Eruption to Evolution

The conscious leader’s journey through chaos.

By Brad Nelson, Partner & Chief Operation Officer, Positive Impact Dental Alliance

How can we lead ourselves and our teams through chaotic and uncharted times? Effective leadership requires making conscious decisions and adjustments based on changing environments that often look and feel like chaos.  

Surviving the chaos

Six years ago, I lived on the Big Island in Hawaii with my incredible wife and our only son at the time. We moved there a few years earlier to simplify life and spend time together. We owned our home, and we were looking forward to the birth of our second son. 

As we all know, Hawaii is a volcanic island. In 2018 we noticed some earthquakes. Everyone seemed to think it was normal volcanic activity, so we carried on with our lives – but the earthquakes continued, eventually turning into cracks in the ground. Still, official channels told us there was nothing to worry about. 

But the cracks continued to worsen. Then steam started pouring out. Finally, we were two hours from home one day when our phones blew up with the news that lava was erupting in Leilani Estates, our neighborhood. We barely had time to get home, grab a few things, and evacuate. Time stood still. We were in complete and utter limbo, physically and mentally. Officials had the area locked down and we all relied on “lawbreakers” who sent out photos and info about which houses were lost. All my attention and energy were directed at figuring out how to navigate this situation with my very pregnant wife and kid. At moments like this, everything else feels irrelevant. That week was like a delirious dream, scrambling for any solid ground to stand on to figure out what to do. 

In the middle of all this chaos, my wife started having labor symptoms. She was at high risk for a C-section which couldn’t happen locally. After making several phone calls, we booked flights to Honolulu for an appointment with a great OB office that was going to help with the birth and advocate for us with the insurance company. After all that, her labor symptoms stopped after we got to Oahu. But three weeks later, our little Kade Krater erupted into the world. 

During that time, the lava had wiped out large swaths of neighborhoods, and so many favorite places. The destruction was devastating and unavoidable. 

The process of creation is often destructive and can feel chaotic. It’s how everything was ultimately created. I draw a parallel between each layer of a volcano and the various levels of our society and business. As individuals, we exist on the surface, making life’s decisions with limited insight into the forces beneath us. If we do not know what lies below, we can feel like a victim of these changes. This is the state of the world, the economy, and the dental industry. New attitudes, generations, and technologies are pushing their way up. How can we lead our teams, our companies, and (perhaps most importantly) ourselves through such dynamic times?  

Leadership in chaotic times

Our teams may not see the broader industry layers and can feel disoriented when something shifts. Even small changes within our groups or practices, something as simple as a new process, can feel as unsettling as an earthquake, creating friction and disorientation. Our teams may feel shaken by societal trends in employment or attitudes, new technologies, and broader economic factors that challenge our initial assumptions.

The leadership team needs to be prepared to forge a path through the chaos. I propose four essential concepts for the Conscious Leader. These concepts are as interconnected as they are crucial.

Context helps us depressurize the situation and helps our teams understand the bigger picture of what’s going on. Without context, we can inadvertently take too much blame or credit for what’s happening on the surface. A broader context enables us to accept the existing forces so we can direct our energy to adapting, not resisting. 

Clarity. Communicating a clear vision in a way that resonates with and is meaningful to each layer fosters congruence, or alignment, in adapting to the unpredictable nature of change and progress. Clear communication about how your BIG GROUP-LEVEL VISION relates to each practice, doctor, and team member cultivates buy-in and enables them to contribute effectively from their unique positions. Our teams don’t need more pressure; they need clarity. Low context and clarity can lead our teams to take the broader trends too personally or misunderstand your true vision. For instance, Positive Impact Dental Alliance has grown quickly through acquisitions. If my leadership team isn’t communicating where each practice is in our vision, our team members can feel forgotten and uncared for. Communicating that vision with clarity provides context to the team. 

Congruence, or alignment, naturally emerges when context and clarity are present. This alignment empowers your organization to adapt to change. Essentially, you want everyone to be on the same page as far as the mission, vision, and culture of your practice. You want people to feel heard and seen. Everyone can contribute from their individual position working toward a common goal. Congruence replaces friction with unity and understanding. 

Collaboration ties these ideas together. We can’t navigate complex forces when each of us only sees a small slice of the broader pattern. Collaboration is essential at every level. Industry collaboration in groups like the DEO is essential. When I first went to a DEO event, I thought everyone knew something I didn’t. The DEO events helped me understand industry-wide factors, which provided crucial context for my leadership and decision-making. Collaboration is where the real magic happens. 

We are only one small part of much bigger, and deeper, patterns that are moving beneath and around us. Our teams are hungry for leadership and stability. When disruption occurs, do we resent it? Or do we elevate our vision, provide context with clarity, promote congruence, and nurture collaboration?

It was this experience of massive change and disruption that blindsided me, that was my call and invitation to step up, and to adapt and become decisive about the things I could control in the overwhelming midst of factors I could not control to move my family into a period of new creation, born of disruption and destruction. It was out of this period that I landed in Oklahoma, and out of these ashes that our dental group was born.

We have a unique opportunity. We can shape how we, and our teams, navigate the inevitable earthquakes and disruptions, and how these lava flows of new creation solidify into new foundations of our life and industry. We’re shaping the future through how we lead in this turbulent time.


Brad Nelson is an avid adventurer and lover of life. You can often find him with his wife and three sons hunting for bugs, building robots, or enjoying a campfire. For fun, Brad leads Positive Impact Dental, an acquisition-model DSO he co-founded in 2018 with his childhood friend Dr. Loren Israelsen. Together they have completed 34 acquisitions without private equity backing. Leveraging scalable technology with strong operations and 250 amazing team members is the only way this has happened. Brad loves connecting ideas and principles from disparate fields to build high performing teams and organizational systems. What lights Brad up is using technology to work WITH human nature to lead teams and practices through an evolving dental landscape.