Management system impact

Feb. 1, 2004
Declining production is an issue facing many practices. This case study describes the situation presented by a dentist enrolled in a Levin Group Consulting Program.

Roger P. Levin, DDS, MBA

Declining production is an issue facing many practices. This case study describes the situation presented by a dentist enrolled in a Levin Group Consulting Program. The practice was facing declining production, demanding specific steps to reverse this dangerous trend.

Situation analysis

This general dentist had been in practice for 14 years with continual growth of 5 percent or more for the majority of those years. In the last three years, he noted a significant slowdown in practice growth with a decline of 3 percent and 5 percent respectively in the last two years. The dentist did not report significantly high levels of stress or staff turnover, and overhead was within normal limits.

Doctor's chief complaint

"I am very concerned about this decline," stated the doctor. "I am already under-funding my retirement program and concerned that I will have to borrow money to meet financial obligations if this trend continues."

Clearly, this doctor had significant lifestyle expenses relative to his income.


Analysis showed that the practice was in danger of continual drop-off. The number of active patients had decreased, likely having switched to doctors who participated in their insurance plans because of economic pressures. No new services had been added in the last three years, and internal marketing was non-existent.

Although this doctor did not have an impending crisis, Levin Group felt this was a serious situation. Any time business begins to show a declining trend, immediate action should be taken to reverse it as quickly as possible.


In any declining trend situation, two approaches must be taken. The first is a short-term solution to halt the decline and the second is a longer-term redesign of all management systems to sustain the gains made. This case study will focus on short-term solutions.

Levin Group recommended the following steps

Active patient records were segmented to determine which patients had visited the practice within the last year, which were overdue for treatment, which had not completed treatment, which were in a phased treatment program over multiple years, which were overdue for hygiene, and which were candidates for additional hygiene services that were not currently provided.

The doctor quickly trained in comprehensive diagnosis and treatment planning. His main approach had been need-based dentistry. After management training, he increased case acceptance by nearly 300 percent and presents patients with more comprehensive care.

Many patients were interested in cosmetic services such as veneers, and also implants. Additional services were added after the doctor completed continuing-education courses. He worked with a specialist to develop an "implant team" approach. The hygienist added several services, including periodontal antibiotic therapy, whitening kit sales, and dispensing Sonicare toothbrushes.

The team was trained on customer service and scripting, allowing the doctor to increase his fees by 7 percent immediately while adding significant value to each appointment. A customer-service system was put in place to create value. Patient customer service surveys reflected this change in the practice.

Financial-arrangement systems were put in place to make comprehensive dental care more affordable.


This doctor was able to reverse his declining trend and increased production during the following 12 months by approximately 17.3 percent. A revenue increase of approximately $85,000 for the practice was realized, exceeding the client's 12-month goal.

I encourage all dentists to have an analysis performed on their practices to identify declining trends. Be certain to factor out fee increases to understand whether the practice is growing simply by those increases or by innovative and proven systematic methodologies.

To secure a reversal of a declining trend, take the immediate steps outlined above, then proceed with a more complete long-term strategy to systemize all aspects of your practice.

Roger P. Levin, DDS, MBA, is founder and CEO of Levin Group, Inc., the leading dental management consulting firm specializing in implementing documented business systems into dental practices. Levin Group is dedicated to improving the lives of dentists through proven dental practice management and marketing consulting programs that help practices reach higher levels of success and profitability. Levin Group can be contacted at (888) 973-0000 or at

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