One of the hardest things in dentistry is to know when to keep pressing onward or deeply reconsider a situation and move on in a new direction.

Everyone knows that perseverance and “grit” are key to success. Anyone who has worked their way to the top can tell you about their moments of doubt, horror stories and wounds acquired along the way. But never re-assessing, never changing course is problematic as well, as it is analogous to sailing with a fixed rudder. It is only a matter of time before you run your boat aground.

Do you have both a plan and a strategic planning process?

Successful management of the direction and functionality of a practice requires the use of both approaches, and that is why every practice needs to not only have a plan but also a strategic planning process. A strategic planning process is an iterative process of self-reflection. It is constant and not just an event. Because it is a “process” of constant reassessment, you can discover when to reimagine and change course. Dwight D. Eisenhower spoke to this truth when he said, “Planning is essential, but plans are useless.”

Where are things breaking down?

An objective way to arrive at an answer is to begin to analyze where things are breaking down. The work of Simon Sinek is helpful in making this analysis. He says we can have breakdowns in the areas of HOW, WHAT and WHY.

Breakdowns in specific areas of a practice are often breakdowns in HOW. This is when people are not executing well-designed and well thought through processes and procedures. This may be driven by a lack of knowledge, understanding, ability and/or desire. And these represent objectively correctable problems. For example, if the margins of our crowns are consistently substandard, we need to go back and figure out where our processes and thinking are breaking down. If a team member is failing to execute their responsibilities in an appropriate fashion, the same approach holds true.

Are you climbing fast in the wrong direction?

Failures can also occur at what I would call a “strategy level.” This is a more global level above execution, because it involves more of why we are attempting to do what we are attempting to do. Simply put, poor strategies will lead practices in the wrong direction. Steven Covey’s metaphor of having our life ladder up against the wrong wall applies here. We can be climbing fast, while simultaneously climbing in the wrong direction.

Does your work feed your soul?

Failures can and do originate on a WHY level. An example of this would be a person working hard and making bank, while hating being a dentist. This represents a failure on the visionary or philosophical level. Failures on this level represent spiritual depravation. In this case, we are going through the motions, yet very little of what we are doing feeds our soul. As a consequence, people often attempt to fill this void in a dysfunctional way, perhaps, with alcohol, drugs, sports, extreme exercise regimens—or something else that easily becomes an addiction.

If we have HOW and WHAT breakdowns in a practice and still have our WHY worked out, staying focused and working through issues and problems is appropriate. However, if the reason things are not being executed well and the reason our strategies aren’t effective is really because our heart isn’t in it, then we have a spiritual crisis on our hands.

Without first addressing our inner nature and our inner truths, we will never be successful at addressing more downstream challenges such as HOW and WHAT. L.D. Pankey was speaking to the essential nature of this truth when he said, “Know yourself.”