Table of Contents
In 2008, I had a choice to make about my dental practice organization. The world was melting down, people were just beginning to lose their homes. Banks were beginning the process of foreclosing on thousands of homes in default. People were losing their jobs and our government was scratching its head wondering what to do. I made a decision to do something well outside my comfort zone at the time. That moment seemed to call for caution, preservation, reaction.
Not survive.
Not pause.
Scale.
While most of the market was pulling back, I opened three additional practices and built the foundation of what would become the most profitable phase of my entire career.
This isn’t a story about luck or timing.
It’s about mindset. It’s about systems.
And it’s about making bold moves when others freeze.
If you’re feeling the pressure right now, if inflation, rising costs, or tightening margins are making you question your next move, I want you to know something:
You don’t have to retreat.
You can build in this environment.
You can grow right now.
Here’s how I did it—and how you can too.
Many People React. Entrepreneurs Prepare.
During the Great Recession, I watched good doctors crumble—not because they weren’t skilled or passionate, but because they were reactive. They:
- Slashed marketing and growth budgets
- Froze hiring
- Put expansion plans on indefinite hold
- Pulled back into survival mode
And I get it. That kind of fear response is human. But it’s not strategic.
I realized early on: if I wanted to build something that could survive any storm, I needed to stop reacting—and start leading. That mindset shift changed everything.
Step 1: I Built Systems That Didn’t Rely on Me
The first thing I did was take a hard look at my operations. The truth?
There were many areas where I was the bottleneck.
Too many decisions ran through me. Too much depended on me showing up and putting out fires. That’s a problem for any dental practice in any season—but in a downturn, it’s a business killer.
So I systemized everything I could:
- Clinical and operational SOPs
- Training paths for every team role
- Metrics that told me whether my systems were working
- Incentives that built trust, enthusiasm and loyalty
That shift created predictability.
And predictability creates profit.
I also learned some invaluable lessons with each dental practice I opened. I document these lessons in my book, Extraction: The Surprising New Formula to Systemize, Scale and Sell Your Business. It’s got some great exercises, tips, strategies and recommended books for you.
Lesson #1: Don’t be the bottleneck. Scaling or growing your dental practice means your role shifts from strictly practicing dentistry to becoming a leader, investor and CEO of your practice. That means becoming the path to success, not the obstacle in front of it. Learn to extract yourself, little by little, from the day-to-day to focus on the 10,000-foot view so you can lead.
Step 2: I Doubled Down on People
When you’re in a tough economy, it’s tempting to cut your team to save money. But I believe this:
The strength of your practice is a reflection of the strength of your people.
Even in the recession, I prioritized hiring and training A-players. I gave my team a clear vision, I treated them with respect, and I created a culture where everyone knew their role in the mission. Everybody on the right bus and in the right seats.
That kind of leadership doesn’t just retain people—it unlocks their potential.
Lesson #2: Great teams aren’t a luxury in a downturn—they’re your survival strategy. In hard times, cutting your team might save money—but investing in the right people builds a business that can weather anything.
When your team understands the mission, feels trusted, and is trained to lead, not just follow, they become your greatest asset in any economy.
Step 3: I Made Every Decision from Data
If you’re leading a business based on how you feel, you’ll ride the same roller coaster as the economy. But when you use data, you get clarity—and clarity breeds courage.
Before opening a new practice, I made sure:
- My systems were replicable
- My overhead was under control
- My production-per-chair was profitable
- My KPIs told me it was time to grow
No guesswork. No gambling. Just informed execution.
Lesson #3: Emotions are unpredictable. Data isn’t. In uncertain times, data-driven decisions replace guesswork with growth. When you know your numbers, you lead with confidence—not chaos. Clarity creates courage. KPIs create control. If you can’t measure it, don’t bet your business on it.
Hard Times Are Mirrors—Don’t be Afraid to Look into Them
If you’re anxious about the economy right now, let me tell you: you’re not alone. I’ve coached hundreds of doctors through this exact feeling.
And here’s what I always say:
Hard times are mirrors. They show you exactly what needs to be fixed, rethought, or leveled up.
So instead of asking, “How does my dental practice I survive this?”
Ask constructive questions designed to help you find answers:
- “Where are my inefficiencies?”
- “What systems are missing?”
- “What does my team need from me right now?”
- “Where can I get better?”
At Optimize Practice Alliance, this is what we do. We help doctors turn their anxiety into strategy.
Because economic downturns aren’t barriers—they’re filters. And those dental entrepreneurs who are prepared will rise.
Here’s What I Recommend Right Now
If you’re running a dental business in 2025 and feeling uncertain, you’re not alone. But don’t let that stop you from moving forward with your plan or dream. These are the same steps we guide our Optimize clients through—and they’re the same principles I used in 2008.
1. Audit Your Systems
What are you still doing manually that could be automated or delegated? Do you have SOPs that a new team member could follow without confusion?
2. Know Your KPIs Cold
To truly lead your dental practice through uncertainty, you need to know your numbers. Revenue per provider tells you how productive your team is. Overhead ratio shows how lean or bloated your expenses are. Patient retention reveals the strength of your relationships and systems. And case acceptance shows how well patients understand and commit to care. These aren’t just numbers—they’re signals. When you track the right ones, you lead with clarity, not guesswork.
3. Overcommunicate With Your Team
Fear thrives in silence. Let your team know the plan. Share the wins. Share the challenges. Build trust and they’ll follow you anywhere.
4. Invest in What Moves the Needle
Now is the time to double down on what works—whether that’s leadership training, marketing that actually brings in patients, or improving your patient education process.
5. Protect Your Mindset at All Costs
You can’t lead in fear. You can only lead in focus. I built my growth mindset during the worst of the economy—and it’s the one thing that’s never failed me.
If You Want Help, That’s What We’re Here For
I built Optimize Practice Alliance so other doctors wouldn’t have to figure this out the hard way like I did.
We help dental entrepreneurs:
- Cut out inefficiencies
- Build strong, self-led teams
- Systemize their operations
- Develop real growth plans
- And eventually exit at top value
We’ve walked this road—and we walk it every day with clients across the country.
If you’re ready to build a recession-resistant practice that runs with confidence, not chaos, let’s talk.
Final Thought
When the economy gets shaky, your business doesn’t have to.
You can grow now.
You can lead now.
You can build your most profitable phase right now.
I did it in 2008.
And I promise you—you can do it now.
Let’s get to work.