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What Level IV leadership is and why you want to achieve it

Jan. 1, 2008
“The most dangerous leadership myth is that leaders are born,” according to management guru Warren Bennis.

by Roger P. Levin, DDS

“The most dangerous leadership myth is that leaders are born,” according to management guru Warren Bennis.

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Truer words were never spoken. Leadership is not bestowed upon an individual by a mentor. Nor is it genetic. Leadership is a skill that can be learned. There are no particular prerequisites — it simply takes knowledge, practice, and desire.

Leadership and dentists

You have probably read many leadership articles, and felt many of these articles weren’t realistic for dental practices. All of the success stories cited are a wonderful reference if you happen to be a Fortune 500 executive with 10 assistants and 15 vice presidents to carry out your every command and implement all of your ideas.

Then, there is your reality. Dentists are not Fortune 500 CEOs with vast corporate resources. To overcome this disparity and discover the life-changing advantages available to a skilled leader, let’s look at the characteristics of leadership.

The five levels of leadership

Levin Group emphasizes a life-changing leadership principle in many of its management-consulting programs, specifically a concept called “Level IV leadership.” While there are five levels of leadership, Level IV should be the objective for every dentist. Let me explain why.

Recognizing your current level and what it takes to proceed to the next level will make a tremendous difference in your practice and your life. I have not met one dentist yet who has worked to become a Level IV leader and failed to benefit significantly — be it personally, professionally, or financially. Effective Level IV leadership is practice and life-changing. Let’s take a closer look at each level of leadership:

Level I — Start

Level I leaders are new in practice. Their energy is boundless and they can barely contain their excitement. They want to finally get out of school, do what you have learned, and earn an income. But they have limited experience owning and operating a practice, managing a team, and implementing documented systems. This leadership phase usually lasts one to three years.

Level II — Competence

At this level, doctors no longer have to think as hard about each procedure. They can perform many of them routinely without a great deal of mental stress or energy. They know how to hire a staff and their offices have developed a routine. The competence that has been developed by these professionals allows them to perform well. Reaching Level II is generally automatic for most professionals.

Level III — Maximum work

Level III usually begins around the fourth or fifth year of practice. In this phase, the practice is very busy, the schedule is booked out weeks in advance, and the doctor is making a reasonable income. Reaching Level III is a goal for every young dentist in practice. The thing to remember is — and this point must be distinctly understood — you do not want to stay there!

Why shouldn’t dentists stay at Level III? Because they are likely doing far too much work to keep their practices on track. A great deal of the doctor’s time is not spent chairside (as it should be), but on administrative and business issues. Gradually, Level III becomes a highly inefficient way to practice, disguised by the fact that the doctor is making a reasonable living.

Without exception, Level III will wear a doctor down.The Level III dentist is overworked, frustrated, tired, and stressed. Often, team members do not function well under a Level III leader, further contributing to an underproducing practice. Many dentists in this phase dread going to the office each day, and a few even consider leaving the profession altogether. In short, Level III is a bad place to be.

In nearly every case, the dentist finds that the business side of the practice is making life difficult, not the clinical side. In addition to working too hard, the practice typically produces far below its potential.

Fortunately, there is a way out. There is something better. There can be more fun, more production, greater profitability, and more time to focus on patient care. There can also be a high performing team in place that efficiently operates the practice day-to-day, allowing the entire office to reach its true potential. It’s called Level IV leadership and it’s where every dentist needs to be.

Level IV — Working through others

Level IV leadership is the ideal goal for every dentist. Level IV leaders spend the bulk of their time focusing on what they do best. Level IV dentists focus 98 percent of their daily time and energy on patient care, while everything else is handled by team members. Many dentists are involved in some activities simply because they have always done them or because they have not considered letting others take over these tasks. Level IV is about giving away responsibilities to people you trust to complete them — without your involvement. Otherwise, there is still a great deal of mental energy expended on tracking, following up, and wondering if tasks have been completed.

At first, it seems daunting or even scary to give away certain tasks that you have always done. “Why wouldn’t I do this myself?” and “Why would I pay someone else to do this?” are two common objections. Does a star baseball pitcher sometimes play left field because he feels he could do a better job of it? No! For the same reason, dentists shouldn’t do what can clearly be accomplished through others. Being a dentist is about providing patient care, not getting bogged down with administrative and other tasks that should be the responsibility of others.

The fastest way to achieve Level IV leadership is for dentists to select key advisors who can work with their team and their practice to reach this goal. Dentists should consider using a variety of advisors, such as accountants, lawyers, recruiters, and consultants to achieve practice and life goals. After all, the right advisors possess the experience and expertise to keep doctors from making mistakes or postponing key activities that set them back in their practices and their lives.

Be aware that transitioning to Level IV leadership is not an immediate process. If team members are to take on more responsibilities, they must be able to rely on effective systems and be trained in those systems. Invariably, systems used by Level III leaders are outdated and ineffective. A doctor cannot move to Level IV leadership until these issues are resolved.

Level V — Strategic

Level V is not particularly suitable for dentists. It applies more to people such as CEOs of Fortune 500 companies. These people are surrounded by administrative staff (and hundreds of others in a support capacity). Unlike dentists, CEOs rarely are the ones who do specific work within the company. As the practice owner and main producer, you don’t have that luxury. That’s why Level IV leadership is the ideal level for dentists.

What level leader are you?

Evaluate yourself and your practice. What level leader are you? The majority of established dentists will find that they are at Level III and have been there for quite some time. The cumulative effect of remaining at Level III can be debilitating. At Level III, doctors become more and more involved in making sure everything in the practice happens, and as a result, they become overwhelmed. Production growth is slower, and profitability does not allow them to reach financial independence at a reasonable age. To move beyond Level III and reach Level IV, dentists may need to call on the services of advisors to help them unleash their potential.

Level IV leadership is the ideal to which you should aspire. You get to do more of what you love. It also happens to be the most productive and profitable activity in which you can engage. Everything else is about what you enjoy — your family, hobbies, friends, or personal interests. Becoming a Level IV leader can turn your practice and your life around in a very short period of time.

DE® readers are entitled to received a 50 percent courtesy on a Levin Group Practice Analysis Program, an in-office analysis and report of your unique situation. To schedule the next available appointment, call (888) 973-0000 and mention “Dental Economics®” or e-mail [email protected] with Dental Economics in the subject line.

Roger P. Levin, DDS, is founder and CEO of Levin Group, a leading dental management consulting firm that is dedicated to improving the lives of dentists through a diverse portfolio of lifetime services and solutions. Since the company’s inception in 1985, Dr. Levin has worked to bring the business world to dentistry. Levin Group may be reached at (888) 973-0000, or at

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