Endo Mastery

Changing your team culture



No one told you when you decided to go into endodontics that managing your team would be one of your greatest challenges and stress factors as a practice owner. Teams are complicated with a mixture of different personalities, motivations, work ethics, communication styles and individual quirks.


Over time, every team develops a culture that is influenced by each person’s presence on the team. One day, you can realize that your team has collectively settled around a culture that is falling short of your expectations, making management more difficult, failing to make progress on goals, and taking away from having fun every day at work.


The only way to change your team culture is through effective leadership because waiting for teams to naturally self-evolve without guidance does not work. Here are 3 common team cultures and mindsets that practice leaders need to address:

Entitlement culture

Entitlement culture is when team members expect special privileges, rewards or concessions that are unrelated to the diligent performance of their jobs.


Entitlement can show up in many ways, including a “What’s in it for me?” attitude, regularly arriving late, over-use of “sick” days, asking for salary advances, or the belief that long tenure entitles them to above-market compensation or makes them irreplaceable.


Entitlement can also be behavioral. For example, team members bringing the drama and distraction of their personal issues into the workplace, and then expecting their bad moods or personal demands to be accommodated.


Recommendation: Entitlement builds up over time. Team members remember every privilege or exception ever given to them or anyone else on the team. As the boss, you need to address entitlement with calm, consistent and detached leadership. Detached means that you care and listen, but you do not allow either personal relationships or emotional situations to unduly influence you. Except for genuinely rare special circumstances or personal emergencies, respecting the fundamentals of the employment relationship must be consistently maintained.

Inertia culture

Inertia culture is when the team is settled into doing their jobs in the same way it has been done for a long time, and they are deeply resistant to any changes that you may try to implement. That resistance can appear in many forms: open disagreement, disregarding instructions, half-hearted “effort”, taking no action unless specifically directed, making excuses to delay changes, and looking for any reason why “it won’t work.”


Inertia is the result of the absence of positive energy for progress. If goals have not been updated in a long time, the motivation to be engaged in improvement is lacking. On most teams, you’ll have a combination of people who are naturally engaged in personal improvement in their jobs, and people who are primarily focused on predictable steadiness in their jobs. Without effective leadership, predictable steadiness tends to dominate as it is the lowest common denominator.


Recommendation: Inertia is like the two sides of a coin. One side is the culture of standing still. The other side is the culture of growth. Switching to a culture of growth requires consistent and positive focus from practice leaders. Don’t underestimate how much encouragement and support your team needs to make changes. Education, coaching, team meetings, new strategies and even 1-on-1 attention are sometimes required to restart a stalled team.

Toxic culture

Toxic culture is when as few as one individual on the team has such outsized dominating or disruptive energy that they shut down everyone else’s motivation. Common signs include a confrontational personality, gossiping, bullying, undermining you or others, passive-aggressiveness, finger pointing, the blame game, overly controlling, etc.


Most of the time, you know who this person is. Frequent team issues often revolve around them, or you may observe how other team members avoid engaging with them. You may find this person difficult to lead or work with on a daily basis. But sometimes you don’t know who it is because they are one of your favorites, and they use that favoritism behind your back in a way that the rest of the team resents or feels is unfair.


Recommendation: Toxicity is rarely about capability and competence, and almost always a behavioral issue that is creating negativity for the team. Even small but repeated behaviors can build up over time to toxic levels. As the leader, you need to address these issues one-on-one, which is necessary (albeit difficult) conversations. Be caring but firm, and make it clear what your concern is and what changes you need to see. Sometimes they may not even be aware of what they are doing. Give them a chance to be better team players, but recognize that some people won’t or can’t adapt and you need to tell them to move on.

Rebooting your leadership style

The sober reality of team cultures is that they reflect your past leadership approach and what you have encouraged or allowed to persist. Just as great teams are the result of great leadership, struggling teams are the result of struggling leadership. But it doesn’t have to stay that way.


Sometimes you need to hit the reset button in a way that the team can embrace a new approach to leadership from you. Often a catalyzing event is useful such as a team retreat to a seminar or engaging a practice coach. These are signs to your team that your priorities are changing, your goals are changing, and that you are investing in your team so everyone can grow and have a better experience at work.

Engaging your team in new goals



In just 3 weeks, the calendar year comes to an end. Most business owners, while enjoying the holiday season with their family, will also be performing their final analysis of the year. Did your practice grow over last year? Have your referral relationships improved? Is your team stable and progressing? Where did you end up in terms of your economic goals?


It’s a natural time to start thinking about what you want from your practice next year. In fact, setting new goals each year is one of the most important responsibilities for a business leader. Whether your goals are modest or ambitious, an annual focus on improvement keeps a practice vital, rather than coasting and slowly becoming run down over time.


Of course, the biggest challenge every practice owner faces is team inertia, which is the tendency of teams to stick to the tried-and-true instead of implementing changes that may have uncertain results. It’s usually not a conscious choice that teams make. It’s a subconscious dynamic where people skew toward doing what they already know well.


For any business to make progress, you must engage the team with energy and focus so that they want to make a sincere and concerted effort. Here are some things that help teams embrace change and growth daily:

Show your commitment

Team engagement shadows your engagement. Many teams are accustomed to doctors coming into the practice excited about a new idea, but often within weeks or days, commitment to that idea wavers or is forgotten. You must demonstrate that you are committed to any new goals, that those goals are important to you, and that you care about the results. Your commitment needs to outlast any initial bumps in the road as you begin to make changes. When the team understands that new goals are the “new normal” for the practice, they adapt faster. 

Breakdown goals and roles

While you may have general or broad objectives for growth or improvement, team members need more details. Goals should be specific and, ideally, they should be measurable. Most team members also need clarity for how their role with the team influences the results, especially when the goal is dependent on teamwork and not the actions of just one person.

Ask for their help

Team members engage more when they feel they are contributing to the team’s efforts to reach new goals. A vital step you can take as practice leader is to ask the team for their help to reach the goal. Despite the fact that you are their employer, each of them knows their job better than you know their job. They know what aspects are inefficient, ineffective, need better resources, could improve with more training, or have untapped potential for growth. Ask them to make suggestions and incorporate good ideas into the plan.

Inspire with possibilities

For teams that work together long-term, a history develops, and patterns form in work relationships, job roles and expectations. Days develop a familiar routine of predictability, which can consistently produce good results but doesn’t provide a lot of motivation beyond that.


This is a classic example of a team that needs to be inspired and their passion for great patient care and practice success reignited to embrace new avenues of growth and new goals. How do you give them a new vision for possibilities? Get them out of their day-to-day mindset. Bringing in a coach or taking them to a weekend seminar are great ideas.


At Endo Mastery, one of the greatest team motivators we have is that coaching clients along with their teams can visit Dr. Ace Goerig’s practice to observe and interact with his team while patients are provided care. This experience really awakens the energy in teams when they see a high-performing team approach the same tasks that they have but achieve such incredibly better results with ease. Many doctors describe this event as a turning point in their team’s growth.

Recognize progress

Finally, it’s essential that you recognize effort and progress when it occurs. Nothing new is perfect out of the gate, and any changes are bound to experience some hiccups at the beginning. Keep your team believing in the goal by recognizing each step of progress. Little celebrations along the way, from daily verbal recognition of individual efforts to recognition of overall teamwork keeps the energy high to carry on.




A recent Harvard Business Review analysis indicates that pandemic-influenced resignation rates are highest among mid-career employees in the 30 to 45 years old range, and also among healthcare workers. Translation: well-trained, educated and experienced people are more mobile than ever in the job market.


While media reports focus on shortage trends (how many teaching, trucking, and nursing positions are vacant, etc.), just one vacant position in your practice can create huge business challenges. Endodontic practices don’t operate with a lot of “fluff” in their staffing. Everyone plays a vital role, and the whole practice is built around everyone being in their place on a daily basis.


Obviously, a resignation initiates an immediate recruitment drive to find a new person. Debra Miller, Director of Coaching, shared some tips last year for recruiting. But recently, many doctors have found it is very difficult to find a new person at the same level of proficiency of the person who is leaving.

Impact of the Experience Gap

In most practices, a new team member who lacks experience creates an immediate ripple effect on overall team productivity. Even small things can take longer. Communication can suffer. Mistakes occur more frequently, which can lead to stress and drama. In short, the rhythm of your team is disrupted, and daily flow is disturbed.


This can be more pronounced in highly productive teams where the teamwork and systems of the practice have been tuned for higher performance and optimized at a more nuanced level. The finer details of teamwork that make the practice particularly productive often aren’t even perceived by an inexperienced new team member.


Even if you can replace a team member with someone equally experienced, it’s important to remember that they will also come with baggage that interferes with productivity. That baggage is the systems and procedures that they are accustomed to in their previous practice. That can be significantly different than the standards in your practice, which creates an alignment issue.

Maintaining Success During Turnover

Often when I look at the historical performance factors of a practice, I notice a sequence of months where there was a sudden drop in productivity … sometimes by as much as 10%. That equates to over $7000 per month in an average practice. Questioning the doctor often reveals those months are when a key team member left the practice.


The only way to maintain productivity and flow in the face of staff turnover is through an effective and focused training program. It is even more important when you can’t hire at the same level of experience. Instead, you should hire for attitude and then train, train, train them up to the level you want.


Most doctors under-invest in team training in general, which is why many practices linger in the average range and under-achieve their possibilities. Growth in an endodontic practice is largely driven by the team, and a team without training resources can rarely improve on their own.


Training is never more important than during staff turnover and yet doctors often make the barest of efforts to provide training. They hope the new person can learn on the go by osmosis, and that other team members will fill in the gaps when needed. This kind of passive approach prolongs the pain of staff turnover.


Your team is the human capital that drives your business success. Practices need an active strategy for training, especially for turnover and also for growth in general. It’s always a useful process to ask yourself if your team is at the level that it should be at, if each individual team member is at the level that they should be at, and what is your plan of action to get the team to the right level? … And keep them there!




Somewhere in the spectrum between being a leader and a manager is the powerful role of being a coach. Let’s understand what a leader and manager are first, and then we can clarify why being a coach for your team is so important.


The role of the leader is to set the vision. The leader is fundamentally curious about possibilities, opportunities, growth and the future of the business. By articulating the vision passionately, leaders inspire the team to create alignment and commitment, which are essential for evolving the practice.


By contrast, the role of the manager is to get results. The manager strives to create focused accountability, so teams achieve specific known goals. Managers set standards, define procedures, and ensure tasks are completed on time and correctly. Consistency, effectiveness and efficiency are all within the domain of the manager.


There is always going to be tension between your inner leader, who relishes in future possibilities, and your inner manager, who focuses on today’s realities. That’s why the central role of coach is so vital!

What Is a Coach?

The role of the coach is to close the gap between vision and reality. Most importantly, a coach understands that the best way is to prioritize the team, teach them better ways to accomplish their goals, give them the systems and resources they need to grow, and support them with encouragement, structure and feedback.

In short, your inner coach should be focused on developing the abilities of individual team members as well as how the team works together collectively. It’s a growth process where you have to give your team what they need to be successful, but allow them the space to learn, internalize, problem-solve and feel a sense of ownership with each stage of growth and success.

Of course, your inner manager immediately wants to take control and micro-manage every new detail. But that is rarely helpful during learning stages because you’re just teaching the team to follow new directions, rather than developing true competency.

The easiest comparison is your children and their school homework. If you jump in and do your children’s homework for them, you are working against your own goals. They won’t learn and they’ll become more and more dependent on you to give them the answers. Instead, you want to be a coach that encourages and supports them, guides them in the right direction, and helps them to figure it out what to do and how to do it.

How Coaching Helps You

What I have learned over the years as a corporate leader and personal growth educator is that everyone needs a coach. Everyone needs someone who believes in them, and who sees their high value. Great coaches shine the light on a better way and how to get there.

That applies at a personal level (such as life coaching through Legacy Life Consulting), at the business level through Endo Mastery, and also with areas like family, worship, community and pastimes (such as sports). It’s ironic how readily most people would accept coaching for golf, video games, or other hobbies but they resist expert guidance for the more important things in life where much more is at stake.

At Endo Mastery, we are very devoted to being great coaches for dental teams. We can’t be in your practice on daily basis to do everything for your team, but we excel at giving teams the resources, instruction, guidance and motivation to grow quickly with measurable results.

In the same way, what really sets Endo Mastery apart from other consultants is that we are great coaches for doctors. We’re not just coming in to help you “manage” your practice better; we’re energizing you (as the leader of your practice) with new possibilities, inspiration, and strategies to achieve a level of success in your practice and life that you probably never thought possible.



Keep the team running smoothly, performing at a high level, and helping the practice to grow requires a steady and focused approach to training. A team trained to the highest professional standards becomes your greatest asset and practice building. Teams that fall short of the mark can limit your success. Here’s some training tips that every practice can use:

Usually when you hire new people, you look for someone with previous dental (or preferably, endo) experience. You count on them coming with a set of skills that lets them integrate quickly and productively with your office.


What you don’t count on, and often overlook, is that they also come with the habits, values and mindsets of their previous practice. It can be a big gamble whether those things are aligned to your office. Many times, a new team member is thrown into the mix and it can be a big surprise down the road when you realize they’re in conflict with your goals.


Every new team member needs one-on-one training, which is often the responsibility of your office manager (for the administrative team) or your clinical lead (for dental assistants). Part of that training needs to be focused on finding the things that need to be untrained. Your team leader, when training and showing job responsibilities to the new team member, should be asking, “How is this different from the way you did it in your previous practice?”


By asking that question and highlighting differences, you create awareness for the new team member of the aspects of their job that they should not be relying on their “default” knowledge nor assuming your practice is the same.

Retraining isn’t about learning again how to do something; it’s about learning how to do something better. In that light, retraining is actually an ongoing process, because dental teams should always be striving to improve.


Every time something good happens, it challenges you to ask what can be done to keep the good times rolling. Every time something negative happens, it always challenges you to look for ways to improve so it doesn’t happen again.


But adapting to these challenging questions is a challenge in itself because often the answer isn’t definitive. Sometimes you are asking team members to be creative and try new things. That’s when you often experience resistance from your team … maybe not open disagreement, but the harder-to-detect “lack of genuine effort”. Team members get attached to doing things in a certain way, they become good at that, and they are often reluctant to step out on a limb when there is no clear benchmark for success.


In retraining, mindset matters more than anything. You have to create a culture that values learning and growth, accepts there are going to be bumps on the road to anything new, and rewards people who fully engage with the process. It’s groupthink, and progressive encouraging leadership that reinforces vision and goals is vital.

Everyone on the practice team plays a vital role. As long as everyone is there, in their lane and performing at a great level, every day can run smoothly. But what happens when something is out of place or goes wrong? A team member is absent, or an emergency (or more) needs to be scheduled into an already full day, or you have an equipment failure that slows everything down.


When these situations happen, it’s important that everyone who is on deck is capable of pitching in as much as possible to handle the flow. That’s where cross-training is so important.


There are certain tasks normally done by dental assistants that administrators can learn how to do. For example, turning over an operatory between appointments, or instrument sterilization. Be mindful of state regulations that may require licensure and a formal training program in infection control. Likewise, assistants should know how to cover certain tasks of the administrative team. For example, answering the phone, scheduling a patient, or processing a payment.


When you have team members who can adapt and be where they are most needed (even if it’s outside their normal role), you create a lot of flexibility. That gives you “court sense” on the fly to direct the team optimally as the schedule flow warrants.



Finding the right person for practice openings is always hard, and as we move into a post-pandemic environment there appears to be more competition than ever to hire the best. At a recent Mastery Circle webinar, we discussed some ideas to help practices with recruiting:

  • Expand your outreach. In addition to all the usual places you would post a job, don’t forget Facebook, Craigslist, the doctor’s personal Linked In page and on your practice’s social media.
  • Develop relationships with local dental assisting and dental administration schools. Offer to be a guest speaker and create opportunities to mix with potential candidates to discover who might be a good fit for your practice.
  • Ask your referring doctors if they know anyone who they wish they could hire but don’t have an opening for.
  • Be clear about the qualities you are hiring for. Focus first on the right mindset: good personality for dental, and a hard worker.
  • Advertise what training that you will provide. Are you willing to train the right person completely? What are the minimum qualifications you are looking for?
  • Many practices have a legacy mindset of female team members. Don’t hesitate to consider male candidates.
  • Create a recruitment bonus for your team referrals. For example, a $500 bonus paid half at the time of hiring and half after 90 days.
  • Similarly, offer a sign-on incentive for new team members: $500 to $1000 dollars with half up front and half after a 90-day probation period.
  • Hire a recruiter for professional assistance.

One final tip: Don’t hire from your key referring offices without talking to the referring doctor first. It’s important to know if the candidate has their doctor’s blessing to move on and, if so, for what reason.