Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
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155 Tell Your Story with Joshua Scott : Dentistry Uncensored with Howard Farran

155 Tell Your Story with Joshua Scott : Dentistry Uncensored with Howard Farran

9/18/2015 12:00:00 PM   |   Comments: 0   |   Views: 628

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Your marketing is your story. If you feel frustrated that you should have started marketing much earlier, "The best time to plant a tree was 20 years ago. The second best time is NOW".

Stream Audio here:

AUDIO - HSP #155 - Joshua Scott

Watch Video here:

VIDEO - HSP #155 - Joshua Scott

There's no doubt is one of the best websites in dentistry. Learn, from the master, the digital marketing strategies that will blow your mind--on HALF the budget of a big direct mail campaign.


Joshua Scott is a marketing speaker and consultant.  He has been speaking to crowds in convention centers and small groups in boardrooms for over 18 years.  He works with businesses and organizations around the country to inspire their teams and create confident marketing strategies.  Josh has spent the last 13 years in the dental industry working with practices to create profitable marketing investments.   


He leads 8E8 Dental Marketing (pronounced “88”), a creative agency specializing in digital marketing solutions. He is also host of the 8E8 Dental Marketing show - a weekly podcast answering dentistry’s most important marketing questions. 


Josh grew up off of Compton Avenue on south side of Los Angeles, so he considers himself part “thug.”  Currently he resides in New Albany, Ohio - a white, picket fence community where the most gangsta thing he ever does is listen to Jay-Z with the car windows rolled down.  He’s been married for over 18 years to his high school best friend Joanna and has two children, Caden (9) and Aliya (5).



Discover more about Josh’s approach to marketing at


Howard: It's a huge honor today to be interviewing Joshua Scott who I am a big fan of with his 8EA dental marketing. That's 8 letter e a, 8EA, I think that's a cool name. I'm so glad to have you on because bottom line, Josh, as dentists we go to school for 8 years and you know, a fireman wants to put out fires, a policeman wants to catch a bad guy and a dentist, man they just want a broken tooth. They want a toothache. I love emergencies the most, but then when we graduate we don't get to fix anybody, we don't get to help anybody, we don't get to do our thing unless we learn skills from guys like you to find us some patients. 

You've been doing this a long time. You're coming up on the big 4-0. You've been doing this 18 years. My average listener, I want to put this scenario in your head. There's probably about 7,000 dentists that listen to this that the number one thing they're all doing is on a podcast, they're multitasking on the way to work. They got a hour commute. Right now you're talking to about 7,000 dentists and she's driving into work and she's thinking, "You know what? I get about 15 new patients a month. I'm paying all my bills, but man if I could go from like 15 new patients a month to ... if I could just get 10 more new patients a month, gosh darn it. It'd all be gravy and my life would be on fire." What would you say to a dentist who says, "Josh, I really wish I could get 10 more new patients a month." What would you say to that dentist?

Joshua: Yeah, I think there's a few things there. Howard, I first wanted to thank you for letting me be on the show today. Also, congratulations on your book coming out. I am looking forward to that. Just wanted to plug that for you. 

Howard: A true marketing guy. You took the first opportunity to market my new book. 

Joshua: Yeah, yeah, so I'm looking forward to it. We definitely have a few quick things that I think we can do when it comes to marketing. I mean, there's so much of it is gonna be a long term focus. It's gonna be having a really great strategy in place. Working that strategy. I think there's a lot of just probably looking at the quick fixes. Sometimes what I tell clients when I'm working with them is the moment you say I need to market you're too late. When you have that knee jerk reaction of oh my gosh, something's going on. We need to market. That conversation is too late. You should have been thinking about that a while ago. In the same sense, there's an old proverb that says the best time to plant a tree was yesterday, or was 20 years ago, the second best time is today. Best time to work on it is now. 

Howard: You've been doing this 18 years and I want to throw a concept out there that you keep hearing over and over on the message boards on dental town is that, you know, when I got out of school the radical new marketing was a full page ad in the yellow pages and I took one out in 1987 and actually got me a free lunch from the executive director of the Arizona State Dental Association telling me how I'm cheapening my profession and I would not pick a cancer doctor out of the yellow pages. It's guys like me that were ruining the profession by marketing. It was a cash cow. I mean, Josh the ad was about $750 a month and it got like 20 new patients a month. I mean, it was just a cash cow. 

Joshua: Oh wow.

Howard: Then if I lived in Phoenix and my zip code is 85044 and every quarter I mailed the whole zip code a little four page newsletter and that was just a cash cow. I mean, it was just crazy. It seems like after 2008, Lehman Brothers crash, everybody just says direct mail just stopped working. Yellow pages stopped working and even the big corporate chains who hire fancy smancy guys like you and have full time marketing departments, they were all telling me, man, the response on direct mail just stopped. 

Joshua: Yeah. 

Howard: I'm asking you, now it's 2015 and you've been in this 18 years. Is marketing today different than it was 18 years ago as far as what works and what doesn't work?

Joshua: Yeah, yeah, I completely think so. I've been speaking for 18 years and educating but I've been in dentistry for 14 of it. Actually, I cut my teeth, I was with a national practice management firm. Paragon Management. 

Howard: Oh yeah, Ken Runkle. 

Joshua: Yeah, Ken Runkle. In fact, we brought you in, what was that? I think 2011 you spoke for us. I was their marketing director for a long time and then in the past three years started my own company. I do some consulting and speaking and then have a marketing company, as well. Dentistry has changed a lot. I agree with you. There's a lot of talk and mail has kind of been the go to in dentistry as far as marketing. I think we're in that space I see we probably have half a dozen clients right now doing mail. The more and more we go the more and more I'm getting out of it, just because your mail campaign , I mean 30,000 would probably be a low end to get in the direct mail. What you can do with half of that or 20,000 of that in the digital space is mind blowing right now. The return and how far it goes is just so much better. We've been getting all of our clients that way. 

Howard: I'm 52, I turn 53 Saturday. The weirdest thing about dental town's demographics is there is no demographics. I mean, you got 125,000 general dentists in the United States. We have 202,000 members on dental town. They're all there. The median of dentists, you know, they don't get out of school 'til they're 25 and they retire at 65, so 45-50 is the top of the hill. 

Joshua: Yeah. 

Howard: Those guys, 45-50, all slide all the way to 65 and you just said the digital space, that flew right over their head, so explain. Explain what's the difference between printing a physical piece of paper and mailing it to someone's mailbox, versus the digital space. 

Joshua: Yeah, I think it's attention. I'm not down all the way on direct mail because it's mailboxes and dentistry is still a local business, but it's attention and it's where eyeballs are at. Right now, I still have people say hey, Josh, what do you think about putting this billboard up? I'm like, man, people ... they're not looking at billboards. When they're driving they're looking at their phones. It's where eyeballs are at and right now they're in a digital space whether that's Facebook, whether that's Search, whether that's reviews, whether that's a number of other social programs. Platforms. You're taking advantage of where eyeballs are at and marketing in those spaces. 

Howard: Okay, say those things again. You said Search, you said ...

Joshua: Search, Facebook, reviews, blogs, podcasts. I mean, you know right now you're doing this podcast. You have so much attention on this podcast. You became like the number one dental podcast almost from the day you started it. You have eyeballs on this podcast, for sure, which is why you're doing it. 

Howard: Okay, you know, I think something you just said that's profound that a lot of dentists don't get is that when you're in your 50's and you got out of school you thought advertising, you thought of making a flyer and sending it to someone's house. Or, you might have thought location. Having a good location on a four lane intersection with a big street sign, a monument sign, you thought that. But Search is actually advertising. Will you talk ... and what he means by that is these mom's are taking out their iPhone and they're going to Google and they're typing in dentist and the name of their city or their zip code. Talk about Search. Explain how Search is marketing. 

Joshua: Yeah, so I think coming out of the whole yellow page era, that was Search. That was analog Search. You open up your Yellow Pages, you're searching for a dentist and you're flipping through. We haven't missed it, but I mean, we realize that that Search, the Yellow Pages has now transformed online to mostly Google. I mean, I think Google controls about 95% of Search. Then you have Yahoo and Bing and everybody else there. That's what it is, you're looking for something online and so what comes up, what gets presented to you. The big thing even that we may miss just a little bit is the impact of the local search. That's where all those guys are going. I mean, if you're on a phone like most people, Google is going after how to make local search more and more relevant to you. It's not just Search but it's local search, as well you gotta be thinking about. 

Howard: Okay. If this dentist called you, went to your website, J-O-S-H-U-A Joshua Scott, and he said ... well, first of all how does that even work for dentists? Is this a monthly program? Do you have like a I want to market a little, a medium, a lot? How does Joshua Scott work? 

Joshua: Yeah, that's a good question. We typically, I mean, my approach number one is going to be budget based. I mean, I think the kind of standard percentage is out there. We're in that 3-5% of production is typically what's advised for dental practices to spend. I find that we're more like 3-4%. I'm gonna look at the practice, I'm gonna look at their needs, we're gonna look at the budget. What we're really good at is putting together a long term strategy. It starts with here's year one. Here's what I would do and it could be anything from hey, the website just needs reworked. You've never had a logo so let's talk about that and the website and let's get involved in Facebook a little bit, too. Down the road, year two year three let's implement some videos. Let's create an orthodontic landing page. Let's do some dental implants type marketing. That's what we do really well is long term strategy. Put all the pieces together and get everything working together. 

Howard: You know what I think? The big problem with these people listening to you right now is they'll sit there and say, okay you say 3-4% of production. 

Joshua: Sure.

Howard: Or, I guess you could ... could you also just say 3-4% of revenue? 

Joshua: Yeah, yeah, yeah. 

Howard: Okay, so 3-4% of revenue. 'Cause production a lot of dentists are gonna ask me, well is that adjusted production? I mean, if the crown was a thousand but Blue Cross and Blue Shield only paid me $850. I just thought that $150 was ... So let's just say 3-4% of revenue. Here's my beef with my listeners is they'll  hem and haw on that and say, "I don't know if I want to spend that kind of money and I don't know if I want to call Joshua and do all this stuff." Then, someone will mail them a PPO plan and say, "Hey Josh, you want to sign up for this dental plan and you'll do all the dentistry one-third off?" It's like they don't blink at that. They're like oh yeah. I'll do everything for 35% cheaper. Then I say no, no, no, no. Half of America doesn't even have dental insurance. Why don't you just spend 3-4% on marketing to get in people that don't even have dental insurance? They're like no, I don't know. I don't know about that. 

Dentists should be driving to work thinking okay, I collect a dollar a month so I should be giving you 3-4 cents a month to attract more patients because new patient flow does equal cash flow and I want to fix some broken teeth and get some people out of pain and feel good about myself. I'm gonna give you 3-4% of collection, get more bodies in my door so I can do more dentistry and you said the first thing you're gonna look at is you look at the budget and then you said first you're gonna look at the website and the logo? But when you say look at the website, back to that Search, is when you look at the website are you gonna be looking at the website so it shows up better on local search? How do I improve my local search? 

Joshua: Yeah, so that's some of it. I mean, you know, the website's a huge part of it. Honestly, it's the hub of the digital space and so we want that thing looking amazing. Howard, what a lot of people miss was at the beginning of last year, 2014, we saw the biggest shift in website technology probably since the creation of websites. When websites were created we had a page and you know, people put information on it, we put video on it, we put images on it and all that. At the beginning of 2014, the end of 2013, mobile usage passed desktop usage for the first time in US history. Okay? 

What happened now is websites are changing. The architecture, because if I have a tablet in my hand, the way I want to navigate a website is I want to scroll on that tablet or on my phone. You can't do that on a screen on a computer and so on a computer it's point and click. You put everything on a page and drop down menus and give everybody a choice of where they want to go, but now on mobile technology people want to scroll and so these pages become vertical. Honestly, you actually have more control over the story and kind of the narrative of the site and what people experience first and second and third and all the way down. That's a huge, huge part right now. A lot of people they've got older sites that are not necessarily mobile friendly. They may kind of work but they're just not optimized for mobile, so that's a huge point. 

Howard: You know what I wish you'd do? I'm being selfish and self-centered here, but my dental office is T-o-d-a-y-s 

Joshua: Okay. 

Howard: I wish you'd start a thread and look at my website on the phone and just get on there and say hey, I just did a podcast with Howard and he said, "Okay, look at my site." Because, I'm doing what a lot of dentists are doing. I think I'm doing the right thing because I'm a dentist, I'm not a website developer so I use Sesame. A lot of people ask me, they say well Howard, if you have five full time programmers and you do dental town, why don't they do your own website? My programmers told me well you're a dentist, why don't you go be an eye doctor or do a heart transplant or I mean ... My five programmers tell me, look, this isn't our space. We're a B to B, we're a dentist message boards online CE and we don't stay on top of the consumer thing. You know? Would you mind doing that? Would you start a thread and tell me what you think that on desktop versus mobile and because ... I'm using Sesame, I mean, am I doing the right thing or is there a better technologies out there? Because I really want that local search. 

Joshua: Yeah, no, I mean your site, it looks good. It's coming up on my phone. There's some good points to it. Nice big buttons. Part of it when you're on your phone, I don't know about you but man my thumbs seem like they're too big sometimes for the buttons and the links. You know, if I was going to give you any advice I think it could be more image driven. There's a lot of text. There's one picture up at the top and so yeah, I think in today's Facebook/Instagram Social Media world nice pictures communicate 80%. You need like 80% pictures 20% text. Go ahead. 

Howard: Just before we go into that website, would you say that Search is the most important? Can I say this phrase? That when a dentist is thinking about advertising for new patients, would you say Search is the number one most important part of advertising and marketing for a dental office? 

Joshua: Yeah, I think so. I know quite a few years ago I had a friend who had a practice, was working for a practice in Washington, D.C. and I remember the revelation when it came to me I said, "Hey, how many new patients are you guys getting online? How many new patients is your website getting?" He said, "Oh, like 50 or 60." I said, "You know, man, 50 or 60 a year. That's great." He goes, "No man. That's like 50 or 60 a month." I said, "What?" And so I went on and they were the number one ranked practice if you searched Washington, D.C. dentists. I went to their web page and this is where my mind shifted, because I was assuming it was a beautiful web page. It was all the bells and whistles. I mean, just amazing technology and it was okay. It didn't seem like a 50 to 60 new patient a month website but it wasn't the website, it was the placement on Search. Being number one in D.C. you just get that much. 

Howard: What can I do? Because I'm in a ... you know, cry me a million rivers, but I'm in a big city. I mean, I got 3800 dentists in Phoenix. When these dentists tell me they show up on page 4 and they're from Parson's, Kansas I'm like dude, that is so lame. I mean, I'm in Phoenix. Half of us dentists are in big cities and half of us are in 19,000 little small towns. When you're in a big city like Phoenix, what can I do to show up on page 1 instead of page 3? 

Joshua: Yeah, so there are a few strategies. Number one, if we're talking about your local listing because Google is going to return at the top. They're gonna show you 3-4 local listings first. I want you in that block, so what's going to affect that are reviews. You'll literally see the people with the most reviews rank higher in Google in the local listings. 

Howard: Most reviews or most good reviews?

Joshua: It's both. It's definitely both. You could have a bunch of bad reviews and rank higher. Reviews play a big role, how much information is on your Google plus page, how much you're updating that. Also, all of your local citations. Meaning, what we run into a lot is when you get multiple doctors and multiple locations or the practice has moved or changed phone numbers now you get ... there's all kinds of different listings all over the Internet. You could have different phone numbers out there, different addresses and Google doesn't like that because when they give somebody a search return they want to have 100% confidence on all the information is accurate. If they don't see accurate information they're hesitant to rank you higher. That's the local search, all right? Those are the main factors there. When it comes to your website, you know, we can get into the code of the website and the title and the meditags and all that, but 90% of website SCO is traffic. I mean, the people that have the most traffic going to their site always rank higher. 

Howard: You're saying that if everybody listened to my podcast, for free I might add ...

Joshua: Yes, right. 

Howard: ... would just go to and go to, that would increase my SCO?

Joshua: Yeah, no, completely. I mean, yeah. 

Howard: Seriously? Seriously?

Joshua: Yeah. 

Howard: Okay, I want every listener right now to put on their hazard lights. We're just going to stop in the middle of the freeway and go to, so that really would increase my traffic? 

Joshua: Yeah. 

Howard: Google sees everybody go to this website they think that must be a better website than the next one.

Joshua: Yeah, and not so much, if they're gonna get on their phone and just type in they're going there directly. They actually need to Google it and then find it and search it so that it goes through Google. Yeah, I mean ...

Howard: Come on, dude. They're driving their car right now. 

Joshua: I know. That's part of Google's ranking is the more people click on it it must be a reliable site especially related to that search. If somebody searches Phoenix dentist and clicks on your site and a bunch of people do that it must be a great site for that. That's a big one. Updated content which is really ... Google, all their algorithm changes the last few years have all been around content and so they want unique content on your site that's added, that's changing. That's where we see the blogs come in, the articles being written and podcasts and videos and creating landing pages and in today's world, you can't build a website and put it online and leave it. You have to be working on it and adding to it. Not just every year but every month, really. 

Howard: I mean, so we talked about the website. You didn't answer my question.

Joshua: I'm sorry. 

Howard: I thought I was doing a good thing so I went to the dental town message boards looking for companies that create websites. This was 5-10 years ago and it was Sesame Communications. Have you ever heard of them? 

Joshua: Yeah.

Howard: Out of Washington. The state of Washington. 

Joshua: Yep.

Howard: I've had their site for years. Who do you recommend for site? Do you do this yourself? 

Joshua: Yeah. We do websites and we approach it a little bit differently. I mean, we're always gonna back up and create the brand for dental practice. Howard, there's a conversation of marketing and then there's the conversation of well what do you market? We can put you in mail, we can put you in Facebook, we can put you out on a website but what are we saying? What are we marketing? I want to figure out, what's the story of that practice? What's the brand? Logo, tagline, photography? Because, I think what's happening in healthcare in general, and what we're gonna see more and more in dentistry is ... one of the things that the Affordable Care Act has done is probably pushed providers. It's kind of taken the middle out. I think we're seeing a lot of, in healthcare, we're gonna see a lot of clinics and we're gonna see a lot of like higher mass managed care and then we're gonna see a lot of high end discretionary type services. If I'm gonna go see an Orthopaedic Surgeon, I want to see the best one in town. Well how do I know that? It's marketing. It's the story. It's that practice. It's their brand. I think we're seeing that in healthcare. We're seeing the importance of brand. We're seeing the importance of story, we're seeing the importance of differentiating yourself. I'm seeing that come down the road in dentistry, for sure. 

Howard: You know, everybody that has data in dentistry that I've been talking to for 20 years has always come up to me and when they showed me their data it's always been consistently the same. The whole deal. In America, which is a huge country and by the way, when people talk about like national healthcare and you know, they talk about like Sweden or Finland or something like that. Sweden has less people than Arizona.

Joshua: Right. 

Howard: I mean, Finland is not even a rounding era of the population in California. But for a huge country like America, everybody shows that half buy on price and half buy on quality. You're saying if you needed an operation you'd want the best. That's 'cause you're a 40 year old male with a zone company or whatever. But half of America can barely pay their bills and they want price, so I want to ask you two questions. For the price market, should your website have coupons? Because coupons were huge. I remember back in '87 if I did a direct mail piece, the first couple I did were just information and I didn't even know if they worked. Then like the third or fourth one I put a coupon, I put two generic coupons. One was $25 off anything minor. Cleanings, exams, x-rays, fillings. $50 off anything major. Root canals, fillings, crowns, dentures, partials. No expiration date. No new patient or anything like that and I thought oh my God, I thought I might as well ... I thought I won the lottery. 

Joshua: Yeah.

Howard: Answer your question, can you be both things to both people? I mean, can your website say oh, I know half buy on price and do you like coupons? Or should you say no, if you're going to be the best if you're the Mayo Clinic if you're the best damn implant doctor in all the state you don't want that. Those are two distinct markets. Can your website get both of those markets on the same website? 

Joshua: Yeah, I don't know. I mean, that's tough. Again, so it all comes back to brand and we have a few clients that they don't want to do the coupons. They don't want to do the discounts and the promotions and so all the marketing is very brand oriented. Very name recognition. It's more high end and so we don't get into all the coupons and the discounts and all that, but honestly man, for the typical dental practice I think, you know, that accepts PPO's and just wants a great new patient flow coming in I think incentives play a role there for sure. I think it needs to line up, again, with the brand of the practice. I just think consumers are looking ... Howard, I think this is what happens. People search, they Google dentists in Phoenix, they're gonna look at the top 6-8 people on Google and what they're trying to do is just figure out, who do I go to? I've got six or eight practices here. They're gonna click on the website, they're gonna read reviews, they're begging somebody like stand out. Please. Give me a reason why I should come to you and I think that the branding and the story and the why you is so important. 

Howard: I want to ask you something that bugs me, and I know in business the number one bias you're always going to have in business is you project your own self in a market of a third of a billion people. Just because you don't like broccoli someone else might. You know what I mean? 

Joshua: Yeah. 

Howard: I don't like it when I'm gonna ... I'm calling back a dentist and so I go to their website and 80% of the time I get to see a picture and I don't know, for some reason I just like to see who I'm talking to. But about 20% of the dentists website it's a generic stock photo of like a family and I'm like, is that you and your family? No, that was ...

Joshua: Yeah. 

Howard: Some of my dentists are paranoid, right wing Republican people and they don't want to have their face show up on Google image and they don't want any footprint on Facebook or whatever, but so my specific question to you is, should the consumer on your mobile website see the person who's gonna operate and do surgery in my mouth? Shouldn't there be a picture of you? 

Joshua: Yeah. 

Howard: The guy who's gonna give me a shot and do a root canal on my tooth? 

Joshua: Yeah. 

Howard: I would want to see it. I mean, I don't know why? I mean, I don't know care if you're short or fat, boy or girl, black or white, I mean I really don't care. I just want to see ... Is that normal or is that abnormal? What do you tell people about putting pictures of themselves?

Joshua: It's completely normal. Honestly, the two things people want to see on your website right off the bat to check of their list is number one, they want to see a picture of the doctor and number two, they want to see a picture of the facility. All that is is they don't want to be surprised. They want to know what they're walking into and who they're going to see. I know when years ago when we chose our dentist here outside of Columbus, my wife, I said, "Hey, why don't you search on Google and see who you like." Because I knew some of the guys in town. She searched and picked this one dentist and I said, "Okay, why did you pick him?" She said, "Well, on his front page there was a picture of him and his family and he just looked like a normal guy." 

That's what consumers, patients are trying to do, is just don't surprise me when I think this is some really nice dental practice and I walk in and it's a kind of older, residential building. They just don't want surprises. They want to see what they're walking into and Howard, I don't know if I asked you, let's see if you know this. What's the number one button people always click on your website? What do you think that is? 

Howard: The number one button ... about? 

Joshua: Yeah. Yeah, about or our team. Like, the doctor, our team, so that's what they're searching for. You look at any analytics you're probably going to see about 80% of people on the site will go to that page because that's what they're trying to figure out. 

Howard: Okay, I want to ask you, so somebody just said this to me the other day, one of my best friends told me this. He said, "Howard, everybody's saying that 50% of the websites only go to the first page."

Joshua: Yeah. 

Howard: I assume it's true that 50% of people that go to the website go to the first page and they're gonna get the phone number, address, hours, whatever. 45% will go to page two and only 5% will go to page three, four and on. 

Joshua: Yeah.

Howard: He was telling me what he did is if half were only going to go to the first page he'd change his website to a one page deal. It all scrolls down. He was saying what you were saying that if you're on a desktop you can click to all these other buttons and all this, but if you're driving, you're down the road or you're sitting there and you're scrolling with your thumb, so he just put all of his pages on one long ass page ...

Joshua: Yeah.

Howard: ... so, what do you think of that strategy? 

Joshua: Yeah, I think it's great. I think that's where the world is at and that's how we're navigating everything on our phones and our tablets. If you're on those devices and you see a standard web page it doesn't feel native to that platform. I think that's a great idea, too. People, they always want to see who the doctor is or the team, the second most page they go to is the new patient visit and the third is contact. Honestly, if you just create a page and at the top it's about your practice and then your team and then new patients and then contacts, you've given them everything they want. 

Howard: I want to say one thing about, by the way, if you quote me you've got to date me because a lot of people say well you said you did this and you don't do that, well when I got out of school I worked seven to seven Monday through Saturday for a decade without blinking. Hell, I married a Catholic girl. She had four kids in three hours. I had $80,000 in student loans, $150,000 practice, $100,000 house and I loved it. I literally loved it. 

Joshua: Yeah. 

Howard: If I had a website back then, I would have had my after hours emergency would have been my cell phone number. Now, I'm not gonna do that now that I'm 52, fat and the kids are raised and grown and all that stuff, but I don't know. I look at the data and it showed on the data that 168 hour work week, these average dental offices are getting 50% of their incoming traffic calls outside of business hours which makes sense because 32 hours out of 168 is only 19% of the hours. You're only open 20% of the hours, 19% of the hours if you're 32 hour work ... so on the website, if you were young and hungry and you just married a girl and she had a couple kids you had student loans, would you have an after hours emergency number on that iPhone dental practice website? Say hey, after hours just call me on my cell or do you think that's just a bad idea? 

Joshua: Yeah, you don't have to do your cell. Having your cell is probably a bad idea, but you can do contact forms. You can make it easy for them to get in touch with you. For me it all comes back to the dentist and the brand and you know, some guys want to do that, some guys don't. Especially the younger guys I'm like man if you could open at seven some mornings, Fridays, Saturday mornings, stay in there until seven or eight at night on some extended days all that is ...

Howard: Well let me give you a couple of historical lessons I've seen around the country and just recently I got back from Australia. 

Joshua: Yeah. 

Howard: When I first went to Australia, the average dentist, this was like back in 1990, the average dentist in my room had one operatory and one employee. Nobody could get in for 6-8 weeks. 

Joshua: Okay. 

Howard: Then you come back five years later and a couple of people are playing around with two operatories, but anyway, long story short, the Australian people complained to their government and their government finally had enough of it. You know, it took six weeks to get into a damn dental office, so the government just went crazy and said hey, if you're a dentist from any of these other countries you can come to us and they let about 1500 dentists in in a country of only 20 million and they put up some new dental schools and all these dentists were all mad. I just got back and they're all mad because the government did that. I said look, you only care about you. I mean, the average dentist in Australia probably wishes he was the only dentist in Australia and he'd only see one patient a day and charge a million dollars cash up front. That's not reality. Right now, in America, you're better off breaking your leg or get in a car wreck on Sunday because you know the paramedics will show up and the hospital is fully staffed. 

Joshua: Right. 

Howard: Because if you have a toothache on Sunday you might as well just kiss your ass goodbye in Phoenix, Arizona. I mean, you'd literally have to call 50 dental offices, leave a message. When people tell me they're graduating too many dentists I say yeah, if you're a dentist but not if you're one of the third of a billion Americans who can't find a dentist after 5, can't find a dentist before they go to work at 8. These dentists are so anti consumerism they'll work 8-5 and take a lunch the same time one-third of America takes a lunch. 

Joshua: Yeah, right. 

Howard: The one hour Mrs. Jones could do some personal shopping and make a dental appointment, oh that's when Dr. Dumbass decides to go to lunch, too. I mean, they can't even do lunch 11-12 or 1-2, they're so anti patient centered and then they look you in the eyes and I say well are you doctor focused? I mean, is it just all about you or do you really care about the consumer? Oh, I totally care about my patients. My hours are Monday through Thursday, 8-4. I don't have an answering service or emergency. I think dentists are gonna get zero sympathy from governments and dental schools until you can find a damn dentist on evenings and weekends. 

Joshua: Yeah. Yeah and I think that that's a great point. I think healthcare in general has got to move more patient centered just overall. I think those are great conversations. 

Howard: I just went to the hospital for about the third time in my life. All three have been with a kidney stone. I went to the biggest hospital in Phoenix, Arizona at Thursday morning at 2am. Thursday morning at 2am. 

Joshua: Uh huh. 

Howard: Guess when I saw the doctor? Guess when I saw a doctor? Friday night at 6pm. 

Joshua: No way, that long? 

Howard: From Thursday morning at 2am to Friday morning at 2am, that'd been 24 hours. 2am to 6pm I mean, I was just sitting there like you've got to be kidding me. 

Joshua: Yeah, yeah. 

Howard: You know? Almost 30, but anyway, I believe that government and healthcare are the two main anti consumer sectors of society. 

Joshua: Yeah. 

Howard: I think fast food, restaurants, home repairs, yard services, everybody else is crushing it. Healthcare and government? It's like their motto is go to hell. Their logo should just be a doctor with a stethoscope flipping you off. 

Joshua: Yeah, yeah. I agree. I think that's one of the things that the recession did. I think when we came out of it ... When I grew up we probably went out to eat as a family like once a month. It was special and it was to our favorite place and my parents took us there and it was a good time and all that. I think what happened with the recession is one of the things that we came out of it there was this mentality of, okay, if I'm gonna go ... My family probably eats out three times a week, maybe. Maybe four. Part of what came out I was almost hey, like my money is worth a lot to me and so if we're gonna pick a place to go and eat I want great service. For me what happened outside that recession was if you got bad service some place you just kind of quit, like, I'm done. I'm not gonna go there anymore. I think we're gonna see that more in healthcare in general but in dentistry, as well. Consumers have a choice with their dollars and  they want to go somewhere where they're known and they feel cared about. I think a lot of that came from that recession. It just kind of woke people up ...

Howard: And it is that first impression. What I love most about my manager and my front desk staff is when you walk in there somebody is going to stand up and go over and say, "Hey Joshua. How are you?" I go into more dental offices than anybody I know, I mean I'm always going to pick up a dentist or seeing someone or whatever, and you just walk in there and you've got two girls with their heads looking down. They got a window that you know, you have to ring a bell or knock on the window and they slide it over and go yes? It's like, really? Really? I mean, you only see that at the post office and at dental offices and at doctor's. You'd never see that at somebody trying to sell you four new tires. 

I want to go back to these reviews, though. You went to a restaurant and you didn't like it. Yelp is a big review site. Google, Yelp. Who's bigger? Google or Yelp? Number two, how come there are so many threads on dental town about Yelp reviews where a lot of dentists think it's kind of a crooked operation. 

Joshua: Yeah, no, for me ...

Howard: Have you heard that? 

Joshua: Yeah, yeah, no, completely. To me Google is the big one in dentistry because it affects Search, so for me, again, it's like everything affects Search so if you can do reviews on Google it actually ranks you higher which means you get more new patients then let's do Google review. For me that's number one. Yelp is the other big player out there. You're gonna see it's a bigger player in the restaurant industry. It's probably a bigger player in hospitality. Yeah, they're out there so that's the war. It's Google and Yelp and it remains to be seen who's gonna come out on top ...

Howard: But when dentists are talking about Yelp, I mean, they talk like it's almost a hostage, crooked operation. You don't hear anybody talking about Google reviews anywhere near that matter. When they talk about Google reviews they're actually talking about what the review actually said. When they're talking about Yelp they're always talking about the culture of the organization. It's almost like a lot of them say I don't even want to advertise with Yelp. I don't even want to get involved because I don't even want them to know my name because next thing you know if you, you know ... Have you heard any of this or not?

Joshua: Yeah, yeah. It's all Yelps algorithm. They're really, really tight. If you're a first time user on Yelp your review typically won't get through so they're gonna block it, but yet if it's a negative review Yelp will let it through. They'll tell you, we think that negative reviews have more legitimacy to them. From my perspective, I get frustrated with them because we'll have clients and we'll run campaigns and dental practices to drive reviews and I'm like look, Yelp, I'm literally sending you 20-30 new users that are signing up to your service to leave a review for this dental practice and you're penalizing them by filtering out, or not recommending their reviews. All the law suits around Yelp have to do with like well, if you pay them for advertising they'll make those reviews come up and be seen and then we start hearing, you know, extortion and this and that and law suits. It all gets crazy. 

Howard: Okay, I'm gonna stop right there because I bet you 80% of the people, just on what they just heard you say, they're thinking well, I just thought if someone makes a Google review you have a Google review. But you're saying a dental office can pay Yelp for a review process or ... let me rephrase it like this. No dentist pays Google for anything to do with reviews ...

Joshua: Right. 

Howard: ... why would a dentist pay Yelp and why would I, why would I be giving Yelp money? Answer that question and should I be giving Yelp money? 

Joshua: Yelp has their own advertising platform so if you spend money with them they rank your listing higher than other people. They do like preferred listing and all that. Rumor has it that if you do that then they loosen up their filter on your reviews. That's what all the law suits have been about was like hey, Yelp wants me to pay them. They're holding these reviews hostage and they say if I don't pay them nobody will ever see them. Whether or not that's true or not, Yelp says it's not true. If you pay to advertise with them you don't see more reviews, but everybody seems to think that it works that way. As an organization, they've made some stances and some decisions on how they filter reviews. Just have not been popular at all. 

Howard: Yes or no? I'm gonna hold your feet to the fire grill. 

Joshua: Okay. 

Howard: Should these dentists driving into work today listening to you on their commute, should they advertise on Yelp? 

Joshua: For me, number one, I want to drive everything to Google. If I'm not getting the results with Google reviews that I want then we may look at Yelp. Bing and Yahoo just partnered with Yelp not too long ago, so Yelp is the main review source for both Bing and Yahoo searches. I'm watching Yelp a lot. I'm still ... As far as advertising and spending money with them I don't know. I don't know if any of our practices do that. I'm not opposed to it, it just, I'm not a big fan. 

Howard: That's kind of funny. You just reminded me of Warren Buffett's, one of Warren Buffett's gazillion quotes and he says when two losers get married for where the merger and acquisition is never a good idea. The minute you said Bing and Yahoo married Yelp I just thought okay, well that's three people that are not in first class. 

Joshua: Right. 

Howard: Not in first place, so that was a [inaudible 00:43:11]. I didn't want to open with this because I think everybody talks about it too much or everybody has Facebook fatigue, but when you talk about social media I mean you can't deny that the founder of Facebook, his dad was a dentist, Ed Zuckerberg. 

Joshua: Yep. 

Howard: Yay dentistry. Ed Zuckerberg, way to go. There are over a billion users. Then Twitter would be the next big guy with 300 million users. Then I guess Linked In, I guess, is the most profitable publicly traded social media. I read that several times. Then there's Pinterest, Instagram, Google Plus, what do the dentists need to know about those social media? All those sites. 

Joshua: Here's my idea on Facebook. I know we're talking about a lot, 'cause I mean people are scrambling. They're trying to figure out Facebook and Howard, I don't know you guys and how you've approached it, but we've had trouble in dentistry figuring out the ROI on Facebook. We've made it all about just content and posting day to day and funny little dental quips and interesting facts and all this stuff. We're trying to figure it out, but what most people, a lot of dentists have slept on Facebook. What's happened is they've become the largest data company in the entire world. It only makes sense that they will be the largest marketing company in the entire world. They were just on USA Today front page. They broke the top 10 most valuable companies in the country at evaluation of $250 billion dollars. Apple is number one, Google is number two, Berkshire Hathoway, GE, Wells Fargo, all those guys. Facebook is number ten. If you thought, if you're watching Facebook to see if they go away, they're not going away. 

Howard: But go back to that ROI because a lot of dentists ask that question. They say okay, well if I post on Facebook everyday am I really getting impatient? I want you to answer that but I want to go back to where the tire hits the pavement. Money. 

Joshua: Yeah. 

Howard: When you were talking about marketing, that Search is the number one thing. When I talk about Yelp reviews you said you know, I'm thinking all that's Search and that's Google. You said 90% of searches. Well, when I do a search on Google I usually get a couple of ads first before, so if I'm gonna spend a dollar, tell my commuters this, if I'm gonna spend a dollar would you do it on a Google ad for your search or would you promote your post on Facebook? 

Joshua: Neither. Here's the best ...

Howard: Are you saying I asked the wrong question? 

Joshua: No, no. Here's gonna be my little secret, right? I'm gonna put it out there. People are gonna get it. This is the best thing to happen to marketing in the last 10 years, okay? Facebook ads. They're called Facebook dart posts. It's not boosting your post, it's not creating content, it is actually putting an ad for your practice in the main Facebook feed. They released their platform like last year. I watched it for a little bit. We got about six practices this year to experiment with it and what I'm seeing in all these practices, number one their website traffic doubles. Because now people, they're sitting on their couch at night scrolling through Facebook, they see a really nice picture ad, image ad of your practice. They see you and say oh, he looks like a nice guy. They click on that, they go to your website and so we're seeing website traffic double, which is great for Search and it's great for whatever, just exposure. Then we're seeing about three to five to six new patients a month as soon as we start running ads. 

Howard: On Facebook? 

Joshua: On Facebook. 

Howard: Okay, so what would that ad be? Are you saying post, you make a post on Facebook and then you click boost the post and give a dollar amount? 

Joshua: No, no. These are different. Facebooks ad platform has grown. Before, what you would do is yeah, you would post something like hey, we got this event going on or its a Facebook post. You boost it which shows everybody that post. You can even extend the audience. What I'm talking about now they're called dart posts and that's just the street term for it. That's just a slang term because what it is is it doesn't post to your timeline. Before everything you wanted to show up on Facebook you had to actually put on your timeline. These you don't and you can target anybody. We have a lot of clients that they want to promote dental implants. We'll target that area 10 miles outside of the practice, 40 yr old and up. You can target females, you know, over 40 who like to watch Downton Abbey. I mean, that's how targeting this marketing could be. 

Howard: Okay, but go through the specifics 'cause these people have been to Facebook. If I'm going to create a Facebook dart post I'm going to ... walk me through that. What does this dentist do? You go to Facebook and then what button would you pull down or ...

Joshua: On your business page, on your practice page you'll see on the left hand side you'll see it'll say ad manager. You'll go there and then it'll just ask you what type of campaign would you like to create? That's where you can boost your post. You can create campaigns to just get people to like your page or you can do these dart posts which are promoting your website. They're not promoting ...

Howard: And is it called a dart post? 

Joshua: Facebook doesn't call them dart posts. That's kind of like the street slang word for it. 

Howard: What would it be on the site? 

Joshua: I think it's like promote your website. 

Howard: Okay, promote your website. 

Joshua: Yeah, something along those lines. If you Google Facebook dart posts you'll see a lot of people talking about it like that. It's the street term for it. Here's some keys here, so number one ... Go ahead. 

Howard: And you're saying there should be an image. A picture. Humans are visual. 

Joshua: Exactly. 

Howard: Should be looking at the dentist, or the team and the facility? Or should it be like ... 'cause you're only gonna do one picture. A dentist is only gonna get one picture what would it be? 

Joshua: Again, it just needs to be great custom photography. It can not be anything stock. People see through that. Pictures of you or the team, always, 'cause we see our analytics and they score ... The really cool thing is you can run multiple ads at the same time. I can run a picture of an ad with you, a picture and an ad with a team and an ad with your building and we'll see which gets the most clicks. Our analytics, always, the team always wins. 

Howard: A team shot. 

Joshua: Yeah. If I could get you with your team in front of the building, everybody's smiling, having a great time and it's like Today's Dental. Call them today to schedule your appointment or whatever. That's gonna score higher than just the building. 

Howard: You know what's funny? We always knew this one news- ... I think it was like the third or fourth newsletter we did we actually went to a photo studio and the guy who's an artistic guy, he put a step ladder there and he made my, you know, the whole team had to get on that step ladder. Everybody was laughing and giggling, it was just crazy trying to get the entire office on a step ladder. That picture was just golden. 

Joshua: Yeah. 

Howard: You're afraid of the dentist and it just looked fun. I mean, it didn't look like anybody hanging off that ladder was going to hurt you. 

Joshua: Yeah, yeah. 

Howard: Okay, sorry if I'm rambling on but trying to be more specific. You're saying if I was going to spend a dollar on social media, it would not be a Google ad, it would not be promote my posts on Facebook, it would actually be a Facebook dart, what do you call it? 

Joshua: Dart post. 

Howard: Dart post to promote my website because if I did that on Facebook, a lot of people are going to click my website link and if they click my website link that's going to increase my Google Search engine optimization. 

Joshua: Yeah. 

Howard: Google Search is going to say, hey, a shit load of people are clicking this website and you're looking for a dentist in this zip code and it seems like that the ten dentist websites in this zip code, this one is getting clicked the most so our algorithm is gonna send you there? That's kind of what you're saying? 

Joshua: Yeah, it's driving traffic to your site, but here's how all this is working together now, right? Because if you were to just go out, you listen to this podcast and you say tomorrow, hey, let's do a Facebook dart post, right? Here's the problem with it. Number one, it's driving people to your website and they're looking at Facebook on their phone, so if your website doesn't look amazing on their phone you're wasting your money. Does that make sense? You got an ad, they click on it then they go over to your website and it's not working and it's broken and choppy, that ads not gonna work for you. That needs to work. The custom photography needs to be there. We're starting to now see all these pieces in the digital space start working together. They click your Facebook ad then they want to see reviews, so they're trying to find that. We call it digital integration where all these pieces are now beginning to fit together so it's like you can do Facebook dart posts, but if you don't have a great website or they go to your Facebook page and there's nothing for the last three months content wise then that's a disconnect. That's why we have to kind of play these games and think about it but everything's starting to come together in the digital space and integrate where it all affects each other. 

Howard: Can I tell you something entirely inappropriate and unprofessional ...

Joshua: Yeah.

Howard: ... and [inaudible 00:53:33]. Did you hear United Kingdom dropped oral cancer and changed it to mouth cancer because the British are saying whenever you type in oral anything 80 million porn sites come up and so they changed oral cancer to mouth cancer because of pornography. Now I'm thinking well maybe I should change my name from Today's Dental to Oral Dental so I get all the websites and ...

Joshua: That's a great idea. 

Howard: ... on that note back to social media. I got to ask you, everybody, you can't throw a cat without hearing the word hashtag. When you're making a post on Facebook or Google or Plus should you have a hashtag in there and what would you hashtag? Your name? The word dentist? Dental? Tell us what you know about hashtags. 

Joshua: I don't know, we haven't done a lot with them. They've been a Twitter, kind of Instagram type thing. Most of it's just been trendy like you see the cool kids always kind of do cool hashtags. They make posts easily more searchable, but I just think all that, that's not patient censored marketing so much. Yeah, I don't know. I think patients like, let's say for example they're searching dental implants. I just don't know that they're gonna go to Twitter to search for dental implants. I think they're gonna go to Google. They want to see websites and information, so there hashtags don't matter. 

Howard: Do you have any data on what people actually do search when they're looking for a dentist? I mean, what do you think key words are in the search? 

Joshua: Dentist is number one, for sure. Just dentist and that area. Dental implants is the second most searched dental term. Following that you get Ortho and Invisalign. Actually, pediatric dental is up there, but then ortho and then Invisalign. I mean, those are about the top five dental searches. 

Howard: Man, have you been following Invisalign stock? 

Joshua: No. 

Howard: Yeah, that's a ... there was sort of a guy in Pakistan and all those patents expire in 12 months. That company is, well, the bottom line is patents are a protective mote around your company and you get higher prices when you got a patent on a drug. What happens to the price of every drug when the patent wears off? The generics come in. 

Joshua: Yeah.

Howard: Invisalign and patents expire in 12 months. Their stock is definitely under serious pressure and the guy who founded Invisalign, looks like he started Clear Correct now ...

Joshua: Yeah.

Howard: ... and so the price of that's gonna come down. If the price of Invisalign fell in half it's gonna probably, there's probably gonna be three or four times as many cases and you're saying it's one of the top five key words. You said dentist, dental implants, orthodontics, Invisalign and did you say pediatric dentists or just ...

Joshua: Yeah, yeah. Pediatric searches are definitely top five. [crosstalk 00:56:33]

Howard: You're saying if you hate a dentist you should create an ad that he's really good at pediatric dentistry and loves children. 

Joshua: 'Cause it'll search good. 

Howard: Truth, cause you know there's one thing a dentist doesn't want and that's a crying three year old. 

Joshua: Yeah. 

Howard: There's nine specialties, I love 'em all, but God bless the pediatric dentist. I don't know how they do it. 

Joshua: Yeah. 

Howard: You get addicted to Xanax and Vodka the second day. If those are the top five key words: Dentist, Dental implants, orthodontics, Invisalign, pediatric dentistry or children's dentistry or something, should those names be on your website? Should they be in your ad? What could you do on your website or your Facebook post or whatever to increase your Google SCO if someone's typing in those five key words and I assume the city you live in or the zip code. 

Joshua: Yeah, that's a great idea 'cause that's one of our strategies when we have a practice that does dental implants, the first thing I'm gonna do is develop a separate landing page, a separate website. One page for it. People when they're searching your website and just exploring they don't want a depth of information. They just want to get the basics. But if somebody's searching for dental implants they want to land at a place where they can be educated, where they can find information. I want a landing page, I want to optimize that for Search. I want to add articles to it. I want to shoot some video for it. That's a great way to bring in Google paid ads. If people are searching for high dollar kind of procedures like that, that's a great investment. So yeah, those are big plays whether it's implants or same visit crowns or orthodontics. 

Howard: I want to pop a hole in that. I know a lot of humans have self fulfilling prophecies like right now, there's a huge movement in the United States. There's a lot of people who believe the end of the world is coming up again. I think October 25th. At 52 years old, I've lived through about seven end of the world's by the crazies, but ... where was I going with that? I lost my train of thought. The same day crown stuff. I don't see that. I mean, everybody's talking about same day crowns, same day crowns. I mean, if I've got a hundred new patients like two people are saying that. When you read dental town and the dental journals you'd think that Syrac and CAD/CAM  was just like the silver magic bullet. In my office, I say that ... I got cad cam and I had cad cam before anybody teaching it had it. I mean, I had syrac one. 

Joshua: Yeah. 

Howard: That was like in the 1990's. Then syrac two, then three then ... I'm gonna ask this question to you, Josh. This is a serious question. Hey Josh, you broke a tooth and you're in my state, here's the deal; this is Tuesday. It's 10:00. You've got two choices, you can stay here about 2 1/2 hours and we'll do it start to finish or you can stay here for an hour and you'll leave in one hour with a temporary. You come back in two weeks for a half an hour. What do you want to do, Josh? It's Tuesday morning at 10:00. You want 2 1/2 hours right now or an hour and come back in two weeks for 30 minutes? 

Joshua: Probably because I travel I might do the one visit, but I know that that's not the normal case. 

Howard: You know what my office is? Four out of five look at their clock and say oh my God, I'd love to be able to leave in an hour. Oh please, just let me out of here in an hour and I'll worry about when I'm coming back in two weeks some other time. Then one in six says, like you, oh my God I'm leaving on a business trip in two days. If you could knock that thing out completely that would be so nice. 

Joshua: Yeah, yeah. 

Howard: Humans are extremist and it seems like, I believe, the number one reason you should not get cad cam is 'cause you know that extremist monkey, once he gets a cad cam will only do cad cam. The one thing you can always bet with a human is they're never gonna be a moderate. They're never gonna be a [inaudible 01:00:37]. They're never gonna say what works for you? Yeah, so cad cam is outstanding if you're balanced, moderate, you know and can ask the consumer customer first. Then, you were talking about I've only got you for one minute. I'm gonna end this one minute with a first opening question, I want 10 more new patients a month. 

Joshua: Yeah. 

Howard: Why should I go to or email, what is it? Joshua underscore Scott at 

Joshua: Yeah, that works. 

Howard: Do you want to give out a phone number? 

Joshua: Oh sure. Yeah, call my cell phone. 614-216-4097. 

Howard: That's 614-216-4097 and you got 60 seconds to tell me, I'm driving to work, I'm just pulling up to Today's which you should be clicking on and writing me a review today for this amazing free podcast and in one minute, Joshua, I want 10 more new patients a month. Why should I call you, email you, go to your website? 

Joshua: Yeah, here's what's happened. Amazon or boarders didn't believe the digital revolution was coming and Amazon put them out of business. I know a Barnes and Noble near you just went out of business and shut its doors. 

Howard: How did you know that? That's true. The only Barnes and Noble in [inaudible 01:02:00] closed down. How did you know that? 

Joshua: I listen to your podcasts, Howard. 

Howard: Oh, okay. Okay. 

Joshua: They didn't believe it. They got put out of business. Yellow pages ignored it and Google put them out of business. Taxi Cabs have not, they slept on the digital revolution and Uber is putting them out of business. As dentists, direct mail and billboards and magazines are going to get to the point where they no longer work. We have to understand what's happening in the digital space and you have to bring in a company who understands how to integrate all those pieces and to create a digital presence that works for you. 

Howard: How much money does your average client give you a month? 

Joshua: It all depends. You know, a lot of times it's just, you know, if they need to do a website it can get higher, but it's all custom. I mean, I really sit down with each practice. I want to work with them long term. I want to create effective strategies. Look, I grew up in the profitability side of dentistry under Paragon Management, so for me, marketing is about profitability. At the end of that year you should be more profitable because of what you've done marketing wise. I'm very aware of that. We tie those numbers in closely. I watch them and that's our goals. 

Howard: This dentist is probably freaking out on price. Like, he's probably thinking well what if she's driving to work and saying Josh, I don't even know if I could spend $500 or $1,000 a month. I mean, what would be the low end where, if it's any lower than that amount you're wasting my time. 

Joshua: You know, I would look at their budget and I would look at all their spending and say you know, it's a million dollar practice. I'd say hey, ideally we need to probably be budgeting $30-40,000. What are you spending ...

Howard: $30-40,000 a year?

Joshua: Yeah, yeah. 

Howard: How much is that a month? 

Joshua: Plus, you know, its 20-25 to 3500 a month. Something like that. 

Howard: $2-4,000 a month. 

Joshua: Yeah, yeah. But see I would look at her practice. She may be spending $18,000 on Yellow pages and so she says she doesn't have any money for what we want to do, but yet I can look at the budget and go ... okay, so like you're doing direct mail. Let's not cut it out completely, but let's start to cut it back a little bit and experiment in some other areas and do some things. 

Howard: I think your biggest nightmare would be that the reality is that, there might be a dentist in this city that has all the data in the world that says Yellow Pages and direct mail doesn't work and then I can find you a dentist in Shawnee, Oklahoma in a town of 5,000 that says, my God we crush it every month in the Yellow Pages. In fact, did you see that write up in, I think it was the economist that said, America is basically 9 different countries? It's like Europe. 

Joshua: Oh wow. 

Howard: Nobody compares Germany to Greece or Portugal to Italy or something. Everybody looks at Europe and sees a bunch of different countries and the economists are saying America, basically has 11 different countries all wrapped up under one ... I mean, 11 separate regional countries. I bet marketing is different in each one of those 11 countries, so when you're playing with national accounts coming in from here to ten buck two, it's got to be ... Okay, so we're completely out of time. Hey, please, I want to selfishly for me, I hope you start a post and just say Howard asked me to review the website and thank you so much for spending an hour with me today. I thought it was a rocking hot podcast. 

Joshua: Oh, my pleasure, Howard. Thanks so much, man. I appreciate it. You're a great guy. 

Howard: All right, and tell Dave if you run into Dave Runkle and Ken Runkle tell them I said Hi. By the way, Dave Runkle was the found-, no, Ken Runkle was the founder of Paragon. 

Joshua: Yeah, Ken's the founder and David's his brother. 

Howard: Yeah, but didn't Dave his brother, didn't he leave and start a waiting room television marketing company? 

Joshua: Years ago. 

Howard: Yeah, like 20 years ago? 

Joshua: Yeah, then it ended up coming back. He's one of the senior players there at Paragon still. 

Howard: Okay, well if you ever see him tell him I said Hi. 

Joshua: I will. 

Howard: Okay, bye, bye. 

Joshua: Thank you. 

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