From Oregon to New York, two orthodontic teams with opposite personalities prove there’s no single formula for growth—only a shared commitment to building authentic relationships with referral partners.
By Alison Werner
In an era when orthodontic marketing often revolves around websites, social media, and search rankings, some practices are finding their strongest growth still comes from something more traditional: referrals. Whether it means stepping outside your comfort zone or leaning into your natural sociability, the most effective strategy remains the same—building real relationships. For orthodontists like Bryan Johnson, DDS, MS, of Bigfoot Orthodontics in Salem, Ore, and Mark Bronsky, DMD, MS, of Bronsky Orthodontics in New York City, cultivating strong, consistent connections with referring dentists continues to be the most reliable driver of new-patient growth.
Rebuilding a Referral Network
After years of steady growth, Johnson began to notice a plateau in his numbers. His team realized they didn’t have a clear strategy for engaging referring dentists. “We didn’t have a real referring dentist marketing strategy,” said office manager Robyn Howard. “We would just do things here and there, but nothing systematic.”
At the same time, the local market was becoming increasingly competitive. More general dentists were offering orthodontic services, and new specialists were setting up practices in the area. Johnson and Howard decided to focus on strengthening their referral base rather than turning to advertising or new service lines.
Their first step was simple: get face-to-face with area dentists. “The dentists that were here when I started are mostly retired,” Johnson said. “So it’s about meeting new dentists, forming new relationships, and reestablishing old ones.”
That meant carving out time to schedule lunches, make personal calls, and stop by offices just to connect. “We do deliveries every six to eight weeks,” Howard explained. “We’ll take goodies—like pumpkin chocolate chip loaves—and make them personal. Some doctors are gluten-free, so we bring gluten-free loaves. It’s not a dump-and-run; we stop and talk a little bit.”
The process took the team outside their comfort zone. “Dr Johnson and I are both kind of introverted by nature,” said Howard. “It’s a bit of a struggle to get out of our comfort zones and do those things. But it’s worth it. We’ve seen a big increase in our referral base this year.”
READ MORE: Smart Growth: Expert Strategies for the Established Orthodontic Practice
Making Growth Personal
For Johnson, the effort has reinforced something fundamental. “It just brings it back to the forefront—how important personal relationships are with your referral base,” he said.
Their outreach also aligned with a complete rebrand of the practice—transitioning from Bryan Johnson Orthodontics to Bigfoot Orthodontics, a name chosen for its regional character and approachability. “It’s catchy and Northwesty,” Howard said. “The feedback from patients and other dentists has been really good.”
The rebrand opened the door for renewed conversations with dentists and provided a natural talking point when reconnecting. “We were able to say, ‘Hey, we’ve rebranded, but Dr Johnson is still here,’” Howard said.
A Relationship-Driven Approach in a Competitive Market
Where Johnson and Howard had to push beyond their introverted natures to reconnect with referring dentists, Bronsky’s growth has been fueled by the opposite—an outgoing energy that makes relationship-building second nature.
Across the country, Bronsky has built his New York City practice around a similar belief in relationships as the foundation for growth. Early in his career, he built his patient base the old-fashioned way—by showing up. “I would go to every single study club I could,” he recalled. “I passed out my cards and said, ‘Just give me a shot.’”
That persistence paid off, helping him grow from a single rented chair to a thriving multi-doctor practice with multiple associates. Even now, in one of the most competitive orthodontic markets in the country, referrals remain his primary growth channel. “Most of our referrals are still doctor-based,” he said.
And while digital visibility matters, Bronsky believes nothing replaces professional credibility earned through authentic relationships. “Every single week, my director of operations books me for dinner with different doctors,” he said. “You want to make sure that they know how much you appreciate them… If you fall off at all, your referrals fall down. It happens very quickly.”
At the same time, he focuses his efforts on quality over quantity. “I limit my focus to that family of practitioners that I think are doing the best work,” he added. “As long as I continue focusing on the best practitioners, I know we’ll be working with people who value quality care.”
Creating Systems That Support Relationships
Like Johnson, Bronsky views relationship building as a true team effort. Everyone in the practice, from the clinical staff to the front desk, plays a role in shaping how referring dentists experience the practice. To keep those connections strong, he’s also institutionalized the process—creating a full-time practice relations coordinator position to oversee outreach, events, and communications. “She’s working on social posts, organizes study clubs, sets up dinners, and coordinates events for our referral community,” he explained.
That sense of community culminates each year in a major appreciation event. The practice hosts its referring dentists and their teams for a summer kickoff party at New York’s Harmonie Club, a private social club. The event includes dinner, drinks, live music, and remarks from Bronsky, who views it not as marketing but as genuine relationship-building. “I make a speech every year to say it’s a joy to be in this New York City dental community. We don’t take it for granted. We value them as people and caregivers—and we mean every word of it.”
That same emphasis on relationships carries over to his associates, who are encouraged to cultivate their own professional networks and find fresh ways to connect with peers in the dental community. His younger associates have taken that philosophy and applied it in creative ways—hosting exercise-based networking events, sponsoring group runs, or partnering with fitness studios to meet peers in more informal settings. “We’ll sponsor an Orange Theory class or a run on the West Side Highway,” Bronsky said. “Then we bring everyone back to the office for wine and hors d’oeuvres.” He sees the gatherings as a fun, authentic way to connect with peers and build community beyond the office.
Growth by Trust, Not by Volume
Bronsky measures growth not just in patient numbers but in the depth of professional trust. He encourages colleagues to approach referrals as a shared-care partnership, especially as general practitioners increasingly add orthodontic services. “Send me your hardest cases,” he tells them. “Send me the ones you don’t want to touch—the craniofacial cases, the adults with periodontal issues. That’s what we do.”
This focus on expertise and collaboration has helped his practice maintain relevance in a crowded field. “We’ve tried to focus on that rather than sharpening elbows with people who move in next door,” he said.
Lessons for Established Practices
Both Bronsky and Johnson acknowledge that growth through referrals takes patience, persistence, and a willingness to recalibrate. It’s about showing up consistently and staying personal—even when the demands of daily practice make it easy to retreat behind email and automation.
Johnson advises orthodontists to watch their referral patterns closely and not hesitate to make changes when growth starts to flatten. “All practices go through cycles,” he said. “You have to look at either new services you can provide or gathering more referral sources, diversifying that.”
Bronsky echoes that sentiment but adds that sustainable growth isn’t just about strategy—it’s about self-awareness. “I’ve made every mistake a thousand times,” he said with a laugh. “But I always want to fire up the engine again.”
The Human Element
For both doctors, success comes back to trust. Whether it’s a handwritten note, a quick phone call, or a shared meal, the most effective growth strategies are rooted in genuine connection—whether you’re an extrovert or an introvert. “It’s about person-to-person relationships,” Johnson said.
In an industry increasingly shaped by technology and online competition, both orthodontists prove that growth isn’t built on algorithms or ads—it’s built on people. OP
Alison Werner is chief editor of Orthodontic Products.
Photo: fizkes/Shutterstock.com
