Reactivate, Retain, Repeat: The Formula for Smarter DSO 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: What’s going on, everybody? Man, Ignite has been off the chain this year. I’m very proud of the content that we’ve been churning out. I’ve been learning a ton. We’ve gotten more tactical this year than ever.

Today’s going to be really fun because we’re going to get to talk to one of the best DSO marketers in the country. Obviously, I love DSO for many reasons, not just because a lot of our clients are DSO, but because DSO’s dental groups, for those of y’all not familiar with DSO, dental support organization, they consolidated and retailified many years ago. Their advertising and marketing is generally best in class when it comes to multi-site provider type stuff and healthcare. I’m really pumped. Ashley, welcome to our crazy, crazy show, Ignite.

Ashley: Hi. Honored to be here and excited. Thank you.

Alex: Guys, we’ve got someone that’s honored. This is crazy. This is so cool. Honored. I’m honored to be here because I get to learn. This is where I get all the tips and tricks, and I post them on LinkedIn like they’re my own ideas. Really, I stole them from you. Ashley, where do you work?

Ashley: I am the head of marketing at Smile Partners USA. We are a dental service organization in five markets. We just closed two more offices in Chicago. We now have 112 locations throughout the United States.

Alex: 112. How many are individual brands? How many brands do we have?

Ashley: Oh my gosh, that’s such a great question. You’re really testing me. Over 70. We have about five or six groups that are spread across the five markets. The rest will be individual brands. Branding identity is huge for us and is definitely a focus for this year.

Alex: House of Brands, not easy. You have a bunch of onesies. You have a clinic, a comprehensive dentistry, that is here in my town.

Ashley: Is that where you go?

Alex: Listen, I don’t really go anywhere. You can tell.

Ashley: Those [unintelligible 00:02:10] look pretty good.

Alex: I’m going to say thank you. They’re not veneers yet, but [unintelligible 00:02:14] he keeps telling me he gets them. There is one that’s even closer. They are DSO as well, but they are like a minute from my house. I go there. This one’s 15 minutes from my house. Same town, but anyways, it’s sprawled out. It looks good.

You’ve got a lot of brands, a lot of domains to run, and a lot of marketing to deal with. This is fun. Ashley, head of marketing. What else is the team comprised of, skill sets, and how many people’s in marketing?

Ashley: Oh my gosh. Not to toot my own horn, but over this past year, we did double the size of my department. I have a brand marketing manager. She’s the one that’s really fulfilling that role and helping these offices keep their identity. She’s helping build out the tone, audience targeting, the copywriting.

I have someone that is specifically just in charge of the paid media. She is managing hundreds and hundreds of campaigns for each and every office, managing their budgets, the keywords, the headlines. She’s actually in a conference right now, learning the greatest about performance max campaigns. We love that.

Then I have someone who is a digital marketing coordinator. His main role is facilitating the office requests from anything, from like a high-res logo. They might need a flyer, they might want to do an Invisalign promotion, or something. We’re fulfilling those day-to-day asks of the offices.

Alex: I love it. We’ve got brand creative and paid media in-house. That’s awesome. You know a ton about SEO. You’re the owner of the SEO minds there of the SEO strategy [unintelligible 00:03:43] Got it.

Ashley: Yes. Strategy comes from me, and then I filter it down. We’ve been working on a very large website project the past year, where we’re transferring our poor little sites that are about 6 feet underground onto a new user experience template. That is mobile first, which is crazy to think in the year of 2025. Then search optimized from a local perspective because we have dental offices on every single corner. We need to make sure that we’re ranking for those dentist near mes, dentist in Alpharetta, for instance.

All of those localized are so important coming back from the website content and then even the Google business properties. My background is in internet strategies. Really following that user from the first touch point all the way through the end of conversion. Calling the office, entering in a contact form, whatever we can do to get those little tushies in the dental chairs.

Alex: Get the tushies in the chair. We’re going to talk about full funnel advertising and reactivation, all that fun stuff in a second. You mentioned dentists near me. Have you changed any of their names to dentistsnearmealpharetta.com? My colleague sent me this. Under Plane of Fitness, there’s a business. The business name is– I’m looking at the picture she sent me now. Best Nail Salon Near Me. Best Nail Salon.

Ashley: I’ve seen that. I’m like, “What year are we living in?” It’s a black hat SEO from the 1980s. It’s funny because one of our groups in Alabama, they are Dental Associates from Near Me. [laughs]

Alex: Guys, it’s only going to work for like a year, and then Google figures it out. Stop. The Yellow Pages still cracks me up. That’s why everybody was AAA painting and AAA HVAC was because you would get opened first. The Yellow Pages AAA would be the first one. Now we have the new version of that.

Back to marketing. I love that you have some of those things in-house. I always advocate for creative strategy needs to be owned in-house, so does marketing ops. Keep the tech and the brand in-house and outsource a lot of things. Y’all have kept paid media in-house, too, which is really cool and interesting. You’re realizing, hey, listen to Speedmax and LSAs and Denville and all those fun new stuff and dental. Let’s go learn. She’s out there learning. I’ve chatted with her. She’s incredibly bright. That’s fun.

Guys, if you go that route, your Ashley needs to know digital very, very well. Needs to know digital very, very well to keep up with all that stuff. What’s a trend [unintelligible 00:06:06] You did Daydust, Ashley, and this will go live in April, I think. 2025, what’s the biggest trend you’re looking at this year to stay competitive in the DSO space?

Ashley: The biggest trend I think is really hard just to nail down. I think you really need to be open-minded to not just what is trending today and what trended yesterday, but also keeping an eye on into the future. I’m really taking a look at personalized, omnichannel. Patient engagement is key, especially with our demographics, how we have some offices in the South. Those demographics still really like to open up a magazine or receive something in the mail. However, with my focus on digital, I have to make sure what we might be sending someone in Alabama in the mail, how is that coinciding and landing with the digital side as well?

Also, consumer expectations are rising while their attention span is limiting.

Alex: Depreciating.

Ashley: How do we keep that top of mind? By leveraging maybe some AI-driven personalization. While I don’t love AI and I really don’t want it to take my job someday, I don’t want to sleep on it and we do need to utilize it, whether it’s help with patients’ calls and screening and how we’re pulling sentiments and how we can take that and learn from the specific keywords that the AI is pulling from those phone calls and how we can utilize that within our marketing.

Then obviously SMS and email is huge. We want to meet patients where they are on social media. Then, of course, with all that in mind, really being transparent and driving patient loyalty through that acquisition.

Something that’s really top of mind for me this past week and even going into this week was re-engagement. Those campaigns are huge. I’ve been working with my team to try and re-engage patients who have missed or canceled appointments. I get it, everyone’s busy. Sometimes we’re going to have no shows, we’re going to have people that cancel last minute. How are we continue to speak to them and stay top of mind?

They are putting emphasis on their health and their mouth. If we’re targeting that certain segment of those missed or canceled appointments, that may lead to some unsubscribes, but I’m okay with that. I think at the end of the day, that is going to lower our cost per leave, but also is going to help clean up our list and abide to those GCPA regulations.

Alex: I love it. You’re looking from the beginning of acquisition to retention and really focusing our attention. I want to get to that in a second. That was really interesting that you said us people here in the South, we like to open things. I do. I’m a timed-out person. I like to open something.

You’re saying you wanted to match the brand. How do you do that with 100 different brands? To send things out, direct mail pieces that are in matched digital. Are you re-skinning? How do you know generally, and is Alabama bucketed the same as Georgia? Hey, they like direct mail plus this, plus OTT. How much do you segment? How do you do this?

Ashley: It’s really not going to be Alabama or Georgia as a whole. It’s really looking at the individual offices. What are their needs? Did we just hire a new provider? Do we need to do a new provider campaign, put their face on the mailer, give them brand awareness, and associate their name with the office? Do we need to do some promotion? Their schedules might even be full, and they’re booking out 60-plus days. That’s not the office that we would want to send a mailer out for. Maybe we just bought a new office in that area.

Again, we want to try and reach a different demographic. It’s really a case-by-case, different situation. I can’t say that one thing that we’re doing for an office works great for another. It’s so different. There’s so much testing that goes involved. I would like to say that I have a playbook for most situations I do. When you get down to the nitty gritty of matching the print with the digital, the omni-channel, everything else. It’s a case-by-case situation, depending on what’s going on behind the curtain in that office.

Alex: Two things I heard that I really liked there, no location is the same as the others. Georgia can be bucketed because where we live up here, it’s rural, but this is not the same as a really rural town, and how they want to receive information. Looking at every location individually and whether they have a private rider.

Suddenly, she did also say that she is monitoring capacity and not advertising and spending any time where they are already booked out 60 days, guys. Muy importante. I see a lot of advertising going to places that don’t need it. The online appointments are showing two-plus weeks out. Please stop advertising there.

I want to talk about automation first. Are you guys using a CRM? I know dental has a ton of its own tooly things for this. What’s the technology, and how do you bucket people? Is it they got an implant, GED, they need to come back? How do you keep it all straight, exact, et cetera?

Ashley: For patient management system or CRM, we utilize Next Health for our online booking and then keeping track of all of our patient communication. That’s where we send all of our campaigns. Then the offices also utilize Dentrix. Those two platforms, most of our offices. Those two platforms are constantly speaking together.

Next Health is what I utilize for all of our patient communications. We just revised all of the verbiage for our appointment reminders and switched up those cadences. We’re really trying to close that gap in that pool with the no-shows and the missed appointments I just expressed earlier. I’m excited to see how that performs. That was just launched on St. Patrick’s Day.

I’m going to collect some data for the next 90 to 180 days or so to see if switching up that cadence, when those patients are receiving the appointment reminders, if that’s going to allow more time for them to let the office know, yes or no, I will not be there.

Alex: I love it. Data. You’re going to collect some data. What are you going to be looking at? Everybody’s always asking this. What actually matters? You guys run some traditional mailers. What data do you look at on the acquisition side? Can’t really tell direct I’ll influence this. Tell us what matters most to you, and all of your marketing campaigns [unintelligible 00:12:10] and acquisitions.

Ashley: I need the [unintelligible 00:12:11] patient numbers.

Alex: That’s it. Guys. Oh, hallelujah. It is impossible sometimes to say it came from this and this was the touch and all that, especially in healthcare. Okay, Ashley, go on.

Ashley: Attribution is huge. I’m always driving referrals. We do utilize a couple of platforms that break down that referral. Whether that lead came from a Google ad, whether it came from an organic or whether it came from social media, or if they just directly called the office.

I also have within our data analytics, those referrals and how they’re broken out. I can make very educated decisions based on that referral data and the attribution. At the end of the day, if you were to ask our CEO, that new patient KPI is by far the most important. Then I’m looking at, again, those referrals, but then also how much we’re spending per lead and per acquisition as well. I’m trying to figure out what is driving those dollars. Then what is the most bang for our buck, so to speak, on that return on investment.

We’ve been testing a couple of different things, like playing with third-party answering services to answer our new patient calls, to see how they can help drive that acquisition when it’s outside of business hours, or during holiday hours, or the office that may have closed for lunch. Of course, if I’m a mom, and I’m on my lunch break, I might call it noon. If the office has maybe shut down for that hour, we have this third party that will pick up that phone and schedule that new patient via our online booking.

Then, even playing with some more digital levers as far as the Zocdoc platform and how that’s going to help us fill up those schedules for those offices that aren’t booking out more than two weeks.

Alex: I love it. Talk about call center a little bit. Some marketers have overlapped some. I interviewed a gentleman yesterday. He’s actually training the call center people to convert because he got tired of them not converting. It was more high acuity, and you have to know ortho and all that, orthopedics, not orthodontics, and stuff like that. How much overlap do you have with this call center stuff? Is that reporting to the COO? Do you influence, say, scripts and conversions? Hey, why aren’t they converting here?

Ashley: Yes, I helped roll out that program. I can’t take full credit because I did work hand in hand with the directors of operations on that with the scripts, and just trying to really optimize. They have this third company, third-party call center. They have a playbook. They know what works and how they’re rolling this out for all of the other healthcare companies that they help with this program.

That doesn’t mean what they’re doing for everyone else worked for us, and also not all or our culture. Especially when we have Dr. Jones, who’s had Patty at the front desk for 30-plus years, and they like to do things a certain way, but Patty doesn’t like to answer the phone sometimes. [laughs] We need to make sure that script matches what that office needs as well as making sure that the services that they’re offering match exactly whatever the call center is saying as well.

Alex: Come on, Patty.

Ashley: [unintelligible 00:15:14] me. Patty’s actually my mom’s name.

Alex: Mom, pick up the phone. It’s lunchtime. Somebody needs a tooth. I love it. I know you’re a big proponent of proactive health education. I think the country is starting to learn dental health is health. You guys really love acuity, though. I always wonder, how much is it investing educating the community on dental health? How much time do y’all spend on it? Or mostly just lower funnel, grab them when they’re looking for a dentist.

Ashley: This is so important to not only myself, but our CEO as well, in understanding the systemic mouth and how that’s connected to literally every other part of your body, every organ, and how they all work together. It all starts here, right up here.

The patient education is becoming more top of mind for myself and my team, whether that’s creating flyers for an awareness month. April is oral cancer awareness month. How are we continuing to educate patients on that importance of screenings? Really strengthening that brand trust through educational content is going to continue to be top of mind. Then just figuring out how we can roll that out across every single brand, every single office.

Alex: It’s not easy. [crosstalk] Don’t downplay it. You took oral awareness month, which you knew that, that was April. You took that, and you said, “Hey, listen, it’s a good chance to advertise for screenings.” A healthy thing, you can use it as a CTA for something that gets people in, I guess. That’s okay. It’s commercially intent. I can tell, you downplay the very smart things that you’re doing. This is good. Guys, you can use an educational piece to drive people into the top of the funnel. I love that.

Ashley: I think the important part there, because that can be scary. Oral cancer, I think, is a little scary. Not utilizing that educational content as a scare tactic, more as awareness and sense of urgency. “Hey, we have the proper tools in our offices to do these screenings. Ask how we can help you today.”

Alex: It is scary. I signed up for this Galleri test, and they’re going to come screen me for all the pre-cancer to test stuff. I’m like, “Oh my gosh.” They had to cancel and move it back a couple of days. I’m like, “Okay, I don’t want to know.” Yes, it is very scary, but everybody needs the education. It is always better to know early with stuff like that, [crosstalk] or you have no chance. I’ve been through that too.

We only have a few minutes. You love SEO, and I love SEO. I want to talk SEO a little bit. What do you guys use to keep up with the directories, the listings of all that? Do you have a patient review system that is going out upon checkout? What are some of your SEO secrets? Don’t share secrets. I don’t really think there are secrets. Where’s your focus?

Ashley: Yes, they’re definitely not secrets. I think they’re tips and tricks, industry standards, really. We utilize Birdeye for all of our online listings. That’s where we store our locations. That’s also where our review generation campaigns live as well. When a patient checks out and we hope they had a great experience, we’re going to send them an email and text within a couple hours of them leaving. Then they can leave a Google review or a Facebook review, or even a Birdeye review, because that’s a thing too with the platform. We really like that platform, Birdeye, as a whole. We’ve been a partner with them for several years before I joined Smile Partners.

There’s so many online review platforms or online listing platforms. I’ve used Yext in my past. I’ve used Uberall. They all do the same things, just cost more than others. From a local perspective, and everything that we’re doing, because like I mentioned earlier, our offices, some of them are so close together. We need to make sure that they are standing on their own. Their reputation management across the board online is all unique to them, tailored to them. They have pictures. We’ll send photographers out. I will ask the office managers for pictures all the time. Send us everything. We love the content.

Alex: It has to look unique. When someone lands on the location page for that location or that website, it needs to look unique. It has to show their personality. There has to be walkthroughs of the clinic. Mama wants to see where she’s about to bring her kids, guys. That applies to every single healthcare vertical.

Ashley: She’s going to read those reviews. Mama Patty’s going to read it.

Alex: Reviews always have nothing to do with the provider or the dentist. It’s always, “Patty didn’t answer the phone. Patty didn’t get my insurance bill. Patty screwed up my appointment.” Patty can’t be the patient too. You get the point. It’s always front office stuff. That’s so frustrating. I think Birdeye has a connection with Yext. They push out through that.

This is a question I’ve always wondered for myself. In dental, do you also claim the listings of the dentists, or they’re too transient? It’s no one’s going to look for a dentist, so you don’t. I’ve seen it both ways

Ashley: Yes. I’ve only actually ever seen this for some of our Alabama offices for the dentists who have created their own GMBs. We’ll claim those and then merge them.

Alex: If you should. Don’t worry. Secret safe. I like it because a lot of times the dentist will show up in GMB. I’m like, “Guys, for like $50 a month, you can just have another potential ranking point.” They’re like, “Well, yes, what if they leave us?” I’m like, “Well, then it’s one less the excess thing that you’re doing.”

Ashley: Eventually, the doctors will leave. They will retire. It’s the name of the game. We’ll rebrand.

Alex: It’s the only way for a small team to keep track of everybody, guys. I love it. I only have a few minutes. I’ve got another one. One final question. You can’t say, what is the biggest trend you’re looking at going forward into ’25 that you’re excited about? We’re both nervous about the robots taking our job. We’re not going to say that. What else?

Ashley: I don’t want to say it’s a trend. I think it’s just an evolution and a culture. Bridging that gap between marketing and patient experience. Sometimes I think we overlook retention strategies. I think that’s been my main spiel today is what are we doing post appointment? It’s not a viral trend, but I do think it’s something that we all need to keep our eyes on and our grippers, and is how are we speaking to our patients after they leave the chair?

Again, going back to that education, being proactive there, building on loyalty, referral programs. Patty, “Thanks for seeing us today. How was your experience with Dr. Jones?” “Oh, it was lovely.” “Okay, great. Please tell us to your friends and family. We would love to give you some referral credit.” That is huge. What are we doing to build upon that? Then, just making sure that whatever I’m doing behind my chair and in my computer is aligning with all of my operational teams. Really, that patient journey is cohesive.

Alex: I love it. Patient journey, cohesive eyes on, and grippers in everybody. Patty played many roles today. Thank you, Patty, for being the patient. Thank you, Patty, for being the front office. I look forward to you enjoying your space.

Something I see some of the best groups do is they call the patient after they left you. It’ll always go to voicemail. Nobody’s going to pick up the phone from a DSO after they’ve already got their teeth cleaned. They call and they say, I hope, gosh, all this automation, we’ve gotten away from humans.

Ashley, I learned a lot from you. We learned some very technical stuff. I love it on reactivation, retention, the CRM type stuff that you’re using, how you look at individual markets, how you judge acquisition and numbers, and the KPIs that matter most to you, and how you juggle 100 and some brands with 3 internal colleagues. Ashley, thank you for joining us on Ignite.

Ashley: Thank you so much, Alex.

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