There is a point at which the systems you relied on to grow your practice can become detrimental. The key to avoiding this: Recognizing when it’s time to upgrade and update your systems. 

By Roger P. Levin, DDS

Every orthodontist has heard repeatedly about the importance of implementing systems into the practice. But they have not heard about how systems can become a limiting factor in practice growth. The same systems that are excellent at helping you to reach a certain level of production and success eventually become the systems that ensure that you cannot grow any further.

Over the last 37 years, I’ve spoken to hundreds of orthodontists who had grown successfully and then were mystified as to why their practice was in a plateau. In most cases, if they had grown successfully over a period, the main reason for the lack of continuing growth was not recognizing the need to upgrade and update systems.

Understanding Both Sides of Systems

There are two sides when it comes to the word systems. The first side is designing systems that will allow you to reach goals and objectives. When new documented, proven, step-by-step systems are implemented into orthodontic practices, they almost always begin to grow and in some cases dramatically. The three words that I just included in the description are critical.

  • Documented means that the systems can be accessed, studied, and mastered by the current team or new team members joining the practice.
  • Proven means that the practice does not have to waste years of trial and error trying to figure out which systems work. It is also unlikely that most orthodontic practices will identify all the parts and pieces that allow implemented systems to create success. Proven means of these systems already exist somewhere and have demonstrated that they will work in the majority of practices.
  • Step-by-step refers to how the systems are designed. We suggest that they be designed as a step-by-step instruction manual even including the necessary scripting. Step-by-step allowa new team members who join the practice to become trained twice as fast.

The second side of systems is the side that is often unknown or unrecognized by orthodontists. It is when systems have been outgrown and now become just as powerful in NOT allowing the practice to continue to progress or increase production.

When systems are outgrown, they hold a practice back and they do it because the practice is still following the old systems. The reason this is often unrecognized is because there is no comparison of the current systems to new systems that could stimulate growth. The practice continues to follow the old systems day by day and when they are outgrown those systems keep the practice where it currently exists.

Motivating and Training the Team

As much as you might like and enjoy your team, it is important as a leader to be aware that most of the dynamic practice changes will not come from the team itself, but from the leader. In most orthodontic practices the orthodontist is the leader even if there is a strong and skilled office manager. To implement new systems to allow for continuing growth, the practice should develop a culture of continual improvement. How do we improve the scheduling system? How do we get more patients who call the practice for consults to schedule? How do we reduce no-shows? How do we reduce overdue debonds? How do we increase referrals from our referring doctors? All these questions relate specifically to systems.

For example, if a practice is plateaued regarding referrals, it needs to look in several different areas including patients, parents, social media, referring doctors, and in the community. It may be cost prohibitive to attack all these areas from a marketing standpoint all at once. One practice we noted increased referrals from referring doctors by 35% in 6 months. This resulted in adding over $200,000 of revenue within the next 12 months. Another practice launched a high-end social media campaign with excellent results in the first 5 months. Then the results began to diminish which indicated that they needed to identify another focus area. They selected community and became increasingly involved in schools and local sports teams and referrals increased again. Referral marketing is a system like any system and eventually it will plateau if it is not continually updated, replaced, and targeted.

Another great benefit of bringing new systems into the practice is that it will motivate the team. When team members recognize that you are working to improve the practice and provide them the best opportunity to contribute at the highest level, it often challenges them to be their best. The presence of leading-edge systems that are updated and improved on a continual basis is one of the factors to increase staff longevity. Staff longevity has never been more important than it is today as we are facing a staffing challenge in dentistry and orthodontics.

Every practice should have documented, proven, step-by-step systems. The truth is that most practices rarely have a comprehensive set of systems for the entire team to access, learn from, and use for review. However, even practices that have documented, proven, step-by-step systems will eventually outgrow them which merely means that they need a new set of documented, proven, step-by-step systems to move to the next level of production, practice success, and daily fun and enjoyment. OP

Roger Levin

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 United States and around the world. To contact Levin or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit or email [email protected].

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