Speaker 1:

Welcome to the Marketing Chairside Podcast by Pro Impressions Marketing, where the team covers a variety of dental marketing ideas to help you attract more new patients in the quantity and quality you need to grow your practice.

Jonathan Fashbaugh:

Marketing is great, but what happens when these leads are hitting a brick wall? I talk with consultants a lot that we kind of commiserate honestly behind the dentist’s backs a little bit to say, “What is the problem with this practice? That practice?” A lot of times it’s not that their marketing is suffering, it’s that they’re not able to convert the leads because of this ugly word, insurance, and how these insurance concerns are addressed and then just the general vision of the practice. You’re listening to marketing chair side, the podcast that understands that Dennis struggle to attract new patients and the quality and quantity that they want. Today, we’re here to give you marketing tips and even tips after the marketing that are going to help you make more of your marketing, get more out of every marketing dollar by bringing in the types of patients you want. Today, I am joined by Dr. Michael Rosen from Wilmington, Delaware. Hi, Dr. Mike.

Dr. Michael T Rosen:

How are you? Thanks for having me.

Jonathan Fashbaugh:

Hey, it’s a pleasure. I just wanted to tell everyone out there just from the outset that Dr. Mike has no ulterior motive in being here. He’s not selling a book or promoting an event. He’s just here to help doctors just like you. I really appreciate that, Mike.

Dr. Michael T Rosen:

Thank you.

Jonathan Fashbaugh:

I’m going to start off with some questions, and really it’s just to give the listener, the viewer some understanding of where you are, but can you tell us a little bit about your practice, your vision for the practice, and just the type of office that you run?

Dr. Michael T Rosen:

Basically a single dental office, getting a little bit older. I have an associate day and a half a week who will eventually hopefully take over and I’ll work part-time for him, assuming he is not there. I have five operatories, two hygienists. I’ve tried three in the past and it didn’t work. Kept getting drawn away from the other things that I was doing. There are four assistants working with just me and two front desk people. We accept insurance, but we’re basically fee for service. If the insurance comes with a book of dentists that you have to see, we are not in that book because we haven’t signed any contracts with anyone. There are some dental offices that have done that where you don’t take insurance, but we don’t mind processing it because the patients don’t understand it. We will process the insurance for the patients.

If the checks go to them, then they have to pay us. Generally speaking, we handle insurance better than the patients do. We know how to get the x-rays out, do all the different things to respond to write the letters. If we’re going to be who we are and take great care of people, we can take care of the things that we do better than they do. I love what I do. I’ve been practicing now for about 40 years. I’m in Wilmington, Delaware, relatively small town, and there’s dentists. There are three dentists in my complex. There are four dentists across the street. There are dentists everywhere, but I honestly don’t feel like they’re my competition. Okay. They’re just dentists that are there, and I love working with them. If somebody has a question or I need a piece of equipment and I can call them up and they can get it back and forth, there’s a lot of camaraderie.

I probably believe that of all the people that I’m talking about, I may be the only person who isn’t signed up for any of the insurance companies, so they’re not my competition. Everybody has their own thing that they have to do. How do I say it? I’ve decided that I would like to play at the top of the pyramid. There’s fewer patients that want to come see me, and when they do, I’m going to take better care of them.

Jonathan Fashbaugh:

Being in that market where there is a lot of dentists, I didn’t hear you say anything that was super atypical from a lot of the dentists that I talk to, but that’s got to shape what their expectations are when they call you. When a patient calls you, what’s the first question that they often ask your front desk?

Dr. Michael T Rosen:

Oh my goodness. What a great question. I always exceed their expectations, so it doesn’t matter what question they ask. Many times that’s not true. It’s one of the most interesting things that ever happens in the office is when a patient is getting aggressive with somebody at the front desk coming in about an appointment, billing, whatever it is, and we never hear that. I find myself, I have to go up to the front desk and I have to tell them, “You don’t know where you are. All you have to do is be nice to them because they will bend over backwards and they will take care of you. They will do anything that you need them to do.” What you find is that they’re so scarred from previous encounters with other offices that they don’t know how to behave, and they don’t know what questions they ask so that when they find someone who’s actually listening and asking them questions and not trying to get them off the phone, everything changes.

By the time they get to me and I’m working on them, they’ve already been through two or three of my staff members, they don’t even care about me anymore, that I’ve had a good reputation that Jonathan put something out there for me on a website that made me look good. That might have been the driver that got them to make the phone call to begin with, but then they forgot why they came. They just knew that somebody was listening and everybody really gets treated. I was going to say, they always get treated like family, but I don’t charge family, so that’s not quite right. Everybody gets treated like that so that you’re not trying to get as much money from somebody, you’re just trying to be their information source. They’ve never been in a situation like that. Certainly not medicine today as they rush you through offices. Dental offices, unfortunately, are moving a little bit closer to that.

You just need to listen to the person that’s on the phone. Why are they calling you? Did they have a bad experience somewhere? Oh, you did. Okay. That looks insincere, but I was just emphasizing, okay, I want to know why they’re having problems because I think we can fix them and my staff does too. The people answering the phone, you want mothers up there that want to mother someone. Okay? Excuse me.

Jonathan Fashbaugh:

No, it’s okay. Can you tell us a story about one of those insurance driven patients that was just like conditioned to expect fast, cheap, low quality dentistry that you turned them into a lifetime patient, a quality patient?

Dr. Michael T Rosen:

The ones that turn into lifetime quality patients are the ones that you see in a time of need and you don’t take advantage of them. You don’t try to maximize your insurance on them. If I get a phone call from one of my patients that their friend is having trouble on a weekend, I’ll come in and I’ll go see them. It doesn’t happen that often. I’ll come in and I’ll go see them, and they’re not getting charged for anything. You just want to take care of them and stuff like that comes back to you. It’s more common, Jonathan, that a patient will have been ours for a while and their insurance changes and all of a sudden they have to go somewhere else if they’re going to get any coverage at all. They became part of one of those groups, and they’re super apologetic. They love us.

I get it. They have four kids every time they come in and get their teeth cleaned. If they do them all together, it costs $1000. Okay. That’s a lot of money to put out there in order to be able to do things. If they can get their teeth cleaned and it’s convenient, and that’s great, and I tell them, when you leave, don’t make enemies, no need to. If you ever have a question about something that somebody’s presenting to you, call back. I’ll just talk to you some evening on the phone and we’ll just scratch our heads and decide whether it feels like the right thing for you. I’ll betcha 90% of those patients come back in the future because they never got the same care that we gave them.

Nobody ever sat down and talked to them. It just turned into a money thing. We just figured the finances out, spread your payments out over a little bit, put it on a credit card, pay it off later. Use Care credit that has one year no interest stuff when you do things. Try to just work within their system a little bit better. The reason I’m not answering your question exactly is because my front desk does it so well, and I haven’t been answering somebody calls and says, “I don’t have your insurance.” Or, “Do you take my insurance?” They may not be completely familiar with it, and they’ll say, “Does it come with a book of people you have to see?” If it does, then we’ll say, “We’re really sorry. We’re not in there, but we do see some other patients that have that insurance and we’re happy to see you if you would like.”

Some of them, they just move on. It was very important to them, the money. That’s okay with us because we can’t treat everybody. That’s really, really tough when you’re trying to decide what to phase out and you’re trying to pay your bills every day, whether they’re your school loans or it’s your mortgage or the food on the table. It’s really, really tough to say no to someone. You’re not the right person. What happens if the insurance companies are taking 30% of your money by the marketing that they do for you? Now all of a sudden you’re only making 10% instead of 40%? Well, you can get rid of a lot of patients and still make the same kind of money and take better care of them and at the end of the day, you have enjoyed what you did.

Then little by little, build the practice up so that their job is to say, “You’re not the first person to call. Most people have the same concerns that you do. We’re going to take great care of you. Okay, come on in.” In some ways, their job is to get people in the front door. Jonathan, you drove them to the office, you had them make the phone call. Okay, they’re on the phone. If you’re playing at the top of the pyramid, there aren’t as many phone calls. When they do call, are they someone that just needs someone to hold their hand, walk them through the system and get to the office and completely wow them with an initial exam that they’ve never seen before? Because initial exams, many times just take place when you’re getting your teeth cleaned real quick. Yeah. Yeah. You need a couple fillings. You go for an initial exam in my office, you’re there for two hours and you don’t get your teeth cleaned.

I only come in for 15 or 20 minutes of that after my staff has come to me and said, “Let’s tell you what’s going on in this room. They have two kids in college, they have this.” Whatever it is, so that I don’t go in there. This is the experiences they’ve had at other places, and this is why they’re here. Everybody gets a chance to calm down, talk to each other, figure out what it is you want. It could be somebody who doesn’t want what we have, but that doesn’t happen very often. They almost always are like, “Oh my gosh, there’s something different about this place.” They have a tendency to stay. Did I answer that well enough?

Jonathan Fashbaugh:

Yes. Yes. I’m kind of picturing, because you mentioned your front desk person, and I’m picturing if you brought someone new in to your organization, it seems like you would have a lot of work to do to kind of de-educate and then reeducate them. I think just as much as patients are conditioned, I think sometimes front desk people are conditioned with a negative feeling like they’re constantly bombarded with a question that they’re trying to answer and don’t know how, which do you present quality when you’re being asked for cheap and fast?

Dr. Michael T Rosen:

Well, cheap and fast you’re in the wrong place. Sorry. You’re just in the wrong place. This is the way we do it. Okay. “Well, I’m going to bring one of my friends. Can I get a discount there?” Sorry. We use just the nicest materials, and I spend lots of time and energy training this staff, and we leave more time for you in the appointment. Sorry, we just don’t do it. it’s a hard question to ask because I like saying yes to people. I don’t like saying no to anybody. It’s difficult for me. I tell an assistant who’s experienced, who comes into my office as a new assistant, and I tell them, “It’s going to take you five years to come up to speed.” They look at me like I’m from Mars because they think that give me three weeks and I’ll figure out where you keep the materials and I’m good to go.

Then you start talking about chronic pain and sleep apnea, and I have my own commercial porcelain lab. Just how do you read patients in order to be able to listen to them? Because some people want, “I need to just get in and out of here quickly because I’m busy during the day.” Others of them have four kids at home again, and this is the only time off they get, and they’re just happy to spend a little bit of time like they’re getting their hair done, and it’s just a different experience. My job is explain things well and don’t hurt them. Everybody’s a little bit different. Even in the morning meetings, it’s very, very funny when we look at the schedule with the four assistants and I’ll have one assistant say, “I don’t want to see that person. They drive me crazy.”

The other three are like, “Are you kidding? I love that person.” It’s just the different personality types and how people match up. We make sure that number four doesn’t see that person so that everybody else will enjoy being with them because they like talking about their family and doing things. So what you’re hearing from me over and over again, this is so about relationships and not about dentistry. I hope I’m not being overly silly. I’m never as funny as I think I am. If you ask my wife, if you were to ask my wife, because I’ve told her, I said, “Dear, what do you think I do for a living?” She says, “Dentistry.” I said, “No, I flirt.” Okay? But I flirt with guys and I flirt with girls. It’s the same thing, but I enjoy it because everybody that I meet is a first date for me. Oh, excuse me, a blind date.

I love meeting people, spending time with them and learning about them. And if you don’t, you’re in the wrong business because you’re cuddled up to somebody’s face all day long in their most vulnerable time. You want them to spend a lot of money and do some really cool things. If you don’t like being around them, then you can’t go down this route easily. Again, it’s about relationships and listening to people. And that’s why you can’t do this all at once, that you have to do it piece by piece. The first pieces of the puzzle are, I have two hour lunch meetings with all of my staff on Wednesdays, and I’ve been doing it for 30 years.

Jonathan Fashbaugh:

Wow.

Dr. Michael T Rosen:

Okay. You would think, what do you talk about after a while? Don’t you run out? No, we don’t run out. We run out of time in every meeting. It gives everybody a chance to decompress. We can talk about stuff. We record some phone calls. I never bring them up at the meeting because it’s a little embarrassing and I don’t want to put anybody in that position. We talk about somebody called and we want to get them in quickly, but we didn’t know where to put them in the schedule. The assistants are saying, “Well, you should do this.” The hygienists are saying, “Well, maybe you should try it this way.” The front desk is saying, well, you guys don’t understand. We had three people checking out and one person checking in, and the phone was on hold and doing all this other stuff.

You have chance to sit down. My version of the story is, who’s the most important person in the office at any given time? It’s the patient you’re talking to. Okay? Everything else goes on hold, it doesn’t matter. That’s just customer service. Dentistry isn’t any different than any other business. You have to little by little, I don’t have anybody in my office under five years right now, I don’t think. At this point, we still talk about the mistakes that we made. Once every two months I get ganged up on, “Dr. Rosen, why did you say that to that person?” It was me not as funny as I think I am, and it didn’t come off as well as it should have. The patient said something after I left the room and the staff feels comfortable enough around me to come back at me and say, “That wasn’t the right thing to do.”

Nobody gets their feelings hurt as long as we don’t beat them up too badly or we find the right time to say it. Just like at home with your wife, don’t have those arguments in anger, you take a deep breath and you come back at it and you find a nice way to, “Okay, how do we work our way through this?” Do the next thing. That’s why this is so tough in a corporate environment with lots of dentists and no meetings and staff that only stays for a month at a time before they go off to the next place. You can’t form relationships like that. I don’t know how you do it. Corporate dentistry doesn’t bother me at all. I think they just make more room for me. They make it easy because that’s not what I want. There will always be a place to go buy Cadillacs instead of Honda Motorcycles.

Jonathan Fashbaugh:

Right.

Dr. Michael T Rosen:

Or whatever it is.

Jonathan Fashbaugh:

Now, if you’re blowing someone’s mind, because I can think of a lot of dentists that I talk to. I love your approach, Mike. I feel like dentistry would be a different world if everyone had that vision, had those procedures. If you’re blowing someone’s mind and they’re like, “I want that.” Maybe I’ve even tried to get there and I’m just running into roadblocks. Can you give any practical as nuts and bolts as you can, advice on steps to get there?

Dr. Michael T Rosen:

No. What a great question. Thank you for putting me on the spot.

Jonathan Fashbaugh:

You’re welcome. We’re going to extract these ideas from you.

Dr. Michael T Rosen:

No, I think that it takes a long time to get everybody on board. For instance, I have two, four, eight, I have eight full-time employees, and I don’t think all eight of my employees can do all of these things at any given time. I have a couple of key people that I know that I can rely on or that somebody else is having some difficulty that that person could fill in. I suspect that what I’m suggesting is that you share this vision with a couple of key people, and then as there’s opportunities for continued education, for contacts, for scheduling, for treatment, all those things come along that who you can rely on, and then you let those other people come along more and more. If you wait for everything to happen at once, it may never happen. Try to break it up into bite size pieces.

You’re sitting there in a small meeting with a front desk person who’s going to intake a new patient and a dental assistant who could help you with your treatment planning and working on the scheduling and relationship building with that person. I might get this wrong a little bit, and I apologize if I do. I spent a lot of time at LVI. LVI, Las Vegas Institute, made me a much, much better dentist than I ever was. I don’t know that you could say that I drank the Kool-Aid. Okay. Excuse me, puppy dog is in the room. I don’t know that you could ever say that I drank the Kool-Aid because there were some things that they were doing. I would almost be sure, not now, but at one time, where they were even trying to have a front desk-less office where anybody could answer the phone. Anybody could bring the patient in.

You were seeing so few patients, it didn’t matter because every patient you saw was getting full mouth restorations done. Little bit of an exaggeration, but I’m just trying to draw a picture as you do this. I was frankly too frightened to try that. I didn’t think it was going to work for me. I didn’t think I could market well enough to bring in enough patients. Sure, if you’re doing three full mouth cases a month, you don’t need to see anything else. What happens if you have a bad month and you only see one? Okay, I would be panicking over that. I wanted my cake and eat to, I wanted to be busy, but I also wanted to do the high end stuff. The way we’re speaking about it here, you’re not supposed to be able to do both of those things. Okay?

You’re not supposed to have a family practice and a big cosmetic practice in the same place because families want to come in, go out, keep churning over, not spend all day with you, okay? They’re a little bit more flexible with the schedule sometimes, but somebody wants to go come in and get a full mouth case done, they’re spending a lot of money and they want to have very concierge type of experience. They want to schedule when they want to schedule, they want to know somebody to call and talk to. They don’t want to get one of four people on the phone. They’re two different practices in the same place. What you’re suggesting is how do you go from one to the other, but you’re going to have two different practices in the same place.

Jonathan Fashbaugh:

[inaudible 00:21:29] for a time.

Dr. Michael T Rosen:

You are. You may have it forever. Depending on how many-

Jonathan Fashbaugh:

Well, I heard you say it starts with time. Understand this is not a change that’s going to happen overnight. You involve some key people that as close to lifers as you can get them. You’ve got these people that you trust anyway, and then the next step is to share that vision with those people and make sure that you’re all on the same page. In my mind, I was like, that’s when those two hour Wednesday lunches have to happen because then you’re sharing the progress and what roadblocks doctor and team that you’ve got going on, and then you invest in training to build on that vision and training those people. Then those people are helping train the other people that haven’t been with you long enough.

Then this is where I thought was interesting. You sandwiched it between time and time. You said time starts with time, and then the last thing in that process that I heard you say was that your expectations have to have time involved too, because it’s not going to be an overnight change. And so you have to just keep at it and keep working at it. I’m sure some people are like, “No, I don’t want to have both practices in one office forever.”

Dr. Michael T Rosen:

I think it’s a little bit scary to jump into the deep end of the pool with both feet and hope that everything works out well because there’s so much on the line if it doesn’t work, and it’s just not that tough to get your key people started on it. You have to be, I thought about it before I got on with you. My daughter is three years out of dental school. I’m in Delaware, she’s in Boston. My associate’s three years out of his residency, and he practices in a corporate office somewhere else, and he’s really, really busy there. It’s funny because people ask him, “Well, what’s the difference?” He says, “Just different.” He is working on it. When he comes in, the same staff is there, not just because we take him to Mexico every year for a few days, but you need to be able to take care of people.

I forgot where I was headed with that, but it just comes down to you. You have a vision, you get a couple people on board and you start working your way through it. I heard, and I don’t disagree with this, if you’re starting a new business, how long is it going to take before you start to get comfortable with what’s going on? You feel like you have enough customers, your employees are settled in, you’ve figured out things, and it takes about three years. If you think that you’re going to do this for six months and you’re going to be done, this is just 40 years. Dr. Goodling, my associate, who I absolutely love. I was thinking about how to introduce him to the world through my practice, and I was going to put him on the website with you guys.

I was going to say, “Between the two of us, we have 40 years worth of experience.” Then I realized I had 38 of them all right? Now he is wonderful at what he does and just unbelievably caring. You would be lucky to have him as a dentist. He is the real thing. There’s something to all this other stuff and running the practice that is just a little bit different because of what he’s been exposed to before. For two years now, he’s been at our two hour Wednesday meetings and he’s running them. Okay? The staff love him. If the staff loves him, the patients love him as well.

Jonathan Fashbaugh:

Well, you mentioned your website, and for those on the listening and watching that, want to check it out, it’s wilmingtondedentist.com, as in Wilmington, Delaware dentist, singular, dot-com. I love your website because it has a clear brand that, yeah, I mean, we will have to get Dr. Goodling kind of featured on there over time. If he shares your vision and we’re communicating that clearly, that should be a natural process. That’s actually something that we’ve helped other offices do when they have kind of a chaotic brand because the they’re that’s never been clearly thought through, guess what? The marketing is usually an extension of that chaos. Our process involves trying to get clarity on dental practices.

What is your brand? What are you known for? At least what do you want to be known for? Because your marketing then needs to clarify that and to communicate that without stumbling over itself and trying to say, “We’re this, but we’re also this. If you want cheap and fast and quality, we could do it all.” It needs to communicate the clarity, but also the focuses that you have and what makes you different such that you are at the top of the pyramid. Dr. Mike, thank you so much for your time and for your wisdom. There are some concepts like the two hour lunch that I feel like we can spend two hours talking about, but we’re out of time today. Thanks very much for joining us.

Dr. Michael T Rosen:

You’re the best. Thank you. It’s a lot of fun. Dentistry’s a lot of fun. This was a lot of fun.

Jonathan Fashbaugh:

Yeah, I think that’s why we get along together so well, we both think we’re really funny. We like to have fun.

Dr. Michael T Rosen:

That’s why our wives aren’t here.

Jonathan Fashbaugh:

Yeah, that’s right. Again, for you watching and listening, if you need help with your brand and your website and marketing and clarifying things, you can visit us online at . For those of you watching, we’re going to put up a little QR code that you can scan to get a consultation. If you’re listening to this, go to . That’s pro, like short for professional, impressions like we’re going to take some impressions, and group, stay with the group, dot-com, and you’ve been watching Marketing Chairside by Pro Impressions Marketing. We’ll see you next time. I’m going to, oh, yeah, right. No, no, we’re done. We’re done. No, I told him. Told him goodbye. Ted says Goodbye. All right. Well, this is your TMJ. It looks a little dusty. There we go. Oh, wow. What’s living in there? Hello?