A Cracker Barrel Lesson

August 24, 2025
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Do you really know what your patients like about you?

Cracker Barrel thought they did. Then they redesigned their logo, revamped their interiors, and tinkered with their menu — all without truly understanding what kept their loyal customers coming back. The backlash was swift, sales slipped, and the brand is now trying to avoid “a Budweiser moment” — alienating your core audience in the name of “progress.”

But here’s the thing: you’re not a public company. You don’t have billions to spend fixing a bad bet. In dentistry — and especially for anyone doing referral based therapies such as dental sleep medicine and TMJ — you can’t afford to guess. Because it’s not just about what patients like about you. It’s also about what your referral sources like. And those relationships are fragile.

Before making big changes — dropping out of network, joining a new one, raising fees, or shifting your sleep medicine positioning — you need data, not hunches.  Cracker Barrel has lost $390 million in market cap.  A similar 24% loss for a dental practice means…goodbye profit.

Start With Your Patients, ask:

Send a quick survey through your patient communication platform. Keep it short and focused.
Read your reviews. Pay close attention to what patients praise you for — and what they quietly complain about.
Listen between the lines. The little things patients highlight (“you always run on time” or “everyone’s so friendly”) are clues to your brand’s secret sauce.

These insights aren’t just feel-good data points. They’re the foundation for deciding what to protect, what to improve, and where you can safely innovate without alienating the people who pay the bills.

Talk to Your Referral Sources

Patients are easier. Referral sources? That’s trickier. You won’t get much from an online survey — you’ll get insight by showing up.

Bring cookies, cupcakes, or — if you really want to stand out — something thoughtful from a local bakery. When you drop by, ask to speak with the practice managerPA, or NP — they’re the gatekeepers who actually decide where patients go.

Skip the physicians themselves. They rarely know the nuances of patient feedback and aren’t usually the ones driving referral behavior.

Your goal here isn’t to “sell.” It’s to learn:

Why do they refer to you instead of someone else?
What feedback are they hearing from patients?
What could make their jobs easier when referring to you?

This kind of insight is pure gold when you’re thinking about any big operational changes.

Protect What They Love Before You Change It

Once you know what your patients and referral sources truly value, you can make informed decisions. If Cracker Barrel had done that, they could have saved themselves a fortune — and a PR headache.

The dental sleep medicine landscape is competitive. Trust is fragile. Before you reinvent yourself, make sure you’re not reinventing away the very things that make you referable, likable, and “sticky” to your patients.

Because the lesson here is simple: guessing is expensive. Listening is free.

The Due Diligence Advantage

Make Smart Practice Purchases With Confidence — and Maximize Value When You Sell

Buying a dental practice isn’t just a financial investment — it’s an emotional one. You’re not just acquiring chairs, charts, and contracts. You’re stepping into a living ecosystem of patients, referral relationships, and expectations.

And here’s the truth: numbers don’t tell the whole story.

You can review P&Ls, production reports, and AR spreadsheets until your eyes blur — but if you don’t know what patients love, what referral sources value, and where hidden risks lie, you’re buying blind.

That’s where The Due Diligence Advantage comes in.

Why This Matters

Making changes too quickly after buying a practice can backfire:

Patients may leave if you unknowingly disrupt what they value most
Referral streams can dry up if you don’t understand their expectations
Operational “surprises” can derail your growth and financial projections

The smartest buyers listen before they leap. They gather insight from patients, referral sources, and internal systems before making strategic moves. That’s exactly what this kit helps you do.

For Sellers: Increase Your Practice’s Value Before You List

If you’re preparing to sell your practice, the same insights can dramatically increase your marketability and value:

Showcase Patient Loyalty – Use the included patient survey to gather testimonials and data that demonstrate patient satisfaction. Buyers pay more for predictable retention.
Demonstrate Referral Stability – The referral source script helps you validate strong physician and dental referral relationships — a huge asset when positioning your practice.
Highlight Strengths and Fix Weaknesses – Use the checklist to identify potential red flags before buyers find them. Clean them up in advance to command a higher valuation.

By proactively gathering and presenting this data, you’re not just selling a practice — you’re selling a proven, thriving ecosystem. That translates into leverage at the negotiation table.

Ready to Make Smarter Practice Decisions?

Before you drop an insurance plan, raise fees, add dental sleep medicine, or make any other big move, get the insights you need to avoid costly mistakes.

Download our Practice Change Success Kit — a free resource that includes:

Patient Survey Template – Discover what your patients truly value about your practice
Referral Source Conversation Script – Learn exactly what to say when you meet with physicians, PAs, or practice managers
Big Change Evaluation Checklist – A step-by-step guide to help you make confident, informed decisions

Make changes with clarity, not guesswork.

It’s FREE when you hop on a 20-minute strategy call.

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Dr. Michael Goldberg is one of the leading educators on dental practice management in the United States.

Michael ran and sold a prestigious group practice in Manhattan and has been on Faculty at Columbia University and New York-Presbyterian Medical Center for 30 years including Director of the GPR program and Director of the course on Practice Management.

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