Unraveling PPC Strategy in Multi-Brand Healthcare: A Peak Dental Case Study

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: Well, you all are in for a treat today, man. We’re going to actually talk nitty-gritty. A lot of what we do on Ignite is talking strategies that we’ve seen broad and overarching but today we’ve got Ruchi. Ruchi, what’s up?

Ruchi Patel: Hey.

[laughter]

I cannot match your energy. I’m just saying that.

Alex: It’s okay. You don’t need to.

Ruchi: Good, that works.

Alex: You do you, or we can’t be friends. All right, so guys, this is going to be a lot of fun today. Ruchi, she’s the best-paid search person in the country. Listen, I got 10 of them. I think they’d all say that too. She’s the best.

She works on some serious large and complex accounts. Today we’re going to talk about a DSO with about 60 domain, 60 different individual house of brands that we get to figure out PPC and SEO strategy for. Today, we’re going to talk search, and we’re going to talk some of the nuances without giving away detailed detail stuff for our client.

We are going to talk some things that you can go implement, whether you own or run marketing for a DSO, any kind of multi-brand healthcare specialty. These tactics will work. All right, real quick Ruchi, what is Peak Dental?

Ruchi: Peak Dental, it’s a dental service organization. Think about it, right? We have a bunch of dental clinics. I’m a dentist. I know how to fix your teeth, but I do not know how to manage my organization. I don’t know how to get new patients.

I don’t want to deal with finances. I don’t want to deal with all that comes with owning a business. Somebody like Peak at DSO, they come in, they help you manage your business efficiently and they take care of everything. All you do is get new patients, scale up your business in the most efficient manner possible.

Alex: That’s right. Hired Cardinal is usually step one with your DSO so that we can scale up your patients. All right. What do we do from them? Media analytics, SEOs. We’ll talk media and some analytics. Media perspective. What are we doing? They were running search when they came to us, right?

Ruchi: Yes.

Alex: Okay. We’re running search any other channels and analytics. Let’s talk about what we’re doing to search.

Ruchi: They were running search, but we are talking about an organization that is helping almost 60 dental clinics across five different states. All of them had their own ads account and quite a bit of the clinics are concentrated in Denver.

Think about a densely populated city like Denver, and you have three different clinics. You are advertising for all of them, but they are in different ad accounts. They are competing with each other.

It’s ultimately the organization’s money because they’re helping you get the right marketing plan in action but my brand A is competing with brand B because they’re in different Google ad accounts. What Pete came to us was like, hey, we have 60 plus locations.

We are slowly onboarding all of these, and I want to make sure that we have an efficient digital strategy in place. We want to make sure that if these need to be one account, we are doing it. If these need to be one campaign, we are doing it.

They were coming to us to just understand what is the most efficient way to manage these clinics and come up with a strategy to actually help them get new patients, which is their ultimate goal.

Alex: Okay. Yes, absolutely. How did we deal with that cluster that they have because a lot of people have this. They’re like, “In LA, I’ve got five locations that are too near to each other.” How do you make it so that they don’t overlap against each other, yada, yada?

Ruchi: First of all, it looks like it’s a dental clinic but when you start looking at the website, you realize that everybody has a niche. If you talk about one of the clinics that they have, they specialize in dentures and dental implants.

It’s not like they do not do general dentistry. It’s not like they will not help you with braces or anything else. It’s only a matter of where they think most of their money comes from and where they want to get more leads.

Whenever you’re dealing with a multi-brand account, all you have to see is find what matters to them and make sure that for that specific location, for that specific service, you are maximizing your spend, your dollars, all your efforts in that location.

Again, just to give you an example, Denver, there are three offices, all of them within a five-mile radius. How do I make sure that all of them are efficient? By understanding what each of the clinic really wants the leads for and making sure that the campaigns are designed to maximize it for clinic A, clinic B, clinic C.

Alex: Got it. You look at every single location, which they’re [unintelligible 00:04:28] brand, so they’re their own business. If they’re really focused on implants, veneers, and stuff, you’ll put the majority of the spend there.

Ruchi: Yes.

Alex: That makes sense. Play down the GD stuff. You’re not getting tons of dentist– Even though I assume they want some of those in because it’s a segue to getting the cosmetic procedures.

Ruchi: Yes. One of the biggest component that we actually have started realizing is existing patient data. It seems very logical to target around a five-mile radius in your clinic but are you sure people do not travel to work from a specific location and the workplace is right next to your clinic?

There are so many nuances when you actually look at your existing patient data for a year and you look at the zip codes, you look at the revenue by zip code. Again, just making sure we are not looking at anything which is not HIPAA compliant, but looking at existing patient insights, you understand that there’s so much in terms of targeting.

You can always make sure that your campaigns in the same region are going after different zip codes and they’re not competing with each other.

Alex: That’s pretty sick, dude. That’s smart because a lot of people just draw the radius and be like, that’s where my head went. I’m just going to draw on the map and make sure my locations don’t touch. You’re looking at the revenue by zip code, by area because I didn’t think about that.

Sometimes you book a dentist by your office. I’ve done that with different primary care and stuff because I know I’m going to be here and that’s–

Ruchi: It’s just easier.

Alex: I’ll just run out of work when no one’s looking. Okay. Very smart. All right. Let’s say, though, that you have two GD practices that really care about general dentistry and they are close to each other. What do you do? Do you not overlap the circles or the maps? Do you keep them separate?

Ruchi: Again, it all comes down to what they do. The messaging is also very different. Think about it. You have two clinics very near to each other. They both do general dentistry. They both do implants. They both have a very visible need, and both of them have the same zip codes where their patients are coming from.

Even then, you can always differentiate because one of them could be very kid and family-friendly, the other one could be specifically for seniors. Even though it looks like they’re exactly the same practice, one of them could be established 50 years back and have a lot of credibility. That’s what goes into their ad copy.

You have to let both the campaigns target all the zip codes that matter to them where the existing patient data points us to, and you have to let them get whatever share of the business they can in the regions. Always remember, they’re still not competing with each other because it’s in the same ad account. One of them wins, the other just does not get the key.

Alex: Oh, that’s the key. There we go. Man, I feel like I’m going to be able to do PPC after this talk. All right. That’s what you do if they’re all the same account not ad group, but you can’t do that with multiple domains. That’s what you taught me earlier before we recorded this. Ad account, it’ll only serve one of them. Okay. How does Google know who to prioritize?

Ruchi: It’s on the bids. Quality score. How good are my ads? How relevant is my landing page?

Alex: They do compete.

Ruchi: Yes.

Alex: They do compete.

Ruchi: Yes, but they don’t end up in a bid war. It’s not like you are bidding $5. [crosstalk]. I either spend money and win or I don’t spend money at all.

Alex: If you are one of the acquired dentists, you probably do need to fight for your right to party a little bit. Yes. You have to say, hey, do I have better quality scores than the other guy in town that you also bought?

All right. That’s interesting. That messaging does matter. Ad copy, but then landing page making sure patient access, all that stuff. Let’s talk about that a little bit. When Peak came to us, did they have the same call tracking and analytics system or did we change anything? Do they have online booking? What are they working with? Call, email, online booking? What’s going on?

Ruchi: I’m glad you brought that up because that was probably one of the most key components of Peak. When they came to us, we had appointment clicks. They have an online scheduler. However, anybody familiar with this domain would know that tracking is an essential piece, but it gets very tricky if you are sending the user from your domain to a different domain to book an online appointment.

That is what was happening with Peak. We had very weak signals with the conversion actions. Instead of actually recording somebody who’s submitting a form, quite a bit of the actions were more related to somebody clicking to go to another website.

Alex: Yes. Entity metric. That’s what was being tracked and fed back.

Ruchi: Exactly.

Alex: Who’s their online booking thing through?

Ruchi: They were using Next Gen before. We’ve actually gotten rid of it entirely. We are focusing on only form submissions.

We are only focusing on phone calls, and with phone calls, we are using a patient prism. It gives us signals all the way down to, okay, this person called X, Y, Z number of calls connected, and only three of them actually ended up booking an appointment. We pass all that data back into Google ads [crosstalk]

Alex: Because you can’t have pixels anymore, so you’ve got to send offline conversion.

Ruchi: Yes.

Alex: They have no online booking on their website anymore?

Ruchi: No.

Alex: It’s all phone and email. We have not seen conversions drop off. That’s interesting. Hey, we love Next Gen, by the way. Great vendor, but it didn’t work out on this one. They don’t have online scheduling. That’s interesting. Everything’s still humming on fine. That means the call center’s good at calling you back immediately. [crosstalk] giving good information, I guess.

Ruchi: Exactly. Again, it’s always a question. Is an online scheduler more efficient than a form? Believe it or not, with quite a bit of our clients, we’ve learned that when you get somebody on the phone call, the chances of actually converting them get way higher.

Alex: Than online booking?

Ruchi: Yes. That’s something that again–

Alex: Why?

Ruchi: Because when you’re talking to the person, it’s so much easier to ask the questions or bring out all the reservations that you have, or any queries that you might have. When you’re doing an online– Think about Zocdoc. You go in. Zocdoc has a very high conversion rate, but the-

Alex: They’re not so much.

Ruchi: Exactly. Because it’s so easy to cancel an appointment, you’ve never connected with the service or anybody on the end of the client. When you’re on a phone call, they’re actually assuring you about the service. They’re telling you that we– Again, I’m not saying that every-

Alex: I just did it. I just booked an appointment with a new dentist where I live now, where I work. That’s an aside. They did walk me through their service and what the new one would be, and I did make a connection with them. I’m like, “Okay.”

He wasn’t like the friendliest guy. If I had booked it online, maybe I don’t go up because I just went online, booked it. If it’s inconvenient that day, I just cancel it.

Ruchi: Exactly that.

Alex: That’s not a huge testament for online booking. That’s very interesting.

Ruchi: I wouldn’t say it’s a universal truth. You have to test it out. That is why you need to have a CRO component. You test out your landing page, you see if an online scheduler is working better than a form. Do not go by what the industry standard says. You have to try, test it out, and decide for yourself.

Alex: You know what you should be doing? I think on my book, it’s important for a certain segment of people like me, I would rather just do it, but then call back.

As soon as they book it, “Hey, I just want to call and confirm, what were you thinking? Did you have reservations? By the way, we have an ongoing dentist care club or whatever. You’re going to get 40% off cash pay or what insurance.”

Someone should be calling so that you get more of a commitment. Anyways, it worked here. Anything with PBC that we’ve done that’s hyper wizardry that some other people couldn’t hear about that wouldn’t damage Pitt’s business?

Ruchi: Yes. We actually did pivot our strategy a few months back. I was just talking about one of their clinics, which is a make-or-break. Of all the clinics, we do know that it is placed in one of the best locations.

They have very high revenue from every patient that they acquire. They have a lot of capacity. It’s a big clinic. The problem was, we were getting some really good quality leads. If you look in Platform, you would think that Cardinal was doing amazing, that cost per lead keeps coming down every month.

However, the feedback from the client was slightly different. They were not seeing the leads actually convert to bookings. It was not that the keywords were not relevant. There was something going on about where the dollar’s going. Is it that we are targeting the wrong places? Is it that there’s an availability problem? Multiple things that we needed to dig into.

One of the things that we realized was, most of that clinic’s revenue was coming from a specific set of zip codes, and it was not the keywords. A very low-intent keyword like just dentures was actually converting. However, a high-intent term like dental implants near me was not converted for-

Alex: This is an older demographic or something?

Ruchi: Exactly. What we realized was-

Alex: Saying that they’re not the smarter ones and not the example ones, but that’s what happened.

Ruchi: What we decided to come up with is, okay, we know that these are the zip codes where things are working really well, and the other zip codes, we need to be super high-intent. We created two campaigns out of one.

We maximized our dollars. 80% of whatever dollar we are spending in this clinic in specific set of zip codes, and we focused on both mid-intent and high-intent keywords. If you are in a zip code that I have flagged as high priority based on past data, and if I know you’re searching for just dentures, I still want an ad to show up because I know somebody in this area has always had a high– They just showed up.

That’s how we allocated the dollars. 80% of spend goes in the zip codes that we think are actually helping them get patients, and 20% goes to the other low-performing zip codes where you still want the presence.

It’s not like they are not bringing in revenue or patients, it’s just not as high ROI as the other zip codes. We implemented this back in June, and things have been pretty good. If you look at my cost per lead, it’s gone up. It’s skyrocketed. We had–

Alex: High cost per lead.

Ruchi: 100%, it’s like 3X times compared to what we were doing before. However, if you look on the business side of things, they are pretty much closing 80% of the leads that they are getting because of the quality of the leads is so high that they’re actually being able to hit their goal of 150 patients a month.

Alex: Well, guys, if this isn’t a case study for CPL sometimes doesn’t matter, you actually have to know what is going on with the end client revenue. Ruchi, I can’t believe how much I’ve learned.

All right, guys, I’m being told to speed up. This was brilliant. That is an example of why CPL sometimes doesn’t matter. Leone teaches us that all the time like, “CPL matters.”

Okay, we want to see that going down generally, but what really matters is the revenue here, which I think if you don’t know that, we got lots of things to connect and to figure out. Ruchi’s figured it out with our great clients at Big Dental. Ruchi, thanks for joining us on Ignite.

Ruchi: Thank you.

[music]

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