Smile Business Diaries Conversation with Dr Simon Bate

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Smile Business Diaries Conversation with Dr Raquel Reis

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Maria Cabanellas: Welcome, Dr. Simon Bate. It's a pleasure to have you. I hear you're from northern England and you have a lot of wisdom to share with us today, so I'm excited to meet you and learn more about you.

Dr. Simon Bate: Thank you very much.

Maria Cabanellas: Absolutely. You know, this is a very unique podcast, I believe, because I have never actually spoken to you before this moment. So I think it's going to be very interesting to get all the details of who you are and where you've been in your journey in dentistry to share with others. To start off, would you kind of give us the foundation of what kind of practice you have, who you are as a person, and all that general information?

Dr. Simon Bate: Okay. So, you've already said I'm called Simon. I've got a private practice in the north of England. Obviously, the United Kingdom has NHS dentistry, a national health dentistry system, and private dentistry. I have a private clinic in the north of England, and I’ve owned it for 17 years.

For the first sort of 10 years, I looked after general patients as dentists do—finding out what works, what doesn't work, looking after people. And then as I did more courses and learned more skills—things like orthodontics, implants, more complex cosmetic work, oral rehabilitation—I started doing more and more bigger cases and less and less general work.

Discovering DSD, that’s what brought all of what I'd learned together into one place and really got it to a position where I could remove myself from general dentistry and just focus completely on the big stuff. It gave me the confidence to do that and to deliver quality cases each time.

Maria Cabanellas: Wow. So, you mentioned the National Health Service—is that what it's called?

Dr. Simon Bate: Yeah, yeah.

Maria Cabanellas: I believe—is that specific to England, or is that all of Europe? Because in the States, where I'm from, we don't have that specific model. Would you be able to explain that a little more?

Dr. Simon Bate: Yeah. So, it’s more or less unique in the world. It’s state healthcare. If you break a leg and you go to the hospital, it'll get sorted—no one will ask anything about you, they’ll just do it.

Dentistry is slightly different in the NHS. Practices are privatized clinics paid for by the NHS. So things like what you get paid as a dentist are set by the NHS, if the patient has a fee that’s set by the NHS, and the NHS decides who can be treated without having to pay anything. So, if you're on a low income or whatever, you don’t have to pay anything at all. But you are then tied by huge bureaucracy and guidelines, and more and more dentists are choosing to leave the NHS now, which is a shame for the population. But for the money that’s provided for dentistry, as a system, it’s just not working.

Maria Cabanellas: Got it. I guess that would be more like our Medicaid or government care here.

Dr. Simon Bate: Yeah, that makes sense.

Maria Cabanellas: So, in your area, is it something you have to do as soon as you get out of dental school? Is this like a mandatory position?

Dr. Simon Bate: Less and less. When you qualify as a dentist in the UK, you can walk straight into private practice and work. But if you want to work within the NHS, you have to complete a year, which is called foundational training. It's a bit like your first year in a hospital, I guess. You work with a dentist who will look after you, mentor you, and at the end of that year, you get given your own NHS number. Then you can be a provider on the NHS.

You have to do one year. They’re talking about increasing it to three or four years because they are struggling so badly to get dentists to work.

Are you familiar with Brexit?

Maria Cabanellas: No.

Dr. Simon Bate: Right. So, in the EU, which is the European Union, the UK was part of that, but we removed ourselves a few years ago. That prevents free movement of people. What used to happen is when the NHS was struggling for dentists, dentists could move from anywhere in Europe and start working here. That’s gone now as well, so there is a labor force shortage within dentistry at the moment.

Maria Cabanellas: Right. And what do you believe is the main cause of it? Purely because of the system—that dentists just don’t want to be involved with it?

Dr. Simon Bate: It’s like anything that relies on public money. The NHS was set up in 1948. The breadth and scope of what could be achieved within healthcare just wasn't the same. People didn’t live as long, so it didn’t cost as much. Now, government decisions prioritize curing cancer over treatable, preventable dental disease.

That money has to be divided up, and the money in the UK system is peculiar in that if you have one filling or ten fillings in one course of treatment, you only pay one fee. That fee is about $70 equivalent, about £60. So dentists have to do huge volumes of work to make a profitable business. They have to use less expensive materials and things like that, and it’s becoming unsustainable.

Maria Cabanellas: Yeah, it's unique but also not. However, in your area, I guess it's common, right, to have to go down that pathway or almost mandatory before you have your private ownership, which you have now. So, taking you back to that moment when you were going through this, how do you feel this kind of set you up for your future? And what did that do to you, to have to go through that process?

Dr. Simon Bate: I definitely don't think it was a bad thing, and I'd recommend anybody to do it. That's a good way to put it. When you're doing such huge volumes of dentistry over a lot of days, you really sharpen your skills really quickly. But it's providing basic dentistry, you know, you're doing nothing complex at this point. You're doing amalgam fillings, you're taking teeth out, you're making dentures, you're doing some root canal.

But when you're fresh out of dental school, you have to do 10,000 hours of simple treatment before you're ready to do more complicated work. I think it's quite right.

Maria Cabanellas: Absolutely. I would hope so, at least for most people, right? So now that you are privately owned, can you tell me about that process—how you got there?

Dr. Simon Bate: Oh, do you know, it's a simple story. The village that my practice is in is where my dad lives, and my dad was literally in the pub and overheard the dentist that owned my practice saying he was thinking of retiring. And I wrote him a letter and said, "I want to buy your practice."

There’s a bit more to it. I was very young—I was only 26. And my uncle's a dentist, so we bought the practice together on the understanding that he would sort of mentor me in running a business, learning to manage staff—all that side of it that you don't get taught in dental school.

And then as he started winding down toward retirement, I’d take over running the business. And then eventually, I’d buy him out, and that’s where I’m at now.

Maria Cabanellas: Got it. So your uncle, correct, was a dentist at the time?

Dr. Simon Bate: Yeah, so he's retired now.

Maria Cabanellas: And so, you had the plan right away to have your own practice, or maybe not? I’m kind of guessing.

Dr. Simon Bate: No. So my uncle, he was very forward-thinking as UK dentists go. He had one of the very first fully private dental practices in the UK. Nobody was doing it when he set his up.

He’d been to see a guy speak called Paddi Lund, who was very focused on customer service and things that just weren’t talked about in dentistry. It wasn’t a thing back then. Dentistry was just somewhere that no one wanted to go—you got your teeth drilled, and you got a silver filling.

So, while I was at dental school, I saw this amazing private practice that nobody had. And my absolute ambition was to have another one of those because it was magnificent.

Maria Cabanellas: Wow.

[Break Segment]

Hello, I’m just taking a quick break from this podcast interview to tell you how you can get started with DSD.

If there was anything that our guest has mentioned that strikes a chord with you, or you are curious about becoming a DSD Clinic, I encourage you to book a call with me.

This is a 30-minute, no-obligation information-sharing session in which I can answer your questions about DSD and discuss your options based on your unique circumstances.

The link to schedule a call with me can be found in the notes on this episode.

Now, back to the interview.

Maria Cabanellas: So, how did you go about it, though? Because I would assume since he was the first one, or maybe you know about his experience personally, being so close to him—what was that like, you know, kind of being the pioneer for private dentistry in your area and being one of the first?

Dr. Simon Bate: Well, by the time I got involved, private dentistry was becoming more and more mainstream. Watching his journey was fascinating. Now, he’d had his practice 10 years by the time I bought mine, so that would have been 1996, 1997. Dentistry back then was almost 100% NHS.

Maria Cabanellas: Did he have any backlash, or were patients kind of hesitant to go to him? You know, there had to have been some fears. What do you think was the hardest part of transitioning?

Dr. Simon Bate: The hardest part, well, the hardest part is like every business, I guess. Even DSD now—it's getting the word out about why it's better. You know, why, when you can have, at the time, a filling for £12, should you go to a private practice and pay £100? Why should you do that? Sounds insane, doesn’t it?

So what John did is he set up this private practice while he was still working in an NHS practice. That way, when he unlocked the doors, if he got no patients, at least he had an income. And then he gradually wound that down until he finished NHS and went fully private.

But what people realized is that once you introduce a bit of customer service—when you don’t keep people waiting for two hours, when you don’t have to have a silver filling, and when you don’t have to wait four months for an appointment—when you start seeing the benefits, word quickly gets around, and his business exploded.

Maria Cabanellas: Right. So did you end up taking any of his advice in his journey and applying it to your own when you transitioned?

Dr. Simon Bate: 100%. I was two years out of dental school when we bought the practice. So, in hindsight, I look back and I thought I knew everything. Turns out I knew nothing.

But yeah, the big lessons were the customer service side. You don’t get taught any of that. And looking after people and, you know, the business side—I didn’t know how to reconcile accounts. I didn’t know anything about HR. I didn’t... you know, the learning curve was steep and severe.

Because the practice that we bought was quite quiet, I was there on my own four days, and then John would come in on the fifth day. So, you know, I had to learn fast. And he was on speed dial on my phone. I talked to him every day for about two years.

Maria Cabanellas: Brilliant. It’s one of the most important things, from what I hear. Is there anything else that you’d say would be the most important to consider for somebody else out there who is trying to do the same thing as you—to buy a practice or transition from NHS to Private Practice?

Dr. Simon Bate: So yeah, somebody who wants to do that has to focus 100% on looking after people. And that includes everybody—that’s your staff, that’s your patients.

People go to an NHS practice because they’ve got no choice. People go to a private dentist because they’ve chosen to. And you have to give people a reason to choose you.

So you’ve got to upgrade your skill set. You’ve got to study. You’ve got to go on courses. You’ve got to practice it, make sure you can do it well. And then, when people come in, you have to be nice to them and look after them, because that’s the bit they see.

If you do a beautiful posterior composite, they don’t know the difference between that and a rubbish one. But they will know if the injection hurts. Or they’ll know if your children have been up all night and you’ve not slept, and you’re cranky. They’ll remember that.

Maria Cabanellas: Yeah, absolutely. I think that’s a beautiful statement. You know, "People go to NHS because they have to. People go to you because they choose to," right?

And the flip side of that too—you’re in a different dynamic. I’m sure you feel a difference in the relationships you have with your patients and your team in those different settings. Would you be able to share anything on that?

Dr. Simon Bate: Yeah, so there’s more to that than you’d think as well.

The problem with something being provided free of charge at the point of contact is if something is free, by definition, it has no value. So things like attendance rates are appalling in NHS practices. Patients just don’t turn up because they don’t see that that appointment had any value. So why should they?

People in private practice, they really, really appreciate what you do because they realize the cost that’s associated with it. People turn up on time. They do look after their teeth. It’s completely different.

And, you know, if you’re trying to do high-volume work on the NHS, you haven’t got time to find out about your patients. You can’t sit down and chat.

I’ll tell you one of John, my uncle’s, stories. He was in an NHS practice years ago, and he said a patient was a World War II veteran trying to tell him about how he’d been parachuted into Japan, I think, and was getting shot at. And John didn’t have time to speak to him because he had a waiting room full of patients. And at that moment, he was like, "Right, I’m out."

You know, the guy was on his own and wanted to talk. He had a fascinating story to tell, and John was too busy to speak to him.

The transition—I didn’t have as much of that because when you do your foundation year, you don’t have the same pressure to work at a huge pace. I only did one year working at that pace.

But, you know, I looked after patients for 10 years, and I live in the same village that I work in. The patients that I’ve looked after for 10 years, they’re my friends. I walk into the pub, and it’s full of people I’ve looked after. And, you know, it’s lovely.

Maria Cabanellas: Absolutely. And I know that this is a common thing. You know, especially when you’re out of dental school, you have a lot of debt, and you’re trying to make that money to repay everything. It can be challenging to get out of that mindset of quantity versus quality, right?

This is like everybody’s dream—to have comprehensive cases every day, full-mouth rehab, you know, and get into the fun stuff. However, it’s not easy, right? It’s not something that you have a little secret recipe for, and it’s done.

Maria Cabanellas: Can you explain what your process was in that—how you overcame the immediate "I need to pay off my debts, I need to earn money, I need to get more patients" versus "I need more time with my patients, I need to create these connections with my patients" and how that balanced out for you?

Dr. Simon Bate: I was... I’m quite lucky on a lot of fronts on this. My wife is also a dentist, so when I wanted to buy a practice—which meant more loans—and I still had student debt left over, and I was taking a huge reduction in my income, my wife was a working dentist and supported that. So that was fabulous.

The other thing is, I bought my practice young—really young, relatively. So I didn’t have a mortgage on a house. We were renting a flat at the time. We didn’t have any children. We didn’t have... When I’ve watched the journeys of a lot of my friends who were buying practices where I am now—where I’ve got teenage children, I’ve got a mortgage to pay on my house, I lease my car—I think, to start that now would be terrifying.

And there’s got to be a real balance, because my advice to a young person would be to go away and learn to be a really good dentist before you buy a practice, but also don’t leave it so long that you can’t take a reduction in income. And finding that balance is really difficult. It’s a challenging thing to figure out.

Maria Cabanellas: So is it fair to say that you sacrificed in the beginning to be rewarded at the end? Is that how it happened for you?

Dr. Simon Bate: Still waiting for that reward... but yeah. No, absolutely.

You make a really good point. My friends who didn’t buy dental practices until they were in their 40s—when we were buying the practice and really struggling to get a deposit together to buy a house—they were going on holidays to the Bahamas. They were buying Porsches. Associates in the UK doing a mixture of private and NHS work can earn a real lot of money.

You know, we weren’t doing that. And you’re right—that’s coming good now. And I imagine when my practice eventually gets sold, it’ll come really, really good. But for that time... I didn’t realize it at the time because I thought it was just all an adventure. But when I look back, I think, "Oh, you know, my wife did well to put up with that, really."

Because I was very... I was very driven. "This is what we’re doing, and we’re not discussing it. I’m buying this practice, and we’re doing it this way, and that’s what it’s going to be." So, you know, in hindsight, I should probably buy some flowers and some wine.

Maria Cabanellas: But you know what? Now you can buy her the whole flower store, right? You can give her everything now.

Dr. Simon Bate: Yeah.

Maria Cabanellas: I think that’s one of the most important things—your support system, right? And then, of course, to say, "I’m going to do this," and actually do it.

Especially like you mentioned, it’s so much harder now. Not just because of everything around us, but having social media, for example, and living in the digital age. There’s a lot of temptation, I think, coming out of school or just beginning as a dentist, where you have to create this image, right? And you have to almost convince people, from an online standpoint, that "I’m already successful"—and then you have to build up to that.

Which I believe is causing a lot of this stepping back from where you really want to go. So, I know this isn’t how you got here, but knowing where the world is today—if you had to do it over again, how would you do it?

Dr. Simon Bate: You hit upon one of my points when I was reading through the prep notes.

My advice to a young person—my single biggest piece of advice—would be: don’t go on any social media related to dentistry at all for five years. Don’t. Because the perception of dentistry—the Instagram perception of dentistry—is not dentistry.

It isn’t that. You know, these young dentists coming out of university, they see... I mean, I’m guilty of it. I have an Instagram page full of beautiful before-and-afters and how nice my practice looks and everything. Because in the digital age, that’s how you get patients through the door.

But that’s not typical of the last 17 years. It’s the culmination of 17 years of really hard work. And that’s getting lost in translation somewhere—significantly so.

Young dentists are coming out, they’re seeing these before-and-afters, and they’re thinking, "Right, I’m going to do a one-day composite bonding course." They’re all good at Instagram, they’re all good at taking photographs and getting testimonials.

But they’re ignoring basic dentistry. They’re missing bitewings. They’re missing caries. They’re not looking after people. And if you do all these cases without an understanding of occlusion, they’re going to fail.

And if you’re not telling people—because you’re trying to sell the treatment, because you’ve got to pay your student loans—you might not be telling them that in five years, it’s all going to be failing and need redoing.

And this... I mean, it’s good for people like me. You know, I’ll be able to make a career out of putting these cases right five years later.

But a young dentist... Oh! And then, sorry, just to add—Facebook now, as well.

There are dentist groups for dentists interested in cars. Dentists interested in watches. Dentists interested in Michelin-star restaurants.

And some of these groups are for true enthusiasts who will talk about an interesting car or an interesting watch. But some of them use it as a tool to show how much money they’ve got.

And young dentists have this perception that they’re going to walk out of dental school, they’re going to buy a house with 10 bedrooms and a Ferrari, and they’re going to do composite bonding—10 units, three times a day.

And they’re not.

They’re not getting the foundations right before they do it. And there are a lot of problems with social media, but certainly in dentistry, that’s one of them for me.

Maria Cabanellas: Absolutely.

Maria Cabanellas: So what exactly would be your foundation day? How would you map that out?

Dr. Simon Bate: So, like we were saying about working within the NHS and just doing basic work—for me, it wasn’t that. Actually, what’s really interesting is how I sort of cut my teeth, if you’ll excuse the pun.

When I bought my practice—this is a bit off-topic and a bit complicated—but there’s also, in private dentistry, a system called Denplan, which is capitation. Basically, patients pay money to Denplan, Denplan keeps a little bit, and then gives the rest to the dentist. And then the dentist has to provide all of their dentistry for that money. It’s a way for patients to budget for their care.

So when I bought my practice, I had a hugely neglected list. I had a thousand patients who hadn’t really had any proper treatment done for 10 years. So what I had to do—and where my foundation came from—was putting a thousand people right, effectively for no money.

Because they were just paying their £20 a month, Denplan was keeping their bit, and I was getting £15 a month—but I had to provide them all with mountains of treatment.

But that did two things:

1. It taught me dentistry training. I did hours and hours and hours of practicing, trying to rescue teeth that were on the edge of destruction.

2. It generated huge loyalty with the patients. Patients were coming to me and saying, “Oh, I didn’t realize I didn’t have to have that food trap between my teeth,” or “I didn’t realize I didn’t have to have a broken one,” or “I didn’t realize I didn’t have to have toothache all the time.”

So 17 years on, the majority of those patients are still with me. And that’s really nice.

Maria Cabanellas: Wow. And so, in the moment—as you’re basically doing free dentistry to catch your patients up to where they should be—what was your thought process? How were you feeling in those moments?

Because I can imagine, you know, you work so hard, you go to school for so many years, you build this practice, and then all of a sudden, the money’s not flowing in just yet. So how did you get over that hurdle and keep yourself grounded at the same time?

Dr. Simon Bate: Do you know what? I didn’t care.

It sounds... when I think about it now, I can’t believe I bought the practice. It should have shouted at me when I was walking around it—you know, the dental chair was held together by duct tape and glue. And I should have known that if that was the state of the equipment, then his patients were going to be similar.

But it was new and exciting, and I didn’t care.

I had the time. I had the time.

My wife was probably getting fed up because she wanted to go to the Bahamas, but I didn’t need anything at the time. I just wanted to look after my patients.

I was just enjoying the ride.

Back then, I probably would have found it arduous and annoying and a lot of things today, but back then, I needed the experience. And I didn’t know that I needed the experience, but it just provided it.

It was great.

Maria Cabanellas: Absolutely. You know, I think that’s something very unique for you because I talk to many dentists—about **DSD, dentistry, the business side of things, and all that—and I find there’s a good handful of people that have trouble walking through that fire of going through the tough grind work and getting to the other side.

So, for those people that are struggling right now, who are in the middle of the fire—where they’re giving free dentistry, they’re repairing their office, they’re getting out of insurance or National Health Systems—what do you think... what advice would you give to those people to help them stay on track?

Dr. Simon Bate: The process is like anything—fitness, business, anything—if you learn to do things really, really well, and you learn to look after people really, really well, the money will just happen.

Maria Cabanellas: Absolutely.

Dr. Simon Bate: I believe it just comes. I can’t—it’s nearly magical. I can’t say, you know, you do all this, you spend all this money on marketing and advertising, you finally get all the work done and everything else, but fundamentally—like I said—most of the patients that I’m treating are still the ones I was treating 17 years ago.

I haven’t done anything magical in the middle—I’ve just learned to do everything as well as I can, and I still do everything as well as I can. I don’t rush anything, and I charge appropriately. I look after people, and it all just follows.

Maria Cabanellas: Now, what tools would you say helped you in your transition, or have helped you today, to sustain where you’re at?

Dr. Simon Bate: That’s an interesting question.

So, DSD and everything else—I’m reasonably new to it. I only became a DSD Clinic just over a year ago.

Because I did everything so early, the hardest transition for me was to go from being a general dentist to someone who just focuses on DSD—bigger cases, rehabilitation, implants, all the rest of it.

And what that meant from a business point of view was that I had to take this thousand patients that I’d been looking after—who were my friends for all these years—probably by the time I came to this 12, 13, 14 years in—

Maria Cabanellas: You’re gonna tell us your age now if you give us all the details!

Dr. Simon Bate: I’m 43! I’m 43. So yeah, between 26 and 43, these people have been coming to me all that time.

I had to employ dentists to come into my practice to then look after those patients for me, to free up my time so I could take on the bigger cases.

Now, that was the leap of faith. That was the bit that gave me sleepless nights, the worry, and everything. Because basically, the entire practice’s income stream, I was giving it to someone else, trusting that I was going to get enough new patients coming through the door wanting the bigger work done—the impactful cases—so that, financially, everything would still work.

And that was—I probably delayed the transition to becoming a DSD Clinic for at least six months because of the stress and the worry of:

"What if—like John opening up his practice all those years ago—what if we unlock the front door and no one comes in? What if I give all my patients away, then I have to pay a dentist to look after them, and nobody else comes in and has any work done?"

Maria Cabanellas: So, in that regard, you had to trust the process, right?

Dr. Simon Bate: It was—it was DSD that gave me the confidence to do it.

Taking a step back from that, I’d done a lot of postgraduate study, courses—I’d done a lot of treatments.

I’d studied fixed orthodontics for two years, I’d studied in London doing complex oral rehabilitation for two years, I’d studied implants for three years.

I could do everything—but when I tried to bring it all together, I was always a bit underwhelmed by the final outcome.

Patients were always happy, always delighted. I had no complaints. But I’d do the same thing that young dentists do now—I’d go on Instagram and look at these cases, and I’d think, "Bloody hell, how are they doing that so well?"

And I’m—by my nature—very self-critical.

Even cases that have gone really well, I can still pick holes in them when I sit down reflecting on what’s been done.

I think as dentists, we’re all a bit like that, almost on a spectrum—things have to be just so.

Maria Cabanellas: Yeah.

Dr. Simon Bate: So, I lost my thread a bit there.

Maria Cabanellas: I wanted to ask you, actually—you mentioned that DSD helped give you the confidence…

Dr. Simon Bate: Oh yeah, so—yeah.

I was delivering these cases, but I was finding them a little bit underwhelming, and that was probably the biggest thing holding me back from saying,

"Right, I’m going to go and just do this all the time."

I’d get a case in where somebody had really severe tooth wear, and I’d plan the case, do the mockup, show the patient, and they’d be delighted.

We’d put the temporaries on in composite, it would look great, I’d prep the teeth ready for crowns. And then, at the last minute, the technicians would cut everything back, lay the porcelain on, and change all the line angles.

And all of a sudden, I’m putting these crowns in and thinking, "Hang on, this doesn’t look like the temporaries that the patient loved! This looks… less good."

The patient’s still happy, but then I’d finish the case and I’d think, "Well, you know what? I’m not doing one again, because I just didn’t enjoy it."

I’d have huge adjustments on the occlusion, I’d send some for remakes, and at the end, I’d just think, "God, that was such hard work, it just isn’t worth it."

So when I started with DSD, and I did my first couple of cases… and it just worked.

And it worked well.

The concepts of guided dentistry, of cut-and-paste dentistry, and all these things just made sense.

Once I realized, "Right, I’m actually confident now—I can deliver on every single case, and I’m good to go,"

That was when I pushed the button.

Maria Cabanellas: That's—that's a really great, um, topic you brought up because I—I hear so many times, and I see it so many times, that we have really smart, really great, just intelligent people that are in dentistry and are so dedicated to education. And you've put so many hours and so much effort into your knowledge that it's very shocking, you know, to hear, uh, such brilliant people have this—this lack of—of confidence in what they really know.

So, to me, when you explain it, it sounds like you—you have everything already. It's really just DSD putting it in a way of assurance maybe? Is that the best way to explain it?

Dr. Simon Bate: To bring everything together under one roof is what they do, and—and the assurance and everything else. And it was a—you know, it was a leap of faith for me. You know, like Daniel in the ortho department—I love him in that—but I can't fathom his depth of knowledge. I've done his aligner course, and, you know, I get some ClinChecks back and there's a giant anterior open bite. The ClinCheck looks horrendous, I can't show the patient, and I'm thinking, "Oh my gosh, am I actually going to fit this and do it?"

But he's overprescribing movements that aren't going to work as well. And then you do the treatment, and then at the end, it's bloody perfect, you know? You know, it's—it's—it’s amazing, you know? Almost miraculous.

So yeah, the confidence that comes with it. But everything was a bit disjointed. So I'd done my ortho training, but I'd done it with fixed appliances, which don’t have the sort of—the—the level of control and predictability as aligners—if aligners are done well. And I—I have to specify "done well." You—you know, there’s aligners, and then there’s aligners.

And—and then when you're trying to do—well, this was a few years ago, before things like Smile Architect—but when you're trying to do pre-ortho for a restorative case, and then, you know, things aren't quite right, and then the lab haven't quite understood where things were going to be, so then your wax-ups are all out, and then you're starting all over again, and—and it just—it just felt disjointed. It was a disjointed situation.

And—and—and everything was—every—the treatment that I was providing was always reactive. I'd—I’d start somewhere, see where I was three months later, and then react to—like, I don’t know—trying to like steer a ship in a storm, I guess. You know, you're blown off course, you keep trying to bring it back.

And—and I'd always get there in the end, you know? I mean, my dentistry—I'm very proud of my dentistry—but—but I always felt like I was having to work probably harder than—than I—I should have needed to—to—to achieve what I achieved.

And, um, and DSD—with the way you—you—you approve a design at the beginning and then everything is guided towards that—just makes so much sense.

Maria Cabanellas: That's honestly a wonderful way of explaining the—the ship with the winds blowing you off course, right?

And I—I—again, I have to explain what DSD is to a lot of people, and—and that’s always a challenge because you don’t understand things fully until you're in it, right? So to have to tell someone, "Hey, it’s—it’s like steering a ship. Where you’re at right now is like steering a ship with all the winds blowing off track. But DSD helps open the—the avenue so you just go straight without any worries, without any, you know, fighting the winds, basically, and—and all the surprises that come up along the process of any case."

So it's—I guess it really comes down to how you want to work, right? And—and so, would it be right to say like—I—or you—have chosen to work with DSD in order to create an easier life for yourself? You know, how has it affected you really?

Dr. Simon Bate: Yeah, it's just a little example of where you've got to make things really hard at the beginning to get better at the end.

Uh, I had to implement a lot of systems at work. I had to buy equipment. I had to do a lot of staff training. The—all—it's kind of—because it—well, I—I keep harping on about the NHS, but the NHS really holds back dentistry in the UK. You know, you don’t get really any practices that—that are like—are like mine. And, well, there's a couple of DSD clinics now.

Um, but, um, to change not just your patient perception of what dentistry is, but your staff at a root level, because it really is—it’s a whole shift, you know? The workflow and everything—it’s completely upside down on—on traditional dentistry. That—that took a lot of work.

And when you’re trying to change the culture of a business, you know, that's—you meet resistance. And, you know, and all—and all the problems that come with that.

Um, it's coming out the other end where your systems are in place, your staff are trained and motivated. And actually, even the staff that were resistant to DSD at the beginning are now saying that they've been left out and they're not getting to do anything, you know? And—and then everything—everything just gets better and better.

But change comes at a price, always.

Maria Cabanellas: Absolutely. So, another example of you just working hard in the beginning, right? Um, so I know DSD is a huge part of—of your practice now. However, you—you transitioned with your uncle, right? Um, and are you—you're the only one practicing on the DSD cases at the moment in the office?

Dr. Simon Bate: Yeah, yeah, pretty much. Um, because we've got—because we've got so—um, patients that I've looked after for all those years, they still need looking after. So, out of a four—a four—we have four surgeries or four operating rooms, whatever you want to call it, um, in the practice. Um, three of them really are still taken up with general routine dentistry.

Um, so my wife's now joined the practice. She works there, um, almost full-time. And I keep nudging her to—to have a go, but, um, again, it's change management. People—you know, Ellen has a very set way of working and—and, um, and so far hasn’t taken the leap.

Um, however, we don't have—we're quite a rural—you know, we are in the countryside, um, and it's not a huge population. We—I don't have patients queuing down the street to get in. Um, if it got to the point where I didn't have the capacity, I'd be saying to the associates and to Ellen, "You have to—you have to now take on the DSD cases."

And I think—and I think, I'm sure if they took the leap and did one case, they would never look back. But it's, um, it's the knowing that they've got to sit down and learn the workflows and learn—you know, when you're—when you're doing quite well, comfortably, and in your comfort zone, it's easy to stay there, isn’t it?

Maria Cabanellas: Absolutely. I mean, that’s a—a great problem to have. Yeah, you mentioned, you know, as you took more of the—the larger cases and—and focused more on DSD, you had to shift your patients over to another provider. Who—who is this, and how did you choose this person?

Dr. Simon Bate: So, well—so the, um—so there’s my wife. My wife does some of—some of the patients. And then we have, um, a couple of associates that come in to work. One of them—do you remember when I said about that foundation year where, when—when you're a young dentist, you’ve got to go and work for, um, for a dentist?

Well, I looked after a foundation dentist for a year who was really good. He's now seven—seven or eight years post-qualification. He’d gone way out into the big, wide world and really learned to be a real quality dentist, and then came back and—and—and looks after some of the patients.

He brought a friend with him who’s—who’s excellent. And, um, oh, and we met somebody else on a course who was—who was working in an NHS practice and wanted some private experience. So I’ve got three guys who do a day each, my wife does three days, and then we’ve got a team of hygienists.

But, you—you—you know, you hit on an interesting point. After looking after people for so many years, giving them to someone else is really trusting your reputation with someone else. And I didn't really fully—I hadn't appreciated what that actually meant until we did it.

Uh, so—but, like, I'm—I'm in a privileged position. I can spend a lot of time with the associates. We do a lot of—a lot of training together. We—you know, the consultation techniques, how we do certain things. It’s been really good for all of us, I think.

Maria Cabanellas: Can you explain the—the dynamic of the office a little more? Because there are so many people that want what you have—you know, to get more involved with larger cases and—and kind of shift their position to grow the practice with more associates or partners of that nature.

Um, but there is that—that middle piece, right? Where you’re in that moment of transition where, you know, we're kind of sharing patients, we're—we're passing patients between us depending on their treatments and that sort of thing. What is that process like for you in your practice today?

Dr. Simon Bate: Um, it—it’s really easy between, um, a husband-and-wife team because patients quite like that—they’re seeing one or the other. So my wife’s done lots of endodontic training, and I haven’t done a root filling for two years or something. I can’t stand them. So it’s brilliant that if one of my patients needs an endo, I can just pass them over and get them back with it completed and completed to a high standard.

with regards to the associates, um, I basically handed over the patient, and that—that’s—that’s their patient to look after because the—the problem with being part-time is if their patient has toothache, they'll come in and see somebody else. But we—we’re very, very strict on—once you've seen a dentist, you've got to keep seeing the same one. Because patients leave. If a patient sees a different dentist every time they come, it's not long before they leave, you know? People want to be looked after by one person.

Dr. Simon Bate: And—and how do you handle that if the patient that you've been seeing for 15 years automatically is no longer qualified to be your DSD patient, for example, and they say, "But I want—I want to see Dr. Bate. I—I only want to see Dr. Bate."

Maria Cabanellas: And it's very—

Dr. Simon Bate: You know, I was—I was almost offended at how easily, um, patients moved over. Um, no, the patients—we—we sent out a really nice letter, and—and I spoke to any patient that rang up and complained. I phoned them up personally and spoke to them—that's really important. And I just explained that because of where I am in my career and what I've learned to do, I—I provide very, very complex treatment.

And the way I explained it is I said, "Look, if you fall over and you bang your four top front teeth on a curb, and one falls out and the others are all chipped and broken, you need to come in and see me really, really quickly and have it put right." I said, "And if I'm swamped with checkups and fillings, you'll be waiting, and it won’t get done. And—and, you know, you'll have a bigger problem."

I said, "I'm still in the practice. I still—I will still be there. If you have a complex problem that needs complex attention, I'll be right there to look after it." Um, I said, "But also, I, um, I manage the—the sort of the vision of the practice, if you will, or the—the—the culture of the business. And I make sure that only dentists are working that—that I would have looking after me."

And then—and—and hopefully, that way, the patients should be reassured that, you know, that nothing significant is going to change. It’s not like I've sold it and left, you know? And, um, you always lose a couple of patients, but on the whole, uh, our retention was really, really good.

Maria Cabanellas: Yeah. And—and would you say it was more of the personal conversation piece that—that did it? Or what was it out of that process that was the most important, you think?

Dr. Simon Bate: Yeah. Patients don’t like surprises. You have to tell them. If—you know, you can't just—if they're booked in with you, and then they leave, and then you move that booking to—to someone else, and they come in and see—you know, patients don’t like surprises.

Maria Cabanellas: Definitely not.

Dr. Simon Bate: They have to be told. Um, so the letter—the letter will probably—I mean, the letter will have been the big thing because, you know, people are—they follow a bell curve, don’t they? Where, at one end, you've got the complainers, and one end, you've got the people you can literally do anything to, and they’ll just—whatever. And then you've got the people in the middle.

So, if you can deal with everybody via letter, right up to the real significant complainers, and then you can manage them with a phone call, that’s the way to do it.

Maria Cabanellas: Wonderful. So, what challenges have you encountered in your career that you—you think people listening should know about and how to prevent? You know, just in general, is there anything that you can think of that you really want people to know about and, um, prevent for others?

Dr. Simon Bate: Um, you know, not really. I mean, we’ve covered a lot of—a lot of the stuff that I would say for most people. Um, you—you—you just have to—you just have to take the leap if you’re going to do it and expect the problems we've talked about.

Um, when you—when you look at dentistry as a business, don’t worry about the money. The money will just look after itself. It’s—everything’s the people. You've got to—you—you—you know, you've got to make sure that you've got the right people in your team.

Um, uh, you—you—you've got to surround yourself with people that—that will look after your business in—with the same care and attention that you do as the business owner. And they’re hard to find. Um, and it’s taken a lot of years building to achieve that.

Um, allowing toxic people to stay in your business is a disaster. And, um, by my nature, I’m not—I’m not a confrontational person. I don’t deal with things like that well. And—and I’ve had to in the past.

And—and—and I would, um—to anyone thinking to buy a practice or run a practice, actually, one of the things I’d really say is really be careful choosing your people. And if they’re not right, don’t—don’t leave it and think they might become right.

Um, be—be supportive. You know, train people, help people. But if people are toxic by nature, they ain't going to change. And—and it’s—and sooner rather than later to sort that out.

Maria Cabanellas: Yeah, that's—that's great advice, really. Um, now as far—you have a wonderful part—I read your, um, your case story, um, uh, that we did for, um, uh, our marketing, right? But it was—it was a story about a case that you've done and—and just your story of how DSD has, uh, really changed the way you practice.

So, besides DSD, is there anything else that you would recommend to others, like, "I can't live without this today"? And—and is it safe to say DSD is one of those things? I kind of assumed there.

Dr. Simon Bate: Yeah, 100%. Um, what I—it’s—I wouldn’t want to go back to using—the predictability—the reason—the reason I will hopefully be a DSD dentist until I drop dead or retire is because all of a sudden, if I suddenly didn’t have the expertise of—of the individual, um, DSD experts on the interdisciplinary team, if I didn’t have, uh, Daniel and Christian and the whole rest of the team to turn to when—’cause even—you know, I’m an experienced dentist now, but, you know, you—you—you’ve, um, you pointed out how old I am, thank you.

Maria Cabanellas: [Laughs]

Dr. Simon Bate: Um, so I—and I still—despite all the years of training, all the courses, and despite all the thousands of hours I’ve—I’ve spent looking into people’s mouths, I still get cases where I think, "I've got no—I don't know where to start." And I couldn't go back.

I couldn't go back to not having a team of experts to—like, it's on—almost at my fingertips—to just help whenever I need it. Um, I—I couldn't—I couldn't go back to not having that. When you’re the oldest, um, and most experienced dentist in a practice, people come to you with their clinical problems. And when you’ve got a clinical problem, you don’t always have anywhere to go.

Um, and that's been a wonderful thing for me. Um, and—and just being able to jump on the Concierge Group, which has everybody on it from the technical team, the design team, the ortho team, and just say, "Look, I’ve got this problem. Here’s some photos, here’s some scans, here’s an x-ray—can you help?" And then by the end of the day, problem sorted. I mean, that’s just—I’m sure that’s unique in the world.

Maria Cabanellas: It definitely is. And the main topic, honestly, that I’m hearing from you, um, in—in all your answers, is that you have a very strong support system, whether it’s in your family, your personal life—you have your wife there and your uncle and the team that you’ve built and everything, which is very important, right? For mental health and everything, um, and just everyday happiness.

But on the other side of it, I don’t think many people, at least in the industry, think about the professional support system. And so, I—I would say DSD offers that to many, and—and you've kind of completed your circle there.

I want to ask you, you know, just to—because we’re—we’re getting out of time here, just to end the—the podcast, we have started a series of questions where a previous, uh, previous person on the podcast is going to ask a question to the next one. So, as of today, where are you applying a beginner’s mindset in what areas?

Dr. Simon Bate: Oh gosh. Um, so I’ve already talked about how absolutely self-critical I am. Um, despite, um, despite how confident I am when I’m talking through a case and things like that, every single case I approach like I'm a beginner. Not because I don’t have the technical skill or the knowledge, but I think it’s really important that you—you don’t, um, uh, sort of over-egg yourself worth, or, you know, compl—uh, what is it? Complacency breeds problems, doesn’t it?

With being so self-critical, I apply that kind of sort of mindset to everything—everything that I do. Um, the minute you stop looking for how you could have done something better is—is the—it’s the same moment you run into problems.

Um, you can’t—you can’t ever become complacent or—or arrogant about the situation that you’re in. You’ve always got to—got to approach everything like it’s brand new, or you won’t—you won’t see improvements.

Um, and—and I am very self-critical. I’ve always been that way.

Maria Cabanellas: Yeah, I think that’s a natural response for the perfectionist mindset, right? The overachiever in—which is generally everyone.

Dr. Simon Bate: But when I look at a case, even a straightforward case where I absolutely know—absolutely know exactly what needs to be done and how to go about it, I'll still run it past the DSD team and say, "Look, I just want—I just want confirmation that this is exactly how you would do it too. And—and are there any ways that I might have missed, or anything of—you know?" And—and that’s how you learn.

Maria Cabanellas: Yeah, and I mean, I would even go as far as saying—I—I would say it’s almost mandatory to get a second opinion on your own work, right? Because it can be dangerous, in a sense, if—if you believe too much in yourself that you’re never wrong, right? And so, um, we’re human at the end of the day, and I think DSD offers that—that confidence and that second check. You know, not to say that we’re—we’re doing it on your behalf. It’s—it’s like handholding, right? And—and you gain that confidence. You get that, um, just that whole philosophy on life to say, "You know what? I’m good at what I do. Uh, however, I’m going to continue on with this, uh, mindset of—of just knowing, like, I could do better," right? And—and it comes in—in teams and numbers, and we’re all here with each other. So it's it's wonderful to hear – thank you for sharing that.

Dr. Simon Bate: Yeah, no – 100%.

Maria Cabanellas: Well, I believe we're all set on time today. I wish we could go on longer because, like I mentioned in the beginning, I'm just learning about you right now. So, um, you know, I hope that we get to speak again soon.

But I want to say thank you from the bottom of our hearts that you dedicated your time to this today and—and shared everything.

Dr. Simon Bate: Well, you're welcome. I hope—hope somebody finds it useful. It's been—it's been a pleasure to speak to you.

Maria Cabanellas: Thank you so much, Simon.