5 Operational Blind Spots: How Doctor-Assistant Friction is Costing Your Dental Practice Profit
Every dental practice owner knows the pain: chronic complaints from your associate doctors about poor assistant support, leading to chairside delays, missed production goals, and increased staff turnover. This isn’t just a daily nuisance; it’s a direct threat to your practice profitability and ability to scale.
To identify the hidden operational ‘slop and holes’ plaguing growing practices, Pathway Dental Solutions’ co-founder, Dr. Sten Ericson, conducted a strategic “red team” exercise, stepping back into the operatory. What he discovered exposed a common misconception among leadership: the problem isn’t the team’s ability to follow protocols—it’s a systemic leadership and standardization failure.
If you are a CEO or owner of a small, growing dental practice struggling with team consistency and chairside efficiency, these five surprising lessons are your blueprint for establishing the operational excellence required for sustainable growth.
- Standardization Failure
Many doctors feel their assistants were messing up, when in reality, the team was trying hard to follow a moving target. Dr. Ericson observed that friction arose when doctors were “expecting the most of their assistants… almost unreasonably, when they weren’t expecting the most of themselves.” If a doctor is constantly changing their setup or deviating from established processes, the assistant simply cannot keep up.
The CEO/Owner Fix: Enforce Clinical SOPs First
The goal isn’t just to make the doctor’s day easier; it’s to create a predictable, scalable system. Standard Operating Procedures (SOPs) for core procedures (like a simple composite or crown prep) must be documented, adhered to, and accessible to the entire team. As a practice owner, you must demand clinical standardization from your doctors first. This level of consistency reduces mental load on assistants, drastically lowers training overhead, and ensures operational efficiency regardless of the doctor in the room. In fact, one study found that practices exhibiting high consistency in clinical procedures report significantly improved patient satisfaction rates, proving the value of achieving clinical consistency in dental practices. (Source: Pulivarthi Group)
- Mitigate Talent Risk
It’s tempting to assign a “rockstar” assistant who intuitively knows a doctor’s every need. However, relying on one person introduces immense talent risk. What happens when that key assistant calls in sick or goes on maternity leave? Your practice’s production grinds to a halt.
The CEO/Owner Fix: Implement a Supportable Model
Pathway Dental advocates for a Supportable Model where all assistants work with all doctors. This is a challenging transition, but it forces the practice to invest in flawless, repeatable training systems and robust documentation. When you can no longer rely on one person’s memory, you must rely on a flawless system that anyone can execute. When every assistant can effectively support every doctor, your practice becomes resilient to turnover, safeguarding your daily production goals and ensuring a smoother path to scaling your operations.
- Establish Chairside Accountability
When Dr. Ericson stepped into the operatory, the team performed flawlessly. Why? He brings an unmistakable presence and a clear expectation: “Your job today is just to keep up with me. Period.” He moves, and the team catches up.
The CEO/Owner Fix: Coach Assertive Leadership
As a leader, you must define the pace and flow. The concept of “Presence” translates to unambiguous accountability. Instead of passively accepting, “The assistants aren’t ready,” doctors must be coached to be assertive: “I’m going into the room now. You will catch up.” This firm approach sets an immediate standard and removes any confusion about who is driving the appointment. Practice owners and CEOs must teach their doctors to be the primary drivers of the schedule, maximizing chair time utilization and practice performance.
- From Complaint to Ownership
Associate doctors often complain about team issues because the consequence of a bad day is merely a “tricky day” for them. They have a paycheck and are shielded by business owners from the real consequences of inefficiency.
The CEO/Owner Fix: Develop Associate Business Acumen
Owners must elevate the stakes by coaching business acumen and an ownership mindset. Remind your associates that if the team isn’t operating effectively, the business might not be able to pay its bills or hit its growth targets. Help them connect their chairside leadership directly to the practice’s financial health—the ability to pay staff, invest in new equipment, and achieve long-term valuation goals. This critical shift transforms associates from passive complainers into active problem-solvers. For further context on developing your clinical leaders, read these 5 Traits For Successful Associate Development. (Source: Dr. Katie McCann Lee DDS)
- System Simplicity
Dr. Ericson noticed doctors sometimes adjusted procedures unnecessarily, claiming, “This case necessitates me to do something differently.” This creates chaos for the assistant who is just trying to follow the manual.
The CEO/Owner Fix: Enforce Operational Consistency
Every time a doctor adjusts a procedure for a perceived “outlier,” they create confusion and inefficiency, increasing training costs and reducing reliability. Operational consistency demands a minimalist approach: fit 95% of clinical situations into your established, core protocols. As a CEO, enforce the principle that genuine clinical variations should utilize established tools and sequences, not abandon the foundational system. This commitment to system simplicity is key to making your assistants exponentially more effective and your practice systems reliably scalable. This directly helps to solve the perennial industry challenge of high staff turnover in dental practices, which is often rooted in poor systems and leadership. (Source: MGE Online)
Ready to Unlock Your Practice’s Growth Potential?
If your small, growing dental practice is struggling to move past chronic team issues and inconsistent production, the solution lies in system implementation, not just staff retraining. Pathway Dental Solutions specializes in establishing the rigorous, repeatable SOPs and leadership frameworks that empower practice owners and CEOs to achieve true operational efficiency and unlock their next level of growth.
Stop losing profit to chairside “slop.” What is the number one system you need to standardize this week to stabilize your practice?
