We promise you an insightful journey as we chat with world-renowned endodontist Dr. Sanj Bhanderi about his incredible life story, from his childhood in Kenya to his successful career in the UK. Discover how he overcame various challenges, including racial discrimination and personal setbacks, to become a highly respected dental professional.
Join us as we explore Dr. Bhanderi's experiences in dental education and training, from his intense studies at Guy's Hospital to his MSc in Endodontics in Manchester. Learn about the various pathways to endodontic training, the importance of investing in yourself, and how learning from mistakes can lead to success in your career. As we delve into the challenges of becoming a specialist referral in endodontics, you'll also gain valuable insights into the mindset of patients and the differences between specialty dentistry in the US and the UK.
In this deeply personal conversation, Dr. Bhanderi opens up about the lessons he's learned from life's challenges, his experiences of divorce and parenting, and the mentorship of the late Dr Mark Hunter that has shaped him as a professional. Don't miss this inspiring episode as we discuss the importance of stepping out of your comfort zone, seizing opportunities, and finding the right balance between work and personal life.
We promise you an insightful journey as we chat with world-renowned endodontist Dr. Sanj Bhanderi about his incredible life story, from his childhood in Kenya to his successful career in the UK. Discover how he overcame various challenges, including racial discrimination and personal setbacks, to become a highly respected dental professional.
Join us as we explore Dr. Bhanderi's experiences in dental education and training, from his intense studies at Guy's Hospital to his MSc in Endodontics in Manchester. Learn about the various pathways to endodontic training, the importance of investing in yourself, and how learning from mistakes can lead to success in your career. As we delve into the challenges of becoming a specialist referral in endodontics, you'll also gain valuable insights into the mindset of patients and the differences between specialty dentistry in the US and the UK.
In this deeply personal conversation, Dr. Bhanderi opens up about the lessons he's learned from life's challenges, his experiences of divorce and parenting, and the mentorship of the late Dr Mark Hunter that has shaped him as a professional. Don't miss this inspiring episode as we discuss the importance of stepping out of your comfort zone, seizing opportunities, and finding the right balance between work and personal life.
Hi everyone, welcome to episode three of series two of Diary of a Dental Coach podcast. In episode one we had Dr Amman Bharti. He set up specialist implant and cosmetic clinic in Leeds and he talked about how a significant event like his father passing away when he was seven is what really spurred him on. And you only realise this later on in life as to how he became successful. And his main take home advice was whenever you get enough opportunities, just say yes. just say yes because you can learn along the way. If you never explored that opportunity, you'll never gain anything from it and in fact, you might have lost that opportunity. So his mindset was just keep going and keep going. So it was a really, really exciting podcast.
Speaker 1:Last week we had Dr Neil Katari. He's quite well known. He's a journalist. He writes quite regularly. The thing that impressed me most about him was he was very balanced and very neutral. He doesn't actually have any bias towards any organisation. When I asked him and questioned him more about this, he said my job is just to inform the dental profession and explain things. So he was really really good at, for example, explaining the recent GDC case Williams against the GDC regarding top-up fees and NHS and his point was do we all understand the NHS regulations and how they work? and he made the point that we probably don't, and there's a lot of things in there that we don't fully understand. So it was a really, really insightful podcast and it was surrounding the NHS, dentistry as well as the GDC, as well as the recruitment crisis, and there was a lot to unpack when we talked last week. So this week we've got world-renowned endodontist Dr Sanj Bhandari. Welcome to the show.
Speaker 2:Thank you very much, Radessa. Thank you for the invitation.
Speaker 1:Thank you for joining. Like I said earlier, we only get the best on the show very, very well known, very well spoken about and everyone praises you as a specialist. So I thought we need to get you on the show.
Speaker 2:Thank you, I look forward to it.
Speaker 1:So we're just going to journey through your story, really. So tell us about so. You said that you came to the UK when you were two originally came from Kenya. Is that?
Speaker 2:right. Yeah, I was actually born in Nairobi, Kenya. I was one of the East African Asians that was a big bachelor and came in the early 70s. So my father's in insurance life insurance company big company in Kenya they moved to the UK. When Kenya became independent around 70, 71, they had the decision to make do they stay in Kenya, do they go back to India or did they come to the UK? They had British passports. They've been brought up my parents have been brought up British education system, O-levels, A-levels, which is the precursor to GCSEs. So it was natural to come to the UK, as many people did in that time, and they went to London, initially North London and then from there the last company moved to Wiltshire, Salisbury, a little city called Salisbury. So I kind of grew up to about the age of 11 in Salisbury, pretty remote, the only brown in the village, as they say It's interesting because our previous guest, alvin Barty, had quite a similar experience.
Speaker 1:He was in a village in Yorkshire and grew up in a sort of similar kind of thing. Do you think that was a good thing? how were you treated back then?
Speaker 2:In those days you can imagine the 70s. I don't know if that's in the age of the audience, but those days it was quite a national front and it was quite old fashioned. I suppose you can look at it And, yeah, being the only, it was good and bad. It was good in that I was kind of unique and a bit of a novelty. Looking back you wouldn't think of it like that, because it's not the right thing for people to think about being unique, but it was a novelty for them. So we were welcome. Generally it was quite friendly. But he obviously had the few kind of racist comments and the people, so would you say that was at school or, yeah, school, yeah, pretty much school, i think I think we did we're only saying to 11th by my father.
Speaker 2:I think the parents they did miss the social aspect and I think they were, as they were, old and working, i think they felt the discrimination more than we did as kids. definitely, i think kids are kind of oblivious to some of the stuff that goes on, although it was really nice schooling, memorable friends. but I think you did catch up with my parents and we eventually decided to move back to London where all the family?
Speaker 1:What age were you when you moved?
Speaker 2:11. So moved to Salisbury I was four years old and then there until about 11, so seven years and then moved back, moved to North West London with family and most of my family live in North West London around that area. So then moved to Stanmore and kind of did my major main high school schooling and sixth form and university eventually stayed in.
Speaker 1:London. Was that kind of a more mixed kind of culture, or was it?
Speaker 2:Yeah, you're back to more familiar territory. There's loads of Indians, our communities there. So it was very different bit of a culture shock for me because I'd grown up almost as a proper English, very traditional English. I went to a grammar school, briefly, Church of England school. Junior school went to a grammar school for a year or two. Very Christian upbringing, so I was brought up like a Church of England boy. It was pretty odd. That's what I think about it. So I was used to the way of life, which was good. I think it was a good education. I could appreciate that way of you know a different way of thinking So, were you always academically bright?
Speaker 1:was that natural for you, though I was average?
Speaker 2:I was never at the top of the class, even at university I wasn't. I was kind of. I know I'm quite self-aware I might have worked hard. I had to get tuition. My parents got tuition in, t tutors in for O levels, for A levels, and I did well. I worked hard.
Speaker 1:When was the decision to become a dentist? when did that happen? at what age? My last minute. How did that come about?
Speaker 2:It was completely by accident. So usual parents, asian parents, your dog to lawyer, that sort of thing. We had a couple of family friends who were dentists. So I thought I didn't want to do medicine because I knew it was a long haul and it just wasn't for me. That summer, before we had to apply for a university entry, that August, that summer went through about three different jobs. I worked for our family accountant, briefly, did a bit of bookkeeping, bored the hell out of me. I considered engineering, aeronautical engineering. Actually, maybe I'll become an astronaut or something. I thought now my physics and maths were not. Maths was good, my physics? I hated physics, so that's not going to happen. Chemistry was my favorite subject. I thought, okay, pharmacy, because that was quite a popular thing for eight Indian nations.
Speaker 1:So, and that's Did your parents influence your decision in any way? Did they try and push you in the direction?
Speaker 2:My dad's in insurance and pensions and my mum was a teacher but she ended up just doing kind of civil service department of health. So none of the professions traditional professions but the usual expectations to be going to something like that. So, I mean back then, when I spoke to Alan.
Speaker 1:He was sort of saying that obviously traditionally in Indian kind of culture the view of a dentist isn't that great. It's only in sort of more recent history where people see-.
Speaker 2:I think that's true. It's true. It was those days. There was a handful of Indian dentists and family. We had a couple of friends, so I looked at medicine, i was okay at chemistry, it kind of fitted in. But then family friends. I said, well, i had dentistry and I guess I hadn't thought about dentistry at all. So I went to watch them and I thought, okay, and it's raised me a short degree. It's five years. Okay, five years is a long degree compared to others, but I like medicine. It's not just five years of medicine. You then got to go through the hospital training and it goes on for God knows how long, whereas dentists you walk out. You're a dentist.
Speaker 1:I think that was exactly sort of one thing I thought about. My parents were sort of encouraging me to do medicine as well And at the time I probably naively thought you know what? dentistry sounds a lot easier. Just five years, you kind of do that, and then you do your one year's training and then that's it, you off, you go.
Speaker 1:And that was the sort of very simple and perhaps a very naive kind of mindset, because once you get into dentistry you realize that it obviously medicine. You come across a much more diverse group of people as well as you get to work in hospitals et cetera, come across different scenarios and it's a very much a team kind of environment And there's a lot of you as well. For example, in a medical year there's lots more students, whereas dentistry is relatively small year and then at the end of it, you know you end up a lot of the time working alone in a surgery And it just depends on who's around you. So sometimes it is kind of there's not a lot of thought that goes into it. You know, at the time you just use the information you have available with obviously even in my time we didn't really have that much internet of searching and researching and doing too much.
Speaker 2:It was just oh that sounds so good, the best. In those days there wasn't really much career going on. It's available. I think the main thing that was is the fact that it was the best of incorporated all sorts of skills obviously the science, the biology, chemistry, that was. I love that, but also the fact that it was constructive. You have to use your hands. It was creative, and having something with both of those together that's quite unique. I thought, well, this is quite good. Actually, It's not purely scientific, but it's not purely. You know, you're not just using your hands, it's everything, and it's got medicine in it end of the day, and so I think it was a good balance and it was a good choice. It by luck, purely by luck, wasn't by design. It was just by luck And no regrets, to be honest.
Speaker 1:So when you look back at your years at university, you look back at them fondly. How, what was?
Speaker 2:it. Yeah, we had it, we were lucky. I mean, i applied to, so it was a career. So we're going back to the choices. So at those days I don't know if that happens now, but we could apply, for those days there were polytechnics, there was universities, traditional red brick universities but also, as a backup, we could apply to what used to be called polytechnics, which are now called they've all changed the university now the modern university.
Speaker 2:So I applied for pharmacy as a backup, ironically and then also dentistry. I only got one offer for pharmacy because I think they knew they will never choose it. So I got one offer. I got offer from astrophysics oddly enough by one of the universities didn't do that And dentistry. I got offers for all four And I chose guys guys, which was Kings nowadays it's called Kings but I got a place at guys hospital and stayed in London, so not too far away from home, and I was lucky to stay. In fact, even though I lived in London parents in London I'm actually get halls for the first two years, so I actually lived out in town. So I had the best of both And we had an amazing year. Actually, looking back, our year, our batch qualified 93, so 89, 93, is a foot. That was the last of the four year course. Then it changed to five years just before it changed. So it's very intense, but was it?
Speaker 1:very practical, very sort of clinical based, because I think there's the argument nowadays, obviously, is that the students don't get that much clinical experience. Yeah, a lot of the emphasis on academic side and communication and things like that.
Speaker 2:Yeah, This is a really thing that the course is longer than it was for us, But you're getting less technical training, less patient experience, which is bizarre. I mean we can talk about the academic side of things because I had a foot in the academic for quite a while, so I know how that system works, But it was a really intense four years, worked hard, played hard. We're in the lab. In those days we had to make our own lab work.
Speaker 1:OK well.
Speaker 2:And we had to wax up. So this is a funny thing Nowadays, all the new graduates, they don't do that. They send their stuff in the hospital to a lab. The hospital. So you don't know what a crown looks like, how to make a crown, so you now go on composite courses to shape a composite We did that, in fact. Isn't that just a big thing for us? Or what a crown should look like, where the cuspable inclines are, and all this little thing. We did that. We made our own crowns, densha's, and we're in the lab until 9.
Speaker 1:So, in terms of volume, how much would you say Like how many crowns would you say you did? We had a lot of dental coaches, so this is something else that I don't agree with the new courses.
Speaker 2:Some people say it's old fashioned, But we had I think it was like 10 crowns we had to make. We had to make five removable, five partial, five full dentures And we had to construct most of those ourselves. We had to make the crowns ourselves. We had 15 endos to do. We had a certain composite quota, So the composites were not too much because it was amalgam in those days, But we had to do some composite. So the quotas, so you had a target to hit by the end of, otherwise it wouldn't sign you up for the finals. So some people stayed behind there to stay another six months And I think I still think that's. I think that the problem is you haven't got that And this is why some of the graduates coming out are struggling.
Speaker 1:So when you graduated, did you feel confident to go into practice and be able to do everything?
Speaker 2:Yeah, not everything, but yes, The only thing we didn't know is how the practice works. Okay, as in the business side of things, which I think maybe the guys nowadays, they introduced more of that, they introduced more soft skills, which is important. I guess We weren't taught that We were like clinical clinicians, That was it. There's no patient communication skills, nothing like that, No medical legal stuff. We kind of we had to learn that as we after qualified. But I think we were clinically competent. We're very clinically competent because we've done so many procedures.
Speaker 1:Yeah, experience obviously as well, and the more practice you do, the better you get, and it's better to fail in those kind of environments where you've got supervision and you've got that support structure around you, because obviously if anything does doesn't go to plan, you know you've got people around to help you fix it, whereas if you're alone as a dentist and something doesn't go to plan and then you're having to problem solve yourself, it's far more sort of challenging. So your decision obviously, when you sent your bio I was like within like four years of graduating, you decided to specialise. Yeah, was that something? did you already sort of have a bit of an inkling whilst you were an undergraduate that you were going to, or have the interest in, endodontics come about?
Speaker 2:So, again by accident, i was reasonably good at endo. We had really good training at guys in perio and endo Really good. You know we did as an undergrad I did periodontal surgery cases. We wouldn't dream of that nowadays. You do courses, post-grad courses, do that. I had experience of perio surgery, endo. We had some of the best teachers in the UK I was lucky just happened to be there People like Professor Tom Pitford who passed away, and we had some of the best part-time clinicians from Harley Street there. So we were very lucky. So I was pretty good at endo. I was confident and not good. I was confident.
Speaker 2:So what I did? after the foundation training in London, i did my foundation training in East London, which was an experience. Then I went straight up to Manchester. There's a few of us from guys who thought, well, let's get out of town, i've been in London for years. So we all went up to Manchester and did a SHO which is DCT2, i think they call it nowadays Did a year's job there And most of them came back. They went back to London and did a really good careers. I decided to stay at Manchester at the time. Manchester at that time was the only dental school outside London that was running at an MSc in Endo. They were also doing an MSc in implants, ironically, but I wouldn't have gone onto the implant MSc because they tended to take older people who have been in practice for 10 years plus.
Speaker 1:So at the time probably, implants weren't that widely available It was.
Speaker 2:I think it was the only course outside the Eastman postgraduate master's course in the Eastman, so it was really sought out. I mean, it was a new thing, implants were just coming into it. And then the other course was Endo. I knew I wanted to do some postgraduate, something formal. And again, right time, right place. I was lucky. I got on with a restorative consultant when I was an SHO And he said why don't you apply for the course? He was a supervisor, he ran the course. So I goes, i'm never going to get on. I mean, he just qualified, done my foundation training and there's no chance I'm going to do it. And one of the other teachers we're getting some nice teachers, people like you may or may not have heard, who sadly passed away a few months ago, mark Hunter, who's really? he was one of our mentors, our teachers there, supervisors, and he said go for Endo. And he obviously saw something. Both of them saw something in me. I applied and I got on. I was shocked So at the time.
Speaker 1:What would you say? were you always sort of confident in your abilities, confident in where you wanted to go?
Speaker 2:What kind of I knew, i think, a few things I knew on to. Just I didn't want to go back to London quickly Once I was in Manchester that time in the early in the it was mid 90s, no, no, it was yeah, mid 90s. Manchester was changing that socially and Musically and everything was changing. I was really a really good time to be this. I had a. I had a better student life doing my post-grad and as they chose, and I had in London, because London's quite a bit different. You were. You tend to be segregated with your own colleges, either with your guys, your Kings or your Royal London, but method entry you're at Sharon Cross. If you're a medic, you're isolated, but in Manchester everyone was together, the biggest is normally the opposite.
Speaker 1:People who are from London originally hate it up north because they think it's too sort of slow and different.
Speaker 2:But you know I die. I loved it, i embraced it, it just it was refreshing. So I thought I got to the MSc. I thought, great, i don't need to go back to London. I got another two years. I did a two-year part-time MSc and I worked in NHS practice up there just to fund it. Because funding myself, which gave me insight into NHS practice, which kind of then directed me away from NHS factor because I can't handle this, i'm not gonna be doing this.
Speaker 1:Because obviously my understanding back then was it was fee per item, it's fee price, and so so was that not really a good thing.
Speaker 2:Me off because I was doing the endo at the same time And I was doing an endo that I was doing ended on T's a proper way in hospital and doing that in practice Even though I was getting a little bit more than I suppose three UDAs would be comparatively. Still you can't. I mean, I only knew one way to do endo our hour and a half.
Speaker 2:You just drop a dam, and I did this and my lucky I was a good practice. That didn't stop me, they weren't restricting me, you know so and I bought my own equipment. Those days I bought an endodontic motor, which was unheard of back in 1995, you know, and, and those wasn't, it was all hand files and everything like that. So I bought my own equipment, my own motors.
Speaker 1:What? why do you think you fell in love with and and a? don't it? was it someone, some people who obviously you've mentioned, have the influence? Do you?
Speaker 2:why do you think the thing about endo is It's not glamorous, it's not the glamorous side of dentistry, but you're in control of everything. You are in control patient, as long as they're fitting well, there's there's very little outside factors that influence The success apart from what you do, whereas with crown and bridge work, with dent, prosthetics, prosthodontics, nowadays implants because definitely with cosmetic dentistry, there's so many other factors that could screw up. It is about how well you've done it. Yeah, you'll fail. Well, the patients is not happy, simple as that. I don't like it. But as endo, no one could say a word to you except your, maybe your peers or, if it doesn't work, the patients in pain. So it's quite simple in the concept. You are in control, you know what you have to do. There's only one objective, there's one or two ways of doing it, it's repetitive.
Speaker 1:So when you look back in your career at that moment in time, what do you, what lessons do you think you learn Throughout that? I mean, did you there any mistakes or anything that? what kind of things would you say you learn from a clinical perspective? You know perhaps, when perhaps things go because it was put especially early on. we kind of like keen and sometimes you know things can, cannot go to plan, what kind of yeah, you know, did you have any?
Speaker 2:Share about that. Yeah, i mean you do learn, i believe, real fun. Believe you learn by your mistakes. Okay, at that time I was working in hospital doing you the textbook way because I was doing a masters, and And then some next day I was in practice doing it the NHS Well, trying to do it in NHS circumstances, not getting paid for it. So you make mistakes in both. The good thing about hospitals you make it in the hospital, you're supervised and you're kind of protected, but you learn from it. In practice you're on your own. This became more apparent when I left NHS and I finished my masters. I went straight into referral practice pretty much immediately. So that was a hell of a jump and you make mistakes and I Think the key thing is to try and be has to be a little bit bulletproof.
Speaker 2:I think maybe nowadays is different. The medical equal climate is different. Now I get it. You know and I understand why young, young colleagues are there's kind of scared of because people make a complaint, but I think that some of its So it's manager is it's it's dealing with those mistakes, being honest about them, don't hide them, don't cover them and learn from them. Why did that happen? So you don't do it again. You've got to be reflective. This is reflections about every you know reflections really important. And some things don't work, some, sometimes teeth fail. You have to accept that.
Speaker 1:So in terms of like experience, i'm guessing back then when you did an MSc, you probably did quite again, quite a volume. A lot of the time nowadays again, when people do MSc's and things, they don't always get that full experience in terms of number of patients or clinical procedures. And then. So what I'm trying to ask is you know this, this idea of going straight into a Referral practice? how was that just a natural progression? Would you not wanted to start out, you know, working in a, perhaps? So did you set up your own practice, or was that? were you working on associate then?
Speaker 2:I was working loads of different places peripatetically. I was like so I think, in the hospital We had a lot. It was a very clinical MSc. It wasn't a, it was very clinical. We were. We spent at least 50% of the time on clinics seeing patients waiting us to big those days. So we had a good experience And I again, i'm a believer if you're going to do a post-grad, if you're going to spend the kind of money now costs to do a Masters course, for example, or you're into playing with it, definitely a masters course You need to be doing it in patients. I just don't see the point in doing An endo. I don't see the point in just doing preparing loads of plastic blocks. It's just why would you do that? you spend I don't know what's an MSc 10 grand a year nowadays. So two years, three years, msc's three years sometimes What? why would you do that In these?
Speaker 1:obviously, are looking What. What would you suggest? I mean, say they probably have an interest, perhaps like yourself, in endodontics, want to Get more experience, you know, and I think the climate, like you said, is very Different now because you're working, for example, in a particular practice where You know perhaps endos done the NHS way, etc. What and? but they've got a specialist interest or they want to specialize that, they want to do a specialised Are. They want to specialize that the thing with a lot, of, a lot of people that they end up wasting money on things that Didn't benefit them. So how would you advise them to make better decisions? because Obviously, everyone has a limited amount that they want to invest in themselves. One courses, how do you make right, the right decisions? I?
Speaker 2:think you need to choose a course that it depends on what level you want to pitch You're aiming for. Really, if you just gonna, you want to stay in general practice and just do a bit more endo, then short courses are ideal. Choose courses that are taught by experience and endontists of his endo. With implant people that do a lot of implants, there's no point Why, why you? why would you pay to be taught by someone who does Does a few of these things? one They're not gonna be competent. They may think they're competent and speak well and But you they've got to be clinically competent. So choose some of our courses run by. You know people do the job day in, day out. Second thing is If you want to do it full time, like proper referral endo, then do it properly. Don't do it half, which is expensive. It's an investment, time and money. I get that now the back.
Speaker 2:In my day There wasn't specialist training as such. There was only these mse's and there's only three places that did them. I was lucky in Manchester was one of them. The other two were in London, eastman and King at guys. So I was at the right time, right place and I did that course. Now you've got. There are formal training pathways In Liverpool and Eastman and Kings. So you've got to follow that path.
Speaker 2:If you want to do it and I said I would say to any young graduate, i've told some Mike Post guys who came through if you're gonna do it, do it now, before you get families, before you Get into the general practice thing. Definitely don't buy a practice. Once you do that, that's it. You're committed For five, at least five years, just to get it stabilized and then it's very difficult to go back. Do a formal post-grad training very difficult. So if you're gonna do it and you've got an idea it doesn't have to be endo, say it's, it could be also, it could be Crown and bridge work or cross the dot, anything. If you get an idea after your foundation training that much you like this And I'm pretty good at it Choose that and Run with it and do it properly. If you're gonna do it, do it properly. You're gonna do it once in your life and if you like doing that, you think you can do that day in, day out, then go with that and do the formal training.
Speaker 1:I think that's an interesting thing because obviously a lot of the time we Most dentists they graduate not really think about the future, think about where they want to go, what they want to do, and sometimes it can take many years before they realize actually what they want to do and what they want to specialize in.
Speaker 2:So And you've got it. If you're gonna do that, you need to be sure about what you want to do. I think nowadays it's interesting because in our day with there wasn't these training things and I was lucky, i happened to be good and I knew yours, and then I was offered a place. I was very lucky and then there wasn't anything else to do. Really, nowadays You've got career pathways To all tall levels. You can be an advanced general practitioner this course is to just say in general practice would be really good at that. You've got hospital pathways, nhs or academic pathways It's already set out or specialist Referral, part a, specialist levels so and everything's there really.
Speaker 1:So you're sportful choice actually academic sort of interest in and and the don't it, and how you obviously Became a lecturer and things that. Was that just a natural progression from enjoying, doing it, wanting to, yeah? I'll call those.
Speaker 2:I mean, some of it is again like slightly by chance. I want to finish my, my training specialist. My masters and There were no in Manchester, there was a one or two ended on tists, the full-time referral. So I started off doing a couple of days. I left general practice pretty quickly and then those other two days I stayed on as a part-time lecturer. I Kept my foot in both doors from day one.
Speaker 2:I think that was really important, actually the teaching Undergraduates initially and then working in referral practice, and that Balances your, your approach, i think. I think it's a really good way of doing things. And then eventually I, you know, i cut down from two and a half days to two days as my practice built up, as I was doing more private referral, i was working in loads of places. I was working in, one day in Manchester, another day in Liverpool. I used to come down to London once about the white Unimates for London, so they stayed down here. So I used to come and do endo for a couple of friends of mine on the weekend and And the challenges that came about when setting up a referral practice.
Speaker 1:Can you talk around that? because obviously some dentists will be like yourself that they might have specialized and wanting to then grow and and make it a perhaps a Specialist and become something like what, what you do, or what advice would you, would you give them?
Speaker 2:I think, initially a thing most when people finish a training, specialist training, whether it's perio, endo, it doesn't matter what it is You've got to build your name because your clients is different to general practice. General practice the clients are the customers, if you want to call it that, a patience off the street. For us Dentists, our clients, it's a different mindset. We have to engage with our colleagues. General practice you try and get public because you want to get patients off the street and into your business. But as a specialist and when he's, when you haven't got your own practice, which I started off, it took years for me to build that name. It's networking. It's going lecturing, doing BDA courses or LDC lectures and You've got to get out your comfort zone and you've got a.
Speaker 2:You know I'm not a natural speaker. I was really sure. I still am kind of shy. It's a bit weird. Especially, i'm okay, but you put me outside dentistry. I'm shy as anything, but you got to get. You've got to do these things to get your name known. And then, once you get your name, your reputation, reputation, obviously your quality of your work could be good. If it's crap, it'll get bad. There's a small world. It works both ways.
Speaker 1:If your work is not good, word will spread so I mean, it's also difficult for referring dentists as well, because sometimes they don't know the person they're referring to. Sometimes They just look at the experience. Sometimes Patients just want the cheapest specialist, for example, or and things like that, and I, like you said, it can be a Mind-fielder, and obviously everyone. Sometimes they want a local practice rather than to travel. There's there's lots of different factors And obviously everyone has their own and I think obviously you have your own specialist with special interest within in the dentics as well. So So there's different levels as well. So you know, you know, i think a lot of I suppose that maybe younger dentists who might be like yourself will be questioning whether a they can become a specialist referral, someone who they can refer to, and is it as as lucrative as as it as it sounds? and how do you? how do you know that you're gonna make Enough money in a way?
Speaker 2:I think the first thing is not to think of it that way.
Speaker 2:Okay money will come when you, when you choose a specialism, you're, you're, by definition, you. You become different to your colleagues. You've chosen a niche and some niches begin, the others. I would say. Endo still relative. It's getting bigger, more popular, but it's still quite a small niche compared to, i don't know, perio, prosedontics, all those quite big.
Speaker 2:So and that's why I chose actually as one of the reasons I did choose endo. So I knew there was an, especially in Manchester, in the Northwest, that in those days when I finished those two specialists, that was it. So I goes, that's why I didn't come back to London. So I'd rather be you know what's the term, not small fishing, a big pond, rather the other way around. So I knew there's plenty of work there and endo was people were starting. Mindsets of patients have changed. They wanted to save teeth, they wanted it, but then no one, no one could do a decent endo And implants weren't really that big in those days. So that wasn't an alternative. So I, that's one of the reasons I stayed in Manchester and chose endo as well. I See one of the things.
Speaker 1:Where I just wanted to check in with you was I do speak to American dentists and in America It's quite common for the general practitioner not to do any endodontics and to them refer to the specialist endodontics. And obviously the the climate and the way things are here is very, very different. You know, do you see that changing here in the UK? You see it is.
Speaker 2:Slowly. In America They're about 50 years ahead of us. They've had specialisms since the 50s. So the minds that they're trained to become general dentists after DDS, their doctor degree, and then a lot of them Go straight into specialisms all they stay in practice. So they already know that even patients know about endodontics. They know about it. So it's a completely different culture. So I think we're gonna be behind that. But it's getting that way.
Speaker 2:We're already seeing some I've got referring dentists that don't do endo period Private, not NHS private. They just don't do endo. They'll. They'll do all the other stuff but they won't touch and they'll. They'll send me everything And then they'll concentrate on the crown bridge video, whatever they're gonna do. So it's getting that already. Which is why I think You mentioned the different levels of endo. So you don't need to refer everything to specialists because some things are basic. So you've got what's called Special interest. There's kind of a mid tier or level two if it's NHS, if you've got an HS contract And there's there's. There's a lot of work there for everyone. For an endo, i think it's a really good specialist to get going to you, as long as you don't, if you reason, be competent at it And you want to develop it, then the money will come, because if there's no one else doing it, The way they get to go to the main.
Speaker 2:I don't think there's any place, friend, only an HS contract. I think it's just ridiculous to have it in there, so I wouldn't even bother doing it. And then going back to NHS practice and trying to work it. It just doesn't work, you just can't do it. Or you can do it But you're not gonna be paid for it. And then it becomes disheartening. You know you don't, you don't, you don't motivate to do it and it's it kills your Enthusiasm to do it. So you end up hasn't got a place in in the.
Speaker 2:In the current system It needs to be done independently And you can pay well doing it, if you think about it. Compared to other specialisms, endodontics you get paid by the patient. There's no lab fee involved. You do the treatment as long as you're efficient. The key thing about endo is which they don't train you even at post grad school. At grad school is Efficiency. You can get if you can make a fish in the endo one visit, not everything, but a lot of it. If you want to talk about money hourly rate, it's pretty fixed. You predict exactly what you're gonna earn and it's not bad. Okay, the profit margin may not be as big as maybe an implant I don't know implants or something, but it's consistent and It's predictable and if you're fishing it is pretty good. I think it's pretty good. It pays my bills anyway.
Speaker 1:Yeah, i mean, i was once talking to actually a colleague once about about this and I don't think he likes endos or his response was And sometimes it's not cost effective to refer a patient for endodontics, they'd rather have an implant. What are your thoughts on that? That's not a one-size-fits-all kind of you can't have it.
Speaker 2:That's in fact, that's actually unethical. It's not that debate We've had ten years ago implant versus and it ended. It's not that that's. If you approach it that way, you one day Medical legally you'll get, you'll catch you up because a lot of the complaints and a medical legal complaints And not because of endo per se They're the fact that when they go back to the records, why was that to be taken out in the first place? So the complaint might have been a fractured instrument or something.
Speaker 1:Yeah, yeah.
Speaker 2:Or also no, sorry at the implant complaint, for example. Maybe the implants failed for whatever reason, but then they'll go back to the notes and say, why is that to taken out in the first place? And if they see that tooth was restorable, you'll do you on that. So treatment planning is important. You can't use that argument, or it's not cost effective. That's really dodgy territory.
Speaker 1:If you still think, people still think like that, that's not, you know it's yeah, you know, of course of course That's very dangerous thing so obviously endodontics comes and I suppose a lot of areas in dentists comes with a lot of risks and a lot of litigation and and complaints, and obviously we live in that kind of era. Now How can obviously, as dentists, we minimize that and how can we make sure we're doing the best for our patients?
Speaker 2:I think if you're doing an endotic procedure In general practice, you need to know your, your own skill set. You need to know your confidence levels And some of it's you learn on courses, some of it's just from your experience in the practice and you stick to that. You stick to that. Unfortunately, back in my day we can get away with a little bit. We could push the boundaries a little bit and we might get away with it. But nowadays you've got to. you really do have to stick to it, because if you do get a complaint then you'll be questioned why did you do that and not refer it to someone who's more experienced, whether it's an interest especially an interest or a specialist? But so that's the first thing. And if you really like it, then you start doing advanced courses, then you start doing your post-grad training and then try and implement it as soon as you can.
Speaker 2:This goes back to the type of courses. Just don't do a course that gives you very little or no clinical experience, because you can't translate that into a patient easily. It's not that easy to do. So you need to be doing something that's clinical or get a mentor or watch people Go and watch. I get a lot of foundation density, young dentists coming to watch me work. It's something I learned even after the masters. I didn't learn completely, end up doing the masters. You learn it after by watching other endodontists in America. in London I used to go around whenever there's a conference I used to go and visit people endodontists who were doing it, and you pick up so much by watching people.
Speaker 1:So where does your motivation come from? Like, how do you keep yourself motivated? for us? Is this just a natural thing? You've just always had this really really big, interesting endodontics where you can't just keep yourself pressured and excited about teeth in a way.
Speaker 2:I think, yeah, it's not about the teeth, it's the fact that I'm saving the teeth, and I think when you've done something so often, frequently, and it's predictable and that just comes with time. I mean, why would you not do it? It's something that you know inside out and it's easy relatively easy And you know the outcome. that's what I was mentioning about Tendo. you can predict what's gonna happen And that's the best thing.
Speaker 1:I don't like So would you say your life became less stressful once you specialised because you could be in more control of the outcome, because you knew what you were, sort of where it was. Obviously, when you start diversifying And I think we sort of touched upon this before we went live, like you said, about the importance of being good and being good at something in particular and then if you regularly do it, you've kind of become an expert like yourself And then obviously you're no longer worried as much about the outcome of because you can do it reliably and predictably.
Speaker 2:For me. I suppose I'm a creature of habit and I like something that I know. I don't like unpredictability That might be a personality trait And I'm doing one thing I know what I'm gonna be doing and I can know I can do it pretty well and I know what's gonna happen. The outcome's gonna be reasonably predictable and good. That's why I think I like Endo and it's quite a specific discipline. There's very few variables in it, except you, and occasionally the case can be tricky.
Speaker 2:But you learn that and I think that's quite important in getting better and better. It's kind of like a snowball effect The more you do something, the better and better you get. And you'll get hiccups. You'll get some mistakes. You do I perforate, not as frequently, but I'll do something that doesn't work. But you learn from it. But you can only do that if you've done it enough times And I think the repetition and doing it's the old.
Speaker 2:I don't know if you've heard of Matthew Seid the bouncing. You gotta do thousands of hours at one specific thing And you don't have to be brilliant initially but you can learn the talent. You don't have to be born to good at Endo, but I think something you can acquire, anything. There's nothing to be Endo. It could be anything. The more hours you do it, the more cases you do. There's only one way of going. It's up. You will get better at it as long as you like doing it. And then there's other things you can do. So I was an associate for 11, 12 years and then I thought I need something different now. So that's where the practice came in. I thought, okay, right, let's look at the business aspect of things And then teaching. There's so many other avenues. If you get bored of practice, you can go into other things, and that's what I ended up doing once I got bored of being a full-time associate.
Speaker 1:So yeah, I just wanted to discuss a little bit about your personal life and things like that, Because obviously you've got two children. you were benching one, you were studying dentistry. One was economics. I think you said it in Cardiff And you said how things change for you personally. What kind of challenges have you faced in your life? what kind of things have you learnt throughout those challenges?
Speaker 2:Yeah, so I've got two sons, the twins, the Millennium babies, so the 22 now. They'll be 23 this year actually. So they had a pretty good lot bringing in munchers the born in munchers it's the main cuneans, which is quite funny. And they had a tricky teenage upbringing because we're unfortunately we're under divorced and they kind of spent half the time most of the time at the moment sometime with me. But they did really well. It was a really good school and good friends and got into uni. One did dentistry. I didn't persuade him either way, it's his choice. He's in Cardiff and the other one, the economics, also in Cardiff. He's gonna graduate next month, so he's finished his degree.
Speaker 1:So how did that change your perspective on life and the way you approach things?
Speaker 2:The divorce is a shock. So it's kind of very disruptive and a bit of a game changer really at that time. But also when you're bringing up teenage boys, trying to protect them, i was trying to protect them as much as I could from all the other stuff that goes on with that kind of process, which is always emotionally difficult. And I kind of used word maybe that is my way I use work as a kind of a focus to distract from the emotional aspect of it, which was quite tricky. So, yeah, you kind of change your outlook on everything family.
Speaker 1:Who, would he say, is your biggest influence on the way you think? who do you think helped you become successful along the way, obviously, become more renowned? I mean, obviously there are your teachers and things like that but is there anyone in your life that you think they really impacted me? They really sort of pushed me forward, helped me grow, both personally, professionally, and gave me life?
Speaker 2:One of the mentors was the mentor of Manchester, who's endontist as well. But he was more than an endontist, he was very holistic and real about life and philosophy. And Mark Hunt, who sadly passed away in January after a long battle against Lymphoma And he was it wasn't just an endontist, he was a mentor, he was a personal friend and outside dentistry in Endo he was just very humble, solid family man and he was a very good philosopher as well, a musician. So I learned a lot of stuff outside Endo from him. I had to maybe step back and reconsider the way you react, being less reactive maybe.
Speaker 1:Can you? give us a bit more insight into, like, for example, what kind of philosophy, what kind of things did you learn from him? Is it perhaps maybe not taking life too seriously, maybe, like you said, changing how you react to negative things that happen in your life? what kind of things would you say? Philosophy was that?
Speaker 2:these are only teeth, end of the day. They're not the end of the world that you can be so in great, so caught up in. We are a branch of medicine, but it's not life. People aren't gonna die. Majority of cases. They're not gonna die if you do something wrong. So you gotta put it into perspective.
Speaker 2:In terms of outside of that, we're lucky to be in a position. We're in a privileged position in the way that we can say in Endo specifically Endo not just in dentistry as well we look after people's health indirectly through we influence how they look after their teeth. But as Endo specifically, i look at myself as a gatekeeper of a tooth, because we make a decision whether the tooth is saved or not. If we can't do it, the tooth usually has to go or something goes wrong. So the stakes are high. Our responsibility is quite important. So, but the end of the day, but in perspective, it's the tooth. It's important for the patient. We do our best, but if it doesn't work, it doesn't work. You just gotta learn from, look at why it hasn't worked and move on and hopefully it won't happen again. It's very calming as well. It's just very calming, very reassuring and, yeah, it was very inspirational. It was very sad to have to have lost when he passed away.
Speaker 1:We're a family. Your parents, siblings did they have any influence on you in the way you, in terms of yeah, i mean my father, my mom, yeah, both my parents.
Speaker 2:Obviously they brought me up. My dad was very disciplinarian. I think I got my ethos about working hard because I wasn't talented. I was never the top of the class at school. I was mid-range, always mid-range, even at dental school. I was nothing outstanding. I never won any prizes. But I think one thing I probably got is if there's an opportunity, i'll take it, i'll look at it, i'll run with it, as long as it's not ridiculous. I'm not a risk taker, particularly. But if I see a career opportunity or something that I think there's something in this, i'll put the foot in the door and see what happens. So I think that's important not to close doors. Just open them, have a look and it could be something. There could be something there. I think that's something important which I think is getting lost with the younger colleagues. They're getting a little bit too scared or they don't want to go out in the comfort zone. Maybe not explore something different in dentistry.
Speaker 1:I think, something that obviously you feel passionate about and again we talked about it earlier about teaching children, teaching the baby dentists, we say, or people that are newly graduates and holding their hand. But I think obviously the thing that I suppose in their defence what they'd say was there's a huge difference between when you graduated or when they graduated and the clinical experience, which again puts them at a disadvantage because they've not had that and then they've had to go out alone and try and make it. And then, secondly, perhaps increased medical legal litigation, things like that, and perhaps now as well, which we all now feeling the social media pressure as well, of needing to perform and needing to be at a certain level. And I suppose that would be the argument. And just if you could shed some light on why you feel passionate about these issues and what things you'd like to do to help the younger generation.
Speaker 2:I think the first thing is in terms of expectations. I mean social media. So it does a lot of good, but I think it's done a lot of bad. And I think you have to be strong, the younger graduates. They've got to have some self, their own self-confidence in knowing what's right and what's wrong and what's appropriate for them and what's appropriate for other people, and not get sucked into this. What a mindset of.
Speaker 2:I don't know whether it's cosmetic dentistry, what I don't understand. Again, it might be because I'm old. All the photos if you're showing photos of pre and post, they tend to be smile makers and things like that. I don't see the difference between they. All look the same to me. And also, it's not the dentist's, except for composite, maybe, anything that's lab-based lab-work. They haven't made that. A lab technician's made all that. Now I know they talk about smile design and this and this, but you know, okay, but it's all much of the sameness to me. That's as. Maybe I'm an end-dontist, i don't see it. But not to get sucked up into that. If you want to get into that, fine, and there's plenty of amazing people who do that and teach that. You know. In terms of composite, even I've gone on a composite course people like Monik and the sound and that and they're amazing. These guys are technically brilliant.
Speaker 2:So to choose, there's plenty of choice. Choose someone that's got the experience, who does it day in, day out and learn from them. But after you've done the course, go and ask can I watch you? Like I said, i get student foundation dentist. You'll all come and watch me And you know most of them are pretty approachable. I would thought the thing they're quite approachable. So if you like a particular area in dentistry, go and watch someone after you've done a bit of course with them or something. Do that and that'll get your confidence And you'll realize that they're normal people. They'll make mistakes as well, but the key thing is how they handle those mistakes.
Speaker 2:So when we get into medical legal territory, don't fob their patience off. Don't hide things and just have confidence in yourself. Don't think what's gonna happen, Don't be positive And if you know, if you do a good job, in most cases it'll work and patients will be happy. They're not all patients are all potential complainants. You know. The majority is still, you know, reasonable. It's just treat patients with respect, colleagues with respect and treat yourself with respect. You were one of the top 1% of the population. You know, academically, wish it hot. Technically we were one of the best, so just have that confidence and run with it. That's what I would say.
Speaker 1:And in terms of like mentorship or mentoring kind of culture. What's your advice on that? How do you find the right mentor? And it's a word that is being talked about a lot. Yeah, it's how do you do that?
Speaker 2:I think in the implant guys have got this sorted. So a lot of the implant courses they follow up with the mentorship, which is really good. And then there's something I'm thinking about doing. But, as I've mentioned, if you do a composite course or you do a ceramic course or something, ask a local, someone who's got a good reputation. Would you mind if I watch you or watch your workflow, because nowadays everything's digital, so workflows are quite important things, not just about one aspect of it. You've got to learn how to do from start to finish the communication, the treatment planning, the smile design, the scanning and all that, and then go to the lab So watch the process in action, which you can't get on a two day course.
Speaker 2:So I think and there's plenty of people that I'm sure will be happy to do that I think that's important In terms of having one more mentorship. That's it depends on the prefer on implants. Yes, you need it, endo maybe. I don't think you necessarily need that for ceramic work or that sort of thing really, and it gets quite expensive as well. So it's a balance really. I think there are enough people, really good people, in our profession that are willing to share their experience.
Speaker 1:Just wanted to touch on because, as mentioning about the recent health problems that you had just wondered, obviously because shed some light in terms of how that happened and how you feel, and whether that's changed you in any way.
Speaker 2:So in October I had a stroke. I had a clot and a bleed and just out of the blue, completely I was at. Luckily I was at work at the end of the day and I kind of collapsed And the dental team with my girls' staff are amazing And went straight to our hospital. So I was in the coma for about 10 days And luckily I got through it eventually. I was off for three months but no, that was aware of no permanent disability, if you like. The coordination's fine speech was okay, eyesight was okay. So that was a bit of a life-changing experience. What I remember a bit And it kind of puts things in perspective. Really what's important is it worth working your ass off five days a week? So I had that. That was in October. Then I went back to work Do?
Speaker 1:you think the health might do you think it might be related to the dentist?
Speaker 2:Not directly, i think it's Or lifestyle or do you think stress related?
Speaker 2:Yeah, it's probably stress related, because I'm otherwise medically reasonably fit. This is where even the doctors don't know what's caused it, but I believe it's gotta be a component of stress, because it's been quite a difficult few years of running up to that point with the divorce and the kids trying to get the kids sorted. So I think that had a major impact. And there's something that you can't measure, they can't test. This is the problem. There's no blood test for stress. But I think it accumulates inside And I'm convinced it was related to stress. And I went back to work briefly down another stroke, but not as severe. I felt it and I went to A&E myself and it was a completely different part of the brain. So I mean, i'm now medically, i'm on medicaid, lifelong medication for that And I've slowed down. I've gone back to work now, but I've gone back to work only three days a week from being full time, which was a bit odd, but I've actually got used to it now. So I can't imagine going doing anymore now.
Speaker 2:I'm lucky I've got a really good associate, rob Jacobs, who was one of my post-graduates in Liverpool and he's taken up the position now So he sort of covers me. So I've got someone behind me and they've got an amazing team as well. All the girls have been with me. For two of them, which has started up my business with me 14 years ago, they're still with me My PA, matisse and Simone, the nurse, and I've got more girls have joined and they've been really strong. Actually, they've kept the business afloat. It would have gone down while I was off. So I'm lucky. I've got good people behind me around me. So from down to three days, and that's enough, i think three days a week.
Speaker 1:So there's a couple of questions before we finish off that maybe perhaps a couple of dark questions. So say, if you were on your deathbed, what three pieces of advice would you give your loved ones?
Speaker 2:Do those things that you were hesitant about doing. Just do them. You don't want to have any regrets when you're too old or on your deathbed, so just go for it. What have you got to lose?
Speaker 1:Just go for it.
Speaker 2:As long as it doesn't hurt anybody, just go for it.
Speaker 1:And the final question before we finish off was what does the future hold for you? What do you hope to achieve in the next few years before, perhaps, you retire? What are your aims and goals, both professionally and personally?
Speaker 2:I think because of the health issues the stroke I think I probably want to get out of the practice. Running the practice sooner than I thought Bit early, i'm still not that old. I won't give up clinical dentistry. I'll keep on doing the endo as an associate. I can't see myself never do it. Well, i can do it when nothing else happens to me. I'm a clinician. I teach but I'm a clinician. I'll never give that up. So I'll carry on doing that for a few years. But I think just my priorities have changed. I think better work-life balance and probably relinquishing the business I think sooner than I thought I would But carry on working as an endontist. I'm going to be doing more teaching privately and with the university, at UCLan next year We're examining at the moment anyway, so I'll be doing more stuff with them.
Speaker 1:So yeah, so what motivates you? What things do you buzz off doing a great endo? What is it that gives you that satisfaction, that you know what I'm happy and pleased with myself for doing this? Is there anything in life, or perhaps?
Speaker 2:The basic thing of that final x-ray, that final off-turation. This still gives me a buzz.
Speaker 2:I think what else I love? teaching and post-grad teaching now and seeing the young going back to undergrad. When I first started teaching in Manchester I did undergrad teaching. Now all those students they're all mature, they're families, they're doing really what you bump into them out of the blue you think fly me done really well And you add a little tiny piece of part of that journey for them, which is really satisfying. And now with the post-grad, seeing them do well, you know, seeing them being specialists and kind of doing what I did 15, 20 years ago, that's very satisfying, seeing that I was part of that journey with them. So I'll always do that. I'll always keep a teaching component to my life.
Speaker 1:And in terms of the profession, are you involved with the organisation like the BDA, things like that. So I'm involved in dental politics at all. Is that something you're interested in or not really?
Speaker 2:Not at this age. I was on the British Ended Ontic Council for 12 years and I was president over the COVID. I was a COVID president for two years, so I had two years. Normally it's a one year post. I was there for two years and I was quite proud of that.
Speaker 2:The British Ended Ontic Society. I tried to make a change. It's a progressive society and the two presidents that came after me and Alan, now that it's a really good society. There's a view into Endo. There's something I would encourage you to join. It's a very progressive, very mixed. It's not a specialist society as such. There's loads of general dentists in there that just have an interest in Endo.
Speaker 2:In terms of politics. That's as far as I've got in terms of politics. Really, i've been involved with the European Society of Endo as well for a while. I might get into it in the future, maybe something I try not to do too much politics because even the universities I try and stay out of that. It's a different ethos, mental state. You learn about people in different sectors of dentistry. The mindset is very different and sometimes you just can't change that. So you learn not to as much as you want to change things. Some of the identity you can. Sometimes you have to accept there's just parallel tracks in that profession. Sometimes they'll change, but I think sometimes you just can't do it. Everyone's different, as I say.
Speaker 1:So any lasting thoughts or anything you want to finish off with?
Speaker 2:No, just in terms of the up and coming. My colleagues, as soon as you can, if you find out what you like and what you're pretty good at, and run with that, whether it's clinical dentistry, you might be academia, maybe research, if you really don't like clinical. But choose something as early as you can and follow that career pathway as soon as you can, before you start getting established, before you get a family, before you get into the business, because then it becomes very difficult and you'll regret thinking maybe I should have done this. If you know, at an early stage, run with it, Just invest those three or four years of training, which will be difficult, but once you've done it it'll all pay back very quickly and then you're on the right path and then it's pretty much it's almost an autopilot. After that It's choosing by the early.
Speaker 1:That's great advice. Thanks for watching, guys. That was a really, really insightful podcast. Thank you, dr Sanj. I will see you for the next one next week. Take care, guys. Thanks for watching. Thanks Bye.