They Lied
February 2, 2025
No, I’m not talking about politicians, shadowy deep-state operatives, or an unfaithful spouse. I’m talking about insurance companies—and the lies they’ve sold, wrapped in shiny packaging and tied up with a bow.
And the worst part? These lies have been repeated so many times that it’s become gospel. It has shaped behaviors—of patients, of dentists, of entire dental institutions. That’s the power of a lie left unchecked, unchallenged, and unquestioned.
Let’s be clear: This is not the insurance companies’ fault. They simply created a product that businesses, unions, and governments wanted. Just like you, they’re in the business of giving their customers and shareholders what they demand.
So, who are their customers? Not your patients. Not you, the dentist. Their customers are the ones footing the bill—the businesses and organizations purchasing group plans. You, the dentist, are merely a pawn in their business strategy. They couldn’t care less about you as long as others are willing to swallow their bait.
The Origin Story of the Big Lie
Let’s rewind to the 1950s and 60s. Labor unions were pressuring employers for better benefits. Insurance companies, always eager for a new revenue stream, saw an opportunity. They bundled dental insurance with medical insurance to make their plans seem more attractive. But there was a catch—dental insurance wasn’t designed to cover dentistry; it was designed to nudge patients toward seeking care. Who could argue with such a noble cause?
Back then, annual maximums were set at $1,000. Fast forward six decades, and—surprise!—that number hasn’t changed much. If dental insurance were meant to cover modern care, those benefits would have kept pace with inflation. But they haven’t, because that was never the intent. The industry didn’t want to create a system that actually covered full treatment—it wanted a profitable product with controlled risk. And it worked.
The result? Dental insurance became a cash cow for the insurance industry. And for a while, dentists thought this was a good thing. They believed it would encourage patients to seek care. And it did… but not in the way they had imagined.
The Three-Legged Stool That Became a Two-Legged Monster
Avrom King saw the writing on the wall in the ’70s, when he predicted the rise of a three-tier dental system:
What he didn’t anticipate was that the third category—private, fee-for-service care—would become nearly extinct. Dental schools now churn out graduates drowning in debt, many of whom have no choice but to start their careers in corporate-owned clinics that promote a transactional relationship with the patient and a focus on production. Meanwhile, fee-for-service practices struggle to find associates who don’t require a complete re-education.
The Lies We Believed
Somewhere along the way, dentists started building their business models around insurance, based on a set of well-packaged, semi-truthful lies.
Lie #1: Accepting insurance brings more patients.
Sure, you may get more new patients. But what kind of patients? Are they committed to their oral health, or are they just looking for whatever is covered?
Lie #2: Insurance won’t dictate treatment.
Maybe not directly. But when patients are given the option of fully covered vs. out-of-pocket, guess which one they choose? Over time, this has eroded comprehensive care, turning dentistry into a game of “what will insurance cover?” rather than “what’s best for the patient?”
Lie #3: A lower-paying patient is better than an empty chair.
This one’s the real killer. Practices that bought into this mindset are now drowning in overhead costs that insurance companies don’t care about. Your rising rent? Not their problem. Your hygienist demanding a raise? Not their problem. Your practice struggling to stay profitable? Still not their problem. Because guess what? You’re not their customer.
The Path Forward: How to Break Free
So, what do you do? You don’t just drop insurance overnight and hope for the best. That’s another form of financial self-destruction. Instead, you need a strategy.
The answer lies in:
✅ Frequent communication – Educate your patients through a variety of communication systems, including a written newsletter. Slowly start education on why insurance isn’t the gold standard through stories and actual patient examples.
✅ Trust-building – Patients choose dentists they trust, not the ones their insurance company suggests.
✅ An exceptional patient experience – Make the experience so unique that its worth staying with you, insurance or not. Think loyalty plan.
✅ Comprehensive diagnosis – Present the best care, not just what’s covered. And present the consequences of episodic or “insurance-based” care.
✅ Marketing to attract non-insurance-dependent patients – You want value-driven patients, not price-shoppers. Become a better consumer of marketing or learn how to do it on your own.
✅ Schedule adjustments – Make room for patients who value quality over coverage.
✅ Learning the psychology of influence – Ethically persuade patients to prioritize their health.
Your Next Move
Frustrated by shrinking profits? You’re not alone. The good news is, there’s a way out.
You can try to navigate this yourself, or you can learn from those who’ve already cracked the code. A great place to start? Join The Liberated Practice and subscribe to Dan Kennedy’s Magnetic Marketing Newsletter. Because in today’s dental world, success isn’t about playing by insurance companies’ rules—it’s about learning how to break free from them.
But Dental Sleep Medicine is Different!
Really? Medical Insurance is a business too. And the same issues mentioned above apply.
Your NPI signifies that you’re a dentist. The insurance companies know it. The discussion over removing E0486 from DME isn’t theoretical. The inclusion of DSM codes in the CDT isn’t innocuous. Both have significant, practical, and financial ramifications, as they will change the rules under which you might now operate. Inflation may never again go down to 1%. Employee costs will never go down. You are not in control. But you should be prepared.
To Your Practice’s Liberation,
Michael
P.S. Over the next 7 weeks, I will be expanding on each of the 7 strategies you can use to help reduce your dependence on Insurance and BREAK FREE.
Practice Success Insights

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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