© Edgars Sermulis | Dreamstime.com
2002 De Clev P02
2002 De Clev P02
2002 De Clev P02
2002 De Clev P02
2002 De Clev P02

The secrets of the top 10%

Feb. 12, 2020
Practices that have production in the top 10% do certain things differently than most other practices. Over time, these differences allow them to build superior practices that are well run.

Practices that have production in the top 10% do certain things differently than most other practices. Although one might suspect that these practices do many things differently, the truth is that there are only a few things that they do far better than others. Over time, these differences allow them to build superior practices that are well run, and that have low stress levels and high production. The benefit to the doctors is that they reach financial independence approximately 10 to 14 years earlier than the average dentist today.

Understanding the top 10%

During the last 30 years, one of the ongoing research studies by the Levin Group Data Center, the data collection arm of Levin Group consulting, has resulted in a better understanding of the top 10% of practices and how they differ. Our findings show that top 10% practices simply do certain key operations better than others. Their real secret of success is that they do these key operations consistently and continuously, and that builds on itself over time.

Examples of the differences of top 10% practices 

They have a 50% lower patient attrition rate. Most practices lose between 12% and 15% of their patients annually. Top 10% practices lose only 7% to 8%. This allows them to increase their patient base by 70% every 10 years. During a 40-year career, with compounding, a top 10% practice patient base will be almost 400% larger than most other practices. 

They capture more of the new patients who contact their offices. Many practices have 10% to 20% of new-patient callers never make an appointment, and another 10% to 20% never show up for the first appointment. These practices often track the “call—appoint—show—accept” cycle, which means that approximately 98% of new patients who contact top 10% practices will make an appointment, 98% of them will show up for the appointment, and 95% of them will accept recommended treatment. Top 10% practices impart more value in the first phone call creating a stronger bond with potential new patients.

On a scale of 1 to 10, top 10% practices score approximately two points higher on a customer service scale than most other practices. While that may not sound like a lot, it is actually over 20% higher than most other practices, which means that they are delighting their patients with five-star customer service. This has a lot to do with the training and energy of the dental team.

They have higher case acceptance. Top 10% practices consistently and rigorously propose ideal and comprehensive treatment with excellent financial options. This leads to a larger average production per patient annually and a higher case acceptance rate.

Top 10% practices don’t waste chair time. Most practices have a no-show rate between 4% and 6%. Top 10% practices have a no-show rate under 1%. This means that they have 3% to 4% more of their appointments filled over the course of a career, which adds up to a very large factor in their success. Given that unused chair time can never be recovered, top 10% practices simply have far less unused chair time.

Top 10% performing practices have a much higher number of active patients currently scheduled. On average, these practices have approximately 95% to 96% active patients already scheduled for their next appointments. Most other practices range between 85% and 90%. This 10% difference is a major contributory factor for practices in the top 10%.

They set very specific goals and targets and measure them regularly. Top 10% performing practices have an excellent understanding of their performance and take corrective action in areas that are not operating at full capacity. Examples include production, collection, profit, overhead, average production per patient, hygiene statistics, no-shows, and even patient punctuality.

They specifically target a minimum number of new patients per month. Rather than simply analyzing how many new patients come into the practice, they proactively design customer service and marketing plans to maintain a referral pattern that allows them to reach the target number of new patients.

Top 10% performing practices continually analyze their insurance scenario. They understand each plan, the discounts, the value of the plans, the number of patients in the plans, and their effect on the practice. They are willing to add or delete plans each year based on each plan’s contribution to practice profitability.

They attract 45% more family members as referrals from new patients than most other practices. Some top practices have specific programs to do this, and others have an outstanding new-patient entry process.


Top 10% dental practices are not vastly different than other practices. They do not get to this point overnight, and they simply do certain things slightly better than others, but they do these things consistently and this builds over time. These are doctors who opened practices, worked hard at building the practices, and focused on creating well-run and efficient businesses, and through experimentation, education, and consulting were able to put together operational processes at a high level. 

Top 10% practices tend to have larger patient bases, lower patient attrition, higher case acceptance, a slightly higher number of referrals, controlled overhead, and more efficient systems, such as in team training. These are a few of the 25 key factors Levin Group has identified that comprise the secrets of top 10% practices.  

Editor’s note: Data and statistics used in this article are gathered from Levin Group Data and Analysis.

ROGER P. LEVIN, DDS, is the CEO and founder of Levin Group, a leading practice management consulting firm that has worked with over 30,000 practices to increase production. A recognized expert on dental practice management and marketing, he has written 67 books and over 4,000 articles, and he regularly presents seminars in the US and around the world. To contact Dr. Levin or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit levingroup.com or email [email protected].