30 years’ worth of data uncovers the truths about practices with high levels of success

By Roger P. Levin, DDS

Over the last 30 years the Levin Group Data Center, the data collection arm of Levin Group, facilitated an ongoing study of the top 10% performing orthodontic practices in America. The objective of the study was to determine if the actions, behaviors, and attitudes of top 10% performing orthodontic practices were reproducible by other practices. The findings have clearly indicated that the same principles and tactics used by top 10% orthodontic practices are all transferable and will help improve performance in almost any other practice. What is also clear is that top 10% practices adhere to these principles consistently, and if your practice wants to experience this same success, you must understand them. 

The Principles

The following principles used by top performing orthodontic practices can be replicated and implemented by all practices who desire to achieve and maintain the highest levels of success. 

1. Superstar performance is a benefit, not a requirement.

If we had found that the principal reason for top 10% performance was that the doctor and staff were simply amazing performers beyond what was possible for most others, then there would be no reason for you to continue reading this article. The analogy that I use in seminars, most recently at the Southern Association of Orthodontists Meeting, is Michael Phelps. Phelps has won more gold medals than any other Olympian. Anyone swimming would think that it would be beneficial to learn from Phelps. But the opposite is true. Michael Phelps is a superstar. All you have to do is look at him to realize that he was built to be a swimming machine. This is not to say that all of Phelps’ success is due to his build. To achieve success, he had to work and train hard. However, without his superstar physical capability he would not have achieved the previously unachievable. So, while Phelps probably can help educate other swimmers, none of them could perform anywhere near his level.

Fortunately, we did not have the same superstar finding for most orthodontists. Yes, there were superstars, but for the most part the doctors that reach the top 10% in orthodontics don’t get there because of some amazing ability. Nor did they get there because they opened in the right location, had the right patient population, had no competition, or any other factor that cannot be reproduced. 

The finding: Top 10% performing orthodontists did not have super amazing abilities or lucky situations.

2. Success doesn’t happen overnight.

Most of top performing practices took anywhere between 5 and 9 years to reach the top 10% from the time that they opened. This is important to note. Practices that reach the top 10% at a highly accelerated pace are aided by other factors. In one case, we found that the orthodontist was able to enter the top 10% within 4 years by spending massive amounts of money on external marketing and advertising. So, while top 10% success was achieved, it was at a very high cost. His overhead was 23 points higher than recommended. This certainly is not the track most other top performers took. In fact, most practices had rocky first and second years before they began to figure out a formula that would work for them. By moving steadily into the top 10% with above average annual growth, they were able to keep overhead relatively under control, manage systems as they grew in order to avoid stress, chaos, and customer service breakdown, and retain a strong core team. In addition, low overhead allowed them to have available funding to invest in different aspects of the practice including new programs, interior design, and technology. By and large, top performing doctors are committed to building strong orthodontic practices, but are well-paced, logical, and thoughtful about their approach.

The finding: Top 10% performing orthodontic practices reach success slowly while maintaining reasonable overhead.

Learn more: Five Things About Top 10% Performing Orthodontic Practices

3. Once at the top, stay put.

Once practices reach the top 10%, they tend to stay there. This is partly due to maintaining the strong foundation they have built over time. They continually expose themselves to new ideas, concepts, programs, and opportunities. This can include clinical, management, and marketing opportunities, team training, updates and upgrades, and new decor or community programs.

The finding: Orthodontic practices that reach the top 10% tend to stay there long-term. They achieve this through a positive focus on continual, but controlled innovation.

4. Long-term staff equals long-term success.

Top 10% orthodontic practices typically have a core team that has remained with the practice long-term. This allows for a high level of knowledge, experience, and stability in the practice. And it didn’t happen by accident. Emphasis on team building by the doctors and practice leaders was evident. There was continual programming in terms of continuing education, team activities, monetary and fun-based bonuses, and true team inclusion in decision making.

The finding: Top 10% performing orthodontic practices often have a core team that contributes to practice knowledge, experience, and stability.

While there were other factors that allowed top performing orthodontic practices to move into the top 10%, the four principles outlined above stood out as Levin Group’s major findings. In the next few articles in Orthodontic Products, I will begin to review many of the specific targets, customer service factors, and behaviors that are part of the findings of the Levin Group’s 30-year ongoing study of top 10% performing orthodontic practices. OP

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 orthodontic practice management and marketing, he has written 67 books and over 4,000 articles and regularly presents seminars in the U.S. and around the world. To contact Levin or to join the 40,000 dental professionals who receive his Ortho Practice Production Tip of the Day, visit levingroup.com or email rlevin@levingroup.com.


We are pleased to announce the launch of the New Levin Group Orthodontic Marketing Program. This breakthrough program includes FIVE FOCUS AREAS—Patients, Parents, Social Media, Referring Doctors, and the Community. 

Levin Group has been the leading orthodontic management and marketing consulting firm since 1985. We have worked with thousands of orthodontic practices. 

If you would like to have a 30-minute discussion about your unique practice situation and how the New Levin Group Orthodontic Marketing Program can benefit you, please visit levingroup.com/orthodontic-marketing-program or contact Angela Pickett at apickett@levingroup.com