teamwork

How Does Culture Contribute to the Bottom Line in Your Dental Practice? 

Communication, Clarity and Cohesion within Your Dental Practice is paramount to your success. But how do you achieve it successfully? I’ve just finished reading The Four Obsessions of An Extraordinary Executive: A Leadership Fable by Patrick Lencioni. It’s a very good illustration of how mindful leadership leads to success throughout an organization. It’s told in the manner of a Rich Dad, Poor Dad type of scenario. One company thrives while the competing company struggles under a frayed culture. While I didn’t find any information that was new to me, it illustrated extremely well how an organization bereft of cohesion, focus, communication and intention suffers and implodes. While an organization driven by a leader with clear vision, strong intentions, transparent and direct communication thrives in an environment of cohesion and unity.  

The book echoes my own beliefs and leadership style and I was reminded of a lot of sound principles and strategies. So, it’s a good reminder for a seasoned team leader and an excellent resource for someone new to a leadership role.  

Four Principles to Establish in Your Dental Practice 

The primary focus of the book to teach leaders how to ensure that their entire team structure is 100% clear on the focus and intention of the organization. I don’t disagree with anything that Lencioni illustrates in the book as important to a leadership role. These are solid principles that will enhance any leader’s role while training new leaders in sound strategies to take into any future leadership position.  Lencioni calls them disciplines:  

  • Discipline 1 – Build a Cohesive Leadership Team

Lencioni considers this the most important of the disciplines in creating a healthy organization with leadership that develops and maintains high-performance.  

  • Discipline 2 – Create Clarity 

The book examines six questions that root out contradiction and cross-purposes in order to create cohesive clarity at the executive level, an essential step before attempting clarity within the organization.  

  • Discipline 3 – Overcommunicate Clarity 

Once clarity is established at the ‘top’ that messaging needs to be communicated over and over again to the entire company, while maintaining consistency, intention and focus.  

  • Discipline 4 – Reinforce Clarity 

The answers to those six questions need to be reiterated again and again to ensure it becomes “embedded into the fabric of the organization” while all functions of the organization are filtered through those answers.  

The book makes it clear that it is the leaders’ job to build and fully protect the culture of the organization. And it is up to the leadership team to ensure that throughout the organization everyone understands what the company aspires to be, and the principles with which it operates.  The focus, as Lencioni makes clear, is on ensuring that all communication flows down to team members in a manner that continually and consistently establishes alignment throughout the organization. 

This book is worthy of your time if you aspire to a leadership role, want to enhance your leadership capabilities or are entering an organization badly in need of a cultural makeover.  

How Does the Culture You Create Affect Your Bottom Line in Your Dental Practice?  

Culture is built through intentional leadership. As a practice owner, it’s your responsibility to define what’s acceptable, what’s encouraged, and what’s non-negotiable. Without clear direction and consistent follow-through, cultures drift, leading to misalignment, inefficiency, miscommunication, and wasted energy.

At Optimize Practice Alliance, we believe strong cultures are created through clarity, communication, and accountability. These principles don’t live on posters or in mission statements, they show up in everyday conversations between leaders and their teams.

That’s why we created the DESC Coaching Template. This tool gives dental entrepreneurs a simple, effective framework to address behaviors, clarify expectations, and reinforce accountability without tension or ambiguity. When leaders communicate clearly and consistently, trust increases, performance improves, and culture begins to positively impact the bottom line.

Culture isn’t abstract, it’s operational. And when it’s led intentionally, it becomes a competitive advantage.

Ready to strengthen your culture through better leadership conversations?

The Power of Servant-Leadership in Your Dental Practice: #1 Secret to Cohesive Teams

In my quest to understand how to be a better leader within my organization and move from dentist to investor in my dental practice, I discovered a piece of writing that became an invaluable tool of my leadership development. In his 1977 essay, The Servant As Leader, Robert K. Greenleaf coined the term servant-leadership. Servant-leadership as a philosophy that centers the organization and its leaders as servants to a greater community.

In his essay, Greenleaf describes the necessary qualities and characteristics of servant-leadership and how these qualities contribute to a healthier organization, community and society at large. He also details the skills necessary for effective leadership.

Using Servant-as-Leader Skills in Your Dental Practice

The skills such as awareness, empathy, the ability to listen, anticipation of obstacles are the foundational activities that resonated with me as being the type of leader embodying the values I also wanted to instill throughout my organization.

Improving leadership in your dental practice

Servant-Leadership Skills Vs. Traditional Leadership Qualities in a Dental Practice Setting

  • Servant-Leadership
  • Listens as a Practice
  • Practices Empathy
  • Leads with his/her values
  • Is Aware of Strengths & Weaknesses
  • Practices Inclusivity in Decision-Making
  • Measures Success through a holistic lens
  • Traditional Leadership
  • Speaks as a Practice
  • Leads through Control
  • Is not necessarily guided by personal values
  • Uses Leadership as a rank of value
  • Top-down Decision-Making
  • Measures Success only through Output

My Own Story of Learning to Lead

In my book, Extraction: The Surprising New Formula to Systemize, Scale and Sell Your Business, I go into the skills, principles and qualities I use to guide my leadership style. In fact, I dedicate an entire chapter to this called Leadership and Execution. But it was this pamphlet that really started it all for me, in how I look at leadership and the way I have molded my own path to leadership.

Applying Leadership Skills and Values in Your Dental Practice

This little pamphlet had a profound effect on me. Within its unassuming pages I found a path for instilling my personal values into my leadership style and using them to help me guide my practice in a way that felt most comfortable for me and that honored all voices within my organization. It’s a quick read and I hope you enjoy it as much as I did.

These are the same values, principles and skills that today guide Optimize Practice Alliance. We really are an organization that practices what it preaches and espouses as its values. If you would like to learn more about OPS, what we stand for and how we can help your organization, take a fast and free assessment and get in touch! We’d love to find out about you too!

Practicing Servant-Leadership in Real Time

One way to discover your values, brush up on your leadership skills and work out your challenges around leadership issues is to speak with other dentists who’ve been in your shoes. Our CEO, Josh Gwinn, runs a monthly mastermind exclusively for dentists.

Each month dentists come together to discuss their biggest issues and find solutions, celebrate each others’ wins and provide feedback and resources to overcome challenges and roadblocks in their practices. It’s an incredible opportunity for dentists to brainstorm together and create a community that works for them. It’s also in alignment with our motto,

We believe the future of dentistry belongs with dentists

Through the values that our founder and president, Dr. Jack Bayramyan, founded OPS on, we are dedicated to providing tools, solutions and long-term strategies to dentists no matter what stage of growth they find themselves. This includes bettering themselves in their mindsets and as leaders of their organizations. Now, you may be asking yourself, what is a mastermind?

Practicing Servant Leadership in Real Time

Servant leadership starts with clarity: clarity about your values, your purpose, and the kind of leader you want to be for your team and your patients. It’s difficult to serve others well if you haven’t first taken the time to define what truly matters and where you’re leading your organization.

That’s why we created the Extraction GPS. This tool helps dental entrepreneurs slow down long enough to clarify their values, assess where their practice is today, and define a clear direction forward. When your vision is rooted in service and intention, leadership decisions become more thoughtful, more consistent, and more impactful.

At Optimize Practice Alliance, we believe the future of dentistry belongs with dentists and that future is built by leaders who serve with purpose, humility, and clarity.

One of the Greatest Strategies of Servant Leaders

Great servant leaders don’t rely on instinct alone, they operate from alignment. They understand that values-driven leadership requires a clear roadmap, so their actions consistently reflect what they stand for.

The Extraction GPS was designed to help you translate servant leadership principles into action. By clearly defining your values, long-term vision, and priorities, you create a framework that supports your team, strengthens your culture, and guides your practice through growth and change with integrity.

When your direction is clear, service becomes sustainable. Your team knows what you stand for. Your decisions reinforce trust. And your leadership creates lasting impact.

Ready to lead with clarity and service at the center?

Unleashing your Unlimited Leadership Potential as a Dental Entrepreneur: 4 Lessons of Extreme Ownership

How seriously do you take leadership as a dental entrepreneur? I went into the U.S. Navy straight out of high school. I spent 6 years in the Military and then ended up in optometry as a vision technician. I was a vision tech for about 3 weeks before being promoted to practice manager. I then spent about 6 years in that optical group managing 35 locations. I became a director of operations, opening de Novos on the East Coast before moving into dentistry in 2012 in my first role was as a VP of Operations for Great Expressions. I moved from vision tech to CEO within 10 years.  

Taking Extreme Ownership of My Own Future 

It was a fast rise, but I got one of my biggest lessons about leadership when I joined Hero Practice Services, a full-service pediatric dental group. The year prior to my joining, Hero had an EBITDA of $13 million. The CEO before me had taken the company’s value from $13 million to $6 million in 11 months. In addition to that, they had a turnover rate in providers of 70% for the previous 12 months. I walked into a dismal, disheartened team and company environment. So I did what I had trained to do as a leader in the Navy.  

I started cleaning out latrines with my soldiers. I put on scrubs and started taking out the trash, cleaning operatories and asking the teams how best I could support them. My actual question to my teams was, “how can I support you while you support the boss?” Some looked at me quizzically, asking, “aren’t you the boss?” And my response was always, “Our bosses are the 5 year-olds walking through our doors every day needing our services and care.”

To me, that is the definition of extreme ownership as a CEO.  I was willing to do any and all jobs to get us back on track and instill a sense of pride, ownership and stability in my teams, no matter how many practices I had to walk into.

Careless Leadership Leads to Care-less Teams 

It’s very easy to get caught up in labels, hierarchy, power, etc. and if you’re not careful, as a dental entrepreneur and leader in your dental practice you can inadvertently create a culture of those kinds of qualities and values. One of the aspects of my job at Optimize Practice Alliance is executive coaching our doctors to help them understand that it’s perfectly fine to be wrong, but it’s not fine to be wrong and blame other people or power-trip them, etc.  

Turning Extreme Ownership into Real-World Results 

Back at Hero, we went from about 40 practices to around 70 and grew our revenue from roughly $60 million to about $140 in a 28-month period. We more than doubled the valuation. We also expanded into 2.5% of the national Medicaid market and sustained that growth until about December 2021 when I left the company to help found OPA. So, what that tells me is we parlayed that cultural shift, always asking “Who’s the real boss?” into hard numbers and a solid increase in market share and company valuation.  

As a CEO, I am constantly seeking ways to enhance my leadership skills and drive our organizations toward sustained growth and innovation. When I read Extreme Ownership: How U.S. Navy SEALs Lead and Win by Jocko Willink and Leif Babin I saw in that book the embodiment of my values as a leader and how I teach and coach those principles for our dental entrepreneurs. This book provides profound insights into leadership that are both transformative and practical for dental entrepreneurs. So, I want to share some of my insights here.  

President Harry S. Truman and his famous sign, The Buck Stops Here!

Understanding Extreme Ownership 

There are many great themes in this book, but the central tenet is the concept of extreme ownership, which posits that leaders must take absolute responsibility for everything in their domain. Harry Truman, the 33rd president of the United States, kept a sign on his desk that read, “The buck stops here.” For me, this quote encapsulates the essence of extreme ownership.

This principle is rooted in the experiences of Willink and Babin as Navy SEAL officers, where the stakes were, quite literally, life and death. By taking complete ownership, leaders can effectively guide their teams toward success while instilling a culture of accountability and resilience. And complete ownership for these leaders, means owning the good decisions (not the credit) as well as the bad ones. The buck stops here. Following are the themes I extracted and wanted to share you with you here.

Key Lessons for Leaders

  1. No Bad Teams, Only Bad Leaders: One of the most striking lessons from the book is the idea that team performance is a reflection of leadership quality. Willink and Babin recount how changing the leader of an under-performing team led to a dramatic turnaround. For dental entrepreneurs, this underscores the importance of developing strong leadership throughout their organization and not shying away from making necessary leadership changes when needed. 
  2. Decentralized Command: Effective delegation is critical. The book emphasizes the need for leaders to empower their subordinates to make decisions and take ownership of their roles. This decentralization not only fosters a sense of ownership at all levels but also ensures that decisions are made closer to the action, increasing agility and responsiveness. For dental entrepreneurs this is crucial for a well-running front office, buzzing operatories and happy hygienists.
  3. Prioritize and Execute: In high-pressure situations, the ability to identify the most critical tasks and focus resources on them is crucial. Willink and Babin’s approach to prioritization helps leaders manage multiple competing demands without losing sight of the primary objectives. For dental entrepreneurs, this means clearly defining priorities and ensuring that the entire organization is aligned with these goals. For instance, if you’re in the middle of scaling your organization while still working chairside, you need to prioritize and execute while your teams do the same. This is crucial to your scaling success.
  4. Simplicity: Complexity can be the enemy of execution. The book advocates for simplifying plans and communication to avoid misunderstandings and ensure clarity. In the business world, this translates to clear, concise strategies and communication that everyone in your dental organization can understand and rally behind. For a dental entrepreneur, simplicity not only translates to greater execution, it ensures safer and better patient outcomes.

Implementing Extreme Ownership as a Dental Entrepreneur 

Implementing the principles of extreme ownership requires a shift in mindset and culture. I’ve put together a short list of practical steps you can take to start integrating these lessons into your dental organization. This list is by no means exhaustive, but it is a solid start with minor shifts in your thinking, processes and accountability as a dental entrepreneur:

  • Model Ownership: Demonstrate extreme ownership in your actions. Acknowledge mistakes openly, take responsibility for failures, and share credit for successes. 
  • Empower Your Leaders: Train your leadership team in these principles, ensuring they understand and embrace their roles as owners within their domains. 
  • Simplify Processes: Review and streamline your organization’s processes and communication channels to enhance clarity and efficiency. 
  • Encourage Open Communication: Foster an environment where feedback is welcomed, and information flows freely up and down the chain of command. 
  • Read the Book: This book is a quick read and the stories are fascinating. Take some time to read it and digest this invaluable information. It can’t hurt and it will most definitely have a profound impact on you as a leader and enhance your skills as a dental entrepreneur.

A Blueprint for Transforming your Dental Culture 

Extreme Ownership is more than yet another book on leadership; it is a blueprint for transforming organizational culture and guiding exceptional performance. As dental entrepreneurs, adopting these principles can help us build more resilient, accountable, and agile organizations. Whether you are navigating a turnaround in your practice, scaling for growth, or simply looking to refine your leadership approach, the lessons from Willink and Babin offer invaluable guidance. Embracing these principles will give you the tools to lead your organization to profound success and realize your vision. 

Support for the Dental Entrepreneur Starts with Clear Direction 

High-performing leaders move fast, but the best ones don’t move blindly. Unlimited leadership potential isn’t unlocked by speed alone; it’s unlocked by clarity of purpose, alignment around values, and a clear direction for where you’re taking your team.

That’s why we created the Extraction GPS. This tool helps dental entrepreneurs clarify what they stand for, define where their practice is today, and map out where they’re going, so execution is driven by intention, not chaos. When your vision is clear, your team can move faster, make better decisions, and execute with confidence.

Leadership becomes simpler when everyone knows the destination. Trust increases. Accountability strengthens. And momentum becomes sustainable.

Ready to lead with purpose, clarity, and conviction?

#1 Rule of Successful Dental Practice Owners: Measure What Matters 

Do you measure what truly matters in your dental practice? Nearly every conversation I have with a fellow dentist-entrepreneur circles around how to know your investment and time is working, ‘how do you know that you’re actually growing your dental practice?’ 

You Can’t Improve What you Do Not Measure

Common sense tells us that in order to keep improving you must keep examining the results of what you’re doing. What is the point of doing a tremendous amount of work unless you’re going to review it to see what has been effective and what has been a waste of time? 

“In God we trust, all others bring data.”

-W. Edwards Deming

Reading a slew of reviews about a business who consistently makes incredible hamburgers but their fries are always soggy is literally reading the lagging indicators of a business that refuses to accept feedback and examine its protocols to address what is working and what is not. Reviews are one way to gain insight into what’s working in your business and what’s not working. They are also a look back into the near past: one person’s recent experience at that one hamburger joint. Make sense?

Here’s What to Measure in your Dental Practice

So, how do you measure and what do you measure? Two vitally important questions every business needs to ask and answer constantly and consistently.  

In the case of dental patient treatment plan acceptance, patient nurturing and dental patient experience, not all actions are created equal. Some of our actions have a greater impact on our environment than others and it’s a good idea to know which ones have a greater impact and which ones have a weaker impact.  

Lead Measure Vs. Lag Measure

First, let’s define some terms. Lead measures or lead indicators help you predict which actions might successful and which might not, in other words, what to keep doing to keep getting the same successful results.  

A lag measure or lag indicator, measures your wildly successful goal with results that have already passed like profit, revenue, and patient satisfaction. They are a little harder to gauge because the results are correlated to actions taken in the past.  

In my book Extraction: The Surprising New Formula to Systemize, Scale and Sell Your Business, I breakdown different forms of measurement and the importance measuring growth and goal achievement play in your leadership role. Let’s look at three measurable areas of your practice here.  

Dental Practice Revenue Growth

  • Leading Indicator: The leading indicator here is the Number of Qualified Patient Leads. By measuring the number of qualified leads generated, your business can predict future sales growth. In a dental practice, your qualified leads are patients who call for an appointment—for a service you can provide with a payer you accept. If the number of qualified leads is increasing, it’s likely that sales growth will follow. If your qualified leads are decreasing this is an area that you want to pay attention to with your team to decide why they are decreasing and what can be done to stop and reverse the trend, essentially get ahead of the ‘problem’ before it becomes one.  
  • Lagging Indicator: Dental Practice Production or Revenue. Production or revenue is a lagging indicator because it shows the results of past sales efforts. As we know, production in your dental practice doesn’t happen if the patient doesn’t show up, accept the treatment plan, and ultimately pay for the dental care you delivered. After sales have been made, revenue is generated, but this data is historical and cannot be used to predict future sales growth. It can help you look back and evaluate what you and/or your team did to increase revenue or the reverse: review what you did that possibly decreased revenue.  

Safety in Your Dental Practice

  • Leading Indicator: Number of Safety Training Hours. By measuring the number of safety training hours completed by employees, including HIPAA and OSHA trainings, a business can predict the likelihood of workplace accidents. There is a documented correlation of safety in the workplace to awareness of rules, laws, regulations and best practices. If the number of safety training hours is increasing, it’s likely that the number of accidents will decrease in the future. 
  • Lagging Indicator: Number of Workplace Accidents. Workplace accidents are a lagging indicator because they represent past events that have already occurred. By the time an accident is recorded, it’s too late to prevent it from happening. But it’s not too late to review protocols, training hours and best practices to ensure accidents decrease and awareness of safety protocols are top of mind for your employees.  

Managing Employee Turnover in Your Dental Practice

  • Leading Indicator: Employee Engagement. By measuring your employee engagement through surveys, anonymous feedback systems, communications and strong morale engagement, your business can predict your future turnover rates. If your employee engagement is low, it’s likely that turnover rates will increase in the future. 
  • Lagging Indicator: Employee Turnover Rate. Your employee turnover rate is a lagging indicator because it shows the results of your past employee retention efforts. After employees have left, turnover rates can be calculated, but this data is historical and cannot be used to predict future turnover rates. However, if your turnover rate is high, you can take a look at your employee engagement protocols to see what is lacking and where you can improve employee engagement.  
What Type of Growth is Expected in My Dental Practice?

The Measurement of Growth is A Measure of Leadership

These are just a few examples of how using and measuring your leading and lagging indicators can improve so many areas of your dental practice. The key takeaway is that leading indicators can be used to predict future outcomes, while lagging indicators show the results of past actions. By tracking both leading and lagging indicators, you can better understand how your actions, decisions and the actions of your teams affect performance so you can make more informed decisions about future strategy. 

The role of a leader is not just to delegate, guide and grow, it is also to measure so you can continue to improve on what has come before. If you’re working with a strategic plan in order to scale your practice, how will you know when to buy your second practice? Is it simply when you’ve socked away enough money or is it when your key performance indicators show that, not only are you financially ready to buy but it’s also the right economic environment to buy?  

Mastering Dental Practice Entrepreneurship

Successful dental practice owners don’t grow by guesswork, they grow by measuring what truly matters. If you’re ready to assess the real health of your practice and make confident, data-driven decisions, the next step is putting the right metrics in front of you.

That’s why we created our KPI Tracker, built specifically for dental entrepreneurs. This tool helps you monitor the key indicators that drive growth, profitability, and sustainability, so you can spot trends early, identify opportunities, and lead your team with clarity.

If you’re ready to stop relying on assumptions and start leading with insight, this tracker gives you a simple, actionable way to stay focused on what moves the needle.

Ready to measure what matters most?

Inside Optimize: How your team “makes” your dental practice

February/March 2023 edition

Inside Optimize is a newsletter focused on what we love – leadership, excellence, and dental entrepreneurship. We hope you love it too! Reach out to the Optimize Practice Services Team at partnership@staging.optimizeps.com.

Read our feature article here.

Extraction by Dr. Jack Bayramyan - Optimize Practice Services

Read the Best-Selling Extraction by Optimize’s own Dr. Jack Bayramyan

Dr. Jack learned the hard way how to build, scale, and exit his business. And now, he wrote the book to help you do the same thing!

3 Ways Dental Practices Can Supercharge Their Teams with the Flywheel Concept

We all know teamwork is required to get your dental practice humming along, but sometimes it feels like one team member is responsible for all of the “humming.” Leverage the Flywheel Concept from Good to Great to get your whole team moving in the same direction.

Read the blog by CEO and Co-Founder Josh Gwinn here.

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3 Ways Your Dental Practice Can Supercharge Your Teams and Win with the Flywheel Concept

A well-run dental practice requires a strong team working together every day. We’ve all been there when the team isn’t behind us. We find ourselves pulling all the weight trying to make the dental practice hum…by ourselves.

A dental practice is like a well-oiled machine, in this analogy, a flywheel. This machine needs every part running smoothly in order to be effective. And achieving a smooth flywheel function requires removing friction and applying force, especially at the beginning of operation when momentum is key.

The flywheel effect in your dental practice results in an accumulation of small wins over time and is based on teamwork, consistency and excellence. Jim Collins introduced the ‘flywheel effect’ in his book, Good to Great. It’s a wonderful analogy to apply to your dental practice as a clear template for creating and sustaining momentum, efficiency and excellence with your teams and your dental practice.

Without teamwork, appointments may be missed, patients may feel neglected, processes may be overlooked and the overall efficiency of the practice may suffer. Each member of the team plays a crucial role, from the receptionist who schedules appointments to the dental assistants who assist the dentist during procedures. Their collective efforts create a positive and comfortable environment for patients, promoting trust and satisfaction. Effective communication and collaboration among team members are key to maintaining a well-run dental practice and delivering high-quality dental care.

Flywheel - Optimize Practice Services - Dental Practice

The Flywheel Concept

The Flywheel Effect pertains to how you can try to build efficiency and teamwork in the practice every day. To illustrate this, I want you to imagine a huge flywheel that weighs thousands of pounds. Your goal is to get that flywheel moving. So, you push and push as hard as you can.

Over time, it slowly starts to move, but it’s a lot of work. Now, add an excellent practice manager, hygienist, an associate or two, and dental assistants trained and ready to get that flywheel rolling. Not only do you not have to work as hard, but you see results faster. With every turn of the flywheel, it gets a little easier.

Eventually, the momentum shifts, and boom! The flywheel is turning, and the “inertia” is working for you, not against you. You find that not everything rests on your shoulders anymore. You’re not making all the decisions. You’re not double-checking everything and the momentum for your business doesn’t rely on one person, you, any longer. You’re created a well-oiled and fully spinning machine.

3 Ways to Leverage the Flywheel Concept in Your Dental Practice

The Flywheel Effect reminds us that real transformation doesn’t happen overnight. Momentum is built through consistent effort, shared commitment, and a clear direction everyone can rally around. When frustration shows up—as it inevitably will—that’s often a sign to lean back into your vision and recommit to the long game.

Progress accelerates when your team understands the destination and how their work contributes to it. Alignment turns effort into momentum, and momentum turns small wins into lasting success.

That’s why we created the Extraction GPS. This tool helps dental entrepreneurs clarify their values, define their current reality, and map a clear path forward—so the flywheel you’re turning is aimed at the right outcome. With clarity of direction, momentum becomes easier to build and sustain.

Ready to create alignment and build momentum that lasts?