4 Dental Marketing Mistakes and How to Avoid Them

Ben Tuinei: Welcome to another amazing, exciting episode of the Insurance Untangled podcast. My name is Ben, and I’m one of the co-hosts of this podcast that’s dedicated towards helping you untangle insurance—if that’s something that you’re dealing with. Today, I have my good friend and co-host Naren with me. I’m gonna be interviewing him today. Naren, how are you?

Naren Arulrajah: I’m doing great, Ben. And yourself?

Ben Tuinei: Doing wonderful, thank you. I just want to thank you again for your last episode. That episode, um, uh, two weeks ago was amazing in the sense of talking about your entrepreneurial journey and giving, uh, uh, listeners sort of a sneak peek into how you’ve been so successful. And, you know, the hope is that there’s something there that can resonate with those that listen to that.

But today we want to shift gears. You know, I like picking Naren’s brain as it pertains to marketing concepts because he’s one of the best in the industry. Um, so today’s topic is: Four Dental Marketing Mistakes That a Lot of Doctors Make—and How to Avoid Them. So here we go.

First, Naren, I guess the first question is obvious, which is: let’s outline those four mistakes. Do you mind doing that real quick?

Naren Arulrajah: Absolutely. I think, uh—by the way—we did a similar presentation in that event we did, the quarterly seminar. So I know many of you attended it, but, you know, probably a lot more haven’t. So I just thought it’s a good idea to cover the same four mistakes that people thought were really, uh, you know, useful for them.

So, the four mistakes are:

Number one is, you know, depending too much on PPO plans. I call it "over-reliance on PPO." And we’ll get into each one, you know, in more detail.

Number two is spending too much money on ads. And I’ll talk about what we mean by this, and where that makes sense, where they don’t make sense, and, you know, what traps to avoid.

The third mistake is ignoring local marketing and SEO. You know, so you’re not really dominating your local market, and of course, you’re not dominating SEO.

And the last one is not focusing on Google reviews.

So those are the four big mistakes. Ben, let’s jump right in.

Ben Tuinei: Yes, I love that, Naren. I’m, um, I like the first one that you mentioned—the overreliance on PPOs. And I’m very, very, very, uh, interested to hear what feedback you have there.Ben Tuinei: Yes, I love that, Naren. I’m, um, I like the first one that you mentioned—the overreliance on PPOs. And I’m very, very, very, uh, interested to hear what feedback you have there. So, when it comes to overreliance on PPOs, can you sort of break that down—what that means? How do you get into that cycle of being too reliant on insurance plans?

Naren Arulrajah: Yeah, let’s kind of, um, talk about a case study here. So there’s this one particular dentist that I worked with, even going back to 2010 or something. And at that time, she was making $650,000 working four and a half days a week. She ran into me at a conference and, um, she, um, you know, was telling me that story and I said what I do. And she said, "Okay, currently all my patients come from PPO plans, so maybe I’ll try this and see if I can get patients who are not on PPO plans so I don’t have to be as reliant on them."

So she started hiring us, and within the first year, she started getting 20–25 new patients a month. And she didn’t want to work an extra half day or a full day to take care of these 25 patients a month.

So she and her husband—her husband was, you know, I met both of them, they’re wonderful people—they have an only son in Virginia. And, um, they decided, "Hey, I’m going to cut the worst PPO plans, the ones who are paying me the least." And she’s like, "Okay, instead of working extra days, I can work the same number of hours by cutting the worst one." She cut the worst one. And then she started replacing those people with the 25 new patients she was getting a month from Google.

And the thing they started noticing is the Google patients are paying full fees. You know, as you know, half of America doesn’t have any kind of, um, insurance. So they are, of course, going to pay you full fees. And many of them needed a lot of work—so, you know, full-mouth reconstructions to all kinds of dental issues they wanted taken care of.

Also, there were plans she was not on, and she could say, "Hey, you’re not on that plan, but we can help you. So come on by, we’ll help you get every penny from your insurance plan." Of course, you know, we do a lot more than what insurance covers—so if you want Invisalign, you know, whatever else, we can also do that.

So she started seeing her revenue go up, but the number of days she worked didn’t change. And then, after dropping one plan, she dropped a second plan, a third plan, a fourth plan. And then almost two and a half years later, I was meeting her and she’s like, "I’m out of my insurance. I only have one plan that I’m with"—I think it was then, you know, Delta Premier or something that was paying her somewhat decently—and everything else was gone.

And I was asking her numbers. She’s like, "Oh, I do $1.3 million, and I work three and a half days." I was just floored. So she doubled her revenue—this was like in my early days in dental marketing, right? So I didn’t realize the power of how to build a business without PPO plans. Literally, she’s making double the money and she’s working one day less. She went from four and a half days to three and a half days.

Of course, she was getting a little older at the time—maybe like late forties—and she had all kinds of health issues because she was killing herself for like 20 years by just doing four and a half, five days of nonstop insurance work where she was getting paid pennies on the dollar. She sold her business, and the new doctor is still a client of ours—so going back, I guess, 17 years. And of course, they’re doing much, much better now. And again, she’s following the same footsteps as my client.

So pretty much she completely went fee-for-service, and only high-end patients, big cases. So it’s all about working less and making more. Of course, the team loves it because they get to spend more time with their patients, and each day they only see a few patients—but these are all big-dollar. Like, every day they make a lot of money. So everyone is happy, they enjoy their life, they go on vacations.

So, you know, I find when you are over reliant on PPOs, the problem with PPO is they take away your control—they set your fees

So, when it comes to overreliance on PPOs, can you sort of break that down—what that means? How do you get into that cycle of being too reliant on insurance plans?

Naren Arulrajah: Yeah, let’s kind of, um, talk about a case study here. So there’s this one particular dentist that I worked with, even going back to 2010 or something. And at that time, she was making $650,000 working four and a half days a week. She ran into me at a conference and, um, she, um, you know, was telling me that story and I said what I do. And she said, "Okay, currently all my patients come from PPO plans, so maybe I’ll try this and see if I can get patients who are not on PPO plans so I don’t have to be as reliant on them."

So she started hiring us, and within the first year, she started getting 20–25 new patients a month. And she didn’t want to work an extra half day or a full day to take care of these 25 patients a month.

So she and her husband—her husband was, you know, I met both of them, they’re wonderful people—they have an only son in Virginia. And, um, they decided, "Hey, I’m going to cut the worst PPO plans, the ones who are paying me the least." And she’s like, "Okay, instead of working extra days, I can work the same number of hours by cutting the worst one." She cut the worst one. And then she started replacing those people with the 25 new patients she was getting a month from Google.

And the thing they started noticing is the Google patients are paying full fees. You know, as you know, half of America doesn’t have any kind of, um, insurance. So they are, of course, going to pay you full fees. And many of them needed a lot of work—so, you know, full-mouth reconstructions to all kinds of dental issues they wanted taken care of.

Also, there were plans she was not on, and she could say, "Hey, you’re not on that plan, but we can help you. So come on by, we’ll help you get every penny from your insurance plan." Of course, you know, we do a lot more than what insurance covers—so if you want Invisalign, you know, whatever else, we can also do that.

So she started seeing her revenue go up, but the number of days she worked didn’t change. And then, after dropping one plan, she dropped a second plan, a third plan, a fourth plan. And then almost two and a half years later, I was meeting her and she’s like, "I’m out of my insurance. I only have one plan that I’m with"—I think it was then, you know, Delta Premier or something that was paying her somewhat decently—and everything else was gone.

And I was asking her numbers. She’s like, "Oh, I do $1.3 million, and I work three and a half days." I was just floored. So she doubled her revenue—this was like in my early days in dental marketing, right? So I didn’t realize the power of how to build a business without PPO plans. Literally, she’s making double the money and she’s working one day less. She went from four and a half days to three and a half days.

Of course, she was getting a little older at the time—maybe like late forties—and she had all kinds of health issues because she was killing herself for like 20 years by just doing four and a half, five days of nonstop insurance work where she was getting paid pennies on the dollar. She sold her business, and the new doctor is still a client of ours—so going back, I guess, 17 years. And of course, they’re doing much, much better now. And again, she’s following the same footsteps as my client.

So pretty much she completely went fee-for-service, and only high-end patients, big cases. So it’s all about working less and making more. Of course, the team loves it because they get to spend more time with their patients, and each day they only see a few patients—but these are all big-dollar. Like, every day they make a lot of money. So everyone is happy, they enjoy their life, they go on vacations.

So, you know, I find when you are over reliant on PPOs, the problem with PPO is they take away your control—they set your fees

Naren Arulrajah: Mm-hmm. They don’t cover the things that the patient really wants, like Invisalign and, you know, uh, crooked teeth or, you know, whatever—right—implants. Like, lots of the things that people really want are not covered because supposedly it’s not necessary.

So you don’t want the insurance company controlling healthcare, nor do you want it controlling your life, because they determine what the patient says yes to and what you can and cannot do.

So I find you don’t have to go all the way to PPO-free or a full fee-for-service model, but I do find that you should get rid of the worst offenders—the ones who are just abusing you. Start getting people who are paying you a hundred cents on the dollar, versus making 60 cents on the dollar from PPO plans.

So I think that’s a huge mistake you want to avoid. You know, life is short, right? Before you know it, five years, ten years have gone by, and you don’t want to look back and say, "Oh, I gave the fat cats of the insurance companies half a million a year. Times ten years? Five million."

All that money—I could have saved it. All that money—I could have, you know, gotten paid full fees and kept it for myself and my team. Mm-hmm.

Ben Tuinei: Right, right. Yeah, absolutely. Yeah. Fortunately, in the industry today, it seems like there’s been more awareness about this overreliance on insurance, right? But I think as we continue to push these topics—in terms of that being a mistake—the more, the better off the industry will be in terms of how doctors are treated by insurance and how much they get paid.

So that was great, Naren. I really appreciate your feedback there. What about the second one here, which is spending way too much money on ads? Yeah. Tell us what that means, and where are they spending that money—and why isn’t that effective?

Naren Arulrajah: Yeah, I think doctors don’t go to marketing school, nor do they enjoy marketing. So pretty much, they listen to other experts, and ads are easy if you’re a marketing company. Because I don’t have to do anything. I collect your money—you give me a thousand bucks, I keep 500 for myself, and I run ads for 500. And I just turn it on. Doesn’t cost me any time.

So it’s a very good way for me to make 500 bucks without doing anything. So of course, you know, all these marketing companies are pushing ads—A, because it’s easy, and B, because, you know, it’s lucrative for them.

The challenge is, um, two problems with ads.

One: people don’t trust ads, right? Why? Because the minute they see an ad, they think, "He’s not good. That’s why he has to run ads," right? That’s how we think.

Therefore, if you look at the cost of an ad patient versus a SEO patient, it’s at least six times more for a Google Ads patient. And for a social media ads patient, it’s like at least ten times more.

Makes sense, Ben?

Ben Tuinei: Oh, yeah. Yeah, really.

Naren Arulrajah: You really have to spend—imagine doing it for one month. Instead of spending a thousand, you’re spending 6,000 or 10,000. Now do it for 12 months. Instead of spending 10,000, you’re spending 60,000 or, you know, 100,000, right? It adds up.

So that’s one reason.

The second reason is there’s a lot more problems with conversions and no-shows. For example, we do track conversion—so, of the new patients who are calling, what percentage are booking?

Naren Arulrajah: Let’s say you’re really good and you’re converting 85% with SEO. With ads, you’ll only convert, you know, 30% or 40%. Why? The same issue—they don’t trust you. So they’re looking for anything. Maybe the person, you know, didn’t smile on the phone enough—I don’t know—they’ll find a reason to reject you, right? Or even if they don’t reject you because they’re polite, they won’t show up.

So A, it’s more expensive just on the basis of the number of phone calls coming in versus SEO, but then it’s even more expensive when you start looking at how many of them actually book and how many of them actually show up.

So the question is: should we not do ads? Obviously, you know, there is a time and place—like going to the emergency room. Should you never go to the emergency room?

No, absolutely—you know, if you have to, you have to go to the emergency room. But the best option is never having to—like, don’t put yourself in a position where you have to go to it. Like, for example, heart attacks, right? If you don’t take care of yourself, and if you don’t eat properly, and if you don’t exercise and run all the tests, yeah, there’s a good chance you’ll get a heart attack and you’ll be in an ambulance going to the emergency room.

So yeah, if you have to use it, you use it. But don’t put yourself in that position if you can avoid it. So I strongly recommend—you know, of course everyone can’t dream for that—but 5% of you can really dominate Google and do really well with that. So I would recommend, if you can get into that—it’ll take at least a year or so and a good marketing partner—I would recommend that.

I would recommend getting Google reviews, you know, 10 or more Google reviews, and then—I know we’ll touch more on that later on—so those are things I would recommend.

Now, when do you use ads? Let’s say you’re a startup, and instead of spending a million dollars to buy a thousand patients, you might say, "I don’t mind spending $400 to acquire that same patient through Google Ads." So that might be a case where I might use Google Ads.

But still, you need to be really good. Your phone has to be an unbelievable phone experience. Your landing pages have to be unbelievable. Because remember—people are clicking with doubt. So if your landing pages are not amazing, if the phone experience is not amazing, they’re not going to convert, which means it’s going to cost you a lot more money per new patient through ads.

Naren Arulrajah: Um, so yeah, I would use it for a startup. I might also use it for high-value services. So, for example, implants—if you’re going to make $4,000 per patient—you might say, "I don’t even mind spending a thousand dollars to get that patient." But then you have to get used to the fact that there are a lot of no-shows, a lot of people with less conversion. So you just have to get used to it.

And of course, still make sure your landing page is amazing, your phone experience is amazing. So as long as all those things are amazing and the math adds up, then I would use ads. But outside of those two scenarios, I would treat it like the emergency room. I won’t go there unless I’m really in big trouble, right? So, you know, yeah.

Ben Tuinei: Yeah, yeah. No, I can resonate with that, Naren. You know, when we do advertisements for my business—and I’m not, you know, I’m not a dental practice, I’m not going after patients—we go after dentists, you know, and the dentists are our primary clientele.

But it’s interesting that when we do advertisements and people come to us because of that advertisement, they’re not coming to me because they trust me. They’re coming to me because they saw an advertisement. So there’s some skepticism.

So I do have more challenges earning the trust from people that don’t know me, you know, and they’re coming to me through some other route—which is why I’m a big believer in this whole concept of creating a marketing system where people come to you because they know you.

Now they trust you. They’ve done the research on you, and they become so much better customers—or in this case for you as doctors—so much more better patients, right? Where they’re compliant, the, um, case acceptance is probably higher among people that trust you compared to people that don’t.

So I think, uh, I think you convinced me there,  that, you know, advertisements—if it’s a mechanism where there’s no trust—yeah, it’s a little bit more difficult to get people to come through the door.

What about the next part here? So, so this is the one, two, three—the fourth one…

Naren Arulrajah: I think it’s the third one.

Ben Tuinei: Oh, the third one, I’m sorry. Yeah. Three out of four. 

Naren Arulrajah: Yes, three out of four. Thanks.

Ben Tuinei: So the next one is ignoring local marketing and search engine optimization. Do you mind spending some time on that too, explaining what that means?

Naren Arulrajah: Yeah, absolutely. So, local marketing is—like many of us know—when you show up a lot on Google Maps if you’re a decent practice and you’ve done SEO well. That’s what we mean by local marketing.

SEO means search engine optimization, which involves both showing up on local maps—not just for your business name or your own name, but for terms like "dentist near me" or specific ZIP codes like “Veneers 60616”—as well as what they call the regular Google SEO. That’s when someone types into Google and results appear below the maps section.

So you want to show up not once or twice, but for at least 100 or more keywords at the very top of Google, whether it’s in local maps or organic search.

Why is that 100 number important? Because if you’re ranking for at least 100 or more keywords on page one of Google, that really means you’re crushing it. You’re in the top 5% of practices that get 95% of the free traffic. So it’s a great metric to focus on: how many keywords are you ranking for? And are you ranking for enough to truly dominate Google?

If you’re not ranking for at least 100 or more keywords, that’s something you need to work on. Like I alluded to earlier, Google Ads can be five to six times more expensive than SEO, and social media ads can be 10 times more expensive. So instead of spending $10,000 a month, you can spend $1,000 a month and get the same—or even better—results.

Also, because people trust you more through organic search, it changes the relationship. It’s almost like this: let’s say I meet you, and someone I trust—like a respected marketing professor—says, “Hey, you should talk to Naren, he’s the best marketing guy I know.” You’re going to trust me because of how you met me.

Versus if I just ran an ad and showed up in front of you, trying to convince you to trust me—that’s a whole different dynamic. Google is like that trusted professor. People go to Google looking for answers. When you show up organically, they trust you. So their mindset is different—they give you the benefit of the doubt. Now, it’s up to you not to screw up.

As long as you don’t mess up, that trust will continue. They’ll become lifelong patients, they’ll bring their family, they’ll refer others, and you’ll have this amazing relationship.

Versus with ads, people start with “I don’t know…” and that hesitation can hurt you.

So I do believe focusing on SEO is critical if you want to do well long term. If you’re selling your practice next year, then I’d say don’t worry about it—you may not have enough time to really make it work and enjoy the long-term rewards. But if you’re planning to practice for anything more than three years—five, ten years or more—then dominate Google. Do really well with Google.

Ben Tuinei: Yeah. No, I agree. I like what you said there. You know, we, um, when I go out and I speak at conferences, um, the type of clients—people that do enroll with us or come to us from those conferences—holy smokes, not only do they trust you, but they love you, and they’re ready to spend money with you because they’ve heard you, they understand what you’re all about.

I imagine that SEO does the same thing—where people are constantly, you know, on your website reviewing the blog, your articles, your philosophy, things of that nature. So, so, so people—because there’s familiarity—are more willing to open up their wallet book, you know. Absolutely.

Let’s do the last one. You already mentioned this, Naren, as well as making a reference that you might talk about this a little bit more. But reviews—so that’s another, that’s the fourth mistake—that practices are not focusing on getting enough or any reviews. Can you speak to that?

Naren Arulrajah: Yeah, I think there’s a lot of misunderstanding here. Some people say, "I have 200 reviews, I’m done." Right? The thing about reviews is it’s like you have to keep getting them. Because think about it—let’s say you had wonderful reviews six months ago, but you don’t have, you know, you only have one or two reviews in the last six months. Why should somebody trust you? Maybe you were great once upon a time, but maybe somebody’s sick and you guys suck now. So Google thinks the same way. If you don’t get new five-star reviews every month, Google thinks there’s something wrong with this practice. So, you know, maybe you used to be good, but not anymore. Which means your rankings will drop.

And people are not stupid when they don’t see recent reviews. They—again, like, see, as humans—the number one motivation we have is to avoid bad things from happening to us. It’s not to create a better future; it’s to avoid bad things from happening. So they’ll use reviews to stop bad things from happening to us. So when you are getting 10 or more five-star reviews every month—and ideally, these are what I call love letter reviews, paragraph reviews—you are set. But not too many people take it seriously and work on it and, like, create a system where every single month they get 10 or more five-star love letter reviews.

So I really think you really need to lean into this. And the beautiful thing is, this doesn’t cost you a dime. You don’t need to, you know, hire somebody to do this. Just do a good job, which you already do. I mean, otherwise you wouldn’t be listening to this podcast. You are a great dentist. Now make sure people talk about it. Just encourage them, and they’re happy to write that review.

Set some targets for your teams, and I—I know I can go into more details—but just focus on getting 10 or more lovely reviews every month. Put a reminder on your calendar, on your phone, just to remind you to see how many reviews you got. If you’re not getting 10 or more, talk to your team. Come up with a game plan and then monitor it every week. So that means every week you’re getting two or two and a half, two to three reviews a week. Or make somebody in charge, make them the champion. Give them a bonus for achieving that target. Have them update you on a weekly basis if you’re on track.

There’s a lot of things you can do, but that’s the fourth mistake I see. That’s the one thing that you can do today. You don’t need to hire somebody. You don’t need to do anything. But as a gift, what I would recommend is book a marketing strategy meeting. We’ll do a complete review, and we’ll tell you all the things you need to focus on. The link is insuranceuntangled.com/msm. Book that marketing strategy meeting, and we would love to help you.

Ben Tuinei: Love it, love it. Check out the show notes for that link there. And, um, you know, I just want to thank you, Aaron. Again, this is an amazing episode. You know, four mistakes that people—uh, practice—dental practices make. And, uh, most business owners want to know what not to do, right? Or things to avoid. And I think you covered—from a marketing perspective, or at least a general marketing perspective for dental practices—things to try to avoid. So thank you again, Nen, for that. That was amazing.

And to our listeners, want to thank you again for joining us on another amazing episode of the Insurance Untangled Podcast. If you liked today’s episode, give us some love. Share this with your friends in dentistry on social media or any other platform that you use, and give us some reviews. That’ll help other doctors find our platform.

Ben Tuinei: And don’t forget to check out our website, insuranceuntangled.com. We do have webinars every single quarter, and we’ll have promotional details on feature webinars that’ll be published on that website, as well as the marketing strategy meeting that Naren offered. To those of our clients that have done that, and even listeners that have done that, have reported amazing, amazing feedback as it pertains to that generous offer from Naren. So, take a look at that, take advantage of that.

Until we meet next time, I want to wish all of you the very best of success. Take care, everybody.