Why are principals and associates always at loggerheads with each other? Why can it be almost impossible to find the right associates to work at our amazing practice, but also almost impossible to find that amazing practice to work at as an associate? 

Join myself and Dr Sarika Shah on this episode where we learn more about self leadership and the ways to prioritise our values to help us find the right working relationships and places of work to be a part of. Let’s figure out how to bring all members of a team together and create the zen we are all in search for while working in our day to day lives. 

Protrusive Dental Pearl:

Be willing to accept rejection. A ‘no’ from a patient today is often a yes tomorrow. Plant seeds for high quality dentistry and you will find yourself harvesting many of these seeds at a later date. Those who fear rejection routinely offer less than their best, which cheats patients out of rightfully making their own economic decisions – inspired by Dr Lane Ochi (the ORIGINAL Dental Geek!)

Check out Flourish as a Female: https://www.flourishasafemale.com/

Use discount code ‘protrusive’ (No financial interest)

Need to Read it? Check out the Full Episode Transcript below!

Highlights of this Episode:
02:18 Protrusive Dental Pearl
04:30 Introduction – Dr Sarika Shah
10:10 Transition to Private Dentistry
13:40 Practice Ownership
17:20 Managing the Practice
24:55 Internal Leadership
29:40 Principals vs Associates Friction
41:56 Women in Dentistry
47:15 Supportive Partners
55:25 Top Advice from Sarika
58:28 Flourish

This episode is eligible for 1 CE credit via the quiz on the Protrusive Guidance App. 

This episode meets GDC LEARNING OUTCOMES A and B

AGD Subject Code 550 Practice Management and Human Relations

Aim:
To explore the importance of self-leadership and effective communication in building successful relationships between dental associates and principals, enhancing teamwork, and optimising practice performance.

Dentists will be able to: 

1. 
   
2. Identify key principles of self-leadership and apply them to improve personal and professional development within their practice.
   
3. Understand the impact of effective communication and aligned values on maintaining strong, respectful relationships between associates and principals in a dental setting.
   
4. Develop strategies to enhance emotional intelligence, ensuring improved patient care and better collaborative relationships in their practice environment.
   

If you liked this episode, be sure to check out IC025 – Parenthood and Dentistry

Teaser: And when this respect is gradually lost, that relationship is most likely going to break down within three years. Okay, there's research behind this. I've read a lot around this. So what it there is, is there's three phases to this. The first phase is like- because even when I went out there to approach women, to approach some of these women are still around. And I think they're awesome. They're powerhouses. But when I went to them to ask for help, I got nothing. And it's not like I just asked once. I asked a few times. I asked several women and I got nothing. So the majority of my mentors and coaches have now been male.

Jaz’s Introduction:
Principals versus associates. Why is there so much beef? I’m constantly seeing on the dental social media groups that principals are bashing associates. They’re saying like, where are all the good associates gone? I’m really struggling to find a decent, honest, hardworking associate. On the flip side, the associates are searching for trustworthy, kind, caring principals that are willing to mentor and provide an environment where you can flourish.

That seems to be a bit of a pipe dream. So who’s right? Are they both right? Or maybe all the associates and principals that are happy, that are in very, very happy teams. Maybe they’re just having some popcorn watching all this unfold. I don’t know. I personally have had some wonderful principals throughout my years.

I’ve also had some not so good ones, so I can totally resonate with some of the things that I said. So in this episode, we will cover how do we promote a good relationship between associates and principals? Where does it begin? How do you know if a principal and an associate are a good fit even at the interview stage?

And if you lead a team, especially if you own a practice, I’ve got Dr. Sarika Shah, who’s all about the systems, and I really admire her. Like, Sarika’s one of these dentists who I seem to always bump into at courses. It makes me think, right? Why is it that I always see the same people at the courses? Why don’t I see any new faces at courses? It’s as though there’s like a 20% of the dentist population that goes on all the courses and everyone else is not going to the courses. I don’t know. But Sarika is someone who I’d always see around.

Well, hello Protruserati. I’m Jaz Gulati and welcome back to your favorite dental podcast. Some of the other themes we discuss are leadership in dentistry, particularly self leadership. And if you’re thinking, hey, I’m not a leader, I’m just an associate, then you are totally wrong. We are all leaders. We also talk about starting your own practice and the challenges particularly faced by women in dentistry who are looking to start their practice.

Why is it that the lecture podiums have less women? Why is it that less women end up owning practices? But these are very worthy themes that we discuss towards the end as well. So make sure you make it all the way to the end. This episode is eligible for CPD or CE. And as we are a PACE approved provider, the subject code for this one is 550. That’s practice management and human relations. We also, as ever, satisfy the GDC’s criteria for enhanced CPD. So all you have to do at the end is answer a few questions on the quiz. The quiz is accessible from Protrusive Guidance, which is our platform.

Dental Pearl
And speaking of platform, it’s the platform that gives us our Protrusive Dental Pearl today. You’re going to love this piece of advice. On our app, on our community, I asked our community, what’s the best advice you ever received in our profession? And I talked about not owning the patient’s problem. Like, I’ve talked about this a lot. But so many of you chipped in with such brilliant pieces of advice. I’m going to highlight one from Dr. Lane Ochi.

And in his contribution, he gave like five or six absolute golden nuggets. But the one I’m going to share with you today is where he learned to be willing to accept rejection. He said that most who practice dentistry successfully recognize that a NO from a patient today often is a YES tomorrow. Plant seeds for high quality dentistry and you will find yourself harvesting many of those seeds at a later date.

Those who fear rejection routinely offer less than their best, which cheats patients out of rightfully making their own economic decisions. So another way to make this tangible and explain it is sometimes we know that a indirect restoration may be the best for that patient, but for some reason, whether we think the patient is just not going to say no, or we think we have this silly perception that patient can’t afford it, while the patient’s just unlikely to go for this treatment option, we give them something suboptimal.

Maybe it’s a cheaper option, maybe it’s a direct restoration, but really you know that this tooth would scientifically benefit from an indirect cuspal coverage restoration. Now, if you think bigger picture, think of the patient with generalized wear, and you are concerned that one day the wear will get so bad that it’s going to become even more expensive to fix, and maybe the patient may need more root canals or more complex treatment.

But maybe you don’t suggest a comprehensive plan. Maybe you don’t suggest any treatment for that wear. Why? Because you’re afraid of rejection. I think forget about rejection. And if you treat every patient with your best intentions, and I know we always have our best intentions, I truly believe you have the best intentions, but don’t hide your cards.

Just show, well actually, ideally, Mrs. Smith, we should be doing A, B, and C. And it will cost this much, but the benefit of this treatment for you will be X, Y, and Z. And having some of those difficult conversations, even if you know you’re going to get a no, but once you get that no now, just as Dr. Lane Ochi says, when it’s the right time for that patient to have the best and the correct treatment, they will come back to you. So start planting those seeds today, Protruserati. And it’s another good reason to join the app. There’s so many good things in just that one post alone. Anyway, let’s join the main episode. I’ll catch you in the outro.

Main Episode
Dr. Sarika Shah, welcome to the Protrusive Dental Podcast. How are you?

[Sarika]
I’m really well, Jaz. Thank you so much for having me on.

[Jaz]
I’m very excited to cover these topics because it’s a little bit about the animosity that we feel and we can sense between principals and associates. But actually what I want to do is just take a step back and learn about a bit more about you as a business owner, a practice owner, someone who has a team, because I feel as though the podcast hasn’t covered those themes as well as it should have yet.

And so I’m hoping to do that. But also you as a strong woman, a leader, we need more women in dentistry who are leaders, who are practice owners. And I feel as though, even like when you look at the courses, you know, you see all these males, males, males, and very few women in dentistry. And so I feel as though what you’re about, you’re changing that as well. So I think there’s a lot of themes to cover, but before we dive into that, Sarika, tell us a little about you.

[Sarika]
Brilliant. So, thank you for the introduction. And I guess a bit more of my professional background. I graduated from Manchester in 2006 and I was an international student then. And I remember one of my first memories was final exams were looming in year five. And just a few months before we had to look for our first job, it was called vocational training at the time VT training. And because I was an international student, I had to apply for over 120 jobs.

I wasn’t prioritized over UK residents, so I had to work extra hard, and I just went all over the country applying for jobs. And then I finally found a job, and I graduated, I moved outside of London, I had my first job in Norwich. And it was VT training, I was an associate there in that practice. It was a large group of practices.

There were four partners in that practice and it was brilliant. I gained so much experience. I think not just from working on the NHS and the dentistry, but also the experiences that I had with working with a big group of dentists as well. So I learned so much in that time. And then I quickly realized that I wanted to do more. I wanted to be better.

So I did my MJDF a year later after my VT. And then I realized that, you know what, I’m going to go out there and I want to potentially specialize in something. So I first looked at perio, that kind of decided against it. And then I went and did my part time MSC in restorative dentistry at the Eastman at UCL. So I did that.

[Jaz]
I feel like at that stage of career Sarika, I feel like we’re all a bit starry eyed and a lot of us want to specialize and stuff. And so I’m glad you had that bug as well. For me, it was restorative specialism. So I wanted to be a restorative red straw and consultant at that stage of life.

And then life took me down a different course. I had these experiences in the hospital. I thought, hmm, perhaps this is not the best environment for me. And so when you look back now at that Eastman training that you did, was that like a thing? The two year, three year, five year. Cause they got lots of different programs, right?

[Sarika]
So I did the full MSE, which was five years, part time. And it was tough because you know what, Jaz, I think that there wasn’t a lot of guidance then. There wasn’t all these courses that we have now, the level of kind of external education that you have postgraduate now is crazy. It’s immense. There’s so much more.

[Jaz]
Too much now. It’s gone the other way. It’s like tiring in terms of what you see now. So it’s actually gone the other way, but yeah, back then, there wasn’t as much help or extra additional thirst that we had for knowledge wasn’t being catered for.

[Sarika]
Yeah, I think there wasn’t guidance and I don’t think there was enough choice at the time. So anyway, I did it. I have no regrets. I absolutely loved it. It was super tough because I was working five to six days a week in Norwich and then commuting to London to do the MSC and then slowly.

[Jaz]
Can I ask you a bit about the MSC? Just a little bit because look, my wife’s on MSC in Paeds. It was three difficult years for her, but it was great feeling when she got through it. However, and we talk about this. A lot of MSCs, they are very academic and the dissertation years, they’re not very hands on clinical. How much of that applied to your MSC? Was it all reading papers and critiquing and writing a dissertation? Or did you actually get to treat any patients? Because usually that’s more of an MClinDent then.

[Sarika]
Yes, absolutely. So, I think with a part time MSc, you’re obviously not in clinic or in hospital treating patients. So you have to be in an environment where you can take all the knowledge and then go and apply it in practice. I think there is an advantage to that as well, because you’re doing it in a normal practice setting. If you don’t want to work in hospital, I think it’s great because you’re doing the whole people management side of thing, you’re problem solving, you’re holistically treatment planning, and these are all huge skills that you need to provide optimum patient care.

So, it was brilliant and I was in that environment. I was given the opportunity where I could treat my patients holistically and I had the whole array of like dentistry that I could do. So it was brilliant. I got a lot of experience, but it was tough.

You take the information. You go and you apply it, you come back, you’ve got to take all your photos, you’ve got to have your case presentations, and then you’ve got to overcome that fear. You’ve got to ask your tutors for help. You’ve got to ask them to critique or give you feedback on your work as well.

And I think that’s how I learned, I kind of overcame that fear and I thought, well, I’ve just really got to take this feedback, learn from it and improve. So my experience generally was brilliant. I loved working in practice, you know? And so in that sense. I took a lot on. Also at the same time, this group of practices, they opened a small group of private practices.

Now I was quite a young dentist then, but because I had all this knowledge, this new knowledge, I again, took on the courage and I went to like the main owner of the clinics and I said, look, I know that I don’t have as much experience as all these other dentists, but I would very, very much like and appreciate if I could have a day or two in your private clinics. And they offered it to me. I was maybe like three or four years in and they offered it to me. So that was brilliant.

[Jaz]
But you made that happen. You asked the universe and the universe gave it to you, right? You forced your way in a good way, in the sense that had you not asked the right questions, knocked on the right doors, opportunity doesn’t just come to you. You have to kind of fight for it.

[Sarika] Yeah, absolutely. And something I’ve suffered from my life is really having that fear to speak up and having, I had a lot of good like external confidence, but I didn’t have a lot of internal confidence and I had this massive fear of judgment from other people.

But I think that, circumstance put me in this position where I had to slowly learn to overcome that. And I realized that if I want to grow, if I want to learn, if I want opportunities, they are on my doorstep. They’re right there. They’re there for me to grab. It’s my choice and my decision on whether I do it or not.

So it’s great. It put me in a great position. And then, in my final year, I met my partner, we plan to get married and then I moved to London and then, oh my goodness. I was like, great, now I have to look for another job. I wanted to work in private practice. I wanted to move away from the NHS to do the dentistry that I wanted to do and work in the environment.

[Jaz]
So at that point you were part time private, right?

[Sarika]
Yeah, I was part time private.

[Jaz]
At that point you moved from Norwich to it?

[Sarika]
Yeah. And you can say it was maybe like 20%, 30% private and the rest was all NHS. So moved to London, had this transition. And then I don’t know if I was just naive, but I thought I could find a job in a private practice five days a week. It’s clearly not the case. And there was nothing out there. You know, I remember like being on all these job sites and really looking for a practice to work in, but there’s just nothing out there. There was no choice. And in the end I decided-

[Jaz]
Is that because the usual channels nowadays, I feel like Facebook has a good presence in terms of finding associates positions and stuff. Is that because that was lacking? Or do you feel as though the market at the time didn’t have positions? Cause I see all the time, principal and maybe you have this complaint. I don’t know. We’ll find out. But principals complaint that where are all the good associates? And their associates are like, well, where are the awesome principals? And like, is it a fact that they’re all out there and they were just not able to connect them? What’s going on?

[Sarika]
Yeah, I really think that there needs to be more platforms and there needs to be a little bit more collaboration. So, I feel like, I think that problem still exists, to be honest with you, Jaz. And there’s got to be something wrong, right? If principals can’t find associates, associates can’t find the practices they want to work in. There is an issue there. And I think that maybe it was that time, like back in the day, that a lot of people, it was word of mouth, and people recommended other people.

I don’t know if that was the case, but I was someone that came from outside of London and there was nothing there. So in the end, I just accepted this job outside of London. They took me on as a private clinician, but it was kind of like a little bit mixed practice and I had to kind of convert, had to start my own list.

And I grew it and I was there for about five years. And then, in between my brother’s a dentist as well. He’s five years younger. We were having conversations and he said, you know what, I think, what about owning a dental practice? And I said, well, it’s been on my mind for like years.

And he said, well, it only makes sense. If we do it together. And so we started to look for practices. Now he lives in the Midlands. He lives in Manchester and we were looking at practices in around London. And then my partner who was then in banking, we would go to him to ask for like, oh, can you have a look at the financials of this practice and what do you think, and his opinion.

So he’d like tag along to all these like viewings that we’d see for all these practices. And also we were looking at option of like setting up a squat as well. So we were keeping everything open. In the end, it didn’t work out with my brother. Logistically, they wanted to stay in the Midlands.

And then I said, right, I’m just going to continue. I’m in this too deep now. I’m too excited. I’m too hungry. I’m just going to like, go for it. And so I started, I kept looking, my husband, Rishi was tagging along and then he got excited and he got hungry, I think he caught the bug. And he said, you know what?

This looks really juicy. This looks so interesting. How about we do this together? So I said, yeah, a little bit hesitant because I was thinking, gosh, we’re like newly married and I’m not sure if we can live together, work together, how’s that all going to be? So yeah, we came across the practice that I currently own. I fell in love with it. I sometimes think-

[Jaz]
So it wasn’t a squat. You didn’t start a squat. You bought an existing practice.

[Sarika]
Yeah, it was an option. I was looking at both options and I had prepared for both options, but, in the end we bought an existing practice. It was a very kind of small two surgery practice. It had a team of, I think, seven people, including the whole team, the whole team, seven. And, we took it on, we grew it, we’ve owned it for seven years now, went through kind of two refurbishments in that time.

[Jaz]
And we went through COVID.

[Sarika]
I went through COVID, had a baby in the middle, like went through all this stuff. I was going through, you know, I had seven years of IVF treatment, so I was kind of going through all that in this phase as well. And yeah, now I lead a team of 28 people and I’m super happy.

[Jaz]
How many surgeries now?

[Sarika]
We’re four surgeries, busy four surgery practice in Canary Wharf in London. So yeah.

[Jaz]
And did you have to like, were you able to extend quite easily?

[Sarika]
So there was space, there was one surgery which was plumbed or wasn’t used. So we expanded into that and then there was like this empty space. So we kind of had to do a little bit of interior architectural, get some interior architectural advice on how we could like reposition and kind of like redesign some of that, the rest of the space. And so we created another small surgery on the side as well. So four surgeries.

[Jaz]
And how many days at the moment are doing clinical, being mom, being principal, being team leader, being all the other things that you do, how clinically involved are you still?

[Sarika]
Yeah. So, it went from working six days a week to then five, then to four. And then I was going through all this health issues and like all my IVF treatments and I went down to three. And now I have, it’s taken a really long time, but I put systems and processes working a lot more efficiently. And so now I work two full days clinically, but a lot of my consultations, things like that, I’ve started to now do online.

So I’d say. It’s kind of three days of work, and then the rest is kind of around admin, practice management, things like that as well. It’s a seven day a week job.

[Jaz]
Do you enjoy it?

[Sarika]
In my practice.

[Jaz]
It’s a forever. When you’re a practice owner, it’s a forever job. And you could tell me about the first few years about the fear. And I mean, people always say that the first few years aren’t going to be very profitable and people accept that. And then people think that, okay, they’re off. There’s a lot of stresses, staffing issues, which is the number one thing that principals complain about staffing problems, getting the right staff, dealing with sickness, getting locum cover, that kind of stuff. How have you navigated all these usual stresses and have you had a different journey at all?

[Sarika]
Yeah, absolutely. You know what? I think owning a practice is like going into a relationship or having a child. There’s so many unknowns and I think it’s a steep learning curve. You just have to experience something, learn from it, grow from it, and then like build on it.

And that’s exactly what we kind of went through. We were lucky that, it was being run fairly well because of our location. We have really a great demographic and really nice patients, but we had to really bring a lot of systems and processes in place. I’m a very organized person. I don’t like mess.

I like everything clean and needs and everything kind of organized. So I kind of did a full clear up processes in place. So that was first thing, because you need the practice to work efficiently. So that’s like the first thing that we started to do. And then it was just about ideas for growth.

How do we kind of grow this practice? And as you kind of grow the practice in terms of more patients coming through the door, inevitably you have to grow the team. So, slowly, we inherited a team, by the way, when you buy a practice, you kind of inherit that team. And obviously you come with new ideas, like a new vision.

You want a new culture, you have new values and existing team might not always align with what you’ve come in with. So they did stay with us for a few years and then slowly that team started to dissipate a little bit. We were recruiting as well. So we were growing. So, recruitment and people management was probably one of the toughest things that we have experienced. I think-

[Jaz]
I’m sure you’ve learned a lot of lessons along the way.

[Sarika]
Oh my goodness, so much. Because that was so new to us. And you think as being a dentist in clinic, yes, we’re managing people all the time. Even as an associate, you’re managing your nurses, your team, you’re working with them.

But I think this is management on a different level. And you’re not just managing one or two people. You don’t just like turn your computer off and go home. You have to continue managing those people. Out of hours on the weekends, and it can be a lot, it can be very, very stressful.

And for very, very long time, we’ve gone through a recruitment crisis, not just in dentistry, but overall in health care. In fact, you hear it everywhere, in retail, at restaurants, in corporates. So we’re going through a recruitment crisis. And I think it started off with Brexit with a lot of staff potentially a lot of dental nurses and reception staff kind of in that sector leaving the profession.

Then we were hit with COVID and then post COVID, there was a lot of external SOPs management we had to do. But then again, we had a lot of practices had major growth after COVID as well. So again, we had to then recruit, but we had to take so many not necessarily risks. I remember when it came to recruitment sometimes that you almost feel like you’re desperate.

Like if you don’t feel a position that it’s going to affect the rest of your business, it’s going to slow your business down. And so you almost like recruiting out of desperation. But we slowly realized that actually by taking people on that weren’t aligned with our culture and weren’t aligned with our values, it brought a lot of toxicity into the practice.

[Jaz]
And the problems get deferred for later, basically. Right?

[Sarika]
Absolutely. And what happens is that you just need one bad pee, to kind of disrupt everything. So I created one rule. I created one rule. I still have that rule. And that’s no more drama. I don’t want drama. I hate drama.

[Jaz]
And the wonderful thing about that is, you tell the applicant, whether it be an associate, interview, nurse, hygienist, whatever, That rule is like, this is the rule. And then they accept the term that rule before they join. Right?

[Sarika]
Absolutely. I’m very honest with them. I tell them exactly what I like, what I don’t like, how the practices run, I’m really pro talking about values. I’m really pro looking at people’s strengths and looking at growth and ensuring that people can take feedback because if a member of the team, doesn’t matter who it is.

If they can’t take feedback. Then we can’t have growth. So, all these things are really, really important to discuss right at the beginning at interview stage. So yeah, you live and learn. And I think when it came to recruitment, I had to just create certain boundaries. We had to create certain rules and then we had to agree on how we were going to recruit.

And we just decided to recruit differently. We also decided at that point, there was this one point I remember where, oh my goodness. I came back home and I said to my husband, I said, I hate this. I hate where we’re at right now. How did we get to this? And I said, we’ve got to change something.

I kind of had to reflect and I’m going to share this with you actually, because I think a lot of practice principals will find this quite useful. I kind of had to reflect back and I had to think that what kind of led to my initial kind of success. And something that I was doing, something that I had to take on was I was doing a lot of self development and I took something all called self leadership.

It was something that I mastered the principles of self leadership. I was using it on myself and I thought, well, hang on a minute. I’m practicing the principles of self leadership on myself and I can see what it’s doing. And there’s so much, there’s such a positive impact. But what I now want to do is I want to start using self leadership on my team.

So I spoke to my husband, I spoke to my manager and I said that, right, we’ve got to make some changes here now. So we came back, we had a meeting and we relooked at our values. We were kind of like living off our old values in the practice. We relooked at our values because our team had evolved. It had changed. We had changed. So we relooked at our values.

[Jaz]
This is like a team building exercise kind of thing?

[Sarika]
Yeah, well, at that time we did it ourselves a year or two down the line. We did it as a team because at that team, at that time the team was still disjointed. We had to, we were looking at kind of building a new team.

So it was really the values that my husband, myself and my manager, we kind of sit down, sat down together and we kind of rebuilt those. And then what we did was the members of staff that were toxic. We let them go. It takes a lot to, it’s not easy letting someone go. A lot of principles, it’s actually something really difficult to do, I think, as a human being. But you have to-

[Jaz]
I mean, a principal is to complain about sleepless nights from the things that drag on from this kind of a stress because there’s so many ramifications associated with that. But it’s one of those things that when you do it, no matter the hardship that you face, it’s like a huge relief.

And I remember one of my principals in the past, after he had to get rid of a toxic team member, he just felt like it was like as if they could breathe again. It was like just such a massive relief is the way he described it.

[Sarika]
Yeah, because like I said, there’s a ripple effect. It’s not about how you feel. I think as a principal, you’re ingrained in your team as well. You’re part of the team. So you’re feeling what your other team members are feeling as well. And if you’re someone that has good connections, good relationships, then they’re going to be open with you and you can see the effect that’s having on them, the impact that’s having on them.

So we had to let go of a few members of the team. We also, anyone that wasn’t performing to the level and the standard that they should have been. We also let go of them. And we also made an agreement that from now on, we’re only going to recruit if we think that person’s right for us.

[Jaz]
I’m glad you mentioned that because one of the questions I’ve been in my head, I want to just pounce the right moment. And this is the perfect moment with the story that you shared is when you are hiring an associate or a team member in general, what’s more important to you? Is it the quality of their CV, i. e. the degrees, the cases they’ve done? Or is it their personality and their charisma and the magic about them when you interview them? Which one of those two are more important in terms of what you found works as a recipe for success?

[Sarika]
The answer to that is look, I’m going to tell you the world we live in now, so fast paced is ever changing. Patients expectations and needs have changed. Okay, so back in the day clinical skills was always prioritized.

You had to be good clinically. Okay, to have a good job. I think now, what makes an excellent or a good dentist, maybe 30 to 40 percent is clinical skills. The rest is all non clinical. The rest is internal leadership. And then you have a little bit of a 10, 20%, which is external leadership. Okay. And within that internal-

[Jaz]
Can you talk about that? What is that? People are listening about this, encapsulated by this theme of leadership, which is so good and really relevant that I want to talk to you about this. But what do you mean by internal and external leadership?

[Sarika]
Okay, so there are various forms of leadership, and most people know of leadership as just leadership.

But when we talk about leadership, we’re talking about leading other people to achieve external objectives. But something people overlook is something called self leadership. And self leadership is where you learn to intentionally influence your thoughts and your emotions. So that’s your choices and your actions to go out there and achieve your goals.

Okay. And so there’s this famous quote that says you can’t go and lead others if you don’t know how to lead yourself. So self leadership isn’t well known in dentistry or in healthcare, but it’s actually out there. Athletes use self leadership. We have top CEOs that use self leadership. We have multinational companies that train their teams on using self leadership.

And if you look at some of the most successful people out there and you hear them speak and you read their autobiographies, they’re all practicing self leadership because you have to be able to control yourself from within. It’s about the inner game and it’s about mastering that inner game before you go out there and play the outer game. So I think that-

[Jaz]
Is it synonymous with emotional intelligence or is that different you think?

[Sarika]
Absolutely. Do you know, the last time we spoke, we were talking about, like physical health and wellbeing and nutrition and mental health, but people talk about physical health and mental health. What people don’t talk about is emotional health and emotional well being. And what is important here is I think as dentists we’ve got to realize that we’re working with human beings and all human beings are so emotive, more now than they ever used to be, because they’re so in tune. Well, they’re more in tune now, I think with their mental health, physical health side of things.

So we really have to be able to, first of all, master and manage our own emotions to then know how we’re going to manage the emotions of our patients, our team members, and be able to then effectively treatment plan from there. So to go back to your question. I think both are important. I think nowadays, clinical skills for me are just a given.

I think if anyone’s going to interview in my practice, they have to have an amazing portfolio. The clinical skills are given, but what I’m looking for is, have they started to master some of their inner leadership skills that includes understanding their strengths, that includes their values, that includes confidence and communication skills.

How authentic are they? Are they just showing up and giving me a front and pretending to be someone they’re not because I’ve worked in this industry for as a dentist for 18 years, I can judge people quite well. And you can see right through that, and that happens a lot, and that’s a sign of a lack of inner confidence to me.

So, these are all the things that I’m looking for. And genuinely, I want someone who’s going to be open communicator, who’s going to be able to take feedback, who can listen to what’s really going on, and be a team player. All these things are really important attributes, I think, when I’m looking for an associate.

[Jaz]
Things that I read online, Sarika, on these forums, when they’re saying about principals will kind of get together and they almost attack the associates and associates do the same thing where they mention or someone moans about some pay issue or something at work not being available.

And then should this be made available to me as per should my holidays be denied because I’m self employed, therefore I can do what I want. And so they have this kind of a friction that you see online. My question to you is where do you think the problem lies? Why do you think there is so much principals versus associates?

And what have you been doing because from an outsider watching in to you and a few times you mentioned to me that sometimes a podcast comes out that really hits home and you mentioned that you have a little chat and you talk about the podcast. And so I really like when you said that and from seeing your website I know the great clinicians that you’ve heard that would that work with you.

How do you, because I know you spend time thinking about this. How do you foster a positive relationship? And why are things probably not going the right way from what we’re reading online?

[Sarika]
Okay, so let’s zoom out of that a little bit, okay? Now, prior to being a principal, I was an associate for 10 years. Kind of having been experienced both roles, I’ve learned that, like, long term success for any relationship, whether it’s personal or work related, it’s primarily built on mutual respect. And when this respect is gradually lost, that relationship is most likely going to break down within three years.

There’s research behind this. I’ve read a lot around this. So there’s three phases to this. The first phase in the job or the first year even is like the honeymoon phase. Okay, both principal and associate they’re trying to like each other and they’re trying to impress each other. The second phase of the second year is where potential issues will arise. They’re both being a little bit more open with each other possibly both parties are trying to look for solutions. If there is a clash or a disagreement then that relationship moves into the third phase, where then you both recognize that you’re going against each other’s values.

So let’s explain what values are because not everyone understands that. So your values are a guide or a set of principles on how you make choices and decisions. And when this is misaligned between two people or even two parties, then you’re going to have disagreements. You kind of, we’ve used that word like toxic, we’ve used kind of where we’ve had relationships that don’t really work.

But I think that when a toxic environment or a relationship starts to break down, there are negative emotions there, at play, that are repetitively being triggered. So when it gets to that point, when that respect is broken, you’re going against each other’s values and it’s happening more on an emotive level.

And that’s repetitively happening, which then triggers and breaks down that relationship completely. So how do we improve these relationships? And why is that important? I think that the first thing is to establish which phase is this relationship at. So if it’s stage three, okay, it’s quite clear that potentially there’s no going back and you may have to kind of amicably agree to go on your own way, in your own direction.

All right, if you’re at stage two, then either party or both parties need to acknowledge that something in this relationship is misaligned. And there is a chance for resolve. And the only way to kind of resolve this is through effective communication. And by that, I don’t mean a text message or an email.

I mean, a real face to face conversation. I mean, a real face to face conversation. And this is a real issue these days. People don’t talk anymore. Like I said, this kind of fast paced world that we live in. We’re becoming more and more accustomed to communicating via messaging and emails.

And it’s very difficult to create a rich, positive relationship and trust in this way. So I don’t know if it’s just something that we’ve become used to in terms of technology, whether it’s time that we don’t have enough time or we’re creating enough time or prioritizing it, or whether it’s fear that we’re just scared of having a conversation. Especially when things haven’t been running smoothly or there’s a problem, right?

[Jaz]
What this reminds me of, Sarika, is some of the issues that young dentists come to me with and they share, not because I’m necessarily going to give them a solution, but because I like to listen and I like to understand. And some of the common themes are the grudge that’s in stage 2 progressing to stage 3 is often with the associate who shows up to work every day and the principal who is many miles away and only ever has communicated by email and it’s very official and it’s like a robot. There’s no there’s a lack of that in person magic. And so that I think has not worked well from what I’ve seen people complain of. Maybe it’s a corporate mentality kind of thing taking over there as well.

[Sarika]
Yeah. This is it, right? And again, it’s going back to values. Maybe for that associate having support, it’s value. It’s one of their values or it’s valuable to them. And if that principal isn’t there, isn’t on site, isn’t available to them, then, it’s going against their values.

And so it’s triggering them. So I think this is why it’s so important at interview stage that you really start to having conversations about this. You’re basically just bringing everything to the table. You’re talking about what’s important to each other. I’m going to mention one other thing as well is I always tell associates that you have to think of yourself as your own business.

You’re not just an associate working in a practice. You are your own business. And what’s happening is that when you are going to work in another practice, you are then aligning with that other practice or you’re going in partnership with another business. So I’d like for them to think of it on, take a different perspective on it.

So if you think of yourself as your business, you have to think, well, as a business, what’s important to me, right? You have to understand what each other’s businesses are about. And at interview stage, you need to have an open and honest discussion between yourselves about it. You need to bring everything to the table.

What’s important to you on a day to day basis? What are your values? What kind of culture environment do you want to work in? How do you build relationships? Right? That’s a two way principle. You have to ask your principal, the principal of the practice that question as well. How do you maintain the relationships in your practice?

And I’d be asking the associate, how do you build relationships? How do you maintain your relationships with your patients, with your team members? And-

[Jaz]
The reason why these are great questions, everyone is because if you are nodding and you’re listening, what’s how I can say, yes, absolutely. This is good. But if you ask that question into you and the principal looks at you blankly, like this is something that they weren’t expecting, that they probably haven’t explored their own values. They’re not really touchy feely about these things. And not that you have to touchy feely, but like, this is a very important exercise and for someone whose mind works his way about being value centered, right?

All that seven habits of highly effective people being number one value being value centered. I’m all about that. And so if you’re an associate and you ask this and you get a blank look then maybe that’s not the right practice for you. That’s open to talking about these being values led and conversely, if you’re interviewing an associate and you’re the principal, and then you ask about this and then you get a puzzle look or you get an awkwardness, then maybe that is a sign that perhaps maybe this person isn’t at the level that you want in terms of the emotional fulfillment from that relationship.

[Sarika]
Exactly. Again, if support and mentorship is important to you, which it is to so many associates, then you kind of have to ask, well-

[Jaz]
Number one thing I think, especially younger dentists, and that’s the number one thing, will someone be around to help me? Will I have someone that I can just show a case to and get some nonjudgmental advice and feedback?

[Sarika]
Yeah. And I hear this so many times from young dentists that they just say that, like my principal isn’t around or I want to be in a practice where I can learn more from other more experienced dentists or even my principal. So that’s really lacking. That’s the other thing is I might be working two days a week in my practice, but I have regular one on ones with my whole team.

I have regular meetings with my team. When I’m in each everyone’s surgery. How’s things going? Have you seen any interesting cases? I am sharing radiographs with them. I’m sharing cases with them. I’m showing my vulnerabilities to make them feel like actually it’s safe and it’s okay for you to ask questions.

There’s nothing like a silly question. We’re all here to learn. We’re all here to grow together. It’s not like a singular thing. Your practice grows if everyone within it is growing simultaneously. And I’m a true, true, true believer of that. So it’s also, I think, talking about financial situation, right?

What is grossing like, what is turnover like on the other hand, right? And are you aligned in that? Because if your practice wants to turn over this much or they have an expectation from you, but you’re only grossing this much and that’s it, and you don’t understand it or have someone to ask questions, or you don’t know who can help you in the practice to kind of grow, then that’s going to be a problem down the line.

And then I think also future goals and growth. Are you someone that is just happy to tick along and do your thing and you’re happy just to sit in your room and get on with stuff or you someone that’s like hungry and you want to learn and like you want to see procedures and you want a bit of mentoring and you want to grow financially, then again, you’ve got to be aligned with that as well

because down the line, and I think there has to be open, honest discussions about this, by the way, I don’t think it should be superficial. I think both parties have to be really honest. And if there’s any kind of sense that there is a dishonesty, or there is a lack of information, either dig in deeper, don’t have the fear, just keep asking questions, or, you know, then you just have to look for something that works and is more aligned with who you are as a dentist and your values and what’s important to you.

[Jaz]
I think the key message here for me from this short discussion on building that right environment is exemplified by something that you do, which maybe it’s not happening enough. It’s just going into all the surgeries, talking about how are you doing today? How’s any interesting cases? I love that you do that. And I think that’s the number one thing that I’ve taken away is that, one thing can just, you can implement this. If you want to have a better relationship with your associates.

How many touch points have you created in a day, in a week, in a month? And how is that happening? And that’s really to find out what’s important to your associates and trying to match that. We’re going to pivot a little bit Sarika to ask you, but i’ll give you another opportunity to add anything to that.

But the next thing I’ll be asking you about is women in dentistry in terms of actually leaders, principals. Why are we seeing such few women principals? But is there anything you want to just add to the principals versus associates before we move to that?

[Sarika]
Yeah. Do you know, Jaz, I was just going to say that I think going back to that point that you are your own business and understanding the other business, right? Because there are very few practices out there where the principal is going to be on site is going to be there working. So I think we are in a culture and an environment where there are a lot more corporates that doesn’t exist. But also think outside of the box. You don’t necessarily have to get support from the principal itself.

You could have a manager that could be touching base with you. You could have a senior associate that’s been there for a really long time. If you’re a young dentist, it’s about connections. It’s about creating relationships. It’s about growing your own business. So think outside of the box. Don’t just shut the door.

If you think that, Oh, X and all these things are my criteria, they haven’t been met, or I’ve had a cross on one of them, right, I’m going to move on to the next thing, because it is difficult to go out there and find a job. It is difficult to kind of tick all the boxes, there are going to be certain sacrifices, there will be some limitations, but it’s about thinking of-

[Jaz]
Compromises that you have to accept, and then whether that compromise sits below the threshold that we all have, and if there is enough going that sits in line with your values and it’s not, there’s no red card offenses going against your values.

And then to actually associates, you’ve got to work on it as well. Have those difficult conversations to, even though it makes you feel sick and anxiety to have those discussions, it’s important to have those because you’re carving a better path as an associate in the practice that you work at. You’re actually looking to work at that relationship and looking to make it work for you and your patients at that clinic.

[Sarika]
Yeah. So in summary, what’s important to you? Remember, relationships are about mutual respect, aligned values and trust, and of course, open, authentic, honest communication and support.

[Jaz]
Fantastic. Sarika, why are there not enough Sarikas out there in the world? Why don’t we have more leaders or principals? Obviously, yeah, I know. I know plenty of women in dentistry who are principals, but there’s got to be, I know what the stats are, but when I’m on looking at these Facebook groups, principals, the vast majority are men, even though nowadays.

Look at the dental school intake is 60% women, 40% men is what you’re getting in the in the dental schools. And it’s been like that for at least ten years now is it because well women are childbearing potentially and therefore that almost is a big stop in their career and they have to then sacrifice so much of their career and ambition for that or is there equal opportunities that are not existing. Can you share any stories that may suggest that could be happening? I’m sure you’ve done a good analysis to what’s going on. What do you think’s at play here?

[Sarika]
Yeah. So I think first, let’s talk about why are there less women principals out there, practice owners out there. And then I think what we can kind of link onto is like, what are the barriers that the women face and maybe some of the things that I’ve heard. So look, let’s go back in time. Let’s go back in history. For generations, the role of women has been to serve and for men it’s been to provide. So, what’s happened here is that we’ve been conditioned both men and women to kind of believe and behave very differently.

So for men for a really long time, they’ve had access to resources and connections, which automatically gives them opportunities, okay, which is what you need to start a business or even operate a business like a dental practice. And for women, the historical kind of conditioning, it’s so deep that naturally we take more responsibility at home to manage the house and the kids.

So in terms of like resource and opportunities, an example of this is that, I didn’t know this, but the right for women to open a bank account was only available in the 1970s. That’s not a long time ago. Did you know that? I mean, not a lot of people know that, but that’s not a long time ago.

And so many women, especially like my generation, slightly younger than me, have grown up not being taught how to manage money. Which really affects their money mindset and understanding money, managing it, having a positive money mindset is key to running a dental practice. Okay? So now women have access to kind of resources and opportunities and we’re slowly seeing more and more female practice owners, but it’s going to take time.

It’s going to take time for that to grow. All right? I also think that dentistry has been a male dominated profession for a really long time. And even when I first started working around 18 years ago, you rarely saw a female practice owner. Those 120 jobs that I applied for, only three of them were female practice owners.

Okay. And there was so male like in character. And I understand now that they had to be because they were in a male dominated profession. So if they wanted to maintain that respect, have that support. They had to behave in a certain way. So I believe that the environment wasn’t supportive for women starting practices.

But again, that’s slowly starting to change. I think also in my experience, until more recently, I think that women, if I may say, haven’t been very supportive of each other. Okay, and I don’t know if that’s because of the lack of opportunities that we have. Now, suddenly the gates have opened and this is almost like this competitiveness that is there.

I don’t know if it’s fear. I don’t know if it’s about looking vulnerable or this fear of judgment. But, there’s also that the fact that there are very few female to female practice owner support groups and networks which are out there. So even if you did want to open a dental practice, where do you start?

Who do you speak to? Where are you going to get honest advice for? Who’s going to give you your time? Who’s going to give you their precious time, right? And I have to say that the majority of my mentors and coaches have been male because even when I went out there to approach women to approach, some of these women are still around and I think they’re awesome.

They’re powerhouses. But when I went to them to ask for help, I got nothing. I got nothing. And it’s not like I just asked once I asked a few times. I asked several women and I got nothing. So the majority of my mentors and coaches and have now been male. So I think that there’s that aspect to it as well.

[Jaz]
Is there an element, Sarika, you think, potentially, and this is just me thinking about relationships in general. And what I find is with everything that I do in terms of clinical dentistry, running Protrusive, the education, everything, there’s a lot involved. So the reason I don’t own a practice is because if I did that it would be the death of everything, all of this stuff.

It would be the death of this, right? So yeah. Having a practice is a huge, huge thing to do. I could have easily have started a practice and not have all this. And so this is kind of like my baby. You know, like you said, practice is like your baby. It’s like a relationship. So this is what I have. And my wife has been incredibly helpful.

Now, during the MSC, I took a lot of the parenting. I supported her to get through the MSC, which was great, but I had to take a step back from things to allow her to do that. Do you feel as though that perhaps the issue may be that because of this historic references that you made in terms of how relationships were in the past and the role of women in the past, that perhaps to own a practice that at that time in your season of life where a female dentist may be owning a practice that they may need their partner to maybe be a bit more supportive to do that. Do you think there’s an element of that?

[Sarika]
Yeah. Let’s talk about that. So, I think something you touched on before, and I’m going to connect to this a little bit as well, is that, look, when it comes to women in their careers, there’s always going to be a clash between them and their biology. Okay.

So I know some women that feel that there is a finite time in which they can open a practice. Okay. And by the time they’ve gained enough experience and cash, some feel that they have to kind of choose between a relationship and kids or practice because they don’t have the time, the mental and emotional capacity for both.

And it could be a reason why more and more women are statistically choosing to have partnerships and children later. And some of them not even at all. I know so many women that are just like, no, I love what I do. I love me. I don’t want to have children. And that choice is open now, right? It was never open before, but it’s becoming more and more open.

And I do think that men have to be more supportive of women. If women want both, and I think men are, I mean, I’m just really blessed that I have a really supportive husband who just basically let’s just lets me live through all my crazy ideas, like nothing gives, I’m always like doing something on top of something on top of something, but you’re right.

Like, inevitably, if women choose to have children, there may be a career break in that time. They may de skill, potentially they could be a loss of confidence. Women also naturally go through a change in identity. Nobody talks about that after having a baby. They may then take on a job that isn’t necessarily something they enjoy, they’re passionate about, it’s just out of convenience.

Because of of childcare. And if you’re a female practice owner, and then you’ve had a child, it’s something additional on top of all your other responsibilities. You’re wearing all these different hats, and it’s not easy. And this is a topic that I love to kind of talk about, guide, and teach and support women on.

But I think the world is changing Jaz. I think women are choosing partnerships now where if they are serious about their career, they’re serious about elevating their career, then they are choosing partners that are going to be supportive of them and when it comes to then having children, we create boundaries, we manage our time, we split the responsibilities, we create balance with work and with life which is really, really important. And you need that to have harmony, but also if you never want to stop growing, you need that. You need that balance.

[Jaz]
And I think what also, what we need is stories like yourself, whereby, you’re a principal, you’re a mom, you wear these different hats. And I think it just needs to be shown more that, Hey, actually, Sarah can do it. Sheila Li can do it. This person can do it. So many great women. Cat Edney in the therapy space, such great women, great leaders, great educators. I see. And I’m like, that’s amazing. But I think people need to be talking about this. And so having that at the forefront and see that actually it can be done.

It just needs a major rewiring of how the family life will be run and lots of difficult conversations once again, to be had. But if someone wants it bad enough, it just starts that conversation and knowing that it can be done. It just has to be organized and rewired part that needs to be prearranged, I guess.

[Sarika]
Yeah. And let’s just touch a little bit on like kind of other barriers that women might face, because I think it’s important to kind of put that out there. And I think it’s really important to kind of acknowledge that gender bias still, unfortunately, exists out there, okay, when it comes to opportunity and pay.

Just recently, I had a delegate on my course in May, and she was telling us a story about how she’s been in this practice for a really long time. She’s actually grossing really well. She’s quite really productive, never any issues, and suddenly a younger male dentist comes in and she finds out a year or two later that he’s on a higher UDA value, and then she requests from a manager. At least I don’t even want more.

I want to be matched. She’s been there for like six or seven years. I just want to be matched. And even then she’s not given that. And again, is the manager giving information that the principal is giving her principals, never having a direct conversation with her. But gender bias still exists, unfortunately.

Okay. And just a message to the women that, you don’t have to be there. You have a choice. If this is what you’re experiencing, then you have a choice. It’s not easy to find another job. I get that. But you still have a choice to be able to move out of that environment. I also think that what I’ve heard is that there’s sometimes a lack of communication from managers and principals because they assume women are going to react emotionally.

They’re not going to say something. If something’s gone wrong, they don’t tell them. They don’t give them feedback because they think that, oh, she’s going to react emotionally. So I think, again from the management side of things is that, you’ve got to be open as well, because otherwise that’s going to keep getting worse and it’s just going to snowball into something else.

I think other barriers women face is, is really internal, not the external ones, is kind of a lack of self advocacy. Like I said, fear of speaking up, right? And sometimes they feel like they’re not being heard, but you also have to be able to speak up for yourself, right? Self doubt, lack of confidence.

[Jaz]
I just want to add a bit on that. Like when you are in this position where you’re constantly battling with inner thoughts and you’re not speaking out, then it’s a bit like a b