Dr. James McAnally

Recently I discussed a somewhat famous restaurateur in Vancouver BC named Vij and the problem he has at his appropriately name restaurant “Vij’s.”

It doesn’t take a Nobel winning economist to see that Vij is wildly successful.  In fact, he’s so successful it is actually hurting himself.  Huh?!?  How is that possible?  Well, while enjoying my time waiting at the restaurant (on nearly every occasion of dining there), I see others coming to the restaurant, see the long line or inquire about the wait (jaw dropping when they hear 2 hours on busy nights!) and because of such they leave.  How many of those are new customers will never return?   Answer: TOO MANY.

What are some of his options to resolve this situation and most importantly to make more money out of his business?  Well, he could open even earlier (increasing his overhead by hiring more staff and of course adding to his personal exhaustion level).  He could build a bigger restaurant and increase the monthly nut he has to service (woops there went that overhead skyrocketing again).  He could increase complexity and open a second restaurant and hope he can systematize the quality of the food.  He could also do nothing and just keep seeing the same high volume of customers, waiting for hours to eat his great food, some customers not coming because it is too crowded, and wearing out his furniture and carpet quickly while still making the same amount of money.   [He has recently opened a take-out only shop next door with a frozen section…..even THAT has not slacked demand at the main sit-down spot!]

Interestingly enough no other Indian entrepreneurs in Vancouver have copied his concept—an obvious thing to do.  Of course, we dentists tend to also not copy what is really working around us.  Dentists tend to copy “procedures and equipment” but not successful systems for sales and marketing.

So what else could Vij do to remedy the situation?  

Well, some information coming from the opposite side of the US from Harvard would help him out. 

Hopefully, you are aware of this fairly old study (and formula) done at Harvard based on pricing and how much a price increase will help or hurt your net profit based on your overhead.  It really illustrates insensitivity to price (i.e. price flexibility). 

Recently, a high end call girl discovered the same, and her story was discussed in ‘Super Freakonomics.’   Once again, more price insensitivity than the uniformed would ever guess.  It truly is universal! 

Harvard’s work years ago showed, if you cut your price by a certain amount, then here’s how much you’ll have to make it up in volume which illustrated the sheer idiocy of doing discounted dental fee plans.  So, based on the volume and wait at Vij’s, his food is way under priced.  It doesn’t even matter what the prices are now….just the fact that crowds of people are willing to wait 1-3 hours for a meal means he’s undercharging. 

An immediate price increase would help him in many ways.  He would obviously make more money.  Yes, a few customers would leave because of price.  Not such a bad thing since this would allow even more new customers to choose to come try the food at the new higher price since the wait time would be less and they wouldn’t leave at the door. 

He could easily increase his prices by 20% to test the waters with his sales per hour over a six month period and analyze the resulting wait times.  If nothing changes, raise em’ 20% again!  Literally, keep raising em’ till the wait time gets down to a reasonable amount for his main dining hours.  He could even have a “discounted” rate for certain hours if he needs to boost his volume during non-peak hours.  There are parts of the world where some of our members have needed to “Vij” their fees to match available work hours.  

Next time, we’ll review how much business he could lose and stay exactly as profitable.

Best,
James

Social Media, People Magazine, Authenticity and You.

As promised, for all those opting into our social sites….here the BIG things dentists need to understand about this “new” media.  Understanding the big picture will drive all the small details…..

Fundamentally, here is NOT what this is going to do (at least right now).  Get this straight:  Social Media is NOT going to generate “boat-loads” of patients as plenty of b.s. up to their eyeballs hucksters pitching such to the profession.  

There are actually more powerful things to worry about with this media beyond that simplistic concept being lied about…..

So……here we go……

1)  Why has social media become so popular so quickly?  A little history helps unravel this one…..

Humans are genetically social creatures (or at least most of us are).  Fundamentally, social organization has always been about survival.  If you hung out with other people and created friendship and empathy you were far likely to make it till the next spring or to the next watering hole. 
   
Back up a few hundred years to “modern” times and you’ll find previous levels of “joining” and being social at heights beyond what we’re accustomed to seeing or have seen during the past 3 decades.  Clubs and organizations in those days were local affairs since communication and transportation were big issues with both finding and attending whatever it is that tickled your fancy.  That, plus lack of mass entertainment, boosted participation. 
   
The great era of belonging locally chugged along with few problems right up until entertainment options started to increase.  Things deteriorated rapidly with the advent of radio and TV.  You can basically graph the decreased numbers of hours that citizens belonged and attended organizations with the increase in hours of TV consumption.

While religious attendance is up for some denominations, when taken as a whole, a smaller % of the population attends religious ceremonies “religiously” than in those by-gone eras. 

RESULT:  We ultimately moved from an age of individual participation to one of watching OTHERS.  
   
It’s not that somewhere along the way we suddenly stopped liking connection and organizing but that it was just easier to sit down in front of a radio or TV and be entertained without the need of being around as many others.  People Magazine has been #1 for decades because it allowed “lazy” social observation and for the “reader” to peer in on the “interesting” lives of others.

2) Interest and involvement is now tipping back to the other direction thanks to social media.

……millions of new linkages are happening right now.  Instead of interest being a one way street of media with media forms all controlled by someone else pushing unidirectionally out into the population and as a result sucking up organizing time, everyone can be their own publisher/organizer and reach others of like-minded interest. 

Suddenly we’ve gone from a few thousand one way streets radiating into the population to millions of freeway interchanges going in all directions.   AND It’s only just begun……..

3) Social Media is MASS Organizational Power Brought to Any Individual Who Cares

Until recently there were few ways to mass people together quickly around a particular topic or interest.  Now it’s quick and easy to reach out and find groups of others, just like you, no matter how obscure your taste or interest.  Big example:  Obama and gang figured this out during the last election.  Little example:  This 4th of July weekend, Seattle was home to the Guinness Book of World Records, World’s largest “Zombie Walk.”  An endless parade of zombies—brides, roller bladers, goths, surgeons, naughty nurses, etc. all mumbling “more brains” as they roamed the streets a few blocks from our house.  Why and HOW would so many “zombie” fans find each other, well in a word—social media.   [FYI:  The “tea-party” is one example of just that very thing happening rapidly and on a large scale..]

This same connection mechanism is playing havoc with “traditional” media.  It is a big reason readership of all kinds of things printed on shaved trees, viewership of TV shows, and listenership of radio is declining by whole percentage points (the first time in history!).  Doesn’t mean that certain demographics aren’t still hiding out in those venues but it does mean different patterns are emerging with who watches what.

People are moving from passivity to activity via these social connection mechanisms of interest.  It translates into millions in lost advertising revenues and millions of viewing/reading hours free’d up to do other stuff.  

Yes, much of that free time will ultimately be wasted on frivolous pursuits but there will be some really cool things that happen as people connect and do interesting things together.    Wikipedia is a vivid of example of what happens when millions of productive hours are free’d up around a common interest and a bunch of volunteers attack a problem.   It’s likely that some dentist sub-culture, whose members might be finding each other right now, will develop answers to problems we haven’t even thought about addressing. (maybe zombie root canals?)

By the way, any group used to organizing its “believers” around one over-riding global theme is in BIG trouble since the splintering of interests and ability to connect means a guaranteed gradual devolution from influence and power. 

4) These changes AND YOUR practice. Coming full circle and using it for your benefit.

Like it or not, social media and these mechanisms of connecting, will play a role in how your business interacts with the world outside of it. 

Particularly, when it comes to reputation and word of mouth for things that cost a lot of money (i.e. significant dental treatment).  A former coach of mine, years ago, correctly remarked that we were entering an age of authenticity where the public would put more trust in those who were authentic.  His statement was made well before social media cracked open the window to peer into who was being authentic and who was not.   Ironically, he made that statement in reference to George Bush’s “authenticity.”  At this point, it’s doubtful how much “authenticity” any of us will place in any President, potential President, or a particular political party.
  
5) How Real Authenticity Creates Business.

The side effects of public belief in authenticity can translate into all kinds of benefits.  For those who are authentic in doing what they say they will do AND producing the results they promise, and giving social proof, they stand to collect benefits both non-monetary and monetary.  This is the kind of authenticity to be thinking about for you and your practice.  This is a component of selling at premium prices.

This kind of authenticity is something to be EXPLOITING via these media.  Note:  exploit in the sense of “to take full advantage of” and applied directly to the definition of ethical selling which I define as “Getting Patients emotionally engaged in a treatment result that is GOOD FOR THEM and getting them emotionally and intellectually committed to treatment.”  If social media creates emotional involvement—you and more patients win.  PLEASE exploit this for patient’s benefit.  
   
6) So…..What can be conveyed authentically to those researching you and your practice? 

Here’s a few:  believability via what you present to the public via staff stories, patient stories, fellow dentist stories, and your personal interests and hobbies.  Yes, that means many things WAY beyond CE or showing blood and guts surgery.  Something I’m still amazed at seeing on random Facebook pages—”hey patients look at me sticking this implant in a bloody socket!”  The former authenticity items all HELP your case more than the later with the trust level needed for patients to commit to treatment and to YOU in particular.  Everyone dentist will make you bleed but which one will you actually trust???

Mouth Meet Feet. If they don’t match, the public will sniff you out via their research…..

Yep, a by-product of ‘all of the above’ serves as a forceful reminder that the age where it was simple to fool people even for a small period of time is OVER.  

WORD TO THE WISEST:  Mouth and feet movement must match.  Forget big brother—Google/the internet is watching and reporting back in real time.  The social sites are filling in the blanks about you and what you have been up to……

Best,

James

Hello friends!

Starting today, I have decided to give you my daily emails for free via the Blog.

I’m not sure how long I will do this so let’s just see how it goes…

You may or may not agree with everything and that’s fine.  But, I’m sure you’ll get something out of it—at least for those who are observant.

Today, I’d like to discuss what most of us refer to as “maintenance” or “preventive” care.

Since this type of care is simply a continuation of treatment (i.e. after reconstruction), I recommend not discussing it at length as if it was an entirely new concept following the end of regular treatment.

Why?

Because it confuses the patient.

After “reconstruction”, they are  suddenly forced to make a new decision.

It’s sort of like starting all over with them again and having to “re-sell” an entirely different service.

Here’s what I recommend… and as always, take my recommendations with a grain of salt; YOU must ultimately decide what is in the best interest of each individual patient…not me.

The ideal situation is, at the appropriate time, YOU not them recommend that their frequency of care gets reduced as they show signs of staying healthy.

Maybe after being seen once every 2 or 3 months as health stays present (disease absent)….you gradually make recommendations to spread out the maintenance visits.  No need to say anything else.

You treat that next visit no differently than the previous visits. No need to take more time to “sell it”, over explain it, or take them back to the consult room to discuss it in anyway.  It is merely their next visit. That’s it.  Realize that fundamentally, people want to be told what to do by their health provider including you as complex case dentist.

After these visits, you (or your hygienist) should spend 2-3 minutes explaining your findings, then, if appropriate, recommend the next visit. I n this example, you might say, “You are doing a lot better, we still need to keep on top of  XXXXX….so I recommend making your next appointment in 2 months and a half…about 12 weeks.”   Then, write the date down on a post it or something, give it to the patient and say something like, “Take this out front and I will see you then.”

This continues until the interval matches the state of health.   At that time, here’s the language, “Your staying stable with the amount of time going by between your visits.  If you start noticing something deteriorating (blood on your brush, floss, interproximal cleaner), I want to see you right away since that can be sign of deterioration and reverting back to the danger of losing teeth or your new dentistry.

And that’s it.

This may go on forever for that patient.

You never call it anything. You just take it one visit at a time and let them have/keep the control.

Watching Your Back.

Until next time,

James

In LA, in between my two quarterly business think tank groups.  One is purely devoted to marketing, sales, and maturing a business.  The other is devoted to focus on both personal and professional efficiency.

Besides our regular meetings at Big Case Marketing, I personally hit the road to consume the same medicine I recommend to our troupes.

A truism is “if you won’t pay for something, you won’t pay attention.”  It’s no wonder that it’s a small elite minority of dentists that I interact with on a routine basis.  Most in the profession are simply too lazy to investigate and then invest in the things that really impact which patients how up and what they buy.  Yes, there are a lot of charlatans out there but the legitimate ones have lots of evidence that support their arguments—thus another reason to devote time to deductive reasoning. 

Another truism is the only way you will get smarter is to hang out with people smarter than yourself and always put yourself in a room where everyone is getting smarter.  Are you doing that regularly?

Sorry folks, but dental society meetings don’t satisfy the above truism, or even clinical CE courses, when it comes to smarts for growing the practice.

I’ve been fortunate enough, to not only hang around Joe Polish (right), who is one of the best marketers on the planet but also to have Dan Sullivan who founded Strategic Coach in my personal marketing/sales coaching group.  It’s being around people like this that translate into more “ninja” for our members with marketing that wins the day in the profession.

Here’s one last tidbit for today—-when thinking about who you want to serve in your practice, think about what kind of patients do you want to be the hero to.  Whoever you want to be the hero to should be the patient you seek out, sell to, and ultimatley take the check from.  This one concept can go a long way to driving your marketing and sales decision.

Viva getting smarter,

James

Avoiding the “rush to cheap” can be a real challenge since it’s easy to get caught up in “retail mentality” as one watches the majority of the retail world heading there.  

This something to be aware of and position yourself away from that game.  If you weren’t aware of the fact that there has been no long term retail discounter in the history of business you should seek out information on that subject versus believing that “discount is king.”  

[Don’t reply, “but what about Wal-Mart” since in business terms it’s still a very young company.  Long term in business means 100+ years.  Furthermore, do you honestly believe you can really out Wal-Mart Wal-Mart with a dental practice’s economics?  Good luck……]  

Here’s a good rule on pricing and who you should watch and pay attention to:  You can be guaranteed that if 95% are doing X (i.e. racing to cheap), then it’s actually more important to look at the 5% doing Y (selling a premium prices).  The 5% likely are in on a secret the 95% do not understand.  

A great example last year was how high end retail greatly limited their supply and sold out of pricey merchandise versus what happened the previous 2 years while they were slashing and burning to move the stuff.  

None of us have the financial base to learn this kind of foolishness on our own with painful “personal experience” so when someone blatantly shows you how to stay profitable and they are in the 5%, even if it is in another industry, retool it for your use
 
I re-visited a real world “pricing structure” mismatch when I was in Vancouver BC last week.  

After one of my many meals going “hog wild” at Vij’s in Vancouver, B.C.

I’ve discussed this example before and some doctor’s will already be familiar with the example but it provides a continual lesson each time I go.  

One of the world’s best fine cuisine Indian Restaurants, Vij’s, (www.vijs.ca) makes its home in Vancouver.   No matter how many times I’ve eaten there, I can instantly make myself hungry by thinking about the food and crave the food there enough to visit Vancouver twice a year just to fill that craving.  (I’m assured by Dr. Irfan Atcha one of our Elite alumni that there are even better Indian restaurants in Chicago and I will eventually take him up on his offer to have a taste test!)  

Vij’s takes no reservations.   The wait time on a Thursday, Friday, or Saturday night at 7 pm can be up to 3 hours.  Even when we’ve went at the “blue-hair” hour of 5:30, there have been 30 people on line.  On this last visit, a Thursday night, the wait was a mere 75 minutes.  As it was a sunny, warm day which also tends to “kill” restaurants in this part of the country since in a region where one only gets a few weeks of summer, going indoors to dine is low on the list for many.

It goes without saying, the food is always good.  They do a great job with making sure you have many choices of wine by the glass and they bring Indian finger food around all the time you wait to keep you happier and to keep your taste buds anticipating the great meal to come.

The problem going on at Vij’s certainly isn’t the creation of demand or food quality.  

Pausing to look around between bites….

It is actually too much demand with some valuable customers seeing the lines and leaving which I’ve observed on multiple occasions over many years.  If they are a new customer, they are likely to never attempt a second trip.  

What Vij isn’t aware of, that can help him out, is what a Harvard study revealed, many years ago and that’s exactly what we’ll go into next time.

Get The Maximum Case Acceptance System for FREE with Your Attendance at a Private Consulting Session

Laser Focus on YOUR Marketing and Case Acceptance for the Elective Dental Economy WHILE Others STAY “Stuck on Stupid”

 New One Day Session Dates Announced:

Los Angeles:   August 16^th ½ Day,  August 17^th ½ or Full Day

Miami:             September 16^th ½ Day or Full Day

Dallas:            October 6^th and 7^th  ½ Day or Full Day

Montreal:        October 14^th and 15^th  ½ Day or Full Day

Miami:            November 11^th and 12^th ½ Day or Full Day

Miami:            December 10^th ½ Day or Full Day

 Dear Colleague and Friend,

While the economy is starting to show signs of life, the dental market remains forever changed following the “great recession.”  Most aren’t ready for the risk and opportunity.  Here’s how you can handle both…. 

Each year, I set aside half day and full day private consulting sessions in my calendar for the One Day Practice Maximizer™ Program.  There are one-practice one-day sessions spent on just your local situation.  The fee is $14,997 for the full day and $9,997 for the half day.  It’s not unusual to see a 5X-10X return on your investment in less than 90 days of returning to your practice.

Additionally, if you “team up” with 2-4 non-competing offices, the fee per office for the full day is reduced to $9,997.

Now more than ever, you should consider spending a full day or half day with me either in Seattle, Miami, Boston, Montreal, or one of our other One Day Session cities.

Here’s a short video overview.  It will tell you all about your day with me.

Why even the highest performers need a day like this:  BECAUSE, here’s what you are up against……..

• Fundamentally, the middle class that traditionally bought dentistry is gutted.  Yes, the upper 20% of the affluent are still on top and gaining ground but the rest of the middle class can kiss their dentistry and standard of living good bye.  Even worse, if their kids happen to be born after 1984, their future is in the tank, and they can look forward to a lower standard of living compared to their parents.

While it’s easy to blame all this on government, political parties, or your pick of recent presidents, the truth of the matter is that globalization and flattening courtesy of the information age means that the rest of the world competes with the jobs that used to be secure and as a consequence predictably bought your services.  The same technology that drops the price of all kinds of dental devices also means that millions of other jobs and items are caught in a downward spiral to rock bottom pricing.  Many in dentistry are caught in that spiral.  

• Ultimately, for you as the dentist, this means the requirement to ever tighten down your focus on the 3-5 “silos” of business you wish to create in the practice be that C&B, implants, sedation, sleep medicine, cosmetics, perio, etc. 

• Additionally, all this results in the absolute need install a sales process that systematically qualifies those interacting with your practice both as existing patient and new patient.  [The Maximum Case Acceptance System is our solution to this problem and that System can also be the topic of our entire day together.]

• Lastly, if you aren’t making yourself and your practice a “linchpin,” as Seth Godin would say, your future in dentistry will be challenging to say the least.  Being a “linchpin” means being indispensable, irreplaceable, and non-commoditizable.  The best way to become and stay a linchpin is to associate and hang-out with others doing exactly the same at Big Case—the One Day Session is one more way to do so.

While the ADA isn’t talking about any of this, we are at Big Case Marketing are not only discussing what’s afoot but we’re making sure you are equipped to handle whatever awaits for as long as they wish to be independent in practice.

While the truth of the matter is, from my business perspective, these days would be far better spent working on various new programs, books in progress, and materials for our members here at Big Case, I realize that some doctors want a once a year “mega-hit” of concepts and strategies. 

If you are in that category then this kind of session is also just for you. 

Who are the One Day Sessions for?

1.  Successful doctors who can’t devote the time to commit to full membership in the Big Case Elite Program. 
2. Successful doctors already at a high achieving level in marketing and case acceptance and because of such, a day of “tweaking” will bring faster results.  These doctors seek an unfair advantage over their competitors. 
3. Successful doctors who are in markets that are already closed for new members in The Elite Program™ and who still wish to gain consulting access to Big Case strategies. 
4. Doctors in other Big Case Programs (Elite Doc’s Letter, Maximum Case Acceptance, Individual Marketing Programs)
5. Doctors outside the North American Market wishing to gain insight on how to adapt the principles of Big Case Marketing to the nuances of their local area.  These one day sessions are also a perfect tie-in for those coming to the US from Commonwealth countries and Europe for training in the US.  You can take back the best of marketing, case acceptance, and behavioral data to use in your home country.   

 And Here’s Who it is NOT for?

1. Doctors incapable of altering foundational beliefs about marketing and sales in their practice.
2. Doctors who are struggling financially and whose backs are already against the wall.
3. Doctors who feel they “know it all” already.
4. Doctors who aren’t willing to make changes in the non-clinical side of their practice.
5. Doctors who lack basic practice management systems.

To avoid having the wrong doctor’s show up for the One Day Practice Maximizer™ an application is required.  You’ll find just that attached for your convenience.

What happens during a private consulting session?

Following acceptance, there is a list of practice statistics and details that your staff must provide related to your marketing, advertising, your competition, your case acceptance rates, as well as other pertinent items related to your application that may be helpful for your specific situation. 

This thorough pre-Program H&P of your practice is taken to ensure that the areas that can be improved are focused on to leverage the results you get.

We also have a proprietary system of “Power Questions” that help evaluate your practice before the session. This protocol looks at you practice from the consumer’s perspective to identify areas you aren’t even aware of that are problematic with getting patients in the door and getting them to yes. 

The practice marketing and case acceptance issues specific to your location and practice are also reviewed from top to bottom. 

Lastly, a custom plan of action is specifically drawn out for you to take back to your practice and apply immediately for more cases and more success.  In other words, you are given tools to go home and implement.

What’s the Financial Return?

Just one or two of the concepts discussed in the first hour related to case acceptance are guaranteed to return to you the investment made in this day.

My review of any internal or external marketing you bring to the table can return 10X the fee to you (Just ask Dr. Charles Barotz in Denver—yes the Dr. Barotz of ‘Drop Dead Gorgeous Dentures Fame).

If you are serious about continued success under the elective dental economy, I’m serious about giving you what you need to make it happen.

Best,

James

Much can be learned from our colleagues on the other side of the big bodies of water. 

It’s not unusual to see our cousin dentists over on “the continent” take 3-4 weeks every summer to recuperate from the rigors of dentistry.  Furthermore, it’s also a lot of the rest of the population before you think that is some sort of elitist concept.

Personally, I’ve done this before.  Currently, I prefer taking more than that in vacation each year and like it broken up into smaller chunks simply because it’s nearly impossible for some of us who are so used to being ‘on’ more often than to unplug it for more than a full week at a time.  The last time I did take one of those “euro-months” rest assured, it was a life enhancing experience.  BTW:  Our NZ/OZ kin will be found doing the same thing come Dec (remember it’s opposite seasons down there).

Interestingly enough you find the cultures in these environments to be pretty high up there on a lot of happiness scales.  Not because they make more money (usually don’t) but perhaps because they’re taking more time to smell the roses.

One take home from all of my interactions abroad in other western cultures is to be sure and allow time to create great moments.  Hey, empire building is totally fun, and personally I love that part of life, AND as you never know when your particular sunset is going to arrive live it up a bit every now and then.

Last weekend, my spouse and I got together with some great friends here in the backyard and enjoyed a Spanish dish called paella.  Perfect social food because everyone gets to watch it cook and it’s a one dish meal.  Start with some cheese, add in a couple of bottles of wine, finish with a bite (or 2, or 3, or 4) of chocolate and you’ve got a low hassle maximum social enjoyment and a great moment that recharges the batteries.

Here’s to summer and paella,

James

Please click here to view the video

For most practices, marketing cosmetic dentistry is a waste of time.  Those two words simply have no power with the consumer.

For that reason, I’ve avoided creating any Programs specifically geared for creating cosmetic cases.  However, after mulling over this dilemma for over 4 years, I’ve finally cracked the “da Vinci” code of cosmetics….. 

This new Program cuts through all cosmetic marketing clutter and increases cases for the most skilled dentists in the profession. 

The video link above will give you a sneak peak into our Program.

Best,

James

P.S.  As always, you have to apply for membership in the Program and you must be enrolled in the Maximum Case Acceptance Program so that your sales systems is functioning in your practice.

Recently, I did a one-on-one interview for our Elite Program members with Ms. Sydney Barrows AKA The Mayflower Madam. 

Sydney ran the most exclusive escort service in New York ‘Cachet’ back in the 80’s before New York’s finest brought her down.  Ultimately admitted it was on of the best run business operations they had seen. 

Sydney went on to write a number of books, including a New York Time’s best seller that has wound up in dozens of business schools as an example of how to “do it” right when it comes to a successful business operation.

Sex and Sex appeal has a lot to do with pretty much everything being sold which is elective.  That by the way, doctor, includes most comprehensive dentistry.

If you’d like to have an opportunity to “be in the know” with some of the discussion from this interview, pay attention because I’ll be posting just how you can do that in the next few days.  It won’t be free but it will be close enough that I’m sure you’ll be more than happy to “peep” in on what was said for your success.

Here’s to being sexy,

James