Three Things You Should Immediately Find in Your Ortho Practice

By Roger P. Levin, DDS


In the world of business manufacturing there is a term, bottlenecks, that refers to the slowest part of any system. The theory is simple. A process can only be as efficient and fast as the slowest part of the process or system. Since 1985, Levin Group has been training orthodontic practices to implement business systems that increase production and we have observed (and corrected) many times that a system will only be as fast and efficient as the slowest part of the system.

If you want to start working on your systems and are not ready to completely overhaul them, then there are three things you should find.

  1. Find your new patient bottleneck

New patients are the most critical factor in the success of any orthodontic practice. The system begins with the first phone call. Whether they schedule, show up, or accept treatment are all factors in the new patient experience system. By simply finding the bottleneck in your practice you can improve the system. For example, you may not be aware that the sooner you schedule a new patient consult the higher the likelihood that the new patient will accept treatment. If the bottleneck is that you are not bringing new patients in for consult in a timely manner, then you must reevaluate and retool your schedule policy for new patients.

  1. Reduce overdue debonds to under 2%

Overdue debonds are 100% pure overhead. A recent new client, after analyzing the practice, was found to have 16% of patients overdue for debonds. This is a shockingly high number, but not rare. Many practices have 6%, 9%, or 12% of patients overdue for debond. Patients who are overdue for debonds are a drain on the practice. They increase overhead, clog up the schedule, create a false sense of busyness and contribute to fatigue. Find the bottleneck in regard to debonds. Is it patients who no-show? Could it be patients who don’t want to pay their monthly balance? Find the reasons and work at that level.

  1. Analyze the manufacturing process

This may sound funny, but the clinical treatment of patients throughout the day is actually similar to a manufacturing process. Patients come in, they move through chairs, they run late, they have unexpected findings, emergencies contact the office, etc. Any or all of these can lead to bottlenecks in the “manufacturing system” meaning the difference between the ideal patient flow each day and what actually happens. When you identify the bottleneck, such as one assistant who is slower than others, and you can act on that bottleneck by training that assistant to be faster. It is critical to search for and fix the biggest bottlenecks.

If your goal is to run the easiest, most efficient, and financially successful orthodontic practice then you start by implementing the best systems. But even the best systems have bottlenecks due to unexpected factors like speed of procedures, patient factors such as emergencies or running late, staff members who have ongoing problems such as illness, etc. Different practices have different bottlenecks, but if you can identify the largest bottleneck in the three categories explained above it will immediately improve practice performance. As always, it also leads to a smoother running practice.


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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