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When I was fresh out of a failed associateship and out on my own, I needed some serious guidance. Since my Dad and everyone else in my family were either farmers or bankers, I looked to the speakers of the day to help me build my practice. I dove in head first, and read and listened to everything I could get my hands on about clinical and practice management.

At first guess I thought that the snazzier the presentation of a speaker, the more he knew. I don’t know, but I began my trek from city to city around the country and spent way more on tuition and hotel rooms than I could afford. I accumulated enough CE credits along the way that I was qualified to take the AGD fellowship test way before I was allowed to actually take the exam (back then it was mandatory to be in the AGD 5 years before taking the test.) I can’t say that I didn’t learn a lot of really good things, but I also was steadily indoctrinating myself with a load of junk that literally took years to get out of my practice. I’ll never forget the single biggest mistake that basically torpedoed 10 percent of my entire practice. There were several ways the “Gurus” totally screwed me up in the head and took giant sized bites out of my practice every time I implemented one of their bone-headed, dry fingered, elitist ideas.

I guess I’ll start with the one single hugest mistake I ever made. I had been out west to a wonderful seminar with my staff. The host doctor was charming and very charismatic. The speakers were great and super intelligent. I learned a ton of awesome technical skills that I still use today, but in many ways, I learned behaviors that weren’t practical down here in the middle of nowhere, Mississippi. One thing that stuck out from the main speaker’s presentation was about an hour long monologue about how insurance companies were ruining businesses and how one particular PPO was the worst of all. They even gave us a sample letter to change a little bit and send out to all of our patients, telling them that we couldn’t possibly provide the standard of care that we had just learned at the prices that were being dictated by this PPO, and that we were no longer going to be a provider for their insurance. I was in my first year of solo practice and I believed every word that the speaker had sold me. I sent the letter. Would you like to know how that went over? Let me tell you. I was just starting out and didn’t have all that many charts as yet. I had 90 patients who had the PPO because a local furniture factory used them for their dental insurance. I sent out that letter and guess how many were still in my practice 6 months later? 2, TWO, T-W-O. I basically lost them all. Do you realize that once you have lost those 88 patients through your own stupidity, they are nearly impossible to get back?

Let’s pretend for a minute that you are the patient. You work hard at your job. Your may hate your job, but you stay there, mainly due to the benefits, namely insurance, that it provides for your family. You figure that it isn’t the greatest insurance in the world, but you are spending your hard-earned money on it and it is yours. You have started going to the dentist in town. He is okay nice, a little slow on his procedures, but he does take your insurance. So maybe you’ll give him a chance for awhile and see how it goes. If the dentist is lucky, he can build on the relationship and leverage it for referrals and a lifetime of care for the patient and their family. Now the hard working patient gets some mail from the young, new dentist. It lies on the kitchen counter for a day or so until, after working a 10 hour shift, the patient opens the letter. He reads where the young dentist is saying that he is such a good hotshot dentist that he can’t possibly make it on the measly pittance of a payment that the worker is paying for. The hotshot dentist says that he is going to raise his prices even higher. Gee, the worker thought that the dentist was already charging enough. Heck, the worker already thought the dentist was getting too much. The patient doesn’t even finish reading the letter, pitches it in the garbage can and tells his wife, we’ve got to change dentists again.

Now I’m not saying that this PPO, or any other insurance company is great, or even good. And I’m not saying that everyone should be a provider. But don’t make the mistake that I did. Be very careful about the companies you partner with, but if you are already a provider with a company, then think long and hard about ending that relationship. Consider all the factors, and for heaven’s sake, don’t send out the letter.

Also, whatever else you think about PPO’s. At least they are working within the bounds of Capitalism. At times like these, where our profession will surely be challenged by those who want to steal from us legally, through Socialism, we have to be sure we know who our real enemies are. This is just one example of how the gurus ruined my practice.