By Jill Allen | Hey Docs! Podcast with Drs. Tanner and Sarah Clark
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There is no single path to building a successful orthodontic practice.
Some doctors start from scratch. Others acquire an existing practice. Some take on multiple locations. And occasionally, two orthodontists decide to build the whole thing together while also navigating marriage, family, and life outside the office.
Drs. Tanner and Sarah Clark have experienced a little bit of all of it.
In this episode of the Hey Docs! Podcast, Jill Allen sits down with the husband-and-wife team behind Clark Orthodontics to talk about their journey from military dentistry to practice ownership, including a startup in North Liberty, Iowa, and an acquisition in Muscatine.
Their story is not about everything going according to plan. It is about learning how to divide responsibilities, trust each other's strengths, adapt when circumstances change, and continue building a practice that works for their team, their patients, and their family.
Being married does not automatically make two people great business partners.
Like any partnership, it requires clarity around roles, responsibilities, expectations, and decision-making.
One of the strengths Tanner and Sarah developed was understanding where each person could contribute most effectively. Sarah gravitated toward the clinical side of the practice, while Tanner took on more of the administrative responsibilities.
That division allowed each of them to focus on areas that played to their strengths instead of trying to split every responsibility evenly.
For practice partners, this distinction matters.
Fair does not always mean 50/50 on every task. A strong partnership is about creating clarity around who owns what and trusting that person to do their job.
When every decision requires both partners to be equally involved, the partnership can actually create more complexity. When each person has defined areas of ownership, the business can move more efficiently.
JA&A Insight: Strong partnerships are not built by dividing every responsibility equally. They are built by clearly defining ownership and trusting each person to lead in their strongest areas.
The Clarks have had the opportunity to experience two very different approaches to practice ownership.
They built a startup in North Liberty while also taking on an established practice in Muscatine.
A startup gives owners the opportunity to create systems, culture, technology, and patient experiences from the beginning. An acquisition comes with something very different: history.
There are existing patients, team members, workflows, expectations, and ways of doing things.
That means an acquisition cannot always be transformed overnight.
At the Muscatine location, the Clarks inherited systems that needed to evolve, including a transition from paper records to a more digital workflow. Rather than expecting everything to change immediately, they approached improvements over time.
That patience is important.
When taking over an established practice, owners need to determine what truly needs to change, what is already working, and how quickly the team can realistically absorb new expectations.
Change may be necessary, but the pace and communication surrounding that change can determine whether the team embraces it or resists it.
Practice ownership comes with surprises.
Even with strong preparation, owners will eventually encounter circumstances they could not have predicted.
For the Clarks, that included navigating an acquisition, team turnover, operational changes, and the disruption of the pandemic.
Those experiences required them to adjust rather than cling to the original plan.
That is an important lesson for any practice owner, but particularly for doctors early in ownership.
A difficult season does not necessarily mean the practice is failing. Sometimes it means the business is changing.
Team turnover can create an opportunity to reconsider roles. A system that stops working can force the practice to build something better. An unexpected obstacle can reveal a weakness that might otherwise have gone unnoticed.
The goal is not to avoid every challenge.
It is to build a practice capable of responding when challenges arrive.
Updating technology or introducing a new process may look straightforward on paper.
The harder part is often helping people change with it.
As the Clarks evolved their practices, they focused on training their teams and creating clearly defined responsibilities. That gave team members an opportunity to understand what was changing, what was expected of them, and where they fit within the new system.
This is one of the most important pieces of change management in an orthodontic practice.
A doctor may understand exactly why a new system is necessary, but the team experiences that change differently. They may be wondering whether their job is changing, whether they will be able to learn the new process, or whether the old way was actually working just fine.
Leadership has to bridge that gap.
Explain the reason for the change. Provide the training necessary to succeed. Define ownership. Then give the team enough time and support to build confidence.
JA&A Insight: Installing a new system is the easy part. Creating team buy-in, accountability, and consistency around that system is where leadership matters.
One doctor can only be in so many places at once.
Two doctors still have limits.
As a practice adds patients, team members, and locations, owners have to become increasingly comfortable allowing other people to take ownership.
The Clarks' experience across two practices highlights why delegation becomes so important as complexity increases.
Owners cannot personally oversee every detail and still have the capacity to lead strategically, provide excellent clinical care, and maintain a life outside the practice.
That requires capable team members with clearly defined roles.
Delegation does not mean lowering expectations. It means creating expectations that do not require the owner to personally execute every task.
When team members understand what they own and have the training and authority to manage it, the practice becomes stronger and less dependent on any one individual.
There will always be another goal.
Another location. Another production target. Another project. Another opportunity to improve.
But success becomes difficult to enjoy if everything outside the practice is sacrificed to achieve it.
Sarah's advice to younger orthodontists is an important reminder not to lose sight of personal life while pursuing professional success.
That can be particularly difficult during the startup and early ownership years when there is always something else that could be done.
Balance will not look the same in every season, and it does not necessarily mean creating a perfect separation between work and home.
It does mean being intentional about what you are building.
The practice should ultimately support the life you want, not become the only thing you have time to live.
One of the most valuable lessons from Tanner and Sarah's journey is that there is no universal formula for practice ownership.
They have navigated military careers, a startup, an acquisition, two locations, marriage, family, changing technology, and team transitions.
Their model does not have to become someone else's model.
That is the point.
Practice owners should be willing to learn from other doctors without assuming they need to copy them.
The right systems, roles, technology, locations, and leadership structure should reflect the goals of the owners and the needs of the practice.
Even the Clarks' ideas for the future, including the possibility of integrating daycare into an office environment, reflect that willingness to reconsider what a practice can look like.
Innovation does not always mean adopting the newest clinical technology.
Sometimes it means questioning the assumptions that have shaped how orthodontic practices have traditionally operated.
Yes. A husband-and-wife team can successfully own and operate an orthodontic practice when responsibilities, expectations, and decision-making roles are clearly defined. Successful partnerships also require communication and trust in each person's areas of ownership.
Responsibilities should be divided according to each partner's strengths, interests, and expertise rather than attempting to split every task equally. Clearly defining ownership of clinical, administrative, financial, and leadership responsibilities can reduce confusion and improve accountability.
A startup allows the owner to establish systems, technology, culture, and workflows from the beginning. An acquisition includes existing patients, team members, processes, and expectations, which may require owners to introduce changes more gradually.
Practice owners should first understand the existing systems and team before deciding what needs to change. Clear communication, thoughtful pacing, team training, and defined responsibilities can make transitions easier to implement and sustain.
As patient volume, team size, or the number of locations increases, owners cannot personally manage every responsibility. Effective delegation creates accountability throughout the team and gives doctors more capacity to focus on clinical care, leadership, and strategic decisions.
Balance begins by defining what success should look like both professionally and personally. Building capable teams, delegating responsibilities, creating strong systems, and setting boundaries can help owners grow the practice without allowing it to consume every part of their lives.
There will always be challenges in practice ownership.
The team will change. Systems will evolve. Technology will advance. Plans will get disrupted.
The goal is not to build a practice where nothing ever goes wrong.
It is to build one that can adapt when things do.
For Tanner and Sarah, that has meant trusting each other, leaning into their individual strengths, developing their team, embracing change, and continuing to redefine what they want their practices and their lives to look like.
That may be the bigger lesson for any orthodontist building a practice.
Success is not about following someone else's blueprint perfectly. It is about building a practice that can grow, change, and continue working for the people inside it.