How to Know When It’s Time to Hire Your First Practice Manager

Running a dental practice is equal parts clinical care, business management, and leadership. For many new practice owners, the early days are filled with the excitement of building something from the ground up. You’re wearing multiple hats, juggling patient care with HR tasks, marketing, scheduling, billing, and supply orders. But as your practice grows, there comes a pivotal moment when continuing to manage it all on your own is no longer sustainable.

That’s when you might start asking the question: Is it time to hire a practice manager?

In this post, we’re going to walk through the key indicators that signal it’s time to bring in a practice manager, the benefits of making the hire, what qualities to look for, and how this one decision can unlock your next level of growth and peace of mind.

Why This Decision Matters

Hiring your first practice manager is a major step. It marks a shift from being a solo leader to building out a true leadership team. Done right, it will free up your time, improve the patient experience, and allow your practice to run more smoothly even when you’re not physically present.

But many dentists wait too long to make the leap. They stay in a reactive mode, stuck in the weeds of the day-to-day, until burnout forces a change.

By recognizing the signs early and being proactive about this hire, you can prevent costly missteps, boost team morale, and set your practice up for long-term success.

1. You’re Working More “In” the Business Than “On” It

If your days are packed from open to close with patient care, followed by evenings of catching up on insurance claims, emails, staff issues, or schedule planning, that’s a red flag. While it’s normal to wear multiple hats in the beginning, it’s not sustainable in the long term.

Your role as CEO of the practice should involve strategic planning, vision casting, and leading your team. When you’re bogged down by administrative tasks, there’s no time left for growth-oriented thinking.

Common signs include:

Spending nights and weekends on paperwork
Putting off projects like marketing, new equipment purchases, or expansion planning
Feeling like you’re constantly playing catch-up

Hiring a practice manager allows you to reclaim your time and refocus on what only you can do: deliver excellent clinical care and guide the direction of the business.

2. Your Team Keeps Coming to You for Every Little Thing

In a small team, it makes sense for you to be involved in daily decisions. But if your staff can’t function without your input on every detail, something’s off.

From vacation approvals and supply orders to conflict resolution and front desk scripts, these are tasks that a practice manager should own. If you’re the bottleneck for every operational decision, you’re setting your practice up for inefficiency and dependency.

Ask yourself:

Am I answering the same questions over and over?
Are staff members unsure who to go to with issues?
Is my physical presence required for the office to run smoothly?

A competent practice manager becomes the go-to for team support and systems, reducing your decision fatigue and creating more consistency in how your practice operates.

3. You’re Struggling with Staff Turnover or Low Morale

People problems are one of the biggest sources of stress for dentists. If you’re experiencing high turnover, tension among team members, or a general dip in morale, it may be time to bring in a strong leader to manage the culture and systems.

Practice managers play a vital role in hiring, training, and retaining great people. They help establish expectations, coach performance, and build trust among staff.

Warning signs include:

Repeated staff complaints
Cliques or gossip that you can’t seem to resolve
New hires quitting after just a few weeks

Sometimes, the root of the problem is simply that your team doesn’t have clear leadership or accountability. A practice manager can be the steady presence your team needs.

4. Systems Are Slipping

In the chaos of a growing practice, systems often fall apart. Billing errors increase. Scheduling becomes inefficient. Supplies run low. You might even notice a dip in the patient experience.

These are symptoms of a business outgrowing its existing structure. What worked when you had three team members and ten patients a day won’t cut it at twenty employees and a packed schedule.

Look for these signs:

Inconsistent check-in and check-out procedures
Missed insurance follow-ups or delayed billing
Confused or overlapping staff roles

A skilled practice manager will help you build, document, and refine systems that can scale. They can train your team to follow these processes consistently, which leads to better outcomes across the board.

5. You’re Ready to Grow but Don’t Have the Bandwidth

Maybe you’ve hit a plateau. You want to open a second location, add an associate, or invest in a new service offering, but the thought of taking on even more responsibility is overwhelming.

That’s exactly when a practice manager becomes essential.

They help shoulder the weight of current operations so you can focus on expansion. They can also assist in project management, vendor communication, and onboarding new staff during a growth phase.

Without a trusted manager, growth becomes a risk instead of an opportunity. With one, it becomes manageable.

What a Practice Manager Actually Does

If you’ve never worked with a practice manager before, it can be hard to know what their role includes. At its core, a practice manager is the operational backbone of your business. They are your partner in running the day-to-day.

Common responsibilities include:

Overseeing scheduling and front desk operations
Managing staff performance and morale
Handling HR tasks like hiring, training, and evaluations
Monitoring office finances and collections
Managing vendor relationships and supply ordering
Resolving patient complaints or workflow issues
Ensuring compliance with legal and industry standards

In short, a practice manager keeps the practice running so you can focus on delivering care and leading the vision.

When You’re Not Ready Yet

It’s also important to know when not to hire a practice manager. If you’re still seeing just a handful of patients per day or haven’t hit consistent revenue milestones, it may be too early.

In the early startup phase, you might be better served by a strong front office lead or outsourced support for billing and HR tasks. But once your systems are solid and your team is growing, the manager role becomes critical.

You’ll also want to be financially prepared. A full-time manager is a significant investment, and you want to make sure their salary won’t cause strain. That said, the ROI on a great practice manager is usually positive within months due to increased efficiency, production, and team performance.

How to Find the Right Person

Hiring your first practice manager is not just about filling a seat. It’s about finding someone who aligns with your vision, shares your values, and can lead your team with confidence.

Qualities to look for:

Leadership experience in a dental or medical setting
Excellent communication and conflict resolution skills
Operational know-how with scheduling, billing, and compliance
High emotional intelligence and a calm presence
A growth mindset and willingness to evolve with your practice

You may find the right person internally. A rockstar front desk lead who has earned your trust and understands your systems could be trained into the role. Or you may need to look externally to bring in new experience and fresh ideas.

Either way, invest time in the hiring process. Ask behavioral questions. Involve your team. Check references thoroughly. The right hire will make your life easier. The wrong one can set you back.

Transitioning Into a New Leadership Model

Once you’ve hired a practice manager, your role as owner shifts. That transition requires intention. Your team needs to understand the new structure, and your manager needs your support.

Best practices include:

Clearly communicate to your team why you’re making the hire and what the manager’s role will be
Empower your manager to lead without micromanaging them
Hold regular meetings with your manager to align on priorities and troubleshoot together
Support them publicly, especially when tough decisions are made

Leadership is not about doing everything yourself. It’s about building a team of people who can do great work even when you’re not in the room. Hiring a practice manager is the first real step toward that kind of scalable leadership.

The Benefits You’ll Notice

When you bring the right practice manager into your business, you’ll likely experience some dramatic shifts. You’ll have more time, more headspace, and more ability to focus on what really matters.

Expect benefits like:

Better team cohesion and morale
Fewer fires to put out
More consistent systems and smoother operations
Improved patient satisfaction
Increased production and collections
Less stress and more work-life balance

The right hire will elevate not only your practice but also your quality of life. You’ll be able to step into your role as a true CEO, not just a clinician who owns a business.

Key Takeaways

If you’re drowning in admin tasks, staff issues, or operational inefficiencies, it may be time to hire your first practice manager
A good practice manager can oversee the day-to-day, manage your team, and help you scale
Watch for signs like system breakdowns, staff turnover, and an over-reliance on you for every decision
Hire when your practice is financially stable and ready for growth, not during early startup struggles
Look for a candidate with leadership skills, operational knowledge, and emotional intelligence
Set your new manager up for success by clearly communicating their role and empowering their leadership
The right practice manager will give you more time, less stress, and a stronger foundation for growth

Ready to Take the Next Step?

Hiring your first practice manager is a decision that signals your readiness to grow into a new kind of leader. It’s a leap, but one that can profoundly improve your business and your life. If you’re struggling with the timing or unsure how to make it work, coaching can help.

At Queen of Dental Life Coaching, we specialize in supporting dentists through every stage of practice ownership. Schedule a consultation today and let’s talk about how to build the leadership team that will take your practice to the next level.