In this episode of the Less Insurance Dependence podcast, host Lester De Alwis welcomes Dr. David Moffet, dental practice coach and founder of the Ultimate Patient Experience. Dr. Moffet grew his own practice from a small two-room office into a $3.4 million business, then spent the last decade coaching dentists around the world, drawing on what he learned along the way. His core message: the problem a practice thinks it has is rarely the real one, and no amount of effort spent fixing symptoms will free a practice from a problem that sits elsewhere entirely.
Dr. Moffet uses a vivid analogy of a flooded courtyard to describe how most practices operate, endlessly bailing out water without ever finding where it’s coming in. Applied to dentistry, this shows up as reactivation lists full of patients who will never respond to a phone call, cancellation policies that try to stop patients from canceling rather than addressing why they lost trust in the first place, and a instinct to soften language around treatment urgency in ways that quietly cost practices both revenue and patient health.
The conversation moves through practical, specific scripting for handling cancellation calls, why team culture must come before any patient experience training, and why hiring for the ability to genuinely care about people matters more than clerical skill. Dr. Moffet closes with a concrete first step for any dentist listening: take a weekend, honestly look at where things are stumbling in the practice, and understand that fixing a problem usually reveals several more sitting right behind it.
Key Takeaways
- The biggest lesson from building a $3.4 million practice: do the opposite of what everyone else is doing. When insurance-owned clinics opened nearby and took the insurance-driven patients away, Dr. Moffet’s practice actually got busier, because it kept the fee-for-service patients who genuinely cared about their dentistry rather than treating insurance as a spending limit.
- A filing cabinet full of patients needing reactivation is a symptom, not the real problem. Those patients have already lost faith or trust in the practice. Calling them back rarely works because the disconnect happened long before the call. The real fix is building trust and creating genuine urgency and concern before that disconnect ever occurs.
- Cancellations should be handled by referencing the doctor’s clinical notes, not a receptionist’s opinion. Framing a cancellation conversation around what the doctor documented, the real risk of delay, moves the discussion from patient versus receptionist to patient versus their own treatment plan, and dramatically changes outcomes.
- Team culture has to come before patient experience training, not alongside it. You cannot train someone to have a caring culture. Hire people who already have a genuine need to please others, then train them on systems and patient experience. Skilled but uninvested hires will always undermine the patient relationship, regardless of their technical competence.
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Episode Timestamps
- 00:00:05 – Introduction & Guest Overview
- Lester De Alwis introduces Dr. David Moffet, dental practice coach and founder of the Ultimate Patient Experience. Dr. Moffet grew his own practice from a small two-room office into a $3.4 million business, then spent the last decade coaching dentists around the world.
- Today’s episode explores why the problem a practice thinks it has is often not the real one, and how to find the one that’s actually holding a practice back.
View Transcript
Lester De Alwis: Welcome to the Less Insurance Dependence podcast. I’m your host, Lester De Alwis, and this show is dedicated to helping dental professionals build stronger, more profitable practices with less reliance on insurance. Today I am excited to welcome Dr. David Moffet, dental practice coach and founder of the Ultimate Patient Experience. Dr. Moffet grew his own practice from a small two room office into a $3.4 million business, then spent the last decade coaching dentists around the world using what he learned along the way. Today’s episode is titled It’s the Real Problem: Why Fixing Symptoms Won’t Free Your Practice. Dr. Moffet, welcome to the show.
Dr. David Moffet: Great to be here, Lester. Thank you very much for the invitation. I’m very pleased to be a guest on your podcast.
- 00:01:05 – The Biggest Lesson From Building a $3.4 Million Practice
- Dr. Moffet credits marketer Dan Kennedy with the principle that shaped his career: if everyone in a market is doing the same thing, do the opposite, because successful people are usually doing something different.
- When insurance-owned clinics opened near his practice, Dr. Moffet feared losing patients. Instead, those clinics absorbed the insurance-driven patients, the ones treating insurance coverage as a spending limit, leaving his practice with fee-for-service patients who genuinely cared about their dentistry. His practice became busier as a result.
View Transcript
Dr. David Moffet: I guess one of the big lessons, probably the biggest one, was a lesson I learned from Dan Kennedy, one of the world famous marketers. He said that if he had to start a business in any town, he’d just look at what everybody else was doing and then do the opposite. At the time when I started my practice, I was concerned that insurance was coming in and clinics were opening up, owned by insurance companies, and I thought these guys are gonna take our patients away. But what they did was they took the insurance driven patients away and left the paying, fee-for-service patients there. So my practice actually became busier because I got to see people who really cared about their dentistry and didn’t use insurance as, oh, I better get my insurance worth this year.
- 00:02:35 – Why the Human Race Solves the Wrong Problem: The Flooded Courtyard
- Dr. Moffet uses an analogy of a man bailing water from a flooded courtyard, tossing it back over a fence, without ever addressing where the water is actually coming in. The lesson: fixing a symptom without finding the source guarantees the problem will return indefinitely.
- A classic dental example: a filing cabinet full of patients needing reactivation. Those patients have already lost faith or trust in the practice and decided not to return; calling them back rarely works because the real disconnect happened long before the phone call.
View Transcript
Dr. David Moffet: There’s a video on YouTube of a man in his courtyard, and there’s a gate, and it’s flooded, and the flood is coming through the grate, and he’s got a bucket picking up the water and tossing it back over the fence, but it keeps coming back through. The solution isn’t to get rid of the water from the courtyard. The solution is to find where the water’s coming from. Here’s a classic one in dental practices: we’ve got too many patients in our filing cabinet that need reactivation, so they need to get somebody on the phone. But the reason these people haven’t come back is they’ve lost faith or trust in the practice. It’s not something you can fix by ringing them up. They’ve already decided they’re either going somewhere else or not coming back at all.
- 00:04:53 – Why Softening the Language Around Treatment Urgency Backfires
- Dr. Moffet identifies a common dentist habit of softening treatment language, calling decay "just a little crack" or "a small hole," which fails to communicate genuine urgency. Patients don’t buy fillings; they buy avoidance of a root canal, an outcome they actually fear.
- The fix requires two things working together: creating real urgency and concern about what happens if treatment is delayed, and building genuine relationships and trust so patients believe that concern is sincere rather than sales pressure.
View Transcript
Dr. David Moffet: Dentists don’t tell people that, they use softening language. They say, oh, it’s just a little crack, it’s a small hole, you need a filling. Nobody buys fillings. What they buy is removal of active decay that is getting near their nerve, that could cause a root canal. Oh, I don’t want that. So create urgency and concern, but also create relationships and trust so that people will come back. Once they do start coming back, then all of a sudden you don’t have to reactivate people.
- 00:06:03 – What to Say When a Patient Calls to Cancel
- Dr. Moffet shares specific scripting: when a patient calls to cancel, the receptionist should say, "Let me pop you on hold while I check Dr. Smith’s notes," reframing the cancellation around the actual clinical stakes documented by the doctor rather than a simple scheduling change.
- This shifts the conversation from the patient and the receptionist to the patient and their own doctor’s clinical notes, a distinction Dr. Moffet says fundamentally changes the outcome of the call.
View Transcript
Dr. David Moffet: When they ring and say, I need to cancel my appointment, the first thing you have to teach those people to do is say, just let me pop you on hold while I check Dr. Smith’s notes. Because when they’re ringing to cancel an appointment, it’s not like changing a coffee, they’re coming for their health and for treatment. Oh, I’ve just checked Dr. Smith’s notes. He said that if we don’t do this this week, there’s a chance that crack could spread and you could end up breaking that tooth and need an extraction and an implant. Is that what you want? So the discussion then becomes between the patient and the notes of Dr. Smith, not the patient and the receptionist.
- 00:08:38 – Why "You’re on Our Standby List" Is the Wrong Message
- Dr. Moffet argues against generic waitlist language, comparing it to being 18th in line for the British throne, where nobody actually cares what number they are. Patients should instead be told they are being personally called because the doctor specifically wants to reschedule their appointment.
- This creates anticipation and pre-commitment before the call even happens, so when a scheduling change occurs, the patient feels chosen rather than simply notified.
View Transcript
Dr. David Moffet: Who cares if you’re 18th in line, it’s Charles, George, William, then that’s it. They don’t wanna be, oh, what number am I on the list. They want to think, there is no list, I’m gonna be calling you because Dr. Moffet wants to bring your appointment forward. So when you call, you say, remember Dr. Moffet said if he got a change in his book, he was gonna call, he asked me to call you. Well, guess what, we’ve had a change. And they go, oh great. So we create anticipation and excitement and they’ve already committed to it beforehand.
- 00:10:21 – Sponsor: Ekwa Marketing
- Lester pauses to recognize this episode’s sponsor, Ekwa Marketing, connecting the theme of building trust in person directly to building trust and visibility online.
- Ekwa Marketing helps dental practices build trust and reputation online through better visibility, so patients can find and trust a practice before they ever call. Book a complimentary marketing strategy meeting at lessinsurancedependence.com/msm or book a complimentary coaching strategy meeting with Gary at lessinsurancedependence.com/csm.
View Transcript
Lester De Alwis: I also wanted to give a shout out to Ekwa Marketing. They are the digital marketing agency that also helps dental practices build trust online and also build a reputation with better visibility, where your patients can find you and also trust you and choose you for the reasons that they need you. If you are looking to do a practice audit on your digital marketing, you can go ahead and book a complimentary marketing strategy meeting at lessinsurancedependence.com/msm or book a complimentary coaching strategy meeting with Gary at lessinsurancedependence.com/csm.
- 00:11:14 – Why Patient Experience and Team Culture Are One Problem, Not Two
- Dr. Moffet references James McMannon of the Ritz-Carlton, who advised starting any business with culture and value statements first, hiring only people who genuinely share those values, then building systems, and only after that training people on those systems.
- You cannot train someone into having a caring culture; they either believe it or they don’t. Dr. Moffet describes hiring skilled clerical staff from other industries who openly questioned the need for customer service at all, illustrating why culture must be a hiring filter, not a training outcome.
View Transcript
Dr. David Moffet: If you haven’t got the team culture right, you can’t build a patient experience, you need the team to be on board. This comes from James McMannon who worked for the Ritz Carlton in America. He said that if he was starting a business, he would start with culture and value statements first and only employ people who shared in that common culture and value belief. Once he had that, then he would work on the systems needed and then train those people. It’s very hard to train people to have a culture. They either believe it or they don’t.
- 00:16:46 – "Be That Servant All the Time": The Business Owner as Employee
- Dr. Moffet references a line from The Remains of the Day, where a butler describes his whole purpose as serving his employer, applying the same idea to dental practice ownership: your customers are effectively your employer, and if you don’t look after them, they will go elsewhere.
- The daily discipline he recommends: constantly ask how today’s patient experience can be better than the last time that same patient was in.
View Transcript
Dr. David Moffet: There’s a movie, The Remains of the Day, Anthony Hopkins plays a butler, and there’s a line where he says a man’s whole purpose in life is to serve his employer. Even as a business owner, your employer is your customers. They’re employing you, because if you don’t look after them, they’ll go elsewhere. So be that servant all the time. How can I make their experience better today than it was last time they were in?
- 00:17:31 – The One Move to Make This Week: Find the Real Problem
- Dr. Moffet compares problems to cockroaches: if you find one, there are usually several more nearby. His recommendation is to take a weekend or dedicated time away specifically to honestly examine where the practice is stumbling, rather than reacting to symptoms as they surface.
- Systems only work with real accountability behind them, meaning a clear plan for what happens if something goes wrong, not just a system that assumes nothing ever will.
View Transcript
Dr. David Moffet: If you find a problem, you’ve probably got a few happening. So what they need to do is take a weekend or take time away and say, let me have a look at what’s going on. Where are the issues in my office, and are we just stumbling through them, or do we have systems and processes? But systems are no good unless we have accountability for those systems.
- 00:18:36 – Turning a Mistake Into Loyalty: The Lost Crown Story
- Dr. Moffet shares a real example of recovering from a service failure: a patient’s crown was lost at the office, requiring a new impression and a delay. After the patient left, Dr. Moffet sent him a scratch lottery ticket worth up to $62,000 along with a note thanking him for his understanding.
- The point: a $10 gesture turned a frustrated patient into someone who told other people about the experience, because a genuine, surprising recovery from a mistake often builds more loyalty than if nothing had gone wrong in the first place.
View Transcript
Dr. David Moffet: The crown that the patient was due to get was lost. He had to have another temporary crown, another impression sent away. As soon as he left, I went to the lottery office and bought him a scratch lottery ticket and put it in a card, and I said, we are so lucky to have patients like you who understand that sometimes things cannot go the way they’re meant to. The scratchy was worth up to $62,000 if he won something. So all of a sudden he’s angry for a day, but how many people do you reckon he told about the dentist that sent him a scratch lottery ticket? Cost $10 to send and try and make it better.
- 00:20:17 – How to Reach Dr. David Moffet
- Email: David@theupe.com — spelled out as "the UPE," short for Ultimate Patient Experience.
- Facebook: open, public page, direct messages welcome.
- LinkedIn: search Moffet, spelled M-O-F-F-E-T, from the French pronunciation. Dr. Moffet is happy to answer any questions from listeners who reach out.
View Transcript
Dr. David Moffet: They can reach out to me by sending an email to my email address, which is David@theupe.com. That’s the UPE, for Ultimate Patient Experience.com. You can find me on Facebook and send me a Facebook message, I’ve got an open Facebook page, it’s not closed. You can find me on LinkedIn and send me a message there too, it’s Moffet, M-O-F-F-E-T. It’s a rare way of spelling it, but it’s from the French. Easy to spell and easy to remember. I’m happy to answer any questions if anyone reaches out to me.
Lester De Alwis: Dr. Moffet, thank you so much for spending your time with us today.
Dr. David Moffet: It’s my pleasure. Thank you for inviting me.
Patients really do not care about what the cost is if they receive a tremendous value — because the value you receive is more important than the money you spend. People don’t want to just buy something. What they want is a relationship.
Mike Sonick
Leadership is what holds everything together. If there’s no leadership, everything crumbles down.
Lester De Alwis
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