I sat across the table from a surgeon who had partnered with a management organization eighteen months earlier. He was frustrated, and he wanted me to understand why.

"I used to run everything," he said. "Now I feel like I'm just along for the ride."

I asked him a question that landed harder than I intended: "When's the last time you engaged in solving one of those problems rather than pointing it out?"

The silence told me everything.

I recognized myself in his frustration. When I transitioned from running my own practice to leading within a larger organization, I felt the same disorientation. The weight of total ownership lifted, but something else came with it. A temptation I didn't expect. The temptation to become a passenger in the vehicle I used to drive.

Here's what I've learned watching this play out across dozens of practices: surgeons tend to fall into one of two failure modes when the dynamic around them changes.

The first is abdication: stepping back from problems and expecting others to solve them. It sounds reasonable. That's what the support structure is for. But abdication transfers responsibility without transferring knowledge. The people closest to clinical reality remove themselves from decisions that require their insight most.

The second is going solo: charging ahead unilaterally, treating collaboration as an obstacle, operating as if nothing has changed. It looks like strength. But independence built your practice. Interdependence builds what's next.

The surgeons who navigate this well do something different. They stay engaged without going rogue. They raise concerns and engage in solving them. They lead within a framework rather than abandoning leadership or ignoring the framework entirely.

The leadership that built your practice is exactly what's needed at this stage, just aimed at different challenges and brought forward together.

Your partner in excellence, Josh Everts, DDS, MD Chief Clinical Officer, OMS360