Power. It’s not a word many dental practice leaders feel comfortable with. Is not a word that I was comfortable with. Whether we like it or not, power is always present in our interactions. The key is not to deny it, but to understand it — because how we handle it determines the quality of communication in our teams.
What is a power gradient?
In his book, Leadership is Language, David Marquet defines the power gradient as the “amount of social distance there is between one person and another,” characterizing it as the subjective feeling of how much more important people are higher up the hierarchy, and conversely, how much more important a leader feels than their subordinates. The steeper the gradient, the less likely people are to speak up. If you would like a broader explanation of the concept itself, you can also read my general article on what the power gradient is and why it matters.
What are the consequences of a power gradient?
In aviation, steep power gradients have caused tragic accidents when co-pilots hesitated to question the captain. Airlines learned from this, training leaders to flatten the gradient so that crucial information could flow freely.
In dental practices, the risk is not life and death — but the consequences can still be serious. When team members hold back ideas, concerns, or feedback, the practice loses its capacity to learn and grow. Problems are hidden, tension builds, and innovation stalls.
What makes the gradient steep?
Several factors amplify the power gap in dental practices:
- Position: Being the practice owner or lead clinician gives you authority by default.
- Knowledge and expertise: Years of education, specialist training, and experience can make others feel their opinion isn’t valid.
- Experience and longevity: Long-serving principals naturally carry more influence — which can feel intimidating for associates or new team members.
Most practice owners don’t intend to create a steep gradient — it’s simply part of the structure. The key is to become aware of it and take action to reduce it.
How to flatten the power gradient
Practical ways to make your practice communication more open and balanced:
Be accessible. Spend informal time with your team — lunch, check-ins, or simply being visible and approachable between patients.
Invite and value input. Say things like, “You’re new, so you’ll see things we might miss — what’s your view?” This empowers fresh voices.
Judge the work, not the person. Focus feedback on actions and outcomes rather than individual capability.
You don’t always have to have the answers. Admit when you don’t know.. Vulnerability is powerful. It encourages others to contribute and share ideas.
Mind your share of voice. In meetings, notice how much you talk compared with others. Aim for real dialogue rather than monologue.
Be present as equals. Go into every conversation assuming the value of each person’s perspective is equal to yours.
Impact on your dental practice
Leadership in dentistry isn’t about being in charge — it’s about creating the conditions where people feel safe to speak up. When you flatten the power gradient, you gain access to the full intelligence of your team. Ideas flow. Trust grows. And your practice becomes a place where everyone leads, not just the person with the title.
If you want to understand how the power gradient may be affecting communication and culture in your practice, take the Dental Practice Leader Scorecard. It will help you identify where your leadership is strong, where there may be hidden barriers, and what to focus on next to build a more open, confident team.
