The Power of Being in the Middle
Everyone dreams of being on top. If you asked my team, they’d say that’s where I am. A few even tell me they’re eyeing my role for when I retire.
But what they may not realize is that it’s not the top that’s most important—it’s the middle. As a practice administrator, I live in the middle. It’s not a place of indecision; it’s a place of connection. I bridge the gap between our dentist/owner and our team, and that space—right in the middle—is where real influence happens. It’s where communication flows, problems get solved, and progress takes root.
Earlier in my career, I worked as a hygienist—just one of the team. That experience has shaped everything I do today. I remember what it felt like to not have a voice, to feel like your opinion didn’t carry weight unless you held a leadership title.
That memory fuels my commitment to listening, really listening, without jumping to conclusions or forming fixed ideas. When a team member brings a concern, I ask them to bring a possible solution too. And often, their ideas are brilliant, especially when they’re rooted in firsthand experience within their own department.
Take COVID, for example. With fewer people on our business team, checkout became a bottleneck. That wasn’t just an inconvenience—it was a safety concern for our patients and staff.
One team member approached me with a worry and a solution: have patients prepay or pay when they arrive. Then we’d schedule follow-up appointments at the same time. We tried it—and it worked. So well, in fact, that we’ve made it part of our permanent workflow. Checkout bottlenecks disappeared, and patients now leave without delay.
Getting Buy-In
Of course, it wasn’t as simple as flipping a switch. I had to present the plan to our owner, hear his questions, and explore his concerns. Patients paying upfront was new for us—and it felt like a risk. But after some thoughtful conversation and a clear rollout plan, he got on board. Sure, a few patients were skeptical at first. But once they saw how much smoother and faster their visits became, the pushback faded. And the practice saw another unexpected benefit: fewer no-shows for larger appointments, since patients had already paid in advance.
The bridge goes both ways. Just like I carry team feedback to ownership, I also translate the big-picture vision from our owners into clear, actionable steps for the team. When done well, everyone feels informed, empowered, and aligned.
Today, our business team confirms appointments, collects payments, and answers patient questions during a check-in call a week before the visit. On the day of the appointment, the clinical team is ready to take the baton—escorting the patient in, delivering treatment, and walking them out, no checkout needed. It’s a flow that feels effortless—and it started in the middle.
Lately, inflation has taken a bite out of every dental practice’s profit margin. For owners, this is a real and growing concern. For the team, it may feel too big to tackle. But when you’re in the middle, you can empower every team member to take small steps that collectively make a huge difference.
Business Team Tip
Train the front desk to respond to cancellations with kindness and confidence. When a patient calls to cancel, never offer the next available appointment right away. Instead, keep the schedule looking busy by offering availability 6+ weeks out.
A simple, caring phrase like “I hope everything is okay” often opens the door to understanding the real reason for the cancellation—so you can handle the rebooking strategically. And always document the call.
Clinical Team Tip
Encourage the clinical team to be intentional with supplies—no wasted cement, no extra cassette wraps. For those ordering materials, comparison shopping among major suppliers can uncover real savings. They might not see the full financial picture, but you do—and you can connect their efforts to the practice’s financial health.
The most powerful tool I’ve found as a middle bridge is policy. A written policy manual and SOPs (Standard Operating Procedures) give structure to your practice. They create fairness, support accountability, and eliminate one-off decisions that can breed resentment.
When a team member asks for an exception, I don’t have to take sides. I can say, “This is non-negotiable per our office policy.” And that’s not cold—it’s clear. Every new hire signs the policy manual, and whenever it’s updated, we all sign again. That consistency brings peace and professionalism to the practice.
Leading from the Middle
Everyone wants to lead. But the most powerful leaders are often not the loudest voices at the top—they’re the ones in the middle, listening deeply, guiding calmly, and connecting people with purpose.
Being in the middle isn’t settling. It’s the space where trust is built, where voices are heard, and where real, lasting change takes shape. And from that position, you just might lift everyone else a little closer to the top.
About the Author
Angela Waller, MAADOM
Angela Waller has been in the dental industry since 1985. In 1997, she accepted the challenge to become the office manager of the practice. Tift Regional Dental Group has been her passion and dental home for 38 years. She served on a Georgia Senate Study Committee in 2015.
Angela joined AADOM in 2015 and received her fellowship in 2019 and her master’s in 2025. She is a lifetime member of AADOM. She is passionate about dentistry and leadership.
