As a dentist, just imagine being a world-class leader and knowing what to do almost all the time in any situation. More importantly, imagine those leadership skills resulting in outstanding days every day you practice. Is this even possible? A concept developed by Levin Group, known as Level IV Leadership, has allowed some dentist to rise to the highest levels of financial success and career satisfaction. Level IV dentists have leadership skills that are so refined they can focus mainly on clinical care while their teams run the practice at the highest levels of efficiency and effectiveness.
Dentists are not great leaders
The reality that most dentists are not great leaders is not based on genetics. It is not an intelligence issue. And it is not due to a lack of interest to know more about leadership issues. Dentists are trained in dentistry. They learn nothing about leadership in dental school, and even if they did, they have no practical reality in which to apply it. Until a dentist is immersed in practice and all of the associated challenges, it is very difficult to learn to be a great leader.
Unfortunately, there is no single course or book that will lay it all out, allowing you to “paint by numbers” and see all of the challenges go away. Secondly, leadership by definition involves leading other people. People are extremely complicated and have all kinds of different issues, parameters, and motivations. A great leader must develop and refine a leadership style that accommodates a variety of personalities and behaviors on a dental team. And it isn’t only the team that needs to be considered by practice leaders. While most patients are fairly nice and appreciative, many have their own desires and behaviors, which include whether to keep appointments, show up on time, accept recommended treatment, pay bills on time, and multiple other factors. This is why there is no single leadership style that can be applied across the board as a dentist. Leadership is situational, and good leaders have to constantly adapt to changing circumstances. As an example, contrasted against the dental landscape of only five years ago, dentistry is currently facing a staffing shortage and team members are requesting much higher compensation. This takes a new level of management and systemization that wasn’t previously required in order to become and remain successful.
So, how do dentists become great leaders?
The four levels of leadership
Levin Group has identified four levels of leadership that represent almost all dentists. The first three levels are very common. Only a small minority of dentists reach level four. Here is a brief explanation of each level.
Level I: The new leader
The New Leader has strong clinical skills, but is not experienced in managing a practice and leading a team. He or she often has no systems in place and is “winging it” as far as running the practice is concerned. Every dentist starts at Level I. This phase is a challenging and exciting time in the dentist’s career and typically lasts one to three years.
Think of Level I as the startup practice. Startups are characterized by high energy, excellent motivation amongst the dentist and the team, constantly adding patients and procedures, etc. As the startup practice grows, it becomes more chaotic with only rudimentary systems, but because the schedule isn’t jam-packed, there is still plenty of time and capacity to manage day-to-day. The role of the dentist as a Level I leader is to do just about anything necessary for the startup to be successful and stay in business.
Level II: The competent leader
Level II occurs after several years in practice. A doctor reaches this level by virtue of working and learning through experience. This is the stage where the doctor begins building the practice, setting the foundation for future success. Doctors generally stay at Level II for only a few years.
The Level II leader runs a practice that is beginning to steadily grow, gradually needing more staff doing specialized work in different positions. The dentist spends more time chairside as is necessitated by the growing volume of patients. As a result, the practice develops new levels of stress, chaos, and fatigue, and the dentist spends a lot of time and effort plugging holes, playing catch-up, modifying procedures and systems, and correcting mistakes to make everything work.
Level III: The overworked leader
The Level III leader is “maxed out.” This phase often begins around the fourth or fifth year of practice and can continue until retirement. It is not a good place to be. The dentist usually finds that the business side of the practice—not the clinical aspect—is creating most of the stress and frustration. In addition to working too hard, the doctor is typically earning significantly below his or her potential. Many dentists spend the majority of their careers in this phase.
The Level III leader is responsible for a busy practice where the dentist spends a lot of time chairside, but also a lot of time outside of patient scheduled hours dealing with other administrative and management issues in the practice. With growth comes more busyness, chaos, stress, and fatigue, and although the practice may have excellent financial results, it is difficult to manage day-to-day. Some dentists develop burnout in this stage. Fortunately, there is a way out. There is something better that leads to more fun, more production, and greater profitability. It is called Level IV Leadership, and it is where every doctor needs to be.
The Level IV leader
This is where doctors want to be, earning more and leading a much less stressful life. In Level IV, the doctor becomes less involved in administrative areas of the practice and focuses more on productive clinical care and referral management.
The Level IV leader actually comes to work each day happy. They do not spend time setting up the day, managing the team, or helping other people to do their jobs. The first thing the Level IV leader typically does is attend the morning meeting that is short and run by staff members. They do not get a lot of questions from the team because the team is excellent, highly skilled and they each think like an owner. Team members know what to do, when to do it, how to do it, and what the results should be. This is all a manifestation of the time and effort the practice leader put in during the earlier stages.
The Level IV dentist’s day is then run by the dental assistants. Dentists don’t spend time at the front desk, they do not handle administrative issues or questions, and they go where the assistants tell them to go. Assistants are in charge of directing the Level IV dentist from room to room and procedure to procedure. Although some dentists reading this article may think that they want to be in charge of their schedule, it is much more relaxing and comfortable to have assistants anticipating what needs to come next and letting the dentist know. The assistants are highly skilled and accept remarkably high levels of delegation, allowing the dentist to focus on the things he or she does best.
At the end of the day, the dentist is finished. The team knows what they need to do to end the day. They often have an opening and closing checklist for each day, and they finish their responsibilities.
Delegation and training are the keys to attaining Level IV Leadership. The Level IV leader has to become an expert at delegation, and the team has to have the skillset to accept that delegation. Level IV dentists do not retain tasks just because they think they can do them better or faster. If team members are legally allowed to do a task, they are trained to do it. A team with ownership mentality will quickly master almost any task, freeing the dentist to focus on the one thing most dentists genuinely enjoy—treating patients and doing dentistry.
In order to reach this level, dentists routinely rely on the help of expert advisors who work with the practice to implement updated systems and train the team to effectively use those systems. These advisors are often called upon to assist doctors with other aspects of their lives, including financial and retirement planning.
Summary
As a dentist, I can tell you that Level IV leaders experience an exciting and fulfilling dental career. Many Level III leaders confuse the fact that they are financially successful with being Level IV. What they are missing out on is the absence of chaos, stress, fatigue, and burnout in the life of a Level IV leader. Level III is not a bad way to work. However, it is not nearly as enjoyable as Level IV.
Being surrounded by a team of people who have an ownership mentality and continually do their jobs well, knowing the expected results, can make all the difference in building a world-class practice and experiencing great financial rewards and fun. Level IV Leadership is not a pie in the sky concept. Dentists who achieve it experience incredible professional and personal satisfaction and attribute their success to their ability to delegate all appropriate tasks to a well-trained and highly motivated professional team.
Editor's note: This article appeared in the January 2025 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.
