In this episode of the Dental Boardroom Podcast, Wes Reed dives into some of the most common and costly business and practice management mistakes dentists make. Drawing from years of experience working with hundreds of dental practices, Wes explains how strong clinical skills alone aren’t enough to build a sustainable, profitable, and stress-free practice.

He breaks these mistakes into six core areas, covering everything from management systems and PPO economics to lease agreements, partnerships, financial planning, and KPIs. Throughout the episode, Wes uses practical examples and real-world analogies (including agile software development) to show how intentional systems and financial clarity can free owners from burnout and help practices scale intelligently.

This episode is a must-listen for practice owners who want to stop managing reactively and start operating with structure, clarity, and long-term strategy.

Many dentists manage by instinct instead of by process. Without a clear management operating system including defined roles, meeting cadence, accountability, and decision-making frameworks, practices become reactive, inconsistent, and owner-dependent. Wes explains how adopting even a simple system and iterating over time can dramatically improve operations and reduce burnout.

PPOs often increase top-line revenue but quietly erode profitability. Wes breaks down how fee schedules, write-offs, chair utilization, and hygiene profitability impact the bottom line. He emphasizes that PPOs are essentially an expensive marketing channel and that growth without profitability can lead to exhaustion, not success.

A lease is often the largest non-clinical financial commitment a dentist makes, yet many sign without fully understanding the implications. Wes discusses escalation clauses, renewal options, relocation clauses, and why poor lease terms can hurt practice value or even prevent a successful exit.

Partnerships often fail not because of personality conflicts, but because of unclear financial structures. Wes explains why production, ownership, expenses, and profit splits must be modeled and stress-tested before forming a partnership and why aligning accounting execution with the partnership agreement is critical.

Most practices rely only on historical financial reports, such as P&Ls, which show where the practice has been, not where it’s going. Wes explains how FP&A (or a CFO model) helps dentists forecast cash flow, plan strategically, and turn financial anxiety into financial control.

Without key performance indicators, practices lack visibility and accountability. Wes highlights the importance of both leading and trailing KPIs, the value of KPI software, and how daily or weekly team huddles around metrics create a culture of ownership and consistency.

1. Clinical excellence alone doesn’t guarantee a successful practice; systems and strategy matter.
2. A management operating system frees the owner from being the bottleneck.
3. PPO participation must be understood at the procedure- and profitability-levels, not just collections.
4. Lease terms can significantly impact long-term practice value and exit options.
5. Partnerships should be treated like financial marriages, with detailed modeling upfront.
6. FP&A helps dentists make forward-looking decisions instead of relying on gut instinct.
7. KPI create clarity, accountability, and better team alignment.
8. AI should enhance well-designed systems, not replace leadership, processes, or strategy.