The Myth of the Cosmetic Practice

Con artists, big money and the marketing of cosmetic dentistry

by Tyson Steele

I recently talked with a dentist who had purchased an advertising campaign designed to attract patients with an interest in cosmetic dentistry.

"This campaign is the best thing since sliced bread," said the salesman. "It was developed by a dentist who lives in a swamp in the Bayou with no roads, no electricity and no running water. Opossums outnumber the people who live in the entire county, and the median monthly income is $46, one chicken and a pound of grits. The amazing thing is that the guy who developed the campaign is producing $120,000 per month in just three days, even though people can only get to his practice by boat!" (Okay, I'm exaggerating -- but the sales pitch really did go something like that.)

Have I Got a Deal for You

The unsuspecting buyer of this campaign spent tens of thousands of dollars for the rights to the ads and the media costs to run them. Over the course of two months, he attracted 14 prospective patients who had exams and follow up case presentations. Eleven of the prospects clearly had sticker shock regarding the costs of treatment. Two were enthusiastic but were never heard from again after they said they would talk to their spouse.

Only one patient was excited enough to book the treatment and put a deposit on her credit card. Ultimately, she spent $14,000 in the practice (a modified treatment plan from the original) and was pleased with the result. In the year that followed, however, she referred just one patient for tooth whitening.

The dentist's total investment to attract $14,000 in treatment included 31 hours spent on exams, case presentations and follow up, and 8 hours spent treating the patient. Assuming he had minimal overhead costs of $200 per hour for staff, facility and equipment, he spent $7,800 on overhead (39 hours x $200.) Lab costs for the case were about $2,500. If the ad campaign had cost $20,000, our dentist would have realized a net loss of $16,300. (In other words, he paid $417 per hour to work!)

Of course, if more of the prospects had accepted treatment, our dentist would have made money. Unfortunately, 11 out of 13 prospects would have had to accept $14,000 treatment plans in order to generate about $750 in profit per hour, or the equivalent of about $150,000 profit per year. Do you see something wrong with this picture?

No matter how you rearrange the numbers: closure rate, value of treatment plan, number of prospects, cost of media, whatever -- it's virtually impossible to make any money! In fact, you can only make money on paper by projecting highly unrealistic numbers. And, trust me, you're not going to close 50% of ad respondents no matter how great you are.

Believe it or Not

I call this the "Cosmetic Myth." It is the unjustified belief held by many dentists that life will be great if they could just find a way to flood their practice with rich patients who are begging for cosmetic dentistry. The gurus perpetuate this myth with their seminar speeches and stories designed to push many dentists' emotional "hot buttons." Ultimately, these stories swirl through the dental community like some urban myth that seems somewhat plausible only because it exploits our inherent belief that "it must be better over there."

In our analysis of hundreds of practices, we have yet to find any dentist, including the gurus, who has become highly profitable through marketing cosmetic dentistry. In fact, every practice that we have ever seen generate more than $250,000 in profit per year is -- without exception -- a family oriented, restorative practice.

Of course, many of these highly profitable dentists do perform a fair amount of cosmetic dentistry on their long term patients. In addition, I should note that we have seen several cosmetic practices that advertise and generate profit in the $150,000 range. And, occasionally, we will even see a highly profitable cosmetic oriented practice that has attracted referrals from other general dentists over the course of many years. However, this is exceedingly rare, and, as younger dentists graduate with better and better cosmetic skills, they become less likely to refer out treatment, greatly reducing the likelihood of developing this kind of practice in the future.

So, here's a reality check. If you've been bitten by the "grass is always greener on the other side" bug. Stop. Take a deep breath and get some perspective.

No "magic pill" will solve your problems, get you happy or help you make more money. In the end, developing a successful practice takes hard work and sound fundamentals applied over time.

So, what should you do if you want to develop a more cosmetically focused practice? Following are some suggestions.

Can't Buy Me Love

Start by considering the prospect pool from which the vast majority of all cosmetic dentistry is drawn. It's not necessarily the wealthy, the baby boomers, or women. (Although some prospects may be all of these.) The vast majority of all cosmetic dentistry is drawn from regular, long-term, high quality patients that dentists already have in their practice.

Ever wonder why those cosmetic ads draw abysmally low numbers of qualified prospects? It's because all the good prospects already have a dentist. After all, how many health conscious, appearance oriented people with thousands of discretionary dollars do you know who don't have a dentist?

Think about it. If you have a reasonably sized patient base, you're already doing much of the cosmetic dentistry that's available to do. Sure, it may not all be major full-mouth cases, but you're picking the low lying fruit, often without realizing it.

Your current patients have a relationship with you. They trust you. They know you. And they are highly receptive to your offers to help them develop a beautiful smile.

In fact, I'm sure you can think of many moderate cosmetic cases you've performed on patients in your practice who would never have responded to an ad. They don't fit the "prospect profile," but they accepted cosmetic treatment anyway. They even refer others to you -- maybe not necessarily for cosmetic work, but for long term restorative care.

So, here's the best way to develop a more cosmetically focused practice -- develop a practice within a practice. First, create a strong restorative practice. Then, begin to educate your patients on their opportunities for cosmetic care.

Don't turn into a used car salesman. Just let patients know what you can do when you talk with them. Put a few of those before and after books in your reception area. Hang a few photos in the treatment room. And take your time. As you do more and more cosmetic treatment, patients in your practice will talk. Eventually, you'll be doing a lot of cosmetics on patients you've grown to love.

C'mon Get Happy

Most importantly, decide to finally ditch the notion that the other guy has it so much better. Comparing yourself to people you know nothing about is bound to make you miserable.

Remember the story of the tortoise and the hare. The slow and steady win the race. And the race isn't about appearances. It's not about who everyone thinks is the biggest cosmetic guy. It's about getting enjoyment out of your practice, having fun with your staff, caring for your patients.

You already have the foundation for an excellent cosmetic practice -- your current practice. So, use it.

And the next time you have an opportunity to buy a cosmetic advertising campaign from the Crocodile Hunter's dentist, who built a huge cosmetic practice while working out of a Volkswagen van in the outback, call me . . . I've got a bridge to sell you.