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Dentists Who Invest

Podcast Episode

Full Transcript

Dr James: 

What’s up team. Welcome back to the dentists invest podcast. I have sat in front of me today particularly interest in doctor doctor Rupert Relia, dr Ricky Rupert Relia, who is here to talk about indemnity and how there is just countless things that, in our opinion, could be done better in that realm and there’s a massive opportunity for Serving dentists whenever they understand, get and implement this stuff into their life. Would you agree, ricky? First of all, how are you?

Dr Ricky: 

I’m very well, thanks, very well. Thanks for having me on the podcast. We look forward to having a chin mic with you today.

Dr James: 

My pleasure, my friend. And what do you think about what I just said? Massive scope to improve things, right.

Dr Ricky: 

Yeah, I think look there’s, there’s, there’s. Indemnity has been around two months, I don’t know how long, but it’s something that all dentists need. But you know we work in an ever changing profession, you know constant advancements, you know we’re always investing in the latest technology. The best course is what about indemnity? Why are we still stuck in the old times? And that’s really one of the things that brought me to where I am today with this journey wanting to help people with their indemnity.

Dr James: 

That’s awesome Top stuff. So, ricky, can you tell everyone a little bit about you just before we get stuck into the podcast and meeting potatoes what we’re going to talk about today- yeah, absolutely so.

Dr Ricky: 

Well, I’m a dentist. So I qualified in 2014 from Manchester uni and I, after qualifying, I stayed in in the Northwest. I was doing a masters, I was working there and in 2017, I then moved back home to the Midlands, moved back in my parents, which was fun, and I got a job working in a group of practices. At that point that’s when things really took a turn for me. Actually, the practice that worked out with there was a dispute, which I won’t go into the details behind that, but there was a disagreement which did lead to me getting landed with a GDC investigation and, of course, you know that well. I’m sure anyone can appreciate how difficult that must be, but and it certainly was for me it was. It was horrible. I wouldn’t want anybody to have to go through it. Unfortunately, as dentists, it’s one of the things that we fear the most. But you know, going on that journey with the GDC the process, of course I lent to my indemnity and I also learned a lot, not just about indemnity as a whole, but also by myself. So, yeah, it was. I’ve had a bit of a difficult start to the career, but equally, it’s been insightful as well.

Dr James: 

You know what, in the tough parts in our life, that’s when we gain the most wisdom. Diamonds are formed under pressure Really, really, really like. And you know there’s actually a school of thought that when you put yourself in a tough positions, you can, you can almost do that, and I know that you never desired to have this outcome, as this was never the purpose right. But you put yourself in a tough position, you’re going to have to find a way out. You’re going to learn a lot on the way and sometimes needs must, and I think it’s amazing that you shared what you just shared so candidly on the podcast, ricky Awesome. And then, of course, just like any situation in which there’s tough circumstances, it leads to us re evaluating and perhaps refining and calibrating our course in life. And how has that looked for you since then?

Dr Ricky: 

Yeah, I mean, you know, with the thing is as a little bit deeper now, but, as as a dentist, you know we’re all perfectionists. We all want to do the very best for our patients, for the practice we work for. You know, we’re all high achievers and we aim high and then when something like this happens, you know, brings you down 1%, one notch, but that is a massive, massive impact. And of course, with with that, you know, getting reported to the GDC, being investigated by the GDC, I might get struck off, I might get suspended, I’ll get judged by patients, by colleagues. I won’t lose my job, I won’t be able to get new jobs. You know all the these are the sort of thoughts that are going through people’s minds and of course, all that equals shame. But actually this is a part of being a dentist. This is a sad and difficult part of being a dentist, but it’s the reality. There shouldn’t be any shame behind it. It’s a process and that’s something I learned a lot. One of the biggest take-hands for me was this is a process that I have to go through. I’ll probably have to go through it many times in the future hopefully not hearings and things like that, but the GDC process is a stressful one, and they know it as well. And, of course, indemnity. None of us want to use our indemnity. We have to have it. We have to pay for it, unfortunately, but it’s there should we need to, and more and more people are going through GDC investigations. Disputes, sort of the complaints were on the rise. Patients’ expectations are changing and we are using our indemnity more so. It’s important to have a provider that you trust and that you can rely upon, that has your back.

Dr James: 

Again, thank you so much for sharing and going into more detail there, and I think it’s actually really empowering to share a message like this on the podcast on the platform, because there will almost undoubtedly be someone listening to this podcast who’s thinking to themselves whoa, I’ve been on the wrong end of a GDC investigation as well, and no one ever plans to be there. They can find a sense of fortitude and solitude that there are other people out there who’ve experienced it and, like I said, there’s wisdom that’s gained in that moment, which is what we’re here to talk about today. Of course, how did that experience with your indemnity look? Throughout that process, how much did they support you?

Dr Ricky: 

I mean the support. They were very good. I think with hindsight I would have done things better, but I can’t criticize their intentions at all. But it goes back to what I was saying at the start, really, which is times have moved on.

Dr James: 

So naturally you would have leaned on your indemnity around about that period. What did you learn about the indemnity system through going through that process?

Dr Ricky: 

Well, the first thing I learned was the one I was with their discretionary. I didn’t even know what that meant, but actually they have the discretion to refuse cover at any point. Now that doesn’t from what I do. Now it doesn’t happen very often, but what does happen more often is you’re almost sort of can’t find the best word to describe but essentially, if you don’t comply with what they want, then they will refuse cover. So they can use Insta to get that discretionary clause whenever they want to. Now, of course, that’s how they run their business and they’ve been doing that for many, many years. But times have changed. Dentistry has changed, certainly, patient expectations have changed. But one thing people are missing is dentist expectations have also changed. We are still people and, I think, having discretion. You’re paying all that money for somebody to say, look, if you don’t do things our way, then sorry, we’re just going to withdraw cover for you. I would say it’s a little bit unfair.

Dr James: 

I see, right, I see, and again, I’ve heard of this phenomenon before, but I don’t really know in too much detail how it works, which obviously is completely not a good thing, given that I was a dentist and given that I purchased this cover and I knew vaguely off the discretionary thing. But I just went with the flow and I was like, okay, well, I’m going to use this major indemnity provider or whatever, because everybody else is. It doesn’t actually work for me and doesn’t suit me, and can I use them whenever I’m in a tight spot, if that ever did happen and certainly it’s a nasty shock to be able to find that out at possibly the most inopportune moment, when you are on the wrong end of the claim which, by the way, it can happen to absolutely anybody you can be the most phenomenal dentist in the whole of my world, and it can happen if you just have one person who doesn’t like you. So I guess what I’m interested to know is how can we protect ourselves against that, or what would you have done differently in hindsight?

Dr Ricky: 

I think. Well, the first thing is I wouldn’t have taken out discretionary cover. It’s a lot more dentists are aware of it these days, but the majority of dentists I speak to anyway are thinking you know what are you talking about here. So I completely get your question. Essentially, you’ve got an organization that you can choose to be a member of and they will give you indemnity cover on a membership basis, on a discretionary basis. A membership, you know, if you’re a member to a club, for example, the member, the membership can be terminated by either party at any point. It’s that sort of thing. Now, of course, the other type you’ve got is legally binding indemnity policies that are underwritten by insurers. They give you essentially the same thing but have different clauses.

Dr James: 

I see so interested in more about those.

Dr Ricky: 

So yeah, I mean legally binding policies. Now, that’s what, that’s what I think every dentist should be having, and it means there’s no discretionary element there. You know, the legally binding indemnity provider cannot turn around and say we’re refusing cover or if you don’t do things this way, then we’re not going to cover you. The fact that it’s legally binding, it’s a contract and that contract is agreed by both parties and it’s once there’s been an exchange of money, then that contract is in force. And, of course, if a dentist needs to use their indemnity, if it’s legally binding, the insurer cannot turn around and refuse cover.

Dr James: 

And I guess the big thing that’s probably on everybody’s minds now that they’ve just learned that some will be familiar with that and some won’t. Some will have just learned it from listening to you speak just now. How does that affect our premiums? Are the premiums higher?

Dr Ricky: 

Well, you think they’re higher, but actually generally, for most cases, the lower animation thing hang on. Why is that the case? So the interesting part with this is because indemnity insurance is regulated by the FCA. There are certain algorithms, I guess there are ways of determining somebody’s risk and that’s what the underwriters will do behind the scenes. They’ll determine if an individual is a high risk and they’ll charge a premium and that reflects that, of course, membership organizations they yes, they have their own underwriters, I guess, working around the scenes, but they can make their own rules as they go along. They’re not bound by the financial conduct authority. They believe a lot the discretionary MDOs. They aren’t regulated at all, which I think is ironic really, because the whole service they provide is all focused around those that regulate us, the GDC, yet they themselves are not regulated.

Dr James: 

That’s crazy Interesting, and I know that obviously you’re someone who’s put a little bit of research into indemnity and how that works, ever since you and yourself and your situation, and maybe just finding out to your own shock that you weren’t going to be covered. And I’m sure there’s lots of other things like that as well. There’s lots of other things that you wouldn’t necessarily realize or understand about the world of indemnity, because really what we do is we just buy our indemnity, we do some sort of cursory scan, we’ll think, okay, we’ll go with this one, maybe this supplier, and then just assume that we’re covered and assume that we’re sorted. Are there other examples of those sorts of instances, maybe in other areas of the indemnity process?

Dr Ricky: 

So well. I’ve got a couple of examples. Firstly, there’s I’ll give you an example about a dentist that recently reached out to me. He was with an MDO a discretionary MDO and his difficulty situation he was in was he wasn’t covered for an visa line work. Yet he’d been doing a visa line for well a while. Then the MDO decided to turn around and say, yeah, actually you’re going to have to pay a few thousand pounds to get that cover back, dated. Now, he wasn’t aware. He thought he was covered. And yet somebody else myself, years ago, when I was with this company, I was, I was doing a visa line work and that formed part of my normal general dentistry membership, if you like. You know it’s not. There was no extra cover, extra premium to pay. So it’s, you know, it’s like it’s one rule for one another, for whatever that expression is. So that’s just one example. So transparency. The second thing I was going to say was in relation to okay, so you know, we, we all talk about the course of clinical records. You know the legal aspects of it. Of course we all have, whether you’re an associate or a principal. You’re going to have some contracts between dentists. Now, if there’s a dispute, a disagreement and I’m not saying one party is right, another party is wrong. Both could be wrong, both could be right, but there is a dispute. Again, that’s something the indemnity ought to be helping with because, of course, if that’s not addressed, that could lead to further problems, like a GDC complaint, for example. So you know why is it fair that they almost say to you well, look, no, we’re not going to cover you for this, but we’ll cover you for that if it turns into a GDC. Surely by addressing, you know, the root of the problem will could even prevent a GDC. So you know, but there’s no transparency in in and it’s not clear cut as to what’s included. For example, mdos, they’ll give you a certificate. You won’t actually get a breakdown of exactly what you’ve got cover for. It will just be a certificate with some basic wording. Of course, with a regulated, underwritten indemnity insurance policy, that’s very different. You know. It’s very clear what you get. You do get well with us anyway. You get legal cover so that legal cover can extend to not just giving you legal protection for GDC cases or if a patient’s suing you, but it does cover for contractual disputes. You know it extends further for any sort of defamation. There’s this cover. There there’s cover for even tax inquiries. You know, all of that is all part of being a dentist and really the indemnities should be as comprehensive as possible.

Dr James: 

I agree, and you know what. It’s interesting that you said all of that, because really whenever we go for the or, in my experience, I just signed up to the indemnity and that was it, whereas actually there’s all there’s lots of nuance to it that dentists don’t necessarily realize until they listen to a podcast like this or they learn it from some sort of resource. But the thing is there’s just no resource out there that really talks about this stuff, at least in my experience.

Dr Ricky: 

I agree. I agree. The idea is you know, we’re all, we’re all you know. For example, if you’re looking at a course, you know you’re going to study the course, you’re going to potentially reach out to the course leader, you’re going to learn about it before you’re going to make a commitment. Why are people not looking at their indemnity in the same way? You know, ultimately it’s a product slash service that you’re paying for and you know dentists ought to know. Well, let’s look at it this way you take informed consent from a patient, you give them the pros and cons. You know you’re making sure that that consent is valid. It’s fully informed. It should be the same thing with us with any product service that we’re signing up for with an indemnity. Yes, it’s compulsory, we all need to have it, but we also deserve to be fully informed as to our options.

Dr James: 

What could dentists do better in your opinion?

Dr Ricky: 

To be honest, it’s it’s a good question. I mean it’s sort of you know, you don’t know what you don’t know. I guess sort of education you know being being understanding that there are differences out there, knowing what you’re paying for, knowing you have a choice as well and also knowing that, just because some of these companies who have been in your face since dental school, you know aren’t necessarily the most appropriate solution to you and of course you know we talk. The other aspect, of course, is cost, is price, and what you’re paying for there has to be value to it as well. It doesn’t mean cheap is rubbish, because one thing we do is we’re trying to keep our prices as comprehensive, of course, but as cost effective as possible. But ultimately it just boils down to sort of having that education, having that awareness and having that freedom to ask questions and choose.

Dr James: 

Love it. Well, you know what? I see a parallel in the finance world, because it’s some of the big boys, whenever it comes to finance, especially for dentists, that actually get some of the poorest returns in their portfolios and offer services which are not necessarily that diverse or not necessarily that well catered towards the dental community in my opinion. But there’s almost like there’s like a there’s like a herd mentality that because these are the some of the biggest, that we should all just go with them because they’re seen as trusted or they’re seen as the best place to go, just surely because they’ve been around the longest or have the most people there. And it’s often not the case. In fact, it in fact not just often rarely, rarely, yeah, really rarely. It sounds like it’s the same Absolutely.

Dr Ricky: 

Absolutely. I mean, look at it this way. You know we, we were all quick to jump on the bandwagon for a new. You know a new, a new composite injection molding course, or a new end of file, or you know a new course, a new technique of doing dentistry, and it’s no different to your identity, basically.

Dr James: 

True. How many endowment providers are there in the UK?

Dr Ricky: 

Oh, that’s a very good question, so you’ve got answer the rest of the questions.

Dr James: 

I guess that’s probably difficult to answer. To get into specific numbers, but to my mind there’s like three that I’ve heard of.

Dr Ricky: 

So put it this way there are three or four discretionary providers. Those that provide insurance are technically their brokers. So you’ve got put it this way there’s a lot more brokers doing regulated underwritten indemnity insurance policies compared to the companies out there doing discretionary cover.

Dr James: 

Right, I see, so the biggest ones happen to be the discretionary ones. Yeah, but actually in reality there are more out there that are non-discretionary. What was the terminology you just used?

Dr Ricky: 

Non-discretionary or underwritten insurance.

Dr James: 

Right, so the majority are. It’s just that their names are not as out there, right, right? Oh, interesting, okay, and how many of them are there just off the top of your head? Are we talking like 10, 20, 30, 50? Okay?

Dr Ricky: 

Over 10. Over 10.

Dr James: 

I see, Okay, Cool, so obviously you’ve met dentistry in similar situations through going through what you’ve been through. If you had to have a checklist of things that you could just take off for the dentists who are listening today, a checklist of things that they could do to make their indemnity more robust, to ensure that all the T’s are crossed and the I’s are dotted whenever it comes to this stuff, what would this be? And even a top three maybe, if you find that easier. Doesn’t have to be a three.

Dr Ricky: 

I mean, look, I would say, just think about what you need and what you want as well from your indemnity. Number one you want advice when it comes to patient complaints. Number two you want cover. You know if a patient sues you successfully, you know there’s got to be that element there that you know a payout has to be made and that’s where they’ll kick in. They’re not going to say, oh, we’re not going to pay out. You know it’s got to be legally binding. Of course you want to be defended If you’ve done nothing wrong. That’s the most important part. You want somebody who is, who has your back at all times. You know is not just thinking about their own bank balance, thinking you know what. It’s cheaper if I settle. No, it’s about your reputation and that is well. To be honest, that’s probably the most important part. Of course, then you’ve got to think about you know your work setting and the circumstances around, what you do for a living. If you’re a practice owner, you should have vicarious liability to cover. If you’re an associate, you still need defamation cover, potentially vicarious liability to cover if some associates employ their own nurses, for example. If you’re working at multi sites, have you got multi site cover. Now, of course, all of this stems from my experiences of things that I wished I had, and some of these things I did have. I didn’t have all of them, you didn’t have all of them.

Dr James: 

And you wish if you could go back, those would be the things that you would change.

Dr Ricky: 

Yeah, absolutely, absolutely.

Dr James: 

You know what that is flipping beautiful, and I understand as well as that, Ricky, that through empowering yourself through all of this knowledge, you also help dentists when it comes to their indemnity.

Dr Ricky: 

I do. I do so I started an organization called the dental defense league and essentially it’s its indemnity different. You know, it’s the things that I wish I had. And I started this really purely because first I was looking for something out there that suited my needs. Quickly realized there wasn’t actually anything there that ticked all that boxes, but theoretically I knew it would be possible. So, and that’s why I formed the dental defense league, I wanted to help other dentists with their indemnities. So what we do is you know we’re not people aren’t joining a club, they’re not membership you know I’m acting as a broker. Well, I am a broker in a way. You know I’m finding them indemnity policies that suits their own individual requirements for their practice, for whether they’re an associate, practice owner, whatever, and essentially giving them a comprehensive solution to to their indemnity needs. You know, even I mean it extends further to things like suspension cover in case. Obviously it doesn’t happen very often, unfortunately it happened to me but of course if a dentist gets suspended, that’s it. Their income is, is is put on hold.

Dr James: 

It’s put on hold.

Dr Ricky: 

Yeah, sorry, I think you’re going to face it with a James. Yeah, the income is put on hold. So you know, ultimately it’s it’s well. You know, can’t we protect our registration, our our license, if you like? And there are policies there that provide you with that element of cover that you can get a payout of. Well, it varies depending on the amount you want to cover, but you can get a weekly payout for up to 12 months that will cover you for whether it’s loss of earnings, whether it’s remediation, training, retraining or, you know, paying for a low come, if you’re a practice owner paying for another associate. Whatever it is, there’s cover. You know that covers things like that.

Dr James: 

Wow, there’s a lot of depth to it and, yeah, I mean it. I guess it makes sense. I just never thought about it before, basically. But there you go, there you go. Thank you for sharing wisdom and knowledge today on the podcast, Ricky. If anybody wants to reach out to Ricky, feel free to find him on the group Ricky Rupert, ricky Rupert, ricky Rupert you’ll be able to find them on there and Ricky can help with anything and everything insurance related whenever it comes to our indemnity. Ricky, you’ve been really generous with your time today. Thank you so much, and we’ll catch up with each other really, really, really soon. Thanks, james.