The leadership steps that will guide your practice to a greater net

What do dentists want? Many want a better return for all of their schooling and efforts. They want an outstanding bottom line. Here's how they can achieve this.

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What do dentists want? Many want a better return for all of their schooling and efforts. They want an outstanding bottom line. They want to take more money home and possibly even have more time away from the office. This article is about profitability and the leadership needed to create that profitability. 

A leader who has a winning net profit (which we’ll refer to as “net”) has made a commitment to be profitable. It is a conscious decision to reach and exceed goals with a defined plan for execution. Profitability will occur because of the plan, which goes way beyond wishing and hoping. It means that you determine your future.

A leader with a large net is one who has a clear personal vision, and one who inspires others. What are your core beliefs? What keeps you in the game? Why would others want to spend their working lives with you? What makes people want to be your patient for life? Write this down, share it, and live this vision, not so much for more money but because it is the right thing to do.

A leader with a large net demonstrates positive behavior, confidence in self and team, and respect for personal and dental standards. It’s important to be in compliance with OSHA, HIPAA, and all dental statutes. Though you do not boast of your increased net, others notice your increased time away, your happy team, and possible changes in your life. You and your team must meet and exceed dental standards. Others are watching.

A leader with a large net makes strong decisions. The leader must earn the team’s trust. Making decisions is a struggle for many dentists. It is a learned skill. The Blatchford motto is: “Progress rather than perfection.” Make decisions, because actions speak louder than words. Keep moving forward. Be in motion. Don’t get stuck in the weeds and be a gossip, have favorite employees, or practice other unfavorable behavior.

If you make the wrong decision, make another decision. When a leader knows the path, the benefits are:

  • attracting a team who wants to move forward rather than becoming stagnant;
  • creating strong systems (scheduling, bonuses, new-patient protocol, telephone systems, hygiene systems) that lead to efficiency and accountability;
  • a team that can see the bigger picture and will make decisions to reach goals; and
  • a doctor who doesn’t micromanage because the team “gets it,” and wants what the doctor wants.

Set goals

Do you, as a business leader, have a stated personal vision? Do you clearly know why you are performing dentistry? Does it motivate and inspire you? Does your staff know this, and have they bought into your vision? What are 10 systems or conversations that are part of your office culture that demonstrate your vision?

Do you have a daily goal for the doctors and hygienists? Many doctors have a secret goal. If this is you, how successful is your secret? Consider instituting a stated office collection goal (different than production when insurance is a factor) and how this can motivate the team. Committed team members like to know the score and play the game with you.

Are you leading a team of accountable winners who know your goal? If your profit and loss statement reports that you are spending over 30% for staff, you probably have several team members who are not really winners but are simply taking space and collecting pay. 

We encourage hiring and cross-training the right people who complete tasks during the workday and are always thinking about how they can work smarter and not harder. A strong team of three bright and accountable members who have a focused leader can produce in the range of $1.5M. 

Your team members already know who is playing to win and who is a drag on the team. If you also know, why are you keeping the incompetents on staff? Yes, letting someone go is hard, yet the team who is really working with you will respect your decision. 

The correct way to set bonuses

A fair and equitable bonus is critical for your success. What would motivate the team to learn more, work for the greater good, have sales conversations with results, and create a perfect schedule? If they know what and how you want to produce every day, the right people will make that happen. All numbers are known and owned by a team who receives bonuses. They know exactly where they stand each day and will help the practice meet its goals because they share in the profits. 

Here’s what does not work for bonuses: the dentist keeps the practice’s formula and numbers a secret and then announces at the end of the month, “I’m so sorry. We had to buy a new scanner, so there are no bonuses this year.” A bonus is a real motivator and needs to be equitable, not based on salary. 

What are your skills?

Assess your present skills. Are you still performing dental school dentistry? Profitability comes from the dentist having developed his or her skills way beyond dental school. Are you interested and skilled in implants, cosmetic dentures, or IV sedation? How about cosmetics and photography? A comprehensive restorative course is crucial to most dentists’ success. A higher net will occur when you are confident in offering a variety of skilled treatments. This may mean setting firm goals in order to meet your continuing education requirements.

Have strong systems

Systems are your standards and procedures for accomplishment. Dentists like to start and complete dental tasks. Systems are also important in the business arena. To create a larger net, you should have total knowledge of how everything is handled in your office, both business and dentistry-wise. Have a written protocol for telephone conversations, emergency patients (what constitutes an emergency?), the purpose of hygiene, collections in hygiene, and much more. 

Having systems eliminates questions throughout the day. “Where is the . . .” or “Who is doing . . .” Your team members should all know the procedures for dentistry and business because the goals are written down and the team goes over them frequently. Your patients need to have confidence in you, and written systems make a difference.

You may also have a system for increasing net, which could include finding a close practice to purchase. Always be available for this opportunity. Many areas are “over-dentisted,” and this is a great opportunity to garner new-to-you patients. If a practice becomes available, you should know about it and make the move. It increases your patient base, sales, and net. 

Profitable leadership is a learned skill. Changing to bigger thinking comes from coaching. A much larger net can be achieved. Blatchford doctors have implemented systems, structures, and learned skills to achieve the results they desire. A good business coach can work with you and your team to figure out your strengths and weaknesses and how to build upon those. 

You are the leader in a business with a potential net of $450K and more. We see discouraged dentists who were netting the US average of $200K and have increased their net to $500K and even seven figures. Fall in love with dentistry again. Look in the mirror and become the leader you need to be.  


BILL BLATCHFORD, DDS, and CHRISTINA BLATCHFORD, DMD, are two strong voices in dentistry for profitability and they place a special emphasis on mastering sales conversations. They are dentists’ advocates for more net return, more time away from the office, and increased enjoyment of life. Dr. Bill Blatchford practiced dentistry for 20 years in Corvallis, Oregon. Dr. Christina Blatchford graduated from Oregon Health & Science University Dental School in 2009 and practices in Milwaukee, Oregon. For more than 35 years, Blatchford Solutions has helped thousands of doctors achieve practice success. In their custom coaching program, Drs. Blatchford work personally with the dentist, spouse, and team to achieve their dream practice. Blatchford Solutions offers books, podcasts, and “Mornings with Blatchford.” For more information visit blatchford.com or call (888) 977-4600. 

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