Dr Andrew Greenland: 0:00

Welcome to another episode of Voices in Health and Wellness, where we speak with leaders, clinicians, and change makers who are reshaping what healthcare looks like today. I'm your host, Dr. Andrew Greenland, and today's guest is Dr. Jeffrey Sherer, founder of the Dental Design Studio, a group of 23 dental practices serving communities across the UK. Jeffrey's not only a seasoned clinician and operator, he's also a former director of the Hellingdon Local Dental Committee, contributor to the BDJ and dentistry.co.uk, and a recognized voice in the media, having appeared on BBC Radio and ITV News. So with that, um Jeffrey, welcome to the show and thank you very much for coming on.

Dr Jeffrey Sherer: 0:35

Thanks so much. Thanks for having me. And uh can I just say I I really admire what you're doing and uh it's a pleasure to be speaking with you today.

Dr Andrew Greenland: 0:44

Thank you, and likewise. So maybe we could start with your journey. What inspired you to build a network of practices like the Dental Design Studio?

Dr Jeffrey Sherer: 0:53

Um, sure. So I I was always passionate about dentistry, and it was something that I I always found I didn't want to work for somebody else. I always wanted to be my own person and run dental practices the way I saw would be best. And um I started off quite early on in my career owning a dental practice, and and really I spent the first sort of five years of that developing the dental design studio and our brand and learning not just about things clinically, but also how to run a practice and and put patients first. And that's something that that was really something that I I loved to do, and it meant a lot to me having my own practice. And then after some time, I thought, well, actually, um I've done this successfully with one practice, um, which was a sort of setting, it was a brand new setup. It was what we call a SWAT practice. Basically, there wasn't any patients or infrastructure there. And I thought, well, I could see myself doing this again um with more practices, and and gradually over the years, through sort of acquisitions and um uh winning some competitive procurements, it sort of grew from there. But uh it was always my sort of dream to have my own dental practice because I really just wanted to do things my own way and have my own sort of unique slant on on providing dentistry.

Dr Andrew Greenland: 2:22

Fascinating. And with that, what is it, what is your secret source? What do you do differently that others perhaps don't? And how have you built on that?

Dr Jeffrey Sherer: 2:30

Sure. Um, well, uh look, I don't want to sort of knock anybody else down because there's some amazing dental groups that are out there, and um I'm I'm a fan of them, and I know a lot of the owners of those groups personally. I think that from our perspective, we work really hard, we try really hard, we we do things not just to try and make a difference in our practice, but also at a national level. So, for example, I spend a lot of my time uh working with the local dental committee, which is for lots of benefit of lots of dental practices, and numerous meetings that I've had with MPs, especially in the last couple of years, to explain where I feel changes could be brought into dentistry. Um, and in terms of our own practices, we've we've done a lot of investment in digital dentistry, um, which has allowed us to be able to offer treatment to patients without the need for dental impressions, which is the sort of more sort of old old-fashioned way, if you like, um, and and move to a format that allows us to have a much better environmental impact and also to give a better result to patients as well. And and I think what what's nice about our group as well is that we're not backed by any kind of private equity company, there's no external shareholders. So, and and I myself am a dentist. So when I make decisions for the group, I make it for as a dentist, and I make it with patient focused in mind. And I feel that I'm very accessible as well, so that all the clinicians in our group know me. Everyone has my phone number, my WhatsApp. And when people need help or support, they've got a problem, um, they have they feel that they have access to that. So I think those are some of the things that have made us um a little different and and successful in in dentistry. And and just constant striving. Myself and my team, we work tirelessly every day um trying to make it better. We never ever sit back on our laurels and think how wonderful we are or what we've achieved. We're always trying to make improvements and do things for the embedment of our staff, our patients, and our practices and the country's dental care as a whole.

Dr Andrew Greenland: 4:58

I really do like that um ethos that you have about constant care and improvement. What have you learned as your role has shifted from being a hands-on clinician to overseeing 23 locations? What are your biggest kind of learnings and taking away takeaways from doing that kind of scale?

Dr Jeffrey Sherer: 5:12

Sure. Um certainly it's a completely different skill set. I mean, when you're a doctor or a dentist, you're very focused on the individual treatments that you're doing for your patients. Um, what I've what I've learned is so many other things in terms of like HR, about building regulations, care quality commission, um, a lot of things about generally running a business as well. I mean, I don't come from a finance background. Um, I didn't know what EBITDA meant. I didn't know much about sort of um the recruitment from overseas and visa sponsorship. So I think for me the biggest thing is just it's just been constant learning and having to become, if you like, a mini-expert at a lot of sub-subjects and topics which traditionally you wouldn't consider or expect as a dentist. I mean, finding out about how to take someone who's living in a different country and provide them with a visa sponsorship so they can come and work as a dentist in in the UK is something that is not taught to us at university like that. Um, producing a balance sheet for a bank because we want to borrow some money to buy another practice is not something we learn at university. So I think the biggest challenge really for me is just um sort of upskilling myself and learning a lot of business skills and general sort of compliance things that are very different to the sort of clinical work that I studied at university for.

Dr Andrew Greenland: 6:52

Yeah, so don't teach you anything like there's a business medical school, dental school, and probably a lot of the other healthcare and training institutions kind of have to learn it on the job, I guess. Um, so what does a typical day look like for you at the moment? And I dare say there is no such thing as a typical day, but with all of these hats that you wear, how do you kind of structure your time?

Dr Jeffrey Sherer: 7:09

Um sure. Well, I I I'm I'm definitely an early starter. I'm normally I normally get up at about between about half three or four a.m. Um so my my day starts with that a cup of coffee, and I I review um all the days performance from the previous day, um, catch up with all the sort of urgent tasks that I that I have. I like to make an early start in the morning so that I feel that um I'm on top of everything when that when the rest of the world wakes up and starts. Um I like to spend a little bit of time learning about current affairs in the morning and see what's happening in in the world, um, just so I keep abreast of the wider world and don't become too sort of completely narrowly focused on on the business of dentistry. Um a lot of times I'll spend dealing with recruitment, um, so new um new new individuals joining us, um, looking at potential acquisitions. Um as you probably know yourself, Andrew, there's a lot of admin that goes with NHS uh provision. So I'm constantly filling in data requests for data from patients we've seen, um the feedback on pilot schemes that we've taken part in, um, all the sort of submission of all the transmission of NHF's claims for patients that we've treated. So a huge amount of sort of uh data work. Um I have a regular meeting uh most days with my senior leadership team where we address any sort of uh major issues that are presenting or or on the horizon. Um, meeting with my my finance director as well to see how we're doing and any areas of questions about that. And really, what I'll I'll try and do is spend some time as well um providing coaching or mentoring for some of our clinicians in the group as well. So there's not a day that goes by that I won't spend some time with some of our clinicians just helping them to improve or answering any queries. Um, and also a big part of what I do, which is probably not the nicest part, is dealing with some of the complaints that we receive as well. Um, and that that can sometimes be quite time consuming because obviously I have to investigate it and then provide a response as well. And the more practices you have, the more people you see, the more clinicians you have working as part of your group, unfortunately, the more complaints that that arise really like that. And I think in the in the sort of post-COVID era that we're in now, people are a little less um uh sort of uh kind to each other at times, and people are quite um quick to voice their their unhappiness or disapproval with something as it as it happens.

Dr Andrew Greenland: 10:13

Thank you. Um obviously a lot of what you've mentioned is sort of quite managerial, operational, business related, but how do you sort of stay connected to patient care and community needs whilst you're managing um 23 practices?

Dr Jeffrey Sherer: 10:25

Um sure. So I still do some clinical work myself as well, so I haven't completely sort of uh stepped away from the coal face. I I I go in regularly to the dental practices and and see some of my long standing patients. Um, I also provide cover as well for some when some of our dentists are away in certain practices. I'll travel to the practice and cover all the emergencies that are there. And and I really like to do that because I think um dentistry is very close to me. I spent a really long time studying it, and it's a shame to sort of allow myself to completely de-skill. And also by visiting the practices and seeing the patients, it also helps me to see um the quality control that's happening in the practice, speak to all the team, have a look at how well the equipment's being uh maintained. And uh I still feel that I've got a lot to offer clinically as well because I've I I graduated 25 years ago. So in that time, I've I've built up a lot of experience clinically, and and that's for the benefit of the of the patients. And and actually what's quite a quite a funny thing is sometimes I when I I sometimes cover one-one sessions basically, where we see emergency patients that been that don't have a dentist that have been referred to us, and they come in and see me, and I've never seen them, they've never seen me, and I'm treating them, and it's like the the the sort of owner and founder of the whole group is providing them treatment at that appointment, and they have they have no clue who I who I am. And I'm not trying to make it out that I'm some big big shot. I definitely don't feel like that or consider myself like that, but it's like you wouldn't in most businesses you wouldn't get like the sort of founder, chief executive sort of dealing with it. You know, you wouldn't get Jeff Bezos packaging up your Amazon order in the warehouse and sending it there. So it's quite a nice feeling, really, like that, because it it um it just sort of shows that you you're never too too big to do the job, and also um hopefully those patients that I do see get um get good quality care from me as well.

Dr Andrew Greenland: 12:44

So you're kind of working undercover when you do that work.

Dr Jeffrey Sherer: 12:47

So it's like undercover boss, really.

Dr Andrew Greenland: 12:51

Exactly. Um, you mentioned earlier on that you manage to grow and scale without having to use private equity money. And I know roll-ups and that kind of structure and um process is quite rife in dentistry. Do you see any pitfalls with that kind of um scaling with private equity and that kind of model?

Dr Jeffrey Sherer: 13:09

Um I I think what happens is you do lose um quite a lot of control with that. I mean, look, it's no secret, we have been approached by private equity companies before, looking to sort of develop a buy and build. I think for me, what it is is I I like to do things my way. And at the moment, I have a lot of uh freedom um in decision making in terms of uh buying practices, not buying practices, investing in the practices that we have. And I suppose when you move into that model of having a private equity uh partner, you do have to have a completely different shift in in mindset because it's no longer totally your business. You have got these strategic partners, and you have to take on board their sort of wishes and desires, and the fact that their main focus is is to try and make a return on the money that they invest. So for them, they're totally data-driven, they're totally finance driven because ultimately that's what they do. Sometimes in dentistry, and sometimes in in my group, and and I'm sure in a lot of other dental groups as well, we do things and we make decisions that are not always the most financially right decisions, but they're right for our patients or they're right for our practices because at the end of the day, um, I see it as a bigger thing than just sort of pounds and pens like that there. So I might go and buy a piece of equipment that that won't necessarily make us any money, but it makes the patient have a more comfortable experience and it makes life easier for the clinician. So financially, it might not be a good move in pounds and pens sort of uh perspective, but it's the right thing to do in that practice, in that situation, and in that scenario there. And I love having that freedom of being able to do that and not being able to not having to sort of justify things to an external um group like that there. But I do realize it is difficult if you are a like a private company because dental practices are expensive to buy, you know, you can easily be looking at paying north of a million pounds to buy a practice, and a lot of people just don't have those resources, and they need um they need that in order to to um to continue their their journey like that there.

Dr Andrew Greenland: 15:42

Thank you. So moving on, you on a previous um chat you shared a story of your hypertension screening pilots that ended up engaging hundreds of patients. Can you walk us through how that started and what the outcomes have been so far?

Dr Jeffrey Sherer: 15:54

Um yeah, that that was a really uh lovely thing, and and it's something I'm extremely proud of that we were part of that there. Um so basically, we were we were approached by the uh ICB, the integrated care board for for two areas in Lincolnshire and Yorkshire and Humber, about taking part in a in a hypertension pilot, which would basically involve us um taking blood pressures for patients that attended the practice. And the idea of it was to identify people who um were um suffering from hypertension, but it was undiagnosed. And so it's a it was a massive sort of um uh public health exercise, really, to see whether we could identify patients who maybe don't visit their GP regularly at all, but come to the dentist much more regularly. Um, so we did so we started that program, we ran it for um six months in about six of our practices. Um over that time, we we took the blood pressure of many, many hundreds of patients, and uh a proportion of those patients, probably in the region of about uh two or three percent of those patients, we identified that they had um significantly raised uh blood pressure, and those patients were then either uh put on a seven-day uh blood pressuring blood pressure program or referred to their GP for further investigation. So we didn't make the diagnosis ourselves, but we signposted the patients um to their GP. And what it really demonstrated how um sort of how holistic work can can take place in dental practice and how in healthcare settings you can do so much more than just um filling teeth or doing dentures or so like that. So it was really a great thing to be part of. There was some challenges with it because initially patients were quite sort of um a bit sort of wondering, well, why are we doing this? Are they allowed to have it with us when they haven't checked with their GP? Was there a you know, where are we going to charge them for uh for it? It was completely free of charge for them. So there was a little bit of uh educational work uh to do in terms of getting patients on board. But it was also lovely for our team as well, because a lot of the blood pressure readings were taken by dental nurses, and that was something that was a great upskilling for them. They learnt a lot from it, and it really made us feel like we were um helping people more than just with dentistry, but helping the whole person rather than just the the mouth. And and as you know, there's lots of links between um gum disease and cardiovascular um health, and so it was really, really great to be able to offer that program.

Dr Andrew Greenland: 18:52

I mean, why do you think dental practices are a good point of entry for broader health screening?

Dr Jeffrey Sherer: 18:58

Sure, I mean it's funny with hypertension because a lot of people are quite nervous when they go to the dentist, so it's probably there was probably some readings that were elevated that maybe wouldn't have been elevated in different settings. But I mean, we do see a um a really large amount of the population on a regular basis. I mean, to put it in some numbers, since we opened the dental design studio 20 years ago, we've treated over a million patients. So that's a huge population of people that are coming through the practice regularly who maybe don't see the GP or they maybe feel fine. So it is a great opportunity within dental practices to provide screening for other healthcare um uh matters in a in an environment that is a is a hygienic medical premises, a premises that has to maintain good levels of cross-infection control that's registered registered with the care quality commission. So it's a it's a great. Healthcare setting, but it's a setting where patients come regularly, so we have that that the wonderful opportunity to do so much more for people.

Dr Andrew Greenland: 20:13

I think you also mentioned the growing focus on diet and obesity, especially in um ethnic groups and children. How are you bringing those conversations into the dental setting?

Dr Jeffrey Sherer: 20:22

Yeah, so it's obviously like that's never an easy conversation to have with patients like that. You do have to be a bit tactful when you speak to people about weight and obesity, especially in a dental practice setting, because the last thing we want to do is upset or offend anybody there. But because of the fact that diet is such a big factor in in tooth decay, um, it does naturally lend itself to being able to have discussions about um diet and obesity with with patients. And more recently, we have been taking part in some programs which um have allowed us to sort of learn more about the effects of obesity and dental health. And we've been training um some of our team to have those conversations with patients who are sort of um showing signs of or are obese, especially children who, by having um being obese at a very early age, can lead to a lot of uh comorbidities later in life. So again, it's another sort of area that dental practices can have a really big role in in helping to prevent disease. And these are things that further down the line have a massive cost implication to the NHS and healthcare delivery. So by having these early interventions that we can provide do go a long way to help preventing uh disease.

Dr Andrew Greenland: 21:54

So thinking about your whole operation, your 23 practices, what's working particularly well for you in the model right now? What are you most proud of?

Dr Jeffrey Sherer: 22:03

Um, one of the things that I find that that gives me a lot of pleasure is seeing the development of individuals. Um, so we have um taken on a lot of apprentices who have sometimes have been school leavers, uh people from other careers, and they've joined us as apprentice, dental nurses, and through working with us and the apprenticeship program of gaining their qualification. I love to see people get their qualifications because I know it's something that they then have for the rest of their life, and you can't sort of take it away from them. So that's something that makes me really proud. Uh the other thing that that uh one of one of my really proud moments is just and this probably is this probably sounds a bit sort of egotistical, and I and I but I honestly don't mean it like that. But um the dental design studio, which is something that I came up with in my head sort of 25 years ago. Um, this year we were mentioned positively in the House of Commons three times by three different MPs who came to visit our practices there. And sort of it to sort of see yourself that you started something from scratch and you put so much time and energy to see it being sort of um uh talked about positively by MPs in the House of Commons is is something for me that makes me feel like that what we have done has made a lot of difference to society and to our patients there. So these are things and and and obviously the growth of the group as as well. Um for me it's it's not um about sort of finances. I mean, obviously everyone needs money to live, and and that's that's of course a factor, but I just like to see things grow and I like to see um us having more practices, and every time we take on another practice, it's like having another child. And uh so I'm extremely proud of all of them, and some of them at certain times act well and are very good, and at some times some of them act badly and are very bad. Um, but but I love them all, and I'm extremely proud of what we've achieved in in dentistry, and I feel that there's a the job's not done, there's a long way to go, and there's a lot more that can be achieved as well.

Dr Andrew Greenland: 24:25

Well, congratulations on your parliamentary recognition. Um, on the other side of the coin, what's perhaps um more um a frustrating thing to have to deal with or complexities, or are there any particular challenges that you're having to work through at the moment in what you do?

Dr Jeffrey Sherer: 24:38

Um sure, yeah. So certainly uh recruitment in dentistry is can be quite challenging, especially for practices that are in more rural areas. Uh, a lot of the young dentists now who are qualifying uh want to work in big cities because of the lifestyle that it gives, as opposed to sort of more rural, quieter locations. So encouraging people to work at those places can be can be challenging. I think also in dentistry, the the the younger generation, and when I say that, it always makes always makes me sound extremely old, but the younger generation of dentists are more focused or want to be more focused on provision of private dentistry as opposed to NHS dentistry. So it can be difficult. I mean, um we have we offer NHS dentistry in in almost all of our practices, and more and more dentists are are not wanting to work within the NHS dental system and work privately. So that that is a challenge in itself. And sometimes um the government does things that are really um challenging that make our job harder as well. So one of the things, for example, was Brexit. So that happening made life difficult for us because of the fact that suddenly dentists from Europe, and there was a lot of dentists from Greece and Spain and Portugal that were coming over to the UK regularly to work as dentists, had to go through a visa sponsorship system, which which added a lot of extra cost and complexity. Um, and and uh obviously during COVID, that was an extremely challenging time for dental practices because we couldn't see patients as much as we wanted to, and there was a lot of um sort of protocols that we had to follow to ensure that people weren't getting infected, um, both staff and patients. So there has certainly been some challenges. You know, I won't say it's all brilliant all of the time. There's some days that I go through the day and I feel like I've been in a really tough boxing match. You know, I uh you get beaten up a bit because things go wrong and you sort of put your head in your hands, but then the next day something really good happens and you think, Well, that's that's made it all worth it, like that. Uh there, you know, if somebody you might have a day where the computer system's not working properly and one of our good dentists resigns, and you think, Wow, I'm really under the kosh here. And then the next day we get um somebody applying to join one of our practices who's a really good dentist, and we're very thankful to have them. And then that that that makes us feel really happy, or the NHS come to us and say, Would you be happy to take on an extra thousand checkups per year? And uh, you know, that that makes a big difference for that particular practice and those patients. So there's highs and lows, as with anything, but we always approach it in the same way, which is we try our hardest and we have a smile on our face, and certainly I'm absolutely thankful for every day, and I absolutely love the fact that we're doing what we're doing. And what I always say to my team and and and anyone who I speak to is that one of the brilliant things about the industry is that we're helping people and we're making a living as well, and I think that's a really great thing because we're doing something positive and and we're earning a living from doing that. There's a lot of jobs that people do that don't really make a positive difference to society. Okay, it might provide them an income and pays the bills, but it it's not really for the public good. So to do something that is for the public good and helps you to um support yourself and your family is is a is an absolute uh blessing and a privilege.

Dr Andrew Greenland: 28:40

Thank you. If you had a magic wand and you could fix one thing in your business tomorrow, what would that be?

Dr Jeffrey Sherer: 28:46

Um I certainly would remove some of the uh the red tape and some of the regulations that we have. Um, I know that some of these things are there designed as sort of safeguarding and help and and and supposedly to make things better, but there are things in in dentistry um that that do hinder us, certainly. Um for it just as a very brief example, when we have uh dentists who qualify from overseas that join us, they have to have a period of of mentorship before they're allowed to work sort of fully licensed, if you like. And that um that can be challenging because these are dentists that can work privately without any restrictions, but in order to work under the NHS, they have to have a mentor in the workplace, and sometimes that can be difficult in practices where there isn't an available mentor. So, why is it that they can work privately without any restrictions? But in order to deliver NHS dentistry, they have to have all of these conditions on them. Um, there's also um a huge weight for people wanting to pass the overseas registration exam. So these are dentists from other countries outside of the EU who are qualified dentists, very experienced in their country, who want to pass the exam to enable them to work as dentists in the UK. And it's a complete lottery when it comes to spaces being offered for that exam. Um, they only have a limited number of seats per year. Thousands of people apply for it, and only a handful of people get um selected, and that's very frustrating for those individuals who could be working in NHS industry in the UK and solving some of the access uh problems that we have, but they just can't get a place to sit the exam to prove that they can work here.

Dr Andrew Greenland: 30:46

Obviously, your business, you're always looking for um new referrals, new patients. But if you had a sudden influx of new patients next week, um what would happen to any given practice? Would anything break or how would it kind of mop up um a surge in demand?

Dr Jeffrey Sherer: 31:01

Yeah, that is a good good question. And sometimes we do have those sort of situations where we're suddenly offered a lot more activity. Um, so we might get told that we can do an extra 10% this year on our activity, what we would normally be commissioned to do. And that can be difficult because most dental practices will have a limited number of surgeries available and limited number of clinicians. So if that happened on a big scale, it would be difficult. But in in our practices, we do have uh room for that either by opening longer into the evening, not all of our practices are open at weekends, not every single dental chair is utilized six, seven days of the week. Some of our practices we are open seven days a week from eight till eight. Um, but yes, I think most practices, if you suddenly said, okay, you've got 50% more patients joining, um, would would initially struggle with that because it takes time to recruit the clinicians and make sure you've got not only the surgery availability, but you also need dental nurses and reception team to manage that influx as well. Um, we sometimes see examples of that where new practices open in in various places and there's large queues down the the road where people are wanting to join that practice and and they just don't really have the capacity to absorb all of those patients immediately. But yet the demand is is is massive and and make no uh bones about it, there is massive demand. One of our practices where we opened um two years ago now, we put on the website an opportunity for people to register their interest for joining as an NHS patient. Um, and within 24 hours, we had over 2,000 people that had registered their interest there. So there's a phenomenal uh demand for for dental services, especially in some parts of the country, which I suppose, on one hand, as a as a business owner, is a good thing because you want to have customers. Any business will want to have customers because that's what makes the business successful. But it but at the same time, it's also very sad to see that there's a lot of people out there who are just absolutely desperate because they just can't access um basic dental services because there isn't availability for them. Thank you.

Dr Andrew Greenland: 33:35

And if you were starting again today, you're obviously being on quite a journey, would you do anything differently? And is there a risk that you wish you'd taken sooner?

Dr Jeffrey Sherer: 33:43

Um, I often think about that myself, and it it is quite difficult because the reality is that um the lessons I've learned are because of the decisions that I made at various times. So I don't think I would do a lot of things differently, to be fair. I think that what I would probably do is be a little bit kinder to myself in the respect that uh I do put a lot of pressure on myself to achieve and perform and to make things work as well as possible. And and sometimes I probably should have uh allowed myself to have a holiday or or a bit of a break or not work at weekends or not work late into the night. So I think I would probably be a bit kinder to myself if I did it again. But at the same time, you know, your journey is what makes you, and um I think that I'm I'm very thankful for everything that I've achieved and done, and um I hope that we we continue doing what we're doing. And certainly I've worked with some incredible people, and I'm very thankful for those relationships that I've had with the people that I've that I've worked with, some incredibly hardworking people that that have helped me. It's not certainly not something I've done on on my own.

Dr Andrew Greenland: 35:05

And finally, what are your goals for Dental Design Studio over the next 12 months? What's on the cards for you and the the business?

Dr Jeffrey Sherer: 35:12

Um, so we've got some um acquisitions, we've got some more practices that we are looking to onboard in 2026. Um, so that's certainly something that that we're very excited about. Um, in one of our practices, we're relocating to a much bigger premises as well, um, which I think is going to provide an incredible um center for patients. And also um there's some really big changes uh coming about for NHS dentistry starting in April 2026, which I think will give patients better access to urgent dental care. And so we're excited to be part of that and and learn about that and get involved. And I think my biggest sort of goal is to carry on doing the good work that we're doing, make the business bigger with more dental practices, but at the same time maintaining the standards and the quality in care that we are offering at the moment. The real challenge, obviously, as you get bigger, is that you lose some control over the quality of the service that you offer. And I'm really determined that that that won't be the case.

Dr Andrew Greenland: 36:22

Jeffrey, this has been such a wide ranging and thoughtful conversation. I think a lot of people don't expect to hear about hypertension pilots and preventative medicine from a dentist. So this has been really refreshing. Thank you so much for your time. It's been a real pleasure to have you on the show.

Dr Jeffrey Sherer: 36:35

Perfect, thanks so much.