The real reason dental patients pick one practice over another

Last week, top behavioural scientist Richard Shotton showed a packed audience of dental practice owners how to win more patients before they ever get in touch. The catch: the proof lands on the phone, and almost nobody is tracking what happens there. You could have spent all two days at the Dentistry Show, walked every aisle, seen every AI tool in dentistry, and still missed the one thing that actually explained why a patient picks your practice over the one down the road.

It wasn't new and it wasn't for sale. It was a panel inside the Leaders' Lounge, packed out with practice owners, running on behavioural science that's been sitting in plain sight for decades. I hosted that panel with Richard Shotton, author of The Choice Factory and Hacking the Human Mind, and a behavioural scientist who's advised Google, Meta and Expedia on how people actually make decisions. With us were Dr Dev Patel and Dr Angela Auluck , who own Dental Rooms, an award-winning practice in Wimbledon. The session covered behavioural science across dentistry.

This article is about the bit nobody at the show was talking about: what happens before a patient ever contacts you.

PATIENTS CAN'T JUDGE CLINICAL SKILL, SO THEY DON'T TRY

Angela opened with the question every owner has:

"You spend years on clinical skill, and patients pick a practice for reasons that have nothing to do with it. So what's the biggest thing practices get wrong about why someone chooses them?"

Richard's answer was that patients can't judge clinical skill, so they don't even try. They swap the hard question for an easy one. He told the audience about Richard Nisbett's halo effect work. The same lecturer was recorded giving the same content, warmly in one version and coldly in the other. The people who saw the warm version rated him better looking, more intelligent, more logical. None of that changed. Only the warmth did. We pick one signal we can measure and let it stand in for everything we can't. And because of social media, patients are doing that long before they've met you.

"We pick one easy-to-measure standout characteristic and use it as a guide to everything else. That's how people judge your expertise. That's how they judge your trustworthiness."

THE HERD DECIDES BEFORE THE PHONE RINGS

Dev pushed him on the bit that happens earlier still. How does any of this reach a patient who hasn't walked in yet? That took Richard to social proof, and Robert Cialdini's famous 2008 hotel study. He talked everyone through it, and the numbers are the argument.

35% reused their towels with a standard environmental message. 44% reused them when the sign said most guests reuse their towels. 49% reused them when the sign said most guests in this room did.

Nothing changed but the words. A 40% lift over the control, and not a penny spent on anything but phrasing. We're a herd species. If we think people like us have already chosen you, we assume those people weighed it up sensibly, and we follow. The decision is being made at home, on a phone, before anyone rings you.

WHAT A PRACTICE ACTUALLY DOES WITH THIS

Angela's follow-up was the practical one: "So what does a practice actually do with that to get more people picking up the phone?"

Richard's answer was to give people a specific, true claim that others like them have already chosen you. His own example for Angela was "in Wimbledon we do more Invisalign than anyone else" if it's true. If you can't say that, "the fastest growing." If you can't say that either, the plain volume you did last month. Specific beats grand. "The grand claim every practice makes gets discounted on sight. The specific one gets believed."

Then he made the point that's stuck with me since. Daniel Kahneman and Richard Thaler, the two behavioural scientists who won the Nobel for this work, were each asked the single biggest thing they'd learned across a whole career. They gave the same answer: make it easy. We overrate motivation and underrate friction. Most businesses pour money into looking appealing and almost nothing into removing the small barriers between deciding to get in touch and actually getting through.

His example was Netflix. A company that spends $25bn a year on content, and one of the biggest lifts in viewing came from auto-playing the next episode, so you have to find the remote to stop it, not to start it. A two-second change in friction. An outsized result. For a practice, the equivalent friction is every extra step between a patient deciding to call and a human actually answering. Richard had pushed the point that experts forget what the experience is like for people who don't know anything about dentistry, and Angela took it on the spot. She committed there and then to pretend to be a potential patient of her own practice, to walk through her own pre-pateint journey the way one of her potential patients would.

IT ALL CONVERGES ON ONE MOMENT NOBODY CAN SEE

Every bit of that converges on one moment. The phone call.

The social proof worked, the friction was low, the patient picked up the phone. And that call is the one part of the journey almost no owner can see.

After the session I spent the rest of the show with practice owners, some in groups, some one to one. I asked the same three questions every time. I went in expecting a mixed bag, a few who tracked it well, most who didn't. That isn't what I found. I didn't meet a single owner who actually knew their numbers.

Q. Do you know how many first-time callers don't get through in a normal week?

• Everyone knew roughly how many calls came in.
• Nobody could tell me how many were missed.
• The honest version, said more than once was "whatever the team tells me".

Q. What percentage of first-time callers actually book?

• Not one had a figure.
• Every answer was a feeling, and the feeling always ran more optimistic than anything they could show me.
• The phrase I kept hearing was "the team's good, they convert most of them".

Which is exactly the warm assumption Richard had spent the hour taking apart.

Q. If you applied one of Richard's insights tomorrow, would you know within a month whether it drove more telephone enquiries?

• Nobody gave a solid yes.
• A few laughed, because once you say it out loud it's obvious.

YOU CAN'T IMPROVE WHAT YOU CAN'T SEE

That's the gap. You can A/B a website because the data sits there. You can test an email because the numbers arrive on their own. The phone is where the whole pre-patient journey cashes out, the point a four-thousand-pound case is won or lost, and for most practices it's a black hole. A recording nobody opens isn't data, and nobody is listening to four hundred calls a month by hand.

Richard's whole argument is that you don't have to take his word for any of it. Test it, and within a few weeks you'll know. But you can only run that loop on a channel you can actually see. From what I've seen, more dentists are turning to behavioural science to understand why a patient chooses one practice over another. The ones who get the full return on it are the ones who can see whether it's working where it matters most, on the phone.

That's what VoiceStack is for. Answer rate, first-time caller conversion, what was actually said when someone rang to ask the price. Behavioural science tells you what to change before the patient calls. VoiceStack tells you whether the change worked, and catches the opportunities as they come in instead of after they've gone. If you've read this far, you're already the kind of owner who'd try one of Richard's ideas next week. The phone is the bit I can help with.