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It feels like a marketing problem You want more new patients, so you invest in digital marketing, explore community outreach, ask for more referrals. You are doing what growth is supposed to look like. But, something still feels off. And even when new patients are coming in, the momentum does not always carry forward. It is easy to assume the issue is volume and more leads will fix it. But, in many practices, the real issue is not how many patients are coming in. It is what h

Why Orthodontics Has Become the DSO's Favorite Growth Play  You may have noticed it at the last study club. Or in the trade press. Or in the conversation at your regional meeting where someone mentioned another practice in your area getting absorbed. Orthodontics is no longer just a specialty DSOs tolerate. It has become one they actively pursue. Understanding why that shift happened, and what it means for your practice, is not optional anymore. What Changed  For years, DSOs

And Why Most Practices Chase the Wrong One Growth feels harder than it should You are seeing patients, investing in marketing, adding team members. The activity is there, and the intention is clear, But the results feel inconsistent. Some months feel strong while others feel flat. And no matter how much effort you put in, growth does not feel stable or predictable. It is easy to assume something is missing. Maybe more leads, better performance, stronger team execution, but mo

When Experienced Teams Stall: The Leadership Challenge of Long-Tenured Staff Many orthodontic practices spend years building something rare in healthcare: a stable, loyal team. You have assistants who have been with you for a decade. Front desk staff who know your patients by name. Clinical leaders who helped shape the culture of the practice. At first, this kind of tenure feels like a competitive advantage. And in many ways, it is. But over time, another dynamic can quietly

The truth about your consult performance is already there, you’re just not looking in the right place. You care about your patients. You believe in your treatment. You trust your TC. So when case acceptance stalls or conversion feels inconsistent, it is frustrating and it hits personally. You start asking:  Is it pricing?  Is it confidence?  Is it personality?  Do we need another script? Before you rewrite anything, pause. Most TC performance issues are not motivation problem

The Leadership Bandwidth Problem: Why Growth Stalls When Every Decision Flows Through the Doctor Growth should make a practice feel stronger. More patients means more opportunity and ideally you have a capable team that has grown alongside the practice. Yet many doctors reach a stage where growth begins to feel heavier instead of lighter. You are answering questions all day. Approving decisions that your team could likely make themselves. Jumping in to solve issues that some

You know the feeling. Production looks strong. The schedule is full. Case acceptance is steady. Yet your collections report tells a different story. A growing percentage of accounts sit 30, 60, even 90 days past due. You tell yourself your team will “circle back.” You hesitate to push too hard because these are long-term patients. You do not want your front desk to feel uncomfortable. So, the list grows. Delinquency is rarely about compassion. It is about the absence of str

Why Most Orthodontic Practices Are Measuring the Wrong Number “Industry standard is 75%.” If your treatment coordinator is below that number, it feels like underperformance. If you are above it, you feel safe. But 75% of what? Because when we look closer, most practices are not actually measuring true consult-to-start conversion. They are measuring a blended production outcome and calling it conversion. And that misunderstanding quietly distorts growth planning. Let’s bring c

The System Around It Is. You care about your team. You want them to grow. You want them to take ownership. You want them to think like leaders, not just complete tasks. So, you give feedback. You repeat yourself. You address the same issues month after month. You hesitate to say hard things because you do not want to hurt morale. If that sounds familiar, the issue is not your intent. It is not your personality. And it is not your team’s capability. It is structure. When fee

How Orthodontic and Dental Practices Build High-Trust Teams That Scale You can feel when culture is off, even if you cannot name it. Most orthodontic and dental practice owners sense it before they see it in the numbers. Energy feels uneven. Communication feels heavier than it used to. Small issues turn into bigger ones. The team works hard, but tension shows up in subtle ways. You know culture matters. You have probably talked about it in meetings or referenced it during rev

Guide the decision forward. You are in the consult room. The plan is solid. The recommendation is clinically sound. And then you hear it. “I need to think about it.” Your team freezes. They want to be respectful. They do not want to push. So they smile, nod, and say, “Of course. Just let us know.” And just like that, momentum disappears. If this happens in your practice, it is not because your team lacks warmth, intelligence, or effort. It is because they lack structure in m

And How Structure Solves It You are not short on ideas. You are short on follow-through. Most orthodontic and dental practice owners we talk to are thoughtful, motivated, and deeply invested in their practices. They attend conferences. They read industry outlooks. They know what matters in today’s environment. Better marketing. Stronger culture. Improved patient experience. More leadership depth. And yet, months later, many of those initiatives stall. The marketing push loses

Everyone Agrees. So Why Isn’t It Moving? You’ve had the meeting. Everyone nodded. The priorities felt clear. There was good energy in the room. You walked away thinking,  this finally feels aligned. Then a few weeks pass. Progress is uneven. Some things move forward; others stall. You hear different interpretations of the same decision. You find yourself reconnecting dots you thought were already connected. If this happens in your practice, you’re not alone. Alignment without

You know change is coming. The real question is what you do with it. If you lead a dental or orthodontic practice in 2026, chances are you are not short on insight. You read industry outlooks. You hear about new patient expectations, tighter margins, workforce pressure, and the growing need for smarter marketing and stronger culture. The challenge is not awareness. The challenge is execution. Many practice owners nod along to industry trends and then return to a day filled wi

The leadership shift behind sustainable growth The frustration no one warns you about You added the software because it promised efficiency. Then another tool to support it. Then a workaround because the team was confused. Now you are logging into six platforms before lunch, your team is asking which system to use, and somehow everything still feels harder than it should. Most orthodontic and dental leaders assume complexity is the cost of scaling. It is not. Complexity is us

If you do not plan differently this year, you will repeat last year. End-of-year planning often feels productive. Numbers get reviewed. Goals get discussed. A few initiatives get listed. And then January hits. Schedules fill. Team issues surface. Decisions pile up. The plan slowly becomes a reference point instead of a tool. That is not a discipline problem. It is a structure problem. COO-level planning is not about inspiration. It is about decisions, sequencing, and ownershi

Every practice owner knows the feeling. You share the vision, the goals, and the direction you want your practice to grow. You talk about culture. You outline expectations. You set targets for new patients, capacity, and revenue. And for a moment, it feels clear. But then Monday arrives. The team is busy. Projects lose momentum. Leaders try to prioritize but end up reacting to whatever is most urgent. You repeat the same expectations. You feel responsible for pushing progress

When Growth Pulls You Back into the Center  When your practice grows, it’s easy to expect support to grow with it. Instead, your team that once felt steady now leans on you for every answer. You want to lead at a higher level, yet you’re the bottleneck for the small things.   It starts to feel like growth is stretching you instead of supporting you.   Here’s the truth. You aren’t overreacting. You’re simply carrying what the current structure can’t hold yet.   The Real Issue:

How orthodontic leaders can protect morale, clarity, and connection during times of change. No matter how exciting a new system, technology, or process might seem, one truth always holds: change shakes the room. A new software rollout, a shift in team structure, or even adjusting how the front desk manages scheduling can subtly ripple through the culture of an orthodontic practice. And while change is often necessary for growth, how it’s managed determines whether your team

Practical strategies for balancing trust, autonomy, and follow-up systems that actually stick. If you’ve ever led a team, you know the fine line between accountability and micromanagement feels razor-thin. You want to empower your people to own their results, but you also need to ensure things get done, on time, to standard.Lean too far one way, and you’re chasing updates and exhausting everyone. Lean too far the other, and you risk inconsistency, confusion, and unmet goals.