Why Doing “More” Isn’t the Answer — Doing the Right Things Is!

Intro: 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.com/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.

Intro: 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 Tuinei, and I’m one of the co-hosts of this podcast that’s been built for you. We dedicate what we do to help you untangle yourselves from the mess of insurance, and we talk about all different topics—from marketing, to insurance, to coding, to practice management—you name it. Today, I have my good friend and co-host with me, who I’ll be having a very fun conversation with: my good friend, Naren Arulrajah. Naren, how are you, my friend?

Naren Arulrajah: I’m doing great, Ben. Thank you for taking the time to have this conversation. I know we are gonna have a fun topic, so I’m looking forward to jumping in, and hopefully, you all are having a great day.

Ben Tuinei: Yes, yes. It’s a great post-Thanksgiving week. Today, we’re gonna talk about why doing more isn’t necessarily the answer—doing the right thing is. But we’re gonna take a look at that from a marketing perspective. So welcome back to all of our listeners.

You know, there’s something that Naren and I both see all the time, and that’s practice owners thinking that doing more to grow is what they should focus on, right? The whole concept of feeling productive just because we’re busy—more ads, more software, more apps, more social media posts, more money going out. But growth—yeah, I think you and I agree on that, Naren—growth does not come from doing more. It comes from doing strategic things, doing things the right way, doing it consistently, and to the best of your ability.

So let’s sort of break that down. Naren, I wanna start on the marketing side of things, if that’s okay. So Naren, why do you think so many practices feel that the answer to growth is just to be more busy with doing more marketing concepts that may or may not work?

Naren Arulrajah: That’s a great, great question. See, I think as humans, we have this bias towards action—especially those who end up in dental school. You know, they were the kids who were getting A’s in class all the time, all the way from grade school or high school. And dental school is not easy. They put you through the wringer, and you’re working extra hard. So a lot of times, we automatically start to think that being busy is a good thing.

But unfortunately, being busy is not the answer. And the other problem I see is that doing the wrong thing is also not the answer. For example, I had a wonderful call with this wonderful client. He is a new client, and he’s getting 30 new patients, but his actual patient volume hasn’t changed because the conversion rate dropped.

Naren Arulrajah: Why? The team is not trained to deal with patients who are calling from Google, saying, “Hey, can you do sedation? Can you do this? Can you do that?” The first issue is they’re missing so many calls, so that’s one problem we need to fix. The second issue is the team doesn’t know how to handle them and how to convince them that this is a great practice and they made the right decision in calling.

But because he didn’t have the data—that he’s only getting a 25% conversion rate—you can’t blame him. He thought the solution was, “Oh, I need to worry about branding.” And he thought, “Oh, maybe there’s a lot of competition in my area, and there are like 30 practices around me, and that might be the problem.” I’m like, no, that’s not the problem.

Naren Arulrajah: This is the problem, right? A lot of times, we are fixing the wrong problem without knowing what the real problem is. So that’s the second reason I think people struggle. Not only is it that a lot of times working harder is counterproductive, but also working harder doing the wrong things is even more counterproductive.

Classic things I see on the marketing side: they run more ads. Now, let’s take this example I gave you, right? He’s converting 25% of new callers into appointments—new patients into appointments—and he runs Google Ads. What do you think is gonna happen to the conversion rate? It’s not gonna be 25%, it’s gonna be 10%. Why? Because if you can’t convince somebody from Google who’s trusting you because they found you organically, and you are only converting one out of four, how are you gonna convert people who are calling from an ad?

Naren Arulrajah: They’re gonna be even less trustworthy. So, like, Google Ads doesn’t work. Of course, step one is to fix the conversion problem. Once it’s fixed, and once you’re at 70–80%, then you can go in and solve that problem.

So that’s a simple example, right? A lot of times, people are spending money—posting, posting, posting, posting on social media—but 90% of the people who see your videos don’t even live in your neighborhood. They live in a different state, different country. So, you know, is it helping?

Always keep asking the question: What am I doing? Is that helping, or is that important? If it’s not, don’t waste your time. So, the 80/20 rule, right? Most of us do 80% of things that are useless, but 20% of the things we do are very powerful. So, continuing to eliminate that wasted effort—the wasted 80%—and continuing to zoom in on that 20% is what makes a difference.

Ben Tuinei: Love it, Naren. Let’s flip to insurance for a moment. On the insurance side, do you see the same pattern of dentists trying to do more to get results—kind of like what we talked about with marketing? You know, just doing more just for the sake of being busy?

Naren Arulrajah: Absolutely, Ben. You know this as much as I do, right? How many dentists do you see that are signed up to, like, a dozen—two dozen—plans, either directly or indirectly through these umbrella plans? And how many of those plans don’t even pay them enough to pay the bills? In other words, they’re losing money. So they’re really, really busy—going back to the point of being busy—but it’s a waste of time.

And how many of them are doing things manually when they can use technology or outsourcing to save time and money? How much are the write-offs? I mean, an average practice collecting a million dollars that I spoke to recently was writing off $546,000 every year—meaning they’re producing $1.56 million in dentistry and only collecting a million. Why? The difference between the usual and customary fees versus, after the fee controls and the reductions, how much they actually get paid. So, there’s so much waste, so much of doing more, but not benefiting from that more.

Ben Tuinei: Yeah, I agree. Well, if I could say a thousand percent—I know that’s not physically possible—but I agree with what you said. And it’s almost as if, Naren, you sound an awful lot like an insurance expert, you know?

Ben Tuinei: But I guess when you talk about marketing—I mean, it’s related, you know? And I agree with you that doing—this whole concept of doing the right thing all the time—sometimes doctors get confused. And the question that usually comes up is: What does that actually mean, especially as it pertains to marketing, right?

So when you hear that, Naren—“do the right thing”—can you sort of unpack that as to what that really means for a practice owner in terms of the whole concept of marketing and how to do that right?

Naren Arulrajah: You know, that’s a great, great, great question. Dentists—when they talk about "do the right thing"—a lot of times, that is based on what they heard somebody say, not necessarily based on data or based on what their problem is.

For example, if your phone is ringing and you’re getting a lot of phone calls—like the example I gave you, 180 phone calls—and you are only getting seven new patients, then doing the right thing is to look at call conversions. Because typically, 180 phone calls should mean you’re getting around 30 new patients or more, and you’re only getting seven. The problem could be the call conversion.

Naren Arulrajah: So a lot of times, one of the muscles I think doctors have to develop is to find out where the problem is. Doing the right thing is finding the right problem and solving it. Doing all the other stuff that has nothing to do with the real problem is not going to make your life better.

He wanted to run more ads—but you know what? When he’s converting at 25%, that won’t help. He’ll be wasting 90% of his money. Right?

So I do think if you’re a PPO practice and some of your PPO plans are losing you money, doing the right thing could be finding those plans and getting rid of them. Why do you need to work hard to lose money? That’s a stupid day. You might as well work one day less—or half a day less—and take it easy and save all that money. You know what I mean?

Naren Arulrajah: So I do think doing the right thing is getting to the root cause.

Based on my experience—18 years—I think call conversion is one of those areas where I see a lot of problems. Some clients don’t get phone calls, so of course, tracking how many phone calls you’re getting, how many leads you’re getting—that is doing the right thing.

Some clients are not ranking on Google for hundreds of keywords, which means they’re not in that top 5%. So if you’re an SEO practice—SEO, by the way, is one-fifth or one-tenth the cost of Google Ads, for example, or even more affordable than social media—so if you’re a strong SEO practice, you need to pay attention to how many people are coming from SEO, how many phone calls are coming in, how many leads you’re getting, how many keywords you’re ranking for.

So doing the right thing is partly dependent on strategy, but it’s about finding where your weakest link is. And some people—they have amazing rankings, but they’re not getting calls. Perhaps the right thing is looking at the landing pages for those services and seeing: Do they have cases? Do they have videos? Are they doing things that make people more likely to call?

Ben Tuinei: Mm-hmm. Absolutely. Yeah.

Naren Arulrajah: Now, Ben, I’m curious—on the insurance side, can doing fewer things actually help a practice grow faster?

Ben Tuinei: Absolutely. You know, I think this concept applies in so many aspects of life and business—the whole idea of “less is more.” When you look at insurance participation, there’s a common theme that goes back the last three decades of doctors doing too many insurances or just signing up for an insurance because a patient says, “Hey, do you take this plan?” Right? And then they contact the office manager and say, “Hey, can you get us signed up?” You know?

And what you effectively do with that is you lose pricing power. So you have to think about that and profitability. There are a lot of insurance contracts that doctors sign where they’re losing money on hygiene. I know—that’s an unfortunate pain point for most these days. So, be careful when it comes to doing too much—too many insurance plans.

There are umbrella networks out there these days where umbrella network strategies do help you minimize the number of contracts that you have. A good example is, we have some clients that participate with over 100 dental plans—like, quite literally, over 100 different dental plan types. And then we have another client, not too far away, that only takes five dental plans or participates with five. And the practice with five dental plans sees more patients and is significantly more profitable.

Ben Tuinei: So it’s not necessarily about joining PPOs from the perspective of marketing—stop, don’t do that. While it is true that you would get new patients from dental plans that you join, the cost is so high compared to doing a lot of the things that Naren is recommending.

So a small, well-managed set of PPOs with optimized reimbursements totally outperforms the chaotic component of having too many dental plans that are hard to manage with low fees.

But that’s actually a good thought process, and I have a follow-up question for you, Naren. When it comes to PPOs, I know a lot of practices lack the confidence to take action with a lot of things due to fear of making mistakes—especially as it pertains to going out of network. There’s this fear that there might be a backfire situation or a situation that creates a burden or stress on the front office team members, or even the doctor herself or himself.

So as a result, a lot of doctors sort of stay in the lane of comfort. But that decision is also not the right thing to do, in my opinion.

So Naren, from a marketing perspective, if a practice owner wants to grow without burning out themselves and burning out their teams with doing too much, where do you think they should start? What’s your recommendation, at least from a marketing perspective?

Naren Arulrajah: Absolutely. I think—look at what’s working and what’s not working, right? And solve for the things that are not working. That’s, like, at a high-level philosophical way I would think about this.

For example, let’s say you are an SEO-driven practice. Are you ranking for a hundred or more keywords? Again, having done this for more than 10 years, I know if you’re ranking for a hundred or more good keywords, you are going to make the phone ring from SEO. You are going to get a lot of people to see you from SEO.

Now, it doesn’t matter what kind of practice you are—you want to know how much a new patient call or lead is costing you. So you need to have call tracking. You need to know, okay, for SEO, in our experience, a lead might cost you $50, $60. In terms of a new patient calling from Google Ads, it’s going to cost you $300. But do you know that precisely for each method?

Naren Arulrajah: And of course, if something is costing you $60 and the other one is costing you $300, the question is: why are you spending $300 to get the same result you can get for $60?

The other issue you might want to look into is call conversions. Let’s say the phone is ringing, you are getting new patient calls, but only 30% are booking. So instead of getting upset and yelling at other people for other reasons, go and solve that problem. Like, how do I increase my conversion rate? Where, out of 100 new patients, only 30 are booking—maybe I can get 40 to book, 50 to book, 60 to book, and perhaps one day, 70 to book. Now you’re doubling your business without spending a dime on marketing, right?

Naren Arulrajah: So I really think being able to zoom in and figure out where the problem is. And unfortunately, if you’re new to this and you haven’t lived in this world of marketing, you need an expert. And one of the things we offer is a marketing strategy conversation where we look at all this data—we spend six hours, we really dive deep and figure out: Where are your bottlenecks? What is holding you back?

And once you figure out what’s holding you back, then we can come up with a plan to solve for it. Now all of a sudden, you are crushing it—you’re doing really well.

Ben Tuinei: Mm-hmm. Absolutely. Love it, love it, Naren.

You know, so I kind of feel like, if today’s conversation made you, as a doctor, realize that doing less is more—and there’s some clarity here, especially on the marketing components to drive new patients in—I highly recommend doing the marketing strategy meeting with Ekwa.

If you visit insuranceuntangled.com/msm,  reserve your spot there. I personally have real, tangible feedback regarding that meeting. At least when I recommend clients to do it, I’ve never had one say that was a waste of time. In fact, they come back to me with a great sense of appreciation, and Naren makes me look so good when I do that, because my clients feel like it was me that did it for them, you know?

And so you can experience that just by going to that website, and that will be included in the show notes as well.

Ben Tuinei: And then, of course, in the components of insurance—we mentioned that as well—you know, our people, and that’s what I do for a living, is we help you strategize to figure out whether it’s tied to marketing, right? In my opinion, less is more. You could have higher fees and a good PPO structure that would allow for you to not, you know, do dentistry at a cost.

Which a lot of practices are doing—they’re forking out money to treat patients that are in their chair on a lot of treatment categories.

Naren Arulrajah: You’re losing money, so you might as well go home, be on a vacation, and have hundred-dollar bills and say, “Take the money.” I’ll be better off if you walk away with a hundred dollars than me treating you.

Ben Tuinei: Right? And I know the whole component of healthcare is that we’re tempted to do a lot of charity work, you know?

Naren Arulrajah: Yeah. If you wanna do charity, go to Guatemala or some country that needs it all—help people. You know, do a clinic one day and go and help people who really can’t afford it. But not people on PPO plans, right? Where, like, they have a job, they’re going on vacation. So like, why are you doing charity work?

Ben Tuinei: Yeah, yeah. And there’s a perception these days that, you know, there are a lot of practices that—when we negotiate fees—I actually have a client in Florida. We raised fees by 50% with one insurance category.

And the doctor actually responded with concern, saying, “Hey Ben, is that fee increase too high? And is that gonna cause my patients to have a knee-jerk reaction?”

And it was so funny, because this particular insurance company was abusing this doctor. Her molar endo fee was in the $450 range in a community where the base-level, non-negotiable rates start at $800 for an endodontist.

Naren Arulrajah: Non-negotiated. That’s crazy.

Ben Tuinei: Well, we raised that to $1,200. We had to negotiate—massage it a little bit—but on that procedure, it went up to $1,200.

Naren Arulrajah: Amazing. That’s 3x—you tripled it.

Ben Tuinei: Yeah, and the whole fee schedule—it came out to be, right, about 50%, roughly two times. And that’s a big win. And again, it’s a situation where that PPO plan could have been dropped. There’s really no reason to be on it, because it’s losing you money every single time you get a new patient coming in. You’re losing money on that particular category of patients.

But Naren, thank you so much. Any closing thoughts as we wrap up today?

Naren Arulrajah: Yeah. I mean, Ben, you are a dear friend, and I know you know more about insurance—the do’s and the don’ts, what works and what doesn’t, which state, which plan—you are like a genie in a box that your clients have when they need to go and do this. So thank you.

I, of course, highly recommend Ben. You know, just—you’ve been doing this for 20 years. Just based on the experience and the knowledge he has—he knows the players, he knows the inside scoops, he knows what works. And of course, you have a team that is as good as you are, Ben.

So I strongly recommend people reaching out to Ben if they think the problem is they have the wrong plans, or too many plans, or, you know—he’ll clean it up for you.

And I think it’s a really good way to end this episode: Are you doing the right thing?

More is not more. Working smart is key. Knowing what the real problem is, knowing what’s holding you back, and just solving that—that is key to success.

Ben Tuinei: Thank you, Naren. Thank you for your wisdom today, and thank you for the kind compliments.

And I want to take a minute to thank our listeners for joining us today on another amazing episode of the Insurance Untangled podcast. If you enjoyed this podcast, share it with your friends—that’ll help us. Give us some reviews; I hope they’re all five stars with really, really good feedback.

And don’t forget to visit insuranceuntangled.com/msm  to take advantage of that marketing strategy meeting.

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Folks, until we meet again, we wish all of you the best of success. Take care now.