Looking back, Dr. Julie Forstadt can now see clearly how toxic things were. But at the time, she thought buying the practice in Sonoma, California, from her longtime business partner would be easy breezy.

After all, she’d been working there for 34 years and had been a partner for 32 years. After two years as an associate, Dr. Forstadt bought into the practice but built her own clientele. The business partners shared supplies and staff, with the exception of each partner having their own hygienist and assistant, which meant the staff knew her well. Most had worked there between 15 and 40 years.

“I thought it would be comfortable for everyone because of the continuity,” Dr. Forstadt said. “Although we didn’t share patients, we were on call for each other, so her patients knew who I was, and the staff had worked with me for decades.”  

Dr. Forstadt was looking forward to modernizing the practice and running things in her own way. She officially became sole owner in February of 2023 and April 1, 2023 was her first day without her partner’s presence. “The practice looked like and ran like a dental practice from the 1960s because my partner ran the practice like her dad did,” she said.

But within four months, three staff members, two front desk, and an assistant decided they would retire too. And when Dr. Forstadt tried making additional changes, she was met with so much resistance that three more staff, all hygienists, quit. Dr. Forstadt had only 2 assistants and one hygienist stay after the exodus and was left working as a dentist and hygienist while trying to replace much of the team.

Prior to taking over the practice, at the urging of a longtime friend from dental school, Dr. Forstadt somewhat apprehensively attended The Team Training Institute’s retreat in Las Vegas. In the past, she hired four different consultants who presented an agenda but, in the end, it felt like “a waste of a whole bunch of money.” However, after attending the event, she joined The Team Training Institute (TTI) and began working with them in April 2023 to help her transition and make changes.  

“I wasn’t sure it was going to work because of my past history with consultants,” Dr. Forstadt said. “But my girlfriend, who worked with TTI for years, convinced me to try. She told me, ‘It’s the best thing ever, and when you buy out the practice, you really need to have them help you.’ I responded, ‘I don’t think I really need them. Things are great. Everybody is going to stay.’ But I went as a guest to The Team Training Institute retreat in January 2023 anyway. I went with an open but cautious mind. I thought, ‘I’m not going to start drinking the Kool-Aid right away’. As I observed the environment and listened to what was being said, it resonated with me. I was impressed. Dr. Meis is genuine. He doesn’t have that façade to him that some people do. I could tell TTI knew what they were talking about and felt extremely comfortable listening to what Dr. Meis had to say.”

With The Team Training Institute’s assistance, Dr. Forstadt successfully transitioned to a more efficient practice, and just one year later (May 2024), she reports that historically, in the 35 years she’s been practicing, 2023 was her most profitable year ever. Plus, for 2024, she’s on track to triple what she did in 2022. “Last year, I doubled my profit from 2022, and this year (2024), I’ve almost produced what I did in 2023 in total, and it’s only May,” she said.

Dr. Forstadt hired new staff, trained them according to her standards, and created a positive work environment with team members who were enthusiastic about what she was doing. She’s operating above capacity and has taken the level of care for patients up a notch. “It’s incredibly amazing that we’ve improved that much, and it validates my decision to stay,” Dr. Forstadt said. “What’s interesting is my girlfriends have all retired from dentistry, and I’m feeling like, WOW, I’m finally able to do what I want to do. I’m making a difference in how we’re taking care of patients and making a difference in how I can pay the staff what they are worth. I’m making a difference in what I take home. There’s a comfort level in that because I know in my heart I can do what I want to do and take care of patients the way I want to without having negativity in the background." 

Here’s how Dr. Forstadt overcame the challenges of her transition and the emotional and operational difficulties that occurred to create her ideal dental office.

Don’t Let Resistance from Staff Stop You From Optimizing Your Practice

In the spring of 2023, Dr. Forstadt brought The Team Training Institute in for Hygiene Explosion training to start implementing changes in the office. “I wasn’t sure how my staff would respond to this training, but I knew I had to do something because our office wasn’t running efficiently,” she said. “I knew I needed to make changes and didn’t know exactly what those changes needed to be.”

After the day of training was over, Dr. Forstadt and her coach Theresa knew there was going to be trouble. “Coach Theresa said to me, ‘In all my years of coaching, I have never been met with that much resistance from staff,’” she recalled. After that, three hygienists quit.

“I had a meltdown,” Dr. Forstadt said. “I thought I should put TTI on hold until I had some staff because, between the front desk people, assistants, and hygienists that all left, I had no staff to train. However, my TTI coaches explained that this was the most critical time for support and guidance. They explained that by hiring the right people, I could set the culture in my office the way I wanted, so I decided to stick it out.”

Her TTI coaches also arranged an emergency meeting with Dr. John Meis. “I knew TTI was for me when Kellie arranged that emergency call with Dr. Meis after I said I needed to put TTI on hold,” Dr. Forstadt said. “The conversation wasn’t just about keeping me as a client; it was genuine concern about helping me. I felt so much better after talking to him. I am forever grateful for that phone call.”

What Dr. Forstadt hadn’t been able to see clearly before is that there had been a lot of undermining going on in the practice for years, which created a toxic environment. For example, her ideas were never implemented before because her business partner nixed them. This meant Dr. Forstadt didn’t have real authority to make changes

“In hindsight, when you’re living in an environment, you can’t always see how toxic it is until you’re out of it,” Dr. Forstadt said. “Now, the atmosphere is so much better. I’m happy to say I have the best group of people now, and they love being here. It’s wonderful!”

Build a Team of People That are Open to Improvements

It’s helpful to be aware that you may be met with some resistance when making improvements to your practice. “If I had known ahead of time that some staff could possibly leave, I might have been more prepared,” Dr. Forstadt said. “I could see that happening with a brand-new person taking over a practice, but I wasn’t brand new, so I thought it would be smooth sailing. It wasn’t.”

Although it seemed counterintuitive, Dr. Forstadt followed the advice of her TTI coaches and started interviewing candidates with less dental experience. She ended up hiring more inexperienced staff than experienced. One hygienist was a new graduate who was Dr. Forstadt’s dental patient since she was a little girl. Her new front desk team member had known her since she was born as her mom has been a patient. One new assistant was a veterinary tech and now has her X-ray and coronal polish license. Another hygienist from Sonoma answered her ad the very day it posted because she knew of Dr. Forstadt. Another had worked with her previously.

“My TTI coaches told me I didn’t need to hire people who already had extensive dental experience, and I listened to them,” she said. “It’s wonderful starting from square one because they are skilled while also open to new ideas. Others with more experience can have their own way of doing things, causing them to resist change. With these less experienced candidates, you get to teach them exactly how you want them to do things and help them understand your thought processes. It has worked out extremely well.”

Previously, Dr. Forstadt battled with her hygienists, who refused to do the procedures she asked them to do. “Before I had given up on getting them to do scaling and root planing,” Dr. Forstadt said. “My hygienists told me, ‘If we refer them out to a periodontist, they’ll take it more seriously.’ But after TTI’s Perio Explosion training, all three of my current hygienists will do S&RP. One of them even schedules time for it on her day off because she loves it so much and finds it very satisfying.”

She has one new front desk team member with considerable experience. “She has some 40 years of experience in the dental field with front of the office and back of the office experience. She can even do both at the same time. We have learned so much from her and she has completely turned around our collections. Dr. Meis says it brings a tear of joy to his eye when he looks at her numbers,” Dr. Forstadt said. She is proud to have such a positive office atmosphere and a team she can trust to do a great job.

Find A Way To Lead That Helps You Enjoy Your Practice

Dr. Forstadt is learning to delegate and lead meetings in a way that is comfortable for her. She is working on building a management team to assist her so she can focus on what she loves doing most. When she got a new payroll system, she had her primary assistant, Deanna, sit with her so that she could learn it to take over. While she’s never had an office manager, she feels Deanna is already doing that job. “Deanna has worked with me for over 35 years,” Dr. Forstadt said. “She is the office manager, even though she doesn’t want the title. Whenever something happens, she’s the one that fixes it. Everyone goes to her. I’m not one to micromanage, so it’s great to have people who will take ownership of certain tasks. I also appreciate having TTI crunch all the numbers for me. I now get to spend my time taking care of people while letting others take care of the things I don’t enjoy.”

She emphasizes the importance of mental and physical health in managing a dental practice. Also, she highlights the unique challenges women face in dentistry and the value of support networks like TTI.

“Dentistry is a very rewarding career, but it is also very stressful,” Dr. Forstadt said. “My husband traveled a lot, and we had two children. I am the wife, the mom, the dentist. When I came home from work, I had two kids to take care of and at the office, my spouse wasn’t available to help me run the office. I realize now how important it is to be psychologically stable so the bumps in the road can be handled gracefully. If we don’t have our mental and physical health, we won’t be successful no matter how many systems are in place. Having someone hold my hand through this process has been invaluable. I really feel like TTI has my back.”

Coaching and resources from TTI not only help her lead better, but they are also available for her team so they can learn to be effective leaders.

“I’m not a natural-born leader,” Dr. Forstadt said. “It’s been extremely helpful working with my TTI coaches and listening to leadership resources they have online. TTI gives me a level of credibility and helps with my authority when presenting my ideas. I genuinely love my staff and want to take care of them. There’s now an openness, whereas before, there was this underlying bad feeling. Before, people were pleasant with each other, but my stomach was always in a knot when I was at work because I could feel the underlying tension and I couldn’t do anything about it. Now, if I think something is wrong, I confront it and do something about it.”

Put Systems In Place

When Dr. Forstadt’s front desk people left, they didn’t show anyone how to do the jobs they’d been doing, despite Dr. Forstadt’s requests. Creating systems is making it easier to ensure the office is never left scrambling should someone quit or even be out sick or on vacation. “We’ve put so many systems in place,”Dr. Forstadt said. “Some systems we have now were put in place in order to survive this past year.”

Connect With Other TTI Members As a Resource

Experiencing a capacity block, Dr. Forstadt has been examining her options. Her former business partner owns the building, and while she initially agreed to sell the building to Dr. Forstadt, at this time, that looks unlikely. Dr. Forstadt created some relief by changing the schedule and staggering the hours when she and her associate work so that their schedules don’t overlap as often. This gives her more rooms to work out of on two of the three days she works.

Not especially excited about the prospect of moving to a new location, she consulted with other TTI members who’ve found themselves in similar situations. “Another dentist who doesn’t own their building, stayed and remodeled it,” Dr. Forstadt said. “We could add another operatory if we remodeled, so that might be what I do. My goal is to be productive in a small place.”

“Last year was really bad, but it was also really good,” Dr. Forstadt said. “We crashed and burned and started over. It was bad to the middle of the year and then got better, and better, and better. And this year is even better. I’ve had some family things that have been pressing on my heart and emotions this year. Dealing with personal grief along with running my office, which is a lot of time, commitment, and mental energy, could be rough, but knowing that my practice is safe and my staff are happy allows me to be with my family when I’m needed. That’s been a huge relief this year. If I’d been dealing with what happened this year with my family alongside what happened last year in my practice, it would have been way too much to handle. The Team Training Institute helped me breathe new life into the practice. Patients ask me if I’m going to retire, and I tell them no. While I wish all this would have happened ten years ago, now that we’ve done all this incredible work, I don’t want to leave. I want to see it through. I’m having fun. My greatest joy is not what is in the bank account, but the joy in the patient’s face and a hug at the end of an appointment, and now I get to enjoy that.”