From 30 to 100 Locations: The Secret to Modern Dental Growth

Announcer: Welcome to the Ignite Podcast, the only healthcare marketing podcast that digs into the digital strategies and tactics that help you accelerate growth. Each week, Cardinal’s experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Alex Membrillo: Guys, this is going to be fun. You know I always say we’re going to have fun, but this time I’m saying we’re going to have fun because Emily Rose is here. If y’all don’t know, my best friend of 35 years is an Emily Rose as well. Me and this Emily Rose are BFFs. Emily, I’m sorry you had to join me on Ignite. Welcome to the podcast.

Emily Rose: I’m so glad to be here. So glad to be here. Thank you, Alex.

Alex: Where are you in actual sense?

Emily: I’m in North Carolina. Fayetteville, North Carolina. A little south of Raleigh, a little east of Wilmington.

Alex: My 16-year-old wants to go to UNC.

Emily: Totally.

Alex: Is that cool or is there another school and y’all are rivals with?

Emily: NC State, of course.

Alex: Is that Fayetteville?

Emily: No. NC State’s a big North Carolina school. Their main campus is in Raleigh, so I think that’ll be a good one to consider also.

Alex: He’s very excited. We’re going to do CollegeSource. Where do you work, Emily Rose?

Emily: Currently, I’m supporting Lightwave Dental as their vice president of marketing.

Alex: I love it. Tell us about Lightwave. How many locations, how many brands, how’s the brand’s ortho?

Emily: Lightwave has 100 locations. When I started with them 6 years ago, we had about 30. Huge growth. Lightwave is just killing it in the space. They consider themselves a dental leadership organization as opposed to a DSO, so we’re really focusing on doctor leadership. We have 36 branded locations, specialty as well as general, ortho, oral surgery. Full mouth implants is a big thing for us right now. Then our general dentistry services.

Alex: Full mouth implants. We’re going to talk about that. You have a lot going on. GD, specialty, 30-some, 36, I think you said, that are Lightwave branded, and then a bunch that aren’t. Is that right?

Emily: No, none of them are Lightwave branded. Lightwave is our DLO brand, and then we have big groups and then individual locations.

Alex: I saw MB2 Dental also had a different name for their thing. Is there actually something functionally different? Do the dentists have more– Is the partnership agreement different? They have more control over their marketing, their adminis–

Emily: Yes.

Alex: What is different?

Emily: For us, I don’t want to speak for others, but for Lightwave, the difference is that doctors have equity within the organization, so they have equity in the full organization of Lightwave, not just in their individual practice. They’re Lightwave shareholders, and they have input in regards to the direction of the company.

Alex: That’s fun. Does that make marketing harder on you guys because you’re getting a lot–

Emily: Pretty big galaxy. If you have more stakeholders, then it just creates more complexity in regards to stakeholder buy-in, but it also makes it really great too. One of the things I talk about is doctor engagement really makes a difference in marketing efforts. If the doctors are engaged, you’re going to see bigger results from a marketing perspective. Huge. The doctors that aren’t as engaged just doesn’t have the same vibe and feeling as you get from the doctors that are.

Alex: They help out more with organic social. You just feel more momentum. Approvals happen faster. They pick up the phone quicker to schedule. They’ll take the extra appointment.

Emily: Right. They get a lot of team buy-in, so making sure the phones get answered. Are they answered well? Are they taking care of the patient? Customer experience is important for doctors that are super engaged. Just the approval part. When doctors are bought into the brand that they’ve helped create, then that flows into all the marketing and the messaging and the communication out to the community. You can’t fake that.

Alex: I guess the DLO thing also keeps the founding doctors around longer, which helps tremendously. They’re not churning and being replaced by the youngsters.

Emily: That’s right.

Alex: That’s good. More stability. Do you attribute a lot of that to the growth from 30 to 100 since you’ve been there? Obviously, your paid media is probably better than everybody else in North Carolina where everybody’s locations are. What’s been the sauce? What’s working? Money’s expensive and everyone’s complaining, and going for same-store growth now. You guys are a shining star.

Emily: The sauce from the growth perspective, I definitely think it’s that the doctors have equity. They have a say in the future of the company, and that’s really appealing to new dentists. Not only doctors that want to grow their business, but also associates that are coming into the practice and then helping the practice grow too. They have an opportunity to have equity in the organization as well. They’re just not employees.

I would say that’s been a big element. I think we have a great leadership team that are really focusing on the right thing. Growing acquisition, looking for practices that fit the culture of what we want to achieve. What’s Lightwave’s culture? They go looking for practices and doctors that support that, as well as a lot of organic growth. Really focusing on growing our practices that do join us organically, not just acquisition.∂

Alex: I love it. Guys, you all hear how Emily Rose is talking here. I’m going to use her last name every time because it’s [unintelligible 00:05:00] Just get over it. How she’s talking is she’s using the private equity terms. She’s talking same-store growth. We’re not just talking PPC, which we will. That is the next question. We’re talking about growth and aligning to what the DE firm is looking for and all that fun stuff.

Let’s talk. I’d love to do an M&A chat, but that’s not our audience. Let’s not talk about the acquisitions and finding acquisitions that align with our culture, because unfortunately, us marketers don’t get a lot of say over that. Let’s talk about the same-store growth. You talk to us about what has worked over the last year, what you credit it to, et cetera.

Emily: I’ll talk about it from the marketing perspective. I think same-store growth comes from, for us, is increasing scheduled appointments. I would say over the last year, that’s been our main focus, increasing scheduled appointments and making it as easy as possible for patients to schedule. Online scheduling, we’ve rolled out as a company over the last year and a half. Just passive, you come to the website, if I’m going to build my business listing or whatever, it’s easy to schedule that way, 24-7.

The other piece is that we’ve been standardizing on our patient experience, focusing on the systems that everyone’s using, and then being able to roll out standardization of how you communicate about appointments to patients. You’re making it easy for them to come in. A lot of it’s going to be the tech staff. We’ve been focusing on that. We’re utilizing a system called Line.

Alex: Oh, they’re in North Carolina, Raleigh. Charlie, what’s up?

Emily: They are my faves. I love working with them. They have a great product that’s really helped us. One of the things I’ve felt since January of 2024 through March of this year, we had almost a 500% increase in new patients, scheduled appointments, and a 67% decrease in our cost for acquisition for PPC by utilizing Line and standardizing our ICM vendor.

Alex: By the way, Line is a headline sponsor of Scaling Up, coming to you October 28th and 29th. It’s a virtual summit for all healthcare marketing leaders. I had to do it. Thank you for plugging. The brand marketing team said, Alex, can you start plugging Scaling Up? Perfect segue. Let’s back up one second. What percentage of patients are booking online versus call and form?

Emily: Oh, it’s still small.

Alex: No way.

Emily: It’s still small. The number one way patients connect with our practices are still phone calls. Absolutely.

Alex: Wow.

Emily: Oh, yes. Oh, my dog’s visiting. She just came in.

Alex: Hello, dog. I usually have one of five cats on my lap, so dog can stay.

Emily: Just as I’m thinking about it, I would have to go back and look at the numbers. I haven’t looked at it recently, but it is small in percentage-wise.

Alex: Older demographic or something like that there.

Emily: I will say it’s very passive. One thing I think about online scheduling is that you have to come to the website to do it. You have to look at your Google My Business listing to do it. I think that it’s added steps. It’s much easier just to click a button and call from an ad or the phone numbers you have saved in your phone. There’s less steps to call for a patient.

Alex: Yes. Specialty stuff, you’re going to see a lot of it call because it’s complex and they have questions. Is it going to work with this and all of that? GD, man, I’d expect the uptake to be whatever.

Emily: I think that there’s patients still don’t know what they need. When you go to an online scheduling platform to schedule, am I a new patient? Am I an existing patient? Do I need an exam? Do I get a cleaning? Do I do a consult? That’s where I think there is some disconnect in regards to that. There could be some opportunity.

Alex: What are we using for the online schedule? What system? Line doesn’t have an online schedule yet.

Emily: We’re using two systems. We’ve standardized on Axle and Flex.

Alex: I’ve not heard of those. Those are not DSO-specific ones, I assume?

Emily: They are dental-specific. They integrate with Open Dental. That’s been a big part of our focus.

Alex: Is Line then taking those and able to say, came from SEM, online schedule, actual booked appointment, and so they are tracking all eight? Awesome. Obviously, we know them very well. Calls and email forms it doesn’t take would lead to calls the person immediately as soon as email.

Emily: Right.

Alex: Tell people about it. They need to pay for this episode. That’s what they should have done. Tell us about it.

Emily: To me, one of the biggest elements that I didn’t know about Line or that’s just happened is that Line’s data, you know how– I’m just going to take a step back. With Google PPC, you can optimize your ads based on phone calls. He said the events. Phone calls or form fills or whatever. You say, optimize my ads, serve ads to the people that are doing these things. Line’s data allows us to optimize our ads based on scheduled appointment. We can actually say we’re going to increase the number of actual scheduled appointments, not just lead, because we’re showing ads, the types of ads that are going to have to back us.

Alex: That’s right. They have to be passed back into ad platform. Not many agencies know how to do it. Emily Rose has a good one. That’s right. It’s not us.

Emily: I would say, too, standardizing and having a partner that works directly with Line has also optimized. LeadPoint Digital is our SEM vendor. They have a great partnership with Line, which has made a huge difference. That means as a marketer at a high level, that’s really important. At the practice level, it makes it so easy for the practice to call and follow up with the patient and a lead. Follow up with the lead, convert the lead faster.

Alex: Why does it make it easier?

Emily: Line has the system, I call it a ghost dialer. The patient fills out a form. They get this phone call at the practice. The practice then picks up the phone like it’s a regular call. They press 1 and they’re immediately connected to patients. Particularly for form fills, that’s the best because you’re reaching the patient when they’re more likely to be interested in scheduling.

Alex: No call center ever calls the forms back.

Emily: No. When we started Lightwave, forms were going to some random email.

Alex: Of course.

Emily: I had no insight or ability. Basically, I turned them all off when I first started six years ago. Who knows? Are they even working?

Alex: It’s wild. I never heard back from a derm practice because I submit a form, you call, and obviously they pick up. It’s awesome. Line takes that. Do you attribute the optimization to the right thing, as in getting more scheduled appointments and increasing cost for new patient scheduled appointment, having the right tech and the right uploads back into the platform, all of that stuff? Help.

With Line, I know you also probably looked at the operator. Your information, it shows you a dashboard of which agent is converting the best, why you’re not getting booked appointments in certain locations, you don’t have the right payers, or you’re too expensive, whatever it could be. All of that is cool for COOs too. Just an FYI, and this is getting turned into a commercial.

Emily: That’s the other thing is it opens the conversation to say, we’re doing radio ads. We’re not getting as many leads from the radio, but our PPC leads went up. We could have conversation around having multiple marketing channels. You are doing all these different marketing channels, and you should see an increase in your PPC campaigns just naturally because that’s the last touch. Don’t just say radio is not working because it’s not getting as many leads as your PPC campaigns, but they all manifest together.

Alex: Radio did not kill the PPC star. Guys, we believe in all forms of marketing, traditional and otherwise. It’s funny that everybody thought traditional would be dead when digital came around, but I am so thankful when a client is running traditional because it makes our life easier. You see leads go up, CTO comes down, brand search goes up, yada, yada, yada. Don’t ditch on radio. Yes, it does. I think it’s really cool when you have sophisticated tracking like you guys do, you can see directionally. You can also see if radio just sucks because you have a heavy market, and PPC really didn’t change much either way.

Emily: Exactly. It’s like my barometer to determine are other things working or not.

[music]

Alex: Healthcare marketers, what’s up? It’s Alex from the future. Guess what? Scaling Up, the healthcare performance marketing summit is back. Scaling Up is focused entirely on driving patient acquisition. Wasn’t hard to implement. You’re talking the largest provider group, health system leaders, everything it takes to drive a patient to your practice or health system from media, BI, analytics, performance creative, SEO, AI, because we’ve got to have that acronym in there.

October 28th and 29th, thousands of healthcare marketers are going to be showing up to this. It’s virtual and it is free. That’s the best part. Last two years, we were charging for it. This year, I want every healthcare market to come. We need to connect more patients with care. We all do. We all need to do it together. I’ll see you there, Scaling Up.

[music]

Alex: Was it hard to implement all of the lead trackings, walk people through the steps? Did you go get COOs buy–? How hard was it? It sounds easy. It’s not easy at 100 locations. What happened?

Emily: We’ve been implementing for probably three years. It’s taken a long time.

Alex: What takes so long? You have a centralized call center. What took so long?

Emily: It’s because we’re a dental leadership organization, I have to get buy-in from the doctor. Because the cost of it was being allocated to marketing, I figured out a way to say, some of it can be allocated to your marketing budget, half gets allocated to your marketing budget, half gets allocated to your ops budget, like your GNA. Then you can say ops and marketing work together to increase your scheduled appointments.

Alex: Smart.

Emily: That worked really well for a while. Then once our regional directors, doctors saw the value of it, it just snowballed. Now I would say we’re moving forward to having everybody have it in the next year or so.

Alex: I took two things away from that. One, that it’s a lot of red tape to convince people and you have to get ops and show. That was smart to say, this can live on the budget this way. Guys, this is some of the things in-house marketers, you all have to deal with, I feel for you. It can go into the budget this way, that way. Don’t try to change the whole system, get a region. Prove the success. The doctors will say, guys, we’re getting more appointments. I don’t know what that Emily Rose and Casey Weber are doing over there, but something’s changed, right?

Emily: That’s right.

Alex: All the dashboards in the world, they don’t care, they’re clinicians. Overall, something changed, the butts are in the seats, and my EBITDA’s going up, so my equity stake is happier. Good. Three years and it never stops, but it is worthwhile. The good lead tracking systems out there, Line being one of them, especially in healthcare, can really help change things. Pivoting a little bit. Sounds like media and digital media. Guys, sometimes it can be that simple, but don’t take away from this. You just do PPC and all your– As much as I would like that to be the headline, it’s not that simple. The clinicians are bought in, so they’re getting more return patients, and they’re running radio, and they’re doing-

Emily: Multi channel.

Alex: -local sponsor– Yes, the whole thing. Guys, it’s not just PPC till you die. Let’s talk a little bit about AI, and I’ll drone on about the nonsense. You guys have done some interesting stuff with actual patient interaction with AI. Right?

Emily: First, I’ll say I am not an AI expert. I keep up with it.

Alex: No one is.

Emily: It’s moving so fast, I can barely keep up with it. We have implemented AI. We use TrueLark, like a text-to-patient AI, and that was super helpful for one of our bigger groups. We’re also beta testing a voice AI called ThirdVoice. That’s really awesome because it allows, to the practice, if they can’t answer the phone, the AI will answer and will increase schedule appointments. That’s been really interesting to try out.

Alex: An overflow.

Emily: We’re testing the texting, and that works. It’s helpful. The voice AI can answer more questions. It can just be a little bit more personal.

Alex: Have you called in and tested it?

Emily: Oh, yes.

Alex: Is it natural? Is it answering complex [crosstalk]?

Emily: It’s hard for me to say because I knew what I was calling in for.

Alex: What happened? What feedback have you gotten from patients calling in?

Emily: Most patients don’t know that it’s AI.

Alex: No way, dude.

Emily: It’s so good. I don’t think people realize that AI is actually answering calls now. They answer like it’s a person. Unless the question trips the AI, which can happen. Then they just say, “Thank you so much for calling, we’re going to have somebody reach back out to you to answer some additional questions and get you on the schedule.” They answer really gracefully.

Alex: Did it take a while to train that AI? You had to feed it, not just your website, but internal docs and, hey, these services do happen here and there. Is it a lot of training for the voice thing?

Emily: ThirdVoice pilot was developed by one of our doctors, Dr. Shreyesh Ruparelia. He has the company. It was really designed specifically for dentistry. He knew already what it needed to be set up to do. Once we were ready to implement, it was quick for us. They’ve been doing a lot of work on the backend, so the practice, people answering the phone.

Alex: I asked you earlier, what would you do if I gave you 20% more marketing budget, more people with what you said earlier, say more PPC – that’s not your answer – what would you do with 20% more budge?

Emily: I would hire more team members. Dentists and dental teams are very human-focused because they’re the ones with patients all the time. Face-to-face interaction with the marketing person really drives growth more, I think. Having somebody there they can answer questions to, somebody that can go to local events, somebody that can be a community engagement. Dentistry is local still, and dentists are also very local. Having that face-to-face interaction, I can’t do from behind my screen as well as somebody who’s in the practice regularly.

Alex: Field marketing specialist and put them– yes. You’re right. It’s local, and I think we forget that. I think on my last podcast, I don’t know if it was Jen and B who I was talking to. She said, “I go to the clinics. That’s my secret weapon. I go to the clinics. The youngsters don’t want to go to the clinics, and so I do.” That’s where you learn the best content. You learn what you’re good at. You learn why you’re not scheduling, and you learn where the community does or does not know about that practice. Emily Rose is spot on. More people in the field helps to grow the practice a little bit more. What would be your first hire? What skillset? I always get this question, and I don’t know the answer.

Emily: I always thought that you needed to hire a marketing manager, somebody who could really lead marketing in the practice. That’s what I used to think. I’ve shifted away from that, and I think somebody who is young and hungry, and motivated, and excited. Then you have marketing leadership that’s helping create strategies for a brand strategy director or manager, and then you have somebody who’s in the field, and they’re super excited, super motivated, want to do all the cool stuff. I think the other piece is the social media. Social media content creation is the bane of marketing leadership and–

Alex: Yes, brutal, especially house of brands.

Emily: It is so hard. Having somebody that can create that kind of content on the fly with the doctor when they’re available, goals, in my opinion.

Alex: It’s called the hardest thing to contract out, and no agency’s good at that, and so that does have to be in-house. That’s interesting what you said. I used to call our team youngry, young and hungry, and we are the youngry flock. Emily Rose did not say a skillset like getting a marketing office person. She said, get someone youngry that can do it all, and is going to be Jill of all trades, because there’s going to be a ton of stuff to do.

I agree. I like when my clients hire a marketing director that knows digital pretty well, that can cover half of the patient acquisition goals at least, and then get some generalists to help out with stuff with tech and social content. I love it. We got to do more content. I know you got another gig coming soon, and we’ll talk when you land. Six months later, we’ll have you back on and see what’s going on. This was fun. Line, you owe me $10,000. We’ll just call it on that.

Emily: Me too.

Alex: Yes, and Emily Rose. She’s going to bring you to the next one. We also referenced her agency, so that’s fun. Cardinal’s not getting any leads from this one. Emily Rose, this was a blast. Thank you for joining us.

Emily: Thank you so much, Alex. Great time.

Announcer: Thanks for listening to this episode of Ignite. Interested in keeping up with the latest trends in healthcare marketing? Subscribe to our podcast and leave a rating and review. For more healthcare marketing tips, visit our blog at cardinaldigitalmarketing.com.