From bottlenecks to breakthroughs: Redesigning the systems in your dental practice


Sooner or later, all practice management systems must be replaced. These step-by-step protocols, which dentists and staff follow as they perform non-clinical tasks, eventually become problematic for different reasons. Some are inherently inefficient because they were created haphazardly. Others functioned well when originally introduced, but gradually became dysfunctional as conditions at the practice changed. And in many offices, systems were merely tweaked when they should have been totally replaced.

Now that so many dentists and specialists face post-recession barriers to success, the quality of their management systems demands attention. Inefficiencies that previously went unnoticed are now making it impossible for practices to thrive. Rather than being part of the solution doctors so urgently need, obsolete systems are part of the problem … contributing directly to declines in production and profitability, causing day-to-day stress, and distracting practice teams from growth opportunities.

Practice makeover, with all new systems

People naturally resist changes in their work routines, but practice owners and team members alike must recognize that outdated systems are holding them back. Practices should launch a system replacement project with an understanding that new systems will improve everything -from small details to the big picture.

To make the process manageable, it should be focused initially on these core systems:

Scheduling – With the right scheduling system, practices can increase their productive capacity (without working longer hours!), achieve smoother workflow, and eliminate many of the sources of stress normally encountered in the office.

Case presentation – This is the point at which potential production can be actualized. An improved system will help determine what treatment is presented - more multi-tooth and elective procedures, not just need-based single-tooth cases. It will also guide all staff members to motivate patients to accept cases by showing enthusiasm and building trust in the doctor and practice.

Collections – If fees are not collected for the oral health services provided, improvements in other aspects of practice performance will be completely undermined. To minimize the problem - a 98.5% collection rate makes sense for most practices - comprehensive collections systems include scripted communication about payment policies, financial options, and procedures for notification and collection.

System documentation, training, and monitoring

Once a system has been designed, it should be documented, with every step spelled out in writing. This will help prevent the degradation of systems due to forgetfulness, personal interpretation, and lack of familiarity on the part of employees who are new or filling in for others.

The step-by-step documentation then serves as the basis for scripting. Team members learn how to operate the new systems by role-playing, using scripts to guide their interactions. With excellent scripting, system function will be highly efficient, consistent, and stress-free.

All systems will gradually become obsolete. Even the best systems will need to be modified as they bring about positive changes in practices. For this reason, doctors and staff must get in the habit of monitoring how systems are working - watching for the formation of bottlenecks, stress points, and performance that falls short of established targets.


The health of a dental practice depends heavily on the quality of its management systems. As both external and internal factors modify the business climate in which the practice operates, these changes can and should be addressed by implementing well-conceived new systems. The goal is for the practice to operate with maximum efficiency … and grow steadily.

Editor's Note: To learn more about the impact of systems on increasing practice production, come to one of Dr. Levin’s upcoming seminars. Pick a convenient date and location at

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