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High-value strategies for practice recovery

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COVID-19 has changed dentistry forever. And while it may be more comfortable for practices to operate in the same way that they did before the crisis, the businesses that will succeed will be the ones that are able to adapt quickly to new approaches in strategy, financial management and operations. Practice leaders who wait to implement new strategies, systems, scripting and staff training will find themselves falling farther behind and constantly playing catch-up.

History repeats itself

The 2008-2009 recession caused a series of challenges similar to the ones that practices are facing now. According to the Levin Group Data Center (the data collection arm of Levin Group consulting) 91% of practices grew every year prior to 2008. However, during and after the Great Recession, between 2008 and 2012, 75% of dental practices declined. Initially it was thought that these four years would simply be an aberration and that practices would return to the “automatic success” experienced by dentists prior to that recession. Unfortunately this is not what happened.

In 2012, dentistry did begin to grow again but at a very slow rate. Some years practices only experienced growth of 2% or less and this was not enough to compensate for a changing profession that was facing constant competition and financial pressures. The challenges to private practice presented by DSOs, expanded marketing programs by other practices, more expensive technologies and higher overhead costs now resulted in dental practices implementing new systems and strategies.

In 2017 through 2019 the economy roared back and positively impacted the dental industry. This economic boon caused some practices to abandon their new systems and strategies and go back to “business as usual” before the recession. They believed that having ideal systems and strategies in place wasn’t essential because practices were again experiencing automatic success and growth due to an excellent economy. And then COVID-19 hit, and the pandemic hit hard.

Dentists have experienced shutdowns, permanent practice closures, loss of staff, confusion on infection control, schedules overwhelmed with pent-up demand, a low supply of personal protective equipment, and securing loans, some of which must be paid back. Now practice owners are trying to figure out how to implement the best systems that will allow them to recover and operate successfully.

The power of systems

The first step in recovery is to understand that every practice is facing a business turnaround. While this may seem obvious, the first few months of recovery may create an unrealistic impression that it will be easy due to the extreme busyness from pent-up demand. However, after about four months pent-up demand will dwindle and most practices will experience a production decline. We estimate that these declines can be anywhere from 15% to 50%, depending on whether the practice implements new systems, scripting and staff training.

So how can you navigate your practice to a successful recovery? Start with systems. Systems are step-by-step documentation of exactly how the practice will run. Systems have always been the underlying key to dental practice success. The best practices have always had excellent well-defined systems and they will now be essential to their survival and successful recovery.

Keep in mind that although there is much uncertainty, the focus of the systems has not changed. Practice areas such as scheduling, doctor productivity, hygiene productivity, the new patient experience, case presentation, customer service, telephone management, insurance analysis and management and patient flow all need systems that are properly implemented and closely monitored.

Unlike restaurants and retailers, people still see dental practices as essential and most practices will recover. The question is, how successful will your recovery be? By addressing the most challenging time in dental history with the most effective and efficient systems and high-value strategies, practices can not only survive but thrive.

High-value strategies

High-value strategies are hyper-focused on one thing — the recovery. Classic management tactics such as establishing a five-year vision or long-term strategic plan are now unrealistic in these uncertain and unpredictable times. We estimate that this recovery will take about 24 months. during this time practices should create systems that focus on increasing production, revenue and profit to the extent allowed while being respectful of the new COVID-19 office protocols that are now in place. Examples of high-value strategies to support systems during this time include maximizing productive chair time, decreasing no-shows, understanding the value of new patients, scheduling the most productive patients and treatment as quickly as possible, maximizing dental insurance benefits, increasing referrals, streamlining overhead, training staff and measuring practice performance daily and weekly.


The supply and demand of dentists to the population that allowed practices to be successful in the past will not help practices in their recovery from COVID-19. Every practice that stays loyal to effective practice systems, adopts new high-value strategies and uses scripting and staff training will recover successfully.

About the author

Roger Levin, DDS, portrait

Dr. Levin is the CEO and founder of Levin Group, a practice management consulting firm that has worked with more than 30,000 practices to increase production. He has written 67 books and over 4,000 articles and regularly presents seminars in the U.S. and around the world. To contact Dr. Levin or to join the 40,000 dental professionals who receive his Ortho Practice Production Tip of the Day, visit or email