Dr Tiv Nirmalann B.D.Sc (Melb)

Dr Tiv Nirmalann B.D.Sc (Melb)

What purchase of $100 or less has most positively impacted in your life? (Feel free to give specific brands/models).

The purchase I made that most positively impacted my life was a ticket to the Dental Student Convention in Melbourne many years ago. You see, when I graduated I was working in the rural town of Warragul (how I got there is another story in itself). I loved what I did, I loved being a dentist and helping people and was quite fascinated that my boss was paying me good money to do something I would have done for free. I loved it so much that I wouldn’t even take a holiday. I was always at work, not the first to arrive but I would be the last to leave. I would tail my boss and absorb everything he had to say.

After about 2 years, my boss was concerned that I was going to burn out, so he forced a 2 week break on me. I am not the greatest at organising holidays, so the days ticked down to my forced break and I hadn’t organised anything. About a day before my forced break a friend of mine who was still in dental school called me and invited me to attend the dental student’s convention. They were low on numbers and needed some extra attendees to make the funding work. I remember her saying “Look it’s not cheap. Its about $100 but you’ll have fun.” Well, remember that I’d been working for 2 years straight and so was pretty flush with cash so I agreed.

The first event of the convention was a social mixer. Pretty close to a pub crawl. I had to travel in and so came to the event late. Back then, I was pretty taken by the movie “The Matrix” (ok now I’m showing my age) so I had a 2/3 cashmere trench coat on. As was customary for me during dental school, I burst through the pubs double doors and what I saw above the rabble of dentists and dental students and up a flight of stairs was one of the most beautiful girls I had ever seen in my life. I’m not sure what had happened (I’m pretty sure she was standing under a down light) but it was as if she was glowing angelically and was a highlight in my vision while the rest of the pub faded way. I then got mobbed by my friends and other dental students that wanted to know “What real life was like” “if I liked what I did since graduation”, etc etc. I was distracted by all their attention and vowed to meet that girl but started regaling my fascinated audience with my dental tales. I later went to find this girl and say “Hi” but I could not find her anywhere…. she had left. Saddened I left for home.

The next day of the convention was a lecture on dental materials. I was taking the train into the city as normal and was reading a book. This one was called “Think and Grow Rich”. It was talking about a premise remarkably similar to “the Secret”. That if you could genuinely believe your outcome, feel it, see it, then the universe would conspire to make it a reality. Well I wanted to meet that beautiful girl and I figured I had not much to loose so I set about imaging that I’d go to the lecture and that there would be an empty seat next to this beautiful girl. I closed my eyes and felt what it would feel like, what my emotions would be, what sounds I would hear, how my feet would feel in my shoes, and so on. I get to the lecture theatre and low and behold there was an empty seat next to this beautiful girl (later I found out that her friends were hung over and decided last minute to skip the lecture – thanks universe).

Well, the universe had indeed conspired to make my reality come true, so the least thing I could do was go and sit down. I plucked all my courage, cleared my throat, walked up to this beautiful girl and said “Hi, is this seat taken?” Not the greatest pick up line ever, but hey, I was a nerd. Well, we are now married, and it has been one of the best things I have done in my life. So the purchase that more positively impacted my life was that ticket to the Melbourne Dental Students Convention all those years ago.

What is the funniest thing that has happened (to you or witnessed) in your job?

The funniest thing I ever did in dental school was when we were in final year. A group of us gave the first years a lecture on their first day on an extraordinarily complex topic. I think it was “The apical repositioning of a mucoperiosteal flap for the purpose of ferrule effect via crown lengthening periodontal surgery”. I pretended to be the lecturer and we had some of our colleagues pretend to be first years (they hung out with the first years for the day to really infiltrate) so that they could answer really complex questions easily. It freeeeked the pants of the first years. The moral of that lecture (and my final slide before I quickly departed as the dean of the facility was about to walk in to give his introduction speech) was “You are at University now, question everything!”

At work the funniest thing was also pretty disgusting. Sometimes patients will refuse to swallow their own saliva when they are at the dentist. I am not sure why, but it’s a thing. My fellow dentists will attest to this. One day I was working on a patient that needed some work done on a very back tooth. I had to see more clearly and asked her to turn her head towards me. Well, she rotated her head almost 90 degrees and the pool of saliva in her mouth (that she refused to swallow) drained straight out of her mouth and somehow managed to fall right down between the gap of my sock and my shoe. I’m not talking about a little drip, I mean a flow. And by the time I realised and reacted, my sock was drenched in her saliva (kinda still makes me wretch thinking about it now). But I was a professional, I said nothing, kept working while my dental nurse was doing her best to hold back outrageous laugher (she had to leave the room twice) and finished the procedure. After the procedure, I limped into my car, drove home, showered, threw out those socks, put new ones one, changed shoes and got back to work. I was pretty annoyed at the time, but it caused endless laughter at work for weeks.

Favourite guilty pleasure after a stressful day at work?

My guilty pleasure in general revolve around “Ice Magic”. You know, the Cottee’s chocolate ice-cream topping that goes hard when cold. I love the stuff. There is nothing like some Vanilla Connoisseur ice-cream, topped with Ice Magic and then a sprinkling of M&M minis. Yummmm! What? I’m a dentist you say, how can I be eating such sweat things. Well let me tell you something smartypants. I’m doing it for you. I’m doing research so you don’t have to. I’m taking one for the team. That’s my story and I’m sticking to it.

My guilt pleasure of all time has to do with Ice Magic in a special combination for breakfast. It is so decadent and so bad that it’s embarrassing. Unfortunately, the question doesn’t ask about it, so that secret deliciousness is still my secret. You want to know what it is? Well, don’t’ blame me, blame Dr Woof Apparel for not asking the right question 😉

 

How has a failure (or apparent failure) set you up for later success? Do you have a "favourite failure" of yours?

Man, I hate failure. You’re taking to the guy who’s parent told him that they’d disown him if his ENTER score was below 99. But, you know what failure causes? Pain! And pain for some reason makes you hyper alert. Everything comes into focus. There is something about pain that makes you so attuned to your environment and to your situation that you can learn lessons from it. These lessons were always there, but it’s the pain (from failure and rejection) that makes you finally take notice. Sometimes it makes you learn lessons that aren’t really lessons. I teach the students I mentor that they need to be careful when using a sample size of 1 incident to make life changing rules in their lives. That’s how you get to need phycological counselling later. Just because something failed doesn’t mean you should never do it again. Failure and pain are great teachers but be careful that you learn the right lesson, and sometimes the lesson is that there is no lesson to be learnt here.

My favourite failure was when I thought I was a good communicator (and let’s face it, almost everyone thinks they are above average in communication – the statistically irony of that statement haha). I was telling a patient about a procedure, they were nodding and saying the right things. I thought they were on the same page as me. Then they walked out, told the receptionist that they would call to make the appointments and the very next day we got a records request transfer notice to another clinic. I was shocked and thrown totally of guard. What had I done wrong? Why did I think I was in good rapport? Was I really a good communicator? Well, that led me to about $300K worth of training and years of practice in patient and staff communication and on how to become a great leader. My practice ceiling, both in terms of remuneration and scope of practice, exploded to levels I didn’t think were possible. Now I teach and mentor other health professionals that want to communicate with patients and staff (check out www.drtiv.com). I’ve put together my own program that essentially solved the problem that when patients and staff understand what you understand then they will do what you would do. Without this failure, early in my career that shocked me and that I couldn’t reason away (like most of us normally do), I would have continued to think I was good and would have staying with my previous ceiling of practice and remuneration.

If you have a billboard for all other healthcare professionals out there with any message, what would it say? (It can be someone else’s quote: Are there any quotes you think of often or live your life by?)

It’s funny, but almost all my quotes come from movies or TV shows. I love the inspiration that some movies can give you. There is the line from Galaxy Quest that goes “Never give up, never surrender”. I also like the Gattaca quote that goes “Don’t save anything for the swim back”. But my favourite and the one I’d have on my billboard and the one I tell all my staff comes from the movie Rocky Balboa. Now I’m not a Rocky fan but this quote is so meaningful in life, especially if you are going through a tough time. It mimics how Rocky boxes. The quote goes “Let me tell you something you already know. The world ain't all sunshine and rainbows. It's a very mean and nasty place and I don't care how tough you are it will beat you to your knees and keep you there permanently if you let it. You, me, or nobody is gonna hit as hard as life. But it ain't about how hard ya hit. It's about how hard you can get hit and keep moving forward. How much you can take and keep moving forward. That's how winning is done!” It's profound, and also too long for a billboard. So I’d shorten it to “LIFE IS ALL ABOUT TAKING THE HITS AND CONTINUING TO MOVE FORWARD”

What is an unusual habit or (conventionally considered to be) absurd thing that you do/love (may or may not be related to your discipline/practice)?

I have an unusual habit of keeping old nostalgic technology. My beautiful wife puts up with it, but our house it littered with toys and gadgets from the 80s. You see, my parents migrated to Australia when I was 3 years old. They left everything behind to give me a new and better life. They worked factory jobs and we had almost no money. So, I couldn’t really get the coolest toys or very many toys in general for that matter. In fact, I hardly ever asked because I knew they were doing it tough. So now that I’m successful and have some spare dollarydoos I look up old toys from the 80s and buy them – the ones I wanted back then. If they need to be fixed up, even better. R/C toys are my favourite and with my trusty 3D printer and CAD software, I can make most replacement parts.

In the last 5 years, what new belief, behaviour or habit that has most improved your life (may or may not be related to your discipline/practice)?

Well the most profound belief I have come to understand is that we are probably in some kind of simulation, but my beautiful and quite intelligent wife (currently completing her PhD) suggested I stay away from that topic so I that I don’t sound like a crazy freak. If we put that aside, my new belief is that not everyone wants to be helped. Some people like to play the victim role and until they are happy to stop playing that role, no one can help them. I used to have sleepless nights about how the people with the worst conditions wouldn’t get access to them. And then I tried an experiment. I started offering tens of thousands of dollars worth of treatment or education for free or very little money. What I found was that the people that saw themselves as victim would still not help themselves to treatment that would benefit them, or if they did, they did not value it. It was a great relief to my psyche. I truly began to understand that people would value me for me if they wanted to and if they didn’t then it was up to them to figure out how to stop being a victim.

What advice would you give to a smart, driven student? What advice should they ignore?

This is advice I give to everyone that will listen. My first boss gave me this advice and it has worked so well. He said “Forget about the money. Focus on the person.” And it has transformed my career compared to other colleges that didn’t get this advice. Counter intuitively the more you focus on the person you are treating the more money you end up making, but by focusing on the money the less of it you make. It’s a strange fact of life, but very true. What to ignore? I think we all know what to ignore, it’s just hard to do. Ignore all the fancy work you see on Instagram and Facebook. Most of it is total BS and looking at it and comparing yourself to it will create mental health issues that are not healthy. Run your own race. Don’t worry about how pretty other people can make their pictures (the reality is that there is a lot of preparation work to make it look good and a lot of post processing to make it pop). Rather consider these images “ART”, something to admire but not meant to be replicated; much like you can look at Monet’s work but would never consider why you can’t replicate it yourself.

What bad recommendations you hear in your area of expertise that you would want to correct the most?

“Just rip it out doc.” I know that when people say that phrase they really don’t have the understanding of the physiology and mechanics of the mouth. There are consequences of pulling teeth out that will manifest in the long run that people that just “rip them out” just don’t consider. You see, teeth work as a team. Every time you pull a tooth out it’s opposing partner becomes useless. Thus, you have less teeth to chew with and the significant pressure of your bite is now distributed to less teeth. Think of it like a house with load bearing wall. Go to a builder and say “just rip it out!” They’ll look at you like you’re crazy. “What do you mean rip out a load bearing wall!” they’d say “We can’t do that. The other walls will take too much pressure and the whole thing will be a risk of collapsing.” Well that’s what happens to the other teeth in the long run. They also shift, tilt and move and soon are no longer aligned to the correct orientation for biting forces. Normally this means, either not enjoying food when you get older or have to spend a lot of money, time and effort to fix it later. Trust me, and listen to your builder – don’t just rip out things that take load.

In the last 5 years, what have you become better at saying "no" to? What new realizations helped?

I’m not good at saying no. I want to help people and give people everything I have to make their lives easier. However, I’ve found that I’ve had to say “no” to people using my time. I have realised that I don’t have enough time to help everyone and some people are just users that take and take but never want to give. So, I’ve had to limit my access mainly by adding a fee to my mentoring program as I found some students just took up a lot of my time otherwise. I also found that people valued my time more when there was a fee attached to it. I don’t like the idea but like most things in life a few people ruin it for everyone else. I’m still not great at saying “no” and it’s something I’m working on.

When you feel overwhelmed or lost focus temporarily, what do you do? (What questions do you ask yourself to get back on track?)

Wow Dr Woof Apparel, these are great questions! (Note from Dr. Woof: Thanks to the great Tim Ferris!) I teach this to my students. There is only one word you need to change when feeling overwhelmed or you loose focus. I had to learn this the hard way, but I want anyone reading this to learn from my pain rather than to do it themselves. Normally when you are feeling overwhelmed what do you normally ask yourself? I used to ask myself the same thing. I used to ask WHY! Why did this happen to me? Why am I feeling overwhelmed? Why can’t I do this? Why am I not like the others?

Asking “why” does not help get over these feelings. Why you ask? Didn’t I say stop asking why! I’ll indulge you just this once, so you never have to ask it again. Think of your brain like a giant supercomputer. Think of it like “Google”. When you ask why, all you do is dredge up all the information about negativity, about what’s wrong with you and what’s wrong with the world and then your supercomputer brain tries to process all these negative thoughts. This leads to more feelings of being overwhelmed. Is that how you find a solution when you are on Google? Let’s look at an example. Say, you can’t change the battery on your smoke alarm, do you type “Why don’t I know how to change the smoke alarm battery”. No you don’t! If you did you’d get responses like, “because you’ve never done it before”, “you’re an idiot”, “you can’t follow instructions”. Not helpful right! So, don’t do this with your brain either. Rather ask that you’d normally ask when you are on Google. You ask HOW! “How do I change the smoke alarm battery.” BOOM! That’s how you stop feeling overwhelmed. Stop asking why and start asking HOW. HOW do I get out of this situation? HOW do I get better at this? HOW can I never do this again? Replace Why with HOW. Now your supercomputer of a brain will start coming up with solutions to your question of how. Having options and not feeling trapped is the No1 way of not feeling overwhelmed. Step 2 is taking any action – doesn’t matter just take an action. (This kind of reminds me of my Ultimate Success Formula I teach my students). You’ll thank me later. In fact, if you want to thank me, if you ever hear someone talking about me, say something nice – I’d appreciate that.

What is your best or your favourite achievement in your career so far?

My favourite achievement is seeing the growth of my students, employees and clinicians that work for me. I love my profession and I love being able to be the shoulders that others can get a boost from to make their lives easier and more fulfilling. There is a lot of knowledge that I’ve accumulated in my life so far, and one of my superpowers is to be able to distil complex information into easily understandable concepts. I want to pass these concepts on so they don’t get lost and can be approved upon. I am also enormously proud of my YouTube Channel “DrTiv” and that the Australian Dental Association has asked me to be their official dental correspondent.


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Dr Tiv Nirmalann B.D.Sc (Melb)
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Balnarring Dental Centre
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Dr Tiv is a renowned dentist with 17 years of experience and a director of a successful 6 chair dental clinic. A respected voice across dental forums, he has been a dental correspondent for the ADC, chair of the ADA Group R on the Mornington Peninsula and a speaker at many conferences to date.

Dr Tiv believes that practising dentistry and teaching it are two very different skill sets, and he has perfected both over the years. His passion for teaching began while he demonstrated at the University of Melbourne dental school for over four years. Never afraid to hire a new grad, he has always put time into mentoring his dentists and takes pride in seeing them flourish. Over 17 years, he has seen it all and is ready to share his experience through coaching dentists of any level of experience who are ready to grow and improve.

Coaching dentists is one of his true passions, outside of performing ‘hero-dontics’ and saving people’s smiles one tooth at a time. He is approachable, honest and friendly despite his trail record of over-achieving and being one of the best in his field. Busy running many projects, his time is precious and he will only choose to work with a limited number of dentists who share his passion for dentistry and have a willingness to grow, work hard and ready become the most successful dentist they can be.


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