Protrusive Dental Podcast
Building Trust with Patients, Consent and Emotional Intelligence with Colin Campbell – PDP244
How should you gain consent for ELECTIVE treatments?
Is selling in dentistry something to avoid, or an essential part of patient care?
How much does emotional intelligence really matter for your success and happiness?
Dr. Colin Campbell joins for a powerful episode that dives into consent, sales, and the balance between profit and ethics in dentistry. He also unpacks the huge role of emotional intelligence—not just in clinical practice, but in life.
Expect real talk, strong opinions, and communication gems that can reshape the way you connect with patients and approach your career.
https://youtu.be/Wtugp1t-IrM Watch PDP244 on YoutubeProtrusive Dental Pearl: Read (or listen to) the book Let Them by Mel Robbins — a powerful reminder to take control of your own life and emotions instead of letting outside events dictate them.
Need to Read it? Check out the Full Episode Transcript below!
Takeaways
- Building trust with patients is crucial for effective consent.
- Consent should be a relationship management exercise, not just a legal formality.
- Understanding the patient’s perspective is key to effective communication.
- Elective treatments should be approached with caution and ethical considerations.
- Sales in dentistry is not a dirty word; it’s about providing solutions to patients.
- Emotional intelligence is a vital skill for dentists to develop.
- Good dentistry is about doing what is best for the patient, not just for profit.
- Continuous education and self-improvement are essential for success in dentistry.
HIghlights of this episode:
- 00:00 Teaser
✨ Transform Your Dentistry ✨
???? Campbell Clinic – world-class private care in Nottingham.
???? Campbell Academy – ethical implant training from beginner to expert.
✍️ Colin Campbell Blog – daily insights to challenge & inspire.
If you liked this episode, check out ‘How to Win at Life and Succeed in Dentistry’ with Richard Porter
#PDPMainEpisodes #CareerDevelopment #Communication #BestofProtrusive
This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcomes A and D
AGD Subject Code: 550 – Practice Management and Human Relations
Aim: To explore the ethical, emotional, and practical aspects of private dentistry, with a focus on gaining valid consent, balancing profit with ethics.
Dentists will be able to –
Explain the importance of trust and rapport in the consent process.2. Recognize the ethical challenges of elective treatments.
3. Outline strategies for building long-term career satisfaction and avoiding burnout.
Click below for full episode transcript:Teaser: When you think about the number they have per hour, less than five is normal, right? Less than five of these breath holds is normal. Between five and 15 is your mild category. 15 to 30 is moderate, and above 30 is severe. You see patients that have what we call an AHI Apnea-Hypopnea Index of 60, and sometimes these breath holds can be 30 seconds.
Teaser:
Profit is oxygen for my business. Get that? It’s essential for life, but it’s not the meaning of life. I do not wake up in the morning going, oh, I’m gonna get some oxygen today, but if I don’t breathe, I’m dead. Right? So we need to-
I don’t think that’s the question. I think the question is what would I do if you or my wife, brother, mother, daughter, son? And so I’d say what you want me to do is use the experience that I have to pigeonhole you as a member of my family.
The world consent is a relationship management. You can’t treat your patient as if they were you. You have to treat them as if they are them. I would like to say to the guys is if you want to be really successful in the industry, both in terms of financially and in terms of the respect you get from your peers and in terms of the satisfaction you get from your job, try and-
Jaz’s Introduction:
Gaining consent for elective treatments, selling in dentistry, the monumental role of emotional intelligence for your happiness in your life and your career. Hello, Protruserati. I’m Jaz Gulati and thank you for tuning in to what I think will be a Protrusive Hall of Famer. This episode gave me vibes of Richard Porter.
The OGs will remember way back when we did an episode called How to Win at Life and Succeed in Dentistry, and we talked a lot about emotional intelligence in that episode. Brilliant episode Richard Porter. Do go back in the archives and check it out, and this episode builds so nicely on that. Dr. Colin Campbell is absolutely scintillating inspiring.
I’m so excited for you to be able to listen and watch this from wherever you’re tuning into. Thank you so much. There are some real great gems on communication and some absolute real talk, controversial, real talk from Colin, which I absolutely loved. So if you’re doing a lot of composite veneers, you may wish to skip this episode. Colin does not mince his words.
Dental Pearl
Now this is a PDP episode, so I owe you a Protrusive Dental pearl. And you know what, I might have actually given you this pearl before. Like recently, maybe I perhaps gave it in a recent episode, but it’s in my head and it’s so relevant for this episode, right? This audiobook, I listen to, “Let them.” Now if you are even slightly into audible books or had a look at which books are on sale right now.
This book Let Them is everywhere. And for good reason, I listen to an audiobook and Mel Robbins, honestly, this audiobook is so, so brilliantly done. You literally feel like she’s talking to you. It’s so easy to listen to, so conversational and my friends, I think this book will change your life. I’m desperately pleading my wife to read this book and she won’t because she doesn’t read.
So as per the philosophy of this book. Let her, let her not read, let her not gain from this book, but let me drip feed the lessons to her. Let me induce a degree of osmosis, informational osmosis, and take control of the situation. So you kind of get a flavor of this book already. I’ll put the link in the show notes.
This book is all about taking control of your life and not letting what happens around you to control you and your emotions. It’s about you taking control of your life. So once again, Let Them by Mel Robbins. I put the link in the show notes. And now let’s check out this absolutely cracking episode with Colin Campbell.
Main Episode
Dr. Colin Campbell, welcome to the Protrusive Dental Podcast. How are you, my friend?
[Colin]
I’m very well, and I’m very excited to be here. Actually.
[Jaz]
You’re the one who’s super excited.
[Colin]
No, no, no. I just spent a few minutes, when I was preparing just eyeing Jaz Gulati and who he was. So I always like to do my research just to get the background because I don’t think we’ve ever met. So I’m really pleased I used to be on. Thank you very much for inviting me.
[Jaz]
Well, I’ve been on the receiving end, some of your lectures, and I want to start by saying that as a public speaker, honestly, up there with one of the most charismatic, energetic and human, like really the way you speak, when I’m listening to you speak, Colin, it’s like no one else in the room.
You are speaking to me honestly, like you have this gift. I dunno if anyone’s told you this. If not, then you need to hear it then, the way you came my radar is dentinal tubules. Maybe in 2019 or something you might done a talk about leadership. Do you remember?
[Colin]
Yeah. Maybe.
[Jaz]
That and a few other lectures you done on, on digital dentistry, implants kind of stuff. So honestly, the pleasure is all mine to have you on the podcast and I know of all the wonderful things you get up to, but for those who are listening around the world, many in the UK, some in Australia, many in the US. Tell us about yourself, Colin.
[Colin]
Geez, that’s a terrible question. So my name is Colin and I’m a dentist. I’m Scottish and I’m very proud of that. I live in England, so I’m doing, I’m trying to do the good work at, do missionary work in England of converting them to the way of the Scottish guy. And I’ve been doing that, I’ve been here for nearly 30 years. And so I live in Nottingham in England, home of Robin Hood.
I am married to Allison and we’ve been together nearly 30 years. I have three children, Grace and Rosie, and Callum. I’m a big into family, love my family to bits, so obviously, and that’s a big part of my life. I am very proud to be a dentist. I’m like first generation university student in my family.
So no one had ever been at uni before. So my mom and dad, did amazing things to get me to university, which I’m so grateful for. And then I’ve had this absolutely just grandstand, extraordinary journey of madness through dentistry for the past 31 years. And I honestly, like, I feel like someone will tap me on the shoulder any minute and tell me there’s been a mistake and I’ll have to stop.
And that’ll be fine because I’ve had such a great time. But if they don’t and I stay well, I’m 53. I have another 32 years left to work, so I’m working till I’m 85. So that’s the story. I mean, if there’s more detail, I’m an oral surgeon, by trade, but I don’t believe in specialized dentistry anymore, which is an interesting, probably separate podcast, I believe in general dentistry and good general dentists.
And that’s what we do a lot of here. But I’m big in the implant world in terms of that’s my world. And I get to do some super ridiculous cool things because of that and travel to places and meet lots of amazing people. And that’s been a joy. So I have a very brilliant portfolio life doing crazy things, and I don’t really know how I got here because none of my plans ever came true. So, that’s, I hope that works as a brief introduction Jaz.
[Jaz]
Absolutely. I knew that your area of interest and what you are known for, you’re known for many things, but like implants is your thing. I didn’t, I must have forgotten that you were actually, on the specialist register, they oral surgeons.
So I forgot about that. So great to have you on about that. So, like you said, though, general dentistry and the fact that good general dentistry is what matters rather than specialism. So I like that little snippet. Could you expand on that?
[Colin]
Yeah. Well, I think in the UK we ran down the route of specialization a lot, right? And we sort of lauded the specialist and we never did it properly. I don’t, in my opinion, so we never created the specializations properly and we never really let the public know what the difference was or even just categorize it well enough. And so look, I got on the specialist list by default in 1999.
When it first opened, in surgical dentistry, and then it was moved to oral surgery because they closed that, because they hadn’t done it properly. But the problem is that like a lot of specialists are not very good dentists, in my view. And a lot of journalists are the most extraordinary dentists and the guys that I work with around the world now.
And I get the privilege of working with, because I run education for a hundred countries for a foundation, I get the privilege to work with the best dentist in the world. And I do, and I get to meet them and see their work. And most of them don’t consider themselves specialists. I mean, they might have a ticket in here or there, but they don’t, the best example is Ronald Young, who’s become one of my great friends, and he’s probably the most famous, certainly the most famous implant surgeon in the world.
And his University of Zurich, he’s a professor there same age as me, but I’ve watched him in clinic. He will cut a veneer prep, he will do a consultation for a patient. He will scale teeth if it’s necessary. He will do an extraordinary implant placement. He’ll restore it. He will be careful with the occlusion, and look at this, he’ll look at the patient holistically.
That’s a dentist to me. That’s what a dentist is. So if you can’t, if you’re not a physician first and you’re not concerned about a patient’s health first, you’re not a dentist, in my view. So, and I think we lost that, and I think people chased a ticket because they thought it would generate them income. And that’s not true. And it shouldn’t be true either.
[Jaz]
I see that and I see incredible value in being a good generalist and having array of skills, not just honed into one specific facet. However, some of the advice that we’ve spoken a lot about on the podcast previously is finding your niche.
One thing I talk about is a niche kebab, right? For every one thing that you add on, you remove something else so that you refine to like two or three things that you love doing. Where does that fit into what you’ve just said just now?
[Colin]
So one of the joys of my life previously before I became injured, was the triathlon. I would compete in triathlon and so I would swim and bike and run. And I was never really that good a swimmer, but I could swim. I could swim okay. So you can’t be a triathlete without being able to do all three. If you can’t swim, you can’t race. Now, you might get really, really good at running, and if you get really good at running, it doesn’t mean you’ve stopped to being able to swim.
So if you learn how to take a tooth out, it doesn’t mean you forget how to take a tooth out. So my best example for you, I guess there’s two, if I could give you them, right? The first one is if I’m an endodontist, I’m a specialist, endodontist, and I open a tooth, right? And I look at it and it’s cracked, mesial, distal, then you can take it out.
The endodontist goes, well, I don’t take teeth out. And the patient’s going, well, I’m here. I’ve traveled for an hour.
[Jaz]
Numb.
[Colin] I’m numb. I’ve paid for it. And they’re going, oh, that’s complete nonsense. Okay. And the other one that’s nonsense, I’m afraid is orthodontists who can’t take x-rays. So that is one of my greatest bugbears, right? I think we’re through that potentially, but I’ve had people like that that worked with me and they go, I don’t take bite wings. And what do you mean you don’t take bite wings? Right? You can’t? Have you? You don’t have, have you not got any hands? Why do you not take bite wings?
And so I’ve seen some turnarounds, I’ve seen get-outs and bail-outs in dentistry based on the, I’m a specialist, right? And I’m sorry that, I can see whether if the tooth to be extracted is super complex and they go, it’s much better if somebody better takes it out. I get that. But not if it’s a central incisor.
Right. And I can see that there are circumstances where the, where it’s better if someone who’s more experienced or more skilled in that area does it, totally get that. But there’s so many ways where the specialists go, I don’t do that. I don’t do that. And we need to just move away from that because we should all do our basic training.
We should all learn how to cut, cut, access the tooth. We should all learn how to take a majority of teeth out, and then we can enhance our skills from there. And then of course we can become a GDP ortho, or a GDP implant, or a GDP Perio or a GDP. And they’re the really good guys.
They’re the really good guys. ‘Cause they can do a lot of it and they can build relationships with patients.
[Jaz]
Amazing. Well, I love that ’cause I agree with it so much. And there might be some facets which we disagree. And let’s see how this podcast goes. Let’s find, I love those moments.
Colin, actually, so let’s try it. Okay. But there’s so much to learn from you, Colin, because what I wanna grasp from you today, the first theme is consent. And specifically, what you do is complicated in the sense that, it’s more specialized and complicated, sinus lifts or all our next potential.
So things that are worth a lot of money. Things that a lot of take time to things that take a lot of surgical skill and training to be able to do. What I have seen from colleagues who are, similar, high level as you, is that the consent, the way I’ve seen consent being done, what my principles used to do that I work with in the past, and what I’ve seen from mentors is that sometimes consent is like this 30 page booklet almost, and it’s incredibly exhaustive.
So I just wanna know, right? ‘Cause everyone’s got their own unique take on this. How do you see, what do you think it takes to be able to adequately consent someone to something that is a bit more refined or something that’s a bit more niche treatment. That’s quite a big deal, right? For these patients to receive surgically, like for example, let’s take an example of a wisdom tooth that’s impacted.
You can do that in a one or two page consent form. The fact now that the treatment you’re doing is worth several times more than that, or several more nuances, how does that change how thick that pad of consent becomes? How long does it take to consent someone? What is the procedures that you do to make sure that you can look someone in the eye and say, you know what? I think I’ve adequately consented you. It’s a big question. It’s gonna take lots of pieces, but, I’d love to take your thoughts on that.
[Colin]
That’s brilliant. Every question that you asked Jaz, is another podcast. It’s beautiful, right? But I will try my best to be as brief as I can, which is not one of my greatest talents, I’m afraid.
But, first of all, you can talk about this in terms of the UK or you can talk about it in a broader scale, right? So the UK is quite a unique environment for consent in the world. And, I know that you have a big listener group that should outside of the UK that’s so I believe so, so perplexity tells me anyway.
And so let’s do it genetically consent, right? If we can do that. And so certainly from a UK perspective, but genetically for the world consent is a relationship management exercise. That’s what it’s a hundred percent. And so in the United Kingdom, and not to go into too much detail, our consent was massively altered by, legally by a lady called Nadine Montgomery, who was an extraordinary woman.
And I had the privilege of having dinner with Nadine Montgomery and to watch her speak and to learn all about her story and all about her son Sam. And they changed consent in medicine in the UK. But when you speak to this lady who was vilified by the profession, because she was the one that gave us, made us much harder, it was much more difficult for us to consent patients.
This was gonna kill medicine. It’s not at all what she wanted. She wanted us to understand her. That’s it . so your job is to understand your patient. That’s it. Now you can put down-
[Jaz]
Can you just explained, for those who don’t know about Montgomery, just to give us a little context background.
[Colin]
I very Montgomery, was she- In the United Kingdom basically, we used to the test used to be, if a reasonable other practitioner said, that’s the way you should go, then you didn’t get sued.
But what happened to Sam Montgomery, Nadine’s son. When Nadine was pregnant and she was a diabetic and she had pre-eclampsia, so she had high blood pressure and she asked for a section and she was denied a section by a female gynecologist. Because at that stage she didn’t like doing sections and Sam had an anoxic injury at both of was born cerebral palsy.
And when they went back to it, she said, you didn’t listen to my concerns about this and had you to them. He might not, I might have had a section and that might not have happened, but she had to, she trained to be a solicitor to change the law. It took her 15 years right now. So what she said was, listen to me when I’m speaking to you please, because I need to tell you my concerns and what Montgomery-
The philosophical part of Montgomery Consent basically says, know your patient in order to treat your patient. So you can’t treat your patient as if they were you. You have to treat them as if they are them. So anybody who practices the way you practice Jaz, totally gets that. So Montgomery consent is no threat to you.
And the other side of this is that in countries where litigation is high, so for example, United States, UK, Israel, right? Those are three biggest ones. We’re terrified of being sued. So we defensively practice really heavily. That’s not the case everywhere at all. It’s not the case everywhere in Europe.
So you would go to Spain and assume that people would consent like they do in Britain, and they don’t because they don’t need to, because the law protects them in a different way. And even in the United Kingdom, the law protects the dentist or the physician much better in Scotland than it does in England, than it does in Ireland.
So that’s mental. So what you want me to give you is, I think I have it here. One second. I usually have it on. Oh, I usually have it on my notice board, but it’s gone somewhere else. I have a blank laminate, a piece of blank paper laminated, and I say, if you want to avoid getting sued, here’s your instructions, because there isn’t an instruction you can’t avoid.
This is human interaction. You cannot systematize it, right? All you can do is do your best to understand your patient. And unfortunately, for a lot of practices of the United Kingdom, who still work either in the NHS or independent practice, who an enhanced version of the NHS, they’re time poor.
Same for GPs. So you don’t have the time to spend a minute to get to know the person who you’re actually treating. And if you spend them, if you take a minute, then you can send patients. And of course we back that up with we, what we do now is we do everything based online. We have online booklets, which explains every procedure.
We do a bespoke letter to the patient and we say, read your booklets and ask any question about the booklet that you want. But when you sign at the bottom, we’ve assumed you’ve read the booklet and you’ve answered all, I’ve answered all your questions, and we give them the headline potential complications.
And that’s all we do. But we’ve done that in an environment where the patient trust us and we always, if we’ve done a say, an immediate, for large case for a patient, we’ll go to a patient, this is really complicated. There’s lots that can go wrong. So we don’t sell it on a false premise.
And I think people get into a lot of trouble because they’re desperate for the work, so they downplay the good and the bad side. Taking all of someone’s teeth out and replacing ’em with implants is a huge, huge procedure. And it’s not to the same on the other side.
[Jaz]
Colin, just want to add in, because I’m enjoying this, but I just wanted to add in one thing, very pertinent to what you just said there, is sometimes colleagues will say that I’m afraid of going to, making the conversation too negative a warning of all the risks. ‘Cause then I’ll lose the quote, unquote, I’ll lose the sale, I’ll lose the treatment acceptance, but I’ll lose the, that’s our point of consent.
[Colin]
But it’s also because you need so much emotional intelligence to be a healthcare practitioner. Clearly, that’s the thing. You can talk people out of any treatment you want. It’s dead easy to talk ’em out of treatment. Because you just say that, well, this could go catastrophically wrong. But it’s a pragmatism test with the patient.
You’re gauging their level of pragmatism. If you’re unable to accept a certain degree of risk, do not have this treatment. And I, this year I became a surgical patient. I had a quite a big surgical procedure carried out at 10, 9, 10 weeks ago. And I went catapulted into the world of going and in medicine, in private medicine.
I mean, they never consented me in writing hardly at all. It was ludicrous. Right. And I was totally cool with that because we had a chat about it and he said, look, there’s not a lot to go wrong with you, but it could, and in fact, something did go wrong. Right. But that’s the deal. Okay. And if you can get to that with the patient, I think there’s a word for it that we used to use in healthcare ages ago.
Trust. That was the word, that’s what it was called. And so you’re trying to develop a trust relationship, right? But if you are a crook, it’s your trust is false. If you’re not, there’s nothing to worry about.
[Jaz]
It’s bit of being your authentic self and allowing the human side, like emotional intelligence is the best way to do it. Having respect for the patient enough to give them an opportunity to back outta something that perhaps is not for them. And the only way you’ll know that is discovery of who the patient is in front of you.
[Colin]
A hundred percent right. And there’s also just a final little of say to this, ’cause my daughter, who’s not a dentist, and none of my kids are in healthcare ’cause I’m a terrible example.
Well my middle daughter is a physiotherapist, so I guess that counts as healthcare. But, my eldest officer is a biochemist, but when she was at, finally in school, she did a project at Cambridge University. She never went to Cambridge, but she did a project when she was at school. And it was a, it was psychology.
It was assessing the degree of risk that practitioners applied to their patients or to their family as patients. Get it? So let’s say you’ve got two, however old your wife is. Let’s say she’s 25, Jaz, right? So your wife is 25 and you have a another 25-year-old patient. They both need a wisdom tooth out.
You’re liable to push the one you don’t know away and take the risk on the one you do, which is mental because you believe in the treatment and you understand the risk benefit analysis, and you think you won’t get sued. And that’s an awful world to be in, right? So we actually will be happy to take greater risks on people that we love because we know the benefits are worth the risk than we are on patients that we’re concerned about because we didn’t get to know them in the first place.
[Jaz]
Well, that’s the epitome of defensive dentistry, isn’t it? Right there. The fact that you not willing to help someone who may benefit from that treatment overall, but because we’re afraid we’d rather push it to someone else or not offer it. And that really is defensive dentistry right there.
[Colin]
And of course, the ultimate sales tool, if you want a sales tool, is to explain two procedures to the patients and say, so let’s say you and my, how old, could I, Jaz? How old are you?
[Jaz]
I’m 35.
[Colin]
Okay, so you are genuinely young enough to be my son. So I’m gonna say, here’s the two options, Jaz. If you were my son, Callum, I promise you that’s the one I would do.
And if you have developed a trust, nine times outta 10, the patient goes, that’s the one I would like. If you’re true, if that’s true, I’ll take it. But it comes to-
[Jaz]
So that’s what you would say to your pa, I mean, this is something that you, this is how you communicate to a patient?
[Colin]
Yeah.
[Jaz]
I think I resonate with that and I I think that’s, ’cause patients often ask, what would you do? And so let’s tackle that, right? Because I’m sure you get that all the time. When a patient asks you, what would you do? How do you then make sure that you’re not giving them the answer? Because it’s not important what you would do, Colin. It’s important that you’ve understood them well enough to relay back to them that actually, based on what you’ve said so far and based on what’s important to you, this is what I would do based on you, not on me.
But how do you have that discussion more elegantly?
[Colin]
Yeah. So I would spin that back to the patient and say, I don’t think that’s the question. I think the question is, what would I do if you are my wife, brother, mother, daughter, son? And so I’d say what you want me to do is use the experience that I have to pigeonhole you as a member of my family and then to treat you accordingly.
[Jaz]
I love that. That’s great. That’s wonderful. I’m gonna keep that as a teaser at the beginning of the episode. That’s awesome.
[Colin]
Yeah. Alright. Okay, cool. Wonderful.
[Jaz]
So, with the consent, going back to it, so you said you have the pre online stuff that they do. So they already have some prior information they’ve kind of pre-qualify themselves.
And then you have some discussion in the clinic where you get to know them and you decide, okay, is this dance for both of you or not? And then of course there’s the squiggle at the end, which people say it’s not worth the ink is printed on, et cetera. How are your consent forms like massive?
And your treat plan letters, because, ’cause quite often I’ve heard is the treat plan letter is not really for the patient. Yes, it’s addressed to the patient, but that treat plan letter is for the lawyers.
[Colin]
Yeah. Let me take you back a step to the process if I can do that.
[Jaz]
Yeah, please love that.
[Colin]
Let you pick an implant. See a patient who is referred to me or refers the themselves to me for an implant consultation. First of all, it’s one hour, right? And people will say, well, it’s all right for you. Well, it’s not all right for me that it’s an hour. And that is what you would call in business a loss leader.
I do not get in that hour enough money to pay that surgery running. Okay? So let’s be clear about that. But we still charge for that. And we charge what seems like a big number for that, but it doesn’t cover our costs. And one of my big areas of interest is the business of dentist. Right? And so, we see the patient for an hour, and I came on here and I’m not interested in punting anything that we do, Jaz. I just wanted to have a chat with you. But we do teach this formulaically, okay?
[Jaz]
Yep.
[Colin]
And there’s ways of doing this, and we divided the hour into four 15 minutes. So if you choose to do it as a 20 minute consultation, you can divide it into fives, but fives are not long enough. Right? But that’s fine. I get it.
I get you might have to do that. Right? So the first 15 minutes is called building the bridge to trust. So the patient gets pre-qualified by a TCO, who are brilliantly trained to say, what do you need? What do you want? And we have 56 of us here. So they get put in the right place depending upon what it seems like they need.
So there’s lots of people doing implant here. So often people will be, well, I call and treated my husband 10 years ago, or whatever it is, right? So they come and see me and they sit down and I go, it’s really nice to meet you. And the first 15 minutes is nothing to do with dentistry or anything.
[Jaz]
And the first 15 minutes is with the TCO or is with you? Sorry.
[Colin]
No, no, no, no.
[Jaz]
Does the TCO happens beforehand?
[Colin]
But the TCOs talked to ’em on the phone, booked to appointments.
[Jaz]
Okay.
[Colin]
Got that information. That information is all set up for me before I see the patient. Any concerns the patient has, what they might be interested in, what the history is, that’s all done, right?
So you are using the team, enhancing the team all the time, and then the patient comes in and then you say, let me tell you about this. And I go, no, no, no, no. I need to know about you for the reasons that we’ve just discussed. Only once I’ve ever had kickbacks from that where I gotta go.
Why are you asking all these questions? And I’ll say to ’em, because I can’t decide what I think you might want unless I know who you are as a person. And so that we call that building the bridge to trust. And the purpose of that is A, to find out about the patient and B, to open the door to share personal information.
Psychologically, if you allow me to share information about me, you will share information about you and we will trust each other. It’s basic human interaction. I will make myself vulnerable to show you that you can trust me. It’s really clear how we do that. The second 15 is the mechanics. We do that really quick.
[Jaz]
Can we break this down? ‘Cause obviously we can go in any way we want in this podcast, but this 15 minutes, like a lot of colleagues will be uncomfortable with this because they may be coming from a background where their entire consultation is 15 minutes. And now to spend 15 minutes to, to learn about someone, it seems like an awful long amount of time.
‘Cause I’ve experienced this before with colleagues who have moved from one type of practice and to another practice where we had to do much longer consultations. And you notice that patients are coming in, they’re booked in for an hour, but they’re leaving after 20 minutes because the clinician is just so used to doing everything so quickly.
What kind of like in the whole interviewing sequence, like how do you encourage the patient to warm up and loosen up and talk about and what exactly do you wanna know? Do you wanna know about their cats and dogs names and what they do on the weekends? And like to what degree are you learning about them?
[Colin]
So I totally get that right. And it’s important that when you enter this world of practice, which is a different level of practice to that, which a lot of people are working at, and to quote the film Rocket Man, and I use this quote a lot of the time, you have to kill the person you were born to be, to become the person you wanna be.
Okay? And that’s difficult. So you don’t get, this is not easy, nor is it supposed to be easy, right? You can learn it and you can practice it. And it’s been well proven that emotional intelligence is a developable skill. It’s a practicable skill. IQ is not, but EQ is, right? So what we’re looking for is a series of opening gambits, right?
Conversational opening gambit to seek out a common ground with the patient. So if I was saying to you, do you have any children? What would you say to him?
[Jaz]
I’ve got two boys, two young boys, six and two.
[Colin]
How old are the boys? Six and two. Yeah, you said six and two. Yeah. What are they like, what is your 6-year-old like? What is he like?
[Jaz]
Well, his sixth birthday is coming up. We’re doing a Marvel theme birthday party. He’s absolutely in love with Marvel. He plays cricket on Fridays and yes, it’s a great season of life to be a dad.
[Colin]
So I have a 17-year-old boy called Callum. So he used to be six. And during the ages of, between about six and 14, we were able to go do the whole of the Marvel Universe as it came out.
[Jaz]
Nice.
[Colin]
Up into, we saw a end game when it was just released. And so I can promise you that if you share that with your son now, the benefits you get when he’s 17 are extraordinary. Do you see what I just did?
[Jaz]
Yes, absolutely. Yeah. You gave something a personal information about yourself.
[Colin]
It took me one question to do that. Sometimes it takes more than one question, are you married? Do you have children? What do you do for work? Did you travel far when you got here? What was your last holiday?
Do you read? Do you like books? Do you like movies? Whatever it is you want to share. And you’ll get to the point where, and the six degrees of separation, ancient research from the United States, if we got into this podcast for long enough, we would be able to find our six degree of separation. You’d be able to say, well, actually, my uncle lived in this part of Scotland for a little while and then he moved to here and I’d do, oh my God, my mom and dad lived there.
And we would go, bang. And you almost always reach that moment in that 15 minutes where you go, bang, that’s us. To see how we are connected, shall we continue with dentistry? And it’s not difficult. It just takes a bit of explanation to do and a little bit of practice. Imagine that was your work. Imagine part of your work was to do that. What a beautiful job that is.
[Jaz]
Well said, well said. To build that bridge is a truly wonderful thing. Now, I’ve seen some of your social media stuff and also in your lectures you talk about books and stuff. If someone, if a young dentist like is wanting to quite rightly develop their EQ, which is one of the most important things they could set themselves up for their career. Are there any resources, books, courses, anything that you could recommend to help develop their EQ?
[Colin]
Well, first of all, they won’t read a book because they’re younger than me. And so if I recommend them or buy them a book, they never read it. So what they’ll want is an AI summary in about 250. So what I would suggest, the young person, let me bracket this in ages.
If you’re under 25, go at GPT or Claude, whatever you like. And ask for a 250 word summary of emotional intelligence by Daniel Goldman and ask for another 250 word summary of talking to strangers by Malcolm Gladwell. Once you’ve taken the effort of reading that 500 words, you won’t be qualified, but you can use that as a platform for moving forward. If you’re older, if you’re between 25 and 40, listen to them on audiobook. And if you’re over 40, read them on a Sunday afternoon in your conservatory.
[Jaz]
I love that. Okay. So yeah, at least you have two book recommendations and different media in which to consume in, depending on what phase of what seasonal life you’re in. The first 15 minutes, what are the second, third, and fourth, 15 minute segments of that implant consultation.
[Colin]
Second is the mechanics. So that is the absolutely standardized formulaic examination for a patient, which is, and I’m not, I promise I wouldn’t swear on this podcast. I promise I won’t. I nearly did. It’s absolutely cast iron, right? So if someone comes to get you, you’ve filled in all the stuff you were supposed to fill in — the complaint, your history of present complaint, your past medical history, your occlusal analysis, all of this stuff is done right. So just do that-
[Jaz]
Data gathering.
[Colin]
With an extraordinary nurse who does your notes and take your photographs and check if you need any radiographs. I don’t take a lot of radiographs nowadays at consultations, but that’s probably pattern recognition from experience. I’m cool if you take radiographs, if you want them.
And sometimes I do, but usually I can formulate a plan provisionally for a patient and usually CBCT, everybody because it’s implant work. But actually I’ll do that if you accept a plan, but I’m not frying you if you don’t. And so that’s it. That’s that bit. And then the third part of it is the bit where you go, okay, let’s pull together what the possibilities are for you here.
And so that is pulling the possibilities together, showing the patient what sort of options they might have for treatment and having that discussion initially. And that runs into the fourth part, which is then the after part of the consultation. So how do you follow that up? Who follows up and what do they get?
And how do you consent a patient afterwards? So that you know what to tell you what happens in our place, and I can show anybody how to set this up, and it’s extraordinary is that TCO deals with a patient and we’ve got five TCOs here. They’re fantastic, but they’re so dialed into our philosophy of how to work, right?
And our philosophy of sales are kinda hate sales, but we have to sell things. So they bring the patient in all the information. So generally speaking, they come in, we do the consultation. Generally they pick that person who’s already spoken to the patient, picks ’em up again, other side, right? Not on the day.
I say to ’em, we’ll be in touch within a day or two. Now we also have an MDT here, which is a multidisciplinary team group, which discuss cases every Tuesday. A lot of the patients go to that, they love that. But it’s a huge thing now, different podcast, but if it’s straight, if it’s relatively straightforward, I dictate the plan.
I fill the plan on my (PMS) which is Dentally, we use. And those plans are presented really well. They’re standardized in the presentation. Fantastic. I dictate a bespoke letter to the patient on Slack. That letter is then formulated and it’s put in a lovely package digitally with the treatment plans, and it goes out of dentally to the patient.
Now it goes, we can tell when the patient opened it obviously ’cause dentally, you can tell from which what IP address it was opened on at what time. So if they ever tell us they haven’t read it, we’ll go, well, will you open it a few? There’s a few things happen. Then patient opens it and signs it. That happens.
They haven’t even been back for a second consultation. The next thing that happens is the TCO phones them and says, are you happy with it? They say, I’ve got some questions. The TCO answers the questions, they sign it, and they all come for diagnostics with the nurse, not with me. So then the nurse does a diagnostic appointment for these guys into treatment.
The next thing that happens is they have, if they don’t want to do it, they want more questions. They have a teleconference with me, right? They have a Zoom call recorded, and the final thing is they come back to talk to me again. But that used to be the standard format. First consultation, second consultation.
I second consult. Now maybe 10% of cases. ‘Cause they go ahead with treatment because of the process. Or they have a zoom call at the end of treatment and the Zoom calls are much quicker than they’re recorded. And they’re much better. And I can show them all the photos and their x-rays on a Zoom call. So the process we have now is really good, but it’s based around the fact that they trusted it.
And I can show you, we invented the treatment box. I don’t know if you’ve ever seen it. I haven’t got one here. And analog days, we did this with Chris Barrow and he took it around the country. We had this beautiful, it was like an iPad case. When it fell out, it had an SD card in it with Campbell clinic, SD card.
It had a teabag, it had all our documents printed under here, but it had them all electronic here. And we put it through the post and that’s what arrived. We’ve done that digitally. Now we still do have that, but we do it more digitally now. So that part of the, how you present the plan, that’s kind of like a given, right?
That’s like checking the patient’s occlusion after you do a composite. That’s gotta be right. And it has to be good depending upon what level of the market you’re at. But the key, the secret sauce, is at the start of the process.
[Jaz]
Okay. So it’s all the data gathering that you’ve done beforehand. It’s the TCO involvement. And it reminds me of, sorry, you were gonna say.
[Colin]
The trust. It’s the trust. It’s building the trust.
[Jaz]
That first 15 minutes is absolutely golden. Without that, you can’t get to where you do eventually end up. And so go back to a little detail though. Like, imagine you’re doing this immediate, full-arch implant treatment and going back to what I said about making those treatment plan letters, like they as though they’re for the lawyers, right?
Not so much for the patient, but the patient is the recipient. To what degree do you subscribe to that and to what degree in the digital sort of sending of these, Adobe sign or whatever you might use, would you say that compared to your co colleagues or people practicing a civil level as you, can you describe what your plans may be like compared to some other industry examples?
[Colin]
So I was an expert witness at quite a high level for 10 years. I am expert in criminal cases beyond civil cases as well. So I can tell you that the law is an ass, and effectively everything becomes a negotiation. So whatever you do to protect yourself, it’s not enough. So stop stressing about getting to a hundred percent and don’t.
Now the way we do it is we have, in your consent letter, we have all these links. So we’ll say dental implant information, full arch reconstruction information, endodontic information, and we put those in if it’s appropriate for that treatment plan. And our admin support does that. So we say in the letter, make sure you read all that stuff.
I’ve told you about it, but make sure you read it. It’s credit card, there’s credit card, Ts and Cs. When did you last read your credit card? T and Cs. And so, never ever. And did you ever say, well, I’m not having the credit card, because actually it remains their property at all times. Never. But you do get patients who want it.
This is the spectrum. So, what we also do when we talk about consultations is, and we’re getting a bit deeper here, is there’s, we’ve got five types of personalities for consultations, right? Five types of personalities, right? So take my personality type, right? I’m a CEO personality. I’m not a CEO, but what I do is, so I can tell you that within about, we’ve never spoken before today.
I’d never met you. Within about 30 seconds. You guys, I really like you and I trust you because that’s what the CEO personality does. But that’s what the CEO personality does, right? And so, if you stitch me up, the wrath will be terrible. So when you get the CEO personality, when I go for my, it was a knee operation I had, when I meet the surgeon in the waiting room, I had bought him, done. And he’s going to me, we’ll send you an estimate and I’m going, blah, blah.
But it’s you. So the CEO personality, they trust really quickly, and so they’re never reading a word of what you sent. Never. They won’t sign it.
[Jaz]
It reminds you of the book have you read, Surrounded By Idiots?
[Colin]
Yes, yes.
[Jaz]
So you are very much the red, dominant?
[Colin]
A hundred percent. But the other personality types are the engineer. So the engineer goes, if you can’t get the engineer, I just wanna show you a prop, right? If you can’t get the engineer and tell him this is a fantastically clever printed crown that I’m not telling you about a podcast, but if you can’t tell him exactly what that’s made of and why you’ve lost.
So the accountant personality, they don’t have to have these jobs. The detail about the detail and about the money and all of this stuff, and they have to be really clear. The teacher, they want to tell you. And then the worst one for ethical drag is the passive. That’s the 40, the 50, 60-year-old lady who’s lost her husband, who trusts you, who’s got plenty of money, and you go, oh, do you know what?
I’m gonna spend your money? So you have to be really clear in your ethics for treating that patient. So that forms part of that process of building the bridge to trust, because those guys need a different calling. Each of them needs a different calling. And that’s emotional intelligence, right? And you can build on that and you do that.
But we give you a framework because it seems complicated now and you have to practice it, and that’s serving patients for what they need. It’s not gaming the system. There’s nothing bent about it. It’s saying, as a professional, I’m prepared to be the person you need me to be, to look after you.
[Jaz]
And what I like about that is, in your communication, in your letters, you are making sure that all bases are covered so that they can go as deep as they want. For example, if someone wants to read the T’s and C’s for credit card is there, but a bit like me and you, I’m very similar to that. Like, I’m very quick to make decisions.
I’m very slow to change them. And so I go by trust. My currency is trust. Maybe my principals who listen to the podcast as well, maybe they don’t wanna hear this, maybe they do wanna hear it. I don’t read the contract, but when I sign, I know lots of people get very deep into the associate contract.
It’s not my personality type. I go by trust. I look John and Chris in the eye. I was like, do I trust these two? Well, John I went to dental school with is one of my best friends. I was like, yeah, I trust these guys and we buried the contract and the day need to pick it up is the day that we need to rip it up and and move on.
[Colin]
A hundred percent. I don’t look at it again.
[Jaz]
Right, right. So that’s how I operate. But I appreciate that my patients are not reflection of me. They’re very different. And therefore the way I do it, Colin, is that I do a lot of Loom videos.
[Colin]
Yeah, yeah. Loom video, we use a lot.
[Jaz]
Exactly. But I know that for a lot of dentists, they struggle. They messaged me saying, Jaz, you talk about Loom, but my first one took me an hour to do. And so, whereas I can bash ’em out in five minutes, everyone again, it’s a exercise that you’ve gotta practice and practice and refine.
[Colin]
You have to systematize your process, whatever your process is. The phrase over the overriding phrase for our consent process is a sheep and wolf’s clothing. That’s what we are. So we are prepared to put on wolf’s clothing for our consent, but we are a sheep. So we are soft and kind, but as far as the consent is concerned, if you go into my consent, it’s as good as anybody’s, but it just doesn’t look like a 45 page massive document that that terrifies you.
That’s the thing that terrifies you. And so I’ll say to the patients, these are the risks that you could get from this. But, I worked in head and neck cancer, so I see how people are consented. My wife works in children’s cancer, still people are consented for cancer operations on half a sheet of paper.
We had a little bit vain and obsessed about ourselves, you know, a little bit. We’re not really that important Jaz, not really. And we should always not be too, we shouldn’t take ourselves too seriously.
[Jaz]
Excellent. Well, I’m gonna move on to the next. I thoroughly enjoyed that. The next bit I wanna discuss is elective treatments and a common scenario, which we all face in our career at some stage probably early on, is like the patient who comes in. And just to make it relatable to most dentists who are, listen to this, so I don’t wanna talk about like full large implant stuff that you do. But let’s say a patient comes in and says, look, I’d like to have a gold crown on my front tooth.
Okay. So that old scenario, which we’ve all faced before, maybe not, or we know a colleague who’s discussed it in the pub with you or on a Facebook group, more modeling. Where do you draw the line for yourself? Like, ’cause you might think that, hmm, is this really appropriate, but is this criminal?
Like, can I do it, can I not? What decision making criteria and what kind of consent skills do we need to be able to consent someone for this kind of electric treatment? Which you don’t think that you would want in your mouth and you don’t believe in, but it may not be like too farfetched.
[Colin]
A lot of dentistry is philosophy and the law is applied philosophy. If you’re not, we don’t teach our children philosophy, which is a huge shame because it helps us to navigate this stuff and who we are and what we think. And so the analogies to this stuff that I’ve always used, so we have a principle in the practice that we use when we teach a lot.
And if you saw me speak, you probably saw a slide that said prefix on it. Right? And it’s a linear analog scale. And as profit one end in ethics or the other, if we don’t make a profit, we die. We can’t treat anyone. But if we do that too much, we should be killed. Okay? And so we can’t be all ethics and no profit, but we can’t be all profit and no ethics.
So we as a team talk about this a lot. Where do we strike? And that’s a philosophical decisions. Interestingly, and I’ll always like to reference this kind of thing, I’ve not been on social media for 10 years, right? Came off in 2015 and my last Instagram post was a picture of my breakfast in 2015.
As a practice, as a business, we have a lot of that going on, but I don’t really see it. ‘Cause it wasn’t very good for me to be honest. And I knew that from early on. People do bring things to me and say, look at this. Have you seen this? And there’s a guy who was batting around recently who was comparing composite buildups to the price, we’re having a nails done.
And he was just going like, if you have your nails done, you might as well have composite buildups. So to me, and let’s be clear about that, that’s abhorrent having composite buildups. And I’ve had composite buildups for wear recently, and my wife never noticed high, still hasn’t noticed. I’ve had ’em done, but my teeth were 50% worn down.
So I had them for functional reasons and I’m delighted I had them. But to do it on a 22-year-old, we have to be really careful of that because that is not without significant long-term risk. Get it? To restore those teeth, to put on a plaque trap to in any way mechanically prep those teeth in any way is a huge problem.
And so we have to be really clear with the patients and tell ’em that, but we don’t. We sell it as a fashion aid. It’s not like buying a top or a pair of shoes, and it shouldn’t nails like that. It’s not well, nails and nails. It’s not like nails. Right? ’cause your nails will grow back and so clearly we have a responsibility to position ourselves where we think the ethics sit for us.
I always go back to do no harm. Part of my graduation, I was required to recite the Hippocratic Oath. Love it. Right? So first do no harm. I, as a practitioner, I will not harm you more than I help you. And so I still subscribe to that and I a hundred percent subscribe to fact to dentistry as a subspecialty of medicine.
I a hundred percent subscribe to that. And that changes how you look after people. Composite buildups for aesthetic reasons. That’s not medicine. And so that’s hairdressing. Let’s be clear about that. That’s it. There’s no health benefit to that. Don’t tell me there’s a psychological benefit, there’s no health benefit to that. And so I won’t-
[Jaz]
The first thing that comes to my mind, as, I mean, I agree, but there, there’ll be lots of listeners who are listening to this right now saying, no, no, no. They disagree. It’s a skill. It’s artistry. It’s giving confidence. It helps their mental health of the patient. And they’ll be thinking that.
But then I would say that one of the things that was taught to me, I did a diploma in Ortho, and actually, I like the thing that the educator was saying was actually there are very few cases of ortho, which actually are functional and health ortho, the primary benefit orthodontics is aesthetics.
[Colin]
Yep. It absolutely is. Don’t get me started on ortho. I absolutely believe that. But I’m absolutely cool with straightening healthy teeth because I know that the long-term prognosis of those teeth is rarely. Not entirely, but really affected. I see plenty of resorption from ortho cases that we have to treat, right?
So again, that’s not without its risks, which should be explained, but covering teeth in polymer right, is, that’s a totally different game. You’re doing that, not you’re doing it quick. You’re doing it to create an appearance, which is unnatural, fashionable. And so I know that people will disagree with this, but do you know what we have to say it like it is, right?
And so I happily have that conversation with whoever you like. So the first treatment for someone like that is to straighten their teeth up. We don’t do aesthetic concept buildups where there’s minimal advantage to the patient. Not at all. We just don’t do it. We won’t do. I mean, just say the patient number.
[Jaz]
Colin? I know you don’t know anything about me in that regard in my clinical practice, but, I made this video, which again, got a lot of love, but also got a lot of hate because I said very much like what you’re saying now is like, I don’t like seeing teeth plastered with composite and I got a lot of pushback on social media from people who like doing so.
But I’m with you and all of men or most of my orthodontic cases that I do like, aligners and stuff. Once I’ve got the teeth in enamel whitened. Yes. And looking great. I don’t wanna touch ’em, I don’t wanna have to put composite on them. Whereas I know people are quick to do that and then to build more volume.
Give the wow effect. Give that shine with the composite. And I see lots of my colleagues do that. But, I’m not just saying this to agree with you, but I think just for those who are listening right now, that actually I think that’s a great point that, when you do that, it’s not as reversible as we’re saying.
So the kind of language that’s being spoken on social media, Colin, I know you said you’re not on social media that much now, but like people are saying no injections, no drilling, no this, we’ll put eight, 10 composite veneers in three hours kind of thing. And that I think has got lifetime implications that probably are not lifetime discussed or make clear lifetime implications.
[Colin]
Lifetime implications. And you’ve not been doing it for that long, so you don’t know if it hasn’t got lifetime implications. The problem is, it’s a relatively new thing, but it’s not new. Jaz, in its principle because in the nineties we were doing Larry, Larry Rosenthal, veneeriology, and veneeriology was to protect.
That’s all the same arguments were used there. And what we see now for the Larry Rosenthal veneeriology is terrible, right? So when we were using porcelain to do this, it was awful. And it’s not, I mean, we’re not prepping perhaps as much, but let’s be clear, you are sticking resin onto these teeth.
You’re creating plaque traps, you’re creating ledges. And please don’t pretend that everybody that’s doing this is an artist. They’re not an artist, right? At the very top, two or 3%, they are an artist. But the guys that are doing it quick, down the bottom end, it’s garbage. Right? And we are seeing it coming through the door and they’re not finished properly.
And they’re done cheap. It’s just, it’s really bad work, right? And it misrepresents the industry as a profession when it’s done badly like that. And I’m sorry, and I know people won’t like that, but you can’t please all the people all the time Jaz. And sometimes it’s important to say, so sometimes it’s important to say much. Would my kids have that? Absolutely, never would they have that.
[Jaz]
Okay. No, and I’m glad we moved away from that gold crown scenario. ‘Cause actually what you are saying is far more relatable, which is the comp veneer wave that we are seeing. And this is a huge thing, like my social media, the algorithm is just constantly showing me this.
And yes, I get it with, it’s a peg lateral. Okay. Like, the two actually that has got some space and size issues and stuff and I get it. But when y
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