Cognitive Dissonance
July 14, 2024
NOTE: This was written prior to the events of 7/13.
Noun:PSYCHOLOGY
“the state of having inconsistent thoughts, beliefs, or attitudes, especially as relating to behavioral decisions and attitude change.”
The emotional reaction was immediate, raw and extreme. The producer and star of a reality TV show had been elected President of the United States. In Manhattan, where he was best known outside of the TV appearances, the despair was palpable.
The immediate shock and revulsion quickly gave way to an outcry for his replacement. Residents on the Upper Westside who resided in buildings with his name on them demanded it’s removal. The emotion and attempts to vilify him have continued unabated.
It’s that emotion that has also contributed to a split in our country. It’s responsible for half the country refusing to see what has been in front of their faces for at least the past year or more, a current President experiencing cognitive decline.
Our family experienced such a decline with our father. Managing this became a major focus for my sister, my brother and myself for nearly a decade. Dad passed away 1 week shy of 90.
It’s difficult to posit whether the process was more painful to my father or the family. But while my father’s pain is over, the family’s continues, as in a form of PTSD, every time we see the blank stare, hear the trailed off thought, and look at the rigid posture in our President the pain returns.
Half of America, including many in the media, academia, and entertainment were so blinded by their disgust and hatred of Donald Trump that they failed to realize what had been in front of their noses for months, if not years, a failing elderly gentleman. The debate was not a unique event. It was a wakeup call.
Cognitive dissonance happens in dental practices. It is seen when employees and vendorsare retained despite their lackluster performance. The fear of change overrides the reality of poor performance. Ignoring reality has consequences.
How often do we hear about an employee leaving and the owner then finding out that the perceived performance was significantly worse. Some have discovered significant financial mistakes and even embezzlement.
Emotion clouds the mind and is a veil through which reality is filtered. It can have dire consequences for businesses and in all areas of life.
That’s why it is so important to have a firm grasp on Key Practice Indicators for both the practice and individual positions in the practice. Objective measurements are the only way to pierce the veil.
Ask most practice owners about their gross revenues and you’ll usually get a quick response. But start digging into profit, overhead %, phone call conversion, ROI on marketing, case acceptance rates, hygiene efficiency and turnover rates and you’ll likely get a deer in the headlights stare. When asked, responses range from “I don’t know”, “OK, I think”, to “Why does that matter?”
Avoiding cognitive dissonance is just one benefit from keeping a close eye on KPI’s. In his book “Good To Great”, Jim Collins found that one of the factors that contributes to good companies becoming great is a willingness to confront the brutal facts.
What brutal facts have we been ignoring?
To open eyes, clear vision and a more peaceful world,
Michael
P.S. The event of 7/13 will hopefully bring the issue of civil discourse into focus. Civil discourse has been lost. Let’s hope it opens some eyes and has some positive outcome.
Practice Success Insights

Dr. Michael Goldberg is one of the leading educators on dental practice management in the United States.
Michael ran and sold a prestigious group practice in Manhattan and has been on Faculty at Columbia University and New York-Presbyterian Medical Center for 30 years including Director of the GPR program and Director of the course on Practice Management.
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