Ten years ago, a sane person would never consider choosing a dentist or a physician without a direct referral. No one can deny the awesome power of word of mouth – a very personal recommendation from one friend to another – a value affirmation of a product or a service. But in this day and age, you can’t overlook the power of “word of mouse.”

I recently had sinus surgery, and I chose the doctor completely from an internet search – and then confirmed my choice by reading what others had to say about their experience. Statistics show that positive online reviews will help your business. More reviews provide a listing that stands out for the right reasons when somebody is doing a search for a dentist in your area.  And Google is the king – the number one ranked website in the world – the number one place for people to search – the most trusted resource for quality information.

Now that you know how to accumulate Google reviews, I am suggesting that you can show these reviews easily on your website. Check out what I have added to my site. On the left hand side of the magenta colored navigation bar, my webmaster installed a Google review button. This links directly to my Google Place Page and in one click, someone can read all of my reviews.

This linkage is an easy and attractive strategy – another piece of the puzzle for your overall on line approach to marketing. It has the additional benefit of helping improve website optimization and organic discovery.

In a recent post, I described what I thought was an effective strategy to obtain rave reviews from patients at the conclusion of their treatment visit. After beta testing this process in about 15 different offices– all good clients – all quality practices – I must admit that it didn’t work very effectively.

There was a lot of resistance from staff because of the time required to spend with the patient in helping them to sign in to Google, and to help with the intricacies of the computer. Logistically, in order to have any chance of success, the office needed to set up a kiosk with a separate laptop computer. A few offices tried using an iPad. Often times the patient – although perfectly willing to endorse a top flight dental experience – did not want to spend the additional time after a visit. It was also reported that patients were possibly inhibited about writing a review while in the dental office.

After much discussion and thought , I believe I can offer a much better solution to reach a realistic goal of obtaining just one Google review per day. My idea is to ask your patient to write a review based on a long history with your practice. This patient appreciates receiving post treatment telephone calls from the doctor, painless comfortable dental procedures, caring attentive staff, and over the top exquisite, consistent customer service each and every time they interact with your office. This is why they return – this is why they refer others – and this is why they love you. Here is how this works.

• Go to your Demand Force dashboard and print out the list of names and e-mails of your patient base. I imagine you could do this in Dentrix or any other management software as well.

• Narrow this list to only gmail or hotmail addresses.  This is because it is so much easier to write a Google review if you have one of these types of email addresses. You don’t have to create an account.

• Choose 15 or 20 great patients from this narrowed  list. These are good friends or patients with whom you have a fabulous relationship.

• Have a staff member call them and ask them if they would be willing to do a nice review or recommendation for you in your practice. This should not be a problem because of the close relationship.

• Once they agree you will send them the following e-mail.

Dear (patient’s name)–I would so much like to thank you for taking the time to do a review of my dental practice. This will help me maintain my first page status when patients do a search for me on Google. There are just a few steps you need to follow.

1. Click on the link below. (This will be the hyper-link to your Google Place Page).

2. Hit the red button that says WRITE A REVIEW.

3. Then sign in with your Gmail or Hotmail account.

4. Select under “your rating” the number of stars you’re giving me. Hopefully five!

5. Write the review in the box.

6. Hit the blue PUBLISH  button and you’ll be all set.

Thanks again for taking the time to do this for me. I truly appreciate it.

If you decide to make obtaining patient reviews a serious priority for your practice, you should be able to quickly accumulate 15 to 20 reviews – and that will truly separate you from the competition. I would very much appreciate your comments and feedback. Please email me at jodena@cox.net and I will be happy to share in future posts.

A few posts ago,  I discussed strategies on how to successfully purchase a dental practice from a retiring doctor where the buyer was essentially going to be the “replacement”. The new doctor in that role would retain the staff and occupy the existing facility. But purchasing a dental practice from a retiring doctor can also be a great way to exponentially grow and add to your existing dental practice. I did this three separate times in my clinical career, and the return on investment was always more than 100% in the very first year! I wish I could say the same for my returns in the stock market. I believe the reason that the return on investment was so positive was for the following reasons.

1. Associate dentist — when I acquired these practices, I had my associate actually work in and maintain the purchased location for 12 to 18 months. That way the patients were comfortable returning to familiar surroundings with staff members they knew and trusted. Nothing had changed for them except the doctor providing dental treatment. They did not have to immediately travel to a new location. They were gradually  transitioned over to our office.

2. Geography — the acquired practices were within 3 to 4 miles of my office. It would not be realistic to expect the same level of patient retention if the acquired doctors practice was not close by.

3. The size of my office — because I had enough treatment rooms, it was easy to absorb all of these new patients as they were gradually transferred. In my experience, the biggest impediment to success or growth is the lack of a proper facility. So you have to be prepared to handle the increased patient flow.

4. Economies of scale — once the old facility was closed down, it greatly reduced the overhead. One location instead of two, and eventual consolidation of staff. Patient relationships had now been established and strengthened over the 12 to 18 months by my associate, and thus patient retention was excellent even with the move to our main office.

I often see situations where a doctor wants to bring on an associate as part of a long term  exit strategy, but there are not enough patients in the practice to keep the associate busy more than one or two days per week. The type of acquisition that I describe above eliminates that problem and gets the associate very busy very quickly.

Next post — another twist for acquiring an existing dental practice.

Selling your dental practice is a complex business event with many emotional and economic issues coming into play. The truth is that hopefully you are only going to do this once – so you better do it right in order to get maximum value. Probably the hardest part is to make the actual decision to sell. But once you are ready, it is essential to conceptualize a detailed plan of action, and that plan may extend for 18 to 24 months.

Don’t start telling patients that you are thinking about retiring. You don’t want to give any patient a reason to leave prematurely. If asked, your answer should be “I love what I do and have no plans at the moment to stop.”

Don’t discuss your retirement plans with staff. There is no way to control what comes out of their mouths, and they could unwittingly be undermining you.

Don’t slow down. Keep to the same weekly work schedule. You should be able to suck it up and work hard knowing that the end is in sight. The value of a practice is time weighted using collections from the past three years. The performance data from the current year is weighted three times more than what happened two years ago. So if you slow down and work less, you are going to be severely penalized. Value is based on the present and not on a glorious history.

Give the office a facelift. Paint, paper, carpet, ceiling tiles – maybe some new reception room furniture. This is relatively inexpensive. You certainly don’t want your practice to look tired and dated when you go to sell.

A big factor in valuation is the size of the patient base. How many patients do you have will be one of the first questions asked. My definition of an active patient is someone who has a scheduled appointment. So make a concerted effort to re-activate every patient that has been seen in the past 24 months and get them an appointment for continuing care. In every practice that I have ever coached, there is a large practice “within your practice” with whom you have lost contact. It is a lot of work –  but will be time well spent.

Don’t go crazy with updating software and technology in anticipation of a sale. These are expensive purchases, and since you will need to sell your practice debt free, you will not have enough time of recoup the value. And there is no guarantee that the buyer would be happy with your choices. Instead of a positive, it could turn out to be a negative.

If you adhere to these suggestions, I am comfortable – especially in this current seller favored environment – you will get maximum value for your practice.

After a brief interruption to comment on Google patient reviews, I want to get back to dental practice transitions. My last blog post on this topic discussed a number of pitfalls to avoid when purchasing an existing dental practice from a retiring doctor. Let me share some specific details based on my experience.

The retiring doctor should leave on the day of the closing=when money changes hands. It is a common misconception that there is value to the buyer when the seller stays on for a short period of time to make introductions to patients. Not true! It is OK for the doctor to leave the practice and have the practice continue on successfully. But you may be playing with fire if you don’t retain the existing staff. The “introduction” and endorsement of the new doctor is made by the retiring doctor in a warm and sincere letter to the patient base. This letter must include a number of vital points.

1.The search – “after a long and careful search I have found a wonderful, talented, compassionate doctor who I know will continue to provide the same care and attention you have come to expect”. List the professional accomplishments – education, training, and experience.

2. The communication – “I have spent countless hours discussing the treatment plans for every patient in the practice.”

3. The continuity – “I am pleased that all of the staff that you have come to love and depend on over these years will be staying on.”  All scheduled appointments will be honored.

4. The thank-you and the pass off– “Thank-you so much for your friendship and continued confidence over these many years.  I am leaving you in good hands, and I know that you will be impressed when you meet Dr. ______. I hope that you will give him/her the same level of support that you gave to me.”

The staff then need to be able to reinforce and expand on these sentiments when discussing the new doctor. The endorsement of the staff is incredibly essential., both on the telephone and in the office. “You are going to love her- she is terrific – and everyone has been so impressed.”

Now all the pieces are in place. The letter was mailed, the staff  enthusiastically supports the new doctor, and the patient shows up for the appointment. But now the buyer has to step up to the plate and hit a home run. A similar analogy is getting a job interview. Someone of influence can set the table and make the introduction and get you in the door. But now you are on your own. It is up to you to sell yourself and close the deal. That is why you need to slow down your operative schedule and make adequate time to do a comprehensive hygiene exam. Every patient you see will be a new patient for you. You are being very carefully scrutinized and judged. Be interested and engaging. You want these patients coming back – that is what you paid for. If these rules are followed, retention rates should be in the 90% range.

Next time – how to prepare to sell your practice for maximum value.

“We interrupt this broadcast for the following breaking news.” That is how I feel about interrupting my series of posts on dental practice transitions in order to comment on Google’s recent policy change regarding patient reviews. In my opinion, this was done because Google wants to grow their review base, while at the same time guaranteeing consistency and compliance with how their search engine optimization programs work with rankings.

In a format change to the local Google Business Map display, patient reviews from companies like Demand Force and others have been moved to a much less prominent position below the name of the office. They have been replaced – to the right of the practice name – by the word “reviews” and “Place page.” When you click those words, a screen opens where you are prompted to write a Google review. As you add Google reviews, all other reviews from Demand Force or Bing or Yahoo are pushed lower and lower down on the page.

I am still a big advocate of the Demand Force review protocol. Their reviews should still continue to be collected because they remain extremely important. And even with this new arrangement, Demand Force’s special relationship with Google means that Demand Force is a relevant and an important player. But accumulating Google reviews now becomes  an absolute priority.

I am suggesting that someone at your practice – while the patient is still at the office – helps the satisfied patient to write a review from the office computer. Asking a patient to do this from home is an exercise in futility. It is too complicated except for the most computer literate.

I have developed a flow chart for how to do this easily. I suggest that you immediately make the process of obtaining reviews in the fashion I describe a number one action item in order for your dental practice to maintain high visibility and positioning on the local Google business map. As always, I welcome your comments and feedback.

The easiest practice transition is an outright sale. The legal documentation is way simpler than a partnership. It is basically a purchase and sale and a covenant not to compete. The success is predicated on the ability of the seller to transfer the goodwill to the buyer. Here are ten common pitfalls to avoid.

1.Arguing about the price – it is not really that difficult to calculate a fair price. As long as the price is reasonable, I never advise my clients to try to beat up the seller on price. I want the seller to be happy so that he/she can enthusiastically transfer the goodwill.

2.Not understanding the allocation of goodwill for tax purposes- this has to be agreed on before the pricing. Typically 75-80% of the sale price is attributed to goodwill. This is favorable to the seller who pays a capital gains tax which is currently 15%. The balance of the sale price is taxed as ordinary income.

3. Failure to retain key staff members. It is OK to change doctors – it is not OK to change staff.

4. Failure to review obligations and commitments. The practice has to be transferred debt free.

5. Misjudging the size of the practice – it is critical to know how many patients are in this practice. My definition of an active patient is someone with an appointment. Unfortunately, many times I get called in as a consultant after the fact – when the buyer is very unhappy – because the patient base they thought they were purchasing is nowhere to be seen.

6. Failure to educate on telephone technique – failure to review scripting for the front desk regarding the new doctor.

7. Aggressive dental treatment – I recommend that the buyer does not suggest treatment unless something is broken or decayed. Once that patient has come back a few times, they really become your patient and then it is fine to recommend more elective treatment.

8. Not slowing down – every patient that you see in this practice is a new patient for you. Take the time to slow down your schedule so that you have the opportunity to interact with these patients and start to build a relationship. Remember that you never get a second chance to make a great first impression.

9. Inadequate letter – a great letter – written by the buyer – which comes from the seller – is the principal way that goodwill is transferred.

10. Retaining the selling doctor for patient introductions. My feeling is that we do not want the seller there at all after the sale is consummated. There is no need for the seller to stay on for 4 to 6 months to introduce patients. It is virtually impossible to get patients to go see the new doctor if the old doctor is still there.

Next time – I will go into more detail on some of these common pitfalls.

In January 2011, I began my 15th year of management consulting and coaching to dental practices on a full-time basis.  So many positive experiences, countless situations and challenges, fortunately lots of success stories, but of course those instances where just when you thought you’d seen it all, something would come along and humble you.

A definite trend in my business is that I have become increasingly involved and spending much more of my time as a facilitator for dental practice transitions. In the Northeast part of the country where I do the majority of my work, I can tell you firsthand that very few dentists are brave enough to start a practice from scratch. The most severe economic downturn since the Great Depression has reinforced that rationale. Even strong well-established practices with marketing dollars to spend are fighting for their fair share of new patients. So for a dentist to secure an equity position in a practice, there are basically two choices: buy an existing practice from a retiring dentist, or buy into a partnership.

It will be my purpose in this series of blog posts to discuss the good, the bad, and the ugly of dental practice transitions. Done well–with incredible attention to every detail–a change of ownership can be profitable and successful. Done poorly–and I’ve seen this far more often than I ever would have imagined–you are talking nightmare. So please take good notes as I try over these next few months to help you avoid preventable, irreparable, costly mistakes that will dash your hopes and ruin your dreams.

Over the years, I have found this subject of practice transitions to be a big mystery to dentists. It would be my pleasure to share information with the dental community at large. As someone who reads my blogs, your endorsement would be most appreciated. Please forward this post to five of your most respected dental colleagues. They can click here and be sure to get some useful information.

Starting next week, I will be publishing an entire series of blog posts devoted exclusively to the topic of dental practice transitions. Whether you are buying a practice or selling a practice or hiring an associate or forming a partnership – these are critical decisions and not actions that you take every day. Over the years, I have found the business side of these kinds of transactions to be a big mystery to the average dentist.

It is my serious desire to share useful information on practice transitions with the dental community at large. As someone who reads my blogs, you could really help me out – and I would be most appreciative – if you would forward this message within your dental network – perhaps to four or five of your peers or colleagues. They can click here to receive ideas and strategies that based on my experience should help them avoid costly mistakes. Thanks for spreading the word.

Over the past three months, in a series of eight blog posts, I have been discussing my ideas and strategies on how to ultimately attract more new patients to your practice using the Internet. For most dentists, creating a website and utilizing social media to grow a practice is still a relatively new concept. No question about it –getting a new patient “the old-fashioned way”– as a referral from an existing patient–is still the gold standard. And we never want to abandon the relationship building that we do with our patients that  encourage those referrals to take place.

But to ignore the power of the Internet, and to not have the opportunity play in that space, is a huge and costly mistake. Every day, thousands and thousands of people do a Google search for a dentist. Every day, people are asking their friends on Facebook about recommendations for all sorts of professionals. Don’t you think that some of these people live in your neighborhood?

So as I close this series for now, I implore you to take action. Immediately! It won’t happen on its own. Hope is not a strategy. Re-read and print out this past series of blog posts. Then lay out and write down a detailed plan with a timeline. A goal without a plan is just a wish. Hire a company to help you build a great website, and then promise to keep adding interesting content. Take a course or two and learn about social media opportunities. Get your staff involved because you can’t possibly do this all by yourself.

It is all about making the commitment. With bacon and eggs, the chicken is just engaged – but the pig is truly committed. So doctors- don’t just dip your toe in the water on this – dive in head first!. The opportunities for significant growth are far too meaningful to ignore. Recognize that your commitment to Internet Marketing must be ongoing. Stay alert–be consistent–be creative – and start to reap the rewards.

P.S. – My next series of posts will be on the subject of dental practice transitions. Over the years, I have found this subject to be a big mystery to dentists. It would be my pleasure to share information with the dental community at large. As someone who reads my blogs, your endorsement would be most appreciated. Please forward this post to five of your most respected dental colleagues. They can click here and be sure to get some useful information.