What happens if the office manager goes on vacation, the hygienist calls in sick, or the dental assistant runs off with prince charming? Missing a team member for even one day can lead to chaos in a dental office. Team members feel overwhelmed, which could ultimately lead to a decline in the quality of patient care. It doesn’t have to be this way.

The Office Manager

I had a wonderful office manager early in my career who worked with me, or more accurately, put up with me, for nearly fifteen years. I hired her within a year of graduating from dental school.

I’ll never forget the first time Debbie went on vacation for a week. Her strict orders were to let everything pile up on her desk and she’ll take care of it when she gets back. Sound familiar?

Imagine the stack of patient charts EOBs piling up. We were not entirely paperless back then, which meant even more busy work every day. When she returned on Monday, I remember her words as she saw the stacks on her desk, “holy shit show.” We all just laughed, and let her get to work.

Fear of Delegation

I couldn’t understand why Debbie wouldn’t let us help her out. I know some of you are thinking that she might have been embezzling money. However, we had checks and balances established to make sure this didn’t happen. 

The real reason, Debbie wanted things done right. She excelled in accuracy, and no one could do it better. She had a business degree, which was, and still is, a rare find among dental office managers. Ultimately, she was the best at the job. 

Debbie’s Next Vacation

With another vacation coming up, I asked her if we could lighten her load.  She told me it would be pointless because she would have to double-check our work anyway.

One of my dental assistants, Darci, worked as my office manager before I found Debbie. Darci went back to assisting once Debbie took over the front. Since Darci knew how to run the front office, we devised a plan. Darci did Debbie’s job for the week, and we made do with the other two assistants in the back. When Debbie came back from vacation, there were no stacks, no stress, and no grief upon return. The delegation of duties had taken place, and all could more quickly return to normal, or so we thought. 

Delegation is Painful

When Debbie came back, she was not happy. Someone had encroached upon her turf. She stated, “I wonder how many mistakes I’m going to have to figure out. I could be here all night.” And she was off reviewing charts, Insurance claims, and payments from the previous week. All of us were sweating bullets, especially Darci. We knew the wrath of the office manager would descend upon all of us if she found any mistakes. 

Debbie requested a meeting before we all went home. In between patients she diligently checked our work and the meeting could only mean we were all in trouble. After the last patient left, we entered Debbie’s lair with our tails between our legs. To our surprise, she thanked us, especially Darci. This was the first time in her dental career that she didn’t return to a “shit load” of work. 

She admitted that delegation and cross-training might be valuable to implement in our office. Here was Debbie’s biggest reveal: “The next time I go on vacation, I will be able to enjoy it!”

Lessons Learned

After this experience, I made sure to cross-train my dental team. This contradicted the teachings and training from all the dental consulting courses I attended. The large majority of dental consultants, to this day, teach what I call “dental silos of responsibility.”

These silos are illustrated in grandiose job titles like “insurance specialist,” “financial specialist,” “scheduling coordinator,” and so forth. While each team member can have an area of focus, they should be able to support each other within their level of training, and of course, licensed capabilities.

For larger businesses, it makes sense to specialize. However, dental teams are smaller and thrive when they’re crossed trained. There’s no reason your hygienist can’t submit insurance claims or answer ledger questions. Dental assistants should be able to enter payments from EOBs, and assist the hygienists at will. Office Managers can clean operatories and explain treatments to the patient. The doc can also vacuum floors and clean operatories.  

Here are some ideas for areas to consider cross-training

  • submitting insurance claims
  • presenting treatment
  • understanding ledgers
  • turning over operatories, sterilizing instruments
  • taking impressions
  • entering payments from EOBs


Here are some of the benefits of a cross-trained office:

  1. Reduce the probability of fraud
  2. Allow for sick days and vacation time
  3. Improve team unity
  4. Greater overall job satisfaction 

To the patient, we are all one team. Work as a team for the star of the show, which is the dental practice collectively.

The benefits of cross-training far outweigh the “specialized” roles of the typical dental office. Be leaders, not followers of the status-quo, and cross-train your team if you haven’t already.

Schedule a Free Consultation