In all facets of business, and certainly in dentistry and oral and maxillofacial surgery, a lot of attention gets paid to online reviews: how to get more of them, how to respond to bad ones, and how to manage your reputation. 

But after decades in the practice, I’ve realized most negative reviews in health care have very little to do with the surgery itself. More often than not, perception comes down to communication. 

A patient can receive excellent clinical care and still walk away frustrated if expectations weren’t clearly set, if financial conversations were confusing, or if something in the process made them feel rushed or unheard. By the time a patient reaches the surgical chair, their perception of the experience has already been shaped by multiple interactions with your team. 

That’s why culture matters more than scripts, reputation strategies, or online review responses.  Culture determines how those interactions happen. 

The team shapes the experience 

In most practices, a surgeon may spend an hour or less performing a procedure. The team manages everything surrounding it: scheduling, insurance discussions, financial coordination, preoperative preparation, and postoperative follow-up.

Every one of those touchpoints influences how the patient feels about their experience, and when a practice has the right culture, those interactions are thoughtful, clear, and patient-focused. When the culture is suboptimal or purely transactional, communication breaks down quickly, and patients sense it immediately. 

What’s interesting is that many organizations try to fix this with top-down programs, corporate playbooks, or forced team-building exercises, but real culture doesn’t come from contrived happenings or slogans. It comes from leadership.

Culture is set by example 

You can’t expect professionalism, accountability, or empathy from your team if you don’t model those behaviors yourself. Teams notice everything. They watch how you interact with patients, how you treat staff, and how you handle stressful moments. 

If a leader walks into the office expecting everyone else to carry the emotional load of the day while they remain detached, the culture will clearly reflect that. But when the leader shows up engaged, respectful, and invested in the success of the entire team, that standard spreads quickly. 

Culture isn’t what gets written in a handbook; it’s what gets demonstrated every day. 

Trust takes time 

Another common misconception is that culture can be engineered overnight—but it can’t. 

Real culture is built through trust, and trust develops over time. It grows when team members know their leader will support them, when communication is honest, and when everyone feels responsible for the patient experience. 

In strong practices, teams don’t just complete tasks; they work together toward a shared standard of care and service.  That kind of environment dramatically improves retention because people want to stay where they feel respected and valued. 

Where negative reviews really start 

When practices receive negative reviews, many instinctually focus on managing the review itself. Respond online, hire a reputation management company, encourage more patients to post five-star feedback. 

Those tactics may be marginally helpful, but they rarely address the real source of the problem.  Most negative reviews begin elsewhere along the patient journey, usually with breakdowns in communication. 

These issues have very little to do with the technical quality of the surgery. They almost always stem from expectations that were never properly aligned. So when teams communicate clearly and consistently, those situations become far less common. And when something does go wrong, as it inevitably can in health care or any business, a strong culture ensures it’s addressed quickly and compassionately before it escalates into a public complaint. 

Hiring for culture, not just competence 

This is why hiring decisions matter so much.  Technical skills are important, but attitude, emotional intelligence, and communication ability often determine whether someone truly strengthens a practice. 

The best teams are made up of people who care deeply about the patient experience and about each other. Systems can be taught and workflows can be trained.  Character cannot. 

When practices prioritize cultural fit during hiring, retention improves, teamwork strengthens, and the patient experience benefits naturally. 

The bottom line 

In what we do, clinical excellence is the baseline. Patients expect that the procedure will be performed well.  What they remember is how they were treated. 

That experience is shaped by the entire team and by the culture that the leader creates. 

Practices that invest in real relationships, clear communication, and authentic leadership build teams that stay longer, communicate better, and deliver a consistently stronger patient experience—not because of a management strategy or a corporate initiative, but because the culture is real, and the optimal patient experience can only be delivered by a team who experiences it for themselves.  

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.