Most problems in dental practices don’t arrive suddenly.
They build quietly.
A small compromise here.
A rushed decision there.
A “we’ll fix it later” moment that never gets revisited.
And then one day, it all feels like it collapses at once — staff issues, cashflow pressure, patient complaints, burnout.
What actually happened is simpler (and more confronting): You didn’t see the dominoes.
The Hidden Mistake Behind Most Practice Problems
Most dentists are intelligent, capable, and well-intentioned.
But under pressure, the brain defaults to short-term thinking:
- “What fixes this now?”
- “What gets me through today?”
- “What stops the discomfort immediately?”
That instinct is human — and it’s also expensive. Because decisions don’t stop where they’re made. They set off chains of consequences.
That’s where this mental model changes everything.
The Model: Visualise All the Dominoes
Visualising the dominoes means mentally following a decision forward in time.
Instead of asking:
- “Does this solve the problem right now?”
- You ask:
- “If I do this… what happens next?”
- “And then what?”
- “And then what?”
It’s a simple shift — but it separates reactive operators from strategic leaders.
Why This Model Is Critical in Dentistry
Dental practices are complex systems:
- people
- schedules
- money
- emotions
- trust
In systems like this, first-order thinking is dangerous.
First-order thinking says:
- “This will get the patient to say yes”
- “This avoids conflict”
- “This keeps the peace”
- “This saves time”
Second-order thinking asks:
- “What behaviour does this train?”
- “What precedent does this set?”
- “What problem does this create three steps later?”
The best practice owners aren’t smarter —
they’re just better at thinking one or two steps ahead.
Dental Practice Examples (Where Dominoes Really Matter)
Example 1: Discounting Treatment
First domino: You discount a treatment to help a hesitant patient say yes.
Next domino: The patient now associates your care with negotiation.
Next domino: Future patients (and staff) expect flexibility.
Final domino: Margins erode. Confidence drops. Price objections increase.
What felt like kindness becomes a pattern you now have to manage.
Example 2: Avoiding a Difficult Team Conversation
First domino: You avoid addressing underperformance to keep harmony.
Next domino: High performers notice the inconsistency.
Next domino: Standards drop quietly.
Final domino: You end up with resentment, turnover, and bigger conflicts later.
Short-term comfort → long-term instability.
Example 3: Rushing Case Presentations
First domino: You rush explanations to stay on time.
Next domino: Patients feel uncertain.
Next domino: They “think about it” or seek second opinions.
Final domino: Case acceptance drops — and you blame price or patients.
The real issue started several dominoes earlier.
The Leadership Insight Most Dentists Miss
You don’t need to predict the future perfectly. You just need to stop pretending decisions end where they’re made.
Most stress in dentistry isn’t caused by bad intentions — it’s caused by unexamined second-order effects.
Elite leaders pause for seconds longer and think steps further ahead. That pause is leverage.
How High-Performing Practice Owners Use This Model
Before acting, they quietly ask:
- “If this works… what does it create?”
- “If it doesn’t… what will it cost later?”
They:
- design systems instead of fixing symptoms
- train behaviour instead of rewarding exceptions
- optimise for repeatability, not convenience
Over time, fewer fires appear — not because luck improved, but because the early dominoes were placed better.
Teaching This Inside Your Practice (Dr Kinnar’s Coaching Lens)
This model becomes powerful when it turns into shared language.
Teams start asking:
- “If we do this every time, is that good?”
- “What does this train patients to expect?”
- “What problem might this create later?”
That’s when your practice shifts from:
- reaction → intention
- chaos → clarity
- effort → leverage
Final Thought
Most dentists are one or two decisions away from either:
- momentum, or
- mess
The difference isn’t effort. It’s foresight.
When you start visualising the dominoes, you stop being surprised by outcomes — because you quietly created them.
My role as a success coach is to help you pause at the exact moment rushing feels justified — because that’s usually where small decisions quietly turn into big problems.
