How Dentists Build Profitable, Resilient Practices Through Leadership, Culture, and Strategy

If you’re like most dentists, you didn’t choose this profession because you dreamed of running a business. You chose it because you wanted to care for people, solve problems with your hands, and make a meaningful difference in patients’ lives. Dental school prepared you exceptionally well for that mission. What it didn’t prepare you for was everything that came next.

Somewhere a few years into ownership, many doctors have the same quiet realization: I’m no longer just a clinician. You’re a leader. A manager of people and systems. A steward of culture. And the owner of a business that generates significant revenue—but often without a clear operating manual.

That moment is where real growth begins.

At Fortune Practice Management, we see this transition every day. And few people understand it as deeply—or explain it as clearly—as Dennis Marvel, Managing Partner and Director at Fortune. With a background that spans entrepreneurship, Wall Street leadership, and decades of coaching doctors, Dennis brings a rare perspective to dentistry: one that connects business performance, team culture, and personal fulfillment into a single, integrated strategy.

This article is a conversation—doctor to doctor—about what it really takes to build a profitable, resilient practice and an extraordinary life along the way.

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A Different Lens on Dentistry: Lessons from Scale and Simplicity

Before entering dentistry, Dennis spent years in the financial world, rising to vice president–level roles at major firms and leading large, complex organizations. But what surprised him most when he began working closely with dental practices wasn’t how different they were—it was how similar.

Whether you’re leading a Fortune 50 company or a single-location dental practice, the fundamentals are the same. Results are driven by people. Culture matters. Systems either support growth or quietly constrain it.

In large organizations, scale comes from clear leadership structures and repeatable systems. In dentistry, scale looks different—but the principle is identical. Even a solo practice depends on strong team culture, clear expectations, and consistent execution at the practice level.

No matter how big or small the organization, dentistry remains deeply human. You’re impacting team members’ lives, patients’ families, and entire communities. That ripple effect is powerful—and it’s why leadership matters just as much as clinical skill.

The Gap No One Warned You About: Financial Operations in Dentistry

One of the biggest challenges dentists face isn’t a lack of intelligence or effort—it’s a lack of education in financial operations. Your training was focused where it should have been: clinical excellence. But when you step into ownership, the game changes.

Suddenly, you’re responsible for payroll, cash flow, scheduling systems, debt management, profitability, and long-term planning. And for many doctors, the financial side of the business feels mysterious or overwhelming.

Here’s the truth Dennis emphasizes again and again: finance is not complicated—it’s just unfamiliar.

Dentistry has its own language. So does the financial world. Once you learn the vocabulary and understand what the numbers are actually telling you, clarity replaces anxiety.

Even more importantly, Fortune teaches doctors to reframe how they view financials. Revenue, profit, and money in the bank are lagging indicators. They tell you what already happened. The real power lies in understanding the leading indicators—the behaviors, systems, and decisions that create those results.

When you focus on the right leading indicators, profitability becomes a byproduct rather than a constant struggle.

The Metrics That Move the Needle Fastest

Not all KPIs are created equal. Some metrics look impressive on paper but don’t materially change your life or your stress level. Others can transform a practice in months.

Schedule Utilization: The Silent Profit Killer

Empty chairs are more than just missed appointments—they’re a direct drain on profitability. The majority of your expenses don’t disappear when a unit sits idle. Payroll continues. Rent or mortgage payments continue. Utilities continue.

A well-designed schedule, consistently filled, is one of the fastest ways to increase profitability without adding hours or stress. At Fortune, we often look at schedule utilization around the 90% mark—measured looking backward, not projected forward—as a sign of a healthy system.

This is especially critical in hygiene. Margins are thinner than ever. One or two holes in a hygienist’s schedule can erase the profitability of that entire column for the day.

Doctor time is even more impactful. An idle hour doesn’t just lose production—it absorbs overhead before the next patient ever sits down.

Productivity Per Hour: Beyond “Staying Busy”

Once the schedule is solid, the next question is productivity. Are you making the most of each unit of time?

This isn’t about rushing or cutting corners. It’s about intentional design. Combining procedures when appropriate. Leveraging team members at the top of their licenses. Ensuring the doctor is focused on doctor-only tasks.

Dentists are often taught that busy hands equal productivity. In reality, productivity comes from systems that allow you to do your best work—consistently and efficiently—without burnout.

Cash Flow and Small Operational Gaps

Financial performance in dentistry is rarely fixed by one massive change. More often, it’s improved through small adjustments across many systems.

A breakdown in insurance processing. Delays in collections. Inefficient case presentation. Each gap might seem minor, but together they create significant drag.

Closing those gaps—often with 10% improvements—can dramatically increase profitability in a surprisingly short period of time.

The Real Constraint to Growth: You

As practices grow, most dentists encounter the same ceiling. It’s not demand. It’s not opportunity. It’s time.

There are only so many hours in a day, and your clinical capacity is finite. That’s why one of the most important skills a dentist can develop is learning how to scale themselves.

This doesn’t mean stepping away from dentistry if you love it. It means building systems and leadership structures that allow the practice to grow beyond your personal output.

Ownership creates leverage. But leverage only works when leadership, delegation, and accountability are intentionally developed.

Why Culture Is the Ultimate Business Strategy

Culture is often talked about in abstract terms, but in dentistry, it shows up in very real ways.

Patients don’t evaluate your clinical skill the way other dentists do. Unless something goes wrong, they judge their experience based on how they’re treated, how the office feels, and how connected they feel to your team.

From the first phone call to the moment they walk through the front door, patients are forming impressions. Is the environment calm or chaotic? Warm or rushed? Confident or frantic?

Team culture directly impacts these experiences—and it’s measurable.

High no-show rates often indicate weak patient relationships or unclear communication. Low case acceptance can point to a lack of trust or alignment within the team. Turnover reveals stress points long before they show up on a P&L.

At Fortune, culture isn’t a “soft” concept. It’s a set of observable behaviors and metrics that directly influence financial outcomes.

Strong culture doesn’t just improve morale—it improves profitability, patient loyalty, and long-term sustainability.

Thriving in Uncertain Times

Economic uncertainty is a constant. What changes is how leaders respond to it.

Dentistry, historically, has proven to be resilient—even during major downturns. During the last severe economic contraction, many practices didn’t just survive; they grew.

The difference wasn’t luck. It was leadership.

Doctors who understand their numbers, maintain strong culture, and adjust strategically don’t have to participate in economic slowdowns. While external factors may influence behavior, your internal response determines results.

Uncertainty doesn’t eliminate opportunity—it rewards preparation.

Strategic Planning That Starts with Life, Not Just Business

One of the most distinctive aspects of Fortune’s approach is where strategic planning begins.

Before discussing production goals or expansion, Dennis starts with a comprehensive life plan. Not just where you want to live or what kind of car you want to drive—but the experience you want to have.

What do you want for your family? Your health? Your time? Your impact on the world?

Only after those questions are answered does the business plan come into focus. Strategy exists to support life—not the other way around.

From there, Fortune works with doctors to create:

• A long-term strategic plan aligned with personal priorities
• An annual tactical plan broken down by months and weeks
• Clear accountability structures to ensure execution

When time, energy, and focus are allocated intentionally, the result isn’t just a better practice—it’s a more fulfilling life.

What’s Possible: Real Stories, Real Growth

Over the years, Dennis has worked with hundreds of practices across the country. Two stories illustrate what’s truly possible.

Both doctors started in similar places: two to three years into ownership, small facilities, and a desire to make a bigger impact. What they shared wasn’t size—it was clarity of purpose.

One began with three chairs—one of which was broken. Today, she operates a 32-operatory facility with an attached multi-specialty surgical suite and serves a patient base larger than many small towns.

The other built a highly impactful single practice, then replicated that model across multiple locations. Today, that organization includes 14 practices and more than 40 doctors.

Neither path was accidental. Both were built through consistent strategy, leadership development, and alignment with a clear “why.”

Redefining Success in Dentistry

Dentistry offers an extraordinary opportunity. Not just to provide care—but to lead, to grow, and to create impact far beyond the walls of your practice.

True success isn’t measured by how busy your hands are. It’s measured by the health of your systems, the strength of your culture, and the quality of life you’re building along the way.

With the right guidance, clarity, and accountability, an extraordinary practice—and an extraordinary life—aren’t just possible. They’re achievable.

And that’s exactly what Fortune exists to help you create.