What You’ll Learn
- What “culture by design” actually means and why it matters for technology adoption
- How to build a written culture guide that creates shared expectations across your team
- Why picking a champion for new initiatives is essential to making change stick
- The biggest mistake practices make when implementing new software or AI tools
- What the most financially successful dental practices do differently
Culture Happens Whether You Design It or Not
Every dental practice has a culture. The question is whether anyone actually built it on purpose.
Stuart Anderson has spent 30 years working with dental practices through the Crown Council and its sister consulting company TOPS. He’s watched thousands of teams try to implement new technology, new systems, and new ways of doing things. And he’s watched most of those initiatives quietly die within a few months.
“If there’s not a strong leader who sits down and says what should the culture of this practice be, what do we believe in, what do we follow, then that culture is just created by default,” Stuart told Adrian Lefler on a recent episode of the Byte Sized Podcast. “It usually just defaults to the person who’s the loudest or that complains the most.”
Culture by default means nobody knows what’s expected. It means every patient interaction gets handled differently. It means new technology gets dumped on the team with no plan, no accountability, and no follow-through.
Culture by design means writing it down. It means working on it together. It means reviewing it constantly so everyone remembers what they agreed to.
What a Culture Guide Actually Looks Like
Stuart shared an example from Dr. Weston Spencer, a Crown Council member who’s built exactly this kind of framework. His culture guide is a printed document that gets reviewed with the team regularly.
One detail stood out. The front of the document doesn’t say “employee manual” or “rules for staff.” It says “a culture guide for leaders at Dr. Weston Spencer’s practice.”
“He’s not dictating to you how to act,” Stuart explained. “He’s saying, I want to empower you to be a leader in this team, and this is how we have this little guide for it.”
The contents cover things that might sound basic but rarely get defined explicitly. What does it mean to start on time? Does that mean arriving at 8:00 when doors open, possibly still eating breakfast? Or does it mean arriving at 7:45, dressed and ready to work?
“I know that might sound silly,” Stuart said. “But a team needs to sit down and say, hey, when a problem comes up, what does our culture guide help us do to work through that problem?”
Other elements include how to handle disagreements, how to talk about patients, how to raise concerns without fear of being yelled at, and how to support each other through change. When these expectations are written down and reviewed regularly, there’s no ambiguity about what the team agreed to.
Why Written Expectations Change Everything
Without a guide, entropy takes over. Stuart compared it to setting a curfew for teenagers.
“The first couple times, they’re home at 10. And then kind of this entropy happens where now it’s 10:15, now it’s 10:30. And it’s like, dad didn’t say anything, so it doesn’t matter.”
The same thing happens in dental practices. A doctor says to be early, but what does that even mean? One second early still counts as early. Without specifics written down and reviewed often, standards slip.
“When it’s written down, it’s really easy to just help team members remember what they all agreed to do,” Stuart said.
The guide also makes difficult conversations easier. Instead of saying “you’re annoying, so we have to fire you,” a leader can point to specific expectations that aren’t being met. Either the person changes or they recognize on their own that they don’t fit.
“They know pretty quick, and so do you, that they don’t fit in,” Stuart explained. “We didn’t waste an entire year with this icky person that’s on the team. This is what we are. If you don’t like it, it’s just go.”
The Biggest Mistake When Implementing New Technology
Practices come home from conferences fired up about everything they learned. They’ve met with 50 vendors. They’ve listened to six speakers. They’re ready to change everything.
This is exactly when things go wrong.
“I think that the biggest mistake they make is trying to do too much,” Stuart said. “In comes a new piece of software, in comes some new tech. Let’s pick one or two major things that we can focus on and work on as a goal over the next six months. Make that the focus. Make that what we recognize and reward.”
Research supports this. Having more than two or three organizational goals at a time is a recipe for disaster. The practices that successfully implement change are hyperfocused on one or two things, reviewing progress every week, talking about it constantly, and recognizing wins along the way.
“It is scientifically proven that having more than two or three goals at a time, especially as an organization, is just recipe for disaster,” Stuart said.
| Approach | Outcome |
| Implement nine new tools at once | Nothing sticks, team burns out |
| Focus on one or two goals for six months | Sustainable change, team stays engaged |
Every Initiative Needs a Champion
When no one owns a new initiative, it disappears. Stuart learned this the hard way through the Smiles for Life campaign, the Crown Council’s charitable whitening program.
“After years of watching an office sign up for Smiles for Life, the doctor extremely excited, a team member very excited, and then when the marketing box arrives, no one takes accountability for it,” Stuart said. “What’s that box? Oh, well, I signed us up for this thing.”
The solution is designating a champion. Not a babysitter. A champion.
“This is the team member that’s going to own the thing. They’re going to know everything about it. They’re going to be accountable for it. They’re going to be in charge of training the team about it,” Stuart explained.
This person handles the training calls, watches the onboarding videos, answers questions from teammates, and keeps momentum going when attention starts to drift. Without someone in this role, new technology just sits in a box or gets downloaded and forgotten.
The champion concept can even be written into the culture guide. When the practice makes changes, the guide says they’ll find a passionate person who owns the challenge and is accountable for implementation.
Building the Guide Together
A culture guide that gets dictated from the top becomes a compliance document. A culture guide built together becomes something the team actually believes in.
“Rather than the doctor just being like, guess what, I made this, everybody live by it, if you’ve got a problem with it, this probably isn’t the place for you,” Stuart said. “No, we’re going to actually create a guide that we write down and print and work on together.”
The best teams set aside a dedicated meeting, maybe two hours on a Thursday or Friday, and create the document as a group. Everyone contributes. Everyone has input on what gets included.
This doesn’t mean the leader has no authority. Decision makers still make decisions. But when the team helps build the framework, they’re invested in following it.
Stuart also recommended bringing in an outside coach or facilitator for this process. Someone objective can redirect conversations when they get weird, help surface concerns that might otherwise stay hidden, and call out dynamics that people inside the practice can’t see.
“A great team has an objective person on the outside that’s helping and being honest and kind of redirecting when things get weird,” Stuart said.
What the Best Practices Have in Common
Stuart was asked what the top Crown Council practices look like from a financial and emotional perspective. His answer kept coming back to one thing.
“There is no way around having a strong leader,” he said. “There has to be someone who is accountable and who is passionate and works on leadership skills.”
The best practices have leaders who stay late, solve problems, don’t complain, and model the behavior they expect from their teams. When the team watches that, they understand the standard.
“Why would a doctor ever think that the team would act any different than the way that they are acting?” Stuart asked. “Hey, our culture guide says to treat everyone with respect, but I’m not going to do that. Well, there’s a problem here.”
These practices also recognize that patients don’t want root canals. They want white teeth, beautiful smiles, confidence, and to be treated fairly. The teams that continue to grow are the ones who understand this and build everything around the patient experience.
Over time, these practices attract the best employees in their communities. They expand into multiple locations. They create models that are repeatable and scalable.
“Their most powerful marketing advantage are the people that work there,” Stuart said. “That’s what I think makes the financial success in the practice for sure.”
In This Episode:
Stuart Anderson, Partner at Crown Council
Stuart Anderson is a dental practice consultant and leadership coach at the Crown Council, one of dentistry’s most respected professional membership organizations. Through the Crown Council and its consulting arm TOPS (Total Patient Services), Stuart has spent his career helping dental teams build what he calls “culture by design,” a systematic, intentional approach to defining how a practice treats patients, handles challenges, adopts technology, and grows. Stuart has worked with thousands of dental practices across the country and is a passionate advocate for dentistry as a profession that can genuinely change lives.
Adrian Lefler, CEO and Co-founder of My Social Practice
Adrian Lefler, CEO of My Social Practice, is a seasoned expert in the dental marketing industry with 14 years of experience. He is widely recognized for his engaging and informative presentations. Based in Suncrest, Utah, Adrian shares his life with his wife, four children, and a lively mix of pets. My Social Practice is a leading dental marketing company, and Adrian is passionate about helping dental professionals succeed in this dynamic field.
Frequently Asked Questions
Why do dental practices fail at implementing new technology?
Most practices try to implement too many things at once. They come home from conferences with a dozen new ideas and expect the team to adopt all of them simultaneously. Research shows that organizations with more than two or three active goals struggle to accomplish any of them. Successful practices focus on one or two changes over six months.
What is a champion in the context of dental practice change management?
A champion is the team member who owns a new initiative. They handle training, answer questions, keep momentum going, and hold the team accountable for adoption. Without a designated champion, new technology or systems quietly disappear because no one takes responsibility for making them work.
How do I get my dental team to buy into a culture guide?
Build it together rather than dictating it from the top. Set aside dedicated time for the whole team to contribute ideas and agree on expectations. When team members help create the guide, they’re invested in following it. Bringing in an outside coach or facilitator can also help surface concerns and keep the process productive.
