Advocate or Adversary?

One of the most interesting things about the World Cup isn’t just the games, but how visitors experience the host country. Their perceptions don’t begin when they enter the stadium. They begin at home, on their screens and devices, as they search, scroll, watch videos, read reviews, hear opinions, and form expectations about what awaits them. And from the reactions of so many new visitors, it’s clear that many of those expectations were not positive.

That should get our attention.

Because perception comes first.

Long before the actual experience, people are already writing the story in their minds. Then, when the experience begins, every interaction either confirms the story or changes it. A warm welcome can challenge a negative expectation. A rushed answer can confirm one. A helpful explanation can build trust. A dismissive tone can destroy it before anyone realizes what happened.

Perception comes first.

The same is true in a dental practice.

Patients do not begin forming opinions when they sit in the chair. They begin forming them before they ever visit the office. They form them on your website, in your reviews, in your photos, in your videos, in AI search, in social media, and in the first phone call. By the time they meet you, they may already have decided whether your practice feels inviting or intimidating, personal or transactional, caring or sales-driven.

So the question is not simply, “Are we good at dentistry?”

The question is, “How are we being experienced?”

Are you being experienced as an advocate?

Or as an adversary?

That may sound harsh. Most dentists do not think of themselves as adversaries. They went into healthcare to help people. They diagnose. They educate. They relieve pain. They restore health. They help people look better, feel better, eat better, sleep better, and live better.

But people do not judge us by our intentions.

They judge us by their experience.

And that’s where the causes and consequences begin.

The cause is often simple: the practice starts with its own agenda before it understands the other person’s objective.

The consequence is powerful: the patient feels managed instead of understood.

That’s when trust begins to leak. That’s when the practice becomes what I have often jokingly called the Sales Prevention Department. Only I am not sure it is really a joke.

The Sales Prevention Department shows up long before the doctor presents treatment. It shows up on the website when the practice talks mostly about services and procedures instead of the patient’s desired destination. Crowns. Implants. Invisalign. Veneers. Sleep appliances. TMJ therapy. Periodontal treatment. Technology. Credentials. Before-and-after photos.

All of that may matter. But too often, the website is built around what the practice does rather than where the patient wants to go.

And those are not the same thing.

Patients do not wake up wanting a crown. They want to chew without pain. They do not wake up wanting periodontal therapy. They want to keep their teeth. They do not wake up wanting a sleep appliance. They want to stop snoring, sleep better, and feel rested. They do not wake up wanting veneers. They want to smile without feeling self-conscious. They do not wake up wanting TMJ therapy. They want the headaches to stop, the jaw tension to ease, and the fear of what is happening to their mouth to make sense.

One of my professors, a wise Irishman from South Boston, once gave me a line I have never forgotten:

“Never try to sell someone a Cadillac when all they want is to take a bus crosstown.”

There was so much wisdom in that.

The mistake is not offering the Cadillac. The mistake is offering it before you know where the person is trying to go.

That’s what happens on too many dental websites and in too many treatment rooms. The patient arrives with a concern, a fear, a hope, or a desired destination, and the practice responds with a menu of procedures.

That’s not advocacy.

That’s inventory.

And inventory does not create trust. It erodes it.

Perception comes first.

When a website communicates, “Here is what we do,” it may be accurate. But when it communicates, “We understand where you are, we understand where you want to go, and we can guide you through the best path forward,” it becomes something that’s rare today and hence, more valuable. It becomes a decision-support system. It moves the practice from selling procedures to helping people reach destinations they care about.

The same issue shows up on the first phone call.

“What insurance do you have?”

There’s nothing inherently wrong with the question. It’s practical. It has to be asked at some point. But when it’s one of the first things a prospective patient hears, beforebeing asked who they are, how they came to call you, what they want, what they’re worried about, or why they called today, it can land very differently than intended.

The practice may think it’s gathering information.

The patient may hear, “Your coverage matters more than your concern.”

The cause is administrative efficiency.

The consequence is emotional dissonance.

Once someone feels sorted, they rarely fully recover.

Perception comes first and sets the stage for everything that follows.

The same thing happens in the operatory.

“You need X, Y and Z.“

The doctor may be right. Clinically, the recommendation may be perfect. But without first understanding the person’s objective, “you need“ can feel less like help and more like a verdict. It can sound as if the doctor has already decided where the patient should go before finding out where the patient wants to go.

Advocacy isn’t simply telling people what’s clinically correct. Advocacy is helping people move toward a destination they value.

Until you know the destination, you cannot be perceived as the guide.

You may be the expert. You may be the clinician. You may be the authority. But authority without understanding canfeel like opposition.

The advocate says, “Help me understand what you’re trying to accomplish.”

The adversary says, “Here’s what you need.”

The advocate says, “What would make this a good outcome for you?”

The adversary says, “This is the treatment plan.”

The advocate says, “Let’s look at the options together.”

The adversary allows insurance, procedures, or production goals to become the frame.

The advocate keeps the patient’s objective as the frame.

That distinction is enormous because people will often accept difficult truths from someone they believe is on their side. They may accept complexity, cost, inconvenience, and even disappointment. But they resist being pushed. They resist being cornered. They resist being told what matters before they have had the chance to explain what matters to them.

This is why many practices struggle with case acceptance even when the dentistry is excellent. The issue is not always the diagnosis. The issue can be posture.

Are you standing across from the patient?

Above them?

Or beside them?

Because across from them, even the right recommendation can feel like pressure. Beside them, the same recommendation can feel like guidance.

Perception comes first.

And this doesn’t stop with patients.

The same question applies to leadership. Do your employees see you as an advocate? Or do they see you as the person preventing them from getting where they want to go?

Employees have destinations too. They want to feel respected. They want to feel competent. They want clarity. They want to know what success looks like. They want to know they will not be embarrassed, dismissed, or blamed when something goes wrong. They want to know the doctor is not merely extracting performance from them, but helping them become better at work they can feel proud of.

That’s advocacy.

But when leadership is only correction, urgency, frustration, and “why didn’t you,” the team can begin to experience the doctor as the obstacle. Not the leader. Not the coach. Not the advocate. The obstacle.

The cause is a leadership posture that assumes people should already understand.

The consequence is resistance.

And once resistance takes hold, everything becomes harder. Training becomes harder. Accountability becomes harder. Change becomes harder. Trust becomes harder.

That’s the lesson.

Before you lead, diagnose, recommend, present, correct, or redirect, you have to understand the destination.

Where does this person want to go?

What matters to them?

What are they afraid of?

What have they already experienced?

What would make them feel safe?

What would make them believe you are on their side?

Because once people believe you’re on their side, everything changes.

The website changes. The insurance conversation changes. The treatment conversation changes. The financial conversation changes. The employment conversation changes. The performance conversation changes. The entire culture changes.

You stop sounding like an obstacle.

You start sounding like a guide.

In a world where more and more healthcare feels transactional, rushed, corporate, and impersonal, being experienced as an advocate may be one of the most powerful differentiators a private practice has left.