Dr. Marie Alejandrino-Buell redesigned her dental practice by implementing systems, cloud-based technology, and AI to handle repetitive administrative tasks, freeing her team to focus on patient care and allowing her to shift from survival mode to true leadership and personal freedom.
- The core shift: Moved from asking "How do I find the perfect employee?" to "What simply requires consistency?"
- Key changes: Documented workflows, implemented cloud-based technology, hired remote administrative support, and strategically adopted AI for routine tasks
- The result: More time for leadership and patient connection, reduced Sunday night stress, and a team empowered to focus on compassionate care
- The takeaway: Burnout often signals carrying too much responsibility, not lack of capability; systems and technology can free leaders to do what truly matters
Have you ever experienced what I call the “Sunday night shakes”?
It’s Sunday evening, and your phone buzzes. Immediately, your mind starts racing. Did someone quit? Is someone calling out? Is Monday about to fall apart before it even begins?
For years, that was my reality. One Sunday night, it was more than a feeling. I was in a recovery room after back surgery, still groggy and trying to get my bearings when a text came in. My hygienist was quitting. Think about that for a moment: I was in a place where my only job was to heal and my practice still found me.
My name is Dr. Marie Alejandrino-Buell. I’m a first-generation immigrant from the Philippines, a general dentist, and the owner of Dental Designs in Oxnard, CA.
Dr. Marie Alejandrino-Buell.
I’ve spent 34 years in dentistry. I was a dentist in the Philippines for two years before I moved to the U.S. When I arrived, I worked as a dental assistant while I studied for and took the California dental board exams.
Here’s something I want you to know: Not being able to practice dentistry while I took my licensing exams did not take away the title of doctor I earned when I graduated from dental school. A license gives you permission to practice. A degree is something you earn, and no one can take it back. I was still a doctor, and that never changed.
I’ve now practiced dentistry in the U.S. for 30 years and that path taught me every role in a practice. I know the front desk, the chairside, and the behind-the-scenes work that keeps a schedule moving. For years, I believed that was what made a great leader: being able to do everything.
That night in the recovery room, I started to see it differently. I wasn’t leading my practice. I was carrying it.
As dentists, we think our biggest challenge is dentistry. I’ve learned it isn’t. It’s leadership: carrying the responsibility for your patients, your team, your payroll, and your schedule while trying to make everyone else’s lives work, and being the person everyone turns to even when you’re the one who needs support.
My office manager of 18 years had already moved on to a new chapter. Then my hygienist quit. Soon after, my lead assistant and my registered dental assistant left too. The team I had spent years building was suddenly gone.
I want to be honest about what that felt like. I wasn’t burned out from dentistry. I still loved the work: the patients, the transformations, the trust. I was tired -- not because I had stopped loving dentistry, but because I was tired of believing everything depended on me.
In that exhausted season, I realized something that surprised me. I had been dreaming about retirement, but not because I wanted to stop practicing dentistry. I wanted freedom: freedom from the Sunday night shakes, freedom to rest without my phone controlling my peace, and freedom to lead instead of just survive.
Instead of redesigning my retirement, I redesigned my practice.
I stopped asking, “How do I find the perfect employee?” That question kept me chasing something that doesn’t exist, and it kept the whole practice resting on people instead of on a foundation. I started asking a different question: “What requires a human … and what simply requires consistency?”
That question changed everything.
Some work in a practice needs warmth, judgment, and heart. Other work needs to happen the same way every time, such as confirming appointments, following a protocol, answering a call, and keeping a workflow on track.
So we got to work. We built systems and documented our workflows so the knowledge no longer lived in one person’s head. We moved to cloud-based technology, and I hired a remote assistant to handle administrative tasks. Eventually, we embraced AI, not to replace people but to support them.
Technology can answer a phone, follow protocols, and keep things consistent. But it can’t comfort an anxious patient in the chair, celebrate with someone seeing their new smile for the first time, or build trust. Only people can do that.
And that’s exactly the point. When the consistent work is handled consistently, my team is free to do what they do best: caring for people. Today, I have more time to lead my team and connect with my patients, and I’m more present with my family.
I thought I was redesigning my practice. But what I was really redesigning was my life.
People often ask me if I’m worried AI will replace dentistry. My answer is no. What concerns me is leaders who spend so much time doing work that technology can do that they have no time left for the work only leaders can do: mentoring, listening, setting a vision, and building a culture where people want to stay.
So if you’re feeling the Sunday night shakes, hear this: It isn’t a sign that you’re not cut out for this. It may be a sign that you’ve been carrying too much for too long. You don’t have to keep carrying it all.
I didn’t adopt AI because I love technology. I adopted AI because I love people.
Dr. Marie ECS Alejandrino-Buell owns and leads Dental Designs, a wellness dental practice in Oxnard, CA. In 2025, she led the first all-women dentist medical mission to Vietnam with Mommy Dentists in Business and Operation Smile International. Alejandrino-Buell is the 2022 recipient of the Leo Tauber, MD and David Fainer, MD Award for Oral Health Professional of the Year and has served on California Dental Association committees and councils.
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