Growing Through Change: My Journey from a Small Team to a Large Team Overnight
When I look back on my 16-year career in the dental field, one of the most defining experiences has been the transition from managing a small, close-knit practice of two doctors and 16 team members to stepping into a practice with eight doctors and 50-plus team members almost overnight. It was the kind of change that required not just adaptability, but also resilience, patience, and a willingness to grow alongside the challenges.
At first, the shift was overwhelming to say the least. In a smaller office, it is easier to get to know each team member on a personal level. You develop a rhythm, and personalities fall into place naturally.
Moving into a team that had more than doubled in size meant starting almost from scratch—learning names, understanding individual roles, and adjusting to so many different personalities and communication styles. There were moments when it felt like every day was an uphill climb, just to stay connected and ensure nothing important slipped through the cracks.
Managing Diverse Teams with a Shared Vision
The dynamics of managing such a large team were complex. Each doctor brings their own approach, and each department develops its own culture.
As a manager, I had to quickly learn not only how to balance those differences but also how to help align them toward a common goal: delivering excellent patient care and remaining compliant.
That alignment doesn’t happen automatically. It requires countless conversations, active listening, and, at times, difficult adjustments.
Creating Structure in a Growing Practice
The challenge, however, also revealed an incredible opportunity for me—the chance to build systems and processes that brought some order to what initially felt like chaos. In a larger practice, structure is not simply beneficial; it is essential. Without it, communication breaks down, efficiency suffers, and patients ultimately feel the impact.
By focusing on creating intentional systems, I’m finding ways to bridge personalities, streamline workflows, and support collaboration across each department.
Each new system implemented ranged from the practical to strategic. On the practical side, we as a team developed tools for scheduling, communication, and accountability that keep everyone aligned. On the strategic side, we created workflows that ensured each patient experience was seamless, no matter how many hands were involved in their care.
Implementing each process was not always easy—change rarely is—but the reward came when I could start to see both patients and team members benefiting from the consistency.
Empowering Every Team Member to Succeed
One of the most fulfilling aspects of this journey has been witnessing growth in my team.
While personalities varied, and not every day ran perfectly, the systems allowed space for individuals to shine. Hygienists could focus more fully on care; assistants had much more clarity in their responsibilities; administrative team members felt increased support; and doctors were able to trust the structure behind them.
It’s become less about managing individuals in isolation and more about guiding a cohesive team.
Of course, no practice—large or small—operates in a state of perfection. With so many moving parts, there were bound to be challenges, adjustments, and moments where things didn’t go according to plan.
What I’ve learned, though, is that perfection isn’t the measure of success. Progress is. Each improvement, each small step forward in communication or workflow, builds momentum that ultimately benefits both patients and the team.
Through it all, I’ve been fortunate to work with some truly amazing team members. Their commitment, talent, and willingness to adapt have been a constant reminder that leadership is not about doing everything alone, but about creating an environment where everyone can contribute to the best of their ability. Even in the most challenging days, their support and collaboration have been a source of encouragement and motivation.
Finding Growth Through Challenges
Reflecting on this experience, I recognize how much it has shaped me as a leader. It has reinforced the importance of patience, adaptability, and vision. It has shown me that growth often comes through discomfort, and that challenges can be the catalyst for innovation and stronger teamwork.
Most importantly, it has reminded me that at the heart of any practice—whether 18 people or 50—are the individuals who show up each day committed to caring for patients and for one another.
This journey has not been perfect, but it has been transformative. I am proud of the systems we’ve built and continue to build as a team, the progress we’ve made, and the people I’ve had the privilege to work alongside.
While the adjustment was significant, the lessons learned and the growth gained will carry forward long into the future—not only for me as a leader but also for the practice as a whole. And I am truly excited about the growth in my team.
About the Author
Melissa Cortes, MAADOM
Melissa Cortes is the Office Manager at Alexandria Old Town Dental, bringing over 15 years of experience in specialty and multi‑specialty practices. A MAADOM and Lifetime AADOM Member, she is currently pursuing her Diplomate credential and actively serves on several nonprofit boards and professional networks.
She founded the Alexandria Collaborative Dental Connection to provide inclusive, role‑specific education for dental teams. Outside the office, Melissa enjoys life with her husband and three children, runs a creative small business, and finds peace tending her garden.
