Interviews

Dr Irfan Qureshi rising to new heights in Implant Dentistry – terms doctor-patient relations `most sacred'

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By Our Special Correspondent

Prominent Implantologist Dr Irfan Qureshi, who is popularly known as ‘IQ’, has a passion for implant surgery and endeavouring hard to excel at it.

“I am trying to break into the international circuit. It is very hard to get into the cutting edge technology that the world is getting into to practice dentistry. But I try and do my best to keep up with the ever-changing technology,” Irfan Qureshi told Dental News in an exclusive interview.

Dr Qureshi who did his BDS from Baqai Dental College, received master’s degree in Prosthodontics from Kings College London and a Diploma in Implant Dentistry from Royal College of Surgeons Edinburgh, was more interested towards Implant Dentistry and that lead him to be the first candidate from Pakistan to attempt the examination of Diplomate in Implant Dentistry. It was followed by his appointment as the examiner of Royal College of Surgeons.

In 2014, he attended the GDIA world symposium in Prague where his case presentation bagged third prize although there were entries from China, Iran, Spain and USA.

In May 2016, he went to Turkey for the PlanMed Implant Education Group where he took part in a poster competition, winning 3rd prize again. There were in 52 entries from around the world.

Talking about his other achievements at international forums, he said that he was invited to Japan by the Pacific Rim Implant Forum, a group of 83 members who invite one international speaker every year. “This year I was invited from Pakistan to speak at their conference which was a huge honour for me to represent Pakistan,” he said with a sense of pride.

“Every time I speak at international forums, I tell them about my country, about our Father of the Nation Quaid-e-Azam Muhammad Ali Jinnah and share the vision for Pakistan. I also tell them that Pakistanis are voted the 3rd best looking men in the world.”

“Every opportunity that I get, I try to project a positive image of Pakistan.

“In 2013, I went to Romania to speak at a conference. Somehow I was not able to apply for the visa for Romania, however immigration rules of Romania says that if you have a visit visa for the UK or the USA, one may visit Romania as a transit passenger. When I was at the immigration desk, the immigration officer asked why I want to go to Paris from Zurich through Romania and not directly, so I explained that I was invited to attend a conference at Romania. The immigration officer took the matter to his boss, which to my surprise approved it. He informed me that the reason he is letting me in is because of his respect for Pakistanis.

The officer told me that his mother was Turkish and in the Turkish earthquake, it was Pakistani army troops who pulled out her mother from the rubble. And they have a lot of respect for Pakistanis and Quaid-e-Azam Muhammad Ali Jinnah, Dr Qureshi said, adding they also have a lot respect for our former President Pervez Musharraf, who is also my patient and my idol, as well. He lived in Turkey as a child and speaks fluent Turkish. So he is very popular there.

“As a matter of fact, I always try and be an ambassador for Pakistan, wherever I go,” he added with a sense of pride.

At the outset of his interview, Dr Qureshi said that his philosophy of life is to try and be the best in whatever I do, be it sports, art, banking or dentistry. My interest was in Implant Dentistry and I try and give my best to the profession. My greatest reward is when I am referred to the patients as one of the best in Implant Dentistry. It is easier said than done that “I want to be the best”, but it entails a struggling journey behind it. Qualification and efforts are needed, but when the matter comes to being the healthcare management, ethics play a huge role in the profession. The relationship between the doctor and the patient is very sacred, whereby the patient hands over itself to the doctor. So the element of trust is important in our field.

The following are excerpts from the conversation with Dr Irfan Qureshi.

Dental News: Why did you choose to become a dentist?

Irfan Qureshi: I wanted to get into an art school, and joined National College of Arts to become an artist. My father wanted me to become a doctor, but we finally agreed on dentistry. I did not like dental school in the beginning as it was very monotonous for me and I found myself as a misfit. In the first two years of my dental school I was having a very hard time coping up, however, in the 3rd year, I finally realized that Dentistry was the profession I’ve chosen and that’s what I should focus to excel upon.

My teachers were a source of inspiration and eventually they were instrumental towards what I am today.

DN: What prompted you to do your BDS in Karachi?

IQ: I did my high schooling in Lahore and once you settle in Lahore, it is very difficult to relocate to another place. I tried my best not to join a Dental or a Medical School, but since I got admitted here, I tried and gave my best to the profession.

DN: In your opinion, how Oral Health relates to the Health of general overall body?

IQ: See, there are much senior fellows of ours in the Pakistani Dental Industry who can definitely explain better about the correlation of entire human body with oral Health. However, the Ilm-e-Tib says, to use the Miswaaq to avoid the heart problems, and several hundred years later, the medical science discovered that the prevalence of heart disease was evident in patients of periodontal diseases. Even the latest Medical Science now uses the assessment of Oral Health to diagnose various diseases of the human body.

Besides, maintenance of Oral Health is also very pivotal to avoid diseases like AIDS, hepatitis, so definitely there is a correlation between the Oral Health and the General Health of human body.

DN: What is your opinion on implementing the Biosafety Protocols at a Dental Practice?

IQ: A dentist needs to be most careful about cross infections control. Dentists happen to be one of the commonest modes of transmission of AIDS and hepatitis. Patients who are aware about this are very conscious about these matters and they do enquire. So, we make sure at my practice that our patients are transparently told about our cross infection control methodologies, our equipment used for sterilization, how we disinfect clinic after every patient and we make sure that our patients know all to ensure that all these concerns are taken care of. The people who I work with at my clinic are constantly encouraged that they should know the biosafety protocols so as to ensure no cross infection takes place. For me this is all part of ethics. The quality of work you produce, the commitment you have to your profession and patient, it is very important that it is honoured as this a very sacred relation.

It has been more than a year since I’ve opened this clinic, despite even today; everything is being maintained as good as new. People who visit my clinic often mention that they find it to be very hygienic, clean and organized. It’s not just me, but it is a team who I work with.

Mentioning the implementation of biosafety protocols, he said that after a patient is treated, the instruments are contaminated; the dental chair is contaminated, so we have to make sure that we disinfect, de-contaminate and sterilize everything, which takes more time. This means I see lesser patients every day because we have to ensure that no cross infection takes place at the clinic.

In our field, cleanliness and sterilization plays a very important part. Even in my clinic, we stay focused round-the-clock to ensure an sterile environment as the patient does not know so we have to ensure that the environment is sterile for the patient and there is no cross infection taking place.

This has also been seen that some practitioners put in the instruments in boiling water and then claim that the instruments have been sterilized. What sterilization is, cross infection control this is something in my opinion must be known to every medical practitioner and a lot of emphasis should be laid on it. The patient trusts the doctor and we must ensure that no foul play is in effect.

DN: What is your opinion on the malpractices in dentistry?

IQ: We were just talking about ethics, one aspect of ethics is cleanliness, hygiene and sterilization, the other aspect is malpractice. Obviously tooth is part of the body and just because it is your mouth and you have 32 of them, it doesn’t mean you extract one and replace it with an artificial one. The tooth is restorable and if it can be salvaged, it must be salvaged. People think that in implant dentistry there is a lot of money involved. I am not going to comment on whether it is right or wrong, but I will state what I do. I have a team with me as one person cannot do everything. I have been doing implants for many years and now I have the requisite qualification to validate my skill, I think I have some experience in implants. I do my own procedures for restoring the teeth but I may not be the expert in it. If I believe a tooth cannot be restored, I have restorative consultant who works with me who I consult and I take her opinion. If I or my restorative consultant feels that we need to refer the patient to another more experienced restorative consultant, we do that and we explain it to the patient. We educate the patient about the treatment that needs to be done, we explain what procedures are involved. It is imperative that your patient understand it complete to be able to take an informed decision.

Sometime a patient might say yes to restore the teeth instead, but the life of the tooth may be limited, the patient does not opt for having an implant done which is more durable. But you have to be transparent with the patient with the pros and cons, which is our ethical obligation. Yes, this happens that some doctors place implants even when the tooth is restorable.

I don’t think patients come to me because I am qualified, but because they trust me. I would never want to breach or betray their trust. At the very least, we should know how to identify whether a tooth is restorable or otherwise.

DN: Will you please tell us about FIDP?

IQ: In 2011, I got tied up with ICOI, which is a Congress of Oral Implantologists. They have around 30,000 members around the world. I became the first Diplomate from Pakistan after taking their exam. In 2011, they had a world congress in Seoul, South Korea.  At the congress there was a young oral Implantologists’ competition, it was an oral presentation. There were many people from all around the world. My presentation got the 3rd prize. Then we decided that we should have a conference in Pakistan on similar pattern. So I came back and spoke to some of my colleagues. Especially, Dr Saqib Rashid, who’s my mentor, my elder brother, he became Patron of the Group and I became the FIDP’s president.

My personal contacts were also very instrumental in getting the conference done. I am lucky to have friends all over the world which was a good starting point. The first conference in 2012, in which Dental News was also a partner, at the DHA Golf Club, we had about 400 participants. Every speaker was international. We had speakers from California, Jordan, Palestine, Germany and South Korea. I believe this was the first time in Pakistan that a conference purely on implant dentistry was done. I feel like an ambassador for Pakistan, and they came to Pakistan despite the security concerns. We were published at the front page of Dental Tribune International and got a massive exposure and response.

The second FIDP was in 2014 two years later. We did it on a bigger scale. We had proper arrangement to conduct the conference. Hashim Hasan from Dental news was very helpful in the execution of the conference. We had invited a famous Maxilofacial Surgeon Dr Aldo Vicari from Venezuella. With no Paksitani embassy in Venezuella, it was very difficult to get Dr Vicari a visa. The way Hashim saheb helped us was very instrumental and we had put in a lot of joint efforts to get the conference done. FIDP is very close to my heart and I would soon like to see another conference happening.

ICOI website states the FIDP as the Affiliate of the ICOI. They also have me mentioned as the Ambassador to Pakistan, which is a big honour for me.

DN: What would like to say about the education system in Pakistan of dentistry?

IQ: I am not going to say that we don’t have a high standard of education in Pakistan. There are people who want to do good work and my request to the authorities is to assist them and let them do good work. The problems Pakistan faces as a Nation are similar to what a dentists faces as a professional or as an occupation in Pakistan. For example, an individual being bigger than the system is a problem.

Or compromised ethics in imparting education is a problem. I believe now that I am 37-year-old, I think differently and I quote Maulana Rumi “Yesterday I was clever, so I wanted to change the world. Today I am wise, so I am changing myself.”

The problem is we keep on trying to change the system. The change is never going to take place if we don’t change ourselves. The change in the system needs to be resonated through us. It is my philosophy that I can’t change any one but myself, and may be if I have changed myself, the other person may get inspired and follow the steps. It is the same with the education system and I am sure it can be improved.

Everybody wants to make money and that’s fine, but there has to be a balance. Education is being run like a business, which to a certain extent I suppose is a requirement, but you can’t forget the principle what the education is based upon.

I believe there is always room for improvement, but the message to everyone is, I may not be able to improve you, but I can improve myself. So the change and improvement needs to come from within and when the change is resonated to the population at large that is when you’ll see a true change.

DN: We have a problem finding the right faculty, do you agree with this?

IQ: There is no simple way forward to this. In this day and age, we have our own lives to run. Faculty depends upon good salary. If a good salary is given out, inducting qualified and experienced faculty is no problem at all. For example, a dentist spends 5-6 years in doing FCPS and after that he gets paid at PKR 100k a month, which may not be justified for the work and efforts he or she has put in the qualification. Or, for example, a dentist studies abroad would have spent no less than USD $100K over a period of two years, when they come back, if they are offered perhaps PKR 40k – PKR60K to take up a faculty position, why would they come in the education and not serve as dental practitioner instead.

I believe there is no shortage of good faculty in Pakistan. It is just that they are not being rewarded for their services, accordingly and, thereby, the dentist decides to carry own practice instead of becoming an academician, Dr Qureshi opined.

I am also a part of faculty as an Assistant Professor of Prosthodontics and the Head of the Department at Sir Syed College of Medical Sciences, and I feel I’m treated justly. Because, whatever, they offer satisfies me so I don’t want to move anywhere else. I do get other offers, but I prefer to stay with my college.

The problem is the other way round in Pakistan. There are qualified people in Pakistan who can’t find jobs. It’s not that the colleges can’t find faculty.

September 8, 2016

Dental is part of the Medical News Group of publications which in 1968 became the pioneer of medical journalism in Pakistan. Medical News is the only periodical in Pakistan which has 3 simultaneous editions from Karachi, Islamabad and online.

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