What Australian Dentists Can Learn From The US Experience – An Interview With Graig Presti, Inc. 500 Dental Marketing Agency

This week on Marketing Monday, Angus Pryor the Practice Growth Specialist will be sharing with you an interview with Graig Presti – Inc. 500 Dental Marketing Agency. We talked about 3 things on what  Australian dentists can learn from the US experience.


Hi everyone, Angus Pryor here, practice growth marketing specialist and number one Amazon best-selling author. And have I got a treat for you, all the way from Austin in Texas, Graig Presti, welcome.

Graig Presti: Thank you for having me.

Angus Pryor: All right, well the truth is that we are in Austin. I am the one who’s moved, Graig.

Graig Presti: This is my home.

Angus Pryor: From local search for dentists, what the heck does Austin know about local search for dentists?

Graig Presti: Well, we know a lot. Actually we’re a four time Inc. 500 dental marketing agency. So we help dental practices all over the world leverage their local area so they can get more production, more patients, more phone calls and more profit.

Angus Pryor: Apparently quite a bit is the answer.

Graig Presti: Yeah.

Angus Pryor: What is Inc. 500?

Graig Presti: It’s a list of the fastest growing private entities in the United States. So basically what that means is we’re one of the fastest growing, most reputable agencies in all of dentistry. You have to qualify for it, it’s an elite list and we made it four years in a row which is actually less than 8% of businesses in this country.

Angus Pryor: Wow.

Graig Presti: We’re very proud of that.

Angus Pryor: Good. Well the topic for today is – what Australian dentists can learn from the US experience. I used to live in the US at one point, we’re not saying that everything that happens in the US happens earlier in Australia. Apparently the usage of text messages, the take-up was much faster in Australia than the US. But in many instances what happens there in the US, it starts there and then it turns up in Australia.

Graig Presti: Right.

Angus Pryor: And certainly in the dental field.

Graig Presti: Correct.

Angus Pryor: The level of competition in dentistry in the US is in my experience, taken it to the next level from an Australian context.

Graig Presti: Correct.

Graig Presti: Yeah, ironically we have a giant wave behind us, right? So basically there are a lot of tidal wave effects happening here in the United States and actually some, as we’ve talked about, have bled over into the Australian market. And really the three main takeaways are this.

Right now it is imperative that you have what I like to call, your Google house in order. And what I mean by that is, not your website, your website’s a glorified brochure, no one looks at it anymore. It’s basically no longer the deciding factor if a patient chooses you versus a competitor.

So your Google house will be your Google My Business page, making sure that’s optimised and looking branded and professional. Google reviews, YouTube channel, YouTube reviews, making sure that when someone does look for you online, you are looking like the best, brightest and no brainer choice in town.

You have less than seven seconds on Google to impress a patient. And they’re not even getting to your website, it’s little in the blink of an eye. Right? And they’e doing it on their smart phone, their tablet, their computer.

So you have to have your Google house in order. Because believe it or not, referrals are Googling you, new patients are Googling you. So everyone is going there to make sure you’Re credible and reputable. That’s number one.

Angus Pryor: Actually it’s interesting you say that and I think that trend is a bit stronger here. But that trend is certainly the case in Australia too. My wife was telling me, this is only earlier this year, that her best buddy at work made a recommendation for a particular healthcare professional and then my wife Googled the business. And as a result of that decided not to go.

So you think about that, once upon a time we have said a recommendation from a friend was the bee’s knees.

Graig Presti: Yes, the best thing you could get, right?

Angus Pryor: And yet she got that recommendation, looked them up on Google and decided not to go. All right, that’s number one, what’s number two?

Graig Presti: Number two would be the invasion of the corporates or the DSO’s, which it’s Dental Support Organisations. Which basically are the private equity of dentistry, right? They play with monster budgets, millions and millions of dollars. They can raise money like that. And what they’re doing is they’re not seeing the local solo medium sized practise as a threat.

So they’re coming in and they’re gobbling up market share because all they need to do is spend a few thousand dollars a month in marketing, plug their systems in and they can start to get patients, market share pretty consistently.  And right now here in the United States DSO’s are actually 20% of the market.

And that trend is just going to continue to increase here as well as in Australia. And so what you need to understand is that we know you can’t play with that budget but you also can’t be an ostrich putting your head in the sand and ignore the idea that corporate.

Angus Pryor: Or emu in our country.

Graig Presti: Yeah, exactly.

Angus Pryor: I don’t know whether emus do put their head in the sand.

Graig Presti: Well for this … We’ll say they do for this context. But for everyone listening to this, is that back in the day corporate dentistry, you know your Aspens and what not, meant terrible dentistry. The patients would just come back to you in droves.

Well unfortunately that’s no longer happening, they’re actually providing really good services. And so they’ve went out and hired really good dentists, they’ve ditched the corporate names and they’ve gone with more of a mom-and-pop branded feel.

And the patients know no different. So you have to compete. The way you compete is be nimble. You don’t have a board of directors, you don’t have to go out to the private equity firm and argue for more money. You just go out, you hire me or Angus literally today if you wanted. Right?

Angus Pryor: So they can respond more quickly.

Graig Presti: Correct.

Angus Pryor: That’s while the downside is they don’t have the deep pockets that these …

What was the acronym again?

Graig Presti: Private equity?

Angus Pryor: No no, DSO.

Graig Presti: Oh Dental Support Organisation.

Angus Pryor: I think we have something like that. I mean it’s basically, if I understand correctly this is let’s call it a group of practices that are co-owned but may not be co-branded, is that right?

Graig Presti: It’s a little bit different than that. It’s basically a group of individuals who are going out and buying private practices and they’re not changing the name of the practice necessarily in some instances

Angus Pryor: So that’s what I mean, so their branding’s not necessarily the same.

Graig Presti: Correct.

Angus Pryor: I mean we may not call it a DSO in Australia.

Graig Presti: And there’s everything in between that, right. There’s no real wrong or right way that they do it. That’s sort of the problem is that it’s sort of cloak and dagger. You don’t necessarily know they’re in your marketplace.

You might wonder why you’re losing patients or not growing as fast as you would. Chances are you may be had a cloak and dagger corporate or DSO move into town and start to spend a little bit more on marketing. And you just did not know that. That happens all the time.

Angus Pryor: Well look, I think most Australian dentists would see the corporates. I heard a step that said last year that the US had clicked over to more than 50% of dentists in the US working for a corporate or a DSO. So it wouldn’t be that in Australia but perhaps we’ve got that.

But as we’re saying, on the downside for a private practice they don’t have the same budgets as these other guys. But on the other hand they do have that capacity to react very quickly.

Graig Presti: Correct, you’re nimble.

Angus Pryor: It’s not that Titanic you’ve got to try and turn around.

Graig Presti: Yeah. I mean we all know the horror stories of trying to sell to an executive team. There’s 10 players in a room and everyone needs to agree on it. Right? When there’s just one CEO or one business owner, the ability to make a decision is your asset. Because you can make it quickly and efficiently.

Angus Pryor: All right, well cool that’s number two. What’s number three?

Graig Presti: Number three is cashflow and marketing. What I’ve had a lot of conversations with, with a lot of practices and my team has had over the last month is a lot of dentists are coming to us who are having cashflow issues because they just don’t have the new patient flow that they maybe had previously because of point number two. Which is the corporate DSO angle, or just competition being intense.

Angus Pryor: Yeah.

Graig Presti: The difference here is that they end up cutting all of their marketing expenses because they view that as unnecessary. Right?

Angus Pryor: As a cost.

Graig Presti: As a cost, as an expense. Just like overhead, rent, keeping the lights on, paying your lab bill. A true overhead expense, right? But in reality marketing is an investment because it provides dividends back to you.

So most just go scorched earth. Nope, cancel everything. I don’t want to do any marketing. They view it as unnecessary. That is absolutely the worst thing you can do when cashflow is tight, because it’s the only thing providing you with cashflow.

It’s the only thing doing anything if you have cashflow issues. Because when you look at it that way, we’re looking at cashflow being king not cash being king. Because that is what provides life blood into your practise that you can reinvest into better equipment, more marketing, et cetera.

So what you need to do is you need to be efficient with your marketing, which is being meticulous with the ROI, making sure you’re tracking it. And understanding the ins and outs of that. You might be able to cut a little bit here or there based upon maybe some fluff that was unnecessary.

Maybe you were running a print ad which not a lot of people are doing. Maybe that’s unnecessary. You could cut that. But don’t go scorched earth, you need the marketing to get that return on that investment which provides the cashflow. You have a top line production revenue issue, not a cost issue.

Angus Pryor: Graig, there’s just one little thing you’ve got to tell us about. What is scorched earth?

Graig Presti: Like burning the fields down to make them regrow again.

Angus Pryor: Okay.

Graig Presti: Right? You ever heard the farmer analogy, like we do this here in Texas. We have controlled burns.

Angus Pryor: Yeah we have that.

Graig Presti: To make everything come back alive again.

Angus Pryor: For the viewers in Queensland where they produce a lot of sugar, you see, they’ll do that. Who knows, maybe they call it scorched earth. Though I’ve never heard that expression.

Graig Presti: That’s my term I use because it’s sort of like burn it down to maybe it’ll grow back later.

Angus Pryor: Right.

Graig Presti: But unfortunately when it comes to dental marketing, it takes years to do that. We often have folks who will try to cut those expenses and then inevitably regret that.

Angus Pryor: Yeah. Awesome. All right, Graig, thank you so much.

Graig Presti: No problem. My pleasure. Good to meet everybody.

Angus Pryor: Thank you.

Graig Presti: You got it.