or something gets me to dust the clubs off. So but I appreciate the technicalities of that and how difficult that is and more by the time you need to play such a key hole that they should go for it.

[00:53:08] That’s a use as an analogy. I love my rugby, but so I’m a bit sad today. And so I’ve used that sometimes in my teaching where you’re trying to get people to look at a perspective and you can say is sometimes like, you know, Jonny Wilkinson is lining up a kick. You’ve got to look at it in such a way. You’ve you’ve got to visualize it and you’ve got to put it in plain view as you can and break it down to that point. So it’s the machinations of those things. So, yeah, I’m not quite a sport, but my biggest activity was exciting stuff, saying if you had a week to sell, what would you be doing outside of work?

[00:53:56] So we recycle a lot. So we’re going down the coast to coast in May. We just we snuck in before Boris’s announcement. So we we booked a welcome to Bridlington cycle. Right. Actually, my brother Richard and his wife, my wife and our daughter. So we’re doing that. So that sort of thing. If we got a holiday, it’s an active one. We I can’t I cannot sit on the beach. I mean, look at the look at the colour of my guys. So I’m pale and pasty. I still have the sun off on the beach, the most uncomfortable place on Earth. So I’ll have to sit in the warm shade and read a book or cycle sail to all that stuff.

[00:54:43] It’s been a great honor to meet you. But having heard so many stories about you from a lot of your students, and and we got some great laughs over the years of that lately.

[00:54:58] Yeah. My good friend to all of them worked under Paul and his brother and Pete friend, who I’ve known for years and years and years, always used to tell me about it. So it’s been lovely to meet you, but always ends it on the same question.

[00:55:14] I do. I do. I’ve got I’ve actually got one more question if that’s OK. Know, we’ll kick off with that. And it’s just because it comes up a lot with people I speak to and that’s zygomatic implant’s.

[00:55:26] And you’ll I just want I just want your thoughts on it, because you know what? I’ve come across some dentists who jump on a weekend course to learn zygomatic implants.

[00:55:35] I personally think that’s bonkers.

[00:55:37] And then whatever your philosophy is on it, what sort of training and qualifications do you think somebody should have to be doing that, that level of surgery?

[00:55:49] That’s always a tricky one. I’m not staying at the door letting people in and excluding people. So I think it’s dangerous to even stranger than the line of who who should or shouldn’t, because at the end of the day, the person holding the drill is the one who has to answer so self and the gdc. So it not how much training you’ve had and what courses you’ve done. At the end of the day, you’ve got to be able to be confident in your own ability and working within your own ability. That again, is what we try and instill in our students and our the people we work with. Because once you lose that insight, life gets difficult and dangerous for all of us. But it’s automatic imprisonment. So you have a good enough record and in the right hands they certainly have a place. But what they actually can deliver again is another one. It’s a common philosophy, isn’t it? And one used by by Boris of Light, which is under promise and over deliver. And I think once you’re at the level where you’re starting zygomatic in your stance across the lines where delivery could prove very problematic. So just proceed with caution would be my word with it. It’s not something again, we know well our level of expertise. And when it comes to that, we’ll we’d found that out if we felt it appropriate to have anyone within our practices to actually provide some interest.

[00:57:31] And so on to my final question, Paul. So much in it’s your last day on the planet.

[00:57:40] You’ve got all your loved ones around you, and you need to leave them with three pieces of wisdom, obstructer of advice.

[00:57:49] If I did this one, three, I think you know that. Don’t don’t forget overpromise under promise and over deliver a good one, but you choose yourself and always try and work within your own capabilities because otherwise life is going to be difficult. Now I look after each other really nothing, nothing, nothing groundbreaking there is that it comes down to what your values are really.

[00:58:20] And you have to ride it out. Don’t what you’re also like broken glass.

[00:58:23] But let’s leave.

[00:58:26] I may you might save some people’s backsides. They’re finally available. And how would you like to be remembered, Paul, if if that upset, then this sense and it was Paul loss, how would you like to be remembered for good company?

[00:58:49] I like making people laugh and I think, OK, most most I can do that without causing offence. I hope people think that I do bring about humor into their lives more than anything I do. And I’ve spent my whole life pissing about expense out of classrooms and detention. And I’ve read one of my reports the other day which was post preoccupied with, you know, amusing the rest of the class. Everyone’s expense, not just his own, but erm I suppose is one of my traits. I’m disruptive, I’m a disruptor I think. But no, I don’t do it maliciously, but I can’t, I can’t resist the old gag and luckily actually you know today of not being pulled out of a. Professionally, it must have been close a few times, and I know that Richard would have would have been close a few times as well when one of your students told me he was one of the lads, always one of the lads.

[00:59:58] And that could be that could be your undoing as well. So, yeah, we really like to be a part of that.

[01:00:05] It’s good to have a good relationship. You know, I think the best of the British society, period, period, ontologies always had a good image of being in a place where you can go and learn a bit, but also have some fun, have some fun and hopefully we’ll get some of that sometime soon.

[01:00:28] And the last question for you, about a month left.

[01:00:32] What do you do in that month?

[01:00:34] Isn’t that what amazes me is that people who go back to work, I seriously, I.

[01:00:45] But yeah, I would not be doing that, that’s for sure. What do you think? I didn’t go particularly mad. A party which is spending time, you know, very, very nice life. No. Where we walk away so I can only do stuff. Let’s spend it with our our children are everything to us and we want to spend it with them.

[01:01:11] Are they going to need some nice stuff. How old are your kids? Twenty nine. Twenty six. I loved talking to you made it actually it was terrifying, as I expected it to be, just to chat down the people, you know.

[01:01:34] Yeah. Yeah, I know. Thank you so much for doing it.

[01:01:38] You know, welcome. This is Dental Leaders. The podcast where you get to go one on one with emerging leaders in dentistry.

[01:01:52] Your hosts Paymen Langroudi and Prav Solanki. Thanks for listening, guys. If you got this far, you must have listened to the whole thing and just a huge thank you both from me and pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you got some value out of it if you did get some value out of it.

[01:02:13] 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. And don’t forget our six star rating.

This week, Prav and Payman take a deep dive into a different side of dentistry as they delve into the numbers with accountant David Hossein.

David tells our hosts how it was that he came to specialise in dental and healthcare accountancy.

He talks about some of the most common financial mistakes made by dentists, old and new – dispensing a boatload of financial wisdom along the way.

Enjoy!

“Banks love dentistry. They will give you money.” – David Hossein

In This Episode

01.04 – Backstory
06.27 – Structures
10.55 – COVID accountancy
14.06 – Starting out
16.47 – Beyond business
18.25 – Theoreticals
38.12 – What dentists should know better
44.02 – On tax avoidance and tax efficiency
51.55 – Out of the office
52.37 – Last days and legacy

About David Hossein

Manchester-born David Hossein is a chartered accountant specialising in the dental and healthcare sectors. He practices with the Macclesfield-based Bennet Brooks firm of accountants.  

Prav Soulanki: You know, I think what’s really important here is that they have that true moment of realisation themselves that if this is their dream and this is their ambition and this is what they want to do with their business then switch that bloody aggression on and give it 110% and I’ve always been one of these people who believes that if you really want to succeed, you really want to do it, you need that pig-headed discipline and aggression to attack it with and if that is distracted with two thirds of your week, or whatever it is, somewhere else, being told what to do, working in a way that you don’t want to work, it’s just going to kill your energy for growth.

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 Soulanki.

Prav Soulanki: Gives me great pleasure to introduce David Hossein to the Dental Leaders podcast. Me and David have had a few conversations over the last year or two, just sharing mutual clients and we just started talking about treatment of dental accountancy and I’ve spoke to a lot of dental accountants over the years and on the whole, they tend to bamboozle me with the language and I’ve found that speaking to David, he seems to break everything down really simply to understand and just full transparency here, David’s not my accountant, but I do respect him and the advice he gives out there. So David, if we just kick it off with just a brief history of where you grew up, what your upbringing was like, and then how you then got into your passion, which is crunching numbers for dentists.

David Hossein: Thanks Prav and thanks Payman. So Manchester lad, grew up in Stretford.

Prav Soulanki: Red or a blue mate?

David Hossein: I am a blue, even though I grew up round the corner from Manchester United. I think for me when the Glazers came in, it became less about football and more about money. Yeah, I think at that time, I was just quite impressed by the loyalty of City fans, how crap their team was but they still stuck by them. So that won me over and it worked out well in the end, so not a bad story. Yeah, grew up in Manchester, never really lived anywhere else apart from a short stint in London and did a bit of travelling, like you do in your youth. How did I get into accountancy? Well, my father encouraged me to take it up, it was something he did as well. So yeah, I think it helped me make my decision because it wasn’t something I would have ever chosen if I’m honest with you, but it turns out I’m actually good at it, so I’m happy for that.

Prav Soulanki: When you were at school, were you one of these numbers guys? Like top of your class at maths and maths geek, not great at English, sort of thing and just accelerating in one subject? Was that your strength?

David Hossein: No, no, not at all, not at all.

Prav Soulanki: No?

David Hossein: I don’t see accountancy necessarily about numbers. I think the software and a calculator will do a lot of the maths for you, I think to be a good accountant, you should be [inaudible] minded and that comes with experience.

Prav Soulanki: So what was the pathway? What was the pathway for you? Did you do GCSEs, A Levels or O Level, whatever the equivalents were back then and then …

David Hossein: Yeah, did GCSEs, did business studies at A Level and as I say, my father guided me into that. Passed my exams, got a training contract and the rest is history and here I am today.

Payman Langroud…: So are you a chartered accountant?

Prav Soulanki: So after you became a qualified accountant?

David Hossein: Yes, I’m a qualified accountant and I also sat my chartered taxation exams as well. That was really helpful for a lot of what I do now, because being an accountant and being a tax advisor is … they’re similar but different. A lot of the transactional tax advisory work, you’ll only get that if you’ve done the tax exams. So that does help in a lot of my work, yeah.

Prav Soulanki: How did you get into dentistry?

David Hossein: Funnily enough, I was at uni, I’ve always had friends who are dentists and naturally they became clients and just did more and more of it until that’s pretty much 95% of what I do now.

Payman Langroud…: So David, there’s more to it than just working out accounts for associates and practises. I mean, tell me about the scope of business. I guess you’ve got that self-employed bit, you’ve got the business owner bit, what else?

David Hossein: Well, most of my work is in the transactional side. So I call myself a commercial dental accountant, which is somebody who … There’s accountants who will say, “Well, here’s your accountant, here’s your tax bill and here’s my fee for the bad news.” Or there’s someone who’s like, “Well actually, where are you in your business and where’s it going to go, and how do I fit into that and how can I support you in that?” So it’s things like business plans and cashflows for new start ups, helping a first time buyer appraise the practise and helping them through to completion really and helping mini groups with their acquisition programmes and helping them through to sales. So that’s really the majority of my work. I can do accounts and tax because obviously I’m a qualified accountant, but my main focus is working closely with my clients.

Payman Langroud…: So give some examples David, of big mistakes you’ve seen clients making that you’ve had to fix?

David Hossein: Yeah, having no accounts, not done by a dental account and it can cause problems further down the line, I think as … So dentistry performs to a very predictable format in terms of fee [inaudible], cost of sales, gross margins and KPIs. Just the accounts I’ve seen, I’ve just been like, “Well actually, this doesn’t make any sense.” In some ways, you have to start again, really then to start to understand how the business is actually performing. That can be more common than it should be. Things like flawed incorporations, so people saying, “Well, I want to have a limited company because it’s going to save on tax.” But then it’s not done by a dental accountant, they don’t understand that you need to have the contracts [inaudible] properly, otherwise the tax man will just cut through it and say, “Well actually, you’ve not done it properly, therefore no you’re not having these tax savings.” Then when you’re coming to sell, that’s another problem that then the buyers can’t understand the structure because it’s not done properly. So I think having somebody who understands the specifics of your area and your business and dentistry, I think is valuable.

Prav Soulanki: David, I’ve got a situation where I co-own a group of practises. I was advised by an accountant, non-dental, or we were as co-owners, of how to structure our company and then how to extract those funds personally, appropriate times and when we declare our divs and whatnot and just maximise on that position, right?

David Hossein: Yes.

Prav Soulanki: However our accountant advises us. Anyway, time went on, the practise moved to another accountant. We got the news that had we had a different structure, i.e. and I’ll just give you an overview, we’ve got a holding company, an LLP and two limited companies that sit under the hodling company because when profits get pushed up to the LLP, we’re paying tax at source, rather than deciding what we’re going to do and how we’re going to plan that. We’ve got no control over that, it’s like, boom, it goes straight onto your-

David Hossein: Tax return.

Prav Soulanki: … you know, your personal-

David Hossein: Yeah.

Prav Soulanki: … and you get leathered by it, you haven’t got as much control. That cost us a lot, a lot of money over the years, but as somebody who’s not accountancy-minded, or clueless about that, we trusted our advisors and we ended up going that and it was very clearly explained to us by the other accountant that, “Look, we could have saved you … ” it was in the region of multiple hundreds of thousands over years, right?

David Hossein: Yeah, yeah.

Prav Soulanki: Can you give me your insight into … Well, do you come across things like this in terms of flawed structures? Also, just a bit of advice out there, imagine you’re starting up a squat, or you’re thinking of growing a group, or whatever that is. Is there an ideal structure to operate under, depending on, I’m assuming what your goals are, whether it’s growth, where it’s acquisition by other people, or acquisition for yourself. Do you want to just run us through structure?

David Hossein: Yeah, absolutely and 100%, that’s a problem. The problem you’re talking about is where does the money go? When it comes to tax, the first thing you always have to answer is start with the end in mind, so what are we trying to achieve by this? Where does the money go? Where does the profits go and where does the capital go? Once you can pinpoint those two things, then from there, you can then map back, well how should the structure work to achieve the income distributions and the capital distributions in the future? You’re quite different Prav, because you’ve got LLP with a company, it’s probably more common where you see, say an associate first time buyer who’s buying a limited company and they have the debt held personally and the company is repaying the loan repayments and they just get hammered for that capital repayment as a dividend. So heavily taxed on it, they’ve got massive bank repayment, and they’re just left very poor from the actual residual profits. It’s entirely avoidable by having a hodling company above the practise that you’re buying, so the debt is held in there, dividends are paid up but the cash stays within the corporate structure to repay the debt and then you’re not having to pay tax on the distributions, it’s only after the bank has been repaid, so lots of structural issues to be very careful of in that scenario.

Prav Soulanki: Is there anything that you guys can to do almost unwind this?

David Hossein: It’s difficult with the bank.

Prav Soulanki: Let’s say something’s happened and you think, “Do you know what? If only the structure was like this.” Is there any point where it becomes too late, or is there a point where you say, “Actually, come and speak to … ” yourself, or somebody like yourself, who’s a commercially-minded accountant, ” … and we may be able to improve your position.” Even if something’s happened in the past the A was either structurally wrong or accounting, cost centres have been done differently, or like you said, the debts going in the wrong direction?

David Hossein: Yeah, it’s harder to fix once it’s in place. First of all, if the debts in the wrong place, then to move it, the banks have to be onboard with refinance and if you lock in at a very good rate, that’s a problem because they’d want a new rate. On other structural issues, yes, it’s possible but you just have to mindful of HMRC’s transactions and securities legislation which is designed for an entirely different purpose, but can tarnish other things when they have unintended consequences, but it has to be looked at on a case by case basis.

Prav Soulanki: What are the main things that you’ve noticed when speaking to clients during this whole lockdown COVID situation at the moment, in terms of the support they’ve needed? Obviously there’s been loans and things like that, cashflow forecasts and things like that, I’m assuming you’ve had to be working on, but what’s your general sense of the market now in dentistry, especially you say you help with people who are starting up new practises and you also help with acquisitions and sales and stuff like that. Can you just give us a temperature check of what’s going on in the market at the moment at both ends of the spectrum?

David Hossein: Yeah, sure. So on new side, I am seeing a lot more interest. I think associates are questioning where they are with life generally, it’s obviously been a mad time we’ve been through so people are saying, “Well, actually you know what? I’ve been through this, I’d like a bit more independence, is this quite right for me?” So I’m getting a lot more inquiries and I’ve seen a lot of people going down the squat route. I think if it’s executed correctly, I think it is a very good return on your money. So I’m seeing more on that side. On the private side, I think the first three months are quite scary for private practises, there’s a lot of uncertainty, so there was a need for, “Well, let’s have a look at the cashflow, let’s see what the situation is.” I’m very lucky that none of my clients had to close because of it, they’ve had to come through and are probably having now, couple of months, best months they’ve ever had because it’s quite difficult to get an NHS dental appointment.

David Hossein: On the selling side, there was, I think it’s fair to say, a lot of acquisitions were paused, so some of the corporates just slowed things down a bit, saying, “Well, hang on a second, let’s let the dust settle and let’s see where we are.” But that’s picking up now. So I think we’re moving towards normality now.

Payman Langroud…: Okay, how long have you been just working with dentists?

David Hossein: With just dentists, about 10 years, 10 years.

Payman Langroud…: So how would you rate the industry compared to other industries, as far as the health of the businesses that you see? Would you say it’s an easier business overall than others, or more difficult?

David Hossein: I’d say it’s actually more difficult because you’ve got the challenge of in many … Well, most of my clients anyway, are bringing in the income. So you’re having to work in the business and be responsible for all your admin and be responsible for all your marketing, and be responsible for all your team training. It’s very different, whereas other people who’ve got a business, they’ve got a corporate structure, where managing director manages the business and that’s not the case with dentistry, I think … Yeah, I don’t envy a lot of my clients. I think it’s quite a hard sector to be in, the hours they do, the responsibility they’ve got, the constant threat of litigation, so something going wrong. It’s a difficult business to be in.

David Hossein: I think that on the other side, if you get past that and you’re commercially minded and you want to go and grow something for creating value, well as a sector, healthcare, but dentistry in general is a great way to grow and build something that can generate future value but in the meantime, be careful of your mental health. Have the right people behind you, it’s a lonely, lonely sector.

Prav Soulanki: You spoke about starting a squat and it being a profitable thing if you do it right and I guess the flip side, if you’re somebody who’s just staring out and you think, “Okay, do I buy in on going concern and buy into cashflow so I hit the ground running? Or do I set up a squat and just set up a business from scratch and I’m not whacking a load of money in,” and bank finance might be easier if you’re buying a business that’s already got a proven cashflow. What would you say are the pros and cons from your perspective of saying, “Right, okay I’m going buy a practise and just … ” shall we say, hit the ground running, but I’m sure you’ve seen all the problems that come with that and then stand squat?

David Hossein: I look at it slightly differently in that what’s your natural … I think people should do what they’re naturally inclined towards. I think you’ve got natural personality times, some people are entrepreneurial and really enjoy rolling their sleeves up and doing things themself. I think that type of personality should go for a squat because if you’re buying a practise and you’re coming in and you roll your sleeves up and try and change everything, everyone’s going to be pissed off at you, and you’d have no friends and it’s going to cause you problems. And then you’ve got the other type of personality which isn’t like that and just wants to come in get started from day one with regular cashflow.

David Hossein: So I think I always look at the personality type first, but to answer your question, I think it’s less cash intensive on a squat but you’ve got to get your marketing right, you’ve got to have that right. So there’s more risk with potentially more return if it does pick up. On the acquisition side, you’ve got the benefit of walking into something that has got a cashflow, a regular income, so you’re not having to work in two places while it’s picking up. I do spend a lot of time convince people not to buy practises.

David Hossein: I think that I’ve had clients and they’ve paid too much for something that it just wasn’t right and after you’ve paid the bank back any tax, you can be actually worse off and the first thing I do when an associate’s looking to buy a practise is well, let’s please look at the numbers closely, let’s compare the post-loan repayments cashflow to what you had before and are you better off or are you worse off? If you’re 10 grand worse off, you’re comfortable with that, you’re happy that it’s tied up in the equity of the practise and as long as you’re going into it with your eyes wide open and you’ve understood, I’ll support you but if then it’s like, well it’s going to be worse off for you, I will try and get that across. The last thing I want is a client that’s miserable because if the client’s miserable then I’ll be miserable and it won’t be a healthy relationship.

Prav Soulanki: Does your role extend above and beyond business and stuff like that? I often find that when I’m speaking to clients, often bleeds into a conversation more than just marketing and you talk about work/life balance and stuff like that and sometimes I’ll have people approach me and say, “I’m thinking of buying practise two.” Because practise one is going really well and I’ve just [inaudible]. We all know that’s not reality, not for most people anyway, or somebody who’s grossing really well as an associate and they think, “Hold on a minute, the practise that I’m working for is taking 60% of the dough, I want it all.” So then they go down that route. Do you find yourself in those situations? Do you find your role extending above and beyond commercial dental accountant? Have you got any stories that you can share with us?

David Hossein: Yeah, sure. I mean, to answer the first question, absolutely, it’s not just about your numbers, it’s about where you are and where you’re going and how you feel and what’s driving you. Yeah, absolutely I think … Yeah, the second thing you mentioned there about the associates not happy about the 60% going, that’s very common and what I always say to people who are thinking of buying is just let’s talk it through beforehand to be clear on what your reasons are for doing it. Do something like that for the right reasons because it is a very big thing to take on and if you’ve not done it for the right reasons, it will make you unhappy. Any stories? What would you like to know?

Prav Soulanki: Summat juicy, mate.

David Hossein: Summat juicy.

Prav Soulanki: Any big names in dentistry who mucked it all up? No, I’m only kidding. Do you know what? Just something out there where you’ve seen perhaps something go wrong or that could have gone the right way, or just stories of where for example, people have bitten off more than they can chew because they didn’t quite know what they were getting into. I often find that, especially with a lot of associates, a lot of them don’t know what they’re getting into and they think grass is greener on the other side and then they realise, “Hold on a minute, I could wake up, stroll into work at 9:30, go home at half five, have my tea, watch a bit of Netflix and go to bed and now I’m doing the 14, 15, 16 hour shift and the majority of that shift is at home, stressing and thinking, or dealing with someone’s going to be off sick or whatever.” Have you had any of those scenarios perhaps, or stories where someone’s bought in and they think, “Oh my God, I can’t do this any more.” Or someone who’s been even braver and said, “Do you know what? I’ve made a massive mistake, I’m getting out of this.”

David Hossein: I have, many years ago, I do try and avoid my clients putting themselves in that situation because I’ve been through it before and I’ve had a client who really overpaid for what this practise was worth. It wasn’t my client at the time, so he came to me after he’d bought it because I would have stopped him doing that but every year, every January, it’d come to, “Here’s your tax bill,” and I won’t mention any names but it was soul destroying for him, said, “Where am I going to find this money from? I’m being taxed on this.” Don’t forget you’re taxed on your pre-bank loan profits. So if you’ve got 100 grand profits but you’re paying the bank 50, you’re only seeing 50 of that, but you’re being taxed on 100. Then if you’ve got a 40 grand tax bill on the 100, then there’s 10 grand left for you and your family. So you’ve got to really make sure you can avoid those capital repayments and yeah, he did come out, he had to cut his losses, but it’s like you say, you don’t throw good money after bad, there is a bad where actually this is not working and luckily, he could sell. He didn’t make a massive loss on it but compare that to where he is now, he’s an associate earning 100 grand, so it’s-

Prav Soulanki: A month?

David Hossein: No, not 100 grand a month, 100 grand a year.

Payman Langroud…: David, you know it’s a good exercise, yeah? Because a lot of dentists, like Prav said, want to open their second or third, or fourth sites, and in those sites they’re not going to be there, right?

David Hossein: Yes, yeah.

Payman Langroud…: In the end, they’re not going be the fee earners. So as a thought exercise, if you were going to open a dental practise, bearing in mind you’re not going to be there earning as a dentist, what would be things you would look for? Let’s say, begin with the end in mind, you want a three practise group, what would you do?

David Hossein: Man, that’s a really good question. I think it’s easier if your first practise is an NHS practise that doesn’t need to do a lot of marketing. If you can convert practise, an associate-led practise, sorry build it into an associate practise that doesn’t need you there, they often say the shift from one to two is harder than the shift from three to 10 because once you’ve three, you’ve got the seeds in place and it’s replicating the business model and the business isn’t contingent on you at three. But going from one to two is where you get cut down the middle, so you really want to make sure that practise number one is very, very self-sufficient and it’s the least of your time. It’s great if you’re not then working in it at that point and then it’s great that you can then work in the new site. Somewhere not too far, so your practise manager from site one can help and come over but yeah, it takes time and I think that’s … I think if I was giving … Go on.

Payman Langroud…: First one’s the NHS, what would your second one be? NHS too?

David Hossein: Well, if it was me, I think that it depends on the location, but a second one that’s private, is a private squat, would be attractive to me because I think your investment at that point is less but at the same time, if the cashflows work to buying another practise, then obviously go for that, but as you know, valuations aren’t very high, so you’ve got to make sure that cashflow works and then when you’ve got two and you’ve got a third one, then you add in then, do you need centralization of your processes and that’s another headache. Do we need a head office?

Prav Soulanki: Do you know, what I find about that, you say practise one NHS, practise two private, but systems and processes in place for expansion-

Payman Langroud…: They’re different types of practises aren’t they?

Prav Soulanki: Yeah, so surely in my … I’ve only ever known, in terms of ownership, private and I’ve worked with practises who are mixed and the processes and the systems are entirely different. I mean, NHS dentistry and the way that’s handled and stuff, it’s a whole world I don’t really understand but when I do get let into it, it feels like chaos. The only reason I say that is because when I communicate with the team members there, it is like they’re going 110 miles an hour and when you’re in a private practise, it feels like the music levels just toned down and you’re just coasting along and it’s smoother, do you know what I mean? Because you’re more in control of everything, rather than being dictated, so the systems and processes will be different. But is the logic NHS first, private squat second?

Payman Langroud…: Well, it’s a very common way of doing it Prav, because you’ve got the guaranteed income first.

Prav Soulanki: Not so much guaranteed moving forward though maybe?

David Hossein: Yeah the question was only two sites and I’m just going off what I see as most common for what I see but I think start with the end in mind. If your goal is to have one and two, then having one that’s self-sufficient and the second is your private where you generate high level returns, that can work. If your goal is, “Actually you know what? I’m going for 10 practises here.” Then yes, acquire several ones, acquire similar ones.

Payman Langroud…: Let’s take it forward then. Yeah, let’s saying we’re going for 10 practises, now you’re at three and you’re saying we’re now looking at some head office staff. Let’s walk through it. How do we get more money? How does it work? Are you in the cash raising side of these businesses too, or not?

David Hossein: I work with the lenders on behalf of the clients but the banks love dentistry. They will give you money.

Payman Langroud…: All right.

David Hossein: So it’s entirely up to you whether you take that on. Yeah, have that now very large debt above your head.

Payman Langroud…: Let’s talk systems then, go on. Let’s say you want to go from three to 10, what should be our systems? Who should we be looking to hire? How much money should we be looking to borrow and then what’s going to be our exit story? From your perspective?

Prav Soulanki: One at a time mate?

Payman Langroud…: Yeah, yeah, yeah, I know.

David Hossein: I have to say, there’s a line that I don’t cross. I don’t step into the business and put an operations person in and there’s a line I can’t go past. Prav’s probably better placed to answer that side, being on the inside, but from the outside, from what I see with my clients, then you want to have your accountancy function centralised. Associate pay, have your payroll, your associate pay centralised so take as much off your practises, have it all centralised. What else? Do you need a HR person at that point? I don’t think so, I think that having an external company can still help, you don’t need to have a HR person centralised. So when people talk about head office, we often make that into a really big thing, when in reality, it doesn’t have to be. I’ve got a client who’s just sold for a very, very good sum and their head office was very loosely put together with laptops and people working from home. It’s how you design it and what the point of the head office is. So if you can take off the payroll, take off the associate pay, paying of bills, having your accountancy function, your purchase ledger, if that can be centralised, great. Doesn’t have to be.

David Hossein: I think it also, again, going back to structures, it depends who you’ve got in the business. If it’s just you, and you want that all in once place and you pay the bills then yeah, centralise it. If you’ve got partners involved, and I think partnership models will become a lot more common going forward then you might … It depends what you agree with the partners and what you want to do, what they want to do and they might say, “Well actually, you know what? I want to pay the bills and I’ve got visibility on that.” I don’t think there’s one size fit all, I think there’s flexibility to what it actually needs. Obviously a big corporate would need to have purpose built offices and an in-house legal person and so on but I think for the smaller size clients, you don’t need something like that.

Prav Soulanki: When people are looking to set up a squat, I’m sure loads of mistakes are made, just the treatment of things financially I’m thinking about, rather than other operational business-type stuff. Are there three big tips you can give from a financial perspective? For example when people have questions like, “Buy equipment outright or lease,” for example. Can you tap into that but also maybe a couple of other for examples where you can just give some advice of what are the best ways to treat different areas of your business from an accounts issue, a tax perspective, to maximise things for you moving forward?

David Hossein: Well, for a squat, the absolute priority is not to spend all your cash and be as pessimistic as you can on how long it will take you to get new patients. If you’re over-confident with it, “You know what? I’m going to have 20 grand a month from day one,” then you’ll base your decisions on that and over commit your cash. Cash is the blood of any business. When it comes to a squat, I always say well, “Well, do you need to do two surgeries from day one?” If you’ve got a certain amount of cash, let’s do one surgery, wait for that to be full before committing to the second and third and so on. So doing things in a staged process if very common, so should I buy something on hire purchase or cash? If you’ve got the cash and you’re 100% certain you don’t need it, and you’ve got a bit in reserve after that, because always have something for a rainy day, then if you’re buy it cash, then you won’t have to pay the interest charge, which although it is tax deductible, then if you’re a company, let’s say it’s 19%, 81% is still a real cost to you, so that’s worth considering.

David Hossein: However, from a tax point of view, doesn’t make a difference. Whether you buy it cash, or whether you buy it on hire purchase, let’s say your year end is the 31st of March and you sign the contract on the 31st of March, you will get the full tax relief on that asset in that financial year. So if there’s no real tax, it’s more about, well can afford to lose that-

Prav Soulanki: Cashflow.

David Hossein: … yeah, cashflow and the extra cost of the interest. It’s what’s the best use of your money.

Prav Soulanki: Any other sort of … So, that’s many one example where I’ve definitely heard questions in Facebook forums and groups where people say, “Should I buy, should I lease … ” are there any other examples of those type of scenarios?

Payman Langroud…: Very commonly people overestimate how quickly business is going to come in, right David? But it’s interesting because if you’re an associate and you’re going to do your first squat, I mean, how you going to even get anything accurate on how quickly you’re going to get patients in? I mean, you’ve never run a marketing campaign, what would you say? If someone says to you, “Look, I’m going to open in Manchester, how many patients a week can I expect?” I don’t know, I’ve never done it before, so what do you do? You say pessimistic, what’s pessimistic?

David Hossein: The way I work my financial models are how many surgeries are you going to put in and what’s the capacity? So I know the question you’re asking, is it five patients per week, or is it 10. I tend to work on the high level perspective, so if that surgery can generate £200,000 worth of revenue, then in month one I would assume zero percent, month two, maybe 5% and then 10% and so you build it up so to the end of year one, hopefully we’re 30% capacity, so 30% of £200,000, 60 grand income. So it’s a staged over. I think I would start with a really pessimistic perspective because if we beat it, that’s great, but if we’ve over egged it, we’ve all got egg on our face. I think it’s very important to have the right marketing team behind you and I think people like yourselves are very valuable to a new squat. I think that like you say, as an associate, you’ve probably never done marketing, you’ve never done an SEO campaign, and I certainly don’t, if I need doing, I’ll go to an expert. I think that’s where you and I probably worked a bit closely Prav, where clients have needed the help and you’ve been very helpful.

Prav Soulanki: Do you know what David? The one thing that I come across a lot is I run, call it a clinic or whatever, but I give up say 15 minutes of my time to speak to people, they can book that through my website and one of the most common inquiries, or let’s say conversations rather than inquired because they generally tend not to lead to me being able to represent them, but it’s somebody who’s a practise owner who’s working at his own practise two days a work, working as an associate three days a week and then comes to me and says, “I want to grow my practise and blow it out the water.” And they have these massive ambitions. The one thing that I find is fundamentally broken there is that job that they’ve got three days a week because that’s holding their practise back from growing, 100%-

Payman Langroud…: You mean their attention, Prav?

Prav Soulanki: Pardon?

Payman Langroud…: You mean their attention isn’t 100% on the practise?

Prav Soulanki: Well, there’s a few things. One of them is the reason they’ve got that three day a week job is they need to put food on the table. Now, the majority of people I speak to about this, they will say to me, “Oh well I’m grossing big numbers at the other practise but I want to grow this so I can do it for myself.” So then I break that down and say, “Okay, you’ve got an associate in your practise, let’s assume you change your two days to three days and gave one day up there, do you think you could make that income that you’re making there in your practise? “Oh yeah, yeah, yeah, I think I could do that.” All right, so we’re moving this conversation along, but I think it’s almost like that comfort blanket, in order for them to do that, there needs to be a point where you just say, “Do you know what? I’m going to tuck my balls in and go for it?” Like an element of risk. I find in that situation, I’ve come across so many dentists who’ve got that associate job, in order for them to get to the next level, they need to commit with 100% aggression and-

Payman Langroud…: Prav, it’s like every moment of growth in a business though, yeah? It’s scary.

Prav Soulanki: Yeah, course it is. Course it is.

Payman Langroud…: We’ve both been in the same situation ourselves. Not from a two days a week perspective but there are things we could both do which scare us and I hear what you’re saying about … skin in the game you’re basically saying. If your life depended on it, you’d really go for it, but you’re almost too comfortable in the associate job, is what you’re saying.

Prav Soulanki: Like cutting your lifeline off isn’t it?

Payman Langroud…: Yeah.

Prav Soulanki: So often the conversation we have is around life, so I will ask that dentist, look-

Payman Langroud…: It takes a personality type though Prav?

Prav Soulanki: Yeah, no, 100% mate, 100%. But if you think, if you lost that job tomorrow, is it going to change what you eat for your next meal? Is it going to change the roof over your head and is it going to change how you commute? If the answer to that question is no, and you’ve got enough ambition, just cut the cord. But if you’re depending on it for survival it becomes more difficult but those two things, the associate job and growing your practise to your dreams, they’re just incompatible. Do you come across any clients, or have you got any clients who are in that scenario or situation, where they’re just ball and chain with the job?

David Hossein: Yes, yeah I do and I think the point you’re making is valid, that it’s to the detriment of future growth in the practise. I think that there can be multiple reasons for it, if the associate’s got a small family, sorry, I beg your pardon, young kids, has got very young kids, then that situation’s giving them flexibility to spend time at home while the kids are young, then that can be one reason for it but I do agree, you look at it, that’s really frustrating because you’ve got this potential here that you could be developing and-

Payman Langroud…: It’s almost by definition the kind of associate who’s going to set up a squat has had to be quite successful as an associate to save up this money and all that, so that job then by definition is quite a good job that they had and breaking away from that is quite hard, I can see how it’s going to come up a lot actually Prav, you’re right.

Prav Soulanki: Yeah, no totally, totally and it’s hard to kiss goodbye to a regular, healthy, fat income right? That you’re used it. Whether you’re spending it or not is a different matter, what you do with it, invest it or whatever but to just cut that cord and then say, “Right, I’m going to … ” We spoke about this earlier, it’s up-climatizing is a lot easier than down-climatizing, right?

Payman Langroud…: Yeah.

Prav Soulanki: It’s much more comfortable and easier to go from a one bedroom flat to a three bedroom house but going in the other direction it’s a lot harder and the same thing, if you’re used to a juicy monthly income, no matter what you do with it, and all of a sudden you cut the cord, it’s got to be a hard pill to swallow.

Payman Langroud…: It’s interesting Prav that they’re coming to you at that point and not at the beginning. Maybe they think they can’t afford you at the beginning or something, yeah?

Prav Soulanki: I think it’s a combination a few things. A lot of people I speak to have said that they’ve been following me or blah, blah, blah, whatever, call it the long-term marketing game, where I’ll put a bit of content out there, I might resonate with some people and I’ll definitely turn a lot of people off as well. I’ll polarise people and so some people feel that I’m approachable and they can just book a 15 minute call with me, have a conversation, we have a nice chat and then going our separate ways and hopefully they walk away with some guidance or some advice or have one or two little ah-ha moments.

Prav Soulanki: Why didn’t they get in touch with me in the beginning? Maybe they didn’t know about me, who knows? But I think what’s really important here is that they have that true moment of realisation themselves, that if this their dream and this is their ambition and this is what they want to do with business, then switch that bloody aggression on and give it 110% and I’ve always been one of these people who believes that if you really want to succeed, you really want to do it, you need that pig-headed discipline and aggression to attack it with. If that is distracted with two thirds of your week, or whatever it is, somewhere else, being told what to do, working in a way that you don’t want to work, it’s just going to kill your energy for growth.

Payman Langroud…: Yeah, true. David what are the few things you wish dentists knew better?

David Hossein: Oh, good question.

Payman Langroud…: Apart from root canal.

David Hossein: We know they know that very well. What they knew better? I tell my team that if you’re waiting for someone to come back to you that’s probably because they’ve had a phone call that day with somebody in a lot of pain and they’ve had to rearrange their whole day for that, so you have to be patient with people, and try them on their lunch, that’s usually a good one.

David Hossein: I think that the benefit of being very disciplined and organised, I think that a lot of the problems that I see are rooted in … I mean, a client at the moment has set up a squat, used to have an associate limited company and it just needs closing down because he doesn’t need that company any more but it’s not been done and it’s racking up £100 a month late penalties and I keep saying, “Well look, we really just need to get rid of that because that is costing you a lot of money and you need that right now.” I think it’s very focused on, “Well, I’m in a squat now, I’ve got to focus on this.” But in the back of his mind, I know that that’ll be grinding him down. When he goes to bed at night, it’s there in the back of his head that, “I’ve still not dealt with that damn thing.” And that’ll be grinding him down. But I think the 15 minute phone call to me to sort it out for him would pay dividends mentally. So, having things that are bothering you and it’s not fun dealing with them, but not dealing with them, will cause you a lot more stress when you go home and you’re trying to relax.

Prav Soulanki: I’ve seen that and it’s something I’ve picked up on, definitely in the last few years, it’s the who not the how and I think there was a big Dan Sullivan thing that rather than trying to figure out how to do it and figure out, “Right, so I’m going to close this company down and I need to fill out this form at Companies House, blah, blah, blah, this, that and the other.” It’s like, “Who can just take this problem away from me and do it and does it every day?” And it’s that 15 minute phone call with you, is that you can take that pain away and that thing that’s holding them back from maybe just accelerating away.

David Hossein: And becoming a bigger problem because the penalties are still being … it’s more expensive not to deal with it, if it’s … You must come across that, Prav. Advice for people, one question I’ve got [inaudible] what advice would you give to dentists to make themself more, I don’t want to use the word organised because that’s condescending but as a dentist, you go into your practise and you’ve got patients, you’ve got responsibilities and there’s all this admin stuff and it’s of no value other than you have to get it done but you still have to deal with it, so switching your mindset into, “Got to get that done because it’ll just grind me down and become a problem if I don’t deal with it.” How do you coach people like that?

Prav Soulanki: I think my advice is, and I can’t remember the guy who came up … because I do a lot of reading, a lot of listening, a lot of watching and stuff and there’s this concept, it’ll come to me who the name of the guy is, there’s this concept called the three alarms and you don’t be restricted to three alarms, it could be as many alarms as you want but just think about, “Okay, this is what I’m going to do today, I’m going to wake up in the morning and I’m going to exercise. I’m going to spend some with my kids between this time and this time and I’m going to go into the office and I’m going to work efficiently like a ninja with no distractions.” Let’s imagine those are the three activities that you want to smash that day.

Prav Soulanki: So your first alarm goes off at 6:00 in the morning, call it a mental alarm, or you can just set the alarm on your phone and have a notification with it and that first alarm says, “Linford Christie, Usain Bolt, I am a world class athlete.” So you wake up, call it positive affirmations or whatever, but you say, “When I’m going into that gym, there’s no distractions, no nothing, I’m a world class athlete.” You may not, million miles away from there but you’re positively telling yourself, “This is all I’m doing.”

Payman Langroud…: Bud, bud, bud the alarm goes off on your phone and you say to yourself, “I am Linford Christie. I am Linford Christie.”

Prav Soulanki: 100% mate.

Payman Langroud…: Is that what you’re saying? Okay, okay, go on.

Prav Soulanki: Right okay, but the point I’m trying to make is you put yourself in the shoes of-

Payman Langroud…: Linford Christie.

Prav Soulanki: Or I’m a world class athlete or whatever, but I’m going to approach this like one of the top professionals in the world

Payman Langroud…: Okay, go on, go on.

Prav Soulanki: So you’ve got that mental attitude where your next alarm goes off and it’s time with your kids, best dad in the world. So what does the best dad in the world do? He takes this thing and leaves it somewhere else, because that’s the thing that’s going to distract you and I’ve got my phone in my hand and then you give 100% attention, and you do whatever the best dad in the world does. Next alarm goes off, Elon Musk, you’re in the office so you sit down and buy loads of bitcoin, I’m kidding. But do you understand what I’m saying.

Payman Langroud…: It’s the alarm, so the alarm goes off at 6:00, you go for your run and then the alarm goes off at 10:00 you look after your kids, is that what you mean?

Prav Soulanki: I’ve got a schedule to my life, I’ve got a diary which says between these hours I’m working, between these hours, I’m spending time with my kids.

Payman Langroud…: [crosstalk] alarms are going off.

Prav Soulanki: Absolutely, yeah, it’s not random mate.

Payman Langroud…: Because I was thinking snooze when you said it, because I snooze my alarm three times.

Prav Soulanki: Yeah, yeah, yeah, I’ll give you some words after this call that will reinforce those habits mate.

Payman Langroud…: David, tell me about the structure of your organisation, how many people are you, how many clients do you have?

David Hossein: So I have about 90 to 100 dentists associate practise groups. My team is five people. We’re a unit inside a bigger unit, currently Bennett Brooks is a top 80 accounting firm so we can provide a very high level tax client where needed and some of the stuff that isn’t the general side, so if you need inheritance tax or … When it comes to the exiting side, there’s a lot of work that’s needed on the tax side, so that’s set. On a day-to-day basis, most of my clients don’t need that, they just need an accountant who can understand their accounts and talk to them about their accounts and their situation.

Payman Langroud…: How do you get over … Dentists are always coming up with crazy accountancy schemes to get out of paying tax.

David Hossein: Well, I think they’ve got a lot of help from people who want to target them and that’s the frustrating thing. If I take on a new client, it’s is there anything I should know and oftentimes, “Yeah, I’ve got this thing hanging over my head and how do I deal with it?”

Payman Langroud…: Is it always BS or are there some things that you could look at? I mean, I don’t know, there was the film schemes and there was this, that and loan yourself that much and pay it back. Is it always BS, should you just avoid?

David Hossein: Anything that has the word scheme in it, yeah, I would pretty much say, “No, no please don’t do that.”

Prav Soulanki: Scheme equals scam.

David Hossein: Scheme equals scam and I do feel for dentists because one, I think they are targeted on purpose, we’ve got very unscrupulous people out there who sit down and make a list of who are the people with money that I want to go after? That’s an unfortunate part of life. I also think that practise owners have this particular problem where if you took out a loan to buy a practise, you can on paper look very rich, but sometimes be cash poor because you’re having to pay the bank back so much and you only realise that value when you sell your business and you go, “Oh thank God for that, I’m out of this now and I’ve got my million pound in the bank,” or whatever it is. So it’s a combination of the two that puts people in that situation as well, “What can I do to get this tax down?”

David Hossein: First thing is, look for the structural things that you can do to make sure everything’s structured tax efficiently, without any schemes, and there’s lots that can be done. If it’s a company, having your wife as a shareholder, just seeing how the family’s income package looks like, to have income distributed in a tax efficient way. Do those things, but when it comes to somebody calling you and saying, “Oh I’ve got a way to get your tax disappear,” just don’t do it. If you really have to do it and you’re that way inclined, let’s say it’s going to save you 200 grand, you use that money and buy a house, don’t go to Las Vegas and blow it all. So if it ever does go wrong, you’ve got the house to fall back on, then you can sell and really pay the tax and interest that they’re going to come for you for.

Payman Langroud…: Yeah, I spoke to a dentist, that’s what he was saying. He was saying, “Take up as many of these schemes as you can and invest the cash and when they come for you, at least you invested the cash.”

David Hossein: Well, they’ll come for you plus interest and penalties and the penalties can be 100% of the tax sometimes, so it has to be a really good investment, put it that way.

Prav Soulanki: You just touched upon, I think Payman asked the question, is what one thing do you wish a dentist could do and the one thing that I often come across is a dentist will get their year end accounts, they’ll glaze over it and they won’t understand it and they’ll nod their heads and they’ll say, “Just give me the bad news, how much tax do I have to pay?” But they really don’t understand the numbers and whatnot and I think a lot of it comes down to the way it’s explained by a lot of people in your position, who just assume terminology is commonplace across borders and whatnot, do you know what I mean?

Prav Soulanki: So I think that’s one thing that I think certainly from your perspective, when I’ve been speaking to you, I have found that you dumb things down for me and that’s helped me understand things better for sure, and I think that’s key but then just one other thing you touched upon when you said practise owners when they dispose of a practise and they realise that the fruits of their hard work over the years, is how do they deal with that huge injection of money, that lump sum? Especially if they’re later on in life, coming towards last 20 years of their life and whatnot and maybe they’ve been the sort of people who don’t spend money and are not going to spend that money in their lifetime. Any tips for inheritance tax and structures and things like that? I know you’re not an IFA or whatever, but just some general sort of things that people often, once again, have conversations, we’ve said this. I can’t advise them on this sort of stuff, so point them in various directions but is there anything you can do from that point of view? I look at it from this point of view and think, “I’ve been working all my life, I’ve paid tax on all that income,” you sell your business, you pay tax again and then you pop your clogs and they get another-

David Hossein: They take 40%, yeah.

Prav Soulanki: … they get another stab at it as well, and well, I don’t want that to happen. Are there any bits of advice you can give?

David Hossein: Advice that it has to be very specific to first of all, do you have kids in the first place? Are you married? How much do you need for yourself? You’re right, passing on … In some ways you look at it and suddenly, you’re 60, 60, 65, you’ve just sold your practise for £2 million, now you’ve got £2 million cash. If you die the next day, you’re going to get 40% bill on it, whereas if you would have held and passed it down to your kids and if they were dentists, let’s say, there would have been zero tax on it because it was a business that you passed on.

David Hossein: So you really have to map back and say, “Well, okay, how much do I need for my retirement? What do I want to do with that money?” I’ve got clients who’ve gone and bought a golf course and if that’s what you want to do, go and do that but once you know how much you need then it’s, “Okay, the rest, where do I want it to go?” Then you’re into thinking about your kids, if your kid is a dentist as well, “Should I help them buy a dental practise?” That’s a business to have, so it’s just seeing what’s right for your circumstances, or is it grandkids, “Do I want to put money into a trust for my grandkids?” There’s so much involved in that situation, it’s very hard to give one answer for it.

Prav Soulanki: Let’s assume it was just cash, let’s assume you haven’t got a business, you’re a training company or something like that, and you’ve just got cash for example, like you just mentioned, that dentists who’s got £2 million with cash or whatever, what would you advise them to do? Seek advice from a … who? What type of person?

David Hossein: I think your IFA, if you’re not interested … I think first question is, have you had enough? Are you out of it now? Have you got any energy left to do a business? If the answer is no, then it’s, well if it’s not going to be a business, could it be an investment in another business, because that’s the halfway point between well actually now I’ve got something that’s fully an investment. So fully-owned business, partially-owned investment in an unlisted company, because that qualifies for business property relief, or am I sick of all that and I’m going to go into properties, investments and trust. Depending on which category you fall in, if you’re in the category of investments, then have your accountant talk with your IFA, and see what they are advising you in the returns involved there and how that impacts on your estate.

Payman Langroud…: Cash, no? You can gift cash seven years before you die.

David Hossein: You can yeah, you’ve got lifetime gifts you can make.

Payman Langroud…: Yeah, I’ll set my alarm for that date. It’s been an interesting chat man, what do you do outside of accountancy?

David Hossein: Well, I’ve got three kids so I spend a lot of time with the family, enjoy that. We try and get out, we’re very lucky to live near some fields here so we try and get out as much as we can, walking. I like to hike when I can, when I can get away, like to go for a hike and that sort of stuff. And food, I like my food.

Payman Langroud…: Do you cook?

David Hossein: Yeah. Yeah, yeah I cook. My wife’s a good cook but I like cooking as well.

Prav Soulanki: What’s your favourite cuisine?

David Hossein: Steak.

Payman Langroud…: Me too, man. Prav likes to end it on his traditional questions, I don’t know if you’ve ever heard this podcast before David, but Prav likes to make our guest cry.

Prav Soulanki: [crosstalk] David, but look, I’ve got a few questions and it just taps into the person behind the voice really, so imagine it was your last day on the planet, you had your kids around you and you had to leave them with three pieces of wisdom, words of advice, call it what you want, what would they be?

David Hossein: Be honest, truth is important, work hard, because anything worth doing is usually hard work and find something that you enjoy, to make it worthwhile.

Payman Langroud…: Nice.

Prav Soulanki: Very nice. How would you like to be remembered? So, “David was … ”

David Hossein: I suppose, “There for me when I needed him.”

Prav Soulanki: Nice. Now, imagine you got a month left to live and you know you’ve got a month left, you’ve got your health and everything in place but you know you’ve got 30 days, what you going to do with that 30 days? Please don’t say, “Look at another spreadsheet.”

Payman Langroud…: He’s going to first of all look at his inheritance tax situation.

David Hossein: Well yeah, I’d do that quickly. I’d probably go to Everest mate, probably try and-

Prav Soulanki: Would you?

David Hossein: Yeah, I’d want to go and … I’ve never been, I’d love to go see the end of the world, that’d be nice.

Prav Soulanki: Nice. David, it’s been an absolute pleasure, I think there’s lots of advice and that’s come out there. If people want to get in touch with you after this and just maybe speak to you and get some advice, is there an easy way to connect with you?

David Hossein: Yeah, so my email address, my website, bennettbrooks.co.uk. I’m on Facebook, I’m on LinkedIn. Yeah, google me.

Payman Langroud…: All right mate, thanks a lot, lovely to meet you.

Prav Soulanki: Thanks David.

David Hossein: All right, cheers guys.

Speaker 2: This is Dental Leaders, the podcast where you get to go one-one-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Soulanki.

Prav Soulanki: Thanks for listening guys. If you’ve 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 that you got some value out of it.

Payman Langroud…: 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.

Prav Soulanki: And don’t forget our six star rating.

Podcasting’s friendliest rivalry gets an airing this week as Payman chats with Jaz Gulati.

Fans will know Jaz as the host of the Protrusive podcast – but this chat reveals there’s much more to unpack.

Jaz talks about the joys of hosting Protrusive, life in Singapore, inspirational teachers and much more.

Enjoy!

“’ll never forget that moment I got my first gold star at age six, and from there, I was addicted to achievement, and that’s been a big driver for me. I just want to constantly do things.” – Jaz Gulati

In This Episode

02.25 – Podcasting
04.38 – Enthusiasm and ambition
10.02 – Specialising
16.14 – Inspiration
19.55 – Singapore
26.58  – Education
33.37 – Protrusion Podcast
43.15 – In practice
51.03 – Global brand
54.35 – Black box thinking
57.49 – Being a tough guy
01.03.15 – Best. Episode. Ever
01.06.02 – Imposter syndrome
01.09.44 – Last days and legacy

About Jaz Gulati

Dr Jaz Gulati graduated with honours and distinction from the School of Clinical Dentistry in Sheffield in 2013.

He is the winner of the Tom Pitt-Ford prize for excellence in orthodontics and the NSK prize for oral medicine. He is also a runner up of the Harley Street Young Endodontist award.

Jaz has travelled extensively, undertaking training in Singapore, Australia, Scandinavia and Dubai.

He is the host of the Protrusive clinical dentistry podcast.

Jaz Gulati: And I’ll never forget that moment I got my first gold star at age six, and from there, I was addicted to achievement, and that’s been a big driver for me, I just want to constantly do things. I’m one of these guys who has this massive to do list, I’m like, tick, tick, tick, tick. If I’ve done something that wasn’t on the to-do list, I’ll put it on the to-do list just to tick it off, just to get that feeling, yes, I’ve done something.

Intro Voice: This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Payman: Jaz Gulati, real honour to have you on the podcast today, buddy. Jaz has been to, qualified, what, seven years? And for a dentist of your pedigree, Jaz, you really have made a massive difference to what I would call sort of the educational landscape, and I’m really interested in what you’ve achieved with this Protrusive Dental podcast, and particularly the Protrusive Dental community that’s come from it. And for me, as a dentist who’s not wet-fingered anymore, it’s now become my link to the wet-fingered world, and I don’t miss an episode. I’m definitely one of the Protruserati. Lovely to have you on the show, bud.

Jaz Gulati: Oh, thank you so much, Pay. It’s great to be on your fantastic podcast, shame Prav’s not here today, but I listen to you guys all the time, the journeys that you guys have. But it’s all the things you said between my sort of podcasts and educational stuff I’m doing, very kind of you, really appreciate it. And you touched on the Protrusive Dental community or the Protruserati, and that’s something a lot of these things that you’ll discover in this episode today came by accident, grew organically, and I just love it, I just love what it’s become, and it’s so exciting to be part of this movement. So yeah, it’s great. It’s moving at a very fast pace, but it’s great to be part of, and I’m very excited for what’s to come with this.

Payman: I mean, traditionally on this podcast we start with where were you born and all that, but now that we’re on it, let’s talk about this. Did you go out to make your podcast, I remember when I was thinking of starting a podcast, and I’ve got Prav on the other side who’s very technical, knows a lot about a lot, or if he doesn’t, he goes-

Jaz Gulati: Marketing genius.

Payman: Marketing genius, he goes and finds out. And he contacted one of the world’s top podcast coach, and we had a session with him. And with me, I know that if I say to Prav, “What’s going to happen, what’s the technical side?” He’s going to fix it. But for you, when you were thinking of doing your podcast, take me through the thought process, first of all, of that, and then the steps you took-

Jaz Gulati: It’s a unique and strange one. Yeah, absolutely, it’s a strange one. Like when I look at origin stories of other podcasts, they had this goal and they had this overarching sort of theme that they want to explore, take everyone for a journey. For me, it was just one simple thing, and it was me and my wife, we went to Singapore. And we had a great time there, we were both working for the same corporate called Q&M as dentists there, and we had a fantastic time. I wanted to stay there forever, but she wanted to come back, she’s a very homely girl and she was missing family life.

Jaz Gulati: So we came back to the UK, and then word got around, on the forums, on Facebook and stuff, any time someone talked about Singapore, they’d tag me in it. And I go to a stage where I was commuting from London to Oxford every day, so an hour each way, and usually that evening commute home was always occupied by me on the phone to a dentist telling them the same thing about, oh, well what’s it like in Singapore, how much money do you earn, what’s the situation like, what’s the Singapore Dental Council like compared to the GDC? The usual questions that you get.

Jaz Gulati: I kind of got sick of it. I thought, “Okay, I wish there was a way to record this in audio format and just get it out everyone so I don’t” … It was a fun thing to do the first eight people I spoke to, but then it got very repetitive. It’s like, okay, maybe there’s something I can blog about this, but blogging, writing is fun and stuff, but I’m very much more into audio and now video. So that was the actual muse, if you like, to start the podcast. Episode number one was expat dentists in Singapore, I had no real plan about how it was going to continue. And the first few was Singapore, then USA, then eventually Australia, and I just ran with it. And what it’s become now is just [crosstalk]-

Payman: Was it Protrusive at that point as well?

Jaz Gulati: Yeah, from the beginning. And to fair, I was toying with the names. I wanted to be a forward-thinking podcast, and I already have an interest occlusion, so forward-thinking, protrusive, to thrust forward. So that’s how that came, marrying up my interest in occlusion, but also something that represents forward-thinking, so that’s why I came up with protrusive.

Payman: What about this sort of infectious enthusiasm that you’ve got for dentistry? I mean, were you a good speaker before, did people come to you for advice? I mean, you seem to take it so naturally. You talk to people and the enthusiasm you have. Where did this start? I mean, were you one of these people … I was talking to Basil, he was saying that he wasn’t top of his class in dental school. What was your story?

Jaz Gulati: Well, I was president of SUDSS, Sheffield University Dental Student Society, so I was very active in that. I was very used to speaking, and something that I was very much involved in. I don’t do the whole, I was listening to Basil’s episode, and I stay away from politics. So the only two things I don’t talk about in my podcast is religion and politics, I stay away from that stuff, everything else goes, and the [inaudible]. But I guess so.

Jaz Gulati: I was also, without blowing my own horn, I was top of the class. I was the first person … Before, I was very embarrassed, in a way, to say this. I was like, “Ah, it’s very egotistical.” But I’ve since had some sort of mind training to change thew way I perceive it, which is basically, I was the first person in the university to get 100% in a finals clinical exam, and now I’m proud to say that, and it was something I really worked towards. So I was always aiming to be competitive and top of the class, and aiming to be one with the community, and a voice, a leader of some sort.

Payman: Where did you qualify? In Sheffield?

Jaz Gulati: Sheffield, 2013

Payman: Sheffield. So were you top of your class in school as well?

Jaz Gulati: Like before …

Payman: Yeah.

Jaz Gulati: Before Sheffield, like sixth form and stuff?

Payman: Yeah.

Jaz Gulati: Yeah, yeah, that was always … And I was thinking about the origin, because I knew I was going to come on the podcast, like where does it all originate from? And I can pinpoint it to when I was six years old. So if you go back far enough, I’m sure we’ll come to it. I’m a refugee, I was born in Jalalabad, Afghanistan. I came here when I was six years old, didn’t know a word of English, and my earliest memory of achievement was sat in year two at the time, and there was this massive board at the front of the class with everyone’s name on it and who got 100% in their spelling test. So everyone had all these stars. So every time you get 100% on the spelling test, you get a gold star.

Jaz Gulati: So obviously everyone had all these stars, and I was the only one without a star. And it went on week by week by week, I never had a star. And I just made it my mission that one evening to practise writing these three and four letter words, cat, home, ball, that kind of stuff. Practise, practise, practise all night. And I’ll never forget that moment I got my first gold star at age six, and from there, it was like addicted. I was addicted to achievement, and that’s been a big driver for me, I just want to constantly do things, I’m one of these guys who has this massive to do list, I’m like, tick, tick, tick, tick. If I’ve done something that wasn’t on the to-do list, I’ll put it on the to-do list just to tick it off, just to get that feeling, yes, I’ve done something.

Payman: So take me back, do you remember when you arrived in the UK? Do you remember that feeling?

Jaz Gulati: I do, I do. It was a strange time, I didn’t really know what was going on. I remember the way to get here was, travelling and whatnot. I was like, “Mom and dad, what’s happening, where are we going?” They’re like, “Don’t worry, we’re going to a better place.” And there we are, I was in England, didn’t know a word of English. And my mom spoke a bit of English, and my dad still … He’s okay now, he’s a shopkeeper, so he can speak English, but he doesn’t read or write.

Jaz Gulati: So I’ve always come from that background of … Which was important for me, because it ended up meaning that age nine, 10, 11, I was doing all the letter reading at home, and it made me very independent. So that was a very steep learning curve, just learning a new culture, a new language at that point.

Payman: And then what point do you remember thinking, “I’m going to be a dentist?” What was the driver for that? I mean, did you have any dentists in the family, or …

Jaz Gulati: Oh, no, no. I was the first person to go to uni, I was the first person to … I mean, with all my cousins and family members, we’re not very educationally-minded. And they won’t mind me saying this, I’m the most studious by far. There’s no one else who even reads in my family, let alone anything. So for me, it was my own experiences. I used to have terrible teeth, really goofy, I was very embarrassed. My upper left one was like a nine millimetre overjut, almost 90 degrees, and I went from being this very shy 11 year old to wanting, I was desperate for braces, because bullying, and [inaudible] wasn’t nice, I would always hide when I’m speaking.

Jaz Gulati: And then when I got braces, it completely changed me as a person. So that’s important in my journey, not only wanting to do dentistry, but also coming out of my shell and being someone who’s now outspoken, in a way.

Payman: Yeah, it’s funny, you hear quite a lot of dentists, and I’ve asked quite a lot of dentists this question, right, quite a lot of dentists actually relate the reason they became a dentist to an experience they had at the dentist. For me it was my brother, he had amelogenesis imperfecta, and he went through a lot of dental work, and one day came back totally beautiful. All my life, when my brother was this kid with teeth falling apart, and then it felt like pure magic as a kid, seeing him, and what it did to him, having that, like you said, bullying and all that, having the confidence to … Like he suddenly had a wonderful smile, and he went through two, three years of work at the Eastman, full mouth rehab for a 14 year old, whatever he was. And it’s still there by today, he’s-

Jaz Gulati: Wow.

Payman: … 50 years old, and it’s still all there. I mean, he gets the odd chip-

Jaz Gulati: That same rehab without any revisions, or …

Payman: The odd chip, the odd chip here and there, yeah. I mean, they put [inaudible] up the back, so probably a good idea. But it’s interesting that that’s what sometimes gets people into dentistry.

Payman: So then, you said you were excelling in dental school. Were you one of these who was making plans early on as to the kind of dentist you were going to be, or did you always think you were going to be in general practise? Why didn’t you specialise, if you were top of your class? Was that on your mind, or not?

Jaz Gulati: Yeah, it was definitely on mind. Initially, first year, if you asked me, I would’ve said, “I want to be an orthodontist,” because it was an orthodontist that inspired me in a way, had straight teeth. But then as I moved along, I had this affinity and enjoyment of endodontics, actually, so there was a tutor called Steven Godfrey, fantastic endodontist, who sort of, who’s just a lovely person and a great tutor, and sort of, sometimes you have that meeting with someone, they inspire you in a way, they take you under their wing a little bit. So I started getting into a bit of endo.

Jaz Gulati: Then I actually met someone on the train, and I was reading a book, it was like, Understanding Partial Dentures, right, I was like a third year student. And the guy on the train was a dentist. I still don’t know his name, so I want to thank the guy who’s listening, if you remember me, from reading this Understanding Partial Denture book. And he said to me, “Hey, you’re reading this book, are you a dental student?” I’m like, “Yeah,” we started talking, and I started telling him, “Yeah, endodontist sounds good, I like root canals and stuff.”

Jaz Gulati: And he said to me, “Are you sure you want to specialise in something that’s about this tall and about this thin?” And I considered that, and I was like, “Crap, he’s right.” It’s like, do I really want to specialise in such a such a tiny environment? And then eventually one thing led to another, and I sort of set my sights on restorative, [inaudible] training, specialty training, because I thought, “Okay, if I can be a restorative specialist, I can potentially be a specialist in endo, prostho, and perio. I can be the don, I can be the king.”

Jaz Gulati: And then eventually, my experience in hospital and stuff said that, okay, if I have to endure through this many years of hospital training with these egos, with this sort of slow pace and … So eventually I went private, and I’ve never looked back, and I’m enjoying my ortho restorative dentistry now, I’ve got a diploma in orthodontics. I’m very much someone who’s happy to travel around thew world, to go to the best courses to learn from the best people, and not having to worry about the letters after my name. Although I have some of those, they don’t define you as a clinician, is what I strongly believe.

Payman: Definitely not. And what about endo, do you do endo? Having said all that?

Jaz Gulati: I still do. But the thing is, the more you learn endo, and it’s one of the reasons why I felt compelled to leave the NHS, because the more you learn something, especially in endo, I mean, when you learn to use EDTA 17%, when you learn to use certain files, you can’t then cut corners, it’s very difficult to. So the more you learn, the more it becomes impossible to do it to the standard you want to in a limited time environment, and then the more you appreciate the complexities, so now I’m in a situation where a lot of the molars I’ll refer. Simple ones I’ll do, I’ll do five to five, I’ll do, but I think about 80% of the root canals now, I refer. Because they’re complex cracks, I feel as though the patient deserves to see someone who will do it the best, under a microscope, and not my five or 7.5 times magnification. Even though that’s good, I feel as though the patient deserves better. So I do some endo still, but not as much as I thought I would do.

Payman: And then this move into occlusion, and sort of … You’re definitely the person I like to listen the most to on this subject, yeah. You’re a bit young for someone who gets into that, usually it takes people a bit longer, like you end up with a few failures, maybe, and sometimes that wakes people up. Or I guess another way is mentor or something. I mean, what made you go that direction so early?

Jaz Gulati: I think definitely mentorship. So one of my principals, I work Fridays at the Richmond Dentist, so [Hap Gill], I actually [inaudible]-

Payman: Oh, is he your principal?

Jaz Gulati: Yeah, he’s my principal on Friday, so he’s [inaudible]-trained. And I met him on Twitter, right? So we used to tweet each other, I was a second or third-year student, and he was this amazing dentist, like celebrity dentist. And it was like, “Wow, we’re tweeting each other,” it was so cool. And I found out he’s from Hounslow, I’m from Hounslow, in West London, we’re the Hounslow Massive. So we had these similarities, and one day I went to shadow him as a student, and then a few years later I went to see him again as a dentist, and we were toying with the idea that one day he might take me under his wing, and he did. So he was a massive influence, because he sort of sat me down in the pub next door, he was [inaudible] letters, and he was teaching me these things about how the lower incisors must meet the upper incisor in a certain way to prevent chipping and stuff, and I was like, “Wow, we don’t get taught this at dental school.”

Jaz Gulati: So he was a massive inspiration, so was Michael Melkers, so was just consuming content by Frank [Spearings] online and stuff, so it’s not the occlusion that excites me, it’s what occlusion can give you, which is how can I do bigger cases? And it’s the knowledge of how it all works together that you can plan the blueprint to how to treat bigger cases. So it’s more the excitement for the bigger cases.

Jaz Gulati: And I guess, you’re totally right, I’m so young, so I haven’t done many full mouth rehabilitations. I know when they come through, I know how to plan one, I know how to sort of send it to which specialist to do to get the best out of them and work as a team and to plan overall, but I still see myself as someone who’s got another 10 years to get more failures, to get more rehabs under my belt. I mean, I’m getting more and more teaching, I don’t teach rehabs. I teach the basics of occlusion, I’m very good at splints and stuff, so I teach that, but I know my limits. I know that I’ve so much more still to learn, but I’ve got a good grasp of in which patients occlusion is important, and which patients it just doesn’t matter and we’re overplaying it.

Payman: Yeah, well, I mean, those decisions, and these are the questions you ask in your podcast. Sometimes they could be even seen as a very basic question, but it’s a question that needs asking. So I was listening to Nick Sethi’s one, and it’s a very simple question. When do you go indirect, when do you go direct? And you’d imagine these things are all set out, and I know you’ve got your traditional teaching, but we’re at that sort of inflexion point, aren’t we, between traditional dentistry, adhesive, traditional minimally invasive, and the rules are changing, and that’s why it’s so interesting. You can ask the question that’s sort of so simple but so important. Same thing with your podcast with Finn, the partial denture … Some simple things that someone who’s at the top of their game to answer. What do you think, when you’ve been to lectures, what was one, or an event, or a conference, one that enthused you the most?

Payman: Like if I was a young dentist now, who would you tell me, “Look, make sure you go and see this guy?” For me, back in my day, Mike Wise, Galip Gurel totally changed my understanding of how to prep within enamel and all that. What about you? Who were the people who-

Jaz Gulati: I can easily pinpoint it to 2014, probably January, February. I was in my DF1 year, it was Koray Feran. Koray’s been on the podcast, and I was in my DF1 at the time, I was in this NHS environment. I just was never exposed to … Yes, as a student, and nowadays, being a student, with the dentistry, the presence it has on Instagram, with Facebook and these groups and stuff, as a student, you can easily get exposed to the highest level of dentistry.

Jaz Gulati: Back then, 2014, it wasn’t as prevalent, it was still, you had to seek it out, and I was seeking it out. But for me, that lecture of Koray’s two hours, the title of the lecture was excellence in restorative dentistry, and I just hadn’t been exposed to that level. So when I saw that, I was like, “Wow, how can I be more like Koray? How can I do bigger cases, how can I be really good at restorative dentistry?” So that’s an easy one for me, that really sparked my interest. And then as the years went by, I started to seek courses, mentors to try and learn about that. But now, it’s so easy and accessible and affordable, with online and the presence that it has everywhere. So it’s never been a better time to be a dentist than how. A dentist who wants to learn, this is a great time.

Payman: So then you did this originally, an NHS job, you said, yeah?

Jaz Gulati: Well, DF1 was NHS, and then I was doing DCT post in oral surgery and restorative at [inaudible]. Their oral surgery was okay, was all right. The restorative was not so good. Because when you’re a restorative DCT at Guy’s, you’re this tiny tadpole in this massive ocean and there’s all these sharks, these guys paying 20 grand a year to do their postgrad, they’re getting all the cases, they’re getting all the amelogenesis imperfectas, they’re getting all the fun stuff. You’re getting the fifth complete denture set on someone who doesn’t attempt to attend, or you get the sort of not so exciting cases.

Jaz Gulati: So that was a bit sad, but I made my time valuable there, I valued my time. I wrote the reservoir and bridge paper, two part paper in Dental Update. So I really worked hard to do that, because I thought while I had the spare time, let me make an impact, let me do something. So that was really valuable, and a journey of eventually getting into education, doing that. I then did restorative DCT, so you get the theme, right? I was gearing my CV up for restorative [inaudible] training. So I was at Sheffield, DCT and restorative, which was a phenomenal post. That was like microscope, [inaudible], that was everything I wanted, and I really loved that.

Jaz Gulati: And then after that, it was like, what next? Because I don’t think my portfolio and my CV and my timing was right me to be able to land a private job, and I was already doing a Saturday NHS job, and I’d wake up and I’d say to my wife, “I feel really anxious about going in today.” Because those kind of conversations pay like, you can have a root canal with hand files, or you can have a root canal with rotary, and there’s a fee difference. Or you can have a metal filling or a tooth colour filling. I absolutely hated those conversations, I was a slow dentist, because if I knew how to do something properly, I just felt like a liar and a cheat if I was cutting corners. So I knew I couldn’t do that.

Jaz Gulati: So yes, it was the adventure of Singapore, yes it was the being able to travel, yes it was the experiencing a new society and a culture, but it’s also not settling for the NHS at the time. And I mean no offence to anyone listening to this, because I think those NHS dentists do a fantastic service, and we need lots of good NHS dentists who work fast, who work ethically, and that’s amazing. But I couldn’t do it. So that was [crosstalk]-

Payman: I mean, those are the conversations they’re having every day, right? I mean, that’s part of the thing that grates you, wears you down in the NHS, having to pretend that it’s all top notch treatment and then not being able to deliver it. It’s a sad story. So why Singapore? Did you do some research and decide that’s the place to go, or what? What was the reason?

Jaz Gulati: Yeah, I mean, like most stories, you usually just know one person that did it, and then you sort of contact them. And with social media, like I say, it’s never been a better time, you can connect with anyone in the world. So it was [Sirindha Poonian] who was there who was two years above me at dental school. So I just realised that, “Hey, she went to Hong Kong then, now she’s in Singapore,” I just sent her a Facebook message.

Jaz Gulati: And sort of like how people were calling me and messaging me when I came back from Singapore to England, it was also hitting [inaudible] as well, who’s now a periodontist, he helped me a lot, he told me about which practise to apply for and stuff. So there are some UK grades out there who were so helpful, and me and my wife decided, if we don’t do it now, when will we do it? How can we break away, how can we have that … We never had gap years, me and my wife. So we thought, “Why not?” There’s never going to be a better time than now. We didn’t have a mortgage, no children. It was just a perfect time.

Payman: So I know you’ve had to do this many times before, but walk us through the process. What was it? Okay, you decided Singapore, then?

Jaz Gulati: Yeah. Decided Singapore, and then you have to find someone who’s going to employ you. So at the time, it was Q&M, was a corporate. They’re still there now, but nowadays they’re so much more difficult to, as a foreign dentist, to get your licence there. So you get like a conditional registration. And the bad point is that even if you’re a specialist in the UK, as far as I know, I might be wrong now, because not current knowledge, but you still have to be conditionally registered with the Singapore Dental Council. What that means is essentially you’d need like a VT trainer. So you need a dentist there who is going to be your supervisor, and that was when it becomes messy, because at any one time, your supervisor had to be there. But the problem is, a lot of these clinics in Singapore, they’re a one surgery clinic. So how does that work?

Jaz Gulati: So that becomes difficult, there are inspections, there were issues like that. I’m not going to get into the messy details of that, but it’s not an easy place, now, as it was back then. But basically, you find someone to hire you, so it would be a corporate. We flew to Singapore, had a nice lunch with them, they had many UK dentists before who had worked for them, so they knew how it worked. They sort of almost equivalent sponsor you in a way, they sort of said, “Yes, we’ll take this dentist on, we’ll fill in their paperwork.” You have your blood tests, and eventually you just send some paperwork for the Singapore Dental Council and it gets approved, that takes a few months.

Jaz Gulati: In that few months, we went to Malaysia and all these countries, travelling while all the paperwork was getting processed, and then eventually it was quite easy to get started.

Payman: Singapore has, I mean, it’s famous for its high standards of pretty much everything, but particularly healthcare, the standards are very, very high. Were patient expectations high there? I mean, what’s the culture of a patient there? Were they highly educated in dentistry and expected everything from you? What was the story?

Jaz Gulati: It’s fascinating, Pay, honestly, it’s so fascinating. Because I went there thinking exactly what you thought, but I worked in two locations. One was in, it’s called [inaudible]. It was like a suburb area in Singapore. The other one was called [Somerset]. This is right by Orchard Road. Have you been to Singapore?

Payman: No.

Jaz Gulati: So it’s like by Oxford Street, basically, of Singapore, just off there. So I worked in these two locations, and they were really different. So in one, I was seeing all these expats, and the domestic helpers of the expats, which was always a weird thing, because it was the expat who was funding the treatment, but we sort of had to negotiate, okay, what’s a fair thing here? Which was just the craziest thing ever.

Jaz Gulati: But then in this other suburban place, I was just seeing what we call uncles and aunties. So anyone who was old enough, we just call them uncle and auntie. And the standard of work there was, it was like fee per item NHS, I was shocked. You see all these big RMGIC restorations, they charge $70 for like a filling there. So I came to a practise, I was like, “We need to get rubber dam, we need to get composites, we need to actually do everything the way I want to do it,” and the culture in Singapore is such that patients come in to dentists to get a clean, so I was doing all the [inaudible] polishes. And it was weird, you were almost doing an exam secretly, like going around doing the charting secretly, because what they wanted from you was like a hairdresser, they wanted to come to you to get their teeth cleaned. They don’t want to hear about a diagnosis and whatnot.

Jaz Gulati: So it was a big challenge for me to actually get the practise geared up for routine bitewings, like most of our patients had never had a bitewing before. So it was really strange, Pay, in that one practise, to answer to you, and that was the bog standard average practise in Singapore. Yes, you got the high end ones, and I went to shadow them and stuff, because I was hungry, I wanted to learn, I want to see these top dog clinicians, and I did, and it was amazing. But the average dentistry was fee per item NHS, I’d say.

Payman: Wow. That really does surprise me. I mean, I’ve talked to a couple of dentists from there, and they showed … Well, they’re trying to be enlightened users and distributors out there, and have shown me their clinics and it just sort of blew me away, something out of this world. Maybe they were the top ones. [crosstalk] that surprised me-

Jaz Gulati: I think so, I think there are loads of really independent practises, but a lot of the corporate ones, they’re there just to give a service like the NHS, is just, people come in, they’ve got missing teeth, they want dentures, very disease-orientated, and that was fine. I was there to upskill, but also to travel as well.

Payman: Of course. As far as language and that sort of thing, did you have to learn anything? [crosstalk]-

Jaz Gulati: No, I mean, everybody speaks English. I mean, your uncle and aunties, they either speak Bahasa Malay or they speak Mandarin, but my nurses were so brilliant, they were fantastic ladies, they would speak everything. English, Bahasa, Mandarin. I started learning Chinese while I was there a little bit, on this phone, like a HelloChinese app, and I can say root canal in Chinese. [Chinese]. So, the thing about that, so it was pretty cool. But no, language wasn’t as big of an issue as you might think.

Payman: What about Singapore as a town to live in?

Jaz Gulati: Amazing. Wow, it’s Asia-lite. It’s like, it’s so good. It was just clean, and the food culture, these hawker centres. I can get like, a plate of chicken rice for like $2.80, and it was bliss, right? It was food everywhere, Singapore’s crazy about food. Everywhere you look, it was food, food, food, food, food, and that was great. Alcohol was really expensive, the culture there, because they want to tax everything, to drive is almost impossible. To have a house is like, whoa, if you have a house there? You’re richer than rich. So most people live in apartments, so we had this condo, had a rooftop swimming pool. It was just the life, it was beautiful. What can I say? It was just a lovely country, great weather, great people, just a great buzz about Singapore, really miss it.

Payman: Did you do a little stint in Australia while you were there as well? Or did you travel to Australia?

Jaz Gulati: We went travelling for about three or four weeks, just [inaudible] the end, we know we were coming back to England now, so we thought, “Right, better go Australia.” As you do, I went to a Tif Qureshi course while I was in Sydney, and I went to a Lincoln Harris course as well while I was there. So I thought, “Okay, let me make the most of it while I’m there.”

Payman: How many hours of education do you think you’ve done, then? You’ve done a lot.

Jaz Gulati: Yeah, I mean, too much, too much. So now, I mean, the CPD, [inaudible], they don’t excite me at all. I don’t think they excite anyone. It’s funny, Pay, you’re a provider of education. Some people get really anal about that, and they’re really, the certificate’s really important, “Can you send it to me ASAP,” kind of thing, whereas I’m like, I’ve got CPD coming out of my ears. I don’t need the certificate, it’s fine. I’ll waive the certificate, it’s okay. So it’s not about the certificate.

Payman: Yeah, you’re right about that, though, you’re right. Some people really do panic about that item. So now we’ve got, look, I’ve got you down definitely as an educator, yeah? I mean I really mean that. Was that a goal? As a high-flying student, and then as someone who’s going on a load of courses and all that, and you were talking about the restorative sort of specialising and restorative … Were you thinking, “I want to be a teacher?”

Jaz Gulati: Yes, to the extent that as soon as I qualified, 2013, I entered the PG cert for dental education. So I knew that, “Okay, I want to do this. Let me set myself up, what do I need to do?” So although I didn’t have enough knowledge to teach, I was always thinking, “How can I become a better educator?” So once I’ve amassed enough knowledge, once I’ve had enough failures, once I’ve really given it my all and I have something valuable to share, then I’ll be ready. So I was gearing myself up to it for many years, I was analysing lecturers, which lecturers really engaged me, excited me, the kind of traits they had. Which ones, although they had all the accolades and letters next to their name, which ones just bored me? I never wanted to be someone who was going to be boring. I always want engaging, like, I always paid real attention to Raj Rattan’s lectures, or stories. Such an amazing storyteller, so that becomes a very important part of me trying to make it through as an educator, so that was important.

Jaz Gulati: And funnily enough, I can go back to first year of dental school, where my buddy Eric, who was a dental student from Korea, and he failed his first year exams. And he said to me, “Jaz, if you can help me pass my first year exams, I’ll take you to Korea, all expenses paid,” right? So I stayed back with him two weeks, I tutored him, we got him to pass his first BDS exams, and that was me like, “Okay, I’m trying to teach someone here,” that was a important part of it, I think. And then two years later he took me to Korea and Tokyo and we had a blast, so there’s a little fun story for you there as well.

Payman: I mean Jaz, you’ve obviously got a talent here. There’s no doubt, in my head, no doubts about it, yeah, that you can-

Jaz Gulati: I appreciate it.

Payman: Being a teacher really is the right move for you. And it’s interesting that it’s come out in this Protrusive Dental podcast way, and who knows where else it’s going to go? I’m sure you’re going to spin off events and all that from it. You have, haven’t you? Or, COVID got in the way of that. Do you recognise this thing that I’m thinking of young dentists who want to be teachers? In my day, that wasn’t a thing, yeah? I don’t know, maybe it’s the ones I’m talking to. But almost every single young dentist I’m talking to is banging on about becoming a teacher. Why? I mean-

Jaz Gulati: [crosstalk]-

Payman: … what’s happened? I mean, why teacher? Why not rich? Why not multiple … You know what I mean? Teacher seems like kind of a left field thing. As I say, you definitely do have a talent there. For sure, it’s the right thing for you. But I hear it a lot, man. Do you hear that?

Jaz Gulati: Yeah, I see it a lot. And I think you’re right, back then it wasn’t the case. But thinking, even as far back to someone like Richard Field, remember when he was like one or two years’ qualified, and he was teaching composites? And to be fair, at that stage, he was doing way better composites than most dentists, right? Like, amazing, and I thought he had every right. But I remember him getting bashed on Facebook about it like, “Who is he? He hasn’t got any experience,” whatnot. And after … He definitely has a place, and he’s done amazing things, and I really respect him for that. But nowadays you see it more and more because people are able to use and leverage the platform of social media to show that, “Hey, I have something to share.”

Jaz Gulati: But I think to answer your question, though, why are young dentists attracted to education? Is, I think, we have such great people like Tif Qureshi and people like him, who, just such inspirational people that we want to be like them, so we try and model them. So I think it’s because some of the most influential person we know in dentistry are educators. I mean, look at the, not that I’ve ever voted or taken part in it, but the top 50 stuff, so many of those are educators. So we look up to these people as educators, and we see that yes, they’ve got their practise and clinical career, but they’re also educating. So I think young dentists naturally just want to model themselves, so that’s my best answer. What do you think?

Payman: I don’t know, dude. By the way, the blowback that you’re talking about with Richard, we got a lot of that with Dipesh at the beginning, because Dipesh was very young. I think he was 26 when he first started lectures with him. And we got lots and lots of that same blowback. And at the time I felt it was really unfair, because he really is a talent above ones I’ve ever seen, he really could be one of the greats in minimally invasive-

Jaz Gulati: Oh, absolutely.

Payman: But, for me, this thing about, “I want to be a teacher,” I hear where you’re coming from as far as a bit of modelling on other teachers, but I think you’ve got to examine the reasons why you want to be a teacher. Like there’s an element of want to be famous in it, and then you’ve got to go, okay, why do you want to be famous? There’s an element of … I don’t know, man, I mean, I can’t put my finger right on it. But it’s like, PG cert, that thing, it’s like, everyone wants to do that now. It’s an amazing thing.

Jaz Gulati: Yeah. It’s interesting, initially a lot of people were doing it because it was something you needed to be a DF1 trainer, so all these people were jumping onboard and whatnot. But you’re right, a lot of people are doing it with a view to that. So they are mapping out their careers in five, 10 years’ time, and they’re thinking, sort of like I did, and my-

Payman: I was on a Instagram profile yesterday, and it said, “Second year dental student and mentor.” But I get it, I get it. I’m not the type to say, “Hey, screw you, why are you a mentor?” But in our day, you had to get out of dental school, do a couple of degrees, teach at university before anyone paid any attention to you. And that was wrong too, that was wrong too, because look at you. You’re giving out this valuable, super accessible, amazing information out, and you haven’t had to go and get it from a piece of paper from a university in order to do that. So I’m not harking back to those days at all, but it does fascinate me that being a teacher’s become a really … It’s almost like being an entrepreneur has become cool, isn’t it? That sort of thing.

Payman: All right, let’s get to the main subject, dude. Protrusive, yeah? I don’t mind admitting that I’m a little bit jealous of what you-

Jaz Gulati: Nothing to be jealous about, man, come on.

Payman: … what you’ve achieved, dude. It’s not to do with downloads, it’s nothing to do with that. It’s to do with, this love, yeah? I feel like, yeah, people will listen to our podcasts because they’re interested in other people’s lives, and it’s kind of a cheat, it’s an easy win, yeah? But with you, you’ve managed to harness kind of the dentist that’s really, I’d call it the geeky tendency in people’s brains, and not just harness it, expand it. Like I’m no geek, dude, I’m really not. I am not a geek. I mean, on that one little subject of bleaching trays, maybe, but I listen to yours, I just want to know more, I want to learn more. And so you say it’s happened by mistake, for instance, yeah, but where do you think it’s going to go now? I mean, okay, what are we going to do? Just wait until other things happen by mistake, or what have you got in the pipeline?

Jaz Gulati: So definitely the biggest thing I have now is making time for the things I enjoy. So I love the podcasting, and very early on, I knew that the editing. So as you know, or as your team might know, one hour of podcasting takes five hours of editing to actually produce and get ready, especially when I moved to video as well, because I saw the power in video. And before, when I was like, the first 20 episodes were audio-only, and people were saying, “Jaz, why don’t you make videos and stuff?”

Jaz Gulati: At the time, it was like those normal insecurities everyone has, like, “I don’t know if I can present myself on video,” and I actually ended up doing this Toastmasters training as well, I was like, “Okay, if I’m going to be on video, I need to get some more training to public speaking,” and stuff. Even though I had a bit of history of speaking on stage and that kind of stuff, but you still doubt yourself. And going forward, I’ve got some people working on the team now, so I’ve got other people editing and stuff, so it frees me up to still be a father, be a husband, be a dentist. I’ve still got all the normal dentistry things to do. So to find time and systemize things so I can still get these episodes out, which I love doing. I sometimes open my phone, I got a message today of someone saying that they had this crappy 2020 and they were not in a good place, but now, from discovering the podcast, they’re now feeling positivity and enthusiasm towards dentistry. And that’s the most common sort of theme I get, and that just [crosstalk]-

Payman: The one you read out, the guy who’s doing the MSC now?

Jaz Gulati: No, this is a new one. This is a new one, I just literally got it before, 20 minutes ago. I checked, I was like, “Wow.” And these are the kind of messages I’m getting more and more frequently about reigniting people’s passion. So I think the future is to keep going for as long as I’m having fun, for as long as I can still balance all my duties, and I intend to. Just keep going and see what comes of it. If I can help more people with the education site, because I’m enjoying that as well, then great. But the main thing is I’m still learning as well.

Jaz Gulati: Because every time I bring on a guest, like tonight, I’m doing a live with someone called Robin Bethel from the USA, and I don’t know that much about elastics with aligners, and now I know which aligners to use, how to use them. So I’m learning as well, and I’m just selflessly sharing that with everyone else. Because I think one thing I am good at is figuring out the pains that we have as dentists and really making them public, and be like, “You know what, it’s okay not to know, but why don’t we just learn together so we can all grow together?”

Payman: Yeah. And what about courses? Tell me about this, what was it called? Occlusion … [crosstalk]-

Jaz Gulati: We had Occlusion 2020, so-

Payman: Occlusion 2020.

Jaz Gulati: … I had Michael Melkers, it was like a joint partnership where I had him. I was going to, well, fly him over to teach at Heathrow and put on this really cool event and stuff, but obviously COVID happened. So we did something crazy, made it a two day Zoom virtual event and stuff. So it was a very stressful period at the time as well, because at one stage I was looking at losing thousands here, basically, from going to a position where I was going to put on this wonderful event, it was going to be so … all this positivity and excitement towards it, to then suddenly making a big financial loss, which I hadn’t really planned for, but then suddenly it came through virtually, it was amazing.

Jaz Gulati: Now, my big focus now is I did the reservoir and bridge master class, which is like … And in a way, Pay, that was me shoving myself as an educator. So I saw the reservoir and bridge master class as a way for me to be able to show people that, hey, you know what? I think I can teach, let’s test the waters. And wow, the feedback I’ve had from that has been phenomenal. Like people, dentists messaging me saying, “You need to charge more for this.” I’ve had dentists send me their cases like, “Wow, I couldn’t do this before, and now you taught me.”

Jaz Gulati: And then one dentist said, “This is the best education I’ve done during lockdown.” So if you think about all the different events and webinars they’re having during lockdown, that kind of feedback, it really gave me the confidence to now being able to position to put together this splint course. So splint course is my baby, this is my flagship thing coming soon, very excited. It’s been four years of content creation coming up to this. Now, back when I was making videos of my first splints, and even in like 201, I didn’t know that it’d have a use one day. That was mostly my failures I was recording.

Jaz Gulati: But now I can put it together, because an area that everyone finds confusing is bruxism, occlusion, splints and stuff. And I feel as though I’ve got a formula to help dentists just simplify it, and that’s what I’m really excited for.

Payman: You know, bud, I don’t think you should worry about sort of monetizing this thing. I mean, I don’t think it should be your focus, by the way. Just like dentistry, you should do the best for your patient, and the money will come, that way of thinking. But at the same time, the amount of free resource that you’re putting out, the value for money of being connected to Jaz Gulati is probably extraordinary, because there’s all that resource that’s coming for free, free, free, free, free, free, free, and as the [inaudible] about the left hook, whatever it was [crosstalk]-

Jaz Gulati: Jab right, I was just going to say that, Pay, I was just going to say that.

Payman: From that perspective, if you come to charge for it, it’s absolutely correct. And by the way, by the way, sometimes you’ve got a purpose-led … I mean, the way I see your Protrusive is a purpose-led thing. You’ve got a situation where everything’s right, and still it’s a nightmare to make money. Look at Drew and what he’s been through. I think of Drew as, well, there’s such a halo around Drew’s head, but he’s such a Godlike figure, such a saint that it should be easy for him to monetize, scale, and grow the [inaudible]. But he’s been through so many ups and downs. And so I don’t think you should feel any guilt about it at all, and I think you should value yourself and charge correctly.

Jaz Gulati: I appreciate that. Initially, I think during the reservoir and bridge course, I had that. Which is why, if I look back, I charged, initially, $22 for it, can you believe it? $22, okay, can you believe it, right? And then now, the price is now $90, which was like the discount thing. But I could easily charge 400, $500 for it, and people still would have bought it and stuff. And that’s okay, because that was part of me … Like you said, I was worried about it. I was like, “Oh my God, I don’t want to be seen as I’m doing this thing to monetize,” but now I’ve gotten to a stage, and with the amount of hours I’ve spent, the amount of sleep I’ve sacrificed to be able to make this next course, I’m totally happy to charge what it’s worth, because I know the amount of value it’ll bring to the dentists, and you’re completely right, I’ve got-

Payman: [crosstalk] value, that’s the point, the value, yeah? If I do this course, I’m going to get value, I’m going to make money myself from it, [crosstalk]-

Jaz Gulati: Absolutely.

Payman: … with the information.

Jaz Gulati: Definitely in that mindset now.

Payman: Yeah. I mean, look, the podcast, it should just keep on going and getting bigger and better, I really think. And when I came to sponsor your podcast, there was nothing, other than, “I completely trust this guy.” And so, you were using our products, and [inaudible] well, there it is. I trust you, you can talk about it, and people trust you too. I think you should keep that going, and I think you should spin off as many things as possible from it. I hope people get inspired by your story, and other forms of education like this, come out. Because we have sort of the university of Facebook, university of Instagram, but the university of podcasts, it’s much deeper learning. What you do, you go in and focus on one small bit of dentistry, and ask those questions of these experts. I really hope that happens.

Payman: And it’s interesting, in podcasting, I don’t feel like there’s a competitive environment. I do feel that in products and courses, but not in … In podcasting, your podcast finds a certain audience, in a way, you know what I mean? Like yours is my favourite podcast, that’s it. If it was this competitive situation, I wouldn’t be feeling that, wouldn’t be thinking that. So I’m really, really happy to see that.

Jaz Gulati: Well, I really appreciate all those things said, and I really appreciate that you guys sponsored my podcast. And for those who don’t know, it was the best conversation ever. It was like, “I trust you, just do what you want.” I was like, “But how do you want me to, you’re my first sponsor, how do I actually pitch it? What do you want me to say, is there a script?” You’re like, “Nah, I trust you.” And I just ran with it. And I love making those videos, some little tips that Dipesh had taught me. I then passed them on, and I credited Dipesh, like, “Look, you guys need to check out the [inaudible] course, because it helped me a lot,” and that was my way of sort of fulfilling that sponsorship, but at the same time, in my usual way, making it a Protrusive Dental Pearl, or making it educational and making it fun and funny, I hope I made it funny with the Maybelline, my wife’s makeup I was using, eyeliner, that’s what it was. But yeah, that’s all been really fun too, so really appreciate your support with the podcast, it’s really helped massively.

Payman: Tell me about your practising situation, how many days are you where, and how many practises are you in?

Jaz Gulati: So two practises now, I’m in Reading most of the week, and Fridays with Hap Gill at Richmond. And actually, the working hours I have now are very conducive to my life. So the most common question I get on social media is, “Jaz, how do you have time to be a father, to be a dentist, to do podcasting stuff?” That’s the most common question of all the questions I get, clinical, nonclinical, that’s the most common question I get.

Jaz Gulati: And one is I’ve got such a supportive family in my wife, and since we came back from Singapore, we’re moving out soon, by the way, but we still live with my parents. So came back from Singapore, living with my parents, and my sister all live … so there’s loads of us in this house, I’ve got loads of support with [Ishaan], my son, and that’s great. So in six weeks’ time, we’re moving out. So that’s going to be a bit more different, it’s going to bring its own unique challenges.

Jaz Gulati: But when I accepted this new position in Reading, this follow this 2:00 until 8:00, 8:00 until 2:00 sort of a shift pattern, so one week I’m working mornings, the other weeks I’m working the afternoon, and that’s why I’m able to be sat here on a Thursday afternoon to have this podcast episode with you, because it landed on that week where I could. So it’s given me a lot of freedom, and it’s not because of COVID, it’s been doing it for 30 odd years. So patients are used to it, the staff are used to it, and I believe it’s why this practise in a little village in Reading has got such a great staff retention. Like, there’s a leaderboard of how many years the nurses and receptionists have been there, 28 years, 25 years, 24 years, 23 years. When you come to work there, you don’t leave. Because no matter how bad of a day you have, it’s just half a day, right? It’s like, 8:00 until 2:00, you’re done. I just feel like for work-life balance, it’s amazing. So that’s actually been really important as well.

Payman: What’s the name of the practise? Who’s the principal?

Jaz Gulati: Principal, it’s actually my buddy from dental school, we were in the same years, John [Cowie] and Chris Reed, it’s Triangle Dental. So these are two young guys, the other associates are young as well. So actually a very young team, and our sort of support network of the nurses and receptionists, they’ve all been here longer than us, so they’re almost like mother figures. And my nurse is almost like a mother figure to me in a way, I hope she won’t mind me saying that. So Zoe, shout out to you, thanks so much. So it’s amazing, the culture of this practise is brilliant.

Jaz Gulati: Now, when I was working in Oxford, it got taken over by a corporate, and the values, the culture just went. And one of my mantras is that successful people are quick to make decisions and slow to change them. So I was very quick to say, “Okay, I’m jumping ship, and that’s it.” So I picked up the phone, and randomly I was speaking to my friend John, I was like, “Hey, I’m looking for a job.” And he’s like, “Oh, no way, I’m hiring.” So it’s funny, when you ask something of the universe, universe gives it to you.

Payman: Yeah, very true, man. Very true. So tell me some of the lessons you’ve learned, you’ve been exposed to quite a lot of different setups now, the NHS, the hospital setup, Singapore, now these two practises, Hap Gill, one of the greats, one of the good guys when it comes to comprehensive dentistry. Tell me some of the lessons you’ve learned from your perspective, from the practise management, patient management, some of the lessons you’ve learned from the best of these guys.

Jaz Gulati: I think, go out there, and shadow, and gain exposure. Had I not seen that Koray Feran lecture, I wouldn’t have been inspired. Had I not met Hap [inaudible] next to the practise in Richmond that one night over a beer. It’s so important to reach out.

Jaz Gulati: So if I wasn’t on Twitter, just reaching out to these guys for no reason, or going to these events, I think you have to make time for that as part of your professional development. So what happens outside of work with these people, the conversations that you have at the funny hours … These are just so important. So things like tubules and stuff, the congresses, the fun that we have.

Jaz Gulati: Drew has, by the way, been such a huge influence to me, I feel as though sometimes that I’m just an extension of him in a way, and continuing on his good work that he set the momentum for, getting dentists passionate again about dentistry. So connect with like-minded people, and that all begins with starting a conversation. So I think seek mentors, and sometimes you just can’t wait for these things to happen. I think my biggest lesson is be proactive. Send those emails, send those messages, and all the people who are just amazing, like I mentioned Tif Qureshi’s name earlier. I remember my first ortho case, 2017. I was messaging him on a Sunday, and he was replying to me. I was like, “What the” … Tif Qureshi’s replying to me on a Sunday afternoon, because these guys are so, so giving like that. I find the people who are most successful that we all know and love in our profession, they are always going to be there for you to give you the time.

Jaz Gulati: So don’t be afraid to think, “Ah, this guy’s really busy, I’m not going to reach out.” Reach out and beautiful things will happen. So I think get out your shell and reach out to more people.

Payman: I don’t know where I heard it, but it’s definitely true, the idea that if you’re going to a course, if you message the course organiser or the lecturer before you get there, and just say, “Hey, I’m coming to the course,” simple as that, yeah? Then you’re going to get more attention in that course, aren’t you? It’s just the way it is, it’s human nature.

Payman: But when I asked you the question, I was talking about, you must’ve seen the way that these practises are run. I mean, I’m sure Hap’s practise is run very differently to your Reading practise, yeah?

Jaz Gulati: Big time.

Payman: But what is it about one that you’ve learned? What are the things you’ve learned? Like for instance, my next question after this was going to be, “Do you want to set up your own practise?” And what’s that going to look like?

Jaz Gulati: I see. Well, I think there’s a lot to be learned. Hap’s way of doing things is very systematised, and everything’s got a flowchart to follow in a way. The staff are highly trained, but the vibe and the trust amongst everyone, it’s a small practise, is amazing. In a bigger practise like the one in Reading, it’s a bit more haphazard sometimes, you’re still working out all the systems and stuff.

Jaz Gulati: I guess at the end of the day, the culture is right. So I feel as though anything can happen in terms of systems, or to automations practise, but I feel as though what these two practises have nailed is the culture, and that all begins with the staff, and brewing a culture of trust with each other. So I think that’s the best I can come up with then, and to answer your next question about would I want my own practise?

Jaz Gulati: If I had my own practise, I’m someone who would give it my everything. Like when I was president of SUDSS, Sheffield University Dental Students Society, it was my baby, I gave it my everything. I feel as though if I had a practise, I’d give it my everything. I believe in myself that I’d make it amazing. You have to have that belief when you do something like that. But if I did that, I know that I wouldn’t have time for the other things, education, the podcasting, that kind of stuff. So I have actually made a conscious decision not to have my own baby in that way, because I do feel I can touch more people’s lives, I can get my message across more through all the other things I’m doing in education than I can by serving a population in a town through a practise, and that’s just the way I see the world.

Payman: Never say never, though, right? Or have you decided?

Jaz Gulati: Never say never, if the Reading practise gets taken over by a corporate, so John and Chris, if you’re listening to this, if that happens, I’ll be the first one out.

Payman: No, but are you really saying that you’re planning never to open a practise, or you’re just saying not yet?

Jaz Gulati: Definitely not yet, and I don’t have any vision in the next five years either. It’s just, I know what I’m like. It’s like a limitation, I’m a perfectionist in a kind of way as well, and I know that I’d have to really throw myself in the deep end for that, and I would, and I’d be totally up for it. But I just don’t see that as the right move for me. Because at the moment, the associate life allows me other luxuries, and time to do other things that I’m not having to think about staffing and CQC and stuff, so I can do all these wonderful, beautiful things I’m enjoying so much. So not now, but never say never.

Payman: I don’t know if you heard our interview with Jason Smithson, but he said something like that. Something like, “It’s possible, but not possible to do well,” a practise and an intellectual, lecture career, and a family life. He was saying two out of three, or one of the … I think there was a fourth one, yourself, taking care of yourself. And he was saying you can’t have them all, you’ve got to decide which one of those is going to take a backseat.

Jaz Gulati: I’m with Jason on this one, for sure.

Payman: Yeah. I think it would definitely be the wrong time now, because I feel like your protrusive thing, you may not even see it from the inside, yeah, but form the outside, your protrusive thing’s in an inflexion point, it’s about to really take off.

Jaz Gulati: It’s like a tipping point. I can sense it, I can sense it at the moment. It’s not just about the metrics and downloads, it’s about the vibe. It’s about the connections, it’s about the message, it’s about the love I’m feeling through the Protruserati, the Facebook group itself has gone more international, and people are just connecting from all over the world and it’s just a beautiful thing to be part of. So I totally agree, I think now would be a terrible time to sort of step away from Protrusive. I want to give it more energy, give it more time. It’s like a baby.

Payman: And so what is the international nature of it? I mean, I notice when you’re talking, a lot of times you sort of translate into American what you’re saying. Do you have a lot of US listeners, or members, or-

Jaz Gulati: So number one is UK, number two is US. It used to be Australia, now it’s US. So US is, month by month the biggest growth is US, and I feel as though that’s … It’s an interesting market. I mean, US has always been like almost like isolationist, right? They always, they have their own sports, baseball and stuff, they always do their own thing, they have their own conference and stuff. So I think to make it in USA, it’s going to be a big deal. So it’s something, I think there’s so many great dentists that we can learn form US as well, so to get them on the podcast, to help, to sort of grow an international community is fine, but ultimately, that’s not what it’s about. It’s about just getting that everyone learning, everyone engaging, everyone just feeling reignited in passion.

Jaz Gulati: And my connections are mostly in UK, that’s why most of the guests are in the UK, that’s why most of the listeners are in the UK, but it’s listened to in over 110 countries now, I’m sure Dental Leaders has got hundreds of countries as well. It’s one of those things that with the medium of podcast, it’s so easy just for people to connect with you, and that’s the beauty of it. So yeah, it’s growing in USA, Australia, and all the other countries, even Germany and stuff is probably number four, I think, which is just exciting. When I open up my podcasting platform and I see all the different countries, it just, wow, it really gets me going.

Payman: If I were you, though, Jaz, our goals are slightly different with why we’re doing it, why you’re doing it, and all of that. If I were you, I would focus on US. Because you know Michael Melkers quite well and all that, and because I think that [inaudible] career in the US is, you’ve got to remember, California is the ninth biggest country in the world, in economy terms, yeah? And so it’s not like here. If you can get yourself … And if I were you, I would do some paid ads and focus them on the US, on the major cities.

Payman: Because when the product’s good, it makes sense to put money behind it and put resource behind it and effort, which is what you’re doing. You’re putting sweat equity behind it, and I know you’ve hired these two guys. But if I were, strategically talking now, now we get away from the passion a little bit, strategically talking, that’s what I would do, man. Because you can track it really quite well, quite easily, and you don’t have to spend loads of money-

Jaz Gulati: I appreciate that. This is great coaching I’m getting, and I agree with you. I think that’s the next step. Right now all my attention, because I’m literally weeks away form the launch of the course, but-

Payman: The splint.

Jaz Gulati: … I think the next step … the splint course. The next step will be to then focus on getting my podcast, which I’m so proud of and what it’s become, to more audiences so that they can feel that connection and it can grow, and I completely agree with you that at some point, paid ads may be the next step forward.

Payman: So let me ask you some of the questions that we ask all our guests. You probably know about a question which is from Black Box Thinking, about errors, clinical errors. What have been some of your clinical errors, and what did you learn from them?

Jaz Gulati: They’re many. The one that always springs to mind in this case is two years out of dental school, just doing a root canal, lower premolar. Now, this patient happened to be an auntie of someone who was a couple years below me in dental school, and I was doing this root canal, and struggling to find this canal. And suddenly, I thought this tooth was necrotic, but I see a bit of bleeding. I put the file inside, take an X-ray, and here’s the premolar, and the file’s just coming out the complete other way, it’s the most shocking radiograph you’ll ever see. Literally, my heart was pounding, I was like, “What the hell have I just done?” I felt so bad.

Jaz Gulati: But whenever a mistake happens like that, my nature is to be very warm and friendly, and so the patient was very understanding about it. I was profusely apologetic about this, and I wanted to just make it right. So we took the tooth out, because it was just buggered, and I did what I knew, was my expertise at the time was reservoir and bridge. I did that, she was happy, I dodged a crazy situation there. I’ve never spoken to that dentist two years below me, because I’m just embarrassed to speak to her. So it’s one of those things, isn’t it?

Jaz Gulati: So that’s one of them, a perforation, and I think that the whole point of Black Box Thinking is what can we learn from that? So I would say to any dentist is don’t be afraid to make an access into a tooth without rubber dam initially, just so you can get your orientation, and always follow the long axis, and even could use a perio probe around to see exactly the angulation, the roots going in, that’s always going to be very helpful.

Payman: Yeah, I made that mistake in dental school. Well, yours was necrotic, but you try and convince yourself it’s pulp, and at one point you realise that ain’t pulp.

Jaz Gulati: You struck oil.

Payman: Yeah. And the you say about long axis, it’s very true, because you cam zoom in so much, with dentistry you can over-focus, can’t you? You over-focus on that crown, and sometimes lose the long axis focus, obviously with a rubber dam as well, I don’t think we were using rubber dams back then. But yeah, I think I’ve done that before.

Jaz Gulati: Very much in fashion, that rubber dam. Rubber dam fam, #rubberdamology, all that sort of stuff.

Payman: Thank God, man. Thank God. I mean, I tell you what, I’m amazed that everyone’s doing like cementing in with rubber dam. I never thought that would catch on. Because back in my day, that was like a crazy situation. But now it’s almost standard, in terms of bonding protocol.

Jaz Gulati: I think that’s a necessity, because you’re seeing these flat preps, essentially tabletop, the margin of error is so fine. You can’t have any sort of saliva contamination. So I think that’s a big thing about it. But I’m so proud of seeing our dental community using more and more dam. I always say, five years ago, I wish I bought shares in rubber dam, because I’m sure that’s climbing, climbing, climbing all the time, [inaudible]. And still climbing. So I think it’s great that we’re using it, it’s definitely, it results in a stress-free dentist.

Jaz Gulati: I think I use rubber dam selfishly, if it’s a simple occlusal, I’ll do it, because I’m less stressed. I just find it reduces my stress.

Payman: Are you tough on your nurse? Are you a tough guy to work for? Because I’ve got a feeling, you’re a lovely guy, lovely person, I get that, you’re very warm, but very high standards. So does that … Which side of you kind of wins?

Jaz Gulati: Sure. I think with nurses, I always believe in making a nurse a cup of tea and looking after them, and gifts and stuff, I’m very much in that kind of nature. When it comes to clinical, one thing I hate, and I’ve had this experience before with nurses, is when I’m not happy with my matrix seal, like the matrix [inaudible]’s there, and the seal’s not 100%? I always say, “Okay I’m going to change this wedge for a different one,” and then she or he will get me a different one,” and you’re like, “Nope, now I choose this matrix,” right? And my nurse Zoe now, she’s used to it, and she knows, she gets why I’m doing it.

Payman: She knows why you’re doing it.

Jaz Gulati: She knows I just want to get a perfect result. But then there are the nurses who just want to have lunch, who just want to give the first matrix [inaudible] to you and they want it to work, and I’ll never get along with that nurse, because that nurse is not in there for the patient.

Jaz Gulati: So I think, as long as you’re on the same team, and the same team is we’re there for the patient, then I think I will always get along with that nurse. So yes, some nurses will struggle to work with me because I will change my mind. And here’s the thing. Nurses, they want consistency and they want protocol. But when you’re trying to do everything to the best of your ability, and every tooth has its own challenges, its own curves. There’s no recipe book for how to treat that patient in that scenario in that quadrant. So my nurse has learnt very quickly with me that actually, although there’s some general things I will like to do, I’ll always like to put a little bit of [inaudible] first before I put the restorative composite, but sometimes I’ll change it up, and there’s a reason for it.

Jaz Gulati: And I love it when my nurses ask me why, I love that. Because I think it’s a great opportunity, it shows me that the nurse cares and she wants to learn. So I always, at the start of a relationship with a nurse, I’ll always say, “I want you to ask me questions. I don’t care if it’s in front of the patient,” because I think it actually makes you look cool in front of the patient as well, because you’re educating your nurse, your patient’s listening, they’re getting value. Like, “Wow, so this is what he’s doing,” it’s not just squirting some filling in, there’s some science behind it. So I think everyone wins.

Payman: It’s one of the hardest jobs in the world, I think, dental nurse, man. Because even the very engaged dental nurse can’t see what you see, yeah? They can’t see there’s no seal there. I mean, if you imagine it, try and change the angle and no mirror, you’re looking like that, and now that’s not right. And then not having control at all over what’s going to happen next, that’s hard itself.

Jaz Gulati: That is so tough, that is so tough. But one way to overcome that, what I do now, when I’ve got a rubbish situation with the matrix, I take a photo, internal camera, just pull it out, and I’ve got in the habit of showing my nurse, “Okay, this is the problem we have, let’s fix it.” So then if you start doing that, if you’ve got a nurse who just doesn’t get it, when you start doing that, and you’re completely right, Pay, they don’t see those issues. But when you show it to them, and then suddenly you’re on the same team, they see why, and that’s made a huge difference in the last three, four years, when I started doing that.

Payman: I don’t know how … I mean, I stopped practising 10 years ago, so I don’t know how correct this is nowadays, but back in the day I used to try and let the nurse do a lot more, whatever it was, whatever the thing was. I was taught four handed in Cardiff, kind of by mistake. There was this bit of the clinic that was four handed, and my favourite nurse was … So I remember one day I came to my first job and I just put my hands up like this, and the nurses looked at me, and she said, “What are you doing?”

Jaz Gulati: Oh, that’s brilliant.

Payman: And I said, “Give me my instruments,” right, and she walked out of the practise, she quit her job that day. Not only because of me, I think, I think there was some history to-

Jaz Gulati: You were the scapegoat.

Payman: Yeah, yeah. But the question of the nurse choosing the shade, for instance, or helping with the shade taking, I had a nurse that was really good at that. The nurse calling the patient afterwards and saying, “Dr. Gulati wants to know how you’re doing,” and all that. Involving your nurse in the treatment really makes a lot, a lot of sense. Because as I say, there’s no control in their day to day. And at the moment when we go … and it’s time to get finished, then they’ve got to start working cleanup again, yeah? And they’re running the whole place, really, right? In the end, they’re the ones running the business. I don’t think they get enough career progression, I don’t think they get paid enough, and they get abused a lot. It’s a tough job, man.

Payman: And now in COVID, I think that’s why we’ve got this sort of movement away from dental nursing, because it’s always the final straw that’s broken the camel’s back. So shout out to all the nurses.

Jaz Gulati: Absolutely, shout out the nurses. Interestingly, I’m starting to see some virtual assistants for dentists pop up now who used to be nurses, because they got the know-how and stuff, so I’ve recently seen this, and that’s a great niche for them, but it’s a shame that we’re losing these clinical nurses because of that reason, because maybe they don’t feel valued enough. But I agree with everything you said, and I’d go to the extent to say that the number one thing that’s going to decide your fulfilment and enjoyment for dentistry is the relationship between you and your nurse and how you work together. I think that, so if I’ve got a nurse with bad vibes, I can’t be myself. I can’t do the dentistry and give my patient the best care. Everything else, all the courses you’ve been on, all the knowledge you gain, all your patient communication skills go out the window if you don’t have a great nurse. So that’s the number one thing in all of dentistry, I think.

Payman: I know this is a really unfair question, but which is your favourite episodes of your podcast?

Jaz Gulati: Oh, gosh, all right. So I would say … I can’t, I can’t, Pay. I can’t do it. I almost did it, I can’t do it.

Payman: No, no, come on, man.

Jaz Gulati: I’m not going to do it.

Payman: Not your favourite episode, your favourite episodes.

Jaz Gulati: Okay, sure, sure, fine.

Payman: [crosstalk] seven or 10, whatever you want.

Jaz Gulati: Fine. The type of episodes I like the most, because I gain the most from, and here’s the thing, the beauty of it is, others will find that completely different. But the ones where my guest is just on fire. Every sentence is like a learning point, and you want to make notes, you want to make notes and notes and notes. So Prof Tipton on fixed-movable bridges, everything he was saying was to the detail, we’re a very detail-oriented profession. Nick Sethi, oh my God, everything he was saying, I’ve got so many WhatsApp messages and Instagram stories of people just showing me their notes of how much they’re learning from that one episode. They’ve been to all these courses for it and stuff, but that one free episode with Nick Sethi who’s a phenomenal educator-

Payman: Excellent episode.

Jaz Gulati: I didn’t appreciate how good he was until I actually had him on. So any episode which is more clinically oriented, which just gives out so many gems, verti preps [inaudible], we talked about with Smithson as well. Anything like that is what I love the most, because I’m just [crosstalk]-

Payman: You don’t have to worry about it. Because look, I get messages about this podcast, there are some that I don’t rate, and I get messages saying, “That was an amazing episode.”

Jaz Gulati: Same, same. [crosstalk] that’s great, cool.

Payman: And then the opposite, the opposite as well, right? The ones that do rate-

Jaz Gulati: I’ve got some people who hate my occlusion episodes. Like I live for those, right? And I’ve got my core group of people who I’d say who are really into it, and that’s why they listen to podcast, because it’s got this bias towards occlusion. But I went to the Smithson course in Glasgow, and I met this one guy, and he was like, “Yeah, I listen to your episodes about, Richard Porter episode about how to win at life and be successful in dentistry and stuff, but all the occlusion stuff, gosh, that doesn’t interest me.”

Jaz Gulati: So everyone’s different, and it goes back to what you said earlier. I think when I was starting to put myself out there more, the thing I was worried about is that I’d get shot down. You stick your head above the parapet, you know that people are going to be there gunning you on social media, “Who the hell is he?” Kind of thing. But the beauty of podcasting is that they have to find you, they have to seek you out on this app, then they have to press play and sit there and listen. Unless they already have some sort of good connection or the desire to learn, then the people who are there to badmouth, the trolls, it’s too much of a step for them to get to. So it’s self-selecting, like you said. You make your own audience, and that’s why I think it’s been successful, because I think it tracks the right people and it retains my tribe.

Payman: I mean, I don’t think that you are an impostor, dude, but do you suffer with imposter syndrome?

Jaz Gulati: I spoke about it with the episode with Drew very early on.

Payman: What I mean is, you must have had thoughts of, “I’m going to do this podcast,” which is a very clinical podcast, right? I mean, do you worry about getting something wrong? Like-

Jaz Gulati: Yeah, I do worry about it. Just, it’s human nature, I do worry about getting something wrong, so I’ll always fact-check. But more and more, now that I’m getting a bit more comfortable with the podcasting, and sometimes I’m happy to say … There was an episode I had with Barry Glassman, he taught me that it’s okay to say, “I don’t know.” It’s such a liberating thing to say, “I don’t know.” So a lot of the time I don’t know something, I’m so much happier to say, “I don’t know,” from people like him. And I think you don’t have to have all the answers, and a lot of the time I’m learning as much as you guys are when you’re listening to a podcast. And that’s the beauty of it, you’re just part of my journey when I’m learning, so it’s okay.

Jaz Gulati: And with the whole imposter syndrome, I felt it a lot when I was going into private practise, like moving into fully private practise in the UK. Not in Singapore, because I felt like it was so much more relaxing to practise in Singapore, because there was no GDC. SDC, if you’re a dentist in Singapore and you’ve been sued? There’s no such thing. Whereas here, the fear is real. So when I was going into private practise, I was doubting my abilities and stuff, and I spoke to Drew about that, and he helped me a lot and got my confidence up.

Jaz Gulati: But I never had it initially with the podcast because I wasn’t really talking about the clinical things initially. It was more about how to move to Australia, how to do this, and when I started to talk more and more clinical, it was just an organic, it was just me being me and the geeky stuff coming out to be honest with you.

Payman: Yeah, because I don’t know, man. I’d worry about it if I was you. I’m not you. It’s a lot easier to say, “Hey, what’s your biggest clinical mistake?” Than to go deep into deep margin elevation, right? I mean, you could-

Jaz Gulati: But one episode I was worried about, Pay, actually, to mention it, is episode 40, which has been such a huge episode for me, is Michigan splints are overrated. Here I am cussing the appliance of the last millennium in terms of dentistry, the Eastman [inaudible], the [inaudible], the holy grail of the occlusal appliance, and I just went and I just cussed the life out of it.

Jaz Gulati: No, I did it in a respectful way, and I sort of hopefully took you through the pros and cons of it-

Payman: It was kind of tongue in cheek, in a way. I mean, it wasn’t-

Jaz Gulati: It was, it was. Yeah, it wasn’t that negative towards it, but I wanted people to realise that when it comes to appliances, there’s more to it than just a Michigan splint. I was nervous about that one, because I was thinking like, “I’m going to get messages from all these professors at Eastman and stuff like, ‘Who the hell are you? Take it down’ kind of stuff,” but no, people just enjoyed it and it’s been good.

Payman: No, I don’t think we need to worry in podcasting, dude. Like you said, the barriers too high, and it’s the reason you can swear on a podcast, right? If you don’t want to listen, don’t listen, yeah? End of story.

Jaz Gulati: It’s true. I’ve started bleeping more and swearing less and whatnot, because when you are explicit on Apple and Spotify stuff, your content doesn’t reach UAE. So I still haven’t had time to do it-

Payman: Oh, really?

Jaz Gulati: But I’ve got to go back in my episodes and remove the explicit label, because I had this one person message me saying, “You content is coming up as too explicit to listen to in my country, can you do something about this?” I’m like, “Oh, I’m so sorry, let me sort it out.” So yeah, careful.

Payman: The AI thing just hears the words, does it? Is that how it works?

Jaz Gulati: No, it’s something that within your settings that you set. Because one time I said a swear word, I was like, “Okay, I better be safe, legal, yes, I’m going to mark it as explicit,” but really I think it’s a bad move. Because a lot of countries, it won’t be allowed so I’m probably going to remove that.

Payman: Yes, I’ve seen it on ours, I’m going to have to remove that myself.

Jaz Gulati: You should.

Payman: So, man, I mean, Prav’s not with us, but I going to ask you his final questions. You are on your deathbed, you’ve got the five or 10 closest people to you, with you. What’s three pieces of advice you leave to them and to the world?

Jaz Gulati: I just think of my son the most when it comes to something like this, and I would say, you can do anything you put your mind to. You can become anything, do anything you put your mind to. That’s number one. But in the same world where you can do anything and become anything, be kind. That’s always been my style, I always hated working environments where the professor was just angry and mean to everyone. I just want everyone to be kind and courteous, I think there’s a certain charisma that is just beautiful about people who are just nice, that’s my favourite. Because there’s some different types of charisma, my favourite type is people who are just kind and polite, and there’s something that’s so much to be said for that.

Jaz Gulati: And I guess another thing I’d say is, like I said earlier, successful people are quick to make decisions and slow to change them. I think nowadays people meander and they think and they think and they think, and they finally come up with a decision, and then the next thing comes up, they completely change it. That’s completely the wrong way to go. Work hard, and make sure that you are the hardest-working person in any room. That’s my sort of, the things I live by.

Payman: Having your son, has it changed your relationship with your parents? For me, I thought that cliché, it’s a cliché, right, but I did feel that, I did feel that. Tell me about how you felt being a father?

Jaz Gulati: Oh, it’s just the greatest feeling on earth for me, there’s nothing better. I feel so blessed to be a father, it’s amazing. So yes, it did change my relationship with my parents, I sort of started to value them a little bit more, in a way. You always value your parents, but you kind of think, “Oh gosh, they changed my nappies for so many years.” Those sorts of little things, and now when my son has a fever or something and I’m like, “What’s going to happen?” Kind of thing, and I think, “Gosh, this is parenthood, it’s real.”

Jaz Gulati: But it’s interesting, I was never that close with my parents. It’s a funny thing to say, because I was always … Once I came here I became very independent, so I’d learn English, I started to speak English outside, at home I speak Punjabi, but then that was less and less and less. My parents never really knew what was happening in my life. Like I remember in A levels, I was in A2, right? So my final year of A levels, and my mom sat there, watching telly, and she goes to me, “Jaz, what do you do in school? What are you doing?” Well I was like, “Mum, I’m doing biology, chemistry, maths, and physics.” And bless her, she said, “Oh, so you’re not doing science, are you?” Because she doesn’t know all that stuff, right? So there was always a bit of disconnect in terms of my world and their world. Through having my son, I feel it’s made us a bit closer, and I’m trying to include them as part of my world, is what I’m trying to tell them, “Okay, I do this podcasting stuff, it’s pretty cool and stuff.” So I’m trying to be more expressive, because I feel as though I’d want my son to be like that as well.

Payman: But Jaz, I don’t know, your son’s so young right now, but I don’t know if you think of it this way, as far as what can you do for your kid that in the end, outside of shelter and health, confidence is what I’d say. And you’re a confident cat, man. Is there something that comes from your parents that made you this, or what?

Jaz Gulati: I think my parents are, within the Afghani Sikh community that we have, they are socialites, I guess, so maybe I got it from that, maybe. I couldn’t tell you. I was always into drama. GCSE drama, I used to love doing the school production, I used to live for that, I used to do all the drama kind of stuff. So I always find that people who did drama at university and stuff, they’re always very exuberant characters, so I sometimes think that maybe it’s because I liked drama and I wasn’t afraid to stand up on stage and do crossdressing at that time, a play in year eight, we did Midsummer Night’s Dream and I was the guy who had to dress up as a girl, funny things like that. So maybe that’s where it comes from, actually, my interest in drama.

Payman: That’s interesting. But for me, with kids, right, I’m always thinking, “Ah, got to make them confident, but I don’t want to make them arrogant.” And it’s like, almost is a thin line. But it’s not a thin line, yeah, because look at you. I’d give you 12 out of 10 for confidence and one out of 10 for arrogance. You really are, and that’s that sort of non-arrogant, non-judgmental way that you talk about things that brings so many people to you. And I’ve heard it 100 times now about you, infectious enthusiasm. It really is, man. It really is. And you’re a credit to the profession, buddy. You really are.

Jaz Gulati: Wow. I mean, thank you so much [crosstalk]-

Payman: You really are [crosstalk]-

Jaz Gulati: … one thing I say, one person who’s inspired me as well is Gary [Vee], we mentioned him earlier. And what you said was, it reminded me of one of his sayings, which are the two most important things which I would love to pass onto Ishaan, my son, and I think what we can teach young people is the two things that his mother instilled in him was self-esteem and self-awareness, right? So have the self-esteem to make sure that when people say bad things about you and people will gun you down, just have that confidence in yourself that you’re doing the right thing, but self-awareness so you know your limitations, and you know that, you stay in your lane, in a way, that you can actually make the biggest impact in things that you actually know about and you can influence, rather than doing things that, a bit ambitious in and away, if you know what I mean. So self-esteem and self-awareness, I always try and think about that as well.

Payman: Let’s move on with Prav’s further questions. How would you like to be remembered? [crosstalk]-

Jaz Gulati: As that really enthusiastic, nutty dentist who just wanted everyone to learn and place better onlays and do better dentistry, and make splints, and get rid of headaches, and just [crosstalk]-

Payman: Proper geeky answer there.

Jaz Gulati: Yeah, I know. It’s true. Just that enthusiastic dentist who just was always happy to help and share.

Payman: And then he’s got this final one that he’s doing now, and I know it all sounds very death-orientated, yeah. You’ve got a month to live, you’re healthy, you’re not in bed or anything. What would you do with the month?

Jaz Gulati: I would go to most magical place on Earth.

Payman: Where is that?

Jaz Gulati: Disney World. I’d go to Disney World, Florida-

Payman: [crosstalk]-

Jaz Gulati: … me, and my wife, my son. We would just go to Disney World Florida, and we’d just have the best month ever. That’s what I’d do.

Payman: The last place I thought you were going to say was Disney World, dude.

Jaz Gulati: That place is amazing.

Payman: Well, it’s been lovely having you, and it feels like we just [inaudible], man. I’m sure we’ll have you again, and I just feel like this little train that you’ve started is going to keep going on and on and on, and I really wish you the best, man, because you really-

Jaz Gulati: All plans [crosstalk], honestly.

Payman: … you’re changing the landscape, buddy, and it’s good to see that. It’s good to see that, really is.

Jaz Gulati: Thank you so much for having me on. I love what you’re doing with Dental Leaders. Keep getting these stories, because so good to connect to everyone’s story, and thank you for having me to share my story, I really appreciate it. And all your support from Enlighten and MSM for the Protrusive, I really appreciate that.

Payman: Of course, of course buddy. Thanks a lot, man.

Jaz Gulati: Thank you.

Outro Voice: is 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 Solanki: Thanks for listening, guys. If you got this far, you must have listened to the whole thing, and just a huge thank you, both from me and Pay for actually sticking through and listening to what we had to say, and what our guest has had to say, because I’m assuming you got some value out of it.

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.

Prav Solanki: And don’t forget our six star rating.

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.

Enjoy! 

 

“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?

Payman: Yeah.

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.

Prav: And don’t forget our six star rating.

Arthif Daniel spends his nine-to-five looking after teeth and his weekends knocking ‘em out.

Arthief’s double life as a well-regarded super-welterweight boxer and dentist has earned him the nickname Dr Hitman.

He chats to Prav and Payman about success in the ring and in practice – highlighting some of the surprising parallels between the gentleman’s sport and dentistry.

Arthif lets us in on his highs and lows and talks about the mental preparation and mindset it takes to live life in the ring. 

 

“Fighters are like sharks. We smell fear. So, just like sharks, when they smell blood in the ocean, they’re on you. It’s the same thing. You show a glitch. It’s in your eyes. It’s in the body language. It’s anything of that sort. And we will feed on it.” – Arthif ‘Dr Hitman’ Daniel 

 

In This Episode

00.40 – The boxing dentist
08.59 – Training regime
15.31 – Psychology
26.27 – Physical chess
31.28 – Nutrition
37.44 – Prime time
43.04 – Parallels
49.29 – Being competitive
51.24 – Faith and mindset
56.33 – Highs and lows
59.22 – Hanging with heroes
01.07.04 – Travel
01.09.45 – Last day and legacy

 

About Arthif Daniel

Dr Arthif Daniel graduated from King’s College London in 2008 and went on to practice in Birmingham and Manchester.

He spent time as a senior house officer in restorative and oral surgery at Guys and St Thomas and has taught primary dental care at King’s College.

Arthif is also a professional welterweight boxer whose dental background has earned him the nickname Dr Hitmann.

 

Arthif: Muhammad Ali said famously, he said, “If I was going to be a binman, I would be been the world’s greatest binman ever.” That’s the attitude which I had in general in life. And that’s something that wherever I want to do, I want to do the best I can, and be the best I can at it.

Intro Voice: This is Dental Leaders. The podcast where you get to go one on one with emerging leaders in dentistry. Your hosts, Payman Langroudi, and Prav Solanki.

Prav: It gives me great pleasure to introduce and welcome Arthif Daniel, or otherwise known in the boxing world as Dr. Hitman. And he’s one of the top 20 boxers in the UK, a dentist as well. And today, we’re going to dig into his story, and learn a little bit more about his world of boxing and dentistry, and how he combines all of that. Arthif, do you want to just kick off by telling us about how you grew up, where you grew up, and just your background… and how he got into boxing?

Arthif: Yeah, sure. Well firstly, thank you to Prav and Payman for inviting me on. It gives me great pleasure to join onto your podcast. You guys have been doing a great job. And yeah, boxing wise… I was born and raised in Harrow in London Northwest. That’s where I did all my sort of primary, secondary school education. And thankfully, I stayed in London. I made that decision to take my dental studies at King’s College London. And so yes, I schooled there, and then around about 2013 it was.. I moved up to Manchester. And yes, now I’ve always maintained my link with Harrow, and I’m a very proud Londoner. And so obviously I’ve still got my family, friends, and also I still do a lot of my boxing and dentistry here in London too.

Prav: And so how did you first get into boxing? Were you inspired by one of the greats or what was it growing up that sort of made you get into boxing?

Arthif: Well, I was very fortunate, I think I grew up in a boxing household. My grandfather first, he was a big Muhammad Ali fan. And, you know, my father’s was the born and under, so he used to tune in to watch the Muhammad Ali fights. And then the great fights after.. In the era of the 80s, with Mike Tyson. I was a huge fan of his, Tommy Hitman Hearns, Sugar Ray Leonard, Roberto Duran, Marvin Hagler, were all that great.

Arthif: So I grew up, you know. In that time, My father was my first boxing coach, he used to, box as a hobby. He did some amateur boxing as well, He was very good. So, I was always physically active, and I used to really love martial arts, Bruce Lee was one of my sort of first icons as well and then sort of Jackie Chan, Ying Bai, Sammo Hung. So it was me and my two elder brothers. So we should always be training together, sparring each other. They were older than me, they used to beat me up. But I’m not too sure about now, though.

Arthif: So yes, it was it was… But yeah, I think, I mean, Muhammad Ali was probably my first boxing idol. Then followed by Mike Tyson. I was a diehard hardcore Mike Tyson fan. And then I was really fortunate to have a proper one to one meeting with him back in 1999-2000, One of my uncles was friends with someone in his entourage. So when he came over to London first, for his fight against Julius Francis, back in January 2000. It was like a dream come true. You know, I was with him, I was with my two brothers and then he invited us back again to watch him train, so I had probably like one to one with him, which was fantastic.

Arthif: And actually, something funny happened, actually. So what happened was, in that time I was also doing GSC Art. So one of my art pieces, I drew on Mike Tyson boxing Lennox Lewis on the moon in space, So I was doing that and then while I was midway through this project, I’m like “Oh wow, I’m going to go see the man himself.” So I went to.. you know, what I need to do? I need to go into school and grab my painting, take it to him to get it signed. So I was like “how am I going to go to school, just by not being there?”

Arthif: So ironically, my grandmother had been in the hospital that time, she wasn’t well. So I would go in, obviously go a couple of times I had to miss school to go and see her, spend some time with her at the hospital. So I came in, and I wasn’t to sure what to say, and she was like, “Oh, are you going to see your grandma again?” I was so put on the spot, and I was so put on the spot so Yeah, she not want to ask that’s it. So what I’ll probably do is that, whilst I’m sort of waiting in the hospital, I’ll probably do a bit of my artwork.

Arthif: So here,”Take it, take it, don’t worry.” So I was like, “Great, great.” So what would happen when am all suit and booted as well. So I went there, and I took it, I showed it to Mike Tyson, and he really liked it. And he was like, “Oh, this is amazing.” And he’d done a massive autograph right across it and I still got that.

Prav: Amazing.

Arthif: And now, ironically, last few years, I’ve become good friends with Lennox Lewis. So I’m planning to take that Lennox one day and get that signed as well, it’ll be nice. I’ll keep that with me.

Prav: Brilliant, brilliant. And so boxing didn’t really enter into as a, should we say a profession, or as a professional, until after dentistry, right? Until you’d qualified. So what was that like growing up, although obviously, you were inspired, and all the rest of it, were you go into boxing gyms, and training at gyms, and things like that? Or was it just your dad training you? And how big a part did that play in your life, compared to let’s say your studies, as you were studying for your GSC, and then moving towards dentistry?

Arthif: Yeah. no I used to actually always sort of box. I used to be part of an amateur boxing gym in Harrow. And then later on in North, which is local as well. So I used to box, I used to train, I used to spar. I used to spa often, but my parents weren’t too keen on me competing.

Prav: Okay.

Arthif: Just for somethings and academia was big in my household. And to be fair, I mean, most parents, especially mothers, they’re not big fans of their children boxing. Even if you can get the champions of today, it’s the same story. Their moms are kind of two types, some of them will still kind of go and support, and watch them in the arenas, but most of them, they won’t want to watch. So it’s one of those things. So I just continued with my training, hand in hand with my studies. And in fact, at one point, when I was at Kings, I also taught… there was a student union club, ironically called Fight Club. So I taught… so I was teaching boxing as well to fellow medical, dental, biomedical undergraduates, which was a great experience. And I also got Danny Williams to come down as a guest one day, and he also took the class, which was phenomenal.

Arthif: And he was also at the peak of his career at that stage as well. So that’s something everyone appreciates. So I just carried on. And then, again I was obviously allowed to compete. And then once I graduated, I kind of became my own man. And I kind of thought, “Okay, it’s my decision now, I guess.” So it’s nice.

Arthif: Then I just carried on. Well, just to sort of do some bouts, but there was nothing set in stone to be a professional as such. I was just carrying on, and then I had some great people around here, always been like an elder brother to me. He famously beat Mike Tyson back in 2004. It was the British and Commonwealth Champion Challenge, with world title Vitali Klitschko in Las Vegas. So he’s had a great career, and I was very fortunate to have him as a mentor early on. And then he was like… so him and a few others are like, “Look you got something here.” And then I was… I used to spar with professionals and amateurs, and hold my own and do well. So then I realised that there was something here, and that there was an opportunity that I had, especially with some great people around me. So I just always said to myself, I don’t want to look back when I’m 60 years old, in my rocking chair, and think what if. So I wanted to give it a go, and give it all. I’m, so happy with what’s happened, I have no regrets. If I went back in time, I’d still do the same thing.

Prav: What if… if you’ve got a big fight coming up, how long before do you have to start the preparation for that? And what is the preparation? I mean, is it possible to be a full on dentist, and prepare for a big fight? Or do you stop and start? Or what do you do?

Arthif: Yeah, so I mean, it depends. Generally, I’ll always train, I’ll always be taking over. So I might have some days off as such, but I’ll always still be sort of active around the gym. So that’s why I’m always, my weight is generally low, and I’m around my fighting weight. So I’m always disciplined and maintain myself in that respect. Generally speaking, if I was to have obviously… so because of that, I’m just constantly in training. And also my diet is monitored. So it’s very… for myself anyway, it’s something I can do. I do manage to juggle and balance well, thankfully. [crosstalk]

Prav: What’s the process?

Arthif: There are professionals out there with day jobs as well. So it can be done. And it just depends, but sometimes generally, if you’re going to be in like a big fight, type of fight… generally, you looking at sort of an eight to 10 week training camp. So if I was to have one of those, I’d probably, in terms of myself, just want to stop, put my dentistry on hold for those 10 weeks, 10 week camp, and just be solid. And that’s the plan that when I’m looking to have my big US fight, hopefully, God willing later this year, and that’s what I’m going to do. Just stop everything else, and go have a 10 week training camp.

Prav: And what’s involved in a typical day of that camp? what time are you getting up, How many hours in the gym, How many fights? [crosstalk]

Arthif: Yeah, it all depends really, but generally… You see the thing is, there’s this little bit of a false notion, but it’s there, people do this, where people burn themselves out. See with boxing, generally in life really, with anything. Even if you take dentistry for example. Dentistry famously, we do the… and especially when we’re talking to the newer graduates.

Arthif: We always remind them that we say that “dentistry, it’s a marathon, not a sprint.” So generally, obviously, that’s how we look at things in life. And the same thing with boxing, you’ve got to be careful of not over-training. I was having a chat with someone recently, a boxing manager recently about this. Sometimes boxers themselves will just get swamped up, engulfed, and go into a zone, and just burn themselves out, and leave everything in the gym. When it comes to the fight week and fight day, they’re drained. They’ve peaked too early. That’s why you got to be smart. And that’s why the legends and likes of Floyd Mayweather achieved so much, because they were very smart in how they did things.

Arthif: One of the great advices I got, for example, from Danny Williams. He said “always listen to your body.” Because sometimes if you’re not feeling to train that day, your body’s not up to it, just listen to your body. Especially with sparring, sparring is really important, you’ve got to be 100% to go sparring. If you’re going to be 50%, don’t do it. Because boxing, there’s a lot of mental aspect involved with boxing. There’s a lot of psychology involved, you can have a bad day in the gym, or a sparring session. And if you’re mentally weak, it can eat away, and you start getting doubts. But sometimes, you’ve got to be strong and say, “Look, everyone has a bad day in all walks of life, and boxing is no stranger to that.” So you may have bad day in sparring, So okay, You just rest up, recover, Look over what you’ve done wrong, where you need to make improvements. And the next day, you’ll have a great day of sparring. But then again, you’ve got to check yourself because if you’ve had a good day, you don’t want to get over ahead of yourself, and get overconfident. You just got to take everything just right, you got to be balanced.

Arthif: So either if you have a bad day, don’t kill yourself. If you’ve had a good day, if you’ve had a great day, okay don’t don’t get overconfident, you’ve got to stay humble. But just generally, yeah. So coming back to the point. So obviously, it also varies of how far you are out from the fight. Because the further out you are, the more harder work you’re going to put in. And you want to taper, so we can give an example of an endo, the coronal plane. Start up high, and then you taper when you get to your peak.

Arthif: So it’s a similar thing, so you spend a lot, obviously the cardiovascular stamina work that… the hard work you can do. The hill sprints, mountain runs, all of that sort of work you do early on. And then gradually start to taper, so towards fight week, you start just doing the lights sharp stuff. You’re just maintaining your weight, you’re just staying sharp, explosive. And then when it comes to fight week, you stop all your hard work, you’re just doing light work, nothing… you’re just doing sort of shadow boxing, some pad work, nothing strenuous. You’re trying to conserve all your energy, physical, mental, for fight night.

Arthif: And then obviously, generally with boxing, obviously you’ll have your weigh-ins the day before your fight. So the day before the weigh in, you might just want to do a few things just to keep your weight, you’re on top of your weight. And that’s that. But really yeah… but generally, you’ll train twice a day. And then you vary it. So you may do some running, so that your cardiovascular will increase with the running stuff, or swimming alternatively. But then obviously not every boxer, for example, can swim, or it might not be a strength, or they may not sort of enjoy it, sort of thing. So it depends what they [inaudible]. So running and swimming, that that works by sort of cardiovascular. So I’ll do sort of mixed days, alternating between those two exercises. This is your strength and conditioning work. And then obviously there’s the boxing aspect itself. And that’s sort of shadow boxing, working with the trainer doing sort of back work, pad work, and sparring itself.

Prav: You spoke about the sort of the mental side of it, yeah. And being mentally on top of it. Go through some of that for me. Because, I mean, obviously, I don’t even think I’ve ever had a fight [crosstalk], let alone a competitive fight. But I imagine there’s an element of fear before a fight. And fear must be.. You must feed on fear a bit as well, right? I mean, it’s good to have life changing consequences if you get the wrong punch, right?

Arthif: Yeah, sure. I mean you don’t think of it like that. I mean fighters don’t. I mean, we’re just different. And I think one of my good friends Pauli Malignaggi, he’s a former world champion, two time world champion. He was talking about one thing. I said… he heard one of my interviews, and I think I said, “Dentists are normal people.” And I said sometimes people when they hear that I’m a fighter as well, they think okay look, we’re normal people. He actually laughed, because Daniel actually, as far as don’t fear, we’re not normal people.

Arthif: And I started laughing, and we had a chat, and in the end of it I said, “You’re right actually.” Because which same person wants to train vigorously, get into the ring, to aim of hitting someone, and he knows he’s going to get hit. And there’s like… it’s true. There’s things about fighters, that it’s true. It’s normal, and it’s very difficult to explain. And sometimes you see on social media. Social media, I mean, there’s things that’s great about social media. And we all know there’s some terrible things about social media. Social media is one of those platforms, everyone’s got an opinion.

Arthif: Once upon a time, you had to be someone to voice an opinion, to have something worthy to say. Nowadays, you just need a Twitter account, or a Facebook account, or whatnot, you can just voice your opinions, and whatever it may be, to everyone. And not that it matters. And that’s why professional people in professional boxing, they’ll see things on social media from casual fans, people who’ve never even stepped three minutes in the ring. And there’ll be saying all sorts of sensationalist things. And so it just doesn’t really add up. And it’s difficult for us boxers, because like to say things that will only make sense to people in boxing, because we’re fighters, and we’re in the ring. But really to explain that to a logical person, logically, it really doesn’t make sense, really.

Arthif: But coming back to your question about psychology, it’s huge. Psychology is such a huge part of boxing, mental strength. I mean, there’s so many examples I can give you, but one example is that you have to have a bloody good poker face to go into the ring. You can’t show anything. So in the dressing room, you’re warming up, you’re ready. And then they say, “Right, you’re ready? Daniel times up, we’re going to the ring, walk into the ring now.” So it’s the same thing. It’s difficult to explain. You’re not nervous, because nervous, this implies negative energy. But you’re anxious. There’s anxiety, because the adrenaline is flowing through your body, your heart is pounding, and you’re literally, as we were taught in physiology, fight or flight mode. And that’s exactly it in boxing, it’s fight or flight.

Prav: Okay.

Arthif: Because when you get into the ring, that’s exactly what’s going to happen. And Mike Tyson very famously said, “Everyone’s got a plan until they get punched in the face.” And that’s true. Because even with professional boxing, with whatever level you’re at, that’s always the thing, we always look at. Even when you look at elite fighters, what’s going to happen when that person lands the punch? And that is always the big thing. How is that person going to respond? Or even, how does a person respond when they go down? Because there’s been great champions have been knocked down. It’s about how you respond when you get knocked down. Are you going to get up straightaway and strong? Or you’re going to be… you’re going to be [crosstalk] doubts, exactly.

Arthif: So it’s about all those things. I mean, a very recent example from few months back, I’m not sure how much you guys watch boxing, or how much you guys know any boxers, but. So there was Alexander Povetkin and Dillian Whyte, fought a few months back. Whyte was supposed to win the fight, and he was winning. He knocked the guy down twice. Povetkin is a very… he’s got solid amateur pedigrees, he’s a former world champion, and he’s been at the very top level. And actually, it’s funny enough, because literally a few days ago, someone was involved his camp, and they were telling me. And they said actually what happened was Dillian Whyte, he overly trained in that fight. So when he came, he just wasn’t sort of fresh and strong. And whereas Povetkin obviously is experienced. So what happened was, Povetkin got knocked down twice. But you can see in his reaction, the way went down, but he got strong. Eventually Povetkin knocked Dillian Whyte out.

Arthif: They’re scheduled not for a rematch in a few weeks time. But it just goes to show, just because someone goes down, it doesn’t mean anything. It shows… what’s the conditioned been like? and also what’s their mental strength like. But that’s really important. So if you’re hurt, you can’t show the fighter you’re hurt. Fighters are like, we’re like sharks. We smell fear. So just like sharks, when they smell blood in the ocean, they’re on you. It’s the same thing. You show a glitch. It’s in your eyes. It’s in the body language, it’s anything of that sort. And we will feed on it.

Arthif: It’s like, I mean, my last fight, because of COVID… when was that? But yeah, it was November 2019. It was in Mexico against a Mexican. And he thought he’s fighting a British guy, and the British guy is going to be bit nervous and so forth. And so he was trying to me out and stuff. But I ended up stopping him, knocking him out in the first round. But what happened was, I knocked him down. And I’m looking at him. I’m analysing him, I’m studying him. What’s his response like? So I’m looking at him. And he took the full eight second count on the floor, and he got up. And I’m looking at him, I’m looking in his eyes, I’m looking at body language, I could see who still hurt. So this is the first round… so you got to be smart, because if a boxer over commits, then you can get countered, you can get hit and get knocked down.

Arthif: If you guys look on YouTube, there’s a fight, Victor Ortiz and Marcos Maidana. Both of them with huge punches, both them had overnight tips, and knockout ratio. So everyone knew this is going to be fireworks, this is not going 12 rounds. In the first round, Ortiz put Maidana on the floor. Maidana got back up, and Ortiz thought, “I got him now. I’m going to go and stop him.” As he came in, Maidana suddenly exploded, bang! right hand on the chin, and he put Ortiz down, immediately, straightaway.

Arthif: So these are the sort of things that happen I boxing, you’ve got to be smart, you can’t get over confident and commit your self, there’s been many times where the boxer would be winning and he’s got the guy against the ropes and suddenly one shot, as a counter shot bang! And the guy is hurt and the fight goes… you know, it just turns right on his head. So I’m looking at this guy am seeing his hurt. Right okay, this is a chance for me to finish, but I’m not going to be stupid at the same time I’m going to be watchful as well.

Arthif: So I unloaded against him and also just watching myself, how many counters and as the referee stepped in, they threw the count in, But you have to look at that, you have to look at how the fighter responds and it sometimes, you know the thing is sometimes people ask “If you get punched, do you get hurt, does it hurt?”

Arthif: So generally you just get buzzed. You know, you will get ringing sounds, it depends how hard the shot is, am sort of exaggerating in the top end of the scale basically. if you get hit…banged hard is that, You know, you can hear a ringing sounds you get dazed or so. But generally, you get hit in the head just like you know, You just push on. The ones that really hurt, is if someone times a good body shot. You get hit in the body, in the right place, the timing with a breath in. you know, you will paralysis someone not literally. but you know, they are completely wounded and those shots can hurt, and you just struggling to breath and that’s why you see many great knock outs when you get hit in the body, hit someone in the right place.

Arthif: I will send you one actually, from one of my fights where I did that. But the thing is they can hurt. So sometimes if your fighting, if your sparring you re.. You get hit with a shot and you’re like, “Ooh” you’re holding your self with breathing and you can’t show your hurt, you have to have a good poker face and be like “what you just shake it of, man what come on.” so the mental side, I think that’s another aspect there: You know, if your hurt you don’t show it, if there’s any fear or anything like that you can’t show it. And that’s where you got a whole as well… another big side of things is mind games. you know, There’s some boxers in history that have just gone down as expects in that, they will wind people up, they’ll say the right things and they’ll just really get under that person skin, irritate them and that’s happened to many great champions.

Arthif: And unfortunately happened to me once, I got the worse of it and it ended up… I lost that fight, because I got so angry and I boxed on emotion, that’s one thing your taught from first day at the gym, you cannot box on emotion, you can’t box if your angry. You got to go in there with a clear mind, focused, you got to be analytical, you got to stick to your game plan and than.

Arthif: You know, if that game plan doesn’t work than you adapt. Floyd Mayweather famously said “A true champion can adapt to anything.” And that’s another great thing, a quote that you can apply for any aspect of life including dentistry. Sometimes in dentistry, we are doing treatment planning things don’t go to plan and you got to know how to adapt or I a clinical scenario. You know, something happens its okay don’t panic. You know, just work around, see what you can do to solve it the issue. You can’t be angry, so in a Tyson furry famously his recently done that to Deontay Wilder. You know, he got under his skin, he got him angry. and you know. his an expect, his a wind up merchant, he is…. so some of this guys are great at it, you know mind games, boxing.. you know, being psychologically strong and mentally strong is crucial in boxing. So It goes actually… its so important with your physical training, you can’t. You know, I can’t emphasis it enough. Boxing actually… most expects will say, its mostly mental.. its more mental than physical

Prav: How much do you size up your opponent, of course you’ve sized up your opponent yet, but how much does that affect, what your training at? Do you have like, this particula guy I’m going to be fighting with has a particular style of fighter, so my training is going to be different and my thinking is going to be different and your game plan for one opponent, compared to a different one. how accurate is that, how much of it, is chess?

Arthif: Massively [crosstalk] I famously said, “boxing is a physical chess match” that’s something I’ve always said. And that’s something that’s very true. With regards to your physical training, not so much because you want to be in the best physical shape for any fight regardless of their style. So you will always do your strength and conditioning, your cardiovascular and stuff. What will change, as we said is “the game plan” and how you going to box. And often you going to have sparring partners who will mirror that style. You know, so if your fighting a a guy who is five ten, you going to try and get sparring partners around five, ten. And if you going to have a guy your fighting is six three, you going to try and get a taller opponents with longer reach, to try to mimic that style. And than you want to go through, you know, with your team, with your coach game plans.

Arthif: So that’s really crucial, you know, Very-very important and you know, its.. and I will give you another example famous example of recent times, I tried to put out as lot analogies as I can to explain my points. So everyone knew in 2019 when Anthony Joshua lost to Andy Ruiz. you know it was all over the headlines. People who don’t even watch boxing knew about that so that would be a good example.

Arthif: What actually happened was Anthony Joshua was supposed to fight another boxer called Jarrell Miller, big baby miller his nickname is. Now that guy, he was twenty stones his fat. Okay that’s what he is, it’s not a nice thing to say but that what he is because he is very athletic in his build, but his huge. Okay, his just not really…he is just over weight, he is over weight. And his slow he plots forward obviously his got power, his strong, but he is not very fast his got slow feet and that who Anthony Joshua was going to fight for his US debut. Anthony Joshua is in training camp for several weeks for this guy, suddenly last minute, was it? I think two weeks before was, the guy failed his drug test and when I mean he failed his drug test I don’t mean something that was just a burned substance in his body, he had…its almost like a pharmaceutical factory that was injected in him, he had every drug you could think of under the heavens and he was even found to have that stuff.

Arthif: So he is not a very nice guy and not many people in boxing speak well of him for obvious reasons. So anyway, back to the story what actually happened was that the fight was obviously counselled. Now they are looking for a replacement for Antony Joshua’s opponent now, for Anthony Joshua had to fight.

Arthif: Now you got to remember his been training for eight weeks. You know, eight weeks for some training camp, for up to that point, and obviously before that as well, he would have know that he was going to fighting him. So he would be thinking about game plans, thinking about things. Suddenly last minute, I believe it was two weeks before the fight, they get Andy Ruiz. Now Andy Ruiz was a very bad opponent to choose for Anthony Joshua obviously we can say that now because he lost, but the point being is that he was a short guy, but he had.. he was very quick on his feet and he had very quick hands, so not really was he like a difficult heavy weight you can hit hard, he was very fast, very explosive and he is quick on his feet, he could move like a middle weight.

Arthif: So his been training to fight big Jeremy miller who is over twenty stones or something and now his suddenly got a completely different opponent, different speed and Anthony Joshua he also trained his whole camp to this fight and his also coming in heavy, because he is thinking, I want to become a bit heavier so I can lend my shots and hurt the guy. Sadly a complete change and that was… either those are the factors for, you know. Anthony Joshua is going to explain on record over some medical reasons of what happened, as to why he lost, which one would be true, which ever the excuse is. But another huge reason, is the fact that the fighter was completely different, he’d been training, his physical weight was different and his gain was completely different too, which is why on the re-march he came down, he came in very light. And his game plan was to box and move around. So you know, that’s the sort of contemporary example to illustrate that point

Prav: But Daniel, how do the nutrition play in this whole game? You mentioned your self earlier “your not like an off season on season boxer, but you on season year round” and than maybe you tailor in, a few weeks before to make your weight or even making that weight in the morning. It’s a science right? It’s not a case of making the weight and you going to fight in that weight, your making that weight for your way in. What is it, in the matter of hours or.

Arthif: Yeah. Let me give you an example, if I give you some of the elite welterweights in the world. The welterweight 147 pound, that’s 10 stones seven. They will work around 12 and half 13 stones. Yeah.

Prav: Wow

Arthif: And than they will fight at 10 stones seven, so am glad I can throw this numbers to illustrate, you know to all the listeners out there, this is the difference we are talking about.

Prav: Yes

Arthif: So yeah, its… what it turns happens, they have obvious a 10 week training camp and in that they will… the thing is with our diets, we still have carbohydrates yes that’s still important to us because we need tat energy, we need to. You know, We are going to be training hard, we are going to be sparing, so we need those molecules. Right, yeah is just about eating the right things, you know I just said “it’s a science” so its, you know, tape or anything done and really you generally, lets say for example, maybe a week, two weeks before the fight, they will probably be.. Depending of where. you know, where their right. But they will be comfortably at least 20 pounds over, you know even on the week of the fight or so. And than they will start taping down.

Arthif: And lets say the fight is Saturday the weigh in would be a Friday. So Thursday they will start slowly the dehydration process, Friday morning than dehydrate and than Friday afternoon obviously would be the weigh in and you got 30 odd hours to rehydrate and to refuel. So that’s how things turn to happen, and you’ve got a… one of the very important things in boxing, is got to be… you got to know your correct weight for fighting, so we all have our walking weight and we have a fighting weight, so that’s really crucial.

Prav: Talk us through the dehydration process, what does that involve? You know in terms of fluid intake, electro lights and things like that. And typically when you go from hydrating to dehydrating, what sort of weight difference are we looking at?

Arthif: So, some boxers are crazy they’ll even loose 20 pound in 24 hour. Okay, that’s typical. You know literally. But yeah, but there’s different ways that will sort of dehydrate that will sweat it out. The thing is that sometimes the obviously the is scientist.. there is a bit of secrecy as well sometimes, with athletes and stuff. so you know, I’ve been taught some good techniques for some… from elite fighters. But yeah, which i probably wouldn’t say publicly at this stage. But you know, I can’t give all my secretes away. But you know, yeah but obviously there’s a smart process, you going to be smart, but sometime people would do…. will go into sonar or they will do different things to dehydrate the day before the weight In or even the morning of the weight in.

Arthif: But once you have dehydrated your self in a certain way, once the weight in than they have to rehydrate the self’s with electro lights obviously. We obviously want to drink, you know hydrate your self properly and adequately, which is why, especially in the US, and the US it relives in that stuff in that regard. But you see the top athletes after the weight in they’ll start drinking Pidilite. So Pidilite is like our cooked up.. you know Diaralyte?

Prav: Yeah

Arthif: The electro lights full of minerals of. see that sort of thing? They get these bottles and its… yeah so, I don’t know why for some reason we don’t have them in the UK. The UK is so behind with so many things when It comes to food and beverages. But so yeah that’s one thing.. yeah. I have that when I’m training out in the US, I’ll have that when I’m training out in the US, I will have some Dioralyte just to restore the electro lights after dehydrating in training and stuff. But yeah that’s something important to replenish, and that’s one of the danger aspects in where people won’t make weight correctly that’s always a danger, So they will dehydrate incorrectly, they won’t hydrate properly and than that will affect obviously the brain, the brain will shrink with dehydration and there for your this greater space. You know the Aracnoides space I believe between the scull and the brain, and than the is more room for vibration and movement, and that’s where you get the real danger. So its all about being smart and how you dehydrate, and how you rehydrate.

Arthif: And this is one of the reasons why the WBC (the world boxing counsel) revolutionised boxing for health and safety for the fighters. You know, sometime in the late 80’s, I can’t remember exactly when, but It was sometime in the late 80’s believe where they introduced the weight in’s the day before the fight, rather than on the day.

Arthif: Traditional they used to have the weight in’s on the day of the fight. And there’s some people . you know, with all due respect, they don’t really understand boxing “Oh, we should introduce same day weight in’s again and because people are killing them selves making that weight the day before and than they have a day.” Hang on a second neutrally you don’t know fighters because, if your going to put weigh in’s on the same day as a fight. Fighters are going to do exactly the same thing they going to do. They going to do anything they can to make that weight and they will compromise them self’s even more and put them self in harms ways even more significantly because on the day they will dehydrate themselves dangerously on the day just to make weight in’, they won’t hydrate them selves properly within the few hours and they going to be…. cause more problems. So that was something WBC champion fantastically and they were successful in archiving to have the weigh in done on the day before

Prav: Is there a prime or age to reach? You know peak in boxing. You know in a lot of sports, you know, you hit your peak or your prime age at lasts say 30 mid thirty or whatever. Am assuming you came into it a little bit late in terms of the pro side of things. Correct me If I’m wrong, and how does that plan out fou you in terms of how much time you’ve got left, [crosstalk] with professional boxing?

Arthif: That’s a really good question. With boxing and sports in general really the modern day understanding of sports science and nutrition, has been a key for longevity. Which is why you’ve got, you know look at Christiano Ronaldo, he’s 36, he’s still an absolutely unbelievable player. You know a few years back, you know if you looked at some of those great stars, if you looked at Brazilian Ronaldo back in the day, Diego Maradona, Pele or other modern greats. They always retired earlier. It wasn’t the same. The understanding of sports science wasn’t not the same. Same as boxing as well sort of thing. But with modern understanding of sports science and nutrition, there’s greater longevity and not just in boxing, but in sports in general. And that’s why the likes of Floyd Mayweather have shown that he’s been boxing past 40 years of age. So he’s shown that looking after yourself, looking after your body, you pay dividends in that regard. Floyd Mayweather is a living definition of an athlete. Never smokes, never drinks. Okay. He’ll always be around his fighting weight.

Arthif: I’ll just give an example on the other end of the spectrum, a modern boxing British great, Ricky Hatton. Fantastically talented, very hardworking, but the problem he had and why his career didn’t last as long as it could have was because he wasn’t disciplined in between fights, in between camps. He would famously balloon up, that’s why he had the nick name Ricky Fatton. He’d say it himself as a joke because obviously, he’s a very humorous guy. Ricky’s a great guy and he’s helped me in my boxing too. But yeah, he wasn’t very disciplined in between camps and if he was, his career would’ve gone a lot longer.

Arthif: Floyd Mayweather, he’s a definition of a athlete. Famously if he used to go to a party where ‘he’s just have a good time, he wouldn’t smoke or drink. He’d just have a good time and just relax. He’d go to parties, his driver would drive him down, have a good time. When he finished, he’d go to the car, change his shoes, put his trainers on, put those shoes in a car, tell the driver, “I’ll meet you home.” And he used to run back home. That’s the things that Floyd Mayweather did. With that, so looking after yourself, that’s how you get longevity. But on Hopkins, in recent times, he became world champion at 50 years of age. The boundaries, the perimeters have sort of moved further.

Arthif: Another big thing about boxing is the amount of punishment that you have and that’s what we call the mileage on the clock. So you can have a 25 year old who has a rocky style of taking three punches and giving three back and you’re going to put miles on your clock with that style, with that way of boxing. The more you get hit, the more it’s going to affect your career, your longevity. So although the age might be 25, biologically they’ll be 45 really. That’s why the likes of Floyd Mayweather and others, they’ve sort of shown different in that regard. So that’s even myself I obviously it started of late but I’m really fortunate I don’t smoke, I don’t drink, you know, I generally sort of live and eat clean, I’m always in the gym, taking over and I don’t have that mileage on my clock with the punishment and stuff.

Arthif: So I’m happy and lucky in that regard, but obviously boxing has a shelf life, you can’t do it forever. So I’ll probably give this another two years or so, see what happens. Obviously with Covid, it’s obviously impaired things and has affected many people’s careers. And it’s affected my own boxing career. September to December. September, October, November … That’s 4 months. I’ve had six fights cancelled just in the last four months, let alone the rest of 2020. So obviously it’s been a difficult year for everyone.

Prav: Everyone. Yeah.

Arthif: But for sports athletes, it certainly has and I can definitely speak on my own. I was supposed to have my U.S. debut in September 2020. Have a big U.S. Holloways fight in the West Coast, which obviously didn’t happen. So now is almost back to quare one. You know, we will have to with my team, My team are looking to keep me active. I want to try and make up for lost time and have as many fights as I can have between now and August, September, when I have my U.S. debut then. Going to see how it goes. So yeah, maybe another one or two years, see how it goes.

Payman: It takes a degree of obsession to want to be the champ, to want to be the best at something like boxing. You’ve got to completely be laser-focused on it. Right. Does that rub off on dentistry? Has that helped you in dentistry, or for now you’re so focused on boxing? Because we had Robbie Hughes on this show and he was a world class kick boxer at one point, but he actually gave up kickboxing to really focus on dentistry. But he says, “If I could be the best in the world at kickboxing, I can definitely be the best dentist.” He’s just got his ambitions of opening 100 practises all other the world and all of this sort of thing. Are there parallels? I mean for instance, when you keep talking about Floyd Mayweather said this or Lennox this, in a way you think of mentors in dentistry. Right. You’ve really been pushed forward by these conversations and the experience of the greats. If you were exposed to great dentists left, right and centre, that would definitely help. Right.

Arthif: Yeah. No, for sure.

Payman: Tell me about the parallels.

Arthif: Yeah. You know what it is? I think generally in life, I’m one of those people where if I do something, I want to give it a 100%. I don’t believe in putting 50% in something. Just since I was a kid, I’ve just never believed in doing something and being average at it. I want to be the best, whatever I did. And it was crazy because … Actually when I went for my BT interview I actually got the job as well, actually. This one liner I did … Generally I’m just nice, they were impressed with me, but they really liked this line actually. It was actually a quote from Mohammed Ali. Mohammed Ali said famously, he said, “If I was going to be a binman, I would’ve been the world’s greatest binman ever.”

Arthif: And do you know what it is? That’s the attitude which I had in general, in life. And that’s something that, whatever I want to do, I want to do the best I can and be the best I can at it. So when I was in my studies, a B was never good enough. I wanted that A. I wanted to flourish in my academics. Not many people know this, as of now, I used to be a massive cricket player. I used to play cricket, I used to play for St Mary’s. I actually got called for Middlesex trials back when I just started university but then it was too much, so i said it’s not going to happen so I didn’t pursue with that. But almost every season I used to be the highest wicket taker in my bowling.

Arthif: When I used to play I always I wanted to envisage myself playing for Middlesex and playing for England. That’s what I wanted to do. For me it wasn’t just, “I’m just going to be a club cricketer and just play on Sundays.” I’d be thinking, “No. I want to do this. I want to be the best at it.”

Arthif: So the same actually with boxing. Obviously, I didn’t envisage myself being a professional at that stage at all but then when I did begin to excel and I had obviously great people around me, that’s an obviously one “Hang on a second, I can do this here.” Dentistry, same thing. It’s like, I’ve been doing sort of stool … I love general practise. I do love dentistry. I’ll be honest, I like every aspect of dentistry, every faculty of dentistry, except one. I’m going to get you guys to guess, which one bit of dentistry don’t I like? And I’m not even ashamed to tell people.

Payman: Aesthetics dentist.

Arthif: Dentures is your guess? All right. What about you Prav, what do you think?

Prav: What you dislike?

Arthif: Yeah.

Prav: The GDC.

Arthif: I don’t think anyone loves them. In clinical dentistry.

Speaker 2: Root canal.

Arthif: Oh my days, Prav got it. I don’t like endo and it’s just something I just don’t enjoy really, especially with [crosstalk].

Payman: It’s very difficult with boxing gloves, isn’t it?

Arthif: Maybe incisors and premolars, maybe. But molar endo? Yeah, no. But yeah, no I really enjoy all aspects of dentistry, cosmetic dentistry, restorative dentistry, all surgery, and also tooth widening.

Payman: Are you a principled?

Arthif: No, I don’t have time to be principled. How can I? There’s no way. So I’ve always been an associate and proud and happy with that. There’s no way I could juggle to be a principle. No, I could not do professional boxing if I was a principle, no way. But all surgery, implants. I love implants. So it’s something that I’m always trying to do courses to further excel myself. I really want to be the best that I can in that field.

Arthif: I’ve been also, at the same time, sort of been doing things like … and to do my masters at the same time. So now I’ve done sort of my post graduate certificate, sort of paying that. So know I just have to set back my cases and do my dissertations in order to get my masters and implants too. So its something that, you know, obviously has slow down my dentistry in terms of the academic side of things. But I definitely do plan in making up for that loss time once I call boxing a day. But obviously I love boxing, and I was very-very fortunate to have been given opportunities already from several people and bodies, when I retire from boxing. I’ve been given some great job opportunities in the boxing field, in the boxing world.

Arthif: Which is wonderful, which is something I always wanted to do And a long side my dentistry, you know, you’ve got plans you want to excel in that, as you said as well. I’ not someone who is just happy to be a boxer and a general dentist and just stay there, just doing the same old thing, no you know. I want to excel, I want to be the best that I can at everything that I do

Payman: You basically said “your quite competitive” right?[crosstalk 00:49:31] did you sometimes get the

Arthif: Of my self I would say. I compete against my self. So [crosstalk]am not

Payman: The down side of being competitive. You don’t get that down side.

Arthif: You know, the thing is obviously, I wouldn’t say its a down side or such because I always want to improve, I don’t want to be the best at something and something adequate or decent for me is not good enough. If I say for someone else, you know, I would be very encouraging and positive “has that’s really good, well done” you know, I believe in being positive with other in order and those around you, that’s really important. With my self something decent or average isn’t good enough, I will strive to improve and get that excellent result.

Payman: Have you ever got any patience coming to you because your Dr hitman?

Arthif: Yeah, all the time.

Payman: Do you get more patience, Do you?

Arthif: All the time. Yeah am blessed, its nice I appreciate that. Those people who know me I’ve never let my success get to my head I’m always grateful and appreciate, I thank god for everything his given me and just believe to be arrogant and hort. You know, god will take my success and just give it to someone else. Its just… I’m grateful thankful to god for everything he has given me and I’m just happy, am blessed and able to motivate people or make someone happy by doing something simple for me because I’ve been I that position and still am where, you know, I have mentors and role models and people who give me their time to do things, so seemly why can’t I do that for someone else.

Payman:

New Speaker: Anyway how much does faith feature in boxing for you, in believe, in thanking for having the opportunity before you go out there and after you win and the gratitude. Just talking about your mind set and believes around.

Arthif: Yeah, you know, definitely I always believed in being grateful thanks to oh my god and , you know, that’s where I get a lot of my strength, patience and you’ve got to be strong, but not just in boxing only, but in life in general, we all have our ups and downs. So, yo know, I get a lot of my strength through my faith and anytime, if we go through difficulties and boxing has been.. one things even for example my record is seventeen and three losses all three of my losses were under very controversial circumstances. Its boxing it’s one of those things, but you got to be strong and rise above it. You know, you’ve got two choices when you get hit with something, you know with that veracity, is all about how you respond.

Arthif: You know, if your going to be weak and let that overcome you. You know, that’s going to be your choice, than you not going to be able to propel any further, If you going to just take it on the chin and be like “you know what? Okay I’ve been knocked down, am going to dust my self up and push on.” And that what makes champions, that’s what makes people great.

Arthif: People will always remember Thomas Edison when inventing the light bulb, how many times did Thomas Edison fail? Countless times, you know, you won’t remember that. You know when you look up an iceberg, you know, the structure underneath the sea is huge, its almost like the tip of what you see on the top, you know there’s all that underneath, you know, there’s all that hard work, dedication, the difficult which people don’t see.

Arthif: For it maybe there’s earning all of those millions, all his millions, he grew up in a room…he grew up in a place where its like just a small room and there’s about ten people in there, you know, he didn’t grow up with a silver spoon, you know he worked his way hard in order to obtain this success and earn all that success and wealth that is earned. And

Arthif: I’ve been very fortunate where we used to do late night sessions with Floyd Mayweather so another thing I sort of picked up from him and Danny Williams where during my fight times… close to my fight, I would train at night so mirror the time of my fight, for circadian rhythms to develop your time in boxing and that’s something something also I’ve picked up with my sports science BSc as well. So in that time Floyd Mayweather he’d be training at night and there would be times were he would just sit and talk with us until sunrise. You know just giving us pearls of wisdom.

Arthif: So its about how you respond and faith has given me that ability to look and analyse things, not just, and just think, you know, look at things for beyond what they are. And its like when I had my last controversial loss I was six and three. Six wins, three losses, you know suddenly you know, and I remember people looking and thinking maybe are you going to stop or are you going to carry on, how are you going to carry on.

Arthif: And yeah of cause I’m going to carry on. You know, and all thanks to god today I’m seventeen to three, you know, I didn’t look back. So I get a lot of that through my faith and I get a lot of that through my strength through god and I always pray, I’m not a perfect person I have my mistakes, but always ill do my prayers I do my 5 prayers a day you know it just take 5 minutes I have my schedule to just thank my creator remember him and it just give me that moment of coming out of this quick.. you know, life is so fast, its so dynamic and you just get like 5-10 min out you just stand before your creator its just you and him and you just talk to him, you know, and it gives you that that tranquillity that’s serenity and its, you know, that’s why in one of the advantages I’ve had beautifully with my boxing, I’ve been able to travel.

Arthif: You know, I love travelling I love seeing the world, I love nature, you know, again you just look at these things and just remember god the creator the his removals creation, you just think of, wow what you there. Space sta… I love, you know, I love astronomy and I look at these and it just allows you to have a moment of time and it just gives you that strength and it gives you that mental strengths that we talk about in boxing which you rally need. So it plays a really big factor in my life and my career for sure.

Payman: Give me two moments like a real… its very obvious right, if I say give me your high moment you’ll say, yeah ” when I won that fight” but I don’t mean that. I mean you have travelled around, yeah you have seen thing that you wouldn’t have seen you have met people you would never dreamt about meeting. Give me one moment, which is high moment and than give me a low moment as well

Arthif: Oh damn, okay, well no one has ever asked me that before. Okay I will I’ve you the low moment first I suppose right, probably the easiest was that, I think the low…yeah there’s been definitely lods in my boxing career, to easily pick out will be all three of my contravention losses, but, yeah, I think its probably the boxer as a fighter there’s not worse feeling than losing its a horrible feeling, you know, but[crosstalk 00:57:28]

Payman: Physical and mental right? I mean you have been [crosstalk] beaten up

Arthif: No, not physical, no I’ve never…its not like I was beaten up or anything like that no. That wasn’t physical hurt at all, I wasn’t physically… for example, one of the fights was just a, you know, robbery for example, two of them was just politics and rubbish and gains hours before I went to the ring, you know, one guy he ended up being a stone heavier than was supposed to be, you know, all sort of rubbish and mind game and rubbish, so no, not physically just mentally, you just down and you just disappointed in your self and just disappointed of the situations, since I was young somebody did this, so I was saying I suppose yeah, you know if I was to say in a nut shell that’s probably been a disappointing[crosstalk 00:58:19] thing and stuff like that for sure.

Arthif: And yeah I’ve been very fortunate to have seen so many high’s. What can I say in the ring obviously the is no nicer feeling than sort of obviously wining, but outside of boxing definitely I’ve hade some great meeting and great contraventions. I’ve just really been fortunate I guess to have had sort of very high profile people who’ve excepted me their circles as friends and trusted me with things and information and I’ve always been very coactions of that and not wanting to revel thing In public. There’s literally…theirs many things I’ve hade very personal moments. Id probably say, I’ve had some really-really amazing personal moments with Floyd Mayweather, that’s why I love and respect him a lot because his done a lot for me and there’s thing that I wouldn’t say on camera or in public that is just between me and Floyd, you know.

Payman: What’s it like hanging out with your idol?

Arthif: Yeah. I just feel I’m blessed, am thankful, you know, it really is amazing. I just myself, you know, I won’t be “oh” be like am just being frozen. I think one of the reasons where I have been fortunate and blessed to have this…be friend with this legends or hall of famous, I just carried myself I’m just being myself, you know, with me what you see is what you get and I just…I’m not perfect, I have many mistakes, okay, but one thing is that what you see is what you get with me and I’ve just carried my self as aim.

Payman: Because a lot [crosstalk] of people stake advantage of those relationships

Arthif: Like for example [e] some people would be like “where ever my use may be, what ever I “if am talking with anyone I voice my views or if its like. For example I pray, am not going to hide and be ashamed of my faith and say “oh am not going to pray for them.” You know what is like with Floyd Mayweather he respects me as so much praying in fact, he gives me a place to pray. There’s time I will be praying and he goes like “hitman” he calls me hitman. Hitman don’t [inaudible] he goes in to another room and he goes and be like “yo get hitman another room give him a place to pray” you know, so I’m just myself, you know, if prayer times come in, so I will step out for five minutes and pray somewhere quietly and discretely.

Arthif: I remember once we were having a chat about something. It was myself, Floyd and a few others in the room. I disagree, I wouldn’t really do this.” I basically disagreed with him and he goes, “Okay, why? Why would you say that? What’s your reasoning for this?” And I just said my reasoning, I just said that and stuff. Basically, my point being was I wasn’t being a yes man and just agreeing with him. I’m very sort of open and just am myself so obvious then respectfully articulated my views and my opinion to him on that regard of the subject about life. And sort of that was the end. So it’s humbling and great to be in those circles and I’ve just sort of been myself really.

Payman: When you go back to your childhood, do feel like there’s a defining feature of your childhood that makes you that guy? On one aspect of it, the competitiveness, the ambition, on the other side of it, what you’re saying now.

Arthif: It’s difficult. No I couldn’t pinpoint to one point, but generally, coming back to it, faith was a integral part of obviously growing up. And secondly was my upbringing with my parents. My mother and father, they were instrumental in my upbringing, especially my mother. I’m a proud mommy’s boy, if you know. My mom is my best friend, so I’m really really close to my mom and I speak to her everyday. She’s my best friend and she was amazing, instilling so many things in me and having that positivity, having no fear. She’s a really intelligent woman, educated. And she would tell me stories, true stories or legends and just tell me aspects of life. She’s still my life coach and my mentor.

Arthif: A lot of that, sort of, no fear approach or just going out there, not being afraid to get something and stuff. Definitely, there’s a big thanks to her for that part, for sure.

Payman: Does she watch your fights? Or she doesn’t?

Arthif: That’s a really interesting question. Basically, she was really upset when I was boxing at first and she wouldn’t want to know. She’d be really scared, she’d be really nervous. And she didn’t approve as well. She didn’t approve, she’d be telling to me to stop and stuff like that. But then as time went she realised, “This guy’s going to do it anyways regardless, so he may as well have my blessings and support and prayers.” I always had her prayers, I guess. Which was great, it was a great feeling for me. So now she’s not scared as such anymore, I suppose. I suppose she knows I can look after myself and I’m pretty good. Obviously she’d still be nervous and she’d still be praying on my fights. And asking, “What’s happened to your fight? Have you finished? Have you won? What happened?” Stuff like that. But she’s very positive so that’s great.

Payman: You talked about your mom worrying about injury, right? And you’re kind of medically trained and all that. How does head injury feature in your thinking or as a fighter is doesn’t?

Arthif: It doesn’t. Because that’s one part of the thing, we’re fighters, we’re not logical. We’re a different breed. So no. All thanks to God, nothing’s happened. No sort of injuries. Obviously you go into a shower, you’ll get wet. So you’re going to get into the ring, of course you’re going to get hit. So you might get some bruising or scuffing or whatever, that’s normal. But it’s like, you’re a fighter, that’s what you expect. There’s been times, for example, I’ve had some busing or a little bit of cut or whatever. And then I’ll have some female members of my family, they’ll be like “Oh no, what’s happened? What happened?” You stretch your arm and like, “Look. Look. It’s fine.” You don’t want to talk about it, you’re a fighter.

Arthif: I don’t want any sympathies for a scuffle mark or anything like that. It’s like, “Come on, I’m not a …” I’m not going to use a certain word. I’m sure you can imagine what word I’m saying. I’m not peep. I’m not one of those. I’m a warrior. I’m a fighter. What’s that. No, so you don’t think about that. No. You go into this fight and you go in there to win. You don’t think about anything else. Are you guys movie guys?

Payman: Yeah.

Prav: Sure.

Arthif: Have you seen the movie Troy?

Payman: Troy? No.

Prav: No.

Arthif: No, you have to. You’ve not seen Troy? Really?

Prav: I like good movies dude. Troy is [fantastic] movie. I’m joking.

Arthif: No, no, no. I was going to drop a quote from Troy but it’s fine, it’s all right. You just go in there, you back yourself, you believe in yourself. You’re there to fight. And obviously, you want to be smart, but there’s a lot of courage. There’s been many boxers who’ve been very talented in the gyms but the moment they step out into the lights, in front of a large audience, they’ll freeze. They’ll have doubts or they won’t perform and it’s sad to see. You’ve got to be strong and you don’t have any doubts. You’re not worried about XYZ or nay injuries or whatever, you’re just there to fight and to win.

Payman: What’s been your favourite country you’ve visited on? All these countries you’ve been to.

Arthif: Oh wow. I haven’t been to any place where I was like, “Wow, what they hell have I come to. I don’t want to come back here again.” So that’s a good thing. That’s a good thing. So I can definitely say that. So I’ve always had positive experiences and it’s nice. I’ve [crosstalk] …

Payman: Maybe as far as with boxing culture.

Arthif: Again, and Payman already asked me, I’ve never been subject to any racism as well. Wherever I’ve travelled, it’s been great. But then some people say, “Don’t forget because you’re boxing, you’ll be in the cameras, media. So people they always come and they want to have some selfies with you or they want to get your signature or whatever. Autograph and stuff. So it’s …” I’ve always had a positive experience wherever I’ve gone. But I really enjoy the U.S. I love travelling to the U.S. And it’s weird because I love New York, New York is amazing.

Arthif: And it’s funny because if you go to the U.S., especially in the West Coast, generally people don’t like New York because it’s very hustly and bustly. There’s a lot of hustle and bustle and people relate it to London. Obviously there’s a difference between London and Manchester. Famously London is sort of on their own mission. No smiles, you go in the tube, no one want to talk to you. But if you go up to Manchester or Yorkshire, or anywhere like that, everyone will talk to everyone. Everyone will smile, “Good morning. How are you doing.” Whatever. And I’ll equate that New York, with London, but New York’s a lot more friendly than London.

Arthif: I love New York, I love all parts of the U.S. where I’ve travelled to. There wasn’t any place in the U.S. where I didn’t enjoy. Obviously, Vegas is cool as well but I really enjoy the West Coast in sort of the California. I think California is a great place. It’s a great place. The weather, the people, everything about it. It’s brilliant. I really enjoy it. I love going to California for sure.

Payman: Love that, man. Well, we’re way past our allocated time.

Arthif: Hey, but I noticed the bridge at the back. You got the …

Payman: San Francisco.

Arthif: San Francisco bridge. Yeah.

Payman: Golden gate.

Arthif: I can see Alcatraz. I’ve been on that bridge loads of times by the way.

Payman: Me too there. Went to Marion County. Right. That’s where all the big houses are, right? Prav always ends this podcast with the same question. Or actually, it’s a set of questions.

Prav: Yeah. It’s a few hypotheticals, right? But, imagine it was your last day on the planet and you had your loved ones around you and you had to leave them with three pieces of life advice, what would they be?

Arthif: Right. Yeah, so that’s a tough one. This one is a profound question. I love profound questions and thoughts. First and foremost, I’d say it’s to be thankful and grateful to God. He’s given me everything. You can easily sort of get in and dragged into that whole spiral of looking at others who’ve been throughout more than you, who’ve been given, whether physical abstract ways or any other way really. But there’s always people who are far less fortunate than you. So it’s really easy to be engulfed in that. So first and foremost is to always be thankful, always be grateful to God for what you’ve been blessed with.

Arthif: Secondly, to do good to others because that good will always come back to you. So treating others how you’d wish to be treated. What you sow in life is what you reap. And always do good wherever you can. And don’t belittle any goodness.

Arthif: So lastly, I’d say it’s to believe in yourself. Go out there, get it. Never let anyone tell you, you can’t do something. There’s always going to be naysayers, there’s always going to be negative people. Everyone has an opinion. People are often focused on other people’s lives and less on their own. So you always get people saying something about what you’re doing. And if it’s negative, take it with a pinch of salt and you just carry on believing in yourself and go out there and get what you want.

Prav: And then, I’ve got two more questions. So the next question is a little bit easier. How would you like to be remembered? So either artist, Daniel or Dr. Hitman was … finish the sentence.

Arthif: A genuine person who gave it their all in whatever they did.

Prav: Good. Beautiful. And finally, a bit of a hypothetical. I’m going to put a little bit of a twist on this. Imagine you’ve got a month left to live. You know you’ve got a month from now. Right. You’ve got 30 days, okay?

Arthif: Right.

Prav: So in this particular case, I’m going to give you all your health. Right. So you’ve to a 100% of your health until the 30th day. What are you going to do?

Arthif: I would maximise my efforts in helping many certain people and society. Just in my ever good I could, whether that be … not just in terms of charitable aspects and doing things financially or giving whatever and just talking to orphans, whatever. Just wanting to help people any way I possibly could. And that’s where also my faith will come in as well because obviously, I believe in a afterlife, I believe in a reckoning. I believe in accountability where our creator will ask about ourselves and or time spent on this Earth.

Arthif: I believe in that where as a Muslim there’s two aspects. One is that, there’s rights of God, between you and God. And then there’s rights of people around you. If you look at a Psalm, most of it is all about being mindful of those around you. Don’t do no harm. It’s always about everyone around you, whether it’s your family, whether it’s your immediate or parents, your spouse, your siblings, your children. Or even you neighbours, talks about the 40 houses around you, are your neighbours. You should be mindful of your neighbours, not causing harm and not causing distress to anyone around you.

Arthif: And it goes on to humanity, then it goes into animals and saying there’s reward in treating every good thing. There’s famous narrations of the… There was a prostitute who obviously, he had a immoral life. One day she went to drink some water, she saw a thirsty dog just licking the mud, it was so thirsty. So she went, filled up her boot from the well and gave it water. On account of just that action, she was forgive by God and given paradise. There was a woman, equally, who neglected a kitten. Tortured it, didn’t give it any food, Treated it inhumanely and she went to hell for it. I cannot preffare abuse to an animal. So that’s just that animals will always [inaudible] with us. So there’s all those aspects there.

Arthif: So just doing good really, it’s like … And there’s another narration which the book of Mohammed said that, “If I were to come upon you, the day of resurrection, the day of judgement , then do any good, even if it is if you have a seed in your hand and you plant that seed, do that.” Which is amazing because some of the scholars when they’ve discussed this and they look at the one example, the parable that Mohammed gave is that, if you were to plant a seed and that would grow to be tree and people would benefit from that tree, whether it be the shade or the fruit of that tree. You’re benefiting the planet with oxygen and carbon dioxide in that respect. So Islam is a lot about benefiting others and treating things around you in a good way, or regardless of what factors.

Arthif: So that’s something that’s a cornerstone of my faith, something I believe in. And at the end days, the problem is that you reap what you sow. When you do that, you’d get goodness in this life and in the hereafter for acting in such a way.

Payman: What an answer, man.

Prav: Beautiful.

Arthif: Thank you.

Prav: I think I’ve [crosstalk].

Payman: What an answer.

Prav: I think I should have a whole nother hour long conversation just to look at that. Take it a bit further. Yeah. Really, really interesting. Thank you so much for your time.

Arthif: Thank you.

Prav: It’s been inspiring.

Payman: It’s been a real pleasure to meet you buddy. Real, real pleasure.

Arthif: It’s been a pleasure being in your show. I’ve heard great things about your show, so it’s been great to have finally been on.

Outro Voice: This is dental leaders. The podcast where you get to go one on one with emerging leaders in dentistry. Your hosts, Payman Langoudi and Prav Solanki.

Prav: Thanks for listening guys. If you got this far, you must’ve listened to whole thing. And just a huge thank you from me and Pay for actually sticking through and listening to what we had to say and what our guest had to say because I’m assuming you 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 much for listening. Thanks.

Prav: And don’t forget our six star rating.

This week’s guest is the youngest member to achieve British Association of Cosmetic Dentistry (BACD) accreditation.

And he is just getting started.

Multi-award-winning Dr Richard Field talks about his early training with the great Christopher Orr and discusses his laser-sharp focus.

He also lets us in on high-profile associate work at Elleven Dental on Harley Street, his recent move to the southwest and much more.

Enjoy!

 

“I get very tunnel-vision when I’m working. Nothing else exists. Just the teeth.” – Richard Field

 

In This Episode

01.54 – Backstory
09.06 – BACD and VT
17.37 – On courses
21.29 – Management
27.52 – Large sums of money
33.58 – Aesthetics vs functional
36.27 – Drive
38.05 – Social media
44.18 – Elleven Dental
46.37 – Bristol
52.24 – Blackbox thinking
55.19 – Last day and legacy

About Richard Field

Dr Richard Field graduated from the University of Glasgow with honours in 2011. He completed his foundational year in Surrey and gained a postgraduate certificate in primary care dentistry from the University of Kent.

He is the youngest member to have been accredited by the British Academy of Cosmetic Dentistry and winner of several awards including Best Young Dentist 2014 and Most Influential Dentist 2015.

Richard Field: So I think we shouldn’t get used to seeing that much money. We shouldn’t just take it for granted. We should respect it, because it’s money, and it’s often huge amounts of money, but you’re there providing a service and you are worth that money, but you should never take it for granted.

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 Langroud…: On the podcast today, one of the young dentists that I consider to be one of the most talented young dentists that I’ve come across, Richard Field, I’ve known since fourth year of dental school, Richard?

Richard Field: Yes. Something like that, yes. Long time.

Payman Langroud…: Yes, and-

Richard Field: [inaudible] dentist.

Payman Langroud…: I’ve been following his career from that time, since I think you were a student helper type at the BACD, and since then we’ve done quite a lot together. We’ve been on conferences together. Richard’s helped teaching on the Mini Smile Makeover course, but I think it’s going to be a very interesting interview, Rich, because you’ve had a bunch of very, if you like, high profile associate jobs, and now got the title of the youngest dentist ever to become accredited by the BACD. That’s quite an achievement in itself, but I think for someone who’s trying to make it out there, a young dentist, the blueprint of following what you’ve done in your career really will be helpful to a bunch of people. Good to have you, buddy. How are you?

Richard Field: Thanks for having me. All good. Had a nice weekend, it’s been good. This is a nice way to round it out.

Payman Langroud…: Yes, so your dad’s a dentist.

Richard Field: Yes, or he was. He retired last … No, a year and a half ago.

Payman Langroud…: Oh, really? And as a child, was there much pressure to become a dentist? Or how early on did you decide you wanted to be a dentist?

Richard Field: Dentistry was actually quite a late decision for me. I’d say, if anything, my dad tried to not put me off, but he certainly didn’t encourage it, because I don’t think he particularly enjoyed the business side of it. He enjoyed the practical side of it, but there was never any push at all, really. I actually only did work experience, so I could tell people to stop asking me do I want to be a dentist like my dad? So I really only did the work experience almost out of spite, to be like all right. I’ve done the work experience. I don’t like it. I’m not going to be a dentist, but I actually found that I did the work experience, I realised that I had no idea what a dentist did. Really, actually, quite enjoyed myself, and actually, from there, I’ve never looked back. Yes, it was-

Payman Langroud…: So you surprised yourself.

Richard Field: I surprised myself, yes, completely.

Payman Langroud…: What were you thinking of becoming?

Richard Field: Well, I originally wanted to be a vet, and I’m allergic to most animals, so that quickly ruled that out. And then, before I got my exam results in fifth year, which is the second last year of school in Scotland, I was all set to go to catering college, because three of my four grandparents, they were chefs. And I was actually all set to go to catering college, and then I ended up doing the dental work experience. I got better results in my exams than I was expecting and that just went from there.

Payman Langroud…: Ah, because I was going to come onto the foodie side of things. One of the few people who I will really trust with restaurant recommendations anywhere in the world. In fact, most of the time when we go on these conferences and things, Richard is the social secretary who plans out all the meals, so that’s interesting. I didn’t even know that then. I had no idea that there was that in your background. What does your brother do?

Richard Field: My brother’s just finished his PhD in, actually, not dental related, but he did it in Sheffield Dental School, and I think it really annoyed him when someone came up to him, and he thought he’d got away from me, and said, “Are you Richard Field’s little brother?”

Payman Langroud…: So what’s he done?

Richard Field: I might get this wrong. He has done his PhD in nerve regeneration, so I think a part of it actually was to do with ID nerve damage. He’s much smarter than me, so I don’t quite understand a lot when he talks, but it’s something to do with nerve regeneration, and I know a part of it was with Sheffield Dental School and the ID nerve.

Payman Langroud…: So, as a dental student, where did you study? In Edinburgh?

Richard Field: Actually, Edinburgh Dental School is now a vodka bar. I’ve had most … During dental school, but no, I was in Glasgow University. That was good fun. I did apply to London, and Cardiff actually was my second. It was either going to be Glasgow or Cardiff. If I’d gone to Cardiff, I think that’s where Tom went, so I could have met Tom a few years earlier, Tom Young.

Payman Langroud…: That’s where I went too, not that we would have met each other, but how much knowledge of dentistry did you have? Outside of the obvious. Had you decided then, once you decided to become a dentist, did you then start taking more of an interest? How much of an advantage is it to have a dad who’s a dentist? I know there’s quite of a lot of you guys, people like Simon Chard and Christian Coachman.

Richard Field: I think it depends. My dad, he is more into oral surgery. He didn’t really enjoy the restorative side of dentistry. We never talked about dentistry ever really, so from my side of things, it wasn’t really an advantage or a disadvantage. It wasn’t really anything from my experience, but I know with some people, if their parents have practises or they’re going to go into the family business, then that can make a difference, but from my side of things, it didn’t really play out. Other than the guy interviewing me at Glasgow was in my dad’s year and I didn’t know if they were friends or not, so that could have gone …

Payman Langroud…: What were you like as a dental student? How did you find the dental course? Were you a high flyer? Because when I met you in that fourth year, I did think you were quite ambitious, focused, at that point even.

Richard Field: Well, I do remember getting pulled off [Pete’s] for being difficult, because they wanted you to put [inaudible] and put it on a micro brush, and I felt that wasn’t accurate enough and I didn’t do that. I remember getting pulled aside for that and saying, “Just do what you’re told.”

Richard Field: I did have my own composite kit. I think it was Dentsply used to run a competition, I think it’s a Ceram.x competition, and when they gave a kit of composites to each dental school. And I found it in one of the tutor’s office and I was like, “Can I have this?” They were like, “Yes, okay.” So I was probably that guy.

Richard Field: Taking photographs at dental school was really, they made it into a big thing. You have to prebook. You can take your own photos. You had to prebook the photographer. He then made a big song and dance about how complicated photographs were to be taken.

Richard Field: He’d just go on to clinic with his cameras, or you’d have to go down to this massive photo studio, and there was a couple of cases that I was photographed, but they made it out as if it was this really complicated difficult thing, which I think was the wrong thing to do for a dental student. They should have been more open about how photography is, and not make it this mystical art.

Richard Field: I probably did annoy my tutors. I probably annoyed them a little bit, but it was like school. There’s ones who relish questions and there’s ones who want you just to shut up and listen, and I got on better with the ones who liked questions than the others. I had one particular, my class tutor, he was very, Dr. Watson. He was very encouraging, and then there was Andrew Carruthers, who was our restorative tutor.

Richard Field: He’s the one that gave me the composite kit, and he had a CEREC in his office again, that no one used, and we got to use that, which was great. There was a few that if you showed an interest they really enjoyed that, and there was a few that just were there to teach and didn’t really want your feedback or your input.

Payman Langroud…: As a fourth year turning up to a BACD conference, how does that feel? Because in my day BACD didn’t exist, let alone turning up to a conference at that age. Did it blow you away? Was that a major influence?

Richard Field: I had no idea what I was going to. There was an email saying, “Anyone want to help out at this conference?” And I was thinking, well, some time off uni. That’d be fun, so I actually had no idea what I was going to, but one of the tutors said he was disappointed in me for going to help all the cowboys at the conference, so there’s definitely the-

Payman Langroud…: Oh, because it was anti cosmetics.

Richard Field: Yes, so there’s definitely some positive feedback from the dental school, some negative feedback, but from my point of view it changed my life, that conference. I can say it without sounding too cheesy. That conference changed my life, because I wouldn’t be here today if I hadn’t gone, if I hadn’t met those people, if I hadn’t seen what you could actually do as a dentist, besides from fillings and removable dentures.

Richard Field: The key turning point was there was one lecture. It was a panel discussion between Chris Orr, Ken Harris and James Russell, and that was the defining moment. Going to that lecture and seeing these three guys present these three cases, doing things that I’d never seen nor thought were possible. That was really amazing.

Payman Langroud…: I would recommend it to any ambitious student who wants to understand what’s going on in the big wide world, to turn up to that thing. Everyone who did turn up ended up having a great career from where I could see. It’s one of those things that you have no idea about, until you have the idea about it, isn’t it? Okay. Then you qualified. Where did you do VT? Up in Scotland?

Richard Field: I did VT in Horley, which is a small town near Gatwick. I lived in Brighton for a year. I actually moved to London for a few months. London then terrified me. I wasn’t ready for that, so I moved to Brighton and I commuted from Brighton to Horley near Gatwick for VT, and then I was very close, actually, to going to Australia.

Richard Field: I did interviews with on Skype, lining them up, and then I just ended up getting an offer from a practise in Islington, because I’d made the decision if I was going to go to Australia I wasn’t going to come back, because it’s a long way to go for a year, go for two years. I know people do that, but I got the offer from the place in Islington and it was a massive, massive practise.

Richard Field: It had 54,000 UDA contracts I think. There was no, you couldn’t book an appointment. You just had to turn up, and when you were finished with your patient you went downstairs and you pulled the next file out from the waiting patient’s paper file. And you call the patient, and they stood up off the ground if there wasn’t a seat, and you take them up, get their treatment, and then their notes were thrown back in the pile, until the next time they wanted to turn up for a checkup. That was-

Payman Langroud…: Can’t imagine you stayed there very long.

Richard Field: I was there for six weeks, and I got fired-

Payman Langroud…: Six weeks.

Richard Field: Yes. I got fired. I don’t mind saying that.

Payman Langroud…: What happened?

Richard Field: I don’t really know, to be honest. I got accused of gaming and I didn’t really know what that was, and I think that I’d wanted to see this person again three months after, because they had an abnormal lesion and I wanted to put fluoride on them, and the boss was a bit, I don’t really know. He didn’t like me.

Richard Field: He said I was gaming the system. I couldn’t work there, and this is at lunch, and next Friday would be my last day. Then my next patient came in after lunch and said, “How are you doing?” I burst into tears. That was an interesting afternoon, but I don’t regret it.

Richard Field: Actually, after that, it was an interesting time. I was unemployed for about four months, and I was sleeping on a lie below on the floor of one of the other associates in the practice’s spare room, until he got drunk one night and was like, “Mate, when are you moving out?” I was like, “Oh, yes,” and then I moved in with a friend from school for a little bit, and Tif then offered my job, and again that was Tif Qureshi, and that was my stepping stone from VET into private practise. Was a bit-

Payman Langroud…: Amazing, so you went to Kent to do that job.

Richard Field: Yes. Kent, so I got two jobs at the same time almost. I got the job with Tif. The interview was terrifying. He got me in and is like, “This is my business partner. He needs a two year composite,” and I was like, “Sorry?” Is like, “Yes, go back to the store and do his filling.”

Payman Langroud…: Wow, really?

Richard Field: That was a baptism of fire, but Tif was a fantastic mentor. We were never on the same day, but you could email him any time of day. 3:00 in the morning or whatever, and he replies in five minutes. Obviously, got the experience within the liner, with the CEREC, with the ABB cases. I didn’t want for any material, anything, so that was a fantastic opportunity, and within a few months I cold called a bunch of practises with CVs, and one of them was quite far away. It was [inaudible] one of your previous guests, Andy Moore.

Payman Langroud…: Andy Moore. What a legend.

Richard Field: He is. Still, to the day, one of my favourite places I’ve ever worked. He knows how to run a practise and he knows how to keep his staff happy. He’s a good guy, really good guy.

Payman Langroud…: Yes, so Advanced Dental wasn’t the most beautiful practise I’ve ever been to. What were you doing there? Were you just a general dentist in that implant situation?

Richard Field: Funnily enough, I was there for about six months and I was like I’ve got a real sense of déjà vu of this place, and it turns out, I went back to my university lecture notes and we’d had a lecture on surgery design, and the example they used was the surgery that I was working in, in Andy’s practise, and so that was a funny-

Payman Langroud…: I see.

Richard Field: Funny roundabout, and I was there, I was a general dentist. Obviously, I got all the bonding cases, ABB stuff, in use. They had a CEREC machine and that was my … I say CEREC was an interesting one, because it really taught you how to prep well, because you saw your margins on screen, so I’m saying I don’t necessarily, I’m not a huge fan of CEREC in terms of aesthetics.

Richard Field: I know it can be beautiful. You’ve got to put a lot of the work into it, but the one thing I was very grateful for CEREC for was teaching me that you’ve got to prep well and see your margins, because if you can’t see them on a 15 inch blown up monitor your technician’s not going to see them in your little stone model, so that was-

Payman Langroud…: Did you take the opportunity to learn about implants while you were there?

Richard Field: Yes and no. It was obviously always there, and I could see if I wanted to. Implants has never really interested me, surgery side of it. The restorative side, absolutely, but I’ve placed some implants with my current boss, with Alfonso. 100% success rate, place two. Still there, but it’s not something that really interests me at all, surgery. It’s something I feel you’ve got to be doing day in day out, like anything, 10,000 hours to get good at.

Payman Langroud…: I’m the same. Scared of blood. So along the way you’re saying you’ve had the fortune of working for some of the best there, right? With Tif Qureshi and Andy Moore, but which courses were you attending?

Richard Field: The courses thing I actually started quite early. I started doing courses actually in the fifth year of dental school through the BACD, and one of them was with Ivoclar and it was a composite course. I think it was one of the regional study groups, and I’m really glad I did that course, because a month or so after I’d had a patient booked in the clinic. Was one of my good friend’s girlfriend, and she had a big old class four in her tooth, and I in my infinite wisdom had said, “I’ll replace that for you. We’ll do a crown.”

Richard Field: Obviously, having no idea that a single central crown is one of the hardest things you can do as a dentist, but actually after this composite course, that actually maybe I could do this another way, and I got speaking to the Ivoclar guy. It segues into one of my motto. If you don’t ask you don’t get, and I asked, I was like, “Can you send me some composite? I’ve got this young girl.”

Richard Field: And he sent me this composite kit, and we ended up booking out two, three hour clinics to do my first big class four, and my friends go, which is actually still there today. I did it in 2006. No, 2006. 2011, and it’s still there almost 10 years later. I actually got that, the Ivoclar guy in to do one of our VT study days. So the course thing is since before I was graduated, and the one that’s made the biggest impact for me was Chris Orr’s course. The yearlong one.

Richard Field: I did that straight out of ET, and if I hadn’t done that course, because I was obviously straight out of ET. It was the job at Tif’s and the job at Andy’s. It was sink or swim. If I hadn’t done that course I wouldn’t have had the beginnings of the skills to do, or have the confidence to do the cases that I needed to do, so of course it’s from as soon as you can would be my advice.

Payman Langroud…: It’s interesting, because Chris himself didn’t used to take people that early.

Richard Field: No, he didn’t. I was the first, actually.

Payman Langroud…: Were you?

Richard Field: I was the first that he allowed, because you used to have to have done at least one year in clinic, one year in general practise, before you could do his course, but I was the first that he let in and straight from BT. And I think now actually he does that routinely, because if you don’t have to unteach bad habits to people I suppose they’ve got a better starting point, a better foundation, but that course, I’d recommend it to everybody. I know there’s other courses out there that are similar, but he’s the man. He’s the original-

Payman Langroud…: It’s a great course. Somehow, he manages to combine depth and breadth really simply. It’s an interesting … I always think about courses as either depth or breadth, and somehow he manages to get both into the same course. Now, look, you’ve worked in some of the highest profile practises around. It’s just a list of who’s who of London really. You’ve worked at the Andy Moore’s, we said, Harley Street Smile Dental Studio. You’ve worked at Elleven Dental. Ten Dental as well.

Richard Field: Ten Dental as well. Not related. That was with Nick and Martin. I’m still at Elleven. Spend there two days every other week and the rest of the time with Alfonso in-

Payman Langroud…: Now, finally, with Alfonso, who’s one of my favourite people in the world, so tell me this. It’s quite a lot of … I’ve only worked in my whole career in, I gave up dentistry, but I worked only in three practises and each one taught me a bunch of stuff. By the way, some stuff, things not to do, but if you had to distil, you’ve worked at these places where they’re right at the top of the field. If you had to distil some nuggets on how to run a practise, I know you’ve always been on the associate side in these practises, but what are the key things you’ve learned about practise management, patient management, team management, products, whatever it is?

Richard Field: I think, if you take Andy for example, I was there, I think I was there 2012, 2015, and if you look at who is still working there in terms of staff, is everyone bar people who’ve retired. So I think the first thing is keep your staff happy, because you’re screwed without them, really.

Richard Field: Treat your staff well and keep them happy, and I know there’s probably people listening to this who’ve worked with me thinking what’s he talking about? I know I can be quite difficult. I know I’m difficult to work with, but I think in the last few years for sure it’s hammered home that definitely keep your staff happy.

Payman Langroud…: Why are you difficult to work with? Do you have very high standards, and someone does something wrong?

Richard Field: I have very high standards for myself, and I have very high standards I suppose for the people around me, but I think the big thing is I get very tunnel vision when I’m working. Nothing else exists. Just the teeth, and I think if you don’t know me I can potentially, I assume I come across as quite, I could come across as quite stern. Or I get very focused in, so I go very quiet, and a lot of our appointments are maybe three, four, five hours long. I suppose it can be quite intimidating sitting next to someone who doesn’t really speak for that much time.

Payman Langroud…: How do you stop that spilling over into the patient? You’ve got these high standards, but bedside manner is definitely part of that, isn’t it?

Richard Field: For sure. A lot of the time, before these big long appointments, I’ll have spent a lot of time with these patients building up trust, building up conversation, but the nurses that I work with are very good and they will talk to the patient. Obviously, I’m not going to be silent for that long, but there’ll be portions of time where I’m just looking and I’ll put my hand out for something, and most of the time I’ll-

Payman Langroud…: If that thing doesn’t fall into your hand, now you’re really pissed off.

Richard Field: I never, I’m not someone who throws things around, I’m not someone who shouts, I’m not someone who does any of that. I just think it’s because I’m silent, that it might come across as quite like I’m angry. I don’t get angry in the surgery. I don’t get … I know a lot of dentists, or not a lot. I know of dentists who throw things around. That’s not me. I’m just quite a focused person, and if you’re new to working with me I suppose it can come across as either rude or indifferent maybe, but certainly there’s no intention behind it. If I ever work with someone new I’ll always say to them when I work I can get quite tunnel vision. Nothing’s ever personal. I get quite quiet, but it’s just the way I work.

Payman Langroud…: Tell me other stuff you’ve learned from these practises. Okay, so treat your staff well.

Richard Field: Treat your staff well. I don’t know if it’s what I’ve learned from these practises, but it’s something that I’ll often talk about with UR qualified dentists. Is don’t make the patient’s problem your problem, and I think it takes a good few years to acknowledge that, because you haven’t given the patient the care. You haven’t given them parity, or you didn’t do the last bad crown.

Richard Field: Don’t internalise your patient’s problems. You’re there to help them. Don’t get stressed about that, and generally I think it takes three or four years to get around to that way of thinking, and that’s something that I think is very important. In terms of from these practises, it’s a difficult one to answer, because I don’t really know any different.

Payman Langroud…: How about the differences between them? Do some of them have morning huddles and some of them don’t?

Richard Field: I’ve only worked in one, it was a morning huddle, and actually that was very good. That was 52, so the morning huddle, it was what were the problems from yesterday? How did they get sorted? Who have we got in today? Do we have any VIPs? Do they need any special things? Have we got lab work going out? Who’s dealing with the lab work? Who’s going to the post office?

Richard Field: That was very useful, and I know that taking 15 minutes out of the morning of your day with getting all your staff together can be quite challenging. 52, I think the first patient was a half nine in the morning huddle. I think it was 9:00 to 9:15, so everyone was in, even the dentists, half an hour earlier.

Richard Field: That’s a weird way of, as a self employed dentist, having to be in half an hour before you work. It’s a different way of thinking, but actually so many problems were avoided from that morning huddle. It’s worth its weight in gold, for sure.

Payman Langroud…: As a young dentist, you’ve probably been exposed to more VIPs. Have to talk about bigger prices than you were comfortable with. These are expensive practises that you’ve worked at. Take us through that, for instance. Leave the VIPs out of it for a moment. When you go to a practise, I remember working in a place where I thought, listen, I definitely couldn’t afford to be a patient in this place, and getting used to those numbers was a challenge.

Richard Field: That’s something actually, that again, I learned on Chris’ course, because there was a day, I can’t remember which day it was, where the homework was go home, look at yourself in the mirror and practise saying large sums of money … About saying is that okay?

Richard Field: I think a lot of us are hoping, so your insurance is going to be £15,000. Is that okay? No. You just stop talking, and silence is again from, I think it was Chris’ course. It was don’t fill the gaps with extra speaking, so you’re going to make, I’m talking about making an investment in your teeth, so I’d never say I know this is a lot of money to pay for your teeth.

Richard Field: I’d say we’re going to be making an investment in your smile. This is, I know it’s a lot of money to invest in your teeth. It’s something you’re going to be having for a long time. It’s adding value, not apologising and knowing your worth, and again, I think that goes hand in hand with not making the patient’s problems your problems.

Richard Field: Don’t be apologetic for the fees that you’re charging, because you’ve done five years of dental school, you’ve done thousands upon thousands upon thousands of pounds worth of courses. You’ve got glasses around your neck, magnify. You’ve got loops around your neck that cost £4,000. You’re in a surgery that’s filled with tens of thousands of pounds worth of material.

Richard Field: You’re valuable and the patient’s there for your help. Don’t be sorry for charging it. It is difficult and it’s not something that you’ll get used to quickly, but for sure it’s just knowing your worth I would say.

Payman Langroud…: By the way, I’ve had the opposite situation as well. Once you get used to those high prices, then you go somewhere where the prices are lower, that feels strange as well.

Richard Field: Well, on that side, it’s also not good to get used to it, because I do find myself just looking at this as numbers and not this filling. And it’s just numbers, but you realise, actually, that’s a month’s wages for someone or that’s a holiday. That’s repairing the car that they might not …

Richard Field: We’re just looking at those. Well, my hourly rate isn’t, I should have charged more for that, because I’ve earned a little bit less on this, but you’re thinking do you know what? That filling is potentially someone’s week, that’s the food budget, so I think we shouldn’t get used to saying that much money. We shouldn’t just take it for granted.

Richard Field: We should respect it, because it’s money and it’s often huge amounts of money, but you’re there providing a service and you are worth that money, but you should never take it for granted.

Payman Langroud…: I like that. You’ve grown up in the era of GDC problems.

Richard Field: Yes.

Payman Langroud…: How much does that weigh on you? Again, when I was your age it was a thing, but it was nowhere near the biggest thing, and I think from the day you qualified until now it’s been maybe the biggest thing of all. How defensive are you? Expand on that.

Richard Field: I would say I’m very defensive, to the point where I’ve turned people away before we even started, because I don’t think that I can either meet their expectations or I just get a funny feeling from someone. I’ll almost, I don’t know if this is an actual sales tactic that people use, but I try …

Richard Field: It’s not a sales tactic, but I really want people to want the work. I’ll never sell anything to someone, and again, I know I keep mentioning Chris, but in every single consultation that I do I say, if you had a magic wand, would you change anything about your smile?

Richard Field: If they say no, then, even if I could see the world’s ugliest crown on their front tooth, I won’t mention it. I won’t dwell on it, because I don’t want someone to do something, because I want to do it. I want them to do something, I’ll say to them …

Richard Field: Well, someone says, “Is there anything that you’d do?” And I was like, “Well, there’s lots that we can do, but if it’s not the first thing you think of in the morning and the last thing you think of before you go to bed then you’ll never be happy, because you don’t want to make the change.”

Richard Field: If you come in one day and say, “Right, I want to do X,” then absolutely I’ll do that for you, but I would rather someone ask me to do something and really want it, than give someone a £20,000 treatment plan and they do it, because they think it’s the right thing.

Richard Field: I obviously ask your question, are you happy with the colour of your teeth? Because nine times out of 10 someone will come in and say they want whiter teeth, and tell you that. I think that’s a very soft, nice approach in dentistry, but if someone just comes in and says what would you do?

Richard Field: Well, aesthetics is a very subjective thing, so what I think would look nice isn’t necessarily what you think would look nice. Is there anything that you’d change? If they say no, then move the conversation on.

Payman Langroud…: How much of your work is aesthetics and how much of it is functional? I know they go together, but-

Richard Field: You mean how much is general and how much is aesthetic?

Payman Langroud…: Well, do you do any wear cases, that sort of thing?

Richard Field: I’d say nowadays I do more bigger, I do more wear cases than I do simple bonding.

Payman Langroud…: Really?

Richard Field: I don’t do as much bonding I think, as people think I do. I don’t do as much bonding as people think I do. I’m happy doing general dentistry and one new big case a month I can work on, because I plan things more than I think I probably should, which is something I got from Ian Buckle. Again, after Chris’ course, Ian Buckle, the inclusion programme is the best thing that I’ve done, because I was turning away a lot of cases that I didn’t know how to treat. And then I think it was about maybe four years ago, I did Ian’s course. Three, four years ago. 2020’s disappeared. I can’t remember it.

Richard Field: I think about four years going Ian’s course, and it taught me how to approach the bigger wear cases. It taught me how to plan things and now I do a lot of my own … I don’t do my aesthetic works up, so I make that very clear. I don’t [inaudible] and then I send that to my lab, for my lab. A lot of the time I’m using a guy in [inaudible] we do a lot of the big wear cases together. And how much of my work is cosmetic and how much is restorative?

Richard Field: I’d say about 50/50. We’ve got new people in the practise now, who are doing more of the day to day restorative work, so the plan is to move more single tooth dentistry onto the new sort of, and for me to free up time in my book to do more of the bigger cases, which is what I really enjoy doing. Working as part of a multidisciplinary team with orthodontists, with implantologist, with the [inaudible] because I think it’s the patient’s getting the best person for everything, the bigger multidisciplinary stuff.

Payman Langroud…: What aspect of it is what drives you? Some people love the planning part, some people love the-

Richard Field: I love the planning part, because it makes me feel safe, and like we say, I’m quite a defensive dentist. I want to make sure what we’re doing is right, and it’s explaining that to the patient. They might come in and say, “I want these two teeth fixed,” and we look at the planning and we can say, “We can fix these two teeth, but we need to fix these nine others as well,” or, “We need to move this here and move this there.” So again, maybe making things fit together, but I wouldn’t claim that I know inclusion.

Richard Field: I really find it satisfying to see things fit together. To see how this tooth will change this tooth, and how sometimes, even though we’re looking at this tooth, we need to involve other aspects of the mouth as well. I find that quite satisfying, when you put the needs together, and all the blue and red dots are in the right place. I find that quite satisfying.

Payman Langroud…: Would you say on the day of the fit you’ve done all that planning, that you know it’s all going to be fine, or is there stress? Listening to you now, sounds like you’re very stressed the day of the fit, right?

Richard Field: The day of the fit’s the worst day in the world. Fit days, go home and have a few gin and tonics after, and just be glad it’s over. I enjoy the planning, I enjoy the preparation, the impressions. I’m glad when fit day is over, but it is very satisfying. Fit day’s the worst day.

Payman Langroud…: Listen, bud, I remember back in the day, I don’t know how many years I’m talking about, maybe seven, eight years ago, maybe a bit after, but you were the original social media dentist that I remember. You were the first one to have your own logo, and I remember you getting quite a lot of chip for it. I remember you getting attacked quite a lot for it. Maybe because you were the first and it wasn’t a thing, right? Then you withdrew from social media quite a lot. Tell me about it, first of all.

Richard Field: I think social media is something that I think is really important to talk about, so I was the first one with a logo. My friend at uni, Ben, he made me a logo as part of his university course, so he used the same one today. Had a logo. I put stuff on Facebook, when Facebook was still a thing, and people commented, and not always for the best.

Richard Field: You’d have to build quite a thick skin quite early, and there was a couple of things that happened a few years later, that I don’t really want to massively get into, but it really left a sour taste in my mouth. I was like I don’t need that in my life, and maybe to my detriment and not by having fully embraced it again ever.

Richard Field: I know there are people that’ve built their businesses on Instagram who have filled their books up months in advance from Instagram, years in advance. There’s people that have no other marketing, other than Instagram, so I think it is fantastic, but it’s also quite dangerous. Not only for dentists, but potentially for patients as well, especially the younger ones wanting Instagram smiles.

Richard Field: To put that in perspective, I have a very secret, and I’m not going to tell you what it is, I have a secret pizza Instagram where I post all my pizzas that I make in my home oven, and I sent a picture of my smile from that Instagram to a dentist. I have a small gap in my upper right lateral [inaudible] and I said what do I need for a nice smile? The answer was 20 zirconia crowns, so-

Payman Langroud…: Was this dentist in Turkey?

Richard Field: It might have been, but the reply I got was 20 zirconia crowns, and I was like okay. Some dentists have asked me about bonding and he said no, that won’t work. Crowns is better. It’ll be £3,000. 20 units, you’ll have two appointments and it’s time to go to pictures, and it looked from a layperson’s really good, and that’s what we’re up against.

Richard Field: We’re up against dentists and the general public, who doesn’t know anything about dentistry. Sees the nice smile for a nice price and it’s very difficult to compete with, and on the flip side in the UK there’s a lot of, I have to be very careful what I say.

Richard Field: It’s a lot of makeovers with composite, and I love composite. I think it’s fantastic, but I don’t think what these patients are being told is the maintenance longterm, so you’re seeing a lot of people with big composite smiles on virgin teeth. Very young. Not knowing the maintenance for the future, and I’ve already had a couple in.

Richard Field: You’ve had these full mouth composite veneers done for a very small amount of money. They’ve already started to fail and can’t afford to fix it, and I’m not saying this is every dentist. There are dentists out there doing phenomenal work with composite that will last years and years, and years and years, but there’s also a lot there that aren’t. And I think we’ll be in a very interesting position in three or four year’s time, when all these influencers or young people who want influencer teeth need it all redone, and I wonder who’s going to do it.

Payman Langroud…: It’s definitely an issue, although I don’t know how you knew that people aren’t telling people. You’ve spoken to these patients, but you can’t always trust patients about that. I understand where you’re coming from. Sometimes a trend picks up and it has its own legs, and then I had Shaadi Manouchehri on the podcast, and she was talking about TikTok. She’s massive on TikTok, and-

Richard Field: I know nothing.

Payman Langroud…: Well, yes. So just to think, on TikTok, the things that trend are they have juicy headlines and something really, like the Turkey thing’s trended on TikTok. People going to Turkey and having their teeth done, and it is problematic with composite, because it can go very wrong very quick if it’s not done very well. The problem’s amplified, don’t they? It’s a tiny little scratch in the composite ends up as a big stain later on, so I do agree with you on that.

Richard Field: I think what Instagram’s done is they’ve taken the medical aspect away from dentistry, and it’s more of a beauty treatment. Say people have their hair done, have their nails done, have their teeth done, and I think it is important that the patients understand that what they’re having done, it might be a little it invasive, but it’s not reversible. I think that’s the side of it, which broadcast or understood.

Payman Langroud…: Yes, especially the no drilling, no injection, that thing, makes it sound like it’s just nothing, and that’s something that a lot of people use for their marketing, don’t they? Tell me about Elleven Dental. One of the most beautiful practises I’ve ever been to, but you’ve worked in all the most beautiful practises. One of the most beautiful practises I’ve ever been to.

Richard Field: I have worked in a room once, with no windows. That was-

Payman Langroud…: What was that, Tif’s place?

Richard Field: [inaudible]

Payman Langroud…: Tell me about the patients you get in Elleven Dental, for instance. Who are they? What’s the patient profile?

Richard Field: To be honest, I think that’s a really interesting question. I find the patients that I treated at Harley Street Smile Dental Studio and Elleven easier to treat than, for example, the patients I treated in Clapham when I was at Ten Dental.

Richard Field: I think the difference is the patients in Harley Street and the patients at Elleven, they are from a better off background, so they’re not saving up to come and see you. And I think when the patient saves up to come and see you there’s a feeling of ownership from the patient. They own you. They’ve paid for your house, they’ve paid for your car.

Richard Field: They’re giving you all of their money and investing everything. They’ve taken out loans and they’ve done this, and I think that’s a very unnerving position to work in, whereas the patients in Elleven Dental or in Harley Street, they’re coming to you, because they want the best or what they perceive is the best.

Richard Field: They’re not going to be financially broken from paying for it, and it’s a lot, it’s a more … I find it actually a more relaxed way of working, because, although, of course, they’re paying a lot of money and you want to do the best job for them possible, but treating the patients that have saved up or taken out loans. I find that really stressful, because their expectations of you are, it’s like they’ve put everything on you, everything on that.

Payman Langroud…: That’s interesting. How about Bristol? How does Bristol … You made the move to Bristol, when was it? A couple of years ago.

Richard Field: End of 2016.

Payman Langroud…: I bet the Bristol patients are easier than all of these.

Richard Field: It’s a real mix, actually.

Payman Langroud…: Is it?

Richard Field: I would say it’s a mix between 11 and 10, Clapham and Harley Street. You’ve got your general dentistry, and then you’ve got your people who’ve moved out of London for whatever reason, or retire to the country, so it’s a complete mix. You can’t judge anyone. Well, you can’t judge anyone at any practise really, so you have no idea who’s going to walk through the door, and especially, because everyone sounds like a pirate in Bristol. It’s very difficult to judge, but it’s a real mix, and we get people who travel. A lot of London patients aren’t London patients. A lot of London patients don’t live in London, a lot of Bristol patients don’t live in Bristol, so it’s a real mixed bag.

Payman Langroud…: Alfonso has several practises, right? So-

Richard Field: I can’t keep up, really.

Payman Langroud…: Yes, so as far as your autonomy in that practise, is he there enough for you to have to talk to him about what you do, or does he just leave you to it?

Richard Field: Well, we do a lot of cases together. He was, up until a few months ago, in the room above me three days a week, but he’s just opened a clinic in the building directly opposite our practise. He’s now there, so it’s a bit more difficult to pin him down, but-

Payman Langroud…: Is he as much fun to work for as it looks? It just looks like every minute is fun with him.

Richard Field: Always, it’s better if the patients don’t go to get the water from the fridge, because there’s always bottles of beer or Prosecco [inaudible] after work or to a party, so no, he’s really good. He’s a lot of fun, for sure. It’s one of the more you feel part of the decisions, rather than an employee, which is nice. He’s very into the team aspect and he’s very into the dentistry, which is rare from someone who owns multiple practises. His main thing is the dentistry. It was one of my attractions to going to work there.

Payman Langroud…: Why did you move to Bristol? Was it [Mena]?

Richard Field: Actually, it was quality of … I’d only been to Bristol once, actually. I met Alfonso at the BAAD, and he just said in passing, “You’re Richard. I’ve seen your stuff. Come work for me in Bristol,” and I was drunk, and I took his card and I said do you know what? This guy seems nice. I’ll give him a call, and I gave him a call and we spoke, and I ended up doing some work experience, some shadowing for a couple of days, and then Mena came through and we stayed over in Bristol.

Richard Field: She went to university here, and I saw Bristol, and then there was a time when I was only really working two and a half days a week, so I had a lot of free time. And I ended up having a deal with Alfonso where for six months I’d go through on a Thursday and a Friday and I’d work there, and if after six months I didn’t like it then we shook hands and I walked away, or if I liked it then I’d have to do more days, which were moving through, so I did the six months.

Richard Field: Loved it, moved through and reversed my commute to Elleven, so instead of commuting from London to Bristol I just reversed the move and commuted to London when I needed to. I remember the first night I got home from work in Bristol, and it was half past six and we had dinner, and it was eight o’clock and we’re like what do we now?

Richard Field: In London, you get home, you have dinner. It’s half past nine, ten o’clock you go to bed, so we got home and we’re like, well, what do we now? We didn’t have a TV at this point, because we just moved in. We ended up going to Asda and doing our shopping at 11 o’clock at night. If I want to walk to work. Takes me 20 minutes. On days where I’m feeling especially lazy, the Italian practise has got Vespas. Vespa to work takes me six minutes, so very different quality of life. It’s much easier to have a work life balance.

Payman Langroud…: Yes, it’s a fantastic town.

Richard Field: I love London. I wouldn’t do anything differently. I’d still do everything the same, but I think there comes to a point where, unless you love the London lifestyle, it’s time to leave, and I was getting to that point.

Payman Langroud…: Now, when you come to London, you stay in an Airbnb.

Richard Field: Pre COVID, yes. I did, and I loved it, because I got to meet friends for dinner, I got a good night’s sleep. Yes, it was great. Now, at the moment, I’m going there and back each day, which is hard, but it’s not an issue, but I’m hoping that once, if COVID dies down, I can get back to staying over, but yes I was Airbnb-ing. It was nice, catching up with people in the evenings and going for a Chinese, and ordering by sections of menu with you.

Payman Langroud…: I’m a massive, massive customer of that Chinese. I went through a phase of ordering it every day for delivery in my office, because my office is actually very close to that. I was looking on Deliveroo and it was 1.3 miles. I was like wow. I was going through the menu, because one of my buddies who I go with, he’s Muslim, so I could never order pork. As you know, the Chinese are huge on pork, so I was just going through the whole pork part, but you are my food don, buddy. I want to get a question regarding the stakes. Have you read Black Box Thinking?

Richard Field: No.

Payman Langroud…: It’s about plane crashes. A plane crashes, they don’t look at who’s at fault. They look at the black box, and the whole point of it is how do we stop this ever happening again? He actually does switch it into medical and says, “In medicine we’re always looking for blame, and for that reason everyone’s hiding their mistakes,” so on this podcast, the idea of trying to learn from each other’s mistakes. What have been some of yours?

Richard Field: I got my big mistake out the way in I think third or fourth year. I think it was third year of dental school. It was one of my first posterior composites, and I tried to use a Sof-Lex disc on the back molar and I got it stuck inside the cheek of the patient, so you imagine putting the disc, and then imagine that getting wrapped up in-

Payman Langroud…: Mustn’t laugh.

Richard Field: Calling the tutor over to-

Payman Langroud…: What do you mean you couldn’t get it out?

Richard Field: No, it was completely wrapped up inside the person’s cheek-

Payman Langroud…: Oh, wrapped.

Richard Field: Yes. I had to detach them on drill. I had to unwind it. Patient needed-

Payman Langroud…: Oh my goodness.

Richard Field: You only do that once, for sure.

Payman Langroud…: That’s a goodie. I love that one.

Richard Field: That was a good one. The only, this is one for the rubber dam uses, if you sandblast make sure you wipe your rubber dam completely clean of the powder, because once you’ve got bond in that tooth, if you knock the rubber dam and the powder goes in the bond, you’re not getting that back out.

Payman Langroud…: Very good point.

Richard Field: You only do that once, and you only glue veneers together. Only do that once-

Payman Langroud…: What do you mean? You mean you didn’t clear in between the teeth?

Richard Field: Yes. When you cemented a case and your teeth are stuck together, or if you’re stuck. You only do that once. A lot of things you only do once.

Payman Langroud…: That’s a good one too.

Richard Field: Normal stuff.

Payman Langroud…: I like that, so Prav isn’t here, but Prav always ends it with the same question, unless you aren’t a listener to this podcast. The question is you’re sitting on your deathbed. You’ve got the five or 10 people who are closest to you, around you, hopefully some kids. I should have asked you about kids, but hopefully some kids and all that by that time. What are three pieces of advice that you’d leave the world with, or your closest people with?

Richard Field: I’d say set yourself goals, no matter how outlandish you think they are, because you might be surprised yourself. It gives you something to work towards.

Payman Langroud…: Did you set yourself the goal of becoming the youngest ever person to be accredited by the BACD?

Richard Field: Goal thing’s quite funny for me, because I set myself youngest, I wanted to be accredited before 30. I wanted to work in private practise full-time, and it was weird, because I hit all of my goals really soon, really early. I think it’s something Tom said, and it leaves you in this really weird limbo, where you don’t really know what to do.

Richard Field: I was in private practise within a year of graduating, and I got my accreditation a month before, on my 30th birthday. And then 30 was really weird for me, because I was in private practise, I had a flat, I was accredited. I didn’t really know what else to do, so then I was just like, well, my goal is for the next few years I’m not going to have any goals. Like you didn’t set an alarm clock for a year I think-

Payman Langroud…: Yes.

Richard Field: It was just nice to just focus on the dentistry, and I didn’t do any courses and I didn’t really go to any conferences, and I just focused on the work and life, which was what was going to be my last bit of advice. There’s more to life than teeth. There’s more to life than whatever job you are, and I think lockdown or COVID’s definitely helped with that. We’ve all had to wait, three, four months where we weren’t working, so set of goals. There’s more to life than teeth or work.

Payman Langroud…: You became a cook extraordinaire, you told me.

Richard Field: Yes. Do you know what? It was terrible, but it did have its good things.

Payman Langroud…: Definitely.

Richard Field: I’ve always loved cooking and it gave me a chance to experiment, which was good fun. My last bit right now I suppose would be don’t compare yourself to others, because you never know the full story, and don’t care too much about what other people think of you.

Payman Langroud…: Definitely. I like that. What are you plans for the future buddy?

Richard Field: Spend more time with my god. I think it goes back to the goal thing. I’m quite content at the moment. I don’t want to want to practise ever.

Payman Langroud…: Really?

Richard Field: Ever, no. Never ever. I can’t think of anything worse.

Payman Langroud…: I would have thought, the kind of control freak that you are, that-

Richard Field: On the dentistry, so I couldn’t deal with everything else. I’m in my surgery. It’s my safe space. I know where everything is, I know where everything’s going, I know I can do good work and I don’t want to have to think about the admin, I don’t want to think about the politics. I don’t want to have to think about anything. I just want to do the work. Want to go home and I want to spend time with my dog, and make pizza.

Payman Langroud…: Yes, so I’m still yet to taste this pizza, and I will be getting the name of that account from you after the podcast. Well, it’s been a pleasure to have you buddy. It’s been a pleasure to have you, and hopefully, when COVID gets a bit better, we can get back to dinners and all the things that we used to do, but it’s been lovely. Thanks a lot for taking the time to do this.

Richard Field: Thanks for having me.

Payman Langroud…: Of course.

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 Solanki: 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 got some value out of it.

Payman Langroud…: 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.

Prav Solanki: And don’t forget our six star rating.

This week we welcome one of the most prominent names in restorative dentistry and prosthetic dentistry, Dr Basil Mizrahi.

Basil talks about the differences between dentistry in the UK, US and native South Africa, and tells us how building extraordinary interpersonal relationships with patients has helped him maintain a reputation as one of the profession’s most thorough and exacting practitioners.

Basil also lets us in on his lecturing with the Eastman Institute and namedrops some the inspirational teachers and mentors who have helped shape his stellar career.    

Enjoy!

 

“You’re going to hate me halfway through treatment, you’re going to be cursing…You’re going to wish you’d never come here. I’m going to get you out at the end, and you’re going to love it.” – Basil Mizrahi

In This Episode

00.48 – A day in the life
02.27 – Early years and backstory
12.18 – On Gerry Chiche
13.22 – US Vs UK and SA
19.07 – Day-to-day
24.37 – Black box thinking
26.41 – Patient journey
45.39 – Early adoption Vs traditional WoW
50.45 – Perfectionism
58.57 – Training and mentors
01.14.45 – What most dentists don’t know
01.18.43 – Best bits
01.20.09 – Last day and legacy

About Basil Mizrahi

Dr Basil Mizrahi is a specialist in restorative dentistry and prosthodontics and widely recognised as one of the field’s most eminent practitioners.

Basil is an honorary clinical lecturer with the Eastman Dental Institute and one of only a few UK dentists to become a Diplomate of the American Board of Prosthodontics. 

 

Basil: Because in the beginning, when you’re starting out, you have a big room of patients and you’re doing everything, just to get patients and to start earning money. Gradually, when I look back now or look at my practise now, you ask me, it’s I would say 99% referral, 99% for me, crown, and bridge, and implants, which is what I like. So you just end up honing your practise, being able to spend more time on less patients, doing the kind of work you want to do.

Intro Voice: This is Dental Leaders, the podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Payman: One of the nicest things about my job is that I sometimes get to meet some of the top people in our profession. And today we’ve got one of the top prosthodontists in the world, Dr. Basil Mizrahi on the show. Basil is in private practise in the West End in London. He has a teaching facility there also. They do many courses, which we’ll get to. And also teaches at the Eastman Hospital as well. Basil, the point of this podcast is to try and get to the person behind sort of the persona. So really first thing is, it’s a Friday, what’s your normal Friday like? What time do you wake up? What do you do?

Basil: Well firstly, thanks for inviting me onto the podcast. Thanks for the kind words, very kind indeed. Fridays generally, I tend to take off. If I’m not teaching, it tends to be my day off. So that’s the day I like to get up at about 7:30, do some gym. This morning, I’ve just been for a run, always like to do a little bit of exercise first and then relax. Inevitably I’ll do a little bit of work. I’ll meet some friends at the coffee shop across the road, we’ve got like a traditional hangout there we go. These days we can’t do it, so we end up grabbing a takeaway and going for a walk. But in the better times, I used to go across the road, just have a coffee, do a little bit of computer work. Can’t really remember, I guess in the last year now it’s been sort of just [crosstalk] put there going for walks. Yeah, so Fridays would be my day off. Although, I say that, but often, well I haven’t been doing teaching for a while. But that’s generally when I’ll do my courses.

Payman: Mm-hmm (affirmative), mm-hmm (affirmative) and take me back to, you grew up in South Africa. Take me back to what it was like growing up in South Africa, and your decision to move, what was it based on?

Basil: So I was fortunate to have a very nice upbringing. It’s myself and my sister, who’s also a dentist, and my father is an orthodontist, and my uncle is a periodontist. So I guess it’s in the genes. But yeah, I grew up in South Africa, we had a lovely upbringing, and a privileged upbringing. At the time, you do live in a little bit of a bubble, not an excuse, but you sort of don’t really know what’s going on around you. And you just enjoy the upbringing, so the climate was amazing. We lived in a lovely house, with a nice big garden. We’d wake up every morning not to weather like this where it’s dull and grey. If it was dull and grey in South Africa, that was a surprise. The sun was out every day, that was normal. But dull and grey, you got a surprise.

Basil: Here it’s the opposite. Dull and grey and if you see the sun is out. So it was a lovely place to grow up. I did all my schooling there. I was actually born in Manchester. So I’m actually, I was born here when my father came over in 1965 to specialise, to do orthodontics in Manchester, I was born. He did his, I think it was a year or two years in those days, and then I was born. And then he went back to South Africa. So I don’t remember anything, but I was actually born in Manchester. I went back and grew up in South Africa. Did my schooling, my dentistry there at University of Witwatersrand. We had a great education at dental school. I didn’t really excel at dental school. I would say I was probably in the middle half, definitely not the top half, definitely not the bottom half. So let’s call it the middle third.

Basil: And even at school, my results, I mean in those days was a different grading system, but it definitely wasn’t near the top of the class, I’d probably say again, middle third. So I never really excelled. I would say I excelled after the formal education part, which is often the case. I see it in many of my classmates now, who’ve done well all over the world. And I remember them from dental school. You would never have thought they were going to be sort of leaders in their fields. But it just shows, obviously the guys that did well at dental school and have been successful. But there were just as many who didn’t excel at dental school, but seemed to find their little niche afterwards. So I did my dentistry in South Africa, then I worked actually, almost like in an NHS kind of practise for a year.

Basil: And then I joined a prosthodontist in a nice private practise and he took me under his wing. That’s where I think I got switched on. And actually, in the Army, we had compulsory conscription, so I did 18 months in the Army. And I hate to say it, but that was probably my best learning experience because we had cart blanche to do whatever we wanted. So there were times, I’d read an article in a dental journal, I can still remember, about sort of periodontal surgery to raise a gummy smile. And I thought, “Oh, this looks good.” And then I’d be in the Army the next week and the next guy that came in, he had a little bit of a gummy smile, I had the article behind him, and I was sort of reading it as we were going along. So we got really amazing experience because money wasn’t an issue and you could take your time. And that’s probably where I got switched on and working in the practise with the prosthodontist.

Payman: What about the apartheid situation? As a kid, would you say that you just accepted it because that’s what it was, you didn’t understand anything else, or when did you wake up to that, or did you always understand what was going on?

Basil: No, if I’m honest, I don’t think I always understood as a youngster. I think I woke up to probably the latter years of school, when you get to 14, 15, and definitely university. Universities are hotbeds for politics. So that’s where you really sort of get switched on and you see the heated debate and you start realising. I mean, I can’t say I was a political activist, so I was probably pretty passive or sort of closed myself off to it. So I mean, I had friends who were really active, and took a much more active role in the sort of anti-apartheid. I probably wasn’t one of those. I’ve never really been an activist in any, whether it’s dentistry or anything. I’m more of a sort of just sit back on the sidelines kind of a guy.

Basil: But I’d say I got switched on, yeah, in latter years of school and university. And then as you get older, and especially when you come out of the system, when I left South Africa. When I left South Africa, I was probably 26. I was pretty mature and 27. But you leave it and then you start mixing with people who look at South Africa and say, “Well, Basil, how could you have been part of this? Didn’t you realise what was going on at the time?” And then you start sort of looking back and you look at the TV documentaries and you realise what you were involved in. But at the time, it’s not an excuse, but to be honest, I wasn’t really involved with it. And I actually say, I left I still think relatively young, but probably security, longterm security was an issue. But I can’t say I left for conscientious objection reasons, I had-

Payman: What was your primary motivator for leaving the country? I mean, you grew up in this beautiful place, you have these established family connections and so forth. Why not just stay in South Africa as a place to live?

Basil: I would say my primary reason was education. I worked for this prosthodontist, who was America trained. He’d trained at Boston University, which in the ’70s was sort of the golden temple for prosthodontics. And I just saw the way he practised and so it was for educational reasons. I just wanted to go to America and do prosthodontics. And that’s probably where I saw. So that was the primary issue, and probably to get out of South Africa, just because of the-

Payman: See the big wide world?

Basil: Yeah, see the big wide world and yeah. It was a way to get out, but I think the primary objective was education. But saying that, I knew I wasn’t going to come back to South Africa. So even going to The States. I didn’t know whether I’d stay in The States, or where I’d end up. But I knew I wasn’t going to come back to South Africa. So there was the sort of just wanting to get out of South Africa for the security and that.

Payman: And do you visit now?

Basil: Yeah, go back probably, my wife’s family is all still in South Africa. So not lately, but we probably go back every year, December. Yeah, so they live amazing lives. It’s a lovely country and I-

Payman: It’s an amazing place.

Basil: My kids are there. It’s a lovely place.

Payman: So then the decision to go to, you went LSU?

Basil: Yeah, New Orleans.

Payman: Yeah, so you targeted LSU because Gerard Chiche was there. Who told you to go there?

Basil: To be honest, not really. I didn’t know anything about Gerard Chiche and I often say to young guys asking me, they say, “Well, Basil, where should we go in America? What’s the best dental school?” Because New Orleans was in the middle of nowhere. I mean, it’s a fun place and I’d recommend visiting for a weekend, and I spent three years there. And to be honest, it was the place I got in. There was a South African guy in charge, and in this world it’s often not what you know, it’s who you know. So he was a sort of connection, I went for an interview, and I got in. I would say the same to anybody looking to specialise. It’s not so much the place you go. So just go where you can get in, go where you kind of… That was the other thing, it wasn’t a private school.

Basil: I could have gone to Penn, or UCLA, but there you’re paying like, I don’t know what it is now, it was like $40,000 a year. So New Orleans was what they call state school, so the cost was low. It’s a cheap place to live, so I just went where I could get in. And then when I was there, I heard about this Gerard Chiche guy. I mean, I was a dentist from South Africa. So I didn’t know about him and then I realised how fortunate I was to be with him. But even today, I would say go where you can get in and we’re going to get out what you put in. So whether it’s Guy’s, Eastman, Kings, Manchester, or whatever, decide where you want to go and you’ll get out, it’s like a driving licence. You get that piece of paper and then afterwards you do what, that’s just stuff. So I didn’t go there because it was the top place. It happened-

Payman: Interesting. And the experience, that three year experience, did it involve some research, as well as just traditional teaching?

Basil: You had to do a little bit of research. My research, I did a master’s in education, instead of an actual dental research project. I’ve done my master’s in dentistry in South Africa, did some bonding study when I was in South Africa as part of a sort of a master’s in perio. So I’d done my dental research. So in America they gave us the opportunity to do a sort of, a master’s, but in education. So we tagged onto sort of the New Orleans non dental school and I did a master’s in education, which actually turned out to help. Does it help me? I don’t know, it’s a nice degree to have. Practically, I learned about America history. But it’s one of those things, we had to do it pretty much, didn’t have the choice. I did it and it’s stood me in good stead.

Payman: What was the great man like? What is he like? I’ve never met him.

Basil: Gerry Chiche, amazing guy. So humble, amazing clinician, good educator, and you can relate to him on a one-to-one basis. He’s friendly. Yeah, I would say he’s definitely one of sort of main influencing factors in my life. He’s a lovely human being, he doesn’t have a huge ego. Yeah, so yeah-

Payman: Excellent because I remember when I disqualified, I was a little bit sort of, I don’t know, disillusioned with VT practise and my boss, Nick Mahindra. He said to me, “Look, go to the BVA library and pick up some books on something you enjoy.” And I said, “Oh, I want to be a cosmetic dentist.” And I happened to pick up his book, and it changed the way I looked at everything. So he’s been a massive influence on my career, but I’ve never met him. The red one, what’s it called? Aesthetics of the Anterior Fixed-

Basil: Fixed Prosthodontics.

Payman: There you go. There you go.

Basil: Yeah, it’s a great book.

Payman: So now you’ve been exposed to the system in South Africa, the US, and now the UK, and you lecture all over the world I’m sure. How would you say we rank here, from the quality of dentists that the country produces, number one, and then the quality of dentist that the dentists become within the system? Because definitely before, I think we didn’t rank anywhere near the top. But for me, I see sort of green shoots of excellence coming through. But I see people who’ve qualified at WITS for instance. I mean, maybe they’re just the ones who come here. But all of them are just superb. So how would you rank us? Where are we?

Basil: Difficult to rank. I can see the results, I haven’t been involved in UK education system. I know we had a great education at WITS, it was very practical in those days, I’m talking what’s it? 25 years ago. I don’t know what it’s like these days. All I know is the South African guys have done very well all over the world. We had an amazing… I think because also, we had so many patients. We had a huge pool of patients to get practical experience on. I mean, we used to come and do extractions and surgery. I remember, we’d arrive Monday morning and there was a queue of about 20, 30 patients we each had to get through in three hours, extracting teeth. And then when you wanted to do perio surgery, you had old cohorts.

Basil: And dentistry, I’ve always said, is a practical profession, so you have to get your hands wet. So from a practical point of view, we had a very strong course because of the patients. Dentistry as a whole, would I say it’s better in the UK, or the USA, or South Africa? I’m fortunate that I think I’ve got both sides of the pond as they say. So America I would say is pretty aggressive. I mean, I came back from my pros programme and you’re looking to cut, you didn’t blink twice. Okay, you’ve been in a prosthodontics programme, so they push you to be a little bit proactive. They call it MRB, maximum resident benefit because if you were prepping teeth for something that you knew may not, they’d say, “Well, don’t worry, Basil, it’s MRB, maximum.”

Basil: So you will get guys coming in, full mouth rehabs. So I would say you come back from The States pretty aggressive, that most things become crowns. When I came over to the UK, then you pick up the European and the UK perspective, which is probably a lot more conservative, more biomechanical approach, more almost thinking. And that took me back a little bit. I think I’ve got a nice balance in the middle. I would say for aesthetics, The States, obviously they got their specific kind of aesthetics.

Basil: But they’re very aesthetically conscious, for better or worse. So they’ll do a lot more veneers and crowns there than we would here. For probably thinking man’s reconstructions, probably the European approach, adhesive bridges they use here. So it’s a lot more I think thought based here. I say here, I’m talking about Europe as well. UK, I find a little bit, I’m not sure why, maybe the NHS system. But there’s a lot of, look, there’s amazing dentistry, but you just see a lot… And I think it’s the system, that NHS just produces a lot of not great dentistry. I mean, I teach dentists all the time and the frustration is, how do we get to do good dentistry on the NHS. And it’s a hard balance to do.

Payman: Yeah. It’s funny because there’s a big portion of the workforce, who’s made it their job to understand the NHS regulations rather than anything else. And you have to because you’re in it. You have to understand what you can and can’t do. But it’s sad. But on the other side of it, I do see, I mean, you’re perfectly positioned to see this. I do see some hope in terms of, we do get some people coming out of here, who are actually nearing the top of the pile. We never had that before. I remember, the top teachers were always Italians, or it was one of those things. Now, I’m sure as a whole, Italy’s got its own problems as well. But I don’t know, the system here is, I’d agree with you. I’d say it probably is the NHS that’s caused that problem. So all right, going forward, how much of your time is spent actually practising being a dentist, and how much of your time is teaching?

Basil: Probably on a percentage basis, 75% practise and about 30% teaching. And I like that balance at the moment. I think probably as I get older the balance will gradually do less practise, more teaching. But at the moment, still my primary focus is the practise. And I think the two feed each other pretty well, which is good.

Payman: Sure, sure. And in the practise, how much of the work if by referral, and how much of it is by word of mouth referral

Basil: Referral, I’m not sure I think, I’m fortunate and pretty unique. I think it’s probably about 98, all referral pretty much, 99% referral, which is quite unique, I think for prosthodontic practise. Yeah, and even in The States. So I count myself very fortunate. Look, I’ve worked hard to do it. But it is pretty much I’d say 99% referral. I get the odd patient who gets referred by a friend. But most of it is by other dentists or other specialists, which is a nice way to practise.

Payman: Definitely, definitely. And then how far ahead are you booked for instance? What are day-to-day situations in a practise like yours? Do you get booked up way ahead, or no?

Basil: No. I don’t look to book up, as long as my week is pretty busy. And even if it’s not, I’ve never chased appointments or been worried about a book that’s quite empty because there’s always other stuff going on, whether it’s the teaching. So if you ask me, if you look at my book, you will get an appointment next week with me, as a new patient. I always try and get new patients in within a week or two. My appointments, a lot of them are very long, three, four hours, sometimes all day. Those take a little bit longer, but you wouldn’t have to wait. It’s not as I would say you got to wait three months to see me. I can start another big case in two, three weeks’ time. So I’m not chock-a-block. Sometimes you go through phases, but I feel a little bit uncomfortable, I always want a little bit of manoeuvring time. So about on average, two, three weeks.

Payman: And what’s the set up in the practise? You’ve got yourself, and associates?

Basil: Associates, so at the moment, I have two small practises, just got two surgeries. I’m there, I have an associate, Jurgita Sybaite, who’s lovely and an excellent dentist. I’m sure you’ve heard of her. She’s going to be one of the stars of the future that you talked about. She’s rising fast. So I love working with her. I have an orthodontist, Nazan Adali, who comes in once a week. And I have two hygienists, who do about two and a half days a week.

Payman: And so you take care of perio yourself?

Basil: No, I mean I’ve done a master’s in perio, I’m not a periodontist. But I like the elective perio and the surgery, but not disease. Disease I send to the periodontist. And if I’ve got a tricky crown lengthening, or some kind of connected tissue graft, I’ll use a periodontist as well. I do some myself, but not all. Perio disease, I don’t get involved. So it’s more the elective perio.

Payman: And endo?

Basil: No endo. Endo I refer out. Also, no endo.

Payman: And what about the, I know you do a lot of implants, but do you do the hardcore grafting part yourself?

Basil: No, I’ll do a sinus lift, but no. If there’s big, major like I don’t do the teeth in a day kind of thing. I don’t advanced lateral window sinus lifts. I keep it within what I know and what I’ve sort of honed my skills at. Every now and again I may dabble, but I know my limitations. I think that’s important, to know your limitations and use the people out there who are better than you for those specific things.

Payman: But kind of in a way, you’re kind of the end of the line, as far as the prosthetics referral goes, right? I mean-

Basil: Yeah.

Payman: Do you feel the weight of that sometimes, or is that not the case? I mean, you’ve got nowhere to send someone, right?

Basil: Yeah. It’s funny, I use that expression. I just say to the patients when they come in, “Well be glad you got here because somehow you got here because I pretty much am the last stop saloon.” So I’ve created that niche for me. So it comes with a weight of responsibility. But it’s just different stresses than other dentists. We all got our own kind of stress, so I enjoy that.

Basil: I like to think, and I’ll often say it, if I can’t do this, I don’t think, unless it’s something specific like a sinus graft, but if it’s broken down dentation, then I sort of like to think if I can’t do it here, I often say to the patients, “I think this is the best place you’ll get it done, I don’t think you’ll get it better. You’ll get it a lot cheaper anywhere else, but not necessarily better. So yeah, I build my practise on being the last stop saloon and maybe that’s why the referrals, I don’t need that many referrals. I mean, I’m always grateful for them, so keep sending them. But a complex case can keep me busy for a long time.

Payman: How often do you hit a situation where you just don’t know what to do next? I mean…

Basil: I suppose my limit, if they’ve got teeth I’m pretty comfortable, most of their teeth and some spaces. Dentures, I’m not a huge expert in removal, so that would be sort of a-

Payman: But I mean within your own scope, how often hit a situation? I mean look, you must be being referred quite some complex situations. Am I seeing it in the wrong way. I mean, explain it to me.

Basil: Yeah, I mean, unless there’s sort of major surgery or after a trauma or something, then I’m not the right person, maxillofacial. But don’t forget working in the private environments, not the hospital realm, so I am seeing relatively, I’m not seeing anything that’s crazy out there, or trauma. They would end up probably in a hospital, in a multidisciplinary environment, that kind of thing. So I mean I’m not saying I can handle it all, I work with a lot of specialists, so they’ll often look at a case and go this is beyond me doing it myself and I will get in a orthodontist, a periodontist, oral surgeon. But I think as the conductor…

Payman: You got it down.

Basil: Yeah. Yeah and I have to think-

Payman: Maybe this is a good time to segue into our portion of the show where we ask about errors. So we ask everyone this and it’s kind of like a black box thinking idea. Have you read that book, Black Box Thinking?

Basil: No.

Payman: It’s about plane crashes. When a plane crashes they don’t say, “Whose fault was it?” They say, “All right, how do we make sure this never happens again?” And they bring out all the facts and try and figure out what it was. And then he actually segues into medical. And he says, “In medical, it’s the exact opposite, where they hide the facts, and everyone’s worried about the blame part of it. And the system’s looking for blame.” So just to counteract that culture, we’re asking everyone and it would be nice to hear Basil Mizrahi’s made a few mistakes.

Basil: Well, there’s always mistakes and there’s always room for improvement, some gross ones. A while back I was pretty much cementing, this is after two years of a case, we’re getting right to the end, my technician’s flown over, we’ve got a full arch going in with individual crowns, probably doing two at a time the cement mix. And I cement the damn, and I mix the two premolars up, so upper right, and upper left somehow. You’d think, well how did it even seep? I don’t know if I was rushing or panicking, there was a lot going on, seated.

Basil: By the time I clicked, or I saw it hadn’t gone down properly, we were working with Fuji PLUS or something, so it was pretty quick. I was pulling it, pulled off and the tooth fractured with the tooth. So then we had to do endo, post and core, new crown. So, that one will stick in my mind. And then recently, implants and then extraction, upper six, close to the sinus, you know what I’m going to say. Dropped it in the sinus. Thank God, oral surgeon colleague, thank Jonathan Collier. And I referred, and he managed to get it out, no problem and put another implant in.

Payman: That works. That works for me. Tell me about the patient journey, Basil. I’m a patient, I get referred by, I guess, what’s the model? A call’s delegate is a referee, the guy who refers. I get referred by this guy, and what’s the first thing that happens? I want to hear about the patient journey. Your examination, how long does it take?

Basil: Yeah, so the examination, you come in, the first appointment’s normally an hour. And a lot of that is talking and getting to know the patient. So I’ll sit down with a notepad for about 10 minutes, just talking to the patient. And then often what I’ll do, and this was told to me by Michael Weiss, another mentor of mine. I’ll take out my Dictaphone once I’ve listened to the patient and I’ll actually record in front of the patient for my secretary, the patient’s complaints, their history. So the patient’s nodding like you’re doing, no, and saying to me yes. And stopping and saying no, it wasn’t. I actually had that for three years. So the patient’s listening to what I’ve heard.

Basil: And then I look, I do an examination. First visit I don’t too much. I get an idea of what’s going on in the mouth. I always take photographs, I think a picture’s worth a thousand words. So I’ll take some photographs and my nurse will get them up on the screen at the appointment. I may take a couple of x-rays just for myself, [inaudible] of that. I generally don’t take models, but the photographs for me. And then I’ll sit with a patient, looking at the photographs. They’ll stand up with me and come over to the screen and we’ll talk. And I’ll show them on the photograph, my thoughts, my initial thoughts. If it’s a relatively complex case, I need to get across to them, that it is quite complex.

Basil: I have to change their perception that it’s what they’re used to, when they go to the dentist, they have a few appointments and their problem’s solved. And often they’ll come to me like that, even though they’re referred, they don’t understand, or they haven’t seen the way I work and sort of want to look at the whole mouth if there’s an underlying cause. So I may need to get across, well, we do have to open up your bite, I can’t just fix that one tooth because you see how you’re smashing. So there’s a lot of trying to get into their mind and just change the way that they’re seeing it one little problem, if there is a bigger, underlying cause.

Basil: And that I do with photographs, maybe some models, and trying to relate to them. Most patients I can get through to, other patients, you sort of realise they’re just not the right fit or they’re not taking it on board. And that may be a patient that’s not suitable for me because I also try and get to the patient across that they’re asking me for the treatment. They need to be wanting it from me. It’s the opposite of me trying to sell it to them. And I stress that back to, I said, “You’re going to hate me halfway through treatment, you’re going to be cursing. But you’re going to start a treatment.

Basil: You’re going to wish you’d never come here. I’m going to get you out at the end, and you’re going to love it. But I just know from experience, you really have to be up for this. It’s a huge commitment to time, to effort, to money.” So I almost try and talk them out of it and if they’re understanding and they see the problems. And I say, “But if you don’t do it, these are some issues.” And I say, “Have a second opinion. You’re going to get a lot easier, you’re going to get it a lot cheaper anywhere else than here, okay. I don’t think you’ll get it better.” So I want them to almost be begging, not begging, but wanting the opposite of selling it to them.

Payman: To understand the value of it. I mean, it must be a big problem for you, Basil, yeah, in that dentists think you’re some top of the pile king of prosthodontics, but you have to, every time you see a new patient, have to convey that over. I mean, from a patient perspective, of course the dentist would have said something to the patient before they refer them. But from the patient perspective, I’ve come to the see the dentist. They don’t know they’re coming to see Basil Mizrahi, right?

Basil: Yeah, I know and sometimes also, when I teach I say to dentists, you don’t always have to come across with everything on day to the patient. Sometimes I’ll see a problem, but the patient is not buying into me on the first day, they don’t know me from Adam. I’m telling you treatment could take a year and costs tens of thousands of pounds, they’re going to run out the room. So sometimes I’ll ease, in major treatment, yes, we can deal with that problem. Let’s put a temporary on there because I always say, it’s one thing talking the talk, so I can talk the hind leg off a patient, and talk, and tell them how good I am, and show them, look at this picture.

Basil: But at times, you got to walk the walk, and that’s when the patient buys into, when I make a first temporary, when I do that temporary on the back tooth. Something relatively simple, then they start seeing, okay, he’s not just telling us [inaudible] easy, this was nice. It was painless, he’s made a lovely temporary. And then they become almost more putty in your hands. And then they’re sometimes more open, that’s why I put a big emphasis, you know me, on temporaries because then they become more open. And before you close off treatment and finish the one tooth, it’s in a nice, stable temporary. Now maybe we can start talking about we may have to open your bite.

Basil: Obviously you want to know that if the patient does say no you can still finish the one tooth. But so it’s either some patients are willing to jump in on day one and they know what to expect, or other patients need to be sort of drawn along, got more comfortable. And I’ll say to the patient, “I’m not ready to do all this yet, I need to get to know you. I need to get to know your mouth. So let’s not worry about all this big stuff. It’s not urgent at the moment. Yes, you’re wearing your teeth down, but I don’t know you well enough to know what I want to do. Do I want to go in full mouth rear, or can I manage this with a bite split?” So that’s-

Payman: So, that first appointment’s one hour. How much do you charge for that one?

Basil: I think at the moment it’s 280.

Payman: Oh, okay. And then so what happens next? Patient goes off, do you send them a report from this?

Basil: No. No, no, no. I never-

Payman: That’s just the initial?

Basil: Yeah, that’s the initial. They get to know me, they get an idea of what treatment may involve. It’s either going to be a simple crown, or it’s going to be big complex treatment. If it’s treatments then I want them to come back for detailed investigations. So that’s another hour, and that’s when I’ll take my study models, that’s when I’ll do full mouth x-rays, that’s when I may send them for a CT scan. I may take a bite registration. There’s a cost for that, they need to understand that. But again, that first, initial consultation, they have to know what they’re sort of in for before they start saying-

Payman: Yeah. Yeah.

Basil: I don’t want them to come for investigations and then I’ll tell them, “Okay, now it’s going to be 30 grand.” So they’re pretty much on board if they’re coming for an investigation. If a patient’s hemming and hawing, I may do the investigations for no cost. For me, for my benefit because I can’t explain in detail, and I don’t know what they need until I’ve had my mounted models. So a patient-

Payman: Do you charge a lot more for that second visit because you got to spend the time?

Basil: Yeah, that’s a more expensive visit for most patients. But again, I sometimes will judge the patient, if that’s going to [crosstalk].

Payman: Yeah.

Basil: Yeah, if that’s going to scare them off, I may not charge that much, and I may build it into the fee because I know if they give me, if I have time, another hour with the patient, I’ll be able to explain, and then they will have the treatment. And that’s when I make up the fee.

Payman: Yeah, I get that. So let’s say you’ve done that second visit and they’ve paid whatever the fee is for the investigations and all that, when do you actually start working on that case? Not during that appointment, right? Is that outside of the-

Basil: Still even one more discussion appointment, after the investigations, I say I need three or four weeks to do my homework because I don’t know, the investigations, I’m not telling them what I need. I don’t even know what they need. So then I say, “Then you have to come back three or four weeks later for a follow-up appointment. So that’s just a relaxed one. Me and you are going to sit down.”

Payman: You’re going to present?

Basil: Yeah, and we’re going to sit with a coffee and just chat through your models, and that’s when I present my thoughts and I hear back from them, their thoughts. And after that, I say at that I’ll present everything, costs, potential costs. They’ll feedback to me and we’ll have a little bit of discussion. And here, all this time I’ve always built my practise on communicating with the patient, building that rapport because I think that’s what’s missing. And I’m fortunate, well I built it that way, but I want the patient to get to know me and me to know them. And very personal interaction because I think with modern medicine, you go see a doctor, it’s 15 minutes in, 15 minutes out. So I don’t write them a report after their investigations.

Basil: I get them back for a discussion. So that’s now three visits where I’ve just been talking, maybe taking some models, no work’s been done yet. But now, I’ve already got to know them pretty well when they come in for the first visit it’s, “Hi, Basil, how you doing? How is this?” And after that, then they get their written report. And that report is pretty concise because I’ve already talked to them. I don’t have to put six pages together with five different treatment options. I’ve spoken to them, they’ve said they don’t want a partial denture, they’ve said they don’t a Maryland bridge, they’ve said they prefer the implants. So my letter is two pages, boom, implant. They know the fee, it’s in there. But there’s no surprises in the letter. So that’s sort of the patient’s-

Payman: Okay, now I’ve had almost three hours with you as a patient and the letter’s arrived. And you’ve already kind of said, “Look, this is going to cost you 100 grand, or 50 grand, whatever it was.” And now I’m seeing, I’ve got a thing in my hand, 50 grand to get this done. Is there a follow-up now? What’s happens next? You make another appointment?

Basil: No. No, not another appointment. Most times we know by that sort of discussion appointment, the patient said, “Yeah, okay, I’ll probably do, just put it down in writing for me and then I’ll have a look because I’ll put the appointments and I’ll call your secretary and make an appointment.” So by that stage we know we’re going to have pretty high acceptance rates. I wouldn’t have done investigations and spent all the time. But there are patients, you’re right, who get the letter and they just don’t get back to me. I’ll get my secretary or I may call them as well, or drop them a quick email, “Dr. Mizrahi Centre, we’re just wondering have you had any more thoughts. Do you want to come back in and have another discussion?” Sometimes I’ll try and get them back in and see another discussion, is there something you’re unsure of?

Basil: But most times, by the time they get to that letter, because that letter will be tailored for them, if they’re not a 50 grand patient, I would have picked that up at the discussion. And they’ve said, “Listen, Basil, I want to do this. But I can’t do it this year, I can’t do it next year. I can’t do it at the moment. What else can we do?” So I would have swung around and said, “If you can, okay, well let’s just do that lower left tooth for now. It’s not ideal, but that’s all we can work with.” And the letter will just be focusing on the lower left because I’ve picked up that they don’t have, they just can’t do a full mouth. Even if they need it, I will tailor it for them. So they get that letter that’s tailored to, we’ve already discussed what they can go ahead with.

Payman: Okay, so let’s say they decide to go ahead and let’s say it’s, I don’t know, two years of work that they’re going to need. Now, outside of the clinical, do you guys do anything above and beyond to sort of… From my perspective you’re doing things above and beyond in the mouth every time they see you. But do you translate that to the patient journey somehow? Do you call them after every appointment? Do you send them presents? What do you do?

Basil: No, but I build, personally, a very personal relationship, every patient, every single patient has my mobile, my personal mobile. The same mobile you have, every patient of mine has it. So I’m texting patients often, they’re texting me. I mean, they don’t abuse it, so otherwise I mean, I’ve been practising now 23 years. But that’s what I was saying, I build a very personal kind of practise. And I get that across to the patient. You will have me at your side, you will feel like you’re the only patient in the practise. So if a patient’s worried, if there’s a big procedure, I will call them.

Basil: But often a patient, I’ll text a patient, “How’s your mouth feeling?” They’ll text me back. We’re on WhatsApp and they all have my phone number, personal. So often they’ll call me to make the appointment. “Basil, I can’t do this appointment.” So I get very involved with my diary, with the patients. And I micromanage which may or… But that’s why my small practise with three or four patients a day works for me, with three days a week, I can micromanage that. That’s my personality. So asking what do you get? They get me, they get 100% of me outside the clinic.

Payman: Yeah. Yeah.

Basil: Okay, they phone me, they want to go in on a Saturday, because they’ve got a tooth, I’ll drive them to Harley Street from Mill Hill and see them, okay?

Payman: Yeah. And what about on price. I mean, your prices are, you just said higher than everyone else’s prices, do you get people saying, “Oh, I can get this cheaper somewhere…” I mean, do you get that discussion?

Basil: Yeah, and I’ll tell the patients, you need to realise you’re at the highest level of cost here. Sometimes even with referrals, they come in and they just don’t realise. So I will say that.

Payman: So what can it run to? What’s your biggest case?

Basil: That being 180, 200K. I mean, that’s few and far between. That’s one case I’m thinking of, but that probably went for about two or three years.

Payman: What about if I ended up needing one crown from you? From the first three visits, how much does that end up costing, 1,000 pounds maybe? I don’t know, you tell me. How much does it cost, the first three visits, before I’ve started?

Basil: Oh, if you need a single crown, you won’t have such a comprehensive first three visits. So I don’t have a recipe. So if you came in and there were single central, a lot depends on the patients. I always say when I’m teaching again, I don’t have a fee per item. So I can’t tell you what a single crown is, because it’s going to depend on how demanding you are from me. What you’re going to put me through, okay? So if I can pick up from you, and that’s why it’s important to discuss, that’s a single central. I will go back and do my treatment planning, and it depends which lab I’m going to use. And I may say to the patient, it depends which lab. And I will gauge from the patient.

Basil: If I come back and say, “If you really want to hit, it may cost 7,000 pounds.” And that may be two tries, it may be a lab in Italy flying over. But I know I can go right back down to 1,500 pounds or 1,000 pounds, whatever. I always have an associate I work with, so that gives me another tier system, which works well. So Jurgita is an excellent dentist. And very often I will say like that kind of scenario, it’s a single crown, I often say to the patient, “Listen…” And I’m fortunate to have Jurgita working with me because I’ll say to the patient, honestly, there’s really not much more I can do than my associate can do, and her fees are literally half my fees because I see all the new patients myself.

Basil: But I’m very honest for myself, because I prefer getting my hands wet on the big meaty cases. And for my conscience, I can’t sit there doing a single crown, my fee per hour would make a single crown, I don’t know, five grand. I can’t justify that. I can justify easily paying 150 grand for a full mouth rehab because I know how hard I sweat and what the patient gets out of me. And that nobody else would probably do it at that level. But when it comes to a single crown or three in a bridge, or nice composites, I’ll often, I will refer the patient to my associate, because I say, “I can’t do anything more than my associate, who’s excellent. She will do the same job as me, but half the price.” And the patients appreciate that. And that’s how we work it within the practise.

Payman: And what about longterm follow-up? I mean, you’ve done so many big cases. Do you end up following them up over the years or do they go back to their own dentist?

Basil: No, I need to follow them up. And I make it clear to the dentists. I do say, “I would want full responsibility for this patient, seeing my hygienist and me following it up.” Because I take responsibility, and the patient also understands that when they come in on day one, often I’ll say to them if it’s going to be a complex case, I’d say, “You do realise, I would need to take control of your treatment? I can’t work with your dentist on this.” Because they’ll up and say, and it may sound quite harsh, but they’ll often say, “Well, can’t my dentist do this part, and you do that part, and then you’ll do this?” And then I’d rather say, “No, rather stick with your dentist.”

Basil: But just too many cooks, you need one person you can come back to for responsibility. And so I will say, and often to the dentist, I’ll call the dentist and just be honest and say, “I know you’ve sent me for this and you… But this is going to affect this. So either I need to do all that, or better you handle it, or refer it elsewhere.” But if I’m going to take responsibility, and yes, it is longterm. So I say to the patient, this is a longterm relationship. So besides trusting me with your work, we have to build up a report. And that’s why again, I do those discussions, three, four visits before I start because I say, there has to be a mutual respect, there has to be a mutual trust because we’re going to spend so much time together.

Basil: You have to get on with me as a person, nevermind how good I am because that will get us through one or two appointments. And I have to be able to accept you as a patient and see that you’re not going to drive me crazy. And so I express that to the patient because it’s a longterm and I said, “Going forward, I’m hopefully going to be around for the next 15, 20 years, practising . I’m the one that you’re going to be looking after. If something goes wrong, you’re going to come back to me, not your old dentist, not the periodontist, not the orthodontist. I’m responsible. So I’m your port of call.” So they have that reassurance, that I’m there for them.

Payman: Basil, what drives you in the clinical practise part of it? I mean, you’ve got this reputation for being very accurate, sort of perfectionist. Is it playing against yourself? Or-

Basil: Yeah.

Payman: Is it?

Basil: It’s probably a little bit of OCD, just getting into the zone, and just wanting to know that I can go to sleep at night knowing I couldn’t get it better. And you’re never going to get to that level, I mean, it’s an elusive target because there’s always somebody who can do it better. But I always draw, I don’t know, you’ve probably seen my lectures, but that picture of the staircase and that’s my logo at the practise. That life is a staircase, also the clinical cases are staircases. So I’m always just wanting to get that next level, which you never get to. That staircase never ends. I don’t know if it’s a good way to live or a bad way, just I’ve had sort of [crosstalk].

Payman: It suits you, right?

Basil: Yeah, it suits me.

Payman: And so as far as being who you are, what’s the tension between brand new stuff that comes out and it sounds like a good idea and people like me, companies are pushing it as a new idea? You’ve seen a lot come and go I’m sure, so you’ve got experience in understanding that. But what’s the tension between wanting to be an early adopter and understanding all the latest stuff, and also not wanting to be an early adopter, and only doing things that are well used and understood? I mean, what do you think about scanners and the whole digital workflow and all that, for instance?

Basil: Yeah, okay, so it’s a good question because you’re constantly being taught, and the longer you’re in practise, the more you realise you’re starting to become a little bit of a dinosaur now. And I never thought I’d hear myself saying that because I remember being a little junior in the room, looking at this guy talking. And so I know I’m probably at the latter end of the career, but it’s a combination, I think experience is huge, you can’t discount experience. So there’s the balance. Yes, you do want to embrace the newer technology and I did buy a scanner last year, we do have a scanner.

Payman: Which one did you get?

Basil: [crosstalk] scanner. To be honest, I use it, I haven’t scanned preps yet. I use it for making retainers because it’s nice and-

Payman: Okay.

Basil: … and expensive. No, but you get to use it a lot and I see what people get out of it. But it’s a crest, where you sort of probably feel you’ve got what’s working for me. Have I missed the wave? Is it too late for me to get into DSD? I see some things that I know my works for me, I haven’t got into the DSD because I think I can do… It has to be quite something to show me how much better it can be. I know people come and say, “Why don’t you mill your temporaries? Why don’t you plan your case using DSBs?” And then I look at my temporaries and say, “Because milling is not as accurate as my temporaries because DSB doesn’t…” So it’s a combination of me probably not embracing it because I haven’t got fully into it. So I’m sure the guys that do DSD will look at me and say, “Well, Basil, you’re not doing it properly.”

Basil: So to get good at something, you really, you have to embrace it. And before you critique it, try it. But there’s a limit to what you can try. Can’t try everything. So yes, you do end up scanning, I’m dabbling in scanning, doesn’t mean that scanning’s bad. No, just means I haven’t spent the hours that the other guys have spent scanning and milling at a margin. Will I get there? Maybe, or maybe I’ll just stick with my analogue impressions because that’s what I have spent hours. You have to also, well for me, focus on what I’m good at. So I do that, I’m glad, that’s why I get on so well with Jurgita, because I’d see her as the young, enthusiastic blood, and showing me all the DSD, she’s amazing at this kind of stuff. So there is constantly that battle.

Payman: I mean, in the last, call it 15 years, how’s your practise changed? I mean, not your practise, your clinical. What do you do differently now than you did 15 years ago? Because of changes and…

Basil: Clinical technique I would probably say it hasn’t changed, still using the same hand pieces, the same acrylics, the same articulators, the same bite registrations. What has changed-

Payman: Adhesive dentistry’s got more reliable, right?

Basil: Yeah, okay. Sorry, yeah. That’s a good… Yes, we’re doing more adhesive dentistry. I suppose implants, I’m doing more adhesive dentistry, doing more implants. Yeah, what else? Yeah-

Payman: On that question of new technology and new technology doesn’t necessarily have to be a computer, I mean, it could be a new porcelain that someone comes out with. I mean, I’m sure you remember, Emax wasn’t always Emax, we didn’t know that Emax was going to be a reliable thing until it became a reliable thing. I mean, how do you asses something? Do you call up your buddies around the world and say, “Hey, Pascal, what do you reckon about this?”? It’s difficult, isn’t it? It’s a difficult situation to be in because you’re-

Basil: Yeah. And again, that’s why in practise, I don’t want to be the first to try something and I don’t want to be the last to adopt it. So I think the world’s a smaller place now, thanks to social media and internet, you can read articles. And we get an idea that things are working. Some things you do push the boat a little bit, but yes, I’ve adopted. I haven’t been the biggest adopter of adhesive dentistry. I’m gradually coming along now. I still think sometimes the pendulum swung too much. I try and keep a balance between mechanical. I do that lecture on mechanical versus adhesive.

Payman: Yeah, I’ve seen that, very good.

Basil: But we all have our biases. So yeah, the materials are evolving. It’s beautiful now we can use things like Emax. We don’t have to prep, cut teeth down to do crowns. So yeah, adhesive dentistry is a big advantage I’d say. Probably the biggest-

Payman: Now, you’re a perfectionist, right? So some people they’re such perfectionists that for instance, I was on your Instagram yesterday. I never thought I’d be saying this. I was on your Instagram yesterday. There are some people who are perfectionists to the point that they can’t even post because they’re worried about what people think about them. That sort of thing. Now, in your case, it might be in the mouth. You don’t stop, right? There’s a point where you have to say all right, you were leading to it before, where we’re going to take impressions now, yeah. But we’re not going to make any more changes. As a perfectionist, there must be a downside to being a perfectionist is what I’m saying. Where does it hurt?

Basil: It hurts, it probably takes some of the enjoyment away, or some of the happiness. I’m quite an intense, I think it spills over into your personality. So I think in the mouth almost, you can handle it because myself that’s why I like doing it, because there’s nobody stopping me, I’m not interacting, I’m interacting with a tooth. I can just bury myself, I don’t have to react to people. So I think for me, sometimes stifles your, just your enjoyment of things or people because you’re trying to keep ducks in a row, if that’s making sense, so.

Payman: Yeah, it does. So for instance, do you have unreasonable demands of your people?

Basil: Yeah, I think if there is a weak area I’d like to work on, it would be a personal area, just my interrelationship. I know I’m not the easiest guy to work with. I think outside the dental environment, I’m pretty relaxed, I’m probably very shy, and unassuming, and probably like I said, the passive one, who you won’t notice at the dinner table. But then something changes when I get into the practise, that’s my little kingdom and I’m the king.

Basil: And I always say to the nurse, when I hire a new nurse, it’s again, I try and talk them out of working for me because I say to them, “I’m going to drive you crazy. It’s hard.” And so that’s where I don’t think I’m the easiest to work with. I’d like to be a little bit better interaction with staff. But saying that, my staff went a little bit over rough patch recently, but my staff generally stay with me many, many-

Payman: I see a problem with perfectionists sometimes where they… Look, in the profession, we see perfectionism as a plus point, right? In a way. So when I see some dentists, they’ll fit a case let’s say, and they’ll be talking out loud in their head to the patient. And they’ll say something that in our world, would make sense. Like you say, “It’s all good, but if only that little thing was a bit better, then that would make it much better for me.” And in our world, I’d see, “Oh my God, Basil’s just put that case up and he’s still saying it could be improved. He’s amazing,” right? But from the patient’s perspective, if you speak in that way, the patient’s thinking, “Oh, there’s something wrong with it now.” And I see young dentists make that mistake quite a lot. When we speak between ourselves, that kind of way of talking makes a lot of sense. But with patients, I’m not sure it makes a lot of sense. Have you been guilty of that one?

Basil: Yeah, I don’t know if I talk out loud. But what I do say is we are our own worst enemies because I’ll take a patient that comes in, that’s not so fussy. By the time I finished making a temporary saying this, they suddenly get switched on and then the site comes back to bite you because they become so demanding, we switch them on. So I see that and I think going back to your point, I think perfectionism’s acceptable in the kind of work I do. I think it creates a better product, but it’s not a good trait to say is it good or bad. So yes, that may be good, but it’s not bad, I think not a great trait to have in life, out of the dental surgery because it stifles you. So could be good and bad like anything. I’m glad I’m like that in the mouth, but I’m not glad I’m like that in life.

Payman: I get it, I get it. You must sometimes get referred a patient because the dentist relationship has broken down with that patient. So a patient who’s a difficult patient as opposed to a difficult mouth and the way the dentist gets out of it is by referring to you. That sort of psychological issues, you must get that.

Basil: Yeah, you do have a breakdown and sometimes it’s almost easier to be a fresh person. It’s easier to take on the case because you’ve got their previous experience to sort of relate to. And it’s always easy to say or show why you’re different. Yeah and again, you’d have to make sure that you can see what you can do differently, because again, the patients will see through you. So again, it’s one thing convincing or talking the talk, and saying, “Well, I’ll do it differently, and don’t worry, that’s not going to happen with me. I’ll treat you kind,” or whatever. But you need to really believe that you can do something different. So if it hasn’t been the optimal dentistry, you need to say, “Actually, I could do that.”

Basil: But if a patient comes in, and it’s happened to me, where I really can’t see that I can do something significant. They may have had a full mouth rehab and yes, the teeth are all white. But it’s not too bad and they’re going off that, “This dentist ruined my mouth.” And that kind of patient I will steer clear of. And I’ll say to them, “Honestly, I really don’t think I can do significantly better. Yes, I can cut all these crowns off.” The risk to benefit ratio, I can’t justify that. So no, I will just say, “I don’t think I can do this. You may want to go somewhere else.” So I need to really see that I can do, or change something, or relate to them better than the previous dentist.

Payman: I guess you got pretty good at spotting that kind of patient. It’s the ones that get through that’s the problem, isn’t it?

Basil: Yeah and again, that’s why I always say to the younger dentists, to spend that initial time. Time is our biggest enemy in dentistry and when you say how malpractice has evolved. I know earlier you asked what’s changed and you were focusing on clinical things, adhesive. But for me, I think in your practise, what changed is again that staircase. If you make your pool of patients just split yourself smaller and smaller, which is nice because in the beginning when you’re starting out, you have a big pool of patients and you’re doing everything, just to get patients and start earning money.

Basil: Gradually, when I look back now, or look at my practise now, you asked me if it’s, I would say 99% referral, 99% for me, crown, and bridge, and implants, which is what I like. So you just end up honing your practise, being able to spend more time on less patients, doing the kind of work you want to do. And then gradually evolving that way. So the spotting, going back to what I was saying, you just need to spend time with the patient. For me, that’s been my biggest practise builder, just that personal time, getting to know the patient. And then you spot the patients that are going to give you trouble.

Basil: And hopefully, obviously every now and again one creeps through. And also, when things go wrong, getting back to what you talked about earlier, because I make mistakes and my mistakes are big P mistakes. But the patient needs to see you as a human being and when you have that rapport, that’s better than any consent form because then they say, “Okay, he’s human. He’s made the mistake. He put the crown on the wrong tooth. Idiot. But he didn’t do it on purpose, whatever. He’s broken my…”

Basil: I dropped a implant in the sinus, the patient wasn’t at my neck, trying to sue me. I apologised, I explained what happened. And that comes from spending time. So when these mistakes happen on a patient, they’ve got to know me. They’ve seen how I break my back, working on them. And the level I’m going to. And they see that you’re a human, whereas if you haven’t got that time, they see you as a robot, in, out, in, out. “Oops, the color’s not right, I’m going to sue him or he better do it again for no fee.” So I don’t have that kind of aggression coming at my neck because of the time. And I’m not a big consent or a huge letter writer. I mean, we do it. But my letters are pretty short, consent is pretty concise.

Payman: So you’ve been teaching for a long time now, both in your Mizrahi Dental Teaching bit, and at the Eastman. How much do you do at the Eastman?

Basil: Eastman, now, probably about six, 10 days a year. Again, in the beginning [crosstalk], yeah, it’s not much any more. I used to do a lot more. But again, when I came back from The States, I did a lot of teaching because I didn’t have patients. So life, your balance is constantly swinging. So as I was doing a lot of teaching and lecturing to get my out there, when the practise starts building up, you cut down on the teaching. So now my practise is at a peak.

Basil: I’ve moved the teaching from a university environment to more my own teaching centre environment. I still go to Eastman, I enjoy the Eastman. And then gradually, that balance will swing, I’m sure in the next five, 10 years I’ll probably start doing more. As I get older I’ll do more teaching back again. So, that’s what’s nice about dentistry. There’s so many directions you can get into when you look out there because people are going all different ways. You’ve started your own company, people who have multiple practises. And that’s the beauty of dentistry, there’s a niche for everybody.

Payman: Yeah-

Basil: [crosstalk] enjoy it.

Payman: Sorry to interrupt you. In the teaching, there’s a view out there, I don’t know if you resonate with this or not. But there’s a view out there that coming on your course isn’t something you should do straight away because it’s like a higher level course. Is that true, or is that wrong? I mean, how many years do I have to practise before I come on your year course, or would you say the sooner the better?

Basil: I would actually say the sooner the better and people ask me this all the time because you want to get into good habits. And that overall perspective of you want a combination of inspiration. Yes, you’re not going to take everything I do. But you also want good basics and you want someone who’s been around, showing you and guiding you, how you can get into that at your level. So I always say to all the delegates that come on, you want to see where you can aspire to be. You don’t want to be a Basil Mizrahi, you don’t want to be another Basil Mizrahi. But you want to see what can be done because I just know when I first started out, I used to see these lectures and things, I would get inspiration.

Basil: So you want to get put on the right track and when you look at all these guys that are coming up now and doing, like you said, all the leaders coming through our profession. I’m sure if you ask them, they were exposed to good people early on. And that gets you on the right track. Yes, different people will take different things from my courses, depending what level you’re on. But even the person first year out of dentistry, yes, their preps may not be as good as the guy sitting next to them, who’s been doing it for five years and been on three courses. But they will still be shown, I will be over their shoulder, because the courses are kept very small and very personal, same as my practise, same philosophy, very small and personal.

Basil: And they will be guided at their level. So if their margins are all over the place, I’m not going to get onto their level and say, “Well, you need this microscopic margin, come under the microscope.” I will take them with their no loops approach, whereas the next guy, who’s on five and a half times loops and been doing crown preps. I’ll take him to the microscope and say, “Right, you want to do the next level, come sit under the microscope now and get your margins.” So everybody, we can take people from different levels and that’s a beauty of a personal feature. And then you get… Sorry. The sooner you get onto that right road and realise the correct approach, then it sets you on the right pathway, going into the future.

Payman: Yeah, so the reason I’m asking, I was in VT. I went into a Mike Weiss lecture. And I think what you just said actually is true. I didn’t really understand what the hell was going on, dude, to tell you the truth because he was trying in crowns. And the idea, no one had ever said that to me. But you’re right that I was definitely inspired. I was definitely inspired that someone was doing something like that. But if someone’s been, I don’t know, five years qualified, or 10 years qualified and they’ve done a bunch of work compared to someone who’s just qualified. You’re saying within the same course, you can talk to both those characters?

Basil: Yeah, because it’s relatively small, so people will bring their study models in, or some guy who’s been doing it for 10 years or so, Basil, how do I take a bite registration when the patient’s got no teeth or all preps, whereas the other delegate next to them has only been their single tooth dentistry and wants to know how you do a squash bite [inaudible] or something. So there is-

Payman: By the way, on our composite course, we feel the same. We feel it’s as good for a newbie as it is for someone who’s been there, doing it for a long time because we start from the beginning. And it’s one of those things, I think that. But there is that feeling out there though, Basil, yeah. I guess it’s one of the problems of being top dog, that, that’s what happens.

Basil: Yeah and again, you can’t be everything to everyone, even in practise. You have to be prepared to lose patients. And I know I’m not, my course is not conducive to everyone. So I speak to every delegate on the phone that applies to my course, they get called, same as my every patient, they have my mobile. And I’ll bounce off of there. So not just the application process on the web. I’ll bounce off of them on the phone, “What are you looking for?” “I’m looking just this.” “Okay, maybe do that course and maybe mine in a few years’ time.” So I’m not trying to be everything to everyone. I learned that in practise, you can’t.

Basil: So same way, I will develop that niche and it’s really developing like you say. The opinion is out there, that yes, Basil’s course is… And I wouldn’t want that to change because I wouldn’t say it’s an advanced course. But yes, you may get more out of it if you’ve been doing things for longer because then you can pick my brain at a higher level. You can take advantage of me, more than someone else doing another course, who hasn’t had as much experience in complex dentistry. You can’t pick their brain as much, so-

Payman: How much do you teach abroad, Basil? You must be invited to a lot of conferences and things.

Basil: Well now, definitely not any more.

Payman: Not now, yeah.

Basil: Yeah. But it’s more around the UK. A lot doing that, the lecture segment, there’s so many people out there that are better than you, or better than me. And that’s what I always say to young, just expose yourself, especially with social media, and YouTube, and everything we’ve got now. Go to conferences, because it’s very easy to get stuck, and I see that all the time, going on local courses, or thinking these are the good guys. The good guys are out there in the big world. I mean, you can go to the furthest part of South America and there’s some amazing lectures. So I don’t run around the world, lecturing.

Basil: I don’t see myself as top. I know when I go to these conferences there’s guys a lot, my niche I think I’m top. But there’s amazing guys out there. And I say, just expose yourself to these people. Go to these international conferences because again, I think the level of conference here in the UK is not great. I’m not talking about the dentistry, there I’m guarded. But conferences, if you go to a conference in Europe, in Italy, you get 1,500 people in an auditorium. You got a conference in England, you get 300 people.

Basil: So somewhere the enthusiasm, that’s what always strikes me. That doesn’t seem to be, there’s a much smaller pool of enthusiastic dentists here than there is in like sized countries, in Europe. I just keep remembering Italy. I went to a prosthodontic conference. I walked into this huge auditorium, 2,000 just in Italy. [crosstalk] I’ll go to a prosthodontic, prostho conference here, we get 200 people. We get boring lectures. So thank God we got people travelling around now. But I would say, can’t now, but when we can travel again, expose yourself. There’s some really top guys. What you see here, locally is not always… I mean, we got some good guys here, but there’s a lot-

Payman: Tell me then, Basil, a couple of questions. What are some lectures and some mentors that stick out in your head from back in the day when you were getting electrified by this? And also now, who do you see out there as great?

Basil: The first one that really stuck out back in South Africa, we had, I don’t know if you remember Garber and Goldstein?

Payman: Yeah.

Basil: Garber and Goldstein, Ronald Goldstein, David Garber, they came over to South Africa. That was the first time I think I was probably second year bent, maybe I just finished then. But I saw these guys lecturing, and making these temporaries, and doing veneers. And that sort of turned a light. Then there was a guy, Harold Charbel, you won’t have heard of him. But he’s retired now, he’s probably about 80. He came to South Africa as well, and he gave a course there. And I just saw the way he did morphology, and the way he worked with his hands, and the way he created temporaries, and knew his [inaudible] and he was just such a passionate guy.

Basil: And he practised only on one or two patients a day. And I said, “That’s the way I want to practise.” The guy, the prosthodontist I worked with in South Africa, Gerald Kaplan, he was an amazing mentor to me. I worked in his practise as an associate. He gave me a lot of time. Lecturers on the lecture circuit, Gerry Chiche, so many good guys, we all know the name Gerry Chiche. He’s good, I think he’s retired from lecturing now.

Basil: I’m going to keep saying because I’m sure I’ll leave someone out. There’s Markus Blatz, there’s [inaudible], Gambarini. And for me, I like to see guys doing what I do, because that’s what I want to learn and for now I’m still a bit in the traditional crossover phase. There’s not that many guys lecturing about that any more. The aesthetics is amazing stuff, and implants is amazing stuff. And there’s so many. There’s names that you’d never recognise, but you look at their work, like you go to these conferences, and you’re going to be blown away. So all out there.

Payman: I think a lot of the, I’ve seen it in your teaching as well, talking about failures and problems in cases. It’s where we’re kind of going. I think before it was all a lot more about showing off, and before and afters. But now we’re going, I think people, the audience wants to see failures more. And you really do learn from those. I remember long time ago, I read one of yours, I think, it was a crack, was propagated in a veneer in cementation, yeah? And I’d done that myself. It was one of those that, I could see it, but the patient couldn’t. And I wasn’t sure what to do next. And then I read yours many years after that and I think you said, “It’s all right.” Something like that. But you know what I mean? That little, it’s a nuance, it’s a small nuance in the work, but it’s something that went wrong. And stuff does go wrong. That’s something, as dentists we need to understand. And be open about, I think.

Basil: Yeah, and I think that comes also with age and experience. You’re not that scared any more. Like when you’re starting out a practise or trying to get your name out there, you’re not going to show failures, you would be scared to. Now, I have no qualms. I do my treatment planning webinars and I always say this is a decision I made at the time and I try and stress it. But then since there’s many decisions and they’re always going to be different, that you can make. Dentistry is not recipe. So we make a decision at that time, on that patient, in that environment, at that moment and you live with it.

Basil: When you come back, there may be another patient, same situation, different time and you’ll make a different decision. I just say be comfortable with the decisions you’re making at that time. But you will always look back and say, maybe now I would make another decision. But I think that’s where it’s good to lectures, to try understand the thought process that got you to making that decision, even though it’s going to be different to your colleague sitting next to you, to another lecturer, who says something different. You want to understand the thought process and decisions are always going to be different, in your own mind and colleagues.

Payman: On the teaching, is there a continuum about this all? I mean, if I do the year course, then I want to do more. So is there more I can do?

Basil: I haven’t affiliated to a university and given formal diplomas and certificates. I know that there’s a lot of that out there. Again, just it’s very time consuming. I want to focus on the practicalities. I don’t want to have to be looking at dentist research and giving them exams, so that they can get the certificate. So I make it very clear, you’re coming on my course, just to learn to be a better dentist, not to get a diploma or certificate. There’s other courses, if you want the master’s then you need to do. So my continuum is the course and then I have the study clubs three times a year, where I take these complex cases and just go through them. We spend a day and bounce questions that always, just from a case presentation you get so much out of it. Then they can start asking you cases.

Basil: I offer my services to people on the course, they can come and have one-to-one treatment plannings. Again, it’s not so formal as many more courses out there, more formal. But I just stick to my little niche and because at the moment, it’s a small ship, I can turn that ship very easily. So if I decide I’ve got a great case and I want to do it live, I’ll say to the patient, “Do you want to come in? Let me do this with 10 dentists standing around, you don’t have to pay.” And I’ll invite 10 dentists to come in. So that just may be one course. It’s not as structured as other courses, but that’s got pros and cons. Gives me the freedom to just turn my shop quickly. People are asking me a lot maybe this year on temporaries, so in three months time, I may put on the website, okay, we’ve got a course coming on temporaries. So that kind of-

Payman: I noticed during the lockdown, you were doing some webinars as well, on a Sunday or Sunday night, Sunday night webinars. How did that work out for you? Was that something you enjoyed doing?

Basil: Yeah, I enjoyed doing that. And I think again there, the little sort of focus I’ve gone through is because over the 20 years, I’ve got so many cases, so well documented. I just choose a case pretty casually. I’ve put it together and then I present that case on the Sunday and I take questions as the questions come through. And I just breakdown that case. We all see befores and afters, especially with Instagram. We all know you scroll down and you see before, look at this amazing veneer case. But nobody gets to see, I always say the endpoint, we all know where the endpoint is. You can see a patient and say, “Okay, you’re got to end up with six front crowns.”

Basil: The hard part is the journey. How do you get them to that endpoint without making them have too many emergencies, without disrupting your diary? And how many appointments do you need? How do you plan the fee? So those are the Sunday night webinars, and I still do them every six or eight weeks. I put out on social media and I’ll just take a case and show you behind the scenes because again, I think that’s where you learn a lot. Why did I make a decision? Why did you use fibre post there? Why didn’t you use a gold post? Well, I used gold post because of X. You could use a fibre post, but then this is the reasons you would use. So it’s a lot of thought. I like teaching that way. The thought processing, rather than saying, “Well this patient had 10 veneers, this is how I did it,” because that’s out there.

Payman: Basil, what would you say a few things that most dentists don’t know, or get wrong, that you wish that they got right and they thought more about? Was it that, what you just said, that zoomed out thought process thing? I mean, let me give you an example. So on our composite course, I wish more dentists paid more attention to primary anatomy, yeah. I mean, we try and put that into their heads when they get there, but they’ll come in talking about layering, and colour, and secondary anatomy.

Payman: But they haven’t focused enough on primary anatomy, simple thing or finishing and polishing for instance, yeah. Everyone’s got their head into colour for some reason, yeah and shape hasn’t. And bleaching, I wish people gave a damn about their impression as much as they keep pretending to know what they’re talking about when it comes to percentages of gels, yeah. Everyone goes into that. It’s always the first question, oh, percentage, gels are gels, that bit. But I wish more people took better impressions. What about in your world?

Basil: So I wish people paid more attention to the temporaries because-

Payman: Yeah, of course. Of course, yeah.

Basil: Because I think again, that allows you to go from single tooth dentistry to multiple tooth dentistry. So I think the temporaries are definitely the key to success when you want to start doing more complex cases. And I don’t think dentists realise that when they come out of dental school. And then they try, the limited knowledge of how to make temporaries, stable temporaries. And when you try and do a more complex case and it goes pear shaped.

Payman: Or even what temporaries are for, right?

Basil: Yeah.

Payman: I mean, your temporary’s a kind of functional thing, isn’t it? It’s not just there to protect the tooth.

Basil: Yeah, it’s not the stop gap. You can’t get to that endpoint unless you go with the temporary, it’s because again, it’s the journey that’s more important than the end result because the end result we can all do. But that end result will be compromised if you’ve had to cut corners going through the journey. And the thing that stops you cutting corners, going through the journey, are the temporaries. And the temporaries allow me to take the time. You see me putting those pictures up on Instagram. I didn’t do that prep in one visit, okay. I may have done that prep over three visits, driving myself crazy. But what allowed me take three visits to do the prep? The fact that I had a temporary and said to the patient, “Okay, come back in four weeks’ time, okay.”

Basil: I’m exaggerating [inaudible], but that’s kind of the only way for me, I can get that level is taking as much time as I need and that’s what the temporary gives. And then also, the hand skills. For me, I think dentistry, sometimes people are losing their hand skills, focusing on the aesthetics. And adhesive is good, but there still is a place for mechanical, and that’s where hand skills, teaching the hand skills are important. And also again, social media, I think a lot of people just focus on the front teeth. I mean, we see Instagram pictures just the cosmetic results. I would love to see, and you never see the gum margins, or we never see a close up picture or impression, what do the gums… That kind of thing. So I think it’s quite daunting, yeah.

Payman: Sorry. The thing with Instagram, a lot of it is aimed directly at patients. And patients don’t want to see the gum.

Basil: Yeah, you’re right, yeah.

Payman: But it’s dangerous, it’s dangerous in so much as if you’re only talking to patients, the way that you can present the thing is different, isn’t it? I mean, you don’t have to be so meticulous as far as what-

Basil: Yeah, and I guess that’s where sometimes the difference is. So my market would be pitching it at dentists, whereas average dentist’s market would be pitching at patients. So there is a slight different perspective.

Payman: So, we’ve got to end of our time. I’m sure you’re busy. But my cohost, Prav, who couldn’t be with us today always ends these conversations with the same question. Oh sorry, I did have one other thing there. What do you enjoy the most? I mean, what’s the bit of it? Is it the treatment parts, like the sort of zoomed into the tooth? Is it the planning part? Is it the social part of actually talking to the patient and getting into their head? Is it the teaching? Is it the light bulb moment, when the student suddenly gets what you’re saying? What’s the thing that you love the most out of all of the things that you do?

Basil: I like the end of a big case and we cement everything, that’s always, after a year and a half of working, when everything goes in and we get to the end. I like zoning out and making a nice temporary. Spending half an hour myself, chairside, just working with my hands, making the temporaries, I enjoy that. That’s probably why sometimes I go overboard because I just like, I don’t know, get into my own world, so I-

Payman: You’re meditating at that point.

Basil: Yeah. I’m meditating. I like the teaching and it probably fuels the ego a little bit. I like the adoration you get from the students when you’re showing them things and they look up and say, “Wow, that’s amazing.” That does make you feel good. So there definitely is that aspect.

Payman: Very honest there.

Basil: Yeah, I mean you like it. A lot of what we do is self fulfilling.

Payman: Yeah. So my final question, Prav’s final question. You’re sitting on your deathbed, you’ve got the five or 10 closest people in your life with you. And you’ve got to leave them with three pieces of advice. What would those three pieces of advice be?

Basil: I think you want to be able to sleep at night with your decisions that you’ve made in practise and in life. And I haven’t lived by that, far from that. I don’t think it’s something hard to aspire to. But if you want to try go to sleep every night just being comfortable with the thoughts and actions you’ve done that day, that’s something to aspire to. I think we may never get there, but that’s something I’d like to say to my to kids, just try to, yeah, try aspire to do that, just get into bed at night saying, whatever you’re doing, for me, that’s key. But also in life, whether I relate it to my kids, my staff. Doesn’t happen that often, but it’s something that’s worth trying to aspire to.

Payman: That’s one.

Basil: That two, or three, or is that only one?

Payman: That’s one.

Basil: I mean, enjoy your life as you… It sounds cliché. I mean, I haven’t thought about it much because I still think I’m quite far off from there. Try create the environment that you enjoy working in. You can tailor your own environment. And I think that comes again, with experience. And you start to see that actually, I can start doing this. Make the environment so it brings the best out of you rather than-

Payman: Make a change. If you’re not happy, make a change.

Basil: Yeah, exactly. Rather than trying to fit in all the time. And that’s yeah, that’s pretty much-

Payman: The third one.

Basil: Yeah.

Payman: What would you do, Basil, if you’ve got half a day to yourself? What’s Basil time? If you could do anything, you’ve got no responsibilities to anyone, half a day to yourself, how would you chill?

Basil: A bit of tennis. I like tennis, I’d go for a walk. Meet a friend, just go for a walk. Having a coffee and maybe just scroll through a little bit of social media, that kind of stuff. Yeah, just chill out. I’m not a huge TV fan. I watch a bit of TV. At the moment all I can relate to is, within the last year-

Payman: Yeah, the last year has just been-

Basil: It’s really different. Well, I haven’t actually got into, I need to do podcasts more. Everyone raves about podcasts, maybe after this.

Payman: It’s like radio on demand.

Basil: Yeah, I need to get into podcasts-

Payman: The nice thing about radio is you can do something else while you’re listening to it.

Basil: Yeah. Yeah. Yeah, I must start doing, everyone tells me about podcasts, all different topics. I’m going to put that on my list of things to investigate, look into.

Payman: Perfect. Well it’s been a real honour, real privilege to have you on, Basil. I know you’re a super busy guy. And I wasn’t even expecting you to say yes to this. So I’m really glad, thank you so so much and we’ll catch up soon. Thank you so much.

Basil: Yeah, thank you so much. Thanks for inviting me on and well, look after yourself. Thanks, man.

Payman: You’ve been wonderful. Thank you.

Basil: Thanks, cheers.

Outro Voice: This is Dental Leaders, the podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Prav: Thanks for listening, guys. If you 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 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.

Prav: And don’t forget our six star rating.