You’re Just Like Tom Cruise

Living in Los Angeles, I meet more than my share of actors.  Not just the more famous ones, but the ones trying to make it.  And there are many of them at the “undiscovered” tom-cruise-in-mission-impossible-4-movie-hdstage of their careers who are pure artists.  By that I mean they love acting. They are passionate about the process of creating a character and performing.  And some of them are extremely talented. They consider themselves as pure artists, but they are starving, because they have not adjusted to the idea that successful actors know that they are not just artists, but are working in an industry trying to make a profit, not just art.

Tom Cruise, on the other hand, knows that he is in a business. He loves acting, and works as hard or harder than almost anyone in the industry at his performances. He has been the lead in 29 films, has won three Golden Globes and been nominated for three Oscars. But, he is also ranked #3 in all-time box office revenue ($6.5 billion so far), because he understands the business of acting, perhaps better than almost anyone.

So what does that have to do with dentistry?  In my experience, the best dentists clinically are artist/engineer personalities.  They want to do great dentistry, and train themselves constantly to get better.  But many of them are in practices that are struggling financially.  Despite being extraordinary “artists”, their careers are not paying off.  Just like the “pure” actors, they don’t like the idea of promoting themselves, or focusing on the business aspects of their practice, and don’t feel the need to understand their “audience.”

Tom Cruise has a PR team, an acting coach, a manager, an agent, a financial advisor and business partners in his production company.  Why?  Because to succeed in acting you need all of those things, as well as talent.

The successful dentists I know all have their team as well. They use a practice consultant to coach them, work with a financial advisor, use outside marketing resources, and have a deeply-engaged relationship with their distributor representative.  And they make sure that their office manager is constantly updating her skills (through organizations like AADOM).

But all that is expensive, you might say.  In response, I say, you know what’s expensive? Houses. Cars. Kids’ educations. Travel. Retirement. That’s why you need to be successful as a dentist, not just clinically excellent.  That takes investment.  Tom Cruise pays his manager 10% of his income because he earns it!  His acting coach isn’t expensive–he’s an investment in growth.  His financial advisor doesn’t cost him money–he makes him money.  And all of these people do these things so that Tom can focus on his performance.

But that doesn’t mean he doesn’t understand the business aspects of his career.  You can bet he’s paying close attention to it. (Just as you should.)  And his reputation is also vulnerable, just like a dentist’s is.  You may have some troubling Yelp reviews, but he’s had some issues with his involvement in Scientology.  But he doesn’t ignore them.  And you can’t afford to either. He fixes it with good reviews for a hit movie (The Edge of Tomorrow).  Just as you should have a systematic approach to generating great reviews. (This whitepaper gives you a step-by-step approach for this.)

Successful dentists–dentists who are thriving and enjoying their work–focus on the clinical and the business side of their practices.  Clients of mine use 1-800-DENTIST because they know their ROI is 4-1 on their marketing investment. They have us build their websites because they know they couldn’t possibly keep up with SEO on their own. Fortune Management clients keep using their coaches even as they get more successful, because they know they can always get better (or slip back into old, unproductive habits.)  Patterson clients know that their rep isn’t just keeping their cabinets full of sundries, but are also steering them in the right direction on new technology, office design and clinical training.

Those are just examples of the many good resources that are available to you.  I list my favorites on this blog on the right-hand side, from Gary Takacs to Spear Education to the Madow brothers, and in the resources section of this blog as well.

Long-term success in dentistry is not an impossible mission, but a noble one.  You’re helping people, and the only way you can keep doing it in the next 20 years is by running your business extremely well.  And that takes a team.

Escaping Gravity with Your Practice

On a manned space flight to Mars, which is 34 million miles away, 50% of the fuel would SLS Booster 11X7 K65634be used to go the first 400 miles.  The reason for that, of course, is what’s involved in escaping Earth’s gravity.  In many ways this is similar to starting and operating a dental practice.

The gravity is your list of fixed expenses–rent, equipment leases, loan payments, utilities, salaries, etc.  Until you “escape gravity”, that is, produce enough to pay your fixed expenses, your practice profit for the month is $0.  After that, you are able to keep an exceptional amount of the collections for that month, because for the most part your variable expenses–lab costs and supplies–is less than 20% of your fees.

This is very different from many other businesses. In most retail stores, for example, the fixed expenses are less than 20% and the variable costs, like the stuff they put on the shelves, is close to 70%. If they sell a lot more in a month, they still only keep 10-20% of what goes in the till.

The challenge for most dentists is that they are barely escaping gravity.  The team works hard at “cracking the nut” every month, and the accountant tells the dentist that her overhead (calculated by all costs except the what the dentist pays him or herself) is 70%.  So the dentist thinks that for every dollar she produces going forward she is only going to keep 30%.  That could not be further from the truth.

Once you escape gravity, you keep 80% of the increase in production.  This economic fact is one of the most beautiful things about the dental practice model.  For example, say a  practice is producing $40,000 per month, (which in the average urban area is still trapped in fixed-expense gravity) and the profit margin is 30%.  That’s $12,000 to the dentist. Now imagine production is increased by $8,000 in the following month. Then the economics change significantly.

How?  Simple.  Because on that additional $8,000, the only expenses are variable ones: lab costs, consumables, and perhaps a bit of employee time.  Even a high estimate of that would come out to only 20% in the average practice.  Which means $6,400 is additional profit.  You’ve gone from making $12,000 to $18,400.  You’ve increased production by 20%, but in fact your profit margin has now gone from 30% to 38%.  And your take-home income has increased by more than 50%!

This is why the more successful practices can do more marketing, bonus their teams more, add new equipment and technology and upgrade their facility, further improving the efficiency, appeal and success of the practice.  It is not unusual for a dental practice producing over $800,000 to operate at less than 60% overhead.

I’m writing about this because I often encounter dentists who are thinking about advertising to get new patients (or using 1-800-DENTIST) and they make a calculation on the return on investment based on their perception of their overhead percentage.  But the production on those new patients is at your “escaped gravity” percentage, which means you can afford to invest in your growth at a much higher level.  You may pay $200 or $300 for a new patient, but if the lifetime value of a patient is $4000, (it’s much more than that, by the way–watch this video if you don’t believe me), and your true profit is 80%, you’ve invested $300 to make $3200.

Do you think group practices understand this formula? You can bet they do.  And if you want to compete effectively with them, you’d better understand it too.

Isn’t this unique economic opportunity good motivation for getting better at what you do, and increasing your production?  Does it not make sense to incentivize your team to get the practice to escape gravity every month, and every year?  By the way, this is also where your economic freedom will come from.  It’s a lot easier to save 10% of your income when your profit margin is 40%.

There are thousands of practices that do this every month, and they don’t have some magic bullet marketing trick.  Okay, they do, but it’s not some secret Google AdWords formula or miraculous direct mail offer. It’s this: consistently creating a great patient experience.  And that may not be easy, but it’s doable.  And when the rewards are this stratospheric (you know I had to complete the metaphor somehow!) then it’s worth the focus.

So get a coach for you and your team.  Or buy a copy of my book for every team member, and have weekly sessions on how you can improve your practice experience. In other words, do something different if you want different results.  And blast off!

 

Are You Drowning in Functionality?

My smartphone makes me feel like an idiot.  It does too much.  For example, it used to frantic web woman phonetake me five steps to play my iTunes, until someone showed me that I just had to swipe up and tap “play”. Or I could just tell Siri to “open music”, if I could just remember to use it.

Our lives are packed with software, applications and technology that have so much functionality that we barely use 10% of them.  And it’s frustrating when we discover that we’ve been doing something the hard way, or wishing we had a solution, when we often had it right at our fingertips.

Why just 10%?  Partly because it’s overwhelming, but also because we don’t have a systematic way of learning and incorporating those functions that we want into our already busy lives.

The average person has more than 30 apps on their phone, and only uses five of them regularly. (Messaging, email, Facebook, CandyCrush, and the camera, if you must know–phone calls don’t even make the top five!)  They forget that they even have the other apps, and sometimes try to download ones they already have.

How does this relate to your practice?

Digital communication applications like PatientActivator, RevenueWell and DemandForce are perhaps the biggest practice time saver o appear in the past 20 years.  Practice coach Gary Takacs, who also owns a dental practice in Phoenix, says their app saves them 30% of the time on the phone, allowing them to focus on the people who do need to have a live conversation.  And that is just using the part of the software that does appointment reminders and confirmations by text and email.

The real juicy stuff, the functions that increase production, are grossly under-utilized by most of our clients precisely because they do so much.  Adapting new systems in a practice is always a challenge.

My solution is simple: make it a process where you incorporate one new function at a time into the practice behavior.  So, if you have or are just getting PatientActivator or another app, this is how I would proceed.

Stages:

The Setup. Here is where you incorporate the basic functions of appointment reminders and confirmations, as well as birthday greetings and other niceties.  You also want to make sure that all your social media is active and linked to the app.  The app is going to start surveying patients automatically.  You will put those responses to good use later.

Updating your Patient Records. Now you want to make sure that you have email addresses and cell numbers for all your patients. This is an ongoing process of updating that information with each patient visit.  Make this systematic.

Requesting Patient Reviews.  This is for Google and Yelp.  The most effective way to get reviews is to email your patients and ask them.  Within that email there needs to be a link that they can click on that takes them directly to your practice profile.  Don’t do this with all your patients at once! You want to be generating a steady stream of reviews.  So once a month, do an email blast to two groups of maybe 50-100 patents.  The first group is patients with a gmail address (those are the only people who can do Google reviews) and the second group you send a request for a Yelp review. If you average one review a week you’re doing great, so don’t expect 100% response rate or anything close to that.  For more on this read this blog post.

Choose Your Newsletter Topics. There are dozens of pre-written articles that allow you to share all the services your practice offers. You want these going out every month, or every two months.  This adheres to the most basic principle of marketing: tell people over and over what you do, so that you catch them at the moment when they care. This can be also done as an earlier step, because it really only has to be done once every six months or a year, but often the dentist wants to write an article or two herself, and this can slow things down.

Posting Reviews on Your Website.  These are the reviews that are generated automatically by the surveys being sent out.  You want to have them load automatically to a review page on your website.  Consumers will want to read them, and it’s huge for SEO. Can’t do that? Then you need a dynamic website like we build with WebDirector.  For more on this, read this blog.

Posting Reviews on Social Media. This is a smaller but very valuable step.  As the survey responses come in, you have the option to post them to Facebook and other social media with essentially a single click.  This should become part of your social media person’s role.  Which means that you need someone in the practice who is responsible for social media.

PA patientCalls_iphone_5Utilizing the Smartphone App. PatientActivator and one or two other services have a phone app as part of the service, which allows you to see your practice schedule. Each team member should download the app. This will serve two purposes.  One, if you have someone who is taking after-hour calls for emergencies, they can see the schedule and tell the person when to come in.  But of equal or greater value is that the dentists can now easily do their evening check-in calls, because the app shows the names and phone numbers of the patients you’ve seen that day.

Doing Marketing Campaigns. Because you have increased your email base, you can do occasional marketing emails such as discounts or contests, or simply letting them know what you do.  You can do a whole variety of these, from free implant exams to Invisalign discounts, to CEREC awareness, and new patient contests. You can also alert patients at the end of the year to use up their insurance eligibility before they lose it. We have templates for all of these.

Of course, your patients can individually opt in or out of newsletters, texts, emails, surveys and marketing campaigns, so you’ll be adjusting this on a regular basis. But doing these steps will tighten your recall and increase your patient awareness, along with giving you new patient flow.  It has become an essential and integral part of your practice marketing.

Do these steps at whatever pace gets them fully integrated into your practice behavior.  You can go too fast, but the real risk is not doing them at all, and missing out on all the production and efficiency that you can achieve. If you’re a client of ours, we offer unlimited customer service, so we’ll talk you through each step when your ready.

Another big plus to fully utilizing these tools is it gives your patients the impression of a modern high-tech practice, which is also a good thing.

The worst scenario is to stop at the basic functionality.  Just like learning to use Siri has kept me from trying to read a text in the car, and Google Maps is teaching me new shortcuts in my hometown, taking greater advantage of all the functionality that you have around you will make you more productive, successful, and smiling a lot more!

By the way, I think this staged approach is useful no matter what technology you’re deciding to adapt.  You may not need all the tools at your disposal, but I’ll bet there are some great functions with a lot of your tech that you don’t even know about or take advantage of.

“Am I Spending Too Much on Marketing?”

flushing money

Feels like this sometimes, doesn’t it?

When most dentists ask me this, they usually are asking about their advertising spending, not their marketing, which encompasses much more.  And my answer is that it’s more likely that they’re probably not spending enough, or they’re spending it in the wrong places.

Tracking your results is essential to being able to answer this question.  You need to know the source of your patients, and this can be done primarily by making sure that the source–either promotion or existing patient–that a patient came from is entered in your PMS, so that you can run a production report on your advertising results.  And, more and more, you can track results back a few steps from there.

For example, with direct mail you can use a unique phone number that forwards to your main line, so that you can track exactly how many calls you received, not just how many patients you acquired.  And with Google, Yelp! and other digital advertising you can see a lot of data, particularly how many people clicked on your ad, so you can compare that to the new patient count.

But let’s get back to the main question.  There are only two reasons why you might be spending too much overall on advertising and promotion:

1. Your schedule is full for the next three to six weeks.  If you can’t see new patients within two or three days at the most, then you will be wasting money on advertising;

2. Word of mouth is not your number one source of new patients.  This the clearest indicator that the experience of being one of your patients does not inspire people to recommend you, and you need to fix that.

As far as your marketing/advertising budget, there are two ways to look at it: as a dollar amount, or as a percentage of your annual revenue.

As a rule of thumb, 5% of your annual revenue is a reasonable amount to spend on your advertising.  I know thriving practices that spend as high as 8%, because they know that their profitability is higher once they have paid their fixed expenses, so they can afford to invest in growth.

As a dollar amount, your marketing costs should range from $20,000 to $40,000 per year. This would be higher with a startup practice–perhaps double that amount–because you need to start building a patient base.

Here is how I would break down the spending:

1. Your Website.  This is the cornerstone of your practice promotion.  Even word of mouth patients are likely to visit your website before calling the practice.  And this is important to remember–your website is a work in progress.  It’s never done, because Google is looking every day at it, seeing what has changed. So you need a dynamic website, where content changes automatically and you can add and change content easily yourself.  For more on this, read my previous blog on websites.

Cost: $3000 for a new website, $75 per month to host and maintain it.

2. Social Media. This is a marketing cost, primarily.  You should be paying someone in your office to add posts, request them from patients, monitor and respond to them, and also keep track of online reviews. This cost is part of their pay, but 12-15 hours a month should be dedicated to this.  There are outside services that can do this, but they still need someone monitoring them.

Cost: $250 per month.

3. Discounts. This is part of your marketing cost, and often people forget that.  If you’re doing a free exam, cleaning and x-rays, the cost is not high if you have digital radiography, but it’s not nothing.  You still have to pay your hygienist.

Cost: $300 per month, assuming 10 new patients attracted this way.

4. Insurance plans.  Dentists often forget that this is a marketing cost.  You are discounting your work to attract patients through the plan.  This number is impossible for me to estimate for you, but I want you to be mindful of it as a promotional expense.  And you can calculate it fairly easily, since you know what you collect versus what you would have.

5. Advertising. This could be anything from bidding on AdWords to advertising on Yelp! or Facebook, doing direct mail, local newspaper ads, or even radio or TV.  Or referral programs like 1-800-DENTIST. I believe in doing everything that works. Keep in mind that the lifetime value of a new patient to your practice is substantial, and worth investing in. If you don’t get that yet, watch this video.

Cost: $1000 to 3000 per month.

Other factors that would increase your advertising cost:

1. You don’t have storefront visibility to your practice. This could add 20% or more to your budget.

2. You have limited hours, or less convenient hours than your local competitors.

3. You don’t take any emergency patients.

Anything that limits the convenience and appeal to a new patient is going to diminish your results, making advertising more expensive. What else could you be doing wrong?  Several things.

Let’s start with your front desk.  If you have someone who is not personable, or who is over-screening the patients, or generally not skilled at converting callers into patients who show up, your advertising spend is being largely wasted.  Fix that first.

You could also be spending too much on a particular marketing approach. Every medium will have diminishing results eventually, either as you increase the budget to too high a level, or over the course of time. Direct mail, for example, will almost always over-saturating a market eventually, and you need to stop for a few months. (1-800-DENTIST would be an exception, because we’re constantly modifying our advertising approach to compensate for this.)

You could be using a promotional approach that gets lots of calls, with very little conversion into real patients, or low production on them.  The wrong type of patients means either the message is wrong, or you aimed at the wrong target audience, or the medium is wrong.  I consider Groupon a classic example of this, and though a few people made it work, I’m glad it’s faded away from the dental world.

My main suggestion is to get professional help. Advertising as an industry is changing at a dizzying pace, and it’s all any of us can do to keep up. And get someone who works in the dental industry.  People behave very differently when it comes to dentistry, ( in case you haven’t noticed!) and you want a resource that understands that.

A good practice consultant and also your product distributor rep should both be resources for you to find the best help, and to make sure you’re getting the best results.

 

Creating Your Panoramic Photo Images

A dentist asked me recently, regarding Facebook Timeline photos, “What camera takes pictures that wide? It’s crazy!”  I took out my iPhone 5 and said, “This camera. And Apple just sold another 15 million of them this week.”  I then showed him the “panoramic” option on my phone’s camera.

Of course, Facebook allows you to reframe an uploaded photo, but the picture needs look right when it is cropped deeply at the top and bottom, and you can only adjust up and down.

But then, wouldn’t you also like to add your logo, or some other message on the photo?  How the heck do you do that!?!?

Amazingly easy, even for us old folk.  First, you sign up at the website www.canva.com.  The tools on this site are FREE.  Their goal is to sell you the rights to uses images, which they provide very inexpensively.  But you can upload your own pictures and combine them, add text to them, frame them, all sorts of things, in a nearly idiot-proof environment, and not pay a dime.

The home page looks like this:

Canva front page

You can create any shape you want, and they have the templates for practically everything, from Facebook ads to Timeline photos, your Twitter heading, website images, your thumbnail photo, your business cards, whatever.  You just upload the pictures you want to work with (and it stores them for you forever as part of your media library), and then you can drag it into the template you want, stretch it, move it add another photo next to it if you want, or super-impose one onto another.

Then you’ll want to add text, and they have all different fonts and colors to choose from.  If you’re color blind, like me, get some help with your choices. Or you can drop your logo onto it. Now just save it, download it, and then upload it to whichever site you made it for.

You can also use Canva to design Facebook contests and promotions, and they have templates for those and many other things.  They also have millions of photos that you can access, and you only pay $1 for each premium element you use for your design.  That’s cheap.  Especially since the rest is free.

You can get way trickier if you take some of the tutorials–framing photos, changing background colors, drawing on the image–but for now you have a simple solution that makes great-looking images.

I did this for my Facebook book page in about three minutes,and the template made sure I knew exactly where the thumbnail photo was going to appear over it, so I could get it looking right the first time:

DENTAL MARKETING GURU.jpg

I still recommend you get team photos professionally done, do nice photos of your office, and take good thumbnail photos of yourself. But now you can dress them up and personalize them easily.

You can also use it to design printed materials, if you’re still into that sort of thing.

I haven’t found any photo tool that’s easier with such versatility. Give it a try!