The PM + Principal Dentist Relationship: Sometimes They Need You Too

Being a Practice Manager is no walk in the park.

And honestly, some of us love it.

The chaos. The organisation. The problem-solving. The team. The feeling that you know your little practice inside and out and that you’re helping create a place where people actually enjoy coming to work and people are given the perfect patient experience.

There is something incredibly rewarding about leading a dental practice.

But sometimes, being a Practice Manager can also feel like a lonely journey.

You’re often the person everyone comes to. The team needs an answer. A clinician has a problem. Something needs organising. Someone needs support. There’s an issue with a patient, a staff member, a supplier, a piece of equipment or the diary.

You’re constantly looking after everyone else.

And then there’s your Principal Dentist.

Your Principal Dentist Is Part of Your Team Too

I was very lucky throughout my years working as a Practice Manager. I had some really great working relationships with my Principal Dentists, and I genuinely loved working alongside them. And, to be honest, looking back, I really do miss working alongside them today. (You know who you are. 💚)

But I also know that not every Practice Manager has that experience.

Sometimes the relationship between the PM and Principal can feel very transactional. There are lists to get through, numbers to discuss, problems to solve and decisions to make.

But your Principal Dentist isn't just the person who owns or leads the practice.

They're part of your team.

And one thing I learned that made a huge difference to our working relationship was incredibly simple.

Once a week, we left the practice for lunch.

Same day. Same time. Every week.

If you need to, book it into the diary like you would any other important appointment.

And here's the important part:

No agenda.

Leave the Practice Behind for an Hour

Don't take a list of problems with you.

Don't spend the entire lunch talking about production.

Don't turn it into another management meeting.

Just leave the practice.

Sit down. Have lunch. Have a coffee. Let them breathe for an hour.

Sometimes you might talk about something serious. Sometimes you'll bounce an idea around. Sometimes you'll talk about the business. Sometimes you'll talk about absolutely nothing important at all.

And sometimes, you simply listen.

You might ask:

“How are you?”

Not:

“Do you want to talk about the numbers?”

“Have you got those dates for the diary?”

Just:

“How are you?”

Because your Principal Dentist may need someone to ask that question too.

Don't Forget How Much They Are Carrying

As Practice Managers, we know how stressful our role can be.

But it's worth remembering what can be sitting on the shoulders of a practice owner or Principal Dentist as well.

They may be treating patients all day while simultaneously thinking about the business.

Staff.

Bills.

Equipment.

Suppliers.

Production.

Patient care.

The future of the practice.

And, depending on their circumstances, the financial responsibility that comes with owning a business and supporting a family.

For many Principal Dentists, their practice is something they've spent years building. It's their livelihood, their investment and something they genuinely care deeply about.

The stakes can feel incredibly high.

That doesn't excuse poor behaviour or taking stress out on the team. It doesn't mean a Practice Manager should tolerate unhealthy workplace behaviour.

But understanding where some of that pressure can come from can help you approach the situation differently.

Sometimes a Principal who seems overwhelmed, short-tempered or distracted may simply be carrying more than you realise.

And as a Practice Manager, you have an opportunity to notice it.

You Can Sometimes Prevent the Fire

We've all been in those practices where you could almost cut the tension with a knife.

Everyone feels it.

The team feels it.

The clinicians feel it.

And eventually, the patients can feel it too.

That uneasy feeling in a practice doesn't stay contained to the people who are having a difficult day. This is where your relationship with your Principal Dentist can become incredibly valuable.

If you have built trust and open communication, you can sometimes step in before a small problem becomes a much bigger one.

You can say:

“Are you okay?”

You can listen.

You can offer another point of view.

You can talk through an idea.

You can help them take a step back.

You can remind them that they're not carrying the whole thing alone.

And sometimes that's all they need.

You're a Team

Your Principal Dentist doesn't have to be your best friend.

You don't have to agree on everything.

There will be difficult conversations. There will be different opinions. There will be days when you both wonder how the practice managed to find five problems before 9am.

That's practice management. 😅

But you do need to be able to work together.

Your team needs to see that the PM and Principal are working towards the same goal.

That doesn't mean pretending you agree when you don't.

It means having the conversations privately, listening to each other, finding a way forward and presenting a consistent direction to the team.

Because when the leadership team is unsettled, the rest of the practice often feels it.

When the leadership team is calm, communicating and working together, the team has something to lean on.

So, Book the Lunch

This doesn't have to be complicated.

Pick a day.

Pick a time.

Put it in the diary.

Leave the practice.

Have a coffee.

Have lunch.

Ask:

“How are you?”

Then actually listen to the answer.

You might be surprised by how much it helps.

It can give your Principal Dentist a chance to breathe, talk, think and feel supported.

It can give you an opportunity to understand what's happening from their perspective, share your own thoughts and strengthen the relationship you rely on every day.

And perhaps most importantly, it reminds both of you that you're not working against each other.

You're working together.

Your team needs good leadership.

Your Principal Dentist needs someone in their corner.

And sometimes, the person who spends all day looking after everyone else needs someone looking out for them too.

That can be you. 💚

A Little Flosswell Reminder

Good practice management isn't only about systems, checklists and getting things done.

It's also about people.

Your team.

Your clinicians.

Your patients.

And the people you lead alongside.

Sometimes the best thing you can do for your practice is simply sit down with your Principal Dentist, have a coffee and ask:

“Are you okay?”

It might be one of the most valuable meetings you have all week.