Every orthodontist wants a practice that runs smoothly. That’s the goal of effective orthodontic practice management, creating an environment where patients have a great experience, team members feel confident in their roles, growth doesn’t create chaos, and success isn’t dependent on a handful of people carrying the entire operation. But as practices become more complex, achieving that level of consistency can feel increasingly difficult.
In a recent conversation with Dr. Jeremy Lustig, orthodontist and entrepreneur of Lustig and Young Orthodontics, we explored the systems and leadership principles that have helped his organization grow from a single practice into a thriving multi-location group.
One idea surfaced repeatedly throughout the discussion: “What looks like a people problem is actually our problem. It’s a design problem,” according to Dr. Jeremy Lustig. It’s a perspective that challenges the way many orthodontists think about staffing, turnover, training, and growth.
Rather than focusing solely on hiring, Dr. Lustig shares that practice leaders should spend more time examining how work is structured, how responsibilities are defined, and whether their systems are truly designed to support the people expected to use them.
“The solution is about how work is structured, how roles are defined, and whether the practice is designed to support those people working in it. This all comes back to us as the leaders of the practice and the doctors.”
In other words, the strongest practices aren’t built by accident. They’re intentionally designed.
The Challenge Isn’t Finding People. It’s Building a Practice That Supports Them.
There’s no question that staffing remains one of the biggest concerns in orthodontics today. Practices across the country are navigating recruiting challenges, rising labor costs, longer onboarding periods, and higher turnover. At the same time, patient expectations continue to rise, technology continues to evolve, and teams are being asked to do more than ever before.
“It’s not just hiring,” Dr. Lustig explained. “And it’s not just the turnover that we experience. But it’s also just the daily reality of trying to deliver excellent care, grow our practices, and still have a life outside of the office.”
The common response is to focus on finding better people. But according to Dr. Lustig, that approach misses the bigger opportunity. “This isn’t primarily a people problem. This is a systems problem.” That’s an important distinction. Because while practice owners have limited control over the labor market, they have complete control over how work is structured inside their organization.
Rethink Organizing Around Job Titles
One of the biggest shifts Dr. Lustig made in his own organization was moving from job titles to job functions.
At first glance, a role like Front Desk seems straightforward. But when you break it down, that position often includes scheduling, patient communication, financial conversations, insurance verification, follow-up, and data entry. Those aren’t similar tasks. They’re entirely different functions.
The same challenge exists in many treatment coordinator roles. Presenting treatment, discussing financing, answering insurance questions, managing follow-up, and maintaining pending treatment pipelines are often bundled together under a single title.
When performance suffers, it’s easy to assume the individual needs more training or better organization. But Dr. Lustig encourages leaders to look deeper, “When one person is responsible for too many unrelated functions, very predictable things happen.” Tasks begin slipping through the cracks. Accountability becomes unclear. Stress increases. And eventually, burnout follows.
“It’s not because the person that’s burning out isn’t capable. The truth is, it’s the role itself. It’s just poorly defined,” Dr. Lustig explains.
When practices separate responsibilities into clearly defined functions, team members gain focus, ownership, and the ability to perform at a higher level.
Systems Create Stability
Many orthodontic practices rely heavily on institutional knowledge. One person knows how insurance verification works. Another understands the process for following up on pending treatment. Someone else knows how aligner cases are tracked between locations.
The challenge is that those systems often live inside people’s heads. And when people leave, those systems leave with them.
“When systems live inside people’s heads, that system, and therefore the practice, becomes very fragile.”
Without documented processes, training becomes inconsistent. New hires learn different versions of the same workflow. Mistakes become more common. Accountability becomes difficult.
The solution isn’t more meetings or more oversight. It’s documentation.
According to Dr. Lustig, every critical workflow should have a clear process behind it, whether it’s how a new patient moves from phone call to consultation, how insurance is verified, or how treatment follow-up is managed.
“When a system is documented and it’s clear, something very powerful happens.” Training becomes faster. Expectations become clearer. Accountability becomes possible. Most importantly, team members gain confidence because they understand exactly what success looks like.
Protect the Doctor’s Time
Many orthodontists unknowingly become the biggest bottleneck in their own practice. Not because they aren’t working hard, but because too many decisions, questions, and operational issues flow through them.
Dr. Lustig sees this happen constantly:
- Scheduling questions
- Technology issues
- Operational troubleshooting
- Routine team questions
The result is that doctors spend time solving problems that don’t require their expertise.“We spend a surprising amount of time doing things that we’re not trained to do.”
His favorite example? “I don’t know how many printers I’ve reconnected.” While funny, the point is serious. Every minute spent troubleshooting technology or answering routine operational questions is a minute that isn’t spent on patient care, treatment planning, leadership, or growth.
To evaluate where his own time was going, Dr. Lustig challenged himself with two questions:
- What is it that I’m doing that someone else could do with a clear system
- What is it that I am doing that only I should be doing?
The answer helped him identify where delegation, automation, and process improvement could create the greatest impact. Because ultimately, doctors create the most value when they focus on the work only they can do: diagnosis, treatment planning, clinical care, and leadership.
Better Systems Create Better Results
One of the most encouraging aspects of Dr. Lustig’s philosophy is that improving performance doesn’t always require hiring more people. In many cases, it starts with designing a better practice.
When responsibilities are clearly defined, processes are documented, expectations are understood, and technology is used intentionally, teams become more confident and effective. Training becomes easier. Accountability improves. Growth becomes more sustainable.
As Dr. Lustig puts it, “Same people. But a better system. Therefore, better results.”
It’s a simple idea, but one that challenges the way many orthodontists think about growth. When practices begin to struggle, the instinct is often to look outward—to the labor market, hiring challenges, or the next open position that needs to be filled. While those pressures are real, they’re only part of the equation.
The practices that thrive aren’t necessarily the ones with the largest teams or the most resources. They’re the ones that have invested the time to thoughtfully design how work gets done. They’ve created clarity around responsibilities, built systems that don’t rely on memory, and established processes that allow people to succeed without constantly reinventing the wheel.
Most importantly, they’ve created an environment where doctors can focus on the work only they can do: leading the organization, delivering exceptional patient care, and guiding the long-term vision of the practice.
At its core, Dr. Lustig’s message isn’t really about staffing. It’s about leadership. It’s about recognizing that while we can’t control every challenge facing the profession, we can control the systems, structure, and expectations within our own organizations.
The strongest practices aren’t built on heroic effort. They’re built on intentional design. They create consistency instead of chaos, accountability instead of confusion, and confidence instead of burnout.
Because sustainable growth doesn’t come from finding perfect people. It comes from building a practice where great people can do their best work.
Watch the full interview to learn more.
