Dentistry Uncensored with Howard Farran

How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356

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Howard Farran:  Hey, it is not every day you get to interview one of your best buddies.  I have been a dentist for 27 years and New Patients, Inc. has been around 26.  Mark, we met so long ago I think I actually had hair when we met.  Did I?

Mark Dilatush:  And I had more hair. 

Howard Farran:  And you had more hair?  But Mark is an amazing man.  I love Mark to death.  He has been doing marketing and looking at results and doing direct mail and I like the way Mark’s mind works, because Mark is a true scientist.  Most research, people try to set up an experiment to prove that they are right.  Mark doesn’t give a shit what is right or wrong, he just tells you that this works.  You have even made comments to me, oh 20 years ago.  You told me one time, you said, “You know what?  We made three fliers and the one I hated did the best.”

Mark Dilatush:  Right. 

Howard Farran:  And you said, “The one I loved the most worked the least.”  And Mark, you are like Google management.  I read Google’s book on management and Google, everything that their customer does is measured.  So if you come into a Google meeting and say, “We should do this,” they say, “Great, show us your data.”  If you have no data, they show you the door.  They don’t want to know what your gut monkey feeling thinks, they want to know what the data thinks.  So Mark, I am going to throw your whole company under a bridge right now.  I am going to put you on the defense.  Everyone says that old guys like me, that you know, I got out of school in ’87.  May of ’87 and Black Monday was October of ’87, but it only lasted a year or two.  Then after the 2000 Y2K, the market popped in March 2000.  But at this last recession, Lehman Day, September 15th, everyone universally agrees the return investment on marketing, it just died.  The economy died, the boat sunk.  How many times have you heard, you know I used to sign up for a ValPak and that is all I did.  I just paid X hundred dollars a month, ValPak, I got 25 new patients.  Now my ValPak doesn’t even work.  I used to have a Yellow Page ad, it used to get me ten a month.  Now it gives me three a month.  Every once in a while I would mail out a newsletter and the phone would ring.  So did marketing die on Lehman Brother’s Day eight years ago?

Mark Dilatush:  I actually wrote an open letter to all of dentistry on the DentalTown forum.  I think it is actually under marketing.  It is the first recession in this company’s history where dentists didn’t run in out of the rain like 11 year olds in a thunderstorm on a baseball field.  They actually stayed with it through the recession, through the last six years.  Normally, if you go through the company’s historical numbers, our own company’s historical numbers, whenever you would correlate our production, our revenues with the recession, you would see a dip.  We have grown 20% year over year for the last six years, okay?  So the open letter that I sent, that I put out on DentalTown, it wasn’t a thank you.  It was finally.  Finally all the dentists didn’t run in out of the rain into the dugout.  Finally they stayed committed to a consistent, orchestrated, efficient, effective marketing plan, even though many of those dentists from doing so, maybe they ended up the year flat.  Well, if you are flat at the end of the year when the industry is losing 18%, you are up 18% against your peers, okay?  So I think globally I think this whole idea of doing marketing, it began when it became legal about 35 years ago.  Then dentists went into the things that they perceived more competitive, like the Yellow Pages.  Every dentist went to the Yellow Pages with their money, because other dentists wouldn’t get pissed off if they did it, right?  And then over the years, the more aggressive and progressive dentists started to branch out into other mediums.  And then Yellow Pages, basically they have evaporated.  There is almost zero value for almost 99.9% of the dentists in the country, unless you want to be the emergency dentist in your town or what have you.  I mean, that revenue pull into the Yellow Pages dried up.  Now you have dentists all over the country going, “Well, I was spending this money before.  Now what do I spend it on?”  Okay, you have the birth of the Internet in that same timeframe, right?  You have, you know, arguably our testing of all other promotion mediums and the statistical effectiveness and risk of each one over 25 years, right?  So as this new money, not really new money, it is the same money.  As the same money was spent and younger and younger dentists are coming in, they don’t remember the old days when you were a shmuck dentist if you advertised, the perception of your peers.  The newer, younger dentists, they have no qualms about advertising.  It is the 55 plus the dentists. 

Howard Farran:  Watch it buddy, watch it.  I am 52. 

Mark Dilatush:  Hey, I am 53.  It is the 55 plus dentists who still have that maybe odd – I don’t blame them.  I am not blaming them at all.  I mean, it is just an evolution.  So in direct answer to your question, this last recession was the worst recession since the Great Depression and it is the first recession in our 25 year history where we didn’t lose 20% a year, we grew 20% a year, okay?

Howard Farran:  So let me throw you under the bus again. 

Mark Dilatush:  Okay. 

Howard Farran:  Because here is what the 50-year-olds are going to say.  And I will say 50, I will put you and me in this boat.  “Mark, I can’t do advertising.  These corporate chains, Heartland and Aspen and Deal, they are doing all of that stuff.  I can’t compete with Heartland and Aspen and Pacific Dental Services.  How is little old me going to compete with those guys in my town? “ Because I hear that a lot.

Mark Dilatush:  Okay.  No, I know you do.  And I think it is important for everybody on this call to recognize that there are two very distinct halves of the dental market.  There are the moms who will chose a healthcare provider for their family based primarily on a pricing setup and there are moms who would look at you like you had three eyes in your head if you asked them to choose a healthcare provider for their family based primarily on price.  All of corporate dentistry is not going after the bottom, okay?  So if you take those two, if you have a total market, women, and you put a dividing line right through the center. 

Howard Farran:  Explain to our viewers why you just said women.  

Mark Dilatush:  96% of the phone calls that come into a dental practice are made by women, because guys like you and I, if we have a toothache we do one of two things.  If we are married, we ask our wife.  If we are single, we call mom, okay?  I mean, that is it.  That is why women make the healthcare decisions for the family unit, not only in America, because we work in five countries.  Not just America.  This is universally true in those five countries that we work.

Howard Farran:  And what five are you working in for international viewers?

Mark Dilatush:  U.S., Canada, actually all of the U.K now and Australia.  We have clients in five countries.  And those two halves of the dental market, that is also true in all five of those markets.  It is amazing. 

Howard Farran:  So you are saying half are buying on price and half are buying on perceived quality?

Mark Dilatush:  Half absolutely will not choose based primarily on price.  So you have to watch your target and you have to watch your design, and let me get back to answer your question.  The solo dentist or the two or three doctors single practice or maybe the doctor who has three or four practices that doesn’t want to become corporate dentistry, right?  Can they effectively promote to the top half of the market while corporate dentistry promotes to the bottom half?  The answer is absolutely.

Howard Farran:  So you say that corporate dentistry is probably targeting the price sensitive bottom half of the market?

Mark Dilatush:  They are.  I mean, there is no doubt.  All you have to do is look at their promotions. 

Howard Farran:  So their promotions to you look like they are going after the Groupon price shoppers?

Mark Dilatush:  Yeah.  Well no, it doesn’t look to me like they are.  They are.  It is not a subjective – if you look at a postcard or if you look at a print ad or if you look at a TV ad or a radio ad or whatever.  Okay, if the prominent design element is about some kind of a deal, act now and you will get a $1 exam or whatever.  Or you will get a free exam for your kids if you come in and whatever.  If that is the prominent design element of the ad, I don’t care what it is written on or if it is audio or if it is visual, you will excite potentially half of the U.S. market.  You will potentially turn off the other half.  Now the converse is true.  If you promote dentistry based on the benefits of Today’s Dentistry, not primarily on price, you will bore the bottom half.  You will entice the top half.

Howard Farran:  And so if my, and I want to come back, don’t let me forget to ask you.  You just named a bunch of things.  You talked about radio and billboard and print and we assume website and SEO. 

Mark Dilatush:  Internet, right. 

Howard Farran:  When you talk about, if this marketing piece, whatever the medium is not going to talk about price, what does interest mom?  What topics would mom read that says, “I like that in a dental office.”?

Mark Dilatush:  Alright, this is where, I hope your listeners can follow along.  If you research the dental market as a whole, on a statistical level, you will find out very quickly how woefully ignorant they are on the benefits of today’s dentistry.  They have absolutely no clue.  That is a value gap, okay?  In other words, their perception is here, dentistry is providing up here, there is your gap.  Right?  Okay, so what you do is you invest a boatload of money in testing and a boatload of money in independent consumer research.  And you pull the data in and you find out what is most important to the moms in the top half.  Now, the direct answer to your question is many things.  Price is still number one concern to mom in the top half.  But dentists confuse that and think that they have to give mom an incentive.  What that does though, is it turns off the top half, okay?  What mom wants is a list of the most marketable attributes that every dental practice possesses.  Every dental practice is different.  Your dental practice is different than a client in Wisconsin.  Okay, you may have multiple doctors there, you may have a specialist, you may be able to take care of the whole family all under one roof.  You may have very convenient hours, I know you have CAD/CAM technology in your practice, right?  You may be able to do restorations in one day.  So you line up a combination of the following categories – price, technology, convenience, public relations assets and services.  You line up those categories and you blast them out in consumer surveys.  And they score them based, well, they are scored based on their responses, okay?  That creates a number, what is most important to what is least important.  And when a doctor comes to you and says, “I want you to market my practice and I would rather have less shoppers than I currently get,” here is exactly what we do.  We pull in their marketable attributes in a survey of questions about their practice.  We line them up, we prioritize them by score and then we fill whatever we are going to do for that dentist with the priority marketable attributes.  Why would you use something that scores a three when the doctor possesses something that scores a ten?  See what I’m saying?  Okay, now here is where it starts to get a little deeper.  Some mediums, like the Internet, like mail, some mediums allow you the space to present eight, nine, ten priority marketable attributes.  Some mediums, like radio and television, don’t.  When I say mail, there isn’t enough room on a postcard to present an argument for the benefits of Today’s Dentistry, which is why everybody that uses postcards put a series of deals on there hoping the phone rings.  But if you move to a tri-fold, you have room, if you move to an eight page magazine, you have tons of room.  Radio, you have got 30 seconds.  You have about, and I know you are going to interview Howie at some point in the future.  Howie writes all of the radio scripts.  You have about 60, by the time you have done the intro and the exit, you have got about 60 words.  You have no chance of talking about all of your marketable attributes.  So what you do in radio is you create five, six, seven, eight scripts, each about one aspect of your practice that scores the highest and then you rotate those through your ad time, okay?  There is a way to do this in every medium.  But anyway, that is how you do it.  I think a lot of dentists think or still think that, and rightfully so, because those are the people they are bringing into their practice and those are the conversations they are having with the patients that come into their practice, but I think most dentists because of that think all everyone cares about is money or their insurance deductible.  That is absolutely not true. 

Howard Farran:  And being a dentist, the one thing that surprises me most about dentists is I don’t know what it is about marketing or modeling, but a dentist goes to college for eight to twelve years to learn how to do a root canal, filling or a crown.  So they just always assume somebody that knows math, calculus, applied math, physics, applied physics, chemistry, applied chemistry, biology, applied biology, dentistry, of course I can do my own marketing.  I know calculus, geometry and trig.  I can write this ad.  And they have zero training.  What do you think of the average dentist’s marketing?  I mean, I still see ads, Extractions, Gum Disease.

Mark Dilatush:  Wait, wait, root canals – because that is what every consumer wants.  They want a root canal. 

Howard Farran:  Yeah, and I look at these ads, but then I know these guys, because they are my friends.  I mean, tonight I am going with a dentist up the street from me to the ASU game.  They are my friends.  But you look at some of your friends marketing and you are like, “Dude, look at all the classes you took in college.  You didn’t take one class in marketing.”  So I want to ask you, so you are seeing the data from all of the United States, from five countries, whatever.  So tell me this, is marketing different in the big 117 towns over 100,000 people versus the 19,000 towns under 100,000 people?  Is marketing different in the South versus the West versus the Northeast?

Mark Dilatush:  It is actually different practice to practice.  I will tell you where we have the most failures.  They are in densely populated urban centers, Manhattan, Financial District in San Francisco, Downtown Chicago, almost downtown anywhere, but we do have successes in downtown places. 

Howard Farran:  Hell, San Fran has got one building that has 160 dentists in there.  How do you market your way out of that?

Mark Dilatush:  They still call, though.  I know. 

Howard Farran:  At that point, wouldn’t you just recommend jumping out the window?

Mark Dilatush:  No, not out the window, but I have…

Howard Farran:  I am kidding, that was a bad joke.  That was a very bad joke, I am sorry. 

Mark Dilatush:  I have on many occasions recommended that they seek a different location. 

Howard Farran:  Yeah, okay so let’s go through it.  You said the five things that catch your attention the most, price, technology, service, what was it, convenience?

Mark Dilatush:  Public relations assets. 

Howard Farran:  Public relations.  So I don’t want to talk about price, because that is a local deal.  So number two is technology.  What technology?  What are you talking about?

Mark Dilatush:  Well, because the depth of ignorance is so vast, it is almost any technology.  Well, you have a CAD/CAM and you would be interested in this.  And so would Serona, by the way.  In our surveys, the way our surveys work is you would ask the consumer a set of four questions.  If you had a dentist that was within five miles of your practice and had moderate pricing, but could take care of all of your family’s dental needs all under one roof and took your insurance, how would you rate that dentist?  And then you would pull one question away and replace it with something else.  You do that enough, it is called a conjoint analysis, okay?  Those answers, addition by subtraction, creates a score.  CAD/CAM question that we put out there, we put those three questions in, but when we talked about CAD/CAM, it said, and I will just paraphrase, if the dentist could start and finish your final restoration in one visit, what does that mean to you?  What value would you place on that?  Off the charts.  We followed it up with a second question.  If they were able to do that, would you change dentists?  76% of them said they would change dentists, okay?  So now what does that tell you?  Does it tell you that patients are into CAD/CAM technology?  No, dentists are into CAD/CAM technology.  Patients are into convenience, right?  Okay, so all of that stuff with technology, hey, here is another one.  How long have intra-oral cameras been around, Howard?  For as long as you have?

Howard Farran:  When I got out of school, they were already there in ’87. 

Mark Dilatush:  They were already there.  Well over 50% of the dental market doesn’t even know what they are for.  Okay, it is things that are already old to dentists.  A classic example would be the cavity detection lasers, the name escapes my mind.  

Howard Farran:  DIAGNOdent?

Mark Dilatush:  Okay, let’s just go with DIAGNOdent.  Okay, you can make a case for DIAGNOdent that the doctor is the most trusting, feeling, warmest happy guy or gal on the earth, because he or she invested money in technology that helps them find cavities way sooner to save the consumer money.  Okay, now you connected technology with price.  See what I am saying?  You could almost take any technology, any service, you can almost take any of that stuff, weave it together to tell the story about a dental practice.  But you have to prioritize them based on consumer scores.  You are going to interview Howie in a later podcast.  Howie is the right brain of the company.  He is the designer, he is the creative.  If you ask me to make you a mailer Howard, it would look like a six-year-old did it with a green crayon, okay?  I am the analytical guy.  I am the business practice management, that is my side.  So between the two of us, I think we create at least one brain, you know, leading the company.  But when you are on with Howie, talk to him about what are some of the things dentists want to change.  What are some of the things that male dentists do when they look at the designs we create for the first time?  It will be interesting to your listeners, okay? 

Howard Farran:  And Mark does know what he is talking about, because when I got out of school 27 years ago in 1987, I hired you and Sally McKenzie.  You guys were the first consultants that came into my office to tell me how to get started.  But you are right about the DIAGNOdent, because you will see one dentist go in there and do the exam and then say, “Oh Mark, you have two cavities.”  And then the next dentist does the exam, but they hold the DIAGNOdent and the DIAGNOdent is going and their eyes get big and then their pull out the intra-oral camera, show them with their RI, print it out, capture it.  And what is funny is the guy who went to The Pankey Institute or the Dawson Center, got their MAGD, they always think they are the best dentists.  But the country only fills 38 out of every 100 diagnosed.  But I think the dentist who gets out the DIAGNOdent and the patient’s eyes get big, then pulls out the intra-oral camera and they see a picture, I don’t care if you fill it with amalgam or composite, they go up front and say, “Yeah, I need to get that fixed.”  And if you fix seven out of ten cavities you diagnose and I fix three out of ten, you are a lots better dentist than me.  And everybody wants to debate amalgam versus composite, but the country… Okay, so technology, so you said CAD/CAM, we talked about intra-oral cameras, we talked about DIAGNOdent. 

Mark Dilatush:  Digital x-rays is another one.  I mean, they are not new to dentistry. 

Howard Farran:  And that is because one dentist is showing them a one inch film on a view box and the other one has got a computer monitor and they can print it out on an eight by ten.  So is that what you are talking digital?  Is that what you mean by digital?

Mark Dilatush:  Alright, let me give it to you more in a grand scheme.  The reason why what we do is effective on the top half of the market is because no other dentist is telling these consumers what we are telling them.  They are all sending them six by nine postcards with 37 purple offers on them.  Okay, that is the difference.  I agree with you that the treatment plan sequence and how you present treatment is also probably equally important, because we have clients who get phone calls, they get appointments, and then you look at their average production and you are like, what are these people doing?  So I agree with you, that is important after they are in the chair.  But the majority of dentistry is promoting dentistry based primarily on price.  We only have a few hundred clients.  There are 151,000 dentists in the country.  When you walk into our new headquarters there is a sign.  It is on every employee’s desk.  It says, today I will teach 10,000 people the benefits of today’s dentistry.  So every employee times 10,000 per work day, those are the number of impressions that we are putting on the street, not based on price.  They are based on the value that the top half of the market wants, but we are fighting all of those other impressions that all of corporate dentistry is putting out there and all of the slow dentists that are attempting to compete with corporate dentistry believe that they are putting out there.  That is the big difference.  The value gap in the consumer’s mind in the top half of the market, all you have to do is fill that value gap.  You don’t have to fill it with coupons.  You really, really, really don’t.

Howard Farran:   Okay, number three was convenience.  Tell me what you are thinking when you say the word convenience. 

Mark Dilatush:  Oh, well it is mom.  You are a statistician on the U.S. economy.  How many moms are working moms?

Howard Farran:  60%. 

Mark Dilatush:  Right.  Okay, so now see you are working, you have a husband, you have a home, probably a kid or two.  What, 1.8 now that the population is declining?  Okay, so I would imagine that every day of your life is probably a pretty busy day.  So would convenience be more important to you now or in the 1950s?  Now, right?  Now convenience, to the consumer, to mom, especially moms in the top half, they want to know if your practice can take care of them, their kids, their husband when we drag him in kicking and screaming, maybe even their mom and dad.  They want you to take care of their whole – she doesn’t want to create a relationship with an ontist, whether it is a periodontist, an orthodontist, and endodontist.  She doesn’t want to create some other phone number, some other person she has to talk to, some other dentist she has to have a relationship, she doesn’t want to do any of that stuff.  She wants to drive up into a nice location, park her car in a nice, safe place and go in and see the same smiling faces, no matter what kind of dentistry her and her family want.  Right?  It makes sense with today’s busy mom.  She wants hours.  We get this, Howard, this drives me insane.  We have this question, well not really insane, but we have this question on our client survey that says do you have convenient hours, and we do this purposefully.  And a doctor says yes.  And the next questions are, okay, what are your hours?  And invariably the doctor says yes and puts in 9 am to 4 pm, Monday through Thursday.  Those are the most inconvenient hours to any working mom anywhere, right?  But the doctor’s perception is that they are convenient.  Now the difference in statistical results between an exact same ad, except being able to list convenient early morning and early evening appointments for our newest patients is remarkable.  It is just one other arrow in your quiver, right?

Howard Farran: But specifically, what would those hours be?  What would be non-convenient hours and what hours would make a statistical difference?

Mark Dilatush:  Anything outside of nine to five.  So when I have a dentist that tells me that, I just ask them, “Would you and your team be willing to come in one early morning a week and stay one evening a week?”  You don’t have to add treatment hours, you just have to adjust your operational schedule.  And nine times out of ten, the dentist says, “Oh, I think my staff will revolt.”

Howard Farran:  And do you know what I tell the staff?

Mark Dilatush:  Okay, I bet I know. 

Howard Farran:  I tell them that America is 88% Christian, every religion, Judaism, Hinduism, Buddhism, Christianity, Islam, every one of them says treat other people like you want to be treated.  And if you have ever used an emergency room on an early morning, evening or weekend, if you can’t give me four hours one Saturday a month, then it is all about you.  And if it is all about you, there is the door.  Because in my practice, it is all about the patients.  And yeah, we are not going to work every Saturday and we are not going to work every early morning or every evening, but exactly, you can adjust the hours.  And you hire on attitude and you train for skill and if your attitude is screw seven billion people, it is all about me, this is all I am willing to do, but I want everyone else to open early mornings, evenings and weekends, I want the hospitals and the malls and the ambulance to be there for me, but I am not going to be there for them.  That is the wrong attitude and it is not a good attitude. 

Mark Dilatush:  Right, but it is pervasive. 

Howard Farran:  Now when you talk about convenience, is convenience hours only or does anything else come to your mind?

Mark Dilatush:  Well, convenience is treating my whole family.  I started with that. 

Howard Farran:  Okay. 

Mark Dilatush:  That is enormous, okay, enormous in mom’s mind.  

Howard Farran:  One-stop shop. 

Mark Dilatush:  Right, in other words, the scope of practice. 

Howard Farran:  Okay, what would you call that?  One-stop?

Mark Dilatush:  One-stop shop, yeah that is fine.  You can call it one-stop shop.  Dentistry for the whole family, you can call it whatever you want.  

Howard Farran:  Okay, so one stop comes to your mind.  And by the way, I want to tell the rural doctors, because there are 19,022 towns.  I am telling you, in this recession I couldn’t even list off the top of my head all of the dentists that started calling specialists in the big town and saying, “Hey are you a little slow?”  Yeah.  “Hey, do you want to come to my office?  I am a two hour drive away.”  They can get anybody.  I mean oral, anybody.  So you can start getting specialists to drive.  And that is the whole business model.  Have you seen the big All on Four that is promoted by Nobel Biocare where they come into the big sounds of these big implant centers.  And what are they doing?  They are just flying in specialists that don’t live in that town that are slow.  And they will say, “We will line everything up, we just need a doc to come in and do the surgery.”  So okay, so one stop, hours – what else comes to your amazing mind?

Mark Dilatush:  As far as convenience?

Howard Farran:  Yeah. 

Mark Dilatush:  Alright, if you don’t take my insurance plan, at least file the insurance for me.  At least be able to tell me what you expect my copayment to be. 

Howard Farran:  And Mark, have your clients in 27 years, we hear all of these different numbers, what percentage of dentists participate in insurance versus I have nothing to do with insurance?

Mark Dilatush:  Oh, that is off the top of my head.  All of dentistry?  I have got to believe it is somewhere between 70% and 80%. 

Howard Farran:  Take insurance?

Mark Dilatush:  Yeah, I don’t know that and I hate to spout out numbers that I don’t know, but that is my gut feeling, Howard. 

Howard Farran:  Okay, so one-stop shop, take insurance, convenient hours.  Anything else come to your mind with convenience?

Mark Dilatush:  Well, it could be something like Wi-Fi in the office.  I mean, these are things that we promote.  It could be convenient parking in areas that normally don’t have it.  It could be almost anything we could hang our hat.  The idea in your message, Howard, is to balance these things.  You can’t just put a piece out there that lists all of your conveniences, because convenience is only 18% of the equation.  Technology is 19%, price is 35%, public relations and services make up the difference.  So you can’t have a piece that talks about any one of those categories.  You have to have a mix, otherwise you miss.  Do you see what I am saying?

Howard Farran:  Yep.  So number four you said was services?

Mark Dilatush:  Service, yeah, it is amazing how services came in fourth.  Isn’t it?

Howard Farran:  And what percent is services?

Mark Dilatush:  I believe it was 12. 

Howard Farran:  12, and what do you mean by services?

Mark Dilatush:  Oh, just having a laundry list of pain, like most dentists put in their advertisements.  You know, we do fillings, we do cleanings, we do whatever, gum whatever.  

Howard Farran:  So you would call that your menu.  Your menu of things that you do. 

Mark Dilatush:  Yeah, your menu, right.  Exactly.  It is less important to the top half of the market than dentists think it is, because I see their advertising and it is 80% of what they are talking about, unless they are talking about a deal. 

Howard Farran:  Okay, then last would be public relations.  What percent is that and what is that?

Mark Dilatush:  Ten.  Public relations can have a profound impact on females.  I will give you an example, and almost every dentist misses the opportunity on all of these.  Prior military service.  Right now if you were in the Army or any of the Armed Services at some point in your career, it is huge.  If you are almost anywhere, but you were born, grew up there, went to school there, went to college somewhere else and came back home, if you have been in the community, the length of time in the community, that is huge.  If you have done charity events, maybe a Halloween buyback program or maybe you have a free dentistry day or whatever you have.  Okay, all of those public relations assets, they count up for a lot.  They really do.  But again, it has to be a mix, right?  It is kind of cool, we actually did the importance of the doctor’s age.  And what we found was is that the consumer doesn’t want Doogie Howser, but the consumer for sure doesn’t want the old guy, right?  So somewhere in the middle is what the consumer wants.  And the reason I bring this up is nobody can change their age and that is fine.  But if you are a real young dentist, whoever takes your picture for your promotions needs to make you look as old as possible.  And if you are, you know, up there then you need to do something with the makeup artist to make you look as young as possible. 

Howard Farran:  Yeah, I stopped wearing Grecian Formula and shaved everything.  I have no grey hair, because it is all in the shower. 

Mark Dilatush:  But see, if I put grey hair on Howard Farran, you would look older.  You would.  You would look older. 

Howard Farran:  Okay so Mark, I want to get to another subject.  So obviously these young kids understand, I mean, you see these young kids on their cell phones.  Even when they go out, they don’t even talk to each other, they are just all over the Internet.   But if you are a 50-year-old guy and this recession is kicking your butt, let’s get to the basics.  What is your go-to first?  Do you still like print?  Do you like direct mail?  Do you like website?  Do you like billboard?  Do you like radio?  What is your go-to?

Mark Dilatush:  Okay, there are three foundational staples.  Internal promotion to your own patients.  It is amazing how many dentists call me and say, “I want to do more implants,” and the first thing they think of is putting an expensive ad on the radio.  And I say, “Well, how many of your own patients know that you do implants now?”  And they say none.  Okay well, let’s promote all of the things that you do to your own patients, because that is going to cost you less money and is likely going to drive instant results in a higher ROI.  So let’s invest a little money into your internal promotion, make sure everybody knows everything that you do, that you have already touched.  

Howard Farran:  Okay, but let’s get specifics.  How does a dentist tell, a dentist has 2,000 charts, 2,000 patient records.  How does he tell them all or she tell them all that she does implants?

Mark Dilatush:  You can be as simple as using the electronic tools, like a DemandForce or a Smile Reminder or what have you and sending them a single – here is something we learned on a statistical level over all of these years.  Single topics.  Now we do newsletters and they have their place.  But if you really want to promote to your existing patients, you won’t send them 27 topics, some of them unrelated, like recipes for apple tarts.  You will send a single topic piece to your patients.  And the other thing we learned is not very often.  Max four times a year.  You go over that too far and they start to tune you out and they will never hear any other message, because they are already going to come in to you twice a year.  They already don’t want to be there.  They are already so happy when they leave, right?  You know, I have got some people like, I am going to send out more newsletters.  No, no, wait a second.  You are already sending 12 a year, which is three times as many as you should send.  So you can send them through DemandForce, Smile Reminder, Lighthouse, whatever electronic service you use.  Most of the practices only have about 30% of their patients with email addresses.  So whatever that content is, print it, mail it.  Get it out into the hands, but it is not a big expense.  It is maybe four times a year.  Email it and mail it. 

Howard Farran:  So if you have 30 of your patients on email, you would email them the piece, if you didn’t have their email, you would mail to them once a quarter?

Mark Dilatush:  I would email to the ones that have an email, I would mail to all of them. 

Howard Farran:  Okay, once a quarter?

Mark Dilatush:  Yeah, once a quarter, different piece. 

Howard Farran:  And cover your low-hanging fruit on internal marketing.  That?

Mark Dilatush:  That and referral generation.  Oh my, you know in 30 some states in this country, it is illegal to incentivize a referral.  But it doesn’t stop literally tens of thousands of dentists from trying it.  I don’t know how many got in trouble, but I just sit there going like this just waiting for the DentalTown post to show up in my inbox.  Honestly, that is the wrong way to look at it and we have kind of sat around quietly kind of doing our own thing.  We have posted a couple of times on DentalTown to try and help out.  The referral isn’t about incentivizing your existing patient to refer.  If you want to spur growth in your internal referrals, make the gift to your existing patient a total and complete surprise.  That covers your behind with the state boards in those 32 states, because you didn’t tell them you were going to give them something, right?  Now I will ask you a question as a guy.  What is more impactful to a female?  A birthday present on the day she was born or a gift that you give her on some random Tuesday for almost no reason at all?  Which one is she going to value more?

Howard Farran:  The random gift. 

Mark Dilatush:  Exactly.  But there are dentists out there spending boatloads of money, almost getting themselves in trouble trying to incentivize their existing – your existing patients now have what is called a social relationship with you.  This is no longer a transactional relationship, this is a social relationship.  It is sort of like going to Thanksgiving dinner and giving your mother-in-law a hundred bucks to cover her expense for the turkey.  It doesn’t feel right.  And especially to the moms in the top half.  The moms in the bottom half, maybe corporate, whatever I am not going to call that all corporate dentistry, but maybe the doctors who are going after the bottom half of the market, which is a lucrative market segment.  No judgment here, it is a lucrative market segment.  Maybe those doctors or that half of the market will respond to an incentive to refer.  But the top half, you are much better off gaining the referral, surprising mom on that Tuesday, and you watch what happens.  She is going to refer three, four, five, six people to your practice. 

Howard Farran:  Okay, so I want to get back to this.  So I am 50 years old.  New patient flow equals cash flow.  I need to start doing some marketing.  I call you up.  Mark, I need twice as many new patients.  What is your, I know it comes down to specific practices, but what is the average guy?  What are you going to talk about?  Print, radio, website, what is New Patient, Inc. going to do?  And by the way, I have to have full disclosure here.  I have given you a lot of money over the years so I am not just, what is that commercial, I am not just a customer, I love the product so much I bought the company.  So yeah, I have hired you professionally over the years.  What does the average doctor hiring Mark Dilatush and how he works and newpatientinc.com today, what are you doing for them?

Mark Dilatush:  If they don’t already have them in shape, internal promotion, properly done external mail, properly done Internet strategy.  Out of those three…

Howard Farran:  Say those three again. 

Mark Dilatush:  Proper internal promotion. 

Howard Farran:  Okay, proper internal. 

Mark Dilatush:  Properly done mail. 

Howard Farran:  Mail. 

Mark Dilatush:  And aggressive and competitive Internet strategy.  Think of a house, those three are the foundation.  Don’t go outside of those three until you can become dominant with those three.  Even if it takes…

Howard Farran:  Okay, I know you have talked a lot about internal and I know mail is important, but I want to start with the hardest one.  Let’s start with Internet strategy. 

Mark Dilatush:  Okay. 

Howard Farran:  Because I have only got you for 15 more minutes.  We are 45 minutes down, 15 to go.  Internet is the most confusing. 

Mark Dilatush:  Yes, and it is over, honestly it is overvalued. 

Howard Farran:  What does that mean, it is overvalued?

Mark Dilatush:  Oh, there are tons of dentists who think they can get all of their new patients off of the Internet.  And honestly, I don’t know one dentist that gets all of their new patients from the Internet.  However, as a primary marketing vehicle, the ROI is excellent because the cost is low.  As a secondary supportive marketing medium, it is awesome.  It works for dentistry exactly the same way it works for Nike or any other consumer item or service or anything.  Like when you go home tonight and you flip on the TV and you see a Nike commercial.  That is the company putting their website on a medium called TV to drive you to the Internet.  That is what that is, okay?  So for the dentist, they don’t have a global reach.  A dentist has a, let’s just use an average, the dentist has a 20 mile reach.  Very few patients are going to drive more than 20 miles to get to the average dental practice, very few.  There are exceptions, I know.  Go ahead. 

Howard Farran:  I have family that drive 1,000 miles, but that is only because it is free and they stay at my house for free.  That is slightly different. 

Mark Dilatush:  Okay, I have to work the law of averages.  Let’s call a dental market 20 miles, alright?  So with the Internet step one, a well-done, important point, consumer-friendly website, that is step one.  Step two, aggressive initial SEO, which is basically, and I am paraphrasing out the wazoo right now, a study of all of the local consumer searches for dental services and then embedding of all of those key phrases in all of the pages in your website. 

Howard Farran:  Okay but Mark, for our viewers around the world, what does SEO mean?

Mark Dilatush:  Search engine optimization. 

Howard Farran:  Which means?

Mark Dilatush:  The process by which you get your website ranked higher for a search.  A search is “Dentist Phoenix” on Google let’s say.  Where your site gets ranked higher than the other 47 other dentists in your market who are trying to beat your ranking.  First step, great website.  Second step, great initial SEO.  Third ongoing step, especially in a competitive market, and Howard, especially in your market, because you are in a competitive market, right?  You have to put website textual changes and some graphical changes on an ongoing basis.  When Google changes their algorithms, you have to change the SEO that is in your pages and social media, you can dominate search if you exploit social media properly.  If you know what you are doing, use the same search, “Dentist Phoenix”.  Somewhere, I don’t know if you can right now, but if you type in Dentist Phoenix, there has got to be a smart dentist in Phoenix who has a Facebook page, a YouTube, a blog linked in and then they are populating all of those social media sites and I bet you some social media comes up in that search.  That is that dentist knocking competition down. 

Howard Farran:  What social media should a dentist be participating with?

Mark Dilatush:  That is a loaded question.  Most dentists should delegate it. 

Howard Farran:  But I mean what social media properties should your dental office be participating with and your staff or someone good?

Mark Dilatush:  I know, you just asked me the same question twice.  I will give you the list.  Okay, if it was me, I would have a blog for sure, a Facebook account and a YouTube channel.  Okay, those are the first three that I would establish.  I would add Twitter and LinkedIn maybe later on. 

Howard Farran:  So Google is the biggest search engine.  Is YouTube number two and Facebook three or vice-versa? 

Mark Dilatush:  Well, no Google…

Howard Farran:  Google is one and YouTube is two?

Mark Dilatush:  I believe Facebook is two. 

Howard Farran:  Facebook is two and YouTube is three?

Mark Dilatush:  Right, but we are not using Facebook, I don’t want to confuse your audience and I certainly don’t want to confuse you, Howard.  Okay, we are not using social media in our Internet department to get Jane down the street to like you.  That is not what we are doing.  What we are doing is we are creating Facebook posts and blog entries and YouTube videos that are named correctly so that when a local consumer types in Phoenix dentist, your Phoenix dentist YouTube video pops up before Dr. Smith’s office.

Howard Farran:  And can I tell you something I see in Phoenix and I mean, you are the marketing expert, don’t get me wrong.  I probably did 15 root canals and pulled 100 teeth this week.  But I noticed in the big cities though, Mark, it is kind of like if you ask an orthodontist, “Are you a dentist?”  and they graduated from dental school and they will say, “No, I am an orthodontist.”  I only know one oral surgeon ever that passed the test.  I asked Doug Triple in Seattle.  I said, “So are you a dentist?”  And he said, “Yeah, I am a dentist.”  And I thought, “Oh my God, because you are an oral surgeon, right?  But you admitted you are a dentist?”  And he went, “Yeah, I was a dentist and then I went to oral surgery.”  But if you ask anybody in my neighborhood, I live in Phoenix, Arizona, proper Phoenix, Arizona, 100% of my neighbors if you say, “Where do you live?”  They say “Ahwatukee.”

Mark Dilatush:  Ahwatukee, right. 

Howard Farran:  Yeah, so I see more people naming their neighborhood than their city.

Mark Dilatush:  Google analytics will tell you, you can actually log on to analytics in your locale.  This is how you start SEO.  You actually do a search and have Google tell you what all of the local consumers are typing in for dental services. 

Howard Farran:  Okay, walk them through how they can do that.  

Mark Dilatush:  Just go to Google and go to Google Analytics and go to Consumer Search.  This is like the design, this is like me designing something.  It would look like a three year old did it with a green crayon.  We have world class Internet team.  They are just like super nerds, right?  They manage all of that stuff.  But that is how to get there. 

Howard Farran:  So what do you want to talk about next?  Do you want to talk more about Internet or do you want to go mail?  I have only got you for eight more minutes. 

Mark Dilatush:  Well, I want to help whoever is listening.  So we went through the three foundational staples.  If your marketing budget is $5,000 a year or $50,000 a year, do not invest in anything else until you have a dominant position in those three things.  That is another big mistake we see.  We see dentists saying, “I have got this money, I am going to go try this.”  And they throw it against the wall and then it likely doesn’t work. 

Howard Farran:  So until you are dominant in what three things, internal, mail…?

Mark Dilatush:  Internal, mail and Internet.  Done right, mail has a 96% success rate.  Done right, the Internet has a 95.6% success rate.  You have a 4% shot at not making it work, if it is done right.  That is not bad.  Now, the next thing I will talk about, which is kind of near and dear to my heart, because I keep looking at the numbers, is you know we track 90% of our client phone calls.  They come in, they are aggregated, right?  Now the aggregated phone calls aggravate me, because 19% of them don’t get answered.  So I have to believe that our client base is a small section of all of dentistry, right?  Because we probably have poorly managed practices and pristinely managed practices among our client base.  So if the average is 19% and dentists are crying that they are not getting enough new patients, okay, answer your phones.  Let’s start there.  

Howard Farran:  Mark, 27 years I have been calling back dentists that leave a message and one in every two goes to voicemail.  And we are talking about 2 o’clock in the afternoon. 

Mark Dilatush:  I know, but people, it is our reputation.  We get the phone to ring, and we get the phone to ring by people, they are not shoppers for the most part.  These are people with $16, $18, $20,000 worth of average revenue in the first year, and they are still not answering their phones.  That is step one, make sure that your phones are answered.  And step two is please review your staff.  You know, get them some help if they need it. 

Howard Farran:  So what percent of your clients are you recommending that dentists record all incoming calls and then once a month go over them and review?

Mark Dilatush:  We automatically record all of the calls. 

Howard Farran:  You have to. 

Mark Dilatush:  We have to. 

Howard Farran:  And don’t you think that the instant the receptionist knows all of the calls are recorded, they just raise their game?

Mark Dilatush:  Well, they raise their game, but sometimes if they raise their game, if it was a poor game, they just raise the poor game more.   You know what I mean?  Okay, so most of them want to go great.  But let’s face it man, if you have been in that front desk of that doctor’s office for nine or ten years, you have been saying the same things 30 times a day.  Like you could probably go to sleep doing a two surface composite.  You have done 14 billion of them, right?  Same thing with your front desk folks, they just start to get stale.  So get them some help, get them some assistance, monitor them, whatever.  Whatever you have got to do, because it is amazing the difference between our clients that actually answer all of the phones and have good, skilled, energetic people who really value the dentist and the dental services that that office provides. 

Howard Farran:  Okay, but specifically to you, you record.  Once they become your client, you record all of the calls. 

Mark Dilatush:  We record all of the calls, my client services team reviews the calls.  If they see a problem, they make the doctor aware.  But there is a chasm between awareness and doing something about it, Howard.  You know, because nobody wants to upset the apple cart with Mary at the front desk who has been there messing things up for 24 years.  So you are asking me what are some of the things I want to talk about, I mean, that should help some of the people watching this thing.  Even if it is just keep your eyes and ears on it, because our clients have access to the same phone calls.  You click a button, you put a login and password and there is every phone call that came into your practice off of your promotion, hundreds of them.  And do you know how many dentists actually listen to them?  Like, 10% of our clients.  They don’t even review them.  So that is why I tell our client services once a month, go through them, send the client some alerts.  Or we give them great feedback.  Hey, Jenna sounds great on the phone.  She is a keeper, or whatever little email we send to the doctor.  But anyway, the bottom line is if the dentist is serious about putting an orchestrated, well thought out, organized marketing plan out there and they are concerned about the money they are going to spend on that and the return they are going to get, answer all of your phone calls and monitor and help the people who are answering your phone calls and you will squeeze every cent out of that marketing investment you possibly can. 

Howard Farran:  Absolutely.  I mean, it is just amazing.  I mean, it is stunning how half of the calls go to voicemail.  And I had one today, I can’t even make this up.  I called them back and it told me I couldn’t leave a message, the mailbox was full.  And you know the dentist is going to whine and blame everything on Obama.  It is like, really?  How did Obama do this?  

Mark Dilatush:  No, I know.  And we get them at lunchtime, too.  It is funny, we work with our clients and say, “What is the challenge?  Why can’t you get your phones covered?”  Well, we all take lunch at the same time.  So the answering machine says, “Hi, you have reached Dr. Schmo and Schmo and we are out to lunch.”  Okay, when is it convenient for mom to call the dental office during her busy work day?  Think about it. 

Howard Farran:  During lunch. 

Mark Dilatush:  During lunch.

Howard Farran:  Yeah, and then you ask the same doctor, you say, “Would you describe your practice as patient, customer focused or dentist focused, all about you?”  They go, “Oh, we are patient focused.”  And they say it with a straight face.  “What are your hours?”  Nine to four, I take lunch twelve to one.  Why doesn’t your corporate logo just be you flipping off the community?  I mean, so it is hard.  But Mark, we are at 59 minutes.  I have got one minute.  Give a big plug.  I have been a client of yours off and on for 27 years, love you like a brother. 

Mark Dilatush:  Same here, Howard. 

Howard Farran:  Go to NewPatientInc.com, but plug yourself.  How can they contact you if they need help?

Mark Dilatush:  Alright, is this podcast or video going to be shown to Townies?

Howard Farran:  Yeah, it is going to be on DentalTown. 

Mark Dilatush:  Oh, okay. 

Howard Farran:  But I will post it on social media, too.  I got 50,000 Facebook friends and Twitter and all of that stuff. 

Mark Dilatush:  A plug, if you want to see what we would do if we were you, just go to NewPatientInc.com, click Client Survey, answer all of the questions.  There are about 60 of them there and about three or four days later you get a marketing plan and a conversation.  And we don’t bug people.  I think, not I think, I know there is, I guess a fear among dentists that if it is a marketing company, they just hound the crap out of you.  Okay, we are the opposite.  We are sort of the educators.  That is why we write the books.  Oh, and if you really want to learn about this subject, Howard, I would invite them to go to DentalTown and there is seven hours of CE on dental marketing.  So the dentists who say, “I am not really sure about this.  I want to learn about it or maybe even make a hobby out of it,” your website and the online CE, there is seven hours sitting right there. 

Howard Farran:  And we are out of time.  We are in overtime, but I just want to say to the live viewers out there, I have used Mark’s services.  I have known him for years.  And he is an amazing man and Doc, look.  You were trained in physics and you know 23 ATP _____ , but dude, you don’t know anything about marketing.  And Mark doesn’t go into marketing hoping and wanting this to work.  Mark has been looking at the numbers for a quarter of a century and he just does what works.  And Mark, I want to thank you for making those courses on DentalTown, for answering a gazillion questions.  Every time someone throws a question out that nobody can answer, I always forward it to you and you always answer it.  And I want to thank you for all that you have done for DentalTown and all that you have done for dentistry. 

Mark Dilatush:  And thank you, Howard.  Same here.  

Howard Farran:  And also after this podcast, listen to the other one with his partner in crime, Howie Horrocks.  I call myself the other Howard, because the real Howard is Howie Horrocks.  Thank you, Mark. 

Mark Dilatush:  Alright, thanks Howard.