DSO Performance Marketing and Online Scheduling Strategies with Daniel Sosa and Amber Nish

Alec Goldman:
Welcome to how I grew my practice. Third episode today, a podcast presented by NexHealth. I'm your host, Alec Goldman. In this episode, we have Daniel Sosa, CEO of OM Performance Marketing and Amber Nish, their VP of Business Development and also former CMO of Community Dental. They are here to discuss DSO performance marketing and the importance of online patient scheduling. Daniel, Amber, it's so good to see both. How you guys doing today?
Amber Nish:
Awesome,
Daniel Sosa:
Great
Amber Nish:
Doing great.
Amber Nish:
Thanks for having us.
Daniel Sosa:
Yeah, same here. Super happy to be here and excited to jump in with you guys.
Alec Goldman:
This is our first episode where we're doing three people myself and the both of you too. So very excited to kind of just have the conversation live with both of you on the specific topic. But before jumping in, it'd be really great if both of you guys could do an intro. Daniel, we'll start with you running performance marketing. You give a bit of background on who you are and kind of how you ended up in this space. And then I think it's really interesting, Amber, how you ended up joining Daniel. So Daniel, let's start with you and then Amber we'll go right over to you.
Daniel Sosa:
Awesome, awesome. Yep, so Daniel Sosa, I'm the CEO of Owen Performance Marketing. What we do is create measurable patient acquisition systems for DSOs. The reason I ended up in this space, actually, that my firm specializes in med tech and fintech, so I really like B2B SaaS marketing. Through that work, we ended up working with a DSO. Obviously really large, sexy industry, and realized the state of digital in that industry was what I call, like say 10 years behind. Very often it's what I call checkbox marketing, PPCs, SEOs, and review management. It's just very much that sense. We wanted to bring our proven framework and expertise. marketing execution into the slow-moving industry to help elevate the baseline and really that's what we're trying to do and bring performance marketing and attribution-based marketing to the DSL space.
Alec Goldman:
Really cool. Amber, welcome.
Amber Nish:
I have the privilege, had the privilege of working for Community Dental Partners, as you said. I was the Chief Marketing Officer there for a few years, but sort of built my career in marketing there. One of the things that as the world evolved and marketing shifted and changed, I needed to build an entire digital marketing platform at CDP for patient acquisition. Actually, we needed support with recruiting as well, which was another place that we were struggling with at the time when I was the CMO. So it gave me the opportunity to understand what I needed and what results I needed. And it was always patience and patience in the door, but needed to create a digital foundation. Worked with a couple of different groups and ended up discovering Daniel with OM and came in and he built something really awesome with me and with the team and we really worked together, worked with our other partners, as you guys are well familiar in, we'll talk about that some today too. Really gave me the opportunity to understand what it could be like to be supported by a digital marketing agency that had evolved past where we were in the digital space and in the dental industry.
And so as things evolved at CDP, I was excited looking for some opportunities to grow and really felt such benefit from what OM had brought to me as a leader that I wanted to kind of package that, partner with Daniel and say, how can we take what we built? out to other industry leaders, because I knew how desperately we needed that. I knew how desperately other leaders would benefit from the products the reporting and the strategies that we had built. So, in the last couple of months, we decided to partner together and see if we can bring some awesome support to the DSO groups. So, that's where we're at today. That's how we came here.
Alec Goldman:
Yeah, I think it's a really unbelievable story. Obviously as the CMO of a large DSO, um, going through the process of finding, you know, agency after agency agencies always meet their promises kind of will communicate a very similar playbook about what to do from a paid perspective, organic, social, what are you doing for reviews? Again, uh, I think Daniel had a nice framework for calling just like checkbox marketing, but Amber you ended up. moving from agency to agency, I guess. What was it working with OM that made you recognize that they were the right company that fit the community at the time?
Amber Nish:
Yeah, a couple of things really stood out about my relationship with OM. One is that we were aligned on the same results metrics. Many groups that I had experience with or had interviewed and decided not to go with got excited about metrics that they came up with and they created and wanted me to be excited about it. It was simple things like impressions or leads or we generated this many phone calls, but none of that mattered to me if it didn't translate into appointments on the book. OM was really aligned with it, we are going to work until we can all talk about appointments on the book and what is going to take to get us there. So I think that was the first major alignment.
And then the second one had a lot to do with OM's consistency and desire to and willingness to project manage really articulately through the process so that our integration was really smooth and the promises that were made upfront, you know, in those big sales pitches up the front of all the cool things we're going to do for you. somebody has to project manage that and make sure that all the tasks get done to execute on that. Daniel and his team do a remarkable job of owning the project management of that piece. It brought so much support and clarity and even training to me. It was a new space for me. And so they were willing to kind of sit in it with me and train. And so I would say those three key things were critical to our relationship and what made me ultimately choose them, stay with them, and then come. decide to hang out with them.
Alec Goldman:
Maybe there was some convincing there, but it does sound like kind of the proof is in the pudding with what Daniel was doing in the community.
Alec Goldman:
Daniel, obviously that speaks volumes. It would be really awesome today if you could kind of walk us through your playbook that you're deploying for DSOs and what was it from a very literal perspective that made Amber feel so, uh, both attended to, but also created results for community.
Daniel Sosa:
Yeah. Um, I might even have some visuals for us, but I think the fundamental piece before I get into visuals is, um, something that I'm sure even you guys experienced at NexHealth, which, um, we call it pipeline-based reporting and pipeline based feedback loop, right? Or, or a patient-based feedback loop where there's so much and the, I blame the platforms, right? The Google ad and Facebook ads for. getting us obsessed with conversion data. We really, need to start working our way back and letting that feedback loop come from customer data. So we're not optimizing for leads or for conversions because, with today's technology, conversions are simple. I can create Facebook lead ads and get you many emails in your CRM or your patient management system, right? Getting people in the door. and adding to production is very difficult. And if we really begin with that data set and have that guide our execution, whether it's organic marketing or paid marketing or social media marketing, you're gonna be able to influence the difficult metric and provide data back to the company to make decisions. And that's really the core of what we do is we wanna make sure that we're starting with the things that move the needle. and letting that drive our digital strategy. Because we want to bring patients in the door. Is it cool if I bring up some visuals?
Daniel Sosa:
So one of my favorite things to talk about is an internal framework that we've created here at OM, called the Convert Framework. And this is really what we deploy at companies. It's a fundamentals-based approach to building measurable and scalable patient acquisition systems. And that begins with a lot of what people skip. It's too easy to go straight to more money at Google Ads and more money at Facebook Ads. We want to have your fundamentals of digital and your analytics in a really, really strong place. Once you have effective reporting and effective feedback loop, we work in the in-market patient acquisition, right? That's your Google ads, your Facebook ads, like the tools to capture those people who are actively looking for their next dental visit.
When you have a healthy foundation, when you have the tools to capture people who are in demand, we work with our partners to create. demand, right? Create patient demand. That's your content strategies, your SEO strategies, how do you your branding strategies. How do you get some We have a healthy foundation, then have the tools to capture demand, have the tools to create demand. So then it really creative strategic marketing happens because you have a complete measurable tool set to work inside of. Um, and then it just becomes taking campaigns or concepts or new product releases and pushing them through that framework.
And really what we want to do is help people build these systems so they can be more scalable. And when you're more scalable in the DSL space, you're either set up to grow and effectively roll into bigger organizations or. have such a healthy system that you can even roll other organizations into your organization really seamlessly. We want to be that type of company that's fundamentally sound so you can be as scalable as you need to be to hit the next level in your business. Um, does that make sense?
Alec Goldman:
Clear to me. wanted to double-check integrated patient acquisition and reporting.
Daniel Sosa:
Yep.
Alec Goldman:
No, I don't want to get too far ahead. I know that there is also kind of just going through all the metrics in the funnel,
Daniel Sosa:
Yeah.
Alec Goldman:
But something that we kind of mentioned in the DSO performance marketing that, um, just like the topic for today also includes online booking and I think something that is historically a problem is that when you're focused on conversion in leads, you're really focusing on email. But in order to focus on getting patients in seats, you need to create additional metrics, right? So one way that I know that you guys, we've partnered together collectively with community, but also what you're doing with tons of DSOs is leveraging technology that would be known as kind of a patient experience platform where you're leveraging things like online booking, reminders, even things like forums to understand all the different touch points to get them in the seat.
Alec Goldman:
So wanted to kind of go through the, not just the framework here, but also the literal details of what that actually looks like.
Daniel Sosa:
Yeah, this is my favorite topic. Um, and we have some kind of industry data that we've pulled from, from various partners to show, um, and why I love this topic because it's easy. especially in the marketing world. There's so much marketing jargon to talk about, high-level marketing, and again, PPC and Google Ads and Facebook Ads and all these things, but what does it actually look like? How do agencies or partners collaborate? How do we use tools like NexHealth?
So what you see here is a real example of how to do marketing. how we do that and how we get down to measurable results for our partners. And to waterfall this a little bit, what you're seeing here, this sample set is from a group that has about 80 locations and we have very top-level data. How many total appointments are we getting? What's our cost per acquisition through paid channels? How are we trending toward our production goals? Obviously, at a very high level, how are we trending this in the direction that we want it to go? In this example, you're seeing our cost per acquisition going down month over month, our total appointments going up, or staying steady.
This is a really interesting data set because this happened during post-COVID when money kind of tightened up and our goal was to be able to decrease spending while maintaining patient volume. But to get into a really tactical collaboration with our partners, it goes a layer deeper where we understand, as I mentioned before, that the feedback loop starts at patient schedules, not at platform conversions.
So what you're seeing here is how we're working hand in hand with the operations team. And we kind of see us and them as the revenue team. Our goal is to drive revenue and drive production inside these practices, to track top-level metrics, right clicks, direct online appointments through NexHealth, total inbound calls, all these things that we
Alec Goldman:
Thanks
Daniel Sosa:
influence
Alec Goldman:
for your time.
Daniel Sosa:
through digital, and then waterfall that into what is actually happening at the practice level. So not only are we saying, hey, we got you all these direct online bookings, pay us more money. How many of those are becoming? opportunities and how many of those are actually scheduled in the books. And I'll stop in just a bit. But what makes this really powerful, especially when you have a ton of locations and you're trying to build these scalable organizations?
It's a lot of decision-making, a lot of budgeting decision-making, and prioritization. So right now, I'm filtered by cost per acquisition. So you can see, out of all these locations, these are the lower-performing locations. Our marketing metric, which is what percentage of leads schedule is low. and our sales metrics. So what percentage of those leads, all those opportunities to actually schedule and get on the books is low? The outcome is this is our highest CPA across all the locations.
Daniel Sosa:
Alternatively, you have a bunch of healthy ones down here, which are $20, $30, very high-performing locations. Some of these numbers are grayed out, but we push that all the way through to production. So we set monthly production goals per practice. And we work against those goals. And it's really effective patient acquisition and really effective data that helps leadership and marketing leadership decide how to take action, how to be strategic. We're not just a group that operates independently and runs your PPC and SEO. We're a group that's working hand in hand with the operations team to make sure that we're effectively growing revenue inside an organization. And I think that is not just what we do and what our framework is built on. I think this is a requirement in today's business. If your partner is not deeply focused on real business growth, that's a misalignment in a partnership, and a strong partnership needs alignment.
Amber Nish:
Alec, I think one of the things that get missed in the mark is that everybody wants to look at their individual sort of department or siloed-level metrics, right? So you're at risk of, let's just say the marketing team is like, Hey, look at all these leads we got you. Could give me more money? I'll get you more leads. But if we're not collaborating with them, do those leads yield actual appointments? Are we giving folks the opportunity to schedule online directly? which is going to absolutely increase your lead conversion rates, right? Are we answering those calls? And then to the point, are we, are we measuring whether or not that's a quality lead?
I just had a great conversation with another DSO leader. It was like, look at this marketing company. Well, how would you analyze this data? They're bringing me, we give them more money. They get us more leads. Why aren't our patients every month going up? I'm like, yeah, there's a disconnect. We got to go in and analyze. Where is the breakdown? Are you not answering your phones? Are we shoving a bunch of leads to you and nobody is answering the phones? The answer to that is 30, 40% of the time. That's true. That the phones aren't even being answered. Are you looking at the data to connect the journey all the way through? And if you don't have time to answer your phones, make sure that they can direct online books, right? But are your teams answering those calls and getting a bunch of bad robot sales calls? Somebody has to be able to tell the marketing team, that your lead is not a quality lead.
Otherwise, the marketing group is just sitting back there going, my metrics are awesome. We're crushing it. Look at all the leads we sent you and that if we look at metrics individually, that is a high-risk situation where it's like, well, hey, it's not our fault. It's your fault. You've got to answer the phone. Or you're not doing this right. But we need that feedback loop that something like this creates so that marketing and operations are communicating together to watch that process all the way through to help ensure that every step of the way is healthy. which I think is critical.
Alec Goldman:
I mean, dentistry is such a local business. So for a DSO, essentially they need to be managing a marketing department per location, not generically over all of the locations as even taking a look at this type of dashboard in front of you. Given that you have a high CPA and low production, your actions at that specific location are going to be fundamentally different from a location that has a much lower CPA. but a different production number, right? So you really need to be granular about each of the recommendations and suggestions you're making at the practice level, not at the DSO level.
Amber Nish:
Yeah, for sure. And I think the only way to get to that is something like this. When you don't have visibility into each location and how you're performing in each location, what the outcome is, you are making these top-level, broad sweeping decisions that may work for some and may totally fail for others. And you don't even know. You don't know what's happening because you're just making these sweeping decisions and running these marketing campaigns, right? We're all going to. run an advertisement for $50 this or in every practice in the DSO is going to do it. But without metrics and systems set up like this, you won't be able to tell whether that's working for that practice and whether it's solving the problems in that location, which I think is, is a miss that's pretty frequently created.
Daniel Sosa:
Yeah, I think one just one last thing I want to show here is just flip what you said, Alec. At the execution level, at my level, to be effective, I need to be able to break down the location specific, like you mentioned. However, at the DSO level, the organization needs to be able to make sound decisions. And when you're doing checkbox marketing, you don't actually have that ability. And the example that I'm showing here. In this case study, we highlight a pretty unique metric, which is a decrease in budget. Anyone who was in business in the last three years probably experienced what this example experienced, where budgets went through the roof during COVID. And then there was a need to decrease the budget at money kind of tying up. To decrease budget when you're a high-growth, high-flying organization can be a very risky thing to do.
And if you don't deeply understand your patient acquisition metrics, it's a very difficult decision to make. And again, with this client. we were able to drive huge decreases in budget while continuing our increase in effectiveness and keep patient acquisition while reducing costs and giving the leadership the ability to say, okay, let's incrementally drop 5% month to month to get to where we need to be and know that they can do that without putting too much risk on the business. I think this is part of that need for marketing to be, and marketing partners to be integrated with the DSO or the dental group. It's a function of business and can't operate as a fully externally disconnected partner. It needs to just be a core part of the business, the same as clinical or operations are.
Alec Goldman:
Amber, did you want to add anything there?
Amber Nish:
Yeah, it just makes me think of just because of my experience that when we were in the throes of things like this, we were able to even in locations where staffing was a challenge, in locations where getting a doctor in was a challenge, we were able to be the partner that said, hey, we actually can help you understand what will happen in marketing if we drop some spin. In fact, it may lower your patient numbers, but that's kind of what you need right now. you need to slow down patient flow because operationally you can't handle it. Or you have to slow down spending because we don't have a doctor, but three days a week, right?
We had some locations that were open on different days and things like that. So the power of the systems that we built enabled very strategic leadership decisions to be made that genuinely two, three years ago we would not have been able to make. That's what I love about digital marketing and the data that we're able to collect through that is we can really get smart and make strong strategic decisions that support the entire business. Like Daniel said, your team is a part of your business. It's a partner in your business and not just an outside vendor that sits over on the side and isn't integrated with your overall KPIs.
Alec Goldman:
So I think, again, it does sound unique in the way that the framework and the literal details of the dashboard that you're providing the DSOs. But it also, that dashboard is contingent, not just on the big platforms and running ad campaigns and doing things through Google, Facebook, et cetera, but you're also contingent on really making sure that you understand the patient data that ultimately lives in an online scheduling tool or an EHR. So it means that a lot of your business is contingent on selecting and working with the right partners. How do you guys kind of think about vendor selection as it's such a fundamental part of your own success?
Amber Nish:
Yeah, I think for us when we, cause I did a lot of vendor selecting conversations, right? I had a lot of opportunities to do that. One that was really important to us was an open API, right? We could integrate and work well with one another and grab data that we needed that may not be essential to what that business function was for the vendor, but we needed it to help us do things like create reports like we just did. And also that was able to serve us with Again, similar to the project management, the willingness to complete the things that you promised we were going to do up front and collaborate with other partners. For me, when the collaboration with NexHealth and OM was succinct, conversations were happening that I didn't even have to be in the room for, right? Because everybody was willing to kind of connect with each other and put things in place to give me the information that I needed. So I would say those were two strong ones. Daniel, what would you add to that as we think about that from the OM side?
Daniel Sosa:
Yeah, it's an interesting question that I can get into both the technical needs and expectations, but to me, all that is driven by my goal of meeting today's consumer expectations. Today's consumer expectations are a great user experience and integrations, so all their information and needs can be done effectively. and analytics so that experience can continually get better and better for them. So what I'm looking for, whether it's a phone system that we implement with DSOs or an online scheduling system like NexHealth, is whether are we able to do these things that, in my opinion, are fundamental to modern effective patient acquisition and modern effective patient experiences. And again, it's user experience, is online booking or online scheduling and that process clunky and outdated, or is it up to date and meets expectations that we expect? Does it have the proper integration?
So it allows us to operate holistically and with all our tool sets. For me as a digital marketer, analytics is extremely important. So much money goes into marketing and digital marketing. And if I can't effectively track that, I might as well go back to putting up TV ads because that's the only difference. The key benefit of digital marketing today is that there's data that allows me to optimize and get more effective in real-time. And I don't want to keep plugging in NexHealth, but what NexHealth has done really well, for me as an analytics geek, is their Google Tag Manager integration is super strong. So we're able to pull so much data through every booking to get better, not just isolate conversions, but isolate conversions that have the type of insurance structures that we like, or different payment structures that we like, and really optimize for the perfect customer for this specific DSO. Those are the things that I'm looking for when looking for technology vendors.
Alec Goldman:
We're at the 26-minute mark and I don't want to end on too optimistic of a note because I know that the last, if you were to say, where are we in the DSO market? Your opening statement was that we're lagging, but obviously, OM marketing is doing a great job, not only winning over customers, but you're able to take customers and almost bring them to your own team with Amber. What does, what's on the next front for OM? How are you guys improving your business? What do you kind of think is next? few years of integrating new technology into your offering and how do you think that changes what DSOs should be looking at?
Daniel Sosa:
Um, I'll kick this one off. And what I'm looking for today or in the next few years is not so much. Continued integration of new technology. It's how do we, what I'm trying to do is elevate the state of it as a whole. It's easy to imagine what the next generation of NexHealth will look like, but the reality is too many, too many dental groups don't even have online scheduling. So like, how are you meeting today, how can you be customer-centric if you're not doing what the customers expect? Of the ones that do have scheduling, I bet. 85% of them don't have conversion tracking and analytics around these tools. I'm really committed to highlighting the problem that's going on in digital today and helping people get to the next level. I like to say I built an industry, I built a business out of being the third agency people work with, because
Amber Nish:
Thank you.
Daniel Sosa:
it's the same story. And if you're not an expert, you hire the agency that does all the nice jargon, and you go to the second one, and then eventually you find someone like us, and we actually follow through and deliver. So for me, V1 is let's elevate the state of digital marketing in the industry, and then let's really drive expert, world-class. digital acquisition, which is what we want to keep doing with companies like NexHealth and some of the phone systems that allow us to get really, really measurable when it comes to these strategies that we're executing.
Alec Goldman:
Amber, do you want anything?
Amber Nish:
Yeah, I would just add, I think one of the unique things that we're pulling together at OM is the DSO leadership side, where the partnership is great because there's all of this technical background and all of this capability that again, served me so well. But another thing that I've discovered is lacking in the industry can sometimes be a deep understanding of how to run a marketing department and how to think about... marketing as a strategy for business objectives. I think I got such a great remarkable education at CDP with some of the strongest leaders in the industry. And so now I want the opportunity to partner with somebody and say, hey, we've got all this technology and we can really help you. And I'm gonna come in and I'm gonna help you build that dashboard, for example, and think about strategy and think about how to lead your department and communicate with your executive team leaders.
And and really feel like I can elevate the state of marketing leadership in the industry as well, because I think marketing has been such a black hole for a long time and it's like, we don't know, we're just throwing out money and we're hoping that the right thing is happening. And I really wanna come in and partner with them and be a part of the team that helps all of the leaders in the space feel like they understand their role a little bit better and can serve the clinicians at the end of the day. DSO's sole purpose is to serve the clinical team and the clinicians who want to grow their businesses. And so I want to help leaders grow in their capabilities as well. And so I love the partnership that we can provide is there's strategy, there's vision, there's technical and tactical sort of all wrapped up in the partnership that Daniel and I have with the team at this point.
Alec Goldman:
You guys are doing great work. Um, thank you both for joining today and, uh, not only talking about the team that you guys are building over at on marketing, but Amber also thank you for sharing your experience and working both with NexHealth and on marketing. Um, it was really awesome having you guys on the show and I'm excited to have NexHealth join your podcast in just about a week.
Amber Nish:
Yes, awesome. Thanks for having us.
Daniel Sosa:
Okay. Oh, yeah. Thanks for having us. And like you mentioned, we have a podcast as well. And one of your team members will be on next week. So check it out. And I'm a huge fan of what you guys are doing at NexHealth. So keep it up.
Alec Goldman:
Thanks so much, guys.
Amber Nish:
Thanks.