Six years ago, I owned a highly successful dental marketing agency that was growing at a crazy pace, and yet I was patently unhappy. I dreaded Monday mornings. I avoided certain team members who notoriously caused arguments. And when there was a knock at my office door, I was either irritated at the interruption or my heart would sink with anticipated dread at whatever problem would be dumped in my lap. I knew it had to change.
When the student is ready, the teacher will appear.
In the fall of 2014, a local business and leadership coach connected with me on LinkedIn and asked me one simple question: “What frustrates you the most about your business?” It unleashed a litany of complaints and concerns that had been taking up space in my mind, and it immediately made me realize I needed help.
One of the most valuable skills he has taught me is the critical importance of leadership. You might have the best product and the most skilled employees, but without strong leadership your business will not progress. You will be constantly mired in the management of day-to-day chaos, which clouds your ability to see where you need to go.
Marketing + Leadership = ROI
You might be wondering what leadership has to do with marketing. Fair question. Our primary job is to generate new patients for you, but it is also to make sure that you gain the greatest return on investment from every new patient. I started to notice that the results we were getting were inconsistent from practice to practice, despite using similar strategies. Highly successful practices had dynamic leaders who communicated clearly, made decisions quickly, and had happy, empowered teams. Practices who struggled to gain ground from their marketing were led by owners who were never taught how to lead.
My personal mission is to deliver the strongest results and greatest ROI on your dental marketing investment. As such, I decided to interview some of the best leadership consultants in the dental industry to help you turn these obstacles into opportunities. As you read this guide, if you hear a voice in your head saying “finally, somebody understands what I’m dealing with,” I urge you to talk to any of these consultants. The results will be life-changing.
Owner and CEO
Golden Proportions Marketing
Why leadership matters for dentists
“Don’t wish it was easier… wish you were better.”
When it comes to leadership challenges for dentists, that’s the simple advice offered by Kirk Behrendt, CEO and Founder of ACT Dental. Leadership, when it is weak, creates problems for dental practices. When it is strong, it creates opportunities.
“Dentistry is the greatest profession ever,” says Behrendt. “You can have anything you want. Anything you don’t have is a function of your leadership or your thinking. If you’re reading this right now and there’s something you don’t have, it’s not the world that needs to get better, it’s you.”
Genevieve Poppe, CEO of Poppe Practice Management, agrees that the potential of a dental practice is tied directly to leadership, but often unrealized by the dentist.
“Almost every dental practice I go into is wanting to grow, grow, grow, grow,” observes Poppe. “When I look at what they have, there is a ton of opportunity that they’re not even touching. Growing is important and new patients are important, but actually being able to capitalize on the work and energy they’re putting in everyday to patient care is really a missed opportunity in almost every practice. I don’t think that most dental owners or teams correlate a lack of leadership competency to those results.”
Why don't dentists prioritize leadership skills?
“I think that dentists, as skilled as they are in their trade, are not good at connecting the dots between their lack of management and leadership skills to their lack of results in their business,” explains Poppe. “Many of them wish they were better managers or that they could be better leaders. I think it would feel more important to them if they understood that it directly correlates with their results and their success in a really significant way.”
“Leadership is the missing piece in dentistry,” says Dee Dee Reid, of Amplified Dynamics. “When a dentist wants more knowledge, they typically lean toward clinical skills. That’s great, but until you have worked on yourself, it’s just noise.”
Behrendt also thinks that analytical-minded dentists struggle to grasp leadership because it can be difficult to quantify.
“This is an industry largely embraced by people who are scientists,” says Behrendt. “They need the data, they need the thinking, they need the rationale behind ‘if I do this, then that.’ Leadership is a hard thing to measure. It’s often subjective, and because of that it makes it one of the lowest things on the totem pole that people work on. But I will tell you, if you get your arms around it, you’ll see it gives you the biggest ROI, and also the biggest happiness.”
Reid adds, “They are so busy with patient care that they don’t take the time to work on the practice versus working in the practice. We have an 80/20 rule. 80 percent of your time should be spent on patient care and 20 percent working on the practice.”
The tell-tale signs of poor leadership in a dental office
“We start every new client by getting a full picture of the health of their practice. We’ll often hear statements like “I just can’t find any good people,” or “I feel like I’m constantly putting out fires” when a practice is not growing. The impact of a lack of strong leadership in a dental practice is easily seen but the root cause is rarely understood,” says Xaña Winans, CEO of Golden Proportions Marketing. These are just a few common signs she sees in a practice that is struggling to find its leader.
- Frequent team turnover
- Cliques and in-fighting amongst team members or departments
- A long to-do list that never seems to make progress
- Constant shifting of priorities
- Short tempers and outbursts
- Team members constantly coming to you to solve simple problems
- Stagnant financial and new patient growth
- Doctors or Practice Managers who micromanage every employee or project
- A history of numerous practice consultants or marketing companies who just “didn’t deliver.”
The negative effects of poor leadership may go unnoticed, be ignored, or be blamed on other factors. But Poppe says that “Sunday night dread” is a common red flag that it’s time for a leadership change in a dental office.
“Sunday night dread is why we have so many people who call in sick on Mondays. I know doctors who are sick on Mondays, I know team members who are sick on Mondays, and it’s very often a result of that Sunday night dread. You have to resolve to do something different in your practice and be responsible for making a change that eliminates that. If you’re the leader or the owner feeling that way, most certainly your team is feeling the same way. I don’t think anybody sets out to start a business where everybody hates going to work,” says Poppe.
Katherine Eitel Belt, Founder and CEO of LionSpeak, is also acutely aware of the toxic effects weak leadership has on team members.
“There’s a huge level of siloing, where people are in little pods and they talk a lot about things but nothing ever really happens or changes. They’re stuck. That’s one thing. The other is there is either a complete aversion to having rich, meaningful conversations that move the marker forward, or they attack. They’re destructive, their conversations are brutal, there’s a lot of passive aggressiveness. Either way is dysfunctional, whether they avoid it or whether they attack it,” explains Belt.
Belt also feels that it’s not the way a dentist leads a practice, but the results that really matter.
“I don’t think there’s one way to lead, I think there are a lot of right ways,” continues Belt. “The question is, are you getting the results you want, do you have the team you want, do you have the level of maturity, the level of accountability, the level of output and outcomes, do you have a work environment that you really enjoy, and do people handle their own issues?”
The benefits of strong leadership in a dental practice
Just as poor leadership can hold a practice back, strong leadership can propel it forward. Leadership training is an investment of both time and money, but the returns are significant and long lasting. Winans says she commonly sees these outcomes in well-led practices.
- Consistent, predictable practice growth
- Increased profits
- Less time spent in the office and more time spent with family and friends
- Team engagement and passion for your mission
- A feeling of peace, wellness and happiness that is felt by the team and patients
- Efficient team meetings with clear objectives and outcomes
- Increased patient retention
Perhaps the most significant effect is team happiness and retention. Dr. David Striegel, founder of Striegel Performance Coaching, sees a direct correlation between leadership and team stability.
“A doctor being a more effective leader directly impacts team retention,” says Striegel. “There’s been a lot of research as to why people stay in jobs. Among the top reasons are growth opportunity and connection. If you don’t have either one of those, then you’re much more likely to have a retention problem. You’re going to have a revolving door.”
There’s little doubt that a happier team and a more positive office environment that come from better leadership also result in a better patient experience.
“The leadership of the practice determines the success of the practice,” says Dr. Mark Montgomery of Amplified Dynamics. “And the success of the practice determines the quality of care to the patients.”
“You can feel it,” observes Behrendt. “You can hear laughter in the office, you just feel differently when you’re in the presence of a great leader. You know that people care, because that’s a value that’s held very high. So when you say what’s the effect of leadership on patient care, it starts with everything. You hear it in the phone call. You hear it in hygiene. You see it in the aesthetic results. Its ripple effect is tremendous, not often seen by the dentist right away, but it’s felt and experienced by everybody, including the patient.”
For dentists who feel that continuing growth is important, leadership can be the greatest catalyst to learning for their team and innovation for their office.
“Every single coach that I have says the same thing,” shares Behrendt. “The better the leader, the healthier the team, the faster the result. Every single time, without question, the thing that slows us down is a lack of leadership or just a lack of willingness to be open and learn and grow and be vulnerable as you continue to grow.”
Poppe feels the same way about the growth potential of teams that work together.
“Teams that are nimble and talk about changes when they see opportunities are more fun to work on and they have a totally different outcome than practices that just do things the same all day, every day.”
How poor leadership undermines the effectiveness of dental marketing
One of the most overlooked, and costliest, expenses of poor leadership is ineffective marketing. Finding new leads and attracting them to a dental practice is a task that is often best handled by a marketing partner. Converting them to actual new patients and retaining them, however, depends on the dental practice. And leadership touches every aspect of that.
Winans says, “It’s easy to blame the marketing agency for not delivering enough new patients or a poor ROI. You might also blame the front desk for not converting those calls into appointments. Then, you can blame the hygiene team for hurting retention by not setting the next recare appointment. Or, you can go stand in front of the mirror and realize that every result you get in your practice is a direct reflection of your leadership.”
Even if they are partnering with a marketing agency that is willing to tell them what to do, Behrendt feels that dentists still need to take a leadership mentality when it comes to guiding the strategic marketing process.
“You can find great companies to bring your marketing to life, to support you, to do all the wiring, but you, my friend, are the chief marketing officer,” says Behrendt. “You’re the one with the vision. You’re the one that makes it happen. You’re the one that makes people feel the way that they do and you have a team of people that support you and buy into that vision. Otherwise you’re just throwing money at the wall.”
Taking reins of marketing also means stepping up and making sure that your marketing agency hears your voice and knows your concerns.
“It’s important for doctors to have ownership of what they want from their marketing. If you want a strategic approach that brings in high quality new patients, don’t go to a cookie-cutter marketing company who pitches the same formula to every practice. Be involved in the process and speak up to ensure you get the outcome you’re looking for,” says Winans.
Even with a well-planned marketing strategy in place, things can still fall apart if the leader fails to clearly communicate the plan to the team.
“Often, their team doesn’t even understand the purpose of marketing or sometimes what is taking place in their office,” notes Poppe. “There can be a huge lack of communication around what’s being done for marketing, what’s the intent of marketing, what we’re actually trying to attract or accomplish with marketing, and our own efforts to convert those leads.”
Winans believes that one of the most important leadership skills is accountability. “It’s human nature to want to blame someone else for poor results, instead of slowing down to see if the problem is something you should own, and ultimately be able to impact. For example, if the team says they are getting a lot of poor leads, an untrained leader will just accept the team’s statement at face value. A strong leader will sit together with their team and listen to the call recordings to see how to improve their approach. The simple act of reviewing those calls together lets your team know that you are invested in their success. That’s true accountability.”
The toughest leadership challenges dentists face
The first step to self-improvement is realizing and admitting that you have a problem. That can be tough for some dentists to face, since many don’t have an accurate perception of their own leadership skills.
“If I really want to know what kind of leader you are, I’m not going to ask you. I’m going to ask the people you’re supposedly leading,” jokes Striegel.
But humility is essential in order to grow as a leader. Dentists shouldn’t feel shame in getting guidance from leadership coaches.
Striegel advises, “Don’t be afraid to ask for help and acknowledge that you don’t have all the answers. Even the best performers, the people who are best at whatever they do in the world, they all ask for help.”
It can be easier to open their eyes as to whether or not they need that help if they consider how well they deal with specific types of leadership challenges.
Behrendt feels that the inability to delegate responsibilities to others in the office is one of the biggest things holding dentists back.
“If dentists learn how to delegate,” states Behrendt, “they grow people around them and they free up hundreds and hundreds (if not thousands) of days of their lives. They get to be more productive, they get to be more happy, and then everybody else is happy.
But that may be difficult for practice owners who feel that they are the best person to perform the task at hand. Behrendt offers a different perspective they can take.
“The key is understanding you suck at a lot of things, but you’re really good at a few,” according to Behrendt. “Spend your life doing the few things that you’re really good at and learn how to effectively delegate. Like Dan Sullivan said in his book Who Not How, stop asking yourself ‘how do I do this?’ Instead ask yourself ‘who can do this?’”
Striegel sees the fear of making a wrong choice as being the primary roadblock to decision making for dentists.
Striegel explains, “When dentists get to the point where they have to make a decision, the desire to be perfect, the desire to avoid being wrong gets in the way of making a decision. I think with experience you realize you don’t have to be perfect. It’s better to be committed and partially right than uncommitted and perfect.”
That indecisiveness can lead dentists into a “decision by committee” approach, trying to reach an agreement by the entire team. But Behrendt says that it is collaboration, not consensus, that they should be seeking.
“You’re not looking for consensus. Consensus is deadly,” states Behrendt. “Collaboration is different. Collaboration is ‘I have decided as a leader this is where I want to go.’ Then you ask everyone to buy in or weigh in. You never ask for everyone’s approval before you make a decision. Remember no one has risked as much as you to build this business. It’s your business. You can’t do that. Deciding has to be done quickly, effectively.”
Fear of Change
Making leadership changes is often perceived as difficult or too much work. That can be more of a challenge than dentists are willing to take on.
Poppe says, “Really being committed to changing your organization and doing things a new way or different way requires a belief in the results on the other side of it and a willingness to push through some hard stuff in the middle. Not everybody will do that.”
Many dentists will lower their own expectations to compensate for their leadership weaknesses. But Poppe encourages dentists to not give up so easily.
“When they started their business, they had a vision for how it would be,” notes Poppe. “They had an idea of what the practice would be like. Almost every person I know that bought a business had an idea of what they ultimately wanted it to be. Almost every dentist I work with is quite a way away from that, and they feel like they can’t get there, and that maybe they have to adjust that dream. Maybe they do, but probably not. They probably just have to embrace the idea that they need to change some things about themselves and then they can have it. It just takes some brave steps and then it’s totally worth doing.”
“Leadership is an inside job,” comments Reid. “It’s about working on yourself. It’s very personal, and it is an opportunity to really be the best version of yourself, if you’re willing to roll your sleeves up and get to work.”
Communication and Feedback
Too often, dentists fall into the outdated feedback model of once-a-year feedback for team members. The result can be awkward situations that feel harsh and punitive to the team members.
“Honestly, I think it’s really crummy to wait until the end of the year to tell a person everything they did that disappointed you,” says Poppe. “That’s how people feel about feedback from their bosses in our industry because that’s what we do. We collect stamps on them all year, and then at the end of the year we write down everything that annoys us about their performance and then we lay it on them. It feels shameful. It feels like a confrontation.”
Reid feels meetings need to happen at least weekly.
“Weekly engagement meetings are far more effective than having reviews yearly or every six months,” suggests reid. “Those weekly engagement meetings actually have their focus on the future, on where we can actually do something about it. If we’re looking backwards, it’s over.”
Poppe feel that in-the-moment communication is also crucial.
“I think the importance of ‘in the moment’ feedback is crucial because it’s hard to schedule one to one time with every single person in your dental office every week, says Poppe. “Being able to communicate as things happen throughout the day in that type of environment is really critical. But when doctors tell me they don’t have time, I like to tell them that you don’t really have time to not be communicating. You don’t have time to continue with the same level of stress and dysfunction and not address it. It doesn’t have to take long.”
“It doesn’t have to be a pull away, I need to talk to you, shameful moment. It can just be ‘hey, let’s do this differently next time.’ It can be so simple, but it takes a lot of awareness and a lot of practice,” adds Poppe.
Reid thinks focusing on the positive can have a huge impact. “Focus on what’s going well. Catch your team doing things right and acknowledge it. Wherever your focus is, that’s what’s going to expand.”
Feedback is also two-way communication. Dentists should be seeking opinions just as much as they are offering them.
Striegel adds, “The key element is asking for feedback for yourself, not just giving feedback. The more specific you can be, the better the feedback tends to be.”
Aversion to Conflict
If there is one thing that dentists seem to avoid at all costs, it’s conflict. And it’s a problem that seems more prevalent in dentistry than other professions.
“There’s a huge discomfort in dentistry with the idea of candid communication or just being direct,” observes Poppe. “They put this really negative filter on the types of conversations that need to happen, and happen every day in other businesses. But in the dental office they hurt people’s feelings.”
Striegel feels that conflict is often just a symptom of not clearly communicating expectations.
“I believe that being a really good leader doesn’t have to have much conflict at all,” offers Striegel. “Conflict is when the expectations are unclear and you have team members who are striving to meet unclear expectations. You’re going to have a disconnect and you’re going to get frustrated.”
So, what it comes down to is leaders being open and honest with their teams. But that, in itself, is a challenge.
Poppe adds, “I wish I could magically change that for our industry, and just tell people to get brave and understand how different their day-to-day could be if they could just talk to each other about stupid stuff. A lot of times it’s so tiny and then it just grows and snowballs right up to the owner or leader level.”
“Everybody starts with the intention of being honest,” says Behrendt. “But, here’s the truth. Sometimes you trade the clarity for niceness. The more you can step into just being clear instead of being nice, and you get more and more honest, the more you are someone who just quickly tells the truth in a calm way and you’re consistent about how you design things and execute. You get the best of both worlds. You get the respect and the results.”
When conflict does arise, it’s important to resolve it promptly. But getting to the root of an issue can seem complicated, because there are often multiple facets of the problem that factor in. Behrendt has a simple solution that can help dentists quickly get to the heart of the matter.
Behrendt explains, “We have a secret formula we use at ACT Dental — E minus R equals C. Expectation minus reality equals conflict. The cool thing about this is if you understand how the formula works, you can see where the conflict originates. Was it with the expectation or was it the reality? Every single time you experience conflict it isn’t really how you said it, it isn’t how they reacted, it was the fact that one of the two wasn’t clear or one of the two didn’t happen. Whenever something bad happens, go back and say ‘E minus R equals C, where did I go wrong?’ And if you use it every time to make that much more of an improvement, you’ll see it makes you a better leader, it makes you more clear, it makes you more consistent.”
Being passive, on the other hand, and completely avoiding difficult situations can be, in Poppe’s opinion, the worst thing a dentist can do.
“I think that the most destructive leadership style is apathy — being the nice guy, being everybody’s friend. I call it false harmony. Everything feels okay, but nothing is really okay. I think that’s the most dangerous, honestly. And I think that’s where a lot of practices live. They’re businesses that tend to do okay enough on their own. They’re kind of lucky that way and so it’s easy to resist change and stay where you have always been and avoid doing things that your team might resist or push back on. I think it’s the apathetic leader that is the most dangerous,” concludes Poppe.
Learning leadership in a dental practice
There are some people in this world who were born to be natural leaders. But what about the rest of us? Can it be learned?
“Leadership can always be taught,” believes Behrendt. “To what extent remains to be seen.”
“I think their success is perpetuated as they tap into their leadership skill,” notes Montgomery. “They evolve in their leadership over time. There are a lot of dentists who are not good leaders when they are in their twenties and thirties. When they turn forty, then they start to get in touch with what it really takes for their patients and their team. I think the forties is when they really start to come into their own in terms of developing the necessary mindfulness, empathy, vulnerability, and curiosity that it takes in order to manifest the type of environment or culture they want to have.”
Poppe also feels that even those born with strong leadership qualities can have a lot to learn.
“There are personality types that are naturally more attuned to being a leader or personality types where people generally follow them,” says Poppe. “They’re outgoing, they’re likeable, they’re clear communicators. But I think even those personality types benefit from learning how to use those natural traits in a way that truly leads people, that truly creates accountability in their team, that truly creates an open and honest work environment where people communicate with each other. So, I think there are people more naturally wired to it, but I think most people have to learn how to really do it.”
The value of leadership coaching
The path to greater leadership is one that should not be traveled alone.
“You have to surround yourself with people who think well,” says Behrendt. “We’re just human beings. We’re not designed to succeed on our own. We need the help of great people, great team members. Show me a sports team that exists with one great player. They need the help of great coaches, great communities, great thinkers, great everything.”
But it’s not enough to open the doors of your practice to a coach. You also have to open your mind to learning.
“The challenge is that if you think you know it all and you don’t really want coaching, you just want validation, all learning stops and you are now the lid on the organization,” adds Behrendt.
Accountability through people and systems
For some practices, the learning process is a one-time process. For the majority, however, the learning never ends and some level of accountability is necessary to keep offices from regressing to their old ways.
Poppe states, “I think there are people who always need some outside accountability, just like they’re people who always need a personal trainer, even though they’re fit and they know how to do the workout. They always have a personal trainer, because that’s how they feel accountable to it. That’s how they don’t cheat or let themselves off the hook. I’m proud when I graduate a client. I like to let somebody move on, but a lot of my clients will at least work with me quarterly as just a gut check, just a refocus. That they don’t need me all the time but they do recognize that they need a refocus and that sort of quarterly interval.”
Striegel also likes to remain involved in his clients’ growth after he has helped them develop their leadership skills.
“What I do is help them figure out what they are already good at and what they need to learn to be able to lead their practice effectively,” shares Striegel. “Then I become a resource for them, so that if they are coming to a crossroads or a fork in the road and they’re not sure which way to take, we talk through the pros and cons of each one and then I coach them through whichever path they choose. That’s the part of the trusted advisor piece that I enjoy most.”
While ongoing coaching keeps dentists focused on leadership growth, organized systems also give them a clear structure to follow so bad habits don’t creep back in.
“Human beings left alone or ungoverned will always slip,” observes Behrendt. “That’s important to know. You need a system of accountability. I like the word operating system. Creating an operating system allows you to be human and not slip back in reverting into bad habits that created these problems for you in the past. I encourage you to have a system, a checklist, and operating system in which you can be you but things get better over time and we stick to the rules and make this place a better place every year.”
When can you expect results?
Results from leadership training usually aren’t instantaneous, but they also don’t take as long as you might think.
“The time it takes varies a lot,” observes Montgomery. “It depends on how deeply curious the person is and how deeply resistant they are.”
“It is a process, but it is easier than most people think and it happens quicker than most people think. If they go in open minded and ready to make the change, it can be within months that we start to see results,” shares Belt.
Even if it does take longer, the wait can be more encouraging as long as signs of progress can be seen along the way.
“You have to give people tools to review results and see action from their communications and see results from their communication quickly,” explains Poppe. “If you don’t, it just feels like too long of a climb and people lose faith. When you can start to have something as simple as a productive team meeting, where one week later a handful of to-dos got done, and we saw a difference in this thing, and we were able to discuss that this was off track and it didn’t hurt anybody’s feelings. That’s an immediate, tangible thing.”
The results of sticking with it are almost always worth it, and it will be obvious when a dentist reaches a higher level of leadership.
“I always say leaders have to accomplish two things, concludes Belt. “They have to accomplish clarity and inspiration. One without the other is incomplete in my book. But if you get a leader that has that beautiful marriage of clarity and inspiration, man that’s the deal.”