#259 This is What Separates $1.5M from $3M Dental Office

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Most dentists don’t realize they’re missing 35% of new patient calls and losing half of the rest on the phone.

In this episode, Gary Bird breaks down the exact systems behind scaling from $1M to $3M, including phone conversion, time-to-appointment, cost per qualified lead, and the referral engine that drives real new patient growth. You’ll learn the tactical frameworks used across 400+ practices to fix missed calls, reduce no-shows, and increase case acceptance by 30%.

This is real dental marketing and practice management data from SMC, not theory.

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Dental Marketing Goat, the go-to podcast for dentists who want to grow faster, market smarter and build practices that thrive in today’s competitive landscape.
Hosted by Gary Bird, the Dental Marketing Goat himself and founder of SMC National - recently named Best Dental Marketing Agency by over 60,000 dental professionals. Each episode unpacks the real strategies, marketing frameworks and operational shifts that high-performing practices use to attract more patients and increase production. Whether you're a solo practitioner or scaling a DSO, you’ll learn how to align your marketing, team and systems to drive predictable growth.

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Transcript

SPEAKER_00 0:00

All right. Today I'm going to be sharing with you how I reviewed 400 practices and what separates a 1 million to$1.5 million in collections to$3 million in collections. If you're at that million dollar mark or somewhere around there and you're really wanting to grow, I'm going to give you what we found in over 400 practices. And it's usually not the things that you think. And we've done this a lot. We've helped a lot of offices grow. There are common denominators in these larger practices that get to that$3 million mark. Or if you want to get to$2 million, same thing, right? And you need to make major adjustments to be able to get there. And again, it's not the things that you think. A lot of times we think, well, if I just had another doctor or another hygienist, then we'll just get there. That's usually not the case, okay? And because there's a lot of stuff that goes into this. So I'm going to be giving you eight things that you need to do if you want to double your practice, if you want to go from 1.5 to 3 million, or if you just want to grow, these are the things that you need to do. And we've seen this over and over and over again. And I firmly believe if you do all eight of these things, you will absolutely grow and you'll grow quickly. Okay. You can you can do you can go from 1.5 to 3 million in a year, maybe a year and a half. Okay, if you if you get all these things in. All right. So first thing that I've noticed that most offices don't realize is that they don't have a marketing problem. They actually have a conversion problem. What do I mean by that? Well, 35% of calls go unanswered at the normal dental practice. Every time we we on the board, you know, dozens of people constantly, and we're constantly looking at brand new people who've never worked with us before coming in and working with us right out of the box. And this is a consistent number. That 35% unanswered rate is just really, really consistent across the board. This is also what other companies have seen. I've seen other people's data on this. It's very, very consistent. Phone calls go missed. And we understand why. Your team is spread thin at the front desk, and you are also not able to predict when patient patient calls are going to be able to come in. And so you have a lot of people coming in at the same time and calling the office at the same time. So you're missing a lot of calls. Unfortunately, inside of those calls, there's a lot of new patients. It's not just existing patients. So you really have to understand that this is a huge hole. And most businesses, like any other business that you can think of outside of dentistry, if you miss 35% of your opportunities, if I miss 35% of the opportunities that were inbound to us and reaching out to us, and we just missed them and they ended up at another marketing company, we would literally go out of business. Same with most businesses. Okay. Dentistry is different because uh the opportunity is so great and the patients come in and they buy treatment and they stay with you for a really long time. So you can still make it work, like you can survive as a business. However, you you can't grow that way. Okay. There's a massive hole at the top of your funnel. And so you have to close that. And there's a couple of different ways you can close it. You can uh hire more people, you can hire a virtual assistant, uh like a VA overseas, those kind of things, or you can use AI. AI is$299. I have a link down for it below. There's no contract, it answers 100% of calls, never misses a call, and it converts better than a human. Okay. The other problem that we run into is phone conversion. Phone conversion for the average front desk person is they weed out about half of your new patients that are calling. Now, I'm not talking about qualified patients, or I'm only talking about qualified patients, I should say. I'm not talking about unqualified patients. So if a Medicaid patient calls or someone who needs ortho and you don't do ortho, like that's not what I'm talking about. I am talking about qualified people that should be coming to your office. Those people don't schedule with your office half the time. If you're not tracking this, you're losing half of your patients. And I know that it's hard to track this. Most people just use their ears and they're like, ah, if it kind of feels like my team's doing an okay job. You're you're bleeding. You're bleeding to death. And it's like, oh, everything's okay. And you have to be able to close this gap. You cannot grow without this. You just can't. And I've seen this over and over and over again. So this is one of the first things that we do when we help our clients on board is that we create visibility around this and we show them. Look how many leads came in, look how many of them were missed calls. We can see if they're new people because we integrate with the PMS. So we can see right away. Oh, you you had 10 people call today that no one answered the phone for. And uh of the five that you did answer the phone for, your team lost three of them. So out of 15 opportunities, you got two of them to schedule. That's a big hole. That's a big hole. So you got to close that. You have to close that gap. That's the first thing that you need to do. And you need to do it in conjunction with marketing. So here's what I hear a lot of times. Dennis will say, well, no, no, no. I'm not going to close that gap until, or I'm going to close that gap, then I'm going to pay for marketing. The problem with that is that you don't have the proper bandwidth understanding until you start marketing of what you're going to be missing. So what I recommend that you do is start marketing and start tracking at the same time and then fix the plane as you're flying it. And you can do it quickly. I've seen people turn this around in a week or two. So you can do it really, really quickly and not lose a ton of money. If you don't know those money, those numbers, you are losing a ton of money. You need to work with somebody who's going to help you close those numbers. And typically it's going to be a third party either tracking the data or a marketing company that's going to help you with that. Okay. So that's the first thing. And if your marketing company doesn't track this, then you, it's up to you. Like you have to figure it out because the marketing companies, like they did their job. They look at this as not doing your job. You didn't answer the phones, you didn't convert on the phones. And and saying, well, they weren't good quality, that doesn't solve unanswered calls and it doesn't solve your conversion problem. Okay. And there's exact scripting. You can check out my other podcasts. I have a ton of scripting, a ton of training on this. It's not hard. Okay. It's not hard. All right. Number next, time to appointment. So this is a big one. So the offices that are at this$3 million mark, they figure out how to get their time to appointment down to a couple days to max a week. And the reason this is important is you're going to get new patients that are going to call you and they're scheduling three to four weeks out. Now you don't, as owner, you don't think that they're scheduling that far out, but they are. The team is confused by the schedule. You see gaps, but they don't see the same gaps. And so they're putting these patients three to four weeks out. And what happens is the no-show rate jumps up to 40% when you're putting people that far out. It's really high. So now you have you didn't answer the phones, you missed a bunch of opportunities, you only converted half of the opportunities. Then you're seeing a 40% no-show rate because you're putting them so far out, you really are just losing all of your marketing opportunities. So you have to track average time to appointment and you have to get that down. There's there's a really cool thing that Dr. Blake taught me about called ghost columns. And it's it's a way to stagger treatment. It's a way to schedule patients based on uh production, potential production, not on just bodies. This is huge. This is an amazing way to schedule and always have availability for new patients. I also have another podcast, we'll link it down below, of where Dr. Shane has a$3 million practice. He went from two to three, he's gonna go to four this year. And he figured out another way that really helps his practice, uh, be able to always get people in and always have availability. It's amazing. So I'll I'll link that down below. These are great. If you want those resources, just comment. We'll get them to you as well if you're if you're on the live stream now. So that is the second thing that you have to do. So, number three, if you want to go from 1.5 to$3 million as a practice, um, you have to start measuring the right things. Uh, it doesn't matter how many clicks you're getting, it doesn't matter how many impressions you're getting. SERP rate doesn't matter. What matters is cost per qualified lead and then how you're doing with those. So this is the bottom line metric that you should be measuring. Now, marketing companies don't like this number because they like to just measure cost per lead. And what that means, it's really important that you understand this, like super important because you're speaking a different language than the marketing companies. Cost per lead for marketing companies almost always means someone went to your site and clicked a button. They clicked the call button or they filled out a form. Who knows if they're qualified or not? And they go, Yeah, we got qualified, we got cost per lead to$20. Or I saw somebody post something, we got we got conversions at$25. Well, the vast nine nine out of ten of those are not patients, they're not potential patients, they're existing patients, they're vendors, they're your mom calling to see if you want to go out to lunch. There's all these things that come through all these ads and land on through the site, and it totally jacks up all of your conversion metrics. So this is why you get really frustrated because when you're talking to the marketing companies, they're looking at it and they're going, Oh yeah, we got we had a bazillion uh conversions, we had a bazillion leads, like so many. And you're like, Okay, well, I had 20 new patients. On top of that, you're bleeding. So the first two points that I went over, you're bleeding all these opportunities, the opportunities that are real, those are going by the wayside. And then on top of that, you have all these things that are being tracked that aren't actually opportunities. So you want to track cost per qualified lead. Super important. How many leads did I get? You need to know that. And I know, I know what dentists think. I've even had people, dentists argue with me on Facebook, Gary, they're not leads, they're patients. Well, they're not technically, because they haven't walked into your office yet. So they're not a patient yet, they're a lead. And it's really important that we delineate the difference because this is how you figure out if your marketing's working or not, and if your team's doing what they're supposed to do or not, because that creates the gap. Because what happens is if you schedule a new patient on your schedule, and then you your the no-show and your team deletes it, it's like they never existed in the PMS. PMSs aren't made for that. So you have to have a different way of tracking this, different from your PMS, because no-shows, cancellations, all those kind of things, they just kind of disappear. So you have to be able to figure out how many qualified leads did I get for my budget. So I'm spending$10,000, I got X amount of leads, uh, cost per qualified lead. So this is gonna give you a dollar amount that it's costing you to generate that opportunity. And then from those qualified leads, I got, let's say, a hundred of them. How many of those came in? And then how long did it take for them to come in? This is gonna give you your cost per acquisition or your CAC. And once you figure out, okay, every time I spend$100, I get a qualified lead, and then one out of three of those are gonna walk in, or one out of four of those are actually gonna make it in after I'm all done and said, and so now my my CAC or cost to acquire patient is$400, and then you want to look at how much production are we doing on that particular patient? Over you can look at a month, you can look at six months, and you can look at a year. We track all of that, and so we look at it and then you go, okay, so you're paying$100 to make the phone ring of a qualified person, and then you're paying$400 for them to get through the door, and then you're doing$2,000 worth of treatment over the next year with them, plus getting patient referrals from them. We're doing good, but a lot of times we see people they come in, they're initially they're like, oh man, I don't I don't know what we're doing, and we're doing the math on it. And it's like, oh, you're paying$500 cost per qualified lead, you're paying a$2,000 to get this person through the door, and then you're getting like you're making$1,500 over the year off of them. Like, it doesn't make business sense. And this is why a lot of dentists can't grow. This is exactly why you're tracking the wrong thing. But all of your click-through rates, your your all all the vanity uh marketing metrics, it looks like you're doing good. It looks like you're crushing it. However, you're not crushing it. You're you're you're just barely treading water. And it's because you're looking at the wrong numbers. And and again, marketing people typically don't understand dental enough to be able to have these conversations. So it's really important in Dental that you work with somebody who understands these things. So that's number three. Number four, this is a big one. This is a big one. To go from$1.5 to$3 million, referrals are are better than digital marketing patients. They're just better. So you need to generate more of them. Okay. So how does that look? If you are a healthy office and you're getting 50 new patients a month, about 40 to 50% of those should be coming from patient referrals. Why? Well, when you have a person walk through your door for marketing, if they stay with you, if they stay in your office and buy treatment from you or they recare, they should be referring to you because you're asking them. So if you're keeping the patients, the marketing new patients that are coming in, if you're starting at zero and you get 25 marketing new patients and they stay with you and they recare with you, they should all be referring back into your office. All of them. Now, if they're not, that tells you one of two things. Either you're not doing a good job with your patient journey or you're not asking. Or both. Right? Now, how do you fix that? Well, I would recommend up front, you, the doctor, you're asking everybody for patient referrals. And it's so simple. Mr. Patient, how was your day today? You know, did everything go smoothly? Did we take care of you? Great. Oh, yeah, we love to hear everything's great. I'm gonna do the treatment, blah, blah, blah. Then from there, you pivot and you say, Well, we love patients like you. So if there's anybody else out there, we survive on referrals, like friends and family telling each other about us. So thank you so much for coming and thank you for being an awesome patient. That's it. And you just keep doing that over and over again. You can also incentivize the team task. That's a whole nother layer, but you have to grow this because the patient referrals, each patient referral is probably worth two or three digital marketing new patients. They're just better. So as you're paying as you're marketing, your patient referral should be lagging behind that. And so you should be double compounding the growth. That's how it's supposed to work. But a lot of times it doesn't work that way because, again, of what I just mentioned. All right. Number next, couponing. Couponing will destroy your practice. And there's this is one of the biggest misconceptions in dental from the dentist perspective, uh, perceptive. So I was just recently having a conversation with uh Bob D on Facebook. We were going back and forth on this, and he's really anti-um loss leaders. So loss leaders are not coupons. Coupon means you're discounting your service. I don't recommend that you do that. In fact, I recommend that you charge the most that you can humanly possibly charge. I think your fees should be the highest in your market. If you are one of the best dentists in your area, you should be charging the most or close to the most. Okay. However, this is a big however, you should have loss leaders, things that you're not going to make money on, but those are just your standard price. Typically, this is gonna be your cleaning, and this is gonna be your exam and x ray. And the reason for that is everybody in your market, the prices are all revealed. Everybody already knows how much a cleaning is, and everybody knows how much an exam and x-ray is in your market. I could do a Google search in any market and tell you, like, oh yeah, it's about 99 bucks or more competitive markets. A lot of people with, you know, uh$69, some markets are$199. You can just do a Google search and you can figure it out really, really quickly. So there's this is called price transparency. Most of the services that you offer, there is no price transparency. I couldn't figure out how much people are charging for a crown in your area. It'd take me a boatload of time to figure that out. And so most services don't have price transparency. So what you need to do is you need to be able to market the cleaning, the exam and x-ray. And I know what you're thinking. It's like, well, it's gonna bring bad quality patients. Well, no, no, no. Only if you're targeting low-income areas that can't afford your services. But if everybody coming in can afford your services and they're coming in for a cleaning and they need dental work, you are winning. You will win and you will be really happy overall. That doesn't mean that you're not gonna have one or two people here or there that are crazy. I have I do free consultations for dentists, and we get crazy people all the time. I get crazy dentists all the time coming in, right? So it's not a money thing, it's just people are crazy. You you gotta understand that. You're never gonna make everybody happy. But you can grow. So, what's more important? Growing and seeing more new patients? Or I don't want to do that because I'm gonna have one or two angry patients. Or what either one I hear a lot. What if I only what if one of my friends and family, what are they gonna think? You know what I mean? They're gonna think we're cheap. Patients don't think that. You go to an oil change place and you get a$99 oil change, don't you? Would you ever pay$400 for an oil change? Because that's probably what it's worth. Oh, they're doing a lost leader at your oil change place to you, the dentist. Because why? You have money and they have to get the car up on the rack to look inside the car. And guess what? They tell you your flux capacitors need to be fixed at$2,000. You have no idea how much that costs, but you know how much an oil change costs. Really important. Dentists fundamentally don't understand this, so it actually creates an opportunity. Okay. Number next, number six, what separates a$1 million from a$3 million office? Google reviews. Um, this is the number one thing you should be focusing on. If you can only focus on one thing, focus on Google reviews. You need to have the most Google reviews in your area. Do not sleep until you get there. Do whatever you can. Okay. Now, I I know it's hard if you're a brand new practice and there's people in your market with 3,000, it's like, how am I gonna, how am I gonna get to where I need to get to? It's gonna be hard. Okay, it's gonna be really hard. However, you can do it and just focus on the practices right around you. Just like draw a one mile circle and like, okay, I'm gonna beat these guys and then draw two mile, and then I'm gonna beat these guys. And the trick is to incentivize your team, give them money to get Google reviews, and they will figure out how to get Google reviews all the time. Okay. Number next, you're gonna have to eventually drop some of these insurances that aren't paying you money. This is a simple one. We all understand that. I have a ton of resources on that if you want help with that. And then lastly, you have to use patient financing. One of our sponsors, Cherry, they're awesome. Ton of my practices use them. If you just start leading with Cherry and start saying, hey, you have this much treatment, starts at$100 a month. Here's your options. You will close 30% more treatment out of the box. Very simple. All right. So if this was helpful, comment down below. If you want each of these, I have resources on. I have full trainings, SOPs, everything you can imagine on each of these. So if any of these strike you, just comment down below which one and be clear so that way I know which resource to send you. And I will help you out and get you all the uh support that you need. Thanks so much. Have a good one.