Being present

I’ll never forget the moment my wife Jamie looked at me and said, “Josh, you’re complicating things. And just so you know — nobody really wants to go see you.” That stung. She was right, but it wasn’t about me. 

I’d built a thriving practice, but in the process, I’d missed teaching my son, Luke, how to tie his shoes. I’d been running so hard — chasing production numbers, stacking schedules, playing whack-a-mole with daily decisions — that I’d lost sight of what mattered most. I was caring for patients in the noun sense, delivering the standard of care. But was I truly caring for them in the verb sense? Was I giving them a human experience where they felt seen and heard?  

The answer was no. And I wasn’t showing up for my family either. 

This winter issue arrives at a time when many of us are reflecting on what we want for the year ahead. More time. Less stress. Better relationships. These are necessities, not wishes. The gift of time is the most precious gift we can give ourselves, our teams, and our patients. 

You don’t have to choose between a thriving practice and a thriving life. But you do have to change your mindset. You have to shift from a 2x mindset — doing everything yourself — to a 10x mindset, empowering your team with high trust, high autonomy, and high accountability. It means building systems that eliminate decision fatigue so you can be present for the vital few things that matter, rather than drowning in the trivial many. 

My father taught me how to truly care for people by taking action. His lessons transformed how I think about patient care. When we leverage technology and systems to handle the routine aspects of care, we create space to connect with patients on a human level. We give them real-time communication, personalized attention, and we give them their time back too. 

Think about the working parent who takes PTO, rushes to pick up their child from school, speeds through yellow lights to make it to your office, sits in the waiting room, and then gets a 10-minute color change before rushing back. What should have been a 30-minute appointment just consumed 2 hours of their day.  

I encourage you to ask yourself: What do you want more of? What do you want to be better? Your answers will guide you toward the changes that matter. 

The orthodontic profession is at an inflection point. We have access to incredible technology, streamlined systems, and educational opportunities that our predecessors could only dream of. But, will we use these tools to do more and run faster, or will we use them to create space for what matters most — being present with our patients, our teams, and our families? 

This winter, I challenge you to look in the mirror and ask: Am I building the practice I want, or am I building the life I want? Because you can have both, but you have to commit to making necessary, and sometimes uncomfortable, changes.   

Your patients want to feel valued. Your team doesn’t just want a paycheck — they want ownership and purpose. And you want to know you’ve made a difference, without feeling like you left everything you had on the clinic floor. 

It’s about everyone you serve — and making sure you have enough left to serve yourself too. That’s how we do more with less, but better. 

Here’s to being present this winter, in every sense of the word.