Why Practice Managers Are Drowning (And How to Grab a Life Buoy)

Being a practice manager in 2026 is one of the toughest jobs in dentistry. You're the bridge between patients, principals, and the team. You're managing rotas, suppliers, sickness, compliance. You're keeping morale up while trying to stop the whole thing from falling over.

Some days you wonder how you're still standing.

Here's what most people miss: practice managers aren't born knowing how to lead. Nobody is. Most were promoted because they were brilliant doers. Organised. Hardworking. Committed. But they were never given a leadership roadmap.

And that's where the chaos starts.

The world has changed

Twenty years ago, a job was a job. People stayed because they had to. Security and salary were enough. The boss was at the top, staff followed orders, and loyalty was expected.

Not anymore.

Now, work is about purpose, not just pay. People leave if the culture is wrong, even if the pay is right. They want clarity. Trust. Growth. Development.

Research from the great resignation showed people have a lower tolerance for work that doesn't give them meaning. A global survey by Glassdoor found that across all income levels, the top indicator of workplace satisfaction wasn't pay. It was culture and values, followed by quality of leadership.

Another study found that the biggest predictors of retention weren't even liking your colleagues or believing in the mission. It was being able to answer yes to three questions: Was I excited to work last week? Did I use my strengths every day? Do I get to do what I'm good at and what I love?

Designing that kind of work takes real skill. Creating and maintaining a positive culture, helping your team see their work as important, it doesn't happen by accident.

The old ways don't work

The hierarchies have flattened. The expectations have shifted. Today's teams don't just want to be managed. They want to be led.

They want clarity. Autonomy. A sense that their work means something.

Whether it's Gen Z team members who want purpose and development, or long-standing staff who are worn out and craving direction, your job has changed.

You're not just managing tasks anymore. You're leading people. People who've lived through rapid change, growing uncertainty, and shifting expectations.

What confident leadership actually looks like

Confident practice managers don't have a special personality type. They don't have years of training. What they have is structure.

They lead themselves first. They unite and guide the team with a clear message. They intentionally create culture instead of letting it happen by accident. They communicate what matters, regularly and clearly. They balance high standards with high support. And they delegate authority, not just tasks.

That's it. Six areas. All practical. All implementable.

The difference between chaos and confidence isn't about working harder. It's about leading differently.

And leadership is a skill you can learn.

If you're a practice manager who feels like you're firefighting every day, or a principal trying to understand what's really going on for your PM, this matters. Because the practices that thrive in 2026 won't be the ones with the best equipment or the fanciest marketing.

They'll be the ones with the strongest leadership.

Join my free webinar with dentistry.co.uk next week - Tuesday, 20 January at 7pm. Register here.