Why Dentists Struggle With Leadership (and How to Fix It)

In a recent Bite-Sized Dental Marketing podcast with Marissa Krugov, we unpacked a reality many dentists quietly face. You went to dental school to become a great clinician. You spent years learning how to diagnose, treat, and restore. You mastered your craft. Then you opened your own practice and realized the hardest part had nothing to do with dentistry at all.

It had to do with people. With systems. With money moving through a front desk you were not entirely sure you understood. With a team that needed leading, not just managing.

If that sounds familiar, you are not alone. You were simply never taught this part.

Marissa, co-founder of Dental Practice Management Agency and a Tony Robbins certified coach with decades of experience across clinical, administrative, and DSO leadership roles, shared a clear perspective: dentistry is rarely the hard part. The leadership is.

No One Prepares You for Ownership

For most dentists, the first few years after graduation are focused on getting better clinically. Then ownership enters the picture, and suddenly the same person producing all day is also responsible for payroll, insurance, collections, conflict resolution, compliance, and team culture. All at once. Every week.

The dental profession jokes that dentists don’t make strong business owners. The real issue is simpler. They were never given the tools. Dentistry gets years of formal training. Leadership mostly gets ignored until something goes wrong.

Financial Awareness Isn’t Optional

When a practice owner doesn’t understand what’s happening at the front desk, blind trust becomes the default system. Claims sit unworked. Write-offs happen without review. Reports get accepted at face value because no one has the literacy to question them. In more serious cases, embezzlement occurs precisely because there was no oversight in place.

The solution isn’t micromanagement. It’s literacy. You don’t need to run insurance yourself, but you do need to understand how money flows through your practice, what your reports mean, and where the vulnerabilities exist. You can be busy and still be losing ground.

Dependency Is Not Stability

One person who knows the claims process. One person who knows how to close out the day. One person who manages scheduling and has never written it down. If your practice cannot function smoothly when one person is absent, it is not stable. It is dependent.

Healthy practices document their systems and cross-train their teams. Knowledge concentrated in a single person isn’t efficiency. It’s risk.

Accountability and Hard Conversations Go Hand in Hand

In strong practices, systems are upheld. Huddles start on time. Expectations are clear. When something isn’t working, it gets addressed with clarity, not aggression.

When accountability weakens, standards quietly become suggestions. Teams feel that shift immediately. And when small issues go unaddressed, they grow. A pattern of lateness, a negative tone, resistance to systems – these things expand when ignored. Addressing them early, privately, and directly is always easier than waiting.

Avoidance doesn’t preserve harmony. It postpones discomfort and guarantees it will be bigger when it finally surfaces.

Culture Is Shaped by What You Allow

A single misaligned team member can impact morale, productivity, and retention across your entire practice. High performers lose motivation when they see standards applied unevenly. Resentment builds quietly. Eventually, you start losing the people you most want to keep.

Fear keeps most practice owners from acting on this. But here’s what Marissa has observed consistently: once a genuinely difficult team member exits, the rest of the team feels immediate relief. The change that felt risky turns out to be the thing the team had quietly been waiting for.

You will get what you allow. Culture is shaped by tolerated behavior, not written policies.

Leadership Is a Learnable Skill

Dentists routinely invest thousands each year in clinical continuing education. The investment in business education, leadership development, and communication training is a fraction of that, if it exists at all.

Ownership requires more than clinical excellence. It requires business literacy, the ability to lead a team, and the confidence to have difficult conversations. Those skills don’t arrive automatically with experience. They require intentional development. And as Marissa was clear about, they are absolutely learnable.

When leadership improves, everything else follows. Systems become manageable. Culture strengthens. Production becomes easier, not because you’re working harder, but because the environment around you is finally working the way it should.