Dentistry Uncensored with Howard Farran
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374 Dentistry Over Dinner with Friends from Singapore : Dentistry Uncensored with Howard Farran

374 Dentistry Over Dinner with Friends from Singapore : Dentistry Uncensored with Howard Farran

4/24/2016 10:34:52 AM   |   Comments: 0   |   Views: 299

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VIDEO - DUwHF #374 - Singapore Dinner


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AUDIO - DUwHF #374 - Sinapore Dinner


Howard sat down for dinner with a gathering of dentists and dental professionals in Singapore. They passed the microphones around the table and spoke about heir journey, how they found themselves in Singapore, and what the state of dentistry is like in Southeast Asia.

Howard:

We're in Singapore, South East Asia. It's about 5 and a half million people. There's 3,000 dentists. When I studied Economics, Singapore is considered an economic miracle. I don't think there's ... I think most Economic experts agree that nothing went from this level to this level faster than Singapore. Right now, we have a podcast show that's listened to, probably about 8,000 dentists from around the world in every single country from Tanzania to Ethiopia, the United States, Canada. Everybody's listening, so what I'm going to do is, I just want to pass around the microphone and I want you to start ... I think all the guys are Dentists and all the women are Office Managers, or whatever. Just tell everybody ... Right now most of them are multitasking, they're commuting to work. They got an hour's commute to work, so edu-ma-cate them. So tell them something they didn't know about Singapore or Dentistry or yourself or whatever. We're going to start with you since you're in the right chair.

 

Dr. Tan:

Gosh, I need a minute.

 

Dr.  Cooney:

I've probably got longer than a minute. My name is Marcus-

 

Howard:

Take your time. Take your time.

 

Dr.  Cooney:

Sure. My name is Marcus Cooney. I'm a dentist from Adelaide, Australia. I've been here 22 years and Singapore is a place that has changed immensely. When I first arrived, there were a lot of similarities that I saw to Australia but a lot of differences. One thing that stands out in Singapore is the quality of the food. It's great in Australia, but here it's exceptional and that's why we're here dining. I joined a practice here. I had my own business in Australia for 11 years before I moved here. I thought there was an opportunity to do something different and Singapore certainly provided that opportunity.

 

 

I've now got a practice that has 12 employed dentists. I'm the Principal. I don't work any dentistry anymore, but I kind of keep an eye on the business and you'll meet Bernard Sew down there later who is my 2IC and he does a great job helping me out. Dentistry is really progressing well. It's great to have Howard here. When I was first here we didn't have that many visiting speakers to guide us along the way. I think he's obviously going to share a lot of pearls of wisdom over the next few days, and we're going to enjoy talking to me. I'll pass it on-

 

Howard:

I want to ask something.

 

Dr.  Cooney:

Sure.

 

Howard:

You've practiced in Adelaide, Australia and Singapore? The research shows that less than 1% of earthlings are living in a country they weren't born in. So you're a very rare dental unicorn in that you've practiced dentistry in 2 countries.

 

Dr.  Cooney:

Is that right? Okay.

 

Howard:

That's a great opportunity to compare and contrast. What the difference between practicing dentistry in Adelaide, Australia and Singapore.

 

Dr.  Cooney:

Okay. The practice model I had back in Australia was very much based on dentist and ancillary. Essentially we could have as many hygienists as we could employ and that's why I did. It was a very efficient, lovely model through that way. Our clientele were ... I always tell the story that my last day at work I saw one lady that I saw on the first day of work 11 years earlier. We had a very, very faithful regular kind of clientele and it was probably what everybody sees in their practice in most parts of the world.

 

 

When I moved to Singapore, and in fact, it nearly stopped me coming here, ancillaries were very limited and the Dental Act was such that only the dentists could do dentistry, hygiene et cetera et cetera. What I saw was a very inefficient kind of a model. It was something that I saw as a challenge to get over and really to set up a profitable practice here quite frankly without having to work 24-7. When I arrived I did fit into the practice that I was at and I did work 6 days a week, and the principals working 7 days a week. Why did I do that? Why did I leave what was fantastic practice in Australia? It was because nobody else had really taken the opportunity to scale things up very much although there were a couple of very nice, elite practices here that employed dentists effectively as the ancillaries. I thought, there's an opportunity to at least to that and that's what I did. However, about 5 years ago the Act was amended and we have hygienists working for us now as well.

 

 

It was a leap of faith and initially I thought I'd made a mistake. Although a lovely place to live, fantastic quality of dentistry always here - there are some eminent practitioners here - but from a business point of view, the Singaporeans see the term doctor as kind of God-like, and you hear that a lot, and that wears back on the practitioner, that they think they have to do everything as well. To actually delegate and get around that, was something that took some time.

 

Howard:

What about dental insurance? Wasn't there more dental insurance in Australia than in Singapore.

 

Dr.  Cooney:

Absolutely. That was one of the primary reasons I moved here was to get away from the dental insurance model. It was something I never really wanted in my practice back in Australia. Didn't really interfere or intervene too much. I ran a ... a cosmetically focused kind of practice back there, and we really just worked on very, very intimate relationships with our patients and dentally educating them, making sure that we had people that wanted to come for premium dentistry. As far as then making that move here and, again, looking for that clientele, it took us a while but we did it.

 

Howard:

We also hear, in the United States, that dentists in Australia, New Zealand, this part of the world, use more glass ionomer or poster composites than Americans do. If you did a hundred MOD composites on a first molar, what percent of those would be glass ionomer or resin. What would you fill those with?

 

Dr.  Cooney:

When I was a kid, my first dentist was a guy called Graham Mout. He was my Family Dentist.

 

Howard:

Graham Millesich?

 

Dr.  Cooney:

Graham Mout, and...

 

Speaker 4:

Millesich is in New Zealand.

 

Howard:

Okay. That's what I thought he said.

 

Dr.  Cooney:

He's kind of a father of dentistry back in Australia, and he's influenced people like Ken Noh, who you know very well and worked very much with Glaze on advanced technology and using that practices.

 

Howard:

He created it? Glase?

 

Dr.  Cooney:

He was involved in the creation of it. Quite correct. Yes. Through that influence, Adelaide is very much a Glase-town, so the bias is there. However, using it as a pure restorative was never really promoted per se, although having said that I was in practice with a guy that would just kind of squirt [inaudible 00:08:36], put in and Matrix band and see you later kind of stuff. What is seen as being the reliable standard as sandwich technique, so basically using the glass ionomer, not as a looting but as a base, and then to use your composite over the top. That was basically what I used in my practice.

 

Howard:

Is that what you used today too?

 

Dr.  Cooney:

I haven't practiced for 5 years.

 

Howard:

Oh, you retired?

 

Dr.  Cooney:

Yes. I have the business and ...

 

Howard:

What is your business?

 

Dr.  Cooney:

The business is dentistry. It's the group practice that I own, yes?

 

Howard:

You have gone from working with your hands to being a conductor, owning your own business for 5 years.

 

Dr.  Cooney:

Correct.

 

Howard:

Talk about that journey and how do you like it?

 

Dr.  Cooney:

Okay. One of the reasons I left Adelaide was I set up several practices, I employed dentists, that kind of thing, but the economies of scale did not quite work as well as I'd envisioned. In visiting Singapore and looking at the opportunity of setting up a business here, I did see that there was a large practice called Tate Partners, Peter Tate set it up. He was the guy with the idea that you get a bunch of practitioners ... Not that he, I don't think he was ever 'hands off', but essentially was just to have the multiple-practitioner model and essentially, whether you self practice or not, you create a passive income stream and he did that very well.

 

 

My practice was somewhat different, but it was an idea I'd already come here with. What was behind that somewhat, was the fact that my brother's a lawyer, his wife's a lawyer, all my best friends did law and they all joined as Juniors in big practices and the guy at the top just ran the thing. So I thought that's a great business model, why don't we do that in dentistry. Essentially I was looking for an opportunity to do that somewhere in the globe. The reason I was able to do it here is we had, as it turned out, somewhat of a captive market in that I'm an 'unbole', which means I'm getting to Singapore's [crosstalk 00:11:13]

 

 

I'm a foreigner and there's a lot of foreigners here and so, really if we set up an expatriate based practice, would that appeal to expats? It was no guarantee but we did that and it's worked. Basically looking at appealing to ... I know what it's like moving to a foreign country, it's very unsettling. There's a whole bunch of people out there similarly unsettled and they're looking for the familiarity and that's where they are ... dentistry is good or bad and it's good. We offer that familiar experience, little bit of home and that's what works and that's what appeals, and through that we've been able to scale up. We've got a bunch of dentists and great staff. There's about 60 staff in our practice.

 

Howard:

60 staff? That's amazing. You could have only more foreign if you were from Antarctica.

 

Dr.  Cooney:

Yes, well I haven't been there but they told me I'm pretty cool.

 

Howard:

Isn't that the next stop after Adelaide? Is Antarctica?

 

Dr.  Cooney:

It's something like that.

 

Howard:

Isn't it a city of ...[crosstalk 00:12:24]

 

Dr.  Cooney:

If you go down to Victor Harbor, which is on the South Coast, and you go there for the summer, it can be 45 degrees and it's abut 3 degrees in the water. That's like 120 and 35 degrees in the water, if you're in Fahrenheit.

 

Howard:

Thank you for sharing your story. Did you want to pass?

 

Dr.  Cooney:

Sure.

 

Howard:

You want to pass? Okay. Let's go ...

 

 

Now you're from a neighbor of him. He's from Adelaide, Australia. You're next door. You're a Kiwi.

 

Dr. Stehbens:

I'm from Australia. From Canberra, but I grew up in New Zealand.

 

Howard:

Oh. So you were born and raised in New Zealand?

 

Dr. Stehbens:

From about age 12, yes.

 

Howard:

From age 12. And that's a Kiwi? A New Zealander?

 

Dr. Stehbens:

Yes, Kiwi is New Zealander. I'm still an Aussie at heart, but yes.

 

Howard:

But you're an Aussie?

 

Speaker 6:

He's a kangaroo.

 

Howard:

You're a kangaroo?

 

Dr. Stehbens:

There's a difference.

 

Howard:

So you're also a rare bird because you practice in Australia and now you practice in a different country, and I think that the world has 2 million dentists and not even a half of a percent of them are ever going to practice in 2 dentistries. Tell us your journey. What made you go from .... Where were you born?

 

Dr. Stehbens:

Born in Canberra, in Australia. ACT.

 

Howard:

Born in Cameron, Australia?

 

Dr. Stehbens:

Canberra, the capital territory. Yes.

 

Howard:

And then went to New Zealand and then left New Zealand, you came back-

 

Dr. Stehbens:

We traveled, with my dad, we traveled a lot. He was a Professor of Pathology so we became that. We ended up in London, in Paris, the States, a few places, and then Australia again and then back in New Zealand. Moved around a bit.

 

Howard:

Did you practice dentistry in Australia?

 

Dr. Stehbens:

No. Just New Zealand.

 

Howard:

In New Zealand?

 

Dr. Stehbens:

Since I graduated I worked pretty much in New Zealand.

 

Howard:

How long did you work in New Zealand before you came to Singapore?

 

Dr. Stehbens:

My age. Nearly 25 years. 25 years I stayed in New Zealand.

 

Howard:

That's an exciting journey. So after practicing 25 years in New Zealand, you decide you're just going to go to another country?

 

Dr. Stehbens:

Yes.

 

Howard:

I think most people listening to this would have way too much fear to say, "I think I'm just going to move to a different country."

 

Dr. Stehbens:

Reasons behind it. There's lots of it, I guess there's thousands, but it really comes down to is when i did the check, the advantage in Singapore, it's English-speaking, which suits me great. It's English-speaking, I didn't need Entrance Exams, like the US was quite prohibitive in terms of having to retrain almost or do a couple of years. England had Entrance Exams and a bit far. I also knew ... I looked at the per capita income. It's the third highest in the world.

 

Howard:

In Singapore?

 

Dr. Stehbens:

In Singapore.

 

Howard:

What was first and second? Luxembourg and Hong Kong?

 

Dr. Stehbens:

No. I think it's Switzerland and ....

 

Speaker 7:

Qatar.

 

Dr. Stehbens:

Qatar it might be, yes. Qatar and Switzerland, something like that. Singapore ranked third at the time.

 

Howard:

Wow.

 

Dr. Stehbens:

Potentials seemed amazing. All in all ... and it also came down to the simple things, the thin threads. I spoke to a whole bunch of different people that at one time or another had said positive things about Singapore. IT forms an impression in your mind. I did the usual thing, make a journey and you start looking at practices and analyzing and it made more sense.

 

Howard:

How long you been here now?

 

Dr. Stehbens:

About 9 months. 7, 8 months.

 

Howard:

Are you liking it?

 

Dr. Stehbens:

I love it. There's a lot of different things that attract you to different countries but here, the potential is just staggering. The heart of the people, I was told that one before. Even when you walk on back streets or you look at what we got out here, the growth potential, the people. They've managed to, in an usual way, bring together a disparate range of society, ethnicities and religions, all in the same spot, and they all get on with each other. There's a certain respect that most people have for each other. It's really unusual, like nothing I've ever seen before.

 

Howard:

Is it, I don't want to sound racist, does it seem more Eastern-thinking as more tolerant than Western thinking, or is that ... ?

 

Dr. Stehbens:

I don't know if it's a difference of tolerance. It just ... Singapore attracts good people, to a large extent. If you're a bit more ambitious, you're looking to make the journey, the quest, you're looking for something ... I wanted to be here partly because it's more central to what's happening in dentistry. New Zealand is a big trip to this part of the world and it's another flight to get to somewhere else to actually see a speaker. We get some that come through, the range and options that they have here is staggering. There's a few factors in there.

 

Howard:

I heard the speakers this week are horrible. That's what I heard.

 

Dr. Stehbens:

Well, they're really, really good and then there's this guy, Howard something. Can't remember his last name.

 

Howard:

What would you say to some dentist who's living in Canada and now he's wished he'd live in Australia or  living in one country and want to be in another?

 

Dr. Stehbens:

When you make the move, you do these things where there's always more to learn. It's almost like because you don't have entrance exams, you've got 2 years penance here. It's a Monastic or you go through 2 years of supervision and you just have to get through that. There's a great range of options. You don't have to take the first thing that hits you. Cutting through all that, the potential here is insane. There's so much potential to build and to grow and to bring in different strands of dentistry. You had people who have moved from a third world nation to first world in 20, 25 years. They're just coming into their own, in terms of they've got a lot of cash, they've got a lot of knowledge and education, stuff like that. They're only just learning what's actually valuable to them. Part of our journey is to help that step. The potential, the upside is staggering.

 

Howard:

I can only imagine. China next door is going to be crazy staggering. When a billion 300 million people end up wanting dentistry done in Singapore.

 

Dr. Stehbens:

Learn English and come here. It's so good.

 

Howard:

You have a very interesting story. You're a dentist from London ...

 

Dr. Gill:

England, absolutely.

 

Howard:

England.

 

Dr. Gill:

I know they're synonymous.

 

Howard:

You made it all the way to the President of the British Dental Association.

 

Dr. Gill:

That is correct.

 

Howard:

First of all, congratulations. I don't care how you look at it, how you cover it. To become the President of the British Dental Association. Wow. What a feat.

 

Dr. Gill:

The autograph's still free.

 

Howard:

And then after you became the President, then you also left England.

 

Dr. Gill:

That's correct.

 

Howard:

And came all the way to Singapore. Tell us your journey. What made you leave? Come on, they let you be the President and then you picked up and left?

 

Dr. Gill:

The two things aren't related.

 

Howard:

They're not related?

 

Dr. Gill:

No. Not directly. The usual thing is the presidency was also in the professional career. Being able to come here was all related to the personal side. My wife decided to relinquish my responsibilities from being married to her, which put me in a very liquid position. One of my lovely friends, Bijou, is on your left ... right ... Just proves the wine works. Told me not to bother going to London, come out here and experience it. He, his wife and wonderful sister-in-law gave me an awesome time and I saw the potential here, which I haven't even touched yet, because I've only been here 3 months. I'm genuinely, genuinely happy being here with the people. I see the potential that the last two speakers have shared with you in terms of dentistry.

 

 

Clearly I've traveled around the world. I know what dentistry could be like and with this country developing fast, sometimes there is a shortage between where they are and where they could be. The last two speakers, like myself, have definitely seen that opportunity and one way or the other, we'll make sure we remedy that.

 

Howard:

How long you been here now?

 

Dr. Gill:

3 months.

 

Howard:

You have to work for someone else for 2 years. How's that going?

 

Dr. Gill:

Interestingly. It's really, really odd. Its difficult for me as a GDP, but some people come here as Specialists, they are obliged to fulfill the same criteria. I'm really quite happy to do that with reasonable people. They're the rulers of the land, you have to observe them, just the same as in England which we used to drive on the left and you guys used to drive on the right. You can't negotiate that. If that's what it is, that's what it is. However, if I had to go to America, do I want to jump through all those regulations in order to work there. No I don't. I rather be here in a beautiful country like this with lovely people and with the upside potential that we clearly believe there is existing here.

 

Howard:

United States is going to cure and solve Global Warming by switching from Fahrenheit to Celsius. We figure that will ...

 

Dr. Gill:

Politics always works short term.

 

Howard:

Figure that will fix it. That cut the temperature in half. Congratulations again for being the past president of the British Dental Association. That's quite a feat.

 

Dr. Gill:

Let me introduce Monsoor. He's just finishing his dinner but he's going to be very happy to talk to you in a second.

 

Howard:

All right.

 

Dr. Walpoor:

Yes. My name is Monsoor and thanks for the introduction Amarjit. I'm probably the youngest one here by the looks of things.

 

Howard:

How old are you?

 

Dr. Walpoor:

28.

 

Howard:

Where were you born and raised?

 

Dr. Walpoor:

I was born in Melbourne. I trained in Adelaide, just like Marcus. I stalked him all the way to Singapore and 20 years later, we've caught up. I trained in Adelaide. I worked in Regional Australia for a while and then I moved to Singapore. This is, starting on my 3rd year here.

 

Howard:

How do you like it?

 

Dr. Walpoor:

It's really good. I moved for very wildly different reasons of everyone so far. I was, at the time, basically unattached to anyone and I figured that before I'm too established in one spot, I wanted to have a change of pace and after working in the country for a while, I figured I'm definitely a city person and I wanted to mix that with working overseas, so Singapore city [inaudible 00:23:20], English-speaking, all those sorts of things. A lot of my cohort was Singaporean so I had a lot of friends in an already existing social network, so it was very easy to make the transition.

 

Howard:

Thanks for talking. Any of you want to talk? You have to talk.

 

Cynthia  Yeo:

I have to talk, really?

 

Howard:

You have to talk because I'm not going to tell anybody how old you are. How long have you been doing dentistry? How long have you been doing this?

 

Cynthia  Yeo:

35 years.

 

Howard:

35 years? You and I were talking earlier. I've only done it 5 years and this is my mom. We were both talking about the fact that when China's dental market ... they have a billion 300 million people, it is mind numbing to think what would happen if a billion 300 million Chinese were getting their teeth taken care of like they were in Singapore or Hong Kong.

 

Cynthia  Yeo:

Yes Yes.

 

Howard:

It's almost unconscionable. Isn't it though? That is probably going to be ... That will probably define dentistry for the next century.

 

Cynthia  Yeo:

Yes.

 

Howard:

If you said what's the next century? It's probably going to be the Chinese century of dentistry. It's just going to be amazing.

 

Speaker 4:

It isn't. I object!

 

Howard:

That's the other shoe. Or will it be the Asian century? We'll call it the Asian century.

 

Cynthia  Yeo:

Actually I was supposed to work in china. Someone had approached me to set up a dental cleaning in Binh Wah which is somewhere from Shanghai, further.  It's like Singapore, very nice city, I've been there. They want to open four cleaning. One is the flagship and the other is in the department stores. They actually wanted to join together with a hospital. They actually engaged KPMG to get people from Australia, New Zealand and even in the US to visit the place and to discuss what equipment should they bring in to start the business. We have a [inaudible 00:25:42] from Singapore to start a dental cleaning for them so they asked me to be a GM for them. Maybe you want to know why I didn't pick up the offer. It was because I still love Singapore. This is my home.

 

 

I believe that in China it is really, really a huge business especially that people are now more aware of dentistry. People are more concerned about their health and so they actually are seeking medical and dental. It's actually a good market for people to visit and start business there too. A lot of the businessmen, they are not dentists neither are they doctors. They are actually investors. They have a lot of money but they don't know what to do about it. They ...

 

Howard:

They can always get married.

 

Cynthia  Yeo:

Yes. I don't know where they get the money from.

 

Howard:

Very nice meeting you.

 

Cynthia  Yeo:

Nice meeting you too. Come to Singapore more often.

 

Howard:

I've got to tell you for my homies back home. Majority of the listeners are back in the United States. The minute I told you I was from Phoenix, Arizona, first thing she said is "Omar Reid". So big shout out to Omar Reid back home in Phoenix, Arizona. It's funny, when I go around the world, if I tell anybody I'm from Phoenix they say, "Oh. That's where Omar Reid's from".

 

Cynthia  Yeo:

Yes.

 

Speaker 4:

[inaudible 00:27:21]

 

Howard:

[inaudible 00:27:23]. You're on board.

 

Dr. Sew:

Yes.

 

Howard:

What is your story? What is your journey?

 

Dr. Sew:

Very interesting story. It's somewhere between Monsoor's and Marcus'. Can you believe it, Adelaide's a small place but there are 3 people from Adelaide at this table. I'm also from Adelaide.

 

Howard:

Does that mean Australia has a big influence on Singapore?

 

Dr. Sew:

I think proximity wise yes. Also, Singapore is quite an interesting place.

 

Speaker 4:

[inaudible 00:27:56]

 

Dr. Sew:

Wow. There you go. I actually did not know that. My story that brought me here was actually quite interesting. Came here ... this is my 16th year in Singapore. I came soon after graduation. Actually got a job in Australia but a friend of mine and I were also budding filmmakers so we decided that it was difficult to do filming in a country town in Australia so we decided to go more urban. It was difficult to find a proper job as a dentist when you're a new graduate in a big city, like Melbourne or Sydney. So we decided why not try Singapore. I had an ulterior motive as well. I was pursuing a girl who was living in Singapore and you hear this story a lot. I made a leap of faith, did a job interview at the Adelaide Airport and came here and found work and met Marcus, actually, but we didn't have a working relationship then, but now I'm working with Marcus at Smart Focus.

 

Speaker 4:

Is that the girl by the way? [inaudible 00:29:28]

 

Dr. Sew:

He's not the girl. Yes.

 

Howard:

What happened to the girl?

 

Dr. Sew:

I'm married to her.

 

Howard:

You're still with her?

 

Dr. Sew:

Married 11 years now.

 

Howard:

Congratulations. Any babies?

 

Dr. Sew:

Yes and I still have my money, so that's good.

 

Howard:

You still have your money? [crosstalk 00:29:45].

 

 

Well it's not over till it's over buddy.

 

Dr. Sew:

That's right. That's true.

 

Howard:

Very good.

 

Dr. Sew:

It's been a fantastic ride. When I came here we thought that we were going to be here for 2 years and every 2 years we would review and go, "Let's stay". You have friends

 

Howard:

And when you said 2 years ago, you mean back to Adelaide or Melbourne?

 

Dr. Sew:

Actually we didn't know. We just thought go back to australia. I did miss home. My family is still there and I always grew up in a place that wasn't so densely populated so, at the start, first the humidity affected me quite a bit. Second thing was that it was difficult to always knock into people wherever you go. There were so many people in Singapore. It was quite shocking at the start. Now I love it. I go back to Adelaide and go "Where's everybody?"

 

Howard:

So your dental school classmates are back in Australia?

 

Dr. Sew:

Yes. Actually I have a classmate here as well. He came here for a girl as well.

 

Howard:

You have a dental classmate here and you have, I assume, several back home?

 

Dr. Sew:

Lots still in Adelaide.

 

Howard:

In Adelaide or Melbourne, wherever. It's very different practice styles. Australia has dental insurance. They seem to be a little more loose with expanded functions or hygienists or advertising market.

 

Dr. Sew:

Yes.

 

Howard:

Singapore seems to be more conservative. You're not allowed to do marketing, advertising-

 

Dr. Sew:

In a lot of ways, yes.

 

Howard:

What's the pros and cons, not for you personally, but what are the pros and cons for the dental industry for the individual? Did that play any effect on should I stay or should I go?

 

Dr. Sew:

Not at all actually. I feel rather blessed. I've moved from one practice ton another and flourished quite nicely in both of them. I think what Singapore offers, and actually most practices if you're willing to work hard, is that as long as I have an environment where I can do what I love to do, you end up succeeding. In Singapore what I loved about your not being able to advertise is you often have to show your work to your patients. It kind of levels in the playing field in some ways. If you have a lot of model to market, it doesn't mean you're better at what you do or more moralistic about your work. In some ways it controls the level playing field, especially in Singapore where you have a lot of very large practices and you have to try to be unique in your own way.

 

Howard:

I want to ask you, a racial question.

 

Dr. Sew:

Sure.

 

Howard:

Having a population of Singapore that's about 2/3rd Chinese, Australian, not 2/3 Chinese, different diets. Do you see race, ethnicity, culture affecting how many cavity a child has by age 6?

 

Dr. Sew:

Absolutely.

 

Howard:

Talk about that.

 

Dr. Sew:

Actually, not even for the children ... but with the children we see a lot of ethnicities, especially in Smart Focus, we probably are about 95 99% expat based so we see-

 

Howard:

Explain what expats is.

 

Dr. Sew:

Expatriates, basically people who are from another country but they come here for work so they are placed in Singapore for a short period of time, usually contractually for about 3 or 5 years. We would see them over a short period of time and they move on. If everything, we have a lot of geographic success in our dentistry.

 

Howard:

[inaudible 00:33:48] hope they move back home.

 

Dr. Sew:

Yes. We don't hear any complaints. The main thing is that we do see that culturally there are a lot of differences. I think Singapore, although they are very cash rich, you see a lot of parents with the money to have their children have the best dentistry but the education is not there quite yet. We do often see a lot of local kids, and I might be generalizing here, but for the Singaporean children that we see , we often see them much later.

 

 

My wife is Malaysian and she comes from a relatively affluent country but the first time she went to see a dentist, was when she was 17, and she had 15 cavities in her mouth. It's just that her parents never thought of taking her to the dentist. This is the paradox in Singapore is that there is a huge population, so per capita, when you have 3000 dentists you think "Wow. I've got so many patients that would come to see me" but you would find there is actually very few that will actually go to the dentist on a regular basis.

 

 

There's a lack of education and same thing in China as well. You would find that ... actually a patient of mine took a picture for me. She travels to China a lot and she took a picture for me. She said "I thought of you Bernard because I was on the train and this man was picking the calculus in between his teeth with a pen knife and there was so much calculus there was no tooth to be seen and he was just picking it with the little knife of his, that he picked out from his pocket".

 

 

There is very little education and it's not the issue with accessibility but also to take care of teeth is not something that is at the forefront of society. Just to give you an example, before I joined Smart Focus, I was at a practice that was locally based and I went to this one very suburban, industrial area to locum [inaudible 00:36:13] for a dentist, a very successful dentist there.

 

 

There was this one guy that came in to the practice and he had broken his front tooth. He had this massive gap on his front tooth. The practice was quite reasonable in pricing and I said "Look, we can do a little filling for you, just build it up. You don't need to even put a crown but that's what you need." And he said "Whoa. That's way too expensive for me." Then when I left the practice, he was the last patient of the day, he left and he drives a 250 thousand car, but to him, there is no value in fixing a front tooth. To us, it's almost unthought of, but to him, it's fine as long as he can drive the very nice Sports Car, I don't have to have a front tooth.

 

Howard:

But did he get the girl?

 

Dr. Sew:

Of course.

 

Howard:

Actually-

 

Dr. Sew:

I have another story of when I first arrived here in Singapore. The interesting thing is when you go to a nightclub, the entrance age for a female is 21, but the entrance age for a male is 28.

 

Howard:

To a club?

 

Dr. Sew:

To a nightclub, yes. I was 22 at that time and I was quite upset because I couldn't get in, but my wife could. The interesting thing is that she knew a lot of people and that's how I got in and there was this guy that I could only describe to you physically as an Asian-looking Jabba the Hut. He had a very beautiful woman next to him. He took me by the shoulder and said, "Bernard, let me welcome you to Singapore. Have a look around". He said, "What do you see?" I said "To be very frank, ugly men and beautiful women." And he said, "Yes. Old, ugly men and young, beautiful women" and he said this is the one thing you have to understand in Singapore, "The world is yours, as long as you have money here. You don't need to have looks. You don't even need to say anything, as long as you have money, the women will flock. That's right."

 

Howard:

That's why I'm here. I just got here toady.

 

Dr. Sew:

But it is a very exciting place and you can certainly make a good living here. Life is very interesting. It's very diverse.

 

Howard:

You talked about the diversity, whether or not the people value it or-

 

Dr. Sew:

Yes.

 

Howard:

But having seen so many diversities of diet, did you think that's a big factor?

 

Dr. Sew:

It is to some degree and interestingly enough, you can always predict it. Funnily enough, the local diet isn't too bad although in schools in Singapore it is quite common to have teachers give their kids sweets as a reward. That's one of the educational things we have to talk about as well with the teachers. It's getting better as time goes by but you can certainly see a diverse set of knowledge when it comes to diet, and not only with sugar but with the rest of the diet as well, when it comes to acidity as well. I do see a lot of patients with issues with erosion at a very young age and we see a lot of mouth breathers, with asthma problems as well. You tend to see a lot of cavities that way, with mouth breathers as well

 

Howard:

All right. Thank you so much. We're down to the final 3. Take it away. 3, 2 and 1.

 

 

Why did you move here? You moved all the way ... here's another story. You lived in Birmingham?

 

Dr. Krishnan:

No. Interesting story. Close, very close.

 

Speaker 4:

[inaudible 00:40:31]

 

Howard:

Where were you in the United Kingdom?

 

Dr. Krishnan:

I had a practice in Edinborough.

 

Howard:

What is it?

 

Dr. Krishnan:

In Edinborough. In Scotland. Scotland

 

Howard:

Scotland. Okay.

 

Speaker 4:

Not in Edinborough, Texas.

 

Dr. Krishnan:

Not Edinborough, Texas. Not even Birmingham, Texas. Edinborough, Scotland. Like most of these guys, I'm fairly new to Singapore. I've only been here for just over a year now. I moved for slightly different reasons, so I'm a general practitioner and I've had my own practice in Edinborough for ... 15, 16 years. I moved with my wife who is the top of the table over there. "Hey D."

 

Howard:

Everyone else came and found a wife. You brought yours with you. She must be a real jewel.

 

Dr. Krishnan:

She is and for a horrible second when you said "Jabba the Hut". I'm thinking ... I was thinking.. "He's speaking about me."

 

Speaker 4:

Ouch.

 

Dr. Krishnan:

Yes. I moved here ... I wear 2 hats. I'm a general practitioner but I'm also the founder and clinical director of C Fast. I'm sure some of your listeners in the States will know that system, they've probably used it. My idea was to come to Singapore to develop C Fast, cosmetic orthodontic brace in South East Asia and Singapore was the ideal place for us to do that. I always view Singapore as Asia for beginners. It's a really nice entry point. It's not too different to what we're used to in the UK in so many ways, apart from the amazing weather, the amazing food and the amazing people. It was quite easy to come and settle here. Also, my brother's been here for 16 years. My brother is  a dentist and he's been here for about 15 or 16 years. He moved a long time ago and he's constantly ... he's spending more time on the golf course than on the practice. I'm thinking I'm doing something wrong with my 5 or 6 days a week in practice in Edinborough.

 

 

I wear 2 hats: I'm practicing here as a general practitioner but I'm also doing a lot of teaching and business development with my wife here, from the C Fast perspective.

 

Howard:

How many orthodontists are in Singapore?

 

Dr. Krishnan:

Good question. I'm not sure. How many orthodontists are in Singapore?

 

Speaker 4:

Think about 60.

 

Dr. Krishnan:

60.

 

Speaker 4:

60? 60?

 

Dr. Krishnan:

6 0

 

Speaker 4:

60 to 100. Something like that.

 

Speaker 6:

Half of them are in the government service and the civil service.

 

Speaker 4:

[inaudible 00:43:28]

 

Speaker 6:

Even less maximum facial service

 

Speaker 4:

This is

 

Speaker 6:

Pediatric dentistry. You're a very lucky guy.

 

Dr. Krishnan:

That's sounds true because certainly my experience of having been here, even within the first 8 months that I've been here. Obviously we don't offer ... my system is not about orthodontics but more about cosmetic dentistry. About straightening the front teeth using an orthodontic [inaudible 00:44:01]. The demand has been unprecedented. I've seen so many patients here. 10 20 a month. There's a big demand here. Patients are now circling Singapore. They're much aware of their appearance and willing to invest in that. Its great to be able to offer some new ideas and some new technologies.

 

Howard:

Two more to go.

 

Dr. Tan:

Okay. Where do I start? My name is Gerald Tan. I was born and raised here in Singapore. I obtained my BDS degree from the National University of Singapore. After they, I did my first post grad in Sydney. My second post grad in London and then I joined the armed forces, the army as a dental officer. Then joined a really well known group practice, Dr. Tay and Partners, for 8 years and I was an associate. Now I am the founder and owner of my own managed group practice. We have 3 GP dentists, 2 specialists and 2 anesthetists.

 

 

I'm very passionate about aesthetic dentistry so I'm the current president of the Aesthetic Dentistry Society of Singapore. That's like the AACD of Singapore. I never thought that being a dentist would allow me ... give me the chance or opportunity to travel to so many places ... All around the world to attend dental conferences and make so many friends. I'm really enjoying the ride so far. Yes. That's the real quick snippet of my journey so far. Yes.

 

Howard:

All right. It's been amazing meeting you.

 

 

Last but not least, who's this next to you?

 

Dr. Patel:

Hi. My name is Amit. I've been in Singapore for 3 and a half years. I graduated from the King's College, London in 2008. I moved out here to travel. I was going to do 1 year here, 1 year Australia and then head back home. It never happened. I ended up staying. I own half a practice in Serangoon Gardens. Singapore is a great place, as everyone has said. I know many of these guys here.

 

Howard:

Do you miss the winters in London?

 

Dr. Patel:

No. They're rubbish. We couldn't even ski there so there's no point in having them. I do miss home, family, friends but life goes on and you go with it. I'm quite happy here at the moment.

 

Howard:

I noticed they have a London Eye here and in London. Is it pretty much the same Ferris Wheel.

 

Dr. Patel:

Pretty much and it makes no sense at all. You can only go on it once. You can only go around on it once.

 

Howard:

So your boy's bigger?

 

Dr. Patel:

They like to compare size but ...

 

Howard:

[inaudible 00:47:24]

 

Dr. Patel:

Size comparison is not important.

 

Howard:

Also explain now. So Singapore is right on the equator, right? Or is it-

 

Dr. Patel:

Pretty much.

 

Howard:

One degree north? And what would London be? How many degrees north?

 

Speaker 4:

Far too many.

 

Dr. Patel:

[crosstalk 00:47:39] It's so far from the Equator, they don't even say the word there.

 

Howard:

Yes?

 

Dr. Patel:

Yes. We like it here.

 

Howard:

Amazing. Thank you to everyone for participating. It's been really fun.

 

 

 


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