Howard: It is just a huge honor for me today to be podcast interviewing Scott Hansen who is the founder and CEO of DentistChats, the world's leading professionally managed chat services for dental practice websites. The business serves clients in hundreds of markets worldwide, and since its founding in 2016, the DentistChats team has handled more than one hundred and twenty thousand online chats. In addition, he manages an INC 5000 orthodontic practice in Kansas City, which has been recognized one of the fastest growing privately held businesses in the U.S. for two consecutive years. While achieving his Master's in business administration at the University of Missouri Kansas City, he was awarded a certificate of achievement for his entrepreneurial work from the Ringer Institute for Entrepreneurship and Innovation. Thank you so much for coming on the show today. How are you doing?
Scott: Oh it's my pleasure. I'm great. Thanks so much for having me.
Howard: So did you start [00:00:58] that [0.3] You're the founder, so you started that in 2016. And one of the things I'm always saying on my website or on my podcast is that, I talk about the funnel. It's like, how many people have to land on your website before one person converts to call? How many people have to call your office before your receptionist converts one to come in? How many people have to come in with a cavity before you can convert one to treatment. And the dentists want to think that all their problems are something else. It's the economy or it's whatever. But I look at that funnel, and it's like, the fastest way to double a practice is to tighten that funnel. So do you have any data? How many patients do you think have to land on a website before someone calls a dental office, and what could DentistChats do to help that conversion?
Scott: Yeah, so our data really depends on the practice, first of all. So, some practices and some websites are really great at converting those patients and others aren't. But about 5% is the average. But we were struggling with the exact same thing with our practice and so, just like you mentioned, I managed my mom's orthodontic practice here in Kansas City for... well see, it's been just over five years and...
Howard: And we were classmates back in the day.
Scott: Yes, yes at UMKC, so I guess we all have UMKC in common.
Howard: That is awesome. Tell your mother hello.
Howard: 300 orthodontists?
Scott: And dentists, yes.
Howard: And would --
Scott: I should say practices, so a lot more dentists and orthodontists than that, but three hundred practices.
Howard: And what percent is general dentist and what percent is orthodontists?
Scott: It's a smaller percent of general dentists just because we got traction first in orthodontics, but I'd say probably about 10% are general dentists at this point. But like I said, it's just... we've started to... we've started to get better branding in the general dental market. But it's a similar return on investment. A dental patient and ortho patient, they should return about the same per lead. But dentists -- It just takes a little bit longer to realize that revenue.
Howard: Right. What orthodontists gets from a new patient is [00:07:04] really [0.4] about $6,500 realized in two years. And a general dentists gets the same amount but it takes five years.
Howard: Is that about the number you like, sixty five hundred?
Scott: I mean, I use fifty five hundred. I try to be conservative but.
Howard: Well no... You're in Kansas and that's a lot lower cost than San Fran or Manhattan.
Scott: Yes that's very true.
Howard: I'd say it's... the United States of America is the worst economic term. No one ever talks about EU data because you wouldn't compare Germany to Greece.
Howard: In America, you compare Alabama to Manhattan and Alaska to L.A. and it's a huge country with a huge variance. So [00:07:41] let's stir up [0.6] how does a dentist listening to you get to work and do some homework and find out what his current web conversion rate is? How would he know how many people are hitting, calling...?
Scott: That is honestly a really tough number to track without some more tool, but the way we did it at a very basic level is we took, How many unique visitors are coming to our website, and how many exams are we scheduling?" So we track when we have the exams, we track where the referral source is, but you know that it's really difficult. When you're asking your patients what their referral source is, they might say Google but it really was their friend's mom or someone else who provided the referral. And so, it's really tough, so unless you have call tracking and other things to figure that out, it's really difficult. So the way we did it, I didn't spend a whole lot of money honestly trying to figure exactly what the number was. I just said, "OK, how many exams are we scheduling and how many unique visitors do we have coming for our website, and is the percentage getting better or worse?"
Howard: Nice. And how much does DentistChats cost?
Scott: So it's $699 to get started, and that covers everything from designing the software to the scripting that we develop for the practice. We put together a really robust profile for each practice so when we have an incoming chat for a particular provider, the conversation looks a lot different than if we were taking it for another provider and it's because of those profiles. Additionally, it covers a calibration period, so over the first partial month, we launch the accounts on the 10th of the month and we chat all the way through the end of the month. And that's what gives us an idea of how much volume as far as the number of chats and how long they're taking and all of that, and that's how we set a flat monthly price. So, the flat monthly price varies quite a bit because we chat for some startup practices and we chat for some practices with twenty or thirty doctors and so it ranges from $100 a month to thousands per month, but the average is $350 a month, so about the average size practice should expect to spend around $350 a month.
Howard: Just to play Devil's Advocate with you.
Scott: Sure, go for it.
Howard: I always assume... now, I'm 55. I always assume that the chat box is a robot. I mean, wouldn't most consumers -- Is it automated? Is it robot, or are you using live humans, and how do you differentiate artificial intelligent robotic answers versus human chat feature?
Scott: Yeah that's a really great question because if the responses are robotic, you can tell, and that devalues the whole conversation. It's not a conversation. I mean, you're talking to a robot, but that's a really big differentiator for us. So, the reason why a lot of people, I think, imagine that they're talking to a robot is because the vast majority of online chat is outsourced to the Philippines or to India or to Pakistan. And so, those conversations necessarily have to be robotic because those people are speaking in English, which is a second language to them and so, it's very formulaic for them. And so, I would say the majority of conversations that you have with people online via chat or with a real person just seems very robotic because instead of them... We're hiring critical thinkers. They all work in the office here in Kansas City. And so, that's really the thing that sets us apart. I'm training these people and they do a really excellent job of building the value and connecting with the visitors on these websites, and that's really what produces a greater quantity of leads for the practice and a higher conversion when those people show up because we're focused on making that practice not only look awesome to the patient but feel awesome to the patient.
Howard: So you said it's a $699 startup fee, then how much is it per month?
Scott: It's different for each practice and it's based upon the volume of chats and how long they take. There's a number of variables, but on average, it's $350 a month for a typical practice. It's like $363 or something like that, if you average it across the board. So, if you took the average-sized practice, you should expect to spend around $350 a month.
Howard: Say the average dental website has a 5% conversion rate, which is one in twenty. What do you think the average dental office conversion rate goes up by adding DentistChats?
Scott: Yeah, that's a great question. It's impossible to nail down exactly, so I certainly don't want to misrepresent these numbers at all, so it's important to remember that some of these people would have called us otherwise and it's impossible to know exactly what that would be. But, generally speaking, we chat with about 4.6% of the visitors coming to the site. So, we're engaging a lot more people. If 5% without chat and then we add 4.6%, some of those people would have taken action otherwise, but certainly we're capturing a fair percentage of people that would have done nothing and left because patients -- they all have the same kind of questions. "Do you take my insurance? How much does it cost?" So, we're engaging people where they're at. But 4.6% of the people we chat with and then 20 -- I pulled stats from August, so these are all August statistics -- and then 26.8% of those people we turn into new patients. Like, we're were chatting with new patient and collect their information. So overall, just over 1% of the patients -- or, I'm sorry, 1% of the visitors to your website, we turn into new patient information that's actionable.
Howard: That is phenomenal. Is there any demographic to a person who responds to chat, or are they more likely to be a Millennial or Generation Xer, or any type of human more likely to chat?
Scott: We haven't done any in-depth studies ourselves, but we do chat for some practices that specialize in serving older demographic and the chat numbers are very similar for those practices, so I'm sure that we're chatting with people from all different demographics. The key is that we're reaching out to them, so we're not waiting on them to click a button. We have a very tactful greeting when someone visits the site after about 20 or 30 seconds when someone's on the site, and we're offering help.
Howard: When dentists send me an e-mail, if they got their website in their signature, I click it. You want to know who you're talking to. Oh my God, I mean, websites is the worst part of a dentists. I mean, there there usually is [00:14:29] a collision course [1.1] learning in advanced dental surgical techniques and their website looks like it was bought five to ten years ago. A lot of people even have a stock photo. I'm like, "Dude, how ugly are you if you can't even have a picture of yourself on your website? I mean, have you not heard of Photoshop?" What do you think are the biggest problems plaguing most dental practice websites?
Scott: I think the biggest problem is -- and there's tons of problems, obviously. Like you mentioned, the content is a big problem on most websites. Most websites, it's a very feature-heavy and not benefit-heavy content. It's not written with a clear understanding of who the target buyer is. But I really think that the biggest problem for most business websites -- not just dental websites but most business websites, but we're running a dental business -- is that they're not primarily focused on creating action from the visitor. If we have a million people come to our website, it means absolutely nothing unless we're turning that into actionable stuff for a practice. People that we can call and get appointments scheduled.
Howard: I mean, how many times have you heard someone say, especially in denistry, "Yeah, I got a million hits on my website." OK, well, buy me a cup of coffee at the Waffle House with a million hits on your website. Were you able to transfer any of that into coin? And you're saying that transfer hits to coin, you should have more actionable features, meaning like "Call this number," or "If you're worried about..." What do you think are the top actionable features?
Scott: Absolutely, that's one way to do it. So, at its base, you want to have good benefit-heavy content. You want to be writing in terms of what the patient wants to hear and what they care about, not what cool bells and whistles your fancy technology in your office has. And the calls to action -- and I'm sure that your audience have a really good idea of what I'm talking about -- but "Click here to schedule now..." There aren't very many websites that have really clear calls to action and make it really clear to the patient how to take the next step. But for chat, we're taking that one step further, so instead of sitting around waiting for them to take action, whether it's to click a button or to call our practice, we're starting the conversation with them proactively. I thought about it like this, and this is ultimately why I started to jump on the chat bandwagon last year and why this whole business existed. I thought, OK, if I had a thousand people -- which at the time our website had about a thousand visitors -- if I had a thousand people walk straight by my front desk and our appointment coordinator didn't stop them and say, "Hey, how can I help you?" I would fire her so fast. But, I allow people to jump on our website and then leave without any interaction from our practice, and, that's ultimately our fault. I was like, "This is my fault. I can fix this on our website and I can create an engaging way -- an engaging digital experience for the people who are interested in our practice.
Howard: Congratulations on getting your MBA. It was a game changer for me. I got mine in '98. Just a game-changer. But one of our teachers was Robert Cianaldi, Ph.D, who wrote the national best-seller "Influence." And he used to talk about the way the human mind works. I mean, there's tons of data on direct mail pieces. One says the phone number and one says "Call now," but when you tell a human, an animal, to do something... I mean, dentists do it all day long. They say to their patient, "OK, tilt your head back." They just tilt it back. They don't sit there and think about, "Well, why are you asking me to tilt my head back?" They don't even think. You just say, "Tilt your head back." Boom. I mean, look at these infomercials. "Call now, call now." You tell them to call. "If you're afraid of how much this will cost, call Valerie now at bling-bling-bling-bling-bling." "If you have fear of the dentistry, please call now and talk to a doctor." You tell them to call, they do it. And, I was wondering, are all your clients in the United States, pretty much?
Scott: We have a few clients outside the United States. We have a fair number in Canada. I think we have two or three prac--.
Howard: Well, Canada is just another state. I was just there. Do you realize Canada and California, they're the same everything. Same number of people, same number of dentists. That's just California 2.0. But did you know if you raised the North American border one hundred miles, you'd pick up pretty much 90% of all the people in Canada?
Howard: Yeah, they pretty much all live within 100 miles [00:19:15] [inaudible]. [0.3] But the point I was getting at of that population, what are the hours of website chatting activity? I mean, when is a website getting hit on?When are people looking at dental websites? What hours do you have to cover for your chatting?
Scott: Yeah. So we cover 24 hours a day. And like, even today on Labor Day, we're chatting for all of our clients, and so the coverage is important to us. We stop answering phone at 5 o'clock on Monday night. People don't stop getting on our websites at 5:01. And so, we want to make sure we're engaging everyone who comes there, and so, our staffing reflects the demand on the websites and so, while people are awake, people are on the websites, and then as people start to fall asleep, obviously the traffic on all the sites goes down and the number of chats we're taking goes down. We have about thirty on our staff, so we started the beginning of the year with six people and we've got thirty on our staff now, and they do a really excellent job, but where chat pays for itself is all those other times. At 5:01, at 6:10, or after the kids go to bed. that's when chat really pays for itself. But chat has a lot of other benefits, too. So, we've learned a whole lot since we got started, and we've found ways to create a real operational advantage with chat, so it's not just a lead service. We're able to direct people to leave great reviews on websites when they're chatting with us and telling us about how much they love the practice. We're able to divert people who are upset about something that happened at the practice and get them to the right person in the office so they don't have an opportunity to leave reviews. There's recruitment. We chat with -- about 1% of the people who are on our site are potential hires, and so that's a big pain point in a lot of practices is hiring good people, and so, we've started to learn you know about all these people that exist on our website and have figured out ways to add value to get their information. If you need to hire a new receptionist or a new appointment coordinator, let's get their information and give ourselves an opportunity to hire that person. Additionally, when we're looking at the chats coming in, we can see what things patients are really interested in. So, if we're getting a ton of questions about a specific kind of treatment, well, maybe we should learn more about that kind of treatment. If we're getting a lot of questions about a particular kind of insurance, or a variety of different topics, why don't we write blogs on that? That's going improve our SEO. There are a number of ways that we can use that data that we're collecting from chat for an operational advantage as well.
Howard: You said something very profound. Practice management, in two words, is patient management, and everybody always looks at websites and everything about getting new customers in the front door. They don't realize how many customers go out their back door. They lose about 80% of their new patients, and by the time the average dentist has five thousands charts, four thousand are gone. And you're right, those phones... You have to control the phone point because, like I say, when people are calling up and they're upset, and saving that patient, to me, is worth more than getting a new stranger. You've already been to the office, I've already met you. I need to know what the problem is. When these dentists have an associate dentist, that's all the data. How come every time Scott Hansen does a root canal, no one ever calls back for a pain med, and every time Howard does a root canal, we get a call from a mortuary saying, "Did you do a root canal on this guy?" I mean, you need to know that, and same thing with staff. You're back there doing a root canal. You don't know who was offended by your hygienist or your receptionist or your office manager. You just need communication, and chatting is a two-way communication.
Scott: Yeah, without a doubt. And I think the two greatest pieces of value that we provide aside from the new patient generation, which it does a fine job of that, and like I said, that's really how it pays for itself. But, the two other really big pieces of value are preventing negative reviews, because that's the kiss of death for a dental practice, and helping recruit for the office. And so, yeah, communication is really, really important, and so, we're training our smile specialists to really engage with the people to get on a human-to-human level. So, we understand that our competitors are the people in India. They're the people that are very robotic, that search for an answer and then copy-paste it. And so, that's really what differentiates us, is we're able to have a person-to-person conversation where they feel more like they're talking to the practice, as opposed to a, "They say A, we say B.
Howard: And I would also think those questions do... Does the dentist get a copy of the questions coming in and being answered each month?
Scott: Yeah, so we have an end-of-month report where it says how chat's working. Additionally, every chapter requires the practice's action we email to them along with a summary of the transcript, and so we have the patient's name, email, phone number, the practice location preference, and then whatever action the office needs to take. We're actually working -- spent about a quarter million dollars developing a really awesome piece of software so that our clients can log in and have a much better understanding of what's going on. Right now it's the e-mails, but by mid-October, we're going to have a really cool, robust solution for them.
Howard: You're really cool. I love your passion, because to me, if everybody's asking about, "Do you take this insurance?" then maybe your website should go back and add content about what insurance you take. I've known dentists that said they increase the effectiveness of their website just by having an insurance page and listing every insurance they take, and you're talking about they're asking about features. Well, if all your patients' chats are asking about Invisalign or something, well, you should have more content about Invisalign.
Howard: It looks like it should be your scorecard, just like in college when you took a test. You found out what you knew real well and what you need to go back and study.
Scott: I'm gonna have to implement that, too. I like the scorecard idea.
Howard: Yeah, it'd be a great scorecard. Eventually, I would almost say if you did it perfectly, you could put yourself out of business. You could keep giving them so much feedback that eventually, no one would have a question. So, what's the craziest -- has anybody ever pranked you, or have you ever had to have a [00:26:09] job? [0.2] Have you ever seen -- [00:26:11] there's a lot of great [0.8] What percent of Americans are crazy?
Scott: There's a fair percent of crazy people out there. Last month, we took about nineteen thousand chats. We took eighteen thousand four hundred and eight chats last month and so, you can imagine that inside that mix, there's some crazy people on at three in the morning. But that's a very, very small portion of the total that we're chatting with.
Howard: What's the funniest question you've ever got?
Scott: Oh my goodness, I don't know. But I tell you what, when I --
Howard: That's probably a blog you could go that would go viral.
Scott: That's a great idea. I love it.
Howard: Top ten, twenty craziest things Americans chatted into a dental website. That would be amazing. Is your software on DentistChats.com, does it have to integrate with the practice management software? Does it matter to yo if they're on Dentrix, Eaglesoft, Open Dental, any of those?
Scott: Nope, it's agnostic.
Howard: It's agnostic practice management software. What equipment is involved?
Scott: So, as far as from the client standpoint or from our standpoint?
Howard: Well, how does -- The dentist's trying to work thinking, "How the hell are you gonna, I mean, you hack into my website?" I know my homies. 90% of them probably can't even remember where they bought their damn dental website. Dental websites, in a dentist's mind, they want to talk about a sinus lift. I mean, your mother. Does Jo want to talk about Invisalign or her return on equity for last year?
Scott: Yep. Yeah. No, I totally know what you mean. So, we've actually --
Howard: So they were at a convention, they gave someone five grand, they got a website and, if they're my age, if they're 55... Hell, they did that five, ten, twenty years ago. So he's driving to work right now thinking, "Well, how are you going to add this to my website?"
Scott: So, we actually take care of the whole process for each client. So we'll give each client before we start service a survey to fill out, and they're going to tell us about their practice so that we can compose the scripting for them, but it's stuff that they already know. What treatments they provide and things that maybe aren't necessarily on their website.You can find who the website creator is just by looking around, snooping around on the website. But we contact the Web developer and take care of all of that for them. So basically, they call us up and say, "Hey, let's get started," and we take care of everything for them aside from that survey.
Howard: You also talk about... when we talking about problems plaguing dental practice websites, you talk about featured phone number, no clear calls to action, no clear branding, generic featured focused content, non-mobile friendly. Does a client ever call you up and say, "Scott, I want to add them DentistChats.com to my website." And you call them back and say, "Dude, I'd first get a new website," or do you fix websites? Do you recommend someone to do a website? And is there a big -- talk about that.
Scott: Sure. So, there have been a few people that we have... maybe refused is too strong of a word, but have not provided service to because they just didn't have the traffic. It didn't make sense for them to cut us a $99 check a month for working a chat for anybody. But because the pricing scales to how much chat's being used, oftentimes the pricing makes sense. Almost always the pricing makes sense unless there's really no one there. And as far as addressing your question about do we fix websites or other digital services, we don't, but obviously we see a lot of different website designers. We see how they work on the back end and how well they're performing, and a guest you had on the show... I don't know... a little while ago, Dr. Kyle Fagala. He owns Neon Canvas. They do wonderful websites. So yeah, we have a list of people that we know do really great work, and he's on the list.
Howard: Well, it really depends on... Just like if you want to buy a car, you can get a Chevy, a Pontiac. You can get a Cadillac. You can get a Ferrari, and in some of these very, very [00:30:23] compared rescissions. [0.9] And I want to throw my millennial dentist friends under a bridge again. I like to do it daily for them just to keep them on their toes. I actually really love them all, I just don't want them to make many bad decisions because when you come out of school $350,000 in debt, you can't screw up much after that. But the biggest screwup they do is, say, they went to UMKC. And I love the Plaza. Who the hell wouldn't want to live in the Plaza compared to Parsons, Kansas, Salina, Kansas? I get it, I'm not dumb. But if you go to an area like the Plaza where they need a dentist like Kansas City needs a meteorite, then you can't get an F on your website. You can't get a D on your website. When you make a really personal decision that says, "Hey, me and my husband met in Kansas City and we're big Chiefs fans, and we love the Plaza and we love all that area, and Man, this is where we're going to be happiest." OK, I get it. But if you get a F in demographics, you better get an A on your dental website. You know what I mean?
Scott: Yes, without a doubt.
Howard: So, I've seen people spend $25,000 on a custom Wordpress -- is it called WordPress? -- website, and they told me it took their brackets from seven hundred and fifty thousand to one and a half million. And then there's other people thinking, "$25,000 for a website? I wouldn't spend $5,000." OK buddy, well then I hope you're in a town of four thousand people and you're the only dentist in town.
Scott: Yeah, without a doubt.
Howard: Think of the difference in the competition in Manhattan versus, you know, Salina, Kansas.
Scott: Yes. Yeah, you're absolutely right. And we work with some clients that spent $25,000 on their website and it didn't work very well. So it's really important, too, that if you're going to drop that expense that you're dropping that expense with someone who you know is going to provide you great service, and so that is one really cool thing about seeing the back end of all these websites is we know who the great providers are. But yeah, you're exactly right. When we refocus our efforts on what's bringing patients in the door, it's amazing how much money we have to spend on a 3-D scanner, if that's what we want. But if we spend it on the 3-D scanner thinking that it's going to bring more patients in our door, it's not going to, so I think you're spot on.
Howard: You have a nice YouTube video I liked on your website.
Scott: Thank you, I did that on Fiverr. That's a great hack for all the people listening is, if you want to do an explainer video for anything, I think I got that done for like $150.
Howard: Well, I was going to say, if you send that to Ryan, we can put that on the podcast.
Scott: Oh great. Sounds great, I'll do that.
Howard: Yeah, I liked it. I liked it a lot. A lot of dentists, when they think about their website, all they think about is, "I should be doing Google AdWords. I should be doing Facebook AdWords." So there's online spend for -- what would you call it -- pay per click, is that what you call that?
Howard: Pay per click. And then there's also the social confirmation through reviews. Talk about if someone's not getting enough traffic, do you think it's because they're not spending enough online pay per click with Google, or do you think it's... Why do you think they're not getting traffic when the dentist across the street is getting traffic?
Scott: The number one thing I would say is a great reviews presence. So if they've got lots of Google previews and Facebook reviews, Google has to use some data to decide who they're going to put first. And so, it uses those kinds of pieces of data to figure out who they're going to rank because they want to make sure they're putting relevant people or relevant websites in front of you for your search. And so, that was one of the things that we focused on that really kickstarted our practice growth. We said, "OK, we've got a few reviews here, a few reviews there." But this is something that costs virtually nothing. We're already making people happy. Let's just have them tell the world about it. And there's also something to be said for confirmation bias, and when people say they love you, they're going to figure out ways to love you more. And so, I think the reviews piece is really big. Another way that we found great success is with Facebook marketing. So, there's certainly a mix of things and it's different for each market, too. So if everyone's doing Google AdWords and you start trying to do Google AdWords, too, it's going to be really expensive for you and so, you have to look at return on investment and what your competitors are doing and how you can find a backdoor to those patients, which is what we focused on.
Howard: Did you see the thread Dental Town called... It was actually a poll called Topic: Anyone thinks a chat box on a website is a good idea? On Dental Town, remember, when you start a thread, when it's a brand new thread, instead of posting a question, you can post the poll. You'll hear so many dentists say... They'll just drop numbers. They'll say, "80% of dentists in Kansas don't do Invisalign." And I always say, "That's awesome. Where did you read that? Can I see the receipt on that?" Then it's always, those fell out of their ass. But on Dental Town, we run a monthly poll. You can create your own poll. But did you see that thread on Dental Town?
Scott: I didn't. Ryan just got me signed up with a Dental Town account, so I have yet to go to town, so to speak.
Howard: But anyway, amazing. The first company said, "We just started doing live chats on our website less than a month ago. The results have been stellar. I'm starting a full mouth rehab case on Monday from the chats." I don't think anybody's saying anything bad. And then one [00:36:18] class chasseur is [1.4] Do the chat servers have monitoring? What's the wait time? Did the patient request get answered? Did they record the chats, or did he talk about recording the chats? Is that a big problem, wait time?
Scott: No. So are you talking about time for a response?
Howard: For a patient to get into the dentist's office. Is that a common question, "How long do I have to wait?" We see government data that the average American who's an existing patient or a patient of record or a new patient has to wait about five days to be seen by the dentist, and that's the data that everyone's thrown around to justify more dental schools, and I agree. I don't think an American... I can get a pizza delivered in 30 minutes. Why should I have to wait five days to see your mom?
Scott: Yeah, I think you're exactly right. And I would say, too, the people that leverage chat really well are the people that have the other things figured out really well, too. So, chat is a great resource and it performs very, very well. But just like you mentioned, if you're not calling the patient and getting butts in seats as soon as possible, your competitor will. And so, it's very important that the other pieces fall into place as well. If we send one of our clients and email at 1:00 in the morning with new patient's information, if they're not the first person getting called the next morning, the likelihood of scheduling those patients goes down every minute every day, so it is important that we take action quickly.
Howard: What other advice would you give a dentist on their website and social media content, social media confirmation? Go back to how your chat can actually help get a review, because I'm convinced that with Millennials, Generation Xers, reviews are huge. And I don't think they're huge for Grandpa. I'm 55, I've got grandchildren. I don't know any grandpas who read online reviews, but they're important for everyone who's not almost senile and dead. But how can DentalChats get me better and more online reviews?
Scott: So when we're chatting with someone that's really impressed with what we're doing, really impressed with our practice, we can provide them direct links to review you on Google or to review you on Yelp or Facebook.
Howard: So you can send a link through a chat box? An active link that I click and goes to "leave me a review?"
Scott: Yep yep. And different practices have it set up differently. I don't sell this, but I developed a review app myself, and so I'm pretty familiar with how those links work, and we can even develop specific links for practices that they click on it, it auto-fills the five stars and is there for the patient to leave a review.
Howard: If you had to put the reviews in order of importance, rank Google, Facebook, and Yelp One, two, and three, what would you put them at?
Scott: Here in Kansas City, I would say, "Google, Facebook, Yelp." On the coast, Yelp might be more important than even Google reviews. I'm really not sure just because I've managed a practice here in Kansas City, and so, I've got a really solid understanding of who our customers are, but I know Yelp is way more important on the coast, especially where you are.
Howard: So, managing your mom's practice, you got an MBA. Do you fear the day you're ever going to go up to her and say, "Sorry, Mom, I need to fire you." And I've been interviewing some dentists from orthodontist graduates the other day from Gorp, and how is that working with your mom?
Scott: So my mom has an associate but I'm slowly kind of taking steps out of the practice. It's way different managing a team of six people than a team of thirty, and we'll probably have fifty or so by the end of the year, and so it really does take a lot of my attention. But Mom's killing it, she loves it. I'm helping her a lot with all the things that I did before. I'm just trying to find ways to really efficiently manage my time for her benefit the best.
Howard: So were you the only child that followed her into dentistry?
Scott: Yeah. My brother works at an investment bank down in Dallas, but I thought about going to UMKC, actually, for dental school, and I worked for her for a summer because my wife was a year behind me in school. She's a nurse and I was just kind of spinning my wheels waiting for her to get out of school before I started dental school, and I started working for her and I frankly didn't enjoy it that much. I don't know if it's my big hands in a small place. I don't know what it was but I've always had a passion for customer service and marketing and sales, and so the partnership for us was honestly very natural.
Howard: So how long have you managed your mom's orthodontic practice?
Scott: I think just over five years.
Howard: Five years? What lessons have you learned? Because dentists, they all get out of UMKC, they have no management training. They have nothing. What takeaways have you learned? What advice would you give to the other UMKC graduates?
Scott: Number one is, know who your customer is. Know who your patient is. It is impossible to make wise marketing decisions if you don't know who your target buyer is. So with every decision we make in terms of marketing, we're thinking, "OK, where is our target buyer and how are they going to engage with the marketing piece that we put out, or the chat, or whatever it is?" Because if we're not attacking those people, then we're going to end up wasting a lot of money. And so, that's why certain marketing mediums work well for some practices and don't work well for others because there's a specific demographic of people that use that medium. So that's number one, and then number two is, you don't have to spend a lot of money to grow your practice. We had a practice that had flat growth for ten years and we started growing it at 30% a year and it's been on the INC 5000 list the last two years and our marketing budget is about 1%, if you don't count insurance.
Howard: God, that's amazing.
Scott: And it's just because we focus on what gives us the biggest bang for the buck, and oftentimes, the buck is not a physical buck. It's your time. It's your energy. It's how you strategize when a patient comes to the office. When do you ask for a review? How do you ask for the review? When you ask for the review, do they walk out the door and then never do it, just like I do when I say, "Hey, no problem, I'll write you a review?" I never end up reviewing people because I just forget, not because I don't want to. So little things like that can make a dramatic impact on your practice, and we chat for some startup practices that absolutely kill it after a year, and it's because they're focused on the business of their practice. They're not just focused on the teeth, and the teeth are really important. But it's all the little things that we do in our practice that make a huge difference. Our patients don't know if the instruments we're using are clean. They're going in our bathroom, and if our bathroom's clean, they're going to assume that our instruments are clean, and it's all of those little things that we can do that have a huge impact. There's not one magic bullet. Chat is not going to make practices grow by 30% a year, but when you add all of those little things together and really try, it's inevitable that you'll grow a practice.
Howard: And that new patient interview. The dentists who just walk in there and start asking, "What medications are you on?" It's like, "Dude, was she just born in Kansas City? She's 30 years old. Is this the first time she's ever been to a dentist? Why did she leave the last dentist?" I've had the sweetest grandmothers in the world tell me. "Well, he wanted to place an implant here, and if you saw how much dust was on his baseboard, I wasn't going to let him touch me with a ten foot pole.
Scott: And what resources you have available. Right off the bat, the biggest resource you have is time. Once you buy all this stuff, it just sits there, and if you're not using your time effectively, it's just going to continue to sit there. And as the practice grows and matures, we've systemized things so that Dr. Hansen doesn't have to do some of the stuff that she used to have to do to build that trust. We're systemizing that into our process, so once you figure out where you are and what resources you have, it's pretty easy to maximize those resources. One of our core values here at DentistChats is to do more with less, and I think if more people owned that core value in their businesses, we'd start seeing a lot more successful startup practices because people would try to figure out what's available and how do I use it to grow my practice.
Howard: You've been running an orthodontic office for five years. It's awesome. I go to your mom's website, bracesbydrhansen.com, and there's somebody that pops up, "Welcome to Hansen Orthodontic Specialists. How may I help you?" Managing an orthodontic office for five years and you've been growing 30% a year. What's growing? Is it 80% teenagers and 20% adults? Is that about the right mix?
Scott: Yeah, our practice is a little bit more. We have a few more adults than that. We're a big Invisalign practice, though, so we've kind of positioned ourself that way deliberately.
Howard: So would you say you're a third adult, two-thirds kids?
Scott: 25% or so.
Howard: 25% what?
Howard: 25% adult. 75%... what do you call them? Teenager? Kid? What do you call them?
Scott: You can take your pick.
Howard: Take your pick. What percent of the Invisalign are adult versus teenager?
Scott: You know what, I really don't know off the top of my head, but our practice is almost 50% Invisalign, and I would imagine that adults is more than 50%. We think that's where the industry's headed. We think that that's going to be the biggest growth in demand for orthodontics is going to be adults over the next ten years. And so, we're just trying to position our practice to be efficient in treating adults because we're going to have growing price pressure from corporate and growing price pressure from Smile Direct Club and different things. And so, we're just trying to figure out a way that we can be right in front of our target buyer. Just all the stuff that I've been talking about. We are actively trying to put those words to action.
Howard: When you say clear aligner -- I mean, when you say Invisalign, is it Invisalign or is it clear aligners. What did your mom think when Invisalign started to go around her and go straight to the consumer or Smile Direct Club? How did that sit with Mom?
Scott: Another one of our core values is to drive your bus. And what that means is we're in control of us, and if we focus on the things that we have control over, we'll win. And so, we're not going to be able to control what align technology does. Their responsibility is to their stakeholders, not to us, and we use it as a tool. And so, obviously, they're in business to make money just like we are, and so because we're not going to change that tide, we're focused on what we can do about it. And what we can do about it is we know that there are going to be a lot of people that still would prefer to pay a little bit more and see a professional to have someone to hold accountable, and so we're just trying to position our practice to be that. And then as the market changes over time, we'll always be right there ahead of it. And so, yeah, it didn't make her happy.
Howard: That is just a brilliant, profound... How old are you?
Howard: You've got to be an old soul to have that good of an answer at twenty-eight years old. Really, that's profound. That's reality. I never like to think or spend any time on anything that I can't change or is not going to change. Except for NFL, I have to admit, the NFL. And that's one of my big quandaries in life. I grew up in Wichita, Kansas, went to UMKC, I was a Chiefs fan forever...
Scott: My mom grew up in Wichita, too.
Howard: Did you?
Scott: My parents met at Wichita State.
Howard: Oh, my gosh. And then I moved to Arizona, so then I became a Chiefs fan, right? I always feel like I am. But when the Chiefs play the Cardinals, I'm having this schizophrenic attack on the couch. I don't know who my real love is. But with the exception of the NFL, there's people that are obsessed all weekend about North Korea and it's like, "Dude, what is [00:49:13] normal." [0.6] If I read every article and everything on North Korea, how could I change the situation? And so, if you're watching it, and it makes you feel good, I guess that's good. But if you're watching and it's stressing you out, then why aren't you? And you can't tell me anything about your own dental office. I only like to do things that make me feel good and can help my family first or my business second. So that was a very profound answer. A lot of these people are so mad at Smiles Direct in their orthodontist and they're having a conniption about it. It's like, "Come on dude, when you owned the biggest horse and buggy company in Chicago and Henry Ford started his car company, were you mad at Henry?" If you start yelling at and getting all mad at Henry, you can't fight the future. But yeah, I think it's going to be a two-tier deal. I could see some young girl in college going to Smiles Direct, check it out like that.
Scott: Yeah, and those are people... Yeah.
Howard: But I can't see a mom and dad doing that to their thirteen year-old.
Scott: Yeah, and that's the thing. It's like, the girl in college, that's not our customer right now anyway. So the market is going to grow and it's just a matter of being opportunistic as opposed to just sitting around and complaining about how the world's changing. It's like, "Hey, let's do something about it." Ten years ago, no one chatted on websites, and then Apple and all these big brands started doing it, and it's like, "OK, well, this must work because they're not going to waste their money on chat if it doesn't work, so why don't we try it?" And so we tried it and it worked, and we're just always focused on what we can do, like how we're affecting the world.
Howard: So where is chat taking off outside of dentistry? Where do you see it outside of dentistry? On what kind of websites? Are there any typical types more than other types?
Scott: There are a lot of e-commerce websites that have chat, so where you can buy stuff. There are very few... Chat is not very popular on websites where you buy services, and that's really where we found our niche. And I have a feeling that right now, it's not popular. Right now, if you got on a hundred dentists' websites, chat may be on one of them, but five years from now, that is going to be way different. And so, what's really cool about right now is, chat's a competitive advantage. It's something that you can have that other people don't have because they're not willing to listen to podcasts like yours and learn about stuff. But in the future, I would guess the vast majority of everyone will have chat within the next five or ten years because it will be just a service expectation.
Howard: Is it more of a return on investment say, urban versus rural?
Howard: Your spread of three hundred data points, of three hundred dentists using it in the US and Canada. Do they tend to be in more competitive, oversaturated urban areas, or are you seeing this taking off in rural, too?
Scott: We see it taking off in rural, too, but I will say if there's any Montana dentists out there, I will give you a deal because you are one of the few states that we don't have. But just like anything, if there's not a whole lot of competition, those people are typically the people resting on their laurels, but change is coming. I'm not concerned about chat taking off in rural areas. It certainly will. But we have doctors from just every walk of life, from little small towns in America to when we look at Manhattan and we've got lots of dentists and orthodontists, so it kind of depends.
Howard: It's amazing when you realize that NYU graduated 7% of America's dentists. New York City is just such a huge, huge sample size. What about specialties? Do you think any... you started in ortho because your mom's an orthodontist. Do you think chat will be more beneficial for some specialties? There's endo, there's ortho, there's pediatric dentists. There's nine specialties recognized by the ADA. Do you see any of them being more favorable for this?
Scott: I'm sure that there will. That stuff will pan out over time, but typically, the way I look at it is the practices that primarily rely on self-generated patients -- so not professionally referred patients -- that's where chat's going to the most effective because obviously, the patients have a choice. They're out there searching for answers. They're searching for a provider as opposed to -- this isn't a dental example, but orthopedic surgeon. You're going to go to the orthopedic surgeon that somebody else tells you is a good orthopedic surgeon. You're not going to read Yelp reviews. And so, any place that there is self-generated patients or where you're the one generating the interest in your practice, chat's going to be pretty popular.
Howard: That would be interesting on Yelp reviews for different types of doctors. It'd be interesting to break that down like you say, like an oncologist. Are you really going to pick your oncologist for your prostate cancer based on a Yelp review by a nineteen year-old kid? Yeah, that would be a real interesting chart.
Scott: One really cool application that we've imagined with online chat that we're not actioning right now but we think that it'll be a big part of online chat in the future is how chatting with post-treatment patients for more serious surgeries like that or more serious doctor-referred professions. How online chat can impact their patient satisfaction scores and how those patient satisfaction scores impact their reimbursement from insurance companies and from the state. And so, we think that there is actually a huge opportunity there, but it's just a matter of not putting the cart in front of the horse.
Howard: Another thing I love about you besides your ma. You all went to UMKC, got an MBA, but I like the fact that on your website DentistChats.com, you say never a contract, no risk, quit anytime. It's not always a red flag but it's usually a red flag in dentistry. Just think of Verizon. Who's last [00:55:42] for you [0.2] got a contract with Verizon? How many times has Verizon made your blood pressure go over two hundred over a hundred? It's like if you and I really enjoy doing business together and it's really working out well for both of us, why do we got to go get married with a contract?
Scott: Yupp, absolutely.
Howard: What are your thoughts on that? Why do you not have a contract?
Scott: I've gotten myself into some marketing contracts with our practice that I wish I hadn't, and on the front side, I'm a sales person. I love sales, I love marketing. I'm making claims about bringing patients to your practice and operational efficiencies that we're going to create with chat, and if I don't deliver on those, you shouldn't have to pay me because I'm not meeting what I promised on [00:56:31] the money that I did. [0.7]
Howard: But that is so Kansas mentality. My dad had nine restaurants. You're not going to believe this. Everything was done on a handshake. I knew his attorney and I still know his accountant name, Carol's accounting firm. But he said, "Well, who is your dad's attorney?" It's like, my dad... They didn't have attorneys back then. Of course, that's the way it is. You also have when you do ROI focus -- I don't know how many dentists know what an ROI is, return on investment -- focus 92% average.
Scott: Yeah, so I'm going to use the stats from August so I have an example that I can walk you through to how we came up with that and also, I'd like to walk that back a little bit. So yeah, it's 92 return on investment to revenue most likely, but not to net. And so, let's say our website has a thousand visitors. Likely, we're going to chat about forty-six times with those people. We're going to generate about twelve new patient leads. We're going to create twelve actionable things for the practice to call and get a patient scheduled, and let's assume that it's a 80% show rate and a 65% case acceptance. We're going to generate north of $30,000 for the practice, or at least help. And we can't take credit for for all of that, obviously. We have people that click to the practice because of the Google review and they would have called, but they engaged us via chat. But if we took credit for all of that, it's almost 100 times ROI to revenue because that's going to cost the doctor about $350 a month for us to provide that service to them, and that's about $35,000 of revenue generated. But if you look at net numbers, if we're at 40% margin or so, that's a 40 times ROI to net. And so, without a doubt, chat's a no brainer as far as developing new business. To me, what makes it most exciting is when you have a team of people that are all here in Kansas City, you have a team of people that have English as their first language, that know about these different treatments. What are the other things that we can do? How else can we take advantage of it? Because the new patient is a no-brainer, but where else can we be creative? It falls back to what resources do we have? My resources as the owner of this business, I've got the people and I've got the computers and I've got their time and I'm paying for their time. So if I can maximize their time by providing value to our dentists, I'm going to figure out whatever creative way I can do to provide value to them.
Howard: I've been beating this horse for thirty years. Not only does Google AdWords you know get you more website traffic, not only does DentalChat get more conversions. You say there's about a standard 5% conversion, that's one out of twenty with chats. You said 4.6, I'll around that to five, you could double that. But dentists, they never take any training for who's ever answering the phone. They don't take them to CE courses. They always go to the course alone to save money, and then when they're back there doing a root canal and that lady up front is answering all these questions... My gosh, if you can get your website conversion from 5% to adding DentistChats and get to 10%, and then if you can start taking your -- I mean do what Dental Town -- we got four hundred-some online CE courses once a week. Buy them lunch and pay them for the lunch hour and get pizza and have them watch an online CE course because they're going to ask her about root canals. They're going to ask her about Invisalign. How is Lucy going to answer a question on Invisalign if she's never even seen an Invisalign course? And, my gosh, I would add DentistChats and I would start taking who's ever answering that phone 10 times more serious. When you're in any other business, who ever answers the phone is called in-line sales, and who's ever calling out customers because they had a hot lead on your website, they texted them. Who is that person? Do we have a contact information? Do we have a number? That is a hot, hot, hot lead. There's seven billion people on Earth and this lady just asked you a question about Invisalign. Who's calling her back? That would be outbound sales, and the outbound sales person in any business in America gets paid more than the guy in the machine shop making the widget. So in dentistry, your mom is back there making the widget and she makes several times more money than the girl who actually got the sale. But you go to any other business outside of medicine, dentistry, and law, and it's reversed. Go to any machine shop in Kansas that the salesman's got a three-piece suit on. He makes six figures. The guy in the machine shop floor makes $25 an hour. And so, dentists just don't get that. The dentists look in the mirror, and every morning they get up, they look around, and they go, "Oh my God, I am all that. Look at me. I am all that and a bag of chips." They think the whole dental office revolves around Doc, and they don't realize that, God, I'd rather have the whole dental office evolve down in-line sales opportunities, outbound sales opportunities, and I could get an associate who just graduated an hour ago to fill the orders in the back room.
Scott: Yeah. You're exactly right. We focus our digital presence to grow our practice, but that was another big piece, too. One of the biggest pieces of resources that we have in all of our practices is our patient list. People that have come into our practice. And what are we doing with that? What are we doing with the people that call? And it is scary to think about how much money all of our practices leave on the table because the people who are answering the phones or answering the chats aren't good enough. And when we start to focus on those things, practice growth gets really easy because most people don't. And even corporate. Corporate can teach a very robotic response to patients, but when you put forty people in a call center, it is much more difficult to control the quality and empathy and value building for that practice, and so I said it before, but we just have to focus on who we are and what we can do because we can make a huge impact on the little things, like you mentioned how we answer the phone. That can impact practice growth a lot.
Howard: Oh, it's huge. It's just huge. And I know my homies. He wants to get a bunch of more cases, so it's like, "OK, dude. I know you want to play some more." And I say, "What do you want to do next year?" "I want to play [01:03:21] for him." [0.3] "OK, what are you place on? Cats? Dogs? You going to go to the pound? You going to pick up twenty cats at the pound?" "No, I want homo sapiens." OK. Well then, take your website so you don't have 5% conversion. Let's get it to ten that land on your website, they call the office. When they call the office, we know right now everybody that measures this stuff say during working hours, eight to five, anywhere between 27% to 50% of the calls go to voicemail. Are you out of your mind? Any small business America would say, "Oh, we need to hire another sales person." It reminds me of the autobiography of the founder of IBM, Thomas Watson, Jr., and he went to IBM and all he focused on, he says, "I don't know computer stuff and I'm not going to get involved with that. I'm just going to focus on the sales." And he started a six-week training course where everybody got the three-piece suits. They went over every question they've ever been asked. The whole class studied for six weeks with a briefcase, a suit. These are all the questions. And all he did is worked on his sales and he said, "If 70% of all the computer salesmen in the world worked for IBM, we'll have 70% of the market share." And these dentists can't tell you if yesterday, they had thirty incoming calls or sixty. They can't tell you where they came from. They can't tell you what percent went to voicemail. And then the hygienist -- on top of all that -- the hygienist and the assistant, instead of the hygienist scheduling a six-month recall or the assistant scheduling the next appointment, they just go out and throw the chart on the front and say, "You do it," as if she's a clerk. Man, that lady is inbound sales. She's driving the whole show. You can go back through a hygienist and schedule your own damn appointment. Tell the assistant, "You schedule the crown seat or the next one." Do it all in the back because the incoming calls are sacred, so that means 80% of dentists will never take her to a dental course, a dental convention, won't educate her, spend no time, no money. They just hire them off the street and put them in the most important job in the office. Then, they turn around and tell me they'd like to have twice as many patients. Hello?
Scott: Yeah, and for the offices that have treatment coordinators, to have your treatment coordinator focus exclusively on sales. That was one big thing that I changed when I came to work for my mom was we had our treatment coordinator, when the office got a little crazy, she was seeing patients in the chair and doing different stuff and it's like, man, this is the person who's giving us our jobs. They need to focus on their job.
Howard: And you ask a dentist, "What is your treatment plan acceptance rate just for decay? Just for a cavity?" We're not talking veneers, bleaching, bonding and Invisalign. We're talking about just for dental decay. They can't even tell you, and it's about 38%. And the guy next door is doing 65% and the dentist doesn't know why he's doing 750 taking home 175, and the guy next door is doing 1.5 taking home 350, when they have the same macroeconomics of the same building, and it's because of the treatment plan presenter.
Scott: Yeah, and the good news is, though, that all that stuff is stuff that we can impact. We can change that, and that's the really encouraging part is, dentistry has changed a lot. Ortho's changed a lot. And I haven't seen it, intimately, how it's changed, but we're looking ahead at what ortho's going to change to and what dental's going to change to. But there's still so much that we have control over, and when we identify those problems, it's up to us to change them, but we can change them. And so, that's the really encouraging part to me is, I don't know how to run a chat business. I started it and we've been focused on what we can do and how we can grow the business, but when you do that, it's very empowering.
Howard: Your mom has seen -- when your mom and I got out of UMKC, it was all stainless steel. Now it's all nickel titanium. And when I got out of UMKC, implants were all blades and subperiosteals, and I haven't seen one of them placed in a decade. Yeah, it's a fast -- Two things: I almost say the half-life of anything dental, as far as technique and when you're doing surgery with your hands, is about five years. But if there's anything I'm sensing more now than ever, it's that the half-life on everything is coming down in the economy. Everything's evolving at a much faster pace.
Scott: I can't remember the name of the principle, but there's some smart dude that came up with this first, but that technology gets twice as fast and halves in price every eighteen months.
Howard: Moore's law.
Scott: Moore's Law. There you go. But that's the reality that we live in. And I know that there's a large audience of younger dentists who listen to this, and that should be the most encouraging thing that you've heard today because as stuff changes faster, there's more opportunity sooner. I think about how grateful I am that I entered into the market the time that I did to start managing Mom's practice because before Google reviews and before Yelp reviews and Facebook and Twitter and everything, you had to grind to develop a reputation in a community. And now, you can look like the biggest, baddest dentist in about one year and be killing it. And that was never an option before, and so, I feel very fortunate and encouraged by the fact that stuff is changing faster because for the people that do want to seize the day, the day is to be seized.
Howard: Yeah, when I was 10 years old, I never imagined that someday the phone would come off the wall, let alone that I'd be able to take a picture with it. But hey, thank you so much. This is very important to me. I called you to be on the show, you didn't call me. I think that's very important, mainly because like I say, when your mom and I got out of school, it was a lot easier to be successful than it is now, and when these kids come out of school they've already got a $350,000 ball and chain around their ankle, so if you got a big ball and chain around your ankle, you don't need to make very many mistakes. And this is one simple thing that can double the conversion of your website from 5 to 10%. Add that to training your damn receptionist and you can do that the cheapest with online CE on Dental Down. Tell your mother that I'm very proud of her after meeting her son.
Scott: Well, thank you very much. Thank you very much for having me, Howard.
Howard: All right, now I'll turn you over to my son. Thanks, Ryan.
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