The Decision You're Avoiding Is Already Costing Your Business
By Sarah Beth Herman, MBA, Founder & CEO, Dentistry Support®
Business owners often assume their biggest financial setbacks come from making the wrong decisions. They worry about hiring the wrong employee, investing in the wrong technology, choosing an ineffective strategy, or expanding before their organization is ready. While those decisions can certainly have consequences, there is another leadership mistake that often receives far less attention: refusing to make a decision at all. Sometimes, the greatest expense a business carries is the cost of a problem leadership already recognizes but continues to postpone addressing.
Consider the unresolved issues inside your dental practice today. Perhaps your accounts receivable continues to grow because insurance follow-up is inconsistent. Maybe your office manager is overwhelmed because administrative responsibilities have never been properly distributed. Your employees may have complained about the same inefficient software for months, yet leadership continues postponing the conversation about replacing it. These problems are rarely invisible. In many cases, everyone understands what needs attention, but nobody has taken responsibility for deciding what happens next.
As 2026 approaches its final months, business owners have an important opportunity to examine the decisions they have been avoiding. The end of the year often creates a sense of urgency around budgets, staffing, operational improvements, and future growth. However, many organizations continue telling themselves that necessary changes can wait until January. The problem with that approach is that a new calendar year does not automatically create better systems, stronger leadership, or improved financial performance. Without intentional action, the same unresolved challenges simply become part of another year's operations.
The Hidden Cost of Decisions You Never Make
Business owners spend considerable time evaluating the financial consequences of their decisions. Before hiring another employee, they consider payroll expenses, benefits, and long-term staffing requirements. Before purchasing software, they review subscription costs, implementation requirements, and potential returns. However, one expense frequently goes unexamined: the cost of continuing to operate with a problem that leadership already recognizes. When an organization repeatedly postpones necessary improvements, the financial consequences can accumulate through wasted resources, reduced productivity, and inefficient operations.
Consider a dental practice paying $1,200 per month for software that no longer supports its daily operations effectively. Employees constantly transfer information between systems, duplicate administrative work, and spend additional time correcting avoidable errors. Although leadership has identified potential alternatives, replacing the system would require employee training, data migration, and temporary operational adjustments. Rather than evaluating whether the long-term benefits justify the transition, the practice continues using the existing software simply because changing it feels inconvenient. At $1,200 per month, the existing subscription represents $14,400 in annual spending, even before considering the additional labor associated with its limitations.
This does not mean every inefficient system should immediately be replaced. Responsible financial management requires evaluating contractual obligations, security requirements, implementation costs, employee training, and the potential risks associated with transitioning to another platform. However, when leadership has sufficient information to evaluate its options and continues postponing the decision purely to avoid disruption, the organization may be paying to preserve an unnecessary problem. The question is no longer whether making a change involves expenses. It becomes whether the ongoing cost of avoiding the decision is greater than the cost of addressing the issue.
Why Familiar Problems Feel Safer Than Uncertain Solutions
One reason business owners postpone difficult decisions is that familiar problems often feel safer than uncertain alternatives. Even when an existing process is inefficient, employees understand its weaknesses and know how to work around them. Replacing that process introduces questions about implementation, training, unexpected expenses, and whether the new approach will actually perform better. Consequently, leadership may continue accepting an unsatisfactory situation because the risks associated with changing it feel more immediate than the ongoing consequences of leaving it unchanged.
This behavior relates to the concept of loss aversion, which is associated with the work of psychologists Daniel Kahneman and Amos Tversky. Their research on prospect theory examines how people evaluate gains, losses, and decisions involving uncertainty. One important finding is that losses can carry greater psychological weight than comparable gains, influencing how individuals approach risk and change (Kahneman & Tversky, 1979). In business environments, this helps explain why owners may hesitate to replace an underperforming vendor, restructure a struggling department, or discontinue a service that no longer contributes positively to the organization.
For example, a dental practice may continue working with an administrative vendor because the relationship has existed for several years. Although communication has deteriorated and service expectations are no longer consistently met, the owner worries that switching providers could disrupt operations. Those concerns deserve consideration, but remaining with the current provider also carries consequences that should be measured. Employees may spend additional time correcting mistakes, managers may repeatedly intervene, and important administrative responsibilities may remain incomplete. An informed decision requires evaluating the risks and benefits of both options rather than automatically treating the familiar arrangement as the safer choice.
Your Employees Are Already Experiencing the Consequences
When leadership postpones an important decision, the consequences rarely affect only the business owner. Employees frequently absorb the additional responsibilities, interruptions, and frustrations created by unresolved operational problems. A process that appears manageable during a leadership meeting may require hours of extra work from the people responsible for completing it every day. Over time, these repeated adjustments can become normalized, making inefficient practices seem like an unavoidable part of running the business rather than a problem that deserves attention.
Imagine a dental practice where insurance eligibility verification is consistently falling behind. Front desk employees begin checking benefits between patient calls, treatment coordinators follow up when coverage information is missing, and the office manager interrupts other responsibilities to resolve urgent insurance questions. The practice continues operating, but several employees are now spending time compensating for a process that lacks consistent ownership. Leadership may recognize the problem while postponing a decision about restructuring responsibilities or obtaining additional administrative support. Meanwhile, employees experience the consequences through increased workloads, competing priorities, and preventable interruptions.
The responsibility of leadership extends beyond identifying what is wrong. Business owners and managers must consider how unresolved problems affect the entire organization, including employees, patients, operational efficiency, and financial performance. A decision that feels inconvenient to leadership may represent an improvement employees have been requesting for months. Addressing these challenges does not always require hiring additional staff or purchasing new technology. Sometimes, meaningful progress begins with clarifying responsibilities, reviewing existing resources, improving communication, and establishing accountability for completing essential work.
Being Approachable Is Not the Same as Being an Effective Leader
Many managers believe they are approachable because they encourage employees to ask questions and maintain an open-door policy. However, approachability is not determined solely by a manager's intentions or personal perception. It is reflected in whether employees genuinely feel comfortable asking for assistance, reporting mistakes, expressing concerns, and communicating when responsibilities cannot be completed as expected. A leader may believe their team has permission to speak openly while employees have learned through experience that raising problems leads to criticism, frustration, or dismissal.
Research on psychological safety provides insight into why this distinction matters. Edmondson (1999) examined the relationship between psychological safety and learning behavior in work teams, emphasizing the importance of environments where individuals feel able to speak up, ask questions, and discuss mistakes. In a dental practice, employees need to communicate openly about insurance discrepancies, billing concerns, scheduling difficulties, and administrative problems before those issues become more complicated. When employees hesitate to report concerns because they fear negative reactions, leadership may lose access to information needed to make timely and effective decisions.
Creating an approachable leadership environment does not mean eliminating accountability or lowering performance expectations. Managers can listen respectfully while still requiring employees to communicate deadlines, follow established procedures, and take responsibility for their work. The goal is to create an environment where employees receive appropriate support and understand that raising concerns early is preferable to allowing problems to escalate. When employees trust that leadership will evaluate their concerns fairly and respond constructively, the organization is better positioned to identify operational weaknesses before they become expensive disruptions.
Stop Explaining Problems and Start Solving Them
There is an important distinction between understanding why a problem occurred and taking responsibility for resolving it. Managers may provide accurate explanations for missed deadlines, incomplete responsibilities, or unexpected operational challenges. Employees may have been unavailable, workloads may have increased, or circumstances outside the department's control may have affected performance. These explanations can be legitimate and necessary for understanding the situation. However, effective leadership requires looking beyond what happened and determining what actions could prevent the same issue from continuing.
Consider a manager who knows their department is falling behind on insurance claims follow-up. The workload has increased, several employees have competing responsibilities, and an important deadline is approaching. Rather than waiting until the deadline passes, the manager should evaluate priorities, communicate with affected departments, determine whether additional support is available, and notify leadership when intervention is necessary. These actions do not guarantee that every deadline will be met, but they demonstrate accountability and give the organization an opportunity to respond before the situation becomes more difficult.
Collaboration should be an essential part of this process. Department leaders must understand that their responsibilities exist within a larger organization and that challenges affecting one team may eventually influence others. Supporting another department does not mean employees should work unreasonable hours or abandon their assigned responsibilities. It means leaders communicate proactively, coordinate available resources, and work toward solutions instead of allowing preventable issues to become someone else's emergency. A manager who recognizes a problem early and takes appropriate action contributes more to the organization than one who waits until the damage is complete before explaining what went wrong.
Loyalty Should Not Prevent Necessary Leadership Decisions
Business relationships often become deeply personal, particularly when owners have spent years building their organizations. Long-term employees may have supported the company through difficult periods, and established vendors or customers may have contributed significantly to its growth. These relationships deserve appreciation and thoughtful consideration. However, gratitude for someone's previous contributions does not automatically mean an existing role, process, or business arrangement remains appropriate for the organization today.
Imagine a department manager who has worked for a dental practice for several years. The manager is well-liked, understands the practice's history, and has developed positive relationships with employees. Nevertheless, their department consistently misses deadlines, communication remains unclear, and other managers frequently intervene to complete unfinished responsibilities. Leadership provides feedback, and performance temporarily improves before returning to previous patterns. Because the manager has been loyal to the practice, the owner continues postponing a structured evaluation of whether the current arrangement remains effective.
Supporting employee development is an important leadership responsibility. Employees deserve clear expectations, appropriate resources, meaningful feedback, and reasonable opportunities to improve. However, accountability also requires evaluating whether those efforts produce measurable progress and whether ongoing performance problems are affecting the larger team. A business owner can appreciate an employee's contributions while recognizing that additional training, revised responsibilities, or other appropriate action may be necessary. Employment-related decisions should also be evaluated carefully in accordance with applicable laws, organizational policies, and the specific circumstances involved.
The same principle applies to relationships with vendors, customers, and business partners. An arrangement that was appropriate when a company was smaller may no longer support its present needs. Continuing an ineffective relationship solely because it has existed for years can prevent leadership from making decisions that benefit the organization as a whole. Loyalty should influence how respectfully and thoughtfully difficult decisions are handled, but it should not replace objective evaluation of current performance and business requirements.
When Every Decision Requires Your Approval, Growth Slows Down
As businesses grow, owners often establish departments and hire managers to distribute responsibilities more effectively. However, some organizations continue operating as though every important decision must still be made by the person who founded the company. Managers may have leadership titles but limited authority to resolve routine challenges, adjust processes, or coordinate departmental responsibilities. Consequently, employees wait for approval, managers hesitate to take initiative, and operational decisions accumulate on the owner's desk.
This situation can develop gradually because business owners have extensive knowledge of their organizations. They understand customer expectations, established standards, financial limitations, and the reasons existing procedures were created. In many cases, making a decision personally may initially seem faster than teaching someone else how to evaluate the same issue. However, continuing this approach as the organization expands can create unnecessary delays and prevent managers from developing independent judgment. The owner eventually becomes responsible for approving routine matters that could be handled effectively by qualified department leaders.
Successful delegation requires more than assigning someone a leadership title. Managers need clear expectations, appropriate decision-making authority, access to necessary information, and an understanding of when issues must be escalated. In dental practices, these boundaries are particularly important because administrative responsibilities, financial decisions, compliance matters, and clinical activities may involve different levels of authority. Establishing those distinctions allows managers to address appropriate operational concerns independently while ensuring that sensitive matters receive the necessary oversight.
If every departmental challenge requires the owner's personal intervention, leadership should examine whether managers have genuinely been empowered to lead. Business owners must also consider how they respond when a manager makes a reasonable decision that differs from their preferred approach. Providing constructive coaching can strengthen judgment and accountability, while repeatedly taking control may discourage initiative. Developing an effective leadership team requires allowing qualified managers to exercise appropriate authority and holding them responsible for how they use it.
Delayed Decisions Become More Expensive as Your Business Grows
Growth can increase the consequences of operational weaknesses that previously seemed manageable. A process that works adequately for a small team may become increasingly inefficient as employee numbers, patient volume, and administrative responsibilities expand. If leadership responds to these challenges by adding more employees or approval requirements without examining the underlying problem, the organization may increase expenses while preserving the same weaknesses. What begins as a minor inconvenience can eventually develop into a significant barrier to sustainable growth.
Consider a dental practice experiencing recurring scheduling problems. Appointment confirmations are inconsistent, employees occasionally miss important details, and the front desk spends additional time correcting preventable errors. Because staff members have learned to work around these challenges, leadership postpones reviewing the scheduling process. When the practice hires another provider and begins serving more patients, the same administrative weaknesses become more difficult to manage. Growth has increased the workload placed on a process that was already struggling.
Similar challenges can occur in insurance verification, billing, accounts receivable, claims follow-up, and employee communication. Adding more administrative employees does not automatically solve unclear responsibilities or inefficient workflows. Likewise, creating additional approval steps may slow progress rather than improve accountability. Before expanding an organization, leadership should evaluate whether its existing systems can support additional demand and whether responsibilities are structured to promote efficiency, accuracy, and consistent communication.
Financially responsible growth requires building systems that can develop alongside the organization. Managers need the tools and authority necessary to fulfill their responsibilities, employees need clear processes, and leadership needs reliable information to evaluate performance. Addressing these requirements early can help prevent business owners from investing additional resources simply to manage the consequences of unresolved operational decisions.
Your Year-End Financial Review Should Begin Before January
The final quarter of the year provides an opportunity to review the financial and operational decisions that will influence the coming months. Business owners often focus on establishing budgets, evaluating staffing requirements, and preparing growth strategies for the new year. However, an effective year-end review should also examine expenses, administrative processes, and performance concerns that have remained unresolved. Waiting until January to begin evaluating problems that already exist may unnecessarily extend their financial and operational impact.
For dental practice owners, this review should include an examination of recurring software expenses, vendor agreements, marketing performance, administrative workloads, and accounts receivable. Leadership should understand whether insurance claims are receiving consistent follow-up, whether eligibility verification is completed appropriately, and whether phone coverage supports the needs of patients and staff. If these responsibilities repeatedly create delays or require additional intervention, reviewing them before the year ends can help determine what improvements may be necessary.
Dentistry Support® helps dental practices manage essential administrative responsibilities, including insurance eligibility verification, billing, accounts receivable, claims follow-up, and phone support. These services are designed to provide consistent operational support and clearer responsibility for work that can otherwise place additional pressure on internal teams. Whether a dental practice relies on its own employees or external administrative support, business owners should evaluate how effectively these responsibilities are being completed and whether the existing structure supports the organization's financial and operational goals.
Not every challenge requires an immediate investment, and not every expense needs to be eliminated. Some decisions require professional advice, additional research, or careful planning before changes can be implemented responsibly. Nevertheless, there is an important difference between waiting for necessary information and postponing a decision because the work involved feels inconvenient. The purpose of a year-end review is to establish a deliberate process for evaluating concerns rather than allowing familiar problems to continue indefinitely.
Three Decisions Every Business Owner Should Make Before Year-End
Meaningful organizational improvement does not require changing every process or resolving every concern before December ends. Instead, business owners can begin by identifying a manageable number of decisions that deserve immediate evaluation. A practical approach is to select three unresolved issues: one financial decision, one operational decision, and one leadership decision. Each issue should be documented with a clear description, the information required to evaluate available options, the individual responsible for taking action, and a reasonable deadline.
The first decision should focus on financial responsibility. Identify an expense, contract, investment, or financial process that has not received adequate attention. This might involve software that no longer supports operational needs, marketing expenses without clear performance measurements, or outstanding insurance claims that require more consistent follow-up. Review the available financial information and identify any additional details needed to make an informed decision. If professional accounting, legal, or contractual guidance is necessary, establish a plan for obtaining that advice before determining the appropriate next step.
The second decision should address operational efficiency. Choose a process that employees have repeatedly identified as confusing, inefficient, or difficult to complete consistently. This could involve insurance eligibility verification, phone management, billing procedures, scheduling, or communication between departments. Examine how the process currently works, identify where delays occur, and determine whether responsibilities are clearly assigned. Rather than immediately assuming more employees are necessary, consider whether better training, clearer procedures, improved technology, or appropriate administrative support would address the underlying issue.
The third decision should involve leadership accountability. Identify a conversation, responsibility, or management concern that has been postponed. Perhaps an employee needs clearer performance expectations, a manager requires additional coaching, or department leaders need authority to make routine operational decisions. Determine what has prevented the issue from being addressed and schedule an appropriate discussion. Establish clear expectations, identify the resources or support required, and set a date for reviewing progress. When sensitive employment or compliance matters are involved, obtain appropriate professional guidance before taking action.
The purpose of this exercise is not to encourage rushed or emotionally driven decisions. Responsible leadership involves evaluating available information, considering relevant risks, and understanding how decisions may affect employees, customers, and the organization. However, once the necessary information has been identified, the issue should have a clear path toward resolution. By assigning ownership and establishing deadlines, business owners can begin converting concerns they have repeatedly discussed into specific actions that move the organization forward.
Ask Your Employees One Important Question
Before the week ends, consider asking the people you lead whether they feel comfortable approaching you when they need help. Although the question sounds simple, the responses may reveal important information about communication, trust, and accountability within your organization. Employees may hesitate to raise concerns because they believe their manager is too busy, previous questions were dismissed, or requests for assistance have not resulted in meaningful action. If employees do not feel comfortable sharing information about operational problems, leadership may be making decisions without understanding what is actually happening inside the business.
When asking this question, focus on listening rather than immediately defending your leadership style. Encourage employees to describe situations where additional communication or support would have been helpful, and consider whether recurring concerns indicate a broader process or management issue. Not every request can be granted, and not every concern will require organizational change. However, acknowledging employee feedback and explaining how issues will be evaluated can contribute to more effective communication and stronger workplace relationships.
Approachability and accountability should work together rather than compete with one another. Leaders can demonstrate empathy while maintaining clear expectations, support employees while requiring responsible performance, and encourage open communication while holding managers accountable for appropriate decisions. When employees understand that asking for help is acceptable and that leadership will respond constructively, problems can be identified earlier and addressed with greater coordination across the organization.
Stop Carrying the Same Problems Into Another Year
Business ownership involves decisions that are sometimes complicated, uncomfortable, and financially significant. No leader can predict every outcome, and even carefully evaluated decisions may require adjustments as circumstances change. However, effective leadership does not depend on making perfect decisions every time. It depends on recognizing what is happening inside the organization, gathering the information necessary to evaluate available options, and accepting responsibility for determining what should happen next.
As the final months of 2026 approach, consider which unresolved challenges you have become accustomed to tolerating. Review the expenses that deserve closer attention, the processes employees have repeatedly identified as inefficient, and the leadership conversations that have remained on your calendar without meaningful progress. Determine which situations genuinely require additional information and which have continued primarily because addressing them would be uncomfortable. When waiting is appropriate, document the reason, assess the consequences, and establish a date for reconsidering the issue.
Your organization does not need to enter another year carrying every problem that has existed throughout the current one. Meaningful improvement can begin with a financial review, an operational adjustment, a leadership conversation, or a clearer assignment of responsibility. These actions may appear small individually, but they demonstrate a willingness to address challenges before they become more difficult and expensive to resolve.
Ultimately, successful leadership requires balancing thoughtful decision-making with the responsibility to act. Employees depend on clear direction, managers need appropriate authority, and businesses require systems that support sustainable performance. The calendar will continue moving forward whether unresolved issues receive attention or not. What changes the future of an organization is the willingness of its leadership to confront those issues and make intentional decisions about what happens next.
Continue Learning with No Silver Spoons® — Upcoming Episode 146
This free training expands on the leadership conversation featured in the upcoming No Silver Spoons® Season 6, Episode 146, which explores the decisions business owners avoid and the financial, operational, and leadership consequences that can develop while organizations continue waiting. The episode examines why familiar problems may feel safer than uncertain solutions, how postponed decisions affect employees, and why effective leadership requires more than explaining what went wrong. It also explores the importance of approachable managers, meaningful collaboration, clear decision-making authority, and accountability as businesses prepare for another year.
If you recognize unresolved challenges within your own dental practice or organization, this episode offers an opportunity to examine how decision-making habits influence long-term performance. The discussion encourages leaders to identify one financial decision, one operational decision, and one leadership decision that require attention before the year ends. Rather than allowing these issues to remain indefinite concerns, the objective is to establish a thoughtful process for evaluating options, assigning responsibility, and taking meaningful action.
The next conversation will explore another challenge that frequently develops as organizations expand: business owners who hire managers and establish departments but remain responsible for approving nearly every important decision. Building an effective leadership team requires more than assigning titles. It requires developing people who have the judgment, authority, and accountability necessary to lead.
References
Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350–383. https://doi.org/10.2307/2666999
Kahneman, D., & Tversky, A. (1979). Prospect theory: An analysis of decision under risk. Econometrica, 47(2), 263–291. https://doi.org/10.2307/1914185
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
Sometimes we have to make the hardest decision before we get to the good part!
A great reminder that taking action and making tough decisions are essential for growth and success.
Delaying tough decisions often costs more than making the wrong move. Taking action is key to business growth.
Avoiding tough decisions often costs more than making the wrong move. Taking action at the right time is key to business growth.
Thanks for sharing another free training.