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May 2012
Volume 33, Issue 5

Objectively Assessing a Dental Practice

Roger P. Levin, DDS

Many patients do not see the importance and value of 6-month hygiene appointments for maintaining oral health. While dentists may find it remarkable that patients would willingly forego regular check-ups, they themselves may not realize that their own practices also require periodic check-ups. Without an accurate practice assessment, dentists may find it extremely challenging to make necessary improvements.

A national 3-day meeting for chief executive officers (CEOs) featured an executive whose job description was “turnaround” specialist. Hired for no more than 3 years at a time, this specialist works with a distressed company, puts it on a better footing, and then leaves, handing the firm over to a CEO, who continues the work he started.

This executive offered many revealing observations about company leaders. “CEOs tend to make a very common mistake,” he said. “They introduce changes such as reducing expenses, cutting departments, and laying personnel off without first understanding the state of their company. They’re making changes that could be detrimental because they are essentially operating in the dark.”

This statement was an excellent reminder of why analyzing businesses—including dental practices—is so important. Practices that have suffered flat and declining production during the recent recession are very much in need of a “turnaround.” An objective analysis is the first step in this process.

ABCs of Assessing a Practice

Making significant changes can be costly and time-consuming if undertaken without first analyzing the practice. The process begins with an in-depth examination of Key Practice Expanders™, including:

  • new patients
  • average production per new patient
  • percentage of single-tooth treatments
  • need-based versus elective procedures
  • case acceptance rates
  • patient referrals
  • average production per patient
  • scheduling capacity versus actual number of scheduled patients
  • percentage of no-shows and last-minute cancellations
  • collections

When these numbers are examined, a definitive picture begins to emerge that clearly shows where the practice needs to make changes. The list of possible challenges in a practice can be extensive. The recommended way to rectify each issue is to establish performance measurements known as “targets”—such as those that follow—which become an important component of the assessment process.

Undocumented Systems: Many practices have systems that only exist in the minds of long-term team members. When these individuals leave the practice, they essentially take the practice’s unwritten systems with them. The practice may then have extraordinary difficulty trying to train new individuals to fill these positions. With documented systems, new team members have defined responsibilities. As a result, they can be brought up to speed quickly and effectively.

Target: Implement documented, step-by-step systems within 8 months.

An Inefficient Schedule: The practice should run the schedule. Yet, many practices unconsciously allow patients to run it instead. Frequently, patients who insist on a certain day and time for their appointment get it—even if it means others end up being inconvenienced. Late patients and no-shows also add to the problem. Practices need to find ways to guide patients toward appointment times that are more convenient for the practice.

Target: Use effective scripting to increase scheduling capacity by 30% in 6 months.

Few Patient Referrals: Even though patients may be very satisfied with the practice, they usually do not think to refer others unless the dental team specifically asks them to do so. An effective patient referral program should be in place that uses proven strategies such as patient appreciation programs, patient testimonials, brochures, mailers, and messages in patient correspondence.

Target: Increase patient referrals by 30% in 6 months with a comprehensive internal marketing program.

Overdue Collections: In a difficult economy, an increasing number of patients are having trouble paying for treatment. Practices may have accounts that are overdue by more than 30, 60, or 90 days. They should rein in overdue accounts as soon as possible with effective scripting and efficient tracking.

Target: Within the next 5 months, reduce overdue accounts receivable by 20%.

Staff Issues: A smart, well-trained team adds to practice growth. A dysfunctional team detracts from it. There are many possible staff challenges to consider: Are staff members properly trained on all systems? Are they capable of doing what is being asked of them? What additional skills do they need?

Target: Establish training protocols for 100% of team members in the next 6 months.

Challenges into Opportunities

As if these issues were not enough, practices face other challenges. Competitors that did not exist 20 or 30 years ago—such as national dental service organizations—could open a practice in the area. In addition, other practices could be marketing new technologies to attract patients.

A comprehensive practice analysis encompasses many facets, including production numbers, staff evaluation, and doctor leadership. Remarkable growth opportunities exist for practices that understand their challenges and establish appropriate targets as benchmarks for practice growth.


Immersed in the myriad day-to-day needs of practices, many dentists cannot step back and gain a truly objective view of their offices. No matter how hard they try, dentists frequently cannot figure out why their practice is experiencing challenges. Many dentists endure issues for years—sometimes decades—without ever knowing how to solve them. At such times, an outside opinion about practice performance and operations can be the catalyst for meaningful and effective change.

Visit the Levin Group Resource Center at, a free online resource with tips, videos, and other valuable information for running a more profitable, efficient practice. Connect with Levin Group on Facebook and Twitter (@Levin_Group) to learn strategies and share ideas.

Related Content: Learn more about patient communication services at

About the Author

Roger P. Levin, DDS
Founder and CEO
Levin Group
Owings Mills, Maryland

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