Communication is crucial when transitioning to fee-for-service. Dr. Elizabeth DiBona talks about her decision—and how she created an effective, empathetic video message that’s a blueprint for like-minded practices.

WE SPEND AN incredible amount of time bending to what insurance wants us to do or maximizing insurance benefits, when we should be focused on high-quality dentistry. Trying to
remain “in network” was draining my time, energy and passion. Also, inflation made overhead rise to a level that was simply not
sustainable. Every day, I reviewed our production and write-offs like, Why is insurance making me write off over $400 per crown?

Our strategy was to communicate with the entire team first, get them scripts and get them genuinely onboard. Then we allowed six months for talking to all in-network insurance patients—preferably in the hygiene chair, because let’s face it, dental hygienists are incredibly effective when communicating with patients, and patients really trust their opinions.

My manager, husband and videographer were all great in helping me refine the video script. I pulled a lot from other dentists on Facebook groups like Dental Nachos, so I’m thankful to everyone I’ve been inspired by. I also suggest having a “non-dental” person review your script from a patient’s perspective.

[To watch Dr. DiBona’s video message for pointers and ideas about crafting your own, click here.]

Our finished video is about eight minutes long. I knew patients would be upset if they didn’t get enough information, so I structured it so they can decide whether to watch the whole thing. Most did. Some didn’t, but we handed out short letters in hygiene bags and mailed letters to all our affected patients.

I was less successful using social media than sharing the video directly. A few longtime patients posted blunt concerns, which I understand, so I ended up taking down the post to allow for more positive communication in the office. Having those one-on-one conversations is time-consuming and exhausting, but patients are appreciative. We also have a membership plan in the works to further address patient concerns.

You need to understand the real reason some patients get angry. They’re upset because they’re afraid of change, and they want to keep you as their dentist.

I level with my patients: Look, you’re going to get letters from the insurance company saying you’ll pay less for an in-network provider. The best strategy is to educate patients and prepare them for any possible misleading information.
Be honest and genuine. Don’t be angry with the insurance company (even though it can be hard for dentists to do!). Remember that anything you say or write can come back at you.

I’m grateful beyond words to my team and patients for their belief in me. Out of 1,500-plus affected insurance patients, only 29 have left to date. Many of those are transferring to a colleague—and he told me he may be dropping the same provider we did, so we may get some of them back this year.

DR. ELIZABETH DIBONA runs the DiBona Dental Group in Exeter, New Hampshire.