Jay and Rupa Patel and their daughter Vidhi talk to Marie Staunton about practising in Camberwell
Dentistry is in crisis. Its worst for 75 years, according to the Nuffield Trust. But all is calm in the Patels’ practice at 6 Camberwell Church Street. Mr and Mrs P, as they are known locally, sit by their first-floor window looking into the heart of Camberwell. In the way of settled couples, they finish each other’s sentences, reminiscing about building the practice and looking forward to the return of their dentist daughter Vidhi from Australia. But slowly the strains of modern-day dentistry become clear. “The first time I came to Camberwell in 1991 it was intimidating. I wanted to climb into my little yellow Nissan and go back to Beckenham,” says Mrs P. “It has always been somewhere where people can dress differently and express themselves. And now it is a cool foodie place where my son comes to eat. Doesn’t he, Mr P?” Jay agrees. He remembers worrying as rival gang members, Brixton Yardies and Peckham Boys, eyed each other in the waiting room. Until one explained that they would not cause any trouble because “Mr Patel is a gentleman and always carries Mum’s bag up the stairs.” The parents of both of them came to the UK from India via Kenya. Mr P remembers arriving to freezing snow at Heathrow in shorts, aged six. As children both Mr and Mrs P worked in their family’s shops. Keen to escape, both qualified as dentists, she at Barts, he at Liverpool. When Mrs P returned from backpacking around the world, her parents suggested it was time to get married. She was introduced to Mr P through an intermediary, according to the traditional “system” used by their family. Couples were matched for four dates at the end of which they decided to get married or break up. In 1991 the same intermediary, Mr Amin, suggested the newly married couple buy his son’s practice in Camberwell. At that time, it was common to sedate patients before treatment. But the widespread use of methadone, recreational drugs and alcohol in Camberwell made the practice unsafe and, the Patels decided, unethical. So started Mrs P’s interest in non-chemical means of dealing with phobic patients, empathy, getting to know the whole patient, not just the mouth. She trained as a counsellor and they built the practice on well-being principles. The Patels take NHS and private patients. They are a diverse group: a Chinese woman with gum disease succeeded in the dentist’s chair by a Kurd insisting on tooth extraction without anaesthetic, the CEO of a US global brand followed by a Ribena sipping child with high levels of tooth decay. Mr P relishes the mix. Suburban private practice would seem “beige”. But local NHS practices are closing. Fear of complaints and stress is sending dentists to part time work in private practice. In the 1990s the Patels had their pick of newly qualified dentists; their last vacancy took 19 months to fill. Mr P trained new graduates for 28 years but stopped when the profession’s fear of litigation meant that form filling was taking longer than treatment. Supervision became a box ticking exercise. NHS list of treatments is shrinking, causing conflict with patients who cannot get the care they want for a £70 NHS fee. The Patels were part of a ten-year pilot where they were paid per patient, like GPs. Clinically it was successful. The dentist gave patients the best treatment, teeth improved, repeat visits reduced. But fewer repeat visits meant fewer patient fees to the NHS so the scheme was stopped. The Patels tried to dissuade their daughter Vidhi from joining the profession which has high levels of suicide, alcoholism, and stress related diseases. By zoom from Sydney, Vidhi explains why she ignored their advice: “Unlike GPs as a dentist you not only diagnose but carry out treatment, often working within nought point three of a millimetre. It requires intense focus, but is completely absorbing, almost meditative.” The day we met, Mrs P had won the trust of a 60-year-old man and given him his first treatment for 45 years. Mr P had stopped a patient’s pain from a broken tooth and received a massive hug. And Vidhi is coming home in September. Practice is easier in Australia, there is no NHS and everyone expects to pay, she says. But she prefers the ethos of the Camberwell practice: “Being ethical, being kind, caring for patients and being good to your community and to the people you work with.
Dentists who treat the whole person
