Trying to run a practice without a solid office manager puts a hard ceiling on your success. In this episode, Jeff explains the qualities that define a real executive manager and how that role becomes the foundation for growth, expansion, and peace of mind.
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Questions From This Episode
What did MGE's internal study find in common among clients who weren't graduating the Power Program on schedule?
Looking at the small percentage of clients who reached the program's executive internship without fully implementing what they'd learned, Jeff says every single one, without exception, lacked a stable, productive, functioning office manager. Some had managers who started training and never finished, some couldn't find a candidate, and some picked someone who didn't work out, but the missing manager was the one constant across every case.
How does Jeff define the office manager role, and why does it matter so much for a chairside doctor?
He compares the office manager to a chief operating officer, running the day-to-day business while the doctor functions more like the owner and CEO. Since a producing doctor is already the primary source of revenue and involved in sales, Jeff argues there simply isn't enough bandwidth left to also run the business, which is exactly the gap a strong manager is meant to fill.
What are the four places Jeff says clients most often find their best office managers?
In order of how often it works out: a family member (who brings genuine skin in the game), someone already on the team with a proven track record, someone from the practice's own patient base, and, if none of those pan out, an outside hire, who Jeff recommends proving out in another role first before handing them the title.
What criteria does Jeff say doctors often focus on when hiring an office manager that actually don't matter much?
He specifically downplays age (he's seen excellent managers in their 20s and 50s), formal education level, and vague notions like "maturity." What does matter, he says, is whether the owner doctor can genuinely get along with the person, since that's the one non-negotiable in a role this closely tied to the doctor.
What are the seven core qualities Jeff looks for in a prospective office manager?
Highly productive, genuinely driven (wanting more but tying that to what they're willing to do to earn it), able to get real compliance from others, able to solve problems and take initiative without being asked, accountable rather than quick to deflect blame, genuinely smart, and able to learn new things and actually apply them. Jeff says raw talent in these areas still needs real training layered on top, since talent alone or training alone, without the other, doesn't produce an effective manager.
Episode Transcript
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Since it's a new year, let's start this week's episode with a little self-reflection. If you're an owner doctor, I want you to do a brief but honest assessment of your practice and answer this question: am I happy with the direction my practice is headed?
If you answered that with an overwhelmingly enthusiastic yes, exclamation point, well done, that's great. But if your answer landed anywhere from a weaker yes to a maybe or a no, I want to ask a follow-up question: do you have an effective, trained, and fully functioning office manager? I obviously can't hear your answer, but if I had to bet money on it, I'd bet you answered no.
Why? Well, there's a reason one of the first steps an MGE client takes on the MGE Power Program is appointing an office manager. There's a reason I've now done six episodes of Dental Business Rx covering the importance and duties of an office manager and other aspects of the job. The reason is simple: uniformly, our most successful clients all have stable, functional, trained office managers. And by uniformly, I mean a hundred percent. There's an absolute causal relationship between a stably successful practice, and I use the word "stably" deliberately, since any practice can have one great month, and a successful office manager. You can try to work around that, hope AI somehow solves it, it's not going to, but experience, and some new data I just found, keeps proving the same thing again and again: a good office manager equals a successful practice.
If you're in the position where another year has gone by without a functional, productive manager in place, I want to point something out. You don't have unlimited time. Life, your practice, your career, all of it has an expiration date, and every year that passes without moving toward your personal, professional, and financial goals can never be recovered. Once time is gone, it's gone forever. So if you're an owner dentist, your long-term business, personal, and financial goals, the ones that materially affect you, your family, and your team, are directly tied to your ability to find and develop a functioning, productive manager to run your business. This matters as much as almost anything else you're doing in your practice. The only thing I'd rank higher in importance is patient care and clinical quality.
So with that in mind, consider this week's episode my appeal to please, please pay attention to this. We're going to look at what the office manager position actually is, why it matters so much, and then what and who we're actually looking for when hiring one. I also have a downloadable checklist for your office manager to help them run the practice day to day. If you don't have an office manager yet, or the position isn't well fleshed out in your practice, this should help you build it out and know exactly who you're looking for. My name is Jeff Blumberg, and I'm your host, and here we are again talking about office managers.
What got me back on this topic was a recent study we did here at MGE. You probably know we run the MGE Power Program, training for the doctor and the manager on every aspect of practice management, sales, organization, staff management, executive skills, financial management, and more. It runs about 78 days for the doctor and manager together. I won't go through all of it here, but I'll put a link on the episode webpage if you want to check it out.
At the end of the Power Program, clients go through something called the executive internship, where we make sure everything's actually been implemented and we tighten up any remaining skills. Theoretically, a client could reach that internship and not immediately graduate because there are things we still need to fix. This happens to a very small percentage of clients, but it happens. So we studied that small group to figure out what was going on, the same kind of self-correction we'd want any practice to do. Uniformly, every single one of these clients who had trouble graduating due to implementation issues or stat problems did not have a stable, productive, functioning manager. Some had managers who started training and never finished. Some couldn't find a manager at all. Some picked a candidate who didn't work out. But in every single case within that small group, the common thread was the same: no manager.
That makes sense, because the whole theory behind having a manager is that this is the person doing the majority of your implementation. This gets a bit misunderstood, because "office manager" doesn't mean the same thing to everyone the way "dental assistant" or "dental hygienist" does. If I say dental assistant, we all know roughly what that means, maybe one has more advanced skills, maybe one is an expanded-functions assistant, but the core role is clear. Same with dental hygienist, same with associate doctor. But "office manager" has no uniform definition. I've asked doctors if they have an office manager, and they'll say sure, but it turns out to be someone part-time, or even remote, which makes no sense to me in a clinical dental environment.
So let's start with how we define the role. For us, the office manager is the person running the business. If you compared it to the broader business world, they're your chief operating officer. They run the day-to-day of the practice while the doctor is more like the owner and CEO. If you're an owner doctor working chairside, you can immediately see why this matters. You're being relied on as the primary source of production and revenue for the business, and you're also involved in the sales process. You don't have the bandwidth, if you're doing clinical and sales well, to also run the business day to day. That's why you need a manager. If 90 percent of your day is spent in front of a patient or in a patient's mouth, you need someone else running things.
So the structure is: you find an excellent manager, get them trained, and they run the business, while the doctor and manager interface regularly as a team to get things done. The doctor decides what they want accomplished, the manager is the execution arm actually making it happen. This is genuinely a high-level position. Assuming clinical oversight is covered, say you have an associate in place, you should theoretically be able to leave town for a month and have the manager keep the business running well. That's the standard: someone competent and productive enough that if an employee can't handle something, the manager can step in, run the staff, and work directly with the doctor as needed.
So what we're really looking for is an executive. Executives don't grow on trees, though I always think that's a funny expression, since what actually grows on trees is leaves, fruit, and nuts. You have to develop them, but they need the raw qualities in place first. Not everyone has the raw material to become a strong executive. So when we're hiring for this position, we're looking for someone who has the potential to become one.
Let me start with what I'm not looking for, because I see people go into an office manager search focused on qualities that have nothing to do with whether someone will actually succeed in the role. First: age. I've seen great managers at 25 and at 55, it genuinely doesn't matter to me. As long as they're willing to commit to training and to working with the doctor long-term, age isn't a meaningful factor. Next, and this might be a bit controversial: formal education. Whether someone has a master's, a doctorate, or a bachelor's isn't especially important to me. I know excellent office managers with just a high school diploma, and some with master's degrees. If someone has a bachelor's in history, what does that actually tell me about running a dental practice? At best, it shows they can commit themselves to completing something, but plenty of people have bachelor's degrees these days, so on its own, it's not a strong signal. Then you get some strange, vague criteria people latch onto, like "maturity," which usually just means something fuzzy like not being a prankster or dressing a certain way. Obviously, if this is someone the owner doctor will work closely with, you have to actually get along with them, that's a real deal breaker if it's missing. But things like age, formal education, and vague notions of "maturity" aren't the big factors for me.
Before I get into the specific qualities I look for, let's talk about where our clients have actually found their best managers. There are really three main sources, plus a fourth if none of those work out.
The first is a family member. I've seen people bring in a spouse, a cousin, a sister, a brother, a mother, a daughter, a son. I can think of one client whose husband, a former bank manager, runs their practice. Another client, Rushi Trivedi, who's actually been on this podcast before, came over from Wall Street to run his wife's practice, and eventually worked himself out of a day-to-day role entirely by training up other managers to take it over, they now run several large practices in New York. Family members do have to have the actual chops, the qualities I'll get into shortly, but the upside with family is genuine skin in the game. If my wife were running my practice, she'd be deeply invested in its success, and that helps, though it's not a substitute for actual capability. Sabri, by the way, would make an excellent manager, but that's beside the point. This is a route we've seen work for plenty of clients, spouses leaving corporate careers to join the practice, spouses already working in the practice, spouses not previously working at all, it doesn't matter, the point is a family member might genuinely fit the role.
The second place clients most often find a manager is someone already on the team, a lead dental assistant, someone up front, a treatment coordinator, I've even seen hygienists turn into managers. The advantage here is you already have an experiential track record with this person, you've watched them work, so you know they're capable of something. They're not executives yet, but they've shown you baseline capability worth investing training and effort into.
If you don't have a viable family member or current team member, a source that's often overlooked, and most people never have to go this route, is your own patient base. Believe it or not, you might have someone in your patient base who'd make a genuinely viable manager candidate, someone you already have some experience with and could see stepping into the role.
If none of those three sources work out, you're left bringing someone in from the outside, which comes with a few extra hoops depending on your situation. Before I'd make an outside hire my official manager, I want to know they're actually productive, I want confidence they're effective before handing over parts of my business to them. So I might start them as a treatment coordinator, or have them do some scheduling first, even if they come in with manager experience elsewhere, because experience somewhere else doesn't mean experience with me. There's also a political dimension to consider. If there's genuinely nobody among your family, patients, or current staff who fits, and you bring someone in from outside and immediately announce them as the office manager, that can create real friction with your existing staff. It tends to go more smoothly if that person is first brought on in another role, say treatment coordinator, and proves themselves there. Once the staff sees firsthand how competent they are, elevating them to manager lands very differently, they're not just a proven commodity to you, they're a proven commodity to the team, and they carry real respect from day one. If you only have one or two staff members total, that political dynamic matters a lot less, and bringing someone straight in as manager may be less of an issue. But either way, I'd want to see real evidence of capability before handing someone the reins cold.
As I mentioned, I do have a download called the Office Manager Daily Checklist, available free on the episode webpage, a tool your manager can use to help run the practice day to day.
So you can source a manager candidate from any of those four places, family, current staff, your patient base, or an outside hire, but the most important thing, across all of them, is that they can actually perform. This applies just as much to family members. I've seen people bring in a brother who just isn't capable as a manager, and it doesn't work out, which strains the relationship on top of everything else. So before I'd actually move forward with anyone, I want to see seven basic qualities in place. There's more nuance than this in practice, but these seven will get you started.
First: they have to be highly productive, genuinely capable of working hard. If it's someone currently on my staff, I hopefully already have stats on their productivity, a treatment coordinator who consistently collects at a high level, a dental assistant who works circles around everyone else. That's someone who's already proven they can work. With a family member, maybe they're competent in a different industry, or if it's a spouse, you already know firsthand whether they're capable of real work. Either way, the last thing you want in a manager is someone allergic to actually working.
Second: they have to be driven. How do you know someone's driven? They're looking for more, but they've connected that "more" to something they're actually willing to do to earn it. If someone tells me they want $200,000 a year because they're "very experienced," that's the wrong orientation. If instead someone says, "pay me this to start, and when we hit this benchmark, can I earn more, and when we hit this next one, can I earn more still, I'd like to see this practice doing five times what it's doing now," that's driven. I want someone driven to expand and build the business, not just someone looking to put in time, and driven for their own growth too, wanting to learn and become more capable themselves.
Third, and you generally won't know this without some direct experience with the person: they have to have shown some real ability to get compliance from others. A schedule coordinator or treatment coordinator gets compliance from patients. A dental assistant gets compliance around post-op instructions. A lead assistant directing other assistants and actually getting results, with those assistants still in reasonably good spirits, has shown they can direct people effectively, not just issue instructions, but actually get people to follow through.
Fourth: they make things work, solving problems largely without needing you involved. Say someone who reports to me runs into a situation they'd normally ask me about, but for whatever reason can't reach me, this isn't about skipping legitimate clinical decisions that genuinely require the doctor, I'm talking about organizational things. I respect someone who takes initiative, even if their solution isn't exactly what I would have chosen, far more than someone who does nothing and just waits for me to show up. If you walk in one morning and your schedule coordinator says, "doctor, we had a scheduling blowout overnight, here's what happened, and here's what I did about it," even if it's not precisely the fix you'd have picked, that's a strong signal. They're solving problems rather than stockpiling them for you.
Which leads to the fifth quality: accountability and responsibility. They own their job. They don't deflect blame or avoid accountability. If a schedule coordinator has a bad opening and responds with, "well, I confirmed that patient and they said they'd be here and just didn't show, so I did what I was supposed to do," that's not really owning the job. A scheduler's job is a productive schedule, full stop, regardless of who technically confirmed what, so what are you doing about it now? I want to see initiative toward solving that, not a list of reasons it wasn't their fault. If someone takes zero initiative and asks permission for everything, I'd never make them a manager, because a manager has to operate largely autonomously and think independently, and they'll have other people reporting to them who need the same. If they can't take initiative on their own individual job, they're not going to be able to manage anyone else's.
Sixth: they have to be genuinely smart, able to actually solve problems. I'm not going to get into every method people use to assess that, I know some practices administer some kind of testing, not for hiring decisions, but for role placement, that's a question for your own HR judgment, but the underlying requirement is real problem-solving ability.
Seventh, and this one's especially important: the ability to learn, and to show they can actually apply what they've learned. Say we teach a new procedure, a new room setup, a new way of collecting money, did they learn it, and can they actually do it? If they can't apply something they were taught, assuming the system itself was sound, how am I supposed to teach them anything more advanced? You can usually see this early in training. If you've corrected someone twenty or thirty times on how to answer the phone and it's still not sticking, that's a real signal, if they can't master something as basic as a phone greeting, how will they handle something more complex? Learning speed isn't the critical factor to me, some people learn faster than others, and that's fine, as long as they're at a reasonable pace, but the ability and willingness to learn is essential. What's genuinely dangerous is hiring a manager who believes they already know everything, "I've been a manager for ten years, there's nothing left to learn," and shuts down any new approach without even considering it. If someone looks at a new method and says, "that's not bad, but here's how I do it, and here's why," and can actually show why their way works better, fine. But someone unwilling to even look at a new idea is a problem, because you want someone driven to keep expanding themselves too, and an unwillingness to learn undermines that.
Those are the seven basic qualities I look for, productive, driven, able to get compliance, able to solve problems and take initiative, accountable, smart, and able to learn and apply what they learn. There are other things worth considering too, but these are the core ones. And keep in mind, even with all seven qualities present, you still have to train them, that's expected, half of the MGE Power Program is training specifically for the office manager. What you're looking for is raw talent plus training. Raw talent with no training doesn't work. Training given to someone without the raw talent, someone who genuinely doesn't like managing people or being an executive, doesn't work either. You need both: the raw material, developed through real training, into an effective executive who can actually run your business.
This matters even more given how the dental landscape is shifting, something I've covered in other episodes. There's going to be a significant wave of practices coming up for sale over the next five to ten years. If you're the kind of doctor thinking about picking up a second, third, or fourth location down the road, you need a genuinely strong executive working alongside you, a real manager who can help you find and build out teams for those additional offices. Without that manager in place, you don't really have a foundation to expand from.
I won't say your entire future depends on it, but if you want the kind of career and practice you're actually aiming for, this is a critical piece. And these people genuinely exist. I know office managers earning six figures, and there's no reason they shouldn't, if a manager took your practice from $100,000 to $600,000 a month, you'd happily pay them well for that. These people may not be where you'd expect to find them either, family, your patient base, or maybe already on your current team.
So there you have it, I know I keep saying it, but you need a manager. In my opinion, it makes all the difference. Let's make this the year you get a real office manager in place if you don't already have one. I promise you'll be glad you did. I hope this helps. Don't forget, the episode webpage has the Office Manager Daily Checklist download, along with a link to the MGE Power Program if you want to learn more. If you want to find out more about MGE generally, you can find us online at mgeonline.com or call us at (800) 640-1140. Have a great week, and we'll see you at the next episode.