By Edwin “Mac” McDonald DDS  

Change isn’t just about external circumstances; it’s also an inner evolution. We go on a transformative journey, and our reflections as we go touch upon our intention and legacy, our personal identity amidst the change, and decisions we make as the change unfolds.  

Challenge 1: Intention and Legacy 

When facing change, having a clear intention is like setting the compass for your journey. What legacy do you aspire to leave behind? Aligning your actions with your deeply held beliefs ensures congruence between your intentions and outcomes. But stress may cause you to move away from your most deeply held beliefs. I’ve witnessed this happen, just as I’ve witnessed deeply held beliefs guide what happens. 

Challenge 2: Personal Identity Amidst Change 

The question “Who do I want to be during this transition?” is profound. It invites introspection. Consider how you want to show up for yourself and those around you, especially those who are most important to you. Authenticity matters. 

Challenge 3: Listening and Accountability 

Change often involves decisions. Whose voices matter? Listening deeply to trusted individuals—those who respect and understand you—can provide valuable perspectives. Forming a leadership team of diverse viewpoints helps guide you toward success. 

The Importance of Values During Dental Practice Mergers and Acquisitions 

Many private dental practices are being acquired by large partnerships in 2024. These transitions have tons of potential and profit associated with them. Associated with these transitions are complex changes for the practice owner and team members…expanded ownership, more complex organizational structure, new operational systems, and a distancing of some decision making. They also come with the unknown of who will be your future partners after the next sale of the organization. Are you prepared for all of that?  

Preparing yourself and your team is essential. On the front end, asking every possible question including questions about the partnership’s core values, how they are integrated into the day-to-day operations, and communicating the importance of that to you and your team is essential to long term success. These questions and expressions are an attempt to examine the congruence and compatibility between you, your team, and your new partners. 

I am witnessing several friends transition successfully to one of these new partnerships. The common factor I observe is that each dentist has great self-awareness and received very strong assurance that they would retain autonomy to continue to practice according to the most deeply rooted values. I also observed that the large partnership was very stable with excellent systems and had high quality leadership.  

My father often told me: “The person that you have an agreement with is more important than the agreement itself.” In other words, a person of strong character will find a way to honor the intent of the agreement regardless of the specific circumstances of the moment. Values have longevity. Circumstances come and go. 

I have also witnessed an abandonment of strongly held values as an organization was going through the painful changes of decline. In abandoning their values, stakeholders were hurt and distanced themselves. It intensified and accelerated the decline. Values matter. Character counts. Clinging to our core values in times of change or decline will increase and accelerate recovery. There are countless Fortune 500 case studies to support this idea. 

Another Example of Values in Transition from My Life 

Finally, I want to leave you with a case study from my church, The Village Church. We had become a multi-site church in response to the demand of many people attending our main campus. As it grew, our leadership became painfully aware that it was not fulfilling our mission and it was not consistent with our closely held values of community and individual relationships. Over a period of several years, each church was given the opportunity to vote on becoming independent. They all voted around 95% in favor of the change. We gave away around 40 million dollars of real estate, equipment, furniture, and other assets to all of the churches.  

Today, the new independent churches are thriving as is our main campus where we attend. The decision was in conflict with everything that is happening in our business and church worlds where there is constant consolidation and scaling. However, the decision was consistent with the values that drive the purpose of the church. The change created multiple thriving churches that are serving their specific communities and growing people and their impact on our world. 

I have spent the last 27 years developing my abilities to restore patients to the dental health they desire. One of my favorite aspects of dentistry is creating a customized plan to help patients achieve their dental health goals, and I do this by hearing each patient’s story, so I not only see the care they need but know the person that needs it. I look forward to that challenge with every patient I see.

Let me share with you my routine for setting the stage at every dental visit for a successful interaction. As I come into the room, the patient is sitting up in the dental chair, and I sit down in front of them knee to knee. Then I say, “Tell me how you feel about today’s appointment,” or “Tell me what questions you have about what we are doing today.”

This does two things:

1. It sets the stage for “I am here for you as your friend and doctor.”
2. It prepares me to be present with them. I get to hear where they are before we start that appointment.

Once we establish what they are thinking and feeling, I ask their permission to lean back the chair. It signals that I am ready to initiate the procedure.

This routine gives them comfort, and when the procedure is done, I can sit them up and basically go through the same two questions: “How do you feel about today’s appointment? What questions do you have moving forward?”

Before and after every procedure, there is intentional time in which we are in relationship. I have found this to be very beneficial in how we move forward with patients. A very small amount of time and intention helps optimize each patient’s time with me, and I believe is a key to the success of my practice.

If you watch one episode of Gordon Ramsay’s Kitchen Nightmares, you will see a repeating theme. Previously great restaurants have come close to shutting their door, because the owners’ passion for maintaining high standards has waned. Diners have dropped them from their A list, their B list, maybe even their C list. Without a dramatic makeover and grand opening, diners are not going to come through the door.

Bring this forward to 2020 and the pandemic. Patrons… clients… customers… have legitimate concerns about moving forward with their lives. Dental teams are doubling down on conversations with patients, along with adopting and adapting to many changes in how they practice. And, then, there is another problem I am seeing in all businesses, not just dental practices. The government gave money to employees to “not work.” Now when they are needed (especially in dental practices and labs), employees want to stay out not only for more “free lunch” but also out of health concerns of their own. They don’t want to take coronavirus back to their family members at risk.

Some of this comes down to the history of the business and how they practiced before and the culture they created…that went way beyond “money.” I’m not saying this is true of all dental practices and less so in the relationship-based practices, The Pankey Institute and other thought leaders promote. But, practicing every day consistently at the quality level of the past takes tremendous commitment. The moral compass of the practice leader—the dentist, must continue to show courage, trust, respect, authenticity, integrity, communication, education and growth, excellence, resilience, purpose, and alignment. Whew! That’s a tall order when you are feeling stressed and exhausted.

It’s no wonder if some of your pre-pandemic passion for spending time with individual patients has waned. When I came out of dental school in 1973, Paul Simon had not yet written his monumental song Slip Slidin’ Away, but within my first decade of practice, I knew the song well and already sensed that life was not on the trajectory I wanted. My passion for dentistry had waned.

We work our jobs
Collect our pay
Believe we’re gliding down the highway
When in fact we’re slip slidin’ away

With inspiration at Pankey and Dawson, wide-wide reading, and encouraging colleagues, I found my way… my passion… my balance… my joie de vivre in dentistry. I discovered how to not only conserve my personal energy but also generate more energy through personal contemplation time and daily exercise. The greatest discovery I made was that my practice of dentistry actually centered around one specific system: the comprehensive patient examination and the meaningful conversations I had with patients during the exam.

The One Thing to look out for is the quality of your comprehensive patient exam. Is it at the highest level?

The comprehensive examination is the “one procedure” or process that gives the dentist the opportunity to express and display his or her leadership “virtues.” Don’t let it slip slide away.

Conversation is where the human side of health care takes place. Continue to spend extra minutes in conversation. The meaningful moments you share with your patients will energize you and help you get through current stressful days. Just remember that having a meaningful conversation, in many cases, requires us to let our guards down and become vulnerable. It means sharing our philosophy and showing our human side… maybe even how challenging dentistry is right now… and yet still so rewarding.