Pandemic or Not: Seven Habits to Adopt in 2021

Roger P. Levin, DDS


The pandemic has created chaos and upheaval in dentistry and in most of the world. In 2020, we experienced industry-changing events, including a shutdown, a reopening, pent-up demand, practice fatigue, patients not returning, personal protective equipment (PPE) and infection control protocols, a dip in hygiene schedules in November, and a production slowdown after pent-up demand ended. While the effects of COVID-19 are still impacting our personal and professional lives, it’s important in 2021 to remember that pandemic conditions will end. During this transition period, it will be beneficial for dentists to focus on the strategies that will strengthen the practice both during the remainder of COVID-19 conditions and during the period after.

Keep in mind that growth going forward will not be as easy as the 5 years before the pandemic began in March 2020, when the economy was nearing record levels of performance. As financial experts are prone to say, “We all look smarter in a good economy.” Whether or not we’ll have the benefit of a strong economy in late 2021 and 2022, there are multiple strategies that most dental practices should consider for improving practice growth and the professional satisfaction of the dentist and team.

1. Reactivate as many patients as possible. Levin Group now defines reactivation as any patient who does not currently have his or her next appointment. Each patient retained in the schedule fills critical chair time for both hygienists and doctors, increases practice production, and decreases the need to add a new patient.

The best way to approach reactivation is simple: The front desk team should work on this every single day. They should address the patient’s 2 main concerns: safety and finances, following effective scripting to those ends. Let the patients know what the practice is doing to keep them safe, and alert them of the financial options that will make dentistry affordable. Patients will then have the confidence to come in, feel safe, and believe they can afford treatment.

2. Monitor no-shows carefully. No-shows mean unfilled chair time in an era when patient volume is lower than before. According to the Levin Group Data Center, practices have stabilized at approximately 85% of their patient volume pre-COVID-19. The target we aim for with our clients is to increase that number to 95% by realigning schedules, maximizing production opportunities, and crafting excellent scripting for patients. Unfortunately, it’s still unlikely that we will get back to pre-COVID volume levels in 2021. This means chair time is now more important than ever before. To maximize chair time, no-shows must be minimized.

3. Design practice systems to maximize practice production. Management systems are the step-by-step, documented operational guidelines and protocols that allow a practice to run efficiently, effectively, and with maximum profitability. Whenever management systems are put in place, practice performance always increases, even if no new patients are added to the practice.

Coming out of a crisis period such as we all experienced in 2020, your systems should be adjusted to achieve robust production and profitability. This isn’t about greed. It is about ensuring the short- and long-term success of the practice. System adjustments to consider for maximizing practice production should include scheduling larger cases as soon as possible, bringing new patients in within 7 to 10 days (a new patient represents 200% to 300% higher financial revenue in the first 12 months vs currently active patients), scheduling emergencies on the same day (as they tend to accept recommended treatments), and scheduling patient appointments to complete as much treatment as possible in one visit. This reduces overhead, increases convenience, and decreases the amount of PPE needed and the number of infection control activities that need to occur.

Systems are the key ingredient to the successful operation of any practice attempting to reach its true potential. They are essential in a crisis but will also serve you well in the future.

4. Work hard at implementing 5-star customer service. Please keep in mind that 5-star customer service isn’t simply about being nice to patients. Customer service is important all the time. It’s a system unlike any other and must be designed step by step with appropriate scripting. If you don’t have an exact process for 5-star customer service, the practice will inevitably make missteps. The Ritz-Carlton, which may be the best example of a 5-star customer service environment, reviews its protocols for every shift, every day. This allows the hotel to perform at extremely high levels of service, impress guests, and create return visitors. There is an entire science to customer service for dental practices that involves creating practice dynamics that increase patient longevity, referrals, case acceptance, and practice production.

5. Accumulate cash. This is still an unknown in 2021, and we can expect a bumpy ride. If the practice can build up cash reserves, it will be in a stronger position to weather any downturns, experience lower anxiety about expenses, and invest in a successful future while continuing to move forward.

Most practices had less than one month of cash in reserve when the pandemic shutdown occurred early last year. It is worth the peace of mind to set aside at least 4 months—and even better, 6 months—of cash as protection for the future.

6. Create a detailed strategic plan. If you’re not doing this one thing, you need to start. There is a reason that the best businesses, including those that have nothing but success, do annual strategic planning. Strategic planning is an intense process utilized by the most successful companies in the world to evaluate what measurable strategies they will implement in the next 1 to 5 years to remain successful or achieve preset goals. By creating a highly detailed strategic plan, you will be able to lay out a 5-year timeline of different strategies and tactics that will allow the practice to grow. Most business experts believe that strategic planning is the single most critical activity that takes place in a company each year. It is not about today. It is not about this year’s budgets. It is about the future. And dentistry is changing, and practices of all shapes and sizes are emerging. Strategic planning is more important than ever before.

7. Be (and stay) optimistic. Optimism is hope for a better future. Your team wants an optimistic leader. People want to be around positive, optimistic people. It simply makes them feel better. Maintain an optimistic attitude and share with your team what you see for the future of the practice. Give them guidance as to how the practice is going to get there. Optimism gives people a sense of purpose. When you tie optimism to purpose, your team members will feel like they belong to something bigger than themselves, and that reinforces why they like being in your practice. This is what great leaders do.

No one knows exactly what the rest of 2021 will look like. Even in a best-case scenario, however, there are certain to be some bumps along the way. By implementing the 7 recommendations mentioned, I believe practices will put themselves in the best possible position to weather COVID-19 as we move toward reducing the negative effects of the pandemic, living in a more stable environment, and having a hope-filled future.

Dr. Levin is the CEO and founder of Levin Group, a leading practice management consulting firm that has worked with more than 30,000 practices to increase production. A recognized expert on dental practice management and marketing, he has written 67 books and more than 4,000 articles. He regularly presents seminars in the United States and around the world. He can be reached at or via the email address

Disclosure: Dr. Levin reports no disclosures.

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