How to Calculate Your Marketing ROI

By Sarah Woods, Core Dental Solution

In my last blog post, I outlined the important key performance indicators (KPIs) to determine how well your practice’s marketing tactics are working. I discussed eight of the most important KPIs for every dental practice and the ones I often use as the directors of the overall marketing strategies I create for my clients. These KPIs are sales revenue, cost-per-lead, traffic-per-lead ratio, lead-to-customer ratio, number of calls (leads), patient retention percentage, number of patients reactivated and new patient source.

Before we start, what’s a lead? A lead is a prospective patient who has reached out to your practice in some way. This could be a phone call, a walk in or a website inquiry. A lead is different than traffic. Traffic is the people who go to the website, social media page or see your advertisement.

Now, let’s breakdown these KPIs and understand how each is calculated.

  • Sales revenue: It is important to look at both the production and collection numbers every month. Production is the raw amount before collections, adjustments and overhead is subtracted. When determining whether marketing efforts are working, production is more reliable than collections because many factors can affect collections. For example, marketing is not related to whether the correct copays are collected, how much insurance is adjusted or the amount of overhead.
  • Cost-per-lead: This measurement is important when determining how much a practice is spending for each lead. Simply divide the cost of marketing campaign by the total number of leads, like this:

cost of marketing campaign
      total number of leads

  • Traffic-to-lead ratio: This measurement is what I use to determine whether a marketing campaign is effective. It is calculated by converting the traffic to leads into a ratio, (traffic : leads). Remember, the traffic is everyone who sees a campaign, website, etc., and leads are the amount of people who reached out to the practice in some way. For example, to see how a website is doing, its analytics are used to determine the traffic. Leads can be measured manually (a staff person collecting information and documenting how many calls are coming into the practice) or with call-tracking.
  • Lead-to-customer ratio: This KPI is similar to the conversion rate in that it determines the amount of leads that convert to customers. The ratio is leads : customers, and can also be reduced.
  • Number of calls (leads): It is crucial to track every lead. The most effective and reliable way to do this is by using a call-tracking service. I don’t recommend staff members tracking leads because these numbers are significantly less reliable. This KPI is the foundation for the rest and it is crucial that it’s accurate.
  • Patient retention percentage: This KPI is calculated to determine the percentage of patients retained in the practice. It is calculated by taking the difference of the number of deactivated patients from the total patients, and then dividing by the total patients and multiplying by 100, like this:

(Total patients- deactivated patients)   x 100 =  Patient retention %
Total patients

  • Patient reactivation percentage: This KPI determines how many overdue patients (hasn’t been seen in at least nine months) are being reactivated. The patient reactivation percentage is calculated by taking the difference of the number of reactivated patients from the total number of overdue patients, and then dividing by the total number of overdue patients and multiplying by 100, like this:

(Total overdue patients – reactivated patients)  x 100 = Patient reactivation %
Total overdue patients

  • New patient source: This KPI is crucial and just like the number of leads KPI, the foundation for all the KPIs. It is crucial that the source of every new patient is entered correctly. This sometimes takes training staff on the importance of marketing and asking the right questions when a prospect calls.

There is one last KPI that I forgot to add to my last blog. It’s the annual new patient growth. This number is calculated by taking the difference of the number of patients in a given year and the number of patients in a previous year, and dividing by the number of patients in a previous year, then multiplying by 100, like this:

(Number of patients in given year – number of patients in previous year) x 100
Number of patients in previous year

Accurately calculating these KPIs is extremely important when determining whether your marketing is effective — and if done correctly, can prevent wasteful marketing spending.


Sarah Woods is a marketing consultant and president of Core Dental Solutions, a full-service dental marketing agency that provides digital, traditional and inbound marketing to dental practice owners meeting them where they are in their life cycle. They approach dental practice marketing with a “holistic” mindset. Rather than incorporating “set-and-forget” marketing tactics to generate revenue and address shortfalls, they turn a dental practice into a well-oiled machine. Sarah can be reached at




How to Maximize Your Marketing ROI

By Sarah Woods, Core Dental Solutions

Recently, I was on a dental forum and a dentist posted that he was looking for some help with his marketing. In the thread, a disgruntled dentist stated, “Marketing consultants are the worst, they will promise the moon, but leave you with crap.” I was taken aback by his comment, and was even a little insulted. However, I wasn’t surprised by his point of view — measuring marketing return on investment (ROI) properly hasn’t been clearly defined to many dentists. I’ve been in practices where their only marketing ROI measurements were monthly production or the number of new patients that come into a practice every month. These are the absolute worst ways to measure whether a dentist’s marketing efforts are working. Many factors outside of marketing affect this data. For instance: Was the prospect’s call answered? Did the team member use proper sales techniques to solidify that the patient would be seen in the office? Was the prospect scheduled within 24 to 48 hours?

Understanding the key performance indicators (KPIs) and the life cycle of marketing are both vital to accurately determine how effectively your practice is achieving its marketing goals.

Data from KPIs should be collected monthly and include:

  • Sales revenue: again, many factors outside of marketing can affect this data
  • Cost-per-lead: cost of marketing campaign and the production from each lead of the campaign
  • Traffic-to-lead ratio: how much traffic is going to your website, social media and other marketing tactics, and how many calls from each
  • Lead-to-customer ratio: how many calls turned into patients
  • Number of calls (leads): the number of calls generated from marketing efforts
  • Patient retention percentage: patients deactivated of total active patients
  • Patient reactivation: how many patients were reactivated
  • New patient source: this is VERY important and must be tracked accurately!

Understanding how to accurately measure whether your marketing is working will help when creating and adhering to your overall marketing strategy. These numbers will determine which marketing tactics are working and which are just a waste of money!


Sarah Woods is a marketing consultant and president of Core Dental Solutions, a full-service dental marketing agency that provides digital, traditional and inbound marketing to dental practice owners meeting them where they are in their life cycle. They approach dental practice marketing with a “holistic” mindset. Rather than incorporating “set-and-forget” marketing tactics to generate revenue and address shortfalls, they turn a dental practice into a well-oiled machine. Sarah can be reached at


Good Communication Improves Patient Care

Donald Wood, CRNA, CPHRM, Patient Safety/Risk Manager, The Doctors Company

Multiple studies have shown that communication challenges can cause health care errors and complications. Dentists regularly provide care to patients who require a health care team with several medical specialties. In these circumstances, dental care provided to a patient requires effective communication among all team members and the patient.

Case Study
A patient presented to a dentist for a scheduled procedure. As the patient was being prepared for the procedure, the patient inquired about the use of an antibiotic. The patient explained that he had undergone joint replacement surgery, and his orthopedic surgeon had instructed the patient that an antibiotic should be provided prior to any dental work. The dentist explained to the patient that current guidelines don’t support the concept of administering antibiotics prior to a dental procedure and was reluctant to prescribe an antibiotic. The patient wanted to discuss the dentist’s explanation with his orthopedic surgeon. He cancelled the procedure and left without being treated.

When a patient’s medical history reveals a prior surgery, the need for collaboration between the dentist and any previous treating physician may warrant a discussion. In this case, an orthopedic surgeon performed the joint replacement. The 2013 clinical practice guideline published jointly by the American Association of Orthopaedic Surgeons and the American Dental Association (ADA), further clarified by the 2014 guideline from the ADA Council on Scientific Affairs, does not specify the need for antibiotic prophylaxis for patients with a prior joint replacement surgery. However, many variables should be considered. The guidelines report that a patient with a medical history of osteomyelitis, acquired immunodeficiency, or drugs or disease that suppress the immune system may require antibiotic prophylaxis before dental procedures.

Effective collaboration, in this situation, includes notifying the orthopedic physician about the need for the dental procedure, the extensiveness of the procedure and inquiring about the need for pre-operative antibiotics based on the patient’s orthopedic history. This collaborative process should begin as soon as a need for a dental procedure is determined.

A similar situation may arise with patients on antithrombotic therapy. This therapy requires a collaborative approach with the physician prescribing the medication. Although the number of antithrombotic medications was relatively limited in the past, several new medications have been approved. These new medications are noteworthy in that for some, there is no testing for therapeutic effect and some have no antidote or reversal agent. To reduce the risk of excessive bleeding, it may be necessary for a patient who is undergoing antithrombotic therapy to temporarily cease taking the medication for several days. As a part of the communication process, the dentist and prescribing physician should determine when the patient can safely resume taking their medication. Documentation in the dental record should indicate the patient’s understanding of when to stop the antithrombotic medication and when to resume taking it. With effective communication among the dentist, treating physician and patient, the overall impact on the patient’s health can be minimized.

Risk Management Strategies
Clear, concise communication can be enhanced by implementing the Situation-Background-Assessment-Recommendation technique. This technique can help a dentist organize communication and present specific details while collaborating with a patient’s previous physician. The following is an example:

  • Situation: A 58-year-old patient with pain, cold sensitivity and advanced periodontal disease.
  • Background: History of total knee replacements in 2010 and 2015.
  • Assessment: Patient needs to have four teeth extracted, bone grafting and preparation for implants.
  • Recommendation: Assess the need and timing of any antibiotic therapy that may be necessary prior to this procedure. If indicated, provide the patient with a prescription for the antibiotic.

Track these requests in a log or other format to determine if a response was received prior to the procedure. Follow up to ensure that communication among the dentist, prior specialists and patient is successful.


Jevsevar D, Abt E. The new AAOS-ADA clinical practice guideline on prevention of orthopaedic implant infection in patients undergoing dental procedures, J Am Acad Orthop Surg 2013; 21: 195-197.

Sollecity T, Abt E, Lockhart P, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints. J Am Dent Assoc. 2015; 146(1); 11-16 e8.

SBAR technique for communication: A situational briefing model. Institute for Health care Improvement website. Accessed February 16, 2017.


Reprinted with permission. ©2017 The Doctors Company. For more patient safety articles and practice tips, visit

Why Plastic Deserves Your Time and Attention

By Dr. Lisa Knowles, Intentional Dental Consulting

It’s hard to fathom what 500 years from now will look like, but I do know one thing that will be around if our planet still exists: plastic. Plastic takes about 500 years to biodegrade — if ever. Scientists estimate this number of years based on extrapolated figures using a respiratory test. They take a sample of plastic and see how long it takes microorganisms to digest the plastic. The amount of CO2 respired is the measured indicator of degradation. Except with plastic, no CO2 is made. Instead, plastic is dependent upon photodegradation. And no one is certain how long it will take the sun to complete this process. So, 500 years is the current guestimate.

I could not help myself from thinking about the amount of plastic consumed in our daily lives. After thinking about this sobering 500-year fact, I started to think beyond my traditional reduce, reuse, recycle mode of environmental consciousness. I thought I was doing a decent job of preserving the planet and educating my children about consuming less, but once I began to think with the end in mind — as Steven Covey recommends in “The Seven Habits of Highly Effective People” — I realized the end for plastic may never come. With that realization, I began my plastic witch hunt at home and in my work places. (Please note that there are pros and cons to paper and plastic usage, and this article focuses on plastic).

Here are 10 ways to taper the plastic temptations:

  1. If you have to use plastic, ensure that you are buying a piece of plastic that was made from recycled plastic. There is no need to make more new plastic than we already have on this earth if we do not need it. There is a type of toothbrush called Preserve that is made from 40 percent recycled yogurt containers. It’s a start. When you do buy plastic, recycle it after using it. Every piece of plastic thrown in the trash ends up buried in a landfill, and it will not see the light of the sun. There is no chance it will photodegrade. That plastic toy, fork, bubble wrap or fast food container will likely be there for eternity.
  2. Ask for less packaging, and think ahead and eliminate plastic bags and wraps. Take reusable cargo bags or backpacks to drug stores, grocery stores, shopping malls and markets.
  3. Ignore the undereducated or put off checkout worker who looks at you with grief when you ask for paper bags (or no bags) while gathering up your purchases. And, choose retailers that gladly offer environmentally conscious check out options.
  4. Consider less disposables in your office. We chose sterilization pouches from Enviropouch instead of thousands of little plastic bags for each instrument cassette. When I price compared how much it takes to buy the bags and all of the wrapping and taping products, the Enviropouch purchases evened out. When I add in the long-term cost savings to the environment, the Enviropouch killed the competition.
  5. Think about purchases on small things like polishing disks. I could have purchased a kit with plastic polishing disks and rubber attachments that came packaged in a plastic holder, but I chose the paper sand disks that come in a small rectangular cardboard box. Sure, it’s not as fancy looking, and it’s not the latest and greatest packaging and marketing color-pleaser. But, it pleases the environment, and it was much, much less expensive.
  6. Insist on a recycling program within your office. The amount of stock we all receive in our offices is extensive. When stock, cardboard boxes go into the landfill, it takes up unnecessary space, and landfills get used up faster. Landfills are inevitable, but we can reduce the rapid filling of them by recycling every thing that is possible. Shredded office paper and regular copy paper can be recycled (shred the confidential materials).
  7. Print on both sides of the paper and use fonts that use less ink. Comic Sans is a font that uses much more ink than some others. Patrick Allan, author of a Life Hacks article recommends Calibri, Times New Roman or Century Gothic; be careful with Century Gothic, however, because its wide font uses more paper. Use draft mode or fast mode to use less ink when it’s not crucial to have the best quality. The less ink we use, the more money we save, and fewer ink cartridges go into a landfill. Do not forget to recycle the ink cartridges. Most office supply stores take those back and recycle them.
  8. Save all the paper and ink costs and waste by emailing documents and using shared file folders within the office. Although paper biodegrades faster, the pollution factor for paper and plastic manufacturing is quite high. Paper mills often use bleach to whiten paper and this releases dioxins into our waterways and grounds around paper mills.
  9. Find local recycle events to recycle unusual things like batteries, bicycles and eyeglasses. My local event (Ingham County, Mich.) is called Recycle Rama. Also, unwanted medicine often is taken at these events, and great for us to remind and recommend to our patients when they ask us what to do with their unused prescriptions.
  10. Be an advocate for environmental consciousness. The healthier we keep our environment, the healthier we keep our bodies and minds. Clutter clogs our minds and physically impedes our outdoor recreation. Pollution from manufacturing plastic and paper produces potentially harmful diseases and illnesses in our bodies and increases our overall health care costs.

When we begin with the end in mind, and actively help to promote a total health and wellness environment for our patients, the choices we make as business owners and health care professionals can impact the environment and our way of life for years to come — maybe even 500 years to come. Small changes in our daily lives not only save us on business costs, but also helps to preserve the future health of our planet and of our patients. As health care professionals, shouldn’t we be leading the way?



Dr. Knowles has a consulting business, Intentional Dental Consulting, and can be reached at