Category: Podcast

Dev Patel: In my world, I’m like, look, if you come work for us, you’re self-employed. You can do whatever you [00:00:05] want. You enjoy it. You work hard, you do well. Great. You save us long term. If you [00:00:10] don’t like it, you leave. There’s no targets. There’s no time, nothing. We’re not going to charge you for courses. We’re not [00:00:15] going to charge you for any kind of clawback. You leave because it’s a free world, and I want you to do well in life. [00:00:20] So if I grow you for 3 or 4 years and you’ve, you know, you develop the skills really well, when you buy your own practice, you want to go [00:00:25] do anything in life, do it absolutely fine. Because in the day, if you’re a good person, that will make [00:00:30] a huge difference in karma and that will always come back. And I’ve got left and come back after and said, shit, we had [00:00:35] a bad time with you. We should have stayed with you after, right? And that will come out of this world. But if you’re one of those owners [00:00:40] out there, small groups or owners who just want to keep this, the same mentality of [00:00:45] I own my business. I put all my blood, sweat and tears into it and I will make sure that everyone who works there works [00:00:50] for me like a, you know, like basically like an employee. You’re never going to succeed or grow the business [00:00:55] any more than what it is now.

[VOICE]: This [00:01:00] is Dental Leaders. The [00:01:05] podcast where you get to go one on one with emerging leaders in dentistry. Your [00:01:10] hosts Payman Langroudi [00:01:15] and Prav Solanki.

Prav Solanki: It’s a great pleasure to introduce [00:01:20] Dev Patel, the owner of Dental Beauty Partners or the CEO of [00:01:25] Dental Beauty Partners, to the podcast. And me and dev regularly have conversations [00:01:30] about running and growing practices. And certainly when I’ve got some advice [00:01:35] I need or, you know, there’s clients who reach out to me about [00:01:40] selling their practices, growing their practices, or growing groups. I’ve got them on speed dial, [00:01:45] and, um, he’s often a voice of reason for me when it comes [00:01:50] to just cutting through the BS when it comes to practice growth. Um, and [00:01:55] I guess the purpose of this podcast is to just go through a few ideas [00:02:00] that we’ve shared during our conversations about practice growth, and [00:02:05] it was stimulated off the back of a conversation where we that we had recently where we said, [00:02:10] wouldn’t this be great if the cause that we were having were on a podcast? [00:02:15] So that’s why we’re here today. So def I want to just sort [00:02:20] of start by, um, getting your maybe your top tips of, let’s [00:02:25] say we’ve got a dental practice owner who is considering sort [00:02:30] of mid growth level, um, doing okay, not a, not a squat setup [00:02:35] or anything like that. And they want to take their practice to the next level. Now I get calls [00:02:40] about this all the time and, and I give my standard advice which which we’ll [00:02:45] go through in a bit. But what are the key areas of the business that that you look at when [00:02:50] you’re advising people to grow their practice? Or once you’ve acquired a practice, or [00:02:55] when you’re looking at a practice with potential to acquire. What are the key? What are the key areas [00:03:00] of growth that you look at? You know.

Dev Patel: Thanks for having me on Prav.

Prav Solanki: Um.

Dev Patel: Look, [00:03:05] I think everyone’s different in terms of where they are in life. Um, I always start with that first [00:03:10] because not everyone’s ambitious, right? Not everyone wants to have 100 practices or have £1 million [00:03:15] EBITDA business. Everyone’s different. And I think it’s best to kind of think [00:03:20] around that first, because if you haven’t got the right ambition and the drive and the kind of, [00:03:25] you know, energy and time to put into growing the business, it’ll never happen. And that’s what most owners [00:03:30] you know are going through. When I look at buying a practice of a 60 year old or a 50 year [00:03:35] old who’s kind of just checked out. Now kids have passed, you know, school and university moved out of house, [00:03:40] they’re not really needing to grow their net wealth anymore in the next ten years. They’re not really [00:03:45] that interested. And that’s why it’s an opportunity for us to go in there with the energy and the time with a young [00:03:50] partner to go in there and obviously acquire a business. So number one is the time and energy. If you’ve got that, [00:03:55] then that’s the So that’s the first step. If you have that and you’ve got the time, you know, and the [00:04:00] resources to grow the business and you can do some really simple things. First, a lot of [00:04:05] hats I see have gotten stuck in this kind of, you know, especially an NHS practice. They [00:04:10] got stuck in this kind of, uh, never ending wheel of just, oh, I’ve got no debt. [00:04:15] I’ve got a contract pretty much free of charge 20 or 30 years ago.

Dev Patel: I’ve got, you know, cash coming in every [00:04:20] year of 200, 300, 400,000, you know, EBITDA, pretty good kind of cash flow for business. [00:04:25] I don’t need to do any more marketing. I don’t need to do anything to business, because actually I don’t get paid more money from the government [00:04:30] for doing more. Right? So why do I need to do anything? And it’s crazy that most [00:04:35] practices I see, the majority of practices I see do not accept new patients, [00:04:40] right? I mean, just imagine any business in any world that says, I don’t want to have a new patient in my [00:04:45] practice. I mean, like, you’re literally just shoot yourself in the foot, right? So that’s [00:04:50] very common. That’s very, very, very common. And actually they they purposely [00:04:55] said, don’t come see us. We don’t have no more capacity left on NHS because they don’t want to have [00:05:00] the potentially awkward discussion of what can we do outside the NHS. You know, [00:05:05] and it’s a good thing, a bad thing, you know, it’s great. We’ve got a solid patient base [00:05:10] for many years that you’ve been, you know, treating well and taking care of them. And that’s good to have that. But [00:05:15] opportunity to have new patients coming in both privately and through the NHS is huge. [00:05:20] And then they also complain about I’ve got no space to to do more dentistry because, you know, I’m doing [00:05:25] 600 days per chair or I’ve got no capacity left. I had more surgeries in, [00:05:30] you know, expand the building backwards upwards change.

Prav Solanki: And I’ve [00:05:35] just I’ve just got a question on that, on that NHS piece. Right. So you said that these clinics have capacity, [00:05:40] they have fulfilled their contract or whatever. Right. And then they say we’re not taking on new patients. [00:05:45] Right.

Dev Patel: Even the whole year round, not just at the end, the whole year round.

Prav Solanki: Okay. But [00:05:50] they say we’re not taking on new patients is the reason for that, that they haven’t got the physical chair [00:05:55] space time to do it, or they haven’t got the nerves to have that conversation and say, convert [00:06:00] that patient to, let’s say, a private patient, or they don’t have the headspace to even think about [00:06:05] potentially private dentistry. Like I want to wrap my head around, like if they’re [00:06:10] at capacity with their NHS, I’d be saying to them, why on earth do you want to take on another [00:06:15] NHS patient? What’s that going to do for you revenue wise, business growth wise, valuation [00:06:20] wise versus a private patient? Right. So so I’m playing [00:06:25] devil’s advocate here. I’d be saying, what the hell do you want more NHS patients for. And you’re saying [00:06:30] actually you should be opening your doors and saying take on some more NHS, NHS patients. Right. [00:06:35] And, and you’re, you’re, you’re that business owner who’s, I guess the [00:06:40] expert at buying mixed practices and growing them rapidly. [00:06:45] Right. So what’s your lens on that.

Dev Patel: Yeah. So I think with mixed [00:06:50] practices regardless of that I I mean, I keep things very, very simple in life generally. [00:06:55] If someone comes to my front door with their NHS fee paying exempt or private, [00:07:00] it’s irrelevant. The human being is the mouth. Let’s give them the best treatment plan possible that you do [00:07:05] for your mum, or your son or your daughter, or however you treat your family. And that’s the best treatment plan. Give [00:07:10] them all the options, both within the NHS and outside the NHS. But that’s it. Keep it really simple. [00:07:15] If you do that, your business will flourish, right? But you have to have the discussion [00:07:20] with the patient. You cannot just shy away from it saying let’s do a five minute appointment for you in, out, in, out [00:07:25] and just stick to the one hat pony, which is NHS dentistry all the time. You [00:07:30] have to be discussing other options. Now, I’m not saying discuss other options. If you can’t do it clinically [00:07:35] now, I’ll be surprised if no one can offer any private industry clinically, because that’d be pretty worrying. But at least the basic [00:07:40] stuff like Typekit composite or private Emax crown or veneer. Now you might have to do some more training [00:07:45] for this, or get dentists in your practice to do that work, but that’s definitely available around the whole country. Number one. [00:07:50] Number two is why you asked the question about why would you say you want to have more patients [00:07:55] in the practice? It’s because they’ve got this simple contract with 1000 patients to [00:08:00] to service every year.

Dev Patel: They’ve been doing it for 20 years. Nothing has to change. It’s basic dentistry. [00:08:05] You come in, do a filling, do a crown, do a filling, do a crown. Whatever you need from the patients. Keep them kind of stable [00:08:10] and that’s it. And there’s no headspace. There’s no there’s no ambition or desire to do anything different. Because [00:08:15] why would you if you’re going to make, you know, 30%, 25% margin of no debt [00:08:20] every year for doing no thinking and no, you know, extra investment in the business. It’s [00:08:25] basically, you know, old school way of thinking, right? But we’re seeing in the news every day. I’m sure [00:08:30] you know, you’re seeing this too, in terms of in the news cycles, about eight out of ten adults can’t get a new [00:08:35] appointment on the NHS because no one accepts patients on the NHS in the first place. Right? If [00:08:40] you just add in some more capacity in your practice from 3 or 4 surgeries to 6 or 7, by adding in [00:08:45] some more surgeries or expand the building, you now have capacity to half the number of days [00:08:50] per jear. Deliver more care to all your patients for longer amount of time.

Dev Patel: So other than a ten minute [00:08:55] point, you’ve got half an hour to an hour appointment now, right? Um, and that’s what it comes down to just basically kind of, you know, [00:09:00] just spreading that kind of contract density into more surgeries. That’s number one. Um, [00:09:05] if you haven’t got capacity to grow, then think about moving the whole thing a mile away within a mile, you know, [00:09:10] then it is absolutely happy with you moving a practice away to relocate to bigger business. That would be a minimum [00:09:15] of five year investment cycle. So you’re actually growing the business by moving it. But by doing that you now have [00:09:20] these bigger locations. You get brand new facilities, modern. And you can, you [00:09:25] know, probably get better, you know, actual location on the high street rather than, you know, typically most practice I see are [00:09:30] houses that have been converted over years and which no one really wants to have that, but it just kind of is the [00:09:35] way it is right now that E1, D1 are really simple to get that cost the high streets, you should be looking [00:09:40] at moving it to all these vacant, huge premises that have been, you know, empty by all the shops that are leaving [00:09:45] high streets. Go there your, you know, your practice with a glass shop on the High Street near [00:09:50] your area. Amazing place to be and no problem from there just as well.

Dev Patel: Um, [00:09:55] and then the third thing is just the really basic part here is just, you know, patient journey, [00:10:00] which I know, I’m sure you know, you’re passionate about as well. Just take care of your patients properly. I mean, a lot of dentists [00:10:05] I speak to go. Yeah. We take great care of patients and asked them. Okay, cool. You go take great care of [00:10:10] patients. So what’s your patient going to look like? And it’s a 15 ten minute examination in [00:10:15] in the practice ask them how the holiday was. You know the kids maybe do a couple of fillings quickly like [00:10:20] within two minutes and then go home. And I think on NHS that is not a patient journey. [00:10:25] That is you just fulfilling your contract as fast as possible because you haven’t got time, because you’re trying to densely [00:10:30] put all your ideas on one surgery, put more chairs in, spread it over more chairs, [00:10:35] get more time back with the patient. Spend more time taking photographs, talking to patient properly, going [00:10:40] through all the options privately and within the NHS. And you’re going to get your growth just by doing that. Like [00:10:45] the hourly rate on that loan will triple or ten times easily. And then [00:10:50] obviously marketing is the last thing, which is obviously great and KPIs. But um, yeah, [00:10:55] talk about afterwards when.

Prav Solanki: It comes to things like KPIs. Um, you know, this is [00:11:00] something that um, so I’ve been through a, as a practice owner, [00:11:05] I’ve been through an acquisition. Um, and then you have acquired several [00:11:10] of our clients and also kiss Dental my brother’s practice. And [00:11:15] I was amazed at how quickly the due diligence process went through [00:11:20] with you guys, compared to the due diligence process that I went through, just in terms [00:11:25] of the racking through the numbers and so on and so forth. And I remember when [00:11:30] Kailash came to me and he said, look, I’ve had an offer and they’ve told me that, you know, this [00:11:35] deal is going to be turned around in this time. And I said, it’s absolutely bollocks. Yeah. There’s no [00:11:40] way there’s absolutely no way they’re going to turn the deal around in that time. They’re just telling you what you [00:11:45] want to hear. But Well, true to your word, it did end up being a really, really [00:11:50] quick turnaround time. Um, what is it about your process when [00:11:55] looking at numbers? And at the beginning of this podcast, I said, you just cut through the BS. Like at the beginning of [00:12:00] this, you just said, look, I look at things really simple. Someone turns up with a mouth. Doesn’t matter whether private, exempt [00:12:05] or NHS, we need to deliver a service to them. Right? And when it comes to [00:12:10] sort of either a due diligence process or an acquisition, or when you’re looking through the financials [00:12:15] of a practice, um, what is what is it that you’re looking for? [00:12:20] And why is it that when you’re doing this process, it’s so [00:12:25] much quicker than anyone else?

Dev Patel: Yeah. Look, I think, um, first [00:12:30] of all, I kind of, um, lead on obviously all the new leads and dealflow that [00:12:35] comes within the business first, just because, you know, I’ve been in 15 years, Prav I mean, I did this before I was [00:12:40] even started. I was looking at practices, purchases and parallels. Right. So now when I look at PNL, I can tell you [00:12:45] eight seconds whether or not it’s profitable or it’s complete BS. And the numbers make sense or not. Um, [00:12:50] so look, the number one is, if, you know, dentistry, like other dentists, you understand [00:12:55] dentistry and the actual patient journey that, you know, the marketing, the lead flow, the workflows. [00:13:00] Um, the dentist reputation, the clinic, the quality of dentistry. That in itself [00:13:05] paints, you know, the the back canvas of a picture, you know, then all it is, [00:13:10] is just putting the dots and, you know, the actual you know, I don’t know what you’re drawing on, on the canvas [00:13:15] together. And really, if you’ve got the if you’ve got a good PNL with a good long track history, [00:13:20] I don’t like seeing things that have grown in 2 or 3 years, because it’s just a quick kind of up and down. Um, you know, [00:13:25] good track record history, um, some good kind of, you know, fundamental growth every year [00:13:30] over a ten year period, or having the same flat growth and not having any growth, which is opportunistic [00:13:35] kind of purchase is what you’re looking for, really.

Dev Patel: And then after that, just to make sure add backs and all the, you [00:13:40] know, the clinical aspects of a PNL makes sense because the rest of it anyone can look at. But [00:13:45] it’s very hard for non dentists to understand why am I adding back this orthodontic [00:13:50] brackets. Because that would recharge it back to dentists and therapist model etc. etc.. So you know you need to understand [00:13:55] the intricacies of dentistry and to be able to really understand that. And then, [00:14:00] you know, after seeing so many probably thousands and thousands of deals over the years, now you kind of know what what [00:14:05] looks right and what looks wrong in terms of the benchmarking and percentages. And, you know, you can probably quite easily [00:14:10] work that on your head. But look where in our model and this is different to everyone else [00:14:15] because we’re investing in partners with equity both both ways. We invest in people. [00:14:20] So I’m not investing in I mean, if I’m buying a underutilised practice, [00:14:25] I’m buying the physical premises and the contract. That’s it. And I’m putting my, my, my own person in there with a partner. [00:14:30] I invest in that person to run that business. If I’m buying into a kiss or to an ascent, [00:14:35] I’m buying into people that I, you know, I think could be great partners and can grow with us in the future. [00:14:40]

Dev Patel: And that’s pretty Completely different to looking at like, you know, due diligence and trying to do what [00:14:45] other groups do, which is look at every single possible, you know, you know, 150, I don’t [00:14:50] know, maybe it’s 150, 200 different kind of checklists of just tick tick tick tick tick [00:14:55] tick tick does, you know, does kind of tick all these boxes. That’s all very relevant. Like, yes, as long as you’re [00:15:00] not going to kill anyone and it’s got a good, decent, uh, you know, no red flags in there for the DH, I’m not overly [00:15:05] fussed what I want to invest in people that I’m actually working with, because that’s the one that, you know, will be the biggest [00:15:10] growth or decline in the future. Right? So yeah, it’s not as difficult [00:15:15] in our model. And it’s very similar to how private equity works. You know they invest in people and the business [00:15:20] is great. You know, it could be good because of uh, of the market [00:15:25] and tailwinds, because of the economics and stuff like that. And, and there might be a big trend right now with [00:15:30] X, Y, and Z by actually investing in the CEO and the founder and the people in the business, that’s where you’re actually investing in a [00:15:35] team. And that’s how I look at it as well.

Prav Solanki: Well, the numbers have got to stack up, right? You can’t [00:15:40] you can’t. You bet on a on a person because you like the cut of the jib or whatever, [00:15:45] right?

Dev Patel: That that that’s a given though, right? Like that’s just common sense. And it’s, uh, it’s really important [00:15:50] to, especially with acquisitions to make sure you don’t buy into a business that’s A11 [00:15:55] pony kind of show, because that’s just going to guarantee, like if it’s a two jetpacks with [00:16:00] one guy working there doing over half the turnover and he’s, you know, retirement age or [00:16:05] probably potentially not, you know, tied in for for long term equity. Why are you buying. You’re buying [00:16:10] nothing. You know you’re buying revenue. That’s going to basically go when that person leaves. And then you basically [00:16:15] pay a lot of money for that revenue that’s not there anymore afterwards. So it’s really important to don’t [00:16:20] get too emotionally bought into the whole lifestyle of, oh, he’s got a great [00:16:25] practice and a great location and he’s doing really well. He’s got a Ferrari and a nice car. I want to buy that practice. I want to back [00:16:30] him. That’s not how it’s gonna work or hurt. You have to always buy as a model [00:16:35] in a business. What am I paying for? Because you’re not paying for a stable and solid, [00:16:40] like a like a government contract or a good practice that’s got like a [00:16:45] long 20 or 30 year history about revenue being done by principle. You’re not really buying a business, [00:16:50] you’re just buying, you know, a goodwill for somebody to leave in three or 4 or 5 years time.

[TRANSITION]: Mhm. [00:16:55] Mhm.

Prav Solanki: And one of the things that really surprises me, um, when [00:17:00] I speak to clients of mine and when I have done sort of more intense coaching with clients, [00:17:05] is, um, the number of business owners, you put a PNL [00:17:10] in front of them and it might as well be written in Japanese. [00:17:15] They do not have a clue. You know, even simple things like difference [00:17:20] between gross and net. Right. And then how that net should be adjusted for a valuation. How if [00:17:25] that principle is taken, I don’t know, a salary out for himself that you [00:17:30] need to readjust in as an associate to value the business. And they’re making the [00:17:35] valuation on the back, on the back of the fact that they only need ten grand a month to live off. So that’s [00:17:40] all I’ll take out of the business. So there’s more profit in there. Um, do [00:17:45] you see similar things in practices that you’re acquiring, or even [00:17:50] with the partners that you’re sort of, should we say, um, [00:17:55] co-investing with? And how important is it for a business owner to understand these [00:18:00] key sort of financial KPIs for running their businesses? [00:18:05]

Dev Patel: I mean, it’s it’s massive. I mean, to [00:18:10] be honest with you, it’s no one’s fault. I would say the majority of business owners in the [00:18:15] UK don’t have a clue what parallels are, right? They just rely on their accountants to send them the numbers end of the year and say, this is [00:18:20] where we’re at. They’ve got no business training and that’s okay. I’m not saying [00:18:25] that’s good. It’s okay. You can get by by doing that and not having to really know your PNL. But [00:18:30] if you want to grow your business and know where you’re at, I always compare this to a [00:18:35] health check, right? Like how you’re healthy? Like getting a health check-up. Or how do you know how much [00:18:40] you weigh? You know, weighing yourself. You got no idea. That data drives everything in my life these days. And [00:18:45] why would you not drive your business based on data, the same way you would do for [00:18:50] when you try and plan, you know, a patient’s mouth and looking at information, evidence. We’re all evidence based [00:18:55] professionals. That’s what we’ve drilled into. But we have zero training on business [00:19:00] HR panels anything. And it’s it’s it’s it’s it’s an opportunity [00:19:05] because as soon as you do that you’re straight away going to add 3,040% revenue [00:19:10] or 34% cost savings or efficiencies by not doing much else. Now, [00:19:15] some people I’m not saying everyone, but some people are actually born innately with this skill without [00:19:20] having to do any training.

Dev Patel: And they might have picked it up like like for example, I picked this up [00:19:25] working my dad’s shop when I was like seven years old or six years old, back in the day in a pharmacy and just [00:19:30] sitting there having to work out how much I sell, you know, something behind the counter over the till was [00:19:35] and what the margin would be if I sold it for this much or that much. Just kind of gave me the PNL understanding of like revenue [00:19:40] and profit margins. Right? And those are the basic skillsets you might have picked up over the years from something in your life [00:19:45] without realising. Um, but not everyone’s got that in them. So, you know, if you haven’t got that in [00:19:50] it, definitely. It’s been trained on because we spend 99.9% of our time on CPD [00:19:55] and training on dentistry. Great. No skill set on sales. No skill [00:20:00] sets on leadership. No skill sets on PNL finance. Nothing. And you just think you’re running [00:20:05] a business which is half the battle. And the other half is clinical. So if you’ve done a clinical great, why [00:20:10] not put any time and effort into it? It’s like saying, I’m going to do only, you know, I’m going to work out my legs only not my arms [00:20:15] or vice versa. You’ve got to do both because a hot body, right.

Prav Solanki: Leg day, mate.

Dev Patel: Yeah. Never skip [00:20:20] leg day. Exactly. So it’s really key. And I think it’s, um. It’s a real big shame, because [00:20:25] it’s not actually any good courses out there that exist that does this kind of level of training and Dental specific [00:20:30] practice management just for dentists at a good level. A lot of them are just basic stuff [00:20:35] like this is what profit is. This is what you know. But I actually like levers of growth because no one’s actually done [00:20:40] this before. There’s very few. I don’t think there’s any group, actually. It’s really been out there on a scalable [00:20:45] model that’s actually gone there and said, I’m doubling the turnover every three years for my practices. Doesn’t exist in the [00:20:50] UK or the whole of Europe even. So there’s definitely an opportunity there for people to learn this. And, [00:20:55] you know, people can share the knowledge and and go through it. But I think it’s super, super important. [00:21:00] Um, and it’s a shame because, I mean, the good thing is now and, you [00:21:05] know, whether I like them or not is another question. But the most of the work is out there. Do give [00:21:10] free valuations, and they do go through the PNL for you and literally go, this is where you’re at now. This is where valuation [00:21:15] is where EBITDA is, is we can do to grow it. And I would recommend anybody who’s thinking about exiting [00:21:20] in the next five, ten years go speak to a broker. At least they can give you some sort of a health check [00:21:25] and analysis on your business now, and where you need to move towards to get your number to get to [00:21:30] an exit in the future. And that’s a free of charge tool that is quite forward to have that in UK [00:21:35] because not everyone’s got that, you know, other countries.

Prav Solanki: But that’s, that’s not teaching a man to fish is it. I mean, [00:21:40] if you, if you look at that side of things and say, right, do the evaluation, it’s [00:21:45] going to be the same situation at the end of the year. Your accountant presents your numbers to you. You look at it, it’s [00:21:50] tumbleweed, and you just say, well, how much tax do I have to pay? Yeah. Do [00:21:55] you see what I mean? And that’s the majority of clients I speak to. Right. Is they don’t understand their [00:22:00] PNL. They never they certainly don’t look at it on a monthly basis. And [00:22:05] those who do look at it semi-regularly, don’t use the data [00:22:10] from it to drive their next business decisions, if that makes sense. Um, [00:22:15] so yeah, you could, you could go and get a valuation from, from any of these brokers. [00:22:20] Right. And they’ll go through your PNL with you. But what are the key numbers that [00:22:25] a practice owner, you just said you could add 30, 40% to your business just by [00:22:30] regularly looking at and assessing your PNL right, whether that’s 3,040% [00:22:35] revenue, whether it’s a cost saving, whether it’s a valuation piece, right, that, you know, if you [00:22:40] if you say to yourself, right, I want to sell my business in three years time, just by regularly [00:22:45] looking at your PNL, you can increase the valuation of your business in 3 or 4 years time. Is that what you [00:22:50] believe? Yeah.

Dev Patel: Yeah, yeah. I mean, I can spend a lot of time going through the whole thing, but just the five points [00:22:55] I would say is, um, if you’re going to get monthly panels, make sure [00:23:00] that drill down into really detailed line items, because there’s no point having 1 or 4 numbers [00:23:05] for your, um, cost of sales. Right? And it’s all bulked into one number. So it just says like, you know, I [00:23:10] don’t know, say it’s like, you know, associate cost or just cost for, for team. And that could be everyone’s cost [00:23:15] associates, staff, everyone. You don’t really know what the breakdown is. So really break down every single line [00:23:20] as much detail as possible. There are companies out there like spot on that do that for you. So you know they can [00:23:25] definitely get that. If you haven’t got an accountant, they can do it for you. Um, or you can just get it on zero, you know, or loads [00:23:30] of other kind of on the their online um, finance softwares and just, you know, do a course [00:23:35] about understanding what each line means and what what happens if one, if you, if you do that to one of them, what [00:23:40] happens to the other one. Right. Everything’s got a cause and effect on most of those line items. [00:23:45] So the basics are revenue number one. Top line right. How do you track revenue [00:23:50] now most patches just as you know just go oh we look in the month how much we’ve we kind of you know take [00:23:55] in terms of cash and then we work out how much pay a dentist and we say good month a bad month.

Dev Patel: That’s what I do. I have [00:24:00] no idea whether or not that’s good or bad or what the target is for you. So set yourself a budget [00:24:05] for the year. The budget is a target that you want to set yourself for the year over the 1st of April, or for the, which [00:24:10] is great tonight and or 1st of January, depending on what your financial year is. Now, obviously [00:24:15] in the UK most people are 1st of April, so just stick to that one. If you’re working with NHS and [00:24:20] just set yourself a target of what I want to achieve this year. So last year you made a million revenue total, this [00:24:25] year 1.2 million, right? How do you increase the revenue? There’s 2 or [00:24:30] things or three things. One is by obviously putting prices up. So weirdly enough, most [00:24:35] patterns don’t pay any prices up for ten, 20, 30 years. It’s craziness. And there’s no logic [00:24:40] behind it. They just go, oh, well, you know we want to keep the same prices working for us. Inflation [00:24:45] does exist, guys. Like it’s like it’s a myth, right? It’s not like it’s a, you know, some [00:24:50] some hidden little gem that no one knows about. It’s out there. It’s on the news every single day. If you know what inflation [00:24:55] is, make sure your prices are above inflation every year without fail.

Prav Solanki: How often should you be [00:25:00] reviewing your prices?

Dev Patel: At least minimum annually. But if you want to be a bit more [00:25:05] on it, like six monthly. Um, but if you’re doing it annually for, for inflation forecasts, whatever you [00:25:10] get from the banking and forecast application for the next 12 months, then normally thereabouts, you know, [00:25:15] um, obviously we’ve had quite big inflation for the last three years. Um, you know, five, six, 7%. [00:25:20] So, you know, we’ve been put prices up quite a bit, but you have to because your cost of goods are going up. [00:25:25] If you don’t do this. I mean, I’ve, I’ve literally been to practice last week. That week. I said my crown is still [00:25:30] £400 for the last 20 years. And I said, you do realise your margins are getting squeezed every single year by a [00:25:35] few percent for the last 20 years is probably a 50% decrease now in your margins on that same [00:25:40] product, like for like. You know nothing about it. Oh, but patients are happy and they just pay for it. It’s [00:25:45] like literally saying that I’m going to give you exactly the same, you know, glass of water today and in 20 [00:25:50] years time, the same cost by making half the profit on that for no reason. Right. [00:25:55] So, you know, you’ve got to put your prices up. And that’s a very common thing with any annually. [00:26:00] Yeah. Annually.

Prav Solanki: Yeah.

Dev Patel: For private revenue obviously not. Nhs and NHS will just do what they want to do [00:26:05] and it’s fixed. The second thing is volume. So volume is the second kind of big factor which [00:26:10] is basically doing more treatments. So more volume of offsetting, you know any procedure. [00:26:15] And that can be either adding more capacity, adding more hours or just utilising hours that are empty right now. [00:26:20] Once again, no practices I go see with an empty surgery in terms of all the hours that are not being utilised [00:26:25] in the week, is that one empty surgery? And I’m just thinking like you’re not exercising correctly. Make [00:26:30] sure you have all the hours booked out and utilised for. So that way you’re actually maximising your current premises [00:26:35] that you’re paying all the fixed costs for anyway. So that’s your volume. Um, and [00:26:40] then after you got your kind of top line and I’ll break that down to weekly targets, it’s much easier [00:26:45] for the team, the managers, the whole, you know, you know, your whole team, dentists to know exactly what targets [00:26:50] each week, have a huddle in the mornings, go through what targets are in the week and how everyone’s performing. At least [00:26:55] that way you’re communicating and you’re aiming towards something and give bonuses to the team for hitting targets. [00:27:00] You know, I know this is like really fun, but they just go every month. Everyone. If we hit target for the group, everyone [00:27:05] gets £100.

Dev Patel: You know, it’s just a nice way to make sure everyone feels like they’re on the same path towards the same [00:27:10] journey to kind of aim for a target. The next thing after revenue obviously, [00:27:15] is a cost. The biggest cost to any business in dentistry is a dentist costs your associate costs. So [00:27:20] review that if you’ve got associates in your practice who are doing like a 10th of [00:27:25] the price versus someone else in the same practice and I’m 50% or the same on [00:27:30] the same percentage. Why is that possible? Actually, if you look at the maths of that, the hourly [00:27:35] rate is the one that is doing £50 an hour and someone doing £500 an hour means that you’re making a loss [00:27:40] for £150 an hour, because your costs are higher than actually what they’re bringing in. It’s a sliding scale. 40, [00:27:45] 45, 50% silence scale or whatever you think you know, you know, in that in that area. [00:27:50] So that way everyone’s incentivised to grow that hourly rate rather than it being, you know, the [00:27:55] same. And no one has any kind of targets for it. And there’s nothing wrong with doing that. All you’re doing is you’re rewarding [00:28:00] people doing well. And the ones who aren’t doing that well, you know, have to keep growing and push themselves. And [00:28:05] then just make sure that you take care of your team.

Dev Patel: A lot of dentist costs go up and up and [00:28:10] up because they’re recruiting at higher and higher, you know, rates or other ones because they’re getting higher churn. [00:28:15] So not taking care of the team properly. So regular one to ones, regular mentoring, regular sessions of training [00:28:20] and and development really helps those dentists feel like they’re getting a bit more for their, you know, value Keep [00:28:25] it busy for them. How to have open discussions with them regularly about what things are going right and what’s [00:28:30] going wrong. But yeah, so the associated costs are really key and the staff costs. So looking at like how much [00:28:35] staff do you have versus FTE staffing versus number of associates in the practice. They’ll have [00:28:40] too many staff to have little staff. How are you utilising the time when they’re not busy because there’s taking holidays [00:28:45] or whatever else? Um, do I have time in lieu? All these kind of things to maximise, you know, your actual costs that you’re [00:28:50] paying out for your teams. And you should be doing regular one to ones with all those members [00:28:55] of teams. So that way you can go through like, you know, their kind of progression for the year, their pay rises and [00:29:00] link it to actual progression. A lot of people I hear about going, oh yeah, we just got told to give another pay rise because [00:29:05] she doesn’t leave soon.

Dev Patel: I’m worried about losing my nurse. You might lose your nurse, but have you even [00:29:10] had a discussion for the first place about why they won’t leave? How are they getting progression? Like, is it the pay? [00:29:15] What’s the issue of causing them to leave in the first place? Right? Um, if you have a good culture, people don’t [00:29:20] generally want to leave. Um, obviously life will happen, people will move house and whatever else. But [00:29:25] apart from that, you should you should be able to hopefully keep your team happy and then you know all the other [00:29:30] fixed costs like your rates and I mean rent rates. Rebate is a huge one that no one does. Even everyone’s [00:29:35] got contracts can get a rebate on their rates. So anyone listen to this right now like [00:29:40] look into it and get some money back for your rates. Right. Like it’s like you can definitely do straight away and it’s easy [00:29:45] to get money back. Um, you know, other things like looking at discounts for your materials and labs [00:29:50] and making sure everyone’s kind of, you know, maximising the procurement discounts there. Now, it’s hard to do it when you’re a small [00:29:55] practice, but if you’ve got a mini group, definitely be looking at like, you know how you can streamline things there. We’re not [00:30:00] trying to say you have to use a certain lab or have to do certain materials, but even going to suppliers and having discussion [00:30:05] with them will definitely give you some more savings than you would have by not having a discussion in the first place.

Dev Patel: And [00:30:10] then, you know, there are obviously other smaller things on there, but nothing major. I mean, you always find that there’s a lot of wastage [00:30:15] sometimes on cost lines like general and other things, because the team goes on Amazon and goes crazy and [00:30:20] orders those things and no one’s looking there. So, you know, keep an eye on that now. Most practice owners who [00:30:25] own their own business don’t let people have their own card, so they only spend money on their own card themselves, not anyone to use [00:30:30] it. So it’s probably not as much of an issue. But keep an eye on all the small things because, you know, it’s [00:30:35] not easy to make EBITDA if you’re wasting 20 or 30 grand a year on irrelevant things that don’t need to be, then a practice [00:30:40] that I want to grow, the business that don’t spend it. But yeah. And then I think the other thing is just investing [00:30:45] in CapEx on technology, because technology can really drive efficiencies, increase sales, [00:30:50] increase conversions, and increase quality of care and help patients and dentists [00:30:55] feel they’re getting better service. So, um, yeah, you know, that money’s worth it [00:31:00] because CapEx does not affect your EBITDA. Remember that guys?

Prav Solanki: Okay. So me and you both know [00:31:05] what CapEx is, right? But I guarantee you there are many people listening to this saying what on earth are they talking about? [00:31:10] Right. So I just want you to just very quickly give me a summary of that is and what [00:31:15] do you mean by investing in technologies? Are we talking about EOS scanners and things [00:31:20] like that? Um, things that will improve sort of digital workflows and that sort [00:31:25] of thing. And let’s go back to CapEx first.

Dev Patel: So CapEx is capital expenditure. So if [00:31:30] I’m buying anything that’s going to last more than a year or like, you know, a few months, like like a like just keep it [00:31:35] simple composite. It’s not CapEx. Use it. You put it in the bin. It’s finished. Right. Like that. That’s [00:31:40] a consumable that’s consumed regularly. Uh, CapEx is anything like a dental [00:31:45] chair or a scanner anything. It’s like buying a car. It’s going to last a long period [00:31:50] of time that over time will depreciate in value because it will get wear and tear. So [00:31:55] anything over normally a few hundred pounds that’s an equipment or machinery [00:32:00] is technically CapEx. So even, you know, uh, opex okay. That’s CapEx. [00:32:05] Right? And these are items where when you calculate EBITDA, which is your [00:32:10] earnings before interest, tax, depreciation and amortisation, that is what they [00:32:15] use for valuations when they buy a business. So when you go to sell your business, they’ll say EBITDA times by multiple [00:32:20] is what you can evaluate. If I spend £100,000 a year on CapEx, that will not impact [00:32:25] my EBITDA anyway. That’s a balance sheet item. Okay. So it’s really important to remember [00:32:30] that people go, oh, you know, I spend 50 grand or 20 grand on this machine. It’s going to impact my evaluation. [00:32:35] And that’s how it works. If anything, you’re going to increase evaluation because someone will pay for those machinery when they [00:32:40] buy the packs. Anyway. You add it on to the purchase when you sell it. So investing in technology [00:32:45] now is not going to impact you negatively anyway, as long as you use it [00:32:50] and it’s utilised to its maximum capacity by everybody, not just sits in the corner like [00:32:55] I see some sewing machines in the corner, practices collecting dust because no one’s using them anymore, right? [00:33:00] That’s not good investment, but are you going to buy digital x rays [00:33:05] at OPG or Cbct? And I don’t know, a scanner like an Itero.

Dev Patel: You know, [00:33:10] these are things that you should very quickly generate you way more EBITDA [00:33:15] times by multiple of seven or 8 or 6 or whatever you’re going to get when you sell way [00:33:20] more value than you would do by not having it. So just as an example, if I buy an item now, [00:33:25] I do ten cases of my idea. Because of the before and after scan, I can show patients what it looks like. [00:33:30] Those ten cases will give me £40,000 of revenue. That will then give me, just say, roughly [00:33:35] £10,000 of profit or EBITDA. That £10,000 [00:33:40] of EBITDA times by seven is 70 £70,000 valuation extra. And I’m [00:33:45] paying 20 grand for the machine. Now is that a good investment for ten cases? It’s [00:33:50] a no brainer, right? So it’s just about the basics of like, you know, what you’re investing in and how it’s going [00:33:55] to give you returns or it’s going to be better for day to day workflow. Like if I’m scanning not taking impressions anymore, [00:34:00] that makes my patients patients doing it better means that I’m spending spending more time doing dentistry [00:34:05] and not wasting time doing, you know, remake impressions again, twice because someone did it correctly [00:34:10] the first time and and etc., etc.. It’s a lot more efficient for the patient and for the dentist [00:34:15] to be doing that and saving material costs. So there’s loads of benefits out there. It’s just about what [00:34:20] works for your patient base and your skill sets and what you want to be doing. But don’t be afraid to invest in your [00:34:25] business. The best investment you can do anything in life is yourself or your business. Yeah. [00:34:30]

Prav Solanki: Absolutely.

Dev Patel: A lot of people don’t do that. And that’s where I find a huge opportunity [00:34:35] because I’m saying, well, great, I’ll do it for you and then I’ll double it for years and happy days, right?

[TRANSITION]: Yeah. [00:34:40]

Prav Solanki: Yeah. And I think on the investment in yourself side of things you were alluding to [00:34:45] earlier, like, you know, a dentist will go on 25 composite courses and they’ll ten, 15 different [00:34:50] ways in which to put this white paste on someone’s tooth to make it look shiny or special. [00:34:55] Right. Um, and then they’ll go and learn how to do this soft tissue grafting or whatever. [00:35:00] Right. All these different techniques, collusion, this, that and the other and very rarely invest [00:35:05] in, let’s say, financial or, you know, the sort of stuff that I talk about a lot is [00:35:10] the sales process, right? And certainly for me, what I’ve [00:35:15] seen certain delegates who’ve been on my sales mastery course, or we’ve done some small [00:35:20] group training for certain certain, um, clinicians as well as TCL’s, is [00:35:25] just that uplift in a confidence [00:35:30] that actually being confident about talking about the [00:35:35] value of what they’re delivering is exceptional value, rather than being embarrassed about it. Um, [00:35:40] and then B just being able to articulate yourself [00:35:45] in using really, really simple language. Um, and it blows [00:35:50] my mind at how many clinicians just don’t have that and either [00:35:55] overcomplicate it, skirt around the money, suffer from this fiscal drag where [00:36:00] it says £5,000 in their head, in for four grand, comes out of their mouth. God knows why. This whole [00:36:05] whole thing. What do you see in in your group with. I’m sure you’ve got a wide range [00:36:10] of clinicians right from those who are what I would sort of call sales [00:36:15] machines are really natural and fluent in the art of sales. [00:36:20] To those who are sort of a little bit more sort of stifled in that way. So [00:36:25] what was the general view from your perspective, and what impact [00:36:30] do you think somebody’s nailing that will have on the overall profitability of [00:36:35] the practice?

Dev Patel: I mean, I, I was very fortunate. I did, um, [00:36:40] you know, a couple of these kind of sales, ethical sales kind of courses very early on, like literally my VCE [00:36:45] year. Yeah. Um, and it was and I still say this today, it’s the best course [00:36:50] I’ve ever done in my entire life. And it’s probably I would actually say it’s contributed [00:36:55] to 70% of my success in my life, because those two, that one two day course, I [00:37:00] mean, that’s how crazy it is. And I think every dentist comes out of university [00:37:05] almost exactly the same. We all taught for five years how to dentistry. We’ve got we’re all, I don’t know, left or right [00:37:10] brained whether to like, you know, very academic and very kind of like process driven. And [00:37:15] that’s how it all came out of university. We’re like exactly the same after that is whether or not you have [00:37:20] it, as you mentioned, like naturally within you to have it. Of cells. Um, and a bit of, you know, good chat with [00:37:25] patients and that kind of rapport building or, um, you need to be taught it, [00:37:30] but everyone can be taught it. And even the ones that we’ve got in our group, you know, we’ve got a few hundred dentists, [00:37:35] you know, around, you know, in mixed practices that aren’t all come out exactly the same from university. All [00:37:40] of them get trained on cells, and some of them do really well and maybe do £400 [00:37:45] an hour. Some of them do okay and do £200 an hour, but it’s still way better than average £100 an hour in the rest [00:37:50] of the country. Right. So everyone can benefit from sales training, even knowing about it and understanding, [00:37:55] you know, how to describe things, explain things, break it down.

Dev Patel: Find out what the concerns are [00:38:00] and overcome them. But whether or not I do it is another question. And that just comes down to, once again, [00:38:05] discipline. It’s like doing the same thing over and over and over correctly every single time. Now, I [00:38:10] could not emphasise how important that is. That is like the most, I mean, the most easy [00:38:15] way to grow your business straight away tomorrow. Just doing that course. Right. But at the same [00:38:20] time, you kind of need to have that that knowledge on [00:38:25] the financials as well, because I do see some great guys who can sell anything as we you know, we know a guy [00:38:30] can sell anything really great. Revenue is great, but their cost spending is also very high and they’re just not controlling [00:38:35] the costs. And therefore the profitability is very low. So you do need to control kind of at the top and [00:38:40] the bottom. And I think it’s harder normally to um it’s much harder normally to grow the top line [00:38:45] because cost actually is easy to control. So if you if you can control the costs and the top line, [00:38:50] you’re winning. And that’s what we’d find. Actually we do have some partners who are great. You know coming in [00:38:55] new partners coming in can can do really well in terms of the top line and growing the business and growing the dentist. [00:39:00] And that’s great. But I love spending money on everything else. And if I kind of conventional scanners or ten different [00:39:05] printers, ten different, um, you know, CapEx. Yeah, CapEx stuff, which [00:39:10] is one thing that’s debt in the business, right? But then they also spend loads of materials, money [00:39:15] on labs because they think, oh, if I get a £500 crown from a laboratory in Italy, that’s going [00:39:20] to get, you know, more, I’m going to get, you know, an extra five likes on Instagram.

Dev Patel: But will that [00:39:25] make any money for them differently versus a £200 crown from a very good laboratory in London? No. So it’s going to [00:39:30] be logical about your time. And it’s all about hourly rates right. Like you can do whatever you want as long as it’s [00:39:35] high. That’s the key thing. Um, if you’re spending ten hours doing a crown from a crown in Italy and you’re trying [00:39:40] to place it and you’re only charging £500 for it, probably not making much money, right? Um, so, yeah, [00:39:45] look, I think, uh, you know, that’s really, really key for sales, but I think in general, look, [00:39:50] none of us have been trained, um, on anything to run a business. My only training I [00:39:55] had on, well, finance was I taught myself. But, like, you know, most of my partners had no, no idea what PNL [00:40:00] was. And we went through them. And that’s part of our training we do with our partners. Um, but like [00:40:05] HR, for example, don’t think only about HR was watching TV saying, you know, American TV shows saying you’re fired. [00:40:10] And I thought That’s normal. You know, that’s kind of normal in the UK. Completely [00:40:15] different in real world, man. I mean, some of the stories that that, that, that, that we’ve experienced over the years [00:40:20] now, it’s like, why have we got all this stuff at university? It’s craziness.

Prav Solanki: And [00:40:25] it’s certainly with HR. Things are changing all the time, right? I mean, you [00:40:30] know, I was, you know, running my small business, the thresh, before we were [00:40:35] acquired by Virgilio. And now, um, they’ve got a whole HR department and that’s opened [00:40:40] a whole new world to me. Right. I guess I’m learning about where I probably might have gone wrong a little bit [00:40:45] when it came to HR. And yeah, probably could have could have got away with certain things [00:40:50] as a, as a small business. Um, but I think it’s important to, um, [00:40:55] to have that knowledge because we’ve got certain people who manage the whole HR in the team, [00:41:00] and it just gives you a little bit more insight into people and what not. And, um, [00:41:05] you know, what their challenges are and how to approach that Appropriately. Yeah. [00:41:10] Yeah. Um, I guess a lot of what we’ve been talking about today [00:41:15] revolves around leading people and leadership, and I think that’s probably one of the most important [00:41:20] aspects or elements of practice growth.

[TRANSITION]: Yeah.

Prav Solanki: I speak [00:41:25] to a lot of practice owners who won’t have that uncomfortable conversation with their associates [00:41:30] or their team members. I speak to a lot of practice owners who won’t even share revenue data [00:41:35] with their team because they feel this is this is the this [00:41:40] is the party line and it regularly comes out that do you think I should be sharing our [00:41:45] revenue? Because then everyone will know how much we’re making. And I’d be like, they just need to go on the [00:41:50] Dental software, mate. It’s all there. Yeah, they see they see the money coming [00:41:55] in and out of the business, right? Just stick it in, stick it on the whiteboard, set a target. [00:42:00] It’s fine. Yeah, yeah. Um, you know, and certain [00:42:05] individuals will will drive their, Over there, go to work car [00:42:10] so that their staff don’t see their car. Right. And then there’s [00:42:15] total opposites who just drive sports cars, right. Which we’ve seen it all. Um, and, [00:42:20] and I think this sort of lack of transparency or willingness to [00:42:25] share transparency in, first of all, your revenue, profitability [00:42:30] numbers with the team. I truly believe [00:42:35] that that’s a real mindset piece that holds back growth. And I don’t know if you’ve [00:42:40] seen that. Yeah. Yeah. And what your view, what your view on that is and how that impacts from [00:42:45] a from a leadership perspective as well.

Dev Patel: I think it’s um, that’s one [00:42:50] aspect of many different things that I see that there’s, there’s two different types of leaders I [00:42:55] see currently. Right. There’s this. And I’m not saying it’s always old school, but generally this old school kind [00:43:00] of leadership style of I want to look poor, trying to make sure [00:43:05] everyone feels that I’m not making them that money and just, you know, take the cash in the bank, but no one knows about [00:43:10] it and keep it all secret. Right. And it’s like, okay, you’re doing that and [00:43:15] that works for you. Fine. But that same person will be penny pinching on [00:43:20] loads of small things. And I’m seeing it from like, you know, let’s try to recharge. I [00:43:25] don’t know, the bin bags to our associates, just anything that can recharge back. They’ll do that. [00:43:30] Let’s try to, um, you know, cut costs by, you know, um, not giving pay rises and [00:43:35] just getting high churn rate because that would say my costs. How do I, you know, protect my business [00:43:40] by making sure no one grows too much. So I don’t want associates doing too well because otherwise they do too well. Then they might take my [00:43:45] patients away from me and I’ll lose my business. And they’re always being on the defensive rather than on [00:43:50] the like, you know, the sharing and the kind of like, you know, proactive approach of running a business. And [00:43:55] I think that’s holding them back massively. And actually, the other kind [00:44:00] of great example of that is, you know, one thing is sharing, you know, your data and sharing [00:44:05] your costs and sharing like how business runs with the whole team and make sure everyone’s on the same targets.

Dev Patel: Because if [00:44:10] you’re working towards the same target, you’re finding what’s more productive. They’ve got better culture and they’re more transparent, [00:44:15] right? Um, but another good example of what I, um, I find astonishing [00:44:20] is where, you know, you might have a principal who is [00:44:25] an older inspector. I’m not saying there’s an age for that, but there’s, you know, on the old end of the spectrum, [00:44:30] the mindset of I’m like, let me tie in these associates by putting in clauses in their contracts [00:44:35] that say they have to hit a certain target for udas. They leave, they’re going to pay me some recruitment fees. If [00:44:40] they leave that, I’m going to put them in chains basically. Right. And and it’s like this mindset of [00:44:45] as soon as you work for me, I own you. I literally own you. That’s basically how they think. And [00:44:50] they won’t say it out loud, but that’s how they think, right? In my world, I’m just like, look, [00:44:55] if you come work for us, you’re self-employed. You can do whatever you want. You enjoy it, you [00:45:00] work hard, you do well. Great. You save us long term. If you don’t like it, you leave. [00:45:05] There’s no targets. There’s no time, nothing. We’re not going to charge you for courses. We’re not going to charge you for any kind of callback. [00:45:10] You leave because it’s a free world. And I always do well in life. So if I if I’ve known you [00:45:15] for 3 or 4 years and you’ve, you know, you develop your skills really well when you’re in practice, you want to go do everything in life. [00:45:20] Do it.

[TRANSITION]: Well done.

Dev Patel: Absolutely fine. Because in the day, if you’re a good person, that will make a [00:45:25] huge difference in karma and that will always come back. And I’ve got plenty left. I come back after and said, shit, we had a bad [00:45:30] time with you. We should have stayed with you after, right? And that will come out into the world. But if you’re one of those owners [00:45:35] out there, small groups or owners who just want to keep this, the same mentality of I [00:45:40] own my business. I put all my blood, sweat and tears into it and I will make sure that everyone who works there works [00:45:45] for me like a, you know, like basically like an employee. You’re never going to succeed or grow the business any [00:45:50] more than what it is now. You might do well on your own and you do well on your own. You’ll never go far. [00:45:55] And what we’re saying is, you know, go, go, go quick on your own or go far together or whatever it is. Right? [00:46:00] That’s how it works. And honestly, it’s, um, it’s quite sad because I do get associates [00:46:05] who’ve come to us saying, well, can work for you. I can’t leave because I’ve got a £10,000 [00:46:10] recruitment fee to get out of this. This one practice I work for. It’s like, how does someone even threaten [00:46:15] them that you can’t legally do that anyway? Because I’m employed and spends £10,000 of equipment fees. [00:46:20] He’s like.

Prav Solanki: Yeah, yeah, yeah, yeah.

Dev Patel: It’s there’s this big difference in leadership styles, [00:46:25] right? And what I’m trying to get at is everyone needs to move towards the, the new generation [00:46:30] of leadership styles because we also have to change ourselves. Right. Like ten years [00:46:35] ago when I first bought my first practice, I have to worry about dentists not having wanted to work full time [00:46:40] or not wanting to do udas. And, you know, the work ethic, it was it was it was [00:46:45] bad. It wasn’t anywhere near as bad as now anyway. Now you don’t want to go to university. They want to be earning £100,000 [00:46:50] a year on two days a week, doing a couple of days and and doing bonding of veneers [00:46:55] from day one without any experience. And I’m like, your expectation levels are here and you’re [00:47:00] not even there yet. Right. So it’s, um. It’s a tough world, but I. I always say that [00:47:05] we work for everyone who works for us. So if I’ve got a dentist or a member of a team, like a nurse or hygienist, [00:47:10] we all work for them and we have to work around them what they want. Let’s work around [00:47:15] that to make them happy, right?

Prav Solanki: Yeah yeah yeah yeah. No, that all makes sense. And this [00:47:20] just brings me nicely to, um, to the conversation [00:47:25] we had probably about a month or two ago now. And, [00:47:30] um, you were talking to me about obviously recently what had happened [00:47:35] at the fresh and, um, how I’m personally stepping back [00:47:40] from coaching. I only coach two clients at the moment, 1 to 1, and I literally [00:47:45] can’t afford to do coaching anymore. Just don’t have the time. The [00:47:50] headspace, um, and I’ve got to split that time. You know, I’ve got I’ve got to choose whether [00:47:55] do I coach a client or do I spend it with my wife and kids that that is the that is the toss up [00:48:00] right now. Right. So I’ve got two clients that I’m coaching and we’ll probably not do 1 to 1 coaching again. [00:48:05] Yeah, yeah. For the foreseeable. Um, and then you said the same thing to me, which [00:48:10] was, um, you get people or dentists asking you all the time, and can you do some coaching [00:48:15] and look, you’re running 50. How many practice is now 57, 57 [00:48:20] practices. Right. Um, you’ve you’ve definitely got [00:48:25] no time for 1 to 1 coaching, right. And um, so we got, we got chatting about this and, um, [00:48:30] you know, should we put a course together. Um, which is what we’ve done. Um, [00:48:35] start scale, exit UK. Um, and the idea behind [00:48:40] that was if me and you can come together and look, I could have shared some information [00:48:45] on this podcast, but you’ve all heard that on several podcasts before about marketing, patient [00:48:50] journey, sales and all the rest of it.

Prav Solanki: Right. But I really wanted you to hear almost like a [00:48:55] fly in the wall conversation of what I normally have with dev when I’ve got a client [00:49:00] who’s got a question that I can’t answer. Or perhaps, you know, there’s an acquisition question [00:49:05] that somebody’s asking me for. I just pick up the phone and speak to dev, and he cuts through the [00:49:10] noise. And so we’ve created a almost like a 12 month program, and [00:49:15] we’ll put the link in the show notes. And if that’s of interest to any practice, [00:49:20] owners want to be practice owners and those who are getting towards the end of [00:49:25] their journey and they’re looking at exiting and how to maximise the value. And [00:49:30] I think we’ve put together something that’s pretty special that doesn’t doesn’t exist out there, [00:49:35] but it’s got to be right for you, dev. Just, just your thoughts on, on, on the program [00:49:40] that we have put together essentially covers, you know, strategic planning, [00:49:45] financial mastery, communication, leadership, marketing, [00:49:50] compliance, patient care, growth and scaling and exit [00:49:55] as well. You know, there’s tons of courses out there that The different facets of this [00:50:00] and, um, you know, I feel quite privileged that you’ve sort of said, look, let’s, let’s [00:50:05] do this. I’m really looking forward to delivering the first cohort. But your sort of view [00:50:10] on this, based on the fact that, um, you know, you get a lot of a lot of clinicians, [00:50:15] um, practice owners come to you and say, hey, I’d like some advice and [00:50:20] help, and I’m assuming you’re in a similar situation, right? You’re just not able to give the time. Yeah. [00:50:25]

Dev Patel: No, no, I think, um, I think it’s almost a bit of a disservice to the [00:50:30] industry that only our partners get that level of coaching. I mean, literally all of [00:50:35] our partners come from normal associates growing into practice. Owners have got two, three, four practices [00:50:40] of us now, and they’ve learned how to grow a business to a million, 2 million revenue within 2 or 3 years. I [00:50:45] just want to share as many people as possible, because I feel like if we can do that, we’ll not only help more people [00:50:50] within the industry get learn how to run a business better, but to grow businesses but also [00:50:55] get better value for themselves. I mean, there’s no course that exists that will give you more value than this [00:51:00] one. I personally believe because if you’re looking to become an owner or currently an owner of one or more of [00:51:05] them, one practice and you can grow your business more by learning however many tips and [00:51:10] tricks from us over the 12 month period, and with some coaching them as well. I genuinely feel you’ll get 20, 30, [00:51:15] 40% more value from that business whenever you want to exit it or every year. And that is, [00:51:20] you know, hundreds and hundreds of thousands or millions of, you know, value, right? So I [00:51:25] think it’s a no brainer. I think it’s a shame that we’re not the only country, by the way, but all countries I go to around the world [00:51:30] haven’t got this kind of course that exists.

Dev Patel: I’ve got loads of dentists in Morocco looking like kind of like, you know, this is a [00:51:35] great course. We should actually, you know, think about doing something similar for the US, obviously. And it’s just like we should [00:51:40] be training on this level of training at university, every dentist, because this is as important, you [00:51:45] know, when you’re a self-employed dentist, whether you’re an associate or an owner, you still need to know how you how penile works, how your [00:51:50] accounts work end of the year, how you grow your personal hourly rates. These are all things you should know about. But [00:51:55] no one’s being taught this. And I think if we can spread that ten, 20, 30, 40 people, 50 [00:52:00] people a year, and we do that over the next ten, 20 years or however long you do it for, you know, I think we can make a huge [00:52:05] difference on, on just kind of building a really good sense for entrepreneurship around, you know, dentistry [00:52:10] and hopefully sharing some of the pitfalls that we’ve been through and some of the blueprints that we know work. Um, [00:52:15] but yeah, I think it’s hugely important. And, you know, anyone out there is interested just, you know, message Prav. And I’m [00:52:20] sure we can get some some spaces for you.

Prav Solanki: Yeah.

Dev Patel: We’ll put we’ll.

Prav Solanki: Put the website [00:52:25] details in the show notes. And then if you guys have got any questions feel free to message me directly [00:52:30] on Instagram. I know dev’s not available on Instagram deliberately, I’m guessing, [00:52:35] um, for personal reasons, to stop him doomscrolling and all the rest of it. Um, [00:52:40] so, um, yeah, if you I think if you want to get hold of them, it’s got to be via LinkedIn. Um. [00:52:45]

Dev Patel: Oh, and that’s, uh, with a picture. That’s fine. Whatever’s easier.

Prav Solanki: Yeah, yeah, yeah. Snail [00:52:50] mail. He was talking about old school dentists earlier, weren’t you? Yeah, yeah. Um. So, um. Yeah, I’m [00:52:55] feel free to reach out and um, inquire and we’ve got, [00:53:00] we’ve got a handful of spaces left for the next cohort. So, um, if you’re interested, [00:53:05] do get in touch. It’s a 12 month program. I would be delighted to have you on board.

[VOICE]: This [00:53:10] is Dental Leaders, the podcast where [00:53:15] you get to go one on one with emerging leaders in dentistry. Your [00:53:20] hosts, Payman Langroudi and Prav [00:53:25] Solanki.

Prav Solanki: Thanks for listening, guys. If you got this far, you must have [00:53:30] listened to the whole thing. And just a huge thank you both from me and pay for actually sticking [00:53:35] through and listening to what we had to say and what our guest has had to say, because I’m assuming you got [00:53:40] some value out of it.

Prav Solanki: If you did get some value out of it, think about subscribing. And [00:53:45] if you would share this with a friend who you think might get some value out of it too. Thank you [00:53:50] so so, so much for listening. Thanks.

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

Payman Langroudi: People often ask me about the best way to increase their whitening in their practice. I’ve [00:00:05] got all the numbers in front of me. I can see sometimes in the same practice, one dentist doing ten times as much whitening [00:00:10] as the one next door. The dentists who do the most whitening are the ones who talk about whitening the most. [00:00:15] That seems kind of obvious, but there’s a group of patients who I would call the lowest hanging [00:00:20] fruit. Patients who come in every six months needing nothing at all. I would definitely ask those patients, [00:00:25] you need nothing because you’re brilliant. Have you ever thought about whitening your teeth? We’re asking everyone Enlighten online training. [00:00:30] Join us for an hour of clinical and marketing tips. Swap unpredictability [00:00:35] with delighted patients and higher margins. Enlighten online training.com. [00:00:40] Let’s get to the pod.

[VOICE]: This [00:00:45] is Dental Leaders, the [00:00:50] podcast where you get to go one on one with emerging leaders in dentistry. [00:00:55] Your hosts Payman Langroudi [00:01:00] and Prav Solanki.

Payman Langroudi: It gives me great pleasure to [00:01:05] welcome Keval Patel onto the podcast of Cana [00:01:10] Health Group, which is a group of five big practices [00:01:15] in and around Milton Keynes, and the Cana Academy, which is an education [00:01:20] spin off from that group. Massive pleasure to have you, my buddy.

Kaival Patel: Thank you for having me. [00:01:25] Payman. Yeah. Really an honour to be here.

Payman Langroudi: Yeah. Thanks for coming all the way.

Kaival Patel: No, no, [00:01:30] it’s not far. Milton Keynes to to London. Very easy. 30 minutes. We’re here. A little [00:01:35] bit of a delay on the on the trains, but yeah. No, no issues whatsoever.

Payman Langroudi: This [00:01:40] probably go into the backstory, all that. But sometimes I’ve got a burning question. And my burning question [00:01:45] for you is around the vibe in the practices. Yeah. Because I’ve [00:01:50] visited and I know how hard it is to keep a culture going even [00:01:55] in one building like the one you’re in right now. Have you managed to keep [00:02:00] that sort of family vibe going across five big practices [00:02:05] with how many employees now?

Kaival Patel: About 130. Yeah. [00:02:10] What about 130?

Payman Langroudi: Was it on purpose or by mistake? Because you certainly have that. I don’t see that with many corporates [00:02:15] or many corporates.

Kaival Patel: The vibe. I don’t know if you remember actually Payman we [00:02:20] met in Alicante. We were grabbing a coffee in between.

Payman Langroudi: How could I forget?

Kaival Patel: And, [00:02:25] um, in between, I came up to you and I don’t think we’d spoken to many times [00:02:30] before that. And I said to you, you probably thought I was trying to blow smoke [00:02:35] up your ass. But I said to you, Payman a day you came to my practice actually changed [00:02:40] our life. What? Yeah. And I’m serious. I’m serious.

Payman Langroudi: So I really thought you were joking. [00:02:45]

Kaival Patel: No, no no, no. So, uh. And again, this was many years ago. You came and [00:02:50] we’d recently taken over a big practice, our first practice. And I was [00:02:55] Uber enthusiastic. I wanted to introduce enlighten and loads of different things there. And [00:03:00] you came to speak to the the associates at the time and they [00:03:05] they had none of it. And I remember you were you were sitting in we had an upstairs [00:03:10] waiting room at that time sitting really regal. I had this really vivid picture in my crossed [00:03:15] legs. And you were talking to these guys and they just grilled you for an [00:03:20] hour. And I felt so embarrassed to have invited you to the practice to try and implement, [00:03:25] you know, a new system. And and yeah, people were just not on [00:03:30] board. They didn’t want to change. And these were all associates that we had [00:03:35] inherited when we’d taken either practice. Some of them were ex owners, um, and they just didn’t like change. [00:03:40] And I think a big, you know, I learned a massive lesson that day, [00:03:45] um, through the embarrassment side of it is I don’t want that culture, you know, I [00:03:50] don’t want that culture. Um, and we’ll probably go through, you know, when we took over the practice [00:03:55] later on. But, you know, it really, I hated [00:04:00] that. I hated that vibe. I hated going to work at that point. It was my own practice, and I hated it. And [00:04:05] I made a conscious decision to talk to my wife, Serena, who’s also the code director. And at [00:04:10] that time, we just had the two practices. And I said, this has got to change. And [00:04:15] that from that moment onwards, things started to change. It took a while to [00:04:20] to really get, you know, the culture change. And what did you do?

Payman Langroudi: What did you.

Kaival Patel: Do? First part [00:04:25] was, um, allowing them to leave and not having the, the, [00:04:30] the people there that weren’t on board with us. But I think also there wasn’t [00:04:35] really we didn’t have a North Star, to be honest. You know, we took over a practice and we didn’t really [00:04:40] know what we were doing. It was just the dumb thing to do. And, um, and, you know, [00:04:45] I had all these dreams and aspirations, but there wasn’t really a guiding North Star. And [00:04:50] what we changed was that North Star, which was positivity and respect, and [00:04:55] we really started to implement that and people that weren’t necessarily on board with it. Then [00:05:00] we had to move them out. Yeah. And people and then hire people that were on board [00:05:05] with it. You know, and that it doesn’t happen overnight. But actually once you start [00:05:10] getting that and you start getting that reputation, people start joining you because of that, and suddenly it’s a lot easier. It’s a bit of a [00:05:15] snowball effect. Um, but that’s what we did. We we ended up, you know, anybody who wasn’t really [00:05:20] on board with it, anybody wasn’t really on board with the things that we’re trying to. It doesn’t mean they were bad people. [00:05:25] Not at all, actually. They were brilliant dentists, brilliant people, but they weren’t aligned with what we were trying to [00:05:30] do. Yeah. And that made every day really difficult at that point. So. So yeah. Thank you man. [00:05:35]

Payman Langroudi: Okay okay. But you kind of in your let’s just spell it out in your head. Yeah. [00:05:40] You started breaking the team down into sort of essential and non-essential people. [00:05:45] People that were going to keep, you know, as you say, be on, on, on message [00:05:50] and be with you. Yeah. And the ones who weren’t. So then, as a operator, [00:05:55] did you manage those guys out? Did you try and change some of them and [00:06:00] realise they weren’t changeable?

Kaival Patel: Yeah. So again, like I said, it happened over a number of years. Yeah. And [00:06:05] initially, you know, there we had when we took over Oxford House which was our first practice, [00:06:10] seven surgeries. Three. And I like I said, you know, we were, we were rabbit in [00:06:15] headlights really. And they taught us a lot actually at that point, the ex-owners, you know, we didn’t [00:06:20] know about ordering. And, you know, a lot of the compliance part of things.

Payman Langroudi: Were you working in the practice at all? [00:06:25]

Kaival Patel: I started yeah, as soon.

Payman Langroudi: As the associate. Yeah.

Kaival Patel: So I was, you know, [00:06:30] again, like I said, Uber enthusiastic. I bought a cbct machine before I bought the practice. Ready for day [00:06:35] one. But again, that that sort of shows the, the disruption [00:06:40] that happened when I sort of came in. I’d been waiting for this practice for so long. Uh, due diligence [00:06:45] takes ages and so on. And I had just done a master’s in implants. I wanted my, [00:06:50] my main aim was just to to focus on implants and Invisalign and sedation. [00:06:55] Those were my sort of key things. So I bought the cbct ready to plonk in on day one. This [00:07:00] practice hadn’t really, you know, changed anything over the last 15, 20 years [00:07:05] for a long, long time and doing really, really well. And and yeah, caused [00:07:10] massive sort of disruption in and around there. Um, so yeah, I mean [00:07:15] it took a, it took a while to understand it all, to figure [00:07:20] it out, figure out how the practice works. Um, and then we moved forward into, [00:07:25] you know, a few years afterwards. And I was really scared, [00:07:30] to be honest. So I was scared to implement any changes. I was embarrassed after a few times, like yourself coming [00:07:35] here and so on, and it was really hard to implement something new. And actually at that point we [00:07:40] thought, well, this must be what practice life is like, you know, because you don’t know any different. And [00:07:45] there wasn’t really the same, you know, there wasn’t the same sort of social media and access to [00:07:50] information to everything.

Payman Langroudi: Which was.

Kaival Patel: This quickly. So we took over the practice in 2015, [00:07:55] and it was probably going into 2017, 2018. So it [00:08:00] happened, you know, over a quite a long period of time. 2017 is when we took over our second [00:08:05] practice and then. Yeah, so so then [00:08:10] I suddenly grew a pair and realised that when we wanted to implement things, you [00:08:15] know, I, I needed to be stronger with it, you know. So explain why. [00:08:20] Explain what the benefit is. And actually, you know, even little things like uniform. I was desperate [00:08:25] to change the uniform, you know, in the practice and just have nice, fresh, clean scrubs. [00:08:30] Um, and I remember when we, when we sort of first, you know, introduced it and one of the, [00:08:35] the owners was like, oh, is this what we’re going to have to wear? You know? And I was really [00:08:40] excited, you know, like this, this is the way it has to go. So eventually it was a case of [00:08:45] nope. Um, you know, this is what we stand for. And actually, I had a conversation with this person when [00:08:50] I, when I sort of reached my, my tether with her and I said, look, to be honest, [00:08:55] you’re the reason at the moment that I’m not enjoying coming to work. You make me feel uncomfortable being in my own [00:09:00] practice. Wow. You know, and and again, this person, not a bad person whatsoever. [00:09:05] It’s just how they were built. You know, and this.

Payman Langroudi: Was one of the ex owners.

Kaival Patel: Yeah. Yeah. [00:09:10] Um, pseudo ex owner. Probably keep it. Keep it that way. I don’t want to, you know, say [00:09:15] anything bad against anybody, but, um. But, yeah, I just said, look, I’m not comfortable [00:09:20] being in my own practice. And that person, she was, she she was really upset [00:09:25] that I said that because she genuinely didn’t mean that for that to be the case. Yeah. Um, [00:09:30] and then I think that sort of started the process of her, you know, edging out to her retirement [00:09:35] and, um, and stopping that way. But I used to just work wherever there was [00:09:40] a spare surgery, I wouldn’t have my set surgery and just have implant referrals coming [00:09:45] over to me, and that was sort of practice life at that point.

Payman Langroudi: This is a very important learning point for [00:09:50] people who want to buy practices, right? I’ve never bought a practice, so I can’t [00:09:55] talk with authority on it. But there’s the [00:10:00] two basic notions of evolution or revolution. [00:10:05] Yeah. Do you come in, smash everything down and rebrand [00:10:10] and rename and you know, the whole thing and say, this is what it’s going to [00:10:15] be like straight away? Or do you come in and make no noise? [00:10:20] Almost make sure that patients don’t realise there’s been a change in management [00:10:25] so that the staff don’t have a problem. Very simple. Keep everything the same [00:10:30] for six months one year six. Some people, you know extends for longer, right? Yeah. Learn [00:10:35] everything you can and then start to evolve the changes. And I always used to think that [00:10:40] was the right way. But Dev Beth Patel. His notion is smash [00:10:45] it down. Yeah, yeah, yeah. And it’s interesting because if there’s a culture that’s [00:10:50] pervasive, it’s been there for 20 years. Sometimes smashing it down might be the [00:10:55] best move. Yeah, but it’s high risk. It’s high risk. High risk.

Kaival Patel: Yeah. So we [00:11:00] adopt something in between now? Yeah. You know. So. But, you know, we’ve [00:11:05] learned little bits along every sort of practice purchase. And the first thing we actually tell, you know, any new [00:11:10] acquisition is what we’re going to do is we’re going to observe for a while because there might be loads of things that [00:11:15] you guys do that I want to implement. Yeah, yeah, yeah. Um, but at the end of three months or six months [00:11:20] or however long we feel we’re going to have a meeting again and say, right, these are the new things that we’re going [00:11:25] to change, you know, and use that word. Make them comfortable with that word. Um, [00:11:30] we might change things. We might keep things the same, but we’re going to go through it with you guys after this period of time. [00:11:35] And then actually we do observe for those few months, you know, unless there’s something drastically wrong that’s happening [00:11:40] in and around there. We let the the team get used to us and we [00:11:45] get used to the team. And because often again, a lot of the places that we’ve. Taken over are [00:11:50] principal led practices. So having somebody offsite. Um, [00:11:55] you know, who’s not there day in, day out is really a challenge to to. The system. So, so yeah. So [00:12:00] so we tell them yeah we’re probably going to. Look to change. Um, and I guess we’re fortunate now [00:12:05] because we’ve got quite. Good reputation in and around the area. People already know you know that. What [00:12:10] we’re about, you know, um, and so they probably expect some of it, but they also [00:12:15] hear the good vibes. They. Hear, hear about the positivity. They hear about the development side of things that we’re really massive into. [00:12:20] So I now found there’s a bit of excitement, you know, from, from a lot of people, um, [00:12:25] people that have maybe been there for a long, long time and really are just averse to change. It’s [00:12:30] hard.

Payman Langroudi: I’ve got a good question for you. You said when I grew some balls like so almost. [00:12:35] That’s almost like an evolution of you, your management style. Yeah. And [00:12:40] by the way, you know what got you too? Got you. There is not going [00:12:45] to get you to the next stage, let’s say. Let’s say you say, hey, listen, I want to go for the [00:12:50] 50 practices. It’s a whole different set of skills. You’ll need to get to 50 than to five. [00:12:55] So there is an evolution of management style as you learn yourself as a manager and [00:13:00] a leader.

Kaival Patel: Massively, massively.

Payman Langroudi: But now, between you and your wife, [00:13:05] what’s her name?

Kaival Patel: Serena.

Payman Langroudi: Serena. Yeah. Are you the good cop? And she’s the bad cop, or [00:13:10] is it. Have you broken into those kind of things or. I’ve got another very important [00:13:15] question on top here. Now, when you’re looking for practices, are [00:13:20] you the sort of cold numbers guy or [00:13:25] are you actually looking for practices where you don’t have to make too many changes? Does that does that raise the price [00:13:30] a little bit? If the culture’s already good?

Kaival Patel: No, I haven’t seen too [00:13:35] many practices that have our culture. So yeah. [00:13:40] So, so I think in terms of and you don’t really know, you can’t. [00:13:45]

Payman Langroudi: Really.

Kaival Patel: Tell.

Payman Langroudi: Until.

Kaival Patel: You’re there, until you’re there, you know, it might look great on the outside and everything else, [00:13:50] but you don’t really know until you’re there.

Payman Langroudi: So small town like Milton Keynes, when you’re so involved [00:13:55] in the Dental world, right? Nurses, receptionists, practice managers every [00:14:00] single practice in the town has a reputation that you can get access to.

Kaival Patel: To an [00:14:05] element, to an element. Again, you don’t. It’s the nitty gritty of the culture that you actually need to know. You [00:14:10] know, it’s actually is there one person who stirs the pot that’s the bit that you need to [00:14:15] to get to quickly rather than, you know, they might they might all look out for each other or to [00:14:20] an extent or, you know, really like the principal dentist that’s there and that sort of thing. But actually [00:14:25] it’s, it’s it’s the finer points and it’s also who are, who’s going to [00:14:30] look to join us in terms of what we’re trying to do. You know, who’s that? Social events that we look to do. [00:14:35] Do they believe in that. You know, that side of things. Do they believe in the positivity side of things? So, you know, a lot [00:14:40] of, you know, I talk to lots of people and they might, you know, I see their their eyes sort [00:14:45] of glaze over a little bit in that, you know, that’s all this fluffy stuff that you’re talking about. Positivity. How does that equate to [00:14:50] numbers? Um, so and some people and some dentists and, you know, some [00:14:55] practice owners, for example, they don’t quite get that part of it. So I think, I [00:15:00] don’t know until I’m there to.

Payman Langroudi: You know, Kunala love teeth.

Kaival Patel: Yeah, yeah, yeah.

Payman Langroudi: The, [00:15:05] you know, he has much less trouble getting associates to work for him. Yeah. Than [00:15:10] comparable practices. Yeah. Because at the moment you walk into that place, you [00:15:15] know, this is a great place to work. Yeah, yeah. And that’s the feeling I got from yours as well. And [00:15:20] one way he does it, he does it in many ways. But one way he does it is by [00:15:25] overstaffing.

Kaival Patel: Okay.

Payman Langroudi: Yeah. There’s more humans around than, than [00:15:30] you would find in a normal practice. Yeah. And I kind of like that because [00:15:35] you just in a practice. I feel like this is not enough humans, you know, number one. Yeah. [00:15:40] But also he does things like surprise and delight for his nurses. That gets them. There was one [00:15:45] person. There was a time where there was one person’s whole job was to find deals for the for [00:15:50] the staff locally. So their staff would get like spa [00:15:55] memberships at half price. Yeah. You know, this sort of thing.

Kaival Patel: Yeah.

Payman Langroudi: Yeah, yeah. So interesting. [00:16:00]

Kaival Patel: It’s really. And we do the same thing. So I think we’re just not. And I think a lot of people [00:16:05] do it as well. They’re just probably not vocal enough about it. Yeah, yeah. Um, so yeah, we did the same thing. [00:16:10] We went to local businesses and just just to have almost like a team card that they can use and [00:16:15] have discounts on, on certain things. Um, but I think for us it’s, it’s getting it [00:16:20] into the day to day. Um, so we, we have this, um, you know, uh, innovation, [00:16:25] I guess, which was the Connor Cup. And, and really, you [00:16:30] get points for positivity. Okay. Yeah. And So, you know, area manager or [00:16:35] or, uh, you know, the the manager will sit with the Harry Potter Sorting hat at the start of the year, [00:16:40] put everybody into four houses, and they’ve decided the names of these houses between them. [00:16:45] And each of the practice has these four houses and and you just so it’s not KPI [00:16:50] driven, it’s not money driven, it’s purely points for positivity. So helping each other [00:16:55] out at the end of the day, um, Google reviews with your names on it and having having a patient that’s had a really [00:17:00] good experience and you get these these points for these little things. Practice manager has a certain number [00:17:05] of points that they can give out if they see, you know, something really positive happening within the practice and what [00:17:10] it did. And then at the end of the quarter, marketing manager will rock up with the prize wheel and they’ll spin the prize wheel [00:17:15] winning team will get something small, you know, like a lunch or a bowling or these sort of things.

Payman Langroudi: Kudos.

Kaival Patel: Yeah. [00:17:20] And then at the end of the year, we’ve got the Kano Awards and there’s a big sort of Champions League trophy that the [00:17:25] winning, winning, winning team gets. And to be honest, those [00:17:30] sort of things. Firstly, it gets a bit of friendly competition between some of the team members, [00:17:35] but the main thing is it gets them working together. Yet they have a team captain. That team captain sort of, [00:17:40] you know, spurs it on and we notice things like that bring bring the teams [00:17:45] closer together. And then when we have group related events then so we have a Kano [00:17:50] Olympics. So in the middle of the year sports day you know, and then you get points for these [00:17:55] sort of things. And what have you learned.

Payman Langroudi: What have you learnt about announcing new [00:18:00] ideas like that to your team without I mean, you know, you said the one person who’s stirring [00:18:05] the pot. Yeah. Let’s say you’re in a meeting with 20 of them and say, hey, I’ve got a new idea. The Kano Olympics, [00:18:10] that one person can destroy that idea there and then by making a noise [00:18:15] or a face or whatever. What have you learnt about how to introduce new ideas [00:18:20] to the team? So for them to take it on and really get the best out of the idea.

Kaival Patel: Yeah, [00:18:25] you’re right. And that one person can destroy it. So we’re really quick To [00:18:30] to have a conversation with whoever we feel that one person is. So [00:18:35] let’s say we have that.

Payman Langroudi: Before the announcement. No, no.

Kaival Patel: So let’s say we’ve had an announcement [00:18:40] and we noticed that face.

Payman Langroudi: That face. Yeah.

Kaival Patel: So we will have a conversation with that person afterwards. Just [00:18:45] saying look, we noticed it. You didn’t look that enthused. Is there something going on? You know, and it could [00:18:50] be something personal. It could be something else. Um, and then we’ll say, look, do you think it’s a bad idea? [00:18:55] Because actually, what we’re trying to do is bring the team together for x, Y, z. And this is what we feel [00:19:00] is going to do. And it’s a really nice thing to do. And we feel it’s a really nice thing to do. So is there anything [00:19:05] that you have against it? And we might hash it out. Normally it’s no and it’s this sort of sheepish [00:19:10] look down and you get a couple of strikes with that. And then we’ll have a conversation [00:19:15] about whether, you know, this is working for us.

Payman Langroudi: And these are these are conversations [00:19:20] you weren’t having in the first practice. You were just like, you know, shy and worried and didn’t want [00:19:25] to rock the boat.

Kaival Patel: It was it was not rocking the boat. Yeah. And it was not knowing what we didn’t know. And I think [00:19:30] over time we sort of grew in confidence with that part of it. And it sounds like we’re really militant about being positive, [00:19:35] but it just sort of happens. It actually the vibes are really good in the practices. And it’s [00:19:40] not just Serena and I, you know, so we hire managers, you hire.

Payman Langroudi: For it. [00:19:45]

Kaival Patel: For it. Yeah.

Payman Langroudi: So attitude. You mean.

Kaival Patel: Attitude. Absolutely. Based on attitude.

Payman Langroudi: How [00:19:50] do you tell. Well like tell me that man.

Kaival Patel: So firstly just the [00:19:55] conversation you know. So conversation wise. And I’ll explain to them this, this image [00:20:00] I have of kind of health group and what we’re trying to do. And don’t get me wrong, we’re not 100% there. We’re definitely 100%.

Payman Langroudi: There’s [00:20:05] this occasional humans who just tell. You can tell. Yeah. So what do you do? Do you, do you [00:20:10] see many, many, many, many until you come across that one that you can just see the spark. Or [00:20:15] are you the type of person who can develop like, you know, people who [00:20:20] are 6 or 7 out of ten into nine out of ten, like, how do you look at that? Do you only want to hire [00:20:25] these superstars and you let loads go and no no no no no. We interview [00:20:30] a.

Kaival Patel: Lot. Yeah we.

Payman Langroudi: Do. Constantly interviewing I guess.

Kaival Patel: No not.

Payman Langroudi: We.

Kaival Patel: I mean, when we have a position [00:20:35] we won’t jump into that that hiring process. But you’re absolutely right. You don’t know until they’re in [00:20:40] place. So what we then do is a one week review. Two week review, three weeks, four weeks, two [00:20:45] months, three months. And during that process, we’re quick to say, okay, look, [00:20:50] you know, this is what we might, you know, have thought you could have done in this scenario. And this [00:20:55] is how we can coach you. This is how we can help you develop that side of it. And if their attitude is good, [00:21:00] then there’s no problems. You know, it’s when they sometimes they might think, [00:21:05] you know, oh, I’ve done this in another place and I know exactly what those people are really [00:21:10] good with systems and processes sometimes and maybe KPIs and, you know, corporate sort of [00:21:15] lingo and everything else. But they’re not necessarily the best people for the people and for us. [00:21:20] We want the managers to really develop the people side of it, because actually, what’s the biggest stress? [00:21:25]

Payman Langroudi: People.

Kaival Patel: People you know. So if you can take away that as much [00:21:30] as you can, the element of stress with the people and be the person that walks the shop floor. Go and say, [00:21:35] see everybody. Go and talk to everybody. Go and see how they are. And sometimes it is that conversation [00:21:40] of, you know, leaving personal stuff at the door. Work is work, but we still help [00:21:45] you out as in whatever way we can. But it is that people side of it. And and [00:21:50] that’s the bit I think we can we can help develop them. Kpis, all these things people [00:21:55] generally can learn, you know, and you just develop systems and processes for that. You make [00:22:00] it, you know, idiot proof guide as to what it is. And I need an idiot proof guide when it comes to systems and processes [00:22:05] and these sort of things. So I understand that element of it. But the people side is the bit where [00:22:10] you don’t know, after two conversations with somebody how great you are with with people, you [00:22:15] have to be, you know, you have to be given the chance in the practice. Yeah. Um, but actually what [00:22:20] we try and say to them as well is, look, it’s our voice, but we [00:22:25] don’t want there to be a them and us scenario. So you have to own that message, you know? So let’s [00:22:30] say we’re trying to implement something and you got to tell the team, yeah, you have to believe in it. And if you don’t believe it, talk to us [00:22:35] now. You know, and tell me the bits that you don’t quite understand or believe in or whatever, because [00:22:40] you have to own that message. And if they own it, then it’s not. Cable and Serena have said, go do this. [00:22:45] It’s we’re going to do this because of x, y, z. And I think that’s important.

Payman Langroudi: But then [00:22:50] how do you handle it when that person says, yeah, yeah, I don’t like the name Olympics. Can we change it to [00:22:55] tour de tour? The tour? The tour de France. Yeah. [00:23:00] And we get that a lot. No, no, but do you know what I mean? When it’s. Let’s say it’s a bad idea. Yeah. [00:23:05] An idea that wouldn’t work across the whole group. Now, now you have to hand. You have to [00:23:10] sort of empathise. You have to get that in. Yeah. And then say it’s a bad idea. And then without [00:23:15] ruining that person’s like, creativity.

Kaival Patel: And we’ve got [00:23:20] a big belief as well that we can try things and it can fail. It’s all right. [00:23:25] And actually, it’s just this this evolutionary cycle. Right? You try it, it might [00:23:30] not work and then improve it a little bit. And actually, if it completely floods, it’s all right. At least we’ve tried it and we’ve tried to [00:23:35] be innovative and we try something different. And you know, there’s plenty of things that don’t quite work out. Um, [00:23:40] and you try it. And that part we empower the team, you know. So if they [00:23:45] have any ideas like that. Yeah, we’ll give it a go. As long as it’s, you know, not going to cost my kidney and house [00:23:50] and everything else to to go with it, you know, let’s, let’s give it a go or give a version of it a go [00:23:55] and then and then try it if it’s the name and these sort of things, you know, there’s far [00:24:00] more smarter people than me in the team. You know, we’ve got an amazing marketing manager, we’ve got a head of growth and development, and [00:24:05] these guys have that creative spark. Yeah, people. Um, so I’ve got a trust in them [00:24:10] as well. Right? It can’t just be careful, you know, deciding all the things and we’ll give it a go and [00:24:15] go from there.

Payman Langroudi: So give me the, the sort of the stats, the snapshot of where we’re at right now [00:24:20] with the group. With the group numbers, I don’t mean necessarily money, [00:24:25] but I’m talking about people, clinicians, non-clinicians just [00:24:30] the whole thing. Yeah.

Kaival Patel: So yeah, five practices, about 28, 29 [00:24:35] chairs between those five practices. Wow. 130 ish [00:24:40] people between them. So maybe 40 odd clinicians and the [00:24:45] rest are employed team members. Um, and [00:24:50] yeah, they’re all big, big places. Um, and one of the practices of partnership practice. [00:24:55] So we own with another associate of mine and.

Payman Langroudi: The org chart outside of, you know, dentists, [00:25:00] receptionists above on the, on the, on the corporate level. What’s the org chart?

Kaival Patel: It’s a really good question [00:25:05] because actually I find when I talk to other group sizes similar to ours, that’s the [00:25:10] bit where it’s tricky at this stage. Um, so we’ve previously had a head of operations. [00:25:15] We’ve had, um, you know, lots of different sort of almost corporate [00:25:20] style jobs. And right now there’s Srini and I as directors. Srini is very [00:25:25] much, you know, into the operations side of the business. I’m focussed on growth and development [00:25:30] side of things, and I’ll probably focus more on the clinicians in terms of getting [00:25:35] them growing and developing. Then we’ve got a head of growth and development. We’ve got somebody [00:25:40] who is in charge of projects and that could be literally anything.

Payman Langroudi: We have one. Yeah, we [00:25:45] have one.

Kaival Patel: And then we have a marketing manager and and her assistant. And [00:25:50] that’s actually in effect the senior management sort of team or the management team. And then we [00:25:55] have the practice managers in each practice area manager. So we don’t anymore. No, [00:26:00] no.

Payman Langroudi: You had one.

Kaival Patel: We had area managers and and we found [00:26:05] that’s the difficulty, I think, of where we are at the moment. So as [00:26:10] we add probably 1 or 2 more sides or it becomes a bit more spread out, then [00:26:15] I think we will probably need somebody. But actually at the moment, Serena tends to do a lot [00:26:20] of that, and she’ll go to the practices. And the main role of the area manager we find is is supporting the practice [00:26:25] managers, but empowering them, you know, and sometimes you can have area managers who mollycoddle [00:26:30] the practice managers. They don’t want to do that. I’ll take it over for you because it’s easy, it’s quick, and they’re [00:26:35] really busy, right? They’re trying to look after X number of people. And we found that actually [00:26:40] what we want to do is focus the next year or so with Serena empowering the practice managers. Get them to the [00:26:45] level that they, you know, we really want them to be. And then and then probably [00:26:50] step away a little bit and have a look if we had a few more sites, um, you know, practices at that [00:26:55] point and I don’t.

Payman Langroudi: Know if you heard the conversation I had with Anushka.

Kaival Patel: Yes, I did, yeah.

Payman Langroudi: So she said of [00:27:00] the mirror for the, for people. But she said she’s got I don’t know what it is. What was it, 37, [00:27:05] 42, 42, 4242 practices. Yeah. And [00:27:10] she said 5 or 6 was a real moment, that things get a lot easier [00:27:15] after 5 or 6. It’s interesting.

Kaival Patel: Yeah.

Payman Langroudi: And I said, why? She said something regarding this [00:27:20] about how the numbers just work better when there’s more than five or so up to. She said up to 5 or [00:27:25] 6. You’re running and running and running. Yeah. Um, both of you have stopped [00:27:30] practising now?

Kaival Patel: Yes. We have. Yeah. Yeah.

Payman Langroudi: So how much are you [00:27:35] working on it, and how much are you not? I mean, are you are you working on it? [00:27:40] Is it is it harder work than when you were a dentist or.

Kaival Patel: Yeah. I don’t think [00:27:45] I’d say it’s harder. I think it’s different, you know. Um.

Payman Langroudi: Are you five days a week? Six days? Are you?

Kaival Patel: Yeah. [00:27:50]

Payman Langroudi: Evenings.

Kaival Patel: All the time. And you know when when you’re married to the other director as well.

Payman Langroudi: Oh, yeah.

Kaival Patel: Yeah. Our conversations [00:27:55] are either about work or about the kids. Yeah. You know that that tends to be what [00:28:00] we’re about. And then we, you know, we’ll have our own chill time and watching Netflix and these sort of things that we like. The [00:28:05] same sort of stuff. But yeah, it’s it’s hard. It is hard, but it’s a different hard, you [00:28:10] know, and it’s.

Payman Langroudi: Not turning, turning up every morning at 830 for a patient.

Kaival Patel: Exactly. [00:28:15] Yeah. Yeah. It’s not the same sort of time constraints as that, but there is no time. Yeah. [00:28:20] You know, my lunchtime, in effect, is when the kids come home at 5 or 6:00 and I [00:28:25] try and have dinner with them, but then I go back to work, you know, afterwards. Yeah. If I’m doing interviews [00:28:30] or these sort of things in the evening. Well, to be honest, you see us and you took a picture of us and there’s three on one side. [00:28:35] I’m on the other with laptops on our laps, covering emails or figuring out what we’re doing with the next, you know, [00:28:40] whatever we’re doing. And so the first hardest part, though, was the [00:28:45] identity crisis I had when I stopped doing clinical work.

Payman Langroudi: Me too.

Kaival Patel: Me too. Yeah.

Payman Langroudi: It’s hard. [00:28:50]

Kaival Patel: Yeah. How did you. How did you get over it?

Payman Langroudi: Well, you know, I was hardly doing any [00:28:55] dentistry whatsoever, but I just wasn’t willing to say I’ve stopped. [00:29:00] I just wasn’t willing to do it. Even though I’d stopped before. But before I knew I was coming back. [00:29:05] This time, it was that question of, am I going to stop? And you really class yourself as a dentist, [00:29:10] you know? Yeah.

Kaival Patel: You do. And that’s your whole identity, right? Yes. When you go to family barbecues [00:29:15] and weddings and you’re introduced as the.

Payman Langroudi: Taxi driver asks you, what do you do? I [00:29:20] still say dentist, by the way. It sounds better than syringe guy.

Kaival Patel: But [00:29:25] there’s a lot of different connotations with that one.

Payman Langroudi: But I think the real key point for [00:29:30] me was when I realised I can always come back. Yeah. And that really just made me [00:29:35] think, oh, okay, no problem, I can, I can leave if I need to. I can always [00:29:40] come back. Yeah. How about you? So how did you handle it?

Kaival Patel: So? So the reason I became non-clinical [00:29:45] wasn’t quite the business side. The business part followed. It was I had a dodgy eye. [00:29:50] So during Covid, um, well, actually, in my 20s, early 20s, [00:29:55] I found out that I had this eye condition. I was that guy at the eye hospital where they bring [00:30:00] all the students to come and have a look, because there’s something weird going on and trying to poke and prod and figure out what it is. [00:30:05] Um, and then during Covid, it must be with the stress of everything. And yeah, it [00:30:10] really deteriorated. So to the point where I couldn’t really see the number plate in front of me, and [00:30:15] I thought because everything was closed, I thought I just needed to change my glasses. I went to the optician. They were like, [00:30:20] no, no, you need to see an ophthalmologist and figure it out. I knew at that point it was the condition that’s [00:30:25] really flared up, and I decided that.

Payman Langroudi: What was the condition?

Kaival Patel: So it’s called theisen’s punctate [00:30:30] keratosis. Keratosis keratitis. In effect, it’s protein plaques on the eye. And [00:30:35] it starts scarring the eyes. And you get vascular growth in there. And so [00:30:40] to be honest I always when it flared up before I had drops and it used to settle [00:30:45] down. But it was really bad at that point. And I thought I can’t do not do you know, I can’t do [00:30:50] dentistry without my eyes. I need to make a bit of a cooler and sat down with Serena and just said, look, [00:30:55] I don’t want a medical condition to to stop me. I want to make [00:31:00] the call on my own. Right. And so at that point, also, we were on this [00:31:05] entrepreneur program with NatWest and actually there was loads of different businesses. [00:31:10] Loved it, you know. So sometimes when we’re all just enclosed in dentistry, it’s a very same, [00:31:15] same world. These were loads of start up businesses and the energy was insane. And we [00:31:20] both realised that we both loved the business side of it, which is unusual. Sometimes you normally [00:31:25] have one person that likes the clinical. One person might like the business, but we both love the business side. So we had a chat [00:31:30] and we said, look, the only way we can probably make it work is by growing and having [00:31:35] more practices. And we also just sat down and figured out this is the first [00:31:40] time we figured out the numbers.

Kaival Patel: So, you know, up until then I was as most principal [00:31:45] owner principal, you do the work, you’re taking pittance out of the practice and [00:31:50] you’re the money that you generate is going into the practice, but you don’t know, you know. So [00:31:55] I was spending loads of marketing and loads on everything and just letting it go because you don’t have the time to just sit there [00:32:00] and, and that’s the only one benefit of Covid is you can sit down and we figured out, you know, [00:32:05] what our surgery costs were and what they’re, you know, running it. And there was a good webinar at [00:32:10] the time which sort of went through all of that stuff. And then we realised, well, actually, we we [00:32:15] need to grow things. We need to spend time on the business. Let’s give it a go. Worst case, exactly [00:32:20] what you said is we’ll go back into dentistry if it doesn’t quite work out. Um, so, [00:32:25] so yeah, that’s what forced me actually to stop. And it took a little while once we were back in after Covid [00:32:30] to finish my cases and yeah, these sort of things, um, Serena had stopped at that point [00:32:35] as well. And then. Yeah. And then we sort of went, went into just focusing [00:32:40] on the business side of it.

Payman Langroudi: And with the I mean, the growth is quite quick. You’re [00:32:45] Covid sorry you started 2015. Yeah.

Kaival Patel: So really slow at the start.

Payman Langroudi: We’re ten [00:32:50] years in. Yeah. And 30 chairs. Not a joke. It’s that’s not [00:32:55] a joke. That’s fast growth. That’s fast growth. With that speed of growth [00:33:00] you’re obviously having to throw every penny back into the business. Right. Yeah.

Kaival Patel: You do, [00:33:05] you do. Um, we do well out of it as well, to be honest. You know, [00:33:10] so I think we yeah, we it comes to funding, actually, a lot [00:33:15] of the time. So, so high street banks in general, you know, they want you to put ten, 20% down. [00:33:20] All the practice we buy are big practices, you know, a million, £2 million things. So 10 to 20% [00:33:25] is no joke. Yeah. But again, we made the call that, you know, we’re going to put this money back in. We’re going to put the money [00:33:30] in to develop the places. You know, we’re going to develop and upskill our clinicians. Um, [00:33:35] and we’ll keep a track of the numbers and we make sure that we’re on top of it. So the last [00:33:40] year or so, I think we’ve been really on top of it in terms of the numbers of things. And we’ll go through [00:33:45] and we’ll have KPI related meetings together. And I’ve got a business coach, and she [00:33:50] also doubles up as a marriage counsellor between me and Serena. So, yeah. Um, but, [00:33:55] you know, we focus on those aspects. And I think the cool thing about the size we are is that [00:34:00] we can try lots of things.

Payman Langroudi: Yeah.

Kaival Patel: You know, and we can try these things. [00:34:05] And sometimes they won’t work, sometimes they work and we sort of develop on it.

Payman Langroudi: So size is a funny thing, man, because [00:34:10] it depends what you’re chasing, doesn’t it? Like I used to I used to want to chase happiness. [00:34:15] Not happiness. Joy. Joy.

Kaival Patel: Yeah.

Payman Langroudi: Pleasure. Yeah, yeah. And he had it all mixed up. I used to think [00:34:20] pleasure and joy and happiness were all one thing. Yeah. So I was chasing that [00:34:25] and that. It’s an unlimited sort of cost base to that, right? So [00:34:30] even more joy. Get even a bigger boat. Right? You know what I mean? It’s there’s no. So [00:34:35] now, though, I feel like I’m. I’m chasing peace.

Kaival Patel: Yeah.

Payman Langroudi: And whatever.

Kaival Patel: It.

Payman Langroudi: Yeah, [00:34:40] whatever the thing is, whatever the thing is, it’s like hiring a new social [00:34:45] media manager. Yeah. And I’m thinking of of of what will it take for this to give [00:34:50] me more peace. Yeah. And often that is hiring the right one. All of those things. [00:34:55] Yeah. Hiring the right one, training them properly, inspiring them. All of that stuff will eventually get you [00:35:00] somewhere where you’ve got peace now, because someone’s doing well at that. So sometimes peace is hard work [00:35:05] itself. Is it nice.

Kaival Patel: Or is it productivity?

Payman Langroudi: Peace. Is it peace for me? Yeah. [00:35:10] Yeah, yeah. Some people. Some people you just met upstairs. He’s all about potential, [00:35:15] you know. Okay. And potential is a beautiful thing, too, you know? And he’s all about automation [00:35:20] and stuff, right? So there’s some things. Turn one person on more than the other. You know, it’s [00:35:25] an interesting question, but you know what you’re saying here about right where you are at [00:35:30] right now. And I’ve been involved in your business enough to know you’re in a happy place. Yeah. [00:35:35] Yeah. I think back sometimes to pre-COVID 2014. [00:35:40] Yeah. We were much smaller company, but we [00:35:45] were so happy. We were so happy. Nice. Yeah. Because the team at that point [00:35:50] was just perfect. It was easy enough to manage whatever it was. 12 people. Yeah. Yeah. And, [00:35:55] you know, we were in a happy place. So this question of where is it going and what is it? What drives you? Do you think [00:36:00] potential drives you.

Kaival Patel: You sort of say peace or say happiness. And I think that’s [00:36:05] probably a problem I do have. I’ve never really that happy, you know, with wherever we are, I’ve, [00:36:10] I’ve always got an itch.

[TRANSITION]: I want more.

Kaival Patel: Yeah, I’ll get the car, I’ll get the house and all these [00:36:15] things. It’s great for a week. And then I don’t feel that content [00:36:20] because.

Payman Langroudi: Things don’t bring contentment. That’s the problem. I never thought I would be this cat to talk, preach this message. [00:36:25] But things don’t. Things don’t. They don’t. I was chasing experiences, right. But [00:36:30] even experiences in the end. Right? It’s a funny thing. It’s a funny thing. But [00:36:35] knowing, knowing what it is for you is the important thing. Because it’s a bit of a [00:36:40] cliche, but the older I get, the more I realise all the cliches are real. Yes. Yeah. [00:36:45] That, you know, um, Stephen Covey used to say a thing about climbing up the [00:36:50] wrong ladder really quickly. Yeah. And knowing which [00:36:55] is the right ladder to climb up. Yeah, yeah. Because running, climbing up ladders quickly on their [00:37:00] own can lead you to wrong places, you know. Bad places.

Kaival Patel: And you don’t [00:37:05] know it until you’re there, right?

Payman Langroudi: Yeah.

Kaival Patel: Yeah, yeah. So, yeah, I think, you know, [00:37:10] I’ve always got this itch. I always need to try different things. And I think.

Payman Langroudi: Were you always very ambitious?

Kaival Patel: Yeah, [00:37:15] probably. Probably so. I used to. First thing is at [00:37:20] school, I used to, um, you know, those DVDs, DVD burner? Yeah. I [00:37:25] managed to save up. I don’t even know. Probably asked Mum and Dad, um, for a little bit of funding [00:37:30] for a DVD burner. I used to copy these DVDs and sell them, you know, in school and bootleg. [00:37:35] Yeah. Yeah. Oh.

Payman Langroudi: Criminal mind as well.

Kaival Patel: Yeah, absolutely. Criminal mind.

Payman Langroudi: Yeah, yeah.

Kaival Patel: This [00:37:40] is why the ankle tag only lets me go so far. Um. And then. [00:37:45] Yeah, I’ve always had something, you know, I, as an associate, I developed an [00:37:50] app called the Dental professor, which absolutely flunked. Um, absolutely flunk because I didn’t [00:37:55] really, you know, put enough time and effort into it, but it was it was almost like the, you know, dentinal tubules [00:38:00] before tubules were sort of there and taking videos from different, different [00:38:05] sources and have educational videos for, for, you know, I used to find, [00:38:10] I used to speak to people straight from at that point or PhD now and, you know, they hadn’t had that much [00:38:15] experience. So I thought, okay, let’s, let’s try and get them that experience and, and monetise it and have, you [00:38:20] know, this, this dental profession.

Payman Langroudi: Why dentistry? Did you, did you want to be this sort of IT guy or something before [00:38:25] your parents stepped in and made you become a dentist?

Kaival Patel: Parents never made me do anything. Yeah. They [00:38:30] didn’t. They wanted me to have a secure profession. You know, they were immigrants from Uganda, got kicked [00:38:35] out, um, from Uganda, and they focussed everything they had on just [00:38:40] educating, you know.

Payman Langroudi: Ugandan Asians, master race.

Kaival Patel: Yeah. Yeah.

Payman Langroudi: I told you this before, haven’t I?

Kaival Patel: They’re [00:38:45] amazing. They’re amazing. Um, yeah.

Payman Langroudi: So [00:38:50] they came over after Idi Amin.

Kaival Patel: Idi Amin, and, um, so my, [00:38:55] my dad’s dad passed away when he was really, really young. So he was he was my grandmother [00:39:00] and he was, you know, the linchpin of the family. And actually my my eldest uncle, [00:39:05] who pretty much resumed that, that father role for, for his he had eight dad [00:39:10] had seven other siblings. And my uncle just passed away recently. And it [00:39:15] was nice hearing the stories of of what they sacrificed and what they, you know, became and [00:39:20] and how hard they really worked. I don’t think sometimes I don’t really have that concept. I [00:39:25] can hear it, but I can’t truly understand, you know, Mom and dad had newsagent’s shops, [00:39:30] um, when I was a kid, and they worked every hour, you know, every hour. Sundays. He wasn’t having [00:39:35] a weekend off. He was, you know, Saturday, Sundays. Um, and all they did was to try [00:39:40] and get me and my sister educated.

Payman Langroudi: How many?

Kaival Patel: How many.

Payman Langroudi: Newsagents.

Kaival Patel: At [00:39:45] the most. They had two at one point, but most of the time they had one. And dad then had a dry [00:39:50] cleaners afterwards. Um, when they, when they sold the newsagents. But yeah. No he wasn’t he [00:39:55] wasn’t like a, you know, a big sort of entrepreneurial chain. He was just grafting, getting [00:40:00] enough. It really was. I genuinely say it to get me and my sister through. They really believed in private education, [00:40:05] went to private school. We had a really bad financial time. At one point I had to move away from [00:40:10] from private school, and my sister was sort of at GCSE [00:40:15] time at that point, so you could tell who the favourite was. Yeah, she, she stayed in school. Now she’ll, she’ll. [00:40:20]

Payman Langroudi: Just discussing this upstairs weren’t we. Like what would it take to make you go back to becoming a dentist. Yeah.

Kaival Patel: Yeah. [00:40:25]

Payman Langroudi: And Sandra was saying even if you had to take his kids out of private school, he [00:40:30] still wouldn’t. Yeah, yeah. So go on. Yeah.

Kaival Patel: So, um. So. So. Yeah. [00:40:35] So I went to this school.

Payman Langroudi: Was it? Where did you grow up? Milton Keynes. Milton Keynes. So then [00:40:40] you went to university?

Kaival Patel: Yeah. In Manchester. Absolutely. Loved my time there. [00:40:45] Absolutely loved my time. It was. It was the best year. 2003 to [00:40:50] 2008.

Payman Langroudi: Around Kailash time. Do [00:40:55] you remember Kailash?

Kaival Patel: No, no I don’t. I met Kailash afterwards, but. But not. [00:41:00] Not at university.

Payman Langroudi: How did you enjoy Manchester? As in. Did you get there like big [00:41:05] city? I’m going to have fun. First time freedom.

Kaival Patel: Yeah, it was a. [00:41:10]

Payman Langroudi: Lot.

Kaival Patel: Of that, to be honest. Yeah, yeah, I used to. I enjoyed, you know, I had a really good group [00:41:15] of friends who I’m really, really close with now. Mixture of dentists and non dentists. And [00:41:20] we enjoyed the time there. You know quite, quite frankly. It was in my same year um, although [00:41:25] we didn’t get together until, you know, after university, but, um. Yeah, I mean, I [00:41:30] did enough to get through. I wasn’t an exceptional student. It’s quite funny. We have we [00:41:35] have some of the speakers that are on our course now who were probably my clinical tutors at that point. [00:41:40] Yeah. They won’t remember me at all.

Payman Langroudi: You didn’t.

Kaival Patel: Remember her? She was a great [00:41:45] student. Oh. Was she? But, you know, I was I wasn’t really, um. I did [00:41:50] enough to get through, except for my final year when I had this stark realisation that if I fail, all [00:41:55] my friends have gone and moved on and I’ll be. I’ll be left where I am and I studied then. [00:42:00] I did study then and I did quite well out of it. But yeah, it was um, [00:42:05] yeah, I enjoyed it. Lots of sports, lots of going out, lots of these. And I like Manchester because [00:42:10] it’s a big city. But everything, especially the Dental side of it, was really quite close together.

Payman Langroudi: It’s [00:42:15] not a big city at all, actually. The middle is quite small, isn’t it? Yeah, yeah, that’s the thing. Yeah. If [00:42:20] you there’s.

Kaival Patel: Lots of things to do.

Payman Langroudi: I went back to Cardiff. Yeah. Um, with a buddy and [00:42:25] we realised we walked around the area that we used to hang out and [00:42:30] we realised there was this tiny little area of the city. I mean, you know, we used to have cars and we used [00:42:35] to go and have a, I don’t know, meal somewhere outside of that little area. But I remember looking at the area [00:42:40] thinking, shit, man, it was that road, that road, that road, that road, that road. And they were in a little like [00:42:45] a octagon. Yes. Yeah. That was at the most two miles. It’s [00:42:50] really.

Kaival Patel: Not not.

Payman Langroudi: Not a big area. Yeah. Not a big area. And I think the central Manchester bit like that. [00:42:55]

Kaival Patel: It felt close. Yeah. And that’s why I wanted, you know, my choices I think were sort of Manchester, [00:43:00] Liverpool. It was all up north really. Um I think I found London too vast for me. [00:43:05] Um, so, so, yeah, I really enjoyed my time there. I really enjoyed my time.

Payman Langroudi: Did you even consider [00:43:10] staying or. No, not at all.

Kaival Patel: No. I always wanted to come back home. You know, I wanted to come back home. So. [00:43:15]

Payman Langroudi: First job.

Kaival Patel: First job in Northampton. So quite close to. To Milton Keynes. [00:43:20] Um, and then probably my, my biggest break was my associate position. [00:43:25] I had sort of one job interview with a chap called rescue who, [00:43:30] um, is, was in Wellingborough, and he’s absolutely [00:43:35] my mentor, you know, in that thing. And I was an associate there for a number of years. Uh, [00:43:40] I learned from him and from how he did things. The importance of having [00:43:45] people come in to to upskill your You dentists, you know, and just just the fun part [00:43:50] of learning. The side of dentistry, you’re not suddenly in a job. 9 to 5, you go home and whatever else it was. [00:43:55] The camaraderie part of it, the social part of it, and also the the learning part. [00:44:00]

Payman Langroudi: And so he’d organised education for all the associates.

Kaival Patel: Yeah, he did, he did [00:44:05] he there was a sort of, you know, a hotel near where he lived and [00:44:10] he’d just, you know, hire out the function room there. And he must have had ten, 12, 15, [00:44:15] maybe 20 associates. And, you know, whoever were into it, [00:44:20] they’d come there and, you know, they’ll they’ll lend their bits and sort.

Payman Langroudi: Of a social.

Kaival Patel: Yeah, yeah. Um, [00:44:25] not necessarily socially. It was they actually learning part of it. So he did the courses, socials and things were, [00:44:30] were Christmases and, you know, these sort of things. But the learning part he used to get these, these and, [00:44:35] you know, I used to speak to other, you know, my friends in, in their positions and so on [00:44:40] and any courses that they wanted to go and they would have to go and find it themselves going, yeah, yeah, go and do it. And [00:44:45] um, and there was nothing local, you know. Everything was London and Manchester and these sort of places. [00:44:50] So. So yeah, I really learnt a lot by me, by him.

Payman Langroudi: And he was a implantology [00:44:55] artist.

Kaival Patel: He do a lot of implants. Yeah, he used to, he used to do a lot of everything. Invisalign, [00:45:00] implants. Um, yeah. Yeah.

Payman Langroudi: And so did you [00:45:05] start learning implants quite quickly or.

Kaival Patel: Yeah, I did my MSC quite quickly. Um, [00:45:10] how long from it?

Payman Langroudi: Like, which year was it?

Kaival Patel: Um, so actually, I completed the MSC [00:45:15] the year I took over Oxford. Oxford House, my first practice. So I completed [00:45:20] 2015. So I must have started. Yeah. 2012, I guess, or 2011.

Payman Langroudi: And I’ve seen [00:45:25] implantology.

Kaival Patel: Yeah, yeah.

Payman Langroudi: Distance.

Kaival Patel: What did you know full time? So [00:45:30] part of it was based in Harley Street, um, BPP [00:45:35] University.

Payman Langroudi: Oh, okay.

Kaival Patel: And then the last part of it, they sort of switched over and it was [00:45:40] University of Warwick, which was the academic year. Um, and at the same time did [00:45:45] her masters in Indo. So she was very Indo focussed and again she finished it [00:45:50] and we also had our first child in that same year as well. I remember having [00:45:55] the interview and Sarina was he was five days old in the interview prior [00:46:00] to taking over the practice, and he was very attached to her. And then she was [00:46:05] having this interview, you know, five days post, post birth. And I just said, look, [00:46:10] if they ask you a dodgy question, you know, just give him a bit of a nudge and get him to cry or something. So it will put [00:46:15] them off the scent. You know, the.

Payman Langroudi: Nature of those early days of business building and [00:46:20] life building that it’s part of the nature of it, that you end up in the same two [00:46:25] years buying a house, buying a business, getting married or having a kid. Like all those [00:46:30] things happen all at the same time. And even though those are the sort of [00:46:35] the, you know, foundations of the life that you’re building for yourself, I remember [00:46:40] being very overwhelmed by those years. I mean, I don’t know, the business for us was [00:46:45] this. And we were losing big amounts of money, huge amounts of money. And then, [00:46:50] you know, it’s a big change to becoming a husband, a father, if that’s where you went [00:46:55] in those years. You said you’re a father. Yeah. People don’t. [00:47:00] People don’t realise that that’s going to come. And then when you’re in it, [00:47:05] you don’t realise everyone’s going through it. You feel like it’s you. Yeah. Yeah. [00:47:10] So you get a little bit older and you see it. See the pattern happen again and again. Yes. Yeah.

Kaival Patel: You’re right, [00:47:15] you’re right. Yeah. But we always wanted we I don’t, you know, even now when we look back at things, [00:47:20] we think, well, actually nothing’s really as busy as whatever that year was, you know, around [00:47:25] it. Um, and so when we bought the first practice, we tried to buy a practice [00:47:30] a couple of years before, and that ended up going all the way to [00:47:35] sort of completion. We were due to complete two weeks later. We were due to get married, and [00:47:40] that ended up not going ahead because the person there was setting up another practice [00:47:45] nearby and telling his patients to to to move over. And so we ended up having [00:47:50] to, to to scrap that. But you know, like I think we were used to a long period of time where [00:47:55] there’s loads of things going. Even the second practice, we had our second child at the time and the joke was, are you just going [00:48:00] to keep having children with practices? And I nope. I moved out next door just to just to stop [00:48:05] anything from happening. Um, but but yeah, so we always had loads of things going on, [00:48:10] which is the interesting part even now with, with the three kids, you know, there’s lots of things going on, but, you [00:48:15] know, it’s not the same as what we had going on at that point, really.

Payman Langroudi: So [00:48:20] where is it going next, practice wise?

Kaival Patel: Uh, we keep growing, I [00:48:25] think. Um, I’ve never been you know, everybody asks this question of how many practices do [00:48:30] you want? I don’t have a number. You know, I don’t want to. I don’t have this ten or 15 or 20 or [00:48:35] whatever it is. I want to buy practices when we’re comfortable doing it and, you know, [00:48:40] finding the right places that suit the sort of portfolio that we have and things that [00:48:45] we feel we can, we can add to. So we’ve got hopefully another one coming through now, but it’s been [00:48:50] maybe a year or 18 months since we, we purchased the one prior to that. So [00:48:55] I think we’ll grow until.

Payman Langroudi: What’s the difference with your group compared to many of the others that for instance, [00:49:00] in Alicante I sat with many, many, many people who were mini corporates. Right. Um, [00:49:05] yours is private more than it is.

Kaival Patel: Yeah. 92% private. [00:49:10] Yeah. 8% NHS. Yeah.

Payman Langroudi: Yeah. And it was funny because I noticed that pattern [00:49:15] of every almost everyone I was talking to was saying, well, we’re buying NHS practices based on the contract values [00:49:20] were, you know, remortgaging, basically buying more and more and more. Yeah. Did [00:49:25] you decide you’re going to go down the quality route right at the beginning and you’re going to stick to that, or are [00:49:30] you open to.

Kaival Patel: So we’ve had the opportunity to buy very NHS heavy [00:49:35] practices. And we’ve always felt it’s just not us. It’s not our vibe. You know, [00:49:40] I don’t mind having a small element of NHS and, um, and having that as historic value within [00:49:45] the practice, but actually we want we want that patient experience, you know, and [00:49:50] the way to deliver that is to do the dentistry that the dentists want to do in and [00:49:55] around there. That’s the dentistry side of it. And then the way you can have the team following that flow is, [00:50:00] is, is really, you know, having a nice building, having a nice presentation, having a nice flow [00:50:05] of things, having time, you know, which is the massive value aspect for any patient. [00:50:10] So um, so that’s what we focussed on. So, so yeah, when we look at practices now, [00:50:15] yeah, we don’t mind if there’s a small element, but it’s mainly private that we probably look to go to. [00:50:20]

Payman Langroudi: How do you feel about this? I was at PDSA at the weekend. Yeah. Yeah. And the question of [00:50:25] people going from feet to private. Mhm. How do you feel about that. Do [00:50:30] you when you’re hiring.

Kaival Patel: Yeah.

Payman Langroudi: Do you discard anyone who’s coming straight from PhD. [00:50:35]

Kaival Patel: It’s a really good question. I think Heart of [00:50:40] Hearts sometimes, you know, if if they’ve gone straight from that [00:50:45] and the, the CV has three lines saying done PhD and [00:50:50] looking for private position, then there’s no want in there. You know there’s [00:50:55] no I can’t see see that drive or if there’s not a cover letter sometimes you know, these sort of things.

Payman Langroudi: Let’s say [00:51:00] let’s say everything’s good on that end.

Kaival Patel: Yeah. And then when we speak to them, I feel like I can develop the, the [00:51:05] dentist. And actually it’s not so much me. It’s, it’s the team I have around [00:51:10] us. So, you know, it’s a very open door policy in all of the practices. We’ve [00:51:15] got a clinical lead dentist now because I didn’t feel like I’m, you know, being three years out of it, I’m not [00:51:20] the most appropriate person to to help train and teach. So we’ve got clinical lead dentists who, who [00:51:25] spends that time with it at.

Payman Langroudi: Each practice, or one.

Kaival Patel: Know, one practice at one practice.

Payman Langroudi: So there’s one clinical lead [00:51:30] for the whole group.

Kaival Patel: The group. Yeah.

Payman Langroudi: And and that’s what an associate are you paying him more for. For [00:51:35] that role.

Kaival Patel: Yeah, we give them a little bit more a month and.

Payman Langroudi: Less time with patients that he’s kind of more time.

Kaival Patel: He [00:51:40] works three days clinically. So he’s got, you know these these sort of two days [00:51:45] where he’ll and he you know he doesn’t necessarily take out a lot of his, his time [00:51:50] as such. But you know, like for example materials if we’re looking through a new, new set of materials, [00:51:55] he loves that side of it. You know, I always joke with him that when wherever we’re we’re out having a few drinks, he [00:52:00] turns into this Dental materials man, or we call him Rubber dam man because he just he loves [00:52:05] rubber dam and showing it and these sort of things. But you need that person. You need that person who loves that [00:52:10] side of dentistry. Um, he does things correctly. He does things in the right way. [00:52:15] Um, so, um, so, yeah. So he spends a little bit of his time doing it. Um, and when [00:52:20] we have a new dentist joined, they’re part of the induction part, but we have everything else around [00:52:25] for that dentist to, to sort of, you know, thrive in again, [00:52:30] quickly sort of know whether they’re not on board with it.

Payman Langroudi: So this question of, you know where [00:52:35] we’re at plus one. Yeah, yeah. There is they’ve got no experience, [00:52:40] but they’ve got no bad habits.

Kaival Patel: Yes.

Payman Langroudi: Isn’t it. That’s the trade off.

Kaival Patel: That’s the trade.

Payman Langroudi: Off you’re [00:52:45] having to make. There.

Kaival Patel: But you just need to have that. You can take the horse to water but you can’t force them to drink. Yeah. So if we have [00:52:50] all that there and I say in all of my interviews is, you know, there’s loads of associate positions out there now, [00:52:55] what we want is somebody who’s wants to develop and is also going to have absolute [00:53:00] respect for everybody else in the team. So if you can do those two things absolutely fine to to [00:53:05] hire you and have you as part of our group, if you feel like you, that’s not you, then [00:53:10] this isn’t the right place for you. And and you know, when, when we go through all the things that we do, [00:53:15] they love it, you know, you see it instantly.

Payman Langroudi: In love, right?

Kaival Patel: Yeah. Yeah. What’s [00:53:20] not to love? And we’ve got the academy. We’ve got courses there all the time, you know. So again, [00:53:25] I don’t force any of my dentist to join the academy because it’s just a kind of health group, you know, side [00:53:30] of things. It’s they can join individual courses that they want to learn more in and these sort of things. [00:53:35] Um, but there’s that development side there. But again, you have to be willing [00:53:40] to turn up to the course and, and take part in it and speak to other clinicians. We [00:53:45] have a million WhatsApp groups, and one of them is just for clinicians. And my one rule in the WhatsApp group [00:53:50] is don’t be a dick. You know, there’s there’s lots of silly questions that you would have asked when you [00:53:55] were young and fresh into it. So, you know, allow these guys to ask questions, [00:54:00] put photographs in there, put X-rays in there and answer it, because we’ve got specialists [00:54:05] and all these wonderful clinicians within the team. And you know what? Everybody loves sharing. [00:54:10] I haven’t met a dentist who does well at their craft who doesn’t actually love sharing.

Payman Langroudi: Yeah [00:54:15] that’s true. Because then she’s a bit like in a room, isn’t it? You want to you want to [00:54:20] talk about it a little bit when you, when you, when you’re with your peers. If you’re into it, if.

Kaival Patel: You’re into it. Yeah. [00:54:25]

Payman Langroudi: So do you think you’re good at telling who’s going to be a good dentist and who’s not?

Kaival Patel: No, [00:54:30] it’s the same.

Payman Langroudi: Same as a lottery, isn’t it? In the same way as you don’t know until you know.

Kaival Patel: Yeah. I [00:54:35] think we’ve hired people who haven’t been the right people after a short period of time and [00:54:40] would damage maybe our reputation and our quality of things. You know, a [00:54:45] bit to maybe money hungry, you know. Whereas I do feel that if you do [00:54:50] quality work and you spend time with the patient, the money will come. You know, everybody makes a good living, you know, when you’re doing [00:54:55] things the right way, if you’re a bit too overzealous with it or unethical, really, then that’s [00:55:00] my reputation. At the end of the day, you know. And so we’ve we’ve had to not [00:55:05] have people carry on with this as a result. Not many, not many.

Payman Langroudi: Positioning wise, you’re at the higher [00:55:10] end of the market, right.

Kaival Patel: In terms of.

Payman Langroudi: Positioning.

Kaival Patel: But you’re [00:55:15] the practices themselves or practices in the price wise.

Payman Langroudi: Yeah. Price.

Kaival Patel: And yeah I’d say [00:55:20] we’re we’re like a John Lewis. We’re not a Harrods and we’re not a, you know, [00:55:25] anything lesser in terms of a supermarket chain, you know.

Payman Langroudi: But so are [00:55:30] you saying there is a Harrods in Milton Keynes? That’s that’s the. You know, you can’t say we’re not a Harrods if there isn’t one. [00:55:35] Mhm.

Kaival Patel: I think there are practices that position themselves, you [00:55:40] know, more up-market than we are. Yeah. And we are family orientated. You know, the [00:55:45] crux of the business and the crux of the practices are family orientated care. Um, it’s not [00:55:50] just high end work all the time, but we’ve also got a referral centre where other practices refer [00:55:55] over to us. Um, and again, we have to maintain, you know, the levels, the quality. [00:56:00] Otherwise people aren’t going to refer. We’ve got 60, 70 practices referring to us now from starting from scratch from [00:56:05] when we took over. So yeah, that.

Payman Langroudi: Wasn’t a referral practice to start with.

Kaival Patel: No, not [00:56:10] at all.

Payman Langroudi: No. How many years did that take to.

Kaival Patel: So we took 2017. I had [00:56:15] the first specialist there, um, which was, uh, an endodontist [00:56:20] who’s, who’s been with us ever since. Amazing guy. And, um, and then now [00:56:25] we’ve got. Yeah. Oral surgeon. An orthodontist, a couple of periodontists, um, [00:56:30] a couple of, uh, people that do sedation implants. Um, [00:56:35] so everything barring a prosthodontist at this stage.

Payman Langroudi: Children’s.

Kaival Patel: And [00:56:40] paediatric, we don’t we don’t have somebody who does.

Payman Langroudi: I would, I would.

Kaival Patel: Yeah.

Payman Langroudi: We’ll talk about that in a minute. But [00:56:45] so impressive man. You make it sound so effortless. I’m sure it’s not [00:56:50] right. I’m sure there’s more effort than you’re. You’re letting on here. Yeah. But at the same time. [00:56:55] So impressive, man. Thank you. Not an easy thing to do. Not an easy. Along [00:57:00] with all the other things you’re doing to make that successful, you know. So what did you do about referrals? [00:57:05] Did you sort of study club it at the academy or.

Kaival Patel: No. What I did was [00:57:10] and I don’t know how right or wrong it is, we went to every single practice around the area [00:57:15] with a box of chocolates or a hamper, um, made a referral [00:57:20] pack and literally physically went to every single practice around the area saying, look, [00:57:25] we’re doing this. We’d love you to support us. The difficult part of that practice is, [00:57:30] is the general practice as well as a referral centre. So it’s.

Payman Langroudi: Seen as [00:57:35] competition.

Kaival Patel: Somehow.

Payman Langroudi: As.

Kaival Patel: Well. So, you know, I made it very clear, and we are crystal clear about it, that [00:57:40] we would never take anybody’s patient. You know, you refer it that patients come back to you, you know, whatever happens. [00:57:45] And so yeah, we went to all the practice. And now every year we do the same thing. We make it wackier [00:57:50] and wilder. Every year we’ve got these doughnuts. And you know, half the time we’re we’re regarded as these, [00:57:55] you know, the doughnut practice or, you know, these massive doughnuts that are all, like, really [00:58:00] nicely decorated. And we’ll go to the practices and we’ll, we’ll, you know, we’ll just give them.

Payman Langroudi: 60, 70 [00:58:05] of them.

Kaival Patel: No. So this will be maybe 150 to [00:58:10] 200 practices will go to. So we’ll go Milton Keynes.

Payman Langroudi: We’ll go wait a minute.

Kaival Patel: Watford. Northampton.

Payman Langroudi: Face [00:58:15] to face.

Kaival Patel: Face to face.

Payman Langroudi: That’s not you.

Kaival Patel: Not me. No.

Payman Langroudi: So that’s one person’s almost whole job, [00:58:20] right? Because that’s, you know.

Kaival Patel: It’s it’s it’s the it’s the most fun and it’s [00:58:25] the most stressful time that. So we have a referral centre coordinator, we have the practice manager there, we have treatment [00:58:30] coordinator and we have the marketing team. And and every year we say, look, let’s plan this a bit [00:58:35] earlier. Uh, we’ll make it a bit. So this year I want something interesting. This [00:58:40] is the bit that gets me kicking. Yeah. So this year we had Willy Wonka golden tickets, you know, um, for, [00:58:45] for them. And they’d have to do there and they’ll scratch something and, and get this golden ticket [00:58:50] and, and these sort of. I just want to make it interesting, make it fun around it. But there’s always this [00:58:55] massive push towards whenever we call it the, you know, the hamper drop days, um, [00:59:00] to, to get it there. But yeah, they’re out for two, two weeks. Um, [00:59:05] how many people. So we’ll have this year we had two cars. [00:59:10] So two in each, two in each. And so we’d go to the doughnut place because it’s all fresh doughnuts made [00:59:15] on that day. They go to the doughnut place, pick up the doughnuts for that day, and then then take it over to.

Payman Langroudi: Like [00:59:20] 7 or 8 times that day, whatever. More than that even. Yeah. How interesting.

Kaival Patel: And then [00:59:25] did.

Payman Langroudi: You come up with that yourself?

Kaival Patel: Yeah, yeah.

Payman Langroudi: It seems so obvious.

Kaival Patel: But I [00:59:30] mean, people don’t. People don’t realise. So the first year we did it, we got loads of these [00:59:35] Cadbury’s chocolates. Me and Serena spent evenings up until 3 a.m. making these boxes [00:59:40] up. And then we, we plonked them in our hallway and [00:59:45] we were like really excited, you know, massive, like layers of these chocolate boxes that were [00:59:50] due to go out and we plugged in the hallway, forgetting that we have underfloor heating. So [00:59:55] I’ve got a few messages from friends of mine that are other practices around the area [01:00:00] with this melted chocolate bars, like, okay, what are you trying to do here? You know, and [01:00:05] we were so excited. We’d put straw in these things and wrapped it beautifully. And yeah. So, [01:00:10] you know, you learn from these sort of things. But again, you look back at it and that’s the blood, sweat and tears that we [01:00:15] were putting into something slightly different. And obviously the clinical side of it [01:00:20] speaks for itself. You know, the specialists are amazing, and they’ll do webinars and they’ll get people together. [01:00:25] We had a our first ever referral centre event, which was like a Vegas [01:00:30] theme, um, event that people came to and, you know, and they could meet the specialists and [01:00:35] these sort of things.

Payman Langroudi: So it’s a massive achievement insomuch as you’re a dominant force [01:00:40] in the town already. So in a way, people think, well, am I feeding [01:00:45] my competitor outside of that practice, having a general practice side [01:00:50] to it? Yeah, yeah. Like, you know, if you’re a little bit competitive and you see this [01:00:55] dominant guy who’s got 30 chairs already in the town, now asking for referrals.

Kaival Patel: Might [01:01:00] piss people off. Yeah, it does actually. I’m sure it does.

Payman Langroudi: I’m sure it does. But but you know, the fact that you’ve [01:01:05] made it as successful as that as quickly as that is a testament to what a great guy you are, man. You’re you’re. [01:01:10]

Kaival Patel: Very kind.

Payman Langroudi: Man. You’re very kind. You’re okay.

Kaival Patel: I think, again, I [01:01:15] just have this itch and I need to do something, you know, we need to keep it going. And, and actually, I think when [01:01:20] you do become complacent is when things start dropping off. You know, and again, it’s not just me. You know, [01:01:25] I have a team around me that are doing all these things and reminding me, oh, we need to do this, that or the other, or [01:01:30] let’s try this, you know, and you’ve met some of them and they’re like, you know, on top of it, good [01:01:35] people. Good people. Yeah.

Payman Langroudi: Your Christmas party?

Kaival Patel: Yeah. [01:01:40]

Payman Langroudi: What is it, 150 people? No. Do you do the. Do you have five separate [01:01:45] ones?

Kaival Patel: No we don’t. No, no. So for the last two years, we’ve got everything. Everybody [01:01:50] together.

Payman Langroudi: Oh, really? That must be fun.

Kaival Patel: It was fun. It was fun. So we have. We call it. That’s [01:01:55] the kind of awards that we do. So it’s an awards night as well as the the Christmas party [01:02:00] and everything else. So I think we had about 100, 110 people. Um, [01:02:05] but it’s interesting, the first, first year we did it, last year we, we [01:02:10] had taken over a practice recently, not not too, too long before that. And we didn’t have too many [01:02:15] people from that practice turn up and these are my sort of benchmarks this [01:02:20] year. I really love it that practice. Virtually all of them came, you know, almost [01:02:25] 20 odd people. And they did a they did a Spice Girls dance, you know, like they got in there. I [01:02:30] always ask for the entertainment. We have our own entertainment. We’ll find somebody. Um, and I [01:02:35] ask if any of our team want to do something, you know? So we have last two years, we’ve had a singer, [01:02:40] you know, really talented singers that work with us. And, um, and then [01:02:45] they wanted to do the Spice Girls routine, which I love it. You know, like, they just got involved and got in there. Um, so [01:02:50] it’s it’s cool.

Payman Langroudi: It takes a lot of emotional intelligence to have these ideas and sell it to people. [01:02:55] Did you get this from the news agents? Did you work there ever?

Kaival Patel: I didn’t [01:03:00] work as much as my sister, just for the record, because she always tells me off. Yeah. Um, I used to play a lot of [01:03:05] cricket when I was younger, so cricket used to be Saturdays and Saturdays. I used to, you know, my [01:03:10] dad would would go and take me to to cricket and these people skills.

Payman Langroudi: Did you always have them? Were [01:03:15] you that kid who was always good with people? Did you get it from one of these activities? Captaining [01:03:20] the cricket team? I don’t know.

Kaival Patel: I don’t know. Yeah, maybe.

Payman Langroudi: Maybe. It comes very naturally to you.

Kaival Patel: Well, [01:03:25] I’d say I’m one of these guys that generally vibe off other people. Yeah. You know, so [01:03:30] I think I’m listening to a podcast and that introvert. Extrovert, you know, like, if I’m in a really [01:03:35] loud environment with loads of people, I’ll shrink up and go in the corner. Oh, really? Yeah. So I’m. But [01:03:40] if I’m in, you know, if I’m feeling the vibe and I’m normally smaller groups, then I’m [01:03:45] really, you know, I feel that energy and I vibe off of it. So I [01:03:50] think sometimes you have to force it when obviously you’re the owner of a business and you have to be there injecting [01:03:55] that energy. Um, what’s your.

Payman Langroudi: Attitude to risk?

Kaival Patel: Sorry. I’m risky. [01:04:00] Yeah.

Payman Langroudi: You like to take risks?

Kaival Patel: I like taking the risk. That’s where Serena’s in there. So she’s not. [01:04:05] She’s not fully opposite. Fully.

Payman Langroudi: You need a balance, right? You need a balance.

Kaival Patel: And she’s. She’s the accountant’s [01:04:10] daughter, you know. She’ll she’ll risk assess. Probably less so now. But [01:04:15] right at the start, you know, she would do the cash flows of the businesses and say, look, how are we going [01:04:20] to make this work? You know, because we looked at lots of practices before the first few. How are we going to [01:04:25] make it work? Is it going to work? What happens if it does? And what are we going to do, you know, these sort of things. And [01:04:30] now she tends to sort of let me fly with it to a certain extent. Um, [01:04:35] but yeah, she’s the one that really sends checks a lot of things, you know, and, you know, [01:04:40] we wouldn’t be anywhere, really, without Serena doing that part of it, honestly.

Payman Langroudi: Let’s talk about [01:04:45] the Academy.

Kaival Patel: Yeah, yeah.

Payman Langroudi: When did you have the thought that you were going to be [01:04:50] like a teaching institution? This is a different thing to being a practice.

Kaival Patel: Yeah. [01:04:55] So I always liked that development side. Like I said, I used to get speakers in for our [01:05:00] own. So so even when we had a couple of practices and then it used to bug me, to be honest, [01:05:05] that everything’s in London or Manchester, even the courses I used to go to, you used to have to travel everywhere. [01:05:10] And I love the development side of it for for associates. I [01:05:15] literally love them, seeing them grow. You can see it in numbers. You can see it in confidence. You can [01:05:20] see it in just conversations that you end up having with them. And um, and I knew for, [01:05:25] you know, I knew I wanted to do something like that across the road from one of the practices, [01:05:30] the top floor of this room sort of came up.

Payman Langroudi: And I’ve been there. Right? You’ve been there? Yeah.

Kaival Patel: So it used to [01:05:35] be just the storage room. Um, you know, you had these salmon pink sofas and random [01:05:40] things in there, and I thought, actually, this this is perfect space to have [01:05:45] an area for us. And the practice we have across the road is sort of utilised every nook and cranny. So, you know, team [01:05:50] meetings and these sort of things, we used to not have space for it. So let me get that. You know, we, [01:05:55] we created a sort of almost like a boardroom. Um, you’re a U-shaped, [01:06:00] you know, section. And then I thought, well, actually, let me, let [01:06:05] me see whether we used to have, you know, courses generally and other dentists around the area used [01:06:10] to, you know, want to come on there and these sort of things. So I said, well, actually, what [01:06:15] if we just designed a program from scratch where, where people can come and join us? The USP [01:06:20] was it was in Milton Keynes and it got blown out of the water because we had people from Ireland and all over [01:06:25] the place coming to it because the speaking, you know, the speakers were so good. I didn’t quite I [01:06:30] underestimated how much work it was to become accredited to, to be [01:06:35] able to, to, to give out a diploma. Um, but once we got that, you know, I really [01:06:40] I loved it. Um, and I’m really thankful, actually, because a lot of the speakers wouldn’t [01:06:45] have heard of us. You know, we I had to reach out to I firstly, I asked other [01:06:50] dentists in that sort of target audience, you know, who are the people that you’re speaking to [01:06:55] and these sort of things. Some of them I hadn’t necessarily heard of so much at that point, reached out to them, [01:07:00] email or Facebook and these sort of things. And these guys took a punt with us. You know, they [01:07:05] were like, well, we haven’t heard of you, but you’re looking to do the right things. We’re happy to speak [01:07:10] on this, this course and stuff.

Payman Langroudi: Like who?

Kaival Patel: Nick Sethi, um, [01:07:15] even Milad.

Payman Langroudi: Um, singing dentist.

Kaival Patel: Singing dentist. Yeah. Um, she [01:07:20] has been on and jazz girl these are guys there. Um, Mitchell Patel and Jazz Gulati [01:07:25] and jazz. Yeah. And he was one of the actually the staunchest supporters at the start. He was so [01:07:30] positive. So, you know, he was just like, yeah, Kevin, just you could do it. Let me help you out. We’ll get people on. [01:07:35] He is.

Payman Langroudi: A great, great guy.

Kaival Patel: Man. Really great guy. And just his energy his infectious. Right. This is what [01:07:40] I mean. Like if I’m in a room with him, I’m suddenly bouncing around because I’m just vibing.

Payman Langroudi: With these, like, one day courses, one, [01:07:45] one event, one evening courses, or like, how did it start and how did it evolve? [01:07:50]

Kaival Patel: No. So so I always had the plan that it’s going to be a year long program. Yeah. Um, [01:07:55] but you can attend each individual course if you want. If you want to. Yeah. But if you want the diploma, [01:08:00] it’s a year long program.

Payman Langroudi: So eight.

Kaival Patel: So there’s 13 courses.

Payman Langroudi: 13 days in the [01:08:05] year.

Kaival Patel: 13 days in the year. Yeah. 14 days, 13 of course, is one of the courses is two days.

Payman Langroudi: And the [01:08:10] sort of the angle of the diploma is what? What is it? How do you what’s the kind of USP of that diploma over [01:08:15] a different.

[TRANSITION]: I mean it’s.

Kaival Patel: Similar to the other ones. The main essence is you’re [01:08:20] just getting good quality education in, in, in a bit of a smaller space. So [01:08:25] it’s quite one on one. The control you get that, that element of it, you feel part of it. I [01:08:30] wanted to create that little community from the delegates as well, where they can share cases and in a safe space [01:08:35] and, and these sort of things. And it’s just for me, it’s the best speakers or some of the best speakers in the [01:08:40] country, and they’re here and they’re in Milton Keynes, and they’re able to teach and train you. And we wanted [01:08:45] to tie it all up into a diploma. And you get something behind attending these [01:08:50] courses, and, you know, the letters after your name and these sort of things. There’s the kudos of it all. But [01:08:55] actually it’s just hands on, you know, like being able to utilise the skills that you learn on Monday [01:09:00] morning. You know, so many times I’ve been on courses, it’s been six months, I’ve not used anything. You know, [01:09:05] we really pushed them to utilise those skills to do it. And and again, [01:09:10] I’ve seen guys that most of the delegates now are probably not our own dentists. They’re [01:09:15] they’re others from all over the place. And, and I see their confidence develop, you know, as [01:09:20] they’re going on. Absolutely. Love it. You know and and when they’re leaving the course and they’re giving me a hug and saying, [01:09:25] thank you so much. You know, you’ve you’ve really improved my sort of, you know, my confidence. It’s not necessarily [01:09:30] that they won’t say clinical skills so much. It will be my confidence because that’s all related to to to learning. [01:09:35]

Payman Langroudi: You teach on it yourself.

Kaival Patel: No I’m.

Payman Langroudi: Sorry.

Kaival Patel: No middlemen. No [01:09:40] no I don’t one I think I [01:09:45] think it’s a bit of imposter syndrome with a lot of the things. But the clinical side, I knew I wasn’t the best [01:09:50] dentist, you know.

Payman Langroudi: But surely there’s a non-clinical piece that you could have taught.

Kaival Patel: So [01:09:55] I’m going to develop that, um, which is a business and management course, um, which, [01:10:00] which will be happening later in the year.

Payman Langroudi: Even on even on Mini smile Makeover, we have a marketing lecture. [01:10:05] Yeah, yeah. I think it’s important. I think it’s important. Part of call it educate patient [01:10:10] education, whatever, whatever you want to call it. Yeah. Yeah. I think it’s important that the non-clinical side [01:10:15] of it is the bit we don’t get taught at all.

[TRANSITION]: We don’t get taught.

Payman Langroudi: You’re right. And you’re a master at it. [01:10:20]

Kaival Patel: I don’t think I am, but.

Payman Langroudi: It should have been. It should have been like 14 days or whatever, you know, 12.5 days, [01:10:25] but. But one of them or half a day, something talking about that side of it. Or you should definitely [01:10:30] do it now going forward.

[TRANSITION]: Yeah.

Kaival Patel: Yeah. So I think we’re going to start this sort of business and management course towards [01:10:35] the end of the year. I need to I’ve got the the framework in my mind. [01:10:40] I just need to make sure that we’re, we’re, we’re going to market it in the right way and you know, and [01:10:45] actually have it beneficial for, for people, you know, whereas business owners or researchers want [01:10:50] to take the leap or people that are one one business and looking to scale up and, and these sort of things, [01:10:55] you know.

Payman Langroudi: Look, you know, I’m a massive fan of yours. Yeah. You know that. Yeah. Um.

Kaival Patel: What’s the. But [01:11:00] heck.

Payman Langroudi: Yeah, I’m a massive fan of yours, man. And like I say, you [01:11:05] seem to carry things off very, like, flawlessly and sort [01:11:10] of effortlessly. And it’s just lovely to see a nice guy doing that. I love that. But [01:11:15] there is always in these stories, a darker side. [01:11:20]

Kaival Patel: Yeah.

Payman Langroudi: What comes to mind if I say darkest day in this journey?

Kaival Patel: Darkest [01:11:25] day?

Payman Langroudi: Well, some of them, you know.

Kaival Patel: I [01:11:30] think what I started off with in terms of, you know, easing [01:11:35] our way into practice ownership and, and the stresses that we had there. I’ve [01:11:40] had, um, I think we’ve had [01:11:45] associates or an associate who was the owner of a business or one of the practices [01:11:50] who left. And they were going through a divorce [01:11:55] at the time. And they said to me, look, I want to leave, but, [01:12:00] Um, I want to try and come back to the area before your [01:12:05] restrictions sort of time piece goes and, you know, they’ll be absolutely fine [01:12:10] with it. And, you know, they’ve supported the business all this time, and they sort of came back as soon as they came back, [01:12:15] there was mass marketing to go and grab their grab the patients back on a really [01:12:20] existing Dem plan list. And, and I felt like a complete wally because I just took it on good [01:12:25] faith. Right? Yeah. Yeah. That, um, that, you know, you’re going to do this, you’re [01:12:30] going to come back, you’ve got to rebuild your life because of everything you’re going through. Um, darkest day was Covid [01:12:35] the day.

Payman Langroudi: In private practice.

Kaival Patel: Right? Yeah. The day where I remember [01:12:40] we were in the waiting room of of Oxford House. And again, we had the only the two sides then [01:12:45] and um, and the announcement came on TV and I [01:12:50] had the team around me, and the announcement came on TV that everything needs to closed down. There was no discussion [01:12:55] of furlough and all these sort of things. And I just cried, you know, like I couldn’t [01:13:00] really, I needed to I should have just stayed bloody strong for the team and everything. But I had this realisation [01:13:05] that all of these guys lives and dependents are dependent on this business. How [01:13:10] are we going to help support them? Everything was going on at the same time and that was [01:13:15] a dark day. Um, and yeah, I think, I think that that [01:13:20] must be the. Yeah, that’s the bit where I feel the emotion now. You know.

Payman Langroudi: I [01:13:25] remember the team coming in. Yeah. Like our videographer guy, he came [01:13:30] in and he said, yeah, I lived with two other people. Both of them just lost their jobs, and they’re heading back [01:13:35] to Italy. Um, how’s my job? You know, like, he came in [01:13:40] like that. That was his opening statement. Yeah. On that day that we said we’re going to close everything [01:13:45] down. Welcome. Yeah.

Kaival Patel: See you.

Payman Langroudi: What about. We [01:13:50] like to talk about errors.

Kaival Patel: Yeah.

Payman Langroudi: Um. You know, because because because your [01:13:55] story is so beautiful and all that. I kind of want these this side to be equally painful. [01:14:00] Okay.

Kaival Patel: I’ll see what I can do.

Payman Langroudi: Clinical errors. Business errors.

Kaival Patel: Yeah. [01:14:05]

Payman Langroudi: What comes to mind?

Kaival Patel: Business error. I think it was. Was that one that one, uh, clinical [01:14:10] error. It’s hard because I’m not that you know, obviously it’s been a while since I’ve done the clinical [01:14:15] side of it, but three years. Yeah, but the, the bit I, I [01:14:20] remember well, like it was yesterday was this, it was my first full [01:14:25] arch implant case.

Payman Langroudi: Oh. All on four type thing.

Kaival Patel: All on it was.

Payman Langroudi: 6 or [01:14:30] 6.

Kaival Patel: Yeah. Yeah. And, um, and I sort of was prepped and ready to, [01:14:35] to, to do it. And so I’ve done the surgical side of it and I was taking the, the [01:14:40] impression for, for probably the temporary work or it might have even been the final work. Um, [01:14:45] and it was a, you know, an open tray impression. So, so the, the [01:14:50] and now this is a patient that was Uber nervous. Obviously they [01:14:55] were, they used to we’d sedated her for the first part of it, just because she was so [01:15:00] nervous with generally everything, and she had a massive gag reflex. So I was always a bit, a little bit shaking it with [01:15:05] this impression. And it was pretty much right at that point. Did the party [01:15:10] and I forgot to, to, uh, to take out the, uh, the post. [01:15:15] Yeah, yeah. Around it. So in effect.

Payman Langroudi: It was all stuck.

Kaival Patel: It’s all stuck. She’s [01:15:20] she’s there. She can see that. I’m sort of sweating thinking I can’t access these posts. [01:15:25] So the only way I can get into it is to drill the, the putty.

Payman Langroudi: The [01:15:30] tray, the.

Kaival Patel: Putty. But she’s. Her biggest fear was the sound of the drill, you know, [01:15:35] that’s why she was.

Payman Langroudi: Oh, she was a nervous patient.

Kaival Patel: Nervous patient. Really nervous patient. So I’m there [01:15:40] trying to drill. Everything’s flying out everywhere. She. She kept getting up every two seconds because [01:15:45] she just couldn’t, you know, hack it. Um, and then I ended up [01:15:50] having to, like, section, basically this thing a complete moron, you know, completely.

Payman Langroudi: Imagine the mess [01:15:55] that was made, their.

Kaival Patel: Mess. And it was stress because she was. So when your patient [01:16:00] is anxious, you’re anxious, you know, a little bit inside yourself. There’s saliva everywhere. She was pretty [01:16:05] much vomiting. And yeah, it was it was horrendous. And then gradually ended [01:16:10] up. And also for this is the one patient you do everything happens right. I didn’t insert the [01:16:15] anything into the access holes as well for some reason I don’t know.

Payman Langroudi: So they got clogged up.

Kaival Patel: They were clogged [01:16:20] up with this. There’s two millimetre holes that I’m trying to drill out. The, [01:16:25] you know, everything in there at the same time. And, um. Yeah. So that’s [01:16:30] the bit where I, you know, what happened?

Payman Langroudi: What happened? Was she cool in the end or.

Kaival Patel: She [01:16:35] she wasn’t. No. She was like completely freaked out afterwards. Took everything [01:16:40] out in the end. I said, look, do you want me? I’m obviously running now, you know, incredibly [01:16:45] late for everything else. And I said, look, I’m happy to try it again [01:16:50] now. Or should we just take a breather and come back in another day and I’ll do the rest for you. [01:16:55] And she wanted it another day. And actually the other day she was fine. She was cool. And [01:17:00] she she understood it. And, uh, I can’t say we laughed about it together [01:17:05] afterwards, but we were okay. We got it done and the end result was good.

Payman Langroudi: So did you take the blame? [01:17:10]

Kaival Patel: Yeah.

Payman Langroudi: You said I have made an error here.

Kaival Patel: Yeah, yeah, yeah.

Payman Langroudi: And [01:17:15] she was.

Kaival Patel: Cool. There’s nobody else you can blame in that.

Payman Langroudi: But she was cool with that.

Kaival Patel: She, she got [01:17:20] it. You know, she, she, she understood it and she didn’t really care to be honest. Like [01:17:25] in terms of whether it’s my blame or anybody else’s blame or whatever else, it’s.

Payman Langroudi: A juicy one. It’s a juicy one. [01:17:30] I think I’m going to accept that. I think I’m going to accept that sometimes I don’t accept them when the [01:17:35] outcome is so happy.

Kaival Patel: Okay.

Payman Langroudi: Sometimes it wasn’t that happy. Yeah, sometimes.

Kaival Patel: I get sued.

Payman Langroudi: So sometimes I [01:17:40] want an unhappy outcome. Like I’m not even talking about being sued. I’m talking about, you know, trust was lost. [01:17:45] Okay. You know, that kind of. But I’m good. I’m going to accept that.

Kaival Patel: Thanks. I appreciate it.

Payman Langroudi: Mainly [01:17:50] because we’ve come to the end of our time. Otherwise I would have sweated you a bit more. [01:17:55] No, I want to talk a little bit around your final questions. [01:18:00] Um. Fantasy dinner party. Three [01:18:05] guests, dead or alive. Who are you having?

Kaival Patel: It’s [01:18:10] a really hard one. I’m guessing that’s why you have it as the. The last one’s there to actually, like, [01:18:15] pick pick three. The first person would be my grandma [01:18:20] who’s who’s passed away. And, um, what.

Payman Langroudi: Was your relationship like with [01:18:25] her?

Kaival Patel: So, like I said, dad had seven other siblings.

Payman Langroudi: But the matriarch, the she was the [01:18:30] linchpin.

Kaival Patel: She was the linchpin.

Payman Langroudi: Yeah, yeah.

Kaival Patel: Yeah, yeah. She was the linchpin and really strong lady. Really emotional, [01:18:35] but but strong lady. And she lived with us whilst I was young. So really fortunate [01:18:40] in the UK, lived with with my family specifically for a long period of time, but especially when [01:18:45] I was growing up. So she was the one that when I came home she’d have a cup of tea ready for me. She [01:18:50] understood very little English, but she knew everything that was going on with Home and Away and Neighbours. Somehow [01:18:55] when we used to get, she’d tell me exactly what’s happened when.

Payman Langroudi: Neighbours brought back memories. Yeah. [01:19:00]

Kaival Patel: So, um, and towards the latter part of her life, [01:19:05] she, um, she had dementia, you know, like quite, quite severe dementia. And [01:19:10] that was the part where everything started happening for us. So we, I got married, [01:19:15] had kids, had the practices. And, you know, I’d love her to be on that table to all [01:19:20] of that. Yeah. My, my Gujarati is terrible. So probably now it’s good. Actually, I’ve got Google Translate. [01:19:25] I can probably tell it properly, but when she lived with us, it was a lot better because that’s the only way we could [01:19:30] communicate. But I’d love her to be there and just for her to see the grandkids. And [01:19:35] and she always had this thing where she’d say, wherever your wishes [01:19:40] go and fulfil it. You know, in Gujarati, you know, my mum and dad might joke about [01:19:45] something and they’ll call me a dumbass or something like that. And she she would completely, you know, stop [01:19:50] them, you know, and just say, no, he’s not you know, he’s going to he’s going to do it. And [01:19:55] you know, I grew up with, with with her, you know, mom and dad are exceptional. But [01:20:00] she she literally was was that person so amazing. She’s person one. Person [01:20:05] two would be, um, I love cricket. [01:20:10] And I was thinking, you know, who could we have from from the sort of cricketing side [01:20:15] of things. And I love India. There’s Sachin Tendulkar, but the person that [01:20:20] I’d have there is a guy called Ms. Dhoni who was Indian captain for a while, [01:20:25] and I’d have him because he wasn’t necessarily the best player, [01:20:30] but he was a great leader, you know, and he managed to lead these these, you know, the [01:20:35] Indian team that won the World Cup and these sort of things. And I just love he had a lot of divas [01:20:40] and, you know big stars in the team. And he managed to gel these guys together and still come out [01:20:45] looking as cool as, as anything.

Payman Langroudi: Do you still play?

Kaival Patel: No, no, I don’t play anymore. [01:20:50] So both of my boys have have started playing now. And, you know, [01:20:55] my my dream will be to have at least one match where I played in the father son [01:21:00] match last year with, with one of them. And I was sore for about three weeks afterwards. It’s [01:21:05] just. But I want to become fit, actually. My big aim for this [01:21:10] year is actually to become fitter and be able to do just just 1 or 2 games with them, and [01:21:15] I loved it. Yeah, I used to love it. Um, so yeah, I’d have msdhoni. [01:21:20] And then the final person is a chap called Mo Gawdat, so. [01:21:25]

Payman Langroudi: I know Mo.

Kaival Patel: Yeah. And he was, he was sort of a chief business officer [01:21:30] with Google X. He’s done some out there things more recently. But [01:21:35] one, one of his, you know, earlier books was was the equation of happiness. [01:21:40] We talked about it earlier.

Payman Langroudi: Yeah.

Kaival Patel: And he lost his son Ali. Um, [01:21:45] you know, when when his son was young and, you know, one of the things you shouldn’t ever have to bury [01:21:50] your your children. Yeah, but he he pivoted at that point, and [01:21:55] he sort of tried to work out the equation on happiness, you know, um, and [01:22:00] super smart.

Payman Langroudi: But you’re right that normally those super smart guys aren’t spiritual in [01:22:05] the way that he is. But I’m a massive fan of the podcast Slow Mo. [01:22:10] Yeah, but I kind of go into these phases of I listen to like nine of them in a row, and then [01:22:15] I come out of it and then like when I go back to that podcast quite a lot, you know, like it’s on a [01:22:20] plane or something. Yeah. It’s weird. I don’t have it. Like during my day to day.

Kaival Patel: It really hit me, [01:22:25] you know, like and.

Payman Langroudi: He’s brilliant.

Kaival Patel: He’s brilliant. The way he speaks is brilliant. And I [01:22:30] think just. It was the first time really, I got into thinking about that happiness side of things. [01:22:35] You know, everything was just all the go all the time and and actually what [01:22:40] is everything for, you know, what is everything for, you know. So I think [01:22:45] that was a you know, I’d love to have him there and just pick his brains on the happiness side of [01:22:50] things. I think I’m constantly striving to to feel that contentment and, and, [01:22:55] you know, hopefully having him on the dinner table, I can bust his brains and, and [01:23:00] figure out, you know, some of some tips and tricks to, to get there.

Payman Langroudi: You know, in the same way as people have [01:23:05] personal trainers in the, in the gym, you know, there is there is space, there is it’s [01:23:10] important here to look at like therapy in a way that is like that, [01:23:15] like an optimisation. Yeah.

Kaival Patel: So so we had somebody recently I got from my [01:23:20] group. Oh really? Her name is Maya Raichura and she works on mental fitness and [01:23:25] it was much nicer.

Payman Langroudi: Way of looking at it, isn’t it? Mental fitness.

Kaival Patel: Visualisation and mental fitness [01:23:30] and actually getting her in and just having that, that session on it, you know, um, [01:23:35] it’s really important and it’s really valuable tools just to visualise that, you know, again, it’s one [01:23:40] of these things where some people think it’s a bit fluffy and whatever.

Payman Langroudi: No, listen. There is. There is a deficit. [01:23:45] Yeah, there is a deficit. I try and fill that deficit with food. Yeah, all the [01:23:50] time. Yeah, I try and fill that deficit with fun. Yeah, yeah, yeah. With ambition. [01:23:55] With all. But there is a deficit. Yeah, yeah. And if we if you can get back [01:24:00] to that deficit and say, hey. Okay. That’s all right. Whatever that is, that is [01:24:05] it. You thought you would never amount to something, or we had a revolution and ran away [01:24:10] or whatever it was. Yeah, yeah. I haven’t done the work myself to know. Right. But there’s definitely a deficit. Yeah [01:24:15] yeah yeah yeah yeah. But everyone has it. Everyone has [01:24:20] it. Yeah. Like, you know, there’s hardly anyone who’s so perfect. And so, you know, we [01:24:25] could. It’s just like. It’s like a personal trainer in the gym. Yeah. Even the guy who goes to the gym every day sometimes [01:24:30] uses a personal trainer. Yeah. Yeah. It’s interesting you got that for your team? Yeah. Do they appreciate it?

Kaival Patel: Yeah, [01:24:35] I think they did. I think they did. Again, it’s different. It’s a bit different. But I wanted to focus [01:24:40] on like January for me is this hangover month? Generally in business, you know you have [01:24:45] Christmas. It’s always really busy and I wanted January to be ignition time for the team, right? So if [01:24:50] not everybody, there was only maybe 20 of our team there. And the morning was, um, [01:24:55] some clinical stuff. And then the afternoon was this. And the people that [01:25:00] really took it on board, you could see that, you know, when they when they left the room, their shoulders were, [01:25:05] were their, you know, their head was up high and they felt that. And some people didn’t quite get it in that [01:25:10] in that period of time. But then you can’t train that in a half a day.

Payman Langroudi: It is about you that makes [01:25:15] you like that, that turns you on so much.

Kaival Patel: I don’t know. [01:25:20] I don’t know. I enjoy that. You know, maybe it’s like a pleaser part of it, you know, like, [01:25:25] it could be that side of it.

Payman Langroudi: What about the being different piece? Why that? Have [01:25:30] you always been that?

Kaival Patel: Yeah. I don’t see it as being different. You know, you [01:25:35] like me.

Payman Langroudi: No. You do. You said. You said that. You know, we got the referral centre. We want to do something different, [01:25:40] you know, like.

Kaival Patel: For getting people out there.

Payman Langroudi: Yeah, yeah, yeah.

Kaival Patel: It’s fun to me. It’s fun to [01:25:45] me, you know, just something, something adventure. Something out there. That’s [01:25:50] the bit that does.

Payman Langroudi: Are you.

Kaival Patel: Easily.

Payman Langroudi: Bored?

Kaival Patel: Like like.

Payman Langroudi: I am. I’m easily bored. Not necessarily by [01:25:55] like actually I am by projects as well. But I just basically go everywhere, wherever I go. I feel like this [01:26:00] could have been so much better than, like a bad judge of places.

Kaival Patel: You’re [01:26:05] that guy, Payman. Yeah.

Payman Langroudi: Yeah. You know, and so if that’s the case, then [01:26:10] it’s exciting to make the thing better, right? Than.

Kaival Patel: Well, I’ll go to places and I’ll [01:26:15] see. Could that thing fit into what we do, you know, like. Yeah. Is that a bit, you [01:26:20] know, that’s that’s something cool or that’s a nice social media trend or whatever else. Can we do something similar [01:26:25] to it?

Payman Langroudi: We were talking about Ken, you know, uh, Ken Finlayson. Yeah.

Kaival Patel: Fmc yeah.

Payman Langroudi: Yeah, I [01:26:30] talked to him quite a lot. And you know, he’s much of what he did was bringing stuff from other industries [01:26:35] into dentistry, you know. Awards the top 50 that were directly out of the [01:26:40] The Times Top 50 list. Yeah. Yeah. Yeah.

Kaival Patel: It’s clever though, isn’t it?

Payman Langroudi: I mean, his [01:26:45] execution is amazing. Don’t get me wrong. Yeah. But but his his sort of genius [01:26:50] often was bringing stuff from other industries in. And you’re right, it’s one of the best [01:26:55] things you can do.

Kaival Patel: Yeah. But dentistry is so isolated. So actually, like I said, when we were [01:27:00] on that programme, there’s lots of different businesses. Actually businesses, all business is all very similar, [01:27:05] you know. So actually you can pull in different things.

Payman Langroudi: And what the bank said to [01:27:10] you, do you want to join the programme. Is that how did you get onto that programme?

Kaival Patel: It was on a whim and it changed [01:27:15] our life quite considerably. But Trina literally said, there’s this programme. It’s for, you know, entrepreneurs, [01:27:20] um, like.

Payman Langroudi: An accelerator thing.

Kaival Patel: Accelerator. Exactly, exactly. Yeah. And she goes, I’m going to apply. [01:27:25] I said, okay, fine, apply. And then she applied and we had an interview to, to sort of get into it. We [01:27:30] went into it and I loved it. You know, I absolutely loved it.

Payman Langroudi: You know, when people say to me, [01:27:35] hey, I want to do some toothpaste, or hey, I want to do that. I normally now just off outsource to [01:27:40] just go join an accelerator, okay. Yeah. Because, because because you know, it’s you’ll be you’ll [01:27:45] figure it out whether you want to do that or not once you’re in this accelerator. Yeah.

Kaival Patel: And it was different. We [01:27:50] were we were already a little bit established, whereas a lot of these guys were Start-Ups. But it was the energy. [01:27:55] It was the energy that I loved. I loved the Start-Up energy. Yeah, yeah, yeah. You know, whereas for us. And that [01:28:00] just just got us going, you know, a little bit more and and again, if when you’re just in Dental world, [01:28:05] you only think in Dental ways. So I actually want to go on something which [01:28:10] is completely external now and just again, just pick on really smart people in their minds [01:28:15] and different, different businesses to see what Drew’s.

Payman Langroudi: Going to a conference in September [01:28:20] in in Norway somewhere. Okay. It’s like a growth summit. [01:28:25] Business growth summit or something. Yeah. And it looked I figured, you know, he’s probably done his [01:28:30] research.

Kaival Patel: He’d know. He’d know. It’s good. Yeah.

Payman Langroudi: Yeah.

Kaival Patel: And in his he’s mine. He’s ours. And [01:28:35] he’s he’s like, you know, 20, 20 times more. Just going to he’ll message me sometimes [01:28:40] and he’s got so many different things going on. But yeah, I think I think those things are invaluable really. [01:28:45] And it’s worth a go. What are you going to lose? Yeah. Of course.

Payman Langroudi: No, it’ll be fun.

Kaival Patel: It’ll be fun. Yeah. [01:28:50]

Payman Langroudi: Final question. Yeah. It’s deathbed.

Kaival Patel: Deathbed.

Payman Langroudi: Surrounded [01:28:55] by your loved ones many years from now. What are three pieces of advice [01:29:00] you’d leave them in the world?

Kaival Patel: Advice [01:29:05] for my children. For [01:29:10] people. It’s [01:29:15] a hard one, really. Honestly, when I. When I think of my children and think of me on the deathbed, [01:29:20] I want them to be happy. Everybody does right? I want them to be financially secure [01:29:25] the way my parents used to for us. And, you know, maybe we [01:29:30] didn’t discuss it so much earlier, but when we first got the practice, we were living paycheque to paycheque, you know, and [01:29:35] that was really scary times. And sometimes you need to go through [01:29:40] it to appreciate other stuff. But I want them to value money, [01:29:45] value their life, you know, go and try things. Hopefully [01:29:50] the position that I’m really hoping that we put them in is a little bit of a platform where they [01:29:55] can try things and not be worried about failing.

Payman Langroudi: How old are.

Kaival Patel: They? Nine. Seven [01:30:00] and two. Nine, seven and two.

Payman Langroudi: Would you want them to be dentists?

Kaival Patel: Not [01:30:05] bothered. I’m not bothered. You know, the two boys, the nine year old and seven year [01:30:10] old. They want to open an ice cream shop together. That’s. That’s their.

Payman Langroudi: Thing.

Kaival Patel: So, um, there’s [01:30:15] a there’s a chap in Milton Keynes who owns a sort of ice cream making factory, [01:30:20] and I think Serena was talking to somebody about it, and it happened to be him, and [01:30:25] he invited them over. So they created their own ice cream and all. This is so nice. But They [01:30:30] want to work together at this point, so we’ll see whether that works out.

Payman Langroudi: But how cool is that?

Kaival Patel: But you know and [01:30:35] that’s of their own. They’ve probably seen us do whatever we do. And whereas in when [01:30:40] I was growing up it was doctor dentist, you know, do something like that. So I think [01:30:45] if you’re going to do whatever you’re going to do, love it. You know. So my sister, she did pharmacy [01:30:50] and she ended up turning to interior designing because she just didn’t like pharmacy. [01:30:55] And she’s an amazing interior designer. And that was her talent, you know. So I don’t want to force them to do anything, [01:31:00] but I also don’t want them to waste any opportunity that that they get. So just and [01:31:05] just work hard, you know, work hard. I think a lot of people see practice ownership and [01:31:10] suddenly, you know, it’s that old cliche. It took 20 years to be an overnight success, you know, but [01:31:15] they don’t realise the hours that you need to do to, to get maybe the lifestyle that you get or that flexibility. [01:31:20] You’ve got to work bloody hard, you know, and work every hour that God gives you in that time, you know. Yes. [01:31:25] It might not help with burnout and these sort of things, but you got to work hard. So I think [01:31:30] work hard. You know, take the opportunities that you’re given. And, [01:31:35] um. And I just want them to be, you know, secure, really, and happy. Just [01:31:40] be happy.

Payman Langroudi: Okay. But let’s introduce another one. Yeah. Go on. What’s one thing that you would tell them to do that you didn’t do? Like [01:31:45] something you regret you didn’t do in your life?

Kaival Patel: Something [01:31:50] I regret that I didn’t do.

Payman Langroudi: You know, that question can be really taken in two ways. Yeah, [01:31:55] it’s I did this. It worked for me. I was kind to be kind, you know.

Kaival Patel: Mhm. [01:32:00]

Payman Langroudi: Or it can go another way. You could say I didn’t enlightened for instance. [01:32:05] Yeah. I didn’t take on finance. Outside finance. Right. And if my [01:32:10] son did a business I’d say take outside finance. Yeah. Life wise what would you [01:32:15] say. What’s what’s the thing that you you wish you’d done or you wished you will do in the future? I think go to the gym. [01:32:20] Right?

Kaival Patel: Yeah. Yeah. So I think health is important, right? Health is important. I’ve hit 40. [01:32:25] And, you know, there’s a lot of things now which I wish I had done health wise, that that [01:32:30] would improve my life going forward. You know, we hopefully have a, you know, more comfortable life. And, [01:32:35] you know, the aim is whenever we retire and doing all those things. But actually, if I don’t have [01:32:40] my health, all the things that we’ve sort of gone into, I’m not going to enjoy that time with, with people. [01:32:45] So yeah, you’re absolutely right. Health. Health. And also again, it’s it’s make [01:32:50] mistakes quickly.

Payman Langroudi: And they’d be worried about.

Kaival Patel: Don’t be worried about it. You know make it quickly. You know [01:32:55] I think people are going to do it. You’re going to learn lots of things and don’t regret any [01:33:00] mistakes that you make. You know, people have this, especially if you’re a bit negative mindset. You [01:33:05] just dwell on the mistake that you made for ten years and you’ve suddenly stopped you going forward. So yeah, you’ve [01:33:10] made it. So what?

Payman Langroudi: You’re going forward but facing backwards, right? So you end up hitting your head on the lamppost. [01:33:15] Yeah. Yeah.

[TRANSITION]: I like that. I might have to steal that one though.

Kaival Patel: But [01:33:20] but it’s absolutely that. So yeah. Look forward be positive and [01:33:25] um, and make mistakes quickly if you’re going to make them.

Payman Langroudi: It’s been a massive pleasure. I’ve [01:33:30] always loved spending time with you. You can always, always learn with you, but particularly in [01:33:35] this context. So thanks. Thanks so much for coming on.

Kaival Patel: I really appreciate you having me on. Thanks, man. [01:33:40]

[VOICE]: This is Dental Leaders, the [01:33:45] podcast where you get to go one on one with emerging leaders in dentistry. [01:33:50] Your hosts Payman Langroudi [01:33:55] and Prav Solanki.

Prav Solanki: Thanks for listening, guys. If you got this [01:34:00] far, you must have listened to the whole thing. And just a huge thank you both from me and pay for [01:34:05] actually sticking through and listening to what we’ve had to say and what our guest has had to say, because I’m [01:34:10] assuming you got some value out of it.

Payman Langroudi: If you did get some value out of it, think about subscribing. [01:34:15] And if you would share this with a friend who you think might get some value out of it [01:34:20] too. Thank you so, so, so much for listening. Thanks.

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

[VOICE]: This [00:00:05] is mind movers [00:00:10] moving the conversation forward on mental health [00:00:15] and optimisation for dental professionals. Your hosts Rhona [00:00:20] Eskander and Payman Langroudi.

Rhona Eskander: Today [00:00:25] we have a guest whose story is the definition of transformation. Jacqueline Hurst is one of the UK’s [00:00:30] leading life coaches, a mindset expert and the author of the powerful [00:00:35] book How to Do You. But before she became the woman inspiring [00:00:40] thousands, she was fighting some of the darkest battles addiction, anorexia and self-destruction. [00:00:45] Her journey took her from rock bottom to becoming a force of change, helping people break [00:00:50] free from limiting beliefs and taking control of their minds. Jacqueline’s no [00:00:55] nonsense, straight talking approach to mindset works, cuts through the fluff and gets to [00:01:00] the real stuff the way that we think. The way that we feel and how we can shift both to live [00:01:05] the lives that we actually want. Today we are diving into it. All the struggles, [00:01:10] the turning points, and the tools that can help you take back control of your own mind. So, Jacqueline, welcome to [00:01:15] Mind Movies. As I was just describing, the reason why I came across this incredible guest is because [00:01:20] I was sent her book and I found it so empowering [00:01:25] and actually challenging at times as well, because it allowed me to challenge my own thought processes. [00:01:30] I’m a massive self-development junkie, so it was right up my alley. But [00:01:35] I’m so excited to have you. Thank you for being here.

Jaqueline Hurst: Thank you for having me.

Rhona Eskander: So I [00:01:40] always like to start from the beginning, and we know that your journey has been incredibly raw [00:01:45] and real. And before we get into the mindset work, can you take us back to the beginning? What was life [00:01:50] like before you changed everything?

Jaqueline Hurst: Gosh, it’s, um, it’s a it’s always [00:01:55] quite a tough question. That one it reminds me of when I wrote my book and, um, I’d written [00:02:00] everything together and my publisher said to me, right now we need a chapter on you. And I was like, don’t be silly. Nobody [00:02:05] needs that. And he’s like, no, no, we need that because we want to know that a, you know what you’re talking [00:02:10] about. And B, how you got where you got to to give us advice. Why would we, you know, why would we [00:02:15] care what you have to tell us your story. And I always find that part and I should probably [00:02:20] look into this myself of the why. But I always find that part really. Um, I still [00:02:25] feel quite touched by the the process of the journey for myself. And I also understand [00:02:30] that it was all working perfectly, which is a big you know, it’s a big thing I still [00:02:35] think about today how things are working perfectly, whether we think they are at the time or whether [00:02:40] we don’t. There’s always this bigger picture. So my journey started really when I was much, much [00:02:45] younger. Um, I looked like on the outside I had this beautiful, wonderful life. [00:02:50] Um, and actually behind closed doors, things were very difficult. Um, I had parents [00:02:55] that went off, um, to America, uh, from when I was ten [00:03:00] years old. They would go off for months at a time, and we were left pretty much on our own to [00:03:05] sort of learn how to, in their words, be independent. And, um, it was [00:03:10] a tough experience for me. Um, I had to learn very quickly to always sort [00:03:15] of portray I was okay.

Jaqueline Hurst: I never wanted to let anybody down. I was always fine when, [00:03:20] you know, they called and everything when actually behind the scenes, it wasn’t that at all. I was being bullied very badly [00:03:25] at school. I had no friends. Um, I got into the wrong crowds, and then [00:03:30] I got into drugs, alcohol, anorexia, all of those things from a very young age of around 15. [00:03:35] So from the age of 15 to 25, um, my life was a shambles, a [00:03:40] total mess, you know, Class A’s, um, whatever I could use [00:03:45] to take myself away from myself. I got into, you know, crazy situations. I’m [00:03:50] very lucky to still be alive. Um, that’s a snapshot of that at 25. [00:03:55] I had a moment of deciding that, you know, I tried suicide [00:04:00] 3 or 4 times. I’d got to a point where it was like, I can’t go any lower, right? [00:04:05] Like, there has to be something different. And, um, I was sort [00:04:10] of lucky I got given this sort of gift of desperation, we call it. And it was it was [00:04:15] a total and utter breakdown. And from that space, every, every day, from [00:04:20] that space, I’ve. I’ve changed and grown and, you know, changed, turned my, my life around, got clean, [00:04:25] got sober, got well with my food and my body image and my eating disorders. Got [00:04:30] through all of my addictions. And, um, I’m coming to my 22nd year clean, [00:04:35] actually. Now. Thank you. So, yeah, through that process, all of that, um, that was how it all [00:04:40] started, basically. But through that process, it’s literally person A and person B today. [00:04:45]

Rhona Eskander: Yeah. That’s amazing. Do you think. And I’m also like very mindful [00:04:50] not to blame parents because I think that our parents did [00:04:55] the best that they could with the knowledge that they had at the time. But with emerging [00:05:00] research and psychiatrists really studying attachment and attachment [00:05:05] styles, I think the presence of parents at pivotal [00:05:10] growth points is really important to our development. Do [00:05:15] you think in some way, without attaching blame to your parents, that that [00:05:20] sense of abandonment perhaps triggered you to make some of the decisions [00:05:25] that you did?

Jaqueline Hurst: I definitely think that’s a really great topic, and I’m really glad you brought that up. We [00:05:30] are starting off with we’re in a society at the moment where you know, your parents are toxic, [00:05:35] don’t speak to them, blah, blah. You know, we’re in a really interesting space with all of [00:05:40] that. For me personally, I come from a space of it’s all happening how it’s [00:05:45] meant to be happening. And that’s ultimately, if they knew better, they would [00:05:50] do better. And so they didn’t know better. So one can either stand around [00:05:55] and hold anger and frustration and hatred and, you know, pain towards them, or [00:06:00] you can do your work, go into coaching, understand it, unravel it, and [00:06:05] have complete peace around that space. So it’s a really important thing to say. So [00:06:10] for me, there is no blame at all around my parents. They absolutely did [00:06:15] the best they could with what they had, which isn’t what I’ve got and isn’t what many people have got. But that generation [00:06:20] also was very, very different. And look what they had learned from. Right? And it goes [00:06:25] backwards and backwards.

Jaqueline Hurst: So I would start off with that conversation. I think that [00:06:30] childhood development is a really important topic of conversation. And I also think that [00:06:35] parents, you know, can also over give to their children where they can suffocate their children and that [00:06:40] can cause problems. So there’s a million things that could cause somebody to go [00:06:45] the route I went through. And two, it could we could say yes, it was abandonment. [00:06:50] And it was, you know, a failure of this part and that part. But that was my journey, and that was how it was [00:06:55] meant to be. And I don’t think that parenting comes with a handbook, and I don’t [00:07:00] think I think parents tried the best they can with and do with what they’ve got, ideally. My personal opinion [00:07:05] is if you have kids, bring your kids up, be available, love them. They [00:07:10] don’t have to have things all the time. They just have to know that they’re loved and that there’s someone there that they can talk [00:07:15] to. That’s a really important thing to do if you’re going to have kids. But, you know.

Payman Langroudi: Have you [00:07:20] got kids?

Jaqueline Hurst: I haven’t got kids. I couldn’t have children. I got told that very young in my 20s. [00:07:25] I actually couldn’t have kids.

Rhona Eskander: And was that because of any medical implications of [00:07:30] what your body had been through, or was that just.

Jaqueline Hurst: I don’t know if the medical implications were part of me not [00:07:35] having kids. I just got told I couldn’t have them. It was going to be like basically impossible. And [00:07:40] again, it was another experience for me. And it’s not actually something that I talk about. So that’s, you know, not [00:07:45] that I’ve got anything to hide, but um, for me, that was sort of I was told, you need. This [00:07:50] is how it is now. I’m a I’m a super positive thinker. So I always believed if I really wanted to have [00:07:55] kids, there would be ways around that, right? You know, there’s adoption, um, etc. [00:08:00] etc. so my journey and my path didn’t take me down that route. But I do believe [00:08:05] that because I didn’t have children, I had this space to grow my business. And [00:08:10] I’ve worked with over 9000 clients now, and that has been so enlightening [00:08:15] for me. And I have really been able to give a lot, you know, through that process. So I feel very [00:08:20] grateful for that. And I’m never someone who lives in a, you know, if this is the fact and [00:08:25] this is what it is, I’ve got to find ways to think about that, to make myself feel all right about it. I’m never going to [00:08:30] be someone who sits in a victim mentality of like, this is terrible. My life’s over. You [00:08:35] know? You’ve got there’s a process to that, but you can’t stay in that forever.

Rhona Eskander: Yeah, I think I think a lot of people [00:08:40] do. But there’s a few things that I want to unpack. First of all, either one of you seen adolescence?

Jaqueline Hurst: Not yet. [00:08:45]

Rhona Eskander: No, it is a masterpiece I really recommend, especially because you’re [00:08:50] in the space of like coaching and so forth, and there’s so much psychology and psychotherapy around it, I [00:08:55] won’t spoil it for you, but essentially it’s about a young boy that gets accused of [00:09:00] stabbing a young girl to death. And when you hear the producers and the writers, they said that, you know, the reason they [00:09:05] were inspired to write this story is because of what is going on in London, which is [00:09:10] very prevalent now. You know, you’ve got these young boys attacking young girls, and it’s [00:09:15] a lower class family up north, you know. And, you know, a loving kind of family from [00:09:20] Liverpool. And they cannot work out how their son turned out like this. [00:09:25] And it’s so, so powerful in so many senses. But talking [00:09:30] about the parenthood side, you would say that looking at them fine. They’re not the most well-off [00:09:35] family, but they were very emotionally available, I think, to the child. And obviously, when the [00:09:40] child is going through the justice and legal side of things, you see an episode [00:09:45] where the parents are like, I could have done better. I’m sorry I wasn’t there. I’m sorry I didn’t intervene. [00:09:50] And you know, one of the rises of violence and misogyny and young [00:09:55] boys is because of this manosphere and this toxic masculinity narrative and how young [00:10:00] boys are being let down. It’s absolutely fascinating. It’s really, really well done. But my [00:10:05] point is, it was interesting to see because as you said, you know, people [00:10:10] find it really easy to blame parents. And even in the show, you could see that the parents [00:10:15] were being tormented by the public because they were like, your son did this, it’s your fault. [00:10:20] It’s the parenting and so forth. But it’s really I think people really just do [00:10:25] the best that they can with the knowledge they have 100%. And I think it’s actually extremely toxic [00:10:30] that we blame parents for children.

Payman Langroudi: Leave blame out of it. I mean, the reason why I asked whether you’ve got kids [00:10:35] or not is that you must. Some of your clients, let’s say, who have got kids, do [00:10:40] they do people sometimes overcompensate for what the deficit that they think their parents [00:10:45] gave 100%.

Jaqueline Hurst: In fact, I was having a conversation like this with my sister recently. She has two children and you [00:10:50] know, she is the opposite of what we got brought up with. She is fully 180% [00:10:55] available for her children. And, you know, and that’s lovely in one way.

Payman Langroudi: Sometimes [00:11:00] too much.

Jaqueline Hurst: And it could possibly be too much in another way. So she’s having to learn how to balance [00:11:05] that. But again, you could be the most loving, wonderful, amazing parent doing everything you [00:11:10] possibly could. And your kids still might blame you for things, but you never this and but this [00:11:15] was too much. And so you know, this is why one has to learn how to step into, [00:11:20] which is what I teach clients your own emotional adulthood. You’ve got to unpack. Can I swear [00:11:25] because I yeah, of course, holding it back. But you got to unpack your shit, right? Because if you spend [00:11:30] your life blaming. My mom did this and my dad did that, and my ex husband did this, and my friend did that. [00:11:35] Like, you’re never going to grow and you’re never going to take responsibility for yourself. And ultimately you’re never going to be happy or [00:11:40] at peace.

Rhona Eskander: Yeah, I really agree with that because on the outside, like, my parents are amazing. Payman [00:11:45] had the pleasure of meeting them. They’re extremely emotionally available and kind, and we’re [00:11:50] there. They couldn’t be totally present with the schooling and stuff, because they were immigrants that were [00:11:55] working like three jobs at once to keep us in a private school, quite frankly. Yeah. And some people might be [00:12:00] like, you had a nanny because we had the nanny from the Middle East. I’m like, a nanny really didn’t affect me. Like, there [00:12:05] was so much judgement that I had a nanny, but that was the only way they could do it to make it work for [00:12:10] my system. However, what I would say is, is that I suffer with crippling [00:12:15] rejection, sensitivity, dysphoria. I cannot.

Jaqueline Hurst: Sorry. Wait, what? What [00:12:20] is.

Rhona Eskander: Rejection sensitivity? Dysphoria? So I was a late diagnosed ADHD person [00:12:25] by my therapist. And so like I take rejection so badly. [00:12:30] You know, this like, beyond, like someone could make a passing comment and I will internalise [00:12:35] it and hate myself and go into this like.

Jaqueline Hurst: Deep really controversial with you.

Rhona Eskander: Here. [00:12:40] Yeah.

Jaqueline Hurst: So one has to be really careful with labels. Okay. Just [00:12:45] putting it on the table here. When I was going through getting clean and getting sober and even [00:12:50] the hormonal issues, all of these things that I’ve had, people have always wanted to slap labels [00:12:55] on me. I mean, I could give you a list of 17 labels. People in white coats told me, you know, [00:13:00] I don’t mean literally white coats, but I mean doctors here and specialists there, right?

Payman Langroudi: They become self-fulfilling, [00:13:05] don’t they? In a way. Once you give yourself a label, you kind of live out that to it. Right.

Jaqueline Hurst: So I [00:13:10] this rejection thing, I would I would at some point love to clearly [00:13:15] not a podcast, but I would love to unpack that with you because I’m already I’m [00:13:20] going to say to you, I’m not sure I agree with that. And I think that many people suffer [00:13:25] with rejection, and rejection is a mind made thing.

Rhona Eskander: I [00:13:30] think the thing is, is like, look, I mean, Payman know me for a number of years now.

Payman Langroudi: She certainly is very, very sensitive to.

Rhona Eskander: Like. [00:13:35]

Payman Langroudi: Unexpectedly sensitive.

Rhona Eskander: Like, I can I can go someone will say something. Someone [00:13:40] said something to me on Sunday. A friend and she didn’t know what she [00:13:45] said had incredibly hurt me, and I just went into the shower afterwards and I was like, sobbing [00:13:50] for like an hour and a half.

Jaqueline Hurst: So, so mindset management. And again, this is really hard just to like unpack [00:13:55] this in one podcast because this is work that I do with my clients and it’s taken over like a series of sessions. But [00:14:00] I’m just going to drop this down here and you can disagree. And it’s cool. I will teach my clients [00:14:05] that when people say things or do things or act in certain ways or whatever, [00:14:10] whatever, actually how you think about that is what matters, [00:14:15] because we can’t control what that person said. How you’re interpreting that in your brain is what hurt [00:14:20] you. Totally not what she said.

Rhona Eskander: Totally. But that that gets me onto the point that I was saying about my [00:14:25] parents is that because of the certain things that my parents have brought [00:14:30] me up thinking, and on the outset, it’s like extremely loving. There is this kind [00:14:35] of confirmation bias that I’ve created in my head that’s like [00:14:40] this person has said that. And the way that I’m receiving the information internalising it is because of my kind [00:14:45] of core belief of what I’ve been brought up with. Right? So, for example, there [00:14:50] has been this aspect of I don’t want to say conditional love, but kind [00:14:55] of it’s like, again, like immigrant mentality. Like the more you achieve, the better that you are, the more [00:15:00] you’re loved. Okay. So that always has been like projected into every aspect of my life. [00:15:05] So when I hear someone say something negative, I’m like, they essentially [00:15:10] are saying I am not good enough because that is the way, right? That’s always like, that is everything. And I [00:15:15] understand that I have total awareness around that. And obviously it’s easier said than done whilst [00:15:20] I have done all the work and I can be like, this is not this is the way like and that’s why I’ve stopped, like [00:15:25] reacting when they say something, but sometimes it internally hurts. You know, I’m human. [00:15:30]

Payman Langroudi: It’s like sometimes you’re thinking about it is one thing, but feeling it is a whole other thing.

Rhona Eskander: Correct. And I think [00:15:35] that I can be like the way that I’m processing this information may not be the way Jacqueline [00:15:40] or Payman is processing the information.

Payman Langroudi: Because you’re planning kids soon, right? So do you reckon [00:15:45] you’re going to overcompensate for that?

Jaqueline Hurst: You can process that differently.

Payman Langroudi: Yeah. Yeah, yeah.

Jaqueline Hurst: I know you’re like, I’ve done [00:15:50] all the work on it. But the thing is, is to a point, because if you had done [00:15:55] some other work on it, right, you will hear [00:16:00] what this person says.

Rhona Eskander: And be okay with it.

Jaqueline Hurst: And be totally okay. [00:16:05]

Rhona Eskander: I’d love to get that, but we’ll book a session after. Can I.

Jaqueline Hurst: Just. The whole reason I want to say [00:16:10] that is not to be contentious, but to say one doesn’t have to live like that just because we have been programmed [00:16:15] that way. Right. I got brought up believing I had zero worth. [00:16:20] Right? If I was valuable, why have you left? Okay. That was my internal [00:16:25] thing, right? Total. I must not be worth shit. Yeah, right. [00:16:30] I don’t believe that at all. So if someone says something to me or does something or whatever, [00:16:35] whatever, I don’t internalise that the way I would have done as a kid. And that work [00:16:40] takes work, right? But it’s 100% possible to change. So I, as you can tell, [00:16:45] as straight talking as you said, no nonsense. I wouldn’t want if you were my client. I wouldn’t want you holding on to [00:16:50] that stuff and telling yourself like, oh, I’m not saying that you are, but like, oh, but this is what happened [00:16:55] to me and this is how I process it. And that’s it. Because it isn’t it. You can change that. And that [00:17:00] is how you make your life fucking amazing.

Rhona Eskander: Okay, okay, I got it, I got [00:17:05] it.

Payman Langroudi: Do you think you need to have gone through suffering and pain [00:17:10] in order to be a really, like, successful coach?

Jaqueline Hurst: I think my authenticity [00:17:15] people know when I work with them that I’m not talking from a I’ve read a book and I’m a [00:17:20] life coach space like been there, seen it, done it, got the t shirt. So I would believe that that’s a [00:17:25] huge part of my success. It’s really, really authentic.

Rhona Eskander: Hey, we had this chat because I had my life coach [00:17:30] come on, and I said, I worked with a life coach for a year and someone that I went to university [00:17:35] is. And one of the big reasons that I chose him is because.

Payman Langroudi: He’s been through.

Rhona Eskander: It. Because [00:17:40] he’d been through the depths of hell. Sorry. I’m going to be blunt. Why am I going to choose someone that [00:17:45] has not been? The whole point is, I’m like, you went through that, you came out of it. I’m going to learn [00:17:50] from you and that’s it.

Payman Langroudi: Like, if I want to.

Rhona Eskander: If this is where we disagree.

Payman Langroudi: I want a full mouth reconstruction. [00:17:55] I don’t have to come to the dentist who’s had a full mouth reconstruction themselves. Listen, I understand [00:18:00] how it’s how it’s helped your story and sort of the centre of your authenticity and maybe, [00:18:05] you know, call it marketing, whatever you want. But my question is, do you believe that someone who hasn’t [00:18:10] been through it can’t be as effective?

Jaqueline Hurst: I can only talk from my personal experience.

Payman Langroudi: In the industry. [00:18:15]

Jaqueline Hurst: And I know that when I was looking for help back in the day, I. I [00:18:20] was an addict. I had a really clever fucking brain. Right? I could [00:18:25] run rings around people that had not experienced or done anything I’d done, [00:18:30] and that wasn’t. I’m not saying that’s a good thing. It was not a good thing. But I had to go and learn [00:18:35] it myself to get better. So do I believe that? Yes. Is my industry unregulated? [00:18:40] Yes. Can anybody read a book and go? I I’ve left my job [00:18:45] in finance and I’m going to be a life coach. Great. And they might be amazing at marketing and they might [00:18:50] have 80 billion followers on Instagram. And people go, oh, that person must be an amazing [00:18:55] life coach. I should go and buy their stuff. And what is their life experience? [00:19:00] And so yes, the answer to your question is yes. I do believe [00:19:05] people in my industry have to have lived a life to know how to [00:19:10] help people. As a coach, I’m not giving people necessarily advice on what they [00:19:15] should do. I don’t know what they should do. What I do is I teach people how to think [00:19:20] and then they work out for themselves what they should do.

Payman Langroudi: For instance, if someone had the opposite problem that you had, [00:19:25] so you’re saying you had low self-esteem. Let’s say someone’s the opposite. Like like [00:19:30] too confident, overconfident, not self-aware. Yeah. Can you help that person since you [00:19:35] haven’t been in that position?

Jaqueline Hurst: 100%. If they want help.

Rhona Eskander: That’s the. That’s the [00:19:40] most important thing. Also, the key thing that she said here was experience. You just complain. You just said, if [00:19:45] I want a full mouth rehabilitation and you’ve not had one. Well, I’m sorry if someone had just come out of dental [00:19:50] school and treated one patient, I’m not going to go to them for a full mouth rehab. I’d rather go to someone with ten [00:19:55] years experience. Experience is the key thing.

Payman Langroudi: Having been through it yourself question.

Jaqueline Hurst: Having been through it [00:20:00] yourself. Yes, I think especially in my industry, I am a believer of yes, someone has to.

Rhona Eskander: My ex boyfriend [00:20:05] was a charlatan and quit his job to become a life coach and was a narcissist and the most awful [00:20:10] human being. It was a joke and he became a life coach. So yes, I do think it [00:20:15] is unregulated and can be dangerous, but I do also think there’s a place for it. And I [00:20:20] do think some of the coaches that I’ve worked with over the years have been better than therapists, dare I say. [00:20:25] And also, but you’ve really got to do your due diligence. And the danger is, is when you’re [00:20:30] vulnerable, you want help, so you don’t necessarily do your due diligence. And that’s that’s the because [00:20:35] I got myself.

Payman Langroudi: No, look, it’s super unfair to ask this. Yeah, but.

Jaqueline Hurst: No, no, please go ahead.

Payman Langroudi: I’m ready for it [00:20:40] because, you know, it takes hours and hours of talking to people. But in that situation where you’ve got Aruna [00:20:45] saying I’m never good enough. Yeah. And you want to switch that.

Jaqueline Hurst: Yeah. [00:20:50]

Payman Langroudi: What are like, what are three top tips that people who feel like that should, should bear in mind?

Jaqueline Hurst: So [00:20:55] first of all, it’s not a feeling. It’s a thought. Right. We don’t feel it. We think it. And [00:21:00] you are in control of your head and your thinking. Right. So you have you have got choices [00:21:05] as to how you think. That’s really important to understand. So the first thing is consciousness, right? Become [00:21:10] conscious of what you’re thinking and and do that, you know, like really become [00:21:15] aware what is going on in my head because most of the time we walk around totally unconscious and [00:21:20] unaware, and you’ve just got this cycle of thoughts going through your brain, like all the time. So [00:21:25] my first tip is get conscious and become aware of what you’re actually thinking. And you, it’s [00:21:30] likely you’re going to find that you are really unkind to yourself. You’re really negative to yourself. [00:21:35] It’s something you’re never, ever, ever going to say to your friend. Ever. Why? [00:21:40] Because fucking mean and rude. So that’s important to think about if I’m not going to say it to them, [00:21:45] why is it all right that I say it to me? Right. So that’s also important to do. And then I would [00:21:50] ask you to look at where the thought comes from and what your life might look like if [00:21:55] you changed it. That’s really powerful. Like, what happens if I look at that [00:22:00] and think I can switch it around and think, actually, I am of value, even [00:22:05] if it’s just to, you know, my kids or my husband. I’m of value, [00:22:10] right? That’s already going to start to change things.

Payman Langroudi: So now you have that insight. Are there tactics [00:22:15] as well?

Jaqueline Hurst: What do you mean tactics?

Payman Langroudi: I don’t know.

Rhona Eskander: Tools. He’s saying like tools. Like in that moment.

Payman Langroudi: Like maybe you [00:22:20] teach her, you know, in that moment, whatever it is, I’m.

Jaqueline Hurst: A big believer of writing [00:22:25] things down. I love, love, love every day. Yeah. And I.

Rhona Eskander: Love it. I love [00:22:30] journaling, it’s the most powerful thing for me.

Payman Langroudi: Do you go back? Do you go back in your journal and look what you wrote six months [00:22:35] ago?

Rhona Eskander: Since I was 11 years old. And I have all.

Payman Langroudi: Of them in a cupboard. Look, when you look at what you were writing six months ago, do [00:22:40] you sometimes laugh at how silly you were being or something?

Rhona Eskander: Because for me, it was never silly.

Payman Langroudi: And sometimes they’re not [00:22:45] journaling like what you were thinking. What you were thinking was incorrect.

Rhona Eskander: Six months. I understand that that [00:22:50] was what was important to me at that time. And the whole point, I mean, some people have the train of thought [00:22:55] that like, you should write things down and then not look at it or burn it or whatever. I actually don’t mind [00:23:00] looking back at stuff. And I’m like, oh, that was interesting because I’d forgotten.

Payman Langroudi: What patterns do you see when you see when you look back [00:23:05] at it?

Rhona Eskander: Um, there is this like pattern of desperation and wanting [00:23:10] to kind of, I mean, I don’t know, like there’s lots of different things. Like, sometimes it’s, [00:23:15] you know, I love to write when I travel. So it might also be about what I’ve done or, um, [00:23:20] the things that, you know, we’ve experienced. There’s sometimes gratitude in there. And I find that that’s [00:23:25] really powerful in the day. And the gratitude would be like just had the most amazing oat milk flat white. And it tasted [00:23:30] amazing, you know? And I’m really grateful I’m writing here amongst the pyramids. Do you know what I mean? So [00:23:35] there’s things like that which I find is really great. And I do think there is power and gratitude and gratitude isn’t this constant [00:23:40] thing of like, my life is amazing. Be grateful there are people less privileged. Like, I really do think it’s being like [00:23:45] like looking around and being like, what am I appreciating? It could be even like being in a clean and quiet house this morning. Do you [00:23:50] see what I mean? It’s just so yeah, for me, that’s it. And sometimes it is just a stream of consciousness being like, I’m waking [00:23:55] up feeling anxious. I don’t know what’s going on. It might not even make sense. Just like stream of consciousness. It’s fine, but [00:24:00] it’s all out in the morning. And then I’m like, okay, great. So I do agree that writing really.

Payman Langroudi: Helps you say write is [00:24:05] the benefit. Both that getting it out of your head and the review.

Jaqueline Hurst: With the people. [00:24:10]

Payman Langroudi: That you.

Jaqueline Hurst: Work with. It’s not just a journaling is really important. It’s not just journaling. It’s about understanding tools and techniques [00:24:15] to actually learn how to change your brain. How does it work, right? Like how do you change your minds [00:24:20] and get into a space of it’s not positive thinking, right? Because that to me is I [00:24:25] love the idea of it. Just that never worked for me. Like, I could never stand in front of a mirror and go, I [00:24:30] feel really confident today. Like, no, it just wasn’t going to work. So there’s tools and techniques to [00:24:35] teach you how to get there, to be able to have an end result of being in a looking in a mirror and going, [00:24:40] yeah, I’ve fucking got this. Bring it on. Right. That’s great. And so there are ways to do that. And that [00:24:45] requires a pen and a paper, you know, and I think there’s something special about getting it from your [00:24:50] head, you know, clearly on paper and working it through. It’s [00:24:55] annoying for people because we’re in the day and age of everything’s fast, but actually when you slow it down, it’s really helpful. [00:25:00] Yeah.

Payman Langroudi: Have you noticed that how many years have you been doing this?

Jaqueline Hurst: Since? [00:25:05] Pretty much since I got clean. I got clean at 20. I got clean in 2003. [00:25:10]

Payman Langroudi: So have you noticed that the problems have changed a lot since mobile phones? [00:25:15]

Jaqueline Hurst: Um, yeah, drastically.

Payman Langroudi: It’s definitely the cause of a bunch of pain.

Jaqueline Hurst: It’s it’s [00:25:20] we are totally disconnected from each other, you know? It’s it’s really [00:25:25] the thing I hate the most is when I walk past, like a family at a restaurant of, like, two kids, you know what I’m going [00:25:30] to say? And parents, and they’re all on the phone. And it’s to me that’s really upsetting. And I’m a real believer of, you [00:25:35] know, being very careful with your tech and having, having, controlling your tech [00:25:40] rather than letting it control you.

Rhona Eskander: Yeah, I love that. And I saw a huge difference. And my friend that I was just telling [00:25:45] you about in Dubai, I mean, she sounds a little bit like your sister. I think she came from a difficult, [00:25:50] broken home and as a result, gives like 300% to her kids. And she definitely made [00:25:55] the choice. I think at one point she wanted to be a career woman, and then she made the choice of being like, no, I’m going to [00:26:00] really dedicate, you know, my life to basically my kids upbringing. And now she’s [00:26:05] thinking about transitioning back into work. But anyway, when I went to go see her, her kids, they [00:26:10] were so amazing. And I rarely say that because I’m not someone that’s super maternal or broody [00:26:15] or anything like that, but I was like, they were such a pleasure to be around. And my husband and I were like, [00:26:20] oh my God, they are so intelligent, so inquisitive, so present. And I was [00:26:25] like, Anna, what have you done? And, you know, she said to me, she was like, and I and I noticed it, no iPads [00:26:30] or no mobile phones. And it was.

Payman Langroudi: Well, at.

Rhona Eskander: Last it was at all. They had to use the, [00:26:35] uh, ten. No, sorry. Eight and six.

Payman Langroudi: All right.

Rhona Eskander: That’s eight and six. Right.

Payman Langroudi: But [00:26:40] you’re right. There’s plenty of two year olds with iPads.

Rhona Eskander: Eight and six. And she said to me something [00:26:45] similar. She goes, you know, I realised if you give a child something that’s less intelligent [00:26:50] than them, like a piece of paper or a ball, they’ll be creative and they’ll use their brains on how to make [00:26:55] it interesting. If you give them something like technology, which is smarter than them, their [00:27:00] brains will start to slow down. And I really saw that because they were constantly being creative around the [00:27:05] house, and you could see that there was like this little distraction. They wanted to be present, they wanted [00:27:10] to be outside. There is no judgement because I do believe, like, again, some parents, that’s what they [00:27:15] use as a coping tool. But I really felt the difference when I saw the way her kids were interacting. [00:27:20]

Jaqueline Hurst: Didn’t Steve? Was it Steve Jobs that said I would never give my kids an iPhone? Okay, so like, [00:27:25] why have why have we not listened to that? Like, this is seriously, like I always say, [00:27:30] people tell you what you want to know. Yeah, you just got to listen, right? So if he’s [00:27:35] saying that.

Rhona Eskander: Yeah. Yeah. It’s so true. It’s so true. I want to I know [00:27:40] that we digressed a lot into the mindset stuff already, but for [00:27:45] you, kind of like late 20s or sort of, um, early 20s. Like what would [00:27:50] your typical day have looked like back then?

Jaqueline Hurst: We’re talking about when I’m in my when I was in my addiction. [00:27:55] Addiction, you know, it was a very dark time and it [00:28:00] still makes me feel quite emotional when I think about it. For the girl that I was then and [00:28:05] I was living, um, literally, I was in some ways I was functioning in other [00:28:10] ways, I really wasn’t. But I would tell you that most of my time was spent behind closed doors, closed [00:28:15] curtains, and on my own, using drugs. Um, I did have a job, and [00:28:20] I could function on that, but a lot of the time it was literally I [00:28:25] was completely isolated.

Rhona Eskander: What was your.

Jaqueline Hurst: Job? I was working as a PA, and, um, [00:28:30] you know, I was, you know, doing cocaine in the toilets at most of most of the time. And, [00:28:35] um, you know, it was it was crazy. And then in the evenings, I would go home [00:28:40] and smoke a load of dope and, you know, shut myself off from the world and, you know, or or it [00:28:45] was, you know, if I was in the mood to actually go out and do something, it would be crazy shit [00:28:50] that, you know, I would go out and come back three days later. Um, and [00:28:55] it was a wild, wild time. And, you know, as I keep saying, [00:29:00] I’m really lucky to say, you know, I’d wake up in different countries sometimes and think, how the fuck did I get here?

Rhona Eskander: Did [00:29:05] you have any real friends at the time? No, none. Yeah.

Jaqueline Hurst: No I didn’t. [00:29:10]

Rhona Eskander: I think that’s really.

Jaqueline Hurst: It’s probably very hard to be friendly with someone like me. Back then, it was [00:29:15] probably impossible actually to do that.

Rhona Eskander: So what was the day? That was the turning point.

Jaqueline Hurst: So the day that [00:29:20] was the turning point was I was living in a squat. I had nothing, no money to my name.

Rhona Eskander: And not in touch with your [00:29:25] family at this point.

Jaqueline Hurst: Wasn’t in touch with my family. And, um, my mum had found out [00:29:30] like that. I was down the road and knocked on the door and [00:29:35] came in and said, you know, you’re my daughter and I love you. And are [00:29:40] you depressed? Like what’s going on? And I don’t know why at that moment, [00:29:45] in that moment, you know, I think I had I think I’d really hit the floor [00:29:50] at this point. And I just thought, I need to say to someone the truth. And I just looked at her [00:29:55] and said, I’m a drug addict and I need help. And she took me to my first meeting. She said, what do I do? I [00:30:00] said, I think you go to a meeting. I’ve heard of meetings. And that was the day I got clean. 27th of [00:30:05] August 2003.

Rhona Eskander: Do you still go to the meetings?

Jaqueline Hurst: No, I went for about six years. It [00:30:10] was the it saved my life wholeheartedly. Saved my life.

Rhona Eskander: So you believe in the program? [00:30:15]

Jaqueline Hurst: I do 100% believe in the A program, the Narcotics Anonymous program. It was [00:30:20] different back then. Um, I wholeheartedly believe in it. I 100% [00:30:25] became who I am from that space. Without that wouldn’t be here. Like, [00:30:30] I owe it my life, I really do. And it is a bridge to normal living. [00:30:35] And like I was saying earlier about labels, I don’t want to be labelled [00:30:40] anything. I want to cross the bridge to normal living. I don’t want to sit in that space. And I [00:30:45] have a very controversial view of addiction, which is different from those in the rooms now. [00:30:50] Um, I do, I do sometimes pop into meetings. I did go back last year because my [00:30:55] father passed away, and that was an incredibly difficult time, and it was the only time in, as [00:31:00] I say, I’m coming up 22 years in August. It was the only time in 22 years I had actually contemplated [00:31:05] it again, which was a very frightening space to be in, and I was grateful to go to a meeting, [00:31:10] you know, or to, um, but I think it’s a really powerful, powerful program.

Payman Langroudi: Isn’t [00:31:15] it rare that people, the first time they go to a meeting, stop [00:31:20] using drugs? Are you the kind of person who’s like, all in on it? I’m in the 4%, all in on the [00:31:25] drugs in the first place.

Jaqueline Hurst: Percent of people that get clean and stay clean. 4%?

Rhona Eskander: Yeah. [00:31:30]

Payman Langroudi: Is that in your character that you go all into stuff like I do?

Jaqueline Hurst: Very much go all in. [00:31:35] But I also believe that it was it was, you know, I was broken. It was a gift of desperation. [00:31:40] I was if you’d have said to me at that point, run down Oxford Street stark naked, and this will [00:31:45] get you clean, I would have done it.

Rhona Eskander: But you know, but I do think it is a type of person, because I [00:31:50] had a friend that was an addict and, um, is an addict [00:31:55] was open about it, very open about it. Um, but would think that he [00:32:00] could control his ability to get clean because he go through lapses. [00:32:05] So he’d be clean for two months, three months, then relapse. And the behaviour [00:32:10] that I observed became too much. And the thing is, it wasn’t because I didn’t want to support [00:32:15] him through the process, it’s just that he didn’t really show signs of ever wanting [00:32:20] to get clean. And, you know, like. And this is the thing. Yeah. And it’s like, he then [00:32:25] had a friend that tried to be, like, gave him an ultimatum because all his relationships broke [00:32:30] down in his life and have continued to break down still to this day. And I had reached a point, you know, where I was, [00:32:35] like money had been taken away. Um, there was too much at this point. I’ve had [00:32:40] enough, you know, like three years of this friendship. I just like I can’t do anymore. Because if you don’t want to help yourself, like no one else can help [00:32:45] you. So someone else came into his life and said, listen, like, because he’d found out [00:32:50] he’d been taking drugs and he said, you have to go. He went to one meeting, half arsed online, and then that was [00:32:55] it, you know, and then just keeps relapsing. So I do think it’s about that commitment. We had an amazing [00:33:00] inspirational ex addict on the podcast as well, Hunter Michael Shepherd, who also [00:33:05] runs a huge program in the US. And he was addicted I think since the age of 12, you [00:33:10] know, and really, really hardcore Core reached rock bottom like you has been clean ever since. [00:33:15] Helps a lot of young people.

Payman Langroudi: Your friend hasn’t reached rock bottom yet, but.

Rhona Eskander: He has reached rock bottom. He has. That’s [00:33:20] the crazy thing.

Jaqueline Hurst: He wouldn’t have done. And I think that we don’t know when it’s our time to reach rock bottom. [00:33:25] And I think addiction is a terribly sad thing to do. And, you know, addicts get a really bad rap. They [00:33:30] get a really bad rap because they do things that aren’t really who they are because they’re ill. And, you [00:33:35] know, until you hit a space where you are willing to rip yourself [00:33:40] apart, really willing to rip yourself apart, stare at all of your defects, [00:33:45] all of your shortcomings. Look at your part in things, all these things that you really have to do. Rip [00:33:50] apart your ego. Get really humble. Learn to say sorry right until you [00:33:55] are in a space in your life which they call it the gift of desperation for a [00:34:00] reason, then there isn’t going to be any change. And so it’s. And the problem is, if [00:34:05] only we could magic something that could make people at that point we’d [00:34:10] be multi gazillionaires. But people either get that or they don’t. And [00:34:15] it’s also not their fault.

Rhona Eskander: Totally. Well, that brings me on to my next point, because obviously I’ve been obsessed with the work [00:34:20] of Doctor Gabor Matte for years. And I read In the Realm of Hungry Ghosts, which talks [00:34:25] about a lot of the patients that he was seeing, and that was the first time that I viewed addiction in a completely [00:34:30] different way, because the way that he I mean, I don’t know if you agree or [00:34:35] disagree with it, but at the end of the day, he totally creates a [00:34:40] sense of understanding and empathy for addicts because he’s like, we are treating this [00:34:45] completely in the wrong way. We’re punishing them, we’re blaming them, we’re stigmatising them. And I was [00:34:50] like, ah, okay. Like this is starting to make sense to me.

Jaqueline Hurst: It’s really important. It’s really belittling. [00:34:55] I remember when I was married and I was engaged to my ex-husband and, um, someone [00:35:00] at a drinks party said to him in front of me, um, why would [00:35:05] you want to marry a guy like that? That was an addict. And this guy was supposedly, you know, had [00:35:10] gone to public school and was supposedly intelligent. And I remember looking at a guy like that thinking, [00:35:15] I feel sad for him, that he still sits in the space of stigmatising people [00:35:20] that have got addiction.

Rhona Eskander: Agreed.

Jaqueline Hurst: You know, agreed. It was, you know, [00:35:25] people just need education on that.

Rhona Eskander: And actually, I think more and more the society that [00:35:30] we’re living in, regardless of the fact that, you know, we’re able to function because we have food and all [00:35:35] the things that, you know, our great grandparents and everything didn’t have. We’re living in a really difficult [00:35:40] time. And it’s become it’s you want to escape the reality. I empathise with so [00:35:45] many people. I mean, I struggle. I’m actually teetotal, been teetotal my whole life [00:35:50] because I knew I had an addictive personality. Really weirdly from a young age. [00:35:55] And I was like, I’m not going to drink. It was like this weird thing, like. And everyone’s like, oh, did you used to drink? I’m like, never [00:36:00] drank, never touched a cigarette, never would touch a vape. Do you know what I mean? Anything like that. Because I [00:36:05] know the way that my brain works. And I’m really glad because also I self-soothe [00:36:10] in other ways, like I self-soothe with like validation, for example, posting social media, all that kind [00:36:15] of thing.

Jaqueline Hurst: And I love that you can say that and be so clear about what you know that [00:36:20] you’re doing. Yeah, a lot of people do these things and they have zero awareness [00:36:25] of why. Yeah. So it’s really powerful that you know that. Thank you.

Payman Langroudi: You know, if she goes to a retreat [00:36:30] and they give her mushroom tea, she’ll have that.

Rhona Eskander: Listen no no no.

Jaqueline Hurst: He’s like not getting involved [00:36:35] in this. No no no no no no.

Rhona Eskander: That that number one. That’s not [00:36:40] true. Again the plant medicine space is something that it is. It’s [00:36:45] true. Like the plant medicine space is something again through Doctor Gabor Matte that I’m interested in. It’s not [00:36:50] to say I haven’t. I wanted to explore ayahuasca once, for example, in South America with [00:36:55] the I didn’t do it in the end for whatever reason, but that is a space that I’m interested in. [00:37:00] It’s no, it’s not. I don’t have any interest in like going and getting high. And when you actually understand how these medicines [00:37:05] work, it’s not about going getting high, you know. It is, it is, it is. I’m very precious about [00:37:10] this thing, you know, because I do think that when done with the right intention, with the right people and the right space, it can. And [00:37:15] I’ve seen some people change their lives through that, not me.

Payman Langroudi: I’m all for it, man.

Rhona Eskander: I know, but you want to [00:37:20] get it high. But I don’t think ayahuasca will. After after a huge vomiting session. You might [00:37:25] be saying otherwise.

Payman Langroudi: What’s your typical client like? Are they like.

Jaqueline Hurst: I wish I could say I have a typical one. [00:37:30] I spend a lot of time signing NDAs, which is interesting. So that’s pretty much my typical [00:37:35] client. Um.

Rhona Eskander: And it’s mostly Americans or UK based or both. [00:37:40]

Jaqueline Hurst: Everywhere.

Rhona Eskander: Okay, fine.

Jaqueline Hurst: Like everywhere. And, um. Yeah. And you know, but it [00:37:45] doesn’t have to be that level. You know, there can also be people that come in and say, you know, I work [00:37:50] on reception and I really need to get some help. And that’s amazing too. Like, my door’s open [00:37:55] to everybody as long as you want to.

Payman Langroudi: Do the work of mentoring.

Jaqueline Hurst: One on one. I work with couples [00:38:00] as well. Um, but mainly one on one. And it’s all done on zoom because I’m all over the. I’m all [00:38:05] over. You know. Some days I’m here and some days I’m there and blah, blah, blah.

Payman Langroudi: But typically, what, once a week [00:38:10] or once a month?

Jaqueline Hurst: Yeah, usually. Usually I like to do a set of, um, sessions [00:38:15] with people. So it can be four sessions or eight sessions. But I’m not in the business of taking [00:38:20] your money. I’m in the business of you coming in, dealing with your shit, learning [00:38:25] how to do it, and then off you go.

Rhona Eskander: So do you make it accessible? I know that’s a strange question because [00:38:30] obviously, look, you know, as people that are interested in health and mental [00:38:35] care, you know, everyone suffers from it, right? And you know, I love dentistry. I love my job. I [00:38:40] can really change the lives of people. But I also know that I’m actually not accessible to a lot of people because [00:38:45] of my fees, because of the kind of work that I provide, um, which, [00:38:50] you know, sometimes can be a little bit of a kind of mental challenge for me. And I get that, and sometimes I’m confronted with that by other people. [00:38:55] Would you say that you are accessible to the layperson?

Jaqueline Hurst: Yeah. I mean, there’s definitely, [00:39:00] um, even if somebody just wants a one off session, there’s like a 45 minute session you can take with [00:39:05] me if that’s what you want to do.

Rhona Eskander: So you’ve also said, um, that [00:39:10] you our thoughts create our feelings. Right. That’s thing something that you.

Jaqueline Hurst: That’s.

Rhona Eskander: Something [00:39:15] that’s something that you’ve mentioned a few times. But sometimes emotions hit before we even [00:39:20] know what we’re thinking, which is what I said to you. The shower situation. Right. She said something. It [00:39:25] hit me. We’ll have a private session on this. It hit me to the core that at that moment I was like this. I couldn’t even [00:39:30] rationalise it. It just. It was almost like it felt like this, right? I’m not going into it. No, no. How [00:39:35] do we catch them in time?

Jaqueline Hurst: Okay. So I like that, I [00:39:40] like it, I like the question. I’ll tell you why. When you’re feeling that feeling, it’s like a little alarm [00:39:45] clock is how you need to think about it. Like a little alarm going off is, oh, I’m feeling this feeling [00:39:50] okay. Now, most people just sit in that space and go, oh my God, I’m anxious, I’m anxious, I’m anxious. Right? But [00:39:55] no, to do your work, you have to say, right, I’m feeling anxious. Yes. What [00:40:00] am I thinking that’s making me feel that way. What’s going on in my head [00:40:05] that’s making me feel that way? When you can unpack that, right. I’m [00:40:10] thinking she said that because she doesn’t like me, for example. We then want [00:40:15] to say, well, first of all, is that true? Is that a fact? Do we know that to be a fact? Because we don’t know what other [00:40:20] people are thinking or what their what their you know, that’s all our assumptions and all our opinions and all our [00:40:25] thoughts. So you unpack the thinking around that, and then you work each thought to [00:40:30] in turn change how you feel. And that’s your process, right? Which [00:40:35] takes work to learn how to do. But ultimately that’s what we do.

Rhona Eskander: Can you give an example? Okay, I’m going to just [00:40:40] make up something. Um, okay. So say a girl says to her girlfriends, oh, um, [00:40:45] I think she looked really fat about someone in her group. I don’t know why she wears jeans like that. [00:40:50] Yeah, it really doesn’t suit her. She’s got really big hips and a really big bum. Let’s just say that happens. [00:40:55] And then the friend gets triggered because she’s thinking, well, I’m not actually much different in size [00:41:00] to this girl, so she must think that about me, right? So unpack that. So she’s triggered. [00:41:05] She’s really upset because you were saying.

Payman Langroudi: What should she do?

Rhona Eskander: What should she do in that moment? Okay, so there’s a dialogue.

Jaqueline Hurst: First [00:41:10] of all, I would say stop making it about you. Yeah, whoever you are. Right. Number one, we take [00:41:15] everything about us, right? Like, oh, my God, they’re going to think this. And then. Right. We’re not that interesting [00:41:20] to other people. Yeah. We’re just not. Yeah. So the first thing I would say is it’s not about you, right? [00:41:25] Stop making it about you. It’s about the person that said that thing. Fine. Then I would say [00:41:30] write down all your thoughts about that. Right. She must think that I’m fat. Or she must think [00:41:35] that I look awful every time I go out. Or she must think dah dah dah dah dah. Right. And [00:41:40] then I would challenge every single one of those thoughts. I would literally go [00:41:45] thought by thought, right? So she must think I look awful too, right? So I would say [00:41:50] to you, really? Like, how do you know that? And you’re going to come up with a 15 million thoughts. And I’m [00:41:55] going to say, but how do you know? And the answer to that is you’re never going to know.

Rhona Eskander: Of course.

Jaqueline Hurst: Right. So when you start [00:42:00] to unpack this, you start to literally break it down. And that’s how you then change [00:42:05] how you feel.

Payman Langroudi: It sounds a bit logical though. And this, these these reactions that she’s having [00:42:10] sound a bit illogical.

Jaqueline Hurst: Her reactions are let’s change the word illogical [00:42:15] to unconscious. So her reactions are from an unconscious space.

Rhona Eskander: I would describe it as [00:42:20] fight or flight. When I personally get in that zone, I would say that I cannot rationalise it in that moment.

Jaqueline Hurst: In that moment. [00:42:25] And so what you have to do is do the work so that you become aware of when you’re [00:42:30] thinking it’s a process, right? First, you have to become aware. That can take a week or two. Then you [00:42:35] have to say, oh, this is the thought I’m thinking, right? How can I think about this differently? Which could take a week or two. And [00:42:40] then the third time in like week three or week four, when people say those things, it doesn’t [00:42:45] it doesn’t hit like that anymore.

Payman Langroudi: I mean, the space between stimulus and response. [00:42:50] Yeah, you must you have explored that.

Jaqueline Hurst: But it’s what you.

Payman Langroudi: Do with that idea [00:42:55] that, yeah, the stimulus and response don’t necessarily have to be the same thing.

Jaqueline Hurst: And they will [00:43:00] be immediate when you haven’t. When you have an unmanaged mind and they will be way different [00:43:05] once you’ve managed. I always say it’s like a puppy dog, your mind is like a puppy, and it comes like when it’s [00:43:10] unmanaged, which most people’s are okay, it’s not our fault we aren’t taught this stuff at school. I wish we were [00:43:15] right, but ultimately it’s a puppy dog. I want to go here. I want to sniff it. I want to go there. I want to go here. I want to go there, right? [00:43:20] Puppies are like lala crazy. When you manage your mind, you’re teaching the dog. [00:43:25] Sit, stay. Come. It learns [00:43:30] and it knows what to do. And that’s what we’re doing with our brains. And your brain is so [00:43:35] fucking powerful. It is literally the driver of your whole machine.

Rhona Eskander: I [00:43:40] mean, look, I’m so I really, really believe and like one observation that [00:43:45] I’ll make is that with you, everything that you have achieved is also because of the power of your mind [00:43:50] and because you really believed and wanted those things. Yesterday I was on a podcast [00:43:55] and they were asking me like, you were one of the first dentists to be on social media. How did you [00:44:00] get there? And I was like, because I really believed in social media as this tool. No [00:44:05] one else was doing it in dentistry because no one believed dentists would be interesting on social media. [00:44:10] I wholeheartedly believed it. Therefore, that belief led me to where I am [00:44:15] today. And even now, when things don’t go my way of certain things, I do take a lot of accountability. [00:44:20] Sometimes a bit too much because I really blame myself. It’s your fault you didn’t think about it hard enough, you know? I’m like, [00:44:25] you could have manifested and controlled every aspect. It’s really hard in relationships because that’s the one part that I realised. [00:44:30]

Jaqueline Hurst: Yeah, relationships.

Rhona Eskander: Can’t control the other person. You can’t. You can’t control the.

Jaqueline Hurst: Other person, you know? Yes. That [00:44:35] is exactly my brain in it. But I don’t want to give off the impression here or your listeners to think like, you [00:44:40] know, it’s all you know, I was always that way. I wasn’t, I was an addict [00:44:45] with nothing at lying on the floor, you know? Fucked.

Rhona Eskander: Yeah, yeah.

Jaqueline Hurst: But [00:44:50] I’m not that person today because of the power of my mind. Because I know how to use it. Because I know how to feed it. [00:44:55] Because I know how to look after it, because I know how to think properly. So that should be empowering [00:45:00] for people to say, well, if she can go from there to there just by using the power of her brain, [00:45:05] I can do these things too. Like, I’m not special and different. Yeah. I’m not.

Payman Langroudi: What [00:45:10] are you struggling with?

Jaqueline Hurst: How long have you got? No, I’m just kidding. What do I struggle with? [00:45:15] Um, I what do I struggle with? That’s a really good question.

Payman Langroudi: Um, [00:45:20] this week.

Jaqueline Hurst: What did I struggle with this week?

Rhona Eskander: Um, you said to me, being in London.

Jaqueline Hurst: My mum, [00:45:25] my mum had a small operation this week, and I often feel overly responsible. [00:45:30] You know, my dad passed away last year, and I’m learning the balance of, [00:45:35] like, how to look after her. And also, um, not, you [00:45:40] know, I can’t mummy her. She’s an adult. She’s 75, but my parents had a marriage where they were together [00:45:45] for like 52 years, and my dad did everything for my mum. And my mum is 75. And, you [00:45:50] know, I said to her the other day, I was like, just print that email, mum, just print it. And she said to me, which really hurt my heart. How [00:45:55] do I do that? And I suddenly thought, okay, you know, so that balance is a really [00:46:00] fine balance. And I would say, and I don’t want to use the word struggle because I don’t think that’s a struggle. But that’s the thing that’s [00:46:05] on my mind. And struggling is not a comfortable place for anybody to be in. And [00:46:10] again, when we get our minds right, we don’t struggle. It doesn’t mean I’m at the I’m not [00:46:15] like, this person is like everything’s, you know, sorted out because life throws at us, [00:46:20] especially me. All day long. There’s shit coming my way, right? All day long. There’s shit coming [00:46:25] my way. Especially me. I’m joking, but you know what I mean. Like we’ve all got shit. It’s how we handle [00:46:30] it in our heads. And I’m really in tune with myself. So if something doesn’t sit properly, [00:46:35] I’ll talk to my friends about it that are also emotionally intelligent. I have great support [00:46:40] around me. I will take it to my coach, you know, and have a conversation with him about, [00:46:45] like, I’m a real believer of like, this is a game that we’re playing this game of life [00:46:50] and we’re always learning, you know? In fact, the more I learn, the less I know. Like for sure. [00:46:55]

Rhona Eskander: What I really loved at the beginning of the conversation as well is this like kind of notion [00:47:00] of divine timing that you were saying to kind of believe that things are [00:47:05] happening for you, not against you? I think that that’s quite beautiful. And that’s definitely been a [00:47:10] mind mindset shift for me and what I’ve been like. Um, [00:47:15] there are so many things that I’ve tried to control, but when they’ve, I’ve actually lost them or it’s gone [00:47:20] wrong, I’m like, oh my God, that was actually so good that happened. You know, like, I’m really glad that’s no longer in my [00:47:25] life. Those people or this, this company or this patient or whatever it is. And [00:47:30] I’m like, I tried to really control the whole outcome of that situation because I was so avoidant of [00:47:35] the pain. And then when it happened, it was awful. When it happened, I was I mean, I’m really like I really [00:47:40] grieve situations. And then like a year on, I’m like, however, I’m not bitter about it at all. I’m like, [00:47:45] it happened for a reason. And I’m kind of glad it’s no longer in my life, you know? And that’s that.

Jaqueline Hurst: It’s funny, isn’t it? Because the [00:47:50] more you control, the less control you’ve got. Yeah, yeah.

Rhona Eskander: But do you believe. Because I think the one thing that I [00:47:55] struggle with because I’m a massive it’s almost like a contradiction because I’m a massive believer in like your mind [00:48:00] and manifesting to a degree, not the toxic positivity type of manifesting, but like, like you said, like you somewhere [00:48:05] in your head were like, I’m going to provide something to people to help people like how [00:48:10] you ended up as a coach, etc. so it’s really important that your little actions every day allow things to happen, but [00:48:15] in a way that’s control. If you if that makes sense, because you’ve put out [00:48:20] your intention of what you want. And I think there’s almost like this fine balance of not trying [00:48:25] to grip onto it too tightly, but like knowing what you want, and also also at the same time letting [00:48:30] things be and happen the way they’re meant to happen. Does that make sense?

Jaqueline Hurst: It does. I had this great teacher and she she said [00:48:35] something which I hope will help you. I know it definitely helped me. And she said, like with things like that, what you have to do is [00:48:40] imagine that you’re like buying that thing on Amazon, right? Once you’ve bought it and paid for [00:48:45] it, it’s on its way and then you release it. Yeah. And I love that because it’s like [00:48:50] you have to, you know, you’ve got to put the work in and then you’ve got to release [00:48:55] it, right. Like, you can’t be spending your life trying to control the minutiae of everything and everyone [00:49:00] around you. Like, it’s just, you know it. Control is an illusion. It’s such an illusion. [00:49:05]

Rhona Eskander: So a question that I’ve got to ask you as well, because I find this topic really interesting, is also about relationships. [00:49:10] Do you believe that people can create or [00:49:15] draw in the type of relationships that they want and keep [00:49:20] them? Or do you think it’s much more complex because you’ve got two people, two brains, [00:49:25] etc., etc.? I mean, what’s your thoughts on that?

Jaqueline Hurst: I think relationships are one of the [00:49:30] is not one of is the hardest thing that people struggle with. Um, on [00:49:35] many levels, because life is really all about relationships, isn’t it? And I will urge and urge [00:49:40] people to do their work on themselves right now. If you’re in a healthy, loving [00:49:45] relationship, you can do the work on yourself as you’re going through those relationships. You know.

Rhona Eskander: That’s [00:49:50] literally my poor husband has had to deal with me doing.

Jaqueline Hurst: That for the.

Rhona Eskander: Past five years.

Jaqueline Hurst: That’s a healthy relationship, right? As you’re [00:49:55] growing and changing, you know, he’s still there and you’re having a great relationship, right? But I [00:50:00] you know, I’m not a believer of like, you’ve got to love yourself before you step into a relationship. But I do think you have to learn [00:50:05] about your patterns before you, you know, before you dive in. And [00:50:10] again, it depends on sort of the levels of traumas and things you’ve had. Childhood plays a massive [00:50:15] role of, you know, the partners that we choose because ultimately I’m a believer that [00:50:20] we choose, you know, our partners is is either our mother or our father. And it’s, [00:50:25] you know, we’re trying to get the thing that we lacked from that parent through that, through the person that we [00:50:30] choose. Um, and so we have to look at all of that stuff in quite deep level. You know, some [00:50:35] of us do before you can have something super, super healthy, you know, you’ve got to know about your boundaries, your [00:50:40] value, your worth, you know, things like that. And you’ve also got to be someone I’m a believer of, like, [00:50:45] you know, you have to learn to really love your life and know that you’re whole anyway, and [00:50:50] that having a partner is an added bonus. But it isn’t everything. You know, a lot of [00:50:55] people get caught up in, you know, I’m single and if I had a partner then I’d be happy. And [00:51:00] that’s a really dangerous way to live your life. No one’s coming to save you. Yeah. No one’s [00:51:05] coming to save you.

Rhona Eskander: I think it’s very.

Payman Langroudi: And I grass is always greener as well.

Jaqueline Hurst: Absolutely.

Rhona Eskander: Um, but also, I always [00:51:10] say that, like, women have also been brought up with this toxic narrative about being saved, [00:51:15] you know, Disney, sex and the city. And I find it really dangerous. Um, [00:51:20] I even said yesterday, you know, like, the biggest hoax of my generation [00:51:25] was like, big coming to rescue Carrie in Sex and the city.

Jaqueline Hurst: Because I remember [00:51:30] those days. Yeah.

Rhona Eskander: Yeah, but.

Jaqueline Hurst: Big doesn’t.

Rhona Eskander: Change. First of all, he was married twice before he gave [00:51:35] you the bare minimum. And then you’re saying he’s coming to Paris to declare his undying love. Oh, and then, [00:51:40] by the way, he also stands her up on the altar. Do you know what I mean? And it’s like, no, but we still want the [00:51:45] big. Do you know what I mean? So I feel like there’s also this toxic narrative around constantly pining [00:51:50] over someone that gives you the bare minimum because they may change, you know?

Jaqueline Hurst: I think I think it’s a very [00:51:55] strange time out there with dating and things like that. Today, I think that men and women are totally [00:52:00] at. They are literally like this. You know, I don’t know if anyone can see that on a podcast, but like, we’re just [00:52:05] on completely different levels today. And I think that, you know, women decided to, you know, burn [00:52:10] their bras. And we wanted equality. And we thought, why not? I want to be in the boardroom, too. And we’ve got to [00:52:15] that point now, which is amazing, you know. Thank you to the suffragettes. Thank you to all these women before us. That got [00:52:20] us to a point where we’ve got a voice and and I feel that, you know, men are a [00:52:25] bit stuck now of like, well, now what? What do we do? And men open doors for women and women say, no, thank [00:52:30] you, I can do that myself. So they’re a bit confused. And yet women really want a man to be gentle and [00:52:35] loving and kind and all the rest of it. And it’s all like everything’s everywhere, you know? And it’s like how [00:52:40] something has to change. Because we’re in a space right now where I’m hearing more and more and more of people just [00:52:45] saying I’m just single and I’m staying that way. Like, I just can’t do it.

Rhona Eskander: I had three women in my surgery over the last [00:52:50] three months that have chosen to have IVF donor babies on their own.

Payman Langroudi: No doubt at all.

Rhona Eskander: No. [00:52:55] Don’t even know donors. And I was like, that’s interesting. Or lucrative jobs 40, [00:53:00] 41 years old were like, he never came along. So I’m doing on my own.

Jaqueline Hurst: I think women have, [00:53:05] you know, accidentally overtaken a lot of men today. And men have [00:53:10] to learn about emotional intelligence, and yet no one’s teaching them. So we’re [00:53:15] really, really stuck at the moment out there. It’s it’s an interesting space. [00:53:20]

Rhona Eskander: Yeah, it really is.

Jaqueline Hurst: Yeah.

Rhona Eskander: You’ve worked with so many clients, as you’ve said. And what’s the most common thought [00:53:25] pattern that holds people back?

Jaqueline Hurst: I’m not good enough, really.

Payman Langroudi: Is that men [00:53:30] as well?

Jaqueline Hurst: Yeah.

Payman Langroudi: I mean, is there a difference between men and women or age groups or different patterns?

Jaqueline Hurst: What [00:53:35] I love about working with men is men are way more logical, right? They’re very bum, bum, bum like. It’s [00:53:40] really clear when you work with a guy and women are a lot more like, you know, spaghetti. Like, then we [00:53:45] go this way and then we go that way, you know? So men are super, super logical, but often, you know, they’re very action [00:53:50] orientated. And so I’m constantly saying to my men clients like, it’s not about [00:53:55] the action, it’s about the thinking, you know. But they are a lot more yeah, logical [00:54:00] action orientated. But um, that’s quite interesting. And women, you know, we’re a bit more complex, right? [00:54:05] We’re a bit more. Yeah. Okay. No more laughing. No, I’m just kidding. But, yeah, we’re a bit more [00:54:10] complex.

Rhona Eskander: You’ve also talked a lot about, like, self-awareness being a superpower. So [00:54:15] thank you for saying that. Self-aware because I work because I was saying but what [00:54:20] is what’s the kind of questions that people should be asking about that? Because you know what the self-awareness piece for me was like? I [00:54:25] got surrounded by so many people. I mean, I was in this echo chamber. Still am still trying to escape the echo chamber. If I’m honest [00:54:30] of a certain type of person in my life. And what I recognised, [00:54:35] there was such little self-awareness. And I think particularly for those people that like being like in the limelight [00:54:40] or like being the centre of attention. Semi narcissists, everything [00:54:45] like that. They really fail to ask questions and like have accountability [00:54:50] and that really bothers me. You know, it really bothers me. Like even as I was telling you about the addict that I [00:54:55] was friends with, you know, it was always everyone else’s fault. You know, there was always I don’t [00:55:00] mind people being imperfect. I don’t mind people fucking up because we’re all human. What it does, mind me, [00:55:05] is the self-awareness and lack of accountability and the blame on everyone else when things go wrong. So what [00:55:10] kind of daily question do you think people should be asking themselves?

Jaqueline Hurst: Well, if you’re dealing with a narcissist, [00:55:15] they’re not going to be asking themselves questions. Let’s just leave it at that. Right. Because that isn’t going to happen. You’re asking, [00:55:20] you know, an apple to be an apple and an orange to be an orange. It’s just not going to happen. So those people [00:55:25] won’t be asking themselves daily questions. But by the way, if you’re saying, oh my God, am I a narcissist, I want you to [00:55:30] know you’re not because you’re asking yourself the question, okay, so so your question [00:55:35] you’re asking me, I’m just double checking here is like, what questions should we ask ourselves to be self-aware people?

Rhona Eskander: Yeah, [00:55:40] exactly.

Jaqueline Hurst: To people, ultimately is just. What am I thinking? That is like the best question [00:55:45] you can ask yourself ever. What am I thinking? And is this thought helping me go in the direction of [00:55:50] where I want to go? Or is this thought taking me into a completely different direction? What am I thinking? Right? [00:55:55] That’s a really important.

Payman Langroudi: To separate the different personas like the, you know, like that chimp paradox, [00:56:00] kind of that, you know, that I feel like there’s three of me.

Jaqueline Hurst: Right? [00:56:05]

Rhona Eskander: Parts. He’s talking about parts essentially. You know.

Jaqueline Hurst: There will be loads of different parts of you. [00:56:10] Yeah. And we’re all are working.

Payman Langroudi: So when you say, what am I thinking? Which one? Which one are me? You know, like. [00:56:15]

Jaqueline Hurst: Still ask yourself the question because you’ll get some really great answers. You know, it’s a really, really [00:56:20] powerful question. What am I thinking? And it also gets you into the self-awareness section. And by [00:56:25] the way, we can’t just stop at self-awareness. Then we’ve actually got to do our work to change.

Payman Langroudi: Something about.

Jaqueline Hurst: It. Yeah, [00:56:30] you can’t just sit there and be like, yay, you know?

Rhona Eskander: So with dentistry, right. Lots [00:56:35] of high achievers. Okay. So we’ve got my partner describes it as in [00:56:40] finance, dentistry, medicine. Like all these kind of corporate careers, they rely on insecure [00:56:45] overachievers. And I was like, that is such a good way to describe so many dentists because they [00:56:50] rely on us, you know, being insecure and wanting to overachieve. And that’s what kind of keeps [00:56:55] us really driven and really dedicated to the job, if that makes sense. Okay. So anyways, there are [00:57:00] lots of high achievers in dentistry, and there’s this constant drive to do more and be better. But how do we balance [00:57:05] ambition with self-acceptance?

Jaqueline Hurst: Our success doesn’t make you happy. And you know, [00:57:10] there’s this lovely Buddhist saying, which I know I’m going to get wrong, but it’s basically about like, you know, you’ve got to [00:57:15] you’ve got to buy the Ferrari to find your enlightenment, right? Like, you’ve got to go there [00:57:20] to understand that doesn’t do it for you. So I would just say to you that you have to learn how [00:57:25] to value yourself on who you are, not what you do. It takes work, but it’s really, really important. [00:57:30] Otherwise, you’re going to be constantly seeking it from outside of yourself. And you, you know, you can [00:57:35] get to the top rung of the ladder, but it just doesn’t mean you’re happy. So learning how to do that is really, [00:57:40] really important.

Rhona Eskander: And I think it’s really sad because as you said, like the constant gratification on social [00:57:45] media shows people otherwise. And I’ve even seen it with some of my friends that have huge profiles [00:57:50] on social media. They chase one thing after the other to get more of the [00:57:55] engagement, more of the love, and they don’t even know they’re consciously doing it. But I know that they do. I was [00:58:00] listening. Do you ever listen to Matthew Hussey?

Jaqueline Hurst: Sometimes.

Rhona Eskander: Yeah, I really like his work. And [00:58:05] he was talking today on a podcast because I listened to a lot of his stuff as well, about [00:58:10] how some people would explain the type of person they’re attracted to. But when [00:58:15] you break it down, type is just based on your ego and insecurity. And he was like, I know it’s a [00:58:20] little bit controversial, but someone might say, but really, what they’re saying their type is, is someone that makes [00:58:25] them feel validated on the outside or makes them feel. So for example, you’re like, if they’re [00:58:30] seen with a certain person and someone goes lucky her, or if you’re seen [00:58:35] with a certain person of a certain status or stature. You know, I mean, people, you know, [00:58:40] you might feel like, oh, I’m good enough. Do you know what I mean? Like, there’s this massive validation with who we think [00:58:45] we should be with, rather than actually breaking down who the person is and whether they [00:58:50] are good for us. And I thought that, you know what? That’s a really interesting point. And the danger is with social media in every [00:58:55] aspect of their life. For example, if you’ve had an eating disorder and [00:59:00] your weight naturally fluctuates, if you are looking skinnier and have a belief that I am better [00:59:05] when I’m skinnier, and then people online are saying, you look amazing when you’re at your skinniest, [00:59:10] it’s just going to perpetuate that belief. Does that make sense? So sometimes it’s really hard to [00:59:15] know who you are and what makes you happy, because you’re kind of seeking that external validation [00:59:20] all the time, and you believe that it makes you happy.

Jaqueline Hurst: You’ve got to do your work because you, you know, and the further [00:59:25] down that path you go of doing your own work, the less any of that stuff happens. Yeah. And [00:59:30] you know what you are, and you know who you are, and you know that you’re good enough and you know. [00:59:35] And it’s all. It’s all okay.

Rhona Eskander: So would you say you’re invincible?

Jaqueline Hurst: Invincible? [00:59:40] I don’t think I’m invincible. No. I mean, what is invincible? What are.

Payman Langroudi: You chasing? What are you chasing? I mean, [00:59:45] it’s an interesting question, right? That anything that happens in your life that [00:59:50] you’ve got to measure it against. Does this bring me more like [00:59:55] if peace is for me. What?

Jaqueline Hurst: You’re all about that, right? I just wanted to have a mind that was [01:00:00] quiet. Yeah, like that was all I ever wanted because I had, like, a really loud mind and [01:00:05] a destructive mind and a confused mind and a hurting mind. And so for [01:00:10] me, it was always about, how can I be somebody who is completely at peace? [01:00:15] And, you know, I feel I feel blessed today that [01:00:20] I could tell you that I have a I have a life where I lead, which [01:00:25] is deeply peaceful inside. And I think that has been, you know, [01:00:30] worth it on every level.

Payman Langroudi: But do you have to unpack it for your clients? Sometimes because [01:00:35] I thought that I’m chasing, uh, happiness.

Rhona Eskander: You did your whole life. [01:00:40]

Payman Langroudi: I thought I’m chasing happiness. Yeah. Then. But actually, I was confusing. Well, what is that, exactly? [01:00:45] I was confusing happiness with pleasure. Right? Yeah. Joy. The kind of very different [01:00:50] those things.

Rhona Eskander: Dopamine hits.

Payman Langroudi: Yeah, yeah. Now I’m thinking contentment, [01:00:55] which is a totally different thing to happiness and joy and pleasure.

Jaqueline Hurst: Also growing.

Payman Langroudi: Up. Yeah, yeah, yeah.

Jaqueline Hurst: I think age [01:01:00] is a big part of that, you know?

Payman Langroudi: Yeah. No, but unpacking those things, you know, like, because you think you’re chasing [01:01:05] happiness, but actually you’re chasing pleasure. Yeah. Yeah. You know, like. So you think it’s a good [01:01:10] thing to do? It’s a worthy cause.

Jaqueline Hurst: It’s what makes you feel good inside, right? Like, you know, [01:01:15] ultimately, if you’re drinking loads, you aren’t feeling good. You think you are, but you know that you’re not.

Rhona Eskander: But [01:01:20] I think people mistake dopamine for happiness. And they don’t realise that it’s a high. And that’s the thing. [01:01:25] We’re constantly chasing highs because things are so accessible to us. We’re constantly chasing the [01:01:30] partner. That’s better. The job, the fame, the looks, whatever, whatever. And and [01:01:35] the thing is, is that we’ve also like we’ve come the compare and despair space is becoming more and [01:01:40] more vast. Because let’s face it, of course there’s going to be someone that’s better looking, more successful. [01:01:45] This, this, like any of us, like, you know, if we compare, you know, and I think that is dangerous [01:01:50] because people don’t get celebrated, like you said, enough for their authenticity and vulnerability. [01:01:55] And I just and it’s sad because sometimes I really see us taking steps [01:02:00] back. You know, when I see comments on Facebook and Instagram, not from me, but like on other [01:02:05] people’s posts, I’m like, things haven’t changed or like not enough people are doing the work, [01:02:10] you know?

Jaqueline Hurst: Well, I think that’s I think that’s it. I think not enough people are doing the work. And I think that’s really, really important, [01:02:15] you know, because.

Payman Langroudi: More are doing the work now than ever before. Right. Are they. Yeah. Yeah for sure. I mean. [01:02:20]

Rhona Eskander: We’re in a microcosm. Yeah.

Payman Langroudi: I used to be a dirty thing to even see a shrink or see a [01:02:25] therapist.

Rhona Eskander: Saying the mental.

Jaqueline Hurst: Health, the mental health. I mean, look, when I started, I remember saying to people, I’m a life [01:02:30] coach. And my dad at the time was like, what? Who’s going to knock on your door? What do you want? Right. He [01:02:35] was so baffled by it. And I remember writing to all the public schools, like all of them, saying, hi, I’m a life coach. [01:02:40] I’d like to come and give a talk to the boys so that I can talk to them about their emotions and how what they’re thinking. [01:02:45] And every one of these public schools wrote back to me and said, we’ve got a nurse on site. [01:02:50]

Rhona Eskander: Oh my God, it’s hilarious.

Jaqueline Hurst: And that look how far we’ve come.

Payman Langroudi: Yeah. So we’ve come a long way.

Jaqueline Hurst: But have we come [01:02:55] too far the other way? Now is the question is everything about mental health and oh my [01:03:00] God, I can’t get out of bed because this podcast is anxiety.

Rhona Eskander: Like you said, I think [01:03:05] you said like you quite rightly said, like victim mentality is the thing that really irks you. And I think [01:03:10] that that is it irks me too, because I’m like, you have rescued me.

Jaqueline Hurst: I mean, I’m not. Listen, [01:03:15] I know I’m very tough, but I do believe in feeling your feelings, right? Like, I’m a real believer [01:03:20] of, like, you know, you break up with your boyfriend’s fucking sit down and eat a tub of ice cream and cry for three [01:03:25] weeks, like you’ve got to have the feelings. And when you’re ready, then you make the change. [01:03:30] Yeah, yeah. So that’s really important, you know. But the victim mentality thing. Yeah.

Rhona Eskander: Because blaming everyone [01:03:35] else. Blaming your life.

Jaqueline Hurst: And not owning your part in these things. It’s really important.

Payman Langroudi: You know what though? You know, like [01:03:40] you said, when you see a family of four all on their phones and you [01:03:45] said about comparing yourself and obviously social media, you end up comparing more. [01:03:50] Yeah. It’s true. But do you do you both recognise here that there was always those [01:03:55] things? I mean, whether or not they were on the phone, maybe that same family [01:04:00] of four would be sitting.

Jaqueline Hurst: Non-stop.

Payman Langroudi: Talking to each other?

Jaqueline Hurst: Absolutely.

Payman Langroudi: Yeah, absolutely. Comparison [01:04:05] wise? Yeah. It’s not every morning, every time you flick your phone, but maybe back then you [01:04:10] used to turn up at a wedding and your clothes weren’t the same as. You know.

Rhona Eskander: What.

Payman Langroudi: I mean? Comparison has always [01:04:15] existed.

Rhona Eskander: Of course, of course, of course. But I think that there’s sometimes, like, a [01:04:20] break from it. You know, like, for example, even if you want to, to dissociate from somebody [01:04:25] toxic in your life, like back in the day, if I fell out with someone in my teenage hood or my 20s, I’m like, [01:04:30] cool. They’re not in my life and I don’t have access to anything they’re doing or what they’re doing, and that’s a decision. Now [01:04:35] this happens. Like you might be tempted, like every now and then just to be like, what are they up to? Like, [01:04:40] you break up with someone. Are they dating someone new? You know, I mean, like, you’ve just got all of this. That just [01:04:45] doesn’t help that whole self-preservation thing. And that’s just my view, because you’ve got the temptations [01:04:50] there. And being human. Sure, I don’t put myself to constantly looking, but every now and then I might [01:04:55] slip and be like, what’s this person doing and stuff? And I think the accessibility to these different things [01:05:00] makes it more difficult. I think.

Payman Langroudi: Like the narcissist life coach, that guy. [01:05:05]

Rhona Eskander: No, I actually laughed. I actually laugh, I looked at his LinkedIn the [01:05:10] other day and I was like, anyone that pays this chump, I feel sorry for him, you know? Um.

Jaqueline Hurst: It happens. [01:05:15]

Rhona Eskander: So I want to ask you something because I think this is really important. If you could go back and have a conversation [01:05:20] with your younger self at her lowest point, what would you tell her?

Jaqueline Hurst: I would say to her, it’s [01:05:25] going to get better than you could ever imagine, you know? And I do [01:05:30] really believe that the extremes that I went through in my life, I mean, extremes, was [01:05:35] for a reason, you know. And that all of that. And I realised that I was like as I got [01:05:40] into coaching and started my business, I was like, now I get it. Like, now I get why [01:05:45] that path was so tough. And, you know, I’m grateful for it.

Rhona Eskander: Do you really believe [01:05:50] that paths are written out for us?

Jaqueline Hurst: I have a feeling that, you know, we [01:05:55] probably choose what we want before we get here. We probably say, this [01:06:00] is what I want to learn. Having this human experience. Um. It’s possible. [01:06:05]

Rhona Eskander: Do you believe it?

Payman Langroudi: No.

Rhona Eskander: What do you believe?

Payman Langroudi: I’ve come [01:06:10] round to the notion of life. Will keep teaching you the lessons until you learn them. You know that [01:06:15] idea? But any any sort of supernatural kind of [01:06:20] angle on it just puts me off straight away. You know, like.

Jaqueline Hurst: Some people just don’t.

Payman Langroudi: But you do. You [01:06:25] know you do keep on making the same mistakes again and again and again until you learn not to make those mistakes [01:06:30] anymore. Life has a way of life has a way of grinding you into that situation. [01:06:35]

Jaqueline Hurst: People never learn. They just keep doing it.

Rhona Eskander: But that’s why I think the thing that terrifies me the most in the entire [01:06:40] world is the deathbed regrets. You know, the one that was written.

Jaqueline Hurst: Never wants [01:06:45] to have a deathbed regret.

Rhona Eskander: But the thing is, you see, you know the nurse that wrote the book. So she wrote a book [01:06:50] and she wrote like the most common regrets. And for me, it’s really reflective of the 9 to 5 [01:06:55] person that lived the cookie cutter life that thought would make them happy. And when you see [01:07:00] the regrets, it’s basically like not taking enough risks, not spending enough time with your family [01:07:05] and friends. Like all this.

Payman Langroudi: Stuff was living for other people, living.

Rhona Eskander: For other [01:07:10] people’s.

Payman Langroudi: Expectations. Expectations?

Jaqueline Hurst: What a terrible way to live your life. I [01:07:15] mean.

Payman Langroudi: The most common regret on the deathbed.

Rhona Eskander: Do you find a lot of your clients experience that?

Jaqueline Hurst: I think they [01:07:20] care what other people think. Yeah, definitely. It’s a big thing about what other people think about [01:07:25] them, and they don’t want to disappoint people. Women, especially big people, pleasing all of the stuff. You’ve got to [01:07:30] unpack it, right? You don’t have to live like that. That’s so, so important. Yeah, it’s it’s [01:07:35] common.

Rhona Eskander: So do you say now that you live by your own rules?

Jaqueline Hurst: You know, my friends would laugh [01:07:40] at you saying that because, like, I am the personification. If that’s the right word of that, [01:07:45] like I do, I, you know, I’m obviously I’m very empathetic and I’m kind, [01:07:50] but I also live a life that I’m comfortable with, and you all can do what you want with that.

Rhona Eskander: Yeah. [01:07:55] What does success actually mean to you now?

Jaqueline Hurst: Peace. [01:08:00] I think it’s all about being peace within myself. And that to me is the biggest, you [01:08:05] know, and most successful thing ever. I think one, I can put my head down at night and, [01:08:10] you know, have total peace. I feel I feel really grateful for that. [01:08:15] Yeah, I’ve worked hard for it.

Rhona Eskander: And you deserve it because you’re amazing. And [01:08:20] I want to ask you lastly as well. What is the future? [01:08:25] What does the future hold? What can we we be excited about in Jacqueline’s world?

Jaqueline Hurst: Do you know what I just [01:08:30] I have to tell you, when my dad passed away last year in August, it was a life changing [01:08:35] event for me. And if I, you know, I always have been a life grabber and a life [01:08:40] lover. But watching somebody you love, especially a parent, pass like that, it gives [01:08:45] you a whole new perspective on what you want to do with your life. You know, for me, [01:08:50] there’s lots of things that I think about doing. You know, the second book for sure, we [01:08:55] talked about that just as I sat down. I think that’s, you know, I’ve got to get around to doing that. That’s really important. And [01:09:00] to have, you know, to spend, which is what I do, real quality time, the people I love, that makes [01:09:05] me happy. I took my mom for a walk yesterday after this operation. She’s had, and her eyes are quite blurry and [01:09:10] so she had to like, hold my arm and blah blah blah. And we stopped and we looked at these beautiful flowers [01:09:15] and one of the garden squares, and I was laughing and I said, so this is what they mean when they say, stop and smell the roses. [01:09:20] So to me that stuff’s really important, which is quality time and being present with the people that I [01:09:25] love.

Rhona Eskander: Yeah. And I think there’s something so profound. I’m so close to my parents, especially my dad. There’s [01:09:30] something so profound about watching your parents age. You know, there’s this sense of, like, vulnerability. [01:09:35] And sometimes my dad’s almost 80, and it is it’s so precious to spend these [01:09:40] moments. It really, really is. Yeah. So important.

Jaqueline Hurst: So important because you never, ever want to say, I [01:09:45] wish I had. I was really lucky. I got one month with my dad. I was with him at the hospital 24 [01:09:50] over seven. I didn’t leave his side and I got to tell him everything I wanted to say, and I know that he got to [01:09:55] do the same for me. And that is one of the greatest gifts of this, you know, awful [01:10:00] experience that we’re all going to go through. It was one of the greatest gifts that I got to have that opportunity [01:10:05] to have, you know, spent that time with him. So, yeah, like spend time with [01:10:10] people you love. Be present. It’s a really powerful thing.

Rhona Eskander: Yeah. I love that so much. And if people want to find you, Jacqueline, [01:10:15] can you just tell us your handles?

Jaqueline Hurst: Okay. So my website’s Jacqueline Hurst. Com My Instagram is [01:10:20] Jacqueline underscore Hurst underscore. My school is the lifeclass.com [01:10:25] and the book is called how to Do You, which is available on Amazon and iTunes and [01:10:30] all of those things.

Payman Langroudi: Quickly, before we wrap up the question of how to do you specifically [01:10:35] you what are some tips to like, say, how do I unpack me, the [01:10:40] real me, rather than the sort of, uh, layers of things that we build on top?

Jaqueline Hurst: So [01:10:45] I think meditation is a really powerful tool to sit down and get to know yourself a little bit better and learn how to [01:10:50] quieten your mind. Um, being really conscious and aware of what you’re thinking, really important. [01:10:55] And how are you living your life? Ask yourself that question like, am I living a life to [01:11:00] keep other people happy? Or am I being true and authentic to myself? Living authentically, [01:11:05] living. Being true to yourself is a really beautiful way to live. And unpacking that is [01:11:10] really, really important.

Rhona Eskander: Perfect. Thank you so much, Jack.

Payman Langroudi: It’s been wonderful.

Rhona Eskander: Thank you for having me. [01:11:15]

Jaqueline Hurst: Thank you.

Payman Langroudi: One of the most common questions I get is how do I do more teeth whitening? The basis of that is to really believe [00:00:05] in it, and the basis of that is to fully understand it. Join us for enlightened online training on [00:00:10] Enlightened Online Training.com to understand how to assess a case quickly. How to deliver [00:00:15] brilliant results every time. Next time whitening Underwhelms try and lighten. Now let’s get to the [00:00:20] pod.

[VOICE]: This [00:00:25] is Dental Leaders the podcast where you get [00:00:30] to go one on one with emerging leaders in dentistry. Your [00:00:35] hosts Payman Langroudi and Prav [00:00:40] Solanki.

Payman Langroudi: It gives me great pleasure to welcome Amal Hourani [00:00:45] to the podcast. Amara is a specialist Endodontist had a few [00:00:50] endodontists on and uh, I actually I was at the PDSA recently [00:00:55] and I was talking to the youngsters saying, what do you want to do? And very few people want [00:01:00] to become endodontist at that age. But all the Endodontist I know are very, very happy with [00:01:05] their choice. And so it’s nice to talk to them. So I want to get into some of endo itself [00:01:10] as well. But massive pleasure to have you man.

Ammar Al Hourani: Thank you so much for having me here.

Payman Langroudi: It’s been a long time [00:01:15] coming. I remember the first time we contacted each other was like, maybe just after Covid. [00:01:20]

Ammar Al Hourani: Yeah. I don’t think I was in the right headspace for it at that point. I think now [00:01:25] I’m in a good place to do this. But yeah, you contacted me two years ago. No chance.

Payman Langroudi: Yeah, it was [00:01:30] around that time. Maybe. Maybe a bit longer. I just remember the endo guys otherwise known as the Endo guy. [00:01:35] Yeah.

Ammar Al Hourani: It could be a play on words, I suppose.

Payman Langroudi: It’s a clever thing to call [00:01:40] yourself something, you know, become memorable.

Ammar Al Hourani: That’s a good. That’s a good name. I think it’s from the falafel guys in America. [00:01:45] Oh, is it, is it?

Payman Langroudi: Is that what your kind [00:01:50] of Scottish dude? In a way. So you came over from Syria? [00:01:55]

Ammar Al Hourani: Yeah, my parents were living in Saudi Arabia at the time and as a doctor. So I think [00:02:00] during the 80s, the the tick out of Syria is to be a professional. And I think a lot of people were [00:02:05] going to to Saudi Arabia because that’s where the wealth was. And I think that was like a launch pad [00:02:10] for a lot of people to go to the West as well.

Payman Langroudi: So did you go to one of those international schools in Saudi? [00:02:15]

Ammar Al Hourani: No, it was no. I went to nursery school in Syria for a little while. That’s how I can speak Arabic, I suppose, because [00:02:20] of that, thankfully.

Payman Langroudi: So you yourself didn’t live in Saudi much.

Ammar Al Hourani: For maybe [00:02:25] three years, maybe three, three years. Four years. Yeah. Not not a long time. Very small period of time. So I don’t really remember. [00:02:30]

Payman Langroudi: But you must remember getting to Glasgow.

Ammar Al Hourani: We didn’t come to Glasgow straight away. We came [00:02:35] to a small town called Bellshill which is just outside Glasgow. It’s in an area in Lanarkshire. [00:02:40]

Payman Langroudi: Do you remember that as a.

Ammar Al Hourani: Six year old? Yeah. Of course. Yeah. I couldn’t speak the language and have a clue what was going on. And you went from [00:02:45] Syria, which is, you know, it’s quite a nice place. Damascus. When I was a kid, to a much more, I would [00:02:50] suppose, a developed. What year was it? I was five, so what year was that? 90, [00:02:55] I don’t know, 1990, maybe 1991, 1991. Yeah, probably 86. [00:03:00] 91. Yeah. About. Right. So yeah, it was good. I didn’t I didn’t speak English, [00:03:05] didn’t have a clue, didn’t know what was going on. Um, and at the time we used to have like, uh, you know, [00:03:10] extra support at school to teach you the language, which was really good. My parents spoke good English, to be fair. So they did [00:03:15] teach us quite a lot. And my dad was always quite forward thinking. We always lived in very white neighbourhoods so [00:03:20] that we picked up the language. So we never really lived in any mixed neighbourhoods. So you picked up language [00:03:25] really quickly. Um, and then we travelled a lot with my dad all over Scotland because he’s a doctor.

Payman Langroudi: Kind [00:03:30] of doctor.

Ammar Al Hourani: Paediatrics. Uh, so he did the specialist training. So we were in Aberdeen. So [00:03:35] when Bellshill. Then we went up to Inverness for a little period of time, then lived in Aberdeen for ten years, and [00:03:40] then he got his consultant job in Stirling and that’s where we went from 1998 onwards [00:03:45] we’ve been in Stirling, which is between Glasgow and Edinburgh.

Payman Langroudi: How do you identify?

Ammar Al Hourani: How do I [00:03:50] identify myself? Yeah, I would say I’m definitely a Scot for sure. Yeah, I feel more like a Scot than [00:03:55] I do an Arab, if I’m being honest. But I’m quite. You know, I’ve got that. I’m proud to be [00:04:00] an Arab. I’m proud to have that sort of lineage. But I definitely think like a Scot, I talk like one. [00:04:05] I definitely think like a Brit. Um, so I’ve always sort of I’m very proud to be from here, but I’m [00:04:10] also proud to have that sort of the nice parts of being an Arab as well. So it’s good.

Payman Langroudi: Yeah, the falafels.

Ammar Al Hourani: Falafels, [00:04:15] the shower, the flat tyre.

Payman Langroudi: And have you been back to Syria at all?

Ammar Al Hourani: Uh, [00:04:20] last time was we, we used to go twice a year. Every year.

Payman Langroudi: Oh, really?

Ammar Al Hourani: Yeah, we used to go twice a year. Every single year because [00:04:25] my parents wanted us to learn the language. So I used to go quite a lot and I loved it. Really great. I did [00:04:30] my my dad was going to move back when I was just about going to secondary school. So I lived [00:04:35] there for about a year, year and a half. So I did my secondary schooling because in Syria you can’t go from primary school to secondary school unless you [00:04:40] pass an exam in primary school. So I did that primary schooling and then yeah, I was getting to secondary [00:04:45] school and I think my mum put pressure on my dad to stay here. So then we stayed here, which was I think that was a [00:04:50] good decision in hindsight. Otherwise we would have been lost.

Payman Langroudi: When did dentistry come into the [00:04:55] equation?

Ammar Al Hourani: At no point did they want to be a dentist. So I finished my. [00:05:00] So when I did my secondary schooling in Scotland, I got one of the highest marks in economics. [00:05:05] I actually got a scholarship for LSE to go and do economics at.

Payman Langroudi: Age Teen.

Ammar Al Hourani: Age Scotland. [00:05:10] You do your Highers a year before A-levels. So it’s it’s a [00:05:15] different system. Yeah. 17, 16, 16, 17. It’s the Scottish [00:05:20] Highers which is different. Works a little bit differently. And I got Scot. Yeah I got an interview came down. So you [00:05:25] know I met the chancellor of the Bank of England. That was your prize at the time which was good. Got [00:05:30] a scholarship. So what.

Payman Langroudi: Happened?

Ammar Al Hourani: Well, you come up, you come from a middle eastern background. [00:05:35] So your.

Payman Langroudi: Parents curtailed.

Ammar Al Hourani: The only the only professions that exist is medicine, [00:05:40] dentistry, engineering, law. So that was like, you know, do [00:05:45] something that has a career. You’re helping people, you know. I don’t think I think it was an alien concept. [00:05:50] Economics, I loved it, I thought it was really nice, but for them it was an alien concept. So it did [00:05:55] work experience with my dad’s a doctor and didn’t really enjoy anything in medicine, and it was at the time it was his [00:06:00] friend who said, come and come and watch me do what I do as a dentist. I like the gadgets. I [00:06:05] thought it was quite a good thing. So I’d done my application for Ucas at the time. I don’t know if Ucas still exists, but [00:06:10] for medicine, and I changed it overnight to do dentistry and I applied to dental schooling.

Payman Langroudi: Because [00:06:15] of that work experience.

Ammar Al Hourani: Just the work experience and because, you know, I was curtailed into a small group of [00:06:20] professions which was accepted by my parents, I suppose. So, um, yeah. So I ended [00:06:25] up doing dentistry, and actually, it’s been good. I’ve never regretted it really, ever since.

Payman Langroudi: I was going to go there. [00:06:30] Actually, that question of we all get curtailed somewhat. I [00:06:35] mean, it’s funny, I speak to some people, they say, I wish my parents had guided me more.

Ammar Al Hourani: No, my parents were.

Payman Langroudi: Not generally [00:06:40] Middle Easterners getting massive guidance, too much guidance. But where [00:06:45] I’m really going with it is you’ve got children. What degree of sort of [00:06:50] guidance are you giving? How old are they?

Ammar Al Hourani: Five and nine.

Payman Langroudi: All right. Too young, too young. But [00:06:55] you’ll get to it, right? Well, people say these lovely things like, I’m going to just let the kid do what they [00:07:00] love. Yeah. But the reality is not that many kids love very much. Like there [00:07:05] are a few. Many are just kind of following the path of least resistance and have no idea [00:07:10] what they want to do. So then it comes to you to then say something. Yeah. You know, they actually ask [00:07:15] for your advice. So what’s your advice? I mean, what is it advice, is it or are you going [00:07:20] to be quite forceful as your parents were?

Ammar Al Hourani: No, I think my parents weren’t really that forceful. I think they just wanted me to have [00:07:25] a good career, to be honest and in.

Payman Langroudi: A forceful way. In a.

Ammar Al Hourani: Forceful way. I mean, what do you know, at the age of 16 [00:07:30] or 17, what do you know really? I mean, I think I quite like the American concept, where at least you do a degree first, you mature a little bit, [00:07:35] and then you come up with your own ideas in life as to what your path in life would look like. I think at 16, what [00:07:40] do you know? Like you see your next door neighbour with a nice car, or you see your dad with good friends or the accountant that’s doing [00:07:45] okay, you know, and that’s that sort of guides.

Payman Langroudi: You imagine we fast forward ten years and literally your son [00:07:50] or daughter is saying, dad, what should I do? What should I do? What do you reckon you’d say?

Ammar Al Hourani: I’d [00:07:55] say, um, honestly, I would actually say to them, go and do medicine or dentistry or something along those lines, [00:08:00] do a professional degree.

Payman Langroudi: It’s so sad, isn’t it?

Ammar Al Hourani: It is. I think I think the only reason is because I think it’s it’s [00:08:05] a career. You know, there’s very few careers out there that, you know, you can work in and build your way up something. [00:08:10] A lot of it is sort of you get a degree and then you go, right, I’ve just done I don’t know, I’m going to make up a [00:08:15] degree like history. And then you end up working in retail and you’re like, how is that? How did that. Does that make sense? I’ve done history [00:08:20] and then I end up being a lawyer and you’re like, how did that happen? You know, so I think it’s a good career if you, you know, because if [00:08:25] I’ve done okay with it and maybe in the future if I have some assets with it, maybe it’s quite good to pass it down to someone [00:08:30] or some, you know, my daughter or my son, just to continue with the concept. So it gives them a dignified [00:08:35] life, I suppose. I don’t know, maybe I’m right, maybe I’m wrong.

Payman Langroudi: I find it a bit sad. I find it a bit sad. And I hear [00:08:40] exactly what you’re saying and I’ve given similar advice. Don’t get me wrong, I’ve given similar advice to my kids, but [00:08:45] I find it a bit sad because there would be no photographers. There would be no movie maker. [00:08:50] Movie makers. Um, some of the richest people in the world now are [00:08:55] gamers. Yeah. Gamers or developers? It developers, it all sorts of things. [00:09:00] Right. And we end up and I actually when, when, when I was talking to my my [00:09:05] son, my son kind of knows what he wants to do. He wants to do aerospace engineering. Sounds great actually. Actually it’s [00:09:10] not you know, it’s a lot of it’s defence really annoys me a little bit. You know, you spend your whole life telling your kid war is [00:09:15] wrong and then it’s a lot of it’s defence. He did he did his first work experience. It was like [00:09:20] missile guidance system, right? I was like, oh shit with GPS. But [00:09:25] my daughter doesn’t really know. And I’m kind of saying, hey, why don’t you be a dentist? And and as I [00:09:30] say it, one part of me thinks, hey, great, because dentistry has been good to us and [00:09:35] we can see. But another side of me says, hey, how? How is it that, you know, what do all these [00:09:40] other people do? Go and end up doing this and that and the other? And did I fail in some way [00:09:45] insomuch as I didn’t introduce her to enough stuff that she didn’t end up having [00:09:50] some sort of passion in some area that then she could go into. And [00:09:55] the best advice for your kid, I think, is just to do whatever very well.

Ammar Al Hourani: I [00:10:00] would agree, I think the only reason why I was saying medicine or dentistry is because I come from that type of background. So I can only advise [00:10:05] them on what I know. And so medicine dentistry feels familiar to me. It’s given my brother a good [00:10:10] life and my parents a good life. Yeah, but you’ve got patience.

Payman Langroudi: You’ve got a patient who’s a banker who’s got even a better life, right?

Ammar Al Hourani: Probably. [00:10:15] And that’s that. So I can only guide on what I know. You know, I can’t guide on the unknown because I can say, go and be a [00:10:20] banker, and you might end up being broke. I don’t know, you know. Yeah. Or losing Jane’s money because of a bad investment, and then you’ll [00:10:25] feel bad about it. You know what I mean? So I can’t really guide on something I know nothing about. So I can only give them guidance [00:10:30] on what I know. But if they find something better, I think they’ll always know that I’ll be there to support them no matter what. So [00:10:35] I think that gives that sort of safety net. So you can just go and experiment maybe a little bit more. I think because I came from [00:10:40] a second generation family, maybe I didn’t have that support network as such, you know, whereas [00:10:45] now I think I’m more comfortable. Maybe I’ve done a little bit, possibly better than my dad, so they can probably experiment [00:10:50] a little bit more. Maybe I wasn’t in that generation where I could experiment, or my parents just came to this [00:10:55] country and that is what they think is the best.

Payman Langroudi: Survival was the key to.

Ammar Al Hourani: Survival is like always like, you know, where are we going to [00:11:00] get you know, I don’t know maybe about your parents. It’s similar to sometimes it’s my parents, but it’s like, you know, you never [00:11:05] know. You know, tomorrow they might tell you to all leave. You know, it’s always having that. It’s not an abundance mindset. It’s a scarcity mindset. [00:11:10] Whereas I think we’ve come up.

Payman Langroudi: Yeah, I mean, we we were running away from revolution. [00:11:15] And so when you’re running away from revolution, safety’s all you want isn’t it. And so safety [00:11:20] ends up being a profession.

Ammar Al Hourani: Well, that’s the thing. I think it’s the same with my parents. I think at that time it was [00:11:25] the I think the 80s and 90s in Syria. You know, they had the uprising at that point as well. And I think a lot [00:11:30] of really good professionals left the country and they have that. They’ve got, you know, the military police and, you [00:11:35] know, secret services and all that sort of stuff they were running from. So I think they didn’t want us to live that fear [00:11:40] they had. But I think in a way it sort of dissipates into you anyway, so you sort of have it to a lower [00:11:45] degree. Exactly. But now my kids don’t have that because I don’t really I don’t I don’t feel I don’t [00:11:50] have that problem to deal with. Does that make sense? I’m sort of lucky from that respect. So I thanked my parents for that for 100%, for [00:11:55] giving.

Payman Langroudi: Your kids haven’t ever lived in Scotland or have they?

Ammar Al Hourani: No, they lived in London.

Payman Langroudi: So they haven’t got any Scottish [00:12:00] feeling about.

Ammar Al Hourani: Zero. I think they’ve gone to Scotland a handful of times. How funny. Yeah, [00:12:05] I know nothing about Scotland.

Payman Langroudi: So you went to Glasgow? What kind of a student were you? Number one and [00:12:10] number two. Around what point did you think I’m going to specialise? [00:12:15] And around what point did you think? Endo?

Ammar Al Hourani: Uh, yeah. [00:12:20] Glasgow was good fun. Great city. I don’t know if you’ve been to Glasgow, I love it. It’s my favourite city. Favourite city [00:12:25] in the UK? Um, I was an average student. I don’t think I was in any way, shape or form spectacular. You know, [00:12:30] my grades were decent. I knew my stuff clinically, I was good, my knowledge was decent, but I wasn’t like an outstanding [00:12:35] student. Nothing like that. You know, some some of the guys in my year were far better for sure, [00:12:40] no doubt about it. Uh, and though I was really lucky, so Glasgow had a at that [00:12:45] time, we were sort of the guinea pig year because the year before was nearly didn’t get all their degrees. Uh, [00:12:50] something to do with the GDC or not following the GDC guide. So the GDC basically wrote our curriculum in essence and [00:12:55] ran our program. So we were lucky in the last two years we did a lot of outreach. So you do specialist clinics [00:13:00] and then outreach. So we were doing for about two years really before we even graduated, which was great. At [00:13:05] the time, there was a guy called Prof. Murray called Murray. Uh, had well, I think he was head of research at [00:13:10] the time. He taught me endo and we had the specialist sort of clinics, and I would [00:13:15] get one on one because a lot of times the students maybe didn’t have a patient or didn’t turn up. So I had patients and I [00:13:20] just did it and I really enjoyed it. I started to get get into it. I didn’t think it was going to be my sort of cup [00:13:25] of tea because believe it or not, I actually wanted to become an orthodontist. I didn’t actually want to become an endodontist. Arthur was always my [00:13:30] thing.

Payman Langroudi: But specialising was always in your head, right? So it was another Middle Eastern [00:13:35] kind of.

Ammar Al Hourani: I guess it’s a paediatrician. Yeah. My brother was going into orthopaedics at the time as well. [00:13:40] So I felt like it can be a general dentist. You know, it’s one of those things. So it plays on your brain. You sort of compete in a sense [00:13:45] as well.

Payman Langroudi: I get it, I.

[TRANSITION]: Get it, I get it.

Ammar Al Hourani: Um, so yeah, I mean, I did my first couple of years, it [00:13:50] was called a senior house officer at the time I was in called DCT. That was the old currency. I did that for a couple of years. That was good. I had an under rotation [00:13:55] within it, which was nice, like.

Payman Langroudi: Restorative ones.

Ammar Al Hourani: Restorative with an endo. It was a massive endo slant to it, like cutting [00:14:00] down the waiting list essentially. So I was really good at it, I enjoyed it at that point. My trainer was had an MSC in Endo, [00:14:05] so he taught me endo.

[TRANSITION]: Oh wow.

Ammar Al Hourani: So that was the first time I started to understand Endo, because he was making me do it on the rubber [00:14:10] dam, sodium hypochlorite. You know, he had all the gadgets. So I got to play with it and I got a lot [00:14:15] of the endo thrown at me because no one wanted to do it in the National Health. So I got to do a lot of endo. So I got good at it, to be fair [00:14:20] in that respect. Um, I then worked in practice for a few years. My sister was [00:14:25] a little bit unwell, so I had to go back home. And so I worked in general practice. I started taking on a lot of the endo [00:14:30] referrals in-house, enjoyed it, bought my own mortar and all that sort of stuff. It was all the expensive stuff. You didn’t have any [00:14:35] of the sort of brands that you have now. You know all the Japanese and Korean brands you didn’t have that. It was mostly [00:14:40] the German stuff, so you had to buy the expensive stuff, basically. But all that stuff enjoy doing. Endo got really [00:14:45] good at it, went to some courses, it was good. And then when I came back from the refugee camps, there was a job that came out as [00:14:50] a staff grade in Endo and that’s when I realised I wanted to become an endodontist.

Ammar Al Hourani: It’s sort of the profession. [00:14:55] I don’t have to explain. It’s like the speciality chooses you over time. You sort of fall into it because you do it [00:15:00] so much. It’s sort of you go, you know what, let’s just do it. And that was the first time I enjoyed going to work. I [00:15:05] started doing that all day, every day. And I loved my job. It was because down to a guy called Robert Philpot, he’s [00:15:10] a consultant at the time and Endo at Glasgow, and he’d just come out of Eastman, gone to Australia, come back, became a consultant [00:15:15] at Glasgow and he was amazing. It was just contagious. He made it lovable and so [00:15:20] he was the driving force behind me becoming a specialist, basically this guy. So and even when in my thesis, [00:15:25] I actually wrote his name as the guy who who made me love Endo. So it’s who you meet in life I think guides [00:15:30] you. And also the profession seems to choose you. I don’t know how to explain that especially chooses you down the line. [00:15:35] Yeah. And so that’s how I sort of became an endodontist. And I’ve never, ever regretted it. I love my [00:15:40] job. Get buzz out of it every day. I feel it’s like a little hobby. I don’t actually feel like it’s a job.

Payman Langroudi: We’ll [00:15:45] come back to the end. Tell me about the refugee camp.

Ammar Al Hourani: 2013. [00:15:50] Me and my dad went to the refugee camps to work for a little while, and then a few other guys went along [00:15:55] with it. We had two dental clinics that we ran 24 hours a day, pretty much [00:16:00] in Rehaniya, which was a town between the city and the Turkish border, had 25,000 [00:16:05] people in it. No services. So then they opened up a hospital. It was a Kuwaiti hospital called the Orient. [00:16:10] My dad opened up a paediatric unit. There was an eye like a prosthetic [00:16:15] eye clinic as well, because a lot of people lost their eyes. That was next door to us. We did that on and off for about nine months. [00:16:20] Brilliant experience. It’s an absolute like.

Payman Langroudi: What was what was the equipment like? Was it. [00:16:25]

[TRANSITION]: Zero?

Payman Langroudi: Oh, really?

Ammar Al Hourani: Yeah. It’s what you get in most refugee camps, you know, like the [00:16:30] heat steriliser and, you know, the basic forceps, some drills, some files. You know, a lot of companies, [00:16:35] to be fair, our sponsor does. We got a lot of donations, but we were running out of money all the time, like we were digging into our own [00:16:40] pockets pretty much every single month because the volume was sensational. And [00:16:45] the problem was, when you go to a refugee camp, it’s a very unusual. You’ve got a very middle, [00:16:50] upper class or middle class families that now live in a refugee camp. They still have the mentality [00:16:55] of, I want the hand on the crown, I want the white filling I want. They don’t seem to have [00:17:00] realised that they’re actually now living in a refugee. They’ve lost everything. Does that make sense? And I think it’s a part of them still [00:17:05] wants to hold on to their identity. So they’ll come to you saying, oh, I’ve got this thing, can you do this? [00:17:10] Can you do.

[TRANSITION]: This?

Ammar Al Hourani: And I’m like, I don’t have I don’t have that type of material here.

Payman Langroudi: It’s a very good point. Yeah. Insomuch [00:17:15] as we feel like refugees are these downtrodden people.

[TRANSITION]: But [00:17:20] a lot of them.

Ammar Al Hourani: Are like me and you.

[TRANSITION]: Exactly like me.

Payman Langroudi: You forget. You forget that, you know, they were regular people, [00:17:25] professionals. Some of them were whose lives got overturned suddenly.

Ammar Al Hourani: Overnight, lost everything. Yeah, [00:17:30] yeah. Their teachers, doctors, I don’t know, pharmacists, you know, you name it, who’ve lost suddenly, lost [00:17:35] everything overnight because of a war. And so they’ve still got that mentality, [00:17:40] but in a refugee camp. And it’s very difficult. I mean, I sometimes it’s difficult to, to, to, to [00:17:45] work with them or achieve their ideal settings because I just didn’t have the materials [00:17:50] and that wasn’t that just wasn’t the right place to do it. You know, what.

Payman Langroudi: Did it teach you? Do you do you recommend [00:17:55] all of us do it?

Ammar Al Hourani: Yeah.

Payman Langroudi: Yeah, because Rona does. Rona goes to [00:18:00] Lesbos.

Ammar Al Hourani: I saw that. Yeah, it was very impressive. Yeah. I mean, like, listen, before I went, I was just [00:18:05] a I was a dentist. I was making good money in Scotland, to be fair. Very good money for my age group [00:18:10] playing football, chilling out with the guys. You know, like all of us. I was pretty selfish. Self-centred, [00:18:15] you know what I mean? Like the the life you thought you were. The whole world is based around you, basically. [00:18:20] And then you suddenly turn up to these places and you’re like, oh my God, I’m. What am I thinking? [00:18:25] And I did a lot of growing up, a lot of growing because you get a lot of time in silence where you just sit [00:18:30] with your own mind and you’re like, what am I wanting to do with my life? Because at that point I was sort of doing stuff, [00:18:35] but I didn’t really have a plan. Does that make sense? I was sort of like walking to nowhere. I was, you know, I was like, [00:18:40] blindfolded. I didn’t really know where my life was going. Didn’t know where my career was going. I was just doing a little bit of everything [00:18:45] in the hope that I sort of landed on something. And that was the first time where I sat down and [00:18:50] had a lot of time to think. And I was like, you know what number of things I’ve realised? One, [00:18:55] I’m not all that, you know, I’m actually a speckle. Two, [00:19:00] I’ve got all the resources in the world, but I’m not using it. Why not? Three people would love to be in my [00:19:05] shoes. Why am I not taking full advantage of that situation? And what was my limiting factor? [00:19:10] Me, I was just scared of taking a risk. And actually I realised that I also [00:19:15] had a lot of, you know, not great friends as well. So I had to get rid of some baggage. You know, you realise [00:19:20] very quickly, actually, there’s a lot of people holding me back. And four, am I being authentic? I’m not being myself. I’m [00:19:25] trying to please everyone around me, but not me. Does that make sense? And so it.

Payman Langroudi: Does. I mean, it’s interesting [00:19:30] that that sort of break, it takes a stop and a break and a change for [00:19:35] you to think about your life. I mean, Covid was a similar thing, wasn’t it? Yeah.

Ammar Al Hourani: It wasn’t really that ambitious either, to be fair. [00:19:40] So I came back as a completely different animal. I wanted it all not because I was greedy, but I was like, [00:19:45] you know what? I’ve got a great I’ve got a golden ticket in the UK. I could do, I could do whatever I want, genuinely.

Payman Langroudi: What about [00:19:50] the stories of the refugees? I mean, what were some of the things that you heard and how [00:19:55] long were people in that camp for?

Ammar Al Hourani: Years.

Payman Langroudi: Years and years.

Ammar Al Hourani: Yeah. Like you’ve got [00:20:00] swathes of population now who’ve never, you know, kids probably older than my kids now who’ve never had [00:20:05] an education, a formal education. They’ve been born in a refugee camp, never been to school.

Payman Langroudi: Wow.

Ammar Al Hourani: Probably never seen a pencil [00:20:10] case. First day I turned up. I’ll never forget this day. First [00:20:15] day I turned up literally ten. 12. Dead bodies on the floor. Blood everywhere, screaming everywhere. I was like, [00:20:20] what am I doing here? And then I got called up by a two guys like, oh, we’ve got this guy who’s [00:20:25] been shot in the face. Can you come and take the bullet out? Like sorry. Sorry. [00:20:30] What? What? Why? Why do you want me to do this? You’re the most qualified. I was [00:20:35] like, well, you two are wearing white coats. Why can’t you do it? Oh. We’re vets.

Payman Langroudi: Wow. [00:20:40]

Ammar Al Hourani: I’m like, okay. And so that’s the type of stuff. It’s just a bit of shrapnel I removed from his face. [00:20:45] But, you know, I’ve done a bit of Max Fox before, but again, you don’t deal with, um, with [00:20:50] gunshot wounds in Max Fox. That just doesn’t happen in the UK. Really? That type of violence. Maybe in bigger cities, but [00:20:55] not in Dundee, where I did it for a period of time. In Preston, you don’t get that type of stuff. So [00:21:00] yeah, it was uh, yeah, you see some horrors, but then you get used to it. I don’t know how to explain it. You become sort [00:21:05] of habituated to bad, bad news, you know, and it becomes part of your life. For a period of time, it was very cold. [00:21:10] That was another thing as well. Oh, really? Turkey’s freezing like it is cold.

Payman Langroudi: And what were your, like [00:21:15] living conditions?

Ammar Al Hourani: We lived in, uh, like, either we lived in a caravan or we lived in, like, a [00:21:20] little room that we had.

Payman Langroudi: Like you were in the camp itself. You weren’t, like, outside in a hotel or something, like. No, [00:21:25] no.

Ammar Al Hourani: There was no hotel. Where do you go? There’s no like I can’t. I can’t say like Payman. Let’s. Let’s meet up at that coffee shop [00:21:30] tomorrow. There’s no coffee shop.

Payman Langroudi: Are you in the camp? In a in a little caravan thing?

Ammar Al Hourani: Pretty much. Yeah. I can’t just go. [00:21:35] Oh, let’s grab dinner tonight or we’ll go to that restaurant. There’s no restaurant. You know, it just doesn’t exist. [00:21:40] It’s not. It’s not your normal day to day life. There’s nothing. It doesn’t make. It took me a good month or so just to get my head around it, to be [00:21:45] honest with you, because it just didn’t make any sense. Then after that, you you. It’s beautiful how the human body [00:21:50] just develops. It just becomes normal. It’s like, oh, you know, this this. I’m in a disaster [00:21:55] zone, basically. But it was good. It was good fun. I learned a lot from it. I learned I made some really good people, which I keep [00:22:00] in touch with to till today. And it made me grow up. I think had I not done it, I wouldn’t be the person I am today. [00:22:05] No chance I’d be. I’d be a very different person now. Yeah.

Payman Langroudi: So then you [00:22:10] come back with this new sort of mindset of you’re going to make the most of yourself. [00:22:15] Yeah. And you’d already done a bunch of endo, I guess. And so now you was [00:22:20] it. Now you decide I’m going to specialise and be, you know.

Ammar Al Hourani: So like I took that staff. Great job in Glasgow for [00:22:25] about nine months. I met this guy, Bob Philpot. Robert. Hi, Robert. If he’s listening to this, [00:22:30] probably won’t, but, um. And he was just amazing. And so it was just a waiting [00:22:35] list initiative, essentially, where you just reduce the waiting list for Glasgow Dental School so that for about nine months [00:22:40] loved it. Used to go to work with a buzz every single day. Every day. Enjoyed it. And I was like, you know what? This [00:22:45] is it. This is what I want to do. But the problem is, when my CV wasn’t strong enough, so I still had to go back to some maths facts, build [00:22:50] my CV to apply.

Payman Langroudi: Just to get in.

Ammar Al Hourani: Yeah, it’s quite competitive getting to the end though. There was only maybe 8 to 12 places [00:22:55] a year so I didn’t get in for a couple of times. I got in the third time at Liverpool. [00:23:00] Um, I approached a guy called Fadi Jarrad. He was the head of department at Liverpool, started chatting [00:23:05] and yeah, I went for an interview, got in. So like, I thank him for essentially having [00:23:10] faith in me to bring me on to the program because at that point I was starting to give up hope. You know, getting into that program is hard, [00:23:15] you know? So he saw he saw something in me, I suppose. So, like I’m quite grateful for that. And then I got [00:23:20] in and just yeah, I just really enjoyed the experience. For four years it was three, three, three, four years. Yeah.

Payman Langroudi: Part time. [00:23:25]

Ammar Al Hourani: Full time.

Payman Langroudi: Four years, part full time.

Ammar Al Hourani: So it was three years, but I had an extension to it. So I had [00:23:30] to do an extension for my doctorate because I didn’t finish it off in time. So I had to take.

Payman Langroudi: And you had to pay as well.

Ammar Al Hourani: Yes, sir. [00:23:35] Yeah. Pay money? No salary.

Payman Langroudi: So how did you pay for it?

Ammar Al Hourani: So I had [00:23:40] savings at the time, so I wasn’t lavish in my lifestyle, which was good. So I saved up a lot of my money, [00:23:45] which is good. So I used that. Um, I worked, yeah. So Monday, Tuesday, Wednesday was in clinic. I stay [00:23:50] in a library. Well, not library, either a library or the common room that we had till about 11 doing my research or [00:23:55] from home. Thursday I’d go and work privately doing endo in Huddersfield and in Liverpool. [00:24:00] So I worked in a few clinics. Friday I would do the lectures that we [00:24:05] would get trained on a Friday or get our seminars on the Friday. Then I used to do the second on call, either at Preston [00:24:10] during the weekends, or I used to do the EDS emergency dental services in Morecambe. [00:24:15] Preston. Was that part.

Payman Langroudi: Of the.

Ammar Al Hourani: Course? No, no.

Payman Langroudi: That was trying.

Ammar Al Hourani: To save [00:24:20] some cash basically. Yeah. And then weekends at work. So I did that for three years. Literally never took [00:24:25] a day off.

Payman Langroudi: Wow.

Ammar Al Hourani: And I had a kid at the time, so I didn’t. When I went into training, I didn’t really factor [00:24:30] in nursery school fees. Yeah. I didn’t factor in. I had a child or a wife. Does that make sense? I [00:24:35] didn’t factor in a family.

Payman Langroudi: When had you gotten married?

Ammar Al Hourani: 2014. [00:24:40] 2014.

Payman Langroudi: During all of this stuff? Yeah.

Ammar Al Hourani: So I came [00:24:45] back from refugee camps, met my wife, uh, got married at the time. My wife. Um, [00:24:50] yeah. And then the specialist training. And so, like, I had. Yeah, like a whole family [00:24:55] with me to deal with. I would definitely say do it if you’re single or just married with no kids, don’t [00:25:00] do it the way I did it. It’s really difficult on your marriage, for sure. It’s difficult [00:25:05] on a lot of things. It’s just you disappear. You disappear into thin air, essentially.

Payman Langroudi: I’ve spoken to a bunch [00:25:10] of specialists who talk about that sacrifice. Right. Um, at the same time, [00:25:15] it’s worth it, right? You know that.

Ammar Al Hourani: Well, it depends what’s worth it.

Payman Langroudi: Yeah.

Ammar Al Hourani: What is [00:25:20] worth it? What are you sacrificing? You know. So for me, uh, I just love my career. You [00:25:25] know, I’m quite young. I wanted to have a good life, to give my family a good life. I need to have a good life. Does [00:25:30] that make sense? So all permeates down. If you’ve got a good income, your family have a good income good, and so on and so on. [00:25:35] Uh, so yeah. So something had to give. To be fair, at the time, she was very supportive. She helped me out [00:25:40] tremendously. But it’s it puts a lot of stress on it as well. So special training [00:25:45] I would say do it if you’re not married and have kids, I definitely think so. If you’re going to do it afterwards, [00:25:50] I think it’s going to it’s a bit more tricky. You’re going to have to manage a lot more stuff, and it’s whether or not you [00:25:55] can manage it, you can come out the other end. That’s the difference.

Payman Langroudi: So then how much is the [00:26:00] course?

Ammar Al Hourani: It’s about 20 grand a year cash, so you have [00:26:05] to pay it in two instalments or three instalments, 20 grand plus your living costs, which is about another [00:26:10] average living cost at the moment. How much would you need? About a month. Three grand, maybe 3 or 4. It depends [00:26:15] where you live, I suppose. Yeah, but for for us we need about three grand a month. About three, three and a half grand [00:26:20] a month. We needed to just about get away with it every month, you know, rent, kids, schooling and all that sort [00:26:25] of stuff. And that was tight, you know, it was tight, but it was okay. And my parents helped, you know, she helped a little [00:26:30] bit as well. You know, it was good. Like everyone sort of chipped in. So we made it work. If you want to make it work, it will work.

Payman Langroudi: Liverpool’s [00:26:35] a good town. Oh great I love Liverpool.

Ammar Al Hourani: Brilliant city. Love it. Brilliant people.

Payman Langroudi: Yeah. [00:26:40]

Ammar Al Hourani: Brilliant city. Good university. Yeah. It’s a very similar to Glasgow that the Celtic connection. The Irish [00:26:45] descent city you know ship making and stuff. So it felt home from home. It didn’t, I didn’t feel it’s [00:26:50] just the accent was a little bit difficult at the beginning to pick up. But after that it was all good. And it’s nice. It gets a bit. [00:26:55] Liverpool gets a bad rep. I don’t know why. It’s actually a great city. It’s not. It’s not that bad at all, you know.

Payman Langroudi: So [00:27:00] it’s my favourite. I like Scousers, they’re just funny, good fun.

Ammar Al Hourani: They’re chilled out, salt [00:27:05] of the earth.

Payman Langroudi: But you’re right, like Glasgow people. I remember when I was on the road, I used to stay [00:27:10] in Liverpool, over Manchester and Glasgow over Edinburgh and [00:27:15] Glasgow and Edinburgh. I just couldn’t understand how like 40 minutes could make such a big difference [00:27:20] to the culture of these people. Man. Correct. Because I was young, I was young enough to want to like, go [00:27:25] and go out and see what’s going on in this city in Glasgow, always end up sitting on the pavement [00:27:30] with 30 people sharing pizza. Yeah that’s Glasgow. In Edinburgh I wouldn’t meet a [00:27:35] single person like no one, no one. And I couldn’t understand how it could be so, so different. Yeah, [00:27:40] I agree, but they are no even massively accents. Massively different.

Ammar Al Hourani: Edinburgh doesn’t have much of [00:27:45] an accent. Yeah, it’s very very, you know, Queen’s English.

Payman Langroudi: And the funny thing is from the outside [00:27:50] you always think Edinburgh is so beautiful, stunning. You know, you always think Edinburgh is the place to be in [00:27:55] Scotland. Definitely Glasgow from the outside because of how beautiful it is. Right. I mean, the.

Ammar Al Hourani: Heritage [00:28:00] site isn’t it? Edinburgh is one of the nicest cities in Europe, isn’t it? Yeah.

Payman Langroudi: So yeah. No, it [00:28:05] always I always think there are lots of areas of cities that are pretty, [00:28:10] but not a city with a whole thing is so beautiful, you know. It [00:28:15] is. You know, you can find a nice bit of London, a nice bit of anywhere, right? But the whole thing [00:28:20] is just.

Ammar Al Hourani: It’s a beautiful city. But then the problem with Edinburgh is you also walk in town. I don’t know if you’ve noticed. It’s very touristic [00:28:25] and then you sort of reach the end of the city. You’re suddenly walking down Princes Street and you’re like, right, I’ve reached the end. Yes, [00:28:30] Glasgow doesn’t have that. Glasgow is just it’s a fun city. It’s great. It’s got a little bit of danger, a [00:28:35] little bit of a little bit of intrigue. But people are brilliant. Good laugh. You can always have a [00:28:40] chat with a guy in a bus stop. It’s very therapeutic. Um, no, I love Glasgow, it’s [00:28:45] great. But my brother went to Edinburgh and so like we, we have that sort of Edinburgh Glasgow clash all the time, but [00:28:50] they’re both brilliant cities to be honest with you. But.

Payman Langroudi: So it’s four difficult years I guess. [00:28:55]

Ammar Al Hourani: Yeah.

Payman Langroudi: You come out now, you’re a specialist.

Ammar Al Hourani: Yeah.

Payman Langroudi: What do you do next? [00:29:00]

Ammar Al Hourani: Well, you come out unemployed. That’s essentially what happens. Yeah. You come out, you [00:29:05] don’t have a job. You know, it’s not like medicine. You come out and you know you will eventually get a consultant job or something. You know, [00:29:10] a locum job, or you’ll sort yourself out, you know, you’ll get a job. You’re never going to be unemployed. Basically, as a doctor here [00:29:15] was a specialist and I didn’t really have a job. So yeah, at the time I’d sort of, [00:29:20] um, it was a discussion I had with my wife at the time. And, you know, I was going back to London. She’s from London. [00:29:25] So we came down to London. It was either Scotland, stay in Manchester or go down to London, you know, uh, [00:29:30] Scotland, I think I would have done well, but it’s a much smaller market. Manchester [00:29:35] was good, but it was already getting really saturated. You know, there was a lot of specialists coming out because of the end of the MSC [00:29:40] programme. You had Sanj, who was teaching at Liverpool at the time. You’ve got Uclan coming along, so there’s a lot of dentists [00:29:45] special interest, maybe not as many specialists, but definitely a lot of dentists special interest. So it was starting to get a bit saturated. [00:29:50] Or then you go down to London and London. You know, no matter how people say, London will always [00:29:55] need more, you know, like it’s just it’s just an all consuming city. But [00:30:00] the problem was I started from zero because I know, like, who am I? I didn’t.

Payman Langroudi: Know anyone.

Ammar Al Hourani: I didn’t know anyone. So [00:30:05] I had to take any job I got to. I had imposter syndrome because I wasn’t really I didn’t feel [00:30:10] like a specialist, you know, I didn’t have enough. I didn’t make enough mistakes to feel like a specialist. I didn’t. I [00:30:15] needed to make my mistakes, you know? I needed the volume. Three people had to buy you stuff [00:30:20] and believe in you because, you know, setting up an indoor referral.

Payman Langroudi: Is very.

Ammar Al Hourani: Expensive. Yeah. You’re looking at 30 [00:30:25] grand probably by the time you buy all this stuff. Probably more. Yeah. So, like, you know, if no one knew who I am and [00:30:30] I’ve got specialist badge and then I’m saying I’ve got me go and go and buy me 30 grand’s worth of stuff like, you know.

Payman Langroudi: So what happened? [00:30:35] How do you negotiate this?

Ammar Al Hourani: So some clinics approached me, which was great. I put adverts out, some [00:30:40] I sort of stumbled upon through friends and just grew it. And I was working in, I think at the time, like maybe [00:30:45] 12 different clinics.

Payman Langroudi: Wow.

Ammar Al Hourani: In two days here. Two days there. Yeah. Like I was just all over the [00:30:50] place, and I was just. No one knew who I was. And, you know, there was a lot of big names already here. You know, people who’ve maybe [00:30:55] written some of the textbooks I was reading or, you know, using the file systems they’ve developed. So I was like, literally, [00:31:00] I was a nobody. You know, you definitely felt like a nobody. And it was a new city. I’m not from London. I [00:31:05] must admit, I don’t like London as a city. It’s not my it’s not my place. I like living outside London. I don’t like London [00:31:10] per se. I like for dinners and stuff going out, but definitely not living in it. So it was very foreign to me. I was [00:31:15] now a Scot who was living in London. Uh, didn’t know my left from my right. Uh, I wasn’t [00:31:20] making a great income. Yeah, I was it was a lot going on at the same time. So that’s when I started Dental guys, basically [00:31:25] that was the that was the whole launchpad of the whole thing to get my name out there. [00:31:30] Essentially. That was it to get referrals like that.

Payman Langroudi: I like how open you are with that. [00:31:35] Yeah. Um, but how come you weren’t making good money if you were working in 12 different clinics?

Ammar Al Hourani: That’s [00:31:40] one. The pricing structure probably wasn’t the best in some places. I was. Still, I didn’t feel like I was worth. [00:31:45]

Payman Langroudi: Maybe you weren’t charging enough.

Ammar Al Hourani: No, I wasn’t charging enough. I think I was I didn’t feel I was worth more [00:31:50] than £600. I’m not being funny. I’m charging a lot more now. But at the time, you know, I went from charging, [00:31:55] what, £200, £300 in the end in Huddersfield. Yeah. To then suddenly saying it’s £600. So for me it was [00:32:00] already.

Payman Langroudi: Sounded like a.

Ammar Al Hourani: Lot. And I’m like oh my god £600. You know that’s a lot of pressure. And so I [00:32:05] just didn’t feel ready for that sort of jump yet. I definitely had imposter syndrome, there’s no doubt about it, you know. And, [00:32:10] um, yeah. Then you start competing, you know, comparing yourself to other, more established endodontists [00:32:15] and you’re like, oh my God, am I ever going to get there? Am I? Who am I? What am I doing? Am I in the right [00:32:20] city? Should I leave? You know.

Payman Langroudi: So how long did it take before you felt like I’m actually, [00:32:25] you know, making progress.

Ammar Al Hourani: 3000 handles, 3000 handles. [00:32:30] Later, I think I felt like I was ready to rock and roll. I could probably do, you know, I felt I could do just about more [00:32:35] stuff to a relatively decent level.

Payman Langroudi: So how long did that take? A couple of years.

Ammar Al Hourani: About four years. [00:32:40] Three. Four years.

Payman Langroudi: Four years?

Ammar Al Hourani: Yeah. Three. Four years of travelling and working. You know, making some mistakes here [00:32:45] and there and everywhere. Not big mistakes, you know, small little mistakes here and there where your brain starts going. Oh, [00:32:50] I’ve been here before. Don’t do that. Or, you know, take that turn. Not that turn, you know. And all these little experience I would [00:32:55] have bought, you know, if you told me, pay 100 grand for five years experience, I would have paid you a hundred grand right there and then for five years experience. [00:33:00]

Payman Langroudi: Yeah.

Ammar Al Hourani: Yeah. All day.

Payman Langroudi: Long. I mean, you’re right to sort of correlate experience with mistakes. [00:33:05] Yeah. Because that’s what it is. There’s there’s no getting away from that 100%. [00:33:10] You can’t buy experience. It’s difficult. It’s difficult.

Ammar Al Hourani: Very difficult. So. [00:33:15]

Payman Langroudi: So I mean, we will talk about mistakes later. Yeah. [00:33:20] Let’s, let’s let’s get to Endo. Let’s let’s talk about endo now. Yeah. Um, [00:33:25] I don’t know. I haven’t really looked at it for 20 years, to tell you the truth. Yeah. [00:33:30] Um, but I kind of want to go down sort of in each area. [00:33:35] I want you to give one solid, like, amazing tip that would improve [00:33:40] anyone’s. Yeah. So in each area diagnosis. What is it about diagnosis [00:33:45] here that most of us don’t realise or should realise or.

Ammar Al Hourani: Listen to the patient? [00:33:50]

Payman Langroudi: Go on.

Ammar Al Hourani: Listen to the patient. Honestly, the patient will tell you everything. See, [00:33:55] a lot of us jump to a conclusion by looking at a radiograph and the referral letter that’s been sent.

Payman Langroudi: Yeah. [00:34:00]

Ammar Al Hourani: So you go. Oh, okay. It must be this. Actually listen to the patient before. You know it [00:34:05] actually isn’t that at all.

Payman Langroudi: Or an example.

Ammar Al Hourani: An example.

Payman Langroudi: What’s a patient going to say?

Ammar Al Hourani: That’s what [00:34:10] patients, for example, will come in. Dentists would say could you do this root canal treatment toothless tip. [00:34:15] But that in itself is not diagnostic. Ttp standards to percussion could be [00:34:20] anything. Inflammation of the PDL can happen because if anything patient comes in they’ve got high filling. They’re [00:34:25] grinding their teeth. They’ve got something stuck in their gum. Their gums are a [00:34:30] bit swollen. Before you know it you’re like, listen, I think you should reduce the filling and your tooth is a lot. You [00:34:35] know, you do a bit of sensibility testing radiograph looks fine. Bit of widening of the PDL. Done. [00:34:40] No, no endo required. They’re delighted. They’ve come in wanting thinking they’re going to pay £1,000. [00:34:45] Fernando. Now you’ve said just I’m going to reduce your cusp down a little. You know your filling down a little bit. Keep an eye on [00:34:50] it. Get a night. Night night. Splint. Check that out. You know. Masters are massive. Temporalis is big. [00:34:55] You know, you’ve got tongue scalloping. You’re a bruxism. Go and get that sorted out. Done. [00:35:00] Patients happy? You know, literally little small things. Like just listen to the patient and do a proper [00:35:05] exam.

Payman Langroudi: That’s it. Let’s say you decide now you’re going to go and you’re going to do an endo. When you when [00:35:10] you’re looking at that radiograph what’s the key thing. Is it is it as [00:35:15] simple as you know the, you know pathway of that file and acts how the access needs to be for [00:35:20] that curve. Is that all we’re saying.

Ammar Al Hourani: I think the first thing is look at the radiograph properly. Go on. Okay. So look [00:35:25] at the I always split the radiograph into three parts. Crown middle of the root somewhere. You know where [00:35:30] the the bone level is and then the root. Look at all three parts really really well. [00:35:35]

Payman Langroudi: Yeah.

Ammar Al Hourani: Once you’ve broken that down then you know what to do with the crown. You know what to do at the coronal third which is relatively [00:35:40] straightforward to get into. You know, and then you can look at the apical third and then you can decide how am I going to access [00:35:45] this properly. Okay. So that’s number one. Number two if you’re going to do the access don’t go for ninja [00:35:50] access as in all that sort of stuff. You know, like if you’re a novice and you don’t do lots of handle, just make your life easy. Make [00:35:55] it big enough to do the job properly.

Payman Langroudi: Yeah. So just explain it. For people who don’t know, ninja access means you’re [00:36:00] super minimal.

Ammar Al Hourani: Super conservative.

Payman Langroudi: Cavity.

Ammar Al Hourani: So small that it’s like the size of the [00:36:05] bung of your, you know, k file, you know.

Payman Langroudi: Yeah. And amongst amongst you guys. That’s kind [00:36:10] of a kudos point, right? Like amongst the super specialists.

Ammar Al Hourani: The irony is a lot of us probably don’t [00:36:15] do ninja accesses.

Payman Langroudi: No. Just for Instagram. Right. Yeah we do.

Ammar Al Hourani: That on Instagram on where you’ve sort of fluked it and you go, [00:36:20] right, I’m going to take a photo of this and show this up. But the reality that’s only a snapshot in time. That’s not how we do it every single [00:36:25] day. Because honestly, you do that. Ninja access. Good luck. Cleaning it out. [00:36:30]

Payman Langroudi: Is the whole point of it. Just to conserve tooth, is that it? Yeah.

Ammar Al Hourani: I mean, yeah, the more you keep, [00:36:35] the better it is for long term. But then you don’t want to be in a situation where you keep so much that you actually have lost the biological [00:36:40] concept of why you’re doing endodontics, which is to get the rubbish out basically, you know, so if you’ve got [00:36:45] the pulp chamber still kicking around and you can’t remove that pulp stone, you can’t find the canals and you’re going to snap [00:36:50] an instrument down there because the access is so small, you’ve sort of defeated the whole purpose. You’ve just made your life more difficult and [00:36:55] you’re not going to get the outcome you probably want. So what was the point? Make it a bit bigger.

Payman Langroudi: I’m probably asking silly questions because [00:37:00] it’s been so, so long for me. But is the access always the same for [00:37:05] each tooth, or is it?

Ammar Al Hourani: Pretty much. Yeah. Once you’ve done enough. Yeah, it’s almost the same.

Payman Langroudi: Pretty much. You don’t [00:37:10] sometimes change the access for a particular curvature of the canal sort of thing.

Ammar Al Hourani: No. You want straight line access. [00:37:15]

Payman Langroudi: So you do something to make it bigger. Bigger? Yeah.

Ammar Al Hourani: I’ll just try to sort of. Yeah. Open it up so that I get straight [00:37:20] line access. So I put less stress on the file, meaning I don’t have multiple curvatures or multiple planes to the file. [00:37:25] So I don’t want to go in at one angle. I’m in a canal. Another angle. And then it’s a third angle that you’re going into. [00:37:30] Or a fourth angle sometimes can be turning away in two different planes. They’ve put for, you know, a cape. I [00:37:35] think what a lot of people misunderstand sometimes is the system that we use is a little bit like a [00:37:40] paperclip. It has areas of tension, compression. You keep doing that long enough, you’re going to snap it somewhere. These [00:37:45] files are great, but they don’t want that much stresses on them. So the less stress you put on them. [00:37:50] And obviously keep some arrogant in the canal so you don’t overheat it either. Temper it down, give it a glide path, [00:37:55] absorb a lubricant, I suppose. Yeah. Then it’s going to make your life a lot easier. So [00:38:00] I’ll get straight line access. I don’t want to put too much stress on that file.

Payman Langroudi: Do we need to discuss that? Is there anything you do [00:38:05] differently regarding isolation than.

Ammar Al Hourani: Rubber dam.

Payman Langroudi: And liquid.

Ammar Al Hourani: Rubber dam and liquid dam? That’s it. That’s all you need.

Payman Langroudi: Okay. [00:38:10]

Ammar Al Hourani: Yeah. Keep it simple.

Payman Langroudi: So. And the instrumentation itself. Yeah. Does any [00:38:15] one hand file any more at all? Is there a is there a place for it or is it 100%.

Ammar Al Hourani: I mean, you still need the hand filing the size [00:38:20] eight and ten k file to get your patenting and your initial sort of glide path. I mean, that that still is [00:38:25] the hardest part of antibiotics, you know, trying to get down with the K file. Yeah. And trying to [00:38:30] get patency. That still is the hardest part. And that part you still have to understand how to do [00:38:35] well. Understanding the k file when it clicks, when it works, when it cuts, when it doesn’t work, that’s [00:38:40] actually the skill. Once you’ve got a size ten, they’re relatively loose. You’ve got so many great file systems [00:38:45] now in the market that will blast away all the way through it. That’s still the hardest part. So yeah, you still need to understand [00:38:50] hand instrumentation very, very well to that point. But do you need to do stepwise technique like [00:38:55] we used to do in the past? No I know you don’t need that. You’ve got such a great file systems now that are not [00:39:00] that expensive. Really that will do you a great job, a very predictable job. And ultimately it’s just [00:39:05] there to create space for the arrogant. Yeah. And it was all about bleach. Like literally if you boil it [00:39:10] down to one thing, it’s bleach. Get the arrogant into the apical arrogance.

Payman Langroudi: Not moved on from bleach.

Ammar Al Hourani: No, [00:39:15] bleach is still the king.

Payman Langroudi: Delete it.

Ammar Al Hourani: No. No.

Payman Langroudi: Is that. Is that an old thing? [00:39:20]

Ammar Al Hourani: You’re. You’re already at body temperature anyway. You’re already at body temperature. So what’s the point?

Payman Langroudi: You know, I thought maybe you heat [00:39:25] it so it kills more bacteria or something.

Ammar Al Hourani: It can do. It can do. It’s more effective. But the problem is then it becomes more runny. And if it goes through [00:39:30] the apex. Good luck. Yeah.

Payman Langroudi: Becomes more funny when you.

Ammar Al Hourani: Eat a bit more runny when you heat it. So you don’t want to be overheating [00:39:35] it too much. I don’t see the point because you’re also activating it when you activate it. You’re also warming it up a little bit. [00:39:40] So your tooth is already a basin at body temperature. So it’s going to naturally warm up irrespective. And [00:39:45] you’re using lots of volume. So because you’re using lots of volume it’s going to do the job. You know it’s all about volume [00:39:50] and time and again it’s the apical third. You get it there. You’re going to be really good. [00:39:55] It’s what you remove. It’s not what you put back in. So as long as you.

Payman Langroudi: So you’d say if you had to choose one or [00:40:00] the over the other. The irrigant. Bleach is more important than removal [00:40:05] of sort of infected dentine or something like this.

Ammar Al Hourani: Yeah. Still bleach I think is number one. I mean, they both actually. [00:40:10] You need both. Yeah. That’s why it’s called chemo mechanical. Because you need the mechanical to create space and maybe remove some of that [00:40:15] infected debris on the dentine. But the problem with that is you don’t remove enough. If we’ve got a lot of cbct studies, [00:40:20] which shows that files only touch maybe less than 50% of the surface. So that means because, you [00:40:25] know, the canal is an ovoid, you’re creating a cylinder within an ovoid. So that means two sides of the ovoid are never going to [00:40:30] be touched. And the only way you’re going to get in there is by activating with an arrogant. So you need the activation to move it. [00:40:35] It’s like having a bath. You need to jump in it to move the whole thing around. So it’s the same concept. The problem is with needle [00:40:40] irrigation, you can’t get the irrigate into the apical third. It’s just not possible. Like again it’s. You think [00:40:45] bleach is thin, you know, runny. But actually when you use it under the microscope, it’s actually quite thick. It’s not as thin [00:40:50] as you think it is. It is far thinner. So that’s when you start seeing the disparities. So you need [00:40:55] to push that arrogant down there. So you have to use either PowerPoint, just push it in, or you’re gonna have to use an activator [00:41:00] of some form. There’s a lot of cheap products out there that can do that for you. So we’re in a great era of [00:41:05] really affordable, great products, if I’m being honest with you. So.

Payman Langroudi: And are they. Okay. So now now [00:41:10] I’ve sort of opened it up. I’ve got bleach around. Are they good [00:41:15] and bad? Apex locators and um, is it a type [00:41:20] you should stick to or.

Ammar Al Hourani: I’ve got one type I love the pro Pax Pixi by Dentsply Sirona. I think it’s a [00:41:25] really great apex locator does a great job for me. Anyway, you’ve got the Morita, which is probably the most studies. [00:41:30] Apex locator. I think that’s really good, but it’s a little bit jumpy in my hands, so I don’t really use it [00:41:35] as much. And then you’ve got a lot of other apex locators. So what works in your hands? As long as you get consistency it’s what works in your [00:41:40] hands. Use whatever you like.

Payman Langroudi: But are you are you sort of system agnostic when it comes to [00:41:45] preparation and filter?

Ammar Al Hourani: Yeah. If you come to the clinic, everything’s OCD, everything’s in [00:41:50] a stage. So if you people are more than welcome to come and shadow me, by the way. But yeah, if you come and watch me, [00:41:55] my setup is, you know, it’s exactly from start a from the burr all the way to Obturation. It’s all set [00:42:00] up in a chronological order. And it’s always been like that. It doesn’t change.

Payman Langroudi: But you don’t follow a particular [00:42:05] type of like, uh, school of.

Ammar Al Hourani: Uh, so I like I like going for much more minimal taper [00:42:10] now, uh, and I don’t like the big tapers anymore because I think you’re stripping away too much dentine. So I do [00:42:15] like the minimal taper, but I still like to make, you know, strip out enough, not strip out, but clean out enough. The dentine, [00:42:20] I suppose, or remove enough of the infected dentine. But yeah, I like to go minimal a minimal now [00:42:25] much more minimal. Keep as much tooth as possible. The more you keep the better the outcome, because whenever you remove you can’t replace. [00:42:30] No material out there is going to replace what you’ve just lost. So I like to stay as minimal as possible. So [00:42:35] that gives us the best long term outcome.

Payman Langroudi: And then the filling.

Ammar Al Hourani: Filling is in the obturation or the coronal [00:42:40] seal filling.

Payman Langroudi: No the obliteration.

Ammar Al Hourani: Obturation I use bioceramic sealers now. So I love bioceramic sealers. [00:42:45] You know, MTA derivative sealers, which is really great. Very good work. Really. Well, the science is backing up [00:42:50] nicely obviously. Be careful what bioceramics you’re using because there’s a lot of them out there in the market. So it has to be truly by ceramic. [00:42:55] So there’s some good products out there that you could use.

Payman Langroudi: That’s the sealant.

Ammar Al Hourani: Sealant and then a single cone technique. [00:43:00] So it’s called obturation. Now you’re not even having to heat it anymore. You just have a correlating GP point which fits [00:43:05] the file system that you’ve used. Put the sealer in and you just put the GP in position. Cut it. You’re [00:43:10] done. It doesn’t take that long now it takes seconds.

Payman Langroudi: But then where are the errors [00:43:15] in that bit? I mean people sort of pull it out by mistake while they.

Ammar Al Hourani: Yeah it can do. Yeah. You [00:43:20] can pull it out. Yeah. You can pull it out if you use the Bunsen burner and your nurses cigarette lighter. Yeah, of course you can. That [00:43:25] obviously that the good.

Payman Langroudi: Old.

Ammar Al Hourani: Days, the good old days. And believe it or not, that’s still a lot of practice mantra in the UK. [00:43:30] A lot of people still do that. So you could I think now you can buy really cheap cutting systems that are as [00:43:35] low as £60 on the market, so you don’t really need to do that. I think people just need to invest. If you invest a little bit [00:43:40] of money, you can make your life tremendously easier. It won’t come out.

Payman Langroudi: And then the next bit, the sort of [00:43:45] the coronal seal, coronal composite.

Ammar Al Hourani: Yeah. So either you reroll the tooth beforehand, [00:43:50] you put it back into a class one and do your root canal treatment, or you do your root canal treatment and then rebuild everything up [00:43:55] for your refining dentist. I think the refining dentist likes you to do, especially with with those endodontists [00:44:00] now, I think we’re more restoratively driven endodontists. So we’re not just endodontists, you know, Cottonwool pellet, [00:44:05] you know, GIC and back to, you know, we do quite a lot of that stuff now for you. And if you ask [00:44:10] us to, we would do it. And I think we like doing it for two reasons. One, it keeps our skill up in that respect. [00:44:15] So we have our finger still on a bit of restorative dentistry. And two, we’re much more confident with the coronal seal. So when [00:44:20] it comes to you and we ask you for an only or a crown, we’re comfortable with what we’ve put in there. So it makes us a bit happier [00:44:25] that we’ve removed the decay ourself.

Payman Langroudi: Because you kind of you own the coronal seal.

Ammar Al Hourani: You own the whole thing. Yeah, yeah, yeah, yeah. [00:44:30] But we expect you to do a really good crown because if you do a terrible crown that’s going to leak back in. So again, [00:44:35] you know, the crown or the only is still very, very important.

Payman Langroudi: How soon after. [00:44:40] Straight away. As quick as you can.

Ammar Al Hourani: Um I would say usually give it 4 to 6 weeks [00:44:45] just to let things settle down. Patients probably paid a lot of money now for the endo. Maybe they’ve come and seen you twice. Um, [00:44:50] you know, it’s a lot of cost.

Payman Langroudi: Did you always advocate some [00:44:55] form of crown.

Ammar Al Hourani: If you’ve lost? Yeah. If you’ve lost a marginal ridge, you’re going to have to use cuspal coverage, especially on a posterior tooth, because [00:45:00] it’s more likely to break. So yeah, you’re always going to advocate. And usually I would usually ask, you know, [00:45:05] advise on what material I would like you to use as well. So it depends on your occlusion. So we check [00:45:10] the occlusion I check the guidance, I check all that sort of stuff. So when I send you a letter back I’ll say could you please do it in X, [00:45:15] Y and Z? And there’s a particular reason as to why I’ve sort of said that. If not, I’ll say choose whatever you want. [00:45:20]

Payman Langroudi: How do you know? Yeah. From my days when I was a dentist, man, when you get in [00:45:25] to the to the pulp cavity. Right. And there’s like, cracks. How [00:45:30] do you know what crack is?

Ammar Al Hourani: A good crack?

Payman Langroudi: A good crack.

Ammar Al Hourani: Is a bad one.

Payman Langroudi: And [00:45:35] ones. Which one is it? When, how? How can you tell whether a crack is a problematic crack [00:45:40] or not? Or can’t you?

Ammar Al Hourani: Well, there’s a number of things. First, discuss the symptoms of the patient. So one, [00:45:45] you know, are they getting symptoms when release on bite. So that usually will tell you that the crack maybe is a little bit deeper down [00:45:50] than you think it is. Two. Look at the bone levels. Have you got any horizontal bone loss? A vertical bone loss [00:45:55] around the margins, which are very important. That’s probably where it’s stopping. Third thing is [00:46:00] we I die. If I die the crack and I see where it is. If it’s still in the coronal pulp chamber on [00:46:05] the sides, I’m good with it. If it’s in the canal, maybe in the first millimetre or two, it’s a bit more problematic. [00:46:10] But we’d still give it the benefit of the doubt and still do the root canal treatment for you. If it’s on the floor of the [00:46:15] pulp, then I think, let’s call it a day.

Payman Langroudi: Even if it’s a tiny little hair.

Ammar Al Hourani: Yeah, yeah, that’s that tooth is splitting apart. [00:46:20]

Payman Langroudi: Okay.

Ammar Al Hourani: And you want predictability. You’re not going to charge the patient. The best part of what, a [00:46:25] thousand £1,200 and then a crown to go. I’m really sorry. That only lasted an hour. You know, a couple of days [00:46:30] or a couple of years. You know, I don’t think most patients would be happy with that. And also, you’re also worried about the bone loss [00:46:35] because if you start losing a lot of bone, you’re going to really compromise the implant placement as well. So again, I’ve sort of [00:46:40] now made you lose a tooth and not great about bone. So the crack as long as [00:46:45] in a nutshell, as long as it’s in the crown, you’re okay? Um, I.

Payman Langroudi: Think it’s [00:46:50] kind of back to the. If the tooth is broken down way, sort of gingerly.

Ammar Al Hourani: Broken [00:46:55] down is in the filling, you.

Payman Langroudi: Mean. Yeah. Before you start.

Ammar Al Hourani: It depends if you if you could do crown [00:47:00] lengthening. Yeah, I’d try to. I’d always advocate trying to save that tooth.

Payman Langroudi: Yeah, but I’m sort of. [00:47:05] At what point does hero become a problematic. You know that’s [00:47:10] that’s the question.

Ammar Al Hourani: There’s two things here. I think the first thing is I know this sounds like, you know, bringing it [00:47:15] into camps, but the first thing is I would say is look at the age group of the patient. If they’re about 19, 20, 21, you [00:47:20] take that tooth out. What are you going to put in there? Are you going to put an implant every ten, 12, 13 years, 15 years? You’re going to have to change [00:47:25] it. So they’re going to change it about 6 or 7 times in their lifetime. That’s a lot of work. Yeah. You don’t know what disease they might have in [00:47:30] the future. Will the implant even be an option for them down the line? You know, it’s all that sort of stuff. So you’re now opening up a lot [00:47:35] of that unknown. If I could buy you a few more years and I’ll buy it might be not the best scenario [00:47:40] that we’re in, but you’d be surprised at how many times you do these and they [00:47:45] last like ten years, you know. So yeah, again. So I try to push based on age group, I’d like to [00:47:50] push that younger patient kick that can a little bit longer.

Ammar Al Hourani: If it fails, we can always do surgery [00:47:55] on that route by a few more years. Again kicking it again. You know, it’ll reheal hopefully with a bit of fresh bone, [00:48:00] then have the tooth out. That could be 15 years down the line. Great. Well, you know, you’ve left that ace [00:48:05] card down the line. You put the implant, now you’re going to be losing more bone. You’re going to have to have more implants. You’re going to have more [00:48:10] disease around the implant, more complications. You might develop patio systemic disease where it might become more difficult [00:48:15] now opened up a lot of unknowns. I’d rather just be predictable. Nothing will replace your tooth. But [00:48:20] obviously sometimes you look at it and you’re like, that’s enough. There’s only so much I can take. Once we’re below bone level or [00:48:25] at bone level, I think you’ve pushed it. I think that’s enough. So I do try my best. [00:48:30] Yeah, but it’s all about consenting. It’s all about consent. Yeah, it’s all about consent [00:48:35] and pulp.

Payman Langroudi: Like pulpal anatomy, Canal anatomy is like. I think [00:48:40] I used to have an endodontist boss as well. Yeah. And he told me, look, there’s [00:48:45] a hundred little side canals and things you can’t see. So what [00:48:50] happens there? Is the sealant going in those, or is the bleach going in those, or is what’s what’s [00:48:55] going on.

Ammar Al Hourani: So yeah, you’re you’re activating the arrogant. Hopefully some of that bleach is going to go into the, into those [00:49:00] little lateral canals. But you can never clean it all out. That’s a problem. We can’t sterilise the tooth. We’re disinfecting it as much [00:49:05] as we possibly can. Yeah. And we’re reducing the bacterial load as much as we possibly can. And then entombing [00:49:10] what we’ve got left in the hope that you don’t give it any substrate to regrow. But obviously we are getting [00:49:15] a lot more emerging science on bacteria and microbiology within endodontics. We also have sampling errors [00:49:20] still within endodontics. So we don’t really know 100% about what’s what’s happening within it. [00:49:25] So there’s that science is constantly emerging. But as long as you’re cleaning sufficiently [00:49:30] that you allow the body to start to heal and the patient symptoms don’t get any worse, and that lesion isn’t getting any bigger. [00:49:35] Slowly, hopefully shrinking, then we’re okay. It’s buying you time. It’s the [00:49:40] science of buying time. Endodontics. That’s all it is.

Payman Langroudi: But if I’m if I’m a general dentist and I can’t find [00:49:45] the what was it called? Mtv2. Am I doing my patient [00:49:50] a disservice?

Ammar Al Hourani: The first thing, not every specialist finds M2. Just to put it out there, I [00:49:55] don’t find M2 every single time.

Payman Langroudi: Is that right?

Ammar Al Hourani: Yeah. Like I’m human sometimes. Take a cbct. And I still don’t find [00:50:00] M2. Like, it’s.

Payman Langroudi: Just sometimes it’s not there, right?

Ammar Al Hourani: Maybe it’s just not there. So then you go. You know what? We’ll keep an eye on it. But the thing, [00:50:05] the beauty of it is, then I can review it over time. And if it doesn’t work out, I can always do surgery. I can go back in and B [00:50:10] and b1 and B2 chop off the the root and buy myself more time. So I’ve still got that skill set to fix that problem [00:50:15] if I can find it. I think if you’ve got a periapical lesion on on that root [00:50:20] and you don’t find nb2, I think yeah, it might not work. I think maybe start thinking about telling [00:50:25] the patient about referral to a specialist or dentist special interest to maybe find that under magnification, if [00:50:30] the patient then says no, which a lot of them would do, then it’s all down to consenting. You’re going to have [00:50:35] to say, listen, I’ve done my best. I’ve got to the full length of the main canal, cleaned it really well. I’m hoping [00:50:40] that it merges with the main canal. Nb2 merges with Nb1 about 80% of the time anyway, [00:50:45] and hopefully you’ll get away with it for a short period of time, maybe a few years, and it [00:50:50] might fail again, and maybe revert then onto a specialist and they might deal with it. So it’s a matter of having that conversation [00:50:55] with the patient. Because honestly, you need to be pragmatic. Not every patient is going to afford £1,000. [00:51:00] And, you know, in terms of economy, you know, hardships and recessions and whatnot, people [00:51:05] are not going to be able to afford it. It’s a lot of money. It is a lot of money, you know. So I respect patients. If they can’t afford [00:51:10] it, try your best to clean it as best as you can, obturate it to the best of your ability and keep an eye on it in the [00:51:15] long run. Um, and then if it doesn’t work out, refer it across or refer it before [00:51:20] you obturate it. If you’re 100%, if you’re not 100% certain.

Payman Langroudi: And what what [00:51:25] is the predictor of a flare up after you finish?

Ammar Al Hourani: Well, [00:51:30] there’s a number of things. So we’re not putting rubber dam on. For example. You’re going to get a lot of saliva in there. So you’ve changed [00:51:35] the ecosystem in the canal to uh, maybe you’ve put some [00:51:40] sealer, not sealer, some arrogant through the apex a little bit off. It sometimes can cause a bit of a flare up. It might not [00:51:45] be a full blown hypochlorite accident, it might just be a little irritation. Yeah. Over prepping the canal. So you’ve gone through [00:51:50] through the other end. So you’re basically going into the PDL? Yeah. And then you need to remember your [00:51:55] flutes have also got infected dentine debris. So what you’ve done is you’ve essentially created a [00:52:00] cut and then you’ve rubbed soil into it. Yeah. So that’s what’s happened. So you’ve drilled a you know, you’ve you’ve [00:52:05] gone past the apex, you’ve drilled a little hole in the PDL in the bone, and then you’ve rubbed infected [00:52:10] debris into it. So you’re going to get a bit of a flare up after it. And the.

Payman Langroudi: Pa area, [00:52:15] a pre-existing.

Ammar Al Hourani: Period.

Payman Langroudi: That’s going to be more likely to flare up.

Ammar Al Hourani: Yeah, yeah. [00:52:20] Especially if it’s the larger the area. Also the more likely it might just blow up just [00:52:25] because the body also needs to start to heal. So you’re going to undergo inflammation to heal. And that inflammation might [00:52:30] not be very kind to you. So it’s you get facial swelling. I’ve had maybe 2 or 3 of these now in my in my career so [00:52:35] far where it’s just, you know, I thought it was a relatively okay treatment And it’s just blown up. Whereas if you’ve got a sinus, [00:52:40] ironically, it’s unlikely to get a flare up because you’ve already got an exit valve already. Yeah, yeah. So that’s [00:52:45] probably not going to happen. So you’re sort of going to get away with it really a bit more.

Payman Langroudi: But yeah I mean is [00:52:50] it is there a situation where you can. Is there something you can do to minimise [00:52:55] post-op discomfort.

Ammar Al Hourani: Yeah. So I usually give my patients ibuprofen before [00:53:00] they start before.

Payman Langroudi: The start of the treatment, before.

Ammar Al Hourani: We start the treatment ibuprofen beforehand because [00:53:05] you know it just reduces you know they’ve got anti-inflammatories in their system already. Make sure [00:53:10] that your working length is spot on. Make sure your prep plant is going to be spot on. Um, irrigate really, [00:53:15] really well. Obviously rubber dam is crucial. Have a great coronal seal between appointments. [00:53:20] Make sure if you’re going to do two visit endo. Make sure you.

Payman Langroudi: Ever do that.

Ammar Al Hourani: Yeah but I would say 10% of those are two visits [00:53:25] 10%. 10%. Yeah. Comfortably.

Payman Langroudi: You know why why would you choose to do it. Because in the first [00:53:30] visit you just couldn’t.

Ammar Al Hourani: So either I’ve, I’ve run out of time or [00:53:35] the patients had a lot of pain. So we want things to settle down a little bit. A sinus, I like the sinus to go away [00:53:40] before I do. Finish off the endo. Um, big pay off collision. Because I told you I’ve been stung a couple [00:53:45] of times, so now I like to let it settle down. If it’s going to flare up, it’s going to flare up now. So at least I can go [00:53:50] back in and still do something about it. If I go in and there’s a malodour, you know, retreatment there’s a malodour, it stinks. [00:53:55] Maybe there’s pus discharging, exudate discharging, blood discharging. I’ll put something. I just want that settle down. [00:54:00] Um, so or, you know, sometimes it could be just a difficult patient. And I’m like, I don’t want this [00:54:05] patient to complain down the line. I’ll put, you know, I’ll do everything as I can so that you don’t come back and haunt me down the line. [00:54:10]

Payman Langroudi: And what do you put while you’re in between the two points?

Ammar Al Hourani: Hydroxide. Calcium hydroxide. Yeah. [00:54:15] Ptfe tape. And then I’ll put cava and GIC two layers and that again, another reason for a [00:54:20] flare up is if your coronal seal in between appointments has been lost, you might get a flare up.

Payman Langroudi: So it’s not good enough. [00:54:25]

Ammar Al Hourani: No, no I’ll go down. Yeah. Cava and GIC I always put cava and then GIC on top, which [00:54:30] is good.

Payman Langroudi: You’re right. It’s an unnecessary risk, isn’t it? For for for one minute extra [00:54:35] to Put something stronger in there.

Ammar Al Hourani: Yeah, exactly. I think sometimes I just feel like if I’m not sure [00:54:40] or my gut instinct is what’s going on here, it’s a bit different. I’ll put calcium hydroxide. Let things settle down. [00:54:45] Bring the patient back in. Do a good endo. And I’m sort of, to an extent, maybe protected [00:54:50] medical eagerly because I’ve done everything by the book. There’s nothing more I could have done differently. Does that make sense? So if you compare me to someone [00:54:55] else, what else could they have done any differently than I could have? Nothing. You know what I mean? So I’ve done [00:55:00] everything I can at that point.

Payman Langroudi: What do you think of. I had someone here who was talking about pulpotomy. [00:55:05]

Ammar Al Hourani: Vital pulp therapy.

Payman Langroudi: Yeah. What do you think of that?

Ammar Al Hourani: I think it’s a [00:55:10] very, very interesting emerging science.

Payman Langroudi: So do you ever do that?

Ammar Al Hourani: Uh, I’ve done a handful. [00:55:15] I’ve not done that many. Uh, just because I’m still not confident enough with it. That’s me. On a personal [00:55:20] level, I’m not talking about the science. I think the science is there, but I’m just not confident with it. And maybe I’ve not had the [00:55:25] cases, really, where I’ve had that sort of patient between the reversible, irreversible Pi test, [00:55:30] that sort of early irreversible pulpitis. I don’t really get a lot of these patients. That’s a problem. I get a lot of patients who’ve [00:55:35] already had endo. They’ve had a flare up. They’ve had a sinus. They’ve had a chronic period collision. So the dentist has already gone and [00:55:40] then done something. So I don’t really get that clientele. I don’t get irreversible pulpitis basically, you [00:55:45] know. So I’ve not had enough of these cases to do.

Payman Langroudi: If I fracture the [00:55:50] instrument in the canal, what must I and my must not do.

Ammar Al Hourani: I [00:55:55] think be honest with the patient number one.

Payman Langroudi: Yeah.

Ammar Al Hourani: You have to tell them.

Payman Langroudi: Yeah.

Ammar Al Hourani: Yeah. Because ultimately it’s their [00:56:00] tooth.

Payman Langroudi: In my day, they say. Yeah, tell the patient it’s kind of like the root canal filling. Fill it. And it’s all [00:56:05] good.

Ammar Al Hourani: So I think I think we need to take a few steps back. I think if you’ve done it at the end of the treatment and you’ve been irrigating [00:56:10] with hypochlorite and you’ve been agitating the Aragon, and it’s been done perfectly, but then for [00:56:15] whatever reason, you’ve gone back in, you know, that one last attempt just to, you know, make sure it’s definitely clean and [00:56:20] it snaps, then you’ve essentially cleaned it in a clean canal. So you’ve obturate with nightly. You [00:56:25] probably will get away with it. That should be, I think. Okay, I’m not saying it’s 100% okay, but [00:56:30] I think you will be alright because you’ve been working through hypochlorite. You’ve cleaned the air, you know. So it’s sort of happened in a more sterile [00:56:35] environment. Okay. If you’ve done it at the beginning of treatment, that’s. Yeah, you’re going to have to fish [00:56:40] that out basically. So tell the patient. Just be honest with them. That’s the consenting process. Tell them that’s going to be a [00:56:45] risk. Tell them about it. Refer the patient on. Now will I be able to always remove it.

Payman Langroudi: No [00:56:50] definitely. They shouldn’t try to take it out themselves.

Ammar Al Hourani: No, that’s I mean, even for us that’s difficult, I would [00:56:55] say I would say hand on heart. For me the hardest two things is ledge management. Removal of files like that for me is [00:57:00] ledge management.

Payman Langroudi: When someone else has alleged it and now you have to try and fix it.

Ammar Al Hourani: They’re so difficult. Honestly, that’s the devil’s [00:57:05] work. That is that is really, really for me. That’s that’s my Achilles heel. That and Fractured Instruments [00:57:10] 100%. I think most specialists would tell you that as well, to be honest, I think. But if you would not disagree with that. [00:57:15]

Payman Langroudi: What about Retreatment? Should [00:57:20] a general dentist without a special interest try retreatment?

Ammar Al Hourani: No, I [00:57:25] think that’s really difficult. Really, really hard because the treatment you need to understand why has that failed in the first place? The [00:57:30] two questions you have to always ask yourself, as any dentist is why is that happened? Can I [00:57:35] fix it? If you can’t diagnose why it’s happened and then you go and fix it, it’s going to fail again because you’ve never really dealt [00:57:40] with the cause.

Payman Langroudi: What if what if you can see the previous end is not the best? So that’s why it’s [00:57:45] happened.

Ammar Al Hourani: Yeah, but.

Payman Langroudi: Then can I fix it?

Ammar Al Hourani: I’ll give it a go.

Payman Langroudi: Well, [00:57:50] well, well, no, this this thing that I was never good at anyway. But let’s say you’re good at Endo. Yeah. Is there something you need [00:57:55] to know about removing the old one? And should you, I don’t know, use [00:58:00] different irrigant. Should you, should you should you now do things differently [00:58:05] the second time?

Ammar Al Hourani: So I think the first thing is why has it been short. So the reason [00:58:10] is maybe the dentist didn’t get to the full length because they didn’t handle it or they didn’t prep it, and then the ledge [00:58:15] didn’t filled it. Yeah. So if that’s happened, good luck getting through that. That’s not really. [00:58:20]

Payman Langroudi: That’s not for a generalist. Right.

Ammar Al Hourani: I think that’s really difficult work for even for us it’s pretty tricky to Retreatment is still pretty [00:58:25] tricky for most specialists. So I would say definitely pass that on.

Payman Langroudi: And if [00:58:30] a patient asks you what’s your success rate? Do you sort of quote the [00:58:35] papers or.

Ammar Al Hourani: I mean, that’s the only papers that you can quote. But I also quote myself, to be fair, [00:58:40] like so I think when you quote papers, you’re always quoting other people’s work. Yeah. So if you’ve done 300 [00:58:45] randos and all of them are worked over a five year period, just tell me that I’ve done 500 and they’ve all worked over five [00:58:50] years. You’ve got 100% success rate. Great. Okay. Or survival, whatever way you want to look at it. Um, [00:58:55] I would usually still quote the papers, but then I would say in my hands, I’ve [00:59:00] been working here for the last six years, and I’ve had I get a handful of patients back every, every year. And it’s within [00:59:05] those that were already ropey to start off with, but they’ve maybe lasted four years.

Payman Langroudi: So it’s [00:59:10] a success rate of no worse than the first time.

Ammar Al Hourani: Yeah, retreatment is always worse than [00:59:15] second retreatment with the lesions. Worse again. Third retreatment not great. [00:59:20] Probably less than 50%. So because you’re, you know, you’re making things bigger again, you’re going in again, you’re blasting [00:59:25] everything open again. You’re weakening everything up. So it’s probably the best. So yeah, Retreatment [00:59:30] is less and then retreatment because the bacteria is different. The microbiology is different. You’re not dealing with Nicholas [00:59:35] and Candida and Fusobacterium Nucleatum and all sorts of other bacteria that live [00:59:40] in extreme spartan conditions. They’re really difficult to get rid of. So you’re now dealing with a completely different ecosystem. And [00:59:45] so even with bleach, they can evade bleach, you know. So how. Well. So yeah.

Payman Langroudi: Can [00:59:50] you humour me with internal whitening a little bit?

Ammar Al Hourani: I love internal. I do a lot of it. Okay. I think [00:59:55] it’s great. So it works.

Payman Langroudi: What’s your problem? Are you leaving that protocol?

Ammar Al Hourani: First [01:00:00] you need to. So you need to understand what caused the internal discolouration in the first place. Is it trauma associated or [01:00:05] not? If it’s trauma and the tooth is really dark, it’s going to be a little bit more tricky. If it’s someone’s done an endo and then [01:00:10] the GP’s become discoloured, you know, and you remove that GP, the tooth almost instantly lightens up. So it depends. [01:00:15] And once you start using bleach it lightens up with the bleach as well. So a lot of times actually.

Payman Langroudi: The hypochlorite the. [01:00:20]

Ammar Al Hourani: Hypochlorite.

Payman Langroudi: Peroxide.

Ammar Al Hourani: Yeah. So by the time I’ve removed the GP point it starts to whiten up because the GP point was above [01:00:25] the siege. And so you can see it if it’s a trauma case, I. Yeah. [01:00:30] Um, really, really. Well use a little bit of ultrasonic just to clean up the dentine a tiny [01:00:35] bit.

Payman Langroudi: Yeah. Good idea.

Ammar Al Hourani: Acidic acid, that chip. You know the Kaiser? Kaiser. Kaiser [01:00:40] protocol. Yeah. Uh, bleach for five minutes. So not bleach. Acid etch, five minutes. [01:00:45] And then I’ll just put the internal whitening and just leave it.

Payman Langroudi: Would you use.

Ammar Al Hourani: I [01:00:50] use Opalescence endo, which is 35% peroxide. And it works [01:00:55] really well. It’s licensed in the UK at the moment. So I use that. And that’s been.

Payman Langroudi: And what did you the walking bleach then.

Ammar Al Hourani: You [01:01:00] walking bleach.

Payman Langroudi: I suppose.

Ammar Al Hourani: I start with walking bleach first to see how that goes. And if it doesn’t work then believe it or not [01:01:05] I then start using your stuff. So I start using the internal whitening internal external with the enlighten [01:01:10] system that works really, really well. It’s worked beautifully.

Payman Langroudi: Do you, do you, do you? Look, people are telling [01:01:15] me, some people are telling me there’s no need. Once once you’ve let’s say you’ve you’ve removed [01:01:20] the GP, you’ve gone to say a millimetre below the HCG. Some people [01:01:25] telling me there’s no need to actually seal that root canal system.

Ammar Al Hourani: With like, something else. I [01:01:30] think there’s always that risk of maybe external cervical resorption. That’s why we do it.

Payman Langroudi: Yeah, yeah, but but telling me [01:01:35] that that used to happen before because of heating the peroxide with a hot [01:01:40] instrument. Possibly. Yeah. And doesn’t happen anymore.

Ammar Al Hourani: To be honest with you, I don’t really know much about that heating [01:01:45] process. To be fair, I still do it the old school way. I cut it under the seat by maybe a couple of millimetres.

Payman Langroudi: Leave it open. [01:01:50]

Ammar Al Hourani: Put a lining of glass Ionomer thin lining glass ionomer. Keep it open. Get the patient you know, obviously. Tell them how to [01:01:55] clean it and then squirt the the gel in and have the whitening tray.

Payman Langroudi: And overnight for how [01:02:00] long do you leave that?

Ammar Al Hourani: I ask them, I usually ask them to change it every 2 or 3 hours by the way.

Payman Langroudi: Yeah, yeah.

Ammar Al Hourani: For a good week. [01:02:05]

Payman Langroudi: And then you leave it open for a week. Yeah. Oh, really?

Ammar Al Hourani: So a little bit in keep it overnight. Keep [01:02:10] changing it. And then maybe after three four days stop doing it. Put a temporary filling in yourself. So I [01:02:15] usually give them some temporary filling or tell them where to buy it from from Amazon. And then I’ll say wait for a week and then [01:02:20] come back and see me, because then it’ll rehydrate. There’s no point. Come and see me straight away. Two reasons one, I can’t bond onto it properly. [01:02:25] I need to give it a bit of time. And then secondly, you know, I want to see whether when it rehydrates, [01:02:30] does it actually look good? Because it might look frosty. And then I’m like, well, that looks great. And then it discolours over that period of the week. [01:02:35] Does that make sense? So I’ll usually let it settle for a little while. Come and see me. You know, a week, two weeks, usually [01:02:40] two weeks because patients can’t come and see me whenever they want to see me. And plus, sometimes they don’t have the space to see them. That’s the problem. I’m not [01:02:45] in that clinic. I might be in that clinic in two weeks time. By the time they come back. Let’s take another photo. Do you like it? [01:02:50] No. I want a bit more. Go back and do a bit more. We’ll remove that filling. Clean it all up. Start again till they [01:02:55] get in a comfortable position. And to be fair, it’s quite predictable. And with the enlightened system. I’m not trying to sell your product, but with enlightened system it’s [01:03:00] worked really well. I’ve not had any issues. Patients are happy.

Payman Langroudi: I like that. Think about teaching. [01:03:05] Do you think there’s a need? I think there definitely is a need. Right. Insomuch [01:03:10] as people are coming out of dental school, having done like one, I heard less [01:03:15] than one molar. Yeah, well, one, one canal of a molar. Yeah.

Ammar Al Hourani: Yeah, [01:03:20] I.

Payman Langroudi: That was an Audi. That wasn’t the case. We did. We did a few [01:03:25] more than that.

Ammar Al Hourani: So the thing is, the thing is that it’s been a change in culture. So we used to have it wasn’t competency based. [01:03:30] We were numbers based. So you had to do like I don’t know I can’t remember what was Glasgow 30 maybe. Yeah. You had to [01:03:35] do in 20 cobalt chromes and 300 fillings and whatnot. And you had the patience. Yeah. There was always patience in [01:03:40] Glasgow. You can’t not have the patience for, you know, now the same students [01:03:45] are struggling to find an A&E in Glasgow.

Payman Langroudi: Why is that?

Ammar Al Hourani: I don’t know. I have no idea. I don’t know what’s happened.

Payman Langroudi: It’s [01:03:50] weird, isn’t it?

Ammar Al Hourani: They’re struggling to get like Nando’s and they’re starting to. So now it’s become competency based. So you could do one good [01:03:55] access and one good obturation. And you’re you’re safe. And I said [01:04:00] to you earlier on, I had to do 3000 before I felt comfortable.

Payman Langroudi: As a specialist.

Ammar Al Hourani: A specialist, you know. So [01:04:05] how is that possible?

Payman Langroudi: Listen, I’m not really 100% what’s going on in the NHS here, but there’s plenty of [01:04:10] endo NHS endo going on which doesn’t pay.

Ammar Al Hourani: No.

Payman Langroudi: And [01:04:15] it’s what my understanding is they shove it off to the to do Mm ft [01:04:20] to do PhD. Like someone who’s got no no experience whatsoever is now doing [01:04:25] the endo.

Ammar Al Hourani: I mean I think the listen as an NHS concept, I [01:04:30] like the concept. I think it’s a great concept as a healthcare healthcare. I think it’s a great concept. Okay. Has [01:04:35] it been done. Well I think it could be done a lot better personally. The thing is, you can’t do something when [01:04:40] the cost of the material costs more than the treatment itself, because then you don’t factor in the dentist. There’s expertise [01:04:45] there years. The cost of running a clinic is really expensive and you’re in the UK. There’s not a cheap [01:04:50] country. I don’t care where you live in the UK. The UK is still an expensive country, so [01:04:55] it’s been done almost as a charity. Yeah, so a lot of people just don’t want to do it. So they become de-skilled in it, or they go [01:05:00] privately and say, oh, I do all this stuff. I don’t do endo. Yeah, you know, that’s a majority. I don’t do dentures. Yeah, [01:05:05] yeah. Just fair enough. I think from that point of view that latter at least you respect the fact that you don’t [01:05:10] do endo and you don’t want to do endo. You want someone else who knows how to do endo to do. And I think that’s good. That’s honourable. I like [01:05:15] that the NHS system however, is everyone should be doing it. You have to offer it to the patient, but [01:05:20] I’m not very good at it. So how can I offer you heart surgery? And I don’t do heart surgery. You [01:05:25] know, you don’t go to your GP and ask them, can you do, you know, can can you start my kidney? They [01:05:30] don’t know how to do that. They refer that on. So we don’t have a great tertiary system in this country for dentistry. We [01:05:35] don’t have a referral system. You know, dental schools are clogged up. Maybe the funding isn’t there. Maybe they don’t have the staff [01:05:40] to do it.

Payman Langroudi: Yeah.

Ammar Al Hourani: And so you’re sort of stuck between a rock and a hard place. And you’ve got litigation also. [01:05:45] I mean, that’s I would always say that the biggest advancement in dentistry in the UK are what’s driving advancements. Litigation isn’t [01:05:50] even the science. It’s I don’t want to get sued. Let’s be honest. You know, that’s the elephant in the room, [01:05:55] right? What’s changed in dentistry over the last 20 years? Being sued?

Payman Langroudi: Yeah.

Ammar Al Hourani: Let’s be honest. Right. No [01:06:00] one’s going to deny that. So I think I feel sorry for a lot of these dentists. You [01:06:05] know, if you told me to do an NHS endo without the equipment I have at the moment, the expertise I [01:06:10] have, I’d do a terrible job being honest.

Payman Langroudi: The majority of endo is being [01:06:15] carried out in the country or those. Right? Yeah.

Ammar Al Hourani: And are they working? Probably some of them are [01:06:20] working. Some of them aren’t working. And I think if you’ve got a nice patient you’ll probably be okay. [01:06:25] And if you don’t, you might become a problem for you down the line.

Payman Langroudi: Terrible thing. You have [01:06:30] a friend or family member says, I’ve got toothache here and it calls me up. Let’s say he’s not near [01:06:35] me or anyone I know. My first piece of advice is don’t have it done in the NHS like my [01:06:40] first first thing I say go.

Ammar Al Hourani: And see a specialist.

Payman Langroudi: First thing I say. Yeah. And [01:06:45] that’s a sad state of affairs, isn’t it? It is. Especially [01:06:50] in endo, you know, because it’s time consuming, expensive procedure. That dentist [01:06:55] is not going to be paid for.

Ammar Al Hourani: No, it’s a minefield. This is a political minefield. Nhs dentistry [01:07:00] is a political minefield. You know, it’s either you change it dramatically.

Payman Langroudi: Where [01:07:05] maybe if you were the king of the world, what would you. How would you change it then? If you liked the idea, [01:07:10] you like the idea, right? You like the idea of healthcare?

Ammar Al Hourani: Yeah, I think I think have a universal. I quite like the Northern [01:07:15] Ireland system to an extent. They have a small number of codes which the dentists do, and then [01:07:20] a lot of it is private. So like the government tops some, you know, does some of the stuff pays for some of the stuff, and then you [01:07:25] have to pay some for some of the stuff, or you go down an insurance policy where the government pays a little, you pay [01:07:30] a little and the insurance pays a little, and that also might work. And that’s what I would do if I was to change it tomorrow, [01:07:35] I would have everyone on some sort of insurance policy. It would come with your work or something like [01:07:40] that. You know, a bit like America. You know, you have your health and dental care comes in with your employment job and then everyone [01:07:45] gets you pay a little premium. Or if you’re at a certain threshold, the government pays the rest of [01:07:50] it. And then you have a lot of centres where you have dentist special interests that do it to a relatively good standard. And anything [01:07:55] above that has to go to a specialist and they get paid for it.

Payman Langroudi: If it was me, what I would do is I would [01:08:00] means test first of all, here. The only only people earning below [01:08:05] X can get any access to NHS, NHS dentistry. [01:08:10] We’re talking leave medicine to one side for now. Then I would take the [01:08:15] budget, which is at the moment it’s 2.5% of the health care budget, and divide it [01:08:20] by the number of people below earning less than £35,000 or whatever the number is. And [01:08:25] I distribute that money here as a voucher to be spent at any dentist. [01:08:30] Yeah, that would work. And those people can go to the dentist by teeth whitening, go to [01:08:35] the dentist by whatever the hell they want for the dentist. Yeah. And that’s the amount of money they’ve got [01:08:40] to spend at the dentist.

Ammar Al Hourani: I think that’s quite nice, I think. Or you would have it at the basic functional [01:08:45] stuff you would pay for. And I think above that you might have to. Yeah. But apart from.

Payman Langroudi: Your basic functional stuff [01:08:50] is an endo is the basic functional stuff, isn’t it.

Ammar Al Hourani: But then that money could then be used towards a specialist [01:08:55] in your endo or a dentist. Interesting. Your endo? Yeah, yeah. And not the GDP per se, unless you’re very, very good at it. [01:09:00] So you can then use that coupon anywhere essentially. Yeah that would work. Yeah.

Payman Langroudi: It’s mad. I think [01:09:05] the one thing we can be sure of here is no more than 2.5% of the budget is coming to us. You know that, if [01:09:10] anything less than that. Yeah, I think I.

Ammar Al Hourani: Think it’s.

Payman Langroudi: I think it should be more creative. It’s not going to be more [01:09:15] though. You know, that’s you know, that’s just not reality. Yeah. So I’d say [01:09:20] as a profession, we need to think of it as less is going to come or the same amount is going to come. [01:09:25]

Ammar Al Hourani: I think just going to an insurance.

Payman Langroudi: What are we going to do with that money? Yeah you’re right. Insurance. But the country’s not set up. [01:09:30]

Ammar Al Hourani: No we’re not. Yeah.

Payman Langroudi: We don’t we don’t enlighten. We don’t offer our team dental insurance.

Ammar Al Hourani: No [01:09:35] one does. I don’t know. One of.

Payman Langroudi: Their benefits. But. But if there wasn’t or there isn’t a [01:09:40] really good one. But if there wasn’t NHS dentistry, that would be part of the culture. People would be asking for [01:09:45] dental insurance when they come and get jobs, you know.

Ammar Al Hourani: Yeah. Or you could have it, I think, in some countries where [01:09:50] you cap the fees.

Payman Langroudi: Yeah.

Ammar Al Hourani: So every treatment has got a fee. Yeah. And it’s capped by the. So [01:09:55] although it’s a free market economy but it’s still capped. The government is like you know, you can’t be more than £100 for a white filling, [01:10:00] let’s say. And then it becomes affordable to the masses. You know that could also work.

Payman Langroudi: What [01:10:05] would you say is the difference between a good endodontist and a great endodontist?

Ammar Al Hourani: Experience. [01:10:10] Honestly, it’s all about experience. [01:10:15] Yeah, but I think experience and then also giving something back to [01:10:20] society, I think. And what I mean by that is by teaching a lot more of the future. [01:10:25] A lot of specialists don’t know. That’s not true. I think some specialists do [01:10:30] do a lot of stuff with the, you know, with undergrads, Post-grads and some of them don’t. I think giving back also [01:10:35] makes you a great specialist. I think it’s fair enough.

Payman Langroudi: But outside of giving back, I mean, I technically I’m [01:10:40] no, no, not only technically I’m referring here. Let’s say I’m a referring dentist and [01:10:45] you’ve got Nancy and me here. What’s the difference between a good one [01:10:50] and a great one like now? Let me give you an example. When I used to refer to my perio guy. Yeah, [01:10:55] he was, he was very good at the gums. Yeah. But patient used to come back saying [01:11:00] periodontist said I need crowns on this, that and the other and this tooth can take it. That tooth can’t. [01:11:05] And full restorative treatment plan would come back. Sold. Yeah. Sold [01:11:10] by the specialist. So it would be like. I’d be like. I’m sending more patients to him. Yeah. Because, because [01:11:15] because, you know, he’s he’s a sort of a higher authority. He’s saying this tooth can take [01:11:20] a crown. This tooth can’t. And he says tells the patient, I would crown that one and send them back. Okay. [01:11:25] That’s that’s not technical, is it? That’s that’s like almost a service he’s giving back to [01:11:30] me as the referrer. You tell me. Is it technical? I think it’s going to be the skill. Do [01:11:35] you do you presale, pre-sell, the crown, that sort of thing?

Ammar Al Hourani: I do.

Payman Langroudi: Yeah. To the patient.

Ammar Al Hourani: Yeah. Yeah. [01:11:40] Of course. Yeah.

Payman Langroudi: Prep them for that.

Ammar Al Hourani: So I think I think it’s going to be similar to yourself. I mean I [01:11:45] do quite a lot of the chords myself. So I would say doing the chords, doing a lot of the hard work for you, prepping [01:11:50] you up for the essentially the, the glory shot being the crown, you [01:11:55] know, and I think that for most dentists would be great because they now know that and it’s been done well. [01:12:00] The core is being done well, being diagnosed properly. They’ve maybe picked up on other stuff that need to be dealt with. You know, [01:12:05] do that filling, do this filling. There’s maybe something here, something there. Keeps them busy in that respects. And [01:12:10] then you’ve got the crown ready for them. That makes you I think that makes you great. And I think being close to the referring dentist very, [01:12:15] very important, having that interpersonal relationship. So a lot of the dentists actually have my personal phone number. They’ll just call [01:12:20] me, text me, voice, message me at one in the morning, sometimes with a problem they’ve had. I think that’s quite nice being [01:12:25] able to be there. Sometimes it’s just counselling. I swear to God, sometimes it’s counselling.

Payman Langroudi: Look, [01:12:30] running a referral practice is a whole skill in itself. It’s a whole art [01:12:35] in itself because by its very nature, you’re constantly losing referrals, [01:12:40] aren’t you? It’s just the way it is. People fall off or they get an in house guy [01:12:45] or something.

Ammar Al Hourani: That’s why you have to constantly do study clubs and lunch and learns [01:12:50] and courses and talks and webinars and all sorts of things.

Payman Langroudi: Are you are you like sending back [01:12:55] like pretty reports and things as well?

Ammar Al Hourani: Yeah. More so intern in house. No, I don’t [01:13:00] do the reports because like it’s already in house. Like you just open up, you know, Dental and check it, you know. Yeah. Yeah, yeah. Externally. [01:13:05] No. Right. You had a really nice rapport with some x rays. Maybe some photos of this cracks. I’ll show you everything. So you [01:13:10] look at it and you go, wow, I’ve never seen that before, you know? And it’s quite nice in itself as educational, but like when I got Cbct report. [01:13:15] Yeah, the same thing. If it’s a really nice, beautiful one with all the angles and shots, [01:13:20] I’m reading it. I’m like, wow, I’m learning from this, you know? So that’s that I like. So yeah, I think [01:13:25] the majority of times I will send a referral, but if you’re in house I don’t send you a referral. I’ll just just read the reports [01:13:30] and have a look at my x rays.

Payman Langroudi: You’ve worked in so many practices. Tell [01:13:35] me your reflections on practices.

Ammar Al Hourani: I think some are really great and [01:13:40] some not so much. And I think it comes down to the principle.

Payman Langroudi: Do you, do you?

Ammar Al Hourani: Yeah. A [01:13:45] principles who works in the clinic and does as many hours as you do and really busts a [01:13:50] gut and works really hard and really shows that, you know, appreciates all the staff around them, [01:13:55] you work that little bit harder for because they’re there, they’re in the clinic, they know what’s going on. [01:14:00] They can they can do it. Whereas in clinics where the principle is not there to sort of sometimes associate Ron, [01:14:05] and then maybe there’s a manager. I’m not saying, you know, there’s some fantastic managers out there, but I don’t [01:14:10] think you’ll ever love your clinic as much as the owner themselves loves it and looks out for [01:14:15] it. Does that make sense? Like your own little baby when they’re there working really hard? Yeah, it motivates [01:14:20] you a little bit more as well to do better. And I think that found the most successful clinics where the principles [01:14:25] they are working with you. They’re the best ones.

Payman Langroudi: I’m more interested. I’m interested in that. [01:14:30] That’s beautiful. It’s wonderful insight. Yeah, but you’ve seen so many, so [01:14:35] many. Yeah. Like, let’s say 25 clinics where you’ve worked in [01:14:40] way more than your average dentist. So culture wise, [01:14:45] like you said, work hard. That’s one thing. Yeah. Yeah. But, you know, you get sometimes [01:14:50] you get a principle who works hard. But he’s awful at like, hiring. Yeah. [01:14:55] Or awful at firing. I find awful at firing is one of the biggest crimes here. I’m definitely [01:15:00] guilty of that crime myself. Yeah. Yeah. Um. And so, like you were saying [01:15:05] to me before, one of your ambitions is to open your own actually multi [01:15:10] sort of specialist centre, not only Indo multi [01:15:15] specialist centre. What sort of lessons are you going to bring to that from [01:15:20] all the practices you’ve worked in. Like what mistakes have you seen.

Ammar Al Hourani: I think number one [01:15:25] I think value your nurse or value the nurses. Honestly I can’t I can’t stress that enough.

Payman Langroudi: I agree with that. [01:15:30]

Ammar Al Hourani: I can’t you can’t.

Payman Langroudi: Stress running the whole running the whole goddamn show, man.

Ammar Al Hourani: You know, they don’t earn enough money [01:15:35] as it is. I think they do. I mean, without my nurses that I work with, honestly, that I do end up with, I can’t achieve the level [01:15:40] of end that I can do. They. They get everything. They order stuff for me. They keep an eye on my book. They talk [01:15:45] to my patients, they keep them comfortable. They do a lot of work that I don’t have to do myself. [01:15:50] Whereas when you start getting temp nurses, oh my God, that becomes tricky. Not because they’re difficult people. They’re [01:15:55] actually a lot of them are really nice, hard working people. It’s not their it’s not their surgery. They don’t know where everything is suddenly. Now [01:16:00] that I know that, it takes me an hour and a half, taking me two hours. You know, it’s just a hard day. It feels like you’re walking [01:16:05] through mud all day. It’s a horrible situation. So look after your nurses is number one. [01:16:10] Second thing is having. Having a great TCO is wonderful because they deal with [01:16:15] all the money, all the chat, all the stuff that you feel you know, a bit uncomfortable with. I don’t like talking.

Payman Langroudi: About the nicest things [01:16:20] about endo is you don’t really have to sell anything though.

Ammar Al Hourani: No, it’s all so so but there the price, you know, sometimes they might [01:16:25] need an endo and a core and they need this. And does that add up to a point. And you go right. You know speak to so and [01:16:30] so. So I’m really lucky. For example, in Grantham I’ve got a couple of, you know, people that do that for me in other clinics. They do that for me [01:16:35] and they do all that talking for me. I don’t have to talk about money. It’s like, well, go and see so-and-so and she’ll walk [01:16:40] you through it and finance and whatnot. They’ll also look after your book, the referrals coming in or referrals coming [01:16:45] out, keeping an eye on things, keeping an eye on your book, making sure it’s busy, keeping in touch with your [01:16:50] referring dentist. That’s what’s going to make your work book work like clockwork, [01:16:55] you know? So I would do that differently. Um, generous Principles. [01:17:00] What do I mean by that? They buy you anything you want. I’m very lucky with the principles I work with. Now, if I send [01:17:05] them a list tomorrow morning, it’s in my drawer. They’ll never say, oh, why do you need this? Why do you need that? There’s an element [01:17:10] of me which also needs to use new stuff that’s coming out in the market. Sometimes you bought me a lot of stuff, but [01:17:15] now I need new stuff. And if you’ve got a progressive person in that clinic, they’ll be like, go for it. Because [01:17:20] they also want to keep going on with the times.

Ammar Al Hourani: Every five years things change. You know, file systems are changing all the time. You [01:17:25] know, there’s always new stuff. And I want to play with the new stuff. Otherwise I’m now stuck. Does that make sense? I’m now behind the times. [01:17:30] And because I teach, I need to also be preaching what I teach. If I’m saying, oh, buy this, this and this and I’m not [01:17:35] using it, I’m a bit of a hypocrite as well. To be fair. So you’ll come out very quickly, or when I’m demoing, it’s [01:17:40] going to look like I’ve never used that file system. Does that make sense? So I’ll look really stupid really, really quickly. So again, from that point [01:17:45] of view, generous principles are very, very good progressive principles. But then at the same time, they also need you to [01:17:50] be progressive as well. You need to be good. Talk, talk the talk patients need to be happy, comfortable with [01:17:55] what you’re doing. You’re not getting complaints. You know, you’re not getting a lot of retreatments and reworks of things that are failing. You [01:18:00] know you’re not causing more ruckus in the clinic. Does that make sense? So you’re also steadying the ship? So that’s why specialist [01:18:05] is a good job, but also a difficult job because I need to make sure I’m happy. Patients are happy. Principal [01:18:10] is happy. Referring dentists are happy. Staff are happy. Everyone has to be happy. It’s a lot of [01:18:15] constituencies. A lot of people have to be happy with your outcome. You’re always examined. Basically, every [01:18:20] end has been examined.

Payman Langroudi: Yeah.

Ammar Al Hourani: And so yeah.

Payman Langroudi: That must be hard.

Ammar Al Hourani: At the beginning. [01:18:25] It is. But then now it’s not. Not so much. I think you get comfortable with it. It becomes your life.

Payman Langroudi: The other thing is, while [01:18:30] you haven’t got your own clinic, from the business perspective, your [01:18:35] earnings are capped only by the number of Indos you can physically [01:18:40] do.

Ammar Al Hourani: Yeah. Hours that you can do. Yeah.

Payman Langroudi: Like, there’s no. There’s no dream of. Hey, I might [01:18:45] double the business next year. No, that can’t happen.

Ammar Al Hourani: No, I already do 4 or 5 [01:18:50] days a week and I hit the absolute limit, so I’ve sort of saturated now, you know.

Payman Langroudi: But [01:18:55] at the same time, I mean, while I was, I was advising all these students yesterday become [01:19:00] an endodontist. The reason I was doing that was because most lenders I know are really happy, man. Yeah, [01:19:05] they’re really happy. They’re earning good money. Yeah. What do you charge?

Ammar Al Hourani: Anywhere between 12. [01:19:10] 1000 to £1200 for a primary retreatments up to £1,400. [01:19:15]

Payman Langroudi: Could be more than that.

Ammar Al Hourani: No, I’m pretty good because I work in different demographics. So, [01:19:20] like, some areas can afford more than others. But I’m on a higher percentage. I’m in some clinics, I’m in higher than 50%. So [01:19:25] I’m always I’m doing I’m all right.

Payman Langroudi: And there’s a lab fee.

Ammar Al Hourani: There’s no lab fee. And also the good thing is [01:19:30] it’s a it works in both ways. You know, like if I work in your clinic because I do a lot of stuff and I do lots of courses [01:19:35] and stuff, you’re also getting a bit of free advertising. You know, you’re being put on the map as well at the same time. So it’s like, think of it as a [01:19:40] football player who gets the royalties for the shirts that they sell.

Payman Langroudi: How does it take you from over.

Ammar Al Hourani: About an hour.

Payman Langroudi: So [01:19:45] you’re doing like four a day or more.

Ammar Al Hourani: For four hours a day? Yeah, 4 to 5 a day.

Payman Langroudi: It’s not bad. [01:19:50] It’s not bad at all, man.

Ammar Al Hourani: Good. Good day’s income. Yeah. It’s not.

Payman Langroudi: Bad. And then. And then how many times a week are you [01:19:55] stumped? Like in trouble or month?

Ammar Al Hourani: In a month, maybe. [01:20:00] A handful of times. And my nurse knows that because she can smell my aftershave. She’s like, when [01:20:05] I smell your aftershave. I know you’re sweating. Yeah. And I start to. I start to breathe more heavily under the mask. I’m like, you know, [01:20:10] I’m really breathing hard because I’m getting angry. Not angry, but frustrated by the situation, you know? [01:20:15] But I think once you’ve done enough, then I know. I know at what point I can stop and say, you know what? [01:20:20] Payman. I’ve done everything I can. I’ve spent an hour on this. Like I don’t feel I can do any more. I’m [01:20:25] happy to refer you to another mate of mine to give it a go, but I think they’re going to also be going to be stuck. But it’s up to [01:20:30] yourself. Or we can finish now. Do surgery. Keep an eye on it. You know, I’m more confident now to say that’s [01:20:35] as far as I can push it. What would you like me to do going forward? Maybe 2 or 3 years ago? Not so much. [01:20:40] I would have kept pushing, pushing, pushing. Ten our mistake took place, you know, and then you’re like, oh, we shouldn’t do [01:20:45] that.

Payman Langroudi: Tell me about the teaching then. What is it? What’s what courses do you run? [01:20:50]

Ammar Al Hourani: So I run the. So two things I’ve essentially got two companies. The Indo Guys is [01:20:55] one. I started that off with my best friend during lockdown as a just keep me busy. So I started doing like webinars [01:21:00] for free and then it became I started working with a couple of companies doing almost. I [01:21:05] did free courses for about six months with a friend of mine, so I did that and that was really busy. And it was it was [01:21:10] good in two ways. Dentists were getting free courses and I was learning how to teach it, which is good. So [01:21:15] I was like, it was everyone was happy. So I’ve refined that and then started to slowly grow into Scotland. And then [01:21:20] I teamed up with my mentor, Sanjay Bhandari. He trained me as, as a doing my [01:21:25] specialist training. So that grew again. That helped me out. You know, he his experience was invaluable. He taught me [01:21:30] to be a good teacher as well, to be honest with you. But also you learn from a lot of people. You learn a bit here and there and you learn some stuff. [01:21:35] You’re like, no, I don’t like that. I’m not going to do that. So you create your own philosophy after a while.

Ammar Al Hourani: My philosophy was I [01:21:40] used to hate going to courses when I was at GDP, because a lot of it was a sales pitch to go and buy their bigger courses. [01:21:45] I hated that, I can’t tell you how much I hated it, or they would talk about how wonderful they are for half a [01:21:50] day, and then you do a little bit hands on an afternoon, you’re like, mate, how can I use that tomorrow morning? Like I’ve not learnt nothing today, [01:21:55] you know. So I wanted to do it. On how I would want to do it myself. So if I was now a delegate, what would I want? [01:22:00] Do the webinars or a lot of the teaching online and do a lot of the hands when I turn up? It’s all hands on. [01:22:05] By the time you’re done, you’re exhausted, so at least you’ve taken on 5 or 6 new tips that you could use on Monday [01:22:10] morning. So we do the principles of endodontics and I do the advanced endodontic course modules. They’re [01:22:15] both Royal College accredited. It’s fantastic. So they’re quality assured. And [01:22:20] we do a Cbct course as well, which is really nice. So that’s my UK courses.

Payman Langroudi: And then what’s the content [01:22:25] I mean the the first. So okay so how many days is it, how many webinars is it. And then how many [01:22:30] days is it.

Ammar Al Hourani: So principles of antibiotics is two days. Um webinars usually a day. Or we [01:22:35] do all the talks in the morning in an hour a couple of hours. Done. And then it’s access cavities, [01:22:40] uh, canal location, mechanical preparation using different file systems. But we teach you [01:22:45] the principles of it once you understand the principles of the whole concept. Kind of location. Pre-colonial. [01:22:50] Flaring. Patency. Glide path prep. You could use it on any file system, then obturation [01:22:55] or vertical and then just single cone technique, which is really straightforward. And a little bit about posting [01:23:00] cause when to use them. That’s day one. That’s day one and two. So by day two you’ve, you’ve sort of [01:23:05] got four years off. And on two days the advance is a little bit more. Obviously there’s trauma management, open [01:23:10] apices, perf repair RCT file fracture removal, ledge management, calcified [01:23:15] canals. So that’s a that’s a different thing. But I would always say maybe do a few more rondos before turning up [01:23:20] to that course because that’s much more advanced, you know. And you could you could tell who’s got the skills for it [01:23:25] and who doesn’t. I only do that maybe once or twice a year. Not not as often. Uh, and then. [01:23:30]

Payman Langroudi: If I wanted to become a dentist with a special interest in endo, you reckon if I do those [01:23:35] two courses, I’m anywhere near.

Ammar Al Hourani: No, I think that’s just for your day to day running of [01:23:40] things. You know, your bread and butter sort of dentistry. If you want to be a dentist, special interest, go and do a diploma. A [01:23:45] diploma.

Payman Langroudi: Okay.

Ammar Al Hourani: Pgcert or a diploma, or maybe finish it off and do your MSC. Msc is just the write up in [01:23:50] year three.

Payman Langroudi: Where would I get that?

Ammar Al Hourani: You could. Lots of great courses out there. So you can do the MSC at King’s, [01:23:55] the long distance one. Um, I think indoor art does one that’s really, really good with Bhavin and [01:24:00] his colleague. Um, where else? They simply end up in Liverpool. There’s Uclan that does a two year [01:24:05] accelerated master’s program with patients, which is fantastic, I think. [01:24:10]

Payman Langroudi: So yours is kind of a step before that.

Ammar Al Hourani: It’s a step. Yeah. I’d like to do one [01:24:15] where it’s a diploma.

Payman Langroudi: I haven’t got around to it yet.

Ammar Al Hourani: One, I haven’t got around to it. I’ve been really busy with a lot of other things. And [01:24:20] also, you need a team for it, and you need a lot of your time. And you need to cut down your clinical work to do it because it [01:24:25] takes up a day of your week just, you know, making sure they’ve got the cases and it becomes its own in [01:24:30] every sense, its own business, of course. Yeah. You know, with cohorts and people are paying a lot of money. So you need to make sure [01:24:35] that they’re getting the quality that they deserve. So that needs a lot of its own attention. And and it needs people [01:24:40] to partner up with me that will be able to do that at my the way I want to do it. And that’s tricky [01:24:45] to be honest. So and then the other course I do is in India. That’s my India courses and the restorative [01:24:50] with two of my really close friends. And we do that.

Payman Langroudi: How often do you do that?

Ammar Al Hourani: 3 to 4 times a year. [01:24:55]

Payman Langroudi: Wow.

Ammar Al Hourani: I love it.

Payman Langroudi: Is it in the same place in India?

Ammar Al Hourani: Every time? Yeah. Mumbai. Yeah.

Payman Langroudi: It’s fantastic fun in India. [01:25:00]

Ammar Al Hourani: I love it.

Payman Langroudi: Why is it fun?

Ammar Al Hourani: Love it, love it, love it. Brilliant, brilliant. Country people are lovely. [01:25:05] It’s changed my.

Payman Langroudi: Life. Delegate wise, what’s the main difference between Indian delegates?

Ammar Al Hourani: So [01:25:10] the first thing. I think we’re lucky in the UK that we’ve got more of a standardised training. [01:25:15] I think when you come at dental school, you’re all very much similar.

Payman Langroudi: Or you get lots of different.

Ammar Al Hourani: You’ve got lots [01:25:20] of dental schools. I mean, I think after Brazil they’ve got the second most dental schools in the world, so you’ve got all sorts. [01:25:25] The second thing is we get a lot of specialists on our course.

Payman Langroudi: And specialists.

Ammar Al Hourani: And those specialists, because a lot of [01:25:30] them, you know, there’s obviously different ways of teaching Ando and some of them is theoretical, some of them with little hands on patients, some of them with [01:25:35] just K files. They’ve never used rotary. So I would say about 30% of our delegates are actually endodontists. Wow. [01:25:40] Because they want to learn rotary. They’ve never, never tried rotary.

Payman Langroudi: Yeah.

Ammar Al Hourani: So that’s really, really nice. So that ups your [01:25:45] game a little bit more because now you’re dealing with people who understand the theory very respectful, very hard working [01:25:50] people. They really value education. They don’t take it for granted, which is very, very important because it’s very expensive. [01:25:55] You know, we charge 350, £400 for the course for two days in India. People [01:26:00] take out a bank loan for that.

Payman Langroudi: Wow.

Ammar Al Hourani: Yeah.

Payman Langroudi: What do you charge for your course here? [01:26:05]

Ammar Al Hourani: Just charge for 1000.

Payman Langroudi: For two days.

Ammar Al Hourani: Two days? Yeah.

Payman Langroudi: Again, that seems a little cheap.

Ammar Al Hourani: I [01:26:10] want it to be affordable for the masses. You know, my bread and butter. I’m really blessed in that I [01:26:15] earn good money from my private practice. That I don’t really have to rely on. My. This is sort of like a [01:26:20] bit of a bit, not a bit of charity, but, you know, a little bit of something different that I do once or twice a month. Does that make sense? It’s not my bread [01:26:25] and butter income. Yeah. So I keep it on. Sometimes I do it as low as 700 £850. [01:26:30] It depends. If you come in a group it comes down in price a little bit more. So it’s affordable. It still [01:26:35] earns me what I would earn in practice on those two days. And so therefore I’m not out of pocket. I’m not making it as a profitable [01:26:40] business. I’m not running it that way.

Payman Langroudi: I guess you get the referrals off those people.

Ammar Al Hourani: You get the referral. Yeah. Yes and no. If I’m doing it in Manchester [01:26:45] or Scotland, I’m not getting any referrals from it. So it’s like the people that teach with me that get the referrals, but [01:26:50] I’m doing it because I enjoy the teaching. You get to meet people, you’re out of the clinic. You know, you’re not stuck in that room under [01:26:55] a microscope. Under the microscope, it’s you versus you. You know, you’re in your own brain. Yeah. You know, you’re stuck in that little box, [01:27:00] which is the tooth, basically. And it can get a bit frustrating if you do it all day, every day. You know, it does get frustrating. [01:27:05] So you get burnt out. You can get burnt out really quick. I think as an end dentist, that’s the thing you have to be careful of. [01:27:10] So that’s why you know your mental health, playing sport, socialising, it gets [01:27:15] out of your brain, you need to get out of your brain. I know that sounds weird, but you know you’re in your brain all the time. It’s for real. You know, [01:27:20] I think.

Payman Langroudi: Any, any bit of dentistry, which is intense. Yeah, intense. [01:27:25] Much of dentistry is intense. But but if you’re if you’re doing things to a certain standard, I [01:27:30] think four days a week is enough for me.

Ammar Al Hourani: Not enough. I mean, I do five because I’m busy.

Payman Langroudi: Cos [01:27:35] you’re hardcore.

Ammar Al Hourani: But no, it’s not because I’m hardcore. It’s just you’re busy, you’re waiting list. You know, people are waiting.

Payman Langroudi: Up, [01:27:40] your prices up.

Ammar Al Hourani: But yeah.

Payman Langroudi: Really that’s the correct move. But I’m just saying. Four days. You can be peak. [01:27:45] Not everyone. I know some dudes. Yeah, there’s six days a week.

Ammar Al Hourani: I don’t know, six days.

Payman Langroudi: Too much, but. [01:27:50] But my point is, if it’s if it’s any level of dentistry where, you know, it’s very intense, the, [01:27:55] you know, let’s face it, dentistry is physically hard. First of all, you’re back and your eyes and all [01:28:00] that. But then mentally hard too. And then the thing you said about being sued. Yeah. That’s constantly [01:28:05] in your face. Right. So it’s mentally hard in different ways. Yeah. I’d say four days enough, [01:28:10] man. Um, let’s move on to errors. We like talking about mistakes. From [01:28:15] from black box thinking. The idea that, you know, people will actually learn from your mistakes. [01:28:20] What what what comes to mind when I say clinical errors? What [01:28:25] mistakes did you make and what can we all learn from it?

Ammar Al Hourani: Um, [01:28:30] so yeah, choosing the wrong materials is one is one mistake. I’ll never forget that. Did [01:28:35] an access cavity? I thought I had an endo z-bar to open up the access. Yeah, and I actually had that [01:28:40] tungsten carbide burr like a proper cutting bone burr and I drilled the bloomin tooth, and [01:28:45] that was a mistake.

Payman Langroudi: Tell me about the endeavour. What is that?

Ammar Al Hourani: So the Endo Z burr is a is a bald [01:28:50] tip burr side cutting bolt. So if you go into the axe, you know, if you.

Payman Langroudi: Yeah yeah yeah. [01:28:55]

Ammar Al Hourani: Yeah.

Payman Langroudi: You’re not going to do too much damage.

Ammar Al Hourani: You can’t you can’t perforate unless you really put your welly into it. It’s really, [01:29:00] really hard. You’re gonna have to really go at it to, to perforate it. Yeah, yeah. Here I took a bird that looked almost identical. [01:29:05]

Payman Langroudi: I just picked up the wrong.

Ammar Al Hourani: Picked it up. I just didn’t see it. Picked it up, put it in before you perforated.

Payman Langroudi: Yeah, [01:29:10] because you were thinking it can’t.

Ammar Al Hourani: Oh, I was like, oh, this is really nice and smooth. It didn’t feel [01:29:15] any different.

Payman Langroudi: Yeah.

Ammar Al Hourani: Yeah, yeah. And I was like, what the hell is this?

Payman Langroudi: Oh, interesting.

Ammar Al Hourani: And it was essentially [01:29:20] created an osteotomy. Uh.

Payman Langroudi: What happened? [01:29:25]

Ammar Al Hourani: Well, first off, I, you know, shat myself. Yeah. I’m not going to lie to you. I was [01:29:30] I was panicked, and I’m really difficult. I just don’t know how to lie. Like, it’s [01:29:35] sort of like you could see some things happen. You can see it from all aspects of my body.

Payman Langroudi: Basically the [01:29:40] everything.

Ammar Al Hourani: I’m just like, read. I’m just, like, bewildered by what just happened. Has it just happened to [01:29:45] me? You know, that type of thing? I just said to the patient, I’m really, really sorry. This is what’s happened. I think it’s beyond it’s beyond repair now [01:29:50] because I really screwed it. But I was honest, I was like, I’m really sorry. I’m going to pay for the for your implant. [01:29:55] I’ll fix the whole thing up and I’ll pay for any future implant. And it’s my really, really good friend Adeel. Adeel Ali, [01:30:00] great guy. Implant just called him up and I was like, mate, I’ve. I’ve created a booboo here. Could you do this for [01:30:05] me? And I’ll owe you one down the line. And that was exactly what happened. Did it for nothing. And [01:30:10] I was lucky because I’m lucky with the people I work with.

Payman Langroudi: Was he cool? Was the patient cool?

Ammar Al Hourani: Very cool, very cool. I said, [01:30:15] like, I’m really sorry. It’s a mistake. It’s never happened to me. It was my mistake. So whatever you want to do going forward, do. [01:30:20] If you want to complain, complain if you want to. But I can remedy for this.

Payman Langroudi: One that didn’t go so well. [01:30:25]

Ammar Al Hourani: Um, okay. So I had a patient that comes in sometimes you have to you have [01:30:30] to take on how do I explain this? You have to listen to your gut instinct.

Payman Langroudi: Yeah, yeah. Your spidey sense. [01:30:35] Right.

Ammar Al Hourani: Patient came in, uh, pretty nasty to reception. Pretty nasty on the phone. [01:30:40] Nasty guy, you know, but a really nice to me. That’s the first thing I learned, [01:30:45] you know? Now, like, this is when I was maybe three years, three, four years ago. So the patient. [01:30:50] Massive crack across the whole tooth. Big lesion, sinus, deep localised pocket. [01:30:55] This tooth is gone. Kept begging me to investigate it for him. Do that until I [01:31:00] went against my judgement. I felt sorry for him. You know, he’s like, you know, [01:31:05] I’ve got this. And that’s when my daughter’s not well and my son’s this and I’m looking after my mom. You know, he’s just sitting there going, [01:31:10] you know, if I, you know. So I did it because I thought that was the right thing to do. Started doing the endo. The tooth was [01:31:15] gone, took photos and a video, and I had a gut instinct. This guy wasn’t nice. You know, I had a bad feeling about this guy. So [01:31:20] I videoed the whole thing. And then I told him, it’s not going to be it’s not going to work. So I made him an appointment [01:31:25] again with my colleague. Same one. He then didn’t turn up to his appointment. Great. Cool. No [01:31:30] problem. Then the complaints start coming from 7:00 [01:31:35] in the morning till 12 in the afternoon. He’d already sent about 11 complaints. Each complaint [01:31:40] was almost like a chapter out of Pathway to Pulp.

Payman Langroudi: Oh my God. What a nutter.

Ammar Al Hourani: All sorts of stuff. All [01:31:45] sorts of allegations. Like I’m lying to him. I’m trying to pay my debts. I’m trying to make money to pay off my car. [01:31:50] My lifestyle mate. Like I have a normal lifestyle. I don’t I’m not lavish in any way, shape or form. And [01:31:55] this went on for hours. Hours. Then I got a letter [01:32:00] from one of the law partnerships. Crap. Myself, obviously. [01:32:05] Again because I was just about to go on holiday, so I was like, you know, it just happened before I went on holiday. Thankfully, the learning [01:32:10] experience here is I took videos and photos of everything, so that got quashed instantly. So [01:32:15] I was lucky in that respect. But that learning experience was just listen to your gut instinct [01:32:20] and take photos of everything. Because had I not taken photos, it’s you, you know, he said. She [01:32:25] said. And it’s always on the side of.

Payman Langroudi: The letter came in from Dental law and then similar.

Ammar Al Hourani: To Dental law was in Dental [01:32:30] law is a different one of those different. One of the other lawyer law companies.

Payman Langroudi: Called your.

Ammar Al Hourani: Indemnity. I was like, what the hell [01:32:35] is going on here? And I was with TDs Taylor Defence Society and I know Neil Taylor. [01:32:40] He used to do some talks for us when we were at doing so. I knew him a very, very [01:32:45] long time ago and bumped into him a few times. And I literally in that email said, I want to speak to this guy directly. I want to go straight [01:32:50] to the barrister. I don’t want, you know, I’m sorry. I don’t want anyone in the middle ground. I want straight to him. He [01:32:55] wrote a great letter. He was like, listen, this part here, paragraph [01:33:00] one. Yep. If you want to take him, take him. The other stuff, my my, my my client is going to take you for [01:33:05] slander, because unless you can prove.

Payman Langroudi: And it went away, he disappeared.

Ammar Al Hourani: Yeah. [01:33:10] We sent the video, sent everything, then disappeared.

Payman Langroudi: That’s nice.

Ammar Al Hourani: And it was the the law partnership to be [01:33:15] fair on them. That company, it wasn’t Dental law partner. It was a different company altogether. They also were starting to deal [01:33:20] with that individual. And I think they also thought that this guy’s a bit of a nutter.

Payman Langroudi: Yeah.

Ammar Al Hourani: And they wanted nothing to do with [01:33:25] it either. And because they saw all the allegations, like, how are you going to prove any of that stuff that I’m using it to pay my debts and I [01:33:30] don’t have any debts. I’ve paid my debts off a long time ago, you know what I mean? So it’s now it’s very difficult to prove the five [01:33:35] six hours worth of fare.

Payman Langroudi: I mean, you lucked out a little bit. I was very lucky because, you know, dental law partnership number [01:33:40] one, they go and buy dental cases from other law firms. Really, because they know how to weaponize [01:33:45] dental cases. They in the in the legal world they’re famous for that how quickly they buy [01:33:50] dental cases. Um, but number two, the fact that your spidey sense kicked in and [01:33:55] you videoed and documented properly.

Ammar Al Hourani: And I think the third thing I think is quite tricky. I [01:34:00] think that’s another thing about being a specialist. It’s pretty tricky to go after a specialist, I think.

Payman Langroudi: Yeah.

Ammar Al Hourani: Because I [01:34:05] can defend myself. Honestly. I can go to court and I’ll go and read the papers.

Payman Langroudi: Right.

Ammar Al Hourani: Pull all the papers out. And actually I would [01:34:10] speak to all my friends and I’d be like, guys, would you be interested to go in? And they would all like a little fight as well. And they’d all come up [01:34:15] and they’ll all be like, listen, this is nonsense. So it’s very difficult to prove I’ve been below [01:34:20] satisfaction because I’ve done everything by the book. Well, what could I’ve what could have someone else done different than [01:34:25] me? So it’s very difficult now to prove. And most of the studies are great for studies on a, you know, [01:34:30] that, you know, on a cat, you know, on a goat, on a dentine tubules slab, you [01:34:35] know, on a on a test tube. How does that show that? I’m. I’ve worked below standard. You can’t prove [01:34:40] that I’ve done anything wrong here. Does that make sense? It’s very difficult to get these studies now to say, because I could turn around and say, well, that was [01:34:45] done on a cat. So we don’t have that problem in, you know, human teeth.

Payman Langroudi: Yeah. [01:34:50]

Ammar Al Hourani: And before you know it, you can. Yeah. But it’s going to take you years to get out of that. That’s I mean, that’s going to be ongoing [01:34:55] for a long time before you get out.

Payman Langroudi: I think you take it for granted. Right. Because you’ve done the the [01:35:00] specialising you’ve done the PhD. So navigating your way around evidence based dentistry [01:35:05] is like drinking water for you. Yeah. A regular guy with panic. Panic. And [01:35:10] then some expert witness comes in and says something. Yeah.

Ammar Al Hourani: And then when was the last time you did dentistry? [01:35:15] 20 years ago.

Payman Langroudi: Suddenly your career, your life’s on the brink. Right.

Ammar Al Hourani: And that’s a shame. That’s a real shame. That’s [01:35:20] a real, real shame.

Payman Langroudi: Well, I don’t I don’t want to be the guy who scares everyone. I was talking to these young kids. [01:35:25] They’re all scared of it, right? And it’s not, you know, peak GDC is over.

Ammar Al Hourani: I think [01:35:30] so, I think now they’ve got all this newer filter systems, which are quite good. I think they are sort of slowly changing [01:35:35] with the times, which I think is even.

Payman Langroudi: Dental all partnerships over. You know.

Ammar Al Hourani: I think because, yeah, I think because they’re having to [01:35:40] be a bit more crafty with who they take on because I think they’ve lost a lot of the insurances on failures, I think. So I think [01:35:45] that’s why they’re now being more I think, I mean, I know a lot of people talk about the American system, but in America [01:35:50] you’ve got market forces. You can’t just, you know, if you sue me wrongly, I can go after you and everyone that’s [01:35:55] ever known you, you know, so you’re going to be extremely careful as to who you’re going to go after. And I think [01:36:00] that then stabilises the market. Does that make. Causes a natural equilibrium.

Payman Langroudi: Whereas here they’ve been suing [01:36:05] each other longer than we have. You know, it’s they’ve figured that stuff out. Exactly.

Ammar Al Hourani: Whereas we were sort of a little [01:36:10] bit of a sitting duck. It’s like, oh, you shouldn’t really sue your patient, you know, all that sort of stuff because it does feel bad, like [01:36:15] you really shouldn’t be doing it. But at the same time, you can’t just come up with a crap, you know, crazy complaint [01:36:20] against me and not expect me to do something about it. It’s like being punched in the street. You’re not going to not punch the guy back, you [01:36:25] know what I mean? It’s like it’s human nature to defend yourself, you know? So we’re not like, we’re not all [01:36:30] like that. Sort of like holy, holier than holy. Yet, you know, I don’t think we’re we’re not there. [01:36:35]

Payman Langroudi: I’ve really enjoyed it, man. I’ve really enjoyed it. Hour and 40 minutes in, I’m gonna finish [01:36:40] off with the usual questions.

Ammar Al Hourani: All right.

Payman Langroudi: Fantasy [01:36:45] dinner party. Three guests. Dead. Dead or alive?

Ammar Al Hourani: Dead or alive? Uh, first one, [01:36:50] I’d sit down with Jose Mourinho. I love Jose.

Payman Langroudi: Mourinho. Yeah.

Ammar Al Hourani: He’s cool. He’s a he’s a cool guy.

Payman Langroudi: I think [01:36:55] he’s a football fan.

Ammar Al Hourani: Yeah. United fan. Huge. Um, I think he’s a great guy. I love the way [01:37:00] he talks. There’s an element of mystery about him. I think he’s very smart. He’s a very smart guy. Um, [01:37:05] yeah. I’d love to pick his brains. Uh, the second one, I mean, these are now the two one [01:37:10] people would know. People one people wouldn’t know first. The second guy salaheddine. I’d love to sit with him, you know, through the crusader [01:37:15] time, because he did a bit of a miracle for the Arabs at that time, when things were looking pretty damn bad. And [01:37:20] it was a miracle, basically what he did, what he achieved. So I’d like to just sort of pick his brain as to what made him do what he did. Was [01:37:25] it coincidences? Was it luck? Was it you know, I think there’s always a tactics and all that [01:37:30] sort of stuff. The third one people won’t know this is Khalid ibn Al-Walid. Now he’s a leader. [01:37:35] During the time that the Prophet Muhammad was just starting to expand outside the Asian Saudi [01:37:40] peninsula or the Arabian Peninsula as the expansion was happening. And he’s a military leader that [01:37:45] is one of the most studied. He never lost a battle. He is he committed miracles all the time. [01:37:50] And so that’s a guy that I like reading up about a lot just to know what is it? [01:37:55] What was it about him basically, you know, is it because he was very good at deception, battle, deception and all that sort of stuff [01:38:00] at that era? So he committed absolute miracles with a lot of the battles. And I actually studied [01:38:05] a lot of it studied in British history as well. They study it a lot in Sandhurst, how he did all this stuff, because it’s quite [01:38:10] novel. I think that’s the three people I talk to. I’d like to understand how they work.

Payman Langroudi: Are you religious? [01:38:15]

Ammar Al Hourani: Um, I wouldn’t say I’m religious, but I would say I fear God. Yeah, I love [01:38:20] God, I fear God. I try to do my prayers. I try to be as good a muslim as I can be.

Payman Langroudi: Isn’t that religious? [01:38:25]

Ammar Al Hourani: But no, I think religious is when you go above and beyond. I think, you know, I think that’s the basics. I think I think that’s the [01:38:30] absolute basics to be a good Muslim. I think I think if you do the basics well as a muslim, I think you’re okay. [01:38:35] Obviously I’m not preaching it. Don’t, don’t you know? But I think if you’re a good person, you’ve got good intentions [01:38:40] in life and you do the basics well, you don’t, you know, you don’t mean any harm to anyone. [01:38:45] I think. I don’t see why you shouldn’t have a good chance of going to heaven, you [01:38:50] know, because you’re not doing any bad.

Payman Langroudi: So. So the final question, the three pieces of advice is that have [01:38:55] you just given them to me or what’s up? I know it’s honestly the.

Ammar Al Hourani: Best advice for me, honestly, is always [01:39:00] if I was speaking to my friend the other day about it and I was like, you know, work hard, um, have good intentions [01:39:05] and eventually everything comes to you. It just does, whether you like it or not, it [01:39:10] will always come good, will always come to you, you know? Just don’t harm anyone. Just be a good person. And if you.

Payman Langroudi: Are, the intentions [01:39:15] point is a really brilliant nuance. Yeah, it’s a really brilliant when when things go wrong. [01:39:20] If your intentions were right that you should be much better. [01:39:25] Much better.

Ammar Al Hourani: And even if it doesn’t go in your way, you can at least sleep at night because you did it by your intentions. [01:39:30]

Payman Langroudi: You know, intentions are really important.

Ammar Al Hourani: And I think that’s the beauty of the whole thing. I really.

Payman Langroudi: Really [01:39:35] enjoyed it. Really learned a lot, man. Really, really enjoyed having you. Thanks so much for coming in after all this time.

[VOICE]: This [01:39:40] is Dental Leaders, the podcast [01:39:45] where you get to go one on one with emerging leaders in dentistry. Your [01:39:50] hosts Payman Langroudi and [01:39:55] Prav Solanki.

Prav Solanki: Thanks for listening guys. If you got this far, [01:40:00] you must have listened to the whole thing. And just a huge thank you both from me and pay for actually [01:40:05] sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming [01:40:10] you got some value out of it.

Payman Langroudi: If you did get some value out of it, think about subscribing. [01:40:15] And if you would share this with a friend who you think might get some value out of it too. Thank [01:40:20] you so, so, so much for listening. Thanks.

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

Payman Langroudi: Tooth sensitivity is an enigma, and it probably becomes a big issue [00:00:05] in different situations in dentistry, but definitely comes to a head in whitening if you have any [00:00:10] problems with sensitive patients. Patients with dentine hypersensitivity to have a go with the enlightened [00:00:15] comfort bundle. It’s a bioactive glass pen with a [00:00:20] hydroxyapatite toothpaste combination that works really well in all cases of [00:00:25] severe sensitivity. So have a look on enlightened Wspa.com. The enlightened comfort bundle. [00:00:30] Let’s get to the pod.

[VOICE]: This [00:00:35] is Dental Leaders, the podcast [00:00:40] where you get to go one on one with emerging leaders in dentistry. Your [00:00:45] hosts Payman Langroudi [00:00:50] and Prav Solanki.

Payman Langroudi: It gives me great pleasure to welcome [00:00:55] Sam Cope onto the pod. Sam is a I would describe you as a minimally [00:01:00] invasive cosmetic dentist. Really? Um, a dentist who started [00:01:05] out as a physiotherapist. Um, a pleasure to have you, buddy.

Sam Cope: Yeah. Thanks so much. And thanks [00:01:10] for inviting me on the podcast. I’ve been I’ve listened a lot to the podcast and [00:01:15] with different people that have been on and things. So it’s yeah, it’s it’s when do you listen inspirational [00:01:20] that you have these people on.

Payman Langroudi: When do you listen?

Sam Cope: I actually [00:01:25] listen to my podcast when I’m in the gym. So I think it’s good because [00:01:30] it keeps you in the gym for longer and it’s almost dead time. So that’s what I listen. [00:01:35] Yeah, that’s what I listen.

Payman Langroudi: And how often do you go to the gym?

Sam Cope: Probably about four times. 4 or 5 times a week. [00:01:40] Oh, really? Yeah. I try and get into a routine. Yeah, usually. Usually in the mornings [00:01:45] or like, sometimes after work. I’ve. I’ve placed the gym so that when I, as I [00:01:50] walk home from work, I walk past the gym. So it’s a, it’s a real guilt trip if I don’t go. [00:01:55] So I’ve kind of done that on purpose just so.

Payman Langroudi: Have you read that Atomic Habits book or something.

Sam Cope: I actually [00:02:00] haven’t. Why? Is that something that you said?

Payman Langroudi: Yeah.

Sam Cope: Oh, right. Okay. Yeah. Yeah, yeah. So. Yeah, [00:02:05] that’s that’s what I do usually.

Payman Langroudi: So what time is that then? What time? What time do you wake up?

Sam Cope: Um, [00:02:10] usually about 6:45. Yeah. And then [00:02:15] I, I only work now clinically three days. So I [00:02:20] work Wednesday, Thursday, Friday. So all of teeth. All at love teeth.

Payman Langroudi: Okay.

Sam Cope: Monday and Tuesday [00:02:25] I have off. But I use that to reflect on all the cases [00:02:30] that I’m doing and also to do other things like things like this, all the fun things. [00:02:35] But I think reflecting on your practice [00:02:40] and going through, because I take pictures of everything, all the stages, and I go through all the cases [00:02:45] that I’ve done the week before, and I go through the cases that I’m going to do in the week, so that when I have my [00:02:50] clinical days, they are super kind of refined and everybody knows exactly what they’re doing. [00:02:55] I have like a list that my nurse has so she knows exactly what to get [00:03:00] out for each patient. So everything just works like a really fine tuned machine. So [00:03:05] having those two days works really well.

Payman Langroudi: How did you get into that habit? Um, [00:03:10] by chance, you are you, like, a massive perfectionist like you? [00:03:15]

Sam Cope: Um, I think I got into it just from different mentors and different [00:03:20] influences that I’ve had in the past. I remember like when I was when I was [00:03:25] in Liverpool, I was at the Dental house, and I remember Stuart Garton saying [00:03:30] to me, you know, dentistry, it’s it’s a marathon. It’s not a sprint. Yeah. And [00:03:35] I didn’t really understand that at the time because I was that one.

Payman Langroudi: Of your first jobs?

Sam Cope: That was. Yeah, my, one of my NHS first [00:03:40] jobs, which at the time I thought, you know, I didn’t really understand what it meant, but now I understand completely [00:03:45] what it means. There’s no like the faster you try to go, it seems like it [00:03:50] can be counterproductive. You make the same mistakes. Yeah, but if you kind of take it slow, You learn [00:03:55] from your mistakes and then you can. You can grow. You get so much better.

Payman Langroudi: Give [00:04:00] me an example. Then when you’re when you’re looking at cases, past [00:04:05] cases and future cases on that day off. Give me an example of something that [00:04:10] you learn by doing that, that the next man doesn’t learn by not doing that. [00:04:15] Like, what kind of thing are we talking.

Sam Cope: Yeah. So I’ll be I’ll, I’ll [00:04:20] do a case and then I’ll look at all of the pictures and something that, you know, the patient walks out, they’re super [00:04:25] happy. Um, and you’re kind of buzzing because you’ve just finished your Invisalign. [00:04:30] You’ve done the composite, and it looks fantastic. You look at the pictures [00:04:35] and you look at kind of your build ups and things, and you think, actually that [00:04:40] tooth looks a little bit grey. Like if we if, you know, if I was going to post that, it [00:04:45] looks a little bit grey. Not really too happy with it. I’ve probably placed too much enamel. So really I need to increase [00:04:50] the dentine layer. Or it could be, you know, you’re cutting veneers [00:04:55] and you look at the the prep and you think, actually, I’ve over prepped there. Or you might say, actually [00:05:00] there’s a, there is a little bit of a black triangle. So maybe I should have taken through the [00:05:05] interproximal aspects, gum levels as well. [00:05:10] I find sometimes where you’ll finish the case and everything looks great, and then you can see [00:05:15] that one of the gums is, you know, slightly square rather than having a nice curve [00:05:20] to it. So you think, actually, if I’d had just done a little bit of laser or laser or something, yeah, [00:05:25] that would have looked great, or using some of the gum cutting burrs I find [00:05:30] works really well. Um, only if it’s for something very, very small.

Payman Langroudi: When I was a dentist, [00:05:35] there was this burr that used to cut gum and coagulate at the same time. Do you know what I’m talking [00:05:40] about? It’s like a ceramic burr.

Sam Cope: Yeah, I think.

Payman Langroudi: That’s the.

Sam Cope: One I’m using. Yeah. Yeah, yeah.

Payman Langroudi: Amazing. Does that still exist? [00:05:45] Yeah.

Sam Cope: Canal, um, introduced me to that burr. Oh, really? Yeah. It does work really well, [00:05:50] I think with with kind of gum contouring and things I’ve done Reena Wadia’s [00:05:55] course for crown lengthening. I think if you’re doing like very small you.

Payman Langroudi: Can do that. [00:06:00]

Sam Cope: Yeah, you can do it, but if not then definitely recommend kind of doing flaps and [00:06:05] and are.

Payman Langroudi: You comfortable with blood. Are you comfortable with flaps and implants [00:06:10] and things?

Sam Cope: I don’t do implants, but I would be happy with doing the flaps [00:06:15] and things I’d say.

Payman Langroudi: I’d say that’s something that one of the things that keeps people away from implants, [00:06:20] right. That not not comfortable with flaps, not comfortable with taking flaps back [00:06:25] and putting them, you know, suturing them back together again.

Sam Cope: Yeah. That’s true. I [00:06:30] think, um, you’ve got I think you’ve just got to learn how everything can fail, but then [00:06:35] you to feel comfortable. So then, you know, if you know, then what you can do [00:06:40] to fix it. I think that’s the key.

Payman Langroudi: Did you qualify?

Sam Cope: So I qualify 2019. [00:06:45]

Payman Langroudi: Wow.

Sam Cope: Yeah. So not that long ago.

Payman Langroudi: Yeah. That’s pretty. That’s [00:06:50] pretty good going. What? You’re what you’re up to in five years.

Sam Cope: Yeah, I suppose [00:06:55] I’ve had great mentors and I’ve just practised so much, [00:07:00] like most. I remember when I was in the Dental house, I was really lucky because [00:07:05] it was an NHS contract that I had, but most of the [00:07:10] clinicians that were working in there say orthodontists, um, people doing composite veneers. [00:07:15] So I had great mentors from them who just, just let me watch as well, which is quite rare [00:07:20] for dentists, I think. So a lot of dentists don’t want you to see what they’re doing. But I had [00:07:25] say if I was going to name drop Kate Jigs Patel. Viraj Patel. [00:07:30] Yeah, such lovely people, even, um, even Stuart [00:07:35] Garson and Rick, they, you know, let me come in and watch them and I’d spend my [00:07:40] days off kind of coming in to watch them because I’d have a day off in the week. And you find that you’re [00:07:45] clinical. You’ll, you’ll always learn from another dentist just by watching them, no matter what dentist [00:07:50] they are, I’m loving.

Payman Langroudi: I’m loving the fact that you’re sort of putting [00:07:55] days off as part of the education. I’m loving that. It’s [00:08:00] weird. Like for me, in my head, that sort of reminds me of, I don’t know, an advert where you have nothing in one [00:08:05] corner of an advert, we call it Negative Space. Yeah, a negative space in dental education. [00:08:10] Like you’re saying, back then, you were taking a day off and watching people, [00:08:15] you know, shadowing them. And right now you’re taking days off and [00:08:20] using those days off to treat and plan and reflect on your previous work. It’s kind [00:08:25] of an interesting thing, man, because, you know, it’s like maybe, you know, like they say, own the gym, don’t [00:08:30] don’t go to the gym seven days a week, you know, like allow some rest and recuperation. [00:08:35] Like in in our terms, in education terms, rest and recuperation doesn’t necessarily [00:08:40] mean sitting on the sofa watching TV. It could mean not having [00:08:45] to be there at 830 in the morning, all dressed up. But working on your career? [00:08:50]

Sam Cope: Yeah.

Payman Langroudi: And very interesting.

Sam Cope: Yeah, yeah, I think doing the three days a week [00:08:55] is great because it means you still kind of you’re like, fired and [00:09:00] ready to go every week. You’re kind of like, oh, I’m actually ready to get back into work now and see impatience. Yeah. And [00:09:05] then on the days off, it’s great as well. I usually have my weekends where it’s just chill [00:09:10] and I try not to think about work. And then on the Monday, Tuesday, I can kind of really [00:09:15] focus down on what’s going on, find, um, I find Instagram and [00:09:20] social media that takes up a lot of time. I was thinking of even getting a kind [00:09:25] of social media manager or something, but they’re really expensive as well. And you’re [00:09:30] always wondering, like, are they going to be able to portray you as well as you’d be able to portray yourself [00:09:35] with the photos and things?

Payman Langroudi: So to start with, no, the thing about [00:09:40] taking people on to do things is to start with quality will drop Compared [00:09:45] to you doing it yourself. Yeah, whoever that is, whatever the job is. Yeah. Because, you know, [00:09:50] you yourself, at the end of the day, you know, it’s it’s the way you want something done. Mhm. But [00:09:55] it’s also the thief of growth.

Sam Cope: Yeah.

Payman Langroudi: Yeah. You know the [00:10:00] comparison is the thief of joy. Yeah. It’s the thief of growth because people who can’t [00:10:05] delegate generally have got sort of like a trust issue. Yeah. [00:10:10] Or a communication issue. Like I find for me it’s more a communication [00:10:15] issue than a trust issue. Some people are just brilliant at setting out what the task [00:10:20] is, what the deliverable is, and you know what progress looks like for someone [00:10:25] else. Yeah. But with me, when I when I’m asking someone to do something, I just [00:10:30] almost like saying I’ll figure it out sort of thing. And even if even though I know this fact, [00:10:35] it doesn’t come naturally to me to delegate in that way. Um, so [00:10:40] those two things trust and communication. But what will happen is that there’s like a dip. [00:10:45] And then if the person’s any good, it’ll be, you know, like the volume of, [00:10:50] of output will outdo the dip. Mhm. And just depends man. It depends [00:10:55] if you’re the type of person who, you know, if one post that’s incorrect is going [00:11:00] to break your heart, then you better not grow.

Sam Cope: I was uh [00:11:05] I’ve got two younger brothers. Yeah. And they’re in this social media age. [00:11:10] They must be you. Oh, yeah. They’ve definitely broke the 10,000 hour rule [00:11:15] on. Oh, really? Yeah. So I was thinking, like, maybe it’s a good idea to kind of teach them, [00:11:20] and they can. I’ll give them a bit of pocket money. Yeah, they can do it. They’re probably better than these social [00:11:25] media managers and things if they if you help them to grow. But I agree [00:11:30] with you. I mean, I, I use different composite techniques and wax ups to [00:11:35] do my composites and I wanted some I wanted something doing well. So [00:11:40] I went to the lab, got to know the lab technicians really well, and [00:11:45] I showed them kind of how I want to do things. And we learned from each other because a lot of dentists [00:11:50] don’t go to the labs. And also a lot of the lab technicians are quite away from what goes on in the clinic. [00:11:55] So I definitely recommend for anyone listening to this to go to the lab, get [00:12:00] to know your technician, and kind of you can go back and forward with, you know, what you know [00:12:05] and what can help. And they can tell you what. And also they tell you new materials that are in and different techniques. [00:12:10] And you can also, if you’re really nice to them, they might even show you some other dentists work, [00:12:15] which also is really good to see.

Payman Langroudi: You know, education right. You’ve got, [00:12:20] you know, letters after your name type education. You’ve got short courses [00:12:25] and, you know, diploma type courses. You’ve got books. I don’t think you should. You should, [00:12:30] you know, people don’t buy enough books because books books sound expensive. [00:12:35] When you look at them you think, oh, £400 for a book, but that’s nothing compared to a course. Yeah. [00:12:40] And the amount of I mean, what tends to happen with the book is the author has got [00:12:45] the pride that, you know, if we’re putting a book out, I’m going to put value into that book. [00:12:50] And there’s. But then, but then education from your technician. I [00:12:55] had one technician who was just an absolute gem. He taught me so much. So much. [00:13:00] Um, brilliant guy, John Oliver in Kent. Um, [00:13:05] but but also salespeople. You know, it’s funny. People, people [00:13:10] tell their receptionists, keep salespeople away. But that salesman [00:13:15] who comes into your practice with the whatever it is, you know, whatever the guy [00:13:20] is selling, he’s got product knowledge. He’s got market knowledge, you know, [00:13:25] that you’re not going to have you’re not going to have. He’s going to tell you what the most successful [00:13:30] dentists using that product is doing and, and how and [00:13:35] that’s gold. And yet we spend our time telling our receptionist. Keep salesmen away. [00:13:40] Salesmen for me are, yes, free CPD for someone who wants to sell [00:13:45] you something. Yes, he wants to sell you something. But free CPD and education [00:13:50] is so multifactorial. What would you say is the most valuable? [00:13:55] I’d say the shadowing one.

Sam Cope: Yeah, the shadowing is very good because, I mean, [00:14:00] I spent a little bit of time with, um, with Rosie, [00:14:05] and she was an oral surgeon, and she showed me how to take teeth out. And I swear I’ve learned more [00:14:10] in that morning with her than I did throughout my whole university. Just really [00:14:15] simple techniques that you look at her taking a tooth out and it just looks like you think. You think to yourself, [00:14:20] you know, God, what my teeth actually held in with because she’s getting them out. They’re just falling out like rain. [00:14:25] Yeah. Um, but, yeah, it’s probably the most important thing.

Payman Langroudi: When did you when did you [00:14:30] decide the kind of dentist you wanted to be? At what point did you [00:14:35] decide, or maybe you haven’t decided yet. Yeah, but were you the type [00:14:40] in university to be thinking I want to be a [00:14:45] private dentist, or I want to be a cosmetic dentist? Or what do you think? What were you thinking [00:14:50] at university about your career going forward?

Sam Cope: So I come from a very kind of 21st [00:14:55] century family. I’ve got a step grandad and a step uncle. Go [00:15:00] on. Yeah. Spell that.

Payman Langroudi: Spell that out for me. Spell it.

Sam Cope: Spell it out. So my grandma remarried. [00:15:05]

Payman Langroudi: Yeah.

Sam Cope: So he’s my step granddad. And then his son is my step uncle. [00:15:10]

Payman Langroudi: He’s got a whole step family then.

Sam Cope: Yeah, yeah. Oh, God. Yeah. I’ve got, like, six brothers. [00:15:15] Like, I won’t go into all of that. It’s like four step brothers. Two half brothers. It [00:15:20] just goes on. But I found that I was [00:15:25] watching. I was watching my step granddad work because he was a dentist and my step uncle was a dentist. [00:15:30] Oh, really? So he worked in a predominantly NHS practice. I shadowed him [00:15:35] and that, you know, he was very old school [00:15:40] and he would just see. You know, 50 patients, maybe more a day, [00:15:45] and he’d have two surgeries running and he’d just bat between the two. No communication happened between [00:15:50] him and his patients. It was just I’d say to him, oh, what did you do for that patient? He went, oh, we just did a root canal. [00:15:55] I was like, did he even know that? Whereas my step uncle, [00:16:00] he he works on Pont Street and he’s fantastic. And [00:16:05] he sees lots of kind of high end people in London. Yeah. Pont Street [00:16:10] in London. Oh, okay. Yeah. And he does fantastic work. That was kind of what inspired me to do [00:16:15] dentistry. I saw him once. There was a woman and her tooth was completely [00:16:20] shattered. She’d fallen over and he’d just rebuilt it so fast with composite. [00:16:25] But when I was, when I was at university, I’d always just thought I was going to do general dentistry. [00:16:30] I never had like a massive flair for composite or anything like that, really. [00:16:35] But when I did my foundation year, my friends were saying, [00:16:40] oh, we’re going to do like a composite course. So I ended up going on the totally [00:16:45] composite one with monarch, and I watched him kind of.

Payman Langroudi: As a foundation.

Sam Cope: As a foundation. [00:16:50] Yeah, just towards the end. Yeah.

Payman Langroudi: Good time to do it.

Sam Cope: And I just found like [00:16:55] after after doing a course like that, I was like, wow. I never realised [00:17:00] that because, you know, when you’re at university you’re taught how [00:17:05] to do something, but you have this huge anxiety that, oh, if I get this wrong, then [00:17:10] I’m going to have to reset the year or I’m going to have to reset the class. So you can never really relax. And I feel [00:17:15] that you learn when you’re relaxed and you’re you’re enjoying it. And and when [00:17:20] you can see that you can do it, then it’s just yeah, fantastic. So I did I did that, [00:17:25] then I ended up doing the year long course with him. And it was after that that I thought, yeah, [00:17:30] do you know what? I think I’d really like to do the composite.

Payman Langroudi: Kind of stream.

Sam Cope: That kind of dentistry. [00:17:35] Yeah.

Payman Langroudi: Tell me about the journey from schoolboy to physiotherapist [00:17:40] to dental school.

Sam Cope: Yeah. So I through [00:17:45] so I always really liked biology helping people. [00:17:50] So I thought, you know, doing something to do with medicine would be great. [00:17:55] I then finished, finished school [00:18:00] and I just didn’t think I was going to get the grades to do medicine or dentistry. So I looked elsewhere. [00:18:05] I was thinking like, maybe I should do biomedical sciences or something, but [00:18:10] then somebody with.

Payman Langroudi: A view, with a view to eventually doing.

Sam Cope: With a view to move. And then somebody said, well, you’re [00:18:15] probably just really enjoy physio. So I did physio and I did that at King’s [00:18:20] in London and that was amazing. It was very research heavy. [00:18:25] Um, so it was very intense. I actually, I’ll be honest, I found [00:18:30] the exams for physio a lot harder than the exams for dentistry. Really? And [00:18:35] it was. It was a fantastic experience and it was intense because [00:18:40] we’d have, you’d have 9 to 5 lectures every day and then the summer holidays you’d [00:18:45] spend on placements and you’d think that in London, you know, [00:18:50] there’s loads of hospitals in London that you could go and but there’s also loads of universities in London [00:18:55] students. So you could be shipped off to Middlesex, Kent for your placements [00:19:00] and then, you know, you’re, you’re in hospital accommodation, which I’ll, I’ll tell you is [00:19:05] dire. Yeah. It’s horrible.

Payman Langroudi: I’ve spent I’ve spent a fair amount of time in hospital accommodation. [00:19:10]

Sam Cope: Yeah. It’s it’s like you’re in a cardboard box with. So, [00:19:15] um, so.

Payman Langroudi: You’re telling me physio what is as hard a degree as dentistry?

Sam Cope: I thought it was harder. [00:19:20] Yeah.

Payman Langroudi: That’s so interesting, man.

Sam Cope: It was.

Payman Langroudi: It was the hardest degree around. [00:19:25] That’s so interesting, man.

Sam Cope: Yeah, I felt I mean, I suppose [00:19:30] I’d already done physiotherapy, so I already knew how to learn. But when I was doing my [00:19:35] dental degree, I was working as a physio Monday, Tuesday nights [00:19:40] and Saturdays.

Payman Langroudi: During the degree.

Sam Cope: During the degree. Wow. And then I [00:19:45] even like I remember the night before my finals, I had like a list of five patients [00:19:50] in the evening.

Payman Langroudi: Wow.

Sam Cope: Um, mainly. I mean, I know that sounds ridiculous, [00:19:55] but it was mainly just so that I could switch off because I just thought, well, I’m not going to learn anything now. I might as well make a [00:20:00] little bit of money and just kind of set my mind aside.

Payman Langroudi: So it’s a bit different to my night [00:20:05] before the exam. I’ll tell you that. The caffeine tablets. I [00:20:10] was studying all that, but. So you worked [00:20:15] as a physio for how long before deciding to do dentistry? [00:20:20]

Sam Cope: So I finished, I finished my degree in physiotherapy, and then I worked for a year [00:20:25] as a physiotherapist, so I was working full time, seeing 20 patients [00:20:30] a day and it was really good. I learned a lot and you learn a lot [00:20:35] about neck back pain, how that works, and then you also learn loads about how [00:20:40] to treat it. So I was also the physio for Millwall rugby team, [00:20:45] which was cool. And then whilst I was doing dentistry I had my own. I [00:20:50] worked for a private clinic so I was on Rodney Street in Liverpool working there, but [00:20:55] then I was also the physiotherapist for Merseyside Fire and Rescue and the Philharmonic [00:21:00] Orchestra, so that was really cool. So I used to get free tickets to the Philharmonic, and then I used to get [00:21:05] some cool stories from the fire brigade.

Payman Langroudi: In a way. On the top of your game in physio, [00:21:10] I mean one year out, but still on the top on a trajectory to be a top physio. [00:21:15] What is the reason for switching? Is the pay terrible? Is that [00:21:20] what it is? I mean, is the pay terrible?

Sam Cope: The pay is you work hard [00:21:25] for the pay that you get. But it wasn’t really that that stopped me. It was more the fact [00:21:30] that there’s a ceiling effect where I felt that the [00:21:35] more the more pay I could. You know, the trajectory was to either open up your own musculoskeletal [00:21:40] clinic, but then there’s only so many patients that you can see in a day. So then it would obviously [00:21:45] be looking at hiring associates and things, or it was going down the route of being with [00:21:50] a football team or a rugby team and following them around the world, which is intense. [00:21:55] And also I found that working for rugby teams and things you [00:22:00] are, you’re obviously there to help them and the players respect you, but you [00:22:05] I never really felt like I was part of the team. I always wanted to play rugby or football with [00:22:10] them because when you’re the person that they [00:22:15] come to when they’re injured, so you’re almost the person that they [00:22:20] don’t really want to see, which is fair enough.

Payman Langroudi: But what a.

Sam Cope: Yeah. So [00:22:25] I felt and also because I was thinking about, you know, the dentistry with my step [00:22:30] uncle and granddad. I just thought, do you know what I can? I could never really envision myself as [00:22:35] being a physio forever. I kind of wanted to branch out, and I thought that if [00:22:40] I didn’t take the opportunity to do dentistry or even medicine at that time, I probably [00:22:45] would never do it. So I thought, well, why don’t I just do the degree and then I can [00:22:50] always decide. I kept my physiotherapy running throughout just in case, [00:22:55] and I still have my Healthcare Professions council um, registration now so [00:23:00] I can still do physiotherapy if I, if I really wanted to, but um, [00:23:05] but yeah, that’s kind of what happened.

Payman Langroudi: And so with that insight [00:23:10] into physiotherapy, you must know a lot about dentists backs. [00:23:15]

Sam Cope: Yeah. We I did a lot of research with it where it [00:23:20] said something like 60 to 90% of dentists will get back [00:23:25] pain at some point in their life. Yeah, and I did a survey amongst, [00:23:30] um, final year students at Liverpool [00:23:35] Dental School and the results were quite, um, quite interesting where [00:23:40] it said, they said that something like 40% of dentists had experienced back or neck pain [00:23:45] in the last six months, and 14% had sought professional [00:23:50] help. The other thing was that the education was quite [00:23:55] poor, whereas most people thought that limiting exercise [00:24:00] and bed rest was probably the best way to manage back pain and [00:24:05] also to improve your posture. Whereas in actual [00:24:10] fact, it’s the opposite. Yeah, yeah. Um, for back pain, you need to be moving as much as possible. [00:24:15] And posture has limited to no [00:24:20] role in the amount of back pain that you have. Yeah.

Payman Langroudi: How much of [00:24:25] back pain is, is sort of specific to the to the patient as opposed [00:24:30] to their habits. You know how you know in perio disease there are susceptible [00:24:35] patients.

Sam Cope: Oh, okay.

Payman Langroudi: Are there backs that are more susceptible. I mean, [00:24:40] does does a back have intrinsic areas of weakness different for [00:24:45] each person? Or would you say in your opinion that it’s just like we all get a similar [00:24:50] back and some of us treat it better than others?

Sam Cope: Yeah. I mean, some I mean, some people [00:24:55] will have medical conditions like scoliosis, which will. Yeah, yeah. Which will make them more susceptible. [00:25:00]

Payman Langroudi: I guess there’s a preclinical kind of.

Sam Cope: But yeah.

Payman Langroudi: That could be going on in many of us. Right.

Sam Cope: The [00:25:05] biggest factor is just the amount of exercise that you do. And also your [00:25:10] your mental state has a massive component on it. Stress. Yeah, [00:25:15] definitely. Yeah. Um, if you’re if you’re in a really good place and [00:25:20] you’re doing lots of exercise. It’s very unlikely that you’re you’ll get back pain. But if [00:25:25] you’re, you know, depressed or very stressed at work, then you’re much more likely [00:25:30] to get back and you’re not exercising, then you’re much more likely to get back pain. [00:25:35] And then it’s interesting.

Payman Langroudi: Because I took five years off clinical practice when we started enlightened, [00:25:40] and then after five years, what I had in my head was mothers get [00:25:45] pregnant, take five years off, and then they come back and become dentists again. I thought I could just about [00:25:50] pull it off, you know. So it took five years off. On my first day back and my first week [00:25:55] back, I had an awful back pain. Yeah, I don’t think it was because, oh, my back wasn’t used [00:26:00] to. It was the stress of giving an ID block for the first time [00:26:05] in five years. You know, or, you know, cutting a crown for the first time in five years. All the things [00:26:10] that I was stressed, I was worried about how it would be going back. And [00:26:15] then once I realised, oh, it’s okay, I’m all right. Suddenly, the back pain went straight away [00:26:20] like it was. It was the stress that was causing it. You know.

Sam Cope: I think a lot of the stress comes from [00:26:25] if you get back pain, a lot of people don’t know what it is and [00:26:30] they think, oh, wow, have I really injured my back? You know what’s going on? Is it muscle? Is it. And [00:26:35] I think when when I did physiotherapy, it was all about kind of doing different [00:26:40] tests and then trying to find out what was going on. But never would it be an x ray or MRI. [00:26:45] Whereas with a, with dentistry, you know, you have to take the x ray and you see the problem, [00:26:50] you treat it and then you get rid of the caries or you do the root canal. But it’s very different [00:26:55] with back pain. I’d say 90% of back pain is non-specific. There is no [00:27:00] you can do every MRI x ray on the planet. You’ll never find the pain. It’s [00:27:05] so there was interesting. Yeah, there was a study that was done on [00:27:10] the amount of it basically had thousands of people and they’d [00:27:15] done MRIs Memorised throughout, you know, 20, 30, 40, 50. You know, you can have early [00:27:20] osteoarthritic changes at 20, but there’s no pain. [00:27:25] It’s what you see on an MRI isn’t.

Payman Langroudi: Related.

Sam Cope: Related to the pain. [00:27:30] Yeah. Which is what? So that’s why it always worries me when, you know, people get private medical [00:27:35] insurance and they get a bit of back pain, and then they go and get an MRI and they say, oh, you’ve got [00:27:40] a herniated disc here, or you’ve got osteoarthritic changes or disc thinning. [00:27:45] And then they’ll say, oh, well, you know, I’m going to go and see the surgeon because the surgeon sees, [00:27:50] you know, he’s only really it’s almost like the one hammer, one nail kind of thing. [00:27:55] So I’d, I’d just recommend anybody that does have back pain just to firstly find [00:28:00] an evidence based physiotherapist and then see them first and [00:28:05] then go from there. Really.

Payman Langroudi: But then if let’s say there is [00:28:10] like a slipped disc that could be causing a big problem. I guess one of the things you guys have [00:28:15] to learn is when to refer to a back specialist or like one.

Sam Cope: Yeah, 100%.

Payman Langroudi: Spinal surgeon [00:28:20] or whatever. What’s that thing called where you can cause incontinence if you don’t take care [00:28:25] of it straight away?

Sam Cope: It’s called cauda equina.

Payman Langroudi: That’s right.

Sam Cope: Um, but yeah, these. [00:28:30] I mean, it’s so rare.

Payman Langroudi: Is it?

Sam Cope: Yeah, yeah. I mean, but that’s why it’s [00:28:35] so important. As soon as you if you get if you get back pain, it’s best just to settle your mind. Go and see a physiotherapist. [00:28:40] Yeah. And then they’ll be able to tell you if there’s, if there’s a real problem. And also [00:28:45] the if you do have a real like a herniated disc, then usually you’ll have [00:28:50] burning pins and needles, numbness down one or both legs all the time. Incontinence. [00:28:55] Yeah. You wouldn’t be waiting for your appointment. You know, you’d just be.

Payman Langroudi: Yeah.

Sam Cope: You’d [00:29:00] know.

Payman Langroudi: So as a dentist, what are the things that we do that are really bad for our backs? Is [00:29:05] it as obvious as we don’t use loops and we, you know, what [00:29:10] are the top tips? What can we do? Exercise, stretch. That sort of thing.

Sam Cope: Yeah, I’d say top tips are [00:29:15] when you’re in surgery, the best posture is the next posture. Don’t [00:29:20] try and stick into one posture.

Payman Langroudi: Oh, interesting.

Sam Cope: Do whatever you feel is more comfortable. [00:29:25] And then that will really help with your pain. Another thing would be [00:29:30] our days are stressful. You know, you see the BDA guidelines of, you know, [00:29:35] you’ve got to do so many stretches in between patients and you’ve got to sit with one patient, stand with the next [00:29:40] patient.

Payman Langroudi: Is that right?

Sam Cope: That’s like, you know that’s intense. Like our days are already intense enough. [00:29:45] And if you’ve got like 30 NHS patients a day, how would you remember to do all this stuff? You won’t remember. [00:29:50] The most important thing is just to, you know, the NHS guidelines is to do 150 [00:29:55] minutes of moderate intensity exercise every day. Just going for a run or doing [00:30:00] the exercise that you enjoy is the most important, because that’s the one that you’ll continue [00:30:05] to do. If you try and force yourself to do, I don’t know the rowing machine and you don’t [00:30:10] like rowing, you won’t do it. You’ve got to give yourself an achievable goal. Um, [00:30:15] but also I do, um, I like it in America, where, you know, if you [00:30:20] want to get, like, strong, then you’ll get a personal trainer to help you in the gym. [00:30:25] Yeah. I feel like as a dentist, like, we go through so much stress, which we don’t [00:30:30] really talk to other people about it because I think it can be perceived as weakness or you’re [00:30:35] not doing your job correctly. But I think seeing counselling or having, um, psychological [00:30:40] help or therapist. Yeah, it’s really good. It’s almost like a personal trainer for your brain. [00:30:45] For your mind. Yeah. And all that. You know, you see these high corporate Americans or [00:30:50] even, like the people in Liverpool Street here or Fenchurch [00:30:55] Street, they’ve all got their own therapists because their jobs are so stressful. Talking [00:31:00] to them and then giving them strategies and being able to to help them really [00:31:05] helps you to kind of negotiate what’s going on in your [00:31:10] life and helps to reduce the stresses and makes you a better person, but also helps you deal [00:31:15] with your job and problems in a much more efficient way.

Payman Langroudi: Yeah, I think, you know, I do [00:31:20] that mental health thing with Rona, and one thing I found is very useful [00:31:25] way of looking at it is kind of what you said about, you know, there is a spectrum all the way from fully optimising [00:31:30] on one side to, you know, being really, really down on the other side. [00:31:35] And you can go up and down that, that staircase. Um, but [00:31:40] that, you know, some people will be on stair nine out of ten and want to get to ten out of ten because they [00:31:45] want to optimise as executives or whatever, and they’ll use a therapist for that. And some people [00:31:50] will be at rock bottom and want to just, you know, survive that. Um, [00:31:55] do you think that with your generation the sort of taboo of that is [00:32:00] less or would you say it’s still there?

Sam Cope: I think it’s definitely I think it’s definitely less [00:32:05] in my generation. I mean, I’m I know I’ve at the moment, my dad’s going through [00:32:10] some troubles and I’ve said, you know, you need to go and see a therapist and things and you do get a lot [00:32:15] of resistance.

Payman Langroudi: From from his generation.

Sam Cope: Yeah, he’s in his 60s and he’s, you [00:32:20] know, he’s the I feel like the life philosophies are very different, probably [00:32:25] from the parents talking to them.

Payman Langroudi: Yeah.

Sam Cope: I read a really interesting study. It was [00:32:30] I’m sure you’ve probably heard of it before, but it was a Harvard study and [00:32:35] it was called the Adult Development Research, and [00:32:40] it was basically 7 or 800 people, and they came [00:32:45] from all different backgrounds. Most of them were kind of Harvard guys. And then they also [00:32:50] got quite a few from Boston where they were kind of at rock bottom. And [00:32:55] they did a long term trial that went well. It’s still ongoing now, but it’s over [00:33:00] about eight years. And they were looking at happiness and [00:33:05] they found that. The trial’s almost conclusion. [00:33:10] I mean, it’s still ongoing, but happiness doesn’t come from fame, material [00:33:15] wealth. It comes from the quality of personal [00:33:20] relationships that you have with friends and family. That was the biggest determinant of [00:33:25] life longevity, happiness. And yeah, [00:33:30] and just overall overall kind of quality of life as well.

Payman Langroudi: It’s interesting isn’t [00:33:35] it? I mean, I think I was 45 before I disassociated happiness from [00:33:40] joy.

Sam Cope: Yeah.

Payman Langroudi: I was up to 45, up to [00:33:45] 44. I used to think happiness must have a giant component of joy. [00:33:50] Mhm. And yet now I’ve changed my mind on it. I’ve changed my mind on it. I mean, [00:33:55] it’s surely nice to have joy around, right. There’s no there’s no doubt about that. Yeah. But I used to equate [00:34:00] them together so much and that’s not the case. I [00:34:05] felt it’s good for someone who learned this skill. I was I was telling my kid, I was telling my my 13 year [00:34:10] old about it, and I was saying, it’s much better for you to learn it at 13 than than wait till 44. [00:34:15]

Sam Cope: Yeah. It’s so true. I mean, I was listening to a podcast with [00:34:20] Steven Bartlett, and he had somebody on there and he, you know, after you earn a certain amount [00:34:25] of money, I think the figure is like 100, 150,000 or something. Anything you earn [00:34:30] over that amount, it’s not really improving your happiness. It’s it’s just pleasure. So [00:34:35] like when you buy like the latest Ferrari or a new watch or something like that. [00:34:40] Yeah. You are, you’re giving yourself joy or pleasure. Yeah. And pleasure [00:34:45] and joy. That’s addictive. Yes. You want to get the next thing.

Payman Langroudi: Short and.

Sam Cope: Short bursts. [00:34:50]

Payman Langroudi: Yeah.

Sam Cope: And I think the key thing for that is, you know, a lot [00:34:55] of dentists are working five days a week and trying to trying to fund this pleasure. [00:35:00] Yeah. And I think sometimes it’s good to take a step back. You know, you don’t need to keep [00:35:05] up with the Joneses, you know? You see, my my step dad said to me [00:35:10] he was. He worked on the rigs and he was the manager of the the rig. He was [00:35:15] on the biggest amount of money. And one of the roustabouts, he was like the guy that’s like mopping [00:35:20] the rig. He said to him, like, God, it must be great being you. Like you’ve got so much [00:35:25] money. And Graham just said to him, look, the more money you earn, it’s just [00:35:30] different levels of skint because you just end up buying a bigger house [00:35:35] or buying something else, and then you just become a slave to what you own. Yeah. And I think I was listening [00:35:40] to this Jemmy Carr podcast and he was saying.

Payman Langroudi: I love him. I love.

Sam Cope: Him outside.

Payman Langroudi: Of comedy. [00:35:45] I like him in comedy. But when I’ve heard him speak outside of comedy, I [00:35:50] really, really like him.

Sam Cope: So philosophical.

Payman Langroudi: He’s brilliant. What is he saying? What was he saying?

Sam Cope: So he said [00:35:55] he was, um. He was taken. He was in America, and [00:36:00] this guy was taking him around this massive house and you had like, you know, [00:36:05] tons of cars and Ferraris and stuff. And he said to him, he took [00:36:10] him around that he was giving him a tour of the house, and he showed him this piece of artwork, and he said, Jemmy, [00:36:15] I bet this piece of artwork is probably worth [00:36:20] more than your whole salary for the year. And he says, and [00:36:25] then Jemmy, he’s great at his comebacks, isn’t he? Yeah, yeah. And he just said. He [00:36:30] said, you know what? Well, I’ve got something that he will never have. [00:36:35] The guy was like, what? Enough.

Payman Langroudi: Mhm. Yeah. [00:36:40]

Sam Cope: And it’s so true isn’t it. Yeah. And I think for dentists too. Like [00:36:45] when is enough. Enough. When have you got what. Everything that you [00:36:50] need. Like why do you have to keep striving for like the next car or the next Rolex or [00:36:55] the next something. I think sometimes it’s good.

Payman Langroudi: I take your point and it’s a very good point. It’s a correct [00:37:00] point. Yeah. And it’s funny because in my language, the [00:37:05] root word for contentment and for wealth [00:37:10] is the same, same word, which is [00:37:15] sad, right? Because those two are very different to each other. But but there [00:37:20] is a thing. There is a thing. I remember talking to Robbie Hughes. You’ll know him. And [00:37:25] chasing watches and cars and planes is ridiculously stupid. [00:37:30] And there’s always a bigger watch and plane and car and all that, and it runs out very quickly. But I will [00:37:35] say something about money. Acceleration of wealth is very exciting. [00:37:40]

Sam Cope: Mhm.

Payman Langroudi: For a while, for a second, for about a month. So you’ll, you’ll know this. You change [00:37:45] practice. You go to a new practice let’s say oh let’s say it’s a big jump like from NHS to [00:37:50] private. Right. And then the same mod whereas before it was whatever udas [00:37:55] now it’s £295 or something on the first one you do and you think, [00:38:00] wow, £295. Maybe you’ll do the reflection thing. Try and make it even a better one and better [00:38:05] one. But after a month, that just feels totally normal.

Sam Cope: Mhm.

Payman Langroudi: And [00:38:10] it’s that moment of acceleration of wealth are quite exciting. And that’s one [00:38:15] thing about wealth. Yeah. Um, but Robbie would talk about living up to your [00:38:20] potential. And I find that quite an interesting way of thinking [00:38:25] about things because it’s not. It’s not my default. Yeah. But it definitely was his. You know, as [00:38:30] a sportsman, you know, he would say that, and he would look at dentistry as he wants to live up [00:38:35] to his potential in dentistry. You know, the dentist he wants to make in the world. Yeah.

Sam Cope: Yeah. [00:38:40] That’s great. Yeah, I think I mean.

Payman Langroudi: Canal, although you could take that back and say, hey, [00:38:45] where does that come from? Yeah.

Sam Cope: Yeah. Yeah.

Payman Langroudi: Like, how come you need to make a dent in the world? Like, why can’t you just [00:38:50] have tea and cakes with your kids, you know?

Sam Cope: Yeah. I think [00:38:55] as dentists, I think we are all cursed with the high achiever. I think if we were, you [00:39:00] know, if you want, if you, you know, I mean, I [00:39:05] was speaking to my brother about this. He’s a barrister. And he was saying to me like, you [00:39:10] know, we are quite well educated and we’re very privileged to be where we are [00:39:15] now.

Payman Langroudi: You and him.

Sam Cope: Yeah, 100%. Yeah. Um, but he said, wouldn’t it [00:39:20] be great if, like, you could just be happy and content with, like, just like a two [00:39:25] up, two down, two kids and, you know, just like a job that you go to every day and you’re completely [00:39:30] content. He said, we’re cursed with the fact that we have to achieve, and you have to do [00:39:35] this to get your happiness. Whereas most, you know, most people don’t have that. [00:39:40] Like, you know, when we talk about our, our lives, it doesn’t [00:39:45] we’re not like the, the general public, which sounds crazy, which [00:39:50] sounds like, yeah, crazy, but it is true. Like I do think we are. We are [00:39:55] all really high achievers, but I think that, um. Yeah, [00:40:00] I think so. Kunal Patel, he’s been a fantastic [00:40:05] mentor for me. And he said to me, look, when you start at love teeth, don’t think [00:40:10] about. Don’t be thinking about the money and things. He said just be the best dentist [00:40:15] that you can be and the money will just come from there. And it is true. I mean, I’ve been there for [00:40:20] a year and I’ve been doing the reflection thing and my, my biggest, [00:40:25] um, I get the most joy out of seeing patients that are really happy and my restorations [00:40:30] lasting a long time and them coming back. And then you’re building that rapport with patients [00:40:35] and you find that the the better you are. That way the money just [00:40:40] comes with it. And then you can do more things and improve in different ways. [00:40:45] And that’s where I found my happiness rather than directly in the money. I think if you [00:40:50] look directly at the money, sometimes that can lead to kind of burnout [00:40:55] as well.

Payman Langroudi: It’s it’s not inspirational, is it? It’s not, it’s not, it’s not it’s a massive [00:41:00] error. It’s a massive error. And as you say, the money is a very relative thing anyway, man. And that [00:41:05] that your dad’s thing was very true. It reminded me of what I was saying. My brother’s an NHS. [00:41:10] Uh, well, not an he’s a consultant radiologist, doesn’t like his [00:41:15] job very much. Hates it. And then I said to him, hey, would you be happy in your job if you earned six [00:41:20] times as much? And he said, well, of course I would. Um, but [00:41:25] then I said to him, but your day would be the exact same day. Yeah. And you know that that [00:41:30] guy mopping the rig with your dad?

Sam Cope: Yeah.

Payman Langroudi: They’re both on that rig. [00:41:35] Yeah, yeah, with water, you know, the rain falling on their heads or your dad’s taking [00:41:40] more than that guy. Yeah, but their day is the same kind of day.

Sam Cope: Yeah, I said, I said, I don’t [00:41:45] know how you did it for as long as you did. I said, it’s like a working Alcatraz out there. [00:41:50] It’s worse than Alcatraz because.

Payman Langroudi: Have you ever been on one?

Sam Cope: I haven’t, thank god. But, [00:41:55] um. But. Yeah.

Payman Langroudi: Would we be away for six months at a time or something?

Sam Cope: We usually do 2 to 3. [00:42:00] Three weeks on, three weeks off.

Payman Langroudi: Three weeks?

Sam Cope: Yeah. So, yeah, it [00:42:05] was. It seemed intense. It seemed to. He seemed to really like it. Um, but. [00:42:10] So this is my stepdad. So he married my mom probably about ten years ago. But, [00:42:15] yeah, when he finished working on the rig, it was, like, the best day of his life. He he [00:42:20] was really happy to finish because, you know, you’re in the North Sea. It’s freezing cold. [00:42:25] And you were on 12 hour shifts for three weeks. But he said [00:42:30] that some of the guys that worked on the rigs, they’d come off and then they’d just they lived in [00:42:35] Thailand or something, or you could just live wherever you wanted to in the world. So they lived like a king in Thailand. [00:42:40] Even these roustabouts that are on hardly any money.

Payman Langroudi: So interesting.

Sam Cope: Jet [00:42:45] off over there. And also while they’re on the rig, everything’s paid for.

Payman Langroudi: Yeah, yeah, yeah. In general, the pay [00:42:50] is quite good, isn’t it? On it.

Sam Cope: Yeah. Yeah. The pay is decent. Yeah, but I mean, even [00:42:55] I mean, my cousin also did it, and now he works [00:43:00] on wind farms and things in the North Sea. But have you, have you heard about the training [00:43:05] that they have to do for that? So when they when they want to [00:43:10] go on the rig, they have to learn how to get out of a helicopter that’s going [00:43:15] under the water and things. So they’re all strapped in, and then they’re in a swimming pool and they’re in [00:43:20] kind of a kind of setup, and then they’re dunked into the pool. [00:43:25] Yeah, my cousin said he was in the front and he was quite calm. He’s quite, quite, quite a calm [00:43:30] person when it comes to things like that. But he said the person behind him wasn’t calm [00:43:35] at all and he was really flapping around and he was kind of grabbing my cousin down while it was going [00:43:40] underwater. They have divers there to help, but he said that was a really scary thing. And it’s [00:43:45] something like once a helicopter hits the sea, it will sink at a metre a second. [00:43:50]

Payman Langroudi: Or.

Sam Cope: So. Once it goes in. And yeah, I mean in a swimming [00:43:55] pool, it’s probably quite nice.

Payman Langroudi: But there are accidents, right? There are accidents of all sorts in those situations. [00:44:00] Right.

Sam Cope: Oh yeah, 100%. So you’ve got to learn, I mean, whether I think [00:44:05] it’s almost like the security at an airport, it’s probably they do these training things just to kind of give you that [00:44:10] sense of security. But if you’re in rough seas in the North Sea, even if you got out of the plane, [00:44:15] those waves are huge.

Payman Langroudi: So do you remember a time where [00:44:20] something switched in your brain because you’re you’re definitely now like after [00:44:25] excellence and doing the best and all of that. And yet you’re telling me [00:44:30] back in your teens you thought you couldn’t get the grades [00:44:35] for dentistry? Do you think you could have got the grades for dentistry, but you had the sort [00:44:40] of like a problem with confidence? Or [00:44:45] was there or were you a kid who wasn’t, you know, crossing the t’s and dotting the i’s while [00:44:50] in your teens. But then something happened in physiotherapy inspired you to say, [00:44:55] oh God, now I want to be the best, I want to, I want to learn everything. Do you remember an inflection [00:45:00] point or what would you what comes to mind when I say that?

Sam Cope: I think, um, I think when I was at school, [00:45:05] I was never kind of a massive high achiever. I was very average. And then when I got to college, [00:45:10] I did a slightly better. And then when I did want to finish.

Payman Langroudi: College, do you mean A-levels? Yeah.

Sam Cope: Yeah. And [00:45:15] then when I finished my degree, I managed to I managed to get a first [00:45:20] in my degree.

Payman Langroudi: And so in that period it was, it was constantly becoming more [00:45:25] and more into what you were doing.

Sam Cope: And I think it was more I think it was more like the belief [00:45:30] in yourself and the fact that actually I can.

Payman Langroudi: Yeah.

Sam Cope: Really do it and all it takes [00:45:35] because I’m not a naturally clever person. But like when I revise when [00:45:40] I was revising for physio or probably I revise more for physio than I did for dentistry, I [00:45:45] won’t lie. Um, but I remember doing like 12, 13 hour days for months. [00:45:50] And it proved to me that if you just really put the time in and put the hard work [00:45:55] in, then yeah, you can kind of do whatever you want.

Payman Langroudi: But what was it that [00:46:00] made you switch from being not that person in college to being that person in [00:46:05] university?

Sam Cope: Uh, probably. I mean, probably just probably [00:46:10] just like adversity. I would of thought, because I had a, I had a few, like, family [00:46:15] problems and things that were going on at the time. And then I just thought, right, I’ve really got.

Payman Langroudi: To the books. [00:46:20]

Sam Cope: Because I just thought because I almost got cut off at one point from, [00:46:25] um, my dad and family. And I just thought, wow, I’m completely on my own [00:46:30] here. If I don’t make this by myself, then I’m buggered. So I just thought, [00:46:35] right, I’ll just get my head in the books and just study my head off. And then my biological dad. That’s [00:46:40] my biological dad. Yeah. Um, so. Yeah, so I think I think sometimes [00:46:45] it does take. I know there’s there’s lots of famous people that say this, but when you do [00:46:50] have adversity, it really does drive you.

Payman Langroudi: Yeah, yeah, yeah. I mean, there would be no [00:46:55] Beethoven. There would be no Steve Jobs, you know, like all these people [00:47:00] went through massive adversity. Um, it’s interesting because [00:47:05] on one level, we’re talking about being content and peace and that [00:47:10] being the thing that we’re after. But on another level, it’s [00:47:15] the, you know, the pressure of life that’s brought out all this genius. Yeah.

Sam Cope: Yeah, [00:47:20] yeah. I think you’ve I think the end goal like, I’ve, I’ve obviously [00:47:25] had to work like really hard to get to where I am. But my end goal was always to kind of once [00:47:30] I’ve got to a point that I’m happy then to take a step [00:47:35] back and I can do my reflections and just take things a bit easier, more easily, [00:47:40] um, which seems to be working a lot better now, But that’s really that’s really [00:47:45] hard to do because, you know, everybody else is working five days a week. [00:47:50] And then you say to people, oh, I’m just doing three clinical days and it’s like, oh, wow, what’s wrong with you?

Payman Langroudi: No, it’s amazing. [00:47:55] I think it’s amazing. There would be no enlightened if I was doing five days a week as a dentist. Yeah. [00:48:00] No way. Um, but but also, I think it’s [00:48:05] not a rule for everyone, but I think for someone like me that if you want [00:48:10] to do dentistry at a high level, if you want to really take care of every step, [00:48:15] um, including the, you know, the social side, making people feel [00:48:20] amazing, including your staff, your patients, you know, all of that [00:48:25] and pay attention to the steps of the actual dentistry itself, the treatment, planning, all that. If you’re [00:48:30] working at that level, I think four days is the absolute maximum that you [00:48:35] can do that at a high level. Mhm. Once you take it to five days I think you then you [00:48:40] start. Okay I wouldn’t even say taking shortcuts, but it would be like I [00:48:45] would temporise something or I wouldn’t be at the top of my game mentally at the top of my [00:48:50] game, if I was treatment planning or, you know, talking to patients, then just something would slip. [00:48:55] And I think three days is absolutely perfect. Absolutely perfect. Whether [00:49:00] the other two days you’re going to do what you’re doing reflection, education, promotion [00:49:05] or something else altogether, you know.

Sam Cope: Yeah.

Payman Langroudi: Property, [00:49:10] whatever. Whatever. You read a book by the river, you know, whatever, whatever it is for you. But [00:49:15] we’re lucky in that a lot of us on three days can earn enough [00:49:20] to support the life we want. It’s not the case in many jobs, right?

Sam Cope: It’s an incredible [00:49:25] opportunity. Like, I don’t really know any. And also how flexible [00:49:30] we can be as well. With our job. You can choose what days you want to do with which practice, which is so [00:49:35] rare in almost all professions. Isn’t it really? Yeah. Um. [00:49:40] Yeah. So important, I think, to like, I, I love, um, [00:49:45] I love, like, dentistry, but I love doing things outside of dentistry, so I’m a bit of [00:49:50] an adrenaline junkie. So I love kind of going skiing and doing [00:49:55] tricks and things, which is great. But then, um, I [00:50:00] wanted to speak a little bit about this because I was part of the, um, the skydiving [00:50:05] team in Liverpool, too. So I just look, when I got to, because I was, [00:50:10] I was quite I was so fortunate to be able to do another degree. I then thought, [00:50:15] right, what can I do that’s really out there? So it was £180 and [00:50:20] they taught you how to skydive on your own and then you got two jumps. So [00:50:25] everybody kind of got taught and then everybody kind of boozed the night before, [00:50:30] which they said, don’t drink anything. So I’m like, okay. And then you stayed in like a big bunker. [00:50:35] And then it was quite funny because the people that were really cocky on the [00:50:40] on the day and on the training.

Payman Langroudi: On the ground.

Sam Cope: When we were on this like tin can of a plane and [00:50:45] it was all ricocheting around everywhere, it felt like D-Day. And [00:50:50] they were really scared and didn’t say anything. You could just see one of them just completely [00:50:55] white. And then, um, and then. Yeah, and then jumping out of the plane. [00:51:00] And it was in the Lake District so you could see.

Payman Langroudi: Beautiful.

Sam Cope: Yeah. So beautiful. All the mountains. [00:51:05] And you flew it down yourself. So I’d say for anyone, like if anybody’s listening to this, that’s like at university, [00:51:10] just take up all the opportunities that you possibly can.

Payman Langroudi: Did you just do those two [00:51:15] jumps or did you? No, I did loads and loads.

Sam Cope: Yeah, I did loads. Yeah. I almost like I [00:51:20] wanted to try and get my license, but it’s so hard in the UK because the weather’s not great. So [00:51:25] if the weather’s over, if sorry, if the wind is over 20 miles an hour, then [00:51:30] it’s difficult to land because the parachute goes is 20 miles an hour, then the training [00:51:35] parachutes. So you just end up.

Payman Langroudi: So did you free fall as well or not? [00:51:40]

Sam Cope: Yeah, we did. From free fall. Yeah, yeah.

Payman Langroudi: What’s that feeling like? Because I’ve been on those ones. Where? On [00:51:45] the ground. The fan thing. Oh, yeah. That feels good. But you’re not falling anywhere, right?

Sam Cope: It’s cool. Yeah. [00:51:50] And then. Yeah, you have to. So when you go through it, you. You jump out on a static line to start [00:51:55] off with about 3000, 3500ft. And then you’ll move on to [00:52:00] kind of dummy pulls where you’re like pretend to pull.

Payman Langroudi: Aha.

Sam Cope: And then you show the tutor [00:52:05] that you can do it. And then eventually you take you higher, and then you do a bit of freefall and then you go further [00:52:10] and further that way. I had a friend and I got there a little bit later [00:52:15] that day, and I spoke to another one of my friends who was on the ground, [00:52:20] and they said, oh, it’s the first plane gone up. And he said, yeah, the first plane has gone up and Ben is on the plane. [00:52:25] I was like, oh, okay, cool. And then I saw people, like jumping out on the static lines. [00:52:30] And when you’re when you when the [00:52:35] parachute opens, you have to wait. You do. You do this thing and it’s like [00:52:40] you go 1000, 2000, 3000. And then you say it again, and then [00:52:45] you look at your canopy and you make sure that it’s square and that everything looks okay. But [00:52:50] I saw somebody kind of as soon as they came out the plane, you could see they were [00:52:55] kind of flapping around a bit, and he pulled his, his cord. So [00:53:00] it meant that, um, so he kind of cut away from it. And then I saw him kind [00:53:05] of like flipping in the air. And then just at the last minute, he managed to pull his [00:53:10] reserve, and then just about kind of crash landed into the field. [00:53:15] So we all went to kind of get him. Anyway, he was grounded for six months after that. But it’s [00:53:20] just.

Payman Langroudi: He was injured.

Sam Cope: No, he was fine.

Payman Langroudi: So why was he grounded?

Sam Cope: He [00:53:25] was grounded.

Payman Langroudi: In traumatic stress.

Sam Cope: Um, so the tutors will just say, look, you can’t [00:53:30] parachute now for the next six months just to kind of get your head straight. It’s almost like after a poker [00:53:35] game when you lose and they say, right, you need to like have like five days out now. Yeah. But [00:53:40] yeah, the same way. But yeah. Did you just.

Payman Langroudi: Carry on jumping out of planes when you saw that, [00:53:45] did that not scare you to not do it anymore or.

Sam Cope: Um, no, [00:53:50] it didn’t, because I just thought it’s.

Payman Langroudi: Not gonna happen to me.

Sam Cope: Yeah. Well, I the [00:53:55] thing is, is that the guys that teach you, they are ex-military, so they kind of teach [00:54:00] you a really regimented profile of what to do. And they’re showing you pictures of what the canopies look like. [00:54:05] And every time you go up, they’ll say, like, Sam, what would you do with this? Sam, what would you do with this? And I’d be like, yeah, cut away. [00:54:10] No, I’d keep that one or I’d wiggle it around or something. So [00:54:15] it was a good it’s a good thing to do as well because you learn like [00:54:20] what’s important to you and like how to manage stress. Yeah, yeah.

Payman Langroudi: Um, you know what I’m [00:54:25] interested in? Yeah. Like, as an adrenaline junkie, like, do you like motorbikes and [00:54:30] jet skis and, like, everything. That’s adrenaline.

Sam Cope: Yeah. Jet skis. I think my [00:54:35] mum would kill me if I got motorbikes and things, so. I love jet skis, but.

Payman Langroudi: As a [00:54:40] as a adrenaline junkie, it’s. I don’t know whether this is true or not. Yeah. Like, [00:54:45] is it that there was a lot of adrenaline in the system because of whatever reason [00:54:50] as a child? Yeah. And so you’re comfortable with adrenaline with the next man [00:54:55] didn’t have. Yeah. Just let me let me just set an example here. As a child, [00:55:00] there’s a drunk father who’s screaming and shouting, and the kid doesn’t know [00:55:05] how to handle it. Adrenaline. Adrenaline and adrenaline. Now, as an adult, he’s an adrenaline junkie. Is there [00:55:10] such a thing as such a link? Yeah. Number one. And number two. I find, you know the rate [00:55:15] of stuff here. So the rate of stuff changing for me [00:55:20] in a walk just isn’t quick enough. Yeah. I just just [00:55:25] does my head in. It doesn’t. The rhythm of a walk really, really annoys me a lot. Although [00:55:30] on a travelator thing, you know, in the airport that rate. [00:55:35] Yeah. I adore that, like, I could do that all day. I’m still walking, right? I’m still [00:55:40] walking. But stuff’s changing at a different rate. Yeah. And on a bicycle, [00:55:45] I could cycle all day as well. You know, stuff’s changing, but on a walk, it’s changing too slowly for [00:55:50] me. And I wonder whether that’s a similar thing to this adrenaline.

Sam Cope: Yeah. [00:55:55] Yeah. Possibly. Yeah, definitely. I mean, I think when I was younger, I mean, my [00:56:00] I remember my friend’s mums didn’t really like me coming round because I’d climb [00:56:05] to like the, I’d climb the tree to the highest branch and they’d be like, oh, where’s Sam? It’s like, oh, he’s [00:56:10] up there. Yeah. And like, yeah. So I think it’s almost like [00:56:15] probably a little bit of nurture. But I reckon nature like I think [00:56:20] I think, yeah, almost just like you.

Payman Langroudi: Haven’t got kids have you.

Sam Cope: No, not at the moment. [00:56:25] No, no.

Payman Langroudi: With kids you’re on the first day the kid’s born. You see, you notice massive difference when you have two. When [00:56:30] you have a second one, the first day you notice, oh my god, totally different child. Like yeah. It’s [00:56:35] like they’ve only been around for one day right? So the nurture hasn’t had much time unless [00:56:40] of course, I don’t know in the tummy maybe.

Sam Cope: Yeah. I suppose just like the different genes that they’ve got. I [00:56:45] mean, me and me and my brother were completely different. Right. But we’re it’s quite nice [00:56:50] because me and my brother were we’re best friends, but we do completely different jobs, [00:56:55] like, I’m. I’m a dentist. He’s a barrister. So what.

Payman Langroudi: Kind of barrister.

Sam Cope: Is he? He does crime and civil. So [00:57:00] I went to see him on one of his cases. Actually. It was really good. It felt like I was on like a drama documentary [00:57:05] or something.

Payman Langroudi: Yeah.

Sam Cope: Have you ever seen a court?

Payman Langroudi: Yeah, yeah.

Sam Cope: It’s very cool. [00:57:10] I definitely I mean, you can just go in to watch any kind of, um, case [00:57:15] that’s on. It was quite good with him because I’d be in a coffee shop working and he’d say, oh, Sam, like, [00:57:20] get here. This is, this is going to be the good bit. So then I’d get there and then they’d do the, um, [00:57:25] they do the things.

Payman Langroudi: I went to one. My friend had an issue and we [00:57:30] went. The lawyer said, which barrister do you want? Do you want, you know, like a standard one? Or should we get a super duper [00:57:35] one? And we said, all right, how much is it? Whatever. And then we went, we said, let’s get the super duper one. Let’s let’s see what happens. [00:57:40] And we went in. And who’s that person in a court, you know, who’s like, she’s not on either [00:57:45] side. She’s not one of the judges, just the person running everything.

Sam Cope: But the usher.

Payman Langroudi: The usher, someone [00:57:50] like that. She was basically running everything. Yeah, she was one talking more than anyone else. And she was kind of in charge. [00:57:55] Right? And I remember the couple of cases happened before my buddy had to go up and [00:58:00] I could see. Who the hell is this person? Like, she’s in charge here, right? Because she wasn’t a judge. She [00:58:05] wasn’t a lawyer. She was just a person running the show here. Anyway, the barrister steps in [00:58:10] the super duper one and immediately says something to her in legalese, right. That I [00:58:15] didn’t understand what he said, but she turned from, like, running the show to looking [00:58:20] through her notes and like, being cowering down a little bit. Yeah. And I just in that first [00:58:25] sentence, I realised, oh, like the expensive barista knows these tricks, [00:58:30] right?

Sam Cope: Yeah, yeah, yeah. Interesting that they have a they always have a conference [00:58:35] between the judge and the two barristers before. So like before a crime, um, before [00:58:40] something to do with to do with like a criminal case. They’ll say the judge will say, [00:58:45] what do you think? And the barristers will just be like, yeah, he’s definitely done it.

Payman Langroudi: No [00:58:50] way.

Sam Cope: And then sometimes the judge will just say, look, just say, I mean, you know, the prisons are like overrun at [00:58:55] the moment. So sometimes the case that I was told the judge had just said, look, [00:59:00] just, just say to them like, he’s definitely he’ll definitely end up going to prison. This guy, if he’s found guilty [00:59:05] and he’s clearly guilty, but just say he can have a six month suspended sentence and [00:59:10] a fine. So they went back to him and then he they said, oh, I’m really sorry. [00:59:15] But he said he wants to go through with the trial. And the judge was like, what? Because he was [00:59:20] almost definitely guilty. Yeah. But I tell you what, the amount of money that is [00:59:25] wasted on these trials and things is just.

Payman Langroudi: It’s a funny thing, though, because if you admit [00:59:30] it, you get a shorter sentence. But if, let’s say you actually didn’t do it. Yeah. And [00:59:35] there you risk a much longer sentence. Yeah. It’s mad. It’s a mad thing when you [00:59:40] think about it. But what really confused me about the law is how important the lawyer [00:59:45] is. Like, so, like, I always had this sort of idea that the law, you know, the [00:59:50] truth, will out in a legal situation. But the lawyer is the key thing. Yeah. [00:59:55]

Sam Cope: It’s whoever can run the theatre the best, isn’t it? It’s like [01:00:00] whoever can act the best. Yeah. Um, and whoever’s, like, more convincing, too. [01:00:05] So. Yeah. So this trial that ended up going on ended up being [01:00:10] a hung jury. So then they’re having to do the trial again in, like, eight months time. [01:00:15] My brother was like, yeah, I think I’ll get him on the next one because because there’s no way he can keep his story [01:00:20] straight, because he’s clearly lying. But I think it only takes like 1 or 2 people in the jury [01:00:25] just to be adamant that they think that he’s right. And then. Yeah, and then it’s hung and then crazy. [01:00:30]

Payman Langroudi: Tell me about after you [01:00:35] did monarch’s course, you decided you want to be that kind of dentist. [01:00:40] Did you change job then to go find that kind of job that [01:00:45] you.

Sam Cope: So when I, um, when I finished that course, um, [01:00:50] I was working, still working at the dental house, and I was doing some, [01:00:55] uh, I was doing NHS work, and then I was kind of increasing the amount of private work that I was [01:01:00] doing. Just naturally. Just because you’re selling gets better. Yeah. [01:01:05] And then while almost towards the end of the year long course, [01:01:10] um, I was very, very, um, privileged to be asked by monarch [01:01:15] to be his apprentice. Yeah. So then I, um, finished my job [01:01:20] at the Dental house, and then I worked as his apprentice for um for quite a while. [01:01:25] And that was that was amazing. That kind of made me the dentist [01:01:30] that I am today. And it was quite it was quite humbling because I was able and I was [01:01:35] so I was so lucky. And I’m so grateful for that experience because I was able [01:01:40] to see, firstly, a very charismatic person and a [01:01:45] very experienced dentist teach. And I got to be able to see his work, but [01:01:50] also seeing lots of different dentists, like lots and lots of [01:01:55] cohorts of people. Yeah. Um, and how, what their skills like. And you [01:02:00] do realise when you’re on those courses because I always thought to myself like, oh, I don’t think I’m [01:02:05] that good a dentist. I don’t think I’m cutting the crowns as like perfect as everybody else. But [01:02:10] you realise like, you know, even the really experienced dentists can’t cut crowns [01:02:15] really, really well and can’t do, like, really good dentistry [01:02:20] all the time. So it was very good to see, and it was really nice [01:02:25] to be able to help people and you could see their progression and things. And I think, um, [01:02:30] yeah, that was a fantastic experience. And also when the [01:02:35] lectures were going on, we’d be messing around with composite and practising and doing composite [01:02:40] veneers and fillings and things like that.

Payman Langroudi: So I think, I think repetition is such a massive thing.

Sam Cope: Huge. [01:02:45]

Payman Langroudi: Such a massive, you know, I saw mini smile makeover. I’m still learning, you know. Still I must have [01:02:50] watched it 80, 90 times, right. Still still learning.

Sam Cope: Yeah yeah.

Payman Langroudi: Yeah. And repetition [01:02:55] people just underestimate the value of repetition. And you know, you saw his content however [01:03:00] many times. But you’re also right explaining teaching is one of the best ways of learning, isn’t [01:03:05] it?

Sam Cope: 100%.

Payman Langroudi: You have to understand it yourself very well, and you learn from the questions [01:03:10] that people, people ask. So then you were doing more of this work then what happened [01:03:15] next?

Sam Cope: Um, so then I kind of wanted to create [01:03:20] my own brand and I was going to move back to Liverpool. So then I [01:03:25] left the practice with monarch, and then I went to Liverpool and [01:03:30] I wanted to get a private job, but I ended up working kind of almost five [01:03:35] days in five different practices, which I definitely wouldn’t recommend to anyone, [01:03:40] but it was very it was an incredible experience because I was working at Roderick’s, [01:03:45] my dentist, um, and then a couple of other private [01:03:50] practices as well. And that was that was amazing because I was able. [01:03:55]

Payman Langroudi: To see.

Sam Cope: Like, yeah, how loads of different practices run, what works, [01:04:00] what doesn’t work, and the importance, like the importance of having a nurse [01:04:05] like I was, I had like two suitcases of all my stuff, like with, [01:04:10] um, computers and equipment and composite and everything, because I wanted to still try and keep [01:04:15] Consistent, so I spent a lot of money on my own things to be able to deliver [01:04:20] kind of the quality of dentistry that I wanted to give and I wasn’t happy with, like using [01:04:25] different materials and different places. So, so yeah, so I used to [01:04:30] so I did that for a while. And then I also whilst I was at one of the practices, there were a couple of [01:04:35] dentists that were relatively newly qualified. So I thought, well that’d be a good opportunity [01:04:40] to kind of help them. Yeah. So I on like Wednesday nights or something, I just [01:04:45] I had a couple of phantom heads. So like showed them how to do different composites and like help [01:04:50] them improve their kind of skills and things. And that was that was really rewarding.

Payman Langroudi: Two [01:04:55] things. What were lessons you learned from those five practices or from all the ones you worked [01:05:00] because you’ve worked in quite a few now? Yeah, good and bad. What would you say? [01:05:05] Like, are you are you thinking of starting your own practice one day? Maybe.

Sam Cope: Uh, I, [01:05:10] I’ve seen how all these practices run, and I think that I’m quite happy [01:05:15] being being an associate for now.

Payman Langroudi: For now. For now, don’t rule it out from [01:05:20] the associate perspective. Then what things have you seen that have been like? What do you think [01:05:25] best practice that you know you’ve learned from the corporate setting? I mean, you can learn a lot from my dentist. [01:05:30] You know, I’m involved with them. It’s an impressive company, man. It’s an impressive [01:05:35] company to be able to pull off what they’ve pulled off across 600 sites. 600? [01:05:40]

Sam Cope: Yeah. Crazy.

Payman Langroudi: Yeah. Do you know what I mean? Like, you’ve got four practices and nightmare is [01:05:45] 600. Yeah.

Sam Cope: Yeah. Unbelievable. I mean, yeah I thought yeah, they’ve [01:05:50] they’ve all got good points and they’ve all got some bad points as well.

Payman Langroudi: A few, a few [01:05:55] gems that you can come up with.

Sam Cope: Um I think as a practice, [01:06:00] I think the most important thing is kind of your, your team. [01:06:05] So I think like being in a practice where you’ve got other people that are there that [01:06:10] you can kind of learn and bounce ideas off is really important. Um, I think [01:06:15] having a practice manager as well, that’s really kind and nice and wants [01:06:20] every everything to work works really well. It’s a.

Payman Langroudi: Tough role. It’s a tough role. Practice [01:06:25] manager is a tough role.

Sam Cope: And also, um, what I’ve learned is you [01:06:30] want to try and stay friendly with every member of the team, and you want to be [01:06:35] humble with everybody, and you should never. I think most, [01:06:40] most important person to treat as nicely as you possibly can and with respect, is [01:06:45] your nurse there on not very much money and they’re helping you out all the time. And [01:06:50] the more you can help them, the more they’ll help you.

Payman Langroudi: Not to mention, not to mention I really [01:06:55] think this. I mean, I think respecting your nurse is a massive. Respecting the person you’re spending the whole day with [01:07:00] is an important thing by itself. Oh, yeah. An aim in itself. But [01:07:05] respecting your nurse in public. So respecting your nurse in front of your patient [01:07:10] Mhm. Wins you massive points with your patient 100%. People don’t realise that [01:07:15] nuance. You know it’s a nuance. But some, some people don’t realise that nuance. [01:07:20] And letting your nurse take a bit more responsibility than she might normally. Deciding [01:07:25] making certain decisions, whatever those decisions are, makes them feel great. [01:07:30] But so in the I can’t imagine any of the ones you’ve worked with, the vibe is more [01:07:35] friendly than Love Teeth. Is it because Love Teeth is a real good vibe [01:07:40] in there? I don’t know. I’ve done work there.

Sam Cope: Yeah, I found that working at all of the practices [01:07:45] working at Love Teeth is just such a breath of fresh air, because [01:07:50] really, everything just runs like a really well-oiled machine. [01:07:55] Like when I was at different practices, you know, I’d have some nurses that were great, [01:08:00] some nurses that needed a lot of input and like, a lot of help. The nurses [01:08:05] that love teeth are unbelievable. They, you know, they’re scanning for me [01:08:10] the really attentive and they and they almost want to learn about how you’re doing stuff [01:08:15] and love that I, you know, after a couple of months with the nurse, my nurses, [01:08:20] she’s called Shea and she’s fantastic. You know, I, [01:08:25] I help her out. And I found this really works as a good kind of hack. So in [01:08:30] the morning, my commute on the train, I will look through all of my patients [01:08:35] so I know what I’m doing. And I’ll leave a little note to say what we’re doing with the nurse, just [01:08:40] so that she can prepare everything so that it’s not stressful. And I’ll say like, you know, this could be a [01:08:45] root canal, or it could be an extraction to get things out for both. And then I do like a [01:08:50] little handover in.

Payman Langroudi: The morning on the.

Sam Cope: So I have Dental. So I just place it on [01:08:55] the. Yeah I just place it on the software. Yeah. I think that’s a real game changer. And it really helps [01:09:00] to kind of rapport with the nurse and when things are running really smoothly because you’ve.

Payman Langroudi: Helped her out stressed. That’s what you’re saying right? [01:09:05]

Sam Cope: Yeah. And you’re not stressing because you know everything that’s going on in the day. The nurse knows what’s going on [01:09:10] in the day. So it means that when you do have a bit of time, you can have a bit of chit chat and a laugh and, you know, you can ask them [01:09:15] about their day. It’s like, even for Christmas, I know she had, um, three children, [01:09:20] so I got all I’ve never met them, but I got them. She was telling me a bit about them and what [01:09:25] they like throughout the year. So it was. I bought them all gifts and things [01:09:30] and it’s so important. It’s just the little things that that can really help. And I think when [01:09:35] you’re at these practices learning everybody’s name, learning, you know, it’s like the Dale Carnegie thing. [01:09:40] Yeah, yeah, yeah. Learn a little bit about them. And then, you know, that helps you build rapport. The other thing [01:09:45] is when I was doing my foundation training, um, I [01:09:50] had a really good mentor, actually, Jane Willett in Glenside practice, um, in [01:09:55] the Wirral. And she had me working as a nurse [01:10:00] for a bit, and she had me working as the receptionist. The receptionist was by far the hardest job because [01:10:05] even though you’re a dentist, Patients will see you as a receptionist and treat you terribly and [01:10:10] you realise that, yeah, like they’re really like quite they can be really [01:10:15] quite cruel to you. And sometimes it’s just because I don’t know if you’ve read The Chimp Paradox, but [01:10:20] it’s like they’re almost like expressing their chimp.

Payman Langroudi: Their inner chimp.

Sam Cope: Exactly. [01:10:25] And then they’re going into the surgery and then they’re lovely to the dentist. And it’s like, because you’ve taken it [01:10:30] all. So I think understanding that the receptionists are going through that and then really helping [01:10:35] them as well and making sure that they’re okay, or at lunchtime just going to buy them some chocolates [01:10:40] or, um, making, you know, and checking in on them every so often as well really helps. But [01:10:45] being at Love Teeth has been amazing because the receptionists that I’ve got at Sutton are [01:10:50] so lovely that I’ve got my own treatment coordinator, so that makes everything so [01:10:55] much easier as well. So I don’t have to think because.

Payman Langroudi: The treatment coordinator will sort of sell the treatment [01:11:00] plan. Is that is that what she does?

Sam Cope: So I will say with my most of [01:11:05] my patient consults. They will come in. I will tell them about all the treatments that, um, [01:11:10] that are available for them, specific to them. And then I’ll go through the price and then [01:11:15] they’ll see the treatment coordinator who will go through their treatment plan, the finance, [01:11:20] the, um, and the things that, you know, things that push [01:11:25] it over the line. Yeah. And then also follows the patients up, and then we’ll let me know if they’ve gone [01:11:30] ahead with X, Y and Z. And then they’ll also kind of check in on the patients and make sure they’re [01:11:35] okay. They’re worth their weight in gold. Really. So good.

Payman Langroudi: And patients are coming [01:11:40] in I guess some are coming in from word of mouth now because you’ve been there a little [01:11:45] while, but otherwise coming in from marketing is that.

Sam Cope: Yeah. I mean, Canal [01:11:50] invests so much money into his marketing. Um, so a lot of patients come through [01:11:55] that just through the reputation of love teeth and then [01:12:00] also a bit through my Instagram. I made [01:12:05] my own smile book too. So I have that in reception, which shows you [01:12:10] all the kind of before and afters. Yeah, yeah.

Payman Langroudi: Oh, really? That’s different.

Sam Cope: Yeah, it’s really good, actually. [01:12:15] It’s quite fun to make. It just makes you just make it through photo box or something. But it shows them all the before [01:12:20] and after. So when people are coming in for their hygiene appointments, they’ll look at the book and they’ll be like, oh, actually, yeah, I’d like [01:12:25] to book in for a consultation with Sam.

Payman Langroudi: In a way, it’s kind of like retro Step. Yeah. [01:12:30] It works. You know, it’s an actual book with your picture, I guess, of your face on [01:12:35] the front cover or something. Not quite.

Sam Cope: But. Yeah, I just have some [01:12:40] teeth and then I’ll have, like, information about me and then before and afters and different smile makeovers [01:12:45] that we’ve done and things. And it just works. It works really well.

Payman Langroudi: I mean, obviously, [01:12:50] you know, be nice to people, do great dentistry obviously that [01:12:55] that helps, you know, improve your reputation and all that. Are there any tactics, though, [01:13:00] that you’ve learned along the way in order to get people to [01:13:05] refer family and friends to you, or post on the internet for you [01:13:10] or whatever.

Sam Cope: Yeah, I mean, I think a good, a good thing is [01:13:15] once you finished kind of a smile makeover or something for someone and and if they’re [01:13:20] happy, um, then it’s asking them to. [01:13:25] I usually get a photo with them, and then I usually say, it would be great if you could post it on your [01:13:30] social media. Yeah. And then they can do that.

Payman Langroudi: You don’t strike me. You strike me as the [01:13:35] kind of kid who who hates saying that to someone, and yet you’re saying it and they’re doing it [01:13:40] because I see all the ones with the enlightened bags. Yeah, yeah. You’re doing it a lot. Yeah. People are [01:13:45] posting, your patients are posting on your behalf, and you’re posting on your patients behalf a [01:13:50] lot. Do you how do you get how did you get over the sort of the bump of asking that [01:13:55] question in the first place? Because a lot of people find difficulty asking that question?

Sam Cope: Well, with I mean, [01:14:00] Canal has been a great mentor. And he just said to me, look, I’m going to be marketing [01:14:05] you and I’ve got your back. But he said that if you’re doing this as well, you [01:14:10] know, it really, really helps. And the first couple of times, yeah, I’m not going to lie, it’s awkward. But [01:14:15] patients like it. You usually say to patients, you know, oh, it’d be lovely to get a picture with you [01:14:20] for social media. And they’re like, oh yeah, actually, yeah, that’s great. And I mean, I [01:14:25] kind of slacked a bit over Christmas in terms of posting. And then I had a patient [01:14:30] come in and they were saying, oh, you didn’t post my picture with me. And I was like, don’t worry, [01:14:35] I’m I’m getting around to it.

Payman Langroudi: I think he said something about he’s very good at this. Yeah. And he said [01:14:40] something about, uh, getting through to the, the patients feel [01:14:45] like if you tell them, is it okay if I put a picture of this on, on Insta, the patient feels like he [01:14:50] must have done a great job because he’s proud of his work. He wants to put it out there. Yeah, yeah. And so [01:14:55] that makes patients feel good. And then. And then exactly what you said, he said a friend of a patient said, why [01:15:00] didn’t you post mine? Weren’t you happy with the way mine came out? Yeah, yeah. And then that sort of [01:15:05] tweaked something in his head that made him then ask everyone, you know, it’s an interesting.

Sam Cope: Yeah, [01:15:10] I think it’s asking. Asking everyone and then posting their pictures and stuff. I think it’s really good [01:15:15] and it really does. Yeah. And then you find that they [01:15:20] come back and you’ve built like a really good rapport with them, and then you find that they’ll [01:15:25] say to you, oh, I’ve got a family friend or something like that, that, that [01:15:30] would really like it. And then I think at that point you should say, oh, well, great, [01:15:35] well give me the Instagram and I’ll give them a message or give me their number and I’ll [01:15:40] give them a text or something. Um, yeah, I think, I think in this [01:15:45] kind of day and age, it’s really nice to have like a personal connection with [01:15:50] your patients because they’ll respect you. But also, um, a patient [01:15:55] people don’t sue people that they like. So even if like, you know, sometimes [01:16:00] things can, can go wrong. It’s just the nature of the world, isn’t it? But [01:16:05] if you’ve got a really good relationship with your patient, then you know you can overcome it and then [01:16:10] you can you can help them. But I think just being kind of a genuine person. [01:16:15] So say like, you know, a patient comes back two months later, the, you know, it’s guaranteed for a [01:16:20] month or something, say the composite, just for example. And they say, look, I [01:16:25] was using my retainer and then I took it out and it chipped or something, you know, is there anything you can do? I [01:16:30] think, you know, just being kind to them and just saying like, yeah, yeah, of course. Yeah, I’m happy to fix it [01:16:35] and say, you know what, I’ll fix it for free. But it’d be lovely if you gave us a Google review about it.

Payman Langroudi: Oh, really? [01:16:40]

Sam Cope: And then, you know, and then you’ve, you’ve then built rapport.

Payman Langroudi: So many moments [01:16:45] like that as a dentist, so many little moments of of highs with patients that [01:16:50] if you then do mention this sort of thing, it does make sense. But the other thing I was thinking was It’s [01:16:55] kind of much more high risk treating patients [01:17:00] from marketing than it is treating existing patients of a practice. [01:17:05] In theory, because someone comes in from a non-profit, does all sorts [01:17:10] of campaigns for for Kunal, but someone comes in from a Google campaign, let’s say, yeah, [01:17:15] you’ve never met this person. They come in and then I know how slick that practice is. [01:17:20] They kind of walk out with a treatment plan. First visit. Yeah. [01:17:25] Then you’ve got to execute that plan. Having met this person once or twice. [01:17:30] Right. And then it’s normally, you know, it could be a big plan. And so [01:17:35] that you guys have to accelerate rapport so [01:17:40] that these situations don’t go wrong because something’s going to go [01:17:45] wrong during treatment. You know, like you just said, you never we’re never 100% happy with our work. [01:17:50] There’s always gonna be something that could have been done a bit better. And, you know, someone can [01:17:55] pick up on that thing. Now, if you have if you’ve known the patient for years, this is never going to happen. But if you’ve just [01:18:00] met the person, you need to accelerate rapport. So I would in your situation, have you heard of the people who contact [01:18:05] the patient before they come in?

Sam Cope: Do I speak to them? Do you mean or. [01:18:10]

Payman Langroudi: Um, it’s an interesting thing.

Sam Cope: Yeah, yeah. I mean, maybe.

Payman Langroudi: A DM or a call [01:18:15] to.

Sam Cope: See what they like.

Payman Langroudi: No, no. As in to build rapport from the beginning. Yeah. You’re [01:18:20] coming on Tuesday. I’m just calling to see if you had any questions before you come in. It’s a really interesting [01:18:25] thing.

Sam Cope: Yeah, that is a good way of doing it, I find, because a lot of people that come in for [01:18:30] these big treatment plans, they’ll usually need some sort of early work. [01:18:35] Early work done before.

Payman Langroudi: And it’s when you build it.

Sam Cope: And also through the whitening as well.

Payman Langroudi: Okay. [01:18:40]

Sam Cope: I find that say if somebody wants composite veneers they’ve already got straight teeth or something. [01:18:45] I get them in. I do do the whitening and then I do the trial smile usually [01:18:50] before. And that’s for composite or. Porcelain? Yeah. Um, and then [01:18:55] it’s at that stage as well that you can gauge kind of what patient they are and whether you can meet their [01:19:00] expectations. And sometimes it’s it’s always a hard conversation to have. But I’ve had it a [01:19:05] couple of times where I’ve said, look, I mean, this is the kind of work that I do, you know, [01:19:10] and I’ll show them pictures before and afters, and then I’ll show them kind of what they want. And if they [01:19:15] sound like their goals are just or their expectations are far [01:19:20] too high, you know, I’ll kind of bring them back down to earth. But if they’re not kind of playing ball, [01:19:25] your.

Payman Langroudi: Spidey sense says no.

Sam Cope: Yeah. Then I’ll say to them, look, I just don’t. I’ll [01:19:30] just say to them, look, I’m a bit worried that I’m not going to be able to meet your expectations, [01:19:35] and maybe it’s best seeking another dentist that perhaps can. [01:19:40] And I think a lot of patients do actually respect that. I mean, and also I’d much rather [01:19:45] do that than have the problems of then that can come in the future. [01:19:50]

Payman Langroudi: Talking of problems, let’s get let’s get to the darker part of [01:19:55] the pod. We like to talk about clinical errors. I [01:20:00] don’t want to just limit it to clinical errors. I kind of like these sort of errors as well. Yeah. Like expectation [01:20:05] errors management errors. Mhm. But so that [01:20:10] you know we can all learn from each others. What comes to mind when I say clinical [01:20:15] errors.

Sam Cope: So when I finished, when I finished monarchs courses [01:20:20] and was finished as an apprentice and things you do have a lot of confidence and obviously [01:20:25] you’re highly skilled like you know how to use.

Payman Langroudi: Companies and you’ve got the same pay check [01:20:30] whatever you did. Is that what The Apprentice means?

Sam Cope: Yeah, you’re you’re you’re salaried and [01:20:35] the job role is really to shadow monarch as he’s doing his dentistry. [01:20:40] You’ll be working in his clinic and doing some of the, um, some of the work there, too. [01:20:45] And then you’ll also be Helping other [01:20:50] students on all of the courses, which run like nearly five days a week. So [01:20:55] it’s it’s intense. It’s a great I mean, it’s an unbelievable opportunity. But [01:21:00] once I’d finished. Once I’d finished that, I felt like my skills had hugely [01:21:05] accelerated, just in terms of like placement of composite, how it works, and [01:21:10] also when you’re teaching on a totally composite course, which you’ll know from the mini Smile makeover [01:21:15] course, um, you know, you’d finish a day and you fixed [01:21:20] like 50 or 60 mistakes, so it’s almost like you’ve done 50 or 60 cases.

Payman Langroudi: Interesting. [01:21:25]

Sam Cope: Yeah. So and you’re doing that nearly every day. So you’re just constantly fixing things for [01:21:30] people. And then when, when these things happen in clinic then you’re like, oh okay, I’ll fix it [01:21:35] this way. So you do come out very confident. Yeah. What you don’t get taught on a lot of courses [01:21:40] is when somebody already has composite veneers, and then you’re kind of, um, [01:21:45] treating them So my kind of clinical, [01:21:50] um, the time that I wouldn’t really call it a failure, [01:21:55] but it’s more where the, the moment where I’ve changed my practice the [01:22:00] most was when I had a patient. They came in with composite veneers [01:22:05] already. They were looking they think they’d been done a couple of years before, but they were looking pretty. [01:22:10] Um.

Payman Langroudi: It’s unforgiving. It’s an unforgiving material.

Sam Cope: It is the most [01:22:15] unforgiving material. You leave one air void or something, one tiny air void, and you’ll [01:22:20] see it a year later. Stained to hell. Yeah.

Payman Langroudi: Brown.

Sam Cope: Yeah.

Payman Langroudi: Right.

Sam Cope: Yeah. [01:22:25] It looks horrible. Um, so, anyway, wanted them refreshed. So [01:22:30] the, um, the process that I would do at the time is take took [01:22:35] off the composite, placed the composite back on, and then they have a week in the composite to kind [01:22:40] of like figure out whether they liked it, whether they didn’t like it. And after a week [01:22:45] really happy. Like felt great. Added a little bit of composite to [01:22:50] a couple of areas, polished, did the final polish and then had [01:22:55] a six month follow up. Was really happy. Left a really good google review. Didn’t hear anything then for [01:23:00] about another six months or something. And then after that six months, [01:23:05] um, I’d heard and I was leaving the practice as well. [01:23:10] I’d heard that they’d gone to a few other dentists, [01:23:15] and they’d always wanted their teeth longer, and I had made them [01:23:20] long enough or something. And I was thinking to myself, well, I’ve done everything as I was supposed to do. [01:23:25] They’ve had the they’ve almost had their kind of trial smile where they’ve seen what the composite [01:23:30] is going to look like and things. So you know what can possibly be wrong anyway, there wasn’t really [01:23:35] too much reasoning with the patient, so I ended up giving them the money back [01:23:40] for the 40th that they wanted longer.

Sam Cope: So then I kind of reflected on the [01:23:45] whole situation and thought, how can I prevent that from happening again? And [01:23:50] the way that I prevent it now is all of my composite veneers [01:23:55] that I do. Any big cases of composite veneers, say four, six, eight. I do, [01:24:00] um, I injection mould, and the reason why I do it that way is because I can. [01:24:05] I know that I can do it predictably, and it means that the patient gets a trial [01:24:10] smile. They can see exactly what it’s going to look like. They take photos. You can even have [01:24:15] them in the trial. Smile for a bit for a week or something so they can see what it’s like. And then once they’ve [01:24:20] approved it, then we’ll place the composite. Then we’ll do a final review. So it adds almost an extra layer. [01:24:25] And it means then that you get the adequate thickness, some [01:24:30] improved strength compared to kind of placing the composite on using wetting resin. You’ve just [01:24:35] got everything on in one go. And then yeah, I found my [01:24:40] um, my cases have of massively improved. And I found that [01:24:45] every you know, most people are really happy with what they’ve got and say before [01:24:50] with my edge bonding, I’ll usually do that freehand, but I will always do a mock up [01:24:55] to show them what it’ll look like before even even edge bonding, and then to see [01:25:00] whether they’re happy with it.

Sam Cope: And then if they are happy, then great. I know I can do probably a lot better [01:25:05] than my little quick mock up. Yeah, but if they’re not happy, then I’ll say, look, I don’t know whether I [01:25:10] can meet your expectations, which is fair, I think. And then, [01:25:15] um, and then. Yeah. And then they can either, you know, go somewhere else or or not [01:25:20] go ahead if they don’t want to. And with the trial smile, I usually charge, say 499 [01:25:25] for the trial smile. And I’ll say to them, look, if you really don’t like it, you know, you’ve not invested [01:25:30] a huge amount of money and this isn’t going to go anywhere. Um, but then if you, [01:25:35] if you do like it, then yeah, then we can go ahead with the, with the composite and kind of go from there. [01:25:40] And I found that just works so much better.

Payman Langroudi: And the the basics of the injection moulding [01:25:45] technique that you use.

Sam Cope: So I use two stents and [01:25:50] then we mock up every other tooth and then every tooth. [01:25:55] And then we will place PTFE tape over [01:26:00] each bond. Place the composite in um [01:26:05] into each into each one, kind of do a bit of a clean up and [01:26:10] then we’ll place the next one in and then um, and then just do a bit of a clean up. And [01:26:15] I’ve just found the cleanup from that is really much better. Much better.

Payman Langroudi: So, [01:26:20] you know, are you not actually you’re compression moulding rather than impression injection moulding. [01:26:25]

Sam Cope: Yeah.

Payman Langroudi: Where you place the composite around where it should be. And then put the.

Sam Cope: Uh, [01:26:30] put the missile in over the top and then there’ll be a hole in the incisal and then just inject [01:26:35] it. But I use heated composites. So I used to use Venus. Now I use Empress. Yeah, Yeah. So [01:26:40] I find that I find that works so much better. And I think it’s really important [01:26:45] to, before you do any injection moulding to be able to do freehand [01:26:50] first because, you know, if mistakes. Mistakes can happen voids. [01:26:55]

Payman Langroudi: You need to know how to do both.

Sam Cope: You need to know how to do both.

Payman Langroudi: Yeah. There are times. There are times where freehand is important [01:27:00] to do right. The situations, many situations that you’ll have to do it in freehand. And there’s many [01:27:05] situations that would be good if it was predictability was completely there. And you can, you know, [01:27:10] it’s like a little magic trick, isn’t it? I could show you, show you before, before you actually do it, what it’s going to look like, [01:27:15] which is beautiful.

Sam Cope: It’s so important to do as many kind of composite courses as you [01:27:20] can.

Payman Langroudi: Yeah.

Sam Cope: Monarchs totally. Composite course is great, but you’ll learn so much more [01:27:25] from doing different. Like Depeche Palmer’s course mini Smile makeover, you learn so many other [01:27:30] different skills and you’ll think, actually, I can do this differently and this is faster, or this works [01:27:35] better for me.

Payman Langroudi: It’s my pet hate. Yeah, we get a call, people say, hey, sell it to me on the phone, [01:27:40] you know? And you’re like, what do you mean? Well, I’m picking between this one and that one. Which [01:27:45] 1 a.m. I going to go to? And and you’re, you know, we I, we talk about [01:27:50] it and we, we give them we give them what they want. But in in your head, you’re thinking if [01:27:55] you were at all serious, you’d be doing all of them.

Sam Cope: Yeah, you should be doing all of them. Really.

Payman Langroudi: You know. [01:28:00]

Sam Cope: Because this is what you want to do.

Payman Langroudi: Let alone this one or that one. There’s about seven of them. You do them all. [01:28:05] You know, if you want, if you want to be that person, you want to learn something really well. And then let’s face [01:28:10] it, like we always say on MSM, it’s the beginning. It’s not the end, right? It’s the practising [01:28:15] is way more important than going on any courses.

Sam Cope: And it’s like, you know, when [01:28:20] between patients, I would usually be messing around with composite and like placing like composite [01:28:25] veneers over stuff. Yeah. Because it is true. Like the only way you get to the top [01:28:30] or to be the best dentist that you can be, is just through practice [01:28:35] and hard work.

Payman Langroudi: It was funny. The pitch was was saying, yeah, when I do an [01:28:40] examination and, you know, there’s really nothing that needs doing. A lot of times my eyes are just going over [01:28:45] the teeth and I’m just looking at tooth morphology.

Sam Cope: Yeah, yeah, [01:28:50] yeah.

Payman Langroudi: And it was, it was so funny because I was staring at someone else, looking [01:28:55] at the patient, like, just in horror at this idea that that’s what he does. [01:29:00]

Sam Cope: Yeah. God, it’s so important. It’s so important just to understand, like, the line angles [01:29:05] and things.

Payman Langroudi: Yeah. And, you know, a lot of courses, they start with drawing the teeth. And there’s good reason [01:29:10] for that. There is good reason for that. If you can draw it first. Yeah.

Sam Cope: Then you’re making [01:29:15] it out of Play-Doh or something like that as well as a good one. Um, have.

Payman Langroudi: You have you moved [01:29:20] on to, you know, um, porcelain [01:29:25] work, big cases with porcelain. Are you very much [01:29:30] in the minimally invasive area?

Sam Cope: Yeah, I do porcelain cases just because composite [01:29:35] doesn’t work, which is.

Payman Langroudi: Known more for composite, is that is that the way it is? You’re more known [01:29:40] for composite?

Sam Cope: Yeah, I do more I do a lot more composite cases for sure. [01:29:45] But there are I mean I’ve got like 3 or 4 porcelain cases, big [01:29:50] porcelain cases on the go at the moment. And that’s mainly just because you [01:29:55] after a while of doing composite and you’re seeing your cases coming back, you see the people that [01:30:00] are good composite cases and you see the people that are not good composite cases. [01:30:05] So a good determinant I think is firstly like wear on the teeth is important. [01:30:10] And another, another good determinant is when they come in for that first [01:30:15] kind of consult, look at the staining on their natural teeth. Because when they have composite that’s going [01:30:20] to be ten times worse.

Payman Langroudi: So true.

Sam Cope: So if you you know, smoking is a big [01:30:25] one. If they’re smoking and they’ve I did a really lovely composite case. And [01:30:30] she came back maybe about three weeks later and the staining [01:30:35] was just ridiculous. Mainly just over the front 40th, which you can imagine [01:30:40] is going to be the worst with smoking.

Payman Langroudi: And definitely staining is the biggest issue with composite, right? That [01:30:45] you know, okay, you talk about chipping. Yeah, true. But staining tends to be the first [01:30:50] failure.

Sam Cope: Yeah.

Payman Langroudi: Um and so that’s why, you know it gets gets to me man. People [01:30:55] people don’t charge enough for composite veneers. You know it’s it’s hard work. It’s really hard getting [01:31:00] it right.

Sam Cope: And I say to P I say to patients, look the composites are like, you know, if you [01:31:05] buy a pair of shoes, you can wreck them around and have them last hardly [01:31:10] any time. But if you’re kind of polishing them every month and you’re careful with how you use them, you can make [01:31:15] them last years. So with your composite veneers, you know, obviously brush floss is normal. [01:31:20] But come back to see us for, you know, your composite polishing for [01:31:25] hygiene appointments so that we can see, you know, you might be able to see a little void or something [01:31:30] after, you know, six months. Once it’s stained a bit and you can just quickly fill that. And [01:31:35] they last so much longer if they’re if they’re regularly maintained.

Payman Langroudi: By the way, I would say bleach your composites. [01:31:40]

Sam Cope: Bleach composites. Yeah. Sorry. Yeah that is a great way to do it. And also you because [01:31:45] the biggest thing is getting stains kind of in between. And when you when you do bleach them it just [01:31:50] gets eliminates all of the stains. It’s so good.

Payman Langroudi: I’d say one day a month [01:31:55] for all patients after bonding. Yeah, definitely. Or longer? [01:32:00] Two days a month if you want to be really super duper. But yeah, but just to number one, what [01:32:05] you said to to clean them up if they haven’t been done before or [01:32:10] number two, prevent the stain from coming in the first place.

Sam Cope: Yeah, I do recommend that. And I have kind of [01:32:15] a composite aftercare form that I give all the patients. So I’m happy for this to be like a link [01:32:20] or something on the podcast if people want it. But I think it’s it’s definitely a really good thing. [01:32:25] And I also, um, I also after each consultation, I’ll write a [01:32:30] kind of summary of everything that we’ve talked about. And then at the end of, um, the big [01:32:35] treatment plans, I almost summarise it and then give them all the aftercare forms, and then [01:32:40] they usually do come back for those regular check-ups, but also kind of reinforcing it into saying that, [01:32:45] you know, composites are not going to last forever. I usually say it’s almost impossible to how long [01:32:50] it can last. I’ve seen them last hardly any time because of staining, and [01:32:55] I’ve seen them last like years and years, and they look almost like [01:33:00] the first day I placed them using exactly the same composite, exactly the same techniques, but it’s just about how [01:33:05] the person looks after them in their mouth.

Payman Langroudi: I think the oldest picture I’ve seen of Depeche is 12 years, [01:33:10] um, unpolished, unreported, his, you know, with microfilm. The whole [01:33:15] thing is the idea of not having to but but also for the teaching purposes. He wants to see what happens. [01:33:20]

Sam Cope: Um, yeah. Yeah.

Payman Langroudi: And then, buddy, he’s got [01:33:25] these 20 year composites. But, um, I feel like that was a long time ago that [01:33:30] I saw that picture.

Sam Cope: Yeah.

Payman Langroudi: Yeah, yeah. Amazing, man. I [01:33:35] mean, I’m learning a lot from you. I would like to get one more, like, [01:33:40] nugget of information around successfully carrying off this [01:33:45] kind of practice that you’re carrying off now. I mean, okay, you said you said you [01:33:50] said what you said. Um, but, you know, I talk to a lot of young [01:33:55] dentists, right? And a lot of them want to be you. A lot of them want to get to be you. [01:34:00] The minimally invasive, you know, AB, ABC or whatever you guys call it ABC, the minimally [01:34:05] invasive AB type dentist. And my advice often [01:34:10] is you can be that guy. You can be so many other types. [01:34:15] Yeah. Why do you want to be that guy? Right. And it is pleasurable. You know, I find wants [01:34:20] more pleasurable than needs in a way. There’s an honesty to it [01:34:25] that I like. Um, there’s there’s a sort of, uh, people want to [01:34:30] be there rather than need to be there. There’s a there’s a joy to it. Mhm. Um, [01:34:35] as well. But advice wise, someone wants to be you because a lot [01:34:40] of the youngsters want to be you. Should they jump in and do it. Should [01:34:45] they look at other things. And if they want to do it what should they do first?

Sam Cope: Yeah, I think [01:34:50] it’s very glamorous in terms of you’re almost like. [01:34:55] It seems to be what everybody wants to do at the moment that [01:35:00] a line bleach composite. But you are it is it is difficult because [01:35:05] even though you know the NHS work and things that you do is I found really difficult. [01:35:10] And that’s why I decided to kind of go into this route.

Payman Langroudi: You say it’s glamorous, right? The glamorous [01:35:15] side of it is a pain in the arse itself.

Sam Cope: It is a pain.

Payman Langroudi: Because it’s glamorous. Because it’s on Instagram. [01:35:20]

Sam Cope: Yeah.

Payman Langroudi: And that means you have to do Instagram, which you could be spending your time doing [01:35:25] other things, learning other things for the sake of the argument. Right?

Sam Cope: Yeah. And dealing with patients [01:35:30] as well is hard.

Payman Langroudi: More difficult patients. Right.

Sam Cope: More difficult. Yeah. The [01:35:35] patients are more difficult. And also it’s the, um, patients expectations especially [01:35:40] I found in treatment.

Payman Langroudi: Yeah.

Sam Cope: They get yeah, definitely. They definitely do change [01:35:45] my treatment. But also, um, I found in London, patient expectations are [01:35:50] sky high. And it’s, you know, being able to deliver that kind of success. [01:35:55] And you see people will look at Instagram and say, oh, I want my teeth to look like this, [01:36:00] which is a dentist, maybe up north or something. But you’ve got to think that [01:36:05] all of the all of these like successful cases that you see where you’ve got these immaculate [01:36:10] composites, they’ve been followed previously by failures and things. So I think, [01:36:15] I think the most important thing, if you want to get to kind of this position, is just [01:36:20] to not be fazed by, don’t let your failures put you down. [01:36:25] But learn from them and yeah, and grow that way and practice [01:36:30] as much as you possibly can. Um, so any time a patient doesn’t turn up, [01:36:35] you should be looking at, you know, um, placing some composite veneers on some [01:36:40] plastic teeth or just getting the handling of the composite so that when you’re then doing a big case, then you can [01:36:45] do it. Um, but repetition and being okay with failure is [01:36:50] like, is really important because you’ll learn from it. And the great thing about composite is it is it is, [01:36:55] uh, it’s an unforgiving material in terms of the staining, etc., but it’s also a forgiving material [01:37:00] in the fact that you haven’t damaged any of the teeth.

Payman Langroudi: Very versatile. Right. Yeah. Yeah, yeah.

Sam Cope: It’s, [01:37:05] you know, you can. And also it’s not like porcelain veneers when once they’re placed it’s it’s harder [01:37:10] to kind of change them. You can change the composite or replace them or refresh them and [01:37:15] things too.

Payman Langroudi: So it’s an interesting thing. Imagine this young dentist, right. Could be you [01:37:20] or could be an endodontist. Yeah, totally different in many ways, [01:37:25] right? Number one, Endodontist doesn’t have to sell anything to anyone. Yeah, yeah. [01:37:30] That’s true. And pressure of sales is hard. It’s a hard thing. It’s hard to enlighten. I [01:37:35] see it in my sales team, you know. It’s tiring. Tiring?

Sam Cope: Oh, yeah?

Payman Langroudi: Yeah. Pressure of sales. [01:37:40] You haven’t got that as an endodontist. You haven’t got any exacting standards. As long as [01:37:45] it doesn’t hurt. Yeah, yeah. As an endodontist. But it’s not thought of [01:37:50] as a glamorous. By the way. Loads of money. You can make loads of money as an endodontist. [01:37:55]

Sam Cope: Oh, yeah.

Payman Langroudi: Yeah, yeah. It’s one of the, one of the best ways of making a lot of money. Um, [01:38:00] in a kind of a predictable way. Um, totally opposites, [01:38:05] right? All things are opposites in it. But both great ways of going. [01:38:10] But one seems glamorous what you’re doing. And if you tell [01:38:15] most young dentists endo because most of them haven’t done many. They go, oh no, no, I don’t want [01:38:20] to do the.

Sam Cope: Yeah, yeah, yeah.

Payman Langroudi: It’s interesting, isn’t it?

Sam Cope: Yeah. You should try it. You really. I mean, [01:38:25] in the different practices that you’re at, you’ll have sometimes that the practice that you’re [01:38:30] in leads you to become the dentist that you become, because you’ll find that you’ll either draw [01:38:35] inspiration from the people that are there, or you’ll see that there’s a definite gap in the market for something. [01:38:40] So then you upskill in that area, and then you take all the referrals from the other dentists. So. So [01:38:45] yeah. So I think if anybody wants to become this kind of dentist, [01:38:50] just takes takes a lot of hard work and just try and do as many courses that you can and and [01:38:55] just practice.

Payman Langroudi: Um, what’s your favourite book? Have you, have you bought a book ever on this subject? [01:39:00]

Sam Cope: Um, the, the book that I [01:39:05] refer to a lot is Sandra Ty’s book [01:39:10] for orthodontics. That’s really good for Invisalign and learning [01:39:15] about buttons and things, but I think.

Payman Langroudi: The name.

Sam Cope: Uh, Sandra. Ty.

Payman Langroudi: Thats [01:39:20] the author.

Sam Cope: Yeah, thats the author. And I can’t remember the exact title, but.

Payman Langroudi: How [01:39:25] do you spell Ty?

Sam Cope: Ty? Ty. Oh, yeah. So thats a really. Thats a really good book [01:39:30] for Invisalign. But then, um, a lot. Sorry.

Payman Langroudi: Go go.

Sam Cope: Go. Uh, [01:39:35] but then. Yeah, a lot of, a lot of my experiences come from doing the postgraduate [01:39:40] diploma. And then its really important that once you know, you [01:39:45] have to understand occlusion, you have to understand, [01:39:50] you know, um, the makeup of a smile [01:39:55] before you can then kind of go on and just place composites of course. [01:40:00]

Payman Langroudi: What’s your course? A course you’re desperate to go on.

Sam Cope: Um, [01:40:05] I’m probably I think the next courses that I’m going to [01:40:10] go on are probably more injection moulding courses, I think.

Payman Langroudi: Um huh. Just [01:40:15] just explore that area more.

Sam Cope: Explore it a little bit more. Yeah.

Payman Langroudi: Have you ever thought of choice or spear [01:40:20] that sort of thing? That that angle?

Sam Cope: Um, a little bit, I think. [01:40:25] I think to like more courses that I’d want to do is communication courses.

Payman Langroudi: Oh, really? [01:40:30]

Sam Cope: They’re so important. Yeah. Um, tell me a bit more about the Khoisan spear.

Payman Langroudi: Of course. The spear. [01:40:35] You know, like, full on occlusion, full mouth rehab type courses. Um, [01:40:40] they’re sort of thought of as the best ones and expensive in America. Mhm. Continuum [01:40:45] of of of the. It’s not only that I’ve really shortened it but but [01:40:50] that’s you know, the kind of dentist you end up becoming. You look at where cases and, and and take care of, you [01:40:55] know, full mouth rehabs on them without worrying too much, I guess.

Sam Cope: Yeah. I mean, [01:41:00] I’ve done a few full mouth rehabs with composite and, um, [01:41:05] some with porcelain and then darling as well. But I think if I think if you have [01:41:10] kind of the core principles in mind, then and also again, learning from [01:41:15] your failures, you’ll be able to. Yeah, you’ll be able to do it. I’ve. I [01:41:20] do have another good, um, book. I think it’s Devang Patel [01:41:25] on full mouth rehabilitation. That’s a really good one. Um, and he goes through how he kind [01:41:30] of builds up composites. I like him and goes from kind of single tooth composites, right? The way to full [01:41:35] mouth rehabs. That’s a really good book.

Payman Langroudi: Have you been on his course?

Sam Cope: I haven’t actually, yeah, I would like [01:41:40] to go on it though.

Payman Langroudi: I like him. Lovely guy. It’s been a massive pleasure to have you, man. Um, [01:41:45] we’re going to end on the usual questions. Fantasy [01:41:50] dinner party.

Sam Cope: Okay. Yeah.

Payman Langroudi: Three guests, dead or [01:41:55] alive.

Sam Cope: So, um, so [01:42:00] I, I’m also a massive history buff. Like, I love history, so, [01:42:05] um, I think, like, the first person I’d probably invite is probably, [01:42:10] uh, Augustus Caesar. Augustus. I think that’d be really cool.

Payman Langroudi: Okay. [01:42:15]

Sam Cope: I think the reason is just because, um, this is going to like, [01:42:20] show me as, like a real history guy. But I do love like I love, like learning about the Roman [01:42:25] Empire, but also him as a person in terms of [01:42:30] managing the struggles that he went through, but also being the most powerful person in [01:42:35] the world. And how to manage that would be quite cool. Yeah. And then the other [01:42:40] two people. So my, uh, fiance, her dad, sadly [01:42:45] passed away when he was three, when she was three years old. So I’ve never met [01:42:50] him before. But the other two people I’d like to invite is is him [01:42:55] and then my fiance as well, because I think that would be really nice for them to be together, [01:43:00] and also for me to get to know him as well.

Payman Langroudi: That’s such a lovely thing. I normally [01:43:05] don’t allow that, that sort of response, but that’s such a lovely thing. That’s such a lovely thing [01:43:10] that you just said there. Beautiful, Beautiful. Final question. [01:43:15] It’s a bit weird. Young person like you. Deathbed.

Sam Cope: Oh, yeah.

Payman Langroudi: Three pieces [01:43:20] of advice for your loved ones on your deathbed.

Sam Cope: I [01:43:25] think, I think. I think it’s almost a reflection of what we’ve talked about on [01:43:30] the podcast, which is knowing knowing when enough [01:43:35] is enough and being able and also being able to really, [01:43:40] you know, the meaning of life almost comes from being in [01:43:45] your tribe and having really good personal family friend [01:43:50] relationships. That’s so important because I’ve seen, like with my family, you [01:43:55] know, people not get on together and then people get lonely and then going into [01:44:00] depression and things like that. So it’s it’s so important. Like keeping your family and friends [01:44:05] relationships is is crucial. Um, and [01:44:10] then I think, you know, getting getting a passion and a hobby is [01:44:15] so important to, um, I think my, my hobby, because [01:44:20] I’m only doing it three days a week now. My hobby is almost become dentistry. Yeah.

Payman Langroudi: Mine is podcasting. [01:44:25]

Sam Cope: But, yeah, it’s, um, I think getting something that you really, [01:44:30] really enjoy. So say, like, um, something, you know, obviously, I enjoy [01:44:35] doing the dentistry and enjoying your job is really important. And like, with the physio, like, [01:44:40] I saw that I couldn’t really envision myself being a physio into my [01:44:45] like, 50s and 60s. So not being afraid to sometimes take a step back and think, [01:44:50] actually, is this what I want to do? And even though it’s a drastic change, which is like a big [01:44:55] financial risk and loss just to do it. Um, and then the other [01:45:00] thing is to maintain a balanced life, which is to ensure [01:45:05] you’re getting the right nutrition, sleep, exercise and stress management to be able to [01:45:10] kind of live and fulfil a good life. I’d say quite crucial. [01:45:15]

Payman Langroudi: Sure.

Sam Cope: Mhm.

Payman Langroudi: Amazing. Really enjoyed that man.

Sam Cope: Yeah. [01:45:20]

Payman Langroudi: No worries. Really enjoyed that. Thank you so much for coming all the way.

Sam Cope: Oh it’s been a pleasure. It’s been really fun.

Payman Langroudi: Thank you.

[VOICE]: This [01:45:25] is Dental Leaders the podcast where you [01:45:30] get to go one on one with emerging leaders in dentistry. Your [01:45:35] hosts, Payman Langroudi and Prav Solanki. [01:45:40]

Prav Solanki: Thanks for listening, guys. If you got this far, you must have listened [01:45:45] to the whole thing. And just a huge thank you both from me and pay for actually sticking through [01:45:50] and listening to what we had to say and what our guest has had to say, because I’m assuming you got some [01:45:55] value out of it.

Payman Langroudi: If you did get some value out of it, think about subscribing. And [01:46:00] if you would share this with a friend who you think might get some value out of it too. Thank you so, [01:46:05] so, so much for listening. Thanks.

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

Payman Langroudi: This podcast is brought to you by enlighten. Enlighten is an advanced teeth whitening system. Join [00:00:05] us for online training, where I’ll take you through everything you need to know about how [00:00:10] to assess a case quickly, how to use the system, how to talk to patients. Because when you [00:00:15] know you can deliver brilliant results, it’s so much easier to talk about it. To book your course, which takes [00:00:20] only an hour. It’s completely free. Visit enlighten online training.com. [00:00:25] Now let’s get to the pod.

[VOICE]: This [00:00:30] is Dental Leaders. The podcast [00:00:35] where you get to go one on one with emerging leaders in dentistry. Your [00:00:40] hosts Payman Langroudi [00:00:45] and Prav Solanki.

Payman Langroudi: It gives me great pleasure to welcome Davida [00:00:50] on to the podcast. Rov is a general dentist with a special interest [00:00:55] in periodontics, whose practice is now completely limited to periodontics [00:01:00] and some medico legal expert witness work. It’s a pleasure to have you. [00:01:05]

Sarovi Davda: Thank you for having me.

Payman Langroudi: What’s your name?

Sarovi Davda: Come from where it comes from. Sarovar, which [00:01:10] is lake in Sanskrit. Okay, so yeah, I’m Gujarati in origin. You [00:01:15] are? Yes, a British born. But my parents emigrated from East Africa, my grandparents [00:01:20] from India. So one of those generations chucked out by Idi Amin, the.

Payman Langroudi: Master race, those, [00:01:25] those those guys.

Sarovi Davda: The master. I love that.

Payman Langroudi: Those guys are great. I mean, I’ve had the number of people I’ve had here [00:01:30] whose parents have come from East Africa, and I knew friends in school. They have a can [00:01:35] do attitude. Those African Indians, while.

Sarovi Davda: They do, I don’t know if it’s gone down to our generation. It’s [00:01:40] like kind of we get a bit of the kushti, you know, like everything’s great from our parents. So we take a [00:01:45] seat back. Yeah, maybe. Certainly. I’m not as ambitious as my dad was.

Payman Langroudi: So, so, so tell [00:01:50] me about your childhood. Where were you growing up?

Sarovi Davda: So I was, um, born in [00:01:55] Kingston, like Kingston Hospital and, Huh?

Payman Langroudi: Jamaica. Sorry. [00:02:00]

Sarovi Davda: Very British by the terms. And like, my mum would take me to Richmond Park to see the [00:02:05] dears when I was little. And then actually on advice of relatives that said, basically there are no brown [00:02:10] Gujaratis where you live. You want to bring up your children with the community around you. We [00:02:15] moved to north west London, so I grew up in Northwood.

Payman Langroudi: And what kind of kid were you? Were you very [00:02:20] studious, very compliant, or were you rebel?

Sarovi Davda: No. Very compliant. So, [00:02:25] um, when I was very little primary school, my, my parents were [00:02:30] really worried about my academic or lack of achievement. And my argument would always be, no, [00:02:35] I’m not last in the class because you’re last in class. I’m last but one. Mum and [00:02:40] I had atrocious spelling. I had atrocious like grammar, probably, well, pretty sure, undiagnosed [00:02:45] dyslexia. And I was always dancing and singing. Probably a [00:02:50] little bit of ADHD probably as well. Yeah, undiagnosed. I was always dancing and singing around the house. And [00:02:55] then one summer my mum worked with me over English. I was very creative [00:03:00] and I managed imaginative, and I got that one year, 83% of my English [00:03:05] exam. And that was what really sparked me into kind of essentially people pleasing through academic [00:03:10] achievement. I loved it, and then I became a proper grafter. And I just, [00:03:15] you know, I worked, I worked my ass off.

Payman Langroudi: But then how did dentistry come on [00:03:20] the sort of agenda?

Sarovi Davda: So I really loved art. I loved [00:03:25] English and communicating with people. I wanted to help people. I decided [00:03:30] as a true co-dependent. And I really love biology. So I [00:03:35] took it to my dad and he was like, make a pros and cons list and bring it to me and [00:03:40] did that. And then he said to me, and it was a really life changing kind of conversation. [00:03:45] He goes, what kind of life do you want? So I said, well, I want the kind of [00:03:50] life we have, like lovely holidays. I want to be at home for my children. So I want to be able [00:03:55] to work part time. I want good work. Hours. And I was deciding between medicine and dentistry and [00:04:00] it was really what fit the bill was the life it offered, as well as [00:04:05] the fact that I wanted to use my hands. I loved the art and creative side, so I had to become a surgeon [00:04:10] and, you know, train even further in medicine. So dentistry was the one for me in that way. [00:04:15]

Payman Langroudi: And what did your dad do?

Sarovi Davda: He was an accountant.

Payman Langroudi: But look, you were interested in English. [00:04:20] You were interested in making things with your hands. Yeah. So I’m interested [00:04:25] in this notion of sort of generational evolution. And I get it. You know, with your [00:04:30] dad running away from Idi Amin, was it Idi Amin?

Sarovi Davda: It was my mum, Idi Amin, but my dad was in Tanzania. [00:04:35] Tanzania. And. Yeah.

Payman Langroudi: So. But with your parents becoming this, that first generation to [00:04:40] leave Africa, I can understand it’s similar with my parents. You know, we had a revolution in Iran, [00:04:45] you know as well. So similarly with my parents, they said they [00:04:50] their advice was to opt for something safe like medicine, dentistry. My brother became a doctor. [00:04:55] I became a dentist here. But the question of your children. Hmm. [00:05:00] And I’m strangely. I’m. I’m. I’m advising my daughter to be a dentist. [00:05:05] Yeah, I am. Because such a great job for a woman. Because you can stop, start, [00:05:10] do four days, do one day. You know, that’s so amazing. If you want to have kids. But [00:05:15] it would be nice, wouldn’t it? If my advice to my kids and your advice to your kids [00:05:20] was be really good at the arts, become [00:05:25] a screenwriter. Like something you could have been, right? I can see, like, you know, you were good at English. [00:05:30] You’re good at talking. You could have gone into that world, but your parents didn’t. I get it, but what’s your [00:05:35] advice to your children?

Sarovi Davda: So my parents and my advice to my children is actually that [00:05:40] in the sense that, okay, so I genuinely believe that I, like the world [00:05:45] today is different to how certainly my I grew up and also what my parents went through. [00:05:50] I do not blame them the slightest for them prioritising for me my financial security [00:05:55] and stability over like go for what you love. But I genuinely believe, [00:06:00] and I could be completely wrong, that I think in this world, if you have the sort of the right [00:06:05] type of work ethic, if you find joy and passion in [00:06:10] what you genuinely love doing, you can make a living from it. But I [00:06:15] think it has to be with your reality that some professions are far harder to isn’t. [00:06:20] Dentistry is a guarantee in some ways. There’s only a certain threshold below you [00:06:25] know which you’ll fall or go. You have a stable ground there. You have a safety net. [00:06:30] Many professions don’t have that safety net. Yeah. So I think that’s something like, especially [00:06:35] as a single woman, I am so damn grateful that I have dentistry. The [00:06:40] financial renumeration I get from it. Also, I happen to absolutely love it. I do. Like, [00:06:45] yes, I could have gone into, I say if I wasn’t a dentist, I’d either be an be an interior designer or [00:06:50] a florist, you know? But I really do love what I do. I wouldn’t change it. So I’ve been lucky. [00:06:55] But I do think, like I tell my children, um, my my daughter wants to be a [00:07:00] dance. She wants to be a dancer. Um, but then there’s the thing is, there are different scopes [00:07:05] within that. So she doesn’t have to be a dancer in the West End. I mean, that has [00:07:10] a finite time. She could open up a dance company. She could like. There. There are. I [00:07:15] think it depends upon your ambition, your mindset and your financial goals. There are places [00:07:20] where all careers can take you. So I do feel like if I can.

Payman Langroudi: But I mean, it’s [00:07:25] easy to say now they’re young enough. How old are they again? Tell me.

Sarovi Davda: Nine and 11. [00:07:30]

Payman Langroudi: Nine, 11. It’s nice to talk about these things when they’re 911. But then it comes [00:07:35] to, you know, what subjects to get to do an A level. Mhm. Um, [00:07:40] and if she said look I want to do drama art and dance. Yeah. And [00:07:45] a bit of you might come out at that point and say, what about biology, chemistry and maths? [00:07:50]

Sarovi Davda: Like a bit of me, I’ll be screaming inside. Like, I mean, I’m really fighting my introjected beliefs [00:07:55] here. Like when I say I give this advice, it’s not without claws. It’s not without me. Like looking [00:08:00] at myself and thinking, my goodness, something’s really coming up within you. Yeah, but I [00:08:05] think that’s my that’s where my work is, like, as in, so, you know, there’s this beautiful poem [00:08:10] that I recite most mornings by Kahlil Gibran, which is about children, and [00:08:15] it says, you know, my children are not my children. They’re the sons and daughters of life’s longing for itself. [00:08:20] They come through me, but they’re not from me. And though they are with me, though they belong not to me. [00:08:25] A couple of more verses, but it’s like, I don’t I wouldn’t say I, [00:08:30] I live in that attitude, but it’s an aspiration. And so if I can align my actions [00:08:35] with that aspiration, I just hope I’m, you know, doing good. [00:08:40]

Payman Langroudi: While we’re.

Sarovi Davda: On it.

Payman Langroudi: That’s it. While we’re on it, what kind of a mom are you? Are you, like, good cop [00:08:45] or bad cop, are you? Because I’ve noticed.

Sarovi Davda: That. People pleaser. Of course I’m a good cop. [00:08:50]

Payman Langroudi: But then. But then. Do you need a bad cop as well? Like, do [00:08:55] you recognise that with your parents? Was one of them good cop? One the bad cop? Was it two bad cops? [00:09:00] My Africa?

Sarovi Davda: Yeah. In some. Okay. You know, my mom was definitely this, [00:09:05] like, the very typical soft, um, nurturing caregiver. [00:09:10] And my dad was more the disciplinarian, if there was one, for sure. They took those typical roles. [00:09:15]

Payman Langroudi: Um, well, you say typical. My mom was like the washy.

Sarovi Davda: Okay. [00:09:20]

Payman Langroudi: And my dad was my buddy, you know? And in my house, I’m the good cop and my wife [00:09:25] is the bad cop.

Sarovi Davda: No way. That’s so interesting, because that’s obviously my upbringing. That’s clouding my. This [00:09:30] is the norm. Okay? This is my norm then.

Payman Langroudi: Exactly, exactly.

Sarovi Davda: Thank you for that. Yeah.

Payman Langroudi: So. So [00:09:35] you are good cop.

Sarovi Davda: I’m. I’m good cop. But. Okay, so I loved taking [00:09:40] the good cop and left, leaving my ex-husband to be the bad cop role. Because that’s [00:09:45] where I was super comfy, because, hey, I’m the one that can look like the good cop. But I but [00:09:50] what’s helped me is in with the divorce is that I have to be I there’s [00:09:55] good cop with boundaries because boundaries. I think I’ve realised a part of being a good [00:10:00] cop as well. So it’s like healthy boundaries with it hopefully put [00:10:05] into in from a sense of love, from a place of love, with love, but not without [00:10:10] discipline, because then that’s just chaos, frankly. So yeah, I would say I’m I’m. [00:10:15]

Payman Langroudi: Are you happy to talk about divorce?

Sarovi Davda: Yeah. So it affects 40% [00:10:20] of us. So. Hey, I’m not alone.

Payman Langroudi: Yeah, yeah. No. Of course. So did you then change when? When [00:10:25] when the separation happened? When? When your ex went away from the house. [00:10:30] Did you then have to compensate and become a bit of a worse cop?

Sarovi Davda: I [00:10:35] think I had to learn for both myself. But as a mother, for my children. [00:10:40] Yeah. What boundaries were. I was pretty in some ways boundaryless [00:10:45] in many, many ways. And so I had to take a really good, long, hard look at myself and [00:10:50] figure out what I contributed to the breakdown of my marriage. And I [00:10:55] guess better myself as a person or, you know, yeah, I’d be able to look after [00:11:00] me more and others.

Payman Langroudi: I want to do a whole series. I want to do a series. I’ve been asking people [00:11:05] now, a series on. I think it’s quite prevalent in dentistry, where [00:11:10] the woman is the primary earner in the house. It’s [00:11:15] more in dentistry than in a lot of other areas because, you know, dentists can earn. And [00:11:20] I also see it with hygienists often the primary earner in their [00:11:25] house. And is it that that causes tension? Because [00:11:30] I always thought of myself as a very progressive sort of, you know, like anything goes [00:11:35] everyone’s you know, I thought asking this question was quite sort of old fashioned and, [00:11:40] and and sort of, um, you know, chauvinistic to say, well, [00:11:45] why shouldn’t a woman earn more than a man? Why should that even affect anything? But when I look in my [00:11:50] sort of friends circle and people I know who where the woman earns more than the man, it [00:11:55] does. I know 1 or 2 situations where it works, but often that becomes [00:12:00] an issue. Anything to say on that?

Sarovi Davda: Yeah, I think that [00:12:05] if it is an issue, I guess my attitude is it’s.

Payman Langroudi: You earning more than him. Let’s start with that.

Sarovi Davda: Is [00:12:10] any in employment? Yes. In the sense, yeah. Um, but then he [00:12:15] had many investments from investing real young in a very smart way. So, [00:12:20] um, but I do think it I wouldn’t be surprised if it [00:12:25] caused an issue in many, many arenas because we’re still evolving [00:12:30] from our, like, brain where, you know, hunter gatherer versus like, [00:12:35] caregiver. And it takes I don’t know how many years it years it takes. But [00:12:40] it takes like six generations for alcoholism to affect affect, like alcoholism, for example. [00:12:45] Don’t know where we want this, but it affects six generations. There’s still part of our brain that, you know, if we’re left [00:12:50] out of a tribe, that part of the brain is activated where we believe we’re in physical pain. [00:12:55] So our brain has so much evolving to do. So if it’s that the man [00:13:00] is earning less, the woman’s earning more and breeding the children. So until the day [00:13:05] that men can actually bear children, I that’s a lot of role to take up in a [00:13:10] equal dynamic. That’s a that’s not equal. You know, so I can imagine [00:13:15] if it’s not bringing home the bacon unless you’re raised very differently, that’s [00:13:20] hard. That’s really in the same way that it may be hard for me, like brought [00:13:25] up in a, again, a typical way with there’s still this, you know, sausage with electricity brain, essentially. [00:13:30] Um, not having a role in the children like when I was in the marriage, [00:13:35] you know, in my mind it was It was like the kids are kind of mostly, you know, that’s mostly my [00:13:40] department. Yeah. And so as much as I can say that’s changed now, you know, I’ve, [00:13:45] I’ve. But I was essentially not really seeking, um, equality in a relationship. I was seeking, you [00:13:50] know, you take this role and I take this role and. Yeah, [00:13:55] it’s very hard. So if it’s hard for me, it’s hard for a man as well. I can imagine. [00:14:00]

Payman Langroudi: Tell me. I don’t want to. Over, over, over spend my time [00:14:05] on, on divorce and and all of that. Yeah, but but tell me other things that [00:14:10] went through your head. I mean, for instance, did you have a feeling of failure [00:14:15] or shame or.

Sarovi Davda: So I think initially [00:14:20] it was a huge grief and disappointment because I always imagined, you know, sitting on a park [00:14:25] bench hand in hand.

Payman Langroudi: Old lady.

Sarovi Davda: Really old, holding hands. I don’t imagine [00:14:30] anyone goes into marriage taking vows and then thinking, you get divorced. But, you know, I [00:14:35] really like, especially the culture that I guess we’re brought up in. Divorce is just not even [00:14:40] an option. It’s like not viewed upon as a viable option. So initially I [00:14:45] felt a huge sense of grief and sadness. I [00:14:50] also kind of knew inside with each step I took, that it was [00:14:55] absolutely the right decision for me. And weirdly, [00:15:00] and I cannot believe I can attribute this only to a higher power, [00:15:05] that I now have huge pride in the sense that it’s one of the most [00:15:10] empowering decisions I’ve ever made in my life. And I have, I can genuinely say, because [00:15:15] I’m touching my heart right now, not a molecule of shame in me about that decision, but it wasn’t instant. [00:15:20]

Payman Langroudi: At the time.

Sarovi Davda: It was at the time there was some sense of, yeah, [00:15:25] just sadness. I don’t know about failure. I’m trying to think about that. No, [00:15:30] because I was too much in the delusion of it’s not my not my fault, it’s your fault. [00:15:35] And that was a delusion. You know, it’s never like one good cop, bad cop. It’s never actually as [00:15:40] black and white as that. But I think I was safe in that delusion that, well, I didn’t, you know, this is not my [00:15:45] fault. I tried my hardest, you know, victim victimhood. Martyrdom was a big, like, [00:15:50] adapted tool for me. So I didn’t feel that sense of failure because for me, it was like I gave [00:15:55] it my all and it failed because of you, which was not the truth, you know? So then I [00:16:00] guess I bypassed the failure bit because I moved into an understanding of what I contributed, [00:16:05] taking both responsibility, but not necessarily like blame. I don’t think the [00:16:10] blame is useful, but to accountability is very useful. And that’s empowering.

Payman Langroudi: Does that book isn’t there [00:16:15] that the you know, Mohamed Hadid’s got a girlfriend, she’s written a book. It’s [00:16:20] called divorce as an opportunity.

Sarovi Davda: Oh, really? I haven’t read it, but I.

Payman Langroudi: Forget [00:16:25] her name.

Sarovi Davda: I really deeply resonate with with the title. Yeah, absolutely. [00:16:30]

Payman Langroudi: Let’s move on. Let’s move on. Um, when you got to guys, it was [00:16:35] guys.

Sarovi Davda: Yeah. Yeah.

Payman Langroudi: What was that like? So was it like. Oh, big [00:16:40] city.

Sarovi Davda: Big city. No, no. Well, I was a London girl already, in a sense. And you know what? When [00:16:45] I went to guys, everyone went back home for the weekend. Like to take their washing [00:16:50] and mum and dad. So it was kind of like. You’re joking. So it was [00:16:55] kind of like going to school in that sense, but I remember. Do you know what happened on one of the first days we were there? So, [00:17:00] okay, I was this little perfectionist, worked my ass off, did really well at GCSE. [00:17:05] So kind of thought, okay, I can do it and then just scrape by with A-levels. I got three B’s, which was [00:17:10] what was needed to get into dental school. And they sat us in this lecture hall and [00:17:15] they said, those of you who have got three B’s all below [00:17:20] are the bottom of the pile. Essentially this is what I took from it. They’re like, that is [00:17:25] the lowest tier. This is a really hard course, and you’re going to have to work really hard. Everyone. [00:17:30] And this is the lowest. And I was just sat there thinking, oh my God, I [00:17:35] feel shite. I feel really bad. I’m not used to being like the bottom of [00:17:40] the fear.

Payman Langroudi: Of God into you in dental school, and it can’t be a coincidence that we had it. You had. It was [00:17:45] just like the way the course is.

Sarovi Davda: Okay. Should I tell you something else I have in dental school? Yeah. Okay. People [00:17:50] can’t believe this when I share it. So we are young newbies. Uh, we were sat in [00:17:55] this again. We were called for a sexual health lecture in our first couple [00:18:00] of weeks, freshers week. And we sat there this big, like, balcony, [00:18:05] um, seats. And then the kind of the stools, you know. What year was this? It was the first [00:18:10] week.

Payman Langroudi: Freshers week. But what year was it?

Sarovi Davda: Oh. First year.

Payman Langroudi: Yeah, but what year was that?

Sarovi Davda: Oh, sorry. 1997. [00:18:15] Yeah, 1997. We were sat there and there was this guy, older [00:18:20] guy, giving a lecture on sexual health, and he said, I’m going to take an anonymous survey. Could [00:18:25] we close our eyes and everyone who is a virgin, put your Put your hands up. Well, [00:18:30] everyone who’s had less than five sexual partners, something like that. Who has had more than sexual. [00:18:35] You know, all anonymous. Hands up. So everyone’s hands were raised appropriately.

Payman Langroudi: And no [00:18:40] one could see. No one. I bet there was some peeking.

Sarovi Davda: You wait, you wait.

Payman Langroudi: Yeah.

Sarovi Davda: So then [00:18:45] at the end of freshers week, what do we see? Showing a video of the lecture. [00:18:50] They’d taken a mature student to give a fake sexual health [00:18:55] lecture that was then had older years sitting, watching the balcony with their eyes [00:19:00] opening open and taking bets on whose cherries they could pop.

Payman Langroudi: Oh my goodness. [00:19:05]

Sarovi Davda: So.

Payman Langroudi: Oh my.

Sarovi Davda: Goodness. If you want to call that out in the podcast. But [00:19:10] yeah.

Payman Langroudi: Today that would be like a police thing.

Sarovi Davda: Today that would be all over the Daily [00:19:15] Mail, the mirror.

Payman Langroudi: You name it, you’re outraged. You must have been.

Sarovi Davda: Yeah. I was like crushed. I was like, [00:19:20] you know, I mean, I was a proper little innocent, you know, just. [00:19:25] Yeah. Oh, no. And I remember walking in on guy’s bar. This [00:19:30] is probably not what you expected to hear when you asked the question. I walked in on guy’s bar and this [00:19:35] was like the this is back in the day where they do these, like, dares. I can’t remember what it called. They called [00:19:40] it like an initiation type thing. And I had never seen a male below the waist [00:19:45] ever at that point. And literally I walked into a guy’s bar and [00:19:50] people were pissing all over the bar. Like with the.

Payman Langroudi: Rugby, kind of.

Sarovi Davda: The.

Payman Langroudi: Rugby. [00:19:55]

Sarovi Davda: They were eating like, um, livers or live hearts, whatever. [00:20:00] They were vomiting in each other’s mouths. I was honestly, I was like outraged. I was like, what [00:20:05] have I stepped into from a really like, sort of tiny little.

Payman Langroudi: You [00:20:10] know, guy’s sheltered. You know, you do know guys, rugby club is the oldest rugby [00:20:15] club in the world, is it not the oldest. Not the oldest university rugby club. It’s [00:20:20] the oldest rugby club in the world. So based on that they were they could do whatever they wanted, [00:20:25] you know. And in rugby that’s kind of the direction sometimes it goes in the partying. [00:20:30]

Sarovi Davda: Yeah. So that was the first.

Payman Langroudi: Thing.

Sarovi Davda: I was exposed to. I was shocked. Yeah. Safe to say I [00:20:35] was shocked.

Payman Langroudi: And the workload. Did you find the workload shocking? I did.

Sarovi Davda: I remember [00:20:40] I must have, because in the second year I remember it being really hard. Where that’s when I started [00:20:45] developing Tmjd. Mhm. Yeah. I like I had, I had such [00:20:50] bad jaw rake I could barely open my mouth. So I was really stressed in second year and that [00:20:55] was a really hard year. I remember second year and probably fifth year I imagine. Yeah that [00:21:00] was stressful.

Payman Langroudi: But then do you have other like did you party? Did you just put your head down [00:21:05] and work? No I did. It’s a transition isn’t it. There’s a there’s a reinvention when you go to university. [00:21:10] Right now I’m trying to persuade my son leave London. Yes. Because, you know. [00:21:15] And the thing is, he wants to go for engineering. And Imperial is one [00:21:20] building down from his school. And and so that and you know, they want to put Imperial [00:21:25] down. I’m saying it’s just a massive error, you know, go somewhere else, leave and reinvent. [00:21:30]

Sarovi Davda: Campus as well. When you get to be with other students, like not just dentists. I think that’s kind of fun, right?

Payman Langroudi: But also [00:21:35] London is I mean, London is so hard if you’re doing really well, but it’s particularly hard if you’re a [00:21:40] student. Right. But then also he knows London, right. You know, go somewhere you don’t [00:21:45] know where no one knows you, that sort of thing, you know. Yeah, but go on. So how [00:21:50] did you get on? Did you, did you enjoy it in the end? Was it fun? Do you have friends from that era? [00:21:55] Well, Lali.

Sarovi Davda: Lali. But she wasn’t in my year, so I should actually, um, [00:22:00] some of the. Yeah, a couple of friends I kept in touch with. Um, a really good friends of mine [00:22:05] in the first year, and this probably happens to many people, but I, I did not [00:22:10] have I kind of just experienced the back end of female [00:22:15] fallouts and stuff. So my friends in the first year weren’t the friends I kept for life. [00:22:20] And then I guess I must have had it on a subconscious level if not conscious that right. I’m not [00:22:25] going to be friends with girls like girls are not safe. I’m something so I made friends with in my [00:22:30] in my tutor group. Two guys I called us Harry, Hermione and Ron, and [00:22:35] they were my best friends in the world, one of whom I actually ended up going out [00:22:40] with for a good couple of years. And, um, and [00:22:45] we had the best time. We had a really wonderful time. So I have very good memories, [00:22:50] actually.

Payman Langroudi: People sitting here saying that university was one of the hardest times and they didn’t have a [00:22:55] good time. And I just just take it for granted.

Sarovi Davda: Everyone has that more recently, would you say, or back in the day, is it harder now [00:23:00] than it was before?

Payman Langroudi: Well, harder mentally for them. And what’s interesting is in our day, [00:23:05] there was no, um, I’m a bit older than you, but in our day there was no social media. And [00:23:10] so university was an opportunity to kind of see the world. Whereas [00:23:15] today, you know, they already know what’s going on in the world. And [00:23:20] so university isn’t as much of a leap into the big wide world as [00:23:25] it was for us.

Sarovi Davda: But when you say no, the world like, how much can you know it from a screen, [00:23:30] right? It’s like I could watch on the National Geographic, the Himalayas, I know. So is that so? What [00:23:35] do you mean by like, they know the world? Like they kind of already aware of stuff, so things aren’t eye opening or.

[TRANSITION]: Yeah. Yeah, [00:23:40] yeah. Like.

Payman Langroudi: Who did we know we were we were in school. [00:23:45] We had our friends around us in school.

Sarovi Davda: We know people like.

Payman Langroudi: Just just yeah, [00:23:50] my my my my son might be, like, messaging some guy in Peru about [00:23:55] a rocket because he’s interested in rockets, right. You know what I mean?

Sarovi Davda: Yeah.

Payman Langroudi: We didn’t [00:24:00] have that opportunity.

Sarovi Davda: No, no, we had a very small world. Small world. Whereas then it was like [00:24:05] magnified massively in university. Yeah.

[TRANSITION]: The university.

Payman Langroudi: Was what you.

Sarovi Davda: Said.

Payman Langroudi: About the course where [00:24:10] there are others. Yeah. You’re absolutely right about that. Because, you know, some of my friends were these law [00:24:15] students and, and so on, and they had a whole different outlook on on life. [00:24:20] You know, they had only like four hours of lectures and loads of library and stuff. It was just a different type [00:24:25] of person altogether. Yeah. And so that was interesting. But what I’m saying is I’ve [00:24:30] had people here, many people here. So university was one of the darkest parts of [00:24:35] there. And it is sad. It is sad.

Sarovi Davda: I’m saddened by that. Yeah. Because for me [00:24:40] it was it was a really great opportunity to like get. It’s like having fun because my mum gave me strict instructions [00:24:45] at university. She goes, I don’t want you bringing home any A’s. No A’s. I want you [00:24:50] to just scrape by.

Payman Langroudi: That’s different.

Sarovi Davda: That’s very different to Asian. Asian upbringing. [00:24:55] Typically, like, you know, stereotype. My parents, I thank them so [00:25:00] often, so much for not putting any academic pressure [00:25:05] on me. In fact, my mum would be my like, she’d she’d tease us down. When we were [00:25:10] revising for A-levels, my mum would always say, I’ve got your favourite movie downstairs, like. [00:25:15] And we’d be like, mom, stop it. We were. She was so great and we [00:25:20] were so self-motivated. For whatever reason, that she didn’t need to kind of she [00:25:25] she was the one that was instigating us to take our foot off the pedal. So when we went to university, she was [00:25:30] like, right, you got to where you need to get to. That’s it. Don’t try that hard. So [00:25:35] I didn’t have that pressure. Yeah.

[TRANSITION]: Did you have any idea.

Payman Langroudi: About perio back then or [00:25:40] specialising or. You know, this is.

[TRANSITION]: A it’s a common.

Payman Langroudi: Question, [00:25:45] right? Where I’ve got loads of younger dentists contact me and say what [00:25:50] should I do. Yeah.

Sarovi Davda: And yeah.

Payman Langroudi: And my advice is a bit opposite to most [00:25:55] right. Most people say do a bit of everything. See what turns you on. Yeah. And [00:26:00] then choose one of those things. Um, and the way they normally say is to go to the NHS, do that for [00:26:05] a couple of years, get your wings, you know, get your, get your experience of all those different [00:26:10] things and then decide. My, my. I say the opposite. I say decide [00:26:15] immediately.

Sarovi Davda: Really?

Payman Langroudi: Pick something. Yeah. And then you [00:26:20] end up enjoying whatever you’re good at, right? Like you enjoy. Because you’re good at it, not because you’re specifically [00:26:25] a good gardener. I mean, if you were good at it, though, you’d enjoy that. Um, I fully [00:26:30] zoomed in on one molecule. Hydrogen peroxide. Yeah. And I enjoy that.

[TRANSITION]: Yeah. [00:26:35]

Payman Langroudi: So that’s that’s what I’m saying. I’m saying decide as early as possible and and then chase [00:26:40] it. What’s your advice?

Sarovi Davda: Well, okay. Going on my own personal experience, [00:26:45] I really wanted to be an orthodontist because I had I had I mean, it was amazing [00:26:50] author, but I yeah, I had orthodontic treatment, got really interested. I thought, that’s what I want to be. I found [00:26:55] it is boring as hell at university. I honestly thought.

[TRANSITION]: It so badly.

Payman Langroudi: Though.

[TRANSITION]: Come [00:27:00] on.

Sarovi Davda: Uh, it’s pretty dynamic, but.

[TRANSITION]: No, no.

Payman Langroudi: But in undergrad.

Sarovi Davda: Yeah. [00:27:05]

[TRANSITION]: People love.

Sarovi Davda: Okay, so I didn’t like.

[TRANSITION]: Don’t they?

Payman Langroudi: Everyone who does ortho loves [00:27:10] ortho.

Sarovi Davda: Do they? Yes. Well, that’s why they do it. You know, it’s like, that’s a selective [00:27:15] bias, isn’t it? Surely. So I wanted to do ortho and they got to university and decided, okay, no [00:27:20] way. Not for me. I then I loved children so much, I was like, I want to be a dentist. [00:27:25] But of course, I mean, you’re the most hated role. Like, well, no, maybe not actually, [00:27:30] but just it’s not easy dealing with kids and and inflicting stuff [00:27:35] on them. It’s not like having a facial. I always say to my patients. So that went aside. And then [00:27:40] I was deciding between endo because I love the kind of the precision and it’s almost like [00:27:45] a bit meditative in some ways. I like that. And, you know, and then perio [00:27:50] really came about because of two things I love communicating. [00:27:55] And it’s I love that whole empowering patients, inspiring [00:28:00] for like, life change because it’s not just a one thing thing like, you know, [00:28:05] oh, I do the best débridement and I’ll get the best results. Nah, it’s mostly patient based, [00:28:10] right? So it’s about psychology. So I love that aspect, but it was really fill our and Graham [00:28:15] smart that you know, if you’re looking at those forks in the road of life which have completely [00:28:20] changed or shaped the direction of life, it’s down to those two human beings. I [00:28:25] give thanks to them, you know, regularly. Um, I went on a course very [00:28:30] early on, a couple of years after graduating, taught by these two Periodontists [00:28:35] Graham smart fellow. And they were just such lovely blokes. They [00:28:40] made they had a very.

[TRANSITION]: Can do attitude.

Sarovi Davda: Very passionate, very [00:28:45] forward thinking, very can do because they taught and they just inspired [00:28:50] me. And I kept in contact with them after the course, basically. Um, I sent them a book, um, [00:28:55] my one of my love languages, definitely gift giving. So I sent them a book and kept in contact. [00:29:00] It was Phil who then inspired me to do the MSC, and Phil, who [00:29:05] invited both Ian Dunn and I on board to take Graham Smart’s place when he passed away, [00:29:10] very sadly.

Payman Langroudi: I see you did a Eastman.

Sarovi Davda: Yes. The Eastman.

[TRANSITION]: In [00:29:15] Bellevue.

Sarovi Davda: Actually, it was in restorative practice. But then my thesis, which was supervised [00:29:20] by Phil, was Império, and it was all on, which is so relevant to the Dental legal [00:29:25] field, prognosis and periodontics. But the. I say but okay, I’m saying [00:29:30] this actually, and there’s some self-seeking here. There’s like, um, I did my [00:29:35] MSC exam the day after giving the day I gave birth. And [00:29:40] I really wish like and it’s not regret I wouldn’t do anything differently. But [00:29:45] like my thesis was so awesome, but I didn’t publish it. I was just too engulfed [00:29:50] in motherhood.

[TRANSITION]: Too busy, too busy.

Sarovi Davda: And Phil said, you know, publish it, publish it. He [00:29:55] even said, I want you to write my book. That’s, you know, periodontics, the whole prognosis [00:30:00] chapter. I just never I didn’t do those things. I was too engulfed in mother motherhood. I was [00:30:05] pregnant like six months after giving, nine months after giving birth to my to my first, and I just [00:30:10] didn’t go on with that. But yeah.

Payman Langroudi: While we’re on it, then while we’re on it.

[TRANSITION]: Yeah.

Payman Langroudi: What? [00:30:15] I mean, it’s an unfair question, right? But but in in [00:30:20] a nutshell, what does the GDP need to know regarding prognosis? How do [00:30:25] I know whether this tooth is saveable?

[TRANSITION]: Brilliant question.

Payman Langroudi: Treatment or [00:30:30] not.

Sarovi Davda: So I’d say, number one, what we need to know is, um, we’re rubbish. So [00:30:35] we’re rubbish at predicting the future. So McGuire et al did a series of studies looking at number of patients, [00:30:40] um, where essentially what they did was they attributed to the teeth, uh, [00:30:45] clinical parameters that we normally rely upon when it comes to periodontal prognosis. So pocket [00:30:50] depth, bone levels, etc., etc., all the things you know, you’d think are bog standard to predict [00:30:55] prognosis. And using those clinical parameters when it came to a dodgy [00:31:00] tooth. We are right. Hardly ever. Basically [00:31:05] 50%. Not hardly ever. Sorry so 50% of the time. And when they are good by [00:31:10] all parameters, let’s say good bone levels, no period pockets, no infra bony defects, no mobility [00:31:15] like good. Then we’re at 80% of the time. Now, this is an old study, right. And it wasn’t a randomised [00:31:20] controlled or anything. So we had to actually have very many really high quality studies long [00:31:25] longitudinal on prognosis. But based upon that it’s essentially you have a dodgy [00:31:30] tooth. And if it’s a 50 over 50 chance, you may as well toss a coin. Patient walks [00:31:35] into my surgery. I say it’s going to last. Patient walks into next door surgery. It’s not. [00:31:40] Take it out now. And that’s the patient’s tooth you’re dealing with. And this is what I found in [00:31:45] my thesis in the sense in my in my study. So Phil and I did a questionnaire [00:31:50] showing the same x rays with no clinical data, but to thousands [00:31:55] of delegates on courses and in the same room of 30 [00:32:00] delegates that we’d be teaching same x ray would have at least one [00:32:05] person saying it’s for the bin, this tooth and another person for him saying it’s going to last [00:32:10] ten years or more.

[TRANSITION]: Mhm.

Sarovi Davda: And that’s with, you know, a small select. But then it was a [00:32:15] large number of delegates. We have very very different views upon [00:32:20] prognosis. So that’s the number one thing. Very heterogeneous in our views. I [00:32:25] don’t have any clinical parameters that form what we call a really safe [00:32:30] basis upon which to assign a really accurate prognosis. The second thing [00:32:35] I’d say to know as a GDP is that it’s mostly driven. And we all kind of know this now [00:32:40] based on patient factors. So it’s about oral hygiene, genetics, diabetes, [00:32:45] smoking all those things. Versus and this is what the evidence [00:32:50] shows that most of us base our clinical um prognosis on radiographs alone. [00:32:55] That’s the most influential. Weems et al. 2013 I think 2003, [00:33:00] they did a study showing that, you know, what is the most influential factor in Factor in prognosis, and people almost exclusively [00:33:05] rely upon radiographic bone levels. And that’s not where that’s not where the evidence lies. [00:33:10] So look at patient driven factors. So those are kind of, you know, I’d say probably two big [00:33:15] take homes when it comes to prognosis. And also because based on that sorry. Third thing [00:33:20] give the tooth a chance. So give the tooth a chance if you can. Unless it’s really really [00:33:25] short, you know, and you kind of know when it’s about to be sneezed at the mouth, give it a chance [00:33:30] because you just never know.

Payman Langroudi: But then do you also see that in your [00:33:35] clinical practice, in that there are some teeth that you think don’t have a chance and they survive? And the opposite.

Sarovi Davda: Yeah, [00:33:40] yeah I.

[TRANSITION]: Do. So there are very.

Payman Langroudi: There aren’t very reliable [00:33:45] prognosis prognostic indicators then.

Sarovi Davda: Well there are in terms of smoking and diabetes. And [00:33:50] those are reliable prognostic indicators in the sense that we have the evidence. You know you smoke ten [00:33:55] cigarettes or more a day. You’re five times more likely to lose your teeth or whatever. And these things I share with the [00:34:00] patient. So if I have a patient that’s got like, let’s say 80% bone loss and they smoke [00:34:05] like a chimney and they have uncontrolled diabetes and they’re obese and they’re got pants or hygiene, [00:34:10] and they continue to do that. Sure enough, they’re going to lose a tooth. That’s very [00:34:15] predictable in that way. But the thing is, if they’re modifiable, those risk factors, [00:34:20] then who knows what the future holds. And I have seen teeth with patients that fully engage [00:34:25] and change hang on far longer than you’d ever think possible. So it really [00:34:30] very much depends upon that. And also periodontal therapy, of course, you know, which is part and parcel [00:34:35] of it.

Payman Langroudi: And you know, the the question of bony infill.

Sarovi Davda: Yeah.

Payman Langroudi: I [00:34:40] mean by now I think we kind of think, yeah, it’s a real thing. It happens. [00:34:45] Yeah. Traditionally that wasn’t the case. Right. That wasn’t not.

Sarovi Davda: So this is something that, [00:34:50] again, Phil enlightened me with. Um, that when I was at university, bony infill was just [00:34:55] a myth. It was like, I remember even talking to one of my MSC, and I [00:35:00] And I did my MSC. I finished in 2013. Um, I spoke [00:35:05] to Bonini, Phil, and the way that I was managing Perry at the time with one of my MSC tutors, and he [00:35:10] said, quote, and what are you going to do next? Rob magic crystals over the pockets [00:35:15] and hope they heal. And I.

Payman Langroudi: Was like.

Sarovi Davda: Then I had radiographic evidence [00:35:20] and there were studies like quark and you know, there were studies coming out saying that you can get radiographic [00:35:25] bone infill. And now it’s like we all accept it and it’s like a kind of a given. You [00:35:30] do certain things.

Payman Langroudi: Is it taught now in undergrad.

Sarovi Davda: It’s taught by okay. So I mean, I’m [00:35:35] not an undergrad. I know what’s taught at undergrad, to be fair, but Louis-jeune and Barley’s work, tortellinis [00:35:40] work is very well accepted across the field in the sense that not not in it has to be certain. [00:35:45] It has to be an infra bony defects. You know, you’re not gonna get horizontal bone loss with certain criteria, etc. [00:35:50] but that’s getting more that we are developing. And this still needs more evidence, but more reliable [00:35:55] ways of getting bony infill around, you know, your clot stability. Essentially that’s what it [00:36:00] is. So it’s and and looking at that, it’s in fact the Luigi Nibali [00:36:05] I went to a course of his recently and he was saying out of the three things he did like this thing, I [00:36:10] can I remember all three. He said, what’s the most influential factor of whether you’re going to get bone infill? Is [00:36:15] it one the patient? Two the anatomy, the actual site. [00:36:20] Or three something else. And it was the it was the site. So it’s not and I thought it [00:36:25] was about the patient. Yeah. But actually that’s the most influential. It’s a type of defect. You have the [00:36:30] site and that will predict whether you get more likely or not to get bone infill.

Payman Langroudi: Can we talk about [00:36:35] floss?

Sarovi Davda: Because can we talk about a.

Payman Langroudi: Bugbear of mine? Yeah. Yeah. I [00:36:40] think we should not teach floss to anyone. Why ask me why?

Sarovi Davda: Okay. Why [00:36:45] why why why? Because.

Payman Langroudi: Because firstly, it’s very difficult to teach [00:36:50] and no one learns. Yeah, sort of thing. You know what I mean? Of course. Now, I’m sure there’s hygienist [00:36:55] around the country saying I teach it well and people learn. Yeah, but secondly, it’s [00:37:00] crap, isn’t it? Floss compared to interdental brushing. And then the [00:37:05] hygienist will say something like, oh, we teach both. Yeah, but since we know the patient’s capacity for learning [00:37:10] isn’t that great for me? Don’t talk about floss at all. Only [00:37:15] talk about interdental brushes. At least they can get into dental brushes a bit more right than [00:37:20] they. Because people struggle with those two, right? I mean, you must have had this, right. You you know, you can get into dental [00:37:25] brush, into the furcation and stuff, right? You can do all sorts of fun things if you really teach a patient. But [00:37:30] I feel like floss just confuses the picture and it ain’t that great. Because, [00:37:35] you know, the other thing about floss, this is my personal bugbear. Where [00:37:40] does where does plaque build? Right in in, you know, the root surface isn’t this beautiful [00:37:45] smooth thing is it. It’s it’s an undulating plaque builds in those rough [00:37:50] areas and floss doesn’t get into those rough areas. You know, it floss would [00:37:55] be all right if they managed to get it on either side. And it was a perfect circular root [00:38:00] surface, but it’s none of those things. The root surface is in and out. Plus can’t get into those nooks and crannies [00:38:05] here, so why even bother? Why bother with floors? I think it’s more a legacy thing. [00:38:10]

Sarovi Davda: Okay, so I would agree with you, but also the studies back you. So we’ve known this since 2016. [00:38:15] It was the world.

Payman Langroudi: I’ve known this since 1995. Back to what [00:38:20] we were.

Sarovi Davda: Talking in terms of the studies. It’s not just a study. It’s like, you know, the world of workshop.

Payman Langroudi: It’s overwhelming. [00:38:25]

Sarovi Davda: It’s like this was in the In the world workshop or the or the I. [00:38:30]

Payman Langroudi: Remember.

Sarovi Davda: The workshop.

Payman Langroudi: In Europe, didn’t it. The floors.

Sarovi Davda: Like. Yeah. So it’s like the [00:38:35] advice is based upon that evidence that getting interdental brush wherever you can and only floss where [00:38:40] you can. But for all those reasons, I personally, again, backed by the evidence [00:38:45] as well, is I’d agree with you. Would you floss is much more technique sensitive. It’s really difficult. [00:38:50] Where is it most difficult? Where you most need it It posteriorly. Incidentally. Um, [00:38:55] and yeah, as brushes are far easier in the sense that yes, of course people [00:39:00] do have problems, but it’s, it’s usually a technique thing that you can get through, get [00:39:05] via different tools, different techniques, whatever. You know, I don’t generally I can [00:39:10] only think of one patient that I who just wasn’t able to get [00:39:15] interdental brushes in. And then, you know, you can go to I’d rather go to inter [00:39:20] pics even if I have to downgrade. I don’t love them at all. I have not found, [00:39:25] I have to say yeah, they don’t have as better as good a biofilm disruption as the interdental brushes, but I’d rather [00:39:30] do that than floss because if they’re struggling with interdental brushes, I think flossing is even harder.

Payman Langroudi: But if we go [00:39:35] out in the street and ask 100 people, they’ll all know about floss.

Sarovi Davda: I think it’s I know, [00:39:40] I think.

Payman Langroudi: That’s weird, isn’t it? We managed to get that story out very well, even though it’s not a great story.

Sarovi Davda: Yeah. [00:39:45] You know, I think it’s it’s almost easier to roll off the tongue brush and floss. It’s [00:39:50] like monosyllabic, isn’t it? Isn’t it? Whereas interdental brush. We need to create a small word for it.

Payman Langroudi: If you if [00:39:55] you ask.

Sarovi Davda: 100 people on the street.

Payman Langroudi: About interdental brushing.

Sarovi Davda: I.

Payman Langroudi: Know only the 5% who’ve had perio [00:40:00] disease will know anything about it.

Sarovi Davda: It’s crazy. I do think we need to re-educate like [00:40:05] the entire profession to personally. I mean, that might be a bit controversial, but honestly, [00:40:10] because it’s evidence backed. Step away from the floss. Floss only when you can’t get into dental brushes. [00:40:15]

Payman Langroudi: Listen, floss has a an amount of good. Yeah, an amount of good.

Sarovi Davda: Brilliant.

Payman Langroudi: My [00:40:20] my my point is, there’s.

Sarovi Davda: Only a limited.

Payman Langroudi: Amount of time. Yeah. So trying to teach [00:40:25] both is an error.

Sarovi Davda: So I always say to patients when they come to me, I always say, right, bring in every [00:40:30] first lesson. Bring in every single thing you’ve you’ve been used using throughout your whole life. [00:40:35] And we’re going to debunk all the myths and misnomers because and this is what I say to [00:40:40] them, I want you to get the maximum results in the shortest amount of time possible. [00:40:45] And the first thing I usually do is say, ditch the floss. Because the other thing is, you know, when [00:40:50] we say interested, we say use the floss where you can’t get into dental brushes. Right. So [00:40:55] where you can get. Yeah. Practically everywhere. No. Apart from lower anterior teeth, how many [00:41:00] times on a non-smoker have we actually seen that there’s a worse periodontal affected region? How [00:41:05] many times? So if a patient is like, I’m not going to be able to spend this amount of time, [00:41:10] I don’t often have that many patients resisting by the time they’ve come to me. But I’m like, even [00:41:15] if it means getting to the back brilliantly and leaving the anteriors that have [00:41:20] no bone loss, I’m willing to trash the floss completely and concentrate what [00:41:25] you have the disease, you know. So I’m on the same page as you for sure.

Payman Langroudi: Amazing. Where are you? On [00:41:30] a guided biofilm therapy.

Sarovi Davda: Where am I on it in terms of do I like it, do [00:41:35] I, I.

Payman Langroudi: What do you say about it? What’s your feeling on it?

Sarovi Davda: Okay. Well, the whole point is to disrupt [00:41:40] the biofilm in terms of dnpr. I’m glad we’ve we’ve changed our views. If [00:41:45] it does the job, great, because it’s very technical. It’s very patient friendly. [00:41:50] So I do have it in my practice. And yeah, very comfortable. And there was some debate [00:41:55] before the S3 guidance around implants and peri implantitis was brought out last October. [00:42:00] In terms of there was a there was a leaning towards Gbdt when it comes to [00:42:05] implants, but that’s actually we haven’t got enough evidence for it. So I think I [00:42:10] use a combination personally. Um, in terms of if patients have a really [00:42:15] acute sensitivity, they’ve got gingivitis, not periodontitis. In fact, they can solve that [00:42:20] with oral hygiene alone, frankly. Um, you know, I’m happy to use guided biofilm therapy. [00:42:25] I think it has a place, but it’s not [00:42:30] going to remove calculus, which I know isn’t the be all and end all. But it’s.

Payman Langroudi: No, they say [00:42:35] to remove the calculus second. Right. Not first.

Sarovi Davda: So I, I think there is a place.

Payman Langroudi: Interesting [00:42:40] idea. Right. Because you don’t go around scratching the tooth like trying to get biofilm [00:42:45] off with the, with the scalar.

Sarovi Davda: Well, scalar is the whole point they were invented was [00:42:50] because we were. We thought root planing was what was needed. So it’s like the [00:42:55] right tool for the right job. You know when I was teaching with Phil we’d show this video. He’d have two videos alongside, [00:43:00] and he’d had this piece of wood covered by stain. And he goes, there are two ways [00:43:05] to get the stain off. One is with a wood planer. Yeah. Okay. A root planer. [00:43:10] And the second is with a piece of cloth and some water [00:43:15] or you know. And he’d do the two alongside and then below that then you’d click and up comes [00:43:20] a picture of intraoral root planing, which is obviously ghastly to look at and to experience. [00:43:25] And these local anaesthetic. And the next one was like, you know, using potentially even. [00:43:30] Right. That’s the thing. Either that or to use a polishing brush. It was in that case. [00:43:35] Or ultrasonics or whatever. And he’d say you know, which one would you rather have as a as both [00:43:40] do the job of course, but, you know, use the right tool for the right job. So [00:43:45] if you believe in route planning, use a route planner. We’re not saying don’t do it. That’s the job [00:43:50] you’re trying to accomplish. Do it. If you don’t use the right tool. So that’s I [00:43:55] think that’s a very powerful message with visuals. Yeah.

Payman Langroudi: How did [00:44:00] you get into the medico legal side.

Sarovi Davda: Again through Phil. God, [00:44:05] I owe so much to him. Thank you. Phil. Um, he had been doing it for the last for 20 years. I [00:44:10] really loved essay writing, and I just I was fascinated [00:44:15] by the field, and I wanted to. And this is a big, big thing. So I started my training when [00:44:20] I knew that I was I wasn’t going to be seeing my children every [00:44:25] day down to the divorce, and I wanted to still drop them off to school, pick [00:44:30] them up and earn a salary and a living. So then that’s when I started to look into Dental [00:44:35] Legal. So I did my qualification with Cardiff University. I took my exams and [00:44:40] then lo and behold, oh, it only took me a me a year and it’s super easy.

Payman Langroudi: And distance [00:44:45] learning.

Sarovi Davda: No, I went in actually at that time because it was pre Covid. So I went into London. [00:44:50] Um there’s an exam but it’s open book. It’s all, it’s, you know, brilliant teaching [00:44:55] as well. So I did all that. You have to present a case. So you have to write up kind of a report [00:45:00] as well.

Payman Langroudi: Like how hard is it. Is it difficult.

Sarovi Davda: Really easy.

Payman Langroudi: Is it, is it.

Sarovi Davda: Yeah, it’s really [00:45:05] easy, but. Well I think I think.

Payman Langroudi: It’s really.

Sarovi Davda: Easy, but I don’t think just me. I’m not like a brainiac. [00:45:10] It’s. No, it’s really easy. The great teaching the exam isn’t meant to trip you up. It’s. [00:45:15] It’s like a very basic exam that’s open book. You can have your stuff.

Payman Langroudi: In the idea [00:45:20] that you are an expert in one part of dentistry. And this is just the legal framework for any kind [00:45:25] of expert. Is that how it works?

Sarovi Davda: What do you.

Payman Langroudi: Mean? So you know about perio?

Sarovi Davda: Yes.

Payman Langroudi: So [00:45:30] your your likely outcome from this is to take care of perio cases. Yes. [00:45:35] But the training is just legal. It’s nothing to do with dentistry.

Sarovi Davda: So it’s oh so you have [00:45:40] like all sorts you have We have physiotherapists going to these. You’re in the room with like um [00:45:45] yeah. You get separated off potentially into like medico med. There’s, there’s [00:45:50] bits where you go into your various field but you have like you know, yeah, social workers, [00:45:55] you have like yeah, you have all different people going into in the civil court system [00:46:00] essentially, usually because it’s very rarely criminal. So yeah, you get you get all sorts of people. [00:46:05]

Payman Langroudi: So what do you now, now you’re going to have to give us like a, you know, like a five minute round up of [00:46:10] how not to get into medico legal problems around because I suspect [00:46:15] it’s one of the most common areas of where people.

Sarovi Davda: You’d be surprised. [00:46:20] Is it so 20% only down to Dental litigation. Is that down to perio? Do you know what?

Payman Langroudi: Number [00:46:25] one is a lot though?

Sarovi Davda: Yeah, yeah, I know you’re right, but I would have thought it was number one. And [00:46:30] it’s not this. This is this is 2017 data. Do I think so. It’s not up to date [00:46:35] I think it’s 2017. But the number one is extractions.

Payman Langroudi: Extractions.

Sarovi Davda: Yeah. And [00:46:40] then it’s after that. What’s that? I think it’s. I can’t [00:46:45] remember now. What’s after extractions? Implants is the last one, but I think it’s going to increase. [00:46:50] It’s about 9%. No, it’s not ortho. It might be endo. [00:46:55] I think the second and third is perio. Fourth is caries and fillings. [00:47:00]

Payman Langroudi: Mhm.

Sarovi Davda: And then it’s implants I think after that.

Payman Langroudi: So how do we not get into trouble [00:47:05] legally regarding what are the most common cases that you see. Are they neglect. [00:47:10]

Sarovi Davda: Yeah. Supervised neglect in the sense that three monthly cleans and [00:47:15] and and and this is the crux. This is really important [00:47:20] and bone loss. Okay. So you don’t have so people probably don’t realise this. [00:47:25] Okay. I can basically not treat a patient. I can be utterly neglectful. [00:47:30] But if they haven’t suffered as a result of my neglect, there is no case. [00:47:35] So that’s called causation. So there has to be a breach of Breach of duty, but it has to be that a breach of [00:47:40] duty has caused an outcome. So if a patient has been receiving three monthly [00:47:45] scale and polishes no oral hygiene, no smoking, nothing, but they haven’t lost bone, no [00:47:50] case. It’s only when they’ve lost bone underneath your care and you haven’t you and and you have reached [00:47:55] your care of your duty of care.

Payman Langroudi: So if they haven’t been informed. Right.

Sarovi Davda: Yes. [00:48:00] Yeah. So the first thing I’d say is what you need to do is ensure that patient doesn’t [00:48:05] lose bone. And you need to know if they’ve lost bone. So take x [00:48:10] rays and what I’ve often. So according to the guidelines right. Asks [00:48:15] every six months if they’ve got caries or something until they don’t. If they’ve got [00:48:20] perio I’d be guided by. If they’ve got perio you should be taking six point pocket [00:48:25] charts every year. So guided by that. So if I have a patient that’s let’s say I’m seeing under like [00:48:30] supportive periodontal therapy and their pocket charts remain stable. [00:48:35] Everything seems clinically great. I only take, um, like, periapical [00:48:40] radiographs to check if something has changed in area or every two years. [00:48:45] You could argue even every four years there’s not really, really tight guidance around that. But if [00:48:50] something periodontal changes, that’s when you need to take investigative radiographs. If you’re in [00:48:55] general practice, you’re taking bitewings anyway. We know that because BSP guidelines that [00:49:00] if it doesn’t show the crestal bone levels, take more investigative x rays. So essentially just know where your bone [00:49:05] is and where I see this mist. And this is the most I’d say I need to do an audit. [00:49:10] But one, the most common reasons for suing your dentist down to perio is when [00:49:15] patients are losing front teeth. Now, it’s not the [00:49:20] backs that they, you know, you lose a front teeth.

Payman Langroudi: That’s [00:49:25] disaster. Right?

Sarovi Davda: So if you have someone who’s a new patient that’s come to you and [00:49:30] they have a history of smoking, take some periapicals the anterior just know where [00:49:35] those that bone level is. Because so often I get um claimants, as in cases [00:49:40] where claimants are suing their dentists who seen them for the last five years. They’ve they’ve got, [00:49:45] let’s say 80% bone loss, but there are no periapicals taken at the start of care. I [00:49:50] mean, balance probabilities, that’s what we work on as a legal test. That 80% [00:49:55] won’t have all been lost within the last five years, but it would be really helpful to have some periapicals [00:50:00] at the beginning and at the end that show. Hey, bone level hasn’t changed. She [00:50:05] came in with 80% bone loss. She’s got 80% bone loss at the end under five years because she stopped [00:50:10] smoking 15 years ago. You know like that I would say take take really good [00:50:15] x rays take accurate I mean I don’t know why we’re [00:50:20] still going wrong with BP’s, but I recently had a case I was literally looking yesterday where it says in [00:50:25] the clinical notes, deep pockets and the BP is like [00:50:30] two, two, two. Where are we not educating our undergrads that if you have [00:50:35] pockets over 3.5mm, you will not get a BP. Yeah, that’s zero, 1 [00:50:40] or 2. Like something is not. I don’t know what’s going wrong but like [00:50:45] accurate BP taking.

Payman Langroudi: Is that common?

Sarovi Davda: Yeah. Really common. Oh it’s one of the, one [00:50:50] of the most common allegations. Um, what what is it? The BP scores were inaccurate and an [00:50:55] underestimation. The bone present. Bone loss present. Yeah. So the most common allegations [00:51:00] I see are not taking accurate. Bp’s not taking six [00:51:05] point pocket charts. That’s really, really, really common.

Payman Langroudi: Six point pocket charts.

Sarovi Davda: Yeah. [00:51:10] Or pocket charts.

Payman Langroudi: Or patient.

Sarovi Davda: Okay. It doesn’t have to be six point okay. It could be four point. Yeah. So not [00:51:15] taking periodontal pocket charts um performing scale and polishes. I [00:51:20] mean we are still using this data terminology, but using scale and polishes as [00:51:25] opposed to acceptable terms for therapy like debridement or PMP or whatever [00:51:30] it takes, but not scale and polishes, not taking reassessment. Pocket charts. You know, um, [00:51:35] because actually, if you don’t start off treating it, you don’t reassess it. Like if [00:51:40] you haven’t diagnosed it, you’re not going to take a periodontal assessment, you’re not gonna take a dental assessment, you’re not going to [00:51:45] treat it properly. You’re not going to treat it properly, you’re not going to reassess it properly. And then one thing that always comes [00:51:50] up delayed or complete absence of offer of a referral [00:51:55] to a periodontal specialist. And I’d say if you’re not, if you’re not confident in treating it well [00:52:00] from the get go, offer referral from the get go and document it. And the other [00:52:05] thing to document discuss periodontal disease is one thing [00:52:10] it doesn’t give any, you know, if you have a claimant standing up in court saying, okay, [00:52:15] they said I had gum disease.

Sarovi Davda: I had no idea what that meant. I didn’t realise that I was [00:52:20] five years away from losing my front tooth. You know, you need to be have a really you need [00:52:25] to have a really tailored conversation with a patient that that understands [00:52:30] what the risk is and how real that risk is. Like we all know smoking is not good [00:52:35] for us. Smoking is not good for our teeth. It’s a very different conversation when a patient hears [00:52:40] you have already lost 80% of the bone holding your front tooth in, and if you continue to [00:52:45] smoke, you will lose it. I can’t say whether it’s in ten years, 5 or 1, but it’s going [00:52:50] to happen. That’s a very different conversation. They can still say, no, I love my fags and I’ll lose my tooth, [00:52:55] no problem. It’s none of our business. Their decision, they’re an adult, but it’s our [00:53:00] job to tell them with personalised terms as opposed to generalised. You have [00:53:05] gum disease. You know that you can lose your two teeth if you. [00:53:10] It has to be in context. That’s what it is in context.

Payman Langroudi: I stopped practising in 2012 [00:53:15] where we didn’t have so much medical, [00:53:20] legal and essay writing in the notes. Yeah, and you’re from [00:53:25] the legal industry that’s built up built up around all of this, right? But [00:53:30] do you recognise what I’m saying when I say that we are now the lawyers of [00:53:35] one? We are now better at writing notes than [00:53:40] fixing patients in a way. You know.

Sarovi Davda: So [00:53:45] we’re pretty. We were pretty dire at reading Barrier, actually, from a long time ago. We’re [00:53:50] probably better at that, to be fair. We’re actually better in our management.

Payman Langroudi: I’m just so, so frustrated with the [00:53:55] fact that the lawyers have won.

Sarovi Davda: You know, would you say they won for sure?

Payman Langroudi: For sure. [00:54:00] 100%.

Sarovi Davda: Yeah.

Payman Langroudi: When I look at my my wife’s still a dentist, when I look at the notes, I’m like, what the [00:54:05] hell, man? Like writing all those notes and and, like, the [00:54:10] amount of time you’re spending writing all those notes. And by the way, we went to A&E, [00:54:15] you know, a major situation, you know, like with slipped disc situation. You know, I was watching the guy. Not [00:54:20] that much. Notes were being written. Not that much. Nowhere near as much. Nowhere. Nowhere near as much as some poor [00:54:25] hygienist has to write about us.

Sarovi Davda: It’s ridiculous. I would agree that [00:54:30] our notes are administrative burden has massively increased down to [00:54:35] lawyers, but.

Payman Langroudi: Disproportionately.

Sarovi Davda: What I can see. Our treatment of periodontal [00:54:40] disease is also like I’m looking back at 1980s notes or [00:54:45] exam S&P exam S&P. There’s like you know nothing going on in terms of treatment. [00:54:50] We have got better at treating it. If we’ve got better at treating it then patients win. Of course [00:54:55] that yeah of course.

Payman Langroudi: And you know.

Sarovi Davda: Like I think good changes and very [00:55:00] cumbersome changes have come about from the legal industry. Yeah I don’t work [00:55:05] for anyone but the court and I mean that. So my duty of care, duty as an [00:55:10] independent expert witness is that I’m an independent. Yeah. So you don’t get any other. [00:55:15] To be fair, you don’t get if.

Payman Langroudi: I’m a dentist in trouble, I can’t call on you to be my expert witness.

Sarovi Davda: No. [00:55:20] So I’m instructed by purpose.

Payman Langroudi: Is that. What is that? I mean, some of them. Some of Some of them.

Sarovi Davda: For [00:55:25] the for the for the for like the. So that justice can be carried in terms of so you [00:55:30] have the whole point of expert witnesses is that we are independent. It’s part of our like directive that we have to [00:55:35] be unbiased, you know, independent expert witnesses. So [00:55:40] I actually get which is incredibly rare by audited my caseload last year, um, [00:55:45] 50% instruction. It was exactly when I say it was like literally the case number, [00:55:50] 50% instruction claimant from the claimants solicitors and 50% instruction from the [00:55:55] indemnity societies representing the, you know, defendant. It might change this year. It’s not going to be 5050 [00:56:00] necessarily on on the on the mark every year. But I’m I’m instructed [00:56:05] equally and my report for each of them is exactly the same.

Payman Langroudi: Do [00:56:10] you do you do you understand what I’m saying when I say a lot of the outcomes of, [00:56:15] of these court cases ends up with a, a disproportionate [00:56:20] again, a disproportionate amount is based on the skill [00:56:25] of the lawyer.

Sarovi Davda: Hmm. I [00:56:30] mean, I’ve only been in court once. Oh, really? So because it’s.

Payman Langroudi: Not following. [00:56:35]

Sarovi Davda: The case. Um. No. No, no. Do you know? Well, no. I have followed up [00:56:40] to many on many, many, many cases up until kind of the 11th hour, where you’ve had [00:56:45] joint expert meetings. You’ve, you know, you’ve really chewed the cud over all the issues up until the very end. [00:56:50] Would I say it matters on a lawyer? Like I said, I haven’t.

Payman Langroudi: It definitely does. Like, well [00:56:55] I’m not.

Sarovi Davda: Yeah it does. I’m not 100%.

Payman Langroudi: Sure about medico legal but in legal. Yeah. The [00:57:00] how good your lawyer is really is the most I for me the biggest variable in whether you’re [00:57:05] going to win or not.

Sarovi Davda: I.

Payman Langroudi: Think actually.

Sarovi Davda: You know do you know what I think the barrister [00:57:10] is a big important part when it comes to actually getting in court, for sure. When [00:57:15] it comes to the lawyer. Yes, yes. And also actually the expert witness, [00:57:20] That is like, okay, when I did my first joint meeting, [00:57:25] so I took on my first case. I was, you know, called to a joint meeting. And when I say joint meeting, sorry, not a [00:57:30] joint meeting, I mean a meeting. So this is my instructing solicitor with, you know, the defendant or [00:57:35] the claimant with some. I was expecting to sit there and just listen to what’s going on. [00:57:40] And I was wrong. Literally the entire two hour meeting was about [00:57:45] my report. And it is the most, I say, pivotal piece [00:57:50] of evidence in the whole thing, at least one of them. It’s [00:57:55] really important. And you have an expert that has a very, you [00:58:00] know, particular view, let’s say a biased view or a particular view. [00:58:05] It’s a big swing component. It’s a big component. [00:58:10] Like, yeah.

Payman Langroudi: Do people ever challenge you.

Sarovi Davda: In [00:58:15] all the like? That’s the whole point, right? Challenge me. Yeah.

Payman Langroudi: No. But challenging [00:58:20] you as the expert?

Sarovi Davda: Yes. The other side.

Payman Langroudi: We don’t. We don’t accept this [00:58:25] expert as an expert.

Sarovi Davda: Ah, you mean.

Payman Langroudi: We want a different expert?

Sarovi Davda: Um, [00:58:30] have they challenged me? They’ll question me on certain points. I’ve [00:58:35] haven’t been sort of shoved off a case because they don’t like my opinion. Because I tend to. I [00:58:40] like to think I don’t.

Payman Langroudi: They want a specialist.

Sarovi Davda: So [00:58:45] they because I because [00:58:50] of what I’ve done and my qualifications. I’ve been accepted as a specialist [00:58:55] in this. Not on the register, but a specialist in periodontics, by the court, by a judge. [00:59:00] And that’s good enough in a sense, because I can basically. Can you argue your own that you are a like a [00:59:05] you have a special interest, you have enough information in this field. And I’ve been able to do that because whatever [00:59:10] my history of teaching 14 years or and my MSC and the fact that I exclusively [00:59:15] practice in perio now, um, but that’s, I guess, my knowledge, you feel like.

Payman Langroudi: That’s a vulnerability, like insomuch [00:59:20] as, let’s say I’m I’m, I’m the dentist and the claimant says something, and then you say something [00:59:25] that’s against me. Can’t I say, hey, this isn’t even a specialist.

Sarovi Davda: Yes. And they have brought [00:59:30] that to court, have they? Yeah, yeah. So when I was in court and I was being cross-examined, they said, are you on the specialist [00:59:35] register? And I said, no, and then I’ll give my qualifications. It’s whether the judge really deems [00:59:40] that to be appropriate. And actually I think well, I’d like to think like when I get talking, [00:59:45] it’s quite clear that I know what I’m talking about. And a lot of the stuff that with [00:59:50] the, you know, I’ll be on the same page, most of us [00:59:55] will be on same pages. It just might be a slightly different view on certain [01:00:00] things. Or, you know, in treatment planning, for example. And actually, I was really pleased to see that [01:00:05] in terms of my particular view on periodontics, which I feel is highly evidence based. There was a case [01:00:10] recently, I think it was 2022, where one of the periodontists that was there [01:00:15] had treatment planning very similar to how I would look at it from Periodontists. [01:00:20] So for example, okay, one of the big things I have is that and this is S3 guidance [01:00:25] back now. We should not be placing implants in patients who have unstable periodontal disease. [01:00:30]

Sarovi Davda: Like it’s just a kind of don’t go there. Whereas actually you’ll get a lot of experts [01:00:35] and they could well be from the prosthetic from like, you know, implant ologists. I know there’s no speciality, [01:00:40] but someone has been placing implants who will conduct a check [01:00:45] of the patient. Um, it’s obviously not from a periodontal aspect for such. And write down [01:00:50] a treatment plan for this claimant that has full mouth rehab of, you know, £70,000 [01:00:55] worth of implants. And then on the other side is a periodontist or someone like myself [01:01:00] who says this patient isn’t yet suitable for implants. And this is why. [01:01:05] And that will be the difference between a £10,000 treatment plan with dentures, [01:01:10] or a £70,000 treatment plan with a full mouth rehab with implants. [01:01:15] And that’s where the the issues are disparate and it goes to court. And that was what [01:01:20] happened actually with this case I’m talking about. It was taken to court. And it was actually the judge that said, [01:01:25] this makes a lot of sense what the periodontist is saying and awarded the [01:01:30] claimant those fees as opposed to the yeah, the claimants.

Payman Langroudi: Fees, had there [01:01:35] been in that case consent from the patient. Mhm. And it had been explained [01:01:40] and the patient had consented properly. If it was informed consent, [01:01:45] would that have changed everything.

Sarovi Davda: In clinical practice. Yes possibly. Right. [01:01:50] But this is where.

Payman Langroudi: In that case.

Sarovi Davda: The government’s awarding like the public is [01:01:55] awarding the amount. Sorry not the public sorry. It would be the it would be the indemnity [01:02:00] society. That’s then awarding that as opposed to the the claimant saying I’ll [01:02:05] take on the risk, I’ll pay with my own money. And if it goes tits up, that’s [01:02:10] fine. But but in court you’re being awarded it by the other side, right? So [01:02:15] that’s when it becomes an issue.

[TRANSITION]: Yeah. Yeah. Yeah.

Payman Langroudi: Of course. Yeah. Where do you fall on? [01:02:20] You know, I’m being a bit biased, but whitening perio patients.

Sarovi Davda: Where [01:02:25] do I fall? What do you mean?

Payman Langroudi: Well, it’s kind of a funny thing, like, should you, [01:02:30] could you can you bleach someone who’s not [01:02:35] stable periodically?

Sarovi Davda: Ah. I see. Um, [01:02:40] well, there’s certainly no health detriment to it in the sense that it’s not going to harm unless [01:02:45] you have ulcerations the gum. That’s going to hurt like hell.

Payman Langroudi: Yeah. More sensitivity, maybe during treatment. But [01:02:50] then even the stable one, you’d get.

Sarovi Davda: Uh, no. Stable. [01:02:55] I think I’m of the opinion that. What’s the problem with doing it? Well, [01:03:00] that’s that’s the test. Not when it’s unstable, necessarily. In terms of stability. I prefer to [01:03:05] work in a very conventional way, which are like, put the fires out first. Yeah. Stabilise. And then the aesthetics. [01:03:10] Like the cherry on the cake. That’s the way I prefer to work.

Payman Langroudi: That’s the. That’s the textbook, isn’t it?

Sarovi Davda: Yeah, but [01:03:15] in terms of the detriment.

Payman Langroudi: The patient wants whitening. Yeah, as long as the patient knows. [01:03:20]

Sarovi Davda: Yeah, I think it’s fine. I’m not going to say no. I mean, I start getting a little [01:03:25] bit uncomfortable when they’re like, I can’t afford to go ahead with a débridement, but I want to whiter my teeth. [01:03:30] That’s just my judgement. But yeah, exactly. Exactly. So so I have [01:03:35] to put my stuff aside. Yeah, I agree with you. It’s their money and it’s their teeth. As long as I inform them, [01:03:40] as long as I inform them. So, you know, you could whiten these teeth, but they may not be teeth left there to whiten in ten [01:03:45] years time. As long as I’m. I’m honest.

Payman Langroudi: And I guess I guess you have to. Some dentists wouldn’t [01:03:50] do it. Yeah, which is fine. Yeah. If then says I would.

Sarovi Davda: Well, see, I have the luxury of not [01:03:55] doing it. So it’s like I don’t have to deal with the actual. I’ve done it, but I haven’t treated [01:04:00] their perio thing very morally. Easily easy for me. Yeah. You know, I can say, [01:04:05] sure, you can get it done with your dentist. Of course. You know, you’re a free human being. Yeah. I [01:04:10] don’t offer it myself. So it’s easy. Yeah. No. Just because they [01:04:15] go back to their genders. I mean, I’m getting referred in patients. Yeah. So it would be very. Also, it’s treading on toes. [01:04:20] Right. So I refer everything back to the GDP. That would be GDP territory. I don’t take that myself. [01:04:25] I just deal with the Perrier.

Payman Langroudi: So have you got no plans to become a specialist?

Sarovi Davda: No. [01:04:30] Do you know? I don’t, and I have thought about it a number [01:04:35] of times because I just love learning.

Payman Langroudi: I love to become a specialist now, with everything that you’ve [01:04:40] done. Isn’t there, like, a shortened way of doing it?

Sarovi Davda: So I could have done it. So the same way that Ian did, because Ian and I have the same [01:04:45] qualifications. So he did do MSC, but like we both got MSC. Yeah. [01:04:50] Um, and he went through the kind of the old grandfather clause type thing. And [01:04:55] obviously he, you know he’s, he’s a star in that sense. I, I [01:05:00] could have looked at doing that, but I just thought to myself it cost [01:05:05] a lot of money. What are the what’s my motivation behind doing this? I don’t want [01:05:10] or need any more patience. I do exactly what I want to do without any [01:05:15] restrictions in terms of my clinical remit, because yeah, I do what I want to [01:05:20] do. Why am I really doing this? And for me and me personally, the reason would [01:05:25] be ego. And that’s something that I need to soothe.

Payman Langroudi: Discount. [01:05:30]

Sarovi Davda: Ego. I need to soothe versus like paying thousands of pounds to get some letters after [01:05:35] my name. And so that’s the reason I didn’t do it through that route. Or I could have to go back and do an [01:05:40] mql. And then I almost prefer to do it that way if I was going to, because then I get to learn. [01:05:45] But again, I’m I know I don’t want to pull out the violin, but, you know, I, I’m [01:05:50] a single income family. I’ve got other places to put my cash at the moment, and I just, [01:05:55] I feel like I’m doing what I do and I love it and I don’t need to do more.

Payman Langroudi: What’s the difference for [01:06:00] me? Yeah. What’s what’s the difference between a good periodontist [01:06:05] and a great periodontist.

Sarovi Davda: My [01:06:10] Phil’s words come into my head now. I was going to say communication because it depends [01:06:15] so much on I would say life style changes. [01:06:20] It’s a patient driven disease. Yeah. The more you can influence [01:06:25] the patient in making those lifestyle changes, the better results [01:06:30] you’re going to get. So I’d say almost like psychology. So I think me too.

Payman Langroudi: So [01:06:35] so there must be right in the training. Yeah. You’ve done some training. Hygienists do training. There must [01:06:40] be a big element of it. Or there should be a big element of it, which is behaviour change. [01:06:45] Yeah. Like how do you get people to change their behaviour. You know, how do you inspire that. [01:06:50]

Sarovi Davda: Okay. So you as an undergrad must have had psychology like Tim Newton was our psychology. [01:06:55]

Payman Langroudi: There wasn’t much of it.

Sarovi Davda: It wasn’t a huge amount. I don’t know if that’s [01:07:00] changed undergraduate training now. Do you know what’s interesting though, in all Known all postgraduate training. [01:07:05] I don’t generally see courses that are based in psychology [01:07:10] aimed at periodontists or general dental practitioners. Not many. Whereas [01:07:15] you get loads of courses on like, you know, surgical technique or, you [01:07:20] know, all the hands, all the stuff. Yeah, all the what we can do in our [01:07:25] hands. We don’t get that much psychology stuff on offer.

Payman Langroudi: I remember learning [01:07:30] loads on the cellular level of the, you.

Sarovi Davda: Know.

Payman Langroudi: The, the host response and interleukin [01:07:35] one and two and just loads on that. Yeah, loads and loads and loads on that. [01:07:40]

Sarovi Davda: But but not very much on psychology.

Payman Langroudi: Now when I say good or great, I [01:07:45] was kind of thinking of it from the referrers perspective as well, you know. So [01:07:50] I used to have a referral guy, uh, Pete Strand. Lovely. Lovely [01:07:55] guy. Um, and he used to there was a real value add to referring to him, [01:08:00] because there would be there’d be a patient who I want to put two crowns on. Um, [01:08:05] but I wasn’t 100% sure if I should on that on those perio [01:08:10] teeth, you know, and obviously I’m doing my root planing whatever, but just not not realising, not knowing [01:08:15] for sure. Will those teeth be okay to put crowns on to, you know, for the patient to spend loads of money [01:08:20] putting crowns on. So I’d refer to Pete. Pete would treat the perio and the patient would come back [01:08:25] saying, I want crowns on those two, please. Yeah. He would he would handle that part of the conversation. [01:08:30] Um, yeah. And I would think that’s a massive value add, right?

Sarovi Davda: I didn’t even [01:08:35] think about it that way. So the reason I had this conversation is because my, my MSC was in restorative dental practice, [01:08:40] and then the thesis was on Perry. Right. So I didn’t even think about the fact that I’m adding value [01:08:45] in that way. I just feel like I’m so obsessed with giving value to the patient, and I didn’t [01:08:50] think about it from the referees point of view. And having this conversation is I do. [01:08:55]

Payman Langroudi: Have referring often.

Sarovi Davda: Right?

Payman Langroudi: You have to bear that in mind.

Sarovi Davda: So I do personally, I can’t stop myself. [01:09:00] There’s something a something a bit compulsive about making an entire treatment plan for the patient. So because I’m doing.

Payman Langroudi: The. [01:09:05]

Sarovi Davda: Restorative. So what I do. Yeah. No, no. Yeah. So I do full mouth periapicals. And I’m obliged [01:09:10] to diagnose and communicate any disease I see. Right. So I end [01:09:15] up telling the patient, both in verbal and written form, every disease [01:09:20] I’ve seen and communicating that to the patient and, and the dentist informing [01:09:25] them of that and the treatment. I do tend to do that and overrun [01:09:30] with my time and admin, just because I feel like it’s both my duty and my compulsion [01:09:35] as a perfectionist. So and I and I just love what I do as well. So that’s part of what I do. [01:09:40] But, you know, our thinking, one of the values I think, okay, on a personal level that I add as a someone [01:09:45] treating your patient perio, I cannot tell you the number of times [01:09:50] that the dentist has come back to me saying, oh my gosh, like their mouth has changed. [01:09:55] But it’s not just for the sake of one round of treatment. So the way I way I treat Perry and I [01:10:00] always have is I take them through. As per S3 guidelines. But I’ve been doing it for years. A really [01:10:05] long oral hygiene. Phase so they don’t get to step two when I’m doing professional debridement [01:10:10] for about three months.

Sarovi Davda: And that’s because I’m seeing them again and again and again. [01:10:15] And it’s like PT sessions where they get into a really long [01:10:20] term habit of knowing what they need to do. And I drive home [01:10:25] exactly why. I mean, my patients go out knowing all about biofilm disruption. They know [01:10:30] it’s not about biofilm removal, biofilm killing or bacterial. They know the ins and outs of the [01:10:35] the stuff they know about mouthwash washing over it doesn’t destroy it. They really have an understanding. [01:10:40] And so I find that if you release patients into the wild [01:10:45] of GDP with a long term aspect and engagement in, [01:10:50] in controlling it, not just for like get them cleaned up, get them there, [01:10:55] you know, pockets below four and then deal with them. But it’s like a changed patient. [01:11:00] I feel like that’s not just value for the patient, but for the GDP, then has to deal with it on the [01:11:05] other side for the rest of their lives. If they are more, if they’re more educated, more engaged, [01:11:10] and they know it’s down to them and them alone, then that’s infinitely better for the the [01:11:15] Dental future as opposed to just quick fix. Out you go. Yeah, [01:11:20] that’s one of the things I think add value that adds value.

Payman Langroudi: I don’t want to be too reductive about it. [01:11:25] Yeah, but let’s reduce it down to pay.

Sarovi Davda: Pay. Okay.

Payman Langroudi: Yeah. Does it pay to [01:11:30] be an expert witness more than it pays to?

Sarovi Davda: If you do it quicker than I do a [01:11:35] referral? Oh, I’m not sure. Okay. Does it pay?

Payman Langroudi: I guess it pays, [01:11:40] but does it pay well?

Sarovi Davda: I, I it depends [01:11:45] how quickly you churn out reports, I’d say. Then it can pay very well. So [01:11:50] if you’re doing like a really simple personal injury trauma case patient [01:11:55] comes in. Okay, so patients had a road traffic accident, a number of different [01:12:00] things going on on their body. Not our business. Chips tooth. Easy [01:12:05] as you have a pro forma report. You’ve done one before. You know everything’s in it. [01:12:10] You change a few things. You could churn one out and about, see them for like a 15 minute exam, [01:12:15] take an x ray photograph, bang out report in what, an hour? Yeah, [01:12:20] two. And you could charge how much? £895. [01:12:25] £1,200, something like that.

[TRANSITION]: Not bad.

Sarovi Davda: Really good. Right. [01:12:30] Especially if you’re an associate. Giving 50% 45.

Payman Langroudi: Of those would be nice wouldn’t.

[TRANSITION]: It.

Sarovi Davda: Yeah. [01:12:35] Okay. So that’s a really easy as in terms of that’s a good turnover. Yeah. For me the way that [01:12:40] I reports when it comes to perio and I’m looking at potentially 15 years worth of data, I [01:12:45] wouldn’t necessarily say it’s a good earner the way I operate. You’d get [01:12:50] people like but is it like saying totally different? He was like, I [01:12:55] can get you down to 50% of the time you’re spending on reports. I really [01:13:00] pour a lot of effort and work into my reports, and I wouldn’t say it’s fantastic, but [01:13:05] I get to work. I get to wake up at ten, start 11, take an hour’s lunch [01:13:10] break, do a couple hours here, work on a Sunday in my pyjamas for that. I [01:13:15] think it’s awesome, you know. And so it’s how much of your time.

Payman Langroudi: Is doing [01:13:20] the legal side and how much of your time is doing actual patients?

Sarovi Davda: 5050 at [01:13:25] the moment.

[TRANSITION]: Oh, really?

Sarovi Davda: Yeah. Is that much.

[TRANSITION]: And and probably my clinical will increase [01:13:30] when I go 5050.

Payman Langroudi: Income wise as well. Or do you still make more being a dentist?

Sarovi Davda: No, I [01:13:35] still make more being a dentist. Oh, yeah. I still make more to being a dentist, because I don’t take on [01:13:40] as many cases as I could. If I churn them out super quick and I’m [01:13:45] sure I could get my my hourly rate better.

Payman Langroudi: And there’s a, there’s a shortage of periodontists. [01:13:50]

Sarovi Davda: Yeah.

Payman Langroudi: Is there a shortage of periodontal legal [01:13:55] experts as well?

Sarovi Davda: Massive massive shortage.

Payman Langroudi: So you could literally double if [01:14:00] you speed it up.

Sarovi Davda: You.

Payman Langroudi: Could.

Sarovi Davda: The thing is okay, so I tried putting up my prices and I have put up my prices and I’ve [01:14:05] still got uptake and I’m still I’m still saying no to cases. So at the moment my the demand [01:14:10] for instruction is, is more than I can take. So I’m turning down cases. [01:14:15] So I have put my price up. But there’s also a ceiling on it I found. So I can’t [01:14:20] just simply put it up to whatever the hell I want, because there may [01:14:25] not. There’s only a finite amount of money in the case to be able to dish out. So [01:14:30] yeah, there is there is a ceiling. I’ve, I found yeah. [01:14:35]

Payman Langroudi: There’s one other subject I want to talk about is um, recently Victoria [01:14:40] Samson was on diary of a CEO.

Sarovi Davda: Yeah.

Payman Langroudi: And from my perspective, [01:14:45] I thought, number one, well done for getting the profession on that platform. Number [01:14:50] two. The number of people who are going to be brushing their teeth a lot better now because of everything [01:14:55] that went on in that one. But there was a significant backlash from, from [01:15:00] Periodontists, um, about sort of I think some [01:15:05] of them were saying that, that she was sensationalising it. But, you know, it’s a sensational platform. [01:15:10]

Sarovi Davda: That’s going to say. Yeah.

Payman Langroudi: Yeah. Um, so some were saying, oh, to fill up her clinic. [01:15:15] She said whatever she wanted to which I know that’s not the kind of person she is, but I, you know, I found myself [01:15:20] defending her, but I did find a bunch of eminent periodontists who [01:15:25] were, you know, pretty angry about the whole thing. What is [01:15:30] your view of what happened? Like, did you you listened?

Sarovi Davda: Yes, I listened, and [01:15:35] I can understand both sides in the sense that, okay, when I first [01:15:40] heard it, some of the things I did feel. Ooh, we haven’t yet got the evidence [01:15:45] for that or that, you know. So there was that that perfectionistic side of item. It may be not perfectionistic, [01:15:50] but that side the part of me that revolted in the sense [01:15:55] that, okay, that’s not quite right. You know, my not quite right thing. Yeah. And there’s [01:16:00] some truth in that. Of course, you know, we haven’t yet got the evidence out there to do saliva testing, which [01:16:05] will tell us everything. Otherwise we’d all be doing it right. But I found [01:16:10] that she came across as such an amiable, which [01:16:15] is no small feat when it comes to dentistry. People don’t like our profession. Full stop. We [01:16:20] are not an amiable profession. So to come across as a young, dynamic, enthusiastic, [01:16:25] um, amiable, someone you know, someone [01:16:30] in a profession, and you can pick on the little bits that weren’t quite right. [01:16:35] Of course you are. Of course you can. There was a lot that she said that was, and drew [01:16:40] attention to the connections between essentially the body and perio, that if we [01:16:45] can get people more interested, I think that’s fantastic. I just [01:16:50] think if you’re looking at the overall benefit versus kind of, it’s not even a [01:16:55] risk benefit.

Sarovi Davda: But if you’re looking at the good versus the not quite right, [01:17:00] I just think overall she I think overall she did a great thing for the profession. [01:17:05] Me too. I do. And I think that the other thing that’s really important that she’s also said [01:17:10] is that that is an interview where you cannot see the edited version. I think it’s there. [01:17:15] It may well be that, you know, there were times where she qualified that [01:17:20] this is there’s one study that’s come out. There’s one this there’s growing evidence [01:17:25] base. There may well have been a caveat to many things that she said that would just [01:17:30] edit it out. So it appears as if it’s fact, because that is much more, you know, of course [01:17:35] people want to hear dramatic headlines, don’t they? So we could have had just had the headlines [01:17:40] without the caveat that came with it. So I’d like to think that I was emotionally generous enough to to [01:17:45] give her the her the benefit of the doubt. But if I look at the overall good versus [01:17:50] disrepute, let’s say it’s the profession has been brought into overall much. Yeah, she’s I think she’s [01:17:55] shone a light on something that will just, if anything, spark people’s interest in engagement [01:18:00] in improving their health.

Payman Langroudi: I think about it right, is that, you know, um, the evidence base and [01:18:05] what that means, you know, what does it mean that the evidence base doesn’t show that I had Avi Banerjee [01:18:10] sitting. Sitting where you’re sitting?

Sarovi Davda: Oh, yeah.

Payman Langroudi: And I.

Sarovi Davda: Lovely guy.

Payman Langroudi: I asked him how long, [01:18:15] how long between a breakthrough and that going into the evidence [01:18:20] base, inverted commas or being taught on MSC programs all over the world, he [01:18:25] said 25 years, something like that, really?

Sarovi Davda: 25. Yeah, yeah, yeah, really long time.

Payman Langroudi: And [01:18:30] so, so if the evidence base today of, you know, multicenter, double [01:18:35] blind clinical trials doesn’t show some of the things that someone says, we [01:18:40] have to bear in mind that that evidence base is almost 25 years old. Almost. [01:18:45] And I’m not being silly about it. Of course. Of course. Someone put out a paper yesterday that [01:18:50] we can all read and sew, sew.

Sarovi Davda: Sew. I completely agree that essentially what let’s say Victoria [01:18:55] Samson, as we’re taking her as example, what she’s saying could actually be be the go [01:19:00] to the standard way of approaching things, because we have so much evidence in 25 years time. And she might just [01:19:05] be, you know, ahead of her game. But I think that’s where the caveats are important. [01:19:10] The saying. So, for example.

Payman Langroudi: And she may not it may be incorrect.

Sarovi Davda: That’s [01:19:15] correct. That’s where it needs to be qualified that there is emerging evidence. This is what I practice because [01:19:20] I really believe that this is the way forward. As of yet, there isn’t enough evidence to to show that we should [01:19:25] all be practising this way. But you know where I could really identify with that? And I was sharing with you earlier [01:19:30] when we’re talking casually that when and I mentioned Phil, our Graham Smith, both presidents [01:19:35] of the British Society of Periodontology in their time and things, um, they were considered mavericks, [01:19:40] as was their mentor mental. Who’s you know, Bernie Keyser? Yeah. [01:19:45] The Eastman. And when he was back in the day, this is over 30 years [01:19:50] ago teaching that biofilm was kind of the most instrumental trigger. [01:19:55] And it was all about disruption, the biofilm. When he was teaching that he was so [01:20:00] shunned that he had to do in secret. It was like the secret society. Then Phil was [01:20:05] given, um, a voice at the annual conference, the BSP. And [01:20:10] when he spoke and he showed a radiograph of having, leaving, leaving behind inadvertently [01:20:15] or much to his dismay, because he tried so hard a bulk of calculus [01:20:20] around a tooth. And lo and behold, there was still in bony infill in the defect [01:20:25] there, and no pocketing. So he said, how can I possibly justify going in with surgery and treating this [01:20:30] when I’ve got all the clinical parameters of health? This pocket’s not even this.

Sarovi Davda: Sorry. No pocket, not even bleeding. [01:20:35] I’ve got bony infill, bulk of calculus. And he was then given the feedback from [01:20:40] generally positive. But there was one very eminent famous [01:20:45] professor teaching actually in one of the London teaching hospitals, who wrote down [01:20:50] on his feedback. This person should not be given any public podium to ever speak again. [01:20:55] And there was a controversial debate going on outside the thing and what he was [01:21:00] saying and practising for 25 years, of which I also basically I gave it a whirl [01:21:05] when I went to his course. I spoke to him, I gave it a whirl, and I found that I [01:21:10] actually got the most phenomenal results in doing a what’s now accepted as S3 guidance [01:21:15] and evidence through the roof. A prolonged oral hygiene phase. Optimising patient [01:21:20] risk factors, modifying them, going for the oral hygiene. I got the most phenomenal results I’d ever [01:21:25] had in practice, so I thought, why would I not do this? And I was on board, but [01:21:30] it was still very controversial. He was considered a maverick until he wasn’t 25 [01:21:35] years in the making. So in that sense, I can really identify [01:21:40] with the Victoria Sampson this world. But again, like I said, it just needs to be clarified [01:21:45] and that this is not universally accepted.

Sarovi Davda: Here is the evidence [01:21:50] I’m relying upon. But evidence based dentistry, everyone goes to, oh, it’s clinical trials [01:21:55] and it’s meta analysis and systematic reviews. When you look at the definition of evidence [01:22:00] based dentistry, it’s not about just the science. It’s the marrying up [01:22:05] of patient centred clinical expertise and the [01:22:10] latest and best quality evidence. It’s those three things. And if I’m finding I get better [01:22:15] results doing one thing in my hands than I was before, and that serves [01:22:20] the patient because the way I was practising didn’t involve local anaesthetic initially. I was doing the whole [01:22:25] thing from patients cleaning subgingival in their pockets and therefore [01:22:30] reducing inflammation didn’t require the I mean, patients were having the most comfortable debridement [01:22:35] you could ever think and the best results. And I’ve changed my view slightly from, you know, [01:22:40] adapting Mint’s techniques and things. But why would I not want [01:22:45] to do that and advocate that? And when I’m then sharing it publicly, simply [01:22:50] say, this is what I do in my hands. And it is backed by this evidence because there was evidence [01:22:55] dating back from Battiston et al, showing that, you know, we’re rubbish at actually removing calculus. So how [01:23:00] big a part of the picture is it? If you can do that, then sort of. [01:23:05] There is a place. That’s what I’m trying to say. There is a, there is a place.

Payman Langroudi: There would never be any progress would [01:23:10] it, if, if.

Sarovi Davda: If we didn’t try.

Payman Langroudi: Things, we wouldn’t try.

Sarovi Davda: Things. Well, yeah. As long as there’s no harm [01:23:15] to patients at the other thing as well, you know, if it’s working as well or better than what [01:23:20] you’re doing before and there’s less risk, then it’s hard to then in some ways [01:23:25] argue with the with those three things patient centred, you know, because again, the other thing that Victoria [01:23:30] Sampson, I mean, and I shouldn’t, shouldn’t necessarily bring her personally into it, but if I’m, if I’m [01:23:35] charging, let’s say double, but it’s not evidence based. Again, that’s a conversation I need to [01:23:40] have with a patient. So if I was using, let’s say, laser and all the evidence shows that it’s [01:23:45] no better than when you’re doing your standard debridement, I need to have a conversation with [01:23:50] the patient saying, look, I think this works in my hand. This is how I’m going to justify A, B or [01:23:55] C. It is double the amount. The evidence doesn’t actually show. It’s better. Do you still want to go ahead with it? That’s [01:24:00] a conversation that needs to be had. So you know.

[TRANSITION]: Yeah.

Payman Langroudi: Documented to.

Sarovi Davda: Documented [01:24:05] to of course. Yeah. Keep yourself out of court.

Payman Langroudi: We’re coming to the end of our time. But I’m gonna go [01:24:10] to the darker part of the pod.

Sarovi Davda: The darker part. Okay. [01:24:15] Let’s talk about the stakes. Oh, yeah.

Payman Langroudi: Clinical errors.

Sarovi Davda: Is it really the darker part? [01:24:20] I think it’s the light, you know? That’s. It’s through the cracks that the light. Light seeps in. Right? [01:24:25] That’s the thing.

Payman Langroudi: What comes to mind if I say clinical error. Yeah. That you made that [01:24:30] the rest of us can learn from so that we can all learn from each other’s mistakes rather than.

Sarovi Davda: Okay, loads [01:24:35] of clinical errors that you can learn from. Um, okay, that’s slightly different [01:24:40] because I’ve made clinical errors now. I mean, I remember in year I [01:24:45] so overly, enthusiastically prepared and filled a molar, [01:24:50] thank God or not, thank God. It was on the husband of my dental nurse that literally looked [01:24:55] like some sort of mushroom or tree. Palm tree had fungi from the apex. [01:25:00] Horrific. I don’t even know how that poor man. I’m so sorry. Wherever you are. Didn’t experience, [01:25:05] like, severe jaw pain. That was what happened. That was one for the Annals [01:25:10] of Dentistry. No. Do you know what? He was right. This thing is so damn [01:25:15] forgiving, isn’t it? So that was horrific. Yeah. Um. Another one. [01:25:20] And I’ll always remember this. I can literally picture her face right now. So [01:25:25] this is actually relevant. Lower 2 to 2. I cannot remember how much bone they [01:25:30] lost, but it was there was bone loss but really motivated patient. And [01:25:35] in the end what happened, what happened is I ended up extracting that lower tooth, [01:25:40] thinking I was doing the best job, you know, since sliced bread of putting an adhesive bridge on the three [01:25:45] from the 3 to 3. And she came back and it was it looked fine. It functioned fine. It wasn’t [01:25:50] something kind of wrong with it as such. But she said, I wish I’d never [01:25:55] taken those teeth out. So worst decision I’d ever made. And I guess now with everything [01:26:00] that I know about prognosis. Yeah, I regret you can’t [01:26:05] ever put teeth back that you’ve taken out. But you can take teeth out that then end up going down the pan. [01:26:10] And that patient will lose their teeth with a different spirit.

[TRANSITION]: Yeah.

Payman Langroudi: Then [01:26:15] it’s a good point.

Sarovi Davda: If they, you know, had at least given it a shot. That’s actually a quote from [01:26:20] who’s the famous Italian Maurizio Zanetti. Yeah, yeah. They’ll [01:26:25] lose in a different spirit. And if not, and he actually finishes it off by I better call my lawyer. Um, [01:26:30] that’s that quote. But so that was really bad. There’s a very funny, [01:26:35] regrettable, but I’m not sure about faux pas like preventable mistake. But, um, [01:26:40] I had a wonderful, wonderful patient. This is a bit funny, but not. [01:26:45] Yeah, not um, he had very sadly over Covid, suffered from [01:26:50] cancer. And I was told by my nurse that, oh, you know, he’s [01:26:55] come back. He’s, he’s had cancer treatment. And I said to him, I said, oh my gosh, [01:27:00] I am so sorry that, you know, you suffered this. [01:27:05] And he said, yeah, we had to miss our planned trip to Japan and everything. And I said, [01:27:10] I go and I never use this terminology. I go, God, what a [01:27:15] bummer. And he said, he goes, yeah, literally it was anal cancer. [01:27:20]

Payman Langroudi: Oh.

Sarovi Davda: And I literally.

Sarovi Davda: Wanted the ground to swallow [01:27:25] me up. But he found the funny side of it. Lovely, lovely, lovely guy. Yes. [01:27:30] That was not. That was not ideal.

Payman Langroudi: I like that you gave three totally different situations. [01:27:35] I mean, I’m going to let you off. Normally I want something that went wrong, that then [01:27:40] the patient. It didn’t go well with that patient as well. But, but but I’m happy. I’m happy [01:27:45] with what you’ve given me there.

Sarovi Davda: Um.

Payman Langroudi: Final question. Fantasy [01:27:50] dinner party.

Sarovi Davda: Yeah. So I thought about this, and [01:27:55] I’m not sure it’s a fantasy, actually, but it’s just like, who would I have? And I thought about it, and this is [01:28:00] what came to me, which is very weird, but okay, I chose [01:28:05] I chose Jesus.

[TRANSITION]: Jesus.

Sarovi Davda: Yeah. Jesus, I, I am very [01:28:10] spiritual. I love like I’m not actually even a born Christian, but I thought really [01:28:15] any enlightened being. But Jesus is pretty popular, right? So I’d have Jesus, [01:28:20] I would have the Dalai Lama and I’d have Donald Trump. [01:28:25]

[TRANSITION]: Oh.

Sarovi Davda: Okay.

[TRANSITION]: And there’s a reason behind this. Go on, go on, go on. So?

Sarovi Davda: So [01:28:30] I just said, I find, like, being around [01:28:35] really enlightened human beings, and [01:28:40] you can’t really get much more enlightened than Jesus and Dalai Lama. I find that even [01:28:45] by osmosis, would they not even say anything? There’s something that I [01:28:50] gain, but especially when they start talking, I think it’ll be very interesting to simply observe, [01:28:55] like listen, to learn the conversation that goes on between those three. And [01:29:00] do you know if it even did a little bit of good by [01:29:05] one of the most powerful leaders in the world at the moment, just [01:29:10] so can a little bit of whatever these two have to offer. That’s a great thing, [01:29:15] right? So it benefits not just it’s more than me in that in that room, but it might [01:29:20] benefit a whole lot of other people. And you know what? It would be so wonderful to see [01:29:25] how enlightened human beings manage [01:29:30] conversation where, you know, if I’m like, [01:29:35] pissed off with somebody, I might start going into like very unhelpful behaviours, right? Because I’m a human being [01:29:40] and I’m triggered and you name it, but I just don’t imagine that would happen. So the modelling [01:29:45] that would go on for dealing with and adversarial [01:29:50] people or circumstances or, or just political [01:29:55] debate, it would be so interesting to see how that was handled from [01:30:00] an observer’s perspective.

[TRANSITION]: It’s interesting.

Payman Langroudi: That’s why I’ve never had something like that before. That’s very [01:30:05] interesting.

Sarovi Davda: Okay. Very weird.

[TRANSITION]: I know you.

Payman Langroudi: Said before, you said you’re spiritual. You said you do [01:30:10] like a prayer here and there.

Sarovi Davda: Here and there.

[TRANSITION]: Yes.

Payman Langroudi: What is your sort of, you [01:30:15] know, religious or your relationship with God or whatever, but how [01:30:20] would you characterise that?

[TRANSITION]: Um.

Sarovi Davda: Deep and wide. [01:30:25] How is my relationship? That’s how to explain it. It’s like. There [01:30:30] isn’t a day that goes by where I don’t touch in with God or whatever you want [01:30:35] to call it. It’s like everyone’s God is different. I don’t think there’s.

[TRANSITION]: A set like.

Payman Langroudi: A prayer.

[TRANSITION]: Like a.

Sarovi Davda: Yeah. So every day [01:30:40] I say the serenity prayer.

[TRANSITION]: Yeah.

Sarovi Davda: And. I [01:30:45] say a couple of prayers that like literature that I’ve read [01:30:50] about, I suppose, like the laws of life that, you know, God has not given [01:30:55] me the right to control another human being. And that kind of sets me into this place of detachment. [01:31:00] And just I think one of my roles of as a human being [01:31:05] is through whatever God given gifts I’ve been given is to be of [01:31:10] service. So to kind of like just before this, you know, I, um, it would be like, [01:31:15] whatever comes out my mouth, may I be a vessel for, like, some good stuff, basically. [01:31:20] That’s it. And whether I, I think whether you believe in God or not, it could be the universe. It could [01:31:25] be like an energy. It doesn’t really matter. I don’t think there’s a prescriptive way of [01:31:30] looking at a higher power God, universe, creator, whatever you want to call it him, her [01:31:35] they. But just something that is more than just me, [01:31:40] that connects every single one of us a little bit, like, you know, fungi. [01:31:45] Yeah, the interconnectedness of all. And if that energetic goodness [01:31:50] can be transmitted in some way and touched even one [01:31:55] human being, that’s awesome. That’s really cool.

Payman Langroudi: That’s really [01:32:00] nicely put. Thank you. Because I really struggle with the whole spiritual side until I realised that [01:32:05] it’s the nature of it that you can’t describe it.

Sarovi Davda: I [01:32:10] think you can be.

[TRANSITION]: I mean, you describe you described it though, without.

Sarovi Davda: Believing in spirituality.

Payman Langroudi: You described [01:32:15] it very, very well there. Yeah. But normally if you ask someone about, you know, what does spirituality or spirituality [01:32:20] mean to you? I don’t know. The answers are just very. But. But then I realised very [01:32:25] late in the day that it is the nature of spirituality that it’s not possible [01:32:30] to describe it in simple one plus one equals two terms. That’s the nature of it. That’s what we’re discussing, [01:32:35] something that isn’t so black and white and that that doesn’t change [01:32:40] my position on it. But that was really beautiful what you just said.

[TRANSITION]: Really beautiful.

Payman Langroudi: Final question. [01:32:45]

[TRANSITION]: Hmm.

Payman Langroudi: Deathbed.

Sarovi Davda: Oh, yeah. Yeah.

Payman Langroudi: Three pieces of advice for friends and family. [01:32:50]

Sarovi Davda: Okay, so I when I was asked this originally, I didn’t realise it was three. So I [01:32:55] definitely have one that might cover all. So my loved ones on their deathbed, [01:33:00] I would say to my girls. Listen [01:33:05] to the quiet voice within that guides [01:33:10] you. Make space for it. And that’s kind of it. [01:33:15] And I’ll tell you why. There’s only really one piece. Because for me to advise [01:33:20] any other human being on kind of potentially what to do, what to think, what to believe is [01:33:25] simply from my history, my beliefs, my traumas, [01:33:30] my colourings, whatever. So actually, the only person that the advice is [01:33:35] right for is me. I’m not qualified to really give any advice [01:33:40] to any other human being, because I genuinely believe we all have that inner knowledge within. [01:33:45] Every single one of us had knows what is right for us [01:33:50] in any given moment. But I can certainly, as a human being, identify with [01:33:55] drowning out that voice, with societal norms, with the things I’ve mentioned, [01:34:00] with just being too busy or too loud. But personally, when [01:34:05] I get really quiet and I listen to that whisper and give it some volume [01:34:10] that, you know, the talking is of, again, a spiritual being. My inner child, [01:34:15] whatever it may be, I already know what’s right, so I’d be that.

Payman Langroudi: I [01:34:20] like the way you talk about this stuff. You should maybe go into that stuff a bit more. [01:34:25]

[TRANSITION]: Maybe I should.

Payman Langroudi: Beautiful.

[TRANSITION]: Really beautiful.

Payman Langroudi: Thank you so much for doing it. Thanks [01:34:30] for coming all the way.

Sarovi Davda: Thank you so much for having me.

[VOICE]: This is Dental [01:34:35] Leaders, the podcast where you get to go one on one with emerging [01:34:40] leaders in dentistry. Your hosts, [01:34:45] Payman Langroudi and Prav Solanki.

Prav Solanki: Thanks for listening, [01:34:50] guys. If you got this far, you must have listened to the whole thing. And just a huge thank you [01:34:55] both from me and pay for actually sticking through and listening to what we had to say and what our [01:35:00] guests has had to say, because I’m assuming you got some value out of it.

Payman Langroudi: If you did get some value out of [01:35:05] it, think about subscribing. And if you would share this with a friend who [01:35:10] 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 [01:35:15] our six star rating.

Payman Langroudi: One of the most common questions I get is how do I do more teeth whitening? The basis of that is to really [00:00:05] believe in it, and the basis of that is to fully understand it. Join us for enlightened online training on [00:00:10] Enlightened Online Training.com to understand how to assess a case quickly, how to deliver [00:00:15] brilliant results every time. Next time whitening Underwhelms try and lighten. Now let’s get to the [00:00:20] pod.

[VOICE]: This [00:00:25] is Dental Leaders. The podcast where you get [00:00:30] to go one on one with emerging leaders in dentistry. Your [00:00:35] hosts Payman Langroudi and Prav [00:00:40] Solanki.

Payman Langroudi: It gives me great pleasure to welcome wiggler [00:00:45] on to the podcast. Barb, I’ve known you for years and years. Absolutely, yeah, it must be [00:00:50] 15 years by now. Would have thought so. Yeah, well, longer, maybe longer actually. Originally a b [00:00:55] c d stuff. Yeah. So that was. Oh It’s above. Above. [00:01:00] It’s got two practices right now. Natural smiles in both Leicester and Corby. [00:01:05] Yes. And I often tell this story in your absence, but I’ve been to a lot [00:01:10] of practices a good thousand and the, the, the [00:01:15] welcome I got at your Leicester practice, I don’t think [00:01:20] I’ve ever had as good a welcome as that anywhere. And you can imagine the different types [00:01:25] of responses that I’ve had when I turn up sometimes. And no [00:01:30] one even looks up. Yeah. Happens. Yeah. And I don’t blame the people sometimes, [00:01:35] you know, sometimes not enough humans. Right. Not enough staff, you know, and you know, someone’s busy [00:01:40] typing or something. And I’m standing there and then maybe they’ll look up quickly and then I’ll say, I’m [00:01:45] Langroudi from enlightened. And they just sort of point to somewhere to sit down, whereas [00:01:50] in natural smiles. Listen, I don’t know if I came at a particular time where you had particularly brilliant [00:01:55] staff or whatever it was. Yeah, but it was years ago.

Payman Langroudi: Number one. [00:02:00] I mean, nowadays everyone’s on to this. Yeah. But years ago, it was a good I’m [00:02:05] thinking maybe eight years ago I would about way before, soon after we’d [00:02:10] opened. Yeah. Way before Covid. And someone jumped up and opened the door for [00:02:15] me. Doctor Langroudi. We’ve been expecting you. How are you? What kind of coffee [00:02:20] would you like? Let me sit you down here. I was like, what a place. And I wasn’t expecting [00:02:25] it in Leicester, to tell you the truth. And suddenly amazing coffee [00:02:30] turned up like, amazing. Better than Starbucks coffee showed it. And it was really [00:02:35] refreshing. Yeah. And the. The decor of the place, I [00:02:40] mean, above and beyond. It was something back then. I mean, I don’t know whether you’ve done it up now or [00:02:45] whatever it is. But back then it was really state of the art, beautiful, minimalist [00:02:50] kind of looking place. And I just thought, this guy is on another like another, [00:02:55] another stream to to most other dentists. Tell me, tell me, tell [00:03:00] me. You know what? What were you thinking? Were you. Were you thinking what people [00:03:05] think nowadays? Where they go? Oh, I’ve had a great experience in the four four seasons in Abu [00:03:10] Dhabi. I’m going to try and recreate that here. Well, firstly.

Bhavnish Waghela: Thank you for inviting me. That’s [00:03:15] the first thing. Um, I think the story goes back to, um. [00:03:20] When we opened our Corby practice. [00:03:25]

Payman Langroudi: Was that first.

Bhavnish Waghela: That was first. So that was to my daughter’s now 18. So that was 2007. [00:03:30] Um, it was a private squat. [00:03:35] I had NHS practice, which I was.

Payman Langroudi: Before.

Bhavnish Waghela: That, before that. And I basically [00:03:40] it was a choice of do we move the NHS to a larger premises. New [00:03:45] contract had just come in and I was like, oh, do I like this contract, do I, do I what do I do, do I grow [00:03:50] it had a property. Shall I use that and move everything [00:03:55] to it or not. And we thought let’s just separate the two. So we did. And I’d [00:04:00] heard of Paddy Lund at the time.

Payman Langroudi: Yeah.

Bhavnish Waghela: And I read his book. [00:04:05] Never met him. Um, and some of the things from that, the non-critical, [00:04:10] critical, non-essential side of things. And at the time, I remember going [00:04:15] to what was then pétrus the restaurant. The restaurant. Yeah. And [00:04:20] had a great meal. Just my wife and I. And [00:04:25] we’d gone for a lunch, but we’d ended up eating and staying. [00:04:30] Firstly with vegetarian. No eggs. Strict. And they’d [00:04:35] catered for us. That was over and above. And they didn’t. [00:04:40] There was no hurry to leave. We’d extended our welcome, I felt. [00:04:45] I didn’t feel. But they. I knew I had till about 6:00. Um. [00:04:50] And they just treated us really, really well. And something that I thought of at the time [00:04:55] was this is how dentistry should be done.

Payman Langroudi: Mhm.

Bhavnish Waghela: Um. Michelin starred dentistry [00:05:00] be treated as a family member, be treated as a really [00:05:05] close friend. Um, and that little attention to detail. [00:05:10] So we did that with our, with the Corby. And then when [00:05:15] we opened Leicester we, we redid it.

Payman Langroudi: Oh, you did it okay. It [00:05:20] looks good. Tell me about the training process that it takes to get [00:05:25] that level of, you know, service from your team.

Bhavnish Waghela: So [00:05:30] it was a joint effort. Um, obviously, I’m, I usually wear the clinical hat and my wife [00:05:35] and my, my practice manager, Carol Boyd, who’s from my Corby practice. Yeah. [00:05:40] Uh, we all work as a team, and she’s well travelled. [00:05:45] We’re well travelled, and we experience things from around the world, and we try and bring them to [00:05:50] the practice. So there are certain things that we had in our playbook. We wanted people to [00:05:55] be welcomed as they come in. We acknowledge eye contact is important. We acknowledge, [00:06:00] uh, treating somebody in the tone of voice. You [00:06:05] know, communication is not just what you say, how you say.

Payman Langroudi: It.

Bhavnish Waghela: Yeah. Um, and how you say it’s even more important [00:06:10] than what you say. Yeah. So, um, it was firstly [00:06:15] a selection process in terms because obviously with a squat it was finding [00:06:20] the right person people. Um, and then [00:06:25] we didn’t have anybody bar one from a Dental background. [00:06:30] Um, only on purpose. So only one of the people that we had was had a dental background because [00:06:35] she was a TCO. So we had to have we wanted to have that, but reception was non dental. [00:06:40] Um, so that was the crux of it. Yeah. So [00:06:45] yeah that really helps. And then it was just because it was a squat. We had time during the [00:06:50] build of you know, I tend to learn from listening [00:06:55] rather than reading, so I’ll send them. I remember, I think [00:07:00] Chris Barrows introduced me to a video of, uh, the [00:07:05] Four Seasons or Ritz Carlton CEO talking about how to treat members [00:07:10] of the team and therefore how you treat the staff. So I sent the team there and we’d go through that and discuss that [00:07:15] and then try and embellish our patient journey that way. So yeah.

Payman Langroudi: It [00:07:20] it must take constant retraining and sort of dotting [00:07:25] the i’s and crossing the T’s. I mean, it’s not a one time thing, is it, that.

Bhavnish Waghela: No, I think because we all develop, [00:07:30] don’t we? You know, I think, as you said quite rightly, back then, we [00:07:35] were very there were very few of us in dentistry doing that. And now everybody [00:07:40] seems to be doing that, which is great because ultimately who benefits the patients. [00:07:45] So yeah, it’s always a case of revisiting our journey, Revisiting how [00:07:50] we wear the touch points are with patients that really, really makes a difference.

Payman Langroudi: I think [00:07:55] I remember back then thinking the only other time I’d noticed that level of service [00:08:00] in a non West End practice, because in Western practice it’s quite easy. There’s so few humans [00:08:05] that you can pull it off. Right. Um but in a non West end setting [00:08:10] was Rahul’s practice in Hartford where again [00:08:15] way ahead of their time. It was just another feeling. You know, I think Laura Horton [00:08:20] was probably there at the time.

Bhavnish Waghela: Well, interestingly, we had used Laura Horton probably about [00:08:25] seven years when Laura had started doing her TCO training. We were one [00:08:30] of the first practices to have a come in and train us at the Corby practice. Oh really? So [00:08:35] we’d had that input prior to opening and then obviously changing [00:08:40] our workflow in Corby and then hence in Leicester as well.

Payman Langroudi: And so what ended [00:08:45] up happening to that NHS practice you sell it.

Bhavnish Waghela: So I sold it basically. Um, it was like [00:08:50] I was struggling because ultimately I sort of shot myself in the foot because I gave the patients [00:08:55] a choice. You can see me on the NHS or you can see me privately. And if anyone with the right mind, [00:09:00] they’re not going to see me privately. So what we then did was we said, okay, I will go private. [00:09:05] If you want to see me, you’ll have to see me privately here. And we had an associate who stayed on at [00:09:10] the NHS practice, and then we just sold it about a year later.

Payman Langroudi: And why? [00:09:15] What was the sort of the driver were you thinking? I want to fully focus on private dentistry.

Bhavnish Waghela: I [00:09:20] think, you know, we had I was in because it was really it was a squat [00:09:25] practice. So very few patients in the early. Yeah, sort of seven, eight months. Um, [00:09:30] so I was working with two hats on. So one day I’d be doing this and sometimes it would because [00:09:35] there were literally a mile and two miles a mile apart.

Payman Langroudi: Two patients.

Bhavnish Waghela: So the patients [00:09:40] could move in the same town. Um, and I would literally go to the NHS in the morning [00:09:45] and sometimes the private in the in the afternoon, and personally, some [00:09:50] will disagree. I don’t think it is possible for one person to do [00:09:55] both. I don’t think it works.

Payman Langroudi: I think I agree to do both [00:10:00] well.

Bhavnish Waghela: To do both well. So either you do it and the thing is this is pre current contract [00:10:05] or when I was doing NHS. Yeah to do NHS. Well the [00:10:10] old contract worked well. The new contract makes it more difficult because [00:10:15] of the restrictions and because of the hands being tied. But I feel even from a treatment planning point of [00:10:20] view, um, you know, quite a lot of our associates are in that halfway [00:10:25] house where they’re sort of coming out of NHS and into private dentistry, [00:10:30] and we like to sort of coach them in how to treatment plan. And [00:10:35] I find it extremely difficult to do both. I found it extremely difficult to as I said, right now we’re going to sell the NHS [00:10:40] and I can just focus on doing what I feel is right for my patients.

Payman Langroudi: And as far as [00:10:45] top tips, because both of them are squats, right? Yes. Top tips for a squat. I mean, it’s becoming [00:10:50] much more fashionable now to do squats because of the high price of practices, I [00:10:55] guess. But it’s a it’s a totally different way of working. I mean, number one, that first, [00:11:00] like you said, 7 or 8 months of working capital just to stay afloat. [00:11:05] Right?

Bhavnish Waghela: Yes, 100%.

Payman Langroudi: I think a lot of people don’t don’t remember that, you know, and I’d [00:11:10] say for anyone doing a business plan, I’m no expert on, on Excel sheets, but but, [00:11:15] you know, be very negative and very pessimistic about what’s going to happen [00:11:20] and have a good amount of money available just to get through that. First, I’d [00:11:25] say year and a half, just to get, you know, just to make it really difficult. Yeah. Um, [00:11:30] you know, be pessimistic 100%. Yeah. But then what else? I mean, [00:11:35] okay, count the pennies. Count the.

Bhavnish Waghela: Pennies.

Payman Langroudi: I well, it’s weird counting pennies [00:11:40] because you’re making this beautiful place that costs money, right?

Bhavnish Waghela: I think you all. I don’t think it’s possible [00:11:45] to. I’ll be quite honest. You know, I will [00:11:50] end even when it comes to buying a flippin watch. I will go to buy something [00:11:55] and end up spending more than my anticipated. So I did the same thing with the practice. Both. Both [00:12:00] practices. Um. I’m a sucker for sales. Um, so therefore. [00:12:05] And I like gadgets, so therefore I end up spending more than I should. But [00:12:10] now it’s a case of I’ve spent it. Um, and sometimes, I [00:12:15] mean, with the first one I did shortcuts. You know, I knew a friend of a friend who could do my plumbing rather [00:12:20] than getting everything to one builder at the time, which I should have done. I made shortcuts to save [00:12:25] corners. The second one, I didn’t do that. So second one, everything went to one one contractor. [00:12:30] And that made such a difference. Uh, so try not to take [00:12:35] shortcuts in the building works. I think it’s very easy to cut [00:12:40] corners financially Lee in the way a practice equipment, [00:12:45] certain equipment I you know I bought all singing, all dancing Sirona [00:12:50] chairs. Do I need them? No. Does it make me more efficient? [00:12:55] No. Do patients realise I don’t think my a deck chair in [00:13:00] my Corby practice? Patients prefer I get more comments about that than I do about comfortable.

Bhavnish Waghela: Comfortable? Absolutely. [00:13:05] So we tend to see things from our point of view rather than the patient’s point of view. Yeah. [00:13:10] So with certain things. So that’s probably where I would say that would be an area [00:13:15] where one could save, uh, business planning. When I open my copy practice, my business plan [00:13:20] was that where’s the wind going? What can I do? Banks were lending, I [00:13:25] had cash. So it was so much easier with the second one. More [00:13:30] competition. Uh, city. So very different in terms of [00:13:35] marketing budget, in terms of that initial cash to keep things [00:13:40] Going, um, but something that, [00:13:45] uh, and I think being a little bit more intuitive or ingenious, [00:13:50] should I say, with regards to marketing, um, or even how you [00:13:55] get cash coming in quickly. I had a conversation with Zach at the time, [00:14:00] and he was telling me how as an implant dentist, what he was doing is, [00:14:05] was sort of, uh, he was basically giving an implant. If you pay [00:14:10] for the implant, you get the crown for free. So you discount it, but you have to pay in full. [00:14:15] So that meant in the first sort of few months, we had patients paying [00:14:20] chunks of cash. Uh.

Payman Langroudi: It just it’s the lifeblood.

Bhavnish Waghela: Isn’t the lifeblood. [00:14:25] Exactly. Cash flow was, was was always a challenge and always will be a challenge in some practices. [00:14:30] Um, but I don’t think I really don’t think a [00:14:35] squat practice is for everybody.

Payman Langroudi: No.

Bhavnish Waghela: Um. I [00:14:40] think the idea of a squat. What people tend to do is they do [00:14:45] the maths. Oh, I can buy this one for this much, or I can set it up for less [00:14:50] than that.

Payman Langroudi: Yeah.

Bhavnish Waghela: And I think the pain points in both are different [00:14:55] because they are there for sure. But I think theoretically I mean I my [00:15:00] NHS one was not a squat obviously. Um, and that was so much easier. [00:15:05]

Payman Langroudi: So you probably haven’t got appetite for it. But let’s say you were going to open a third practice. [00:15:10] Now would you buy an existing business?

Bhavnish Waghela: I probably would. Yeah.

Payman Langroudi: Just to get you [00:15:15] past the initial idea of pain.

Bhavnish Waghela: Yeah. Yeah. I would buy in. I would buy [00:15:20] an existing concern, which is doing well financially, which has [00:15:25] potential scope. Yeah. Yeah. Now that might be chair time scope. It might be physical scope. [00:15:30]

Payman Langroudi: Building scope.

Bhavnish Waghela: Yeah, it might be something else.

Payman Langroudi: Something going on.

Bhavnish Waghela: Right. Absolutely.

Payman Langroudi: So [00:15:35] look, when I came to see you, I was really taken. One thing that kept sticking in my [00:15:40] mind was this guy is like a linchpin in Leicester. Like, [00:15:45] it felt like, you know, everyone or you know that a lot of the movers and shakers, [00:15:50] people who own what it was chains of things, chains of [00:15:55] petrol stations or something, something like that. And I remember you, I remember saying to you, oh, where’s [00:16:00] the best Indian restaurant? And you were like, oh, well, my friend owns all of them, and they’re there. And you just knew. [00:16:05] You knew the people. Yes. How important was that compared [00:16:10] to, you know, the way people think about it is I need this much money for marketing. I’m going to do some Google [00:16:15] ads and Facebook ads. You know, like I’d say it’s super, in your case, super [00:16:20] important.

Bhavnish Waghela: Yeah. So my story is slightly different. Yeah. Um, I belong [00:16:25] to a Hindu sect, and we have our European headquarters [00:16:30] at the Neasden Temple, which some people have probably seen. Some of you may have seen.

Payman Langroudi: Yeah, I’ve been there. Beautiful.

Bhavnish Waghela: So, [00:16:35] um, We have a guru and at the time of opening [00:16:40] the Leicester practice, we have a system where we all, if we’ve got a [00:16:45] tech we had, we were opening a temple in Leicester, really nice temple, large square footage [00:16:50] and I was part of the fundraising team and as a as an element of fundraising, [00:16:55] we all donate a figure to the temple. The thing off. Yes. [00:17:00] And I had paid my commitment. So [00:17:05] I had written a little note to my guru, who was in India at the time, and I said, [00:17:10] I’ve paid this. I have a business dental practice. [00:17:15] He knows he knows me quite well, and I’m thinking of leaving dentistry [00:17:20] and going into something else because I’ve had enough. Um, and [00:17:25] also in the same thing, it was, uh, should I donate some more? She [00:17:30] didn’t say donate more. His. He. In fact, there was a monk who happened to [00:17:35] be there. So they rang and they said, right, speak to him. And he said, open a practice in Leicester. I’m like, [00:17:40] God, you’ve just. And with me and my faith, I’ll do whatever [00:17:45] he says. There was no intention of doing a practice in Leicester.

Payman Langroudi: Oh I.

Bhavnish Waghela: See. So that [00:17:50] was the driver. The last time I had asked him a question about [00:17:55] something personally, it was about moving out the country. And [00:18:00] this was the third time I had asked him. And that third time I’d asked him, [00:18:05] which was sort of 2004 or something like that. He said, don’t [00:18:10] ask me again. Stay in Leicester. And there’s obviously something in it for, for, for me in that. [00:18:15] So when he said open a practice in Leicester I was like, okay, fine, we’ll start looking. [00:18:20] So we saw a few existing concerns, not much going on. And then the premises [00:18:25] that we have, um, is a retail two shops.

Payman Langroudi: Yeah. What was it before? [00:18:30]

Bhavnish Waghela: It was a mobile phone shop, but no, it was, it was more than a mobile phone shop, [00:18:35] though. Yeah, it was a mobile phone shop. But also they were the they were the first BlackBerry [00:18:40] centre in the UK. And when they moved from there to where [00:18:45] they are currently, it was the largest provider of e phone contracts in Europe, [00:18:50] in UK. So very, very large in terms of space as well for [00:18:55] us. So we have upstairs we have the whole building. Um and downstairs is the dental practice, upstairs is space [00:19:00] to do whatever with. Um so in terms of opening in Leicester. [00:19:05] Yeah, we have a lot of connections. I’ve been there for since nine. Yeah, pretty much. So schooling, [00:19:10] friends, temple, social life, in-laws, parents, [00:19:15] everybody.

Payman Langroudi: I’m interested in the faith point here in two [00:19:20] different ways. If you, for instance, when you ask this question and [00:19:25] this person says do X, do you unquestioningly [00:19:30] do X thinking this guy is a experienced human. [00:19:35] Or do you really think there’s some sort of supernatural? He’s he’s [00:19:40] got the answer. Number one. And number two. I bet [00:19:45] fully believing that this is good advice means that it’s almost like a [00:19:50] self-fulfilling prophecy, right? Because every time something’s going wrong, there’s something in your head goes. [00:19:55] But this was the advice I was given. So you push through challenges, you [00:20:00] know, you make bigger plans, knowing, thinking that it’s going to go right. So I’m interested [00:20:05] in, you know, your faith system here. And obviously, you know, all this everything I’m telling you, you know, [00:20:10] like, so are there times where you ever doubt it? Yes.

Bhavnish Waghela: I mean, [00:20:15] okay, so the answer to your first question is there’s an element of both. Firstly, our [00:20:20] guru who passed away in 2016. Sorry. [00:20:25] Um, we have uh, so our guru will announce [00:20:30] a the next one, a successor prior to them passing away. But [00:20:35] no one knows who it is and it’s sealed. So it’s a very large organisation. Um, [00:20:40] we just recently opened a temple. We we opened the world’s largest [00:20:45] Hindu temple in new Jersey on 210 acres. We’ve opened. Last year I [00:20:50] was there for the opening, a Hindu temple traditionally built in Abu Dhabi, [00:20:55] which some of our colleagues have been to. Um, so, you know, we’re good like that and we [00:21:00] do a lot of good for the community.

Payman Langroudi: So when you say guru, this is the global leader of that whole [00:21:05] organisation. Correct? How do you know him so well? Family.

Bhavnish Waghela: So I’ve been going to the temple as [00:21:10] as a child since I was about ten. Um, I [00:21:15] also went to become a monk myself. So after A-levels. So [00:21:20] around the A-level time, I thought, I don’t wanna do this, I want to become a monk. And my dad said, because [00:21:25] with with being a monk, you have the opportunity. Like getting married. Not [00:21:30] all marriages work. So in a similar way, not all monk hoods work. So it [00:21:35] was a case of, right, you’re going to become a monk. There is a bit of a stigma if you do come back, [00:21:40] but ultimately that’s your that’s your choice. So my dad said to me, if you go, I want you to get a degree [00:21:45] before you go or get some. Because if you do come back and you haven’t got anything, then [00:21:50] you’ve got nothing to fall back on. So between A-levels [00:21:55] and starting uni, I thought, let’s check it out. So we have a little we have a village in India. [00:22:00] Population of 600 people. That’s our global training centre for monks [00:22:05] went there. You have to wake up at 4:00. You have to then, you know, [00:22:10] do your daily things.

Payman Langroudi: Pray all.

Bhavnish Waghela: Day. Pray? No. You [00:22:15] are given a timetable. The timetable would consist of that. We have [00:22:20] a sow cows. So you go and clean the cows out. You feed the cows, [00:22:25] then you go and do cooking. You then maybe doing a scriptural [00:22:30] learning. You then have to read learn because I can’t. I could read [00:22:35] some Gujarati so I could read and write basic. So now then they teach [00:22:40] you, then Sanskrit and then Hindu philosophy, Western philosophy, all this sort of stuff. And [00:22:45] then it was quite a lot. And the most important thing is you have to cut ties [00:22:50] with family. Oh, like cut when you actually became [00:22:55] ordained, become ordained as a monk. And that was challenging. So I did that for 4 or [00:23:00] 5 weeks and said, no, this isn’t for me. So I came back. So as a result of all of these [00:23:05] historical events, events, I know our guru really well and [00:23:10] he knows me quite well. So, um, it’s a 1 to 1 type situation. [00:23:15]

Payman Langroudi: When you ask. Yes. And when he says, how much of that would you say is divine intervention [00:23:20] and how much of that would you say? He’s a very experienced person. He’s been asked lots of questions.

Bhavnish Waghela: I’d say. I’d say [00:23:25] about 70, 30, 3070 of it for me is divine and 30% [00:23:30] is experienced because he has. He gets I mean, in his life’s [00:23:35] time, he had written 750,000 letters.

Payman Langroudi: Ou. [00:23:40]

Bhavnish Waghela: Replied to from people asking him all sorts of questions [00:23:45] may not be even nothing, you know, whatever they may be. He’s visited hundreds of thousands, hundreds [00:23:50] and something thousand homes. He was guru from 1971 to when he passed away. [00:23:55] So, you know very well travelled. Um, so.

Payman Langroudi: Then. Okay, so then he says, do it. Then this [00:24:00] thing I’m saying about the self-belief you have when someone says that, did that play a role, is [00:24:05] that where you would turn when things were really bad or. Yes.

Bhavnish Waghela: Because again, going back to our [00:24:10] the philosophy in our sect and Hinduism is God [00:24:15] does everything for a reason. Now if you just think about that one fact, if you truly [00:24:20] believe that, then come what may, even if I’m having [00:24:25] a bad time.

Payman Langroudi: There’s a.

Bhavnish Waghela: Reason. It’s a reason [00:24:30] for it. If I’m having a great time, I’m having gratitude to him or [00:24:35] them. So therefore, uh, in times of strife [00:24:40] or in times of good, there’s always a, uh, belief [00:24:45] that this is for me and my my betterment.

Payman Langroudi: You don’t have to answer this. Yeah, but when [00:24:50] is it that you’ve most questioned your faith?

Bhavnish Waghela: Oh. [00:24:55] Actually, I [00:25:00] would probably say why. You know, I know [00:25:05] that. I know the theory. The theory is that God does things for me and my family. [00:25:10]

Payman Langroudi: Even when in mysterious ways.

Bhavnish Waghela: Mysterious ways. But when things aren’t right, [00:25:15] when things are going, are not going to plan. You think, why? Why me? And I [00:25:20] think that’s quite normal.

Payman Langroudi: When was.

Bhavnish Waghela: That? Um. So [00:25:25] soon after we opened Leicester, I said, like I said, [00:25:30] my my guru was the reason why we opened it to some extent. Yeah, yeah. Um, we opened [00:25:35] and it was like, oh, this isn’t as easy as I thought. Last time I did a squat, it was easy. This time it’s not [00:25:40] as easy. And that was you know, it’s stressful at times because there’s a lot more competition. [00:25:45] And you think I am doing what you ask me? Why is this not happening? That kind of thing. [00:25:50]

Payman Langroudi: And so cash flow crisis and things.

Bhavnish Waghela: Yeah. It happens. Um, [00:25:55] and the challenges we have, you know, from an accounting point of view, they’re separate businesses. And so [00:26:00] it’s difficult to sort of transfer transfer from this or that or a third business or whatever it may be. So yeah. [00:26:05]

Payman Langroudi: But and how do you feel? How come you haven’t gone to three and four and six. Are you content with [00:26:10] two?

Bhavnish Waghela: It’s very interesting. All my friends, like you said earlier, you know, a lot of my friends [00:26:15] are, uh, multiple serial businesses. So, you know. [00:26:20]

Payman Langroudi: Hundreds of things.

Bhavnish Waghela: Chains of things? Yeah. Um, and.

Payman Langroudi: I [00:26:25] expect you could get access to cash, right?

Bhavnish Waghela: Of course I can.

Payman Langroudi: Like, you could raise £5 million tomorrow [00:26:30] if you wanted to.

Bhavnish Waghela: Easily. Yeah.

Payman Langroudi: So what’s made you not?

Bhavnish Waghela: And it’s a case of I’m not [00:26:35] in it for the money. I don’t need, I don’t feel the money is my driver. Okay. [00:26:40] Um, I am comfortable. I have what we need. Um. I [00:26:45] am looking after the future, my family, and that’s all taken care of. Money’s [00:26:50] there, and money is accessible. However, I feel that I [00:26:55] am. There’s more to me than just the dentistry. [00:27:00]

Payman Langroudi: Yeah.

Bhavnish Waghela: So there’s my the temple side of things. Yeah. My voluntary work [00:27:05] for that. Um, and as a parent, as a family man, I [00:27:10] think sometimes what.

Payman Langroudi: Happens is you.

Bhavnish Waghela: Spend time is spent with with with with them is more important. I’d rather [00:27:15] have time at home than at work.

Payman Langroudi: I like that. How old are your kids? [00:27:20]

Bhavnish Waghela: I’ve got one daughter. She’s 18, going through A-levels now. She had a maths mock today.

Payman Langroudi: So [00:27:25] yeah. Mine too. Mine too. Same age right? Yeah. What do you want to [00:27:30] do?

Bhavnish Waghela: Do you want to do architecture?

Payman Langroudi: Did you, did you want it to be a dentist?

Bhavnish Waghela: No.

Payman Langroudi: Like not. Not. Did you tell her to? [00:27:35]

Bhavnish Waghela: I didn’t want her to be a dentist.

Payman Langroudi: Why not? It looks like. Seem to me as one of the most [00:27:40] successful dentists I know.

Bhavnish Waghela: I think I think the challenge. Thank you.

Payman Langroudi: Define [00:27:45] success how you like. Yeah, but I define it as someone who loves their job, good at their job, [00:27:50] and, you know, is living a good life. You seem you seem like [00:27:55] you’re crossing those those things, right? Yeah.

Bhavnish Waghela: I’m fortunate that I am. Yes, absolutely.

Payman Langroudi: So then [00:28:00] why wouldn’t you want that for your daughter?

Bhavnish Waghela: Because I think what I find the biggest pain point for me is, [00:28:05] um, the business is reliant to some extent on me. [00:28:10] Yeah. If I want to. I’m not the kind of person that [00:28:15] will my failings or will go on holiday tomorrow. I will not [00:28:20] counsel patients at short notice. I don’t like doing that. I don’t like that happening to me. [00:28:25] So I like to live by those rules that I want people to live by with me. So [00:28:30] one of the things that I don’t like is I’m not able to live a semi-nomadic [00:28:35] life. Oh, I can’t work from home as easily as I would love to. And I like I’d [00:28:40] like for my daughter to have that independence geographically.

Payman Langroudi: That’s [00:28:45] it. That’s a good point.

Bhavnish Waghela: That’s it. That’s the one thing.

Payman Langroudi: Because, you know, I stopped practising [00:28:50] in 2012 completely. [00:28:55] And when you fully stop, you realise the things you used to love about [00:29:00] it and the things that you used to hate about it. And I used to love [00:29:05] humans. People don’t meet that many people these days. Right? But the thing that I [00:29:10] hated was what you just said. Turning up, having to turn, having to turn up. Yeah, I was [00:29:15] turning up. Turning up. Right now I’m turning up today. Yeah. It’s the having to having to turn up the relentless [00:29:20] nature of that in.

Bhavnish Waghela: My social circle. We meet regularly in [00:29:25] Leicester.

Payman Langroudi: Your buddies?

Bhavnish Waghela: Yeah, yeah. And none of them have [00:29:30] to be, you know, if on a weekday we go out and I [00:29:35] have got home at later than I want to. Yeah, I have to [00:29:40] be in clinic ready to for the show to start come what may. [00:29:45] Every. They don’t have that.

Payman Langroudi: Yeah yeah yeah.

Bhavnish Waghela: Yeah. So and I envy that to some extent. [00:29:50]

Payman Langroudi: It’s an interesting point man. It’s an interesting point. Let’s get back to your childhood. [00:29:55] Yes. What made you even look at dentistry in the first place? What kind of kid were you? Were you, like, a [00:30:00] studious?

Bhavnish Waghela: I was quite studious. I was very, I mean, strict parental [00:30:05] upbringing. Um, we lived in an area in, in Leicester called Oadby, [00:30:10] and I remember being. So I’m born in Africa, my parents about, [00:30:15] uh, Nairobi, Dar es Salaam. We lived in lived in Nairobi, so born in Dar es Salaam, moved to Nairobi, moved here when I was [00:30:20] about 3 or 4. Um, and then my dad was [00:30:25] we moved for economic purposes. My dad got a job here, so he [00:30:30] was working. I was schooling, and it was very much [00:30:35] a case of we are away from the Indian culture. We need to keep strict [00:30:40] Indian values, which which we did.

Payman Langroudi: Yeah. Sometimes even more strict than back home. Right. It’s [00:30:45] almost like.

Bhavnish Waghela: A.

Payman Langroudi: Yeah, overcompensating thing.

Bhavnish Waghela: Overcompensating. Yeah. But the funny thing was that I [00:30:50] was one the area that we lived in just happened to be a very non-Indian [00:30:55] area. So I was one of three brown faces in the school.

Payman Langroudi: Was it Leicester.

Bhavnish Waghela: Leicester in Oadby [00:31:00] to get bullied a lot? Uh-uh, um, my dad made me do martial arts and I did loads [00:31:05] of taekwondo and really good. And there was a lot of sports, but [00:31:10] purely martial arts. Um, and then, um, with regards to dentistry, [00:31:15] I dentistry. I was quite studious, so I wanted to sort of pursue, you know, the traditional medicine, [00:31:20] law, dentistry in those days. Um, and my dad [00:31:25] didn’t, wasn’t pushing me into anything or parents weren’t. But again, going back [00:31:30] to the temple, we had some elders in our temple. Elders meaning someone [00:31:35] older than me, not old, old people. And they were recently qualified doctors [00:31:40] who were doing show jobs and stuff like that. Um, and they sort of put [00:31:45] me off doing medicine, basically.

Payman Langroudi: Junior doctors. Right?

Bhavnish Waghela: Totally put me off. So I [00:31:50] said, fine, I’ll do dentistry because it was the next best thing in a way. Um, so hence that’s why I did dentistry. [00:31:55] I fell into that. And also my dad, my dad had a business at the time, part time, where his [00:32:00] business partner’s son was a dentist. And I sort of saw him have a, you [00:32:05] know, a good life. Exactly.

Payman Langroudi: What did your dad do?

Bhavnish Waghela: So he was a graphic designer. Um, [00:32:10] but he went into project management for a design company, mainly doing [00:32:15] point of sales for Rolex and car watch brands and jewellery [00:32:20] brands.

Payman Langroudi: In that generation that got up from East Africa. Africa [00:32:25] in general and came here. There’s something about that generation. The [00:32:30] ones that did that. Yes. Yeah. Because Africa is an interesting place in itself. [00:32:35] There’s a there’s a, there’s a can do thing about making it in Africa. [00:32:40] And then they brought that here. Yeah. And put the same. And I think there’s so many people [00:32:45] I’ve talked to good friends, people I went to school with as well that that generation just [00:32:50] had. It’s almost like, you know, I don’t know if you’ve seen Gary. Gary Vee. Yes. He talks about sort of the [00:32:55] the benefit of being an immigrant. Yeah. You know, the it’s an interesting [00:33:00] thing. So all right you decide dentistry. You turn up first day back. [00:33:05] Which year was it?

Bhavnish Waghela: 1992.

Payman Langroudi: Guys. Kings or [00:33:10] kings itself? Not guys.

Bhavnish Waghela: Yeah.

Payman Langroudi: Yeah. So the same year as me?

Bhavnish Waghela: Yeah. Okay.

Payman Langroudi: 1990. [00:33:15] So what was your first day? Big city.

Bhavnish Waghela: First day. Big. I hated [00:33:20] it. Did you? I absolutely hated it for the reason. That one. I had just come back from India because, like [00:33:25] I said, I wanted to become a monk.

Payman Langroudi: You were monk.

Bhavnish Waghela: Yeah, yeah. Um, I was alien because [00:33:30] of that. Because I had mentally conditioned. I used to be strict vegetarian. In our sect, we don’t [00:33:35] don’t drink alcohol. We have no onions, no garlic. So it’s a case of. [00:33:40]

Payman Langroudi: Is it Jain?

Bhavnish Waghela: So it’s not it’s Swaminarayan.

Payman Langroudi: Similar.

Bhavnish Waghela: But in terms of the food. Yeah. Because everything [00:33:45] has an effect on it. You are what you eat kind of thing. Um, and then I [00:33:50] was in this town or this city, which was so much bigger, and obviously I’d been to London, but every time [00:33:55] I’d been to London, it was with my parents, or it was with people from the temple. So it was always Neasden, and [00:34:00] now I’m by myself living. I had a for some reason I missed my halls [00:34:05] application, so I was staying in Tooting Bec because I needed somewhere [00:34:10] that was That was self-catering.

Payman Langroudi: Miles away from stranded miles and miles.

Bhavnish Waghela: Away. Miles [00:34:15] away. It was like, I can’t remember what bus it was, but.

Payman Langroudi: It was self-catering for the night.

Bhavnish Waghela: For the food [00:34:20] purposes. So, um, that was bad.

Payman Langroudi: And did you find the course [00:34:25] a struggle? Everyone does to some extent.

Bhavnish Waghela: Initially, yes, because I didn’t do biology at A-level, so. So [00:34:30] it was like, oh my God, I the first time I failed an exam was or first time I had to reset [00:34:35] an exam was biochem.

Payman Langroudi: You know Sarge, you know Sarge, my partner, [00:34:40] we were sitting next to each other in, um, Cardiff and we looked down this microscope [00:34:45] and he goes, well, that’s muscle, isn’t it? And I was like, well, how do you know that’s muscle? [00:34:50] And he and his only thing he could say is I just do. Yeah. You know. And now I get it [00:34:55] in a way. Now I get it, you know, the way muscle looks. Yeah, yeah. But back then I was like, I just could not believe [00:35:00] that that was his answer. I just do.

Bhavnish Waghela: I totally get.

Payman Langroudi: It. Remedial [00:35:05] classes for biology A-level people who hadn’t done biology A-level.

Bhavnish Waghela: Okay. We didn’t have that.

Payman Langroudi: Yeah. [00:35:10] I found it so hard, I found it.

Bhavnish Waghela: I found that a struggle.

Payman Langroudi: Um, did you take [00:35:15] to the clinical better?

Bhavnish Waghela: 100%. I, I also play the the Indian [00:35:20] drums. The tabla. Oh, yeah. And my dad was my. So my dad’s degree was fine art. So we’re quite an artistic [00:35:25] family. Aha. Um, so I’m quite good with my hands. Yeah. And therefore, the [00:35:30] clinical side of things was so much easier.

Payman Langroudi: And did you find a sort of a clique of Indians [00:35:35] that you got into? Yeah. That’s right.

Bhavnish Waghela: Yeah. We still keep in touch. One of my best mates from Uni [00:35:40] Maori, he’s in Melbourne. Neera was in the same year as me. Anoop? Yeah. Anoop was. You’re [00:35:45] above me. Tiff was Europe. So that whole cohort, uh, we know quite well. I know quite well. [00:35:50] Yeah.

Payman Langroudi: So then five years went by. Who was your first ever boss?

Bhavnish Waghela: So [00:35:55] I did, uh, in. Yeah. First [00:36:00] year I did it in a place called Horncastle, which is where it’s basically 20 miles [00:36:05] from Skegness. Oh, it’s a it’s a it’s a really small [00:36:10] town where there were two dental practices. The nearest one was Lincolnshire. Sorry, [00:36:15] Lincoln. Yeah. So there was no support clinically. My. My trainer [00:36:20] was brilliant. Um. Very supportive. He understood the [00:36:25] needs that I had clinically, emotionally, [00:36:30] socially kind of thing. So it was really good in that respect. Um, but [00:36:35] we had to get stuck in because there was nothing around us. Yeah. You know, wisdom teeth and [00:36:40] surgicals and everything.

Payman Langroudi: So what was the hospital that you to get? Oh, [00:36:45] I see, I see. I see.

Bhavnish Waghela: Yeah. Lincoln. Because the whole it was, I was part of the Lincolnshire scheme. So [00:36:50] Jason Wong. Yeah. Was in my cohort.

Payman Langroudi: Right?

Bhavnish Waghela: Yeah.

Payman Langroudi: Funny. [00:36:55]

Bhavnish Waghela: Mad.

Payman Langroudi: Oh, funny. All right. So then I guess you felt a bit isolated.

Bhavnish Waghela: Very much so. [00:37:00]

Payman Langroudi: Skegness.

Bhavnish Waghela: So the round trips. I basically from home [00:37:05] to Horncastle was 90 miles. So [00:37:10] I bought a house. I thought I’d stay there. I lived there six months, then commuted the rest because [00:37:15] it was just I had no. So I just there’s only so much time you could spend with your with your boss. [00:37:20] Right. So. Yeah.

Payman Langroudi: So then you I guess.

Bhavnish Waghela: I did that.

Payman Langroudi: And then that year you [00:37:25] decided I’m coming back.

Bhavnish Waghela: I came back to Leicester. Um, I worked in my one [00:37:30] of my dad’s friends practice. Um, I was there for quite a while. Very NHS. [00:37:35] But my whole thing was doing good dentistry as best as [00:37:40] I possibly can. Um, because it was a case of trying to get [00:37:45] skilled.

Payman Langroudi: So do you remember, even in those early days, learning [00:37:50] things like. What is that guy your first boss doing really [00:37:55] well, and what is he not doing so well?

Bhavnish Waghela: He spoke to patients very well. [00:38:00] Yeah. You know, it wasn’t a case. You know, dentistry seems very much of a sales role at the moment Uh, [00:38:05] with with the kind of dentistry that we’re as a profession are going [00:38:10] into. So, in effect, you’re a glorified salesperson [00:38:15] trying to sell a treatment plan to a patient. And I [00:38:20] don’t like that. So when I was in my, um, [00:38:25] my boss was excellent in explaining treatments without [00:38:30] the need to oversell. Yeah. Yeah. And it was always about. It’s not about the money. [00:38:35] It’s about the patient. It’s always about the patient.

Payman Langroudi: And what about the way he was managing his practice, his staff? [00:38:40] The.

Bhavnish Waghela: So it was quite a homely atmosphere because it was literally [00:38:45] him. One hygienist and myself.

Payman Langroudi: Very friendly, very friendly. [00:38:50]

Bhavnish Waghela: Um, he lived above the practice. The practice.

Payman Langroudi: Was downstairs.

Bhavnish Waghela: Yeah. That kind of thing. [00:38:55] Um, and it was really, really nice because it was a very friendly [00:39:00] atmosphere to work in.

Payman Langroudi: For that first boss is so major. Yeah. It makes such a such a difference. Sets you on a [00:39:05] particular trajectory. Yeah. What about your dad’s buddy? So you knew him well?

Bhavnish Waghela: So we I [00:39:10] knew him. We knew the family. Yeah. Um, and it was a larger NHS practice [00:39:15] in Leicester, so I worked there. And again, it was for me, it was like I was, I [00:39:20] was quite, I would say good at the clinical side of things. [00:39:25] And I was a little bit more on it compared to him because he.

Payman Langroudi: Was old timer. [00:39:30]

Bhavnish Waghela: Old timer. Yeah. And therefore I would get given [00:39:35] more elaborate cases of work.

Payman Langroudi: Cosmetic.

Bhavnish Waghela: I got to do that early [00:39:40] on. And in those days, um, there weren’t really many postgraduate qualifications, [00:39:45] but I did the. What was the MFA or MFA? Yeah. Um, [00:39:50] and then started taking photos of my work and, and sort of criticising it. Yeah. [00:39:55] Probably it started going to a couple of I went to a CD event a few years after that actually. Yeah.

Payman Langroudi: Yeah. [00:40:00] Basically I hadn’t started.

Bhavnish Waghela: No, it hadn’t started then.

Payman Langroudi: Did you do any? Rosenthal.

Bhavnish Waghela: I did the Rosenthal thing. [00:40:05] I we used to do a lot of, um, I did the first Rosenthal thing and I thought, this is not for [00:40:10] me.

Payman Langroudi: But there wasn’t there was no cosmetic dentistry back then. That’s all there was.

Bhavnish Waghela: No, it [00:40:15] was very limited. Yeah. Um, and I felt [00:40:20] that cosmetic dentistry or more restorative dentistry is is [00:40:25] where. So, you know, the whole adhesives thing was, was not around then.

Payman Langroudi: Yeah. It wasn’t.

Bhavnish Waghela: Around. It [00:40:30] was more just prep things and.

Payman Langroudi: Yeah.

Bhavnish Waghela: Do crowns.

Payman Langroudi: Yeah. Yeah, yeah. So then then [00:40:35] how long did you stay in that one?

Bhavnish Waghela: I was there for about three and a half years.

Payman Langroudi: Until you bought your. [00:40:40]

Bhavnish Waghela: Nhs. Then. Then I thought, you know what, now I need to move. I had a bit of cocoming couple of [00:40:45] jobs, uh, met my wife.

Payman Langroudi: Um, she dentist too, isn’t [00:40:50] she?

Bhavnish Waghela: No. She’s, uh. So she’s nothing to do. Dentistry. She did a psychology degree. [00:40:55] Oh. And at the time, she was working as a business advisor in a local [00:41:00] business. Um, a local company that used [00:41:05] to support businesses. So we met whirlwind affair, met [00:41:10] in October, got married in June of the next year, and then we bought a practice the year after.

Payman Langroudi: And [00:41:15] she’s very involved in the running of the businesses. Yes. Um, [00:41:20] to the point that, I mean, it was even obvious to me when I visited that she was taking [00:41:25] care of a lot of the non-clinical side. Yeah. And you were the clinical. Did she did [00:41:30] you sort of plan it that way that you said, like, come into the business?

Bhavnish Waghela: Yes or no? [00:41:35] Um, so again, I suppose when I opened my, the Corby practice, um, I [00:41:40] struggled, you know, I didn’t, you know, when you have an NHS practice, there’s no such thing as marketing. There’s [00:41:45] no need for marketing. And the amount of money I wasted on advertising in this magazine [00:41:50] and that magazine. And so you learn from your mistakes. And I made a lot. Uh, [00:41:55] so we got Chris Sparrow involved in with our, with our practice And, [00:42:00] um, one of the things that Chris said is because I was doing everything clinical dentistry, payroll, [00:42:05] all everything was done by me. And he goes, Bob, you just need to now start [00:42:10] delegating things. So at that point, he was the one that said, right. So we thought, right, [00:42:15] let’s delegate all the stuff to all that stuff to her. Um, [00:42:20] my manager was looking after the staff and whatever it may be. So yeah. And since that [00:42:25] day, that division has been very good.

Payman Langroudi: I think Chris Barrett, [00:42:30] he gets a bit of stick, but I remember a time walking [00:42:35] into practices and thinking, he’s been here. You can tell. He can tell. Yeah, you can tell. There was [00:42:40] something about I mean again, these days it’s so common. Um, but back then he was way [00:42:45] ahead of his time at 100%. Way ahead of his time, 100%. So all right, you [00:42:50] start the NHS practice or you buy by the NHS practice. [00:42:55]

Bhavnish Waghela: Yeah. So that was an old retirement sale. Yeah. It was It was literally 600ft². The [00:43:00] guy didn’t do anything other than amalgams. We took over [00:43:05] May the 4th, I remember it. 2001. We [00:43:10] closed it for a week, and I remember in his surgery he had a large [00:43:15] window that the patients would face with a net curtain. I [00:43:20] remember taking the net curtain down. There were crowns in it because they were flicked, you know, it was the [00:43:25] most disgusting practice. Literally, it was terrible. They had the old school, [00:43:30] um, X-ray developing.

Payman Langroudi: Thing.

Bhavnish Waghela: And that was literally I had to get a sander to [00:43:35] remove that. So we just just cleaned it up. Myself, my friends [00:43:40] and brother and everyone, we just chipped in, you know, the old school sort of family business thing [00:43:45] got in there. Within a week we’d turned it around, opened and.

Payman Langroudi: Yeah, [00:43:50] but at this point, you weren’t doing any of the implants? No. So when, when [00:43:55] did that level of Clinical. I mean, you know, to want to open a private practice, [00:44:00] obviously your your clinical skills must have moved on. So what was [00:44:05] sort of the point that you went, well, I’m going to do private dentistry. Why? I mean, you know what I mean. [00:44:10] You could you could still be an NHS dentist today.

Bhavnish Waghela: Absolutely.

Payman Langroudi: But something flicked in your head.

Bhavnish Waghela: I did. Um, [00:44:15] so it was a case of I wanted to do something that would sort of. I wanted to do [00:44:20] it in those. I did the Eastman Year certificate course. Good one.

Payman Langroudi: And restorative. [00:44:25]

Bhavnish Waghela: Yeah. And the restorative.

Payman Langroudi: Back then, it really was the.

Bhavnish Waghela: It was really, really good. And what what I realised then [00:44:30] was, um, you get to hone your skills in various various [00:44:35] disciplines. Yeah. Um, and from then I met [00:44:40] a wonderful lady called Ryvita who passed away. Um, Raj Prakash and Ravi to Prakash [00:44:45] Raj.

Payman Langroudi: Prakash.

Bhavnish Waghela: Raj Prakash, his wife, she passed away. Yeah. So she was on the same cohort as [00:44:50] me. And I know Raj from King’s. So I used to. And he was doing [00:44:55] implants. So he then said, look, Bob, there’s this Ashok Sethi’s course. [00:45:00] So I did Ashok’s one year jump. Brilliant.

Payman Langroudi: So you got [00:45:05] NHS Eastman?

Bhavnish Waghela: Ashok Sethi I did the Eastman course. Ashok course at 33 [00:45:10] Harley Street. Ashok was brilliant.

Payman Langroudi: Opened your eyes to that.

Bhavnish Waghela: Opened my eyes. But he was really [00:45:15] open hearted as well. Because I would go in on a day when he would be working. I’d take [00:45:20] a day off and go and see him. He’d be my. He was basically my mentor. Then I did the World [00:45:25] College Diploma when he was still director of it.

Payman Langroudi: Yeah, yeah.

Bhavnish Waghela: Um, and [00:45:30] then. But that was after I’d opened my. So I did Ashok’s course, started placing [00:45:35] implants, and and that was when the new contract was had come [00:45:40] in, and I was like, you know, do we grow? What do we do? And I thought, I can’t really grow [00:45:45] in the premises that I was in. I can’t really promote the kind of dentistry that I want [00:45:50] to do. So then we then open this.

Payman Langroudi: It seems like today, it seems like [00:45:55] such an obvious thing to become like one of the early implant ologists in Leicester. I mean, massive [00:46:00] population in that area, right? You know, people don’t realise the population [00:46:05] of Leicester and its surrounding huge towns is like Birmingham, you know, it’s like a huge, [00:46:10] huge population. Today it seems so obvious, but you must have sort of worried that, [00:46:15] you know, is there space for an implant practice here?

Bhavnish Waghela: If you think about it, when I opened [00:46:20] the practice in Corby.

Payman Langroudi: Yeah.

Bhavnish Waghela: Corby at the time was the teenage [00:46:25] pregnancy capital of the Europe.

Payman Langroudi: Yeah. At the time when back then, everyone was blaming everything [00:46:30] on single mums instead of immigrants. Absolutely.

Bhavnish Waghela: Yeah. So [00:46:35] it was terrible. And in fact, I remember when I opened the when we were opening the, the [00:46:40] practice and my manager at the time, Carol, she’s, she’s from Corby, she was like, I’m not [00:46:45] sure if this is going to work.

Payman Langroudi: Mhm.

Bhavnish Waghela: Um, we’ve had some trouble. I remember one day we went in [00:46:50] and it was private dentistry awards. We were an up for an award 2000. [00:46:55] I can’t remember what year it was and I woke up. I had my alarm had gone off [00:47:00] and we had a car that had gone off the main road and crashed [00:47:05] into my front door in my practice, like, what the hell? We had to [00:47:10] stop. Yeah, yeah, but it’s in those. You know, when you said they say [00:47:15] diamonds are made under pressure and the team were brilliant, [00:47:20] we worked really well. So it was. But those that Corby practice or [00:47:25] that opening, that kind of practice in Corby was a challenge because [00:47:30] of the demographics of the area.

Payman Langroudi: Yeah. I want to get on to Implantology itself [00:47:35] a little bit. Okay. Um, because there’s definitely a [00:47:40] split between dentists who kind of are being very crude here, like blood [00:47:45] and don’t like blood. Yes. Yeah. There’s definitely some people do not want to ever [00:47:50] cut a flap. Yeah. Yeah. And then you get the other type. Who up for it? You know, maybe they’ve [00:47:55] done an oral surgery job or something, but they’re up for it. Do you remember [00:48:00] being the first type and forcing yourself to become the second type, or were you always that surgically [00:48:05] orientated kind of cat? Did Ashok unlock you?

Bhavnish Waghela: I think Ashok [00:48:10] unlocked me. I’ll tell you what I think. I think one of the things that I found was when I did the, uh, [00:48:15] restorative course at the Eastman. There wasn’t any surgery in that [00:48:20] at all, but the restorative aspect of it grounded me. [00:48:25]

Payman Langroudi: It’s important, isn’t it? I mean, we think of implant ologists as someone who sticks screws in the bone, but [00:48:30] it’s the full planning of the case. That’s the key.

Bhavnish Waghela: I think that’s the problem. I think, you know, [00:48:35] the oral surgery head leads to, oh, I can put an implant there [00:48:40] because there’s bone there, but then you’re not thinking about the restorative.

Payman Langroudi: Absolutely.

Bhavnish Waghela: So, [00:48:45] um.

Payman Langroudi: Is that a good basic understanding of.

Bhavnish Waghela: Of the That’s [00:48:50] pretty, pretty well versed from what I remember at uni and then post [00:48:55] uni. Um, I liked to keep abreast of what was available in terms of courses [00:49:00] and things. Um, and then when I did Ashok’s course, that was like, I wasn’t scared [00:49:05] of cutting a flap, ever. Um, because again, when I was at King’s, [00:49:10] we got chucked in at the deep end. Um, unlike things now [00:49:15] where you’re probably lucky to get a crown, whereas then it was you just [00:49:20] go in. And at that time, we also had I remember we had a two week stint [00:49:25] at A&E where we were suturing all sorts of things. You know, whether it was a knee or a [00:49:30] mouth, it didn’t make a difference. So you had to do it. Yeah. Um, so for me, [00:49:35] it was more always being an extension of the restorative side more than [00:49:40] the surgical side.

Payman Langroudi: Alright. So the first thing is the kind of person who throws themselves [00:49:45] in. Yeah. Um, loads of people do the do the training and then don’t end [00:49:50] up putting many implants in. Tell me about that. I mean, like, if [00:49:55] you were going to give a young dentist’s advice or anyone’s do implantology. First of all, you say [00:50:00] get some training. Yeah, yeah. But loads of people get the training and don’t end up doing any implants. [00:50:05] What’s the what’s the unlock there?

Bhavnish Waghela: I think I think going back to basics again. So firstly [00:50:10] learn to restore. Um, if you’ve got to. That’s what I’m, that’s.

Payman Langroudi: What I.

Bhavnish Waghela: Want to. I’d [00:50:15] recommend learn to restore do some restoration. So you know the the nuances [00:50:20] of implant placement. Yeah. Um, and I think it’s technically [00:50:25] easier now because of guided surgery, guided placement. But [00:50:30] I feel that if you know where to restore, then do a decent [00:50:35] course. I’m not here to say what course, but ultimately do a course. Get [00:50:40] a mentor. Yeah, I think that’s really important because ultimately things can [00:50:45] go wrong. And if you don’t know what to do, you’re a bit stuck.

Payman Langroudi: Have you mentored [00:50:50] people?

Bhavnish Waghela: I have done, yeah. Um, we used to. Again, [00:50:55] it was one of these things that Chris recommended we do where, um, it was a case of reaching [00:51:00] out to our local practices for, um, referrals. Yeah. So [00:51:05] we did that, and then I would mentor associates or practices to come, and I’d go in there, [00:51:10] they’d come to us.

Payman Langroudi: I mean, implant mentoring is one of those things where it’s you’re going [00:51:15] to have to pay for it often. Yes. Because, you know, these are highly skilled people giving up their time. [00:51:20] But I think people underestimate the number of people who will say, [00:51:25] sure, come and watch me for a day.

Bhavnish Waghela: That’s what I used to do.

Payman Langroudi: You know that watching [00:51:30] watching experienced people. It gives you so much more than the treatment planning [00:51:35] piece. You know, it gives you just a whole lot of different skills.

Bhavnish Waghela: You know, like we said earlier, [00:51:40] it was a case of, you know, communication is not just [00:51:45] what you say, it’s how you say it.

Payman Langroudi: And the nuance, isn’t it?

Bhavnish Waghela: Those nuances [00:51:50] that really make a difference to how patients see you and how the team sees [00:51:55] you and stuff like that.

Payman Langroudi: So now let’s talk about, okay, you’ve done implant training. This this [00:52:00] this young dentist has done some implant training. He’s got himself a mentor. He’s maybe even stuck a [00:52:05] few implants in. This is so unfair. What I’m going to ask you next here, the [00:52:10] question is this. Yeah. If you had to boil [00:52:15] it down to 1 or 2 aha moments regarding [00:52:20] implants. What? Think back to [00:52:25] what were 1 or 2 unlocks in your own head. Moments of of of unlock [00:52:30] that you thought aha. Now I understand implant. Now now that I get that more and I’ve [00:52:35] asked this question, I asked Nilesh, uh, Palmer and he said, [00:52:40] uh, suturing. I asked Andrew Darwood and [00:52:45] he said 3D thinking, you know, and examples of [00:52:50] when it was that what comes to mind if I say, aha, where you thought, God, I’ve [00:52:55] got this, now I get it, now what happens? Soft tissues.

Bhavnish Waghela: I think we always underestimate [00:53:00] the power of the end result in terms of [00:53:05] soft tissues.

Payman Langroudi: Yeah, the emergence profile.

Bhavnish Waghela: Emergence profile, but also the thickening of [00:53:10] that connective tissue grafting where appropriate, using it, [00:53:15] being able to do it.

Payman Langroudi: To your advantage.

Bhavnish Waghela: To your advantage. Because so many people come [00:53:20] with, uh, you know, especially free end saddles, it’s like maxillary [00:53:25] free and saddles, you have to do a sinus graft, and then you [00:53:30] are left with that vertical height [00:53:35] loss discrepancy. And a lot of dentists would just put pink porcelain. I’m not Ashok [00:53:40] taught me. He’s not a big fan of pink porcelain, so wherever possible [00:53:45] we avoid that. Obviously with full arch cases it’s a different thing. But in the posterior area [00:53:50] we sort of like not to do that.

Payman Langroudi: So what do you do to sort of avert from having [00:53:55] to do that?

Bhavnish Waghela: So I’ll do I do a fair amount of soft tissue grafting.

Payman Langroudi: Grafting.

Bhavnish Waghela: Um, yeah, [00:54:00] basically.

Payman Langroudi: And so did you have a situation where [00:54:05] you didn’t do that, you found that and you know, like the the unlock?

Bhavnish Waghela: Yeah. I had a patient [00:54:10] where I had placed implants on her right side. Absolutely. [00:54:15] No problem. It wasn’t it was a bounded saddle. So I think I placed a four and five, probably some of the easiest implants. [00:54:20] You can do loads of bone, put them in nice position, nice, straight. And [00:54:25] then then something happened. Uh, I had to do the left hand side and [00:54:30] there was a bit of a recess there, did some grafting and I didn’t do a tissue graft. [00:54:35] Um, and what ended up was that the tooth looked really long.

Payman Langroudi: Yeah. [00:54:40]

Bhavnish Waghela: It worked. There’s loads of bone there, but it looked long [00:54:45] visually. Not when she smiles, but when she lifts up her cheek so [00:54:50] she doesn’t look the same as this side.

Payman Langroudi: Yeah, yeah. And the learning curve around soft tissue. [00:54:55] Is it much more difficult? Must be right.

Bhavnish Waghela: Much less.

Payman Langroudi: Predictable.

Bhavnish Waghela: First it’s. I think it’s. [00:55:00] I think it’s fairly predictable in the right if you understand the process.

Payman Langroudi: What you’re.

Bhavnish Waghela: Doing. Yeah, yeah I [00:55:05] did. Um, Kelly’s courses. I’ve done a few of those. So he’s [00:55:10] very good. Um, and again, go back to Ashok [00:55:15] again.

Payman Langroudi: No.

Bhavnish Waghela: So, yeah, but also think of some of the things that Ashok was teaching at [00:55:20] the time was obviously this is pre surgery. Pre um scanning. [00:55:25] Yeah, yeah. So he was um placing and [00:55:30] taking an impression at the first stage surgery. [00:55:35] Closing it. Yeah. And then getting his technician to create [00:55:40] the soft tissue in wax, and then making a restoration to that defined [00:55:45] soft tissue before and then making a provisional. And then you’re training that that works really well. [00:55:50] Yeah.

Payman Langroudi: You kind of pioneered that. Yeah. Yeah. So now [00:55:55] going forward, how much of your work is guided and how much is most of it guided [00:56:00] now.

Bhavnish Waghela: I’d say a about. 60% [00:56:05] guided. But all my [00:56:10] full arch cases.

Payman Langroudi: Let’s say guided, wasn’t available. You could still pull it off. Right.

Bhavnish Waghela: Because yeah, I mean, that’s how we did. [00:56:15]

Payman Langroudi: That sort of baptism of fire. But do you see some some youngsters who have [00:56:20] gone straight to guided and and don’t have the basic skills. Does that happen?

Bhavnish Waghela: I’m sure it [00:56:25] does. Um, I haven’t seen anybody, but I’m sure it does because ultimately the. You’re relying [00:56:30] on that guide. Yeah, you’re relying on the accuracy of that guide and the planning [00:56:35] to give you exact position in the In the bone. Um, and. [00:56:40]

Payman Langroudi: How often does that go wrong? The guide. The guide is inaccurate, for [00:56:45] whatever reason. I mean, what are the things that go wrong with the guide?

Bhavnish Waghela: I think the [00:56:50] biggest problem with guides, uh, would be cooling.

Payman Langroudi: Mhm.

Bhavnish Waghela: Um, [00:56:55] I think if you’ve got a decent scanner, um, obviously [00:57:00] most and it also depends on who’s doing the planning. I mean I do my planning myself. Yeah. So [00:57:05] I’m planning it. Everything in house. Um, so I don’t think [00:57:10] it can go that wrong. But if you don’t know the surgical nuances of bone [00:57:15] density and placement and, you know, just the lingual [00:57:20] recesses that can occur around in the mandible [00:57:25] and stuff like that, just basic anatomy, then I’m sure things can go.

Payman Langroudi: Interesting, isn’t it? Because all of [00:57:30] this, as we call we call all of this experience. Yeah. But experience [00:57:35] comes from errors. 100% right. You know. And you say, oh, I want [00:57:40] to really experience doctor to do my work or whatever that means. He’s made lots of errors. I [00:57:45] remember.

Bhavnish Waghela: I remember my we we had this we it was a case of we [00:57:50] were doing so few in the early days. And then suddenly when things start to [00:57:55] fail, you start to think, why are they failing? I said, because we’re doing a lot more. Yeah, it’s a statistical. [00:58:00]

Payman Langroudi: Exactly, exactly. So how many do you do now?

Bhavnish Waghela: Probably [00:58:05] about 5 or 600. Depends. Oh.

Payman Langroudi: So it’s most [00:58:10] of your work?

Bhavnish Waghela: Yeah.

Payman Langroudi: So do you not do.

Bhavnish Waghela: I do, I do, I do I [00:58:15] don’t do, I don’t do many fillings.

Payman Langroudi: Crowns or.

Bhavnish Waghela: Crowns, I do, I do because I enjoy doing crowns. [00:58:20] I enjoy doing cerec. Most of my work is part of a rehab of some [00:58:25] kind. So if I’m doing crowns, it will be. I mean, this morning it was four crowns [00:58:30] and two implants, placement and prep and whatever that kind of thing is. So it’s it’s more of a. [00:58:35] The. Yeah, a big change in that respect.

Payman Langroudi: An overall treatment. [00:58:40]

Bhavnish Waghela: Plan. Treatment plan. Yeah.

Payman Langroudi: So look you did what you did, but let’s say your [00:58:45] daughter was going to be a dentist and she wanted to be [00:58:50] a surgical dentist. What what what would be the advice now? Because [00:58:55] it’s a different era now. Yeah. I mean, for instance, what you’re saying about the [00:59:00] restorative side. Would you send them off to Kauai first? I would.

Bhavnish Waghela: I think I think [00:59:05] I would recommend she does some kind of.

Payman Langroudi: Uh, occlusion.

Bhavnish Waghela: Occlusion, [00:59:10] restorative training first. Um, and then I [00:59:15] would, you know, surgical training is is recommended. [00:59:20] I mean, I was fortunate because when I did my PT, we [00:59:25] had to do everything ourselves. Um, I would go to the local hospital and [00:59:30] shadow. And what do the max facts. Um. So [00:59:35] it was, it was good. And then obviously in Leicester I’d go to the [00:59:40] max there and get, get stuck in. I did a clinical assistantship [00:59:45] in, in the max in Leicester, did a restorative clinical assistantship there as well. So it was working [00:59:50] in various different aspects of it.

Payman Langroudi: I bet you knew all the people in the hospital. That’s [00:59:55] how you got there.

Bhavnish Waghela: No I didn’t I wish I did, I do now, I didn’t [01:00:00] then.

Payman Langroudi: I just figured when I came to Sweden I was like, this guy knows everyone [01:00:05] in this town. Oh. All right, so one [01:00:10] last thing on implants. All on four.

Bhavnish Waghela: Yes.

Payman Langroudi: I’m more interested. I’m more [01:00:15] interested in the marketing side of that. What do you do to get all on four patients? I mean, are you [01:00:20] doing ads? Are you?

Bhavnish Waghela: We are doing some ads. Uh, we we are doing some ads. [01:00:25] But I think what we’re looking, we tend to say to patients or [01:00:30] ask our ads, focus on pain points. So more along [01:00:35] the lines of are you struggling chewing? Are you [01:00:40] having these ads?

Payman Langroudi: Ads like newspaper ads?

Bhavnish Waghela: No, they’re more online ads.

Payman Langroudi: So [01:00:45] that age group, do I guess they’re on Facebook, right?

Bhavnish Waghela: Facebook?

Payman Langroudi: Yeah, yeah.

Bhavnish Waghela: Um, [01:00:50] we have done, um, little campaigns. [01:00:55] We do every now and again. We’ll do like an open implant. Implant open evening [01:01:00] where we’ll just invite people to come. We’ll do some form of marketing to attract people. Um, [01:01:05] and then they come in. Initially when we did them, we would have a time slot in the evening. [01:01:10] So we’d have some food and we’d have 15, 20 people come. Ask [01:01:15] as many questions as you’d want. I do a little presentation to the patients. Um, and [01:01:20] then we’ll have a quick look in the mouth and say, yes, you’re suitable. Let’s get you booked in. That’s how we’ve done [01:01:25] it.

Payman Langroudi: And how many of those do you end up doing? Like all on [01:01:30] fours. Is it loads.

Bhavnish Waghela: It’s probably not that many. We don’t. It’s not an we’re not an [01:01:35] all on four focus. It’s not my focus.

Payman Langroudi: Um, have you been to Evo?

Bhavnish Waghela: I have. [01:01:40]

Payman Langroudi: Phenomenal, right?

Bhavnish Waghela: Very slick.

Payman Langroudi: I want to have him on.

Bhavnish Waghela: Yeah.

Payman Langroudi: I want to have him on.

Bhavnish Waghela: Um, [01:01:45] I’ve been to Evo, but the trigger was, um, [01:01:50] a practice in Germany. In Ulm. Michael weiss. Unbelievable. [01:01:55] This this clinic is huge. They have a tree in the in the reception. Wow. [01:02:00] Um, and I went there through Bree Dent ages ago. Um, [01:02:05] and they were very slick. It was like you got three choices. Dentures, [01:02:10] fixed teeth, or somewhere in the middle, which will fall [01:02:15] out.

Payman Langroudi: Basically.

Bhavnish Waghela: So, um, but we do maybe [01:02:20] 3 or 4 a month.

Payman Langroudi: It’s a lot. Still a lot.

Bhavnish Waghela: Yeah.

Payman Langroudi: Let’s move [01:02:25] on to the darker part of the pod. We like to talk about Errors? [01:02:30]

Bhavnish Waghela: Yes.

Payman Langroudi: Chemical errors. What comes to mind? You [01:02:35] know. Have you have you. Have you heard of Black box thinking? It’s a it’s a book where a plane crashes. [01:02:40] Mhm. They look at the black box. They find out what happened. Then they distribute [01:02:45] that information across all the pilot community all over the world without any blame. [01:02:50] And they say look this is what went wrong. Let’s all try and learn from it so it doesn’t happen again. But [01:02:55] with medical Dental, we don’t do that. Yes. We tend to sort of hide from [01:03:00] our errors. We do because blame is a big factor.

Bhavnish Waghela: 100%.

Payman Langroudi: So to [01:03:05] buck that trend, what comes to mind when you think clinical errors?

Bhavnish Waghela: Yeah. Uh, the first [01:03:10] thing is more of a straightforward cosmetic thing with with [01:03:15] a simple partial denture. Had a, had a patient very [01:03:20] early on. She wanted a partial. She had a partial. We made [01:03:25] her a new partial. She went home. Her daughter didn’t like it. Wanted her money back. [01:03:30] Fine. So what we do now is if we’re [01:03:35] doing anything that is, uh, removable or even fixed, [01:03:40] uh, even if it’s, like, for an all on four case prior to finishing, if [01:03:45] it’s a removable, take it home, leave it, show [01:03:50] as many people as you want before you approve, because [01:03:55] once it’s approved, we’re not going to change it. And if you do want to change, it will cost you. So they are given plenty of time [01:04:00] to confirm they’re happy with that. If it’s a fixed [01:04:05] solution, um, we’ll do a try in, uh, we’ll take loads of photos, [01:04:10] loads of videos, and we’ll send that to the patient. Um, and then so those [01:04:15] are cosmetic things and that all of those changes that I made in our practice were mainly because of this [01:04:20] one lady whose daughter didn’t like her. Partial.

Payman Langroudi: Yeah. Um, I think it’s a good [01:04:25] thing, you know, to prep the Prep the patient and say some of your nearest and dearest aren’t going to like it because [01:04:30] there’s good reasons for it. I stuck veneers on my dad and I remember [01:04:35] pulling the chair up. I remember the nurse going, oh my God, that’s beautiful. My dad, for the first time in [01:04:40] my life, telling me he’s proud of me. And I looked at him, thought, that’s not my dad anymore. Yeah. You know, like [01:04:45] I was used to the gaps. Yeah. You know, the weakness was what I loved about him or whatever it is. Yeah. [01:04:50] So I get why it could happen.

Bhavnish Waghela: And this is it. Because ultimately, I mean, more [01:04:55] often than not, it’s a third party who will trigger [01:05:00] a complaint of some kind.

Payman Langroudi: And it’s a complex situation, right? Sometimes we’re talking about 50 [01:05:05] grand of spend. Absolutely. Yeah. So he’s gone off and someone’s persuaded him spend this money. He didn’t even need it in the first. You know [01:05:10] what I mean? Something like that. Yeah. Go on.

Bhavnish Waghela: So that’s the first thing that was a really straightforward [01:05:15] way very early on. So that was the other thing. Sometimes what happens is we get caught up [01:05:20] in the haste Of [01:05:25] treating patients because a patient puts pressures on [01:05:30] us. I want it ready for this date. Yeah. And I don’t think patients understand that. [01:05:35] Uh, especially when a situation is bad from the get [01:05:40] go. So I remember quite a year, many years ago, a patient [01:05:45] had an event that they wanted to be done by. She had some [01:05:50] gingivitis. She wanted some veneers. So we did it very quickly. She was sedated [01:05:55] and obviously she had some black triangles, post [01:06:00] everything healing. And it was like, okay, I’ll do it. We’ll do it again. But it was [01:06:05] a painful experience.

Payman Langroudi: So what happened in the wedding?

Bhavnish Waghela: She went to the [01:06:10] wedding with, like, black triangles because it could be done in time, [01:06:15] right? You know, again, it was like, you know, if you’d come on time again, it’s just you.

Payman Langroudi: But [01:06:20] how did the patient take it?

Bhavnish Waghela: She was really upset.

Payman Langroudi: Yeah.

Bhavnish Waghela: Very upset. [01:06:25] Um, and then they were emigrating. So it was. [01:06:30] We’re moving out the country. I’ve got to go to this wedding. It’s my brother or sister’s wedding. She [01:06:35] had the. She was wearing a, um, one of those clicky [01:06:40] smiles. Oh, really? Snap on, snap on. Smiles. So when she took it off, it [01:06:45] was horrendous underneath. So.

Payman Langroudi: You [01:06:50] tried to be a hero.

Bhavnish Waghela: We tried to be a hero. So hero antics. I think what happens is we tend to try [01:06:55] and save teeth for patients because we feel that it’s ours and it is [01:07:00] our responsibility ultimately to help them. But sometimes we have to tell a patient what can be done and can’t [01:07:05] be done.

Payman Langroudi: Yeah.

Bhavnish Waghela: We have to be honest about that.

Payman Langroudi: Often. It’s not. It’s being honest with yourself as [01:07:10] well. Right. Often you’re pushing the boundaries a little bit and the patient doesn’t realise. [01:07:15] You haven’t sort of made that clear to the patient that I’m pushing the boundaries a little bit [01:07:20] on this one. Um, and then it goes wrong because you’re because you’re pushing the boundaries. And [01:07:25] then we’ve got a situation.

Bhavnish Waghela: So very often I mean I think the, the older I’m getting the more I’m [01:07:30] telling them the, the this is not possible. Or if I’m doing this, I don’t think it’s going to last as long [01:07:35] or let’s be honest about this, this is this is the.

Payman Langroudi: I [01:07:40] like those two stories. But I just think for someone who’s done as many implants as you, for [01:07:45] instance, there must be a better story than those two stories.

Bhavnish Waghela: About a few implants [01:07:50] fall out on me.

Payman Langroudi: Go on.

Bhavnish Waghela: Oh, there’s this one. There’s this one girl, one lady that I that [01:07:55] comes to my I mean, she’s brilliant. She still sees me now. Uh-uh. Uh, bilateral sinus lift. She’s an ex-drug [01:08:00] user. I’m not a smoker. Her gran [01:08:05] was. I did all on for her. For her gran. She was paying for this. This [01:08:10] granddaughter of hers. And these just, you know, I think I did bilateral sinus lift, waited six, eight [01:08:15] months, put implants in left hand side one fell out, the other one [01:08:20] fell out, another one fell out. Fell out. Oh, shit. And it hadn’t happened to me before because [01:08:25] it’s always worked in my hands.

Payman Langroudi: Yeah.

Bhavnish Waghela: And then you start looking at the the [01:08:30] physiological aspect of Implantology, uh, or [01:08:35] the health related aspect of it.

Payman Langroudi: I mean, the drug abuse and all that.

Bhavnish Waghela: Yeah. But she still sees [01:08:40] me. So it was a so.

Payman Langroudi: She was.

Bhavnish Waghela: Cool. She was cool because but from a clinical point of view, I [01:08:45] should have waited longer. I should have explained to her that, you [01:08:50] know, I wasn’t as frank about how [01:08:55] things can fail is more communicative, isn’t it?

Payman Langroudi: Hadn’t happened [01:09:00] to you before? No. Yeah.

Bhavnish Waghela: And it was probably one of the first patients that I’d seen where [01:09:05] I had that history. In fact, the only person I’ve seen with that history.

Payman Langroudi: Yeah.

Bhavnish Waghela: So. Yeah. [01:09:10] Luckily, I’ve been fortunate. Nothing.

Payman Langroudi: If I say. What about if I say who is your most difficult patient? [01:09:15]

Bhavnish Waghela: Invisalign patients.

Payman Langroudi: Because they get suddenly very exacting, [01:09:20] don’t they?

Bhavnish Waghela: Luckily, I don’t do much. But I think what happens is as your teeth become straighter, you become more and more, and [01:09:25] they forget where they came from.

Payman Langroudi: Listen, I’ve been that parent. I’ve been that parent with my own [01:09:30] kids, Invisalign or my own kids ortho. Where at the end I’m just giving the guy, not me, my wife [01:09:35] giving the guy a really hard time about this one millimetre. Yeah. You know. [01:09:40]

Bhavnish Waghela: And I think I think what happens is we, we as I think [01:09:45] okay. So firstly patients forget where they come from. Mhm. Um [01:09:50] we are not at good at communicating [01:09:55] what can and can’t be done from the get go. And I [01:10:00] think we’re all scared of being sued FTP, whatever it may be that [01:10:05] we will say okay fine, I’ll do what I can. Yeah, [01:10:10] yeah. Um, and often there is not much we can do. Um, I. [01:10:15]

Payman Langroudi: Think there’s a tension. Do you recognise this here? That it’s. It’s a young a young man’s trap to fall into. Yeah, [01:10:20] but the tension between you mentioned it before making the sale. Yes. [01:10:25] Yeah. The amount of enthusiasm you have to have for it. Yeah. I can take care of this [01:10:30] in order that the patient gets confidence so that you make the sale. And what [01:10:35] you just said, pointing out all the limitations of the treatment. And [01:10:40] it’s a young man’s trap because actually and we both know it, that we’re getting to the stage where we’ve had [01:10:45] to talk to doctors and, you know, family members and all that, actually a doctor or [01:10:50] a lawyer who tells you A, B, C, X, Y, and Z are big risks [01:10:55] here. Yeah. Do you actually respect that guy more? Yeah. Than the one who says, [01:11:00] yep, we can do this. Let’s go. Yeah. Because we all know nothing is yet. We can do this. Let’s [01:11:05] go in medicine. Right.

Bhavnish Waghela: Absolutely. I think I’m.

Payman Langroudi: Very, you know, where we sell the Invisalign? [01:11:10] Because now we made a silly target for the Invisalign open day. We said yes, let’s sell [01:11:15] ten Invisalign. Let’s get everyone geed up over that fact. Yeah. Now we’ve pushed [01:11:20] someone to say, hey, go ahead. We’re going to make this beautiful. Now, a year later. [01:11:25] Yeah, that comes back to get you, bite you. You know.

Bhavnish Waghela: So this is the thing that we’ve done. We’ve, we’ve [01:11:30] I think some of the, one of the things that we’ve done with our open days, whether they’ve been we don’t do many Invisalign open [01:11:35] days, we’re not an Invisalign practice or business, um, is even when we’ve [01:11:40] done open days or smile makeover open days, we’ve always we’ve very [01:11:45] rarely put really strict targets in place for our team, because ultimately [01:11:50] we’ve always felt that the end result is a happy patient, rather than [01:11:55] however many veneers or however many case acceptances. [01:12:00] Obviously, that’s part of the business. We have to look at those figures, but it’s not the [01:12:05] be all and end all of what we do in our practice. Um.

Payman Langroudi: The funny thing with aligners [01:12:10] is, as people discount them, there isn’t that much money in aligners [01:12:15] is anymore?

Bhavnish Waghela: No.

Payman Langroudi: You know. And this effect that you’re talking about is exacting [01:12:20] patient who needs to revision what they call it revision? No. Um, refinement. Refinement. [01:12:25] Yeah. So you’ve got a double whammy. People are bringing their price down, throwing in free everything with it, and then refinements [01:12:30] on top. It’s not as profitable as a couple of rounds. Exactly. [01:12:35]

Bhavnish Waghela: Well, this is it, isn’t it? I mean, I sort of talk to my associates and I say, look, ultimately, if you think [01:12:40] about an Invisalign case, um, it’s going to take you this amount of time [01:12:45] and this many visits and you’re going to make from a, from a purely, [01:12:50] very simple profit and loss, you’re going to gross this much. Whereas [01:12:55] if you did two crowns and we have cerec, [01:13:00] um, you can it’s going to it’s such a no brainer.

Payman Langroudi: Yeah, yeah, yeah.

Bhavnish Waghela: So Quadrant [01:13:05] Dentistry you’re doing best. Good quality quadrant dentistry for the patient [01:13:10] is far more profitable from a business point of view for everybody.

Payman Langroudi: Yeah. [01:13:15] Tell me about associates. Do you reckon [01:13:20] you’re quite good at spotting a good associate? Because you’ve had some people. Gomez. Yeah. Talked [01:13:25] about? Yeah. Who? You know, gone on to do things of their own. And, you know, I guess they’ve learned from you [01:13:30] as well. Yeah.

Bhavnish Waghela: I think I think, um, there is an element of it’s a two way street. [01:13:35] Mhm. I believe that there are some people that want to learn. Yeah. And [01:13:40] some people that want to earn. Mhm. And I, I have [01:13:45] hired both and I’ve fired those that just want to earn. Mhm. [01:13:50] Um historically we’ve done that because again you know there [01:13:55] is a really because both the practices have been nurtured, [01:14:00] patients have been nurtured by me and the team. We have an element of [01:14:05] expectation by patients and by the staff of how a patient is treated [01:14:10] by associates. Mhm. Um, and you know, I did an audit of how [01:14:15] much free stuff I’ve done, and we’re talking thousands of pounds [01:14:20] worth of stuff, because for me, it’s not about the money. It’s. I’ll [01:14:25] fix it. Don’t worry about it. You’ve paid me to do this. I’ll. I’ll sort it. Um, whereas not [01:14:30] everybody thinks like that.

Payman Langroudi: No.

Bhavnish Waghela: That’s right. So when it comes to [01:14:35] sometimes we’ve had to hire because we’ve needed to hire. Mhm. Um, there’s only so much I can [01:14:40] do. And therefore a quick hire especially in this market is, [01:14:45] is, is needed sometimes. And then you sort of figure out as they started how good they [01:14:50] are or not or where they need nurturing. And if they are, if they want to be nurtured, [01:14:55] it’s brilliant. Um, luckily we’re lucky in that the team that we have at the moment are [01:15:00] all very good in the way they are receptive to [01:15:05] being being mentored.

Payman Langroudi: Would you feel like you can spot [01:15:10] them?

Bhavnish Waghela: No. I’ll be honest.

Payman Langroudi: Well, you know, you’re not wrong. I mean, you know Prav. Yes. [01:15:15] He’s got this process for hiring, not dentists, but hiring his team. I [01:15:20] mean, if you walked you through the process, it’s this unbelievable thing. Like, they go through this, [01:15:25] this whole answer questionnaire thing where he’s got some trap questions that anyone who gets [01:15:30] that one wrong is taken out. He’s got a bunch of things that happened just by automation [01:15:35] to ask him. And then they come, uh, the 4 or 5 finalists come [01:15:40] in for a week each, and then the team decides who’s. And he goes often at the end of all of [01:15:45] that, he ends up firing that person one week later. Because. Because it’s the wrong person. He’s [01:15:50] not the person. He thought he was kidding. Wow. Um, but is that.

Bhavnish Waghela: Do you say that’s all automated?

Payman Langroudi: No, there’s a big [01:15:55] automated piece. But then even even once it’s all done, the five people come in for a whole [01:16:00] week for a trial. Trial week? Yeah. And what my my basic point is, even with [01:16:05] a process like that, you can get it wrong. Um, but you know. [01:16:10] What can you learn from someone in an interview? It’s difficult. Just their communication [01:16:15] style.

Bhavnish Waghela: It’s like when you go out on a social, you know, if you meet somebody, you’re introduced to somebody. Yeah. Um, and [01:16:20] they are very, you know, first time you meet somebody, second time. Third time [01:16:25] you meet somebody. It takes a long time to get to their [01:16:30] real, real self. Yeah.

Payman Langroudi: It’s funny, my friend talks about this here, that if [01:16:35] he has a dinner party, he invites three people to the dinner. It was three families [01:16:40] to the table. Because people get on really well that first time. Because everyone tells their best stories. [01:16:45] Yeah. But if you invite them again. Yeah. They haven’t got those stories to go to anymore.

Bhavnish Waghela: Everyone’s [01:16:50] on their best behaviour for the first few times. And then. Then you’re stuck. I used to do this [01:16:55] system where I’m a big believer. So, you know, some people are heavy handed. [01:17:00] Yeah. Like physically they the way they, you know. Yeah. Massage or whatever [01:17:05] it may be. So I used to get the associates to do an A scale and polish on me on me to see how heavy handed they were. Um, [01:17:10] and then we’ve not hired people based on that or hygienists and stuff like that, [01:17:15] because ultimately it’s you’ve had patients who’ve [01:17:20] been treated by staff or been treated by the team who are very happy [01:17:25] because of the fact that it didn’t hurt them.

Payman Langroudi: Yeah.

Bhavnish Waghela: The, the you know, everyone [01:17:30] knows this, that there are certain dentists that are not skilled in their ability [01:17:35] to produce an exquisite restoration, but the patients will love them. Yeah.

Payman Langroudi: That [01:17:40] gentle dentist thing, you know, painless injections. It goes a distance [01:17:45] massively. I think I bang on about this too much. I’ll talk about in the previous podcast. [01:17:50] Painless injection, I think is like maybe the most important thing you could do.

Bhavnish Waghela: I 100% agree [01:17:55] with you. You know, so many times I’ll get told, um, that, you know, [01:18:00] you’re the first time I’ve had an injection. I keep coming back to you because it doesn’t hurt.

Payman Langroudi: Yeah.

Bhavnish Waghela: Um, [01:18:05] and even with implants, I will make a song and dance about how much it’s going to hurt them after [01:18:10] anything I do. And when it doesn’t hurt that much, they think I’m brilliant. [01:18:15]

Payman Langroudi: Yeah.

Bhavnish Waghela: So yeah.

Payman Langroudi: What do you see as the future for you? [01:18:20]

Bhavnish Waghela: Um.

Payman Langroudi: Do you want to wind down? Do you want to sell?

Bhavnish Waghela: I think so. I probably [01:18:25] look at selling in the next 7 or 8 years.

Payman Langroudi: Say eight years, maybe.

Bhavnish Waghela: Maybe sooner. [01:18:30] We’ll see. It just depends. Because obviously, if my daughter does architecture, then it’s a seven [01:18:35] year course. So I need to sort of think about. But also I think I, you know, what would I do. I enjoy I really.

Payman Langroudi: Enjoy.

Bhavnish Waghela: Dentistry. [01:18:40] I probably do a lot more volunteering at the in our organisation. Yeah. Um, [01:18:45] I. Would travel probably [01:18:50] travel. And because I enjoy implants, I’d probably [01:18:55] teach. I’d probably roam be a roaming. I placed implants [01:19:00] at sensu as well, you know. Yeah, yeah. And I go there every [01:19:05] now and again and do that. So I could probably just do that on a few days a week and then sell [01:19:10] up in London.

Payman Langroudi: You do that?

Bhavnish Waghela: Yeah.

Payman Langroudi: Oh, nice. It’s a weekend away.

Bhavnish Waghela: A weekend, usually [01:19:15] a Saturday. Um, but again, it’s sort of ad hoc. Um, [01:19:20] we we instructed people to help us grow our Invisalign a few years ago. [01:19:25] So it’s like a symbiotic thing that way.

Payman Langroudi: Nice. Which practice do you go to? All of them.

Bhavnish Waghela: The. The [01:19:30] both London Bridge and Wimpole.

Payman Langroudi: There’s two.

Bhavnish Waghela: Yeah.

Payman Langroudi: So you’ve [01:19:35] never taught before?

Bhavnish Waghela: No teaching.

Payman Langroudi: No ambition [01:19:40] to.

Bhavnish Waghela: Not really. No.

Payman Langroudi: That’s different. That’s nice.

Bhavnish Waghela: I think I think even [01:19:45] even, you know, I think everyone’s seeming to sort of write their exit planning is to have [01:19:50] a business where they end up coaching or training of some kind. [01:19:55] Yeah. That isn’t me. I’d probably join my friends in their businesses doing something. [01:20:00] Yeah. Rather than it wouldn’t be dentistry.

Payman Langroudi: Well, [01:20:05] you’ve, you’ve, you’ve you’ve pretty much completed dentistry. If dentistry was an [01:20:10] arcade game. You’ve completed it.

Bhavnish Waghela: I’ve completed a few levels. Then I’d be 30 years this year. [01:20:15] So for you.

Payman Langroudi: As well, right? Yeah. I’m going for my 30 year thing in summer. Yeah.

Bhavnish Waghela: We’re planning on meeting [01:20:20] a few this year somewhere, if that works.

Payman Langroudi: Out. We’ve come to the end of our time, so, um, [01:20:25] I’m going to finish it with the usual questions.

Bhavnish Waghela: Go for.

Payman Langroudi: It. First [01:20:30] one’s a fantasy dinner party. Three guests, dead or alive. Who [01:20:35] do you have?

Bhavnish Waghela: Okay, so I would probably have my guru. Um, [01:20:40] obviously, for for the fact that he’s [01:20:45] not here physically. Um, then I would have. Mahatma [01:20:50] Gandhi.

Payman Langroudi: Yeah. He’s [01:20:55] been before to these dinner parties.

Bhavnish Waghela: And there’s another person. So I’m quite a passionate Indian. Yeah, [01:21:00] and there is. There was a person in the in the Indian independence movement. Um. [01:21:05] Oh my God. Sardar Vallabhbhai Patel. He [01:21:10] was not recognised for his role in the independence of India. [01:21:15] Um, but he was slightly opposite to Gandhi. Okay. [01:21:20] Gandhi was very much about. Yeah. Peaceful revolution.

Payman Langroudi: He was. He was. Malcolm X [01:21:25] was.

Bhavnish Waghela: Like the Malcolm X of that. Um. So three Indians.

Payman Langroudi: What’s his name?

Bhavnish Waghela: Patel. [01:21:30]

Payman Langroudi: Um.

Bhavnish Waghela: His his his. Um. Yeah. Slightly different [01:21:35] approach. He was a bit more of a, you know, we need to do this properly. Kind [01:21:40] of a bit more gung ho approach. So, three massive Indians.

Payman Langroudi: Interesting dinner [01:21:45] party. Yeah.

Bhavnish Waghela: Because those two are polar opposite.

Payman Langroudi: You’re sort of identifying [01:21:50] as an Indian. Yes. As a Gujarati or as a Hindu, as a, you know, the [01:21:55] different things that you identify as. Yeah. And I guess it’s super important to you. You know what I find really [01:22:00] interesting? How your staff were talking about the temple and what they’ve like, [01:22:05] learned about it from you.

Bhavnish Waghela: And I talked about it quite openly. And also we, um, every year [01:22:10] at Diwali.

Payman Langroudi: They.

Bhavnish Waghela: Come. Uh, we have an event that’s massive events in Neasden. [01:22:15] Yeah, it’s over two days, Diwali. And the next day is the Gujarati New Year. And over in [01:22:20] Neasden, they get like 50 or 60,000 people over the two days. In Leicester we get 15, 20,000 people. [01:22:25] And I’m quite heavily involved in that.

Payman Langroudi: So look that identity [01:22:30] right. You know, it’s it’s important right. It’s it’s what [01:22:35] how you define yourself. Do you recognise what I’m saying? If I say if [01:22:40] you’re let’s say your daughter doesn’t want to marry [01:22:45] a Hindu or or whatever that. And I can imagine you’d want them [01:22:50] to 1 or 2. Right. But do you understand? Do you recognise what I’m saying regarding [01:22:55] evolution of that? Evolution [01:23:00] of that, you know, like kind of kind of what? You said your dad came here overcompensated. [01:23:05] Overcompensated. Hence, you know, then you did what you did. Each [01:23:10] one is an evolution. 100%. Yeah. And I’m not saying [01:23:15] she needs to marry a Swedish guy. Yeah, whatever. Let her marry whoever she wants to marry. [01:23:20] But. But Jensen was saying, like regarding evolution.

Bhavnish Waghela: Yes.

Payman Langroudi: Of [01:23:25] second generation. Third generation, you know, and in the same way, not just marry. Uh, [01:23:30] let’s say she didn’t say architecture. Let’s say she said, I want to act in plays. [01:23:35] Yeah. Yeah. You know, that’s.

Bhavnish Waghela: Very interesting.

Payman Langroudi: Alarm signs.

Bhavnish Waghela: Because she [01:23:40] she she did. She’s a phenomenal singer.

Payman Langroudi: Is she.

Bhavnish Waghela: And she’s done a diploma in musical [01:23:45] theatre singing. Oh, wow wow wow.

Payman Langroudi: So she’s kind of come up.

Bhavnish Waghela: So it has come up and the discussion has [01:23:50] been had.

Payman Langroudi: Oh. How interesting.

Bhavnish Waghela: Um, and it was a case of. Look, we understand, but [01:23:55] get a degree. Get a degree first.

Payman Langroudi: Same thing as your dad said to you, right? Yeah.

Bhavnish Waghela: Basically. [01:24:00]

Payman Langroudi: Yeah.

Bhavnish Waghela: But yeah, I think, um.

Payman Langroudi: Because there are things that stay the same. [01:24:05] Yeah. Like advice like that. And then there are things that need to evolve. And it’s, it’s an [01:24:10] interesting sort of I.

Bhavnish Waghela: Think the challenge being from where I am from. Yeah, is we [01:24:15] live in this crossroads or I live in this crossroads where.

Payman Langroudi: East and west.

Bhavnish Waghela: East [01:24:20] and west and yes, okay, I am Western, but my faith is eastern. [01:24:25] Yeah, my spirituality is eastern, and as a family we are quite [01:24:30] religious. So we don’t drink and we’re vegetarian and we go to religious, [01:24:35] we go to the temple regularly or we go to events that are religious very regularly. So [01:24:40] what she sees and what she has seen growing up is me going to the temple, [01:24:45] me doing a red dot on my head and me praying in the morning, and her mum listening to various [01:24:50] discourses and lighting candles in the house and you know, all these things. [01:24:55] So she, she’s very much. She herself does a bindi [01:25:00] every day at school, and so she’s quite religious in her way, but even [01:25:05] more Western than us.

Payman Langroudi: So it’s definitely it is evolving anyway. [01:25:10]

Bhavnish Waghela: It is.

Payman Langroudi: Evolving. Yeah.

Bhavnish Waghela: Interesting. You know, thought process is mindset. You know, even even, you know, [01:25:15] if you look at, uh, gender equality and those kind of things. Massive change. [01:25:20]

Payman Langroudi: Yeah. Yeah, yeah. The final question. Yeah, it’s a deathbed question. I [01:25:25] don’t want to be morbid, but it’s a deathbed question. On your deathbed, surrounded by your loved ones, your grandchildren’s grandchildren, [01:25:30] if you had to give them three pieces of advice, what would they be?

Bhavnish Waghela: Don’t [01:25:35] focus on. Focus [01:25:40] on your family. Focus on time with your family. Um, and [01:25:45] that’s not just your children. It’s also your parents. Yeah, I think we forget [01:25:50] our parents too much.

Payman Langroudi: Yeah.

Bhavnish Waghela: I would say [01:25:55] that money comes and goes and is not important. And [01:26:00] don’t look at your neighbours. You know that whole [01:26:05] compare. Don’t compare.

Payman Langroudi: Yeah.

Bhavnish Waghela: Don’t compare is I think comparison is the worst thing. So focus [01:26:10] on your family, parents and children time with them because [01:26:15] that’s never going to come back. Yeah.

Payman Langroudi: Someone told me that about parents and [01:26:20] and I said, oh no, both my parents are still alive. And he said he said, it’s not that. [01:26:25] He said, it’s not that. Talk to them while you still can. Yeah. And I hadn’t considered [01:26:30] that. And this was this was years ago. I hadn’t considered that I was too young. And [01:26:35] now I’m realising what that guy was saying.

Bhavnish Waghela: And, you know, as we get older, I’m [01:26:40] seeing my friends. Unfortunately, both my parents and my wife’s parents [01:26:45] are still alive. Yeah. Um, and my friends [01:26:50] are losing parents, and that day is going [01:26:55] to happen. So the more as day goes by, we think, you know, I need to.

Payman Langroudi: Spend [01:27:00] more time.

Bhavnish Waghela: Spend more time with him. Yeah.

Payman Langroudi: Yeah. Good advice. It’s been such a pleasure [01:27:05] having you. Thank you. Thank you so much for coming all the way as well.

Bhavnish Waghela: Thank you, thank.

Payman Langroudi: You, thank you so much.

Bhavnish Waghela: It’s been great.

[VOICE]: This [01:27:10] is Dental Leaders, the podcast [01:27:15] where you get to go one on one with emerging leaders in dentistry. Your [01:27:20] hosts, Payman Langroudi and Prav [01:27:25] Solanki.

Prav Solanki: Thanks for listening, guys. If you got this far, you must have listened [01:27:30] to the whole thing. And just a huge thank you both from me and pay for actually sticking through [01:27:35] and listening to what we had to say and what our guests has had to say, because I’m assuming you got some [01:27:40] value out of it.

Payman Langroudi: If you did get some value out of it, think about subscribing. And [01:27:45] if you would share this with a friend who you think might get some value out of it too. Thank you so [01:27:50] so, so much for listening. Thanks.

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

Payman Langroudi: This podcast has been brought to you by Mini Smile Makeover. Mini Smile Makeover is a two day anterior [00:00:05] composite course led by the extraordinary talented doctor Dipesh Palmer. Two [00:00:10] days of full on, hands on composite training, purely focussed on [00:00:15] anterior work composite veneers, polishing, finishing, shade matching. You also [00:00:20] get a free enlightened kit. Plus we have a great time and a party in the middle. Find out the. [00:00:25] Details. [00:00:30]

[VOICE]: This is Dental Leaders. [00:00:35] The podcast where you get to go one on one [00:00:40] with emerging leaders in dentistry. Your [00:00:45] hosts Payman Langroudi and Prav Solanki.

Payman Langroudi: It [00:00:50] gives me great pleasure to welcome Sarena Kiani on to the podcast. [00:00:55] Sarina is a young dentist who’s moving quickly through some of the most [00:01:00] high profile practices in the UK. A pleasure to have you.

Sarina Kiani: Hi. [00:01:05] Thank you so much for having me here. Such an honour. It is.

Payman Langroudi: So, [00:01:10] Serena, I know you through mehdi’s practice and [00:01:15] latterly through rhona’s practice. And for a lot of people, [00:01:20] these would be dream jobs. Yeah, but these were your first few jobs.

Sarina Kiani: I know.

Payman Langroudi: And sort [00:01:25] of. My burning question is, how did you get these jobs? I mean.

Sarina Kiani: Yeah, [00:01:30] fair. I get asked that question a lot, actually. Oh, you’re so lucky. Like, what [00:01:35] did you do?

Payman Langroudi: Uh, how did you meet them?

Sarina Kiani: Yeah, yeah. Um, I am lucky, [00:01:40] and I feel really incredibly grateful. Um, I I’m [00:01:45] not even one of those people you see a lot at Dental events. I think that a lot [00:01:50] of the jobs that I have now and the people that I’ve met were just organic. [00:01:55] So, Mehdi, I met when I was a Dental rep for GSK. I [00:02:00] was my job was literally to knock on every single door in London a dental practice [00:02:05] and sell them basically Sensodyne and Corsodyl toothpastes. [00:02:10] And I met Mehdi, obviously instantly felt like he was the best dentist I’d [00:02:15] ever met because he’s so charming. And then I actually ended up becoming one of his patients, [00:02:20] doing my teeth with him, all this stuff. And then he [00:02:25] wrote my reference for dental school. So I didn’t even want to be a dentist until quite [00:02:30] later on in life while I was a rep for GSK, because I thought, oh, I quite like [00:02:35] what they do, like this intimate 1 to 1 that they have with their patients and the challenges [00:02:40] that they face, all these things. So Mehdi came about through working for GSK [00:02:45] and then.

Payman Langroudi: Dental is.

Sarina Kiani: Called yeah, Refreshed Dental. And then I [00:02:50] just stayed in touch with him and and it kind of just grew from there. And I would [00:02:55] joke about, you know, when I graduate, you’re gonna hire me. All these things. I’d drop a little, [00:03:00] um, you know, a little on purpose. Yeah. On purpose. A little [00:03:05] a little seed for him not to forget about me. All through dental school as well. Um, [00:03:10] kept in touch, but genuinely, it was because I actually, um, wanted to [00:03:15] stay in touch. And then rhona’s practice. So Chelsea Dental Clinic, um, [00:03:20] came about during Covid. Dental school I was going to was Kings and [00:03:25] we closed for something like six months. I wasn’t able to go into dental school [00:03:30] and do anything. Everything was online and I hated it. I’m [00:03:35] not the type of person who can just sit there on the screen for hours on end and learn that way. [00:03:40] I need to physically be doing stuff. I need to physically see things. So then, um, at the [00:03:45] time, I had a friend. Well, I had a friend. I have a friend, Luke Athwal, who works at Rhona’s [00:03:50] clinic. And I messaged him saying, look, I am. I’m dying here. Can I get a job [00:03:55] as a nurse? As a dental nurse? Um, anywhere, you know. Just so I can [00:04:00] do something during Covid. And he recommended Rhona’s clinic. So during [00:04:05] Covid, I was a dental nurse at Chelsea Dental Clinic, and I was [00:04:10] working with everyone there. Our Richard, Rona, Luke [00:04:15] and Sarah. And so I met all these people. I met the team during Covid, [00:04:20] just working as a dental nurse. I was one of the worst dental nurses you can think of because I was just [00:04:25] looking at the work. I’m not paying attention to any of the suction and like writing secret [00:04:30] notes for things I wanted to learn. Um.

Payman Langroudi: And which year of dental school was that? [00:04:35]

Sarina Kiani: That was 2020. So during literally the height of Covid.

Payman Langroudi: You were. [00:04:40]

Sarina Kiani: What, a.

Payman Langroudi: Third year student.

Sarina Kiani: Fourth year? Fourth year? Yeah. Fourth year at the time. Um, [00:04:45] third year. Fourth year. Yeah. Fourth year at the time, I think. And yeah. [00:04:50] So I met everyone then. And to be honest, I didn’t think like I’m working as a dental nurse. [00:04:55] And then one day I’m going to have a job at Chelsea Dental Clinic. I didn’t think that way. I just always [00:05:00] had this, like imposter syndrome of who the hell do you think you are? Which I think most people have. [00:05:05] And I think a lot of females in dentistry have as well, that kind of mindset. And [00:05:10] then fast forward now.

Payman Langroudi: So yeah. How did you end [00:05:15] up working there after two years?

Sarina Kiani: After? Um, no. Even a year after [00:05:20] my PhD year, Rona gave me a ring and she, like, [00:05:25] out of the blue, called me.

Payman Langroudi: She called.

Sarina Kiani: You? Yeah, she called me. And she was like, do you still [00:05:30] want that job here? And I thought, what? No way. Are you crazy? Are you calling [00:05:35] me? I just graduated. What do you mean? Um, obviously on the phone that was going through my head, but [00:05:40] on the phone, I was like, yeah. Hell yeah. Please. Yes. I just said yes. Even though inside [00:05:45] I was thinking, who do you think you are? There are incredible Dentists that work [00:05:50] there, like Mittal, who I had literally put on a pedestal. Everyone’s work is [00:05:55] insane. Like, who do you think you are working there? And I thought, you know what? I’m [00:06:00] never going to learn. I’m never going to improve until I just throw myself into the deep end [00:06:05] and just start. I’m never going to feel ready. So what’s the point of, [00:06:10] you know, saying no and then regretting it and things like that? So I [00:06:15] said, yeah, and then here I am now.

Payman Langroudi: And she’s incredibly good at picking up [00:06:20] on people’s sort of personalities. Yeah. I guess you saw something in you.

Sarina Kiani: Yeah. [00:06:25] She said, I think communication maybe. I think I’m a people’s [00:06:30] person and I’m quite chatty. I make people feel comfortable. And I think [00:06:35] that obviously the work is important in dentistry. You need to be good at what you’re doing, especially [00:06:40] if you’re going to be charging people a lot of money. And that side of things I’m always keen [00:06:45] on and I’m very humble about. Keen on improving all those kind of things. But I think [00:06:50] the people management side of things, um, plays a big factor [00:06:55] as well. And I think that’s what I know I’m good at. And I think that [00:07:00] what is what maybe she saw in me what Mehdi saw in me as well, because I think the dentistry [00:07:05] you can learn, but the people skills I think is a little bit harder to teach.

Payman Langroudi: It’s more an [00:07:10] innate thing. It is a more innate thing. Um, but you said, look, you said you had no intention of becoming a dentist, so [00:07:15] you were a rep.

Sarina Kiani: Yeah, I know.

Payman Langroudi: What were you thinking when. I mean, when when [00:07:20] you studied, what were you thinking? You want to be.

Sarina Kiani: I wanted to be. I wanted to go into medicine. [00:07:25] Let’s be.

Payman Langroudi: Really?

Sarina Kiani: Originally I did, and if you Google me, [00:07:30] there’s a picture of me in the Fulham local news with my holding [00:07:35] my GCSE papers up with all the ace stars that I got. And then underneath it says, you know, [00:07:40] Serena Kayani wants to be a doctor, wants to study medicine. And, [00:07:45] um, when I was in sixth form, I. Well, after that picture, I got a scholarship [00:07:50] to a private school, uh, Latymer Upper School. And I [00:07:55] was doing my A-levels. I thought I wanted to do medicine.

Payman Langroudi: Tough school. [00:08:00]

Sarina Kiani: Yeah, very tough school. Hard time. And I would volunteer at [00:08:05] Chelsea and Westminster Hospital. Ended up in the stroke ward, which isn’t really the best ward to [00:08:10] be in if you’re trying to do medicine, because it was tough. And I was [00:08:15] quite an emotional person. I would go back home after each shift and I’d cry, and it would take [00:08:20] quite a toll on me. And I thought, I don’t know if medicine is for me. Just from a mental [00:08:25] health point of view. I thought that I can’t detach from patients, so I kind of left [00:08:30] it there. Yeah. Um, I did biomedical science. Um, I did [00:08:35] a masters in biotechnology. I thought I’d go down more of the pharmaceutical route, and I applied for [00:08:40] a job at GSK. At the time, the only thing that I could get was being a Dental [00:08:45] rep. And I thought, you know what? I’m just gonna work my way up into more of the pharmaceutical [00:08:50] side of things. And then while I was a rep for GSK, you know, knocking on doors, selling [00:08:55] Sensodyne, I met a lot of dentists and I thought, hang on a minute. This is like [00:09:00] medicine where you’re challenging yourself a lot and you have to use your brain. You have to be on it, but [00:09:05] it doesn’t have that emotional effect on you where, you [00:09:10] know, patients aren’t dying. Touch wood and you can go home and kind of [00:09:15] leave it there. You have more of a 9 to 5. You can have a family. This [00:09:20] might be something that might suit me. And I thought, oh, God, yeah. So I applied [00:09:25] to King’s, got rejected on Ucas, applied [00:09:30] a few more times, got rejected again.

Payman Langroudi: As in waited a year.

Sarina Kiani: Yeah, [00:09:35] so I applied, got rejected and then I waited a year. Reapplied [00:09:40] got rejected again, did all the things on the website that it said you need to do. And at the time, [00:09:45] it wasn’t like I was just applying blindly and just hoping for the [00:09:50] best. I was messaging the admissions board. I was asking them literally tons of questions [00:09:55] what do I need to do? What do I need to show? What should I write on my admissions form? No [00:10:00] one in my family has even graduated from university. No one’s a dentist. [00:10:05] My brother owns an incredible tattoo shop like which.

Payman Langroudi: I wanted to talk about.

Sarina Kiani: Yeah. [00:10:10]

Payman Langroudi: Because I drive past that shop every day. She’s beautiful.

Sarina Kiani: It’s amazing. He inspires me [00:10:15] every day. And, um, so, you know, I didn’t really have anyone [00:10:20] apart from the friends that I’d made, kind of, you know, midway through [00:10:25] GSK working there and. And Luke and Rona and all these people [00:10:30] that, you know, I would be inspired by, but I didn’t really have anyone in my family or my circle that I can [00:10:35] ask about, you know, even can you help me with this application form? So after [00:10:40] getting rejected, um, the last time I thought, you know what? I’m just going to set up [00:10:45] a meeting. I emailed the head of admissions at King’s at the time, and I [00:10:50] said, could I please steal five minutes of your time to speak to you in person and [00:10:55] see, you know, what can I do to improve my application? And he was kind enough to say yes. [00:11:00] So when I went there, I went armed with, you know, what do they want on [00:11:05] their website? Exactly what they want. And what can I show that I have to at [00:11:10] least warrant an interview? And he said to me, look, just because you’ve come here today, just because you tick all those [00:11:15] boxes, doesn’t mean that you guarantee yourself an interview. I said, I completely understand, but please just [00:11:20] have a look at my application and see if you think I should have an interview. If [00:11:25] I have an interview and I fail, I will never message you again. I will never contact [00:11:30] you and waste your time ever again. That’s how sure I was that I wanted this and I knew [00:11:35] I should be accepted.

Payman Langroudi: How did you know to do that? Did you just come [00:11:40] up with it yourself?

Sarina Kiani: No, I.

Payman Langroudi: Someone told you to do that?

Sarina Kiani: Yeah, someone [00:11:45] did tell me to do that. And also kind of watching the people around me. Even my [00:11:50] brother, for example, who doesn’t take no for an answer. And watching people [00:11:55] not fail necessarily, because I think failure is only when you give up on something. But [00:12:00] having setbacks and having challenges that you, you know, you don’t succeed at [00:12:05] and just keep keep people that keep going. Yeah, I had a lot of those people around me, [00:12:10] not necessarily in dentistry or anything medical related, and I thought I [00:12:15] just needed to be a bit more confident. And I was older at the time, so I think that helped. And [00:12:20] a week later, I got an email saying, here’s your [00:12:25] interview you’re going to have. I think it was like 12 mini stations, 12 different people. [00:12:30] It was rigorous. It was the graduate entry. So if you think about the cohort in [00:12:35] the year, it was narrowed down even more. I think there was only 16 people that [00:12:40] were being accepted for the graduate entry. And so it was even tougher to get in. [00:12:45] And I smashed the interviews. Luckily, obviously I got in and [00:12:50] that was that. And then I thought, yeah, smooth sailing. First year of [00:12:55] dental school.

Payman Langroudi: I want to kind of go back to that notion, because a lot [00:13:00] of people would get that rejection and just accept it. Um, some [00:13:05] people are more sort of go getters or something. They sort of push harder. [00:13:10] Um, and but at the bottom of all of this is kind of resilience, [00:13:15] right? And resilience might be the most important skill [00:13:20] or, you know, quality that you can have in work and life. [00:13:25] Yeah. Because eventually things tend to come around to you call [00:13:30] it by luck or coincidence or whatever, but it takes resilience for you to still [00:13:35] be around when that happens.

Sarina Kiani: Definitely.

Payman Langroudi: So this sort of self-reliance [00:13:40] or the, you know, pushing a bit harder, not taking no for an answer. Where does [00:13:45] that all come from? Were you always that cat? Is that what you were like as a child?

Sarina Kiani: I think it [00:13:50] comes from my mum.

Payman Langroudi: What about your mum?

Sarina Kiani: Yeah. We moved. She honestly [00:13:55] is my biggest inspiration. We moved to England from Iran when I was about three, [00:14:00] and she raised me and my brother as a single mum. There was a time when we were literally [00:14:05] homeless.

Payman Langroudi: From the get go.

Sarina Kiani: Yeah.

Payman Langroudi: So your dad was in Iran?

Sarina Kiani: No.

Payman Langroudi: He [00:14:10] came.

Sarina Kiani: Yeah, he was here. Um.

Payman Langroudi: But they [00:14:15] broke down early.

Sarina Kiani: Yeah. Broke down. She had to survive on her own. She hadn’t [00:14:20] finished school, and she could barely speak English. She had five jobs trying [00:14:25] to raise me and my brother, and she got us. Yeah, she would cleaning [00:14:30] post office, Anything you can think of.

Payman Langroudi: Jobs just to pay the way.

Sarina Kiani: Yeah. She came [00:14:35] from being in Iran and being limousine driven to to [00:14:40] school because her her dad was a big army general in Iran. For the [00:14:45] king to then coming here and having nothing, not speaking a [00:14:50] word of English and then having to, you know, do all kinds of jobs to be able to [00:14:55] look after me and my brother. Like, I remember she would have her job, we’d wake [00:15:00] up, give us breakfast, take us to school, go to her second job, and then we would get [00:15:05] picked up, usually by other parents. Yeah. Go to their house for a few hours. So she [00:15:10] finished working. Then she’d pick us up, take us for dinner, go back to another job.

Payman Langroudi: Wow. [00:15:15]

Sarina Kiani: And I think without I don’t speak about it too much because it’s [00:15:20] a lot. But I think that’s where resilience comes [00:15:25] from. Because knowing that, you know what, you just got to push through and you’re not in [00:15:30] the nicest way possible. You’re not special. These things happen to a lot of people, and [00:15:35] it’s unfortunate, but what do you want to do? Do you want to just sit there and and feel sorry for yourself? [00:15:40] Or do you want to actually say, you know what? Yeah, sure. Those things did happen, but they were 20, [00:15:45] 25 years ago. I actually want to make a difference now in my life. I’m not going to sit [00:15:50] there being like, yeah, I had this bad experience and that’s why I’m a little bit sad [00:15:55] or I’m depressed or all these things and I’m not, you know, depression and things like that is, is different and can happen to anyone. [00:16:00] But I think resilience is just loving yourself [00:16:05] and knowing that I deserve to get everything I want in life [00:16:10] and be happy, feel at peace, feel accomplished. [00:16:15] I think happiness comes from knowing that you’ve put yourself [00:16:20] through a challenge and you achieved it. It’s not about comparing yourself to other people, which happens [00:16:25] a lot in dentistry. You know, you go online and you.

Payman Langroudi: Happens a lot in life, right?

Sarina Kiani: It happens a lot in [00:16:30] life. You go online and you’re comparing yourself constantly. Oh, maybe I should be doing this. I should be here. I should [00:16:35] be doing that. And I think comparison, like everyone says, comparison is the thief of joy. Yeah. And [00:16:40] being able to just focusing on yourself, what are you doing every day [00:16:45] that makes you feel proud? Like something small. If I put my alarm for 6 a.m. to go downstairs [00:16:50] and go to the gym or go on the treadmill, whatever it is, if I then turn off that alarm and then [00:16:55] didn’t wake, I don’t wake up that day. I know in myself I feel really disappointed in myself. [00:17:00] I’m not doing it for anyone else. I’m doing it to show myself some respect. [00:17:05] And I think that’s what makes you feel more powerful [00:17:10] as a person.

Payman Langroudi: Although, look, both of those things sound great, [00:17:15] don’t they? Resilience sounds amazing. Yeah, the self-respect thing that you’re saying sounds amazing. Yeah, but [00:17:20] have you ever suffered the downside of that behaviour too? Like are there situations that you [00:17:25] should have gotten out of, I don’t know, some boyfriend that wasn’t suitable. [00:17:30] Wasn’t good. But you stuck at it because that’s the kind of person you are. You stick at things to the [00:17:35] bitter end or you know what you’re saying about the alarm. I get it, of course, but [00:17:40] you know, there is some sort of be kind to yourself piece that you might be missing. [00:17:45] Like maybe you’re too hard on yourself in some areas. Does any of that resonate?

Sarina Kiani: Yeah. If I had a [00:17:50] penny for every time someone said to me, you’re too hard on yourself, I think I’m [00:17:55] still working on it is the honest answer. I don’t think I stick at things if I’m unhappy. [00:18:00] I value my mental health and my peace a lot. [00:18:05] But definitely the first year after I was [00:18:10] so harsh on myself, I would have sleepless nights thinking about some crown. I did [00:18:15] some sensitivity, some patient got as if like that was the be all and end all [00:18:20] of life. And I really I stopped seeing any friends. I would go home, I’d be researching [00:18:25] things. I’d be trying to. I was just thinking about work all the time [00:18:30] because I thought my like you said, my it was almost like [00:18:35] my self love or my self respect was tied to how good my work was [00:18:40] or how much my patient, you know, congratulated me for something.

Payman Langroudi: Or [00:18:45] I watched my brother, my my brother was always top of his class, got straight A’s at everything. [00:18:50] And then he got to he got he’s a doctor. He got he got to a certain point where he started [00:18:55] failing exams and because he’d never failed exams in his [00:19:00] life before. Yeah. All his, as you say, sort of self respect. His identity was [00:19:05] bound up in being this super brain. And so when he started failing exams [00:19:10] he literally had a breakdown over it, you know, like something. And I had never seen him, [00:19:15] you know, weak in that way. Um, when I think about it with my own kid as well, you know, he’s [00:19:20] good at studying. He’s passed everything he’s ever done. One day, like [00:19:25] all of us, he’ll come up against, you know? You know, when you got to Kings, everyone [00:19:30] was really good at studying. Yeah.

Sarina Kiani: I, I can’t resonate with that more. [00:19:35] I when I had the scholarship to Latimer. Latimer [00:19:40] because I was, I was studying all the time during my GCSEs. [00:19:45] I really enjoyed it. But you’re right, I was equating my value to how [00:19:50] good my grades were. And coming from like a turbulent background at home, there’s [00:19:55] a lot of unrest.

Payman Langroudi: That’s the order that you found in that turbulence.

Sarina Kiani: Exactly. I thought that, [00:20:00] you know what? This is the only thing I can control. Yeah. And so I’m just going to make sure my [00:20:05] grades are amazing because I can’t really control much else that’s going on at home. And this is the only [00:20:10] thing I can control. And so when I got into Latimer, the level of intelligence [00:20:15] there and how.

Payman Langroudi: There are really motivated.

Sarina Kiani: From a young age, they have these incredible [00:20:20] role models. You know, my mom is a role model for me too, and she had a hard time. But I [00:20:25] mean, education wise, these these parents that were teaching them so much, these, [00:20:30] you know, private education, all of these things. I’d never had any of that. And so teachers, I failed [00:20:35] my A-levels really badly.

Payman Langroudi: And and it was the first time you’d really failed. [00:20:40]

Sarina Kiani: Yeah. And my entire identity shattered. It’s so true. I forgot about it. I [00:20:45] almost suppressed this memory. But you’re very right.

Payman Langroudi: How did you feel? Shame and sort [00:20:50] of shame.

Sarina Kiani: Depressed. I had this, I went into this bubble [00:20:55] of like, I wasn’t good enough just because my grades were failing. And so I was failing as a person. [00:21:00] And I kind of had this thing in my, in my brain that I’d now failed my family like I was [00:21:05] supposed to save everyone.

Payman Langroudi: Squandered the opportunity you’d been given.

Sarina Kiani: Yeah, exactly. And I was so grateful [00:21:10] for this. Uh, I was so grateful for the scholarship, [00:21:15] and I felt like I’d failed. I’d I’ve disappointed everyone. They took this big [00:21:20] chance on me and I just ruined it. That’s how I felt. And it was sad.

Payman Langroudi: Out of that.

Sarina Kiani: I [00:21:25] did biomedical science where no one had this pressure. Everyone was relaxed. [00:21:30]

Payman Langroudi: So you didn’t retake your A-levels?

Sarina Kiani: No. I wanted to get out of it. I was stuck [00:21:35] in that bubble, and I thought, you know what? I need to get out. I need to shift my headspace. [00:21:40] I ended up taking, um, biomedical science just because I didn’t know what else [00:21:45] to do. On, on. What do you call it when they they add you to the list? Clearing. That’s it. I went [00:21:50] on to clearing as this kind of save me moment of I just need to get away. [00:21:55] I need to get away from this pressure I’m feeling. And it was the best thing I could have done because [00:22:00] I spent three years not really studying. I’d say I was enjoying [00:22:05] life. It felt like the.

Payman Langroudi: Pressure.

Sarina Kiani: The pressure was off Greenwich and my campus was in Kent [00:22:10] and I was enjoying life. I was a lot more relaxed. There was no more pressure [00:22:15] and I could just decide on what I wanted to do with my future without [00:22:20] feeling this kind of, you know, burden of my grades really equate to my value. [00:22:25] So I think that’s where it kind of calmed down.

Payman Langroudi: When did you become a cool cat? [00:22:30]

Sarina Kiani: Cool cat? Yeah, kind of a cool vibe.

Payman Langroudi: Yeah, a bit cool. You are kind of cool. [00:22:35]

Sarina Kiani: Oh.

Payman Langroudi: You’re always cool. No. Was that a recent reinvention?

Sarina Kiani: Do you [00:22:40] know what? My school teacher. So in primary school, I [00:22:45] will never forget one parents evening. I had my teacher at [00:22:50] school told my mum. Serena’s very quietly confident and [00:22:55] growing up now, I’d say, like, 30 years later, I only just realised what she meant. [00:23:00] I’m not the loudest person in the room. I just can’t be. But I feel [00:23:05] at peace with myself inside. I don’t feel nervous around people, [00:23:10] but I’m not very loud about it. And I think cool cat.

Payman Langroudi: That’s [00:23:15] cool. I’ve translated that as cool cat.

Sarina Kiani: Yeah. I’ve translated. Yeah. Thank you so much. I take that [00:23:20] as a big compliment. I think that I don’t know, I don’t know what the answer to that [00:23:25] is. Just peace in myself and maybe not so much. [00:23:30] Putting anybody on a pedestal I think helps too. I think [00:23:35] I’m always inspired by people, even at work. I’m [00:23:40] in admiration of everybody, but I never put anyone on a pedestal in the sense that I don’t [00:23:45] think they’re better than anybody else, or even with myself and anybody. [00:23:50] I’m working with my assistant. I don’t know someone that’s cleaning [00:23:55] the practice after working hours. I don’t feel like there’s a hierarchy anywhere. I [00:24:00] think that helps as well. I just see everyone as a human being. Respect them for where they [00:24:05] are and what they’ve achieved, but never feel like I can’t speak to them [00:24:10] because of it.

Payman Langroudi: It’s a superpower. It’s a It’s a superpower because a lot of people sort [00:24:15] of turn things into hierarchies.

Sarina Kiani: Yeah, and it.

Payman Langroudi: Becomes.

Sarina Kiani: Awkward.

Payman Langroudi: They can’t help themselves. [00:24:20] Yeah. They cannot help the idea that where am I in the pecking order? [00:24:25] And hence, where is this person in the pecking order and where is that person in the pecking order? And [00:24:30] I don’t know, I always, I always think of it like this, you know, like talking to the Nigerian guy in the toilet in [00:24:35] a nightclub. I just find myself saying, what, 45 minute conversation with that cat? Yeah, [00:24:40] yeah. And then I remember a friend of mine saying, why are you talking to that guy? You know, all right, I shouldn’t have been in the toilet. I should [00:24:45] have been out there. But he was a great guy, you know? He was. But it comes [00:24:50] naturally to some people. Yeah, and hierarchy comes naturally [00:24:55] to other people.

Sarina Kiani: Definitely. You know, and it works for them.

Payman Langroudi: Yeah, yeah, yeah.

Sarina Kiani: It doesn’t work for me. It makes me [00:25:00] nervous. I think as long as I see everyone as a human being and trying, I’m very good. I think [00:25:05] 1 to 1 with people. I think where that doesn’t work so well is in a big crowd, because you [00:25:10] start to feel a feel a little bit more, you know you’re trying to connect with everyone 1 to 1, but it’s harder in a crowd. I think [00:25:15] that’s where extroverts do better. Um, but I think as long as you have [00:25:20] like a human connection with someone and see them as a human, because even you know your professor, he’s [00:25:25] still a human being and go home. He might have a wife and kids, and he has very human challenges [00:25:30] he faces. And if you want to connect with someone, you might want to connect on those levels [00:25:35] instead of, okay, yeah, this this person is invented, the caries detection die, [00:25:40] you know?

Payman Langroudi: And anyway, anyway, for instance, uh, Avi Banerjee. [00:25:45] Huh?

Sarina Kiani: Oh, yes.

Payman Langroudi: Who taught you?

Sarina Kiani: I’m one of my. Yeah, yeah, yeah, I was in his class.

Payman Langroudi: I was talking [00:25:50] to some of his students, and they were going, oh, Professor Banerjee is so strict and all of this. And [00:25:55] I know him as almost the softest person I’ve ever come across.

Sarina Kiani: The nicest person ever.

Payman Langroudi: Soft. [00:26:00] I mean, strict would not be the word I would I would associate with him. And so it’s so interesting because if you’re [00:26:05] in that hierarchical thinking, you go, Professor Banerjee, he wrote Picard’s manual [00:26:10] like, you know, he’s he’s this unapproachable. And yet I [00:26:15] don’t know him as that. I just know him as Avi. Avi, to me, is the softest people I’ve [00:26:20] ever come across. So sometimes those people are projecting something themselves, aren’t they? Is that they have to, I guess, in [00:26:25] that position.

Sarina Kiani: Definitely. It’s funny you should say that. I was in his class and granted, I was [00:26:30] the graduate entry. I have to say, when I was younger, maybe I wouldn’t really be this confident. [00:26:35] But in his class I felt like I could go up to him, ask him questions. [00:26:40] I felt like, yeah, he’s really approachable and he was always really nice. And no matter how stupid [00:26:45] my questions were, because I think he realised it would come from like a genuine place, whereas there’d [00:26:50] be some people that just say things for the sake of saying things or they’re trying to show off. And I think that if you’re not [00:26:55] being very authentic, you can smell. When someone’s not being authentic, then you feel [00:27:00] like you want to be mean to them in a way because you’re like, oh, just be real. Just be you. What’s wrong with you? [00:27:05] You know?

Payman Langroudi: So then entering in as a graduate. Yeah. [00:27:10] Is different to coming out of school. Definitely. And did you live [00:27:15] at home or did you live?

Sarina Kiani: Yeah, I moved back in with my mum, which was amazing. [00:27:20]

Payman Langroudi: So it’s a very different university experience to your first 100% 100%. How [00:27:25] did you find it? How did you feel like you got on? I mean, anyone who says Dental school was, they found easy. [00:27:30] I just don’t believe them at all. No, dental school is hard.

Sarina Kiani: It was really hard.

Payman Langroudi: But what [00:27:35] aspects of it did you find hard? Because I found pretty much everything. Looking down on [00:27:40] microscope, I found a nightmare. The. The first exercise is just like, you know, drilling. [00:27:45] I found a nightmare. The exams I found, the volume of work. I didn’t [00:27:50] do biology A-level either. Yeah. How did you. How did you handle the actual course [00:27:55] content itself?

Sarina Kiani: The course content was hard. The first year I’d forgotten how to study because I was working [00:28:00] and I completely forgotten. So the first year it was really hard. [00:28:05] I remember after my first exam at the end of the year, I cried during these animals. I’m going to fail, I didn’t [00:28:10] fail, thank God. I don’t know how I passed, but I it was really difficult. The content [00:28:15] itself was harder than I thought, but I think at that stage I was locked in. I was like, you know what? This [00:28:20] is the degree that I actually chose to do. This is the career that I want to have. And so [00:28:25] the material was more because I want to learn this, because I want to do it tomorrow instead [00:28:30] of I need to just learn this stuff to pass. You know.

Payman Langroudi: When it got to the clinical bit.

Sarina Kiani: Then it was. [00:28:35]

Payman Langroudi: Easier and you were better.

Sarina Kiani: Yeah, I.

Payman Langroudi: Was always.

Sarina Kiani: 100%. Or just like physical [00:28:40] manual skills. I was a lot better in clinic than I was kind of in the [00:28:45] books. And but of course it’s important to know what the material. The hardest [00:28:50] part actually in dental school wasn’t any of that. Do you know what the hardest part of being in dental school was? [00:28:55] Being shouted at by staff and feeling about this small. Now I love [00:29:00] kings. Nothing against kings. But there were certain members of staff that, for absolutely [00:29:05] no reason, would always want to kind of instigate their authority [00:29:10] onto you. And being older than maybe some of the younger students who. Yeah, [00:29:15] they were being naughty.

Payman Langroudi: They were greeted with, you did it.

Sarina Kiani: That grated me because I thought, why are you speaking to me? I’d be like, [00:29:20] Sharon, why are you speaking to me like this? Because I think of myself. If we were outside at the pub together, [00:29:25] you, you know, we’d be having a really respectful conversation. Why are you shouting at [00:29:30] me? Because I’ve. You know, I’ve walked the wrong way around the clinic. Like, this is ridiculous.

Payman Langroudi: I did a house [00:29:35] job, and I distinctly remember six months earlier I was a student. Yeah. Six months later, [00:29:40] I was a houseman. And suddenly you’re in sort of in-between phase between student and [00:29:45] the actual teachers. Right. Yeah. And I remember talking to one of the teachers and saying he was such a lovely guy. I was [00:29:50] saying, you’re so lovely. Now. How come you weren’t lovely back, you know, then. And he [00:29:55] said something. I mean, I was 25 years ago, but he said something around. It’s justified. [00:30:00] There’s almost an abusive culture in Dental school justified by the idea [00:30:05] that it’s a high pressure job. So if you can’t take that degree of abuse from me, you’re [00:30:10] not good as a dentist, which I definitely don’t agree with.

Sarina Kiani: No, I don’t agree.

Payman Langroudi: That’s [00:30:15] where it comes from. The culture’s almost that we’re going to abuse you a little bit because you’re going to get you’re going to [00:30:20] get abuse from your patients.

Sarina Kiani: Exactly what they said. They said, if you can’t handle this, what are you going to be like as a dentist? [00:30:25] And I would say, well, actually, you know, I don’t agree with that. Thank you very much. I wouldn’t [00:30:30] be shouting at my patients. And I do understand, you know, respect [00:30:35] where respect is due, I always there’s no hierarchy. However, your professor is your [00:30:40] professor. I don’t disagree with any of that. And you should listen to the rules. I wasn’t saying, [00:30:45] you know, you shouldn’t listen to the rules, but I just didn’t understand the need for that. Kind of, like, aggressive [00:30:50] talking down at someone, belittling someone kind of behaviour. It didn’t happen [00:30:55] that often. Let’s be real. But when it did happen, it hurt. It hurt a little bit. Yeah, [00:31:00] because I can be sensitive as well, I think. And I think that hurt a little [00:31:05] bit. But it’s true. Dentistry is challenging. And you have times where patients are like that too. [00:31:10] And you’ve got to just take it on the chin and realise it’s not personal. People will always speak [00:31:15] to you in a certain way because based on their own ideas [00:31:20] of themselves, not anything to do with you. And I think you’ll find peace [00:31:25] knowing that you’re not that important in life. And whatever happens to you isn’t, you know, [00:31:30] aimed at you. It’s just everybody else is just thinking about themselves in their head. I [00:31:35] think that helps.

Payman Langroudi: When you say you could be sensitive.

Sarina Kiani: Yeah.

Payman Langroudi: I mean, an example of that [00:31:40] where you’re over sensitive. Oh, is it over?

Sarina Kiani: How many? How long have we got?

Payman Langroudi: Is [00:31:45] it over something like someone’s words or something like that?

Sarina Kiani: Um, I think even navigating [00:31:50] work, you know, dynamics, sometimes [00:31:55] it’s difficult to take criticism. It’s really useful. And [00:32:00] when you take the emotion out of it, you’ll know that actually this is been [00:32:05] told. So for my own benefit and I will learn from this. But at the time, [00:32:10] you know, it can hurt a little bit.

Payman Langroudi: Mhm.

Sarina Kiani: And I think.

Payman Langroudi: More than it should.

Sarina Kiani: More [00:32:15] than it should. Yeah. More than it should sometimes. But I think I’ve learned how to manage that as [00:32:20] well. A lot better than I did at the beginning of, of dentistry or [00:32:25] working really not dental school but working.

Payman Langroudi: So I don’t want to make it sound like a job [00:32:30] interview. Yeah. Yeah. But we’ve kind of kind of come across some of your super, super powers, [00:32:35] right? You’re resilient. You’ve you know yourself quite well. You know, [00:32:40] you’re interested in your piece and all of that. You’ve got a good brain on you. You can work [00:32:45] hard. You’re brilliant with people. What would you. What would you say are your biggest weaknesses? Okay. Sensitive. What else? [00:32:50]

Sarina Kiani: My biggest weaknesses and something I’m working on is definitely not [00:32:55] equating my work to my value now. So I used to do that [00:33:00] at school. My grades would be equated to my value. But I have to remind myself [00:33:05] all the time now. There’s no such thing as perfect. Stop trying to be perfect. [00:33:10] That little ledge. You know, nobody died from having a little ledge on their composite. [00:33:15] You know, anything like. That’s silly. But I think my biggest weakness right now is just [00:33:20] not focusing on perfection and being okay [00:33:25] with the journey of learning. You’re getting better every day. Stop [00:33:30] trying to be perfect right away. I think that can [00:33:35] hurt sometimes when I sit at home and I’m thinking about my work, or I take a lot of photos of my work. [00:33:40] And so I sit there and I analyse it, and I have to remove myself and be like, actually, you know what? It’s okay. [00:33:45] Just just relax.

Payman Langroudi: Usually I don’t accept that answer because, you know, that’s a classic. I’m too much of a perfectionist, [00:33:50] but I hear you. Um, it definitely slows you down as well because [00:33:55] for me, my kids go to the French school. Okay?

Sarina Kiani: Yeah, yeah. A lot [00:34:00] of my friends did. Yeah.

Payman Langroudi: Yeah. And my, my wife speaks French and, uh, they, uh, I [00:34:05] did French for six years in school. Oh, wow. I understand pretty much everything they’re saying, but I [00:34:10] won’t. But I won’t speak French. I will not speak French, because in case I get a masculine [00:34:15] and feminine wrong, and they. And they keep saying, yeah, they keep saying, look, just do it. Just [00:34:20] whatever. Who cares? We’ll correct you. But you know that level of I’m not a perfectionist at all, but in this, [00:34:25] in this area. Yeah. Um, that bit of perfectionism has held me back big time. Yeah. And [00:34:30] it’s the same with anything else you take on. Let’s say you start doing ortho. You’re [00:34:35] not going to be the best orthodontist for the next 15 years. Yeah, but does that mean I shouldn’t start doing [00:34:40] it? Yeah. And you’re going to suffer loads if that’s.

Sarina Kiani: What.

Payman Langroudi: You’re thinking about. Things. [00:34:45]

Sarina Kiani: That is 100% my biggest weakness, because I’m always trying to plan and mitigate all the [00:34:50] risks. Sometimes I prevent myself actually just doing it, and I think it’s held [00:34:55] me back from a lot of things I’ve wanted to do. Like I always imagine myself and it sounds silly, [00:35:00] but like on a stage doing presentations, not so much clinical presentations, but I [00:35:05] don’t know, working for Sensodyne even and and doing all these things. And I was like, no, you [00:35:10] know. Yeah, but you’ve got to do A, B and C before you can do that. And it’s held me back a lot. [00:35:15] You’re right. And when I compare myself to my brother, for example, who just doesn’t [00:35:20] worry about those things and goes for it and just does it.

Payman Langroudi: Let’s talk about him a little bit, because I’m [00:35:25] fascinated by him. Um, I’ve never met him. I drive past his tattoo shop, which, for anyone [00:35:30] who hasn’t seen this, one of the most impressive shops.

Sarina Kiani: Have you been inside?

Payman Langroudi: I’ve [00:35:35] stared.

Sarina Kiani: It’s got like, a pool table. It’s insane.

Payman Langroudi: He’s just the most amazing shop I’ve seen [00:35:40] in ages. I’ve often almost crashed my car looking into it. But when [00:35:45] you turned to studies, did he turn to street culture or something? How did you end [00:35:50] up in tattoos?

Sarina Kiani: Uh, he art. Actually.

Payman Langroudi: Art.

Sarina Kiani: He was an artist. Well, he is an [00:35:55] artist. He doesn’t actually do any of the tattoos himself. He does the designs. So [00:36:00] he used to do these incredible paintings and very. He used to sit [00:36:05] there for hours on end. He’s. I think he’s got ADHD. His his brain couldn’t focus on [00:36:10] studying. And that wasn’t his thing. He didn’t like it. Fair enough. He was very artistic and creative. [00:36:15] And so he would do everything. He was one of those people who had his fingers in a lot of pies, and [00:36:20] he still does. So he would go and buy something on eBay and sell it for more expensive. [00:36:25] At the same time. He’d be painting a painting at the same time. He’d have another part time job. [00:36:30] He was just one of those people just completely doing things, constantly doing things. He will have [00:36:35] an idea now and tomorrow he’ll execute it. He wouldn’t be worrying about, you know. Yeah, [00:36:40] but this could go wrong and that could go wrong. He just does it. He just calls the people and does it, and he’ll make mistakes [00:36:45] on the way. But at least he’s doing it. And I and I think that is what I need to learn 100%, [00:36:50] just to go for it and not worry so much. Um, but yeah, he’s.

Payman Langroudi: Older than [00:36:55] you.

Sarina Kiani: Just a few years. Yeah, three, three a year.

Payman Langroudi: It’s just the two of you?

Sarina Kiani: Yeah, just the two of us? Yeah. [00:37:00]

Payman Langroudi: So are we going to see a gigantic dental practice [00:37:05] opening up? The way he’s done his tattoo shop. I mean. [00:37:10]

Sarina Kiani: He asked him. He asked me about that all the time.

Payman Langroudi: No. Listen, I’m sure you [00:37:15] haven’t got plans tomorrow to do it right? But. But if you did open [00:37:20] up a dental practice.

Sarina Kiani: Yeah.

Payman Langroudi: Have you got an idea of what you would want it to be, like, [00:37:25] 100%? Really? Really.

Sarina Kiani: I’m have a big vision on the brand [00:37:30] I am, and the kind of brand I would create if I created anything. If [00:37:35] I created a toothpaste tomorrow, I know exactly what that toothpaste would be and who it would be [00:37:40] for.

Payman Langroudi: We can talk about it. Yeah, I keep on telling you not [00:37:45] to, but. Good. Yeah. Go on, go on.

Sarina Kiani: I think it would be [00:37:50] quiet. Quiet. Confidence is what would the brand [00:37:55] would be peaceful, clean girl era which is like popular now on on TikTok [00:38:00] and things like that. And but it’s more than that. It’s having beautiful [00:38:05] little things that you appreciate and you [00:38:10] admire and you find that, [00:38:15] you know, make your day. Having a really nice skincare for me, for example, [00:38:20] like really makes my day knowing that I’m going to use this beautiful packaging [00:38:25] that I’ve just opened up and I’m going to use this beautiful skincare, all these little things during the day give [00:38:30] me this like endorphin rush. So I think if I were to create something, [00:38:35] it would have the same feel that you feel. You know, it’s very beautiful and it’s very [00:38:40] well designed and obviously, you know, good quality too and all [00:38:45] these things. But I’m not sure about dental practice just yet. Yeah.

Payman Langroudi: Oh, [00:38:50] so this place that you’re describing isn’t a dental practice?

Sarina Kiani: No, this is more. If I were to create something, [00:38:55] a brand. Yeah. Yeah, I think.

Payman Langroudi: I mean, it’s a similar idea anyway. Right. [00:39:00] So are you saying you you don’t want to ever open a dental practice? Have you ruled [00:39:05] it out?

Sarina Kiani: I’m not sure I do. Yeah, I haven’t ruled it out. I [00:39:10] think that leaning.

Payman Langroudi: Away from it.

Sarina Kiani: You know, I graduated two years ago, I think.

Payman Langroudi: Yeah, certainly. [00:39:15]

Sarina Kiani: Yeah. I’m not trying to rush yet, but I [00:39:20] think if I ever did open one, it would be that kind of vibe.

Payman Langroudi: I [00:39:25] mean, well, you know, there’s, there’s disadvantages and this advantages to being qualified. [00:39:30] Two years ago. Yeah. And people whenever I say that, people say, well what advantage could there be to being [00:39:35] two years out. But the biggest advantage I know is you’re still closer to being [00:39:40] a human than than dentist. Yeah. That’s true. And we all, a lot of us forget what [00:39:45] it’s like to be a patient. Mhm. A consumer. In fact, one of maybe Rona’s [00:39:50] superpower is she has never forgotten that. Yeah. And so you know, but that [00:39:55] that idea that the reason I’m asking you about what would be your dream practice at this [00:40:00] stage is because you’re so much closer to being a regular person. Give it another ten years of being a dentist. [00:40:05] And often we forget we people. People forget what it’s like to be a normal person [00:40:10] before they even qualify as a dentist, because they jump into that persona of doctor. [00:40:15]

[TRANSITION]: Yeah.

Sarina Kiani: I think yeah. It’s true. The [00:40:20] less you know, the more you can just be yourself and not know. [00:40:25] I mean, I’m not talking about the dentistry side of things, but if I, you [00:40:30] know, don’t know the CEO of this really big brand that much in my head, then I’m not as nervous [00:40:35] of just going up to them at an event. Does that make sense? I think one of the superpowers [00:40:40] of naivety, maybe you might call it, is that you [00:40:45] will just do.

Payman Langroudi: Things that you don’t worry about.

Sarina Kiani: Yeah, worry about [00:40:50] it less because you don’t know so much. You don’t know what you don’t know.

Payman Langroudi: Yeah, yeah, yeah.

Sarina Kiani: So you just do it. And [00:40:55] then obviously other people would be like.

Payman Langroudi: It’s almost like beginner’s luck, you know, like beginner’s luck is a real thing. Yeah, [00:41:00] yeah. And what it is, is that you focus in on just one thing only. And [00:41:05] by focusing on one thing, you can execute that one thing, you know, like, sometimes the [00:41:10] first time you swing a golf club, you hit it all a long way away. And then [00:41:15] after six months of playing golf, you can’t do it as much. Yeah. That’s true. It’s a real thing.

Sarina Kiani: Yeah, definitely. [00:41:20]

Payman Langroudi: So you got through dental school. What was your [00:41:25] first job?

Sarina Kiani: First job after dental school? I had two, so I [00:41:30] worked for a little mini corporate. And I also worked for Midea. How did I get [00:41:35] those jobs?

Payman Langroudi: I was post PhD, right?

Sarina Kiani: Yeah. Post Post-phd.

Payman Langroudi: Sorry, PhD. Like, who was your boss [00:41:40] there?

Sarina Kiani: Uh, I had an incredible boss. Kamal Farooqi. [00:41:45]

Payman Langroudi: First boss is such.

Sarina Kiani: An important person. Amazing person. [00:41:50] Learned so much from him. Very chilled guy and very high quality. So takes [00:41:55] a lot of, um, you know, pride in his work, which I admire.

Payman Langroudi: I love London.

Sarina Kiani: Yeah. [00:42:00] London. Southall. So really busy. Huge practice. [00:42:05] Very high needs area. So I was literally thrown into the deep end. And [00:42:10] I was doing minimum two root canals and extractions on each patient every [00:42:15] single day. Wow. There was a lot, but.

Payman Langroudi: But you learned a lot.

Sarina Kiani: I learned so [00:42:20] much. And I also learned exactly what I don’t want to do for the rest of my life, [00:42:25] too, because I thought, you know what? If this was me, or if this was my mum, I [00:42:30] wouldn’t want them. I wouldn’t want to do the root canal on them. And I from that [00:42:35] day after my PhD day, I literally was like, I’m never going to do a root canal. Ever again in my life. And [00:42:40] I also said to myself that the only way for me to. Achieve the kind of work I want to [00:42:45] do is if I don’t continue with the NHS anymore. And I think [00:42:50] as incredible as the NHS was for teaching me so much, I was just [00:42:55] a little bit older and I thought, you know what, I don’t really want to continue with this. I need [00:43:00] to throw myself into the deep end for what the end goal is, which is working privately. And so I just took the [00:43:05] plunge. Called literally 120 practices. I had little black book of [00:43:10] all their names.

Payman Langroudi: Many of whom you knew from your.

Sarina Kiani: Many of them who I had maybe even seen once. [00:43:15] I wouldn’t be as stretched to say I knew them, but I’d seen them. I feel like I [00:43:20] built a little bit of a connection with them, and I just went and knocked. I messaged so [00:43:25] many friends, a lot of which were like dental nurses or hygienists. Hey, do [00:43:30] you know anyone that might hire? I heard a lot of no’s, obviously, as you would. I turned [00:43:35] up to one of the practices that I got the job, the mini corporate. I just turned up. I wasn’t getting any [00:43:40] responses from the emails. It was down the road from my mom’s. So I turned up one day with [00:43:45] a little USB drive with like my portfolio of work. I would take pictures as well during my [00:43:50] PhD year. I would take pictures of everything and anything as horrendous [00:43:55] as it looked. And when I look back now, I think, what the hell was that? My first ever composite bonding case [00:44:00] was horrendous and I took, but I took pictures of it. And I also put in handwritten [00:44:05] reviews from patients because in South Hall a lot of patients, their English wasn’t [00:44:10] very good and they couldn’t go on, you know, Google and leave me reviews. I would get them to write [00:44:15] handwritten reviews, and I would take a picture of it, and I’d put it in this like PowerPoint presentation [00:44:20] that I took on a USB stick with me everywhere. And I got.

Payman Langroudi: Amazing.

Sarina Kiani: Yeah, I got the job from [00:44:25] the first job that I got, the little mini corporate. He actually said to me, [00:44:30] I can’t believe you turned up because he also was the clinical director for like 15 [00:44:35] practices. So this is what I mean about I didn’t know what I didn’t know. If I knew that, [00:44:40] maybe I would have been a bit more nervous. But at the time I didn’t know. I just thought he was, you know, the main guy at [00:44:45] that practice went there and I said, hi, do you have five minutes? He’s like, not really. But I [00:44:50] said, please, you know, I’ll come back when you have five minutes. Um, and he sat down with me. I plugged [00:44:55] in my little USB and I showed him, honestly, the worst work ever. But he just said I hired you not because of your [00:45:00] work, but because you had the courage to come and knock on my door [00:45:05] and actually ask me for a job.

Payman Langroudi: So there we go again. Yeah, yeah, there we go again. You [00:45:10] pushing and resilience and and I remember I, I never I [00:45:15] only applied for jobs where there were jobs. Never did I go somewhere and say have you got [00:45:20] a job. Yeah. Um, but you went to 100 people. Yeah. 100. That’s, [00:45:25] you know, 98 nose as well. Yeah. Bearing in mind, you know, that that resilience, [00:45:30] right?

Sarina Kiani: Genuinely, that comes from naivety as well, I’d say. Yeah. I think it goes back to what you [00:45:35] said, because the less you know, I didn’t have a lot of friends [00:45:40] in dentistry in the sense that, you know, my mum wasn’t a dentist, my dad wasn’t a dentist. So I didn’t really know [00:45:45] how things work that.

Payman Langroudi: I kind of knew from your GSK days that you could just show up at reception and say, [00:45:50] someone around.

Sarina Kiani: Yeah, actually, that’s so true because I would cold call, I would have to go to reception [00:45:55] and working for GSK as a rep, I learned very quickly that the [00:46:00] boss is not the principal dentist. The boss is the receptionist, the [00:46:05] manager at the practice who often is got nothing to do with dentistry. And if [00:46:10] you’re sweet with them, just by being genuine and being nice to people and just having a real conversation. Oh. [00:46:15] Hi, Sharon. How was your kids? You know, he’s, you know, some samples or whatever it was. I [00:46:20] learned that they are the gatekeepers. So when I wanted a job, it was the same. [00:46:25] I’d go, I’d be real with the people at the door. Not just be friendly to the [00:46:30] dentist who’s going to give me the job and then ignore everybody else like they don’t exist? I think, [00:46:35] yeah, I think that helped too.

Payman Langroudi: It does. I mean, that’s the first thing we tell our people [00:46:40] when they join here about the managers and the receptionists [00:46:45] being the key people. Um, and I mean, it’s weird, man, because some dentists [00:46:50] tell their receptionists keep everyone away.

Sarina Kiani: Mhm.

Payman Langroudi: I mean, you [00:46:55] know. Yeah. Join join me on the supplier side now. Yeah.

Sarina Kiani: Yeah that’s. [00:47:00]

Payman Langroudi: True. Some some dentists tell them that some choose to like what you just said there. [00:47:05] They almost exert power over the ones they don’t like. [00:47:10] And the opposite over the ones they do like. Yeah. Yeah. And that’s where you got in by [00:47:15] being lovely and respectful and remembering people’s names and children and all of that. Yeah. [00:47:20] Um, but for me, it’s a funny one. Now, you’re a dentist. You can sort of look at it from the other side. Yeah. Salespeople [00:47:25] have a bunch of information, a bunch of information [00:47:30] that they can. I would look at now, if I was a dentist again, I would look at salespeople as educators because [00:47:35] they know at least they know about the market, right? They know they know about best practice. They know so [00:47:40] and so in reading is doing this amazing thing that, you know, you could learn from. They know about [00:47:45] their product, their product specialists, right? So they can explain how to sell that product or the [00:47:50] benefits are so, you know, and yeah, maybe once in a while they’ll ask you to buy something. Yeah. [00:47:55] But a lot of lot of dentists have this idea that salespeople should be kept away because I’m busy [00:48:00] being a dentist, you know, and then they’ll go on a weekend course for education, you know, see [00:48:05] them. Yeah.

Sarina Kiani: Yeah, yeah. And realise actually that it’s probably a good thing if you’re, you know, [00:48:10] friends with them.

Payman Langroudi: And did you have in your head any idea of the type [00:48:15] of dentist you wanted to be?

Sarina Kiani: I met a lot of amazing. Yeah, I met a [00:48:20] lot of amazing dentists and even mehedi himself.

Payman Langroudi: Yeah. Who were the are the standout ones that you [00:48:25] met? Right? Mehdi.

Sarina Kiani: Definitely. Mehdi. Yeah, definitely.

Payman Langroudi: What was it about him?

Sarina Kiani: Even [00:48:30] now, I still work for him. His enthusiasm [00:48:35] every single day. His positive energy. I’m not saying, you know, [00:48:40] fake it, but sometimes you do got to fake it till you make it. And I think just [00:48:45] how much he loves everything he does. I think that stands out. You [00:48:50] know, you meet some people and they’re energy vampires, and you meet other people, and they motivate [00:48:55] you and they give you. Yeah, they give you energy just by. They’re not trying to do it. They’re just being [00:49:00] themselves. They’re just genuinely happy having a great day and it rubs off on you. [00:49:05] And I think people like that definitely.

Payman Langroudi: I think look there is some faking [00:49:10] it as well. Yeah. Because sometimes you’ve had a terrible morning and you come to your business [00:49:15] and then you kind of put your face on for your business and yeah, you know, say, say [00:49:20] hi to people and smile and so on. There is an element of it 100%. Um, at [00:49:25] the same time, he he is a very positive person. Who else? What other kind of traits? [00:49:30]

Sarina Kiani: Uh, Luke Athwal very good friend of mine.

Payman Langroudi: One thing. Are you his friend from from GSK [00:49:35] as well?

Sarina Kiani: No. Do you know what? I became friends with him just through Instagram. So more.

Payman Langroudi: Of [00:49:40] him.

Sarina Kiani: Oh, we just started kind of messaging. We had a lot [00:49:45] of mutual friends and actually we started going to like Ibiza together with these groups of friends [00:49:50] and just being like, genuinely friends. Nothing to.

Payman Langroudi: Do.

Sarina Kiani: With dentistry. Amazing. [00:49:55] What I love about him is he’s such a cool, cool cucumber. That’s a.

Payman Langroudi: Cool. [00:50:00]

Sarina Kiani: Cat. Yeah. Cool cat. He’s a cool cat. And even the kind [00:50:05] of challenges he faces and how relaxed he is, I think that’s my favourite trait. That’s [00:50:10] something I look at even today and I think, yeah, definitely need to be more like that. Even when things go wrong. [00:50:15] Or, you know, patients can be a bit challenging. I think being a cool cat and [00:50:20] reminding myself that, you know what? He’s got a lot more stress than I do and a lot [00:50:25] more complex cases than he’s a cool cat. That means I can be a cool cat. I think that as well. And [00:50:30] obviously Rona during Covid, watching her transform the practice, because [00:50:35] I was in the practice when the practice wasn’t renovated yet. Yeah. Didn’t [00:50:40] have such a big number of staff. I watched it kind of blossom [00:50:45] and grow so much. And to what it is today is insane.

Payman Langroudi: It’s an extraordinary [00:50:50] practice. It really is. Um, and her connection to all the [00:50:55] movers and shakers in London.

Sarina Kiani: Yeah.

Payman Langroudi: Is amazing. Yeah, [00:51:00] definitely. It is amazing. Um, what are the patient groups like in [00:51:05] these different practices? I mean, so these ones are very sort of family practice. Where is it? Twickenham.

Sarina Kiani: Twickenham [00:51:10] and Hampton.

Payman Langroudi: So is it, as you would expect, just families, kids?

Sarina Kiani: Yeah, I’d say [00:51:15] a lot of very genuinely nice people. Reasonable I describe as because in [00:51:20] dentistry things don’t always go to plan. You know, cram might have not come on the day.

Payman Langroudi: Exactly.

Sarina Kiani: Yeah. [00:51:25] And I think that helps. Really helps a lot of very reasonable people. [00:51:30] Um, yeah. Very educated, very nice. It [00:51:35] makes going to work. You need to have, I think, two, two things. A good boss and [00:51:40] good patience. And then that makes the day a lot nicer. And I think definitely [00:51:45] at his practice he’s cultivated that. I think you are your tribe. So you attract [00:51:50] what kind of energy you give out. And I think a lot of his patients are very similar.

Payman Langroudi: And you’re [00:51:55] still working both practices.

Sarina Kiani: Yeah I.

Payman Langroudi: Do. So I mean, maybe I’m wrong, but are the prices much higher [00:52:00] at Rona’s?

Sarina Kiani: Yeah, there are different pricing, different location. Um, but the quality of work is [00:52:05] the same.

Payman Langroudi: So how does that feel?

Sarina Kiani: At the start, [00:52:10] it felt wrong asking patients for so much money.

Payman Langroudi: But you [00:52:15] get used to it very quickly.

Sarina Kiani: You get used to it.

Payman Langroudi: Yeah.

Sarina Kiani: Because you realise that I can’t. This is. This [00:52:20] is the price. Because this is the practice I work at. It’s not my practice. And also you realise that actually, [00:52:25] you know what, with all the effort I’m putting in and knowing that I’m going to give my 110% [00:52:30] because I know me, I think, why not? This is worth it. I know how much I’m going [00:52:35] to care about this tooth for you.

Payman Langroudi: Yeah, yeah.

Sarina Kiani: So it is worth it.

Payman Langroudi: I found the acceleration [00:52:40] was exciting, right? When you when you change jobs and go to a practice where the prices are [00:52:45] much higher for about the first month, you’re whispering. It’s so exciting. [00:52:50]

Sarina Kiani: Yeah.

Payman Langroudi: It’s really exciting that that feeling that I used to do for £140, that I’m doing for 299, [00:52:55] or that crown that I was doing for 700. Now I’m doing for 1400 [00:53:00] or something. Yeah, and for about a month. It’s super exciting. You think [00:53:05] you’re doing numbers in your head and you think, wow, this is going to be amazing. And then very quickly it [00:53:10] all becomes very normal.

Sarina Kiani: Can I be honest?

Payman Langroudi: Yeah.

Sarina Kiani: Can I be completely honest? And this might sound [00:53:15] very, very naive. Yeah, I don’t think about the numbers at all. [00:53:20] I’m in a privileged position where obviously I’m making enough to, you know, [00:53:25] get by and I’m good. But I never look at the numbers. I don’t I never [00:53:30] think about it. I should and my husband says to me all the time, I should too, but [00:53:35] I try not to focus on it. I think I’m at a stage right now.

Payman Langroudi: Don’t focus on.

Sarina Kiani: It. I focus more on, [00:53:40] you know, the experience. Yeah. The lab. How am I going to do this treatment? Which lab is better? Should [00:53:45] I go and watch, you know, Stuart next door doing his incredible restorative work and learning [00:53:50] from him and all these things. Should I go and speak to Mitchell about the best way to fix the gums? All these [00:53:55] things? I think my headspace is is there. So I don’t think too much about the numbers. I [00:54:00] should think about the numbers.

Payman Langroudi: Don’t think about the numbers during the day.

[TRANSITION]: Yeah, yeah.

Payman Langroudi: But at the end of the day, [00:54:05] tot up your numbers. Yeah, that’s good practice, man. That’s good practice for everyone. [00:54:10] But but another interesting thing is, if I can give you a piece of advice in [00:54:15] your that’s so early on in your career. Yeah. Learn how to give completely [00:54:20] painless injections.

[TRANSITION]: Yeah.

Payman Langroudi: Completely painless injections. And the [00:54:25] the word of mouth you’ll get from that. Yeah. Because very few of us [00:54:30] dentists give completely painless injections. Yeah. And I experienced it myself. [00:54:35] My wife gave me an injection 25 years after I became a dentist. [00:54:40] And I felt zero. I felt nothing. The first I felt of it was when it started going [00:54:45] numb. Yeah. And it’s a very simple thing. Dry the area.

[TRANSITION]: Yeah. [00:54:50]

Payman Langroudi: Topical for full. 5 or 6 minutes. Five. Six minutes of topical. And in that [00:54:55] 5 or 6 minutes. Thank God in private practice, we can make relationships. We can talk. We can discuss [00:55:00] hopes and dreams, holidays, failures. You know, talking to patients. Very important in [00:55:05] private practice.

[TRANSITION]: Part of my work. Yeah. Yeah.

Payman Langroudi: So five, six full minutes of this [00:55:10] Topical on dry mucosa and then very [00:55:15] slowly, very, very, very slowly, almost five, six minutes of pushing that plunger.

[TRANSITION]: In.

Sarina Kiani: The cartilages. [00:55:20]

[TRANSITION]: As well.

Sarina Kiani: I heat those up. I’m not gonna lie. I think I am good at.

[TRANSITION]: That. [00:55:25]

Sarina Kiani: Because I. You’re right. I’ve even had people come to me and said, oh, I’ve heard you’re [00:55:30] very good with anxious patients. I get a lot of anxious patients. I had a patient come in the other [00:55:35] day. She come, she come three hours just to see me because she saw a [00:55:40] review on my TikTok.

[TRANSITION]: The word of mouth, the word.

Payman Langroudi: Of mouth from anxious patients goes.

[TRANSITION]: Quick. [00:55:45]

Sarina Kiani: Judgement pain free.

[TRANSITION]: You.

Sarina Kiani: Know, taking your time.

Payman Langroudi: Even silly things [00:55:50] like when you first put your hands in their mouth, do it very gently. Even something as silly as [00:55:55] that.

[TRANSITION]: I’ve got.

Sarina Kiani: Freakishly small hands.

[TRANSITION]: So sometimes.

Sarina Kiani: People call up the practice and they’re like, I [00:56:00] want to be seen by Serena. I swear this has happened a few times, especially at Maddie’s. They [00:56:05] say I need Serena to see me because I’ve seen the pictures of pictures of her. And I need someone with small [00:56:10] hands.

[TRANSITION]: Genuinely.

Sarina Kiani: I’ve got the world’s smallest.

Payman Langroudi: It’s [00:56:15] funny because there are occasions in the industry where it’s incorrect to be gentle. Yeah, there [00:56:20] are times where you have to push some matrix down, some gingerly, quite hard or whatever it is. Yeah. There [00:56:25] are times where good dentistry is not gentle. Yeah, yeah. But gentle dentistry [00:56:30] is always good. It’s one of those things. It’s such a big practice builder that news [00:56:35] travels so quickly almost within families as well, because whole families are nervous [00:56:40] together because they’ve all told each other stories. Um, and then whole families tell other [00:56:45] nervous families, and people follow my wife around. I mean, only [00:56:50] for that reason. I mean, she’s a nice person and all that, but it’s a big factor.

[TRANSITION]: It is a big factor. [00:56:55]

Payman Langroudi: Big, big, big factor.

Sarina Kiani: I mean, if you saw me and you thought [00:57:00] I told you I’m going to stick a needle in your mouth, I think most people wouldn’t be [00:57:05] nervous. I think this goes back to what I was saying about brand. I think that [00:57:10] if you are a personable person and you’re calm and you’re [00:57:15] genuinely just in everyday life, like, I’ll go to the gym and I’ll meet someone or I’ll go [00:57:20] to, you know, a coffee shop, and I’ll speak to someone. I might ask me, what do [00:57:25] I do? And I tell them, I’m a dentist. They’re surprised and they think, oh, genuinely. [00:57:30] I’ve heard people say, oh, I’d want to come and see you. You seem nice because [00:57:35] most people are scared by going to the dentist. They’re nervous. They don’t know what’s going on in their [00:57:40] mouth. It’s quite a big thing, trusting someone to be inside your mouth [00:57:45] and not knowing what’s going on. And I think that, yeah, 100% you do get followed [00:57:50] around. If someone feels like they are in good hands, or that they can trust [00:57:55] you, or that you’re calm, you’re a nice person. Nice person works too. Or [00:58:00] you’re funny. Sometimes I think I’m funny.

[TRANSITION]: Funny looking.

Sarina Kiani: Yeah, [00:58:05] I think it helps.

Payman Langroudi: So the patience that Chelsea must be quite demanding.

[TRANSITION]: Mhm. [00:58:10]

Payman Langroudi: And you’re newly qualified. You must have had [00:58:15] some concerns about that. Have you now figured it out. Like what you need to do, [00:58:20] say and do and when you need to ask for help and this sort of thing. How are you. How are you managing [00:58:25] that?

Sarina Kiani: You know, no one has said, oh, did you just graduate? No one’s ever said that to [00:58:30] me. Have you? Newly graduated? No. I might look it.

Payman Langroudi: No, you don’t look it. [00:58:35] But.

[TRANSITION]: But I think.

Payman Langroudi: How do you negotiate it yourself? When you have a patient who’s demanding and you’ve got a job [00:58:40] that looks difficult.

Sarina Kiani: Look, I know my limitations. So after a console, I can [00:58:45] kind of gauge suss someone out a little bit. And I think that if they’re very aesthetically driven [00:58:50] or very aesthetically demanding, I know that maybe right now they might not be the best [00:58:55] person for me to treat. I know my limitations. I also know what everybody [00:59:00] in the what everybody else in the team is good is good at doing, and so I’m good at delegating. [00:59:05] You know, if I, I think the case is a little bit tricky. Send them straight to the orthodontist [00:59:10] specialist. If I think that this is a full veneer case, you [00:59:15] know, tend to top teeth, then I’ll send them to Rhona [00:59:20] or Luke or Stuart. You know, so I think delegating and knowing your [00:59:25] weaknesses is is smart.

Payman Langroudi: Hard to know, though, isn’t.

[TRANSITION]: It, because.

Payman Langroudi: You don’t know [00:59:30] how good you are at something until you’ve done it?

Sarina Kiani: I think if you’ve done it, yeah, if you’ve done [00:59:35] it a few times and you feel more confident, I just gauge on [00:59:40] the kind of energy the patient is giving me, how demanding they are, and correlate that [00:59:45] with how much experience have I got in doing this? Am I.

[TRANSITION]: Going to be do you think.

Payman Langroudi: You sort of empathetically [00:59:50] like, are you an empath?

[TRANSITION]: Can you can you 100%? I can sense.

Sarina Kiani: When someone’s. [00:59:55]

[TRANSITION]: See.

Sarina Kiani: That’s also a weakness because if I don’t get so at Chelsea, sometimes you [01:00:00] might not get that huge reaction that you might get somewhere else. You know where some people are really [01:00:05] grateful. Obviously, they’ve paid a lot of money. The standards.

[TRANSITION]: Are different. Expect high standards. Yeah.

Sarina Kiani: So, you [01:00:10] know, they might not look in the mirror and start crying.

[TRANSITION]: Yeah.

Sarina Kiani: So sometimes you think, oh, oh. [01:00:15] You’re like.

[TRANSITION]: You have this moment inside where you’re like, why are you.

Sarina Kiani: Not crying.

[TRANSITION]: At the.

Sarina Kiani: Transformation [01:00:20] that I’ve just done? Um, and you, you know, because I’m such an [01:00:25] empath, I can feel it. You know, if a patient comes through the door and they’re being a little bit short with me, I instantly [01:00:30] think, oh, my God, you know, they don’t. You know, they might not like me or something. I’m working on that too. [01:00:35] That happens, I think, a lot. And learning to separate yourself from their reactions [01:00:40] is important too.

Payman Langroudi: So when you’re working [01:00:45] in a practice like Chelsea.

[TRANSITION]: Yeah.

Payman Langroudi: Have you not [01:00:50] come across a situation where there must be some sort of borderline [01:00:55] situations? Right. Like there’s going to be things you’re doing for the first time. [01:01:00]

[TRANSITION]: Should I give you an example of where.

Sarina Kiani: Communication broke down? Because I keep talking about how [01:01:05] amazing I am at communication.

[TRANSITION]: Actually.

Payman Langroudi: Sometimes the podcast.

Sarina Kiani: Sometimes things don’t always [01:01:10] pan out how you want.

[TRANSITION]: And you have.

Sarina Kiani: To also realise that that’s okay too. No one died. You know, [01:01:15] I had an instance where a patient was running late quite [01:01:20] significantly, and I had a full diary. I had another patient coming in and [01:01:25] my go to kind of my predisposition isn’t to be, you know, judgemental. [01:01:30] What the hell are you doing? And being right. It’s always like, oh, I wonder if they’re okay.

[TRANSITION]: Yeah.

Sarina Kiani: Do you think they might be [01:01:35] able to make the appointment? Do they even want to know they’re paying a lot? Do they even want to maybe change the [01:01:40] day? That’s what in my head, my thought process. Right. So I called the patient, and I’m like, you [01:01:45] know, I’ve noticed you’re running late. Are you okay? Do you still want to come? Yes. I’m coming. Very [01:01:50] short, very blunt. I’m like, oh, okay. Put the phone down. They come there about [01:01:55] half an hour late to a 45 minute appointment. Now we’ve got 15 minutes. Now I can’t really do much. [01:02:00] You’re going to pay the full amount for that 45 minutes, and I’m not going to be able to give you everything [01:02:05] I would have if you actually had the time. And so they come and I say, oh, you know, are you okay? [01:02:10] Just being my general empathetic self. Right. Doesn’t work for some people. [01:02:15] You were you know you were. Now I’ve only got 15 minutes. Are you okay to continue [01:02:20] with the appointment? Why are you reminding me that I’m late? This is so out of order. So disrespectful. [01:02:25] And I’m like, whoa, wait. What? And go. We’re doing the [01:02:30] appointment. Everything’s so frosty. I’m in her mouth. It’s very awkward, I feel uncomfortable, [01:02:35] the nurse is uncomfortable. I can feel the tension in the air.

Sarina Kiani: So me being me, I. [01:02:40] After I sit her up, I’m like, I’m really sorry if I offended you. Makes it worse. Um, [01:02:45] makes it worse sometimes. Don’t address the elephant in the room. I learned that the hard way, too. [01:02:50] She. She left anyway. It broke down. She wrote [01:02:55] an email to the practice saying I was I was, um, you know, disappointed. [01:03:00] I was being reminded that I was late. And in my head I’m thinking, oh my God, no. Like, I [01:03:05] was trying to see if you even wanted to have the appointment shortened, you know, because I’m not going [01:03:10] to be able to do everything we’d planned to do. That was my thought process. And then I learned, you know what? Don’t [01:03:15] speak so much sometimes. Don’t just leave it. You don’t have to [01:03:20] always be someone’s best friend. You know, you’re empathetic in your head, but in someone else’s head that has [01:03:25] obviously come across the wrong way. And that’s okay, too. And that was a hard pill to swallow [01:03:30] because I would I would go home and think, oh my God, like, now she’s upset with me for all this thing. [01:03:35] And I realised that everyone’s perception is different. Their reality [01:03:40] is different. I might have not meant any harm, but obviously it [01:03:45] didn’t come across that way. And that’s okay.

Payman Langroudi: I bet you the same patient, if you’re five [01:03:50] minutes late for them, go berserk as well.

Sarina Kiani: Yeah, and I wasn’t even telling them off. I was just trying to make sure. [01:03:55]

[TRANSITION]: They were okay. Yeah.

Payman Langroudi: Let’s get to that darker part of the pod.

[TRANSITION]: Um.

Payman Langroudi: Darkness [01:04:00] stakes.

[TRANSITION]: Mhm. Mistakes?

Sarina Kiani: Yeah.

Payman Langroudi: Clinical errors.

[TRANSITION]: Yeah. [01:04:05]

Payman Langroudi: What comes to mind when I say clinical error. What happened and what did you learn or [01:04:10] what can we all learn. You know that’s the point of it isn’t it.

Sarina Kiani: Let me paint you a picture.

[TRANSITION]: Payman.

Sarina Kiani: It [01:04:15] was my first day in my first private [01:04:20] job.

Payman Langroudi: Midi.

Sarina Kiani: Midi. [01:04:25] Yeah. First zirconia crown that I was [01:04:30] going to prep for. First big treatment. That was my first big treat. Private treatment I [01:04:35] was ever going to do. Patient comes in. Give them my ID block. [01:04:40] Big. Very tall, big gentleman. Very nice guy. I [01:04:45] always wait about ten, 15 minutes, sit them upright, wait all [01:04:50] the usual. And then I’m checking. Is he numb? It’s not numb. Okay. [01:04:55] Give him a little bit more. Wait another five, ten minutes. He says he’s numb. [01:05:00] Tongue feels a bit numb. Lip feels a bit numb. Okay, fine. Give the rest. [01:05:05] Sit him back down. Take the burr to his tooth. And he jumps in [01:05:10] the air like he. He screeches and my heart sinks. I’m thinking, oh my God, [01:05:15] he’s not numb. There’s no way. What’s happened? Give him a little bit more. Give [01:05:20] him a little bit more. A little bit more ID?

[TRANSITION]: Yeah. Again.

Sarina Kiani: Uh.

[TRANSITION]: Buckle [01:05:25] ligament or.

Sarina Kiani: Ligament? I tried everything in the book.

[TRANSITION]: Mhm. [01:05:30]

Sarina Kiani: And every time I’d take the drill, he’d jump again. And I thought, oh my [01:05:35] God, this isn’t going to work. I sat him up and I said, look I can’t prep the tooth today. [01:05:40] You’re just not numbing up. And at that point, you know, some time has gone by and I see [01:05:45] that he can’t close his mouth. He’s unable to, like, really close his close his mouth and [01:05:50] he starts to say, I can’t swallow Serena. I’m like, oh my God, I’m panicking because I’m thinking, [01:05:55] you know what? This is the first Crown prep in my private job, and I’ve ruined it. I’m [01:06:00] going to stop dentistry. I’m going to give up dentistry. It’s not for me. And he goes home. So I rebook [01:06:05] the appointment. I’m thinking, oh, it’s all fine. He calls. We’re just about to close. This is a [01:06:10] Saturday, by the way. He calls. We’re just about to close. I need to come back in. I can’t breathe, I don’t [01:06:15] feel well. He comes back in. Everyone else is left. By the way, all the other dentists. There’s only one other dentist [01:06:20] and he’s. He’s left. He comes back. I call the other dentist. I’m like, please turn around. I don’t know how to [01:06:25] manage this. I’m a bit worried. And he comes in. One of my colleagues, bless him, he comes back [01:06:30] and he checks. He checks his airways, he checks everything. Does the standard, you know, procedure [01:06:35] in this. At this point I am shitting myself. But I [01:06:40] am very good at not showing that I’m shitting myself. So I’m like, no, it’s fine. You know, these things happen sometimes. [01:06:45] We have given you a lot of anaesthetic, But inside I am dying. I’m crying. I’m [01:06:50] thinking I’m giving up dentistry. I’m already thinking in my head of all the other careers I might want to pursue. And [01:06:55] anyway, my obviously very experienced colleague is able to calm [01:07:00] him down, give him some water and he’s totally fine. He sends him home.

Payman Langroudi: It’s a panic.

Sarina Kiani: Attack. [01:07:05] I have a panic attack. Yeah, he’s having a panic attack. What’s going on? What was going on? I think he had a little bit of a panic [01:07:10] attack. I’m having a panic attack. Yeah. He leaves, I’m shaking. I’m. [01:07:15] Someone’s then bringing water for me because I’m panicking, I go home. I [01:07:20] didn’t sleep all weekend because I was waiting to call him back on Monday, make sure he was okay. And [01:07:25] yeah, of course he’s okay. Comes back, obviously spend the rest of the week planning [01:07:30] the the type of lay I’m going to give him that’s going to work this time. And [01:07:35] lo and behold, yeah, it does work because I did something differently and it was all okay. And luckily [01:07:40] Touchwood, he was good. He was a good patient. It couldn’t have happened on a better patient, you know. [01:07:45] But it was a good learning curve because I.

Payman Langroudi: Spent the learning point.

Sarina Kiani: The learning [01:07:50] point.

Payman Langroudi: Differently.

Sarina Kiani: Nothing that these things happen that actually why have [01:07:55] I just ruined. I ruined my entire weekend worrying about it and not sleeping, and I probably [01:08:00] ruined everyone else’s weekend. That was around me, worrying about it and realising that these things [01:08:05] happen and it’s okay. And it probably happen again. Probably not the same mistake, but [01:08:10] something will go wrong again and it’s okay.

Payman Langroudi: I mean, I like it, I like it because [01:08:15] it’s a bit different. Yeah, but it’s not enough. I mean.

Sarina Kiani: You want to get darker.

Payman Langroudi: Have you got any darker ones?

Sarina Kiani: Not [01:08:20] yet.

Payman Langroudi: Genuinely management issues I mean like that previous one. That was a good one. Any other management [01:08:25] issues?

Sarina Kiani: Genuinely, no.

Payman Langroudi: You haven’t been doing it long enough.

Sarina Kiani: That’s what I’m saying. It’s [01:08:30] hard to give you really dark, juicy things because I’ve haven’t been doing it that long.

Payman Langroudi: Biggest [01:08:35] mistake as a tactical mistake that you’ve made in your career.

Sarina Kiani: That make mistakes. [01:08:40]

Payman Langroudi: Um.

Sarina Kiani: It’s gonna sound so cringe though. You’re not going to want to [01:08:45] hear it.

Payman Langroudi: Yeah.

Sarina Kiani: Go on. I don’t believe in any mistakes because.

Payman Langroudi: I don’t want to hear.

Sarina Kiani: That. Exactly. I knew you wouldn’t want [01:08:50] to.

Payman Langroudi: Hear it.

Sarina Kiani: Because even even working for a certain place, you know, six months. And I thought, oh, I need to get [01:08:55] out. Even that taught me a lot.

Payman Langroudi: Yeah, but look, the reason I’m asking is because [01:09:00] mistakes teach us. Yeah, but I don’t. So that’s why I’m asking.

Sarina Kiani: I guess I [01:09:05] don’t know. I haven’t really.

Payman Langroudi: It might be.

Sarina Kiani: I think it is. I haven’t had any dark juicy.

Payman Langroudi: But [01:09:10] it’s interesting. Yeah. Because a lot of what you’re saying you’re, you’re following up with. And that’s okay. [01:09:15] And it’s almost like, I don’t know, it’s a new experience for you letting yourself off the hook. Yeah, [01:09:20] a little bit.

Sarina Kiani: Definitely.

Payman Langroudi: Which is good though. Yeah. Because like, evolution [01:09:25] is a really important thing when it comes to I mean what we’re talking here now. Mental health.

Sarina Kiani: Yeah. [01:09:30]

Payman Langroudi: Where we’re at.

Sarina Kiani: I think so I think getting older is realising [01:09:35] that you’ve got so many more years of this to come. And [01:09:40] do you want to suffer? Do you want to put yourself in this position [01:09:45] again and again and again? I think when you’re younger, it can feel like you’re in this bubble [01:09:50] and the most, you know, horrendous thing that’s happened. You know, whatever’s gone wrong at work, you [01:09:55] can feel like that’s your entire world. But when you’re older and you get humbled by life and [01:10:00] other things that happen outside of work, you realise that you you do it is okay. [01:10:05] Because, you know, I’ve got more important things going on at home. There are people that are suffering with more [01:10:10] important things that, you know, it’s just teeth. You can relax and you tried your best [01:10:15] and I think that’s important.

Payman Langroudi: You told me before off mic [01:10:20] that you kind of manifested things in your life.

Sarina Kiani: Yeah, I hate that word [01:10:25] as much as anybody else, but yeah.

Payman Langroudi: What does it mean?

Sarina Kiani: I have a little sheet of paper. I [01:10:30] took a picture of it genuinely, where I wrote the dates of the [01:10:35] years, and next to it I had GSK, I wanted [01:10:40] to go to kings and kings only for dentistry. And all those things happened. They might [01:10:45] have not happened in that year that I’d planned them to, but everything that I [01:10:50] had imagined, I achieved now after I achieved it. [01:10:55] Was I happy and content? Absolutely not. Like anything in life, any goal in life, [01:11:00] you realise when you achieve it that you still want to achieve something else. There’s always something [01:11:05] you want to gain. And I think that’s where it comes back to the mental health things that I [01:11:10] say. I realised quite quickly that if I couldn’t make making my cup of [01:11:15] coffee in the morning the most enjoyable thing, that I would never be happy. And I think [01:11:20] romanticising all the little things in life brings you so much more joy. It’s [01:11:25] the same for people that say, you know, I live for the weekend. What about the rest of the five [01:11:30] days in the week? And I think if you can make all those little mundane [01:11:35] tasks really, genuinely enjoyable, whatever it is, you know?

Payman Langroudi: I mean, they [01:11:40] call it living in the moment, right?

Sarina Kiani: It’s hard, though, living in the moment, I find. Hard because I’m [01:11:45] an overthinker. So what does that even mean? So instead of saying to myself, for me, it [01:11:50] didn’t work, saying living in the moment didn’t work because I’m always like planning things, right? Instead, [01:11:55] I said, focus on the enjoyment of the moment. What [01:12:00] am I doing and why is this so pleasurable?

Payman Langroudi: Enjoyment is an interesting word here because [01:12:05] I don’t know if you’ve ever looked at any Anthony Robbins Tony Robbins stuff.

Sarina Kiani: Yeah.

Payman Langroudi: And he’ll throw [01:12:10] the word enjoy into it. Yeah. And as soon as like he’ll say something [01:12:15] like, how can I get through this thing as quickly as possible and enjoy, enjoy the process. And [01:12:20] as soon as you put enjoy in your brain, fix comes up with different things because your brain [01:12:25] is sort of pain. Pleasure thing.

Sarina Kiani: Yeah, yeah, yeah.

Payman Langroudi: You know.

Sarina Kiani: I heard on a podcast [01:12:30] that anxiety I used to suffer a little bit with anxiety when I first [01:12:35] started working privately on the way to work. I’d have this rumbling in my belly where I felt like, [01:12:40] oh my God, I hope everything goes okay. I hope it’s all well. Yeah, I learned on [01:12:45] the podcast that anxiety is the same chemical reaction in your brain as [01:12:50] excitement.

Payman Langroudi: Yeah.

Sarina Kiani: And if you tell yourself that it’s actually I’m just excited. I’m excited for [01:12:55] the day. You have to lie to yourself. After a while, your brain will actually take it as an excitement.

Payman Langroudi: It’s [01:13:00] the same chemical.

Sarina Kiani: It’s the same.

Payman Langroudi: Chemical?

Sarina Kiani: Yeah. Kind of. Yeah, exactly.

Payman Langroudi: And he’s asking, um, [01:13:05] Olympic athletes or something. How do you feel? Well, someone someone is asking, but he [01:13:10] kind of popularised that idea. It’s interesting. It’s an interesting thing. Um, and both [01:13:15] can be true, right? You can be excited and nervous at the same time. Um, but just. [01:13:20]

Sarina Kiani: Focus on the excitement part. You’re you’re still going to be nervous.

Payman Langroudi: But being this overthinker. Right? [01:13:25] I’m an overthinker myself. Yeah. And sort of the power of now thing it says [01:13:30] now. Right, right, right now is more important than definitely [01:13:35] the past.

Sarina Kiani: Definitely. But but you know, even the future.

Payman Langroudi: The future as well. Yeah.

Sarina Kiani: You’re not there. [01:13:40] You’re not. Why are you then? You’re just rushing through life and you can’t enjoy it? Yeah, definitely. [01:13:45] Because if you think about the year and all the big holidays you have planned. Yeah. Great. [01:13:50] That’s like, what, one 2% of the entire year or even like January Blues. Why [01:13:55] does January have to be blue? You know, why can’t it be colourful?

Payman Langroudi: No, no, I always think of [01:14:00] it, you know, like people who work in the city, they work their butts off sometimes, right? Or most of the time. [01:14:05] Um, and sometimes buy back happiness for four weeks of the year. Yeah. [01:14:10] In the Caribbean?

Sarina Kiani: Yeah.

Payman Langroudi: And what about the other.

Sarina Kiani: Yeah. Don’t get me wrong. I would love.

Payman Langroudi: To be.

Sarina Kiani: A Caribbean. [01:14:15]

Payman Langroudi: No, but my.

Sarina Kiani: Happiness would be through the roof. But.

Payman Langroudi: But what about the other 48 weeks? You know, like, [01:14:20] that’s it’s a it’s a bloody good point. Yeah.

Sarina Kiani: People ask me all the time, how was your week? [01:14:25] What did you get up to? And if I actually told you my week I went to the gym, I [01:14:30] went to work, I came home, I cooked, Didn’t see anybody. Didn’t do anything exciting. [01:14:35] Quote unquote. Exciting? Yeah. I had the best week. Why did you have [01:14:40] the best week? Oh, because I wore my favourite new gym gear that I’ve been [01:14:45] ordering online from China that arrived. You know, I’ve been waiting for for three months, or I [01:14:50] bought these new coffee beans that I’ve been waiting to sniff before I grind, because I bought this new [01:14:55] coffee machine that I’ve been trying out this little latte art on, like silly little. [01:15:00] I noticed decaf in the night and then caffeinated in the morning, of course, which is a nightmare. Trying to [01:15:05] change the beans. I’m ten out of ten. Do not recommend. Um, but I [01:15:10] realised that actually I had a great week. I, you know, I called my uncle in [01:15:15] Iran and we had this 20 minute revelation of on FaceTime over. But [01:15:20] if I told you that that sounds like the most boring week ever. But I had the nicest week. Genuinely, [01:15:25] I had a great week.

Payman Langroudi: Yeah, let’s look quickly. Social media. Yes, [01:15:30] because you seem very native. You seem very, very comfortable. Yeah. I was looking at your [01:15:35] TikTok. So comfortable talking to the camera. Hot takes on things. [01:15:40] Yeah. Um, all dressed and made up and all that. Tell [01:15:45] me. Talk me through it. I mean, how much of it is, you know, like, pure, sheer, tactical, [01:15:50] you know, hard work and how much of it is you just can’t help yourself making content. [01:15:55]

Sarina Kiani: Do you know the content that works really well is the one where I’m literally eating. And I just [01:16:00] had an idea and I thought, let me just film myself. That goes viral. And the one that I took [01:16:05] literally three hours.

Payman Langroudi: Yeah, likes that.

Sarina Kiani: Three hours perfecting this case that [01:16:10] I wanted to talk you through and all the science behind it. No one gives. No one cares [01:16:15] about that. And so I think it goes back to like just being yourself and being.

Payman Langroudi: Does it represent [01:16:20] to you? I mean, does it represent to you a marketing platform? Yes, it’s marketing 100%. [01:16:25]

Sarina Kiani: No, it’s it’s not self-expression. I’ve never Been someone that tries to [01:16:30] express that loudly, outwards to people.

Payman Langroudi: You seem very comfortable.

Sarina Kiani: Like, because I have an ulterior [01:16:35] motive. It’s the brand. I want to get my name out. It’s me hustling. It’s [01:16:40] my way of hustling. It’s my way of getting my face out there so that I don’t miss an opportunity [01:16:45] having my first brand deal. Do you know how excited I was about that?

Payman Langroudi: But did you. Did you were [01:16:50] you doing it before you were a dentist?

Sarina Kiani: No.

Payman Langroudi: So? So then you’ve come to it [01:16:55] quite recently?

Sarina Kiani: Yeah.

Payman Langroudi: Yeah, yeah.

Sarina Kiani: And just as a dentist only.

Payman Langroudi: But the execution [01:17:00] is so good. So did you just find that you were good at it.

Sarina Kiani: As a, you know, zombie [01:17:05] scroller? After a while you start to realise, like, trends that work. [01:17:10] You start to speak in the lingo of the social media as well, and you realise you’re [01:17:15] a millennial. Calm down. You’re not a Gen Z or whatever.

Payman Langroudi: Yeah.

Sarina Kiani: And [01:17:20] so I think that helps too.

Payman Langroudi: So do you find TikTok easier?

Sarina Kiani: It’s a lot easier, 100%. [01:17:25]

Payman Langroudi: Easier to grow, right?

Sarina Kiani: It’s so much easier because you reach the entire world. You can have [01:17:30] one video that has, like, millions of views and, um, it’s I’m still working on it, trying [01:17:35] to build, like, a community, finding what it what is it? What is my brand? What am I trying to actually achieve? [01:17:40] And I think the ones that work really well is when I’m giving information because there’s you [01:17:45] forget how much you actually know that the general public don’t know and.

Payman Langroudi: How.

Sarina Kiani: Useful that information [01:17:50] actually can be. Yeah, some something silly that you think. Well, that’s obvious. As a dentist, [01:17:55] it’s not obvious to someone that isn’t in the dental world.

Payman Langroudi: This is what I mean about being closer to [01:18:00] being a real person than a dentist.

Sarina Kiani: I think that helps.

Payman Langroudi: But then when you [01:18:05] do it, does it? Is it are you getting sort of a bit of a high from [01:18:10] the likes and the views, or is it translating?

Sarina Kiani: I think comments. Yeah.

Payman Langroudi: Because [01:18:15] is it translating to patients genuinely?

Sarina Kiani: I had a patient come in. It’s still slow [01:18:20] and steady for me personally right now. I’m still growing it. But I had a patient, the one that came [01:18:25] in three hours. She travelled to come and see me because I’d spoken about anxiety and [01:18:30] Dental anxiety, and I posted this review. This patient had put about, you know, non-judgmental [01:18:35] dentists where you’ve had some mental health issues that meant that you neglected [01:18:40] your mouth. And, you know, if you go to the dentist, a lot of people say that they see a lot of judgemental [01:18:45] dentists. And she came all the way just to see me because of that one post. [01:18:50]

Payman Langroudi: But, Serena, I mean, I could pull 30 dentists in front of me here, [01:18:55] and we’d all agree it’s good for marketing. Yeah, but that’s 29 [01:19:00] of them aren’t going on and posting.

Sarina Kiani: That’s because they’re taking it too serious. [01:19:05] I think that’s another thing. Like I take my job very seriously as a dentist, and everyone always says when [01:19:10] I’m in the room with you, you’re very serious, but you shouldn’t take yourself so serious. And I think on social [01:19:15] media that can come across if you’re trying to be very, you know, by the book or the GDC watching me, obviously [01:19:20] you work ethically, but you but you don’t need to be so robotic about it. I think [01:19:25] that’s the beauty of social media.

Payman Langroudi: Yeah, but what do you think stopping other people that they take themselves seriously. And I think that’s [01:19:30] it.

Sarina Kiani: They’re worrying too much about what people think. They’re worrying too much about. Oh, but what I said [01:19:35] might not be completely factual.

Payman Langroudi: You’re not worried about what people think of you.

Sarina Kiani: Never worried about what people think of [01:19:40] me. I’ve always worried about obviously, what my patients think and being, you know, a good team [01:19:45] member in my practice, but never putting something online and worrying too much about what people think. If [01:19:50] someone is always going to not like you and someone else is always going to like you, there’s always [01:19:55] going to be both. So if you sit there worrying so much about what people think, you’ll never be able to just [01:20:00] be yourself.

Payman Langroudi: Have you been trolled?

Sarina Kiani: Yeah, of course, there’s always inappropriate [01:20:05] comments or comments.

Payman Langroudi: In your comments.

Sarina Kiani: Yeah. Do you know what I do? I block them [01:20:10] or I delete them. And I think this is a you know, I’m not going to go sit on there and reply [01:20:15] to them because Tom, Dick and Harry had five minutes, you know, or are [01:20:20] bored at home and want to take the time to write a nasty comment. If I reply [01:20:25] then that says more about me. Obviously there’s time when you think yeah, your mum, but you don’t [01:20:30] write that back because you think you know what? I hope [01:20:35] that your day goes better than whatever you were going through to write me that message.

Payman Langroudi: See, [01:20:40] Rhona used to complain a lot about trolls, and then I used to think, well, she’s being oversensitive [01:20:45] here because, you know, it comes with the territory.

Sarina Kiani: They can be nasty sometimes.

Payman Langroudi: But then she showed me some and it was like, I hope [01:20:50] your parents die.

Sarina Kiani: Yes, they can be nasty.

Payman Langroudi: Well.

Sarina Kiani: They can be really nasty sometimes [01:20:55] or they can be really personal sometimes as well. And you think, oh my God, like, who are you? Is it someone I [01:21:00] know? What’s going on? But, um.

Payman Langroudi: It’s not enough of a problem to stop you from [01:21:05] doing it.

Sarina Kiani: No. Not yet. I’ll let you know when I’ve got Ronan’s following.

Payman Langroudi: Yeah, [01:21:10] I guess it’d be different. But still, I’m still interested in the fact that you’re not worried about what other dentists [01:21:15] think of you. That’s. That’s what stops a lot of people.

Sarina Kiani: Yeah, I think that [01:21:20] I can’t change who I am. So if I put on a persona [01:21:25] to please you, ultimately, inevitably down the line, you’ll see that [01:21:30] that’s not me. So if I’m just being myself on social media, you’ll see that in person, too. [01:21:35] And so if you don’t like me when you see me on social media, you’re not going to like me when you see me in [01:21:40] person. So what’s the point of trying to be someone else, you know? And I think that the people that [01:21:45] know me, you know, the people on my team, people at work, they like me. They think [01:21:50] I’m a nice person. Patients think I’m a nice person. And ultimately, I think that’s all that matters. [01:21:55] I don’t need to be worrying what any other dentist think. As long as I’m, you know, [01:22:00] I’m a respectful, nice, genuine person. I don’t sit there. I don’t bitch about anyone. I don’t [01:22:05] say anything nasty about anyone. You know, there’s a lot of gossiping in dentistry that happens. [01:22:10] People love to bash other people’s work. Go and look on social media and compare and [01:22:15] and say nasty things about people’s work. I’m sure it happens to me all the [01:22:20] time or to my work. I’m sure my story gets posted to, you know, sent to someone else in [01:22:25] the DM and nasty comment is made. Do I sit there worrying about that? Absolutely not. Because what can [01:22:30] I do to stop that? That’s just that person and their insecurity. I’m not accountable for their insecurity. [01:22:35] If they want to feel better about themselves by doing that, by all means. I don’t really need to do that. Me and my friends [01:22:40] really aren’t like that. The people around me aren’t like that. So I don’t need to be like that.

Payman Langroudi: And are you only [01:22:45] tackling TikTok and Instagram, or are you looking at LinkedIn and YouTube?

Sarina Kiani: And [01:22:50] it’s definitely not YouTube. Um, I think TikTok [01:22:55] and Instagram for now, because it’s all aimed at patients. I’m not trying [01:23:00] to impress other dentists. If you look at the captions in my [01:23:05] posts, they’re aimed at people. So I’m not trying to show you the most incredible [01:23:10] onley prep that I’ve ever done with my DM and all the all the materials [01:23:15] I’ve used, which I have. I’m actually just trying to show the patient what [01:23:20] they can have done in their mouth. So it is aimed at people.

Payman Langroudi: What’s your process?

Sarina Kiani: What [01:23:25] do you mean.

Payman Langroudi: Your content creation process? Like do you sit in one day and make six, [01:23:30] seven, ten reels?

Sarina Kiani: When I do that, it doesn’t work. So [01:23:35] it’s got to be when it comes to my mind. I’ll just write it down. I’m one of those people.

Payman Langroudi: Your mind. You write it down. [01:23:40]

Sarina Kiani: Yeah. In my In My Notes app, I have a notes app full of stuff.

Payman Langroudi: At some point in the future, you execute [01:23:45] on that.

Sarina Kiani: Or maybe I’ll just do it there and then if it’s really like an urge, because I [01:23:50] find with social media, if you’re trying to make a video and it’s a bit too planned [01:23:55] out, you’re not being yourself as much, so your energy is a bit off. Whereas if you’re very [01:24:00] you know, I’m very excited. I need to make this video right now. It does come across a lot nicer as well. [01:24:05] And those are the ones that do a lot better 100%.

Payman Langroudi: Interestingly, we’ve come to the end of [01:24:10] our time. Oh, that went quick.

Sarina Kiani: That was so enjoyable.

[TRANSITION]: Thank you.

Sarina Kiani: I had the [01:24:15] best time.

Payman Langroudi: Haven’t finished yet. Haven’t finished yet?

Sarina Kiani: Oh.

Payman Langroudi: We’re going to end on the same questions. [01:24:20] Oh, yeah. We always end.

Sarina Kiani: On. Yes.

Payman Langroudi: Fantasy dinner party.

Sarina Kiani: Oh! [01:24:25]

Payman Langroudi: Three guests.

Sarina Kiani: Three guests.

Payman Langroudi: Dead or alive.

Sarina Kiani: Dead or [01:24:30] alive. It would have to be a female entrepreneur. 100% [01:24:35] women that I admire. [01:24:40] There’s a lot. There’s a lot of females.

Payman Langroudi: Being a woman than a man.

Sarina Kiani: In [01:24:45] what way?

Payman Langroudi: In life.

Sarina Kiani: I don’t like saying it is because I think that. [01:24:50] Then you’re saying that you’re limiting yourself because you’re a woman. Men face a lot of challenges, [01:24:55] too. Just different ones. I wouldn’t say that. No, and I wouldn’t say I wouldn’t want to [01:25:00] shout that around to young girls listening to it. She thinks, oh, life’s going to be tougher for me because I’m a girl.

Payman Langroudi: But then [01:25:05] why are we looking at female entrepreneurs? Why not just entrepreneurs?

Sarina Kiani: Because I’m a female. And so I think that I can relate [01:25:10] to their challenges more. You know, if I was a guy, I’d be like, well, I have [01:25:15] male role models. It’s just it’s just whatever you relate to. I think female [01:25:20] for me, because I’m a female. And so the challenges that they’ll go through, for example, planning when to [01:25:25] have children will be a challenge for me too. And so I think, look, if they can do it, I can [01:25:30] do it. Yeah. And I think that is what.

Payman Langroudi: Like which one comes to mind when you think female.

Sarina Kiani: Right now? Just off the top [01:25:35] of my head. Grace Beverly Hill, Beverly grace Beverly, the [01:25:40] founder of Tala and Shreddy.

Payman Langroudi: Oh.

Sarina Kiani: Um, she is a very educated woman [01:25:45] who went to, I think it was Oxford or Cambridge and set up [01:25:50] her brand. She talks a lot about mental health, a lot about, um, how [01:25:55] young girls can, you know, start up their businesses or what they want to achieve [01:26:00] and their brands and all these things. I think I listened to a lot of her. She has a podcast as well. [01:26:05] I listened to a lot of her, um, podcast and her You know.

Payman Langroudi: I don’t know her [01:26:10] name, but the lady who did the ordinary skincare.

Sarina Kiani: Yeah.

Payman Langroudi: Do [01:26:15] you know.

Sarina Kiani: Who? No.

Payman Langroudi: Do you know her name?

Sarina Kiani: I’ve got her face. But I’m very bad with names.

Payman Langroudi: Okay. Go on. [01:26:20] Who’s your second guess.

Sarina Kiani: Or second guess? Dead or alive? [01:26:25] Hmm. This is tough. I genuinely am very [01:26:30] bad at this. I had a list, and then I forgot it. Very bad with names. Um.

Payman Langroudi: But [01:26:35] go on, like, go category wise. Like female entrepreneur. What would be another category? [01:26:40]

Sarina Kiani: Do you know what the one you said is? Shah. Shah? Completely rogue. Nothing. Dental [01:26:45] Shah, the Shah of Iran would be cool.

Payman Langroudi: Yeah. He’s made an appearance several times.

Sarina Kiani: Yeah.

Payman Langroudi: Has [01:26:50] he? Yeah. Yeah.

Sarina Kiani: I feel like my questions are not going to be as as intelligent as other people’s. [01:26:55] They’re going to be a little bit more.

Payman Langroudi: Did you did you know your grandfather, the general?

Sarina Kiani: Yes. Yeah. Yeah, [01:27:00] yeah I was I grew up going to Iran every summer and just hanging out [01:27:05] at his incredible house and.

Payman Langroudi: Oh.

Sarina Kiani: Really? Eating the pomegranates that he’d grow in his garden. [01:27:10] Yeah, it was incredible. And then when he passed away, I stopped going to Iran.

Payman Langroudi: I didn’t [01:27:15] see.

Sarina Kiani: The.

Payman Langroudi: Point anyway. Similar story for me.

Sarina Kiani: When was the last time you went?

Payman Langroudi: 12 years ago. [01:27:20] With my. After my grandma passed away.

Sarina Kiani: Yeah. Did the family kind of breaks away? [01:27:25]

Payman Langroudi: Yeah. Third one. Can you think?

Sarina Kiani: Third [01:27:30] one around a dinner table? [01:27:35] I don’t know. You know, it’s tough. It [01:27:40] shouldn’t be this hard saying these.

Payman Langroudi: You know, you [01:27:45] put too much pressure on yourself that you know it’s going to be the right person, but it doesn’t.

Sarina Kiani: It’s like I’m [01:27:50] trying to think of, ah, someone from friends, maybe. Yeah. Yeah.

Payman Langroudi: Which [01:27:55] one do you like?

Sarina Kiani: Oh, what was his name? He passed away.

Payman Langroudi: Matt? No, the other guy. The other guy. [01:28:00] Chandler.

Sarina Kiani: Chandler.

Payman Langroudi: Yeah. His real.

Sarina Kiani: Name? Yeah. I should know his real name. [01:28:05] Yeah. Someone funny like that. Someone light hearted.

Payman Langroudi: Like dinner party [01:28:10] fun.

Sarina Kiani: Yeah, but obviously, given how he passed away, I’m. I’m guessing there’s a lot more [01:28:15] to it. And I feel like that would be nice to to talk on a deeper level with someone like [01:28:20] that. That on the outside is so funny. Making me laugh all the time, all the time, and has so [01:28:25] much going on in the inside.

Payman Langroudi: Interesting dinner party. Yeah, him and the Shah.

Sarina Kiani: So nobody [01:28:30] that loud because I think everyone’s a bit of an introvert, I’d say. Yeah. [01:28:35]

Payman Langroudi: Would you call yourself an introvert?

Sarina Kiani: Yeah.

Payman Langroudi: And it’s funny because before [01:28:40] I met you, I thought you were this really massive extrovert.

Sarina Kiani: Everyone thinks that.

Payman Langroudi: Everyone thinks I’m.

Sarina Kiani: This.

Payman Langroudi: Weekend [01:28:45] with you at Mini Smile Makeover. I realised no, no, you’re much more quiet. [01:28:50]

Sarina Kiani: Yeah.

Payman Langroudi: Person.

Sarina Kiani: That’s how I come across. Everyone always thinks. Oh, she must be, you know, so [01:28:55] loud. I’m in bed by 8 p.m.. I am so boring.

Payman Langroudi: Why [01:29:00] would you call yourself shy?

Sarina Kiani: No, I’m sure I’m not shy.

Payman Langroudi: I’m proper.

Sarina Kiani: Shy.

Payman Langroudi: Are you very shy?

Sarina Kiani: You [01:29:05] don’t seem shy.

Payman Langroudi: I’m very shy.

Sarina Kiani: Really very shy. I would have not thought.

Payman Langroudi: That there are people in this building I haven’t [01:29:10] been introduced to yet. And so I haven’t. I haven’t gone up to them yet. I need to be [01:29:15] introduced to people.

Sarina Kiani: Because, see, in like a Dental event. Yeah. I would [01:29:20] wouldn’t be the first to go up to someone. Hi. You know what’s there? But if they were talking to me, then I’d open up like this [01:29:25] onion. But yeah, I don’t think I’m shy, though.

Payman Langroudi: Most of the time. Karma. [01:29:30]

Sarina Kiani: Karma. Yeah, I mean, I, I’m quite. Yeah. [01:29:35] I’ve got quite a strong faith. Yeah. I’m Muslim.

Payman Langroudi: Oh. You believe?

Sarina Kiani: Yeah. Yeah, yeah, [01:29:40] yeah, I believe in, you know, a higher power, 100% karma. [01:29:45] I think karma goes a little bit hand in hand. You know, if you do wrong, that things [01:29:50] will happen to you. But I don’t think it’s that black and white, you know.

Payman Langroudi: So [01:29:55] let’s get to the final question.

Sarina Kiani: Um.

Payman Langroudi: On your deathbed, many years from [01:30:00] now with your you tomorrow. Grandchildren’s grandchildren. Um. [01:30:05] Three pieces of advice.

Sarina Kiani: Ooh.

Payman Langroudi: You’d leave [01:30:10] for them in the world? What would they be?

Sarina Kiani: See, people are going to watch this and go. She’s so young. [01:30:15] Like, what advice has she got to give? No. But then what I would say to them is I. [01:30:20] Don’t worry about what people think.

Payman Langroudi: Yeah.

Sarina Kiani: Just be yourself. What comes naturally to [01:30:25] you? It took me a long time to be myself, by the way. When I was a lot younger, [01:30:30] I would, you know, imitate other people and.

Payman Langroudi: Try and be someone else.

Sarina Kiani: Yeah. Because I thought, oh, [01:30:35] I see someone. They were popular. Maybe I wanted to be a bit like them. I didn’t know who I was.

Payman Langroudi: I had [01:30:40] a super cool friend. I think I spent 5 or 6 years trying to be him. Massive isn’t it? [01:30:45] Massive, massive.

Sarina Kiani: Because you realise I don’t even like what she’s wearing. Like what? Why am I even wearing this blazer? [01:30:50] I don’t even like blazers.

Payman Langroudi: No, but that famous quote about be yourself, everyone else is taken.

Sarina Kiani: Yeah, [01:30:55] yeah yeah yeah. That’s true. Someone wrote that to me in a card once.

Payman Langroudi: To be yourself. Is that your first Your [01:31:00] first piece of advice?

Sarina Kiani: Just don’t overthink it. I tell myself [01:31:05] that today. Don’t overthink it and just do it. I’m [01:31:10] on an advert.

Payman Langroudi: One of those like, fuck it, do it.

Sarina Kiani: Yeah. Don’t [01:31:15] think too much. Just do it. Just do it. And don’t take no for an answer. When you [01:31:20] want something.

Payman Langroudi: I can see that in your behaviour.

Sarina Kiani: Don’t take no for an answer. It will happen. It might just not happen in that [01:31:25] way that you want.

Payman Langroudi: I can see that in your behaviour. Yeah. I mean, like those sliding doors. Those. [01:31:30] If you hadn’t have. For the sake of the argument. Ask for that admissions tutors [01:31:35] meeting. Yeah. Or if you hadn’t turned up at that corporate mini corporate [01:31:40] with your CV, you might be you might be a totally different person [01:31:45] now. Yeah. Probably not. Probably not. But because you’d get through anyway.

[TRANSITION]: But [01:31:50] yeah. Do it maybe in a different field.

Payman Langroudi: Yeah.

Sarina Kiani: And I’d probably still meet you, but in [01:31:55] a different way. Maybe business wise.

Payman Langroudi: I’m interested in the manifestation thing. I’m gonna try.

Sarina Kiani: It. Yeah. So [01:32:00] it’s not about. Oh, okay. I want this to happen. It’s about [01:32:05] lying to yourself that this is already happening. How would I feel if I wanted [01:32:10] to be a business owner? For example, how would I feel as a business owner? What would [01:32:15] my day look like and what? How would I feel? And a big part of that is how I dress, [01:32:20] how I carry myself. All these things.

Payman Langroudi: You’re not saying it’s a supernatural thing. You’re saying it.

Sarina Kiani: Actually. [01:32:25]

Payman Langroudi: Works out that way because you’re because.

Sarina Kiani: You start doing it today. You’re already doing it today. [01:32:30] So if I said to myself, and I did this last year, I said I wanted to be I wanted [01:32:35] to manage stress a lot better at work because it can be quite stressful. I started [01:32:40] managing stress at work by telling myself, you know, okay, I can feel the stress coming [01:32:45] on. I can calm down, calm down, peaceful. How would the type of person I want [01:32:50] to be react in this situation and just react that way now and then, slowly, [01:32:55] slowly. You just become that person. Yeah.

Payman Langroudi: You know, give it a go.

Sarina Kiani: Yeah. [01:33:00]

Payman Langroudi: International DJ. Yeah. Don’t know anything [01:33:05] about music. Yeah. Amazing. Thank you so much for coming.

Sarina Kiani: Thank you so much for having me. It’s been such a pleasure. [01:33:10]

[VOICE]: This is Dental Leaders, the [01:33:15] podcast where you get to go one on one with emerging leaders in dentistry. [01:33:20] Your hosts, Payman Langroudi [01:33:25] and Prav Solanki.

Prav Solanki: Thanks for listening, guys. If you got this far, [01:33:30] you must have listened to the whole thing. And just a huge thank you both from me and pay for actually [01:33:35] sticking through and listening to what we had to say and what our guest has had to say, because I’m [01:33:40] assuming you got some value out of it.

Payman Langroudi: If you did get some value out of it, think about subscribing. [01:33:45] And if you would share this with a friend who you think might get some value out of it [01:33:50] too. Thank you so so, so much for listening. Thanks.

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

[VOICE]: This [00:00:05] is mind movers [00:00:10] moving the conversation forward on mental health and [00:00:15] optimisation for dental professionals. Your hosts Rhona [00:00:20] Eskander and Payman Langroudi.

Rhona Eskander: Hello [00:00:25] everyone! Welcome to another episode of Mind Movers where we’re joined by Doctor Filippa [00:00:30] K who is a GP, author and menopause expert. She has [00:00:35] been an incredible force within the medical community, and I just want to say, [00:00:40] I actually met her when I got asked to be on the Piers Morgan Show and I was like, oh, she’s [00:00:45] just incredible. You know, I was being ripped apart by Piers Morgan, but not not by Piers Morgan. Who [00:00:50] was it then? Jeremy, Kyle and Phillipa was amazing. And what I [00:00:55] have found extremely interesting recently is that Phillipa has released a book specifically [00:01:00] on menopause. I have reached out to her as well regarding my own questions with [00:01:05] PMDD, mental health, fertility, and so forth. From [00:01:10] mood swings to brain fog, Doctor Philippa has unpacks the physiological and psychological changes [00:01:15] that women face during menopause, and how society’s silence around the topic can [00:01:20] leave women feeling extremely overwhelmed and isolated. So [00:01:25] today we’re going to explore the strategies to support mental health, challenge the stigma, and empower [00:01:30] women to take charge of their health during this transformative time. So welcome [00:01:35] Philippa.

Philippa Kaye: Seems like quite a challenge in a podcast, but let’s go.

Rhona Eskander: Yes, I [00:01:40] love that so much. You know what, Philippa? I like people to really meet the person [00:01:45] in front of me first and foremost. So I want to know a little bit about you. [00:01:50] Where did you grow up? Where did you go to university and why did you choose to become [00:01:55] a doctor?

Philippa Kaye: So I’m a cliché. I grew up in north west London. I went to medical [00:02:00] school in Cambridge and then in King’s College London. Um, but there is one question [00:02:05] at medical school interviews that you’re not supposed to answer, which is, well, you’re supposed to answer [00:02:10] it, but not the way that you want to. And the question is, why do you want to be a doctor? And what everybody wants [00:02:15] to say is, because I want to help people. And for some reason, that’s not supposed to be what [00:02:20] the answer is. I think that’s a really good answer, like a really good reason. But apparently [00:02:25] that’s not supposed to be what you say, but I did. I always wanted to be a doctor. I always wanted to help people. [00:02:30] There was a very brief moment in time, apparently in nursery, where I thought I was going to be a ballerina, but by [00:02:35] the time I was 4 or 5, I was set. And media medicine [00:02:40] is a little branch out of that. But in my average day I might [00:02:45] see 30 patients, I might have 60 patient contacts, but I [00:02:50] can reach thousands and tens of thousands and sometimes millions of people [00:02:55] on a show on ITV or on Sky news or wherever it might [00:03:00] be. And I think that there is a really important role to that [00:03:05] part of medicine, because there is no point in us writing articles [00:03:10] in a medical journal like The Lancet got to go where the people are, and sometimes [00:03:15] the people are reading the newspaper and sometimes they’re watching this morning. And actually [00:03:20] everybody needs that health information in a really understandable way. [00:03:25] And so that’s what we do. And inherently I think I’m really nosy. [00:03:30] And as a GP, I get to be really nosy and actually go inside people’s houses [00:03:35] and be nosy. And that are the two bits that I think make a good doctor to be nosy [00:03:40] about you and want to know you and who you are and what makes you you. Because that feeds into [00:03:45] everything that happens to your body. And being able to communicate [00:03:50] with you and translate the medicalese into English.

Rhona Eskander: Did you? So obviously you wanted [00:03:55] to be a doctor since you were young? I mean, that would stay the same with me in dentistry. Did you find [00:04:00] medical school enjoyable, challenging or both?

Philippa Kaye: So I am the only medic [00:04:05] in my family. Um. And I remember really clearly some people being like, well, [00:04:10] you’ve got no clue what you’re getting into. And other people being like, well, you must really want to do it. Um, [00:04:15] I loved school. I’m sorry. I know so many people hate it, I [00:04:20] loved it, and I loved medical school. And I still sometimes say all doctors [00:04:25] and dentists, I’m sure, have to do continual professional development. We have to keep learning because medicine didn’t [00:04:30] stay still when I qualified in 2004. Um, and I go to [00:04:35] these lectures and I think, God, the body’s fascinating, like, wow. And [00:04:40] I still get that sort of light up moment where [00:04:45] I think this is really interesting. This is where I want to be. And I really appreciate how lucky I [00:04:50] am to have that vocation. And I see so many people struggle, And I think that to [00:04:55] have a vocation is a really special thing, and then we get to use [00:05:00] that. Um, and so in some ways, and again, cliche sounds [00:05:05] really boring, but when your work is your passion, it’s okay.

Rhona Eskander: Totally. [00:05:10] So the funny thing is, is that I was I’m opposite to you. Everyone in my family [00:05:15] is pretty much doctor or dentist on my dad’s side. Typical kind of immigrant generation stuff. [00:05:20] Um, but I didn’t want to be a doctor. And one of the big reasons for me is because. And [00:05:25] now with my diagnosis of A.D.D., it kind of makes sense. It was all a bit too broad for me. So [00:05:30] I went to not broad, broad broad, right. So when I went to, I did this thing I cannot remember [00:05:35] what it’s called. I was trying to tell someone what Nottingham University did it before you apply to do [00:05:40] medicine and you do this kind of weekend where you’re a pretend doctor and they wake you up at like 2 a.m. [00:05:45] and you don’t know when it’s going to happen. And you rush to this like fake A&E. And, you know, it’s all very dramatic. [00:05:50] And I remember also, you know, sitting, pretending to be a doctor, and then a patient [00:05:55] comes in with all these symptoms and you’re meant to semi diagnose. And I found the whole thing quite overwhelming [00:06:00] because it was so broad. And as you know, with A.D.D., we you know, when you find something you really [00:06:05] like, you tend to want to hone in on it.

Rhona Eskander: And although. Yeah, exactly. And I feel like dentistry gives you the opportunity [00:06:10] to hyperfocus much early on because you are just dealing with the mouth. Although elements [00:06:15] of the training deal with medicine and you’ve got that part of it. I think the honing in on the teeth, the gums, [00:06:20] the mouth, etc., and using your hands almost immediately in second year really [00:06:25] helped me. I hated dental school, and the reason why I hated dental school was [00:06:30] because I didn’t really get on with the dentist, if I’m honest with you, I’m a natural creative. [00:06:35] So I did for English and Philosophy, chemistry and biology, and [00:06:40] I was my teachers were like, she needs to go to Oxbridge and do PPE. And [00:06:45] then I was like, oh, but I want to be a dentist. So there was this kind of dichotomy that was going on within [00:06:50] me that was like, where do I go? And I found myself naturally gravitating towards [00:06:55] the people in the arts, you know, the people that did English, the people that did politics, etc.. Um, [00:07:00] so that’s what I think that I found challenging. And the studying I did [00:07:05] find challenging.

Philippa Kaye: So I think, um, that I find it really [00:07:10] fascinating that dentists do the beginning of medical school. Yeah, I know how many teeth [00:07:15] there are. There are. That’s about it. Right? So they do like [00:07:20] two years worth of medical school and we know how to count teeth. Yeah. That’s [00:07:25] it. So it seems amazing to me that you have all of this knowledge and then in one area [00:07:30] and, and I think that when a patient walks in the door in general [00:07:35] practice, you have the whole of medicine open in your head. Right? And then they ask you, they sit [00:07:40] down, how can I help you today? And in fact, you’re not even supposed to say that. You’re supposed to just have the silence [00:07:45] and let them bring something in, and then you sort of have to turn in your head to the chapter on orthopaedics [00:07:50] or gynaecology or whatever it may be. And as you ask the questions, you’re getting narrower and narrower [00:07:55] and narrower. And but when you do your medical school training and you do a bit of this and a bit [00:08:00] of that, I went around and I thought I could see myself in this job, and I could see myself [00:08:05] in this job, and the only job I couldn’t see myself in was actually orthopaedics. I don’t want to stand [00:08:10] and hold a leg all day, and and general practice gives me the opportunity to [00:08:15] do all of those things. And you can make your job what you want it to be. So for example, [00:08:20] fitting coils or implants or something that’s a little bit more practical. But [00:08:25] for some people they do have that opportunity to say, I want to do microbiology, [00:08:30] but microbiology and only a viruses and only of this kind of viruses, and they can drill down [00:08:35] and but I think I’d get bored.

Rhona Eskander: So do [00:08:40] you think that’s why you were drawn to general practice as a GP? Because it [00:08:45] allowed you to have that spectrum. You know, where you could dip into all various [00:08:50] parts of medicine.

Philippa Kaye: I think it’s a combination of things. I think that’s the first bit and that’s the biggest pull. [00:08:55] And in particular, I really enjoy women’s health, children’s health [00:09:00] and sexual health. And whilst they sound like they’re linked in the hospital, they’re not, of [00:09:05] course. And so I could do all of those things. But when I was in medical [00:09:10] school, if you would have asked me, I would have said I wanted to be a premature babies doctor, a neonatal paediatrician, and [00:09:15] I loved that job. Yeah. Um, and you really saw what [00:09:20] you were doing and felt what you were doing in that job. And I went looking for female [00:09:25] mentors. And I’m 45, which is not that old. But actually, the world of medicine [00:09:30] has changed quite a lot in terms of helping women [00:09:35] be less than full time and have babies and understand that that’s [00:09:40] part of the career. And I couldn’t find a mentor that had what I also wanted, [00:09:45] which was to be married and have lots of kids, and I [00:09:50] could see people that did one thing or another thing, or try to do both and and how difficult [00:09:55] it was. And I thought, I’m not sure that I want to do this. So let me create my [00:10:00] way within general practice that I can do as much as I [00:10:05] want of this bit. I mean, obviously not neonatal peds, but you see loads [00:10:10] and loads of children. About a quarter of our work is children and, and and so the [00:10:15] two things together made me made me go for that. And occasionally people will say, [00:10:20] oh, you’re just a GP, do you ever want to go back to hospital medicine? And we always say, there’s no such thing as just a GP. [00:10:25] That’s a speciality in itself. We are specialists in general practice. It’s not the same, it’s different. [00:10:30] And no, I don’t want to go back to hospital medicine. I really think that this is the best choice [00:10:35] for me to be able to do all the bits that I want to do.

Rhona Eskander: Yeah, it’s funny as well, because [00:10:40] again, a lot of things that were drilled into me as a teenager about [00:10:45] dentistry when I looked into it, was that it’s much more suited to a woman because of the hours, [00:10:50] because of the flexibility, because of the fact that it’s genuinely unless you are in hospital, [00:10:55] which very few people are. It’s a 9 to 5 job. You can take time off, you can be flexible, [00:11:00] you can do more private. And whilst there are so many females, [00:11:05] it’s a female dominated industry. Dentistry. Still, women are not [00:11:10] at the forefront in the top positions. So what I mean by that is people go, yeah, but there’s so many female [00:11:15] dentists. Okay, but where’s the ones that are part of the boards, you know, of the big [00:11:20] organisations? Where are the ones that are at the forefront of the lecture stages? Where are [00:11:25] the ones that are part of the decision making and the committees? You know, you see so few of it. And [00:11:30] whilst a few people may come along, I think there’s still a degree of misogyny and, [00:11:35] um, a little bit of misrepresentation, to be honest with you. [00:11:40] And again, a lot of female dentists will go off and do kind of aesthetics and, [00:11:45] you know, very few will become implant surgeons or surgeons in general.

Rhona Eskander: And I challenge [00:11:50] that quite a lot within my industry. I mean, quite famously, there was a big online conference [00:11:55] in Instagram, was at its embryonic stages, and I remember there was all [00:12:00] the big amazing male dentists holding this conference, and they sent me an invite and I go, that’s [00:12:05] great, but you don’t have a single female on the panel. And I think I got like a sort of bot [00:12:10] reply or something. And one of the guys on the panel, I knew quite well, he’s one of [00:12:15] the most respected dentists in the world, and the guys [00:12:20] in the group chat sort of made fun of my message, you know, like, oh, look, you know. And he said, no, she’s right. [00:12:25] You know, women should be at the forefront. Women should be part of the decision making. And this is a global issue [00:12:30] anyways, as we know. But I do find it interesting because as I said, people, a lot [00:12:35] of women had chosen dentistry as well because of the flexibility of lifestyle. What [00:12:40] I do want to ask you as well, which I know will feed into, you know, the bulk [00:12:45] of our conversation. Do you think that medical misogyny [00:12:50] is still a big problem?

Philippa Kaye: Yeah.

Rhona Eskander: And for those people that don’t know, can you [00:12:55] define it? What what do we mean by medical misogyny? So I think.

Philippa Kaye: There’s two things here. I think there’s misogyny, [00:13:00] which actually means a hatred of women. And and that’s not sort of how people [00:13:05] use it in speak, but it means a hatred of women. And then there’s medical sexism. And [00:13:10] and we have to remember that women [00:13:15] have been around for millennia and for millennia. We have been judged on what we look [00:13:20] like and our ability to bear children. When you think about the big [00:13:25] changes in sort of women’s health, that link with women’s place [00:13:30] in society, those are the Abortion Act in the 60s, the pill in the 60s, [00:13:35] HRT, you know, whilst it was discovered earlier, didn’t really come to the fore to [00:13:40] the 60s. That’s less than a century ago. So these are the things which were really [00:13:45] a game changer for women. The pill separates women’s from having sex with necessarily [00:13:50] having children, and all of that entails. And 60 years worth [00:13:55] of something is not the same as five millennia worth of something, right? And [00:14:00] so these changes take a huge amount of time. Women weren’t mandated to be in medical trials [00:14:05] until towards the end of the last century. That means that you could have [00:14:10] any trial on a drug or on a condition, and not include women in it, because [00:14:15] the little darlings are too complicated with those periods. And, you know, and they might be pregnant. [00:14:20] Yeah. We’re different. Sometimes it’s complicated. That doesn’t mean that you exclude us.

Philippa Kaye: And [00:14:25] so some of what we might call medical sexism or medical misogyny is [00:14:30] about a lack of knowledge. So when I went to medical school and [00:14:35] learned about heart attacks and the image of an [00:14:40] overweight man in his 60s with a fag in one hand, clutching [00:14:45] his chest with the other and sweat dripping down his face. Right. And [00:14:50] actually, women might present feeling a little tired or dizzy or with backache, and that was [00:14:55] never taught. Now, some of the reason why that was never taught was because it wasn’t known. [00:15:00] And so I don’t think that is misogynistic. I don’t think that comes from a place of [00:15:05] hatred or sort of a deliberate, um, a deliberate [00:15:10] trying to hurt women that comes from a place of a lack of knowledge. And so that [00:15:15] bit needs to change. But we know really clearly that the gender health gap [00:15:20] is real and the gender pay gap is real, never mind things like the gender orgasm gap. So [00:15:25] the gender pay gap is, for example, that women’s pain is less likely to be taken seriously [00:15:30] than men’s. Yes, you are less likely to get painkillers in A and E, and [00:15:35] there is this idea in society that to be a woman is to live with pain that periods might [00:15:40] hurt and that having a baby might hurt, and that you just have to put up with it and continue in the [00:15:45] Tampax advert with your roller skates on.

Philippa Kaye: Plus managing your kids, plus managing your work. [00:15:50] Plus plus plus plus plus. And actually, to be a woman doesn’t have to be mean [00:15:55] that you have to live with pain. And that message needs to feed down not just [00:16:00] to women and society, but also to medicine and [00:16:05] what we’re taught in medicine and how we challenge that. And often in the menopause space and [00:16:10] the menopause campaigning space, I’m asked, don’t I get frustrated about how [00:16:15] slow things are? And I say, well, one, we’re fighting these millennia and that takes time. But two, that people [00:16:20] have to understand where we are in the process. In order for your doctor to [00:16:25] do something different, the guidelines have to change. In order for the guidelines to change, [00:16:30] we need to show that there is evidence that the guidelines need to change in order to produce [00:16:35] that evidence. We need to do the trials. In order to do the trials, you have to fund the trials in order to get the funding for [00:16:40] the trials. We have to be aware that there is an issue. That’s where we are raising awareness of [00:16:45] an issue. That is the point where we are at raising awareness of, for example, testosterone [00:16:50] use in women in menopause and the studies are being done right. And so these things take [00:16:55] a lot, a lot of time. And in the meantime, we have to continue to advocate [00:17:00] for ourselves over and over again.

Rhona Eskander: Yeah. Because I, you know, [00:17:05] forgive me, I cannot remember her name, but the very famous BBC TV presenter, because she came out, [00:17:10] the one with the short hair or she came out endometriosis.

Philippa Kaye: Yes, yes.

Rhona Eskander: Exactly, [00:17:15] exactly. And like, I think it was really interesting because I think she felt really gaslit as well, because [00:17:20] her pain was really real and her symptoms were really real. And like you said, she was almost [00:17:25] fobbed off. This is normal. This is just pain. It’s part of being a woman. Deal with it. [00:17:30] Uh, a controversial question. Do you think that if it was men that were experiencing [00:17:35] the symptoms that we had had periods and all that stuff, that more funding would go behind [00:17:40] the research needed to help the situation, [00:17:45] the circumstances and the symptoms.

Philippa Kaye: How many medications are available over the [00:17:50] counter for erectile dysfunction? They’ve been available over the counter for quite a long time, [00:17:55] haven’t they? You know, research happens for things that people think are important. And [00:18:00] as I said, they’re raising awareness. Now, if the people making the decisions [00:18:05] are men, they’re going to potentially or at least previously think about issues that affect men. And [00:18:10] for a long time, there was this idea that women are essentially little men and we’re [00:18:15] not. So it’s not that we are shorter and weigh less. It’s the fact that oestrogen, progesterone, [00:18:20] testosterone, all genders have all those sex hormones. But and that [00:18:25] oestrogen affects all parts of your body, not just your womb [00:18:30] and your breasts. And that impact affects your brain [00:18:35] and it affects your joints and it affects your bones. And so we need to look at [00:18:40] women in the context of that as opposed to thinking, well, they’re just the same as men. They’re not. [00:18:45] And when we saw that, for example, really clearly in Covid, why [00:18:50] were women doing better than men after the menopause? What was it? And [00:18:55] there is this idea that sex hormones are about your reproductive system. They’re much [00:19:00] more than that. They affect every part of you, from the hair on your head to the skin on your feet. [00:19:05] And so too, for men. And I don’t think [00:19:10] maybe I’m naive, but I don’t think that these things [00:19:15] are necessarily done malevolently. I think there’s just this [00:19:20] is what I was taught. This is what I know don’t know. And I think that there is a real [00:19:25] difficulty that both medics and society [00:19:30] have with saying, we just don’t know. Now, and one of the most [00:19:35] difficult conversations you have with a patient is.

Philippa Kaye: I can see your suffering [00:19:40] and we can’t find what the thing is to do about it. I can’t find it on [00:19:45] a blood test. I can’t find it on a scan. That doesn’t mean that whatever is happening to you isn’t [00:19:50] real. Endometriosis is a particular condition. The average length of diagnosis [00:19:55] is eight years, and for people who don’t know, that’s when there is tissue similar to the lining of the womb [00:20:00] and is deposited on other parts of the body. And so whilst the lining of [00:20:05] the womb build up every month and you have your period that comes out through the vagina and, and the blood [00:20:10] and the womb lining goes, if that tissue is on the outside of your womb or [00:20:15] on your bowel, for example, when you bleed, you’re bleeding internally and there’s nowhere for that to go. [00:20:20] And that causes inflammation and scar tissue, which cause all the symptoms not seen on a blood [00:20:25] test. Now there is a there are more specialist scans, but [00:20:30] often not seen on a scan at all. And the gold standard of diagnosis is with keyhole [00:20:35] surgery. And that you’re not going to necessarily do for everybody who comes in [00:20:40] with symptoms initially. And so the time to diagnosis is long [00:20:45] for all kinds of reasons. But it starts with this idea of [00:20:50] yeah, period pain is normal. No it’s not for anybody listening. If you can’t get off the toilet for three days [00:20:55] because you’re bleeding so heavily, if you’re missing school or work because you’re bleeding so heavily or you are in pain, go to the doctor. [00:21:00] We will do something about it. Mhm.

Rhona Eskander: I don’t know if this was just [00:21:05] a rumour. I also saw a clip on social media, as you do, that claimed [00:21:10] that the word hysteria is related to hysterectomy [00:21:15] and the symptoms that a woman had from a mental health point of view. [00:21:20] Is there truth to that? I want you to unpack that a little bit.

Philippa Kaye: For me comes from a Greek word, um, [00:21:25] and hysterics. Um, and it was thought that hysteria [00:21:30] was due to the wandering womb, um, and in the 19th century, [00:21:35] few were a bit difficult. Maybe you were a bit mouthy. [00:21:40] Maybe you were irritable. Maybe you had anxiety. The treatment was electrical stimulation [00:21:45] of your clitoris by a medical professional. Yeah. [00:21:50] So, um, so, I mean, orgasms might have helped. Who knows? They’re good for all kinds [00:21:55] of things. Um, but women’s sexual pleasure was so [00:22:00] not thought of that this was a medical treatment for the wandering [00:22:05] womb.

Rhona Eskander: And was a hysterectomy. The solution towards at all.

Philippa Kaye: So [00:22:10] a hysterectomy means removal of the womb. How did that. So this is history of medicine. [00:22:15] I’m not sure if that was used as a treatment, but the hysterectomy was much more common than it used [00:22:20] to. Used to be much more common than it is now. Because if you had, for example, in [00:22:25] very, very heavy periods and we didn’t have things like a coil or the pill, [00:22:30] then a hysterectomy would have been solved. The problem because you removed the womb. Okay, well, you’re not having [00:22:35] bleeding anymore. So hysterectomy is aren’t as common as they used to be. I don’t know their [00:22:40] history around that. It’d be interesting to find out, but.

Rhona Eskander: Yeah, but the word hysterical is not [00:22:45] necessarily got a positive connotation. And so the fact that even like a hysterectomy, [00:22:50] hysterical. Like we should be challenging language in the same way language is being challenged [00:22:55] in lots of different ways with regards to gender, I think it’s really important that we give that consideration. [00:23:00] So there is.

Philippa Kaye: A there there is a link automatically, um, [00:23:05] between the word hysterical, which is not the same as mentally unwell, [00:23:10] you know, and you don’t really describe men as hysterical. It’s actually a derogatory word [00:23:15] aimed at women. And the basis of that word is because you got a womb.

Rhona Eskander: Yeah. [00:23:20] It’s really interesting. Now, one thing that really resonated that you just said [00:23:25] that is sometimes we have patients and we certainly get this in dentistry as well, [00:23:30] where they have symptoms and you cannot provide necessarily a [00:23:35] solution. Um, in dental school it was described as either [00:23:40] having phantom symptoms or, you know, that, you [00:23:45] know, there was always a link perhaps to something mental health. As I progressed [00:23:50] further onto my career, I started to read the work of what I consider [00:23:55] to be more progressive doctors, and my father would argue, who was a more old [00:24:00] school doctor. It’s a little bit woo woo. And the reason why I say woo woo, because in [00:24:05] his mind it’s not necessarily tangible. So, for example, I read the work of Doctor [00:24:10] Gabor Matte, the work of Doctor Bessel. You know, the body keeps the score. And [00:24:15] I think that there’s a real gap within medicine and dentistry that does not allow and give space [00:24:20] to recognise that certain emotions, traumas and past [00:24:25] behaviours can certainly contribute to the symptoms that we get and manifest physically. [00:24:30] What’s your thoughts on that?

Philippa Kaye: We know that the brain and the body talk to [00:24:35] each other. We don’t quite sure how they do it, but we know that they do. [00:24:40] And actually everybody can think of an example of that. You have a bad cold and you just [00:24:45] feel a bit blah, and you don’t feel happy and you don’t feel energised, right? [00:24:50] Um, and when you’re in pain that your mood drops. So these are examples that people [00:24:55] sort of think, well, yeah. Or your libido drops. Why would you want to have sex? [00:25:00] And so we know really clearly that physical conditions [00:25:05] can have mental health symptoms and that psychological conditions. And by that I don’t mean made [00:25:10] up I mean related to your mental health can have physical symptoms. So [00:25:15] in depression that might affect your sleep, it might affect your energy, it might affect your appetite. And [00:25:20] in really severe depression, it can even affect how quickly you speak [00:25:25] or how quickly you move someone with anxiety. If you watch someone with severe anxiety [00:25:30] who is shaking and fidgeting and their heart is racing and they’ve got palpitations and chest [00:25:35] pain and shortness of breath and they feel sick, so we know really clearly that the two interact. [00:25:40] We also know that your gut is what we sometimes call your second brain. Your gut produces serotonin, [00:25:45] same as the brain, and it responds to serotonin.

Philippa Kaye: Actually really interesting. In regards to [00:25:50] women’s health producers, there are bacteria that are involved in the production of oestrogen and the response [00:25:55] to oestrogen. It’s called the ester bloom. And. And so we know they talk to each other. We know [00:26:00] that if you give patients with irritable bowel syndrome an SSRI antidepressant [00:26:05] doesn’t mean they’re depressed, but it makes their symptoms better. We know that we can use antidepressants [00:26:10] for all kinds of things which aren’t depression. So there is a [00:26:15] definite link between the two. I think there’s a [00:26:20] struggle in two ways. One is with the doctor saying, there is nothing more I can do [00:26:25] in terms of medicine, which is hard for us to say when we want to make you better. [00:26:30] And actually, I think as GP’s often we’re better at that than hospital doctors [00:26:35] sometimes because we, we see things from a different angle. So as a GP, [00:26:40] I’m ruling stuff out most of the time and then as a hospital doctor, a GP has already said [00:26:45] to you there’s a problem here, I might not know what it is, go find it. Right. So they’re ruling stuff in [00:26:50] and we know you. We know your family often. We know where you live. We know what you do. [00:26:55] It sounds really creepy. Um, but.

Rhona Eskander: Stalker, we.

Philippa Kaye: Know about you. [00:27:00] And sometimes we’re having these conversations [00:27:05] where we say, I see what? That you are struggling, but there isn’t [00:27:10] necessarily a medicine to fix that. So now what are we going to do? And actually the answer [00:27:15] often in those situations is around talking therapies. And that’s [00:27:20] where the second barrier comes in, which is the patients often say, you’re saying I’m crazy, I’m making [00:27:25] it up. And I’m not saying that. What I’m saying is there isn’t a medicine [00:27:30] to help. So what we now need is some kind of therapy to help you manage [00:27:35] what you have. And so if you go into a chronic pain clinic, you will [00:27:40] have a consultant anaesthetist, probably, who will be talking about medicines and sometimes epidurals [00:27:45] and all kinds of things. And you’ll also have a chronic pain psychologist because [00:27:50] not everything in medicine is answerable. Exactly. And that doesn’t mean [00:27:55] that we can’t help you in some way. Their help might be different. And there is a lot [00:28:00] of evidence that for certain, um, symptoms and conditions that often they [00:28:05] will be related to what are really clinically called adverse [00:28:10] childhood events and what are less clinically called often horrible stories [00:28:15] of abuse and things like that. And I think that we have to be [00:28:20] really open to talking [00:28:25] and thinking about those things, but I think that it requires a mind shift in both [00:28:30] the doctor and the patient to be able to say, [00:28:35] this is where we are. And the reason why that’s so hard often is because [00:28:40] we ought to start with, well, maybe your thyroid’s just low, because I can fix that with [00:28:45] a tiny tablet. And so you have to go down one route before you get there. And that’s [00:28:50] really difficult for everyone. Do you what’s your.

Rhona Eskander: Thoughts as well. [00:28:55] Because again, you know, going back to sort of the more progressive doctors that look into that and I know [00:29:00] that the NHS is integrating that and there’s huge amounts of research. Talk about this a lot on my podcast, [00:29:05] Integrated Psychedelic Therapy. So I know that, for example, some places are offering [00:29:10] um, in not in the UK necessarily, but in Switzerland they’re doing a lot [00:29:15] of research around mushrooms. They are also, I understand my friend [00:29:20] had a ketamine drip, you know, for her depression on on the NHS, which I’d [00:29:25] never heard of. That part of medicine is completely new. But looking at the history, because I read a [00:29:30] great book, How to Change Your Mind, um, which goes into the history of psychedelic medicine. [00:29:35] You know, these, this, these medications were actually making huge amounts [00:29:40] of progress back in the day. Then Nixon comes into power. War on [00:29:45] drugs comes in. Hippies, love and light. I don’t want to go to the Vietnam War. It’s all quite interesting, [00:29:50] you know. But then when I look at the psychiatric implications, you know, these medications were used [00:29:55] for PTSD. You know, people that were going to war, um, marriage counselling, all [00:30:00] those different things. Do you think any of those medications will actually make headway? And [00:30:05] for the ones that are being used like ketamine, do you think there is benefit or you know, what’s your views? [00:30:10]

Philippa Kaye: Let’s start with, um, I do not recommend that people take illegal [00:30:15] recreational drugs with the idea that it’s going to help you medically. [00:30:20] That is not what’s being talked about. Microdosing. Um, under [00:30:25] medical supervision. We’re not there. Two very separate things. And actually, medicine is [00:30:30] really interesting because we use illegal drugs [00:30:35] in illegal way a lot of the time. So medication for [00:30:40] ADHD, um, is a controlled drug because essentially [00:30:45] they’re stimulants. We use opioids. Um, if [00:30:50] you have an operation, if you have, I don’t know, a spinal anaesthetic, if you’re having [00:30:55] a caesarian section, we use them at end of life. Um, and they can all be abused [00:31:00] and misused in different ways. Um, and so there’s often been [00:31:05] a crossover. And what we need here is more research. [00:31:10] And what seems to be the case is that there are lots of people doing things sort [00:31:15] of on their own saying, you know, well, I just get this from my friend around the corner. That’s [00:31:20] not the same as what we’re talking about. And I think that we just need to know more. Another [00:31:25] example is using magnetic stimulation of the brain and TMS. [00:31:30] Yeah. Transcranial magnetic stimulation. And for a long time, [00:31:35] a treatment for very severe depression was ECT. Electric convulsive therapy. [00:31:40] And when I did psychiatry when I was a psychiatric show it was [00:31:45] something it is still used was something that was used is still used. Not in a One Flew [00:31:50] Over the Cuckoo’s Nest way and people are given an anaesthetic.

Philippa Kaye: It’s not the same. [00:31:55] And actually, for people with very severe catatonic depression, it [00:32:00] can work. And so and now there are forms which is sort of [00:32:05] you might consider it almost like ECT light. And now they’re talking about magnetic stimulation. [00:32:10] And all of this to me is entirely fascinating. And we need [00:32:15] more research because what we’ve got are vulnerable people. And whenever [00:32:20] any of us is unwell in whatever way, we are unwell. And I say this as a patient who’s had cancer [00:32:25] myself, we are vulnerable to the snake oil because we want to be better. [00:32:30] And where medicine doesn’t have the answers in the terms, [00:32:35] in easy terms in a pill, right? Because often answers [00:32:40] are hard if they involve doing more exercise and eating a certain way. Et cetera. Et [00:32:45] cetera. That’s much harder than please take this tablet three times a day. And where medicine doesn’t [00:32:50] have the answers, and other people make huge claims about [00:32:55] what it is that their product, their supplement, their course, their whatever [00:33:00] can do. We want it to work so desperately that we’re vulnerable to it. And I think [00:33:05] that actually we need to do good research, which is not quite the same [00:33:10] as research. We need to do good research, find out more to protect [00:33:15] the people, because there are an awful lot of people out there selling an awful lot of stuff for an awful lot of money. [00:33:20] Mhm.

Rhona Eskander: Yeah. Because it’s interesting because as I said to you, like LSC has a dedicated site, Psychedelic [00:33:25] Research Centre, which is super interesting. So I’d love to see. But as you said unfortunately [00:33:30] the problem is where the abuse comes in, where people take these to self-soothe in a way [00:33:35] that without doing the work, you know. And I think that where it becomes more of an interesting [00:33:40] is, you know, when you see the research centres in Switzerland where you have a 70 year old patient with [00:33:45] cancer that then has therapy alongside some of these treatments, and [00:33:50] I think that’s the only way it can really sort of move forward, as you said, with good research. Yeah. You [00:33:55] mentioned that you had cancer. So let’s talk a little bit about that. [00:34:00] How old were you when you got diagnosed? What were your symptoms?

Philippa Kaye: So I was 39 [00:34:05] and I didn’t have the classic symptoms. I had bowel cancer. I call it the shit cancer. It doesn’t have great [00:34:10] PR bowel cancer because it’s brown. Um, and people don’t like talking about it. [00:34:15] Um, I had had three emergency caesarian sections and my appendix [00:34:20] out and an ectopic pregnancy, actually. So I’d had a lot of, um, pelvic surgery. [00:34:25] And after the birth of my youngest, who is now nine, [00:34:30] um, I had some pain in my skull and thought, well, [00:34:35] you’ve got a lot of scar tissue down there, all right? And managed it for [00:34:40] a period of time. And then a few years later, actually, I had much worse pain, but [00:34:45] not constant. I didn’t have a change in my bowel habit. Everyone has a bowel habit. You might go to the toilet once a day. [00:34:50] You might go to the toilet twice a week, six times a day. Whatever. Your normal is your normal. And if that changes for [00:34:55] more than three weeks, your doctor wants to know about it. I didn’t have that. I didn’t have blood in my poo. I didn’t lose weight, I wasn’t tired, nothing. [00:35:00] I just had this pain sometimes before I went to do a poo and [00:35:05] it began to hurt more. And I went to my GP and I said, um, what [00:35:10] do you think is going on? I think it’s related to scar tissue. And she went, well, yeah, [00:35:15] it’s got to be let’s go and see a gynaecologist. And I went to see a gynaecologist [00:35:20] who said, I think your womb is stuck to your bowel, which happens [00:35:25] from scar tissue.

Philippa Kaye: Um, and I’m going to need a bowel surgeon in there with [00:35:30] me. So I think you should go and see a bowel surgeon first. So I went to the bowel surgeon, who went. Well, we better [00:35:35] just be careful and do a scope. And I remember thinking really clearly. Well, that’s annoying, because [00:35:40] I don’t want to take a day off work and do the bowel prep and be on the toilet all day, and then have to take another day off work and [00:35:45] have someone shove a camera up my bum. Um, but I was like, well, all right. Um, [00:35:50] and I remember that they pushed the drugs into my arm and I lay down and thought, okay. [00:35:55] And there’s a screen there for the surgeon to see, and and I [00:36:00] can’t help myself. So I looked at the screen and he put the camera in, and then I saw my cancer. And [00:36:05] because it was eight centimetres up. No, sorry, it was 12cm up. [00:36:10] They left me with eight centimetres of of rectum. And I turned my head and I looked [00:36:15] at the surgeon, and as his eyes came up, I thought, oh, that’s [00:36:20] it. The world changes today. And I [00:36:25] remember really clearly what happened next, which was he couldn’t get past the tumour. [00:36:30] It was too big. And he said and it was hurting and, and [00:36:35] I said, you know, you have to do what you have to do. Don’t worry about it. And he was like, no, we’re going to go and do a CT colon a different [00:36:40] way, which is essentially where they then fill your bowel up. Um, and then they take [00:36:45] like an x ray scan, a CT scan of it.

Philippa Kaye: And he said, but first I need to give [00:36:50] you a tattoo. Now I’m a good Jewish girl, and my parents would never [00:36:55] have let me add a tattoo. And I my mom was waiting outside [00:37:00] to pick me up, and I said to him, what do you mean my mom’s [00:37:05] going to be furious? And he said, I have to tattoo your tumour [00:37:10] from the inside so that when I go and get it from the outside, if it hasn’t gone through the wall, [00:37:15] it had. But he didn’t know that at the time. I won’t be able to see it, so I need to tattoo it. [00:37:20] So he put the tattoo in and, and he said he and [00:37:25] they sort of sorted everything out. And he said, I’m going to be right behind you there, wheeling [00:37:30] you back to the bay. I’m coming to talk to you. My mum [00:37:35] was there before me, before he was, and I turned to my mum and actually, this [00:37:40] is something. I was 39, I had three kids and a husband. Never occurred to me that I was going to tell [00:37:45] my mum that I had cancer. And I turned round to my mum and she could see that I’ve been crying and she said, [00:37:50] what’s the matter? Did it hurt? And I said, mummy, I’ve got cancer and a tattoo. I’m so [00:37:55] sorry. Yeah. Yeah. And that was my primary thought at that exact moment. [00:38:00] Obviously that then passed and that was no longer my primary thought. But for a while I focussed on that bit. [00:38:05]

Rhona Eskander: And so then what was the treatment? So what did [00:38:10] they decide? That was the best port of call.

Philippa Kaye: Um, so then it was all really quick. Really [00:38:15] quick. Um, and I had [00:38:20] a large part of my bowel removed a week later. Um, [00:38:25] so where it was, they took a few centimetres below, but they took lots [00:38:30] above, and that’s a really big operation. And there’s a possibility that you might have a stoma [00:38:35] bag, which I didn’t. Um. And your bowel does not like [00:38:40] being touched. It does not like it. And it needs to heal and rest, but it might [00:38:45] go on strike for a bit too. And you have to learn to eat again. You have to go through a period of time of nothing [00:38:50] at all, and then 30ml of fluid, an hour of water, and then you work your way [00:38:55] up, and then eventually you get to like a broth and then milk, and then and you [00:39:00] work your way up to eating and, um, then I had six months worth of chemotherapy [00:39:05] and then they said, and now we think everything should [00:39:10] be done. Let’s just do a scan to check. And on that scan, they found more lesions. Oh, no. [00:39:15] And we were then January February 2020 just [00:39:20] as COVID’s coming. And they said, well, let’s just hang on. Maybe it’s one of those things. [00:39:25]

Philippa Kaye: And by the time we got to April, there were many more [00:39:30] lesions. And they said, well, we can’t wait. We’re going to need to do a really, really big operation we need to [00:39:35] take out. Bearing in mind the first one was a whopper, we need to take out some of your small intestine and some of your [00:39:40] muscles around your stomach and your back, and we might have to take out [00:39:45] more large bowel and we’re going to put chemotherapy in and blah, blah, blah. And we’re in lockdown. And [00:39:50] they were talking about the recovery after that. And everybody’s kids were at home [00:39:55] and homeschooling. And I thought, I don’t know how I’m going to do this. I literally I don’t know how I’m going [00:40:00] to manage this. And they said, well, we’re also not sure about putting you in hospital [00:40:05] in this exact moment. And so they did a sort of like a mini surgery [00:40:10] in the May time to try and hold things off. And by September we [00:40:15] were about to enter lockdown again and they were like, you can’t wait. And I was in hospital [00:40:20] for 15 days. Ten of those days were in ICU on my own. And [00:40:25] that is undoubtedly the hardest thing [00:40:30] that I have ever done in my life.

Philippa Kaye: What it also taught me, [00:40:35] though, is something that I did not know before. Genuinely, I did not [00:40:40] know before, which is that I am enough. I can be enough for me. [00:40:45] I can be strong enough for me. And you don’t have to go in happy. [00:40:50] You don’t have to be toxically positive the entire time. You [00:40:55] just have to keep stepping and you can do that stomping, [00:41:00] angry. But that is where your strength is. And that really has changed [00:41:05] me to know that. And then after that, when they put the chemo [00:41:10] directly into my pelvis and they removed a whole bunch of stuff. [00:41:15] And then since that, that’s when they said, we’ve got it all and [00:41:20] we think that you’re cancer free. And that was [00:41:25] 2020. And since then, I have [00:41:30] still had surgeries every year to try and fix the issues that the first surgeries produce. [00:41:35] And every January I don’t make a New Year’s resolution. I make a hope. [00:41:40] And that hope is please this year. Let it let my [00:41:45] cancer not come back and let me not have a surgery. Yeah, I haven’t made it yet. [00:41:50] Hopefully this year will be the year.

Rhona Eskander: Honestly, you’re so amazing and I [00:41:55] feel every word because both my parents had cancer a few years [00:42:00] apart from each other. And I think it’s, you know, it’s it’s so difficult. I [00:42:05] mean, I’ve not been in that position, but having a parent in that position, weirdly, I was like, I’d rather have [00:42:10] it than my parents. Um, my dad is like my hero. [00:42:15] So for me, it was the most harrowing thing. And he was in surgery for like 13 [00:42:20] hours. And I remember thinking he he was dead. I’m going to be honest, because I was like, [00:42:25] why haven’t we heard from anyone? Why hasn’t anyone updated me? And I had this huge panic attack, [00:42:30] and he had a radical, radical vasectomy, just everything removed. And that affected his lifestyle [00:42:35] forever. Because you’ve got problems of incontinence, you’ve got problems with, [00:42:40] um, uh, you know, older, you know, your sex life gets affected, [00:42:45] everything gets affected. So he’s had to have multiple surgeries as well to try and rectify it.

Philippa Kaye: But I think that [00:42:50] that well, we know that 1 in 2 of us are going to have cancer at some point in our lives. That means [00:42:55] everybody is going to be affected by it, because we’re all going to know somebody with it or have it or, um, [00:43:00] you know, have a work colleague or whatever that may be.

Rhona Eskander: Why? Why do you think the numbers have increased even though [00:43:05] our lifestyles are better?

Philippa Kaye: So I think there’s a number of I’m going to come back to that. But I think [00:43:10] that we are getting better at diagnosing cancer. We are getting better at treating cancer, and that means that more of us are [00:43:15] either going to survive it or live with it. Okay. What we’re not good at, because we’re not good enough at getting [00:43:20] people to come forward with the symptoms in the first place, and attendance at screening isn’t high enough. [00:43:25] And all of these things, but what we’re really not good at is talking about survivorship and what you’re left with. What are [00:43:30] you left with if you live with a stoma, which sorry, which can be life changing [00:43:35] and life saving, what are you left with if you have low anterior resection syndrome because [00:43:40] you’ve had most of your bowel removed and I can’t wait for the toilet. And what are you left [00:43:45] with? If you’re put into a premature menopause, or that your brain is affected, or [00:43:50] you have neuropathy and you can’t feel your hands and feet or. Right, and we don’t talk about that, all [00:43:55] of those things, and we need to do much better at those. Why do I think that more people are having cancer? I think [00:44:00] there’s a number of reasons here. There’s two things we know that cancer in young people [00:44:05] is getting more common and in particular actually around bowel cancer.

Philippa Kaye: And bowel [00:44:10] cancer is a cancer where they think that there are a significant number of patients [00:44:15] and cases that could be prevented from lifestyle now. Mine was found out to be genetic, which [00:44:20] in itself has implications because when they gene tested me and [00:44:25] they found the gene that they doubled my risk of bowel cancer. So [00:44:30] there’s the concern not only is my cancer going to come back, but am I going to get a new bowel one because my [00:44:35] genes haven’t changed, but also it has implications for the rest of my family, right? [00:44:40] Because if I’m a carrier, yes, I could be the first mutation, but maybe my siblings. What about my [00:44:45] kids? And so you make a decision for yourself. Yes. I want to know because [00:44:50] of the links with other cancers and various other things. But this knowledge then goes to other people [00:44:55] as well. But we know, for example, that processed [00:45:00] meat and red meat and alcohol and smoking and obesity and [00:45:05] sedentary lifestyles, all of those things contribute to cancers. But we also have [00:45:10] to remember that when we talk about 150 years ago, most [00:45:15] people were likely to die either at birth or in the first couple [00:45:20] of years of life. And if you’re a woman and you made it past childhood, your next time [00:45:25] that you’re most likely to die was during childbirth, right? So [00:45:30] and then if you manage to get past that, then your life expectancy was sort of not [00:45:35] so significantly lower.

Philippa Kaye: But when you then look at life expectancy overall in the Victorian times, [00:45:40] you say, well, those numbers are much lower. We’re living much longer. Are we? Yes, we are, but [00:45:45] but those numbers are skewed because so many people died in childbirth or [00:45:50] at and around birth, that it means that the average, because this is how maths work [00:45:55] works, gets a lot younger. And so we are now thankfully [00:46:00] more likely to survive childhood with vaccines and nutrition and clean water. We [00:46:05] are now thankfully more likely to survive childbirth with good antenatal care and care on the labour [00:46:10] wards, etc. etc. which means that more of us are going to be hitting points where we can get these things [00:46:15] and and we need to do better at prevention. [00:46:20] And some things around prevention are not sexy and exciting, [00:46:25] but they do work. And we know, for example, that there [00:46:30] is no safe amount of alcohol to drink. Well, no one wants to hear that, but that is [00:46:35] true. Alcohol is a carcinogen. We know that physical [00:46:40] activity decreases your risk of cancer. It’s a bit boring, isn’t it? People [00:46:45] would prefer to do something else, but actually those are the things that would make a [00:46:50] huge difference.

Rhona Eskander: So lots of things to unpack. First of all, my partner says this all the time because [00:46:55] he’s reading a book on Alexandria, some half Egyptian. I don’t know if you knew that, but he’s reading a book in Alexandria. He’s really excited. We’re going [00:47:00] to Egypt. He’s never been. And he’s fascinated by Alexander the Great. And I talk about, like, [00:47:05] the ancient Egyptians because the ancient Egyptians were super progressive in medicine, I’m sure you know, and I’m like, yeah, [00:47:10] but no one really lived that long. He was like, no, that’s a misconception. He’s like, because people the time that we’re going [00:47:15] to die was in, you know, as you said, childbirth or when they were really young. [00:47:20] And then actually lots of people were living till they were like 70 or whatever, but it’s skewed [00:47:25] numbers. So I love the fact that you’ve brought up that point. One thing that becomes [00:47:30] apparent to me is, you know, for me, what really worries me as a society as [00:47:35] a whole is that we want the easy way out. I once read Something [00:47:40] Beautiful, an article by Mark Manson. He wrote the book The Subtle Art of Not Giving [00:47:45] a Fuck. I don’t know if you’ve read it, you know, and he wrote an amazing article [00:47:50] about New Year’s resolutions and happiness as a whole. And one thing that he brought [00:47:55] up, which I really loved in the article that I read, is that if you ask most people, what do they want [00:48:00] in life? They will say, I just want to be happy.

Rhona Eskander: Okay, [00:48:05] what does that look like? I just want a nice partner. I want to go on nice holidays. I want [00:48:10] a job that I like. I want enough money to enjoy my life. I want great sex. They say all these things. [00:48:15] He says, well, it’s all very well saying that things. But the question that we really need to pose is, [00:48:20] how much are you willing to suffer for what you want? So what I mean by [00:48:25] that is you could say, I want to be a really successful doctor like Philippa, have a platform, be on [00:48:30] TV, go into a work environment where I love treating patients, or I want to be like Rhona and [00:48:35] have my own dental practice. But what they don’t understand. Do you want to do a 60 hour week at some point [00:48:40] in your life? Do you want to sacrifice time with your friends and family or your social life? So [00:48:45] when you start asking those questions, because usually there is so much that goes behind [00:48:50] requiring the life that you want, most people don’t want to do that, and that’s [00:48:55] the same. There’s a similarity in what you said because you said, are you willing not to drink alcohol? Are [00:49:00] you willing to wake up early to exercise or go after work? Are you willing to make healthier choices? [00:49:05] And most people want.

Rhona Eskander: That brings me on to a question that perhaps [00:49:10] is going off onto another tangent. But with regards to health, i.e. the eating [00:49:15] less and exercising more, the easy way out seems to be ozempic [00:49:20] or these weight limiting drugs. Now they have their place, [00:49:25] as we know, with people that actually need them. But what I’m seeing more and more, especially because [00:49:30] I’m in the world of social media, where aesthetics and the way you look and dropping [00:49:35] 2 or 3 kilos makes you look and feel better is something [00:49:40] that people are doing. And I have even models and influencers admitting to me in my practice that they’re taking [00:49:45] it. They’re already a size eight. We’re not talking about various people now. Do they live a [00:49:50] healthy lifestyle? No. They party, they drink, they take drugs. Et cetera. Et cetera. [00:49:55] So what is your view on the weight loss injections? Where do you think it’s going? [00:50:00] Is it being regulated? I’d love to know, because. And could it have a positive impact? [00:50:05] Because it is limiting your ability to eat and drink alcohol, [00:50:10] etc.. So could there be a positive benefit?

Philippa Kaye: And let me just answer the first, first bit, [00:50:15] which is I think that that with regards [00:50:20] to happiness, satisfaction is not quite the same as happiness. And I think [00:50:25] that the answer to all of that is to be able to find the joy in the tiniest [00:50:30] of things, to be able to find the joy in sitting under a tree and watching the sunlight through [00:50:35] the leaves, to be able to be present in any moment and [00:50:40] actually find the peace within that, and to [00:50:45] be satisfied and say, this is enough for right now. I have enough [00:50:50] and not to constantly be grasping for the next, the next, the next. And that, [00:50:55] for me is the answer to where where happiness is for me. That’s not the same for everybody [00:51:00] else. Um, I think that weight loss drugs are [00:51:05] saying something very interesting about society. Yes. Let’s [00:51:10] start with the fact that obesity is a chronic disease, which [00:51:15] is mostly genetic, with over a thousand genes involved. [00:51:20] Epigenetics is how your environment shapes your genes, and environment absolutely [00:51:25] plays a role in whether or not these genes express. But we have been brought up in a society [00:51:30] which has a huge amount of weight stigma. Every book you’ve [00:51:35] ever read or film you’ve ever seen, the bully is a fat kid. A fat, stupid [00:51:40] kid, right? When you look at a picture in the newspaper and [00:51:45] you are looking at someone with obesity, they have a grumpy face.

Philippa Kaye: We are not shown, [00:51:50] and that weight stigma means we have evidence to say that if you have obesity, [00:51:55] you are less likely to have a front facing job, to be a receptionist, to work in a shop, right? You [00:52:00] are less likely to attend your screening programs. You are going to have worse mental health [00:52:05] as well as physical health. The stigma about obesity is very real [00:52:10] and medicine and the government have not helped us, right? We put all the blame and [00:52:15] the onus on these people when actually no one is telling the truth, which is losing [00:52:20] weight is really hard, really hard. Keeping that weight off is really hard. When [00:52:25] your metabolic set point and all of your hormones are fighting to maintain the weight that [00:52:30] you have. And so these medications are an [00:52:35] absolute game changer in the world of obesity and diabetes, when up until [00:52:40] then, the only thing which has evidence for working is surgery, which is life [00:52:45] changing surgery. And now these medicines there is not evidence for any diet [00:52:50] in the long term. So people lose weight and they put it back on. [00:52:55] Often putting on a little bit more and then they lose weight.

Philippa Kaye: And that yo yo dieting has a real effect [00:53:00] on the body. So we need to be honest with patients and say, I see you [00:53:05] and it’s hard and it’s not your fault. Let’s just start with that. And actually when you do that with patients, [00:53:10] they are almost so overwhelmed by that because [00:53:15] I am yet to meet a patient who has obesity, who doesn’t know [00:53:20] that they have obesity, who hasn’t tried absolutely everything that they can over the years, [00:53:25] every diet, every everything because they are desperate to [00:53:30] lose that weight. So let’s be honest and say, I see you. It’s really hard and society has not [00:53:35] helped you at all. And these medicines have a huge place within that [00:53:40] and that access should be easier. There [00:53:45] is also a risk for every medicine that we have, every [00:53:50] choice that we make. When you cross the road, I need to cross. The benefit of crossing this road is I will be on the [00:53:55] other side. The risk is a car might hit me, right? Everything that you do is [00:54:00] a weighing up of the positives and the negatives. And when we are talking about [00:54:05] obesity, the potential benefits of these medications are huge. [00:54:10] And in those people it might be worth the potential [00:54:15] side effects the nausea, the vomiting, the diarrhoea, the abdominal pain, right, the [00:54:20] being on them long term, all of those things as your weight gets less [00:54:25] and less and less and less and less.

Philippa Kaye: And now we’re talking about someone with a healthy BMI. Well, hang on, what’s the benefit [00:54:30] that I’m getting physiologically in my body in [00:54:35] order to balance with these risks? Well, my risk benefit ratio changes. [00:54:40] And these medications are not licensed for use in people [00:54:45] with a low BMI and the potential for misuse is [00:54:50] huge and we are seeing it. We are seeing young girls going to A&E with severe abdominal [00:54:55] pain. We are seeing young girls with eating disorders who [00:55:00] are, you know, standing on a scale with a bunch of rucksack with weights [00:55:05] on their back in order to say, oh, but I am this weight and [00:55:10] there definitely needs to be regulation around misuse. [00:55:15] That doesn’t take it away from the huge group of people [00:55:20] that need it. And then we need to separate. Sorry. We need to separate [00:55:25] the idea of weight from physical [00:55:30] activity and health because I don’t care what [00:55:35] your size is, physical activity is beneficial. And so [00:55:40] people who say, well, if you’re over, if you have overweight, if you have obesity, you [00:55:45] should just move more. Then you’ll lose weight. No, you should just move more. Full stop. It’s good for you. [00:55:50]

Rhona Eskander: But this is the thing. Like. And it’s like, I’m going to get emotional about this because I [00:55:55] cannot tell you that. Like, as a child, I was pretty confident little [00:56:00] girl. And I kind of loved my body because, you know, you don’t come out of the womb hating your body. [00:56:05] My mother was from a middle eastern background with some [00:56:10] European blood in her as well. We’ve got my grandmother. My great grandmother was German, um, and [00:56:15] my mom was really tall. She was a model. She also had her own eating disorder, went off and [00:56:20] did nutrition. Kind of healed herself through that. Um, but I think that there was always [00:56:25] this fascination with the kind of tall, white, blonde, skinny person. [00:56:30] And so, like, you know, there were comments that were made from my parents, you know, who typically, [00:56:35] again, come from a middle eastern background but desperately want to fit into this kind of like European setting. [00:56:40] I didn’t care, and it wasn’t until I went to university and all the girls who were boarding school [00:56:45] girls who all had eating disorders. I never had an eating because I went to a school in Queens College, [00:56:50] you know, you know London very well. Multicultural London is vast. [00:56:55] You know, I didn’t have a problem. I am Middle Eastern. My body shape is Middle Eastern, small [00:57:00] top, half hips and bum. Like that was just a thing. And then everyone told [00:57:05] me I was overweight. And then I got asked to do modelling. And then everyone was like, well, you can’t.

Rhona Eskander: You’re too big to go [00:57:10] to this casting. You’re too. And I was like, okay, so I developed an eating disorder. And the problem [00:57:15] was, is that everything around me, of course, the media perpetuated an [00:57:20] idea that I was big. Bridget Jones was deemed as being big. She was not big. She was eight [00:57:25] stone, I think even or nine stone in Bridget Jones. You know, Britney Spears, [00:57:30] the most talked about thing was when she put on weight. Special K diets eat cereal like [00:57:35] once a day, you know, so the idea that the smaller you are, [00:57:40] the better you are was heavily ingrained. And unfortunately, as I dropped weight, I [00:57:45] look. People told me I looked better, and I think that I was sort of grateful for the Kardashians [00:57:50] in a way I can’t really. I don’t really like them in general because suddenly I was like, oh, having [00:57:55] hips and bums is cool. Do you know what I mean? Like suddenly, suddenly, suddenly, I was okay to have [00:58:00] instead of being told to cover up that part of my body, I could go to the gym feeling okay, [00:58:05] and now I’m seeing a regression again, that people are like, no, [00:58:10] again, you know, being waif thin and Kate Moss style. And I think that’s where [00:58:15] the danger I’m seeing. And I think, again, you’re having celebrities endorsing their fitness program after, um, [00:58:20] losing seven kilos in a week. Sorry, you’re on Ozempic. You know, it’s obvious no [00:58:25] one loses seven kilos.

Philippa Kaye: Even if you’re even if you’re not on Ozempic. You have a personal [00:58:30] trainer every day and you have a personalised meals, and you do not [00:58:35] have to get three buses to work, and you don’t live in a food desert [00:58:40] where you have to get a bus to go to a supermarket, and you can only have what you can carry and you can [00:58:45] only afford what you can afford. And you’re working three jobs and you’ve got kids and and and these [00:58:50] are not you know, we’re comparing apples and oranges. There are fashions and trends in everything [00:58:55] with regards to women, from pubic hair to body size. [00:59:00] What that means is you will never, ever, always be the ideal. [00:59:05] And we need to learn to separate ourselves from that. And that is incredibly [00:59:10] difficult. And as someone who’s on the telly, the [00:59:15] first time that I was asked to do a photo shoot for a magazine I [00:59:20] was writing for, and I went to this place and the [00:59:25] the magazine, um, brand also had one [00:59:30] of those lads mags, and the studio was shooting, um, a bikini [00:59:35] shoot and then me straight after. And I remember walking in and seeing a [00:59:40] rack of bikinis thinking, yo, I’m a doctor. No way. I’m literally here [00:59:45] for like, the shot of me at the top of my column. Yeah. What is going on? And, [00:59:50] um, somebody put makeup on my face and somebody told me what to wear. And [00:59:55] then an editor came over, looked at a still of my photo and said, she looks too young. [01:00:00] Make her look older. She looks like she she looks like she they won’t take her seriously enough. And I remember [01:00:05] thinking, in my job, no one has ever made a comment about what I look like, [01:00:10] ever. And you step into this world where what you look like matters.

Rhona Eskander: You [01:00:15] say that, but I think I have been judged since I applied for dental school. And I say that because, [01:00:20] look, I was telling I had an I had a chat with one of my friends who’s a journalist [01:00:25] yesterday, and I was like, look, I really struggle because by nature I’ve always loved colour, I’ve always [01:00:30] loved getting dressed up. And I kind of got coined by the the media as the glamorous [01:00:35] dentist. And I just think that that doesn’t necessarily have a connotation [01:00:40] of being taken seriousness. Yeah. And I think like I remember as well, I was asked [01:00:45] to do a big campaign for a big brand because I had endorsed their medical product [01:00:50] so well because I truly believed in it. Patients loved it, they loved everything I was doing. And I turned up for the photo [01:00:55] shoot and they were like, but can you, like, tone down the face? I was wearing mascara. I’m like, this is my [01:01:00] face. Like, literally, this is my face. My features are the way they are because I’m Middle Eastern and [01:01:05] I can’t tone it down. Like, even when I’m not wearing.

Philippa Kaye: Makeup, but in the NHS, no one ever said, [01:01:10] oh, you look a bit pale today. You did a night shift like, no, no, no. Yeah, I hear you.

Rhona Eskander: I [01:01:15] hear you. But there was certainly look, I went for my Bristol interview and I’ll never forget it, you know. And again [01:01:20] I think I wore a colourful suit and everything like that. And I think that they had made a comment that [01:01:25] I probably wasn’t suitable to become a dentist. And I didn’t get into the dental school, and [01:01:30] I went to my Leeds University completely dressed in the way that I wouldn’t dress. You know, I wore a really dowdy [01:01:35] black suit. I scrape my hair back and I just talked about the NHS essentially, [01:01:40] you know, and I got a place, but I knew that I was a fraud in a way, because what I presented in the interview [01:01:45] was what I knew they wanted to hear, and to a degree, perhaps in interviews and things like [01:01:50] that, you know, we need to do that. But I think throughout dental school, there was always these comments from people [01:01:55] about the way that I look or about what I was wearing and so forth. Social [01:02:00] media has given me the freedom to have expression. You know, the one thing is that I have creative [01:02:05] expression to be like, you know what? I am a bit glam, but I also know my stuff. [01:02:10] I also love my patients, and I think, you know, even the ability to show [01:02:15] empathy is something that’s challenged by colleagues. You’re amazing at it. I [01:02:20] talk about it all the time. I’m not afraid to cry on camera. You clearly aren’t either. But [01:02:25] I’ve had medical colleagues and go, but if a patient sees you like that online, they might think that [01:02:30] you’re not stable enough to treat them. And I’m like, I disagree.

Philippa Kaye: So I think that humanises you. Yeah. Patients [01:02:35] like to see the human. But as doctors, we have to be very careful of how [01:02:40] much you give. Yeah. Because if you give a little piece of yourself every [01:02:45] single consultation ten minutes apart, there is nothing [01:02:50] left for you. Yeah. So in some ways, my [01:02:55] strong lipstick is part of my armour. Yeah. Put it on. And I am doctor K, right. [01:03:00] And in some ways it does that. But I think that we would never be [01:03:05] having this conversation if we were two men. Yeah. And as soon as you [01:03:10] change the word women to men. If that feels weird. [01:03:15] No, we wouldn’t do that if we were two men. And maybe I’m generalising. There will be some. But, you [01:03:20] know, in general, then there’s a sexism issue, right? That [01:03:25] we don’t judge people in the same way. I have had patients stand [01:03:30] at my at my door when I’ve opened my door and called a name and they’ve said, oh, [01:03:35] but I wanted to see doctor K. I am doctor K. You don’t look like doctor K. [01:03:40] Oh. Professional makeup artist didn’t do it. I didn’t do my makeup this morning. And I sort [01:03:45] of say jokingly, no, that’s me. Just not on breakfast TV this morning. Oh, [01:03:50] you’re like, let’s talk about you, shall we? Yeah. People [01:03:55] feel that they that they have a right to comment. I have two boys and a girl. When [01:04:00] I had a girl straight away.

Philippa Kaye: Day one. Oh, [01:04:05] is she your princess? And my husband would say no, she’s our engineer. Mhm. And they make [01:04:10] people make comments about little girls in the way that they don’t make comments about little boys. [01:04:15] Don’t you look pretty today. Haven’t you got a nice dress on. Not. [01:04:20] Aren’t you so strong. Look at you running. Look at what your body can do for you. [01:04:25] You know all of those things. And that messaging starts so young, so young, and [01:04:30] it’s so ingrained. And it’s actually really difficult for us to fight that [01:04:35] constantly. Yeah, because it is a constant. It’s not like you can [01:04:40] just feel good about yourself today and then it’s all okay. These things are a constant battle. And then I think [01:04:45] if you add something like menopause into the mix. Yeah. Where there are changes [01:04:50] in your body and suddenly you feel the weight of society saying, [01:04:55] well, hang on, you’re supposed to give us children and look good, and now you can’t give us children, and you [01:05:00] know, you’re a bit wrinkly and your boobs are saggy. And it’s not a wonder that [01:05:05] aside from the physiological changes that are happening in your body and to your mind, [01:05:10] that society puts a whole other pressure on you. And that is one of the reasons why I find women’s health so fascinating, [01:05:15] because you can’t separate it from society and culture, and sometimes [01:05:20] religion too. So is that what drew.

Rhona Eskander: You to writing your book about menopause?

Philippa Kaye: Um, [01:05:25] so I wrote my first book about menopause came out a few years ago, and that [01:05:30] was purely born out of the need of the women that were walking through my door. And [01:05:35] that was sort of five, six years ago that I was writing it [01:05:40] and it wasn’t talked about at all. Um, and there was such a knowledge gap. [01:05:45] And, and whilst we may be better in some groups [01:05:50] at talking about it, actually, when we went up and down the country on the this morning menopause bus, [01:05:55] the question I was asked more than any other was what is the menopause? How am I going to know if I’m in it? So we think [01:06:00] that we’re writing about it and talking about it all the time, but actually often we aren’t. Um, or [01:06:05] that it’s not getting to everybody. Um, and, and so the reason [01:06:10] that I wrote this book was because not everybody wants to read like an essay based book. [01:06:15] People learn in different ways. And I wanted something that was full of pictures and infographics [01:06:20] and diagrams that made things really clear, but also [01:06:25] that menopause is not a book, is not a subject which is just for women [01:06:30] in their 40s that everybody needs to know about women’s health.

Rhona Eskander: So [01:06:35] tell me as well. So what are the hormonal changes that happens during menopause?

Philippa Kaye: Got to go back to [01:06:40] GCSE biology just a little bit for people listening. The menstrual cycle comes from your stimulated [01:06:45] by hormones in your brain tells your ovaries come on, I’d like you to mature an egg. The ovary [01:06:50] produces oestrogen and then there will be a spike in a hormone in the brain. Out [01:06:55] comes an egg, and the shell of that egg produces progesterone. [01:07:00] And the egg travels down the fallopian tube, waiting for Mr. Sperm [01:07:05] to come along and fertilise it. Implant. Be pregnant. And if you’re not, [01:07:10] if there is no sperm fertilisation doesn’t take place, then the hormone [01:07:15] levels will begin to fall and the egg and the lining of the womb will shed in your period. And [01:07:20] we start again. But you are born with all the eggs you are ever going to have. And actually, [01:07:25] actually, to me, this is one of the most gobsmacking facts ever. The egg that you were made from [01:07:30] was formed in your grandmother’s womb because the egg that you came from was [01:07:35] formed when your mother was developing in your grandmother. And that’s why if your grandmother [01:07:40] drank, it can affect you. And so you’re born with all the eggs [01:07:45] you’re ever going to have. You lose lots of them even before puberty. And although only one, sometimes [01:07:50] two eggs mature each month, you actually lose about a thousand.

Philippa Kaye: And at some point they [01:07:55] run out. And when they run out, the menstrual cycle is not going to restart again. [01:08:00] And you go through the menopause. It literally means the last period. What [01:08:05] that means is that your brain produces high levels of the hormones trying to kick [01:08:10] start it, like yelling at your ovaries, let’s go! But the levels of oestrogen and progesterone [01:08:15] fall, and that is what causes the symptoms of [01:08:20] the menopause. Now we have a medical word for the day that you started your period. That’s called menarche. Menopause [01:08:25] means the last period. We can’t tell that you’ve been through it generally until you haven’t had a bleed for for 12 [01:08:30] months. After that point, there is no such thing as one last bleed. If you bleed after not [01:08:35] having bled for 12 months, you must always go to the doctor. But, um, just [01:08:40] as starting your period was just one point during puberty, the lead up [01:08:45] to that last period has lots of changes, and it’s called the perimenopause. [01:08:50] And you can have symptoms for years before that last period and for years afterwards. [01:08:55] And those symptoms are not just related to your [01:09:00] womb. They can affect your whole body.

Rhona Eskander: And again, because people really [01:09:05] don’t talk about it. And I think I only heard of the term perimenopause, I promise you in the last like 3 or 4 [01:09:10] years, because a few people told me about that in the office. I [01:09:15] know that we also did an Instagram Live, which is, by the way, still available on my [01:09:20] profile on Instagram if anyone wants to look at it. I know a lot of people have asked this. [01:09:25] I know we’ve discussed this before. Can you delay menopause, or is there anything that makes menopause [01:09:30] onset earlier for some people than others?

Philippa Kaye: Yes. Um, so [01:09:35] if you smoke, you’re likely to go through menopause. On [01:09:40] average a couple of years earlier than people who don’t. We’re not exactly sure why, but we know that [01:09:45] smoking fills up your arteries, so maybe it fills up the blood supply to the ovaries as well. And [01:09:50] the average age of the menopause in studies is 51. But that is actually the average [01:09:55] age of Caucasian women in the Northern Hemisphere. And we know that black women are likely to go through a little bit earlier [01:10:00] than that, and that you can have symptoms for up to a decade before. Um, and [01:10:05] there is some evidence around things like legumes [01:10:10] might make a difference about oils might make a difference, but [01:10:15] actually we think it’s mostly genetic. Aside from the smoking about when you are [01:10:20] going to go through and if you have a family history of a premature or an early menopause, then [01:10:25] you’re more likely to have an early menopause yourself. If we take out your womb, even though we’ve left [01:10:30] the ovaries in, you also are likely to go through a slightly earlier menopause. But there is no [01:10:35] medicine that I have to delay when you’re going to run out of eggs. And [01:10:40] so people say, well, I’ve got the pill or I’m on the coil or whatever. [01:10:45] No, it might cover up the symptoms, but you’re going to run out of eggs when you run out of eggs. [01:10:50]

Rhona Eskander: What about stress?

Philippa Kaye: So stress can affect your [01:10:55] menstrual cycle. But that isn’t the same as affecting [01:11:00] when you’re going to go through the menopause. So I can turn off your menstrual cycle using [01:11:05] medications. That doesn’t mean that I’m saving those eggs for later. [01:11:10] And that doesn’t seem to work. Which then begs the question, okay, if you have [01:11:15] IVF and we stimulate loads of eggs in a month, does that mean you’re going to have a menopause earlier? [01:11:20] It doesn’t seem to do that. And Um, and, you know, yes, we absolutely do need more [01:11:25] research. But it comes back to the fact that about a thousand eggs have the potential to mature each month. [01:11:30] And maybe in IVF, we’re just making more of them mature. Um, than than would naturally. [01:11:35] Um, but there there is [01:11:40] definitely harm related to smoking. We also know that people who do not exercise, [01:11:45] who drink alcohol, who have obesity, are going to have worse, are more likely to have worse perimenopause [01:11:50] symptoms when they come. But I think that what we need to do is change [01:11:55] the mindset from I must delay the menopause. Well, why do you want to delay it? Well, because [01:12:00] I want to be young and I want to have good skin and I don’t want to have [01:12:05] symptoms to, well, hang on, you can have all of those things and be happy and be well [01:12:10] and be healthy after the menopause. Because on average, women in this country live about a third [01:12:15] of their lives after the menopause. And that might change to half of your life after the menopause [01:12:20] and, you know, in 100 years time. So actually, maybe we need to ask a different [01:12:25] question, which is how do I be well and healthy afterwards as opposed to trying to put it off? [01:12:30]

Rhona Eskander: Yeah, I love that. And I think that’s a really beautiful way to end it. I could talk to you about so [01:12:35] many things. I think we’re going to have to do a second episode with you, Philippa, because you are [01:12:40] so wonderful. For those listening, could you please tell them the name of the book and where they can also [01:12:45] get it?

Philippa Kaye: So the book is called The Science of Menopause. It’s published by Dorling Kindersley and you can get [01:12:50] it anywhere and everywhere online and in bookshops. And I am am [01:12:55] on social media at Doctor Philip. Okay.

Rhona Eskander: Perfect. Thank you so much. This has been so [01:13:00] lovely and thank you for your honesty and vulnerability. She’s an absolute force, so I recommend that you do follow [01:13:05] her, because I’ve gained a plethora of knowledge from just following her and, you know, had the honour [01:13:10] of also being in her presence. So thank you guys, and don’t forget to like and subscribe to my [01:13:15] YouTube as well so that you can get the long form videos. Okay, see you next time. Bye bye. [01:13:20]

Payman Langroudi: This podcast is brought to you by enlighten. Enlighten is an advanced teeth whitening system. Join [00:00:05] us for online training, where I’ll take you through everything you need to know about how to [00:00:10] assess a case quickly, how to use the system, how to talk to patients. Because when [00:00:15] you know you can deliver brilliant results, it’s so much easier to talk about it. To book your course, which takes [00:00:20] only an hour. It’s completely free. Visit enlighten online training.com. [00:00:25] Now let’s get to the pod.

[VOICE]: This [00:00:30] is Dental Leaders. The podcast [00:00:35] where you get to go one on one with emerging leaders in dentistry. Your [00:00:40] hosts Payman Langroudi [00:00:45] and Prav Solanki.

Payman Langroudi: Working for a corporate. [00:00:50] In this case, working for my dentist. Um, it’s going to be an interesting [00:00:55] podcast. We’ve got we’ve got a few people working at my dentist at different levels in different practices, [00:01:00] and try to get the sort of the story of how it is to work for [00:01:05] them and how it is to work for a corporate in general, and obviously in the normal way [00:01:10] that we do with this podcast. Sort of the career story of the people. So it gives me great pleasure [00:01:15] to invite or to to welcome Claire Stenhouse onto the podcast. Claire is a [00:01:20] hygienist therapist at my dentist in Skegness. In Skegness. [00:01:25] Yeah. Well done for coming all this way, Claire. Okay. Hey, um, I [00:01:30] think we’ve got to start with, you know, Claire, you do a lot of, uh, teeth whitening.

Claire Stenhouse: I do. [00:01:35]

Payman Langroudi: Which is. Which is why I’m so interested in you. Um. And you are a therapist, too. [00:01:40]

Claire Stenhouse: I am.

Payman Langroudi: And yet we have a lot of hygienists who don’t get involved [00:01:45] in things outside of just hygiene.

Claire Stenhouse: Yeah.

Payman Langroudi: So in [00:01:50] your career, was there a moment where you decided you were going to sort of branch out? [00:01:55]

Claire Stenhouse: Yeah, I mean, I typically do a lot of [00:02:00] National Health Service fill ins. Um, that’s my normal day.

Payman Langroudi: Adults as.

Claire Stenhouse: Well. Adults [00:02:05] and children. And, uh. I suppose [00:02:10] doing National Health Service work is what I love doing. But all [00:02:15] day, every day it gets a bit tedious. So that’s why I decided that I wanted to branch out a little [00:02:20] bit. And then, of course, I got the call from Michelle Holmes asking if I wanted to [00:02:25] trial the enlighten, and it’s just all gone from there. Really?

Payman Langroudi: Yeah, but why is it that you [00:02:30] find it so easy to talk to patients about the colour of their teeth, whereas we’ve [00:02:35] got loads of even dentists who really worry about it?

Claire Stenhouse: I think the [00:02:40] hygiene side of that brings that along quite nicely, because [00:02:45] people come in saying that they’ve got a lot of staining on the teeth, so then you’ve got the opportunity [00:02:50] to talk to them about having an airflow or having whitening. If they want something more Something more [00:02:55] pertinent than they can have the whitening done. So I think the hygiene side of that makes [00:03:00] it a lot easier to do the whitening.

Payman Langroudi: So is that typically the kind of patient that you end up whitening, someone who’s got the recurrent [00:03:05] staining? Yeah, because when I was a dentist, that was obvious. It seems so obvious, isn’t it? Someone’s got some imbrication [00:03:10] in the lowest. Yeah. Constantly staining, constantly having to come and have it cleaned off. Why [00:03:15] don’t we just make you some trays so that you don’t have this problem again? Yeah, yeah, it seems so obvious, isn’t it?

Claire Stenhouse: Yeah, it is quite [00:03:20] obvious. And I always say when we’re doing an air flow, I always say it’s not going to whiten your teeth, it’s just going to brighten [00:03:25] your teeth. So if you’d like them whitening, the only way forward is to obviously have them whitened. [00:03:30] And that’s how we go from there.

Payman Langroudi: And were you doing any whitening before enlighten.

Claire Stenhouse: I used to do [00:03:35] the Philips Zoom. Yeah. Um I did quite a few cases of that to be honest, but.

Payman Langroudi: They were already [00:03:40] kind of in that mode.

Claire Stenhouse: Already. Yeah, but that took two hours. So it was full. [00:03:45] Yeah. Full on. Yeah. So that was two hours of my day list gone. [00:03:50] Um, so yeah. Then enlighten just seems to work for us.

Payman Langroudi: And so [00:03:55] what percentage of your work now is non-scaling Polish? Is it the majority [00:04:00] of your work?

Claire Stenhouse: Yeah. Yeah, yeah. I’d say 6040. So 40. [00:04:05] Cleaning 60. Everything else? Yeah.

Payman Langroudi: And so in a typical day, [00:04:10] you’re doing how many fillings?

Claire Stenhouse: Ten.

[TRANSITION]: Maybe ten fillings a day.

Claire Stenhouse: Ten fillings [00:04:15] a day. Well, ten patients that need fillings a day. And then private work on top of that. Yeah.

Payman Langroudi: And so [00:04:20] what happens when when a patient comes in. How do they end up with you? Does a dentist push [00:04:25] them towards you or.

Claire Stenhouse: So they’ll come in for a check-up with the dentist and then they’ll prescribe the treatment [00:04:30] to the therapist? However, current, um, regulations [00:04:35] have come in. Now that we don’t need a prescription, we can work to our own initiative so we can do check-ups as well. Now. [00:04:40] Oh, right. Yeah. We, um, we’ve got exemptions from local anaesthetic. We’ve got exemptions [00:04:45] from fluoride varnish. The only thing we haven’t got exemptions from is a whitening [00:04:50] prescription.

Payman Langroudi: You need a need a prescription.

Claire Stenhouse: Still need a prescription for that. But yeah, for a local anaesthetic and [00:04:55] fluoride varnish. We don’t need a prescription anymore.

Payman Langroudi: And how about that? Is there a moment where someone has to explain [00:05:00] to the patient that you’re a therapist, not a dentist?

Claire Stenhouse: Not anymore. Because I’ve been there for 15 years and we don’t take [00:05:05] on new patients. So all the patients know that I am a therapist and not a dentist. [00:05:10]

Payman Langroudi: Um, that conversation must have to happen at some point.

Claire Stenhouse: It does. So what did you say?

Payman Langroudi: What [00:05:15] did you say about it?

Claire Stenhouse: I don’t. So, um, we trained with the dentists [00:05:20] at dental school. We did a lot of our, um, lessons with the dentists at dental school. [00:05:25] But then the dentists go on and do the more complex work than the therapists. [00:05:30] So that’s how we try to explain it. Um, which, yeah, a lot of patients are more [00:05:35] than happy with.

Payman Langroudi: And forgive me for not really knowing, but what happens? Let’s say you’re doing an [00:05:40] mod and it suddenly turns very, very deep. Do you stop and.

Claire Stenhouse: Call [00:05:45] the dentist? I’m very, very lucky at my practice that I can call one of the dentists through at any point [00:05:50] for advice. So yes, I’ll sometimes put a temporary in and then refer it back to the dentist. [00:05:55] Book an appointment with a dentist. But I’m very lucky in the fact that most of them will just come through there [00:06:00] and then and have a look for me and tell me next stage.

Payman Langroudi: And we had you on mini [00:06:05] smile makeover for the anterior composites.

Claire Stenhouse: Yeah.

Payman Langroudi: And you’re going to come again [00:06:10] and all that. But do you have any further have you had any further training on restorative [00:06:15] after your course?

Claire Stenhouse: No. Just no. Just the mini smile makeover.

Payman Langroudi: So for posteriors, [00:06:20] you for instance, do you sectional matrices, do you use rubber dam. What do you.

Claire Stenhouse: Do. So I [00:06:25] normally on posterior teeth I’m working on the NHS so I’m afraid it’s a good old fashioned [00:06:30] amalgam or amalgam. Yeah we still use we’re still. Yeah we’re still on amalgam. [00:06:35]

Payman Langroudi: So you’re not doing any private therapy fillings.

Claire Stenhouse: Occasionally. [00:06:40] Not very. So if a patient comes in and they’d like a composite filling, then I do offer them, um, [00:06:45] the chance of having a private one. But the thing is, I’m not that confident with [00:06:50] them, to be honest. So I’m going to come back on the anterior course and then maybe go [00:06:55] on posterior.

Payman Langroudi: Well, you know, what we found was I don’t know if by the time you came we’d stopped doing it yet, [00:07:00] but we used to give a prize for the best.

Claire Stenhouse: Yeah. You did.

Payman Langroudi: And therapists and therapists constantly winning [00:07:05] that prize. Now, I don’t know if it’s a self-selecting thing, because the kind of therapist who [00:07:10] pays £1,000 to come on a composite course might be the kind who’s really into it.

Claire Stenhouse: Really into it. Yeah. [00:07:15]

Payman Langroudi: For whatever reason it is, the therapist is doing better work than the dentist.

Claire Stenhouse: Told me that last time. [00:07:20] Yeah, yeah.

Payman Langroudi: Which is. Which is interesting.

Claire Stenhouse: When I come on the fifth and sixth, sixth and seventh, I will try my hardest [00:07:25] to to win that prize.

Payman Langroudi: Tell me about your journey into therapy. [00:07:30] Were you a dental nurse?

Claire Stenhouse: 17 years? Yeah, as a dental nurse.

Payman Langroudi: Um, what made you decide [00:07:35] 17 years in to do? Make make the change.

Claire Stenhouse: I went to my boss one day and said, um, [00:07:40] I don’t just really want to do dental nursing for the rest of my life. Is there anything you can advise me? [00:07:45] And he just said to me, why don’t you don’t you apply to go to university? And I applied and I got [00:07:50] an interview and I got offered a place.

Payman Langroudi: It was supposed to be really super competitive.

Claire Stenhouse: Yeah. And I.

Payman Langroudi: Think. Did [00:07:55] you study.

Claire Stenhouse: Sheffield? I think because it wasn’t something that I’d always wanted to do, [00:08:00] and it therapy was very new at that point when I went to university. So [00:08:05] it wasn’t really something that I’d thought about. So I think because I wasn’t.

Payman Langroudi: Invested [00:08:10] a lot psychologically.

Claire Stenhouse: I wasn’t I was quite relaxed about the whole thing. [00:08:15] So I don’t know whether that helped me get through the interview. I don’t know. I don’t know, but yeah, I [00:08:20] went for the interview, offered the place, and.

Payman Langroudi: I’d like to understand, like what happened 17 years into nursing. Did [00:08:25] something happen that made you think now’s the time?

Claire Stenhouse: Yeah, I just got a bit. I think my kids had [00:08:30] gone to school at that point, and I just felt as if I was in a bit of a rut, and I just wanted to [00:08:35] do something else. But I’ve always worked in dentistry since I was 16, so I didn’t really want to leave [00:08:40] dentistry. So I just had a word with my boss and he said, why don’t you just try? I think it was. [00:08:45] He said, why don’t you try for hygiene? But then when I applied, it had changed [00:08:50] to a therapy course. It was therapy. So.

Payman Langroudi: Yeah. And it’s full time course. Yeah. Did you have to save up and [00:08:55] pay for it or pay for your life?

Claire Stenhouse: Bizarrely, it was paid by the National Health Service. [00:09:00] Oh, really? And they also paid me a bursary to go to university, which I [00:09:05] think was about £600 a month.

Payman Langroudi: I didn’t think that sort of thing existed.

Claire Stenhouse: And I think the course [00:09:10] was £18,000 a year.

Payman Langroudi: They paid all of that.

Claire Stenhouse: They paid all of it.

Payman Langroudi: Oh, goodness.

Claire Stenhouse: And I hardly [00:09:15] took any student loans out either, so I never I never lost anything.

Payman Langroudi: Maybe you lucked out. It was like a moment [00:09:20] where they decided we need therapy.

Claire Stenhouse: Yeah, but then it stopped. So when. So when I finished [00:09:25] university, there was no, like, big. You’ve got to come and work for the NHS. [00:09:30] I think I went and worked privately for the first two years. I didn’t even work for the NHS. But yeah, they paid for [00:09:35] for everything, which was bizarre. And it’s only now. I mean, I’ve been a therapist for 15 years. [00:09:40] It’s only now that the NHS is saying we need we we need therapists. [00:09:45] Um, and they’ve given us the exemptions. I’ve now got a performer number so I [00:09:50] can open a course of treatment. So it’s only 15 years in that they’re [00:09:55] saying, yeah, you can work on the NHS.

Payman Langroudi: So and if someone, if someone’s a nurse listening to this.

Claire Stenhouse: Yeah. [00:10:00]

Payman Langroudi: And they’re considering, you know, and you know I feel like our profession definitely [00:10:05] on the DCP side, it’s just there isn’t enough sort of movement [00:10:10] and career sort of progression.

Claire Stenhouse: Yeah.

Payman Langroudi: So if someone’s thinking, look, I’m nursing, I’m a good nurse, I [00:10:15] like my job, but I want to do something more.

Claire Stenhouse: Same as I did. Yeah.

[TRANSITION]: What what what.

Payman Langroudi: Would you [00:10:20] say are the biggest differences? Like, you know, for instance, now, I guess you have to worry [00:10:25] about the GDC breathing down your neck. Yeah. Whereas as a nurse you don’t. Yeah.

Claire Stenhouse: Yeah you [00:10:30] do.

Payman Langroudi: Yeah. Yeah yeah. But I just made that up. I mean yeah, the considerations [00:10:35] that someone should be thinking about what makes what makes it something to go [00:10:40] for And what surprised you about it? For instance?

Claire Stenhouse: It’s hard work. It’s very stressful. [00:10:45] I don’t know whether I can say go, go, go for it. It’s it’s rewarding. [00:10:50] But I think a lot of the dentists [00:10:55] refer a lot of children to me. Yeah. I [00:11:00] don’t think a lot of the dentists particularly like working with children. It’s [00:11:05] harder, it’s harder. So they refer it to me. So from 3 p.m. till 5 [00:11:10] p.m., you’re just kids on a daily basis. It’s just kids, really. And by 5:00, my [00:11:15] head is blown. It’s really, really hard work. So it’s very stressful. It’s [00:11:20] very stressful. But then I’m a therapist on the NHS. So a therapist working purely [00:11:25] privately.

Payman Langroudi: How long do you get for a filling on a kid?

Claire Stenhouse: 20 minutes.

Payman Langroudi: Oh my goodness.

Claire Stenhouse: Yeah 20 minutes. [00:11:30]

Payman Langroudi: La oh you don’t give LA to.

Claire Stenhouse: Kids. No not particularly. No no depending on age and tooth but no [00:11:35] not not necessarily.

Payman Langroudi: What about if it’s an adult m.o.

Claire Stenhouse: 20 minutes.

Payman Langroudi: 40 minutes. [00:11:40] Beginning to end.

Claire Stenhouse: Yeah.

Payman Langroudi: Yeah. Well, no wonder, no wonder they’re sending patients to you.

Claire Stenhouse: Yeah. [00:11:45] But then I’ve been doing it for 15 years, so. Yeah, yeah. When I first qualified, [00:11:50] when I was at university, we had an hour and a half. Yeah. On clinic to do. To do a filling. [00:11:55] And when I first went in to work in my first NHS job, I think I was given [00:12:00] 40 minutes for a filling and I panicked. I was like, there is no way that I can do [00:12:05] a buckle, buckle, cup of tea in 40 minutes. But you just.

Payman Langroudi: About the course [00:12:10] itself, did it surprise you how difficult that was? Because when I got into dental school, it just blew me away.

Claire Stenhouse: How difficult [00:12:15] it was. A lot of our lectures were with the BDA students, and they’d [00:12:20] done physics, chemistry, biology. I hadn’t I’d done biology [00:12:25] at school a long time ago.

Payman Langroudi: O-level?

Claire Stenhouse: No, it wasn’t [00:12:30] O-level. What was it before that? Uh, no, it was it was O-level. Yeah. Um, and [00:12:35] a lot of our lectures were with the BDS students and it baffled [00:12:40] me. Absolutely baffled me. I didn’t understand it and I used to.

Payman Langroudi: Find exams hard.

Claire Stenhouse: No, [00:12:45] no, not after a while. Because what I did is I used to go home and I used to go on [00:12:50] BBC bitesize. Oh, yeah. And I used to start from the scratch with with the things until [00:12:55] I understood it, because. What a swap. Yeah. No, um, but [00:13:00] that was the way that I got through it. I learned all the basics, but yeah, it was really hard. Really hard. And I [00:13:05] think it’s even harder now.

Payman Langroudi: I think it’s harder in many ways. Right. It’s hard in the sort of the [00:13:10] book part of it. Yeah. The reading and all that understanding. And I remember thinking sometimes [00:13:15] I was a kid, you know, I was 18 or 19 years old. Sometimes a lecturer would say something and I’d for [00:13:20] myself decide, nah, this isn’t important. Yeah. And then two weeks later, you realise none of that was important.

Claire Stenhouse: Really [00:13:25] important. Yeah.

Payman Langroudi: And so, because it’s a word you’ve not heard, or you just get a feeling from the person that this [00:13:30] isn’t important. Um, you realise soon that this is the absolute minimum you need to know [00:13:35] it’s nowhere near the maximum.

Claire Stenhouse: Absolutely.

Payman Langroudi: Yeah. And then on the other side of it, the first time you do [00:13:40] a filling, the first time you do an endo, the first time you do a crown, prep whatever it is, the first time it’s, [00:13:45] it’s it’s heartbreakingly difficult. Right.

Claire Stenhouse: Yeah. No it is.

Payman Langroudi: On a patient. [00:13:50]

Claire Stenhouse: Yeah. And you’ve not got your tutor stood behind you, guiding you through it. You’re on your own.

Payman Langroudi: And did you do. You must have [00:13:55] done some phantom head stuff as well, right.

Claire Stenhouse: Yeah. We yeah, we did we, we had, um, I think we had six [00:14:00] months just doing hygiene on phantom heads before we were allowed to go on to fillings. Yeah. Yeah. [00:14:05] But then we did all our phantom head work with the BDS students as well. But it was very competitive. [00:14:10] Yeah. Yeah. At university? Yeah. Yeah.

Payman Langroudi: So then. So this brings me [00:14:15] nicely on to this part of the pod that I like to talk about, sort of the darker part [00:14:20] of the pod where we like to discuss mistakes.

Claire Stenhouse: Okay.

Payman Langroudi: Um, and it comes [00:14:25] from black box thinking, and it’s about, you know, the fact that we tend to hide our mistakes in the medical world because [00:14:30] in the medical world, we kind of like to assign blame to mistakes. Um, [00:14:35] but then what that means is I don’t learn from yours. And you don’t learn from mine. Yeah, absolutely. So to [00:14:40] buck that trend, what comes to mind when I say what clinical errors have you made?

Claire Stenhouse: I [00:14:45] have given somebody an ID block on the wrong side. I’ve done that. Yeah yeah, [00:14:50] yeah. And the left right mistakes. I’ve done that.

Payman Langroudi: Well, [00:14:55] how did you. What happened?

Claire Stenhouse: What happened? I just had to apologise to the patient and ask her.

Payman Langroudi: The patient realised before you did.

Claire Stenhouse: No, [00:15:00] no, she didn’t have a clue. Even though I’d already said to her we’re doing a filling on the lower right. And then I numbed [00:15:05] up the lower left.

Payman Langroudi: Um, were they understanding?

Claire Stenhouse: Yeah. She was. She was absolutely fine. Um, yeah, she [00:15:10] was fine.

Payman Langroudi: What did you did you then give the other side? No, I didn’t send [00:15:15] them home like that.

Claire Stenhouse: Um, no, I yeah, she came back about a couple of days later, and. Yeah, she was absolutely fine. Um, [00:15:20] at university, um, on one of my practical exams, they asked me to, [00:15:25] um, fill a lower left seven mod. I did a cracking job. It was a beautiful amalgam [00:15:30] filling. Only I’d done had done it in the sixth. So that is something that I don’t do anymore because [00:15:35] I failed and I had to go back two months, I think. Um, so it.

Payman Langroudi: Wasn’t a real patient.

Claire Stenhouse: It wasn’t [00:15:40] a real patient. But I think, um, that’s now like I checked three times before I fill [00:15:45] a tooth.

Payman Langroudi: What about a management thing where just like, what comes to mind when I say, who’s your most difficult [00:15:50] patient? Not necessarily from the clinical aspect of a patient who, you know, you [00:15:55] end up losing trust or, you know, you must. You know, one thing I noticed [00:16:00] is sometimes you get a patient who’s really rude to the nurse, and then when [00:16:05] the dentist comes in, they’re sweet as pie.

Claire Stenhouse: Mhm.

Payman Langroudi: What’s that situation like that. You know a patient.

Claire Stenhouse: I am [00:16:10] I think I’m at that age now where.

Payman Langroudi: No one.

Claire Stenhouse: Dares. No. And if somebody’s rude to me [00:16:15] I am actually rude but not rude back but I will, I won’t take it. Um, [00:16:20] but that’s only come in like the last 5 or 6 years. But if somebody is rude to my nurse as well, I will [00:16:25] say.

Payman Langroudi: Pull them.

Claire Stenhouse: Up on it. Yeah, I will say you can’t speak to her.

Payman Langroudi: So what comes to mind when I say it. Your [00:16:30] most difficult patient.

Claire Stenhouse: I’ve got loads.

Payman Langroudi: Yeah. Go on. What comes to.

Claire Stenhouse: Mind? What comes to [00:16:35] mind? Um. Oh, crikey. You know, put me [00:16:40] on the spot.

Payman Langroudi: Well, you know, there’s patients who can’t go back very far. The patients who complain, complain, complain [00:16:45] about something.

Claire Stenhouse: I had a patient in on Tuesday who was [00:16:50] booked in for upper left six.

Payman Langroudi: Filling.

Claire Stenhouse: Filling. [00:16:55] And I said I’m just going to pop your chair back. And he said, I can’t lie down. And I said, I’m really sorry. [00:17:00] I can’t see what I’m doing unless you lay down. And he said, But I’ve got a bad back. And I said, [00:17:05] well, I’ll be perfectly honest with you. I also have a bad back. I said, if if I lean over, I’m [00:17:10] going to be out for a couple of days. I said, but if you want to rebook with somebody else, then that’s perfectly fine. And he said, [00:17:15] no, I’ll do it. And then he said, my wife won’t be able to lay [00:17:20] back if you need to treat her. And I said, well, if she’s ever offered an appointment with me, I suggest you don’t [00:17:25] book it and let her see somewhere else. And he was fine all the All the way through the appointment. I kept checking that he was all right, [00:17:30] asking him if he was okay. Yeah, yeah. Went out to reception and complained and said to the [00:17:35] receptionist, do you think it’s fair that I had to lay back just because she’s got a bad back?

Payman Langroudi: Mhm. [00:17:40]

Claire Stenhouse: Typical patient. Yeah we get that a lot.

Payman Langroudi: And [00:17:45] what happened. Nothing.

Claire Stenhouse: Nothing. I don’t think they’ve put a formal complaint [00:17:50] in. But you never know these days do you.

Payman Langroudi: Have you ever had a formal complaint.

Claire Stenhouse: Yeah I had one not long ago. About [00:17:55] three weeks ago.

Payman Langroudi: What happened?

Claire Stenhouse: Um, so a child came in, [00:18:00] was referred to me for six extractions. Um, A’s, [00:18:05] B’s and C’s. All were mobile.

Payman Langroudi: Do you do extractions as well?

Claire Stenhouse: Yeah. I’m on deciduous [00:18:10] teeth. Yeah.

Payman Langroudi: Oh, really?

Claire Stenhouse: Came in with grandma. Um, I’d already [00:18:15] seen him the week before for fillings. And I’d said to grandma, we’re just going [00:18:20] to do the fillings today and try and get him used to coming to see us. Came in for extractions. [00:18:25] They were grade three mobile, so I just used jail. Didn’t give an injection. It was only [00:18:30] I think it was 7 or 8. Um, put the gel on [00:18:35] and left it for two minutes. Talked to the patient, talked to Nana, made everybody nice and comfortable. Um, [00:18:40] went to take his tooth out, which was hanging out, and [00:18:45] he screamed. But I had already got the tooth, so I just took it out. And [00:18:50] he.

Payman Langroudi: Your fingers.

Claire Stenhouse: With my fingers. Yeah. And he was leaving the room and I said to him, are we still [00:18:55] friends? Because he was quite upset by this point. And he said, yes. And he came over and gave me a hug. Um, complaint [00:19:00] letter came in from the mum the next day saying that I had restrained him. I’d [00:19:05] not given him any local anaesthetic or any anaesthetic. Um, I spoke to him [00:19:10] atrociously. Um, and what else.

Payman Langroudi: Was mum sitting in the room? [00:19:15]

Claire Stenhouse: No, mum wasn’t there. Grandma came with him. Mum wasn’t in the room. My mum wasn’t there. Grandma came, um, [00:19:20] all sorts of things in this. Um, it was just a and I’ve recently found out it [00:19:25] was just therapy staff who saw my son. It wasn’t even a dentist. Mhm. Um, it [00:19:30] went on and on. It was really quite nasty to be honest. Um, but thankfully I have a [00:19:35] nurse in surgery with me and all my notes were completely up to date. [00:19:40] So I just rang the ju who responded and not [00:19:45] heard anything since, but mum wasn’t even there. Grandma was there.

Payman Langroudi: On reflection. [00:19:50]

Claire Stenhouse: Yeah.

Payman Langroudi: Would you have done something differently?

Claire Stenhouse: I would not have let grandma come. So [00:19:55] from now on.

Payman Langroudi: Oh, you don’t just want the kid?

Claire Stenhouse: No, I want kids [00:20:00] and a parent. I think that’s the way forward. So we have a policy in [00:20:05] place that parents have to come for exams and sign the consent form. But [00:20:10] if they want somebody else to bring them for treatment, they have to give their permission, which was given. But [00:20:15] from now on, going forward, I only really want the parent in there.

Payman Langroudi: But do you see what I mean [00:20:20] with that question I asked you about? What do you say to the patient about therapist or dentist? [00:20:25] In this case, she’s flagged that and said, I didn’t.

Claire Stenhouse: Know therapy stuff.

Payman Langroudi: So in a way, that’s [00:20:30] maybe part of the.

Claire Stenhouse: But she did know because she didn’t. Yeah. The dentist had already told her. Yeah, [00:20:35] yeah. And everything was in our notes. And even that was. Yeah, even that was in the notes, even, uh, [00:20:40] even the point of saying that we’ll do the fillings first and then try the extractions and see how it goes. [00:20:45] It was all it was all in the notes. Everything was in the notes.

Payman Langroudi: So are you saying that there was some sort of, I [00:20:50] don’t know, malicious intent?

Claire Stenhouse: Yeah.

Payman Langroudi: Yeah. Why, though? Yeah. What? Try it on.

Claire Stenhouse: I don’t [00:20:55] know whether he’d gone home very upset and grandma had [00:21:00] felt stoked.

Payman Langroudi: The flames?

Claire Stenhouse: Yeah. Stoked the flames, I don’t know, but we was all lovely to him. Lovely [00:21:05] to him? Yeah. When he was there, so I don’t know. But yeah that was a couple of weeks ago but that was the first one. [00:21:10] So I haven’t done bad. It’s.

Payman Langroudi: Yeah. Yeah. Listen man it’s part of it’s part of.

Claire Stenhouse: Being [00:21:15] a clinician. It’s upsetting though when it happens. It’s. Yeah. It’s not it’s not easy.

Payman Langroudi: I mean [00:21:20] I haven’t practised now for 14 years or something, but I in the times [00:21:25] that I got complaints, the most upsetting ones were where I was doing something slightly [00:21:30] out of the ordinary to help the patient.

Claire Stenhouse: Patient? Yeah.

Payman Langroudi: And then, yeah, I, [00:21:35] I can almost say it’s gone wrong because it was out of the ordinary. Yeah. Whatever the thing was. [00:21:40] Yeah. Like, you know, I decided to add a tooth to a denture in that same appointment where I really [00:21:45] should have just booked another appointment. And the patient said, can you do it today?

Claire Stenhouse: And then helped them out.

Payman Langroudi: Help them.

Claire Stenhouse: Help them [00:21:50] out.

Payman Langroudi: And then it’s gone wrong. Yeah. And then the patient’s written a letter that’s almost saying the opposite [00:21:55] saying this guy’s tried it on, you know.

Claire Stenhouse: Tried something. Yeah.

Payman Langroudi: And that’s where it gets [00:22:00] really painful.

Claire Stenhouse: You’ve tried to help somebody.

Payman Langroudi: You were trying to help. Now, if I. If I then extrapolate out [00:22:05] that to, let’s say, a serious situation which that becomes a GDC hearing. Yeah. [00:22:10] Let’s say I’ve got my kids in private school. I’ve got debts. Now, suddenly I’m [00:22:15] catastrophizing about what’s going to happen if I lose my lose my license. And then you can [00:22:20] start to understand why. You know, dentists take their own lives sometimes.

Claire Stenhouse: Yeah. No. Absolutely. [00:22:25] And it’s it’s upsetting because it. She tried to [00:22:30] say that I was quite horrible to her. And I’ve, I’ve been treating kids for 15 years and most of the kids come in, [00:22:35] they’re like, hi Claire. Are you alright? And it was upsetting to think that somebody thought that I’d actually been horrible [00:22:40] to a child. That was the worst thing. Um, and as.

Payman Langroudi: Much similar to what I’m saying.

Claire Stenhouse: Yeah. And [00:22:45] as much as you try to, like, shrug it off and go, oh, yeah, it’s fine, I’ll let the deed. It was like just waiting [00:22:50] for the deed you to respond.

Payman Langroudi: Stress.

Claire Stenhouse: It’s it’s it’s quite stressful and you don’t realise sometimes [00:22:55] how much it’s stressing you out. Um, but yeah, it’s quite, it’s just you [00:23:00] like to think that you’re very, like, brave.

Payman Langroudi: And what’s mad is, what’s mad is I just [00:23:05] said to you, what should a young nurse who’s thinking about going to therapy think about. And you [00:23:10] said it’s a stressful job and you didn’t mean the day to day is stressful. [00:23:15] You meant a few of these incidents.

Claire Stenhouse: Can make it.

Payman Langroudi: Maybe one every three years. [00:23:20]

Claire Stenhouse: Can make it.

Payman Langroudi: Real enough to make it.

Claire Stenhouse: A very stressful yourself as well. And um, [00:23:25] yeah, it does. It makes you question yourself and whether you’re doing the right thing and you have to like, really think back to the [00:23:30] appointment and was there about there wasn’t. So yeah. No it’s fine.

Payman Langroudi: Tell me about working at a corporate. [00:23:35] Uh, your practice was bought by my dentist.

Claire Stenhouse: It was?

Payman Langroudi: Yeah. So you were already a hygiene [00:23:40] therapist in this practice when it when it happened. I mean, I’ve [00:23:45] been to a lot of my dentist practices, right? And they’re all now very branded up and all. Yeah. Was there a moment [00:23:50] where you thought this, this building that I know so well? I’ve [00:23:55] got so many memories and suddenly they’ve ripped it apart and, you know, rebranded everything, I [00:24:00] guess some new people probably. Yeah. Was there a moment of like. Like almost. I mean, it’s a silly word, [00:24:05] but like, grieving for the past.

Claire Stenhouse: Yeah. And my patience and my patience as well. Yeah. Yeah. [00:24:10] It was, it was, it was quite upsetting. Was it when they came in. Yeah. And I’ll be honest with you, my dentist [00:24:15] has changed so much just lately. Yeah. When they came into my practice 15 [00:24:20] years ago, it was a completely different bunch of people and they weren’t as [00:24:25] nice as what the people are now.

Payman Langroudi: They’ve got a massive focus now on the clinicians they have. [00:24:30] They want the clinicians.

Claire Stenhouse: Happy and the staff as well. Yeah, it is a massive change. But at the.

Payman Langroudi: Time [00:24:35] the attitude was a bit different.

Claire Stenhouse: Very different. Yeah.

Payman Langroudi: Explain to me like some something that was upsetting.

Claire Stenhouse: So [00:24:40] I’d been a therapist using my therapy with my [00:24:45] employer at the time, and he sold it to my dentist, and all they wanted me to do was hygiene. Yeah, [00:24:50] but they hadn’t got a dentist. So if they’d had just managed to get a dentist [00:24:55] one day a week to prescribe to me, I’d have been able to do the treatment. But they didn’t. But the patients [00:25:00] were left with nobody. They did get somebody just one day a week, [00:25:05] but the patients were just left with no appointments. It was like if the dentist just comes in and does the [00:25:10] check-up, I can do the therapy work.

Payman Langroudi: In a corporate environment, though [00:25:15] a little problem like that can take six weeks to sort because.

Claire Stenhouse: It has to.

Payman Langroudi: Go [00:25:20] up the chain of.

Claire Stenhouse: Command. Yeah.

Payman Langroudi: And then down the chain, I’m thinking my wife works. My wife owns [00:25:25] some of enlighten.

Claire Stenhouse: Right. Yeah.

Payman Langroudi: Okay. She she’s a dentist. Yeah. She works at a corporate. And we [00:25:30] said, look, you know, she owns the company, right? What about we do a little enlightened promotion? Yeah, yeah. [00:25:35] It took a year. One year? Yeah. For them to. To approve. Firstly the idea. Secondly, [00:25:40] the creative. Thirdly, the price, the offer. It took a year.

Claire Stenhouse: Yeah.

Payman Langroudi: And if [00:25:45] this was a normal practice, you could have just told the boss. Look, here’s what it is. By day after tomorrow, something [00:25:50] could have happened.

Claire Stenhouse: Exactly.

Payman Langroudi: So is it. Is it different now?

Claire Stenhouse: It’s a lot different now. It’s a lot quicker now. [00:25:55] Yeah. It’s a lot quicker now.

Payman Langroudi: So what happens? Let’s say you’ve got a problem now.

Claire Stenhouse: Yeah.

Payman Langroudi: How long do you think it will take to [00:26:00] fix a problem like that?

Claire Stenhouse: Um, my area manager is brilliant. So if I email my [00:26:05] area manager, she will get back to me and say, leave it with me. Really? Yeah.

Payman Langroudi: Call her out. Call her out.

Claire Stenhouse: Laura. [00:26:10]

Payman Langroudi: Laura. Well done, well done Laura.

Claire Stenhouse: My dentist and Michelle [00:26:15] Holmes as well. The. Yeah. Michelle. Yeah. Michelle’s lovely as well. So yeah it’s a it’s a lot it’s a lot better [00:26:20] now but we’re 15 years in so and then they, they just they seem to care. [00:26:25]

Payman Langroudi: So now from your sort of career prospects, [00:26:30] I’m trying to persuade you to do anterior aesthetic work. Let’s say [00:26:35] you come back to mini smile makeover and you decide. I mean, you’ve been once, but [00:26:40] you decided it’s not for you yet. This time you decide I’m going to try and do it.

Claire Stenhouse: Yeah, I have decided [00:26:45] I am going to do it.

Payman Langroudi: Really, really.

Claire Stenhouse: Amazing.

Payman Langroudi: So. So what steps would you now have to take [00:26:50] to be referred private aesthetic cases?

Claire Stenhouse: I don’t need to I don’t need to be prescribed. [00:26:55]

Payman Langroudi: I don’t need.

Claire Stenhouse: Prescribed.

Payman Langroudi: You’ll just sell it to the patient.

Claire Stenhouse: Sell it to the patients myself. Yeah. It doesn’t need prescribing. [00:27:00]

Payman Langroudi: When did that change?

Claire Stenhouse: Um, so it’s all been changing over the last couple of years. So before I [00:27:05] obviously would need a prescription for local anaesthetic. Yeah, I’ve just done the exemptions [00:27:10] course, so I don’t actually need a prescription for. Um, and I can do an examination [00:27:15] as well. Um, we always have been able to do, but never been allowed to. Um, [00:27:20] so whatever’s in our scope of practice now, we can now do. So if I see a patient and [00:27:25] they want composite bonding, I can go ahead and do it.

Payman Langroudi: And you scan [00:27:30] as well.

Claire Stenhouse: Yeah. Alicia does it for me, you know.

Payman Langroudi: But you can. [00:27:35]

Claire Stenhouse: See it’s much better at it than I am. But you can scan. I can scan, yeah. Yeah.

Payman Langroudi: Is the scanner kind of [00:27:40] available or is it.

Claire Stenhouse: Yeah, it’s. Yeah, it’s always available. It’s always there. Yeah. Yeah, yeah. We’re trying to convince [00:27:45] them to. So we’ve got a little spare room. It’s very tiny, but you could just get a chair [00:27:50] and a scanner in there. So we’re trying to convince them to make that into a little scanning room. So it’s always [00:27:55] available. If there’s no surgery free, then we can pop in there and leave it in there as well, because it’s [00:28:00] a bit of a clack carrying it around everywhere.

Payman Langroudi: I’m going to put you on the spot now.

Claire Stenhouse: Okay.

Payman Langroudi: What are [00:28:05] the best and worst things about working in this environment. Like in a corporate [00:28:10] environment.

Claire Stenhouse: In a corporate. Um. The [00:28:15] best thing, I suppose, is the support that you get. I’m [00:28:20] going to be honest with you. It all depends on your practice and [00:28:25] the manager.

Payman Langroudi: The particular.

Claire Stenhouse: And the team. Yeah. Um, if you’ve got a good manager and a good team, [00:28:30] then everything runs really smoothly. Um, I’m very lucky in [00:28:35] the fact that I do whitening. One of the dentists [00:28:40] does the composite bonding, one does clearcorrect and one does implants. And [00:28:45] we all.

Payman Langroudi: Tend much crossover.

Claire Stenhouse: No, we don’t cross over. We all refer to each other. [00:28:50] And that’s the lovely part of working. Um, but I don’t know [00:28:55] whether that happens in other practices. That’s just our practice.

Payman Langroudi: I mean, you’ve done you said you’ve done 120 [00:29:00] enlightened cases. Yeah. So many of those cases would be implant patients [00:29:05] or So. Patience.

Claire Stenhouse: Yeah. Yeah, yeah.

Payman Langroudi: Finish clear. Correct. And upgraded.

Claire Stenhouse: Composite bonding. But [00:29:10] want to, um, be a be one before they start.

Payman Langroudi: So all the dentists are cool with you doing it.

Claire Stenhouse: Instead.

Payman Langroudi: Of [00:29:15] them.

Claire Stenhouse: Doing.

Payman Langroudi: It?

Claire Stenhouse: Yeah, yeah, yeah. Interesting.

Payman Langroudi: I know it’s such a lucky position to be in.

Claire Stenhouse: I know, I [00:29:20] know.

Payman Langroudi: And then you get paid by percentage.

Claire Stenhouse: I do get paid by.

Payman Langroudi: Is [00:29:25] that the same across all, um, my dentists.

Claire Stenhouse: I don’t know, I think different hygiene therapists [00:29:30] work differently, I don’t.

Payman Langroudi: Do you only work in that practice? Would you work in a.

Claire Stenhouse: No, I work for an independent practice [00:29:35] as well. Oh, really?

Payman Langroudi: Okay, so tell me about this here. You know, sometimes I’m just gonna call you a hygienist [00:29:40] for now. Yeah, okay. Sometimes the hygienist doesn’t feel like part of the team, okay? Because they’re not [00:29:45] there the whole time. And I remember we used to have a hygienist in one of my practices. She was only there one [00:29:50] day a week. Yeah. And she used to tell me, um, we’d talk and she’d tell me, you know, [00:29:55] in dental practice, you’ve got hierarchy situations sometimes. Yeah. My dentist. Quite different, actually, when [00:30:00] I’ve been there. Um, it feels like a flatter hierarchy because, you know, [00:30:05] it’s my dentist. That’s the boss. It’s not. It’s not the dentist themselves. Right. Yeah. Um, but [00:30:10] what the scientists tell me is, you say, you know, I don’t even want to go to the Christmas [00:30:15] party, but it would be nice to get an invite.

Claire Stenhouse: Oh, she never got invited.

Payman Langroudi: Yeah, because she was. Because she was one day [00:30:20] a week.

Claire Stenhouse: Yeah.

Payman Langroudi: You know, they didn’t consider her as one of the team.

Claire Stenhouse: Yeah. Okay. So.

Payman Langroudi: Yeah, but [00:30:25] I’m not talking about the Christmas party. I’m talking about overall. Overall. You’re there. I don’t know, one day a week or two days a week. The other [00:30:30] one. The other job. Yeah. You’re not really properly part of the the full time staff. [00:30:35]

Claire Stenhouse: Yeah.

Payman Langroudi: Or maybe again, you’re very lucky and you feel like you are.

Claire Stenhouse: Yeah, I do.

Payman Langroudi: But you really [00:30:40] land on your feet. I have.

Claire Stenhouse: I know because, yeah, you see things on Facebook, don’t you, [00:30:45] about like what you’ve just explained. Not feeling part of the team and everything. And yeah, I [00:30:50] get it. And I have worked in practices before that I have felt like that. But no, I do actually [00:30:55] feel part of the team.

Payman Langroudi: Oh, so the best. So the best thing is.

Claire Stenhouse: Is they’re going to pay me for [00:31:00] this.

Payman Langroudi: Yeah. So the best thing is you’ve got the support. For instance, [00:31:05] my wife works at Bupa. We moved house and they just found her another job on.

Claire Stenhouse: The other side.

Payman Langroudi: Yeah. So there’s that. Right. [00:31:10] So if you ever want to move from Skegness, you could always. What’s the downside.

Claire Stenhouse: Of working for a corporate? [00:31:15]

Payman Langroudi: Yeah.

Claire Stenhouse: I suppose like [00:31:20] you just said, things do take longer.

Payman Langroudi: So even now. [00:31:25]

Claire Stenhouse: Yeah. So when I went when I did the enlightened course online, [00:31:30] I went to my boss at my other practice, which is independent, and [00:31:35] explained to him everything about him. And he ordered the kits straight away. Yeah. [00:31:40] And I know that.

Payman Langroudi: At my dentist there was a process.

Claire Stenhouse: It was it was a process. So yeah. [00:31:45] And my independence. So there’s lots of there’s [00:31:50] lots of rules and regulations at my dentist that aren’t in place. And [00:31:55] at the other one.

Payman Langroudi: And you understand why.

Claire Stenhouse: I understand.

Payman Langroudi: The stress.

Claire Stenhouse: Yeah. Yeah. Yeah, absolutely. [00:32:00] But yeah I suppose that’s one of the, the downsides. But you know, [00:32:05] everybody who’s worked at my practice has been there for a long time.

Payman Langroudi: So it’s are they as flexible [00:32:10] when it comes to holidays.

Claire Stenhouse: I’m self-employed. So they are. Yeah. So they are. Yeah I [00:32:15] think we have to give six weeks notice if we want holidays but yeah. No they are. Yeah.

Payman Langroudi: But let’s say it’s five [00:32:20] weeks notice. Is that a definite no. Or they’ll consider.

Claire Stenhouse: It. They’ll consider it. Yeah. That’s right. Yeah yeah yeah yeah. No. [00:32:25] Yeah. No they’re not strict like that. That’s right. Yeah. No it’s good. And like um I’ve had quite [00:32:30] a few health issues over the last couple of years. So they, they’ve been really good.

Payman Langroudi: Understanding.

Claire Stenhouse: About hospital [00:32:35] appointments and things like that. Yeah. Yeah, absolutely.

Payman Langroudi: I think if you know, I’ve got friends, my wife actually had [00:32:40] had a health issue too. If you’re ill. Yeah. A corporate might be the best place to be.

Claire Stenhouse: Yeah. No, they’ve always been.

Payman Langroudi: Okay [00:32:45] because they really do dot the I’s and cross the T’s when it comes.

Claire Stenhouse: To. Absolutely. Yeah.

Payman Langroudi: That sort of.

Claire Stenhouse: Thing. I’ve had [00:32:50] to go home some. Not not often, but a couple of afternoons I’ve had to leave and it’s, it’s been absolutely [00:32:55] fine. Apart from the patients.

Payman Langroudi: They’ve.

Claire Stenhouse: It.

Payman Langroudi: Not.

Claire Stenhouse: Being fine?

Payman Langroudi: Of course. [00:33:00] So where do you think you’ll be in five years time? Do you feel like you’ve fully retired? [00:33:05]

Claire Stenhouse: Oh, really? Hopefully. Are you thinking of it? Yeah. We’ve, um. We’re we we’ve [00:33:10] got a narrowboat in Nottingham that we go to every weekend, and we’ve just bought, um, [00:33:15] an old narrowboat that we’re doing up. Um, and our intention is to [00:33:20] five more years go live on the narrowboat. So. Yeah, hopefully five years. Yeah. Yeah, [00:33:25] it might take a bit longer than that, but yeah, that’s that’s the plan. So hopefully in five years I won’t.

Payman Langroudi: So you’re saving [00:33:30] up right now or.

Claire Stenhouse: Um. Yeah.

Payman Langroudi: It’s expensive. It’s expensive being [00:33:35] retired.

Claire Stenhouse: Yeah I know, yeah, I think so. I don’t think I’ll enjoy [00:33:40] full time retirement, so I’m probably going to end up working two days a [00:33:45] week just to keep you going.

Payman Langroudi: I used to have a boss who was really into, [00:33:50] uh, sailing. Yeah. And he he he used to go away. Actually, I really attribute [00:33:55] a lot of what I learned from this guy by by mistake, actually, because he used to go away for [00:34:00] four months at a time and he’d just have a little chat with me and say, look, just, just make sure everything’s okay and do [00:34:05] whatever you want and just go. And I learned a lot from just that. But but he put a Dental chair [00:34:10] on his.

Claire Stenhouse: Did he really?

Payman Langroudi: Wow. And and he sails around [00:34:15] Croatia.

Claire Stenhouse: Right. Okay.

Payman Langroudi: And, you know, the sailing community, they tend to sort of go [00:34:20] together. Yeah. From port to port. And he’s kind of just known as the guy. If you’ve got toothache, then. [00:34:25]

Claire Stenhouse: You pop on his.

Payman Langroudi: Boat. Maybe the narrowboat.

Claire Stenhouse: See, that is another, though. Another thing I’d like [00:34:30] to do if.

Payman Langroudi: Direct access from the narrative.

Claire Stenhouse: Yeah. Yeah. Just stick it on the side of a towpath. [00:34:35] Another thing I’d like to do there is a big ship, isn’t there, that goes around all the. Oh, why [00:34:40] does it. I used to work with a dentist who used to go, and it was like this big first aid [00:34:45] ship. And they used to do dentistry on there. Yeah. Charity work. I’d love to do that.

Payman Langroudi: Where? Like in Africa [00:34:50] or something?

Claire Stenhouse: Yeah, I’m sure it was. Yeah, somewhere around there. Or even go on one of these. Of these? [00:34:55] Is it dentate? Yeah, I’d love to do something like that. I’ve said that for years, but I’ll get [00:35:00] around to it at some point. But yeah.

Payman Langroudi: Whenever this question comes up, I always think about, have you heard of effective [00:35:05] altruism? No. So it’s got a bit of a bad name now, but [00:35:10] I’ll explain to you why. So, you know, let’s let’s say we want to do some charity work. Yeah, yeah, [00:35:15] there’s there’s an island in Greece where all the refugees first come to Lesbos. [00:35:20] It’s just full of refugees, right? You can go there and you can help out.

Claire Stenhouse: Oh, really?

Payman Langroudi: Yeah. [00:35:25] Um, Rona, my co-host. She does it every year on the other podcast. But [00:35:30] the question is this, like, why?

Claire Stenhouse: I just think it’d be rewarding.

Payman Langroudi: Yeah. [00:35:35] Yeah, it is. It definitely is. Yeah.

Claire Stenhouse: And I’ve done something good.

Payman Langroudi: Yes. But but, [00:35:40] you know, this is my point that, you know, sometimes someone like Rona, she’s a bit super high end cosmetic dentist. [00:35:45] Yeah. And she says sometimes you’ve got some very sort of rich, famous [00:35:50] person giving her hell about some quarter of an inch on a on a tooth [00:35:55] because she’s a cosmetic dentist and she says when she goes to the refugee camp, it’s like suddenly [00:36:00] keeping things real where you know, people, you know, need her help and so on. Yeah, and I get all of that. [00:36:05] But if the end goal is to alleviate suffering, [00:36:10] yeah, you do better working as a [00:36:15] therapist, banging out composite veneers and paying [00:36:20] money into charity, paying money to people on the ground.

Claire Stenhouse: Yeah, I’m going to do [00:36:25] it.

Payman Langroudi: If that’s the end goal. If the end goal is making alleviating pain, let’s [00:36:30] say. Yeah. Now, if the end goal is you yourself being the one to alleviate the pain.

Claire Stenhouse: Yeah. No, I think [00:36:35] that’s what yeah.

Payman Langroudi: I get it. I completely get it because, you know, there’s something in it for you. But but you’ve got to also [00:36:40] like be wary of, you know, there’s a power to that.

Claire Stenhouse: How is.

Payman Langroudi: That. Yeah. Like [00:36:45] let’s imagine I’m driving a truck that’s got bread on the back.

Claire Stenhouse: Of.

Payman Langroudi: It. Yeah, yeah. And there’s the hungry here. Yeah, yeah. [00:36:50] Now of course I want to feed the hungry. Yeah, but there is a there is an element of power there that says if I don’t feed [00:36:55] them, they’ll die.

Claire Stenhouse: Right.

Payman Langroudi: Yeah. And I have the power. Okay. And so all I’m saying, [00:37:00] I don’t want to be an idiot about it, because I completely get why people want to do it myself. I want to [00:37:05] go to Lesbos myself. Now that I’m not a dentist, I want to go and do some dentistry. Yeah. [00:37:10] I completely get it. But I am talking about just the other side of it. Yeah. Is that to fully understand [00:37:15] what your motivation is around that? Yeah. And make sure that motivation isn’t [00:37:20] the power side of it. Yeah. Yeah. It is.

Claire Stenhouse: A [00:37:25] little.

Payman Langroudi: Bit. I love your honesty.

Claire Stenhouse: Yeah. No. Maybe there is maybe just a little bit. Yeah.

Payman Langroudi: We tend to end this podcast [00:37:30] generally with a fantasy dinner party.

Claire Stenhouse: Okay.

Payman Langroudi: Three guests, dead [00:37:35] or alive. What comes to mind? I should have warned you about the question, but I like just hitting you. [00:37:40]

Claire Stenhouse: Okay. Um, not dentistry related. Anybody? Pink.

Payman Langroudi: Pink. [00:37:45] The artist.

Claire Stenhouse: Yeah. Pink. The artist. Yeah. Um.

Payman Langroudi: She’s good.

Claire Stenhouse: She is very good. I saw [00:37:50] her at Wembley. Oh, did you go? Yeah, it was brilliant. Um. Oh. Oh, my. [00:37:55] Grandma.

Payman Langroudi: Oh, nice.

Claire Stenhouse: Yeah.

Payman Langroudi: Were you.

Claire Stenhouse: Close? Yeah. Very, um. Pink. [00:38:00] My grandma and the Queen.

Payman Langroudi: The queen?

Claire Stenhouse: The queen.

Payman Langroudi: She’s made. She’s made appearances [00:38:05] in this party before. It’s an interesting one with pink and your grandma, though.

Claire Stenhouse: Yeah, and [00:38:10] the queen.

Payman Langroudi: I’m sure your grandma would be like.

Claire Stenhouse: I know she’d like pink better than the Queen, I think. Yeah, yeah, yeah, [00:38:15] yeah.

Payman Langroudi: It’s been a massive pleasure to have you.

Claire Stenhouse: Thank you very.

Payman Langroudi: Much. It’s a massive pleasure to have to see you [00:38:20] back in London again. And you’re coming out brilliant. I look forward to seeing you on Mini Smile Makeover.

Claire Stenhouse: In a couple.

Payman Langroudi: Of weeks. [00:38:25] In a couple of weeks. Thank you so much for doing this.

Claire Stenhouse: Thank you.

Payman Langroudi: It gives me great pleasure to welcome Perrin Shah [00:38:30] onto the My Dentist episode of Dental Leaders. Perrin is [00:38:35] a dentist who had her own clinic in India and then [00:38:40] moved to the UK and started working at my dentist, so it’s a pleasure to have you. [00:38:45]

Perrin Shah: Thank you Payman so much. It’s an honour to be invited on your podcast. [00:38:50] Um, I have been listening to your podcast on my drive way back [00:38:55] home. Long drives and I make sure my partner listens to it as well. [00:39:00] It’s. It’s very lovely to be here with you this evening. Thank you for inviting me. [00:39:05]

Payman Langroudi: It’s lovely to see you. So we saw each other in Bristol?

Perrin Shah: Yes.

Payman Langroudi: At one of those training [00:39:10] events.

Perrin Shah: Yeah.

Payman Langroudi: Yes. Yeah, yeah. And, um. So, look, I’m always [00:39:15] interested in stories of people getting up from one country and going to another, especially to do dentistry. [00:39:20] Bearing in mind how difficult it is to to move to the UK from [00:39:25] with an Indian, uh, degree. Yeah. But I’m also very aware of how hard it [00:39:30] is to become a dentist in India. Very competitive nature of the thing. Um, [00:39:35] tell me about why dentistry. Like, how did it happen?

Perrin Shah: So basically, uh, [00:39:40] in my, I would say in my family, even in the extended family or [00:39:45] nobody is a doctor or a dentist. So my mom really [00:39:50] wanted someone to be in the medical background.

Payman Langroudi: And they do.

Perrin Shah: Yes they do. Yeah. [00:39:55] Yeah.

Payman Langroudi: For no reason. Yeah. For no reason.

Perrin Shah: They just feel that they should have some. But also [00:40:00] I never I my father has always been into business and I [00:40:05] never wanted to work for someone. I wanted to have my own business. So. Uh, [00:40:10] because you have the flexibility to work, to take holidays when you want, and you’re not [00:40:15] in no pressure of working for someone.

Payman Langroudi: Are your parents still in India? Yeah. What does your father do? [00:40:20]

Perrin Shah: So my father is retired now, but he used to make raw materials [00:40:25] like kerosene, acetone, acetic acid. Oh.

Payman Langroudi: Chemical engineering.

Perrin Shah: Yeah, yeah, [00:40:30] yeah. So he. We have our own factory, but he’s given it to someone now because [00:40:35] of cause of his age. But I have been there, and he is super hardworking. So [00:40:40] I was like, no, I want to get there at some point. But of course [00:40:45] he wanted he never wanted me to join the factory because it involved [00:40:50] long hours of travelling. And he said, you settle on something which [00:40:55] you it’s very local to you. And then because I always wanted [00:41:00] like to fulfil my mom’s dream as well. So I was like, okay, let’s get into medical background. [00:41:05] But my other option other than that was journalism. Oh really? I thought if I couldn’t [00:41:10] get into dentistry, my second option was to get into journalism [00:41:15] because I wanted to do Bachelors of Mass Media. So that was my plan.

Payman Langroudi: Interesting. [00:41:20]

Perrin Shah: Yeah.

Payman Langroudi: Are there times where you think, what if, like, you wish [00:41:25] you did get into journalism?

Perrin Shah: Uh, yeah. I was like, okay. I was like, it’s [00:41:30] fun, it’s travelling. It’s just after the news every now and then. Yeah. And it’s also [00:41:35] about interviewing people like you are right now. So but once I got into dentistry, [00:41:40] I thought, yeah, this is for me because I started loving it so much. Yeah.

Payman Langroudi: What [00:41:45] was the course like? Did you was is the course difficult like when you got there? Did you did.

Perrin Shah: It? Um, yeah. [00:41:50] Getting into dentistry was difficult. Yeah. But once you are in, initially [00:41:55] it was tough because of course everything is new. We had. And [00:42:00] so I remember still, um, we had anatomy, uh, hands on [00:42:05] practical. And we had, we saw the dead body for the very first time. [00:42:10] A lot of formalin. And I had two of my colleagues who just passed out.

Payman Langroudi: Yeah.

Perrin Shah: With [00:42:15] the smell or they can’t see. So it was a bit of, you know.

Payman Langroudi: For instance, how many people [00:42:20] in your year.

Perrin Shah: 100.

Payman Langroudi: 100?

Perrin Shah: Yeah.

Payman Langroudi: And I mean, we [00:42:25] kind of I kind of know what, what the expectation is on numbers of, of [00:42:30] treatments you have to do here. But what was it there like? I mean, how many endos had you done by the time you became [00:42:35] a dentist?

Perrin Shah: Uh, until final year, which is the fourth year there. We [00:42:40] were just allowed to do maybe anteriores until canines [00:42:45] because they had reserved the molars for postgraduate studies. Okay, but when we were internship, we [00:42:50] can’t do molars if we wanted to. So I did at least 15 molars, [00:42:55] I would say, during my entire time in endodontics there.

Payman Langroudi: But internship means what? The year after [00:43:00] your.

Perrin Shah: Internship is, the year after you qualify.

Payman Langroudi: You have sort of hear.

Perrin Shah: No before you [00:43:05] get your certificate.

Payman Langroudi: Oh, really?

Perrin Shah: So after the fourth year, you have one year where.

Payman Langroudi: You practice. [00:43:10]

Perrin Shah: In practice, but in hospital where you were once training.

Payman Langroudi: Oh I see.

Perrin Shah: So you’re you’re [00:43:15] unofficially a dentist, but you can call yourself as a dentist because there’s no exams. [00:43:20] Then you have done everything.

Payman Langroudi: So how long after you qualify? Did you decide you want to open your own clinic? [00:43:25]

Perrin Shah: So, no. After I finished my bachelor’s, I [00:43:30] came out. I saw that a lot of loads of dentists in and around and how [00:43:35] much I, I was good at clinical dentistry. I wasn’t confident at all. So I was like, [00:43:40] no, you have to step up one like you have to take a step further. Yeah. That’s when I got [00:43:45] into Masters for Pete’s. Pete’s. Yeah.

Payman Langroudi: Why did you pick Pete’s? You like children?

Perrin Shah: No. [00:43:50]

Payman Langroudi: No.

[TRANSITION]: The thing is, because. [00:43:55]

Perrin Shah: It involves everything. I did not wanted to leave general dentistry. So [00:44:00] Pete’s included everything. Whatever comes from endo, ortho fillings, [00:44:05] crowns, dentures.

Payman Langroudi: Oh, so ortho was part of it?

Perrin Shah: Yeah. So we had to do space maintenance. [00:44:10] We had to give appliances removable and partial for habit breaking and stuff. We [00:44:15] had to give crowns for both adult and deciduous teeth. [00:44:20] And we.

Payman Langroudi: So was it a full time course?

Perrin Shah: Yeah, yeah. A three year course. Full time. [00:44:25]

Payman Langroudi: Oh my goodness.

Perrin Shah: Right. And full time in the hospital. Yeah. Oh yeah.

Payman Langroudi: So so then [00:44:30] when you when did you open your practice? Soon after.

[TRANSITION]: That.

Perrin Shah: Soon after that.

[TRANSITION]: Yeah.

Payman Langroudi: So do you think was it a [00:44:35] pedes practice?

Perrin Shah: Initially, I started as a pedes practice. Yeah, but then, um, [00:44:40] the parents started asking me, can you treat us as well? Um, so initially I [00:44:45] was a bit sceptical. Should I or should I not? But then I said, let’s go on, let’s try, because I know it, I [00:44:50] know fillings, I know root canals for patients with difficult like very flattened ridges. [00:44:55] I used to call my friends who were also specialists, and then they used to call me for [00:45:00] consultations for pedes. So this is how. And then I went into a fully full practice.

Payman Langroudi: Did you [00:45:05] did you buy an existing practice or did you set up one from squat?

Perrin Shah: I set up on my own because [00:45:10] in that area my parents lived for 30 years.

Payman Langroudi: Mumbai.

[TRANSITION]: Yeah, yeah. [00:45:15] So everybody.

Payman Langroudi: Loads of.

[TRANSITION]: People.

Perrin Shah: They everybody knew them. Yeah. And my grandparents as [00:45:20] well. So it was very easy for me to open an area where they know me and [00:45:25] my family. So I used to get a lot of friends, family, extended family.

Payman Langroudi: Did you get the money?

Perrin Shah: So [00:45:30] initially my father helped me. Yeah, to set up the practice Purpose. And [00:45:35] then once I started working, I never asked him again because.

Payman Langroudi: It was.

[TRANSITION]: A success.

Perrin Shah: Yeah, [00:45:40] a good success. I started making profit in third month, I would [00:45:45] say.

[TRANSITION]: Wow.

Perrin Shah: Yeah. And it was a very well established practice.

[TRANSITION]: Yeah.

Payman Langroudi: Intensely. We don’t realise [00:45:50] how lucky we are.

[TRANSITION]: Yeah.

Payman Langroudi: Insomuch as something like that can even happen. Yeah. Because I [00:45:55] was dentist and we started enlightened. And for the first five years we made loss.

[TRANSITION]: Yeah. [00:46:00]

Payman Langroudi: And big losses, you know. Huge losses. And there’s nothing as painful as working your [00:46:05] butt off and losing money.

[TRANSITION]: Yeah.

Payman Langroudi: It’s really hard. And in dentistry. And I was a dentist, [00:46:10] so I just thought it’d be like dentistry, you know, make some people happy and you’ll get some money, you know? But not the same [00:46:15] at all.

[TRANSITION]: Yeah.

Payman Langroudi: So. So you had this perfect situation, and then you go and meet your husband.

[TRANSITION]: Yeah. [00:46:20] Yeah.

Perrin Shah: So things happened, and we met [00:46:25] online and then online. Yeah. We met online. And then, of course, [00:46:30] he had come to India.

Payman Langroudi: He lives like a like a dating app.

Perrin Shah: No, it wasn’t a dating app. [00:46:35] It was, um, I would say, uh, he was my friend’s friend. [00:46:40]

[TRANSITION]: Okay.

Perrin Shah: And then, um, we met. I was like, he just said hi, [00:46:45] and then I said. And then we started conversation. But it was also kind of arranged marriage, I would say. [00:46:50]

Payman Langroudi: So you were kind of looking for a husband at that point?

Perrin Shah: My parents were.

Payman Langroudi: Okay. [00:46:55]

Perrin Shah: And and I knew that this is the time now. So of [00:47:00] course, your parents would want you to get settled down and stuff. Yeah, but I was pushing until my career [00:47:05] is set up. Yeah. So once everything was done, I had no choice. So [00:47:10] then I was like, okay, fine, let’s do this. Let’s get into this world. And then I met [00:47:15] him. My family met him. He came to Mumbai a couple of times. He lives in Mumbai. His [00:47:20] parents lives in Mumbai as well. So we met there. And then I said, [00:47:25] um, his name is Bhaumik. So I said, Bhowmick, I can’t leave my practice, but [00:47:30] I want you as well in my life. So he said, come to UK, see if you like [00:47:35] it. If not, we’ll come back to Mumbai or I’ll help you set a practice in UK. So [00:47:40] this was the thing which said no, let’s give a chance. So that’s why I moved to the UK. [00:47:45]

Payman Langroudi: But why did he want to move to the UK?

[TRANSITION]: Me?

Payman Langroudi: No. Why did.

[TRANSITION]: He want.

Perrin Shah: He was [00:47:50] already in the UK.

[TRANSITION]: I was already in the UK. He was.

Perrin Shah: He came here to study.

[TRANSITION]: When he was 18. I [00:47:55] see.

Perrin Shah: Yeah. And he was already established here. So he said and I think you’ll like it.

Payman Langroudi: And [00:48:00] so then you went from owning your own practice in India, in Mumbai [00:48:05] of all places, which is like a fun town, right? You know, like someone [00:48:10] doing well in Mumbai can have a great life.

[TRANSITION]: Yeah.

Payman Langroudi: To landing in what? London. [00:48:15] Was it London? No, Bristol.

[TRANSITION]: You’re in Bristol?

Perrin Shah: In Manchester.

Payman Langroudi: Then he was in Manchester. Cold [00:48:20] and raining.

[TRANSITION]: All.

Perrin Shah: The.

[TRANSITION]: Time.

Payman Langroudi: That must have been a culture shock in the first place, right?

[TRANSITION]: No. [00:48:25] The thing is.

Payman Langroudi: Were you cool with.

[TRANSITION]: That?

Perrin Shah: No, I came in Feb 2020 just [00:48:30] before Covid.

[TRANSITION]: Oh, so by the time yeah.

Perrin Shah: I came in Feb and I [00:48:35] think the first lockdown was in on 23rd or 25th of March.

[TRANSITION]: Yeah.

Perrin Shah: And I was a bit [00:48:40] shocked because of Covid, a pandemic. And then I was like, okay, in my. [00:48:45]

[TRANSITION]: Mind, I.

Payman Langroudi: Didn’t have a job.

[TRANSITION]: Yet. No.

Perrin Shah: From working full.

[TRANSITION]: Time. Yeah.

Perrin Shah: To [00:48:50] sitting at home.

[TRANSITION]: And like a lot of people.

Payman Langroudi: And it was a lovely summer.

[TRANSITION]: Lovely summer. [00:48:55]

Perrin Shah: And we had this in our mind that, okay, I will give [00:49:00] my exams. Everything was done and then I’ll pass. I’ll give my part one in [00:49:05] August, part two and.

[TRANSITION]: Next.

Perrin Shah: Year March Owari and that’s it. But [00:49:10] then when you come here, you come to know everything is short. Even the dental practices are short.

[TRANSITION]: Yeah. [00:49:15]

Perrin Shah: So of.

[TRANSITION]: A shock.

Perrin Shah: Yeah. A big shock to me.

Payman Langroudi: By the way, what happened [00:49:20] to your practice back in India?

Perrin Shah: So I had to give it to someone. I had to sold it [00:49:25] away because I had a friend who wanted to take it, but I just was [00:49:30] wondering if. What if something happens? They’ll contact my parents.

[TRANSITION]: Yeah.

Perrin Shah: And then my parents [00:49:35] would already be worried how to fix that problem, so I just sold it.

Payman Langroudi: How [00:49:40] many years did you have it beginning to end?

Perrin Shah: Uh, one and a half year.

Payman Langroudi: It’s a bit tough, man. If you’re making [00:49:45] a success of it.

Perrin Shah: The thing.

[TRANSITION]: Is.

Perrin Shah: I saw another practice opening next. [00:49:50] Just two shops from mine.

[TRANSITION]: Yeah.

Perrin Shah: And there was a new practice came up.

[TRANSITION]: Yeah.

Perrin Shah: Initially [00:49:55] I thought, okay, this is going to be a trouble for me.

[TRANSITION]: But no.

Perrin Shah: She was making her [00:50:00] money, I was fine, I had my set patients. They knew how I work.

[TRANSITION]: Yeah, yeah, yeah.

Perrin Shah: And I used to see a lot [00:50:05] of emergencies for children on Sundays as well. Yeah. Because they knew.

[TRANSITION]: She’s. [00:50:10]

Payman Langroudi: Your source of patience. Wasn’t the man walking down the street? Your source [00:50:15] of patients was your grandparents reputation. You know. You know what I mean? Like, it’s a it’s a, you [00:50:20] know, we actually we make a mistake to think we’re in competition with each other anyway. Yeah. [00:50:25] We’re in we’re in competition with other spending.

[TRANSITION]: Yeah.

Payman Langroudi: Holidays. Whatever. Cars. Those are the things we’re in competition with. [00:50:30] But I can imagine that if I’m thinking back to when we started, if I was in profit a [00:50:35] year and a half in, nothing would have stopped me. I would have kept going. So it must have been a big step for you. [00:50:40]

[TRANSITION]: Yeah.

Perrin Shah: I had tears.

[TRANSITION]: In my eyes when I.

Perrin Shah: Yeah, yeah, yeah, 100%.

Payman Langroudi: And so [00:50:45] where did my dentist come into this equation? Was it when they reopened after Covid?

[TRANSITION]: No. [00:50:50]

Perrin Shah: The thing.

[TRANSITION]: Is.

Perrin Shah: So once Covid hit, um, I was in Manchester, [00:50:55] and then my husband got a job in Boeing, which is in Bristol, the aerospace hub. [00:51:00]

Payman Langroudi: Is he an aerospace engineer?

Perrin Shah: He’s aerospace.

[TRANSITION]: Engineer.

Payman Langroudi: Oh, really? My son wants to study there.

Perrin Shah: So it [00:51:05] was a dream job for him?

[TRANSITION]: Yeah.

Perrin Shah: And I was doing nothing at that time. So in [00:51:10] that time, I started giving, I started I was starting Ferrari. I was all prepared, and then they were shot. [00:51:15] So I gave a part one.

[TRANSITION]: Okay.

Perrin Shah: So I was like, let’s do something. [00:51:20] And then we moved to Bristol. And then I started working as a dental nurse in a private practice. [00:51:25]

[TRANSITION]: What a nightmare.

Perrin Shah: Yeah.

Payman Langroudi: But practice owner to dental nurse. Imagine. [00:51:30] I can imagine how you were feeling.

Perrin Shah: But I wanted to learn about [00:51:35] the culture of dentistry.

[TRANSITION]: In the UK.

Payman Langroudi: I know why. Which. Which practice was.

[TRANSITION]: That?

Perrin Shah: It was smile. Orchard. [00:51:40]

[TRANSITION]: Okay.

Perrin Shah: Yeah. French dental.

[TRANSITION]: Practice. Yeah, yeah.

Perrin Shah: Lovely practice. I learned a lot. Uh, [00:51:45] it was a mixed, uh, NHS, a small contract with predominantly private. Did [00:51:50] that for a year.

Payman Langroudi: What did you find was the main difference between practices in the UK [00:51:55] and practising in India?

Perrin Shah: People don’t bargain here.

[TRANSITION]: People don’t.

Perrin Shah: Bargain. [00:52:00] Yeah. In India, they bargain for even a small filling.

[TRANSITION]: You.

Perrin Shah: You have to negotiate a lot. [00:52:05]

[TRANSITION]: Really?

Perrin Shah: And that’s tough.

[TRANSITION]: Yeah.

Perrin Shah: Because they are. Because there are so many dentists [00:52:10] in India.

[TRANSITION]: Yeah.

Perrin Shah: Yeah, yeah. They know that if they can’t afford you, there’s someone else who will do it for cheaper. So. [00:52:15]

Payman Langroudi: And what about, like, numbers of patients per day?

[TRANSITION]: It’s pretty much the same. [00:52:20] Yeah. The private practice. Yeah.

Payman Langroudi: Not the NHS.

[TRANSITION]: No.

Perrin Shah: So we [00:52:25] don’t. We have NHS. We have government funded practices there. It’s cheaper. [00:52:30]

[TRANSITION]: Yeah.

Perrin Shah: But patients know that they are going there and they won’t be paying much.

[TRANSITION]: Mhm.

Perrin Shah: But [00:52:35] we most of us were doing private work only.

[TRANSITION]: Yeah. Aha.

Payman Langroudi: So. [00:52:40] Okay. You worked as a nurse there.

[TRANSITION]: Yeah.

Payman Langroudi: Tell me, tell me any [00:52:45] bit of information about what it’s like being a nurse compared to being a dentist. Like, what’s one [00:52:50] thing about being a nurse that most dentists don’t appreciate?

Perrin Shah: Um, they [00:52:55] are humans as well. I would say, because.

[TRANSITION]: Yeah.

Perrin Shah: If patients are annoyed with [00:53:00] the dentist.

[TRANSITION]: Yeah.

Perrin Shah: They will start, you know, moaning at you that [00:53:05] you’re not suctioning properly. There’s a lot of pressure. But you can see it’s not you, it’s the dentist. [00:53:10] But all you have to say is. I’m sorry. I’m sorry. And the [00:53:15] other thing is, you know.

Payman Langroudi: You sometimes get a dentist treating you badly, like, not not badly, but, like, you know, that [00:53:20] sort of. Yeah. Hierarchy.

Perrin Shah: Yeah. Thing they’re not in a good mood. Yeah. Yeah. Yeah. [00:53:25] A lot of times.

Payman Langroudi: Oh, you know, like some people say the dentist leaves and doesn’t even say thank you [00:53:30] at the end of the day. Like, does that happen?

Perrin Shah: Yeah. I mean, so many times. [00:53:35] And then you also feel that how is in a good mood today. So that my day [00:53:40] goes good because, you know, if he or she is in a bad mood, your day is ruined because [00:53:45] they just.

Payman Langroudi: You know, did most of them know you were a dentist or sometimes.

Perrin Shah: All of them.

Payman Langroudi: You still [00:53:50] shout at you?

Perrin Shah: Yeah.

Payman Langroudi: Because they really.

Perrin Shah: Yeah. And then you just have to say. But the thing is, [00:53:55] we I had taken a step back as well because I was not from this country. Yeah I know. So I knew [00:54:00] that I have to make a position by myself. Also, the other thing [00:54:05] what we came across was the accent. Yeah, I could understand, but [00:54:10] I was not sure if they can understand me. I know. So I yeah, [00:54:15] I don’t know. And I was like, okay, should I work hard on hard on this? So then I went on to become a head [00:54:20] receptionist in a specialist practice in Bristol. That was quite life changing for [00:54:25] me.

Payman Langroudi: Which practice.

Perrin Shah: Was that? It was Bristol Specialist Dental Clinic.

Payman Langroudi: Oh, I know that one.

Perrin Shah: Yeah. And I [00:54:30] had a lovely time there. And they are still my friends. I go to their events.

Payman Langroudi: So [00:54:35] even like so like you don’t become head receptionist by mistake, do you? Like you [00:54:40] were trying your hardest and. Yeah. Trying to be very good. Yeah. Even the sort of nursing reception [00:54:45] jobs. Yeah. Which is admirable. It’s admirable. Man. You go from being the daughter of an industrialist [00:54:50] at your own practice to working your hardest as a dental nurse, I like that.

Perrin Shah: But I didn’t want [00:54:55] it to sit at home. That was the thing. I didn’t want it to sit at home. I didn’t want it to leave dentistry. [00:55:00] Yeah. Because I absolutely loved dentistry. Once I got into it, I loved. So if you [00:55:05] see my Instagram, my Facebook, everything is about teeth. Yeah. I don’t follow people much [00:55:10] because I love dentistry. That’s the thing. And I was like, okay, let’s [00:55:15] let’s get it. And being on being on head receptionist or receptionist. I would say the amount of [00:55:20] um, communication skills are built up. Even talking on phone with them, you know, [00:55:25] reminders, booking appointments, greeting them. And then you got to know that, okay, I’m [00:55:30] the first point of contact, how important person I am to the patient who are coming to the practice.

Payman Langroudi: Yeah. People [00:55:35] don’t appreciate how important the receptionist is.

Perrin Shah: But this practice did lovely practice. I would say [00:55:40] if anyone gets a chance, go and work there.

Payman Langroudi: Who was the boss?

Perrin Shah: Uh, it was my. [00:55:45] It is owned by my dentist.

Payman Langroudi: Oh, is it was it was it was it. Yeah.

Perrin Shah: Okay. And then that that that [00:55:50] point, I was like, okay, the GDC is still short. Two years, no exams. [00:55:55] Let’s apply for dental hygiene and therapy.

Payman Langroudi: Oh that route.

Perrin Shah: Yeah, yeah. So I took that route [00:56:00] because I wanted to start clinical because I was just wasting my time. Yeah, yeah. And then. [00:56:05]

Payman Langroudi: Did you worry that, you know, like, you might have forgotten how to give an ID block and any of.

Perrin Shah: That? Yeah.

Payman Langroudi: Yeah, it’s a worry, [00:56:10] isn’t it?

Perrin Shah: I didn’t, uh, use the handpiece for about more than two years.

Payman Langroudi: Yeah. [00:56:15] And sometimes now you go on vacation for two weeks and you’re a little bit shaky. Yeah.

Perrin Shah: Imagine how [00:56:20] it would be.

Payman Langroudi: Yeah.

Perrin Shah: For two years.

Payman Langroudi: I always thought about it. I took five years off and then went back. [00:56:25] And I used to think to myself, I was worried about it, for sure, but I used to think to myself, loads of women have babies for five years [00:56:30] and come back. Yeah. So that was for me. Five years was the number that I thought. It’s just about doable. [00:56:35] Yeah. What was shocking, though, what was surprising for me was in that five years, people [00:56:40] got better and I didn’t. Yeah. And you don’t actually realise it’s true. But in that [00:56:45] five years, it became standard for everyone to use rubber dam for posterior [00:56:50] composites. Whereas before that five years it wasn’t. Not many were doing that in that five years rotary [00:56:55] endo came in. Yeah, yeah. And I was only ever using hand files. Yeah. And suddenly [00:57:00] almost everyone was using rotary endo. And so, you know, shockingly, the market got better while [00:57:05] I hadn’t. And that surprised me. That surprised me. So. Okay. Now, how did you then [00:57:10] become a dentist? You did the oral.

Perrin Shah: Yeah. So? So that’s how I got into my dentist. [00:57:15] Yeah, we had this area manager at that time was Tim Paul, and he knew I had [00:57:20] applied for hygiene therapy, so I just asked him, I’ll be hopefully getting registered [00:57:25] in a year’s time because that’s how long they took. Yeah. If you have any jobs, let me know. Yeah. And [00:57:30] he said, I will get you a job because that time dental therapy was boom. Everybody [00:57:35] wanted a therapist. So that’s how I got into my dentist. I started working [00:57:40] as a therapist. I would say June 2022. [00:57:45] And that’s when I passed my oral part one and part two in the same year, [00:57:50] because I just wanted to get it done out of the way.

Payman Langroudi: That’s also a tough exam, right?

Perrin Shah: Very tough exam. [00:57:55]

Payman Langroudi: So were you hitting the books hard?

Perrin Shah: More of smart study, I would say, because the passing percentage [00:58:00] is 50%. You should know what you are studying. Yeah, because you’ll forget after that. I’m pretty sure [00:58:05] nothing. Nothing helps. Only the communication skills helps. So I would say any [00:58:10] overseas dentist coming to the UK should know the communication skills. Thank you. [00:58:15] Sorry. How can I help you? It’s lovely to meet you. And all those things are required in this [00:58:20] country for the patients.

Payman Langroudi: Super important, super important.

Perrin Shah: It’s every day thing and [00:58:25] this is what they teach us in Harare.

Payman Langroudi: So yeah. Yeah, yeah. Okay. So then [00:58:30] you passed part one. Yeah. And carried on as a therapist. Yes. And [00:58:35] then.

Perrin Shah: Passed my part two in the same year.

Payman Langroudi: And then.

Perrin Shah: And then joined.

Payman Langroudi: You were available [00:58:40] to be a dentist.

Perrin Shah: Yes.

Payman Langroudi: And with my dentist like very sort of supportive at that point. [00:58:45] Very supportive because they knew who you were by now. Right.

Perrin Shah: And the criteria to get [00:58:50] registered with the NHS performer list was you should have at least three months of experience in the last two [00:58:55] years. Well, like us being in being Covid dentist, we had [00:59:00] no experience. Yeah. So they gave us private work for first three months. Yeah. [00:59:05] And that we used it for our experience to apply for the performer list. So this is how it [00:59:10] took six months. And then I had a stable private list and started on NHS. [00:59:15] And then there you go.

Payman Langroudi: What a journey. What a journey, man. [00:59:20] Yeah. You know, just to get to work.

Perrin Shah: Yeah. It was crazy to. To [00:59:25] start working as a dentist.

Payman Langroudi: Yeah.

Perrin Shah: Yeah.

Payman Langroudi: I bet you felt proud of yourself right at the end of that journey. Yeah. [00:59:30] So then now. Now you’re an associate at a my dentist. [00:59:35] Do you sometimes reflect on, you know, you were the boss in [00:59:40] your previous place in India, and now you’re an associate here, and it must [00:59:45] it must grate on you. So that, I mean, when when you were working in your own place, [00:59:50] you could change something tomorrow.

Perrin Shah: Yeah. It takes a very long time [00:59:55] to get your work approved. They do approve all of my requests. It [01:00:00] just takes a very long time.

Payman Langroudi: What kind of requests? Like, if you’re looking for a new piece of equipment or something.

Perrin Shah: Yeah. [01:00:05] So let’s say a new, new material which I want to use. Yeah. You have to [01:00:10] fill in a material request. Yeah, you have to fill in a form. You have to write down what [01:00:15] advantage it will give to your patient, how it will upskill the income, and [01:00:20] what are the charges and how many days you work, and [01:00:25] then how many private patients you do. And then you submit this to the head nurse or the manager. They [01:00:30] take it forward and then you don’t know whether it will get approved or not. But till date they [01:00:35] haven’t even rejected even once. But it does take a long time. Very long time. How [01:00:40] long? At least four weeks. I would say.

Payman Langroudi: It’s not that bad. It’s not that bad. [01:00:45] You know, I’ve been surprised that they’ve been very good at approving our materials list. For instance, [01:00:50] you know, we did this composite, um, course as well. And it got to a point where I said, look, [01:00:55] why bother sending your people to the courts if they can’t get the materials?

Perrin Shah: Exactly.

Payman Langroudi: Yeah, yeah. But then but then they were [01:01:00] very good at it. They were very good with it. Um, you know, working for a corporate is a funny thing [01:01:05] because there are benefits to it. Yeah. And what I found is [01:01:10] this is before your time. Yeah, but maybe ten, 15 years ago, no [01:01:15] one used to do it on purpose. It was like, I’m just getting this job because, you know, I need a job. [01:01:20] But now I know. I know plenty of people who choose to go and work for a corporate. And, [01:01:25] you know, different corporates do different things. But it’s almost like, you know, what you’re going to get. [01:01:30] Yes. And when you go to the independent sector, you might get something fantastic like your, you know, [01:01:35] where you did work somewhere or you might get something. Yeah.

Perrin Shah: That’s very true. [01:01:40]

Payman Langroudi: You know, so knowing what you’re going to get is it’s kind of an important point. What else would you say are the [01:01:45] benefits?

Perrin Shah: I would say I when I was working as a nurse in an independent [01:01:50] practice, I could understand dentistry because I could know what was [01:01:55] happening. Um, with my with corporates, I would say, um, they pay [01:02:00] us on time. Every 15th you get money in your account no matter what. Yeah. Even if [01:02:05] it’s Christmas you get beforehand. Yeah, but with independent, I knew we used to keep [01:02:10] on asking, where’s the money for this month?

Payman Langroudi: Yeah, my wife used to work in a place six months. She didn’t get paid. [01:02:15]

Perrin Shah: Yeah, so I knew this, and I was like, no, this is people have EMIs, people have mortgages, [01:02:20] and they rely on the salary. This is not done. And there would be always [01:02:25] some glitch in the accounts you have to keep on asking. I have seen associates when I was working [01:02:30] as a nurse, they used to keep they were behind the dentist. That our accountant [01:02:35] that. Why why is this wrong? But with corporates everything is so, so crystal clear. [01:02:40] Even if there’s something they are very good in getting back to you. Yeah, I would say that.

Payman Langroudi: You [01:02:45] do quite a lot of enlighten.

Perrin Shah: A lot. Yeah, I love it.

Payman Langroudi: Yeah.

Perrin Shah: Yeah.

Payman Langroudi: What do [01:02:50] you think is the difference between why is it some dentists do loads and then you [01:02:55] get other dentists who just don’t want to talk about the colour of teeth. You know, like, why do you find it easy [01:03:00] and others find it so hard.

Perrin Shah: Personally, I feel it’s the mindset. [01:03:05] Yeah. If they think its price is too expensive, they’re not going to sell it. Yeah. How I [01:03:10] see is you’re getting the product, you’re getting the experience and you’re getting the colour. Yeah. [01:03:15] So why shouldn’t we charge this?

Payman Langroudi: But outside of charging, I mean then you could say okay, a [01:03:20] cheaper whitening, but I’m talking about whitening itself. A lot of dentists worry about I [01:03:25] don’t want to embarrass the patient. I don’t want to offend the patient. All these sort of things. Yeah. [01:03:30] Whereas others, it’s like water off a duck’s back. They feel like very comfortable. When I, when I was a [01:03:35] dentist. Before we even started the company. Right. I used to do loads and loads of whitening, which is kind of maybe the reason we went this way. [01:03:40] Yeah. I used to feel like if I don’t talk about it, I’ve done a disservice to the patient. [01:03:45] Yeah. I had no worry about it, but loads and loads of dentists, you know, have trouble [01:03:50] with anything that isn’t a youneed conversation. And, you know, whitening isn’t [01:03:55] a you need a conversation.

Perrin Shah: So I all I ask them is what are your are your concerns? [01:04:00] What do you like about your smile and what you don’t? And I would [01:04:05] say 99% of them say I don’t. Yeah, I don’t have 100% [01:04:10] the smile I want. And then my conversation starts from there. Okay. So how can I help [01:04:15] you?

Payman Langroudi: Is that you say that to every single patient. What do you like about your smile and what.

Perrin Shah: You tried to. Until I. Unless I’m running [01:04:20] late.

Payman Langroudi: Yeah, of course, of course, of course. Yeah, but that’s a great starting point. That’s a great starting.

Perrin Shah: I’m trying. I’m trying to build [01:04:25] it. Make it a routine now. And, um, before [01:04:30] I started whitening, I was quite not sure would I [01:04:35] want to sell whitening because myself, I hate sensitivity. So when [01:04:40] I was doing my masters, um, there was a guy from the marketing team had [01:04:45] just come to, you know, sell his product. Yeah. And we just used [01:04:50] it and oh, my God, I had a bit of sensitivity, but my my, um, colleague, [01:04:55] he was, uh, he used to smoke a lot. What? So when he got his wife, he started crying. [01:05:00] He said, Baron, I can’t even have my dinner or not. I can drink my water. And then [01:05:05] I was like, oh my God. Whitening gives a lot of sensitivity. I’m not ever going to sell it to my patient. Yeah. When [01:05:10] I when I got to know about enlighten, I did the course with you and then I was [01:05:15] like, before I even I’m going to sell it to my patient, I’m going to do it on myself. So I got it done. [01:05:20] I was super pleased. I by third week I could see the difference myself. [01:05:25] My nurses started saying, oh Baron, what have you done to your teeth? They look so white. And [01:05:30] then I didn’t even do the top of, you know, the syringes and my shade is [01:05:35] still the same. And then that’s what I sell it.

Payman Langroudi: So once you, once you saw it for yourself, you got massively [01:05:40] confident to confident.

Perrin Shah: And I tell the patients that if I can do it, you can definitely [01:05:45] can. And if there’s sensitivity, I can’t promise there wouldn’t be. But I’m here to look after you and [01:05:50] oh my God, so many of my patients with tetracycline staining hypoplasia. [01:05:55] And they have had tears in their eyes because they never believed that [01:06:00] they could have achieved the shade. And that’s what gives me pleasure of me treating [01:06:05] the patients. So this is, I would say, my personal experience of selling enlightened to my patients as compared [01:06:10] to the other dentists in the practice.

Payman Langroudi: Have you tried the pen?

Perrin Shah: Not yet. [01:06:15]

Payman Langroudi: Oh, you like that?

Perrin Shah: I have started with two patients who have given the pen.

Payman Langroudi: Oh, they haven’t finished yet.

Perrin Shah: But [01:06:20] now they are ongoing, so. But they haven’t come back to me with sensitivity. So I’m pretty much like. [01:06:25]

Payman Langroudi: You like that? Yeah. You know what we do when we develop the product? We try and focus on the super difficult patients. [01:06:30] Yeah. And once, once you get a patient like I’ve got one patient, there was a time where we used to tell [01:06:35] our customers, send us all the super difficult patients. I’ve got one patient. If she puts her tray [01:06:40] in no jail, she gets massive sensitivity. Oh, like massive sensitivity. Okay, [01:06:45] just by putting the tray in place here. So that patient ends up becoming one that I want to [01:06:50] test things on. Because the thought process is, if I can make any difference there. Then [01:06:55] the normal patient is going to get massive. Yeah, that’s the idea. Or get some patients who [01:07:00] get like tetracycline with very thin enamel. Yeah. That’s the biggest nightmare situation of them all. Yeah. If [01:07:05] you can get that patient anywhere at all, then a regular patient with enamel who’s not a [01:07:10] tetracycline, then you know, that’s actually how we got the attachments. Exactly. Came [01:07:15] from that.

Perrin Shah: And I would say I, I have received a lot of five [01:07:20] star Google reviews with enlighten, and I do only enlighten. So my dentist [01:07:25] now have I think several. They have had Philips and Enlighten [01:07:30] and I have never done any Philips on any of the patients, but I know [01:07:35] some of my nurses who were doing it. They said parent, let’s say today I want my teeth [01:07:40] are so sensitive, can you do something? And all I had to say is use Sensodyne. You know there’s [01:07:45] nothing else we can do. And then enlighten came in. I [01:07:50] have not even sold one Philips Phillips to any because I didn’t try it myself, so I don’t know [01:07:55] how I would be confident enough to give it to within time. I’m so I know [01:08:00] if anything goes wrong, I’m here to help you and I know you guys are fab, so [01:08:05] you guys are so easily accessible. Just a call away that this patient has this [01:08:10] problem. How can we fix it? And there you go. The next day the materials are in the [01:08:15] practice. So this is the service we like.

Payman Langroudi: Nice to hear.

Perrin Shah: That. Yeah.

Payman Langroudi: Nice to hear that. Um, [01:08:20] on this pod we like to talk about mistakes so [01:08:25] that, you know, we can learn from each other’s mistakes. What comes to mind when I say clinical [01:08:30] errors? What? What have you done?

Perrin Shah: Most important, I would feel communication.

Payman Langroudi: Yeah.

Perrin Shah: Even [01:08:35] if you missed out something small, which is small for you but big for the patient, [01:08:40] it brings out a massive, um, loss [01:08:45] of your patient. They lose trust in you.

Payman Langroudi: To give me the example. [01:08:50]

Perrin Shah: Um, let’s say about, um, [01:08:55] Crown. Yeah. You give all the options for the crown, but you missed out on [01:09:00] a metal crown, which is the cheapest just because it’s a private patient. Yeah. And then [01:09:05] because metal is NHS, I work both NHS and private, so it doesn’t come to your [01:09:10] mind straight away. But then that’s what I learned from that mistake. That. So the patient was [01:09:15] just said why didn’t you give an option of metal crown on private. [01:09:20] Because that’s an option. I said 100%. And then he didn’t come. He [01:09:25] lost trust in me, basically because he was like, this dentist is just.

Payman Langroudi: He thought you were pushing [01:09:30] the private. He was a private patient. Yeah. Yeah.

Perrin Shah: So that’s that [01:09:35] happened very early in my career with my dentist. Yeah. And then I was like, no. Now [01:09:40] my notes say metal ceramic fused to metal, porcelain [01:09:45] fused metal and zirconia or porcelain. So I always remember I have [01:09:50] to tell them and it’s it’s up to them.

Payman Langroudi: What about your your most difficult patient [01:09:55] was that was that actually I’m going to guess that was the UK that wasn’t [01:10:00] India in India. Uh, no. No, I’m going to guess your most difficult one was British. [01:10:05] Am I wrong.

Perrin Shah: 100% in India? You can be nice to the patient. You [01:10:10] can call them. You can give a box of sweets.

Payman Langroudi: Fix this.

Perrin Shah: Problem. Fix this problem. No, [01:10:15] you don’t have anything in your mind that they’re going to sue you at any point here. There’s [01:10:20] always constant worry with what you hear about the cases in the practice.

Payman Langroudi: Yeah.

Perrin Shah: Oh [01:10:25] my God. Every patient you feel today, they are so good. Tomorrow they can be your [01:10:30] complaint. So I had a patient. She was a private patient. [01:10:35] Saw a colleague eight months ago, uh, with a pike apical [01:10:40] periodontitis. Okay, with severe pain. And the dentist had opened up. The third [01:10:45] gave a dressing and just advise Advice. Root canal treatment with crown or replacement. Options [01:10:50] extraction and replacement. So she took. She was fine. [01:10:55] She didn’t come for eight months. The pain came again. She saw me for emergency. We charge [01:11:00] £99 for emergency. She came in and she came and she was very rude. [01:11:05] She said, you guys don’t do a good job. Just get the tooth out. And I said, okay, that’s fine. Quite [01:11:10] young 35 year old. And I said, we can’t save your tooth. If you want to [01:11:15] now get the tooth out right now. I said, okay, that’s fine. I have 30 [01:11:20] minutes. I’ll try my best. I got the tooth out, gave sutures [01:11:25] everything. And I said, okay, the healing will take place. The post-operative [01:11:30] instructions. I gave her everything. And I advised her some painkillers. In an [01:11:35] hour, she calls back and she said, the pain is horrible.

Perrin Shah: I said, yes, you need to take your painkillers because [01:11:40] the numbing injection has worn off now. She said, I took one. It’s not helping. [01:11:45] I’m helping. I’m taking Co-codamol. Nothing is helping. And. And she was just calling the practice every [01:11:50] five minutes, and they were telling me that this patient is constantly calling us do something. [01:11:55] It’s like. Okay, I said. Then she I called her, I [01:12:00] said, what’s wrong? Give some time. Everything will be fine. She said, no, I called my GP. [01:12:05] The GP said, you have to fix me. I said, yes, I’ll fix you but just give yourself [01:12:10] some time. Take painkillers. If you don’t take Co-codamol, it’s too strong. Just take two ibuprofen. [01:12:15] You’ll be fine. Fine. Next day she calls back and she said, [01:12:20] I think the socket is infected, I need antibiotics. I said, I can’t prescribe you [01:12:25] antibiotics over the phone. I have to see you first. She came in again. The socket was not infected. [01:12:30] Nothing I touched. She didn’t had pain, but she just said the pain is too bad. [01:12:35] Give me antibiotics. And I was a bit sceptical. I was like.

Payman Langroudi: What do you think was going on there?

Perrin Shah: It’s [01:12:40] just anxiety. It was more was more psychological, I would say. And what [01:12:45] happened was I said, okay, I’ll give you antibiotics. And she she started to threaten me that [01:12:50] the GP said, if the dentist doesn’t give you antibiotics, the GP is going to file a case. And I said, no, it [01:12:55] doesn’t work like that. I know what you are saying. Yeah. And then I [01:13:00] gave her antibiotics in the end. I said, if she’s happy, just take your antibiotics. Yeah. She didn’t come back [01:13:05] three months later. She sent an email, a written complaint that [01:13:10] she wants her money back. £99. And I was like, I have done [01:13:15] everything you could. I have given you antibiotics. I got the tooth out. I saw you for follow up.

Payman Langroudi: What [01:13:20] did you do?

Perrin Shah: I contacted my indemnity.

Payman Langroudi: For £99.

Perrin Shah: Because that’s that’s the rule [01:13:25] in the.

Payman Langroudi: In my dentist.

Perrin Shah: My dentist? Yeah. She said give money [01:13:30] back. She said it’s up to you. But the patient was very local. So I was like, [01:13:35] if I she’s got back to me after three months because somebody has told her to try to file a written [01:13:40] complaint and you might get your money back. So I said, let’s try a return, a response [01:13:45] to her complaint and take it from there. So I didn’t give her money back and that was [01:13:50] it.

Payman Langroudi: Oh. Nothing happened.

Perrin Shah: Nothing happened.

Payman Langroudi: Oh, nice.

Perrin Shah: So I thought if I give her £99. [01:13:55]

Payman Langroudi: Yeah.

Perrin Shah: This is a word of mouth. She’ll tell everyone in the area [01:14:00] that she gives money back. Just file a complaint.

Payman Langroudi: It’s a possibility.

Perrin Shah: I tried, but [01:14:05] then that’s it.

Payman Langroudi: It’s also. It’s not nice to give [01:14:10] money back when you feel like someone’s trying something on you.

Perrin Shah: Yeah, that’s what I felt.

Payman Langroudi: It’s not about the [01:14:15] money. It’s about the. The victory. The person’s giving. Yeah. On the other hand, um, [01:14:20] when I was a dentist, I was giving money back all the time. Like, if the slightest. I just give money back when people didn’t used [01:14:25] to ask for their money back. Like to be super duper on, like, any small problem. Yeah, [01:14:30] you just try that once. Although, I don’t know, maybe in my dentist there’s a process to giving money back. [01:14:35]

Perrin Shah: No, no, you can give it straight away.

Payman Langroudi: Oh. Can you?

Perrin Shah: And it’s up to us. I have given money to the [01:14:40] patients back if they are not happy. I said you are not happy. Take the money back.

Payman Langroudi: So hear me out. Hear me out. The [01:14:45] you get a patient you’re doing. I know three fillings on them. The patient says something. Something, [01:14:50] anything. The next visit says, oh, I had a little bit of sensitivity on one of them, but it’s settling down. Yeah. [01:14:55] Surprise and delight. I’ve taken the charge of that one off. Yeah, it’s it’s such [01:15:00] a weird sort of. It doesn’t sound like it’s the right thing to do. Yeah, but you win this massive [01:15:05] win with the patient at that point. Yeah. I used to buy, um, Sonic airs myself [01:15:10] as an associate and surprise and delight patients with them for no reason. [01:15:15] Yeah. And by the way, I here’s free electric toothbrush. The amount of patients that would then come to me [01:15:20] because these people would refer to me, I would give them to the patients. I’d done sort of high end [01:15:25] treatment to. Yeah, yeah. The amount of work I got from these Sonic airs. Yeah. And I remember [01:15:30] my boss being sort of he didn’t want to be involved in it, so I bought my own ones. Yeah.

Perrin Shah: No, I [01:15:35] have.

Payman Langroudi: Surprise and delight. Works well. Or sometimes, uh, extirpate the park. Get the patient [01:15:40] out of the pain. Yeah. No charge.

Perrin Shah: No charge. Yeah. Yeah. I’ve done so much I give. [01:15:45] Yeah. I’ve. I’ve given them money for root canal treatments back, which is like 650, £700,000 [01:15:50] sometimes. Yeah. But this patient, I just thought, why come after three months? [01:15:55]

Payman Langroudi: Yeah, yeah yeah, yeah.

Perrin Shah: Because somebody has told her something that try doing this. And I was like, no, [01:16:00] she’s very local to us. It’s just going to spread.

Payman Langroudi: It’s an interesting point though. I never thought about it that [01:16:05] way. It’s interesting point.

Perrin Shah: I thought let’s try.

Payman Langroudi: Yeah. Yeah.

Perrin Shah: I spoke to my colleague as well. She’s quite senior in the [01:16:10] practice. Yeah. And she said, yeah, I tried.

Payman Langroudi: What does the future hold for you? Me? [01:16:15] You’re going to open another practice?

Perrin Shah: I would want to. So currently I’m doing my [01:16:20] MSC in endodontics. Are you with Simply Endo. If you have heard about it. Yeah, I know that [01:16:25] university. They are affiliated to University of Chester.

Payman Langroudi: Yeah, yeah, yeah.

Perrin Shah: And I’m in. [01:16:30] I have finished my year one. I’ve, I’m going to go to year two in February [01:16:35] which is the speech of diploma. You can leave after that if you want. Or you can complete your thesis, which [01:16:40] is dissertation in year three. So I don’t know what’s going to happen after year two, but I’ve started doing a lot of [01:16:45] root canal within the practice.

Payman Langroudi: I like that.

Perrin Shah: So yeah.

Payman Langroudi: And then Ender. Ender [01:16:50] is underrated, man.

Perrin Shah: I think it’s bread and butter of the practice, which most of the people don’t like it. [01:16:55] Yeah, but.

Payman Langroudi: It’s really.

Perrin Shah: Underrated.

Payman Langroudi: It’s really underrated by dentists because we’ve all had one [01:17:00] difficult endo when we were a student. And as a job, I think the best thing about [01:17:05] it is you don’t have to sell anything. Yeah. Yeah. If let’s say, let’s say you get internal referral [01:17:10] for endo. Yeah. You’ll be busy doing high like value work. [01:17:15] Yeah. Getting people out of pain, which is always lovely. Yeah, but also not selling a goddamn [01:17:20] thing to anyone. There’s a nice thing about the pressure of sales. It’s a pain in [01:17:25] the end when you’re a dentist, you know?

Perrin Shah: Yeah. And it’s so straightforward. You do a root canal [01:17:30] treatment, and then you just say you need a crown. Otherwise the. Yeah, yeah, it will have [01:17:35] problems. And the patient already has paid money towards the root canal and they [01:17:40] go for Crown straight away. Don’t even think should I pay for this or not. So it’s a win win [01:17:45] situation I would say. Yeah. And it’s bread and butter. There’s [01:17:50] so many endo cases every day. If people start liking, they’ll start making, they’ll [01:17:55] start seeing the difference okay.

Payman Langroudi: So you’re doing that. And is there plans for a practice or.

Perrin Shah: No I would want [01:18:00] to open my practice. Yeah 100% at some point.

Payman Langroudi: Cool. Indulge me. Let’s say let’s say you had [01:18:05] like a dream practice. Let’s say billionaire came over and said go go crazy. What are [01:18:10] you thinking? Are you like, high end cosmetic or like which which kind of which angle would you go more [01:18:15] towards?

Perrin Shah: Paediatric dentistry.

Payman Langroudi: Oh really?

Perrin Shah: Yeah. Because what [01:18:20] I’ve seen in southwest is there’s no private. There’s one in Bristol. [01:18:25] Yeah. There’s nothing else. Most of the all of the patients go to Bristol Dental Hospital. [01:18:30] Mhm.

Payman Langroudi: And I think Private Pete has actually ignored, you know, because. But [01:18:35] I would have taken my kid to a Private Pete’s if I, if if I wasn’t a dentist, you know. [01:18:40]

Perrin Shah: And I would want, I would want myself to qualify for sedation first.

Payman Langroudi: You’re [01:18:45] a glutton for punishment, man. But I suppose you need to. Right. [01:18:50]

Perrin Shah: Yeah. So if I want to do Pete’s, I should know. Sedation. Yeah. So get [01:18:55] that sorted first. Endo is on the way. And then hopefully a practice. [01:19:00]

Payman Langroudi: I’m impressed.

Perrin Shah: Man. But I have to save up a lot.

Payman Langroudi: Yeah.

Perrin Shah: Unless [01:19:05] you have some investors, let me know.

Payman Langroudi: The billionaire? Yeah. Um, [01:19:10] how do you find Bristol? One of my favourite cities, I love Bristol.

Perrin Shah: Lovely. It’s. [01:19:15]

Payman Langroudi: Do you live in Bristol?

Perrin Shah: I live in Bristol. I live in Frenchay.

Payman Langroudi: Yeah. Oh, friendship. Yeah, I know it.

Perrin Shah: Yeah. Lovely [01:19:20] city. There’s so much to do. There’s so much to do in Somerset. Keeps you as busy all the time. [01:19:25] So many walking trails. We bike a lot.

Payman Langroudi: So do you. We’re gonna [01:19:30] end it end it with the usual fantasy dinner party.

Perrin Shah: Yeah.

Payman Langroudi: Three guests, dead [01:19:35] or alive.

Perrin Shah: Um, so it would be my grandmother. [01:19:40] She’s no more, unfortunately.

Payman Langroudi: Were you close?

Perrin Shah: Very close. [01:19:45]

Payman Langroudi: On your mom’s side.

Perrin Shah: On my dad’s side? Yeah. She was. She. She [01:19:50] was the person where she was very social. She was a principal in a school, and she [01:19:55] was working just a day before she passed away. Oh, she was people [01:20:00] friendly. And I would want to become like her at some point in my life. [01:20:05] I wish I could go even closer to her.

Payman Langroudi: Amazing.

Perrin Shah: Yeah.

Payman Langroudi: Who else?

Perrin Shah: Um. I [01:20:10] lost a very close friend in my dental [01:20:15] school. So it was an accident. She was my roommate.

Payman Langroudi: Uh.

Perrin Shah: In [01:20:20] hostel, and we were coming back from Mumbai to, uh, [01:20:25] the dental school, and it was a three hour journey, basically in train. So once we reach the station, we [01:20:30] used to have this, um, Uber cabs and we were in that and [01:20:35] the truck, the there was a truck passing by next to [01:20:40] our cab and the tire, the rear tire just bursted. [01:20:45] Bearsted like just I don’t know the pressure or what, I don’t know. The [01:20:50] driver passed away at that point. My friend passed away at that point, the [01:20:55] one in front of the driver is the one next to him. She had 36 [01:21:00] bone fractures.

[TRANSITION]: Oh my God.

Perrin Shah: And oh my God. [01:21:05]

Payman Langroudi: And you were there. You were on the.

Perrin Shah: Other side on the back in the in the car behind that. So I’ve seen everything. We [01:21:10] we stopped there and I could see organs on the.

Payman Langroudi: Oh my goodness.

Perrin Shah: I [01:21:15] just don’t want to go back there. But I wish we had spent some more time together because she was [01:21:20] so lovely. Yeah. And yeah, she didn’t. And that’s destiny, [01:21:25] you know. You don’t know. It wasn’t your fault. Nobody’s fault. It was the truck next.

Payman Langroudi: To.

Perrin Shah: You. But [01:21:30] it’s. It’s how it is.

Payman Langroudi: What do you believe [01:21:35] about that? Do you believe in destiny?

Perrin Shah: No, I don’t believe in destiny.

Payman Langroudi: Karma.

Perrin Shah: Karma. [01:21:40]

Payman Langroudi: Do you believe in karma?

Perrin Shah: A very strong believer. Yeah. I don’t believe in luck.

Payman Langroudi: Do [01:21:45] you believe in God?

Perrin Shah: Yes.

Payman Langroudi: Took a bit too long to say that.

[TRANSITION]: Yeah. [01:21:50] I mean, it’s.

Perrin Shah: More of a belief.

[TRANSITION]: Yeah.

Perrin Shah: But it gives me calmness in [01:21:55] myself. It makes me when I pray. Yeah, it just gives me a sense of satisfaction. [01:22:00] Uh, so we we are so grateful to God, to parents for the life they [01:22:05] have given us.

[TRANSITION]: Mhm.

Perrin Shah: So it’s it’s just something invisible. But you have a very strong karma. [01:22:10]

Payman Langroudi: Karma. Do you believe in, in, in like supernatural karma.

Perrin Shah: And [01:22:15] it has happened to me.

[TRANSITION]: Supernatural.

Perrin Shah: Yeah. What you do will come back to you. [01:22:20]

Payman Langroudi: No. But what do you do? I was good to you in Bristol. Now you’re good to me now. Yeah. It’s obvious. It’s an obvious thing. [01:22:25] That’s not supernatural. That’s obvious. That’s just. That’s just. That’s just one thing leads to another. But [01:22:30] do you believe in supernatural? Go on. Karma happens. I find some money on the floor. I [01:22:35] don’t hand it in. I go and buy something. That thing screws my life up. Yes.

Perrin Shah: So if. [01:22:40] Let’s say you find £1,000 note on the floor, you [01:22:45] take it, you know it’s not yours.

Payman Langroudi: Yeah.

Perrin Shah: You buy a very good phone [01:22:50] for you. I’m pretty sure that phone will not last long. 110%. [01:22:55]

Payman Langroudi: I love that 110%. Because.

Perrin Shah: Because I have [01:23:00] not been through that. But I have seen that even if just.

Payman Langroudi: Like bad energy. [01:23:05]

Perrin Shah: Yeah, if I have betrayed someone or I’ve just given some negative comments to someone or I’ve done [01:23:10] something wrong unknowingly, that has come back to me in the same situation with a different [01:23:15] person. And I could sense it that, oh, this. That’s what it was I did wrong [01:23:20] to that person today. It’s happening to me. I’m a very, very I could I wish I could make a tattoo of karma. [01:23:25] I’m so.

Payman Langroudi: Sorry. You know? But don’t you believe good things happen to bad people as well?

Perrin Shah: They do.

Payman Langroudi: So [01:23:30] that’s not karma, is it? It’s anti anti karma.

Perrin Shah: But it’s if they would have done something good [01:23:35] in their life.

[TRANSITION]: Oh I see.

Payman Langroudi: Yeah I love it. I [01:23:40] didn’t think our conversation would be going there. But a third person.

Perrin Shah: Um [01:23:45] third person I really want to meet Steve Jobs.

[TRANSITION]: Oh [01:23:50] nice.

Perrin Shah: From where he was and where he went, it’s more. He [01:23:55] was into business. A very ordinary man. Often he was very ordinary man [01:24:00] from where he was to where he went, leaving behind a legacy.

[TRANSITION]: Yeah.

Perrin Shah: Which [01:24:05] is just doing numbers in the industry. Yeah. I would want to meet him and [01:24:10] just shake hands, you know that. How did you achieve this?

Payman Langroudi: It’s not the first time Steve Jobs has [01:24:15] been invited to one of these parties. That’s amazing. But I’ve really learned a [01:24:20] lot. Thank you so much for doing this.

Perrin Shah: Thank you, Payman for inviting me. [01:24:25] It’s been an honour, as I said, and it’s been lovely to be here at your studio. Thank you so much.

[TRANSITION]: Thanks. [01:24:30]

Payman Langroudi: It gives me great pleasure to welcome Alicia Willis on to the podcast [01:24:35] as our My Dentist series continues. And you know, you’ve got the [01:24:40] privilege of being the first dental nurse on this podcast, the [01:24:45] first real dental nurse, because we’ve had a couple of dentists who did dental nursing, [01:24:50] in fact, just before, um, but the first real dental nurse and I really wanted [01:24:55] to get dental nurse onto this pod for ages now. Um, how long have you been a nurse [01:25:00] for?

Alicia Willis: About three and a half years. Roughly trained at my dentist. [01:25:05]

Payman Langroudi: And you? Have you had other jobs before that?

Alicia Willis: Yeah. [01:25:10] Retail.

Payman Langroudi: Retail?

Alicia Willis: Yeah. Anything that I could really get my hands on while I [01:25:15] was in school to earn extra money. And I never, ever saw myself doing this job.

Payman Langroudi: But how did it [01:25:20] come about?

Alicia Willis: I got made redundant from a retail job. I kind of needed that kick to do something [01:25:25] more. I don’t know. Worthwhile, I suppose, in my eyes. Um, [01:25:30] I went to er to do nursing at university as, like to work in a hospital. [01:25:35]

Payman Langroudi: Proper nursing?

Alicia Willis: Proper nursing. Decided that was not for me. Hard, hard. Really [01:25:40] hard. Long shifts. Yeah. And I just feel so sorry for everybody, [01:25:45] and I can’t. You can’t go into that job and have such a big heart. Aha. [01:25:50] Um, so I got the opportunity to become a dental [01:25:55] nurse and thought, why not give it a go, see how you get on. And I actually [01:26:00] really enjoy it.

Payman Langroudi: Do you like it from the beginning?

Alicia Willis: Yeah. I thought it was a lot to learn. I [01:26:05] can’t imagine being a dentist. Like, I can imagine there’s so much more, obviously, but [01:26:10] it’s just different. Really different. I never I’ve never [01:26:15] even considered looking at teeth. And now I look at look at everybody’s teeth.

Payman Langroudi: And you’re Claire’s nurse. [01:26:20] Yeah. Sometimes. Right.

Alicia Willis: Every time.

Payman Langroudi: Every time. Okay. And you rotate around some of the other [01:26:25] dentists as well. One thing I’m quite interested in. Have you only ever worked at this? My dentist practice. You’ve never worked at a different. [01:26:30] Okay, so.

Alicia Willis: So I’ve done the odd day.

Payman Langroudi: At other practice. Yeah. Yeah. So [01:26:35] sometimes, you know, it’s interesting to sort of see, you know, how do different businesses run? Yeah. But [01:26:40] I’m quite interested in the question of how do different dentists run. Because [01:26:45] you never know as a dentist, you never know whether what you’re saying and doing is [01:26:50] different to what other people are saying and doing, because you don’t really watch many other [01:26:55] dentists work.

Alicia Willis: I suppose not. They’re all different [01:27:00] in their ways, obviously some more strict than others, I suppose. [01:27:05]

Payman Langroudi: On patient.

Alicia Willis: Both.

Payman Langroudi: Go on.

Alicia Willis: Um, I think [01:27:10] the way that some people come across dentists can be like, I don’t know. For example. [01:27:15] Suction. Sometimes it’s a bit like, oh, I’ve missed my cue. You haven’t. [01:27:20] It’s just the way they speak, the way they are and come across, I think [01:27:25] as well, in front of patients. Dentists are different than when the patient’s not in the room.

Payman Langroudi: Some are right. Do [01:27:30] you find some aren’t though.

Alicia Willis: No some aren’t.

Payman Langroudi: Some are themselves the same.

Alicia Willis: Yeah. Some are still chatty. Some. [01:27:35] Some don’t like you to be chatty when there’s a patient. It’s more serious. Really? [01:27:40] Yeah. Some. Yeah. Some are different.

Payman Langroudi: And so when you’re working with a new dentist, let’s say [01:27:45] you’re having to gauge. What. What kind of dentist is this?

Alicia Willis: Yeah.

Payman Langroudi: Have [01:27:50] you gotten quite good at figuring it out?

Alicia Willis: I’d like to think so. You you can kind of. I find notes [01:27:55] and are a big thing. Yeah. You know, whether they like to hog the computer or not, [01:28:00] hog the computer as to whether or not you’re more of a note writer than a discussion. Um, [01:28:05] but yeah, it’s easy to gauge to start with, I think just [01:28:10] by the initial conversation you have with them as to whether or not they care to get to know you. If [01:28:15] I’ve just stepped foot in the room, I’ve never met them. Yeah.

Payman Langroudi: And then. So let’s let’s say you’ve got [01:28:20] a dentist who don’t click with. Then your whole life, your whole day [01:28:25] is now ruined. Ruined in a way. Yeah.

Alicia Willis: Yeah.

Payman Langroudi: And you know, we do this other podcast. [01:28:30] It’s like a mental health podcast. And, you know, we’ve been really delving into this question [01:28:35] of why do dentists take their own lives much more than loads of other professionals. [01:28:40] Yeah. And I think it’s a very multifactorial thing. But there is this question [01:28:45] of you spend the whole day with your four walls and this one other person, and [01:28:50] if if you and this one person don’t particularly get on or whatever [01:28:55] it is like, maybe it might be nothing to do with you. It might be that person’s own life is stressed [01:29:00] out or I don’t know. The boss has said something to that person to piss him off. Or if you and that one person [01:29:05] aren’t clicking your whole day is totally different to the opposite, [01:29:10] where sometimes you know you really click with click with your nurse and you’re laughing and you’re enjoying and yeah, that [01:29:15] sort of thing. And you know, as a dental nurse, you you’re working with so many different dentists [01:29:20] that you can see that that difference in the working relationship. [01:29:25]

Alicia Willis: Definitely. It’s me and Claire love a sing song. Any given chance we can. [01:29:30] The radio is turned up and we’re singing. It’s just enjoyable. And with dentists, [01:29:35] they are all so different. And some don’t have the radio on. Some like the silence, [01:29:40] some would chat and some will leave the room for a coffee when you’re just alone. So you [01:29:45] get to know who’s who. But I suppose I’m quite chill about if [01:29:50] they’re. If they’re not bothered, then they’re not bothered. If they don’t want to sit and chat or don’t want to sit and chat. [01:29:55] Some days are different for everyone, I suppose.

Payman Langroudi: But then what about this whole hierarchy [01:30:00] of a dental practice? Do you get to get sometimes people sort of, [01:30:05] who clearly want to stamp their authority over you?

Alicia Willis: Yes.

Payman Langroudi: Go on. Give me [01:30:10] give me give me an example of how how that pans out. Like what do they do? So I [01:30:15] like things this way. And what what is it?

Alicia Willis: Um. Specifically [01:30:20] things like how you are. How how you mix your alginate. [01:30:25] That’s a big one, I find.

Payman Langroudi: Are they focussed on that?

Alicia Willis: Yeah. Like just different things [01:30:30] that, like, everyone is so different. So alginate. Some people like it better than others. [01:30:35] Some people would rather have it. So it’s literally about to set going in the patient’s mouth. Yeah. Yeah. Everyone’s so different. [01:30:40] Um, and if you do it wrong a couple of times, in their eyes, it’s wrong in your eyes it’s not. [01:30:45] I think they’re they’re like, no, listen to me. I’m, I’m in charge here, [01:30:50] which is fine. But it’s just obviously learning that they don’t mean things. [01:30:55]

Payman Langroudi: I was with a nurse. The treatment finishes, but [01:31:00] your work isn’t finished. Oh, no. Your work almost feels like it’s just continuous. Yeah, [01:31:05] like there is no stop to it because, like, you’re cleaning and cleaning. And then once you’re done, it’s time for [01:31:10] the next patient. Yeah.

Alicia Willis: Yeah.

Payman Langroudi: Does that does that make the day go quicker, or does that [01:31:15] really tie the hell out of you? Because it must do, I think. Okay. The dentist is doing the notes, [01:31:20] but there’s some sort of break between the being on show and break and being on show and [01:31:25] break.

Alicia Willis: Yeah. It. Some days it’s fine. I suppose if you work private or NHS. [01:31:30] Nhs days are long. They can feel like you’ve got 3040 patients [01:31:35] a day. It does get tiring. Um, but yeah, as soon as you’ve cleaned and set up, the next [01:31:40] one’s in and then out. And it can sometimes seem like, oh, it’s 10:00. I didn’t even realise [01:31:45] the time has gone that quick. Other days I’m thinking, when’s lunch? So it [01:31:50] can vary.

Payman Langroudi: Would you get the dentist who says, hey, do you want to go ahead now? And there’s ten minutes [01:31:55] to lunch.

Alicia Willis: And yeah, no, the root canal box is not coming out at 10 to 12. [01:32:00]

[TRANSITION]: Really?

Alicia Willis: Yeah.

Payman Langroudi: But sometimes he says, the patient says, yeah, let’s go. Yeah. [01:32:05] You’re not you’re not going to do anything about that, right? There’s nothing to.

Alicia Willis: Do about that. Nothing I can do about that. I’m off. [01:32:10] I go to get the box.

Payman Langroudi: So then I don’t know from the outside. I get the feeling [01:32:15] that there’s obviously there’s good and bad things in every job. But isn’t the worst thing about [01:32:20] the job that you’re not in control of the day?

Alicia Willis: Yeah, I suppose [01:32:25] it is. I’m not. Then again, I, I work on reception [01:32:30] some days. So.

Payman Langroudi: Which one do you prefer?

Alicia Willis: Oh, nursing.

[TRANSITION]: Really?

Alicia Willis: Yeah. [01:32:35]

Payman Langroudi: Why? On reception, you have to ask for money and stuff.

Alicia Willis: Yeah. And everyone will come down and go. This is the worst part, [01:32:40] because they have to pay and reception. It’s nice because you can chat a bit more. You’ve [01:32:45] got time to because they’re just paying and they don’t have to leave and things like that. But [01:32:50] a lot I find if a patient. This is an example, I’ve been on reception, I’ve checked [01:32:55] a patient in and they’re angry because the dentist is running late. Well, I’ve just sat down as a nurse [01:33:00] to check you in, and I’m now your nurse in surgery. And then the [01:33:05] instant attitude changes when they see the dentist and realise, I’ve just spoken to you like rubbish [01:33:10] at reception, and actually now you’re my nurse and I don’t. I find that [01:33:15] people are more rude in reception than they are in surgery. So no, [01:33:20] it’s.

Payman Langroudi: I remember times where the receptionist and the nurse saying, this patient’s [01:33:25] kicking off, and then they come to me and they’re sweet as pie.

[TRANSITION]: Yeah.

Payman Langroudi: That happens.

Alicia Willis: A lot.

Payman Langroudi: Yeah, [01:33:30] that must piss you off.

Alicia Willis: Yeah it does. Because you can, you [01:33:35] know, your patience as well. So you know who’s ruder than others, I suppose. Um, [01:33:40] but yeah, when they come in and they see your face and they know you, then you’ve got to nurse for [01:33:45] them. They’re like, oh, you can tell. They think, oh no, I messed up at reception.

Payman Langroudi: What about [01:33:50] do you sometimes can you sometimes tell this is a nervous patient?

Alicia Willis: Yeah.

[TRANSITION]: Oh yeah.

Payman Langroudi: Before the dentist figures [01:33:55] it out.

Alicia Willis: Yeah. When I’ve take them up the stairs and they don’t speak, and I’m like, [01:34:00] are you okay? Have you had a nice day? No. Not now. I’m here. Well, I don’t like being here either. [01:34:05] I kind of have to try and break the ice a bit, saying I’m at work like it’s not great for me, but [01:34:10] I don’t know.

Payman Langroudi: I think it’s such an important part of the job, though. Yeah, because in the end [01:34:15] it’s going to focus in on that tooth.

[TRANSITION]: Yeah.

Payman Langroudi: Whereas you can [01:34:20] reassure I mean it’s amazing what a little touch on the shoulder from the dental nurse at [01:34:25] the right moment. Yeah. Can reassure that patient. And you know what. We’re so in it ourselves [01:34:30] here. We completely forget what a nightmare it is being a patient. Yeah. When was the last [01:34:35] time you had a filling?

[TRANSITION]: Um. Excuse [01:34:40] me.

Payman Langroudi: Or anything done? Have you had anything done?

Alicia Willis: Yeah. I’ve had. I’ve had a filling, [01:34:45] um, scale and polish. It’s not always the nicest thing, but having someone [01:34:50] there, you know, that you trust as well, I suppose, because you don’t know the dentist. And also [01:34:55] you don’t know your nurse, but you know that someone’s there sucking [01:35:00] the water away. That is not letting you drown. Stuff. Just little things like that. That I [01:35:05] suppose. And we can chat to them and reassure them. And if I’ve had something done, I’ll [01:35:10] say, look, I’ve had this done, this is what it feels like. And that’s my, my big thing as well [01:35:15] is that I’ve never had an injection in my mouth.

Payman Langroudi: Have you.

Alicia Willis: No, no. So when someone [01:35:20] says, how does that feel. I don’t I don’t know. I don’t.

Payman Langroudi: Know.

Alicia Willis: Sorry. So [01:35:25] which is really hard.

Payman Langroudi: You should have one done tomorrow.

Alicia Willis: Yeah, but no Saturday. It’s my day off. [01:35:30]

Payman Langroudi: Yeah. Okay.

Alicia Willis: But. But no, like, I haven’t had it done, so I can’t say to them this [01:35:35] is what it feels like. Claire says it feels like you’ve been punched in the mouth. I don’t know what [01:35:40] that feels like. I also haven’t been punched in the mouth.

Payman Langroudi: What are some things about being a dental [01:35:45] nurse that most dentists don’t appreciate? Probably [01:35:50] some dentists don’t appreciate.

Alicia Willis: Yeah. Um, probably [01:35:55] a time spent in, like, the decon room. Like [01:36:00] with all the instruments, all the work that you put into spending the time when the dentist [01:36:05] downed tools and goes home, we spend cleaning down, putting away all the instruments ready [01:36:10] for the morning so they can turn up in their days. Easy. I’d hate. I’d hate [01:36:15] for in the morning to walk into a surgery and it’s empty. Because what use is that to [01:36:20] anyone? And then you rush in in the morning. So I do find that some dentists will go home [01:36:25] instantly. When that patient leaves. They’ll follow them out, come back in the morning and don’t appreciate the work that’s done [01:36:30] when they leave to make sure it’s right for the morning, because there is a lot behind it.

Payman Langroudi: I [01:36:35] bet.

Alicia Willis: Yeah.

Payman Langroudi: What else?

Alicia Willis: Um, it’s [01:36:40] a really hard question. It’s not something I think about. I [01:36:45] mean, I just get on with it.

Payman Langroudi: I mean, you must get dentists who ask you to make them a cup [01:36:50] of tea.

Alicia Willis: Yes, but I’m also quite quick at saying. Can I have some?

Payman Langroudi: Oh, [01:36:55] really?

Alicia Willis: Yeah.

Payman Langroudi: And the opposite. Right. The right? The dentist offers to make you a cup of tea.

Alicia Willis: Yeah, we’re quite lucky [01:37:00] in our practice. We don’t have anyone that’s we don’t have many that think of a hierarchy [01:37:05] either. Really? Yeah. We’re quite lucky. Um, like [01:37:10] I’ll say, have we got time for a cup of tea? Like, if we’ve got a gap or if they say, right, let’s [01:37:15] get the next one in and then we’ve got longer.

Payman Langroudi: I’m just going to have a lot of work to do. [01:37:20] Sorry.

Alicia Willis: It’s all right. Um. So. [01:37:25] Yeah, I wouldn’t say it’s it’s hard work. It’s it just [01:37:30] kind of flows and. No, I do get a cup of tea sometimes. If, if it’s a good day.

Payman Langroudi: What [01:37:35] about career progression.

Alicia Willis: Within my dentist?

Payman Langroudi: Well, as a dental [01:37:40] nurse, I feel like in our profession, we’ve kind of failed in this area. Some [01:37:45] practices are great at it. Some practices. You come in as a trainee, become a nurse, [01:37:50] then further qualifications. They even push people to become hygienists. [01:37:55]

Alicia Willis: Yeah.

Payman Langroudi: Even dentists. It happens.

Alicia Willis: Yeah.

Payman Langroudi: Um. Tco [01:38:00] rolls, head of reception. The manager rolls these sort of things. And I think in a [01:38:05] corporate, there is much more scope for this sort of thing. Yeah. Than an independent. But, but [01:38:10] but I do come across a bunch of practice principals who say [01:38:15] I don’t want an ambitious nurse. I want someone who comes in, [01:38:20] does their bit, leaves and doesn’t want to go any further in their career, which is heartbreaking, [01:38:25] really, in a way. But you kind of you kind of get it right because they’re saying, you [01:38:30] know, that’s that person in that job and that’s the stable person not constantly moving on. And they have [01:38:35] to.

Alicia Willis: But then for that individual it’s not.

Payman Langroudi: Yeah. By the way. By the way, we should we should get that [01:38:40] cleared. There are some individuals who want that job.

Alicia Willis: Probably.

Payman Langroudi: You know, they don’t want to think about [01:38:45] career progression. I mean, maybe it’s not an easy life. Maybe it’s got three children in as a single mum [01:38:50] and just wants to pay the bills, you know, and, you know, you know, doesn’t want doesn’t want any [01:38:55] further stress. You know, it depends on the situation. But the question on [01:39:00] career progression, I think as a as a profession it’s something [01:39:05] that’s lacking. Do where are you with that? I mean, where are you at now? Where do you [01:39:10] want to be? Are they in? My dentist is there. Do they encourage career progression? [01:39:15]

Alicia Willis: I’d say there’s a lot of courses out there that they can put you on that will improve [01:39:20] your knowledge. Like what?

Payman Langroudi: Um, well, oral health, education, that sort of thing.

Alicia Willis: Yeah. We’ve got we’ve [01:39:25] got that. It’s I think it’s harder to get on that because they do it through like an ABN course. So [01:39:30] it’s a harder course to get on. I’ve just done implant training. Oh yeah. Um, which [01:39:35] I find really interesting. It’s not a qualification like any BDM, but it’s [01:39:40] an extra one to even just help you get in, in practice to do it. Um, there’s [01:39:45] lot lots of different courses with radiography or things like that, but I do find that [01:39:50] you like. I don’t know if it’s easier in a city because we’re on such a small area. [01:39:55] I don’t know if because we don’t need radiography train nurses because the practice isn’t big enough. We [01:40:00] only run with four surgeries, so there’s nowhere for us to do x rays. The [01:40:05] dentist may as well just take it in the room as we do it, so there’s no need for the nurse to. So some [01:40:10] some cases like that, then there’s no there’s no reason to do it. Whereas obviously [01:40:15] you need an implant nurse for an implant whereas you can’t do it. So.

Payman Langroudi: So [01:40:20] have you started doing some implant nursing?

Alicia Willis: Yeah. Yeah, I enjoy it. Different gory [01:40:25] sometimes.

Payman Langroudi: Which of all the different things you nurse for different procedures. What’s your favourite [01:40:30] or your least favourite?

Alicia Willis: Whitening.

Payman Langroudi: Whitening is your favourite. Yeah. Oh, amazing.

Alicia Willis: Because [01:40:35] as soon as they walk in, they’re like unhappy. And they walk out [01:40:40] smiling. And what more can you ask for?

Payman Langroudi: Yeah, it’s kind of happy dentistry.

Alicia Willis: Yeah. [01:40:45] Um. It’s just.

Payman Langroudi: You do the scanning.

Alicia Willis: Sometimes. Yeah. Um. We [01:40:50] have nurses who prefer to scan. It’s not my favourite thing to do. Admittedly, [01:40:55] yeah. Um, but, yeah, we just send them down to the nurse that’s doing [01:41:00] it at the time. We’ll go and find someone. And if it’s not me, it’s someone else. Um, but. Yeah, it’s [01:41:05] just I just. We never, ever fail with it. It’s just a good guaranteed [01:41:10] thing that you can deliver.

Payman Langroudi: And what’s your [01:41:15] least favourite?

Alicia Willis: Hmm. Probably a scale and polish.

Payman Langroudi: Oh, [01:41:20] really?

Alicia Willis: Yeah. It’s boring.

Payman Langroudi: Really? Because only suction.

Alicia Willis: Yeah. [01:41:25] There’s not much to chat about. It’s. They’re in and they’re out.

Payman Langroudi: In the end. It must be boring. [01:41:30] Yeah.

Alicia Willis: It is. Well, it is, and it isn’t. It’s remembering everything [01:41:35] because there’s a lot going on. So that always I don’t we don’t do it that often. Um, [01:41:40] so getting everything out and sitting, setting up and takes [01:41:45] time. Um, but no, I, I don’t dislike Ando. [01:41:50]

Payman Langroudi: It’s just like with a nurse. You’ve got to be always one step ahead. Like, what’s he going to want next?

Alicia Willis: Oh, [01:41:55] yeah. I like that game.

Payman Langroudi: That’s the key. Key skill, isn’t it? Yeah. Don’t be to guess that right. [01:42:00]

Alicia Willis: Yeah. And when I work with Claire, she’ll describe something to a patient and like, I [01:42:05] don’t know, a slower handpiece. She’ll describe it like a rattling toothbrush. And I know what she [01:42:10] means, so I’ve already got it out the door. Yeah. So stuff like that, it’s. And it’s also knowing [01:42:15] who you work with and what, like no one else would know that. So it’s little things [01:42:20] like that. That.

Payman Langroudi: So. So where do you want to be in five years? Like what do you think you’re going to be doing [01:42:25] in five years time? Do you think you’re going to be doing the same job, or do you not think in five years time [01:42:30] frames or.

Alicia Willis: I, I try not to because you never know what’s going to happen. I also [01:42:35] don’t think Claire would want me to leave her. Yeah, but I don’t. The [01:42:40] hygienist thing would interest me.

Payman Langroudi: Really?

Alicia Willis: Yeah. I don’t know. I [01:42:45] don’t think I’d want to do to do therapy, but then I could change my mind in five years. But I [01:42:50] also it’s the responsibility side of it for me that it’s all on [01:42:55] me. Yeah, that freaks me out slightly, but, I mean, you get over that. [01:43:00]

Payman Langroudi: Yeah, of course it freaks you out. Like, you know, we were just talking and, you know, actually, Claire was saying that very [01:43:05] thing. She was saying that the biggest difference between being a nurse and being a therapist is the stress [01:43:10] of messing up. Yeah. And and the stress of a complaint coming in and so [01:43:15] forth. Yeah. Um, yeah. But every job has its [01:43:20] own nuance, right?

Alicia Willis: It does.

Payman Langroudi: Yeah. You know, like, I don’t know, you could be a pilot and you’ve got the stress of [01:43:25] a storm or something. Yeah, it’s still some jobs are still worth doing, even though there is stress. Yeah. [01:43:30] Um, but, you know, I’d encourage you if if you’re thinking that way, I’d [01:43:35] encourage you. You might as well, if you’re going to do hygiene, to do therapy as well, because therapists [01:43:40] are so in demand these days. Um, if you if you said to my to my dentist, [01:43:45] that’s what I want to do, they’d support it and help you somehow.

Alicia Willis: I think maybe [01:43:50] not as an individual, but as a whole. I think it’s something they are looking into anyway [01:43:55] with hygienists. Um, so there are bits and pieces, I think, out [01:44:00] there that are being considered. Um, because I’m just probably [01:44:05] just a nurse. I don’t know how they look at us. But I [01:44:10] do think there are opportunities out there that can be had [01:44:15] by nurses when they’re available. And I do think it would be soon. Like in in-house training [01:44:20] rather than going to university, because that for me wouldn’t be ideal. [01:44:25]

Payman Langroudi: Why?

Alicia Willis: Just because we live in such a remote area? The travel to uni? I’d then [01:44:30] have to either probably stay there a couple of days a week, as well as work to afford life. It’s [01:44:35] it’s hard.

Payman Langroudi: It’s what is it, three years?

Alicia Willis: Yeah, I think so. [01:44:40]

Payman Langroudi: It’s worth it, man. Honestly, I know, I know, you said you just bought a house and all [01:44:45] of that stuff. Yeah, but. And it’s hard, right? It’s hard to get [01:44:50] in. Oh, yeah. Super hard to get in and super hard course. Um, [01:44:55] but three years will fly by.

Alicia Willis: Oh. It would. I’d be busy enough to, [01:45:00] uh.

Payman Langroudi: Yeah.

Alicia Willis: Make it fly by.

Payman Langroudi: Yeah, yeah. Um, I’d consider it. You know, you [01:45:05] obviously like dental practices for whatever reason. Yeah. You know what I mean? You did a few jobs, but then [01:45:10] you found one that you like. Yeah, yeah. Within dental practice, there are many roles. And [01:45:15] you can get to this next level quite easily. You’re not easily. You got to get in and all that. Yeah. I wouldn’t [01:45:20] let the the worry of the responsibility get in the way. Um. Mistake. You’ll handle it.

Alicia Willis: Well. [01:45:25] Yeah, I like to think so.

Payman Langroudi: Let’s talk about errors. We like, talk about errors. [01:45:30] Okay. What mistakes have you made? Have you ever done something [01:45:35] where you, the patients complained about, you know.

Alicia Willis: Touch wood?

Payman Langroudi: I [01:45:40] haven’t or a dentist complained about you. Has that ever happened?

Alicia Willis: No. I’ve [01:45:45] actually been to a lot of places, which I don’t want it to sound big headed, but they’ve all said I’ve had [01:45:50] a nice day and that for me is everything. I’d hate for someone to go, don’t put me in with her again, [01:45:55] because that’s not.

Payman Langroudi: Okay. What was your worst day as a dental nurse?

Alicia Willis: It’s [01:46:00] always being put in a different practice because you don’t know the ropes. Everywhere I work slightly [01:46:05] differently. Every person and dentists work differently. The patients expect to come [01:46:10] in six months later and the same routine six months ago. It should be the same.

Payman Langroudi: Does [01:46:15] it happen occasionally where they say, look, we need you somewhere else?

Alicia Willis: Yeah. Um. And that’s. It’s [01:46:20] not. It’s scary. It is. And I know not many nurses probably [01:46:25] enjoy travelling to a different practice where you don’t know anybody. Um, and just [01:46:30] sitting and having lunch with other people. Obviously, you’ve got to start a conversation and get on with [01:46:35] your day to make it go a bit quicker. So it is nerve wracking. And then working with the with the dentist. You are stuck in [01:46:40] four walls with a stranger. So it can be scary. And they all work differently. They all like using [01:46:45] different instruments and different things. And you can’t guess what that dentist wants because you don’t know them. [01:46:50] So that can be hard.

Payman Langroudi: Have you been in the practice? I’ve certainly have, man. Where [01:46:55] there’s like different power bases.

Alicia Willis: What do you mean, power bases?

Payman Langroudi: Like you’ve got? I don’t [01:47:00] know, let’s, for the sake of the argument, say it’s the manageress. And so [01:47:05] and so receptionist are one power base. And then you’ve got the [01:47:10] head nurse and so and so hygienist or another power base. And they hate each [01:47:15] other. And it’s like, it’s like a, it’s like a constant. Like, which team are you in? I’ve [01:47:20] worked in a place like that. Yeah. No I can’t say I have.

Alicia Willis: Yeah I can imagine it won’t. No [01:47:25] I haven’t it’s our practice.

Payman Langroudi: Is a happy.

Alicia Willis: Practice. Nice. Yeah. And [01:47:30] it’s just everyone kind of gets on.

Payman Langroudi: It does sound.

Alicia Willis: Nice from.

Payman Langroudi: From what Claire says about [01:47:35] it as well. It does sound like a nice place to work.

Alicia Willis: Yeah. It is. I never get out of bed and think, oh, I’ve got [01:47:40] to go to work today. Oh, really? Yeah, I just just go and get on with it. And I do enjoy [01:47:45] being there.

Payman Langroudi: You know, I do this thing, this training for enlighten where we talk about, [01:47:50] you know, we’re going to try and focus on enlightened for a week or whatever. Yeah. And then I asked [01:47:55] this question and I say, what would it take to make you want to look forward to coming to work even [01:48:00] more than usual? And it’s a funny one here because I say [01:48:05] it. Yeah. And you’ve got the principle. You’ve got everyone sitting in the room and everyone goes [01:48:10] completely silent. Yeah. And then you have to sort of tell them the other ideas that other people [01:48:15] have had to make it more fun to come to work that day. Yeah. But interestingly, like, I think it’s one of the most [01:48:20] important questions you can answer, right? Like that’s a key question. Yeah. Yeah. What would make [01:48:25] work funner, more fun than it already is? Yeah. And you could go to something simple [01:48:30] like supply pizza. Yeah. Or different hours. Flexibility. I mean, how [01:48:35] do you get around that thought? Yeah, that, you know, you have to turn up every day. And [01:48:40] some of your friends work from home.

Alicia Willis: Yeah, we was just having that conversation upstairs.

Payman Langroudi: Oh.

Alicia Willis: Were [01:48:45] you? Yeah. Um, I do have to turn up every day. And it would be lovely to wake up in the morning [01:48:50] and think. I’ll stick the kettle on, and then I’ll pick up the phone and have a few phone calls. Because you work from home. [01:48:55] Yeah, but no, you you have to go in every day. My routine is the same. Um, [01:49:00] we set up in the morning exactly the same time. Yeah. Clean down every day. Exactly the same [01:49:05] time. So, no, you you do have to turn.

Payman Langroudi: What I’m saying is your enthusiasm [01:49:10] for the job, right? Where the job entails turning up every day. Sometimes [01:49:15] a thankless job because you’ve got some full dentist who’s like, you know, in a bad mood. [01:49:20] Yeah. Not in control of your day. Yeah. And yet you love it, right? [01:49:25]

Alicia Willis: So the people make a massive difference. Patients know.

Payman Langroudi: The. [01:49:30]

Alicia Willis: Team, the staff. Massively. If, I suppose if one’s in a bad [01:49:35] mood, it ricochets. But no.

Payman Langroudi: Practice.

Alicia Willis: Yeah. Not [01:49:40] really. You can tell when someone’s got an off day, but you try and lift them and you [01:49:45] put. I don’t know, a Christmas song on and it lifts the team spirit a bit. But no, we’re all [01:49:50] quite jolly and do just get on with it. And if something’s not done, you say you ain’t done [01:49:55] this and then someone else picks up the slack.

Payman Langroudi: It’s not funny what you said about the radio. Yeah, because [01:50:00] I used to. When I was a dentist, I used to play classical music. Not because I’m a massive [01:50:05] fan. I mean, kind of. I became a bit of a fan because I kept playing it so much, but I had [01:50:10] it in my head. That’s expensive music. Oh, okay. Yeah. And so I had it in my head [01:50:15] that I was a young fool, to tell you truth. But I had it in my head that if expensive music is playing, I’m [01:50:20] doing expensive work. Right. It all goes together. Yeah. My nurse was [01:50:25] like, I want the local station on. Yeah. And I said, that’s cheap. That’s a [01:50:30] cheap thing. The local station. Whereas this is classical. This is an expensive thing. Yeah. And I was [01:50:35] saying think of that. Think of the business rather than your your day to day. And eventually she started enjoying [01:50:40] the classical too. But but it’s so interesting here because what is on is [01:50:45] actually a massive thing. Mhm. It is.

Alicia Willis: And it is.

Payman Langroudi: The.

Alicia Willis: It like.

Payman Langroudi: It’s kind of the difference [01:50:50] between happiness and sadness.

Alicia Willis: Yeah. And if I play Christmas songs it annoys people.

Payman Langroudi: That would kill me. [01:50:55] I hate Christmas songs. I’m a bit of a scrooge.

Alicia Willis: Oh, no. See, I [01:51:00] would start playing Christmas songs at the beginning of November after Halloween.

Payman Langroudi: Oh, God.

Alicia Willis: Claire won’t have [01:51:05] that. Yeah, so I’ve only just been allowed to start playing three songs a day.

Payman Langroudi: Well, are you happy to have [01:51:10] Christmas songs all day?

Alicia Willis: Oh, yeah. What heart. Christmas. It’s on in the car all [01:51:15] the time. Yes. So I’m allowed now three a day. Whereas [01:51:20] that turns me into the jolly person. I’ll sing, I’ll dance. [01:51:25]

Payman Langroudi: That’s your.

Alicia Willis: Thing. Yeah. So I.

Payman Langroudi: Don’t.

Alicia Willis: Know. It does lift the.

Payman Langroudi: Spirit once I’ve heard last Christmas. And [01:51:30] do they know it’s Christmas? I think Christmas should be every three years. [01:51:35]

Alicia Willis: No.

Payman Langroudi: Honestly. Honestly, like like the Olympics or something. Every four years because it just comes around so quick. It’s [01:51:40] not special anymore.

Alicia Willis: But it’s a guaranteed thing to look forward to. Special every year.

Payman Langroudi: It’s every year, [01:51:45] you know, it’s two years. Every other year, every other year would be perfect. No, I [01:51:50] don’t like that.

Alicia Willis: And family as well. If people live away, it’s [01:51:55] the one time of year you know, they’re all going to turn up.

Payman Langroudi: That’s true.

Alicia Willis: Because they don’t have a choice. [01:52:00]

Payman Langroudi: Are you born and bred? Skegness?

Alicia Willis: Um, I am, yeah. I’ve got family in [01:52:05] other parts of the UK, but not far away.

Payman Langroudi: Never lived anywhere else?

Alicia Willis: No.

Payman Langroudi: Do you never have [01:52:10] that feeling of. Hey, great wide world? No. Why?

Alicia Willis: It scares the life [01:52:15] out of me.

Payman Langroudi: Why?

Alicia Willis: Because I’m such a homeless.

Payman Langroudi: You know your town so well.

Alicia Willis: Yeah, and [01:52:20] I’m such a home orientated person. Like my mum and dad. I would always [01:52:25] close family. Yeah. If I can. Any chance I get, I’ll go around there. Like, even though I’ve moved [01:52:30] out. And if I don’t know if I was up and moved to Australia, I wouldn’t even know what to [01:52:35] do with myself. I think I’d just sit on FaceTime to them all the time.

Payman Langroudi: So like [01:52:40] going on holiday, right?

Alicia Willis: Yeah, but I know I’m coming back.

Payman Langroudi: Your home is your home.

Alicia Willis: Yeah. [01:52:45] And I feel safe. Yeah, I don’t know. I’ve always been the same. I don’t like going out [01:52:50] of my comfort zone.

Payman Langroudi: Interesting. Why not? So you’re happy?

Alicia Willis: I don’t know, this is out of my comfort zone. [01:52:55] But, yeah.

Payman Langroudi: Let’s end it with the usual way. [01:53:00] Fantasy dinner party. Three guests, [01:53:05] dead or alive. Who would you have alive. [01:53:10]

Alicia Willis: Harry styles?

Payman Langroudi: Oh, yeah?

Alicia Willis: Yeah.

Payman Langroudi: Like him.

Alicia Willis: I [01:53:15] just think he would bring the.

Payman Langroudi: Joy to.

Alicia Willis: The joy. Yeah. Um. Do [01:53:20] they.

Payman Langroudi: All have a mix of.

Alicia Willis: Dead or alive.

Payman Langroudi: Or dead or alive? I [01:53:25] mean, it could be, I don’t know. Jesus Christ. For all you know.

Alicia Willis: Whoever you are, I’d say Michael Jackson. Oh, [01:53:30] yeah. I have a lot of questions. And I also, I also don’t know if he’s dead or alive because [01:53:35] there’s conspiracies. Uh, but this is a very young person approach, I suppose. [01:53:40] Um, and I probably take a friend because they’d want to witness it. [01:53:45]

Payman Langroudi: Who? A friend like a friend. A best.

Alicia Willis: Friend? Just a friend.

Payman Langroudi: Oh, I like that. [01:53:50]

Alicia Willis: Probably take them because they’d want to also experience that.

Payman Langroudi: Oh.

Alicia Willis: That’s sweet. And [01:53:55] I wouldn’t want, probably want to go alone.

Payman Langroudi: Like, you can have Albert Einstein. Whatever. You’re taking a friend.

Alicia Willis: Yeah. Because I think [01:54:00] they’d appreciate that.

Payman Langroudi: Perfect, perfect, perfect. Do you like being on your own?

Alicia Willis: No.

Payman Langroudi: I [01:54:05] got that feeling. Have you ever. Do you ever go to, like, a restaurant by yourself? Nope. Why?

Alicia Willis: Because [01:54:10] I. I hate the thought of people going. Oh, my day didn’t turn up.

[TRANSITION]: That’s so [01:54:15] interesting.

Payman Langroudi: We were talking about this on another pod. Yeah. Like, why does it. Why is that?

Alicia Willis: I [01:54:20] don’t.

Payman Langroudi: Know. No, but why is that the fear? Like, okay, you’re in this restaurant by yourself. If I saw [01:54:25] you, that is not what I would think. I think she’s someone working in this town. Yeah, like [01:54:30] it wouldn’t even cross my mind that your date stood you up.

Alicia Willis: Must be a younger person like thing. [01:54:35] I genuinely like my friends at work. Are probably 30 plus. Yeah, [01:54:40] whereas I’m 24. Yeah. And they would go and sit by themselves. Yeah. I’m hoping [01:54:45] I’ll just grow out of it because I’d like to. I’d like to say to myself, like, oh, I’m going to go [01:54:50] to Manchester for the night and go and eat in my favourite restaurant because I can.

Payman Langroudi: Yeah.

Alicia Willis: But [01:54:55] I don’t and I wouldn’t.

[TRANSITION]: Yeah.

Payman Langroudi: Okay. But would you sit on a river [01:55:00] side by yourself.

Alicia Willis: In my town? Yeah, but I wouldn’t drive [01:55:05] somewhere to sit there.

Payman Langroudi: In case someone thought. Is that.

Alicia Willis: Why is she [01:55:10] sat on her own?

[TRANSITION]: Yeah. Yeah.

Alicia Willis: I don’t know why.

Payman Langroudi: Oh, okay. Okay. Tell me by yourself. At [01:55:15] home? By yourself? Are you good like that? No, no.

Alicia Willis: Only just started to be. But [01:55:20] I don’t know why.

[TRANSITION]: I love being by myself.

Alicia Willis: Yeah, and a lot of people say that. Yeah, [01:55:25] I don’t know.

Payman Langroudi: Amazing. I didn’t think the conversation would go there either, but, um, [01:55:30] it’s been a massive pleasure.

Alicia Willis: Thank you.

[TRANSITION]: For having.

Payman Langroudi: Me. Thanks a lot for being the first nurse on the Dental Leaders [01:55:35] podcast.

Alicia Willis: I’ve enjoyed.

[TRANSITION]: It. Good to see you. Thank you.

[VOICE]: This is Dental [01:55:40] Leaders, the podcast where you get to go one on one with emerging [01:55:45] leaders in dentistry. Your hosts [01:55:50] Payman Langroudi and Prav Solanki.

Prav Solanki: Thanks [01:55:55] for listening, guys. If you got this far, you must have listened to the whole thing. And just a huge [01:56:00] thank you both from me and pay for actually sticking through and listening to what we had to say and [01:56:05] what our guests has had to say, because I’m assuming you got some value out of it.

Payman Langroudi: If you did get some value [01:56:10] out of it, think about subscribing. And if you would share this with a friend [01:56:15] 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 [01:56:20] forget our six star rating.