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The Doctor Led Practice

Doctor leadership is often either the last skill to be developed or it is completely ignored.  Dentistry, by its very nature, has created systems to attract academics to its ranks.  Not those who are actually skilled at business or especially adept at dealing with people or even good with their hands.  We had to make the grades to enter Dental school.  Think about how you got here.  Excel at your grades and pass an SAT and you arrive at college.  Finally get your act together and do well in your core classes and pass an entrance exam and you’re a freshman in Dental school.  Fumble through the basics and arrive at clinical only to find out you lack the basic hand skills to perform in a small area.  You graduate by the grace of God, and you find out you are really not prepared to wear the various hats of an owner of a small consumer driven business.  We all have faced the same problems.  We all have fallen short.  The successful in dentistry are those who learn new skills, attract a staff to compensate for our weaknesses, and serve our patients well.  Start your journey knowing the secret to success in Dentistry is a “service” state of mind.

A Wall Street Journal survey showed that CEOs found they were born with only 40% of their leadership abilities.  The remaining 60% was developed through experiences.  You don’t have to reinvent the wheel.  Leadership can be taught and passed on to others.  The first task of a leader is to define: What is reality?  You must decide what is core.  You must cast a vision.  That vision must be measurable and specific.  What is the underlying truth that drives your practice?  It goes even further than a mission statement.  This vision or reality creates the core of your practice, a yardstick by which all of your decisions are measured.  Just as important, what are you making core that is not?  Is having your practice open Monday thru Thursday core?  Of course it’s not.  Is only working 9 to 5 core?  No.  Compassion, caring, service, convenience, and integrity are the basis for reality in a consumer driven small business.   These tenets never change.  Your hours, fees, and services are just systems that change to reflect the demographics of your patients.  Core never changes.  The way you deliver it does.  Take your time and map out these core realities and then communicate them to your staff.  You will notice I did not say: Tell them or write them down on a sign or mission statement.  You have to communicate them to your staff.   Whatever it takes for them to “own” these core realities is job number one.  Remember:  You will never go any further than the staff member with the lowest level of commitment to that vision.  If the vision is not clear, no strategy will work and it will be impossible to prioritize correctly.

The proper sequence is:

  1. Vision:  You must be able to see it clearly and translate that to ownership by the staff.
  2. Strategy:  What will it take to get there?  Let the staff have input.
  3. Priority:  How to make it happen?  Use the insight of your staff to help you eliminate blind spots in your planning.

Preserving core and stimulating progress through change is the second skill of a dental leader.  In the business of dentistry the only constant is change.  I can truly say that the technology, materials, and systems of my practice never stay the same.  They respond to new science, technology and market pressures.  Never get used to the status quo.  When you’re done with change, you’re done.

The staff won’t be motivated or committed unless the doctor is.  When something needs to be fixed, fix it.  This includes “freeing up some one’s future”.  Every day we make emotional deposits and withdrawals with our staff. The trouble is that the individual staff member is the only one who knows what the balance is.   Show up late and leave early, fail to compliment a good job or correct problems and you are destined to a mediocre practice at best.  In over 30 years of practice I was always the first to arrive and the last to leave.  I never asked my staff to do something I wouldn’t do.  At the end of the day I helped suck cleaner through the vacuum lines and take out the trash.  We all pitched in to finish the job that was begun that day.  What you must do is model what you want done.  Few leaders are successful unless a lot of people want them to be.  Every successful practice exists due to the assistance of many other people.  Conversely, many people whose success stops at some point are in that position because they have cut themselves off from everyone who has helped them.  They view themselves as the sole source of their achievements.  As they become more self-centered and isolated, they lose their creativity and ability to succeed.  Continually acknowledge your staff’s contributions, and focus on appreciating and thanking others and the conditions will always grow to support your increasing success.  You will never get ahead until your staff is behind you.

Don’t miss what is really important:  People.  Whether it’s your staff or patients, your ability to understand and lead them controls your ultimate success.  Consensus building is paramount. The final task of a leader is to say “thank you”.  Sandwiched between you casting a vision and saying thank you is a commitment to your patients and staff of “service”.  Get a service state of mind and the money will come.

A leader can give up everything but the final responsibility.  As the owner of a practice and a practice management group I can tell you that if a practice is having problems, it is always the doctor’s fault.  By omission or commission, doing something or putting it off, you are to blame.  There are three practice management laws that you must learn and commit to memory.  I call them Dental Truths:

  1. There is no way to get better at giving patients what they don’t want.  If you are not growing, you are not meeting your patient’s needs.  Regardless of the excuses about wrong location, poor demographic, economic downturn, poor staff, or low dental IQ, there is someone a couple of blocks from you doing great.  Stop blaming outside influences for your lack of success.   There are successful practices in virtually every small and large town and city.  In Dentistry there are two types of practices:  The Donor practice and the Recipient practice.  The Donor practice drives patients away by not embracing the challenges of a consumer driven business.  They are not convenient, caring, or compassionate.  They are the best referral source the busy practice down the street has.  The Recipient practice is the one who works consumer hours, treats the patient right, listens to patients and gives them what they want while telling them what they need, and finding ways to help them afford it.  If you don’t know a Donor Practice, it is you.  It is very difficult to lay this out for an existing practice.  They argue they are doing everything right and still not growing.  The goal for any consultant is to hold a mirror up to your practice so you can truly see what is wrong.  If you accept a limiting belief long enough, it becomes truth for you.  Be careful what you accept as truth in your practices.  If it is not what you want, change it.  There are 3 letters that will guarantee your success. They are N-O-W.  When is the right time to market? NOW.  When should I make some practice management changes?  NOW.  When is the best time to reread that book?  NOW.  Henry Ford said it best:  “You can’t build a reputation on what you are going to do.”  Start today.
  2. Your systems are precisely designed to give you the results you’re getting.  Keep doing what you’re doing and you will keep getting what you’re getting.  If you want more, be more.  Change is the only constant.  With change, come choices.   You need to be committed to change.  Tony Robbins describes the meaning of CANI by emphasizing the need for a lifetime commitment to “continued and never-ending improvement”.  The strength of your systems will ultimately determine the range of patients you can inspire.  These systems are not static.  They will constantly evolve.
  3. You must precede your practice to the next level of productivity.  When you received your dental license it meant you were just barely not dangerous.  That dental license is just a learner’s permit.  A commitment to a lifetime of learning is the track that will guarantee success.  Productivity doesn’t have anything to do with technology, and clinical skills alone will not take your practice to the next level.  It takes leadership and a team approach to reach that next level.  When you are at work, be at work doing dentistry.  Productivity starts in the mind of the dentist and is then communicated to the team.  Enthusiasm comes from the top.  Model the actions you want your staff to have.  Efficiency comes thru training and delegating to the maximum extent allowed in your state.  Focus your learning for maximum effect.  If you want to go to the next level, you will have to make a new commitment.  If you want more, you must be more.    You are exactly where you want to be.  Otherwise you would change.  Forget the excuses and start taking action.

Allow me to close “dental leadership” with 6 lessons to grow by.


  1. Know your stuff.
  2. Declare your vision.
  3. Maintain absolute integrity.
  4. Show uncommon commitment.
  5. Expect positive results.  Turn disadvantages into advantages.  Hidden within every disadvantage or obstacle lies an equally powerful opportunity.
  6. Some 10 years ago I read an article on the truth about life.  While the author’s name escapes me the truth lingers on.
    1. There will be lessons in life.
    2. There are no mistakes – only lessons.
    3. A lesson is repeated until it is learned.
    4. If you don’t learn the easy lessons, they get harder.  Pain will get your attention.

You don’t have to reinvent the wheel.  Learn from my mistakes and the hard earned lessons of a mentor.



Michael Abernathy, DDS

[email protected]