Building Your Practice Bridge: How Missing Systems Create Risk

The bridge you're walking across has missing planks. Every step feels uncertain, progress slows to a crawl, and you might even consider turning back. This perfectly captures what running a dental practice feels like when critical systems are missing or broken.

Most dental practices struggle with five fundamental gaps: inadequate onboarding that never fully integrates team members into the culture; collections and financing systems that allow money to leak through cracks; chaotic scheduling that creates daily stress instead of predictable production; case acceptance approaches that focus solely on the dentist rather than leveraging the entire team; and leadership systems that fail to create accountability and coordination. The consequences manifest as constant frustration, team turnover, and profitability challenges.

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We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams.

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Episode Transcript

Paul Etchison (00:02):
Imagine you're crossing a bridge, but some of
the planks are missing.
Every single step feels riskyand you can't trust the bridge,
so you slow down, second guessyourself and maybe even turn
back.
That's what it feels likerunning a dental practice
without solid systems.
You keep trying to move forward, but those weak spots keep
holding you back.
Today, we're going to take thatanalogy and break it down for

(00:25):
your practice.
We're gonna look at the mostcommon planks that are missing
in dental offices and why somany owners try to patch the
problems instead of fixing themoutright, and I'm gonna give you
a simple way to rebuild yourbridge so that it's strong
enough to carry not just you asthe leader of the practice, but
your entire team across.
So by the end of this episode,you're going to see exactly
where the gaps are in yourpractice and how to start

(00:47):
closing them, one plank at atime.
Now you are listening to theDental Practice Heroes podcast,
where we teach you how to createa team-driven practice that
allows you tons of time off,tons of profit and tons of
freedom, all while takingamazing care of your patients
and your team.
I am Dr Paul Edgison.
I am the host of the podcast, adental coach, the author of two
books on dental practicemanagement and the owner of a

(01:10):
large group practice in theSouth suburbs of Chicago.
If you're looking to build apractice that is a true business
and not a job, you're in theright place.
All right, let's talk aboutthis crazy planked bridge that
you're walking across.
Now, for some reason, I don'tknow, I think you have to
imagine the bridge, because Idon't know if anyone's actually
walked across one of thesebridges Like I'm picturing, like
cartoons, like you're in theAmazon jungle and stuff, and

(01:32):
it's like ropes with planks andstuff.
So maybe you've actually hadthat experience, but nonetheless
, you get an idea of what I'mtalking about.
So when we look at ourpractices, we have to decide as
the owners what are the missingplanks, what are the parts that
are missing in the functioningof our practice day to day?
And I can tell you I've beencoaching for six, seven years

(01:54):
now the most common planks thatI see in practices are the
onboarding, these new hires.
They never get fully trainedand because they never get fully
trained, they never really getfully invested in the culture of
the practice, which leads to alot of training and onboarding
which isn't really done verywell.

(02:14):
So it's so important that wedecide these things.
We have to figure out how wetrain people.
We've got to figure out whatare the things that we want them
to know, who is going to trainthem, who is going to be
responsible for them and who isgoing to hold that trainer
accountable for training thetrainee so often overlooked, and
it's not one of those thingsthat seems like a lot of fun to

(02:36):
put together.
But I assure you, when you doit, man, you feel those results
and it makes a big difference inthe longevity of how long your
team members stay with yourpractice.
All right, the next plank iscollections and financing.
We've got money leaking throughall of the cracks in our broken
systems, so we've got to figureout our practice.
When do we collect?

(02:56):
How much do we collect?
How do we finance?
What are we willing to finance?
How do we?
What systems of financing do weuse, and does everyone know how
to use them?
What is the verbiage that weuse?
How do we say it to ourpatients in a way that's kind
and polite but still assertiveenough that they comply with our
policies?
So this is often one of themost disappointing things to

(03:16):
have not functioning in yourpractice because you've done
everything, you've done all thework, you just didn't get paid.
And a lot of times our practiceowners will say, hey, I, you
know, I got this policy.
I've been telling them to do it, this is how we do it, but it
doesn't get done and nobodychecks on it.
So if that's your practice,that's a very important plank,
all right.
The next blank is blockscheduling, when our schedule

(03:37):
creates chaos rather thancontrol.
So how do we set up ourschedule for success?
I worked with someone, dr PatVuong, and he implemented the
DPH block scheduling system inhis practice.
Now he had a big associatedriven practice, much like mine,
and they were doing about$350,000 a month.
They went practically overnightfrom 350,000 to 500K a month,

(03:58):
so that practically overnightfrom $350,000 to $500,000 a
month.
So that is an additionalproduction, a jump in yearly
collections to of about $1.8million, if they can sustain
that.
So that shows you the power ofthe schedule, and we luckily get
to create the schedule.
We are the creators and theinventors of the schedule.
So there's no reason for us toset up our days in ways that

(04:21):
create chaos and make our livesmiserable while we're at work.
All right, the next plank iscase acceptance systems.
You know owners can think aboutthis.
Often.
We'll say, hey, I want to do, Iwant to learn how to talk to my
patients to get them to say yesto more things.
But we forget about the team.
And how do we get the team tounderstand their roles in case
acceptance?
How do we utilize everyone inthe office so that we can

(04:43):
maximize the amount of patientssaying yes?
And I know that might soundnasty like we want our patients
to spend more money in ourpractice, but think about this
If you are ethically diagnosing,then every time your patients
say yes, they're gettinghealthier.
So why wouldn't we want thatfor our patients?
If we are only telling themthey need things that they
actually need, then we shouldwant them to say yes to

(05:04):
everything we say.
We should want 100% caseacceptance.
So let me remind you, it's notjust you at your practice that
case acceptance is hinging on.
Now.
You are the most importantpiece as the owner, as the
dentist, but your team can do alot of this as well.
So there's nothing wrong withtrying to improve in that.
And the last plank that I see isleadership and communication

(05:24):
gaps.
We see teams that areuncoordinated.
There's no one held accountableto anything.
So what we try to work withwith our clients is we try to
get everyone moving together.
How do we get the whole teammotivated and excited and
enthusiastic?
How do we get the whole teammotivated and excited and
enthusiastic?
How do we get everyone to feelimportant, valued and heard?

(05:45):
And this is easily the mostpowerful thing that you can do
for your office.
But it's often like the mostambiguous and most difficult to
put like into a step-by-stepdocument.
And this is where I think DPHreally stands out, as our
coaches are only practice owners.
I mean, we've got systems forthis, but we've also got years
of experience learning from ourmistakes, working with really
big teams.
I mean you aren't going to finda handbook that tells you how

(06:07):
to handle every single situation.
You're not going to find theparagraph that tells you what to
do when one of your employeesstarts poaching other employees
from your dental office.
And then you got another onethat keeps getting caught vaping
in the bathroom poaching otheremployees from your dental
office, and then you got anotherone that keeps getting caught
vaping in the bathroom.
That handbook doesn't exist,but I assure you.
You can approach it with aframework and you can approach
it with the right mindset andthe right verbal skills, and

(06:27):
that can make or break how yourpractice operates.
So those are the planks on thebridge that might be missing in
your office, and without theseplanks, the bridge, I mean, it's
obviously it's not safe to walkacross.
You're going to fall throughinto the canyon and Dora the
Explorer and boots are not goingto help you there.
Now I remember a client of minenamed Daniel, and he was a super
hard worker and he had asuccessful practice.

(06:49):
He was doing really well, like1.5, 1.8 million but it was
really burning him out and thereason was that his hustle he
was a hustler.
His hustle got him to success.
He was putting in late hours,he had a strong sense of doing
things perfectly like, kind oflike you know, the perfectionist
that we all see in ourselves alittle bit, but he wanted

(07:09):
everything perfectly done withcare and precision, and he had
really high standards for histeam, which is great.
But as his team grew, he foundhimself struggling to keep up
with holding them to that highstandard that he created,
because they were just gettingtoo big, and that's when things
started to really slip and hecontinued to burn out.
And when we worked together westarted building those systems

(07:31):
and often when I was telling himlike hey, we got to do this, we
should do this, he would tellme you know, we already have
that, we've already done that,and that's the thing.
Is that just because you have itor you've already done it, it
doesn't necessarily mean thatit's working.
Now, as dentists, we are soquick to put in an easy fix for
something.
We give a team member like aneasy, like real quick verbal

(07:54):
reminder, or we leave them asticky note, or we do a one-time
training with our team and thenwe say we never have to do it
again and we tell our teamquickly and we just hope that
they're going to get it whenthey're doing things differently
than how we want them to do.
But fundamentally, something ismissing with that approach.
Or sometimes we just hope thatthey're just going to figure it
out on their own, like thenatural consequences of the way

(08:15):
they do things are going toteach them that they shouldn't
do it that way and theseproblems will fix themselves.
And I hate to break it to you,but you know what?
This never, ever works ever.
It just doesn't work that way.
You get the result that thesame problems show up over and
over and they drive you crazy.
I mean it's like the holes, theplanks opening up on the bridge

(08:38):
.
It's just you know there'ssomething missing there.
So you've really got to slowdown, you've got to move
backwards, you've got to buildfrom the foundational point and
go from there.
Now I just started working witha new client and he joined our
mastermind and we often startwith working on mission, vision,
core values and brand promises.
Now he had this meeting withhis team the other week and he

(08:59):
was telling me about it.
He said it went great.
He really felt good about itand he explained the core values
and everything.
But he also explained to histeam how the core values it's
not just for how they treatpatients, but it's how they
treat each other.
And he said things such assaying please and saying thank
you and respecting each otherand being polite and
constructive and teamwork andshowing gratitude to each other.

(09:21):
And I just thought it was socool to see that he tied in that
discussion with his core values, because we often see that core
values and we say, okay, youknow what.
That is how we talk to patients, but we need to tie it back to
like this is how we treat eachother.
So this is what I'm talkingabout these planks.
They're foundational.
We need to move backwards andfind out where we miss that

(09:43):
foundational piece.
This is foundational culturebuilding.
That will help him build.
Every single plank, everysingle system in his office will
build off of this foundationthat he set.
So it's so awesome andrefreshing when I hear clients
do things like that.
It's such a good leadershipmove.
So how can you rebuild yourbridge properly if you feel like

(10:06):
there are some planks missingon your bridge?
So step back, look at whichplanks are the weakest.
When we start working withclients, we often have so many
different directions we could goin.
It's hard, it's overwhelming.
We've got to pick which onesare the weakest and which ones
are the most important fortackling first, because, let's
face it, you can't do it all atonce.

(10:26):
And then we just pick that onearea and we build on it and we
go piece by piece from there.
So you do the same.
So you need to do the same.
Fix one at a time, not all atonce, and no matter where you
start, make sure that youdocument it, make sure it's
clear, make sure there arechecks and balances as part of
it and, no matter what,communicate.

(10:48):
This is the most important part, because the thing is is, if it
isn't verbalized, it doesn'texist.
You have to communicate it andonce you fix one of these planks
, it doesn't mean that it's notgoing to need to be maintained.
Just like the bridge, it's notset it and forget it, but the
main idea is that you can buildthese planks one by one.
I want you to lead and inviteyour team across that bridge and

(11:12):
guide them, putting the planksdown as you go.
That bridge doesn't just holdyou, it holds your entire team.
So in closing a bridge withmissing planks, it is scary.
Right?
Look at your practice this weekand decide what planks you have
that are missing and create aplan to make every single plank
solid so that you can walkacross with your team with

(11:34):
confidence.
And if you need help doing this, set up a strategy, call with
me and learn about our coachingoptions.
We are kicking off this year'smastermind next Friday and I
know there were so many peoplethat felt like they just missed
out on it.
And yeah, you kind of didbecause it's going to be awesome
.
But you know what?
I may have enough people to doanother cohort, possibly in

(11:54):
January.
So if that's something thatinterests you, or one-on-one
coaching, please reach out to me.
Go to our website,dentalpracticeheroescom, and I
want you to remember building apractice that runs itself isn't
about one big giant overhaul.
It is truly about strengtheningyour practice one plank at a
time.
So thank you so much forlistening and we will talk to
you next time.