Verdict

I welcome any suggestions or advice regarding my situation. My dad runs a dental group of four clinics. We have a CEO, and I assist her in an operational and analytical capacity. The clinics offer a full range of dental services except for complex oral and maxillofacial surgery. Clinically, the team is strong - this is partly subjective, but we have a loyal patient base, and every friend or acquaintance I've referred has been satisfied with their treatment. My concerns are not about dentistry itself, but rather about how the business is managed and scaled. From a financial perspective, I believe we carry a relatively high overhead, with net profit margins of roughly ~10% of revenue. Here's the breakdown of our expenses: Category % of the total Instruments 1.05% Materials (crowns, implants, braces, etc.) 16.25% People (salaries, learning, events) 68.07% (salaries are 67.38%) Rent (one of the locations is rented) 5.94% Utilities (water, electricity, etc.) 0.8% Hospitality (tea, coffee, etc.) 0.3% Small supplies for office/clinics 0.55% Legal and insurance consults 0.07% Other equipment & repairs 0.61% Software and IT 0.24% Logistics, internet, phone lines, etc. 1.29% Marketing 1.71% Other 3.12% A major challenge is our IT infrastructure. We have our own dental practice management system, which technically covers all operational needs, but it is extremely outdated - written in Delphi, which is essentially obsolete today. As a result, integration with modern tools is very difficult. Our database is based on an early-2000s MySQL structure, and much of it appears to have been developed without consistent standards. There are around 170 tables with inconsistent or meaningless naming conventions - for example, 30 tables simply named c1 to c30, each containing unrelated data. Column names are often non-intuitive, and even basic references are confusing; for instance, clinic identifiers are stored as arbitrary numbers like 65 or 32 instead of readable labels. Operationally, we currently rely on one software engineer and one hardware technician. The software engineer continuously maintains legacy systems and is effectively on call at all times - for server outages or urgent issues - which limits his ability to develop improvements that could significantly increase efficiency. I have suggested hiring part-time support to reduce his workload and accelerate development, but this was declined due to budget constraints. Marketing is another major bottleneck. Our marketing manager is experienced but quite resistant to change and tends to dismiss new initiatives early. As a result, we lack end-to-end marketing analytics and cannot reliably measure return on ad spend. We also use a single long-standing phone number that has been active for decades and is expensive to maintain. However, leadership is reluctant to adopt call tracking numbers, which limits our ability to attribute patient acquisition to specific channels. As a result, while we have a strong and loyal base of returning patients, the flow of new first-time patients remains relatively low. The CEO is the only person with full responsibility for business performance and receives a share of profits, but much of her time is consumed by administrative burdens such as regulatory compliance, data protection requirements, budgeting, and tax-related changes. Despite multiple attempts on my side to propose improvements, most ideas are either rejected as unnecessary or considered outside the current budget. Some of the initiatives I have suggested include: A full redesign of our website, which is significantly outdated and difficult to navigate More modern marketing approaches, including proper UX and conversion-focused design rather than cluttered layouts with excessive CTAs Introduction of offline advertising with trackable QR codes and call-tracking numbers (e.g. subway ads, outdoor placements, gyms) Implementation of structured KPIs to monitor marketing performance and operational efficiency Development of procedure-specific landing pages to improve conversion tracking and lead quality However, there is a recurring decision-making pattern where approaches are evaluated based on whether "everyone else is doing it" (then it is considered safe) versus "nobody else is doing it" (then it is considered risky or unnecessary). For example, when I proposed procedure-specific landing pages, the response was that "it hasn't worked for anyone I know," despite broader industry evidence suggesting otherwise. I have also spoken with multiple marketing agencies, most of whom argue that our current advertising spend - especially on contextual and targeted ads - is insufficient for a large metropolitan market. They estimate that increasing spend by at least ~30% would be necessary simply to maintain visibility, as our current presence is effectively diluted in a large city. The company itself is about 30 years old and has a strong, loyal patient base, but we are not generating enough new patient inflow relative to our potential and marketing efforts. Dentists are compensated at around 20-25% of revenue, with top-performing specialists earning more. Overall, I believe the core issue is not clinical quality or demand, but the lack of modern data infrastructure and decision-making based on measurable performance metrics. My father is an excellent clinician with strong intuition, but the business side currently lacks reliable data and analytics, largely due to outdated systems and fragmented information. On a broader level, dental marketing here can be quite aggressive. In some cases, patients see one price online but encounter additional fees once they arrive at the clinic. Since they are already there, a significant percentage agree to proceed with treatment. We do not use this approach. Another issue that frustrates me is the number of conferences, webinars, and dental consultancy programs the CEO attends, many of which seem heavily focused on selling products or promoting their own services. For example, the CEO once enrolled both herself and me in a dental finance course. Out of the session: ~50% was promotional content and product marketing ~30% was advertising their future webinars and consultancy services ~20% contained actual useful material Even basic concepts like the PnL statement, balance sheet, and cash flow statement were presented as if they were newly discovered ideas. When I raised these topics previously, they were dismissed somewhat jokingly, as if I was "just a 30-year-old boy", who knows nothing of the industry. The homework assignment made this even more striking. They asked participants to calculate monthly revenue by treatment category and send it to them for "evaluation" - presented as if it were an analytical exercise. Without any hesitation or apparent irony, they also advertise that they operate dental clinics in several towns themselves, which makes the whole setup feel even more questionable, so you basically feed your own internal data to them. It's striking how easily these things are accepted at face value, despite their limited practical value. Recently, my dad had a key realization: there are hundreds of clinics offering similar treatments with similar materials. The real question is how to differentiate. However, he has no idea about branding and positioning. So I don't even know what to say really, who's insane here me or them?