Building resilient DSO dental teams

Dr Elizabeth Himel

Wed. 10 December 2025

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If there is one thing that dentistry has taught me, it is that the ability to read people will take a clinician further than any continuing education course ever could. Clinical skill matters, of course, but leading a team, running a practice and growing into multi-practice ownership—that is where emotional intelligence becomes everything. The last few years have changed the workforce. Turnover happens faster, and consequently personalities shift and expectations are different. Early on, I found myself frustrated by the constant change. Now, I have learnt to accept it as part of the process. People come and go, but every person teaches something to those who pay attention. The key is recognising who is just passing through and who is truly meant to grow with the practice.

Pour into your core: Identify your heartbeat

Over time, I have learnt to pour into my core team—the heartbeat of the practice. That includes my associate dentists, hygienists, assistants, laboratory technicians and office manager. They are my stability. They are the people that I trust to keep the ship steady when things get chaotic. When that core group is aligned and strong, the wider team can still thrive, no matter how often it changes.

Working with Aspen Dental has made that possible on a larger scale. The dental support organisation (DSO) framework gives me the foundation and structure that I need while still allowing me to lead in my own way. It is the best of both worlds: the independence to shape my practice culture and the support to keep scaling sustainably.

Since taking over her father’s practice and joining Aspen Dental in 2019, Dr Elizabeth Himel has embraced a contemporary, growth-focused approach to clinical care, leadership and culture building in dentistry.

Lead by example, not by title

I have always believed that leadership is about example, not title. My team knows that I will never ask anyone to do something I would not do myself.

If telephones need to be answered, I will answer them. If sterilisation is backed up, I will glove up. That is simply who I am. I believe in being an in-the-trenches type of leader because respect is not earned behind a closed office door; it is earned alongside the team. When people see their leader doing the work, it changes everything. They do not just follow because they have to; they follow because they want to.

Grace and grit: When compassion meets accountability

Leading multiple teams means constantly reading relationships: understanding when to push, when to support and when to let go. Holding people accountable is one of the most difficult parts of leadership, but it is also one of the most important. I have had team members I cared deeply for, people in whom I saw so much potential, but who simply could not accept feedback or own their growth. Those situations hurt. It is natural to want to fix things, to help, to believe that if the message is delivered in exactly the right way, it will finally click. But it does not always.

That is where I have had to learn that compassion and accountability can coexist. It is possible to care about someone and still hold that person to a standard. It is possible to wish someone well and still know that it is time to move on. That balance of grace and grit is where real leadership lives.

Invest in those who show up

When people show up, learn and care, I will invest in them every time, through continuing education, advanced training, mentorship—whatever it takes. I want my team members to grow personally and professionally because that is how the entire practice is elevated.

Aspen Dental’s model gives me the resources to do that at scale. I am able to mentor, train and support my dentists and teams while still focusing on patient care and on the culture that makes each office unique.

Mentorship only works when alignment exists

Working with associate dentists has taught me how important alignment really is. If our ethics and goals align, I will go all in to help them succeed. However, mentorship only works when both sides are willing to grow honestly. When it clicks, it is one of the most rewarding parts of what I do: helping someone build confidence, find his or her voice, and step into his or her own version of leadership.

Read the room: Qualitative cues matter more than you think

At the end of the day, leadership is about people. It is about knowing when someone needs encouragement and when someone needs accountability. It is about reading between the lines to see who is thriving, who is struggling and who is quietly checking out. That awareness helps protect culture, energy and standards.

“When leadership is rooted in heart, integrity and a willingness to get one’s hands dirty, people notice.”

The numbers tell part of the story

While emotional intelligence guides the day-to-day, I have learnt that sustainable practices also need to track tangible markers of team health:

Retention rates in core clinical and leadership roles versus entry-level roles: Not all turnover is created equal. Understanding where stability matters most helps leaders allocate energy and resources strategically.
Engagement with professional development: Who is pursuing continuing education? Who is asking for more responsibility? These are the people investing in themselves and in the practice.
Clarity of communication: How clearly do team members understand their roles and expectations and how they contribute to the practice’s overall success and reputation? Confusion breeds frustration; clarity breeds confidence.
Patient satisfaction: Team cohesion directly affects patient experience. When the team is aligned, patients feel it and trust it.
Mentorship progression: Are associate dentists growing into leaders themselves? Real success is not just about retaining talent; it is about developing it.

Growth does not always feel good—and that is okay

As I have stepped deeper into the world of multi-practice ownership, I have realised that growth does not always feel good. Sometimes, it is uncomfortable, messy and full of lessons nobody asked for.

But I also know that those moments never last forever. Every time I have hit a difficult season—whether related to people, systems or self-doubt—it has ultimately led to a stronger version of me. In a DSO environment, that willingness to face discomfort is what allows teams and systems to evolve rather than break under pressure.

Final thoughts: Leadership is earned, not given

Leaders will not get it right every time. None of us do. But when leadership is rooted in heart, integrity and a willingness to get one’s hands dirty, people notice. That is what keeps a team resilient. That is what keeps a leader growing.