Dental practice
Dr James Goolnik on Why Patient Trust Comes Before the Sale
The London dentist and author explains why listening, honest options and a first visit that delivers what the patient asked for build a practice that patients stay with.
461 Marketing Back to Basics with James Goolnik : Dentistry Uncensored with Howard Farran
Video from Dentistry Uncensored with Dr. Howard Farran.
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How can a dental practice build patient trust without overselling treatment?
Start with what the patient came in for, then listen for the reason behind it. Dr James Goolnik argues that honest options, one clear recommendation from the whole team, realistic promises about comfort and cost, and a quick early win earn the trust that later treatment decisions depend on. Keeping patients matters more than chasing new ones.
Dr James Goolnik has spent his career asking why patients choose a dentist and why they leave one. Speaking with Howard Farran on Dentistry Uncensored, he argued that most practices fixate on how many new patients come through the door and forget a more useful question: why is this person sitting in my chair, and what made them leave their last dentist?
His answer is that trust has to be built before any treatment is sold. Patients often say one thing and want another, and unless the dentist finds the real reason for the visit, the same patient will be in another practice's chair within six months. Much of what he teaches about communication, rapport and practice culture comes back to that point.
Goolnik takes his lessons from outside dentistry as much as inside it. He described going back to the same hotel because the people there made him feel looked after, not because it was cheapest, and asked why a dental practice should be any different. The rest of the conversation set out how he turns that idea into daily habits.
Key takeaways
- Find out why a new patient left their last dentist, or they may leave you for the same reason.
- Give patients one clear recommendation with its advantages and disadvantages, not three competing opinions.
- Deliver what the patient asked for on the first visit, then earn the chance to raise everything else.
- Never promise painless dentistry, because one broken promise about comfort can end the relationship for good.
1. Find the reason behind the visit
Goolnik's starting point is the gap between what a patient asks for and what they actually want. A 45-year-old accountant who walks in with a broken tooth is also telling you something about his last dentist. Was he hurt, did he move house, or did nobody explain his options? Each answer calls for a different conversation, and missing it repeats the mistake that sent him away.
He treats rapport as the first clinical task rather than a courtesy. Building it quickly, he said, is how you learn what the patient is really looking for. It also changes the economics of a practice: attracting a new patient costs a great deal, so the aim is to attract them once, keep them, and let the relationship bring in referrals from their friends and family.
Reviews follow from the same habit. His practice asked patients directly why they came and whether they would share that experience, and at the time of the interview it had collected 136 Google reviews. The request came from the dentist himself, framed as a small favour, while the team sent the follow-up email that made saying yes quick and easy.
2. Give one clear recommendation
At the time of the interview Goolnik ran a London practice with several specialists under one roof, and he was blunt about what patients do not want: three specialists arguing in front of them about whether a tooth can be saved. The specialists can debate among themselves. What reaches the patient should be a single recommendation, with the reasons, advantages and disadvantages laid out plainly.
Patients now research their own care, he noted, and many arrive having read frightening stories about root canals. The dentist's job is to explain the best treatment and its trade-offs, including cost and long-term predictability. Once the clinical case is clear, a treatment coordinator takes over the timings and costings, work his team handles better than the dentists do.
Price transparency is part of the same honesty. His practice published its prices on its website, so a patient looking for the cheapest possible dentistry could see quickly that it was not the right clinic. Neither side wastes time, and the patients who do book arrive already knowing what kind of care they have chosen and what it will cost.
3. Win the first visit and keep your promises
Goolnik disagrees with dentists who refuse a patient's request until every other problem is fixed. If someone with gum disease asks for whitening, he tells them plainly about the other issues, then whitens their teeth, teaches them to brush better and books them in with the hygienist. An early win shows the patient that they were listened to.
That first win often leads to much more. Patients notice fresher breath and gums that no longer bleed, start to trust the practice, and come back for the treatment they were told about. Sent away without what they asked for, he warned, they may buy a whitening kit online and avoid dentists for another five or ten years.
The same principle rules out overpromising. He dislikes dentists who advertise painless dentistry, because no one can deliver care with nothing felt at all, and a patient promised otherwise will not trust that dentist again. His book, Brush: Proven Strategies to Make You and Your Dental Business Shine, grew out of notes he began writing while mentoring younger dentists.
