Neutral Zone
Welcome to Neutral Zone!
A podcast about the people behind the Dentistry profession.
I'm Dr Fran Brelsford and I invite you to meet a different dentist with me on each episode.
We chat with the humans behind the drills and the instagram profiles.
No hustle, no ego, no clinical chat.
Just good old fashioned conversation, new questions, and genuine connection.
Episodes dropped on Wednesdays.
Because there’s more to life than teeth.
Neutral Zone
Richard Porter
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Meet Richard.
Richard spent years working in an NHS hospital consultant role in restorative dentistry but now dedicates most of his working week to teaching alongside private clinical practice.
Some of you will know him through attending courses at Aspire dental academy - now held at the new state-of-the-art Aspire Clinic in London's Fitzrovia.
In this episode we talk about all the Cs - connection and communication, and the importance of comfort and confidence in competence.
@rwj_porter
@aspiredentalacademy
I'm Richard Porter and this is Neutral Zone.
SPEAKER_01Hi Richard, welcome to Neutral Zone.
SPEAKER_00Hi.
SPEAKER_01Thanks for giving up your lunchtime on a Wednesday.
SPEAKER_00It's my pleasure.
SPEAKER_01In your beautiful new clinic.
SPEAKER_00I'm glad you like it. It's your second time here.
SPEAKER_01It is. We've only we've only met briefly, maybe twice.
SPEAKER_00Yeah, at Manchester for the charity event.
SPEAKER_01Yes, a lecture.
SPEAKER_00And then your lecture was excellent.
SPEAKER_01Thank you.
SPEAKER_00I really enjoyed it.
SPEAKER_01Thank you.
SPEAKER_00Don't take it the wrong way.
SPEAKER_01No, no.
SPEAKER_00You never know if you what you're going to learn when you go to any sort of conference. I remember sitting there thinking, I I wish I had a pen and paper to take notes of what you were talking about. Really? Yeah, I really enjoyed it.
SPEAKER_01Oh, thank you.
SPEAKER_00Yeah.
SPEAKER_01Big compliment. I think I was talking about habit stacking.
SPEAKER_00Trevor Burrus, Jr.: You were talking about habit starting and and you know you had your stones and the bondability hierarchy, stuff we teach as well. But just the way you presented it was so nice and linear.
SPEAKER_02Thank you.
SPEAKER_00And and when you're doing education, I you know you've got to try and take away anxiety. I think the the flip side of education is when people try and give you anxiety, they try and give you FOMO, like look at what I can do, look at what I've got, look at what you haven't. And I thought your lecture was very much this is what I do, and this is where you can buy it from. And you could if you like this idea, you can take away and use it. Yeah. It's giving value. Trevor Burrus, Jr.
SPEAKER_01Oh, thank you.
SPEAKER_00That's right.
SPEAKER_01Yeah. The clinic is gorgeous. Aaron Ross Powell The number of details. The living clay on the walls.
SPEAKER_00Trevor Burrus Do you know again I can I and the circadian lighting. I there are a few things that I contributed to that. The architectural team and my business partner heel are the kings of detail. So I'm I'm swept along on the majesty of their the architectural design. Ying and Nick, who designed it, are architects are that's right.
SPEAKER_01Last time I was here, you were choosing pebbles, or they were choosing pebbles.
SPEAKER_00I would be pebble-free in my opinions. But they have chosen beautiful pebbles. Well, go and have a look at them. Yeah, it is lovely. It's a nice place to be.
SPEAKER_01Trevor Burrus, Jr. Yeah. Richard, one of the first questions I ask everyone is how much of your identity do you think is tied to being a dentist?
SPEAKER_00I mean the answer is a lot. And but within within that role as a dentist, you've got different roles. So it might be patient provider, it might be practice principal, it might be educator, it might be staff mentor. And within that role as a dentist, I think you will have different bits that identify and resonate and make you feel like you're contributing more within that. If you work as much as I'm sure you do, I think I know you do, and and I tend to, it's foolish to say it's not part of your identity. It hasn't sort of formed a big part of your identity. And it is. And who I how I feel about myself, it is absolutely integral to that. So a big, big chunk of who I am is my professional life without doubt. Trevor Burrus, Jr. Yeah, maybe.
SPEAKER_01Who are you if you're not being that role, if you're not a dentist?
SPEAKER_00Aaron Ross Powell So uh Cherno, I I'm not trying to restructure your question, but I guess it's what part of my job do I find most fulfilling? And my passion is to help people flourish. And the the place where we've curated that down the most is within the realm of dentistry. So seeing dentists who are already flourishing and helping them grow more to people who are struggling, people who are considering leaving the profession, um, and putting them in a position where they can they can choose a path that feels beautiful to walk down. That probably means more to me than anything. A lot of my career was, as you you probably know, was in a hospital. I just saw a lady from the from the hospital this morning, actually, uh, who is an NHS patient and can't get any help anywhere. And I just agreed to see her free of charge. And seeing patients like that who have had big cancerous sections and their quality of life is in the gutter, and you can build them back up. I I love that as well. I love and I I hope it's not indulgent. I hope it is. I'm trying to work out in my own head, it's not just because it's like really hard and low, look at me, I can do it. But it's actually you do actually get to see someone flourishing and get their life back.
SPEAKER_01So it goes beyond the dentistry technical bit.
SPEAKER_00Yeah, dentistry is a vessel, isn't it? It's like if you give someone an amazing smile or they're they're in pain, you take the pain away, it's a it's an incredible thing. If you if you look and there's evidence to back this up, if you look at somebody's circulating cortisol level, their stress hormone and you know their inflammatory status, and you do your beautiful work, Fran, and give them a better smile, you can measure their blood and you can measure their stress levels and the hypothalamic pituitary adrenal access, and it drops. They flourish more because of what we do.
SPEAKER_01Powerful.
SPEAKER_00For dentistry, it's amazing. Like people think that you think you're drilling and filling. You're not, you're really, really making a difference to someone's life.
SPEAKER_01I like when somebody's terrified and then they actually come and like fall asleep in your lap.
SPEAKER_00Aaron Powell Yeah.
SPEAKER_01I like that.
SPEAKER_00Do you? Yeah. That brings you satisfaction.
SPEAKER_01Trevor Burrus, Jr.: Yeah. I just think you've you've managed to it's hard to make someone less anxious about anything. But then if they And I think you have to surrender as as a patient. And then if you've managed to do that you've made somebody trust you who was terrified. I think that's I agree with you. I think that's a big plus.
SPEAKER_00Trevor Burrus, Jr.: I mean that that's a segue to some of the things we were talking about before we came on camera, but because what you just said that I think is really important. It's you. It's not the profession, it's not your equipment. They've connected with you, and you have then put them in that state of dere relaxation. That's the magic.
SPEAKER_01Trevor Burrus, Jr.: And that's what the podcast's about. Trevor Burrus, Jr.: Is it the people behind the drill, you know?
SPEAKER_00Trevor Burrus, Jr.: Yeah, because dentists do get dehumanized a bit, don't they?
SPEAKER_01Trevor Burrus, Jr.: Yeah, everyone hates us as well.
SPEAKER_00And you get told you hate it. But I have this joke, a million people have heard it already, but you've probably had it too, is where you're you're at work and the next patient walks in, you've never seen them, and they look in and go, I hate the dentist. I'll do it on camera, I hate the dentist. And I would say, can you imagine going to Sainsbury's and you buy a loaf of bread and you go, I hate checkout stuff. Trevor Burrus, Jr.: You know, security come and kick you out. Whereas we take it on the chin. I'm so sorry.
SPEAKER_01Trevor Burrus, Jr.: Well, like you're on a train and they or they have posters everywhere now, don't they? Even on the bus, and it says we will not accept harassment of our staff.
SPEAKER_00For sure.
SPEAKER_01Or even in Space NK the other day, I saw it behind the checkout, and you think, who is mad in Space NK?
SPEAKER_00Everyone's Junior, I was getting on the tube yesterday, and there was a lady who'd been sort of preaching very vocally outside the tube, and they shut Oxford Circus tube when the stairwell was absolutely full. And the chap was on at the bottom saying, Could you back up, please? And she started hitting people on the head with her banner. These people were just kicking randomly on just a banner that says be nice. Yeah, exactly. Be kind to everyone and you think, Welcome to London. Welcome to London. Trevor Burrus, Jr.: But it's interesting, friend, that you I'm sorry, this yeah, I know you're not Trevor Burrus You're interviewing me. Yeah, I am a little bit now. But that brings you that's the one thing you said. It brings you satisfaction to change someone's sort of emotional state. And that's obviously landing points with you. It's landing home as significant.
SPEAKER_01Trevor Burrus, Jr.: I think as well, when you've been in when you've done the job for a while and you've not you're always going to be challenged by certain clinical bits. But when you've got a grasp on the clinical, you almost the job is m much more of like a conveyor belt of of things. So you're almost looking for a wider meaning to what you're doing once you've got that bit sorted, I think.
SPEAKER_00Aaron Ross Powell I completely agree. Aaron Ross Powell Yeah. I completely everyone's looking for growth. And like when you're a dental student, you learn like Krebs cycle, which is a stupid thing to have on the curriculum, by the way. And you learn about the sphenoid bone. And in dentistry, if you ever see the sphenoid bone, you've you've gone too deep down that margin. But you you go through your growth, don't you? And you have to achieve your exams and then you do your foundation year and you achieve something. And the growth is always there. But you're right. When you reach a level clinically and you think, okay, this is not causing me anxiety now.
SPEAKER_01I'm kind of I've got my systems.
SPEAKER_00Yeah. Then you your mind does cast its uh net further out and you think, well, what what else can I grow? How can I grow?
SPEAKER_01Yeah. That's a long-a long career. It can't just be all about drilling and fitting.
SPEAKER_00Trevor Burrus, Jr.: Do you know I think it's I think you know the human-to-human connection for me is easily the most important thing because you'll never you'll never tire of that. And I hope you never tire of it. And so it is helping the person. It is and I don't mean the teeth, I mean the person who happens to own the teeth or the mouth. It is that connection. And that will never get dull. You know, humans are fundamentally social creatures. Not just social creatures, but we're social creatures that we do not do well on our own. Like it's really not good for us. Loneliness and isolation is evolutionarily used to mean dead.
SPEAKER_01Aaron Ross Powell And that is dentistry most of the time. Trevor Burrus Yeah. In a room like this big on your own, maybe a lot smaller in some London practices actually. Maybe with a nurse that you get on with, maybe with a nurse that doesn't get on with you.
SPEAKER_00Trevor Burrus Yeah. And maybe a nurse is a stranger to you. And you're aligned.
SPEAKER_01Trevor Burrus, And it changes every day. Yeah. No lateral light. And then you're just thinking with patients that hate you or are very nervous.
SPEAKER_00We're really setting the profession correctly.
SPEAKER_01But it can be very isolating.
SPEAKER_00Trevor Burrus And you can then think I'm required to do to a given standard something I don't think I'm actually that good at. Like you know, if I'm talking about comfort with competence, I would say to any delegate, would you write your name on a piece of paper and have Fran watch you do it and she's got her camera on and 30 other dentists watching you, would you write your name on a piece of paper and they'll say, Yeah, I would do that. Okay, would you do Mo Lorendo with with 50 dentists watching you? You may not. And the only difference is you don't believe, you don't have the confidence in the outcome. Now, if you're doing that day in, day out on people, and particularly if you have that big sense of responsibility, that's a stress. So giving people comfort and confidence with their competencies is is really important. Because at least then you can take that anxiety away. I'm always wondering, you know, the I ask everyone, how often do you get Sunday night syndrome? Like who who starts thinking right.
SPEAKER_01Sunday scaries.
SPEAKER_00Yeah, Sunday scaries, that's a better name for it. Thanks.
SPEAKER_01You can have that one. It's not mine.
SPEAKER_00So I'm taking notes here again. I'm taking notes when I'm trying to speak. And uh Yeah, and and th they can creep in. They can creep in on Sunday morning. And you get people to open up and about it and they say, yeah, I do. I'm worried.
SPEAKER_01I've definitely had that earlier on in the in in the career.
SPEAKER_00Yeah, it's a horrible feeling. It's a horrible feeling thinking you're required to do something clinically and you're not entirely sure how. So there's doubt.
SPEAKER_01Aaron Ross Powell And a horrible feeling that you've you've done all the degree and so you know on paper you've got it. That's your job then for the rest of your life if you're not going to change. And yet you're still nervous on a Sunday like going to school.
SPEAKER_00Trevor Burrus, Jr.: Yeah, and and we'll see if you agree with this. And you know, some of the other competences competencies I think people need are I'm not trying to drag our conversation to connection straight away, but if if I ask a group of dentists, put your hand up if you've met a patient you really, really don't like, maybe even hate, it's every dentist. And then I will say to them, and put your hand up if it was their teeth or their personality. You know, which and it's always personality.
SPEAKER_01Aaron Ross Powell Oh, 100 percent.
SPEAKER_00It's never the teeth. And you know, if there's a problem with the teeth, you can refer it. It can refer it to you, and you can refer it to a specialist or a friend, you can get help. But dealing with a a person. And I don't see that on the curriculum. I don't I don't see I don't see people being taught that.
SPEAKER_01We had uh quite a big communications uh module. I I did my degree at Sheffield. Um and I think we were one of the first batches, I'm not sure what it's like now, but I remember being maybe it was useful and we didn't know we had it and others didn't, but um we'd be put in scenarios where one's the patient, one's the dentist opposite each other, like this.
SPEAKER_02Yeah.
SPEAKER_01And there'd be a script or someone you'd you'd be like, right, you're an angry patient, be angry at Fran. And you'd have to that's very hard. Or or this is a procedure they don't understand. Keep going.
SPEAKER_00Yeah, okay.
SPEAKER_01And I think that maybe is more was more helpful than I realised.
SPEAKER_00Do you think it moved the needle then on your communication skills?
SPEAKER_01Do you know what I don't think anything Well maybe maybe that's a big statement. I was gonna say I don't think anything prepares you till you're there.
SPEAKER_00I agree. I agree. Yeah, I just I I I I think it's an infinite skill. And I think it's something that should be highlighted as foundational to the outcome of your career and how you feel about your job. I think it should be elevated to that status. I again I think that's what the ancient ancient philosophy and every philosophy since has taught us. It is your ability to see as well as you possibly can into the minds and hearts of the people you're dealing with and understand them. And if you can do that, you can you can at least have agency. You can at least connect if you choose to connect or withdraw if you want to withdraw. But you have to understand the fundamentals of human thinking to be able to do that.
SPEAKER_01I think so, like psychology and empathy together.
SPEAKER_00Yeah, yeah. I mean, yeah, psychology is the big title. Like why does a human think and feel how they think and feel? Where does it come from? And then when you're dealing with the human mind, we have to work with models. It's infinite, and so you have to use a model. And the models are pretty good. I mean, they're probably in impossibly naive for the vast complexity of humanity, but they work.
SPEAKER_02Yeah.
SPEAKER_00They're reproducible, they're demonstrable, and they're very effective. And I think some of those models should be taught. And then once you look at the models, understand the skills you can use to deploy them. I mean, we I I do teach this. You know, it's one of the most enjoyable things to teach.
SPEAKER_01Aaron Ross Powell So your kind of working week now, Richard, is more teaching than clinical.
SPEAKER_00Aaron Ross Powell It's a mixture because it was 50-50 until I left the NHS. I was a restorative consultant for you know the better part of 20 years. And a lot of that was teaching embedded into that role, masters of it clinically, and then I'd probably have two days teaching, specifically just teaching.
SPEAKER_02Okay.
SPEAKER_00And then that has shifted a little bit. But what we've done here, the the big thing we wanted in the center was to integrate live clinical encounters into the teaching. So there's a lot of crossover there now.
SPEAKER_01Yeah.
SPEAKER_00And that means I can see a patient upstairs and I can do everything, including all the audio in crystal clear clarity and all of the clinical procedures, and that can be watched live on site, on a big cinema screen, or transmitted anywhere around the world. So it's trying to combine those two. So when you talk about communication, like I would love you to pick your worst ever patient, put them in my chair, and let's let's have a discussion.
SPEAKER_01Uh-huh.
SPEAKER_00And then you can pick it apart afterwards and think, well, what's the real motivation here? Where's that coming from? What are those unspoken words? What does that body language tell you? You know, because you're because I'll just tell you now, and I'm not watching you for now. No, no, no.
SPEAKER_01You can tell you are.
SPEAKER_00Your body is speaking all of the time.
SPEAKER_01Aaron Ross Powell Yeah, and nonverbal is massive, isn't it?
SPEAKER_00It's it's so i it it definitely is. I I'm just gonna do a quick qualifier. People say it's it's it's it's body language first, then tone, and then words, and that's true. But that doesn't mean your words don't matter. They're about seven percent of communication.
SPEAKER_01Okay.
SPEAKER_00Unless you're just texting, then they become a hundred percent. If it's just a letter, then it's a hundred percent. But body language is it predates our evolution of language. So you and I had to be able to communicate nonverbally and survive as a species before we evolve language. So yeah, it's massively effective. And it's I mean, the some of the studies are hilarious on predictive outcomes from body language tells.
SPEAKER_01Aaron Ross Powell I mean you see patients come in, don't you? And you Or you go out to I had a guy actually yesterday and uh he was squeezed in. I know him quite well. I went out and I was like, oh. Hi, come in. And I I looked at him and I said, You're in pain, aren't you? Yeah. He's like, you have no idea. And you could see his eyes were just in pain. And um He didn't say anything. Aaron Ross Powell No.
SPEAKER_00And didn't need to.
unknownYeah.
SPEAKER_01Maybe because I know him already a little bit.
SPEAKER_00Well maybe I mean familiarity tells, like your subconscious mind is looking at familiarity amongst people you know and reading them, you know, far, far more effectively. But there are universal body language signals that we can pick up. You can walk into a room and feel tension.
SPEAKER_01Yeah.
SPEAKER_00And you can see someone who's who's angry before they've even come near you. You know, we are we're we're phenomenal threat detectors when we stop listening to words and we actually pay attention to our our what we're actually seeing, what our mind is seeing. We're very, very good at it. And we we can tell when someone is at ease, when someone's being honest. We're good at it. And that's the fundamentals of communication.
SPEAKER_01Like, do you teach this here then?
SPEAKER_00Yeah. Yeah.
SPEAKER_01How?
SPEAKER_00So it takes a while, but f first of all you have to understand there are skills. There are skills. And the skills are pretty infinite. Like you can you can develop the skills, like you can play the piano. So I could play twinkle, twinkle, little star, or you can play lists piano concerto number two, Hungarian, whatever. You know, you can go as far as you like with communication skills, and that's why I love it so much, because you're you never stop being a student.
SPEAKER_02Yeah.
SPEAKER_00If you teach the fundamentals of human psychology, which we all have we all have, they're all the same, in almost everyone, with small variations that make us individual, unique people, then if you understand that, then you can deploy it. So the philosophy behind it is, I would say to you, Fran, you are on a journey of self-discovery, and you will be until your last hour of life, and so am I. And you're never going to fully know yourself, and neither am I. We're going to find out about ourselves on this journey. But it is unbelievably connecting and engaging. If I stop finding out about myself and I just ask you about your journey and prove to you I'm curious about how you are, how you're feeling. So the fundamentals of communication are curiosity. It starts with curiosity. And if you're my patient, I if I'm teaching this, I will demand, demand that you prove you're deeply curious about the person in front of you. And if you demand it, you'll see it because I'll be focused on you. And you uh let I'll expand one little thing. So when someone is stressed or feeling threatened, the blink rate will go up. So let my fake blink rate go up when I start doing this during the interview, and you will know I'm slightly uncomfortable. The opposite with a blink rate dropping down isn't that you blink slower. You blink slower when you're focused.
SPEAKER_01Yeah.
SPEAKER_00So I'm not analyzing you. Don't take it the wrong way. And your blink rate has almost gone down to three a minute. Like you'll really focus on this conversation. So you but your subconscious mind sees it. And all we will do occasionally is just say, like, your body language tells are always there. Like, let me give your listeners a challenge. Look through your phone and look at your last selfie and see if in your selfie you do this. Okay? See if you've tilted your head to the left or the right and exposed your carotid artery for the photo. What message? So a photo is a message.
SPEAKER_02Yeah.
SPEAKER_00It's a signal. Any photo you've ever seen of anyone, they are saying, this is the signal I want you to notice about me.
SPEAKER_01Yeah.
SPEAKER_00And your subconscious, yeah. Your subconscious, and people say my subconscious is in control. Okay, well, you tell me what you're going to dream about three nights from now, or you tell me if your subconscious is going to do it. And if you grind your teeth, you tell me you're choosing to do that, or your subconscious is making you do that. Your subconscious is in control. And the photo comes and you go like this in the picture. Have you got your phone, Frank?
SPEAKER_01Trevor Burrus, Jr. I I genuinely don't take selfies.
SPEAKER_00Trevor Burrus, Jr.: No, good. Well, not good. You people can take selfies, but uh it's a very common thing for people to tilt their head in a selfie. And that is exposing an artery. And it is you're exposing a big artery, you're exposing your carotid, and you're saying, I'm no threat. It's a no-threat signal.
SPEAKER_01Aaron Ross Powell So interesting.
SPEAKER_00So body language you can teach to infinite level, and I love to get people engaged in this. And then we teach tone. So there's different tonalities. There are different tonalities. I hate the dentist. I hate the dentist. I hate the dentist. You know, there's tonalities to everything you can say.
SPEAKER_02Yeah.
SPEAKER_00And then you have the words that go with it. And we teach all of those. We teach body, words, and tone. So that you can convince the patient you're trying to see where they are on their journey, and for that tiny moment, the curated journey of their life whilst they're in the dental practice, whilst they're in your chair. And if you're committed to seeing them and understanding them, how that communication is just it's more important than anything else. It's almost been proven. Daniel Kahneman talks about he was the first psychologist to win the Nobel Prize in economics for money. So a psychologist winning the Nobel Prize in money. And it was people would rather do business with someone they like and trust than someone they don't, even if the person they like and trust is less able to do the job and is more expensive. So in dental terms, that is patients like dentists who they like and trust, I would rather have dentistry with them, even if they're crap at dentistry, are more expensive. That's a Nobel Prize. So it's hard to argue against. So it's proving you're trying to connect if that's the right thing to do. Trevor Burrus, Jr.
SPEAKER_01Yeah, and I I can see that completely because if they're comfortable, that's all they care about.
SPEAKER_00Yeah. If they fall asleep in your chair.
SPEAKER_01Yeah.
SPEAKER_00It's like watch my body language. That's how that's how comfortable I am.
SPEAKER_01Expensive now.
SPEAKER_00Trevor Burrus, Jr. So when that happens, do they sit up and get expensive enough, no doubt. Do they sit up and go, I can't believe I fell asleep?
SPEAKER_01Aaron Powell It's interesting. It's kind of fifty fifty. Some of them are in denial.
SPEAKER_00Really?
SPEAKER_01And they'll say, um My nurse is quite fun. She at the moment she'll deliberately say, Oh, you had a little cat cat nap then. And um some of them are like, I did not fall asleep. She's like, well, you you were snoring.
SPEAKER_00Seriously. I mean seriously, it's your nurse is like the judge and jury here. You were definitely asleep.
SPEAKER_01I don't know if I dare do it, like, oh, you fell asleep.
SPEAKER_00Yeah.
SPEAKER_01Otherwise, people are just like, oh, I can't believe I fell asleep.
SPEAKER_00Yeah, it's lovely then.
SPEAKER_01Especially when I always give this pre-chat before I'm putting rubber dam on. And you know, a lot of them, if they haven't had it before, you are putting something on. It's all m it's very claustrophobic. And or if you're not warning them, you're coming at them with something over their mouth. And I talk about surrendering and just like, you know, you're safe and blah. You can do all of these things with it on. And it's amazing at the end when they weren't sure. And they're like, I love that thing.
SPEAKER_02Yeah.
SPEAKER_01I'm like, it See, it's it's very interesting, but it's a barrier between what we're doing. And I always say to them, unfortunately, modern life is so busy that this is a forced rest with the dentist. Even with the drinking.
SPEAKER_00Dark glasses.
SPEAKER_01Dark glasses, and usually I say bring your headphones, listen to something else while once it's on.
SPEAKER_00Aaron Ross Powell And Because it's like that mini nap you sometimes get when you're lying in the garden or you're watching TV and you just nod off and you think, oh my God, that was so peaceful. How did that happen? And yeah, with that and if you can generate that in the environment.
SPEAKER_01Trevor Burrus I read somewhere it it also is when you you don't move your body for a certain amount of time. So it makes sense why you fall asleep in a car or a train or like you say. Because your brain just thinks I can't do anything, so may as well fall asleep.
SPEAKER_00Yeah, I love that. How do we make our brains do nothing? I need some of that. I might I'm gonna give myself some caries and book images.
SPEAKER_01Like the weighted blanket and things.
SPEAKER_00Yeah.
SPEAKER_01Same thing.
SPEAKER_00Well it's and you know, and if you think of a baby, like a baby, they get wrapped. You know, they're like swaddled, aren't they? You know, when they're first born, they're like this and they're just like out. So maybe that maybe that circuitry is still in us.
SPEAKER_01Aaron Ross Powell Yeah, someone said that's why you fall asleep in the cinema. Just like going back in the womb.
SPEAKER_00Wow. Wow. Depends on what you're watching. Trevor Burrus, Jr. Yeah.
SPEAKER_01Got a drink and a snack and it's dark.
SPEAKER_00Aaron Powell Could be. And certainly the dark glasses, I think, do it. And then the sense of trust and you're lying down, you're supine. And for me, the rubber dam, I think it externalizes the teeth. And you know it's a multifunctional orifice and and but you kind of it's like the teeth are out.
SPEAKER_01Aaron Ross Powell Yeah, I'll always show them. Some people d decline to see anything, don't they? But show them in the mirror and like, look, all I'm doing is working on that those few teeth now. And it y when you can see the uh contrast and they get I think they get it.
SPEAKER_00Trevor Burrus Do you think maybe it's also I mean this is just an idea that it's they know their airway is not being challenged as well. Because when there's loose things in your mouth and you know and the rubber dam with a beautiful seal, we're we're really selling the rubber dam here.
SPEAKER_01This wasn't uh intentional.
SPEAKER_00No.
SPEAKER_01No, I talked about safety with it. Yeah.
SPEAKER_00Okay.
SPEAKER_01I always say I I'm pretty sure this will become mandatory with time.
SPEAKER_00Aaron Ross Powell Yeah. I love a bit of history. Sanford Barnum.
unknownTrevor Burrus, Jr.
SPEAKER_01Oh, really? I didn't know the name of the guy.
SPEAKER_00No, for 1800. Trevor Burrus, Jr. Yeah, 1854.
SPEAKER_01Yeah.
SPEAKER_00At the California Dental Association meeting. And he did it with a napkin. So he had a napkin like you get and he cut the corner off. And he said, if I get a cloth napkin, I push it over the tooth, I get much better dryness. And that was where it sort of started. Yeah, it's nuts, isn't it?
SPEAKER_01It is. I can imagine making something like that for uh mechanical, just a little a little kind of metal ring.
SPEAKER_00Trevor Burrus, Jr. It was a little hole. That's what it was. And we kind of do it now just with a clamp and some non-litex. I think Marshall Kelleher taught me that a long time ago. Yeah. Crazy.
SPEAKER_01So when you're doing all of this teaching You must come across uh dentists who are struggling.
SPEAKER_00Yeah.
SPEAKER_01What do you think are there any kind of patterns on the ones that are struggling or the ones that seem to be thriving? Are there kind of any similarities?
SPEAKER_00Yeah, I mean that's broad, friend. So I think it can start at the beginning. I think some people go into dentistry because they're made to. I think they're made to, you know, through parental pressures and family pressures and stuff like that. And if you're walking down a path you don't want to walk down, and it's quite a hard path, it feels brutal. If you're walking down a path you really, really want to walk down, obstacles are just fun things to overcome. And that's a big, big difference. One of them is free motivation. It's just fun and enjoyable, and you s you lean into it. And the other one, you're having to rely on willpower. And if you're relying on willpower, it is finite. And you will then have more disposition to work in an easier environment or an environment where you challenge yourself less and you might cut corners. And so there are personality characteristics as well where you can measure in people, which are things like hard work and attention to detail, which are normally distributors in human psychology. And if somebody isn't into attention to detail and finds hard work, which you measure by how many tasks do you start but also complete, not how many you start, but how many do you complete. So like you set up a podcast and you are recording episodes, you've completed those tasks. Then people said, I must do a podcast. And I said, Well, how many episodes have you done? Zero. So if you have someone who's attention to detail oriented, walking a path they want to walk, and has the hard work built into them, like that conscientiousness is the personality characteristic we call it. That's made up of industriousness and orderliness. If you have those things, then those people tend to do well as long as they can connect with patients. If you can't connect, you don't like your job, you're struggling with it. And we've had people turn up on the course front and say, like, I've got two GDC cases at the moment, I had four last year. You know, thing I'm really struggling, I'm here for you to wave your magic wand. Literally, I've heard those words. Just wave your magic wand and fix it for me. And I can say, well, I can teach you technical dentistry and I can try and teach you psychology, but you're going to need a journey of self-discovery to see. To see if this aligns with who you are and what you want. I always say to people, if you're doing it just for money, I promise you, go and work in the markets. Go and work in the broking. Go and broker commodities. Yeah. Go and work at Goldman Sachs.
SPEAKER_01Trevor Burrus, there's easier ways to make money.
SPEAKER_00Trevor Burrus, Jr.: And big money. You know, you might sell your practice for 10 million quid or something, but I know people get that as an annual bonus. They get as an annual bonus when they were 28 years old.
SPEAKER_01Aaron Ross Powell Especially London.
SPEAKER_00Aaron Ross Powell Yeah. Less so now, but you know, they all seem to be comfortable. The guys I was at school with who did that.
SPEAKER_02Aaron Ross Powell Yeah.
SPEAKER_00Yeah. So I people do struggle. I think the thing they struggle with most is, you know, it comes back to them getting an environment where they're pressured to compromise on time. Maybe we should do a little little thing. How I say to you, so if you you're not my student, Friday, you don't need to learn anything from me, but I would say when you do a consultation, how long do you want? And I didn't say get. I didn't say get or need. How long do you want? And that's the key. And other people will say, well, actually, if I want, I really would like an hour. You know, I want an hour. And then we'll say, well, how long do you get? And they'll say, well, 15 minutes. Okay, well that's that's tough. Because you you're not getting what you want. And you've got to want to be there. And then you can get into difficult habits and you know, are you squaring off your admin cleanly every day? Are you getting your notes done? Are you are you reporting on every radiograph? Are you are you doing all your attention to detail? Have you got the equipment you want? You know, have you got your caries die?
SPEAKER_02Yeah.
SPEAKER_00Or are you guessing? And how does that feel? And I think it's all those those moments and experiences that can accumulate in people and it starts to feed into their concept of themselves. And then they don't like being having that identity tied into being a dentist. And I get it. And I we see that a lot.
SPEAKER_01Yeah.
SPEAKER_00A lot.
SPEAKER_01It's like um I'm just thinking back to some of the worst jobs I've had and what's the worst? It's probably exactly what you're saying. When you're being encouraged down a path of doing it a way that doesn't align to who you are.
SPEAKER_00Yeah, a hundred percent that.
SPEAKER_01So every day you're lying to yourself.
SPEAKER_00Yeah.
SPEAKER_01Um it's it can be quite um subtle.
SPEAKER_00Because it can creep.
SPEAKER_01Yeah, creep in.
SPEAKER_00Was that working in practice?
SPEAKER_01Yes. Yeah. Actually um talked about this on another podcast very briefly. But I've walked out of a couple of jobs and people were shocked at listening to it as if I don't know. I the way I see it is that you're self-employed protects you as well as the practice. And if something's not working for you the same way that it's not working for a practice, and if things are actually wrong and incorrect with it not being there, that is your way of getting out.
SPEAKER_00Yeah, it is, yeah.
SPEAKER_01Um it's actually better than being employed in in that r respect.
SPEAKER_00Yeah.
SPEAKER_01But um there was a I probably can't say things for legal reasons, but there was a a practice I worked for that was the first of their kind in the UK. And it wasn't quite open, so it was due to be open. So I was there at the start. No medical emergencies box.
SPEAKER_02Yeah.
SPEAKER_01There were salespeople employed as treatment coordinators who'd been selling kitchens and cars the week before. Wow. Taking OPGs. Wow. And then with marker pens putting where implants would go. Wow. And no one had even asked me if I did implants. Now this is probably seems quite extreme, but the way it was sold to me was that I was going to have a salary plus what um private income I had a proportion. So it was very appealing because I was trying to get you know, pursue my career. It is. It felt qu like a a good in-between going from NHS to private. And um I kept raising these things, and they, you know, you're I was being filmed because I was apparently going against company policy, speaking out. And in the end, you just have to almost hold your own and just keep remembering that no, this is not okay. Trevor Burrus, Jr.
SPEAKER_00Because that was just you must comply.
SPEAKER_01Trevor Burrus, Jr.: Yes, you must comply. They wanted me to see there'd be patients in multiple rooms and I'd go between. So numb someone up. And and it was just a lot um Did this go on for long?
SPEAKER_00Were you there long?
SPEAKER_01Six weeks.
SPEAKER_00Wow.
SPEAKER_01Um I took and I didn't see very many patients in that time either, but I had a salary, so I was given time and thinking they knew, you know, let's just like they employed someone um eventually to try and help them get up to CQC standards, that kind of thing.
SPEAKER_00Aaron Ross Powell You're supposed to do that before you're open.
SPEAKER_01Yeah. But I remember them saying, you know, there's a patient out there. I was like, oh, we can't see anyone, there's no medical emergencies box. And they said, well, he's not going to have a heart attack. That's not how it works. It's not there because everyone's going to have a heart attack. It's just a necessity. But yeah, I I took my little suitcase and I have so much stuff of my own on a on a really early in the morning, just as reception pulled up, just didn't say a word, just took all my stuff and left. I had to block every number and just emailed head office.
SPEAKER_00Aaron Ross Powell Oh my god, this is like proper.
SPEAKER_01Yeah, because I felt very intimidated at the same time. And I think I was a lot younger. I'd it I wouldn't have lasted six weeks now.
SPEAKER_00Aaron Ross Powell And if I can paint a scenario or ask you a question. If it hadn't been quite so bad but was deteriorating and they'd started paying you, do you think you Because I see some people get caught in the financial trap as well. Like their lifestyle adjusts and the money's coming in a little bit as well. And I see it even in the NHS, and people say, well, I've got this and I've you know I've kind of bought into this lifestyle. Now I'm on this hamster wheel.
SPEAKER_01Aaron Powell I think that would make it even worse.
SPEAKER_00Yeah, I do.
SPEAKER_01Because then they've got a hold on you.
SPEAKER_00Aaron Powell Yeah, they have. And you've got outgoings. And you think, well, now I need to walk out. And you walked out.
SPEAKER_01Aaron Ross Powell I did. I did do I did demand the salary for the six weeks I got it.
SPEAKER_02Trevor Burrus Did you?
SPEAKER_01Yeah.
SPEAKER_02Nice. You're quite strong.
SPEAKER_01They can only say no, can't they? But I just wrote down every single point of the contract they'd gone against. Trevor Burrus So I mean these contracts exist.
SPEAKER_00Yeah. Yes. And you are relying on the system there, though.
SPEAKER_01Yeah.
SPEAKER_00And then their integrity. Because you know, in building this i uh my comparison, and I don't know if I have my naivety removed, but dealing with our profession, which is quite heavily regulated, and arguably over-regulated, certainly has been argued in the past that we are. I'm not sure we are. Because dealing with builders and contractors who are not regulated, and I promise you it whatever if if anyone watching this is married to one uh or knows one, you'll probably agree. It is brutal, ruthless, and cutthroat. And anyone coming into the industry with full integrity, you are not brutal, ruthless, and cutthroat enough, and you will be chewed up and spat out and bankrupt, which means it's a self-perpetuating cycle in the construction industry of we'll work alongside each other, but I am watching you. And if there's any weakness, I'll have you. And if there's anything you do, and if there's any debatable, there's even in this room you're in for and we've got debatable things on one cord over here, and there's a power line too close to a data cable. So we're getting sound. It's like, well, who's going to pay to have it fixed? And they're just like, well, I'm not, well, I'm not. And it's just conflict. It's conflict all the way through. And embezzlement and theft. Not with a lot of them. Our contractors have built this that are actually very good, but we we've it's unbelievable. So I think we need we need to. Because it shows there's display. Trevor Burrus, Jr.
SPEAKER_01It's absolutely fair.
SPEAKER_00Yeah, I agree. I agree. I agree with you. It's absolutely fair.
SPEAKER_01Trevor Burrus, Jr.: I think sometimes as well, dentistry is an odd an odd industry that you talk to I have friends in other jobs and other industries, and they just think it's crazy.
SPEAKER_02Trevor Burrus, Jr.
SPEAKER_01In the way that I've described that people think that's brave walking out of that job. Like I've got friends in other positions who would just be like, well, it's not right, so you're out. It's not crazy.
SPEAKER_00Trevor Burrus, Jr.: Juno, I know we're supposed to be sharing things, so I'll share something with you. I wanted to leave the NHS hospital job I was in for a number of reasons. And I don't want to speak ill of anyone, because I got to work with some wonderful people, incredible surgeons, helped so many patients. It was amazing. But it's definitely time for me to go. And I I don't mean it arrogantly or boastfully, but there was a bit of me that kept me there. I was like, well, if I go, what's going to happen? You know, who's going to treat so-and-so? Who's going to finish this case? Who's going to be able to do this? And you realize the world will keep spinning when you walk out. You're not that important, Rich. And everything kind of just carries on. It certainly doesn't circulate around you. And you left- I left and I just remember thinking. It's a similar thing to what you're saying, that people walk out and they say, I'm out. I'm gone. And everything will will carry on.
SPEAKER_01Advertise your job again.
SPEAKER_00Trevor Burrus, Yeah, they will. They will. And you know, I I I tell our delegates this with the NHS. I don't think the NHS is a particularly good employer, I'm afraid. Because particularly for dentists, because they hold all of the authority but don't take any of the responsibility. Like if you have an error as a dentist, you don't go in the dock with an NHS representative by your side saying, I'm complicit in this error or this outcome. You're all on your own. And it it does it it almost traps you into it. I find it a very difficult employer from that point of view. And if you leave or you exit or you have a nervous breakdown, all they're going to say is who's going to see the patients? Who's next? Where's the locum list? Get someone in. Yeah, yeah, I hope you're right. Get better soon. Let us know when you're coming back. Return to work interview, book it in. I d I don't f find it cares. Am I being cynic?
SPEAKER_01No, but I I think you could argue that on any job, the employer in the end. They have their own needs to be met in a work capacity. Trevor Burrus, Jr. They do. So yes, they might be sad if someone after 30 years has decided, do you know what, I don't want to work here anymore. And they're not retiring, they're going somewhere else. But as soon as they've got over that that day, or then it's like, okay, we we need to advertise the job. That's true. Which is why you have to advocate for yourself.
SPEAKER_00Yeah, I okay. I like that. I mean I think you're right. I I just I miss the human touch.
SPEAKER_01Yeah.
SPEAKER_00You know, I miss I I it saddens me slightly. Trevor Burrus, Jr.
SPEAKER_01Maybe I'm a bit caught.
SPEAKER_00Trevor Burrus, Jr.: No, no, I don't think you are. I think you're a realist, and I think that's true. But I will um I I will die on the hill of believing humans need connection. Definitely. And there's value in it.
SPEAKER_01Aaron Powell Definitely.
SPEAKER_00Trevor Burrus And there's value in it.
SPEAKER_01I'm very lucky now to work in a practice where it definitely feels more than work and we can all get on and there's a bigger kind of thing. And I never feel Sunday scary going into work.
SPEAKER_00That's so cool. Do you know people hearing that will because you've just shown them it's possible. It's so nice.
SPEAKER_01Aaron Ross Powell I remember shadowing a lady in um Sheffield who was in community dentistry before I started dental school and she said she never dreaded going into work. And it's one of the reasons I did it.
SPEAKER_00Aaron Powell Yeah. It's such an important message though.
SPEAKER_01Trevor Burrus And I remember thinking, wow, she never dreads work. Because I I grew up with people, you know, saying, Oh God, we've got to go to work tomorrow. And it's I was like, gosh, she never dreads getting in the car going to work. What a lovely career.
SPEAKER_00If you can if you can travel to work and think, I'm actually looking forward to being there, I'm excited by my day.
SPEAKER_01Yeah.
SPEAKER_00What a lovely feeling.
SPEAKER_01Trevor Burrus, Jr.: Yeah, it is a privilege.
SPEAKER_00Yeah. And and you know, being a gratitude plays into that as well. But your work circumstances, your concept of how you rank in terms of your ability to deliver. And you get a call from the ward and say, we think your patient's having an embolism. Can you come and manage it? And you've got BDS, maybe MFDS, and you think, well, that's going to be a challenge. You know, I remember the shape of the sphenoid bone, is that relevant? For me, it was always the lack of competency. But if you if if you can go to work, I would argue if there's any business owners watching this, your biggest and best asset and your biggest liability are staff. But if you've got good staff, you should cherish them.
SPEAKER_01Trevor Burrus, Jr.: And happy staff.
SPEAKER_00Trevor Burrus, Jr.: Well, if they're cherished, they will be. So if you're an associate. Valued. Yeah. If you were my staff, I would say, right, Fran, unbelievable. Cash cow. Really good at her job, lovely to have around. How do I make sure she never wants to leave? That would be a daily thought going through my mind. I need I need her to see all these other jobs. People are going to poach her. She's going to go, Are you mad? Do you think I'm ever leaving a spire? Of course not.
SPEAKER_01Trevor Burrus, Jr.: I think a lot of practices miss that though, that there's a focus on we don't want them here anymore, but they're missing the elephant in the room is the ones that are there, and they don't want them to leave. Trevor Burrus, Jr.
SPEAKER_00It's because they don't call them fran, they call them a performer number. They say you this is your performer number. Trevor Burrus, Jr.
SPEAKER_01I have not thought about that for a long time. I can still remember it.
SPEAKER_00Trevor Burrus, Jr.: Yeah, don't give me a box. I'm not if I want a number. Who's the person?
SPEAKER_01Aaron Ross Powell I'm just 43031.
SPEAKER_00I like that.
SPEAKER_01Yeah.
SPEAKER_00Yeah. But that's that's I I think all of the you know back to your original question about what are the challenges in dentry. I think it we we summed it up there. It's all of those put together. And I think people can get into a pickle. And we try and help them as much as we can here.
SPEAKER_01Aaron Ross Powell What's your advice to them then if they're struggling?
SPEAKER_00Trevor Burrus So uh i everything starts with know yourself. Everything starts to know yourself. And if if you want to know yourself, you should know all of yourself. Not just the bits you want to see, but the bits you don't want to see and the bits you don't like to show.
SPEAKER_02Yeah.
SPEAKER_00And that is an inward journey that lasts forever. But know what your motivations were. So you're gonna have some realistic goals in life. And if you haven't got a goal, so the I the way I teach it is this is imagine you have an infinite load of directions, you're in a sphere, and you can go in any direction. You only find out if the direction you're walking along the path is meaningful and pleasant to you and pleasing and joyful once you started walking it. And if it's not, then it doesn't feel fulfilling. So life doesn't feel fulfilling. Sunday night scaries. If you have got some curated direction, so let's say we just make it a circle, like a compass, and I can say, well, I don't I don't want any of these directions. I don't want any of that, but I like that sort of range, this 30-degree range. At least we can curate the direction you want. And is that family? Is it money? Is it working week? Is it freedom? Is it opportunity? Is it security? Yeah, what time is it? Yeah, and and really do the work. And that's we call that a future authoring exercise. So we'll ask everyone to do a future authoring exercise, and you'd have to go into your own head and think, what and you know, one of the questions, for example, I would give to you, Fran, is like two years from now, describe to me your average Tuesday. Okay, who are you with? How often do you see, let's pick, for example, your mum. Do you get to take it for lunch as much as you want and spend time with her? And if that's important to you, we're going to book it on a Tuesday and we're going to create that life.
SPEAKER_01And once you've got direction for that, life feels to work towards.
SPEAKER_00And then your future. So how you feel in the moment, believe it or not, this is another psycho. I'm not trying to do a psychology.
SPEAKER_01No, no, no.
SPEAKER_00How you feel in the moment has very little to do with your past. It's a lie, like my past. Past traumas and stuff like that. It's your brain predicting your future.
SPEAKER_01Based on patterns it already knows.
SPEAKER_00Aaron Powell Well, so it's based on memories. It is based on memories and experiences and the emotions we attach to them. But if I example it in an extreme way, imagine your past has been full of security, opportunity, freedom, love, everything you wanted, and you had abundance and wealth, and you've lost it all, everything. You're now living in a skip, eating old crisps out of a discarded packet, and you're cold and alone and unloved. Don't tell me your past makes you feel different in the future.
SPEAKER_01Yeah, that's very true.
SPEAKER_00Flip it around. You've had a terrible past. You were alone. You struggled for money. Food wasn't abundant. You lived in a very impoverished way, and now that's gone. And you have love, friend. You have abundance, you have freedom, security. How do you feel in the moment? You feel good. Your brain is a prediction machine, and it's taking everything that's happened and everything you know and everything you're connected with and making predictions for your future, and it will give you feelings, those feelings in the moment. And that's how we experience life. We think it's our past, it's not. Your brain is fundamentally a prediction machine and it's predicting things. And if we can predict a better future, we feel great in the moment. So we try and future author for people and align their values.
SPEAKER_01Make them think what they do want.
SPEAKER_00Find out what's in their heart with their values, connect it with the goals, and if they're aligned, moving forward. You've got to have the values and you've got to have your goals and have them aligned. And if they're not aligned, like if your if your goals are money and your values are something completely different, which is like free time and creativity, it's you're gonna it's gonna be difficult to f-quit and be an artist.
SPEAKER_01Trevor Burrus, Yeah.
SPEAKER_00Well, exactly. Beautiful. You don't even need it. That's the exact thing you have to do. Yeah.
SPEAKER_01You know, it's I always think if I wasn't gonna go down a route that I needed income, one of the um driving reasons I went to university was to make sure I had a better income than I grew up with.
SPEAKER_00Yeah. Me too.
SPEAKER_01I I wouldn't have done dentistry. I would have gone and been an artist or gone and done French and Because I think Do your listeners know you're an incredible artist?
SPEAKER_00I'm not going to embarrass you. I'm talking to them now, not you. You're amazing. I love looking at your work.
SPEAKER_01It's it's a privilege, I think, to go and do something without the money being there.
SPEAKER_00For sure. For sure, yeah. Yeah. And that that that's the financial trap.
SPEAKER_01Yeah.
SPEAKER_00That is the financial trap. And if money's no object, what would you do?
SPEAKER_01Aaron Ross Powell Maybe if this whole thing that's coming in that Elon says is coming in, I might be an artist. Either minimum income's coming in or saying don't don't save for retirement, because by the time we get there, there'll be no need.
SPEAKER_00Do you know it's hard to bet against him? You hit a trillion. And you send these rockets into space, it's hard to bet against him. But uh Yeah, it's very interesting. I don't know the answer to that question. I know in this country we can't afford our pension debt, so we're in trouble with that. So I hope he's right in a way. Otherwise, we're going to be working too well. 86.
SPEAKER_01Have you ever been in a in a part of your career where you thought, do you know what I'm struggling? And youth.
SPEAKER_00Oh, for sure.
SPEAKER_01Yeah.
SPEAKER_00Oh, definitely. Do you know I and I won't mention names, but I'm blessed with some of the people I've come across. And I I I don't think I'm alone in thinking I got to where I got to in no small part by some elements of luck. Like I think most dentists I speak to say, General, I got lucky. And that's not imposter syndrome, but like meeting you was luck. You know, it is. I feel lucky. And now it's led to me talking to you here and having this experience. And you can pick up I've picked up things from people which feel lucky to me that have either pulled me through or have shown me a way that resonates with my values, a value that was uncovered in my heart. Like I can remember I won't mention because they might see it, and I don't want to embarrass them. But a couple of people where my work ethic was one way, and I'd meet someone else, and I could see their work ethic, and it was like someone turned on a light, and I remember thinking, I love that work ethic. And then you find out that's that journey of self-discovery, and you think, that's who I am. I've d I just found a little bit about myself and it can pull you through. And the most uncomfortable times in my career are when you have a predicted outcome or a predicted experience and you're either not capable, competent, or surprised or betrayed. You know, so if if there's if you've tried to to say I can do a job or a particular procedure and you can't, I find that awful. And that was really in my junior days. And that's why I ran back to do postgraduate training for the rest of my life.
SPEAKER_02Uh-huh.
SPEAKER_00I do remember I, you know, when I was a foundation year, it was in the very early days of UFC fighting.
SPEAKER_01Okay.
SPEAKER_00Yeah. I wasn't one of them. But I had a patient who was. And he's a lovely kind guy, like a lethal weapon. And it was uh I hope you don't mind me indulging in the story.
SPEAKER_02No, no.
SPEAKER_00And he he and so I graduated from Guy's, and you know, I felt I was really reasonably well trained. And I was working in a practice, and I'd had to take a tooth out the day before, and when I'd been handed the forceps to deliver this now loose tooth, a crusted autoclaved cusp was on the beaks of the forceps from a previous patient. That was where I was working. And in this situation, this guy had caries that went into a pulp, into the pulp in his lower right six. And I said to my nurse, could I have the rubber dam and the file systems? Um I need to extirpate this. And they asked us, What's rubber dam? And I think we got a file.
SPEAKER_01Okay.
SPEAKER_00And so there was no rubber dam. You're asked to do endo. This is an approved foundation you practice. And they had one file for endo, which was autoclaved at the time, because it's pre-CJD, and you had to put a ring on your finger with a little chain on it and try and remember those. Yeah, and extirpate. And I was trying to do this as best I could for this guy. And my endo was obviously appalling. And he developed a big fat face and had to go to hospital, and he missed his shot at the world championships. And I remember thinking, right, there's about 42,000 dentists in the country, and I'm the worst. And I'm not I I'm either going to leave or I'm going to improve. And I and I genuinely remember thinking like And that was VT VT. That was my vocational, yeah. Yeah. And everything else was fine. Like doing doing composites seemed fine at the time. Like managing perio communication, I was okay at. It was anything where there was that level of technical expertise, which I didn't possess, I definitely didn't possess, I didn't have the experience, and we definitely didn't have the equipment. And I there weren't mentors I could rely on. And I put this guy in hospital. He had to go to the John Ratcliffe. And he was under max fax there, and he had his tooth taken out, and he was better and fine, but he missed his fight. And I remember thinking, that I can't have a career of that. So I went back to hospital and I got a job at the Royal London. And then I didn't leave for the next couple of days. Yeah, and I'm it was that sense of inadequacy. I think it was that. I couldn't live with that.
SPEAKER_01Yeah. And like outside dentistry, are you that kind of person in life as well? Like driven for results? You seem to be.
SPEAKER_02I guess.
SPEAKER_01So then it is really hard when you can't perform clinically, I think. Oh, yeah. If you're that personality, and a lot of people are who go into these careers.
SPEAKER_00Yeah, I yes. I I I mean, I we I don't know if we're going to talk about insecurities, but e everyone, most people are motivated on some level by some hidden level of subconscious insecurity. And every single person alive has this. And they're either aware of it consciously because they've done the work or they're not aware. And the people who are not aware, the insecurities will be controlling you far, far more than being aware. And so, in terms of performance, like uh the the the big insecurities people have are significance. An insecurity is something you can't create yourself and you need from other people. It's a need. So these come from a position of lack. And the big six are significance, approval, acceptance, being perceived as very bright, intellectual, um conscripting pity. Conscripting pity or being powerful, like super dominant.
SPEAKER_01Aaron Ross Powell So they want pity or they they don't have attention.
SPEAKER_00Yeah, and they they use pity to gather which would be similar to the first one significance, yeah. If you if you can control pity if you generate a lot of pity and you're a perpetual victim, it's a form of control over other people because you can't be persecuted as a victim and other people's behavior has to change around you because you're the victim. So that's one thing. And and you know, I do a lot of work in psychology now, and you have to go through the journey of self-discovery. And for me, I think it's significance. I definitely like being able to perform so I l I lean into difficult things and doing them live now.
SPEAKER_02Okay.
SPEAKER_00Because if I can do that live, it just feels it feels good to do it live because it's a challenge. And I get to prove to myself that I am who I think I am.
SPEAKER_01Ah. But it's a nervousness before, but you probably don't get very much anymore. Um Do you feel nervous before?
SPEAKER_00I I think I've well, maybe I'm kidding myself, but I've learnt to enjoy that. Like it's it's the same with doing physical training. If you do physical training to a level where you think all I have is pain, and I'm just gonna do more, you can find yourself smiling.
SPEAKER_01Yeah. It's like when you work to exhaustion in the gym. I find that really funny.
SPEAKER_00Yeah.
SPEAKER_01Like you don't do that at work.
SPEAKER_00You get better and better, you do. Yeah, you do. It's and it's yeah, because uh so we're in one of our development groups, we'll have everyone wear a heart rate monitor, and we say, okay, we have to take our heart rate up for the next five minutes to over 95%. And and should we just go to a hundred? And should we just hold and let's just bounce around 95 to 100 and you think.
SPEAKER_01I think you're smiling because it's almost like sadistic.
SPEAKER_00It is a bit sadistic. But it's it's like it's like discovering yourself. Aaron Powell, Jr.
SPEAKER_01Yeah, and knowing the real limits.
SPEAKER_00Yeah. Yeah. And pushing through them. Pushing through them. So I i if you don't ask me questions for I'm gonna keep talking. That's the problem.
SPEAKER_01This is what makes my job easy.
SPEAKER_00Aaron Ross Powell So there's a personality characteristic. And it has the name neuroticism, but what it means so the the personality model we tend to use is called the big five. And it's made up of openness, and your openness is astronomically high.
SPEAKER_01Aaron Ross Powell Really?
SPEAKER_00Uh without doubt. We'll do the test when you're off camera and you're gonna be like 99 out of 100. There is conscientiousness, hard work, ambition, drive, extroversion, which is your sensitivity and propensity to experience positive emotions.
SPEAKER_01Really? Is that the definition?
SPEAKER_00Yeah. That's what extroversion is. That's interesting. Yeah. It's your it's the realm of positive emotion. So joy, fulfillment, pleasure. Trevor Burrus, Jr.
SPEAKER_01So you're more open to joy as an extrovert.
SPEAKER_00You find it easier to access.
SPEAKER_01Aaron Ross Powell That's so interesting. I've never thought of it like that.
SPEAKER_00Trevor Burrus Your personality psychology, you could do a whole like we I teach that over like 12 weeks. It's an incredible subject. There's agreeableness. Agreeableness, which is compassion and empathy and kindness and warmth, that natural disposition. And you will know people who are just sort of it's like being around an angel when you're just close to them. They're just massively agreeable. And then there's the realm of negative emotion, sensitivity to negative emotion. And that's called neuroticism. Now, none of your listeners have ever woken up because they're too happy with how a procedure went. You've never lost sleep because your composite was so good.
SPEAKER_01No.
SPEAKER_00But if if you get the letter or the complaint. Trevor Burrus, Jr.
SPEAKER_01Maybe that's to come.
SPEAKER_00Trevor Burrus, Jr.: Or the post-op sensitive, well, congratulations, you won the composite world award then. But if if you but you can worry. You can worry forever. No one treats a patient and goes home and says, I'm smiling because everything was so good today. But you can be anxious about work forever. You can worry about the patient all night. You can lose sleep and have wake-ups because you've got that. So humans are far more disposed to the N than the E, the extraversion, the positive, we're far more disposed to that. And it's normally distributed. Does that make sense? So we've got this normal distribution. And your neuroticism score, if it's very, very high, you experience consciously and subconsciously events that land and cause more impact and are harder to recover from at an emotional level. You can think of neurocism as a threat sensor. Trevor Burrus, Jr.
SPEAKER_01So you're feeling things deeper.
SPEAKER_00Trevor Burrus, Jr.: Yeah, and anticipating them more and seeing threats that might not even be there. And it's a really important facet. Now these schools aren't fixed. They're not fixed. So the number one thing we are asked for when we teach this is someone says, look, I am on an anxiolytic. I am anxious about all sorts of stuff. And I don't know why. There's nothing specific. I said, what are you anxious about? I don't know. I just feel anxiety.
SPEAKER_02Yeah, run on anything.
SPEAKER_00That is someone running on a high end. And then they'll say, Is it something I can do? And I said, of course there's something you can do. Of course. This isn't fixed. Yeah, you can fix it.
SPEAKER_01Trevor Burrus, Jr.: Thinking of people.
SPEAKER_00Yeah, well, good. So the same bit of your brain that tells you to worry is the same bit of your brain that says don't get in Richard's ice baths upstairs. The same bit of your brain because I promise you, if you want to do it after the podcast, we'll go upstairs.
SPEAKER_02No, no, no. Not today.
SPEAKER_00Trevor Burrus The same bit of your brain that says don't do that is the same bit of your brain that gives you the worry. And you can take conscious control of it and you can say, this is one example, and say, I'm going to get into this horrible, life-threatening cold environment, and I'm going to breathe my way through it, and you can watch the scores drop.
SPEAKER_01Trevor Burrus, Jr.: So are there people that that end score is so low, they're the ones that we all know them where. They just seem to be attracted to danger almost.
SPEAKER_00Trevor Burrus, Jr.: Yes, yes.
SPEAKER_01And they're not looking at the danger.
SPEAKER_00Trevor Burrus Yeah. And they they have unbelievable tolerance to stress. But it's the extremes of any of these scores you have to be careful. Because if your neurotism score is like zero or one, that that's the first diagnostics for a psychopath. Like psychopaths have unbelievable stress tolerance.
SPEAKER_01Trevor Burrus Interesting.
SPEAKER_00Trevor Burrus They have very little impulse to be able to do that. Trevor Burrus Yeah, I mean and psychopathy doesn't mean you want to hurt people. Psychopathy is impulse control and stress tolerance. Like you have no impulse control, because why would you? And you're infinitely these people I've worked with a couple of psychopaths. You could set the operating theater on fire. Trevor Burrus, Jr.
SPEAKER_01laughing because I'm sure a lot of people would say this.
SPEAKER_00For surgeons in the NHS, it's it's like close to eight percent. Aaron Ross Powell can be diagnosed with psychopathy.
SPEAKER_01Trevor Burrus And how many What's the percent in the general public?
SPEAKER_00About 1.2.
SPEAKER_01Aaron Ross Powell And it's eight in NHS.
SPEAKER_00So it's about one in fifty people. I mean one in fifty people will have some form of personality disorder or characteristic. It's psychopathy, which is impulse control and unbelievable stress tolerance. Machiavellianism, which is Who is that? So that it comes from Nicolai Machiavelli, a 16th-century Italian politician who gave the famous question, is it better to be feared or loved? And Machiavellianism is your ability to manipulate and taking and using manipulation to your advantage. And that's a nice ethical question, because if you manipulate someone to be healthy, you know, is that a good thing or is that a bad thing? But in that in that context, it's really to your advantage and their disadvantage. That's Machiavellianism. There's narcissism, and that's a spectrum. Everyone's a little bit of a narcissist, but it's when it becomes very, very significant. And the best way to think of narcissism is you're in a movie and you are the star of the movie. And everyone else, literally everyone else, even your own children and family, are extras in the movie.
SPEAKER_01Okay.
SPEAKER_00And the movie star is the star, can't be questioned as the star. And they're the hero. And if you help the hero, you get cast in the movie and you are rewarded. But if you challenge the hero.
SPEAKER_01You die. You've got a baddie in the movie.
SPEAKER_00And then the last one is sadism, which is just horrible because that's pleasure and other people's suffering.
SPEAKER_01Yeah. Yeah.
SPEAKER_00And you'll often see combinations therein.
SPEAKER_01Aaron Ross Powell That's so interesting.
SPEAKER_00Trevor Burrus Yeah, but you do you know the the Well, they're not all those four, but they have incredible stress tolerance. And you look at prisoners, they're similar, you know, that that you in there are some sex distribution differences between these things. It's fascinating to say it is fascinating. Because and I I dentists like there will be dentists watching this who will see a patient walks in who's got that. And you might meet someone who enjoys it when you're upset. They might enjoy it. I mean, can you think of that? Like they meet a highly agreeable, warm, kind, compassionate person. And those people tend to make contracts with the world that if I'm nice, the world will be nice back, which isn't true. And then you then you meet a predator who finds pleasure when you're upset. It's real. I know I'm oh God, I've gone dark.
SPEAKER_01It has gone dark.
SPEAKER_00Should we talk about the telescope? But it's real.
SPEAKER_01Are there any specific traits that are more common in dentistry?
SPEAKER_00I think we get such a spectrum of people coming through, and there's no evidence that I can pull out that I know of of personality characteristics and dentistry. The two things you will see so let's brighten it up. Because what you can say, if if you look at a combination of psychometrics in a human, which ones predict success? And can we measure that and see what the correlation is? And that's fabulous, because we can do that. So the first one is IQ, and that is equally normally distributed. And if you have got into dentry a stem field degree, you're really like 115 plus. And because it's normally distributed, I I say to anyone, if you don't know what to put in your gratitude diary, if you've got an IQ of 115, the flip side on the other side of the curve is 85. You know, 15 up, because the hundred is always set as the average.
SPEAKER_02Okay.
SPEAKER_00There's as many people below 85 as there are over 115. And if you're below 85, you will struggle to operate a till at McDonald's or a pocket calculator. So if you're at 115 and above, you should wake up every day and you were given a brain, and my God, thank you for that.
SPEAKER_02Yeah.
SPEAKER_00So IQ is correlates with outcome. It doesn't correlate as highly as conscientiousness. Hard work is more predictive than IQ. But if you combine the two, it's cumulative. So IQ correlates at about 0.25. Um hard work, high conscientiousness, correlates at about 0.35 and they accumulate.
SPEAKER_02Okay.
SPEAKER_00So now we're we're close to 0.6, which is really good correlation. If you add an extra version for an, you can add another 0.2. So if you are joyful, high low threshold for feeling good about stuff, optimism. Hardworking and bright, that's kind of the best combination you can have. Openness, which is your realm of creativity, you you know I I know the joy you get from drawing, because you smile whenever I say the word draw. You smile on the D of draw, and I'm similar, is neutral. High neuroticism, sensitivity to negative emotion is slightly negatively correlated. This is with income and career success. Um, and high agreeableness is negatively correlated as well. So the perfect like this isn't the perfect life, but this is career success, bright, hardworking, and happy. Openness is irrelevant, creativity is largely irrelevant. You don't suffer much in your head, like your tough mental resilience, and you're not very nice all the time. You're willing to have some boundaries. The best example of that is you're willing to walk out of a job after six weeks of not being happy. I think you you got it all. It's true though.
SPEAKER_01I think if you if anyone else had been in that job you six weeks is probably too long, though.
SPEAKER_00Well, maybe you're just tough.
SPEAKER_01No, it was bad.
SPEAKER_00I love it.
SPEAKER_01Um let's briefly go back to connection, because it was running a bit um over. How would how do you think people can get more connection?
SPEAKER_00So the only thing that stops us from being connected to someone else is us thinking about ourselves. So move yourself out your own way. And I I don't mean stare like a weirdo on the tube, but I mean stare metaphorically at the person you're looking at. So I'm not going to make it weird, but a bit weird. When I stare at Euphran, I'm looking at your mind. I'm trying to look at your mind.
SPEAKER_01Okay.
SPEAKER_00Because it's mind-to-mind connection.
SPEAKER_01Yeah. Yeah.
SPEAKER_00And you and I are our minds, and our minds live in our brains. And those brains give us emotions, feelings, and thoughts. And those emotions, feelings, and thoughts become our actions. Yeah. Now youfran can only know me through my actions.
SPEAKER_01Yeah.
SPEAKER_00So you can only know my mind through my actions. And I can only know your mind through yours. But what we're trying to do is a mind to mind connection.
SPEAKER_02Okay.
SPEAKER_00So it's understanding that my behaviors, thoughts, tone, words, movements are my only vessel for connecting with your mind and yours and mine. And we that's how you do it. So the first way to do that is to be curious about yourself and your own mind. And then once you've taken In that to a certain level, be massively curious about other people's minds.
SPEAKER_01Trevor Burrus And genuine curiosity. Trevor Burrus, Jr.
SPEAKER_00Oh, you've got oh you can't fake it. If you fake it, they're going to feel violated. It's faked when you meet a salesperson and they go, oh, how are you today? It's like you don't care how I am, you want my money. But if you genuinely are curious, and I think you should be curious, because it might all end tomorrow. I've seen enough patients at the end of their life. Life is precious and short. So be curious, be massively curious. And once you're curious and you start to see it, you will innately become passionate. So that the path to any internal motivation system is curiosity, passion, purpose, autonomy, and mastery. It's a five-step process. Start with curiosity, then become passionate about connecting with people and understanding them. And then it then you know if you can feed it into your job, it becomes purpose. Then you don't need to learn to do it, you just get better at doing it on your own. And then people say to you, wow, you're so good at speaking to people. And you've hit that sort of mastery zone. But it starts with curiosity.
SPEAKER_01Trevor Burrus, Jr.: Yeah, I'm just thinking if if you genuinely do like people chatting to patients isn't very hard because you're genuinely interested in the answer. It's like it's when certain people come through the door and you you're just chat-chat-chatting and then you're like, I need to do I need to do my job.
unknownYeah.
SPEAKER_01Because you've clicked with them. Some people it's very hard. Trevor Burrus, Jr.
SPEAKER_00Yeah, I agree. And if people are monosyllabic, you know, but then you can see why they're not speaking to you.
SPEAKER_01Yeah.
SPEAKER_00And then remember that person, I promise, still wants connection. So all you have to do is say to them, I see you and I see why you might be speaking that way. And I fully understand it.
SPEAKER_01That's the harder type.
SPEAKER_00That's that's uh but that's called a label. So a label is when you name how someone is feeling. And even if you get it wrong, they don't care because you're still saying, I'm curious, and I'm here.
SPEAKER_01You care enough to ask. Yeah.
SPEAKER_00Yeah, I'm showing you, I'm trying to tune in on how you're feeling. And it's the intent, it's not the outcome, it's the intent. And you're saying, I'm not in my way, I'm after your mind. That's all it is. That's the label. That's that's one of the first skills we teach. First skills we teach in communication with real skills are mirroring and labeling. And a mirror is when you will use the patient's words. So you say to me, I say, Fan, how was your day? And you say it was fine. And I would just put a tone into that and say it was fine. And you will fill that void. You'll go, yeah, yeah, yeah. And you've just heard me. Because I've used your words, I prove to you I've heard you. You know, and if someone says, I you know, I don't like the dentist, you don't like the dentist? And they will fill the gap and give you that information. Yeah. At the same time, they've heard, you've heard me. And then you can use a label. It sounds like that was an upsetting experience for you. Like you've named my feelings. My God, how much do you love me? Mirror and label, it's a beautiful set of opening skills. We teach people and and we do we encourage people to do role play with it. And and like you can send people home and send them home with skills and say, right, you're gonna get in your Uber. You need to do skills three to seven and twelve on your Uber driver tonight and watch what happens.
SPEAKER_01Aaron Ross Powell, interesting.
SPEAKER_00It's a it's uh it's incredible.
SPEAKER_01Aaron Ross Powell So being open really to it to connect more.
SPEAKER_00Aaron Ross Powell Yeah. Yes. Being open to you know, the hardest thing is convincing people that there's value in this.
SPEAKER_01Yeah.
SPEAKER_00And I think it's because everyone could communicate. They will say, but I I am all you know, we like to think we're good at stuff, and I can speak to my mum and dad, and patients seem to like me, and I have an okay relationship with a receptionist. But you might be operating at a two out of ten, and that might be good enough, but you have no idea of the opportunities in life when you get to three, let alone six, let alone eight. And it's a continuous journey. Um so I I try to convince people that that connection is key. We teach dentistry too.
SPEAKER_01Yeah, yeah. Yeah.
SPEAKER_00Those fantasies are uh, yeah, you know the fantastic patients. We love the right bird. Oh, wouldn't it be nice? Maybe that's what we should get Elon to do next time. Maxillas, they can just drop them off.
SPEAKER_01I know. I uh it sounds awful, but I'm sure everyone has those days where I think it'd be nice to just do it with no one.
SPEAKER_00Dentistry is fun. The dentry is actually it's like colouring in. It's it's fun. It's the thing it's attached to that all the challenges come from.
SPEAKER_01Yeah. It is should have all been technicians. Yeah. Everyone's got a cup of tea, and it's a lot of things.
SPEAKER_00Yeah, bits of bits of plaster all over the nicely messy. Yeah, little flames everywhere. It's like you're in a candlelit room. I love it.
SPEAKER_01Let's uh let's round everything up.
SPEAKER_00Okay.
SPEAKER_01What advice would you give or do you wish you'd received if you went right back to the beginning of a career?
SPEAKER_00Wow. Wow, you've absolutely flawed me. What do I wish I'd been told? Um Invest your money. Don't waste it. Use money. Because you're you're gonna have some left over and invest that in there's a guy called Jason Greystone who talks about investment and put that aside because it would just money like it's not money for money's sake, but money gives you security, opportunity, and freedom.
SPEAKER_01I wish I'd invested earlier, even when you don't even when you're skint.
SPEAKER_00Yeah.
SPEAKER_01Even if it was tiny.
SPEAKER_00Yeah, tiny.
SPEAKER_01Yeah.
SPEAKER_00I promise Warren Buffett talks about it, you know. Compound interest.
SPEAKER_02Natural interest.
SPEAKER_00Compound interest, compound interest. And you won't get the reward straight away, but the compound interest is worth a lot. Um if you just push as hard as you can when you have the energy and align your values and your goals as quickly as you can. Find out who you are, find out what you're good at. Remember, a lot of people are going to try and sabotage you, because a lot of people don't want you to succeed. Learn to see where that's coming from. Relentlessly follow your your truth. But know your truth first of all. I wish I'd done that more instead of meandering a little bit and then thinking, do you know what? They're wrong. They're they're they're misleading me. I'm I'm I'm right. And push for it. Build systems for removing friction. Like the best thing that's happened to me recently is AI no creation.
SPEAKER_01Aaron Ross Powell One of my friends has uh his own business with that.
SPEAKER_00Good for him.
SPEAKER_01Yeah.
SPEAKER_00I love him. I don't uh I don't maybe I'm spending money with him already. But you know, a little microphone like this or a simple uh simple app on your phone and any of the big engines, you can you can create Yeah.
SPEAKER_01Like my boss said, it's probably saved him an hour a day minimum.
SPEAKER_00Yeah.
SPEAKER_01Massive, isn't it? Trevor Burrus.
SPEAKER_00And the bigger the case, and everyone who's ever met a very difficult patient here will know that's the one you've got to write the most notes on. Whereas if you just say, well, here's a full transcript and populate the relevant notes and keep the transcript. Like the and people say you're allowed to do that. Well, when you discuss something with a patient, you have to write down patient said this, I said this, patient said this. I'm just doing it for the whole conversation. So I I I love being able to write incredibly good notes within about three minutes. So nice.
SPEAKER_01Yeah.
SPEAKER_00And that gives you time. So I yes.
SPEAKER_01AI notes.
SPEAKER_00Invent AI notes. I think that's the advice I would have given, though. Not that not the AI notes bit, but everything before that. Just know who you are. Know who you are and shamelessly pursue it with passion and enjoy it.
SPEAKER_01That's great advice. Thanks. Thank you for your thank you for your time.
SPEAKER_00Thank you for making the journey. It's so nice to see you again. Ice bar for next time.
SPEAKER_01And in a lovely podcast studio.
SPEAKER_00It's cool, isn't it?
SPEAKER_01Yeah. Thank you.
SPEAKER_00Not at all.