Planning an internal marketing system should begin by identifying the gaps between what you believe the essence of your dental business is and the way your patients see it. When the two are in harmony, your business becomes a “customer-focused” organization.

Create a pleasant atmosphere.

The décor of your dental practice is in essence a marketing tool and should therefore target your ideal patient. The perfect décor is not found in a magazine or created with a big budget. It’s the type that presents a comfortable atmosphere and reflects a positive image of your dental services. However you design you office, remember to include portraits of your patients (on the walls), a catalog of your services (with before and after pictures), and…if you can…an infomercial (playing on your waiting room TV).

Reward Referrals.

Recognize referrals received from patients in a way that will encourage more. This can be achieved first by responding promptly to a referral with a hand addressed “Thank You” note and a $15-20 gift certificate of some sort. Encourage your staff members to request referrals from existing patients (preferably without advertising a gift certificate).

Send Greeting cards.

This timeless business etiquette is essential to any internal marketing program; it includes holiday greetings, “miss you” notes, birthday cards, etc. Independent surveys by Hallmark Business Expressions support the “no-brainer” claim that sending business greeting cards strengthens relationships with customers, prospects and employees. Keep in mind that a business greeting should be more formal than a personal greeting and most importantly - hand-addressed.

Monthly Newsletters.

A monthly newsletter on the topic of dental health is a great way to remind people of your presence and advertise special offers or procedures. Many dental marketing companies can automate this function for you at a very cost effective rate.

When you have structured a model for your internal marketing system, you should involve one or two employees to set and track measurable objectives. The overall objective of the system should be to sustain an acceptable rate of patient retention.

The idea of marketing in dentistry is typically associated with targeting and attracting “external” customers in order to expand a business. While most dental practices allocate resources to target and attract new patients, few make the same investment to retain the existing ones. When it comes to marketing, dentists must understand that their local market share (10 mile radius) is limited; therefore, sustaining a high long-term revenue production entirely through the treatment of new patients is simply not plausible.

What is Internal Marketing in dentistry and why is it important? Council on Dental Practice explains in “The Power of Internal Marketing: The Key to Dental Practice Success”:

Internal Marketing is about building relationships. By strengthening ties with current patients, you motivate them to schedule regular dental visits and use more of your services. These patients are likely to become loyal and dedicated members of your practice.

With time, your Internal Marketing program begins to function as an effective external marketing tool because when your patients understand and commit to the value proposition of your dental practice, they become your champion promoters.

What is SaaS? It’s a software application deployed as a hosted service. Customers subscribe to use an application rather than purchasing it directly, typically on a per-month basis. In this pay-as-you-go method, customers are afforded a flexible, low-cost, no-hassle model so they can concentrate on running their core business rather than spending capital to purchase applications and integrating them into a localized system. Many dental software developers including Denticon and us have already embraced software development in this progressive mindset.

Ultimately, the experience of using such a software application is similar to that of traditional software installed on your computer, but with a few very important added benefits:

Accessibility

Consider how you can view your email from almost anywhere there is Internet. This is because all the data is stored on a remote database instead of a local computer. The same is true for SaaS applications, which you can use from multiple locations.

Scalability

Any decent SaaS vendor should have spare capacity in their infrastructure. They should also be able to add additional capacity very quickly. Meaning if you need to increase storage, it should be a matter of just purchasing additional licenses or subscriptions.

Painless Maintenance

The SaaS application vendors take responsibility for managing the application including performance, up-time, security, reliability, and scalability. In on-premise software, customers either mange these aspects in their own or pay a hosting company or application outsourcer to do it for them.

Less upfront cost

SaaS software is typically subscription based so no upfront costs. I’m are not saying that SaaS will cost you less in the long run - in fact the long term costs may be the same as installed software. But you don’t have a big capital outlay upfront.

Less risk

Following on from the point above. Buying software is a risk - it may not work as expected, adoption may be poor - any number of problems. Why not test the water. With most SaaS applications the commitment is minimal. If it doesn’t work out the way you anticipated, you have invested a lot less than with an upfront purchase.

In his book From Lemons to Lemonade: Squeeze Every Last Drop of Success Out of Your Mistakes , Dean Shepherd points out the two most common ways people deal with failure – denying and overreacting. “If you don’t talk, you keep emotions down, but after awhile you have a severe reaction,” Dean says. On the other hand, talking about your failure too much is also unhealthy, as persistently discussing negativity escalates other problems.

The most beneficial way of dealing with failure is to discuss it with colleagues from an objective point of view without emotionally dwelling on it. Few tips to help you along:

Take responsibility without blaming yourself.

Just because your dental practice or any business for that matter is failing, does not mean you are a failure. Analyze the influential factors which lead to your undesired situation and understand what role your involvement played in the process.

“Don’t let failure become normalized”

Dean Shepherd warns, “If we end up failing a lot, failure can become normalized, and when we fail, we don’t feel any emotional reaction. That may sound good, but if you become desensitized to failure, you’ll become desensitized to commitment. This creates a bad cycle: you have less investment in your endeavor, so you fail, and you don’t learn from it.” It’s easy to fall into this bad cycle if you avoid taking responsibility for your actions.

Avoid making the same mistakes

This concept requires constant practice because it’s really easier said than done.

Decision Making in good times:

You’re experiencing an influx in new-patient turnout, your practice is selling twice as many treatment plans this year as it did last year, and your staff has become especially productive. In such times, it’s almost natural for us to lose our sense of objectivity and attribute the recent prosperity to our glorious leadership ability. Consequently, we tend to look at businesses through rose-colored lenses and our ability to assess risk goes out the window.

The key to decision-making in good times is to be particularly objective in every situation to avoid unnecessary risk. This is a difficult practice because when everything is going our way, it’s intuitive for us to accept speculation as part of our business strategy. In many ways, overconfidence can be more far more damaging to your business than lack of confidence.

Decision Making in bad times:

Your new-patient flow has slowed down, old patients are sending complaint letters, your employees are quitting, and your practice is barely breaking overhead. In such a time, (need to say) it isn’t easy to remain positive, much less confident. We begin asking ourselves questions like, “Is this my fault? Which decisions brought me to this? Should I have listened to others? What needs to be done?”

More over, while in the hot seat of leadership, we also tend to conclude that our business is the only one doing poorly and our confidence dwindles. Don Moore, an associate professor of organizational behavior and theory at Carnegie Mellon’s Tepper School of Business, says confidence or lack of is misleading and slightly out of whack with reality.

Overconfidence, which could be your undoing when things are going extremely well, is key to your success in tough times. In tough times, you need change, which needs to be introduced with bold and difficult decisions. BNET’s Andrew Tilin points out, “Confidence experts say that in stressful times, leaders need to be level-headed and courageous. Be brutally honest with yourself and others, and get comfortable with making changes and even going against the grain.”

In my last article I talked about the same topic, and that’s because this is an area which so many dentists get wrong. Hiring isn’t just about filling up positions – it’s about creating a smoothly-run, effective team built on the diverse range of talents, personalities and perspectives your dental practice needs.

Getting the right, quality employees isn’t easy, but it is seriously important to your business. It can be made easier, too, by following a few simple steps.

1. Get Good At Knowing What’s Bad

When most people apply for jobs, they don’t look at their weaknesses – and why should they? If you there was a chance you could get a position you wanted without needing every qualification listed in the job description, wouldn’t you take it?

It doesn’t cost people anything to take a shot. Unfortunately for you as the employer, it can cost you a lot of time and money if you’re not prepared for it.

The best way to handle unqualified applicants is to go through their applications. If someone’s experienced and able, this will shine through in lots of concrete examples. If they’re taking a chance, everything will be a lot vaguer.

Experienced with…
BAD: “I’m experienced in selling treatment plans.”
GOOD: “I’ve consistently sold more than $60,000 of Dentistry each month.”

Excellent with…
BAD: “I’ve got excellent communication skills.”
GOOD: “I’ve improved patient retention by 15% over a period of six months.”

Team Player
BAD: “I work well with others.”
GOOD: “I’ve collaborated with staff members to organise morning huddles and monthly meetings.”

Successful in…
BAD: “I’ve successfully done X.”
GOOD: “I’ve negotiated and reduced overall laboratory expense by 15%.”

Responsible for…
BAD: “I’ve been responsible for internal marketing.”
GOOD: “I’ve improved patient retention through implementation of effective and ongoing internal marketing campaigns.”

2. Rethink How You Do Your Homework

If you phone your applicants’ former employers, I can pretty much guarantee you two things: a standard commentary and no valuable information. From their point of view, bad-mouthing is risky legal territory that it’s best not to go anywhere near. In short, it’s really just best not to bother.

Great, 21st century alternatives to calling are these three sources: Google, MySpace and Twitter. Go to these sites, type in the applicants’ names and use their profiles to get to know each of them a little. You never know – you might turn up something far more interesting than you’d ever thought possible…

Worried about the ‘invasion of privacy’ implications? Don’t be. These sources are all in the public domain, so whatever you uncover is yours to take. Happy sleuthing!

3. Make The Interview Count

When it comes to interviewing, the main things you need to be on the lookout for are integrity, reliability, a strong work ethic and diversity. The best way to find the applicants with these is by asking behavioural questions, which Brian Libby of BNET defines as those which “require candidates to give examples from their past experience and describe how they used specific skills that are relevant to the job”.

Getting people to think on their feet really isolates your serious contenders, so a series of behavioural questions common to all applicants is the best way to make your interviews count.

It’s also really important to keep the interviews objective: it’s great if an applicant shares one of your passions, hobbies or experiences, but that doesn’t make them a useful asset to your dental practice. As Charles Handler of Rocket-Hire.com puts it, “the key is reducing subjectivity and making the process more job-related”.

4. Keep The People You Choose

When you’ve finally put together the perfect team, how do you keep it? A high turn-over rate costs time and money, and your practice’s success depends on keeping as many quality employees as possible. This is a complex issue, so I’ve dealt with it in another article. Check out ‘Dentists With A High Staff Turn-Over’ for more details.

On a conservative end, if one entry-level employee ($8/hour) is replaced at a rate of once per month, you’re looking for at a cost of $42,000 per year.

It’s true that some employee turnover is unavoidable, even desirable. Some turnover is necessary, to replace marginal employees with more productive people who bring new ideas and expertise. This is where your ability to hire and retain valued performers comes into play.

Implement a retention program in your dental practice. Don’t wait until turnover costs become unacceptably high. Here are a few tips that will help you maintain a long and productive business relationship with your staff.

1. Don’t assume common sense.

Most dentists will assume an understanding of excellence and get disappointed when their staff doesn’t perform. What is simple and obvious to you is often new information to others. Nobody can read your mind and so it is your responsibility to take the time to define “excellence” in performance, actions and results.

2. Personally survey your best employees

In order to find out what keeps them in your practice, what they need to be happier and more productive, and what would cause them to leave. Not only will you gain highly beneficial information about improvements your practice needs, but strengthen your employer/employee report.

3. Structure your interviews to analyze applicant’s personality and his/her sense of excellence.

By the end of an interview, you should be able to see and feel how the applicant defines, performs, explores and expands his/her sense of excellence. You’re looking for someone with who has a similar understanding of the idea.

4. Invest in training.

Support the excellence you’ve defined by training your staff to perform your expectations. Make an effort to regularly take your staff to a continuing education seminars at institutes like LVI. Effective training pays for itself.

5. Be a coach, not a cop.

Inexperienced and ineffective business leaders assume that their job is to police their employees while effective and respected leaders guide their employees’ direction. Be aware of body language and tone of voice as well as language choice. Catch your team doing the right thing and celebrate what is good and the importance of each job. B.F. Skinner advocated that reinforcement is a vastly superior psychological tool (and simpler to utilize) than punishment. When you weigh the side effects of punishment, versus the possible success of reinforcement, the choice is clear.

As a local business, your ultimate goal is to outlive your immediate competition, which is dealing with the very same problems you are. In doing so, you are likely to inherit their share of the market. Some of what I suggest may be uncomfortable, but it is logical and necessary.

Stop Extending Credit

I urge you to apply this strategy in good and bad times because it will retain a higher quality of customers and won’t impede your cash flow. Yes, you are likely to lose a few patients, but the kind you probably wouldn’t miss in the first place. Remember, it’s your cash flow that keeps your dental practice in business, not your revenue. I suggest limiting financing to third party credit unions like CapitalOne or CareCredit.

Eliminate Unnecessary Spending

This includes special perks you may be providing for your staff (keep the bonus system in place!!) and luxury spending on your office space. If you like hosting a monthly staff meeting at a five star restaurant, I recommend you order pizza instead.

Trade Front Desk Person for a Salesperson

During the survival mode, anyone who isn’t directly involved in producing for your dental practice is expendable. This may be a good time to replace an extra front desk person for a good treatment plan coordinator. I would also advise against cross-training employees because you will cause discomfort in making people perform tasks they don’t enjoy and probably aren’t qualified for. Moreover, you will waste your time and money when you could easily hire someone specifically for “the” job.

Ask Vendors for a Discount

Call your vendors and laboratories; ask for exclusive discounts in exchange for a committed relationship. You’ll be surprised by how much it will lower your overhead.

Expand your Marketing

Refine your marketing campaign to accurately target your local area and if that means spending more money, so be it. In my article, Effective Dental Marketing Model, I briefly touch on marketing outlets that are particularly effective in dentistry. The key is to study your ideal customer – usually a middle aged woman with kids — and exploit all effective outlets with a marketing campaign that would appeal to your ideal customer.

Instead of creating a comprehensive set of strategies for dealing with an economic slowdown, I chose to list the above five guidelines because an economic slowdown manifests itself differently in every situation. There is no “cookie cutter” approach.

During market slow down, you should expand your marketing campaign.

The above does not imply allocating more capital to your marketing account, far from it. It suggests that you refine your marketing campaign to be highly targeted and efficient in part by eliminating marginally productive marketing outlets and strengthening your star performers.

A few seminars, a few books, a few business classes, and a ton of trial-and-error led me to design an effective dental marketing model pictured below (with a few general outlines). NOTE: This model is strictly for marketing dentistry.

Direct Mail

If you pay attention to marketing strategy debates, you may have heard the big topic, “Hand-addressed letter vs. Postcard”. In the context of dental marketing, it is a useless argument because both approaches are effective in the right situation. I found that postcards with a strong ‘call to action’ theme are more cost-effective in external marketing than hand addressed letters. While hand-addressed letters are significantly more effective in internal marketing because they are strong report builders.

Web Marketing

Web marketing is the new “front” and can be intimidating for those who do not understand it. I suggest you introduce yourself to the basics of online marketing, but don’t waste your time on trying to master the process, which is quite intricate. Invest in a good website (don’t pay more than $5,000) and find a solid web marketing company (I recommend Customer Magnetism). An effective website can produce over 20% of your new patient flow.

Email

Email is strictly for internal marketing and it can be very effective in bringing existing patients back. Make an effort to systemize email collection in your dental practice.

Local Newspaper

I found that small-time local newspapers are more effective in producing more new patients than a big-time city paper. It makes sense because local newspapers are highly targeted towards middle age population in your area.

Give your mind some rest.

If you remember studying the biochemical processes of our brain, you know that our mind is not exactly resting while we sleep. Resting our mind involves more than just sleeping for 8 hours; resting our mind involves meditating and it is estimated to be practiced by only 2 percent of the world’s population. Meditation is described by Jon Kabat-Zinn in Wherever You Go, There You Are, as mindfulness. Kabat-Zinn’s definition of mindfulness is “paying attention, on purpose, in the present, and letting go of judgment”. In essence, it’s about focusing your mind on simple task such as breathing to allow other parts of your brain to rest. It is important to understand that you cannot force thoughts away, instead let them go by focusing your attention back to your breath. Try to meditate few times a day, especially when under stress.

Learn to Delegate.

Being a dentist you’re probably of the personality type that qualifies as a “perfectionist”. You may find yourself taking on too much work out of natural desire to do everything perfect. Overwhelming yourself with work will induce a great deal of stress. Remember, in order to be an effective “stress-free” leader, you must learn to delegate. An effective leader is not a one who perform every task in the office, but one who can recognize the strengths of his/her subordinates and assign tasks to them accordingly.

Accept failure.

The idea of failure is a scary…you may even get stressed out thinking about it. The sooner you embrace failure as an inevitable part of life, the more you will benefit from your mistakes.

Know your triggers.

You know yourself better than anyone and you know which situations or triggers induce stress in your life. Make a list and analyze it. Develop a strategy for dealing with stressful situations you can not avoid … like being stuck in traffic.

Eat Well and Exersive.

You’ve heard this one over and over again because it works. Make a commitment to exercise for cardiovascular fitness three to four times a week. Maintain a well-balanced diet and maintain your ideal weight.