The Sovereign Dentist
The Sovereign Dentist
Most dentists got into this for the lifestyle; the freedom, the autonomy, the life only ownership can buy. Most of them aren't living it. The practice that was supposed to set them free runs them instead.
Hosted by Alastair Macdonald, The Sovereign Dentist is a standing conversation for owners building something durable: a practice you'd never want to sell, a team that makes the business build itself, and the kind of freedom that lets you leave on a Tuesday afternoon without the whole thing crashing down.
We get into the real mechanics - associates and partnership, incentives and equity, standards, and the difficult conversations most owners avoid. No scripts, no hacks. Source code, not tactics, because your problem set is defined by the capabilities of the people you lead, and an entrepreneur's number one job is to stay relevant.
Let me fold time for you so you can enjoy the very freedom you seek.
And when you're ready to go wider — geopolitics, wealth, family, legacy, the architecture of a sovereign life across every domain that matters — that conversation lives on our companion show, The Sovereign Guide.
The Sovereign Dentist Podcast is provided for general educational purposes and does not constitute clinical, legal, tax, accounting, or financial advice. No advisor, consultant, or professional relationship is created by listening. Nothing discussed is a recommendation regarding any specific transaction, partnership, or practice structure. Consult licensed professionals in your jurisdiction before acting. Individual results vary and no outcome is guaranteed.
The Sovereign Dentist
2: THE Answers to the Test
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
You're not sick of mistakes in your practice. You're sick of the same mistakes.
Two assistants, same role, same systems, wildly different results. Working out why took me five years and became the day-one training in every business I've owned since.
There are only two kinds of errors happening in your practice right now. One is 95% your problem. The other isn't yours at all.
Most owners can't tell them apart.
Here are the answers to the test.
Watch the full training on my YouTube channel.
If you're looking for more of my philosophical, geopolitical, or macroeconomic content, visit my other podcast, The Sovereign Guide.
More can also be found on my YouTube channel.
In 2008, late 2008, as the financial crisis was ravaging asset markets around the world, my business, due to fortunate anticipation of the crisis and profiting from it, preparation for it, was thriving. And I was in a situation where I needed an additional assistant. At the time, my primary kind of admin assistant was, let's call her Tammy, because, well, that's the name her parents gave her. Tammy was my point person, and she had been... She's a very sweet person, but a little bit unreliable. And what Tammy gave me was an opportunity to upgrade the quality of my systems, at least my systems as they related to her, uh, enabling and manifesting the things that I needed done in the world. Her, her role as a high-performing assistant needed some systems around them. And so I built those out, and they continued to kind of break down and so forth, and I still wasn't really getting the results that I wanted. But she reached this level, you might be familiar with this, of being functional. Not optimized, not great, but functional. She was super sweet and a very well-intended, very earnest person. And as the business was going through this just incredible growth at the time, I hired a second assistant. And let's call her, well, the same thing her parents called her, Catherine. Catherine showed up as this dynamic, high-energy character, maybe only a year or two younger than Tammy, but just a, a full volume character. And she stepped into these systems that had been created around and for Tammy, but really for me And in the onboarding of Catherine, something interesting happened. Very quickly, she was creating disproportionately better results and better standards, better results, more results than Tammy had been, even though she'd been working with me for a couple of years by then. And this got me thinking, paying attention to the nature of where things were breaking down. What I'm going to share with you will, uh, in a moment, I think be extremely liberating for you in how it is you spot and are able to measure the types of errors in your practice. I maintain that you are not sick of mistakes and errors in your practice. You are sick of the same mistakes and errors. And what I noticed is Tammy would make the same mistakes, and wherever possible, I would step in and upgrade the system to account for it. But I still couldn't quite get the results I wanted, again, until Catherine showed up by contrast in the same supportive role, delivering radically better results. What was revealed is there are two types of mistakes that they were making, the same two types of mistakes that are being made inside your practice. Over the course of the next couple of years, I whittled away at this framework until by twenty thirteen, I had completely or comprehensively crafted what I'm about to share with you, what I call the measures of error. Sometimes I refer to it as beyond blame. Over the course of our time together in the future, I'm gonna share with you one of the most at depth, one of the most powerful concepts to radically upgrade the quality of outcomes that you create in your business, which is using mistakes and errors as points of discovery. There's a lot more here, but I'm gonna move on for now. There are two types of mistakes that happen in your practice. Now, I'm gonna share this with you peer to peer. But at the end of this short abbreviated delivery that I'm giving you now, you will find a comprehensive video version on YouTube of me teaching this respectfully to you in exactly the way that I am advocating for you to teach to your team. Please go there. This is no gated things, you don't have to give me your email. Just go there and watch this. This is, as I say, bedrock training. Every single employee on day one in any and every business that I have owned since that date gets to go through this training. I alluded in the previous episode to the fact that the best employees will thank you at the end of this training. So there are two types of mistakes. The first are mistakes of what I refer to as omission. Omission, of course, suggesting something is missing, and my job is to spot what is missing. Over time, as my team becomes more sophisticated and experienced and leadership emerges, it is their job to spot what is missing What could be missing? Any number of things. Tools could be missing, training, a script, a process, a system, an understanding of priorities. What else could be missing? Well, when I deliver this to employees, they will inevitably will have someone raise their hand because as you'll see in the video, I insist that you get buy-in for this training from your team while you're teaching it. It's a dynamic delivery. What else could be missing? And the team members will always say, "Well, time. I didn't have time." It's entirely possible, but time is an important one. So put a little asterisk there on this whiteboard of kind of left column and right column that I draw out. Again, you'll see all of this in the video. I put a little asterisk there next to time because it can be true, and it can also not be true. You'll see how we deal with that in a minute. Time is often, uh, often used as a hiding place. I would have, but I didn't have time. And you're thinking because you were too busy hanging out in the break room? We'll come back to time. Resources, support, actual support from team members, a clear path of what their day or their task should look like. Any number of these things could be missing. Now, it's important that the team understands. Well, with respect, it's more important that you understand and then give to them the fact. The fact is that Ninety-five percent of the responsibility to solve these things that are missing are yours. They are yours When I can discover something that is missing in my business, it is of course immediately and obviously my problem to solve. What Tammy kept unearthing early on were breakdowns in the systems, the teaching, the onboarding, the actual physical phone systems of relaying calls to our different office on the East Coast, et cetera. She revealed those. But the ninety-five percent was mine to fix. Five percent is hers. Five percent is all the team is responsible for, coming to us with the things that aren't working. They are the ones uniquely positioned to spot these as early as possible, and their sole responsibility is to come to you and say, "Doc, boss, this didn't work. This is broken. Something's missing." Let's go back to time. Why is time tricky? Well, as I alluded to, because for some people it's absolutely true. If you're anything like me, you have burdened your highest performing individuals with more responsibility. We always do this. We refer to it as, you know, the squeaky wheel. It is the underperforming person that gets all of our attention and the high-performing person that gets all of our work and responsibilities handed off to them Those high-performing people may be in a situation where because of what I refer to as the burden of the capable, are given even more stuff to do. You're always gonna be leaning toward giving work to the capable. It's possible that they need some capacity. They need more time. So what we will do is we will give them a time sheet, maybe in 15-minute increments, that they must maintain for at least two days, catching in real time where it is that their time is going. Now, this is where delivery is everything. I can give it to you as if it is something you owe me, or I can give it to you as an employee, as somebody that I'm trying to help improve the experience of. Giving somebody this time sheet is something you do for them, not to them. The difference is the level of honesty you can expect. If I am being told-- If I'm telling you, "You must do this because I wanna know," what are you gonna see? You're gonna see some of the most ridiculous puffery and claims of extraordinary burdens of work that these characters carry. But if you're doing it for them, you're more likely to get the truth I'm giving this to you t- so that we can figure out how to create more capacity, give you some time back. We've gotta get this. This is data. It's data-driven. At the end of those two days, we can stand back and look and say, "Okay." In the case of the high-performing person, or anybody for that matter, we can say, "Hey, I notice here that it's taking you half an hour to do this particular task, and Jack over there is able to do this in twenty minutes, so I'm gonna put you with Jack and see what he can do to help you get that number down." It's useful for me. I have upgraded the system. Another version of this might be, "Hey, I notice here that we've got you doing project X or responsibility Y. The truth is, that's not yours. That's Jill's. Let's give it back to her." This is very common, particularly in practices that are going through rapid expansion, where suddenly more is being asked of everybody, but the distribution of tasks is not updated frequently enough. We look up from a burst of growth, and we've just dumped a fire hydrant worth of demands on the team. This is very common. Same reason that we turn to this time journal. We're able to identify the people that we are burdening excessively and those that are puffing things out, doing tasks they shouldn't be doing or claiming to do things that they aren't, riding on the coattails of those that are Time requires some nuance. So we always come back to that. At the end of this list of things that I've got buy-in from everybody talking about what could be missing, I've got a list of everything in the practice that could possibly be improved. Errors of omission are completely understandable, and not just must we change our philosophy about these mistakes, we have to if we believe that we are running, building ecosystems in our business of growth. If you can see your business as an ever-expanding organism, an ecosystem that harnesses the ambitions and skill sets of others, then the onus is on you to make it easy for your team members to come to you right away with breakdowns, inefficiencies, misunderstandings, and so forth. Ninety-five five, you guys bring this to me or to the lead as fast as you can. I don't want you suffering a minute longer than you have to if you're burdened with broken stuff, poor onboarding forms, dysfunctional checklists and systems, or too much placed upon your plate and the time of the-- time, hours in the day that you have to do it. Now we move over to the second column. Whereas the first I've typed and written up there, omission, and in parentheses I've put something's missing. The right column is a very different one. And in my delivery to you, and yours to your team, I'm going to be way more deliberate. In the right column, we have errors of commission. What does that mean? Well, in parentheses, I'm gonna write there something as opposed to omission, something is missing. Commission, something was chosen What possible things could we choose to do that would be a mistake? Again, turning to you as my team, you're going to offer being late, gossip, being unkind, not operating by the core values of the practice Not being a good support, being selfish withholding information You notice right away that this list is a very different one. These are things that individuals are choosing. You would have seen this before. Somebody will show up and say, "I'm sorry I'm late, but the traffic...," dot, dot, dot, and holding in their right hand the very Starbucks order that they chose to turn left instead of turning right when they pulled out of their driveway because they thought, "Well, you know, it'll work out fine." They chose to allocate their time poorly and are blaming it on some other outside thing. These are choices. It is a choice to gossip. It is a choice to withhold critical information. It is a choice to be unkind and mean with employees, fellow coworkers. These things are chosen. These are also the things that have a very different skew of responsibility. Whereas in omission, I've drawn there ninety-five five, here in commission it is zero one hundred. Zero percent of this is my responsibility or my doing. It is also completely out of my power to effect change. You give me the misses in omission, I'm onto it. I want this practice radically upgraded. Radically upgraded, and this is how to do it. Start with the breakdowns. Nothing to be mad about here But this side, commission, these are choices, choices made by you, the team members, that have a negative impact on not just the practice, but the lived experience inside it. For that reason, it is zero res-- zero percent my ability to affect outcomes, my responsibility, and one hundred percent yours. Whereas this column of omission controls and dictates the outcomes of the practice. This produces the results that feed our family and serve our patients and produce good clinical outcomes. The systems and the infrastructure that supports the production of what we do in the marketplace, acts of commission here on the right column will define the lived experience of you working inside of it. I turn to you as my team and I say, "Who here has ever worked in an environment where these things were prevalent?" Everybody raises their hands. Everybody knows what it's like to be stuck in a culture of this sort of toxicity. This is where it gets extremely powerful. I have shown you, my team members, that this stuff I can't wait to fix it for you, but these things I cannot wait for you to fix it for us. Here is the line that I use all the time, and it is yours to deploy. Again, you will see this in the video When I'm standing there pointing to co-mission, I will say, "It is my responsibility to do what I can with the choices that anybody makes in this column. I will stand guard at the gate of this practice to protect you from this type of an environment. And if I need to, I will protect the practice from you. I will protect this practice from you if you choose to do this and infect the environment of this team that I work so hard with and care so much for. I take this seriously, and I take it seriously for you, and if I need to, I will take it seriously from you." Zero, 100. Let the weight and impact of that statement hit them in the chest just as it did now if you put yourself in their shoes. What we're doing here is signaling three powerful things. The first is this is an organization that is actively seeking growth via discovery of our inefficiencies, breakdowns, and errors. That means it's safe to bring things to me. It is also signaling an awareness of the types of problems, and finally, it is signaling the severity of the choices that they will make to which you are compelled by morals, by your ethical standards, by your claims to care for them to step in and stop This is benevolent leadership. This is powerful, and it is clear. And I can tell you as sure as I have a nose on my face that you will have team members at the end of this training thank you for it, because it gives them the answers to the test. And for the best team members, it gives them a sense of safety and the knowing that you actually have an infrastructure that will protect them from all of the crappiest experiences that they've had in all of their previous jobs. Of course, you see right away the dangers. You have to actually follow through on it. You have to actually step up and protect them from this in the practice. This is a dangerous declaration for you to make if you are not somebody who follows through. But if you're not, well, your results will find you anyway. To the extent that you can deliver this and make it clear to the team, and it lands the way it does all the time, you will have established a bedrock principle of operating in and with the practice. These are the answers to the test. These are the things they want to know. These are the things that we can point back to in six months' time when they thought that the trap door just opened up and Jane was released, even though she was so great and everybody loved her and what happened? They now have a framework to point back to. And as you'll see when you go and watch the video, I go into much greater depth, and I give you a lived delivery example for you to replicate. Going forward, when it is time to let go of somebody, particularly a prominent person on the team, someone who is a high-impact person or has been very tenured, they've been around for a thousand years, that's a very destabilizing thing for the rest of the team. Why did Doc let them go? What do we do on Monday morning when Jane was released? We do the same thing every time. "Guys, you'll notice that Jane's no longer with us. We came to the end of our working experience. Things didn't go the way either of us had expected, but we'll always think about her for," insert really great thing that she did that one time that we all chuckle about. We will always speak well of our ex-employees. Always. Your job is to foster a relationship in the community that even those that are fired will know that they will be honored post-departure. It's the right thing to do. It's the right thing to do Jane is no longer with us. We came to the end of our working experience. I know it didn't go the way either of us had wanted or hoped. It didn't go the way either of us expected, but man, did she make the greatest brownies. Anyway, just a quick recap, everybody. We're gonna go through the measures of error, omission, commission super quick, and as you'll remember, dot, dot, dot, just this is all done for all of us. What have I just told you? What do you think led to Jane's departure? Not a bad word is spoken about her, but the framework speaks volumes. Jane chose to behave in a way that was ugly, culturally insensitive, miserable to be a part of, and I followed through on my commitment, and I've got your back The link to the video is in the show notes. It's on YouTube. Go and check it out. Deploy this Monday morning. I can tell you that if you can make this a bedrock training principle for your team, you will structurally upgrade all of the outcomes and the cohesion of the team, and the best will rise above, and the worst will reveal themself as they themselves are revealed by this framework. Get into it. Deploy it. It only works all the time
SpeakerThat's it for this episode. Thanks for being here. Hey, there's only two things that you have in your life, your time and your attention. That you've given both to me for these few minutes of today means
everything. Cheers.