Interview


British Dental Journal 220, 331 - 333 (2016)
Published online: 8 April 2016 | doi:10.1038/sj.bdj.2016.256

Phillip Dowell: 'Effecting behavioural change in patients is terrific'


Professor Phillip Dowell is International College President of the International College of Dentists 2015-2016. Phillip was principal of Witley Dental Practice in Godalming for almost 30 years and has lectured widely in periodontology. In the 1970s he worked in the West Indies then studied periodontology in the USA and in Cardiff. A keen traveller, skier and sailor, Phillip has led dental study tours and in late 2015 sailed 2,700 nautical miles non-stop across the Atlantic Ocean. He is married to Sheila, a consultant in occupational and aviation medicine.

Why did you choose dentistry as a career?

Phillip Dowell: 'Effecting behavioural change in patients is terrific'

I grew up in the small South Wales town of Merthyr Tydfil and the family were very close. My grandmother was the matriarch of the family and she had two daughters and a son. My mother was the eldest daughter; she had myself and my brother. The father of my oldest cousin, from my aunt, was a dental technician who used to slave away in the basement making dentures. He always said if his son (my cousin) Norman was going to be clever enough he could become a dentist. He said it was much better being a dentist than a doctor because there's no on-call, you can make more money, and you can work when you want. So sure enough cousin Norman went to dental school and became a dentist. When it came to my turn, I didn't know what to do – in fact I quite wanted to be a pilot (which I did later become) – but my parents said gosh if you can emulate Norman... So I did, and that's why I became a dentist.

Why did you decide to specialise in periodontology?

I would say I had a passion for oral medicine and all the gum diseases that you can get that are related to other systems in the body. But what I like about periodontology is that it's the most important area of dentistry where you have to effect behavioural change in a patient. You have to get them to clean their teeth properly and understand the health advice and prevention in order to effect any kind of cure for the disease. I really like that as I like talking to patients. You have to spend time telling people what the disease is, how the disease comes, what is the cause, what is their problem, how they should be cleaning and when, etc. All the things that are preventive. Effecting this behavioural change is terrific, and when you see it happen and see the results, it gives you a real high. It's the patient that's doing it, not you the dentist necessarily.

You have to spend time telling people what the disease is, what is the cause, what is their problem...

As a postgraduate in my thirties I found periodontology fascinating and still do.

What was it like working in the West Indies early in your career?

I worked in a private practice in Trinidad for about three years in the 1970s before I got married. I really enjoyed it although understanding the local accent was difficult to begin with. I could have stayed; it was always party time. Nothing was seemingly taken that seriously and I wanted to do perio training and to get back on track academically. When I realised that there were procedures that I needed to improve it made me apply for and be awarded a fellowship at the Eastman Dental Centre in Upstate New York.

Was it while living in Trinidad that you began sailing?

While I was living there I learnt to fly. I used to fly part time for a bank and I used to fly from Trinidad to Tobago and come back and go into the dental office. I got my pilot's licence there. It was interesting because I'd always wanted to fly and this was an ideal opportunity because the Trinidad Dollars you earned couldn't be spent anywhere else, so I spent them on learning to fly.

Then, when I went to the States, I got an American licence followed by a British licence when back in the UK. Learning to fly in the UK is hopeless because of the weather – so often the cloud ceiling is so low you can't see anything and the winds are often strong. You have to wait for a good day.

Flying and sailing are very similar as disciplines with meteorology, navigation, radio telephony etc; after all the sail of a boat is essentially an aerofoil.

How did you establish Witley Dental Practice?

I came back from the States and went to Cardiff to do a research degree, then I got married to Sheila. Sheila was a medical student at Charing Cross so I moved to London. I was still working in the perio department at the dental school of the University of Wales in Cardiff but a friend who I'd known in Trinidad had a tiny one-surgery practice in Witley and he sold it to me. Then it got busier and busier and I bought a larger GP practice on the same lane in 1989 (they were also moving into bigger premises) and made it into a dental practice. I sold the practice three years ago, became an associate part time for a couple of years then moved out.

Witley Dental Practice is just a mile walk from home in Milford but I always drove as I played squash at lunchtime. A 40 minute game of squash, a quick shower then I jumped back in the car so the first patient after lunch always saw this red-faced, slightly dripping dentist.

Has it been difficult to combine being principal at a general practice with lecturing, writing, travelling and family life?

For the first seven years we were married I worked seven days a week really. I only took a week's holiday a year to go skiing. The older I got and the more established I got I would take more holiday. But I would be flying in from somewhere in the morning then book patients in for the afternoon. I was crazy like that. I was like 'I must go into the practice, I must see what's happening'. It was juggling really.

How long have you been involved with the International College of Dentists (ICD)?

I was asked 21 years ago and I almost can't remember who asked me. Someone said to me (in the UK) there is this great organisation, would you like me to propose you, and I said 'yes, sure. Sounds good to me.'

The ICD is a very high end organisation and in the States it's incredibly well known and highly thought of. I was in Washington in November and as President I inducted over 300 new fellows and I shook hands with them. I had repetitive strain injury! In April I'm going to China and last year I inducted 50 new Chinese fellows. All the fellows in China (up to 300 now and they only recently joined) are academics. Not one single practitioner. In the UK there are between 70 and 80 members. We haven't been as proactive as we should have been but I have been doing my best to get the word out. The trouble is you can't ask to join. You have to be invited.

What are your main goals for your year as International President of the ICD?

To foster internationalism. I recently said in my speech to members that all nations need to talk in order to get agreement on all sorts of issues. We have got 15 sections in the college; sometimes the sections are called autonomous sections, but the word 'autonomy' kind of means self-governing. They're not really self-governing because there has to be a central thread of governance coming through from the top down through the Executive of the College. My goals are to change the governance structure to make it more fit for purpose for the twenty-first century, to promote internationalism and to encourage people to go to other sections. The American section has about 6,000 fellows. How many of those fellows have ever gone to a meeting abroad?

Wherever I go around the world I've contacted someone from the ICD. When I was leading study tours I would take a group of British dentists to visit the local dental school in Vienna, for example, and learn about the way they do their training, their methods for provision of care, rates of disease, and so on, and use the experience for CPD. All of this was facilitated by my connections with ICD.

The ICD wants growth in order to generate income from the dues so that we can do all the things that we need to do in order to push the College forwards.

Before becoming International President, I was the first European President of the ICD for 20-odd years and it's a really fabulous honour to be able to say I was international president of such a great organisation.

Did you create the Fellow Inspires Fellow (FIF) initiative?

Phillip Dowell: 'Effecting behavioural change in patients is terrific'

Philip with the rest of the crew on the Atlantic crossing in 2015

I took part in the Atlantic Crossing to make money for the ICD's Global Visionary Fund (GVF), of which I chair: the philanthropic arm of the college. The thing about philanthropy is that the fund only becomes sustainable once it reaches a certain amount of capital. These days with interest rates being so low you need a pretty high capital in order to make much interest. So FIF is to get more and more money for the GVF, our educational and humanitarian aid foundation for the whole of the College. The Atlantic Crossing generated close to $7,500 from donations. It's not massive but if everybody does their little bit, it helps. So if you're planning to climb Kilimanjaro or run a marathon, say that you're doing it for the GVF. Whatever the challenge is, say that it's for the FIF and make some money for the Fund.

Money from the GVF goes towards initiatives for people who apply for grants. We have a committee of people experienced in public health that assess and approve grant applications.

Last year Henry Schein gave us $100,000 worth of materials and equipment to be given over three years. We don't have enough funds in the GVF to give money because we're trying to grow it to a sustainable level at the moment, but we do have materials and equipment. So, for example, we've just sent a veloscope machine to India where they're studying pre-cancerous lesions because in India oral cancer is a huge problem with betel nut chewing and so on.

Phillip Dowell: 'Effecting behavioural change in patients is terrific'

Philip with his wife Sheila

Another thing the ICD is involved with is the Dental Safety Programme (DSP), through collaboration with the Organisation for Safety, Asepsis and Prevention (OSAP). We go out to third world and underserved communities and spread the word about best practice and how to, for example, sterilise instruments even if you don't have the right equipment. We've also collaborated with an organisation on antibiotic stewardship in the fight against antibiotic resistance and presented this recently in India.

How can BDJ readers get involved with the ICD?

All you have to do is go into the ICD website. www.icd-europe.com; worldwide www.icd.org. I would say that if you know a fellow or want to get to know a fellow or get in touch with one – if you have the right criteria you can be sponsored. You don't have to have a PhD or fellowship or whatever, it could be that you're a general practitioner but you do a lot of work in the community such as help the aged or help people with problems, anything like that. Anybody that has done something – been a treasurer or a secretary of something, president of a local BDA branch, anybody who wants to be involved – to give time to the sense of collegiality you get from an international organisation and the sense of being able to meet and greet people from all over the world. It's very easy to stay in your own little bit of the world and just do your own little bit, home, practice, practice, home, and the occasional event outside, but it's good to try to take a wider view of things.

There are going to be more regular meetings in the UK. There's not a great onus of responsibility on you when you become a fellow but you do have to take a fellowship pledge. There's a dinner every year, usually in London (January this year, in Knightsbridge), one international meeting a year in Europe – this year in Milan. Find out more on the website.

You need to have been qualified for 5-10 years only so that you can say you've done something and become established after training. Fellows tend not to be someone in the early part of their career with a young family and perhaps unable to easily travel. It's not written in stone but it's more something you would join towards middle age, but saying that, the College definitely needs more young fellows.

What are you plans when your ICD presidency comes to an end?

I will become the Immediate Past President and I will stay on the council for another couple of years or so.

I think I said to somebody, I feel that what I'm doing now is more important than what I've done over the last 40 years because over the 40 years I've had some wonderful patients and one-on-ones and so on, but when you have a position where you can affect the lives of thousands of people it's really inspiring. I've got too much I want to still give to go and play golf or sail all day.

Interview by Kate Quinlan


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