The Associate that Bought an iTero (How to Make your Own Luck) – PDP062

Jaz’s Introduction:
Welcome, Protruserati to episode 62 of the Protrusive Dental Podcast. In this episode we’re going to explore some very big themes about as an associate, how can you make yourself indispensable to practice? And what we can learn from Dr Rosh Panju, who is a friend of mine, who is known for many reasons, good reasons but he bought an itero scanner. Now these things aren’t cheap. So what goes inside the mindset of an associate who goes out to buy his scanner versus the associate who refuses to even buy a flowable composite for example.

And the associates that are missing out on using the best techniques for their patients just because my principal won’t buy this for me and therefore they’re not living up to their true potential. They’re perhaps not doing the dentistry to the level they want to be and they’re blaming it on the materials that they don’t have because of the principal that won’t buy it for them but then guess what, sometimes you have to make your own luck.

So part of the Protrusive Dental Pearl I want to give you is A) make yourself indispensable to your dental team. If you’re an associate listening to this, how are you indispensable to your team? Do you help out with team training? Do you boost team morale? Are you really helpful in collecting reviews for your practice? Because nowadays we can’t be leeches but it works the same way as a principal, are you providing value for your associate?

So I think there should be a synergetic relationship between an associate principal and we’re going to cover some of those themes today in this episode. The second Protrusive Dental Pearl, oh my goodness you’re getting two is when I used to work between three different practices I found it really difficult, a real challenge to transport my camera, transport my loops, transport all the composite and stuff that I actually bought a lot of instruments over the years. How do I transport that around?

So I’m going to show you one way that I did it. I was using like this big black parrot box. It wasn’t actually parrot brand but I’m going to show you an example, there’ll probably be a video now playing in the background as I’m speaking here but essentially it’s a big box that you could buy heavy duty and you get these like cut out foam areas that you just have to sit down one day and do the hard work and design the measurements yourself. So that you can slot your camera in perfectly.

Because what you don’t want to do as an associate is have to dismantle your camera every time you’re moving from one practice the next practice and then reassemble the lens and the body and the flash every time you join a practice or have a barrier to taking photos or in the middle of treating a patient be like oh just one moment I have to go grab something and go find and troll through your bag to find that thing that you use between practices, it’s just not going to work.

So this is something that I bought some time ago. It’s been useful to me to transport my equipment between surgeries so I’m passing that on to you as an example. So I hope that helps some of you associates who are working between practices and thinking oh my goodness how can I transfer my equipment from practice to practice. So let’s join, let’s give our ears to Dr Rosh Pan or if you’re watching this on YouTube or Dentinal tubules welcome and I hope you enjoy this episode.

Rosh Panju, my friend, welcome to the Protrusive Dental Podcast, how are you?

[Rosh]
I’m good. Thanks very much. Thanks for having me. I feel like I’m a little bit like an imposter because I’m nothing like your other guest but-

[Jaz]
Don’t be silly, just like what you did you mentioned you messaged me some time ago because something interesting happened right? You told me for some years now you’ve been listening to the podcast and stuff and I really appreciate our engagements and our chats and stuff. But then you said that there was one episode you didn’t listen to because the title didn’t interest you right? Because it was the airway one right?

Because now that’s not important but then you listen to it and you’re like oh my god this is one of the best episodes I listened to. So I actually noticed this in my stats when I look at my stats. A lot of people who use this in the episodes have skipped that one but it was amazing to hear your feedback and this episode Rosh, today will be just like that. Because you think that ‘you don’t have a story’ but I’m telling you I’m going to extract a story out of you because I’ve really seen value in what your story is. So before we dive into that, tell the listeners a little bit just a little bit about yourself before we go into your history and why I think you’re such an awesome guy.

[Rosh]
Thank you. Basically, I graduated from Liverpool in 2012 and at the moment I’m living and working in Surrey. So I went to Liverpool as an international student and now I’m a dental associate at a number of practices.

[Jaz]
And you’re doing mostly implant work or restorative or?

[Rosh]
Yeah, I love anything surgical even from university. Actually in third, fourth year I loved extractions. I loved the surgical side of it. It was always something that I enjoyed. So at the moment I’m doing two days a week, general dentistry and then all the rest of the time I’m doing implants at a number of different practices. So at the moment I’m overall I’ve got seven jobs but only two of them are general dentistry.

[Jaz]
And you told me something crazy like you do work quite a lot of the days of the week right?

[Rosh]
Yeah and it can get confusing but I think we’ve got a system now. So I know like the first and third Mondays of the month I’m in one practice, the second and fourth time on other Thursdays are the same. So I do work hard and I think post covet for some reason. I’ve been working flat out for six months, no breaks, I get a few days off here and there but now I think towards Christmas we’ve got my indoors here, it’s nice to just take a break a little bit. So I’ve got a few days off coming up now in December.

[Jaz]
Well people who don’t know this I’m going to reveal it. I hope you don’t mind. It sucks that your in-laws are coming to you and I don’t mean that because they are in-laws. I’m sure in-laws are lovely but it sucks that they’re coming to you rather than you going to them because what you don’t know guys is that Rosh’s in-laws live in the Maldives right? So this Rosh visits the Maldives on an annual basis?

[Rosh]
Yeah I do, it’s a brilliant place. When I told my current principal that my in-laws are from the Maldives he just laughed and he said you can’t choose your parents but you can choose your in-laws.

[Jaz]
That’s a great way to put it. So I think that’s amazing but you know the fact that you go to such a beautiful country. I mean I went there for my honeymoon so that’s just amazing. I always remember the fact that when I first learned about you that always stuck to me. Hey Rosh, the guy who married the Maldives lady, who gets to go to Maldives every year so you absolutely smash that out of the park. So you’ve got a life management strategy all in place. I know that already but this episode is about some unique things that I think associate dentists can learn in particular from your story but also dentists who maybe are afraid to make the jump into private dentistry.

So why don’t you kick off with your story because you’re international student, you’re from Kenya, you did your BDS in Liverpool but because of some certain reasons you could not follow the traditional path of going straight and working for in the UK, it’s the NHS public sector but the you had to, you were forced to go private. So tell us a little backstory about that.

[Rosh]
Yeah so exactly like you said. I came here from Kenya and when you come here to study dentistry from Kenya in my you know my case in particular there was no way that I was going back. I think dentistry in Kenya is very at least in the place where I grew up in Mombasa, it’s just emergency dentistry generally speaking. So I knew that as soon as I came here I wanted to settle here. It was very interesting the first few years. The culture was so different for me. It was a little bit of a shock but eventually I think I adapted and now I’m very comfortable over here.

So when I graduated the VT was still covered as a student visa so I was quite lucky. But beyond that there’s only two visa options. One is either you work as a self-employed person but then you have to invest a couple of hundred thousand pounds in a business or you work as an employee but dentists are unique in that sense aren’t they? Because they’re self-employed without having to invest in a business. So there was no visa category for me. So I went into the hospital and I spent about two and a half three years doing the different rotations and-

[Jaz]
Was it surgical? Was it purely surgical or what kind of stuff were you doing?

[Rosh]
Six months were mixed, the other two and a half years were all surgical and I hated it literally. I remember I was working in the regional trauma center and the oncology center. My first job out of VT, I started on a Wednesday and I was on call on the weekend alone and literally after the ward round the consultant in fact the consultant doesn’t come on a Saturday. So registrar did the ward round with us he went home and two hours later I get a beep from the nurse patients had a carotid blow out on the bed and by the time I got there the bay was evacuated, all five liters of blood was on the floor and I’m just thinking what have I done you know I qualified to be a dentist. I’ve done dentistry. Day three on the job and this is what I’m dealing with and it was-

[Jaz]
The patient survived did he?

[Rosh]
No.

[Jaz]
Oh man that’s tough.

[Rosh]
It was yeah. And we had a few of those during the six months that I spent there but retrospectively. I think it’s the best thing I’ve ever done because now I mean everybody will come to a point in their career especially in their early career where things go wrong and I think it helps to put things in perspective. At the end of the day you do mess up, it is the truth. It’s not someone’s life and when things go wrong I just remember that actually that you know things could be a lot worse.

[Jaz]
I like how you said that because it gives you a different perspective, it appreciates that it’s just teeth okay it’s just teeth and it’s nice to have that and I always make this joke I don’t think i’ve made it on the podcast for so let’s do it now like no offense to any of the professions about to name here okay so hygienist right? Some great hygienists I work with see too much calculus in one place oh my god look at all that calculus right? Then the therapist might say oh my god this my composite has a flash lingually oh my god okay?

The dentist will say okay that’s no big deal my crowns have open contacts okay and then another specialty might be like oh my god oh my god worry about these things and then the maxillofacial surgeon was like none of this matters okay because as long as your maxilla is in the right place and everything, you’re breathing is it’s all okay so I think giving you that level of sort of perspective is important to have and a lot of people have done maxfacts I’ve shared that with me actually so it really makes you almost karma in when things go wrong in dentistry because if you get a bit of a bleed while you’re doing a crown fit like yes not ideal but it’s like okay there’s bigger things in this.

[Rosh]
Definitely 100% Yeah so I’m glad I did it and I know if I was British because in fourth year we will go to the oncology ward and stuff and I think if I grew up here and I didn’t have the issue of visas. I probably wouldn’t have done it and I would have lost out actually so I’m glad I did it and I’m glad that my path in a way took me there.

[Jaz]
Do you think that you would not be placing implants and being interested in surgical today was it not for your experiences that you had that you’re forced into?

[Rosh]
Yeah. 100%. So basically after my hospital job they basically went a maximum of three years because beyond that you either become a registrar and go on a training pathway or you go back into dentistry and give somebody else the opportunity to do that. So every year I have to renew my visa and when it comes to that point June-July time I’m like will I get a job? Will I not?


And you’re always a couple of months from being you know going back to Kenya and it’s quite stressful because my parents don’t have a home back home and everything they had they put into my education. It’s not cheap being an international student in the UK. So going home isn’t an option so you have to try. So when it came towards the end of my third DCT year, I was like what am I going to do and then my wife kept telling me why don’t you just apply to dental practices and see what happens? And I was like I know how it works, they can’t. They have to apply for a sponsorship license from the home office, but the home office isn’t giving them out. So I just didn’t do it and then she without telling me, went on to the home of this website and went there’s a list over there of almost a thousand businesses that have a tier two sponsorship license from the home office and she went through the whole list and she found seven dental practices that actually were sponsors and she wrote a cover letter and she took my CV and she just sent it to all seven of them.

[Jaz]
All behind your back?

[Rosh]
Yeah so towards the end she is when she told me ‘Rosh this is what I’ve done, I’ve sent it.’

[Jaz]
She’s a dream woman oh my god wow.

[Rosh]
Yeah so she sent it and then three responses came back and she was like ‘Rosh you’ve got three interviews’ and I was like wow this amazing. He was one of the practices that I got an interview at and the other two were remote. One was somewhere in King’s lane I think near Northridge and the third one was in west Wales in Naboth and that’s the one eventually that I got and we opted to go for. So we packed a bag from north west England and we went to a little village called Nabath and that’s where we spent three years and-

[Jaz]
Was this private or was this NHS?

[Rosh]
It was a private salary. So it was quite a low salary compared to what my colleagues were earning on the NHS. But actually I think salaries in the UK are very arbitrary because where we are now for example if you’re earning 70- 80 000 pounds it’s an okay living whereas in west wales what hours on 35 000 pounds a year you could live like a king out there. You could and the people are lovely, the nicest people I’ve ever met. We are 10 minutes from the beach and it was actually a good place and I would never have gotten that job if it wasn’t for my circumstances I think and we had a great time and I think that was just private, no NHS.

[Jaz]
How did you feel? Tap into the feelings that you had because I had and you must have listened to episode three when I talked about transitioning to private where I was feeling like the word you used was imposter right? And so I’m putting myself in your shoes, you’ve done purely maxfacts, you haven’t touched a diamond bur, you haven’t touched probably done any tooth dentistry, restorative dentistry in that while and your wife has just all done this amazing puller, pull a rabbit out of the bag trick and you’re moving now to Wales. Well you’re not having any anxieties about but not just private dentistry but just going back to dentistry again?

[Rosh]
Absolutely so absolutely you’re right because I did my VT, three years in hospital I haven’t touched a drill and now you’re going back first into dentistry and secondly, three years of not charging patients because hospital work is all free and then talking money to patients is a huge barrier. You’re almost apologetic about charging what you’re charging and I don’t think I was that bad but I just feel like sometimes I would tell the patient a crown is 500 pounds and you’re nervous but I think yeah it was definitely quite scary for me.

[Jaz]
You forget that don’t you? No one talks about that, you all talk about going from maxfacts to maybe dentistry and then thinking ‘hey the lack of dentistry and lack of experience recent experience and having anxieties about that’ but then also yeah you’re right about going back into a system where’s fee per item charging and how you get along that. So how have you because now we can just go down this little channel past, how do you think you can advise someone who’s in a similar place as you where they’re going to position where they have to now charge patients and they’re feeling the same things that you feel like ‘hey how am I how I’m going to do this effectively? How can you get out of the break of the shackles, break free of the shackles of discussing money with patients and any advice you can share?

[Rosh]
The first thing I would say is to believe that what you’re advising the patient is the right course of treatment for them because as long as you don’t believe it there is no way that they’re going to believe it and as to patients are not they can tell straight away whether you’re off or you have doubts about the treatment. So just believe in your plan yourself first and then the second thing is just you have to say it with confidence to the patient this is it you know there should be no doubt because there isn’t because what you’re doing is right? And then in the beginning what I would say is because in the beginning what happened to me is when I’m telling a patient the cost in my head the filling is 120 pounds and by the time it’s come out of my mouth it’s 95.

So what I started doing was just writing it down. It wasn’t computerized where I was and you have a little piece of paper with the cost fee and everything so write it down before I tell the patient to generally think about what the cost is according to the practice that you’re in. Put it down on the paper and then you know you can’t change it and then just be confident the patient needs this and if you actually don’t do it because it’s happened to me if if the patient doesn’t go ahead with the treatment plan they’ll come back for, if they don’t do a filling they’ll come back for an endo, if they don’t do a crown they’ll come back for an extraction.

So in my head I’m thinking I know selling is a bad word but I have to convince that patient but that actually they want to have this done for their own good and I think that telling them that you’re not going to change the price is the cost. It is what you’re doing you know for that patient and I think you just say it and I think the more you say it with confidence I think the more the patient believes they need it and I think that’s how I went about doing it. Do you have anything?

[Jaz]
Yes, no I 100% agree with you. I went through the same struggles yet it’s called the neuro fiscal drag. So from here to here you lose 30 40 pounds like just from just this direction from like that right? So I’ve totally been there man so I would to add on to what you said all the fantastic things the other thing is eye contact make sure you can look patient in the eye like so many people like I’ve seen they give a price and they’re like is because i’ve been in a consultation room is that can that be a thousand pounds and looking away that’s not good okay.

And also watch your voice tone so don’t go like high pitch because when you say high pitch it’s like you don’t get it or you’re not sure yourself but if you if you say something on a lower pitch and you say as it is like this could be 800 pounds and we will do this this and this it you know patients can sense it and it’s important and totally the biggest thing that you said I think is that if you do not provide this service for that patient which is totally the right treatment plan for them based on your expert opinion then the consequences will not be good, in terms of the outcomes and if the patient says I want to be able to choose steak and by not by not having this treatment with you they will not be able to meet their own goals then you’re deserving the patient. So I completely agree with you and it’s great that over the years you’ve overcome that in a way and you’ve shared your feelings about going back into private dentistry and that can be quite you know it drives anxiety.

[Rosh]
Yeah a hundred percent. I think with that job as well I think my principal was quite good. He mentored me well into talking about prices with patients and what he did in the beginning was he would do the checkups, make the treatment plans and then send them to me so it became a lot easier to get into that side of it. I didn’t have to in the first few months I didn’t have to. I mean this was you know six years ago and now it’s a bit different because I do feel a bit more confident in talking about these things to patients.

So the mentorship was great in that practice from everything from discussing just customer service management going from the NHS where they’re waiting in any for you for three hours to having that mindset of meeting them at the front desk and walking them in, walking them back out at the end of the appointment. It was good. I’m really glad I went into it.

[Jaz Interference]
Hey it’s just Jaz here again. Interfering with this episode to tell you that this episode is brought to you by makemeclear. MakeMeClear is my favorite tool to use when I’m presenting a treatment plan to a patient so anything that’s deemed as expensive dentistry, I will make a MakeMeClear treatment plan because they are beautiful, they’re really easy to understand and my patients find it really thorough but not overwhelming. So i’ve been using this for almost six months now and I’m loving the results I’m getting so if you want to check out MakeMeClear go on the website makemeclear.com Join me the 21 day free trial and if you like it use the code protrusive that’s p-r-o-t-r-u-s-I-v-e. protrusive. To get 25% of your plan just join the 21 day free trial and you will see for yourself why I love it so much so check out makemeclear.com to get on that straight away.

[Jaz] Back to Episode
Sounds like you gained a lot in that post and look you’re now an associate multiple practices and I just think we need to talk about this following thing like, on some of these Facebook dental groups you see people posting like ‘hey you know what, I would like to use air abrasion but my principal won’t buy it, are there any alternatives? What can I do? Should I use pumice or whatever you know fast forward two years later, oh yeah I’m still not using air abrasion yet my principal won’t buy it okay?’ Just go out and buy the air abrasion yourself right?

Just go about yourself and people think okay fine air abrasion 450 pounds 500 pounds maybe if you want to get the poshes one is three grand it’s the Aquacare for example no association’s going to do that some maybe do but you okay went out and you bought your own itero right? So I just want to let that sink in guys okay and I’m not saying that you know for you to show off in any way, Rosh nothing like that okay? I just really value your mindset.

Okay I really value mindset and I’ve been a big fan of buying my own stuff because what here’s what happens right? When you start buying your own stuff one of the reasons the principal might say no is because I think new principals, they want to keep their associates happy but they also want to run a business. And I think all principals have had the following happen to them: they buy something that the associate wants and then the associate doesn’t use it or it just doesn’t bring any value to the practice. It doesn’t add anything or anything like that and that is really disheartening right?

But then when you as an associate when you buy it yourself and you demonstrate to the principal ‘hey I’m using this daily and it’s actually improving my outcomes and there is an ROI’ even if it’s just like the perception of the quality that you’re giving then there’s no principal in the world worth their salt who when it comes to restocking or rebuying when something breaks to pay for the rest and then buy another one or whatever what do you think about that?

[Rosh]
A hundred percent, a hundred percent. The amount of times I’ve been to a practice where the- what the fanciest Endo kits sitting around doing nothing, why? Because the new associate doesn’t use this system, they use protaper and then they’ve had to buy them so absolutely it’s quite bad from a principal’s point of view to get everything and then by the time the associate leaves and that’s the other thing about my generation, we don’t stick to a job, we don’t see our failures and we’ve moved on in a couple of years and I think the principal sitting with expensive equipment doing nothing.

 Absolutely and I think the whole way this started was when I started doing implants I did my courses, my mentorships. I had a general dentistry position one day a week in a practice in hampshire and I could see the potential for implants and that’s why I bought my whole implant kit, my motor, my surgical kit, condenses sinus lifts everything the whole kit and within six months I made all the money back and by that point basically I was able to it’s one of the few places where I’m still getting 50% as an associate and I think that’s the reason for it because beyond that six months I’ve just made all that investment back and the principal has seen you know the value in it and I think I think that’s exactly spot on what you said.

[Jaz]
You need to think about Corey Ferran. I need to get Corey on the podcast. I’m a huge fan of his actually, one thing he says is that principal right? They have the fear inside them because they’ve got such a business to run at the end of the month they need to make sure that all the staff are paid right so and what he argues that associates we don’t have the fear alright?

And I agree with him sometimes we don’t because it is so easy for us to go home and you know we’d have to worry about if the nurses are sick so much as is a principal’s problem right? In a way and whether the practice is profitable or not as long as you’re associated you get your money on time you’re usually not moaning right? That’s how it is.

So it’s a different mentality but when you switch that around and you think like you did like you bought your kit you brought your own implant motor that kind of stuff had you not bought it you would never done the number of cases, had the clinical exposure, the experience, the income from that right? So I am totally with you, Rosh. I think that what you did is fantastic, you make your money back and then you grow as a clinician and you’re able to offer more of those services and I’m sure your principal respects you massively and should anything happen to your implant motor I have no doubt that you’re if you just have a proposition to your principal I’m sure they’d get it for you.

[Rosh]
100% and the other thing that you said actually about the fear that principals have in running a business, I 100% agree and I think that’s the one thing that associates sometimes we struggle with that we feel in our head that charging a certain amount to a patient is unethical but actually discounting that is unethical to the principal because at the end of the day if the principal’s business can’t survive then you’ve got lots of nurses, receptionists out of a job and the business shuts.

So you have an ethical duty to the principal to make sure that the practice is running for the sake of the thousands of patients registered with the practice but also the employees who survive based on that business running.

[Jaz]
Absolutely and I think if you look at the running costs per day of the surgeries and then you have to factor in all the other expenses then you when you give a discount right even if the discount is 20%, let’s say it’s a thousand pound treatment and you discount 200 pounds and now you get let that patient walk away and they like you more or whatever for 800 pounds. Maybe your personal bottom line may have suffered a little bit but as a practice that’s a huge loss because it’s something like some stat maybe you know it, maybe don’t but I remember listening to it somewhere where like if you discount by 20% this actually affects your final take home by like 50% or something like much greater than 20% because the fixed costs are still there.

[Rosh]
Exactly. 100%. And a lot of your patients wouldn’t actually appreciate it I think in the sense that associates will put a discount but sometimes they feel embarrassed to tell the patient they’ve actually given them a discount so the patient goes home not even knowing that they’ve had it discounted and you it’s not actually made a difference to that relationship at all.

[Jaz]
Amazing. So rule number one is don’t give a discount. Rule number two if you give a discount make sure the patient knows they have a discount right? So they can feel that special warmth that you know really you shouldn’t be discounting but if you do at least tell the damn patient that you’re going to discount so they can feel it as well otherwise what a massive waste. What a huge waste. So tell me how do you lug this itero around to multiple practices?

[Rosh]
So it was a huge decision whether I should buy the flex or the element 2. The flex is the laptop version much more portable and easier to carry around but actually you need a really good functioning laptop. If there’s any issues with the laptop you have to get another one. And it’s a bit slower. It doesn’t look as slick so I was really scratching my head over which one to get but I got element 2 in the end. It’s a lot bigger but it comes with a portable stand, so I’ve got a little suitcase with warm memory foam and all that and it’s not as difficult as I thought it just takes about maybe three or four minutes I’m packing it up, three and four minutes on you know unpacking and it’s quite easy so I’m taking a little suitcase so in my boot there’s implant kits that I lug around with me everywhere and there’s a huge itero suitcase so there’s no room for anything else there and it drives my wife crazy actually.

[Jaz]
Man, I’ve been through that man my wife was driven crazy by the boxes I’ve had I mean I remember in Singapore I had this massive silver box case and now i’ve got something that’s like a parrot but a cheaper version I don’t have it anymore now because I’m mostly at one practice now and then the other thing is I just keep it at practice but maybe as part of the pearl from this video any associates working in multiple practices and you’ve got loads of equipment I might just show you my setup so I might put that in there. Anything else you want to add about the itero or buying equipment before we move on to your MBA?

[Rosh]
Yeah, no I think the itero has been a great tool. It makes life easy. The patients love it and when I got it a few months ago my principal actually told one of his colleagues about it and I got offered a job based on that. So I’m two days a week I mean two days a month I go to this other practice and do a little bit of work for them there purely based on itero and I think it’s a little bit like patience sometimes when we ask for a 20 pound deposit for a patient to come in, it’s just getting that little bit of commitment to make sure that they’re committed to coming for their appointment and it’s a bit like that with the associate like I think the principal knows that this guy is committed to getting you know good quality dentistry done and I know he’ll be a good addition to the practice and I think that’s how I got that position and he made my books full, the new principal I’ve only been here you know a few times and he’s asking for more days but at the moment-

[Jaz]
You deserve that, Rosh. You deserve that because the reason you’re here today is because you know your mentality. People will be listening to this and a lot of people will just not get it, Rosh there are still people who listen to this and they just won’t get it they’ll be like no I still don’t get it how can associate by terror or why should an associate have to buy an itero these people just completely missing the point I’m sorry guys but you’re missing the point. What you done there is thinking a little bit differently to what you know what the norm where the principal should always provide everything for the associate but you’ve seen the benefit you reap the rewards already this led to another opportunity for you and you took it and you’re very happy there, you’re busy there so more power to you and I think there’s a lesson here for all associates, don’t be afraid to pull out your wallet buy something that you need or you want that’s going to elevate your dentistry take you to the next level gain you more experience and you will not regret it I think.

[Rosh]
Definitely 100% agreed..

[Jaz]
Tell me about your MBA. Oh my goodness, this is exciting. Tell me. I mean how do you squeeze it in? I mean this lovely wife of yours who’s done so much in your journey like do you even have time for her?

[Rosh]
Exactly I’m in trouble a lot of the time but honestly she’s so supportive it’s great it I am lucky in that sense I think but yeah the MBA so I think so growing up as an Asian in east Africa Gujarati I was quite embarrassed with my business skills because we were meant to be some of you know my dad was a was a great talker a great person at you know talking to people in that way and I think I just felt like it’s something that I’m not geared towards and it’s something we never learn in dentistry like you know it’s shocking that we don’t learn in dentistry I think there should definitely be some modules on business in there because even if you don’t want to practice just the running off of practice and some of those things are useful information says so that’s why I did it, that’s why I bought into the MBA and I think I’m a year into it so it’s six modules and a dissertation at the end so I’m module three is due now and I’ve learned so much it’s just amazing.

[Jaz]
So where is it? Which institution is this MBA with and how do you squeeze it? Is it online learning webinars? What is it? What’s the format?

[Rosh]
So the MBA so there’s two kinds of people, who do an MBA one is somebody who wants a very good managerial position afterwards and in that case the university does mention but the tuition fees are like 80, 90 grand so I’m one of the top places in London in fact I before joining my MBA I spoke to Nilesh because I think he did an MBA as well and I think he went to one of the top universities for me I just wanted the knowledge I’m not looking to go into it so I went for a cheaper online version. So it’s Arden university, they have I think they have campuses in Birmingham and one in London as well so that’s the university I’m with it was about twelve thousand pounds and I think so far actually it’s really good it’s really good learning the first three modules the things we’ve covered one of them was leadership styles so that’s great leadership styles I think there’s different types of leaders different things work with you know different people that you’re working with so that was something very relevant to us I think when-

[Jaz]
Can you give us one gem can you share from the two modules you’ve done? One maybe tangible damn gem that you think actually no this could be applied to dentistry and this tip will help dentists anything that you’ve come across so far yeah this is really valuable that might help dentists?

[Rosh]
Okay I’ll brush over one quickly please one was culture I think appreciating that we live in a global society and learning about different cultures is important when you’re talking to staff and different people but the bigger challenge for me I think was my current module I haven’t finished it yet but it’s on change management and I think change management, it’s just relevant right now because one of our, my colleagues in in my general dentistry practice where I’m working is retiring we’ve got a new colleague and I think the whole system is changing because the practice the way it’s been run, it’s been there from the 80s, all the staff have been there from the 80s. I didn’t change anything when I went there. I just came in and worked and the new associate is quite new and young and dynamic and we want to change and I think the way to do it is quite tricky. You can annoy a lot of people when you’re bringing changes to do anything in life and I think just you know how to just bring in you know two three changes at a time and get people on board with why you’re doing what you’re doing and make it their idea let them own it and do it themselves. So I think that’s working quite well. I think that’s the biggest one for me. Leadership as well I think it was a great module but I think this one I’m only saying it because maybe it’s not that important but it’s very relevant for me I think at the moment.

[Jaz]
I think change will always be met with I mean I’m sure they talked it will always be met with resistance like any time a new contract comes up right it’s that met with massive resistance right even though it may be better or worse whatever but it’s always met with resistance any type of change covered stuff is relevant and I’m going to give a shout out to my buddy Carm Jandu, who works in the in Glasgow right? He’s a dentist buddy of mine and I love what you said about making it their idea because it’s sort of something that I picked up from somewhere and I told Carm because I told Carm of my current working situation where I work in a practice where we work from 8 a.m till 2 p.m. like a shift pattern and then the next week I’ll work from 2 p.m. till 8 p.m. right and I love this it’s amazing for having a family life and the podcast for me is it’s just wow it allows me to do so much more outside of dentistry as well but then imagine you had to implement this in a in a practice right because this practice i’ve been working has been doing it for like 25 years or something so Carm loved the idea and and Carm was like how am I going to implement this I’m like it’s going to be really challenging you have to double the staff overnight you’re going to meet so much resistance and both we both concluded that hey come we need to do it in a team meeting where you need to sit down with your staff okay not in a manipulative kind of way but be like we want to make two bubbles or we want to make work more dynamic uh has anyone got any ideas and let them come up with it as a team and honestly he’s been loving it so that’s awesome man that’s so amazing you’re doing MBA man honestly it’s a massive respect to you I’m really excited to see what other things you learn maybe I’ll invite you back for part two so you can do an MBA in half an hour with Rosh Panju. that’d be pretty last question I want to tell you and then I opened the mic to you to any other input that you wanted to do is do you sometimes wish that going back to when you qualified that actually you weren’t an international student and then you followed the pathway that was more normal for a UK grad you sometimes think that or are you now thinking different?

[Rosh]
See I think that would have been an option I think a lot of people that come here the easiest route actually is to get a spousal visa and I was a rebel, I went and did my own thing so that was not an option so I think NHS dentistry I think the only thing that I missed when I because I didn’t do NHS dentistry was volume and I think it’s very good in the first couple of years you’ll do loads and loads and loads of stuff that in private dentistry you probably volume wise take maybe four or five years to cover it’s a good thing and a bad thing I guess. It’s a good thing because you learn fast I don’t know if you read this study once there was I think it was in Japan I’m not sure but what they did is they put two groups of people in different rooms and they told one group you have 12 hours and I need you to make 60 parts you’ve heard that one haven’t you know I haven’t I’m really fascinated go for it so they told the one group you have 12 hours I want you to make 60 pots, a clay pot in that 12 hour time and you’ve got to be quick because otherwise you wouldn’t make it and they told the other group of people you’ve got 12 hours and I want you to make just one part and it has to be perfect. It has to be spot-on everything should be great about it and by the end of it, the group that made 60 their 60th one was actually better than the other groups one part because they’ve been learning from their mistakes they’ve been doing so much of it but by the time they’re doing the last one that it was it was a lot better so I think that’s the one advantage within assist industry that you will do so much work that you will get really good really fast at general dentistry and I think you know when people are asking about courses and stuff in the beginning I think you know that’s one thing to bear in mind don’t quickly jump into just any course there’s maybe a few courses that are are useful like occlusion or communication but I wouldn’t jump straight into complex you know complex big courses like you know implants or ortho or anything like that just carry on doing really good general dentistry and then move from there I think so that’s the one thing I missed with nhs dentistry apart from that I think u I you know I would probably have been an nhs dentist if I had my British rights and everything but I think retrospective there’s no regret for sure 100% I’m really happy where I am now.

[Jaz]
I’m a huge fan of these stories about how adversity happens and this happens but then that leads you to the next path and because you went and did the max facts that you enjoyed surgery and then implants and then because of your mentality and your grit and your just the nature of the person you are, Rosh. You invested in itero which led you to the new job so it’s like the butterfly effect you know one thing leads to one small action in the past you know leads to these massive waves in the future so I’m a huge fan of believing that and I think for those listening from outside the UK, the NHS is like a a treadmill dentistry and I don’t mean to offend anyone over that but let’s face it you’re seeing a multiple factor of patients compared to in the private sector and is about volume and but the volume what Rosh was saying was that volume is a good thing sometimes when you’re a young dentist because it gets you working fast, it gets you to diagnose fast, it gets you to take lots of radiographs, lots of restorations lots of teeth, extractions whereas if you go fully into private and in a quiet list then how you’re going to get those failures, how are you going to get to making your 60th clay pot right which is amazingly I’m so glad you shared that story with me, not a story that study with me I guess I didn’t know about that but I love it love it for sharing that. Rosh that’s it, i’ve really enjoyed talking to you but have you got any final things you want to say?

[Rosh]
Okay maybe I think with associates I think obviously dentists you know we’re a small world we know each other well and I think it was on your podcast or maybe on another one where I heard somebody say the best associates are the ones that treat the principal business like their own and I think that’s quite important I think and that’s what I have noticed everywhere you just go in there you treat it like your own face you treat it like your own patients you know and I think that you’ll definitely get successful in that way not financially but just be a very fulfilled dentist because you’re going to work and you know the patients feel like they’re not in somebody in a corporate structure they feel like there is that personal touch the staff feel that you know the same thing like I know sometimes when reception is busy at the end of the appointment I’ll just go into soa book the patient’s next appointment and do everything myself before they go out so reception just has to take money and you know that’s it and I think that’s quite important if you can treat it like your own practice then I think you’ll do well in that practice the principal will appreciate you and I think it’s good for everybody.

[Jaz]
I totally agree with you if you see some rubbish by the you know on the driveway or practice pick it up know the name of your cleaner that comes every day to clean your practice okay? Know all the protocols for when things don’t go right so you can support your principal and I think I totally agree with you that’s only going to breed the right culture right it’s not going to be the right culture and I think from that people will to see how much you care and when you show the universe you care the universe will reward you in ways you can’t imagine so honestly I really enjoyed talking to you and I told you it’d be an awesome episode and you doubted yourself. So again thank you so much for coming on buddy.

[Rosh]
No brilliant thanks for having me. I look forward to you knowing your next podcast.

Jaz’s Outro:
Well there we have it, Rosh Panju, everyone thank you so much for joining me on this podcast it was really fun to record. He’s just a down to earth guy and I think he’s exemplary associate not just because he bought all that you know scanner and stuff you just listen to him and you think that he has something to give, he has some value to give to his practice that he works in and he cares for his staff he cares for his principal. So this is how we think we should model ourselves, be like Rosh. Thank you so much for listening all the way to the end. Check out the next episode with physiotherapist Krina Panchal, where we discuss tmj physio this will absolutely make a massive difference to your patient base if you’re seeing patients with tmd and of course if you haven’t already signed up for the launch offer for the splint course which I’m so excited to release. It’s taken years of hard work to actually put something together that covers everything from diagnosis to examination to which splint when which is the biggest most confusing thing that we have as dentists, how to know which splint is the most appropriate one for your patient. I broke it down and made a system out of it which I am so proud of now so check it out on splintcourse.com sign up for the update. When it launches I will let you know.