Growing pains in business – symptoms and causes

If you are running a three-chair practice with £500,000 in sales and 10 people, you can “wing it” 80% of the time and hold semi-formal meetings to create structures and protocols 20% of the time.

If you are running a 6-chair practice with £2m in sales and 20 people, you can “wing it” it 20% of the time but 80% of the time there has to be structure, protocol, systems.

The journey from one to the other reaches a point at which “winging it” no longer works.

That’s when the growing pains become apparent.


  • Irritating mistakes start to happen;
  • Patient complaints are heard;
  • Team members begin to express frustration;
  • Stuff doesn’t get done;
  • Everything takes longer;
  • Worst of all – gossip begins because the chain of command isn’t well established and communications flow sideways instead of top down.

The challenge when a small business becomes large is that many of the successful habits you learned when you were small become bad habits – they have to be replaced by a different set of habits when you become bigger.

It’s a very good idea to keep an eye out for the symptoms, so that you can identify the cause early on – and do something about it.

Almost always, what you have to do is create the protected time for formal management meetings (3 hours per month) and regular weekly reviews (1 hour).

Once more – here is the agenda for that monthly management meeting – I’ve been using a version of this for over 20 years. I’m still getting paid to remind clients to use it.

02239 CB Monthly Meeting Agenda FINAL


Published by

Chris Barrow

Chris Barrow has been active as a consultant, trainer and coach to the UK dental profession for over 20 years. As a writer, his blog enjoys a strong following and he is a regular contributor to the dental press. Naturally direct, assertive and determined, he has the ability to reach conclusions quickly, as well as the sharp reflexes and lightness of touch to innovate, change tack and push boundaries. In 2014 he appeared as a “castaway” in the first season of the popular reality TV show “The Island with Bear Grylls”. His main professional focus is as Coach Barrow, providing coaching and mentorship to independent dentistry.