Abe Kasbo discusses addressing all a DSO’s audiences—new and existing patients, the dental team, and recruits—successfully with integrated marketing that does not rely on any one platform.
DSOPro: Tell us about your background and how you became involved with dental.
Verasoni has been in business since 2005. We basically cut our teeth on Wall Street and in healthcare. Over those 19 years, we’ve been very fortunate to work with companies like Henry Schein, Colgate, Ivoclar, Acteon, Georgia Pacific, and many DSOs across the country.
I’ve been fortunate to have the opportunity to speak around the country and several times in Europe about branding, ecommerce, health-tech, and how social media actually has impacted integrated marketing. We do a lot of primary research in the field, which we bring to our clients. The marketing landscape is extraordinarily dynamic, and our approach is vastly different from what’s out there. I am well aware that what I think I know today may all change 5 minutes from now. It is very humbling to be in this space, but you must recognize that in order to succeed.
We’ve been in the DSO space for about 14 years, but whether we’re partnering with a Fortune 500 company or with a DSO, there is no difference in our approach. The only difference is size and scale. Marketing is really about people and their behavior. Once you understand how the market and how your customers behave, it doesn’t matter whether you’re doing it for a conglomerate or a DSO. I would say our DSO business has flourished over the past 3 years because our message is being much more well received because DSOs are tired of marketing hype and are looking for steady marketing leadership.
DSOPro: You mentioned “integrated marketing.” What does that mean in your context?
A marketer’s job is to convince people to use your products or services. It’s that simple and that hard. The convincing part is the key, and that requires an omnichannel or integrated approach. Otherwise, you’re just dropping marketing bombs. While there is a lot of good work being done in dental and the DSO space, DSOs are a bit behind other industries. For some reason, the industry tends to be addicted to everything digital, and that is not necessarily the right prescription for DSOs. Digital can’t fix everything if your brand or your patient data is off. The integrated or comprehensive approach with digital being used as a tool amongst other tools is how other industries make an impact. We are trying to bring that thought process to our DSOs.
Integrated marketing is the core of branding, it can’t be done on a single channel. The question is how do you do it responsibly and effectively?
Many issues impact the marketing success of DSOs. One is marketing efficiency. Marketing efficiency is necessarily connected to whether you use a single arrow or multiple arrows, and we use the latter. The other thing that’s pre-requisite to integrated marketing is the relationships that a lot of DSOs have with their agencies, which in my opinion really needs to be examined. Transparency, or lack of it, is a real issue on the marketing side of the business. Recently we were on a call with a DSO that was working with a traditional agency. While conducting a marketing audit of their digital ads, we found 20% of their total budget was being wasted because it was on “set it and forget it.” They simply didn’t know and didn’t know how to ask or where to look.
So, there are a lot of serious issues with digital marketing, including fraud, which is why we can’t and don’t rely on a single tactic. I’m publishing a book later this year called Irresponsibly Digital. In it, I tell the story of the Chief Marketing Officer of Uber who revealed he lost $150 million on digital ads. Uber is a digital company. This goes back to that humility thing—what do we folks who market DSOs think we know that the folks at Uber, an entirely digital company, don’t know? We must constantly check our math. I’m a big proponent of the active management of marketing and, also, toning down the vanity analytics portion that is so pervasive in the DSO industry.
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So, an integrated approach uses different marketing channels and platforms to help clients achieve their goals.
DSOPro: Can you explain what you mean by “vanity analytics”?
DSOs should really care about only one thing—the conversions from their marketing campaign. In the case of digital advertising, they should not care about the number of likes. They shouldn’t care about website traffic because 60%-65% of website traffic in the United States is actually fake. Fake traffic and bots drive fake analytics, not real patients.
Digitally, we need to focus only on what’s happening to the relevant traffic you’re getting. Meaningful analytics are derived from human visitors to your digital properties who are in your area and may be interested in your services. That’s our only focus. Remember, there are practice operational components to vanity data as well. Are people calling you or sending you an email? How fast do you respond and what is the quality of that response? Just because you respond doesn’t mean that you’re responding correctly. Every detail counts in touching a patient, customer, potential hire, etc.
DSOPro: What falls under the umbrella of your definition of digital marketing?
Websites, social, database marketing, SEO, and SMS (short message service). Email, banner advertising, anything that you do on YouTube. That’s all digital. Something that people don’t appreciate is the average open rate on an email coming from a DSO is somewhere around 25% easy. More importantly, the conversion rate is much higher on email than social, for example. The average engagement rate on an organic Facebook post in healthcare is 0.02%, and overall is about 0.06%, according to the latest study from RivalIQ. So, if a DSO has a thousand people on their Facebook page, and let’s say they’re all relevant and they post something organically, that means less than a half a person gets to engage in that post. Seriously? And we’re still talking about Facebook as a serious platform and are willing to just hand over our budgets?
The engagement rate across the board in social, including TikTok, is actually very low. Remember, digital and social media platforms are like having your own TV station. Yeah, you can create great content, but your network, your audience is the most important thing; not how cool or engaging your posts are. You can have all the cool posts in the world, but if your audience isn’t there, it’s a waste of time and resources.
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Looking at the engagement rate results, you can see it’s a downward slope from the upper left to the bottom right. So, it’s not just a Facebook or social thing. People forget that marketing is not about platforms, it’s about people and how they behave, and we must go back to that. When we do, we’re going to find that, one, we’re going to build a better brand, and two, people are going to respond better. And three, we’re going to build equity in that brand more efficiently.
Think about all the digital companies we know and love. Amazon, Apple, Facebook, Uber, even TikTok advertise on television and billboards. Why? Integrated marketing works. We may not have their budgets, but we can learn from them, and we do, and craft plans that make sense for our clients.
DSOPro: What are best practices for patient retention and acquisition, and website design for multi-location dental groups?
The brand and reputation of your DSO is the essence of why patients come, stay, or leave. Web presence is an important part of a multifactorial equation. At the heart of all that is the quality of your clinical work and how you make people feel. When we’re looking to market the DSO as an entity, whether it is a branded house or a house of brands, we take the same approach we do with our hospital systems because they also have multiple locations and different audiences. You must consider the following audiences—your new patients and your existing patients. New patients are five times more expensive to acquire. Marketing and converting existing patients on services they need is much less expensive. Within every integrated or omnichannel plan we deliver, we consider patient audiences and connect them to total practice revenue. And the web is a platform to drive that strategy. There’s no cookie cutter approach here because every DSO’s situation is different.
We have to remember that patients are the lifeline of DSOs, but DSOs have to think bigger because they can’t deliver their services without the heartbeat of their practices, that team of talented doctors and staff.
Recruiting doctors, hygienists, and team members is non-stop in the industry, and a great team is the deliverer of your product and brand. The brand implications here are crucial because your reputation as an employer very often is a predictor of what kind of talent you can attract. So, your brand must speak to three audiences: new and existing patients, existing and future employees, and doctors. That’s what hospitals do.
Remember, everyone is subject to your marketing, and I mean everyone. That’s why your brand image, what you say about yourself and how you want the market to perceive you and pass your messages about you along, must be crafted very carefully.
Best practices in every sector are about consistency. Campaign consistency, brand and message consistency, and above all, delivering exceptional care. Even with all the marketing out there, 60%-70% of new patients come from your existing patients. That’s your best tool. We tend to work from the inside out. Make sure the patient experience is the best it can be and then tell that brand story consistently across the channels relevant for each client.
Patient experience is always at the forefront. We consider every piece of marketing communications a patient touch and reflective of your patient experience, so it must be high quality. All digital properties, including websites, must exceed consumer expectations. The digital consumer is also the digital patient, there is no separation between them. Everything that we’re used to doing on Amazon, we need to be able to do on your DSO site.
As for patient retention, it goes back to bifurcating your strategy to patient marketing. Patient retention is about more than just keeping the patient, it’s about making sure they know you have services they need. All of that must be put into motion as part of a much larger plan, which is why we advocate for developing an integrated plan or at least starting with a marketing audit. This way DSOs can see exactly what’s going on in different parts of their marketing—what we’re doing for new patients, existing patients, the dental team, and for recruiting. The entire business is affected by how you communicate your brand.
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DSOPro: What are some of the common mistakes being made when it comes to marketing?
On the digital side, it’s absolutely “buyer beware.” With all due respect to digital companies, there is a lot of confusion in the marketplace. For example, we created a plan for a fairly large DSO, but their digital company would not give us access to look at anything. The excuse was “It’s proprietary,” and I can tell you it’s not. It’s about as proprietary as oxygen. Ultimately, we found about $600,000 in digital fraud and that’s only from the data we could get our hands on. This is a sensitive subject and people don’t like to hear about it. But in any other industry, this would be unacceptable. I can’t tell you how many people we have saved from getting hammered by fraud.
DSOPro: Is this fraud intentional?
Of the ads you see on popular websites, researchers who are much smarter than I am say that about 70% of the budget allocated to those ads ends up being fraud. Remember the Uber example? Big tech, Google, and Facebook are black boxes. Sure, you get nice looking reports with primary colors, but make no mistake about it, they are black boxes. There’s serious research in this arena done by amazing people that is ignored by the DSO industry for one reason or another. We do not ignore them, and that’s not easy. Facebook reports they purge a billion fake accounts every quarter. So, it’s many things, including the programmatic nature of buying digital media. For example, a brand will say, “I want to target people in this demographic who live in this area” and Google will find those sites and programmatically buy those ads. Fraudsters create look-alike websites with look-alike demographics. They build them really cheap—they can do them with AI now. And then Google will serve ads, paid by you, to those sites. No human sees these ads, but you’re paying through the nose for them. What’s crazy is there’s no incentive for Google, or digital agencies, to vet those sites.
The other thing here is the digital agency incentive structure and the tolls advertisers have to pay along the way doesn’t work for businesses, it only works for many agencies and big tech.
DSOPro: What do you tell clients about investing in social media and Google advertising.
Look, you have to take a strategic position here, but you must do it thoughtfully. This space is wrought with fraud and hype. There are two things to consider—the efficiency of that and reducing the risk of fraud while promoting the business at the same time. This is tricky but we must be honest with ourselves.
Going into social media and Google ads, the first thing you need to know is to be skeptical about their promises and reports and look at them with a critical eye. Let me give you an example. Procter & Gamble, the world’s largest marketer, decided to decrease its digital marketing investment and they saw a bump in business. There are many examples of companies pulling back on their digital investment and seeing an increase in business. You can Google everything I am saying here to verify it. So digital continues to be a vital strategy for business but it’s not the be-all end-all.
Additionally, the lifecycle of your DSO should dictate your marketing strategy, not platforms. If the problem requires digital, then we’ll examine how to do that in a meaningful way. That requires a thoughtful approach and real work. DSOs in Kansas City are much different from DSOs in New York City. There’s a different climate environment, media environment, and culture. The costs are wildly different. When you couple that with their business model and business life cycle, the macro-economic environment which must be taken into account, everything better be custom.
We sit with leadership and go through every aspect of their business and figure out how and what marketing communications can solve those issues, which digital is a part of. We literally go through an extensive discovery. Then we outline what needs to be triaged and what we need to do going forward for the next 12 months, which is then continuously analyzed. Digital is simply a tool in a much larger arsenal and strategic approach.
DSOPro: What are some of the most innovative things you have done or seen clients do?
I think the most innovative thing we do is literally make budgets work smarter and harder. But really the other most innovative thing is looking at their entire marketing enterprise and helping DSOs communicate more effectively with their key audiences—patients, team, and docs. More than anything we have hard and honest conversations. That doesn’t seem sexy, but if you don’t do that, you’re not delivering value.
We always start by setting that foundation for success, then provide the marketing infrastructure. If a DSO plans to hire a marketing team, it needs a marketing VP, a creative team of whatever size, and someone who has some digital literacy and website experience. That tends to be costly and risky. We can shrink the costs and risks exponentially by providing an outsourced service that becomes your in-house marketing partner that works in real time. So, our clients are agile, and their campaigns are high quality.
About Abe Kasbo
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Abe Kasbo is Founder and CEO of Verasoni, a marketing communications advisory, consultancy, and agency. Founded in 2005, this innovative firm delivers meaningful, integrated marketing communications strategies to Fortune 500, middle-market, and startup clients in the United States and around the world. Verasoni serves the dental market including DSOs, distributors, manufacturers, and consultants. Abe is a sought-after advisor to C-Suite executives on strategic communications, branding, and public relations strategies.
He is immediate past Chair and current board member of the Center of Innovation & Entrepreneurial Studies at Seton Hall University. He served as Community Board Member for The Walt Disney Company’s live action movie, “Aladdin” starring Will Smith. He was inducted into the Seton Hall University Entrepreneur Hall of Fame in September 2018 and holds a master’s degree in public administration (Healthcare Policy & Management) and a Bachelor of Arts in Political Science from Seton Hall University.
Abe is the author of the upcoming book, Irresponsibly Digital, slated for publication in Q3, 2024. He is featured in media including The New York Times, Forbes, Institutional Investor, e-Marketer, PBS, Insider Intelligence, Bankrate.com, Dental Economics, FOX, Becker’s Dental Review, and international media in Europe and the Middle East. He has spoken at Princeton University, Fordham University, Yale University, the University of Michigan, Rice University, and Temple University, among others, and is a sought-after speaker on marketing and business topics including digital transformation, ecommerce, digital and social media, and business competitiveness.
Verasoni
Verasoni is a fiercely independent marketing consultancy, advisory, and agency that delivers critical, meaningful, integrated marketing communications strategies and campaigns to clients in the United States and around the globe. Verasoni has served the dental industry since 2007 and DSOs specifically since 2010.
Verasoni enjoys a well-earned reputation as leaders in marketing who serve as trusted partners and advisors to our clients with honesty and transparency. Visit Verasoni.com and follow on LinkedIn to learn more.
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