You've partially hit the nail on the head already. Being a "good" dentist may not be all that your patient's think it will be, having a great chairside manor and an aimiable personality makes an even bigger impression. As scary as this sounds, you could be an awfull dentist but have the best patient rapport and have a fabulous perceived reputation with your patients. On the flip side, you could be the greatest dentist, but have an awfull chairside personality and have a poorly perceived practice. The best theory that I've found, and my patient's tell me that it's great for them, is that if you treat your patient's when they're in the chair like you'd want to be treated when your in the chair, you'll generally do pretty well. The bottom line is that your patient's have many choices about where they can go, some of them will just go where their insurance plans are accepted, some will just go to whoever can see them the quickest when they have a toothache, but most folks will go where they actually like the personality of the dentist, hygenist, and staff.