Being a Great Clinician is Overrated

The title got your attention, huh? Before you start getting angry at me, realize that while I think we all need to be great clinicians, there’s another talent that’s just as important but often forgotten, and inspires far less passion that the idea of being an exceptional clinician.

I remember the first time I sat down with my accountant for lunch and we covered the topic of “financials”, most notably the P&L and Balance Sheets for my business. It was 21 years ago, but I remember it like it was yesterday. I was almost choking on a salad as he tried to explain “simple” things like “basis” and cash vs. accrual. I now wonder how I ever owned a practice without knowing this stuff.

So, I ask you: Are you an orthodontist who does business or are you a business owner who does ortho? I’m willing to bet you’re the former, and most likely can’t stand those who fall into the latter category. They’re not worried about the “craft” of orthodontics, and all they care about is money. They’re soiling the profession, or at least that’s what many of my colleagues tell me.

The problem is that the perception of the business owner who happens to do ortho is wrong. We all think it’s the person who owns 25 practices or the lowest fee in town practice that sees 200 patients a day. You couldn’t be more wrong, and moreover, you better start thinking like a business owner.

When I was in dental school, we had an amazing instructor who did exceptional dentistry. He was fastidious in his attention to the most minute detail and his work was spectacular. He went out of business twice, though, because he was so focused on the practice of dentistry and providing care, that like many of my peers, he just imagined that great work translated into a great balance sheet.

It’s really important to keep in mind that the practice of orthodontics and running a successful practice are independent of one another. There’s nothing that says an amazing business owner can’t also be an amazing clinician, and one needs to hone both skills. In today’s world, it is imperative that you master both. In competition, the average clinician with exceptional business skill will win out over the amazing clinician with mediocre business acumen almost every time.

Do you spend all of your time focusing on the clinical practice of ortho, wondering about wires, forces, new technology and mastery of clinical skill, but can’t tell me what a cash basis balance sheet means? Can you tell me the prescription of your brackets but don’t know what the overhead should be for each of your categories of expenses, and maybe worse, don’t even know the categories you should be looking at? Do you know what technology costs, but have no idea what it costs to buy a high producing Facebook ad? Can you create fantastic treatment plans, but have no idea how to create a pro-forma for a bank or have your own business plan?

There was a time when you could get away with being just an amazing clinician and let the rest work itself out. There is so much competition today that those who understand business and how it runs have a distinct advantage over those who do not.

If you don’t have the practice of your dreams and a low stress practice life, then get educated, join business groups, read business books and become the “complete” clinician; one who understands the business side and not just the clinical side.

Become an expert in every aspect of running a practice and spend more time with great business owners outside of orthodontics, learning the basics of good management. Hire consultants, go to classes, vet those who teach you and find a business mentor, pick the brain of your accountant and attorney. Throw as much effort into being a great leader manager and business owner as you do being a great clinician. Become an expert in the business management so that you’ll always be comfortably in control and solvent, being there to provide care for your patients.

And don’t listen to those out there who try to convince you that if you focus on the clinical side, everything will work out just fine. My former teacher is proof to the contrary.

After all, as one of my mentors once taught me…no money, no mission.

All the best,

If you’re not a member of our geographically exclusive OrthoPreneursRD Facebook page there are only two prerequisites: You’re an orthodontist (yes, you can be an associate) and you want to contribute to a group of like-minded peers who have come together to share our practice ideas and solve our common business, leadership and management issues. Email me at to learn more and to see if your region is available.