Tyson Downs, the owner of Titan Web Agency, has years of experience working with dentists helping them meet their revenues goals. Prior to starting Titan Web Agency, he freelanced in SEO and Web Design while working in the corporate world. Tyson is a graduate of Brigham Young University, the father of 5, and a passionate bodybuilder.
Tyson created a digital marketing agency that truly 'gets it'. They understand what it is like to own and run a small business. They understand the challenges that you go through each day, because frankly, they face many of the same challenges. They treat you like a person, like a friend, not just another 'account'. They speak to you in terms that you can understand. They ‘get’ that you aren’t an SEO expert. All you want is to get more leads coming in. They aren't a low priced, budget, churn and burn agency. They like to say: “You can have quality. You can have low price. But you can't have both.”
If you’re in need of more patients, and are considering a marketing company, consider Titan Web Agency.
VIDEO - DUwHF #1053 - Tyson Downs
AUDIO - DUwHF #1053 - Tyson Downs
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Howard: It is just a huge honor for me today to be podcast interviewing Tyson Downs with Titan Web Agency. Titan Web Agency has years of experience working with dentists, helping them meet their revenue goals. Prior to starting Titan Web Agency, he freelanced in at SEO and web design while working in the corporate world. Tyson is a graduate of Brigham Young University, the father of five and a passionate bodybuilder, so you should switch from iTunes right now and go follow us and subscribe on YouTube. He's naked right now on the show - if you're listening to us on iTunes. Tyson created a digital marketing agency that truly gets it. They understand what it's like to own and run a small business. They understand the challenges that you go through each day because frankly they face many of the same challenges. They treat you like a person, like a friend, not just another account. They speak to you in terms that you can understand. They get that you aren't an SEO expert. All you want is to get more leads coming in. They aren’t a low-price, budget, churn-and-burn agency. They like to say, "You can have quality, you can have low price, but you can't have both." If you're in need of more patients and are considering a marketing company, consider Titan Web Agency. And what I want to say before we let the man talk is that overhead, I mean, the simplest way to look at overhead is if your cost for a year are a dollar, and you do a dollar's worth of dentistry, your overhead is 100%. So, what do you do? You try to save money on supplies and you try to not give raises or bonuses and you just try to cut down that cost; but if you raise your sales to $2, now your overhead is 50%. And watching overhead, when I got out of school thirty years ago, the average dentist had 50% overhead, now they have over 65% overhead - that's two thirds - and the bottom line is you're signing up for all these PPOs which are lower prices, every time the earth goes around the sun all the staff want a raise, so your overhead is ticking up and usually the way to solve overhead is patient flow equals cash flow. You get in more new patients, you market, you advertise, you get in more new patients. You do more same-day dentistry. When you tell someone they have a cavity, always ask them if they want to do it now. You have extra rooms. You work through lunch, you stay late. But Tyson, I know my homies, they don't go bankrupt, dentists only have a .4% bankruptcy rate. Hell, restaurants have a 20% bankruptcy rate the first year. The only way a dentist goes bankrupt is he gets his license taken away, and that's about 85% of the time for alcohol, 15% for opioids. So, they're not going to go bankrupt. So they paid their rent, mortgage, equipment, build-out, computer, interns, malpractice, professional dues. They've paid all their bills so, that one more new patient that month is pretty much nothing but net income gravy and all they want is ten or fifteen more new patients a month. What do you do when a dentist calls you up and says, "Tyson, I need fifteen more bodies walking in this door each month."?
Tyson: What we like to do is we like to have a strategy session with them. We like to find out the why, of course. Why do you need this? Where are you at now and where do you want to be? So once we understand that a little bit more, we can understand the strategy to approach that. If they're having a hard time paying their bills and bringing any money home, then we know this is pretty urgent. We need to start getting some new patients in right away, whether that's through some Google ads or some focusing on emergency dentistry or whatever it may be. But the why, I think, is a big thing that a lot of people don't go into so if we understand the why, we can help the dentist get there a little bit quicker.
Howard: Well, what are some of the why's that you're seeing in the field?
Tyson: So I'll see from... "I'm working two jobs right now. I work at a corporate practice. I'm trying to stay here at my own practice three days a week", and obviously, the why there is he wants to be his own boss. He doesn't want to have a corporate boss anymore. And so, cases like that, I work with him and say, "What are you doing as far as networking in your community?" That's a big thing, when somebody goes to a dentist, that they've seen you around the community, seen you promoting different events, maybe a local Little League or something like that, and that's going to go a long ways. Another why is, "Tyson, I've been doing well over the past few years, but I see a dentist down the road that seems to be doing a lot better." So sometimes it’s a matter of ego. They want to be the best and the most well-known in the town so it depends on who it is and what their goals are.
Howard: Yeah, dentists are competitive because for four years, I mean, all through college, you take a chemistry test in undergrad and then they post the forty answers, ABCD, on the back and they're competitive because in undergrad, only the top 10% got to go on to med school, dental school, law school, and then they get into dental school and only the top ten or 15% get to go on to grad school or whatever. So, they're extremely competitive. But tell that guy working three days in one place and two days in another to grow a pair of stones and you die. You can't pretend to learn how to swim by crawling along the side of the swimming pool with one hand and one leg in the water. You just dive in headfirst and remember, nobody goes bankrupt unless you have a substance abuse problem, and if you do have a substance abuse problem, just go get that fixed. Go work on that. Go be an associate somewhere and go to treatment, get fixed, and then dive in headfirst. One of the things I really love reading on your site, you say - by the way, his site is titanwebagency.com. By the way, where did you get the name Titan? Is that related to Tyson?
Tyson: No, it isn't, and actually, if I would have thought about it more and seen how closely those two are, I probably would have went with something else, but I liked the name Titan just because it feels strong and mighty, but hindsight is 20/20. It is what it is now and so I'll stick with it.
Howard: Why didn't you go Tyson Web Agency?
Tyson: Well, it was just me for a long time, but I built a team of probably about ten that work with me on a consistent basis and I didn't want to be seen as the only person in the company that can do anything. So, I have an account manager that manages the accounts with me and I don't want somebody, when they come to me, thinking, "Oh, I thought you were going to do everything for me, Tyson." Well, that's not realistic when I have a number of different clients.
Howard: Well, great minds think a lot, because that is why I did not call my dental office, Howard Farran DDS. I said, "If I'm going to go out and build this big brand, Howard Farran, everyone's going to call my dental office and want me", and I felt like graduating dental school was like being given a lawnmower. I didn't want to push a lawn mower for sixty-five years, so I went with Today's Dental because the number one thing was they can't get into the dentist. Right now, for the United States, it's a five day wait to get into a dentist if you're an existing patient or new patient and 8½% of emergency room visits are odontogenic in origin because they can't get into their dentist. So, I went with Today's Dental because I wanted to build that big brand, so they call that phone and then, if I'm in, they could give them to me. But you said 71% of people click on page one search results. 88% of consumers trust online reviews as much as a recommendation of a friend. 93% of online experiences begin with a search engine. 77% of patients search online before booking an appointment. But this is what I think, the other thing that you said - let me see if I can find it so I don't butcher your words - basically, I'll just butcher it since I can't find it on your website - I see all these people doing all these Facebook posting and they're just Facebook, Facebook, Facebook, that's interesting, but that's not when they're looking for a dentist. I mean, it'd be like, I don't know, let's say I need a bypass one day, so I could be glossing over all these heart doctors or whatever doctors, whatever, but that isn't today. So, it's very different when you just broke your tooth, or you've got a toothache this morning, or you're brushing your teeth and found a hole in it and you want a dentist. That's a very different human behavior than just surfing your Facebook pages and seeing all these ads fly by. Correct or...? Same with television ads.
Tyson: Exactly. I think that Facebook can work for certain demographics and certain dentists that have very specific goals. However, I always tell my clients the best marketing strategy is a diverse one. So, if they want to test Facebook, fantastic, let's test it, let's throw a couple thousand Dollars over three or four months and see what happens. But let's not just put all of our eggs in the Facebook basket, or even the Google AdWords basket, even though Google AdWords can be extremely effective. I work with a few different drug rehab centers and what happened? Google started restricting the keywords by about 90%, and so these rehab centers that been spending $20, $30,000 a month on AdWords, all of a sudden, they were bidding on everything and could only spend $5,000 or $6,000 a month on AdWords max because everything was filtered. That's part of the reason why we want to have a diverse marketing strategy and see what works. Once we find out what works, that's where we put most of our focus and time and attention, and then fine-tuning even more.
Howard: Just, you homies out there, every time I see a report come out on dentists and substance abuse, they pretty much mirror the population. About 14% of Americans have substance abuse issues and that's about the populations of dentists. They've never been really higher or lower. Same with divorce rates. They are always the median, the main. But I'm really proud because I'm Irish, 100%, and in Ireland 38% are alcoholics.
Howard: The only people that beat us is Russia. Those damn Russians are 40%. My goal is that someday the Irish get to 41%. I don't know if I should do that with Google AdWords. So, how tied... the dentists... talk about the difference between putting money into your website for organic search and reach and all that, versus just paying for it. One you earn it - I always say that's like making love to your girlfriend - whereas one you pay for it. What's more effective, pay to play or earning it at home with a great website?
Tyson: I'm going to give a very on the fence answer. Both of them work and I think that both of them should be used. Reason being is, you want to build something up that's going to last for a long time. You want to build up a good strong web presence and that's through a website that provides a great user experience, that gives the visitor what they want, that the search engines can read and understand, you want to become... I tell my clients 'popular online', meaning you have people that are referencing your site and linking over to your site, is going to help in the search results. But that can take, in competitive markets, that can take months or maybe even years if your competitors are doing a good job, to get where you want to be. So, in that case, that's where you really need to be using other avenues, whether it's Google ads, or postcards can be extremely effective, getting into Facebook, seeing what you can do there, but you shouldn't rely just on one avenue. It's always, always a good idea to start sooner as opposed later with your organic presence.
Howard: You were in Utah, and I've seen several reports that Utah is the most crowded of the fifty States and it has the lowest dentist to population ratio of all fifty States. You work with clients all over the United States, correct?
Tyson: That's right.
Howard: Do you... because these young kids, I've got two dental schools down the street from me, Midwestern in Glendale and A.T. Still in Mesa, and all of my Mormon buddies are like, "Well, you know, I want to go home because that's where Mom and Dad are" and all that stuff. Do demographics matter? I mean, when you're working with clients around the United States, are people in rural areas less likely to be a client because they don't need your services? Do you have more clients in Utah because there's a dentist on every corner? Do demographics matter or could you go in the most crowded place and just out-market, advertise, SEO and search everyone?
Tyson: I have, let's just say, clients all over. I have some clients in Utah, clients in a number of other States; clients in small markets, clients in very large markets, and what the difference is - the basics are the same, we need to make sure your website is up to par, that it can be read, that you get your good local SEO on that - but the main difference is how much you need to spend. If I have a dentist in Houston and he is brand new and he wants to rank number one, great. That's a good goal. However, Houston's a large area. Other guys have been marketing for ten years. So, let's be realistic. What do we need to do? How about we start going after the close neighborhoods to you? One, that's going to bring in more localized and more targeted visitors to your office, but two, we'll be able to get quicker results as well. So, in bigger markets, yeah, you're going to probably have to spend more because everybody else is spending more, unless you have some type of a magic formula, which people promise, but they never actually have. It's realistic that you're going to have to pay more because everybody else has that strong presence and has done it for a while. In some smaller markets, there's not much competition and a lot of dentists haven't done anything besides put up a website, and in cases like that, I've had dentists come to me and just need to have a new website and have it optimized, have the 'Google my Business' set up properly and get a few citations set up, and that's all they need and they're still number one in a three-pack. So, it varies heavily. But those competitive markets, it's going to take some money to make some money.
Howard: Yeah, and by the way kids, a lot of time, when you get out and you're starting your practice and these people will brag that, "Oh, I'll get you on the first page on Google. I'll get you the first blah, blah, blah." Well, if I Google 'Howard Farran DDS', I'm going to be the only result. So, it's really hard to ask what page one is because you don't know what they're going to be searching.
Tyson: Yeah, and that's what I see as a problem in our industry is people will say whatever it takes to get the business. When I talk with a client, I'm basically interviewing them as well to see, are we a good fit? Do I think that they're going to be on me checking all the time, "My rankings aren't here, my rankings aren't here. What's going on?" And if that's the case, I'm not going to do business with them. They need to understand the big picture. I try to set that expectation right from the get-go. It's going to take a while for the work that we do to be seen and recognized by the search engines and for us to make some progress, but I set a good timeframe for what I expect to happen and show them how we're going to track the leads that are coming in so that they can tie that investment that they're making back into their return.
Howard: Everybody's saying that search is rapidly changing right before our eyes, going from texting to voice, and back to my reading Peter Lynch beating the Wall Street. All my economic training is Peter Lynch. I can just hear his voice saying, "When you look at these national stocks and you live in Omaha, well, how's that restaurant doing in Omaha?" I remember analyzing Boston Market twenty years ago. And I did what Peter Lynch said. I kept going there and eating and seeing all the happy customers and all this stuff like that, and I've noticed within my circle of friends that people are now, when they pull up that Google on the smartphone, they're not getting their big meaty thumbs out, they're hitting that little voice icon and they're talking into it. Do you think that's going to change? Do you think that's going to have a material impact on search?
Tyson: I think it will. It's really hard to say how it's going to affect local search. I know that it's affecting search on Amazon and Alexa drastically. If you tell Alexa, "Hey, order me some X, Y, Z", she's just going to order what's the first result? So, I would anticipate that it would start to go in the same type of direction with Google. You tell Google, "Where's the closest dentist?" or "Who's the best dentist in my area?" then something similar is going to be happening, and then that's where it's ever so important that you show up well in the search results.
Howard: Yeah, gosh, I almost died because when I called the ambulance I said, "Siri, call me 911!" She says, "Hello, 911." She just changed my name. When I got out of school, the big ones were going in a retail instead of a medical-dental building, big pages in the phone book and direct mail, and now the phone book, I declare dead. I mean, I don't know anybody, I've never seen anybody use it. Now everyone's in retail on every corner. The phone book is dead. Is direct mail dead too?
Tyson: I don't think so. It's not a service that I offer, but it's a service that I'm a big believer in. I've done a lot of research and worked with a lot of dentists that use direct mail and, if done right, it can be extremely effective. In my opinion, the best way to do it is to do oversized postcards, and if you're on a budget, you can do every door direct mail - they call it EDDM and that is through the US postal service. That ends up being much cheaper.
Tyson: That's right.
Howard: What does that stand for?
Tyson: Every door direct mail. So, you'll select a zip code and then it will go to every door within that zip code, but the best way to do it is if you can buy a list. The most important thing when you're sending out direct mail or sending an offer is having a good list. If you don't have a good list, it doesn't matter how great your offer is or how pretty your postcard is, but if you can get a good list of new move-ins in your area, new home buyers, whatever it may be, and send a direct mail to them, then you're going to be getting some results. And it's not just one, you never send just one. You're going to send one after another month, and then after maybe three months, then another one six months, and make sure that you're tracking that. That's where so many fall short, is they're not tracking the calls that come in and that's as easy as ordering a call tracking number and then you don't have to ask people, "Hey, how did you find out about us?" You don't have to have a very unique offer on that. You can just have your regular offer and if they call that number, then it shows up in a report and you see how many calls and appointments that generated.
Howard: One of the reasons television is dying is not only are the people under fifty just not watching it, but when you sit there and you're trying to watch a news program and every ten minutes they give you four minutes of commercials, and none of them are targeted. I mean, I don't want a little chair device that's going to carry me up to the second floor. I don't have restless leg syndrome. I don't want a class action lawsuit. It seems like media has gone from, back when I was a kid, where just ABC, NBC, CBS, they just blanketed these big consumer package goods products that maybe everybody would want to eat oatmeal or Captain Crunch or whatever, but as it gets digital, people have really got to think about targeting. So, my first question is, if I was a dentist and I want to do a lot of implants on Grandma and Grandpa, I would think that it would be more likely they'd go to their mailbox and get a direct mail than find me on Facebook or Google. Is that true or false?
Tyson: I agree with you 100% there. Now, that isn't to say that we don't use Google because you want to find people searching, but, yeah, Grandma and Grandpa are going to be looking at the mail a lot more and on the computer less. And then if you do some ads on the Internet, what about using Bing at that point, because what's the default browser on most computers that Grandma and Grandpa use? It's Internet Explorer. And what's the default search engine? It's going to be Bing. So, at that point, it's a little bit more targeted and if you can get more targeted, you're going to get the better results we talked about.
Howard: Man, that is profound. I've never heard anybody say that, and that is so obvious. If you're going after Grandma and Grandpa, you're right, they would be on Bing, they would be on Internet Explorer. That is true. So, what about if you were, say, an orthodontist or a pedodontist, and you wanted the kids, but the kids aren't going to make the appointment? I keep reading things from people like Regina Herzlinger who's a DBA, a Doctorate Business Administration from Harvard University, in healthcare economics. She's been saying for thirty years that Mom makes nine out of ten appointments. True or false? Do you believe that?
Tyson: That's how it is in our house. I agree 100%. I'm busy working. Mom is extremely busy too, but she picks up the slack there and sets those appointments and takes the kids to the appointment. So, yeah, I agree 100%. And so, in cases like that, you're going to want to get in front of the moms.
Howard: How are moms different on social media? I just read the other day from Professor Scott Galloway at NYU School of Business, saying that YouTube was 80% males. Do you think moms... if this is a female industry, which it is - thirty years I can vouch to you, if a guy like you walks out, I'd say, "Hey Tyson, you've got five kids. I'm doing their insurance. Real quick, give me the birthdays of all five of those kids." It's like deer in a headlight. They don't know any of that information. Mom always brings in the insurance. She always knows the birth date. She knows all that stuff. How would finding Mom on social media be different than finding Dad?
Tyson: Obviously Facebook would be one that you'd want to look at at that point, and with Facebook advertising you can get extremely detailed in what you're going after, but I wouldn't just leave it to social at that point. When you're doing perhaps Google AdWords, you would maybe want to speak a little bit more mom-language. In the app, maybe talk a little bit about how easy it is to set up the appointment, so they can save time during their day or get time back during the day, whatever it may be. So, you want to speak their language. And look at local networking events where it's more women. Where do women go for local networking events and can that orthodontist office perhaps have some type of an open house or a tour for a preschool? I know that may not be the biggest thing that's going to drive business, but it's these little incremental things. I read this book called 'The Slight Edge'. I can't remember the author now, but 'The Slight Edge' talks about how you're doing these little things every single day. You're not seeing much happen at first, but over time you look back and you can see a profound change. And so, if you're making an effort to do networking events on a regular basis, to test out different marketing efforts, then you're going to notice a big difference over time.
Howard: So, if they go to your website, titanwebagency.com, there's a place there where you can download 'Get a complete overview of your local SEO performance in minutes, search rankings, local listings, reviews, onsite SEO, social media. Simply enter your business name and we'll do the rest'. Talk about that report.
Tyson: That's the report, we use very special software that goes and looks up your business and it puts in... you put your information, then we pull back what you're ranking for, the different keywords you rank for, and we scour the web and look at references over to your site. Are you listed on Yelp? If so, is that information correct? What's your Google My Business information? Is that correct? And we'll actually know where you're ranking and how you compare versus some of the competition. The main thing is, you may think that you're doing well, but go run this report and we'll show you some areas of opportunity where you can improve.
Howard: And that usually does?
Tyson: Oh, absolutely. I would say that anybody that's run that report has come away with something that they can do better. For example, we'll give an on-page SEO analysis. For those that aren't technical, that means we'll look at your website basically how the search engines look at it, and then show you where there's things that could be fixed. It could be as simple as your website right now the title tag maybe says 'Home' - I see that on a regular basis - and we typically don't want that. We want it to say something like, 'Dr. Baxter, Salt Lake City dentist'. We want it to be more descriptive so that search engines can read that. And so, that report will give you an idea of what's missing and what needs to be fixed.
Howard: What else are they going to find on your website, titanwebagency.com?
Tyson: We have a number of different reports that are available that can help them improve their performance for their Google AdWords, help them improve their SEO. We have some patient care forms and I actually have a, if you don't mind, I'll give a website they can go to where we're going to give them a very comprehensive website audit - that's getmyaudit.net. They go to getmyaudit.net, that's my site, and fill in their information and we'll provide a report ...
Howard: getmyaudit - A-U-D-I-T.
Tyson: That's right.
Tyson: Dot net.
Howard: Oh, dot net, okay.
Tyson: They'll put in their information and we'll send them over, within a couple of business days, a very comprehensive analysis of their web presence and their rankings for their important keywords.
Howard: Okay, let me see if I got it to work. Yup, there it is. Free website analysis, report analysis. Titan Web Agency. Achieve greatness. Free website and online presence analysis. How's your website performing? Are you paying for little to no results? Do you know where your website is missing the mark? How would you like to get a free SEO report analysis that contains all the information? I want to switch gears completely to reviews. Bottom line is, all honesty, I'm fifty-five. All my buddies that I go hang out with and watch the Cardinals and now the Diamondbacks, who haven't won a game this month, and the Cardinals football quarterback coach, our quarterback is ranked thirty out of what? Is it thirty-two NFL teams, or thirty-six?
Tyson: I was thinking it was twenty-eight.
Howard: How many NFL teams are there? Yeah, well, Phoenix, Arizona Cardinals has the prestigious ranking of number thirty, which means that I might be able to get a job as... there's thirty-two teams and we're thirty, so it's going to be a depressing deal. But I've never seen anybody use Yelp or get a review. When I go lecture, a bunch of dentists will say, "Hey, you want to go here? You want to go there?" There's four or five of us in a car. I've never in my life one time seen a fifty, sixty, seventy-year old dentists say, "Well, let's read a Yelp review before." I've just never seen it. Is that because I'm a grandpa and have four grandchildren and this is a millennial thing, or is it a San Francisco thing that doesn't happen in Kansas? Back to that Peter Lynch thing, he keeps saying, "Howard, look at this business in your backyard. Don't look at a Wall Street analyst. The richest stock investor in the world is Warren Buffet, and he lived in Omaha purposely because he didn't want to listen to all the bullsh*t in Manhattan.” So, sell me Tyson. Never seen it, never seen it.
Tyson: So this is what I tell people that are wanting to work with me or that I work with, is your ideal customer, your ideal patient isn't you. So, don't make your decision on what needs to happen because of a conception, pre-conceived notion that you have. You don't use Yelp, okay, but does that mean people don't use Yelp? No, it doesn't. There could be an ideal patient that wants a $50,000 smile makeover and they use Yelp. So, are you going to get on Yelp or not? So, yeah, there's things that we need to do even if we don't personally use them and we need to be able to swallow our pride and say, "This can be a potential avenue for success for me and I at least need to look into it." I have a psychologist that I work with. She was like, "No Yelp. I have beliefs and they don't fit in that belief system." Okay, no Yelp, that's fine, but people will go and search for a psychologist on Yelp. They do, and if you're not listed on Yelp, or if Yelp creates a listing for you and there's nothing on there, then you're going to be negatively impacted. So, don't have these beliefs that because you don't use something, somebody else won't. And that goes along the lines of when I work with these clients on building their websites, they sometimes think, "Well, my website needs to do this and this and this or look specifically like this because that's what I like." Absolutely not! Your website is not for you. Your website is a storefront. Your website is a 24/7 salesperson for you. So, let somebody that's objective, such as ourselves, make these recommendations on what needs to happen on your website, and then we can make some tweaks so that you're happy with it as well.
Howard: So, we put this podcast on Dentaltown, but I also own Orthotown, the magazine is mailed each month to ten thousand eight hundred. I've always noticed the orthodontists are twice as intense marketers than the general dentists. Do you think it's because the average Invisalign ortho case is sixty five hundred, whereas the dentist, he's going to get a new patient, it's going to be a cleaning, exam and x-ray and a couple of fillings? Have you noticed that with orthodontists? Because you say you serve the industries of dentistry, plastic surgery, physicians, healthcare professionals, orthodontists, drug rehab, psychologists, physician groups, accountants and lawyers. So tell me the difference between your dentist clients and your orthodontist clients.
Tyson: I think the main difference is, you hit the nail on the head, these typical cases that are coming in for an orthodontist are higher in value typically. Not always, but generally they are. And so, they're willing to usually spend a lot more money because "Hey, I can spend four thousand a month if I'm going to be able to get a three time return or a two time return" or whatever it may be. So, just because that higher lifetime value seems... and a lot of the orthodontist that I've talked to generally, seem to be a little bit happier, really enjoy the work that they do, and maybe it's because there's such immediate differences visually and they can see their work a lot more.
Howard: So, you've noticed your orthodontist clients are more happy in general than the general family dentist?
Tyson: A very small sampling and purely anecdotal, but that is what I've seen.
Howard: Yeah. Do you think it has something to do with the fact that they don't give shots, there's no drilling, there's no surgery, there's no blood, there's no gauze, there's no surgery, there's no infection, there's no antibiotics, there's no pain meds, it's just glue and rubber bands? Do you think that might be a huge part of it?
Tyson: I think so. I agree, yup.
Howard: When's the last time an orthodontist got an infection, a dry socket, a swollen face? So, they're generally happy. Well, what percent of revenue do you think the average orthodontist does spend and what do you think average general dentist does spend, as far as collections, percent of revenue spent on marketing and advertising?
Tyson: I don't get into it them at that level, and I don't because that part of it isn't my business. If they're brand new coming in and they haven't advertised much before, a lot of times they're like, "Tyson, I don't really know where to start. What can you recommend?" And I'm only going to recommend something that I know is going to help and going to work for them, and so I'll try to find out, best case scenario, if you could get X amount of patients per month, how much would that be worth to your practice? And once they give me an idea on that, then I'll let them know, "Hey, yeah, I think that we can work together." But as far as the percent of that, I've heard eight to ten, ten to fifteen, but I don't get into that with my clients. I let them keep that part private.
Howard: Do you get into about the cost per head to a get a new patient from what your services does, about what it costs per person per head, per capita?
Tyson: Some of them I do. Actually, there's a couple of them that do. They're like, "Tyson, we need our leads to be at about $X per lead that we have coming in."
Howard: And what dollar are they saying?
Tyson: For leads coming in, they're saying between seventeen and twenty. A new ad meant to be eighty to a hundred, which they're a very high-volume practice.
Howard: What was $17 a head, and what was $80 to $100 a head?
Tyson: Leads. So, about $17 to $20, and then...
Howard: $17 to $20 for a lead?
Howard: And $80 to a $100...
Tyson: Yeah, because a lot of them aren't going to be qualified...
Howard: And what?
Tyson: A lot of them won't be qualified, so that's why our cost per lead is less or they won't close all the leads that come in.
Howard: And how much for a closed lead that comes in? What would that number be?
Tyson: That particular one that does a lot of high volume, they're looking at $80 to a $100, which I think is pretty low. They've told me that their lifetime value is $5,000 per, first year value is about $1,250. So, if they're willing to pay $80 to a $100, I think that's pretty low. I think most probably pay a little bit more if they're going to be getting in new patients.
Howard: What do you think the average dental office is spending to get a confirmed new patient?
Tyson: Good question. I'd probably say in that $100 range.
Howard: $100 range. The point I'm making, so, you said something very profound. The average orthodontist, their average new case is $6,500 for braces, Invisalign, whatever, but he realizes that income in twenty-four months, two years treatment and a lot of them have got the treatment down to eighteen months. The dentists' value of a patient nationally is the same as that number, but they don't realize that they realize that over sixty months. So, the dentist is going to get $6,500 out of this patient but it's going to take five years. The orthodontist is going to do it in eighteen to twenty-four months. And then when you look at that $100 a head, the most amazing marketing ever done, and what was used for every dental office I know that's in the $3 to $4 million a year collection, was mergers and acquisitions. So, he's seeing $100 a head. So, that guy across the street is retiring from you and you say, "Well, how many of your patients, how many active patients do you have?" And he says, "Well, I've got two thousand." When you've got two thousand, what's two thousand times a hundred, and then you say, "Well, I'll give you a check for that and then you go away, and I move those charts in the office," because that city used to have five dentists and now it has four. And then five years later, another old guy, and now you're down to three. Look at the reverse of that. Tyson's got five kids. I had four kids. Imagine that old man and you don't buy it and roll those patients into yours and reduce that town from five dentists to four, and now some young, hungry, twenty-five-year-old Mormon dentist from A.T. Still, who wants to go out and have five kids, who's going to work his butt off seven to seven, five and a half, six days a week, do the parade, do the market. I mean, you're trading out Grandpa for someone who's carrying around about 1,800 milligrams of testosterone per decaliter and is fifty years your youth, and it's just the most brilliant strategy in the world, is to buy out the old bulls that are turned out to pasture and roll them in. So, a lot of times when you look at those patients, listen to this guy. So, if you didn't buy that practice, now you're going to have to take that practice money and give it to Tyson to get the patients. So, these are confirmed patients that have been in the office. The only thing that comes down to is what is your definition of an active patient? But I want to go back to reviews again, I do - because everybody keeps talking about it. What do they call it? - social confirmation. And we're only dealing with moms who make 90% of the appointments. Regina Herzlinger thinks it's upwards of 93%. Do you think moms need social confirmation for purchase more than dads?
Tyson: That's a tough question, if I think about it. I'm going to look online more myself, and I can only judge it based on me. I do look on one online more myself and talk to friends less; my wife, she'll look online and look at reviews, but she'll talk to friends too. She's just more social than I am. So, I think that women are going to get the recommendation of a friend probably a little bit more than men would. A man would just look, "Oh, five stars. Okay, let's book something", if they have to or, "Oh, Wife, I've found a good dentist, he has five stars. Here, why don't you book an appointment?" So, I think men probably rely on the Internet just little bit more for that proof, and women probably speak to their friends a little bit, but that's a guess and I could be completely off.
Howard: No, that's what everybody's saying. The anthropologists are saying that when they study apes and monkeys, humans, gorillas, chimpanzees, orangutans, bonobos, gibbons and all the monkeys, every time a boy monkey talks to another monkey, the woman will talk to five. It's a five to one ratio. The University of Chicago does studies on how many words we say a day. Every year they've done it, for twenty, thirty years, women are always north of 7,000 words a day and men are under 1,500, which is why they like YouTube because they don't want to say anything. They're just going to listen to a one-way lecture, which is a very different experience than getting on Facebook and making a comment and all your girlfriends reply and comment, and you're going back and forth and private messaging. And I saw that with my five sisters. I grew up with five sisters. They were just obsessed. They had best friends and friends, and girls that they used to be, you know. You've got five kids. How many boys or girls?
Tyson: Three boys, two girls.
Howard: And what are their ages?
Tyson: I have a little princess who turned five yesterday and I have a nine-year-old boy, a twelve-year-old boy, a fifteen-year-old girl and a seventeen-year-old boy.
Howard: Yeah, and it's a small sample. You could have a shy, introvert girl and extrovert boy, but the girls are just far more social, so, maybe those social... so, how does the... I know what my dentists are going to think, there's no way he's going to say, "Hey, Tyson, can you do me a favor? Could you leave me a review?" I mean, they hate that stuff. They don't ask for referrals. I've talked to... I've podcasted pretty much every dental consultant I've ever met or had dinner with, and the one thing they all agree on 100% is, the first day they just go in the office and observe, and when they observe, some offices are doing this or that, but they've never... no-one's ever observed asking for a referral or a friend or a loved one on day one. It's never been observed and it's just so counter-culture. So, my question is, how do you get more reviews? I mean, he's not going to ask for one.
Tyson: That's a good question. The dentists that we work with, we help put together a review system for them and there's a link on my website in the menu 'Get More Reviews' and they can learn about that system. But there's things that I don't like to do for my business. I don't like to have phone calls that take hours at a time or clients that want to continue to talk about stuff that we've already talked about and emailed. There's just things I don't like to do, but I do it because I know that it's best for my business. I see dentists that I work with, they do awesome, awesome at getting reviews and, without fail, what that is, is that at the end of the appointment, the dentist just asks a favor. They're getting ready to leave and they're like, "Hey, do you mind doing me a favor? We're trying to get the word out about our practice, and if you could leave a review on Google, it'll just take a couple minutes, I'd really appreciate it. Angie at the front desk will give you more information." So, if that is specifically said, asked for, that review on Google, let them know that you're looking forward to reading it. Now, a lot of this stuff I've got from Maui Bob on the Dentaltown forums, that's going to greatly increase the chances of getting that review, when the front desk does something about it and then your practice management software sends out that request for the review, whether it's a text message or an email, and then maybe you send out a postcard a few days later too. But you have to ask for it. There's things that you don't like to do...
Howard: Who did you refer to on Dentaltown?
Tyson: What's that?
Howard: Who did you refer to on Dentaltown?
Tyson: Maui Bob. He has a review system and he helps dentists get more reviews.
Howard: Spell it. M-A-?
Tyson: M-A-U-I, I think.
Tyson: Maui Bob.
Howard: Bob Summers.
Tyson: That's it, yeah.
Howard: Yeah, Bob Summers. Okay, now I've got you. I've read that there's a lot of Google cracking down, Yelp cracking down on people saying, "Leave us a review and I'll give you a Starbucks gift card” or trying to bribe people to get reviews. All my reviews were done by my five sisters and all their... they each have five friends. So, I was able to build all my reviews just through family and friends. What do you think of that strategy?
Tyson: Yeah, the most recent thing is Google has said, you don't want to gate reviews, meaning you send somebody to a landing page and if they click one star or two stars, filter that review into a feedback forum. That's been the general practice for quite some time, and Google is saying, don't do that. If you do that then you can get in trouble. So, sure, ask for Google reviews, but don't offer me anything for it. And Yelp has said, don't ask for Yelp reviews at all. I think that the best way to get Yelp reviews is to have a decal on your door that says something, check in on Yelp or Yelp customers love us, and if they check in on Yelp, then they're going to get a request on their phone to leave a review. As far as Yelp goes, that's about it. Yelp Watch is where people come from leaving a review. So, if they see they're coming consistently from one specific site, then they know that you're asking for Yelp reviews and they're going to start filtering them.
Howard: I've also, when I look at Bob Summers, 'Get More Reviews', that was Episode 483, you said the word 'door'. I have always put a box of business cards by my door and, I'm in a retail center, I'm in a center with a Safeway and a Pizza Hut and a Chase Bank and a tanning salon. I think the tanning salon, that's got to be the bizarrest business. I mean, we're only nine miles from the sun and there's a tanning salon on every single corner in Arizona. But, my gosh, I'll probably grab a card once a month. You're out for dinner, you're out this and you're like, "Oh, look at this store. This is cool." You can take a picture on your cell phone, but it's really nice when you just have the box of business cards by the door and you just grab one.
Tyson: I think it's a great idea. Something that most people don't do, but it's just those little things like that, is it going to get you five patients a month? No. But could it get you one patient every two years? Yeah. And what did that cost you? So, absolutely, I think something like that's a great idea.
Howard: And every time you got to go with the family to the grocery store and you're in there, I always walk back to the pharmacy and press the flesh with the pharmacy, "How are you guys doing?" Because people are always going up to them and saying, "What's best for toothache? Would you recommend Anbesol or Excedrin or Extra Strength Tylenol?" And they go, "No, I recommend Howard", and they have my business cards in their wallet. That's another thing with dentists, every time you ever ask a dentist for a business card, "Oh, I don't have one." "Okay, well, you're with your wife. Does she have them? How come she has 1,400 things in her purse and none of your business cards?", and you say you don't like going to the grocery store, why don't you go hang out with the pharmacist for twenty, thirty minutes, and make sure he's got your cards in the drawer, and just keep pressing the flesh. I wanted to ask you, you do dentistry, plastic surgery, physicians, orthodontists, drug rehab, psychologist, physician groups, accountants, lawyers. How is dentistry different? How is dentistry and orthodontics different from lawyers, accountants, physicians? Have you learned anything over the years, how we are unique or things that we don't do that the plastic surgeons do or the psychologists or whoever?
Tyson: I have seen dentistry can be a little bit trickier and probably 80% of my clients are in dentistry. So, that's where the majority of my time is spent.
Tyson: About 80% are dentists, so that's where the majority of my time is spent and it's a little bit more complex at times, mainly dentist and then attorneys, usually because they have duplicate Google listings. They have perhaps a listing for the practice name, a listing for their own name, and then one of their listings is getting filtered out and they're not showing up well in the search results and if you just have a general SEO person come in that hasn't worked with dentists or attorneys before, they could royally screw things up when typically, it's a fairly simple fix to make sure that your proper listing is showing up. So, that's one thing that's unique that needs really to be addressed by somebody that has the experience.
Howard: You know, they always talk about in business... are you a fan of 'Shark Tank'?
Tyson: I've watched it many times, yeah. I actually listen to a similar podcast, called 'The Pitch', that's from Gimlet Media. If you haven't listened to that, I'd recommend that.
Howard: You should post that on Dentaltown.
Tyson: Yeah, I will.
Howard: But they're always, what is your unique selling proposition? What makes you unique? Mr. Wonderful will say, "How come I can't just go give some other kid half the money and just do this myself?" How can a dentist or an orthodontist - or is it even important, to differentiate themselves, to be different? When people say, "Well, damn, there's a dentist on every corner." Okay, well, are all the dentists the same on all the corners? How would you recommend that these kids differentiate themselves?
Tyson: I think the first thing is they need to really define their target demographics. Once they define that, then they're going to be able to develop a unique selling proposition that speaks to them. Now is it, are you going after primarily cosmetic cases? Okay, you are, you want those higher revenue patients. Great. Then how are you marketing to them? Are you marketing to them as just another one of their group and a friend, come on down, we'll take a look at you. It's going to be a spa-like environment. What is it? So, you need to really dive deep, define your target demographic and see what resonates with them. When I work with clients, I've had people say, "Well, Tyson, there's nothing really different about my office", and part of me appreciates their honesty, the other part of me is kind of frustrated because there has to be something. Why else is somebody going to choose you? Maybe you're the dentist that's open till 9 p.m. Maybe you're the dentist that has a clown coming in on Wednesdays. I don't know. Whatever it may be, you have to do something that's unique, that draws extra people in. So, that's a discussion that I have with my dentists and a lot of them take it to heart and will come up with something, but unfortunately some of them don't. They just want to be another dentist among the sea of dentists.
Howard: When you study social media, 1% of your friends on your social media, doesn't matter what it is, Facebook, Twitter, LinkedIn, Instagram, Dentaltown, 1% start all the conversations, 9% engage, comment, reply, whatever, 90% just lurk. They're just a social animal. They're afraid of public speaking. My g*d, it's just... on stage they cr*p their pants. So, when they get a bad review, I swear to g*d you have to walk off the cliff. They're calling you from the San Francisco Gate Bridge and they're either angry and want to get a lawyer and sue them or kill them or shoot them. How do you handle negative reviews, especially since dentists just are so... nine out of ten are just snowflakes to the core?
Tyson: I get this, I'd say, kind of regular, maybe once a month, one of my clients got a bad review and I tell them what they need to do and that is we take out the merit of the review. We're just going to assume the review was accurate. I don't care. I'm not getting into a he said, she said, but you need to own the review and you need to professionally respond and you need to take the high road. No good is going to come of arguing or back and forth, which I unfortunately have had clients do against my recommendation. I make the recommendation to reply similar to this, "Dear So-and-so. We are extremely sorry that you had a bad experience at our office. We want to make it right. Our goal is to make sure that every person that comes in is treated like family and we fell short. Please call - and then insert dentist's name - at this number. We'd like to address any issues that you have." If I'm reading that and I'm a potential patient of that office, I'm going to see crap happens. Things happen that are out of our control and somebody's not happy, okay. But what was the dentist response? They took ownership of it and they want to fix the issue, as opposed to attacking the person, which I've seen, and, "Okay, I'm going onto the next dentist if I see that." So, they really need to own the issue.
Howard: I just went to my physician yesterday for my yearly physical and when I went in there, he was so... I thought he was going to die or cry. I mean, he was just visibly upset, and he goes, "I'm so sorry, I can't believe this." He goes, "My nurse sent in the wrong blood deal. This is not what I needed on you." And I knew it at the time because I only take one medication, it's thyroid, and when I saw it wasn't on the list I said, "Are you sure this is right? Because it doesn't have thyroid." And then I thought, I don't know, maybe it's been stable since 2005 and he don't want to check anymore. But he told me that when that happens, people just go insane. I mean, they just lose it, and I just tell dentists, I mean what percent... I mean, if someone asked you, "Tyson, what percent of Americans would you say are just batsh*t crazy?"
Tyson: I think, to a point, we all are about some things.
Howard: We all are about some things. I love that one. Yeah, we all are.
Howard: And then you get a bad review. I mean, are you kidding me? You're going to practice dentistry for ten, twenty, thirty, forty years and you're not going to accidentally order the wrong blood stuff, try a new lab, something goes completely wrong, or it goes completely right but the person receiving it is completely crazy. When you go to a Farran family reunion, 50% of them should be under deep study by the Centers for Disease Control, trying to figure out what went wrong. I assume it was inbreeding fifty years ago. I'm not for sure. I can't believe we've gone an hour. Is there any questions I wasn't smart enough to ask, or anything else you wanted to say?
Tyson: I think you did a great job of covering everything. The advice that I give to dentists that are out there is, when you're trying to get started with your online presence, go with somebody... when you do your research, find somebody that you're comfortable with. I talk to dentists and sometimes they just are looking for somebody that is the cheapest and, okay, are you just going to go to the cheapest guy to fix your teeth? Is that what you want to be seen for? You're going to go to someone who's going to give you quality so, do your research and find somebody you feel comfortable with. I never pressure anybody into working with me. I don't deal like that. I'm just going to talk with them, give them a recommendation and they need to feel comfortable with somebody that they're paying to improve their online presence. So, if they want to look at what we have, go to getmyaudit.net like I mentioned, and then put in their information, and we'll send that over to them. If they want to talk, they can talk. But you covered everything that I can think of. The last thing we want to do is put off establishing an online presence because every day it's just going to become more and more important to have.
Howard: Yeah, and I want to just add a couple things. When you're in a medical-dental building, you're going to have to spend twice as much on this type of marketing. Why do you think all these big stores go in the mall? Because that's where the traffic is.
Howard: And, my gosh, when you look at these four-lane intersections in Phoenix and Salt Lake, some of these intersections get thirty, forty thousand cars a day. That's just like having thirty, forty thousand hits on your website. So, if you go in a medical-dental building, you're going to live in Tyson's house for the rest of your life. Get visibility. You know what's funny? I was reading this book, a hundred years ago, this business guy said, "If you're not seen from the horse’s trail, you don't exist", and now the horse has gone, but it's the car. I was reading in this deal, New York City, their biggest public transportation problem was the depth of manure in the streets of New York City and they would shovel it to the side and on the sides, it would be six feet deep, shoveling this stuff to the side. So you've got to be seen from the automobile windshield, you have got to have a retail location, and the other thing is that the millennials do differently, is you're not going to get immediate results. You build brand, you build advertising campaigns over years and years and years. You just can't come to Coolidge, Arizona and build a brand overnight. It just doesn't work that way. It might work that way in your Instagram mind, or Snapchat, but that's not how it works in the real world. And so, when you do these marketing things, remember it's just a daily twenty-mile march, and you march five days a week, you march fifty weeks a year, and it’s week after week, year after year, and five, ten years down the road, if you had the right strategy, your student loans are paid off and you're glad you went to dental school and life is good. And I just want to tell you about the seventeen-year-old boy here. I've got four boys. They're twenty-eight, twenty-six, twenty-four, twenty-two. I did not have a boy that did not stack a car around that sweet spot of seventeen. So, good luck with that, Tyson. Does he have auto insurance on the car?
Tyson: We don't. We're somewhat lucky with our seventeen-year-old. He is intellectually disabled, so he will never drive a car. He's a challenge, but he's a joy.
Howard: Oh, right on. My gosh, Zach was the saddest one. Remember when Zach got his car. He saved up forever, he bought this beautiful blue Mustang. It was the most gorgeous car. And his first trip out of the house was to Chick-fil-A.
Ryan: He was actually on his way home from work.
Howard: Chick-fil-A? No, no, Chipotle.
Ryan: Oh, was it? Oh, yeah.
Howard: He got off work and then he went to Chipotle. He pulled out of the Chipotle parking lot and stacked the car.
Howard: Well, hey, seriously, Tyson, thanks for taking an hour out of your busy day and coming on the show and spending it with my homies. Thanks for posting on Dentaltown. That's why I called you. You didn't call me. Remember, there's no advertising on there. I asked him, he didn't ask me. There's no money changed hands. I'm a big fan of you, big fan of your post, but thanks so much for coming on the show. I really appreciate it. Hope you have a rocking hot day, buddy.
Tyson: Great, thank you. Appreciate it.