Confidence is absolutely everything when it comes to dropping PPO plans. Every dentist who has resigned from PPO plans experiences doubt—did I do the right thing? Will I lose too many patients? This article reveals the real data from hundreds of practices and shows how confidence—both in yourself and your team—is the deciding factor between success and failure.
The Psychology of the PPO Exit
Here's something that happens in 100% of cases when dentists resign from PPO plans: they have second thoughts. Not most dentists. Not some dentists. Every single dentist who has made this transition experiences doubt after signing the resignation letter.
The question haunts them: Did I do the right thing?
This is completely normal. You've just fundamentally changed your business model. You're stepping away from a system that seemed safe and familiar, even if it was limiting your profitability. The psychological discomfort is inevitable.
But here's what separates the dentists who thrive after dropping PPO plans from those who regret the decision: confidence. Specifically, confidence in the data, confidence in the strategy, and confidence in their team's ability to execute.
What the Data Actually Shows
The Retention Rate You Actually Get
Based on coaching hundreds of dental practices through the PPO exit process, we have solid data on what happens after dentists resign. When executed properly, practices retain between 80-90% of their existing in-network patients.
Think about that. You're not losing the majority of your patient base. You're keeping most of your patients. The ones who leave are typically those who were less committed to your practice anyway or those whose insurance situation genuinely changes.
Compare this to what dentists imagine before they resign. Most think they'll lose 40%, 50%, or even more of their patients. The reality is dramatically better than the fear.
A Real Case Study: What 100 Calls Really Meant
Here's a case study from this week. A doctor resigned from Delta Dental. The resignations were processed, and the letters went out. The office received one hundred phone calls in the first couple of weeks.
One hundred calls. That's a lot. Any dentist would feel panic setting in.
But here's the critical detail: Of those 100 calls, only 12 patients requested that their records be transferred to another practice.
Why did those 88 patients call? Primarily because they were confused. The letters from Delta made it sound like they had to find another dentist. The confusion prompted them to call the office for clarification. But once they spoke with a properly trained team member who explained that they could absolutely still come to the practice, nearly all of them chose to stay.
In fact, many told the team, "I'm so glad I called. I'm definitely not going anywhere." Some were even offended on the doctor's behalf: "That was nasty of Delta to send that letter."
The Role of Confidence in Your Team's Performance
Why Team Training Matters
The difference between success and struggle often comes down to this: Did you prepare your team for what was coming?
Practices that work with a coach prior to resigning from PPO plans receive extensive training. The team learns talking points. They practice responses to the questions they know will come. They understand the strategy and their role in it.
Then, when those hundred calls come in, the team is ready. They're confident because they know what to say. They can reassure patients. They can answer objections. They can turn confusion into an opportunity to strengthen the relationship.
In contrast, practices without this preparation panic. When the first patient calls confused, the team doesn't know how to respond. Their uncertainty translates to the patient, making the patient feel more uncertain. The result is higher cancellation rates and lower retention.
The Expectation Effect
There's a powerful principle in psychology: When you expect something to happen and you're prepared for it, you handle it far better than if it comes as a surprise.
Imagine two scenarios:
Scenario 1: You're told, "We might get a lot of calls in the next couple of weeks. Patients will be confused about whether they can still come here. Here's exactly what you should say..."
Scenario 2: The calls start coming in unexpectedly. Nobody warned you. You're scrambling to figure out what to do.
Same situation. Completely different outcomes. In Scenario 1, the team stays calm and does their job. In Scenario 2, the team panics and makes mistakes.
Building Confidence Through Understanding
Henry Ford captured something profound when he said: "Whether you think you can or you think you can't, either way you're right."
This isn't just motivational platitude. It's describing a real psychological mechanism. When you believe you can succeed, you behave differently. You stay calm. You make good decisions. You communicate more effectively.
Conversely, when you believe you'll fail, your actions align with that expectation. You communicate hesitantly. You second-guess yourself. Your uncertainty spreads to others.
The Preparation Is the Confidence
Real confidence doesn't come from ignoring reality. It comes from being thoroughly prepared for what reality will bring.
When a doctor knows from data that 85% of patients will stay, that confidence is grounded. When a team knows the exact words to use when a patient calls confused, that confidence is earned. When everyone has practiced the situation multiple times, confidence is justified.
This is why extensive coaching before the PPO exit is so important. It's not just about learning the right strategies. It's about building the confidence that comes from deep preparation.
A Story About Confidence in Action
There's a powerful story that illustrates the power of confidence in moments of pressure. At the 2018 Phoenix Open golf tournament, a professional golfer named Garry Woodland played a practice round with Amy Buckerstad, a young golfer with Down syndrome who participates in Special Olympics. This was no casual round—hole 16 at the Phoenix Open is surrounded by a stadium with 30,000 spectators during the tournament. Even in the practice round, 10,000-15,000 fans were in the stands.
Amy teed off, hit a beautiful shot that landed pin-high in the sand trap. Then she said something that revealed everything about confidence: "I got this. I can do this." Not hesitantly. Not hoping. With clear, confident belief in herself.
She hit a perfect shot out of the sand and then made a birdie putt. When Garry Woodland was interviewed after winning the US Open championship later that year, he credited Amy. He said he watched her that day—how she believed in herself, how she executed without doubt, how she didn't let the pressure affect her—and he made it his practice to use that same confidence.
Confidence, expressed through positive self-talk, became the key to championship performance.
The same principle applies to your PPO exit. When doubt creeps in, when you're having second thoughts, return to the data. Return to the preparation. Tell yourself: "I got this. I can do this."
When the Doubt Hits
What to Do When Second Thoughts Arrive
You will have moments of doubt. This is guaranteed. When they come, here's what to do:
1. Return to the Data
Practices keep 85-90% of their patients. You are not losing your business. You are improving your profitability while serving most of your existing patients.
2. Remind Your Team
Your team members will also experience doubt. Your job as the leader is to remind them of the strategy, the data, and their preparation. Reinforce their competence.
3. Focus on the Patients Who Stay
Don't obsess over the 10-20% who leave. Celebrate and strengthen relationships with the 80-90% who choose to stay. Many will be more committed than ever, now that they've made an active choice to remain your patients.
4. Use Positive Self-Talk
Tell yourself what Amy Buckerstad told herself: "I got this. I can do this." This isn't denial. It's confidence grounded in preparation and data.
The Downstream Effects of Confidence
Patient Perception
Patients pick up on confidence. When your team is confident, calm, and reassuring, patients feel that. They trust your judgment. They believe you made the right decision.
Conversely, if your team communicates doubt, patients absorb that too. They start wondering if leaving your practice is the right move.
Financial Impact
When you successfully retain 85% of your in-network patients and transition them to your fee schedule, your revenue often increases despite having fewer patients. The patients who stay are typically more committed and more likely to accept treatment recommendations.
Practice Culture
A successful PPO exit transforms practice culture. Your team learns that they can handle challenging situations. They become more confident in all their interactions. The entire practice benefits from this shift.
Preparing for Your PPO Exit
If you're considering dropping PPO plans, confidence starts before you send the resignation letters. It comes from:
- Understanding the data on what really happens
- Having a clear strategy for the transition
- Thoroughly training your team
- Practicing difficult conversations
- Knowing exactly what you'll communicate to patients
- Believing in the financial math that makes this move make sense
Each of these elements builds genuine, justified confidence. Not hope. Not positive thinking. Real confidence built on preparation and data.
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This article is based on coaching data from hundreds of dental practices that have successfully dropped PPO plans and research into the psychology of confidence and performance. Listen to the original podcast episode
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.