When to participate with PPOs…(are they jerks?)

Dear Dentist,

Are you thinking about participating in PPO plans for your new dental practice? You’re not alone. Many private practice owners wrestle with this decision—and understandably so. PPOs have a reputation for limiting treatment options and slashing reimbursements. And yes, many dentists feel stuck between building a patient base and preserving their profitability.

But before you completely write off PPOs, let’s take a clear-eyed look at when they actually make sense—and how you can use them strategically, not reactively.

The Controversial Truth About PPOs

Let’s not sugarcoat it: PPOs are one of the most hotly debated topics in dentistry. For many private practice owners, they represent frustration, reduced clinical autonomy, and profit margins that feel too tight to sustain.

But here’s the part most people leave out: PPOs, when used intentionally, can be powerful growth tools—especially for startup practices.

The key isn’t to blindly accept every plan or to avoid them altogether. The key is strategy.

The Good: Access to New Patients and Predictable Revenue

The number one reason dentists participate in PPOs? Patients.

PPO plans are popular. And being listed as an in-network provider puts you on the radar for hundreds, if not thousands, of potential new patients—especially in your first year of ownership when visibility and trust are still growing.

PPOs can also:

• Fill your schedule consistently

• Increase case acceptance by reducing out-of-pocket costs for patients

• Serve as a marketing tool that costs less than a billboard and delivers more qualified leads

For startup practices, that kind of volume can create the momentum you need to reach profitability faster.

The Bad: Lower Reimbursements and Less Flexibility

Of course, PPOs come with trade-offs.

You’ll likely face:

• Reduced reimbursement rates compared to fee-for-service

• Protocols and rules dictated by the insurer

• More paperwork, follow-up, and administrative complexity

And yes, it’s frustrating to provide top-tier care at reduced fees while juggling compliance with carrier policies.

But with careful fee schedule evaluation and negotiation up front, many practices find that they can make PPOs work—at least in the early growth stage.

So, When Does It Make Sense?

PPO participation makes sense when:

• You need to quickly grow a new patient base

• You’re in a highly competitive market where patients expect in-network providers

• You have a clear business plan to evaluate, manage, and eventually reduce PPO dependency

• You treat participation as a business strategy—not a permanent commitment

This decision should always align with your long-term vision. If you’re planning to shift to a fee-for-service model in the future, PPOs can serve as a bridge—not a ball and chain.

What’s Next?

If you’re still unsure whether PPOs fit into your model, you don’t have to figure it out alone. At Ideal Practices, we’ve guided over 900 successful startups, many of which began with some level of PPO participation—and eventually transitioned to more profitable, patient-aligned models.

We can help you:

• Evaluate which plans are worth considering

• Strategically negotiate fees

• Map out a transition plan to protect profitability as your practice matures

Bottom line: PPOs don’t have to be the enemy. With the right plan, they can be a launchpad.

If you’d like help navigating this piece of your startup journey, reach out. Let’s talk about how you can leverage PPO participation as part of a smart, strategic launch—and still build the practice you’ve always envisioned.

To your success,
Stephen Trutter
The Startup Dentist Podcast | Ideal Practices

P.S. Be sure to subscribe to our updates for more insights like this. You’ll get access to real-world lessons, expert interviews, and proven frameworks that support private practice owners every step of the way.