From Entrepreneur to Well-Run Practice, by Roger P. Levin, DDS

In Innovation by Dental Entrepreneur

Business schools now have courses and tracks on entrepreneurship. There are many differing definitions of an entrepreneur, but for the purposes of this article we will simply define it as someone who starts a business. Dentists are entrepreneurs. They often start or buy a business that needs to be developed, expanded, systemized, and moved beyond the entrepreneurial stage. There are three identifiable stages of moving from entrepreneur to well-run business. The key to success and happiness is moving through all three stages.


Whether you start your own practice or purchase one, there is an incredible amount of time, effort, energy, and work that goes into it. The goal is to make it successful: to be able to pay bills and gradually generate profit, providing an income, equity, and return on investment to the entrepreneurial founder.

Unfortunately, entrepreneurial start-ups or purchases can be chaotic. Due to no business training in dental school, most dentists have little idea of what they are really doing in terms of running a business. The good news is, unlike a business with an innovative product that no one has ever seen before, a dental practice can quickly access resources to help them get things off the ground. Supply reps, design firms, mentors, consultants, and on-line and live education are all part of the entrepreneurial growth experience.

Again, once the practice is operating there will be a great deal of daily chaos and stress, but at this stage, the stress is more welcome than resented. Entrepreneurs are usually energized, and it takes a lot to wear them out. However, if an entrepreneur dentist doesn’t develop systems in the practice that enable it to operate smoothly, stress and fatigue will eventually grow, customer service problems will emerge, profitability will decrease due to inefficiency, and other negative factors will impact the practice.

The key in the entrepreneurial stage is to implement systems throughout the practice. Systems are the number one factor in dental practice success. They need to be clearly defined (step-by-step) and be measurable. Practice management systems are the main contributing factor to making practices successful.

Remaining stuck in this stage is not a good idea. The dentist will have a career filled with stress, frustration, staff turnover, and continual distractions. This is the nature of an early entrepreneurial business and can be fun and exciting…for a while. Unfortunately, there are dental practices that never fully move beyond this stage.


When the right systems are in place and the team follows those systems, then the practice is ready to move beyond the entrepreneurial stage to Stage 2. Often, assuming the entrepreneurial dentist has established clear goals and targets to be achieved, the practice will be on track and continue to grow. However, it will eventually go on “autopilot” and hit a plateau where it can either remain or fall back. Constantly improving and updating your systems is the key to creating a smooth-running day-to-day operation with excellent team performance.

Stage 2 is a very comfortable place to be. The only “negative” is that it’s far below the practice’s full potential. That means the dentist will have to work longer than necessary to reach financial independence. If it is a conscious choice by a dentist to remain in Stage 2, then that is fine. However, in my personal mission of wanting to provide every dentist with the best information and options, I encourage all dentists to strongly consider moving on to Stage 3.


A Stage 3 dentist focuses more time and energy on the future growth and development of the practice. They learn to work both in the business and on the business. Dentists almost always must work in the business creating production through clinical treatment. This is a normal factor of dentistry. But many dentists leave no time for future development, and they won’t get past Stage 2. In essence, they are stuck, because they are not thinking about strategy or innovation for the future of the practice.

In Levin Group’s ongoing 30-year study of top 10% performing practices, we have noted that the top doctors continually delegate as many responsibilities as possible to others, allowing them to focus on two things–excellent clinical care and the future of the practice. If practices aren’t able to do this, then this restricts their growth and will keep them at a certain level. Stage 3 doctors uncover the true potential of the practice by allocating time on creating and implementing a strategic plan for the practice. They identify the practice’s strengths, weaknesses, opportunities, and threats to identify the best strategies to maximize the strengths and overcome the challenges. Practices at Stage 3 are the ones that have the highest return on investment from the beginning early stages. In an era where dentists are taking on more debt and risk than ever before, the entrepreneurial dentist deserves a more secure return on investment and that can only come by moving from Stage 1 to Stage 2 to Stage 3.

In Stage 3, we also note that top performing practices have dentists who access outside resources on a regular basis. They use advisers, including accountants, attorneys, and consultants to help them understand what their options are, expose themselves to concepts they’re not familiar with, and evaluate strategy and innovative possibilities for the future. In many cases, we have seen one advisor make a significant difference in the direction and career of a practice.


Many dentists begin their careers in the entrepreneurial stage. It’s a stage that’s exciting, energized, and full of hope. Being there is great, but staying there is not. Every day, the practice should have the goal of moving into the next stage and eventually getting to Stage 3 where they have a smooth-running, enjoyable 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 www.levingroup. com or email