Why Discounts Can Fully Derail a Dental Practice | Sadie Stewart | FF
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Sometimes the biggest threat to cash flow isn’t empty chairs, it’s not believing in the value of your services.
In this Fail Forward episode, Sadie Stewart shares the story of a dental practice consulting engagement that felt, at the time, like a painful professional setback. Despite improving collections, tightening systems, and supporting the team through serious cash flow challenges, one deeper issue kept holding the practice back: a generous owner dentist who wasn’t ready to change the discounting habits that were undermining the business. Sadie eventually made the difficult decision to step away, only to be called back later in an entirely different role as a neutral professional during a difficult practice transition. That experience opened a new path into conflict resolution, mediation, and dental practice transitions, reminding us that failure isn’t always the end of the story. Sometimes, it’s the moment that redirects your career toward the work you’re uniquely equipped to do.
Listen in for a quick, honest reminder that the setback you’re carrying may be pointing you toward your next meaningful chapter!
Sadie: Aloha. This is Sadie Stewart from Honolulu, Hawaii, and this is my Fail Forward story about turning a professional setback into a very meaningful growth experience in my career. I've been consulting with privately owned dental practices for about ten years, and when I think about a failure that ultimately led to growth and new opportunities, one client immediately comes to mind.
At the time, I was still a relatively new consultant. I was excited and determined to help transform a practice that had been struggling with serious cash flow issues. Because I knew finances were already tight, I wanted to be respectful of my consulting fees and focus on strategies that could create the biggest impact using the team they already had.
We took a very holistic approach. At first, we cleaned up patient accounts, reviewed aging reports and accounts receivable, worked through insurance claims to increase collections, improved billing systems, and implemented strategies to recover outstanding balances. We also focused on schedule management, making sure the doctor and hygiene schedules stayed as full and productive as possible.
Every week, I ran reports, measured progress, adjusted strategies, and kept looking for ways to improve the practice's financial health. But every month, I noticed the same pattern. Thousands of dollars in treatment were being discounted or written off, all personally authorized by the dentist. No matter how much we improved collections or filled the schedule, we could never outpace the revenue that was walking out the door through unnecessary discounts.
I realized the problem wasn't a systems problem; it was a mindset problem. The dentist had an incredibly generous heart, as most do. He genuinely wanted to help every patient and often felt uncomfortable charging the full value of the care he provided. I spent a lot of time talking with him about the psychology of dentistry.
I explained that there were really two sides of owning a practice. One side is definitely caring for patients with compassion, but the other side is running a healthy business that can continue serving those patients, pay the team, invest in new technology, and keep the doors open. I also had to explain that because he was contracted with insurance companies, routinely discounting services could create compliance issues with those agreements.
The staff had become discouraged. They worked incredibly hard to collect balances, improve accounts receivable, and follow our financial policies, only to have the dentist override those efforts by giving additional discounts. It created confusion and frustration, and it made it nearly impossible for the systems we had built to succeed.
After several months, I had to make one of the hardest decisions of my consulting career. I realized that despite everyone's best efforts, I couldn't want success more than the practice owner did. I respectfully stepped away from the engagement because I didn't feel it was right for him to continue spending his limited cash flow on consulting services when he wasn't ready to make the changes that were necessary.
About a year later, I learned that the practice had been sold. The transition was incredibly difficult. There were disagreements between the previous owner and the new owner. The entire team was let go, and the situation ultimately required professional mediation.
Ironically, I was asked to come back, but not as a consultant focused on operations; I was asked to come back as a neutral professional to help mediate the situation. This experience completely changed the direction of my career. It introduced me to practice transitions, conflict resolution, and mediation. I discovered an entirely new area where I could help dental practices navigate some of the most challenging moments of their business.
Looking back, I once viewed that consulting engagement as a failure because I couldn't save the practice, but today I see it completely differently. That experience taught me that success isn't always measured by changing the outcome for one client. Sometimes success is allowing a difficult experience to shape your own growth and reveal a new path that you never expected.
That one practice opened the door to an entirely new chapter of my consulting career, and because of it, I've been helping more and more practices and dentists through practice transitions and some of the most significant decisions they'll ever make. Sometimes the greatest opportunity is hidden inside the very thing you didn't think would work out.
