“Plans are only good intentions unless they immediately degenerate into hard work.” 
― Peter F. Drucker

In my marketing book, I quote a joke about frogs:

Five frogs are sitting on a log. Four decide to jump. How many are left?


Because there is a difference between deciding to do something and actually doing it.

When I speak to doctors who are considering buying professional services, they spend countless hours thinking about whether they should go through with a purchase or not.

Other times when I work with clients, they’re apprehensive about investing in a new advertising campaign or bringing on additional staff to move the practice forward. In the end it generally boils down to fear, and that fear usually comes in three limiting forms. You’re going to read about each of them and get some coping mechanisms to help you make decisions more effectively.

1. Fear of losing money; or getting ripped off, again.

2. Fear of failure.

3. Fear of the unknown.

Your fears usually paralyze you from taking action. And taking action is the only thing that matters in business. If you’re standing still, you’re nothing more than a sitting duck. Your competitors aren’t waiting till you’re good and ready to take them on. They’re coming for you right now. If you want to fend them off and take control, it’s not enough to take aim; you actually have to pull the trigger.

1. Fear of losing money; or getting ripped off, again.

If you haven’t been disappointed by at least one marketing/SEO/advertising company, it probably means you’re not trying hard enough. I love it when I come across a doctor that’s had a bad experience. It just means that my ability to make them money will be that much more valuable. The hard part is getting past the initial distrust and apprehension. In truth, it does make me sad when I hear about how you might have been steered in the wrong direction. One doctor I recently had a call with was advised by his marketing company to do movie theater ads. Really! Needless to say, they didn’t work at all. He lost money on the ads, and they made no perceivable difference to his practice. He was now, understandably, worried about making the same mistake again and getting nowhere fast. There are ways to gauge if you’re going down the same path twice, and there are ways to sense if one company smells the same as the last. More on that later.

Before we go any further, let’s get into the topic of money. 

It doesn’t matter how much money you have, you’re always going to be afraid of losing it. You can’t help it. Not only have you been indoctrinated by your parents from the time you first held a dollar bill, but your psychology is hardwired to avoid loss. It’s a rational evolutionary byproduct of your survival instinct. You’re not as motivated to go after something as much as you are to keep from losing it.

The truth is that for the vast majority of human existence, we’ve been on the brink of starvation. It would only take one drought or fire or insect horde to wipe out an entire village’s prospects for surviving the following season.

Think about it like this. If you were living 5,000 years ago with no stable agriculture, disease and pest control, or a way to reliably store and preserve your food, what would motivate you more: Would it be the possibility of a huge harvest if you gambled and planted all your seed this spring? Or would it be the ability to sustain yourself and your family by saving half your seed over two seasons, just in case something happened? It would be the latter. The people that preferred the former are being dug up with little brushes by men and women in khaki shorts and wide-brimmed hats.

If you’re alive today, there’s a good chance that somewhere in your evolutionary past, your ancestors chose to be conservative and save seed. Those prudent genes were passed down to you over time. You can’t help but feel a sense of loss every time you spend money.

The one exception to this behavior is observed in people that have experienced an unstable childhood—people for whom change was a constant or inevitability. That could mean anything from extreme poverty, to abuse, or moving from one place to another repeatedly. Anything that caused flux and a perception of instability in your early childhood could make you more prone to taking risks.

I have good news for you. Money is the easiest thing in the world to get.

You may have been taught that money is hard to make. It’s not. Learning to play your kid’s favorite video game is hard. Making money is easy.

It doesn’t matter how destitute you become, you can always pick up a rag and a bucket of water and start making money. Any idiot can make money. It’s the easiest thing in the world to get. Pimple-faced teenage McDonald’s employees are making money for shaking salt on fries.

Find a way to be of use to another human being and you can get money. Stop and think about that for a minute. The actual getting of money is not a hard act. You, as a doctor, basically do the same thing but just get more of it. You found a way to be of use to others and they’re now paying you. Easy. The mechanics are not at all difficult. So if you spend some money, is it really a huge tragedy? It’s not. There is always more of it, and you’re smart enough to get it.

And I’m not, by any means, suggesting that money doesn’t matter. It matters a great deal. To a business, it’s the very lifeblood that keeps it going.

So if money is easy to make, why are you being stopped in your tracks by the fear of losing money? It’s because you’re not certain about your purchase. Certainty leads to action, and you need to get certain about your money. Either hire that staff member or don’t. The only thing you shouldn’t do is sit on the fence. You have to pull the trigger. Stop aiming and make a decision. It’s the only way forward.

When making your choice, the main thing you’ll need to learn is the difference between an investment and an expense. Expenses are things that you’ll get nothing from, not even a potential return on your investment. A useless employee who drags down the whole team with complaints is an expense. Your electricity bill is an expense. (Though in fairness to electricity, at least you get some light out of the deal. But it’s still an expense.)

An investment is something that has, at the very least, a potential for a return. Your marketing and advertising are an investment. Your courses and continuing education are an investment. It’s just that most people get it wrong. Read my article on branding to find out why.

So what about those pesky marketing companies that don’t deliver?

You deal with them by examining what went wrong with the last company, before you meet with them. You ask them what they plan to do for you. If it sounds like the last company you hired, they’re probably just as bad. Here are key trigger words and phrases you should look out for:

  • Branding
  • Name recognition
  • PR
  • News coverage
  • Web design
  • It’s about you as the doctor
  • Social media page
  • Twitter
  • Facebook
  • Join the online conversation
  • Inbound marketing
  • Proprietary software
  • Build you X number of links per month
  • Write you X number of articles per month
  • Facebook contests
  • Viral videos
  • Viral content
  • Followers
  • Likes

All those words should make you question them deeper, or better yet, just end the meeting and move on. If they’re going on about any of those topics, they probably don’t have a clue.

When you’re deciding who to contract, you need to make sure that you’re buying progress, not activity. If the company you’re talking to is handing you a long list of deliverables, run for the hills. Your success will not come about from activity. As I say in my bookActivity does NOT equal progress.

When you’re looking to hire a marketing firm, you need to make sure that their focus is not on you. Their focus should be on your prospective patients. Here are some general guidelines that should send off alarm bells.

  1. They work with multiple competitors in your city and pitch their “experience” as an asset. Your competitors should be dirt to you and to them. Unless you have a way to make money off of these competitors, your marketing company’s only interest should be in taking away 100% of their marketshare. How can you trust the marketing company not to take your proprietary discoveries and use them with your competitors as well? You can’t. And you shouldn’t hire a trojan horse.
  2. They’re generalist. They work in all industries and promise to help you get leads. Because converting traffic to leads is all about understanding the buyer well enough to target their psychology, the generalized tactics these companies use seldom work. Be weary of anyone that tells you about “best practices.” The truth is that nobody knows 100% what will work in YOUR market. It needs to be tested. Or they need to have a proven system that works for YOU.
  3. They’re designers, not marketers. Winning business out of the market is not about how pretty your site looks. It’s about sucking in the leads and converting them into paying clients. That’s the job of your marketing. Be weary of hiring a designer to do a marketer’s job. In general, designers want to make you pretty. Marketers want to make you money.
  4. They’ve never built up a successful cosmetic practice.There’s a lot to be said for experience. It’s all well and good to make you nice-looking ads, or get you to the top of Google. But what happens when you come across a problem that’s not related to that? Building a practice requires the expertise and intellect to overcome the roadblocks that arise as you grow. If your marketing company hasn’t built a successful cosmetic practice, they won’t know how to deal with the unexpected and industry-specific issues.
  5. They have a long-term contract. I learned long ago that if we do a great job, contracts are a formality. Clients don’t want to leave me when they see that I make them money. In the past, I’ve come across situations where clients were being held to year-long contracts they couldn’t get out of, and even cases where the supplier was holding their domain name hostage. These practices are despicable. If your marketing company doesn’t have the balls to stand on their own merits, they shouldn’t be hired. Anything beyond a three-month contract is unnecessary. You’ll be able to see progress in three months and know if something has the potential of working at the six-month mark. If they don’t have a simple termination clause in the contract, don’t sign it.

2. Fear of failure.

You’re a high achiever. You don’t like to make mistakes, and in your line of work, mistakes can cause lives. You expect a lot from yourself and so do the people around you. The pressure to be perfect is everywhere, and it’s daunting. It’s understandable that you don’t want to make mistakes. Thankfully, business is not medicine.

In business, and your practice IS a business, you NEED to make mistakes to learn. It’s not getting something right that’s of any value. In fact, always getting things right leads to arrogance, and that leads to complacency, which ultimately leads to failure.

If you never take the shot, you’ll never hit your target.

And yet that’s what you might be doing. You’re sitting there agonizing over every single detail of a proposal when you know in your gut if it’s right for you or not. You go over and over the options in your mind and are scared about looking the fool. You aim and you aim and you aim and you never pull that trigger. And that’s not good.

Nothing in business, and I mean nothing, ever happens without action. Well, almost nothing. The one thing that happens without action is defeat. The idea that the mountain will come to you is a myth. If you stand in one place long enough, the mountain will NOT come to you. The mountain will land on you so your competitors can climb over the rotting corpse of your practice on their way to success.

In business, inaction is the single most damaging variable to a practice. It keeps you from moving forward. It stops the implementation of great initiatives. It corrupts employee morale and keeps you from hiring great people. It’s a slow-acting poison that slowly brings your practice to its knees.

So how do you overcome the fear? You embrace it.

You take it upon yourself to understand that failure is good for you. You look at every opportunity to fail as an opportunity to learn. When you were in medical school, did every surgery go perfectly? In fact, has every surgery gone perfectly since you started your practice? Probably not. It’s normal to run into problems. But did you learn from your mistakes? Are you a better doctor because of them? I’m willing to bet that you are.

If you make a hundred mistakes, you’ve financed your own education. You got a master’s course in what works. Failing is not the problem. Failure to learn from your failure is. The reality is that if you never take the shot, you’ll never know anything; and you’ll never achieve anything that will contribute to your long-term growth and expansion.

“You can’t build a reputation on what you are going to do.”
—Henry Ford 

3. Fear of the unknown.

This last fear is also genetically inherent. After all, the unknown has killed many an ancestor before us.

We carelessly repeat sayings like “Curiosity killed the cat” without a shred of examination to see if they are valid, and more important, relevant things to say. Sure, curiosity may have killed some cats, but who cares? Curiosity is also responsible for countless inventions that you enjoy today. The unknown is not bad, if you have a strategy.

And that’s the secret to overcoming the unknown. If you’re doing senseless things for senseless reasons, the unknown really will kill you. That new Google pay-per-click campaign will suck all your advertising money in under a week. But it won’t be because it was unknown or new. It was because you were lacking strategy and direction.

And here’s the worst part. You won’t know if your strategy is sound unless you pull the trigger and take the step into the unknown. Easy to say but hard to do, right? Well, there is a way to do it. Whenever I come across a situation where a client is afraid to take a step in what I know is the right direction, I do one simple thing:


Projecting likely scenarios into the future is the best way to overcome your fear of the unknown. It goes beyond the rudimentary “What’s the worst that could happen?”-type scenario. I try not to tempt Murphy’s Law too much in that respect.

Projection is the process of working out likely scenarios, both good and bad. In most cases, you’ll find that your mind blows up the unknown to epic proportions. It’s like hearing a mouse at night while camping, and your brain taking the noise and projecting an image of a grizzly bear in your mind. Business is no different. Everyone creates their own boogymen.

If you take your scenario and project into the future the possible spend, yield and overall risk, you will find that the unknown seems a lot less frightening. All of a sudden you look at a huge potential failure as a simple investment in your education at the cost of a few thousand dollars. Future projections give you the roadmap to plan a strategic approach.

I always try to combine projection with careful tests. Going into any venture with a realistic and safe test eliminates all the uncertainty from a scenario, and gives you real data to use for your bigger decisions. It takes the unknown and makes it known. Once you know a thing, you no longer fear it as much, which allows you to take action.

Whatever you’re struggling with, whatever you’re planning to do, do something! Pull the trigger before your competitor does!

“Do not wait to strike till the iron is hot; but make it hot by striking.”
—William B. Sprague