“I haven’t heard anything new in years,” one of my former clients told me. “I hope you are bringing good material, because the last few seminars I have attended I could have taught myself,” shared one of my current clients. Challenged by these comments, I reflected on my 17 years of working with oral surgery practices—seeking a philosophy, a group, an organization that is designed not to fail but to succeed no matter the obstacle. This search led me to the Navy SEALs and Extreme Ownership. Extreme Ownership explains how Navy SEALs operate through their training, missions, and, ultimately, most aspects of their lives. The philosophy centers around a zero-failure mentality ingrained through repetitious preparation and unwavering fortitude. There are no excuses, only solutions.

The Navy recruits approximately 40,000 candidates annually. Roughly 6% of those people express interest in the SEAL program. Only 25% of the SEAL candidates survive Hell Week and continue to future phases. Many candidates arrive believing that their physical capabilities will be enough to deliver them from the initial BUD/S (Basic Underwater Demolition / SEALS) training. Yet, it is only those with the will and determination to succeed that are the ones that progress to the next level. SEALS undergo this extensive training to ensure that they have the technical skills, the mental stamina, and physical conditioning to complete their missions with a zero-failure mentality. Does any of this sound vaguely familiar to you? Are there any similarities to your dental and oral surgery training program experience?

Taking Extreme Ownership of your practice begins with the recognition of the parallels between the oral surgeon’s training and career to that of a Navy SEAL’s. Much like a SEAL’s mission, surgeries are intended to be a zero-failure endeavor. The process of performing surgeries is a culmination of training, focus, persistence, perfection, and continual improvement. Some oral surgeons are motivated by goals, commitments, passions, work ethic, stage of career and more. Today’s oral surgery residents will likely be carrying $1,000,000+ in debt when you consider the purchase of a practice/share in a partnership/ new facility, school debt, and a reasonable house and car. This should be all of the motivation in the world for a zero-failure mentality view of your practice. Successful surgeries are only one element of the success possible with your oral surgery practice—and that success stems from teamwork. Your team is defined as your employees, your practice partners, your referring doctors, and your advisors/experts (consultant, accountant, attorney, representatives, etc.). As the leader, your duty is to inspire each of these groups to ensure your goals and objectives are met.

Every practitioner is met with obstacles no matter their stage in the life cycle of their career and/or practice. These obstacles will be staff turnover, the changing environment of marketing and promotion, new competitors, referral patterns, other dental specialists taking on traditional oral surgery procedures, and the list goes on. But, like a Navy SEAL, we must first know the mission and then demonstrate a zero-failure mentality and overcome. Here are the four elements that you and your team must own to overcome and secure your success—knowledge of the mission (goals), training and conditioning, mental fortitude, and leadership.


Starting with the mission (goals and mission are synonymous for this section) is the first and most important step. You will read and hear that you need goals –written goals. This could not be more accurate. Written goals are paramount to your future success. At some point you decided to become an oral surgeon. There was a clear path (mission) of college, dental school and an oral surgery residency. That required qualities like focus, discipline, persistence, being a perfectionist, being driven, and even being competitive–much like being a SEAL. Once you completed residency and were in practice, the drive to continue compounded with the need to fill chairs, build your practice, and of course pay off your debt. Distractions and complacency are the enemies of success for you and your team and that is why you need written goals to stay focused.

  • Do you have a concrete, written three year plan (mission)?
  • Are you and your team able to explain the practice mission concretely and concisely?
  • Are your current daily activities demonstrating that you are working towards your goals?
  • Are your daily activities driven by the practice mission?
  • Is your team actively working towards your goals? Do they know the goals, understand the goals, and believe in the goals?
  • Who is monitoring the mission progress and holding you accountable to those goals?

You and your team need the direction of goals to ensure everyone is working the same mission. Without a clear mission and purpose, team members get caught up in just doing tasks which will only carry the practice so far. A zero-failure mentality, much like oral surgery, starts with a clear plan that everyone understands. From there, it moves on to focus, training, persistence and remaining solutions oriented. Let’s face it, this likely pales in comparison to the intensity of your surgical training!

Continued Training and Conditioning

Over the years, I have run into one consistent problem with many practices–and it is a big, pervasive impediment to their success. The surgeon(s), manager(s), and team run their practice just like they clinically treat patients. Take, for example, the treatment plan for an infected tooth—remove the tooth and move on. Once the tooth is gone, there is typically little reason to go back to that site (unless there was a complication or…..we plan an implant to replace the tooth). Using that analogy with the practice, the team looks at a problem the practice is facing, diagnosing the issue and addressing it once. Addressing a practice management issue/problem/opportunity once does not cut it. Removing an infected tooth is a one-time event that will likely remedy the patient’s infection and pain. Unlike the infected tooth, practice management systems must be an evolutionary, on-going, pervasive process within your practice. Systems and solutions implemented early in your career should change and evolve as your practice grows, matures and encounters new challenges. This requires team training. Team member development (hopefully), employee turnover, etc. will demand even more training. As your team improves, your practice improves. Your team should be experiencing ongoing, constantly evolving training to ensure they are prepared for your practice mission. The continued training and conditioning comes from team meetings, department meetings, individual development plans and routine (daily, weekly and monthly) feedback from a manager and/or surgeon.

  • Do your current practice management systems support your current practice mission?
  • Is your training geared to ensure each team member understands and believes in your mission?
  • Does each team member understand their individual role in the mission?
  • Is your team training repetitive, consistent (at least monthly) and challenging?
  • Does the team get routine, consistent feedback geared to prepare them for the mission?

With your mission firmly implanted and coupled with great training, your team will be equipped to deal with at least 80% of the obstacles they will encounter daily.

Mental Fortitude

Those Navy SEAL candidates had to qualify to enter the BUD/S training by passing an extremely rigorous physical fitness test; however, a strong mind is what pushes SEALs to overcome the urge to ring the bell and ultimately go on to finish the training program. Many teams fail to implement new concepts, scripting, systems, etc. purely out fear. In the SEAL program, the candidates learn the 40% rule. When your mind tells you to stop, you have only reached 40% of your capabilities. Where does that fear come from? The fear can manifest from a few key areas:

  • Fear of doing it wrong and/or it will not be perfect the first time.
  • Fear of something negative happening (i.e. the patient or referring doctor will be upset).
  • Fear of you being upset, disappointed or even livid.
  • Fear of the unknown.

If you and your team understand the mission, understand the steps necessary to achieve the mission, everyone trains for the mission, and there is universal belief in the mission, the fear will and does subside. Fear may not go away, however, the team will feel more confident moving forward. This is where I refer back to the quote from my former client, “I haven’t heard anything new in years.” We don’t always need a new idea on what to do, we often need to focus on “how” to achieve it. Consistent effort from each team member and owning the 40% rule will empower your team to face the guaranteed daily obstacles. Ultimately, your entire team’s attitude defines your success.


Leadership is the proverbial question of what came first…..the chicken or the egg? Should the leadership discussion happen at the beginning or at the end? Ideally, leadership should manifest throughout the mission. Your team needs to know what you want and how soon you want it. They need to know you are there to provide the strategy; you are there for course correction and to be on the mission with them. For a mission to be successful, the entire team must understand the goals, their individual role in achieving the goals, and what they are to be working towards daily. This concept is a stark difference from what I see in many practices where employees, not team members, are purely focused on doing their job or, even worse, tasks. Successful oral surgery teams are comprised of problem solvers and critical thinkers. The team will diagnose (surgeon diagnosis) a patient’s problem and provide a resolute solution. The team will successfully handle emergencies from referral sources. They help patients understand treatment planning and how payments to specialists work (we prefer payment now and not later). Individually and collectively, team members make a difference. So, for your mission to be successful, the training and leadership should empower your team to problem solve all day, every day to ensure the surgeon can concentrate on diagnosing and providing care because he or she are the only ones that can handle that facet. This should be your objective as a leader—surround yourself with a team that will carry on the mission while you are seeing patients.

  • Are you clear and consistent in your message about your mission?
  • Are you viewed as being on the mission with the team?
  • Are you leading by example through your daily actions?

You are not on a solo mission. With leadership, you can bring out the best in your individual team members. That leadership will help your team become acquainted with the 40% rule and push beyond what everyone thought was possible.

Where to start?

Like a SEAL team, your team must understand the mission, have continued training and conditioning, mental fortitude, and leadership. Without any one of these elements, your success will be hindered. Those elements provide the preparation necessary to ensure your days are smooth, productive, and position you to be the respected oral surgery office in your area. The same focus, persistence, perfection, and continual improvement used to get through your training is what you need to achieve your mission through Extreme Ownership. Many of you read this article looking for solid answers on how to improve your practice. The solid answer starts with you, your Extreme Ownership of your practice, and your zero-failure attitude towards your practice’s success.

Posted with permission from the American Association of Oral and Maxillofacial Surgery (AAOMS) © 2018. Copying any portion of this material is not permitted without the express written permission of AAOMS.