Does your dream have a strong foundation?

In the pursuit to build your dream practice, you have most likely thought about how big you would like the space to be, how many operatories you’ll have, or the colors you’ll use. You may have even come up with a name or a logo. Have you thought about your operational foundation? Having a strong foundation will fuel the results you’ll need to realize your dream. After almost 20 years of working with hundreds of practices, large and small, I’ve distilled operational strength into four foundational cornerstones.

  • Purpose, Mission & Vision
  • Cash Flow & Profitability
  • Setting expectations and delivering on promises
  • Do what you do best

Let’s unpack each of these cornerstones a bit further.  

Purpose, Mission & Vision

Having a well-defined Purpose, Mission and Vision are critical to every successful business.

Your Purpose is the driving force behind every decision made regardless if it’s choosing which candidates to hire or deciding the location of a practice. These decisions create the environment you, your team, and your patients will live in. Be sure this environment is an accurate representation of your values and goals.   

Your Mission is how your Purpose will be delivered to the greater audience. What should your team do and say? What are the day-to-day behaviors that define your service platform?

Your Vision is more tangible; it’s the look and feel of the actual environment and experience. The ability to share your vision with your team in a way they can truly embrace is invaluable. Your team must know what right looks like, not from their perspective but from yours. When every team member knows the why (your Purpose), how (your Mission) and what (your Vision) and is aligned with them, the way forward is well marked and intentional.

Cash Flow & Profitability

Cash flow is the number one area where businesses struggle. Maintaining a positive cash flow is absolutely critical to a strong foundation. When cash is tight decisions are made that are less than ideal; candidates are hired, leases are signed, and equipment is purchased based on what you can afford rather than what is best for your business.

Have a clear understanding of the timeline to profitability. Understanding the ebb and flow of incoming revenues as well as how to control variable expenses is necessary to properly manage cash flow.

Set clear expectations and deliver every single time

Every business communicates to the consumer what to expect whether intentionally or unintentionally. If your practice is advertising fast, friendly, same day appointments, you better have the ability to make a same-day appointment every time a patient asks for one. When there is a disconnect between what we promise and what we deliver it eliminates the opportunity to build trust and gain buy-in. When there is no trust, there can be no real emotional connection. Great reputations, loyal patient bases, and tenured team members are all a result of managing expectations and delivering on promises.

Do what you do best and hire the rest

Too many times we see dentists wearing too many hats within their practice. Get honest feedback on your leadership skills, communication style, and ability to manage conflict. These are all critical skills that are developed over time with intentional focus. It’s unrealistic to believe that you are good at all these skills! Accept that you may need to refine these soft skills and seek out resources to help you develop them.

In addition to soft skills, you’ll also need support in other areas such as legal and financial advice, human resources, and performance management to name a few. Surround yourself with mentors and coaches aligned with your Purpose. Don’t be afraid to seek out and ask for help.

The most elite athletes would never consider going without coaches and advisors; give yourself the same opportunity for success and do what you do best.

Define your Vision with the Vision Worksheet available for download here.



With her vast experience in operations management with some of the country’s leading dental organizations, Suzann Harms leads the Jameson Operations Development Program helping doctors achieve their vision of productive and profitable multiple location practices.  Suzann has led dental organizations in effective rollouts in new markets, personnel management and acquisition, development of company culture, fulfillment of annual revenue goals and overall patient satisfaction. Her diverse leadership experience in growing multiple location practices helps doctors and practice owners identify growth opportunities and forecast accurately the next steps in their strategic plan.

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