148: Why Your Marketing Campaigns are Falling Flat

Welcome everybody back to another episode of the Dental Boardroom Podcast. It's Wes, your host, coming at you. And today we are carrying on with the Executive Session, which is sort of a sub-series here on the podcast show. And I've got our two esteemed regular guests, Michael Anderson with Wunderist and Megan Shelton with Shelton Solutions. Hey team, how you doing?

Doing great. Good to be here.

Nice. Megan?

Good.

All right.

Doing well.

We've got a good, uh, I would say set of questions and content around a subject that dentists care a lot about. It's related to marketing. So Michael, you're gonna be the MVP of the show today as I'm gonna ask a number of questions to you about marketing. How do dentists market effectively in today's world? And, uh, what works, what doesn't work. And then as we go, I wanna weave you in, Megan, and talk about when patients start to show up because of the marketing efforts, how do you then convert those into, uh, a case acceptance? And then ultimately sort of boom brings back to me on what happens then when the dollars start to land from that funnel, uh, end to end. So let's dive right in. Most practices have some kind of offer out there, a new patient special, a free consult, something. But having an offer and having a good offer are two very different things. Today, we're going to break down what actually makes an offer work. So, Michael, let's start here. What separates a strong offer from one that just sits there?

Yeah, we get this all the time, and I think it's a really important, important part of marketing. The first thing I'd say is Not every practice needs an offer, right? The thing you need to start with is what are your goals? So a scratch practice, they're looking to, you know, build their book, get patients in. Offers are a really good idea. A practice transitioning into new services or a new model, right? We're starting to do implants, we're starting to do aligners, we're moving towards fee-for-service. Offers are a really good tool. But I think oftentimes people look around and they say, well, what's everyone else doing? And they just put it up there. That's not really an offer, is it? So the first thing I would start out with is, you know, ask yourself, if I have an offer, how did I come up with it? And if it's, well, that's what my friend did, or I looked on Google and it's what everybody else did, there's probably a problem there. The thing that can help push you beyond that is to define a goal and say, listen, we need to grow our patients. And then set a stop point. Say if we get to this point, that's where we can pull back from an offer. And what you want to do is you want to move away from, you know, telling them what you do. So, hey, we see new patients to actually showing value. Here's a great example. You know, one could be we do Invisalign versus, you know, we can help you get straighter teeth in 6 months. There's a fundamental difference between those two positioning points. Now, obviously offers always come down to a price point, and that's where you get to decide how aggressive you want to be. If you're a scratch startup, you're like, I just need people to come in and leave some reviews. Look at other offers and come below that for a limited period of time. Create urgency. Hey, we're doing something special here. We're opening our doors. This is a unique opportunity to get something you won't get in 2 months. That's a real offer. $99 new patient special in perpetuity, not a real offer.

Yeah. What do you do? And is there something standard in the industry where I'm a dentist and let's say I just bought a practice or I am starting up a practice, or maybe I just want to reinvigorate my practice. And I, and I have this moment where I say I need to make myself known to the marketplace. I.e., marketing, branding, and then the calls come in and then you have the sales call in the funnel there. What, uh, can a dentist do to survey the market, understand the market, and know what lanes or channels of offer types would be more successful in a given area? And I also suspect that there would be some initial analysis on the type of practice and the nuanced value propositions of that doctor's focus. What can dentists do to have sort of an initial analysis done?

Yeah, I think it's always a good idea to kind of build some tool to keep track of your competition, right? It could be a spreadsheet, it could be more sophisticated. And I think a lot of people don't do this, you know, for, for our industry and marketing for dentists, we do this, we keep track of what our competition's doing. I know who's top price point, who's kind of middle, who's low, what their product spread is. That's how we can make adjustments.

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And so whether it is truly pointing and clicking on Google and looking at a few websites, which is, you know, probably not a bad place to start, or getting more advanced and asking a tool like Claude or ChatGPT to do some heavy lifting for you, or engaging a professional, working with a dental coach or a marketing agency to go even deeper because there's some really cool tools that, you know, you can use professionally to get into the weeds and really understand How, uh, how your competition is positioned. All of those are going to put you in a better spot, but at a minimum, you should have an understanding of the practices within a 2-mile radius. Do they have an offer? What is the offer and how much is it? And if everyone has the same offer, nobody has an offer.

How, how much trial and error is there when you're trying to discover a marketplace and the best way to access the marketplace and how much of it is do good research and right on day one, the first dollar spent, it's going toward the most effective channel. Does that question make sense?

I think it's so uncommon in business that we can sit in a room by ourselves and figure things out. So it's a good practice to have a starting point. Spend a couple hours on the weekend, look at your competition, have a thesis. After that, it's trial and error. But the problem is, I think if most dentists are being honest, there's very little trial and error. I have a $99 new patient special offer. That's what I've had from day one, and it doesn't work. And it's like, well, did you try $97? What about $89? Is saving $10 really so important to you that one, making the phone ring and having patients come in that can turn into lifetime patients, can turn into crown cases, aligner cases, all of these, you know, cases you want to do, is that $10 margin that you're saving, is that worth it? If that's the case, then in this month, in the month of March, to celebrate March Madness, we're doing our March Madness offer and This month we're doing an $87 new patient special offer. Try it out. And if you don't like it, bad patients come in, stop it.

So when we talk about what makes a great offer, we're sort of just talking about the deal, the terms of the deal, uh, the, the, the free, the free X-ray, the free this, or the discount that. Um, also when you're trying to make up a great offer, um, is the offer also contingent on the lane that you are marketing through? So would a flyer, a ground-mailed flyer, have a different type of offer than let's say a Facebook group ad?

You know, I think what ends up happening is the call to action changes, right? So you might have something that says, hey, you know, comment or, or enter your information or call or text. Like these are, this is the end of the offer, but I like this thought. If you can't explain your offer in One to two sentences or less, then it's not a good offer. And so from that standpoint, if it's on a flyer or a Facebook ad or a website, you know, the offer itself should hold true. I do want to continue to make this point though. It's not all about the dollars, right? And you don't have to have the cheapest. It's about perceived value. So it's not a race to the bottom. Sometimes the perceived value is that you are the cheapest. Other times the perceived value is that you can solve a problem that other people aren't positioned to solve.

I think in the beginning a doctor needs to accept probably lower margins. And you know, most doctors who are just getting started tend to rely a lot on PPOs, which I've always felt are the most expensive lane for marketing because of how much your UCR you're surrendering because of the PPO. Let me switch it over to you, Megan. What are some of the signs you see when it looks like an offer is actually clicking in the marketplace?

Well, when you see it working, one of the first signs is going to be that your front desk doesn't flinch when they talk about it. So there's no apology, there's no gentle landing of what the offer is. They're very confident in relaying it and there's no disconnect between what the patient's going to experience and what the offer said was going to happen. And so internal signs I typically look for are conversion rate on your incoming calls, which most companies like Wunderist, when you work with them, you're able to hear those incoming calls, listening back to those where the ones that didn't land and where you can improve from that. So is the team trained to handle the offer and the inquiries surrounding it? I also like to see that the practice has an onboarding script that, like Michael said, we're not racing to the bottom. We're incorporating our value system with our practice into that script for when the patient calls. The offer is the door, but for them to walk through the door, we have to have a script that facilitates building value straight from the beginning so that it's not a discount. Account that we're, we're handing the patient. And then ensuring that your team understands the purpose behind the offer. Like, why are we trying to do it? I think, Michael, you brought up a great point. Not every practice needs a new patient special. So if you're at capacity and you're reserved out for hygiene 6 months, why are you running a new patient special? This makes no sense. We should be focusing on annual patient value or maybe diversification of services that we're able to provide. But, but making sure our team understands why we're running this promotion and what our objective outcome is meant to be. And yeah, consistency, right? So marketing is going to get the phone to ring, but operations and experience is going to determine if that patient stays and if they pay.

And I would, I'll talk a little bit now about the financial aspect to, to marketing. I look at a lot of P&Ls. I oftentimes like to break out the marketing spend across different marketing channels, like, like online marketing, ground mailer marketing, other types of marketing, so we can try to track what's working. And I'm sure, Michael, at Wunderist, you have a way to sort of illustrate a return on investment there for, for marketing and ultimately migrate to the, to, to the efforts and the types of offers that are working well in a given marketplace or for a given practice. From the financial standpoint, so my side of things, I generally say there's not really a budget for marketing. It's the one overhead item where I say it's not a standard 2% or 6%. It's where you are in your life cycle. And a newer doctor is probably going to have a higher percent of their collections. Allocated toward marketing efforts. And I, I would say I generally see marketing on the low end, literally at 0%. This might be a very mature doctor, very established, great reputation. And it's just, it's just going all the way up to somewhere around 6 to maybe even 8% for a doctor who's trying to grow aggressively. And if you're only collecting $30,000 or $40,000 a month, maybe you're a newer startup, uh, it's going to be a huge portion of your collections needs to go to that. I'm curious if you guys agree with this statement. I always view there's 3 primary systems in a dental office. There's the marketing systems, there's the operational systems, and it's a big umbrella, the operational systems. So that's you, Megan. And then there's the financial systems, and that's me. That's accounting and tax and cash flow planning. Forecasting, debt management, yada yada. I always think that the marketing is the number one system because if you don't have money coming in, if you don't have patients showing up, there's no money dropping in the bank account and there's no, there's less need, I will say, for operational excellence when your practice is running very slowly due to deficiency in patients. So when I started Practice CFO, I had to focus almost exclusively my first few months on just speaking engagements, meeting with dental bankers and dental attorneys. And most of my time honestly was playing the field in the marketplace. That's what it was. Eventually, uh, clients, uh, clients started to come in and now I really had to turn my attention on the operational side. And then really fast forward a number of years before I really turned my attention on having a strong financial set of financial systems, because now we have more cash flow, more overhead, more need to budget, higher taxes. That evolution or life cycle is generally what I see. Do you both agree that if I had a dollar to spend and only a dollar to spend, that marketing would probably be the first place it would go? I mean, after you have your basic team in place.

You know, it's interesting. I think what I agree with is that is frequently the life cycle of a practice and from a, just a reality from a boots on the ground, like, yeah, you got, you got to get the phone to ring. But as a marketing agency, I'll say increasingly for me, I recognize that, you know, there's times we say, hey, listen, I don't think we should do marketing for you because operationally you are not ready for it. And so Well, I agree with you, Wes Read CPA, that like, that's how it plays out. You're, you're a, when you start a business or you're growing a business, things are messy, right? There's no way to do it perfectly. And so I'm probably talking more about a hypothetical perfect world, but the reality is if your operations are not in place, they're not set up, all this other stuff can be very difficult. In fact, this is why we have so many dentists that will say, I've tried marketing and it doesn't work. Right. Well, It's because you don't have the operations in place. And so I think that, that, you know, in a perfect world, you get all these things to work together. Um, but I think all too often people will have a bad experience with marketing because they have not gotten to a place where they're ready for it.

Yeah. Megan, any comments on that?

I would actually echo Michael here. Um, one of the things I commonly see is One, if I, I take a survey of all the P&Ls of the clients that, uh, Practice CFO works with, or any of us worked with, a lot of them do spend some degree on marketing and they still say, I don't know what they do. It doesn't work. What is SEO? I don't even know what my marketing company does. I hear it all the time. And then I listen to their phone calls and I'm like, well, Yeah. Yeah. Your operations is lacking. Your training is lacking. So the area where I would say is really important is getting clear on who their identity is as a practice and who they wanna treat, and then training their team because otherwise they end up spending these marketing dollars and then they end up with a lot of patients that don't align with why they open their startup or their practice to begin with. And now they're like, I was more profitable as an associate. And I'm like, yeah, kind of the chain of commands. And so all 3 of our wheels here are so integrated and they're dynamic and they feed each other, right? So there's like a loop feedback system between what you do, Michael, what I do, what you do, Wes, and you need all 3. And so you kind of got to put 30 cents into each of us and say, like, okay, this is where where we're going to go because filling one bucket isn't going to, isn't going to work. And Wes, you know that when we invest the profits that remain, we don't pour it all into one spot.

I think that's a good summary right there. It reminds me a little bit of software development. There's a term that all of Silicon Valley knows and uses religiously. It's called agile development. And agile development is, I'm going to use a metaphor that's commonly used in this area, but you, you decide you want to build something to get you from point A to point B. So you build a skateboard. And it does it a little bit better than walking, and you put it out there and you start selling it. And then you realize, oh, if I throw a handlebar on here, I can get there even faster. And so you, then you release that in a second iteration. All the while between iterations, there's selling the product. There's the financial aspects to the money coming in for that product. These are called MVPs, minimum viable products. And it's an iterative, uh, loopy upward process. Of growing your, uh, your, your business. I think that may be the case here because you bring up a good point. If I go spend a bunch of money on marketing and phone calls start coming in and my front office doesn't know what to say, or we get them into the chair but the team gives the patient a terrible experience, uh, then all that marketing money ultimately does go to the wind. And it's not the marketing company's fault for that. And so I guess they all three need to be working in conjunction, the finance side too, because if the money's coming in and you're not disciplined around its use, there won't be more money to go to that next iteration as you level up and level up and level up. All right, let me go to the next, uh, section here, uh, about, uh, offers, types of offers. Is an offer right for every practice? So here's my question for you, um, Michael. Are there certain types of, uh, of practices, uh, Or are there certain practice types, markets, or growth stages where an offer makes a lot of sense and others where it could actually hurt you?

Yeah, I think that, you know, there are absolutely types of practices that offers are a really good fit for. So, um, a scratch startup, you know, just that, that earliest point of we don't have patients, we need people to come in the door and And I like your skateboard analogy here. Sometimes the patients you get when you start are not the patients you mature into, and that's okay. You know, it's, it's per— it would be great if we could just open our doors and target the perfect patient. And, you know, sometimes we're not ready for that perfect patient. We have to do some learning and we'd rather do some learning, you know, before they come in. So I think offers are a big part of opening a scratch startup, in my opinion. I also think offers are a really good fit for practices that are starting to offer new services, you know, aligners, implants, full arches. And here's a way to think about it. You know, you've gone through the training, maybe you associated somewhere and you kind of got your, your confidence built up, but you're doing it for the first time with your team. And that means there's going to be learnings. It's probably not going to be your best work, right? And I think it makes a lot of sense to say, hey, I need to get some people in so our team can go through this process together.

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Now, this is what I always recommend. If you, if you're going to do an offer for a service, like implants, like aligners, like full arch, make a deal with the patient. Say, hey, I'm going to give you a real offer here. This is not a typical one, but I'm going to ask you to sign a model agreement, right? And now the patient's sitting there saying, oh, this makes sense to me. I'm doing something too. And the model agreement says we're going to document this a little bit. We're going to take some before and afters. We're going to ask you to do a video. And hey, not everybody's a good fit for this. If you don't want to share your experience, we get it. But I'm willing to give you a pretty good offer. So one of the problems we see happen is how do you get away from having to need offers? Social proof, credibility, reputation. These are the things that someone says, I heard about you, I'm willing to pay more for you than for someone else. And the best way to get there is to take those first patients that you get on the service side and say, can we record a little bit of this? Can, can I get a testimonial from you? Boom. Social proof. So that's the big thing. And, you know, Megan started talking about the practices that aren't a good fit. So Megan, I'd like you to keep going on that one. You know, there's all these practices that, you know, certainly if you have your chairs full, maybe you need to dial the offer back. But, but I think Megan had some good thoughts on that as well.

Yeah, it's fun. I was on a call last week on a session with a business team member, and they were like, We're getting so many new patient calls and I'm scheduling my existing patients 9 months out. And I said, okay, well, why are we getting new patient calls? Because you're incredible. Great. But then like, let's look at, let's look at the patients we're treating. Are they all in alignment with who we are now as a practice, as opposed to who we were 5 years ago when we started this journey? And maybe it's time to redefine our ideal patients and start transitioning patients to, you know, a different, we make a different type of offer, like an offer that they can go somewhere else or we don't invite them back. But so patient teams that are at capacity should not be advertising for new patients unless they have the space to add a team member, a hygienist, a provider, or an associate, right? So that's different. If doctor's at capacity and open to expanding, expanding their provider reach, then let's, let's look at that. Teams that aren't trained on financial conversations. If it becomes that the only way our team is able to close a treatment plan or to inspire a patient to say yes is by offering a discount, we are not ready to offer a discount. We need to be able to do both. Otherwise, that becomes the crutch that we land on. And we're handicapped forever.

Like so many things, communication is a different, a major differentiator. I have found when I'm talking to a doctor in, in a financial planning meeting, and I just noticed this doctor has a very fluid communication style. They have good energy, even a little bit of charisma to it. It's engaging. And if, and not every team member needs to be this flawless communicator. But they do need to, how to, how to speak confidently. And in the beginning, they might feel like they're putting on a, a show and there's the whole imposter syndrome. Uh-oh, I'm being an imposter. The reality is when everybody, whenever somebody's trying to develop a skill, you're always an imposter in the beginning because you're trying to play a role of something that maybe isn't natural with where you are. And then in time though, it becomes a habit and it becomes your style and it becomes a lot more natural. I just find communication to be so critical. One of the things I wanna talk about briefly is, is in that agile development and, and evolution as a firm early on, you may be dependent on PPOs or a lot of these discounts, but as soon as a doctor can become less reliant on those through good marketing, operations, communications, et cetera, the better life they're going to have, the less they're gonna be on this treadmill that's more and more and more dentists are on these days. Of just working so hard and not really taking home more. And so those skills outside of the mouth, outside of the clinical, I find are, are the biggest differentiators in doctors who are able to get ahead financially, have a really well-balanced life. And so as you go, try to narrow that strike zone in your practice. Which patient are you willing to take?

And I think that goes with like brand positioning, right? And so if you're If you have positioned your brand and your practice to be a fee-for-service, yet you're offering something that's maybe bottom of the market pricing, you might be misaligning yourself. And so why are, why are we going there? If you have the reps and you have the quality of life, you know, you don't need to be offering a lowball offer. But there are times in our practice, like Michael said, early on as we're developing our, our charisma, our connection, our repetitions with our clinical outcomes, all of those those things, that might be appropriate as we're trying to garnish patience. But later in your seasons, if you're at that season where, you know, you know who you are and you're living that life, Wes, like you've helped them strategize for, then don't race to the bottom.

Yep. And it's not just a matter of the evolution of your business becoming that higher brand naturally. Sometimes you have to say no. To patients or to, uh, an insurance, uh, contract or to sign. You have to be willing to say no so that you are guarding what the things you say yes to, then the type of dentist that you are and the brand that you develop. You know, think of the company that's done this the best, in my opinion, in all of history of any company is Apple. Besides Nvidia, it's the largest company by market share on earth, and it is a luxury brand, their margins are so much bigger than other iPhone or phone producers. They're, they're thick. Why? Because they positioned themselves that way very early on. And rarely do you see a company that has a premium, you know, like a Birkin bag, you know, a huge premium, but sells like a Toyota. There's just so many of them at a premium that is like the the pinnacle of what great branding is. Now, obviously I'm not saying dentists need to be Apple, but that concept of defining your strike zone and then working toward that strike zone, the way you communicate that to the team, the way you price yourself, the way you talk to the patients, the way your website, uh, messages your brand and who you are, all eventually, it's like you grow into it. You grow into that, but you've gotta be intentional, I think, about defining that. Um, one of the, one of the things I, I wanna talk about too are bad offers. Um, really quickly, uh, I wanna ask you, Michael, what should a doctor be doing on a weekly or monthly basis, either individually or with their marketing consultant to evaluate which offer is turning out to be a bad offer and which one is turning out to be a good offer? What, and what are the signs of a bad offer?

Yeah, so much of this comes back to data and tracking. And I think, you know, across marketing, this is probably one of the most broken areas, right? But, you know, I think everybody kind of can lean into the idea of branding and story and, you know, then as Megan has shared, oftentimes when it comes to the tough conversations, hey, is this working? Everything falls apart. And, you know, The nuance of this is as marketing is democratized, as you can go on Canva and say, oh my gosh, look what I built. You can go on Claude and say, look at what I wrote. It's the things behind it that get forgotten about making sure you have tracking codes and making sure you have a conversion pipeline. And the conversion pipeline doesn't just stop with leads. I want to pause here for a minute and say that most marketing really has this problem where they'll say, hey, campaign's going great, we have 100 leads. What are leads? Phone calls, form fills. Well, what happened? We don't know. And so what you need to do is you need to look at an offer and say, how can we measure if people are doing this? It could be that the front desk asks people, they say, hey, you know, how did you hear about us? And you write it down manually. It's not great, but it's something. Ultimately, what you want to do is you want someone to come through a form, you want to capture them, and then you want to say, of these 100 people, how many became patients? So then you could look at that and say, this offer gave us a bunch of patients. And then you can look at those patients and say, are we happy with these patients? Or you could say, this offer is not working. Nobody's calling. And this is where that iteration, those changes make sense to say, well, we got it. We got a $125 new patient special. It's not working. Great. Do we need to change the value side of it or do we need to change the money side of it? Right. Which one are we going to try next and try that for a month? So tracking data and then carving out the time to look at data is critical. And if you're not doing that, then you're just crossing your fingers and hoping that the offer is going to work.

And how much is the dentist— how much does the dentist expect to be involved? In that data aggregation and analysis? How much should the marketing company do, uh, or is it a mutual activity that they do together? For example, with Wunderist, what does it look like, these interactions that your team would have with the dentist when they're looking at the numbers? Run through that, that process.

We get to cheat a little bit. I mean, listen, this has been a problem I've been trying to solve my whole career, and I, you know, every time I get a chance to talk to you guys, I'm going to bring it up. We integrate with practice management software and, and it's out of sheer laziness, right? I don't want to have to call the front desk and say, hey, can you Send me a CSV and it just breaks down. So for our practices that integrate, we're able to look at the leads that we generate by channel. So I can say, how many leads do we get from Google Ads and by offer? And we can not just see how many convert into patients, but we can also look at the production from those patients. So we can say, is this good? You know, are we, are we getting an ROI here? And so that, that makes it easy for us and for our doctors. Now I'll pause here and say that if I'm a dentist, I want to go into my CEO mindset here and I want to say, I don't have time for this. Of course you don't. And I need to delegate people. So I'm going to ultimately talk to the marketing agency and you should ask a question, say, how are we going to track this offer? And when is a good time for us to regroup and stop and let them tell you what they're going to do? And if you like what you hear, say great. And if they start talking about leads and, well, you got to kind of figure it out, say, okay, I, then I need to go get someone on my team and say, hey, front desk, come over here. Your job in 3 months is to go and do an audit of these leads and figure out which ones converted and which ones didn't, but you need to delegate it to someone else. Don't. Think to yourself that you're gonna do it.

Yeah, there's, there's, there's data points and KPIs that are needed for a doctor to have that x-ray to then leverage their time, meaning use as little time as possible to get the most effective, uh, results from what that data is telling you. So let me come over to you, Megan, on this one because new, new patients are coming in. We're trying to gather data on this. Whenever I think of something that systematically needs to happen, with some sort of SOPs and training. I think of a management system, and you both know I use EOS here at Practice CFO. It's a specific management operating system. It's like, it's like a, a, a coded framework that you can just take off the shelf and plug into your company and follow it. And it has a cadence of meetings, a leadership structure, sort of channels of accountability and communication. There's a software we use called Streti. Right. There's this whole like framework. It's not just haphazardly me coming in in the morning and hoping that I'm running my operations well. It's like a playbook, you know, in a sports, you know, the quarterback, how they have on their, their arm, all the plays there. And they're looking at that. It's like, you've got all that dialed in. What, what, um, on the operational side, uh, processes do you try to put into place where this reviewing the marketing information and doing something with it and delegating it so the doctor isn't spending 30, 40% of their time in marketing, but that it's effective. What, what do you do?

Well, that is where I see the director of first impressions playing a key role. They're, they're the person who's responsible for being the first person on the phone, the first line of defense with texts, with emails, and then they're responsible for tracking all of that information. If you work with a company like Wunderist, there's a few others out there that have platforms that have the KPIs and the metrics for you, that's great. Makes their job even easier. If not, we plug in a tracker to be able to keep record or diagnostics of what's happening, who's coming in, and also who's going out. Um, there's also platforms like Practice by Numbers, Dental Intel. So those couple well, but a lot of times we have multiple metric systems that we're needing to reference as a CEO. But in terms of marketing, we need to look at who's coming in, who's coming out, where they're coming from, what the conversion rate is, what the dollar return is, how much we invested in all of those things, and be able to give a summary of that to the doctor on a regular basis. That cadence is going to be specific and determined when you create your strategy plan with your marketing company, depending on what your deadline, your buy-ins are for when you want to achieve said outcome. You know, so if you're running a new patient special or if you're running an all-on-X opportunity, how many are we trying to get? What's our goal? What are we willing to invest for that? And how long are we going to wait to see the return? And how often are we checking in with Michael to see, is this landing or where's the, where's the system, the chain breaking?

But we, yeah, I love that you just said return there and Wes, we can't let you get away without answering some questions today.

So, you know me, I got a question for you.

So a lot of practices will not run an offer unless it makes money on day one, right? This idea of like, if I have a special, like, am I going to get an ROI on this? So, you know, what's, what's the right benchmark? Walk us through how you think about this. Do we think about lifetime value? How does the math break out when you think about success, at least for that first engagement on an offer?

Yeah, a couple thoughts. Number one is that dollars invested in marketing oftentimes don't produce results for many months and sometimes years. There are literally times where someone will reach out to me 3 years after some conference I went to, uh, and, and say, the window has opened up for me to need your services right now. And in some cases they have to hear about my firm or my name. I, I think it's like 6 or 7 times before it becomes like a, like, like a brand recognition of validity and trustworthiness. And so those, the marketing spend isn't always gonna translate next day, somebody calling or showing up. That's number one. I think there's an incubation period that's very common when it comes, uh, to marketing. From the time of marketing spend to the time that dollars hit the bank account. Um, that's my, that's my first thought on, um, on marketing. And I, I just think they need to be, I, I've just always found if a dentist isn't engaging their marketing company and, um, my dentists who have large practices, you know, they're doing 2, 3, 4 million, they are They know their marketing person, their marketing team, they know their marketing spend. They just track this. They allocate some time to being engaged in that. But the lifetime value of a client is something that all of us, I think, as business owners sometimes underestimate is what is the true value of this client? If, if this patient is gonna be with me for 10 years, let's say, and let's say every year they're spending, I don't know, $500 for dental work and you sort of what's called net present value that back to today. Let's say 10 years, you know, $500, that's, that's $5,000. And let's say your margins on that are, are 50% because most costs are fixed and you're going to pay certain costs whether or not you get new patients or not. So let's say your profit margin is $2,500. For that. And so if your marketing spend for that particular patient was $200, $300, that's a good deal, but you have to see it in that longer-term picture. One of the questions I have for you is, do you know what the average patient tenure or lifetime is in a standard practice? I don't have any data on that. I'm curious if you do, because that does affect the lifetime value of a client.

On our end, you know, There's a lot of numbers that run around. Um, what we're excited about is we're, we're starting to collect our own data. So we're, we're able to get better answers, but we're early in that dataset. So like the dataset kind of has its own ceiling, right? So I like to speak about things that I know, and I think it's going to take a little time for us to really mature our dataset. We're, we're ultimately looking forward to providing reports to the industry. That are broken down by specialty, by service, and by region, which really makes the question you're asking tough, right? So if you think about different regions or types of practices, you're going to get different responses. But I think what I generally see is this sort of 6 to 8 year window for patients and somewhere in that sort of $6,000 to $10,000 or more range for lifetime value. And as we can all imagine, it's going to depend on the type of practice, the additional services they offer, their treatment style. But we kind of use a general benchmark in there. I guess what I would say is I think there's people that throw these numbers around as though they know. I don't think that there's a lot of good data sets out there. I think companies like Dental Intelligence and Practice by Numbers are the closest we would have. Are, you know, sometimes I'll, I'll hear numbers get tossed out, but I'd love to see stronger reports industry-wide from companies like that that would help answer those questions.

I think that'd be a fascinating KPI if a doctor tracked every year their total active patients, how long those patients have been active patients. And there's going to be an attrition, but tracking the— not only the new patient inflow, everyone tracks that, but the attrition flow as well, outpatients not returning back, and getting a better understanding of that because there's a hugely different lifetime value of a client, a patient, if the average patient is there for 3 years versus 15 years. And, um, and the longer that a— there's the more stickiness there is between a practice and their patients, the more I'm willing to be aggressive on the offer. And most people, once they come in and they have all their x-rays done and they know the front office, maybe they know the hygienist by name most people don't want to uproot out of that into another practice where they, you know, there's no guarantee that that new practice is going to be any better. And so getting patients in the door dialed in with the x-rays and familiarity with the practice is so powerful. And I hope doctors understand that lifetime value of, of a patient, uh, and therefore can be willing to be aggressive on that.

And one thing to add, I just, I want to double down on this. I am very bullish on lifetime value when we hear numbers in the industry. And I think this is, as I said, for us, and it's true for everyone, we have not been tracking data for long enough to really have good numbers, right? You think, think about the type of practices that opt into Practice By Numbers, that opt into Dental Intel. They are younger practices, right? So I think if we could really do a forensic audit of the dentists that are 65, the dentists that are retiring, those are the ones where you would see lifetime value of 25 years, 40 years, 35 years. And I think, and I'm generalizing here, a lot of times those data sets do not exist in the companies that are speaking about lifetime value. And so we have artificially, in my opinion, compressed it just by nature of how we track it. And so I think over the next 10 to 15 20 years, there's going to be great data on this. So, you know, I think that— take that for what it's worth.

I think you have a great opportunity here, Michael, because you got a growing and a pretty large firm just for dentists, aggregating data on that.

Yes.

Especially if you could have data localized by state and even by sort of city, the value of that. I mean, think of these big companies out there. Data is gold these days. Data is gold. Like my, my ex-brother-in-law, His name is Jeff Green. He runs a company called The Trade Desk. He's the founder of The Trade Desk. They're, they were added to the S&P 500. Interesting story. The guy was literally without a job and living with his mother-in-law when I met him, and now he is worth about $2 or $3 billion. But his company, all they do is they aggregate massive amounts of data on users, and then companies and ad agencies can log in, slice and dice that data to target very specifically. But the, and then his company charges an immense amount because of the, relevance of the data that's then used for effective targeted marketing. And you're right, dentists don't have a lot of data to work off of, so they're just like in the dark trying to figure it out as they go in their local area. And you building that data could be incredibly valuable as a marketing resource.

So a little sneak peek, right? The reason we like to do all this stuff is because when you think about it from an operational perspective, our team logs in in the day and right now we can go in and we can see all these clients that are integrated. So if a client success manager has 50 accounts, they can go in and they can see which one has good ROI and which one doesn't. I don't have to wait for the front desk to call and say things aren't going well. That by itself is huge. But now if you want to add automated alerts, you need to have benchmarks. So you need to say, what does good performance look like in this area? So if I were to just say, hey Megan, how many new patients is good for a practice?

Every practice is different. We need to set—

every practice is different.

Outcome that we want them to deliver on.

Yes. And so you want to start to develop profiles and say, okay, this regionally in this particular area, this is kind of a rural area, this is a suburban area, this is an urban area. They have aligners, they don't. And that where you start to cut that data apart, that's where we can start to set standardized benchmarks. That's what we are continuing to press into so that we can evaluate a campaign and say this campaign is doing great, this campaign is not doing great, and we can do it from a software layer first and then have people jump in and solve problems.

Yes. All right. Let's stick the landing with this subject. Leading with value. So, so I'm going to zoom out and I do think offers have their place and these discounts and whatnot, but at the end of the day, is the offer even the point? So here's my question to the group. Or is, or is it really about how well you communicate your value to a patient? What is ultimately gonna drive value of that company, success of that dental practice? Is it the marketing or is it just the way they, they, they show up to the patient and to their local market as a small business and as a dentist?

I, I like thinking about Groupon. You know, Groupon was a phenomenon, and at the end of the day, I think we all perceived that there were real discounts there. But if you looked at the Groupon and it didn't look fun, it wasn't a restaurant that had a good reputation, you didn't see photos that made you feel like it's something you wanted to do, there was no amount of discounting that would allow you to say, that's what I'm going to do. And this is, this is the same thing in dentistry and everything, right? You need to create perceived value, real value for offers to work. And, and I think that too often people think that slapping up an offer is a, is a solution. $99. But they spend no time thinking about what the $99 will give you or the aligner offer or the implant offer or what the free consultation. Let's try complimentary. Consultation, retain a little bit of value, and then explain to me in detail what I'm going to get. You know, what's, what's this experience going to be that makes you so much different?

Yeah.

I mean, is it, is marketing the actual bottleneck or is it case acceptance? Megan, talk to me about that because how, I don't know, what's the average case acceptance in a general dentistry practice these days?

33 to 35%.

33% to 35%. I wonder what the economics would translate to if, if, if they could get that up to 50% to 60%. I can tell you just sort of huge, right? It would be massive.

Yeah.

So is it a marketing issue or is it a, a case presentation, a communication, a patient experience issue? I think at the end of the day, it's going to be some of both.

Yeah. I mean, that comes back to Michael's take on where do I spend the dollar first, right? Because he doesn't want to be set up for failure with their marketing dollars. He wants to deliver the outcome that we're investing in as dentists. So, um, yeah, an offer isn't an accelerant. It's not a— it is an accelerant, but it's not a foundation, right? So if you don't have the systems in place to clearly communicate the value without the discount, the team's language, the patient's experience, the clinical standards, then the offer is just masking a problem.

Well said. That was well said, Megan. Yes. I mean, let's just look at you, for example. You were a Practice CFO client. You ran a dental practice. You're very crisp as a communicator. It's very clear, the message when you're conveying that. Message. It lands well. I have to think that that was a significant aspect to your success. Not the only aspect, but a significant aspect to your success when it came to case acceptance. And, uh, so compliments on that. But I do think that you're right, that people try to take the shortcut, and the shortcut is big discounts without understanding the financial implication as that dollar, that discounted dollar, plink goes through the P&L of labor, lab supplies, indirect costs, and ultimately lands on the bottom line. And I think a lot of times it might be running negative, so it might feel good to get a patient in and to do a treatment, but it might actually be taking money outta your pocket to do that treatment if you don't understand the economics. That's why at the back end of this whole funnel is reviewing your financial statements. As well. And what's happening if you're spending money for marketing and, but your bottom line is the same, even if your collections are going up a little bit, then you're simply working harder for the same take-home.

And that's one thing I'll add, being a Practice CFO client, I love when our P&Ls had some of the change percentages in the far right column, right? So it shows me year to date what my numbers, my revenue I'm generating, my collections. Shows me the percent of growth, and then I could go down to my operating income, I can go down to my net profit, and I can see, is that percent of growth the same? Because Wes, you mentioned a lot of times, well, it's fixed costs. Well, I agree, in theory it should be, but because our practices develop that Parkinson's disease, as they start earning more, they start spending more, and they're spending money on things that isn't driving revenue. So then their operating income shrinking, their profit margins are shrinking, and they don't see the same growth percentage in those following categories.

Wes Read CPA: Agreed. I always tell dentists this, the, the phrase we've all heard it, less is more. And I think that when it comes to marketing and operations, uh, and this is me putting on my personal financial planner hat for a second as a CFP® is if doctors could live disciplined in their personal life, It allows them to take out less from their practice checking account to their personal checking account, whether that's through payroll or through a draw. They can pull out less, which means more stays in the practice, more working capital to sleep better at night. Once you get above your working capital base, which I usually put at 1 month of collections, anything above that, then you can start using that to invest and discover marketing and hiring. Michael, or hiring you, Megan, to get good coaching. Great dentists, I've just found they're so eager for good coaching. They wanna sharpen that saw year after year after year. It's just in their, their DNA to wanna be coached extremely well and then to implement that coaching across their, their team. All right, last question, which is really a call to action, which is always the best way to end a podcast episode. For practice owners listening today, and they want to tighten up their offer starting right now, this week, what's the one thing each of you would tell them to do first? Michael, take it away.

I think the first thing to do is to go and audit your offers as a patient. You go through it, literally go through it and, and see what that experience is like. I think you'll find that it breaks or it's not compelling. As part of that audit, look at your competition and see if it really is something that differentiates you. And then make sure you know how you are tracking results. If you can do that and you can answer those hard questions, you will have offers that work much better.

All right, Megan, one thing, stick the landing here.

Before you launch anything externally, ask yourself, if 50 new patients called today, does your team know exactly what to say? Do they know what to do? And do they know how to make those people feel like they made the right choice and came to the right place?

I love it. This has been such a productive conversation, and Megan, I can't echo that more because You may go spend a bunch of money on marketing. If it doesn't ultimately convert into a patient in the chair, then it is ultimately money in the wind. And it's not the marketing company's responsibility for that. They did their job, really. So this has been great. The last thing I'll encourage doctors to do related to that, those communications as phone calls come in and cases are being presented, is role play, role play, role play. I know it sounds childish. I get that. But role play and simulation, this is why like pilots have to spend thousands and thousands of hours in simulators before they actually get in the air, is because role playing is the best way to develop yourself without crashing the plane in real life. So, have your teams role play a lot. Listen to these phone calls. This should be a routine part of the process for helping everybody become better communicators to convey the value that you want as a dental practice owner. Thanks everybody for showing up. We've got a lot more great subjects. We'll do an episode at some point on, on how, how AI is affecting the marketing world as well. Michael will be really eager to hear your thoughts on that one too. So thanks, Michael and Megan, for another great episode of the Dental Boardroom Podcast.