The Octopus Organization: A Leadership Model For Your Dental Practice

January 15, 2026

An Octopus Organization uses decentralized leadership to minimize bottlenecks, enhance accountability, and provide business owners with more time.

Harvard Business Review recently featured the “Octopus Organization” concept. Here are the key takeaways and how they can be applied to private dental practices.

Running a private dental practice means treating patients, managing the team, overseeing the schedule, making business decisions, and maintaining work-life balance, often all at once.

Most practices grow until they hit a ceiling, making the doctor the bottleneck. When all decisions are routed through one person, even top team members must wait, causing slow days, missed opportunities, stressed patients, and a tired owner.

One way to break that ceiling is to adopt a decentralized structure known as the “Octopus Organization.” This approach empowers the team, improves efficiency, and sustains quality care without constant doctor oversight.

Why dentists hit a leadership ceiling

Initially, the “doctor at the top” model is effective. You are close to every system, every patient, and every team member. However, as the practice adds providers, operatories, hygienists, and more moving parts, the same model starts to slow everything down.

• Decisions back up in your doorway, even small ones.
  
  
• Team members ask for approval instead of solving problems.
  
  
• Processes drift because no one owns them from end to end.
  
  
• You carry the mental load of the whole practice, even when you are chairside.
  
  

The issue is rarely effort. The issue is structure. A practice that depends on one person for momentum will always be limited by that person’s time and attention.

Pyramid leadership vs octopus leadership

Traditional practices resemble a pyramid, with the doctor at the top, information flowing up, and instructions flowing down. This simple, fragile structure works only when the practice is small and the leader is always available.

The octopus model has a clear center and strong, specialized “arms.” The center sets direction, culture, and priorities. Each arm acts within its domain, responding quickly without needing constant permission.

In an Octopus Organization, you stay the central leader. Your goal is to stop being the default decision maker for everything. Instead, you build leaders who own parts of the practice and give them the tools and guardrails to lead effectively.

What the “arms” look like in a private dental practice

The “arms” are real areas of ownership, each with clear decision-making authority and measurable outcomes.

Here are some common “arms” that work well in owner-led practices:

• Office Manager: Owns daily operations, staffing coordination, scheduling systems, and the flow of the day.
  
  
• Financial Coordinator: Owns insurance processing, collections, payment options, AR follow-up, and financial scripting.
  
  
• Treatment Coordinator: Owns case presentation, follow-up, patient questions, and conversion systems.
  
  
• Lead Hygienist: Owns hygiene protocols, perio standards, reactivation, patient education consistency, and hygiene schedules.
  
  
• Clinical Lead Assistant: Owns operatory readiness, supply levels, lab case tracking, and clinical setup standards.
  
  
• Patient Experience and Marketing Lead: Owns new patient intake, review systems, community outreach, and referral workflows.
  
  

A practice doesn’t need every “arm” at first. Many start with two or three, expanding as the team matures.

Real examples of autonomy that matter

Decentralized leadership becomes clear when you consider the daily interruptions it can resolve. The octopus model moves these decisions to those closest to the information.

Instead of, “Doctor, can we squeeze in this emergency?” the scheduling lead uses a written rule set to place emergencies, protect production blocks, and communicate expectations to the patient.

Instead of the schedule collapsing when a hygienist calls out, the office manager uses a rebooking script and a short list of flexible options, making the call without waiting for you.

Instead of you reviewing every insurance hiccup, the financial coordinator works a defined escalation ladder: first call the carrier, then refile with documentation, then bring only true exceptions to you.

Instead of payment conversations being avoided, the financial coordinator follows a consistent financial policy, offers approved payment options, and tracks acceptance rates weekly.

Instead of you correcting hygiene notes, perio protocol, and patient education in real-time, the lead hygienist trains the team on the standard, audits charts, and runs a monthly calibration huddle.

Instead of you noticing supply shortages at the worst moment, the clinical lead manages levels and ordering and reports monthly on waste and stockouts.

Instead of you reacting to negative reviews after the fact, a patient experience lead monitors feedback, follows up with unhappy patients, and drives a consistent review request process.

Instead of new patient intake being inconsistent, the lead owns the phone script, the confirmation cadence, and the handoff from the front desk to the clinical team.

The guardrails that keep autonomy safe

Autonomy without structure creates chaos. Structure without autonomy creates bottlenecks. The answer is clear guardrails with genuine decision freedom inside them.

Useful guardrails for dental practices include:

• A short, clear practice mission: the experience you want patients to have, the standard you refuse to compromise.
  
  
• Written policies for scheduling, finances, clinical documentation, and customer service, kept simple enough to use daily.
  
  
• A defined list of “doctor required” decisions, for example, clinical diagnosis, final treatment plan approval, and any situation involving patient safety.
  
  
• Key performance indicators by domain, so leaders know what “good” looks like. For example, AR days, hygiene reactivation, case acceptance & late cancellations.
  
  
• A cadence for feedback, such as weekly leadership huddles with a monthly scorecard review.
  
  

When these guardrails are in place, leaders can move quickly without hesitation, and you can remain confident that the practice remains consistent.

Delegation that actually sticks

Many dentists assign tasks but retain decision-making control, thereby trapping themselves. Octopus leadership delegates by role, giving true ownership instead of a managed checklist.

Try shifting your delegation language:

• From: “Can you do this?” to “You own this domain, what is your plan?”
  
  
• From: “Ask me first,” to “Here are the guardrails, decide and then inform me.”
  
  
• From: “Bring me problems,” to “Bring me options, and your recommendation.”
  
  

This shift is cultural. It teaches critical thinking, reduces interruptions, and raises leadership across the practice.

A simple way to start building your octopus

You don’t need a major reorganization to start. Move decision-making gradually, deliberately, and clearly to the right place.

1. Choose your first two arms

Choose two domains that create the most interruptions and have clear outcomes. Many start with operations and finances, or operations and hygiene.

2. Define the domain

List the outcomes, decisions, exceptions, and metrics for each domain. Keep it short; clarity beats complexity.

3. Build a playbook

Create a concise set of SOPs, scripts, and rules, so leaders can act in real-time. If a document isn’t used weekly, exclude it from the playbook.

A weekly leadership huddle stops issues from escalating. Share updates, blockers, decisions, and next steps.

When something goes wrong, treat it as a training opportunity. Adjust the guardrail, update the playbook, and let the team member own the fix.

Signs it is working

As your practice becomes more octopus-like, you will notice practical changes:

• Fewer interruptions during patient care, and questions get answered within the team.
  
  
• Faster problem resolution, issues are handled at the source, not escalated by default.
  
  
• More consistent patient experience, scripting, and standards are owned and reinforced.
  
  
• Better numbers, because leaders watch their scorecards and improve their systems.
  
  
• More energy, you spend your attention on dentistry, vision, culture, and coaching.

A decentralized practice is still doctor-led. Leadership is shared among team members. When your team can act with you, your practice becomes easier to run, grow, and enjoy.

Not sure where to start? Contact us today!

References

Cheitowskyj, V. (2025, December 18). Effective delegation: Maximizing the skills of your dental team. American Association of Dental Office Management. https://www.dentalmanagers.com/blog/effective-delegation-to-maximize-dental-team-skills/.

Griffin, A. P. (n.d.). Delegation—An important management tool in dental practice [PDF]. Practicon. https://www.practicon.com/content/pdf/resources/3/13-Delegation-An-Important-Management-Tool-in-Dental-Practice.pdf.

Le-Brun, P., & Werner, J. (2025). The octopus organization: A guide to thriving in a world of continuous transformation. Harvard Business Review Press.

Maragliano-Muniz, P. (2024, June 1). It all starts with leadership. Dental Economics. https://www.dentaleconomics.com/practice/article/55040818/it-all-starts-with-leadership.

Reed, P. (2025, July 9). The dentist–manager partnership: The most overlooked key to practice growth. The Profitable Dentist. https://theprofitabledentist.com/the-dentist-manager-partnership-the-most-overlooked-key-to-practice-growth/.

Sanders, E. (2025, May 30). Elevating leadership from the inside out: Why smart dentists invest in their office managers. The Profitable Dentist. https://theprofitabledentist.com/elevating-leadership-from-the-inside-out-why-smart-dentists-invest-in-their-office-managers/.

Spitz, L. (2025, October 28). The strategic partnership: Aligning business and clinical priorities. American Association of Dental Office Management. https://www.dentalmanagers.com/blog/strategic-partnership-aligning-business-and-clinical-priorities/.

Werner, J., & Le-Brun, P. (2025, November–December). Become an octopus organization. Harvard Business Review. https://hbr.org/2025/11/become-an-octopus-organization.