Grow your dental practice with word-of-mouth.
Because the mainstream methods didn't work for him...
In 2024, I worked with a startup office in Pasadena, CA.
I had performed every possible mainstream method of generating new patients: SEO, Local SEO, Google Ads, Facebook Ads, Instagram Ads, Google Business Optimization, Review Generation, Website, Landing Pages, Photography…
But it didn’t work.
I had promised him growth, but had only delivered disappointment.
From this experience, I began to realize that the mainstream methods of marketing had grown severely out of touch with what people actually respond to.
The landscape of marketing had fundamentally changed, but we were still relying on the same old methods.
The mainstream methods help address the issue of awareness.
What I realized was that awareness is no longer a competitive advantage.
The promise goes like this: Pay a 3rd party marketing agency, and with their proprietary methods, they’ll get you an advantage with awareness.
Your ads will show up to interested people.
Your website will show up for keywords.
Your Google Business Profile will rank higher.
As a result, you’ll “catch them when they’re hot”.
Yes, these were significant advantages when other offices weren’t online.
But now, every competitor is just a click away, and people are clicking.
Awareness of your existence is no longer a competitive advantage for growth.
It's now too costly to compete on mainstream methods.
Consider that advertising is the last viable mainstream method for growth.
Every platform (Google, Facebook, IG, etc) that owns the awareness you seek to get, have made it a pay-to-win game.
Why advertising is the last viable mainstream method.
1. SEO is no longer a viable strategy
- Traditional SEO is largely obsolete for local businesses, as Google now prioritizes Maps, proximity, and reviews over organic rankings.
- It hasn’t been working since 2018.
- 3 logic questions:
- If “winners” of SEO continually reinvested into the few valuable keywords, shouldn’t competition be impossible?
- Why do SEO providers run ads?
- What if Google decides that instead of paying 3rd parties for an advantage, they want you running ads? (Hint: They did)
- Learn more.
2. Social media platforms have very different goals than you
- SM platforms reward virality. The more viral content they have than their competitors, the more users they get.
- Do things that entertain the global population and the platform will give you eyeballs.
- The temptation is to create entertaining dental videos.
- You seek to serve a local population who aren’t focused on content about dentistry.
- Treat social media as a trust-building tool, not an awareness-building tool.
- That means shunning global vanity metrics in favor of deeper connections with your smaller local community.
- Use other methods to create awareness.
- Learn more.
3. Offline methods mismatch targeting and goals
- Mailers
- It cost us 60x more than online advertising to get the same result.
- Why? Because 95-97% of the local population aren’t interested at that moment.
- See the data.
- It’s a targeting mismatch. Sure a few will come, but you’re showing up as annoying spam for those you’re a mismatch for.
- It cost us 60x more than online advertising to get the same result.
- Billboards
- They’re not for getting people to take action.
- When is the last time you pulled over and called the phone number on a billboard?
- Name three phone numbers you remember from a billboard. Two? Maybe one?
- Billboards are great if you want to convey ideas. You likely talked to a friend about a movie you saw on a billboard.
- They can also be used to create familiarity. You likely remember the names of a few accident firms or injury lawyers.
- A more cost-effective, and less annoying, way to create familiarity is online advertising because you can focus your budget on the interested.
- They’re not for getting people to take action.
- Learn more.
4. Online reviews grow distrusted and reach is limited
- Today, reviews are heavily incentivized by all businesses, it’s called review inflation. People know this – they’ve been offered incentives.
- They question what a dental office did to get 1,000 reviews.
- After about 200-300 reviews, you get diminishing returns or even distrust.
- No matter how many reviews you have, you won’t show two cities over. Google limits your exposure. To expand reach, you have to pay Google.
- Learn more. (Strategy #2)
Unfortunately, advertising is a strategy that’s daily becoming:
- more expensive,
- less effective,
- more annoying,
- to an online group that’s disappearing.
Why advertising is becoming unsustainable.
1. Advertising costs increase and profit margins decrease
- Advertising is the only remaining leverage that platforms offer you. To increase the number of people aware of you at will, you must advertise. Platforms are very aware of this dependence.
- Advertising platforms continually decrease the barrier of entry. They say things like:
- Ease: “You don’t need technical knowledge because now Gemini AI can set it up for you.” (Not recommended btw)
- Cost: “You don’t need to pay an agency to set up your ads. And now you can also boost your Instagram post for just $3 and 3 clicks.”
- The result dependence and lower barriers of entry? There are more offices advertising than ever.
- Dental office dependence on advertising is expected to increase by 25% in 2026.
- The result of more advertisers? Increasing costs and disappearing margins.
- Let’s say you seek make $1,000. They platform will charge you $900. Don’t want to pay it? That’s okay, your competitor will. In fact, let’s charge you $950.
- The result of increasing costs and disappearing margins? Practices get an incentive to intentionally increase margins from each patient. This lowers trust in the long run and creates a downward spiral.
- Learn more.
2. Regulation is tightening around tracking and algorithms, even more in healthcare
- An advertisement that’s profitable is profitable because it resonated with the people who want what you offer.
- Eventually, all that’s left are people who didn’t resonate with it. So you have to create another ad that’s profitable.
- It’s unlikely your ad is profitable off the bat. Empirically, I’d say about 95% of ads won’t work at first. So how do you create an ad that works?
- An algorithm targets and distributes your ad, you track metrics, then you make incremental improvements until it’s profitable.
- Restrictions mean that your ability to make incremental improvements decrease. Now, it takes more time and money to create a profitable ad.
- Learn more.
3. 52% of Americans use an Ad Blocker
- This statistic includes the elderly. A much higher percentage of people under 50 use it.
- Statistically, you probably probably use it too. So why do we engage as if your prospective patients don’t?
- The people’s opinion are in that metric: “We don’t like ads!” and you’re showing up as one.
- We don’t like being shouted at.
- Learn more.
4. People are opting out of the online space for a more analog lifestyle
- 50% of Americans are cutting back on social media. More plan to in 2026.
- We don’t like our attention being leveraged and optimized by algorithms so that an advertiser can sell us things we don’t need.
- Vinyl is making a comeback.
- See the data.
- Learn more.
Mainstream methods create unsavory temptations.
Because more advertisers means diminishing margins, there’s only one clear way to rely on advertising for growth: increase the average value of each patient.
You can see how this quickly becomes a slippery slope that you’re better off avoiding entirely.
The more ethical, and smarter, approach is to create conditions where this temptation doesn’t exist.
The solution is to create the conditions that beget word-of-mouth.
I realized that we had to fundamentally change our focus from marketing for new patient acquisition to marketing for word-of-mouth.
We take our fixation on generating awareness, and redistribute those resources to creating a practice that people spread the word about.
In this approach, word-of-mouth becomes the new patient marketing.
Word-of-mouth unlocks sustainable growth.
Today, the best practices don’t rely on advertising or digital marketing to grow.
They leverage ads or digital marketing at the start, then gradually let word-of-mouth take over their new patient needs.
Word-of-mouth unlocks ethical growth.
Recall that the way to win advertising is through increasing the value of each patient.
The best practices increase the average value of each patient by earning more referrals per patient, not by recommending treatments that aren’t needed.
The conditions for word-of-mouth can be intentionally created.
Hint: It’s not by leveraging incentives or reminders.
In each of us, is an innate desire to share things that others might find valuable. It’s our default posture as social beings.
Certain conditions prevent us from being able to share: taboo, lowers our status when shared, it’s better alone.
It’s about aligning your practice with what they consider to be valuable, then removing the conditions that prevent word-of-mouth.
Why doesn't everyone take this approach?
Becoming a practice that spreads through word-of-mouth is more emotionally difficult:
- You’ll have to reinvent many areas of your practice. It’s easier to work with what you already have, than to receive feedback, reexamine, and adjust what you do to better serve those you seek to help.
- Others can’t do this work for you. I’ve made frameworks and prompts for you to leverage. But ultimately, you’re going to have to make the decisions and own the results. It’s emotionally easier to outsource the decisions and have someone to blame.
- It requires empathy. It’s easier to make something we like for ourselves, rather than to understand the desires and fears of others and create something for them.
But the benefits of becoming remarkable are worth it.
Besides new patient growth, consider some other benefits of becoming remarkable (worthy of making a remark about):
- Treatment acceptance gets easier.
- Trust is transferred from the person who referred you.
- You engage more often with people who are already aligned with what you offer.
- You can ethically raise prices.
- You’re no longer “another” provider, where the cheapest option wins. Instead, you can intentionally raise prices that reinforce your new narrative.
- Increased patient satisfaction because now people aren’t just getting dentistry, they’re paying a premium for something better than “just dentistry”.
- Peace of mind.
- Know that you’ll always be in demand because you’ll be the only provider who provides dentistry that way.
- Provide non-corporate dentistry to people who don’t want corporate dentistry.
- More personal satisfaction.
- Do work that you can be proud of.
- Make the impact you seek to make.
- Earn the respect of peers.
- Thrive.
Consider taking the course.
I’ve created a free course for you to learn the most important concepts and to create a remarkable practice.
It’s free because I promised myself that no one would have to go through the disappointment my client did.
Start there, and if you have any questions, don’t hesitate to reach out.
P.S.
I didn’t tell you the full story of my client.
I recently reached out to him and he graciously forgave my broken promises.
He also told me that he was now opening a second office that was focused on niche, high-fee services.
According to him, had grown his practice 80% by word-of-mouth and 20% by mainstream online presence.
Our approach is inspired by and dedicated to him.