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“Nothing will kill a great employee faster than watching you tolerate a bad one.” —Perry Belcher

At one point, it might have been delightful. Not now. Now it stinks. Your first patient of the day mentioned it, and most of your team is holding their noses, eeewwwing and guuhhhrossing all morning.

Someone hid their grilled blue cheese sandwich in the recesses of the break room fridge too long, and now the office reeks. You wouldn’t keep it in there just because it’d been there for a long time. Ignoring it isn’t an option.

There’s probably someone on your team who was good at some point, maybe even great. But like that sandwich, they’re past their prime in your office, and most of your team is put off by their behavior. Some patients have even complained. They’ve been coached, and you hope they’ll change, but you’re merely prolonging the inevitable. In Thing Again, Adam Grant writes, “You can lead a horse to water, but you can’t make it think.” You’re also risking that this cancer on your business will metastasize.

These people need to become part of your past. It’s not mean; it’s the opposite. Allowing non-performers to overstay is a lose-lose proposition every time. There are no exceptions. Letting them go liberates them to seek an employer who’s better suited for them. The disenchanted person gets their wish to be out of your office, and you can find someone who’s a better fit. This is a win-win-win, and your only regret will be that you didn’t cut the cord sooner. They’ll be better off at Status Quo Dental over on Average Avenue. They can do their thing without the pressure of high expectations, and you can move faster after dropping the millstone. Before you can find and develop the right people, but first you have to eliminate the wrong ones.


If I had a dollar for every time dentists have told me their teams “don’t want to do sleep” or complain about how “insurance won’t pay so no patients move forward”, I’d have enough to buy a 2013 Camry with 135,277 miles on it.

The problem isn’t which bite technique you’re using, the medical insurance maze, or the STOP-BANG. To be sure, there are issues with each of these, but the major issue we can address for the good of your patients, your profitability, and your practice is… (cue Europe’s The Final Countdown keyboard riff)


Do you have the right team members in the right roles? Outfitting your team with the right people is crucial to your success. You can’t do DSM alone, and you can’t do it when you’re plagued by inefficiency and incorrigible or incompetent team members. They’ll leave you drained and discontented.

A great vision without great people to execute the plan is like a tree without branches. To build the dental sleep practice of your dreams, you need to first ensure that the right people are in the right seats, on the right bus. Because DSM is an emergent niche field, it’s unlikely that you’ll be able to hire an experienced sleep assistant. It’s even less likely that you’ll be able to identify a sleep champion with a proven track record. What will you do? Quit before you start?

Of course not.

James Baron and a team of sociologists found that hiring a professional with specific transferable skills triples the likelihood that a business will fail. Poaching a star employee from another practice is also tied to a high failure rate. However, hiring someone with character, commitment, and cultural fit is likely to lead to success. The right person with the right energy and a history of continual learning can be the missing link. Positive mental attitude (PMA) goes a long way.

Where do you find these people? Anywhere and everywhere. The clerk whose checkout lane you prefer at the grocery store because they quickly get you through the line even when you have an overflowing cart and a 50 lb. bag of dog food. If you’re like me and you just have a container of strawberries and a jar of peanut butter, you’ll still wait behind the person with the cart that’s like a leaning tower of groceries just so you can yap with the personable clerk for a minute. Their energy is infectious.

Can you picture that person checking in a new patient or scheduling an appliance delivery? Use your imagination.

Or the barista at your favorite coffee shop. You’ve seen them effortlessly juggling nine complicated drink orders with an average of twelve ingredients each. And they still remember your name. You feel seen. Acknowledged. Important. Can you envision this individual making your patients feel the same way during a consultation?

Imagine her discussing a patient’s sleep study results with the same gusto and ebullience that she so flawlessly demonstrated when serving up your half-caf-mocha-wocha-skinny latte.

Of course, both the clerk and the barista will need training. They’ll need to learn what AHI is, how to interpret sleep test results, and lots more. It’s not a trivial undertaking. But for someone who has the wherewithal to learn all those drink orders or the ever-changing produce SKUs and what aisle they keep moving the beef jerky section to, they can certainly master the ins and outs of your burgeoning sleep practice. Together, you can go far. Fast.

If you want to spend time with more Dental Sleep Medicine colleagues sharing best practices, register for the 2024 Transform Dental Sleep Symposium in Scottsdale, AZ on February 2-3, 2024.

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