What drives a dental professional to take the leap from associate to practice owner? Join us as we explore Dr. Kothari's unique journey from dental school to owning his own practice, as well as his passion for addressing pressing issues in the dental field through his insightful writing. Neel shares his experiences from Bristol University, his time in Colchester, and the various factors that led him to make this important career decision.
Navigating the complex world of dentistry comes with its fair share of challenges, but investing in yourself and your professional development can make all the difference. Our conversation touches on the importance of understanding the needs and motivations of patients, colleagues, and team members, as well as the valuable role of mentorship in more than just clinical aspects. We also discuss how to approach honesty, reflection, and transparency when it comes to balancing aesthetics and healthcare in the ever-evolving dental field.
As we wrap up our discussion with Dr. Neel Kothari, we tackle the intricacies of NHS dental associates' contracts, the implications of self-employment versus employment, and the formation of new organizations striving to improve the culture and practices within dentistry. Together, we consider ways to manage conduct, address the recruitment crisis, and ultimately make dentistry work for everyone involved. Don't miss this enlightening conversation with a dental professional who's truly making an impact in the field.
What drives a dental professional to take the leap from associate to practice owner? Join us as we explore Dr. Kothari's unique journey from dental school to owning his own practice, as well as his passion for addressing pressing issues in the dental field through his insightful writing. Neel shares his experiences from Bristol University, his time in Colchester, and the various factors that led him to make this important career decision.
Navigating the complex world of dentistry comes with its fair share of challenges, but investing in yourself and your professional development can make all the difference. Our conversation touches on the importance of understanding the needs and motivations of patients, colleagues, and team members, as well as the valuable role of mentorship in more than just clinical aspects. We also discuss how to approach honesty, reflection, and transparency when it comes to balancing aesthetics and healthcare in the ever-evolving dental field.
As we wrap up our discussion with Dr. Neel Kothari, we tackle the intricacies of NHS dental associates' contracts, the implications of self-employment versus employment, and the formation of new organizations striving to improve the culture and practices within dentistry. Together, we consider ways to manage conduct, address the recruitment crisis, and ultimately make dentistry work for everyone involved. Don't miss this enlightening conversation with a dental professional who's truly making an impact in the field.
Hi everyone, welcome to episode two of series two. Last week we had Dr Amman Bharti on this show. He talked to us about how he had a growth mindset and in every opportunity, every challenge, he saw opportunity and continued to grow and became fearless in the end and now designed a life where he's comfortable doing implant dentistry predominantly and cosmetic dentistry and he feels like he has a work-life balance. He's also started his podcast called Dentistry Unmasked and he's there to highlight issues that are affecting the profession. So as a follow-on from that, today we've got a very special guest called Dr Neil Katari. Welcome, neil, to the show.
Speaker 2:Welcome, Odessa. Thank you for having me on.
Speaker 1:Really so. Neil is a journalist. Everyone will have heard of him or know of him. He's a quite famous writer in dental circles and talks about pressing issues, and we were just having quite a frank discussion before we came live on air about how he tries to maintain a balanced view on things and tries to write more, in a sense, to benefit the profession, rather than showing any bias or having any bias when he's writing.
Speaker 2:Sorry to interrupt you, Modasa. I'm sure I do have plenty of biases.
Speaker 1:But you have that in the back of your mind, thinking about it prior to writing that you want to try and portray an objective message, shall we say?
Speaker 2:Perhaps. I suppose what I'm trying to do is I'm trying to take myself and my own interests out of the equation. So if I'm writing about a subject the philosopher Rawls wrote about organizing systems behind a veil of ignorance so that you yourself are not in it, and that's what I try to do. I'm a principal dentist, but I'm not necessarily just going to be writing about principal matters. I'll try to advocate and support a lot of scenarios, even if it doesn't personally affect me.
Speaker 1:So tell us about where did you grow up? What was your childhood like?
Speaker 2:Okay, so I grew up in northwest London, Kingsbury famous for its food and, amongst other things, My mum was a childminder, my father was an accountant and they both came over from East Africa A typical story. I didn't have very much and sort of worked their way up. Really, I think they were quite surprised when I said I wanted to go to dental school. I think my dad said are you sure? I said no, yes, it sounds as if I wanted to do it, So I was never pressured into it.
Speaker 1:So what sparked your interest? Because obviously with all of Asian it's always become my doctor, become a doctor. What sparked the interest in dentistry?
Speaker 2:I think, if I'm absolutely honest, I got good grades and I got better grades than I perhaps thought I would get. I didn't know precisely what I wanted to do and I took a gap here. I worked during that gap here, did a bit of travelling and I suppose I don't know what made me choose dentistry, but I looked at lots of careers in healthcare which I felt that I wanted to go into You come across very articulate and well spoken and obviously you write very well.
Speaker 1:Was that a natural whilst you were at school? Were you good at writing? Was there any Terrible?
Speaker 2:No, Okay, many people may not know this, but I've written a few articles now. Quite a few started in 2008. Almost every single article I've written my wife Prief reads she's a music teacher and she's taught English as a foreign language. She's fantastic and at first there were lots of red marks, lots of corrections and it's got easier over time, but it was really outside of my comfort zone by a long way. I'm one of those sort of typical science students.
Speaker 1:Fun memories of childhood. Do you look back in a positive way? enjoyed it.
Speaker 2:Yeah, absolutely. North-west London was a great place loads of friends, loads of people. One of the things that's good about London is that you've got a lot of family close by as well. Yeah, so yeah, very fun.
Speaker 1:Where did you study at university?
Speaker 2:I studied at Bristol University And how was that like?
Speaker 1:Did you enjoy your interviews there?
Speaker 2:I really liked Bristol, a really fantastic city. I still try to go back there, In fact, whenever I'm picking courses I was picking a course that I wanted to do I always look to see if there's one in Bristol, just so I can go back and see what remains Things like that. So, yeah, absolutely loved it. After university, i did my VT in Colchester, which was great, and then I went into predominantly NHS practice in Cambridge for a few years before before buying my own practice.
Speaker 1:Right, okay, so roughly, how long did that take? Was it a natural thing where you're always going to buy your practice after you graduated? That was the plan, or how did you decide to buy your practice?
Speaker 2:Yeah, i mean I wanted to, but I didn't really have a plan. I suppose we all have a lot of us have a desire to want to go into practice ownership. Some people do, some people don't. There's a number of pull factors. I think when you're younger, it's really hard to work for someone because you always think that you know better than everyone else. And then you become a practice owner and you think, oh yeah, i can kind of see why they're doing it.
Speaker 2:I think it's part of growing up really, but when you're younger, you do think to yourself oh, if I had my own practice, i could do it this way. So for me, running a practice was something that I wanted to do. I don't know why I don't never really sat down to think about it, but I think there were several reasons, and one of them was wanting to give it a go and see if I could do things and make a success of it.
Speaker 1:Was it like having that autonomy, being able to decide things for yourself, or was it just? yeah just felt like you wanted to be in control of things, I suppose.
Speaker 2:Yeah, lots of things autonomy, making more money, that space. I mean I wasn't doing badly as an associate but I thought to myself well, do I want to you know if I'm going on courses to try and improve my skills? do I want to set things up the way I want to? What will happen for the future? I found it particularly. I mean a lot of running a practice is really difficult and boring and mundane, and it gets easier with time as you start developing systems and ways of doing things. And I think also sometimes you get a bit better at talking to people and finding out you know how teams work.
Speaker 1:How big is your practice at the moment? How many surgeries is it?
Speaker 2:So I've got five treatment rooms, so five surgeries, and I've got quite a good team, so several dentists, two hygienists, oral surgeon who visits us and myself.
Speaker 1:And the album of your practice. Now for.
Speaker 2:Since 2010.
Speaker 1:Okay, so about 13 years, Excellent. And what was that journey like? Because you know, obviously because this podcast is more about, i suppose, growth and mindset and how I suppose people learn and were brave and took, like, big decisions. So, obviously, when you bought this practice, and was that in consideration, what kind of things did you consider? Or was it just? I'm just going to see how it goes and make a go of it?
Speaker 2:Yeah, yeah, i'd like to tell you that I had this really strong business plan and a really strong business case And I knew all the numbers and the figures And I didn't. I knew very little. I took the plunge and I learned along the way. I wouldn't even say I made loads of mistakes. I made some, but you know what?
Speaker 1:would you say like the biggest challenge, because at the start is always the hardest, because you're building that foundation, you're getting those patients to trust you, you're trying to build your profile, you're trying to attract patients. you practice obviously what you're in it, just perhaps commitments as well. What was that like for you at the start? And you know? just just give us some insight on that, on the perhaps some of the challenges you faced at the start.
Speaker 2:Yeah, i mean I was already. you know I've really learned a few years as a associate, so I went on loads of courses. I was addicted to courses right at the beginning And so I didn't particularly struggle clinically too much, because one of the good things about the NHS is that you get a lot of experience very quickly, especially if you're going through lots and lots of cases. In terms of the challenges, i suspect it's very hard to pick one, but if there was one challenge, if there was one, one almost category, i'd say it's trying to understand what people want and what what service you're providing And I don't just mean to your patients, but I mean to your, your team and your staff and and everyone else around you. you know, understanding why people come into work and what their reasons are, and trying to get the motivation back.
Speaker 2:Yeah, and sometimes it's you know. So I've done a few value exercises with my, with my staff, and we've sat down and tried to figure out what it is they want. And you know, when we go to all the university, we all say, oh, because we want to help people and we want to do this and we want to do that. It all sounds wonderful. But sometimes, when you sit down and you talk to people about their reasons of why people want to work I mean, i've heard countless times people say things like when I don't want to just be at home and be a mum, i want to do something else, so I want to have, you know, something where I can switch off from doing this and I want to try and achieve something. And everyone will have their own reasons, but actually understanding those reasons is very, very important. It helps you to figure out what sort of roles you can give people and who's going to thrive in what roles and who's who's not.
Speaker 1:So the interesting dental implants. How soon was that after you bought the practice and how did that come about?
Speaker 2:So during my VT years, having a discussion with my VT instructor he was fantastic, by the way I think he saw that had an interest in oral surgery and you know, i think one of the things that he said is look at your age. Dental implants is going to be a big thing and you really need to get yourself involved in it. You know, even if you're not placing implants, you've got to be able to restore and do something, and I think he was right. So I went on, went on a few courses and had a lot of mentoring really really good mentoring. I was really lucky, excellent.
Speaker 1:So we talked about mentoring in particular last week and how perhaps we need to introduce a mentoring culture more in dentistry because obviously for a lot of associates it's very expensive and getting a mentor to come in and come out to your practice and what you do, things etc. And everyone expects to be paid for that kind of service. And then obviously I've heard of some of the older dentists where, similar to yourself, where they've just had people and people have sort of helped them along, and what was that like or what was your experience with the mentor?
Speaker 2:Right, it was really good. I think the thing to remember and this is something that I think perhaps a lot of experience I'm not massive experiences, people far more experienced but I think what a lot of people would agree is that the best investment you're ever going to make is on yourself and your skills and your ability and you know dentistry.
Speaker 2:We mustn't be led too much astray by what we see on the internet and on Facebook and various forums. What most people are looking for is it's just a good, solid pair of hands, somebody who is, you know not necessarily not necessarily knowing everything, but knowing what they can't do and developing their skills. So you know a lot of bread and butter. Dentistry is not just incredibly profitable, but it's very much in demand, now more so than ever, and one thing I would say is that, you know, if you learn the basics well and you pay somebody to whether it's a course or whether it's an individual you've got someone who's sharing their experience, not just their clinical experience. I mean, i can. If it's like, i'll name my mentor. Yeah.
Speaker 2:I went to his name was Mr Well Gurgus and he taught me at at Eastman and his practices very near mine now and he was fantastic and you know, not only did I learn good clinical skills, actually things that you learn that you wouldn't think that you learn, like how well he talked with patients and you think actually that's really important. I mean, you know you can use anesthetic to calm people down, but you can also use your words and and these things come with experience. So when you pay for mentoring, what you're really getting is not just somebody to keep you safe, but you're getting access to experience and you, and that's really important.
Speaker 1:I think this is the trouble obviously there's, especially now there's a lot of people providing training, there's a lot of different courses out there and the frustration for a lot of dentists is making those the right decisions and choosing the right courses of the right mentors, of the right and first. Obviously everyone has different kind of it's like Dr Aman Bharti last week. He was just saying that look, i went on a course and then I just went and placed an implant on a look for a simple case and did it. Now that's obviously somebody who's obviously perhaps got quite a lot of confidence already and got that growth mindset and and things. But for most people they did feel a bit uncomfortable doing something like that for the first time alone.
Speaker 2:Yeah, absolutely, because it's a different time and it's a different era. I mean, we do now have training, standards and rules and regulations and you know and I think it's important to say that, whilst in the past it was perhaps easy to do those sorts of things, in today's day and age it's much, much harder to do. When I talk about mentoring, i'm not necessarily talking just about just about implant cases. It can be anything. I mean, if you want to know how to improve your crown preps, take photos, take x-rays, do all the standard things, and then go talk to someone it could be during your lunch break, it could be just a friend or a colleague and ask them what they do. You know, technicians have a wealth of information, so it really isn't about. You know that there's a lot of things that you do have to pay for, but there's a lot of things that you can.
Speaker 1:You know that you can gain just through your own actions and through your own as it is an interesting attitude that obviously you personally have, where you're trying to work out your own strengths and weaknesses and then use them to be able to refine those areas or or improving those areas, and it's actually quite a refreshing attitude to have to be able to, to have that self-awareness, because sometimes, especially with dentistry, almost have to feel like we have to put a persona on, like we know everything kind of thing and that's a kind of a dentistry kind of as a surefire way of knowing someone's not particularly experienced.
Speaker 2:I think Dunning Kruger referred to that as the peak of stupidity, or somewhere along that.
Speaker 1:I think that's the thing that we kind of need to change that attitude and sometimes accept that we've always got something to learn and there's always going to be new things, that you learn every single day from different people, different situations, different circumstances that's, that's right.
Speaker 2:But I mean, there's a saying which is in dentistry you can either be good, you could get good, or you could give up. And you know it's very, very, very difficult to just be good. You have to learn, you have to fail, and that's one of the things that I feel very sorry, particularly with younger dentists, because I don't, i don't. I mean, i hate the word safe spaces, but if we're using that term, i think a lot of people nowadays don't have a safe space where they can fail predictably and fail with emphasis of learning. So I think we do need a, we do need, do need that space, but it's interesting word this fairly because there's a obviously what named the person?
Speaker 1:but there was somebody on Facebook who didn't like a few of the posts where I've mentioned failure or talked about failure, and it's an interesting thing because he thought I've never failed in my life. I don't know what you mean by failure. I don't fail and what I'm saying is that sometimes it it's a word that I suppose, as dentists, we don't like hearing, but there's nothing wrong with something failing because, like you said, the more you fail, the more you're gonna learn. But I mean it's, but what? but my thing was it was, it was almost like a defensive mechanism. It's felt like I don't feel comfortable saying that.
Speaker 2:I feel that something and it was just an interesting kind of yeah yeah, that's right, because there's a unusual dichotomy going on where you know if you want to succeed. If you take, for example, let's say, the Dyson Hoover, we all, we all see the product, but I think there are some statistics that say James Dyson did something like 5,000 prototypes before.
Speaker 1:Yeah, yeah, yeah, so the question is what?
Speaker 2:how do you measure success and how do you measure failure? it's incredibly difficult. There are some, some things which are very clear. So something succeeded or failed, but then there's a huge spectrum in between and it's unlikely that you take on a task, any new task, and be good at it straight away. There's an industry standard, which is that I think it was published in one of Esposito's papers that if you, you know, unless you've encountered something about 50 times, you're still in the beginners phase, you know, you might, you might think that you've not failed, but you don't know, you're still a beginner. So it's difficult because you need to.
Speaker 1:You need to balance the need to get on and do something and get those cases under your belt this is obviously perhaps a point that I wanted to perhaps ask you a little bit about, because at one point I was speaking to one of the dentists and he'd obviously trained abroad and he he basically said that, look, i started placing implants and, yeah, things failed. But when they fail that I could just say to the patient it's your fault that it failed and I'll just do it again. But in this country, obviously, failure is is either not acceptable, and there's always the element, or in the background, of a patient's expectation, or the worry of a complaint, or the worry of something happening. And what I'm saying is that patients, perhaps especially in this country, won't like the idea of of you practicing on them, and not often are we comfortable telling patients that we're doing something for the first time or and and something. How do you think we can? you can as well deal with that or get around that you've got to be candid.
Speaker 2:You mustn't be too keen or too eager to take on cases. When I was starting off with implant mentoring, the conversations were awkward and it takes some time before you you improve on that. And one of the things that I said is that look, you know, i am training, i am learning. The carrot on the stick is that you'll have an experienced mentor with you, so we'll ensure that we try to get the quality of the work as well as possible and, of course, your fees will be a bit lower. So that's that's how it worked for me offering incentives, but being truthful and honest about it and not trying to not trying to necessarily miss, not mislead, but not trying to be too eager to get cases under your belt. You know, and I'll fully admit this, when I was younger I perhaps was too eager to do implants. I mean, i can think of several cases now where I'd probably do a resin bonded bridge and I look back at the cases, think what on earth was I doing? You know, and you have to be honest about that, it's not.
Speaker 2:You know, i don't feel that I was acting unethically at the time, but it's part of the learning process. You don't know what you don't know. So you have to evaluate. And learning is not a fixed thing. It's a dynamic, continuous process. So reflecting is important. But you're right, people do feel like it is very, very, very difficult to admit failure. But you just need to be open, be honest. It may take you longer to get the cases, but you'll be more predictable And I think also you'll be more medically safer.
Speaker 2:You know, if you're spelling things out and you're saying, look, i'm going to write you this detailed letter, i'm going to be as honest on this candidate as I can.
Speaker 1:you're more likely to be safe than if you're trying to encourage a treatment process That's yeah, i think it's kind of similar, like, especially when I first started out I suppose I felt like I had to do certain things. So even difficult extractions I'd be like, yeah, i can do that, or I jump in there and then sometimes you obviously get into problems and then ended up sort of referring. And I think nowadays I'm far more careful And even sometimes you think I'm pretty sure I can get this tooth out, but this patient seems a little bit So I need to do, just do the right thing and just say, look, this is the situation, these are the risks you know, and what do you want to do? So, as long as you've done all that and then they still consent to the treatment, that's fine. But that's me now, and before it was, it was almost like I suppose I didn't have that self awareness that for me it was like, because in dentistry as well, i think it's quite a lonely place a lot of the time It's you and that patient and you're dealing with that situation. So you sometimes you don't even know how good the guy next door is or how good the other guy is And sometimes, like myself personally, you put that pressure on yourself, thinking you should be able to take that out?
Speaker 1:Why do you need to ask for help? Or why do you need to refer that? So, and then there's that worry of am I referring to you? What should I be at this level? What standards should I be at? And, and I think you know, in dentistry as well, we don't always show that side or like to show that side that you know everyone's at different skill sets and different levels. And you know and sometimes it's almost a game, because I remember, even when, when, when I newly graduated, it was this like everyone would like be on this shockingly high UDA rate because they had to make sure that. And you're like really, are you really on that? Yeah, and then you'd be doing all this private and you're like, well, i'm not doing anything. Do you know what I mean? There's this like competition between anything who's really telling the truth and who's who's not, kind of thing.
Speaker 2:But yeah, just an existing. So your confidence is great And sometimes patients even want that. But what they need is competence, and they need you to be able to spell out the risks. And part of being a professional is not necessarily whether or not you make mistakes, but it's how you handle those mistakes and how you, how, how you act And you know essentially when we, when we are treating patients, we have a relationship with the patients. That relationship is not a symmetrical relationship. We can't expect our patients to know the knowledge that we've learned over university. So there's a power imbalance And our role is not to necessarily act in an overly confident manner, but to try to make sure that we are acting and advocating for the patients. So they're coming to us, they're putting their trust in us, and very often when we're young, it's very difficult, isn't it? It's very difficult to say actually, i need assistance, i need help. I don't know this. And why would you? if you've not taken out many complex wisdom teeth, why would you actually know?
Speaker 2:this My oral surgeon says you know, we all, we all, we all think we're. You know, no matter how good we think we are at taking teeth out, there's always one that comes along and humbles us.
Speaker 2:And that always stuck with me because you know that is true. So, discussing the risks and the benefits, it's not about being too confident or too negative, it's just about giving a fair appraisal so people know what it is that they're doing before they go into. And the saying is you know, if you tell somebody before it's a reason, if you tell them after, it's an excuse.
Speaker 2:Yeah, that sort of goes to explaining how people perceive it. So it is difficult. The best way you can do that as hard and as painful as it can as it is is to just be as critical over your work not necessarily to the point where you're obsessing about it, but just so that you can take bits away. Try to try to get other people share your cases, ask what would you have done differently. Try to give yourself the time to do it as well. You know there isn't a rush. You know sometimes we don't give ourselves enough time and we're not getting the best out of us.
Speaker 2:Sometimes people will say the most important person in a treatment room is the patient. That's not true. The most important person is you. You know they are paying to come and see you, they're putting their trust in you. You don't really care what their opinion is. You want to tell them what the options that they have. You know, if somebody says, oh, can you just resubmit this bridge and it's impossible, you need to very quickly find a way of telling them why it's impossible. So there's confidence and there's competence. And you know, i think, even if we debate this till we've learned our faces, some of it does come with experience which is tricky, which is very tricky.
Speaker 1:I mean, this is something obviously we discussed over email. Obviously we wanted to talk a little bit about, i suppose, the current trends with the young dentists at the moment with composite bonding and Invisalign So I suppose this sort of neatly moves us on to that topic And obviously we did discuss this last week actually with Dr Amun Bhatti last week, and his whole podcast was actually based around this and the fact that a lot of the younger dentists are now showing the NHS and going straight into private practice and obviously doing these cosmetic treatments. What are your thoughts and opinions on this?
Speaker 2:Yeah, i think part of the reasons why cosmetic treatments have become more in demand is because we have become more cosmetically aware as a population, as a society. But there is to a degree you know from being absolutely honest some of it being pushed by the profession, and I think there are a number of reasons for that. But one of the reasons which I've always, sort of always thought in the back of my mind is because it's very clearly private. So if you're working in a fully NHS list, there's a lot of grey areas, but when it comes to cosmetics, there's almost a universal agreement that actually, if this is cosmetic, the NHS shouldn't provide it. Now, there's no rules saying that, there's no contractual legislative rules prohibiting you from doing that, but we've all come to this almost collective view that the NHS doesn't provide cosmetic treatment. There's absolutely no reason why we think that is just what we think.
Speaker 1:Yeah, yeah. So what advice would you give to young associates now just starting out? And obviously there's this pressure of the peers doing the Instagram dentistry, posting them online and sort of. I suppose everyone just seems to follow like a trend And everyone thinks that that's just a way to go because everyone wants that. And it was interesting because I think I watched a bit of Amund's podcast last week with Paul Tickton and he was obviously saying about composite bonding is actually the only UK thing And a lot of other countries actually laugh at the fact that the UK provide this kind of treatment and things. So what are your thoughts on and what advice would you give, i suppose, newly graduated dentists?
Speaker 2:There's a huge place for it, there's demand for it. But understand the basics of dentistry, because if you don't understand the basics of dentistry things like occlusion, perio, all the basic things you won't also have the tools to get yourself out of trouble If things go wrong. So you need to have a good foundational basis in general dentistry before you move on and want to do that And also try to understand what it is you're trying to do from dentistry. So this is probably more of a philosophical point on what you're going to achieve. So you know, when I do dentistry I sound the horrible thing to say, but I don't really care about the aesthetics of my patients' teeth more than they do. So if somebody comes in and they want to have their teeth whitened, i'll talk to them about the pros and the cons. But you've got to try to, you know, let them lead you on that, because what we are trained to do is provide healthcare Cosmetics. If we talk about, if we really talk about what we're doing, we're not really just dealing with health care, although I do accept, you know, alignment and various things can improve on things. And also, just, you know, people might be more inclined to look after their teeth and I completely get all of those things.
Speaker 2:But I think one of the things that I would say is just understand what you're trying to do. And for me, when I do any form of treatment, it's quite simple I'm trying to maintain function for life for that patient. So you know, in the back of my mind I'm thinking how long is this repair going to work, what is the benefits of it, and how do I get my patients to the point that when they're a lot older they're going to be able to eat and chew comfortably? So you know, understand what you're trying to aim for, and then go on courses and the rest will fill. You know, the gaps will fill themselves in.
Speaker 2:So when I was first qualified I'm not sure we really properly talked about perio at a young age because that's a bit of bleeding who really cared? I'm not a big fan of perio myself in the sense I don't like doing it, but I have good hygienists, i've got, you know, people I can refer to and understand that what you're trying to do from a healthcare perspective is maintain function, maintain the ability for somebody to chew and smile and eat comfortably for the duration of their life From an aesthetic perspective, what your goals are essentially is trying to ensure that the patient is happy with their smile Not that you're happy with their smile, but that they're happy with it. So there is an overlap and the two do cross over, and there is a place for both.
Speaker 1:It does become sometimes can become a bit of a glare, you can't it? you know the line between cosmetic dentistry, healthcare dentistry and, i suppose, being ethical as well, because obviously, especially in the private sector or cosmetic sector, there is an element of selling and promoting certain treatments and things, and we've been a lot of the time we stray that boundary.
Speaker 2:Yeah, i mean the moment you charge for your work, you're selling something. I mean selling has a very negative connotation to it, but the question is, what are you selling Now? I'm selling healthcare and people are paying me for my time and sometimes for my treatment, sometimes for my thoughts. I'm still selling it. Maybe that's ethical, maybe it's not. I think it's very possible to do cosmetic dentistry. Sorry, let's not call it cosmetic, let's call it aesthetic dentistry. Yes, two things. But I think it's very possible to do it aesthetically, and especially if people are coming to find you. But my personal view is you know, i care about aesthetics to the extent that my patients do. Beyond that, my primary goal is to maintain function for life, make sure that people can eat and chew and function when they're a lot older, and that dictates my treatment planning.
Speaker 1:So you know, i think it's interesting because I come across a lot of different obviously dentists of different types and we all have our own, i suppose, philosophy of how we do dentistry and what kind of things we think are right and what things we don't want to be doing. That And it's kind of an interesting, i suppose, mindset And I know obviously we always talk about, you know, when you're looking at a patient, deciding what to do, we'll all have our own different viewpoints on what to do, but we also, like you said, we also have a philosophy of how we treat our patients, for example, and some patients that that will really work on, and especially the ones that you've got that trust and they've seen you a few times and they built that trust. So they'll always go to you for the advice of do you think I should do this? What do you think about this? So it's an interesting one.
Speaker 2:You have to understand that from a consumer perspective. Let's talk about patients as consumers. I know these are horrible words, i know these are awkward words, but if we assume from a consumer perspective, you know, if you go to a Chinese restaurant, you probably want Chinese food, so you need to understand what your demographic wants, and most of my patients want me to provide them with good quality care. They don't want to see me. They'd rather they didn't have problems. So what I'm selling is preventative care. Now, some people need a lot of it and some people don't, and if they don't, they don't see me that often And that works for both of us. You know I get very bored, and seeing patients every six months for checkups when their mouths are perfect, it's incredibly boring.
Speaker 2:So you know, they can come back in once a year or once every 18 months, perfectly fine with that.
Speaker 1:So I wanted to spend the next part of this podcast, as you're talking about the political issues and the sort of, i suppose, the you know the things that you're probably quite vocal about as well and want to talk about. So obviously, one thing I personally, obviously a lot of people who may know me, and one of the things that sparked my interest in social media was obviously a situation during the pandemic where associates weren't paid correctly by the practice owners and there was lots of things like that happen. What are your thoughts on how that was handled, in particular by the NHS and the BDA? because a lot of the I suppose the grievances are still being vocalised and obviously you know I joined Shazia's Armoured Group, british Dental Action, probably as a result of my situation and finding. Perhaps you know people who had suffered, perhaps with similar situations. How do you think you know, when you look back and reflect on that? do you think it was managed correctly? Do you think things could have been done differently?
Speaker 2:What kind of I think it's always easy with hindsight to say yes, things could have been done differently. But I mean, I look like, as you know, there have been times where I've been very supportive of the BDA and times where I've been very critical. But the fact of the master remains is that associates no longer contract directly with NHS England. They contract with a practice owner who contracts in turn with NHS England. So whenever you have a chaotic situation or a scenario, especially when people have suffered losses, people are always looking for leadership, perhaps even sometimes someone to blame. The BDA have no ability to govern how NHS England contracts with associates. They can advocate and they can highlight and they can tell ministers and tell people in NHS England in various positions of power what the scenario is, But they are not party to the contract, They're not setting the terms. So if people say the BDA should have done more, say well, what? What can they do? I mean, perhaps you can have some answers there. I don't know.
Speaker 1:Well, i wanted to ask obviously there's a couple of things that were on that point. Obviously recently they did engage me and asked me about what my views were on whether a dental NHS associate is being salaried and having an employed contract or what. I think the majority were against it, but what do you think the implications are for that and what are your thoughts on that? Do you think that's a good idea or not a good idea?
Speaker 2:I think that when you have self-employment with employment terms, you're getting the worst of both worlds. You're carrying all the litigation and regulatory risks of being self-employed, but you're not having any of the benefits that come with employment. So you know let's talk just numbers here As time has gone on, there are quite a lot of people who are in 83% of the population of dentists or associates. Increasingly, a lot have been women, and people have got considerations like maternity. I've got considerations like part-time working, all sorts of things like that.
Speaker 2:And I think that the question is not whether or not you want to be a self-employed or employed. The question is what actual situation are you working in? Now you may say, oh, i want to be self-employed because I'm able to do lots and lots and lots of UDAs. Well, that's great, that's good for you. But if you're putting yourself in a position where you're not, you're actually working in something that's very similar to employment, you're not getting any of the benefits. I'm afraid when you have things like COVID, or when you have disasters or something, i'm afraid those are some of the risks. So from my perspective, i think that there is a genuine need to have an honest discussion on actually whether associates are better off as being employed, whether employment is a better structure, because we're in a scenario right now where some people not all have absolutely terrible targets on the back and conditions very similar to employment. You must work these hours, you must do these things, you have to space out your UDAs over a certain number of months.
Speaker 2:You have to use these materials or these laboratories. Okay, great, Not against all of those. There's genuine business reasons to do that. But at the same time, what about the benefits that they would have if they were employed? So if something goes wrong because they were put into a position where actually it was unsafe for them to work, what recourse do they have? Who is going to advocate for them?
Speaker 1:Right now, we've got a terrible situation where younger dentists like Lucy Williams you may recall the case- Do you want to tell us a little bit more about this case, and then obviously we can talk about that.
Speaker 2:Yeah, i mean essentially. Lucy Williams had a dispute with the practice owner. She was sent to the GDC. She was given a number of charges. When you read those charges one of the scary things that dentists like myself look at we think, oh yeah, we've probably done all of those things ourselves. She's put in a position where nobody understands the NHS rules and regulations. Tremendous pressure to meet various targets or whatever Sent to the GDC, and the GDC have taken a very, very, very strong approach to say, well, actually, you must have been dishonest.
Speaker 2:They didn't tell her why she was dishonest and they were absolutely lambasted by the high courts and the courts familiar. They said, well, it's not just that you were wrong in charging her with dishonesty and erasing her, it's not just that you were wrong, but how on earth could she possibly be subject to a rule that doesn't exist? And what she done was she charged top-up fees for crowns to say, well, look, if you want a tooth-colored crown, you can pay the difference on the NHS. And actually it turned out that there isn't anything prohibiting this. And the courts were very you know, in discussing and debating what's happening. They looked at it and they said, well, actually, this is actually in the spirit of the NHS, not against it. But the problem that I have with this is not necessarily the case of whether she was right or wrong, but who's advocating for her. Now, if she was an employee, i think that things will be very different. I think she'd have some better degree of recourse to say well, actually, hang on a minute, i am an employee, i'm working in accordance with what the practice owner or the manager wants and representing this company.
Speaker 2:But right now, again in her case, she has all the disadvantages of being self-employed and none of the benefits of being employed. So I understand people will look at self-employment and say, oh well, actually I'm probably going to get paid a little bit less. I understand that. But you've got to look at the whole picture and I think it's absolutely shocking that we've got to a point where, as a profession, we are absolutely letting down young dentists who couldn't possibly understand the rules and the regulations And they've been put in this very, very difficult and awkward situation. So it was a very pivotal case really, because it transpires that a lot of the dogmas that exist within NHS Dentistry aren't real. No one's really properly analyzed and assessed the NHS contract, so we're all basing it off here, saying what's been passed down from wise, experienced old NHS dentists who've always done it this way, which is great.
Speaker 2:But how do young, inexperienced dentists actually learn the right way? It's not written down anywhere. Everyone's working in a way where you know there's not regular courses. There's no easy way for people to learn this And the truth of the matter is I probably shouldn't say this, but I will prior to 2006, the general accepted rule was that, look, people are probably going to do a little bit more on the NHS than they would have done otherwise because of the way their system is.
Speaker 2:And the GDC and a lot of regulators say look, as long as you're not really going silly, we're probably just going to you know, if you're mostly okay, we're probably going to leave you, leave you alone, and if you're generally trying to do what's best for your patients, we're not going to really rigidly regulate you. The problem is NHS Dentistry doesn't work if the GDC or the regulators take a very rigid approach to it, because you can't have two equally true positions. You can't say that the rules are vague and we don't understand them and then also seek to enforce them rigidly. Both things cannot be possible And that's why we're letting down a lot of people And that's why a lot of people are, quite frankly, scared. I mean, you know I've seen notes from hygienists that are longer than what I write down for an implant. Nobody needs to know that you've used a cotton wool roll. No one needs to know what's such a stupid. No one cares It's not relevant.
Speaker 2:But people are doing these things because they're trying to do the right thing And I think we're letting them down.
Speaker 1:How do we change this then? How do we actually make it? Because the issue is, the rules can be quite confusing and obviously not all of us will understand it, and obviously experienced dentists have been working in the system longer, so perhaps they do understand it.
Speaker 2:Actually, it turns out that I'm far from understanding it Even very experienced dentists.
Speaker 2:Yeah, i mean, i was reading something today which is in the NHS contract and you can all check this whoever's listening. Under the NGDS contract, clause 101 says you must only provide advanced mandatory services if you've got a referral contract or as a referral service. So you've got to have a special contract for it. And when you read what the advanced services definition is, which is in the contract, it specifically says by virtue of the special expertise experience equipment, this is considered advanced mandatory words to that effect. So it actually puts us in a very difficult position because we all believe that if you've got the capability and the skill to do something, that you should do it on the NHS.
Speaker 2:And whilst I understand precisely why we believe that and whilst I think that's a very ethical position, it's not what the contract says. It's not precisely what the contract says. And what it says under that is that you know it's not necessarily to the level of the skill that the dentist can do, but it's in respect of the patient. So here's the problem. Let's say you could take out a complex wisdom tooth and you have the skill set to do it, as I read the contract technically, unless you've got a referral service unless you've got a contract for advanced mandatory care, you're in breach of the contract. You're doing something that you're not contracted to do, which is a bonkers thing, absolutely bonkers. It would help the NHS immensely. So I don't think any of us really understand it, and I've been to lectures where people have tried to teach me and explained to me various things And I think, look, you're selecting the bits that you think sound ethical.
Speaker 2:That's fine, but that's not what it says.
Speaker 1:Yeah, it's kind of an interesting thing And I think that's the thing with, obviously, dentists. We're not legally trained, we're not that way sort of usually inclined, you know, obviously, but a lot of the time I don't pay that attention to detail And obviously even associates and things. What I find as well is obviously this tinkering of contracts, especially associate contracts, and some obviously having a BDA and then lots of different clauses and have work in. Especially corporates are very notorious for doing this, where they put different things and you think that's a bit unusual. Even one of my first jobs it was like a six month notice period and when I went to someone I'm not really heard of anyone having to wait six months before they can leave a job, but that was what was in the contract.
Speaker 2:And the flip side of it is that, whilst I have heard people saying oh about corporates, there's something other. but the actual flip side of it is that a lot of them tend to be very organised, they tend to pay people on time, provide opportunities. So I don't look at corporates and think good or bad. I think there's pros and cons. I think what we have to do as individuals is we have to look at our own actions, our own abilities and ask ourselves you know, what do we want? What can we contractually agree to and what we don't? Because I think if you do agree to something, you should try to honour it. So that's my general view. I appreciate some of the clauses might seem absurd, but there are some.
Speaker 1:One thing is they've got proper lawyers who've looked over these contracts and obviously put these clauses in that aren't. You know, to the untrained eye or somebody who perhaps might be new, you perhaps don't even pay too much attention. Yeah, it's a standard BDA contract. Just sign there, it's fine, kind of thing, and you sign across dotted line and then when something happens it's like well, it's there when you contract, what do you mean? And then you're having to refer back to it. It's there when you contract.
Speaker 2:I mean look the lesson there is that you can spend a lot of time trying to learn and understand the clauses before you sign it, or you can spend a lot longer after you signed it. Yeah, but once you've signed it, you've signed it and the courts don't care. They don't care whether you've agreed. What they care about is, you know, are the terms fair? Are they not fair? I mean, if you, if you put something that's very much against, let's say, public policy, then you can't enforce it. You know you can't contract out of, let's say, certain statutory rights or various things like that. But you do have to take ownership of this. You do have to be the one to really read through your contracts And if you don't understand it, get help. You know, for all the criticisms that the BDA has, they do have people who can help with these things.
Speaker 1:Yeah, i have by myself. when I was a BDA member for over 10 years I used that service and it was it was it did help And it does help having somebody check over up free feed and being able to verify different things and clauses. So obviously this sort of comes nicely onto the sort of final portion of this podcast which I wanted to to touch upon. I mean, was obviously the criticism there from the profession about the NHS contract. I suppose the BDA And there's obviously people advocating associates, advocating principles. I mean there's a lot of problems, there's a lot of issues, there's a lot of things to solve, there's a lot of positive things, there's a lot of negative things, there's a lot of things.
Speaker 1:But what I wanted to sort of because whenever I read your posts on social media I'm always interested in seeing what your opinion is and what you take is on a situation and why you think certain things It's always, it's always one that I always myself look out for because a lot of the time, as well as social media, everyone has their own way of responding and some people have their sarcastic way of responding to something that measured but more intelligent kind of way of thinking.
Speaker 1:So that resonates with me and that's something that I always want to sort of always like to think about and hopefully I can make a difference, through the coaching as well, to the profession and hopefully people can understand the benefits of it. And at some point, you know, it may be common practice for for dentists to have coaches that are helping dentists improve. So what I wanted to ask you was obviously the pandemic brought out a lot of things you know what's the word like, would we have out things at the closet and and sort of caused a lot of issues, so much so that organizations like the British Dental Action and Group was formed, i think the British Association of Private Dentistry or cosmetic dentistry reforms, but lots of different divisions and lots of different people with different agendas, because in essence they felt the BDA didn't support them throughout this situation and wanted to form their own organizations.
Speaker 2:And what I'm really like In part, but yes, a lot of people also had a lot of time on their hands and were scared with uncertainty. comes a degree of chaos and people always try to order that chaos, which isn't the right solution.
Speaker 1:What you want to do is try to lessen the chaos, not try to structure it in order, because you don't have the information to tell you, what resonated with me before we went live and air was what you said, was was and this is obviously my purpose really as well is is to hopefully have some kind of organization that's for the individual practitioner and doesn't have that bias towards NHS, doesn't have that bias towards private dentistry, doesn't have that bias towards associates and principals, but has that, that we just want to make things better for the profession and we want to make things better, a better culture where we're thriving, growing and sort of remove the toxicity in a way. And do you think there's a way that that can happen Or do you think it's just always going to be this, i suppose, divide and you know, obviously we've talked to yourself, i mean, i've been through it as well but there's this relationship but I'm hoping things are changing where this principle versus associate situation and when you want to leave somebody.
Speaker 2:There's a lot to unpack there. but look, toxicity isn't always bad. Sometimes they're out there grievances and they need to. they need to need to be able to have a forum or a place to vent and a place to advocate for their own, their own organizations or their own memberships or their own types of density that they're doing. Dentistry is a very diverse group, and I don't mean with you know, people of different colors and cultures, i mean we work in a very diverse way. you know, community dentists work very different to people in, let's say, high end aesthetic practices and everywhere in between And, as a result, i don't think it's really possible to have one group that's going to always be able to advocate for everyone And that's perfectly fine. We don't have to have one.
Speaker 1:I think it's more the culture, and I think that's the problem. I think it's fine to have different viewpoints and different opinions and different agendas and different championing different causes, shall we say, and I don't have an issue with that, and it's important that, as as intellectual people have debates on whether certain things are right or wrong and and things, and obviously we're looking for that leadership or we're looking for organizations to to think about those things or, and some are improving.
Speaker 2:But what's what's wrong with the culture? I mean, what, what bits are you?
Speaker 1:What I'm saying is I think obviously myself, there's an obviously, you know, there's the principle versus associate kind of culture that exists And I think you want to sort of change that because I feel like especially the parts are more intelligent, ones are changing their approach and realizing that I suppose investing or or helping your associate and empowering them will benefit the practice overall and finding ways or incentives to make things work together.
Speaker 1:But the thing what I what really has sort of highlighted throughout my own situation and throughout this whole situation, is the number of people, especially dentists, they've gone on to practice their own set of their own practices now And the ones that have experienced this situation, for example, especially when they're leaving a practice, and the implications that has and it becomes a very personal kind of situation, even though the person who wants to may want to leave was, you know, it might be career development there's genuine reason why everyone in any sector should be allowed to leave a job.
Speaker 1:What I'm saying is that these kind of situations always a lot of the time, especially if the associates valued or been there for a long time causes disputes And, like you mentioned this, lucy Williams, i'm pretty sure that there may have been an element of that in why this was. You know what I'm saying is this kind of culture is as big, was and probably is a bit too common. A bit too common, and we need to. What my job is to sort of almost try to get people to understand that it's not. We're not against each other. We should be for each other, and we are. We should try and help each other.
Speaker 2:We are. We are against each other to a degree because everyone's got competing interests and they're not always perfectly aligned, and that's unfortunately. When you're in a self employed scenario, you are your own business and you know. It isn't the case that you can very easily change human behavioural psychology very easily. Well, i'm not sure you can, i'm not sure it's possible. What you can do is you can try to advocate and fight for your rights and, and you know, if I find that sometimes people are in dispute with each other, i think it's absolutely abhorrent that, that they go and sometimes refer people to the GDC. But my view is slightly more complex on this, which is that I don't necessarily think I mean as much as I think it's abhorrent that they do that. I don't. I can't look at the individual who does that and say, oh, you should change.
Speaker 1:I don't think that that's what I'm trying to say is how do we promote good conduct amongst the profession? What I'm what I mean by that is is is quite clear even, even.
Speaker 1:and I know all these social media isn't the most accurate of places, but it's what's quite clear is that there's a lot of people who might you know, even some people who want to learn, and they might post about something. It might be something someone, someone else might think it's very simple, but then they'll respond to it in a very judgmental way. And what I'm saying is that let's take that example.
Speaker 2:Yeah, to a degree. Yes, sometimes people might post things in a very judgmental way, but you can't stop somebody who reads something and interprets it in that way, and that's one of the problems with social media. You're trying to convey very complex messages in a very short period of time in a very small space. So somebody very, very experienced might say, no, this is what you do. And somebody might say, oh, how dare you be so rude and tell me that way. I'm trying to learn. And then somebody might place you know, and you see these things all the time people will place an awful repair of some sort and everyone's like, wow, that's amazing. Clap, clap, clap. And you think is that really helping that person? Is that helping the patient? Is that judgmental? So what I would say is that the perception of conflict isn't always the same as the reality.
Speaker 2:What happens on social media? you know, in a lot of practices you have a lot of longstanding associates. You hear about a lot of the bad ones and, in my opinion, i think associates do need to stand up for themselves and advocate for themselves. They need to demonstrate value, they need to get involved with. You know, the relationship is a negotiation. It's a two-way relationship. If you're constantly looking for a principle to make things better for you, it's not going to work. Well, i mean, you're continuously re-looking. You know It depends on the practice. If you think that you can do better somewhere else, go somewhere else.
Speaker 2:But let's be honest, there's a lot of people who are doing very, very, very well in whatever system they're working in, and you know they don't often want to take the risks. They don't want to go on courses. They don't want to. As we were talking about earlier, paying for mentors and doing these things. Unfortunately, you have to invest in yourself. You have to. You know you have to invest in yourself. You have to go on courses. You have to do what you can to try and make the best scenario for yourself. You can't always look at other people and say how does that person change? Because they're not going to.
Speaker 1:Yeah, so basically the change that you want to see in essence.
Speaker 2:Yeah, i mean the change that you want to see and make yourself attractive to other potential practice owners. you know, I mean, when I look for an associate, if somebody comes in and they say, oh, I can do this and I can do that, I can do that facial aesthetics and this and the other, it won't work in my practice. So there's a place for people out there, but you have to be willing to put yourself out there and you have to be willing to take the risks.
Speaker 1:I just wanted to ask a final question. Sure, i mean, how do we deal with this? It's a long I know you probably say it's been ongoing, this for a long time but the recruitment crisis How do you see that, obviously a shortage of dental nurses as well as dental dentists, and especially NHS practices have struggled to fill their positions? Where do you see this in the future And how do you think it could be best managed?
Speaker 2:Again, there isn't a single answer. Every practice operates in a different environment, so my practice is predominantly private. We have a small list which is mostly with children, and a few patients are tax exempt. When you I was talking earlier about trying to understand I think I'm not sure if this was before we went live what we were talking about just trying to understand what people want and their reasons and their values and why they're doing what they're doing.
Speaker 2:Surprisingly, a lot of people don't want to work in a system that's very underfunded, with excessive targets. And when I say people, i'm not talking about dentists. I'm talking about nurses, hygienists, receptionists. Because we ask the question what do we need to do to make NHS work? I have no interest in trying to make NHS dentistry work. I'm interested in trying to make dentistry work because we're dentists. First, we're not NHS dentists or private dentists. We're dentists And within our profession we have a huge scope to practice the way that we want to. I think that's a privilege. You have to decide what type of dentistry you want to do. But the mistake that we sometimes make is we say, well, how do we make NHS dentistry work for the dentist? Well, actually is, how do we make it work for the team. There's a lot of work that needs to be done for nurses and for other people, and you have to make sure that they have a reason to want to work.
Speaker 2:Marcus Buckingford, who writes about leadership and recruitment over in the States, reported several things, which is that, whilst money is an important factor, there are several factors that really stop people from leaving, and one of them perhaps the top one is whether they get a chance to do something that they love or do something that they find meaningful and are good at what they do. So, essentially, the question is not how do we solve the recruitment crisis, but how do we make the system we're working in attractive for people to want to come and work in there. That's the fundamental starting point, and you have to ask yourself can you do that within NHS dentistry or in private dentistry? Can you do that? And I think what you have to do is you have to look at the various team members and find an average of that and say what type of dentistry do people want to do? Now, some people will really, really really want to do community dentistry, and that's great And there's a place for that, but the issue that we've been having with NHS dentistry has been going on for a very long time, which is that it's a budgeted system.
Speaker 2:The budget hasn't kept up with inflation. The budget for NHS dentistry has remained relatively static over the last decade. Patient charges have been increased almost exponentially. You may recall, prior to COVID there were successive years of 5% increases. Now that's very difficult because that's what patients are paying. So it means that patients are then increasingly finding themselves almost outpriced of NHS dentistry. But it also means that you as a practice and a practice owner do not have the ability to keep up with equipment and materials and things that will interest people.
Speaker 2:When I speak to a lot of younger dentists, i find that a lot of people are interested in things like digital dentistry and cameras and camera setups and all these things, and they all come at a cost. So there's absolutely nothing wrong with saying that I work for money or I work for this reason or I work for to serve my community. There's absolutely nothing wrong with that. But you have to find out what type of dentistry you're doing and how you make it attractive to other people. It is very difficult because a lot of NHS dentistry in particular let's be truthful about it has been carried out from people overseas. If you go to any dental practice, maybe half an hour outside of a main city, you may struggle to find people who are UK trained, don't you? And that's not me sounding discriminatory, it's just a fact. So a lot of people have gone back to Europe and a lot of people are not coming, and COVID has perhaps impacted on that or perhaps sped things up because the direction of travel was going in that direction anyway. But how you make it attractive to people?
Speaker 2:Now, as far as I'm concerned, for me personally, i need time to have a chat. I enjoy talking to my patients. I enjoy having teas and coffee breaks. My nurses do. I need fairly fancy toys because it keeps me interested And I'm not able to see lots and lots and lots of people? I was. I just struggle with that now because I always run late. So I need some breaks in the day so that I can do other things and run the practice and have a cup of tea with my nurse, and that could be just as important for her. Don't be foolish into thinking that your nurses come to work with you because they love dentistry. Nobody really loves, but it's odd to even say oh, i do this because I love tea. What a weird thing to say.
Speaker 1:Yeah, it's true. So any final thoughts that you want to give the viewers on this podcast. It's been really, really insightful and I really loved having you on.
Speaker 2:No, no, nothing really. Ok, yes, maybe, if you're a dental associate, don't try to be too nice. One of the problems that I see constantly is that there are so many people who are very, very high in empathy and try to help their patients. Don't try to be too nice. Be competent, you know. A good setup for you is you have to think about the factors that stimulate you and want you to work in dentistry right, not always bending over backwards for patients. It's a negotiation, it's a relationship. Good dentistry works when both you and your patients are trying to work together to get to the same goal. That's when good dentistry works.
Speaker 2:If you're putting yourself in awkward positions, leave. Don't do it. Stand up for your rights. You don't have to be. You don't have to be. What's the word forceful in that? Just be polite, but look after yourself. You are the most important person in your room, not your patients.
Speaker 2:I know that sounds awkward and controversial to say, but if you're having a bad day, that could affect your performance, and patients want competence. If you make a mistake, the risks are high. So look after yourself, and I say that for the staff as well. I mean you have to pay your staff well. You have to make sure that you understand that they just you know. Once you might want to see lots and lots of patients, they might not want to as well. So figure out a way of working that works for you both. You can't do this without them. They can't do this without you. So that's the only thing I would say. Don't constantly look for somebody else to try and help you or provide your answers. I used to be like that. I used to think, oh, you know, oh, i could do this better, or this is right or this is wrong. I think as you grow up, you become a bit more tempered in your view and things change a bit.
Speaker 1:Excellent, brilliant. Thank you so much for coming on this podcast Really really insightful And there's so many things that we can all learn from this And I just wanted to say thank you very much for coming on And thanks, guys, for watching and we'll see you next week for the next one. Take care, enjoy the rest of the week. Thanks, bye, bye.