How to Determine if your Practice is Ready to Successfully Resign from PPO Plans

Gary Takacs: 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 am Gary Takacs, founder of Thriving Dentist Show and co-host, excited to bring you this episode today. This episode is titled How to Determine If Your Practice Is Ready to Successfully Resign From PPO Plans. If resigning from PPO plans is on your wishlist, you’re gonna love this episode.

Before we get to this episode, though, I have two quick announcements to make. First announcement is, if you’re a regular listener to The Thriving Dentist Show, you know that we frequently provide virtual events for our listeners to attend. They could be webinars, they could be panel discussions, they could be just conversations with experts, and we do those on a regular basis. We always provide those at no cost to attend. In some cases, you get CE—sometimes we do, sometimes we don’t.

Gary Takacs: It depends on the nature of the event. But if you’re interested in going into some of the topics that we cover in more depth, you’re always welcome to attend our events. I would direct you to thrivingdentist.com/events. And what you’ll see, what pops up on the screen, is the next event on our schedule. If you’re interested in that, visit thrivingdentist.com/events,  and let me encourage you to take a look at those and come join us.

The next announcement I have is we have a marketing tip from my co-host, Naren Arulrajah. And in this Thriving Dentist Marketing Tip, he’s gonna talk about—he’ll answer the question: What are the different types of digital marketing options? Really useful information. One, make sure that you’re always on the leading edge, and Naren’s gonna kind of unpack that and let you know what the different types of digital marketing options are.

Well, no further ado, here’s Naren, and he’ll answer the question: What are the different types of digital marketing options for a dental office?

Naren Arulrajah: Hello, everyone, this is Naren, your co-host of The Thriving Dentist Show. And in today’s marketing tip, I’ll be discussing the different marketing options and what are the differences between them.

Literally, there are four different types of marketing options for you. One is Google Ads, one is Google SEO, the third one is social media ads, and the fourth is organic social media, or free social media. Between these four categories, 95% of the patients will come through these four categories.

So am I gonna focus on the 5%? No. The 5% is like radio, TV—the traditional marketing. So let’s focus on the 95% that find you through digital marketing. And I would say half of that 95% is SEO, but unfortunately, it belongs to the top 5% of practices.

Naren Arulrajah: So, SEO is the hardest, but it can be delegated, meaning an amazing team can help you to rank for a hundred or more keywords, which is the minimum benchmark if you want to be in the top 5% that gets 95% of the free traffic.

We have done that for, you know, literally 18 years, year after year after year. And every single client of ours, once they pass year one, is ranking for a hundred or more keywords. And some clients are even ranking for 200, 300, 400, 500 keywords or phrases at the top of Google for free.

So that’s number one. Now, why is it hard? Because you have to do a lot of things Google cares about, and it takes time. So typically, in year one, we put around 600 hours into that first year.

The second option is Google Ads. Now, Google Ads is fast, and it’s the most cost-effective of the other three. For example, Google Ads might cost you $300 per new patient. A good SEO plan might cost you $30 to $60 per new patient. So at least it’s five to ten times more expensive.

Why is it more expensive?

Naren Arulrajah: People don’t trust ads, and ad prices continue to go up. Google needs to make more money to make its shareholders happy and increase its stock price. So obviously, little by little, it keeps nudging the price of Google Ads higher and higher and higher.

And because it’s an ad—it’s clearly marked as an ad—people don’t trust it. So you’re gonna have more no-shows. You’re gonna have fewer people accepting or booking appointments when they come through a Google Ad. So you have to keep that in mind.

I wouldn’t spend money on Google Ads until I have an amazing phone team trained. The typical practice is only booking one out of three new patients. So make sure you’re not typical—you have an amazing team, well-trained, and you know your conversion rate.

The other thing I would look at is the landing pages.

Naren Arulrajah: Do I have amazing landing pages that make people want to call, even though they know they clicked on an ad and therefore they’re a little bit concerned—maybe there’s something wrong here?

So make sure your team is awesome, your landing page is awesome, and keep in mind, it’ll be at least five to ten times more expensive.

Use Google Ads when you are a startup, or use Google Ads strategically for certain high-value services where you might be making a $5,000 profit and you’re okay with spending $500 to get that new patient. So in those two cases, I would use Google Ads.

Now, third one is organic social media. Like I said, SEO belongs to the top 5%. Organic social media, which is free traffic from TikTok and Instagram, belongs to the top 1%. They’re called influencers. The question is: Are you an influencer?

Naren Arulrajah: Are you spending 20 hours a week personally to create content and really becoming—living and breathing—being an influencer?

If you are, great thing to lean into. It works. But you have to spend a lot of time—typically 15 to 20 hours a week—just becoming a student of how to be an influencer. You pick a platform like Instagram or TikTok, and you master it, and you just keep leaning in. You’re doing two to three videos a day. It might take you two years. So you have to be patient also—you’re not gonna see results right away.

Now, if you don’t want to be in that 1%, most of my clients—99% of my clients—they don’t like to put themselves out there. They don’t want to be in that 1% of influencer social media wins.

So in those cases, you can also rely on social media ads.

Naren Arulrajah: Social media ads are even more expensive. When you look at the cost of a new patient, it’s typically even double the cost of Google Ads. Why is that? At least with Google Ads, people are typing in “implant near me” and an ad for you shows up. So at least they’re thinking of implants.

But social media ads—that’s not the case. They’re not even thinking of implants. They’re watching their favorite video on Instagram, and all of a sudden your ad shows up. So the chance of them remembering and showing up to your practice even after they book is very remote.

So you have to get ready for a lot of no-shows, and you have to be okay with that.

Also, the conversion rate—meaning when they pick up the phone and call and book—also goes down. Why? They don’t trust you. And they weren’t interested. They saw an ad for something, and they were doing something else, and it was just easy to click on, and they clicked on it and easily booked an appointment.

Naren Arulrajah: So make sure you understand this: Google Ads, social media ads, organic social media, SEO—and use them accordingly.

If you’re going to be practicing for multiple years, I would lean in on SEO, because A) it can be delegated, and B) within a year, you can get into that top 5% with the right team behind you.

I would also use Google Ads as a fill-up—both if I’m a startup, as well as if I need extra patients for any particular type of service, especially those high-value services. I might use it as a filler.

Social media—free social media—I would only lean in if I feel I’m confident in being an influencer, and I’m willing to dedicate the time, day in and day out, to do that.

And social media ads—I would only use it as a last resort, like if I have topped up everything else.

So that’s my take on it.

Now, if you want us to do a comprehensive review of your own marketing, book a marketing strategy meeting. It’s ekwa.com/td. We’ll tell you how you are doing, how your competition is doing, and give you a roadmap if you want to dominate specifically SEO and Google within a 12-month period.

So that’s our gift to you: ekwa.com/td.

Naren Arulrajah: Hello everyone. Hope you are enjoying 2026. Gary and I are really excited about the episode today, and if you have any further questions on the different marketing options, hey, feel free to book a marketing strategy meeting. The link is ekwa.com/td, and we would love to do some research and give you some detailed answers.

There is a groundswell movement, Gary, of dental practices and practice owners in every part of the country—especially private practice owners—who are realizing that it’s not financially viable for them to remain in-network with PPO plans. And the main reason is, you know, costs have gone up a lot, and we all know this. We call it affordability. I mean, that’s the new buzzword that a lot of people are talking about, and it’s not affordable to run practices anymore at the same reimbursements that were set years and years ago, right?

Naren Arulrajah: Your expenses have gone up, the pay that you give your people has gone up. In some states, I’m hearing $50–$70 average hygiene fees per hour, right? At least. Sometimes even like $100 in some states. So, practice owners are really, really struggling to keep up with increased costs when the PPO reimbursements haven’t gone up.

But at the same time, to add insult, some PPO plans are actually lowering fees—even though the costs have gone up so much. In many cases, it’s not profitable to do hygiene anymore. Like, you are losing money by taking care of a hygiene patient on that PPO plan.

A recent study by the Health Policy Institute reported that the majority—which means more than 50%—of dental practice owners in the U.S. are considering resigning from at least one PPO plan in 2026.

Naren Arulrajah: Let me repeat that: more than 50% of practice owners have said, "Enough is enough. I’m going to resign from at least one PPO plan in 2026."

Some are obviously planning to resign from multiple PPO plans. However, not every dental practice can successfully resign from PPO plans. In this episode, Gary will explain how to prepare to resign from PPO plans.

Let’s jump in to some of the questions that we got from our audience.

Gary, I have heard you talk about the three most important factors to determine if your practice is ready to successfully resign from PPO plans.

Gary Takacs: Yeah, Naren, I’m really excited about this podcast episode. So we’re gonna essentially unpack how to be prepared—how to be ready—to successfully resign from PPO plans.

Before we get into this episode, though, I want to take a minute and honor a very dear friend of mine. At the time we’re recording this—you know, there’s a lag between when we record and when an episode is published—but at the time we’re recording, a week ago, I lost a very dear friend in dentistry, Dr. Bruce Baird.

If you’re a listener of this podcast, you’ll know Bruce. Bruce has been on the podcast many, many, many times. Bruce was a dear friend of mine. He was a mentor, he was a colleague, he was an inspiration to me. He passed away very suddenly.

Gary Takacs: And our profession has lost a giant. If you haven’t heard about that, I wanted to honor Dr. Baird and bring it up in today’s episode. He was a giver, an entrepreneur, an amazing dentist. He founded the Productive Dentist Academy, and our profession is at a loss.

It’s also a reminder to me that life is precious—very, very precious. It’s one of the reasons why I am so adamant about helping our clients achieve an effective work-life balance.

Naren Arulrajah: I want to second what you just said. Dr. Baird—I met him, I believe in 2007 for the first time, and he made an impression on me. I still remember our conversation from the very first time I met him. He was a giant, and he has been a giant for decades, right?

He made a difference in the lives of many practice owners and patients. He was practicing for, again, a very, very long time. I’m saddened, and my deepest condolences to his family and everyone affected.

Gary Takacs: He was someone who just absolutely loved every bit of dentistry and made an impact on so, so many dentists, patients, colleagues—just incredible. If you’re a listener of faith, please keep Bruce’s family in your thoughts and prayers.

Well, so Naren, you asked a very important question: What are the three most important factors to determine if your practice can successfully resign from PPO plans?

I’m gonna number them one, two, and three, Naren, so we can kind of keep them in order—but they’re not numbered by importance.

Gary Takacs: Number one has to do with how relationship-driven your practice is. Do you have a relational practice or a transactional practice? And what I mean by relationship-driven is, we connect with our patients. We likely know their names, their spouse’s names, their kids’ names, their dogs’ names, their hobbies, their interests—we know what’s going on in their lives.

What’s a transactional practice? Transactional practice is literally that—they come in for a transaction. We don’t need to know their name. It’s just a transaction.

And if I was to draw a continuum—a horizontal line that represented a continuum—and on the left-hand side it represented highly relational, and on the right-hand side it represented transactional, I don’t think any practice is purely relational or purely transactional. But what I’m looking for is, where are you on that spectrum?

The more relational you are, the more you’re ready to resign from PPO plans. So the question I want our listeners to answer is: Where are you on that spectrum?

Gary Takacs: If you’re more relational than you are transactional—hopefully almost all the way over to the edge of being relational—then you get a green light for your readiness.

If you step back and look at it and, honestly, you say, "Well, I’d like to think that we’re really relational, but I’m not sure we are," then it doesn’t mean you can’t resign, but it means we need to get that house in order first.

So number one is the relational component—how relational.

Let’s assume that you’re listening and saying, "Yeah, we’re really relational." Green light. Green light.

Let’s go to the second criteria: demand. Demand in your schedule. And I want to answer that very specifically—how far out are you booked for a new patient appointment?

How far out?

And most doctors don’t know. So let’s take a look in your schedule and take a look: When is the first available new patient appointment?

Gary Takacs: I want to be specific about the type of new patient appointment. This is not someone in pain—nothing urgent. Maybe the patient calls and says, "Hey, I’m looking for a new dentist. Are you accepting new patients?" And you say, "Yes, we love to see new patients."

I want to be able to offer that patient a new patient appointment within a week of the call—offer it. Now maybe they say, "No, I’m involved in a big project at work right now. I was thinking more like three or four weeks from now." That’s fine.

But when we look at this, the farther out you’re booked, the more demand you’ve got—which means you’re more ready to resign from PPO plans. Your readiness is there.

If I ask you how far out you’re booked, and I say, "Hey doc, how far out are you booked?" and you say, "Well, I can get you in this afternoon. I can get two or three in tomorrow," are they ready to resign from PPO plans?

Naren Arulrajah: Absolutely not, Gary. They’re not. And I think—but why not?

Gary Takacs: You’re talking—why not?

Naren Arulrajah: Yeah, because what’ll happen is when you drop a PPO plan, the number of new patients you’re getting every month will drop—specifically that PPO plan. You’re gonna lose patients.

Gary Takacs: If your practice is open now and you lose patients, what’s it gonna look like tomorrow? It’s gonna look like Swiss cheese.

Naren Arulrajah: Exactly. And we have seen this happen. You know, I don’t want to toot your own horn because you don’t like that, but I’ll just tell you—a couple examples just popped into my head, Gary. There’s one particular client—before they came to you—they dropped a plan, and their schedule did look like Swiss cheese.

They didn’t do it properly. They didn’t create the demand up before they dropped the plan, and all of a sudden the doctor was panicking. "What do I do? What do I do?" You know, "I’m panicking, my team is panicking, people are thinking of jumping ship."

And it can create a huge problem if you have this—I think what you call the Swiss cheese problem.

Gary Takacs: Yeah, it’s open schedule. So in this case, we actually want you to be booked out dysfunctionally, right? Because when you lose patients, you have the room to lose them.

You’re going to lose patients. I’ve never seen a situation—in over 400 examples—where we haven’t lost some patients. You usually lose way less than we think. But if you already can’t afford to lose any, then now’s not the time to resign from PPO plans.

Let’s go to the third criteria.

Gary Takacs: Third criteria is: Do you have marketing—proven marketing—in place in your practice to replace the patients you’re going to lose, and also to replace the historic flow of patients that have come from the PPO plans?

If you’re a regular listener of The Thriving Dentist Show, you’ve heard me talk about this. I want you to think of the PPO adjustments that you experience—the difference between UCR and the contracted fee—as a marketing expense. Because you’re paying Delta to provide you patients. You’re paying them in the form of deeply reduced fees. That’s how you’re paying them.

Let’s say with Delta, you’re getting 20 new patients a month—meaning the patient went to the Delta website, found you, and chose your office. The day you resign from Delta, that number goes to zero, because you’re no longer listed on their website.

Gary Takacs: So do you have—in my example—20 a month? If I annualize that, that’s 240 patients a year coming from Delta. Do you have marketing in place to replace those 240?

If you do, you’re ready.

So again, readiness factor number one: if you’re relational, you’re ready.

Number two: if you have more demand than you can possibly handle right now, you’re ready.

And number three: if you have marketing in place—proven, with data to support it—to generate and replace the patients that you’re going to lose, and replace the ones that have historically come in from the plans, you’re ready.

If you’re not, it doesn’t mean you can’t ever go out of network. It means you’ve got to solve those first.

It’s kind of like, Naren, if you’re a runner and you decide you’re going to run a marathon, you don’t just show up on the starting line. How would that work out, Naren?

Naren Arulrajah: Yeah, I agree. It won’t work out. You gotta—

Gary Takacs: Prepare. You gotta be ready. So it doesn’t mean if you have a yellow light—or red light—on any of those three factors that you can’t go out. It just means we’ve got to get that house in order first.

Naren Arulrajah: Thank you, Gary. Of the three factors—right—let me summarize them again for the listeners.

One is: are you relational?

Two: do you have enough demand so when you do go out of network, your schedule doesn’t look like Swiss cheese?

And finally: do you have marketing? Because remember, your marketing used to be the PPO plans—because they were the ones driving your new patients. Now, do you have other marketing outside of PPO plans that’s able to bring in the quality and the quantity of new patients you want?

If these three factors are in place, then you are ready to go drop PPO plans. Those are the three factors.

Gary, do you have a favorite? Do you have something that you consider is most important?

Gary Takacs: Well, I’d have to answer that situationally, Naren, because the one that would be most important would be the one of the three that’s missing.

Naren Arulrajah: Oh, that’s a good point. Which—

Gary Takacs: It’d be that one, yes. But if we’re dealing with it from a blank slate—meaning—

Naren Arulrajah: Everything is missing.

Gary Takacs: Then I would say… door number one.

Naren Arulrajah: Door number one.

Gary Takacs: Relational. Because when you’re relational, patients don’t want to leave. When you’re transactional, it doesn’t matter—because someone else can provide a transaction, right? But when you’re relational, they don’t want to. Doesn’t mean they won’t leave, right? But they’re less likely to leave. Especially—the more relational you are—the less likely they are. That doesn’t diminish the importance of the other two at all, right? But I would have to pick door number one, being relational, because that becomes the foundation to do this.

Now, here’s the tricky part about that one, Naren. It’s very subjective. Would you agree?

Naren Arulrajah: I agree, Gary. So how do you measure if somebody is relational or not? I know the way I would look at it is I would go and read Google reviews. And I would say—what are people saying about you on Google, right? Is every new patient saying, "I’ve never had an experience like this"? "You guys are so kind." "You guys are on time." "I love you guys." "You guys listen to me."

Gary Takacs: When you look at those reviews, are they calling out team members?

Naren Arulrajah: Yes.

Gary Takacs: In a positive way. Good point. "Oh my gosh, Susan, my hygienist, was amazing." Are they calling them out? That’s one way. Can I add some more there? There’s not a one-dimensional way of looking at it, but that’s a great suggestion.

Here’s another one. Alright doctor, stick with me on this. Without looking in your practice management system, can you name 10 patients in your practice off the top of your head that own their own business? Can you name 10 schoolteachers in your practice without looking? Can you name 10 firefighters, paramedics, first responders in your practice?

Gary Takacs: If you can’t, you might be a little delusional about being relationship-driven.

And I’ve had that conversation: "Oh, well I can’t remember names, but I know their face." Yeah, that’s not good enough. That’s not good enough. "Well, I just don’t remember names." Start remembering names. Make it important.

The only reason you can’t remember names is you don’t make it important. You haven’t made it important. And if you’re not remembering the names—or your team members aren’t remembering the names…

I love it—Naren, I used to be an in-office consultant for many, many years, right? And someone would walk through the door, and the person at the front desk wouldn’t even look up from the computer.

Naren Arulrajah: Yeah.

Gary Takacs: How relational is that? How hard is it—if I have a male by the name of Naren scheduled for a 1:00 p.m. appointment, and it’s around 1:00, and a male walks in—guess who it is?

Naren Arulrajah: It’s…

Gary Takacs: It might be Naren.

Naren Arulrajah: And by the way, nowadays there’s pictures next to the name of the person, so you know who it is.

Gary Takacs: Another way you can determine how relational you are is—how are your phones being answered?

Naren Arulrajah: Yes.

Gary Takacs: If you don’t know how your phones are being answered—if you don’t listen to recorded calls—you don’t know how your phones are being answered.

Naren Arulrajah: I think you’re bringing up an excellent point, Gary. I see 80% of practice owners don’t know how their phones are being answered. And they assume it’s the best in the world. But when they listen to it—I know you’ve had this experience because we have mutual clients—they cringe. Like, it’s just so bad. But they haven’t known it for years, sometimes.

Gary Takacs: Naren, earlier this week—right? I won’t name names, but I’ll give a situation. Earlier this week I was doing call training. I actually do this as part of our work in coaching. I play six calls: I play four good ones—meaning they made an appointment—and I play two that need work. And we talk about improving our call conversion percentage.

We’re looking for 70% or more of new patients that call—70% or more should end up scheduling a new patient appointment.

This is an office—a great solo dentist practice, really good. One of the things he loves to do is dental implants. And the call came in.

The most common question that a new patient asks when they call—what do you think that is, Naren? More than 60% of the time.

Naren Arulrajah: I mean, I know one—if it’s a new patient: “Do you take new patients?”

Gary Takacs: Yeah. “Are you accepting new patients?”

Naren Arulrajah: Mm-hmm.

Gary Takacs: That was the response: “Yeah.” Nothing else.

Then he said, “Well, I’m interested—I see on your website that you guys do dental implants. Do you guys do dental implants?”

“Yeah.”

Naren Arulrajah: Right.

Gary Takacs: That was it.

Naren Arulrajah: I mean, the person has some hope and expectation when they’re calling, right? Typically, they go through Google, they spend a lot of time even deciding to call you, and then they pick up the phone and call. And if I get this—"Yeah"—like, almost like, “I don’t want to talk to you. I’m just doing it because somebody told me to…"

Gary Takacs: "I’m sorry you called."

Naren Arulrajah: "I’m sorry you called," exactly.

Gary Takacs: And this was a new team member—newer in the office. And technically, she gave the right answer. Yes, they’re accepting new patients, and yes, they do implants. But that is not acceptable.

Naren Arulrajah: Yes.

Gary Takacs: Go back to our continuum. Is that relational or transactional?

Naren Arulrajah: That’s transactional.

Gary Takacs: Worse. It’s off the chart—transactional.

Naren Arulrajah: Off the charts. Yes.

Gary Takacs: And I told her—write this down. I want you to say this in the future:

“You know, our doctor loves doing all kinds of dentistry, but he especially loves helping our patients restore their dental health with dental implants. You called the right office.”

Where is that on the spectrum, Naren?

Naren Arulrajah: That is an eight or a nine, Gary.

Gary Takacs: On relational—it’s way over here.

Naren Arulrajah: Yes.

Gary Takacs: So that’s another way you can measure that. But I do think sometimes practices—doctors, and I’m calling you out—I’m not going to sugarcoat it. You think you’re relational because you want to be relational. But your behavior doesn’t support it.

Naren Arulrajah: Right.

Gary Takacs: You know, when you walk into do a hygiene exam, you need to recognize that patient. “Gary, it’s so good to see you. How’s their yoga studio going? And I’ve got to ask you about your grandson Canaan—how’s he?”

How do I feel as a patient? I feel like I’m in the right spot.

Naren Arulrajah: Yeah. A million bucks. Because the doctor cared about me. Like, typical doctors—like you said—they feel like, “I don’t want to see you, I’m seeing you because I have to,” and they’re watching their watch. You know what I mean? Versus, here is somebody who knows me, who’s interested in me—not only my health, but me as a human being.

Gary Takacs: Yeah. Well—and doctor, do your homework. I hope you have somewhere in your computer system where you have personal information about patients. Every office does.

Take some time before the start of the day and prepare for the patients that are coming in. You don’t have to know every one of your patients’ names at all times. You just need to know the ones you’re seeing today. That’s it.

And if you’re willing to do that, you’re going to now model that to the team members. And now they’re going to follow your lead, and they’re going to be doing the same thing.

Lead by example. If you want your team members to be relational, you’ve got to lead by example.

Alright, Naren, I’m going to switch gears. I’m going to ask you a question.

So, the third factor, Naren, to determine if a practice is ready to resign from PPO plans is having marketing in the practice to replace any patients the office may lose—as I mentioned—and also replace the historic flow of patients that have come from the PPO plans.

What would you recommend to our listeners regarding the most effective ways to attract quality new patients today?

Naren Arulrajah: Absolutely, Gary. That’s a wonderful question. And let me define marketing. Marketing is helping your ideal customer persona—or patient persona—to find you, like you, and trust you.

So today, in 2026, they are finding you on search engines and AI search engines. To throw some stats around, people use Google 12 billion times a day. They use Google Maps 5 billion times a day, and they’re using Google AI Overview more than a billion times a day—and that’s growing. Of course, they’re using ChatGPT a couple hundred million times a day, Perplexity again, perhaps a hundred million times a day.

So they’re going to these engines—especially Google, both for AI and regular search or map search—and asking questions: "Dentist near me," "Who’s good at implants?" "How much does this cost?" That’s how they start. Ninety-five percent of the patients—that’s how they start.

So the first question you have to ask yourself is: How am I doing with Google?

Naren Arulrajah: Given that 95% of the patients are finding you first on Google—when they’re typing these search terms in or asking these questions—the second is, do they like you?

In other words, they see you again and again. Let’s say you’re dominating SEO, you’re showing up, and because it’s organic—meaning it’s not an ad—they’re seeing it and clicking on it. They see you again and again for different things they’re looking for. Now they like you subconsciously, or they feel like they should check you out.

What do they do? They click on your website. They read your reviews. They go to your website. Does it load fast? Does it have the information that they’re looking for?

For example, if I’m interested in implants, does it have perhaps some before-and-afters where you have done some wonderful work, and it shows the work you’ve done? Perhaps a video where you’re welcoming them. Perhaps when they go to the About Us page—some information on your hobbies, and they like to travel, and you like to travel. Same thing for your team, right?

So, help people find you—that’s where you dominate SEO. Then help people like you.

And finally, they have to trust you. And I’m going to give you two tips around trust.

Naren Arulrajah: One is Google reviews—which is, I recommend a minimum of 10 five-star reviews every single month, and paragraph reviews. That’s the minimum I would recommend.

And then the second is the way the phone is answered. The average dental practice only converts 30%—33%—of new patients. It’s pathetic and unfortunate, because doctors spend a lot of money on marketing.

But the good ones—like the ones that work with Gary and his team—convert 70%. I’ve even seen 80%, some even convert 90%.

So those are the keys, Gary, for marketing. Of course, SEO can be done by somebody else. Your website can be managed by somebody else. But Google reviews and phone—you have to play a role in it.

Yes, you can have a coach like Gary helping you, especially with the phone experience.

And now, if someone wants to do a deep dive on how you are doing—because I gave you generic advice—like, is my SEO good? If yes, why? If not, why? All that kind of detailed questions—book a marketing strategy meeting. It’s ekwa.com/td.

What are your thoughts, Gary?

Gary Takacs: Yeah, you’re absolutely right, Naren. I mean, we’ve been using Ekwa since 2018, 2017—thrilled with it. Once I became confident that Ekwa was going to do what they said—do what they said, when they said, on time, on budget—I started recommending it to my clients. And I see great results.

So I would schedule that now and, you know, start replacing the hundreds of thousands of dollars you are handing over to the fat cats at Delta—with a very modest budget. You know, $1,250 a month, all-inclusive. It’s a $15,000 annual fee—radically different than the massive amount of money you’re writing off.

Naren Arulrajah: Thank you so much, Gary. I have another question for you. We really zoomed in on the most important three factors. Are there other factors to consider as a practice starts thinking about resigning from PPO plans? Let’s say if I’m one of those 50%+ practice owners who have decided to drop one or more plans—what else should I be thinking about, Gary?

Gary Takacs: Yeah, Naren, by the way, that number from the HPI—Health Policy Institute—was 66%. So you’re right, it’s above 50. The actual number was 66% are planning to resign from at least one PPO plan.

Alright, I’ve got six more. These are secondary readiness factors, but they’re important.

Number one: Are there fee-for-service offices in your area, or those with very reduced insurance participation? In your town, in your area—are there any? Because if there are, we just did the Roger Bannister effect, haven’t we?

Naren Arulrajah: Yes. I mean, the first person thinks it’s impossible—like the four-minute mile—but once the first person does it, everybody else does it. Like, hundreds have done it.

Gary Takacs: So if you’re in a town with 30 dentists—just making it up—and there are two that are either fee-for-service or have a greatly reduced footprint, that should be encouraging news. Because they’ve proven that it can be done.

Number two: What is the income demographics in your area? Specifically, what is the average household income within a 10-mile radius of your practice? You can get that information—plenty of ways. I don’t know if you’ve heard of the internet, Naren?

Naren Arulrajah: Actually, Gary, it’s kind of funny—I Googled the other day, "How much should a dental practice owner spend on marketing?" and Google literally gave me an essay answer, gave me like four references, and it took, what, two seconds? It has the world’s information at its fingertips—it’s crazy how awesome it is.

Gary Takacs: Right there. So look at the income demographic—average household income within 10 miles. Every area has a mix of demographics, right? I mean, Mississauga is an upscale suburb of Toronto.

Naren Arulrajah: Right.

Gary Takacs: But does everyone make the same amount of money in Mississauga?

Naren Arulrajah: No, no.

Gary Takacs: No. I’m in Scottsdale—Scottsdale has its own demographics. There’s a range from lower income to very affluent. So look it up. If they’re going to have to pay a little bit more to come to you, do they have the household income where they can do that?

Naren Arulrajah: Exactly. I mean, one way to look at it is—if they’re taking expensive vacations, driving nice cars… definitely. If there’s a Starbucks nearby or a Whole Foods nearby—definitely they have money to come to you.

Gary Takacs: I think they changed the name of Whole Foods, Naren…

Naren Arulrajah: Whole Paycheck.

Gary Takacs: Whole Paycheck! Still spelled the same way—“Whole.” Takes your whole paycheck to go to Whole Foods. By the way, I love Whole Foods… just in case Whole Foods wants to sponsor the podcast—we love you!

Number three: What is the cost of living in your area—especially housing? And I don’t necessarily mean buying a house—because people of lower income typically don’t have the resources to buy a house—but if apartment rent in your area is $5,000 or $6,000 a month, and most of the new people moving in are renting apartments, then there might not be a lot of disposable income to pay out-of-pocket expenses if insurance doesn’t cover it. You’ve got to pay attention to that.

Number four: Do you have an in-office membership plan in place in your practice to attract new patients who don’t have dental insurance? That can be a wonderful way to roll the red carpet out and attract people without insurance. Is that in place? If it is, you’re more ready. If it isn’t—get one.

Number five: Does your practice provide some high-value services? If your menu of services is plain Jane, vanilla, everyday general dentistry—they can get that anywhere.

But do you have some high-value services? You don’t have to have a whole menu—but are we doing anything that the worst DSO in your area isn’t providing?

The more high-value services you provide, the less insurance-dependent you are. People pay for what they want before they pay for what they need.

Number six: Are your admin team members prepared to answer the question from a potential new patient: “Do you take my dental insurance?”

If their answer is “No, we’re not in-network,” you’re not ready to go out of network. We’ve got to be able to answer that question well.

By the way, here’s how to answer that question:

Let’s say I’ve got Delta. “Do you guys take Delta?”

"Hi, my name is Carly. Who am I speaking with?"

Let’s say his name is George.

"George, first of all, great to meet you today by phone. I look forward to meeting you in person. Let me answer your question: although we are not contracted with Delta Dental, we have many patients that have the very same dental insurance you have. Let me tell you how it works here:

1. You can choose our office for your care.
2. Whatever benefits you have with Delta, you can use them right here.
3. We’re going to file your claims for you—make that nice and easy.
4. We’re on your side to help you get every dollar of benefit.

As I mentioned, we have many patients with the same dental insurance you have.

George, our patients tell us that the reason they love coming here is that they know our doctor would never recommend anything that isn’t in their best interest. They also know we treat our patients like family.

George, I would love for you to experience dental care in an office like that. You deserve that.

Can I make an appointment for you?"

That’s a little different answer, isn’t it?

Naren Arulrajah: That is very true, Gary.

Gary Takacs: That’s a different answer.

Naren Arulrajah: I really think the last tip you shared—how to answer the question “Do you take my dental insurance?”—is very powerful, Gary.

Gary Takacs: Yeah, because your marketing could be working great. What’s your job at Ekwa? What’s your job?

Naren Arulrajah: To make the phone ring. To have new patients contact your office. That’s it.

Gary Takacs: And you’ve got to be wanting to pull your hair out if you are providing the phone calls, but the office isn’t answering them in a way that facilitates scheduling a new patient. Right? If you’ve done your work—you did your work.

Naren Arulrajah: Exactly.

Gary Takacs: But that’s not the end of the equation. You’ve got to make sure that we can answer it right.

So keep in mind—the three most important factors, I would put up there as tier one. But I would consider those six other factors as well.

Final Thoughts

Naren Arulrajah: Thank you, Gary. If a dentist is listening to this episode and they realize they’re not completely ready to resign from PPO plans, what should they do next?

Gary Takacs: Well, certainly what I would recommend is—again—focus on those three prime factors, and focus on the areas that you could improve on.

• Focus on becoming more relational.
• Work on your schedule—maybe reactivating the people who are past due so your schedule fills up.
• And number three—get marketing.

The third one’s easy to solve. Set up a marketing strategy meeting and get that done. That’s where I would start.

Naren Arulrajah: Thank you, Gary. Appreciate it. Gary, I thoroughly enjoyed this episode—helping practice owners resign from PPO plans. The three key factors and all the six other ideas you shared, I think, laid a wonderful foundation.

And if you are struggling with marketing, like Gary suggested, book that marketing strategy meeting: ekwa.com/td.

And if you really want to have a one-on-one conversation with someone like Gary—who has been helping practices literally for decades and has helped at least 700 practices, last time I checked, resign from PPO plans—book what we call a Coaching Strategy Meeting. And the link for that is: thrivingdentist.com/csm (for Coaching Strategy Meeting).

Gary Takacs: That’ll be a meeting with me. So when you click that link, it opens up my calendar. Schedule the time that works for you. It’ll be a one-hour meeting with me.

We can talk about anything you like. I’d like to learn a little bit more about your practice. I’d like to know what some of your goals are. And we can talk about our coaching and determine if that’s a good fit.

We are accepting new clients. We don’t always accept new clients because the support we provide is very intensive. There are times when we have a waitlist.

However, we are accepting new clients right now. We had a number of clients hit the finish line at the end of 2025 and successfully retire and transition their practice. And because of that, we have some openings.

Gary Takacs: We’d love to talk to you if that’s of any interest.

Well, as we wrap this up today, I want to take a minute and thank all of you for the privilege of your time. We appreciate your listenership. Thanks so much for the privilege of your time.

Hope you found some useful things you can apply. We know that our listeners are people that take action, so let me encourage you to take some action on the things that you learned in this podcast.

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