We spoke with Paul Graham, Managing Director – Medical at Christie & Co, and Chris Barrow, Director of Business Education at The Campbell Academy, about the role of leadership, education and operational management in the dental sector. As the coaching and business development programme, Extreme Business, becomes part of the training centre, The Campbell Academy, the pair discuss the challenges facing practice owners, evolving approaches to team development, and the skills required to lead and manage dental practices in a changing market.
Running a dental practice today requires much more than clinical expertise. How have the demands on practice owners evolved in recent years?
Chris: The modern dental practice owner must wear far more hats than was previously the case. Clinical excellence remains the entry ticket, but today an owner also needs to understand leadership, finance, marketing, patient experience, technology, recruitment, communication and performance management. Alongside this, dentistry itself is changing rapidly. We now have intra-oral scanning, digital treatment coordination, AI, more sophisticated patient communication and increasingly complex marketing channels. None of those things creates a successful business on their own. They must be joined together by good management.
For me, the biggest change is that owners can no longer afford to be the heroic individual at the centre of everything. The successful practice of the future is a Senior Leadership Team-managed business, with clear systems, good people, meaningful KPIs and a regular rhythm of meetings, training and accountability. The owner’s job increasingly becomes one of leadership – setting the direction, creating the culture and making sure that the right people have the tools and confidence to deliver.
Paul: From what I am seeing across the market, owners are juggling more than ever before. Alongside delivering excellent patient care, they’re having to tackle recruitment challenges, rising costs, increasing regulation and decisions around technology investment.
They’re also responding to changing patient expectations, with greater demand for convenience, accessibility and a seamless patient journey.
What strikes me is how much broader the role of a practice owner has become. They’re not only clinicians, but also business leaders, responsible for building strong teams, driving growth and ensuring their practice remains competitive in an increasingly complex environment.
Technology is playing a bigger role than ever, but knowing where to invest and how to generate real value from those investments is becoming just as important as the technology itself. This is reflected in our Dental Market Review 2026, which found that technology and practice improvement remain key priorities for operators, with 61% of the more than 27,000 dental professionals surveyed planning to invest in new equipment and technology over the next 12 to 24 months.
Many owners find themselves heavily involved in the day-to-day running of their business. Why is reducing owner dependency such an important goal?
Paul: Many owners naturally become the go-to person for everything, especially if they’ve built the practice themselves. The challenge with this is that when too much relies on one individual, it can make it harder to grow the business and can create pressure on the owner themselves.
From my view, the most successful practices are the ones where the owner has built a strong team around them and empowered others to take responsibility. That creates a more resilient business, improves consistency and allows the owner to focus on the bigger picture rather than the day-to-day firefighting.
It also makes the practice more attractive from a buyer or investor perspective. A business that can operate successfully without depending on one person is generally seen as lower risk and better positioned for long-term growth.
To what extent does investing in people and professional development contribute to long-term business growth?
Chris: Enormously, but with one important factor – education must change behaviour. Sending somebody on a course is not, by itself, an investment. The investment produces a return when somebody comes back to the practice, does something differently and that new behaviour becomes part of the way the business operates.
The best practices create a culture of continuous development rather than occasional training. That means regular clinical and non-clinical education, quarterly progress interviews, peer review, coaching and clear performance expectations.
It also creates opportunity. Good people are far more likely to stay when they can see a future for themselves and opportunities to grow. Ultimately, sustainable growth is delivered by people. Buildings, scanners and software are important, but it is well-trained, engaged people who turn those assets into better patient experiences, stronger performance and a business that is less dependent on its owner.
You often talk about building a ‘golden goose’ rather than simply building a business to sell. What does that look like in practice, and why is it such an important goal for owners?
Chris: I’ve never believed that the sole purpose of building a dental business should be to sell it. I would rather help an owner create what I call a golden goose: a business that produces reliable profits, creates opportunities for the team, delivers an excellent patient experience and gives the owner choices.
Those choices might eventually include a sale, but they might equally include reducing clinical days, bringing in a partner, developing another location or simply enjoying the income and lifestyle the business provides. A golden goose does not depend upon the principal being in surgery five days a week. It has good associates, therapists and hygienists, capable management, documented systems, sensible financial controls and a dependable flow of patients.
Most importantly, it can operate successfully when the owner is not in the building. Ironically, many of the things that make a practice enjoyable to own also make it more attractive when the time eventually comes to sell. So, my advice is: build a great business first. Optionality follows.
Practice owners are constantly exposed to new ideas, advice and best practices. What separates those who successfully implement change from those who struggle?
Chris: The problem for most practice owners is not a shortage of ideas. It is an excess of them.
We live in a world of podcasts, conferences, WhatsApp groups, social media and endless advice. The temptation is to come back every Monday morning with another bright idea for the team. Successful owners do something different. They decide what matters, translate it into a small number of actions and then build accountability around those actions.
That means somebody owns the task, there is a deadline, there is a number to measure where appropriate, and there is a meeting at which progress will be reviewed. In Extreme Business, we place enormous emphasis on rhythm: daily huddles, weekly performance tracking, monthly management meetings, quarterly reviews and training, and annual planning.
Implementation is rarely glamorous. It is repetition, measurement and follow-through.
Education gives you the knowledge. Coaching and management help turn that knowledge into action. The practices that make progress are not necessarily those with the most ideas. They are the ones that get the important things done consistently.
What are buyers typically looking for beyond strong financial performance when assessing a practice?
Paul: Beyond financial performance, buyers are increasingly looking at the overall quality and sustainability of a practice. Factors such as a stable clinical team, a loyal patient base, modern systems, strong management and the effective use of technology can all influence a practice’s attractiveness.
Buyers are also paying close attention to how well a practice is positioned for the future. They want to see evidence of good governance, efficient processes, strong staff retention and opportunities for continued growth. A practice that can demonstrate consistent performance, while adapting to changing market conditions and patient expectations, is often viewed more favourably.
I would also say owner dependency is another key consideration. Buyers want confidence that the business can continue to perform successfully after a transaction, rather than relying heavily on one individual. Practices with good teams, clear systems and strong day-to-day management are typically seen as lower risk and better equipped for long-term success.
How are current market conditions influencing the decisions of dental practice owners, whether they are looking to grow, bring in partners or plan for an eventual sale?
Paul: Current market conditions are making a lot of owners take a step back and consider what they want from the next stage of their business. Some are looking to grow, others are considering bringing in partners or investors, while many are starting to think about succession and eventual exit planning.
The good news is that demand for quality practices remains high. As a result, many owners are focusing on making their businesses as attractive and resilient as possible by investing in their teams, improving systems and processes, and creating a practice that can thrive independently of them. Whatever the end goals, it’s about building a stronger business for the future.
If you could give practice owners one piece of advice about investing in their business, their people and their future success, what would it be?
Chris: Invest in the operating system of the business, not simply the visible assets. A new surgery, scanner or refurbishment can be valuable, but sustainable success comes from having the right people, properly trained, working within clear systems and understanding what good performance looks like. Create time for management and measure the numbers that matter. Train your clinical and non-clinical teams. Develop future leaders. Document the patient journey. Make sure the business can function without everything having to pass across the owner’s desk.
And think longer term. The objective should not simply be to increase turnover next year. It should be to create a profitable, resilient and enjoyable business that delivers a great experience for patients, creates worthwhile careers for the team and gives the owner freedom and choice. Do that consistently and you create something that is valuable whether you intend to own it for another twenty years or sell it in five.
Paul: My advice would always be to invest in people first. Technology, equipment and facilities are important, but they don’t differentiate a practice on their own. What patients remember is how they’re treated, the consistency of care they receive and the trust that’s built by the team around them.
The best practices I’ve seen have strong cultures, engaged teams and leaders who invest in their people. Those businesses typically achieve better patient satisfaction, stronger retention, better clinical outcomes and more sustainable growth. They’re also more resilient and less reliant on any one individual.
One of the best businesses I ever sold wasn’t the biggest group or the most profitable on paper. It was a relatively small portfolio of practices where the owners had built an exceptional culture. The team was stable, engaged and aligned behind a common purpose. Patients felt it, staff felt it and buyers recognised it immediately. The fundamentals were outstanding and the business was valued accordingly.
By contrast, I often see larger groups with more surgeries, greater scale and significant upside potential, yet they don’t attract the same level of buyer interest or value. Why? Because the fundamentals aren’t as strong. Culture is inconsistent, staff turnover is higher and the patient experience isn’t as compelling. Buyers ultimately pay for what exists today, not what might exist tomorrow.
The most successful practices I see are those where owners are building a business that can thrive without relying on them for everything. By developing your people, strengthening your systems and creating a clear vision for the future, you’re not only building a better practice today but also creating more options for growth, investment or an eventual exit down the line.
To discuss your dental business in more detail, get in touch with Paul Graham: paul.graham@christie.com or 07739 876 621