Broadening the Dental Category

When VCR’s first came out, many people predicted it would be the demise of the cinema business.  It didn’t happen.  What did happen is that by 1988, video rentals and sales reached $4 billion annually, passing movie sales, which continued to grow.   (Oddly, when DVD’s came out, people predicted the same thing, yet in 2011, movie theater revenue was $10 billion.)  So what really occurred here is that the category broadened.  People assumed it was a zero sum game–people would either watch videos or go to the movies.  Instead, they did both.

Similar things have happened in dentistry. Cosmetics barely existed when I came into the dental field in 1986.  Now it is conservatively a $10 billion segment of dentistry.  When Invisalign came out, many thought it would erode the bracket side of orthodontics.  Instead, it broadened the category.  Literally millions of people, mostly adults, who would never have considered braces were excited about the idea of Invisalign, and as a result many more patients were treated, and the bracket business didn’t recede at all.  Most significantly, it broadened the category of orthodontics for the general dentist.

3D Cone beam imaging is now doing the same thing to implants.  Cases that were previously a near impossibility, or at the very least with a high risk of failure, are now done with pinpoint accuracy, much less surgery, faster healing times, and longer-lasting results.  And once again, the category is being broadened for the general dentist.

And yet, what I still see is a tendency by dentists to limit themselves to what they already know and do well.  It’s a natural tendency.  But thriving dentists are broadening their approach to the dental category.  They are adapting new technology, getting more training in new procedures, and offering a wider range of treatment to their patients.  As a result, their patients are accepting more comprehensive care, getting implants, trying Invisalign or Six Month Smiles, whitening their teeth every two years, eventually getting veneers (I finally did myself in January, and I love them!)   And most of all, having a lot of fun in their practice.

But most practices do not tell their patients all the options available to them.  This is a marketing misjudgment.  We often assume that when we tell people something once, they were actually listening.  People don’t listen until they care, and find it relevant to themselves.  The most basic tenet of marketing is to tell your customer (your patient) over and over what you do and why it’s good for them.  This means newsletters, in-office videos, email marketing to your patients, and most of all, your staff talking to patients about what is possible.  Waiting for people to ask assumes they know what to ask for.  They are looking to you for professional guidance.  Their goal will remain to do as little dental work as possible until you explain the benefits of new dentistry to them.

One my main goals is to broaden people’s appreciation of dentistry from simple teeth maintenance to a service that vastly enhances the quality of their life.  So I encourage you to take a look at your practice.  How can you broaden your approach to the dentistry you offer your patients?  (And don’ t they deserve it, after all?)  Think about new courses, new technologies, new services.  And then, most importantly, tell your patients about it.  The rewards await you!

Hot Off the Presses–my 4th Edition

The latest edition of my book, “Everything Is Marketing” was just released today.  It has a lot more information on the internet world, from what type of website to have, to dealing with reviews, Google Places, Facebook and more.

For my readers I’m doing a special offer.  You can get the book at the link on this page using the discount code “fred joyal” (with the space and not the quotation marks) and the book is $10 shipped, and the audiobook is $20.  The book is also available on Amazon and Nook. (I’m working on the iBook and Audible editions–whew!)

Howard Farran of Dentaltown fame says, “This book is a must-read for every dentist and everyone on the team.  Fred shows dentists how to think about their business from a marketing standpoint, and offers dozens of ways to put that knowledge to practical use.”  Thanks, Howard!

If you already have my book, the most critical change is in the online chapter, and I’m happy to send you that chapter for free.  Just email me at fred@1800dentist.com and ask for Chapter 23,  and I’ll send you a word doc.

Thanks to all my supporters out there, and I hope this book and blog continue to help dentists thrive and enjoy every practice day!

The Last Thing Your Patient Hears

Many times in life, great experiences are completely erased by what occurs in the last few moments.  How often have you loved a movie right up until the predictable (or incomprehensible) ending? Or gone to a fine restaurant, recommended by your friends, and had a fabulous meal.  Great service, unusual dishes, worth the money, terrific atmostphere, and then you waited 35 minutes to get the check!  It wiped out the whole positive experience.  Now when people ask you about the place, you say, “Yeah, great food, but…” It’s that “but” that changes everything.

If you’re aware of the fact that most patients are evaluating your dentistry by the experience of being in your practice as much or more than they by your clinical skills, then you should be thinking about what the last thing is that the patient experiences in their visit.  There are two critical times in any service experience: what happens first, and what happens last.  I speak at length about the first experience–how you answer the phone, how you greet new patients–and those moments are very important, but I want to talk now about what happens last.

The problem is we make this mistake all the time in dentistry.  The last few minutes of the appointment very often involves someone trying to get the money out of the patient, and even worse, having to explain why the insurance doesn’t cover it.  Or trying to get the next prophy appointment scheduled while they’re trying to run out the door to get back to work.  You can have the sweetest people working in your office, in a fun environment, with great technology and wonderful chairside manner, but then the last taste in the patient’s mouth is money issues, and insurance confusion, and your scheduling needs.  Tainting everything.

My point is, take care of all these things sooner. Get the money chairside.  Do the explanation of coverage ahead of time.  You have to do it anyway, so slide it forward.  We love to put off things we don’t like to do until last–it’s human nature.  But you need to override that tendency because it’s tarnishing the experience of the patient visit.  There are thousands of practices who get all the money dealt with chairside, as soon as the diagnosis takes place.  It’s just a matter of changing procedure, and using the right words.  Don’t say, “It’s our policy,” say, “We like to take care of all of this ahead of time, so that you can just leave the office when your done and not worry about it.  We have to take care of it anyway, so let’s do it now.”  Then you know if they have sticker shock about the treatment.  Or if they actually don’t have the money to pay for it, because then you’ll be trying to collect your fee, and hoping to get some percentage of it.  Get all your money, or don’t start treatment.  It’s just a change in procedure.  You are in business to make money, right?  There’s nothing mercenary or unprofessional about it.  You completed an expensive education and set up a facility that is costly to equip and operate.  You should be paid for the services you provide.

And do schedule their next appointment chairside as well.  Most people have smartphones with their calendar right there, and you have computer access.  Get it done.  Slide it forward.

So now, instead, the last experience of the practice is you giving them a little goody bag of some floss, toothpaste, a travel toothbrush, maybe a pack of Advil and some home care instructions.  And maybe, just maybe, it’s the dentist giving the patient a call later, or sending a text, asking how the patient is doing.  Now that’s a great way to end the visit, and make it a positive experience right through the finish.  Whatever it is, be conscious of what you’re doing, knowing that it is your last chance to make a good impression.

When It Comes to Self-Financing Dentistry, Shakespeare Was Right!

When the economy shifted a few years ago, many dentists I know starting giving their patients a break and accepting terms, financing treatments themselves on patients who had lost their job or their homes, or who were just tight on money.  And I applaud their generosity.  But the most common experience was they ended up losing both the patient and the money.  Many of these people couldn’t make the payments, so rather than come back they went to another dentist, and often times paid the second dentist to finish the work the first dentist started essentially for free.

Accounts receivable is bad business, to be sure. But self-financing is also bad marketing. Statistically, if you have payments more than 90 days overdue, you can be 90% sure you will never see the money.  So why do dentists do it?  To be a nice person?  Because the patient had been a good patient for a long time?  Because the need of the patient was so extreme they didn’t feel they could ignore it?  All good reasons, but the unintended consequences are most often negative.  As Shakespeare said, “A loan oft loses both itself and friend.”

Sometimes there’s a deeper reason, that dentists are so overwhelmed by the constant whining about the cost of dentistry that they devalue it in their own minds.  And that’s where the unconscious marketing message comes in: when you agree to self-finance, you’re telling the patient that even you don’t believe you deserve the money, that you’re too expensive.  That’s why they’re so comfortable not paying you.  You think you’re building loyalty, but instead you’re compromising on your value position.

I’m going to make an absolute statement. There should be no accounts receivable in your practice.  No more than there are with your  dry cleaners, or any restaurant in town, or your supermarket.  If you are not paid at the time of service, you guarantee a percentage will be written off.   Because when it comes to bills that patients feel required to pay, you don’t make the list.  They pay their rent/mortgage, their car lease, their grocery bill, and their credit cards.  I could add ten more items to the list and you still wouldn’t be on it.

So why not only work on patients who will pay you?  That shouldn’t be a radical concept.  What you offer is valuable, worth every penny, and a better long term investment than almost anything else your patient is spending money on except food for their children.  And that’s the marketing message you want to communicate.  You communicate that very effectively when you insist on full payment for your work at the time of service.

So what should you do when you have a good, long term patient, someone who has been with you for years, and he lost his job?  He comes to you with a broken crown or a cracked molar and simply has no money to fix it.  Instead of financing him yourself, just do the work for free.  Say to him, “Look, you’ve been a good patient for years. This would cost $1000 to do this, and I know you don’t have it.  So I’m going to fix it at no charge.  But there are two conditions: first, you don’t tell anyone that I did this.  And second, the next time you need work done, you’re going to have to pay.  This is a one-time thing.”

You’ve made it clear what you’re willing to do, why you’re willing to do it, but it’s not the way you’re going to continue doing business with this person.  They will appreciate it, and instead of them owing you money and not being able to pay you, you’ve added one more experience that makes this person a loyal patient, and most likely they will soon get a job and continue as a paying patient.  Not all the time, of course.  Nothing works 100% of the time.  But the odds are a whole lot better than when you self-finance and hope to get paid.  Best of all, you’re not devaluing your dentistry.  You’re choosing to be generous with something extremely valuable.  Whole different message.

The rest of the time, I say get the money chairside.  This isn’t a fantasy.  I can tell you a hundred practices that do it with every procedure, every case.  They simply say, “This is what the treatment will cost, and this is what your insurance covers. How would you like to handle the rest?”  Don’t save it for last, when they’re leaving the office.  I’ll discuss this concept in more detail in my next blog, so stay tuned!

Hey–You Look Different! Facebook Timeline Changes Your Fan Page

On March 30, Facebook launched a new look for business fan pages called Timeline, which drastically alters the appearance of your page.  This is the new format for all fan pages, not optional. You will want to put some time into updating your page quickly, because otherwise it will not look right. There are several key points and advantages to know about this new layout.

1. Your cover photo is now panoramic, which means it’s a wide horizontal picture at the top of your page.  I recommend using a team photo, or combining two photos side by side.  You will have to combine the photos yourself before you upload the picture—this can’t be done within Facebook.   It can be a photo of the dentists with the logo of the practice on the side.  Do not put offers or promotions in the cover photo.  Facebook doesn’t like it.  Also, keep in mind this photo is public–anyone can see it who searches for your page.  It will create a much nicer look for your page, so take some time with it, and change it every once in a while to keep it fresh.

2. Where before all your posts showed up chronologically, now you can “pin” a recent post and it stays up at the top of your page for as long as you want instead of getting replaced by the next post.  Which means if you have a special post or photo, or a promotion, you can keep it well in view.  Take advantage of this feature–it’s an excellent improvement.

3. Your practice address appears right under your thumbnail photo, and people can click on it and get a map.  It also displays your phone number.

4.  Just below your address, it now shows if your practice is open at that moment. Facebook looks at your office hours to determine this, so make sure your hours are accurate and up to date in your basic information.

5. The next valuable change is that there is now a section that appears called “Recommendations.”  This is written by people who have visited your fan page or “checked in” to your practice on their phone and then written a review.  This is different from a wall post.  If for some reason your recommendations do not appear, it means you have not set up your fan page as a “local business & place” in your basic information.  Change that, because you want people to see what patients have to say about your practice.  Also, underneath each recommendation is when it was posted, so you want to keep these fresh as well.  (see my previous blog about using iPads in your office to get a steady flow of reviews).  You don’t want recommendations sitting there that say “four months ago” or “nine months ago”.   People want to see current reviews.

6. Under the cover photo you will see buttons for your applications.  All of these can be selected by you except “photos”, which is permanently there.  You should have an app that allows people to request an appointment, and another to show your latest promotions. (The one you see there is a feature of our Patient Activator service.) Also, you can change the name of any of these apps (except the Facebook basic ones), and you can move their positions so that the four that appear are the ones that you want.  The Patient Activator application for your Facebook page automatically posts reviews, and you can add promotions, and it also lets people request an appointment and you’ll get an immediate email.  This should be a feature of any digital communication application that you are using.

Lastly, keep in mind that the most important part of your page will always be the wall posts, no matter what else Facebook changes.  You will still want fresh new posts and comments all the time, posted by you and by your patients.  Even when Facebook does its next unexpected change, which is inevitable, that will remain the core value of your fan page.  Remember, your primary Facebook strategy is to personalize your practice and give your patients a forum to recommend you.

What Century Are You From?

A dentist recently told me about a new patient he had in his office who was going on and on about her previous dentist, and how much she loved him and how she had gone to him since she was a teenager.  The dentist finally asked, “So what happened to him?  Did he die, retire, what?”  ”No,” the woman said, “he just hadn’t bought any new technology in like ten years, so I left.”

Do you realize what it takes to get someone to leave a dentist they love?  They hate finding a  new dentist.  (That’s why I have a business.)  But this is how people are starting to look at technology.  They expect it to change all the time, and if they’re seeing the same equipment in your office, with nothing new, nothing upgraded, in a decade or two, they will start to believe that they are getting second rate dentistry.

If your practice feels like it’s from the 1990′s, people are going to notice.  And slowly, imperceptibly, your practice will shrink.

I understand that upgrading technology is expensive, but you have to factor in its marketing value.  When you can show a patient that you have digital radiography, and tell them that it reduces the radiation by 80%, that’s a consumer benefit.  And if you haven’t considered CEREC or other CAD/CAM technology, do you not believe that patients would rather have one appointment instead of two?  Do you think they are perfectly fine getting another round of shots and drilling along with having to show up again?  CEREC is an enormous benefit to the patient, especially in this time-crunched society we live in.  And you could try to make excuses that the quality isn’t there, but the margins on the latest version or CEREC rival the finest labs out there.  That may have not been true five years ago, but technology changes.  It improves.  Constantly.  So you need to improve constantly too.

You also want to incorporate things like e-mailing and texting, and using iPads in your office, and using social, media, because it gives your practice technological cachet.  Even if the technology is not used on the clinical side, it makes the impression that you are a modern dental office.

There was a time when a dentist could create a facility and use it for forty years and sell the whole place at a good value when he retired.  That’s no longer true.  If you don’t continually upgrade your practice, and instead let both the equipment and your patient base age, then you’ll have nothing to sell.  The generation under 35 years old, which is the basis for a long term practice, changes technology long before it’s obsolete.  They buy new cell phones not because the old one doesn’t work anymore, but because the new one has a better camera.  They buy an iPad3 the day it comes out, even though they have an iPad2. And they see CAT scans, MRI’s and all sorts of new equipment whenever they see an MD.  And yet you have the same drill, the same chair, the same furniture in your reception area, the same beige x-ray arm swinging at them that they remember from their childhood.  And they aren’t interested.

Remember, this younger, tech-craving generation is the future of your practice.  This is where your future production will come from.  So from a marketing standpoint, this is the order of change I recommend:

Digital radiography (and intra-oral cameras to go with it)

CEREC or other CAD/CAM

3DCT Cone beam scanning (with a soft-tissue laser for implant placement)

This last one is critical if you’re doing implants to any degree.  Personal injury lawyers have figured out that cone beam exists, and if you mess up on an implant case and get sued and haven’t done 3D scanning, you could lose big time.  The settlements and judgements on these cases have been staggering, sometimes ranging between $500-750,000.  That’s unheard of in dentistry, but now it’s happening.  Beyond the great marketing value of the imagery, it’s essential protection.  And it makes implant placement remarkably more accurate.  And the devices now talk to your CEREC.  Digital dentistry at it’s best.

Use this technology and tell your patients why you have it why it benefits them, and you’ll find it pays for itself in no time.

The iPad 3 is here! Time to buy iPad 2s for reviews!

With the release of the new iPad, you can now get the old iPad2 for as little as $400.  For those of you who have heard me speak, you know I suggest getting iPads to have in your office so that patients can use them to “like” your Facebook page and post on your wall, and also do a photo or video that you can use for your website as well as social media.

If you haven’t done it, now is the time, because you don’t need iPad 3s.  All you want is the most basic iPad 2, with just wifi, because it will still do everything, and now it’s cheaper than ever.

This falls into the category of making things as easy as possible to get the most results.  If you want a few reviews, ask people to do them when they get home. If you want tons of reviews, “likes” and comments, get some iPads.  And once get them, go to www.skinit.com and buy adhesive covers so that you can put your Facebook username right on the front (like I did here for my book page).  Also put your Yelp address on the bottom, and if your patients do Yelp reviews they can post something nice there as well.

Remember, you don’t want them doing Google reviews from the iPad. Google disregards multiple reviews that come from the same device.  Ask them to do it on their phone.  They can find the office on a Google map and log in (if they have a gmail address) and review your practice.

The extra added benefit is people will see you as a modern, high tech practice. That’s a good thing.

When cheap isn’t the way to go

Last weekend a dentist told me a terrific story that speaks to the whole idea of helping people to understand the value of dentistry.  So often we’re challenged with getting the idea across to patients that spending money on their teeth is worthwhile.  It’s unfortunate that because health insurance plans exclude the teeth, people assume that they are not as important as the rest of their bodies.  And the concept that their overall health is directly linked to their oral health is trickling out very slowly amidst all the noise about health care in the past couple of years.

Anyway,  the story.  This dentist was planning on doing some painting on his house, so he and his son went to Home Depot to buy a ladder.  Once in the ladder section, the father began checking the tags on the ladders, and the son asked, “Dad, what are you doing?”  The dentist said, “Looking at the prices.”

And then his son said, “Dad, do you really want to climb up on the cheapest ladder?”  Beautiful. So simple. So clear.  And here’s the kicker–his son was ten years old!  Imagine if we could get people to see that they really shouldn’t want to find the cheapest way to maintain their teeth.  If I were a dentist, I would tell this story, and then draw a direct parallel to the patient’s teeth.  And explain it to the person like a ten year old!

QR Codes and Your Practice

I’m sure you’ve noticed these little black and white bar code squares showing up more and more.  If you’re wondering what they are, they are codes that someone can read with the camera on their smartphone that will automatically lead them to a website, or they can also be any other information you want going to their phone, like your contact information.  You’re seeing them on magazine ads, posters, business windows, and even billboards (which seems a little dangerous, to have people holding their phones up and trying to capture the QR code while they’re driving.)

This goes to to my blog, which you are at already!

If you read my previous post about the explosion of smart phones, and how more internet searches will be done on phones than on computers within the next couple of years, you may realize that the easier a business makes it for people to go to their website on the phone, the more likely they will get a person’s attention and business.  Now, I don’t necessarily believe that you will experience a massive flow of new patients based on these codes.  But I do believe that they have value, if of course you have a good website.

The main reason I like them, and this is a theme I will repeat often, is that it gives your practice “technological cachet”.  By that I mean people will see you as a modern practice, using the latest digital communication tools.  We live in a world where people expect new technology all the time.  They wait in line the day the iPad 2 comes out, even though they already have an iPad, and the only difference in the new one really is a camera, which they already have in their iPhone.  People don’t get a new phone because they lost their old one, now they get a new one every year or two because the features have improved.  This new-tech expectation will transfer to your practice, and if they don’t see new technology, like CEREC or digital radiography, or see you engaging in digital communication like with texting and email, (or QR codes), then they assume you are not a modern practice, and move on to one that is.

So how do you get QR codes, and how do you use them?  Simple.  And free.   You go to Esponce, for example, and put in your website URL, and they will automatically generate a QR code for you.  Then you just send it to yourself as an image (get all the variations). It is just like a digital photo. You can also just get a QR reader application on your smart phone, like the one from TapMedia (search applications for it) and it will not only read QR codes for you, but it will also generate them.

For now, I would put  the code on your business cards as well as any print advertising that you are doing, like direct mail.  You can make different codes that have more information, or send people to a specific part of your website. You can even get more adventurous and create ones that give people special offers or discounts.  My only caution would be to not make a QR code that is essentially a contact card, i.e., all your business information, as the code may become so dense that many phone readers won’t be able to decode it.

I know, one more annoying thing you have to get around to.  But it all adds up.  And it doesn’t take much time. Why not do it now, and get some new business cards, which you probably need to do anyway?

Smartphones and your Dental Practice

I recently read a prediction that by 2015, more Internet searches will be done on smartphones than on computers.  This means people will actually use their phones to access the web and search for whatever they want more than they will on their computers.  But let’s face it, a smartphone is a computer.  My iPhone does more and has more storage and Internet speed than my laptop did 8 years ago.

Also keep in mind that more than half the phones out there are smartphones, and that keeps increasing.  And now that Google is buying Motorola,  that is going to be accelerated.  Android phones already outsell iPhones, and 60% of the new phones sold are smartphones.

What does that mean to your dental practice?  Well, first of all, you will need to make sure that when your practice appears on a Google map, that you’ve put as much information as possible in Google Places about your practice.  In an earlier blog, I describe how to do that. This also means that the steady migration away from yellow pages use will continue and likely accelerate.

It also means your website should look good on a smartphone’s browser.  That’s easy to check.  Just use your phone and look up your website.  Most web designers now can make a version of your website that displays better on phones and tablet computers like the iPad.

The best part is that more and more, this computer that is always in their pocket makes it easier for you to contact patients, either by text or email, and to even send them photo or video messages.  It also means that more of them can use their phones while they are in your office to check in on Facebook and post a comment, and also do a Google or Yelp review of your practice.  (Remember, they need to do Google reviews from their own devices, not your computers or iPads in your office.  Google ignores reviews that come from the same computer.)

And someday, they are going to be able to make and change their appointments right there on their phones without even calling you.  It’s coming, and people will expect it, so start to prepare yourself mentally for this.