Stop Rescuing Your Dental Team: When Support Quietly Becomes the Problem
- Sarah Beth Herman
- 7 days ago
- 10 min read
By Sarah Beth Herman, MBA, Founder & CEO, Dentistry Support®
There is a sentence I hear all the time from dental practice owners and managers: “I don’t know what else to do. I’ve tried everything.” Usually, they are talking about an employee. They have trained them, they have retrained them, they have changed the schedule, they have adjusted the role. they have reminded them, they have written a new SOP, they have paired them with the strongest person on the team, they have had the conversation in the office, followed by the conversation after the conversation, followed by an email summarizing the conversation so there is no possible way anyone can say they did not understand the conversation. Then Monday comes, and somehow we are right back where we started.
If you have led a dental practice for any amount of time, you have probably been there. What I want to challenge in this week's Dentistry Support® Free Training is the assumption that the answer is always to do more for the employee. Sometimes it is. Sometimes an employee truly has not been trained properly. Sometimes the system is terrible. Sometimes the expectation was never clear. Sometimes a person has been handed a responsibility without the tools or authority to accomplish it. But sometimes we have done so much for an employee that we have accidentally removed their need to take responsibility for themselves. That's a different problem. And it's one dental leaders need to get much better at recognizing.
FREE TRAINING: START WITH THE RIGHT QUESTION
When someone on your dental team is struggling, don't start with: “What is wrong with this employee?” Start with: “What kind of problem am I actually dealing with?”
I think leaders should separate performance problems into at least four categories: a mistake, a knowledge gap, a pattern, and a choice. They require very different responses.
A dental assistant grabs the wrong material because two nearly identical products were stored beside each other. That's probably a mistake, and it may reveal a systems problem.
A new insurance coordinator doesn't understand how your office wants a particular benefit documented. That's probably a knowledge gap. Train it.
A front-office team member repeatedly fails to complete the same assigned task after the process has been taught, documented, reviewed, and discussed multiple times. Now we're looking at a pattern.
When that pattern continues after the person understands the expectation and has what they reasonably need to meet it, the conversation begins to change.
Dental leaders get themselves into trouble when they keep treating every performance issue as though it is still a training problem.
We train again, we explain again. We create another checklist. At some point, another checklist isn't going to fix it.
YOUR DENTAL PRACTICE NEEDS CLEAR EXPECTATIONS
Accountability doesn't begin when someone fails. It begins when the expectation is established. Before I hold someone responsible for missing a standard, I need to know whether we actually gave them one.
“Keep the schedule full” isn't a particularly useful standard. What does full mean?
“Stay on top of AR” sounds good, but what does on top of mean in your practice?
“Answer the phones quickly.” How quickly?
“Follow up with patients.” Which patients? How often? How many attempts? Where is it documented? Who owns the next step?
If five people can hear the same instruction and come away with five different interpretations, the first problem isn't accountability. The first problem is clarity.
Research in dental practices has shown direct relationships between leadership behaviors and team communication. Chilcutt (2009) found that leadership approaches influenced team identification, communication, decision-making, and conflict management in dental practices. The study also noted that inadequate leadership and communication training can contribute to staff-related stress and turnover. (ScienceDirect)
More recent research makes the point even more relevant. A 2026 study examining leadership in primary-care dental practices found that leadership is woven into patient care, running the surgery, and running the practice itself. The researchers described dental leadership as relational and connected to emotional intelligence, clinician well-being, and effective clinical care. (ScienceDirect)
In other words, this isn't something separate from dentistry. It's part of running a dental practice.
FREE TRAINING EXERCISE: DEFINE “DONE”
Pick three recurring responsibilities in your practice this week. Maybe they are: Insurance verification. Unscheduled treatment follow-up. Claims follow-up.
Now ask the employee responsible for each task: “Tell me what done looks like.”
Don't tell them first. Listen.
You may discover that what you think you've communicated and what your employee believes they're responsible for are completely different
That's useful information.
Before you create accountability, create clarity.
BE CAREFUL WITH THE EMPLOYEE EVERYONE LIKES
This is where leadership gets uncomfortable. Every dental practice seems to have had one. The employee everybody loves. Patients love them. The team loves them. They've been there forever. They know everybody's birthday. They're funny. They're the person organizing lunch.
They may also be terrible at completing the responsibilities attached to their position.
Now leadership has a problem because addressing performance feels personal. So instead of dealing with it, everybody quietly works around it. Another employee checks their work. The office manager reminds them. Someone else finishes the task. The doctor says, “That's just how they are.”
No. That's how we are allowing them to be at work.
The American Dental Association specifically warns that negative behavior and attitudes that continue to be tolerated can influence dental-office culture. Its practice-management guidance recommends frequent, honest communication and direct management of performance problems rather than allowing dysfunction to continue. (Ada Developers Academy)
This doesn't mean you fire somebody because they made a mistake. It means you stop confusing being liked with performing the job.
Those aren't the same thing.
THE CONSEQUENCE DOESN'T DISAPPEAR
Here's where I think this becomes really important for dental practices.
When one person doesn't complete their responsibilities, the work usually doesn't disappear.
Someone does it.
The hygienist is waiting for information that wasn't entered. The doctor gets pulled into a problem that should have been resolved before it reached them. The office manager stays late. Another front-office employee takes over. The billing team has to research something that should have been documented. The patient calls again because nobody followed through. You may believe you removed the consequence from an employee. What you actually did was move it.
That leads to a question I think every dental leader should periodically ask: Who is paying for the consequence I am removing from somebody else?
Your best employees are often the answer.
That's a problem.
Recent research examining stress across the dental workforce found that poor management, inadequate support and guidance, perceived inequality, and lack of effective leadership were recurring themes associated with workplace stress. Respondents also described the importance of feeling valued and appreciated at work. (PubMed Central (PMC))
Think about this from the perspective of your strongest employee.
They arrive on time. They do what you ask. They solve problems. They follow the SOP. They don't require daily reminders.
And because they are reliable, what happens?
They get more work.
Meanwhile, someone who repeatedly fails to perform gets more coaching, more meetings, more accommodations, more deadline extensions, and more of the leader's attention.
Eventually, the dependable employee notices.
Of course they do.
PSYCHOLOGICAL SAFETY DOES NOT MEAN NO ACCOUNTABILITY
I want to spend some time here because I think this has become confused in leadership conversations.
Your team should be able to tell you when something went wrong. They should be able to say, “I don't know.” They should be able to ask questions.
An assistant should be able to speak up if they notice something concerning. A front-office employee should be able to tell the office manager that a process isn't working. Someone should be able to admit a mistake before it becomes a larger one.
That's healthy.
But psychological safety doesn't mean nobody is responsible for anything.
Research by Higgins and Weiner (2014) examined longitudinal data from more than 58,000 teachers across approximately 545 schools over three years. Their findings showed that felt accountability had a cumulative positive impact on performance, while psychological safety could strengthen the effect of accountability. (Academy of Management Journals)
Later work by Higgins et al. (2022), using more than 170,000 teacher survey responses across 545 schools, continued examining the relationship between psychological safety, felt accountability, and organizational performance. Their findings showed that the relationship is more complicated than simply assuming psychological safety alone produces stronger performance. (LSE Research Online)
Those studies weren't conducted in dental practices, so we shouldn't pretend they were.
But they raise an important leadership question that absolutely applies to us: Why have we decided that caring about employees and expecting them to perform are competing ideas?
They aren't.
You can say: “I understand why this happened.”
And then: “We still need to correct it.”
Both sentences can be true.
FREE TRAINING: USE THE ACCOUNTABILITY CHECK
Before you decide someone has a performance problem, run through these five questions.
Was the expectation clear?
Could the employee explain exactly what was expected without you filling in the blanks?
Were they properly trained?
Not, “Did someone show them once?” Did they actually demonstrate that they could do it correctly?
Do they have what they need?
Software access. Time. Information. Authority. Equipment. Support. A reasonable workload.
Has the problem been addressed directly?
Not hinted at. Not mentioned casually while walking through sterilization. Actually addressed.
What happened after the conversation?
This is where patterns become visible.
Did performance change? For three days? For three weeks? Not at all?
That tells you something.
STOP HAVING THE SAME CONVERSATION
This is another trap I see.
“We've talked about this six times.”
Then why are we preparing for conversation number seven exactly the same way? If nothing changes after every conversation, the conversation itself has become part of the pattern. That doesn't mean the seventh conversation has to be angry. It probably shouldn't be.
It needs to be different.
Try: “We've discussed this previously, so I don't want to repeat the same conversation. Tell me what you're going to do differently this time.”
Now the employee has to participate.
Or: “I want to make sure we're clear. This is no longer an isolated mistake. I'm seeing a pattern.”
That's a very different conversation than: “Please try harder.”
Clarity is incredibly valuable.
YOU DON'T NEED TO FIX EVERYTHING
Some of the people reading this became successful precisely because you're good at solving problems.
Someone needs something? You handle it.
Something goes wrong? You fix it.
A patient is upset? Give me the phone.
A schedule falls apart? Move over.
That's useful when you're building a business.
It can become a problem when you're building people. If every difficult problem eventually gets handed back to the practice owner or office manager, nobody else ever learns how to carry difficult things. The next time an employee brings you a problem they reasonably should be able to solve, try resisting the urge to give them the answer.
Ask: “What do you think we should do?”
If they don't know: “Give me two options.”
If one option is clearly better: “Okay. Which one do you recommend?”
Now you're developing judgment instead of dependency.
Research on accountability within distributed leadership at a U.S. dental institution found that shared accountability involved personal ownership, agentic action, and shared beliefs. That is particularly relevant here because accountability isn't merely leadership watching employees; healthy teams develop people who see themselves as owners of their part of the work. (PubMed)
FREE TRAINING: LOOK AT YOUR STRONGEST EMPLOYEE
Here's your final exercise, and this one may tell you more about your practice than anything else in this training. Identify one of your most reliable employees.
Now ask yourself: What additional work are they doing because somebody else isn't doing theirs?
Don't answer too quickly. Look at it.
Did they inherit follow-up because another person never finishes it?
Are they constantly checking somebody else's work?
Are they the person everyone calls because “they'll actually get it done”?
Are they staying late?
Are they fixing mistakes?
Have you rewarded their reliability by making them responsible for everybody else's unreliability? If so, that deserves your attention.
Your strongest employees need leadership too. Don't spend all of your leadership capital on the people who require the most correction.
BEFORE MONDAY
I'm going to continue this conversation Monday, but I'm deliberately not giving you that conversation here. Episode 138 of No Silver Spoons takes this subject somewhere much more personal.
I talk about hiring family.
I talk about hiring people I had worked with before because I was convinced they would be different working for me.
I talk about the times I've retrained, reassigned, reminded, fixed, covered, and given another chance because I believed I could somehow help someone become the employee I saw the potential for them to be.
And I share something I've had to learn after years of leading people:
“Seeing potential in someone does not obligate them to do something with it.”
There's another line from Monday's episode I want you thinking about before you hear the story behind it:
“Consequences don't disappear just because a leader removes them. Most of the time, they transfer to somebody else.”
I'm saving the rest for Monday. For now, your assignment from this Dentistry Support® Free Training is simple. Look at one performance problem inside your dental practice. Decide what you're actually dealing with.
A mistake? A knowledge gap? A pattern? Or a choice?
Then look at yourself.
Was I clear?
Did we train?
Did we provide what was reasonably necessary?
Did we address the problem directly?
And if the answer to all four is yes, stop automatically assuming that doing more is the answer. Sometimes leadership means providing more support. Sometimes it means getting out of the way long enough to find out whether the person you're supporting is willing to carry their part.
We'll continue that conversation Monday on Episode 138 of No Silver Spoons.
Until then, take this training back to your practice. Because your goal isn't to build a dental team that needs you to rescue it. Your goal is to build one that knows how to take ownership.
References
Chilcutt, A. S. (2009). Exploring leadership and team communication within the organizational environment of a dental practice. Journal of the American Dental Association, 140(10), 1252–1258. https://doi.org/10.14219/jada.archive.2009.0048 (ScienceDirect)
Higgins, M. C., Dobrow, S. R., Weiner, J. M., & Liu, H. (2022). When is psychological safety helpful in organizations? A longitudinal study. Academy of Management Discoveries, 8(1), 77–102. https://doi.org/10.5465/amd.2018.0242 (LSE Research Online)
Higgins, M., & Weiner, J. (2014). Weathering the storm: Effects of psychological safety and accountability on performance. Academy of Management Proceedings, 2014(1). https://doi.org/10.5465/ambpp.2014.12561abstract (Academy of Management Journals)
Mertens, S., et al. (2020). Leadership in dental practice: A three stage systematic review and narrative synthesis. Journal of Dentistry, 102, 103480. https://doi.org/10.1016/j.jdent.2020.103480 (ScienceDirect)
Making the implicit explicit: Leadership in primary care dental practice. (2026). Journal of Dentistry, 165, 106283. https://doi.org/10.1016/j.jdent.2025.106283 (ScienceDirect)
Shared accountability in distributed leadership for improved healthcare access: A study of a US dental institution. (2022). Leadership in Health Services. https://doi.org/10.1108/LHS-03-2022-0019 (PubMed)
Disclaimer:
To learn more about Sarah Beth Herman, the author of all free training content you can read her bio here. These materials are intended to provide helpful information to dentists and dental team members. They are in no way a substitute for actual professional advice based on your unique facts and circumstances. This content is not intended or offered, nor should it be taken, as legal or other professional advice. You should always consult with your own professional advisors (e.g. attorney, accountant, or insurance carrier). To the extent, Dentistry Support ®has included links to any third-party website (s), Dentistry Support ® intends no endorsement of their content and implies no affiliation with the organizations that provide their content. Further, Dentistry Support ® makes no representations or warranties about the information provided on those sites. You can view our privacy policy and terms and conditions by clicking those pages in the footer of our website
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