The short answer
Pay is the smaller question. Most practices underpay the role because the role was never defined. A practice manager who owns rostering, patient flow, team performance conversations, supplier and cost lines, and the weekly numbers is worth materially more than one who owns admin — and costs the owner far less in unmade decisions.
Owners ask what a practice manager should be paid. The more useful question is what the role is allowed to decide. A manager paid well to execute the owner's decisions is expensive administration. A manager paid well to own outcomes is the single largest reduction in owner dependence most practices can buy.
Why the pay conversation is really a scope conversation
Market rates vary widely by state, practice size and whether the role includes people leadership. That range only becomes meaningful once you can say what the person is accountable for. Write the scope first; the number follows it, and it is easier to justify — to yourself and to them.
Five things a practice manager should own outright
- Rostering and diary design, including how gaps and short-notice cancellations are filled, to a written standard.
- Patient flow and experience from first call to recall, including how complaints are handled.
- Team performance conversations — the routine ones, not just the escalations.
- Supplier relationships and defined cost lines, with a spend limit they can decide inside without asking.
- The weekly numbers: they run the meeting, present the same three measures, and name what they are changing.
What the owner must stop doing
The role fails when the owner keeps a private veto. If decisions inside the manager's scope are overturned in front of the team, the team learns to route around them and the manager stops deciding. Back the imperfect calls publicly and correct them privately, or accept that you still own the job.
How to tell within eight weeks whether it is landing
- The number of questions reaching you inside their scope is falling, not flat.
- They bring you decisions already made with reasoning, rather than options to choose from.
- The weekly meeting runs without you in the room and still happens when you are away.
- At least one problem was resolved that you never heard about until afterwards.
When the current person can't grow into it
Sometimes the honest answer is that the scope has outgrown the person. That is a structural conclusion, not a character judgement, and it is kinder to reach it in eight weeks than in three years. Define the role you actually need, be direct about the gap, and give a genuine, time-bound chance to close it before you decide.
Where this gets solved
Build the leadership layer →Written by
Rhea Jain, founder of Swift Transformations Pty Ltd and owner-operator of a multimillion-dollar Australian dental practice, with a BSc in Psychology and a Master of Human Resource Management.
Last reviewed .