Evolving your business systems into 2023 and beyond—Part 4

Search Dental Tribune

In his fourth article on evolving practice business systems, dental consultant Chris Barrow explains that the secret to successful leadership is sustainability, maintaining a constant pace over time. (Image: MrArtHit/Shutterstock)

Tue. 10 October 2023


In previous articles of this series, I have referenced the seminal work The E-Myth Revisited by Michael Gerber. I looked at financial systems in Part 1, practice marketing in Part 2 and the patient experience in Part 3. In Part 4, I would like to address the topics of leadership and management—terms which are often misunderstood, transposed and confusing. In this article, I want to focus not so much on the performance of people but on their behaviour and highlight the behavioural habits that characterise great leaders and managers in dental practice.

What is the difference between leadership and management?

Leadership is about your relationship with people. Management is about the deployment of systems. You cannot lead systems. You cannot manage people. You can lead people. You can manage systems. As a practice owner, you must be a good leader of good managers. As a practice manager, you must be a good leader of your team and in charge of systems.


Let me give you my own definition of good leadership:

  • you are the custodian of the vision;
  • you are the example of on-brand performance and behaviour;
  • you are brilliant at effective delegation.

You as custodian

You have a three-year vision, a 12-month plan, 90-day goals, monthly management objectives, a weekly focus and daily tasks. You share the vision, plan and goals with all your team on a regular basis—and they understand and accept that the vision, plan and goals evolve all the time. You imbue every aspect of the business and every member of your team with the passion and excitement you feel.

You as an example

If you are late, everyone can be. If you are untidy, everyone can be. If you are miserable, everyone is!

You are on stage, in the spotlight, 24/7! You must be in first and out last, must possess an eye for detail and must be aware of everything and everyone. You must be able to read a 1,000-word newsletter after everyone else—and spot the typo they all missed. You must lead your team, your clients, your suppliers, your advisers, your strategic alliance partners, your family, your friends and (sometimes) yourself. There is no time off!

You as delegator

You delegate everything that does not involve your unique abilities and invest 80% of your time in your unique abilities, leading the team the other 20%—because your team members are the managers of your business (and your life). To do so, you explain what you want in clear terms, describe the outcome you are looking for and agree on a deadline for completion. You then back off and do not micromanage, but neither do you back off too far—into abdication. In delegating, you accept that the best team players will get it right 90% of the time and mess up 10%—that will be how they learn.


Everything you ever needed to know about business is embodied in the fundamental systems originally identified by Michael Gerber and about which I have said much in my series of articles so far:

  1. financial systems (discussed in Part 1);
  2. lead generation systems (marketing, discussed in Part 2);
  3. lead conversion systems (treatment plan presentation and conversion, discussed in Part 3);
  4. customer relationship management systems (the patient experience, also discussed in Part 3);
  5. operational systems (clinical governance and compliance); and
  6. people systems (creating, leading and managing the team, discussed in this article).

First, read The E-Myth Revisited and learn the principles. Second, read The E-Myth Dentist and learn how the principles apply in practice (declaration of interest—I am co-author but receive no royalties).

Performing and behaving like a leader or manager

How do you find the time to be a great leader or manager? Do you remember the circus act of a performer spinning plates on top of sticks? We look on in amazement as the artist adds more and more plates—and great show is made of letting plates lose momentum, wobble and almost fall—but just in time, the artist reaches the stick and spins, and the plate regains momentum. As the artist does that, at the other end of the line, another plate begins to wobble. The audience loves the “risk” that a plate will fall. We love to watch others take risks like that—the plate spinner, the trapeze artist, the walker balancing on the high wire.

How often does your life seem like the plate spinner’s act? We have a habit of making our lives too complicated: too many relationships, too many patients or clients, too many apps on our devices, too many appointments in the calendar, too many decisions to make, too many emails to reply to. Too many times, we poke our noses into things we should not bother with (bright shiny objects—I am terribly guilty of this) or we micromanage people who do not need or appreciate it.

We have too many plates to keep spinning. Plate spinners know their limits. Do you know yours? Think about the plates you have spinning—and ask yourself:

  • Do you have enough?
  • Do you have too many?
  • What can you do to simplify your life?

Are you any good as a leader or manager?

It can be useful to conduct a SWOT analysis on yourself before you start to consider how you can lead others and manage systems:

  • Strengths—what do you consider to be your strongest capabilities? When do you feel in the zone?
  • Weaknesses—how do you let yourself down? When do you feel outside of your comfort zone?
  • Opportunities—where do you see your greatest chances of success, both personally and professionally?
  • Threats—what can stop you, drag you down, block you, damage you?

The controversial subject of tolerations and how to remove them

Clients understand that personal and professional evolution is about deciding what you want more and less of in life—and doing something about it. If you want more money, more time, greater fitness, more clients, more qualifications, and if you want less travel, less paperwork, less procrastination, less stress, less having to do everything, then take action!

If only it were that easy. Ask yourself what you must remove from your life before you can move forward.

We all tolerate things that do not work properly, situations that are not right and relationships that do not work, in our personal and professional lives. Those tolerations slow us down, eat into our self-confidence and prevent us from moving forward. The job you hate, the commute that wears you out, the computer that does not process data fast enough, the team member who is not on-brand, the patient or client who drives you nuts.

Make a list of all the tolerations in your life. Let me warn you—this is scary stuff—it will move you outside of your comfort zone—trust me and be brave.

When I first conducted this exercise for myself, many years ago, I decided that what I wanted to do more of was public speaking, writing, coaching and content development and that I would focus all my efforts and finances on creating an environment in which I could spend 80% of my time on my unique abilities and 20% of my time doing “everything else”.

Take a sheet of paper. Draw a line down the middle. Head the left-hand column “My unique abilities”. Head the right-hand column “Everything else”. Start writing and determine what your unique abilities are.

Learning to delegate effectively

Delegation is an essential aspect of time management. We are all doing too much—some more than others. How do we delegate well? The first step you should have already completed by listing your unique abilities in the left-hand column and everything else in the right-hand column. The second step is to identify who you are going to delegate “everything else” to.

For example, in my personal life, I delegate:

  • housekeeping to the cleaners;
  • gardening to the gardener;
  • holidays, social occasions and special events to my wife;
  • my work–life balance calendar to my business manager, Phillippa Goodwin.

In my professional life, I delegate:

  • finance to my accountant, Doug Murphy (hand-picked because he is also a mentor);
  • calendar, calls, meetings, travel, accommodation, even lost property to Phillippa;
  • branding and marketing to my daughter, Rachel Barrow, who runs her own marketing agency.

The third step is often problematic—the act of delegation:

  • Explain and agree on the task—give a full and proper brief.
  • Agree on the resources required.
  • Agree on what the outcome will look like.
  • Agree on any cost implications.
  • Agree on a deadline.
  • Agree on the method of reporting back.

For simple tasks, this is far too complicated. In situations like that, you can rely on the individual to whom you have delegated the task to use their common sense—if they do not have any, they should not be working for you! For more complex tasks—like building a website—you must have these agreements in place.

The secret of attractive leadership is to then step back and leave your team to get on with it. The reason I am successful at delegation is that I do not interfere when the task has been agreed on—in any event, I am busy with other things. My support team love it that I trust them enough to make their own decisions—it gives them a sense of purpose in their work that they do for me; they own it. An empowered team, entrusted with responsibility, will increase your effectiveness by an order of magnitude that far surpasses the investment you make in them.

How leaders and managers communicate

How often do you communicate with your internal support team? Not often enough. How do I know that? Because part of my work is dealing with the consequences. My all-time number one saying is “All problems exist in the absence of a good conversation.”

Those conversations can be one-on-one or team meetings. Here is a meeting schedule I devised some years ago for “perfect practice” and to minimise the risk of relationship and communication problems in any business:


A 15-minute daily huddle before the curtain is raised, to review the good and bad points of the previous day and to preview the day ahead.


A 30-minute weekly reflection on the best and worst bits of the previous week and agreement on what we can learn and how we can evolve.


A 3-hour (half-day) monthly review of all key aspects of the business:

  • financial performance;
  • marketing results;
  • customer relationship management highlights;
  • pipeline and sales;
  • operational issues;
  • team well-being.


A full-day quarterly meeting that covers the items in a monthly meeting in the morning and that involves team training on any of these in the afternoon.


An annual getaway that includes an overnight ideally in a location away from the practice location, dedicated to:

  • the same agenda as for the quarterly meeting but with the annual review on the first morning;
  • fun on the first afternoon;
  • party and awards on the first evening;
  • plans for the coming year on the second morning;
  • fun on the second afternoon.

Appraisals are yesterday’s leadership tool. The concept of sitting down with an employee once a year for “judgement day” is Industrial Revolution stuff—not the connection revolution of today. I agree that individuals require personal progress interviews however. If you decide on them, here is your meeting agenda:

Part 1—questions for the team member to answer:

  • What do you like best about working here?
  • What do you like least about working here?
  • What would you most like to change about your work here?
  • In what area would you appreciate some further training?

Part 2—feedback I would like to give to you:

  • What I like best about the work you do is...
  • What I like least about the work you do is...
  • What I would most like you to change about the work you do here is...

Just about every survey of employee satisfaction ever undertaken has come to the same conclusion: that people stay in a job when they feel genuinely appreciated, can see a career pathway for themselves, feel well paid for what they do and are having fun—in that order. It is not all about the money.


Success is defined as “doing what you love to do, with the people you love doing it with, when you love doing it”.1 The secret of long-term success is sustainability—not short sharp shocks on training courses but the ability to maintain that 80% pace for mile after mile, for month after month, stretching into years. Great leaders and managers are those who follow these guidelines relentlessly and consistently over long periods. I love being a tortoise, and people seem to enjoy my leadership and management style.

Editorial note:

This article has been published in Dental Tribune UK 03/23.


  1. Morris T. True success: a new philosophy of excellence. New York: Berkeley Books; 1995. 294 p.

Business Business development Leadership Practice management

Leave a Reply

Your email address will not be published. Required fields are marked *