The weekly tracker patterns that reveal profit leaks, people problems, and the fixes that work.

What dental practice owners really worry about on a Monday. And the four levers that change everything

Monday morning, 26 January 2026, starts the same way most Monday mornings do for me. Coffee, laptop, and a queue of Weekly Trackers from owners and managers inside The Extreme Business 100.

The tracker is simple. Every weekend, clients answer a few prompts about wins, challenges, priorities, and behavioural changes. My job, before Monday lunchtime, is to read them and respond with three or four straight pieces of mentoring. No therapy, no fluff, no “well done” padding. Just the levers that move the business.

What strikes me, week after week, is that the themes repeat. The details change, but the underlying mechanics of a dental business are beautifully predictable.

The first category is always capacity and cash. Diaries with gaps, conversions stalling, plan churn after a provider change, and the familiar sensation of “we’re busy but the numbers don’t match the effort”. The advice is consistent too: pick one number you refuse to let drift, protect the diary like it is inventory, treat uncompleted treatment as a pipeline, and forecast cash weekly so shortfalls are spotted early rather than explained late. When cash dips, the solution is rarely panic. It is discipline.

Close behind comes people. Recruitment pipelines that rely on hope, not process. Resignations that wobble back into “maybe I’ll stay”. Return-to-work situations where compassion is necessary but boundaries are missing. Maternity returns that create a hidden holiday and cost liability that nobody has modelled. Occasionally a more serious HR scenario appears, and the message is always the same, follow process, document everything, keep it factual, and protect the practice. Being kind and being firm are not opposites.

Then there is culture and leadership. Owners describing themselves as micromanaging, overwhelmed, or stuck as the bottleneck. Managers wrestling with how to hold standards without becoming unpopular. Senior clinicians overstepping into other people’s diaries, creating tension and destabilising the team. In these cases, my role is to bring everything back to governance. Who has decision rights, what are the rules, how are they measured, and what is the meeting cadence that turns talk into action. Most “people problems” are actually system problems.

Technology is now a weekly feature. Scanners, printers, note-taking, CRMs, automation, digital treatment plans. The promise is huge, but the risk is always the same: expensive kit and clever software that never changes behaviour. My advice is blunt, adoption needs minimum standards, training, measurement, and a named owner. Digital only improves profit when it improves workflow, conversion, and patient experience.

Finally, there is the personal element. Ill parents, health scares, fatigue, and the quiet toll of carrying too much for too long. This is where the work becomes more statesmanlike. The business still needs pace, but the owner also needs boundaries, sleep, and a protected rhythm. Many of the best decisions made in practices are not financial or clinical. They are decisions to stop rescuing, to delegate decisions not tasks, and to build a business that can breathe without the owner’s constant presence.

That is a Monday morning in my world. Different trackers, different practices, and the same underlying truth. The practices that win are not the ones with the cleverest ideas. They are the ones that implement the basics, consistently, with clarity and accountability.