The Problem Everyone Knows About Is the Problem Leadership Needs to Fix

2 days ago

14 min read

By Sarah Beth Herman, MBA, Founder & CEO, Dentistry Support®

There is something interesting that happens when people discover you own a successful business. They see the company you have built, the employees you have hired, the customers you serve, and the opportunities you have created. And sometimes, the first thing they say is, “It must be nice.” And yes, it is. Building a business is something I am incredibly grateful for. I love creating opportunities, developing teams, and building something that did not exist before.

But there is a side of entrepreneurship that people rarely see.

They do not see the payroll responsibilities, the difficult decisions, the operational challenges, or the countless hours spent making sure the business continues functioning. They do not see the problems that come with managing employees, maintaining customer relationships, and making decisions when there is no particularly good option.

And they certainly do not see the problems that everyone inside the company already knows exist.That is what I want to talk about today, because one of the most expensive mistakes a business can make is becoming comfortable with something that is not working.

Think about your dental practice for a moment. Maybe insurance verification is consistently behind. Maybe the same billing mistakes keep happening. Maybe employees repeatedly complain about a process, but nothing ever changes.

Everybody knows the problem. Everybody has learned to work around it. And somehow, it has become a normal part of the business.

There is a difference between solving a problem and becoming really good at living with it.

If you want to build a business that operates better, you need to understand that difference.

When Temporary Solutions Become Permanent Problems

Most operational problems do not begin because leadership intentionally chooses to create an inefficient workplace. Usually, someone makes a reasonable decision during a difficult situation.

An employee leaves unexpectedly, so another team member temporarily takes over their responsibilities. A software system does not provide the information a manager needs, so someone creates a spreadsheet. A department falls behind, so another department begins helping with the workload.

At the time, these decisions may be completely appropriate. I have made similar decisions in my own businesses.

The problem begins when the circumstances change and nobody evaluates whether those temporary solutions should still exist.

Six months later, the spreadsheet is still being updated. The employee is still performing responsibilities that were supposed to be temporary. The additional approval process is now part of the workflow, and new employees are being trained to follow systems that leadership never intentionally designed.

Eventually, someone says, “That’s just how we do it here.”

I do not particularly like that sentence. Not because every process needs to be perfect, because that is unrealistic, but because I want to know whether that process exists because it is genuinely effective or because everybody has stopped questioning something that never worked particularly well.

A process should not survive simply because employees have become familiar with its weaknesses.

If your team cannot explain why a process exists, what it accomplishes, and who is responsible for it, leadership needs to investigate.

Your Team May Be Hiding Problems Instead of Solving Them

Imagine your dental office consistently struggles to complete insurance verification before scheduled appointments.

At first, the front desk catches missing information. Then the treatment coordinator begins checking insurance details before discussing treatment plans. Your office manager creates a spreadsheet to track incomplete verifications, and eventually, another employee starts reviewing that spreadsheet every morning.

Patients stop noticing as many problems because employees have become extremely good at catching mistakes before they become visible.

Leadership looks at the situation and assumes things have improved.

But have they?

You now have several employees monitoring, correcting, and compensating for something that should have been completed correctly in the first place. You may have reduced the visible problem without fixing what caused it.

And that distinction matters.

The next time your team is short-staffed, someone is absent, or the schedule becomes unusually busy, the original problem may return because the underlying process was never repaired.

I want business owners to start paying attention to the work their employees perform simply to prevent another process from failing.

How often are employees reminding someone to complete a responsibility? How many people are checking information that should already be accurate? How frequently does a manager need to intervene because nobody clearly owns the next step?

Sometimes what appears to be an employee productivity problem is actually an operational design problem.

When you continue adding people to compensate for inefficient processes, the company becomes more complicated without necessarily becoming more effective.

The Danger of Making Dysfunction Feel Normal

There is an important concept in organizational research called normalization of deviance.

Sociologist Diane Vaughan examined how departures from established standards can gradually become accepted when repeated exceptions do not immediately result in visible failure. Her research surrounding the Challenger space shuttle disaster offers an important perspective on how organizations can become comfortable with practices that should have been questioned (Vaughan, 1996).

Of course, everyday dental practice operations involve very different circumstances and consequences. However, the underlying organizational behavior is worth understanding.

Something happens that should not happen. Nothing serious occurs immediately, so people become slightly more comfortable allowing it to happen again. Eventually, the exception no longer feels unusual.

Consider a dental practice where claims are occasionally submitted with incomplete information. An employee catches the mistake and corrects it. The next time it happens, another employee identifies the problem.

Eventually, the practice starts depending on someone catching the error instead of improving the process that allows the mistake to happen.

Then one day, nobody catches it.

The claim remains unpaid, the account requires additional follow-up, another employee has to investigate the issue, and management becomes involved. Everybody wants to know how the mistake happened.

But sometimes the more important question is why leadership allowed the conditions that produced the mistake to continue.

Your employees should not have to depend on luck, memory, or the assumption that someone else will catch the next error.

When exceptions become routine, leadership needs to determine whether the company's standards are actually being followed.

What Employees Learn From Problems Leadership Ignores

You can tell your employees that communication matters. You can emphasize accountability, efficiency, quality, and teamwork during every meeting. You can include those expectations in your company's core values.

But your team is paying attention to something much more important: what actually happens.

Imagine an employee reports the same concern to management five times. Perhaps information is consistently missing during patient onboarding, two departments are using conflicting reports, or a system requires unnecessary steps that repeatedly delay the work.

Every time the concern is raised, leadership acknowledges it but does nothing meaningful.

Eventually, that employee may stop mentioning the problem.

That does not mean the problem has disappeared. It may mean the employee has decided that reporting it will not accomplish anything.

Research on psychological safety provides useful insight here. Edmondson (1999) identified the relationship between psychological safety and learning behavior in work teams, emphasizing the importance of an environment where employees feel able to raise concerns, ask questions, and discuss mistakes without unnecessary fear.

But creating an environment where employees feel comfortable speaking up is only half the responsibility.

Leadership must also do something useful with the information it receives.

That does not mean every suggestion becomes a new policy. Sometimes financial, legal, operational, or customer considerations make a proposed change impractical. Sometimes the answer is no, and that is acceptable.

But explain the decision.

If you are evaluating a solution, tell the team what you are evaluating. If the issue requires additional investment, communicate the considerations involved. If something is not going to change, help employees understand why.

An open-door policy means very little when important concerns disappear into another meeting.

Leadership is not simply encouraging communication. It is demonstrating that communication matters.

Stop Confusing Employee Accountability With Broken Processes

Whenever a recurring problem appears, leadership needs to determine whether the issue comes from the process, the employee, or a combination of both.

These are not always the same problem, and they should not automatically receive the same solution.

Sometimes an employee genuinely needs additional training. Sometimes a manager is not holding people accountable. Sometimes someone understands the responsibilities of their position but repeatedly refuses to meet reasonable expectations.

Those situations require direct accountability.

However, sometimes several employees make the same mistake because the process itself is poorly designed.

Consider a dental practice experiencing recurring problems during new-client onboarding. Office-specific information is missing, the receiving department does not understand the next step, or someone forgets to document an important instruction.

Every time the issue occurs, leadership addresses the individual employee. Yet the same type of mistake continues happening.

At some point, I want to know what the process is allowing.

What information is required before onboarding begins? Who verifies that information is complete? Where is it documented? How do employees demonstrate that they understand the requirements? What happens when something is missing?

In my own businesses, I have experienced onboarding challenges that required more structured employee training and accountability. One solution involved developing office-specific knowledge assessments using information collected during onboarding. Employees were required to demonstrate their understanding of that information before beginning work with an office, with a passing standard of 96 percent.

The first rounds of testing revealed something important: employees were not consistently demonstrating the knowledge the business expected them to have. That information provided an opportunity to evaluate the training and accountability process rather than simply assuming everyone understood the material.

I am not suggesting every dental practice needs the exact same testing system. I am suggesting that leadership needs a reliable way to determine whether employees understand their responsibilities.

If the process is unclear, improve it. If the training is insufficient, strengthen it. If the expectations are reasonable and someone refuses to follow them, address the performance issue. Do not treat every operational failure as an employee problem, and do not treat every employee performance problem as something that can be solved by redesigning a process.

Both approaches can become expensive.

The question leadership should ask is: What would we need to change to make this mistake difficult to repeat?3

The Management Hours Nobody Is Tracking

There is another cost associated with recurring operational problems that business owners frequently overlook: management time.

Think about how often your leadership team discusses the same issue. Perhaps the problem comes up during a morning meeting, someone sends a message requesting an update, and later, a department manager calls another manager. An employee needs assistance, a customer complains, and eventually, the business owner becomes involved.

Each individual conversation may seem relatively minor, but those conversations accumulate.

Imagine four managers each spending 30 minutes every week addressing the same recurring issue.

That equals two hours of management time every week.

Across 50 working weeks, the company has invested 100 management hours in one unresolved problem. That calculation does not include the employees performing corrective work or the customers affected by the issue.

Now imagine several recurring problems consuming similar attention.

You do not need to calculate the financial value of every minute inside your business. But you do need to recognize that unresolved problems consume resources even when those expenses do not appear as separate line items on your financial statements.

Every hour spent discussing the same preventable mistake is an hour that cannot be invested in employee development, improving customer experiences, strengthening systems, or planning future growth.

When leadership repeatedly addresses the same problem without correcting it, the company continues paying for that problem.

The expense simply becomes familiar.

Dental Practices Cannot Afford to Normalize Administrative Chaos

Dental offices operate in an environment where administrative accuracy affects patient experiences, employee productivity, scheduling, and revenue.

Insurance verification provides a clear example.

When eligibility information is missing or inaccurate, the consequences rarely affect only one employee. The front desk becomes distracted while checking patients in, the treatment coordinator gets interrupted, the office manager may need to step in, and patients can become frustrated as the schedule begins falling behind.

Eventually, someone says, “Insurance is always a nightmare.”

And yes, insurance can be complicated.

There are payer requirements, coverage limitations, processing delays, and circumstances outside the practice's control. But that does not mean every insurance-related problem should be accepted as unavoidable.

Your practice should have a clearly defined verification process. Employees should understand who owns the responsibility, when verification should happen, what information must be documented, and how unresolved questions should be escalated.

The same principle applies to billing and accounts receivable.

If claims consistently age because follow-up is not happening, information is missing, or responsibilities are unclear, leadership needs to investigate.

How often does your team correct preventable errors? How many claims require unnecessary follow-up? How frequently does someone need to locate information that should already be documented? How much employee time is consumed by recurring problems?

At Dentistry Support®, we help dental practices with administrative responsibilities including insurance eligibility verification, billing, accounts receivable, claims follow-up, and phone support.

Our goal is to help practices operate through more consistent administrative systems so in-office employees have greater capacity to focus on patients.

Whether you manage these responsibilities internally or work with outside support, the expectation should remain the same: build a clear process, assign responsibility, measure performance, and address recurring weaknesses.

Do not normalize administrative chaos simply because your employees have become skilled at handling it.

Your team should be supporting patient care, not constantly compensating for preventable operational failures.

Growth Makes Unresolved Problems More Expensive

Entrepreneurs enjoy talking about growth. New customers, additional employees, new locations, higher revenue, and more opportunities are all exciting parts of building a business.

I understand why. I love developing new ideas, identifying opportunities, and creating something that did not exist before.

But growth is not the only responsibility of leadership.

We also have to make sure the things we have already built are functioning properly.

Consider a dental practice that consistently struggles with patient onboarding. Every time the practice accepts a new patient, some important information is missing. Employees scramble to correct it, the issue gets resolved, and everybody moves on.

Then it happens again.

Now imagine the practice adds another provider or significantly increases patient volume.

The same inefficient process is suddenly handling more work. More missing information leads to more corrective work, more interruptions, and greater management involvement.

Growth did not necessarily create the problem. Growth increased the demand placed on a process that was already struggling.

This is why business owners need to examine the condition of their operations before continually expanding them.

Updating procedures, improving reporting accuracy, strengthening employee training, reviewing workflows, and resolving recurring concerns may not be particularly exciting work.

But it matters.

There is nothing unimportant about correcting a process that employees rely on every day. And there is nothing impressive about growing a company while ignoring the operational weaknesses that threaten its ability to function effectively.

A bigger business is not automatically a better-operated business.

Sometimes the Real Problem Is the Decision You Keep Avoiding

There is another reason operational problems survive longer than they should.

Sometimes leadership already knows what needs to happen. The solution simply requires an uncomfortable decision.

Maybe the software you invested in is no longer meeting the company's needs. Maybe a manager has defended an inefficient process for years. Maybe an employee needs additional accountability, a responsibility should be reassigned, or the solution requires admitting that something you previously approved was not the right decision.

Those situations can be uncomfortable. I understand that.

But discomfort does not automatically justify leaving the problem alone.

Business owners often tell themselves they will address an issue when things slow down, when the schedule becomes more manageable, when another project is completed, or when the company has more capacity.

Sometimes postponing a decision is reasonable. But other times, we are simply avoiding something we do not want to deal with.

And those are different situations.

In a growing business, there will always be another priority, another customer, another employee concern, another deadline, or another operational challenge. If you continually wait for the perfect time to address an important problem, you may be waiting for a time that never arrives.

Meanwhile, the company continues paying for the issue. Sometimes leadership requires delegating other responsibilities so you can give an important operational weakness the attention it deserves.

That is not abandoning your other priorities. It is recognizing which decisions require your involvement.

Your Five-Day Recurring Problem Audit

This week, I want you to choose one recurring problem inside your dental practice.

Not your biggest strategic challenge or an entire company restructuring. Choose something your employees experience during an ordinary workweek.

Maybe insurance verification is consistently behind, important onboarding information gets missed, accounts receivable follow-up is inconsistent, or several employees spend time reviewing work that should have been completed correctly the first time.

Choose one issue everybody knows exists but nobody has permanently resolved.

Day 1: Identify the Problem

Ask your team one direct question: “What is the problem in our practice that everybody has learned to work around?”

Let employees answer without immediately explaining or defending the situation. Document the concern, determine how frequently it happens, and identify the people and departments affected.

Day 2: Examine the Actual Workflow

Follow the process from beginning to end. Identify who starts the work, who receives the information, who verifies completion, and where mistakes occur.

Pay close attention to the workarounds employees have created. Do not assume the written procedure reflects what happens during an ordinary workday.

Day 3: Calculate the Cost

Determine how much time employees spend correcting or compensating for the issue. Include management involvement, duplicated responsibilities, delayed tasks, and any measurable financial consequences.

Do not focus only on the original mistake. Look at everything the company does because the mistake continues happening.

Day 4: Identify the Root Cause

Determine whether the issue is related to an unclear process, inadequate training, missing information, insufficient accountability, or another operational weakness.

Do not automatically blame an employee or assume the solution requires additional staff.

Instead, ask yourself: “What would we have to change to make this mistake difficult to repeat?”

Day 5: Make an Actual Decision

Choose one meaningful improvement, assign responsibility to a specific person, establish a completion deadline, and determine how success will be measured.

Schedule a follow-up review to evaluate whether the issue has genuinely improved.

The objective is not to create another spreadsheet, hold another meeting, or have another conversation that ends with everybody agreeing that communication needs to improve. The objective is to make a decision that changes how the work gets done.

Because awareness alone does not fix operational problems. Leadership decisions do.

Do Not Build a Business Around Problems You Refuse to Fix

There is a difference between having a successful business and having a business that appears successful because employees have become exceptionally good at compensating for its weaknesses.

Your revenue may be increasing. Your appointment schedule may be full. Your employees may be working incredibly hard, and your patients may not immediately notice the operational problems happening behind the scenes.

But those things do not automatically mean your practice is functioning effectively.

Sometimes the most important leadership decision has nothing to do with hiring another employee, opening another location, or pursuing another opportunity.

Sometimes the most important decision is correcting something everybody already knows is broken.

Your employees should not spend years working around problems leadership refuses to address. Your managers should not be investing hundreds of hours in the same preventable mistakes. And your patients should not experience unnecessary frustration because administrative processes lack clear ownership, effective training, or consistent accountability.

I do not expect business owners to eliminate every challenge. I certainly have not eliminated every challenge inside my own companies.

But I do believe we have a responsibility to keep paying attention, improving the way our employees work, creating better experiences for customers, and building organizations that operate better next year than they do today.

Success does not mean we reach some magical stage where problems disappear.

It means we become more capable of recognizing what needs attention and more willing to make the decisions required to address it.

So find the problem everybody has learned to live with. Ask why it is still there. And if it is worth fixing, decide what happens next.

Because knowing a problem exists is not the same as leading your company toward a solution.

Continue Learning with No Silver Spoons® — Episode 145

This free training expands on the leadership conversation explored in No Silver Spoons®, Season 6, Episode 145, where we examine the recurring operational problems organizations have learned to tolerate and the responsibility leadership has to address them.

The episode explores how temporary workarounds become permanent processes, why employee concerns sometimes go unresolved, and how recurring mistakes quietly consume management time and company resources.

The challenge is simple: identify one problem your organization has learned to live with, understand why it keeps happening, and make a decision that moves it toward resolution.

In the following episode, we'll continue this conversation by examining the difficult decisions business owners postpone and the consequences that accumulate while leadership waits.

Because avoiding a decision does not mean you have avoided the consequences. It usually means someone else is already dealing with them.

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

Vaughan, D. (1996). The Challenger launch decision: Risky technology, culture, and deviance at NASA. University of Chicago Press.

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