Entering the healthcare industry as an executive in 2003 was a vast departure from the finance markets I had been working in. Something in my way of seeing business prompted a friend and mentor to introduce me to a surgeon in Las Vegas, which eventually led to a 5-year run that was amongst the top in the sector. That became the springboard for starting my consulting firm in 2008. Since that time, I have repeatedly implemented ten foundational principles to transform and grow a variety of specialties.

Now, I need to make an important point. The single most difficult hurdle I had to (and often still do) overcome was creating a management philosophy and an internal brand message that helped physicians grow comfortable with marketing practices. Although at times early in my experience I did occasionally cheapen the message by applying non-medical messaging I learned how to elevate the message of “care” utilizing innovate and tried-and-true marketing principles.

The experience taught me a great deal about how to engage with patients, aka. customers. It also revealed that medicine was evolving, and the “big business” side of the industry was shifting the traditional dialogue for the individual practice. (Note: The principles that grew out of this experience are especially effective for practices with some or all cash/elective procedures or services – and mostly effective for any specialty.)

So, here we go. What I’m sharing here are 10 essential ingredients proven in our consulting to transform your practice.

Business Structure Is Essential

I am grateful that medical schools choose to spend their time training doctors on their specialty rather than what business schools teach their students about operating businesses. When my life is on the line or I’m laying on a treatment bed I don’t want the best MBA in the room with a scalpel in hand. I want the most highly trained and competent medical specialist for my specific treatment.

Think of your practice as a traditional manufacturing business. The clinic is your production floor – it’s where all the widgets (diagnostics, tests, histories, etc.) are assembled for final sale. You, the physician, are the final salesman of your product. Behind the scenes is an executive team who has laid out a clear strategy for producing the highest quality products at the highest level of service. Some practices have this solidly in place. Most practices do not.

To put it finely, here’s what you need:

  • Leadership Structure
    • CEO: The Man or Woman with the plan – strategic, visionary, head decision maker, clear-minded maker of purpose
    • COO or Director of Operations: backstop, go getter, head executer of all things tactical
    • Team Leaders
      • Reception: customer service idealist, relentless purveyor of kindness and welcoming
      • Medical Staff: efficiency master, creative communicator, innate leader of wage workers
      • Surgical Staff: doggedly detailed, precisely planned proactive producer
      • Billing Staff: money minded, perfection-oriented generator of cash flow
    • Customer-focused team members: until or unless you have the right people on your team that sincerely wants to be selfless and service oriented, no matter the circumstances
  • Strategic Plan
    • High level overview of what your business needs to be and can be in the next 18-24 months (throw away your five year plan right now!)
  • Tactical Plan
    • 2-3 page document detailing what needs to be done, who is responsible for doing it, and when it is supposed to be done

Customer Service is Job One

Patients, aka customers, are the sole reason you have a business. Act like it! This doesn’t mean the customer is always right. I don’t believe that. If they’re not right because you’re wrong in the way you treat them make it right. If they’re wrong because they’re wrong, there are more fish in the sea.

Allow me to digress. My wife recently had a consultation to do a retrofit of her nose and airways. For years she’s suffered from a deviated septum and has finally decided to get it fixed. While waiting with her in the lobby, I was appalled at the treatment the reception desk provided their patients. It was clear that this practice had no vision, weak leadership, and poor business structure. They were relying solely on a surgeon’s good hands to stay busy. If they were to have a clear plan for their business, they would transcend.


Phones are almost always your first, middle, and last impression. So, you must invest in your phone team to make sure they are the right people with the right skill set. Just because someone owns a phone doesn’t mean they know how to use it. Invest in skills training regularly. If your reception team is taking calls and you have a busy practice, evaluate if it wouldn’t be better if you had a central call center. Distracting your reception team from the customer is never a good idea.


Your reception team is and has been overlooked for years. Because they are paid the least they are treated with the least respect. Remember, for every patient you or your medical staff see or treat once, they interact with at least 4 times on average per visit. Reconsider putting your best staff where everyone can see them and stop treating them like second class citizens. Again, invest in their skill and service development!

My grandma was one of the most proper women I have ever known. She wasn’t born to any high station. She was simply trained by her parents that being mannerly was the ultimate show of respect to others. Grandma taught her sons and grandsons that any time a lady entered the room a man should stand.

I have applied that principle with all reception teams I have ever led or consulted. It is amazing to watch how significance is communicated with that simple gesture. In 2005 I warned my reception team that if a patient’s foot hit the floor across the door threshold without them standing, I would fire them on the spot. It only took one offense for them to see how serious I was about this top shelf customer service gesture. Implement it now.

Medical Assistants.

These critical personnel need to be almost as acquainted with your strategic marketing plan as they are their operational protocols. Here’s the test: if you wouldn’t be proud of them at your side in a public social setting, they probably aren’t a good fit.

There are thousands of amazing service-oriented people out there who can be trained or certified to fulfill their duties and enhance the effectiveness of your marketing efforts. They prove to the customer that what you said they were in your marketing materials is either true or false.


You are the sole reason anyone comes to your clinic. When you have created a team and culture of customer service your job will have more vitality and provide your patients with better care. Your ideal encounter should take, on average, seven (7) minutes. This helps you concentrate your care, focuses your patient on your diagnosis and treatment plan, and leaves them feeling like you are who your marketing says you are. There are, of course, exceptions to this time standard. They are few. Hone your engagements and watch customer satisfaction increase.

Proper Personnel Training Equals High Customer Satisfaction

Our most successful clients invest the equivalent of one high performing full-time employee’s annual salary each year on staff skills development. Those who grow exponentially may invest twice that much. In return, most make a multiple of 20-30 times on that investment. Especially in elective medicine (ophthalmology, plastic/cosmetic surgery, orthodontics, aesthetics, etc.) this multiple can be returned as often as quarterly. My case in point follows:

Elective Surgery Practice In The Southwest

  • Conversion Rates
    • Prior to consulting: 28-30%
    • Post consulting: 57-60%
  • Surgical Volume
    • Prior to consulting: 25-30/mo
    • Post consulting: 60-70/mo
  • Advertising
    • Prior to consulting: $7-8,000/mo
    • Post consulting: $40-50,000/mo
  • Pricing
    • Average per procedure prior to consulting: $1,800
    • Average per procedure after consulting: $2,600
  • Revenue
    • Prior to consulting: $45,000/mo
    • Post consulting: $182,000/mo
    • Post consulting ROI (including ad spend): 2.16 or 216%

Our method for these results took 18 months to fully execute. Gains occurred within 60 days due to our aggressive training schedule of 3 days per week two times per month. Our training regimen started with proper phone skills, followed by proper reception skills, followed by proper clinical service skills and scheduling, followed by proper physician interaction skills. The outcome is extraordinary and common with practices who want to be great.

A word on personnel selection. Take more time to hire. Take less time to fire. You and the employee know whether they’re cut out for the job you’re asking them to do. Don’t waste time getting aligned and proving that your marketing promises are true.

I have a short list of failed marketing relationships with medical practices.

In one case I failed to realize that I was desperate for their approval, rather than fighting for what was right. After spending five figures, not including my retainer, of my client’s money, I realized I hadn’t done the hard work of knowing their market and crafting a message consistent with their practice patterns and potential customers behavior. I wish I could take that one back.

Marketing Isn’t Always Selling

In fact, marketing is the parent discipline to sales and advertising.  Marketing is about message. More than message, however, it’s about authentic messaging. Marketing is the part of your strategic plan that determines:

  • What your market is
  • What your competition is
  • Who your customer is
  • What your customer wants/needs
  • How your customer needs to hear your message
  • How to get your message to more customers

Marketing is the overarching concept about how your practice should be positioned in the market to achieve optimal growth. It involves a host of sub-disciplines that need to be synced up and performing at a high level. When this is achieved, market share is captured.

Adverting Messaging Matters

Suffice it to say, what you say about yourself matters. More than just that, it’s how you say it – both in your media and in your practice. Consumers buy more because of how they feel than what they think. This is especially true with medicine – even more so with elective medicine.

Cognitive Dissonance has proven to be a primary factor is people opting not to buy, even when a strong desire exists. I see this most frequently manifest when someone seeking elective procedures comes to a practice after being persuaded by highly effective advertising.

The patient comes with excitement and anticipation, mingled with some apprehension. They want what they were sold on the Radio or social media ad. Then, their experience differs vastly from the messaging that persuaded them. Instead of a caring doctor they found a distracted one. Instead of being greeted by a staff that felt like the message they were casually engaged or treated like a distraction. Instead of a counselor that confirmed the value they expected they met a timid teacher.

You get the idea. If it doesn’t feel like it sounded, you will lose customers. If your message isn’t clear and persuasive, you won’t get people to click or call. Craft a message that is authentically you – unless the authentic you is broken. If that’s the case, fix you before you invest in spreading the good news.

Selling Isn’t Shady

We hate the idea of selling in medicine because we equate it to a bad car buying experience. I have a few really good friends who are car salesmen. I feel badly they have been painted with that brush. To be fair, the industry has earned their reputation.

So, don’t act that way. Be a teacher. Educate your patient on risks, benefits, and alternatives. Teach them why your treatment plan is in their best interest. Educate them on the long-term value of the treatment and give them time to make sense of it. Never settle for lower fees that the value merits. If you have a problem with price it is due to the fact your value doesn’t match.

I have a simple philosophy about sales. Sales is nothing more than giving people what they want, when they want it, at the value they can see, and an affordable way to pay for it.

Media Is the Medium

No matter what your business is, media is the medium most likely to accelerate your growth. Here’s another case in point.

In 2003 the practice I began managing was performing around 25 elective procedures per month (+/- 10% for memory’s sake) at an average fee of around $1,600 – smack dab in the middle of the market (any pricing strategist will tell you this is the worst place to be).

The top 3 sources of new patients, in order, were: Referrals, Word of Mouth, Existing Patients (patients who came in for one thing and added another). To grow, we determined a robust marketing strategy needed to be implemented. SEO was nascent, social media marketing was non-existent, and Google ads were evolving. TV, Outdoor, Print, and Radio were the media kings of the day.

We executed an aggressive strategy, planned for 12 months. After month two and six figures the doctor came to me and asked me to stop the advertising. When challenged he said it was because it wasn’t working. When challenged again he said that media leads hadn’t overcome the other top three sources. It was true. I argued however, it was because media takes time. He countered by not signing the checks.

Interestingly, all three of the top lead sources had increased during the media run. No thanks to insufficient data, I could only argue the hunch that the top three were performing better because of the media. I lost the argument and we paused the advertising.

In 45 short days our lead and surgery volume had decreased dramatically – to say nothing of revenue. An analysis of the data revealed something interesting and persuasive. Not only had the top three declined, but they had declined below their previous averages.

In the end, volume quadrupled at the highest price in the market and our team was regarded as one of the top performing in the industry. The transformation exceeded seven figures.

I learned a valuable lesson about my hunch that I later proved with irrefutable data. I learned that media, when properly implemented for a practice with its act together is the tide that floats all boats. I probably don’t have to say it. But, I will. Media makes wealth by getting your customers to you instead of someone else.

Growth Is Essential

Your market either doesn’t care about your success or wants you to have less of it. So, staying the same is actually you in decline. Your market has at least one other organization trying to gobble up as much market share as possible. Unfortunately, this sometimes is the least deserving competitor. So, if your mission is to do great things for people, you must commit to a growth strategy.

A more recent case study involves one where I wasn’t sure I could offer much help. Their conversion rates seemed good. Their pricing was close to on. And, they seemed to have a stronghold in their market. Internally, they are committed to success and decided a consultant was in order. I was gratefully selected.

In less than three months their conversions increased on average by more than 10%, resulting in financial gains in the millions. In one procedure segment they have nearly doubled conversions.

They have never looked back and are growing and expanding at a sustainably impressive rate. Each month we train their entire staff, including physicians. They just keep getting better.

Wealth Isn’t the Enemy

Prosperity equals improved healthcare equals happier, healthier customers equals prosperity. Thriving and becoming wealthy should be the rightful outcome of physicians who pay the price of time and money to become who they are and do what they do.

Not Marketing Is NOT an Option

Whether you’re doing it for the money or doing it for a higher purpose. Marketing your practice is essential. A well-rounded strategy will have at least some combination of the following:

  • Referrals and recommendations
  • Word of Mouth
  • Digital Media
    • Google Ads
    • SEO
    • Social Media Ads
    • Social Media persona
    • Video Media (YouTube, Podcast, etc.)
  • Traditional Media
    • Television
    • Outdoor
    • Radio
    • Print/Direct Mail

The combination depends on what the data tells you. If you don’t know what the data is or how to find it, you need to hire someone who does. My first marketing contract was a radio, newspaper, and direct mail campaign. Later we added TV and endorsement deals for professional sports teams.

For reasons I can’t get to in this article without putting you completely to sleep, I do the traditional media only in specific markets for specific reasons. It’s not that they’re bad, they’re just harder to track. I am wary about spending that doesn’t have accountability.

Regardless of what’s best in your market, having a fully executed game plan will change your practice. As you can see, to me the marketing strategy has as much to do with your operations as it does your media. If there were a silver bullet, it would be this: aligning external message with internal realities and spending to the point of diminishing returns.


These ten things aren’t the only things to consider for your marketing strategy. They are a good glimpse into the framework of success for marketing your practice. The devil, as they say, is in the details.

Creating the plan and framework is the first step. Start today with defining that for you and your practice. Then, start to assemble the assets (trainers, media, creative, content, etc.). Next, make sure you have an execution strategy with clearly defined action items and measurement. Finally, execute and correct.

I am yet to find an example where this doesn’t work free from uncontrollable externalities like death or government interference.