Several years ago on a day in March, I was packing cord for an eight-veneer case. My hygienist was waiting for me to check a patient and my office manager had just come in to place two emergencies on the schedule. I suddenly became aware of my heart beating in an irregular fashion that immediately caught my attention. I quietly excused myself from the chair and sat down in the break room for five minutes. Later that day, I called my cardiologist’s office but the receptionist told me I couldn’t be seen until October. 

I explained that I had an irregular heartbeat and that six months down the road I might not be alive. She said I could be placed on a waiting list. 

Here’s another story: my dental assistant had recently been having some lower GI issues that were causing her concern. Colon cancer runs in her family, so she was quietly freaking out. When she called her GI’s office, she was told that she could be seen by her doctor in five months or by a PA in two. She agreed to schedule a colonoscopy three months down the line. 

What's a concierge doctor?

Last week, I happened to be talking to my primary care physician, a concierge doctor (more on that later), and I relayed these stories as well as my frustration at the current state of medicine. He commiserated with me and explained that there’s no such thing as a “private specialist” anymore. They have all joined large groups that have been bought by hospital systems or corporations. And because of this, the individual specialist has no say in the scheduling process and, in fact, is totally removed from the office protocols in general.  

This made me think about where dentistry is going in terms of the corporate and large group practice model. Particularly, I thought of a new patient I recently saw who was very dissatisfied with her previous dental office that was bought by a corporation two years ago. This new patient had been seeing a particular doctor at that office for years, but learned at her last appointment that doctor was longer with the practice. Therefore, she would be seeing someone else instead. She was very upset that she had not been informed of this change before she came in for her appointment. 

Don't make your patients wait

As I have written previously, running a successful fee-for-service (FFS) practice depends, in part, on stellar customer service and relationship building. Not participating in insurance plans translates into fewer patients, and these patients are willing to see you because your practice offers different things than other offices. These include availability, the highest level that dentistry has to offer, payment plans, and a willingness to serve the patient in every way possible. If we go back to the medical model, an FFS dental office is exactly like a concierge medical doctor. 

If you are unaware of this medical model, it is when a primary care physician limits his or her practice to around 600 patients (as opposed to the potential 3,000+ patients many physicians now juggle). These 600 patients pay a yearly fee directly to the PCP that averages close to $2,500 a year per patient. In exchange, the doctor guarantees access to a yearly physical where the doctor talks and listens to your every concern. Callbacks from the doctor (not a PA) can be made the same day on a private number. 

This has become a wildly successful practice model because there will always be a demand for high touch customer service coupled with the highest quality care possible. 

And dentistry is no different. Sure, patients want to save money and utilize their insurance coverage wherever possible, and there will always be that segment of the population that will only do what their insurance covers. But there will always be a place for a small FFS practice—a practice that caters to those discriminating patients who are willing to pay out of pocket for exquisite cosmetic and restorative services delivered with an elevated level of customer service. 

So how do you raise your practice to achieve “concierge level”? First, create a vision and mission for your office that places the patient’s needs squarely at the forefront. Second, know that bigger is not always better or more profitable. Thetime you spend with each patient is the most valuable asset that patients crave, and the larger your practice, the less time you have to give. 

Don't insist, assist instead

Lastly, create office policies that “assist” and don’t “insist.” Flexibility in terms of appointment times or payment plans is always appreciated for those patients who are paying out of pocket to come see you. It is not unusual for me to come in an hour or two early—or even on my day off—to accommodate a patient who desires cosmetic/ advanced restorative services. 

I’m always reminded of the patient who, years ago, pulled me aside to tell me that her PCP was “going concierge” and asked what that meant. I explained that the doctor was limiting their practice to a small number of patients and, for a yearly fee, would be able to be seen the same day for any medical issues. They would also spend more time with the patient and would be available after hours for any questions or concerns. After I explained this, I remarked, “Hey, you know what? We are a concierge dental practice and we don’t even charge you a fee. That’s a great deal!” 

Editor's note: This article appeared in the June 2026 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.