Owning a practice gives you the kind of autonomy most professionals only aspire to.
You lead the team, shape the culture, set the direction, and make the big calls. But your freedom comes with a price. Every day, practice owners are asked to make decisions that affect people, profits, growth, and long-term stability.
And that can be exhausting.
In a recent Sunrise Dental Solutions Masterclass, Dr. Tony Feck and Dr. Matt VanderMolen shared an important concept. Good decision-making is not based on gut instinct alone. It comes from having a clear framework to guide each decision.
Their message was practical, honest, and directly applicable for practice owners who want to lead with greater clarity and confidence in a high-pressure environment. To explore how these strategies can support your practice, connect with Dr. Feck here!
Until then, let’s take a closer look at some of the key insights shared.
Why Decision-Making Feels So Heavy
For practice owners, decision fatigue is real.
You are not just deciding what to do next. You often weigh incomplete information, future consequences, time pressure, and the emotional impact on your team and yourself. All of that happens while you are also running a business and delivering patient care.
As Dr. Feck pointed out, stress is part of the deal. You do not eliminate stress from ownership. You learn to manage it better.
One of the best ways to do that is to create a system for making decisions. Much of the stress around leadership comes from uncertainty. When you have a plan for how to think, you reduce the anxiety of the unknown.
What Kind of Decision-Maker Are You?
Not every decision deserves the same amount of attention.
Dr. Feck breaks decisions into two categories:
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- One -way doors
- Two-way doors
Type 1 Decisions: One-Way Doors
These are major decisions that are difficult to reverse. Once made, they carry long-term consequences.
Examples might include:
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- hiring a key team member,
- adding an associate,
- opening a satellite location,
- moving the practice,
- or making major strategic changes.
These decisions deserve careful thought, research, and outside input.
Type 2 Decisions: Two-Way Doors
These are decisions you can reverse or adjust without major damage. These include many operational and day-to-day choices, such as:
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- changing a process,
- trying a marketing approach,
- choosing continuing education,
- or making decisions already guided by office policy.
The problem is that many owners treat every decision like a one-way door. That slows everything down and creates unnecessary stress.
Your purpose, vision, and values should guide many of the everyday decisions you face as a practice owner. In reality, many choices are clearer than they initially seem because the best routine decisions are not made impulsively in the moment. Instead, they are grounded in the deeper foundations you establish for your practice. When you are clear on why your practice exists, the future you are working toward, and the philosophy that shapes how you serve patients, those principles act as a compass. They help filter options, simplify decisions, and keep your actions aligned with the direction you want your practice to grow.
Your vision is where you want your practice and life to go. Your philosophy reflects your beliefs and values. And underneath both is purpose—your reason for doing what you do.
Dr. Feck framed it with one simple question:
Will this decision move me closer to where I want to go, or farther away?
That question alone can simplify a surprising number of decisions.
Purpose does not need to be narrow or overly complicated to be effective. In many cases, it can be as simple as committing to become the best version of yourself while helping others do the same. When purpose is defined in this way, it provides both clarity and resilience. It creates a steady foundation that makes difficult decisions easier to navigate and keeps leaders focused on growth, service, and long-term impact.
Good Policies and Good Data Make Better Leaders
Two things can dramatically reduce decision fatigue in a practice.
Clear policies create consistent standards for how routine situations are handled.
Reliable data provides objective information that guides decisions instead of relying on guesswork or emotion.
Together, they give practice owners a structured way to approach choices, making it easier to move forward with confidence and consistency.
Policy
When your policies are clear, decisions become straightforward. If a team member asks for time off, for example, the first question should not be, “How do I feel about this?” It should be, “What does our policy say?” Without clear policies, owners are forced into reactive decision-making.
Clear policies create fairness, consistency, and fewer emotional headaches.
Data
Reliable data reinforces a principle every practice owner should remember. You cannot manage what you do not measure. When your marketing is working, the numbers should clearly reflect it. When systems begin to break down, the data should reveal where the gaps exist. And when revenue, case acceptance, or scheduling needs improvement, the right metrics provide a clear guide for what needs to change.
The more your decisions are rooted in reality, the less likely they are to be driven by guesswork.
Make Sure You’re Solving the Real Problem
One of the most common leadership mistakes in a practice is believing you are solving the problem when you are actually addressing a symptom. When you move too quickly to fix what appears to be wrong, you risk investing time and energy in the wrong solution. A simple way to avoid this is to pause and ask deeper questions. The “Five Whys” technique helps you work backward from the visible issue until you uncover the true cause.
For example, you may notice that your practice is missing its production goals. At first glance, the explanation might seem straightforward.
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- Why? Because there are holes in the schedule.
- Why? Because there are not enough new patients.
- Why? Because marketing seems weak.
- Why? Because incoming calls are being missed.
- Why? Because the business office is understaffed.
By continuing to ask why, you move beyond the surface problem and identify what is really driving the issue. When you understand the root cause, you can take action that actually fixes the problem instead of simply managing its symptoms.
A Better Framework for Big Decisions
For larger, high-stakes decisions, it helps to follow a structured process that allows practice owners to evaluate options carefully and move forward with confidence.
1. Define the Objective
Start by getting specific. What exactly are you trying to accomplish?
A vague goal leads to vague action. A strong objective should be clear, measurable, realistic, relevant, and tied to a timeline.
For example:
Increase practice revenue by 10% over the next three months. That is a decision-making target you can actually work with.
2. Gather the Right Information
Big decisions require evidence.
This might include production numbers, case acceptance rates, budget projections, new patient metrics, team performance data, or profitability analysis. The point is simple, decisions improve when your inputs improve.
3. Consider More Than One Option
A common mistake among leaders is becoming emotionally attached to one idea too early.
When that happens, tunnel vision takes over.
Instead, step back and generate alternatives. If your goal is growth, there may be several ways to get there: better case acceptance, stronger internal marketing, improved financial arrangements, team changes, or a shift in services.
The first answer is not always the best answer.
4. Think Beyond the Short Term
Some decisions solve a short-term problem while quietly creating a long-term one.
For example, adding more PPO participation may bring in patients quickly. But if reimbursement stays flat while costs rise, that short-term gain may become a long-term profitability problem.
This is where strategy matters more than tactics. A quick win is not always a smart win.
Dr. VanderMolen made an important point: real growth often comes from improving several areas together, not relying on one single fix.
5. Reduce Emotion and Bias
Emotion will always play a role in decision-making, but should not drive the process unchecked. That is why an outside perspective is so valuable. A coach, mentor, trusted colleague, or leadership team member can often see what you may be too close to recognize clearly. More importantly, they can challenge your assumptions and help you think through the full implications of a decision.
When seeking advice, the goal should not be to have others simply affirm your thinking. Instead, invite honest input. Ask someone to play the role of devil’s advocate. Ask what you might be overlooking and where the potential risks lie. At the same time, strong leaders know how to create space for others to contribute openly. If you are asking your team for input, it helps to be the last one to speak. Sharing your opinion too early can unintentionally shape the conversation and limit the perspectives that might otherwise emerge.
6. Make the Decision
At some point, thinking has to turn into action.
This is where many leaders get stuck. They search for complete certainty, hoping that eventually the “perfect” answer will appear.
It won’t.
Absolute certainty rarely arrives when making important decisions. If you wait until you feel 100% sure, you risk delaying progress and losing valuable momentum. In many cases, having about 80% confidence is enough to move forward. What matters most is taking thoughtful action and continuing to adjust as you learn.
A quote from Theodore Roosevelt:
“In a moment of decision, the best thing you can do is the right thing. The next best thing is the wrong thing. The worst thing of all is to do nothing.”
The lesson is simple. Progress requires movement. In business, hesitation and indecision can be as damaging as making the wrong choice. Leaders who move forward thoughtfully create opportunities to learn, adapt, and improve over time.
7. Review the Outcome and Learn
Once the decision is made, the process is not over.
Look back. Evaluate the results. What worked? What did not? What should be repeated, refined, or avoided next time?
Even bad decisions can become valuable if they teach you something useful. In fact, much of leadership wisdom comes from decisions that did not go perfectly.
Progress is built through action, reflection, and adjustment.
Progress Beats Perfection
It is easier to steer when you are already moving.
When you stand still, you cannot adjust much of anything. When you are in motion, even if you are slightly off course, you can correct.
That is an important reminder for any practice owner stuck in overthinking.
You do not need to make every decision perfectly. You need to make thoughtful decisions, evaluate them honestly, and keep moving forward.
The goal is not perfection.
The goal is to make better decisions with more clarity, less hesitation, and greater confidence, so your practice can keep growing in the right direction.