How to Grow Your Dental Practice in Uncertain Times

Narrator: Are you looking to grow your dental practice and attract top-tier new patients? Discover the potential of digital marketing with a personalized strategy session. Join Lila Stone, the marketing director at Ekwa, for an exclusive 90-minute consultation. Lila and her team will dedicate six hours before your meeting to create a customized marketing plan specifically for your practice. This valuable opportunity is free of charge and comes with no commitments. Visit www.insuranceuntangled.org/msm to schedule your meeting with Lila today. You’ll also receive a free analysis report so you can start transforming your practice through the power of digital marketing.

Narrator: You are now listening to another episode of the Insurance Untangled podcast, where we explore the various challenges faced by dental practices due to their reliance on insurance. Join us in this podcast as we dive deep into the issues surrounding dental insurance dependence and offer practical solutions and strategies to help you take control of your practice’s financial future.

Ben Tuinei: Welcome to another exciting episode of the Insurance Untangled podcast. My name is Ben Tunei, and I’m one of the co-hosts on this podcast. And you all know we, we sort of created this and dedicated this to you so that you, you know, to help you untangle yourselves with the mess of insurance that you may be experiencing. Today I have my good friend and colleague Naren with us today. How are you, Naren?

Naren Arulrajah: I’m doing great, Ben. I’m really looking forward to this conversation.

Ben Tuinei: Absolutely. We got a fun one lined up for you today. So today’s topic is how to grow your dental practice in uncertain times. You know, arguably, Naren, a lot of dental practices have been feeling uncertain times since the pandemic. You know, it’s kind of been a roller coaster over the last five years.

So, some context behind today’s episode. You know, today’s world feels shaky. Lab fees are going up, patients are losing insurance, and many dental practice owners are asking, how can I grow when everything feels uncertain in today’s environment?

You know, the answer to that is smart marketing for just about most, if not all, the dental offices, right? Marketing isn’t just about getting your name out there — it’s how you stay strong, attract new patients, better patients, and grow, even when the world feels out of control. This is still something that we see happening in a lot of dental practices across the country that take the marketing component seriously.

So here are five of the most commonly asked questions that we received in the past few months about this topic, and I’m gonna go through them one-on-one with Naren here.

Ben Tuinei: So, Naren, first question is: what does it mean to grow a dental practice during uncertain times?

Naren Arulrajah: It’s a great question, Ben. Thank you for having me. Yeah, I think this topic — how to grow your dental practice in uncertain times — is a timely topic because a lot of us are feeling a lot of uncertainty. Business owners, individuals — a lot of changes happening around us, in our communities, around the world.

And I think when we get uncertain, we start worrying. And when we start worrying, we postpone decisions, we postpone things, right? So how do you stand out, and how do you succeed regardless of whether the time is uncertain or not? So that’s really, I think, the theme of this conversation.

So, I think the ones who grow in uncertain times, they’re really, really, really, really good at going back to the basics and zooming in on the basics. What I mean is, you know, there are things that don’t change, right?

Naren Arulrajah: So, those things never change — doesn’t matter whether it’s uncertain or not. For example, a practice that provides day-to-day dentistry, taking care of their patients — that’s not gonna change. Everybody wants good oral health. And, you know, if you are really good at attracting people for good oral health and taking care of them really well, that’s great.

But imagine you’re good at attracting, but you don’t do a good job, and they write you nasty reviews or you don’t get any reviews — so now you’re in trouble. I think people who get in trouble in uncertain times are the ones who are not realizing the keys, or the key things to focus on, and then just focusing on those things.

So I think I just talked about the kind of patients you want to attract — like, okay, I want to attract the day-to-day dental patient, and I want to take good care of them.

Naren Arulrajah: That’s one strategy. The other strategy could be, you know, I also want to do these three high-value services, and over time, I want to do a little bit more, a little bit more, a little bit more — so my revenue from those high-value services that I love doing continues to improve.

Now, to do that, people aren’t going to write a $10,000 check without seeing really powerful cases where you have changed people’s lives, right? So you need to work on getting those cases, highlighting them on your website, getting good at case presentation so you can talk to them about the future and how you’re going to help them create the future that they want — and that they’re willing to spend $10,000, $20,000, $30,000 for.

So again, you go back to the basics of what’s going to make that successful, and you stick with it. I think uncertain times is when you have to be realistic and stick to the basics more so than in certain times.

Naren Arulrajah: Certain times, every idiot can succeed, right? I’m sure — I mean, if you’re a veterinarian right after COVID, anybody who was a veterinarian was crushing it because everybody wanted a pet, right? Everybody who didn’t have pets wanted a pet, and they just had an influx of demand. Everyone who was breeding pets was succeeding.

Now things are back to normal — that’s not the case anymore. Now you really have to wake up. So when things get hard, it’s kind of like, you know, when the tide rises, you don’t see anything. When the tide falls, you know who’s naked, right? Like, you just know who’s not doing a good job.

So I think this is a time where the ones who are not doing a good job, they just start feeling it. The ones who are doing a good job, they don’t — because they get stronger, right? People — when there’s more uncertainty, more unpredictability — they go for safer choices.

So, the one who has tons of Google reviews coming in every month, the one who consistently attracts the right patients outside of PPO plans, therefore they’re not giving up so much money — those kind of people who are focusing on the hard but important stuff tend to do well.

So that’s my advice in uncertain times at a high level.

Ben Tuinei: Yeah, no, I love it, Naren. Just a quick follow-up to that, if you don’t mind. You know, when we talk about economic conditions and just sort of changes as it pertains to the world, the US economy — in dentistry, what kind of changes, like specific changes, are you seeing that are causing doctors to feel like we are in uncertain times?

Naren Arulrajah: Yeah, I think costs have gone up. This is lab fees, employee costs — everything is up, like, 50% in the last five years. I mean, I’m just ballparking it, right? Some are up more than others, but your revenue hasn’t gone up, especially if you’re a PPO practice. So in one sense, you are getting squeezed — you are spending 50% more than you did, and then you’re not making 50% more. So that’s the big problem, right? Cost rising.

Second one is, people are expecting more change in the next 10–20 years than we have ever seen. Why? Because AI is going to replace pretty much most white-collar jobs. Dentistry, I think, is one of the furthest ones to get hit, because you need a human being who’s working on somebody’s mouth. I don’t think any of us are comfortable having a robot dig holes in our mouth, right?

Naren Arulrajah: So I think you guys are safe. But imagine anyone in a desk job — marketing, office work — all those things, they’re gonna get automated. The AI is gonna do it. Because remember, AI is very consistent. AI is gonna do a better job than somebody, let’s say, replying to emails or customer support. AI will do 90% of the emails better than the person.

Even today, I know doctor friends of mine who would go to AI and say, “Hey, this person is upset. Can you say these things but in a nice way?” AI just plops out an email for them in two minutes. That would’ve taken them one hour to fret over and stuff, right? So we’re all doing it.

So all of those jobs you had where the people were just pushing paper and stuff — they’re gonna be gone.

Naren Arulrajah: So what that means is people are gonna lose jobs. Those who had insurance won’t have insurance anymore. Uber drivers, right? Maybe in five years we won’t have Uber drivers anymore because — oh yeah — I mean, I use Tesla’s full self-driving. I go door to door. I just press the button and I just sit there. And of course, I have to still pay attention because the law says you have to supervise and whatnot. So I’m paying attention. If I don’t pay attention, the computer will beep at me and literally ban me — like, it’ll stop me from self-driving.

But my point is, technology is getting so good. Many of these things that we thought only humans could do — can. So it’s going to be a lot of disruption.

But if you give people what they want versus what they think they need, you have an unfair advantage.

Naren Arulrajah: We all want, you know, that beautiful smile. We all want — I mean, those of us who care about health, especially those of us who are 40 and above — we want good oral health. So give us what we need. If you focus on giving me what I need — we want great customer service, we want attention to detail, we want high-quality stuff — so give me what I need, don’t give me what I want.

And I think the problem with PPO is you’re not giving people what they want, because you’re doing free dentistry. Remember, we don’t appreciate free things. I mean, this is why, you know, like a soup kitchen — nobody says thank you, nobody does anything, the ones who are benefiting from it — but maybe when they don’t need that anymore, they are willing to go and splurge their money at a nice restaurant and pay a hundred bucks for a meal.

Naren Arulrajah: Why? Because they want it. They want to have that experience. All of us, doesn’t matter the socioeconomic status, we will pay for things we want. So focus on what people want, not necessarily need. And then get good at it. Get good at attracting those patients. Get good at taking care of those patients. Get good at communicating with those patients. And then eventually get good at doing it — not just yourself, but with a team.

So you’re not like one person — like, oh, you have to answer the phone, you have to do everything. Rather, you have people who are as good as you in taking care of these needs.

So I think that’s one of the blessings in disguise when it comes to these challenges — like cost going up, PPO patients not appreciating you because you’re not giving them what they want, because they’re coming to you because it’s free — and then like pivoting. I think this is a great time to do all of that.

Naren Arulrajah: So I really think — I’m sure we have heard this in politics as well — a crisis shouldn’t be wasted. When there’s a problem, that’s when people are willing to change. So if you have a crisis in your practice and you’re struggling, take this as a moment to pivot. Take this as a moment to change and get good at these key success factors — these basics.

Ben Tuinei: Yeah. No, I love that, Naren. You know, in listening to your comments, you kind of answered the third question here a little bit in terms of what we’re getting feedback from listeners on, which is — how does marketing help with situations like what we’re feeling with uncertain times?

And you mentioned attracting the right patients. So, with regards to that question — let me read it again — how does marketing help for situations like this, you know, to relieve the uncertainty of the economy and help boost dental practices? What are some of your other thoughts regarding how marketing can be very helpful in times like these?

Naren Arulrajah: Yeah, so I’m gonna make two points. You kind of touched on the first one — attracting the right patients. If you are a health-centric practice, attract patients for those keywords, you know, who are looking for that. I have 40 clients who are holistic dentists — dental practices. They do really, really, really well. Why? Because those people care about the materials that are being used in their mouth.

So if that’s what the patient wants, and you are attracting those patients, they will pay whatever you want them to pay. And I see these practices, and I look at their numbers. So that’s one niche.

Some of the practices I work with, they’re very much into sedation. So they’re targeting patients who are afraid to go to the dentist because of the pain. A lot of those patients haven’t gone to a dentist in many, many years, so they have a lot of work to do.

Naren Arulrajah: Yes, a little bit of filling here, lots of little stuff. But when you add it all up, that’s a big case, right? And then because they make them feel comfortable, they won’t go anywhere else. They’ll come to you and keep coming to you — and tell everyone they know who’s also afraid of a dentist to come to you, right?

So attract patients based on the niche or niches you’re going to focus on. Others focus — like we talked about — on health, right? So you can really, really figure out what kind of patients you want to attract and focus on attracting them.

And of course, the fundamentals there are: they have to find you — that’s SEO. And you don’t want them finding you through ads, because then they don’t trust you from the first minute they hear about you.

Second is: you have to make them like you and trust you. That’s why I think videos and reviews and those kinds of things — even cases — come in.

Naren Arulrajah: So once you identify who to attract, fill the entire loop. Make sure you’re doing a good job in helping them find you. Make sure you’re doing a good job in helping them like you. And finally, make sure you’re doing a good job in helping them trust you.

And in the beginning, I would recommend — pick one or two areas. Don’t try to do everything, because then you’re going to do nothing well, right? It’s better to do one or two things really well. And once they’re going well, then go to the next one.

Remember, many of you have been here for a long journey. Just like your mess was not created overnight, your recovery won’t be created overnight either. So set plans and goals, and make sure you are on track.

Naren Arulrajah: So don’t say, “Oh, see, I wanted to be three times bigger. I’m not there, therefore I’m a failure.” No, that’s unrealistic. I want to be 20% better — 20% better in terms of number of keywords, number of phone calls, whatever the metrics are. Just set reasonable targets, and then just make sure you get there. And once you get there, set another reasonable target for the following six months or one year. Just know what to do, and then focus on it.

The next thing I would focus on is retaining them for the long term. So start with an amazing new patient experience. How do you wow them on day one, the very first time they’re coming into your office? Maybe a really well-designed office tour — kind of welcoming them, rolling out the red carpet, making them feel at home, and listening to them as part of the new patient interview.

Naren Arulrajah: Like, find out what their concerns are, what their dental story is. If somebody says, “Oh, the last dentist never listened to me,” write it down. Make sure you’re listening to them. Listen to what they want, and make sure you’re incorporating it.

Maybe somebody else said, “The last practice I went to treated people like numbers. They didn’t know me, they didn’t care about me. Every time I went, it was like déjà vu — I’d tell them something and they didn’t remember it.” So remember it. Maybe you should write notes in your system so you know things like, hey, Patient A has a daughter in university and she loves talking about her daughter — so ask her about her daughter every time she’s in your practice, right?

Naren Arulrajah: Because that’s important to her, right? The minute you become interested in them, they become interested in you. So find out these nuances in terms of what each patient wants, and use the new patient experience to lean into it.

And of course, it’s not just about the first meeting — it’s the follow-through. Are you entering the right notes in your system? Do you have the right habits to kind of keep reinforcing those things that matter to the patient?

And what you’ll notice is most people want similar things. Of course, some might pick two out of three, and somebody else might pick another two out of the other three — doesn’t matter. But there are going to be like six things: relationship-driven care, being interested in people, doing great work — all those fundamental things.

Naren Arulrajah: So I would lean in on attracting the right patients based on your vision, as well as retaining them.

And finally, don’t forget to ask for those reviews. Just because they’re happy — if they don’t write those reviews, you’re not going to get new patients. Because they’re happy, but those reviews are like today’s way of getting referrals.

They will attract ten other people like that person, because that person will say, “I love coming here. This is the best doctor I’ve ever worked with. She knows me, she knows my family. Every time I go there, I look forward to it.”

Somebody else is like, “Oh man, I’m treated like a number at my current dentist. Let me go to this practice.”

Oh, and somebody else might say, “Hey, I haven’t gone to a dentist for years. I’m not ashamed to say that because I hate the pain.”

Naren Arulrajah: This person makes it feel so easy and so comfortable. Now, somebody else who has the same need — they’re gonna come to you because they see that review. So not only do a good job in catering to these unique needs that you want to cater to, but make sure those are turning into reviews.

Sometimes it could even turn into cases — like, you know, if it’s a cosmetic case, showcase the after smile — like how you transformed somebody’s life. When I see something like the smile I want, I’m gonna be attracted to you because you have created the smile of my dreams for someone else like me.

So these are all fun stuff. You know, success is not about working harder and grumbling and complaining. It’s about noticing what are the key things — and then just zooming into those and being disciplined about those things.

Ben Tuinei: Yeah. Yeah. Shoring up on your processes and kind of — I like what you said about the relationship part, right? It’s just — you can tell a difference in customer service when you’re a long-term customer of a certain… whether it’s a dentist, chiropractor, or retail shop or whatever. I notice we frequent more of the small businesses where we feel like we’re coming home, right? We’re family.

You know, it makes a world of difference in terms of people referring to you, you know? So that’s wonderful.

Ben Tuinei: Naren, next question here. So this — again — this is another question from a listener. And I believe the answer to this question is, of course, a resounding yes. But here’s the question:

Can I really grow my practice while others are shrinking?

Me personally — we’ve seen that in our business, where we were growing while competition was in decline in recent years. So I have to say that I’m a big believer that the answer to that is a resounding yes.

What say you from a dentist’s perspective — like a dental office perspective, Naren — with regards to, “Can I still grow while the economy and other dental practices, on average, are declining?”

Naren Arulrajah: Absolute yes. But there is a caveat. Of the hundred practices I’ve seen, only 20% actually grow in these times. 80% don’t. The 20% who grow stop doing the things they’ve been doing that have been making them go in circles. They just figure out what are the keys — like some of the things I talked about today, you know, both in attracting and keeping patients — and they zoom into those, and they track those, and they get better at those, right?

So if you are willing to be disciplined — if you’re willing to say, “Okay, let me attract the right kind of patients. I’m doing all the things to keep attracting more of the right kind of patients.” For me, it could be general dental, it could be holistic, it could be cosmetic, it could be sedation. Then I’m doing all pieces of it. My SEO is getting better and better. My cases are getting better and better. My reviews are getting better and better — then you absolutely grow.

Naren Arulrajah: But if you don’t have that discipline, you’re not gonna grow. If you’re doing the same old thing and going in circles, you’re not gonna grow. Same thing with retaining patients, right? If relationships are important to them, are you leaning into it? Are you looking at your reviews to make sure that those people keep talking about how you care about them? Are you getting 10 more reviews?

So once you figure out what are the keys to success — if you’re willing to stick with it — 100% guaranteed, you can grow. I’ve done this for 18 years and I’ve seen people go from zero to, you know, millions of dollars in take-home pay and so forth. So I have seen this. And many of these people are my friends. Just like my kids grew up, their kids grew up, and now they’re at the same stage as me.

Naren Arulrajah: So we are like — even beyond work — we are colleagues and friends. We talk about our kids. And anyways, so 100% — I’ve seen this for so long — absolutely.

But if you keep doing the same things, and if you have the same bad habits… Some of the bad habits of people who are not successful is blaming and pointing fingers. They’re always pointing fingers. Every day is the salt mine, but it’s not their fault. It’s somebody else’s fault. Usually they blame the team, they blame somebody else, and they just go in circles. They don’t make good decisions.

So they make rushed decisions. They don’t think through the important decisions. So they end up with the wrong partners, the wrong team member — and then they have to redo it and redo it and redo it.

So if you are willing to fundamentally change — 100% — you can grow.

Ben Tuinei: Yeah, I believe you. I’ve seen it. I still see it in today’s day and age — that when practices are applying the marketing concepts that you’ve mentioned, they don’t experience the ebbs and flows, right? They don’t experience September like almost everybody else does. Right? Huge difference. Huge difference in the practice dynamics.

Ben Tuinei: So, question number five here, Naren, is: What’s the difference between having marketing or having a marketer, or employing a marketing strategy — versus having the right marketing plan and strategy?

Naren Arulrajah: Yeah, I’m gonna talk about what is the right marketing strategy. Going back to the basics — the fundamentals of marketing — is helping people find you (meaning the right patients for you), helping them like you, and then finally helping them choose you.

So, if you have identified your right patients — let’s say for argument’s sake it’s sedation and general dentistry — you need to rank for those keywords. That’s how you help them find you. Not for one or two keywords, but dozens and dozens for sedation, dozens and dozens for general everyday dentistry. And Google Analytics will tell you all this, and you better show up on top of Google search results — meaning among the top 10 results.

You can run ads — they’re typically five to ten times more expensive and people don’t trust it. You’re going to have a lot of no-shows. I wouldn’t focus on ads until I’ve maxed out SEO and I’m crushing SEO in my neighborhood.

Naren Arulrajah: So that’s the "find you" part of a successful — or right — marketing strategy.

Second one is helping people like you. The videos, different types of content — that makes people like you. Even saying hello and welcome on the contact page. For example, you can figure out the time zone where the person is logging in from, so you know if it’s morning or afternoon or evening. You can say, “Good morning,” “Good afternoon,” on the welcome page, so people are like, “Oh wow, it’s personalized. They care about me and they’re paying attention to me.”

Helping them like you — videos are another great way, right? Simple videos where you’re not talking dental mumbo jumbo, but just in language a fifth grader can understand. Short videos, not overproduced — you’re not hiring a video team. You’re just using a smartphone and maybe having somebody in your team shoot it for you, and then putting it up there.

Naren Arulrajah: So it’s very authentic. People care about authenticity today. They don’t want produced stuff — because produced feels like they’re being sold to. Versus authentic — they feel like it’s real, and it’s coming from the heart.

And finally, reviews — we talked about that, right? They have to trust you. Just because I say so, or you say so — it’s not enough. So cases and reviews — keep adding them, keep adding them, keep adding them. Ten or more reviews a month, plus beautiful cases — especially with the after full-face picture. Not just the close-up of teeth, but the full face — because that shows transformation, especially for cosmetic-type cases.

Naren Arulrajah: That’s still not enough. You also need follow-up systems. And you also need metrics. For example, if somebody misses a call, are you texting them? Are you reminding them about an appointment using text?

Are you tracking your conversion rate? The average dental practice is only booking one out of three new patient calls. Are you booking all of them? If not, how are you going to solve for that?

So these are all like tiny, tiny tweaks you can make to really get to an A level — and then maintain it there.

Ben Tuinei: I love it. I love it. Well, that’s awesome.

You know, as we wrap up here, Naren, I’m thinking about, okay, what’s the end goal? And as you’re chatting, I’m thinking about when Gary was in that earthquake in California — when the double-decker fell on him — and I’m thinking about earthquake technology, right? You have buildings these days that are designed to survive earthquakes, right?

So while the whole world around them is crumbling, it’s business as usual in that office — in that building, right?

So as far as the end goal — when we’re talking about how do we survive and thrive during uncertain times — what is the end goal with what we’re talking about today?

Closing Thoughts 

Naren Arulrajah: I do think — going back to that statement that changed my life — there are things that don’t change. Psychology doesn’t change. Human behavior doesn’t change. Humans are humans, right?

Understand what that is — both to attract and retain them — and lean into that. On the attracting side, help them find you for things they want. Like, “I want health,” — help those people find you. “I care about the materials,” — target those keywords that people are searching for who care — like mercury-free, mercury-safe, zirconia, etc.

Help people find the things they want — and then take care of them. If relationships are important to people — which it is for most people — be interested in them. Ask about their family. Send them that gift for their birthday — handwritten. Thank-you notes. Handwritten birthday wishes they never expected from their healthcare provider.

Naren Arulrajah: Like, figure out what are the keys — that 80/20 rule. I think I alluded to that in one of my other episodes. What are the 20% of things that really stand out — that really make a difference? And just do those things in a disciplined fashion.

Another person whose quote had an impact on me is Chet Holmes. He said, “Successful people don’t do a hundred things or a thousand things. They do ten things a thousand times — or ten thousand times.”

Like, what are those ten things in marketing? What are those ten things in your practice? And then make sure either you or your partners are doing those things. Your job is to just make sure they’re being done. That’s it.

It could be one minute, five minutes — but once you know what those things are, and if you are able to check in at the right frequency — some you might check in daily, some weekly, some quarterly — it doesn’t matter. As long as you’re on top of it and you know what those are — you’re gonna be successful.

Ben Tuinei: That’s wonderful, Naren. Truly appreciate your insight and knowledge.

And what I want to end with today is — in a time that yes, there is a lot of uncertainty — the truth is that there’s still success to be had. There’s still growth to be made, right?

So, if you’re wanting to grow your practice — no matter what the economic conditions are in your community — I highly recommend getting together with Ekwa Marketing and Naren’s team to perform at least a marketing strategy meeting.

No matter if you already have one in place, it’s never a bad idea to have a second opinion or to just check on the status of your strategy to see if it’s actually working.

So, to take advantage of that, visit insuranceuntangled.com/msm to request a complimentary marketing strategy meeting from the team at Ekwa.

Ben Tuinei: Well, Naren, thank you so much for your insights again today. What another amazing episode. A lot of great content, and we just want to thank you — and I want to thank you personally — for your willingness to answer these five questions from the listeners. So thank you again, Naren.

And to our listeners — I want to thank you for joining us today on another amazing and very important episode of the Insurance Untangled Podcast.

If you enjoyed today’s episode, don’t forget to share this with your friends on social media and give us some love — give us some reviews. That’ll certainly help other doctors find our content.

Visit our website, insuranceuntangled.com, for future webinars and episodes that might be of interest to you.

But until we meet again, folks, we wish all of you the best of success.

Take care now.