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Fixing Ops Breakdown in High-Growth Dentistry
From revenue leakage to streamlined execution—how a performance management system stabilized a fast-scaling dental practice.
A multi-location healthcare provider was struggling with revenue leakage, unsecured payments, and claims delays as the business scaled. Over 6 months, we built a performance management system that standardized processes and improved accountability. The result was reduced unsecured payments, faster claims cycles, and a measurable increase in operating income.
Challenge
Brighton Modern Dentistry was scaling at 25% YoY growth—but behind the scenes, cracks were forming. Their newly hired front office team (none with dental experience) faced a steep learning curve.
The consequences were costly.
Meanwhile, the back office grew resentful. Gossip and mistrust spread. The challenge wasn’t just operational—it was cultural.
To understand what was really driving the breakdown, we used a multi-method diagnostic:
- Stakeholder interviews across front and back office
- Staff surveys to capture team sentiment
- Workflow observation in live environments
- Business performance analysis (claims, revenue, adjustments)
- Gilbert’s PROBE model to assess drivers like capacity, motivation, and environment
The issue wasn’t training alone. It was a mismatch between job complexity and employee capacity:
- Roles demanded nuanced knowledge of insurance, codes, and financial conversations—but new hires lacked core dental knowledge
- Expectations were unclear and inconsistently delivered
- No coaching, accountability, or feedback systems existed
- Toxic dynamics (mocking, blame) went unchecked
Even high-potential employees couldn’t succeed in this environment.
We introduced a Performance Management System to clarify expectations, support behavior change, and rebuild trust.
Core Components:
- Defined Performance Standards tied to business metrics
- Coaching Infrastructure → weekly 1:1s, monthly reviews, quarterly checkpoints
- Two-Way Feedback Loops to repair trust and engagement
- Behavioral Accountability Frameworks to reset culture
- Clear Advancement & Exit Protocols to manage underperformance with dignity
This wasn’t just about operations. It was about reconnecting the team to shared purpose.
This wasn’t just about operations. It was about reconnecting the team to shared purpose.
- Phase 1: Stakeholder Alignment → Defined goals, success measures, and staff expectations
- Phase 2: Coaching & System Rollout → Weekly check-ins, monthly evaluations, and feedback loops
- Phase 3: Optimization & Retention Decisions → Structured support plans, respectful exits, and culture reset through collaborative planning
Results & Impact
Brighton Modern Dentistry reframed performance as a strategic growth lever. With systems, roles, and accountability aligned, they not only protected revenue—they created a culture that could scale with confidence.
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6%
Net Operating Income increase by plugging critical financial leaks through structured performance management systems.
Front office staff gained confidence in insurance verification and payment collection, while workflow handoffs became predictable and reliable.
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Unsecured payments dropped from 13.2% through clear payment collection protocols and staff training.
Real-time tracking systems provide visibility into payment status, while structured workflows eliminate payments falling through handoff cracks.
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9 Days
Faster claims processing from 40+ days to 31 days through structured workflows and accountability frameworks.
Staff developed competency in insurance requirements and coding accuracy, reducing claim rejections and administrative overhead.
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Cultural Transformation
Rebuilt trust between front and back office teams through performance management systems that replaced toxic dynamics with structured communication and shared accountability.
Weekly coaching sessions restored psychological safety and collaborative problem-solving.
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Scalable Foundation
Created blueprint for sustainable growth with performance infrastructure that supports expansion without relying on heroic individual efforts.
New hires can be onboarded with clear expectations and measurable success criteria.
Expertise
This project drew on our strengths in performance design, organizational structure, and accountability systems. Our ability to align culture with process enabled the practice to stabilize operations and scale with confidence.
Scale Without Breaking Operations
If your business is scaling fast but struggling with misalignment, trust breakdown, or operational chaos—we can help you build systems that stabilize performance and unlock growth.
