10/16/2026
Has your dental team ever read a contract and still wondered, “Who is helping us address the rules themselves?”
Dr. Rob and I believe that question deserves a thoughtful conversation.
At what point does explaining the problem stop being advocacy and start becoming an excuse for doing nothing?
I recently came across another article published by the American Dental Association titled “Dear ADA: Recoupments,” and I have to admit, I found myself shaking my head once again. Not necessarily because the information was wrong, but because it represents something that has frustrated me about organized dentistry for years. We have become exceptionally good at explaining to dentists how insurance companies operate, yet remarkably reluctant to challenge the rules that allow some of these practices to continue.
The article addresses the issue of dental insurance companies recovering alleged overpayments by withholding money from future claims, sometimes involving entirely different patients. It offers guidance about reviewing contracts, understanding applicable state laws, maintaining documentation, and following the appropriate procedures when disputing a recoupment.
And there it is again.
"Read your contract. Understand your contract. Know your rights. Follow the insurance company's procedures. Keep good records. Contact someone if you need help."
Does anyone else feel like we've been having this same conversation for the past 30 years?
Now, before someone suggests that I don't believe dentists should understand their contracts, let me make something perfectly clear. At My Practice My Business, contract literacy is one of the fundamental principles we teach. Dentists absolutely need to understand the agreements they sign, the obligations they accept, and the rights they retain under applicable state laws.
But understanding a contract and accepting that its provisions should never be challenged are two very different things.
And that's where I believe organized dentistry continues to miss an enormous opportunity.
While others were explaining the rules, we were working to change them.
Here in Utah, Dr. Rob and I decided that simply explaining unfair insurance practices wasn't good enough.
We didn't believe dentists should have to accept every provision an insurance company placed in a contract simply because the company had the resources and leverage to put it there. We believed that when certain business practices created unfair consequences for dental professionals and their patients, those practices deserved legislative scrutiny.
So we went to work.
Through My Practice My Business, Dr. Rob and I have spent years working with legislators, educating dental professionals, and helping advance legislation intended to establish meaningful protections against problematic insurance practices.
In 2017, Utah passed SB44, addressing insurance company control over fees for non-covered services. In 2021, HB359 addressed issues involving network leasing, downcoding, and bundling. In 2025, HB495 included important protections involving insurance recoupments, plan limitations, and payment practices. And in 2026, HB58 continued addressing additional issues involving insurance contracts, transparency, and the rights of dental professionals.
None of these laws appeared out of thin air. They required identifying problems, explaining their consequences, working with legislators, navigating opposition, and continuing to push for changes that some insurance companies undoubtedly would have preferred to avoid.
And no, we didn't accomplish this alone. Legislators deserve recognition for their willingness to listen and act, as do the dentists and others who contributed to these efforts.
But someone had to bring the problems forward and help develop workable solutions. That's what we've been doing. And while no legislation eliminates every insurance problem, these laws demonstrate something the dental profession desperately needs to understand.
The rules can be changed.
Which brings me back to the ADA's article. If we're going to discuss recoupments, why aren't we also discussing the states where meaningful protections have been pursued or enacted? Why aren't we helping dentists understand how those changes happened and how similar efforts could be undertaken elsewhere?
Why is the conversation so often about what dentists must tolerate rather than what organized dentistry could accomplish?
Apparently, advocacy is easier to recognize when it comes from inside "The Club". There's another part of this that I find increasingly difficult to ignore.
Despite the legislative work My Practice My Business has helped advance, we have NEVER seen our organization acknowledged in national conversations about dental insurance reform.
Now, I'm not suggesting that every ADA article should mention MPMB, and Rob and I certainly don't need a parade every time we accomplish something worthwhile.
Although, considering how much time we've spent working on these issues, I suppose a marching band wouldn't be entirely inappropriate.
But seriously, wouldn't it make sense for a national organization that claims to represent dentists to highlight successful legislative efforts, regardless of which organization helped make them happen?
Wouldn't dentists in California, Arizona, Idaho, Washington, or any other state benefit from understanding what has been accomplished in Utah?
And wouldn't it make sense to connect those dentists with the individuals who have firsthand experience navigating the legislative process?
I can't tell you why MPMB isn't being mentioned, and I won't pretend to know the ADA's private motivations. But I will tell you what concerns me.
I sometimes wonder whether recognizing the accomplishments of organizations outside the traditional association structure has become uncomfortable for those who have long positioned themselves as the primary voice of organized dentistry.
Because acknowledging that a relatively small organization has helped advance meaningful legislation raises another rather inconvenient question.
If Rob and I can help accomplish this much, what exactly is preventing organizations with substantially greater resources from doing even more?
And that is a question I believe dentists deserve to have answered.
Rob and I are two people. What's everyone else's excuse? Let's put this into perspective.
My Practice My Business is not a national dental association collecting membership dues from tens of thousands of dentists. We don't have the financial resources, national infrastructure, or extensive legislative departments available to some of the larger organizations representing our profession.
We're a dentist and his wife who became tired of watching dental practices struggle with insurance company practices that too many people seemed willing to accept as unavoidable.
Rob has spent decades practicing dentistry. We've experienced the frustrations of running a dental practice, managing employees, dealing with insurance companies, and trying to maintain a profitable business while providing patients with excellent care.
We understand what happens when reimbursement fails to keep pace with expenses. We understand the administrative burden created by insurance company policies, and we understand the frustration of being told that the answer to an unfair business practice is simply to read the contract more carefully.
So rather than accept that nothing could be done, we started asking legislators why these practices should be permitted in the first place. And we've continued asking.
Which makes me wonder what could happen if the entire profession approached insurance reform with that same determination.
Imagine the legislative progress that could be made if national and state dental associations actively collaborated with independent organizations that have demonstrated experience pursuing these changes.
Imagine if the focus shifted away from who receives recognition and toward how many dentists could benefit.
Imagine if the people with the greatest resources were willing to work alongside the people who have already helped produce results.
The possibilities are enormous.
And yet, we continue reading articles explaining "Why dentists should review their contracts".
Wonderful.
Perhaps the next article could explain how to change the laws that allow the most troubling provisions to exist.
Have our leaders become too far removed from the problems-or too close to the companies creating them?
There's another question I've been reluctant to ask publicly, but the longer I watch how organized dentistry responds to insurance problems, the harder it becomes to ignore.
Are some of the individuals leading our profession simply too far removed from the day-to-day realities of practicing dentistry to fully appreciate what today's independent dental offices are experiencing?
Or is there another possibility we should be willing to examine?
Have some professional organizations developed relationships with the very insurance companies they're supposed to be holding accountable that make meaningful confrontation uncomfortable?
I am not accusing any particular individual of improper conduct, nor am I suggesting that every association leader has a conflict of interest. But I do believe these are legitimate questions, particularly when dentists are paying substantial membership dues with the expectation that their interests will be represented.
When was the last time some of these leaders personally had to explain to a patient why their insurance company wouldn't pay for a professionally accepted treatment?
When did they last have to reconcile an unexpected recoupment, manage rising employee compensation while insurance reimbursement remained stagnant, or explain to a team member why the practice couldn't afford another raise?
And for those who are still practicing, are they experiencing the same financial pressures as the average independent dental office?
These aren't theoretical issues for Rob and me. We live them, and we work with dental teams who experience them every day.
Perhaps that's why we're not satisfied with another explanation of how insurance companies operate. We've seen what happens when someone actually challenges the rules.
Now, I fully recognize that professional associations must maintain communication with insurance companies. Collaboration, negotiation, and productive working relationships can be important components of effective advocacy.
But there is a difference between maintaining a professional relationship and becoming so concerned about preserving that relationship that you're reluctant to challenge the other party.
At what point does collaboration become accommodation? And at what point does accommodation become complacency?
I believe association members have every right to ask how potential conflicts of interest are disclosed, how legislative priorities are established, and whether relationships with dental benefit companies influence the positions their organizations take.
These questions shouldn't threaten effective leadership. They should create opportunities for transparency. Because the responsibility of a professional association isn't to keep insurance companies comfortable.
It's to represent the interests of its members, even when doing so requires difficult conversations, uncomfortable disagreements, and legislative changes that insurance companies would rather never see happen.
And if the leadership of organized dentistry believes that stronger insurance reform isn't possible, perhaps it's time to invite more people into the conversation who have already demonstrated that meaningful change can happen.
Enough with "Read your contract". I cannot emphasize this more.
Dental insurance contracts are business agreements. They are not sacred documents that must remain unchanged simply because an insurance company drafted them.
An insurance company can include a provision in a contract that benefits the insurance company. That doesn't automatically make the provision fair, reasonable, or beyond the reach of appropriate legislation.
Contracts operate within the boundaries of applicable law, and those laws can be amended when legislators determine that additional protections are warranted.
That's precisely why legislative advocacy matters. When an insurance company tells a dentist that a particular practice is permitted under the contract, the conversation shouldn't necessarily end there.
Sometimes the next question should be, "Why is that practice permitted under the law, and should it continue to be?" That is the difference between simply teaching dentists how to operate within the existing system and helping them improve the system itself.
And dentistry needs both.
I recognize that the ADA has advocacy programs, legislative initiatives, and resources intended to help dentists. Those efforts deserve acknowledgment where they produce meaningful benefits.
But having an advocacy department doesn't automatically mean that every important issue is being addressed effectively.
Publishing an article doesn't necessarily mean a problem has been solved.
And maintaining relationships with decision-makers doesn't mean much if those relationships aren't being used to pursue meaningful improvements.
Advocacy should be measured by outcomes, not organizational charts, committee meetings, or the number of articles published explaining why a problem exists.
Complacency has become one of dentistry's most expensive habits. There's a phrase I keep coming back to when I watch these situations unfold.
"To do nothing while others proclaim that nothing can be done is a crime of complacency."
Not a literal crime, of course, but a failure of leadership that our profession can no longer afford.
For decades, dentists have been told that insurance contracts are complicated, insurance companies have the upper hand, and there's only so much anyone can do. We've attended the seminars, read the articles, listened to the experts, and watched as one generation of dentists after another was encouraged to accept the business arrangements placed in front of them.
Meanwhile, the financial and administrative pressures continue.
Dental practices are expected to absorb increasing costs for employees, equipment, materials, technology, and regulatory compliance while navigating reimbursement arrangements that may not reflect the actual cost of providing care.
They're expected to investigate payment discrepancies, dispute denials, reconcile recoupments, and devote valuable employee time to understanding insurance company policies.
And somehow, after all of that, the advice is still to read the contract?
At some point, we have to recognize that continually explaining a problem without pursuing available solutions risks becoming part of the problem.
I am not suggesting that every insurance practice is unlawful, that every contract provision is unreasonable, or that legislation can solve every disagreement between a dentist and a third-party payer.
But I am suggesting that our profession has become far too comfortable accepting explanations in place of action.
And I believe dentists deserve better.
This isn't about making MPMB famous. It's about making dentistry stronger.
Let me make something perfectly clear.
Rob and I don't need the ADA to put our pictures in a newsletter, invite us to a fancy dinner, or present us with a plaque recognizing our work.
We would much rather see dentists across the country benefit from the legislative approaches we've helped advance. If another organization can take what we've done in Utah, improve upon it, and help establish stronger protections in another state, we would welcome that effort.
If the ADA wants to collaborate, share resources, or connect its members with people who have firsthand experience pursuing these reforms, our door is open.
And if someone else has developed a better solution, we'd genuinely like to hear about it.
Because effective advocacy should never be about protecting an organization's reputation or preserving its position within the profession. It should be about protecting the people that organization claims to represent.
A good idea doesn't become less valuable because it originated outside an association boardroom.
An effective advocate doesn't become less credible because they aren't part of the traditional leadership network.
And meaningful legislation doesn't become less important because someone else helped make it happen.
If we're genuinely interested in strengthening dentistry, then we should be willing to collaborate with anyone who can help accomplish that goal.
Anything less places organizational pride ahead of professional progress.
Dear ADA, Here's What I'd Really Like to Know:
Instead of another article explaining how insurance companies can recoup money, why not publish an article examining which states have established meaningful recoupment protections and how dentists elsewhere can pursue similar legislation?
Instead of simply reminding dentists to understand their contracts, why not help them identify the provisions that deserve legislative scrutiny?
Instead of treating independent advocacy organizations as though they don't exist, why not recognize the work being accomplished outside the traditional association structure and invite those advocates to participate?
And perhaps most importantly, why not demonstrate to your members that effective advocacy isn't measured by how many times you explain an insurance company's position, but by how often you successfully help improve the conditions under which dentists practice?
Rob and I are ready to have those conversations.
We've been having them for years.
We aren't asking the ADA or any state dental association to abandon the work they're already doing. We're asking them to build upon it, recognize successful approaches wherever they originate, and use their considerable influence to help bring meaningful protections to more dentists.
Because if two people working through a relatively small organization can help advance legislation that changes the way dental insurance companies are permitted to operate, imagine what could happen if the entire profession decided to work together.
And to those who continue suggesting that nothing meaningful can be done, I would simply point toward Utah.
Something can be done.
Something has been done.
And there is absolutely no reason to stop now.
Dentists have spent enough years being told what insurance companies are allowed to do. It's time their professional organizations focused more attention on what can be done to change it.
Because advocacy without meaningful action eventually becomes little more than commentary.
And dentistry already has plenty of that.
My Practice My Business: Advocacy. Community. Empowerment.
We don't just teach dentists how to understand the rules. We work to change the rules that need changing.
Referenced article: ADA News — Dear ADA: Recoupments (September 2026)
