Endo Mastery



In the past month, we’ve witnessed an extraordinary example of how trust gets broken. Elon Musk’s nascent tenure as owner and CEO of Twitter has seen a flurry of changes that have altered trust:

  • The team doesn’t trust their leader after brutal workforce cutbacks and vastly increased work requirements on those remaining.
  • Advertisers don’t trust the service as a safe moderated place for their brands and have stopped buying ads.
  • Users and key influencers don’t trust the platform’s verification and are looking at other options.

Of the three stakeholders, the trust of advertisers is the most important since they are the true “customers” of the business. 90% of Twitter’s revenues come from advertising. When they stop spending, the company’s financial foundation is shaken.

Referrals and trust

In the endodontic practice, you have the same kind of vital relationship with your referrers. Your practice is driven by referrals, which means that GPs need to know they can trust you. If you take steps (like Elon Musk) that damage trust, you can expect referrals will go down. But the opposite is also true. If you take steps to increase trust, you can increase referrals.


What does a referrer need to trust about you? Clinical ability and taking care of patients are the top two, but that’s obvious. It’s safe to say that practically every endodontist has those two points covered. So, what are the less obvious trust factors that can influence marketing and growth? These are more discretionary and it’s your choice how much you commit to building trust in these areas. Can they trust you and/or your team to:

  • Always schedule an emergency patient in pain on the same day?
  • Answer the phone promptly in a welcoming and caring manner?
  • Calm a nervous or fearful patient before and during their visit?
  • Ensure patients have financial clarity and no payment surprises?
  • Speak highly of the general practitioner?
  • Support the GP’s treatment plan?
  • Provide treatment quickly and gently?
  • Call the GP directly if any patient leaves the practice unhappy?
  • Receive referral reports on the same day as treatment?
  • Ensure patients return to the GP as soon as possible?
  • Be available to answer questions about a patient case?
  • Make it as easy as possible to refer a patient?
  • Establish a friendly team-to-team relationship?
  • Visit their practice periodically with pop-by marketing gifts?

You might think that your practice is good at most of these things, but the question to ask is whether you are clearly reliable to the point where it becomes as equally obvious as your clinical ability.


Even some of the simplest things, like the pop-by marketing gifts, become much more effective when the GP’s team realizes they can count on it. That’s when you have established such trustworthy processes that they know, without a doubt, they will see you every month or two. Presence of mind at the highest level!

Most important trust factor

On the list above, there is one factor that is particularly important to drive growth in your practice. That is why it is listed on the top: scheduling emergency patients in pain on the same day.


When a GP can absolutely trust—without question—that their patient in pain will be seen and relieved of pain on the same day by you, then you become the easiest, most reliable and most obvious choice for their referrals. You end up getting 100% of their emergency referrals once that level of trust is achieved, which leads to getting 100% of all their other endodontic referrals. It’s the ultimate relationship-builder in endo.


Becoming a practice that can deal with emergency patients so responsively and nimbly takes effort. The schedule must be tuned and optimized to allow it, and the team must be prepared and know how to adapt for emergency patients throughout the day. And all this needs to be done in a way that isn’t stressful for you and the team. It should be effortless.

Endo Mastery Practice Coaching can help you enhance and grow referral relationships significantly. For more information, visit https://endomastery.com/practice-and-team-coaching/



It’s a puzzling situation that we find ourselves in when it comes to hiring. Dental jobs should be among the most desirable. They are very stable jobs in a caring and supportive environment with a relatively small team where every person has a vital and appreciated role. Plus, they are pretty good jobs income-wise. And yet, finding qualified or even interested team members is like pulling teeth recently.


Last month, at our Mastering the Effortless Endodontic Practice seminar in Philadelphia, an informal survey of doctors revealed that over half of them have an unfilled team position in their practice. That means that if you are looking for someone, and half the doctors in your community are also looking, there is some pretty significant competition for skilled dental personnel.


Even worse, doctors talk about hiring someone who literally doesn’t even show up on their first day, or someone who stays for a few weeks and then jumps ship without warning to go to another practice for 50 cents more per hour.  At Endo Mastery, we believe that a team that performs well should be paid well, but if you end up in an all-out bidding war for new hires, it creates additional problems. It’s hard to justify paying a new team member more than someone who has worked for the practice loyally for several (or many) years already.


I believe the turbulence in the employment market will eventually settle down, but until then doctors in many dental markets should not expect to easily hire someone who has high level experience and skills.

Personality and trainability

If a new hire can’t come with the whole package already in place, then you need to hire at a lower level and train them up. In this regard, you’re going to have to start somewhere, and you should focus on finding people who have a great personality and who are trainable. That’s attitude and aptitude!


Attitude characteristics that are desirable include people who are fundamentally happy, drama-free, a people-person who is caring and empathetic, highly communicative (which is different than being excessively talkative), self-motivated to do well in their job, and a team player.


Dr. Goerig always likes to ask prospective employees about their current or past involvement in team sports, because that often reveals someone who has some competitive drive to do well, knows how to work with others to accomplish goals, and is accustomed to being coached.


For aptitude, you want someone who has a natural ability to learn quickly and become proficient. Look for people who are engaged, highly curious, detail oriented, have an ability to stay focused, and track record of teaching themselves new things. Some people are doers, which is what you want. Watch how fast they walk because that’s a big indication of how much energy they bring to everything they do.

Keep your eyes open everywhere

If you are prepared to hire for attitude and aptitude—and train for dental to the level that you want—then your pool of candidates expands significantly. In fact, you can find great people in non-dental environments who would be so grateful for the opportunity for a dental career.


Look for people who you notice repeatedly that they excel at face-to-face interactions with you in the businesses you patronize. That could be a barista at the coffeeshop (service-oriented), a bank teller (detail-oriented), or the person behind the counter at a jewelry store (very accustomed to talking about high-value items so that people happily pull out their credit card).


Give them your business card and say, “If you are thinking about making a career change sometime, give me a call.” That way, you’re not committing yourself to anything until you’ve had a chance to vet them more thoroughly, including having your office manager in the conversation.


You will know if you have a good candidate when your office manager agrees that the potential hire has an energy level and ability to be a great team member.



The problem with practice management is that you spend most of your time chairside, which is where you need to be and want to be. Unlike other businesses where an owner/manager’s role is primarily to oversee everything happening in the business in real-time, doctors often don’t have the opportunity to notice problems or opportunities as they happen. 


When you do find out, it’s often too late to act on it, whether that is after a patient leaves, at the end of the day, on a month-end financial or referral report, or at the end of the year when your accountant delivers bad news. So, when practice management needs your attention, you’re often in a reactive mode and already feeling behind the 8-ball, which leads to frustration and stress.

Team dependency

Endodontists are incredibly dependent on their teams, but most doctors don’t feel like they have an equally incredible team. They may feel their team is good, kind and caring with patients, and generally capable. They may also feel that someone on the team isn’t meeting expectations, that there is too much drama, socializing and gossip, or the team isn’t engaged or focused on practice goals. As a result, there always seems to be an issue to deal with.


Dr. Ace Goerig often says that 90% of success and growth in the endodontic practice is driven by the team. If you don’t have a team that you can count on for both patient success and business success, then you are always going to be worrying. Part of your brain will always be listening to what’s happening in the background when you’re trying to focus 100% on the patient in front of you.

Sometimes there is a genuine performance or personality issue with a team member, but the gap in overall team performance (which makes the difference between a good team and an incredible one) is almost always a leadership and training gap.


Great teams need a clear understanding of your vision for the practice, which includes your vision for patient care, referral relationships, daily flow, and productivity. They also need a clear understanding of the metrics that are essential to drive the practice’s success and growth. And finally, they need to understand their specific role and priorities to ensure the highest level of patient and referrer care, and the highest level of care for business goals.


When teams are trained fully to the level that they are capable of, doctors have confidence that their vision and standards are being met every minute of the day. They know the team is managing the right things, and they are capable of taking on more responsibilities for daily operations. That takes stress off your plate, and lets you leave each day knowing that the team has completed everything comprehensively and correctly.

Systems dependency

A lot of practice management stress is also caused by disconnected practice systems. The left hand isn’t supporting the right hand and vice versa. This is often revealed in the practice schedule, where patients are routinely scheduled for longer than they should be. Sometimes the scheduling is stretched out because the doctor wants a “time buffer” … which is often a sign that the doctor and clinical team have not coordinated their clinical flow so that assistants are responsible for almost everything that a doctor is not medically and legally required to do.


Equally you see disconnected front office systems. For example, if patients are not committed to their out-of-pocket costs for treatment on the day of the consult, you’ll see consults reschedule for treatment, or an increase in accounts receivable in order to keep them in today’s schedule. Either way, something entirely preventable has created a disruption.


Systems like new patient intake, scheduling, clinical efficiency, productivity, collections, marketing and practice finances need to be streamlined and integrated to remove the gaps and ensure everyone on the team is rowing in unison to get the best results.

Effortless endodontics

When teams and systems are aligned to your vision, and when the training and processes are established for consistent team performance and practice results, your life in the practice changes significantly. At Endo Mastery, we call it “effortless endodontics”, which lets you optimize your efficiency, eliminate your stress factors, achieve great financial performance, and have fun every day in the greatest profession.



“Shouldn’t it be easier by now?” — that’s a question a lot of doctors ask at a certain point in their careers. After years of striving to establish referral relationships, dealing with staff issues, and balancing the books each month, persistent concerns about the practice are still living rent-free in their heads 24-7.


It can seem like a constant treadmill that can drain your enthusiasm, leave you too tired at the end of the day to enjoy your life outside the practice, and interfere with your sleep in the worst cases. Inside the practice, there’s never a feeling of being complete and fulfilled; there’s always some nagging issue to deal with, team drama to arbitrate, or stressful business decision to be weighed.

Emotional work/life balance

When we think about work/life balance the way that most people do, we usually think about the balance on our time. Popular wisdom holds that to be fully happy in our life, we should be working toward working less. The idea is that less time at work should result in less overall stress in our life.


Time balance isn’t necessarily the panacea that every doctor needs. For example, arbitrarily reducing time at work could have a financial impact that would complicate life, rather than simplify it. And, trying to walk away from practice issues, rather than address them head-on, is likely to amplify those issues even more.


For most doctors, work is a necessity and therefore, even if you can’t alter your time balance right now, you can take steps to improve your emotional work/life balance. Emotional balance means that you’re not carrying around stress and emotional baggage from work that poisons the rest of your life.


At work, each day should be enjoyable and productive, and you truly feel that you are practicing endodontics in a personally and professionally fulfilling way. You are free of distractions and drama, practice systems are tuned to ensure the schedule runs smoothly, and your team is 100% engaged in helping you deliver clinical excellence to patients and relationship excellence with referrers.


After work, when the day is done, you leave without feeling incomplete, worn out or burnt out. You have the energy and satisfaction of knowing that the practice and team effortlessly achieved your goals today, and the confidence that it will do so tomorrow as well. You can be 100% present for your family and friends, and there is nothing bringing you down.


When we think about work/life balance the way that most people do, we usually think about the balance on our time. Popular wisdom holds that to be fully happy in our life, we should be working toward working less. The idea is that less time at work should result in less overall stress in our life.


Time balance isn’t necessarily the panacea that every doctor needs. For example, arbitrarily reducing time at work could have a financial impact that would complicate life, rather than simplify it. And, trying to walk away from practice issues, rather than address them head-on, is likely to amplify those issues even more.


For most doctors, work is a necessity and therefore, even if you can’t alter your time balance right now, you can take steps to improve your emotional work/life balance. Emotional balance means that you’re not carrying around stress and emotional baggage from work that poisons the rest of your life.


At work, each day should be enjoyable and productive, and you truly feel that you are practicing endodontics in a personally and professionally fulfilling way. You are free of distractions and drama, practice systems are tuned to ensure the schedule runs smoothly, and your team is 100% engaged in helping you deliver clinical excellence to patients and relationship excellence with referrers.


After work, when the day is done, you leave without feeling incomplete, worn out or burnt out. You have the energy and satisfaction of knowing that the practice and team effortlessly achieved your goals today, and the confidence that it will do so tomorrow as well. You can be 100% present for your family and friends, and there is nothing bringing you down.

Achieving practice peace of mind

Most doctors have the fundamentals of a stress-free, highly productive practice in place, but are missing the final step that makes it all work with effortless efficiency and worry-free results. It’s like building a house with Legos where each brick is slightly off in size: You’re always going to see cracks and gaps that reveal weaknesses and fall short of your vision.


True peace of mind comes when you have optimized systems and a highly trained team that is focused on all the things that make endodontics enjoyable and rewarding for you as the doctor. The right checks and balances, the right reporting systems, the right marketing, and each team member trained to the highest professional level mean that the practice’s systems start worrying for you.


Let us help you on your path to stress-free practice success and personal peace of mind. A great way to begin is our upcoming Mastering the Effortless Endodontic Practice seminar in Philadelphia next month.



It takes a lot of effort to get your practice set up the way you like. Once you have achieved an acceptable level of operational and financial success, it’s a great relief. The pressure is off, and each day develops a predictable routine. At the end of each month, you take home enough income to live well enough. Welcome to the comfort zone.


While the comfort zone feels like you’ve successfully passed through all the great hurdles of practice ownership, it’s very deceptive. It’s actually one of the riskiest stages of a doctor’s career. That’s because the comfort zone lulls you into a state of inertia, and you can end up being caught at that level for decades. Your comfort zone has become your greatest limiting factor.

Comfort zone limiting factors

In my view, there are 4 primary reasons why the comfort zone takes over your mind and limits your future potential:

  • The first reason is that you develop a motivation vacuum. Since the comfort zone is defined as having your needs fundamentally achieved, there isn’t anything external that is pushing you to keep moving forward. It is true that a certain percentage of people are naturally self-motivating, but most people are motivated responsively: we act more when we feel a need to address, rather than a want to pursue.
  • The second reason is that you become risk averse. If you have it made, why upset the apple cart? In the comfort zone, anything that has the potential to create a disturbance or disruption to the established routine is viewed with skepticism. Research shows that people tend to overestimate potential risks by double and underestimate potential benefits by half. That’s a recipe for saying “no” to things, even those that are a good bet.
  • The third reason is that you develop organizational habits. Every business, group or organization develops an internal culture around how things get done. In practices, doctors and teams get settled into a certain way of doing things. This occurs as a result of past training, inherited processes, or simply repetition. Once habits are established as the “norm” for the team, any change can be met with resistance.
  • The fourth reason is that you suppress your deserve level. Most doctors, once they are in the comfort zone, are doing well enough financially that they are probably the highest income earner in their extended family. Endodontics is a very rewarding career, even in the comfort zone. So, many doctors downplay and suppress their desire and belief that they deserve more because they already feel advantaged compared to most people.

Of the 4 factors listed above, organizational habits and deserve level are the most insidious. They can quickly sap you of any motivation you have and make steps to growth seem riskier and not worth it.

Deconstructing your mindset

Years in this mode of thinking progressively weaken you. As life goes on, your needs evolve but your practice becomes more fossilized around a lower-level comfort zone of the past. It’s not unusual for doctors who have been comfortable for many years to suddenly find themselves feeling frustrated, worried or unsettled:

  • I need to earn more income for my financial goals.
  • I need to take more time off for work/life balance.
  • I need to have more fun at work with less stress.
  • I need to modernize my practice and team.
  • I need to reconnect with my colleagues.

These are signs of responsive motivation (to emerging needs), and they are usually accompanied by risk concern (to the possible steps to resolution).


At some point, action will need to be taken because worry becomes stress, stress becomes anxiety, anxiety becomes distress, and distress becomes pain. The only question is at what point you decide to take action, and how effectively you find your new vision and path to future success.



There’s an old saying about how, if you want to make sure something gets done, you should ask a busy person to do it. Busy people have to stay focused in order to get things done, and consequently they get many more things done than unfocused people. It’s a blessing and a curse. The curse is what drives Busy Doctor Syndrome.


Doctors caught up in the busy syndrome are resistant to anything that appears to make their life more complicated than it is now, even things that will eventually make it better. They have their nose to the grindstone and they are not looking up to even notice the opportunities around them. All they care about is checking off that daily list of things that need to be done.


The list gets populated by things that need to be done in the practice, and things that need to be done in life. Most people divide their time between work and life and many people talk about work/life balance. But what is generally true of the busy syndrome is that regardless of where you draw the line, a busy person tends to fill up the available time on both sides. It’s rare to find someone who is time-limited and overwhelmed at work while being relaxed and unstressed at home, and vice versa.

No one else can do it …

The problem is that busy people fall into the “no one else can do it” trap. They take on tasks and responsibilities because they feel they are the only person who can. In reality, “no one else can do it” is actually an abbreviation for:

This leads to some unusual anomalies in the choices of busy doctors. For example, consider a task that occurs over and over again every month that a team member could be trained to do very well. Every time the task comes up, the busy doctor has a choice to slow down and take the time to train a team member, or to do the task easily, quickly and correctly themselves. Because their mindset is predominantly shaped by the feeling and focus of being “too busy right now”, they endlessly put off the beneficial step of training and delegating.

Overcoming the busy syndrome

Not surprisingly, resistance to training and delegating is actually commonplace in endodontic practices. When Endo Mastery begins coaching with our clients, we analyze the doctor’s activities and daily flow. Almost as a rule, doctors are generally losing at least 2 hours of every day on tasks that could be delegated to team members. That’s a big chunk of time that could be better spent by the doctor to reduce their busy syndrome while delivering care to more patients with less stress.


If you’re feeling the busy syndrome in your life, start by asking what is the simplest thing you do all the time that you could train a team member to do. Nothing is too small, and small things are the easiest to train at first. Do one thing every week, and progressively move to more comprehensive tasks. It is a process for sure and one that is a lot easier with coaching because Endo Mastery does the training for you. But on your own, you can make a big dent on your time crunch as all the little delegated tasks add up.



Last week at the AAE meeting in Phoenix, I spoke to a lot of young endodontists about the challenges they are facing. Overwhelmingly, it is a financial precipice for these doctors, who are sitting on a mountain of debt as they try to get started in the profession. With 83% of the dental class of 2021 having student loans and the average debt load of over $301,000, young dentists are caught between the proverbial rock and hard place. Young endodontists have even more debt on average when you add in the financial burden of their residency.


Education is, of course, an investment in your future. But it is an investment that needs to begin producing a return right away after graduation. Servicing that debt is an immediate need, as well as supporting your cost of living. So, for new endodontists, they need to act quickly and, more importantly, in the right direction that sets up their entire professional future.


Most of the young doctors I spoke to have the goal to eventually own their own practice. However, their educational debt greatly affects their ability to get financing, and buying an “average” endodontic practice in every way (average productivity, referrals, staff and facility) is even out of range.

Start Ups and Associateships

Faced with this limit, there are really only two options. The first option is a cost-controlled start up consisting of an affordable location, minimized square footage, essential equipment and minimal staff. With a start up, you avoid paying for goodwill in a buyout, which means you’ll be starting with a zero referral base. Your life from day 1, will be about marketing, marketing, marketing to develop referral relationships.


A lot of doctors choosing the start up route make some pretty fundamental mistakes that cost them a lot of unnecessary expense and stress at the beginning. Real estate and leasing mistakes, over-equipping beyond the essentials, under-trained team members, poorly set up practice systems, and none of them obviously have any realistic experience in dental referral marketing. It can be a long row to plow without careful planning and support.


The second option when faced with financial limits is to associate in a practice, at least as a stepping stone while you pay down your debt and save money. The challenge with associating is determining what your income could be in the practice you join. You want to be in a practice that is ready to grow quickly by expanding clinical capacity. Otherwise, you could end up in a practice where you only complete two cases a day (or less!) on average, and you end up spending most of your time twiddling your thumbs (with your take-home pay reflecting that reality).


There are specific criteria that are helpful for associate doctors to determine if a practice is ready for them and can get them busy quickly. The first criteria is whether the practice is already successful at an above average level. If an “average” doctor completes only 3 to 4 cases per day, a truly associate-ready practice will have an owner doctor who is completing at least 50% more cases (5 to 6 cases per day).


Above average productivity is a sign of two important things that every associate wants to find in an employing practice. First, that the practice knows how to market and build referral relationships. Second, that the practice has figured out how to be efficient and productive clinically. That’s what will drive your income most as an associate, and that’s why associates in Endo Mastery-coached practice typically earn 2 to 3 times as much as associates in other practice environments.


Finally, I should mention the corporate vs. private practice landscape. Corporate entities are building their presence in the profession, and they are on a hiring spree for associates. I would suggest you use the same criteria to evaluate corporate positions. Focus on the specific practice you would work in, how truly associate-ready is it, how many cases will you complete daily, at what fee and collection ratio (since your compensation is percentage driven on collections). Also, keep in mind that working for these organizations adds another layer of management and oversight above you. Carefully consider whether the corporate culture is something you want to live with.

Your Career Start Options

There are a lot of questions about starting out and it’s hard to find clear answers. To help solve this problem, Endo Mastery has launched a free Career Start program for endodontic residents and new endodontists. This program features twice-monthly videos and a free one-day livestream seminar in June: “Pathway to Your Ideal Success in Endodontics”.


Whether your focus is new practice start up or associating, the Career Start program will give you some very practical information to make the best choices, plus crucial financial guidance to eliminate debt quickly and maximize your income. We’re really excited about this program. It’s something we’ve wanted to do for a long time, and we hope you join us!



I don’t know any more about elephants than the average person, but I am confident that taking care of an elephant requires specialized skills. If I were responsible for one, I would strive to be much better than the average elephant caregiver. I would want my elephant to be as happy and healthy as possible.


You are responsible for an elephant, in the form of your practice. Endodontists go to dental school, not business school, so most endodontists learn business ownership by necessity and by the seat of their pants. As a result, endodontic practice owners understand business ownership better than the general population. That much is true.


But what if my question was whether you understand business ownership better than your colleagues, who are also endodontic practice owners? Most doctors would answer that they are average, which actually means that they don’t know for sure. That’s a huge blindspot because you should know how well you are doing at making your practice “as happy and healthy as possible.”

Overcoming Your Blindspot

How does my practice appear to a referring doctor? How does my team appear to a referring An ancient elephant parable tells the story about how 6 blind men each touched different parts of the elephant to describe it. Depending on what part they touched, they formed different perspectives on what an elephant is. The tail is a rope, the side is a wall, the ear is a fan, the leg is a tree, the tusk is a spear, and the trunk is snake. None of them had the full picture.


Endodontists spend the vast majority of their time focused on treatment. That’s a great perspective on clinical care for the doctor. But heads-down in the operatory on a daily basis is a very limited perspective as a business owner, and it is the source of many blindspots and missed opportunities.


If clinical care is the heart of the practice, then viewing your practice from the position of a doctor in the operatory is akin to looking from the inside out. As a practice owner, you need to look at your practice from the outside in. Here are some perspective questions you should cultivate to overcome blindspots. Think about each one as a blind man touching just one part of your practice. What do they sense and what conclusions do they reach?

● How does my practice appear to a referring doctor? How does my team appear to a referring doctor’s team?

●   How do I compare with other endodontists in my area? What is unique or different about my practice compared to those practices? What do I or my team do better than other endodontists and their teams? Where are we deficient?

●   What perception do patients have when they speak to my practice on the phone? What first impressions are created by my facility and team when the patient arrives. What experience does the patient have during their appointment?

●   What is the experience of team members who work in my practice? Beyond clinical care, what would my team describe as my main priorities as a business leader?

●   What is my family’s perception of my practice, my responsibilities, and my work schedule?

●   If I was a different doctor who was buying my practice, what opportunities would I see that have not been taken? What deficiencies or limitations have been allowed to persist?

●   How do I feel as the owner of my practice? Have I achieved my vision?

●   How would an outside coach view my practice and opportunities?

The last question, obviously, relates very closely to Endo Mastery. It’s what we do. Most doctors have difficulty developing their “outside in” perspective for two reasons. The first reason, already mentioned, is that delivering clinical care is the heart of the practice. You can’t be everywhere else at the same time. Second, most doctors don’t have the broad-based knowledge across the whole profession to evaluate their practices objectively. As a result, most doctors vastly underestimate their opportunities for improvement and growth, and fail to act on those opportunities.


As coaches, we see this pattern everyday. Doctors are astounded by the level of growth they can achieve, how quickly they achieve it, and how blind they were to those possibilities before they started coaching. The light goes on once you shift your perspective and start asking the right questions.



If you could magically reside in patients’ minds as endodontic conditions develop, you would see a pattern of behavior develop. On the balance, considering the general population of patients, when do most patients take action and seek out diagnosis and treatment?

●   In stage 1, patients might notice very mild initial symptoms: a twinge or something feels distinctly “off” at times. Most patients will be dismissive of initial symptoms unless they are exceptionally proactive and dentally educated.


●   In stage 2, symptoms progress to a steady concern: there is a growing discomfort that distracts them regularly. Some patients will seek out care, but many will “watch and wait”, and perhaps use OTC treatments to minimize symptoms or search the web for home remedies and advice.


●   In stage 3, discomfort escalates into pain: an ever-present throb and ache makes them unhappy and disturbs their sleep. Many patients will reluctantly realize that treatment is needed, although some cling to the false hope that the situation will resolve itself without effort, cost or intervention.


●   In stage 4, pain becomes severe and hard to bear: they are in crisis to find emergency relief as soon as possible. Patients make emergency calls to their GP, and their GP makes an emergency referral to the endodontist.

Considering how frequently we see emergency patients in endodontic practices, it’s a pretty clear sign that human nature is often biased towards waiting until pain is constant and the state of crisis is compelling.

Physician, heal thyself

At Endo Mastery, we see the same pattern in doctors with respect to their practices and lives. Some are proactive and vision-oriented, but many doctors are motivated to call us because symptoms in their practice and life are causing growing discomfort.


There are a wide range of symptoms that start out as a twinge but, as time passes, escalate to become greater concerns. Common ones include:

●   Stress around debt or cash flow

●   Decrease in energy or not having fun

●   Business or team management burdens

●   Team drama or poor team dynamics

●   Desire to work less without sacrificing income

●   Frustration from lack of growth, desire to grow

●   Loss of a key referrer or competitive pressures

●   Changing life goals and adapting the practice

●   Difficulty training the team

●   Desire to improve lifestyle and income

●   Feeling a lack of opportunities or resources

Waiting until you reach a point of crisis undermines everything you are working for. If something is needling you to the point where you are worried about it every day, carrying the stress around with you, and making it difficult to relax or sleep, then it’s clearly time to take action.

Visualizing Your Future

A great exercise is to think of what you want your practice and life to be like in 5 years. That is enough time to change literally everything and bring your practice and life into alignment with your ideal vision. But a lot of doctors don’t do this because they feel they don’t have enough opportunities, resources or control to achieve their desired outcome.


You don’t really know, however, until you dig in and start to take action leading to a solution. So, that is useful advice that we can learn from your patients: Don’t ignore the voice in your head until you’re in crisis.



Given the chance, I think most doctors would enjoy being able to work less and earn more. Not only would work/life balance improve but rising income would add to your lifestyle spending power and overall net worth.

At the same time, a lot of doctors don’t believe it is possible for them to work less and earn more. In their minds, they have an equation that links how much work is required to earn a certain level of income. That equation tells them that to earn more, they need to work more. On the flipside, it also tells them that if they work less, they will earn less.

They also point out factors in the practice that seem to preclude the possibility of working less and earning more. Often, they believe their team as not ready or capable of rising to the challenge. Or they express doubts that their referral base could refer more cases.
More referred cases are the primary driver of higher income for endodontists. (A secondary driver is which insurance plans you participate in, which affects the reimbursement rate per procedure completed.)

So, for your income to rise, you need to complete more cases and there is no denying that sounds a lot like working more, not working less. In fact, completing more cases in the context of your current team structure, practice systems, and clinical workflow is probably more work. But it doesn’t have to be!

How More Cases Equals Less Work

In my mind, “work” has two meanings. The first is the “I’m going to work today” meaning, which is the time we spend away from our family to earn an income. The second meaning is “labor” … something that draws our physical and/or mental energy to accomplish tasks. Before I address the first one, let’s talk about the second one.

How much you feel the labor of anything depends on how much you love doing that task, and how much resistance you feel while doing it. Even when you love something, if you experience a great deal of resistance to achieving your goals, it can diminish the love significantly. Likewise, even an easy task that you hate to do feels like a huge burden.

Most endodontists have settled around a middle ground between what they love (delivering endodontic care to patients), the “labor” it takes on a daily basis, and the income it generates. But when you try to change the parameters, such as completing more cases to earn more income, the resistance scales up dramatically.

There are doctors who complete 4 cases a day and they feel stressed and labored. Other doctors complete 8 or 10 cases a day and feel effortless ease all day. The difference between the two is how you have optimized your team, systems, marketing and workflow. It’s no different than if you were a baker. The systems to bake and sell 100 loaves a day aren’t going to work for baking and selling 1000 loaves a day.

When doctors refine and improve their systems so that 8 cases per day are just as easy as 4 cases per day, what happens is that 8 cases actually become easier than 4 cases. It’s literally less work and more income on a per day basis! Professionalizing your practice to that level means purging out so much inefficiency, repeated effort and timewasters that were rampant at 4 cases per day (but allowed to persist). Suddenly, everything is in place for you to effortlessly complete more cases than you ever thought possible.

How Efficiency Drives Growth

What is common is that inefficient doctors and teams have difficulty believing they could complete twice as many cases during the same time. Their inefficiency is literally obscuring their opportunities for growth. Getting past the disbelief mindset is often the biggest challenge at the beginning.


The truth is that 90% of growth in an endodontic practice is driven by the team. When the team becomes focused on optimizing the doctor’s time, improving daily flow, and scheduling patients smartly so the doctor is never rushed nor ever idle, the value of the doctor’s time inside the practice can soar.


Value outside the practice soars too. If you have 50% overhead expenses to begin with, and you increase the number of cases you complete by 50%, then profits almost doubles! Wow!

Cases, Income and Work/Life Balance

It might be hard to visualize from where you are now, but this transformation of “work” is experienced by our clients over and over again as they grow. And it’s matched by a tremendous increase in income. For most doctors, going from 4 cases per day to 6 cases is enough to double their take-home. 8 cases per day can triple income!


Once you are successful at that income level, then you really have choices about how many days you are going to “go to work” … the first definition of work that I mentioned. For example, rather than 3 times the income, maybe choose 2 to 2.5 times the income while working one day less per week. Or, you can also keep your practice and income growing by integrating an associate, which opens up many short- and long-term options for amazing work/life balance.


There are so many possibilities and I always love to talk to doctors about their vision and how it can be achieved. I invite you to contact me anytime for a complimentary practice analysis and transformation conversation using the button below.