Marketing Lessons Learned from Thriving Practices

Narrator: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice—one that provides personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, your podcast co-host. The title of this episode is Marketing Lessons Learned from Thriving Practices. So, we’ve gone to the Brain Trust here, and we’re gonna share with you the things that we’ve learned over the years in marketing from thriving practices about how to attract and keep quality new patients in your practice. I think you’re gonna really enjoy this episode.

Hey, before we get to the episode, though, two quick announcements to make. If you haven’t already joined RIDA, the Reducing Insurance Dependence Academy, I would encourage you to do that. And the reason why we’re talking about this now is every fall, we do a RIDA Summit. It’s a five-hour virtual event, done on a Friday. It’s coming up this fall, and it is just chock-full of information to help you successfully reduce your insurance dependence.

Gary Takacs: First step would be to go to the RIDA website. That’s RID Academy—Reducing Insurance Dependence—rid.academy, and register for the academy. And we’ll be sending announcements to our academy members on when the annual summit is. This would be our fifth annual summit. Each summit has exceeded the previous one in terms of size and impact. If you’re trying to figure out how to reduce your insurance dependence, that summit’s the place for you. So, RID Academy, come join us.

The second announcement I have is we have a returning guest, our great friend of the podcast, Dr. Jared Williams. And Jared is gonna share with you two tips regarding extraction of wisdom teeth and surgical extractions. This is the kind of information that if you extract wisdom teeth and do surgical extractions, you’re gonna be able to use this information right away.

With no further ado, here’s Dr. Jared Williams.

Jared Williams: Hey, guys, do you struggle with your production, especially when it comes to surgical extractions or wisdom teeth, for that matter? And are you fearful of any nerve that you’re working around? Well, if that’s you, I wanna let you know you’re in luck. I’m Dr. Jared Williams, and I’m gonna share with you the two tips that I use in order to boost my production and be able to sleep at night when I’m working next to a tooth that’s by the inferior velar nerve. Let’s jump into it.

Alright, guys, I just wanna let you know when you are looking at a case, the number one thing that you have to do is take a step back. One thing I find when I watch social media is that a lot of doctors are intrigued by taking out teeth very quickly and being able to see those bloody teeth on the gauze.

Jared Williams: But the challenge is, that is false. It’s not about how fast you do things; it’s about how efficient you are, along with making sure the patient smiles after surgery. So, a couple things I want you to realize. If you’re gonna boost your production and you’re gonna be able to sleep at night, you have to remember this acronym: NRC—nerve, root, crown. Alright, repeat after me: NRC, nerve, root, crown. If you remember those three letters in that order, you’ll never disturb the nerve, and you’ll boost your production without even thinking about it.

Alright, there’s 1, 16, 17, and 32. Now, if we’re looking at boosting our production, we have to ensure that we have the right codes, because if we don’t have the right codes, what’s gonna happen is you’re gonna essentially be working at a significant discount, or even for free. I’ve worked with doctors where they are telling me they’re coding third molars as just simple extractions and/or surgicals.

Jared Williams: And I wanna let you know, if you are having struggles with that, I created a single guide that’s gonna allow you to code with ease. And that’s my Third Molar Extraction Secrets. What I wanna let you know: NRC—nerve, root, crown. So, if I look at this every time I work on a patient, I always trace out. And the reason why I do that is this: that’s the first thing you should be looking at when you’re looking to take out a lower tooth. I don’t care if it’s a third molar, second molar, first molar, doesn’t matter. You always wanna look at the nerve first.

The second thing you wanna look at is the roots, ’cause the roots are gonna tell you a lot. Then the last, but not least, is gonna be the crown. Now, when you focus on NRC, what happens is it allows you to really hone in on your coding.

Jared Williams: So, there have been times where I’ve seen doctors code a tooth like this as a surgical—partial bony or a complete bony—and I would let you know all of those are false. Same thing with 17. All those codes will be false. See, when you look at NRC, you have to remember if there’s nerve involvement with the roots, then right off the bat, it’s gonna be a 7241—complete bone with complications.

When you do that, you are, number one, alerting yourself that, hey, I can’t be quick by taking these teeth out. Number two, you’re also letting the patient know, hey, there’s gonna be nerve involvement, so there’s a likelihood of you having numbness. And when you speak that and you’re able to isolate that and diagnose it on the x-rays, then it’s putting everybody in the position for success.

See, it’s not about how fast you get these teeth out. It’s about how efficient you are, along with having your patients smile after surgery. And, ladies and gentlemen, if you follow those simple words of nerve, root, and crown, your production is gonna be boosted by default, and you’re never gonna have to worry about the inferior nerve again.

If you deserve to smile through surgery, I’m Dr. Jared Williams. Have a phenomenal day, and I look forward to meeting, shaking your hand, and also seeing you at one of our future courses. Make it a great one.

Gary Takacs: Welcome back to The Thriving Dentist Show. This episode is gonna be a little diversion from our normal format. I’m gonna be asking very specific questions to Naren about marketing. Naren, as you know, is our podcast co-host. He’s the founder of Ekwa Marketing. He’s an expert in the world of dental marketing. And we’re gonna tap into his brain, and mine, to talk about how to consistently attract quality new patients.

I’ll make an opening comment and say, it’s my perspective that every thriving practice has an appetite for adding new patients to their practice. Every practice does, because if you’re practicing comprehensive care, you’re gonna get to a point with many of your patients where they are restored. And of course, that’s something to celebrate, right? Yes. ‘Cause maybe they come to you with all kinds of different situations going on in their mouth, and over time, you get them restored.

Gary Takacs: And as you get them restored, of course they’ll still be patients in your practice, but it’s less likely that you’re gonna cultivate treatment out of hygiene exams from your existing patients because you have succeeded at that. So now we have to look at, well, how do we attract quality new patients? Because quality new patients often has to do with the velocity of your practice.

And if you’re a regular listener to The Thriving Dentist Show, you know that we are a fan of thriving practices that are growing—that are growing. You know, we teach our clients, if they’re growth-minded—and they are—that we want to be growing by at least 10% in collections every year. Notice how we measure that: 10% in collections every year. And those are years where you’re not adding other providers.

Gary Takacs: Maybe you’re not adding any more hygiene, you’re not adding another doctor, you’re not adding maybe a specialist that works part-time in your practice. This is just the regular course of events. You wanna be growing by at least 10% a year, because you’re either growing or you’re dying. And given those two options, I’m on the growth side, and I think you are too.

Now, some of you might say, what do you mean, Gary? Isn’t there a third choice? Well, the third choice would be staying the same. But staying the same—if you think about what does that look like—Naren, what does staying the same look like on a graph? What does the, yeah, I mean, line look like?

Naren Arulrajah: It looks flat. It’s kind of like a person, you know, when you turn on the heart rate monitor—I mean, the, the, the—

Gary Takacs: It’s a flat line graph.

Naren Arulrajah: Flat line graph. So it’s like they’re dead. And the reason staying the same is equal to dying is because your expenses are going up. So, meaning every year is gonna be worse than the prior year if your expenses are going up and your revenue stays the same, right? Which means you’re working harder for less and less and less money. Isn’t that the form of dying for a business? Yeah. You know, because even your personal expenses are going up, your business expenses are going up, but you’re making less money because of that—because of this flatlining.

Gary Takacs: So really, new patient flow is vitally important to be a consistently thriving practice. Okay, with that opening in mind, Naren, I’m gonna volley some questions over to you, and we’ll kind of go back and forth on these. We’ve got a handful of questions. These were submitted by our listeners about marketing, and we thought you’d enjoy kind of hearing our perspective.

Again, our answers come from our experience in working with thriving practices. Alright, the first one, Naren, is: when should a dentist start thinking about marketing?

And let’s kind of frame this a little bit. Let me get a little deeper on this. Before opening, before buying a practice, or after? You know, the truth is, if someone becomes a practice owner, there’s basically two pathways to become a practice owner, Naren. They can do a de novo practice—start it from scratch, right? Or they can buy one. When should the dentist start thinking about marketing in either one of those scenarios? Maybe start with the de novo office, and then talk about someone that’s buying one.

Naren Arulrajah: Yeah, absolutely, Gary. So let’s say, if you are starting with a startup practice, I would say start marketing at least several months— even six months—ahead. Why? Because every successful practice, every successful thriving practice we have ever worked with, has a marketing machine that’s able to attract ideal patients. That’s the key word: ideal patient. Not any patient, but ideal patient. If you don’t have marketing in place to attract those ideal patients, you’re going to start in a negative. I mean, you’ll go in, you’ll have fixed expenses—your rent, your team pay, etc.—but you’ll have zero patients. So definitely starting marketing before is the smart way to go.

Now, if you’re buying—

Gary Takacs: Lemme piggyback on that, Naren, because if a doctor that’s doing a de novo practice—a startup—doesn’t start marketing ahead of time, the common tendency is to do what? To attract—

Naren Arulrajah: Sign up for PPO plans.

Gary Takacs: They sign up for PPO plans. And there are experts in the area of de novo practices. And they’re not necessarily wrong to say, if you’re gonna do a de novo, go ahead and sign up for some plans. Yes. And maybe you need to be selective about the ones you sign up for—look for ones that have better reimbursement and so on. I don’t necessarily disagree with that, Naren, but now think about what that does for your startup. It already—

Naren Arulrajah: You’re starting with patients who are not ideal, right? The ones who will only have dentistry done if it’s paid for by insurance—where you can only do tooth dentistry, right? Because there’s only so much the insurance company… they’re—

Gary Takacs: They’re not interested in… they’re not generally interested in optimal oral health. They’re interested in what can I have done that’s free—that’s covered by insurance. Now, again, I don’t necessarily disagree with that for a startup.

Naren Arulrajah: I mean, from a survival perspective, if that’s your only option versus not being able to pay your bills—yeah, from that perspective, I would agree. You have to do what you have to do just to pay the bills. But from the perspective of building this amazing practice you dreamed about, that’s the worst thing you could do. Because now you’re getting the wrong kind of patients every single day. And every single day, you and your team get trained on taking care of the wrong kind of patients. You know, how do we do single-tooth dentistry? How do we live in a world where every ideal treatment recommendation—"No, it’s not covered by insurance, I don’t want it. I don’t want it." So like, you get trained on giving up your ideals, giving up what you went to school for, and living with whatever you can get, which is not a great way to live.

Gary Takacs: I’m gonna hold your feet to the fire, Naren. So now you’re suggesting six months ahead. Yes, there’s nobody to answer the phone. There’s probably no website done yet. What do they do?

Naren Arulrajah: Great question, Gary. See, people think marketing is instant. It’s not. Human beings don’t go from hearing about a business to liking them and choosing them in 30 seconds. Usually, it takes weeks and months and so forth, right? I mean, you know this, right? Relationships you have—I mean, I’ll be turning 50 this year, Gary—you’ve been on this planet for a while. I mean, you don’t decide to go do business with somebody in one second. Like, sometimes you may have thought about a decision for years, right?

So marketing is the same thing. People don’t just—remember, people are not living in the middle of a desert where they don’t have any other dentist and you’re the only guy showing up and they’re lining up outside your door. They have lots of options. And usually, when they’re willing to switch, it’s because they’re not happy with their current option. That’s when they wanna switch—and they’re gonna take the time to think and choose you.

So by starting early, you can invest in SEO, for example. SEO takes time. You know, it’s one of those things—it’s for people who are willing to think long term. It may take one year for you to really start seeing results. So the later you wait to start SEO, the fewer results you will see by the time you open the door.

So, for lots of reasons, I would recommend it. Now, what if a rare phone call comes in in the first few months? I mean, that’s easy today, right? You can have it forwarded to somebody’s cell phone—maybe even your cell phone or somebody else’s—or the voicemail could pick up and say, “Hey, I’m really sorry I missed your call, we’ll call right back.” And then, of course, you can find a workaround.

Gary Takacs: Now, perfect sense. I like SEO an awful lot. How long does it take—you know, here we are at the time we’re recording this, 2025—how long does it take to really get SEO fully dialed in for… and I know that it’s relative to the Google search algorithm. How long does that take?

Naren Arulrajah: Yeah, in our experience, Gary—I’ve been doing this for 18 years—and we specifically, you know, that’s our superpower, if I may call it, which is helping people dominate SEO and rank on Google. The magic number is 100 keywords ranking on page one.

The minute you are ranking for more than 100 keywords among the top 10 results of Google search—searching for a hundred different keywords and phrases—you are now in the top 5%. In our experience over 18 years, we can absolutely guarantee you: anybody—it doesn’t matter whether you’re a startup or an established practice—should be able to get there in less than a year. In some cases, we have gotten there in six months, in four months, but I have never seen anybody not get there in 12 months.

So, within 12 months—if you’re one of those conservative people like I am and you want to plan for the worst and be happy when you’re surprised—then I would say give yourself a year to really rank for a hundred keywords.

Naren Arulrajah: The minute you start ranking for a hundred keywords, then you are in a different field—almost like a different planet. I mean, it’s kind of like—we talk about the top 1%, right? They have capabilities. Their kids go to the best schools, they have money that’s making money for them, so they’re not making money through trading hours. They have unfair advantages.

Once you’re in the top 5% of SEO—and as long as you can keep it—Google will try to kick you out, because Google makes money when you’re not in the top 5%. That’s when you have to give them Google Ad money, right? So Google is in the business of not letting you stay in the top 5%.

Assuming you can get there and stay there, it’s an unfair advantage. And I say give yourself a year to get the unfair advantage. There’s a lot of behind-the-scenes things you have to pay attention to, like NAP, and Lighthouse score, and backlinks, and even Google reviews that you have to work on in those 12 months to get to the top 5%.

So, I mean, I can go in depth, but that’s a short answer, Gary.

Gary Takacs: Let me go to the second part of question number one. A listener is buying a practice. The practice has never done marketing, ’cause they just did—it was kind of old school, where they got their patients by referral. When should that soon-to-be new practice owner start marketing?

Naren Arulrajah: Immediately. But obviously I wouldn’t start marketing before you sign the deal, because the deals can fall apart. But literally, if you’re signing the deal today, I would start my marketing today. And the reason is, both Gary and I alluded to the fact that you have patients, and then you have ideal patients.

Yes, PPO will give you unlimited amounts of patients, but they’re not ideal. A, because you only make 60 cents on the dollar because of the write-offs and everything else. Also, because these people will only do what’s covered by insurance, which means you can’t do ideal dentistry.

So imagine if you’re buying a practice that has not done any marketing—more than likely it’s gonna be a PPO practice where most of the patients are not ideal patients. So it doesn’t give you the practice of your dreams. Yes, it’s a good launching pad. Yes, you have cash flow on day one. You have something to work with.

Naren Arulrajah: So for those reasons, you’re buying the practice. And I think that’s not a bad idea, but the sooner you start marketing, the sooner you start growing your freedoms. In other words, the minute you’re getting 10, 20 ideal patients, now you can decide to drop a PPO plan that is treating you the worst. You can decide to even cut your hours and focus more on those ideal patients versus wasting your time with these patients—in some cases, you might even be losing money on.

I mean, Gary, you had shared with me examples where literally, by not taking certain patients, you are saving like $150 just because of the way the PPO was structured with those patients.

Gary Takacs: Costing you money to take care of those patients. Exactly. I’ll add one dimension to that, Naren. The office that, say, is a PPO—the office you’re buying is a PPO practice—and they’re not doing marketing. Actually, they are doing marketing. If they’re a PPO practice, then they’re doing marketing by paying Delta to provide them patients.

Yes, but they’re paying a massive tax. I like—for our listeners, if you’re perplexed by this—think of your insurance adjustment as a marketing expense, because you’re paying Delta to provide you patients. And if you’re paying 45% of your revenue to provide you patients, that is a massive, massive tax. And there are a lot of better ways to do this.

Alright, Naren, let me move to the second question. It’s kind of a two-parter, so let me read both parts: How should dentists think about marketing? Is it just ads and social media? I think that’s a great question.

Naren Arulrajah: Absolutely, Gary. I think a lot of people think of marketing as ads and social media because it’s something that’s in their face. They see ads all day long, and of course they hear about social media from all their employees, because one of the biggest excuses that employees may have is, “Oh, I’m working on your marketing—on your Facebook page,” even though they’re checking their own Instagram. So it’s in their face, they hear about it all the time, especially if they have young teenage kids. Again, those things—especially social media—you see them all the time, so that’s what people usually default to when they think about marketing.

But the reality is, having done this for 18 years, I know Google Ads are at least five times more expensive than a well-run SEO campaign. Now, the gap between Google Ads and SEO will widen the longer SEO has been in place—assuming it’s good SEO. I’m not talking about bad SEO.

Naren Arulrajah: Now, the thing about social media is—again—it’s kind of the haves and the have-nots. I talked about 5% of the websites getting 95% of the traffic for free from Google. Same thing with social media. One percent of the people posting on social media get 99% of the traffic. They’re called the influencers. They’re the ones spending 20 hours a week posting and becoming content queens or kings, and they have a following of 100,000 people liking them and so forth.

Yes, for those 1%, they do really well with social media. But 99% of the practices I work with—they don’t want to be on social media 15 hours a week. They don’t want to put their lives out there. They don’t want to make this a 15–20-hour gig every single week for the rest of their life. So for them, social media really doesn’t work. Even though it has a lot of the sex appeal, it really doesn’t produce results.

Naren Arulrajah: How do we know all of this? We track everything. We track it through forms and special tracking numbers so we can see exactly what’s happening when a patient is calling in. And we find SEO is by far the most cost-effective, long-term strategy.

Now, like I said, the downside is it won’t happen quickly. It’ll take time. You need a year for you to get to that 100 keywords ranking on page one. But once you have it, your job is to just defend it. I have clients who’ve been with me for 14 years—they are ranking for even 600 keywords now. LifeSmiles—seven or eight years now—ranking for 600 keywords.

So the beauty of SEO is, yes, it takes a while—about a year—but once you get strong, then you can get stronger and stronger.

Naren Arulrajah: Now, that’s still not enough. I mean, both social media or Google Ads or SEO brings people to the door, but they have to be convinced. So you need to have before and after pictures, depending on the type of work you do. For example, if you’re doing high-value dentistry, you want to showcase the cases you’ve done and how you’ve changed people’s lives. Because people today—they want proof. They don’t just trust your word. Just because you rank—that’s not enough for them. They want to see the cases. They want to see the examples.

Also, they want to like you. So perhaps you can use videos to get them to like you. Today, that’s so easy—you can record things on your smartphone. Even something as simple as, “Hey, welcome to my Invisalign page. I’m so glad you’re here. Look at all of the cases I’ve done. We would love to help you. Call my office.” Something as simple and short as that—easygoing, down to earth—where people feel comfortable with you.

Naren Arulrajah: Now, your competition—if they don’t do it, and most competitors are not doing it even in 2025—they don’t have amazing cases, they’re not ranking on Google, and at the same time, they don’t have those videos to welcome people. So if you’re doing all three things—

Gary Takacs: I’d argue a little bit, Naren, that our listeners have the cases. But you know what? They don’t have the photos.

Naren Arulrajah: I think you’re right.

Gary Takacs: At least, I’m saying Thriving Dentist listeners—yes, they absolutely likely have the cases. But they’ve gotten lazy about getting the befores and afters. They don’t—I’m sorry, did I say that, or was I just thinking that?

Naren Arulrajah: I think you just—

Gary Takacs: Thinking that? I just—I said it. So doctors, if there’s one thing you take away from here: make sure you’re getting the before and after. And we need the before. You’re always getting the afters—well, let’s make sure we get the before so we have some ammunition to put on your website.

Naren Arulrajah: And even on the afters—one caveat: full-face pictures are worth ten close-ups. And the reason is, the patient is not a dentist. They don’t understand or appreciate the nuances that a fellow dentist will understand or appreciate. But they can see the transformation. They can see that smile—that sparkling smile—and they can say, “Oh yeah, I was gonna spend $30,000 to buy that car. Now I can see spending it instead with Dr. Smith.”

Gary Takacs: It’s worth more than that.

Naren Arulrajah: Exactly.

Gary Takacs: Alright, Naren, I’m gonna make a statement, then I’m gonna ask a question—question number three. So the statement I’m gonna make is: I think the human condition today, in 2025, is that most humans are impatient. I think that’s a reality today.

Naren Arulrajah: Yes.

Gary Takacs: Most humans are impatient. I was a victim of that recently when I was lecturing in Rhode Island. I land, and I pull my Uber app up—and it was gonna take eight minutes. I’m not waiting eight minutes. I’m going to Lyft, because it was six minutes. We’re impatient.

So how that relates to this next question is: Why is it important for our listeners to have both a long-term and a short-term marketing strategy?

Short-term is the impatience part. Why is it also important to have long-term?

Naren Arulrajah: Yeah, most people are impatient, but most successful people are patient. I mean, look at Elon Musk—he started working on SpaceX 25 years ago. Today, we call him a genius and say he can do magical things, but it’s an overnight success 20 years in the making. It didn’t happen in two minutes. So I do think if you study anyone who’s successful, they are very patient. They think long term.

So I do think if you’re in this for the long term—if you’re planning to retire in a year or sell your practice in six months, then of course I wouldn’t recommend what I’m about to say. But if you’re here for anything more than three years, and you really want to enjoy dentistry, and you want to do the kind of dentistry you love, and you want to make your future better than your past—in other words, like Gary mentioned, a practice that’s growing 10% or more every year—then I really, really, really think you need to think long term.

Naren Arulrajah: And long term, I think, comes down to fundamentals. I love Michael Jordan. I was in Chicago when he came back and won the three championships. He’s one of those guys who understood the keys to success. And of course, his mentor and coach—they talk about this. He’s into Zen, he’s a very philosophical guy and so forth. Phil Jackson—that’s his name.

Gary Takacs: Phil Jackson, yeah.

Naren Arulrajah: Phil Jackson. So, you know, he talks about fundamentals, right? The basics. And to me, the fundamentals of marketing are:

One is helping people find you. And we talked about that. The short-term strategy could be Google Ads or any kind of ads. The long-term strategy is dominating Google—getting into the 5%.

Two is helping people choose you. I think Google reviews are important. Getting 10 or more Google reviews every single month. You and I coined a phrase called love letter reviews—these are paragraph reviews where people don’t just give you five stars, but say why they love you.

And again, if you go to LifeSmiles and look at their Google reviews—just type in LifeSmiles Phoenix—you’ll see what I’m talking about. They have more than a thousand reviews, and many of them are love letter reviews. So get 10 or more of those reviews. And trust me, Gary has coached every one of his clients—and those who follow his program, they get 10 or more reviews month after month after month.

Gary Takacs: You’re building marketing ammunition by getting those reviews.

Naren Arulrajah: Exactly. These are the fundamentals, right? You have to dominate Google so people keep finding you. And then once they find you, you have to give them a reason to choose you. Reviews are important. The cases we talked about, Gary—those are also important. Especially the full-face pictures, the after pictures, the before pictures—even the stories you can tell. Like, explain why the patient came in and how they felt. You can even do a write-up around it.

And don’t try to be perfect. Your first case may not be your best case. Or the pictures may not be the best pictures. But by the time you’re doing your ninth or tenth, you’ll get better, and better, and better. And at some point, if you don’t like the very first one, you delete it and add a new one in its place. So you don’t have to wait for perfection.

Naren Arulrajah: So I think Google reviews, cases, and SEO to me are the fundamentals—the long-term strategy.

The short-term is doing whatever you need to do. Yes, like you said, Gary—if a startup needs to pay its bills, and they have no other way of paying bills other than working with PPO patients who are not ideal—but it’s one way to pay the bills, hey, sign up for the short term. But don’t make it your long-term strategy. Because then you’re stuck. Every year they’ll pay you less and less. Your expenses will go up, but your fees won’t. So technically, the amount of money you make will go down and down and down.

So don’t make that your long-term strategy. Use something like a PPO as a crutch when you have to. Use Google Ads as a crutch. Like, let’s say you want to hit a certain target—and even though to get an Invisalign patient through Google Ads might cost you $500—you’re like, “Okay, I’ll make three times as much, so I’m okay with spending $500 to get that Invisalign patient.”

Gary Takacs: This next question—I’m very intrigued by your answer. I’m interested in this. I didn’t submit it, but someone did. But I’m as interested as whoever submitted this.

In a concise answer, Naren: What should your marketing actually be doing for you?

Naren Arulrajah: Yeah, I really think, you know, at the highest level, Gary, what the marketing should be doing for you is attracting the right patients. That’s step number one. And of course, the components are the things we talked about—the fundamentals: showing up when people are looking for you, convincing them with cases and reviews.

And the last piece that I didn’t touch on is the phone experience. Again, Gary’s clients have an advantage because he trains them on how to answer the phone and how to increase case acceptance. But really, the thing that I’m excited about is not necessarily just attracting the right patients—it’s the freedom it gives to drop those PPO plans that are bullying you, that are taking advantage of you.

You don’t drop all of them, but you could drop the worst offender first. And once you drop the worst offender, you’ll have the courage to drop the next-worst offender, and so forth.

So, like, I’ll tell you a story, Gary—this is an actual client of mine. I started working with her in 2011, and at that time she was doing $650,000, working four and a half days, and all PPO patients—100%. So she was killing herself. She was literally getting sicker and sicker because she was just working harder and harder.

Gary Takacs: Hamster on a treadmill.

Naren Arulrajah: Yeah, hamster on a treadmill. And then she heard somebody else use us and said, “What the heck, I’ll try them.” It’s a one-year investment. Let’s see what happens. And before she knew it, she was getting 30 new patient calls. And she’s like, “I don’t want to work five and a half days.”

So her husband—he works in the military, really smart guy—he’s also a finance guy. He said, “Why don’t we drop one plan and see?”

Of course, this is before you and I started working together, so they didn’t have anybody helping them. They just did it the dumb, stupid way—they dropped the worst plan.

And before you know it, she went to a $1.3 million practice. It took a three-year span. So she went to $1.3 million and still had one PPO plan. And they were doing three and a half days’ worth of dentistry.

So the thing ideal patients do for you is they give you options. Options to get rid of the non-ideal patients, get rid of the marketing methods—like PPO plans—that are bringing in non-ideal patients.

So that’s what kind of gets me excited the most, Gary.

Gary Takacs: Can I give you my slant on that answer?

Naren Arulrajah: Absolutely.

Gary Takacs: So the question is, What should your marketing actually be doing for you?

Wait for it…

Making your phone ring.

Naren Arulrajah: Ring! That’s—

Gary Takacs: The end.

Naren Arulrajah: Yes, the end.

Gary Takacs: That’s the answer today. Today, yes. 99+% of all new patient appointments are made by the telephone. Yes, that will change. That will change as more offices embrace real-time online scheduling. Quite a few offices are using real-time online scheduling for hygiene appointments, but they’re not using it for new patients.

Naren Arulrajah: I think the reason they don’t use it for new patients is there’s a lot of unknowns. You don’t know what kind of an appointment—

Gary Takacs: You don’t know what you’re dealing with. Yeah, exactly. But I think the answer—What should your marketing be doing for you?—in today’s context: making your phone ring.

That’s marketing’s job right now.

Now, in some cases what’s happening with doctors is, the phone’s ringing, but they’re not converting the calls to appointments. That happens—

Naren Arulrajah: A lot.

Gary Takacs: That’s not a marketing problem. The marketing’s job is to get the phone to ring. Right?
Then it’s internal operations’ job to convert that call to an appointment.

Naren Arulrajah: Let me ask you this. I know you have helped your clients go from, let’s say, the average of 30%—which is what the average dentist does—and I’ve seen that you go up to 80–85%. What are the keys to that success, Gary? How do you make that happen? I know it’s in the details, it’s what you do and how you do it, but just at a high level?

Gary Takacs: Yeah, it’s a whole combination of things. We have lots of success taking an office at a 30% conversion rate and getting them to 75%. And the difference in that is a radical difference in your number of new patients.

But it’s a process. And it’s training. It’s really about connecting with the caller. There has to be a connection. It’s not a relationship yet—it’ll be a relationship once they come into the practice—but it’s connecting with the caller.

It’s asking for the appointment.
The main reason why someone doesn’t appoint? No one ever asked for the appointment.

You know, patients will sometimes go on and on about what’s going on in their mouth, and the call just ends. It’s like, “Okay, well, I’ll be back in touch.”
And the team member could simply say—hopefully we got their name—“George, I’m sorry you’re experiencing this. Our doctor has lots of experience with the things you’re talking about. A great next step would be to make an appointment. Do you like mornings or afternoons?”

And just by asking that question, now we take a sort of rambling, disjointed call and turn it into a productive call that results in an appointment.

But there’s lots to it. And there’s some faulty call training out there in our profession. The faulty call training says that a new patient call should not last more than two minutes.

I completely disagree with that.

Yes, you can make an appointment in two minutes. However, the likelihood that they’re going to keep it is extremely low, because there’s no connection.

So if you’ve been… if you’ve drunk that Kool-Aid, you’re drinking the wrong brand.
Two minutes or less? No.

However, it doesn’t have to be a long call.
Our data shows that somewhere in the four- to five-minute range is where we can connect with them, make a meaningful connection, and make the appointment.

Alright, let me shift gears to question number five.

According to the data, nine out of 10 practices in the U.S. have no real marketing strategy at all. Why is that?

Naren Arulrajah: I think, Gary, you know, the dream that every dentist starts with—which is to change people’s lives, to do dentistry that is challenging and that keeps them engaged, where they can continue to learn—ends up getting killed for most practice owners. And that’s because, knowingly or unknowingly, they fall into the PPO trap.

And PPO forces you to work faster and faster, see more patients, because the amount of money you make per patient continues to go down year over year, adjusted for inflation. Of course, without inflation, then the numbers stay flat. But every year there’s inflation, every year your expenses are going up. So practices end up getting into survival mode and just doing more and more and more dentistry.

So they don’t really—it’s kind of like when you’re drowning—you don’t get your head out to just think for a second.

Naren Arulrajah: Just keep paddling and keep paddling and keep paddling. So I would strongly urge every single one of you: you think you don’t have choices, but you do. And I’ve heard this story—“Oh, I can’t get out of PPO plans in my neighborhood because everybody else is on a PPO plan.”

Or, “My son is going to university, so I don’t want to rock the boat right now. Let me just wait till they finish.”

They come up with reasons why not to change. And I’m sure you’ve heard this phrase, right? Keep doing the same thing you were doing yesterday and don’t expect any different results. If you do the same thing, well—

Gary Takacs: Einstein called that the definition of insanity. Albert Einstein said the definition of insanity was continuing to do what you’ve always done, expecting different results.

I’d answer it a little bit differently—we’re saying the same thing, right? But why do nine out of ten practices have no real marketing strategy at all?

Because they rely on being a PPO provider to provide their marketing.

Naren Arulrajah: Yeah, yeah, exactly.

Gary Takacs: And that’s a lame-brain strategy. Because you’re paying 45% of your revenue in the form of a continuous tax.

That’s your marketing. That’s your marketing.

Naren Arulrajah: And it’s attracting non-ideal patients who will only do what’s covered by insurance. So you’re spending 45% as a marketing fee every time they come in—and you don’t get to do ideal dentistry.

It’s like a lose–lose on both ends.

Gary Takacs: It’s a self-perpetuating behavior. It just produces more of the same.

Alright, we’ll close on this one, Naren. And it’s a great question:
If I want to build a smart, clear plan to grow my practice with marketing—and to gain an unfair advantage over my competitors—to attract not only the number of new patients that I want, but the type of new patients I want, where do I start?

Naren Arulrajah: Yeah, so definitely, I think it’s really—think about this particular episode, right? We talked about the importance of having a long-term marketing plan. We talked about the fundamentals that make the successful people succeed and everybody else fail. The people who succeed focus on the fundamentals, which are long-term strategies.

So once you kind of realize that, “Okay, you know what? I’m gonna do something. I don’t want to be getting my patients from PPOs, ads, or anything that’s costing me five or ten times as much—I want to do the right thing,” I would recommend just get a report card.

So we do what we call a marketing strategy meeting. It’s a $900 value. We don’t charge extra for it. The link is ekwa.com/td. Or you can go to ekwa.com/msm. Either link will work.

And when you go to that link, share some information. Our team will do research.

Naren Arulrajah: They will research not only you but your competitors. They will find out how you’re doing, how your competition is doing, and also they’ll give you a plan. So in addition to giving you the report card on how you’re doing versus competition, they’ll give you a plan on:

• How do you dominate SEO?
• How do you dominate all the components of internet marketing?

So you are the one who has the unfair advantage. You are the one who’s mastering the fundamentals. And then they’ll give you the plan and the report card—and then it’s up to you to decide what you want to do with it.

But I urge you: don’t rely on PPO plans as your marketing option. I know that’s what most of you—I mean, most practices—do. I hope you’re not in that bucket.

Slowly but surely, start strengthening your marketing. Start getting these ideal patients. And as you start getting ideal patients, you can kick some of these PPO plans to the curb. You can pay your people better because you—

Gary Takacs: Don’t need them anymore.

Naren Arulrajah: You don’t need them anymore.

Gary Takacs: You’re getting them from another source.

You know, most doctors that are PPO doctors say, “I don’t do marketing.” When in fact, they do. Their marketing was to sign up for—I’ll use Delta because they’re the 5,000-pound bully.

“I signed up for Delta. And because I’m listed on their website, that’s how my new patients come in.”

So, you are doing marketing, and you’re paying for it dearly—yes—in the form of your insurance adjustments.

And you could spend a fraction of that—a very small fraction of that—and produce a much better result. And not only just a numerically and analytically better result, but truly enhancing the enjoyment of your practice.

Because now people are choosing you for reasons other than “you’re on their insurance plan.” Maybe they’re choosing you because you have expertise in cosmetic dentistry, and they’re interested in improving their smile.

Closing Thoughts 

Gary Takacs: So now that’s the, you know, the pathway that they join your practice. Maybe you have a biologic practice or a biomimetic practice, and there’s people in your community that are attracted—they’re choosing you for that. Maybe you embrace technology, and they absolutely love that. They think technology is gonna help you take better care of them, and they’re choosing you because of technology.

Whatever your flavor is, whatever your secret sauce is, let that direct your marketing to give people reasons to choose you. And you’ll not only be enhancing your numbers, but you’re gonna be enhancing your enjoyment. Because now patients are coming to you really saying, “Doc, I’m interested in you helping me enjoy great oral health. What can you do for me?”

Imagine that—instead of, “Does my insurance cover it?”

Naren Arulrajah: Absolutely, Gary.

Gary Takacs: Naren, this has been very, very helpful. This has been a fun episode to do. Obviously, there’s a lot of moving pieces in marketing.

You know, we’ve used Ekwa since 2017 as our marketing agency—absolutely thrilled. Not only thrilled with the results, but thrilled with the quality of patients. I will often refer our coaching clients to Ekwa, especially those that are going out of network, because we need to replace Delta with another source. And we can replace them with organic SEO and spend a fraction of what we used to be spending on marketing.

I’d encourage you to go to ekwa.com/msm—that stands for Marketing Strategy Meeting—and take advantage of the report card that Naren and his team can do for you. We did that in 2017, and I’m thrilled.

I’m thrilled I did that many years ago.

Gary Takacs: Also, if we’ve kind of intrigued you at all to think about successfully going out of network, this is something we do in our Thriving Coaching. Would love the opportunity to help you kick Delta to the curb.

You can find out more about that by scheduling a coaching strategy meeting with me. Go to thrivingdentist.com/csm—Coaching Strategy Meeting.
And we can talk about your practice, what the path might look like, how much time it might take, and whether your practice is prepared for it.

It’s not something every practice can do. It’s certainly something every practice could do over time, but it’s not something every practice is prepared to do now. If you’d like to find out, just go to thrivingdentist.com/csm.

You’ll talk with me. I’ll be on the other end of that meeting and would love to have a chance to meet you and talk about how this might look in your practice.

On that note, Naren, thank you for contributing to this episode. Kind of a different type of episode, but a fun one.

Also want to take a minute and thank all of our listeners. We appreciate each and every one of you. Thank you so much for the privilege of your time, and Naren and I look forward to connecting with you on the next Thriving Dentist Show.