Secrets of the top 10 percent


It may come as a surprise, but there are only a few key factors that make top-tier practices stand out from the pack.

It’s obvious to expect that practices with production in the Top 10 percent will do certain things differently than most other practices. What may be unexpected is that only a few key things set them apart. However, over time this small collection of differences allows them to build superior practices that operate efficiently with low-stress and high production.

Understanding the Top 10 percent

Over the last 30 years, ongoing research by the Levin Group Data Center have resulted in a better understanding of Top 10 percent practices and how they differ from others. Our objective in this study has been to evaluate what they do differently and which of those aspects can be replicated by other practices. Our findings show that the vast majority of the differences that contribute to the success of Top 10 percent practices are simply that they do certain key operations only slightly better than others. Their real secret of success is that they do them consistently and continuously and that builds on itself over time.

Differences of the Top 10 percent

It would be wonderful if I could outline the one thing that every practice should do to be a top-performing practice, but that is mere fantasy. Practices that perform in the top 10 percent did not get there overnight and there was no one thing that propelled them into that success. These are doctors who focused on creating a well-run and efficient business, and through experimentation, education, or consulting were able to put together enough operational processes at a high-level. Most of these practices gradually moved into the Top 10 percent and have remained there.

There are approximately 25 key areas where Top 10 percent practices outperform others. While they do not always outperform in all 25, their secret is, again, that they do them consistently. Over time that leads them toward long-term success. Here are five of those key areas where top 10 percent practices perform well:

  • Lower Patient Attrition. Most dental practices lose between 12-15 percent of their patients annually. Top 10 percent practices only lose between 7-8 percent. This means that over time they can increase their patient base by 70 percent every 10 years.

  • More Active Patients Scheduled. On average, Top 10 percent practices have approximately 95-96 percent active patients already scheduled for their next appointment. Most other practices range between 85-90 percent.

  • Lower No-Show Rate. The average no-show rate for most practices is between 5-7 percent. The no-show rate for Top 10 percent performing practices is less than 1 percent.

  • Higher Number of New Patients. Top 10 percent practices have a higher number of new patients for numerous reasons. They tend to attract patients with Five-Star customer service, excellent internal marketing, and effective new patient capture systems.

  • Higher Case Acceptance. Top 10 percent practices have higher rates of case acceptance. They tend to master the methodology of creating value in the minds of their patients and presenting treatment in an influential and motivational manner. Statistics indicate that case acceptance in Top 10 percent performing practices can be 20-25 percent higher than most others.

Top 10 percent dental practices are not vastly different than other practices. They simply do certain things slightly better. The difference is in their consistency, which helps them build success over time. Consider the five areas listed above as ones that can be improved for greater consistency in your practice. When you do, you could be well on your way into the Top 10 percent.


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 dental 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 Dr. Levin or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit or email 



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