Healthcare growth is hiding in your funnel

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.

Ashley Petrochenko: Hey, everybody. Welcome back to another episode of the Ignite: Healthcare Marketing Podcast. Joining me today is Jesse Fiest, the director of growth marketing at Spring Fertility. Jesse, welcome to Ignite.

Jesse: Thank you so much. I’m excited to be here.

Ashley: We have a lot to talk about today. We’re talking about long patient journey, how people are finding care, how do you keep them engaged over that, how do you take that funnel and find opportunities for growth in there that might be leakage, and then digging into how do you even use patient experience as a growth model. Lots to talk about. Really excited. Before we dig into all of that, can you give our listeners just a quick high-level overview of who you are, where you are now, the work that you do, and all those good things?

Jesse: Yes. Thank you again so much for having me. I’m really excited. It’s cool to be here, Ashley, so appreciate it. I’m Jesse Fiest. I’m a healthcare marketer. I’m currently the director of growth marketing at Spring Fertility, and Spring Fertility is a multi-market conception and preservation care provider, world-class labs, world-class outcomes, and really enthusiastic and engaged patients. A lot of spring parents and babies out there, which is really fun to be working with.

I’ve been in healthcare marketing for over 15 years. I started as a representative for an agency that was helping intended parents, gestational carriers, and egg donors and freezers go throughout the process across several dozen IVF clinics in the United States. It’s a really fun base to start from. I really know this patient experience really well because I was working with dozens and dozens of folks very closely who were experiencing it across a bunch of different providers, 370 or so providers of fertility care in the United States. I got to gain an opinion on a vast majority of them. I come with that background and a love of all things digital and SEO and AEO.

Ashley: Great. This is the perfect place to be to talk about all those things. We like to talk about how healthcare marketing is marketing that really matters. Like you said, there’s spring babies out there, people that you have literally helped achieve their dreams. It’s such a meaningful work to be doing, and I’m really excited to hear about what’s helped you connect those patients to Spring Fertility. It’s a long journey. That’s where we’re going to start.

Often it’s a long and hard journey. It’s not an easy place to be for expectant mothers, future mothers that are trying, and then there’s also people who are maybe delaying the egg freezing. Either way, I think it’s still a hard decision to make for a woman. Where do you go in that long journey? Where do people go? How are you thinking about that experience or content along that pathway?

Jesse: I respect, firstly, just the dividing out those two service lines. There’s conception: folks who know that they want a baby, and they’re frustrated by their delay in conception. Then there are folks who want the power to preserve the future right. Whether or not they’re going to ultimately use this as a tool, they want to protect a future right to parenthood. That’s preservation. Oftentimes, we see it as egg freezing. Those are two very different surface lines, and the barriers and the emotional motivations are very different. The demographics are different. The considerations are different. Having those separated out.

I would say that my standard is to never expect it to be one and done. You got to go in there with the long haul. Ferring Pharmaceutical has this really great visual that they’ve created through the years of focus groups. They will spill it out onto a really large table, like a conference table across seven executive tables if you ask them to do so, and it shows all the different decision-making phases. It helps one who might be new to the field understand this is really complex, it’s really long, and it’s worth being patient about.

My default standard is never one and done. It’s never over. There’s a lot of really fun things for people to do on the internet or on their phone. If they’re still engaging with us in any capacity, they’re still interested, at no point am I like, “All right, we’re giving up.” They’re talking, they’re learning from us, then I consider them part of our continued outreach.

Ashley: It’s a long journey, and during that journey, let’s talk about maybe where you said there’s a lot of fun things on the internet, on their phones, where they could be getting resources, but I think there’s also word of mouth. There’s live events. Thinking about how do you think about your brand and where it shows up across those different touchpoints, where do you prioritize investments and time? Where do you think it’s more important for the brand to maybe just show up strong first? Where do you think it’s most important to prioritize your focus?

Jesse: I think as a healthcare growth marketer, you have to understand that there’s opportunity costs to any investment you have in terms of your budget, your team, your focus. The best place for me is to start with our current proven acquisition sources. Not so much reported, because that was great 15 years ago, but we used Fresh Paint. Shoutout Fresh Paint. Hello, love them.

Ashley: I’m so jealous too. You guys were all just out in San Diego on the beach making little pictures.

Jesse: It was beach, yes. It was very nice. That event team knows what they’re doing. They are helping us, of course, utilize our attribution awareness, observed attribution. You start with what’s working, and then you consider from there. You start with what’s working, and then you look at the talent on your team and your budget and what can you do. You work within your area of expertise and your area of genius, if you can, with the team that you have, and then you look at the scalability and the economics of growth.

One of the questions that you and I were just talking about prior to our recording was: what are the specific behaviors that I’ve learned to watch for that tells me that someone’s still deciding versus them having quietly dropped out? I feel like I treat it as never presuming that they’ve quietly dropped out. You’ll never know unless you ask, and that’s something that I actually don’t see a lot of marketers approach as eagerly as perhaps we should.

Several jobs back, we had a fun little cold lead campaign that was over text where we said, “Send us an emoji for how you feel about why we haven’t heard from you in a while.” It was like, dancing girl, “I’m having too much fun. You won’t hear me,” or stethoscope, “I’m dealing with dual diagnosis.” We gave them a bunch of fun and playful– just send us back emoji-style. Asking and then making it fun for them to respond, not only reengaged, but gave us a little bit more first-party data on why we hadn’t heard from them. Otherwise, you are guessing why you haven’t heard from them. I thought it was an interesting topic that you and I had previously discussed.

Ashley: The funnel is often oversimplified. It’s a funnel, but it really is not. It is this long, winding journey with detour side quests.

Jesse: Side quest. You’re not going to know what’s going on with them. At an individual level, I very much respect the idea that every time I interact with them, I’m being honored with their time and attention. They could be crying over a negative pregnancy test, and I’m getting them right then or that day, or they just found out that their husband or their partner’s changing jobs, and so they’re uncertain about their insurance. They would have executed, but now there’s uncertainty.

With Spring, I’ve had the ability to extend what was previously a rather short nurture journey, and we have extended our evergreen nurture journey to 18-plus months. I’m like, “Let’s go.” We came to play. We know that this is long-term. We know that folks consider it a long time. If they take a behavioral action that shows us they’re ready to convert, they jump off of that evergreen, and they’re now speaking with operations about their appointment.

As a marketer, I’m almost always dealing with folks who aren’t taking that immediate action, and I’m not discouraged by that. My presumption is that they’re interested, but that it’s complex. I also feel that I’m in a constant battle with human nature. As a marketer, we’re always encouraging folks to take the next step, and that’s scary. Human brain has evolved to say, “Hey, I’ve been doing this for so long, and I’m still alive.”

Any new step that we take, oh boy, that could be the thing that just gives me the info and reorganizes how I’m thinking about my timing and my life plan and my partnership, and that’s really scary. Some identity things come up. Whether or not that’s conscious or not, I’m aware of the fact that I’m asking folks to confront, in so many words, some very uncomfortable truths when they take a simple step of asking for a consult. It’s a very real conversion optimization that is very front and center of how I consider growth.

Ashley: It’s a very big step. I think there are a lot of stigma and thoughts around women’s roles, and there’s a lot of questions that go into: do I take that consult? I think more so than maybe in any other different types of healthcare. It is a very big step, and then it’s hard to take. Maybe if given any specific examples of how on that journey, and you have visibility into it, how are you looking for those signals that someone is ready, or maybe this is the content or the answer that is going to help move them?

Jesse: Your content should be designed around the symptom, condition, treatment, and considerations all pre-conversion. That’s what your content team should be making certain so that your organic folks who are doing their research are finding you and they’re saying, “Okay, they really know their stuff.” In terms of leaving the door open, once someone has raised their hand and then they didn’t convert, your lifecycle, your experience with them continues. I almost say I expect that in my service line.

If there isn’t some hesitation, then almost wouldn’t know what to do with them. You’re going to want to be aware, certainly, of the signals in terms of their interest, so the site pages that they’re looking at, if it’s financial or if it’s a specific doctor page, or if you can see that they’re coming from a certain condition page, but reiterating the asking is key. This is a bit of a hot take too, but I know that there is a huge preference for online self-booking.

I got to say, we know that in marketing there’s a rule of thumb of 7 to 12 touches, and I think sometimes that booking conversation is part of the conversion. We sometimes say, “Oh, get them self-booked.” It’s okay for maybe an egg freezer or someone who’s always saw this coming, and they don’t have any hesitation. Maybe they’re in a same-sex relationship, and they are not mourning the emotional experience or the identity shift of needing conception care, and so they’re ready to book, “Let’s go, baby. We got it.”

Other folks, they need a little bit of someone going, “Yes, I like what you’re saying. This makes sense. I’m glad you called.” There are times where I figure it’s absolutely worth testing your ultimate conversion or your appointment attended ratio for folks who had that first touch with a live person who’s empathetic and trained.

Ashley: You were looking at both patient experience through calling through as well as online booking, and conversations are coming from which. I think this is a good segue. We talked a little bit about how do you find that friction in your funnels? You’re maybe maxed out in a market, you are reaching a ceiling, you have a pipeline, you can’t increase ad budget, so what do you do? Where do you optimize and look for those frictions?

Jesse: Where can you look for those frictions? I dare say we’re not so unique. I think healthcare has a pretty consistent application of friction drop-off. I think that speed to lead is going to be your first. You have to hear them. As soon as they tell you that they’re interested, you go, [gasps] “We heard that you were. That’s great.” Then a countdown clock begins in terms of reactivation or engagement with them to ultimately have them convert.

Sometimes in conception care we say that there is a sort of a courage timeline. They have that courage to execute and put that consult request in at 9:00 PM. Boy, golly, I hope you catch them when they’re still feeling courageous because a lot can change by morning. Either making the most of those moments and then looking at your conversion points, you can see pretty classically that folks will go onto the website and maybe look around and then jump off, and you can see those page path analysis by cohort. That’s a drop-off where you can optimize your site for.

Then if they go on and they get halfway through your booking experience and then they drop off, time to improve your conversion experience a bit or to simply ask a nicer, more simple question. You never want to ask something that you can’t action on. If your system doesn’t need it or your follow-up doesn’t need it, let’s take it off. Again, they’re dealing with this cognitive overload and a burden, so you want to make it really easy.

I do think too that humans have this way of making intuitive and emotional next steps that they hope are okay, and then they’ll intellectualize those steps later. If you ask someone why did you choose us, they’ll give you some really great takes. The research says that a lot of the times why they chose you is because you’re the first ones that responded to them when they raised their hands, and you kept the inertia going. That’s really important.

Don’t you dare discount tempo. Don’t you dare discount finding people when they’re ready to move and making the most of it. That trying to conceive couple who has the equipment at home to go ahead and do that, arguably, they have a renewed sense of optimism every cycle, every month. They’re going, “Okay, maybe this isn’t the best time. Let’s try again.”

There’s something very similar, and I’ve worked in consulting for addiction. You see the addiction cycle behavior, so you know the time of day or the time of week that you’re likely to see the most interest. You want to get them when folks are headed into work and wish that bender hadn’t happened, or something to that effect, like something a little different happening. It’s striking when the iron’s hot and doing your best to honor that it might be a long haul, and then not being exhausted by that long haul. No problem. Let’s educate you along the way, let’s check in comfortably. We’ve got so much resource, so much content, so much to share. We’re not exhausted at all by the idea of it being a slow build.

Ashley: I want to get back to that exhaustion piece. I think that’s something maybe we have to communicate up to C-suite, who may be wants to see things maybe a little bit faster. I think that’s one separate question. I want to go back to: you mentioned specific times of days for cohorts that you’re watching, and how does that patient experience which you’re trying to optimize. Have you found throughout your career at different organizations aha moments that you were like, “Okay, this is a missed opportunity that we should have caught sooner,” or “I want everyone to know this”? Just advice that you have for people who are really trying to improve that patient experience.

Jesse: I found that being an analytics in systems, when I can go to my operations partners and give them an average if they don’t already have, most of them will have this, an average by day of week or hour, and say, “This is what I’m seeing. Is this what you’re seeing?” Normalizing and getting on the same page about, this is what a Monday should look like. This is our standard for a Tuesday. This is a Monday after a holiday. Are we all on the same page?

Normalizing on that and making clear that there are certain waves of a weekly experience for site and conversion. That way, no one has to waste some of the emotional time where you could be solving problems with finger-pointing or being like, “Why is the site down?” No, no, let’s normalize. Let’s talk about the natural rhythms that most healthcare will have an established natural rhythm, and getting on the same page with leadership and your operational partners and IT, maybe, and starting to understand those. When you start to make things really stable and understood across departments, then you have more time to problem-solve and to really address the issues.

Ashley: I like that. Going back to the data, normalizing it, common language that everyone can speak to, and it’s, we’re on the same team.

Jesse: We’re on the same team.

Ashley: We’re on the same team. I love that.

Jesse: I think that’s interesting, that question that you said of what are the metrics or milestones when a nurture is working and when it isn’t. I thought that was a really great question. My presumption, of course, it’s working. They’re opening it or engaging with it. Also, folks, if it isn’t working, maybe they’re past treatment, and they’re holding their baby right now, and I hope that’s the case for them.

If I said something that was cool, and they’re like, “Oh, Jennifer needs to hear that,” if they’re still opening it, that’s still a relationship. There’s still equity there. It’s cheaper than ever to set up something that continues to communicate with folks who are interested in it and engaged in and opening it. Maybe they’re not a patient, but they’re a potential advocate, and they’re a provincial referrer.

Ashley: Let’s skip it. This has been nice. We have the existing pipeline that you’re optimizing for, but then how do you turn those happy mothers or happy– what do we call people who freeze their eggs? I don’t know the [crosstalk]

Jesse: Sometimes, we call them freezers.

[laughter]

Ashley: You have these advocates that are happy, how are you then activating them and building your program around them?

Jesse: One of the things I think is so interesting is, as a growth marketer, there’s so much time and energy spent with, “Go out and find strangers who might like us.” We’re like, “All right, no problem. I can do that. That’s my job.” One of the things that’s a missed opportunity is collect the equity of the people who know us and love us. There’s something there. A ton of people are raising their hands. Look at your first party data, your NPS scores, your surveys, your nurse’s notes.

There are people who are saying, “I would do anything for you,” or, “You helped me have my baby,” or, “Wow, you gave me a few more years to feel like I could find Mr. or Ms. Right without having to rush.” Wow, these are big things that we’ve done for folks. It’s not embarrassing to ask them to help other people make that decision. One of my favorite ways to set that up is to create with the hierarchy of ultimate asks. What is the easiest ask? What is the lowest value? It’s usually NPS survey response. Then the next one is a Google review for the clinic and for the doctor.

Then for the folks who maybe have a little bit more something to give, and you know that they exist, is it co-hosting a lunch where they talk about their experience freezing their eggs for their coworkers? Coworkers influence each other’s health decisions more so than ever before. Huge deal there. Then there are folks who are like, “You can call me when you get interviewed by CNN. I want to be on that list.” Then others who just say, “Here’s a picture of my baby. Here’s a video. Here’s my story. I can’t wait to share.”

One of the presumed, or what I think is, I’ve sort of pieced together, unofficially, something that’s holding systems back from setting up advocacy or promoter ecosystem capture is two things. One, the companies don’t even understand the equity loss. They don’t understand. They aren’t piecing together how valuable a content machine it is, how valuable social proof it is for your marketing team.

Communications doesn’t understand how powerful it would be to have a ready-made call list of people in whichever state you want who had certain treatments lines associated with certain doctors, to be like, “You’re ready. Oh, you’ll stay. Oh, thank you.” They’re ready. There’s so much value to be had there. You really need to have an imagination of all that is possible.

At Kindbody, previously, I set up a system that was easy to share, that you could say the treatment that you’d gotten and where you’d gotten and the doctors, it was all very informed and write agreements, and then you said the level of commitment or communication publicly you were willing to present that to.

Ashley: Rebuilding sets of actually communications that your post-nurture experience that you’re [crosstalk].

Jesse: Yes. It’s a bit of a growth loop in that you don’t want anything you build nowadays to demand a human to do every part. You’ve got to presume that your future selves are going to be even more busy and successful, and you need to set up a system that allows you to empower that additional success.

Used to be like, “Oh, email Sarah if you have a great story and send her a baby picture. Here’s the URL to the form that captures all of the permissions approved by legal. Here, drop that picture in there. Give us the video too, and then fill in a few of these boxes, and then let’s create an API that creates that as a social post. Let’s create that as a blog post.” Then that triggers communications that says, “Do you want them on your list for a press communication? What other questions would you like them to answer?” The cynicism there is no one wants to do that.

Hey, folks, humans are wide range. There is someone who is begging to do that, I promise. No matter who’s listening, there’s someone who wants to do it. I would say the best way to get going is to put someone in charge of it who either knows what you’re missing because they’ve seen it before, and they can benefit from it. When I set it up, I was like, “Oh, my life is so much easier. Thank goodness.” Communications was like, “Thank you, Jesse.” It was great. It compounded. Either do that or find someone who’s also a sharer.

Don’t put a shy person in charge of your advocacy build, because they’re like, “I would never,” and we’re like, “We know you would never, but other people absolutely will.” Social proof is contagious, and enthusiasm is contagious. You want at least someone who’s like, “I know you want to. Let’s go.” Is coming at it with a little bit of certainty.

Ashley: Hiring the right people for the role, and you really have to make something repeatable and scalable. I like that. Then operationally too, you mentioned you have to get insights from the doctor, the insights from the nurses, the people. How do you even operationally get that into the marketing sphere of knowledge and into your CRMs? Is that all interconnected as what you’ve built before?

Jesse: Ideally, you’d want a system that took all of the little nods along the way. I’ve been looking for a system that would do just that, but right now, I think your best guess is to piece it together. There’s going to be a note. There’s going to be somewhere your clinical team is leaving notes to one another. Ooh, in so many words, this person’s a bit of a handful, or oh, this has been tricky. You’re going to find an indicator that says maybe this is not the person who you want to be sending multiple requests to. Then somewhere else or maybe similar location, there’ll be an indication that this is absolutely who you’d be wanting to send it to.

Could also make it publicly available on your website in a place where, like, “Are you excited about us? We’re excited to hear,” and start accumulating information there. I had a mentor who worked at a cancer treatment center, and she told me really early there’s nothing as compelling as a person who said, “I survived this because of this. This is my full name.” I was like, “Wow, I could beat that. Amazing.”

Ashley: 100%. That is why people want to hear. They want to feel themselves represented in the brand and a real person, not–

Jesse: A real person. One of the other projects I’m really proud of, it was almost 12 years ago now, but I look on the website, it’s still up. We created an advocacy program where these women said, “Yes, I’ve worked with this company. I was a gestational carrier for them. Here’s my bio. Here’s all the hesitations my husband had for me to not do it, but how we overcame them.”

Then fun little unique things about them, because by definition, they needed to be young mothers, mothers with younger children, that would help any other woman say, “That’s my kind of gal.” There would be quick little things that’d be like a fashionista, but like TJ Maxx or like Harry Potter fan or like dog mom or like loves to camp. Then we got a really diverse set of women, and we said, “Here, there’s 15-plus women. Any one person should be able to go onto this and say–

Ashley: It’s me.

Jesse: Yes.

Ashley: It’s me. [laughs]

Jesse: Exactly. That’s what we’re all striving for when we humanize doctors. You just want someone who’s in your corner, and there’s something about them that feels like they would be cheering for you or he would get it when you connect, and that’s at heart.

Ashley: I had surgery over the summer, and I love my doctor. Dr. Theo, you’re the best. I will tell everyone, “I drove five hours. I won’t keep moving to New York City. I will now drive seven hours. I don’t really care.” It’s like you want someone to feel that passionate and then to tell all your friends about it. Thinking back to that long patient journey and where you’re going for that trusted recommendation, I found him through a Facebook group. I found their recommendations there. How do you curate your advocates, and you can do the things like PR, interviews, getting NPS scores, all of that stuff that’s for you, you don’t want to harm authenticity of it, but how do you make them-

Jesse: No, I live in [crosstalk].

Ashley: –[unintelligible 00:21:43] in those spaces?

Jesse: I’m super excited about this question, Ashley, because this is my personal breakdown of it. The more the identity of the need is associated, so that’s to say– You said you had surgery. I don’t want to do patient information on this.

Ashley: Oh, I’ve been telling everyone. I’ve been meaning to make a LinkedIn post. People are sharers. I’m not a sharer. I’m a sharer one-to-one. I’ll tell you personally.

Jesse: One-to-one, okay.

Ashley: Endometriosis is also something very much not diagnosed, not like people talk about it. 10 years of got to figure out what’s wrong, but there’s support groups. There’s a Facebook group. People are all coming together to find the best doctors who know how to actually treat this disease.

Jesse: Here’s the breakdown that I’ve seen over close to 15-year healthcare marketing is that depending on how much you identify with the reason for your need for service, so you’re saying, “I have endometriosis.” Let’s say Turner syndrome. Usually, a pre-existing diagnosis means you have a community or a trusted source already, which means there’s no ad that’s going to win you against the recommendation of your trusted source, not a chance. You got a Facebook group already. Are you kidding me? That’s gold. You got a Facebook. You’ll drive anywhere they say.

That’s really how I approach it, is you think of your patient groups and demographics associated with those that seek treatment by primary care physician. Those are your referrals, and your practice liaison, your precision liaison, earned referrals that convert beautifully. In a healthy practice in my line of work, you’re going to want 40% to 60% of your converting to be from referring providers. Then you break it up by additional demographics of, if they knew and they have an identity around it, so LGBTQ or single mothers by choice, those are usually identity demands, and those are going to be who you earn through partnerships and who you earn through deep connection with a community and trust.

People who are out there saying, “I have endometriosis” or “I’m a single mother by choice,” that’s how you earn those folks because there’s no generic ad or piece of content. Then you have the other folks that are individualists. They don’t identify with their need, they don’t know why they need, and they’re maybe researching. That’s why you have to have really great organic SEO and AEO AI and social proof.

Then healthcare is local. Healthcare is local unless you’re doing national mental health. Maybe healthcare is almost always local. You’ve got to keep those Google business profiles up to snuff, and you got to have your social proof there, and it needs to shine. I think of it as a bit of soup. There’s no one thing that’s going to solve it all, but you got to get a healthy dose of all of those market shares by audience identity. Then make sure that you’re validating experiences, which is Google and sometimes AI, AEO, GVO. Those are validating experiences.

Ashley: I think with the whole AI landscape and discovery, they’re weighting those human reviews and opinion and so much more. I know Reddit just got downgraded, but reviews still matter. People still want to hear from real people, and the LLMs know that. They’re more important than ever to those advocates.

Jesse: You know what I think about with AI and AEO, I think about what SEO has been for a long time. I love SEOs. It’s a puzzle. It’s such a fun puzzle, but for a long time, it’s been proof of how it’s a health indicator in and of itself. Can you do the difficult, time-consuming thing enough to show me that you have your act together enough that I should trust you? A lot of healthcare marketing, to me, is showing the systems that we’re worth trusting. You can have a lot of cheerleaders and people that are excited about you, but if that’s not digitized, that’s an incredible waste, and you will be left in the dust.

I’m so excited about this. The future of compounding content or mattering or showing up is capturing the authority of your clinicians, getting that digitized. They’re saying incredible things left and right, and they don’t even know it. They’re like, “Ugh.” They say it all the time, “Oh, everyone knows this,” and they don’t realize how great it is and how hard it is to capture all of that equity.

Going in and making certain that you’re getting how they think and how they diagnose things and what their standards are for diagnosis is exactly what AI wants to understand, but then also capturing the equity of your promoters and your advocates because it’s time-consuming, it’s hard to fake. Branded content generation, we can mass-create all the time, but those two layers of the authority and the social proof, that you can’t fake, and it’s hard to get. Systems that optimize those [crosstalk]–

Ashley: That’s the winning ticket for the future of marketing.

Jesse: Oh, yes.

Ashley: There’s surveys that are showing that a lack of trust that Americans, I think globally, have in institutions. People are doubting even healthcare organizations. How do you build that trust? It’s through the providers, it’s through their knowledge, their expertise, and then verifying that with real people that look just like you.

Jesse: 100%.

Ashley: That’s how you win.

Jesse: I love that.

Ashley: We solved it. I loved it.

Jesse: We did it. [laughs]

Ashley: Got your new framework.

Jesse: One of the great questions, too, I have to say that I was super excited to talk about was you asked about what happens when that next incremental earn campaign is partially dependent on a conversion optimization that is outside of your jurisdiction. Can we go there, Ashley? Can we talk about that?

Ashley: Yes. We talked a little bit about marketing ops, the patient experience, how do you navigate that realm when you can’t control it.

Jesse: I’m so appreciative of this because I recently had this experience where I was asked to increase spend in Google search, and number one for a lot of bottom-funnel Google search is really what brings them in. It reels them in. It gets a lot of credit, last-touch attribution, but it’s a go-to for a lot of folks. A missing piece for a lot of executives and partners, people who are not in paid media, something that I’ve noticed that they don’t understand, which is key to educate them on, because it’ll make your life so much easier, is this presumption of let’s just turn up spend, and it’ll just be that easy.

I finally, after a lot of years, have realized that if I can communicate to them that when we turn up spend, we’re not getting the same quality lead because the ad platforms are already really, really good at finding the best possible lead for my dollar. That next dollar doesn’t get me a duplicate, so to speak, of that last. It gets me one that’s lower on that quality curve. This is so important, I find, Ashley, because otherwise, you’re going to be half of your career is people are like, “Just turn up that budget,” and you’re like, “Oh my gosh, you guys.”

Ashley: Why isn’t anything actually converting into a real patient? [unintelligible 00:27:44] both sides.

Jesse: Exactly. I love the idea of when is it a conversion conversation versus an additional leads conversation. I know the gold standard is that additional leads are supposed to be there for systems that have proven themselves and that are efficiently converting them, but welcome to the real world. If you’re a growth marketer or you’re listening to this podcast, and you’re being asked to create new leads, you don’t get to say, “Well, I’ll create those incremental growth demand as soon as they do right by the ones that I’m creating.” You don’t get to say that.

What you have to do, what I recommend you do, is you say, “Hey, let’s be heroes here with me. Be a hero with me.” I’m taking this from an executive from the Fresh Paint conversation that I had in Laguna Beach who said, “Yes, inspire this in folks. I’m going to increase my ad spend, but I’d love for you help me to reduce the reduction of the fields on our appointment. I will bring more people to our door if you make it easier for them to go through.”

“That way, our appointment attendant cost will not skyrocket. Please partner with me in this.” Once folks understand that you can’t just turn it up into oblivion, they go, “Oh, we need to change and maneuver and work together for conversion to fit with the additional spend.” That’s a big missing piece in a lot of conversations.

Ashley: You’re trying to bring people along, and there is a way we can work together to achieve this goal. What are common objections? Like a very siloed platform for you to bring them together.

Jesse: They’re very siloed. I love working for a clinic that’s still doctor-led because I’ve worked at places before where it’s not so much, and it has just other lists of interesting business experiences. The doctors are always saying, “Hey, guys, we’re patient first. We’re patient-experienced first,” and it’s so nice to hear doctors say that. That’s really what your system should be is are you making it easier for them? We’re not trying to make it easier for us, guys. Let’s get all the information because that means all of our duckies are in a row. How great for us, and my life is a little bit easier. What about that person again who had worked up the courage to make this call to begin with?

Let’s honor that courage and not overwhelm them. Really going back to that shared standard of what’s easiest for our patient or our user, and it almost always is what’s easiest or better for conversion. It’s a very nice shared standard to have. What balances it, and why you don’t come in storming the first day of being like, “What’s easiest for the patient? Let’s reduce these fields,” is you also want to have a partnership that’s long-standing with these folks with the problem and the optimization down the road.

Ashley: It’s like some things you can’t change. We all have a role in our organizations, but having that alignment around what matters to the patient experience. I was just speaking with Kayla Shoup at Tend Dental, and the patient experience is one of their core pillars of the entire organization. If everyone can rally around that and make decisions, that’s going to be just a little plug for scaling up a whole session on how they optimized their whole online booking journey-

Jesse: Love that.

Ashley: -what that looks like, and how they reduced friction. Really excited. You’ll love that one. I think listeners will want that one too, but you can’t always change management. It’s really hard, but aligning around what are the pillars that matter to our organization, why they matter, and what’s the role that you play as an individual person into achieving that.

Jesse: I’m not against a little bit of theatrics in the whole, “I don’t want to waste all—” Occasionally, you do need to say, “Guys, I would do it. I would do it if I thought it would be good for us, but it’s not. I could light the money on fire right now. It will go just a little–” Not all the time. Just saying, it’ll get us just this far because there’s a certain type of spend. If this is really how we want to do it, we really need to make some changes to make it valuable spend and for there to be what we’d like.

Ashley: Yes, that’s what we want, and I think showing them– we touched on it a lot in this conversation. There’s an overlap of how aligning around the data, showing them that, showing them the friction, showing where people drop off. That’s what helps tell your story-

Jesse: Yes, absolutely.

Ashley: -because saying the truth is important. There’s a lot of ways. It’s not easy, and it takes time.

Jesse: I love the FOMO experience there too, Ashley. I’d be like, “I was on our competitor’s side, I got through it, and I’ve done this so many times.” I timed it. I got through it in six minutes. Ours took 14. Back in the day, when we were recruiting certain folks, we always said, recruiting young mothers, we’re like, “It’s you against Cocomelon.” You need to be able to get people to take an action before the podcast episode changes or their toddler cries out or their dog barks.

Ashley: That works so well. People do not want to be up-competed.

Jesse: Compare it to what it is, and hey, I just jumped off in there. That’s something I do, I would say, monthly. I am on my competitor’s site looking at what it is that they’re doing, timing myself on their systems and seeing what they’re– because it’s worse.

Ashley: It’s like the secret shopper thing. You have to be a secret shopper of yourself as well as your competitors. What are they doing great? Where are they failing? Where’s the opportunities? Lots of lessons can be learned by that snooping around and just being observant and seeing what it actually is like to be a patient.

Jesse: Specifically, I think with conversion of appointment requests and appointment booking experience because there’s almost no other conversion experience that’s going to impact as much as that. There are times where I’m not all that intrigued by what Semrush wants me to know about some of their essay. I’ll do a gap measure analysis, but it’s not intriguing to me across the board.

It’s specifically intriguing to me to the point where it all converges, which is that collection where someone submits and then it’s addressable after that, because until it’s addressable, you’re looking at cohorts in general. Then as soon as you have a name and phone number or an email, then you will have magic that you can begin to do and interact, and you can converse and send them like an emoji option text response experience. There’s so much stuff now.

Ashley: Love that tip, too, that idea. It’s like I always think, what’s the easiest? Is it Stephen Covey who says you own that bank of trust with people, and you have it, and you can only do an exchange, and so you can’t ask for more than what you have. That’s a very easy ask, and it still just gives you that little bit of knowledge to know which path they should go onto and look at.

Jesse: I’m a big fan too of people are almost willfully ignoring the data that we already have, and marketing will be like, “Oh, we don’t know. We have no idea. We’re not sure.” Go ahead and take a quick little look at– If we had asked the question, “What is your ideal family size?” Asking that a little earlier, or what does health look like to you, or what would make you an advocate of this practice? I guarantee you that the majority of practices ask questions like that, but it’s buried somewhere in a part of your system that marketing actually rarely sees. Find your way to it, and you’re going to find so many exciting claims.

One of my favorite things about bringing together how we find great leads and what matters to folks in advocacy was when I would have these advocacy conversations with a focus group for advocates, and you would find the most compelling gal who had recruited nine of her friends, and she was super valuable, and you’re like, “Oh my gosh, I can’t believe we got you. What a Godsend you are.”

She was just a gift. When you finally had built up the equity to ask her the question, Ashley, and you’re like, “Tell me how you decided on us?” You’re thinking she was going to say, “Because of all of these great perks and we’re female-owned,” or something, and she’ll say, “Well, it was really you or–” Then she’ll name the competitor that you would have never guessed she’d ever consider ever in a million years. You have nothing in common with them. You realize that you get your most compounding, most valuable patients sometimes because you are the fastest to respond and the easiest to submit your consult request with, and all that other stuff was just window dressing.

Ashley: Also balance: when is it speed to lead? When is it all of the others [crosstalk]?

Jesse: To lead. It’s always, always.

Ashley: We’re totally open. I had my ceiling leak again, fourth one in my house. Who answered and got there in 45 minutes? He’s my plumber now. He’s that [crosstalk]

Jesse: There you go. He’s your plumber now, and will be until you move, right?

Ashley: Or until he goes first. That’s what happens.

Jesse: Sure. That’s true. People, for whatever reason, they’re overthinking so much of this that you need a system that responds quickly and quickly says, “We heard you and we’re excited.” Then you need a system that gets, almost like a soccer coach or like a person getting their protein in. You need those 7 to 12 touches not as a thing that you’re peeved about, but as a get ’em in. Get those touches in.

It’s like you submit your form, and you got a nice email about all of the research we’ve done. That’s a touch. We’ve got that. Then that next conversation is a touch, and then email. Getting them in and feeling excited about getting them in and optimizing those, that’s the game. I say game with total respect to the fact that we’re changing lives by making certain that treatment-ready patients see world-class doctors.

Ashley: It’s a game because it’s fun. Marketing is fun.

Jesse: Also marketing is fun.

Ashley: This has been just such a great conversation, Jesse. Thank you so much for just sharing all about the work that you’re doing. I think listeners are going to have a lot of great takeaways on how they can make these advocates at their own organizations and operationalize it, make it happen so next year we have more and more people who are getting the care that they need.

Jesse: Thank you.

Ashley: Thanks again for joining. If marketers, listeners want to connect with you, where can they find you?

Jesse: Please find me on LinkedIn. Connect with me on LinkedIn. I’m Jesse, spelled like a boy, Fiest, which is fiesta without the A, on LinkedIn. Connect with me even if this is six years after being published. Go ahead. I’ll think it’s fun. I think it’s all be great. Connect with me if you’re a bigwig or if you’re a newbie. I’ll think it’s cool either way. I’d love to hear from you and look forward to talking shop. I always love talking shop.

Ashley: I love it. Listeners, I hope you also join us again in just, I think, five weeks. We’ll be at, when this publishes, maybe three weeks if we’re scaling up, where we’ll be sharing much more insights just like this, listening to marketers who are solving some of our biggest challenges. Thank you again, Jesse. We’ll see you all next week.

Jesse: Thank you, Ashley. Appreciate it.

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