One simple change that will boost your Practice's efficiency - a guest post by Mark Topley

I do most of my work with practice owners on the structural problems that seem to continually drain time, energy and good people from a business. Recruitment cycles that never end. Team members who can't quite seem to get there. Managers who are technically in charge but are still doing half the previous job. Owners who feel responsible for everything.

Now of course there are dozens of moving parts in any practice, and dozens of plausible places to start fixing them. But if I were forced to pick the single change that has produced the biggest efficiency gain, across the widest range of practices, I'd pick this one.

Get specific about what ‘good’ looks like.

I don’t mean a poster, a values statement or an employee handbook. I mean an ongoing, repeated, behavioural conversation that runs through every role in the practice.

It sounds almost too simple to bother with. In my experience, it's the one thing most practices haven't actually done.

Here's what I mean. Most teams in most practices are working without a clear, shared picture of what good looks like in their role. They have a job description, which tends to be a list of tasks. They have an induction, which usually focuses on systems and policies. They have a manager who knows what good looks like in their own head, but has rarely articulated it in a way that anyone else could repeat back.

So the team works from approximation. They do their best version of what they think good is. The principal works from a different picture, often a more demanding one. The gap between those two pictures is where most of what gets called underperformance actually lives.

It's not a people problem. It's a clarity problem.

A typical example - I recently worked with a reception team being asked to handle deposit conversations more confidently. The principal has explained the new policy, the rationale, the wording. Six weeks in, the conversations still aren't happening consistently. Some patients are being asked, others aren't. Some team members hold the line, others quietly avoid it.

The instinct is to conclude the team isn't bought in, or needs more training, or doesn't have the confidence. Sometimes that's true. More often than not though, what's missing is a

specific, behavioural picture of what good looks like in that conversation. 

• What actual words to use.

• What tone.

• What to do when the patient pushes back.

• What's a soft no versus a hard no.

• What the standard is, and where the line sits.

Without that picture, the team is being asked to perform to a standard nobody has ever fully described. It's no wonder it doesn't stick.

The same pattern shows up across almost every part of practice life. Good triage. Good handover between clinical and admin. Good morning huddles. Good chairside support. Good response to a complaint. We use these words as if everyone shares the same definition, then get frustrated when the behaviour doesn't match the one we had in our heads.

The shift is mechanical, but it changes the practice quickly.

Pick the role or moment where the friction is loudest. Describe what good looks like in it, concretely, in behaviour, with examples. Run it past three people on the team and see if their picture matches yours. Where it doesn't, you've just found the gap.

When you do this properly, two things happen almost immediately. The strong performers exhale, because the standard finally matches what they've been doing all along. The people who've been drifting suddenly have something specific to aim at, and most of them rise to meet it. The very small number who can't or won't are now visible in a way they weren't before, which is also useful information.

The efficiency gain isn't dramatic on day one. It compounds over time. You get less things that need to be reworked. You need fewer awkward conversations. You get faster onboarding. There’s less drifting. Less of the low-grade tension that comes from people not quite knowing where the line is.

It isn't glamorous work. It's slow, careful, and unfashionable. It's also most of the job.

Mark Topley is a leadership and team performance consultant working with dental practice owners across the UK. Through Great Boss Academy, he helps principals stop over-functioning, build clearer structures, and lead teams that don't depend on them being in the building. He writes and speaks regularly on culture, retention, and the realities of practice leadership.