True Dental Success Institute

Dentist, Entrepreneur or Babysitter?

Last week, I was honored to host a meeting at the W Hotel in San Diego with a group of some of the most driven, focused and successful practicing dentists that I’ve ever met.

For two days, my Elite Practice Mastermind group strategized how they could further streamline their practices to provide better care, create more freedom, time off, and of course, become more profitable.

Their practices range anywhere from a small three operatory start-up producing under one million dollars, to a fifteen plus operatory seasoned office with several million dollars in revenue. Their level of experience varies from the first year of practice ownership to one year from transition and retirement from dentistry.

But while their backgrounds seem to differ greatly, they all have one thing in common… they have all taken the time to look at the big picture and plan strategically rather than just tactically. Or as Michael Gerber, the author of the book the bestselling book, E-Myth Revisited would say, “They take the time to work on their business, not just in their business.”

The format of our group meetings begins with each doctor sharing the strategies that are working best in their offices followed by a discussion of their sticking points- the challenges and frustrations that they face on a daily basis.

The group then collectively focuses on their challenges and together we design a plan of action with a deadline. The group holds that doctor accountable for taking steps to implement the plan. Being supported and held accountable by a group of your peers that you respect is an unbelievably powerful and effective method for accomplishing goals and benchmarks as well as persevering during difficult times.

One of the biggest elements of our program involves implementing systems and protocols that have the power to exponentially improve the practices of our members.

But systems such as referral generation, patient reactivation, patient retention, overhead and cash flow control, and new patient acquisition are only effective if the support team embraces and follows through with the strategic plan.

So the question of the weekend that came up over and over again was, “How do I get my staff on board with all of these changes?!”

My answer to this question is simple: you must hold them accountable.

The follow up question is as predictable as the previous question, “How do I hold my team accountable without turning into a full time babysitter?”

Here’s the quick and dirty solution.  (Note: without this structure in place, you’re destined to have a mediocre practice filled with chaos and frustration.)

The Team Accountability Agreement

This agreement converts your passive “job description” into an agreement signed by the doctor and team member. Here are the steps to making this work:

  1. Whether or not you already have one for each position in your office, ask each team member to create their own job description. In order to accomplish this, simply have the team member write down what they do throughout the day. This exercise alone can be enlightening for the owner and the team member.
  2. Schedule an individual meeting with each team member to review their self-created job description. Openly discuss positional responsibilities that need to be added to the document and duties that need to be removed from the list.
  3. Once this list of responsibilities has been customized and agreed upon by the owner and the team member, the document is signed by the owner and the team member. It should be clear to both parties that the agreement is a contract that will be used as a tool to assess the effectiveness of the team member at his or her position. A defined list of consequences for not adhering to the agreement should be included in the signed document.
  4. In order for this system to be effective, the Team Accountability Agreement must be enforced by the team member’s direct supervisor and failure to consistently perform the agreed upon duties must be dealt with immediately.
  5. The owner of the practice must regularly meet with the department supervisors to ensure that the accountability agreements are being followed and enforced.

Some of you may be thinking that you don’t want a bunch of robots walking around mindlessly checking tasks off a list, and that’s a valid concern. But my clients and I have actually seen the opposite to be true. We’ve found that team members actually embrace the accountability systems because they know exactly what is expected of them and they feel validated that the doctor will actually know all of the hard work that they accomplish throughout the day.

Of course, you don’t want to run your practice like a police officer- only operating based on negative reinforcement. There also needs to be a built in mechanism that rewards the team members who consistently meet and exceed their accountability agreements.

Running your practice through a series of defined efficient systems will increase the effectiveness of your team and turn your practice into a world-class organization!


All the best,

Mark Costes, DDS
Founder Dental Success Institute
Founder Horizon Schools of Dental Assisting
Author Pillars of Dental Success

P.S. If you’d like to learn more about joining our Elite Practice Mastermind group, or to find out about our practice building products, events and coaching programs, you can call my assistant Ashlee at (888) 293-7436 or email her at

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