When most dentists dream of owning multiple practices, they picture freedom. What I learned by the time I had sixteen offices is that scaling doesn’t multiply freedom; it multiplies everything—your strengths, your weaknesses, your stress, and your blind spots.
I made mistakes that cost hundreds of thousands of dollars and a few that almost cost me my sanity. But those mistakes forced me to evolve from a dentist who leads into a leader who happens to be a dentist.
These are the most critical lessons I learned on the journey from one practice to sixteen.
1. Vision & Culture: The Multipliers of Your Leadership
By my third practice, I realized I hadn’t duplicated success—I’d duplicated stress. Each office had its own micro-culture, and I was just the hero running between them putting out fires.
Growth doesn’t create strength; it reveals it. The breakthrough came when I realized my real job wasn’t to fix problems—it was to create frameworks so problems got fixed without me.
- Lesson: If your team can’t repeat your vision in one sentence, you don’t have one. Our vision became simple: “People First.” It wasn’t marketing fluff; it was a filter for every decision. Every hire, every policy, every purchase had to pass that test. Confusion is expensive. Clarity is cheap.
- Lesson: Culture isn’t what you say; it’s what you celebrate. We started each meeting by highlighting someone who lived our values that week. Recognizing small wins trained everyone to notice them. Good culture pays dividends you can’t see on a spreadsheet: fewer mistakes, higher retention, and smoother days.
2. Systems: The Engine of Predictability and Freedom
For years, I confused my availability with leadership. My phone was a 24/7 hotline for every minor issue, from ordering prophy paste to filling a schedule gap. At first, it made me feel important. Later, it made me a miserable bottleneck.
- Lesson: If it’s not written down, it’s optional. We started documenting everything: how we schedule, how we order supplies, how we submit claims. We used a simple model: Document, Delegate, Duplicate. That framework turned chaos into consistency and dropped our errors dramatically.
- Lesson: Consistency beats intensity. Our hygiene recall system used to be an emotional rollercoaster. We built a simple, written “three-touch” system for every overdue patient. Within 90 days, hygiene production across the group jumped over 10%. Same patients, same staff, better system.
Systems don’t restrict creativity; they protect it. They free your brain from repetitive decisions so you can focus on leadership. Freedom isn’t the absence of work; it’s the presence of reliable systems.
Watch the full, in-depth conversation on these hard-won leadership lessons.
3. Cash Flow: Your Oxygen Tank
You can have record-breaking production and still be broke. I learned that the hard way. One year, our group posted its highest revenue ever, and I was still moving money between accounts just to make payroll. “Growth” had outpaced our financial discipline.
- Lesson: Cash flow is a leadership discipline, not just an accounting metric. For years, I ran with almost no cash buffer, constantly robbing Peter to pay Paul. The stress was immense.
- Lesson: Your buffer is your oxygen tank. We implemented a rule: every office must keep a minimum of one to two months of overhead in reserve. Everything changed. Suddenly, we could make calm, strategic decisions instead of desperate ones. If an autoclave died, we just replaced it. No drama. Financial margin creates emotional margin, and emotional margin brings the joy back to ownership.
When cash flow is strong, you lead from vision. When it’s weak, you lead from fear—and fear is the most expensive leadership style there is.
4. People & Communication: The Speed of Trust
People are your greatest expense and your greatest asset. I used to think paychecks were enough to motivate them. Then I lost three rock-star employees in two months, not over money, but because they felt unseen.
- Lesson: People don’t leave companies; they leave conversations that never happen. I started doing short, monthly one-on-one meetings with key team members, asking three simple questions: What’s working? What’s not? What do you need from me? It took 15 minutes per person and changed everything. Morale went up, turnover went down, and production followed.
- Lesson: Clear is kind, and silence is expensive. I used to avoid conflict because I didn’t want to be the “bad guy.” In reality, every problem you ignore compounds interest. The cure was candor—having direct, respectful conversations the moment something felt off. Healthy conflict, handled quickly, builds trust.
The Leadership Equation
After more than a decade of mistakes and adjustments, I’ve boiled it down to this:
Leadership drives Systems. Systems drive Culture. Culture protects Cash Flow.
That’s the chain reaction of a healthy dental organization. If I could go back and tell my younger self anything, it would be this: build leadership before you build locations, protect cash flow like oxygen, and face your problems fast. Freedom doesn’t come from owning more; it comes from owning better.
