How to Scale Your Practice With Dr. Shankar Iyer

Nov 9, 2018 | Podcast

Trying to scale your practice but feeling overwhelmed by all the “marketing gurus” telling you to implement Google ads, SEO, Facebook ads, email marketing, plus everything under the sun immediately? Take a deep breath! One thing at a time. It’s important to determine what is most effective for your practice.

In this episode of Dental Marketing Secrets, we’ll cover:

  • Dr. Shankar Iyer’s recommendations on how to successfully scale your practice
  • Why it’s important to focus on ONE marketing avenue at a time and succeed at that rather than taking on too much, too fast
  • An easy method to get Google reviews from patients
  • How to handle price shoppers
  • Why proper training should come before marketing

Today, I spoke with Dr. Shankar Iyer, internationally recognized prosthodontist and Past-President of the American Academy of Implant Dentistry. He emphasized the importance of tackling one marketing avenue at a time and really giving it time and dedication. Once you’ve mastered that, move to the next one.

Watch the Interview Here:

Read The Transcript of The Interview With Dr. Shankar Iyer:

Alyssa: Welcome to Dental Marketing Secrets! Today we have Dr. Shankar Iyer, who’s awesome! And just to introduce him – are you the current president-elect of the AAID? Or are you the past president?

Shankar: I’m the past president. I was the president last year.

Alyssa: Ok, so maybe I’ll just let you introduce yourself. I’m sure you’re going to do a better job than I will! So give them a little bit of background about yourself.

Shankar: All right. So I’m basically a full-time practitioner and I have a practice in Elizabeth, New Jersey. I also teach at Rutgers University in the Department of Periodontics and Prosthodontics. I’m a prosthodontist by training.

I also run several courses on dental implants around the world. I have four centers overseas, and I’m also co-directing the course with Dr. Minichetti in Las Vegas and Dr. Jack Piermonti at Rutgers University. So that’s basically my background.

Alyssa: Awesome! So very successful, right? And I was checking out your website. I saw that you guys recently did some rebranding. Your practice was Smile USA and now it’s Malo Smile USA?

Shankar: Yes. That’s right.

The whole concept of rebranding came about because there was an increase in demand for immediate solutions for full launch restorations. And we did notice a lot of changes taking place especially when it comes to affordable solutions. In the past, we used to nurse the case along. We used to stage these cases and drag them on for about a year or a year and a half. We found that is sometimes met with a lot of resistance in the patient.

They’re looking for an immediate solution that will give them some kind of confidence. So we looked into some options. Dr. Malo approached me and asked if I would partner with them in the United States to rebrand my Smile USA into Malo Smile USA.

It’s going to be two years now. We started this at the beginning of 2017 and now the headquarters are going to be moved to Elizabeth, New Jersey. So that’s the reason behind rebranding our existing office structure.

Alyssa: Oh cool, yes, I saw that there were three locations right on your new website?

Shankar: That is correct: Rutherford, Elizabeth, and Jersey City.

Alyssa:  Awesome. So, is that a lot – scaling up to three locations?

Shankar: It isn’t because you know we do draw different patients from different parts of this region. For example, Jersey patients come from Brooklyn and the surrounding areas. Rutherford usually gets a draw from West Jersey and Jersey. Elizabeth usually picks up a lot from the South Jersey area. So we’re kind of strategically positioned to attract this clientele or those in need of some solution.

We have some basic marketing strategies that we’re employing to reach out to the target audience.

Alyssa:  OK. So tell me a little bit more about that. What are those strategies like? My goal for this is really to help new dentists or people still trying to figure out what the right marketing approach is for them.

Shankar:  So it’s a great concept to be able to share some of the success stories so we can help a lot more dentists achieve the outcomes that they’re looking for rather than investing into a coach or investing into somebody who would say that they want to transform their practice or double their practice. Everything comes at a price.

My practice is about 22 years old. It does take a while to attain some level of stability within your own practice. With advertising, you know you can get an immediate surge.

For example, once you stop advertising the flow will stop. Looking back into the days of the Yellow Pages people who ran full-page ads usually attracted a larger pool too. But then once you stopped advertising those Yellow Pages, your patient pool dropped as well.

You’re seeing that trend with pay-per-click. You’re seeing that trend with advertising on TV and radio. So, you get spikes with these advertisements. So more than advertisements we are focusing a lot more on long-term strategy. We want to have a robust site that is heavily integrated with SEO rather than doing pay-per-click. We are focusing more on trying to get our website set up thoroughly with a lot of backlinks and trying to figure out how we can establish a presence outside of the realm of social media.

One of the drawbacks of social media for us is it’s our friends that usually like our page. We want to be able to get patients to like us. And that has been a challenge. So, we are doing a lot of internal marketing to make sure that they go and like our page and give some reviews.

You need to have a very strong internal infrastructure to be able to meet the demands. You can advertise anything you want but if you’re not able to deliver these products in-house it will become very evident very quickly that you are not what you say who you are. And that may sometimes backfire.

So, you really need to have a lot of training in-house before you go out and make some noise. I strongly recommend those dentists who want to be involved with implants get some training with the American Academy of Implant industry. They are supporting a lot of the educational avenues and then you can work with your strategist to see how best you can position yourself in the marketplace.

Alyssa:  I think that’s great advice, and I really like that you’re focusing on SEO as well because it’s so important. I saw on your website you had three hundred and seventy-five reviews. Are you automating everything to get all of those reviews?

Shankar:  No we don’t automate it. Somebody actually sits with the patient. Most of our geriatric patients don’t have Google profiles. We have our staff actually create an account for patients or give them an account. This makes them want to write a review. Once you leave the office you forget about it. And then no matter what kind of promotions you offer, it’s simply not going to work.

So we have an in-house person that actually bonds with the patient. We gently ask patients who have completed the treatment or some phase of it. So we get a positive response and then they don’t hesitate. We don’t do it after surgery because the patients just want to get out of the office. These are patients that have finished a nice procedure like a basic cleaning or some of the basic dental procedures. That’s the best time to ask for a review. Asking for surgical cases sometimes could be challenging. We wait until we finish the entire implant procedure and then we ask the patients for their feedback.

Alyssa:  Yeah. I think that’s smart.

And I also really like what you’re talking about with focusing on internal marketing. You can do that stuff with social media. I’ve seen a lot of people do those things successfully. If you’re using an email marketing system you can upload your email addresses into Facebook. Then you can target those people with your ads to just like your page to make sure that you’re building a community out of it. Like hey, you have a cleaning coming up or something like that. That’s really powerful stuff.

Shankar:  Yeah – it’s a continuous process. I mean we cannot have all the answers. And if you want to go for every strategy you’ll go broke.

Alyssa:  Yeah, I think being really, really good at one thing and that being your thing is important.

Shankar: Yes it is.

Alyssa: I know some people I talk to are against old-school marketing like billboards, magazines, and sending out postcards. Or they are all for it and against the new age stuff. Do you have an opinion on that? Do you think that old school stuff doesn’t work or do you think that it does work? Especially for older patients?

Shankar: You have to be careful what you wish for.

If you know if you want to go after a household like that… For instance, there used to be target mailing lists for people who come in fresh into a neighborhood. So, you would get the database for that and then you can geo-target based on the demographics of a certain neighborhood. Let’s say income rates of $40,000 – $70,000.

So you could do a lot of this kind of database marketing. It’s a hit or miss.

I’ll give you an example. I sent out an email to the Hudson County area from the Jersey City office. It was about 40 dozen emails and the click rate was probably about 5 to 6 percent. People opened it but we got zero response at that time. So this could turn out to be a very expensive exercise without knowing who you’re trying to reach. So if you’re going to advertise implants there’s no point in going through the yuppie market because that’s not the market you should be going after.

And then the ones that you want to send an email to – many of those patients don’t have an email account. So you can do all the e-mail marketing you want to, but it’s not reaching the right target audience. So if you want to go into a high-end market then maybe the billboards could be one of the ways to attract attention. If you run an ad based on a particular type of service you’ll find that you’ll populate your practice with those kinds of patients.

Let’s say I have a before and after of a particular procedure. That would generally tend to attract patients who look like that. So you’ll find that if you advertise for Invisalign with a photo of crooked teeth, you’ll attract patients who will fit that profile. We don’t want to promote Invisalign to people who are healthy or are already in their 50s and 60s. It may not really work. So it’s a science.

It requires a lot of education. If you’re not involved in the process you can lose your shirt! The guy who was doing the marketing would not know what you want and they’ll say look at your visibility rate. So many people have opened up your emails and this is what has happened. It all sounds good, but doesn’t translate into patients walking into your practice.

That’s what I’ve seen and I’ve been doing this for about seven to eight years now. We’ve seen all kinds of responses. We kind of narrowed it down to organic search. That’s what we rely heavily on. Organic search seems to have a better retention rate than just pay-per-click.

The pay-per-click ads seem to attract the price shoppers. They look at it and you’re the first one to appear. It’s kind of cool. They want to go and see and then the next thing they would see would be your website.

And if the ad is not supported by proper documentation on your website, that can have a negative impact as well. So I would say you clean up your own website internally make sure it is sound and scientific. Make sure it has a lot of credentials, it’s really backed by some solid information, has a good site navigation, and so on. Then you know you can get into different types of marketing on the web.

Direct mail I think is pretty much done. I have not seen much success with it. I don’t really recommend anybody doing any kind of direct mailing unless you are deep into the parts of America where they love to open up their mail and see what comes into their mailbox. In my own household, I used to get about five pounds worth of mail almost every day and now it’s trickled down to four or five mailings a day. And that will soon disappear in my opinion. So I think the direct mail may be on the way out.

Alyssa: You can see that there is definitely a revolution with all that right.

Shankar: It’s a big sea of change in how patients are looking at their services. And we’re relying more on Internet marketing and direct referrals.

Alyssa: First thing that people do when they need something is they Google it, right? You don’t sign up right away. They are retargeted. So that’s how the process works. And you’ve got to keep up with it.

Nobody’s looking for services in their mailbox! It’s just not happening anymore.

Shankar: That is true. And also you know Dentists love to use scientific terms. In terms of search engines, they would go and hire somebody else to just get me “veneers” as a keyword and veneers is not a good search phrase.

And the normal average consumer is not searching for that. They’re searching for something like “affordable dentistry” or they’re looking at “how much does it cost.”

Or “what is the price of an implant” or something than that. Because Google tells you what’s the most searched keyword. And sometimes we spend a lot of money on keywords and they’re not giving us results.

Alyssa:  Yeah. So when you do get these people that are price shopping, how do you handle that?

Shankar: That’s a great question because you know once they come in this is a hot lead.

They have already been to a couple of offices. How do you set yourself apart?

It starts from the person who was greeting the patient the moment they walk into the office. They have to get that “welcome experience.” They’ve got to really be connected with the patient to show them that this office is about compassion and that they really care. Show them there is proper diligence, proper follow-up, and it’s an office that’s run very well, and we take care of the patients well.

So we really put up some of those patient testimonials right up front in my office. I have some accolades that we’ve received as well. We sometimes run promotional materials on TV. There are interviews that we play with no audio. So then they kind of figured out what is going on here. You know this looks like an office that is very popular. The patients are coming in. Everybody’s smiling. They’re treated well. And then they see the doctor that’s always very caring.

We do spend a lot of time in with every new patient. I mean these are normal things. You read them in the books. But when you go to your office it doesn’t get practiced well because your team is not in sync with the doctor. The doctor would just expect the staff to pretty much follow their lead. But unless it’s reinforced in the huddle it’s never going to happen. So we always find time to find who the new patient is on the schedule and we make sure that that patient is taken care of well, they are not waiting for too long, they are going to be seated properly, and then all of the records are taken. So, we can come up with some kind of a diagnosis at that first visit. So then you know you have your staff talk up the doctor.

Now there’s a lot of downtime between the patient visits so after the X-rays you know waiting for the doctor for the exam at that time the staff doesn’t leave the room. This staff is sitting there talking about how good the doctor is, and how happy the patients are. They usually check with the staff in their decision that they’re making is correct or not, what the reputation of the office is like, and how the general post-operative trauma would be. They’ll even ask what the post-operative care would be and so on. We usually have the staff well trained in terms of how to respond to some of these objections and rejections.

Alyssa: Right and that’s so important because a lot of times you know I hear from people that’s a big problem. You know people are just price shopping and it’s difficult for them to set themselves apart. That’s a huge part of marketing!

Shankar: Absolutely, and there’s no definite way to measure that. I mean you have to do the same song and dance for every patient. You cannot prejudge them. You know we don’t do a biopsy of the water before making a case presentation. You know we just do the same course with every patient for everybody whether they want to accept the treatment or not we still go through the process of the case presentation.

Alyssa:  So, do you guys ever offer anything like a discount or offer to get new patients in the door? Or you rely solely on organic search?

Shankar: Yeah because you know it’s very hard to track this.

This is my philosophy. If I offer a discount the other patients say I want to get into that program! So there’s always a two-level offering. You know, if it’s insurance that is one thing. If it’s a cash client it’s another thing.

So my philosophy is if I’m willing to take coverage for insurance, and let’s say an implant costs for my practice is that say $1800 dollars for the implant body and you’ve contracted with the insurance that is now going to allow be $1450. Now there’s a dilemma. There’s $1450. For the patients being insurance and there’s $1800 for somebody who doesn’t have coverage. You know you should be feeling good about the fact that you’re willing to accept the lowest possible fee from the insurance and still do a good job.

And then I would use that as a yardstick. And we don’t necessarily itemize or piecemeal the work. We say this is what that you need. This is what it is going to cost. And I kind of package that as an option to the patient rather than itemizing it because some of these treatment plans could run six or seven pages if you don’t itemize every single procedure we do. So if the patient wants it we will still break it down. But I believe that you know we shouldn’t be selling crowns or implants we should be selling a service. So it is a matter of function. And that’s the aesthetics. So we can always play with the numbers. You know in your mind what your overhead is. So if I can calculate all of this, and if I know what my production and overhead is, I do this math in my mind and say this is what it’s going to be to do this procedure. So that’s the kind of case presentation that I normally offer to my patients.

Alyssa: So you know while we kind of wrap this up, if there was any advice you could give somebody who is maybe just starting off or somebody who is struggling and really trying to figure out the whole marketing world, what advice would you give them?

Shankar: Well you know if somebody is just starting off I would say you should equip yourselves with a lot of knowledge. Do your CE courses on a routine basis. So you will see that your ability to expand the scope of your practice will immensely increase.

The eyes don’t see what the mind doesn’t know. So the more you are able to provide for a comprehensive diagnosis the more successful you would be in your practice. When you are starting off we all want to be having instant success. Success is not a goal. Success is constant and a never-ending improvement, as Tony Robbins says. You want to be able to have a very thorough understanding of the entire field, but you want to be recognized as a professional.

Do you want to call yourself a cosmetic dentist? Implant dentist? Are you a general dentist? Or are you a specialist? So we define our own role, and we need to follow that principle and philosophy throughout our case presentation. The concept of marketing and advertising is a good adjunct to your overall abilities to present yourself in the marketplace. So they both go hand in hand.

You can have all the skills in this world but nobody is going to come to you because you have golden hands. You cannot have your own trumpet and blow your horn. Nobody’s going to come to you. We’re in an age with a lot of competition in the area. We have more than 2,000 dentists graduating every year. So it’s only going to increase in terms of competition. To set yourself apart get as much education as possible and align yourself with a good marketing strategist who can help you with this entire process in terms of their understanding of what you wish to accomplish. And then to come up with a game plan.

And have performance markers along the way so you can assess if your marketing strategy is going to work or not. And as they say, “Rome was not built in a day.” You should expect to stay with the marketing strategy at least for a couple of years before you start to see the results. So it’s not a touch and go situation where you advertise for two months and expect see a result. So if you’re just getting into the Internet stay with the course for at least two years. You’ll find that you will become more popular on the Web. And it’s only going to help your practice. Also, have a very strong team that you build in-house so that can complement your skills and they are ready to receive clients from all the marketing efforts.

Alyssa: So many golden nuggets there. That was amazing. I love what you said about success. I love what you said about how it takes time. And yes, Rome wasn’t built in a day. It’s so true. You’ve got to stick with it. That was great!

Shankar: And then we can get frustrated because you know you can do it. But you don’t know the right strategy and what will work for one practitioner may not necessarily be reproducible. These are all customized solutions. Somebody has to sit down with you and work. And we need to have the ability to spend the time, it doesn’t get done by just giving somebody money. If you can sit down with a person, analyze the strategy, and partner with them, then they can help you with your goals.

Alyssa: Right. And tracking results! That’s so important. A lot of times people will just say “oh I don’t even know if it’s working.” You know it’s so important to really look at it and say is this working? How many new patients am I getting from this? Where’s the source? What are the numbers? Looking at the numbers and facts and saying this is working. This isn’t working.

Shankar:  So, it’s all about the metrics you need to have numbers. So you know if they do well or not.

Alyssa: Right. Anything else you want to add?

Shankar: Well you know I think the whole purpose of the webinar was to kind of have an overview of some of the strategies, but I think the short way to make all this work is that we need to have a global plan and that doesn’t happen with just one strategy alone. Somebody like you, Alyssa, I know you have very well-thought-out plans that you do for dentists. I really commend you for what you do and how you’re doing it. I love what you do for many of your dad’s posts in terms of the marketing for the courses. I just love the way you position it in the marketplace. I think it gets noticed and we can see the success. So I want to commend you for everything that you do for dentists in terms of enhancing their practices.

Alyssa: Oh, thank you so much!

Shankar:  Very nice. Good and thank you for having me on this webinar. I hope I was able to provide some advice and some perks for dentists to think about.

Alyssa:  Yeah, I think that people will definitely get a lot of value out of this. I certainly did and I thought it was fabulous.

Shankar: Keep up the good work. And thanks again for having me on this webinar. I appreciate it.

Alyssa:  All right. We’ll talk soon. Thank you so much!

Guest Expert on Dental Marketing Secrets: Dr. Shankar Iyer

Scale Your PracticeDr. Shankar Iyer is Dr. Iyer is a Diplomate of the American Board of Oral Implantology/Implant Dentistry and a Fellow of the American Academy of Implant Dentistry. He has lectured in over 30 countries and presented at over 100 symposia in Implant Dentistry and Prosthodontics.

His patients come from all over the world and he has maintained his patient base for over 20 years. Besides teaching and treating dentists in the United States, Dr. Iyer has taught and trained over 3000 dentists from around the world.

You can visit his website here:


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