There is a particular kind of exhaustion that comes not from working too hard, but from working the same way for too long. It is the exhaustion of the treadmill. You are moving, you are putting in the effort, the numbers look roughly where they should be, and yet something feels like it is not quite working the way it once did or the way you imagined it would.
The treadmill is seductive because it keeps you busy. And when you are busy, it is easy to mistake motion for progress.
But here is the question I want to put to you today, and I want you to sit with it honestly: when did you last stop and ask whether the way you are running your practice is actually the most effective way? Whether the habits, the systems, the routines you built years ago still serve you? Whether there is a better way that you have simply never had the space to consider?
For most practice owners, the honest answer is: not recently. And that gap, between the way things are and the way things could be, is where profit quietly disappears.
The Treadmill Doesn’t Just Happen in Business
Before we talk about your practice, I want to acknowledge something. This is not just a business problem. It is a human one.
We do it in our relationships, running the same patterns of communication until we wonder why we keep having the same conversations. We do it in our health, following the same routines until we realise they stopped serving us somewhere along the way. We do it in how we spend our time, our energy, our attention.
The treadmill is the default state. Reflection is the deliberate choice. And most of us, in the busyness of life and business, choose the treadmill over and over again simply because stopping feels counterintuitive when there is so much to do.
The irony is that the time you spend stepping off the treadmill is the time that pays the highest return.
In business, the practice owners who create space to think, to question, to evaluate, consistently outperform those who simply keep running. Not because they work harder. Because they work differently.
What the Treadmill Looks Like Inside a Dental Practice
It shows up in ways that are so familiar they become invisible. Here are some of the patterns I see most often when I walk into a practice for the first time.
- The appointment book is structured the same way it was five years ago, even though the patient mix, the associate team, and the equipment have all changed significantly.
- Recall systems are running on autopilot, using the same messaging and the same timing that was set up when the software was installed, with nobody checking whether they are actually working.
- Fee schedules have been reviewed in isolation, without a corresponding look at whether the gap between fees and costs has grown or shrunk.
- Team meetings happen at the same time every week and follow the same format, covering the same topics, with the same people leaving slightly uninspired.
- The practice has the same opening hours it has always had, even though the demographic of the surrounding area has shifted considerably.
- Suppliers have been used for years because changing feels like effort, even though costs have crept up and nobody has renegotiated in a long time.
None of these things is catastrophic on its own. But together, they represent a practice that is running on inertia rather than intention. And inertia is expensive.
The Profit Problem: When Turnover Becomes the Only Number That Matters
This is where I want to spend some time, because it is where I see the treadmill cause the most financial damage.
Practice owners are, understandably, focused on revenue. Turnover goals are motivating. They are tangible. They give the team something to chase. And when the revenue number looks healthy, it is easy to feel like the practice is performing well.
Turnover tells you how much is coming in. Profit tells you how much is staying. They are very different numbers.
I have sat with practice owners who are generating impressive revenue figures and are genuinely surprised when their accountant hands them a profit and loss statement that tells a very different story. The money came in. But it also went out, often faster than it came in, and often in directions that had not been looked at carefully in years.
Wages: the largest and least examined cost in most practices.
Wage costs as a proportion of revenue are one of the most telling indicators of practice health. The benchmark varies by practice type, but most well-run practices aim to keep total wage costs, including the principal dentist’s drawings, within a healthy percentage of revenue. When rosters have not been reviewed, when overtime has crept in, when roles have expanded informally without a corresponding look at the wage bill, this number quietly climbs. And because payroll happens every week or fortnight and feels like a fixed cost, many owners stop questioning it.
Supplies: the bill that nobody watches closely enough.
Dental supplies are a category where costs escalate gradually and invisibly. A product gets substituted because it was out of stock. A new material gets trialled and never reviewed for cost-effectiveness. A preferred supplier raises their prices incrementally and nobody notices because the invoices go straight to accounts. Supply costs that sit at 7% of revenue and drift to 10% or 11% represent tens of thousands of dollars annually in a practice turning over a million dollars or more. That is not a rounding error. That is a real number.
Overheads that have never been renegotiated.
Laboratory fees, software subscriptions, insurance premiums, equipment service contracts, cleaning, waste disposal. When did you last review each of these line by line? For many practice owners, the honest answer is that they have never done it systematically. They inherited these costs, or set them up early in the practice’s life, and they have been running ever since. In a cost-of-living environment where every supplier is passing on their own pressures, assuming your costs are reasonable because they always have been is a costly assumption.
The Profit and Loss Statement Is Not a Report Card. It Is a Rearview Mirror.
Here is something I say to practice owners often, and it tends to land hard: by the time your accountant hands you the profit and loss statement, it is already too late to change what it says.
The P&L is a historical document. It tells you what happened. It does not help you change what is happening right now, this month, in your appointment book and on your supplier invoices and in your wage bill.
Waiting for the annual P&L to understand your practice’s financial performance is like driving a car by looking only in the rearview mirror. You will eventually see where you went wrong. You just won’t be able to do anything about it.
Practices that manage profit proactively look at their numbers monthly, at minimum. They know their wage percentage. They know their supply costs as a proportion of revenue. They have a feel for whether the gap between what comes in and what goes out is growing or shrinking. And when something shifts, they catch it in weeks, not at the end of the financial year.
How to Step Off: Building Reflection Into Your Practice Rhythm
The solution to the treadmill is not a retreat or a dramatic overhaul. It is something much simpler and much more sustainable: it is making space for deliberate reflection a regular, diarised, non-negotiable part of how you lead your practice.
Here is what that looks like in practice.
Quarterly business reviews, done properly.
Set aside half a day every quarter to look at your practice from the outside in. Not to put out fires, not to review the week’s schedule, but to sit with your key numbers, your patient data, your team structure, and ask honestly: is this working? What has changed? What should change? Put it in the diary now, treat it like your most important appointment, and do not cancel it.
A monthly financial dashboard.
Work with your bookkeeper or accountant to produce a simple one-page financial summary each month: revenue, wage costs as a percentage, supply costs as a percentage, and net profit. You do not need a full P&L every month. You need enough information to know whether your key ratios are moving in the right direction. What gets measured gets managed.
An annual cost audit.
Once a year, go through every recurring cost line by line. Call suppliers. Renegotiate where you can. Cancel what you no longer need. Ask whether every cost is earning its place. This is not an exciting task. It is, however, one of the highest-return activities available to a practice owner and it takes a day.
A system review cycle.
Every six months, pick two or three key practice systems, your recall process, your new patient experience, your treatment presentation approach, and evaluate them with fresh eyes. Are they still fit for purpose? Are they producing the outcomes you want? What would you change if you were setting them up from scratch today?
Ask the team.
The people doing the work every day often have the clearest view of what is not working. Create a regular, safe channel for your team to raise what they see: inefficiencies, frustrations, ideas. The best improvements in many practices I have worked with came not from a consultant or a new system, but from a team member who finally felt they had permission to say what they had been noticing for months.
The Practice You Want Is On the Other Side of the Pause
I have worked in and around the dental industry for over 30 years, and the practices that consistently perform well, the ones with strong profit, engaged teams, and owners who actually enjoy coming to work, are almost never the ones doing the most. They are the ones doing the right things, reviewed regularly, adjusted thoughtfully, and run with genuine intention.
That does not happen on a treadmill. It happens when you step off, look at the machine, and decide deliberately how and whether to get back on.
So find the time. Protect it. Bring your curiosity and your honesty to it. And ask the question that the treadmill never lets you ask:
Is this still the best way? Or is it just the way we’ve always done it?
Those two questions, asked regularly and answered honestly, are worth more to your practice than almost anything else you will do this year.
If you would like support structuring a business review process, understanding your practice’s key financial ratios, or simply having a fresh set of eyes on how your practice is running, we would love to talk.
Book a free consultation here, or call Ameena on 0416 313 118 | Julie on 0407 657 729.