By: Dawn Patrick, Dental Practice Coach + Director of Operations IgniteDDS
As a dental practice owner or manager, you work hard to create a positive, high-performing team culture. But what happens when a team member continuously falls short of expectations?
Allowing poor performance to persist damages morale, impacts patient care, and affects profitability. That’s why having a “line in the sand” conversation is essential—it ensures accountability, removes emotion, and sets a clear path forward for improvement.
This blog will walk you through how to conduct this conversation effectively, step by step.
Step 1: Prepare for the Conversation
Before addressing poor performance, be fully prepared. This prevents the discussion from feeling like an emotional reaction and instead makes it a constructive and professional conversation.
✅ Gather Documentation:
- Review specific examples of performance issues.
- Note previous coaching discussions or warnings given.
- Identify the impact of the behavior on patients, team members, and the practice.
✅ Clarify Your Expectations:
- What does success look like in this role?
- What needs to change immediately?
- What support or resources will you provide?
✅ Set Your Mindset:
This conversation is not about punishing the employee—it’s about creating clarity and accountability. Approach it as a leader, not as an enforcer.
Step 2: Start the Conversation with Clarity and Purpose
Your opening sets the tone. Keep it direct, factual, and professional while showing that you care about their success.
Example Opening Statement:
“I want to have an open and honest conversation with you. I value you as part of this team, and my goal is to help you succeed. However, I have noticed some ongoing concerns with your performance that need to be addressed immediately.”
Why this works:
- Acknowledges the person’s value to the team.
- Clearly states the purpose of the conversation.
- Keeps emotions out of it.
Step 3: Present the Performance Issue with Facts
Instead of generalizing, provide specific examples of the performance issue. Avoid vague feedback like “You’re not doing your job well.” Instead, focus on observable behaviors and impact.
Example Statement:
“Over the last month, I’ve noticed that treatment plans are not being reviewed with patients before they leave. We discussed this expectation in our team meeting, and I also provided coaching after I observed it happening multiple times. Yet, it’s still not consistently being done. This impacts patient care because patients leave without a full understanding of their treatment options, and it also leads to lost revenue for the practice.”
Why this works:
- It presents a clear issue (treatment plans not reviewed).
- It provides context (past coaching and team discussions).
- It highlights the impact on patients and the business.
Step 4: Draw the Line in the Sand
Now it’s time to set the non-negotiable expectation. This is the moment where you make it clear that things must change immediately.
Example Statement:
“This is the point where we need to make a change. Moving forward, I expect every treatment plan to be reviewed before the patient leaves. This is not optional. If this does not change immediately, we will need to discuss whether this position is the right fit for you.”
Why this works:
- Uses firm, clear language (“This is not optional.”)
- Removes ambiguity by stating the specific change required.
- Sets a consequence if the issue isn’t fixed.
Step 5: Set Expectations and Offer Support
Once you’ve set the expectation, show your commitment to helping them succeed. Offer resources, training, or mentorship to improve their performance.
Example Statement:
“I am here to support you. If there’s a challenge preventing you from following through on this, let’s talk about it now. Otherwise, I need your commitment that this will change starting today. Can I count on you?”
Why this works:
- Demonstrates leadership and support.
- Opens the door for honest communication.
- Secures commitment from the employee.
Step 6: Document & Follow Up
Holding the conversation isn’t enough—you need to track progress.
✅ Document the conversation: Write down what was discussed, the expectations set, and the employee’s response. Keep this in their HR file for accountability.
✅ Set a follow-up date: Schedule a check-in meeting in one week. Let them know you will be monitoring improvement closely.
Example Closing Statement:
“I appreciate you taking the time to have this conversation. I believe in your ability to make this change. I will check in with you next week to review progress.”
Why this works:
- Shows appreciation while reinforcing accountability.
- Communicates belief in their ability to improve.
- Creates a clear follow-up plan.
Common Mistakes to Avoid
To ensure your conversation is effective, avoid these common errors:
❌ Being vague – Instead of saying “You need to do better”, specify what needs to change.
❌ Letting emotions take over – Stay calm and professional. Stick to the facts.
❌ Not enforcing consequences – If improvement doesn’t happen, follow through with disciplinary action.
❌ Avoiding the conversation altogether – Hoping the issue resolves itself rarely works. Address it before it escalates.
Action Steps: What to Do This Week
Here are three things you can do this week to strengthen accountability in your practice:
- Review Team Performance – Identify any unresolved performance issues. Prepare for a line-in-the-sand conversation if needed.
- Set Clear Agreements – Ensure every team member understands their responsibilities and what’s expected.
- Commit to Follow-Ups – If you’ve had past discussions with employees about performance, check in this week and reinforce expectations.
Final Thoughts
Having a “line in the sand” conversation isn’t easy, but it’s necessary to maintain a high-performing dental practice. When done correctly, it creates clarity, accountability, and a culture of ownership.
Remember, as a leader, your goal is not to punish, but to ensure that every team member contributes to the success of the practice. By setting clear expectations and following through, you build a team that respects your leadership and thrives under it.
Have you had to draw a “line in the sand” with an employee before? What strategies worked best for you?
Photo by SHVETS production
