Relocating to Trinidad as a dentist – the challenges and the rewards
Shenilee Hazell talks about her decision to relocate to her place of birth, Trinidad, and the challenges she faced setting up a dental practice.
The end that started it all
Three years ago to the month, I made the most rewarding, life-changing decision. After calling the UK my home for twenty years, I decided to move to the Caribbean, to my place of birth, Trinidad. I gave my very comfortable mixed NHS/private London dental clinic three months notice and started prepping for an adventure which I now know I grossly underestimated.
Everyone thought I was crazy. After all, here I was saying farewell to somewhere most saw as a ‘place of opportunity’ for me, instead to run headfirst into the unknown. What I intrinsically knew though was that ‘place of opportunity’ actually meant ‘comfort zone’.
As an associate general dentist in the same clinic for more than eight years , I had put my heart and soul into building a great reputation. I established great patient relationships and was always very booked up. Despite this, I felt myself slipping into autopilot.
Somehow, there was boredom lingering within me. Well, that would soon evaporate completely! In October 2017, I packed my belongings and headed south to a new adventure, leaving my London life behind to work in a place called St James, a district in the capital city of Port of Spain.
Nothing worth having ever comes easy, and this has certainly been my experience.
Practising in the UK for well over ten years, I got used to what I now appreciate were luxuries. Access to great dental materials (with next day delivery) at reasonable costs is no longer par for the course. I also realised I could not prescribe things like fluoride toothpaste because it was not on the list of approved pharmaceuticals in Trinidad and Tobago. How would I treat my high risk caries patients?
What I mostly missed was the supportive network of dental colleagues. I miss the unity within the profession of dentistry.
My first registration meeting with Trinidad’s dental council would set a very unsettling tone for what to expect within the present dental culture. I was left with the impression that the philosophy of ‘drill, fill and charge the patient’ was commonplace. While there are many wonderful dentists in the country who do not subscribe to this mantra, there are many who do. And one dentist who does, is one too many.
I asked for protocols, published rules (as in the UK with the General Dental Council) and any additional information pertinent to my perspective practice. There was nothing in place.
Adapting and changing
Since dentists are “self-regulated” in Trinidad, the regulatory body (the dental council) is made up of other dentists, people who are in direct competition with each other. I also grew to learn that in the council, patients rarely complain about dentists. It is dentists who complain about other dentists.
My experience as a dentist revealed that one of the major reasons that prevents patients from seeking care is anxiety. Most commonly due to a lack of knowledge and access to information..
I found the culture of educating patients on treatment options was not the norm. Patients show up, tell you their problem and expect you to fix it. Co-diagnosis – a concept where patients are actively involved in treatment decisions based on us, the dental professionals educating them – was just not commonplace.
I decided I wanted to change things – I wanted to educate. I wrote eight articles in one of our national newspapers on dental health. They were packed with all the research I had gathered. A sense of pride filled me, and I really felt the content would help patients.
You can imagine how gutted I was when my educational efforts with regard to my newspaper articles were met with negativity from my dental peers.
You see, there is an archaic law that exists which disallows dentists from advertising. This law incidentally used to be present in the UK but has now been updated. The concept is that when a dentist advertises it does not create a level playing field for all dentists. This creates a divide between dentists who want change and dentists who don’t want a change. The people who don’t want change are the older, more established dentists.
A social media presence needs to critically conform to strict informational existence. Having always used social media to connect and educate, my online presence became a negative talking point within the dental community. Other dentists found specific faults with my presence online. They made official complaints that criticised me for sharing my patient testimonials, my prices and available services. These are things I thought would help improve people’s access to dental care. Here, dentists are supposed to be discrete.
Things here were strikingly different from the UK. I felt that this may be an opportunity to be involved in a change of the dynamic in Trinidad
The process and reward
After working for just over a year as an associate dentist I felt that many of the changes that I wanted to see could not be achieved if I were to remain working for someone else. I saw a gap in the industry and got to work filling it – pun intended.
I never dreamt of owning my own clinic. Ever.
I started this journey to bring better dental care to my patients and opened the door to mountains of work and responsibility. Cue adulting mode! Leases to sign, business loans to apply for, registration processes to battle through, staff to interview, hire and train, and so much more. I began planning, investing, and also hired a business coach. While I had been practising dentistry for more than a decade, being a business woman was new to me .
Tapping into my network of friends and family, I started gathering opinions. For six months I worked eighteen-hour days and still found the time to reminisce about the ease I had left behind in London.
I sought the counsel of my uncle who had run a successful doctors’ hub with multiple medical disciplines called “Doctors Inn”. After venting my week-to-week challenges to him and soaking in any encouragement and guidance he offered, I went on to name my clinic Smile Inn Dental (pun intended). My mission was simple. To leave everyone I encountered smiling and give them a patient-centred experience, which was like no other.
If I can impart guidance to anyone it’s this: you can do it! Ignore the noise and follow your heart.
The launch and beyond
With Smile Inn, I knew I wanted to provide an exceptional experience. One that might change the face of dentistry in our region. Once I established what I wanted the patient experience to be like, I simply reverse-engineered the process and got to work. I started by setting the bar high. I felt that patients deserve the highest quality of care, equipment, materials , service and overall experience.
Garnering inspiration from Pinterest screenshots, sketches and designs, I wanted the space to emit an aura of zen. I also wanted to incorporate technology in order to have a fully digital workflow to optimise my team and patient experience.
Diving headfirst into a completely new world of responsibility and work was uncomfortable, but fruitful. By capitalising on one of my greatest strengths – being detail oriented – it made the process arduous but completely worth it.
Rewarding beyond belief
My clinic’s launch Day was emotional, busy and rewarding beyond belief. In October of 2019 we opened our doors to ‘SMILE INN’ the dental experience.
Seeing the culmination of two years of hard work come to fruition is an experience words cannot describe. I will always be grateful for the support of my friends and family who all came out to support me on my launch day. As well as my phenomenal staff who truly put their best foot forward.
When building a team it can be hard to transfer one’s passion to staff. But I’m continuously heartened by my team. On weekends when the clinic is closed, I receive messages from them with suggestions of how we could improve things at our clinic. They are always engaged and motivated to improve.
In the months that followed our launch, patients have flowed in and we have organically garnered a loyal patient base.
I’m really proud to bring the first Invisalign Scanner in the Caribbean to Trinidad! But this achievement was indeed a process. Step one – become a professional pest! It took two solid years of emails, phone calls, rejections, roadblocks, more phone calls and continuous problem solving to be victorious in my quest.
The knowledge that this technology would revolutionise the delivery of care to my clients kept me going.
My Invisalign scanner was delivered the same week that Smile Inn opened. Our territory manager from Invisalign even flew to Trinidad to make sure we were set up.
Due to my persistence I was also able to open the door for others in Trinidad to purchase the Invisalign scanner.
I’m so proud that Smile Inn has grown from strength to strength. In June of 2020, we opened the doors to our second location.
Despite the challenges, I have embraced the love and support from my patients, my team and my army of friends, pedalling forward.
I’ve learnt that keeping a focused mindset is essential, as well as accepting that the pathway is never simple. I encourage anyone to reflect on your part in the world of dentistry and raise the bar .
There is room for all of us and our ideas to provide better care as dentists.