It’s amazing what you can find in old closets. I was cleaning out one of mine the other day when I ran across an old, dusty, beaten up Yellow Pages. The fact that it made its way into my closet where it lived for years and not immediately into the nearest trashcan is astounding! I even thought back to 1987 for a couple seconds as I shoved that sallow beast into the Hefty bag. How many of you recall placing expensive ads in the Yellow Pages?

When I graduated from University of Missouri- Kansas City dental school in 1987 the Yellow Pages was a total cash cow. Back then all the “older guys” wouldn’t place an ad in it because they thought it would harm their reputation. So, of course, in Howard Farran fashion, I did it in a huge way and it worked like a winning slot machine for more than a decade! But then every dentist caught on and it eventually started to break even and then lose money. Ten years ago my practice, Today’s Dental, had three full-page ads in three different phone directories. Today we have one small ad in our small local phonebook that covers my neighborhood of Ahwatukee in Phoenix, Arizona.

The slow and steady decline of the Yellow Pages was simply caused by the slow and steady rise of the Internet. And because Mom switched from the stale, static scarcity of limited paper ads in the Yellow Pages to endless Internet search engine results which link to an endless number of Web sites containing information ranging from meet the dentists to blogs on every subject, I now spend $500 a month just on pay-per-click Google ads!

We get so much bang for our buck with online marketing! On the other hand, there are a lot of moving parts with online marketing; things start to add up and it requires a lot of upkeep. You’re not just tweaking the content or the usability of your own Web site anymore – you also have to be mindful of social media, search engine optimization (SEO) and ads on Google; and then throw in all of the tracking that needs to happen to ensure you’re getting a decent return on investment (aka, inquisitive phone calls and new-patient appointments), you’re talking about a full-time job! Unless there’s a member of your staff completely devoted to your online marketing efforts, you’re probably not going to achieve the results you’re hoping for (read: “paying for”). I don’t know about you, gang, but I can’t afford to have one of my assistants or hygienists or even my practice manager spending time updating the practice’s Facebook status – times are tough, we’re a lean crew and we’ve got patients to tend to!

There are a lot of components to juggle and they all channel into the one most important part of online marketing – SEO. Becoming the top practice in a search on Google and Yahoo is the gold medal for every practice’s marketing plan. When someone types in “Ahwatukee dentist” we want our practice to be the first thing potential patients see. It’s what earns you the most new patients – the lifeblood of any dental practice.

The recent recession hit Arizona pretty hard; it was second in state home foreclosures after Nevada, and thousands of Arizonans lost their jobs. The dental industry in Phoenix was hit hard and more than 150 dental practices closed their doors. Some were my very good friends who opened their doors more than 25 years ago like me! But like I’ve written time and time again, when the going gets tough you cut your costs; lower your prices; join a few dental PPOs; add more services to your now smaller patient base like placing implants, using CAD/CAM, treating sleep apnea, incorporating Invisalign; and last but not least, you double or triple your marketing efforts.

The Yellow Pages died in my area, maybe your area is different but I doubt it. You will only know if you track it all meticulously! I went from creating my own dental office Web site in 1999 with my own full-time programmers to now outsourcing it to Sesame Communications because its team did it better than our team could do it internally. Building our B2B (Business to Business) Dentaltown.com Web site was an entirely different set of skills than building a B2C (Business To Consumer) TodaysDental.com Web site. The biggest reason was search engine optimization (SEO). Dentaltown.com does not show up on a Google search because it is a private dental Web site community (which, by the way, recently passed its 150,000th member). We do not want patients doing a search for dental-related questions and answers by trying to become a member of Dentaltown.com. That is not our focus and it’s not why Dentaltown.com exists.

I want patients who live in Phoenix, Arizona, “Googling” dental-related searches to land on my TodaysDental.com Web site, and that is what Sesame did for me in spades! I usually show up first, third and fifth on Google and Yahoo searches. Now my Web site and Google ads are cash cows!

It simply doesn’t make any sense to hire someone to handle our dental office marketing internally. The skill set to understand SEO is far beyond the scope of handing it as a part-time job to any one of my current staff members! People who understand SEO have to do it full time, just to stay on top of it, and all of the good ones earn six figures. I knew this was an outsource play and I needed to find an SEO expert. We needed someone who could be a master of this new, lucrative online marketing tsunami.

You are all likely familiar with my 5 D’s: 1. Design Your Plan; 2. Drop Everything You Don’t Need to Do; 3. Delay Everything You Can’t Drop; 4. Delegate; and 5. Do. This decision, obviously, falls heavily on number four – Delegate.

Since 2008 we’ve been working with Sesame Communications, which has overseen and worked on many of our marketing efforts from Web site development to tracking phone calls. I seriously thought I knew of what we needed to do to increase our SEO and be front and center in Google searches in my area. I was so wrong.

From the get-go my eyes were opened to the myriad components that work together to increase SEO. Did you know you have to have a presence on YouTube? Did you know you need to focus on creating a special mobile Web site for iPhone and Android users? Did you know the fresher your content, the better your SEO? Did you know you really needed your Web site to go live years ago instead of last week (yes, even that impacts SEO)? Did you know posting on Facebook and linking directly back to your Web site impacts SEO as well?

(Speaking of Facebook, I want you to “Like” my three Facebook pages so you can always see what we are posting on…
Today’s Dental: www.facebook.com/todaysdental
Dentaltown: www.facebook.com/dentaltown
And please follow me at www.facebook.com/drhoward to see my daily tips and where I will be lecturing again near you or some place fun in the sun!)

Because of our decision to outsource to a marketing company, we have coherence between our Web site and mobile site, search engine optimization, pay-per-click advertising and a social media strategy, as well as our patient portals and patient engagement tools. On average, we get 148 calls each month from our online presence alone – 41 of those calls can be specifically identified as new patients.

Because 30.43 percent of our prospective patients visit our Today’s Dental Web site before they make their first appointment (as shown by our Sesame analytics dashboard), we decided it was in need of a redesign. Our original Web site had become outdated – and it was merely three years old. With the goal of our site being to get patients to pick up the phone and call our practice, we worked with Sesame, who came to the table with solid research and helped us understand what content needed to be present, and what design elements would keep prospective patients on the site longer. Since we launched the new site in 2011, our bounce rate (the percentage of visitors who enter our site and immediately leave) has decreased from 47.79 percent to 40.52 percent.

And while mobile sites might currently make up a smaller percentage of online activity, it has been suggested that they will exceed desktop browsing in the next three to five years. Think about it, guys! How many of your friends own an iPhone or an Android? Probably everyone! It’s pretty rare to find anyone using a candy bar phone that only makes calls anymore. It’s for this reason we had to develop a mobile site. The mobile site gives patients an optimal view of our site. It reduces image sizes and contains only the information prospective patients need to make a decision, including links to appointment requests and click-to-call functionality. On average, our practice gets 17 calls per month from our mobile site with three of those calls specifically identified as new patients.

One of the key agreements we have with Sesame is improving SEO on popular search engines like Google and Bing. You can’t get to the top of a Google search and just forget about it. It’s a continuous method and it needs to be constantly updated – and every couple of years, the pesky powers that be at Google change up how their engine pulls up information. I’ve learned a good SEO strategy doesn’t just focus on the term “Phoenix dentist,” but also what are called “long tail terms” and terms that aren’t as popular. In September 2011, we decided to focus our efforts on improving our SEO for sleep apnea in Phoenix – and in three months we moved up 66 places.

We’re fairly new at integrating Google AdWords into our marketing plan, but basically when someone types in key words, like “Ahwatukee dentist,” our ad should come up first next to his or her search. Then you set a limit as to what your monthly budget is. The more you spend, the higher up your ad will appear. We spend about $500 a month, but a lot of the effectiveness has to do with how those ads are written. My practice would have a hard time doing it alone, because it is extremely time consuming to come up with new ad ideas and also to track the performance of each ad. You have to keep coming up with fresh content and you have to make sure your staff gets involved.

I was shocked to find out social media has a major impact on SEO as well. Facebook, YouTube and practice blogs all contribute to higher rankings on search engines. We designed our Facebook, YouTube and blog pages to match the look and feel of our Web site. Basically we feed Sesame bits of information about our practice from time to time, which they turn into Facebook posts. We also take 30- to 90-second videos and post them on YouTube, which Sesame optimizes within YouTube.com. Everything connects as well – so when we put a new video up on YouTube, we use Facebook to link to it, and also back to our Web site. Or maybe my associate, Dr. Michael Glass, will post a new blog about sleep apnea, and we will link to it via Facebook and our Web site. In the last five months, we’ve increased our likes on Facebook by 39 percent and we now have 233 percent more patients using Facebook to “check in” at our practice (aka, let all their friends know they’re at Today’s Dental).

(Before you write your next blog you should read our blogs for ideas! I actually think the best dental blogger in America is Alan Mead, DDS, and you should check out his site: MeadFamilyDental.com.) If that’s not enough mind-blowing integration for one practice to worry about – all of our SEO strategies work well into our patient reminder system. Through our practice dashboard, we know 13.3 percent of our patients prefer phone reminders, 4.35 percent prefer SMS text and 86.86 percent prefer e-mail (in which we’ve recently integrated a “refer a friend” button – which, so far, has been used by 13 of our patients). We give all of our patients the option to choose which reminder method they prefer. And all of this automation puts downward pressures on your number-one largest cost, labor!

And when all those calls start coming in, you need to make sure your staff is trained how to close each and every call by getting each one to schedule an appointment. One of the best guys out there to help you with this is Jay Geier and his Scheduling Institute. Jay and his crew just about doubled our close rate of newpatient phone calls. I know this because we can track everything with Sesame’s help.

You know why this sounds like a lot of work? Because it is! If you can manage all of these things yourself, do it! If not, I strongly suggest you work with a company like Sesame that can help you out. These are merely my suggestions to you, and I hope you consider them, that is unless you’d prefer your practice to end up old, dusty and unused in years like the Yellow Pages.