2025 Year in Review. What Thriving Practices Did Differently

Intro: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice—one that provides personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, your podcast co-host. The title of today’s episode is very appropriate, given that we’re publishing this on New Year’s Eve. The title of this episode is 2025 Year in Review: What Thriving Practices Did Differently.

I’m going to do a little bit of a year in review for you today before I get to my announcements. Before we get into this episode, I want to take a minute and wish each and every one of our listeners a very Happy New Year. Here we are on the eve of a new year—here’s to making 2026 a year filled with joy, happiness, and, on the business side, your best year yet. Nothing would make me happier than to have you achieve that.

Before we get into the episode, two quick announcements to make.

First announcement is: you may know that we often do virtual events for our Thriving Dentist audience. We do webinars, we do panel discussions, we’ll have various experts at different times, and we do those throughout the year. We do those at no cost—those are done as a courtesy to you, in appreciation for your listenership.

If you want to see what the next event is coming up, just go to thrivingdentist.com/events —and register. Although there is no tuition involved, you are required to register. So, periodically visit that landing page for our events and make some plans to join us during 2026 as a way to supplement your continued education. Come join us!

The next announcement I have is: we have my podcast co-host, Naren Arulrajah, joining us with a Thriving Dentist marketing tip. This tip is in response to a question that was submitted by one of our listeners. The question is: Why do startup practices use Google Ads, even though it’s more expensive?

If you’ve ever wondered about the strategy of using ads, Naren is going to unpack that for you.

No further ado—here’s Naren on: Why Do Startup Practices Use Google Ads, Even Though It’s More Expensive?

Naren Arulrajah: Why do startup practices use Google Ads, even though it’s more expensive? This is a great question.

What do startup practices not have that established practices do? It’s active patients. So what are they doing? Instead of paying an owner hundreds of thousands of dollars—or a million-plus dollars—to buy a practice in exchange for those active patients, they are saying, "We’re going to grow those active patients ourselves." So, the money they save by not having to pay the old owner for those active patients, they’re willing to invest.

You have two options for getting new patients. You can get them through SEO, which means you don’t run any ads. People find you organically, choose you, and you get new patients without ads. But the problem with SEO is it takes time. So, startup practices say, "You know what? Instead of waiting and building my SEO, which might take a year, let me immediately jump in and use some of the money I saved by not buying a practice—perhaps hundreds of thousands of dollars—and invest it in Google Ads."

Now, Google Ads are a lot more expensive than SEO. For example, a new patient you get from Google Ads might be 10 times as expensive as a new patient you get from SEO. For that reason, you’re going to spend a lot more. But compared to the hundreds of thousands of dollars you save by not giving the old owner money for those active patients, perhaps you have the money to do that. That’s why startup practices use Google Ads—to get new patients aggressively.

Keep in mind, your expenses are going to be really high. You might end up spending $200, $300, or even $400 per new patient.

The other thing you also have to keep in mind is: people who come through ads are not going to trust you. Why? Because they know they clicked on an ad. Their subconscious mind is saying, "Why is this doctor running an ad? If he’s a qualified doctor, he should be good. So he shouldn’t be running ads." Now you have to fight that doubt they have—doubt around, "Are you good? Are you not good?"

As a startup practice, you also won’t have hundreds of Google reviews. So, on one hand, they have doubt because you’re running ads. On the other hand, they don’t trust you because you don’t have a lot of reviews. So, you really have to train your team extremely well. Help them perform at an A+ level. You have to listen to your calls.

You need to know your call conversion rate. One of the things I’ve noticed is that call conversion rate with Google Ads is typically half of the call conversion rate with SEO. Why is that? Because of trust.

So don’t invest money on Google Ads unless you’ve already trained your team to be amazing when it comes to answering the phone—rolling out the red carpet, welcoming patients, and booking the appointment. Make sure you’re investing in training. Make sure you have a good team before you start spending money on Google Ads.

The other thing I would caution you about is having amazing landing pages. Of course, it depends on the type of ads you run. For example, if you’re running ads for Invisalign, and I go to your Invisalign page and I don’t see a lot of examples of you helping people with Invisalign—those beautiful after smiles, the full-face after smiles—why would I, who clicked on an ad that cost you $5, trust you when I don’t see any examples of amazing outcomes you’ve been able to create?

So again, don’t run ads until you can create those amazing landing pages. Those landing pages should have at least four to five cases with full-face after pictures. Even do a small write-up for each case—explain what happened. The before picture could be a close-up, because many people won’t let you take close-up pictures when it comes to their not-so-awesome smile. But after smiles—when it’s awesome—they’ll love to smile and give you the full-face picture.

Also, videos are very powerful. Welcome them. So on the Invisalign page, say something like, “I’m so glad you are here to learn more about our Invisalign. We’ve been helping patients with Invisalign for so many years.” Especially if you have prior experience—even before you opened this practice—include that experience. Welcome them. Have them look around, see those cases, call the office. Make people realize you’re friendly, you’re welcoming, and you’re really looking forward to seeing them.

Those first impressions are what make them decide to pick up the phone and call.

Now, finally—like I said—it is more expensive. So, as a startup, you also want to dominate Google. To dominate Google with SEO, it’ll take at least a year. By doing that, you will eventually cut down the cost of a new patient literally by orders of magnitude. One-fifth the cost, or even one-tenth the cost.

Like today, I’m having a meeting with one of our clients. It’s costing him $30 per new patient—literally. Compared to Google Ads patients, which would cost him $300 per new patient.

Now, if you want to figure out how you’re doing with marketing overall—how you’re doing with Google reviews, how you’re doing with Google Ads or SEO—book a marketing strategy meeting. That’s my gift to you. I just gave you generic advice for all startup practice owners. If you want to figure out what you need to do, book that marketing strategy meeting.

As a startup practice, you need to dig in for the long term. Make sure you’re building a strong foundation, which means you’re dominating Google. You’re ranking for 400 keywords. To see how you’re doing overall with marketing, and what you need to do to dominate Google and dominate marketing, book a marketing strategy meeting.

The link is ekwa.com/td.  When you go to that link, you can book a one-hour meeting. Our team will spend six hours preparing. They’ll tell you how you’re doing with Google reviews, how you’re doing with landing pages, how you’re doing with SEO, and they’ll also give you a roadmap—a game plan.

So take advantage of it. It’s our gift to you.

Naren Arulrajah: Really excited about today’s conversation, Gary—2025 Year-End Review: What Thriving Practices Did Differently. Now, as a co-host of this podcast, I know there’s a lot you have learned, and I have learned, and our clients have learned. Both you and I have mutual clients, so hopefully we can bring some of that into today’s episode.

This is going to be full of really high-quality information—again, based on real-life experience with dozens and dozens of practices. So, take your pen, take some notes, and of course, if you find any of these ideas useful, implement them, which is the most important thing. And of course, we would love to hear your experience.

Now, you heard my tip—if you’re a startup practice, or any practice, and you need help to evaluate your marketing to see if you are doing well with AI in the age of AI, please book that marketing strategy meeting.

Once again, that link is ekwa.com/msm. 

Now, we are publishing this on the 31st of December, so I also want to take a minute to wish all of you a Happy New Year and an awesome holiday season. As we look forward to 2026 and open up this wonderful, amazing new year, also take a minute to reflect on everything you have accomplished—the people you are grateful for, the people you want to thank.

I know a lot of times in life, you don’t get everything you want, but we definitely do get some of the things we want. So, hopefully, let’s spend a minute to be grateful, be thankful, and then jump right in.

Gary, any comments on how you feel about 2025?

Gary Takacs: Oh, you know, this is going to be a fun episode, Naren, because the reality is, if I step back and look at the dental profession in 2025, I think it’s fair to say that it’s a bit of a mixed bag. It’s a mixed bag, right? And I have an interesting seat at the table to provide a look in the rearview mirror.

If I look at my work as a coach, I have some really great examples of practices where 2025 was absolutely their best year yet. It’s just a continuation of the trend. However, as many of you know, I spend time speaking, I spend time teaching outside of my coaching work, and it gives me broader exposure to what the profession has experienced. And I think if we take our focus to a broader lens, the reality is there were a lot of practices that struggled during 2025—struggled with not enough new patient flow, struggled with insurance companies reducing their fee schedules.

And because they were in-network, they were subjected to that. Parts of the country experienced, in terms of the economy, a bit of a mixed bag.

You’re in Canada, which is different, but what would you say the Canadian economy was like in 2025?

Naren Arulrajah: I mean, both—of course, 90% of our clients are American, so I totally echo what you said, Gary. It kind of feels like 2007, 2008—remember the last recession? What happened then was the banks exploded, managers dried up, and all of a sudden, people got really worried and stopped spending money.

What’s different this time is AI—that’s the disruptor. So, on the surface, the economy looks like it’s growing, because if you look at the growth in the economy, almost all of it is coming from like 10 companies—NVIDIA, Google, and so forth. But even those companies, including Amazon and Google, are laying off tens of thousands of people. Whether we like it or not, we all know eventually AI will do more and more of human work. And already, companies—especially the leading-edge companies—are saying, "I don’t need people to do this work anymore."

So I do think the next four or five years are going to be bumpy. And like always—I know you and I talked about this—when this happened the last time around, when things get hard, the people who are swimming naked—of course, the tide goes down—they’re exposed and they go out of business. The ones who are strong get stronger. And I honestly feel like we are going through that phase again.

Gary, I think 2025 is the beginning where the good ones—like you said, some of your practices are thriving, they’re crushing it—they get even stronger. And the ones who are just hand-to-mouth, just barely surviving, they’re having a hard time.

And I think you’re right. For example, studies are showing that everything is more expensive—in both Canada and the U.S. They ask people about groceries, about heating, about housing costs. Everything is more expensive. And that trend hasn’t changed. 2025 is more expensive than 2024.

Gary Takacs: Well, that’s certainly true within dentistry, right? I wish, Naren, I wish there was a dental cost-of-living format that we could measure—what our expenses are. Because absolutely everything we buy in dental offices is more expensive. Everything we buy.

And then, when we also look at wage inflation—wage inflation in 2025 was extreme. And it’s continuing. It’s not letting up. It’s continuing. And yet, when you combine that with the model that most dentists—more than 90% of dentists in the United States—this is sobering, Naren. More than 90% of the dentists in the U.S. do not set their fees.

Now, some of you listening may say, "Wait a minute—what? Wait, what?" Step back and look at it objectively. If you’re a participating provider of an insurance plan, you do not set your fees. The insurance company just did. And those fees are going down.

So think about that, Naren. Your costs are going up—in some ways, extremely so—

Naren Arulrajah: Like, for example, the last five years, it’s up 50% for most practice owners.

Gary Takacs: And yet your revenue is going down because you let a third party set your fees. If there was a term that I would use to describe—and you’ve alluded to it, but I’ll put a label on it, Naren—I believe that 2025, when we look at economics, was disruptive. And AI is part of that disruption.

Naren Arulrajah: Yes.

Gary Takacs: Disruptive. And if you keep doing the same thing—you know that analogy of the boiling frog comes to mind. For those of you that aren’t familiar with it, I’ll explain it real quickly.

This is a fable—the fable of the boiling frog. The fable goes like this: word has it that if you have a pot of boiling water and you drop a frog into the boiling water, the frog will immediately jump back out and save itself.

By the way—don’t do that.

If we have anyone who would like to do an experiment, do another experiment. Don’t do that one.

But on the other hand, if you put a frog in a pot of warm water and then turn the heat up, the frog will be like in a jacuzzi—enjoying the jacuzzi—and will actually boil itself to death because it doesn’t jump out.

In my opinion, that absolutely describes where 90%—90-plus percent—of dentists in the United States are by participating with PPO plans. They’re the frog in the boiling water.

You know—it’s just fine. It’s warming up. It’s nice. It’s working fine. "I’m busy. My schedule’s full. I’m doing fine." And then they keep turning the heat up. Next thing you know, you’re boiled to death.

I believe our economy, and the way the current business conditions are right now, it’s disruptive. And you’ve got to pivot. You’ve got to change.

Same old, same old—I’m going to suggest—is not a good strategy right now. That’s what the frog in the boiling water did.

However, on the positive side, there are many dentists who had a lot of positive things going on in 2025. Despite the fact that things are a bit disruptive, they responded appropriately—and it was their best year yet.

So I think the mood of the year—if you think of the mood of the year—the mood is one of uncertainty and disruption. I’ll add that term—uncertainty—in there as well.

Naren Arulrajah: Yeah, exactly. I want to piggyback on that, Gary, and I want to ask you a question.

As you look back at 2025, what story or stories did this year tell you based on your work with these dozens and dozens—probably like 60+—dental practices?

Gary Takacs: Yeah, it’s actually many more than that, Naren, in terms of coaching and having intimate involvement with practices. And you know, the story is: these are the good old days. That’s the story that rings true in my client base—these are the good old days. Not before. Not “back in the day.” Now—these are the good old days.

Why? Because people are more interested in health than they ever have been.

Naren Arulrajah: Right?

Gary Takacs: Yeah. Is that a truth, Naren?

Naren Arulrajah: Yes.

Gary Takacs: I mean, look—I can give you many indicators. People are living longer, right? And by living longer, they don’t want to live longer in a decrepit state. And let’s talk about that dentally. They don’t want to live longer with no teeth. They want to live longer having all their teeth and chewing function. So people are more interested in health than they’ve ever been in the past.

We have advances in technology that allow us to do things clinically that were more difficult in the past.

Naren Arulrajah: Even AI, right? With diagnostics—it’s a game changer.

Gary Takacs: Yeah. AI and diagnostics. We recently had the CEO from Overjet on our Thriving Dentist Show podcast, and she gave some really interesting insights into how AI is going to help us improve diagnostically beyond where we’ve been in the past.

Placing and restoring implants is another area where we have all kinds of advances. But it can go beyond that. Think about any number of high-value services—helping people achieve health in ways they’ve never achieved before.

Another trend I see is this: as the world becomes more automated, customer service goes in the toilet.

Naren Arulrajah: Yes. Absolutely. I mean, now people are even talking about AI receptionists and whatnot, right? There’s no relationship anymore. It’s dying, which is unfortunate.

Gary Takacs: But how many times—any of our listeners—how many times have you looked for a phone number to actually speak to a person? I mean, I know, it’s crazy talk—you want to speak to a person who might be able to answer your question or help with a problem you’re experiencing. And you go in this endless loop.

So, if you can excel at customer service—if your office can be the exception to that—how do you stand in the minds of your patients? You stand bigger than ever.

The humanistic side of dentistry is more important than it ever has been. And offices that excelled—those that had a record year in 2025—they mastered the behavioral side of dentistry. That people side of dentistry.

Shifting patient expectations—Naren, I think the consumer is more demanding today than they’ve ever been.

Naren Arulrajah: Exactly.

Gary Takacs: Think about how long things last. How long do we expect our new laptop to last? Longevity in product cycles is longer than ever, yet it’s also conflicted because of all the new advances—we always want the latest and greatest.

Naren Arulrajah: Yeah, I’ll give you a practical example. You can literally go to Google today and ask a very specific question, and it’ll give you a thoughtful 100-word answer. Now people are taking that answer and going to their doctors.

You really have to up your game, because consumers no longer have to dig through three websites to find three different opinions. Google will summarize it for them.

So it’s good and it’s bad. On one hand, you have patients who don’t know the full picture and are kind of getting lost. On the other hand, you have people who care about their health. They’re asking, “Hey, my mom got dementia” or “My dad had dementia, and I remember the doctor said they had gum disease. What can I do? How do I make sure I don’t go down the same path?”

So I think this is all really, really interesting.

Gary Takacs: Another example—just clinically, to take a quick detour—the public awareness of sleep apnea is much greater than ever before. And part of that is the companies that provide solutions to sleep apnea. You’re seeing ads everywhere. The awareness factor is greater.

People today realize that sleep apnea is a very serious—perhaps life-threatening—condition. It’s not just an inconvenience or snoring noise. And they want solutions. That could be you, if that’s an avenue you want to pursue.

But in any area a doctor has interest in—what I call high-value services—there’s something the public is interested in, that you could provide. And it could set you apart from your typical drill-fill-and-bill dentist.

If you’re a drill-fill-and-bill dental office—

Naren Arulrajah: You’re in trouble.

Gary Takacs: You’re in trouble, yes. And by the way, what are most PPO practices?

Naren Arulrajah: Unfortunately, they are drill-fill-and-bill.

Gary Takacs: Drill-fill-and-bill the insurance company—and accept a 45%…

Naren Arulrajah: Exactly.

Gary Takacs: Make a 45% haircut on a commodity. They’ve commoditized you.

Naren Arulrajah: Exactly. And that’s what you have to be careful of. Even AI is doing that. So you have to stop being commoditized. You need to have those relationships, those deep connections with your patients—educating them.

Gary, let me switch gears.

What stood out to you about the practices that struggled the most in 2025? What were the common patterns?

Gary Takacs: Well, there are some things that really jump out at me. One would be an office that has failed to understand that marketing is an absolute essential business function that they have to master. Marketing is something they need to master.

Most dentists—especially if you’re a PPO practice—don’t think they need to market. They think, “I don’t do any marketing.” Well, yes you do. Signing up for that PPO plan is marketing.

And from this moment forward, I want you to think of your adjustments—the amount you’re writing off—as a marketing expense. For example, let’s say we have a typical million-dollar practice. Run the math on this scenario with me: they collected a million dollars, and 85% of their patients are PPO patients. They’re experiencing a 45% discount. How much are they writing off for the year?

Naren Arulrajah: So, a million-dollar practice, 85% are PPO patients. If you’re only keeping 55% of that 85%, then you’re writing off around $300,000 to $350,000. That’s like $30,000 a month. That’s a pretty big number, Gary.

Gary Takacs: Do you have many clients that spend $30,000 a month on actual marketing, Naren?

Naren Arulrajah: No! We charge $1,250 a month for our clients, and they get 20+ new patient calls every single month just from Google and SEO alone. So no need to spend $30,000 on marketing.

Gary Takacs: I actually did the math, Naren. $467,000 is what they wrote off.

Naren Arulrajah: Wow. $467,000?

Gary Takacs: So that’s not quite $40,000 a month.

Naren Arulrajah: Almost $40K. Like $2,500 short of it. That’s crazy.

Gary Takacs: It is crazy. So that’s one of the things I think offices fail to recognize—that they’re paying Delta to provide them with patients. And as a result, they’re getting $0.55 on the dollar. You have to start looking at that as a marketing expense. And there are so many better ways.

Now, let’s go a different direction—it’s not one-dimensional. Another big reason practices struggled? Leadership gap.

Naren Arulrajah: That’s a big one. Probably number two after marketing.

Gary Takacs: Yeah, I’d put it right there—leadership gap. They failed to emerge as a leader in their practice. And as a result, they’re not leading their patients, and they’re not leading their team members. Team members today are demanding more. They want an engaged workplace, and that’s not being provided.

And by the way, when you have a leadership gap, one of the byproducts is higher turnover. Offices with high turnover absolutely struggle.

Now, I don’t think turnover is something we can completely eliminate. I’ll be pragmatic about that. But I don’t want anyone leaving your office to go work in another dental practice down the street. If that happens, to be blunt—look in the mirror. That’s what happened.

You have to make your office the best game in town and attract and keep the best team members. Not easy—easier said than done. But necessary.

Another area I would go to? Complete lack of systems. Everything is just knee-jerk. There are no systems.

Naren Arulrajah: Can I brag on you for a minute, Gary? One of the keys to your clients succeeding year after year and making every year their best yet is the nine KPIs you insist on.

You measure these KPIs monthly and help your clients get better. Then, you implement systems to improve those KPIs. For example, one of the KPIs you track is number of new patients. If a client isn’t getting enough, you help them identify the root cause. Maybe marketing isn’t working. Maybe the conversion rate is low—calls are coming in but not being booked.

Or maybe it’s trust—if they’re not consistently getting Google reviews, that’s a good indicator that patients don’t trust the practice yet. So, you not only track the KPI—you solve for it.

If their conversion rate is 30%, you and your team get on the phone and coach them to improve it to 70%. So even if a practice is struggling, I’ve seen you help them turn it around. I’ve seen people go from $50,000 a month to $100,000 a month in two years.

Gary Takacs: Thriving teams have systems—and those systems support them. They help retain people. Without them, team members get frustrated.

Let me name a few more failures I’ve observed this past year:

Reactive decision-making. Just making knee-jerk decisions instead of having a master plan or framework for decision-making.

Naren Arulrajah: So you’re saying—go left today, go right tomorrow, then back to left again? Just spinning in circles?

Gary Takacs: Exactly. It’s like a pinball machine—bouncing all over the place. That leads to team stress, turnover, HR issues. You put all that together, and the dental office becomes a very frustrating place—for doctor, team, and patients.

But it doesn’t have to be that way. You can avoid all of this. It’s like walking through a landmine field—you just have to avoid stepping on the mines.

Say you’re not getting a consistent source of new patients—great, let’s build a marketing plan.

Overhead too high? If you’re giving away 45% to the insurance company, that’s the culprit. You’re not going to solve that by saving a dollar on a box of gloves. A “nifty thrifty dentist” isn’t going to change their practice by cutting small supply costs.

You need fundamental change. Like getting 100% of your fee instead of 55%.

Naren Arulrajah: Thank you, Gary. Let me switch gears. You’ve also studied the best of the best—the most successful practices.

What did they do differently in 2025?

Gary Takacs: Yeah. You know, I would—following a similar pattern I started before—say they’ve learned how to master marketing. And I truly feel like today, in 2025, as we’re recording this (soon to be 2026), any dentist can feel like they have their hand on the spigot for the garden hose. They can turn it up, they can turn it down.

By that I mean they can modulate their new patient flow in the practice through science—through proven strategies that have worked—not only to attract the right number of new patients, but also to attract the right types of new patients.

Let’s say your office had a good year in terms of numbers last year, but you felt like the cosmetic dentistry component of your practice was kind of stalled out. And so, what you want to do in 2026 is see more cosmetic cases. I truly feel—with the right marketing resources—you can make that happen. You can not only get more people through the door, but more of the right types of procedures you’d like to be doing.

So that’s one thing: they master marketing.

Another is a leadership mindset on the part of the owner-dentist. Being a true leader—with a vision that inspires your team. A vision where they feel like they’re part of something that’s bigger than themselves.

Next: strong systems. Systems that are just buttoned down.

For example, a hygiene reactivation system that works like a well-oiled machine—reactivating patients who are past due. That system ensures we don’t just let patients drift away.

And this applies to all our systems. We have clear communication—doctor to team, and doctor to patient. We have a real understanding of the economics of the practice—not a fleeting understanding. We know our profitability.

Naren Arulrajah: Like you mentioned, if you’re giving away 45% of every dollar you produce to the PPO plan in the form of a write-off, you’re losing money. You might as well shut your doors and retire—or just not even come to the office. You’re wasting your time.

Gary Takacs: Yeah. I’ll focus on a couple more.

If you’re a regular listener to the show, you know how strongly I feel about the importance of a really strong hygiene department. And sadly, I feel like—using that word disruptive again—some dentists are thinking they should abandon hygiene.

“Heck, I lose money every time I see a hygiene patient—maybe I should just get rid of it.” I couldn’t disagree more.

First of all, think about our patients’ health. They need professional hygiene care. Sure, they can do a decent job at home…

Naren Arulrajah: I’ll raise my hand—I need hygiene care. I mean, we all do. Even you do, Gary.

Gary Takacs: Yeah, we all do. We still need the support of our hygienists. So no—we need to double down and make hygiene an even bigger part of our practice. Because hygiene has a direct correlation to the doctor’s schedule.

Naren Arulrajah: Exactly.

Gary Takacs: In our client base, about 60% of high-value dentistry comes out of a hygiene appointment. Because we’ve planted seeds—maybe the patient was interested in Invisalign but wasn’t ready. Then, something in their life changes, and now they are ready. They say, “Doc, I’m ready to do that Invisalign we talked about.”

But if we don’t have hygiene going on, where’s that going to go?

Naren Arulrajah: Exactly—they’re going to go to somebody else.

Gary Takacs: Another office.

Naren Arulrajah: And then they may even come back… but the opportunity’s lost.

Gary Takacs: Yeah. So hygiene is more important than ever. And if it’s costing you money to provide hygiene, the root cause is likely your fee. If you set the fee—raise it. But if someone else is setting the fee—like the PPO plan—you’re losing money. And you need to get rid of the culprit.

Change that.

And I’d say maybe most importantly, these practices have a strong, calm, visionary, confident culture. A culture that’s bigger than any one person—and your team believes in it.

Nothing easy about building that. But how much effort have you spent on it? If the answer is “not much,” then it’s not going to happen by itself.

You’ve got to change it.

I’ve had the privilege of working with over 400 practices that have successfully resigned from PPO plans. Now, the truth is—that’s not for everybody. You know what’s a lot easier, Naren?

Naren Arulrajah: Signing up for a PPO plan.

Gary Takacs: Exactly. Think about the phone call…

In PPO practices, team members who answer the phone typically have a low level of customer service.

Naren Arulrajah: Yeah. They’re like order takers. “I get free dentistry—when can I come in?”

Gary Takacs: “I’m calling for my free dentistry. Can you get me in?” And anybody can answer that.

But helping a patient understand why they should be a patient in your practice? That takes work. That takes skill.

Naren Arulrajah: That takes brain. I really believe one of the things that’s going to happen with AI is this: people who are thinking, who are using their brain on a daily basis, will thrive. The ones who are just checking in and being order takers? They’ll be replaced.

Hate to say it, Gary, but the writing’s on the wall. This is the time where if you’re a knowledge worker—or any worker who interfaces with people—you need to start using your brain. You need to start leaning in.

Gary Takacs: AI will control anything that’s commoditized.

Naren Arulrajah: Exactly.

Gary Takacs: And how do you protect yourself from that? By doing work that cannot be commoditized.

Naren Arulrajah: Exactly.

Gary Takacs: That’s the gist of it—right there.

Naren Arulrajah: Thank you, Gary. And by the way, Gary said marketing should be a key focus. If you want to make 2026 your best year in terms of marketing, book that marketing strategy meeting:  ekwa.com/msm 

And if you need help with leadership, culture, or systems—and you feel like you’re climbing an uphill battle—then book a coaching strategy meeting:  thrivingdentist.com/csm 

Gary, let me switch gears.

I know staffing has been a problem for several years—going back to COVID—and it still seems to be a major challenge.

What are thriving practices doing to attract and keep great team members?

Gary Takacs: Yeah. You know, I would say that COVID was the pivot—the turning point—that really developed into the staffing crisis we’re still experiencing. And it’s not isolated to dentistry, right? It’s happening across many different industries.

We have to create a better environment for our employees—for our team members.

The offices that are doing well with this? They work on culture. They don’t just hope it happens—they create a culture. They support their team. They have open channels of communication.

Here’s a simple example: Pre-COVID, a doctor could be considered an “advanced” dentist if they did annual reviews for team members. Right? Because most doctors avoided them altogether. But today, an annual review doesn’t cut it. It’s too far out in the future. What we need are regular check-ins with our team members.

Naren Arulrajah: You know why a lot of doctors stopped doing annual reviews, Gary?

Gary Takacs: Why do you think?

Naren Arulrajah: Because they’re afraid of the raise conversation. They think the team member will ask, “Am I getting an increment?”

Gary Takacs: Exactly. The team member thought the review was when they’d get a raise. So doctors thought, “I don’t want to deal with that—so I just won’t do reviews.”

What if we separate the review from the raise?

Instead, we have regular check-in meetings—progress reports. How are you doing? What resources do you need to improve this? We actually assist our team:

“What resources can I provide you to help you succeed?”

People want to be heard. Your team members want to be heard. Do you have an environment where they can be heard? Where they can speak up—and you can respond?

So, this really comes down to leadership, vision, and regular training. Also:

• Create growth pathways for team members.
• Ask, “How can I help you get where you want to go in your career?”
• Create flexibility. For a long time, I believed the best teams were made up of full-time employees. I no longer believe that.

If someone wants to work three days a week because that fits their life—why not create that schedule for them?

There are a lot of different ways to approach this. But the key is creating an environment that is a win-win—for the doctor and for the team.

Naren Arulrajah: Thank you, Gary. Yeah, this is a really tough nut to crack—staffing challenges. And you’re right: if you don’t overcome this, it’s very hard to build a strong practice. Because if you have a revolving door, how can you grow?

Knock on wood, you’ve been able to help 98% of your clients solve this. And of course, maybe 1 or 2% are just… beyond help—because sometimes they’re in their own way.

But for everyone else, there’s a method to the madness:

• Daily huddles
• Check-in meetings
• Hiring the right people
• Letting go quickly when someone’s not a fit

I’ve seen this in your best practices. They “get it.” It’s almost in their DNA.

Gary Takacs: There’s even more to it, Naren. It’s really about creating an environment that allows your team members to thrive—and making that a priority.

It may sound tricky, but it’s very important.

Naren Arulrajah: Thank you, Gary. Let’s switch gears.

We’ve talked about people, and what the best and struggling practices are doing.

Now let’s talk about the top practices from a financial perspective.

How do the top practices stay financially strong—even with rising costs and tight PPO fees?

Gary Takacs: Yeah. You know, it really comes down to—

Naren Arulrajah: Is it by saving a dollar on a box of gloves?

Gary Takacs: Well, I think our listeners could answer that question for themselves by now—no.

Spending two hours of your time to save a dollar on a box of gloves? That makes no sense. Now, hey—in all fairness—I don’t want to pay any more for gloves than you do. But that’s not where our time and effort needs to be.

So what does matter?

I’ll give you the number one system that makes the economics in your practice work—above everything else: Scheduling system.

I think I just heard some heads explode there.

Naren Arulrajah: Scheduling system?

Gary Takacs: Yeah. Think about it.

• Do you have a daily goal?
• Do you have a scheduling template that allows your team to actually hit that goal?
• Do you monitor it daily?
• Do you adjust as needed?
• Is it finely tuned?

Or… is your team just filling in names in a digital appointment book—just plugging people into openings?

Scheduling, scheduling, scheduling.

I’ve set a goal for our clients to grow by at least 10% every year in collections. Now, assuming nothing else changes—we’re not adding a new provider or more hygiene days—how do we get that growth?

Naren Arulrajah: Simple math. If you’re producing $3,000 a day, and you want 10% growth, your new target is $3,300 a day. Or maybe even $3,500. That means you need to schedule the most profitable cases first.

So every day, if you’re doing one to three productive, profitable procedures, that growth isn’t a problem.

Gary Takacs: I’ll let out a “dirty little secret” that’ll sound obvious once I say it: Most of dental financial management is just a math problem.

Naren Arulrajah: And it’s like grade 2 math. We’re not talking about Ph.D.-level calculations here.

Gary Takacs: No, literally—it’s second-grade math.

How can you be profitable if you give away 45% to the fat cats at Delta? You can’t solve that with coupons or discount supply websites. You won’t solve that by saving a buck on gloves.

That’s “new math” for sure—and it doesn’t work.

What does work?

• Scheduling: Create a template that works.
• Have discipline around your schedule.
• Know what you want to grow in your practice—because not all growth is created equal.

Let’s say you want to do more high-value services—that’s going to contribute more to your profitability. So let’s do more of those. Let’s also work toward reducing insurance dependence, step by step.

It’s still a small percentage of practices that have dropped PPOs—but those that have are seeing more profitability, enjoyment, and freedom than ever before. And they’ve solved a lot of other practice headaches in the process.

So the question becomes:

What are you doing in 2026 to take steps toward that?

If you’re not ready to drop PPOs yet, that’s fine. But what are you doing now to move in that direction?

Naren Arulrajah: Great question, Gary. Just understanding those two math problems—the daily production goal, and the 45% insurance write-off—if you solve just those two, you’re going to be so far ahead in 2026.

Gary Takacs: We teach a really good scheduling template, Naren. It can be customized for every practice.

But the idea is this: Engineer your schedule.

Stop the rollercoaster of productive day, dead day, productive day, dead day.

Naren Arulrajah: Yeah—it’s about starting with the end in mind and creating the day you want. Repeatable. Predictable.

Gary Takacs: And as you do that, you’ll unlock other opportunities.

Maybe you realize: “Hey, we need more of a certain kind of dentistry to stay profitable.” Great—then the next step becomes: how do we generate that?

Naren Arulrajah: Thank you, Gary. Let me go to the last question I want to get into:

If a dentist wants 2026 to be their strongest year yet, what is the one move from 2025’s top practices that they should copy right now?

Gary Takacs: Well, you know, I’m going to bring it back full circle to what I said at the top. And that is, if you’re allowing some other entity to set your fees, you have got to take steps to change that. Because that entity doesn’t care how profitable you are. That entity doesn’t care if you’re successful or not.

Naren Arulrajah: So you’re saying take control of your practice.

Gary Takacs: Take control. Take control. If we think about another business—Doctor, just step outside for a moment. I think sometimes we’re so emotionally engaged in dentistry that we see things from a fixed perspective. “Oh, I have to participate in PPOs. Every dentist in my town does.”

Well, that might actually be the best reason not to do it.

Let me ask you this: if you owned a restaurant, would you let another entity set your menu prices?

Naren Arulrajah: Well, you could—but you’d go out of business. If I were your competition or had no interest in your success, I’d set your prices low just to put you out of business.

Gary Takacs: Exactly. Would you allow an entity that has no vested interest in your success to set your fees? No. The answer is no.

So take steps—and remember, these can be baby steps. This isn’t jumping off a cliff. It’s taking measured steps in the right direction.

For example, you could add services not covered by insurance. People still ask, “Is that dental implant covered by insurance?” or “Is Invisalign covered?” They may not like the answer when we say, “No, insurance only covers basic procedures,” but guess what?

They’ll often still say yes. Because people will pay for what they want before they pay for what they need.

So that’s a step you can take.

Another step: pick off some of the low-performing PPO plans. There are some plans where it actually costs you money to treat the patients. Start with those. Resign from the ones where you’re losing money every time you treat someone.

If you cut that plan, you’ve already improved your economics. You’re not losing as much money.

I’m not saying resign from Delta as your first step. Not at all. We work our way there.

But maybe the most important move you can make is this: Put your practice in a position where you set your fees—based on your quality, your cost of doing business, and your standards. Not based on someone else’s numbers.

Naren Arulrajah: And this is advice that would help 90% of practice owners listening to this.

Gary Takacs: Absolutely. Even if you’re in a dozen PPO plans, and we reduce that to six, you’ve already significantly improved your practice. It doesn’t have to be all or nothing.

You don’t have to go all the way to fee-for-service. But if that’s your goal, I’ll be your biggest cheerleader. That’s the best way to build a thriving practice. Still, there might be a good reason to keep one or two plans. That’s okay. Just be strategic about it.

Every time you take a step in that direction, you’ve improved your practice.

Naren, as we wrap up, I just want to say—I’m more excited than ever about 2026.

I’m an optimist. Yes, listeners can accuse me of that. Guilty as charged.

But you can have a thriving practice in 2026—one that provides:

• Personal satisfaction: Taking care of patients you enjoy, surrounded by a team you love.
• Professional satisfaction: Doing the kind of dentistry you’re passionate about. Whatever your “flavor” is—cosmetic, implants, ortho—choose the flavors you enjoy.
• Financial satisfaction: Being rewarded handsomely for your care, skill, and judgment.

There’s never been a better time to pursue that. Never better than 2026.

There’s so much opportunity in front of us.

Naren, I’ll close with this—this literally happened to me yesterday…

Gary Takacs: I was doing a Zoom call with one of our coaching clients. And this client, as of January 1st, 2025—the beginning of this year—was completely out of network. This is an office that went all the way out of network.

He said, “Gary, you know what’s been great about 2025?”

I said, “Well, I have a little sneak preview because I have access to your numbers. I know a lot of things that were good in 2025.”

But he said, “No, no. You know what? Outside of the numbers, the most important benefit I got?”

He said, “I’m now taking care of patients who choose to be in our practice because they appreciate us.”

Think about that, Naren. What did he say?

Naren Arulrajah: Yeah, I mean—they chose to be in the practice. It’s not because you were free. It’s not because you were on a list. It’s because they wanted to be there.

Gary Takacs: Exactly. They made a conscious decision to come to this practice. To be taken care of by this team. This doctor. For tangible reasons they valued.

And he said, “Gary, I lost patients—just like you said I would. Some of them hurt. Some individual patients that I thought I was connected at the hip with—turns out, they didn’t really value me.”

Naren Arulrajah: Mm-hmm.

Gary Takacs: “Because they ran to a PPO practice. And I had trouble with that at first—emotionally. But then I realized—they didn’t really appreciate me. They didn’t really appreciate our office. And I’ve now made room for people who do appreciate us.”

“New patients now choose us—with full awareness. We’ll help them with their insurance—we can assist them—but they’re not insurance-dependent. They want to come here for other reasons.”

And he said, “That has changed my entire perspective. My enjoyment of the profession went up geometrically. Because everyone in my office now appreciates coming here for their care. That wasn’t true before. Some were there for their ‘free’ whatever.”

He said, “To me, emotionally, that was more important than the economic benefit. And the economic benefits are incredible—but having a practice full of people who really appreciate us has made all the difference.”

Well, as Naren mentioned earlier, as we wrap up today—take action.

That’s another thing successful practices do: they take action. They don’t just think about it. They act.

If you need help with marketing, I’d encourage you to set a marketing strategy meeting.

If you’re interested in coaching—if you think coaching could benefit you—schedule a coaching strategy meeting. We’re accepting new clients and would love the opportunity to work with you if that’s your wish.

Go to: thrivingdentist.com/csm  — Coaching Strategy Meeting.

It’ll be a Zoom meeting with me. We’ll talk about your practice and how we can make 2026 your best year yet.

Naren, on that note, I’ll bring it back full circle.

To all our listeners—a very, very Happy New Year. Here’s to making 2026 your best year yet.

Thanks for the privilege of your time. We appreciate each and every one of you.

Naren and I look forward to connecting with you on the next Thriving Dentist Show.