A practice manager once stood outside a surgeon's office for three full minutes before knocking.

The surgeon wasn't in a procedure. Wasn't on a call. He'd simply made it clear — through a thousand small signals — that interruptions weren't welcome.

The manager had a problem that needed ten minutes. Instead, she'd spent two days trying to solve it alone, made it worse, and was now bringing a crisis that would take an hour to untangle.

It's a pattern we see in high-performing practices more often than you'd think. And it rarely starts with bad intentions.

Talented surgeons become practice owners, and the habits that protected their focus in training start to quietly work against them in leadership. The calendar fills. The administrative demands stack up. The clinical responsibilities don't go anywhere. And somewhere in the middle of all of it, the team learns — without anyone saying it out loud — that bringing problems forward feels costly.

Problems start arriving late and fully formed. Ideas go unspoken. Small issues quietly become large ones.

Leadership research is pretty clear on what happens next: when teams don't feel like they can reach their leader, trust erodes. Not dramatically. Gradually. And by the time it shows up in turnover or culture surveys, it's been building for a while.

Most of the time, this isn't a leadership problem. It's a bandwidth problem. When practice owners are stretched across clinical, operational, and administrative demands simultaneously, availability becomes a casualty — not because they don't care, but because there's genuinely not enough of them to go around.

The fix rarely requires a personality overhaul. It usually starts with an honest question: what would change in your practice if your team knew they could reach you when it mattered?

The answer tends to point the way forward.

Your partner in excellence,

Josh Everts, DDS, MD

Chief Clinical Officer, OMS360