Regional managers have one of the most critical yet misunderstood roles within a DSO. They bridge the gap between executive strategy and execution at the practice level, ensuring that big-picture goals are carried out effectively across multiple practices.

When an organization has strong regional leadership, practice growth accelerates, culture strengthens, and teams feel empowered. Without strong regional leadership, practices can experience friction and burnout, leading to short-term decision-making. The key difference often comes down to one factor: experience.

The most effective regional managers didn’t start their careers in spreadsheets or boardrooms. They started on the front lines.

At the DSO level, leadership teams are responsible for setting vision, allocating resources, and driving long-term value. At the practice level, teams focus on patient care, staffing, scheduling, and addressing day-to-day problems. Regional managers live in the middle of those two worlds.

This role isn’t about enforcing policies or pushing production targets. It’s about alignment.

Great regional managers understand how corporate initiatives land at the office level. They know which strategies will help practices thrive and which ones will unintentionally hinder their progress. Their job is to translate strategy into action in a way that feels supportive, realistic, and sustainable.

Regional leaders who have worked in practices, whether as office managers, assistants, hygienists, or treatment coordinators, bring a level of empathy that can’t be taught in training sessions. They’ve felt the pressure of a full schedule. They’ve managed staffing shortages. They’ve navigated difficult patient conversations. That experience shapes better leadership decisions.

Instead of asking, “How do we increase production this quarter?” they ask, “What do our offices need to perform at their best?” This mindset shift is critical. When practices feel understood and supported, performance tends to follow naturally.

In many cases, regional leaders who have spent time in a large, fast-paced DSO develop an even stronger foundation on the front line.

That exposure often includes additional knowledge on claims submission, scheduling systems, administrative operations, and the day-to-day challenges of supporting a consistently full patient schedule. That intensity builds real-world strengths: stronger organization, greater efficiency, sharper problem-solving under pressure, and the patience required to navigate difficult patient situations with professionalism and care.

However, some organizations treat regional managers as production enforcers, measuring their success by how hard they push offices to achieve financial goals. While this approach may yield short-term gains, it often comes at the expense of morale, employee retention, and patient satisfaction.

A more effective approach is built on support, not pressure.

Our model positions regional managers to focus on removing obstacles rather than creating new ones, advocating for offices at the corporate level, and coaching practice leaders rather than commanding them.

Within the Operation Dental model, regional managers focus on building reliable systems, ensuring proper staffing, and investing in training to create strong operational foundations. These foundations enable performance metrics to rise naturally, with profitability as a byproduct rather than the primary focus.

Practices don’t push back on leadership because they dislike structure; they push back when they feel unheard.

Regional managers with ground-level experience understand the realities of the practice and speak the same language as the teams they support. Our regional leaders know when to push, pause, and when to elevate concerns. This fosters trust at the practice level, where teams start to view regional support as a valuable resource rather than a threat. Offices become more open about challenges, problems emerge earlier, and solutions are found faster.

As DSOs scale, the need for strong regional leadership only increases. The organizations that win in the long term will be those that view regional managers not as compliance officers, but as partners in practice success.

That starts with who you hire and how you empower them.

Regional managers who have walked in the shoes of the teams they support are better equipped to balance growth with culture, performance with people, and strategy with reality.

Ultimately, the strongest DSOs aren’t built by pushing practices harder. They’re built by leaders who know how to better support them.