Many of the tasks in a successful orthodontic practice—from administrative to clinical—can be delegated to the team. But to remain successful, the team needs to be kept accountable.

By Roger P. Levin, DDS

Very few businesses have greater delegation potential than an orthodontic practice. We estimate that in top orthodontic practices literally 90% of practice tasks can be handled by the team. These tasks range from administrative duties to clinical assistance. One reason top orthodontic practices are successful is that they have teams that are highly accountable and do what needs to be done, when it should be done, and how it should be done. This is an aspiration that every orthodontist should have for their practice.

What is accountability?

Accountability is simple. It is simply people doing exactly what they say they are going to do. Let me repeat that…

People doing exactly what they say they are going to do

If you have a practice of people who do exactly what they say they are going to do, then you have very little to worry about except increasing delegation. You don’t have to follow up with people, nag people, worry about things that aren’t being done, have anxiety or stress over the fact that it might not get done, or face the reality that it didn’t get done at all. You already have a practice that gets things done and the next level of  true accountability is making sure people know exactly what they are supposed to do.

Having people know exactly what they are supposed to do when asked stems from the practice leader. It is up to the leader to create a practice with systems, policies, and protocols that are clearly laid out, easy to understand, results driven and backed by training. Orthodontic practices that accomplish this mission are orthodontic practices that have the highest levels of leadership and success and a true “culture of accountability.”

A culture of accountability is when every team member who accepts a request from an orthodontist, office manager, or other team member, owns that specific action and will get it done unless there are unforeseen obstacles. In that case they will go back to the individual to whom they promised to get it done (accountability) and discuss the situation. They never leave it hanging or incomplete. They never let a challenge be the excuse for simply ignoring the request that they have agreed to. They either get it done or find a way to communicate as to how they will get it done.

As a leader, there are some easy ways that you can create accountability. These include:

1. Never ask anyone to do anything without a deadline 

One of the biggest factors in miscommunication and lack of accountability is not having a deadline. There’s a big difference between saying, “Can you call or text Mrs. Smith?” and “Can you call Mrs. Smith by this afternoon?” Notice the second example has a deadline. Now the person knows exactly when this must be done. Providing a deadline gives a person the opportunity to decide whether they can get it done and respond accordingly, or to ask what should be shifted to complete the task. Calling Mrs. Smith is a relatively quick activity, but many other requests take more time than needed.

2. Understand the amount of time involved in the request

We have seen many orthodontists that make requests of team members thinking that the action will only take a few minutes when it actually might take a few hours. Even reaching Mrs. Smith, in the above example, may not be that simple. It could take two or three phone calls and text messages to set up the appointment. Furthermore, Mrs. Smith could be on a 10-day vacation. This is an example of when a team member should cycle back to the orthodontist, explain why the task was not completed, and ask what further action should be taken.

3. Teach your team that they can negotiate deadlines

Sometimes you’ll make a request, but the team member realizes it will be next to impossible to get it done. This is not due to a bad attitude, resistance, or lack of caring. Things come up and life happens. As a leader you must empower team members to inform you about whether they can meet a deadline. When interferences arise, it’s best to immediately work it out with the individual who made the initial request.

4. Make sure the team member knows the desired result

One of the big factors leading to failure of accountability is when the other person does not understand the desired result of the task. For example, simply leaving a message for a patient that is overdue for an appointment is not an acceptable result when the real accountability is getting the overdue patient scheduled. However, we have heard many team members explain that they left a message when responding to questions about why they didn’t get a patient scheduled. This is not due to laziness or unwillingness on the part of the team member. The team member genuinely believes that the task was to leave a message because they did not understand that the desired result was to get the patient scheduled. Many systems break down in practices because the desired result is not understood.

5. Always end by asking if there are any questions

The last line of each conversation should always include giving the person permission to ask any questions for clarification. You may believe that you are always straightforward and clear in communication, but that may not be the way it is received. Allowing for questions and empowering your team to ask questions goes a long way toward enhancing accountability and achieving an excellent result.


Nothing may be more important than accountability in an orthodontic practice. The more accountable the team, the more efficient the practice. A high-level of team accountability typically leads to higher production, profit, and income. It also leads to excellent follow through with patients, great customer service, and a positive and enjoyable practice culture. 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 Ortho Practice Production Tip of the Day, visit or email [email protected]

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