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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252 New Patient Acquisition with Scott Eklund : Dentistry Uncensored with Howard Farran

252 New Patient Acquisition with Scott Eklund : Dentistry Uncensored with Howard Farran

12/9/2015 2:00:00 AM   |   Comments: 0   |   Views: 635

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AUDIO - HSP #252 - Scott Eklund

Watch Video here:

VIDEO - HSP #252 - Scott Eklund

• How a website is the digital front door of your practice

• How Doctors can use SEO to be more visible online

• How reviews affect the buying decision of patients

• How social media can help Doctors stand out from the competition

• How contests are an underutilized method of getting new patients

• How patient engagement platforms like Dental Sesame/SolutionReach help Doctors reduce no-shows and increase production



Scott Eklund was the Marketing Manager at Sesame Communications - a leading Dental Marketing and Patient Engagement provider. He has helped hundreds of doctors increase new-patient acquisition and improve patient satisfaction.



Company phone number 866-437-5384

Company email -

Howard: It is a huge honor for me today to be interviewing Scott Eklund and I love Scott so much because he lives in Seattle, Washington, but he's actually an Arizona Cardinals fan and he hates the Seattle, is that a fair statement?

Scott: Of course, yeah. I live in Seattle but hate the Seahawks.

Howard: Ha. We beat them last night, this weekend. We beat them on the Sunday game in your town. 

Scott: Yeah, that hurt. That one definitely hurt. 

Howard: I expected you to cancel on me today. I figured I would dial in and there would just be a "Sorry, buddy." [crosstalk 00:00:44] The reason I called you, and thank you so much for doing this interview, is because when I got out of school in 87, the killer new marketing was a full-page ad in the Yellow Pages. The dozen or so young kids like me who were young and would try anything, we were crushing it. 

We were paying about $1,500 for a full-page ad in 87. Only about a dozen dentists in the entire city of Phoenix, Arizona was doing it. We were getting like 100 new patients a month from it. The older guys thought it was stupid because every dentist, when I was 24 and owned my own practice, every dentist 50 to 65 would say "Well if you had a heart attack, would you look up a cardiologist in the Yellow Pages? If you were dying of prostate cancer, would you go to the Yellow Pages for an oncologist?" 

They just didn't get it and now what I'm afraid of is, now all the guys are old dogs like me, I'm 53, to 70, that they're missing out on this whole digital [inaudible 00:01:45]. The whole world's moved from Yellow Pages to a smart phone and when you go looking for new patients on the smart phone, dude you're crushing it. 

I'm not smart enough to ask you questions, I wanted to call you and say what could you tell these old guys about if they're not showing up on smart phones, that they're just missing new patients. You know they all want new patients; I've never met a dentist that says I have too many patients.

Scott: Exactly. You never hear that.

Howard: How can you help my listeners get more new patients?

Scott: I think you kind of touched on it right there, that things have changed a lot in the last 5 years. Even just 5, 7 years ago, you could use the Yellow Pages and you would crush it. You would just send them some money, they would run some advertisements for you and you were fine. That's definitely not the case anymore. Everything has moved towards digital, it has moved towards smart phones, and we're in more of a research economy now. Just having a menu online isn't really enough anymore. 

For example, if you're going out to eat, you're not going to open up the Yellow Pages. You might in the past, you might have driven around and taken a look on the street. Now there's things like Yelp, you can find the top rated restaurants, you can see their menu online. More importantly, you can see the photos of their food, you can see photos of the restaurant, so it's not just about having a menu anymore. 

Google and all these search engines are making sure that they have a good user experience, that you have this content on your website that's going to help the user out. When it comes to SEO, there's a lot of different things that we can touch on. Where would you like to start with that? 

Howard: I'm on DentalTown all day, every day, since 1998 and I read a lot of their questions. First question I want to ask you, true or false, that all this digital, smart phone all that, that's basically for half of Americans that live in the big cities like Seattle and Phoenix and doesn't really apply to the small town, rural markets where the other half of America lives. True or false.

Scott: I think with a lot of the questions like that, it's a mix of both. For example, iPhones and Android devices have skyrocketed in popularity in the last five years. In fact, in May 2015, mobile searches overtook the amount of desktop searches nationwide. Now, the thing to keep in mind, you might have heard somebody spout that statistic before, is that's nationwide and that's for everything, that's for shoes, somebody searching for a plumber, somebody looking for a handbag on Amazon, that's everything. 

When we talk about dentistry specifically, that's going to be a lot different. For example, in the Seattle area, there's a lot of mobile devices. We're in the backyard of Microsoft. We have a really strong tech community here, so mobile devices and being mobile-friendly is really important. Like you were saying, in a smaller town area, not so much. There's going to be a lot more people using desktops, it's going to be a lot less important. 

Now the good news is, you can find out where you lie on that spectrum of "Do I need a mobile website? Or am I all right with what I have right now?" You can go into your Google Analytics and you can actually figure out how many visitors right now are coming from mobile devices and that will tell you, is this time to get a mobile-friendly website or can it wait a little bit.

Howard: Okay, explain that, what you just said: mobile-friendly website. You're talking to thousands of dentists and they're all alone, they're all commuting to work, that's pretty much what everyone tells me who listens to the show. I'm driving to work right now, I'm going to be at work in 15 minutes. How do I get to work and know if my desktop is mobile-friendly?

Scott: The easiest way to do it, the definitive answer, is to just Google a term, Google "mobile test." Google, because they have in their ranking algorithm a factor that says if you have a mobile website, we're going to rank you higher, especially on mobile searches. If you type in that tool, you're going to be able to tell if you have a mobile-friendly website. It's going to say yes or no and this is going to say these are the things you need to fix. You can just hand that to your marketing agency, your web developing agency-

Howard: So you go to your dental office website, like I would go to, or I would just go to Google and type in "is mobile-friendly?" 

Scott: I haven't tried that. What I would do is just Google the term "Google mobile test." It'll take you to a Google website and then you just type in the URL for your website, so 

Howard: Okay, then. Type in "" It said "this porn site has been taken down."

Scott: Of course, you should know better than that.

Howard: Too many naked teeth. 

Scott: Yep.

Howard: I also want to add, true or false, Yelp is for restaurants, not dental offices. 

Scott: False, and I think where some of that confusion lies is that when Yelp started off, that is what it was for. That's no longer the case. In fact, if you want to see the prominence of Yelp, just Google your practice name or your doctor name and then "reviews" into Google and you'll see that Yelp is generally pretty high on that list. 

In fact, if you just Google generic terms like "in Seattle," for example. If you right now Google the term "dentist Seattle Washington," a Yelp listing is going to be very high on the search results. That's because people use Yelp to find their dentists now. 

Howard: Okay, so I'm a dentist and I'm not feigning expertise on SEO and all that but I do pay attention to it because I think you have to have a flair for marketing in any business. I don't care if you're a plumber or a dentist [crosstalk 00:07:19] or a doughnut maker. 

All my friends that I walk into their office in my backyard and they've all bought a website 5 years ago and they haven't touched it since. I say "Well, why don't I film you and say 'Hey, Scott Ecklund, tell me what's hot in dentistry today' and then make a little video and upload it on your website." 100% of dentists can do that, that I walk into, but if they could do that, would that increase their SEO so that they show up more on searches?

Scott: Having a video on their website? 

Howard: Fresh content. 

Scott: Fresh content, okay.

Howard: Is fresh content really the king of SEO? Again, I'm a dentist, I'm not you, I've been told that if you buy a website and it hasn't changed for 5 years, Google's not really going to point anybody there because they call it dark, it's not fresh, it's not original content.

So there's two dentists on the corner and one dentist, once a week walks up to his [inaudible 00:08:27] dentist and says "Hey, give me a 60 second pitch on how to save my teeth and not die with dentures." And she gives a rocking on answer for a minute but if they went and uploaded that to their dental website, that would be fresh, original content.

Scott: Mm-hmm (affirmative), yeah.

Howard: Google would point more people there. Is that true?

Scott: I love debating with other SEOs about this and the reason I think you hear that from a lot of different people is because we all go to the same blogs. We all hit the same spots. The content is out there and what people have said is that fresh content is extremely important. Now, I think the disconnect is people don't think about [used 00:09:07] cases for that. 

For example, the Seahawks game that we just had and unfortunately just lost, if you type in "Seahawks," Google knows that you want to find most likely the latest score. You're going to want to see either the latest score of the game or you're going to want to see when the next game is. It's going to surface that fresh content because they know that timeliness is important. 

But, for example, if you want to learn Apollo 13, that not a lot of information has changed since the Wikipedia article was posted, or the last article was. So freshness is not nearly as important and I would argue that dentistry leans more towards an Apollo 13 use case as opposed to the latest Seahawks game that just happened a few days ago. Freshness is not nearly as important as unique content in my eyes.

Now, is having 15 year old content that is outdated a bad thing? Yes. But if no major advancements have happened in fillings in the last 5 years or you haven't changed your process for that, I don't think that it's beneficial to put in a lot of effort for that. I think it can be better spent in a lot of different areas. 

Howard: I think most dental consultants think that about half of your patients should be word-of-mouth referral and half of them should be marketing new patients because you've got to keep these patients that are coming in. At least half of them have got to be customers for 5, 10, 15, 20 years or you're really not going to build up a dam and build a big lake on this stream of new patients coming in. 

Half should be internal marketing, the other half's external marketing. Talk to the dentist who is listening to you right now who says "You know, I'm only getting like ten new patients a month that aren't word-of-mouth or referral and for all my financial goals and overhead and all the equipment I bought, I'd really like that to go from 10 to 20. What would you tell that person to do? 

Scott: The first thing that I would do is seeing what they're doing already, how are they getting those ten patients? Is it through SEO, is it through direct mail, is it through pay-per-click advertising? So we can figure out one, what's already resonating a little bit. 

Now, ten new patients a month, that's not exactly what they're looking for, so I would say what are your goals? Do you want ten new patients right now or do you want to play the long-term game with SEO where you're going to get a higher return on in investment, but it's going to take a little bit longer. So I would first start with [crosstalk 00:11:31]

Howard: What's a little bit longer? What time frame are we talking about? 

Scott: Generally, I tell people that with SEO you should have a really big sit-down at six months. The first month of signing an SEO contract and working with an agency, they're really just setting the ground work, they're making sure all the processes are set up, they have all your information, all your accounts, and really setting that foundation. 

With Google, it takes a little while, especially with dental websites, to climb those rankings. It takes them a while to spider that information, to consider it, and to change those rankings. I think at about six months, that's where you're going to see those results. Any good SEO agency is going to be sending you monthly reports most likely. They might have monthly or quarterly phone calls with you as well, and they're going to talk about "Okay, these are the key metrics that you need to be paying attention to." 

One, the key words, which we always hear about keywords. You want to rank for "dentist Seattle," or "crown Seattle," or "filling Seattle," but ultimately as a dentist, you don't care about key words. In fact, you don't even necessarily care about visits to your website per se, you care about new patients. If you're marketing agency isn't driving everything back to that new patients number, then they're not doing a good job.

They'll talk about the new patients they're getting, they'll talk about the amount of visitors they're driving to your website, and in turn the key words. They should really be talking about all three of those things.

Howard: It reminds me of the dot com bubble that I lived through and couldn't forget from 93 to 2000 and all these companies would talk about how many clicks and users and members, and you'd say "Yeah, but how much money did you make?" 

Scott: Exactly.

Howard: They'd say "Oh, we never made a penny but we have a million clicks." It's kind of deja vu of Facebook, you'll talk dentists "Well, how's your social media?" And they'd go "Oh, we now have 1,200 Likes on our Facebook page." I don't know how you buy a cup of coffee with 1,200 Likes on your Facebook page.

Scott: Exactly.

Howard: How many dentist clients have you helped over the years?

Scott: Hundreds.

Howard: Hundreds. You work at Sesame Communications, that's a huge leader in this whole deal, walk them through some [inaudible 00:13:44]. If some dentist called you, and by the way, how can they contact you?

Scott: First off, I would like to clarify because things have changed recently. I actually took another job at another company completely outside of dental very recently, so I no longer work with Sesame Communications. We definitely left on good terms, but the views and information expressed today are my views and not necessarily the views of Sesame Communications, but I would say that they're an amazing company.

Howard: You're not even working in dental?

Scott: For the time being, no. I'm not.

Howard: But you're just doing this out of the goodness of your heart anyway? Or are you planning on getting back in dental? 

Scott: I love the dental and medical marketing community that I've been in for the last three years, so I just want to give back. Over the time, helping those hundreds of dentists, you build a relationship with a lot of them and you realize there's a lot of good people in dentistry, so if I can give back to the community by doing this, I'm more than happy to. 

Howard: That's awesome, Scott. I like you even more. Talk to this listener, they're driving to work, what did you usually do for the average dentist? What were they calling you for, how much money were they giving you for how long, and what were you doing for them and what were the results? 

I want them to have a recipe like what it costs, what their expectations should be. I don't want to raise anybody's expectation that you can call somebody and all of the sudden get 100 new patients a month or [inaudible 00:15:09]. Talk about what you did for these average hundreds of dentists. 

Scott: In a marketing agency, generally you're going to see full-service, so it all starts with the website. That's going to be your foundation because ultimately most marketing efforts, you're going to drive them back to your website. If you're doing direct mail, if you're doing pay-per-click, if you're doing radio, television, even referrals. If someone refers you, they're going to go to your website to learn more about you. Making sure that you have that solid website and that foundation is first, and then it's getting the eyes on that website.

Generally, my focus has always been on the SEO and pay-per-click, what can we do from a digital marketing perspective to get those patients to you. We talked about the six months waiting for results. I don't necessarily want to get into pricing information, but generally when you look at marketing agencies for the dental community, you're looking anywhere from 150 on the very low end to 800 dollars. Just depending on the amount of services you want, if you want monthly phone calls, agencies are going to have different packages.

Howard: You're saying marketing agencies. Can you name the top three, five, or ten biggest marketing agencies in dentistry for a dental office?

Scott: Yeah, definitely. I'm going to say Assessment Communications first, but I would say-

Howard: They're out of Seattle.

Scott: Out of Seattle, Washington. There's Televox, there's Rosemont Media, there's PBHS. Let me think of some of the other bigger players.

Howard: PBHS?

Scott: Yes.

Howard: Rosemocks?

Scott: Rosemont Media. I'm probably more familiar with them because they also work with plastic surgeons, so from my previous job at a previous agency, I was a marketer for plastic surgeons.

Howard: Huh. And then Televox, T-E-L-E-V-O-X?

Scott: Correct.

Howard: Those four are pretty much all dental places, Sesame, Televox, Rosemont Media, PBHD?

Scott: PBHS. Yes.

Howard: PBHS. 

Scott: Yes, so I would so those are some of the bigger players and of course, I'm sure I'm missing a few of them, but those are the ones that come to mind.

Howard: Because I think a lot of them, a lot of listeners, might be thinking that the answers would have like Demandforce or the one 1-800-Dentist owns, what is that, a patience activator? 

Scott: Yes, 1-800-Dentist is definitely a big player as well. Demandforce is more practice management software, they have some good tools over there but I'm not too familiar with their websites.

Howard: Back to the deal, the first thing you said is you want to make sure the website is solid.

Scott: Yes.

Howard: Okay, talk about what's a solid website. The dentists listen to you, they dream about root canals. I think a lot of dentists seriously ... A lot of my friends will say "When was the last time you even went to your website and just looked at it?" Because I ask probing questions, I really want to know and most of them say "God, I haven't looked at it in a couple years."

Scott: Yeah. Yeah.

Howard: What should they be looking for? If this listener goes to their dental office and she looks at her website and pulls it up, what should she be looking at? Should she pull it up on the desktop or her iPhone? 

Scott: Well, I would argue that you should just do both. Let's start at the very beginning of the customer journey here. It's going to start off with either a referral or they're going to say "Okay, I need to find a new dentist in my area." So we'll use Seattle as an example. The first thing they're going to do is type in "dentist Seattle Washington." 

Now, about 70% of the traffic that comes to your site, let's say 60%, is probably coming from that one term if you're ranking highly for it and there's other terms that you want to rank for: cosmetic dentist, emergency dentist, crowns, fillings. All those other things, but a lot of your traffic is going to come from that main term "dentist" plus your location. 

When somebody types that in, the first thing they're going to see is the title tag for your website, so they're going to see the ten results, they're going to see the advertisements at the top, they're going to see some local listings. Then they're going to see the title tags and the meta descriptions. The title tags, it looks like you're looking at a computer right now, are the big blue text, it's about 90 characters and it's essentially the title that people click on when they go to a link in the search results.

You want to make sure that you have an optimized title tag, something that is going to be eye-catching, something that people know is relevant so if they type in "dentist," it should have the term "dentist" in there somewhere. The next think they're going to take a look at is the meta description, so you need to make sure that you have something that's really inviting for those people, say "Seattle dentist: We're going to take care of your cosmetic, implant, general dentistry needs." So that's the first step.

Howard: Would my website get higher SEO if, you know my website name is Today's Dental, if it was Today's Dentist, if the top search word was "Phoenix dentist"? Would my website perform better if my name was Today's Dentist? 

Scott: If your website has the term "dentist" in it, it helps a little bit and about four years ago, they called that "exact domain matching" and "keyword matching for your domains." That was a lot more important than it is now. For example, if you just had the website name, that was going to help a lot. Now, it's not nearly as effective. Google has kind of tuned down that ranking factor so it's not as important, but it does still help.

If we continue on that customer journey, the first step, having that title, that's really the welcome mat into your practice website. You need to make sure you have that title and description. The next step, once they actually click on your website, you need to make sure that you're engaging that user. You have about five seconds to grab their attention. There's a lot of studies on how quickly people look at a website and get that impression. This isn't just for dental websites, this is for all websites as a whole. You have about five seconds to grab their attention. 

What I've seen on a lot of websites that are poorly done is you'll see these photos of these rolling wheat fields or these cityscapes that look really nice, but they don't say anything about dentistry. You want to have something where in those first five seconds, they know that they've landed on a dentist's website and that that dentist might be able to help them. 

I recommend having a photo of a real patient if you can, otherwise a stock photography, a photo of somebody or a photo of the doctor and the patient or a photo of the staff and the doctor. That way, they know what they're getting into and they can learn a little bit more about you within those first five seconds. 

First thing, that impression. The next thing, once they say "Okay, I've spent five seconds. This looks like it might be the dentist for me," they're going to start reading your website so the next thing is making sure that you have good content on your website. I've taken a look at your website really quickly, the first thing that you say is "Welcome to Today's Dental in Phoenix, Arizona," I believe. That's a great way to start your website and then after that you need to talk about the benefits of them choosing you as a doctor. 

The phrase that I like to use all the time is "People care about benefits, not features. People don't buy drills, they buy holes." You really need to talk about the problem that you're solving for them. The don't necessarily care that you do a filling, they want to have their toothache stopped. They don't necessarily care that you do cosmetic dentistry, they want to have a beautiful smile at the end of the day, so making sure that you're talking about what's in it for them on your homepage as quickly as possible is really beneficial. 

Howard: Right on. And you think photos are important too?

Scott: Definitely. I think before and after photos are something that's a necessity, so you need to make sure those photos are easily accessible on your website, that they can be clicked on in a link in the menu, and better if you have a photo or two on your homepage. Now, the thing with before and after photos, and I think it's "The ADA Guide to Practice Management," I forget where I saw it, where they have basically a whole section on best practices to take before and after photos.

It talks about the angles that you should take it at, it talks about you should manage their smile, it talks about the lighting, the cameras that you should use, and it really makes a big difference. The problem I see with a lot of photos is that they're inconsistent, so for one, it might be shot at this left angle, the other one shot at the right angle. 

One, they might have a full-face smile, one they have a slightly different smile, and it's hard for the average patient to see the results that you're driving if the photos look vastly different. That's something I would definitely recommend making sure you're doing properly.

The next thing, we're talking best practices, what people are looking at when they hit your homepage, having testimonials on your homepage is also a great thing to have on there. It's really a great sign of social proof that says "Hey, other people are going to this dentist. They've had an excellent experience. They're happy with this dentist. They're continuing to go to this dentist." If you can have a photo of a patient giving a testimony all on your home page, that's ideal. If you can just get the text or written testimony, all that's great as well. 

Besides having that testimonial on your homepage, I would also make sure that you have a dedicated page on your website that talks about testimonials as well. Hopefully, as a good dentist, you have more than one testimonial that you can showcase. The next thing I would touch on, a lot of people are talking about how video is really the next big thing. We talk about "Oh, all you have to do is shoot a quick video, put that on your homepage as kind of an overview of your practice, people are going to love it." 

I have a slightly different view, there's kind of two camps in this. You have the people that say you need to have a professionally shot video and you have the people that say it's okay to pick up your iPhone and have [bad 00:24:57] lighting, it's really authentic. 

I don't necessarily agree with the "pick up an iPhone and shoot a video for your practice." There are a lot of things when you pick up an iPhone and just shoot a video that can go wrong. You can have the lighting be off, you can have poor audio, you can have bad camera angles. It can really look low-budget, so as a dentist, you want to pride yourself on being very meticulous, on driving good results, but if somebody sees a low quality video, that's going to be a bad representation of your practice. 

When it comes to an overview video, I highly recommend spending the money, and it doesn't have to be a lot. Sometimes you can get a video shot for $300 up to $2,000 depending on your area and the competition in the area. That's really going to allow you to show your personality to everybody on your practice website. 

Now, when it comes to video testimonials, I would take the exact opposite approach. You don't want to have a professionally shot video testimonial reel on your website. That's for pretty much the exact opposite reasons. You want those to be authentic, you want to have a patient come in ideally basically right after they're really happy with the results, whatever it might have been, so you have that authentic look, they're glowing, they're really excited and you can see that energy in the video testimonial.

If you have them come back for a professionally shot video testimonial, it might be weeks, months later and that enthusiasm is gone, so I highly recommend that when it comes to video testimonials, just shooting it with your iPhone. But when it comes to the overview video, the one you put on your homepage, on your YouTube, on your About Us page, having that be professionally shot. 

Howard: Should one of your tags just be reviews or should that be on page one? Let me back up. One of my very smart friends in Ahwatukee, he's a dentist, he said that he reads that 50% of people who go to a website never go to a second page. He just has his first page, you can just scroll down for eternity, so he's got his website two ways. Yeah, you can navigate it on the bar and click to next sections, but if you're not a navigator and you just scroll down, you'll hit his entire website. Good idea, bad idea?

Scott: I would agree with that generally. I think that on your homepage, you're more likely for people to read your content as opposed to having them click. Obviously, clicking is a relatively easy action but it's still an action that they have to do as opposed to just scrolling down on your page. So yeah, if you can fit all those things on your homepage, I would recommend it, so the testimonials, before and after photos, photos of the doctor, some good copy to say why you're a good choice for them. Putting that on your homepage. 

Now, the thing you want to be careful of is what's called "duplicate content." You don't want to put all your text about fillings, about crowns, about everything that you're doing on your homepage and put that on your internal pages or other pages of your website. Google's going to see that as duplicate content and it's not going to help you rank better. 

Howard: What do you think about testimonials when you go to so many dentists' websites and it'll say "Oh, great office. I loved the staff." Anonymous. Or "Man, I'll tell you what, Dr. Scott Eklund was fantastic." S. White. Do you think it's better to have a testimonial and the patient's real name?

Scott: Yeah.

Howard: Am I too cynical of a bastard that if I see a great testimonial by you and it's by Anonymous or P. K...

Scott: Are you talking about if it was anonymous, it might be a fake review that they just wrote up?

Howard: Yeah, yeah.

Scott: Yeah, I think that that does happen sometimes. Now, a smart person could also just add a name, so Sean P., and have that be a fake testimonial as well. I think the more information you can get from an actual patient, the better. If you could get a photo of the patient and they're willing to put that up on the website, obviously you would need a written consent for that, but if they said "I got a filling. I was very happy with the results" and you have a photo of a real patient-

Howard: Yeah.

Scott: And just their first name, that's golden. That's as good as you can get. Taking a step back from that, if you can get their name, I would recommend doing that just because it shows more credibility to the review. 

Howard: Yeah, I would agree. That would seem a lot more authentic. 

Scott: Yeah.

Howard: To get reviews. What's more important, a Google review or a Yelp review?

Scott: Google review, hands down. It is much more important and the reason for that-

Howard: Can you numerical, I mean, 2 to 1, 3 to 1, 4 to 1, what would you say?

Scott: I would say 2 or 3 to 1. It's definitely the best.

Howard: 2 or 3 to 1. Why is that? Explain why.

Scott: There's two reasons that's really important. The first one is when somebody is doing a generic search for a dentist in Seattle or dentist in Phoenix, a lot of the local results, and usually ... The local [packets 00:29:54] changed. It used to be seven results and you'd see a map and then their phone number, some stars, and some other things. It's recently been reduced down to three, but with those results you're able to see how many reviews those people have. 

Now, it only pulls Google reviews, so if you have less than five Google reviews, it's not going to show the star rating. If you have more than five, you're going to get a nice little star rating next to your local listing so people can see one: how many reviews you have. Obviously if somebody has 50 reviews, they're going to be a lot ... People are going to think they're a lot better doctor than if they just have ten reviews. 

Ultimately, you're able to see the stars as well, so if somebody has five stars, that's a great thing to show for having somebody click on your result as opposed to the doctor beneath you. It's really important from a click-through perspective or just clicking on it, and it also helps with your rankings on Google, so if you have a Google review or you have a lot of them, it's going to boost you in those local search results as opposed to having a review on Yelp or Health Grades or any other websites.

It's twofold. You get a lot of benefits from it from just a search perspective as well as people actually seeing your reviews. Now, Yelp is extremely important as well, so my best practice that I've been telling doctors for years is make sure you have at least five Google reviews so you get that star rating so people can easily see how many reviews you have and how well of a doctor you are. To patients. 

After that, start pushing people and recommending people to go to Yelp because people check that as well. What a lot of people forget about is that when somebody is looking for a dentist, there might be two viable choices, they're really between you and some other person and they're having a tough time telling which dentist is the right one for me. A lot of times, they're going to type in your name plus reviews and then the other doctor's name plus reviews. 

When they do that, your Google reviews are going to show up, your Yelp reviews and most likely your Health Grades reviews and a few other sites as well. You want to make sure on all those properties, that you have reviews on them. Google, being the first priority, Yelp being the second, and I would argue that Health Grades would be the third.

Howard: Arizona has 3,800 dentists and half of them are in the Phoenix metro, so you're a Phoenix dentist, you're not on page one for "Phoenix dentist," and you can buy your way. You can buy a Google AdWord. Is just buying your way to the top, is that as effective as doing it the hard way with SEO and earning it? 

Scott: It can be. When you're in an extremely competitive area, SEO is a little bit more of a tough sell for exactly that reason. You're competing essentially against 1,400 people for ten spots. That's really not a lot, percentage-based that is just absolutely horrible odds. When SEO is really effective for a really competitive area, if you're that dentist that is on the second page near the top, you're going to be able to get on that first page almost guaranteed with SEO. 

But in a competitive area, if you're looking on page 14 and you're looking to get on page 1, that's probably not going to happen. It's possible, sometimes it does happen, but the odds of that are a lot less, so that's when other forms of marketing are more effective, like pay-per-click, like direct mail, like social media and more referral-based marketing.

Howard: Okay, so rip through those. You said pay-per-click and that would be pay-per-click, you can buy Google AdWords, you can buy Facebook ads, I assume you can buy Bing and then there's also the Angie's List and Yelp. You can give Angie's List ... How can Yelp and Angie's List be authentic? When I'm watching an Angie's List commercial, I'm always a little cynical because I'm like "Oh, find the best roofer, find the best dentist, find the best plumber." And then the next thing I'm getting is a flyer to give Angie money.

Scott: Yeah, exactly.

Howard: That confuses my walnut brain. Explain this question: Should you be giving Angie's list and Yelp money?

Scott: Great question, and it definitely depends, which is a horrible answer to give, but if I explain it, I think that'll make more sense. If you want to know if Yelp or Angie's List is the right choice for you, Google the term "dentist" plus your area. If you see Yelp come up in one of the first three spots, you should probably advertise with Yelp. If you see Angie's List coming up in the first three spots, you should probably advertise with Angie's List. 

The reason for that is because Google's goal is to make sure that people have the best user experience and they know that people in your area are using Yelp if it's the top three results. They know "Okay, a lot of people in the Seattle area, they're really tech-heavy. They use Yelp a lot, we're going to put Yelp at a higher listing." 

But if you're in, say, Wisconsin, where people might not use Yelp as much, Google is going to have that on the second page which is a good indicator that a lot of people don't use Yelp in your area, so then it's not worth advertising with them. That's an easy indicator of saying "Okay, a lot of people in my area use this service, Yelp or Angie's List, or if they don't and that's the easiest way to tell if you should advertise with them. Does that make sense?

Howard: Did Angie's List come up on the first page? Yelp did. [crosstalk 00:35:26] I don't really play Phoenix because I don't know if it's different in Seattle, but everybody in my zip code, we all live in Phoenix here. But everybody in this area, if you ask them "Where do you live," they say "Watauga." 

Scott: Hmm. 

Howard: So I would just assume that since Phoenix is an hour's drive north south and an hour's drive east west, that if you were looking for a dentist around here, you would just search Ahwatukee. 

Scott: Definitely.

Howard: Definitely.

Scott: Yeah.

Howard: What do you call that when local communities within a city call themselves a different name? Is there a tag term for that? 

Scott: No, the term that people might use is "hyperlocal marketing," but...

Howard: Hyperlocal marketing. Okay. 

Scott: It's more expensive. 

Howard: For me, the search would be "Auwatukee dentist," and you're saying if Yelp shows up in the first ten or Angie's shows up in the first ten, you should give them money. 

Scott: Most likely. With any marketing effort, you need to be testing, you need to be tracking to see if that's actually worth your money. One of the nice things about Yelp, and keep in mind Yelp kind of has a bad reputation for a reason, they can be really difficult to work with from a small business advertising perspective.

Howard: Oh my god, if you go to DentalTown and you type in Yelp, there's 20 threads about people who are just so mad and frustrated. Why are there 20 threads on DentalTown talking about how mad they are with Yelp but you don't see 20 threads on DentalTown about Google AdWords or Facebook AdWords? Why is that?

Scott: It's for the exact reason you think that, I don't want to get in trouble with Yelp and have them knocking on my door, but they have slightly shady business practices. I think that the rumor in what you'll hear some people say is you'll have a representative come up, and like I said, this isn't my perspective, but what some people say. 

That you'll have a Yelp representative call you and say "Hey, I saw that you have some negative reviews, spend some advertising money, we'll go ahead and make sure your positive reviews show up better, that more people still come to your practice." There's a lot of that kind of under the table type thing going on that's not necessarily good business in a lot of people's eyes. 

Howard: Have there been any court cases on it? Anybody take it in front of the judge? 

Scott: Yes, there have been court cases.

Howard: What did Judge Walker say? Of course, you're too young, you probably don't know who Judge Walker is, do you?

Scott: I don't. I know Judge Judy.

Howard: Oh my god. Judge Judy. Well the first big judge show was Judge Walker, and it was so funny. It was a small claims court and it was so funny because you always knew who was going to win because he'd say "Well, Scott, do you have your receipt?" Scott would say "Uh, no, I don't have a receipt." And he'd just roll his eyes. Everyone learned from Judge Walker, keep your receipts. That was Judge Walker's legacy. So Yelp's been in front of the judge before? 

Scott: They've been in front of the judge before. They haven't lost a case, so innocent until proven guilty. In the Law's eyes, they haven't done anything wrong. At the same time, you will hear a lot of public sentiment that they're not necessarily the best company to work with.

Howard: I would sum that up then that they're just very aggressive.

Scott: Yes, I think that's a good way to put it. They're very aggressive and with some people, the return on investment just isn't there. For example, I would say I've had a lot of patients be unsatisfied with Yelp, complain to me personally about it. I have had a fair amount of patients, uh doctors, say "Yelp is actually great for my business, I've driven a lot of patients."

Howard: What would you say to this, everybody says Google Google Google and Google get all the attention. What percent of the searches in America are probably on Google. 

Scott: You can tell this in your Google Analytics and for dental it's about 70 to 80%.

Howard: Maybe if all the dentists are all playing Google and Google AdWords, should maybe you go and check out Bing or Yahoo for a targeted niche market play?

Scott: One of the great things about working with an SEO company and doing SEO is that if you're following the best practices to rank for Google, you're following most of the best practices to rank for Bing. Now, there's not a direct correlation, they have hundreds of engineers at each company that work on the algorithm to figure out which one is the best result. If you're ranked number 1 in Google, you're not going to be ranked number 1 in Bing automatically, but there's a correlation there. If you're ranked highly in Google, you're going to be ranked fairly well at least in Bing.

Howard: You're in Seattle, that's where Microsoft is, that's where Boeing is, that's where Amazon, very high tech and my favorite company in the entire world, Starbucks which accounts for about 40% of my obesity. Rumor has it that they're teaming up with Apple to go against Google in some ways, is that overly simplistic?

Scott: There's definitely some truth to that. Obviously, when anybody has that high of a market share, everybody's going to do everything that they can to bring them down a peg. Apple definitely tries to not push people towards Google for a lot of different reasons because they're competitors in a lot of different areas. Obviously, Microsoft is doing everything that they can, so I wouldn't be surprised if you see more partnerships between them in the future. 

Howard: Okay, let's talk about the 4,000 pound gorilla, Facebook. What are your thoughts, can I really get ten new patients a month off Facebook?

Scott: Usually not. You'll have these social media experts say that it's just going to crush it for you, that you put good content out there, show people what's going on in your practice and your personality, and your going to be fine. There's a little bit of truth to that. Facebook can drive some new patients for you but it's not trackable. 

It's all going to be from referrals, so what that's going to help with is if these moms or these people get together and they ask "Hey, I need a new dentist, who do you recommend?" Because another mom is highly engaged with you on Facebook, she might give you a stronger recommendation to her friend than if you weren't on Facebook, but it's not going to have a large net effect on how many new patients you're going to be getting. It's just more of a long-term referral-based play. 

Howard: You know how the pendulum always swings, like it's too far to the right then it swings too far to the left, the pendulum is swinging. Do you think marketing has gone too far digitally with the whole conversation being website, Google ads, Facebook, Twitter, LinkedIn, Pinterest, whatever, and people are not paying attention to the old school of a great location with street signage, a Yellow Page ad, direct mail, a billboard? 

You've been at the digital forefront at one of the biggest digital advertising companies, were you seeing some of these old school things still working where you were thinking sometimes on your client, "You're too Google Ad focused, maybe you should remember what they used to do back in the 50s and 60s and 70s?"

Scott: Oh definitely, it's all part of a marketing [inaudible 00:42:59] and it varies by location. For example, I've worked with some dentists that have a great return on investment with Valpak 00:43:07, for whatever reason in their area, it just crushes it, it's those little coupon advertisements that go out there. That's for some people all they need to do which blows my mind, but I'm not going to argue with them. With some people, direct mail is extremely important. If you have a good direct mail company, they can target the right audience when it comes to location, when it comes to-

Howard: Do you know the www on Valpak? Is it just Val, V-A-L-P-A-K?

Scott: Yes, that's how you spell it. I don't the website but that's how you spell it.

Howard: Okay, sorry to interrupt. 

Scott: Oh, no, that's fine. Direct marketing, when you can get really good targeting with that when it's household income, when it's gender, when it's marital status, you can really find your exact patients and advertise them very well. I think one of the ones that you get on is extremely important is location. There's only so much somebody from a marketing perspective can do for you if you have a horrible location or if you have a bad practice. You can only polish something so much, you can only put lipstick on a pig sometimes.

Howard: I think a lot of these kids don't understand. I think one of the critical mistakes they make is when you go into a mall, and I'm just pulling random numbers off the top of my head, and the rent's like $30 a square foot. Then you go next to a grocery store and it's $20 a square foot. 

Then they find some medical dental building tucked off onto a side street and they go "Man, what a bargain, it's only $10 a square foot," but they're comparing rent to rent to rent when it's really rent plus $10 more square foot of marketing, location, location, locations, and then the mall is like $10 a square foot plus twice, you know, so I look at my retail. I retail rented from 87 to 94 then they opened up a pad in the parking lot and they opened up for bid and I bid against a Burger King, a Wendy's, and a Dairy Queen... No, Dairy Queen, Long John Silver's, and then me. And I won the bid.

Scott: Nice.

Howard: The head of Long John Silver's literally was so mad, he even called in and said "You don't need this place, I need it. You don't need it." And I thought to myself, I forgot how old I was in 94, but I thought, "I'm going to be here 40 years, I want a visible location." 

I just see 30 years of so many people struggling in these locations that you can't see from a car windshield and I'm out there in a free-standing building on a four-lane intersection, on [48th and Ally 00:45:49], I think it's 30,000 cars a day, and you can see me right out your car windshield.

Scott: Very nice.

Howard: How would you compare that, what percent of that would be my marketing compared to my website and all the digital marketing? Do you think it'd be 50/50 or do you think it would be even more valuable? Or less valuable?

Scott: In your case, I think that you have an extremely amazing location, you really can't beat that, and it depends on how good the location is.

Howard: Then if anybody calls we just say, "Well, do you live in Ahwatukee?" And they go "Yeah" and I go "Well, you know at the corner of 48th Street and Ally where the Safeway is? We're that dental office right in the parking lot, Today's Dental." Almost every single time they go "Oh yeah. Yeah. I've driven past that a hundred times, yeah." You know what I mean?

Scott: Yeah and I feel you, I mean-

Howard: I just think that's like the American Express tagline, I mean that's just priceless, isn't it?

Scott: Definitely, definitely. If a dentist is looking to find that dream location that's crushing it, I believe there's two services that I'm familiar with that can help people with that.

Howard: A demographic service?

Scott: A demographic, household income, locations, I believe New Patients, Inc. helps with that and I believe Practice Café has a service for that and I believe it's the ADA Practice Management book has some information on that as well, so there's some resources to help people out in finding that perfect location whether they're looking to open a second office or start their first one.

Howard: You're saying New Patients, Practice Café, and what was the third one?

Scott: I believe the ADA has a book on practice management that has information about that as well.

Howard: Really? Huh. Is there any chance that if you find that, you could email me that? 

Scott: Yeah, definitely. I'll take a look at that. 

Howard: Do you work with anybody specifically at Practice Café or New Patients, Inc.?

Scott: I have absolutely no affiliation with them. In fact, the only reason I know that New Patients, Inc. offers that is that I heard them mention that in another podcast in an interview and for Practice Café, I saw an advertisement that they were pushing for that service.

Howard: Yeah, I did a podcast with New Patient, Inc. Mark Dilatush and Howie Horrocks. Howie's in Los Vegas and Mark Dilatush out on the East Coast, and I've known them forever. They're just great guys, great guys. Is there any chance if you find that ADA practice thing and I'll put it in the notes to the podcast?

Scott: Yeah, I'll take a look for that. Like I said, that's the one I'm not sure about, but I'll do some more research on that.

Howard: Okay. What else do you want to talk about? I've only got you for ten more minutes and sometimes I feel like when I'm interviewing young whipper-snappers on top of something like that, I'm not smart enough to even be asking the questions. Sometimes I feel like I should just zip my mouth shut and let you give an hour lecture. 

Scott: Yeah, I think there's two things we could touch on. I would say practice management software is a big one. A lot of people don't have these systems in place to really help them with internal marketing so we're talk about-

Howard: Now is that when you were talking about the Manforce? Was the Manforce the one that was bought by Quicken?

Scott: Yes. 

Howard: Is that what you're talking about, software?

Scott: Exactly, yeah. 

Howard: Okay, so what are the ones similar to the Manforce?

Scott: Sesame has a solution for that, for practice management software, and Solution Reach, and I would say that those are the top three: Demandforce, Sesame, and Solution Reach. You have some other competitors, I believe Televox has a solution, Lighthouse has a solution for that as well. So there's a lot of different people that offer practice management software.

Howard: Okay, so I've only got you for ten minutes. You're talking to a guy who couldn't tell you the difference in Lighthouse to Manforce, Sesame, or Solution Reach, any more than he could tell you the difference between Moe, Curly, or... Explain what that software market segment is and what it does for your... The bottom line is I want to grow my business. 

Scott: Ultimately, what it's going to do is increase the lifetime value of your patients and help with internal reactivation, so when we're talking about that from a high level, that's things like online bill pay, that way you don't have to have your front desk tied down to get a payment and you can have people pay outside of office hours. It's things like having phone recordings so you can make sure your front desk is doing well. 

A lot of times, the front desk can get a little complacent, they're not necessarily giving good service and that's really another first impression of your practice. You don't want your front desk person sounding lethargic, you want them to be upbeat and happy to hear from that patient so having phone recordings is a great tool to use to make sure that you're having that solid interaction. 

It also has automated appointment reminders, so making sure that your front desk once again doesn't have to do anything, an email or a text message or a phone call automatically gets set up to remind a patient to come in for their appointment so that reduces your no shows which is going to have a big effect on your bottom line. 

A lot of them have really good recare and reactivation tools, so you can make sure if somebody hasn't been in for two years for a cleaning, you can see the list of every patient that's been that way and it'll have their contact information. If you have their email address, it'll have their phone number, it'll have their address. You can call them, email them, or send them a postcard saying "Hey, we'd really love you to come back in, get you back on schedule." So that's going to make sure that you're increasing that lifetime value of your current patients.

It's also really good for one time, if you get any new hardware, if you get a new Cerec machine, you can tell them about it from an email blast so it allows you to send information to your patients very easily. If the end of the insurance year is coming up, you want to get people in so they can get their cleanings and any work done before everything rolls over. You can send emails out that way and just increase the value from a lot of different perspectives, a lot of different ways of your current patient base. 

You can also use it for things like internal referrals, so after somebody comes in for an appointment, you can have it automatically send them an email saying "Hey, thank you for coming in, it was great seeing you. Can you please leave us a review on Google+, on Yelp, on Health Grades?" That's an easy way to get those reviews higher which, if you put that on Google, will help you with your search engine results, it will help you with converting people at that last step as well.

A lot of different tools that can help you run your practice more efficiently, increase lifetime value, reduce no shows, really a tool that I think a lot of practices should have in place.

Howard: Now, if you signed up for Sesame's called In Solution?

Scott: Sesame is called Dental Sesame and Ortho Sesame.

Howard: Okay, it's called what? Sesame is called what?

Scott: Dental Sesame.

Howard: And what's the other one?

Scott: Ortho Sesame for orthodontists. 

Howard: To be totally honest with everything, I am a Sesame customer, I have been for five or six years [inaudible 00:53:13].

Scott: Good to hear.

Howard: What do they call it? Legal disclaimer or whatever disclaimer. You're more close to the patient and I think dentists are more close to standing around in a circle drinking the purple Kool-Aid. A lot of dentists thing that these [cat cams 00:53:34], that everybody's searching for same-day crowns. I just don't see that. Is that something that dentists want to believe? 

What do you think dentists or patients are searching for? Because I've heard that patients, for everyone searching for a same-day crown, there's like a hundred people searching for "Phoenix dentist who takes Blue Cross and Blue Shield" or "Phoenix dentist who takes Delta Dental" or "Phoenix dentist who takes United Concordia." That's like 100 to 1 over a dentist with a laser or a cad cam or something. Is that true or false? 

Scott: Oh definitely, definitely. But there's definitely a difference between what somebody searches for and what's important to them, so if you have that information on your homepage or on a "What makes us different" page, you know, "What sets us apart," that's going to be something that's going to sway your patients to choose you as opposed to somebody else. They're not going to search for that, I agree. Nobody searches for "Dentists with Cerec" or "Dentists with cad cam," nobody does that.

If you have that information and you can say "Hey, we can take care of this whole thing in one visit, there's no lab work, there's nothing else. We're going to take care of you." That's something that is a benefit, that's something that people care about, so it's how you phrase it.

Howard: We live in a big country, there's a third of a billion people here. There's a couple million in Seattle. Would you say that probably half of them, their biggest concern is price, so you've got to let them know that you do take insurance or Delta or Blue Cross Blue Shield or Connecticut General or something like that?

Scott: Definitely, I would agree that half are price, half are saying "Okay, which dentist takes my insurance and I'll just pick probably whatever one's the closest or whatever one is most convenient." But you do have the other half that are going to research their dentist, make sure that they're getting the best option, they think "I'm not sending my child to a dentist just on price, that's ridiculous. I'm not taking my smile to the cheapest person, I'm taking it to somebody that's going to give me a beautiful smile."

Howard: But half the country, right? If I'm a divorced woman with two kids and my husband doesn't pay child support, I'm looking for the guy who takes my insurance, you know what I mean?

Scott: Definitely.

Howard: True or false that the hours you post on your website, once your office is closed and the guy across the street is open for another hour and someone searching "Ahwatukee dentists" and it's 5:15 and I'm closed and the guy across the street is open at 6, that Google will point him to the open hours? 

And that your hours for when you're drilling, filling, and billing teeth, where the dentist is working could be expanded up front, kind of open the funnel and say "Okay, I'm going to have my front desk start answering the phones an hour before I get here and an hour after I leave and maybe open Friday and Saturday." So that when people are searching "Ahwatukee dentist," my hours are open so Google's pointing them to my website. True or false, is that a good strategy or am I off-base there?

Scott: Well, yeah, it's definitely true what you are saying where if on a Saturday if one practice is open, it's going to say "Open now" and then for the other practice, it will say "Closed right now."

Howard: But would Google serve up the "open now" office ahead of the closed because I can't see the logic of Google pointing me to a business that's closed if there's one very similar that's open?

Scott: Yeah, that's a good question and I don't want to say that I know the answer to that when I don't know 100%. I would say that it has a small ranking difference, or it's a factor, but if somebody is far and away a better dentist in Google's eyes, it's not going to put them lower just because somebody else is open. Once again, you were saying, if somebody sees an "open now" and the other dentist is closed now, that might be enough to sway their decision. 

Now, from a dentist's perspective and a lifestyle choice, do you want to be open on Saturdays? That's definitely up to the dentist. I don't think just because on SEO it might make a difference, it's right for you.

Howard: What I would say, you know how we were talking about has the pendulum swung too far, everybody's talking about Google ads and they're going to build their practice on Facebook. I will go to the grave after 20 years at this office saying that the number 1 thing I've done for 20 years to increase my new patients is answering those dang phones. 

I go into a dental office and I say "How many incoming calls did you have last month?" No idea. "How many of them came in when you were closed?" No idea. "How many of them were answered by a live human?" No idea. If I just worked that data, because all this marketing might double my phone call traffic but they don't even know how many phone calls they get. All my friends, I was running a, well, I don't want to throw anybody under the bus, but they'll sit there and they'll be closed Friday, Saturday, and Sunday. 

Every dentist I talk to, no one's answering the phone, they're not tracking the incoming calls, they don't know if they're new patients, old patients, and all they have is an answering machine. What would you say to that dentist?

Scott: I think it really depends on how hungry you are. I agree that that's something that you should be doing, but that's obviously a talk you need to have with your front desk and say "Hey, once a month or every Saturday, we're going to work on Saturdays. We're going to answer the phone because that's what our patients want and we're a patient-centered practice." We don't spill out that [dog 00:58:56] when we say that we're patient-centered, we are actually patient-centered and it's about them having a good experience.

I think it is really effective and you were just saying that there's a lot of truth to that, you've seen it first-hand and that makes a big difference.

Howard: In the Seattle area, how much would it cost to just find an extra lovely lady who doesn't work in your office Monday through Friday, to just come in there and answer the phones on Saturday and to be able to pull up the computer and answer your question or whatever? What do you think you'd have to pay that person?

Scott: That's a good question. We're talking about the minimum wage going to 15, but it would be worth it.

Howard: So 15, and if she's answering the phone from 8 to 1 or 8 to 2, I mean, the chance that she schedules someone like you calling in and asking this, the chance that she schedules an appointment for you Monday, Tuesday of the next week is guaranteed.

Scott: Oh, definitely.

Howard: I just don't know how you'd ever lose money on that deal. 

Scott: Yeah, that's a great point. Let's talk about the lifetime value or the year one value of a new patient. For some practices, it might be $700, for some it's up to $1,500, so if you're getting one new patient a month from having somebody on the phone on Saturday, that pays for itself easily.

Howard: What is the range of the first year value of a patient or a lifetime value of a patient? 

Scott: The first year value, I hear anywhere from $700 to $1,500.

Howard: $700 to $15? And then when you measure lifetime, what is the lifetime with that, 5 years, 10 years, 7 years or?

Scott: You know, I personally keep track of one year value because that's the metric that we report on to say "Hey, this SEO is worth your money" or "This marketing is worth your money," that's what I've always done so I don't know the answer for lifetime value of a dentist, or of a patient. That would be a good thing to look into.

Howard: Well Scott, that is just so honorable of you as a human that I called you, I wanted you to do this because I know you are so damn sharp and now you're no longer with Sesame and you still gave me an hour of your life today. You're smart, you're adorable, what a good guy to do that. Thank you so much.

Scott: Thank you.

Howard: The hour's over. Thank you so much for giving me an hour of your life when you can't even make a dime off of it. 

Scott: Well, thank you. It was my pleasure. I definitely had a good time, it was good talking with you. 

Howard: All right, buddy. Thanks a lot. Talk to you later.

Scott: Okay, thank you.

Howard: Bye bye.

Scott: Bye.

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