214: Dental Marketing That Actually Grows Your Bottom Line

I was increasing my bottom line by about 30% per office, which is awesome. But I began to kind of look at what I thought was kind of the glaring missing piece was, well, man, what if I doubled my new patients? What if I tripled my new patients? Like, man, that would give me 100% bottom line increase.

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Well, hello everybody, and welcome to another episode of DEO's Growth Secrets podcast. I'm Jake Poole, the CEO of the DEO of the Dentist Entrepreneur organization. And today I have with me Neil Zemba, founder and CEO Rise dds. And we are going to go deep into. Into marketing attribution. Right? So this is the golden ticket to understanding and really maximizing the ROI of your marketing investment, which is like the thing that keeps dentists up at night along with associates the most, is that where's my marketing money going? So, Neil, you have gone ahead and tried to solve this, so I want to hear about it. But first, if you can give us a little bit of an introduction.

Sure. Well, thank you so much, Jake, for having me. It's really an honor to be here and kind of talk about this subject. I'm very passionate about this subject, as are my partners at our dso and yeah, my kind of high level background. I sort of jokingly refer to myself as a Silicon Valley tech nerd with a rural hillbilly twist. I'm from a very small town in Michigan, went to U of M and kind of did that. Did the thing that a lot of people in tech wanted to do at the time, which is to move to Silicon Valley and start a company. And I was just ignorant and inexperienced enough to be delusional enough to think that I could pull that off. So we moved to California shortly after, actually, while I was still in school. I did that. I did end up graduating to appease my mother and make her happy, because if I didn't, she would kill me. My mother's a third grade school teacher for 35 years in Tecumseh, Michigan. And that would have been a big deal if I got into college and didn't graduate. So I ended up graduating and we started a tech company called Surf Technology with a friend of mine and we did a lot of marketing attribution for at the time, this was when Shopify and Drop Shipping was just starting to become a thing. So we built a lot of systems and tools for e commerce. We built one of the first cloud based point of sale systems and we sold that company in 2015. I then moved back to Michigan and my. I had two partners who graciously invited me to join their DSO as a partner. And my initial response to that was that sounds really awesome and exciting, but it sounds also illegal because I'm not a dentist. So how do I own practices? And they told me about the DSO model and I really fell in love with it.

Beautiful. So we're going to talk about marketing and figuring out where your marketing dollars are going and kind of this age old connection between Google and Facebook and running ads and how do you connect that into what patients actually came in and what treatment they accepted and paid for really. And so it's connecting the marketing systems with the patient management system. So that's what we're going to talk about. But I think it's really important to know Neil, your background, which is you, as you just said you were with a dso. You essentially started a dso. So maybe walk through, you know, the folks are listening, they're probably thinking the same things that you thought when you decided to start Rise. So what were the problems you were encountering with your new patient marketing?

No, I think for me it was really kind of two things. I came on as our chief operating officer, you know, to, to credit my partners. They already had two offices before I kind of came into the picture, learned the business, had to learn a lot of the jargon in terms and things like that. And I know we've talked about this before, but I'd always resonated with Dent a lot because a lot of my family are scientists or they're in healthcare in some capacity. And I always kind of naturally resonated with dentists as like a fellow entrepreneur, businessy guy because dentists to me always struck me as like they have to, they have to learn business skills and they kind of have to be an entrepreneur whether they like it or not. And I remember, you know, going, going to U of M and I, I was a guest speaker and professor there for, for a while and U of M is a really great dental school and I remember talking to a lot of students there and I was like, oh you know, do you want to start a practice one day? And you know, what kind of business classes are you taking at Michigan, which also has a really nice business school? And I just remember their, their response was kind of like a resounding like, what, what are business classes? You know, what's once entrepreneurship. And I was like, oh, okay, there's a, there's a big gap here with kind of business skills. And I found that, you know, working with, with dentists later on, a lot of dentists are, I'm always like super impressed by dentists that are also great business leaders because it seems to me like they've had to like learn that from YouTube or books or other things like that. And they have to kind of be like auto didacts and learn it themselves. And that was kind of my experience. So I kind of had to. I always kind of considered myself more of a business guy and I sort of had to learn sort of more, more of the clinical know aspect of the business. But it kind of ended up being a really good, good fit. But you know, there, there were a couple things that really kind of eventually drew, drew me to marketing. I mean, frankly, the first thing was when I first talked to my partner, Dr. Kizzy about it, he, he pulls me into his office and he goes, look, I think you're a smart guy, you know, you're a fancy data tech guy, whatever. I just want to let you know that I've always struggled with marketing. We were trying to fill our schedule and every single marketing company I've ever worked with, I've hated and I'm leaving out some four letter, four letter words. So that just always stuck with me. And I was like, okay, marketing. So I just remember kind of asking around to a lot of my buddies that were practice owners or own groups or whatever, and I just asked them like, who should I use? Like, who do we bring into rdso? And I just remember instead of getting like a resounding, you know, list of names, I just kind of got all these like horror stories of, well, I spent all this money on this company and don't use them and you know, don't do this and that. That kind of stuck with me as well. But I started to do these like financial exercises where I started to, to realize like, okay, we're spending all this money. All my clinicians want to do continued ce. They want to be great at placing implants or they want to just do great clinical work, which, which is awesome. But we also at the same time are really struggling to fill our schedule. So I started looking at my numbers and I was And I'm a chief operating, operating officer in this situation. So naturally I'm, you know, reducing my cost of goods. I'm, you know, negotiating my, you know, salaries and payment terms with my staff. I'm doing all this optimizing and one day I just started looking at these things and I was kind of thinking like 80, 20 rule, right? Like, what's, what are the things that I should really be focusing on to move the needle in my practices, Especially as we're trying to stabilize our practices, grow, you know, have achieve same store growth and then bring on additional practices. And I, I kind of did the math and I was like, man, if I optimize everything perfectly, I'm basically, by my math, I was increasing my bottom line by about 30% per office, which is awesome. But I get, I began to kind of look at what I thought was kind of the glaring missing piece was, well, man, what if I doubled my new patients? What if I tripled my new patients? Like, man, that would give me a hundred percent bottom line increase. And I started asking around and I was like, am I crazy? Like, why would I not try to like double my new patients? And I got the, the response that I kind of got was like, yeah, that's crazy because, you know, like, yeah, I'll double my new patients and give me a private jet while you're at it. You know, it just. And I was like, why is that? So again, kind of this, you know, applying data, but also being sort of blissfully ignorant, you know, kind of being a newbie, I just started asking these questions and I landed on my marketing companies that I was working with. I started to realize they were really the problem. They were supposed to be the ones that I could lean on to. You know, I started asking them questions like, how much money would you theoretically need to double my new patient volume? And I realized they really couldn't tell me. Like, they really didn't understand the dental business. And I don't want to name names or poo poo anybody or whatever, but they didn't understand what they needed to do. Is it Facebook ads? Is it Google Ads? What is it? And I realized, you know, pretty quickly my definition of success as an owner for great marketing is I want to spend money and I want to make the most money possible from the money that I'm spending or said another way, I want to spend my, let's say I want to spend $4,000 per month per practice as my budget. I want to bring in the highest volume of quality new patients that I can. That's my definition of success. Whereas the marketing company's definition of success was I'm going to give them money and then they're going to give me a bunch of leads, conversions and impressions. So there was, I know we talked about KPI delusion. You know, they were measuring, you know, things in a very vanity metric, woo woo way. It's not a bottom line. They're not KPIs, they're vanity metrics. So that was kind of my first foray into really trying to solve that problem. And I, I instantly kind of, you know, reasoned like, okay, well the first problem is that I need to somehow like plug my marketing into my patient management system because that's what's going to tell me like, where are these patients actually coming from? So I wanted to take the agency model and like flip it on its head. So like, in other words, it's not, I have $4,000 right now. You go to, you know, you go to many different vendors and everybody's got their own biases. There's nothing wrong with that. But I'll be like, hey, you know, vendor A who specializes in Google Ads, what's the best use of my budget? And they'll say, oh well, obviously it's Google Ads and we're going to do this and this. And they start immediately getting very technical about all things Google. Then I ask the Facebook guy the same thing and they give me a totally different answer and the mail person says a totally different thing. And I was like, okay, everybody's got their biases, but I want to run ads like a great wealth manager runs ads. If you give a great wealth manager a hundred thousand dollars, they don't put it all on Tesla stock because they just know Tesla stock. They would take it and they would put some in a index fund, maybe put some in precious metals, put some in a REIT with real estate or something like that, and they're going to balance that portfolio and then they're going to reassess that on a regular basis. So that was kind of the initial, you know, start of, of what came to be rise DDS to try to solve that marketing problem.

Yeah, it's kind of like whenever, whenever you're a hammer, everything's a nail kind of thing. So you really can't just can't rely on the opinions of people. At the end of the day, when it comes down to how to run a really great business is data. It's data and experimentation. So you realize that, you realize that inside of dental, it was Hard to find that marketing relationship. I think it still remains hard inside the deal. We're always looking for the best marketing agencies and vendors to come work with our, the people that we work with. But it's, it's not an easy, you know, it's not an easy place to be is becoming an agency. And so there wasn't a lot out there that was resounding. You know, this is the company to go to. And, and it seemed impossible. Like no one was really thinking that you could increase patience that much. So you said, I need basically data. I need to start to understand where my patients are coming from. Is it Google? Is it, is it Facebook? Whatever, you know, whatever. And then understanding what those patients do now. So, Neil, this is where I want to get into like the details of, of what you've built. So you've built a software that connects the marketing channels that are out there with the patient management system. So just give us like, give us detail on that like, because a lot of times, you know, I think marketing companies will say we help, you know, where these business come from. Right. But when they say that, what are they not doing that, that rise. DDS does.

Yeah, the, the main problem has to do with how they measure success. So normally, like if you're, if you're a practice or a DSO and, or and you go to a, a marketing company, I always say everything's all hunky dory when the economy's good and you know, the patients are coming in. And in those cases, the marketing company, nine times out of ten is probably still not doing nearly as much as you'd think that they're doing. And so you just kind of write it off and sort of attribute it, you know, that, you know, to, to them, you know, doing their job basically. Right. And the reality is that it kind of comes to light when, when, you know, shit really hits the fan and you know, you have a bad month or something like that. And then, and then you ask your marketing company like, how do we improve this? And the problem has to do with their definition of success. So when you say, I need more quality new patients, they instantly translate that to, oh, they need more conversions. Conversion, meaning it's a jargony term meaning more phone calls or form fills is a conversion. The academic term for conversion is unqualified lead. And I'm like, gee, I wonder why they don't call it that. Right. That kind of gives the whole show away. So what happens is then they start to play with the radius. They might increase the radius from a 10 mile drivable distance to 30 miles or, you know, we were in southeastern Michigan, we would have them pulling from Ohio and Indiana. No one's going to drive from Ohio to, you know, to up two hours to go to our practice in Michigan. But boy, did it sure generate phone calls. So to them it looked successful, but to me it was a massive waste of money. And so this has to do with, with the term of qualitative versus quantitative metrics. Phone calls are a quantitative metric, they're not a qualitative metric. A qualitative metric means you have to take those leads and actually make sure that, okay, are they in the right drivable area? Right. Are they a reasonable drivable distance from my practice, number one? And number two, do they have the right insurances or can they afford treatment? So I always say, you know, not to sound crass, but for most offices, if you're a PPO office or something like that, you have to now do really, really insanely detailed geotargeting in certain markets in order to target people that can afford treatment. I mean, just to be blunt, you want to target people with money and people that have insurances. So you also want to. There's a lot of psychology involved in the type of marketing. So implants is a really good example. You have to understand the psychology of why would somebody, you know, go on Google, for example, to look up implants. And a lot of the times depending, you know, Google's a keyword based advertising system. So you know, if I just, you know, a lot of companies will just bid on the words, you know, dental implant. And the problem with that is that most people when they're googling dental implant are simply just price shopping. They have like a really expensive treatment plant plan in front of them and they just want to kind of shop it around. Now if you're really good at closing and converting, could you convert them over? Yeah, you could. But you know, do you want to spend $2 to acquire that patient or $200 to acquire that patient? And this is all of the data that, you know, pretty much all marketing companies right now just don't have that level of sophistication to be able to show you that data. So what rise DDS does is we actually integrate all of the APIs of the marketing channels. So Google meta, which includes Facebook and Instagram, Bing, TikTok, right? Everybody wants to know TikTok's blowing up. You know, how does TikTok compare to Google compared to meta? You know, and so the system shows you, you know, again, data, data doesn't lie. People do. You know, it, it, it pulls in the patients, tells you what exact source they're coming from down to the campaign and in many cases now down to the ad. So the technology just continues to get better over time. And it tells you, hey, these five patients came from this Google campaign. These five patients came from this one. You got three patients from this Meta campaign and they spent this much money. So now you have this. You know, I always said I wanted this list, right? If I'm, if I'm spending $4,000, I want to maximize my returns, but I also want to. This is what I think a CMO's job really should be. A lot of people think a CMO has like a very subjective job. I think a CMO's job is actually very scientific. It's very specific. Which is their job is to take your monthly budget and determine, okay, 62% goes to Google Ads. Here's why 15% should go to SEO. Here's why 20% goes to goes to meta. So in the Rise system, the agency model is flipped on its head and every dollar is fighting for its life. Every ad is fighting for its life because you can see this scoreboard like in a sports game. You can see a leaderboard of, hey, these campaigns made you this much money. And then you know what we find is too. So it goes from most profitable down to break even. And then there's all the campaigns that are losing money. So what we found is when we started to audit DSOS using the Rise DDS system, when we looked at this leaderboard, it looked like an iceberg. That's the only thing it kind of reminded me of because 30% ish on average of the, of all their marketing that they were doing, only 30% of it was profitable. 70% of it was breaking even or losing money. And that's the insight that you have when you can actually track and associate the dollars to the campaigns.

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Yeah, so I love that. And you Know to be fair to marketing, some of the marketing companies, they would probably welcome this. I mean this, this technology has not always been for everyone. And so this is a win win really for everyone. Because if you know what that 30% is, whether you market company, I mean a lot of the DSOs are doing marketing internally anyway. But whoever is doing the marketing, if they know what the 30% is, you can take the $70 and put them into the $30 place. Right. And so you can start to really, really see an roi. So your software, as far as, as far as we know, I don't, I don't know any other softwares that are doing it this way in dental that are connecting those systems. So connecting Facebook, TikTok, all the social media, Google especially if you're running Google Ads, people are searching on Google into the patient management software. So Neil, can you run us across like maybe some examples of what's, what's happened when you kind of thrown this, this in there, like what are some examples of clients who, what they were spending, what did they end up finding that was working for them? What do they do? Walk us through someone who's thinking about this, exactly what it will look like.

Sure. So it's kind of funny because again I'm, I'm, I'm a, I'm a techie guy but I, I'm from the country originally, so I have a lot of countryisms and one of them is noise versus money. And so what we find is a lot of marketing makes a lot of noise but it don't make much money and vice versa. You know, the, the, the general pitch that we're all sold by marketing companies is hey, if we get you a lot of views, those views are obviously going to translate to quality patients and that's obviously going to translate into money. But what we find is that's not necessarily the case. And on top of that, you know, all, not only are not all views created equal. So like for example, a view on, you know, the marketing jargon, we call it impressions. So you know, to people listening, if you've ever, you know, been pitched every month and said hey, we got you 10,000 impressions this month. Didn't we do a great job? You know, and you're looking at your schedule and you're like well you got me a bunch of Medicaid calls, you didn't give me a bunch of, you know what, what did you bring me? So we find that Google is much. Google is the most high intent platform that there is for marketing still in 2024. And it goes up and down. Like, marketing can be very seasonal, you know, different channels. This is kind of interesting. Different channels are better for different treatment types, which kind of makes sense, like for Instagram. Instagram is really good for advertising, like cosmetic and Invisalign, for example. And it makes sense because, like, Instagram is like an aspirational platform, you know, so people go on Instagram and they're posting vacation photos and things like this, and people go on Instagram to kind of get a hit of dopamine. You know, it's more aspirational. Google is more utilitarian. I'm looking, you know, best implant dentist near me. Best dentist near me. Boom. The ads look like a haiku. There's nothing there, right? It's like two lines of text. And what, you know, it's getting more visual. All the platforms are kind of merging together and one copies the feature of it or another of another, whatever. But in general, Google Ads outperforms everything else by so much of a margin that I've started to think about it. I call it like pemdas. Think about pemdas in math class. Parentheses, exponents, whatever. And I always say the P is Google. So every single one of our clients at Rise, when we come on, we always make sure that their Google Ads and just Google in general, meaning SEO and Google. My business is extremely profitable because you, like, I'd say like 50% of the time we come into a situation and their Google Ads are just not very profitable and they're just not being run the right way. Specifically meaning they're putting. They're grouping keywords together in weird ways. Again, going back to intent. If you have cosmetic and hygiene, you know, but also implant keywords grouped in together, it's kind of weird. And I always tell, you know, people, like, let's say that, you know, you want to buy a Porsche and you're googling Porsche. It'd be kind of weird if like Hyundai comes up or, you know, you're like, I'm looking for a Porsche, you know, pretty specifically. So if you're looking for a cosmetic case, you know, you want cosmetic content. If you're looking for veneers, you want to see, you know, content, you know, based around veneers and ads based around veneers. So those are some kind of specific examples. Social media is really interesting because it's changed a lot over the years. I think consumer behavior, patient behavior, looking at dental services has changed a lot over the years as well. And so I would say in general, Meta, Facebook and Instagram is making a comeback. But you want to be very, very specific with the type of content that you're putting out. And if you're running cosmetic ads, for example, you want to make sure that those cosmetic ads, I always say, think about it from a patient experience perspective, right? If you go on social media and you, and you see, you know, an ad for veneers and you click that ad, you then want to go to the website, the practices website on that veneers page. You don't want to go to the homepage, you don't want to go to the hygiene page. You know, so they send people all these, you know, irrelevant pages and then they expect that they're going to click around themselves. People have really, really short attention spans online. Right now in the Amazon, you know, on demand Netflix world in which we now live, you really have to, I call it aligning the planets. So it's really cool because with the RISE platform we can actually measure in really close to real time. What happens when we make these tweaks, like when we send ads to the veneers page versus another page, you can see the calls come in and the patient's book and then them spend money on veneers. And so it's, I always kind of use the metaphor, like imagine, you know, you know, you and your marketing company are driving a car and the windshield is blacked out. That's kind of how the industry has been. And you're having to rely on Google, on Google's tools. Google and Meta's tools, which are okay, but they have nothing to do with dental, they have nothing to do with health care. I always thought like, okay, Google's tools are probably awesome, right? It's Google. Like they're a huge fancy tech company. Like obviously they have to have amazing tools. No, they're really bad. They're really, really bad for, for, for measuring what we're trying to measure, which

is surprising, which practice management softwares do you integrate in with? And is this, is this something that's hard? Is this easy? I mean this is the, that's the big idea here, right? Is that you can now go in and see what people have accepted and where it came from, the marketing, how hard is that process connection?

So it's kind of funny. I mean when we first started we thought this was going to be about a three month project and I was going to spend like 20 grand to do it. It took us three years and over a million dollars of development to build it out. But I know we Were talking offline about this. We started this company because we felt like we had to. I think a lot of people listening are probably very entrepreneurial. And you know, you don't just start a company willy nilly. You start it because you're passionate about the mission or else it's not worth it. You know, like it's hard work. So it was really hard to build it out. I mean we built a lot of integrations ourselves, but we also leverage other API companies that can integrate into the PMS systems and then we do on the healthcare side. So we have Rise DDS and we have Rise MD on the healthcare side where we're integrating into EHR systems. We integrate with about 96% of all PMS systems right now. I always say all, all the, if your PMS system has a workable API, like a real API, we can integrate into it. And we most likely already do. And we're just expanding the list of EHR systems that we integrate with. And you know, in terms of the process, I mean we can, we'll get it up and integrated within a day. So it's really, it's really easy to connect it.

Well, because this is new. I think the best thing that somebody would do is what I would do is we would set up a demo and really see it. I mean we are kind of in a verbal format here. But this is something that needs to be seen. You need to see the dashboards, you need to see what it looks like to have a patient come from a Google keyword and then look at the exact treatment and how that, you know, not only that, like what did they say on the call, what did they, you know, what are they? The notes from the doctor, Everything that's available in the patient management system. See that connected to the actual ad that brought them in. The insights are incredible. And this is the future of marketing. I mean this is extremely data driven. So if folks want to set up a call, set up a demo, Neil, I'm sure you'll take those just to show what's going on. And I think, you know, what you guys have created is it's, it's needed. I think doctors are going to be really, I don't know how you go without something like this. Whether it's with Rise or whatever software comes out, you have to be able to attribute your marketing to the actual patient. So you know, I think everyone really needs to start understanding that this is the future and starting to see what it looks like.

Yeah, and to that point too, like I, I, I'M personally more mission driven. I think now more than, more than anything. I mean, it's been so cool and validating to, you know, go on this journey. You know, the first three years were pretty brutal because we were just building it and I didn't, I wasn't fully aware that the technology was going to work. And, you know, but now we have a whole AI component. It fully analyzes what's going on with your front desk. There's so many components to it. And I, I really, my hope is that this really accelerates sort of a movement to, you know, we're, we're not going to be able to work with every practice, obviously, in the country, every DSO or what have you. We have maybe 1600 locations now that we work with. We have 65 staff. I mean, I'm just so happy like with our team and what we've been able to, to build. But, you know, larger DSOs are trying to build this in house and we're, we're consulting with some of them to actually help them do this themselves. I mean, I'm not terribly, you know, I don't, I think that's awesome. Right? Like, I think it's, I think it's great. And I think just empowering dentists to be better entrepreneurs to see their data. I'm much more mission driven now than anything else. And so I think I'm just excited to kind of see how, how far this can go. But. Yeah.

All right, Amazing. So, Neil Zumba. Zemba with a rise dds. You're gonna see rise ds I think in a lot of spots. I think you guys are going to become essential to, to really any, anyone that's doing marketing and spending money on marketing. If you're, if you're doing anything more than kind of like local, you know, the local events, local school stuff, you're doing stuff online. The ROI, taking that 70%, it's not working. Knowing what that is and reallocating it, the ROI is huge. So looking forward to seeing you around, Neil. And this is just the beginning, I think, of a new revolution in marketing that's coming from somebody who used to have a marketing agency. So I really believe in this.

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