Step 5: Building Relationship-Driven Dental Practices That Retain Patients

When practices transition from PPO insurance dependence to fee-for-service models, relationship strength becomes the primary factor in patient retention. This guide reveals the strategies high-performing dental practices use to retain 85-90% of existing patients during transition—and why relationship elevation directly impacts your ability to succeed outside of insurance networks.

Why Relationships Matter More Than Insurance

Among the six steps required to successfully resign from PPO plans, relationship elevation stands out. If patients know you, like you, and trust you, they'll choose to stay with you when you leave PPO networks. They actively decide not to take their chances elsewhere.

This isn't accidental. Dentistry is fundamentally personal. It's intimate. It involves potential pain, vulnerability, and trust. Patients don't simply transfer to another practice because they're no longer "in network"—they transfer because they didn't have a strong relationship in the first place.

The Data on Patient Retention

Coaching work with dental practices undergoing PPO resignation reveals consistent results: practices with strong relationship-driven cultures retain 85-90% of existing patients when leaving PPO plans. Those without this foundation experience significantly higher patient loss.

The difference? Patients with strong relationships think, "I don't want to take my chances going somewhere else. I love what I have here." Patients with weak relationships think, "If you're not in my insurance, I'll just find someone who is."

The Reality: Room for Improvement

Even practices with excellent reputations can improve their relationship-driven cultures. Consider this framework: "You're only as good as your last game." Athletes don't rest on past performances. Neither should dental practices.

If your practice has 650 five-star reviews on Google, that's evidence of current performance. But can you be better? Absolutely. The question isn't whether you're good. The question is whether you're still improving.

Core Strategy: Brainstorming Team Meetings

Start with team meetings where you collectively brainstorm ways to elevate the relationship-driven aspect of your practice. This isn't heavy training or serious business—it's creative thinking.

Ask your team: "What else can we do to show our patients we care? What would make someone feel genuinely cared for?"

The Umbrella Story

One practice's assistant noticed something during brainstorming: in rainy climates, patients showed up wet because they didn't have umbrellas. Her suggestion? Buy umbrellas branded with the practice name, place them in a stand at reception, and tell patients: "Take one with you and bring it back next time."

This simple idea communicates care. You're not handing an umbrella to a stranger—you hand umbrellas to people you care about. The practice now has patients walking around town with their practice name on an umbrella, staying dry while being reminded of their dentist.

This idea started impractical. But impractical suggestions often lead to practical innovations. The framework matters: create space for team brainstorming without judgment.

Proven Relationship-Building Tactics

The Evening Care Communication

After significant treatment, contact patients that evening. Originally done by phone (the "we care call"), this now works equally well via text message.

Example message:

This accomplishes multiple things:

• Demonstrates genuine care beyond the clinical relationship
• Provides reassurance about post-treatment experience
• Shows personalized attention (not a mass text)
• Reinforces that the dentist is personally invested in patient outcomes

When personalized, these messages significantly elevate patient perception of care. When generic or impersonal, they have minimal impact.

Patient Information Systems

Create a systematic way to capture and track patient information across your entire team. This includes:

• Family member names and details
• Children's names and ages
• Spouse or partner information
• Hobbies and interests
• Important dates (birthdays, anniversaries)
• Professional background
• Recent life events

The critical insight: while many dentists put this information into patient records, most teams don't contribute. The road to mediocrity is paved with good intentions. Only the dentist enters data, and inconsistently.

Making Information Systems Work

To transform this from intention to reality:

When a team member enters information, acknowledge it immediately. This positive reinforcement creates habit. Over time, entering patient information becomes automatic—part of their role.

The Morning Huddle Strategy

Before hygiene starts each day, review patient information together. The team pulls up notes on upcoming patients and discusses what they know:

• "Sarah's getting married next month"
• "Tom's daughter just graduated college"
• "Linda's grandkids are visiting this week"

Now when hygienists greet patients, they're prepared for meaningful conversation. The patient feels genuinely known and cared for—because they are.

Addressing Self-Talk Limitations

Many dentists undermine their own relationship efforts through negative self-talk. Common example: "I have a bad memory."

This is usually untrue and always counterproductive. Someone with a genuinely poor memory wouldn't have completed dental school (which requires memorizing organic chemistry, biochemistry, dental anatomy, and hundreds of clinical protocols). You have a good memory.

If you feel your memory isn't serving you well in clinical interactions, the solution is discipline and systems—not acceptance of limitation. Use your practice management software. Use written notes. Use team support. Use the morning huddle strategy.

The Foundation: "People Don't Care How Much You Know Until They Know How Much You Care"

This principle, emphasized by dental leaders throughout the profession, captures why relationships matter more than clinical expertise in patient retention.

Your credentials, experience, technical skills, and knowledge are irrelevant unless patients believe you genuinely care about them. Your clinical excellence is expected. Your care is what makes the difference.

When patients know you care, they:

• Stay with you through transitions (like leaving PPO plans)
• Accept treatment recommendations more readily
• Refer friends and family to you
• Communicate openly about concerns
• Overlook occasional mistakes or delays

When patients don't know you care, none of your clinical excellence matters.

Vision: The Doctor Art Degoni Example

At the University of Pacific School of Dentistry, Dean Art Degoni was known for something unusual: he could walk into a class of 100+ students and identify every student by name. In a dental school with nearly 400 students, imagine being one of those students. You're blending in, invisible in the crowd.

Then the dean looks you in the eye and says your name.

How does that feel? It feels like you matter. Like someone cares enough to know who you are.

Patients feel the same way when you remember details about their lives. You don't need to remember 400 patients—you might have 500-1,000. But within that, there's always room to demonstrate that they individually matter to you.

Specific Actionable Tactics Summary

Daily Actions

• Morning huddle: Review patient notes for 5 minutes before starting the day
• During appointments: Reference personal details learned ("How did your daughter's job interview go?")
• Team reinforcement: Praise specific examples of relationship-building in huddles

Weekly Actions

• Team meetings: Brainstorm one idea for elevating relationship-driven care
• Information review: Ensure patient notes are current and detailed
• Follow-ups: Send evening care texts or calls after significant treatment

Monthly Actions

• Celebrate wins: Share examples of exceptional patient relationships with the team
• Assess culture: Ask, "Are we improving our relationship-driven approach?"
• Adjust systems: Fix any barriers to team participation in patient information gathering

Why This Matters for PPO Resignation

When you resign from PPO plans, relationship strength determines your outcome. Practices where patients love you retain 85-90% of existing patients. Practices where patients see you as "the insurance dentist" experience massive patient loss.

Investing in relationship elevation now—before you resign from PPO plans—is strategic preparation. By the time you make the transition, your patient relationships are strong enough to sustain it.

Next Steps in Your PPO Resignation Strategy

Relationship elevation is one critical component of a comprehensive strategy to successfully resign from PPO plans. Combined with knowing your data, mastering digital marketing, getting your team on board, creating membership plans, and strategic communication, relationship strength becomes the differentiator between transformation and struggle.

The most successful practices understand: in a fee-for-service model, relationships aren't nice to have—they're the foundation of your entire business model.

Reviewed by

Naren Arulrajah

CEO & Founder, Ekwa Marketing

Naren Arulrajah is the CEO and Founder of Ekwa Marketing, a 300-person dental marketing agency that has helped hundreds of practices grow through SEO, reputation management, and digital strategy. A published author of three books on dental marketing, contributor to Dentistry IQ, co-host of the Thriving Dentist Show and the Less Insurance Dependence Podcast, and a member of the Academy of Dental Management Consultants. He has spent 19 years focused exclusively on helping dental practices succeed online.