Dr. Jagjit Shergill, an implant surgeon, talks about his experience managing multiple practices and also offers some advice to young dentists.
Have you ever wondered what the key to owning multiple practices is? Dr. Jagjit Shergill – implant surgeon and multiple practice owner – talks to us about his success and how anyone can apply his approach to their own career.
Dr. Payman Langroudi: Jag, as a very successful implant surgeon, I think people watching this material will want to know, if they were just starting out as dentists and wanted to get into implantology, what are your key pieces of advice that you would give to someone young who wants to get into this field?
Dr. Jagjit Shergill: There are three; come in right away. You're never too young. And by come in, I mean get a mentor, go to the offices. People like me are quite happy to say, "Come and see how we work." We like to get involved with the younger ones. Come in, from day one, immerse yourself in the environment and make it sound normal and feel normal to be giving implant surgery to patients from day one, as it should be. So from day one, you start the journey, initially observing and being mentored, then getting involved, formalizing yourself. Then eventually, either you just keep yourself in that role or you add other factors, like what we did just today, the Mini Smile Makeover course.
Dr. Payman Langroudi: How early would you say? Would you say that if someone has just qualified that it's a good time to be with you?
Dr. Jagjit Shergill: It's perfect.
Dr. Payman Langroudi: Serious?
Dr. Jagjit Shergill: Yes. Because the same patients are going to come into your office whether you're a FD, whether you're in your first year post FD. So you really should have enough knowledge to know what's appropriate and what's not appropriate for conversation. So absolutely, from day one.
Dr. Payman Langroudi: Okay. So then let's say I'm a young man coming to watch you. Then I know what's possible. At what point should I start actually drilling for the implants, actually doing the work? Right away?
Dr. Jagjit Shergill: No, not at all. I think it's definitely important to find a happy medium. Basically, when confidence is greater than your competence, you have problems. Find your own levels of competence in observing, assisting, co-diagnosing, and engaging in retraction during surgery by taking a formal course, getting a mentor, possibly substituting, or not being involved surgically at all. Go through the recovery phase. Go to designated courses. Make sure you're doing everything within your level of competence. The most important thing is if it's for you, you'll find out very quickly. It's very contagious.
Dr. Payman Langroudi: So you mainly do everything on 4?
Dr. Jagjit Shergill: Larger cases, lots of all-on-4s, lots of full mouth implant cases. I will still do occasional or quite a few single and lateral implants and two or three at a time. But my preference is for large rehabs.
Dr. Payman Langroudi: And don't just do implants.
Dr. Jagjit Shergill: No, I have three stakes in dentistry these days. Implant surgery, I took on a lot of implant work; cosmetic restorative, I've been doing that for 28 years, and a lot of orthodontic work. I got pretty lucky about 10 years ago. Two of the first guys in the States were actually taught Six Months miles by Ryan Swain, who was the owner of Six Months Smile at the time. That was ten, eleven years ago. I do quite a bit of Invisalign, I want to do more. But the three aspects of orthodontics, cosmetic restorative surgery, and implant surgery mean that I actually have a pretty good chance of being able to do most things without sending patients who come into my office.
Dr. Payman Langroudi: How come you didn't stay in one of these three directions instead of doing all three?
Dr. Jagjit Shergill: I get bored easily. If I'm involved, I'm 100% involved. And if I were to do just one of those factors, I'd get bored. So, I think the most sensible thing for me is to know if I'm dividing all my time, one third, one third, one third, one third, and there will be months where I'll do a lot more implant work and orthodontics, and other months more aesthetic restoration.
It allows me to delve into all three aspects and provide a complete and appropriate multidisciplinary treatment to patients, no matter what comes through the door. So I might think something won't really excite me, but I'll advise patients and have one of my associates do the work.
That's happening more and more. But it's nice for me to have these three aspects of dentistry, which in themselves I could easily do full-time, any one of these three aspects. But keeping those three, broadly speaking, available to me every day, is what keeps me going.
Dr. Payman Langroudi: It's quite interesting to me, someone like you, who is so involved in deep implant treatments, to then come to a Mini Smile Makeover course. We see one or two people coming. I wonder if this continuous learning is why you became so good at implants in the first place?
Dr. Jagjit Shergill: Possible.
Dr. Payman Langroudi: Because if I think about it, if I were at your level in implantology, I wouldn't have bothered with composite. I would just be there now. But you're here and you're humble enough to learn from someone like Dipesh, who is 20 years younger than you. And we often hear, "I don't think he could teach me anything." So what's it about you? Is it curiosity?
Dr. Jagjit Shergill: I don't want to be a pioneer. I don't want to do the groundwork, learn everything again and make all the mistakes. I would rather say: what parts of dentistry interest me? Who is doing well, who is ethically, morally and professionally successful, not just professionally but commercially, is important and I think we should copy. Let's learn. But let's do it straight from the horse's mouth, rather than from someone who has been there.
The reason I really came here the last two days, and by the way, it was a fantastic course. Honestly. I'm not just saying that. I sell myself, so to speak, to patients that if you have a dental problem and you want a long-term functional aesthetic outcome, anywhere from the smallest change you want to make to a full mouth rehabilitation, I can provide that. And the great thing about it is that it allows me to get those patients early: young, old, immaterial, who literally just want, preferably, no injections, no drills, very cost-effective treatments. I can say, "On a scale of zero to 10, where zero is minimal intervention, no intervention, and 10 is full mouth implants, I can provide the full range.".
Dr. Payman Langroudi: Are you finding that patients are now asking for composite?
Dr. Jagjit Shergill: They come and say they want to glue.
Dr. Payman Langroudi: This is something new, isn't it? How long ago did this start happening?
Dr. Jagjit Shergill: I think, to be honest, it's been about since you guys started doing things online. There's a cause and effect there. I would definitely say in the last year or so.
What I like about the way this Mini Smile Makeover course, as well as Enlighten, is put together, is that it offers a package approach to the patient. Maybe we can say, “Great, we can whiten them, we can straighten them if you want, we can contour them.” At each stage you are one step further than you were, and you can stop at any of those stages. You don’t have to go through everything. You can stop, we can reassess.
Dr. Payman Langroudi: It's what we call progressive treatment planning, not knowing from the beginning where you'll end up as everything progresses.
You own multiple practices. What would you say is the key to managing multiple practices?
Dr. Jagjit Shergill: Good managers.
Dr. Payman Langroudi: Do you have one in each?
Dr. Jagjit Shergill: One in each, yes. We used to have more clinics, many more clinics than we have now.
Dr. Payman Langroudi: But when you had a lot more, what was the key?
Dr. Jagjit Shergill: The key was having good managers. We've all had bad managers in the past and they've come and gone, which is good.
Dr. Payman Langroudi: Do you think you're good at hiring?
Dr. Jagjit Shergill: I don't actually hire, that's the weird thing. Once the manager is in place, they'll hire. Other than the dentists, I don't get involved. With the nursing staff, even the hygienist, the manager will hire them, because he spends more time with them. I get involved in the layoffs. I've had some fantastic managers over the last 20 years. I've had some crappy managers before that. The reason I couldn't cope is because everything is stressful. The stress level from one office to two is very high. From two to three and from three to four it's almost zero, there's a certain amount of duplication, but then you get to a stage where you realize that actually sometimes less is more.
Dr. Payman Langroudi: When you have multiple offices and managers in each of them. How often are you in contact with each of these managers?
Dr. Jagjit Shergill: Daily.
Dr. Payman Langroudi: Oh, every day with everyone?
Dr. Jagjit Shergill: It has to be, otherwise there's no point.
Dr. Payman Langroudi: So, you literally trust them to tell you what problems exist.
Dr. Jagjit Shergill: Absolutely. And the good ones, especially in the last six or seven years that I've had, have not only been good, but they've protected me from most of the problems that will come. If it gets to me, it's been through the triage process: it's not important, it's annoying, or it can be resolved. By the time it gets to me, it's a special clinical problem that no one else can solve. Or it's something that I'm legally obligated to do.
Dr. Payman Langroudi: What would you say was your weakest moment? Professionally. Like a bad day, where something went really wrong?
Dr. Jagjit Shergill: Oh, there are a lot of moments like that, but they only last two hours. The next patient comes in and then you're at your happiest. Catch me at six different times throughout the day. I'll be the happiest person in the world and then "why am I doing this?". Then the happiest person in the world and then "why am I doing this?" I have a binary disconnect. When I'm off, I'm off, and when I'm working, you can push me as hard as you want. It's not a problem. So I think honestly, I have a healthy attitude and what could be worse? If you're healthy, you can eat, drink and chew. We do better than most people.
We're actually a phenomenally impressive profession. And you can choose your own level of stress. A lot of the stress that we put on ourselves is the greed for more patients or the desire to have more complicated treatments. I think as a profession we're being tested hard by the government and some of the regulators. But for the most part, if you think about it in the grand scheme of things, we're doing pretty well.
And I don't take anything for granted. I feel very grateful for this profession. On the bad days when things are going wrong; with the patients, with the labs, with the associates, and with the staff, I sit down and think that, actually, everything is fine. I'm not in a coal mine.
Dr. Payman Langroudi: What kind of boss are you?
Dr. Jagjit Shergill: Very detached, my staff actually laughs at me, because if any of the other nurses come to work with me they are initially nervous, and my staff says I am the easiest dentist to work with. I do most things myself, if I can. In that sense, I am very caring. But there is a limit. I have a long fuse, but when I explode, I explode. That is why it is very important for me to have managers who can handle all the things that could have a trickle-down effect for me to explode one day. It is not an aggressive blow, it is like a father telling me “you let me down” and because I am always praising them, to hear “it was not necessary” and to walk away is actually more painful.
Dr. Payman Langroudi: How do you manage to juggle six days a week of clinical work and running multiple practices at the same time?
Dr. Jagjit Shergill: It's about managers. But now I take eight or nine weeks off a year. I didn't use to. When I'm at work, I can't relax. When the door closes, I'm gone. So, in the last few years, I've taken eight, nine weeks off.
Dr. Payman Langroudi: Are you actually free? What's going on, you're not talking to the managers?
Dr. Jagjit Shergill: Not completely off. It'll be a phone call every few days. Last year I took a month off. I was in Africa for a couple of weeks on safari and then I went to the States for two, three weeks and I think I only contacted the service three times. But now I only have a small number of offices, it's easy to manage, to be honest. The girls are great.
Dr. Payman Langroudi: So what's your advice? If you had to give someone advice who wanted to get into the multi-practice game, would you tell them to do it? Or would you say that now that you've shrunk down, you feel more comfortable in this situation?
Dr. Jagjit Shergill: No, I think it's fine. I think it depends on your personality traits, if your idea of a vacation is to lie on a beach for two weeks, I would limit myself to one practice. If your idea of a vacation is to do that, but every day you read books about something, business books, travel or whatever and you're very active all the time, then multiple practices might work for you. I know at least three people who have over 20 practices. The happiest people you'll ever meet. They're the first ones in the bar and the last ones out, they work incredibly hard, and if you ask them how they're doing, they'll tell you, "I'm doing great." I think sometimes a practice is lonely. But I think I'd rather have one well-known practice than ten crappy ones.
Dr. Payman Langroudi: You seem to enjoy the pressure.
Dr. Jagjit Shergill: Yes, that's right.
Dr. Payman Langroudi: I won't say you're an adrenaline junkie, because that's a bit different than that, but do you like high-pressure situations?
Dr. Jagjit Shergill: Yes.
Dr. Payman Langroudi: Being an implant surgeon in itself is a pressurized thing, but having a lot of practice and being an implant surgeon at the same time, do you think you work well under pressure?
Dr. Jagjit Shergill: Yes, I think so.
Dr. Payman Langroudi: And do you get bored easily?
Dr. Jagjit Shergill: Yes, it's a dangerous combination, but it's a good one. I think I'm doing well, but my employees have told me otherwise. They can tell when I'm under pressure, I think I'm pretty calm and everything is fine, but they can see a difference in my demeanor. From very jovial, laughing and joking with patients to very serious, but still jovial, but very direct. So, I would tell all my younger colleagues to stay positive, there's a lot of sadness and sadness, but it's a fantastic profession.
Dr. Payman Langroudi: Do you have children?
Dr. Jagjit Shergill: I have a three and a half month old baby. As time goes by, when he grows up, we'll see.
Dr. Payman Langroudi: But if you had a child who was 18 years old now, would you tell them to head to dentistry?
Dr. Jagjit Shergill: My friend has a wonderful 14-year-old son. He’s our boy and he’s phenomenal and he keeps saying, “Dad, I want to be a dentist” and I say, “Son, come on, let’s do it.” But that being said, I think that no matter what profession you choose, as long as you set out to strive to be the best or if you just set out to do the best at that moment, you’ll be fine. I have ten nieces and one nephew. Six of them are in dentistry. Two are dentists now. I wouldn’t push anyone to do that. If you’re a student or a recent graduate, stay positive. For every person you hear in the media saying it’s a bleak situation, I guarantee you there’s someone who is excited about this profession. Look for the ones who are positive. That’s what will give you value. They’ll say come and visit, learn. Educators who use almost a family approach. You'll find it's the best profession in the world, in my opinion. Where else can you be a doctor, a surgeon, a radiographer, a businessman, a confidant, an artist, a scientist, all in one? Whatever direction you think is more your forte, you can go for it. There are massive challenges in this profession. It's a solitary profession a lot of times. If you're someone who likes to have a fantastic social life. a good living, but most of all to feel professionally advanced in their life, you have to keep taking courses. You're never too old to learn. You come to places like today, it's a previous composite course, but it fits perfectly into my whole range of little transformations.
Dr. Payman Langroudi: Have you ever taken a composites course?
Dr. Jagjit Shergill: Yes. About ten or twelve years ago. It's been a while.
Dr. Payman Langroudi: What do you think about Dipesh?
Dr. Jagjit Shergill: That's okay, right? An incredibly impressive piece of work, but equally impressive is the performance. Humble, down to earth, very, very knowledgeable, and extremely good at conveying that point of view.
Dr. Payman Langroudi: It's one thing to be good at dentistry, and it's another to be good at teaching dentistry. Teaching dentistry is different from actual dentistry. He's a very good dentist, but he's getting better and better at teaching dentistry.
Dr. Jagjit Shergill: Regardless of the profession, even if he was an architect, you can be pretty sure that somewhere along the way he would have had a teaching, counseling or mentoring role. I think it's very similar to the artistic bent. If you have a way of making yourself understood in an easy, relaxed, but quite authoritative way, which is what I do, that's pretty good. If you want to copy, great. If not, no problem.
Dr. Payman Langroudi: Who were your mentors?
Dr. Jagjit Shergill: Paulo Malo. It's a long story, but he threw me into the pool from one of the excavators on his farm. David Hornbrook. Patrick Palacci, I spent some time in his clinic in Marseille. There were a few over the years, and the phenomenal thing was about ten, twelve years ago, I went to San Francisco for five days, and Michele and Pascal Magne did a five-day practical course in aesthetic porcelain. Which was a phenomenal level of work with those two key people and with UCLA. Now I'm at the stage where, looking back, I think if I had known what I know now, instead of getting involved in this field seven years after I qualified, I would have gone straight in.
Dr. Payman Langroudi: Back then, however, there weren't that many courses.
Dr. Jagjit Shergill: It's true.
Dr. Payman Langroudi: What year did you qualify?
Dr. Jagjit Shergill: In '91.
Dr. Payman Langroudi: I qualified in '95. And I remember I wanted to go on an esthetics course and there was one in New York and nothing in the UK.
Dr. Jagjit Shergill: Exactly. Today, for example, there are a few newly qualified dentists here and I'm sitting next to them and they're excited. There are 30 people here and they're all excited. In those early years of training, where whatever path you're put on, your career is going to be headed in that direction, being involved with other like-minded people who are savvy with social media, you start to think that some of these are going to be the educators and Dipesh Parmars and people like you in the future. It's a good time to get into this field because the continuity, the momentum is already there. You've finished college, you've finished medical school and you're on that learning curve. And as soon as you get away from that, then the background noise of life can get in the way.
Dr. Payman Langroudi: In our time, at first, it was only considered if you invested your time.
Dr. Jagjit Shergill: Absolutely. I qualified in '91. And it was the last cohort where VT wasn't mandatory. So I went straight to associate, I was seeing 65-70 patients a day. One patient in five minutes. I knew the day after I started that this wasn't for me. The next day I started looking for practices, literally the next day, and I put my ad out.
Dr. Payman Langroudi: How many years before you opened your first practice?
Dr. Jagjit Shergill: A little over two. Because I wasn't in a hurry, I worked as a substitute. But the next day I told my manager that this wasn't for me. I gave my three months' notice, and they were very understanding. So, at first, I looked for courses. I had to travel all over. I spent a lot of time in the States, South Africa, Europe, a lot of time on various courses. As you said, we are so lucky now. These new graduates are spoiled for choice from day one. Instead of wondering what courses are there, they wonder what courses should I take? And the fact that we have such enthusiastic and motivated young people is contagious. And the most exciting thing is that this is just the beginning. As they evolve, this can only have a positive effect.
Dr. Payman Langroudi: Wonderful. I won't take up any more of your time. Thank you very much for coming for the mini smile makeover.
Dr. Jagjit Shergill: Thank you for having me.
Source: enlightensmiles.com
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