Building a Fee-for-Service Practice Through Trust, Diagnosis, and Meaningful Conversations with Dr. Brian Vence

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Episode Description

In part one of this two-part conversation, Dr. Brian Vence shares a deeply thoughtful and experience-driven perspective on what it actually takes to build a successful fee-for-service practice—one rooted not in persuasion or sales tactics, but in trust, diagnosis, and meaningful human connection.

With more than three decades of clinical experience and a career dedicated to interdisciplinary, comprehensive care, Dr. Vence reframes treatment planning as a behavioral and relational process, not a transactional one. He challenges the idea that comprehensive dentistry is something that must be "sold," and instead positions it as a process of helping patients clarify their own values, goals, and tolerance for risk—at their pace, not ours.

This episode explores how dentists can meet patients where they are without abandoning ideal diagnosis. Dr. Vence explains why patients often fixate on a single tooth or isolated concern, and how honoring that starting point—when done thoughtfully—can open the door to deeper, more comprehensive care over time. Rather than overwhelming patients with full-mouth solutions on day one, he advocates for sequencing conversations, building psychological safety, and creating space for patients to envision what's possible.

A major theme of the discussion is the concept of "Pathways to Essential and Meaningful Treatment." Dr. Vence walks through how environment, language, and timing directly influence patient decision-making—and why treatment planning conversations are often better held outside the operatory, away from the fight-or-flight associations many patients carry with dentistry.

In this episode, you'll hear:

• Why fee-for-service dentistry begins with mindset and culture—not insurance policies

• How to stop "convincing" patients and instead become a clear, unbiased sounding board

• Why comprehensive treatment planning is fundamentally about behavior, not procedures

• How environment and language influence whether patients feel safe enough to future-focus

• The importance of honoring patient autonomy while still holding space for ideal diagnosis

Dr. Vence also shares practical insights into new patient workflows, from the first phone call to in-office consultations, emphasizing the value of curiosity, listening, and slowing down. He highlights why efficiency often crowds out effectiveness—and why the most productive clinical days are rarely about volume, but about depth of connection.

This conversation is especially relevant for dentists who feel tension between practicing the dentistry they know is right and navigating patient hesitancy, financial concerns, or insurance-driven expectations. If you've ever felt frustrated trying to align comprehensive care with patient readiness, this episode offers a grounded, humane, and sustainable way forward.

Part one sets the philosophical and relational foundation. In part two, the conversation continues into diagnosis, case presentation, and how to guide patients through complex decisions without coercion.

This is not an episode about selling dentistry. It's about helping patients—and clinicians—make clearer, more meaningful choices.