Every dental practice owner eventually stops coming in, whether through a sale, retirement, a new role, or an illness nobody planned for. What happens to patients, the team, and the schedule on that day is decided years earlier by how much of the practice depends on the owner personally. Dr. MaryJane Hanlon sold her own practice in 2014 to lead the clinics at Tufts University School of Dental Medicine. The practice did not survive the transition, and patients called her afterward asking where to go. This article explains what stops in a practice when the owner stops, cites Harvard Business Review survey evidence that most private companies have no plan for an unexpected departure, and shows how to test the Ready question of The Succession Filter™ with a planned week away and a one-page continuity plan.
Introduction
In 2014, I sold my practice. I had been asked to lead the undergraduate clinics at Tufts University School of Dental Medicine, where roughly 800 dental students trained, and I could not do both jobs. I had to move quickly.
The practice did not survive the transition. For a long time afterward, patients called me to ask where they should go. In fact, 12 years later, this past month, a patient called me for a new referral.
I tell that story because of what it showed me about the day an owner stops coming in. By then, almost everything that matters has already been decided: who your patients trust, what your team can do without you, and which decisions only you can make. You decide those things on ordinary Tuesdays, years before you leave.
So I want to ask you the question I wish someone had asked me ten years earlier. If you did not come in tomorrow, or for the next month, what would happen to your practice?
Key Takeaways
• Every owner stops coming in eventually, and many do so without warning.
• What happens that day depends on how much of the practice runs through you personally.
• Most private companies have no plan for an owner's unexpected departure, and small practices are among the most exposed.
• The Ready question of The Succession Filter™ asks whether the practice could run without you and whether you have ever tested it.
• A planned week away and a one-page continuity plan will tell you more than any amount of assuming.
Two Ways to Stop Coming In
There is the departure you choose: a sale, a retirement, a new role. And there is the one that chooses you, such as an injury, an illness, a family crisis, or exhaustion that finally wins.
Owners tend to plan, at least vaguely, for the first kind. Almost nobody plans for the second. J. Yo-Jud Cheng, Boris Groysberg and Paul Healy reported in Harvard Business Review in 2020 that 63% of private companies in their global survey of board members had no contingency plan for the sudden departure of their chief executive. The article does not give the sample size. The authors add that small firms often need such a plan more than large ones do.
A solo or small group practice is about as small as a firm gets. In many practices, the owner is the lead clinician, the final decision-maker, the face patients know, and the only person with every password, so if the owner stops, a great deal stops with them.
What Stops When You Stop
Walk through your practice in your head and ask what would stall within a week if you were not there.
Start with the clinical side. Who sees your patients, and who handles emergencies? Patients in the middle of treatment are the most exposed. A crown prep without a seat date, an implant waiting for restoration, and an ortho case mid-course all need someone qualified who knows the plan. Hygiene can keep running for a while, but exams need a dentist.
Then look at the business side. Ask who can sign checks, pay the lab, run payroll, and get into the bank, the software, and the insurance portals. Many insurance arrangements are tied to the individual dentist rather than the practice, so check what yours would require for a covering clinician to see your patients. Rules on patient records and their custody vary by state. Your attorney and your state board are the right sources for the specifics, and you want those answers before you need them.
Your referral relationships need the same look. The specialists you send patients to know you, and your patients follow your recommendations because they trust you. When you leave, your team needs to know whom you would send people to and why.
Most owners who do this honestly find a short list of things only they can do, and a much longer list of things only they know how to find.
The Patients Who Called Me
When patients called me after the sale, they were not asking about the building or the equipment. They wanted to know where to go next, and they were asking me because their trust had been with my team and with me. Very little of it had transferred to the new arrangement.
Bo Burlingham, who interviewed owners for his book Finish Big, found that the owners who were content with their exits felt settled about how things turned out for the people who had helped them build it, and for a dental practice, that group includes patients. Trust in a practice is personal, and it moves slowly. If the plan is for patients to keep their trust in the practice after you leave, they need to have built some of it with other people in the practice before you go.
That is the strongest argument I know for making the practice less dependent on you, and it holds whether you plan to sell in two years, step back in ten, or stay until you are eighty. Patients who already trust your associate, your hygienists, and your front desk have somewhere to go when you are not there.
Testing Whether the Practice Is Ready
The first question of The Succession Filter™ is Ready: could this operate without me, and have I ever tested whether it can? Most owners believe their practice could run for a while without them. Very few have tried it.
Here is a test you can schedule this quarter. Plan a week away. Arrange coverage for patients in active treatment and for emergencies, then make yourself unreachable for anything that is not a genuine emergency. Ask your team to keep a simple log of every question, decision, or task that would normally have come to you.
When you come back, sort the log into three groups:
1. Things that needed a dentist, which tells you what clinical coverage you need.
2. Things that needed a decision, which tells you what authority you could delegate.
3. Things that needed information only you had, such as a password, a contact, or a process that lives in your head, which tells you what to write down.
The third group is usually the longest, and it is the easiest to fix.
A One-Page Continuity Plan
After the test, write one page that would let your practice get through an unplanned absence. Keep it short enough that your team will read it and specific enough that they can act on it. It should cover:
• A covering dentist you have already spoken with, and what you have agreed.
• Who on your team has access to the bank, the practice software, and the insurance portals, and where the credentials are kept securely.
• Who tells the team and patients, and roughly what they say.
• Where the key documents are kept: leases, contracts, insurance policies, your attorney's and accountant's contact details.
• Whom to call first.
Review it once a year, at the same time you review your fees and your goals. It costs very little, and if the day comes, it is the difference between a team that knows what to do and a team waiting for a call from you that will not come.
Want a head start? Download the free one-page continuity plan and fill it in with your office manager this week. GET IT HERE
Final Thoughts
The day you stop coming in is coming, whether you choose it or not. You can decide now what it looks like, through the trust your patients place in your team, the authority you hand over, and what you write down.
Schedule the week away. Keep the log. Write the one page. Then ask the Ready question again, this time with evidence.
Book Your Free Practice Efficiency Call
If you are not sure what your practice would do without you for a week, a free 30-minute Practice Efficiency Call is a good place to start. We will look at where the practice depends on you and where it is losing time or money. https://calendly.com/drmjhanlon/the-hanlon-group-consultation
-
Take a planned week away and have your team log every question that would have come to you. If the log is long, the dependence is high. Sort it into things that need a dentist, things that need a decision and things that need information only you have.
-
At minimum: a covering dentist you have already agreed terms with, who can access the bank, software and insurance portals, who communicates with team and patients, where the key documents live, and whom to call first. Check record-custody and insurance requirements with your attorney and your state board.
-
Yes. An unplanned absence can happen at any age, and a practice that can run without you for a few weeks is also easier to step back from, easier to grow and easier to sell if you ever decide to.
-
What is the Ready question in The Succession Filter™?
It asks whether your practice could operate without you and whether you have ever tested that. Ready is the first of three questions; Right and Remains follow.