How to get patients to stay with your dental practice for life?

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Intro: You are now listening to another episode of the Insurance Untangled podcast, where we explore the various challenges faced by dental practices due to their reliance on insurance. Join us in this podcast as we dive deep into the issues surrounding dental insurance dependence and offer practical solutions and strategies to help you take control of your practice’s financial future.

Naren Arulrajah: Welcome to another exciting episode of the Insurance Untangled podcast. I’m Naren, one of the co-hosts of this podcast dedicated to helping practices that are tangled up with insurance. We talk about topics that help you take more control and create a bigger and better future for you, your patients, and of course, your team members. Today, my guest is Ben, my dear friend and co-host, and we’ll be talking about a really good topic that many of you have written to us about—how to get patients to stay with your dental practice for life. It’s a wonderful topic. Both Ben and I are gonna be having a wonderful conversation around this. Ben, thank you for your time today, and thank you for jumping in and joining us today.

Ben Tuinei: My pleasure, Naren. It’s always great chatting with you. What an amazing topic to talk about today. Looking forward to it.

Naren Arulrajah: Ben, the topic today, once again—how to get patients to stay with your dental practice for life—is based on a post that I saw not too long ago. Dentists were talking about how to get patients to stay for life, and they talked about the challenges with that. It really struck me because everyone in that discussion—from dentists to office managers to even hygienists and front desk coordinators—said the same thing: it all comes down to trust. But here’s what really stood out. So many dentists admit they’re struggling to build that trust because they’re short on time, overwhelmed by insurance, and just trying to keep up. So I wanted to unpack this with you today. How do we build long-term loyalty? How do we build long-term trust when it feels like dentists are in a rat race, just trying to do more and more for less and less money?

Ben Tuinei: That’s actually a really great question. I hear it all the time as well. You know, the truth is, Naren, at least for me, patient loyalty isn’t about discounts or free things like free whitening or reward programs—although those things can sometimes be helpful. It’s more about how patients feel when they walk in your office. Who was it—uh, Maya Angelou or somebody famous—yes, that said, you know, people rarely remember what you say; they mostly remember how you make them feel, right? Which is the key thing when we’re talking about how to increase loyalty from patients, get them to trust us as well. Practices struggle with that. They struggle with the loyalty component. I think when it comes to most dental offices these days, especially with the current economy, I feel like it’s survival mode, right?

Ben Tuinei: Right. And then you have these terrible PPO reimbursements that make everybody upset. Our profitability and margins are really down, team morale is down, and everyone’s trying to do more with less time and less resources. Then what happens next is that you tend to speed through the day, speed through these patient appointments, where the emotional connection that you can have with a patient is not there. That is a lost opportunity in terms of not only earning loyalty from patients but maintaining it. So if you want patients to stay for life, you really, really, really have to build trust through things like empathy, transparency, consistency in your delivery—even if the insurance companies make mistakes and make it difficult. When we’re viewed by the patient as a trusted source because the patient feels like we really care about them and are taking care of them, that’s the kicker right there to me, Naren, in terms of that whole component of loyalty and trust.

Ben Tuinei: So, thank you. And that kind of brings up a thought, Naren. Now, when people talk about this whole concept of patient loyalty, we always bring up the concept of marketing, right? It’s not the flashy or pushy way of doing things, but more of doing things in a deeper sense—by talking about marketing and loyalty at the same time. So with that said, Naren, in introducing the concept of marketing and how it has a big tie into loyalty, how does marketing actually support loyalty beyond the chair time that you spend with patients?

Naren Arulrajah: That’s a great pivot, Ben, and a great question. How does marketing actually support loyalty beyond the chair? I think, having done this now for 18 years, I really believe that a lot of doctors misunderstand marketing. I think it’s because of the survival mindset, right? You’re struggling, struggling, struggling. So you just look at the number of new patients—like patients are a thing, as opposed to real people, real human beings, real emotions, real thoughts and feelings about stuff.

And going back to Maya Angelou, right? It’s not about what you did, it’s about how you made me feel. So I think we have to reframe how we look at marketing. When we reframe it, we really need to look at it from the patient’s perspective. How do we make both new and existing patients feel welcome, feel they belong, feel they’re at the right place?

Of course, when it comes to the nuts and bolts of marketing—that is, the website, the Google reviews, perhaps even your email communication—if you do that on a consistent basis, and even social media posts, they all have to kind of work together to build that trust, build that, “Yeah, you know what? I’m in the right place” feeling.

And like you said, it’s all about that feeling. It’s very hard to measure, very hard to quantify. So you have to provide that. Imagine a brand that reflects warmth. Imagine a brand that reflects trust. Imagine a brand that reflects genuine care. That’s a brand that I want to be part of.

And how do you do that? I’ll give you a simple example. Let’s imagine reading a Google review, and it talks about how the team and the doctor care about that particular patient—where the patient says, “You know what? I have been trying to find my perfect dental home, and finally, I found it. They know me. They know what’s important to me. They even know my kids. They inquire about how my kids are doing. I don’t feel like I’m just a number—just one more thing they have to get through for the day to make some money—but rather someone they care about, someone who they take seriously, whose oral health and well-being they take seriously, not because some spreadsheet told them to, but because they genuinely care.”

So your website and your online marketing have to reflect that. Now, if you are that practice, but somehow your website doesn’t reflect that in terms of highlighting those reviews or highlighting video testimonials where people just love your practice, how do you expect someone who doesn’t know you yet to know that’s who you are?

Naren Arulrajah: You have to make it easy for people to choose you, right? Not make it hard. So go back to what makes you trustworthy. Why do your patients love you? Why do they sometimes even get on a plane and come see you, or see you for multiple generations—the grandparent, the son, and even the grandkids? There’s a reason for it. But now, I think in the hubbub of business, we forget the way to look at things from a patient perspective.

And then the other thing that we forget is it’s about consistency. We all know the story of the hare and the rabbit, right? In that story, pretty much the hare is the sexy one—the exciting one, the cool one—but it gets distracted. It doesn’t do anything consistently versus the tortoise. It’s consistent. It’s really slow, but it just keeps doing it day in and day out.

Imagine you’re getting 10 or more Google reviews every month consistently, and you have a system for this. You talk about it in your morning huddle, and everybody’s bought in, and everybody just works on it day in and day out. It’s not sexy. I mean, Google reviews are not sexy. But imagine getting those lovely reviews again and again. You’re going to show up more on Google search. You’re going to be appreciated by—and chosen by—patients a lot more than your competition, right? It’s about consistency.

So I think a lot of people misunderstand marketing. They think it’s about gimmicks and deals, and some way to—you know, I don’t want to use the word “scam”—but technically that’s what you’re trying to do. Through a gimmick, you try to fool somebody. It doesn’t work.

But imagine, on the other hand, you are a consistent practice. You get those 10 love-letter Google reviews a month. You continue to look at whether your website is showing up on Google for all kinds of searches, and you continue to make sure that happens. So it’s not like some weeks you show up and some weeks you don’t. And again, I’m not talking about ads—I’m talking about organic.

So I really think, if you really want to build trust, be consistent. The Google reviews, showing up on Google search consistently—just keep paying attention. What typically happens—you know, I run a team of 300 people, and I have been an entrepreneur for literally 18 years now—when you start doing things consistently, your team starts doing things consistently. Now it becomes a habit. Just like a child learning to brush their teeth twice a day and then keeping that habit for the rest of their lives until they’re 90 years old. Same thing happens with your team, right? Same thing happens with your business. Just focus on consistency. Focus on that stick-to-it-ness.

Ben Tuinei: Mm-hmm. Yeah. Love it, Yeah.

Naren Arulrajah: Thank you. Yeah. One of the big takeaways from the thread I saw on Reddit was that loyal patients aren’t built overnight. I know we live in this quick-fix, quick-answer world. It’s daily effort from the dentist and the team. What are some practical things practices can do to strengthen loyalty from the inside out?

I’ll give you a secret, right? I have two types of clients. The ones who are just crushing it—meaning they’re getting two, three times more new patients than they know what to do with—and the ones who don’t. And the ones who don’t have three things they suck at, all at the same time.

Number one, they don’t get 10 or more Google reviews a month, especially these love-letter Google reviews. Number two, their conversion rate—the percentage of new patients who end up booking appointments—is dismal. It should be at least 70%. They’re like 30%, 40%. And number three, they’re not getting enough phone calls.

But to me, they all go hand in hand. I don’t know why, but it’s almost like a doom-and-gloom loop. It just gets worse and worse and worse. When people do these three things really well—especially the Google reviews and the conversion rate—they excel. So I would love to hear your thoughts, given your experience with practices, Ben.

Ben Tuinei: No, I love that. I love that. And going back to your question, you mentioned a key phrase: "inside out." How do you strengthen patient loyalty from the inside out? I think that’s a very important question, because starting from the inside is actually where you want to really start. I think loyalty—it comes from within, it comes internally.

So I think the first thing, when you look at your practice dynamics, what is your number one asset? What is your number one expense? Your team. So having a loyal team, and mechanisms there to retain really good people—I think that’s where it starts. It starts with the team.

Ben Tuinei: You know, when you look at patients—patients trust, at least people in general—we trust familiarity. Familiar faces and familiarity with people, right? The consistency that you mentioned. So if your staff changes every six months, patients feel it. They start to question, "Why do people keep coming in and out of this office?"

Secondly, I think it’s important to communicate very clearly. And this is actually, in my opinion, one of the more overlooked dynamics of a dental practice. We all try to work hard on communication, but patients tend to leave when they get confused about something, or they feel a sense of pressure with how you’re delivering the presentation. So take a minute to really explain, and take your time. Use plain English. Use words that people understand. Talk specifically about what’s going on and why the treatment really matters to that patient, but do it from a very gentle perspective and a very clear perspective to these patients.

The third thing, Naren, is empathy. I think empathy is huge. When we start to develop a skill set to be empathetic with people, I would do that outside of work and inside of work. Practice that on a daily basis. Small things—such as remembering people’s birthdays, following up with them after big procedures, or asking them how their kids are.

I remember there was a cosmetic dentist in Phoenix that we were really trying hard to recruit. He didn’t want to join our DSO group. I was working for a DSO. He didn’t want to join any PPOs. He was totally fee-for-service. And they had notes. They had a specific sheet that they built on things they learned about their patient every visit. Their goal was to add one new thing to that list every single time the patient came in, so that the next time the patient came in, they would follow up with those patients on those items.

Ben Tuinei: This particular dentist would write letters of recommendation for his patients who were going to college—or for their kids. Things like that, where people feel these small touches show that you’re part of their life. You’re a leader in their community, a big person in their life. Being a part of it inside and outside of the practice is important.

And then, finally, Naren, circling back to the team—which to me is so important—it’s important to train your team on emotional intelligence. Having a calm tone, putting a smile on your face every time you’re talking to somebody, even if you’re doing it over the phone. When you do things like that, especially with patients who are anxious, you tend to find that those patients have a great sense of appreciation for how you treat them to alleviate their anxiety.

So those are things that you really cannot automate. Why? Because this is all about culture in a practice dynamic, Naren. When we focus as leaders and business owners on our team members—and allow our team members to have the training, skill set, and empathy that we want them to have when they’re communicating with our patients—they’re representing our brand.

And when they do that well, you tend to find that—well, speaking of insurance—there’s really no need to be insurance-dependent, because patients come to you because they trust you. Well, I should say they trust you—and also maybe love you as well.

Naren Arulrajah: Right.

Ben Tuinei: So, that said, Naren, let’s kind of tie this all back into the business side. Because the reality is that loyal patients are more profitable for a practice, right?

But insurance makes loyalty so complicated. So my question for you, Naren, is: how can marketing help practices build loyalty even when insurance feels like it’s not in control?

Naren Arulrajah: Yeah, that’s a great question. And I want to unpack the statement you just made—that insurance makes loyalty complicated. Let’s think about that statement, right?

See, the problem with insurance is the very first question in the mind of all these people is, “Is it covered by insurance?” So it’s not loyalty. It’s not that you are a great dentist. It’s not that you take care of them like family. There’s this other message in the middle that keeps complicating the whole relationship: “Is it covered? Is it covered?”

And unfortunately, I think in the world of faster and faster, we tend to find shortcuts. And I think the shortcut that people with insurance—who come from PPO plans—take is “Is it covered?” So when that shortcut is in the way, it’s almost impossible for you to build trust. It’s impossible for you to build loyalty. I’m not saying it’s impossible, but it’s really, really, really hard.

And part of the challenge when you are in a PPO practice is the amount of money you get paid. You have to do almost double the dentistry for half the money. So pretty much, you don’t have time to build that trust. So on one hand, they hit the patient by changing the way the patient thinks by saying, “Is it covered?” And then they hit you by making you work twice as hard. So you don’t have time to build loyalty.

And I think it’s a great—if somebody was to give them a prize for coming up with the perfect business model where you take advantage of both sides of the coin, which is the doctor in this case and, of course, the patients—they do a beautiful job. They manipulate both people and put both in a box where they really can’t get out.

It’s kind of like a frog in a boiling pot. It’s boiling, and things are getting worse. You’re getting sicker, your patient care suffers, your team is just going through the motions—but you feel like you don’t have a choice. You feel like if you don’t go along, you’re in trouble. So it’s almost like this dependency mindset they create. And they’ve been very good at it. They’ve been doing it for a long time, and they get better and better at it.

But I do think something has fundamentally broken. After COVID, all the expenses have gone up 50%. Insurance is not up 50%. So people are saying, “Enough is enough. I’m not going to put up with this. I’m not going to be the one paying the difference—where my costs are up 50%, but my income from insurance is not up 50%. I don’t want to be the one taking that money out of my own pocket or working even harder just to make ends meet.”

Now, let’s imagine a different practice—where you’re starting to drop insurance, and you’re starting to attract loyal patients through great marketing. We talked about consistent marketing, right? If you are starting to do that, then the question is: What are the components of that?

I kind of touched on it, but I’m going to really, really drive it home. Number one is: You want to be the one people are finding when they have a need. Just like if you’re running a Japanese restaurant that serves a certain kind of sushi—when somebody Googles, you know, “designer sushi” or “South American sushi” or whatever the keywords are—you better show up.

Naren Arulrajah: And the good news for a dental practice is there are hundreds of these keywords that you can show up for. Again, there might be 10 types of services you provide, and each service, there might be 20, 30 keywords that people are typing in to find that service—implants, veneers, you name it. So are you the one they’re finding organically without you having to run ads? And a key metric is if you’re ranking for a hundred or more keywords and phrases on the top 10 results of Google, that means you have an unfair advantage.

Now, something interesting is happening. I know for a while everybody was excited about ChatGPT and so forth, and I just saw that there was a class action lawsuit by two grieving parents where a ChatGPT literally talked their son into committing suicide. This is a computer science 23-year-old graduate with depression, and he goes to this lake in Texas, and he was chatting from 11:00 PM till 4:00 AM. Literally, I posted this on the I Love Dentistry Facebook group, and it was literally saying, “You know, champ, keep going.”

It was literally encouraging him to do this, right? And the poor kid took his own life. So I think one of the mistakes that a lot of these AI companies have made is they have not been thoughtful and careful. Like Google doesn’t do that. They’re much, much slower, but they will never, ever, ever, ever, ever put somebody at risk. They will say, “No answer. I’m not gonna go there. End of story.” But they won’t do this because they have been so cautious.

So I do think Google is getting stronger. I mean, if you notice their stock price, it’s up a trillion dollars. Google still is used 12 billion times a day—12 billion times. You know, ChatGPT is used maybe a hundred million times a day, and most of that is, you know, “Edit my essay,” or, “Summarize this document,” not necessarily finding a local doctor.

So I really think lean into Google. Try to rank for at least a hundred or more keywords. That’s my first to‑do for you. Number two, I already alluded to it: get 10 or more love‑letter Google reviews. These are really powerful. That’s how people decide which doctor to go to—at least 10 or more a month—and they should be paragraph reviews.

Finally, you know, is your website easy to use? Does it work on all kinds of devices? And does it reflect you as a human being? Are you someone they can relate to? If you like traveling, showcase those pictures. If your team, one of your team members, is into baking, have them talk about that or include a couple of pictures on that. Why? We connect with people like us. One of the ways I think we have lost in this digital world and the mobile world is we kind of forget that there’s a human being behind all these roles and situations.

Naren Arulrajah: So do anything to humanize your team, to connect with your team, and make it easy for people, right? People still are impatient. So if your website is slow to load or hard to read or hard to find information, they’re going to go to the next one.

And finally, even social media—be consistent with it. It’s not about doing some gimmick here or gimmick there and killing yourself, like living for social media, but be consistent. I know I touched on being consistent. So that’s how you attract and keep patients for life.

A quick SEO checklist:
Are you ranking for 100 or more keywords?
Are you getting 10 or more love-letter Google reviews each month?
Is your website optimized—is it fast, and does it really connect with people on a human-to-human level?

Those are some of the key thoughts I would lean into if you want to convert and become a practice built on trust.

So if you’re listening to this and you feel your practice is running on autopilot, and you’re not doing any of these things—at least from a marketing perspective—to find, attract, and keep high-quality patients, hey, check out the marketing strategy meeting. That’s insuranceuntangled.com/msm.  Book the meeting.

We will tell you how you’re doing in all these areas, and we’ll even give you a report card versus your competitor’s report card. And finally, we’ll give you a plan.

If you’re doing great and already attracting—remember I said there are two types of clients: the ones who are crushing it and getting two to three times the number of patients they want, and the ones who are constantly struggling. If you’re constantly struggling, more than likely, these things are not going well for you. So you just need to work on them.

And a lot of this can be done by a very good marketing team. We have 300 people—a very sophisticated, deep marketing team that understands all the components and can do all of this.

So that’s my two cents, Ben.

Ben Tuinei: No, that’s awesome, Naren. I love what you said. I fully believe that loyalty isn’t luck. It’s a result of what we talked about—clear systems, very strong communication with patients, and a marketing strategy that really highlights and amplifies your strengths as a dentist. So, love it, Naren. I agree.

Naren Arulrajah: Thank you. Thank you, Ben. And I know you did a marketing strategy meeting, and I know you recommended a lot of your friends. What’s your experience with that?

Ben Tuinei: Yeah, thank you for asking that. I highly recommend it. You know, our clientele—many of them do the marketing strategy meetings and come back and immediately report back to me their thoughts. And not a single person has come back and said, “That was a waste of time.” In fact, some way, somehow, a lot of doctors credit me for what they learned, because I made the recommendation. But in the end, that just speaks to the fact of how valuable it is.

A doctor may be nervous about doing marketing or investing in marketing, but listening to these things and resonating with them and thinking, “That’s where I want to go, that clicks with me”—do the marketing strategy meeting. I can promise you, you’ll walk away with an enormous amount of value, for sure. So insuranceuntangled.com/msm  for that particular offering.

Naren Arulrajah: Thank you. Thank you, Ben. And thank you, all of you, for joining us today for another amazing episode of the Insurance Untangled podcast.

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