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DSO's are here to stay. Whether you like it or not.
We work with independent dentists only. And people often think that we must hate DSO's. But that's not true at all.
DSO's have a pretty logical purpose of existence: Use economies of scale and business efficiencies to lower costs and add convenience to dentistry.
Fine -- but what does that have to do with you?
My answer: not much.
And really, it shouldn't concern you that much. Unless...
You don't know these 3 secrets.
That's a bit dramatic. Of course, you should have a high level of awareness of the market, and a clear understanding of where you are positioned in it.
But these 3 secrets are a good first step. So let's get started.
1. Cost-Per-Click (CPC) Is Irrelevant
This might be the first time you've ever heard that.
For those of you that aren't sure what Cost-Per-Click (CPC) is, let me tell you.
Cost-Per-Click (CPC) is the amount of money that you spend when someone clicks your ad.
This metric is only used in online advertising, because you can only track "clicks" online.
So many people (even "good" marketers) are obsessed with CPC. They are constantly trying to lower CPC. They want CPC as close to $0 as possible.
I get it. To the untrained marketer, lowering CPC would seem important.
But let me tell you why it is not even relevant at all.
CPC is not relevant at all because it doesn't measure your Return-On-Investment (ROI).
Who made more money, the doctor that paid $1 per click or the doctor that paid $100 per click?
Who knows? We don't know what the ROI was. CPC is a shallow statistic that cannot be judged on its own.
Let's dig a little deeper with an example:
Dr. Jones paid $2,000 for 1,000 clicks on his ads this month. Of these 1,000 clicks, 15 people scheduled an appointment. Of the 15 people that scheduled an appointment, 5 people cancelled and 5 people no showed. So only 5 people showed up to their appointments. Of the 5 people that showed up to their appointments, 4 had X-Ray's and an Exam and didn't need any further treatment right now. 1 had X-Ray's and an Exam, and you proposed a $20,000 treatment plan to them. But they said no. Because this final patient just lost their job and is in the middle of an expensive divorce.
In total, Dr. Jones brought in $500 of revenue, and paid $2,000. Dr. Jones netted negative $1,500.
Dr. Jones' CPC: $2 per click
Now, let's look at Dr. Windfall.
Dr. Windfall paid $4,000 for 200 clicks on his ads this month. Of these 200 clicks, 15 people scheduled an appointment. Of the 15 people that scheduled an appointment, 2 people cancelled and 2 people no showed. So 11 people showed up to their appointments. Of the 11 people that showed up to their appointments, they all had X-Ray's and an Exam. 6 of them didn't need any further treatment right now. The other 5 needed a cumulative $50,000 in treatment. Of the $50,000 in treatment that Dr. Windfall presented, $35,000 was accepted. The other $15,000 wasn't accepted, but Dr. Windfall will see them again in 6 months for a cleaning.
In total, Dr. Windfall brought in $35,000 of revenue, and paid $4,000. Dr. Windfall netted positive $31,000.
Dr. Windfall's CPC: $20 per click. A whole 10x more than Dr. Jones.
Do you see what I am saying? CPC is irrelevant without more information.
So what is the relevant statistic that matters most?
What is CPDE? It is Cost-Per-Dollar-Earned.
It is how much money you spent to earn a dollar in revenue.
Dr. Jones' CPDE was $4. That's right. Dr. Jones paid $4 for every $1 earned.
Dr. Windfall's CPDE was $0.11. That's right. Dr. Windfall paid eleven cents for every $1 earned.
Which would you rather be?
Of course -- Dr. Windfall.
So to sum this up, it is fallacious to believe that CPC is the most relevant statistic when it comes to online advertising. However, so many people think that CPC is the most relevant statistic. Now you don't.
In fact, Gary Vaynerchuck (a world-renowned digital marketer that gets paid hundreds of thousands for a speaking engagement) thinks you should pay as much for a click as you can afford.
This way, your marketing will be so effective that you will dominate the search results. You will be able to buy up all the advertising space. Your competitors will not be able to afford it because their ads are less effective than yours.
This is a little extreme. But the truth is that higher quality leads usually come at a higher cost-per-click.
Now you know: CPC is irrelevant, and CPDE is the real thing you need to care about.
While you are distracted by irrelevant metrics, DSO's will be outbidding you and winning all of the ad space. Don't let this happen to you.
2. Your Patient Don't Decide What Is Important To Them. You Do.
"Wow Isaiah. You're getting a little woo-woo!"
I get it -- this might seem like a foreign concept. But give me the opportunity to show you why this is true.
In Dr. Robert Cialdini's book 'Pre-Suasion', be demonstrates an important point to bolster my claim. He uses scientific research, experiments, and hard evidence to show us that:
1. What Happens Right Before You Make An Offer Influences Peoples' Decision Making
2. People Decide What Is Important To Them Based On How You Frame Your Offer
3. Shifting The Attention Of Others From One Thing To Another Also Shifts The Importance
I will quickly break down each of these.
First, what happens right before you make an offer influences peoples' decision making. This is absolutely true, and let me give you an example.
In Dr. Cialdini's book, he shares an experiment that his research team did. This experiment used a mattress company. The mattress company asked their buyers what factor influenced them the most when they shopped for a mattress.
Now get this:
When the mattress company used an image of raining pennies on their website, the buyers ranked price as the most important factor.
When the mattress company used an image of clouds on their website, the buyers ranked comfort as the most important factor.
What you say to, or show people immediately before you present your offer will influence their decision.
Next, people decide what is important to them based on how you frame your offer.
Time and time again I see independent dentists making this huge mistake with their advertising.
They will take out an ad in a newspaper. A magazine. A local newsletter.
They pay for these ads, and the focal point of their advertisement is price.
FREE CONSULT. $39 EXAM & X-RAYS. $1,000 OFF AN IMPLANT + ABUTMENT + CROWN!
For an independent dentist to advertise this way is sacrilegious offense.
Because it makes the patient care more about price and "deals" than what you can actually compete on in the long-run. Culture. Quality of care. Personal touch. Know your doctor. Whatever! Anything but price!
That is a race to the bottom that you can't win.
Finally, shifting the attention of others from one thing to another also shifts the importance.
It's kind of a funky sentence, but I hope it makes sense. And if it doesn't, it will.
Has anyone ever called your office and asked, "Hi, how much is it for a crown?"
I bet they have. I know they have.
Now, you can shift the importance from price to quality right now, in this moment.
You can do this by responding, "That is a good question. Our crowns usually cost between X and X based on your unique situation. And our prices are right in line with what you could expect to pay other places. To get you an exact cost, though, I invite you in and we can do an exam. We don't use crowns from China like a lot of other dentists. Is cost the main concern that you have, or are you also concerned with the quality of care you receive?"
If they decide cost is most important, then fine. Move on -- they weren't the right patient for you.
However, give it a try. By shifting the attention, real-time, from cost to quality, you will see an uptick in the appointments you book.
Of course, make the statement true. You can frame it however you want, but the point is to shift the conversation from cost to quality. One way or another.
DSO's are masters at focusing the attention on what they do best. Price and convenience. So what must you do?
You must shift their attention back to what you do best -- whatever that is.
3. Turbulent Systems Lead To Turbulent Results.
DSO's really nail systems. The best DSO's have an airtight system for everything that they do. Marketing is no exception.
Systems are important for a bunch of reasons, and here are a few:
1. Systems Standardize Work
2. Systems Create Consistency
3. Systems Make Improvement Easier
Having systems throughout your practice makes life easier for everyone.
By eliminating discretion of your staff, you get a standardized quality of work more consistently.
Not only that, but you can improve your quality of work more easily. Because you have a clear way of doing things, you can observe the various parts of the process and easily identify areas of improvement.
But how does this relate to marketing?
Many independent practices change their marketing "strategy" constantly.
They have a half-baked plan. They let the winds of the next best salesperson take them away. Away from what? Their current strategy.
Have you ever considered doing something other than dentistry? Maybe you were up late at night studying HIPAA compliance and thought to yourself, "hmmm... maybe I could do something else other than this dentistry thing."
Well -- I'm glad you stuck with it. But imagine what would have happened if you dropped everything to pursue something else. Let's say software engineering.
You left your dental program, and two weeks later there you are learning about avascript.
What happened to all your progress in dentistry?
It's gone. Time wasted. Energy wasted. Money wasted.
Then, one day you decide to go back to dental school. After a year of software engineering you realized how exhilarating HIPAA compliance is.
Again. Time wasted. Energy wasted. Money wasted. All gone.
This sounds extreme. But it is exactly what is happening with so many practices when it comes to marketing.
You see, every time you change your direction with your marketing, you create massive turbulence. You've spent (and wasted) time, energy and money implementing something, but then give it up.
I get it -- the new and shiny thing can seem compelling. Salespeople are masters of making your current situation seem horrible, and selling you on new elixirs that will save the day. Until they don't.
So what can be done about this? The best way to approach this is to get really serious about your marketing strategy. The DSO's are very serious about theirs, and they rarely deviate from the plan.
If anything, they will keep their current plan in action, and just pilot some more things to see how they work.
Will some money be wasted?
But the cost of becoming the fool of todays trends is huge. You won't have a reliable, predictable, diverse marketing strategy that will work in the long-run.
Turbulent systems lead to turbulent results.
If you consistently change your marketing strategy, your results will consistently change.
Independent dentists always tell me that they feel like they have all their eggs in one basket.
"I am concerned that all my new patients come from the same referral sources."
"One day my ads seem to work, and the next day they don't."
This can be concerning.
The only way to abate this is to formulate, and stick with, an airtight marketing strategy where your bases are covered. Where your eggs aren't all in one basket. Where things are being measured, and optimized, at a radical level.
All sales aside, I will hint you in on something.
DSO's are simultaneously testing new strategies across their practices. When they find a real winner, they implement it company-wide, and then begin optimizing some more. Testing some more.
It is really hard to do this as an independent practice. Because you only have one practice.
Any test you run is a big deal. In many cases, you don't have enough feedback or data within your single practice to run effective tests anyways.
That's why we are working hard to bring a system like this to independent dentists. We are collecting data that will allow us to test, iterate, and optimize campaigns for all of the practices we help at once.
All sales aside (I think our service sells itself), it is important that you have some way to continuously improve and optimize your efforts. Otherwise, DSO's will be the only ones doing it. That is not a force you want to be up against without some serious firepower of your own.
I've included a 4th bonus here for you.
It ties right in with number 1, Cost-Per-Click (CPC) is not the most relevant metric. You will want to pay attention to this bonus. It is often overlooked, and will change the way you look at marketing.
4. Lead Quality Outweighs Lead Quantity Every Time
After my example in the first part of this letter to you, it should be clear why this is true.
But I want to expand on what I already said with a few more important points.
In the example of Dr. Jones and Dr. Windfall, you might have been thinking to yourself, "This sounds a bit far-fetched. The quality of the leads people get on the internet can't be that different."
I can assure you -- they are.
The search-engines and other online advertising platforms know what makes a quality lead.
With a little marketing magic, you can give your advertising campaigns objectives. These objectives will give the algorithm feedback. The feedback will tell the algorithm which leads were high quality and which leads weren't high quality.
Why is this important?
It is important because if you let the algorithm optimize for your actual performance (and not just on click cost), it will begin to charge you a little more per click for leads that are much more valuable.
You heard me right. It is possible (and a good idea) to open up a feedback loop for the algorithm to see how well it is doing.
If you show the algorithm what a quality lead is for you, and give it permission to charge you more for quality leads, it will gladly take that offer.
There is another critical thing I must mention.
I have never heard this talked about in relation to dentistry, but it is a game-changer.
The more information you have about a lead, the easier it is to turn them into a paying patient.
If your leads are currently coming in with a first name, last name, and phone number (which I bet they are), you've got to change that ASAP.
Imagine if you were tasked with calling your leads. You got a list of people to call each day. The list only included a name and phone number (and the general understanding that they are interested in your practice for some reason).
Would you want to call them?
I wouldn't. What would I say?
"Uh... hi there this is Isaiah with Big Smiles Dentistry and uh I see you sent something in for us. How can I help you?"
Yikes -- it is scaring me just reading it!
So what would make this better? I'll show you in a minute.
But first let me explain what sales really, truly is.
Sales is the collection of accurate information about somebody's current situation and their desired situation. Sales is asking questions to gather this information in a methodical and strategic way.
If you have the right information, it allows you to present a solution with ease. It feels like fresh air.
You don't have to guess.
If you have all the information about where someone is, where they want to be, when they want to be there by, and if they have the financial ability to get there, you no longer have to "sell."
You just have to connect the dots.
So this is sort of conceptual still, so let's put it in action.
Let's say that instead of getting a lead with just a name and a phone number, you get a lead with the following information:
Name: Justin Smith
Phone Number: (904) 990-8477 (that's me!)
Email Address: email@example.com (not me!)
I am missing four teeth.
I have been missing these teeth for between one and six months.
I currently use dentures and they are causing me discomfort.
I am experiencing severe pain.
I can't eat certain foods and I have to modify the way I chew.
I haven't fixed my problem yet because I am scared of the dentist.
I don't have dental insurance.
I won't need a payment plan because I have enough money to cover my treatment.
I have been ready to get this taken care of and I want it taken care of as soon as possible.
The best time of the day to contact me is the morning.
See the difference?
Who would you rather call?
Which lead would you rather have?
I think we can both agree that Justin Smith is looking like a pretty attractive lead!
So the difference is night and day. We could easily connect the dots to call this lead.
"Hi Justin? This is Isaiah with Big Smiles Dentistry and I was calling because we got your submission in. Thanks for taking the time to fill that out. So it sounds like you are missing a few teeth and are feeling a lot of pain with your dentures." *wait for acknowledgement* "That is definitely something that you want to get taken care of as soon as possible. I had an appointment open up tomorrow at 9:30am. Are you able to visit us then?" *wait for answer* If no, then, "Ok -- what day and time is usually best for you. I can take a look to see when we can fit you in."
You get my point.
The second phone call is so much easier. All you have to do is connect the dots. And by connecting the dots, you will connect with your prospective patient at a much higher level.
This takes the selling right out of dentistry. Because the hardest part of selling is the methodical collection of honest information. Collecting this information real-time, on the phone or in person, makes everyone uncomfortable. You, your staff, and the patient.
But if the information is given to you while the patient is in the comfort of their own home -- bingo!
That's what you want. That will change the game for you.
So the main point -- quality leads are much better than a bunch of "junk" leads. Make sure the leads you get in have the information you need to connect with your prospective patients at a deeper level.
Your front office will thank you!
Until next time,
P.S. If you have any questions for me, you can reach me by email at firstname.lastname@example.org. If you have any marketing questions or concerns for your specific practice, you can also book a call with me below.