The Coach Barrow blog in 2025 - a review: from octopuses to dashboards

A review of all my blog posts in 2025, highlighting the main topics covered

2025 has been a year of two parallel truths in independent dentistry. on one hand, the pressure has been relentless: operating costs have risen, team expectations have shifted, patients have become more cautious, and the overall economic mood has been unpredictable.

On the other hand, the best owner-managed practices have not just survived. they have used the pressure as a forcing function to get sharper, more disciplined, more digital, and more intentional about what they stand for.

Early in the year I found myself in a familiar place: planning. A retreat with a couple of thoughtful critics, looking hard at strengths, weaknesses, opportunities and threats, and being realistic about what could tighten as employer costs bite. The shared conclusion was simple: only the strongest and most agile will feel safe, and agility is no longer a nice-to-have. it is the strategy.

What follows is the story of the year as it unfolded through the blog.

Not every post was about dentistry, but almost every post pointed to the same central idea: the independent practice wins when it chooses to run like a modern business with a human heart.

1. The economics: your margin is being hunted

If 2025 had a mascot, it was the octopus.

I used “operating cost per utilised surgery per day” (ocpuspd) as a blunt instrument to force clarity: empty chair time is not neutral, it is expensive. when the benchmark shifts dramatically, you cannot “tweak” your way back to health. You have to redesign the machine: more utilisation, more productive clinical days, better diary rules, better conversion, and yes, braver pricing.

This shows up in unexpected places. the perennial idea of “renting out a surgery” sounds like an easy win until you actually price it properly: calculate true operating cost per surgery per day, add a sensible profit margin, and then watch the would-be tenant recoil at the number. It's not that your number is wrong. it is that most people have no idea what a modern surgery costs to keep open.

Then there is the bit that many owners still try to avoid: communicating fee increases.

One of the more practical moments in the blog came from using ChatGPT (and my own version, The Extreme Business Autopilot©) to craft a calm, empathetic reply to a patient who challenged a plan price rise.

The key learning was not “let AI write your emails”. It was: write your standard responses in advance, train the whole team to handle the conversation, and stop treating pricing as something to apologise for. avoidance is dangerous.

2. The patient journey: the white space returned, so we had to get better

As the year progressed, more practices started to describe the same pattern: more hesitation, more unsigned treatment plans, more no-shows, more “I’ll think about it” disappearing into the ether. I called it "white space returning", and the fix was not cleverer scripts. It was better systems.

The post on helping patients say “yes” in uncertain times was fundamentally about reducing friction and increasing confidence: clearer communication, better follow-up, stronger use of patient finance where appropriate, and a more deliberate consultation pathway. The practices that convert well do not “wing it”. They design it.

The most human version of this theme came in July, when three principals in four days used some variation of “I feel like a fraud”.

The response was part mindset, part mechanics: stop comparing your inside to everyone else’s outside, accept seasonality, and then take immediate action (reactivate existing patients, run short-notice campaigns, target unfinished treatment plans, create fast feedback loops).

The point was simple: despair is rarely cured by thinking, but it is often cured by movement.

3. Digital dentistry stopped being a differentiator and became the baseline

One of the clearest strategic messages in 2025 was that digital workflow is no longer a “premium add-on”. It's a foundation.

I updated my “nine revolutions” list to reflect what is now shaping the modern dental business: intra-oral scanners everywhere, a digitally capable TCO, therapists operating at full scope with digital tools, in-house 3d printing, smile simulation moving from airbrush to AI, Guided Dentistry, AI note-taking and feedback, Chairside dentistry, and the looming shift from traditional search to generative AI-driven discovery in marketing.

The strategic punchline was this:

The independent practice does not beat bigger groups by being cheaper. It wins by being better. And “better” increasingly means combining technology with hospitality and experience.

That is exactly why the T.H.E. difference idea mattered so much this year. Smaller practices can shine when they use modern tech to create confidence, and then wrap it in warmth, certainty and consistency. The giants can scale process. independents can scale care.

4. People, leadership and culture: the hidden margin

2025 also kept circling back to a less comfortable truth: many practices are trying to run 2026-level businesses with 2016-level people systems.

The associate-principal relationship is a fault line. The "associate development programme" post framed it as a “quietly growing tension”: technically competent associates who are culturally disconnected, and practices with massive potential that cannot convert it because expectations, coaching and alignment are missing. In a high-cost world, disengagement is not an inconvenience. it is a threat to survival.

By December, the “Extreme Business Autopilot© hit parade” made this painfully clear.

Among the ten most asked questions of the year were: why surgeries are half empty, why cash is tight even when busy, why associates underperform unless chased, why meetings change nothing, and what to do with a TCO beyond giving them a job title. These aren't clinical problems. they are leadership problems.

Leadership also means boundaries. "The Dartmoor Dental Way" story landed because it captured a core lesson: decide how you do things, and be willing to say “absolutely not” to requests that violate your values or your model. Independence without boundaries is just chaos by another name.

Owners and leaders are not robots. I wrote openly about burnout in October, catching myself doing the very thing I warn others about: running too hard, too long, under the delusion of indispensability. the reminder for 2026 is simple: you cannot lead well if you are running on fumes.

5. Exit, value and the consolidation backdrop: be sellable even if you never sell

The acquisitions landscape remained a quiet presence in the background of 2025, but it influenced behaviour. The mid-year overview highlighted what buyers look for and why valuation is not just about revenue. It's about sustainable earnings, risk, and what the business looks like without the owner doing everything.

That's why I kept returning to the golden goose idea in workshops: prepare for exit even if you are years away, and prepare a golden goose if you do not want to sell. Independence is easier to defend when the business is a machine, not your hero story.

The direction of travel for 2026: the independent practice that wins

If I had to summarise the “ask” of 2026 for owner-managed practices, it would be this: "become more measurable, more digital, more intentional, and more human."

Here are seven practical themes to carry forward:

1. Run the business from a cockpit, not from gut feel. AI-driven dashboards are coming fast, pulling real-time financials, productivity, marketing ROI and CRM tracking into one place. the winners will be the ones who can see early, decide quickly, and course-correct daily.

2. Protect chair time as if it is your most expensive stock. Treat "ocpuspd" as a weekly reality check, and redesign diaries, hours and team rhythms to keep chairs utilised.

3. Make pricing a strategy, not a reaction. Write the scripts, train the team, and stop hoping the problem disappears.

4. Design conversion, do not “hope” for it. Reduce white space with deliberate follow-up systems, better consultation structure, and confident communication.

5. Use digital workflow as both care and cost control. scanners, guided dentistry, AI support tools and chairside capability are becoming normal expectations, not luxuries.

6. Treat associates, managers and TCOs as assets to develop, not variables to tolerate. Set targets, coach consistently, build accountability, and close the cultural gap.

7. Hold the line on values and boundaries. A strong independent practice is not one that says "yes" to everything. it is one that knows what it is, and what it is not.

If 2025 taught us anything, it is that “used to” dentistry is finished ("we used to do this but then we stopped").

The practice that thrives in 2026 will be the one that builds its own economy: clear numbers, strong systems, modern tech, brilliant people, a calmer owner, and a patient experience that feels unmistakably human.

Merry Christmas and thank you for reading this blog.