Your Best Employee Quits Friday by Dr. Jeffrey E. Greenberg

Now what?

by Dr. Jeffrey E. Greenberg

You get a text late one Friday night that your office manager, the one who has been with you for years, is putting in their notice. By the time you process what just happened, you’re already spiraling. Not because you’re angry (OK, maybe a little), but because a single thought is running on repeat: What do they know that nobody else does?

Then the answer hits you. A lot.

The insurance verification process? They built it. The workaround for that one printer that jams every third Tuesday? They figured it out. The morning huddle notes, the supply vendor contacts, the way they onboard new hires without a manual because they are the manual? Your office manager, who just gave their two weeks’ notice, is the keeper of this information.

If you’ve been in practice long enough, some version of this story has already happened to you. Or it will. This scenario doesn’t always have to have a bad outcome though. The best way to combat uncertainty is leaning into your unique systems.


Your most valuable (and most vulnerable) asset
There’s a term for the kind of knowledge your best people carry: tacit knowledge. Cambridge Dictionary defines it as knowledge you don’t get from being taught or from books, but from personal experience. In a dental practice, that looks like the assistant who knows exactly how to troubleshoot the suction when it acts up, the front desk lead who has the patient communication style down to an art, or the hygienist who quietly manages the recall system in a way nobody else fully understands.

These people are incredible. They embody the culture of your office and keep the wheels turning. In a lot of ways, you want every team member to become a key knowledge holder.

But here’s the thing that’s easy to overlook: The more knowledge one person holds exclusively, the more risk your practice carries. Not because that person is doing anything wrong. They’re doing everything right. The vulnerability isn’t in the people. It’s in the system, or the lack of one.


This isn’t about blame
Let me be clear: Your key employees are not the problem. They’re often the reason your practice runs as well as it does. It’s one of the reasons you are so grateful to have them on your team.

Sometimes knowledge gets concentrated into one person on purpose, by accident, or because nobody else asked to learn it. That’s not hoarding. That’s just how busy offices work when documentation isn’t a priority. (And honestly, when is it ever a priority?) If you get shivers down your spine when thinking about the state of your business if you got sick, this applies to your role as well!

Let me be up front: You cannot control when someone leaves. You can’t predict illness, pregnancy, or injury. But you can decide today that when those things happen, your practice won’t fall apart and your Sunday won’t be spent at the office trying to figure out why the suction doesn’t work before Monday morning’s surgery.


Building a system that has your back
Here’s where most advice articles would hand you a 47-step implementation plan. I’m not going to do that, because I know you’d bookmark it and never open it again. Instead, here are the three things that actually matter.

Start the conversation the right way. When you bring up documentation to your team, some people will hear “we’re making you replaceable.” That defensiveness is completely normal. So don’t frame it that way. Start with something real: “I want us to build a system so that when someone is out sick or on vacation, the rest of the team isn’t scrambling.” That’s not threatening. That’s a relief. You’re telling your team you want to take pressure off them, not squeeze more out of them.

Start small and skip the minutiae. You do not need to document every single thing your office does. Start with the five or six workflows that would cause the most chaos if the person who owns them disappeared tomorrow. Morning open, evening close, new patient intake, insurance verification, equipment troubleshooting, for example. Get those on paper or documented digitally so they can be accessible anywhere, and you’ve already reduced your risk dramatically. James Clear in his book Atomic Habits put it well: “You do not rise to the level of your goals. You fall to the level of your systems.” Don’t try to capture everything. Capture what matters most.

Make it part of the culture going forward. Add documentation to job descriptions for new hires. Build it into your onboarding. When a team member develops a new workflow or improves an existing one, the expectation should be that they write it down, not as busywork but as a contribution to the team.

As the saying often attributed to Henry Ford goes, “The only thing worse than training your employees and having them leave is not training them and having them stay.”


Where to start on Monday
You don’t need to overhaul your entire operation. Here’s a realistic starting point: Pick one workflow that keeps you up at night. Sit down with the person who owns it. Ask them to walk you through it step by step. Write it down together. That’s it. That’s the whole first move.

From there, you can build. A free generic task management tool like Todoist or Trello can help you track what’s been documented and what hasn’t. For practices ready to go further, a cloud-based platform like Flomo gives you a library of templates for standard operating procedures built for dental teams so you’re not starting from scratch.

But the tools matter less than the decision. The decision to stop relying on any one person’s memory, including your own, as your practice’s operating system.

If your employee suddenly gives their notice or quits, this pre-planning can save you a world of stress later. Build the system now. You’ll thank yourself later.

One thing worth emphasizing is learning the skills to reduce your own stress by taking charge of the systems in your practice. It all starts with taking the first step. I think today might just be that day for you.

Dr. Jeffrey E. Greenberg is a general dentist, the owner of Sweet Spot Dental in Cambridge, Mass., and co-founder of Flomo, a SaaS platform that helps health care practices build and manage their SOPs. Originally from Long Island, he now lives in the Salem, Mass., area with his husband. His dual perspective as a practicing clinician and startup founder gives him a front-row seat to the operational challenges small dental teams face every day. When he’s not chairside or building software, he’s probably overthinking the perfect patient workflow.