Practice Perfect

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"Start thinking about where you're going to play, what can you be the best at? Answer these questions. What can you be the best at? What can your practice do better than all of your competitors? And importantly on the back of that, is that something that the market wants? Because you can be really great at shining toenails, but if nobody wants to buy toenail shining, it's irrelevant. Okay? So think about that. What is it that you can be the best at? What can your practice be the best that that your clients actually want, need, and deserve to get from you?"

Nick Dumitru (00:43):

Welcome back to another episode of Practice Perfect. The title of today's episode is, "Stop chasing the silver bullet and get to work: understanding strategic and tactical objectives to get things done." There's a lot of ways that you can grow a cosmetic practice, but there's only one way you can fail at it, not getting shit done. That's it. I see doctors make this mistake over and over. They go to conferences and they come back and they dump everything that they've learned on the desks of their employees. They'll come back with all kinds of tactics and new tricks and new tools and the greatest and latest offer that they can use to grow their practice, and they try to make it somebody else's problem. The end result is that really nothing ever gets done.

Nick Dumitru (01:31):

Here's the thing about the latest shiny object, and here's the truth about growing cosmetic practices: there is no silver bullet. There's no magic wand. There's no secret tactic that you can use. Nobody's reinventing the wheel here. Nobody's coming up with anything so revolutionary that it will catapult your practice into the stratosphere. It just doesn't exist. I don't care who you talk to. I don't care what claims they make. The fact of the matter is that there are some fundamentals that you have to put into place and you have to do the work. More importantly than that, you have to start to think strategically. Because there's no single tactic that can really make or break your business, you have to start thinking about why you're doing things because at the end of the day, the reality is that the wrong strategy and inaction will cause failure 100% of the time. So let's discuss the difference here between strategy and tactics. I think we've discussed tactics and strategy in previous episodes, but I think it merits going over them again.

Nick Dumitru (02:34):

What's the difference between them? Strategy is the what and the why. What do you want to do? "I want to take the beachhead." "I want to have the largest skyscraper in the world." "I want to have the biggest Botox practice and nonsurgical practice in my city." Okay? That's what you want to do. Why do you want to do it? Those are the fundamental questions. Why do you want to take the beachhead? "Because it will lead to winning the world war," right? That's how military strategists may have thought about it. "We need to take this beachhead because we have to get a foothold into mainland Europe," for example. So there's a why behind it. "We want to have the largest skyscraper in the world." Why? "Because we may attract more tourism. We need to be looked at as leaders. We want to attract more business." "I want to have the biggest nonsurgical cosmetic practice in my city." Why? Sometimes the why is just because you want to make more money, but the reality is that your, 'why,' should include exclusivity, something that you can do better than anybody else.

Nick Dumitru (03:37):

Now, tactics is the what and the how. "I want to take the beach head." What are we going to do to get there? Well, we have to put a bunch of ships together. Right now, we're getting down to the tactical level. We have to start hiring a construction company to build that skyscraper. How are we going to do that? "Well, I know a guy that can make an introduction to a construction company or we're going to tender for bids." The, 'how,' is extremely important when it comes to tactics, but if you don't have the strategy behind it, it's doomed to fail. Because if you have tactics without strategy, your chance of success is greatly diminished.

Nick Dumitru (04:13):

The other thing is action. If you have tactics and strategy without action, you're also destined to fail. So I want you to understand that this paralysis of analysis, this coming back with a thousand different tactics and not knowing why you're implementing them, right? Running around in the circle is not the same as running forward. I've mentioned this before, I mentioned it in my book. Activity doesn't equal progress. You're after progress here. In your practice, you want to move forward. You don't want to just run around in a circle chasing your tail with the latest and greatest tactic that you've come back with from the last seminar that you attended. So let's go over some of the possible growth strategies that you can use to grow a cosmetic practice and understand that really, you should be doing some of all of these, but I have grown practices using just one of these and I do have clients right now they're using a single strategy and it's working just fine.

Nick Dumitru (05:08):

The first one will be social media. The second one will be direct to consumer advertising. The third one will be content creation and SEO. The fourth one is reviews and influencers. And the fifth one is public relations. What I'm going to do is unpack each of these a little bit for you. So in social media, you could do videos. You can go on YouTube, you can have a YouTube strategy, and you're going to be the King of YouTube or the Queen of YouTube, and you want to own that space. You're going to produce the most videos, the best videos, the most interesting, and action taking videos that you can. So that's one strategy you can use with some sort of social media.

Nick Dumitru (05:42):

You can do posts on social media, like Facebook, long posts, video posts. So now you can use strategy both on YouTube and social media. You could start a group on Facebook. Facebook groups are something that Facebook has gotten behind. So that's another social media strategy. You could start a beauty group and really start to market to those people and then start to siphon off patients and clients from those groups. Social media is one way that you could do it. You could theoretically do it as a single tactic.

Nick Dumitru (06:10):

The second one is direct to consumer advertising. This is one that we heavily employee. It's one that I believe in mostly because you have control over your business. So this is something like social media ads, that's interruption advertising. Or you could do search ads where it's seeking advertising, when people are actually looking for a product or service with Google ads in any kind of a social format. You could do Pinterest ads. Anything that goes direct to consumer and you've got control over. Again, I've got clients that are very successful doing just this. They make a lot of money just doing direct to consumer. The advantage is that you can really control the platform because you're paying for it and as long as you stay within their guidelines, you've got a lot of leverage there.

Nick Dumitru (06:51):

The third tactic was content creation and SEO. By SEO, I mean search engine optimization, if you haven't heard the term before. So this is really where you're engaging with the seeking behavior of consumers. They are out there and they're looking for a solution to a problem or they're looking for a provider actively. This is a lot of bottom of the funnel stuff that you can do. They're going to take action right away. Again, this is fantastic. You can put out a lot of relevant content, do your keyword research, make sure that it's relevant and put out the content that attracts consumers and position yourself as an authority. You can build a very big website. You can use blogging, for example, to bring in those people and then get them to take action from your main site, either on mobile or desktop.

Nick Dumitru (07:33):

You could do vlogging. Again, this content creation where you're just producing videos, so not necessarily for social media, but you could put it on your website and then promote that or use SEO to bring them there: informative videos, educational videos, videos that answer questions. All of that stuff you could do. You could do a lot of this content creation. So again, that's another strategy. Absolutely, that'll work. It can work. It takes a little longer. There's a lot of effort involved, but it can work.

Nick Dumitru (07:59):

The fourth strategy was reviewers and influencers. On a previous episode we talked to Joe Sinkewitz, owner of Intel Influence. You can take a look at that episode, have a listen to it, and you can hear more about this influencer marketing. But again, you can recruit people to push your message. That's what influencers do. You can recruit a bunch of people, you can pay them. It's slightly controllable, depends on the quality of the market. You can leverage that once you get it on your own website. But again, this is a theoretical potential strategy. You could also try to become an influencer yourself and get yourself an audience, do all kinds of crazy stuff and get people following you as a physician or a lot of before and after to do surgeries.

Nick Dumitru (08:40):

I don't particularly agree with that, but I do see people in the market that are doing that and are doing well with it. Being in the market, getting this kind of third party endorsement is great for helping people convert better. Again, these kinds of reviews, getting a lot of good online reviews. You can try to leverage review websites and people that are going there will then see your great reviews and then check you out. Again, this is kind of a parasite strategy. It works well. You should be engaging with it no matter which one of these you do. But again, if we look at it as a single potential strategy, in theory, you can get some business that way. Yes, it can work.

Nick Dumitru (09:13):

A fifth one is public relations. The last episode we did was all about public relations. Have a listen to that if you want to learn more about that. But again, this is third party endorsement. This is exposure. It's using someone else's audience to try to build your practice. It can work. It's a longterm asset. It's an evergreen asset. Again, it's another strategy. So you've got all of these strategies, you can look at them and see which ones fit your business. This is why I want you to really start to separate strategy from tactics. When you're looking at, let's say, "I want to build the biggest surgical or nonsurgical practice in my city, which of these strategies are going to help me get there?" Then within the strategies, which of the tactics? "I think social media marketing is the way to go."

Nick Dumitru (09:58):

Maybe you've gone to one too many of these meetings and plastic surgery seminars and one too many of the gurus have been on stage and told you that social media is the only way to go, and you've totally bought into that and you'd like to try that as your strategic objective. Social media; you've got your strategy, your strategy is going to be social media to build the biggest nonsurgical practice. Then you look within social media and see which tactics will work best for me. "Where do I put my money and effort? Is it in videos? Is it posts? Is it in groups? Is it a mixture of the three?" So what's the strategy? And then go down to the tactical level and see how you're going to implement that.

Nick Dumitru (10:33):

What I want you to understand, no matter how you look at this, is that there is a cost to any tactic. It can be financial, it can be time, it can be emotional and spiritual. What I don't want you to do is I don't want you to jump on the latest bandwagon just because it looks, "free and cheap." Right now, I'm doing air quotes. Unfortunately, this is not a video podcast, but just imagine me doing sarcastic air quotes for, "free and cheap," because the fact of the matter is that you still have to go and put in the work. Even if you pay your staff or you have a company do it for you, you still have to pay. There's a payment to be made either with your own blood, sweat, and tears or with your family time. You may be sacrificing time with your kids, time with your spouse or just financial where you're just doling out this money for salaries and third party companies doing it for you.

Nick Dumitru (11:25):

Whatever the case, there's no free ride. Don't think that anything is free. If a guru's telling you that social media is great, "Instagram's the next best thing because it's free, it's free, it's free," it's not. You're a physician, you got to value your time. Your time is worth money and if you're putting your time into selfies, you're still putting in time into selfies. It's still costing you. If you're ignoring your kids to take selfies for your business and then prostituting them on there as well by bringing them into this because someone's told you that you've got to put your family on there, there's still a cost. There's a cost that they're going to pay and the increased exposure and seeing themselves and what that does to them, and there's a cost for you to do the work and put that on there and get it edited and whatever it might be. There's always a cost to it.

Nick Dumitru (12:09):

So think very carefully about the lifestyle that you want to build. That's where I'm getting at with this. When you choose a strategy, it's going to impact your life. It's going to impact your finances and it's going to impact not just your future, but your family's future, your spouse's future. Your extended family's future. Are you going to show up for those family events because you're too busy taking selfies and shooting videos. I'm not saying that that's wrong, don't get me wrong. There's a little hint of sarcasm just because I don't like doing that stuff. But if you're great at that and you love doing it, more power to you. Go ahead and do it, but don't kid yourself in thinking that you're not paying for it in one way or another. All right.

Nick Dumitru (12:48):

Now, that we've gotten clear on not following the next shiny ball, I'm hoping that you're clear on not taking everything and trying to run with it because the point of this podcast, I want you to understand two things here: one is really the difference between strategy and tactics and making sure that any tactics that you learn about when you go to these seminars, when you watch online videos, that they fit into your overall strategy, that they make sense, that they slot in and they support your effort and your overall goal.; And the second thing I want you to understand is that when you're coming back with a ton of stuff that you want to implement because you've heard about it and you dumped it on your staff, the net result is going to be inaction and inaction kills a practice. That's what's going to stop you dead in your tracks.

Nick Dumitru (13:35):

Having to do and redo and redo and redo things all the time because you're always jumping from one thing to the next and never following through is a guaranteed way to not net any results because you're just doing it out of desperation and you're doing it not because it's in line with your overall goals in your strategic objective. You're doing it because you just heard it and it's new and it's novel and that's not necessarily the thing that you have to do. You need to get the fundamentals in place first, then see where these new tactics fit in, what are the latest and greatest technology fits in? If you're going to send out a video make sure that it fits into your overall objective. If you're going to build a website, make sure that there is a reason for it and that people are actually going to access you through your website.

Nick Dumitru (14:19):

If you're planning to do 100% social media advertising, you don't necessarily need the website. That's an extreme example. You should always have a website, but in theory, you wouldn't need that. If you're starting a YouTube channel and you're going to get all of your business through the YouTube channel, you don't in theory, need a website because you are getting all your business from there and you could just get people to call. So all you'd really need is a phone number and the YouTube channel and a ton of videos, and you could in theory, get your business that way.

Nick Dumitru (14:46):

So think about that strategic objective. here's your homework. I want you to sit down and think about where in your market you want to play. When you're thinking about strategy, you're thinking about where you're going to do business and why you should be doing business there, and how you can do business there. If you're in a place where it's completely saturated and the one type of service, jumping into that market may not necessarily be the smartest thing unless you've differentiated or you've got a unique product or unique approach or a unique offer to give to that marketplace so that people can choose you.

Nick Dumitru (15:22):

Start thinking about where you're going to play. What can you be the best at? Answer these questions. What can you be the best at? What can your practice do better than all of your competitors? And importantly on the back of that, is that something that the market wants? Because you can be really great at shining toenails, but if nobody wants to buy toenail shining, it's irrelevant. Okay? So think about that. What is it that you can be the best at? What can your practice be the best that that your clients actually want, need, and deserve to get from you? What can you offer that none of your competitors can? What can you do that they can't copy? How can you become on replicatable, so that you're not in competition with them, you're not in competition with anybody? You're unique in the market and you can lead your marketplace.

Nick Dumitru (16:09):

Next, you want to talk about what is your strategy for being the leader in that space? So once you've identified the space and you know what you can be the best at, what's your strategy to become the leader there, to get the most exposure, to be looked at as the foremost authority? Then we get into the tactics. How are you going to go after that position? So a little bit of strategy, a little bit of tactic: social media, web, video. Start thinking about how you're going to go after it. These are just some of the questions you need to start to answer and once you've got all the answers, sit down and get down to the tactical details, the nitty gritty, what you have to do exactly to make that happen. Because again, like I said, inaction is a killer and the best way to eliminate inaction is to have clear steps to move forward and then take steps towards that because you don't have to do it, rather you don't have to like it, you just have to do it and that's how your staff has to think as well.

Nick Dumitru (17:04):

All right, so that's your homework. You've got your homework. Sit down, take a look at all the information you've amassed from online sources, my podcast, books that you've read, seminars that you've gone to and work out which tactic is best to achieve your strategic objective. Hey, you've got a bunch of stuff. Write it down. If you have to, make a list, make sure you're clear on your strategy, and then identify out of all of these things which can you implement and which ones will support your strategy? Then start implementing the ones that may give you the highest yield and that you can easily implement the quickest and then work towards the longer term goals. After that, that will give you the highest yield and start putting them into action.

Nick Dumitru (17:48):

The most important thing you have to do is stop getting ready to get ready and get something done. So I want you to go out there and make the moves that are necessary for you to achieve your dreams. Thanks for listening. As always, you can find these podcasts that thinkbasis.com or iTunes. Any links or anything that I've talked about in the podcast will be in the show notes, and if you've got any specific questions that you'd like me to address on future podcasts, don't hesitate to go to thinkbasis.com and just leave a message on the live chat over there and we will make podcasts for you. I'll try to find experts or I'll answer your questions myself and I will see you on a future episode. Stay tuned.

The post Stop Chasing The Silver Bullet And Get To Work: Understanding Strategic And Tactical Objectives To Get Things Done – Practice Perfect Podcast Episode #19 appeared first on Think Basis.

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"You have to think about PR as a funnel, right? Initially, you want to make sure that, a, your name is getting out there as much as possible in the right way and so you start off with a really big opening of the funnel, but then over time you can distill that down into what your particular area of expertise is."

Nick Dumitru (00:33):

All right, welcome back to another episode of the Practice Perfect Podcast. Today, we've got a very special episode. We're going to start talking about public relations. Now, public relations is an area that I haven't focused on personally in our business. We primarily do public relations for SEO value or to try to leverage it for other assets. I'm very excited today to have with us Bretton Holmes. This is his 20-year anniversary from starting Holmes World Media and we've decided to do this podcast to really shed some light on public relations and how it can be used.

Nick Dumitru (01:07):

Just like you guys listening today, I'm also going to be learning today because this is an area that fascinates me. Like I said, I don't particularly touch it myself, but I know it has tremendous value. It's added tremendous value in the past when we've worked with other firms with our clients as well. Bretton has a wealth of experience. Very quickly about Bretton, he has, like I said, been doing this for 20 years. He started his practice in the down and dirty business of Beverly Hills plastic surgery marketing, so he's going to have some stories for us I'm sure.

Nick Dumitru (01:36):

Bretton is also a former Marine in the United States Army, and while I'm not in the US being in Canada, if anything should ever happen with a world power, we will come crying and screaming to the American military. Bretton, I would also like to thank you for your service on behalf of the Canadians as well.

Bretton Holmes (01:52):

Thank you.

Nick Dumitru (01:53):

All right. Having said that, Bretton, I'd like to get right into it and I'd like you to really lay the foundation of, well, first where you started and then we're going to talk about what public relations is in your mind. Just give us a little bit of background about where you've come from. Like I said, you started out in Beverly Hills, you told me that, and I'd like to just tell the audience a little bit more about it.

Bretton Holmes (02:13):

Yeah. I got into media relations and image development via public relations after I graduated with a master's degree in playwriting of all things. I have an undergrad in criminal justice, so it runs again but I went in 180 degrees the opposite direction and ended up working for a firm in Los Angeles that specialized in medical healthcare PR for a lot of Beverly Hills plastic surgeons. I got thrown in day one to working with experts like Dr. Harry Glassman. I did PR for Dr. Gary Alter who's probably most famous for doing Caitlyn Jenner's transition surgery and quite a few others as well, Dr. Paul Nassif who is famous for a little show called Botched.

Bretton Holmes (02:59):

It was a great way to start because going into it initially I had no background in PR. My brother who's five years younger than me has a degree in it but had never ventured into it. What I found pretty early on was that the playwriting storytelling aspect really informed that process in a way that I had not expected it to. As a result of that was able to then start my own company shortly thereafter, working with medical experts of all different varieties and sizes.

Nick Dumitru (03:35):

It's great. Now, you said that you studied playwriting and storytelling and I think your take on public relations is a little bit different than a lot of people's. It's usually typically very schmoozy and just trying to get you in front of people. What caught my eye in speaking with you is really this whole aspect of story. Can you define for us what public relations means for you, and then, I want to jump into the story aspect, but just how do you define public relations? What is it for a doctor?

Bretton Holmes (04:03):

It's the way that reach out to what I call your potential patient base. That is people that are out there who need what it is that you can do for them but aren't aware that you exist. By engaging in a public relations effort, you're able to better inform them about what you can offer in a way that is essentially endorsed by a third party, i.e. the press, right? You're not out selling yourself directly. You're not necessarily doing as many ads maybe as you otherwise would be. You're providing information for the public to pick and then utilize and seek you out as the expert of choice. That's essentially in a nutshell what I see this.

Bretton Holmes (04:48):

The storytelling aspect, obviously, you got to have a story to tell, whether that's a treatment or a process that you utilize or you're commenting on a current event or something else that's in the press to get you press. They tend to have what I call a lemming mentality when it comes to stories that they do. It's not uncommon if I'm working with a doctor and we get them on one TV station in the local area, all the rest tend to follow suit, if we're lucky, usually. It's really a matter of making sure that you understand what the nature of your practice is, what you're trying to accomplish and getting that very honed so that you can get some messaging out around that. That's really the key, I think.

Nick Dumitru (05:33):

This is interesting. My take on it originally was that you were crafting a story to tell about the practice, but what I'm hearing right now is that it is a story in the press that you're trying to somehow come parallel to and then merge with that with what the practice has to offer. Is that correct?

Bretton Holmes (05:53):

It can be. That's one aspect of it, but you're absolutely right when you that one of the elements of doing effective PR outreach is generating a story from within your own expertise, right? I would say that's what I call the proactive side where about 70% of what I do is take a story that the doctor or the practice wants to get out into the public side and then we formulate that. We come up with what we feel like is the best pitch essentially. The other 30% is where I notice something in the press that aligns with their expertise or something they can talk about and then we put out a press release about that.

Bretton Holmes (06:33):

One of the things that I always tell the docs that I work with is, "You may want to just do this one type of procedure because it's your favorite one to do, but you have to think about PR as a funnel, right? Initially, you want to make sure that, a, your name is getting out there as much as possible in the right way and so you start off with a really big opening of the funnel, but then over time you can distill that down into what your particular area of expertise is." For example with Dr. Alter, he wanted to do one type of procedure, was running into problems because it wasn't at the time apparently popular procedure in the eyes of the press.

Bretton Holmes (07:13):

I said, "Well, we can get to that point. You're going to have to open up what you can talk about because at the outset what we really want to do is get your name out there as much as we can in the most proactive manner possible, and then over time, you'll be able to become known for this one procedure that you want to do.| That's essentially what ended up happening for him.

Nick Dumitru (07:32):

Interesting. One thing I like to do on these podcasts is I really like to get down to the minutia of examples of how this is done in the real world. Can you give me one or two examples from each of those cases, so one where you are creating a story? Just a concrete example so that the audience can really start to think about their own practice and what they can provide in terms of stories and how to craft them, and then, the other one maybe even like what's a current news story that you would latch onto today, for example, that you would be keeping an eye out for in the press?

Bretton Holmes (08:04):

One example, I would say is Alter is a great example because he's got a great name for a plastic surgeon. I think initially when we started working together, and I was still in my PR infancy but I was learning as quick as I possibly could, my philosophy is the only bad press is no press, right? A lot of doctors may hear that and say, "Oh, my gosh, what does that mean?" Well, I think for his case in particular, he had a procedure that was not really primetime material, I would say, in terms of being able to do a story on it, right? It was a difficult pitch to begin with, but it was also something that while the vast majority of women wanted to do wasn't something you could put on TV.

Bretton Holmes (08:52):

We had a discussion about that and I said, "We need to be able to come up with a way to pitch this effectively and show it so that those that are interested can do it." This was back when the Berman twins were big and they were doing a lot of press outreach and we're implementing some outreach that was negative about certain procedures that women were getting in prose. He made a really good point. He said, "Look, I don't really care if it's negative. People need to know where to go to get this done."

Bretton Holmes (09:22):

That occurred to me that that's really in a lot of respects with plastic surgery especially because you're dealing with some areas that may not necessarily be able to be put on the news at 6:00 or what have you that if you look at it from a perspective of, "Oh, this could be a potential negative," it may not be. You've got to think about it in those terms that you don't really know what the response is going to be until you put it out there and the worst thing that they can say is no. It doesn't mean that you can't go back to the drawing board and come up with another way to angle it or pitch it or tell the story of it, right?

Bretton Holmes (10:01):

A lot of times, they're going to want a patient. If you're doing press outreach, they want to do a human interest story, "How does this change the person's life? What is it about this that caused them to want to go seek out this particular expert?" et cetera. Things like that. When you talk about minutia, that's all it is. It's about getting down to the nitty-gritty details and providing the press with what they need which is a good story really. I think that's the biggest factor when you're doing PR, especially in the aesthetics world because it is so competitive. You've got a lot of different moving parts.

Bretton Holmes (10:38):

The press over the last, I would say, 10 to 15 years has changed considerably where I would say less likely they want to promote a particular doctor or what they perceive as promoting a particular doctor. If you pitch it in the right way, it becomes less of a promotion and more of an informational for the public. Part of what I do is I try to explain to them, "Yes, I know this looks like an aesthetic procedure and I know that you believe that you're 'promoting 'this doctor, but really what you're doing is providing viable information for a huge amount of the population that needs it and is looking for it. They might as well get it from you guys as opposed to some other outlet," if that makes sense.

Bretton Holmes (11:23):

What I have to do is play middleman between what the press needs and what the client needs and bring those two halves together.

Nick Dumitru (11:33):

That makes total sense. I want to unpack a couple of things here for the audience because the people listening to this are either practice managers or physicians that have their own practice and they're not necessarily always trained in marketing. A couple of things that Bretton touched on there are very important. The first thing is really the power of story. I'm going to tell you a quick little story at the end of this little ramble about good press and bad press. Story is powerful because it's how the human brain learns.

Nick Dumitru (12:00):

If you think about the way that religion and knowledge has been passed down over the centuries, it's usually through parables, through story, right? The Bible, any kind of religious texts, they all teach through stories because stories cause emotion. They cause an emotional reaction in the brain. We believe and understand and remember our emotions a lot easier than we do facts and figures, right? If you learn a statistic, you'll be very hard pressed to regurgitate it, but if you said, "Jennifer really healed herself very quickly and got back to life and was able to have three kids and a wonderful family and lived with her husband until she was 85 because she was able to heal her," whatever it might be, right?

Nick Dumitru (12:40):

You remember that kind of story a lot easier than you would remember that 96% of people recover from general surgery, right? That's not something that you would be able to remember, but you can always remember a story. The important thing is that you can also retell a story. The other powerful aspect of stories is if somebody sees something on the news or Bretton gets you in front of some TV show that as you tell your story, that story is very easy to be repeated. As you tell your facts, facts are very hard to remember.

Nick Dumitru (13:10):

They'll just say, "Oh, I don't know what some doctor said something about you can have breast augmentation, as opposed to, "Oh, I saw this woman online. She had breast augmentation. Oh, my God, her confidence jumped through the roof. She got a new job. She was able to start dating again after she got divorced. It was amazing. It was so inspirational. It was this guy downtown, Dr. Brad," or whatever you want to call him. They can remember that kind of story a lot easier. The fact that Bretton really focuses on a story I think is very unique.

Nick Dumitru (13:38):

Most PR agencies that I've dealt with in the past, they really just focus on exposure where they don't craft this aspect of it. I think that having that additional training there is fabulous. Now I told you, I'd tell you a quick story about the importance of good versus bad press. Bretton also said that the only bad press is no press, that flies around a lot as a popular knowledge-type fact that goes around. We've all heard it before. I heard it before, and frankly, I didn't believe it for a long time, but in 2009, I had a client here in Toronto who was really leading the industry. We're really helping them.

Nick Dumitru (14:14):

We helped them grow from four employees to 44 laser techs at one point that they had and they grew really, really fast and really aggressively. Unfortunately, they had a death in the clinic. That's a horrible thing to happen. Not only horrible for the person that died, but also horrible for the employees in that business because we thought the business was over as well so that there's no surgery without risk. I don't want to be crass, but in medicine, that is one of the risks of having cosmetic surgery. Patients do go in to that with eyes open, but obviously nobody wants to die.

Nick Dumitru (14:45):

When that hit, they had some of the worse press I could have imagined. Just horrible, like horrible, a total hack job on them. There were lobbyists here going after them. The press was going after them. There was one of those reporters that had a bone to pick and he was going after them almost personally. I looked at this guy, I just thought to myself, "Wow, we're done. This is totally finished." The interesting thing that happened out of that experience that I learned is that three months after that whole wave of press happened, they had their best sales month ever. Their sales jumped right back up.

Nick Dumitru (15:19):

People started coming in to have surgeries and this really bothered me for a long time. Unfortunately, I don't know the actual paper. I'd love to be able to cite the paper, but I looked into it and there is a psychology paper done on this. What they discovered was that whenever something gets media exposure, there is an effect where for a little bit people are all aggravated and annoyed, but then they stopped remembering the details. Like I said, story is a lot easier to remember than facts and the facts start to go away.

Nick Dumitru (15:46):

What they found is that the older the person was, the faster this went away. On old people, it's a matter of days and people in their 20s and 30s, it's maybe a couple of weeks to a month that this effect lasted. Then, they stopped remembering what it was that they knew that company for and all they remembered was the notoriety. What happened is they were doing this research because of fraudsters like people scamming old people and what they found is that when they ran those news reports about these scams happening, the scams actually became more successful a couple of weeks after the fact because the old people stop remembering what that company was featured for, right?

Nick Dumitru (16:24):

Like Acme Corporation, they just got on the phone and the guy said, "Oh, this is Joe from Acme Corporation." They're like, "Oh, Acme, I think I've heard of you guys." They started to trust them more.

Bretton Holmes (16:37):

One of the aspects of that a lot of people in my industry know but isn't I would say common knowledge among the public is that if you've got a doctor who is trying to become an advocate, this happened a couple of years ago, I had a doc who his whole thing was wanting to be an advocate for patients, which is altruistic and great and it's definitely needed, but je went a little too far with, got sued. What ended up happening was the company that sued him got absolutely more patients than he did because they figured that the reason that he was doing it was just trying to ride on the coattails of the story that had been done five, six, seven other times. He ended up losing patients as a result of trying to go after the other practice that had had a similar incident.

Bretton Holmes (17:30):

It's very interesting the way that the human brain works in that regard because I always tell everybody an advertisement will tell somebody how to find you, but a piece of press will tell them why they should. Whenever you're doing PR outreach, I think you have to keep that at the forefront of your mind because what happens in a lot of practices and for all the practice managers out there are probably going to scream, "Yes, yes, he's right," when I say this, but you get stuck in your cave a lot of times because you are around the other employees.

Bretton Holmes (18:02):

You've got the leadership of the doctors or doctor in the practice. You all are arrayed against the common goal. It's very easy to lose focus on what's going outside that office. I think it's really important for practice managers and doctors alike to understand that you may not know everything there is to know about what's going on with the temperature of the public or what their perceptions are. It helps to have somebody who's an objective for a party to be able to come in and guide you in that because it's really easy for medical practices.

Bretton Holmes (18:36):

I see it not only with plastic surgery practices but also in orthopedics and dermatology and spine and a bunch of other ones where you get so focused on what your message is supposed to be that you don't consider that it may be being informed by the people touting it as opposed to what's actually happening outside the office, if that makes any sense.

Nick Dumitru (18:59):

Absolutely. It makes total sense. What Bretton is saying is that there are parties out there that are promoting things and this perceived very differently. It's also effective in very different ways than if you're getting this third-party endorsement. On the back of that, Bretton, talk about the third-party endorsement because there's a lot of psychology that happens when somebody refers another person. Even if they come up in a Google search or they're on a news outlet, it's a different type of psychology than if somebody gets a piece of advertisement in the mail or they come across an ad that's clearly an advertisement on TV or in newspaper or whatever versus a new story. What is the difference for you in PR and how does that work differently in the mind?

Nick Dumitru (19:44):

It's pretty straight forward. The answer is that you're either promoting yourself or somebody else is promoting you. I don't necessarily like the word promoting. I think it's more of a legitimizing force really when I think about what the impact of the press can have because we all hate it when you go to a doctor and they're very salesy. We don't like that. I think plastic surgeons in general have a tendency in the press, in the media, through movies, what have you to be perceived in that way where we were trying to up sell the patient on, "You need this and you need that to make that work," et cetera.

Nick Dumitru (20:24):

When you get a piece of press, you've got somebody who is informing your potential patient base from a non-sales standpoint because that's why I focus on expertise 99% of the time because it's really about what they need, right? It's the press is looking for the best possible expert to comment on it. Really in my world, the best possible expert is defined as the person who gets to them first. I talked to hundreds of doctors every week to think, "Well, I'm so great. The press should just come to me. They should just know how wonderful I am."

Nick Dumitru (21:01):

The fact of the matter is, "No, you need somebody who knows who to go to first of all who can present it to that media person in a way that it's usable information, right?" You're not just battering with the press release every week. You're actually encouraging a conversation and a relationship. That's one of the other, I think, big aspects to what it is that I do that doctors don't understand because in days gone by, it was you had to go schmooze with the reporter and have lunch. You go hang out at the gym and talk.

Nick Dumitru (21:34):

They don't care about that anymore. I don't have to be where the reporter is. In fact, I would say about 95% of the time when I get a story done, I'm nowhere near where the story is happening because all the press cares about is getting the story. They want the content. They want to be able to know that if they have questions, they're going to get answered, that they're going to have a liaison between themselves and who it is that I work with. Really, all they care about is getting content. That's their main focus.

Nick Dumitru (22:04):

They don't care about having lunch with me, although I'm a great conversationalists at lunch. That's not their primary purpose, right? They want to be able to do their job just like everybody else and get the information that they need and look like a rock star to their boss, which I do what I can to help make happen for them.

Nick Dumitru (22:24):

That's pretty cool. On the back of that, I wanted to ask, it doesn't matter where you are, you said, it doesn't matter where you're located, which is fantastic. That means that well, one, you can help anybody. Two, it really opens up the type of media that the physician can get because I think one thing that doctors don't understand is the fact that they can get national press or they can get press outside of their jurisdiction and still leverage it. I want to talk about two things. The first is what media do you work in? Where's the best bang for the buck for the doctors? Then after that, I want to ask you about how to leverage the press that you are getting.

Bretton Holmes (22:57):

Right. I would say to answer your first question, national is always local, right? As an example, if I get a doc and Allure magazine just to name one. There's hundreds of them, but they're one of the more well-known ones. That's going to play in a local market somehow because there are people in that local market that's subscribed to that magazine or are going to see that story on the web, where they are when they're doing the search, et cetera. I always tell doctors, "Don't discount going nationally because it will help your practice and they need to know you're there."

Bretton Holmes (23:36):

Because invariably when they call New York City, it is the Mecca of Press for Aesthetic Experts, they'd use everybody in New York City multiple times. It's nice for them when they get somebody who is from Poughkeepsie or who's from Austin who has maybe a different perspective on the same topic. That's part of that, leveraging that story to an extent where they want to be representative of the whole country. They don't want to just be representative of New York City. Even though there's a ton of great experts there, no question about it, same goes for LA, there are also enormous quantities of great experts in Middle America and probably in the middle of Canada as well.

Bretton Holmes (24:22):

In terms of leveraging the press, I always say, "Make sure that you're promoting it on social media when you do get it," because what I find a lot of the time is that, social media, I always say and you may disagree with me, but I don't think that doctors in and of themselves know how to leverage it properly yet because there's so much of it and I tend to look at it like a tiger in a cage with the door open and everybody just throws raw meat at it hoping it won't eat them. There's a way to provide that, streamline the content to that social media that you could probably talk about way better than me, but I always say, "Make sure that you're getting it out there before you do it, after you do it, while you're doing it as possible because it helps that symbiotic relationship between you and the press outlet."

Bretton Holmes (25:16):

You always want to be transparent with memo and backlink and all that stuff because they need the SEO just as much as everybody else does, but really, it's about building that relationship that I look at what I do is not only representing expertise but also helping the doctor to foment the relationship between their local and national media outlets because they'll come back and use you again. If they have a good experience and the information that you're submitting to them has been vetted and fact checked, it foments trust.

Bretton Holmes (25:50):

That's critically important, especially in aesthetic medicine and in medicine in general because the doctor is asking total strangers to trust them when it comes to putting their hands on them. I think when you think about it in that context, the story becomes much more crystallized, right? Because if you're approaching it from the standpoint of, "We want our patients to trust that we know what we're talking about and we know what we're doing," it's better than, "We're cheaper than the next guy," right?

Bretton Holmes (26:25):

Also, I think in genders better relationship with the press what you want to create. Going back to the self-promotion thing, if you've got somebody in your office who is sending out a press release every week and not really making those connections in a visceral way because everything is personalized still even with all the social media aspects that we are all living under, it makes a difference when you go up to a reporter at a TV station or a producer at a TV station directly as opposed to just sending out a random press release and waiting and hoping they're going to call you.

Bretton Holmes (27:04):

That's one of the things that I focus on in my practice is making sure that the followup that I do with the press is absolutely personalized. It's funny because I've had press outlets go, "You're tenacious in a nicest way possible." They appreciate it because they're getting constantly daily with story items, and if I call and I'm the one in the thousand that's going to call them directly and ask them how their day's going, they're going to read my release. I've seen it happen. I've been able to do this for as long as I have just because when I approach it like, "I'm here for you. I realize that you need me as a resource. I'm here for my doc as well. We've got a really good story that's going to make you look like a rock star. It's going to be easy to do. I'm going to make sure of that and there's not going to be any problems."

Bretton Holmes (27:58):

They love it. Now, not everybody will do that story, but the ones that will end up getting press out of it which is always great because it helps everybody. It helps the media and helps the docs, it helps me. It's all good. I always tell my docs, "Make sure that you're promoting the press that you do get. Put it on your website, backlink to the station or the article. We'll have you the radio interview if you will," because it helps them as well.

Nick Dumitru (28:26):

I think you hit the nail on the head there with the followup. So for anybody who's listening, first thing you should understand is that on this podcast, everybody that you hear, there's no kind of kickback. So I've got no financial investment in Bretton or anything. I'm just trying to bring you guys the best information possible. Having said that, I mean this earnestly, just putting out a press release is a huge waste of your time. Don't do it. Doing PR on your own, again a huge waste of your time because if you're not busy enough to make sure that you don't have time for PR, then you're doing something wrong. When you do start to get busy, if you do have time for the PR, you're not going to be able to sustain it afterwards.

Nick Dumitru (29:02):

To Bretton's point here, you're not in the business of a one off here. You're not doing a one-off promotion, a launch. You're not selling shoes here that are going to last for a season. You're in the business of medicine. Being in the business of medicine is a big investment. It's a big financial investment. It's a big career investment. It's a big time investment in terms of your education. You want to look at your business as a long-term career. You want to look at it as a long-term asset that you're investing in over time. When you're going to do PR, it's not a thing that you do one time. It's not an episodic thing. It's not something that you do and then you kind of come back to it later on.

Nick Dumitru (29:40):

It's something that you should be looking to invest in over the long term of your practice because when I speak about in my book that there's a formula to this, there really is a formula. It's just like baking a cake. I try to explain this to doctors all the time. When you're baking a cake, you can't leave out the flour or the sugar or the leavener and still say that you've got a cake, right? Not any one of those things will work. Conversely, you can't bake just flour and hope to get a cake, right? This is not one of those things that you learn in science class where you're controlling for one variable and you remove one. It doesn't work that way.

Nick Dumitru (30:10):

The business of cosmetic surgery is a formula and you have to put all of the pieces together. If you've got just SEO and nothing else, no social media and no PR, no content, then you're not going to do well, right? You may be ranking or you may have your ads going, but it's not going to do well long term because the supporting actors are not there, right? Just like when you're baking that cake, the supporting actors have to be there. Even if it's just a drop of vanilla, that drop of vanilla can make all the difference versus leaving it out.

Nick Dumitru (30:40):

That's how I look at PR as well. Bretton, having said that, I know one of the things that you advocate is really sustaining this for at least six to 12 months. I want to talk about that because I think it's important for people to understand that it's an investment in their practice. What's your thinking of how long someone should stay at the whole PR game?

Bretton Holmes (30:59):

Well, in my best 20 years of doing this, my experience has been the longer you're in it, the more it increases your notoriety, your media coverage exponentially. What I find is a lot of times and I think you've said this, I usually say, "It shouldn't be a shot in the arm." It can be. You can get a huge momentum shift very early in depending on factors that are not in anybody's control, but what I look at is, the best way to explain it, I guess is that I'm like a farmer and everybody thinks farmers make crops grow, but they don't. All they do are set conditions.

Bretton Holmes (31:38):

My job as somebody's media relations expert representative is to plant those seeds and set those conditions so that they will be buyable at some point. We don't know when, I always tell people, "Look, I can make the water come out of the tap, but I can't tell you how hard or how fast it's going to come out, but there will be water," right? If you've done everything that you're supposed to be doing and you're doing it consistently, you will get press coverage. People will start to know more about you. You'll get more patients. You'll be able to charge more, et cetera, but I think in this age of immediacy that we live in these days, everybody wants it as quickly as possible.

Bretton Holmes (32:16):

I would say the best efforts that I've seen implemented are really the nine to 18-month mark. That's really the sweet spot. I usually tell people, "Do at least a year. Don't panic if it doesn't shoot off like a rocket the first month or two. It takes time to get that stuff rolling, to get the press familiar with you that you're here. This is what you have to offer." I've done stories with reporters that I had sent the press release out five, six times to them. No kidding. Had probably made 20 calls. The 21st call, I get them on the phone and they're like, "I'm pretty sure we did this story."

Bretton Holmes (32:55):

I'm like, "No, you haven't done the story. You've just got my press release five times and I've been calling you." They're so busy that they don't even know a lot of times what it is that they're doing because for them, if they're doing two stories a day or one a day, it can tend to run into each other and they lose that focus. That's why I have a job. It's because I take advantage of that to an extent. I think that that's really the best way to describe what it is that I do is I set conditions and usher those through and make sure that all the elements are in place to get the doctor or the practice that I'm working with the best initial exposure to the press that I possibly can because that's going to turn into press coverage for them.

Bretton Holmes (33:44):

You're going to have a better relationship with the reporter or the producer. It makes a huge difference in terms of the story you end up with and how that whole process goes. It's just like think about it from your own practice, patient interrelationship calls, right? You want the patient to have a great experience. You put those steps into place to make sure that from the time they'd come in or they call your office even. I always tell people, "The most money you should be spending on employees is who answers the phone," because one of the things that I'm sure you probably would agree with this is that first impression, you can't ever get back. You cannot ever get back. You can't redo it.

Bretton Holmes (34:26):

I try to approach it with the press in the same way that we want to make sure that from the outset we're sending them information they can use. It's letting them know we're here to help you do your job. We've got a great guy or gal here who can talk about what you want them to talk about in an expert way. That in my experience ends up with a great piece of press that will stick around. That's the other thing about this is that advertising comes and goes and it's usually just, "Here's our address. This is how much cheaper we are than the other guy." Press will stay around for a long time. I've had press that I've done that I still get calls on five years later. It's amazing the power it has if it's done correctly.

Nick Dumitru (35:14):

I couldn't agree with you more in terms of that first impression on the phone. The way I look at it is that that first impression really sets the expectation for the standard of care for the rest of the treatment. It really defines your ability to convince that patient to go with you and your practice because if that first impression is off, then how are you going to treat them once you've got their money and they're on their way out the door, right? What's the post-care going to be like if you can't even cater to them when they haven't given you their money yet?

Bretton Holmes (35:40):

Exactly.

Nick Dumitru (35:42):

That's hugely important. Now, you also touched on this, the longevity and what we typically refer to as evergreen content, it's stuff that's going to be with you forever the rest of your life. It will always be viable. It will always be green and flourishing. While I'm a big direct response marketer, I really believe in tracking everything, PR is one of these things where I will not actually advocate tracking because I understand that we do PR for different reasons. From my perspective as a marketer, I need it for leverage. For me, if I'm going to be doing some barbecue, you kept mentioning Austin, so it's gotten me hungry, so we've got us [crosstalk 00:36:19] barbecue now. If I'm going to be barbecuing a brisket, I can't leave out the salt, even though the salt is maybe only 2% of the brisket, right?

Nick Dumitru (36:27):

98% maybe you're advertising, but it's that 2% that gives it the flavor and that's where PR really is at the end of the day. It's something that you've got and you're going to cure that meat for a long time and you want to keep having that seasoning on there for a long, long time. That's what PR is. It may not be that shot in the arm. Where I've seen doctors fail at this personally, like Bretton said, is don't look for that shot in the arm like you're going to be on the news and all of a sudden, you're going to be swamped with patients.

Nick Dumitru (36:55):

Frankly, it doesn't happen that way. The odd time it may if you get enough coverage and you're high enough at a celebrity status, but what typically happens is that the awareness goes up for your procedure and then people start looking for it because again, they don't have time to necessarily go and search out the individual, but what happens when they do search it and they find your site, now you're putting out ads and they come across your advertising or social media is that they see that you are now endorsed by this third party which is the news outlet. The general public perception, at least before Trump ruined it for most of them, is that the media [crosstalk 00:37:30] does their due diligence, right?

Bretton Holmes (37:32):

I still think in a lot of respects, even though the press has gotten a really bad rap that it's still a legitimizing force. I don't think that's ever going to change. Even though people, there's a certain segment of the population that will rail against how bad the press is, they still watch the evening news. They still read a magazine. They still read newspapers. They listen to the radio. I think there's still this revival that they ever were and it does have that component to it of what I like to refer is that synergistic effect you were talking about, the fact that you can't just advertise.

Bretton Holmes (38:11):

I always tell people, "If you're advertising, keep doing it, but you need to make it work harder, not try to do just that," because what I find is a lot of doctors, you may agree with this, they didn't get into being a doctor because they wanted to go in to business. You know what I mean? They wanted to help people. They want to practice their craft, et cetera. They didn't get into it because there's such a big fan of accounting and human resources stuff. I think doing things that are going to help the other things that you're doing, just like when you're cooking a brisket, you've got time, temperature, spices. All of those things have to work in cohesion with each other, and if one element is missing, it's going to ruin the entire thing. It makes all the other aspects work less effectively.

Bretton Holmes (39:01):

I always try to tell people, "Look, if you're advertising, it's important to continue to do that while you're doing the media outreach because once you get a piece of press out there, that piece of press is going to bolster the amount that your ads are going to work for you and vice versa." If you're doing ads, you start doing press. The ads are going to help the press too. It's just in the eyes of the public. You have to have that synergistic effect in place all the time consistently to make it work effectively.

Nick Dumitru (39:34):

I think that PR I always look at it as a huge force amplifier and it's in ways that people don't realize. Unless you're in this field, for sure, doctors don't understand, but I'll tell you it even trickles down to your search and it's not just because of the links. Google has something called the RankBrain algorithm. When you get exposure on PR, what happens locally is people start to search about you because they just can't help it. They saw you or maybe you promoted on social media and then they start to search your name on Google to find your website.

Nick Dumitru (40:02):

Well, the RankBrain algorithm always takes that into account and it doesn't happen right away because it would be pretty easy to manipulate Google if it did. Over the course of a few weeks to a couple of months, what you'll see is that your search results start to trickle up as well. PRs, whether you get that link or not, yes, I'd love to get the link, that's always the goal. If you're going to get exposed anywhere, you'd love to ask for that link back. Even if the media outlet refuses to give you the link, just having that exposure and the additional searches that happen really bolster your business over time.

Nick Dumitru (40:31):

If you can do this a few times a year, then you're laughing. Then, it's going to be very, very hard for your competition to keep up and they won't really know what's happening because none of the SEO tools are going to expose that tactic whatsoever. It really is that force multiplier that you're after. Bretton, I'd like to try to keep this podcast to a digestible length and we're starting to hit that mark. I'm going to start winding it up a little bit. I've got maybe two or three additional questions I want to ask you on behalf of the audience and myself.

Nick Dumitru (41:01):

The first one is, again, this is not because I'm trying to plug Bretton or anything, but I really want to get a feel for what the financial investment is for a doctor so that they can start budgeting it out. What are you looking at typically to get this kind of help?

Bretton Holmes (41:15):

Sure, some of it depends on where you happen to be. If you're trying to go with a local company and you're in New York City, you're going to be paying top dollar. I can be anywhere from $5,000. I've seen prices as high as $20,000 a month. Somebody like me who's a one-man show with an of expertise is probably going to be, I would say on average, low end, you're looking at a couple of Botox shots per month to hire somebody like me. I'm rare. They're out there, but I would say, "More money is not necessarily better."

Bretton Holmes (41:50):

I've done campaigns where I was partnered with a bigger firm like Hill+Knowlton or a FleishmanHillard or something like that who I knew was we're making three, four, five times than I was, but they tend to be dinosaurs. What I like to think of myself as is a sniper of press coverage. I can go places that the big guys and gals can't because they're so encumbered by the infrastructure that they have to deal with that really what they end up doing is you've got an intern doing calls if they're doing calls which is very rare or writing a press release and I would say that, "While that press releases is a necessity, it's also critically important that it'd be well written and be written in a way that a reporter is going to recognize it for what it is and get the pertinent information out of it."

Bretton Holmes (42:37):

I usually use a one-page release which I recommend. If you got a company or somebody that recommends you do two to three-page press releases, I wouldn't recommend that because they just don't have time to read them.

Bretton Holmes (42:49):

It's really a calling card, right? The press release is there so that when I call, I go, "Hey, did you get it?" and they can pull it up on their email and go, "Oh, here it is," and they've got 15 seconds to give it a read and they can tell me right there if that looks like something that they could do that's viable which is what I want because I only have about 15 to 20 seconds on the phone with them at any given time unless it's somebody I've worked with for the last 15 years and we're talking about how are our kids doing and stuff. I think that's, that's one of those aspects that it's not really how much you spend. Does the process make sense?

Bretton Holmes (43:27):

I wouldn't say a $15,000 a month campaign is going to be any better than a $5,000 a month campaign. It just depends on who you're talking to. Do you have a good rapport with that media relations person or not? Because a lot of times, what I find is you've got to be willing to hear hard truths about your perceptions about your practice. If you're paying somebody to tell you that, you got to be willing, I think, on some level to listen to them and take that to heart. You may not agree with it, but when somebody hires me, I always make them aware.

Bretton Holmes (44:00):

I'm like, "Look, I'm not here to be your buddy. I'm here to be your advocate. I'm here to represent you. If I see that there's an issue, I'm going to tell you what it is. You may not like it, but you're not paying me to be your friend. You're paying me to do a little math for you and tell you the truth," which is I think part of the reason why I've been in business so long is because people know I'm not going to be asking them about anything. It's just like anything. The price structure, I would say, "Don't do anything less than a year."

Bretton Holmes (44:30):

If you haven't ever done it before, if you have done it before and you've got some press and you haven't done press in the last two years, I would say. "If you want to get back into it, check the year, just get back into it for a year because you're going to need to get your sea legs under again for a little while. Prices like anything, it varies. More cost doesn't necessarily mean better results.

Nick Dumitru (45:01):

Absolutely. I'll tell you something about the big firm. I haven't had a lot of luck with the big firms and they're definitely not tenacious in the nicest way possible like you are. I can tell you they're not going to go [inaudible 00:45:14] for you. That's great advice I think, definitely look for someone that's going to be there with you and with you long term. Bretton, I've got two more questions and then we're going to wrap it up. The first question is, is there anything I haven't asked about that you think is important for the audience to know about public relations?

Bretton Holmes (45:31):

Nothing that comes to mind immediately. I would say that it's really about making sure you're willing to hear the truth about what an outsider's perspective is on the nature of the practice. That's I would say the biggest thing is that be wary of getting stuck in your cave. I don't know how many ... I don't know if you're familiar with Plato's Allegory of the Cave, but that's always a good starting point for how a medical expert should look at their practice because it's very easy to get lulled into a sense of, "We know exactly where our patients are." You may have an idea of who that is, but you may be leaving a whole bunch of people out there inadvertently without access to you that you could otherwise get.

Bretton Holmes (46:19):

That obviously plays into the messaging part of the outreach, but I would say, especially in today's sort of marketplace, it's not enough just to put a pretty girl in a bikini on the side of a bus. How does that differentiate you? You've got to be able to differentiate yourself in a way that people can utilize it.

Nick Dumitru (46:44):

Great. Before I ask my last question, how can people get ahold of you? Where do they reach you? How can they contact you?

Bretton Holmes (46:51):

You can take a look at the website. It's www.holmesworldmedia.com and it's Holmes like Sherlock, so it's holmesworldmedia.com and you can fill out the little contact form or shoot me an email.

Nick Dumitru (47:09):

I'm going to put the website in the link for everybody so that they can grab it right from the iTunes' description or from our website at thinkbasis.com. I'll make sure that that's there for you. Bretton, last question, and this is a very important one for me. I do get down to Austin about once or twice a year. At least I have historically and not much last year, but I have been down there several times and I have a very important question and that is, where's your favorite barbecue place?

Bretton Holmes (47:37):

Oh, man, that's a tough one. Golly. Favorite barbecue place? Everybody says Franklin's, they're very, very good. Don't get me wrong. I would say my favorite place is ... There's so many. PoK-e-Jo's is really good here. I got to be honest. It's a chain, but they're really good. They do consistent work. I've been to the higher-end one which is typically Lamberts, but it's funny you asked that because my brother is a chef here in town. I would argue that the barbecue that comes out of their restaurant is probably up there with Franklin's because that's not their primary thing, so there's not a bunch of pressure. I would say there's not a bunch of pressure there for them, but it's solid. It's really good. Really, really good. [inaudible 00:48:25] PoK-e-Jo's.

Nick Dumitru (48:28):

I'm going to check them. I haven't been to that. For me, so far, I'd say for brisket was Terry Black's. They do a really nice show on their brisket.

Bretton Holmes (48:35):

Terry Black's does a great job.

Nick Dumitru (48:37):

Just for the sheer experience for anyone visiting Texas, just head out to Salt Lake just because of the firepit. I wouldn't say their barbecue is the best, but it's just a fun place to go.

Bretton Holmes (48:45):

It is a fun place. Location is great there for sure. If you really want to get into some historical barbecue, you got to go to Kreuz's in Lockhart which is just outside of Lockhart. It's great because you get back to ... They don't really give you utensils, you just use your hands, so it's awesome. They have a fire there that they've actually had going for decades and decades and decades. When they built the new location, they actually physically moved the entire fire while it was still burning to the new location so that it was continuous, pretty amazing place. They've got these inch and a half the porkchops. They're just amazing.

Nick Dumitru (49:26):

All right. I'm going to relisten to this whole part of this recording and I'm going to put links to all of those places because if anybody else listening to this is clearly as passionate about barbecue as the two of us are going to want to find out exactly where those places are. Bretton, I want to thank you for coming on here and enlightening everyone about public relations. It was a great experience and great learning experience for me as well and I will make sure that everyone knows how to get in touch with you as a way of saying thank you for being on here for everybody.

Bretton Holmes (49:54):

Awesome, man. I appreciate it very much. It's great to talk to you.

Nick Dumitru (49:57):

Wonderful. Thanks to everybody else for listening and we will see you on the next episode. Thanks for listening to Practice Perfect. I hope this episode has given you a lot to think about. I hope you've got actionable ideas that you can take back to your practice and go back and make changes, make improvements, and take it to the next level. If you want, show notes and additional help and advice and articles on how to grow your practice, visit us at thinkbasis.com where we hold the podcast. That's T-H-I-N-K-B-A-S-I-S dot.com or just Google the Practice Perfect podcast to be able to find the listing page. Have a great day and a wonderful week and I wish you all the best with your practice. Go out there, make a change and make it happen.

The post How To Do PR The Right Way For Your Medical Business – Practice Perfect Podcast Episode #18 appeared first on Think Basis.

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"Try to make sure that you're surprising and delighting them because above and beyond just a straight referral systems, there are the stories that your company tells. And then there are the stories that the customers will tell on the back of their experiences, and some of those stories if they're done right, can carry on forever."

Nick Dumitru (00:33):

Welcome back to another episode of Practice Perfect. Today we're going to discuss why you should treat your customers unfairly so you can grow your business. Not all customers should be treated the same because the reality is that not all customers have the same value to your business. Some customers will help you grow your business, some will hold you back from growth. You've got people that buy and then people that will just whine, complain, moan, leave negative reviews. Some people just suck up all your time by being overly anxious or trying to find fault in what you're doing and those are not the customers you want.

Nick Dumitru (01:10):

What we're really talking about here is something called the Pareto principle. The Pareto principle was named after Italian economist Vilfredo Pareto. It's also known as the 80/20 rule, a law of the vital few, or the principle of factor sparsity. And what the 80/20 rule, which is commonly how it's referred to in business states, is that roughly 80% of the effects come from 20% of the causes. What does this mean in your business? Well, 80% of your business, 80% of your income typically will come from about 20% of your customers. You have to identify them and treat them unfairly. That is to say advantageously. You want to pay special attention to them, you want to give them benefits.

Nick Dumitru (01:54):

What typically happens is that the squeaky wheel typically gets the grease. And in any business, the person that complains will typically get the most attention. The complaints are often also responsible for how you set policy. So sometimes your staff will get a very strong emotional charge from a negative experience with a customer and then they'll think that they need to apply that to everybody. But nothing could be further from the truth because these people that are causing these issues in your practice are the ones that are going to keep you from growth. So you want to make sure that you're aware of the ones that are actually adding value and ignoring the ones that aren't because those emotional charges shouldn't carry through your business decisions.

Nick Dumitru (02:38):

Paying attention to the complainer, the whiners, the bitchy customers, that is a huge mistake in a practice. You want to try to avoid that. We're not going to touch on that a lot today. Instead, I want to focus on the positive here. I want you to start thinking about the people that value to your practice and we're going to talk about some strategies about how to deal with them and how to enhance that experience.

Nick Dumitru (02:59):

The first thing I want you to do is to not take the good customers for granted. It's very easy for you to take them for granted, to not pay attention to them, to just assume that they're going to come back, but the reality is that they have a lot of options in the market. They can do anything that they want and if you take them for granted, you're opening yourself up to competition, you're opening yourself up to them going somewhere else. If you're not touching base with them, if you're not making sure that they're happy, if you're not giving them special incentives, then there's absolutely zero guarantee that they'll come back to you over time. Because any little thing can throw off that relationship and if you're not building equity over time, you risk losing that. And then you risk going down and wondering why you have to keep adding new customers all the time when really you shouldn't be building a robust, for example, an injectables business if you're doing Botox or Juvederm or other neurotoxins. You want to make sure that those people come back to you and don't take them for granted. Even though they've been coming to you for a couple of years, don't assume that they're going to be coming to you for the next 10 years, which is what you really want.

Nick Dumitru (04:06):

What I want to focus on is really who you should be paying attention to and there are two types of customers that I want you to pay special attention to and those are super buyers and super referrers. So let's get into each one and see what they mean.

Nick Dumitru (04:21):

A super buyer is somebody that buys everything from you. If you've got a service, if you're doing a new laser, if you're going to offer any kind of special and open house, this is the kind of buyer that always comes back to you. They love your practice, they love you, they love coming there and they love buying everything. They don't mind spending money with you and they spend a lot over time. They come back over and over and they'll engage with everything from service to product and make sure that they are 100% in your practice. So the super buyer is the first person that I want you to pay attention to. These are the people that you should be tracking and you should see their lifetime spend. They have a high lifetime spend and make sure that they're coming back. If they haven't been back for a while, that's a huge indicator that you've got a problem.

Nick Dumitru (05:05):

What do you want to do with these people? Well, one thing you can do is add them to a VIP list. You want to start treating them differently. You want to give them first dibs on new services and specials if you've got something coming up. If you know you're going to do a promotion, you want to make sure that you reach out specially to them and make them a special offer to come in ahead of time before things are booked. Make sure that they get VIP treatment and that you're securing the spot that they want. Don't put them on an email list and then just blast out the email and hope they'll respond like everybody else, because the reality is that they may not get the time that they want. And this is a VIP buyer. This is somebody that you know is going to spend money in your practice and you're lumping them in with everybody else.

Nick Dumitru (05:48):

And then when they call in, they can't get the time that they want and that's where the wedge is formed. That's where the opportunity for your competitors to come in happens. For example, if you're doing a holiday promotion, let's say you're running a Christmas special, everybody wants to look good for the holidays, Christmas and new year. If she can get her time in based around her work or her personal life or her shopping and she can't get the time that she wants, she may just click on a competitor's ad, go over there because they're also offering neurotoxins and she's able to get her wrinkles treated when she needed them for the holidays. So rather than looking bad for the holidays, she can change brands. And then what you've done is you've given away one of your prime customers to your competitors just because you treated them the same as everybody else.

Nick Dumitru (06:35):

So super buyers are very, very important. Get them on the VIP list. Do white-glove service. Reach out to them. Make sure that you bend over backwards and let your staff understand that these are different clients. They're not going to be treated the same as everybody else on your mailing list. Everybody else that came in and spent a fraction of the amount. Make a big deal out of it, give them a gold card, a platinum card, make sure that they understand that they're part of a program. Make sure that they understand that they get a free gift bag every time they come in. Let them feel special, and then they will build this loyalty to your practice and make sure that you've got this person not for the next three months or six months, but for the next two years, five years, 10 years, 15 years. So that you can retire and still have this person in your practice because then you're building value in your practice over time, and then it becomes a sellable asset and you've got something that you can move to either a partner, maybe your child. I've got practices where the children are now coming into their parents' practice, or you can just straight sell it as a business entity that you've now got a valuable list there and you've built these processes and you've got these loyal customers and then you can show ongoing revenue.

Nick Dumitru (07:47):

The other thing that you want to do on this VIP program for these preferred customers, the super buyers, is you want to start thinking in terms of exclusivity. What can you do in your practice that will give them access to something that nobody else can have? How special can you make these people feel? What can you do for them that's not available if someone just calls in off the street? Sometimes you'll see restaurants do this with a secret menu that only insiders have. This is the kind of thing that you want to start thinking about. So the super buyers, get them into a VIP club, get them treated special by your staff. Make sure that they get the appointment when they want it. Reach out personally, call them, email them directly. Don't do mass emailings and bring them in and keep them for life. That's the first one.

Nick Dumitru (08:30):

The next we're going to talk about super referrers. Now, a super referrer may or may not be a super buyer. This is where I would also lump in things like a social media influencers if they're actually sending you people. Super referrers are the ones that really, really help you grow your practice because not only are they buying and they may just be okay buyers, average buyers, so they're adding some income. They may be super buyers, but more importantly they may be referring two to 10 other people into your practice over time. This kind of person is extremely valuable because it is a cost efficient way to grow a practice.

Nick Dumitru (09:11):

Let's quickly examine what referrals can do for your practice. If you have 500 clients and then each of them refers one person, you end up with 1,000 clients, you're essentially doubling your practice. So stop and think about that for a second. You haven't spent a penny. All you've done is gotten your existing customers to refer one other person. It's a slightly unrealistic example. You're not going to get 100% referral rate, but that's where the super referrers come in. These are the people that will refer a minimum of two to three people, and as much as 10, 15, 20 people over time because they are typically socialized, they talk to people, or they are broadcasting online or they are just really talkative about what they're doing. Very open individuals. They're extremely powerful because one of them can make up five, 10, 15 other clients. Again, just like the super buyers, even if these people aren't buying a lot and they're referring a lot, you want to make sure that you start treating them special.

Nick Dumitru (10:15):

Now, it would be very easy to recognize a super referrer, but the problem that I see in practices is that nothing is tracked. You may have percentages for closing ratios, you may have all of that, but nobody's really tracking the story behind that in terms of referrals.

Nick Dumitru (10:33):

The first thing you've got to do to identify super referrers is make sure that you've got some sort of tracking in place for each of your clients and put the data somewhere that your staff can access and use. So it doesn't help you to have a patient file either electronically or a paper file that has a list of 20 people that this individual referred, if your staff can't act on it, if they can't label them and act upon it. So the first thing that you're going to have to do is make sure that you've got some sort of tracking in place to identify who's referring you patients.

Nick Dumitru (11:06):

The other big mistake I see which is really even worse than the tracking, is the fact that practices don't have a mechanism to encourage referrals. So they are kind of allowing the customers to dictate the growth of their practice. They're not encouraging people to send other people there in a way that they have control over. So if you're the same way, if you're getting referrals because you're doing a good job, but you think that doing a good job is the only way to get referrals. I want you to start re-examining your practice and take a look at the points at which you could encourage a referral. You want to make sure that you're nurturing that process over time. You want to make sure that it's repeatable and consistent so that your staff gives people the opportunity to become referrers. You don't want to just sort of rely on anybody's good nature.

Nick Dumitru (11:56):

Let's go through a few examples of what you could do. I want to give you something concrete, something that you could put into place in your practice. And more than that, what I really want you to do is just start thinking about the opportunities of where you could engage people. And the thing about a referral system is that it is not a singular act. You don't have one method of asking for a referral maybe at the front desk and think that that's the only place that you could do it. You want to start thinking of it in terms of multiple systems that you have in place at different points along the customer journey so that you can get them to refer.

Nick Dumitru (12:34):

Once you're tracking these super referrers, one thing that you could do is create an insider's club. This club would only be available for people that refer at least three other people into the practice. And by refer, I don't mean just make an introduction. I mean they are responsible for three other people buying services or products from your practice and then you can attribute that to that individual. So to get into the insider's club, you can make people aware of that. This is one referral system that you can have. At this insider's club, you can talk to them after their purchase or you can talk to them while you're doing injections and just very casually get your staff to say, "Hey, have you heard about our insider's club? I know you've been coming here for a while..." And then just go into the pitch about what the insider's club is and the benefits and ask them if they know other people.

Nick Dumitru (13:21):

You can do it very soft like, "Hey, do you know other people doing these kinds of services? Do your friends ever do this?" If they say yes, then go, "Oh wow, have you heard of our insider's club? It's got great benefits." And then build the benefits around that. Either special discounts, anything that can make it advantageous for that person to really want to be part of that club and really be on the inside. Again, exclusive services and offers and events are one way to encourage that and make them feel like they're part of something and that they want to be in as opposed to just being on the outside like everybody else.

Nick Dumitru (13:54):

Another thing you have to be cognizant of is the fact that when you're asking for a referral, what's really happening is that you're asking for that patient to do the work for you. You're asking them to go out and find you their friends, their family, their coworkers, and bring them into your practice. Now, if that's completely self-serving, what I think you'll find is that it will trigger a mechanism in their psychology that makes them a little bit ashamed or they're getting something for it. Then they feel a little bit guilty because they would rather give that away. A lot of people are very giving. In particular any industry that deals with a lot of women, a lot of them may be mothers, there may be very nurturing, so they've got this kind of built in mechanism to always want to give.

Nick Dumitru (14:37):

And not always the case, but you'll find that that happens particularly with the people that are very social and they want to go out and be out there and do stuff for people and throw parties. They typically have a giving nature. So you have to be aware of that and make sure you are creating your referral program in such a way that you're able to cater to that psychology, to make sure that you give them something. One example would be to give them some gift certificates that they can give to their friends. Very easy. $50, $25, $100, whatever you feel is warranted. It would be only on the insider's club, like I said, not available to the general public. But because this patient refers a lot and they're a good buyer, you can tell them that you want to get other people like them. And to do that, what you've done is give them a gift certificate for $100 and if the person comes in and redeemed that, then they'll also gain the $100. And just play that by year, see how that goes over.

Nick Dumitru (15:34):

If you're able to give something away that the person can take to their acquaintances, their family, their friends or coworkers, and it is more altruistic, it's more like a gift, it's more like a special present, maybe a limited time coupon, a limited time gift certificate for $100 or a gift card. Then you'll find that it's a lot easier for them to approach people because they've got something to give away. So even if they hear a coworker saying that she wants to do something, maybe do something about her lips or wrinkles or belly fat, whatever it might be, if she's got a gift to take to that person, it'll be a very different transaction than if they were going to them and just talking about you and telling them how great you are and that they should come there.

Nick Dumitru (16:21):

Another thing you can put in place is exclusive events where their friends can only get access through an insider's club member. This may be a VIP night, this may be a special evening, whatever it is. It's something where it's, again, not open to the general public. You could have, if it's legal and ethical to do so, like a champagne night, wine and cheese. If you don't want to use alcohol, you can just find great food, great catered event, an educational session. One thing that we've done is dinners with a doc or lunch and learns, where you may even take them out to a restaurant. Take them out for some great foods, some seafood, some steak, whatever it is in your country. I know we have listeners from all over the world, so it's hard to really narrow it down to one specific type of food, but just think about taking them out somewhere fancy. And because they're insiders club members, you get them to RSVP and then you get them to bring a friend.

Nick Dumitru (17:16):

So this could be a bring a friend event, where you may want to educate a friend. And then they get exclusive event-only pricing at that event only available through the VIP club and the insider's members. This is a great way to really grow your network, to really bring people together. And again, by providing this night out, who doesn't want to invite someone out to a great dinner? That's a very easy thing to do. You tell them the type of person that you want to come, you give them a second seat, so bring a friend.

Nick Dumitru (17:50):

Girls' night out, for example, that's another one that we've done. Have a great girls' night out where you will be at this event. You're going to learn about all these things. Try to book a private room so they can ask questions. Don't go to like an open restaurant with one huge table. Make sure you book a little event room, nice intimate event. Have the doctor at the front of the room, put in a little bit of audio, let them teach, let them educate, answer questions about the different services. Maybe do a live demo if you're doing it inside your practice or if the facility that you rented is available for that and they allow that. And really look for ways to make it more of a community for these people because at the end of the day, the people that buy are not all the same.

Nick Dumitru (18:33):

One, a customer is not a customer, is not a customer. You want to make sure that you're identifying the people that are making a difference to your practice and they're working with you to grow your practice. The repeat buyers, the big spenders, the big referrers, the big spenders plus referrers. People that are just talking you up online. And maybe you're tracking that and they've got a YouTube channel or they've got an Instagram account with a lot of local followers and they're able to send you people. You want to proactively reward them. You want to surprise them.

Nick Dumitru (19:05):

When you're doing these programs, always keep in mind that privacy is paramount. You're dealing with medical information, so you don't necessarily want to disclose who was referred. But if you've got, let's say Joanne referred Eleanor, then you want to make sure that Joanne know that she's had a referral come in from one of her contacts. Someone has redeemed her coupon. You can't disclose who it was, but you want to thank her and as part of this process, you want to create little points of surprise.

Nick Dumitru (19:34):

Maybe there is a spoken referral mechanism, so you say, "Oh, you bring in a person, if they redeem their coupon, we're also going to credit you with $100 gift card towards any service that you wish." And then when that happens, when they actually get it, then you want to do a special something for them after the fact. Something that's a little bit of a surprise, a special surprise that they're going to get after the referral happens so that they get a little bit of delight. They get the endorphins kicking off. They get that little reward mechanism happening in their brain and they are surprised and delighted by your company and by your staff. Something completely unexpected because that again, will create a bonding and then in addition to just the straight referrals, they'll also start telling people about you and about what happened. Maybe it's a huge bouquet of flowers, maybe it's a special gift that they weren't expecting when they came in, something that they can keep on their desk at work. Whatever it might be, try to make sure that you're surprising and delighting them because above and beyond just a straight referral system, there are the story that your company tells. And then there are the stories that the customers will tell on the back of their experiences and some of those stories if they're right, can carry on forever.

Nick Dumitru (20:49):

One example I'll give you is there's a restaurant in LA and what they did is at the end of the meal in the car, there were two fresh bottles of water and a nice little note. Because after a meal, you had dessert, you go out on the drive home, you might get thirsty and it's such a nice thing for them. It was a complete surprise.

Nick Dumitru (21:10):

People would go have their meal, the valet brings the car around, and then inside the car is this little note saying, "Thank you. Here's complimentary spring water for you to enjoy on your ride home. We hope to see you again." Whatever it might be, it just creates a little bit of delight and what do you think happens the next day? Or when someone's asked, "Hey, do you know a good place to eat?" What is that person going to do? They're not only going to say that it was a great meal, but they're also going to talk about what happened when they got in the car and the freshwater was there and it's completely unexpected. All of a sudden it becomes a big thing, and the person that's looking for a place to go has a reason to go there above and beyond the food, above and beyond the notoriety of the restaurant, whatever it might be.

Nick Dumitru (21:53):

What I want you to do, what your homework is on the back of this podcast, is I want you to start looking at your patient journey. Start thinking about where you can create these kind of moments. What can you do? And once you have that in place, I want you to look at your tracking. That's something that you should be doing immediately and make sure that you're able to tease out the big buyers. Are you tracking average spend, lifetime value of the customer? Are you tracking how much they spend per year, over the years? You need that number. That's a crucial number that you have to have in your practice.

Nick Dumitru (22:24):

And then in addition to that, I want you to make sure that you've got a mechanism for tracking the referrals. How many people has this individual brought into your practice? And on top of that, how much money their referees have spent with you. Because all of those numbers can be used to really treat these people special, put them into VIP programs. Then you can understand that when you're doing something special for them, if they've been responsible for bringing in 10, 20, 30, $40,000 worth of additional business or euros or yen or wherever you're listening to this. If they brought in an additional 40, 50, $60,000 worth of services and revenue to your practice, then it's really not going to be a big deal for you to take them out to dinner for 100 bucks or 200 bucks. And you can justify it and you can enhance it and more importantly than all of that, you can make sure that it's repeatable, predictable and consistent and that's how you grow a practice.

Nick Dumitru (23:22):

Thank you for listening. If you want the show notes, make sure you go to thinkbasis.com and grab them there. The link will be provided inside of the podcast transcript, so you should be able to see it on iTunes or wherever you're listening to it, or just go to thinkbasis.com directly and you can grab it there in our podcast section. It's up in the menu on the website. If you've got any questions, any topics, anything that you want to hear about, make sure that you engage with us. Just go to thinkbasis.com and there's a little chat button. I'd love to hear from you. Let me know the topics that you're interested in and I'll be happy to try to cater some of these podcasts based on the listeners. All right. Get out there, grow your practice, and I will see you on the next podcast.

The post Treat Your Customers Unfairly So You Can Grow Your Business – Practice Perfect Podcast Episode #17 appeared first on Think Basis.

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"If you as a physician don't know how to bring that conversation down to the level of the purchaser, you are doing yourself a disservice. This is where the influencer marketing comes in because it really is in their words. It's their understanding. They're using the same vernacular, the same language. The reviewer or the influencer was going to be another mother of two that's got to go to soccer practice and she just happens to have a YouTube channel and she's going to talk to that mother in a way that you will not be able to. It will be absolutely impossible for you to connect on the same level."

Nick Dumitru: 00:45 Welcome back to another episode of Practice Perfect. Today, we're going to talk about influencer marketing. If you're not aware of what influencer marketing is, don't worry about it. I've got probably the foremost expert on the planet on influencer marketing. His name is Joe Sinkwitz. He is a serial entrepreneur, the CEO and founder of Intellifluence, the largest social influencer platform on the planet. They've got the most users of anybody online. He's also the author of The Ultimate Guide to Using Influencer Marketing. His name is Joe Sinkwitz. Welcome, Joe.

Joe Sinkwitz: 01:18 Hello Nick.

Nick Dumitru: 01:19 Great, Joe. What I want to get into today is this whole concept of the influencer marketing. I'd like to get the audience to understand what it is because I've had situations where plastic surgeons have taken it upon themselves to do the influencer marketing. They've tried to become the influencer, right? They're trying to get Instagram famous, get the status. I've always felt that that is not the highest and best use of time for a physician because there are other ways to do it. Before we get into the nitty-gritty of that and how it can be leveraged, I think you're the best person I know to start introducing people to what influencer marketing is, if they're not aware of it. What is an influencer and what is the marketing around that? Talk to us a little bit about it.

Joe Sinkwitz: 02:02 Sure. I think the easiest way to explain is influencer marketing is simply having someone else tell your story for you. There's quite a bit of misinformation out there online, "What's an influencer? Who is an influencer? How do they work?" A lot of people will say that there's only certain ways that they could be used. I like to bucket them into three different groups. We have aspirational influence, authoritative influence and peer influence. For aspirational influence, that's your general celebrity. That's the Kim Kardashians of the world.

Joe Sinkwitz: 02:37 Authoritative would be within the realm of plastic surgery, perhaps, maybe someone that's a board certified. They're overseeing physicians. Maybe they're overseeing and approving specific medical devices that could be used, someone with a lot of credibility. The peer would be anyone that could potentially recommend a service. It's your neighbor, it's the person down the street that went through a similar issue. We can start there with how different types of influence is used by based on like what psychological trigger you're looking at.

Joe Sinkwitz: 03:12 From a plastic surgeon example, I don't think it makes a lot of sense for a surgeon to spend a ton of time trying to become Instagram famous as you say. It would make more way more sense for them to take that time and effort and resources frankly and devote it in such a way where they might work with a localized celebrity or maybe a newscast. Someone that's somewhat famous, somewhat known in the media and provides services either shared services or supremely discounted services in exchange for just media mentions and explaining what they're doing. From there, as an audience of those, I'll call them celebrities still, as an audience of those celebrities, we recognize that they may have been compensated for their efforts, but we also recognize them like they have something that we want, but it's not that strong of a desire.

Joe Sinkwitz: 04:04 All it's doing is if we're going back to the whole ADA rules, acknowledging that, "My attention is now piqued. I know that this exists." Now, we need to confirm the desire and that's kind of done via authorities. If I feel like I want to have a particular surgery done because I'm an overweight guy for most of my life, let's say, I'm going that route. Well, I see the celebrity that went through a similar situation. They're confirming, "Hey, this is out there." The next step would be an authoritative figure, essentially backfilling either blog posts, YouTube videos that are really in depth, going into, "Hey, here is a mechanism that can be used to solve this medical problem. I am the expert on this very specific niche, ergo I give it my attest and approval."

Joe Sinkwitz: 04:55 From there, that's great. I have my interest validated, but I don't feel like I need it yet. It's when my peers actually go through with this that it creates a compulsion and that's where I got into this realm is I had that background in organic search. I had the background in affiliate email and it wasn't until I started playing with the psychological triggers of influencers that I started to recognize I can go through the whole ADA, get the attention, confirm it, create a physical need for this product that can only be alleviated via a purchase and then a pile on effect of amplification after the fact.

Joe Sinkwitz: 05:34 I know that's a little bit longer of an answer than perhaps you were expecting, but that's how I view it. I don't view influencer as just this singular thing. I have to view it in terms of there's an entire campaign strategy that you could build around these individuals to earn outsized dollars.

Nick Dumitru: 05:53 I think that's great, Joe. I think you touched on a couple of things there I'd like to unpack little bit for the audience. The first one is ADA just because our audience is a little bit ... Well, they're physicians. A lot of them are physicians. A lot of them are business owners with med spas, but they're not necessarily up to speed with marketing. I just want to quickly let everybody know what ADA is. when Joe refers to ADA, it is attention, desire and action. Whenever you put some advertisement online, some offer online, you first want to get the prospect's attention, then you want to confirm their desire that they actually want what you've got to offer, right?

Nick Dumitru: 06:26 You can slap someone in the face, but if they didn't want it, it's not exactly a good form of attention. Then finally, you need them to take action. You have to make them an offer and give them own avenue to take action. That's what Joe is referring to when he says that. Now, Joe, I want to ask you a little bit more because in your book here you say that you've got the three types of influencers that you refer to, but you really dig down into this whole celebrity thing. I think that everybody thinks that the celebrity is the gold standard.

Nick Dumitru: 06:53 I'm seeing a shift in society now where people are a bit more fragmented. Everybody's not paying attention to the exact same big topics. Everyone's customizing their life and their attention and their desires. In your book, you say that in business they highlight the use of aspirational that is celebrity influence. While it's clearly effective, it isn't even the most effective form of influencer marketing. Talk to us a little bit about that. Why is that? Why is the celebrity not the most effective? What would you do instead?

Joe Sinkwitz: 07:22 If I recall Cialdini's Influence: The Psychology of Persuasion, it has to do with the psychological effects of we all want what our heroes have, but we absolutely need what our peers have. Peer influence is actually the most powerful one. It's just a recognition that when you're looking at similarities between who does what, who has what, we have more in common with our peers, ergo the decisions that they make influence significantly more than what celebrity does. There are cases where celebrity influence matters quite a bit. Those tend to be more on mass market type items, a particular brand of cola or chips or something along those lines.

Joe Sinkwitz: 08:06 If it's something that almost everyone has appeal towards, then it makes sense for that audience. The reason I recognized a little earlier going like a localized celebrity, it's cheating a little bit. With a localized celebrity, it's someone that you do have slightly more in common with. Similarly, you could have an authority figure with a large enough audience where you can cut out the celebrity piece all together and just say, "Okay, I'm using the concept of the desire and the affirmation of that desire all in one go. Peers though, we just found that there's significantly better ROI as well.

Joe Sinkwitz: 08:44 A peer in terms of a plastic surgery, it could just be the patients, successful patient outcomes and just asking them to go through step one through, "Here's all the reasons why I would choose the same doctor again based on the successful outcomes. Here's my problem. Here's how they alleviated my problem. I know that my wife when she was a kid, she had a really nasty gash on her arm going down a slide. I think she like reached out and like hit a branch and just ripped her arm open. Well, the regular surgeons in the ER, they closed it up nicely, but she needed cosmetic surgery to provide a normal scene for a young girl which is important."

Joe Sinkwitz: 09:25 There's all these different use cases I could see from a peer perspective of, "If this happened to your kid, wouldn't she want the same outcome of helping them feel normal again because that's probably the biggest issue out there versus like trying to maximize desire of one's physical traits?" That's where I go. You can go through the blog posts, the videos, the image shares. It's like the before-and-afters. Those work great. At that point though with peers too, it becomes a repetition. If your clients are all pretty happy with the outcome of their procedures and they're all sharing, it almost creates a little community into itself and that really helps to solidify that, "This physician is great. I should be using him because all his patients love him."

Nick Dumitru: 10:17 I think that's fantastic and I'm glad your wife's okay now that that happened when she was young. I can completely agree with what you're saying about the influencers and building up that little buzz in the community and really the tribe around that physician. It really helps to convert a lot better. Before we go a little bit further into this, you mentioned that you could think of some case studies and stuff. I always like to give the audience just some concrete ideas, some concrete examples and I want everybody to really get excited about this and make sure that they don't make the same mistakes that I've seen.

Nick Dumitru: 10:47 I think we'll talk about that a little bit later, but how would you use influencers, just a concrete example, like in a campaign? Let's say that I'm a plastic surgeon and I am thinking of I really don't have the time to become Instagram famous. I'd rather be performing surgeries because that's where I make my money, but I at the same time I really want to tap into this online world, the sense of influencers getting other people to spread my message for me. Give me one or two example campaigns that I might think to set up as a plastic surgeon.

Joe Sinkwitz: 11:20 The first one that comes to mind, Nick, is blogs simply because it allows you to fully tell your story. What I would do here is it depends on the specific niche within plastic surgery. I will just use the kid's example because it's still fresh in my mind here where if I specialized in pediatric plastic surgery, what I would do is ask my clients if they have a blog to share their story about what they went through, the catharsis of all of this pain and suffering that they have to watch in the eyes of their child and how it was basically solved because that's what it's all about like, "I helped the kid get better," and just tell that story out. Of course, the link goes into the professional site and you could use it as like lead gen purposes essentially.

Joe Sinkwitz: 12:11 The way I think you make it work though is you provide some incentive. Maybe it'd be incentive as non-monetary. Maybe it's just you highlight those positive stories on the physician's portal to show, "Hey, here's all these people that trusted us and we did not betray that trust." A similar concept of course for providing long format stories is YouTube because within YouTube you could have the verbalization of what occurred as well as show some still images of, "Here's the before and here's the after. Look how great it is. Look at this kid. He's running around. He's happy now. This is awesome. Thank you so much for making this a possibility." Then, you could take those videos and you could embed them into a blog post as well.

Joe Sinkwitz: 12:56 Instagram is another quickie just to show like, "Are you happy? Are you pleased with the outcome? It's a very easy selfie. You don't even have to do the before and after if you're uncomfortable with that thing as a client and you take the selfie of, "This worked. I'm so happy. This is awesome," and have them tag a certain phrase. Then, you could utilize something programmatically to pull in Instagram cards on the site just to show a cascading wall of love essentially, "Here's the people we helped. Look at them." People like that constant reinforcement that they're going to be making a good decision.

Joe Sinkwitz: 13:34 I don't think it's terribly difficult to even dip one's toes into it, especially if they've already had clients. If they don't, then you're actually having to talk about it somewhat aspirationally of, "I have children. Thankfully none of my children have needed to have a type of surgery," but if I trusted a particular doctor that I'm working or has contacted me on this topic, I might say, "If I needed to use the service, here is who I would use and here's why." List, "XYZ, trustworthy, whatever, whatever, whatever." Those elements can be separated out of course.

Joe Sinkwitz: 14:12 If you're working with a very small client base or a nonexistent one, you want to grow the market, you can use that aspirational type storyline in conjunction with using existing client base for already live stories. It's one of those flywheels that can go on for essentially forever.

Nick Dumitru: 14:29 I think that's great. You've touched on a few very important topics. I want to try to expand on those just a little bit for people. What Joe is talking about here is sometimes in marketing we'll refer to it as parasite marketing, but I don't like that term because it can have some negative connotations in terms of how it's done. I prefer to look at it more as symbiotic marketing. What Joe is referring here is really you getting access to other people's audiences, right? These influencers, people that have blogs, that have Instagram channels, that have YouTube channels, they are cultivating an audience. They're cultivating the type of people that want to listen to them, pay attention to them.

Nick Dumitru: 15:08 Then as a marketer, as a physician, you want to try to reach these audiences and you can do it in several ways. One of them would be to optimize your website to try to get search traffic. Another might be to go and pay for Facebook Ads and Google Ads and try to capture them that way, but it really doesn't tap into that second layer of psychology that Joe's influencer marketing does which is essentially giving you that peer recommendation or giving you that authority recommendation from someone that's built an audience and has already done the connection for you, right?

Nick Dumitru: 15:39 We take this endorsement and it's passed on, right? The trust that the influencer has for you or seemingly has for you on their posts is now transferred to you and then you get access to that audience. I think that that's a very important component that is a lot harder to do with advertising. The reason that I like influencer marketing and why we're really delving into it is because of that second layer of psychology, the fact that you can gain trust a lot faster than you could with traditional advertising or waiting for people to discover you on your own platform like your website or your own Facebook page. I think that that's hugely important.

Nick Dumitru: 16:15 Now, one of the mistakes that I see a lot of the times is when physicians have done deals with "influencers." I say quote-unquote because they have different degrees of authority and more importantly the audience. What Joe's just said here is he touched on blog posts which is web, he touched on Instagram which is social media and he touched on YouTube which is video. Joe, in your book here, you say that what you want to do is really find out where your potential customer is spending time online, who influences them, what their focus should be and when in doubt, test.

Nick Dumitru: 16:50 Talk to us a little bit about that because one of the biggest mistakes I see that physicians make is they'll do a deal with an influencer, but that influencer's audience is like in India or in a totally unrelated city. We've really got a geographic reach to plastic surgeons. Talk to us a little bit about that, about finding the right audience and the people that influence them.

Joe Sinkwitz: 17:10 Certainly. I think geography is the most obvious example that you hit there. If you're going to be influencing on a localized level especially, you need to understand where that particular influencer is going to be based. That's an easy one. In terms of figuring out which network to focus on, it comes back to like a buyer persona. You're needing to look into your own data. What's the gender? What's the age? Is there a socioeconomic breakdown that you're aware of? Do you already know various interests that they have that you can piggyback on top of? Just understanding those light variables can help you determine what type of material do you have to put in front of this individual for them to make a decision.

Joe Sinkwitz: 17:57 If they're very young audience, it might be sufficient to be on TikTok and Instagram as a mechanism for education. That might be sufficient. If it's an older audience, they're probably going to want to do a little bit more research because, "Hey, we're older people." We know that you don't want something flashy. You want to make sure it's going to work. That's where something like a blog posts or the deep YouTube videos come into play, just showing, "All right, here's all the steps. Here's all the issues. Here's all the results." From there, absolutely you're going to need to be testing.

Joe Sinkwitz: 18:33 Now, some networks are going to be inherently better than others. Does it make sense to be pushing hard on LinkedIn? Maybe, maybe not. I don't know. I've not actually tested this specifically within the plastic surgery market, but that's one of those concepts. If the audience that you're going after is somehow some professional level plastic surgery, then perhaps. Does it make sense to be on Pinterest? My inclination is going to say possibly only because it's very image based and you could do a quick and easy before and after, but I'm not entirely certain. Pinterest in my head at least seems to be a little bit more towards the outcome. I'm sorry, the like the recipes of the world, that things that you want the bookmarking versus Instagram is a little bit more towards the lifestyle of what's occurring than Pinterest is.

Joe Sinkwitz: 19:25 I would think that might be a little bit better just off the top of my head. However, the only way to fully know would be to try to even take the same influencer that might have a decent following on both channels and run an offer simultaneously. What did their audience actually think? Did they care? Was there more committing engagement and likes and all that stuff that occurs on Instagram versus number of pins that occur on Pinterest. That's where I really get to. I really tried to get into the head of the buyer persona psychology, so I could try to figure out where they are online. Then, I just tried to put something in front of them that I think they're going to like.

Nick Dumitru: 20:05 That makes a lot of sense. Now, Joe, in your book, you also talked about the difference between influencer marketing and advertising. One of your chapters here is basically the headline is influencer marketing is an advertising. You state that, "According to Nielsen, 84% of consumers prefer communications from their friends and family over other sources of influence." Then you really get into the concept of ad blocking and the fact that when it comes to advertising, consumers are really able to shape their view of the world. They're able to filter out things that they don't want to see and really build these walls around them.

Nick Dumitru: 20:41 I think one of the reasons I'm very excited about influencer marketing is because it gets across all of those barriers. Talk to us a little bit about that. How is influencer marketing different from advertising in your mind?

Joe Sinkwitz: 20:53 Well, I think the first one you mentioned, there's a certain ad blindness that we've all become accustomed to when we're searching on Google. Most of us know where those ads are. Google plays games a little bit, but we can figure that out. As we're going through and we're reading various content on the web, we know when those auto pop-up videos are ads. We know to tune them out. We know to automatically mute them, whatever our stance might be. If we're really sensitive against those types of ads, we might have employed an ad blocker which will essentially trim that out from our lives.

Joe Sinkwitz: 21:28 However, if your neighbor is promoting the same product that you just muted in an ad, it's a lot harder to mute your neighbor. You're already giving them some of your attention. You've already invested in various relationships. You actually care about what they have to say. That's what really comes into play. Additionally, what I found interesting in our data as we got going is we didn't see any drop off in efficacy when it came to disclosure, meaning let's say that, Nick, you had a post about a plastic surgeon, but you did disclose, "Hey, I had been a client and I'm getting a referral fee if anyone signs up here." Well, that disclosure does not take away from the likelihood of me clicking through for whatever reason.

Joe Sinkwitz: 22:19 I think it has to do with the reality that most individuals recognize that nothing in the world occurs for free. There's always some reason behind a post, but at the same time, by showing that, "Yes, this is sponsored, or, "Yes, this was an ad. Yes, I'm being compensated for my time and effort as I should be," it's not hurting. It's not hurting the overall response rate. People recognize almost everything on the web probably exists for profit reason, but if you're willing to state like, "Yes, this is what the reason is, but it doesn't change that this is a quality product," they're more likely to take action. You can't really do that with traditional advertising. It's locked into a channel and is forced down your throat.

Nick Dumitru: 23:07 I think that segues quite nicely into the next part of the book I want to talk about, Joe, and that is the sort of the mechanism of how to hire them and how to pick and hire a social influencer. One of the things you recommend in the book is that you should be generous with the compensation. I'd like to touch on that a little bit just because I think from what I've seen with physicians, the only experience they typically have is either with a PR firm or they get approached. We see that a lot as well like we'll get an influencer that approaches a physician and makes a pitch and then they end up spending a pile of money and getting very little results back in terms of, like you said, the efficacy of it and only because this was not an influencer that had inappropriate audience.

Nick Dumitru: 23:49 I think what you touched upon with the audience selection, that's the first category, but also I find that the physicians just don't know how to value the exposure. They don't know how to do this deal. Can you talk to us a little bit about the type of compensation that's available, what sort of deals you see happening, what's worked best and just bring people along into how to start thinking about a value exchange in terms of hiring somebody?

Joe Sinkwitz: 24:13 Oh, boy. Well, actually, it's fairly complicated. You're correct where you have to make sure that you've identified the right people first. That's first and foremost. That's the only thing that really matters. When it comes to the compensation, all I'm really talking about is to not lowball. If you found individuals that correctly identify either your target audience or have the ability to be in front of your target audience, pay them. In terms of the actual compensation, I've seen it vary significantly based on the product and service. What I noticed doesn't work too well is when it's just a pure commission basis, especially if it's a professional influencer. This is something that they do for their livelihood.

Joe Sinkwitz: 24:58 When you reach out to such an individual and say, "Hey, go do all this work and I'll give you 8% of sales," they don't have necessarily that guarantee that everything's going to turn out okay. In the back of their head, the web is unfortunately a little bit unsavory at times where there's no control over fraud. They want to make sure they get paid. What tends to work best even if you want to be primarily commission-based is some upfront payment or just a guaranteed payment like, "Here's the minimum you're going to get and here is how high that ceiling could go based on actions and activities."

Joe Sinkwitz: 25:35 Within the plastic surgery market, maybe there's also some aftercare products. For that case you might be able to provide the product as a sole compensation if the people that you're giving the product to are those that actually need and want that type of product. If you're just doing it like an Amazon-style campaign, just blasting out to anyone that has a profile, that's not going to work out nearly as well. If again you've identified the right people and you're giving them products that they actually want to use and will see the value of, then product as a compensation is fine. It's when you start combining them that you usually get the best bet.

Joe Sinkwitz: 26:14 My favorite campaigns that I see will involve some product, a guaranteed minimum of cash and then a sweetener. That sweetener is, "Hey, if you keep promoting this over time, here's your commissional percentage that you might receive," because then it invests that influencer that much more. The best outcomes always occur when both incentives are aligned, the incentive for the physicians to get more clients and better clients, the incentive for the influencers to maximize their income for the time that they spend on this. If you're able to cultivate and create an offer that allows for both of those KPIs to be hit, then you're going to win.

Nick Dumitru: 26:59 I think that's fantastic. With plastic surgery, in some States, in some parts of the world, there are some issues with offering percentages. I like the idea of giving out these sweeteners, these bonus products. I want to just bring that down concretely for you guys listening right now and just give you an example. What Joe has touched on here is let's say that you are a plastic surgeon and you're doing CoolSculpting or you're doing breast augmentation, whatever it might be, you offer that influencer, for example, you could do the surgery comp and you could also pay a little bit for a promotion or you could just do a straight surgical exchange where you do the breast augmentation.

Nick Dumitru: 27:34 If you've got CoolSculpting, you could offer this CoolSculpting for free. Let them have a session or two. Let them get some results. Let's say you do the abdomen. You let them get the results. You do the full course of treatment, but in exchange for them continuing to promote you, you could do for example a maintenance treatment or you could do a secondary area of the body. Maybe she wants the flanks or the arms or the chin or whatever it might be and you could really do an ongoing deal like that. The great part about this exchange, the barter-style system is that you are getting basically full tilt for advertising. If that person wanted to charge you, let's say $10,000 to promote you on their channels, it might cost you two or $3,000 in services, right?

Nick Dumitru: 28:18 If you're CoolSculpting, you've got some consumables or maybe you've got a laser machine even better and you've got no consumables, you could purchase that $10,000 in advertising for next to no payment, right? Then, it's just essentially your staff's time to administer the treatment. Maybe you're paying them $40-$50 an hour. The treatment takes an hour. It costs you $50, $60, $100 if you're more generous. Then the consumable if it's laser, you may not have some. If it's CoolSculpting, you've got your credits you've got to pay for. Then again, you're paying a few hundred dollars there. Then, you've got yourself centrally a full advertising promotion deal for the cost of your consumables and your internal cost which is a fraction of what it would cost you to purchase that outright.

Nick Dumitru: 28:59 Now, what Joe is also suggesting is that you give the person some money because you want them to be pushing this as hard as possible, right? You want to also make it worth their time to come in because some people, this is their livelihood, this is their living. As much as they might love the CoolSculpting, they can't really take the CoolSculpting and pay for their rent, right? The landlord is just not going to accept that. You also want to try to compensate them a bit financially as well, keeping that into account because then the motivation level goes off the chart. That's just one example of what you could do.

Nick Dumitru: 29:29 Now, Joe, in your book, the next point you'd touch on after being generous and this compensation and thank you very much for unpacking that for everybody and really giving the different options because I think physicians generally are just used to paying money, right? They're just used to paying out cash and they don't necessarily think about these alternative ways of doing deals, so I think that that's fantastic. Now, I want to touch on the other side of that value exchange. Now, this influencer has gotten something. She's gotten something for free. She's gotten some ongoing care, like you said after care products. You may have been given creams and products to use as she's doing the promotion.

Nick Dumitru: 30:05 One of the things that you mentioned is really this concept of leveraging that content and reusing it. I think that that's something where the doctors, they look at the one-off deal and they got promoted, but then they don't think of how to reuse and repurpose that content. Can you talk to us a little bit about that? What have you seen? How is content being reused? How is that value being leveraged by the person purchasing the influence?

Joe Sinkwitz: 30:29 Certainly, Nick. I think the easiest way to start is to think about the long format video again. You already know that it's a video that exists on YouTube. Well, what else comes with that? You could take that long video and create short snippets of video that you might be able to put on Facebook for Facebook Live. You could take them and throw them into Instagram stories with short format videos. You could take the still imagery of that and put it into Instagram, into Pinterest. You could take the transcription and turn it into a blog post on your site and then take that video that exists on YouTube, embed it within the blog posts so that people come into the blog are incrementally driving up the video views as well.

Joe Sinkwitz: 31:14 There's just this way of taking content and slicing and dicing into multiple ways. If it was a really great piece of work, you could take it and use that content in your ads. If it worked really great on Facebook organic, you might as well promote that as a post. If you're having success with a type of traffic that's coming in, you could start embedding those little pieces looking like the Instagram card. If you had success with the Instagram campaign, you could take some of those cards and embed them on the site for when referral traffic comes in via Instagram.

Joe Sinkwitz: 31:49 Then you're playing another little psychological trigger of just like me, where someone's already in the frame of mind coming from Instagram, they go to your site, they see something else that is showing that Instagram is a part of your strategy. It just creates another little additional connection. It's just finding commonality in the user. There's that many ways to do it and I'm just touching the surface here. You can get it into podcast if it made sense. You could get the really high-performing blog posts over into Reddit communities that are related to what you're doing. You can get them all over the world there. I don't think there's any shortage of how you could slice and dice.

Nick Dumitru: 32:30 I agree. I think at that point it becomes really an issue of creativity for their marketing company. What Joe is talking about here guys is really this concept of curation. The fact that you can take a piece of content and then make additional content. I can tell you that if you've got someone that created a great video for you, you could take, like he said screenshots of that video and quotes and then really write your own article about it, right? Like a thank-you post, "Hey, thanks to Joanne that just reviewed us on her YouTube channel. Here's the channel." Then, you're cross-promoting, so she feels good that she's getting promoted by you to your audience, but at the same time you are now creating content on your blog.

Nick Dumitru: 33:08 You're able to capture additional search traffic on the back of that, right? You're able to really use that psychology to show people that there are others out there using your services and happy with your services. Joe touched very briefly on advertising. I can tell you that in some fields that we've worked in, these review posts, the testimonial posts, these things that are natural-looking videos where someone's just holding up an iPhone have done extremely well with advertising to the point where they in some cases beat our other ads that we've just been able to beat every control with these personable things.

Nick Dumitru: 33:41 When you hit the right audience, like the right avatar, the person that looks like the person that's going to buy from you, when you've got someone that's very similar to your target market, they tend to do very well because when someone's looking at your before-and-after photo gallery, they're really looking not necessarily at the quality of your work as much as trying to find a body, a body shape, breasts, tell me whatever it is that they're looking at that's similar to their situation. That's what everyone's looking through in life. Then with the influencer marketing, you go a little bit further where you also take that angst out of the equation, where they are now no longer afraid to go with you because someone's gone before, right?

Nick Dumitru: 34:24 This is just an engrained piece of the way our brain works, right? If you see someone taking a step somewhere and they didn't sink, they didn't get attacked by a cougar or something and no rock fell on them, then you're probably okay to go, right? If you're the first one, you'll be a little more careful. You're going to look up, "Are rocks falling? Is there any kind of dangerous animal? Is this quicksand?" The people that came second tended to survive, right? The ones that went first, they're pretty much not around anymore because they took the danger. Then, the second person, "Okay, I got to walk around that bit of quicksand to survive," they're the survivors and that's what we are. We are descendants of those survivors.

Nick Dumitru: 35:02 What social media influencers do and what this body of influential content that you can get and build up on your website does is it gives people that assurance that they're not first and it satisfies that fear that they have in taking a chance with you. I want you to start thinking creatively about what you're doing, whether it's on Joe's platform or somewhere else. If you've got any influencer content or random testimonials, how are you repurposing that? How are you leveraging that? I think Joe's touched on just a little bit of what can be done here and he's given some great examples, but go back to your web team, go back to your marketing team, your inhouse staff and just figure out how can you take that content and really get the most value out of it.

Nick Dumitru: 35:44 At that point, you're then leveraging what you're paying out, right? With an ad, you pay it out and then the ad is pretty much done and you don't get to reuse that content in any way, except maybe if, like on Facebook, you've got a few comments, you can maybe try to take screenshots of or something on the actual ad, but generally speaking it's one and done. Whereas with social media influencers, it can really live on for a long, long time. Now, Joe, I want to really go a little bit further in this whole concept of leverage here and another thing that you mentioned as part of the strategy of hiring an influencer. You identify the right audience, right? You identify the right channel to be an Instagram, a Facebook, a YouTube, wherever it might be, Pinterest.

Nick Dumitru: 36:25 You've done these things. You've hired your social media influencers. You've been generous with compensation. You're now leveraging their own content across multiple things, your blog, your social media pages, your own advertisements. We're doing all of that, but there are a lot of influencers that they don't have a huge audience. In your book, you call these people secondary influencers. I'd like you to go a little bit deeper into that because they tend to cost a lot less, but they can provide that fulcrum for the leverage. What is that? How are people using these secondary influencers and what do you recommend that we do with them?

Joe Sinkwitz: 36:59 I primarily use them for amplification. In most cases, the peer influencers, they're going to be micro-influencers, hyperlocal influencers, people with relatively small followings that they're still relevant to your costs. What you want to do then, to happen is to keep sharing your stories, share your content out. If you're focusing on like the Toronto area because you're up in the frigid cold of Canada, if they're focusing on that market and they've identified a whole bunch of people, maybe they can't afford as a physician to be giving out $1,000 worth of stuff to a person that might only have 100 followers, but all the 100 followers are in Toronto and the person's in Toronto. Well, okay. Could that physician afford to spend $20 a week for that influencer to just share out the doctor's blog posts and videos that go live?

Joe Sinkwitz: 37:58 That's all it is. It's just a matter of continually hitting your audience with people that are also in your audience. For there, it's just that repetition, that wolfpack mentality that could build up when you apply pure influence to a large degree. I like to think of the concept of seven touches where I want to have as many as seven different ways a prospective brand might find my service and sign up for it. Maybe they get an email. They see an ad for it. They have an organic listing that they see in Facebook. They come across an influencer that used it and tagged my service, etcetera, etcetera, etcetera.

Joe Sinkwitz: 38:38 If you have this amplification that's constantly ongoing for your core market and it's actually easier since you have a very defined core market, you increase the likelihood of converting a potential prospect into a sale. That's how I'd use them. I'd use them primarily for small amounts of cash in exchange for constant amplification.

Nick Dumitru: 38:58 Very nice. I think that that's a key concept a lot of people just don't even think through and we're going to get into your platform a little bit next I think. For everybody listening, Joe talked about disclosure. Just full disclosure, guys, we are not getting any kickback. We don't have a compensation structure. The link that you'll find on the show notes will be a straight link to Joe's website. We're really doing this interview because I love to bring cutting-edge concepts, things that will give you an edge over your competitors. I really believe that this platform is one of those things because as we used it, it became a lot easier than the old manual way of doing it.

Nick Dumitru: 39:33 Before we get into that, Joe, I'd like to touch upon KPIs, the key performance indicators. I think when hiring social media influencers, it's a little bit different than advertising, right? As an advertiser and maybe as a physician that's used to advertising, we're used to looking at things like traffic volume, conversion rates, time on page, things of that nature that we can really point to. With the social media influence campaigns because there's so many ways to slice and dice this, it's really the Swiss Army knife of advertising because you can get direct promotion, and yes, you can use those same KPIs, but then, you can get all of this leverage, right?

Nick Dumitru: 40:10 You could use it to really improve the conversion rate of your existing pages for example. You could slap this on your procedure page. Then once you've got like five or six of these video influencer testimonials, that page may be doing better for you. How do you measure the success of the campaign? How can we start thinking about this? How can we wrap our brain around what makes the exchange successful?

Joe Sinkwitz: 40:32 I think it depends upon what point in the campaign you are, right? Different types of content you're creating might have a different KPI. If you're doing authoritative style and celebrity style hit initially, the KPI while it's a secondary KPI of sales because that has to be happening, you might just be looking to do outreach in terms of branding like an overall reach of just get us out there as far as possible. Then, it might be further down in that funnel of, "Okay, the next step down, the slice and dice, taking these and having a different influencer posts images." Then, it might be a little bit deeper into sales. For that and if you're doing link tracking, you're probably using some sort of a UTM campaign, so you can accurately track or at least the best of your abilities what medium was this touching, which influencer and for which specific campaign.

Joe Sinkwitz: 41:25 Then, you're trying to tie it all back from the sales did he have eventually. On the amplification side of things, your KPI might just be, how much did you move the previous levels KPI? If you're at a certain sales amount for influencer posts that already exist and you have data on and you leverage some implication on top of that, did that move that original needle or not? Then, it's just tying different steps of the funnel all the way back. Of course, you're dealing with multiple mediums. You're talking about omnichannel which is the Holy Grail of marketing that no one's cracked yet, so we're all hoping we get there.

Joe Sinkwitz: 42:04 So long as you have accurate link tracking setup, maybe you're using coupon codes in a smart way that you could try to at least tie it back to the original influencer and the timeframe in which the initial campaign took place, you can tie it all through. You could be using custom-coded 1-800 numbers in the United States at least so that you're able to try to tie activity back to a campaign. You could see like, "Hey, I got a phone call from a piece that we did a year ago that you just forgot about, but it was a decent YouTube video, someone interacted with it, called the number in there."

Joe Sinkwitz: 42:40 There's a lot of ways you go about the tracking. I like to try to combine multiple methods if possible. I don't use the phone number stuff as much, but I do like to use UTM campaigns wherever I can and then coupon codes that were designed to be given out to an audience simply because I know that coupon codes are going to leak out and people will be using them that maybe had nothing to do with the campaign, but ultimately because I like sales, that doesn't bother me. If I'm able to also use a decent UTM tracking to determine where the individual did come in and what touch points they have along the way, then I at least have some good data to go off of for when I start doing my post-mortem to decide what are the next steps, how do I recreate, how do I iterate and get better.

Nick Dumitru: 43:25 I think that's fantastic. I just want to expand on that a little bit for the audience because you touched on some important things there. The first concept is this idea of evergreen. When you pay for an advertisement, like I said, it's pretty much a one and done, the platform is there, it's like the traffic store, you go there, you buy some traffic. Once you're done buying, the transaction is done and your traffic goes away. That's what happens with traditional advertising which is fine. It works great. It's got its place. What Joe just touched upon here is really this idea that the campaign lives on. It lives on past this transactional point, right?

Nick Dumitru: 43:58 A YouTube video, a blog post, if you've done the right deal with that influencer, it should be the right deal to kind of live on forever and they want their content to be out there forever. They never want to reduce their volume of content. What happens is that that promotion, that deal that you just did really lives on for years. Plastic surgeons really need to take this look into the future and take the long-term perspective on their practice because it's not something that you're doing overnight, right? You went to med school. You got into this. Now, you're a physician. You're going to be in this practice for 30-40 years possibly, maybe longer. I've seen some guys that are well into their 70s that are still operating.

Nick Dumitru: 44:37 You're going to be at it for a long time and you want your promotion out there a long time as well because the moving parade of life is constantly going on. As these people start to engage in their own discovery activities, new people will find you with the same promotion. Whereas your advertising may have been gone, this evergreen content, really you look at it as a long-term investment. The more of it that you can do, the better it will be for you because the discovery activities that people engage in will always bring them back there, right? Nobody reinvents the wheel here. Everybody comes online. They're born. They get to the age of majority. They can start to make their own decisions. Then, they start dealing with the exact same issues that their great grandparents are dealing with, right?

Nick Dumitru: 45:18 It might be packing on weight around the gut. Maybe breasts are too small. Whatever it might be, they're dealing with that and then they go online and try to find you. Being out there constantly will really give you this steady flow of customers that you're after, of patients. Now, the other thing that Joe touched on was really the idea of tracking. You want to make sure that you know where things are coming from. He said UTM. That's a term that you can use in your analytics to go in and capture things from links but also the tracking phone numbers and they're not just like the toll free, yes, in North America, Canada, US. We've got clients in Sweden, clients in Australia, they have phones and there are services out there that will give you a phone number that you can use for tracking. Again, that's very important for you to keep in mind.

Nick Dumitru: 46:05 Now, Joe, the next thing I want to talk about here before we get into the platform and I think this will be a good way to start talking about the platform because for me this was always the biggest challenge and I know that physicians have this concern as well. That's really the fact that you've only got so many hours in the day and so much staff to help you out. I'm always looking for ways for doctors to try to leverage their time to try to make things easier for their staff, for people working in their practice. For me, one of the biggest benefits of Intellifluence was the fact that it saved us time. Finally, for the first time ever because we've been doing this for a year, it gave us a way to really manage these, I look at it like hurting cats.

Nick Dumitru: 46:51 A lot of these social media influencers, some of them are not that paying attention because some of them have delusions of grandeur. Some of them are just distracted. Your platform really gave us that ability to zero in on this and leverage the platform to give people back their time. One of the concerns I know that they're going to have is how much time does it take? How much effort and time is it going to take the money they can come up with, but what about this idea of time? How is it to manage these kinds of campaigns?

Joe Sinkwitz: 47:21 It can be actually pretty time intensive. There's no getting around that. Whenever you're designing any marketing campaign, there are shortcuts you could try to take. If you already know some of the information in regards to the geography, the categories of interest, the type of activities that people are already into, you can jump right in. Now, our platform obviously I love it. I'm the CEO of Intellifluence. I'm going to pimp my product as much as possible. There's a lot of platforms out there and the reason they exist is because they're trying to cultivate a group of people and section them off and apply filters that you could search on, so you're able to directly interact and get started right away.

Joe Sinkwitz: 48:04 I think you can spend a couple hours and create a campaign and let it run. Now, that's just on like a single type of content though. I think you should always devote at least a few hours afterwards to try to think through, "All right, I'm pleased with how the first step of the campaign took place. I'm pleased with this. How do I make this even better? How do I make it better? What's the next step? Do I go back to the same medium and get more people? Do I take this medium and use it elsewhere?" That's where it gets complicated.

Joe Sinkwitz: 48:37 Obviously, we offer managed services just because it is a complicated manner like most agencies. Our clients, they'll just come to us and say, "You do this. Here's what we're trying to accomplish. Here's what our clients are willing to do. We'll deal with the client and we'll deal with you." That works great. As an individual physician, you might run into roadblocks. I'd say you're probably going to want to maybe test something simple out your first on your own, so you have a good understanding and then work with an agency you trust to try to run a really complicated campaign to maximize your sales.

Nick Dumitru: 49:12 Well, I didn't even know you guys doing managed services now, so that's pretty cool. Joe, tell us a little bit about Intellifluence. I'd like to give you the opportunity to talk about the platform, talk about the company and just give everyone a little bit of insight of what they should be doing on there and how it helps.

Joe Sinkwitz: 49:27 Sure thing. Intellifluence is currently the largest warm contact influencer network. What that means is that every influencer that we have in our system physically signed up to work there. We did this because we ran into a problem years and years ago. We are digital marketers. I've been in digital marketing for over 20 years. Ran into situations where I might receive a cold email database of people that might work, but I spent a lot of time going back and forth trying to assess if the individual even does this work. Do they know they're in this list? I had a lot of angry replies.

Joe Sinkwitz: 50:02 I wanted to create something that a brand could join and they immediately already know, "Yes, that person wants to do reviews. Yes, this person, they self-categorized who they are, what they do, what they're interested in, as well as what they believe their minimum compensation should be." It takes a lot of guesswork out of trying to navigate the wily world of influencers. You could absolutely do this manually. We just try to take as many of those manual steps as possible and make them irrelevant. An interested brand could just get off to the races and save as much time as possible. It is a SAS platform, meaning that everything is doable by yourself.

Joe Sinkwitz: 50:45 Usually what happens is at a sufficient level, larger companies or agencies as they're referred to will determine, "Okay, this works well for us. Now, we just need someone to manage it full time and then we take over for them if they want to."

Nick Dumitru: 50:59 Fantastic. I'm going to put links to all that in the show notes for everybody and I'm going to ask you one more question, but before we do that, what I wanted to ask you this, is there anything that I failed to ask you about Intellifluence or influencer marketing that you feel people should know that's very important for them to keep in mind?

Joe Sinkwitz: 51:18 I think the one thing that maybe we didn't touch upon is it just another [inaudible 00:51:23] and the answer is no. I had a lot of experience in SEO. At one point in time in SEO, a group tried to splinter off and determined that inbound marketing was the only way and SEO was dead. Clearly, it was not the case, but inbound marketing had its role. Again, it happened with content marketing. Content marketing is the only [inaudible 00:51:44] inbound and SEO are dead. That wasn't true either. Now, we see the same thing happening again with influencer marketing where it has a very strong role, but it doesn't negate the other channels.

Joe Sinkwitz: 51:55 I think this has significant staying power. I think it's going to be regulated at some point in time, heavier than it currently is. Because it works well even when it's disclosed, I think it's a tactic and a concept you could utilize probably for the rest of your career.

Nick Dumitru: 52:13 I couldn't agree more with that and I like the examples that you gave there where people, they're always crying about the next big thing and this is going to be the only thing. I've always looked at the patient's psychology when people make a decision to go with a physician. What I look at it as it's almost like trying to pick a lock, right? You have your tumblers and you're trying to get past one to the next, to the next to really open up that decision-making mechanism in the person's mind to decide to go with you. That happens in a very complex way. There's no real straight light way to do that to get the person to make a decision. You have to be where they are when they're picking that tumbler.

Nick Dumitru: 52:51 They might be afraid of anesthesia. They might be afraid of bad results. They might really want something that they don't know that you have. They might have something that they didn't even know that they wanted which is where this influencer marketing comes in. As you get these reviews, you're really also leveraging the brain power of the influencer. More importantly than their brainpower, you're leveraging their perspective on things. When we're in business, we tend to become a little bit myopic. We tend to look at things from our angle. I see this particularly with plastic surgeons and doctors in general where they'll start using big medical terms because they just assume that everybody knows it, right?

Nick Dumitru: 53:31 Everybody in every industry is guilty of that because as you become hyper-familiar with something and an expert in that field, you start to shortcut the language. You stop enjoying talking to beginners and you start enjoying talking to experts and peers because it just makes the conversation faster. You get to shortcut it. When someone's making a decision to buy your product or service, they are beginners because they're not in the industry, right? A mother of two that is taking the kids to soccer practice and worrying about bake sales and whatever doesn't really care about subcutaneous versus visceral fat. She doesn't know what those two things mean.

Nick Dumitru: 54:09 If you as a physician don't know how to bring that conversation down to the level of the purchaser, you are doing yourself a disservice. This is where the influencer marketing comes in because it really is in their words. It's their understanding. They're using the same vernacular, the same language. The reviewer or the influencer was going to be another mother of two that's got to go to soccer practice and she just happens to have a YouTube channel and she's going to talk to that mother in a way that you will not be able to. It will be absolutely impossible for you to connect on the same level.

Nick Dumitru: 54:42 If you're able to pick that lock successfully, then the door is open for you and you get the success that you are trying to get in the first place. I think that that's where this social media influence really has a big, big role to play in the entire picture of marketing. Joe, how can people get in touch with you if people want to ask you questions, learn more about you or the platform or your book? Where can they do all of that?

Joe Sinkwitz: 55:08 Sure, intellifluence.com has links to just about everything. If they want to reach out to me personally, I answer all my own emails. It's [email protected]. They can usually find me on Twitter. It's C-Y-G-N-U-S-S-E-O.

Nick Dumitru: 55:23 Awesome. I'm going to put all of those links in the show notes. If you guys need those, you can go to thinkbasis.com or if you're listening to this on iTunes or Google, you should be able to just open up the description. It's going to be a long description. This will be closer to the bottom just because we do the full transcript, but if you scroll down there, you should have the full links to get in touch with Joe. I'll make sure I grab all that data and have it in there for you guys. Joe, I want to thank you very much for your time. This was very informative. I think this is a type of marketing that is rarely if ever discussed in the plastic surgery. Nobody really knows about it.

Nick Dumitru: 55:56 Like I said, when doctors dip their toes into this field, they really are doing it the wrong way. I'm very happy that you're able to shed some light and some expertise and I want to thank you for being here.

Joe Sinkwitz: 56:06 Happy to do it, Nick.

Nick Dumitru: 56:08 Thanks for listening to Practice Perfect. I hope this episode has given you a lot to think about. I hope you've got actionable ideas that you can take back to your practice and go back and make changes, make improvements and take it to the next level. If you want show notes and help and advice and articles on how to grow your practice, visit us at thinkbasis.com where we hold the podcast. That's thinkbasis.com or just Google the Practice Perfect podcast and you should be able to find our podcasting page. Have a great day. Have a wonderful week. I wish you all the best with your practice. Go out there, make a change and make it happen.

The post How To Find And Hire Influencers To Promote Your Cosmetic Practice – Practice Perfect Podcast Episode #16 appeared first on Think Basis.

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"This is where you can start thinking about the strategy of your practice. When I say strategically is you need to look at your practice and how it's going to impact it and what stage it's at. If you need to take the beach versus take the stronghold tactically and strategically in order to win the war, you have to look at it. So what stage of this battle are you in? What part of the war are you engaged in that you need to move forward?"

Nick Dumitru: 00:39 Welcome back to another episode of Practice Perfect. Today we're going to talk about whether or not you should charge for a consultation. But before we get into that, I'd like to invite you to come to thinkbasis.com. We've got a live widget on there. I'd like you to engage with that widget and just let me know exactly what you're struggling with in terms of your plastic surgery marketing. What is holding your cosmetic practice back? I'm looking for more ideas to create these podcasts so I can help you guys out and I'd really like to get some feedback on that so I'd love it if you guys would just engage with that there and let me know. I will see those myself. If I'm offline, I'll get the messages later. Yeah, just head on over to thinkbasis.com and get that done.

Nick Dumitru: 01:23 Let's get into the consultations. Now in my consulting practice, this is probably one of the most frequent things that I have to deal with, if not the most frequent thing that I have to deal with. This comes up all the time for every practice, this idea of whether or not you should charge for a consult, what's better to have a free consultation or a paid consultation. Now, there are advantages and disadvantages to charging for a consultation and the same goes for a free consultation. I'd like to examine each so you can decide which is right for your practice.

Nick Dumitru: 01:58 Now, this is a strategic question and I want you to start thinking in terms of strategy and not just a tactic of whether or not you should try to charge for this consultation. What I mean by strategy versus tactic is when you're talking strategy you're thinking more long-term, you're thinking about how what you're about to do is going to impact the overall business, whereas a tactic is just a technique. It's something that you're doing. For example, in this case we're talking about whether or not to charge for a consultation; that's a tactical move. It's something that you're going to do. It's an action. And then I want you to start thinking about why you're doing that action strategically and how that's going to impact the rest of your practice.

Nick Dumitru: 02:42 I want to give you a way to think about it in a way that will help your practice in the long-term. I don't want this to be a short term solution for you. I want you to be able to adapt to this concept, this strategy as your practice changes over time. I get a lot of situations where plastic surgeons think that if they do something, they've got to do it forever. I think this comes from the medical background, the fact that if you decide to do a tactic, you've got to always repeat that because that's the way it's done, that's the way it has to be, but it doesn't have to be that way forever. Making a change in your practice is not as scary as changing your surgical techniques.

Nick Dumitru: 03:21 I want you also to understand that whatever you decide, whatever you decide to try out in your practice is something that will be able to change over time. There's no danger for you doing it. You can try something out for two, three, four months and then go back and revert and change your mind on that.

Nick Dumitru: 03:39 Okay so let's first examine the free consultation. What happens when you have a free consultation? This is going to be a generalization and there will be edge cases where this won't be the case. For example, places where you may have a monopoly or there's not a lot of competition or quite frankly your competition just sucks so it wouldn't really matter what you do, you're going to get the bulk of the business. That's not typically the type of situation I deal with. I deal primarily in competitive markets in medium to larger cities where you've got to deal with competitors, you have to deal with a market that has a choice, that can pick somebody over you. That's where I'm going to be focused on is these markets where you do have to deal with competitors. The market can change their mind and very quickly go to your competitor if you make a mistake.

Nick Dumitru: 04:31 A free consultation what you'll see typically is this, you'll see a much higher volume of patients. You'll see a lot of patients because they may be further up in the buying cycle. They may be more at the inquiring stage and they're not ready to commit financially. Your cost of leads, your cost of acquiring the leads are going to be a lot lower. By costs, I mean your advertising costs. You'll have to pay less to get a lead to fill in a form and come to your practice. If you're not engaged in paid advertising, which you should be, then what you'll see is that your effort to gain them, the number of articles you may have to write or the number of social media posts that you have to post will be a lot lower. So just your overall cost of effort and money to acquire these leads and these patients that you're going to see is typically a lot lower with a free consultation.

Nick Dumitru: 05:22 Now, on the other side of that your no show rate will typically be a lot higher, because these people are further up. There may be more tire kickers. They're looking to get information more than go through with a transaction, so this is an informational situation versus a transactional one. It's not to say that they're bad patients, it's just that they are not quite yet ready to move forward and they could become patients later on. Now, not all of them will be like that obviously. You will get some people that are ready to go on. The free consultation is just what they needed. It's the impetus for them to take action.

Nick Dumitru: 05:56 The way I look at this is I like to say to people that you're going to have to kiss a lot of frogs before you find your prince. Depending on where you are in the world, you may not be familiar with that story. It's a children's story about a princess that had to kiss a frog to find her prince and find the person she's looking at. And really in sales and in cosmetic surgery we're looking to do a lot of the same things. With a free consultation, you will have to kiss a lot of frogs before you discover those quality patients. So just be prepared for that.

Nick Dumitru: 06:24 Again, this not to say that free or paid is better. I want you to start thinking about what this means strategically for your practice. So what will it mean in terms of having to see a lot of people? And we'll get into that a little bit later. Everything has implications. So free consultation, having to see a lot of people, you may obviously have to staff up or get support or just be prepared to sit around. Those are all things to consider. That's the free consultation. Let's quickly examine the paid consultation.

Nick Dumitru: 06:53 Now with a paid consultation, what you'll typically see is a lower volume of patients. Unless you're a celebrity, if you've gotten to that celebrity angle, you're able to get good publicity in your area. I would argue that these days changes it a little bit as well because people are not paying attention to singular forms of media anymore. But let's say you've got just a celebrity status in your city and in the medium that you're acquiring patients from. Maybe you're putting out a lot of video or you're putting a lot of this effort in.

Nick Dumitru: 07:23 I don't distinguish between free and paid in terms of oh, I'm so happy that I'm not paying for getting these leads because you're paying one way or another. You're sacrificing either your family time or you're sacrificing your health, your stress and you're putting forth effort. So whether you're getting a lot of patients on social media and you've established more of a quote unquote celebrities type status, you're Instagram famous, you're still putting forth that effort.

Nick Dumitru: 07:50 Just understand that if you've got a paid consultation and you don't have that sort of volume and celebrity and desire for people to come in, you will typically see less patients on any given day unless you've got a solid lead flow and you're able to acquire a lot of patients to keep yourself busy and keep yourself booked. But if you're a mid level practice or even doing okay and you're switching from free to paid, all things being equal be prepared for your lead volume to go down. So your leads and the number of patients that you're going to see may drop a little bit, sometimes quite significantly.

Nick Dumitru: 08:26 Now, just like with the free consultation where I said that you have to be prepared for more no shows and things, generally with a paid consultation you will see a higher quality of individual. It's not always the case, though. I'm seeing a really strange trend that's happening, I'd say over the past six to eight months in the more competitive markets where people are just more distracted than they've ever been. Even though they paid, they put down a credit card, they're ready to come in for these consultations, there's still no showings. So that's still an issue. Lately, I've been seeing that, like I said, in the past six to eight to 12 months or so that's just been a trend that happens.

Nick Dumitru: 09:03 But with a paid consultation, if you've got a paid consultation, you should typically expect someone further down the buying cycle. This is someone that maybe has gone to some free consultations or maybe has gone to some other paid consultations and now she's ready to go through with her decision. She's on that journey from the beginning where a person thinks that they may need something to the point where they're ready to take action. You can just think of that as a journey, as a buying path is how I describe it in my book. Is they're on this path and when they are paying for consultation, they're further down this path and they're ready to go. You should expect that. That's typically what happens. Again, I don't say that as a hard and fast rule because I have seen people starting to flake more lately, but that is typically what you should expect.

Nick Dumitru: 09:53 That's one of the main things about a free versus paid is the number of people in the quality and the readiness of them to purchase and go through with their surgery. Those are the two or three biggest differences that you'll see.

Nick Dumitru: 10:06 Now, I said that you should start thinking of this in terms of the strategy of your practice. What is it that your practice needs? Depending on what level you are, let's say that you're a younger physician, you're just getting into the market versus someone that's established and has been there for a long time and has a following, has a referral base, this is where you can start thinking about the strategy of your practice. When I say strategically easy, you need to look at your practice and how it's going to impact it and what stage it's at. If you need to take the beach versus take the stronghold tactically and strategically in order to win the war, you have to look at it. So what stage of this battle are you in? What part of the war are you engaged in that you need to move forward?

Nick Dumitru: 10:49 With the younger physicians, someone that's maybe younger or even established but not busy, no longer busy, that happens as well. I'm going to put you in the same boat because both of you are dealing with the same issues. Now, the younger physician needs to see more patients. Because he or she may not be in a good spot in terms of a referral base or they may not have a lot of before and after photos. They may not have a lot of experience. So they need to see a lot of patients to gain that experience and get the volume and get people coming in because it moves the practice forward. It gets the practice going.

Nick Dumitru: 11:23 Now, what I see is typically with a practice that is more established but not busy, they're in the same situation. They still need these patients. But typically what I see is that the doctor's a little bit burnt out. They're suffering from this idea that they should be more successful. They've got the anguish in their own mind and they're fighting against the psychological issue as well. That really comes from the fact that they are basing their current success on past expectations. They had these things from the past, but their current reality is not that and then it causes this fragmentation in their mind and that leads to unhappiness.

Nick Dumitru: 12:01 What happens typically is that they don't have the energy to see a lot of these free tire kicking patients, people that are further up the path. That's really an energy issue. Age doesn't really have a lot to do with it. I'll tell you that I've seen doctors that are in their 70s, mid 70s and still going really strong and they're ready to go. Their mind is in the right spot and they've got the energy level to do that. Typically with younger doctors, that's not an issue because they haven't been burnt out yet. But it's not an age thing. It's really a psychological, emotional, depression style situation that you're dealing with there.

Nick Dumitru: 12:39 A practice without a lot of volume, without a lot of current volume in a market that has the volume to sustain it should strategically look at a free consultation and see if that's something that they can handle. So look at the strategy. I need more patients. I need to grow the practice. I need to breathe some fire into it. I'm charging 100, 150, 200, $300 for a consultation, whatever it is that you're charging that may be putting people off. It's costing me a lot more to acquire my patients. I've got the time because I'm not busy so strategically I should consider bringing on free consultations or at least the option of it to try to increase the volume on my slow days.

Nick Dumitru: 13:18 So you look at it strategically, like if you're busy on Mondays and Wednesdays, because that's when everybody wants to come in, you can do a consultation on a Tuesday or Thursday if you're available and then do those free maybe to try to free up those spots. If someone is resisting paying for a Monday, you can try to shift them over to a Tuesday."Well look, the doctor's willing to see people on Tuesdays. It's A bit busier. You may have to wait a little more, but it is a free consultation. Is that something you may be interested in?" So you give your staff this strategic tool that they can use at a tactical level to try to fill up your non-busy times.

Nick Dumitru: 13:53 This is what I'm talking about when I'm saying you've got to evaluate your practice, what stage is it in and look at it strategically and see what impact it will have for you to switch from free to paid and vice versa.

Nick Dumitru: 14:04 Now, I don't just deal with doctors that are struggling. I do deal with doctors that are doing very well and they just want to do better. If you're a successful practice, when should you consider a free consultation? What I see and what I deal with typically is when you want to increase the volume of your practice and the physician is busy, but you want to scale, you want to open up a second, third, fourth, fifth location and you really want to move this over, you want to increase the volume of people that you're putting through your practice and increase your income and you want to leverage your time by offering a medical consultation for more patients without you being there.

Nick Dumitru: 14:42 What I mean by a medical consultation is rather than offering a physician consult ... in our consultancy we tend to differentiate those two. So we look at a physician consult as that's the cream of the crop, that's the top level that you can get as a patient. But you can also give something to people that are just looking to maybe do a little tire kicking, get some answers, maybe get their hands on some implants and see what they feel like. Just from the purchase ... on their buying journey. They're not quite there yet. You can offer your staff to them as opposed to your time. You can make that time free.

Nick Dumitru: 15:17 That's one way for you to leverage in a busy practice where the physician is maxed out, but they do want to see more patients. They want to capture more of that market to capture that market. Really the variable will be time. You go from a person that's ready to go in a month or two months or three months or six months or a year or two years to their surgery, you still want to capture that patient and start nurturing them.

Nick Dumitru: 15:39 The way that you do that is that you let them engage with your practice. You get them on your list and you follow up with them over time and really nurture them through that decision and try to accelerate the decision but without tying up the physician's time. Because you're busy, maybe you're maxed out with these paid consults anyway, but you do want to scale, you do want to try to get more geographic reach, you want to open up multiple locations, you want to bring on a partner and really grow your practice. To do that, you need the volume to increase the volume. This is something where you could offer a free consultation as a strategic decision to help you grow the practice.

Nick Dumitru: 16:13 Again, strategy versus tactic. The tactic is not as important as the reason why you're doing it. So look at that in terms of where your practice is at and what your goals are. Those are the two biggest things that you have to really look at before you make a tactical decision, before you make a move and decide which tactic is better, is look at where you're sitting and where you want to be, and then decide if the tactic is going to help you achieve that strategic objective.

Nick Dumitru: 16:40 Now, the other place a successful practice could start changing is when they need a lower cost of acquisition. So more patients, they want to pay less to get these patients and they want to really free up the doctor and they want to put the doctor to do more surgeries as opposed to doing a lot of these consultations where maybe tying up a lot of his time. So by offering this kind of free consultation, by changing the model, the strategic model from going to, let's say you could go from a physician consult to a pure medical consult where they just see a medical specialist or someone that's not the physician and they only see the physician for a brief amount of time. Again, this is a strategic decision. It can impact the quality of your reviews. It can impact the quality of the patient. It can impact everything, but strategically would allow you to grow.

Nick Dumitru: 17:28 You need to decide if this is something that makes sense for the practice, if this is a strategy that you want to employ. Again, when you try something, it doesn't mean that it's forever. It's not a forever thing. Yes, there's effort in going back and forth because you've got to train staff. But if you are running regular meetings with your staff, that shouldn't be a problem because you're valuing their input and they're part of the company, you should be able to make these kinds of moves and carefully calculated tests without issue.

Nick Dumitru: 17:54 Now, we've talked about how going free versus paid can cause certain issues like no shows and so on. So I want to discuss some coping strategies, some things that you can start to think about in terms of how to handle some of those situations.

Nick Dumitru: 18:09 One of the things that I want you to think about is how you can increase the show rate, decrease the no show rate, because there are tactics that you can employ which will help them. Like reminders, taking a credit card, things of that nature. You start to look at the no show situation if it happens to go up with a free consultation and look at ways to build value into that consult and talk to your staff and really train them up and make sure that you are policing them doing these tactics that bring people into the practice. Because like I said, a free consultation isn't necessarily better all the time or worse than a paid consultation. It's really a matter of how you handle that and how that impacts your practice. So one of the things that you need to start coping with is this no show rate. So start thinking about how you can deal with that.

Nick Dumitru: 18:57 Now, if you've gone with a paid consultation, one of the impacts that can happen is that can tie up the doctor's time. If you do 100% of your own consults with no staff support, you may be struggling with how to handle the physician's time. That's one of the things that you can start talking to your staff about is how can they be leveraged to ease up the burden on the physician. So you as a doctor, how can you now employ your staff and how can they help you?

Nick Dumitru: 19:23 So invite them to give their ideas of how they can help you see more patients squeeze more in, in the same amount of time. If it's taking you an hour, an hour and a half to see a patient, how can you reduce that to 45 minutes? If you're seeing them to 45 minutes, how can you reduce that to half an hour or 20, 25 minutes without impacting the quality of the perception that the patient has, so their perceived value of that consultation? But how can they increase your time and then get more volume through there? That's another thing that you have to start thinking about coping with.

Nick Dumitru: 19:54 I want you to start thinking about having a plan for how to deal with no shows. On a free consultation or a paid consultation when people no show, what is it that you're doing? What is the staff doing? What are you doing as a physician to maximize that downtime other than twiddling your thumbs and feeling bad about it or doing unproductive activity like paperwork or your files or something where you kind of retreat into your sanctum and don't do anything that moves the business forward?

Nick Dumitru: 20:21 Now, paperwork's important, but it shouldn't be a high energy activity at your most prime time. Typically you're seeing patients during the day when you've got a lot of energy; you shouldn't be doing a low energy activity like your files when you could be doing something more productive, picking up the phone, working on your marketing, whatever it might be. Think about how you can switch gears like that. If a patient doesn't show, rather than feeling bad about it, how can you maximize that downtime? What can you do? What are the strategies that you guys can employ and what are the tactics that you can put in place to really help you cope with that if that happens and you get no shows?

Nick Dumitru: 20:56 While you're working on getting more people to show, you're also working on managing this downtime so now it's not a wasted effort for the practice. You could do mini team meetings. You could do ... working on things together. You could go on your own and work on things. You could pick up the phone. You could get your staff to call out and get referrals and get people coming back for non-surgical treatments. How can you maximize that time for the whole practice when a patient no shows for whatever reason?

Nick Dumitru: 21:27 Now, we talked a little bit about building value. One of the most important things here when you're coping with no shows is how are you building the value? Why are people coming to your practice? What's the reason that they're there? Why do they want to come in the first place? And are you building the value for them into coming into the actual consultation even if it's free? Just because something is free, it shouldn't lack value. The person should be excited about it. So how are you dealing with that? Start talking with your staff. Start talking with your marketing director and really figure out exactly why people are coming in and what you're adding a value to that transaction that people actually want to show up.

Nick Dumitru: 22:07 The other thing I want you to realize is that in a competitive market, if you've got people that are providing the same services as you, whether it's Botox or breast augmentation, it doesn't matter, if the consumer has a choice it's very important for you to stand out from them. I highly recommend you grab my book. If you haven't, you can grab it on Amazon and you can fill it in on our website ... thinkbasis.com. I'll put a link in the comments. But if you haven't gotten the book, and I'm not trying to sell books here, believe me. The number of plastic surgeons in the world, if I got all of them to buy a book, it would not make me wealthy. There's just not enough plastic surgeons out there to do that. That's not why I wrote the book. I wrote the book to really help you.

Nick Dumitru: 22:47 I want you to get an understanding that when you have competition in the market, if you're a commodity, if the consumer has a choice, they will go with the person that they feel best meets their need and they have a reason to purchase with them. So you can't afford to think that you're the only option in the market anymore.

Nick Dumitru: 23:06 This is a misconception that I see, particularly with doctors that have been in the market for a while, 15, 20, 25 years. They don't understand because the good old days are gone. The good old days when someone came to their practice or called or was referred and they're almost like a give me patient, it was very easy to close them. Those days are gone. These days in some of the larger cities, they've got 40, 50, 70, 90, 100 something plus options to go to. They are educated by the market and by your own association. The American Society of Plastic Surgeons actually tells people to go see at least three doctors.

Nick Dumitru: 23:43 So don't assume that because they have booked a consultation with you, there's a reason for them to come to you. They may either have booked two or three more after your visit or before. So you have to make sure that you give them a reason to come. You remind them about how great it is and tell them all of the benefits of coming in to see you and not making a decision until they've seen you.

Nick Dumitru: 24:06 Even if they've gone to the other two or three competitors, they should be so excited about coming to your consultation that they will wait to make a decision with them. They will have gone there, walked out of their practice, but they're still so excited to come see you because you've built up that value in the consultation that they will wait to make a decision. And it gives you the opportunity to actually close that sale, to actually make that patient your patient and take them out of the market.

Nick Dumitru: 24:33 Now if they've got people booked afterwards, they should have had such a great experience in your consultation that it becomes a no brainer to book with you on the spot. That's the other flip side of that is that you want to take them out of the market so that they don't even have to bother going to the other two or three competitors and then they become a no show for your competitors as opposed to you. So keep that in mind.

Nick Dumitru: 24:55 I want you to start thinking about the coping strategies in this situation. When you're thinking about a paid versus a free consultation, all of these issues will crop up. It will change strategically. You may have a reason for doing it, but understand that there are ramifications to any action and that you have to have these coping mechanisms in place. So these coping strategies and then the tactics to go along with them and deal with that strategic objective and the strategic problem that you start facing as a result of changing from free to paid or paid to free.

Nick Dumitru: 25:28 Now to sum it up, I want you to understand that there is no right or wrong answer to the paid versus free consultation. The only thing that really matters is that you figure out at what stage your business is in, your practices in and what strategy is best for your practice at that time.

Nick Dumitru: 25:45 So look at your practice. Honestly, evaluate it. Strategically, what you want to do. Where do you want to go from where you're standing right now? Where do you want to be? What's the strategy that's going to get you there? And then decide on this tactical operation, whether it's going to be free versus paid, and then how to deal with that and do that.

Nick Dumitru: 26:04 All right, so I'm going to leave you with that question. That wraps up this episode. What strategy are you going to employ and why? That's the question I want you to answer. At your next team meeting I want you to really talk about that and start answering that. And really get your staff to start thinking about the bigger picture as well because a lot of times staff will get bogged down in the details and then they don't understand why you're doing it and they may get frustrated. So really discuss it with your staff, discuss it with your practice manager and figure out where you want to get to and why you're going to make this change.

Nick Dumitru: 26:36 So if you're struggling with the idea of charging for a consultation because you feel it solves some problems, you may find that if you haven't really dealt with the other issues, that it doesn't solve those problems at all. So figure out what it is, what's the problem that you're trying to solve, go out there and solve it.

Nick Dumitru: 26:52 As always, give me some feedback. Go to thinkbasis.com. Engage there. Either send an email or engage with a little live chat widget on the site and let me know what you're thinking. Let me know what you're struggling with. Let me know what it is that I can help answer. I'd love to compile a Q&A episode at some point, so the more questions the better. And I will see you on the next episode. Good luck and go out there and make a decision on your paid versus free consultations.

The post Should You Charge For A Consultation? Paid Vs. Free Consults – Practice Perfect Podcast Episode #15 appeared first on Think Basis.

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"I funded most practices that are at least trying to make an effort and follow up, in most cases trying to manage it through Excel, which was really not made for that. They end up just having a huge list of names with phone numbers and sometimes emails, but there is no logs of activity, where was the last conversation was dropped off, what was the reason for conversion or non-conversion, and they don't really at the end come to the right insight of what is working and even sometimes more important what is not working."

Nick Dumitru: 00:44 Welcome back to another episode of the Practice Perfect Podcast. On today's episode, we're going to discuss probably the number one thing that leads to success or failure in a practice, and that is the ability to follow up with your leads. Any monkey can start generating you leads online. The quality of a lead varies. We're going to get into that a little bit. But today, we're going to really dive deep into what makes that work. And back by popular demand, I've got with me, Izhak Musli, who is the former CEO and founder of AtlasKPI, one of our most popular episodes. If you haven't listened to that one, go back and listen to Izhak on that one. He's got some great points to make, and I think you'll learn a lot. That company was acquired and Alex has moved on to his next venture. So I'm also going to call him a serial entrepreneur on this podcast, and we're going to dive deep into the next software and his insights and what he's seen with running both of these companies. So, Izhak, welcome.

Izhak Musli: 01:40 Thank you, thank you, Nick.

Nick Dumitru: 01:41 All right. So, Izhak, you started AtlasKPI because unlike a lot of people that I seen in the industry, you are paying attention to some things that other people weren't, and that is basically what makes a practice work, what takes them to success, what numbers they should be paying attention to. So I want you to take me through the journey of what you learned through running Atlas and what led to this new venture with your medical PRM software.

Izhak Musli: 02:10 Yeah, it's actually very related to each other. So Atlas was really focused on the data analytics, understanding that doctors are not all the time business-oriented or not all the time passed up business schools to understand better how their business work or understand their ratios of their expenses. Really, the key performance indicator that makes the different for most businesses, I realized we were working with different practices that they're very focused on conversion rate, but don't really understand what is conversion rate means, or which conversion rate of the process, or a process as a whole. They wouldn't be able to identify the process from the number point of view, and that really led me to start AtlasKPI to simplify that process, generate for them dashboards so it would make sense to them what they see in the business, the results that they see when it comes to the bottom line profits or even revenue and understand how is it really being generated from a number point of view that represent the process of that.

Izhak Musli: 03:07 When I started to work with the practices more and more over the dashboard, I started to notice that really what can make the difference is not even the optimization of the business, it's really the front end of the business. It's all the part of marketing. There is a whole disconnect from the marketing agency that's not able to access the EMR or the ability to track the leads activity. And when I mean leads activity, I mean anything starting from where the leads are coming from, which we focused obviously, and later, we're going to touch it even more about the qualified leads, not just any type of leads, all the way into full conversion to become a patient and generate revenue to the practice. There is a disconnect between the two, which from Atlas point of view, all the time I was being asked, one time from the marketing side, "Oh, we really would like to see it." And then from the practice point of view, "Ah, where do you like to share it with my marketing."

Izhak Musli: 04:00 Atlas was a dashboard. It was not really made for a CRM type of filling up the gaps. CRM is client relationship management, and that's really started to lead me into thinking, "Oh, there is something even greater to solve that can really move the needle from a different angle before even starting to understand the numbers in order to optimize the practice and focus more on the lead generation, understand how it's being generated, what works, sometimes even more important what is not working and dive a little bit deeper than just thinking of knowing the lead source, which nowadays lead source is not probably the most relevant figure anymore when it comes to leads." So that's really kind of like how it's related to the other that brought me to start a medical PRM.

Nick Dumitru: 04:44 Very cool. And I think just in that little talk that you just gave, I think you've touched on a lot of big points, which I think we're going to have to start unpacking a little bit. Let's just start with the frustration from the agency side. I can tell you as an agency owner, one of my biggest frustrations is definitely the ability to get data in and out of things like CRMs. And for those of you that don't know what a CRM is, it's something like a Salesforce or HubSpot, some of these preexisting ones that aren't really built well out of the box for plastic surgery practices. They don't really work well. And a lot of times, I can tell you I find that it's very difficult to get data. While it may be easy to get it in, it's very hard to get it out sometimes to the point of purchase.

Nick Dumitru: 05:28 So when you're feeding a lead in, when you're feeding something from an advertisement online, like Izhak was saying, the source of the ad is not necessarily so important. And one of the things I want to unpack is this whole idea of omnichannel, the fact that people go across channels, they'll go to your Instagram, to your Facebook, to your Google ad and do a search, go and check you out on websites like RealSelf, these third party review websites and then come back to your website and make the purchase. And it didn't really matter where they... sort of like the journey that they followed through, is not as important where they started, is where they end up. What's important is that you're able to track your efforts across those channels and the fact that that channel is making you sales. So you're not accidentally cutting it out because you thought that it's not producing for you.

Nick Dumitru: 06:17 And as an agency owner, like I said, while we're able to feed in these leads from the various sources, I have no idea if the practice is actually making money most of the time. And the shocking thing is that the doctors don't even know if they're making money. So they'll pull up spreadsheets, they'll do all of these convoluted things to try to get to the numbers. But at the end of the day, they don't know if that lead came in and book surgery and how much money that generated for the practice. And if they do know it, it's because they spent hours and hours digging through the spreadsheets and teasing out that data, which just slows down the whole effort because now we don't know where to scale, we don't know where to get these new leads from, we don't know how to move forward with that. And just not having that data is hindering a lot of practice.

Nick Dumitru: 07:02 And I would say from what I see from the agency side is that one of the biggest things that holds them back is, one, not knowing their numbers, and two, not being able to follow up with them. Izhak, I want to get into that a little bit more. So let's start talking about your definition of a lead. So what is a lead to you? How do you define it in your system?

Izhak Musli: 07:20 So there is really... and not getting too technical, but I'm just going to use two different figures for that. One is going to be MQL, which is marketing qualified leads, and the second one is going to be the SQL, the sales qualified leads. And there is really two types of leads. If we try to separate them into two different names, I'll say we'll touch on prospect, which is more on the marketing side. It's to find people that are putting inquiries that you have no idea who they are, that maybe you have only name and phone number, or maybe just the name and an email, and you want to qualify them and then move them over to the other side of the fence, which is the SQL or the sales qualified leads, which where the practices really can start to focus and say, "Okay, I know that he's a potential patient. I know that if I give him the right information or answer the right answers to these questions, I can make and book consult and from there the doctor can take it and convert him into a patient if then is still relevant."

Izhak Musli: 08:14 So when we think about leads, it's important for the practices to realize that there is two sides for leads. It's not just one big thing. Any type of phone number that coming in through the website is not necessarily a lead yet, and I think that that's where I'm also working with practices to understand that there is a two-step type of process. The first one normally I think that needs to be on the lower tier and kind of like envision it like a virtual walking patient. If somebody's just walking into your practice, he's always going to hit the front desk. And they're going to ask him a couple of questions. He's going to ask his own questions. They're going to make sure he's actually a potential and he's not just trying to sell them a marketing services, or merchant services, or anything like that, or new hardware, or new machinery. And there is obviously different type of criteria as in different types of questions that they will ask before they're going to say, "Okay, now we can speak with our patient care coordinator, which we're going to put on you a lot of effort and give you all the answers to all the questions."

Izhak Musli: 09:13 So the two steps are normally all the inquiries should accumulate within the front desk. They should start to reach out to every inquiries that they get. Then we'll call them a prospect in this case. They need to reach out to them, they need to speak with them. In most cases, we found that over 80% of practices not following up on a lead more than one time. After the first time they get the information, they tried to call that prospect. If he didn't answer, in 80% of the time, they're not even going to try a second time understanding that a qualified prospect can go up to $400 on average with some practices. So it's kind of crazy when you think about it. But if they will start to follow up and that's kind of like all goes together, then we're jumping from one thing to another.

Izhak Musli: 09:58 But if they will manage the follow up process to qualify those prospects, all those inquiries that are coming in from all the different channels that they have, like you mentioned, whether it's RealSelf or their website or their social medias. And they will try to put an effort and try to make it systematic, to try to make a phone call, then send them a text message if he's okay with that, send them an email, add them to the email dripping campaign that they probably already have within MailChimp or any of those types of engines, reach out to them on social medias, etc. All kinds of different methods that they need to try to follow up and get more interactions with those inquiries, understanding that each one of them can be the next patient or that can happen from the front desk point of view.

Izhak Musli: 10:42 Once it's been qualified, and only then, then it moves to the patient care coordinator, that then will speak with qualified leads that are potential to become a patient, give them the right answers, understanding that it only take one wrong answer to lose the opportunity. So you want to make sure that the patient care coordinator he's actually trained to answer all the hard questions and then turn them into a consult where the doctor can come, meet with them, and of course, convert them hopefully for a patient. When we speak about leads, it's really the importance of defining it as the two sides of the fence. There is first the prospect, those prospect turning into leads.

Nick Dumitru: 11:23 I couldn't agree more. And I want to backtrack just a little bit on the lead things and go even a little bit further up the chain from marketing agency standpoint. Just because I find that a lot of doctors and office managers they don't really understand the whole online marketing game and how it works, so I want to just clarify a few things in terms of what a lead is and how we define a lead, because you'll talk to people and they'll promise to generate your leads from anywhere from $20 to, like you said, $400, $500 a lead depending on the type of lead that they're generating and the source that they're getting the lead from. But a lead is not a lead. This is the type of thing where quality really makes a difference and the way that it's generated really makes a difference. Now, I want to get into some concrete examples of that just from the agency side.

Nick Dumitru: 12:12 So I'll give you an example. One way that you can get a lead, old school way is to buy a list. So you can buy a list of names and addresses and phone numbers of people that may be a good prospect for you. That was the old school way of getting leads. You hand that to your salesperson, they would do outbound calling. Here's your list of leads, good luck with it. You'd bang the phones all day and hope to get a sale. That's one kind of lead. Now, with the internet and the way that things are progressing these days, you can generate leads with online ads. That's the most typical way that it's done these days. You can also get a lead from a TV source or other sources, but let's focus on the internet. Even within an internet lead, there are multiple ways to get them. So very simple, one would be the difference between interruption and search or seeking advertising.

Nick Dumitru: 13:00 So when someone is seeking, when they're in a seeking behavior, they'll do something like go to Google or Bing and they'll type in a search term like breast augmentation of Manhattan or whatever. And they will try to find a physician because they are actively seeking versus interruption advertising on a platform like Facebook or Instagram, where people are not really looking for anything. They're there hanging out, spending time. And this called interruption marketing because you are interrupting their flow. Typically, they're bored, they're looking at pictures of family, cats, travel, whatever it might be, and then you can get in their face and get their attention. And it's a very powerful form of advertising. But that type of lead can be a little bit colder because they're further up the buying cycle. Everything's a journey in terms of when someone wants to do a procedure and when they actually go through with the procedure. Think of that as a journey, as a roadmap.

Nick Dumitru: 13:51 And if they're further away from their goal, because they're no longer seeking, they're not right there at the end ready to go, they may be interested. So that type of lead is a little bit colder. We call that a colder lead versus a hot lead, which is ready to go and ready to book surgery. A cold lead may need some nurturing. So while the volume is much higher, you have to do a bit more work to try to get them in because they will be a little bit less engaged. You've interrupted them, they've acted on impulse, and they may not be ready to go for a couple of months. So like Izhak was saying, when that kind of lead comes in, where I see the most amount of failure with practices is their inability to follow that up in a consistent manner. Because if let's say you have to follow up a lead just even once a week as just say like that's a bad example, but let's just say you do it once a week, you get 100 leads that week. All of a sudden, next week it's 200 you're following up for. If you're doing it for 30 days, by the end of the month, it's 400 leads that you're now having to follow up to consistently that week. And it starts to become a real challenge without tech in place.

Nick Dumitru: 14:53 And just to finish off that conversation, I want to give you one last example of a really cold type of lead. So you can get people to fill in online forums, but there's a big difference between what Izhak's getting at with a marketing qualified lead, which may be a person that has filled in a comprehensive form. So that's just a simple example of someone that's put in the extra effort to tell you a lot of information and give you a lot of feedback versus let's say that we run a contest for like win a free session of Botox or free injectables to take care of your wrinkles, we're going to have one winner. Well, you might have 1,000 people fill in that form. But while they may be leads in the sense that they're interested in that kind of service, they're not a warm lead or even a hot lead at all. They're very cold prospect.

Nick Dumitru: 15:37 And the point of all of this is that a lead isn't a lead isn't a lead. A lead has to be qualified. And when they come in, the only way that you can really handle it as a smaller practice with maybe just one, two, or three people at the front desk is to have something in place to follow that up and nurture that. So, Izhak, I want to hand it over to you again and really start talking about this kind of leverage, like where do you see practices failing and how is the technology that you're putting in place, how is that leveraging the staff and the people in their efforts to be able to start following up with these leads?

Izhak Musli: 16:13 So it comes in two different areas that really focusing... I funded most practices that are at least trying to make an effort and follow up, in most cases trying to manage it through Excel, which was really not made for that. They ended up just having a huge list of names with phone numbers and sometimes emails, but there is no logs of activity, where was the last conversation was dropped off, what was the reason for conversion or non-conversion, and they don't really at the end come to the right insight of what is working and even sometimes more important what is not working. In most cases, they just end up with a huge list that nobody know when was the last time somebody talked to them, or if they were editing to the email campaigns, or if they were trying to text them and they don't come to any consistent process or recipe, I'll say, that say, "Okay, when a lead comes in, you need to call them right away. Then if you didn't answer, call them again later on that day or first thing tomorrow morning, send them a text message, send them this email." And that's what we found that works the best to get the response back and convert them into a patient or qualify them.

Izhak Musli: 17:19 It just doesn't work that way and there is no system. The EMRs do not have the ability to log activities. They are made for exactly what they are, for the electronic medical record. Once that lead is ready to schedule an appointment, only from their on really the EMR kicks in and some of them doing great job, some of EMRs. But anything before that is really untrackable, people are not tracking it. So medical PRM, what they develop is really the tool that helped them not just to understand what works and not working by generate and populate all the marketing information that agencies need in order to understand the different types of campaigns, if it was a promotion that triggered them to come in or if it was a Google advertising that pushed them to come in and not just the website form.

Izhak Musli: 18:10 Like you mentioned before, it's the entire journey to understand the journey of how they end up coming to that website to submit that form, or how many times they were visiting the website, or if they came from a paid advertising, or if they came from organic search, but also to be able to enforce the activity, the log of every activity that was every touchpoint that was made for that prospect to qualify them, every touchpoint that was made by the patient care coordinator to move them forward, to schedule the appointment. And then if there is no appointment at the end, or if there is no conversion, or if the lead is not qualified, then to also log the reasons of why not so they can stop to spend their money and help their marketing to become more of a sniper type of marketing and not just blasting shotguns to everywhere in spending the budget of the marketing everywhere.

Izhak Musli: 18:58 The goal or the entire game is all the time to optimize and to improve user data so your marketing can really start to narrow down the procedures that you want to promote and bring you the most qualified people for those and not just blast on social medias and spend all the money inside Google advertising that definitely would generate to you a lot of inquiries, but probably not to the things that you want and not maybe the highest qualification for those.

Nick Dumitru: 19:23 And not necessarily on the bottom line. I think that's the point that a lot of these doctors are missing is that they get starstruck with the inquiries coming in. Everybody feels really busy. But at the end of the day, I found very few of them know exactly where the money in the bank account came from exactly. They know it's from their business, but they don't know exactly what generated and they're just happy for the phone to be ringing and for them to be talking to people.

Izhak Musli: 19:50 Exactly.

Nick Dumitru: 19:51 So, Izhak, you hit on a lot of big points and I want to backtracking. Again, a lot of the people that listen to this podcast are physicians. Their office managers, they're maybe not necessarily trained in marketing and business. And I just want to make sure that we go step-by-step so that everybody understands the important of this because you make some very, very big points very casually and I get it. But I want to make sure other people don't gloss over that. And one of them is that the point that you made with the staff where the staff they don't have their processes in place, where you end up with anecdotal information. And I find this in a lot of practices. When I talk to a doctor and they're telling me that, "We've tried something and it doesn't work," I said, "Well, hold on, why doesn't it work?" Because I'll never forget this story. I went to a practice and one of my first steps typically is to try to raise what the physician is getting because that adds to the bottom line profit, like a $500 raise in your services can sometimes double some of their bottom line profits if they're only making 500 bucks on the actual procedure and profit.

Nick Dumitru: 20:55 So I always look at profitability first. And what I do is I just start adding it up. And then one of the staff said to me, "Well, I don't know, a lot of people don't like these new prices. They're complaining." I said, "Really? How many people? How many did you call?" "Well, a few." "No, exactly like how many phone calls did they have?" "Well, it was one." Oh, so one person complained because the staff they bring their own bias into your practice, like their own life experience, their own upbringing, whatever their parents did to them to make them think a certain way." They bring that to the practice, and then as a physician because you're not there. The physicians typically... you're busy doing other things, preferably surgery, or you're in seeing patients, or follow ups, or seeing actual medical cases if you're a hybrid model where you're cosmetic and a hospital, you're busy doing medical things and you're relying on the staff to give you that feedback.

Nick Dumitru: 21:50 But as a business owner, when you take off the doctor hat and put on the business hat, as a business owner, you can't rely on anecdotal information. You need the hard data. You would never introduce a new drug if someone just said it looked like it worked well. But I find that very casually the doctors will listen to the office managers and just take their advice. They just take their word for it when they don't have any actual concrete proof. They don't record calls, they don't record data, they just pay out for advertising and basically listen to the staff. And because the staff brings their own insights into it, then you end up making the wrong decisions. And then there's a lot of frustration and then I end up hearing, "Oh, we've tried that and it doesn't work." Well, the thing is that you don't know what you've tried and you don't know how you tried it because you're just relying on one data point which is an opinion.

Izhak Musli: 22:40 And you remind me of a saying that we used to say knotless all the time. And it's a very known, it's not ours. But without a data is just another opinion. And we always used to go by that. Anytime that somebody was trying to argue anything within the company or even with clients, if you don't have the data to back up what you tell me, you most likely just had one bad experience that made you to come to this conclusion. People are very emotional. We normally going to remember the bad things, the bad things about the client that complained, not all the other clients that were super happy from that. And that's what we later going to take forward and make the decision based on that, which is it's the wrong decision in most cases.

Izhak Musli: 23:18 It's very emotional, it's very loaded, it's sometimes just one client that was very loud and complained very strongly about one thing, and then you take it and put it across everybody else and you really damage your business this way. So you're 100% right. One bad experience does not mean that something is working or not working. If you don't have the data to back it up, you're just guessing 100% of the time.

Nick Dumitru: 23:41 Yeah, and it's shocking and it's expensive. I can tell you that complained with that just the $500 increase, that was at that point, even before growing the practice, that would have cost that physician $160,000 in profit, like extra profit a year without doing any more work. And it was just because one of the staff members felt feelings about raising the price by $500 for $8,000 procedure. Yeah, it's heartbreaking to see that happening. And I'm excited by the fact that you're introducing things where you can start to empower the staff to have that and empower the doctor to have that date on the back of their work.

Nick Dumitru: 24:20 And another big point that you brought up is this consistency, the idea of doing things consistently, the fact that being able to answer the hard questions, making sure that they ask the right questions, that they answer them the same way all the time, that when you make an adjustment to the answer, you can see the outcome on the lead flow in the booking rate and the closing rate of the sales. So how is the software doing that? What do you have in place to be able to do that?

Izhak Musli: 24:46 So I first started the communication. I'm making a lot of predefined type of activities. So it's a lot of dropdowns, not just free text. So people cannot just do whatever they feel like. And that's kind of like number one mistake when you're not consistent is to give people the freedom to just make up things. You need to give them inside guidelines. So most of the system is defined by predefined activities. So when you select, "I send them an email," you need to select which of the emails? "I send them a text," which text did you send them? So there is no many place. There is also of course places for notes, for additional stuff because there is always corner cases, not everything follow the 80-20 rules. But for the most of cases, you'll be able to keep them. If you follow up the right way within the system, you'll be able to keep everybody in the same line.

Izhak Musli: 25:33 So like you said, you'll be able to see exactly what works. And you can say and you can define and you should use your marketing providers because that's where the knowledge needs to come into place. How many times did I try it before I conclude whether I should change it or whether you work's not working and then how to improve it? And in marketing, and I'm sure you're going to agree with that, there is the AB testing. Everything is the AB testing. Before you can conclude anything, you have to test it at least one more time in a different angle to conclude which one is a better way. Even if something is working, maybe there is a better way of doing it. And the same way works with processes. So when they give the same answer all the time, maybe there is a better answer to give that may generate more results. But you first have to analyze what are results from answer number eight. And that's really how the system has been developed.

Izhak Musli: 26:21 So most of the things are predefined, there is not so much place for, "I told the mix and why and he asked me why and said... in most cases, 80% of the time clients or prospects will ask the same questions, I'll recommend to every practice to predefine the answers that they want to give, the emails that they want to send, the tests that they want to submit, the social medias to their channels and they want to go after those clients and prospects so they can communicate with them and interact with them. Many marketing tools and marketing agents would allow you to define dripping campaigns and move them between the different campaigns that they will get. So it's different predefined emails that they will keep getting based on if they opened the email or didn't open the email. And if they opened the email, they would start to get a different chain of emails, and then you can also test which chain generate them to come back. And the same way it works for prospect and leads, the same way it can bring an existing and established patients as well.

Izhak Musli: 27:18 So the whole mythology can work on all angles and can really move the needle in so many different areas of the business, whether it's to increase the number of qualified consults that they get or the people that actually sits in front are way more relevant and much more potential to become a patient, which obviously is going to right away benefit your conversion rate and will generate for you the more specific procedure versus if you like to do more rhinoplasty or liposuction or breast augmentations, the doctor will have the power finally to say, "Oh, I want to get more of that procedure, more consults of that, and not just random people coming for any type of things." That will benefit directly the revenue, the profits, and the final and probably one of the nicest thing is to improve your marketing ROI, where your budget of your marketing will generate for you more money at the end. I think that that's really where we're trying to pinpoint everything.

Nick Dumitru: 28:14 Yeah, I couldn't agree more on that. And you touched on that point just now about predefining the questions that patients ask. And I got to tell you that you're jogging my memory because I have to say that that's probably the number one thing I'll see in any practice that's gotten more than one person picking up the phone, is that there's zero consistency in how the two... if there's two receptionists, they do things very differently, even between the two of them. And it's not just them. Even in the practice where it's just one receptionist and you would think you would have some consistency because things are not predefined, it's really relying on her mood and whatever she feels like saying that day. And there's no checklist in place, there's no predefined answer, there's nothing that she can go to to really create that consistency and have that flow.

Nick Dumitru: 29:03 And I'll tell you as a marketer, the issue that I have with that from a marketing standpoint is that it throws off my AB testing on the other side. So you're talking about AB testing within your software, which, by the way, that just made me super excited. I can't believe that you're even thinking that way. I've never seen any kind of software think that way in terms of AB testing these processes, which is absolutely critical. But going back to the marketing side where, yes, I do have the ability to AB test quite easily, AB test landing pages, messaging headlines, images, ad, ad types, ad targeting, delivery targeting, all that stuff we can AB test and it's fantastic. But here's the thing, if that is going on and then the receptionist is doing something wrong, like if I'm doing a click to call campaign, and I'm trying to track how many calls I get and how it goes, her ability to book that day and her consistency is the number one factor that's going to determine the success of my AB test.

Nick Dumitru: 30:01 So it throws all that off if the backend variables are not in place and they're not static. And that's a huge mistake as well. And again, it introduces what I would call pollution in the data. And it gives you data that's just dirty and not useful and you can't know where you went wrong. So you end up screaming at the marketing company when really it's your staff, and you've got no idea what the staff is doing. Whereas if we could keep those in place and start having that consistency with the software and having the data on the back of that, I think that it'll also improve your decision making on the marketing side and ultimately enable your marketers to do a better job for you, because a lot of agencies, they just want to get your results at the end of the day and keep you paying. They want to do a good job for the most part, not all of them, but as you say, for the most part, they want to try to do a good job and it'll help them do better for you as well. So I think that that's important.

Nick Dumitru: 30:57 Izhak, another thing that you brought up and it got me excited and I didn't touch on it when you previously just spoke, but it's this idea of data versus insights. And I find that a lot of people that bother to track, that are even at that way, which I'd say is like 1% to 2% of cosmetic practices that have gotten even to the point where they've got a spreadsheet and are kind of aware of what's going on even though it's painful, they've got this data, and I'll define data as numbers like let's say 25% or 30% closing rate. They've got this data, but they don't have the insights. And what you said there about being able to take notes and give you the reasons why and why not, talk to me about where that came from and why you put that in. Because I know as a business consultant, I'm always looking for that insight. I'm looking for the story behind the data, and I want to know what led you to that and why you built that in.

Izhak Musli: 31:49 Yeah, that's obviously the nature of what I do is always data. If it started even from Atlas, it's just the way business works. Knowing what works is only one part of the equation. If you don't know what's not working, you can really spend so much effort than money in one place and not understand that you can just take that budget to take that efforts and put them into the other side of the equation and double your performance. So the importance of the insight is more than just, like you said, just the numbers. The data, yes, it's nice to have, it's great that they fill up in Excel. But if they say, "Oh, my conversion rate is... and I'm going to take the number that a lot of people like, 70%, which we know it's most times not correct, but will touch the 70% and you say, "Oh, why is it only 70%?"

Izhak Musli: 32:38 You can challenge numbers that you get from the data. You can do that only when you have the insight. If you don't have insights, you can really not challenge the number. You just have to agree and accept it the way it is. And for me, as an analytic side, it's the hardest part just to accept the number the way it is and not that why is it like that? Can we get it better? Can we do a better performance on this? How can we improve that number, or why is it so bad? Sometimes you say, "Oh, I'm getting 100 prospects, but only 10 out of them are scheduling a consult. That's a 10% conversion from prospect to consult. Can we change that? Can it be better? Is this the best that we can do without the insight of the data, without all the entire story, which means you need to accumulate the data, you need to put it inside the process?

Izhak Musli: 33:23 You will never know if you can improve it, you'll never know if it's the right number, if it's accurate, if it's just the number that is random based on random activities of different people that do their job. Like you mentioned, one reception answer A, the other reception answer B, that can fluctuate the numbers in tremendous ways. So without keeping consistent the storyline or the guidelines that you set inside your business and then apply the data on top of that, you will never going to be able to get the insight. I think that's really the importance, the ability to challenge those numbers.

Izhak Musli: 33:56 So if you made $2 million that year, and next year, you want to set the goal, your goal is going to be a completely a guess. If you don't have an insight that based on that you can say, "I'm going to tweak X, Y, and Z in order to then set this goal." You're just going to make up stuff. And that's what I see all the time. We used to see it in Atlas. I see it when people speak about generating more leads, "Oh, I'm going to spend more money on my marketing. I'll generate more leads." Doesn't mean you're going to generate more consults, it doesn't mean you're going to make more money. You may just going to spend more, but that's the only fact that you currently have.

Nick Dumitru: 34:31 Absolutely. One of my favorite sayings from my book is that activity doesn't equal progress. And that's what it is. People love to get the activity and they love to feel busy, but they kind of put blinders on when it comes to checking if it actually added to the bottom line. So on that insight, I love how you said challenging the data. I love that. I'm going to take that saying from you and I'm going to use it from now on because I think it's very important. And I always try to... just for the listeners, I try to bring it back to a concrete example in terms of what that means. So I'll give you a case that I was just dealing with the other day. And this happens actually in a lot of practices where they have to decide between a free consultation versus a paid consultation. It's a very typical thing to decide. Younger doctors, they'll typically try to do a free consultation to get more people in the door. What happens when you add a fee is that it'll tend to drop your number of consults, but you hope it increases the quality of the consult because the person's a little bit more serious.

Nick Dumitru: 35:28 So that's a decision that's very typical across plastic surgery, cosmetic, anywhere that deals with consultations, this whole free versus paid. And when you add the fee in, what immediately happens is that your conversion rate from your leads goes down. That's an immediate thing that you can pretty much expect it to happen unless you're in an area that doesn't have a lot of competitors and you're kind of like the only option and you've got a monopoly. That's an edge case. Most big cities, though, you've got another, 30, 40, 50, 70 plastic surgeons like you would have up here in Toronto or LA or somewhere, or 100 in Manhattan. So in those cases, what will happen is that your number, the data will go down. So if you went from say like a 50% or 60% conversion from lead to consult, it'll drop down to 40 or 30, whatever it is, you'll see a drop.

Nick Dumitru: 36:17 And then it's very hard to know where to move forward. So this is where I see people getting stuck without the insights. When you say you can challenge that data, yes, it went down, oh, what was [inaudible 00:36:27], our consults went down. But the question then becomes, of the ones that came in, did more of them book surgery? So are these people that are paying the consultation fee more likely to convert into paying clients that actually book surgery and pay you for a surgery? So are you making more money on the back of those consults, or were you making the same amount of money on the back of the free consults you're getting the higher volume, but then was the conversion to surgery the same? And when it drops then, the question starts to become why is the drop?

Nick Dumitru: 37:00 So here's where the insight comes in, and this is where they get paralyzed. "Oh, no, the consultation is dropped. What are we going to do?" The only option, it's usually just an on or off switch for most of them. It's like boom, either consultation fee on or off because they're just at the beginning of that stage. And without the insights to know what is the objection to the price, tell them that it's $100 $200 consult fee. What is the objection? What's the story behind that? What are they saying? Oh, they don't want to pay because oftentimes it's not the money that's the issue. It's the fact that your sales staff didn't do a great job of selling the consultation and the procedure. And then if you've got that insight and your sales staff starts to say, "Well, they don't want to book." Okay, we'll ask this question, "What's the issue? What is the answer that they're giving you?"

Nick Dumitru: 37:47 Now, you start to get the data. And then you've got ways that you can start to adjust and then you can, like you said, put in those places that you can start to AB test in those standardized answers and empower your staff to really convert more of those people and then bring that consultation number back up. But when you've just got a hard percentage number, you've got nowhere to move from there. It's pretty much either on or off, and then they get paralyzed and don't know what to do. So the fact that you guys are thinking about that just from a business development standpoint is very exciting for me as a consultant. The fact that I can think that I can give this to the clinics that we work with and the practices and the plastic surgeons that we work with and tell them that they've got that and empower their staff to have that data and then I can get that data fed back to me as a consultant really lets me do a better job for them as well as them doing a better job for themselves. So I think that that's fantastic.

Izhak Musli: 38:39 Yeah, and I think you gave a great example. I think it's a classic example of many practices that have these challenge. I used to be asked this all the time in Atlas and there is really without a clear understanding of the operation and the processes, it's very hard to consult them whether you should or shouldn't charge for a consult. You need to understand the staff and that's part of what we also develop inside the system. Everything is user-based, so you can really see which front desk user, or even which patient care coordinator interacting more, or what type of activities they are applying that then benefit later the performance to the goods or the bad. So then you can know which person you need to improve more so.

Izhak Musli: 39:17 If you see that most people that coming for Botox that say inquiries and speaking with that front desk representative are likely to book less appointments after that versus the other, let's say the second front desk person that you have that getting their Botox and having a higher number of consults booked you know that you have a training issue. You need to go back to that same rep and speak with them exactly about Botox, exactly for what reasons you need to speak with them. If you see it's a male versus female, that's really the insight that you'd be able to get by logging it correctly, by applying the right technology to log all those different types of inquiries and applying all those resources and efforts to at the end try to generate more revenue to your practice and grow the business. So like you said, it's to test all the time, to always challenge the numbers, and always improve the process. That's the name of the game that's really running your business.

Nick Dumitru: 40:12 Yeah, absolutely. And I think we could talk for hours on this type of stuff. And just for the sake of brevity, I want to try to keep these episodes to like 45, 50 minutes, typically under an hour just to give doctors a chance to listen on their commute or when they've got to spare a few minutes. So I think we could go really deep into this. And you guys that are listening to these regularly, you can bet Izhak will be back because we've also discussed a few other ideas that I think would love to touch on together.

Nick Dumitru: 40:39 But Izhak, before we wrap things up on this, what I'd like to hear, because when we talked offline about this stuff, you are telling me about some features that frankly just got me extremely excited, so I want to give you the opportunity to just tell everybody if you had to narrow it down to, let's say, one to three features or four features that you think are killer features in terms of moving the needle, because I'm really all about growth and expansion and getting people to have the life that they want with their business, what are those features? Walk me through maybe the top three or four features that you think will really move the needle for these practices that you guys are doing that others aren't.

Izhak Musli: 41:20 I think I'll start probably with number one. It's the sense of urgency, the ability to integrate an embedded forms inside the website. So when a lead come in, when you get any interaction from a potential prospect, you get notified and you notify the right people inside the practice. So right away they can jump on this opportunity and try to make a contact. Remember that the person is probably browsing multiple different websites. It's kind of like first come, first take. The first practice that actually is going to reach out is going to have the best chance to give the right information to be able to win that opportunity. So the system have the ability to notify the people right away. The moment they sent me the information on the website, right away your patient care coordinator, your front desk, the doctor, anybody in the practice can be notified whether it's a text or even an email. So right away, they can reach out back to the lead and provide all the information.

Nick Dumitru: 42:11 At first, I just want to tell everyone I love that part of it because there's something called buying momentum. Whenever you're selling anything, some people they get into... not most, some people, buyers in general, whatever they're buying, they get into a velocity. So you've got this buying velocity, the momentum and that carries them through to the sale. And if that's interrupted and it's not timely, like Izhak is saying, you really lose out. So if you're waiting until the next day to call your prospects because it's coming in by email, like I've gotten one case where they're literally having to refresh the email every few minutes just to see if the lead came in, that kind of thing is really killing your practice because what Izhak just said there is huge and a lot of people don't realize this. And that is that the market for cosmetic surgery has been trained by everybody from these guys on the forums and blog posts and RealSelf, right through to the American Society of Plastic Surgeons.

Nick Dumitru: 43:05 And any of these societies online, they are told to contact multiple places. They're educated to do this. They're advised to do this by your governing bodies. So don't assume that because you got a lead. They didn't also submit three other forms two minutes ago. And what Izhak said is whoever gets to that first, gives the highest signals an indication of the quality of care that that patient can expect. Because if you can't be bothered to call somebody back when they made an inquiry for 48 hours, that's how they're going to feel that they're going to be treated when they're a patient of yours. If you get back to them right away, that's the first impression that you can take back. That's the indicator of the quality of care that they're going to receive from your practice, the timeliness, the attention, the fact that you care enough about their business and you want them to be with you.

Nick Dumitru: 43:57 So that's something that a lot of people just take for granted and they don't understand that you're in a competition now. You're not alone. This isn't 15, 20 years ago when I started, when plastic surgery was kind of novel, and then you had a couple of options. And if someone called you because they found you online, because SEO was a brand new thing and you happen to be dominating on Google or whatever excite or Yahoo or whatever was top of the Packback then, that they weren't calling five other places. But now, in this day and age, the age of instant communication, they are calling multiple places. So feature number one, I think that's killer, don't underestimate the importance of that. So I'm going to hand it back to you, Izhak. Feature number two, go.

Izhak Musli: 44:39 I'll say auto-population of data. So once you using the integrated forms of the software, when somebody submit information, everything is being populated automatic. So you don't really need to ask how did you hear about us, or what made you today submit this online information, or whether you never even answered after you submitted information. All the marketing data that later conclude what works or not working completely populates automatically, whether you paid for that lead or you found via organically or any of those. I think populate the data automatic and need to start typing inside Excel in a consistent manner is one of the most important things and saving a lot of hours and time for many practices.

Nick Dumitru: 45:21 That's another big one. So I'll tell you what, I'm laughing because it's just that you take me back through a time where it's like right back through the beginning of my career when I started all of this stuff. And the classic way a lot of people are still doing it with spreadsheets now is how did you hear about us? Yeah, well, I can tell you that the accuracy of that data is absolutely non-existent. I was trying to think of a clever analogy, but I couldn't come up with one. But it's just non-existent because, first of all, you're asking that patient to do the work for you. So you're relying on their industrialness... I don't know if that's a word, but you're relying on them being willing to do the work to try to remember to tell you how they heard about you and not just default to Google. "Oh, I did an online search." You don't know that. You don't know.

Nick Dumitru: 46:10 They may have clicked on your ad. So you don't know if it came from your ad campaign or from organic. That's a classic like number one mistake right there. You don't know where to put your money because you're running ads and it's organic. And you don't know if that person actually clicked your campaign and came in or went on the Google organic because Google is still Google to most users. They don't even realize half the stuff is ads. So that's a classic mistake.

Nick Dumitru: 46:33 The second one is you're relying on your staff to actually ask that question in the first place and them not default because most practices don't record the calls and they don't track for accuracy to make sure that the staff is asking that in the first place. And you're introducing human error on a second level. So now, you're sandwiching the human error for a really tasty error sandwich there because they're not doing anything accurately. So the client may not give you the right answer, and then the staff may not answer and then because they forgot. They just default to whatever the most popular one is. And I guarantee you it's going to be either referrals or Google, 100%. So auto-populating of the data where the machines doing the work and giving you accurate data, I can't say enough how important that is. So feature number two, again, that's killer. That got me excited when you told me the first time as well. So I'll hand it back over.

Izhak Musli: 47:23 Okay, and I'll give you the last one, which is also the nature of where all of it leading to the end. And we said talking about the insight and we talk about analytics, of course, the reporting side, where just by doing the regular work, there's work that they do today that just by using the system, they will be able to see the ROI on their marketing. There is ability to enter all the different campaigns, or even if they just want to enter how much they spend on marketing this month. If they don't want to break it down to the campaigns and the different promotions and different coupons that they're applying out, they can do that as well so they can see it on the lowest level degree. But they can also see it from a very high level by just entering how much money did you spend on marketing and then by see for the patient and for what procedure did they convert it for, earned from them. They're going to be able to get the ROI for the marketing. They'd be able to see the customer acquisition costs, so how much they really pay for a lead, for qualified lead or just for prospects.

Izhak Musli: 48:21 And the last, obviously, the conversion rates, they'd be able to see how many leads scheduled a consult, how many consults turn into patients. And that's just few of the numbers and the figures of the analytic side, not including of course all the different type of flogging of the activities of the front desk, the patient care coordinator, and the different provider, different locations, different procedures, but all of that of course is building inside the system. The data is there, and from past experience, I know already how to use it in trying to benefit the practice the most.

Nick Dumitru: 48:50 You got a little experience there. Just for you as business owners that are listening, I'll tell you, Izhak, again, he hits some of these very big points very quickly that I want to make sure that you don't gloss over or miss. And one of them that he hit there is really having those essentially what I'd call red flags, your data, your dashboards. Those are really the things that you can keep an eye on your business as like a 30,000 foot view of your business as a business owner, right between surgeries. Before you do your end of day, you can just have a look and really see if those numbers are off.

Nick Dumitru: 49:28 If you know what the mean is, if you know what it is on average, and you see that something spikes either up or down, as a business owner, that's a trigger for you to look into why that's happening. Because if it's good, if it's spiking up, you want to do more of that. If it's spiking down, you want to see what's wrong with that process, or like Izhak just said, the difference between maybe two of your consultants or two of your receptionist. Hey, what's going on with them? Did something happen in their family, something in their personal life, or have they stopped following the procedures? What's changed? And let me dig into that. And why that's important for you is because you can plug a hole very quickly, right before the ship goes down. You sprung a leak, you can plug it as opposed to waiting until you're waist deep in the water and about to capsize. And that's why that's important as a business owner.

Nick Dumitru: 50:16 And I want to make sure that whether you use software or not, that you're starting to pay attention to that in your own practice. So, Izhak, I'm very excited about this software. I know my clients that I've spoken to about are excited about this. I know the industry is going to benefit tremendously from it. Well, first, I'd like to ask you if there's anything I didn't ask you about it that you feel is important for everybody to know?

Izhak Musli: 50:41 No, I think we covered the most of the importance. As long as there is the will to increase and improve your practice and not just keep your head down and just do your thing, the day to day doctors are very busy, not all the time, really want to play the role of the business owner. That's really the way to make things very easy and keeping creasing and keep improving the business in the most easiest way. They can delegate it even to the office manager to look at the dashboard, to look at the numbers. Marketing information, sometimes you need to review, not even on a daily basis. Sometimes a strategy can take 90 days to start to see really results. By the time it's getting... people make decisions. It takes more than just one banner, one time for a potential to actually submit information you need to pop up in multiple places.

Izhak Musli: 51:26 So it's not something that they need to do on a daily basis all the time, some of them can. I don't want them to think that they now need to learn how to become a specialist of marketing. They can use system like that just to close the gap between the unknown of the marketing agencies shooting today in the dark to a well-known and understanding the data, justify the marketing or making sure they use it and making sure that their front desk and their people are actually maximizing every opportunity. It's their own benefit to do that. So I've seen some practices that actually the marketing agency are the one that are running and chasing the front desk to call people and make sure not to forget to follow up and do all of that part because it's a win-win at the end. The doctor wants to keep to use them, they want to show the performance. So when embedding a system like that inside the practice is really just been a benefit. There is really no downside to that as far as I see it.

Nick Dumitru: 52:19 Yeah, I can tell you I've done that dance-chasing, chasing after the practice to actually pick up the phone and call people. So I'm laughing because I know exactly what that feels like. I did actually remember my point from what you made before and then a second point on what you just said. And that point was that with this data it really takes ego out of the equation. I'll tell you where this came up for me is when I was speaking in France and I am cast. There was a physician there who was very proud of the fact that she was very big on her Instagram, putting her success in Zuckerberg's hands over there in case he changes his mind, her whole business with tank.

Nick Dumitru: 52:54 And then she wasn't paying for her marketing. And all that said to me is that she's afraid to pay for marketing because she doesn't know what works. And because if I told you you give me $1,000 and I'm going to hand you back $2,000, how many times a day would you want to do that transaction with me? You'd want to do all day long. And that's what marketing does for a business. You hand out some money, you go to the traffic store, you buy some traffic from Facebook and Google, and then they hand you back some money, and then you do it over and over so that you can grow aggressively and consistently and predictably and under your control. So that's what this software does. That's what having these numbers in place and easily accessible, where, like Izhak said, you can empower your staff to do it, where you're not having to hound them all the time, where you can all look at the same data very quickly and just say, "Hey, guys, this is what our goal is, this is what our target is. Go make it happen."

Nick Dumitru: 53:46 That empowers you to use your staff and their intellectual ability to at its full capacity, which is extremely, extremely important. The other point that Izhak made is just being able to keep an eye on, like he said, your spend. So I'll tell you a quick story with one of our larger clients. We took over the Google campaigns from a previous company. And what Izhak said about some stuff taking 90 days, it's the nature of the industry where it just takes time. This isn't an eCommerce transaction. And while I'm not a big believer in waiting a long time for your campaign to show results, like I like to get more immediate results. What we did with her is within two weeks, we spent $30,000 on Google and we flooded them with leads. And she hadn't seen this kind of acquisition before.

Nick Dumitru: 54:30 So she's freaked out a little bit, "Oh my God, turn it off, turn it off." Because unlike a lot of practices, she actually was tracking her spend versus her income. But because there's this lag, you have this cohort of people, the group of people that are coming in on day one and maybe their transaction because it's not an eCommerce transaction, you've got to book a consultation, deal with life, show up and then buy, it can take 30 to 60 days, 90 days, like Izhak said. So what was happening is that we turned it off in two weeks because she thought she was freaking out, like money's flying out the door. By the end of the month, that was ROI positive. 60 days later, it made a ton of money, like doubled pretty much the amount of money or more, I believe from what I remember of what it was.

Nick Dumitru: 55:14 Having those numbers and understanding how they change over time as well is critically important because that allows you to scale. Like if you're dealing with a lot of competitors in your market, the only way to win is to have these numbers because that allows you to acquire the patients, that allows you to spend more than your competitors. That's how you win. You don't win by just going on Instagram and not knowing what's happening because ego is a bitch, ego will make you do things because you've got notoriety and you've got people telling you how great you are. But when you don't know what the numbers are, egos can make you do all the wrong moves. It can make you make all the wrong moves and take the wrong decisions, and that's what you're avoiding with this kind of software.

Nick Dumitru: 55:55 So, again, really big points that Izhak touched on I just wanted to expand on that a little bit. Izhak, how can people get in touch with you? Firstly, how can any doctors that are interested get ahold of you and check out the software, get a demo? And how can potential partners get ahold of you personally if they're interested in speaking further?

Izhak Musli: 56:14 Simple as going to medicalprm.com. They have form over there. I'm getting a text message the moment I get a lead. I jump on it just like I preach what I practice. That's probably the best way for partners and for potential opportunities. It's an early stages. I'm not sure what they are listening to this podcast. But at the moment, it's December and it's pretty early stages of the system. So more than happy to discuss with potential partners, potential clients, get feedbacks, give my own, and grow it from there.

Nick Dumitru: 56:44 Beautiful. Okay, so guys, I'm going to put these in the show notes. They'll show up on iTunes and Google and on our website obviously, I think medicalprm.com. Grab the link from their contact, Izhak, if you didn't type it in from the actual podcast. And you know Izhak just said that it's in the early stages. I want to talk to you guys about something called first-mover advantage. And this is where the person in the market that makes the first move ahead of the competition tends to do well and win. And whether you take this further or not, take a look at the software, talk to Izhak, at the very least, learn what he's doing. And I'm going to be jumping on this as soon as he says that the covers are off of it.

Nick Dumitru: 57:24 I'm very excited about it just because from a marketer's standpoint, for my clients, this solves the number one problem that I have as a marker in a business dev guy. And helping practices double and triple, this is the number one thing that holds people back is this ability to follow up, this ability to act quickly and the ability to actually know what's making a difference in the practice. So I hope you guys take advantage of it. Izhak, it was a pleasure as always. I want to thank you for joining us. And I have a feeling everyone's going to be hearing from you again. That's for sure.

Izhak Musli: 57:58 Thank you, thank you. Looking forward for the next time.

Nick Dumitru: 58:00 All right, thanks everyone. And I'll see you on the next episode. Thanks for listening to Practice Perfect. I hope this episode has given you a lot to think about. I hope you've got actionable ideas that you can take back to your practice and go back and make changes, make improvements, and take it to the next level. If you want show notes and additional help and advice and articles on how to grow your practice, visit us at thinkbasis.com, where we hold the podcast. That's T-H-I-N-K B-A-S-I-S.com, or just Google the Practice Perfect podcast, and you should be able to find our podcasting page. Have a great day, have a wonderful week, and I wish you all the best with your practice. Go out there, make a change and make it happen.

The post The Number One Success Factor For Your Cosmetic Practice – Practice Perfect Podcast Episode #14 appeared first on Think Basis.

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"The one thing that'll kill your business is doing nothing, sitting there analyzing it to death, right? The paralysis of analysis will kill your practice."

Nick Dumitru: 00:23 Welcome back to another episode of Practice Perfect, the podcast for those running cosmetic aesthetic medical practices and anyone that's trying to improve their business and their lives. Alright, today's title is going to be, If Your Practice is Failing, It's Your Fault, and I want you to get a handle on your mindset and your limiting beliefs. So this podcast is going to be all about the way that you think, all about the way that you are holding yourself back, and ultimately it's going to be about accountability. I want to keep you accountable. I've seen too many doctors fall into the victim mentality where they'll start blaming everyone from their staff, to the marketing companies, to the economy, anything they can think of just to avoid taking responsibility for the fact that they are in charge of their own practice, they are the masters of their own destiny, and I want you to get that you are in charge of your future and it's your responsibility to move yourself forward.

Nick Dumitru: 01:28 No one else is going to do it for you. If you want your practice to succeed, the buck stops with you. And I'm telling you this, even if everyone poops the bed, if all of your suppliers, your marketing company, everybody soils the sheet, it's still your responsibility to fire them and course correct. Don't sit there wallowing in your own self pity about things not working. If something isn't working, figure out why and fix it, because at the end of the day, nobody should care about your practice more than you do. And I've seen this over and over. I've been doing this for 20 years and I got to tell you that one of the most damaging things that I've ever seen in medical practices is when the physician cares less about his or her practice than I do. When I care more that the phone is being picked up and that the emails are going out and that people are showing up for the procedures, then the doctor does, that practice isn't going to go very far because the reality is, you're the only one that's going to benefit longterm.

Nick Dumitru: 02:32 Your employees come and go, your marketing people come and go, your web suppliers, whoever it is, they come and go. You're the only one that's in this for life. You've made the commitment to it, and if you aren't taking responsibility for that commitment in your own practice and caring more than anybody that works for you, you're letting yourself down, your family down and your future down. And I know that may sound harsh, but I want it to be harsh. I want you to get it through your skull that you have to care. You can't just sit back wanting to do surgeries all day, not caring about how things are going. You are in charge of your practice and until you grow to such a state that you can start putting a CEO in place to run the day to day operations, the buck stops with you.

Nick Dumitru: 03:19 So let's examine where that comes from, because the thing is that the same instincts that make you a good doctor are killing your business. Your compassion and your loyalty to staff, your unrelenting analytical thinking, fear of making mistakes, thinking because you got through med school that you're qualified to do everything yourself, all of that is holding you back. And the only reason you think you can do everything is because you're arrogant, because society has put into your mind that just because you went to med school, you're qualified and intelligent enough to do everything. And I'm going to let you off the hook here because you don't have to know it all. Just because you're great at medicine doesn't mean that you're a great marketer. You know the funny thing is that I was speaking with a doctor just last week, someone wanted to sign up for services with us and where we go through an elaborate vetting process with them, we do a full interview and the thing is that even though he's never built an eight figure practice, he thought that he was qualified to have an opinion on my recommendations because he read a few books, or he went to some seminar, or he went to one of the big meetings and some guru on stage told them one thing or another.

Nick Dumitru: 04:31 He thought that he was qualified to have an opinion, and I'm not saying this out of arrogance, what I want you to understand is that there's a difference between arrogance and experience. There's a difference between reading about something and actually doing it. And if you're sitting there and you're arguing with your marketing people, with people that are hired to be experts with someone like me that's been added for 20 years and has built multiple practices, because you've read a book or heard something online or have gone to one of the meetings, or one of the seminars and somebody on stage told you the latest, greatest thing and then you're arguing with the professionals that you hire, you're making a huge mistake and that is just hubris. It's one thing to have data. It's one thing to try something and then have it not work based on the data that comes back, and it's another thing for you to handcuff your staff to tie their shoes together and then ask them to run before they even get going.

Nick Dumitru: 05:33 And here's the thing, most doctors, they are not great business people, they're not great marketers and that's okay because they're great doctors and that's the craft that you should focus on. In the years that I've been doing this, I've seen maybe less than 1% of doctors that can do medicine and business great at the same time and the ones that do it had to sacrifice a lot. They sacrificed their family time or their ethics. I've seen some guys that have done some very unethical things like walking into operating rooms with a full film crew without permission and stuff at hospitals. They've done all kinds of things. A lot of them will sacrifice their free time. They don't have a lot of time for golf and hanging out with people and their friends.

Nick Dumitru: 06:13 They're working like dogs every minute of the day. If they're not in surgery, if they're not in consults, they're doing their marketing, they're filming their videos, they're doing their podcast, whatever it might be, writing books, whatever it is, and they're really sacrificing their time, their free time. And whatever it is that they sacrifice, you have to understand that it doesn't come for free. It doesn't come easily. You have to put in the work and they work like crazy to get ahead, and you have to understand that working like crazy doesn't mean running around in a circle. You want to move forward, right? Running in a circle and running straight, expend the same amount of energy. You spend the same amount of calories, the same effort, you run out of breath the same way, whether you're making no progress or you're making great progress, and if you don't know what you need to know to move the needle forward, you're never going to get there, and thinking that you can do it yourself isn't going to do the trick.

Nick Dumitru: 07:11 And when I talked about those instincts, perfectionism. Perfectionism is a disease. Perfectionism is one of these things that you need to have in medicine. You need to have when you're doing your surgeries, you have to do things right. Business is not the same way. Perfectionism isn't progress. Analyzing something to death is another disease. The paralysis of analysis is a disease, where you get paralyzed just trying to think about which way you should go. Again, fantastic instincts for a physician. Excellent instincts. If you're doing surgery, you want to analyze it. You want to make sure that you're using the right tools and the right way at the right time. In business, being last and being perfect is the death toll because it means that you're doing nothing. When I see that in a business, a business that takes so long to make a decision that they make no decision, I know that that business isn't going to go far. And from an outsider in terms of a medical degree, because I'm not a physician, I find this really interesting.

Nick Dumitru: 08:11 I have a very unique perspective working with all these doctors and you know I've known guys that wouldn't think twice about cutting off five pounds of fat from someone's stomach while they've got the body opened up, the human body exposed, but those same doctors will take six months to make a decision about what toilet paper to use in the bathrooms practice. Even though they're taking these life and death, sometimes life and death decisions, even though I know cosmetic surgery is relatively shallow compared to deep surgery, but you're still opening up a human body. Think about that. You are willing to take that risk because well you've been trained, you've got the training, but what's making you afraid of moving your business forward is the fact that you're not trained and the fact that you think that you should know or you could know all of the things that someone that studied marketing for longer than you've studied medicine knows.

Nick Dumitru: 09:02 It's something that you should seriously re-examine because it's holding you back. The fact that you don't know what you don't know is very dangerous. The guy I told you about that I was talking to just last week, he knew just enough to be dangerous, just enough to cause him self harm in his marketing and his practice, and he's wasting time reading marketing books when what he should be doing is seeing consults, getting his lead gen going, getting people in the practice, staying on top of his staff to make sure that calls are happening and that the leads are coming in and that he's going to be able to perform surgery and make more money, and then grow his business by hiring other doctors instead of doing all that, he's stimulating his need for education, right? He's gone right back to school. He's going there and scratching that itch of knowledge, right?

Nick Dumitru: 09:50 That festering wound of knowledge, the infested, infected, disgusting need to keep learning things and not do anything in your practice. Right? Because a lot of people confuse doing something and learning something. Learning something, having learned something, even having understanding of something isn't doing something. You want to move your practice forward, you take action, you move forward. Don't sit there reading a book thinking that you learn the latest greatest marketing tactic, and then not use it thinking that that's progress in your practice. It's not. That just mental masturbation, you're just sitting there and intellectually masturbating to the latest knowledge that doesn't move the needle forward. I challenge you to go to the bank and try to deposit your knowledge. Go to the bank and just tell them, "Hey, you know what? I went to med school, I've got this degree, and then I also read these 700 books on marketing. I'd like to put them all in my bank account."

Nick Dumitru: 10:46 You'll get laughed out of the bank because the banks work on cash. They work on money, they work on success, and success is in knowing success is doing and if you don't know how to do, get someone to do it for you. And again, the fears are what are holding you back, right? The instincts, the great instincts as a physician, and let's get into the fears of making a mistake, right? The fear of making a mistake. I'm going to let you off the hook and let you know that in business, mistakes aren't fatal. You can make these mistakes. You can move your practice forward by adjustment, making a mistake, adjusting going the right way. They're not fatal, right? You're not puncturing a major organ by putting up an ad that maybe doesn't perform as well as it should, but you're learning right from your advertising you're learning.

Nick Dumitru: 11:36 You can move it forward. It's okay to make these mistakes because you're going to move your practice forward with every step. The one thing that'll kill your business is doing nothing, sitting there analyzing it to death. The paralysis of analysis will kill your practice and it's okay to look stupid. It's okay to do something and make that mistake and learn. You know? I'm going to let you off the hook on that because a lot of doctors are also afraid of what their peers will say, or what their spouse will say, or what their staff will say that, Oh, look at you. You screwed up. It's okay. Screwing up is okay. Making that mistake is okay. As long as you're moving your practice forward and you're learning from it. And even if you did it yourself, that's a kind of learning.

Nick Dumitru: 12:17 You Did it yourself, you know that you shouldn't do it yourself. You've learned something. You move forward because the reality is is that the cost of doing nothing, the opportunity cost of not moving your practice forward, is a lot higher than anything you're going to lose by trying something. You think you're going to lose a couple of thousand dollars or euros wherever you're located, I know we have a readership all over the place, you think you're going to lose a couple of grand? Well, guess what? By doing nothing, you could have lost $600,000 over the course of the next couple of years or more, maybe $6 million over the course of the next decade, or more depending on what you do now because it's exponential. It's the same as pointing a gun. If you move a gun slightly at the point of origin, if you move it by just a half an inch, a few millimeters where the bullet ends up could be meters a hundred meters miles apart depending on the range of the gun and the distance from the gun.

Nick Dumitru: 13:17 And these small adjustments that you make right now, can either make you or cost you millions over the course of your practice, tens hundreds of millions over the course of your life because you didn't do something. So you think you're going to lose a couple of thousand dollars by testing out an ad? guess what? You're going to lose a couple of million by not testing it out. And this fear of losing money, I see this paralyzed people more than anything. I see this paralyzed doctors in a considerable way and I don't understand why, because you've got a medical degree. You have money coming in, you're always going to have patients. There are always people out there looking for your services. As long as you can get in front of them, you're always going to have money. Money will always come back to you. Don't worry about spending it. But here's the thing about money, no amount of money that has ever existed has ever been able to buy a single second of time on this planet, not a second.

Nick Dumitru: 14:13 The wealthiest person couldn't pay for an extra 10 seconds of life at the end of their life, even if they gave all their wealth away. It's impossible to get, and I want you to have that urgency. I want you to understand that time is fleeting. Your potential is going past you as you're sitting there analyzing your spreadsheets, making decisions, fretting over minor expenses. If you want to move forward, take action, do something now. Because even going the wrong way and hitting a wall is better than not going at all, because at least you know you're going in the wrong direction. So stop fretting like a pansy and get some help. The people that don't know what to do, hire the people to do it for them. The wealthiest people, the most successful people in the world get help doing the things that they don't know how to do.

Nick Dumitru: 15:06 They hire the people to do it for them, and then they incentivize them to do it. And I don't want you to think that this sort of mindset, this limiting way of thinking stops with the business owner, it doesn't. It also comes from your staff. The mental disease isn't just reserved for you. Your staff comes into your business with their own mental baggage. How you have to understand that people's experiences shape them. People's beliefs from their parents, from when they were young, from things that they've done shapes the way that they act now, and they will bring this baggage and they'll carry it and they'll happily shove it into a corner into your business and clutter up the processes and the progress with everything that they've brought in from their life. So I want to go through some of these things. I want to go through some of the limiting beliefs so that you can talk to your staff about them, you can start addressing them with them.

Nick Dumitru: 16:01 And one of the biggest things that I see is that they're bothering your prospects too much. You get a lead, somebody fills out a form on your website, they don't get in touch with them, they leave a voicemail, they forget about it, because they think that they're being bothersome because maybe they don't like getting phone calls, or maybe they've got low self worth because when they were children, their parents told them to be quiet, to not interrupt, to not talk, don't be annoying, don't offend, right? All of these things, the politeness when translated to sales and business hold you back. And what I want you to talk to them about is this, that the world has changed, alright? This is in the 1950s or 60s when people love to get a phone call, right? And then if you left a message, then they will call you back right away because it was one of the two phone calls they got that week or something.

Nick Dumitru: 16:52 People these days are busy and you're not bothering your prospect, you're providing them a valuable service in their hectic lifestyle. Things have changed. People are busier than they've ever been, right? People say this every decade, but it's true. It's just getting more and more busy, more and more distracted, and they're calling your practice because they want to change their lives. The prospect is calling because she wants to change her life. There's something about her life that's making her unhappy and you're not bothering her, you're providing a valuable service because she may have been distracted. It's great customer service to call again to "bother them", because most women put themselves second. They call because they're unhappy. They finally had a minute to call you and then they've put themselves second, they weren't able to pick up the phone and they missed your call and then they dealt with whatever they were dealing with in their lives.

Nick Dumitru: 17:48 They put themselves second, second to their kids, second to their spouse, second to their job. All kinds of things get in the way and if you allow them to slip through the cracks because you thought you were bothering them, they'll resent you for it, because you didn't remind them and they'll appreciate you when you do. When you call that fifth, sixth, 10th, 15th time, 20th time that month, because she just couldn't pick up the phone because she had to deal with life and she forgot what form she filled out online even. She couldn't return the phone calls and you finally get her on the phone, it'll be a sigh of relief for her. So understand that you're not bothering them, but trying to get in touch and helping them achieve their dreams. You're providing invaluable customer service to a woman that's allowed her dreams to take the backseat for years.

Nick Dumitru: 18:37 So if your staff in a cosmetic medical practice do your job, stop letting your own baggage interfere, get it done. Call again and again and again and there's going to be a bad apple. There are going to be those that complain. You're going to hit some bad calls. You're going to get people that use their baggage to make you feel bad that you called them because they're angry about whatever bullshit is going on in their life. Understand that that's not the reality for most. Those are not the patients that you wanted anyway. Don't let those people dictate how you move things forward in the future. Get it done. Help this woman achieve her dreams because she didn't go on your website and fill out an online form or pick up the phone and call you because she didn't want to make a change. It's just that life got in the way and she put herself second once again.

Nick Dumitru: 19:27 Another limiting belief I come across, another piece of baggage that gets dragged into your practice is this idea that it's too expensive. This is a very big one. I see this all the time and it crosses over from staff to doctors as well as this is not reserved for staff because it's very tempting to think that, "Oh, they're getting paid less. They're not making the same money that I am as a physician." Also. They're obviously going to think that it's more expensive. No. I also see this in doctor. Some doctors are just cheap. They're just cheap. There's no other way to do it. Right. I'm not saying you know that it costs a little money to go with them. They are just stingy, they're misers. They don't want to spend their own money because their own background, whatever that is, it's contributing to their own inability to sell, because they are cheap. Maybe they were brought up with cheap parents, maybe they grew up poor, whatever it might be, they have a sense of low self worth where they feel that causing money pressure on somebody is burdening them, that it's their job to make sure that they save their money.

Nick Dumitru: 20:32 It's not, it's not your job to tell people how to spend their money. Your personal belief about money's probably standing in the way of you making more money. What someone's willing to pay is different than what you're willing to pay. Just because you think something's too expensive doesn't mean that the patient does. Now, your staff are particularly guilty of this and are afraid and often ashamed to charge more for your services. They invite discounts when no discounts are needed. A lot of times I see them discouraging you from raising your rates.

Nick Dumitru: 21:04 I've had this happen in practices. I've gone in. I've said, let's slap on an extra 500 or $1000 because you're providing a valuable service here. That $1000 goes directly to your profit margin. If you're making $1,000 profit and we can increase the overall sale, let's say it's a $5,000 sale, you're keeping 1000 if we can add an extra thousand and charge 6,000 instead of five, well, it's this proportionately larger on your profit margin because you went from 1000 to 2000 you've doubled your profits, and discounts work the same way. If you're discounting $500 you're having the profits, you're taking 50% less profit, and these people in your business are doing this. You may be doing this, not realizing how you're hurting yourself, giving these discounts uninvited oftentimes because you don't understand how to sell, you don't have a good selling process, you may be ashamed of selling, it may be a dirty word in your mind, because in medical school you are taught that, real doctors don't sell, real doctors provide service.

Nick Dumitru: 22:11 The other S word and all of these limiting beliefs are holding your practice back from doing more and being more and making more money. So just because you think something's too expensive, it doesn't mean that your patient does, and you may be thinking that, "Oh, have I give people a discount? It's doing them a favor." When in fact it could be harming their experience. Have you ever thought of that? Have you ever thought of how what somebody pays impacts how they experience the procedure that they're getting? I'm going to guess that you haven't, I want to let you in on something, there was actually a study done with this with wine. They did it with wine. They hooked up people to machines.

Nick Dumitru: 22:51 They started analyzing the brains to see what happens. And here's a quick rundown of the experiment. So volunteers were given wine to taste with clear labels, right? The wines were marked with prices ranging from $4 to $22 per bottle. Okay. So they anonymize the wine and then they labeled them with just the price of the wine. Okay, $4 to $22 per bottle. And here's what happened, the volunteers rated the allegedly higher priced wine as tasting better than the allegedly cheaper one, right? And they ran MRIs, magnetic resident imaging, they had them hooked up so that they could see what their brains are doing, so it wasn't just feedback data, it was actual measured data, not just opinion data. And the MRI scan showed that when those evaluations were made two parts of the volunteers' brains experience greater activity.

Nick Dumitru: 23:43 So they were evaluating the same wines, but during one of the evaluations versus the other, their brain was more active, so they're experiencing something different. Now here's the thing, in reality, all the wines were the same and they were all about $14 a bottle. So it's the same wine labeled with different prices causing higher levels of satisfaction and more enjoyment of activity in the brain. So think about that, think about how that applies to your procedure when you give that discount. What is that really doing? What's that doing for that patient's experience? How is that making them feel by the end of the surgery? Did you do them a favor? Did you do them a favor by saving them a few bucks and making their experience shitty? Did you do your practice a favor by having your profit margin, cutting it in half, hurting your practice and at the same time lowering the level of satisfaction for that patient because you gave them a discount?

Nick Dumitru: 24:43 Well, I'm going to answer that for you. It's pretty easy. No, you didn't. You screwed yourself and you made the experience worse for the patients. And let's dig a little bit deeper into what happened in that experiment, and what's that called. And that's called the marketing placebo effect. In medicine, you're very familiar with the placebo, body's ability to heal itself when suggestions are made through fake pills, whatever it might be, marketing's the same way. The way that your patient experiences the procedure isn't 100% tied to your surgical skill, and again, this that arrogance that I was talking about where you feel that your skill is 100% responsible for how things go in your practice. It's not. And if you're not taking advantage of this marketing placebo effect and thinking through how things are being used throughout your practice, you're holding yourself back. You're limiting beliefs and your mental baggage and your staff's mental baggage are hurting your practice. Even when you're think you're doing the patient a favor and after all, the goal at the end of the day is to have a great result with high satisfaction and happy patients.

Nick Dumitru: 25:47 If charging them more gives them a higher sense of satisfaction, you have a moral obligation to do so. You have a responsibility to your family, to yourself, to your staff, to your practice, to your future, to charge more for your services and to root out these limiting beliefs, to treat them like the disease that they are and use your medical instincts now to fix your practice, to get to the root of this disease and treat the problem, not the symptoms. Now, there are a lot more limiting beliefs. We're going to cut this short for the sake of the length of this podcast, but I hope that this has given you something to start examining. I hope that it's given you a lens through which to look at your practice and see where you're constraining it, where your beliefs are holding you back, where you as a physician care less about your practice than the people that you hire to work in your practice.

Nick Dumitru: 26:44 And I hope that you go out there and you start hiring for your weaknesses. I hope you start to identify what your weaknesses are, and instead of the solution being education, it's to hire professionals in your staff, contractors, consultants, whatever it might be that can give you the right answers where you are weak. And understand that weakness isn't something to be ashamed of. And when I say weakness, I mean that you are fantastic in certain areas of what you do, but nobody, and I mean nobody, no wealthy person ever has tried to do everything themselves because they hire for their deficiencies and they incentivize those people to get it done for them. And you should be thinking the same way, acknowledge what you don't know. Acknowledge where you're weak. Acknowledge where your practice is negligent, where they're failing, where your practice needs to help, and then get the right people in place to do that, measure them.

Nick Dumitru: 27:43 Take your instincts out of the way, right the same instincts that are making you a great doctor and really move your practice forward. Put the pieces in place on the back of this self-awareness to really move yourself forward. If you haven't subscribed to the podcast, I highly recommend that you do hit the subscribe button on iTunes or whatever podcast listening service or app that you've got. There's a lot more coming. We're going to be recording a lot more of these. I hope you're getting value out of this. If you've got any ideas, leave comments on iTunes, preferably go to our website or just write to [email protected] and just send me your ideas for shows. What are you struggling with? What are you having problems with? What's your staff struggling with? Let me know what you want to hear about and we will be happy to do our best to record. We're going to have some guests moving forward throughout the rest of this year as well, so stay tuned on that. Make sure you hit the subscribe and stay up to date with everything that we're going to be putting out there. All right, thanks and see you on the next episode.

Speaker 2: 00:13 Practice Perfect.

Speaker 3: 00:14 Actionable business information to take your medical practice to the next level.

The post If Your Practice is Failing, It’s Your Fault – Practice Perfect Podcast Episode #13 appeared first on Think Basis.

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"So you can create the most elegant and beautiful solution to a problem that you've got in your business, but if your staff can't sustain it and be consistent with it, then there's no point to doing it."

Speaker 3: 00:14 Actionable business information to take your medical practice to the next level.

Speaker 2: 00:19 Now your host, Nick Dumitru.

Nick Dumitru: 00:27 Welcome to another episode of Practice Perfect. The title of today's show is, your practice is falling apart every day, what are you going to do about it? Now medical professionals tend to like order and a state of healing, but unfortunately, businesses and medicine, the state of business isn't one where it is constantly getting better by itself. If you create an incision in a body, generally in a healthy person, that incision will heal. The correction that you've made will get better and in time that patient will fully recover and continue to be robust and make improvements. But I want you to start thinking of your business a little bit differently.

Nick Dumitru: 01:06 The first concept we're going to talk about is entropy. Now entropy, I'm sure you've studied science. You are probably familiar with the term. I'm going to define it in a way that's easy for everybody else to sort of understand so that we have some common ground. And the definition of entropy that we're going to use is the tendency of all things in the universe to fall apart or more accurately to fall into disorder from order.

Nick Dumitru: 01:31 Now, business systems are no different. They're in a constant state of entropy. I'm talking about things like your customer service, your web content, your website structure, your technology infrastructure and your marketing. Examining each one of those little bit by little bit, look at your customer service if you're not on top of your customer service. The market can change, employees can change, and then you start to decay. Basically your customer service starts to get worse and worse and worse without you attending to it. Your web content can be the same way. It can become out of date. It can be subject to maybe not looking the way it should be. Styles change. The structure of your website may be different. Maybe a user interface element is introduced, for example, a mobile device versus a desktop, and now the way that you've got your site structured is no longer efficient to be navigated. That can sort of fall apart. Just because the world is changing, times are changing.

Nick Dumitru: 02:27 Your technology infrastructure. If you don't update your technology, your backbone, the backbone of your business, it can start to fall apart because security holes are discovered. Things start to no longer work with maybe new equipment or old equipment stops functioning. All that stuff isn't a constant state of decay. Your marketing is no different. Your ads can get stale, your messaging can get stale, the market's sentiment can change. So all things in business are in a constant state of entropy. They are put into order by yourself, by your staff, by your consultants, and then they tend to revert back into a state of disorder.

Nick Dumitru: 03:06 So the question I have for you is, what is your organizational half-life? Not to define half-life is the time required for a quantity to reduce to half of its initial value. Now I want to use that analogy here because I want you to start thinking of it that way. How much time do you have until what you've put into place is half as effective as it was today? And I want you to start looking at the different components of your business that way because procedures are not enough. The blame ultimately lies with management and making sure that these systems are robust and in place and functioning properly over time without you. Now, there are two things that you need to ensure for this to happen.

Nick Dumitru: 03:47 In order to have a robust infrastructure, you need to ensure consistency and sustainability. If something isn't being done consistently, then your half-life is short. In some practices, that's as soon as you walk out the door. So let's say you're asking your staff to call people right away. While you're standing over them, they pick up the phone immediately. They get a lead. Something comes in by email. Someone filled in an application on your ad. They'll pick up the phone immediately as soon as you turn your back and you walk out of the room, that's no longer happening. So the half-life of that process is extremely short. It's literally minutes. It's as soon as you turn your back. And you have to start thinking about every system in your company that way. What infrastructure is in place to ensure a longer half-life, to give that process a better chance to work over time. Because if it's not being done consistently, then your half-life is very short. So consistency is the first element that you need to pay attention to.

Nick Dumitru: 04:49 Now let's talk about sustainability. If something isn't sustainable, it's just as bad as being inconsistent. For example, grinding your workers to the point that they won't be able to sustain the procedure isn't the answer. You can create the most elegant and beautiful solution to a problem that you've got in your business, but if your staff can't sustain it and be consistent with it, then there's no point to doing it. So by this point, you're probably asking yourself how to do these things. And if you're a longer time listener, you understand that I like to try to give you some practical, usable advice in these podcasts, in these talks that we have together so that you can go back to your company and start implementing them. I deal with this situation in two ways. The first way is to create a feedback loop. The second way is to schedule regular monthly meetings. So let's go over each of them in turn.

Nick Dumitru: 05:43 Getting feedback from your staff is extremely valuable. So you need to give your staff a 360-degree feedback mechanism. Because there's no way that you or your managers can know if they're doing a good job without anonymous feedback and the culture of candor. So you want to solicit this feedback from them. You also want to make sure that your staff understands that it's anonymous and safe. Creative mechanism technologies in place, you can do anonymous forums, whatever it might be. If you're a very small organization, it'll be a little bit tougher. But if you've got four, or five, six, 10 people working under you and you start to solicit this feedback on a regular basis, you can expect a certain level of anonymity there. And what's also important is that they feel safe.

Nick Dumitru: 06:28 In a paternalistic organization, people try to avoid blame. They do try to shy away from the gaze of the business owner or the manager because they know that they're just going to get dumped on. They know they're going to get attacked. They know that rather than looking for a solution, the culture is one of placing blame and that's not what you want to have in your company. What you want to have is valued candor. You want them to understand that their feedback is there to make the company better, and the way that you solicit that feedback is in such a way that they're safe and they're not going to be attacked. There will be no repercussions to them giving you that feedback.

Nick Dumitru: 07:06 Because if you operate in a paternalistic style, you're just shooting yourself in the foot because you're taking all of the collective brain power that you have in your business, and you're basically just compartmentalizing it and putting it away in a closet that'll never be accessed by anyone else in the organization, and you're going to do yourself a huge disservice like that. You want to access that brain pool. You want to have them tell you what's wrong so that you can improve. Because without that feedback, you don't know if what you're doing is right or wrong.

Nick Dumitru: 07:35 You may have the best intentions, but that intention can be perceived very negatively. And then what happens is the employee then takes it as a slight and they're seeing you doing harm to them. And then it just becomes this festering open wound that gets infected, and then nothing ever gets resolved, and you're think you're doing good, they think you're doing bad. And then you think that they're being ungrateful, and then they think that you're not understanding what they're going through. It almost sounds like like parenting to some degree, but it's very important to get that feedback because what's you're after is solutions. You're after a successful practice, you're after moving it forward. You're not after placing blame, you're not after inefficiencies. So that's the first thing, the 360-degree feedback mechanism.

Nick Dumitru: 08:19 The next thing that I always implement and practice is a regularly scheduled monthly group meeting. And I also recommend that you take smaller teams and have them do daily huddles at least once a day, preferably two to three times a day. Usually first thing in the morning, maybe at lunch to check in and make sure that everybody's got what they need to do their job. There are no problems. Or if there are problems, how they're going to be dealt with and that they've got the tools to deal with them.

Nick Dumitru: 08:46 Now these monthly meetings, when you involve the whole organizations, they're really magical. You'll be amazed at how steadily your business starts to forward when you have this kind of feedback and collaboration each month. I look at them as sprints. You've got people coming together every 30 days. That means that they've got 30 days to implement what was decided on 30 days ago. And what you'll find is that in preparation for these meetings, even people that tend not to do things, they may leave it till the last moment. So maybe a three-day job will take them 30 days to do, but on those last couple of days, they want to make sure that they get it done because they don't want to be the ones that let the team down.

Nick Dumitru: 09:28 And these sprints really move things forward over time because if you've got them monthly, then you've got a monthly sprint. That means that 12 times a year, your business will have taken forward progress. It would have made forward progress, it would have moved towards its goal, and it's sustained and consistent. And that's important here because you're doing this every month. So that's one of the best things that you can do for your practice. When you can come together and let everyone contribute.

Nick Dumitru: 09:56 Now, the key to this is to make it a collaborative effort where everyone has a say. Don't run this like a dictatorship where it becomes a blame game, or a bitching session, or they all just come to you for answers all the time and they weren't given the opportunity to come up with solutions on their own. You really want to solicit this kind of contribution from the team. And if you find that you've got team members that can't contribute, then you have to start thinking about making a change. So this is also a great way for you to evaluate your staff and their ability to contribute to the business and move the business forward. And keep in mind that not everybody is an ideas person. So it could be that some people are just doers and not thinkers and which is okay, a business needs both of those people. Just keep that in mind, but you can really gauge the value of each employee at these meetings and see what they've done to contribute, what they've done to move your business forward.

Nick Dumitru: 10:52 Now, what I want you to also understand is that you should not expect your business to run smoothly. No successful growing business runs smoothly. Businesses that are in a stable state, everything's smooth, they're usually in the processes of dying. At the start, we discussed entropy a little bit. Energy in the system means higher entropy. If your business is experiencing a lot of change and a lot of problems that are not a result of incompetence, that's good. That's a good thing. It means that your business has a lot of energy and momentum and that's what you want. If you have something that's just stable and it's just slowly decaying, it's still technically in a state of entropy, but it's also in a state of the decay, that's not what you want.

Nick Dumitru: 11:36 If you're adding energy into a system, again, things will fall out of order. Like do you think that Apple computer, or Microsoft, or any other large company, Amazon, do you think that they're running smoothly? They're not. They're innovative. They're moving forward. They're in a constant state of entropy. They're constantly evolving, but it's controlled chaos. So your job is to accept and manage the chaos. You have to accept change. You have to accept problems. You can't look at problems and let them defeat you. You can let them make it be a sign that something's wrong in your practice. It's not necessarily the case. If it's entropy as a result of innovation and progress and growth, it's fantastic. You want to have those problems. You want to tackle them. You want to have a challenge for your team to handle when they come together every month.

Nick Dumitru: 12:26 Now your job as a leader is going to be to organize these systems so that they are robust and repeatable without your constant involvement. And that's really your job as a leader in your organization. It's not to denounce problems, it's not to place blame. It's to design your practice in such a way that it is robust and resistant and actually thrives on this change. So that when a problem comes up, as opposed to it crippling your organization, you have the mechanisms in place to tackle that problem and innovate on the back of it.

Nick Dumitru: 13:00 For example, if patients are constantly complaining about the wait time, that's a problem in your practice. So you can either sit there complaining about it, blame the doctor for being late, blame the staff for not getting them in on time or mismanaging or double booking. Or you can look at ways to innovate and you put a mechanism in place that identifies that. So something as simple as those monthly meetings where maybe your operations manager tells you, "Hey, we've got a long wait time. We've got complaints. How can we fix this? What can we put in the waiting room? How can we adjust our systems? How can we innovate to be the best practice in the city on the back of this problem that we've identified?" So the problem's not crippling you, it's now spurning innovation. It's now giving your team a challenge to move your practice forward.

Nick Dumitru: 13:47 And that's what I mean when I say that you can accept the change and use it as a jumping board, a platform for you to move your practice forward. Because entropy, change, chaos problems, those are nothing more than veiled opportunities for you to become better and set yourself apart from your competitors and really take the lead in your city.

Nick Dumitru: 14:08 All right, I'm going to get off my soapbox here. I think I've made the point. I want you to go out there and start taking action. I also want to ask you to subscribe if you're listening to this on iTunes. And do me a favor, if you go to thinkbasis.com where we host the podcast, go on there and fill out our form and give me some feedback on topics that you'd like to hear about. I'd love to get feedback on new topics that you want to hear about. It helps me understand how to move the podcast forward and what to do for additional topics for you guys, and I'd love to answer any questions that you've got. All right. Having said that, get out there, get your practice going and go up and hug some problems.

The post Your Practice Is Falling Apart Every Day. What Are You Going To Do About It? – Practice Perfect Podcast Episode #12 appeared first on Think Basis.

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"So life is going to move forward, business life is no different. Business life is going to move forward. The market, market conditions, market realities will change every single day. And if you're not in the market, you can't adapt to that change. If you're getting ready to get into the market, you can't adapt to that change. If you're getting ready to build that new website and you haven't done it, right? Even if it's crap, it's better than not having one. Because you can change it, right? This is the thing that I want you to understand, that business is fluid."

Practice Perfect: Actionable business information to take your medical practice to the next level. Now your host, Nick Dumitru.

Nick Dumitru: Welcome back to another episode of The Practice Perfect Podcast. If you own a medical cosmetic practice, you're a plastic surgeon or you own a med spa, then you're definitely in the right place, right? The title of today's episode is going to be, it's okay to make non-fatal mistakes in business, even fatal ones. The reason I want to talk to you about this topic today is because you may have seen business people that open up competing businesses with you if you're a physician or you may have a business and you're wondering why it's working or why it's not working.

And I've seen this over and over in the practices that I work with and I wanted to really shed some light on this because the fear of failure can really hold you back. Now doctors just like engineers, some business people that are engineers first tend to have a harder time struggling with making mistakes. And this is because doctors are analytical by nature, right? So it's not your fault. The same instincts and trainings that make you a good doctor, that make you good at your job, that make you good at performing procedures are also the same instincts that can hold you back in business.

So what ends up happening? And this is a great quote I heard from somebody, is that instead of playing to win, you end up playing not to lose.

Nick Dumitru: [02:00] And that happens a lot because in the past I've had clients that were more interested in how their logo looked than if their staff was picking up the phone. They were so concerned with making sure that every little detail was correct, that they were missing the bigger picture. And like I said, that's great, if you're performing surgery, you can't take any risks. You can't have a mistake. You have to make sure that every detail is perfect or the patient is not going to be happy.

But what I want you to do is to start to learn to focus on what moves the business forward. Not insignificant details, those things are things that you can swing back around to later. You don't have to worry about making sure that every little thing is perfect every single time and sacrificing progress as a result of that. In my book, I say that activity doesn't equal progress. It's one of the main premises of the book. But it's also true that preparation doesn't equal progress either. So I don't want you to get stuck constantly getting ready to take your first step.

Nick Dumitru: [00:03:00] Take the step and then adjust to the conditions later, right? You don't sit when you wake up in the morning, you go outside. I happen to live in a colder climate, so we do get cold days with ice. I don't sit there at the front door looking out of the door thinking, "Should I take this first step? Should I go?" I've got the door open, I'm standing in the doorway and I don't sit there for an hour wondering if I'm going to slip, how I should put my foot down. I just go out there, I put my foot down, feel around a little bit. If it's not really icy and I know it's safe, then I move forward, right?

And this is the same analogy that you can use in business. You have to get your feet on the ground, you've got to get moving. Because as long as you're trying to get ready, you're not going to make any progress. And if you don't make progress, your business doesn't move forward and you don't get anywhere. It's quite literally just like life. Unfortunately, in business it becomes very easy to sit back and start analyzing everything, making spreadsheets, getting ready to get ready to make a move.

And a lot of times analytical people satisfy their need for accomplishment through this preparatory process, right? So you may have made all the spreadsheets to projections, everything you wanted to do, but not actually made any move to take action on that. And until you take action, nothing happens. Until you make a move, it's all in your mind. Even if you put it on paper, it's still in your mind because nobody's actually made a physical move forward. If you are trying to get ready to make lunch, but you don't actually cut the vegetables, start frying, you're not going to get that lunch done. It's just going to be a recipe.

And that's what you're essentially doing, is you're spending time over and over prepping these recipes but never actually turning on the fire and getting anything in that skillet and getting cooking. And I just see this over and over and it's a huge detriment to a lot of businesses. The danger to you as a practice, as a business owner is that as you're sitting there making all of these preparations, the market can move past you, right? If you were getting ready to do, let's say a print advertisement 10, 15 years ago, I've been at this for over 20 years, but I still remember the days when we used to make print ads.

We used to still cut things out on paper and put them on film and get them to the newspapers, film, camera ready art, it used to be called. And then that used to go in the newspaper. I've seen people spend a year or two trying to get ready to get going and get advertising. And then what happens is the internet came along. So as you're getting ready to put out that newspaper ad, here's the internet.

Nick Dumitru: [00:05:30] Now everything's changed. All of your plans are useless. So you have to understand that if you plan for too long, life can move right past you.

The market can move right past you. And I'm sure you've maybe have heard the saying by John Lennon, "life is what happens to you while you're busy making other plans," right? So life is going to move forward, business life is no different. Business life is going to move forward. The market, market conditions, market realities will change every single day. And if you're not in the market, you can't adapt to that change. If you're getting ready to get into the market, you can't adapt to that change. If you're getting ready to build that new website and you haven't done it, right? Even if it's crap, it's better than not having one. Because you can change it, right?

This is the thing that I want you to understand, that business is fluid. The game these days, because largely a lot of it is online means that you can't make detrimental mistakes. And I want you to understand that. So the title of the podcast was, it's okay to make nonfatal mistakes in business and even fatal ones. Why do I say that? Because as a physician, if you are a doctor, if you are a med spa owner, you may have a slightly different attitude because you may not even be a physician. You're a business owner, so you get some of this stuff initially and you may be looking at the doctors and wondering why they're not doing that.

And I want you to understand this is important for getting your competitors as well and what's freezing them in their tracks. But if you are a doctor, if you're a plastic surgeon, you're going to do surgery. That preparation time is crucial for you because you've got pretty much one chance to get that right, right? If you make a mistake, let's say you're doing liposuction, you're performing this liposuction and then you puncture the abdomen, that can be fatal. And it's completely understandable. You're training your mindset, every instinct, everything that got you through med school is teaching you to do that.

But you have to separate that from business because business is very difficult to have fatal mistakes, right? If in business, let's say just in the aspects of marketing and promotion, for example, where I see a lot of people getting stuck because they're worried about their reputation and whatnot. They start to make a lot of mistakes and they get frozen in their tracks and they start to listen to too many people and they make no decisions ever thinking that it's going to be a fatal mistake. But the reality is that it's not.

So let's start examining some of those fears. I'm going to go through two big ones that I see typically from physicians. So the first one, the biggest fear that I usually find is looking bad or being ridiculed. Typically, it's by their peers, it's by other doctors, sometimes it may be by the staff or the market or they have delusions of grandeur thinking that they are famous somehow just because they've been on a news talk show or if someone's following them on Instagram or Facebook.

Here's the reality. The reality is that only a small subset of the market engages in cosmetic surgery. So no matter how famous you think you are in your own small world, the pond is still tiny. So you have nothing really to fear in terms of grand scale. Look at what that doctor did. Nobody's talking about you. Nobody's going to remember you next week even if you put up a ridiculous billboard or a strange Facebook ad. As long as you're compliant with the law and you're not breaking the rules of your governing bodies, then you're going to be perfectly fine, right?

So this is why I'm saying it's a non fatal mistake. In terms of a fatal one I'm going to get into that in a little bit, but I want to keep going on this fear of looking bad. The truth is that you are never taught business in school, right? It's not your fault and you have to figure it out. And to figure it out, you have to make mistakes, right? Nobody gets anything right the first time, 100% of the time. So it doesn't matter if you look foolish. Those are just other people's opinions.

And here's the thing with those people, they're not going to make payroll. They're not going to help you pay your staff. They're not going to help you pay your rent, your surgical equipment. They're not going to assist you in any way just because they're ridiculing you. So their opinion is irrelevant. It's irrelevant to your business life, right? If your competing physician, your colleague, looks at you and says, "Look at what Jack did," or, "Did you see Jennifer's ad? She looks ridiculous."

The reality is if the market reacts to it, you got leads, you got clients, you've got patients, you have money, that's what matters. Their opinion, 100% irrelevant. That's nothing but ego and hubris. So as soon as you can free yourself from that shackle and do what the market needs, not what your competitors and your colleagues think you should do, the sooner you'll be able to move forward in business. And I want you to always remember that these people, right? The ones that you are so afraid of their opinion, and it can even be family members, right? It can be a parent or it can be even a spouse sometimes, right?

The thing is that they're never going to go to the bank with you. They're never going to go and help you pay your rent. They're never going to help buy your family a new home. They're never going to help you take your kids on vacation. They're never going to free up your time so you can spend some quality time with your children, right? Because you had enough money to hire help. They're not going to do any of these things. They're not going to walk to the bank with you and deposit any of their money into your bank account.

They're just not going to do it. And by you being shackled by their opinions, you are now sacrificing everything that you could have been in the future based on nothing more than an internal feeling of possibly a little bit of shame or whatever it might be that's holding you back. So that's the first fear that I see, the fear of looking bad. The fear of being ashamed, the fear of other people ridiculing them. And I want you to start mentally reframing that in your mind and start thinking about what the reality is, what is really happening, what do you need to do?

Is your goal to look great in front of your peers or is your goal to really move your practice forward? And now it is possible to do both, but I'm going to tell you, you're going to get a lot more respect from being successful than by following the rules 100% of the time, right? And by rules, I mean the unspoken rules, not the legal rules or any laws governing your marketing and advertising. I'm talking about the unspoken little snickers that people might say because you've put out a video online that they may feel was too aggressive or they wouldn't have done that, right?

I get that a lot as well. So that first fear, you need to start to reframe, free yourself of the shackles. Take those steps and you're going to realize that at the end of the day, any minor transgression gets forgotten and any success gets lauded forever. They're always going to be talking about your success. A lot of them will start envying you, but any little thing that you put out on the path to getting there is really not going to matter in the long term and definitely will have zero impact on your success because your success is determined by the market.

So the only people's opinions you should care about are the people that are coming and actually paying money into your practice. That are actually choosing you out of the market versus your competitors. Those are the people that you have to cater to. Their opinions are the ones that matter. And when I say their opinions, their opinions only matter if they've paid you some money. If they're still out there and they're ridiculing you or making comments on your Facebook ads, those people are also irrelevant because they are not clients, right?

Once they become clients, once they become patients, then their opinions can start to matter, right? So let's get to fear number two. This is the second biggest fear that I come across. And it's typically the fear of losing money. Now, here's the truth about money. And a lot of people look at money as this great thing and they think if they invest or even spend or waste a few thousand dollars 10, 20, 30, 100,000, that is the end of the world. Biggest mistake I've ever made, right? I want to die. I just lost $30,000 because I chose X marketing company and they didn't do a good job. Or I put out this newspaper ad and I got zero results even though the rep promised that I was going to get everything in the world from putting up this full page newspaper ad.

Nick Dumitru: [00:13:30] But like I said, you need to make mistakes to figure it out because nobody's taught you. Unless you're working with someone like me, you don't have the knowledge and experience to move this forward. So if you're also worried about making mistakes, you're always going to be frozen. And money's one of those things that the truth about money is that money is easy. All right? And I know when maybe you don't have access to a lot of it. Maybe you're just starting your practice or you've hit hard times in your practice a little bit because your marketing starting to falter.

You've got the wrong staff or they forgot to pick up the phone, whatever it might be. I get it. I get that it can feel like a big deal, but here's the thing. Money's so easy that you could literally clean toilets and get paid, right? A very unskilled job. You don't need to go to school. You don't need to do anything. You just need to mimic the action of another human being and you can make money. You'll start to get paid because money is that easy. It's not a hard thing to get, and it always replenishes.

And you have every advantage as a physician [00:14:30] in getting more money out of the market because they're always printing more money. And when they start printing it and we go digital, they're always going to be able to add bytes into a computer and generate more money, right? Money is one of these things that exists largely in the mind space. And yes, I'm not going to get into arguments about currencies that are backed by actual goods and whatever. Those times are long gone. And the reality is that now, money is pretty much infinite.

And if you think that, "It's not infinite because you need to exchange goods or services for that. And services and goods are finite, it's hard to scale to a certain degree." Well, here's the thing. Let's take a look at things like video games for example. Inside video games they've created virtual worlds where digital goods are exchanged and the only thing driving those digital goods are the electricity, which is abundantly available from the sun. So if you theoretically powered a gaming center, right, a server farm with solar power, it would be zero cost other than the equipment.

And then inside that world you could have tens of millions of dollars of exchanges, everything from digital goods like clothing to weapons in video games, right? All digital goods, infinite, an infinite amount. The only limitation is human creativity. So money itself is always available to you. And if you're in business, if you're in motion, here's the thing about it. It always replenishes. There's always more of it. Even if you go bankrupt, right? You still have your degree. As long as you didn't break the laws, as long as you didn't harm patients, as long as you took care of your reputation, you can make financial mistakes.

It's okay for you to invest because if you invest 30000, the reality is you just have to perform a few more operations and cover that cost. If you invest 100000, it's the exact same thing. Money always replenishes as long as you're in business because you're going to get paid, you're going to do that next surgery. There is no shortage of money. So the fear of losing money is also an irrational fear. Because there's something that you should be much more afraid of and a lot of people don't talk about this at all and that is opportunity cost.

Let me explain opportunity cost for you a little bit. Opportunity cost is what you could have made, what you could have been if you have taken an action now, right? So in simple terms let's say that you need to walk a thousand miles, right? And today you just got frozen because like I said, you're in your doorway and you're not sure if you're going to step out and you spend half the day looking at your driveway wondering if you're going to step on that icy driveway or not, right? In that half day, you could have walked several miles, right? Maybe 5, 10 whatever it is.

Maybe you're a good jogger, maybe you run marathons, whatever it might be. In half a day, you could've run miles, maybe tens of miles, depending on how good you are and what fitness level you have. In businesses, the same way. Businesses have different speeds and different fitness levels. But at the very least, at a comfortable walk in half a day, you could've gone a couple of miles, right? Versus spending that whole time wondering about getting going because you're afraid to lose something. Maybe when you fall or you slip a little bit, maybe some change would have fallen out of your pocket and you're afraid of losing 50 bucks or 100 bucks or two bucks or whatever it might be.

It's the same in business. People sit there frozen and fear about losing a little bit of money and they don't think about where they could have gone because in two miles opportunity could have been there for you, right? In your two mile walk or 10 mile walk, whatever you ended up doing, you could have met somebody that somebody could have become a patient. That patient could have generated you $10000 in income, right? Business is the same way. When your business starts to walk, it walks towards opportunity. And nobody talks about this opportunity.

The opportunity cost is huge and the reality is that whatever you're thinking of investing, even to the point of bankruptcy could cost you a lot more in opportunity cost than you could have ever lost if you invested it. If you're sitting there fretting about buying some ads on Google or social media or hiring a marketing company, and you're sitting there frozen in fear about the mistake that you might make and if it's just money, if they're not going to break the law, if they're not going to do anything illegal. If they're not going to ruin your reputation and it's just the money holding you back, your opportunity cost could cost you a lot more.

Because here's the reality in business, the whole point of investing in your business is to make mistakes because you learn from the mistakes. What are mistakes to a business person? What are they to a marketer like myself? Mistakes are data or data depending on how you want to pronounce them, different parts of the world. But they are data and that data or data educates you. It gives you the knowledge to know how to take the next step, right?

If you spend money in a certain direction and you do something and you see that that doesn't work, that's just as valuable as if it worked. Because now you know which way to go. If you walk in the wrong direction, right? If you need to go to point A and you're walking towards point C and you're walking that way and someone stops you and says, "Hey, no. This is point C, you need to go towards point A. It's that way," at least you know where point A is now, right?

If you don't take any action, if you don't have any data to work by, then you've got nothing to go with. You've got no information. You haven't invested in your business to not even learn what works or doesn't work. And I hope you start to see how ridiculous that is. Just being frozen, trying to save. I've seen people just trying to squirrel away every penny instead of investing back in their business. They'd rather put it in the stock market where they have zero control than to invest it back in themselves and in their business and in their marketing. So I really want you to understand that.

That money's always replenishing and it's okay to make mistakes because the mistakes buy you the information that you need to start making the right moves. And it doesn't matter if you're right or wrong, what matters is the learning so you can improve and you can move forward with your next decision. I'm going to give you a quote right now to let you off the hook a little bit. And this is from Ray Dalio. If you don't mind being wrong on the way to being right, you will learn a lot. If you can't tolerate being wrong, you can't grow. And that's the truth.

That is the truth in business. If you can't tolerate being wrong, you can't grow. And so many doctors live in fear of being wrong because they've been battered, beaten, and abused by life and society and school and parents into always having to be right. And it holds back practices. I've seen this over and over. I can't stress that enough. Now, this fear of being wrong also translates to your staff. So I want you to understand that it's not just you I'm talking about. You need to encourage your staff to take risks. You need to encourage them to make mistakes. Because the reality is that if you're not innovating, you're going to die.

If you don't innovate, you die. That's just the way business is. Businesses that innovate, that look for new opportunities before the previous opportunity runs out, it's something called the sigmoid curve. I may do an actual post on the website about that because it needs some visuals. But typically that is a cycle. It's like a sideways S. So before the S starts to dip down, you need to move to the next thing that's working, right? You need to identify when that stops working and then start making plans for the next thing while you've still got those resources at their peak or near their peak.

And what happens in a lot of organizations, what I see is that doctors behave as if they're in hospitals because medicine is a paternalistic system. In hospitals, the doctor's the boss, and everyone looks to him or her for answers. And if this attitude carries over into your private practice, right, where it's a business, it's no longer medicine depending on where you are in the world, you're not going to be able to get additional income necessarily, right? Because it may be covered by insurance only, maybe social health care like we have in Canada and a lot of European countries.

But depending where you are, if you keep carrying that attitude over and you don't have an attitude of service, an attitude of leadership, then it's going to hold you back and it's going to harm you more than it helps you. And a lot of doctors, because of this attitude, this setup in these medical institutions, means that they feel like they're always the parent. That's right. It's a paternalistic system where they feel like they have to have the answers and they're always telling you what to do. They don't let people contribute and they don't let people fix their mistakes and make mistakes.

Nick Dumitru: [00:23:00] And if you've got children, I want to ask you, you'll get this right away. And for those of you that don't have children yet, let me explain at least a little personal parenting advice that I've noticed over the years. Is if your child is in the kitchen and they start to make a mess, they throw their cereal and milk on the floor, whatever it might be, they throw their pancakes around, whatever they're eating, they make a huge mess while you're not there in the kitchen. What's our instinct as parents typically? Right. It's to go in there and clean it all up.

But what should you do? What do you do? How do you train that kid instead of belittling them and yelling at them and letting them understand why it's bad through verbal discipline, right? Which does nothing but brings that person down and brings the individual down. And I'm talking now in a dual track here, both parent and leader in your business with employees, right? That kid is not going to learn and they'll start to repeat their mistakes. So what do we do? Right. Well, I don't do it, but historically what has been done is they start to beat the children, right? Then you get angry little kids that move forward in life thinking that's the right thing to do as well.

And then that gets carried over. And then you get this constant, paternalistic hierarchy throughout life. And what happens to the children typically and employees is that they're afraid to go out and be independent and make mistakes and innovate on their own. When the reality is that if your child made a huge mess, the only way for that child to learn the consequences of that action to them and to you is to make them clean up their own mess. So if your employee makes a mistake, belittling them, yelling at them, telling them that they did a crappy job isn't going to get it done. You have to give them the chance to correct their mistakes.

Let them go and clean up their own mess, fix their own mess, make them responsible for it so that they understand that the next time they screw up, they have to fix it. And this will free them because now they know that if it's a mistake, it's their mistake and they're going to own that mistake and they're going to own what they learned from it, right? So always take the learning from their mistake. What did we learn from this? How can we improve on the back of this? What can we do better next time? Let them give you the answers. And if they're incapable of fixing their mistakes and giving you the answers, don't take over, fire them.

Get rid of them because they're not helping your practice. You've got a B player or a C player, not an A player. You're not a charity and you're not going to be able to grow and sustain that growth over time and have any kind of meaningful goals reached if you're the only one doing everything and have all the answers. And there's a reason why we have trade between countries. And that's because we take goods from one place to the other where it's manufactured more efficiently, better, more innovatively, and we exchange that for other things. And that's how the world spins, right?

I'm not talking gravitational, I'm talking economically. That's how things work. That's why we don't try to make everything ourselves. That's why we import things. That's why we exchange goods. That's why one place has great wine and they're happy to exchange that for the hard wheat out of Canada so that they can make bread, right? That's how things happen.

Nick Dumitru: [00:26:00] And business is the same way. Your employees are contributing, right? It's a village. It's not a dictatorship. And yes, the responsibility ultimately lies with you.

But if they're not contributing and helping you, then you've made bad hiring decisions or you've got legacy staff that need to go. And it's okay to understand that the people that got you here may not be able to get you to the next step. And that's fine. And you can be compassionate and you can let them go nicely without ripping them off or just throwing them out. You can try to put them in different positions. But what you shouldn't do is let them hold you back and what you shouldn't do is suppress their ability to innovate and contribute to your practice by being a paternalistic leader that is top down dictating everything that you do because you're going to be cutting yourself short.

You're going to be dismissing their ability to go out and learn and come back to the practice and innovate with you. Now I want to give you another quote. This one's from Jack Welch. If you don't know who Jack Welch is, he was the chairman and CEO of General Electric between 1981 and 2001. During his tenure, GE, their company value rose by 4000% on the back of his leadership. Okay, and I want to give you a quote directly related to this and here it is. When people make mistakes, the last thing they need is discipline. It's time for encouragement and confidence building. The job at this point is to restore self-confidence.

I think piling on when someone is down is one of the worst thing that any of us can do. That's from Jack Welch, and he is arguably one of the most successful CEOs in history. Not the most, but one of the most. Phenomenal growth, unbelievable leader. And what he's trying to say there is that if someone makes a mistake and it was a genuine mistake, you learn from those mistakes, you encourage them and you encourage them to make more mistakes moving forward, just not the same mistakes, right? And like I said, when I say mistakes, this is not like gross incompetence, like having an inability to do their job on a regular basis.

Those are not the kind of tolerable mistakes that we're talking about. But if they've put their foot out and they've stepped out that door and they slip and fall, you don't go and say, "Why you slide and slip and fall?" Right. You say, "What do we learn from this? How can we examine the driveway better? What would you do? Can we put salt there to make this safer for everybody?" Right? It's a learning. It's an opportunity and the risks that they took was on your behalf and you let them take those risks because that's how you move your practice forward.

It's okay to make mistakes. So an organization's ability to learn and translate that learning into action rapidly is the ultimate competitive advantage. I want you to understand that there's no better advantage than making mistakes quickly and learning from them in the mix. Start making the right moves on the back of the data that you got back. And remember that businesses in medicine, don't be paralyzed by your own indecision. What you fail to achieve by not taking action is going to cost you a lot more than anything you could ever lose by taking it.

Because 99% of the time, all you're going to lose is a bit of money, right? And money always comes back to you. But what you gain in terms of experience, that compression of time, time can be compressed, right? Time is not the static thing. If someone asks you for a meeting next week and you say, "Well, I'm free right now, would you like to talk?" You've just compressed a week's worth of time into a few minutes. And it's like that in business, the faster you can learn things, the better you can move. Imagine if you take three years worth of learning slowly and you can compress that into six months worth of mistakes.

What you can do with that two and a half years in terms of growth, how much more revenue, exponential revenue, because now you've got new patients that then refer other patients and it's exponential because one becomes two becomes three becomes five from referrals. Just think about how you're holding yourself back by not making a decision because your fear of ridicule, fear of losing money or any other irrational fear that you may be experiencing right now. And I'm happy if you want to leave comments in the podcast, I'd love to discuss any other ones that you need to have reframed and thought about.

I will do a follow up episode on that for sure. So that's the parting thought I want to leave you with. Not taking action is going to cost you a lot more than anything you could ever lose by taking it. So as always, if you want the show notes and if you want any of the links or anything that I ever speak about in these podcasts or the transcripts, if you need them, then by all means, please go to thinkbasis.com, click on the podcast link. I think eventually we will do a dedicated URL that will redirect to that as well just to make it easier for you. But for now, just go to thinkbasis.com. T-H-I-N-K B-A-S-I-S.com and click the podcast link and all of the episodes will be there for you as well as any of the show notes. Thanks for listening. I hope this was helpful for you. Now stop listening, go out there and take some action and I will see you on the next podcast.

The post It’s Okay To Make Nonfatal Mistakes In Business, Even Fatal Ones – Practice Perfect Podcast Episode #11 appeared first on Think Basis.

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"When you are engaging in social media, when you're taking selfies, putting out videos, and relying on that for business, the control is 100% out of your hands. If Facebook goes under or the government decides to shut them down or break them up, whatever, anything can happen, your business can tank."

Practice Perfect: Actionable business information to take your medical practice to the next level. Now your host, Nick Dumitru.

Nick Dumitru: [00:33] Welcome to another episode of Practice Perfect, the podcast for business owners running cosmetic surgery practices or medi-spas. Today, I want to talk to you about social media.

Now, I've got a slightly contradictory opinion about social media. I'm going to challenge you a little bit in how you're thinking and hopefully by the end of this talk, you're going to have a better understanding of how to use social media for your practice so that it doesn't damage you, it doesn't hurt you, it doesn't end up using your time in a unproductive manner. I want to start by talking about a recent talk that I gave in Paris at the IMCAS Conference earlier this year.

For those of you that don't know IMCAS , it's a fairly large conference. It was about 11,000 attendees the last time I went there. I spoke on stage and as I was waiting for my turn, one of these physicians went up to talk about her social media.

Nick Dumitru: [01:30] She's a fairly well known doctor, I guess, online. She has a practice in California. She was discussing social media and how it was affecting her practice, how she was so proud of the fact that she's not paying for marketing, she's not spending money on ads, she's got very minimal span and so competitive in California. She talked about how she was using social media. Now, she put up some numbers there in the numbers I was not very impressed with in terms of gross volume. And in my opinion, what she was doing was providing a very dangerous line of information for anyone going into business. Now, I say it's dangerous because not all practices are thriving. And when a practice isn't thriving or has a lot of competition, the worst thing that you can do for your practice is spend time, effort, energy, and money doing something that doesn't add to the bottom line.

Nick Dumitru: [02:28] Let's start talking about what's wrong with social media first and foremost. Now, there is a time to go all in on social media, and I'm not saying that social media doesn't work, but it has to be used the right way and at the right time to make a difference in your practice, otherwise you really are just doing it for your own sake, for your own vanity. So let's talk about what's wrong with it. Many people that are very much advocates of social media these days, for example, Instagram is the latest and greatest favorite of everyone that's touting social media these days. Those people are not taking into account the history of what happened with Facebook. Facebook is by far the largest platform. It's still one of the best producing platforms in terms of ads and it is the one that's pretty much been around the longest that is still in existence today.

Nick Dumitru: [03:19] So when we're examining social media, when we're looking at Instagram, we want to first take a look at the history of Facebook and what happened there. Now, Facebook used to be great. A lot of people spend a lot of time, energy, money, building up these pages, business pages on Facebook, and getting organic reach. Organic reach was the big thing. Social media was going to be the next wave. It was going to put advertising out of business, because now all you had to do is put up a few selfies, go on social media, and rely on your fan base to really drive your business. Well, the thing that people don't understand is that Facebook at the end of the day is a business. They're not there for your sake. What happened originally with social media, and rightly so, I'm not blaming Facebook for this, this is absolutely correct on their part.

Nick Dumitru: [04:06] They took a look at it and they saw that the platform was driving business from their pages, from their fan page. What they did is they decided that they would reduce the organic reach on those pages and now it became a pay to play platform. So all those people that spend all that time, energy, effort, and money building up all of these engagement, and pages, and likes. You remember who likes used to actually matter? I do. They don't so much anymore because it's not about that, it's about engaging your customer on the social media platform. Well, Instagram, and whatever comes next, whenever you're listening to this, whatever the next big social media platform is out there, it's going to be monetized. Facebook is already talking about starting to monetize Instagram. They're already exploring avenues. They're already looking at a messenger, and how to engage people there, and how to create those communities, and it too will become a pay to play platform. What do you think will happen when that is put into place? Nick Dumitru: 05:07 I'll tell you exactly what's going to happen. Your organic reach is going to diminish. All that time, energy and effort you've spent building up your various Instagram followers and all of that will just go by the wayside, and you will have to pay to play. Now, if that weren't bad enough, if Facebook deciding to kill organic reach wasn't bad enough, there's another thing that you have to start thinking about in terms of business development, practice development, and that is do you want your business to be in your hands or do you want your business to be in the hands of third parties like Facebook and your customers? If you said anything other than in my hands, then you need to reexamine your business. The reason for that is that when you are engaging in social media, when you're taking selfies, putting out videos, and relying on that for business, the control is 100% out of your hands.

Nick Dumitru: [06:00] If Facebook goes under or the government decides to shut them down or break them up, whatever, anything can happen, your business can tank. If your customers don't engage or they don't feel like coming in and you're just relying on this organic reach and organic posting, again, they have all the control. You as a business owner have no control. I didn't want to be controversial in Paris when that doctor was talking, but again, like I said, her numbers were not that impressive in terms of gross volume. And that's okay. If you just want a lifestyle business, then that's perfectly fine. You can have a lifestyle business and be perfectly happy with social media. But if you want to build a robust business as a business owner and you have to start thinking yourself of yourself as a business owner, as a business owner, you need to have control of your incoming prospects, your leads, your lead flow, your engagement, and people coming to you.

Nick Dumitru: [06:53] Organic reach isn't going to do that for you. It doesn't matter how many selfies you take. What I would have asked that physician is if I needed another 400, 500, 1000 leads this month because your business is struggling, or you've added this new piece of equipment, we need to get it out there. How many more selfies would you need to take to generate those? The answer is that she wouldn't know, because she has zero control of for business. All she's doing is relying on the charity of her customers and on the charity of Instagram to give her her patients. We're going to talk about the benefits of social media and a little bit, but I want you to first understand what's wrong with it. And that mindset, the mindset is a disease. It can really hold you back.

Nick Dumitru: [07:37] While it will produce some results, you're leaving a lot of money on the table because you are trying to be too stingy and too cheap to actually invest in your practice and have control of it as a business owner. That's the problem with this organic reach. That's where it can harm your business. That mindset is that disease and it can be very dangerous because here's the reality, social media isn't free. Okay? Organic social media isn't free. Even if you don't want to pay for ads. Even if you think that the best way to go about it is not to give Facebook, and Instagram, and all these other platforms any kind of money because you're very proud of holding it for yourself. She was very righteous, by the way, on stage, and very proud of the fact that she had zero control of her practice.

Nick Dumitru: [08:23] Now if you've got that mindset and you're doing this organically, the reality is that you're spending a lot of your own time, and your time is worth money. And as a physician, your most valuable time as a doctor is in performing money-making activities. That's consultations and producing procedures, doing procedures. All right? Any other activity that you're doing isn't a money generating activity in your practice. And if you don't value yourself enough to put yourself into a money-making activity and you think that doing a selfie, or a little video, or putting your children out on social media because some expert told you to do so, right, for the sake of trying to get a patient? If you think that that's a good use of your time, then by all means go ahead. I personally don't think that that's a great use of your time. I don't think that you're going to make more money by just doing selfies all the time. You're going to make money by having control of your practice, plain and simple.

Nick Dumitru: [09:24] Now, like I said, it really depends on the type of business that you want. If you need to feed your ego, if you're that type of person and you get off on the pseudo celebrity aspect of it, then by all means spend the time on social media. Go ahead. Like, if that's feeding your soul, if that's what your soul needs to feel good, then do it, but understand why you're doing it, right? Don't fool yourself into thinking that this is how I'm growing my practice. That's not what it's about. Now, if you're looking to grow a robust practice under your own control, then you need to start advertising and you need to take advantage of the advertising available on these social media platforms to get the people engaging to you. And there is a way to do it. I'm not going to get into that now. There's a way to do it right to make sure that you're not losing your shirt.

Nick Dumitru: [10:08] But what I want you to take from this is that you have to understand where the control is, right? As a business owner, if you don't have control of your lead flow of your marketing, of your advertising, then you're vulnerable to everything from market conditions, to Congress shutting down social media platforms or breaking them up, and right through to just plain old greed, good old-fashioned where the social media platforms just want to take away the organic reach because they need to make money as well. They have employees, they have servers. It's not a charity, they're a for profit business, and they can absolutely choose to do that because it's their platform and they have the control.

Nick Dumitru: [10:48] You need to decide what you want, what kind of practice that you want, and how slowly you want to grow. Because the other thing with social media organic reach is that it's not scalable, whereas advertising absolutely is. You can double, triple, quadruple your advertising spend and your lead flow and really take over a market, and all it costs you as money. On the subject of money, I want you to start looking at money a little bit differently, because there's a difference between a cost and an investment in your business. Spending money on advertising doesn't have to be a cost. It can be if it's done wrong, right? If you've got people that are talking about branding, and reach, and exposure, and top of mind awareness, yeah, absolutely that's going to be a waste of money for you. But if you're talking about direct response style advertising where people take action based on what you put in front of them and you can measure it, then it doesn't become an expense.

Nick Dumitru: [11:44] It's an investment. Because the reality is that money is fluid, right? There's always more of it. There's never a shortage of cash. So when the money goes out into advertising, it comes back as surgeries, or injections, or laser treatments, whatever it is that you're doing. When it comes back to your practice, it's a revolving door. So if you put out a thousand, you do the treatment, right, and then maybe you made $500 profit, right? We got a thousand plus the $500 profit, it came back. It's a revolving door and it doesn't matter if it's ten thousand, or a hundred thousand a month, or a million a month. Depending on the size of your practice, it's the same thing. That's how you have to look at it. It's an investment that goes out there and then comes back with business for your practice. Whereas with organic reach, you may have spent the time, the energy, the effort, all that time doing these videos, and selfies, and posts, and they may bring nothing back because you've got very little control over that.

Nick Dumitru: [12:41] Again, it's in the hands of a third party and you're relying on the charity of your customers to come in, because you're relying on getting their attention and you basically become a dancing clown. You have to start entertaining them. I personally have more respect for you than that and I want you to understand that you don't have to do that. Now, if you choose to do that again, by all means, I'm not judging you. Absolutely. Go ahead. But understand that you're doing it for reasons other than having control of your practice.

Nick Dumitru: [13:10] All right. Having said that, I don't want you to be completely scared about social media advertising. There is a reason to do it, and I'm going to get into that right now. Now, the main reason that you want to do some social media activity, as long as it's not your primary lead acquisition source, is because there is data out there that shows that it can increase your conversion rate in office.

Nick Dumitru: [13:34] So when somebody becomes a lead and then you also have a lot of social media activity out there, the right kind of social media activity, then they start to know, like, and trust you. They start to engage with you a little bit. They start to gain an affinity for you, so that when they come in, they're much more disposed to converting with you. Right? So they come in, you don't have to explain as much to them all the time, you don't have to tell them so much about yourself, but this is not activity that needs to be done every week. Right? Especially not by you. You can definitely put your staff in charge of that. You can do the odd video yourself, you can do some videos maybe once a week or once a month where it goes out there and it stays out there. Like, it doesn't have to go away, and you can use your paid ads to start retargeting those people that are engaging with your practice and that have maybe a filled out a consultation request or made a phone call, and then start to engage them in this conversion-building effort.

Nick Dumitru: [14:34] So, there is some advantage to social media. Having said all that, there is an advantage but it has to be done for the right reasons, and now this will help you understand what kind of content to craft as well. Because if the goal of your social media is no longer to try to entertain and garner attention, you start to think about who the audience is, the value of them having certain types of information, and then using that to help them make a decision to go with you. It really focuses the content, right?

Nick Dumitru: [15:05] So now that your content team isn't trying to jump on every single trend that's out there, it really helps your staff understand what the goal of the marketing is, what the goal of the social media posts are. It's to create affinity. It's to create liking. It's to create knowing. It's to create authority to some degree. And it doesn't have to be you doing it all the time, 100% of the time. You can recycle videos, you can get them to edit clips, you can get them to use software out there that makes it look live, for example, where if you're talking, it can look like they're filming you. There's software that'll let you go live on Facebook, and YouTube, and other platforms without you actually having to be there, and you can do a more intelligent style of social media where it's not relying on you to be on all the time. It's not putting your family out there, right, unnecessarily. It's not endangering your children.

Nick Dumitru: [15:55] Because on a side note, I have a partner out in Australia and he's done a lot of security work and I can tell you one of the worst things that I've seen is how children are taken advantage of online and how people start to obsess just because they've seen a photo on the internet and then they start to go after these children. I personally as a parent will not want to have to put my child on social media or on my marketing just to try to make money. I respect my privacy. If you're a more private person, then I want you to understand that you don't have to be the dancing clown these days, because every other expert and their mother is going to tell you that you need to do this. You need to put yourself out there. You need to get your family on there. You need to take selfies at the cottage. Nick Dumitru: 16:40 You don't have to do that. You do not have to do that. And this is why I'm saying. It's a bit of a contradictory stance that I have, only because I've done it so much. I've been at this for over 20 years. I've not had to request that of anyone that's worked with us in the past. Now, do I recommend social media? Absolutely. If you've got the bandwidth and the time and your business is doing well, then that's the time to really focus on it. If you're struggling for new patients, if right now you're making a little bit of money but not the kind of money that you should be making and you've got an extra 20, 30, 40, $50,000 that you're thinking of putting into marketing and maybe hiring a social media person or running advertising, I'll tell you if it's done right 100% of the time, not 99%, 100% of the time, you want to start running ads, because it's in your control and that will make a difference to your practice.

Nick Dumitru: [17:32] Okay, so I'm going to get off my soapbox a little bit. I just had to get that off my chest with the social media. I just thought that at that particular conference in Paris that it was just borderline irresponsible and dangerous to be telling doctors who are relying on their practices for their income, their family's income, and their employees, to really go whole hog in on social media as opposed to really focusing on the fundamentals of their marketing first, getting a thriving practice, and then investing back into social media and some organic once they've got that robust patient base and income coming into the practice. I don't want you to feel that you need that and I want you, depending on wherever you are in your business, whether you're doing well or not doing so well, to understand the reason behind social media, when to do it, how to do it, and the fact that it needs to be done in the right way.

Nick Dumitru: [18:26] I hope this has helped. If you enjoyed this podcast, and by all means, please subscribe to it on iTunes or your favorite podcast platform. I will be putting out more episodes like this. And check out our website if you are looking for any kind of additional information on this particular podcast or you want the transcripts, and the show notes, and any kind of links, they'll be at thinkbasis.com. That's T-H-I-N-K-B-A-S-I-S.com. Just look for the podcast link and you'll find this episode there. All right, thanks for listening and I will see you on the next episode.

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