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AUDIO - HSP #181 - Naomi Cooper
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VIDEO - HSP #181 - Naomi Cooper
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It's easier than you may know to think like a patient. Especially when it comes to your marketing, you need to stop thinking like a dentist.
Naomi Cooper is President of Minoa Marketing, a dental marketing and social media firm founded in 2010. She also serves as Chief Marketing Consultant for Pride Institute.
With over 15 years of B2B and B2C marketing experience, Naomi is known for the depth and breadth of her marketing expertise, her ability to build brands while stimulating consumer response and her extensive executive leadership experience.
Naomi is a published author, a regular columnist in Dental Products Report & Inside Dentistry, a sought-after speaker and a dental industry opinion leader who was recently named to Dental Product Reports’ 2015 Top 25 Women in Dentistry.
In her role as a consultant, Naomi advises dental & specialty practices as well as dental-facing companies, offering strategic marketing implementation services, generating actionable leads, measuring return on investment, facilitating vendor introductions and creating a system of ongoing marketing accountability.
From 2000 through 2009, Naomi served as VP of Marketing for 1-800-DENTIST, one of the dental industry’s most highly respected sources for patient lead generation and dental marketing. She holds a BA from UCLA and a Certificate in Business Management from Loyola Marymount University.
www.minoamarketing.com
naomi@minoamarketing.com
310-878-2399 phone
“Like” Minoa Marketing at http://www.facebook.com/minoamarketing
Follow me on Twitter at http://www.twitter.com/naomi_cooper
Howard: It is a huge, huge honor today to be interviewing my buddy since ... I think I met you in 2000. You were the vice president of 1-800-DENTIST for damn near a decade. You have one of the most amazing marketing minds. I mean, you've been cutting edge ever since. I remember ... was it 2000 that I met you about?
Naomi: It was in December of 2000.
Howard: Wow, you remember the month. I must have had a memorable meeting with you if you remember the month, but my gosh. I mean, back then, and I mean seriously, marketing was kind of a new thing in dentistry. Now it's 2015. Everybody's talking about marketing because they're trying to get new patients and everything, but you and Fred [Joyle 00:00:47], you guys were on the cutting edge. That's amazing. I always wondered whenever I see Minoa Marketing I always look at that and think you could actually spell that out of your name Naomi. Is that ... ?
Naomi: It is an anagram.
Howard: It is an anagram? I guessed it correctly?
Naomi: You did.
Howard: Okay, well, I should give credit to Ryan. Ryan saw it first, and then we were looking at it like, "Oh, my God. You can get that." How are you doing?
Naomi: I'm doing great. I'm doing great. How are you, Howard?
Howard: Good as ever. I'm as good as ever. I'm always good, and my four boys, Eric, Greg, Ryan, and Zack are doing good and my 3-year-old granddaughter and they're all [crushing 00:01:24], so I'm all happy. Hey, I want to start with ... I don't ever like to talk about anything that anyone agrees on. I always like to find the most uncomfortable questions, the 4,000-pound gorilla. This is what I hear on the street, Naomi. That something happened around the [Lehman's Day 00:01:42] 2008, and it pretty much killed direct mail.
Everybody's been talking about Yellow Pages has been dying for a decade, but now, pretty much every dentist on Dentaltown will say, "You know, back in the day from 1990 to 2008, if I mailed a flyer to everybody that lived in my zip code, I could get a whole bunch of new patients, and I'd only have to do that maybe once a year. Now, even some of these big corporate [dentist exchanges 00:02:11] say, "Man, we'll do a direct mail piece and we don't even know that we mailed it." Has marketing changed since Lehman's Day 2008?
Naomi: Marketing has changed dramatically. I don't know that it has anything to do with Lehman or with the market crash in general, but it has a lot to do with the [inaudible 00:02:29] that people started making decisions differently starting around the mid-2000s. You'll remember that was also right around the time that Facebook started getting really popular, that Google searches and SEO and SEM, search engine marketing and search engine optimization, started to become very prevalent as part of our daily lives. I think what you're seeing is a reflection in dental marketing of the overall marketing landscape changing. Of course, as ever in dentistry, we're a few years behind.
Howard: Okay, so I want to hold your feet right to the fire because I've got an amazing guest on with you. This is what every dentist says on the street. They just say, "Man, if I can just get 10 or 20 more bodies in my office. I'm paying my rent, mortgage, equipment bill, computer engine. I'm paying all my bills, and I'm making some money, but damn it, if I could get 10 or 20 more new patients a month in my office, it would be sweet." What would you say to that dentist?
Naomi: Well, first of all, there's no magic bullet. Anytime anyone tells you that there's a guaranteed way to do everything for everyone, they're lying their socks off. That's number one. There can't be a universal answer, even though it is, of course, a universal question. The reality is what is the situation of that particular practice? What's the situation of that particular doctor? Are they in peak growth mode? Are they starting off a practice? Are they looking to add an associate? Have they just recently added an associate? Are they are in a high-end area? Are they in a solidly middle-class area? Are they in a growing area or a shrinking area? All of these things have a huge impact on the kind of recommendation that I would make for any individual dentist. The one thing I can say for sure is that every dentist needs to have an amazing, incredible, fantastic, cutting-edge, of-the-moment website.
If a dentist does not have a website that was built in the last 36 months, preferably the last 24 months, I guarantee you that their website is not up to par. If there is a universal answer, it's have a great website and have that website able to be optimized when it comes to search. The reason for that is several-fold. Number one, it means that when people do find you that they have a positive impression of you. If they find you and they have a ho-hum impression of you, it's just as if they walked into your practice and had a ho-hum impression firsthand. They need to have that amazing firs impression, and the reality is that there's this thing called the [1.54 5-second 00:05:07] rule. Howard, I'm not sure if you've heard of the 1.54 5-second rule?
Howard: No, no.
Naomi: The 1.54 5-second rule tells us that in online marketing, we have 1.54 seconds to get 5 more seconds of that person's attention. If you can't answer within 1.54 seconds that you area dentist, that you are in the right area, that your phone number is easily found and your address is easily found, that you are offering the most cutting-edge latest technology or whatever it is that your target patient wants, if you can't demonstrate that so they know they're in the right place in the first 1.5 seconds, there's no chance that you gain the additional 5 seconds. The additional 5 seconds is when they start to look around and scroll and browse. That's when they start to make their decision. That's the first way. The second way is that if they find you even through word of mouth, the reality is that word of mouth isn't today what it was 10 years ago.
It used to be that people would write it on a Post-It note. "Oh, go see Dr. Howard Farran. He's amazing." Right? On that Post-It note they'd write it down, they'd put it in their pocket or put it in their wallet and then they'd call you. They'd look you up in the phone book, and there was no way for them to get information. I can tell you as vice president for marketing with 1-800-DENTIST, they used to call us and say, "Hey, have you heard of this guy? Have you heard of this woman? Are they any good?" As if were the Better Business Bureau for dentists because there was no other ways to find out information about dentists. Today, there's infinite ways for them to find out information about you. They can go to Yelp. They can do to Google reviews. They can go to Healthgrades reviews. They're going to travel all around the Internet to find out who you are.
They're also going to end up on your website, and if your website doesn't tell them exactly what you want them to know about you, if it doesn't tell them how solid your practice is, as my father would say, "What kind of an outfit are you running here anyway?" Right. What kind of an outfit are you running and does your website truly reflect that?
Howard: Now, were you also saying that the website should be within 3 years old because all the older websites were built for a desktop PC and now most of the traffic, over half the traffic's coming via the phone? Is that mainly what you're thinking?
Naomi: Well there are several reasons. That's a big one. Number one, search engine optimization strategies change. Google updates its algorithm. They just did another major algorithmic update as of I believe it was August 5th of this year. They also pay attention to different things when it comes to search, so if your website was optimized for search 2 years ago, that doesn't mean it's optimized for search today. Also, browser optimization and user experience optimization. If your website was built for a desktop computer or if you have a "mobile website," that's very, very 2012. In 2015, we all know that if we still have the same phone we had in 2012, we'd be behind the times.
If you still have the same website you had in 2012, I guarantee you you are behind the times. The reality is that what Google pays attention to, and we all need to pay attention to what Google pays attention to because of that 80% of search engine traffic comes from Google, if Google's paying attention to things like freshness. Not just longevity, which used to be what it paid attention to, but now it's paying attention to freshness. How fresh is your content? How relevant is it in this day and age? How constantly are you updating and putting new content on your website? That's one of the things that Google's algorithm is looking for. Above and beyond that, Google's algorithm is looking for whether you are mobile optimized. If your website is not mobile optimized, it won't even come up in the search for people who are looking on a mobile phone.
You need to have what is called a responsive-designed website. Responsive design means not just that it's a mobile optimized website, but that it automatically shifts literally the makeup of the website and the layout of the website automatically shifts based on what kind of browser the person who's looking at your website is using, so absolutely that's a reason. Then the last reason is have you re-examined your branding? Do you still have that logo from 1987? If you still have that clip art logo of the dancing tooth from 1987, there is no way that in this sophisticated marketing-oriented day and age where consumers are so much more savvy that they're going to perceive you as a top of the line dentist. No matter how responsive or no matter how well SEOed your website may be.
If your branding isn't on par with the kind of dentistry that you're providing, you're absolutely losing out on perspective new patients.
Howard: What I did, I left my logo the same, but I switched my face picture our with Brad Pitt, and I hope that will help.
Naomi: [Inaudible 00:10:17]. In a pinch, Brad Pitt always works. At least for your target demographic of women, I'm guessing as for most dentists, women who are 25 to 55.
Howard: Okay. Is that who we should be targeting? Women 25 to 55?
Naomi: Well, I think it depends again on your area. Depends on the services that you offer. If you have an implant-oriented practice, for example, you're probably skewing a little older, right? If you have a typical family practice, most of my clients tell me that's the key group that they're looking for. They're looking for a 25 to 45-year-old moms who have young children so they can continue to build the practice, and they're looking for the 40 to 60 or 70-year-old women because they're the ones coming in for a lot of restorative care and dragging in their husbands for that kind of care too.
Howard: Nice. Naomi, this is what dentists tell me. Whenever you talk about Yelp, they always tell me this. They go, "People only use Yelp for restaurants. I don't know anybody that uses Yelp for a dentist. It's a restaurant thing." Now granted I'm 53, so most of my dentist friends that I go out with are my age, but what would you say to dentists, older dentists like me, who are sitting there saying, "Naomi, people go to Yelp to find out where the best steakhouse is now. No one picks a dermatologist or a dentist on Yelp." What would you say to that?
Naomi: Here's what I would say to that. First of all, my 78-year-old mother just had to have a root canal, and she didn't like her last endodontist that her GP sent her too. She said, "Naomi, I need a new endodontist. Of course, she thinks that I'm the most knowledgeable person when it comes to finding a dentist.
Howard: You are! You are!
Naomi: [Crosstalk 00:12:00] was I went to Yelp, and I had my mom go to Yelp. She went to Yelp, and she read the reviews of the 3 endodontists that dentist had recommended to her. One of them, if you can believe this, an endodontist in San Francisco that's clear across town from her had 58 5-star reviews on Yelp. If that doesn't convince a patient, I don't know what will. Here's the thing, and this is what I really try to encourage dentists to do is to go down into that ... You know that door in your house, Howard, when you were growing up and it led to the basement and it was that really scary door that you never wanted to go near when you were 5 years old or 8 years old? I don't know about you, but that's how I was. Go to that door, and open up that door. Walk down those very scary stairs.
You're going down in the basement of your brain, and in that darkest, dampest corner with a single burnt out light bulb hanging over it, there are two big levers in that corner. One of the levers is rusted in the on position and the other lever is rusted in the off position. The lever that's rusted in the on position is your dentist brain. Okay? The lever that is rusted in the off position is your human brain. What I want everyone who's listening to this podcast or watching this podcast to do is I want you to work really hard to turn off that lever of that dentist brain. Turn it off. You might have to pull with all of your might and turn it off and stop thinking like a dentist. Right? Then for a minute ... this is why we have study club photos on practice websites like disgusting clinical bloody photos that all of your study club friends would love, but have no place on a dental practice website.
You need to turn that off, and you need to go to the other lever, which is of course rusted into the off position. I want you to pull up with all of your might to turn that one on. You need to start thinking like a patient. To patients, what Yelp is telling them is about your level of customer service. Just like a restaurateur, I have a friend whose husband owns three restaurants, and he would say that Yelp has nothing to do with the quality of the food that's served in restaurants. It only has to do with how good the wait staff is or the front of the house staff. It's the same thing. Patients have no way to judge your clinical ability. That's absolutely true. They never [inaudible 00:14:28] well. Your specialist that you refer to do. Your study club buddies and your dental school buddies, they know your clinical ability. Your patients don't. They just know a couple of things about you.
Are you nice? Are you gentle? Do you have small hands? Right? What's your team like? Is your team wonderful. Does your team treat them with respect when it comes to their bodies and their wallets? Those are the things that patients care about. You care that your degree is from the best dental school and that you're a diplomat of the whatever, whatever, whatever, whatever. Patients don't care about that. To them, you are a dentist. You have the DDS, the DMD at the end of your name, and to them, that makes you the most educated person that they know when it comes to dentistry. What they care about isn't that you're educated. It isn't how much CE you've taken. It isn't how many courses you've gone to or how much you've done to better your practice. They want to come in and they want to know is it clean? Are people nice? Do they respect me?
Yelp tells them that, and that's why they do use Yelp because they're looking at you as a delivery of customer service, not as a clinician. Not as a technician. They're looking at you as any other customer service experience, and it can make or break you.
Howard: Naomi, the problem is ... I get it. I'm a dentist. I would seriously rather pull more wisdom teeth than go to an opera, a play, or play golf. I mean, seriously. There's nothing more fun than pulling 4 wisdom teeth or doing an amazing dental case. How does a dentist know if his or her website is good, mobile friendly? I mean, because if you call the person that built it, I mean, they're not going to say, "Oh, yeah. Thanks for the money, and oh yeah, you're right. It does suck." How does a dentist know if what she bought is any good? Should she get out her iPhone and pull up her website or are there people who can look at your website who are independent? If you go to a convention floor and walk up to a guy who sells websites, they're not going to say, "Oh, yeah. You're fine." They're always going to say, "Oh, you need a new one," so what does that dentist do?
Naomi: Here's what I would say. What I would say is you absolutely need someone who's not a salesperson to take a look at your website. That's one of the reasons I have a job is because dentists come to me and they say, "I need a neutral third party. I need someone who I'm paying for their time and so they don't have a conflicting agenda. They don't have another reason to tell me a different answer from the truth. When I'm on the phone with one of my clients, I'm only beholden to them. I'm not beholden to any other sales agenda. The Yelp guy calls you, and he's going to tell you Yelp's the best way to market your practice. The website person calls you, and a new website is the best way to market your practice. Guess what? When the SEO guy calls you, SEO is suddenly the magic bullet that's going to fix your practice marketing.
Any salesperson has a sales agenda. When I lecture and I talk with ... I have the potential to talk with a hundred people a once ... I always ask all the front desks to raise their hand in the audience. I ask them, "How many sales calls do you get a week that you have to field for your doctor?" The average answer is 20 to 30, 20 to 30 sales calls. I'm not talking about Patterson and Shine reps. I'm talking about marketing services representatives only, 20 to 30 every single week. Different websites, different kind of service providers, and they all have a sales agenda. The best thing that a dentist can possibly do is have a neutral third party, someone who's a marketing consultant who's familiar with the dental industry, whether that's myself, which I do for [Pride 00:18:21] Institute as their chief marketing consultant, or whether it's through any other of the practice management firms, most of which now have marketing divisions.
It's key for you to get someone on your team. I call myself the virtual chief marketing officer for every one of my dental practices for the 1 hour a month that they actually need me. They don't need a highly paid member of the management team of the dental practice in the marketing suite every day of the week. They need me 1 hour a month, and 1 hour a month I can tell them yes this is a good idea, no that's a bad idea. Why don't we think more strategically? Why don't we stop throwing spaghetti against a wall and see what sticks? Why don't we come up with an overall plan, an overall strategy, and overall budget, and then figure out just not the universe of what you could do, but what you should do. The answer is yes, there are ways to measure whether your website is good. I can actually provide you with a website checklist that you can share with your viewers after this is also Google has a tool online.
If you just go to Google and you type in website optimized for mobile, check my website to see if it's optimized for mobile, any combination of those words, there's actually a Google link, which I can also provide to your viewers, that will tell them, "Yes, your website is optimized for mobile" or "No, it's not." It's an on/off switch. it's either optimized for mobile or it's not, and the best person to tell you that is Google themselves.
Howard: Well, to my viewers, what I didn't like about podcasts that I listen to is you'd have to stop the car, get off the treadmill, and write something down. I always do a translation of all that, so that'll be in the notes. All my podcasts ... if you're listening to this on iTunes or whatever ... yeah, on Dentaltown, we'll have the notes, those websites. Naomi, get specific. What is it? She's driving to work. She's going to get to work in 40 minutes. Most of my viewers, they all tell me the same thing. Probably 80%, 85% of them are on an hour commute to work. The ones that do 30 minutes listen to this thing half way, back, back. She gets to work and she wants to talk to the big dog, Naomi. What does that cost? How does that work? If she's getting to work and she wants the lowdown on is my website ... ? If someone wants to talk to you, how does that work and what does that cost for a consultation?
Naomi: Well, the first thing they can do is they can first of all e-mail me. My e-mail is naomic@prideinstitute.com. First of all, they e-mail me. I'm happy to set up a time to talk with them anytime. How Prime works is we're a consulting firm. We work by the hour, so we have an hourly fee. Typically, how I start off, with is commensurate with the hourly fees of all the consulting firms in the industry. How typically I start off with my clients is I like to get to know them a little bit better. Again, just like I said, there's a universal question, but there isn't necessarily a universal answer.
I need to know as much as I can know about the practice before I can actually make recommendations for that practice, so that practice can do the best marketing that they can possibly do for their individual goals, objectives, and situation. Typically, how they start off is with what we call a marketing diagnostic. Marketing diagnostic. It's about $3,000 and provides for us to spend 3 or 4 hours on the phone together, me getting to know you. There's a 20-page questionnaire. I know that sounds scary, but it's mostly multiple choice. A 20-page questionnaire that my clients fill out, and in that 20-page questionnaire, it gives me all the information that I need to know so I can customize recommendations.
At the end of those 3 or 4 hours that we spend together, doctors have an 8-page written plan, essentially a marketing plan for their practice that's customized to their practice and to their needs and to their goals and their objectives and their situation and where they'd like to be 2 years, 3 years, 5 years from now. That's the approach that I like to take, a highly customized approach. Another way is they can come to one of my seminars. They can go to PrideInstitute.com and click on seminars and education and learn about some of the courses that I'm giving in 2016 so they can learn a little bit more, maybe take a little more DYI approach perhaps but at least know what it is that they're getting into and understand a little bit more so that they can know what they don't know. Does that make sense.
Howard: It does. I've always begged you ... I wish you would put out and online CE course. On Dentaltown, we put up 340 one-hour courses and the views are over half a million, so 550,000 views on 325 courses. I'd love to have a course from you, and it would be a form of marketing really because it's really weird. It's [inaudible 00:23:22] podcast or is a multitasking behavior, and online CE is a desktop behavior. What's amazing to me is the podcast people and online CE people, a lot of it's different markets. I mean, most of my friends have never even done a podcast.
Naomi: I would love to, Howard. I actually spoke at the ADA meeting in 2013 and they put my course online. It was very popular. I contributed to one of the chapters to their new book on marketing, which came out this past spring, and I'm going to be speaking again at the ADA this year, which I expect they're going to put online. I'd be thrilled to put one on Dentaltown.com as well.
Howard: We'd love to have you. Naomi, you hear this a lot from consultants. They say that dentists should ask their patients for referrals. The truth of the matter is, the natural selection of dentists, no one gets in unless you get A's in geometry, trig, and physics, and biochemistry. They don't feel comfortable. They feel like I didn't go to school for 8 years to ask you for something and it's unnatural. They want their work to speak for themselves.
What would you say to your dentists. I mean, should a dentist ... like if you were my patient, what should I say to ... We're not talking about a mobile phone ad or a search engine optimization, but I'm talking about the physical, in the flesh. Should a dentist really ask for a referral and how does that work? What does that look like? A lot of dentists also tell me that they think it makes you look desperate.
Naomi: Well, this is what I will say, Howard, is number one, the fish sinks from the head. If you can't ask for referrals, you can't expect your team to ask for referrals. If you can't ask for online reviews, you can't expect your team to ask for online reviews. If you don't ask, you don't receive, so that's number one. Number two, of course, it's not natural. It's a skill. Like any skill, it has to be practiced and perfected. Howard, how long did it take you to prep a crown the first time?
Howard: Three hours.
Naomi: Most doctors say 5, so you're ahead of the curve. Three hours. It took you 3 hours to prep a crown. How long did it take you the 20th time you did it?
Howard: Yeah, an hour.
Naomi: An hour?
Howard: Yeah.
Naomi: Then how long does it take you now?
Speaker 3: [Inaudible 00:25:37]
Naomi: Ten minutes?
Speaker 3: [Inaudible 00:25:40].
Naomi: Four minutes?
Howard: Hang on. My son's asking [crosstalk 00:25:43].
Speaker 4: Could we actually stop the interview for like 1 second? We're getting a little feedback.
Howard: Okay.
Speaker 4: Do you think you're phone's possibly unplugged or you're not using headphones are you? Testing, testing.
Naomi: Yep.
Speaker 4: Okay, we had a little glitch. Sorry about that guys. Go back into the interview.
Howard: Yeah, so now it takes me seriously 5 minutes to prep a tooth for a crown.
Naomi: Five minutes to prep a crown, and how did you get that skill? Did you get it by just osmosing the information from your professor or did you have to practice? You had to practice is the answer. The more your practice ... that's why we call it dental practice. Right? The more you practice, the more you get up your speed. The more you get up your skill. Verbal skills are muscle memory. If you had to prep a crown ... You're right-handed, right, Howard?
Howard: Right, right.
Naomi: If you had to prep a crown with your left hand with all the knowledge in your head, how long would it take you? You wouldn't be able to do it?
Howard: Three hours. Right. It would be horrible.
Naomi: Three hours. It's muscle memory. It's all muscle memory, and verbal skills are no different from clinical skills in that way. In other ways, they're very different, but in that way, they're absolutely no different, so my answer would be that it's absolutely essential for any doctor to learn how to ask for referrals. There are very, very, very specific ways to do it in terms of asking for referrals. At Pride, we call it [AFRs 00:27:05]. Asking for reviews are virtually the exact same verbal skill. It's actually really simple. It starts with one thing. Actually, I'm going to have to pause now. I'm sorry.
Howard: That's all right.
Naomi: Hold on one sec. My gardener is here and about to make a lot of noise. Hold on.
Speaker 4: Testing, testing. We're getting a little bit of feedback [inaudible 00:27:34].
Howard: Well, it's the Internet.
Speaker 4: Well, it's coming out of hers and back into ours, so I just wanted to make sure about ... but it's not doing it anymore.
Naomi: Sorry about that.
Howard: That's all right.
Naomi: Started with the leaf blower. The reality is that ... where were we?
Howard: How do you actually ask for a referral or an online review? I mean, help this dentist geek, introvert, scientist, engineer.
Naomi: [Crosstalk 00:28:07].
Howard: I'm looking if you were the patient. I mean, you would totally intimidate the patient. You're a gorgeous lady and he just wants to do a great root canal and now he's trying to ask you for a referral. I mean, it's just totally unnatural. They're probably rather go ...
Naomi: It is unnatural, so here's the thing. The first step is getting over yourself, getting over your ego, and just deciding that you're going to suck at this for a little while, and that's okay. Just like you sucked at prepping crowns for a little while, but you had to get through the second part to get to the good part. Am I right, Howard?
Howard: Right.
Naomi: Accept that you're going to suck at it for a little while and be okay with that. You know what this is great for is being humble. Humility is a really beautiful thing that your patients can really relate to, and if you've ever had a time when you snapped at your assistant and then you apologized for it in front of the patient. "Oh, I'm sorry. I didn't mean to be curt with you." Then the patient looks and says, "Wow, what a wonderful guy, that he's even apologizing to his team member in front of me." It's the same thing. If you stumble over your own tongue, there's nothing wrong with that. There's nothing to be embarrassed about. In fact, it humanizes you to your patient. It might make them like you even more. That's number one.
Number two is it's a very specific set of skills that you have to learn, just like if there's a procedure I don't know for preparing a crown, and there's a certain number of tasks and a checklist that you go through, I'm sure. It's the same for asking for referrals. You just don't have that secret checklist yet. It starts very simply whether it's asking for referrals or whether it's asking for an online review. It's the exact same checklist. The only difference is, in my mind, is this a patient who has a smartphone glued to the palm of their hand throughout their entire appointment? I know you have patients like this, Howard. They're texting. They're Facebooking. They're checking in. They're doing all these things like this while they're in the chair. Am I right? If you have a patient like that, you know this is a person you're going to ask for an online review.
If you have a person who's phone does not come out of their pocket or their purse the entire appointment, it's much more likely that asking them for a referral is going to be the right path. You decide tech savvy, not as tech savvy. You start off the path with that. Then it's virtually the same all the way through the process. It starts off very simply. How you start off is you fish for a compliment. It's really easy. Just get them to say something nice to you about yourself. "How was your visit today? How did that go? How are you feeling?" Any sort of open-ended question that gets them to respond and do it with a big smile on your face, right? If you do it with a big smile on your face, they're much more likely to emphatically smile back. It's natural human psychology. You smile; they smile. Right?
They're mirroring you. Big smile. "How was everything today?" Right? The patient is going to say, "Dr. Farran, you guys just knocked it out of the park once again. What can I say? I thought that was going to be really painful, and all I can say is I barely even felt it. You give a great shot" or whatever it is that they're going to say. You're going to say, "Oh, my God. I need to write down what you just said because it's so brilliant. Hold on. Let me go run and get a pen and a piece of paper. Okay, I'm back. Okay, now what is it that you were saying? Hold on. Let me write this down because what you said patient Naomi was so brilliant I have to write it down here. I want to share it with the whole team. Wait, one more time. What was that that you said? I just want to make sure I capture it." No matter what they said, no matter how benign or how inane it was, it's the most brilliant thing you've ever heard in your life. Okay?
Now you're writing it down. You're taking notes, and by the way, you're going to correct all of the capitalization and punctuation and grammar to make sure that what you're writing down is perfect. Right? That when it gets captured and used as an online review, it's perfect in writing and your patients look smarter than they really are. Right? You're going to write it down and then you're going to write an e-mail to the patient. You're going to just say, "First of all, thank you so much for this amazing compliment. I want to share it with the entire team. First of all, I want you to know that we do this on purpose." You don't have to use that exact language, but essentially the message is it's our goal to provide exactly that kind of care to every single one of our patients.
"We would actually want you to know that we're actually accepting new patients. By the way, our friends the MDs have done us no favors. They have made all of our patients believe that every medical practice is full, and patients assume the same thing about us." You have to tell them, "We are accepting new patients, and we would love more patients just like you. If you have any friends or family that you know would appreciate the kind of care that you've received in our practice, it would be the highest compliment you could possibly pay us to shout this from the rooftops. What I just wrote down I'm going to share with the whole team, and I want to make sure everyone on the team sees it, but maybe more importantly, I'm going to cc you on that e-mail, Mr. Patient or Mrs. Patient. What I'd love to do is I'm going to put a link to our Yelp profile and a link to our Google profile at the bottom on that e-mail. Would you mind cutting and pasting your own words into your Yelp or Google profile?"
You know if they have a Google profile, if they have a Gmail account, it's pretty simple. You have it in your practice management software. "I would love it if you would cut and past it because so many patients have no idea that this is the kind of care that we provide here. Our patients know, but the people who aren't yet our patients don't know. We'd love it if you would share that perspective with them." That's not begging. That's not sounding desperate. That's sounding complementary. That's sounding interpersonal, and by the way, it will sound terrible the first 20 times you do it. It won't sound right. You'll trip over your tongue. You'll be embarrassed. Then there's an opportunity for humility, right, and an opportunity to humanize yourself with the patient and say, "Look, I'm really not good as asking for this. Right? Bear with me, but it would really mean a lot to me."
Just the words "it would really mean a lot to me" alone have a huge effect on people. You still might only have 1 in 20 people that you ask actually write a review, and that's okay. You don't want 20 reviews a month. You want 1. You want 1 every month for the next 24 months. I call the first 10 positive online reviews prophylactic reviews. They are protective measures against the crazy person. I know, Howard, you probably don't have many crazy patients, but a lot of my clients do. It just takes 1 crazy having 1 bad day to shout it from the rooftops and write that 1 negative review. If you have 10 positive reviews, guess what happens when someone reads that review from the crazy patient? They just say, "Oh, there's the crazy person. There's one in every bunch," and then suddenly, that negative review means nothing.
My answer to why you need positive reviews is you need to inoculate yourself against the potential for a negative review. If you don't have one yet, congratulations, and keep your fingers crossed. If you do have one, all you've got to do is get 10 positive ones to drown out that noise. By the way, if the person doesn't have a smartphone in their hand, it's the exact same set of verbal skills. Fish for the compliment. "How was your visit today?" The patient says, "Oh, it was amazing." You say, "Oh, my God. Thank you so much. We do that on purpose. It's our intention to provide that kind of care to every single person that comes in here, and we would love to have more patients like you. In fact, we are accepting new patients. If by any chance you know anyone you think would appreciate this kind of care, please have them call me personally.
That's a really important part. Please have them call and ask for me personally and tell me that you sent them. This is the kind of thing that doesn't sound like begging. It sounds like caring.
Howard: Yeah, we had a lady call up trying to get in the office, tied up my receptionist for an hour. The best one I have, the sweetest lady in the world, and since we didn't meet all of her crazy getting her in now, getting the cleaning now, no [inaudible 00:36:31], then she dropped us a bad online review. It was insane. It was insane. There are absolutely crazy people. In fact, the older I get, at 53, I'm at the point where I actually think I'm the only normal person on earth.
Naomi: You mean [inaudible 00:36:47], right Howard?
Howard: What's that?
Naomi: You mean 43?
Howard: No, no, no. Do you still in your mind ... let's [discuss marketing 00:36:57]. Do you still break it up into internal marketing, external marketing, and is asking a patient for a referral, you call that internal marketing? Or is that kind of a passe division of marketing? What is the whole marketing checklist? What should a dentist be thinking about?
Naomi: What I try to think about is yes, absolutely, there still is internal and there still is external marketing, but beyond that, I try to break it down when it comes to external because internal marketing, it used to be there were only two things to do [inaudible 00:37:32] internal marketing asking for referrals and getting them, right, and external marketing, which was Yellow Pages or 1-800-DENTIST. That was pretty much it or maybe direct mail, right? There weren't a lot of choices. The difference is now internal marketing is a really small piece of the pie. When I first started consulting with practices individually, and this was 6 years ago when I left 1-800-DENTIST, most of the practices I talked to were still getting 80% of their new patients from word of mouth. Today, that's not true. Today, it's at best 50/50 in most practices.
If you're doing better than 50/50, you area lucky, lucky dentist. Today, you have to have many, many more tools in your toolkit, so what I try to look at beyond internal versus external, internal is still the most important kind of marketing you can do. Number one, it's free, right? Number two, it's low-hanging fruit. Finally, the best patients are the ones that come by way of word of mouth. Absolutely. However, it's not enough anymore, and so what's really important I find is I like to think of whether a marketing medium, whether a marketing campaign is I call it my T3 Theory, right? Is it timely? Right? In other words, is it hitting people when they're looking for a dentist? Right? Is it targeted? Targeted, by that I mean is it going to people in the right neighborhood. Right? Is is trackable? Trackable meaning do you know whether it worked or not?
That's the biggest problem in marketing historically in my view is that [inaudible 00:39:20] money into the wind and crossing your fingers and praying that it would work, right? Does your Yellow Pages ad work? I could ask any dentist 20 years, and they would say, "Well, I think so. That's why I'm spending $2,000 a month on it." Right? They believed that hopefully it was working. They had no way to know whether it was working unless they were actually using tracking phone numbers, which a very small minority of dentists really do. They might be doing radio or TV ads. How do they know whether those things are working? There's an old story at 1-800-DENTIST. We used to ask people when they called, "How did you hear about us?" It's kind of a funny question to ask because actually if you ask any marketing professor they will tell you that self-reporting is one of the least reliable methods of tracking.
You ask someone how they heard about you, they're almost never going to give you the real answer because they themselves don't know the real answer or don't remember the real answer. We would ask people, "How did you hear about 1-800-DENTIST?" They'll say, "Oh, I saw you on ABC." "Oh, really? What show?" "Oprah." Literally, everyone said Oprah. It didn't matter if we had never run on Oprah in their market ever in the history of 1-800-DENTIST, they would still say Oprah because that was how they remembered it. That was how their memory brought it up. The reality is that even if you're asking how did you hear about us, it doesn't mean that you're getting a reliable tracking method.
The beautiful thing about online marketing, the beautiful thing about any kind of virtual or digital marketing is that you have a footprint. You have the ability to track. You have the ability to know where patients are coming from. You have what we call breadcrumbs in marketing [inaudible 00:41:01], and you can tell where those breadcrumbs led from. That gives you evidence and it lets you decide we should put more money towards this effort or less money toward that effort rather than crossing your fingers and praying.
Howard: Well, you want to say that you saw it on Oprah because then people think you're smart and you're in Oprah's Book Club because if you just say, "I heard it on the Jerry Springer Show," people just don't think you're right in the head, but you said the Yellow Page ad was $2,000 a month, which brings up the question, "How much should a dental office be spending?" Is there any trackable data like what percent of a dental office collection goes to marketing, tracks with dentists that have million-dollar practices versus $500,000 practices? I mean, what do you think the best practices spend on marketing?
Naomi: Sure. Well, back in the day, they used to say 3% of gross. That was the old number that I used to always hear 15 years ago, even 10 years ago. Now, because there's so much more noise in the marketplace, we're competing with group practices. We're competing with corporate dentistry. Many, many of my clients tell me there's one of these new corporate chains coming into the area that I suddenly need to compete with. We need to get a little more aggressive than that, so 3% used to be the number. The other thing is that 3% was the number before we needed to keep up with all this digital technology. Right? Here's what I would say. I would say the average is 5%. I would say it vastly depends ... it can range. It really depends on first of all how big of a practice do you have.
If you have a practice that's grossing 600 versus a practice that's grossing 6 million, it may not be a flat 5% across, but I would say for the average practice doing about a million dollars gross per year, we should definitely say about 5%. However, that's in a regular year. Now in marketing just like in football we have these things called building years. The 49ers this year. That's my team. They're in what we call a building year, right?
Howard: Yes, it's the best news I've heard all year. I'm an Arizona Cardinals fan. I don't like the Seahawks or the 49ers, but continue. I try to look past that with you, Naomi. I try not to think of you as a 49ers fan.
Naomi: I appreciate that.
Howard: I try to think of you as a closet Cardinals fan, but continue.
Naomi: In a building year, you're investing in infrastructure. In a building year, you're investing in championships you're going to win down the road or patients you're going to win down the road. In a building year in marketing, we're building infrastructure too. We're building a website. We might have a one-time expense that's associated with building that website. We might have a one-time expense associated with rebranding the practice. We might have other one-time expenses that come up in a building year. In a building year, it could be up to 7% of gross, so I like to think of the range is anywhere from 3% to 7%; 3% if you have very, very simple marketing objectives. You want 5 or 7 new patients a month more than what you have right now. You can probably get away with 3%. Five percent you're looking to significantly impact your new patient flow, and 7% you're significantly looking to impact your new patient flow and you're in a building year.
Howard: Okay, well, Naomi, here's a problem that you and I both have is when you tell a dentist to spend 5% of their collections on marketing, they all whine and waffle and all that stuff. Then a PPO plan sends them a fee schedule that's like a 30% reduction across all their fees across the board, and they don't even blink and they sign them. I'm like, "Dude, why do you not even blink for a 30% pay cut, and then when someone says spend 5% on getting patients, and you waffle?" What is wrong in their thinking that they'll do that?
Naomi: It is an excellent question, Howard. The bigger question is the 5% is one time. That's a one-time marketing expense. The 30% in perpetuity. It's forever you give that discount on that patient. I don't know. All I can say is that, again, our friends the MDs have done us no favors in this regard. They have created an entitlement, and insurance mindset among patients, and unfortunately to some degree luckily for our industry not to a great degree but to some degree, and again, depending on socioeconomics and depending on geography, our patients do have an insurance mindset. They do have an entitlement mindset where they believe ... and it's because we haven't taught them that we are not Mds. My old boss, Fred Joyle has a great saying, and he says, "When you think what to do in a dental practice, do exactly what a doctor would do and then do the exact opposite. The exact opposite."
Whatever a doctor would do and do the exact opposite. We need to educate our patients that dental insurance is not comprehensive, that it's not catastrophic, that is is essentially a defined benefit plan for a very small number of preventive and restorative procedures, and they're going to be really lucky if it covers anything at all and that you accept it as a form of payment but that you do not accept it as payment in full. That is a very different mindset, and I guarantee that if you're at 90% of the fee schedule for your area, the average fee schedule for your area and you're not having 50% to 70% of your patients on insurance, you can afford to spend 5% of gross. You can afford to 7% of gross. [Crosstalk 00:46:38].
Howard: Naomi, I want you to talk to these young kids that have just come out of school because what they're asking on Dentaltown is, "Okay, I got out of school. I've been out for 5 years. I've only got so much time and money to resources. What's the hottest thing I should spend on? Should I market and become an implant dentist a cosmetic dentist? Everybody selling a [Cad Cam 00:47:01] machine says that the market wants a same-day crown. Some people say that moms make all the appointments and they only care about their kids. They don't care about their dad and grandpa. Some say women make all the appointments and women have 3 or 4 times as many headaches as men. They should be TMJ, TMD. If there's a young kid out there that says, "I can't be every kind of dentist out there, but, is there any types of practices in marketing that's hotter, low-hanging fruit more than others or ... ?"
Naomi: I would say all of the ones that you just said, that you described are all hot. Also, short-term ortho is another one that's really hot, but Cad Cam, short-term ortho, laser dentistry, something that is patient focused, patient-centric dentistry. What it is that people want. I would say add as many things as you possibly can. Sleep dentistry, sleep medicine, appliances, implants. Whatever it is that your patients are asking for. Howard, I heard this from you once. I remember a long time ago when you were lecturing about cosmetic dentistry, and you said what you did when people started asking for whitening and your front desk asked you, "Should we offer whitening?" and you blew her off. You were like, "That's bull crap. I don't want to offer whitening. Who's going to do that?" You told her to start ticking off hash marks every time someone asks for whitening, and the first month it was one. You were like, "Well, I can dismiss the one crazy."
The second month, it was two. You're like, "Well, not statistically significant. The third month, it was 5, and the fourth month it was 8. Suddenly, you could see what it was that people were asking for, so I would say the most important thing is to listen to what your patients are asking for and offer more of that. Look at what your competitors are offering and offer more of that. The more CE that you can get to offer things that patients want, to offer comfort-conscious and patient-centric dentistry, things that will respect patients' dollars and respect patients' time and respect patients' threshold of pain. Anything that you can do to reach all of those sort of objectives are going to be the things that help to grow your practice.
Howard: What I did that was really hot is I combined sleep dentistry with children's dentistry and now I advertise, "I'll put your kid to sleep. Never deal with them again. Just drop them off in my office. We'll put them to sleep." I'm just kidding. Hey, Naomi, a lot of these young kids because they're a huge devourer of these podcasts, they're not like us where we knew knew Jim Pride. Jim Pride, I saw that guys lecture in 1987. He was a legend. By the way, when I think of Jim Pride ... this is how funny my brain works ... half of his conversation would be about dentistry awesome information, and the other half would be about ... He actually grew his own grapes and was into making wine. The guy he only had two subjects.
It was building a great dental practice or making great wine, and I remember [inaudible 00:50:15] with him like I could smell raisins or this or that and I was born in a barn in Kansas. Anyway, tell them ... a lot of these young kids ... how many years ago did he pass away?
Naomi: I believe it was about 10 years ago.
Howard: Yeah, so anybody that came out of school in the last 10 years and never met him, tell them about who Jim Pride is and the Pride Institute and why you decided to work there and what they're all about.
Naomi: I work with the Pride Institute actually. I have my own company, as you know, Minoa Marketing, but Pride reached out to me actually when I left 1-800-DENTIST and they ...
Howard: The e-mail address you gave was NaomiC@ ... you said Pride Marketing.
Naomi: Yes, I do have a Pride e-mail. Most of the work that I do with doctors, all of the work that I do with doctors is through Pride. I also serve as an advisor for dental companies, dental companies that don't have a chief marketing officer or VP of marketing. In that capacity, I work at Minoa Marketing, but I do work very closely with Pride and all of the work that I do directly with doctors is trough Pride Institute. Pride, as you've mentioned, has been around for decades and decades. It's one of the most highly respected practice management organizations in dentistry. Pride developed the curriculum at the University of the Pacific, the dental practice management curriculum at UOP. It is well known. Anyone who graduated from UOP in the last 20 or 30 years went through Pride's curriculum, and Pride actually had its curriculum spread through over a dozen dental schools throughout the country.
Then as you said, Lehman happened and all of the dental schools cut their practice management curriculum from all of their curricula. In the last few years, you've started to see practice management creep back into the curriculum in dental school, but most dentists graduate from dental school with virtually no business training whatsoever. Maybe one business course, maybe. Definitely pretty unlikely that they've ever had a marketing course. What Pride does is it essentially offers that graduate-level business training. They have something called the "master track," which is essentially like a 2-year MBA for dentists who don't feel like actually going to business school. It's done on a continuum basis on the weekends. The Pride team comes to you, and the doctor comes to Pride's headquarters in California.
They're about an hour outside Napa Valley, so a very, very pleasant place to come visit, and we teach dentists how to run a business. We teach dentists which numbers to pay attention to, which ones matter, how to manage their team, how to exhibit the leadership qualities that you need in order to be able to lead a team successfully. Again, these are not things that we learn. We learn how to be a technician in dental school. We don't learn how to be the manager of the practice. We don't learn how to be the HR department. We don't learn how to be the CEO or how to be the CFO, and so knowing how to look at ... let alone the vice president of marketing. Learning how to look at your practice and to wear all of those different hats as the owner of the practice and not just the chief technical officer hat is a skill just like prepping that crown, just like asking for a referral or an online review.
It's something that has to be taught and something that has to be practiced. That's what Pride Institute is famous for. When they approached me after I left 1-800-DENTIST and said, "Look, we'd love to bring this kind of marketing expertise to all of our clients," this was 2008. It was right around that time. It was actually 2009, and they were clamoring for how can we deal with this new marketing landscape? There are way too many choices now, and we don't know how to pick what we should do from what we could do. That's why Pride brought me in, so that's why I teach my marketing course with Pride. We teach it 4 to 6 times around the year around the country throughout the year. I also lecture at major dental conventions around the country including ADA coming up this fall, and I'd love to do an online CE course with you, Howard, as you suggested.
Howard: Hey, I got 5 more minutes with you, and I'm not going to let you go to exactly 60 because I'm just honored to have you on there. I want to talk about something that's a little more delicate for me to talk about since I'm a man, but you were named one of the 25 most top women dentist in dentistry, and I couldn't agree more. You probably would have made the list of just the top 5. When I was a freshmen in dental school, the senior class had one woman. Now the classes are 45% women. Being a man who's 53, I don't know if there's any difference in women ... Are there any issues of being a woman dentist versus a man dentist? Are there any woman's issues that you can think of or what to talk about to the women dentists here.
I mean, I always tell my editorial team every time I review Dentaltown, the most sensitive I am to my own magazine, I say, "I don't want an dentist to always be a man. I want more articles by women dentists. They need role models." It's tough to be a young woman looking for older women role models because there hardly were any. I mean, like I say, there used to be almost none, so is there anything you'd like to say to the young women dentists out there?
Naomi: Absolutely. First of all, I think the number is closer to 55% of dental school grads today are female. It's over 50%. It's easier for me to talk about this as a woman, so I'll take that load off of your back, Howard, but it is very sensitive because not every woman is the same. Women are as diverse a population as men. There are women who want to have families in their 20s shortly after graduating from dental school, and that takes them down a different path. There are women who want to forgo having children into their mid-30s and they built a practice. There are women who don't want to have children at all and who never do and decide to take a third path, but certainly whether a female dentist chooses to work the typical schedule that the classic male dentist worked for 30 years, 4 days a week, all day every day from 8 a.m. until 6 p.m. or whatever the hours were, dentists certainly enjoy a comfortable work-life balance for the most part, but there are long days and they are draining days. I think women have a lot more options. They have a lot more choices.
Studies show that females with graduate degrees are very likely to be married to males with graduate degrees. The women I know coming out of dental school that I've met coming out of dental school are often married to other dentists or engaged to other dentists, so I'm seeing a lot of husband-wife practices come up. I'm seeing a lot of sibling practices come up. I'm seeing a lot of daughters joining their fathers in practice, so again, no different from men, women are a very diverse population. Some of the things that do affect some women are their desire to have children, their desire to work for as many years, their need to provide for their family. Some male dentists when the whole burden is on your back to provide for your family because you're the sole breadwinner, there's a lot of motivation there. When you're a female dentists who's already married to a male dentist and there's two breadwinners, the pressure is not as great.
I'm finding that some female dentists are using dentistry as a very flexible career. The ability to come and out of it before children, after children, to work 2 days a week if they feel like it, to work 3 days a week if they feel like it, to work 4 days a week if they feel like it depending on where they are at every stage of their career. I think what's great about dentistry and one of the reasons why it's ranked one of the top professions to go into every year by U.S. News and World Report and all the other publications that come up with these kinds of lists is because of not only the high level of compensation but the high level of autonomy and the flexibility that it offers to women. I see dentistry as an amazing career for a woman whether she wants to make it a 40- or 50-hour a week job or whether she wants to make it a 20-hour a week job.
I also think that corporate dentistry is gaining from this demographic shift because I think there are more dentists out there who want to be part-time employees, and I think that the corporates are really taking advantage of this demographic shift and hiring women. Women can also be much more gentle in some ways, and they do have smaller hands than men generally speaking, so women are seen as caregivers. They're seen as providers. They're not seen as being as harsh. They're not feared as much. They're not as imposing, so I think it can do a lot to take these sort of [Steve Martin 00:59:31] stereotypes if you want to call them out of our profession. This is probably a subject we could have a whole podcast just about this. I think, Howard, it would actually be a great thing for us to do a panel of women in dentistry and talk about these issues as a podcast.
I think a Google Hangout style podcast would be amazing. I could go on about it for hours, and I see it manifesting in any number of ways, positive, neutral, negative. It's going to change the face of our industry.
Howard: Well, Ryan, how many can we have on at one time? Three?
Speaker 4: Yep. [inaudible 01:00:05] four way [inaudible 01:00:08].
Howard: Yeah, I can do one with three others. You get me two others, my God, I'm on it.
Naomi: [Crosstalk 01:00:15].
Howard: Naomi, when dentists tell you that they want to ... when women dentists tell you that they want to have four kids like me, do you recommend electric shock therapy or just a full frontal lobotomy?
Naomi: I think that's a personal decision.
Howard: It's a personal decision. Okay, well, we are out of time, and Naomi, seriously, man, I think you're a rock star. I think you're a genius. I've known you forever, and it's just a huge honor that would you come on the show today for ah hour. If you want to come back and do a podcast on just women dentistry, I would love it. It would be an honor, and all of our viewers are hoping that we get to see an online CE course from you one day because marketing is a totally different beast when I got out of school in '87 because it was true. All you had to do is ... I was one of the earliest 1-800-DENTIST clients. If you had full-page ad in the Yellow Pages, signed up for 1-800-DENTIST, you could get a hundred new patients a month. Those days are gone.
Naomi: Yeah. [Crosstalk 01:01:14].
Howard: Thank you for your time, Naomi, and have a rocking hot weekend. Okay?
Naomi: Thank you.
Howard: I hope the 49ers just get crushed.
Naomi: Thanks so much. Bye.