What Wall Street CEOs Do That Dentists Should Too
- Charles Ekweribe, CPA, EA, MBA
- Sep 16, 2025
- 4 min read
Updated: Sep 21, 2025
Why a CEO Mindset Changes the Trajectory of a Dental Practice
Dentistry is a hands-on profession, but your office is also a business with significant assets, recurring revenue, and complex operations. Wall Street CEOs excel because they operate with discipline: they prioritize measurement, strategy, and value creation. When practice owners bring the same rigor to their finances and operations, the difference shows up in stability, patient experience, and long-term wealth. That shift starts with consistent measurement—translating daily activity into a few meaningful indicators you review on a cadence.
1) Use Data Over Instinct
Why It Matters
Successful leaders make decisions not by guesswork but by observing signals in their data: revenue, collections, utilization, and expense behavior. For dentists, applying this means being able to see real numbers frequently so you can act before issues become large.
What to Track
Amount collected vs amount billed.
How well hygiene is utilized.
Overhead costs relative to revenue.
New patient numbers and patient retention (return or preventive visits).
Treatment acceptance rate.
Gap Signals
Metrics are not tracked on a regular basis.
Feeling “busy” without financial gains.
Expenses creeping up without clear reasons.
How to Start
Pick 5-8 core indicators.
Set up a dashboard you'll review weekly or monthly.
Use your software and financial reports.
Take action when the numbers move.
2) Own Your Compensation Strategy
The Principle
Predictable, fair, and performance-aligned compensation helps maintain stability, reduce risk, and avoid burnout. It separates what you need to live on from what the practice can distribute when business is doing well.
How Dentists Should Structure It
Set a base salary to cover personal and living costs.
Define performance-linked distributions or bonuses based on profitability metrics.
Build reserves for taxes, slow periods, and reinvestment.
Review compensation vs business health regularly (quarterly or semiannually).
Gap Signals
Income fluctuates significantly.
Personal finances or expenses become unpredictable.
Tax bills or big expenses catch you off guard.
3) Engage Financial Leadership (CFO Mindset)
Why It’s Important
Having someone who focuses on strategic finance frees you from reactive mode—spotting cost issues, planning ahead, optimizing structure, guiding decisions with data rather than reaction.
What It Looks Like
Forecasts for cash flow and upcoming expenses.
Monthly reviews of income vs expenses, efficiency, scheduling bottlenecks, collection timelines.
Tax planning year-round, not just at end of fiscal year.
Using financial reports to guide decisions: hiring, pricing, service mix.
Gap Signals
Financial review only around tax time.
Surprise expenses or cash shortfalls.
No one explicitly tracking financial strategy aside from accounting/bookkeeping.
4) Invest for Long-Term Value
The Mindset
A CEO invests—even when immediate payback isn’t obvious. The investments in systems, training, equipment, and reputation compound over time, increasing value, stability, and growth opportunities.
What Dentists Can Invest In
Reliable practice management and scheduling systems.
Patient messaging, recall and follow-up tools.
Staff training, documented standard operating procedures.
Upgrades in technology or equipment when efficiency or patient experience will improve.
Building reputation through consistent quality and appearance (both clinical and patient experience).
Gap Signals
You avoid making necessary upgrades because cost seems high.
Training, systems, or improvements feel optional.
No strategic plan for long-term growth, expansion, partnership, or transition.
5) Prioritize Profitability Over Busyness
Common Trap
Many practices fill their schedules but still struggle with margins, cash flow, or personal financial satisfaction. High activity without attention to cost or value often masks inefficiencies.
How to Shift Focus
Analyze which services bring strong margin and emphasize them.
Reduce waste: no-shows, idle operatories or hygiene slots, inefficient supply usage.
Ensuring schedule matches your best patient value-adding services.
Review overhead regularly: staffing, supply costs, lab fees, rent.
Set fees aligned with value you deliver, not just competitive pressure.
Gap Signals
Your calendar is full but take-home income is flat.
Overhead rising without improvement in profit.
Feeling exhausted and under-rewarded despite high effort.
From Practice Owner to Practice CEO: 6-Step Action Plan
Define your strategic metrics. Pick 5-8 metrics across finance and operations. Establish a schedule for reviewing them (weekly / monthly). Make sure someone sees the data regularly.
Set time-bound goals. Short-term (upcoming quarter) and longer-term (1-3 years). Tie them to metrics and revisit frequently.
Design your compensation structure. Define your base salary; plan for additional distributions or bonuses; account for taxes and savings.
Install financial leadership. If full time CFO isn’t feasible yet, use outsourced or fractional CFO resources. Prioritize forecasting, financial oversight, and strategic advising.
Invest where value compounds. System improvements, procedural consistency, staff training, branded patient journey, better equipment. Choose investments that both improve patient experience and internal efficiency.
Make profit-first operations habitual. Review which services are profitable, eliminate waste, optimize schedule, minimize no-shows, keep overhead under watch, price for value.
Ready to Lead Like a CEO?
You don’t need a Wall Street office to gain the CEO mindset—what matters most is consistency, discipline, measurement, and intention. At PPCA, we partner with dentists as your financial strategist and advisor—your Dental CFO—helping you build dashboards, structure compensation, plan cash flow, and invest where returns compound. Let’s make your practice not only a source of income but a source of long-term value, stability, and peace of mind.
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