Alex Membrillo joins us for our inaugural episode to share his expertise in patient acquisition strategies. Alex is the CEO of Cardinal Digital Marketing, an agency which specializes in working with healthcare practices. Learn what marketing channels drive the most leads, where practices are wasting their time, and what you should be focused on at various stages of your marketing growth.
Alex Membrillo joins us for our inaugural episode to share his expertise in patient acquisition strategies. Alex is the CEO of Cardinal Digital Marketing, an agency which specializes in working with healthcare practices. Learn what marketing channels drive the most leads, where practices are wasting their time, and what you should be focused on at various stages of your marketing growth.
Today we're asking the CEO of Cardinal Digital Marketing how health care practices can get more leads. This might be cheating but let's see what he says. All right. So in our last primer episode, we distilled all the ways practices can increase revenue into five general buckets. And today we're going to start with bucket number one, which is lead generation or getting more patient leads. So Alex is joining us today from Cardinal Digital Marketing. Why don't you introduce yourself? Ken, you said I was the inaugural interviewee? Now I'm disappointed. It sounds like there was one before me. There was in a primer. There was a primer. We had a primer. Sorry I primed you, Alex. Sweet. I don't know what that sounds..looks.... Okay, so. Hey, everybody. So this is fun being on the other side of a healthcare marketing podcast. I'm Alex Membrillo We run in very similar circles as Charlie. We are the agency side though, so we help multi-site PE-backed provider groups scale, their patient acquisition, through digital marketing, SEO, paid search, website, analytics. You think it, we could do it as long as it's online and helping patients find the care they need. We do it in part through great technology partners like Liine. I was not paid to to say that, but and I hope you guys don't ask me Liine-specific stuff. I got people that work with your platform all the time but I can help with high level fluff that you can. No fluff. Okay. No fluff. No fluff. Now that guys, listeners, it's going to be great. We're not going to screw around. Alright, Ken. Don’t let me intro myself again. Let's keep going. It was perfect. That was amazing. Yes, we aren't, we aren't here to talk about Liine, that's for sure. No Liine. No Liine involved. Let's start with just in general discussion and then we can go into some questions if we need to. But I guess big question, as a fellow marketer myself, I have an opinion on this. I want to hear what you think, though. Do you think it's unfair to talk about marketing lead generation without marketing as a whole? Are we are we kind of cheating? Talk about lead generation in isolation without talking about branding. And these days, I would say these days I would say yes. I think the patient journey is more complex. You know, five years ago I started the agency 14 years ago, it was simple, you threw up...you didn’t even have to make a landing page. You didn't need call tracking or a call center. You just threw an ad on Google ads and sent them to any page on a website they’d can convert because the competition was worse than that. So, you know, that was good. But over the last few years, the basic journey has become more complex. We see brand impressions on Facebook, Insta, Tick Tock, YouTube, display ads, wherever it may be, or do our own research - I tore my ACL You’re researching now on Google. Hell, ChatGPT sent us a lead the other day which is crazy, so I think the patient journey is complex. I think it's short shortchanging it to just talk about lead gen. I think the whole thing is performance marketing brands are part of that brand and performance marketing go hand-in-hand to to drive patient volume. So I see it as one or the other and stop giving clients the option to opt out of brand or upper funnel campaigns. I’m going to say like this is what eventually drives your CPL down. So you have to do it. Great tech partners will help you figure out what channels are successful and where you're falling down operationally. But you got to do it all together these days. And I've got the shirt that would make you think that I only cared about one channel run TV, (Run PPC) but you got to send me that. Man, that's cool. They're good. $25. Well, what else, Ken? What was your opinion, Ken? I kind of agree that we're we're basically asking for the icing on the cake when there's like the whole rest of the cake is kind of important, too. But we're going to try and cheat a little bit anyway because we're going to try to talk just lead gen exclusively, because.. That's what I know best. That's kind of where we're... that's where we're at in the funnel, which you’ll only know about the funnel if you saw the last episode. But that's where we're at in the funnel. Okay? So let's let's just again try to cheat and bite right into the meat. If you had to pick two or three marketing channels or activities for a health care practice and you don't know anything about this practice, is there an answer like is are you going to tell them like, these are the main things that work? Yeah, yeah. Channel. It’s hub and spoke website has got to be a great hub because there's no point in driving SEO or listings or reviews or PPC traffic from your spokes back to a shitty looking website that doesn't convert, and’s got no online booking, etc. So the website matters a lot, the right content in the right places and that and the right creative to to convince people you're the provider group to go with. But then SEO reviews and Google ads is really all I need at a basic level for smaller groups. And then you start scaling 10, 50, 100 locations. You got to start layering on all the upper funnel channels because you run out of demand at the bottom of the funnel. Bottom of the funnel stuff is good up to like 20 locations. I mean, yeah, you scale pretty well with that. So you think 20 locations is a good kind of break point to start looking upper funnel? Yeah. Then you got to really start bringing a marketing director and get more sophisticated. You're probably doing to know those every quarter you need like a new market playbook where you're going to have brand awareness campaigns. When you open. Yeah, it gets more complex, but you can get to 20 locations, sell out to a PE firm without having done any of that complex, expensive stuff. Hmm. Interesting. Is there any particular activities or channels you're seeing overlooked, like any kind of hidden secrets? Yeah. SEO Yeah, maybe because we work with a lot of PE-backed groups. I think the timelines are too short, that the patience is limited and but it's a phenomenal channel. If it's looked at correctly, it's like a content thing to make your website rank or a good see SEO person is looking at the UX of the website and helping get conversion rates up for pad traffic and organic. They're teaching you how to get patients into the door faster. So yeah, I think SEO is like tried and true and it's not going anywhere. And Google's search volume hasn't decreased at all. And so yeah, very much alive and well and underplayed, especially in our little niche we’re in. And is that mostly local SEO or how does that kind of shakeout. Yeah. Just for the medical groups so I think better used to be in maps right. You got to be in maps when someone types in“orthopedic surgeon near me”. That's going to be a maps and reviews and all that stuff, but you can optimize those listings and then below it you have organic, which matters and for locations, providers and then all the educational content matters too. But SEO’s phenomenal. And I would very short patients in the field that was great. So it's all Google ads, Facebook ads and you know, it's not I don't think that's the right approach. Do you think they're overlooked because most agencies suck at that? Or why did practices not dive? Suck at explaining the value. Do you love this? I have the... It's a dynamic background for you guys. Oh, it's great. Yeah. Yeah, it's good. And you can see like I hand drew this in COVID. ****ing logo and stuff No I’m kidding. I overpaid someone to do this gibberish I think. I think SEO is miscommunicated the value of it. I think when we're initially bringing on the project, the PR firms like want to get in advertising. Okay, quick returns. No. It’s like 1 to 2 year play. Bring me in after your first run after funding year one. or year two So we've got a three year ramp on it, like don't bring me in when you're maximizing EBITDA to sell. But it's a phenomenal channel. It's still the best still drives the majority. Rich, like this is a recorded podcast, Rich. Rich is literally... Get the **** outa here. That is great. I, I want to say I love the personality here. He’s just straight, what a bunch of rubbish. All right, let's move on. I was going to ask about the breakdown. So you said SEO is majority for like a successful, successful successfully, I guess structured marketing play. Yeah. Okay. Yeah, Yeah. And then they get bigger. Google ads takes over and scales much more than SEO does, much faster. Up to 20 locations, baby. Awesome. How about, let's just keep rolling. So are there any particular places you see practices who just don't quite know what they're doing? Are they wasting time or money in certain places? Yeah. Good question. You know, the ones where I think they're wasting time is they're scaling advertising before they set the proper technology foundations. They get really big because they're good at advertising, but then realize they didn't set up like a like a CRM or call center. And I'm not saying that just because this is ya’ll’s podcast. I say it all the time. It's very hard to go back and implement call center or sorry call tracking CRM marketing automation at 500 locations. It's like dude just set this shit up at 20 locations. It seems like a big expense because you’re small, they will be a bigger distraction trying to move through instead of just trying to move your sailboat right now and do things correctly. Also, getting the right technological foundation when you're small is cool. You're going to learn faster and yeah it’s an investment up front. But like if you're not an idiot, the learning should be good enough to like, usurp your competitors pretty quickly, even when you're small. So yeah, I think technology needs to be set up forefront and I think marketing is going to change to like, half of the recommendations I find myself making these days are like tech investments when people are getting going with us Oh yeah, it's interesting. Go get these things and we can help. And if you don't have these things, we're going to be flying blind. I kind of don't want to mess with you. Yes. Another way of saying or to play that back, there's not necessarily a particular channel or activity that you see them wasting money on. It's all of them. But because they don't have good technology to know what's working and then they're also not optimizing what they're doing with the leads, right? They're just they're not going to be able to optimize any channel that they're messing with that. That's right. Get that tracking. You're never going to know, and Liine might say differently, but I don't think you're ever going to know like multi-channel attribution and you don't need to. You need directional information. You need to know how the operations taking calls and converting you need to CRM. So I can understand how to market your patients on an ongoing basis and get ongoing referrals and stuff like that. So it's not really the wrong advertising. It's like the wrong structure, putting the wrong foot ahead. Yeah, like too quickly. So yeah, I mean, the advertising, I don't see like huge issues there. It's generally like they're just not doing it and they don't have the tech in place and they want to start running before they start with that stuff. So yeah, different cases, but when you get a group small, you can do the right things. When you get a big have you, it's just takes forever and I don’t have the patience for that. But yeah start small with the right tech. Perfect. Cool. I'm sure a lot of practices are curious how much they should invest in marketing. Is there a kind of a hard and fast rule like percentage of revenue or growth trajectory they should look at? Or how do they think about that? 30% of every dollar that comes in should go to your digital advertising. I don't know for medical groups. I know for agencies like high growth agencies like us will spend 15 to 20% every month on marketing and sales. And that's what we do because we're a high growth agency for medical groups, I don't know, 5 to 10%. I would, I would think really high. But the higher growth groups like that spend a lot on advertising, do really well if they understand what the advertising is driving and then they just pour more fuel on the fire, those are groups that kill it. They put the right systems in place to know what that next dollar would do. And then they say, I'm go spend ten or next dollars. And then the opposite problem comes into play where we don't have enough clinicians, mid levels, whatever to support, and then they've got to solve that problem. You know, somebody just asked me this Ken I can't remember, it was some PE group and they brought on a new marketing person who doesn't have a lot of health care experience. And so she asked me that. So I asked like five or six of our customers and 5 to 7% of revenues. What I've heard in general on average, and then the high growth to Alex's point, probably the highest I heard was 15. But then people that are more aggressive that I would consider really legit were more like ten. And I think I think probably there's plenty of practices that are five or a little bit below and it's just it's just probably not enough It’s called a lifestyle business. That’s what it is. Yeah. Okay. You grow 10% a year and you're going to give great care to your patients. And it's the lifestyle business. It’s not what I want and probably not what makes for the best clients. But it's also okay Cool. Alright. Let's kind of consider different stages companies and practices might be in so if they're just getting started like they they really have no idea what they're doing with marketing is there like day one what they should be researching or jumping into? Should they start with the SEO, start with Google? Like should they ask questions before they even do that? How would you kind of direct someone like that? Yeah, website SEO. I want to make sure that you're ranking or at least set up to rank for the most important keywords like orthopedic surgeon near me, dentist near, me, all that stuff. So you're location pages is where I start. Make sure they're awesome. They can convert a patient. I'm going to make sure you have online scheduling. They calls CTAs that you have an email form and then I'm going to say, okay, all that's in place start generating reviews. User birdeye, use yex, blah blah blah and then we're going to start advertising website Website and SEO. Listings reviews, advertising. You mentioned online booking a few times. Is that just like if you're not doing online booking, like you're an idiot. Is that how you feel? Yes, I think so. But like there's a lot of groups that aren't. Yet. So like you're an idiot in a host of other like a gaggle of other idiots are right there with you. But like, dude. I’ve read so many.... heh dude dude... I read so many stats that, like our generation and younger all want to book online. I don’t want to ****ing call What are we going to do. I’m going to sit through 18 prompts. Okay, email form is going to take me three weeks. I call, I send an email form to a derm practice because I got this weird shit on my eyes. And it’s been two weeks and nobody's called me back. So like, I'd rather book the thing online and you can do that any time of night and stuff like that. There's not a lot of good online booking systems that let you see marketing all the way through. NexHealth is pretty good for dental, but in the general medical space, like what do they say? A lot of blue ocean or whatever that stupid buzzword is like someone go invent that shit and make it easy to use for medical groups and marketing companies as well. And even if you don't believe that you're that most people are going to do it or they're still like, who cares? Give give patients another way to schedule with you. Like, why wouldn't you offer it. It’s not even that. Why? Because the providers are picky on when they want to take.(That’s true) The consults It's always that. It's not that they don't think nobody will come. It’s that the providers are a pain in the *** and own the provider group and they don't want to step on their toes and tell them because it'll ruffle. The feathers and I say like, All right, well that's fine. Don't don't ask me why the advertising is not working. What the ****. Your competitor does online booking. So. Very simple. Awesome. Well, let's skip ahead to another practice. And this. This time they've been doing some SEO. They've been running ads. They’re just not sure where to go from there. You've kind of hinted at this already. Your thoughts. But let's just kind of pretend we haven't talked about this. What would you kind of say someone should do to kind of go beyond SEO ads or should they just not? Or how do they optimize? Well, they should. They should. There's only so much demand at the bottom of the funnel, like how many people are searching for orthopedic surgeon near me. Like, not a ton. So you still have to like there's a lot of we mostly work in the low acuity space where the health care decision is made in a day but in my opinion is influenced over months. Right. So if you saw that veterinary hospital’s ads, billboard, TV, digital radio or display or on YouTube over six months from when you moved into town, like OK when you finally go to search this time the vet clinic near me and you've got City Vet pulled up, they're like, I'm going to go with the one that I saw brand impressions of the last six months. So yeah, running really smart brand advertising campaigns is very good. Facebook Insta, I still think is the best platform for that YouTube also very good and then Google has it’s own display ****. So that's all very good. And if you live in Montana, you can't do Tik tok. But no, I definitely think everybody should be going to the upper funnel channels once they've like built the right technology and marketing foundation for the website. Very important like and I don't want to see any billboards running at you can't even run YouTube yet. So the best practices have a lot of creative in-house capabilities, not big teams, but modern, creative in-house with abilities. They have a young marketer that knows the new channels and can speak to the patients that are also, you know, trying to utilize online technology and stuff like that. So even the older populations like Senior Care, you'd be surprised they know how to use a phone and shit like really well, they know, they know how to use technology. You'll see them pull up. They're all their all of their medical records and they know how to book online. Like it's not an excuse to say my demographics, all there. We don't need that. Those mofo’s don’t want to call in either. Nobody wants to call in. No one wants to do it anymore. So old or young. Regardless of what your patient demographic is. Everybody wants the same thing, which is patient access made easy. I'm addicted to Instagram, so I've stayed off the TikTok. Should I should I not download TikTok or what do you think I should do? My wife is on the TikTok all the time. I don't know, man. I don't want them. I'm not I'm not even going to I'm just going to keep it away from myself. It's the same ****. I don't know. I know. Yeah, same thing. Awesome. We're about to probably have to wrap, but I want to ask one more question because I think it's important I hear this question... Ken’s like this is the worst fucking podcast. No, this is the best. I am actually. This is what we want. I’m actually super pumped about how this is going. They're all downhill from here. Yeah. So I've heard this quite a bit. Uh, practices or any business really. They're working with an agency or they have some kind of marketing person they don't really know how to compare. Or is this working? Should I be shopping for a different agency? Like they don't really know what they're doing? Is there a certain data set they should be asking for, or how can they really know their their agency is doing the right stuff, performing? I guess. How would you speak to that? Yeah. What's the goal? Filling capacity. Your capacity is not filled. Like what? Where is the problem? Back from there. Is it like patient is too high on a cost per lead or you don't know? Like if you don't know, then you may have the wrong technology partners. Like the best thing to do is go find an agency that has worked in your specialty. If you're a vet clinic go find an agency that's worked with several vet clinics and they get them on the phone, they're not going to give you benchmarks in their case studies. I wouldn't either. But they may tell you without naming clients, expect a CPL around here cost per booked client, not patient in vet space to be around here. You should be ranking here, go get opinions, and then it's a gut reaction. But at the end of the day, you should know some of these metrics that are further down other than like clicks and impressions and ranks, like how many leads, how many patients are they sending traffic based on capacity or are they just spreading advertising evenly everywhere or are they talking about wider issues like tracking all the way through? Do they help you in applying good call center, tracking practices and CRM? Are they talking technology? Are they unsophisticated? The right agency can be the right fit when you’re smaller and unsophisticated. That's probably the right solution is you don't need crazy agency capabilities and as you grow need to get more sophisticated, it's okay to break up and move on, but go get a second opinion from someone else in the space. You can go from there. Also, if you're a VP of marketing at a vet clinic, just go to LinkedIn Go hit up other VPs of marketing that are not competitive geos ask them to hop on a quick call. What’s your CPL? What is your agency doing? What technology do you use? Just go to LinkedIn and find someone that you could trust. You don't even have to ask an agency. I love that. That's a good idea. I well, it's been it's been awesome. I love this. Alex, I want to give you a second. Tell people where they can find you in case they're interested. Did you freeze? Well, I can tell you where to find Alex if we have to. Their website is Cardinal Digital Marketing dot com, and hopefully he'll jump back on, but definitely check them out if he if he doesn't unfreeze because they are they're awesome. Oh, there he is. Alex. Sorry. My internet keeps switching. That’s ok. You there, Ken, you got me? I got you. We got what you need. We got what you need. I promoted your website. Anything else you want to say about yourself before we depart? Yeah. No. Find. Find. Find us on LinkedIn. If you have any questions, hit up Charlie first and then if he can't answer come ask Rich. Yeah, I'll give you a cell phone. I'll give you his cell phone. Give him this weak *** Apple tracking stats here. Happy to help Thank you. Thanks, brother. Need any help promoting let me know, ok? We appreciate it. Later brah.