He Got SUED, And He WON! FULL DISCLOSURE – IC027

Jaz’s Introduction:
The issue that really is at heart here is the emotional trauma that dentists can go through when a complaint happens and when it proceeds to the courts and whatnot. And we are talking a lot about that today. And we’re going to be sharing today a triumph, an actual triumph, because this is what we need. Our profession needs to hear it from someone who’s been through a very long and arduous case and come out the other side with a victory. I hope it leaves a very pleasant taste in your mouth at the end of it. But also what I want to extract today from our guest, Dr. Gulshan Murgai, is while the human emotion sides, because I’ve got colleagues who’ve been through complaints, formal complaints, and it cripples you. It really cripples you. It makes you doubt your judgment. It makes you lose your enjoyment and fulfillment. Personally, I haven’t been sued yet, and I know it’s going to come, right? It’s going to happen. We have to face off, and when that happens, I really hope that I’ll be robust enough for it not to affect my mental health. And one of the things that I’m supporting with this episode today, is the charity confidential.

I’m going to be leaving the phone number in the show notes. If you need support emotionally because the themes that will be discussed in this episode resonate with you and you need help. Please don’t be afraid to pick up the phone to call confidential, who are an independent charity dedicated to your emotional health as dentists to help you overcome these nasty episodes that we may sometimes have to endure.

Hello, Protruserati. I’m Jaz Gulati and this is an interference cast, something nonclinical, and I just cannot wait to get this out to you. I think every single dentist in the world should hear this story to hear about the challenges. Because one of the themes that we cover is just because a patient likes you doesn’t mean that they won’t complain.

And when that complaint lands, it can really turn your world upside down. Now Gulshan, our guests, very robust man, very forward thinking, amazing how he handle it. But we’re not all built like that. And so sometimes we may need more emotional support. So if anything, I hope this episode inspires you. I hope this episode gives you hope.

I hope this teaches you something about the importance of going to risk management lectures and understanding what it takes to come out the other side when something as nasty as a complaint and having to go through that process is just sickening. So I’m hoping this will help you in some way.Let’s check out the main episode and I’ll catch you in the outro.

Main Episode:
Dr. Gulshan Murgai, welcome to the Protrusive Dental Podcast. How are you, my friend?

[Gulshan]
I’m good, Jaz. Thank you very much for the invitation. I really appreciate the platform.

[Jaz]
No, I really appreciate you making time for this. And I just want to start by saying thank you for allowing this to happen, because you have to think about the fact that you’re exposing yourself, you are sticking your head above the parapet and stuff like that. And therefore, it’s not easy for anyone to go and do that and share this story, which involves negative themes like being sued. And I really appreciate the fact that you are happy. Talk about this. That’s a huge step, and I feel our profession needs this now more than ever, which is why when I saw your Facebook post of that triumphant victory, now we see the triumphant victory. But what people don’t see is the years of heartache, sleepless nights. I don’t know. You tell me. We’ll talk about that. Background, what happened? And I’m sure, I know you’ve been having lots of messages, but over the years it hasn’t happened to me yet, but my colleagues, they get suicidal thoughts. They get really crushed, crippling fear going into work. And I’ve seen what is done to my colleagues and a lot of some of these colleagues have completely gone non-clinical now. And I don’t even trust myself, Gulshan, that if I was to get a serious complaint, it was to go in that direction. I don’t even think I’m robust enough to really overcome it in the way that I would want to. So that’s what we’re discussing today. So, Gulshan, before we dive in to your story, just tell us who are you, where do you work, what are you about?

[Gulshan]
So, you know my name’s Gulshan Murgai. And I’ve been a practitioner since 2001. I’m a graduate of the University of Birmingham. I’m really proud of my teaching from Birmingham and what it’s allowed me to do. The way I was taught, and what I learned was such that. When I got out into practice, so we’re talking VT now. I really didn’t enjoy my VT job within six weeks. I was like, what the hell have I done? This is not right for me. Long story short, I had to get out of the situations quick cause I could obviously finish VT. And then I was looking to buy a practice because I realized, you know what, I’m not going to be forced into doing things other than the way I was taught five years of teaching. And you’re taught to do things the right way very strictly, pass the exams and then all of a sudden you’re in practice where you’re making money for someone else and then later on for yourself.

And I thought, you know what? I’d like to keep my good habits. So I did my VT job, did a short stint as an associate, and very soon bought the practice. So where I’m sitting. I bought this in 2003, so-

[Jaz]
Wow. So straight after VT, this is your venture now. I know you qualified 10 years before me, therefore you are in the cohort and we always have this thing in dentistry where we look at the new generation and we think, ‘Ah, this new generation has it so bad. We had it good or whatever.’ Or the previous generation before you had it even better. So, 10 years ago before I qualified, you’d like to think that you had far more clinical exposure at dental school than I did, and then the new guys coming through have far less than I did. Did you feel ready clinically to take that step into your own practice clinically?

[Gulshan]
Clinically yes, because my VT job, I was busy, I was really busy. But let me put things into context because of where I was practicing. So I was in, sorry, a reasonably affluent area. And what you need to know is the end of vt, my income was 55% private, right? So vt, so we’re talking 2001- 2002.

[Jaz]
That’s quite rare.

[Gulshan]
So when I joined this West London practice as an associate, I already knew what I could do and I was lucky. I was living at home. I had no outgoings, right. I was able to buy a new car and all I spent my money on was the car that I bought and education, right? So it’s important for you guys to know that I only entered dentistry to follow a surgical career path, right? Some people will say, I’m a failed medic. I can put that to rest. Certainly not. But all of our family, friends, everyone I knew growing up was a doctor or a surgeon, albeit my parents are not doctors and surgeons, right. It just so happened to be our circle of friends. It’s all I knew. So I wanted to follow the surgical career path. I went into dentistry to basically go down a max fax route. But probably six months into undergraduate years, I was like, no way. I’m not going to do any more than I need to. So what I did was as soon as I could, I got out of VT and finished that. I started looking at surgical courses and things like that, and I remember my first few, I remember being at these very expensive courses. That I was paying for out of my own pocket, and there was me and a friend of mine that I qualified with from Birmingham and everyone else in the group was 50 something, practice principals and Jaz, they wouldn’t even talk to us, right? They were like, what are you doing here? You’re below us. And I carried on with it. So I placed my first implant in 2002, so the year after I graduated.

[Jaz]
Mm-hmm.

[Gulshan]
And yeah, I haven’t stopped since then. I needed a practice where I could continue that, so I then borrowed a large amount of money from the bank and I bought this practice, which was an existing practice that had a pedigree of implant dentistry that used to be owned by one of the World College tutors in implant diploma. So that’s what I did. So I kind of went into that and kind of, it’s been implant dentistry first. So my history in digital dentistry goes a little bit further back, but I had to pause and then I kind of kick that off as well. So-

[Jaz]
So, what’s clear from that little thing. So what’s clear is, A) your mindset is like very much growth. You have very much a growth man’s mindset. It is very clear to me. The second thing is you took massive action. I do feel that in our careers, you have to, at one stage take massive action and it’s very clear you did that. And also you are the master of implementation and you did it well on these courses to be able to apply it straight away. And then you control your own environment by making your environment conducive to that. So that’s super clear. Can we now get to the story where the main reason for this episode. We’re going to do a second episode, by the way, for those listening and watching. We’re going to talk about which is the best scanner, and that’s coming very soon. But for this one, just tell me from the beginning about this complaint issue. What happened that led to the complaint, and let’s go from there.

[Gulshan]
So it’s kind of good that we’ve gone through the history, right? So imagine 2003, I’m buying this practice. 2004, I moved in already. Made some significant changes to the way it was going to be honest, I had to just start from scratch. I was missold this practice. It was a big financial plunge and long story short, I turned it around. So we’re into the end of 2004 now. It’s almost a year since I bought the practice. I’ve got already some history in implant dentistry and this new patient comes along and it was November, 2004.

Just a standard new patient to the practice. And yeah, she lived relatively locally, standard new patient, did whatever she needed doing. So it was restorative, ground, bridge, whatever it was Later on in that things changed in that, it was clear that bear in mind this was a private practice. She was being seen under private contract, right. What she would do though, is she would go to other dentists for her NHS kind of let’s say routine care examinations, et cetera, and then she’d rock up here when she needed any treatment. And that was a bit unfair because it was like, okay, well what happened in between? So you need to know that I was treating her, just looking at my notes for nine and a half years as an irregular patient, right?

[Jaz]
Mm-hmm.

[Gulshan]
So when I stopped seeing her, it was 2014, so like nine and a half, 10 years, right? And in that period, she was seeing me and seeing other practitioners as well, but she was based locally around here. What happened after that is where everything changes. And this is what your listeners need to know because-

[Jaz]
Can I just stop you? Ask a question, at that point, like, was she pleasant to you? Did she like you, would you say between 2004? Cause she keeps coming back to you and she obviously trusts you to know, to work in her mouth and not the other dentist. So that shows me that she trusted you so she knows you and likes you and trusts you. At this point, you got so much more rapport now. And so it’s important to state that, because some people think and please correct me if I’m wrong there, that if a patient likes you, that they won’t sue you. That may or may not be true. What do you think?

[Gulshan]
Yes. Doesn’t work like that? We’ll go into that probably later on, but I’m kind of trying to set the tone. You’re absolutely right, Jaz. In that, I said this to my legal team that were involved that, hold on a minute, because other parties are saying other things, and bottom line is, as you’ve said, this woman’s trying to sue me. Right? For clinical negligence, this is basically a personal injury case. It’s all about money. And in order to get that money, the other side have to prove that I had a breach of duty of care. So my point is that, like you just said, if that was the case, why don’t you keep on coming back to me, and paying me money to do stuff. But let’s just say this patient had a complex mental health history.

I know her so well. Obviously I can’t mention names, but I know her so well that when I was having case conferences with my legal team, I didn’t even have to go to my notes because we had a rapport. This lady has cried in my surgery because of things going on in her life, and you don’t forget things like that, you know? So, yeah, you’re absolutely right. So we had a rapport. She spent good money with us, and she was very complimentary of the service we’ve provided at the time.

[Jaz]
Mm-hmm.

[Gulshan]
But the big problem, and this is what your listeners need to know, is when that gets tainted because of comments made out of context, right by our so-called colleagues, and that’s what’s happened in this case, right? She’s been going here, there, and everywhere because of her changing financial situation. So when she could afford to have her treatment done with us, she was wanted to, but it got to the point in 2014, what changed was that she had disappeared off for a few years and she’d come back and a whole bunch of her upper posterior teeth had gone.

And I was like, what the hell? What’s going on? And she told me, and it’s not too important, but what is important is that because those upper posterior teeth were gone, my lower implants that I’d placed for her some years before had no opposing contacts. Right. But the last time I saw her was she came to me having seen her NHS dentist for options to replace these missing teeth. And I gave her the standard options, denture implant over denture, implant, retain, bridge, or keep your gaps, but then you’ve got no posterior function. Gave her options and that was it. Right? Obviously, we followed up on it maybe some days later, and we were told she’s decided to go elsewhere, right? She’d already told me that someone else was cheap, and I was like, sorry, that’s my fee. I can’t change what I’m. And basically that’s when the problem started, in my opinion because now that I’ve, through my legal team, had all of the records from all of the different people, you can start building up a timeline and bear in mind this case kicked off for almost five years ago. Right. And in that time, obviously I didn’t see her, but she was seeing other people. And before-

[Jaz]
So I just want to make it really tangible, so this is between 2014 and about 2017 she was seeing other people. And then she actually complained in 2017, is that right?

[Gulshan]
Yeah, that’s right. So it was, no it was 2016.She actually came to us. She’d move it out of the area. So she was in Lincolnshire. And this is important because she’s contacting us about, what implant she’s got, her general dentist in Lincolnshire being seen on NHS basis is just saying, gimme some information. Give us some screw loosening. Now, bear in mind when I’ve last seen her, she’s got my opposing teeth. So if they’re screw loosening, something’s changed.

[Jaz]
Mm-hmm.

[Gulshan]
Hey, that’s fine. That’s her prerogative. She’s moved on. Right. No issues with that. And I’ve got a whole email chain between me, her and my practice manager at the time saying, yeah, no problem. We’ll help you. We’ll do this and that. But what happened was she wanted help for free. She wanted to be seen for free. She made a big deal about the fact that, oh, it’s going to take her five hours to travel from Lincoln down to here in Watford. And I was like, sorry, but you’ve moved, we’ll help your general dentist, no problem. So we’ve got a paper train to show that we were doing everything we could to help. Then she requested her records. I was like, okay, yeah, you can have your records, but is there a problem? And yeah, she put it in writing that she wasn’t happy and she wanted to make a complaint. So as soon as someone says that two things can happen. What should happen according to UK rules is that you should say, no worries. You are allowed to make a complaint. Here’s our complaint’s procedure. Right? So we send her our complaint’s procedure and wait and wait and wait, and we don’t nothing back. And then she says, and this is months later, she’s like, okay, I don’t want to use that procedure. I’m going to lawyers. Okay. Soon as that word gets then indemnity gets involved. And so the complexity there was that I’d changed my indemnity provider from when I was treating her many years before to that particular time. This is now 2017.

[Jaz]
Mm-hmm.

[Gulshan]
So I ring my indemnify and say, what do I do? And they’re like, well, you weren’t with us when you were treating her. You’ve gotta contact the old lot. So it gets complicated here.

[Jaz]
Mm-hmm. It gets very messy when you change. But there’s something called a retroactive cover. Does that not apply?

[Gulshan]
I had all of that. It was not a problem. I had all of that and I’ve gotta say massive thanks to NPS Dental Protection. They were my old indemnify. I hadn’t paid them any subscriptions, premiums, whatever you want to call it for years. And yet they supported me according to their contract. Obviously part of the original contract, but that’s scary to think that I’m paying this guy now and they can’t support me. You can understand why, because now I’m on a insurance-based scheme.

[Jaz]
But just educate me Gulshan because I’m now with an insurance based scheme as well. When you join an insurance based scheme, is that not something that you do to say that if I sued from a case in the past, you’ll also cover me for that? Is that an add-on? Does that exist?

[Gulshan]
That does exist with some providers, Jaz. So, good question. So there’s basically claims made and which is one type of policy, and then there’s another one. So you’ve gotta speak to your existing indemnified to say, look, this is where I’m with you right now. I’m looking to move to that. Do I need anything such as what’s called runoff cover? And so on. It gets a little bit complicated, but there’s basically two different ways of having cover one’s claims made and I forgot the other term.

[Jaz]
Sure, sure. No problem.

[Gulshan]
Regardless, I had cover for historic claims.

[Jaz]
Mm-hmm.

[Gulshan]
Bear in mind that in the UK, if someone has treatment done 10 years ago, and then now today they find out that they’ve got a problem with work that they’ve done, had done in the past. From the time that they find out that they’ve got a problem, they’ve got three years to make that legal challenge, right. And that’s how this went on for so long. Unfortunately for new people entering into the profession and people like me 21 years in, doesn’t matter how long you’ve been here, you need to know that there’s litigation risk, right? Whether your NHS private mix doesn’t make any difference and therefore, I’d like to share with you and other people listening what I’ve put into place over the years, because this is not the first time I’ve been sued.

[Jaz]
Mm-hmm.

[Gulshan]
But every time you do get a complaint of any sort, whether it’s a little internal thing that you resolve. Or something litigious like this, or GDC or all of the above. If you don’t learn from it, you are going to just get into bigger and bigger trouble. And I can tell you for sure I’ve changed huge in huge ways from when I bought this practice, when I qualified to how I am now in terms of what services I offer, my record keeping and my conversations with my patients.

All of that has changed. But getting back into this particular case, 2017, it starts and the minute the word lawyers has mentioned, you go to indemnity and then basically they represent you. So it starts off with them looking through your case. And the number one thing they’re looking for Jaz is vulnerabilities. Right? And there’s different types of vulnerabilities. Clinical and then record keeping. Apart from that, well, unless they see the patient, they don’t know.

[Jaz]
Mm-hmm.

[Gulshan]
So this is what’s really important.

[Jaz]
Can I just clarify that, Gulshan? If you continue, because it’s really important for the story is that, in her own words, in her one sentence, why does she believe that you were negligent? What harm did you cause? What was the thing that she’s claiming then?

[Gulshan]
So what happened in 2017 was this, it was a bit of a surprise. So bear in mind, 2016, we’ve been trying to help her, right? We’ve been saying we can provide a screwdriver, this, that and the other. It was screw loosening of an A button, right? And we were going to help her general dentist sort it out for her because she didn’t want to travel down here. It’s soon came to light that she’d be happy to travel as long as we paid for. Now I’m like, you haven’t been a patient here years. Why am I doing this? Anyway, turns out that outta the blue, I’m at the end of a long day, six, seven o’clock in the evening. My front of house basically tells me there’s a patient here who wants to see you. Is it possible? And they mentioned the person’s name and immediately they mentioned this person’s name. I’m like, I know exactly who this is. And my team at the time, they weren’t here when I treated her years ago. So I stopped with my patient in surgery and said, gimme a minute. Let me just go and chat to this person. And long story short, she’s in my reception area with an implant bridge in her hand in a sterilization pouch. So clearly she’s been somewhere, right?

[Jaz]
Mm-hmm.

[Gulshan]
And it takes her about two minutes to tell me that she’s come down here to Watford, my town, wearing my practices, and she’s seen a practitioner around the corner from me. And that basically, the implants that I placed for her have failed. And she’s thinking that what she’s got in the sterilization pouch is her implants, right? And she’s aggrieved at that. And she’s saying, you place these for me? What are you going to do about it? Type of thing.

[Jaz]
Mm-hmm.

[Gulshan]
And I’m like, you know her name. I say, what you’ve got in there is not your implant. I said, would you mind opening, let me just have a look. She opens her mouth and I can see two implants sitting there, lower left sides. And what’s in the pouch is two a buttons and a bridge that’s been chopped off. And I said to her, whoever you’ve had chopped that off, it’s now their responsibility and yours because they did it. And I said, it didn’t need to be chopped off. It could have been pulled off because it was cemented.

[Jaz]
Mm-hmm.

[Gulshan]
And had they actually conversed with me and asked me, I would’ve been happy to help, but now you and he have gone into that scenario, it’s nothing to do with me. And I asked her politely to. And then after I finished with my patient, I spent a long time documenting the conversation. And I knew then this is just going to kick off and be huge. Obviously then I knew who she was seeing, which is the practitioner within five minutes from my prac, my place. And I thought, now it makes sense. But what really hurt Jaz was the fact that she’d been lying to me, for months from 2016, telling me she couldn’t, she didn’t want to travel from Lincoln. And it turns out that she was coming backwards and forths to Watford for a long time. She was having treatment here.

[Jaz]
And, just to touch on that now that we know that, and you reveal that part of the story years later in terms of you obviously when we come to the end, triumphantly overcoming this case with success, was that part of the narrative significant that she was actually lying? Was that significant for the narrative?

[Gulshan]
Massively. Because you gotta remember this case is snowballing, right? So it starts off with a complaint, right? Everything gets sent to the legal team. Now, when I say everything, this patient’s got six dental implants that I’ve placed over the years. Multiple Crown Bridge. There’s photographs, there’s X-rays, there’s CT scans. There’s nine and a half years of clinical records or type right? It’s too big, quite frankly, to just, well, I wouldn’t print it because it would be. . So what we did was we created a digital dossier and we handed it to our lawyers who handed it to theirs. Right. Obviously that then went to our side. And when the other side then says, right now we’re armed with something, they start building a case against me, whoever it is, right. And in doing so, they hire an expert witness. So they give my dossier records and this patient’s complaint, this patient is obviously their client. They’re acting on their behalf. They give it to an expert witness who, again, is one of our colleagues, right, who basically takes everything apart and puts their spin on it, right?

[Jaz]
Mm-hmm.

[Gulshan]
They shouldn’t because an expert witness is meant to be totally independent. But it’s clear that this case was a dental law partnership against me. And everyone in the UK knows who TDLP are, right?

[Jaz]
Mm-hmm.

[Gulshan]
And they have a host of expert witnesses who just act for them. And a lot of people will say, well, if they’re just acting for them, how can they be impartial? Yeah.

[Jaz]
How is that independent? Is that legal? How does that work?

[Gulshan]
There’s ways of getting around the system and they do. And you can see this because the same expert witnesses come up for TDLP and IWiN Mitchell and all of these other big law firms that take on these no win, no fees. Independent kind of legal cases against medics and dentists around the country.

[Jaz]
Is there a list of these dentists who back for the other side?

[Gulshan]
It’s not difficult to put it together, Jaz. And actually if it did happen and it went public, there would be I think a bit of a backlash, but obviously these people are independent practitioners in their own right. Some are retired and it’s their way of making money. And some are still practicing and it’s something they do on the side. They’ve done further qualifications.

[Jaz]
I’m just saying if you’re going to, if you’re a dentist, you want to enter the expert witness world and do some legal work, good on you. But just by back for the right team back for justice, I mean justice, some patients may deserve, and some dentists may be negligent. We can be negligent as a practitioner.

[Gulshan]
Absolutely.

[Jaz]
These patients need protection from that. But the whole, it’s one of those things, isn’t it? It’s difficult to swallow.

[Gulshan]
Yeah. Absolutely. And obviously I know who the names are and so on, and as soon as they’ve got an expert witness, we get an expert witness. Right? So that’s when things get a bit scary because now all of a sudden, this person you’ve never met before is looking through your records and checking, did you do things the right way? Okay. And obviously, I’m going to suggest that. In this case I know that I did right. It might not been a hundred percent perfect, but it was done correctly. And I’ve gotta hold my hands up that we don’t get things right every time. Like I said, we’re all human, right? And when I talked generally earlier about vulnerabilities in the case and the amount of people that have contacted me since I’ve made this case public, a lot of people have said, can you help me with this? Can you help me with that? And the first thing I say is you have to look through your notes. You have to be honest with yourself, and say, number one, did you do things the right way? And there is no, ‘Oh, but it’s NHS. Oh, but this, that.’ This is no excuse, right? Because when we qualified, we didn’t get stamped on our head saying, NHS dentist or private dentist, right? You learn how to do dentistry properly. After that, it’s up to you. So the first thing that Alaska colleague is, do you feel you did everything by the book, number one? And that includes consent and giving people options. Remember I said left VT 55% private, right?

[Jaz]
Mm-hmm.

[Gulshan]
That’s simply because I gave every patient every option that I could deliver, as well as options that I couldn’t deliver, right? And then people surprised me. People who were exempt and on benefits went away for 3, 4, 5 months and saved money and came back and had things done with me privately. And that’s what I’ve done for 20 odd years. It’s been what’s made me successful. So back to this expert witness gets hold of your notes and you’re waiting to see what do they find?And in my case, in this case, they’ve cited with me, so letters written to the other side to say, you need to cease and desist, right? Because there is no case here. But they didn’t, and they carried on. Now, for some reason, the law firm that my indemnity we’re using changed over everything handed to another law firm. I then ended up with another expert witness.

[Jaz]
Gosh.

[Gulshan]
The good thing is the second expert witness also backed me. Right. And that expert witness-

[Jaz]
And this expert witness didn’t already know you? As independent to you?

[Gulshan]
No, no.

[Jaz]
Okay.

[Gulshan]
No, they’re not allowed to know you. They’re no contact whatsoever. It’s your legal people who it is that they use according to the type of case. So if it’s crown and bridge, they might choose a prosthodontist if it’s all implant related. They might choose someone who’s got a history in implant dentistry, but it needs to be someone that can give relevant experience. Here’s where some other cases fall down Jaz, because we’ve already mentioned this term expert witness, but there’s a bunch of people out there who are qualified to be expert witnesses that cannot necessarily qualified to make comment on work that you and I or any of the practitioners done. Mm-hmm.

[Jaz]
So it’s like me commenting on someone’s implants, but I’ve never placed an implant. Well, I have, but like, I don’t do implants basically. I’m not in that field, but me commenting, is that- Okay.

[Gulshan]
Yeah. It’s a really big deal. I’ve had this kind of situation in the past as have colleagues where the case is getting very serious and the person on the other side who’s basically coming at you with all of this information might not have done or been involved in the type of treatment that you’ve provided, and therefore, how can they actually make-

[Jaz]
There’s no credibility there, in my opinion.

[Gulshan]
No. They might have qualifications, they might have loads of letters after their name and sometimes I get controversial online and I say about all of these diplomas and things that are quite frankly, a waste of time. I’ve got a diploma, which is mostly a waste of time, right? It’s my implant diploma from the Royal College of Surgeons. Now, hardest exam I ever did. Right. And it means a lot to me, but that’s all just me. No patient gives a damn whether I’ve got a diploma from this Royal College or that Royal College in implant dentistry. What it might help with is a case like this where if someone tries to sue me and I can show that I’ve got this, that, and the other qualification, which was independently examined, right. Then it might help.

[Jaz]
Okay.

[Gulshan]
Yeah. But if I’ve got this qualification, and I’ve been doing implant dentistry for let’s say 20 years, but I’ve only placed 50 implants. Do you see what I mean? About how well, where’s the value in that diploma qualification? It’s the same for an expert witness.

[Jaz]
Mm-hmm.

[Gulshan]
So they’re qualified as expert witness and making comments, but they don’t actually actively provide that treatment, then you’ve gotta ask, where’s the credibility? And that’s one of the ways we want this case, because later on through the case, when it gets more and more serious and then there’s barrister involve, because then there’s talk about going to court as soon as talk about going to court, because of the other side won’t cease and desist. Things get expensive. There’s big meetings. I’ve spent hours and hours. Conference calls with four or five other people to defend this case. And the bill is just going up, and up, and up.

[Jaz]
Now, for you, it’s costing you your time, your precious time.

[Gulshan]
Yes.

[Jaz]
That’s the most valuable thing we have, but am I right in thinking that because mps their protection, were protecting you, they were paying all the legal costs and everything.

[Gulshan]
Everything. That’s why I have to give massive thanks and praise to them because-

[Jaz]
Can you claim back loss of earnings just out of curiosity?

[Gulshan]
No.

[Jaz]
No. Okay.

[Gulshan]
There is a rule which my lawyers told me about afterwards, because many people who commented online after I put this thing out publicly on Facebook, many people said, you must count to, so you must do this, you must do that. And I’d love to. But number one, NPSs obviously won’t pay for it. And the second thing is that even if I did choose to pay for it, there’s protection for the patient, right? In a personal injury case in the UK, a rule was introduced in 2013, which means that a patient is able to make a personal injury claim, against medical dentist, whatever without recourse. That means even if they lose, sorry? Yeah. If they lose and you win and there’s no case to answer, it doesn’t matter how long it took, you can’t go after them. Because the law says that if you could, then these big insurance companies and agencies would basically prevent patients from being able to complain. Okay?

And you’ve gotta see it from that point of view that there’s some huge agencies out there, which people are scared to go after hospitals and this, that, and the other. And they’d never get caught out. So it’s there for good reason.

[Jaz]
It makes sense. I think, and when you put it like that, I think, that protection makes sense. Otherwise, I will say we need to start, start a crowdfund right now. And I know that you’d get a big amount to do it, but because of the nature of it, we can’t do it. Can I just ask you on the human emotional side, like, I’ve seen you lecture live for, you’re a confident guy. You’re a great speaker. You are very successful in what you do, which is great. And I love that. And, I just look at you and I think, wow, this guy could handle it. Did you have any low points? Because for me, I mean, I get like a whiff of a complaint. I’ve never had a formal complaint yet.

Touch wood and I say yet, because it’s coming. And I know that, but. Even when something fails, a temporary crown really falls off, just for me as my personality, it affects me a lot. And so, and I know lots of dentists who get crippled by this, absolute crippled by this. So how did you cope emotionally?

[Gulshan]
So, that’s like two separate questions, Jaz. So one thing is, I’m massively passionate about the clinical work I do, right? I take it personally, if I can’t satisfy the requirements of a patient, whether they’re new or old, it doesn’t make any difference. And actually the best thing about my work and my practice that I’ve developed is that my regulars, they recognize that.

They recognize that I go all out, day and night to try and to do what I can. And I did for this lady as well. I honestly hand and heart did, and my legal team know that, I got emotional a few times in some of the case conferences. Where it’s really difficult to know what someone’s saying against you, and you know that they’re out for money, right.

And you’re thinking, but I did this, this, this, this, this free of charge. So one little aside, this isn’t the first time I’ve been sued, right? But I’ll tell you one thing, every single time someone’s come after me, sadly it’s been the people who I’ve done the most for, right?

[Jaz]
Mm-hmm.

[Gulshan]
The people who I’ve gone out of my way for. It’s often been those people. So that’s one thing. The second thing is that, how did I feel personally about this particular case? I felt angry because nothing more than that. Just angry because like I said, as I knew her for nine and a half years, I knew her type of character, and got on really well.

I knew a lot about her family, her situation and there was some degree of, I felt sorry for her situation, which is why I was trying to go out my way to help. But there’s only so much you can do, Jaz. We’re all human and I come to work to earn some money. I’ve been in a lucky position where I’ve been financially successful for a long time, so I can afford to go out and do things for people for free whenever I want to.

Right. And in this particular case, I was trying, but we’re going to take it so far when you know that they’re irregular tender, that in my opinion, kind of disloyal. So yes, I was angry. I was angry at the fact that she had taken it legal that this was going to cost me time, money, and effort to fight it. But because of that anger and that determination, and having gone through all of my records multiple times, I thought this is rock solid.

[Jaz]
Mm-hmm.

[Gulshan]
So what you need to know is, I said to my legal team right at the start, under no circumstances and like settle rules, right? So the legal team have to have your permission to settle. They’ll send you a standard letter. And before they even asked for my permission, I just told them straight, been through it, left, right, and center. I’m not giving up on this. That was years ago. Mm-hmm. . So that was my stance on this.

[Jaz]
But, someone who’s not as robust as you, someone who maybe has only two years into their implant journey, and imagine that happened to a young dentist. Right. And maybe got a different life circumstance, whatnot.

I mean, let’s take a moment. Think of our colleagues who are at different stages, and young dentists vulnerable. And maybe that dentist whose record keeping that day wasn’t as good as it should have been. And then even though what you did was right, but your record keeping wasn’t good. Then you can’t help but feel helpless and really it can affect you. Now, your record keeping was good. You had this long history, you had some experience before you even treated her and whatnot. So I think that gave you the courage and the termination and the conviction that you needed. But what advice would you give someone who really needs some help? Emotional help?

[Gulshan]
Jaz, excellent question. And that’s the whole point of this. This is why number one, I publicized the post. And number two, I agreed to do this with you to help not just colleagues that are 21 years in like me, but also mainly for the new graduates, the people that are scared that this might happen. Because I do see the fact that a lot of new graduates are really quite happy just to refer out things, which really we’ve all been taught how to do. Right, and it’s because of litigation risk, I believe. So that’s going to be there. I’m afraid, guys. That’s the world we live in. That is the profession in the UK. So my advice would be that if there are vulnerabilities in your case and you know about them early on, then give yourself a break, learn from it, and basically say to the team, hands up. Yeah, I can see how there’s vulnerabilities in here. Why should the rest of the group of people that are indemnified by that agency, whether it’s insurance based or otherwise suffer and have their premiums go up because you are being egotistical about this, right? You’ve gotta put your hands up and say, you know what? My bad, I should have I clinically might have done things perfectly, but you know the rule, if you don’t write it down, it didn’t happen, right? If you don’t write it down, it was upset. And that’s why the notes have to be the way the notes have to be now, right? So if I go 15 years back, 18 years back and look at my records, I’m appalled. I’m like, okay. Yeah, that would stand up now-

[Jaz]
Because you’ve got the scars now, right? Because you’ve got the scars.

[Gulshan]
Exactly.

[Jaz]
And now you can criticize your former self.

[Gulshan]
Precisely. And if you don’t do that, which is audit, right? It’s you self-auditing and doing something to get better, to reduce your risk. So it’s risk management, basically. So it’d been on many of those courses. Now I’m in a position where I can teach it and look at what we are doing now, right? This is me through you helping other people mitigate their risk in clinical dentistry by saying, listen, there’s dos and don’ts and there are pain in the butt. Having to write reams of notes. So for instance, yesterday I did a 10 hour clinical day. I then spent two and a half hours afterwards at home writing up all of the records. Right. That’s crazy. But if you want to win the next case and the next case, because like you said, we all know they’re coming, right? This is not going to be my last case, right? Yep. We need to have that on our side. And if you have that on your side, and you can just dump that on the legal team and say, go guys, run with it. By the way, I’m not settling this one. Right. They’ve got some ammunition to fight for you. But if you don’t help them to help you, I’m afraid you’ve got to back down. And say, you know what? I’m going to take this one on the chin. Can you settle it for me without accepting liability? And then away you go. You carry on. But you don’t carry on the same way, Jaz. You’ve gotta learn from it. And you’ve gotta say, what did I do wrong or what did I not write down? Or whatever it is what courses do I need to go on? And off you go and you start learning and developing.

[Jaz]
And would you say Gulshan, one thing I feel is that then there’s all these composite veneer courses and fancy stuff, there’s not enough people going on these risk management courses, right? There’s not enough people going on the soft skills courses.

[Gulshan]
It’s not as sexy, Jaz.

[Jaz]
It’s not as sexy.

[Gulshan]
So what happens is, and I’ve been on these risk management courses and the kind of people that are on these risk management courses, they’re people that have been done already, right? People like me, people have been sued. People have been in front of the GDC, people who have been told by the indemnity organization, if we are going to get you off this right, you better be able to show you’ve been on this, this, this, this course. Right? Go and get the CPD certificate now. That’s what happens. So when you land up on these courses and you realize everyone around you’s got history and you can tell because everyone’s sad, no one’s smiling at these courses. And it must be difficult for the people that run them too. But you know what, they’re so, so important. It’s like when you get caught speeding.

[Jaz]
I was just going to say it’s a speed awareness course. It reminds me of my speed awareness course.

[Gulshan]
Speed awareness course, right. Someone I know went on one recently and said to me that what, it was enlightening. It was absolutely enlightening.

[Jaz]
I actually learned a lot from my speed awareness course.

[Gulshan]
Yeah. And this person who I’m talking about has been driving for about 15, 16 years, 18 years and said it was enlightening. It’s exactly the same when you go on these less sexy courses. So I was given a course here on Friday, and part of our course is a lecture on materials. And I said to my delegates, I said, when was the last time since uni you went on a course about material selection? No one does it. It’s not sexy. No one’s going to pay good money to go on a course to learn about materials. Right. But actually our feedback tells us from our day courses that we run, that’s the most popular part. So it’s about stepping outside of the box, thinking laterally about these kind of cases that occur, the kind of dentistry that you are doing and what you can do to mitigate your risk. Right. Because like you said Jaz, it’s going to happen to everyone.

[Jaz]
Mm-hmm.

[Gulshan]
So, I was told when I qualified from Birmingham that it’s highly likely that in your first X number of years, you’ll be sued twice or this many times. Yeah, it’s much, much harder than-

[Jaz]
The number I was told in 2013, Raj Ratan stood up and he said something like, you’re going to be sued five times your first three years or something. Complaint, like something crazy. And it was just at that time where the UK had become number one as a most literal, or number two, basically overtaking Israel or something at the time.

[Gulshan]
That’s right.

[Jaz]
It’s coming. And so, the key lesson we just shared just now is get those courses under your belt now, because it’ll make you a safer practitioner. But also when the proverbial hits the fan, not if, but when, it will also help you then as well. And just so I don’t forget, in the show notes, I’m going to put the phone number for Confidental, which is a charity. If you need emotional support, any point. These are guys who do great charity work and will help you emotionally, if you need it. Gulshan, can you just tell us, can you conclude the case? What happened at the end? How did it happen? And then, because you’ve shared already some lessons, anything else that you want to share in terms of lessons to people watching and listening?

[Gulshan]
So, the first thing is that when you get into a case like this and you choose to defend it, right? Because let’s say there aren’t so many vulnerabilities there are expert witnesses on your side. There’s lots of meetings to be had. So it got to the point and there’s several emails that I sent and saying, hold on a minute, why is this getting to court? Because literally legal documents are coming from court now to say this is what’s happening on this date, that day, and we’re getting deadlines from court. And I’m like, we’ve already told this person years ago to see some desist. So the lessons are that you don’t, once you get into it, you don’t stop and give up, because if you do, it’s going to get very costly. So once you are in this role and your indemnity organization is supporting you, you’ve gotta remember, other people have given up their time, money, and effort, right? So if you pull out, it’s a real slap on the face for them. So we kind of support each other. And, at the end of the day, they’re trying to protect my reputation. And the reason that we’re publicizing is to try and help other people know that you don’t have to roll over every time, right? So we go through and it’s getting to the point that there’s a court date, right? And I have to now give up three days of my life to be at court. I’m going to get examined, cross-examined. I’m going to be given evidence she’s going to be there. I haven’t seen her for years, you’ve got to know how to behave in court. You’ve gotta keep your composure, be professional, all of those things. And that takes some planning, preparation. Now, amongst other things, I’ve been to court several times as well. Pleased to say everyone, every single time, it’s not for everyone. It’s not for the lighthearted, right?

[Jaz]
Oh, I can imagine.

[Gulshan]
Not nice places to be. You only enter these things if you’re going to go all of the way. Right? Because if I said to them, yeah, I want you to defend this four and a half years, and then at the end. I choose not to go to court. Right? The whole thing falls apart, right? In this particular case, my own team had to subpoena me, which basically means I’m forced to go to court, right? I couldn’t say no. So that’s what they do and they apologize and they said, look, it’s a legal thing. We have to do this because you now have to it in court. And that’s happened to me in the past where I’ve had to give evidence in other cases and I really, really didn’t want to. But when they know you’ve got evidence to support that case and it’s make or break, you’ve got no choice. So that’s one thing is keeping your composure, keeping level headed. We’re all professionals and there’s many times in our careers when we’re put into situations where we’re outta our comfort zone and you’ve gotta roll with it. You’ve gotta have a support team around you. So the long drawn out answer to your question is having people around you, like you just said about Confidental, about emotional support.

I couldn’t have done this without my support team at my practice, my legal team, their support, and at home. Because this stuff comes home with you. This stuff is in your head. You’re taking time out at lunch, before work, after work to be able to put all of this together. Um, yeah, it takes hours and hours to do.

[Jaz]
Because you’re so busy. You run a lab, you are so involved in education. You have a busy 10 hour days clinical practice, and then to have this on top, I mean, wow. Training.

[Gulshan]
Yeah. It’s my training, it’s emotional training. So I look at other people and I think, how the hell do they do this, that, and the others? Because I’ve taken on all of these other things in my life. So if you want to be a rock solid practitioner and be able to mitigate your risk of things like that, and sleep at night and have hobbies and blah, blah, blah, then you’ve gotta look at your whole big picture. You’ve gotta look at what’s common.

You’ve spoken about work life balance. Mine’s messed up. Mine’s not great, but like I said, all of those people around me know me. They know what drives me. And actually I get bored very easily. So I’m not asking for more legal cases against them to stimulate me. But what I’m saying is that I need to be kept busy.

So, because this case, in my opinion, my side was rock solid, I was able to roll with it. It’s when there’s vulnerabilities, Jaz. It’s when you know you didn’t say something, you didn’t give him an option, you didn’t write it down. Endo was crappy. You know anyone that sees it’s going to laugh at you. Yeah. You’ve got to just put your hands up and say-

[Jaz]
Acceptance and learn from it.

[Gulshan]
My bad. Yeah.

[Jaz]
Did you end up going to court then, Gulshan for this one?

[Gulshan]
No, it’s literally, what happened was they pulled out, so there was a deadline on this. This was just a few weeks ago. This was a deadline, a court deadline on the Tuesday that the other side and north side had to hand in the dossier.

Right. So the court has to know upfront what all of the arguments are from each side because the court wants to know that their time’s not being wasted otherwise they fine you. The other side basically left it to the last minute. Tuesday morning was a deadline. Monday, four o’clock in the afternoon, they pulled out the case in time.

That was it. So their vulnerability was actually their expert witness. Right. Their expert witness would’ve been taken apart by my lawyer and actually by me. My own barrister actually said that he wouldn’t want to go up against me. Not in this case, right?

[Jaz]
Yep. Yep.

[Gulshan]
I honestly know this lady from me treating her for many years. I form bonds with my patients, right? And that’s how they allow me to do invasive treatments for them, and they give me money for it, right? Yeah. People forget that-

[Jaz]
That’s a high level of trust involved to get to that stage.

[Gulshan]
Yeah, massively. I’m still, I’ll tell you shocked when someone comes to me for a full arch implant case and I’m like, wow, I’ve only met you three times and you let me just do that to you, and then you paid me for it. So, the level of trust is crazy. And I don’t know if I could do it. But these other people do, and this is what I try to get my team around me to appreciate that guys, these people that come and put their trust in us, pay for our lifestyles, pay for everything, right? So have some respect for the fact that they’re in this position. So it’s about looking at that bigger picture. Jaz. The other thing that made me angry about this case was that if the other practitioner involved in this case had just said, you know what, can you gimme a hand with this? I know she was your patient before, but she’s here now. Because I’ve done this for other people. Right. That practice and I have some history. And there’ve been some legal cases between us, so I’m not surprised. That’s why I believe this patient was kind of pushed towards-

[Jaz]
Spared on, you think?

[Gulshan]
Yes, definitely. Because it was all about money and what she had done by this other practitioner was the opposing full arch. And because the occlusion was totally messed up, hence early on. Exactly.

[Jaz]
Hence the cascade of events right?

[Gulshan]
Exactly. And we could prove that because we now had all of the records of all of the different practices, you could put together a timeline. And actually she was suing me for my implants that were in there for years. And they were successful, right. When the practitioner-

[Jaz]
And they’re still there? Also integrated?

[Gulshan]
Yeah. Some of them are still there. In fact, a practitioner that tried to take them out couldn’t get one of them out. Cause it’s so well integrated, right? But this other practitioner who spurred her on to complain about me. He placed multiple upper implants. I cleared the arch, put a full arch in there, right, immediately loaded it. They all failed, right? Then he went and placed more implants for her, and some of them are okay still, but this is what I don’t get. My implant was still there, but because of things that were said to her outta context, that’s where the problem is. So I suppose in closing, talking about this case, what I would say is, whether you’re an associate or a principal, whether you’re moving around practices, what’s most important is making sure that your patients stay with you, right? Do whatever you can. So customer service, whether NHS or private, makes no difference, right? The longer they stay with you, the less likely you are to get a complaint and the more likely you are to get the opportunity to fix things if it goes wrong, right?

[Jaz]
Mm-hmm.

[Gulshan]
And the first thing is saying, sorry. In one of my lectures, I talk about dentists and technicians and their egos. Right? And you know what? Even if you haven’t done something wrong to say, I’m sorry about the way you’re feeling, you mentioned Roger Rutten been to many of his legal lectures, and you don’t necessarily say sorry for what’s happened, but you definitely say sorry for the way they are feeling.Or have been made to feel that goes a long way to diffusing the situation. Now sometimes we’re given that opportunity, other times we aren’t. Right. In this particular case, I could show you emails where we said, ‘Hey, sorry you’re having trouble, but we’re here to help.’

[Jaz]
Yep.

[Gulshan]
She just didn’t want that help. What she wanted was money to pay for the full art she had done somewhere else. See what I mean?

[Jaz]
I mean, what I want to know now is the last thing is those three days that you had booked off, please tell me you enjoyed yourself. You opened some champagne and you, you went away to, to, to, to put this behind you. Don’t tell me you went to work and you-

[Gulshan]
So the champagne was opened on the Monday night. When I got the news, it was an email late in the afternoon. I was with patients. My practice manager called me down and said, you have to look at it. You have to. I was like, oh my God, what happened now? And I go down and the lawyer sent an email and the subject line was in capital letters so that we didn’t miss it. And yeah, he said it all, and the relief Jaz, I just literally collapsed into a chair. And I was like, oh my God. I called all of my team. Whereas, a small to medium sized team, I called everyone. We opened the email together and read it. And yeah, I was just relieved. It wasn’t a problem having to go to court. That was a Monday, the following Monday would’ve been in court. It wasn’t a problem for me going to court in this matter. Right. Because I knew the case, it was hassle. Right. So, yeah. My days were blocked. The girls opened them up. Yeah. I’m afraid. I did go to work. I think one of the days I might have even gone to another practice and helped another colleague. But yeah, I had plenty of time to celebrate in between.

[Jaz]
I hope you did. And, I really appreciate you making yourself vulnerable. Oh, guys, we have to appreciate and salute Gulshan here because he’s sharing his story with you. How many other people are stepping up to share these stories? Okay. Not enough. And you’ve shared these lessons, you impart in some lessons. I really appreciate you, you giving your time for this and energy for this. And I really hope that this reaches all the dentists, whether they’ve been never been sued before, or they have been through it. Because I think there’s so much we can learn as a profession. And you’ve inspired me, Gulshan, to get some more guests on about risk management. I want to do more risk management kind of episodes to help our professions. And I have much to learn myself as well. So, Gulshan, how can we reach out to you? Please tell us about website, Facebook, all that kind of stuff that people want to connect with you, learn more from you.

[Gulshan]
Generally social media. So Facebook is where I’m kind of most prevalent. I’ve got various pages on there, but just search me up, send me a message. I’ll get messages from dentists and people in dentistry worldwide. I don’t need more of them. I see them. And-

[Jaz]
You run a few Facebook groups, don’t you?

[Gulshan]
I’ve got three Facebook groups with thousands of members, they’re all kind of focused towards digital dentistry, I’m afraid to. If that’s not your bag-

[Jaz]
We’re going to be talking about that next anyway, so if you want to learn more about digital dentistry, then we’ll tell you about those groups. But yeah, do reach out to Gulshan, please thank him. Please, if you found value from this episode, Please. Do you know you spent an hour with us there about, I think this deserves a thanks from our community. So, from Protruserati to you, Gulshan, thank you so much for sharing your story, my friend. I’m really, really pleased for you. I’m really pleased that you had the conviction yourself to fight this for encouraging your defense IT. And yeah, hats off to it. NPS, thank you NPS, for allowing this to happen. I think that’s credit where it’s due.

[Gulshan]
Absolutely.

[Jaz]
And I hope that wherever you are listening to this, if you’re going through a rough patch, I hope you get some inspiration from this.

[Gulshan]
Thank you, Jaz. Thank you for the opportunity and yeah, absolutely. Colleagues out there, several have already contacted me privately and didn’t want to talk about things publicly, but I was utterly shocked in the first 24 hours of putting this message out that had been successful in this way in the first 24 hours. I’ve got over 500 likes and comments. It’s still going up. It’s over 700 now. And yeah, it just shows that firstly, people actually occasionally read my posts, which is great . But also the fact that it rings true with so many people that they know that there’s this risk out there. And yeah, for years I’ve been talking about helping people to reduce their risk in political dentistry. Yeah, I put it out there. Feel free to contact me. Thank you, Jaz.

Jaz’s Outro:
Amazing. Thanks so much. There we have it. Guys, thanks so much for listening to this very special interference cast all the way to the end. If you like my non-clinical episodes, please do give it a rating on the podcast app that you’re listening to, or if you’re watching on YouTube, give a thumbs up to say that it made it to the end and I gained value from that. And please say thank you to Dr. Gulshan Murgai. Putting his head above the parapet, showing up, turning up. We have to always appreciate people who turn up and represent our profession in the way that he did. So thanks so much Gulshan for sharing everything that you went through, and I hope wherever you are listening, if you’re going through a rough patch right now, let it be known that it’s a group of colleagues that are here to support you. And if you need any support, please do click below in the show notes or scroll down and see the phone number for Confidental who are in charity that can help you so you don’t have to suffer alone. We are a community of dentists and we want to look after each other’s mental health. So please let it be known that you are not alone, my friend. I’ll catch you in the next episode of the podcast. Thanks so much for listening all the way to the end.