February 25, 2024
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In his book “Good To Great”, Jim Collins discusses howgood companies grow into great ones.  The framework he discovered was that great companies have disciplined people, disciplined thought, and disciplined action.  “Confronting the brutal facts is a discipline practiced by the leaders of the companies studied.

Yet today, brutal facts are explained away.

o Increase in automobile fatalities.
o Increase in construction work fatalities.
o Increase in illegal migrants.


Could public policies that promote the use of mind-altering substances such as marijuana be contrubutory?  Could public policy that incentivizes illegal migrants by offering them free housing, food and healthcare be a cause? Could a government system incapable of confronting the brutal facts and taking disciplined action be a causative factor?

Finger pointing and finding fault in others are not Good ToGreat qualities mentioned by Jim Collins.

Whatever your political bent, as a business, the ability to confront uncomfortable facts can impact your ability to thrive.  Here are some of the brutal facts relevant to dental practices.


30% turnover rate for dental assistants in 2023
Patient retention rate avg. is 58% (Jarvis’ benchmark is 85%)
Hygiene retention rate avg. is 66% (Jarvis benchmark is 80%)
Perio to Prophy % is 27% (Jarvis benchmark is 60%)
Case Acceptance avg. is 45% (Jarvis benchmark is >65%)


While it’s important to confront the brutal facts, it’s what’s done with them that turns a good or even struggling business into a successful or great one.  Key in the process is to understand what the facts mean and their root cause.  

A dental analogy is, seeing a cavity and filling it.  Leadership would involve figuring out WHY that cavity occurred and how a change in hygiene habits, diet, or other factors, is true prevention that helps a patient more than just having a filling.

What’s stopping dental practice owners and team members from employing such a Good to Great process?

One of the barriers is another one of Jim Collins’ Good to Great factors, what he calls “level 5 leadership”.


Level 1:  The Highly Capable Individual

Level 2:  The Contributing Team Member

Level 3:  The Competent Manager

Level 4:  The Effective Leader

Level 5:  The Executive


From Jim Collins: While Level 5 leaders can come in many personality packages, they are often self-effacing, quiet, reserved, and even shy. Every good-to-great transition in our research began with a Level 5 leader who motivated the enterprise more with inspired standards than inspiring personality.

Dentists and hygienists are trained to be highly capable individuals.  It’s a requisite for graduation and licensure.  The leadership pathway is rarely discussed in dental schools (except of course, in the Practice Management Course at Temple University’s Kornberg School of Dentistry, that I direct along with Dean Ismail, himself a level 5 leader).

Jim Collins posits that there are 2 groups of people, one who cannot lead because they just don’t have the innate talent and the second who have the seeds of leadership within.  The environment and qualities that can create a level 5 leader includes.


They are self-reflective.
They pursue conscious personal development.
They have a mentor(s).
They have had a great teacher(s).
They had loving parents.
They were stimulated by a significant life experience.
They experienced working for a Level 5 boss.


The good news is that Leadership can be learned.  It can be modelled and practiced.  

Want to learn how to be a better leader?  First look in the mirror.  Second, confront the brutal facts.  Third, set up a Complimentary Strategy Session where we can discuss a personal and customized pathway that will enable you to become a level 4 or Effective Leader, and lead your team to success and greatness.

To your success,


P.S.  One of the qualities of an effective leader is clear communication.  This happens to be the topic being covered in the next series of Coffee With The Coach webinars.  


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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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