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Case Acceptance in Smile Design with Dr Gurs Sehmi – PDP035

Case Acceptance – sounds dirty doesn’t it?

Well its kind of important.

We can make a huge difference to the lives of our patients and do more of the Dentistry we love to do. But only if your patient sees value in your treatment plan and believes you are the right Dentist with the right solutions.

I spoke with Dr Gurs Sehmi who shared all his secrets! (I kind of forced it out of him!)

The protrusive dental pearl for the episode is a video I shared on Protrusive Dental Community (FB page) using a Endodontic tool to squirt peroxide gel deep in to the access cavity to treat an internal bleaching case (see images below!):

Before internal bleaching. UR1 sustained trauma – it was root filled with an MTA plug and GP by my Endodontist, Dr Cesar Munoz
After internal bleaching. What a difference!

Unfortunately no Video podcast for this episode (technical error on my part!) but for anyone inspired by Dr Gurs Sehmi’s protocols, do check out what he has to share:

Here is the link to register for the mentoring program: https://accelerator.dentalnotebox.com/

This is a link where people can sign up for live cases https://dr-gurs-sehmi.lpages.co/live-case-stream

The Dental Notebox Instagram/ FB link is: https://www.instagram.com/dentalnotebox/

https://www.facebook.com/DentalNoteBox/

If you like this episode, you will love Communication gems with Dr Zak Kara!

Transcript:

Jaz Gulati 0:29
Welcome to the protrusive Dental podcast.

Gurs Sehmi 0:32
Jaz. Nice to meet you. Thank you for inviting me.

Jaz Gulati 0:35
It’s finally good to have you on – I remember meeting you a few years ago at a charity event. It was a BSDO charity event. And even before then I knew about your online presence. But even since then, I have seen some really amazing video content that you’ve produced and you’re a very good educator in the video content and recently, you came to mind when people were asking me, ‘Jaz, do you you know any resources or where I can learn digital dental photography, and your teachable course came to mind straightaway and I shared that. And that’s why I reached out to you – some amazing content that you produce.

Gurs Sehmi 1:13
Cool. Thank you. I’m glad you like it.

Jaz Gulati 1:18
Tell the listeners a little bit and people now who are watching on YouTube, tell them a little bit about yourself, where you practice what kind of work you do.

Gurs Sehmi 1:27
Sure, okay, so we’re a little bit specialist. I work with Rahul Doshi who a lot of people will probably know he owns The Perfect Smile – I’ve been working there for the last 10 years or so. Recently, in the last three to six months, I’ve started just doing a little bit and just opened up a little bit closer to home. And when we do the more complex cosmetic kinda treatments that’s that’s really how we’re we’re pretty focused on completely, but people who are looking for a really robust, comprehensive solution. Those are the kind of people who we who we kind of attract and, and those are the guys who we normally treat as well. So typically larger cases as well.

Jaz Gulati 2:18
Well, what comes to mind and the reason I, the ‘mission’ I’ve given you today is the case acceptance because you could have all the knowledge up here, and you can have all the great hand skills, but until you can get the patient to be on board with the plan and have the same sort of expectation, same sort of vision, you’re not going to get happy patient and you’re not going to get to do the dentistry that you want to do. So the first thing I’m gonna ask you straight away off the bat is describe a little bit about what you’ve created now in our last 10 years working there. You’ve set something up now so congratulations with that. But what is your ideal patient journey and how does that feed into ultimately getting to the type of Dentistry that you want to do.

Gurs Sehmi 3:04
Yeah, sure. Okay, so that’s like a super complicated question right? With so many different aspects. So let’s, let’s kind of take it break it down. You did you mentioned getting the patient on board – this is 90% of the full proccess of what we do is giving the ownership of the treatment plan to the patient. Now, in addition to your you’re absolutely right in that most dentists, right, there’s not a lack of knowledge or lack of courses out there, right? Everyone, well, if you start going on courses on occlusion courses, you know what CR is you know what CO is, you know how to prep a veneer, a crown / onlay – you know all this stuff: Ortho, you know, implants…. all this knowledge is out there – Dentists HAVE the knowledge, but it’s getting the patients to say ‘Yes’ to a comprehensive treatment plan, which typically where we work can range from anywhere from, you know, £10,000 to £30,000. And you need to also have the confidence in your own skills that you know how to do this, because when you go to all these courses, all you get is theoretical knowledge, really. I mean, a lot of you guys probably know, Prem Sehmi and sometimes I speak to him and I’m like, dude, you know, you run all these courses like veneer, prep courses and everything and people get to try out a veneer prep. But the models you guys try out on there all that best case scenario, these guys, the models don’t need veneers. They’ve already got a perfect smile. So you’re learning to do preps on perfect teeth. You know, things like this. It’s not real life is when you start taking that theoretical knowledge, putting it into real life. And honestly, you make mistakes as well, and learning from the mistakes and it’s only through physical practice. Do you actually get better and better you know, so I mean, the the whole process, it starts from the marketing, your online presence. Okay? So you have to, you have to have the guts to be polarizing online. So what I mean by that is, you have to be honest with your own voice, right? And say, look, I’m really good at treating this kind of situation. Okay, so whether whether it’s like, I know All-On-4 or something, let’s say you just pick one. And then you’ll become like, a million times more attractive to that kind of customer who’s thinking about All-On-4 because you’re the person to see for that treatment, you know, so there’s a whole bunch of people doing this here, align beach and bond. I’ve got no interest in that. So you’ll never see me talking about that kind of stuff, which is fine because the all-on-four guys don’t want to know about align bleaching bond. So, number one is position yourself in the market to attract the kind of patient who you want to attract. Then when that patient comes in, there’s there’s like a two hour process two to three hour process that we go through. from, you know, it starts with information gathering, you know, find out what the patient wants, find out emotional triggers, present the treatment planning session, we carry out the whole consultation in certain way, and, and then ultimately get a case acceptance. Okay, so it’s very different…

Jaz Gulati 6:29
I am just going interject for a moment. So you talked about having that correct online presence to essentially target the right type of patient for the right type of care that you want to deliver. And I think you really beautifully described that and to position yourself in practice, but something that I think you said, which I think will help a lot of young dentists is along the way, along the journey, you WILL make few mistakes here and there, and how can you pick yourself up so let’s see a couple of years qualified and you try t o be a little bit more ambitious with your treatment because that’s where growth happens if you stagnate and you don’t challenge yourself you’re not going to grow right? And that’s a couple of mistakes and hoping nothing too big. What advice would you give to that dentist before we then pick up the conversation so what what actual advice would you give that dentist because you know that was you some many years ago, that’s someone else now. What advice can you give us?

Gurs Sehmi 7:21
Okay, so first of all, get some kind of mentor – someone who is better than you at the stuff that you want to do. This doesn’t necessarily need to be paid mentoring, but when when I was young, we spent 1000 pounds a month on mentoring right, getting my head straight, and you know, saying we did it for a year. So that’s what’s that £12,000 plus VAT that EDUCATION that came with that mentoring has paid for itself like so many times. So having someone to talk to about cases is going to minimize your mistakes, okay, because each case is different every time you pass a case on to a mentor, they’re going to see things which you’re not able to see straight away. Okay? So it’s all about minimizing your mistakes, and then be completely upfront and honest with the patient. If it’s the first smile design you’ve ever done. Say, Hey, look, you know what? This…I’ve been to like a million courses. I know exactly how to do this. But I want to be completely upfront, okay? This is this is what’s complicated in your case, which I haven’t done before. But this is how we’re going to minimize that. And any risks of anything because you want to, you want to, you don’t want to scare the patient off by your inexperience, but you do want to level with them and say, Look, this is all the bad stuff that can happen. And this is how we’re going to minimize all of that happening.

Jaz Gulati 8:51
I think that’s a really good point. I think sometimes dentists are afraid to tell the patient that this might be the first time you’re doing a procedure but it’s all about the correct setup. The correct way in which you communicate that. So I think you said that really well, like, Look, I’ve done the courses, and here are the mistakes that can happen, here’s how we’re going to mitigate them. But by the way, this is the first time but don’t worry, I’m really looking forward to doing this. And I’ve got a whole plan and structure for you to give that patient the confidence and to be fair if that patient is not on board…then that’s not the kind of patient you won’t be treating for your first case anyway.

Gurs Sehmi 9:24
Yeah, because they’re going to give you more problems later down the line. What you’ll find is most patients are so nice. They’re so genuine understanding. Most Dentists have already built up a lot of rapport with their patients as well. So when they’re in the mindset now that they want to do something a bit more comprehensive, there’s a level of trust that’s already there. And you say you’re in general practice and one of your patients has got all this tooth wear and now they’re ready to do something. You need to change that trust from being your general dentist to being someone who’s really good at this complicated situation and for wear cases, for example, and I know that like, okay, a real life example last year or maybe the year before this guy came in, and he had this wear pattern to it, I didn’t know what was causing it, right? But when it comes to like, occlusion and everything, I know that if I generally open the bite up and you’re in CR, then things would generally be okay. But I’ll just straight up honest with it. I was I look, we’ve treated like so many weird cases, but yours is slightly different This sets of teeth which have worn and certain teeth, which are like, perfectly new, you know, so I’m not 100% sure how this has happened. But what we’re going to do is build everything up in temporaries first, make sure that everything is right in the temporaries because we can change whatever we want. We can change the aesthetics, change the bite, we can change anything we need to and only once we’ve got it right and temporaries are going to move forward. Okay. So the risk with wear cases is that you restrict envelopes of motion, you don’t make the bite harmonious with a patient’s jaw. And then you get fractures, right? And when patients are paying 1200 a unit, then that’s an expensive problem. And they’re paying a lot for the security that, you know, problems shouldn’t happen. So, yeah, in that case, I was like, Dude, look, look at your wear, this is not something we see every day. But this is how we’re going to do it. We’re going to address all of this, make sure it is correct on temporaries, that gives them the confidence to say, you know what, yeah, we can move forward with this.

Jaz Gulati 11:39
And then that’s the ultimate consent process as well. So thanks for going on that little detail with me because I think people would have listening would have picked up on that. And you mentioned it, I think that’s gonna really help people. So we’re now back to the TWO HOUR process. So you’ve now done your correct marketing for the right type of patient for the treatment that you are known for. So the example you gave was all on four So the patient now turns up, what is this two hour process?

Gurs Sehmi 12:06
Okay, so first of all, first of all, there’s an hour before the two hour process, okay, so the patients would inquire via the website, they would come in for a free consultation, typically free consultation with with the treatment coordinator who is a team member who knows a lot about the processes and the ethics of the practice. So, patient comes in talks to treatment coordinator gets an idea on cost. Okay, on my website and my sort of videos that I do online, I try and just be open and upfront about the costs. Yeah, there’s no point in hiding that. But earlier, a patient knows about the cost, the easier the sale is going to be. Okay? Because you don’t want you don’t want to get to the point where you’ve invested so much time in building a relationship. And then you say that’s going to cost this much and the patient’s like Whoa, I wasn’t expecting that.

Jaz Gulati 12:56
So because if the if the number that you…. if the sort of fee of the treatment that your practice has, and the patient’s expectations are not at the correct match, then that can be one reason that you won’t be getting to do that dentistry because the patient genuinely either could not afford it or does not value it at that level. So it’s good point, actually, and something that I try and do as well, even on any sort of Instagram inquiries that I get. I know, some people are like, oh, when you come to the clinic, we’ll have an open discussion and always difficult to give a price because everyone’s different. Whereas I’m like, Look typically £3-4,000 for a course of Invisalign, whitening, whatever. So I’m very open. Is that Do you think that’s a better way? In your opinion?

Gurs Sehmi 13:40
Yeah, I mean, there’s so many people who are just shopping around and that’s cool. You know, if you want to shop around, that’s absolutely fine. But there’s plenty of people who, who kind of know how much it is. Okay, so if someone’s looking, I had an inquiry on Instagram the other day and the lady was like, Yeah, I’ve seen like veneers cost roughly this, this kind of figure. And I think, and I just said, Look, if you want if you want veneers, it depends on how many to roughly £1,000 a tooth. How many do you want to do? You know, you don’t say how many do you want to do, but that’s essentially what you’re saying. So the patient effectively chooses how much budget is, you know, by how many teeth that they want to do.

Jaz Gulati 14:23
So that’s something that the TCO will explain?

Gurs Sehmi 14:28
Yeah, I think legally, you’re supposed to have your prices on your website as well. But the thing is, it’s very difficult for a patient especially the kind of patients that I see where they’ve got multiple issues, maybe they need root canals, maybe they need perio treatment, you know, all this stuff they can’t do until you’ve seen them, you can’t diagnose them, right. If you’re selling them a product like Invisalign, or all-on-4 or, you know, something like that. Then it’s very easy. They’re almost like picking off the shelf, hey, I would like this. But when you’re trying to sell a comprehensive solution to that, you know, we know your math is terrible. Thank you for trusting us with that, I don’t know how much it’s going to cost by it’s going to be roughly between here and here. You can see he can give a range just to make sure you know, they know roughly what they’re in for. And then once they have the assessments, you know, we’ll talk about the assessment how we do that, but they then understand their problem and then they’re building up trust and then you know, there’s it’s much easier for them to say yes, if they know the price, because the price is it is a stumbling point. It’s not the only one, but it can be significant for a lot of people.

Jaz Gulati 15:42
So in the one hour with the TC, they’re discussing prices, discussing different types of treatments – essentially in a few sentences, what’s the aim of the TC?

Gurs Sehmi 15:56
to see if we’re the appropriate practice for the patient and To get the patient to pay 200 pounds for a clinical consultation,

Jaz Gulati 16:04
brilliant, okay, so then now the all on four patient comes in, they’ve had a lovely discussion with your treatment coordinator, who I imagine will also show examples of other cases that you’ve treated. Just answer any queries because you would have trained your treatment coordinator to a high standard they can they know, they can just, you know, off the shoulders give all the answers because they’ve done it so many times before. And then they’re like, you know what, I think I’m interested in this. I like to go ahead with the consultation, and then they pay the 200 pounds and then they will come back to you on another day.

Gurs Sehmi 16:39
Yeah, definitely.

Jaz Gulati 16:41
So is this the best time to now talk about that appointment?

Gurs Sehmi 16:45
Yeah, what the next one? The actual clinical consultation? Yep. Yeah. So what you mentioned about the TCO, absolutely right. They need to have all of the information right loads of before and after photos. If they’re talking about implants, they need to know the difference between immediate delay advantages, disadvantages, all the kind of nitty gritty, nitty gritty because they have to build up a lot of value, especially, you know, we charge 200 pounds for the consult. That’s a, that’s a lot compared to a lot of other practices. So, again, they need to be able to build up enough value to sell the 200 pound assessment. So once they’ve done that, the patient comes in.

Jaz Gulati 17:21
And just a quick question for you – is your TC taking photos for you?

Gurs Sehmi 17:28
No, this happens at this appointment.

Jaz Gulati 17:30
Okay, so you don’t have any photos to go by?

Gurs Sehmi 17:34
No, it’s a bit hit and miss. It’s very difficult bringing the photo element into the TCO. Because especially if there’s limited number of cameras in the practice, I think the practice has maybe two cameras. To the clinicians, me Sam, we have our own cameras. So it’s just a logistical thing. You know, if the photos are taken at that TCO appointment, because remember, some of the people who come in from TCOs won’t go ahead with a full assessment, they realize that maybe we’re not the right people. They may, you know, for whatever reason, so dedicating a camera to them is a little bit tricky. Sure. So when they come in for a clinical consultation, that’s when the photos happen. So, the first half an hour of the clinical consultation, I’m either seeing someone in a different room for just a small appointment to review something like that. Or this is really important. I’ll be chilling out upstairs with a coffee, okay? Because getting your mindset in a calm and positive way, like before that new patient consultation is really important. Right? The vibes you give off in those first three seconds that’s make or break really. So while I’m chilling out my nurse or someone is taking photos, and quite often, especially if we’re looking for implants or a comprehensive treatment plan, which we know from TCO Cons, we’ll have an OPG taken as well. Okay all of these things are printed out two copies of each photo and, and a Sharpie pen. Okay that Sharpies pen is the practice’s best sales tool okay a little two pound pen or whatever it is you can do it with you know iPad pros or touchscreens and stuff like that a little bit flash but to be honest, I like the rawness of a pen and paper. So if you want to interrupt me at any point, do it okay, because I will just talk about this process.

Jaz Gulati 19:38
No, I like. So it’s back to the roots, you know, pen and paper, the feeling and the patients that are in front of you. I like where this is going.

Gurs Sehmi 19:48
Yeah, absolutely. So know what the patient’s in for I’ve got the TCO notes. I know a little bit of history then the Nurse will bring me up the photos before I see the patient. So I’ve got a bit of an idea on what going on.

Jaz Gulati 20:00
How many minutes allows between the nurse? How long does it take your nurse? nurses to do all that? You know the OPG, the photos or chitchat?

Gurs Sehmi 20:10
About half an hour

Jaz Gulati 20:11
30 minutes on average.

Gurs Sehmi 20:13
Yeah, cool. So then they’ll call me down. And let’s say the patient’s name is John. Get your mindset in the right way before you go into the room. Okay, head up, positive tone of voice going. Hi, John, how you doing? My name is Gus, I’m going to help you today. Okay, that’s it, shake their hand. And that’s really important because you need to portray confidence. You’re, this is this is like a show. Okay, this is the theatre production. You’re the star role here. So you’ve got to make a little bit of an entrance. And then I come the way our surgery setup after walk around the patient and sit down him on my side, and even the angle at which my chair is at the beginning of the consultation and the end of the consultation is stuff that I’ve already thought about. Okay, so I’ll sit down the patient and I’ll be like, hey, John. Thanks for coming in today. I’ve read all your notes he came to see now me the other day and, you know, I’ve got a whole bunch of photos as well and x rays. I kind of know why you’re here. But is it okay? If you just tell me your whole story in your own words? Okay. And, and then you listen, right? That is my standard line and my standard entrance for every single consultation, right that it doesn’t matter what what they’re in for. I just want to hear their story now. But you want to also acknowledge that they’ve told their story before. And the last thing you want to do is annoy them. You’ve probably called a bank or something and you get passed from person to person to person, and each time they don’t know what the first person’s in the message hasn’t been passed on. That’s super frustrating, right? So we have to acknowledge that they have told a story, but you want to hear it again. Okay, so this bit takes up almost 15 to 20 minutes of them telling me the story again. Wow, it’s really important. The way that that we listen as well. It’s we use processes called active listening. So I don’t know if you’ve covered this in other podcasts as well.

Jaz Gulati 22:26
we haven’t No, please tell us about active listening. I mean, I feel as though I’ve done a bit of this but sometimes people who may be listening between passive active what the difference is, please, please tell my listeners.

Gurs Sehmi 22:39
So you want to keep the conversation going, but you want the patient to to know that you’re listening. And you want the patient to also know that you care, right? And the way you do this when the patient is telling you a story, you don’t you don’t interrupt them. Okay, but you do. Make kind of noises like ‘Um, Yeah. Oh, yeah, totally agree’. You know, just stuff like that to keep the conversation flowing. It also shows the patient that you are listening. The key points in the conversation is always going to be a couple. You just repeat back to them what they just said. Okay, so let’s say Oh, yeah, John. Yeah, that’s, that’s terrible. So when he was six years old, this Dentist had his knee on your chest?

Jaz Gulati 23:25
So you just like every patient, Gurs, that’s like every single patient!

Gurs Sehmi 23:29
Yeah, yeah, absolutely. So, you know, you got empathize with him, and he can’t he definitely don’t tell them that they’re wrong. Okay? The patient must never. Okay, it’s not that the patient is always right. But they must always be, they must always feel like they’re right. Okay, so we empathize with them. And we say, hey, look, you know, this is terrible, and a lot of them have had a terrible story and a bad experience leads to a lifetime of neglect, which leads them to our practice, right? That’s, that’s the typical process, then the patient will get to the end of their story eventually. Okay? And then we need a way to turn the conversation around. So I then have a couple of questions which I can ask them to basically switch it around. So I can be… instead of a listening role, take it into an educational role. Okay, I bet you will know those questions.

Jaz Gulati 24:30
Can I guess what it is? I want to guess that, like where this is going, but is it asking permission for the patient to then go to the next stage and and therefore they feel in control? Because I think that’s a really important thing for patients to feel like that even like when I’m giving oral hygiene advice, like, Can I have your permission to just give you some feedback on how you’re brushing like even little things? I like saying it that way is anything to do with that.

Gurs Sehmi 24:56
Yeah, so that’s, that is part of it. So it depends what the patient is in for. Okay, so if a patient is in for like a full mouth rehab, they’re really embarrassed about this smile and it’s more of a functional issue rather than a anesthetic issue, then you want to pick up the emotional trigger points during the information gathering when they’re when they’re talking. So, let’s say the thing was, look, I’ve lost so many back teeth that I can’t eat properly with this crappy old denture that I’ve got, and I can’t even go out for dinner. Okay, so then, you know, that’s their emotional trigger point. That’s the end goal, their angle isn’t a perfect set of teeth to look amazing in the mirror. They just want to be able to go out, okay, this is the results of the treatments that you can provide. So, what you can do is, okay, look, John, so I think I know a couple of ways in which we’ve helped a whole bunch of people in a similar situation. like yourself, to be able to have a good solid set of teeth, so they can go out to eat wherever they want. Okay, do you mind if I just show you a couple of these now? So that’s the ‘Do you mind?’ bit, that’s the getting the permission. But sort of prepping up to that question is, hey, look, we’ve seen your situation before. I know a couple of ways to fix it. Do you mind if I just show you those now? They always say yes. Right? And then I call this a control question because it switches the control of the conversation to to the clinician, and this is the moment to shine so you’re not selling at all. It’s really look, you’ve got option one, option two, option three, whatever, you know, these are the different pros and cons of all of these. And this is the rough, you know, the kind of price points in which we don’t overcomplicate things as well. You know, when it comes to full arch implant cases, there’s probably about 20 different ways that you can restore it different materials different sort of immediate / delayed, all this kind of stuff. Just keep it really simple. If we’re looking for full arch implants, for example, then I’d say look, we can have something which is removable. Ultimately, what clicks into to dentures, it’s really fixing implants. It’s super solid, and it will let you have the end goal of what you wanted. But some people don’t like the fact it’s, it’s removable. So we got a fixed one, I can see again, you’re saying, Do you want something fixed or semi fixed? You know, what would be better for you. And then you can go into more detail on the fixed solutions or the semi fixed solutions. So I kind of think of it in my head like a tree. At the top of the tree. You’ve got like 20 different solutions, but each one’s got us branch. So you’re asking just them to decide on little stuff and eventually You make your way to to the ideal trial treatment solution that they’re they’re looking for.

Jaz Gulati 28:05
That’s a good point. I think one one thing that people, dentists and this is not just young dentists, Gurs, this is all dentists, at some point struggle with in communicating is that the whole satisfying the GDC about has every single option being explained. But my argument for that is, if a patient has come to you, for example, and they’re missing an upper premolar, for example, and they want to have that replaced and they’re presenting complaint is, you know, I really when I smile on the side, I get really embarrassed, I really want this tooth replaced, okay? Yet what you what you find in every single treatment plan is do nothing – A. Do nothing. That is a completely inappropriate plan that yes, they should know that. Yeah, you know, technically you can have nothing but that’s not why they’re here today, in the same vein, because that’s a very simple example. What you’re describing usually is very complex dentistry. But there are some things which based on the story they’ve given you, you know, that they’re not going to a denture will not be appropriate for this person because they want a more fixed solution, so automatically whittles away these choices, so you don’t have to explain the 732 combinations. You listen to the patient, you find out what they want. And you describe the things that are most appropriate for that patient. And then in terms of goals, and what’s biologically possible, I suppose, I think I just want to say that point because I think people get hung up on explaining every single damn option.

Gurs Sehmi 29:24
Yeah, absolutely. So you don’t need to explain it in a lot of detail. So I do always mention it. I’ll be like, Okay, number one, you could have a denture I know you’re gonna say no, but you can have it. Right. You move on again. You move on. It brings a saying something like that also brings a bit of humor and lightheartedness to the whole consultation. This… you got to try so hard to make this consultation as comfortable to the patient. Essentially, when in communication… is depending on what kind of book you’re reading, you can split the brain up into two main bits, the emotional brain and the logical brain, okay, we have to please the emotional brain first, in order to even talk to the logical brain, which is going to make the end decision. So making them feel good, getting them a cup of tea, getting them the room at the right temperature. You know, the team members asking how their day was, you know, ‘was it okay getting there?’, all this kind of stuff, making them feel at home. Really important in getting that ultimate case acceptance. If then if the patient doesn’t like you as a clinician, say you’re you’re scruffy, you walk into the room, your shirts half half tucked out, right? And you smell a fag or something like that, you know, they might, you might be working in the best practice in the world. You might have the best team in the world, but you’re not the right person for them. They’re going to choose that so they’re going to go somewhere else. Everything from the practice to the team, to the treatment plan that you present. All has to work for that patient, right so you you can’t overemphasize on the treatment plan thinking, you know what, this is the best option for you. Everything matters, right? We’re looking at case acceptance, we’re not looking at what dentists are generally looking at, which is just the treatment plan. Right? We would really treat the patient as a human. So yeah, kind of meandered off a little bit on that.

Jaz Gulati 31:21
No, this is all very very good information. So you asked the sort of control question about you know, where they want something fixed or semi fixed and then you down that decision tree and then I started talking about the fact that you know, not you don’t you know, you have to be careful in how you explain things because there’s a million ways to do it has to be appropriate for the patient. So the let’s say the patient and said okay, and the taking down the road that this is a treatment they want How does it continue from there?

Gurs Sehmi 31:48
Okay, before I go into that one, let me just show you the other control question which is for aesthetics cause similar pattern, but the guys in for aesthetics, they emotional trigger point. is a slightly different, and you need to switch the conversation to show that you know everything about smile design, okay? Because if you’re talking about (just) smile design they’re going to be like, ‘What is this guy talking about? This is not appropriate.’ So the way I do that we listen to the patient and we’ve done our active listening, so it’s, hey, look, John. So I know that we can make your smile look amazing. Okay, that’s the first thing just build up the confidence. And hopefully the patient said, I want my smile to be amazing. So you pick that emotional hot trigger, and you say, they’re just like all the photos you see in the waiting room, you know, every single smile. We’ve done every single one of those. And there’s a certain process that we go through when we’re starting to design a smile. Do you want me to show you a couple of these things now? Okay, so again, we’re, it’s on the emotional trigger point, say that you can satisfy that Emotional trigger points and can I show you how we do this okay and sometimes I share this on my Instagram is those pictures where you know you’ve got a small photo and you’ve drawn over the that small photo with a perfect smile and even that is so rehearsed that there’s certain principles of smile design I mean I didn’t go over was 20 3040 principles, there’s no point in going over all of them but you want to do the most appropriate ones and suddenly end up with this nice smile on this photo. And the patient is thinking I could have that and I want him to do it because he kind of knows what makes a perfect smile.

Jaz Gulati 33:40
So this is your sharpie pen on their just maximum smile photo..on the ‘E’ photo? or is it on the lip at rest?

Gurs Sehmi 33:49
We just have a smile and smile retracted. Okay, so just smile and smile retracted. Those are the two key photos for this stage. And if the patient goes ahead with treatment, I’ll normally just take a full series But we checked things like the E, lips at rest and all of those kind of stuff. FMV sounds all of that during the clinical part of this assessment. Okay. By the way, that clinical part of this assessment is a maximum of 10 minutes. Yeah. So, whereas most Dentists, that that is the bulk, that’s the least important bit of this assessment.

Jaz Gulati 34:25
Very interesting. So where’s it going? I’m very intrigued in terms of the sort of process because it’s all about it’s about the right process. And the theme so far I’m hearing is that, yes, it matters what you say, but not as much as how you make them feel because a patient will never forget how they felt when they’re with you. So that’s a message that I’m hearing from you about how the patient generally feels about the environment they’re in also what you’re making them feel about potential treatment.

Gurs Sehmi 34:53
Yeah, so when you’re talking about treatments you want to be energetic and enthusiastic about it because this is a Big deal for the patient, right? You can’t be like, yeah, we could do something is gonna be like logic or that look, if you’re excited for the patient, and you can see that transformation in your head before it’s even happened. And you really want the patient to go ahead because it’s gonna completely change their life, you know, let that emotion be seen to the patient. Again, it helps them. But to be honest, that bit comes a little bit with confidence when you’ve done a couple of cases and you can truly see what can be done. Then, then it becomes easier and easier, the more you do, the easier it becomes right?

Jaz Gulati 35:38
That’s right. And, yeah, the more experience you get, the more people’s lives you influence, the more confidence you get to influence other people’s lives in that way.

Gurs Sehmi 35:47
So then, I mean, the next stage is we’ve taken control, we’ve done a bit of education. We also want the patient to be clear on costs at this stage. So it’s a it’s a veneer case, I’ll ask when he came in to see the treatment coordinator did they go over the kind of costs for for this kind of stuff? And typically they’ll be like, yeah, they did. So I’ll just reiterate, I’ll be like, Okay, look, if we’re looking at veneers, it’s just over 1000 pounds each. So if you have four veneers, it’s gonna be between four and 6000. We have eight veneers somewhere between eight and 11,000, something like that. So they’ve got a rough idea in their head, how much this plan is going to cost them. Okay? With implants, it’s slightly trickier because although an implant is say £3,000, if it’s as a single front teeth, you can then have to build in value of the sometimes there’s a root there so we have to take the root out and then we got to use guided surgery to place the implant got to make a good temporary, we then have to come back and the type of implant we use. All of this stuff, you know, typically adds up somewhere between around £4,000 between four, four and a half thousand something like that, which is a big difference to £3,000, right? So now we have to also build in value for the kind of treatments which we do. So at this stage, I’m probably about 45 minutes into the whole consultations, we start talking about costs here. And let’s say…let’s say we’re talking about guided surgery, I will literally take five to seven minutes explaining to the patient what guided surgery is right and why it’s such a cool thing. How we take digital x rays of a three dimensional X ray scan, plus the oral scan, we merge them together, we plan the implant treatment on a computer. And we have this really cool guide made 3d printed which will help us precision get this implant in exactly the right place.

Jaz Gulati 37:55
So are you showing them a visual?

Gurs Sehmi 37:56
We almost always – yeah, we’ve almost always we’ve got a guide, right? Some patient’s guide is in the background. And you can – it would be good to have visuals of this stuff readily available. Most patients have seen an X ray. So seeing a 3d X ray doesn’t really change stuff is for them to see the difference between 2d and 3d is and isn’t a big thing. Even the the scans, they’ve had impressions, so I think I don’t actually use visuals. And I think maybe the case acceptance might be higher if I did, but it’s not bad. Not using the visuals. And I think I get away with a lot of it because of the energy and the confidence. So it’s

Jaz Gulati 38:42
about you. It’s about you.

Gurs Sehmi 38:46
Yeah, yeah. So again, you don’t have to differentiate yourself from every other dentist out there. So assume the patient’s been to like five of the consultations, right? And typically they have and we’re not the cheapest. So why do they pick us rather than all the other people? Well, one, we’ve spent a lot more time with them. So we’ve got more of rapport with the patient. But also, because we explain everything in a lot of detail. If we’re doing a smile design, again, we’ll explain that we do everything in temporaries, we will get this picture which we’ve drawn on this piece of paper in your mouth. And we don’t know if that’s going to be your perfect smile. You have to go home and test it out. you test it out, you come back, you tell me what you like, what you don’t like, we refine it until you’re happy. Then we make the porcelain, okay, so again, what that’s doing is that’s eliminating risk. Okay. So there’s always an element of risk in a treatment plan, right? Things could always go wrong, but what are you doing to eliminate risk? Okay, so again, it’s showing that you care showing that your practice has procedures to, to minimize risk and acknowledging that these risks are there.

Jaz Gulati 40:07
I love that. I love that. You’re, you know, what we’re all doing is I’m hoping we’re all explaining the risks, but I love the fact that you go one step above that and say, This is a risk for example, I mean, let me give an example you know, not so cosmetic dentistry related, but real world dentistry, you’re removing an upper molar and I always warn my patient that look it’s close to something called a sinus and sometimes there’s a link between the mouth and the nose, but then just that one extra sentence: ‘but don’t worry, the gentle way that we’re going to do the cutting of the teeth, the roots will mean that it’s going to be as gentle as possible and then we can stitch it off if needs be, and we’ll give you all the care you need. Just that reassurance for example, can can make a world of difference. I really like that.

Gurs Sehmi 40:55
also, especially for like implant stuff – I will slways, once the clinical consultation or this chapter is coming to a close, I’ll be like, Okay, look, I’ve told you all the really cool things that can happen here. Do you want me to try and talk you out of this right now? Okay. So again, just lightening the whole thing up. But it’s at that point I do honestly say, I’m going to try and talk you out of this right here are all the bad things that can happen. Okay. And within implants, we’ve got a policy that once we agree on a plan, we’re going to cost, no matter what complication happens, we’re going to sort that out free of charge. Okay. So I do say you know, it most of the time is plain sailing, but implants might not stick, we might get infections stuff may happen, right? It’s not going to cost you anything else, but it is going to increase our treatment time. It’s going to be a pain in the ass as well. But you know, there’s definitely no cost. So again, it’s reducing risk, okay. Nobody wants to be you know, you’re getting a House extension and they’ve quoted you £20,000 but coming in at £40K. You know, once you’ve started the work your backs against the wall, you’ve literally got no choice. So you don’t want that patient to ever feel that they’re in that kind of situation.

Jaz Gulati 42:14
Very good. So then you’ve explained all that and the patient seems to be on board, are you sending the patient away with like, a 20 page letter? What happens next? What’s the final part before you actually and then what happens between now and then actually, them coming in to get their implants placed or their hygiene started to get, you know, biologically ready to have the treatment?

Gurs Sehmi 42:38
So at this stage, I haven’t even looked in the patient’s mouth.

Jaz Gulati 42:43
Wow. Okay.

Gurs Sehmi 42:45
So we’re having all of this conversation from photos and x rays. Okay, so, uh, once have pretty much got the plan, which I think the patient’s going ahead with. I’ll be like, Look, this This all sounds good on pen and paper, but it’s okay if I just have a quick look in your mouth and see if this is possible. Okay, and then patient is tilted back a little bit, we start having a look in the patient’s mouth, we start extra orally, the nurse will name out each and every muscle that we’re palpating we check for tenderness, the jaw will palpate the jaw, the nurse will say out loud, is there any clicking? Is there any popping? Is there. Any crepitus any of these things? Right. So, during this whole consultation, there’s a massive checklist of about seven pages. And the nurse is reading everything out and I’m responding. Yeah, yes, no, whatever is appropriate. And that’s again, building value. Right? The when the patient gets up from this, the patient’s always like, I’ve never had a consultation that thorough. They probably have but there hasn’t been the show elements involved, right? We say it out loud because the patient is always listening to everything.

Jaz Gulati 44:01
That’s amazing.

I was just going to say that I really like that and someone, a previous guest on his podcast, Zack Kara, who by time this one comes out, would have been on one more time as well he calls this ‘show your working out’. You know, like in maths, so you do a complex equation and you get one mark for the answer, we get three extra marks actually showing you’re working out, you’re showing you’re working out with a patient and that’s, that’s got great, like you said, quite a building value that you are thorough, but like, everyone’s done it everyone always checks for mouth cancer. When we do our soft tissue exam. I actually say to my patients Okay, now I’m looking for signs of mouth cancer. Okay, everything’s good. And then they’re not Oh, wow, they’ve they’ve checked them out cancer was everyone’s done it. But you know, if you don’t tell them you’re doing it, you’re not building and so that’s, that’s really cool.

Gurs Sehmi 44:46
Yeah, so we go through the whole whole process that you know, it takes us about 10 minutes, but then we’ve got a cosmetic analysis at the end as well, which I use for those patients who have cosmetic emotional trigger points actually being in that, you know, it’s heavily a cosmetic improvement that they’re looking for rather than functional. So that’s when, you know, verbally will say, Oh, do the teeth fall in the smile line is the midline, coincidental with the middle of the face, you know, all these things. This is where the F, v noises and all of this stuff comes in. And we’re also communicating with the patient because it’s like, one of the questions how many teeth are on show? Okay, so I’ll be like, okay, John, just smile for me. Okay, I’ll take the smile photo, I’ll be like, okay, so when you smile, this is the number of teeth that we can see. 123456 You know, so again, it’s, it’s very, it’s not so much a consultation where you’re just looking at stuff. It’s a it’s a conversation. It’s like I.. hate taking your car for an MOT especially I’ve got old cars, right and there’s always that stuff that needs to be fixed and it’s a horrible thing. To take a car for an mot and realize you got to spend £800 on something. But what my garage started doing and over the last couple of years is sending you a little video, right showing you that they’ll be like, hey, look, you know, check this, this rotor right there. So you can see that it’s really thin here. So it’s like, oh, yeah, there is a problem. How are we going to fix it? It changes the dynamic to the dentist saying, look, you need to fill in here. And the patient being and that’s 200 quid or being Okay, look, your tooth has some decay here. Right? We could do a filling here. Would you reckon? It’s a completely different dynamic one of those, the patient is being forced into having a feeling the other one is like, Hmm, okay. Yeah, if a feeling is the best solution, let’s go with that.

Jaz Gulati 46:49
Co-diagnosis comes to it comes to mind with that, doesn’t it?

Gurs Sehmi 46:53
Hmm, yeah. So it’s, there is co diagnosis, but also you need to kind of guide it. So a typical situation a patient’s got a post crown, it’s been there for forever in a day never cause a problem. There’s a slight PA area on there as well. So you need to be able to explain to the patient that that tooth is weaker. Right? And typically what I do you see it on the X ray. It’s a whole load of white on a little bit of tooth. So I’ll draw the outline of the tooth. And I’ll say like, Okay, look, everything whites on this tooth is, is manmade. Okay, it’s not adding any any strength. How much of your own tooth in percentage do you think you’ve got there? Right. So but getting them to say, oh, probably about 30%. I’ll be like, yeah, I’ll probably agree with you. Right? So this tooth is probably only got 30% of its original strength. Okay, so they already know that. It’s, it’s not the best tooth in the world. So if you’re doing a smile design, and you’re including this tooth, they know there’s a risk that you Do this smile design and 2,3,4, 5 years down the line, it could break and because they’ve been involved in the the assessment and they understand the health of each tooth that it’s not surprised when it breaks and quite often I’ll be like – Look, when it does break, it might be a three- four grand job to fix it. So again they know that

it’s like when a suspension brakes on my car, I know it’s £1,000 job, because my garage has told me so if you

Jaz Gulati 48:32
You like your car and mot analogies don’t you?

Gurs Sehmi 48:35
Mate.. if you have old cars!

Jaz Gulati 48:42
Fine. So you’ve done your clinical exam now, and I love the whole checklist process and you’re getting the patient involved. You’re not telling them they need fillings, you’re showing them they need the fillings. What happens next?

Gurs Sehmi 48:56
Okay, so you’ve pretty much got the treatment plan from the beginning. And now if you’ve confirmed that that’s appropriate, so I’ll just be like, hey, look, so I need to give you these treatment plans. Okay? And if you give me 10 to 15 minutes, I can do it for you right now. And what I’m going to give you is this, this treatment plan. Okay, so we’ve probably spoken about seeing the hygiene a couple of times, and they know what the cost of that is. So that’s one treatment plan that I’m going to give you. Another treatment plan is and I’ll give them the options of the kind of stuff which they would interest showing more in. So if it was, say all-on-four fixed for the top, I’ve been like, Okay, look, I’m gonna give you one plan for all on four, I’m going to give you another plan where we use implants and locators. And, you know, and then you can decide what you want to do after that, you know, so give them a couple of options. For veneers, you can give them an option if you’re not sure where they set price wise how much they want to put into this, you can give them an option of that. Six veneers, eight veneers, 10, veneers, whatever.

Jaz Gulati 50:03
And that so they’re really different sheets of paper for six, eight and 10. Or?

Gurs Sehmi 50:08
yeah, so veneers are slightly different it is three sheets of paper, but it’s usually the six veneer option. And then if you choose to add two more, this is how much it would cost. Yeah. Okay. And then if you so instead of giving them you know, an 8 – 10 – 12,000 £ piece of paper where they can add up that’s the ridiculous thing that they’re adding up your what you get is that eight 8000 plus the two and a bit thousand plus two and a bit thousand. So it’s like, if I upgrade from six to eight, this is how much it would cost extra.

Jaz Gulati 50:46
And by this plan this is not like a text heavy plan. This is like an estimate or is this actually a description?

Gurs Sehmi 50:52
Yeah it is. Not. It’s um, he put put everything on in your practice management. Software. However, however it works, and you can just print a plan. Okay, and so yeah, really all they want to know is the cost your cost of the thing, right? And there is a, like a letter which goes out, which is got lots of different templates. So that goes out after the Yeah, that’s, that’s nothing. So if you’ve got those situations where you’ve got this post crown, and you don’t know how long it’s gonna last, those things need to be kind of documented a little bit differently.

Jaz Gulati 51:31
Fine said you’re gonna give them some time. So what it sounds like is they go away with this, these estimates, like have plans in their hand. And then you also are going to follow up with a more comprehensive written plan. Explain the risks that are relevant to that specific patient. Are they paying a deposit towards some time with you yet? Or are you giving them some time to sort of speak with their partner’s/ family? What was the final bit involved with they can finally come and see you – who discusses the financing with them? Is it the treatment coordinator again? Or how’s that work?

Gurs Sehmi 52:06
Yeah, so the end of every consultation clinical consultation, this time booked into the TCO, diary. Okay, the treatment coordinator diary. And I’ll say to the patient at the end of the clinical bit, so you know, give me 10-15 minutes, we’ll have a coffee, and we’ll take it from there. So nurse takes the patient upstairs to where I was having my coffee at the beginning, and, and just make small chitchat. Now my nurse is so cool. She, she, she gets the feedback off the patient. And she can pretty much tell me if they’re going to go ahead or not right from just taking the patient off the stairs. And if they need to, like build up trust and all that the nurse and the patient can just chat for a little bit. So after about 10-15 minutes, we meet in the treatment coordinator room. And just before I tell you what goes on in there on you mentioned, do they need to go and speak to a significant Other to make the decision – at the initial treatment coordinator appointment. Quite often, we will ask if there’s anyone else who needs to be involved in the decision for going ahead with this treatment. So we’ll get the the details of the decision maker, really. And we want that decision maker to be in on the clinical consultation. Okay, because if you go through all this effort, and they need to ask their partner before they can even go ahead, it’s a waste of time, all that value is just going to be all that patient is going to give the decision maker is the pieces of paper, right with the cost. So that’s, yeah, that’s not the value is not there. So you do want to make sure that the decision maker is there. And when you’re talking, you’re talking to the patient and the decision maker okay.

Then we come together in the TCO room, okay? And you would think this would be high pressure thing, but this all the effort goes in right at the beginning. It’s like an inverse triangle, right? If you, if you imagine the information gathering at the top, that’s how much time information gathering takes. And you know, discussing treatment plans underneath that clinical consultation is a lot less This is effectively the closed part of the sale. This is literally five minutes of my time, if that’s right, and it’s so chilled out. So patient comes in. If the decision makers there, they come in as well. Treatment coordinators there and I’m there as well with all treatment plans. We’ll show them the the treatment plans. I’ll be like, hey, John, look, to before we go in to this, did you have any questions while you’re upstairs? And typically the answer is no, I was just checking my emails. Okay. So that’s a good answer. Because if they if every single question has been answered in your clinical consultation. They’ve got nothing to think about, they’re thinking about something else, right? their visit to a dentist, which is normally a high stress situation for them. So we’ve taken them from typically if they’re stressed out about going to the dentist that we’ve taken them from a highly stressed, frame of mind, to a much calmer frame of mind. We’ve fed their emotional needs, we’re now communicating through logically because the sale – selling the dream is all emotional, but the close is all logical. So now we’ve got these treatment plans or facts and figures, you know, all printed out and I’ll be like, Okay, look, the first thing is see the hygienist for a couple of sessions. We spoke about it, this is what it costs. And then these are your options. This is what it costs. This is what it costs. Okay. So there is two parts. There’s the clinical closure, and then there’s a financial closure. The clinical closure happens typically in the surgery. Have I found the right treatment plan for you? Okay, And you’re going to gauge that from what the patient says? Or are these the kind of options that you’re looking for? Right? And the patient will say, yes, they may not be able to make a decision right there and then they may need to think about it. And once you’ve done the clinical pleasure is just the bad money then. Right? And then it’s like, Look, this is what this option cost us about that option costs. Does this all make sense? And they’re like, yes. When can I start? Okay. You surprised at the number of people who, who say, when can I start? Okay, if you go through this process, it’s long winded, right? But you’re selling much higher treatment plans right. Then when I was working in the NHS, I’d get excited when wegot a white filling, you know, but here we’re doing full mouth. You’re not selling a little product for a little tooth, we’re selling much more than a smile this is going to change someone’s life.

Jaz Gulati 56:59
How many years Have you been doing it this way for?

Gurs Sehmi 57:05
yeah, and you know what? There’s no shortcuts as well.

Jaz Gulati 57:07
Sorry, I got cut out, cut out there. Sorry.

Gurs Sehmi 57:11
So about 10 years,

okay. And there’s no, there’s no shortcuts. Okay, so we’ve tried eliminating one little section because if you imagine it’s very time consuming, and if you can reduce the treatment, the time investment here, you can do more treatment because this isn’t, this is not necessarily profit generating time. Right? You spending so much time with the patient, the only reason we take 200 pounds is to show that the patient is serious about this. Yeah. And it’s, it’s a loss leader, right? This is hardly covering the wages to keep the practice open. So we will try and take this out, but it just doesn’t run as smoothly you don’t get the case acceptance. So it’s actually a false economy, trying to rush these things. And remember all of our patients well The vast majority are self referrals that people who’ve seen stuff online, they want, they want us to solve their problem. Okay? So it’s a slightly different dynamic if you’ve got a referral practice, because if your dentist says, hey, look, go and meet my mate, he’s really good at implants and you send them across, that guy can easily sell a 10-20 grand plan because all the sale has been done by the original referring dentist. Okay, all the trust is already there. And typically, they’ve talked a bit about money, so they know it’s a bit expensive. So we’re taking cold patients who’ve never seen us before. And at the end of this process, those guys are saying, Look, when can I begin? Yeah, then the treatment coordinator can go through the the money side of stuff, all the finance options and literally everything like that. Typically they will booking for a hygiene session and just pay for that themselves. And this whole process So if you notice, there’s no pushiness about it at all, you know, the patient has to opt in the patient has to be like, yes, you’re the guys for me, this is the plan for me. I want you guys to do this. Here’s my money. You know, that’s, it’s, it’s weird, because years ago, you read sales books, you learn about closers, and you know, all this verbal ninja work that he can do. Right? But I found the more you close your patients in, the more you say. You do this by this time and you get discounts. They just cheapens you. Right. And you don’t want that. At the end of the day. We are just humans, the patient and me. We’re just humans, right? I just have a bit of a skill that I can fix teeth. The patient can probably do a million things that I can’t do. So, okay, it’s like how can we make this work? How can I fix your teeth and Yeah, we’re all happy. But at the very broad sense, that’s, that’s what’s going on here.

Jaz Gulati 1:00:05
That is, Gurs, that is absolutely fantastic. I really appreciate you giving you a time to really deconstruct the entire patient journey. And, you know, some people listening to this right now watching this right now, you know, they’re thinking, gosh, I don’t have a treatment coordinator. I don’t have that much time to allocate – my principal is going to kill me if I start doing it for this long. But I think if you take away the principles that you said, and eventually, you know it, you know, Rome wasn’t built in a day, it took you some years to get to this point. So everyone’s on a journey, take your time. And I think the best thing that you could do if you’re not quite set up to replicate the amazing journey that you’ve produced, is by back to the very, very, very, very first point is deciding who your ideal patient is, and making sure that they’re the ones coming in. I think if you focus some of it on that, then I think that Part of the inverse triangle, the broadest part is even broader and more appropriate. Would you say that’s a fair thing to say to someone who, who can’t quite have the setup that you have the moment?

Gurs Sehmi 1:01:11
Yeah, absolutely. So here’s, here’s something really cool. Okay, we’re filming this right in the midst of this COVID lockdown, right? It’s like Easter bank holiday. And in this lockdown period, I’ve had, I think, six consultations with patients online and not been able to do any of this process. And on average, these treatment plans which these people online have been introduced to is between 10 and £15,000 Okay, so I think I totally up is about 60,000 pounds and potential treatment, people who have never seen in my life, okay. contacted me via the website, or Instagram on social media, whatever, it doesn’t matter how they get in contact with me. And what I did was just took this information gathering bits okay just feeding the emotional side of the sale right and introducing them to cost and options and I just did that and verbally you know the patient’s already knew how much it was roughly going to cost and they’re all ready to come as soon as we’re able to go for this lockdown. So another way you could do this is – you want to position yourself properly right so what I mean by you know, market positioning What are you good at? What is that tiny little segment of the population? who are looking for this one specific problem? How can you serve them best understand their needs, communicate this through effective marketing and get inquiries. Okay, then, if you’re doing this a few a day, you know, maybe six o’clock these these consults by the way, I’ve only taken me half an hour, these video consults because we don’t have to take photos before We don’t have to do the clinical consultation, we’re not doing the close, all we’re really doing is taking a lot of time out of surgery and, and doing it online. Now, the downside is you don’t make as much of an emotional connection. I don’t know how well this would work in a non lockdown scenario. Okay, but a lockdown scenario is the best that we’ve got. So that’s what we’re, that’s, that’s what I’m doing. I’m really surprised at the results. But it is it is working. And it’s only taking up half an hour at a time.

Jaz Gulati 1:03:36
That’s fantastic. And I’ve had one patient consultation myself via zoom and I’ve got three more lined up and patients raring to go with the orthodontic treatment. Thankfully, a lot of the work had been done before in terms of and the next point want to make is that you know, you need to have your entire team on board as well. So you can’t do the kind of stuff that you’re doing. If you haven’t got the right receptionist, the right nurse – Everyone needs to be in on it from from the person who’s reading out your checklist to the the warm and friendly environment as created by reception. So it’s generally a team effort. I think it’s fair to say as well.

Gurs Sehmi 1:04:12
Absolutely, absolutely. So you can do that if you’re an associate. Right? First of all, you’re usually got one nurse, okay? So if you’ve got one nurse, they know how you can work but can you can train your nurse to do this whole checklist and this process and get them on board. And also, people think that leadership in a practice is top down. Okay, so practice owner will take the lead everyone else, but there’s upward leadership as well. Okay. So, upward leadership is when the associate can actually go to the to the practice owner and say, hey, look, you know, I’m going to try and push and it’s going to generate, you know, X amount more potentially, but I need six months to try and implement this. Is that cool? So you effectively had to sell the idea to your practice owner. Right? Taking into account their possible hesitations in terms of lost clinical time, then you have to catch up on those UDAs, all that stuff. So,

Jaz Gulati 1:05:15
yeah, leading from the bottom is leadership. Absolutely. That’s fantastic. Gurs. That is a so many fantastic gems there that you’ve given us a really appreciate it. Thanks so much for coming on. And for those who want to be able to learn more from you, please do send me your website link so that they can get in touch. Because I know you’ve run the photography course online, which people have been signing up to, which is amazing. If you’ve got any more resources, I’d love to send them to everyone, please send them to me. And it’s been really nice chatting to you today.

Gurs Sehmi 1:05:49
Cool. So I’ll tell you what, what we’ve got going on. Okay, so please, all this period of time we’ve been working on basically this everything I’ve told you now. Right building it into a course it’s called the ultimate case acceptance course okay details every little aspect you know from body language what you say how you say it, the information gathering stage all the different stages it kind of lays them all out so it’s really transparent okay? And how to deal with individual situations. We’ve got a an online course on occlusion, okay, understanding the basics of occlusion how we take a very complicated case 10 into a simple case, we’ve got the photography, we’ve got restoring dental implants, and I’m sure there’s like one or two other little mini courses that we’ve got going on as well. And we’re, we’re building this all under the kind of the Dental NoteBox accelerator brand and people who sign up to this kind of like an online mentoring scheme, and they get all these courses for free. Okay, so I think it’s like 5000 pounds worth of courses or something that you can access for free and there’s just like a monthly subscription, which is a lot less than what I used to pay for my mentoring, but it’s getting to the stage where where I’m at now wasn’t about the knowledge we covered this right at the beginning, it wasn’t about the the knowledge, but it’s about the practice and constant refinements and improvements that you’re gonna make. And it’s a lot easier to, to get to where you want to be if you’ve got someone helping you and who’s done it themselves. So I’ll give you the links to all this stuff and

Jaz Gulati 1:07:33
love to check it out. Thank you. Thanks so much. That sounds really really fantastic. All those all things and also going into deep I mean, you gave so much value in this episode, but to go in even deeper, as well as the whole implant side and occlusion. Sounds really awesome. Thanks so much, Gurs. Have a lovely time with a remainder of this. lockdown, take care, stay safe, and it’s a great it’s been great having you on the show today.

Gurs Sehmi 1:07:58
You too. Thanks for having me. Thanks. That’s really great.

Hosted by
Jaz Gulati

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