133: Marketing & Patient Avatar Creation

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Hello, everyone, and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott, and today I'm here with CEO Gary Bird of smc. Gary, so great to be with you, man. I'm going to jump right in because I had an interesting experience last night, and I think it'll, like, open up a cool conversation that you and I could take on. So this guy calls me good friend of mine, acquaintance, good friend. And he's like, hey, I want to do what you're doing. Which is always an interesting way to start the conversation because you're like, what do you know about what I'm doing? Is it the good or the bad stuff that I'm doing?

Right?

And he's like, you know, like, what you did with CDP and stuff. Like, I want to do that. He's not a clinician. He's like, I want to do that in chiropractic. And I've got this idea, and so I want to bring in some smart people, bring in some money, and then do what you did. Does that sound right? He just kind of left it, like, so it was interesting because I'm sitting there pondering, thinking, how do you answer this? It feels like such. He's simplifying such a complex question in my own head. And it was also helping me perceive, like, how the world thinks about creating success, just generally. So I'm having all these philosophical conversations in my head, and this guy's just looking for a little bit of help. And I said, well, tell me what you think that we did. What do you think we're doing over here at Community Dental Partners? And he's like, well, you brought in some really smart people and you partnered with clinicians, and, you know, you opened up a bunch of locations and you took some headache off of them. And so I want to get some smart people together and, you know, get some money and then make that happen. I'm like, okay, like Maybe on a general sense, you know, he's on the right. But like, tactically, is that really what I did? Is that really what's going on here? So I'm, I'm digging in my own head because it just does not feel right at all. And I'm like, think about the customer, Emmett. What. What customer problem is he solving? Like, at foundational level? So I said, hey, in like chiropractic, like, what customer problem do you think you're going to really solve here? He's like, well, I'm going to help these, you know, chiropractors so they can do this. And I was like, no, no. But like, for their, like, why should they partner with you? But like, for their customers, it's like, well, there's this chain called the Joint and you know, they get you in and out and they're really streamlined and, you know, so I really like what they've done. I'm like, great. What do they not do well? And he said, oh, well, they don't really take care of this customer type, etc. You know, if you have these. And I was like, okay, so do you want to take care of that customer type? They don't. No, no, no, I don't want to take care of those either. I'm like, okay, for the customer avatar that they take care of, what are they terrible at? And he's like, I don't know. I don't think anything that I can think of. I'm like, so then why should you even exist? You know, like, why even create something? And so then it made me kind of step back and say, what I saw was dentistry really sucked in my mind at taking care of a specific type of patient and in a certain kind of way, you know, and I might be dramatic and saying like, they really sucked at it, but it felt like if 40% of the marketplace is going to see the dentist and 60% isn't, that 60% has a reason that their prioritizing their time, money and energy towards other things. So to me, we're terrible at something. And there was a niche that I thought we could be really good at. And it started off with pediatric, it started off with Medicaid and creating this like, over the top experience to try to overcome the fact that dentistry really is, you know, a hard product to sell. And then it expanded into underserved markets generally. And then that's become like, my passion is just to look for these niches. Anyway, I was thinking about you and this podcast coming up and I thought, how Many times do people come to you and say something like, so, Gary, like, where should I advertise? So, Gary, like, what's the best, like, marketing, you know, product that I should buy or something like that? Do you get that question quite a bit of time?

Every time. It's. Every single. What you just described, I get every single day. And it's very interesting because how I've learned how to deal with this, and this might not be the right way to actually deal with it, but what I do is I start talking about their operations and I go, oh, that's awesome. Yeah, I would love to help you with that. How many new patients do you need? And guess what? Most people say, we don't really know. We want to maybe double. I go, oh, wonderful. That sounds great. Okay, great. We're going to double your new patients. How soon could you see those patients? Well, what do you mean? Well, if I called your office today, I could pick up the phone right now and call. When would they tell me I could get in? Oh, I think hygiene's booked out, like, two weeks. Okay, well, you're not ready for doubling your new patients then. And so dentistry has always used new patients as the fixer. Right? We're gonna use it to fix, but however, they can't figure out why everybody's hitting this glass ceiling. And there's. I mean, when I say everybody, a lot of people are hitting this marketing glass ceiling where it's like, okay, if. If your retention rate's 90%. And I know this is not for Everybody, but most GP practices are, like, we retain about 90% of our patients. They're getting about 50 new patients a month per office. They're spending, let's say, $5,000 a month on marketing. If you do the math on that, you should be full and no. Have no capacity in about six months to a year and a half at the most. So something's broken. And what's broken is the data that they're using to actually measure success. And this is where it gets really interesting. And I know you're passionate about this, and I know you're going through and solving a lot of these things, but what they're looking at is they're looking at total retention of all patients, and Maybe it is 90%, but the marketing patients, which are the ones they're using to scale, that's actually like 20% or 30%. So they're spending this money, they're losing these people right out the back door before they even get started with them. And then they can't figure out why we're not growing. And we have a 90% retention rate, which isn't really their fault either. But that's why I. What I've basically taken up the mantra of is I have never been successful with a practice that had poor operations. It's impossible. Operations has to be solved before you can solve marketing. There really is almost no point and going out and buying a bunch of practices, building, especially building de novos. Right. If you don't have marketing figured out, you're just, it's a suicide mission. And, and it's only a matter of time until you, you, you. It's really, really painful. So marketing. Marketing is super important. I love marketing. I want to sell marketing. I want to help people reach their goals. But I can't do it unless operations is squared away. And operations really can't be. And I've learned this from you. Operations can't be squared away unless clinical. Super clear on what they want to do.

Yeah, let's follow kind of that theory of constraints here. Right. So I think part of the problem, just human nature, is I'd love to solve everything with like some tactical dollars, you know, and in fact, then I just want to negotiate for the cheapest solution and let's call it good. Right? So, hey, point A or point B will solve my problem. This one's $400, this one's $200. Easy decision. The problem as you're laying out isn't really tactical. It's more systemic. And what you're saying is if you kind of follow the systemic issues, you start with kind of an operational piece specifically. And operations can be so broad, it sounds like what scheduling is, is one place to start. You're diagnosing answering your phone. Answering your phone.

30% of phone calls aren't answered right now. So that means if you're spending $10,000 on marketing, $3,000 of it's down the drain before you even get out of the gate. Now, the beautiful part about dentistry, this is the awesome part. You can have 20, 30% retention rate with your marketing dollars and still end up with a five to one return.

Yeah.

Right. So.

So it's the, it's the awesome problem because it creates a bunch of atrophy of actually getting good at stuff. Right. Because we think we're better than we are.

Yep.

Because the scoreboard shows that we're, you know, we're profitable.

So let's go, let's go back to chiropractic, because I used to work in chiropractic. So a lot of people ask me well why did you choose dentistry to niche down to and not chiropractic? Because chiropractic doesn't have those crazy margins. You it's the same amount of money to make a chiropractic phone call ring for a new patient as it is for dentistry. But they get a fraction, right? They might get a hundred bucks at the joint versus the average dentist is getting 350, 400, $500 right through the door on the first shot. So you're looking at a 5 to 1 difference and but the same amount to generate that lead. So in chiropractic, guess what, you don't get that wiggle room. And that's why you don't see people scaling and doing things like what the joint has done is they figured out the speed part and to get you in right away at one set price which nobody else has figured out. And, and that which is awesome. But then there's other problems that are created by that.

But so anyways, so if I'm kind of self diagnosing maybe I'm that person who said I went to this marketing firm, then I went to this marketing firm and I know what my problem is, I just need to go get another marketing firm. Right. And you're saying hey, I think I can help you diagnosis a little bit deeper. And so you go to the operational piece and then you said well, if the operations is going to say well I need to understand what our clinical team wants to drive here. Right?

Yeah. So, so it's very simple. There's only really and this I love simple mental models to help us break things down because clinical is so complicated and I'm not smart enough to ever know all of what they do but I do know the consumer buying habits and how they perceive it and then how they end up coming into the office. So there's really only three ways that a patient comes into the office. Now if you ask clinic the clinical side how many ways a patient comes in the office, it's going to be millions, right? But there's only three from the patient's perspective. And then operations glues that together and it's, it's very simple. It's hygiene, it's the doctor's schedule. So that's like emergencies how my, my, I'm in massive pain, I need to see a doctor right away. And there's, there's the other one for I want a consultation. So I hey, I need all on four. I need Invisalign or I want some Cosmetic work done. And I just need to come in for a consultation. Right? That's. That's basically it. You can say.

So it's kind of the. The third one's almost like an aspirational. What's my potential here? What can I.

And everybody. And, and, and you can't. You can do whatever you want, but you basically, the, the. That last one that I was talking about there for, for an appointment, it's. Everybody does it for free. Like, if you go out and you say, hey, it's gonna be 300 bucks, and I'll look at your. And see if you qualify for ortho, no one's gonna show up. So it's kind of like this universal. Hey, it's free to come in and look at you. If you want to deal with larger treatment that's just, just like, it's free to walk onto a car.

You'd have to have a pretty big brand, you know, like on TV or something. You'd have to have a brand that was pretty in demand in order to charge for something like that, right?

Yeah, yeah. Especially when the market has already dictated the price. So if every orthodontist is saying, hey, the consultation's free, and you come in and say, well, we charge $300 just to look at you. The market's already decided, right. Your. Your competition is already decided for you. Then you have examine X ray, which. That has a cap. I don't recommend free, but there's a cap on it, right? You can't say 500 bucks to come in and look at you to. To help you with your problem. And then you have hygiene, and hygiene has a cap on it. And those are the three ways that patients come through the office. Now, those each have restraints and operations because hygiene, you can't really get ROI from a hygiene patient until you flip them to clinical, and you can't. And. And then bringing somebody in on the doctor schedule has a certain ROI to it because they're going to need that treatment right away, but then they typically don't have insurance. They. They're. They. There's a reason that they're in pain at that moment, and they don't have a dentist to go to. Right. So. And then the. The consultation side is more of a sales model than a retention model.

Yeah, I love that. And what I found, if you start, you know, kind of picking at that, too, on the operations team and the schedule, what you find is they don't have total clarity on the type of patient the doctor is willing to see. And they get frustrated too. Like, I've done things where we've rolled out treatment coordination efforts, really gotten good at our treatment coordination, only to have the doctor like, yeah, I don't want to do that treatment. Right. Or I don't have the capability to do that treatment. So, you know, people will ask me, like, where would you start if you were going to build out your model? The first thing I'd start with is sit down with the clinician and get super clear on like, what problems they want to solve in the world, you know, from a clinical perspective. Now, I don't know if you've ever used something like this, but the one I use is I say, hey, doc, there's a million patients standing out front your door all the way from age 0 to age 100, and they have every clinical need possible. So you got everything from your pediatric Medicaid to your geriatric all in fours that wants to spend $50,000 on a case. Whatever. Which patients do you personally ask for first? You know, which ones do you say? All of them want to see you. Which ones do you say? Okay, yeah, I want to see those first. And it's, it's usually what I find is where their capability lines up for like time and dollars. Work out well, right? Hey, I'm really good at this and I can do it well. And there's a sense of like, challenge and enjoyment at their level. Right.

And everybody's different on that front, right? Not, we're not all the same. So, like, I've met doctors who love just pulling teeth and they get, they're like my time in chair for what I'm actually getting paid. Even though it's a small treatment, it only takes me a little bit of time. So they've built a business around that. Right. And they, and it's a major need. And then someone needs an implant, then they refer it out or whatever. So, yeah, I love that approach. And unfortunately, because I'm in marketing, if I even go directly to the doctor and figure that out, and let's say we do get really good alignment, it almost doesn't matter because operations has to be involved with that because they're handling their cube beaming well.

Yeah, because you want. The schedule's ultimately going to be air traffic control for everything. Right? So I agree. But don't you almost need that level, I mean, I'm speaking idealistically. Don't you need that level of clarity to provide marketing level advice? Because if you're really getting into like core marketing and branding, if I'm trying to target a pediatric patient or trying to target geriatric. I mean, my marketing strategy is totally different, isn't it?

It's totally different. Yeah. Because one. So I'll describe how they're different. One is a short buying cycle patient and one is a long buying cycle patient. One. One is the difference between buying a home and buying a pizza. Right. Like from, from just a time standpoint.

Because are you saying. And if I get this right, the geriatric side tends to be the aspirational. I'm trying to solve a longer term problem for the most part.

Well, let me put it this way. No one wakes up today for the first time and goes, I need $30,000

in treatment and I like need it this afternoon.

That's never happened. No one goes, no one wakes up today for the first time and never heard anything about this and go, oh, I just want braces. What ends up happening is a kid goes to school, they're just happy and then some kid goes, haha, you have crooked teeth or whatever, right? And they go, what? And then they look in the mirror and then they compare them and then they see an Invisalign ad and then all of a sudden they want braces. Well, there's a whole process of education because the rest of the world that's a cosmetic treatment, right? The rest of the world doesn't even think about it. It's a thing here in America and maybe a couple other countries. So that's something that happens and it takes time for that to happen. And then there's a whole buying process behind choosing somebody for that and the trust and all those kind of things. If I wake up today and I fall over and I chip my tooth and I'm in massive pain and I'm coming on a podcast soon, I'm going to find a dentist right away, just in the same fashion I'd find a plumber. So if my, if my toilet was overflowing, right, Like I'm getting a plumber today. It doesn't matter what it costs. Doesn't matter.

Okay, so you're saying it's down. Yeah. So you're saying it's down at the treatment level. The procedure level drives it because I can be older or younger and have a chipped tooth and pain, right? So at the procedure level, I need to understand like what procedures that Doc wants to do because I need to know if I'm targeting a long term branding. Right. Level or if I'm targeting building funnels,

retargeting, getting back in front of those people for the bigger treatments. If you're not retargeting and getting in front of them again and again and again for months, then you're just, you're not going to be able to get ahead. But on an emergency patient, it almost doesn't matter if you're retargeting them because they're finding a doctor today no matter what. So. And then there's everything in between as well. And it really, it makes a huge difference, too, because from an operational standpoint, if I want to get a patient in the door, if I'm doing larger treatment, I can create a longer Runway with my sales process by, even if I don't have clinical space by putting them in a room and saying, okay, what's your needs? You know, we can meet those. Let's set up an appointment with the doctor, follow up with them. When someone chips their tooth, or if I want to get my teeth cleaned and I'm already behind because I'm new to town, they're not going to wait. It doesn't matter if you say two weeks out. They're just going to find somebody who's going to come right away.

Yeah, that's. You know, I was thinking through the accounting and metric piece, too, is like, when I finally do the procedure for 30 grand versus 300 bucks, the 300 bucks, I probably want to count my marketing that I've been doing over the last week or so against that. Right. And all those procedures. But the 30 grand, I might want to count, like, you know, in all the 30 grands I'm doing against all the marketing I've been doing for six months and look at almost like a rolling average of costs. And to your point, too, then I'd have to also have a timeline of like, hey, Gary, I hired you. It's been 30 days. Why don't I have, you know, 10 large cases yet? Right. It doesn't. It's not going to work that way.

Well, you can. So you can make it work that way. Because remember, sometimes people hear this and they say, well, Gary, you said they're long buying cycles that takes months or even years sometimes. There's always people at the bottom of the funnel, though.

You just got to catch them at which part of the funnel.

Yeah. So there's somebody who's been doing research for the last three years about how am I going to get my mouth fixed and. Or how am I going to get these braces? And there's finally going to be that buying decision.

So you're going to get Some low hanging fruit, especially if you're offering it in an area where they haven't had easy access and you're finally kind of retargeting them at the right time.

Bingo.

So we're working, but if you're going to build a long term model, you've got to build that funnel yourself that you kind of own, right?

Yeah. Well, there's. So this creates a whole nother dynamic. Right. When you get into the larger treatment, the way I think of it is this. I break dentistry into two business models. Again, I'm simplifying it for my sake, for simple marketing mind. But you have Netflix, the Netflix model, and you have the Mercedes Benz model. Okay, so what's the Netflix model? The whole name of the game is Mrr. Monthly recurring revenue with Netflix. And they have 500 million subscribers. If they raise their price $1, they make $500 million more across the board. And no one quits, no one leaves. Right. This is your more of your GP and your, even your pedo models. Right? That you're, you're building trust. You're not getting a huge upfront ROI by charging $15 a month as Netflix, but you're getting that money over and over and over again. And they're coming back. And when there is a need or you do roll out a new service or you do raise your prices a little bit, they're still with you right there. And that's one business model to recurring business.

I think we commonly say, like volume, it's a volume practice, right. It's got a lot of volume coming through it.

Volume and recurring I think is key because you can do volume and lose everybody and you lose the magic of a recurring business from an entrepreneurial standpoint. Right. Or a business owner standpoint. Now the other model is this Mercedes Benz model. What do they do? They sell a car and they sell it for a lot and they have good margins on it, but they're only as good as their last Mercedes Benz that they sold. That's it. And then the next month it all starts over. It's a sales driven model. If the economy crashes and nobody's buying Mercedes Benz, everybody loses their job and the, you know, the place shuts down. And so that is your, that's your ortho, that's your, your, you know, your full mouth implants, things like that. And so with those models you have to be. And nobody's doing this. And I've seen people build custom stuff, but I'm saying from a vendor standpoint, you need to build Some kind of CRM or some kind of customer journey where hey, yeah, they reached out to us and then we followed up. And then we followed up. And then we followed up. I actually work with a company that was founded out of ClearChoice. So when clear Choice sold, they went over there and they started another kind of similar to Clear Choice, but it's a different business model. It's denture implants. So it's about half the price of full implants. And they built. They went to Salesforce, which Salesforce is an operating system for a business. Right. And they built their whole own system for following up. I entered into their funnel because I wanted to see what they do post marketing. It's amazing. They follow up with me every single week. They shoot me texts every month. They call me, they email me, they text me. Nobody. Like there's very few operations that actually have figured that out. And that's a whole nother level of, if you will, marketing. But it's needed on that larger treatment if you're going to win long term.

Let's talk about, you know, that side of the model for a minute because I think it's worth, you know, not a lot of people get to talk about this, but CRM versus pms. So practice management software, right. Built for really three purposes. I need to put somebody on a schedule, I need to be able to chart the case, and then I need to be able to bill it out. What's interesting about that for the more enlightened business owner is there's nothing customer centric about those things. They're purely just like make the office function type stuff. When you look over on the CRM side, instead of being a B2C model, it's a B to I. It's like very individualized. And it's. The customer is going to be the center of this. It's a software specifically designed and I guess for people who've never used a CRM, they've definitely been a part of a CRM. Right. Every time you've entered your email address, you started in what and do you like. You know, Russell Branson really uses funnels as really the essence of what marketing is. Right. It's just a funnel of let them see the billboard, then let them, you know, consume this material, then let them consume this material, and then pretty soon they. They are purchasing. Is that how you think about marketing too?

Absolutely. And there's. There's gates or there's bottlenecks along the way. Right. And that prevent you. And then all, all anybody's job is, whether you're in marketing operations or clinical, is to figure out what's preventing people from moving through those gates. Can we produce enough revenue to make that continue to happen, to move down to where we want to go?

And the thing that made dental so lazy and bad at this is. And I asked one of the bigger firms on where do you put your leads? And they're like, what's a lead? Some of the bigger DSOs haven't really even. And I think they're starting to get their mind around this. But it was like, you send out flyers, you have some percentage that come in from those flyers. And like, that was the entire marketing. Like the funnel was this and then this, right?

Yeah, because marketing because, because dentistry for a long time has always marketed by legislation, meaning you just kept the demand high and the supply low, and you always win and there's long lines and everybody's happy, right? Yeah. Now that model's falling apart a little bit. I think a good way to think about this, that maybe people inside of a dental office would understand, is your HR recruiting tool that you use to follow back up with people. Right? So when people come in and they apply for a job, you don't just leave it there and just go, oh, I have a hundred. No, you move them through a funnel and you're like, okay, they're in the first. These, these are qualified. We want to talk to these.

Well, if you're not, that's what you should be doing. Yes.

Yeah, yeah. If you're struggling with hiring people, that's what you. Yeah, you have to do that. And then, so it's first appointment, there's the first meeting, second meeting. All right, we're thinking about hiring them. We didn't hire them, but we're going to keep them in our second layer, so that way we can follow back up with them if we need to hire somebody in the future and you have those opportunities there, the, the, the larger case treatments, especially when you get up above $5,000, you, you, you have to have that if you're going to really win with those patients. You can't just call one time and then they're out the door and never to come back again.

You know, if you've never heard of CRMs, it's worth signing up just to get a couple demos. Now, the thing I'll tell you is, if you sign up, they'll put you in their CRM and you will get retargeted like crazy. But it's just such a good learning experience to Understand the power of that model. I mean, some of this is getting broken down. Apple's kind of pulling it all apart. But the ability that if I go to a website, right, and then it shows up on my Amazon and then it shows up on my Facebook and it shows up in my Instagram feeds, et cetera, like that's brilliant capability that dentistry's, you know, just scratching the surface on and really needs to get into more. And then, you know, if you've got emails, I mean, sounds like the one that you were, that you kind of got in the funnel. I mean they were far ahead. If they're sending you email, follow ups

and everything else, text email before I'm a patient. That's the tricky part.

Right, right, yeah. At the lead level, you're not even in their practice management software, you're in their CRM software. And there. And the thing I don't think people realize is these CRM software is like, you can build out the whole journey where you can say, if Gary opens this email and he clicks on this, then send him this. If he doesn't open the email, send him this. You know those emails I get where it's like, you haven't opened my email. I'm so sorry, did I offend you? Right? And they just try to get you to open another email so they can get you on the next part of their journey. So.

Yeah, and you don't. And I'm not saying all dentistry needs that. Right. Like again, if you're. If. But there's, that has to be part of your repertoire or understanding at least of like, okay, what, how are we going to communicate with these dentists? Because there are a lot of, like, there's a lot of different business models that are cropping up and I'm not saying they're right, but you know, the, the, the direct to consumer orthodontics. And then there's the, oh, we only, we only help people clean their teeth and do very minor procedures, but we make it very easy for the younger person to come in and go through that experience. So people are going to start experimenting with these different business models. They may work, they may not, but yeah, there's still a lot of room left there from this standpoint.

Well, I think one of the problems is right now from equity valuation perspective, you can still make money on a business side doing what some call rack and stack, where you just partner with a bunch of practices or buy a bunch of practices and then kind of hope that plays out. I have a lot of anxiety around that because I always ask, what's the core value offering? What's the core value offering to the dentist? But I think even more, you could be supporting the dentist really well. But no, patients really know whether a practice is supported by a DSO or if it's supported by an idso. What all these names we're coming up with, right. Lso, pso, whatever it might be, the patients just know, like, are you solving something? And I find that it's like around convenience. That's what I want solved.

Yep. Yeah.

Are you making life easier for me?

So here's. So people always ask, like, does the consumer care if I have. You know, they think I'm a corporate dentist. It's like they. No one wakes up in the morning and goes, I want to go to a dentist that has 200 LOC. You're not a gym. You know what I mean? Literally do not care how many locations you have. It makes no difference to their life whatsoever. No one's.

Yeah, you're not Verizon. They're not looking at a coverage map. Right, Exactly.

The no one knowing. They don't care. All they care about is when I do a Google search and you pop up, especially for those short buying cycle patients. Proximity. When can you see me? And what's the bar of entry? And do you now do you answer your phone? Those. You do those four things and you do them well. You will have all the new patients you can humanly possibly handle. Even if you have a subpar marketing platform to help you perform that.

What about the anxiety that you just naturally have as a business owner when you first start to niche? Because the reality is to do really good marketing. You're saying, hey, here's who I want to take care of. Do you have a chipped tooth? You're at least having an ad that's like, are you in pain? You're targeting that. But then someone's like, yeah, but if they need dentures, I still want to be able to service them, you know,

so you can't be all things to all people. And you. And niching down is like crucial to be able to get good at what you want to do. And you can. There are obviously, if I'm fixing a chipped tooth cleaning, that tooth is very close in the family. Right. And it's very natural. Next step. If I own a gym and I sell proteins in the gym, that makes sense. Right? But if I try to sell, you know, cars, try to sell tires. Yeah. For my cars, that doesn't make sense. Like, why are you selling me cars, Right? So it's, it's making sense in the val. The. The family tree of what you're actually offering. So to your example, you always use. And I'll use it for more of a marketing example, if you have dancing chick monks on your website and you're trying to sell implants, the implant patient's gonna land there and go, no, this isn't the place for me. If you're trying to sell implants and you have, you know, all this high tech equipment and the scanners coming across the patient's face with the cool B roll, and you're trying to get moms to bring their kids in there, it's not gonna happen. It's like trying to mix, you know, Wells Fargo and Chuck E. Cheese together. It's not a good. They don't, they don't relate to each other.

Yeah. And I think because dentists, you know, they'll go do their CE credits, right? So for them, it's all kind of the same world of clinical treatment. But to your point, we really have to be thinking from the consumer's mindset. I mean, that's what, really, what this comes down to is unless you're seeing dentists, and that's your only patient type, you know, is other dentists who, you know, the consumer just doesn't think, doesn't break the world vertically or horizontally the way we do, they kind of, I have a problem. What's the solution? I have this problem. What's my solution? Right?

What's my next step in that solution? Right? And you can, that's where you can start to serve people. So I'll give you an example. I had a dentist one time send somebody from their office, sent me a picture of a smile that they did, and it looked great. I looked at it, I was like, man, those teeth look awesome. And the person in the office said, yeah, these teeth look awesome, don't they? And I said, cool, we'll put it up on the website. The dentist called, freaking out. This is not doctor so and so did this. And the margins are this and did it. And like, he's like, freaking out. And I'm like, doc, I'll just be honest with you. It looks like a really good smile to me. I would pay money for to have a smile like that. And he's like, but you don't. And I'm like, the dentist sees stuff that nobody else sees. They really do.

Oh, man. I think of all the poor patients that are, like, still in braces right now, because the Orthodontist, like, yeah, but it's not perfect enough. And it's like, please let me out of these braces. I've seen that before where the patient's like, please, I promise you it's good enough.

It's good enough almost for my retainers every day. Yeah, it's like prison.

Yeah. I've literally had, like, orthodontist just out of anxiety. Like, I know the patient wants out of these braces, but if someone takes a picture and it ends up in this society and they show it at this conference and they might, you know, and it's fascinating, this underworld that has nothing to do with the consumer.

I think every business, it doesn't matter what your business it is, you always start with the avatar. Who is your avatar? And then you go to. And this is my opinion, what is the problem that you're solving for them or what value are you adding to them? Then you can add in, what are you passionate about and how are we going to build the model and all that stuff. But what happens in dentistry most times is they skip the first two steps, and then we just experiment on all that other stuff. And sometimes it works, sometimes it doesn't from a monetary standpoint. But avatar, who's your avatar? Has to be number one or else what are you doing?

I find that oftentimes as a business owner, you're almost overwhelmed to sit back and think about that. Right. It's like, I don't know who I want to see. I just want a bunch of patients. You know, it's kind of back to your thing. I just want a bunch of patients. Is that something you guys kind of help them walk through that framework to help figure out, because they come to you and they're like, hey, I need you double my patience, or whatever. But really, you need to have more clarity on some of this other stuff. So are you helping them solve that or how's that work?

To a point. So usually, because I can't answer it for them, right. That's the worst thing in the world when I'm answering, fixing their problem for them in that sense if they don't have it. But basically, what it boils down to is the number one question we always get is, if I pick this avatar, I can't help anybody else. And it's like, no, of course you can still help other people. We just want to know what your core focus is. And then you can build smaller avatars around that. As long as. Again, as long as it's in the family, you can't go pito to, to all the way up to, you know, all on four. But as long as it's in the family, we can begin to work through that with you. And then again, what I do to just simplify it for them is they're only going to be coming in in three ways. Right. So where do we want? What patient, what kind of patient do we want? What does that look like? You know, in some areas that maybe the median household income is 100,000. In other areas I've seen people, the median household income is 30,000. Right. So that's different. There's going to be different things that they're going to be able to afford, that they're going to want, that they're going to desire. Their dental IQ is going to be different. So once you nail that down, then you can actually start to work backwards. Now if people want to do it more scientifically, more so than emotionally, you can actually take, and I know you have seen you guys do this, I've seen other practices do this. Take your patient base, load them up into a system like Buxton and there's several others. There's a mosaic does this as well. You get a code. This is your code.

These are psychographic data. Yeah, yeah.

And you get that all laid out. It's expensive, so most people don't end up doing it.

But even if you just dropped it into like a spreadsheet and just did your own demographic, like okay, how many females, what's their age group? You know, you know, do, do I know some something about their psychographic info? Do they tend to be, you know, are they driving Mercedes or are they driving Toyota? You know, it's like, yeah, well here's the even, at least target that.

Here's the even simpler way. Take your patients and drop them on a map, like their addresses and their little pins and just literally drop them on the map. People are shocked when we show them this because no one ever looks at their practice this way. They're like, wait, wait, that's a high income. We're in a high income neighborhood and we have a high income families right around us. And we get no patience from there. But people are driving from 10 miles down the road from a middle income over here. And it's like, well, why do you think that is? We have no clue. Why are you between them and the school or them in the Costco? Oh, we are. Everybody travels down this road. Well, that's why it's an easy. But we're missing the opportunity right next door. To us. And so that's where we're gonna go fish now. And that, that's just an easy way. And to your point earlier, like, we can really dig into the data. And I know a lot of tech companies do that and they know like, exactly who's buying their product, when and, and what, what clothes you're wearing when you buy it, and all that kind of stuff. But, but in dentistry, there's, there's, there's still so many people.

We don't have to be that good. I mean, let's be honest, we don't have to. If we can just be a little bit better than we currently are. Right. We get like this massive return on it. I mean, that's kind of the secret on playing in dentistry. If you can just be a little bit more mindful, a little bit more business savvy, a little bit more customer centric.

Yep, yep.

One of my favorite stories, I actually heard it from Heartland many years ago, but they were looking at de novos and they found that if the dentist, you know, their model is very focused on helping the general dentist be as capable as possible, Spend a lot of money on helping general dentists have a lot of capability. They found that if the general dentist didn't do, I think it was like seven endo cases in the first month or two, that the growth of the practice wasn't as strong. Which is interesting because it's just a procedure out of a lot of procedures. What they found in spending some money on studying these patients was patients were communicating. It's to your thing on pain. And since they thought of the practice and the dentist as solving a pain issue, since they couldn't solve a root canal need, what they would communicate to, what they found they were communicating is, hey, it's a great dentist, but they can't get you out of pain. And it's fascinating to me because I'm thinking this poor dentist who might have like a thousand capabilities, except for this one. It's interesting again, how the consumer perceives it.

Yeah.

And so we have to be like, really mindful is if we're going to be the ones that try that say, hey, we're here to get you out of pain. Like, there's certain capabilities you got to develop.

Not only that, but it's the patient not understanding it, I think is really crucial. And the best example that I've ever been able to draw up on this is when your car breaks down or something's wrong with your car and you take it into the mechanic, you just Assume that the mechanic is going to be able to fix it because they're a car mechanic, right? And then when they go, oh, I got to take you down to the muffler shop. Go right down the road. And you're like, why do I have to go to the muffler shop? Like, oh, because we don't do that. Or you need this or you need that, and we don't. Oh, we don't have this technology.

The year of this car isn't the one that we service. Or.

Yeah, and you're just like. You're sitting there dumbfounded, like, how are you even in business? Right? Like, I'm here with a broken car, and you fix cars, and you can't fix my car. So then you end up going to the next place in the next place. That's how patients feel.

Well, and when you find the place, who's like, oh, yeah, we can take care of this. And you're like, well, I've got these other cars. Can you take care of them, too? And they're like, oh, yeah, yeah, we take care of all those things. Then they're like, okay, done. I'm never gonna. Because you just don't want to take the risk again. You know, even if you love that, you're gonna have to go 10 places. Right?

Yeah, exactly. So that's. So that's all patients assume. Unless you're like, hey, we're a pediatric dentist, or we're ortho. We only do braces outside of that. Or some specialties can be in there, too, but outside of that, they just think that you do dentistry and that you can fix their problem, whatever their problem is, and they have to be educated out of that. They have to be taught that, no, no, no, no, no. We don't do this. We don't do a root canal. We don't do this. We don't do that. They have to be taught that.

Well, and what you'd really want to do ideally is say, but here's what we're really like, everything. And, like, if you're not going to increase your capability in those things, you're like, no, no, no. We're the specialty shop for fillings. You know, whatever it might be. Like, if you need fillings, like, you should be coming here first. Yeah, yeah, that's. That's great stuff. All right, so, man, this has been great. Gary, anything like happening in marketing that you think is, like, just interesting right now?

Yeah, it's just the most. Most practices are still trying to market, and they don't they don't realize that the real problem is a labor shortage. Right. Or they know that they have a labor shortage, but they're trying to solve it with more new patients, which just creates more problems. And then normally marketing people wouldn't tell you this because it's kind of bad for business on our end, but it.

It.

You. We got to get this labor problem solved because that's what's going to open up the floodgates to be able to

get these patients in because you're 30% not answering the phone goes to 50, 60, you know, whatever.

Exactly. Exactly. So. And it's not just that. It's like scheduling people out and pushing people out. And, like, there's a lot of that going on. And a lot of these businesses are trying to manage. And I get it, because I manage a business, too. You got to manage payroll, and you got to make sure this much money is coming in to pay the bills. So you got to see this many people. So you're trying to cram people in, but then the team has to adjust and punt people out. And so someone's going to get the boot further out and further out and further out. And that creates frustrations and being totally vulnerable. Like, we. I've dealt with that before. Like, hey, we're growing. We doubled. But we don't have enough bandwidth to get people through onboarding to do the marketing that they need. So then you have to change your operational system to be able to support that. Right. And to be able to bring those people in. So it's. It's. Until that's solved and until that starts coming together, like, the growth that a lot of people want and. And need like, that they're aiming for is just really hard to hit because in marketing, and I'm just here to tell everybody, marketing isn't going to solve that. Right? Like, marketing isn't the thing that solves that. What it is is getting your team, retaining your team. And it's like what you guys are doing in cdp, building an awesome culture, making people, making sure that people are passionate about what they do, keeping them there, and then adding a couple more people. And then all of a sudden the floodgates open up and you can have that rocket growth that you. That you've always.

Well, it's interesting you say that because just hiring the people doesn't totally sell because now you got to get them trained up to, like, get the scripting down. And you did a great presentation, by the way, for DEO around using marketing on the HR side Yeah, I mean, maybe we can talk about that for just a second because there are people trying to solve that. But really, you have to think of your team a lot like this customer stuff now. Right?

Same way. Yeah. So. So pre. Pre Covid. The biggest problems that HR people had is how are we going to sort through all these resumes? That was the number one. Like we just. How do I sort through 200 resumes?

What am I going to do with all these hygienists who want to work for me?

Yes. Yeah. And how do I even begin? Like, I have to spend so much time to even look through all 200 of these applications. Right. So. Which was great. So that means you didn't have a problem. So that means it never got attention anywhere. In almost all of the United States. There maybe was a couple exceptions with big DSOs that had, like, doctors that. That were a little bit ahead on this, but outside of that, no one. It wasn't really a problem that people were trying to solve. All of a sudden, overnight, you had a lot of people exit the industry. So skilled people who have that skill set, that have been trained said, I'm going to go start a marketing company. I'm going to start a social media company. I'm going to become a consultant. I'm going to come. I mean, go look at how many consultants are hygienists. Right. And so you have all these people exiting and they're going to other companies, other industries or maybe in the same industries. They're just not in the office anymore. And you. You all of a sudden now have to compete. So it's you versus tons of other people. And now it's a.

It's not just Dennis, like, yeah, Olive Garden, you know, Walmart, Target. Yeah, everybody.

Well, not only that, but remote companies. So we're 100% remote. So if you're competing against me, I'm like, well, you can work at home and you'll have no commute and you'll have a similar pay or better pay, and we give you benefits and you can, you know, your kids at home, sick, whatever. That's not a big deal. Right. You're doing computer work like that. Good luck. Compete like you're competing against that. Now that's hard to compete against. So you now have to think, okay, well, of the hygienists that are left or any position that's left that wants to stay in this industry, who am I competing against with them and what do they actually want? And like, for hygienists, as an example, we, because of the nature of the pandemic, and a lot of hygienists are women, and a lot of them had kids and they stayed home with their kids because their kids were out of school. They said, I kind of like this, and I kind of got a side gig, but I still want to do some hygiene stuff. So now you have to be flexible and say, okay, well, we're willing to take part time people, we're willing to give you flexibility in your schedule, we're willing to let you pick this, and you have to kind of build out your stable of hygienists, and it's harder. Right. But that's what you have to do if you want more hygienist where? And then if you say, no, I don't want to solve that, then the recruiting company, local recruiting company comes in and goes, hey, we'll pay you 1.5 times more than what your, your job's paying you right now. You can pick, you can work all the days you want or work no days. And if you respond to a same day ad, we'll give you $100 or $200 bonus for going in that day. But guess who pays for all of that? The dentist does. And so now when you're like, oh, we need a hygienist now. You hire the recruiter. And the recruiter's like, oh, by the way, we're gonna add benefits now too.

Yeah.

So if you don't service the market, the avatar, someone will. Someone will step in. An entrepreneur will step in and just go, we'll service the hygienist or we'll service whatever it is. And so that's what now, that's now what we're competing against. And now we have to market. Now marketing comes in and goes, okay, how do we sell ourselves and make it better than, you know, whoever else we're competing against?

I mean, in a lot of ways, I feel like what dentistry is having to do is just what every other entrepreneur has always had to do. Figure out these sales, marketing operation, HR issues. Right. We just had good margins and, you know, a good situation where maybe that wasn't as much the case, but it's not like, well, the pandemics make things a little bit more extreme. But I think generally where things are going to settle out is you just have to be a great business owner going forward.

100%. Yeah, the ones, the strong will get stronger. The ones that had great cultures and really had this figured out beforehand will just continue to get stronger and the ones that are like, I just don't have the energy to deal with that right now. We'll kind of drift, just get weaker and weaker and weaker. And over time, the stronger companies will rise to the top and the weaker ones will be weeded out, just like in all. I mean, that's the way it goes in business.

There's some great partnerships, too. I mean, we're having a cdp, you know, So I think there's synergies too, that are getting created where people are like, hey, I wasn't good at this, but I was great at this. You know, can those get put together?

Well, I'm, I'm trying. Like, I see it, right? So I'm like, I was on a phone call and they. Someone showed me a software, they're a vendor, and they're like, look at this software. And I'm like, that's really cool software. Like, I love. If I worked in a dental office, I'd want to have that. And I asked them a question because it was probably the third really cool software that I saw that week. I said, okay, so I'm just gonna ask an honest question. And I'm just. I don't have the answer. My software is really cool that you log into and see marketing, and you need to check it every day. And your software is really cool, and this guy's software is really cool, and this guy's software. And really, you need all of them to be able to do your job. That means you're going to be in a software every 30 minutes. You're going to have to log into a different dashboard. How do we really expect the end user to be able to do that? And they were just like, I don't know. And that's where we're at as an industry is like, we're doing the blueprint series right now where we're going through the patient journey before the patient gets into the office or right after the patient gets into the office, which most offices don't think about. And we're stacking technologies and saying, okay, this is the technology that they go through here. Here's the technology the patient goes through here. And, and we're trying to. I'm trying to bring that together of like, okay, look, this is how you have to use these things together to leverage your labor shortage, your, Your lack of time, your crunch at the front desk or your crunch at your call center to be able to move people through that. And again, I don't have the answer, but that's the future is like, yeah,

I think mapping that's even just mapping that, Gary, for the industry is like super helpful. I think we're going to get to a tipping point to where someone's just wanting an Apple esque type solution.

Yep.

I've been doing a lot of work with Tab32 and Kiltesh over there. You know, whether they pull it off or somebody else pulls it off, I just don't know. Like, to your point, if we can have 40 softwares we log into and then all the middleware and then IT teams having to make sure that they work for every location, then, you know, I think we want that all in one solution.

Absolutely. Well, and what we're. So what we're really passionate about actually solving is what we've gotten massively good at is taking. Here's a lead, someone clicks something, it's a real human that did it. And a real human called and we know what happened on that call. And a real human showed up to the office and they spent this. So this is how much it costs and we measure it in simple terms. This is how much it costs to make the phone ring and this is how much it costs to get them to walk through your door in any given day. And you can look at that. And then we're mapping it and we're getting better and better. Yeah, it's huge. Right. But that's this, that's the tip. Right. That's the front end of it. And then now we need. Now you do the next part and the next part and the next part and the next part. Until you can follow that patient all the way through the office and know where each part is breaking. Then where, then the journey's never done

well because the person who knows that knows where they can pound in more dollars and where they should stop the bleeding. Right. That's not working as well as I thought. So.

Yep. And you can also provide more support too. I can say, oh, doctor so and so is really good with these kind of patients. And doctor, you know, the other doctor is not as good with these kind of patients.

They're actually tying avatars to clinicians.

Yeah, yeah. Which is invisible right now to most practices. So when I. Here's, here's what happens with marketing all the time. It's this doctor celebrated because they closed a lot of treatment. Right. And then we go and look at the numbers and they're like, yeah, they got like three or four people to say yes to a lot of treatment. That's really cool. Let's look at what happened to their Marketing patients. Literally, they had saw 30 of them, none of them accepted treatment.

Yeah.

Then we have the other doctor over here who's not celebrated because their, their treat, their case, their case average is not as high as doctor number one and they're not celebrated. We don't talk about them. But then we go in and look at their marketing patients and they, they got $300 on each of them and on average, and they recared 80% of them. Guess who wins that war in 12 months or 18 months or 24 months. But no one. You can't even look at it.

There's too much focus on the front end treatment acceptance dollars and not enough on the long term. Mrr.

Right, exactly. And then, and then you go in and now do what I just told you and try to go do that in, in one of these tracking soft or in your PMS even worse. Right. You're gonna be like, where do I even start? And you can't. So then we go to what we know. What was your average treatment acceptance?

Right, Right. Hey, Gary, we said we were gonna like talk 15, 30 minutes. This has been freaking awesome. We could probably do another hour. So always love it. Hey, if somebody wants to reach out and just get some help.

Yeah, absolutely. So you can, you can go to my website, smcnational.com and connect with me there, or you can connect with me at my. On my email, garygarimcnational.com Happy to answer your questions or at least point you in the right direction.

I thought you were going to say we're not taking any new customers. You know, just like close it with that. No, that's awesome. You've always been such a huge help for the industry, a great thought leader. So really appreciate you being here on this podcast. If you guys want to connect with him on DSO Secrets as well, he's active. They're always helping people out. So thank you again, Gary. And until next time, keep smiling.

Thank you, sir.

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