The $5 Trillion Opportunity: Why Dentists Are Missing the Wellness Revolution
- Robert H. Maccario, MBA
- Jun 16
- 6 min read
By: Robert H. Maccario, MBA
Clinical Excellence Isn't Enough
The U.S. health and wellness industry is worth over $5 trillion, yet dental services capture less than 4% of this massive market. Despite dentistry's clear connection to whole-body health, most practices are missing out on this boom while struggling with fundamental patient conversion challenges.
The data presents a stark picture: the average treatment case acceptance rates hover around 46%, while new patients accept treatment at a dismal rate of 25-35%. Even more troubling, the retention rate for new patients falls below 59%. This decline isn't just about lost revenue—it's about missed opportunities to deliver optimal care. These concerning statistics point to a fundamental gap in how practices approach patient engagement.
Beyond Clinical Acumen: The Psychology of Patient Decisions
Clinical expertise remains vital, but behavioral acumen—understanding how and why patients make healthcare decisions—has become the key determinant of practice success. While many practices still rely on outdated, pushy sales approaches that alienate today's informed consumers, leading practices are discovering something different: when you align optimal care recommendations with natural human psychology, patients choose comprehensive treatment willingly.
Good Dentistry is Good Business: A Two-Dimensional Approach
High-performing practices are rooted in a commitment to clinical excellence but have integrated behavioral exams into their patient interactions to deliver the full scope of "quality care." Excellence requires mastering two distinct but interconnected dimensions of quality:
Conformance Quality: The first criterion should always be, when considering new or current procedures, do they meet or exceed clinical standards? Treatments should be effective, reliable, and based on modern science. If the answer is yes, then go to the second criterion.
Perceived Quality: Does the process meet or exceed consumer expectations? Emotional connections drive purchasing decisions far more than technical details. As Seth Godin famously said, "Customers don't buy products; they buy stories, relationships, and magic." The standard of care should focus on these two dimensions of quality, making profitability a by-product.
"Build your practice on conformance quality, but market perceived quality."
Stop "Selling" Dentistry—Create a Buying Environment
Patients expect the same level of service from dental practices as they do from other consumer services—they want to feel understood rather than being sold to. The key shift is moving from selling to creating a buying environment. A redefined comprehensive exam should include a behavioral assessment that identifies how and why patients make treatment decisions, creating an environment where patients feel understood rather than pressured.
The good news is that this approach is more consistent with most dental teams' natural behavior—a strong commitment to ethical practices and the delivery of excellent patient care, fostering a supportive environment that prioritizes the well-being of patients, synchronized with the patients' value system.
The pressure to "sell dentistry" often conflicts with their innate caregiving instincts. This tension may lead to feelings of demotivation and burnout among team members, as they struggle to balance the demands of "production goals" with their professional values and desire to provide compassionate care.
Get Off the New Patient Treadmill
Retaining a patient is 5 times more cost-effective than acquiring a new one, yet most practices invest heavily in acquisition while neglecting retention. This doesn't suggest that new patients aren't essential for growth. However, instead, practices must strike a better balance between acquisition and retention in today's highly competitive marketplace, where resources may be limited.
A practice's survival depends on mastering clinical excellence, but today, the real differentiator is mastering the psychological dynamics of patient engagement. Patients don't just buy treatment plans; they invest in attributes that resonate with their values. If a practice fails to align messaging with those values, even the best treatment plan can lose its emotional impact.
Why Traditional Sales Techniques Are Killing Your Practice
Remember Blockbuster? They had market dominance and brand recognition, yet failed to recognize shifting consumer behavior, turning down Netflix's offer to sell to them for $50 million. Fast forward—Netflix is now worth $24.74 billion, while Blockbuster is almost extinct. Your dental practice is at a similar crossroads. If it fails to adapt to patient expectations, it risks irrelevance, just like Blockbuster.
Why Patients Buy & How Patients Buy
The process outlined in this article focuses on both current patients of record, many of whom have diagnosed but untreated conditions in their charts, and new patients to establish a trusting relationship.
It all starts with a simple conversation, regardless of their status in the practice, whether they're a current patient of record or a new patient. Taking a bit more time upfront will save a significant amount of time in the future, resulting in a dramatic increase in treatment acceptance and patient well-being.
What You Should Listen For
Three key principles:
Put the conversation into the proper context: "Mrs. [Patient], just like a fine hotel or a friend in our home, we want to treat you like a guest. Would you mind if I asked a few questions so we may take better care of you?" It is essential to emphasize that providing the best, most affordable care is our primary goal.
The best communicators listen more than they talk. This type of interaction is not an interrogation; it is a sincere conversation. Use an 80/20 mix—80% listening, 20% asking appropriate, tactful questions.
Skip the "sales pitch." Now is not the time to go into a presentation. To enhance patient well-being and increase treatment acceptance, a practice must coordinate the behavioral exam with the clinical exam to facilitate a more cohesive treatment consultation, aligning care recommendations with the patient's values.
Listen for the "Why" They Purchase
What did you hear that is important to them—their motivators? Why would they buy this treatment plan? Over the years, we have found that typically, patients predominantly express only one or two of these five motivators:
Pain/Fear - Physical or emotional discomfort now or fear of future pain
Appearance - Desire for a better smile, confidence, social or professional image
Time - Avoiding unexpected interruptions in their schedule or missed work
Cost - Concerned about price, insurance, or an unanticipated costly emergency
Health/Function - Long-term wellness and functionality
Identifying the patient's motivating factors, also known as their PATCH (Pain, Appearance, Time, Cost, Health), is crucial for effective treatment planning. Patients do not have all five motivators; they commonly have a primary and a secondary motivator. This system minimizes two of the most common mistakes in a consultation: #1. The treatment coordinator tries to address all five motivators, or #2. The treatment coordinator only discusses the motivators that are most important to them. Typically, in a dental practice, if there isn't a lack of money, then it's health and function. Both #1 and #2 can break rapport with the patient, who is now thinking, "Why did I answer those questions if they're going to ignore the information?"
The DISC System: Understanding "How" Patients Buy
The practice needs to become "chameleon-like." Use the DISC behavioral assessment to identify communication preferences. Understanding that "I like people like me, and I buy from people I like" isn't manipulation—it's respectful, essential communication understanding. By adjusting your behavior to align more closely with patients' natural preferences, you create a personalized care experience that modern consumers expect.
During the initial patient interview, what did you hear or observe about their behavior? In this example, we circle the observed behavior on the assessment grid—how do they make decisions? Watch and listen for distinct behaviors. You may not get all four consistently, but three will provide a solid understanding of how they make purchases.
In this example shown above, during the intake interview, the patient displays four "S" and three "C" behaviors. Looking at the first graphic, you will see that "S" and "C" are more reserved and people-oriented. Since they prioritize relationships, it's advisable to speak at a slower pace and anticipate detailed responses, given their reserved nature. Unlike a pure "C" that might be task-oriented, this patient will rely heavily on the relationship to build trust. It's a soft process—attempting traditional high-pressure sales techniques to "close" the treatment plan will alienate this patient.
When you understand PATCH and DISC systems, you will now know why they buy and how they make buying decisions. You know what to say and how to say it. In this example, identifying and interacting with the patient as an "S" type indicates that the situation is a safe, trust-based "buying environment."
Conclusion
Developing and implementing behavioral fluency is the differentiator from the consumer's perspective. Your practice's future depends on this evolution. Clinical excellence remains your foundation, but patient psychology and behavioral understanding will determine whether you thrive or even survive in today's competitive landscape. The question isn't whether you can afford to implement these systems—it's whether you can afford not to.
Ready to Master Behavioral Fluency with Your Patients?
We've worked with hundreds of dental professionals across North America to build practices and businesses based on trust, clarity, and lasting growth.
Let's talk.
Robert H. Maccario, MBA
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REFERENCES:
US National Health Expenditures: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2024.01375
Tracking Case Acceptance Rates for Dental Practice Growth. https://www.practicenumbers.com
Increase Practice Profitability by Tracking These …. https://www.thedentalcfo.com
How dental practices fare in case acceptance, collection … https://www.beckersdental.com
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