The Absolute Worst Position for A Dental Practice


It’s funny where and when thoughts come into your head. I was hiking into a crater of a volcano when I noticed the tree that you see above. There I was, in the bottom of this crater on top of 400 feet of hardened lava – and I thought of dentistry.

Lonely tree at bottom of volcano crater
Lonely tree at bottom of volcano crater

This tree was pretty much all by itself on essentially barren rock. No nutrients or rainfall to speak of. Doing ‘just fine’.

That little tree reminded me of so many dental practices that I interact with. Doing enough to survive, but never enough to thrive.

Despite the environment, some dental practices are able to survive. Now when I say survive I don’t mean barely stay afloat. These practices provide good jobs for a small team and provide a ‘good’ life for the dentist and his/her family.


What if I told you that tree had been the same size for nearly 20 years? Because it was big enough to survive it never had to make changes to thrive!


‘Just Fine’ is the worst place for a dental practice to be, in my opinion. These practices are at the mercy of any little change tearing everything down.

Let’s take dental insurance, for example. Recently our profession has seen dental benefit companies suddenly drop reimbursement. This slight drop is typically about 25-50% of office profit of many practices. This singular event (out of control of the practice) suddenly wreaks havoc on sustainability.

Let’s say another ‘corporate’ office moves into the area and competes for the same pool of patients. After all in the bottom of a volcano crater there isn’t a plethora of resources. While the established office could likely fight off a startup private office (that little tree to the right of the surviving tree), the newer, larger, deeper pocketed ‘corporate’ office is likely to deal a deadly blow to the surviving practice.

Let’s say the practice faces a drought. The economy of a dental practice is cyclical. Many of many contemporaries tell me this happened in the 1980’s with the bust of oil and gas. My generation first felt this in 2001. Me and most of you reading certainly felt this in 2008. If you don’t continuously grow strong then you are at risk of wilting away from a drought.

Whenever I speak I always start with a slide that says “Create A Disruption”. It’s my sole goal. Without a disruption we can’t make a change. And without this change (with came about due to disruption) we can’t move forward to thriving.

If you find yourself surviving and not thriving – it’s time for a disruption.

This disruption is very different for each person. If you’re anything like me you go through several disruptions that lead to change over the course of your career.

Here’s three pieces of advice that I can pass along.

1. Don’t ever take it for granted. It can all change quite quickly or even worse it can change very slowly leaving your unaware. An abrupt event can usually be overcome. It’s the slow, creeping change around you that leaves you vulnerable.

2. Participate in meaningful dental events. I don’t believe in most state meetings – they are way too behind the times and led by the wrong people, in my opinion. And taking goal focused clinical training by itself isn’t enough. You need to attend dental events. These events are broader meetings that give you the opportunity to see many things at once and get introduced to something you want to explore more.

3. Surround yourself with great people. Nothing is more motivating than hanging out with winners. I once told a young dentist – “I don’t hang out with losers, I hang out with winners.” That holds true in your personal life, your professional life (other dentists), and with your dental team members. People have a tendency to become what they hang around with. Oh and winning isn’t solely financial – i’m talking about all around winners. I have a friend who takes time off who has inspired me to preplan my vacation for the year. I have a friend who is charitable that inspired me to do free dental days. I have friends who do well financially who inspire me to achieve financially.

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