Getting Real in a Dental Office


Tough choices, discussions need to be made when a practice goes through a transition, but steps should be made to ensure talented staff members stay on board.

Getting Real in a Dental Office During a Transition


Carla had her dream job as the office manager of a thriving orthodontics practice. She always had a passion for leading and solving problems. But this time was different. She came onto the scene during a challenging time…the pandemic.

It was December of 2019 when Carla joined a staff of 15. The COVID pandemic caused the orthodontist, Mark, to make the tough decision to sell his practice. He was close to retirement age and decided it was time to leave. Remember, we were all in a state of unknown as to when the world would go back “to normal.” At 60, he felt it was easier to retire than go through all the challenges that lay in front of him.

Miracle of miracles, he was able to sell the practice to a younger clinician. The new doctor, Kevin, did things a bit differently. Since the staff was part of the deal, he only brought over his own lab person, front desk, and a clinical team member. Do you see where I am going with this story? There were a lot of changes that were happening in this transition.

Some of the staff had been with Mark for 25-plus years. They were used to doing things their way and didn’t just resist change but became passive aggressive at times. They weren’t rude or technically insubordinate. They just didn’t comply with the changes that Kevin wanted. This fell on Carla’s shoulders to merge the 2 staffs together and be the change agent.

Kevin wanted to keep Mark’s patients happy during the transition. But they didn’t know or trust him. It was the regular staff that were critical in keeping the patients coming back. This is why the staff was so valuable. It is bad enough that a doctor that you trust retires. But, to lose the relationships patients have had with the staff for all these years would be another huge loss to the practice.

Carla jumped into action and had 1:1 conversations with team members letting them know how much they are valued. She understood that they had been doing things a certain way for perhaps 10-15 years and now change was going to be implemented. At times Carla had to walk a tightrope and have difficult conversations encouraging staff to get on board or leave the practice. Keep in mind the timing of this. We had the pandemic. And now we have a dental staff shortage.

She identified key leaders to help her with the transition. But this was tough. The stress and pressure were overwhelming at times. But she kept at it. She believed that being transparent about the bottom line was crucial for staff to understand. Kevin didn’t always agree with how much information she was sharing and had a few uncomfortable conversations about it. She started thinking that maybe she was crossing a line periodically to make everything work.

When they returned to the office post-COVID, there was a steep learning curve. The staff had to learn new ways to do things and voiced their discomfort daily. There was a period when the staff didn’t know who to look to for leadership. The struggle continued.

Finally, some of the key players decided to retire. They didn’t want to change how they did things. During this struggle, Carla continued to advocate for the veteran staff. Sometimes, Kevin would give approval, and other times he was impatient and frustrated with how badly things were going. He wasn’t consistent with the services and fees. At times, he would back down and give a patient free goods and services, which was impacting the bottom line.

Carla finally had enough when she didn’t receive a paycheck. Money was tight and bad decisions were being made. She was exhausted and needed to find a less stressful position. It was with a heavy heart that she said her goodbyes.

She had a couple suggestions for practices that go through this kind of transition.

  • Be transparent. Let staff know the reality of the situation. Change was necessary to blend the 2 staffs.
  • Monthly staff meetings. Have the staff help with coming up with a new mission statement. Share long-term and short-term goals and strategies to achieve them.
  • Keep the doctor informed. The doctor’s support and respect are needed to make this transition successful.
  • Get staff involved. This can be done with brainstorming sessions and increasing your online presence on social media. If someone is on their phone all day, have them do posts taking pictures to show the doctor’s personality.
  • Assign specific tasks to your team to develop community.
  • Give staff autonomy to do things.
  • Have the appropriate metrics to gather data for your staff. For example, track and time check ins, when the patient is taken back, and when the visit is over. When you have this information shared with your staff, they can start to see the bigger picture. Not enough patients, no growth, no income, no paychecks, or delays. Show them how these measures impact whether they go over onto their lunch hour. This will help with their buy-in to identify and fix the problem.

I wish this story had a happier ending, but it was time for Carla to move on. These changes have casualties like this. The problem is that with this shortage even more pronounced today, we can’t afford to lose good dental staff. Particularly if they have been a devoted part of the team for so many years. This is what getting real in a dentist office looks like.

Have you experienced a situation like this? If so, I would like to hear about it. Email

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