Slaying the myth

July 1, 2000
"How far are you from Boston`s Logan International Airport?" read the e-mail query. "I had porcelain veneers placed about 15 years ago, and I don`t like the way they look today. Could you replace them for me?"

Who says dentists shouldn`t reap great rewards and some of their best new patients via the Web?

Tom Orent, DMD

"How far are you from Boston`s Logan International Airport?" read the e-mail query. "I had porcelain veneers placed about 15 years ago, and I don`t like the way they look today. Could you replace them for me?"

I sat staring at my computer screen. Was this for real? Yes. Judy is a corporate attorney for Baccardi Rum who lives in Bermuda. While it may sound like heaven, she later explained to me that living on the island makes it tough to find the kind of dentistry she wants. A few more e-mails and a couple of weeks later, I prepared six Empress porcelain laminate veneers. On her return visit, she brought a friend.

Patients won`t find you just by "surfing the Net"

Fifteen years ago I heard Dr. Omer Reed repeat the timeless wisdom, "If it`s been done before, it`s probably possible." The train of thought that believes we shouldn`t expect new patients (lots of them) from our Web sites is one of the greatest - and most disabling - myths spread about the Internet and dentistry. This was true three years ago when the only people looking at a dentist`s Web site were other dentists. But everything has changed since then. The number of users reached critical mass. Take an informal survey of your patients this week. Count the number of households with access to the Web. You will be shocked. The Web may have been an ineffective tool for dentists seeking to attract new patients two or three years ago; today it`s anything but. Tom Peters said, "Quote me in five years and you`ll be dead wrong." With the Internet, it`s more like five months!

Judy`s case was not an isolated incident. Shortly thereafter we met a new patient who was interested in "fixing her back teeth." Again, her sole referral source was the Internet. She had a mouth filled with old, broken-down amalgams, and wanted them all removed. The $20,000 fee was paid ahead to qualify for a 5 percent prepayment courtesy.

Like Judy, and more so than many good patient referrals, this patient was sold on our office based upon what she learned from our Web site. Patients entering our practice through our site know more about us than those from any other source. They`ve "pre-qualified" us before ever setting foot inside our "bricks and mortar"! Cases have ranged from veneers to TMJ therapy to the full Empress reconstruction. As 1999 came to a close, we exceeded $100,000 in treatment that was directly traceable to our Web site.

At what level is ROI considered successful?

My practice annually spends in excess of $100,000 on external marketing (advertising). Whether spending $1,000 or $100,000, every penny spent - and subsequently every penny earned - must be traceable!

We have triple-redundant systems to track the referral source of each new patient. The bookkeeping program then tells us what we`ve spent for each ad. A return of 3:1 during the first-level referral, in the first year, is great. In actuality, if you were to track secondary and tertiary referrals, and extend beyond the first year`s collections, 3:1 would bear 5:1 or better. How did our Web site measure up in 1999? After a complete revision, several upgrades, writing custom software for online appointing, Web hosting, and all the extras, we spent roughly $2,000. That`s a return on investment of 50:1!

That figure is a freak of the times. How and why is this happening? There are more factors than one can possibly identify, but here are just a few:

Although more than 80 percent of dentists have access to the Web, less than 5 percent have individual office Web sites.

Many Web-referred patients express the feeling that our office must be "leading-edge" since they found us on the Internet.

Nobody has extra time. How often have you heard, "If there were only 25 hours in each day"? Now there is instant access, meaning patients can even complete the appointment process from the convenience of their desktop computers.

"24/7" - Twenty-four hours a day, seven days a week - your prospective new patients have access to a world of information via your site.

Interactivity with anonymity. Surfers have complete anonymity if they choose. Choosing a dentist is a very important and personal decision. Patients appreciate the ability to look into your practice from behind the protective one-way mirror of the Net.

Offer live real-time help online

New supporting technologies and strategies are unleashed daily. How would you like to be able to offer surfers the option of asking questions and chatting live with your dental team members through your site? It`s already happening.

Downloadable software called HumanClick has a cleverly designed cartoon icon, embedded on the pages of your choice, which beckons the surfing prospect to chat with your staff. Offering "live" online help, the little cartoon man is an almost irresistible link between cyberspace and your dental practice. He offers to chat only when you or your staff are online. If no one is there to help, the surfer can leave a message. The message is subsequently e-mailed to the team member of your choice. When there is someone to help and the icon is chosen, the sound of a ringing telephone emanates from your computer. When you "answer," you are engaged in live chat. The very first time I tried this incredible new tool, I was in conversation with a severely phobic patient. The last time she had seen a dentist she was "put to sleep" for all of her fillings. We met face-to-face just a few days later. There`s no way to tell if she ever would have had the courage to visit the dentist if it weren`t for the "human" side of the Internet.

In addition to allowing live interactive chat, HumanClick also offers sophisticated tracking capabilities. Almost as eerie as George Orwell`s "Big Brother," you can silently "watch" as prospective patients browse through your site. You`ll know which hosting service they use, what browser (including version) they have, how long they spend at your site, and even which pages they view. You`ll even know how they found you. Was it a Yahoo search that led them your way, or was it that banner you just purchased from an e-company?

Picture this for live chat: "Hi there. I noticed that you found us through an Alta Vista search. That`s my favorite search engine as well. I see you spent almost 20 minutes in our smile gallery of before-and-after photos. Are you interested in cosmetic dentistry? By the way, you should consider switching to a newer version of Netscape. Your version still has some problems with the newer Web graphics!" It`s not inconceivable, but it isn`t recommended either.

All of the gathered information should be helpful in determining the future direction of your site. Where are the referrals coming from? You can spend more time and funds improving that source. Which pages are viewed the most and which are never used? Future revisions should take this into account as well.

If you are interested in HumanClick, go to Like so many innovations on the Web, the price is unbelievable. At least for now, it`s free!

Online appointments and online response

I recently had a revealing conversation with the owner of a local ski shop. When I told him how excited I was about the response we`ve been getting to our Web site, he told me he was thinking of developing a site. But he would never consider having his e-mail address on the site. Why? He couldn`t bear the thought of responding to all of the questions it would generate!

My recommendation for him (and anyone else considering developing a commercial site) is to forget about the Web. Interactivity is the Web! Have you ever surfed the site of a company and wanted to ask a question about a product, but realized there was no way to contact the company online? That causes extreme frustration. The least you should consider is a contact icon that generates e-mail to you or your staff.

Perhaps my current favorite feature of the Internet - and likely the source of much of our Web success - is our online appointment form. It is very similar to the new patient phone slip our staff uses when new patients call for their first visit. Prospective patients desiring an appointment can complete the form online, filling in their name, address, telephone number, and e-mail address. Each patient is asked to tell us what he or she would like to have done on the first visit and give us a preferred day and range of times.

Initially we responded by e-mail and telephone. Today we lean toward simply giving the patient an appointment that meets his or her expressed needs and e-mailing the appointment date and time. We ask for confirmation of the appointment by return e-mail. Follow-up confirmation then can be done by phone if necessary. A few years from now, we`ll likely look back on this process as being as primitive as ledger cards and a pegboard would seem today.

The next step in Web sophistication will likely include true online appointing. Staff would designate certain times as available for online appointments. These appointments then would become visible to the prospective patient, who would fill out the forms and schedule the appointment online. Every week we receive a few online appointment requests. When we`re running radio ads, it`s not uncommon to see that number instantly double or triple.

Build your patient e-mail database now!

Every prospect who e-mails you a question, fills out a form, or makes it into the office should become part of your e-mail database for the future. Develop a routine for collecting the e-mail addresses of your existing clientele as well. We`ve developed a bright yellow half-sheet form to collect the addresses of existing patients. One of these forms is clipped to each record of the day to help us consistently ask for addresses.

In addition to placing the e-mail addresses into our practice-management software, we store them in Excel and Eudora. In the brief time we`ve been collecting, we`ve stored several hundred addresses and found many uses for the information, such as:

Contact - Many patients who have moved will keep their e-mail addresses long after phone and mailing address changes.

Confirmation - It won`t be very long before the majority of your appointment confirmations will be performed by automatic e-mail generated by your practice-management software.

The "e-letter" - How many times have we started a program of monthly mailings to our patients? Marketing experts say that anything less than monthly contact risks enormous attrition.

The "e-letter" is a fast, simple device to maintain contact with patients as often as you choose. Mail to your entire database simultaneously. Don`t limit your list to those who frequent your practice. Always include those who`ve contacted you by e-mail for any reason. E-mail is a wonderful, free service, so take advantage of it.

The first two subjects of our e-letters were very well received. The first discussed the media`s attention to the relationship between heart disease and periodontal infection. The twist was that the media didn`t make it clear that 80 percent of adult Americans are affected by gum problems, and that often there are no obvious signs or symptoms perceived by the public. The second "e-letter" discussed fluorosis. Few parents understand the relationship between excessive doses of fluoride and fluorosis. The letter suggested that parents actively gather information, such as finding out if the water supply is fluoridated and following up with a physician and dentist to be sure that the proper dose is received.

Are banners and "positions" worth the investment?

I`ve spent several thousand dollars on banner advertising, simultaneously using three different companies. To date, we cannot identify one new patient from any of these sources.

How can we tell if they came from a banner? We had our designer create a "false entry page" into our site. If referred from one of the banners, the surfer is linked into the false page corresponding to that company?s banner. On the entry page, they?ll have the chance to print out an online coupon for $75 off any service in our office. Not one patient has reported finding us through a banner, and we have never seen a courtesy coupon.

Would I recommend that dentists purchase banners? When queried, some of my other Web-savvy acquaintances reported that they too had purchased banners, but only to protect position ? that is, to prevent others from acquiring the opportunity should the banners prove fruitful in the future. It?s clearly a gamble, the value of which, at this point, I can?t predict.

Multiple-niche marketing

A number of years ago, I coined the phrase Omultiple-niche marketingO to describe a very effective method of dental-practice advertising. A typical dentist?s Yellow Pages ad lists all of the different services he or she offers ? root canals, crowns, bridges, implants, dentures, partials, extractions, etc. This laundry list most likely will have the effect of implying that the dentist is the Omaster of nothing.O So why not focus your attention on two or three very specific niches in dentistry? If you enjoy implants, then devote a major portion of your site to implantology. Show before-and-after pictures of happy patients who?ve been restored (preferably by you) with implants. Written testimonials are also a very powerful tool.

The diagnosis and treatment of breath disorders is another subject that will attract new patients. Other marketable niches include TMJ, multilingual staff, cosmetic dentistry, etc.

OLong-distance surfersO often land on your Web site. Although some do so intentionally, most simply don?t specify geography when entering their search. Rather than losing the prospect, consider sharing referrals and less geographically desirable hits with other dentists. For example, if someone from your neighborhood lands on my site, they?re directed back to you! If you would like to join the network, go to

There likely will never be a better time to develop a Web site. Five to 10 years from now we all will have sites, but the impact and return from any single site will pale in comparison to the opportunity that exists today. Your site is a mirror and a window to your practice. Seek out a highly skilled professional to develop and maintain your site. I?ll see you in cyberspace!

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