Transform your practice and increase production

Oct. 18, 2013
With three out of four dental practices reporting declines during this recession, many dentists are wondering how they can regain their momentum, while others are simply waiting for conditions to improve.

by Roger P. Levin, DDS

With three out of four dental practices reporting declines during this recession, many dentists are wondering how they can regain their momentum, while others are simply waiting for conditions to improve. Unfortunately, wondering and waiting will not slow their losses, let alone relaunch their practices on a growth trajectory. To achieve a high level of success, dentists must seek ways to transform their practices as quickly and intelligently as possible.

Based on our experience increasing production for thousands of dental practices, Levin Group understands exactly what doctors must do to adapt their businesses to the realities of the new dental economy. Each practice has its own particular needs, but three broad and powerful concepts stand out:

  1. Innovative planning
  2. Systematic operations
  3. Extreme delegation

1. Innovative planning: Deciding where you will be

For dentists who opened their practices 30 years ago, the path to future success was clear. Dentistry offered a high level of career predictability. Through efficiency, income and profitability could be increased in most cases, and few doctors in that era were motivated to draw up a strategic business plan.

Now, even moderate success does not come automatically. To grow in the tightening dental market, practices need a smart business plan that includes specific goals and innovative ways to reach them. In effect, the strategic plan defines the new business model for the practice, and should answer such questions as:

  • Who is your market?
  • What should your practice brand be?
  • Will yours be a solo or multi-doctor practice?
  • How many treatment chairs will there be?
  • What services will you provide?
  • What proportion of income will come from each service?
  • Will your practice focus on a particular type of treatment or on patients?
  • How many days/hours a week will the practice be open?
  • What year will you retire?

In addition, your plan of action will benefit from conducting what is known as a SWOT analysis, which identifies internal Strengths and Weaknesses, as well as external Opportunities and Threats. This eye-opening evaluation of where the practice stands is an excellent way to clarify your thinking and help you devise a workable strategy for success. To benefit from it fully, the doctor should perform an annual SWOT analysis to take advantage of new developments.

2. Systematic operations: Defining how it will be done

All businesses have systems -- the defined steps and procedures used to accomplish the many tasks in a day's work. Highly successful companies design and implement efficient systems that streamline operations, improve quality, minimize conflict and stress, and increase productivity and profit. Dental practices should emulate these business models.

Excellent systems should be created to meet the objectives of the strategic plan. A dental practice may ultimately have dozens of systems and subsystems, but dentists should initially concentrate on the following:

  • Scheduling -- This important system serves as the backbone of all daily practice operations. With a well-conceived scheduling system -- including such features as 10-minute rather than 15-minute increments, and procedures for minimizing no-shows and cancellations -- the practice thrives. Production and profitability increase while stress decreases. Patients are more compliant. The work environment improves. The practice becomes more profitable. There are techniques that enable doctors to increase their production time by approximately 32 days per year without working one more hour.
  • Hygiene -- The hygiene department plays several key roles -- building relationships, keeping patients scheduled, monitoring patients' oral health needs, and contributing substantially to overall practice income. The right hygiene system facilitates all these vital functions.
  • Internal marketing -- The new and more competitive dental economy demands a consistent and innovative approach to marketing. This system includes multiple strategies for generating patient referrals and raising the practice's profile in the community.
  • Case presentation -- Rather than merely informing patients about proposed treatment and waiting for them to respond, the most successful dentists script presentations to motivate acceptance. The total system -- covering everything from identifying the patient's need, scheduling the consult, making the case, closing, and follow-up -- is designed to meet specific objectives. These are building trust and value, raising the acceptance rate, and increasing the proportion of elective dentistry performed.
  • Practice financials -- Proper handling of the practice's financial affairs will make a major difference on the bottom line. Issues such as overhead control, investments in new technologies, payroll management, cash flow, debt service, and so on need to be reviewed and addressed systematically.
  • Patient financials -- From financing options to insurance to collections, all aspects of patient finance must be handled in order to receive timely compensation for services while maintaining good relations with patients. Scripting plays a major role in the successful handling of patient financials.
  • Customer service -- Patient satisfaction is a byproduct of excellent clinical care and customer service. Few patients can judge clinical skills, but all are capable of passing judgment on how they're treated. There are two keys to pleasing customers -- one is controlling their experience and making it as positive as possible, and the other is communicating with patients about what happens at the practice. Customer service systems address both with equal care.

Design these major systems, document them in writing step-by-step, and develop scripts to guide staff members in their use. This will put the practice on solid footing for excellent operation and superior results.

3. Extreme delegation: Designating who will do the work

Many dentists confuse being responsible for all practice operations with trying to do it all. They tend to be micromanagers, striving for perfection in administrative matters as they do in clinical performance. This is admirable, but misguided.

As the primary producer and income earner in the practice, the dentist must delegate all nonclinical tasks to staff members. Known as extreme delegation, this approach has a profound effect not only on practice production, but also on job satisfaction, for doctor and staff alike.

Delegation does not mean relinquishing control. How tasks will be handled in the practice is still determined by the practice owner, who has the final say about who does tasks and whether or not performance is satisfactory. The only real difference is that, rather than spending personal time on routine administrative matters, the doctor is caring for patients, i.e., producing income.

For extreme delegation to be successful, an ongoing staff-training program should be in place. This includes:

  • Step-by-step systems documentation -- Generated when practice systems are implemented, this is a written checklist of every step to be taken to carry out an administrative procedure. It serves as the basis for…
  • Scripting -- Essentially translations of the step-by-step directions into conversational guides, scripts show staff members how to communicate effectively with patients. Though they should not be used verbatim, scripts do assure that key points are made and all necessary steps are followed in the proper sequence.
  • Training -- Scripted role-playing should be on the agenda at monthly staff meetings and training days, which can also include presentations by outside experts. Seminars and other training opportunities away from the office are also an important resource for staff development.
  • Performance reviews -- The practice owner should review the performance with each team member at least annually, discussing the employee's strengths and contributions, where improvements can be made, what additional training is needed, and what the individual thinks about practice operations and their career development.


In the face of great financial pressures and increasing competition, dentists whose practices are flat or declining must find ways to transform their approach to the business of dentistry. The old model, successful as it was for so many decades, no longer works. Doctors can reinvigorate their practices with powerful transformative concepts, including strategic planning, systems, and training. These will stimulate growth and reconnect practice owners with their passion for dentistry.

To learn how to run a more profitable, efficient, and satisfying practice, visit the Levin Group Resource Center at -- a free online resource with tips, videos, and other valuable information. You can also connect with Levin Group on Facebook and Twitter (Levin_Group) to learn strategies and share ideas.

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