The conversations you're avoiding are costing your Practice - a guest post by Mark Topley

the conversations you avoid don't disappear.

That uncomfortable knot in your stomach when you think about addressing Sarah's declining performance? The way you find excuses to postpone discussing Brenda's attitude problem? The awkward dance around money conversations that leaves everyone confused and frustrated?

You're not alone. These difficult conversations plague practice leaders across the dental profession – and the cost of avoiding them is higher than you think.

I'm getting ready for the London Dentistry Show on 3–4 October at ExCeL, where I'll be running a joint session with Lisa Bainham from ADAM. Our session, "Let's Talk About It – Real Conversations in Dental Practice," tackles the discussions that make us squirm.

Lisa will address the patient-facing conversations: handling complaints, discussing treatment costs, and supporting anxious patients. My focus? The internal conversations that keep practice leaders awake at night – addressing underperformance, confronting poor behaviour, and navigating money discussions with your team.

Here's what I've learned after years in leadership: the conversations you avoid don't disappear. They fester. They multiply. They transform small issues into practice-threatening problems.

Every day you delay addressing that team member's attitude, you're sending a message to the rest of your staff. Every time you skirt around performance issues, you're undermining your practice standards. Every avoided money conversation creates confusion and resentment.

The timing will never feel perfect. The conversation will never be easy. But your practice, and your team, deserve better than avoidance.

In the run-up to our session, I want to share practical strategies for the three conversations most practice leaders find impossible to start. Because once you master these discussions, you'll transform not just your practice culture, but your own confidence as a leader.

Underperformance

We’ve all seen it. A member of the team isn’t pulling their weight – late with tasks, slower than they should be, not following systems. Everyone notices. You notice. And yet it feels awkward to raise.

The way through is curiosity first:

“I’ve noticed X isn’t being done the way we need it. Can you help me understand what’s getting in the way?”

Often you’ll find there’s a simple reason – lack of clarity, lack of training, sometimes even lack of confidence.

But it can’t stop there. Show empathy – that you want them to succeed – and then use authority to set out the standard and the timeframe.

A phrase I often use is:

“I want you to succeed here. To do that, this needs to change. Here’s the support I can give, and here’s when we’ll review it.”

Curiosity, empathy, and authority together turn a difficult conversation into a constructive one.

Poor Behaviour

Behaviour is culture in action. Eye-rolling in a meeting, sharp comments to colleagues, or constant negativity – it all chips away at the team.

The mistake many leaders make is to let it slide for the sake of keeping the peace. But peace without honesty isn’t real peace.

Here’s what to do: name the behaviour, not the person. Keep it factual.

“I noticed you interrupted three times in the meeting today.”

Then set the boundary:

“That’s not how we work here. I need you to reset on this.”

It doesn’t have to be aggressive. But it does have to be clear. Because if you ignore poor behaviour, you’re telling the whole team that the standards don’t really matter.

Money

Few conversations make leaders more uncomfortable than talking about money – whether it’s pay rises, bonuses, or CPD funding. It feels personal. It feels risky.

The temptation is either to shut it down quickly or give in to avoid the awkwardness. Neither works long term.

Instead, take the same three-step approach:

1. Curiosity – “Tell me what’s behind your request.”

2. Empathy – “I can see why you’re asking, and I value your contribution.”

3. Authority and clarity – “Here’s how we make pay decisions here, and here’s what the process looks like.”

Being transparent about the “how” behind the decision builds far more trust than trying to dodge the question.

The Thread That Runs Through It All

Whether it’s performance, behaviour, or money, the same principles apply:

●      Curiosity – seek first to understand.

●      Empathy – show you’ve listened and care.

●      Authority – set boundaries and expectations.

●      Clarity – kindness is saying the thing that needs to be said.

These conversations aren’t easy. But they are necessary. And they’re the mark of a strong leader.

One Challenge for You

What’s the one conversation you’ve been avoiding that, if you had it this week, would make everything else easier?

It won’t get easier by waiting. But it will get easier with practice.

And if you’re coming to the London Dentistry Show on 3–4 October, come and join Lisa and me for ‘Let’s Talk About It’. We’re on at 0915 on Friday, and 1530 on Saturday. You’ll leave with practical tools you can use straight away – with your patients and with your team.

Because real conversations are what keep practices healthy, teams engaged, and leaders effective.

Connect with Mark at great-boss.com