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The hybrid model is gaining traction because it reduces execution volatility and protects continuity when local capacity fluctuates.

On a typical Monday morning in a multi-location dental organization, the pressure shows up in small, familiar ways. Phones back up. A patient wants to reschedule because childcare fell through. Another asks what their insurance will cover. A third calls again because a message from Friday still has no response. At the same time, hygiene openings appear, the schedule starts to drift, and the front desk tries to keep pace while handling walk ins, check ins, and provider requests.

Multi location dentistry struggles when execution varies by location, shift, or the individual who happens to be on the desk that day. For DSOs, this variability shows up on the P&L through overtime, schedule holes that reduce production, lower conversion when follow ups slow, and AR aging when claims and patient billing work is not executed consistently.

When responsiveness drops, patient intent cools. When claims and patient billing work ages, cash flow becomes less predictable.

Heading into 2026, many DSOs and practices are operating under persistent pressure. Labor volatility continues. Operating costs rise across wages, benefits, technology, rent, and supplies. Reimbursement adapts slowly. In that environment, instability becomes expensive quickly, and it shows up in patient access, schedule integrity, and the consistency of experience across locations.

Hybrid operating models are gaining traction because they address this reality directly. They create continuity when local capacity fluctuates, and they let organizations scale while protecting the patient experience.

Hybrid operations are becoming dentistry’s default risk strategy

Many leaders first encountered hybrid staffing as a response to hiring friction. In 2026, the more useful frame is risk management.

The sequence is consistent across organizations. Slow inbound response leads to missed appointments and lost patients who never convert. Unworked voicemails create a silent backlog. Delayed follow ups reduce case acceptance. Gaps in eligibility and benefit prep turn financial conversations into rework. Incomplete claim touchpoints and billing updates increase friction and extend the time between care delivered and cash collected.

Overtime rises when teams have to clear backlogs after hours. Schedule holes widen when recalls and short notice backfills are not worked consistently. Delayed responses reduce conversion because patient intent cools before the next step is set. When claim touchpoints and patient billing follow through vary by site or shift, AR ages and cash becomes harder to forecast.

During check in peaks, calls roll to voicemail and callbacks slip to the end of the day. A queue owner works callbacks continuously and keeps same day closure realistic. Recall outreach runs on a set cadence and backfills short notice openings. Eligibility is verified before the appointment, reducing day of rework and avoidable reschedules.

Hybrid operating models reduce this exposure by creating redundancy and steady execution for workflows that should not depend on a single location’s staffing stability. The practical definition is straightforward: hybrid operations split execution across local teams and remote support so critical administrative workflows continue with consistent ownership, even when local capacity fluctuates.

That shift matters because it changes the executive question. Leaders stop asking how to cover an understaffed desk and start asking which workflows must stay stable for the organization to hit its goals. In practice, those risks usually show up in a few domains:

Patient access risk: responsiveness, routing, and closure of inbound requests
Schedule integrity risk: confirmations, short notice backfills, recall reactivation
Financial readiness risk: eligibility preparation, documentation, pre appointment clarity
Cash flow risk: claims touchpoints, billing follow through, aging reduction
Brand risk: inconsistent communication that erodes trust across locations

COOs see hybrid as a way to reduce firefighting and make execution repeatable across sites. CFOs see it as a way to reduce volatility that erodes margin through overtime, inefficiency, and missed production. Investors see a more scalable operating system with lower key person risk, clearer governance, and fewer performance swings tied to local staffing luck.

Hybrid supports scale without diluting culture or patient experience

Experienced operators hesitate for a reason. They have seen implementations that feel transactional. They worry patients will sense distance, and they worry culture will erode when work gets distributed.

If remote support is bolted on without standards, context, and clear ownership, patients experience handoffs, inconsistent answers, and slow resolution.

Patient experience is shaped by responsiveness, clarity, and follow through. When calls go unanswered, when questions take days to resolve, and when the same patient has to repeat information because accountability is unclear, the experience feels careless even when the team cares deeply.

Hybrid can protect the human experience when leaders treat culture as a design constraint and build guardrails that keep communication consistent and ownership clear. The guardrails are operational:

A single standard for communication tone and empathy, supported by training and review
Closed loop handoffs, with explicit ownership and definitions of done
Location context embedded into workflows, including scheduling rules, provider preferences, and payer patterns
A quality cadence that reinforces consistency, judgment, and escalation accuracy

A patient deciding whether to schedule treatment does not evaluate your internal structure. They evaluate whether someone answers quickly, explains clearly, and follows through reliably.

Hybrid can improve culture at the location level. When the front desk is no longer buried under accumulated follow ups and unresolved tasks, the team has capacity for higher quality in person interactions. Check ins become calmer. Conversations become less rushed.

Problems get handled with more patience.

What hybrid workforce changes for a practice: clarity of work, ownership, and continuity

These guardrails only work when leaders define which work requires local context and which work benefits from consistent execution.

Some work is real time and relationship heavy. It depends on local context and judgment in the moment. This includes sensitive patient situations, dissatisfaction escalations, and complex scheduling decisions. These interactions benefit from local proximity and situational awareness.

Other work is repeatable and process heavy. It benefits from specialization, steady capacity, and consistent closure. This is where hybrid models tend to create continuity without compromising care. Examples include follow ups on unfinished treatment plans, recall and reactivation outreach, confirmations, eligibility and benefit preparation, claims touchpoints, patient billing updates, and administrative tasks that otherwise consume front office attention.

Reschedule requests are captured and worked using the location’s rules, with exceptions routed to a named local owner. Recall outreach continues until a clear outcome is recorded. Benefit details are verified and documented before the day of care.

The operating requirement across both categories is clarity of ownership. Each workflow needs:

An owner responsible for closure
A definition of done that is visible and measurable
An escalation rule that routes high context issues to the right local leader or clinical team
A feedback loop that reinforces quality and consistency

Without these elements, distributing work increases coordination cost and creates patient facing confusion.

In my work with DSOs through Reach, the inflection point tends to occur when leadership stops treating these workflows as optional tasks handled between interruptions and starts treating them as core operational infrastructure tied to production and patient trust.

Leaders can evaluate progress through operational signals that indicate continuity is improving:

Faster responses to inbound requests, with clearer closure
Shorter follow up completion windows, with fewer aging items
More stable schedules, with fewer last minute holes tied to unworked recall and backfill activity
Better readiness before appointments because eligibility preparation and documentation happen consistently

The executive lens: adopting hybrid with discipline

Hybrid efforts disappoint when leaders treat them as staffing changes. The execution exposes ambiguity in ownership, standards, and escalation pathways that has often been tolerated because local teams have carried the burden through effort and overtime.

A disciplined adoption starts with three executive decisions.

Decision 1: Define what must remain local because it carries the relationship

Leaders need to identify the interactions that require local context and should not be optimized purely for speed. This includes sensitive situations, complex scheduling decisions, dissatisfaction resolution, and care coordination that relies on clinical judgment. These moments require clear escalation rules so remote teams can route issues quickly and consistently.

Decision 2: Define what must be standardized because variability is too costly

Leaders should identify workflows where inconsistency quietly erodes performance: inbound responsiveness, follow up closure, recall reactivation, eligibility preparation, and revenue cycle touchpoints that affect patient billing and collections.

Standardization in this context creates predictable execution, clearer ownership, and consistent patient communication.

Hybrid supports this decision by enabling specialization and steady capacity for repeatable workflows, which helps the organization maintain continuity even when staffing fluctuates locally.

Decision 3: Define what success looks like in 90 days

Hybrid should be evaluated through leading indicators that reflect continuity, not through activity counts. The scorecard will differ by organization, but it should answer a practical question: are critical workflows closing faster and more consistently, and is that consistency translating into schedule stability and fewer patient access failures?

Examples include response timeliness, follow up completion windows, readiness before appointments, and measures of schedule volatility that tie directly to patient access and recall performance.

From there, expansion becomes a controlled choice. Leaders can start where fragility is highest, prove improved continuity, then extend the model across sites with clearer standards and governance.

Hybrid operating models are becoming common across dentistry. They help organizations maintain continuity under structural pressure, protect patient experience through clearer ownership and standards, and support scale without relying on ideal staffing conditions.

These three decisions turn hybrid into a governed operating model with clear accountability. For executive teams, the practical test is whether patient access and revenue workflows hold steady when a location is short staffed or volume spikes, without forcing overtime or last-minute schedule moves. Prioritize the workstreams creating the most volatility in production and cash forecasting, then use a 90-day scorecard to confirm closure and handoffs are consistent. If those indicators improve, expanding the model becomes a scaling decision.

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About the author:

Cory Pinegar is the CEO of Reach, a fast-growing company redefining virtual staffing for dental practices across the U.S. Since acquiring the company at 22, he has scaled Reach to support thousands of clinics while cultivating a culture of clarity, accountability, and purpose. A passionate advocate for sustainable growth and human-first leadership, Cory also serves on the boards of Veriffic and the Parkinson’s Foundation.

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