How To Do PR The Right Way For Your Medical Business - Practice Perfect Podcast Episode #18

Nick Dumitru

"You have to think about PR as a funnel, right? Initially, you want to make sure that, a, your name is getting out there as much as possible in the right way and so you start off with a really big opening of the funnel, but then over time you can distill that down into what your particular area of expertise is."


Nick Dumitru (00:33):

All right, welcome back to another episode of the Practice Perfect Podcast. Today, we've got a very special episode. We're going to start talking about public relations. Now, public relations is an area that I haven't focused on personally in our business. We primarily do public relations for SEO value or to try to leverage it for other assets. I'm very excited today to have with us Bretton Holmes. This is his 20-year anniversary from starting Holmes World Media and we've decided to do this podcast to really shed some light on public relations and how it can be used.

Nick Dumitru (01:07):

Just like you guys listening today, I'm also going to be learning today because this is an area that fascinates me. Like I said, I don't particularly touch it myself, but I know it has tremendous value. It's added tremendous value in the past when we've worked with other firms with our clients as well. Bretton has a wealth of experience. Very quickly about Bretton, he has, like I said, been doing this for 20 years. He started his practice in the down and dirty business of Beverly Hills plastic surgery marketing, so he's going to have some stories for us I'm sure.

Nick Dumitru (01:36):

Bretton is also a former Marine in the United States Army, and while I'm not in the US being in Canada, if anything should ever happen with a world power, we will come crying and screaming to the American military. Bretton, I would also like to thank you for your service on behalf of the Canadians as well.

Bretton Holmes (01:52):

Thank you.

Nick Dumitru (01:53):

All right. Having said that, Bretton, I'd like to get right into it and I'd like you to really lay the foundation of, well, first where you started and then we're going to talk about what public relations is in your mind. Just give us a little bit of background about where you've come from. Like I said, you started out in Beverly Hills, you told me that, and I'd like to just tell the audience a little bit more about it.

Bretton Holmes (02:13):

Yeah. I got into media relations and image development via public relations after I graduated with a master's degree in playwriting of all things. I have an undergrad in criminal justice, so it runs again but I went in 180 degrees the opposite direction and ended up working for a firm in Los Angeles that specialized in medical healthcare PR for a lot of Beverly Hills plastic surgeons. I got thrown in day one to working with experts like Dr. Harry Glassman. I did PR for Dr. Gary Alter who's probably most famous for doing Caitlyn Jenner's transition surgery and quite a few others as well, Dr. Paul Nassif who is famous for a little show called Botched.

Bretton Holmes (02:59):

It was a great way to start because going into it initially I had no background in PR. My brother who's five years younger than me has a degree in it but had never ventured into it. What I found pretty early on was that the playwriting storytelling aspect really informed that process in a way that I had not expected it to. As a result of that was able to then start my own company shortly thereafter, working with medical experts of all different varieties and sizes.

Nick Dumitru (03:35):

It's great. Now, you said that you studied playwriting and storytelling and I think your take on public relations is a little bit different than a lot of people's. It's usually typically very schmoozy and just trying to get you in front of people. What caught my eye in speaking with you is really this whole aspect of story. Can you define for us what public relations means for you, and then, I want to jump into the story aspect, but just how do you define public relations? What is it for a doctor?

Bretton Holmes (04:03):

It's the way that reach out to what I call your potential patient base. That is people that are out there who need what it is that you can do for them but aren't aware that you exist. By engaging in a public relations effort, you're able to better inform them about what you can offer in a way that is essentially endorsed by a third party, i.e. the press, right? You're not out selling yourself directly. You're not necessarily doing as many ads maybe as you otherwise would be. You're providing information for the public to pick and then utilize and seek you out as the expert of choice. That's essentially in a nutshell what I see this.

Bretton Holmes (04:48):

The storytelling aspect, obviously, you got to have a story to tell, whether that's a treatment or a process that you utilize or you're commenting on a current event or something else that's in the press to get you press. They tend to have what I call a lemming mentality when it comes to stories that they do. It's not uncommon if I'm working with a doctor and we get them on one TV station in the local area, all the rest tend to follow suit, if we're lucky, usually. It's really a matter of making sure that you understand what the nature of your practice is, what you're trying to accomplish and getting that very honed so that you can get some messaging out around that. That's really the key, I think.

Nick Dumitru (05:33):

This is interesting. My take on it originally was that you were crafting a story to tell about the practice, but what I'm hearing right now is that it is a story in the press that you're trying to somehow come parallel to and then merge with that with what the practice has to offer. Is that correct?

Bretton Holmes (05:53):

It can be. That's one aspect of it, but you're absolutely right when you that one of the elements of doing effective PR outreach is generating a story from within your own expertise, right? I would say that's what I call the proactive side where about 70% of what I do is take a story that the doctor or the practice wants to get out into the public side and then we formulate that. We come up with what we feel like is the best pitch essentially. The other 30% is where I notice something in the press that aligns with their expertise or something they can talk about and then we put out a press release about that.

Bretton Holmes (06:33):

One of the things that I always tell the docs that I work with is, "You may want to just do this one type of procedure because it's your favorite one to do, but you have to think about PR as a funnel, right? Initially, you want to make sure that, a, your name is getting out there as much as possible in the right way and so you start off with a really big opening of the funnel, but then over time you can distill that down into what your particular area of expertise is." For example with Dr. Alter, he wanted to do one type of procedure, was running into problems because it wasn't at the time apparently popular procedure in the eyes of the press.

Bretton Holmes (07:13):

I said, "Well, we can get to that point. You're going to have to open up what you can talk about because at the outset what we really want to do is get your name out there as much as we can in the most proactive manner possible, and then over time, you'll be able to become known for this one procedure that you want to do.| That's essentially what ended up happening for him.

Nick Dumitru (07:32):

Interesting. One thing I like to do on these podcasts is I really like to get down to the minutia of examples of how this is done in the real world. Can you give me one or two examples from each of those cases, so one where you are creating a story? Just a concrete example so that the audience can really start to think about their own practice and what they can provide in terms of stories and how to craft them, and then, the other one maybe even like what's a current news story that you would latch onto today, for example, that you would be keeping an eye out for in the press?

Bretton Holmes (08:04):

One example, I would say is Alter is a great example because he's got a great name for a plastic surgeon. I think initially when we started working together, and I was still in my PR infancy but I was learning as quick as I possibly could, my philosophy is the only bad press is no press, right? A lot of doctors may hear that and say, "Oh, my gosh, what does that mean?" Well, I think for his case in particular, he had a procedure that was not really primetime material, I would say, in terms of being able to do a story on it, right? It was a difficult pitch to begin with, but it was also something that while the vast majority of women wanted to do wasn't something you could put on TV.

Bretton Holmes (08:52):

We had a discussion about that and I said, "We need to be able to come up with a way to pitch this effectively and show it so that those that are interested can do it." This was back when the Berman twins were big and they were doing a lot of press outreach and we're implementing some outreach that was negative about certain procedures that women were getting in prose. He made a really good point. He said, "Look, I don't really care if it's negative. People need to know where to go to get this done."

Bretton Holmes (09:22):

That occurred to me that that's really in a lot of respects with plastic surgery especially because you're dealing with some areas that may not necessarily be able to be put on the news at 6:00 or what have you that if you look at it from a perspective of, "Oh, this could be a potential negative," it may not be. You've got to think about it in those terms that you don't really know what the response is going to be until you put it out there and the worst thing that they can say is no. It doesn't mean that you can't go back to the drawing board and come up with another way to angle it or pitch it or tell the story of it, right?

Bretton Holmes (10:01):

A lot of times, they're going to want a patient. If you're doing press outreach, they want to do a human interest story, "How does this change the person's life? What is it about this that caused them to want to go seek out this particular expert?" et cetera. Things like that. When you talk about minutia, that's all it is. It's about getting down to the nitty-gritty details and providing the press with what they need which is a good story really. I think that's the biggest factor when you're doing PR, especially in the aesthetics world because it is so competitive. You've got a lot of different moving parts.

Bretton Holmes (10:38):

The press over the last, I would say, 10 to 15 years has changed considerably where I would say less likely they want to promote a particular doctor or what they perceive as promoting a particular doctor. If you pitch it in the right way, it becomes less of a promotion and more of an informational for the public. Part of what I do is I try to explain to them, "Yes, I know this looks like an aesthetic procedure and I know that you believe that you're 'promoting 'this doctor, but really what you're doing is providing viable information for a huge amount of the population that needs it and is looking for it. They might as well get it from you guys as opposed to some other outlet," if that makes sense.

Bretton Holmes (11:23):

What I have to do is play middleman between what the press needs and what the client needs and bring those two halves together.

Nick Dumitru (11:33):

That makes total sense. I want to unpack a couple of things here for the audience because the people listening to this are either practice managers or physicians that have their own practice and they're not necessarily always trained in marketing. A couple of things that Bretton touched on there are very important. The first thing is really the power of story. I'm going to tell you a quick little story at the end of this little ramble about good press and bad press. Story is powerful because it's how the human brain learns.

Nick Dumitru (12:00):

If you think about the way that religion and knowledge has been passed down over the centuries, it's usually through parables, through story, right? The Bible, any kind of religious texts, they all teach through stories because stories cause emotion. They cause an emotional reaction in the brain. We believe and understand and remember our emotions a lot easier than we do facts and figures, right? If you learn a statistic, you'll be very hard pressed to regurgitate it, but if you said, "Jennifer really healed herself very quickly and got back to life and was able to have three kids and a wonderful family and lived with her husband until she was 85 because she was able to heal her," whatever it might be, right?

Nick Dumitru (12:40):

You remember that kind of story a lot easier than you would remember that 96% of people recover from general surgery, right? That's not something that you would be able to remember, but you can always remember a story. The important thing is that you can also retell a story. The other powerful aspect of stories is if somebody sees something on the news or Bretton gets you in front of some TV show that as you tell your story, that story is very easy to be repeated. As you tell your facts, facts are very hard to remember.

Nick Dumitru (13:10):

They'll just say, "Oh, I don't know what some doctor said something about you can have breast augmentation, as opposed to, "Oh, I saw this woman online. She had breast augmentation. Oh, my God, her confidence jumped through the roof. She got a new job. She was able to start dating again after she got divorced. It was amazing. It was so inspirational. It was this guy downtown, Dr. Brad," or whatever you want to call him. They can remember that kind of story a lot easier. The fact that Bretton really focuses on a story I think is very unique.

Nick Dumitru (13:38):

Most PR agencies that I've dealt with in the past, they really just focus on exposure where they don't craft this aspect of it. I think that having that additional training there is fabulous. Now I told you, I'd tell you a quick story about the importance of good versus bad press. Bretton also said that the only bad press is no press, that flies around a lot as a popular knowledge-type fact that goes around. We've all heard it before. I heard it before, and frankly, I didn't believe it for a long time, but in 2009, I had a client here in Toronto who was really leading the industry. We're really helping them.

Nick Dumitru (14:14):

We helped them grow from four employees to 44 laser techs at one point that they had and they grew really, really fast and really aggressively. Unfortunately, they had a death in the clinic. That's a horrible thing to happen. Not only horrible for the person that died, but also horrible for the employees in that business because we thought the business was over as well so that there's no surgery without risk. I don't want to be crass, but in medicine, that is one of the risks of having cosmetic surgery. Patients do go in to that with eyes open, but obviously nobody wants to die.

Nick Dumitru (14:45):

When that hit, they had some of the worse press I could have imagined. Just horrible, like horrible, a total hack job on them. There were lobbyists here going after them. The press was going after them. There was one of those reporters that had a bone to pick and he was going after them almost personally. I looked at this guy, I just thought to myself, "Wow, we're done. This is totally finished." The interesting thing that happened out of that experience that I learned is that three months after that whole wave of press happened, they had their best sales month ever. Their sales jumped right back up.

Nick Dumitru (15:19):

People started coming in to have surgeries and this really bothered me for a long time. Unfortunately, I don't know the actual paper. I'd love to be able to cite the paper, but I looked into it and there is a psychology paper done on this. What they discovered was that whenever something gets media exposure, there is an effect where for a little bit people are all aggravated and annoyed, but then they stopped remembering the details. Like I said, story is a lot easier to remember than facts and the facts start to go away.

Nick Dumitru (15:46):

What they found is that the older the person was, the faster this went away. On old people, it's a matter of days and people in their 20s and 30s, it's maybe a couple of weeks to a month that this effect lasted. Then, they stopped remembering what it was that they knew that company for and all they remembered was the notoriety. What happened is they were doing this research because of fraudsters like people scamming old people and what they found is that when they ran those news reports about these scams happening, the scams actually became more successful a couple of weeks after the fact because the old people stop remembering what that company was featured for, right?

Nick Dumitru (16:24):

Like Acme Corporation, they just got on the phone and the guy said, "Oh, this is Joe from Acme Corporation." They're like, "Oh, Acme, I think I've heard of you guys." They started to trust them more.

Bretton Holmes (16:37):

One of the aspects of that a lot of people in my industry know but isn't I would say common knowledge among the public is that if you've got a doctor who is trying to become an advocate, this happened a couple of years ago, I had a doc who his whole thing was wanting to be an advocate for patients, which is altruistic and great and it's definitely needed, but je went a little too far with, got sued. What ended up happening was the company that sued him got absolutely more patients than he did because they figured that the reason that he was doing it was just trying to ride on the coattails of the story that had been done five, six, seven other times. He ended up losing patients as a result of trying to go after the other practice that had had a similar incident.

Bretton Holmes (17:30):

It's very interesting the way that the human brain works in that regard because I always tell everybody an advertisement will tell somebody how to find you, but a piece of press will tell them why they should. Whenever you're doing PR outreach, I think you have to keep that at the forefront of your mind because what happens in a lot of practices and for all the practice managers out there are probably going to scream, "Yes, yes, he's right," when I say this, but you get stuck in your cave a lot of times because you are around the other employees.

Bretton Holmes (18:02):

You've got the leadership of the doctors or doctor in the practice. You all are arrayed against the common goal. It's very easy to lose focus on what's going outside that office. I think it's really important for practice managers and doctors alike to understand that you may not know everything there is to know about what's going on with the temperature of the public or what their perceptions are. It helps to have somebody who's an objective for a party to be able to come in and guide you in that because it's really easy for medical practices.

Bretton Holmes (18:36):

I see it not only with plastic surgery practices but also in orthopedics and dermatology and spine and a bunch of other ones where you get so focused on what your message is supposed to be that you don't consider that it may be being informed by the people touting it as opposed to what's actually happening outside the office, if that makes any sense.

Nick Dumitru (18:59):

Absolutely. It makes total sense. What Bretton is saying is that there are parties out there that are promoting things and this perceived very differently. It's also effective in very different ways than if you're getting this third-party endorsement. On the back of that, Bretton, talk about the third-party endorsement because there's a lot of psychology that happens when somebody refers another person. Even if they come up in a Google search or they're on a news outlet, it's a different type of psychology than if somebody gets a piece of advertisement in the mail or they come across an ad that's clearly an advertisement on TV or in newspaper or whatever versus a new story. What is the difference for you in PR and how does that work differently in the mind?

Nick Dumitru (19:44):

It's pretty straight forward. The answer is that you're either promoting yourself or somebody else is promoting you. I don't necessarily like the word promoting. I think it's more of a legitimizing force really when I think about what the impact of the press can have because we all hate it when you go to a doctor and they're very salesy. We don't like that. I think plastic surgeons in general have a tendency in the press, in the media, through movies, what have you to be perceived in that way where we were trying to up sell the patient on, "You need this and you need that to make that work," et cetera.

Nick Dumitru (20:24):

When you get a piece of press, you've got somebody who is informing your potential patient base from a non-sales standpoint because that's why I focus on expertise 99% of the time because it's really about what they need, right? It's the press is looking for the best possible expert to comment on it. Really in my world, the best possible expert is defined as the person who gets to them first. I talked to hundreds of doctors every week to think, "Well, I'm so great. The press should just come to me. They should just know how wonderful I am."

Nick Dumitru (21:01):

The fact of the matter is, "No, you need somebody who knows who to go to first of all who can present it to that media person in a way that it's usable information, right?" You're not just battering with the press release every week. You're actually encouraging a conversation and a relationship. That's one of the other, I think, big aspects to what it is that I do that doctors don't understand because in days gone by, it was you had to go schmooze with the reporter and have lunch. You go hang out at the gym and talk.

Nick Dumitru (21:34):

They don't care about that anymore. I don't have to be where the reporter is. In fact, I would say about 95% of the time when I get a story done, I'm nowhere near where the story is happening because all the press cares about is getting the story. They want the content. They want to be able to know that if they have questions, they're going to get answered, that they're going to have a liaison between themselves and who it is that I work with. Really, all they care about is getting content. That's their main focus.

Nick Dumitru (22:04):

They don't care about having lunch with me, although I'm a great conversationalists at lunch. That's not their primary purpose, right? They want to be able to do their job just like everybody else and get the information that they need and look like a rock star to their boss, which I do what I can to help make happen for them.

Nick Dumitru (22:24):

That's pretty cool. On the back of that, I wanted to ask, it doesn't matter where you are, you said, it doesn't matter where you're located, which is fantastic. That means that well, one, you can help anybody. Two, it really opens up the type of media that the physician can get because I think one thing that doctors don't understand is the fact that they can get national press or they can get press outside of their jurisdiction and still leverage it. I want to talk about two things. The first is what media do you work in? Where's the best bang for the buck for the doctors? Then after that, I want to ask you about how to leverage the press that you are getting.

Bretton Holmes (22:57):

Right. I would say to answer your first question, national is always local, right? As an example, if I get a doc and Allure magazine just to name one. There's hundreds of them, but they're one of the more well-known ones. That's going to play in a local market somehow because there are people in that local market that's subscribed to that magazine or are going to see that story on the web, where they are when they're doing the search, et cetera. I always tell doctors, "Don't discount going nationally because it will help your practice and they need to know you're there."

Bretton Holmes (23:36):

Because invariably when they call New York City, it is the Mecca of Press for Aesthetic Experts, they'd use everybody in New York City multiple times. It's nice for them when they get somebody who is from Poughkeepsie or who's from Austin who has maybe a different perspective on the same topic. That's part of that, leveraging that story to an extent where they want to be representative of the whole country. They don't want to just be representative of New York City. Even though there's a ton of great experts there, no question about it, same goes for LA, there are also enormous quantities of great experts in Middle America and probably in the middle of Canada as well.

Bretton Holmes (24:22):

In terms of leveraging the press, I always say, "Make sure that you're promoting it on social media when you do get it," because what I find a lot of the time is that, social media, I always say and you may disagree with me, but I don't think that doctors in and of themselves know how to leverage it properly yet because there's so much of it and I tend to look at it like a tiger in a cage with the door open and everybody just throws raw meat at it hoping it won't eat them. There's a way to provide that, streamline the content to that social media that you could probably talk about way better than me, but I always say, "Make sure that you're getting it out there before you do it, after you do it, while you're doing it as possible because it helps that symbiotic relationship between you and the press outlet."

Bretton Holmes (25:16):

You always want to be transparent with memo and backlink and all that stuff because they need the SEO just as much as everybody else does, but really, it's about building that relationship that I look at what I do is not only representing expertise but also helping the doctor to foment the relationship between their local and national media outlets because they'll come back and use you again. If they have a good experience and the information that you're submitting to them has been vetted and fact checked, it foments trust.

Bretton Holmes (25:50):

That's critically important, especially in aesthetic medicine and in medicine in general because the doctor is asking total strangers to trust them when it comes to putting their hands on them. I think when you think about it in that context, the story becomes much more crystallized, right? Because if you're approaching it from the standpoint of, "We want our patients to trust that we know what we're talking about and we know what we're doing," it's better than, "We're cheaper than the next guy," right?

Bretton Holmes (26:25):

Also, I think in genders better relationship with the press what you want to create. Going back to the self-promotion thing, if you've got somebody in your office who is sending out a press release every week and not really making those connections in a visceral way because everything is personalized still even with all the social media aspects that we are all living under, it makes a difference when you go up to a reporter at a TV station or a producer at a TV station directly as opposed to just sending out a random press release and waiting and hoping they're going to call you.

Bretton Holmes (27:04):

That's one of the things that I focus on in my practice is making sure that the followup that I do with the press is absolutely personalized. It's funny because I've had press outlets go, "You're tenacious in a nicest way possible." They appreciate it because they're getting constantly daily with story items, and if I call and I'm the one in the thousand that's going to call them directly and ask them how their day's going, they're going to read my release. I've seen it happen. I've been able to do this for as long as I have just because when I approach it like, "I'm here for you. I realize that you need me as a resource. I'm here for my doc as well. We've got a really good story that's going to make you look like a rock star. It's going to be easy to do. I'm going to make sure of that and there's not going to be any problems."

Bretton Holmes (27:58):

They love it. Now, not everybody will do that story, but the ones that will end up getting press out of it which is always great because it helps everybody. It helps the media and helps the docs, it helps me. It's all good. I always tell my docs, "Make sure that you're promoting the press that you do get. Put it on your website, backlink to the station or the article. We'll have you the radio interview if you will," because it helps them as well.

Nick Dumitru (28:26):

I think you hit the nail on the head there with the followup. So for anybody who's listening, first thing you should understand is that on this podcast, everybody that you hear, there's no kind of kickback. So I've got no financial investment in Bretton or anything. I'm just trying to bring you guys the best information possible. Having said that, I mean this earnestly, just putting out a press release is a huge waste of your time. Don't do it. Doing PR on your own, again a huge waste of your time because if you're not busy enough to make sure that you don't have time for PR, then you're doing something wrong. When you do start to get busy, if you do have time for the PR, you're not going to be able to sustain it afterwards.

Nick Dumitru (29:02):

To Bretton's point here, you're not in the business of a one off here. You're not doing a one-off promotion, a launch. You're not selling shoes here that are going to last for a season. You're in the business of medicine. Being in the business of medicine is a big investment. It's a big financial investment. It's a big career investment. It's a big time investment in terms of your education. You want to look at your business as a long-term career. You want to look at it as a long-term asset that you're investing in over time. When you're going to do PR, it's not a thing that you do one time. It's not an episodic thing. It's not something that you do and then you kind of come back to it later on.

Nick Dumitru (29:40):

It's something that you should be looking to invest in over the long term of your practice because when I speak about in my book that there's a formula to this, there really is a formula. It's just like baking a cake. I try to explain this to doctors all the time. When you're baking a cake, you can't leave out the flour or the sugar or the leavener and still say that you've got a cake, right? Not any one of those things will work. Conversely, you can't bake just flour and hope to get a cake, right? This is not one of those things that you learn in science class where you're controlling for one variable and you remove one. It doesn't work that way.

Nick Dumitru (30:10):

The business of cosmetic surgery is a formula and you have to put all of the pieces together. If you've got just SEO and nothing else, no social media and no PR, no content, then you're not going to do well, right? You may be ranking or you may have your ads going, but it's not going to do well long term because the supporting actors are not there, right? Just like when you're baking that cake, the supporting actors have to be there. Even if it's just a drop of vanilla, that drop of vanilla can make all the difference versus leaving it out.

Nick Dumitru (30:40):

That's how I look at PR as well. Bretton, having said that, I know one of the things that you advocate is really sustaining this for at least six to 12 months. I want to talk about that because I think it's important for people to understand that it's an investment in their practice. What's your thinking of how long someone should stay at the whole PR game?

Bretton Holmes (30:59):

Well, in my best 20 years of doing this, my experience has been the longer you're in it, the more it increases your notoriety, your media coverage exponentially. What I find is a lot of times and I think you've said this, I usually say, "It shouldn't be a shot in the arm." It can be. You can get a huge momentum shift very early in depending on factors that are not in anybody's control, but what I look at is, the best way to explain it, I guess is that I'm like a farmer and everybody thinks farmers make crops grow, but they don't. All they do are set conditions.

Bretton Holmes (31:38):

My job as somebody's media relations expert representative is to plant those seeds and set those conditions so that they will be buyable at some point. We don't know when, I always tell people, "Look, I can make the water come out of the tap, but I can't tell you how hard or how fast it's going to come out, but there will be water," right? If you've done everything that you're supposed to be doing and you're doing it consistently, you will get press coverage. People will start to know more about you. You'll get more patients. You'll be able to charge more, et cetera, but I think in this age of immediacy that we live in these days, everybody wants it as quickly as possible.

Bretton Holmes (32:16):

I would say the best efforts that I've seen implemented are really the nine to 18-month mark. That's really the sweet spot. I usually tell people, "Do at least a year. Don't panic if it doesn't shoot off like a rocket the first month or two. It takes time to get that stuff rolling, to get the press familiar with you that you're here. This is what you have to offer." I've done stories with reporters that I had sent the press release out five, six times to them. No kidding. Had probably made 20 calls. The 21st call, I get them on the phone and they're like, "I'm pretty sure we did this story."

Bretton Holmes (32:55):

I'm like, "No, you haven't done the story. You've just got my press release five times and I've been calling you." They're so busy that they don't even know a lot of times what it is that they're doing because for them, if they're doing two stories a day or one a day, it can tend to run into each other and they lose that focus. That's why I have a job. It's because I take advantage of that to an extent. I think that that's really the best way to describe what it is that I do is I set conditions and usher those through and make sure that all the elements are in place to get the doctor or the practice that I'm working with the best initial exposure to the press that I possibly can because that's going to turn into press coverage for them.

Bretton Holmes (33:44):

You're going to have a better relationship with the reporter or the producer. It makes a huge difference in terms of the story you end up with and how that whole process goes. It's just like think about it from your own practice, patient interrelationship calls, right? You want the patient to have a great experience. You put those steps into place to make sure that from the time they'd come in or they call your office even. I always tell people, "The most money you should be spending on employees is who answers the phone," because one of the things that I'm sure you probably would agree with this is that first impression, you can't ever get back. You cannot ever get back. You can't redo it.

Bretton Holmes (34:26):

I try to approach it with the press in the same way that we want to make sure that from the outset we're sending them information they can use. It's letting them know we're here to help you do your job. We've got a great guy or gal here who can talk about what you want them to talk about in an expert way. That in my experience ends up with a great piece of press that will stick around. That's the other thing about this is that advertising comes and goes and it's usually just, "Here's our address. This is how much cheaper we are than the other guy." Press will stay around for a long time. I've had press that I've done that I still get calls on five years later. It's amazing the power it has if it's done correctly.

Nick Dumitru (35:14):

I couldn't agree with you more in terms of that first impression on the phone. The way I look at it is that that first impression really sets the expectation for the standard of care for the rest of the treatment. It really defines your ability to convince that patient to go with you and your practice because if that first impression is off, then how are you going to treat them once you've got their money and they're on their way out the door, right? What's the post-care going to be like if you can't even cater to them when they haven't given you their money yet?

Bretton Holmes (35:40):


Nick Dumitru (35:42):

That's hugely important. Now, you also touched on this, the longevity and what we typically refer to as evergreen content, it's stuff that's going to be with you forever the rest of your life. It will always be viable. It will always be green and flourishing. While I'm a big direct response marketer, I really believe in tracking everything, PR is one of these things where I will not actually advocate tracking because I understand that we do PR for different reasons. From my perspective as a marketer, I need it for leverage. For me, if I'm going to be doing some barbecue, you kept mentioning Austin, so it's gotten me hungry, so we've got us [crosstalk 00:36:19] barbecue now. If I'm going to be barbecuing a brisket, I can't leave out the salt, even though the salt is maybe only 2% of the brisket, right?

Nick Dumitru (36:27):

98% maybe you're advertising, but it's that 2% that gives it the flavor and that's where PR really is at the end of the day. It's something that you've got and you're going to cure that meat for a long time and you want to keep having that seasoning on there for a long, long time. That's what PR is. It may not be that shot in the arm. Where I've seen doctors fail at this personally, like Bretton said, is don't look for that shot in the arm like you're going to be on the news and all of a sudden, you're going to be swamped with patients.

Nick Dumitru (36:55):

Frankly, it doesn't happen that way. The odd time it may if you get enough coverage and you're high enough at a celebrity status, but what typically happens is that the awareness goes up for your procedure and then people start looking for it because again, they don't have time to necessarily go and search out the individual, but what happens when they do search it and they find your site, now you're putting out ads and they come across your advertising or social media is that they see that you are now endorsed by this third party which is the news outlet. The general public perception, at least before Trump ruined it for most of them, is that the media [crosstalk 00:37:30] does their due diligence, right?

Bretton Holmes (37:32):

I still think in a lot of respects, even though the press has gotten a really bad rap that it's still a legitimizing force. I don't think that's ever going to change. Even though people, there's a certain segment of the population that will rail against how bad the press is, they still watch the evening news. They still read a magazine. They still read newspapers. They listen to the radio. I think there's still this revival that they ever were and it does have that component to it of what I like to refer is that synergistic effect you were talking about, the fact that you can't just advertise.

Bretton Holmes (38:11):

I always tell people, "If you're advertising, keep doing it, but you need to make it work harder, not try to do just that," because what I find is a lot of doctors, you may agree with this, they didn't get into being a doctor because they wanted to go in to business. You know what I mean? They wanted to help people. They want to practice their craft, et cetera. They didn't get into it because there's such a big fan of accounting and human resources stuff. I think doing things that are going to help the other things that you're doing, just like when you're cooking a brisket, you've got time, temperature, spices. All of those things have to work in cohesion with each other, and if one element is missing, it's going to ruin the entire thing. It makes all the other aspects work less effectively.

Bretton Holmes (39:01):

I always try to tell people, "Look, if you're advertising, it's important to continue to do that while you're doing the media outreach because once you get a piece of press out there, that piece of press is going to bolster the amount that your ads are going to work for you and vice versa." If you're doing ads, you start doing press. The ads are going to help the press too. It's just in the eyes of the public. You have to have that synergistic effect in place all the time consistently to make it work effectively.

Nick Dumitru (39:34):

I think that PR I always look at it as a huge force amplifier and it's in ways that people don't realize. Unless you're in this field, for sure, doctors don't understand, but I'll tell you it even trickles down to your search and it's not just because of the links. Google has something called the RankBrain algorithm. When you get exposure on PR, what happens locally is people start to search about you because they just can't help it. They saw you or maybe you promoted on social media and then they start to search your name on Google to find your website.

Nick Dumitru (40:02):

Well, the RankBrain algorithm always takes that into account and it doesn't happen right away because it would be pretty easy to manipulate Google if it did. Over the course of a few weeks to a couple of months, what you'll see is that your search results start to trickle up as well. PRs, whether you get that link or not, yes, I'd love to get the link, that's always the goal. If you're going to get exposed anywhere, you'd love to ask for that link back. Even if the media outlet refuses to give you the link, just having that exposure and the additional searches that happen really bolster your business over time.

Nick Dumitru (40:31):

If you can do this a few times a year, then you're laughing. Then, it's going to be very, very hard for your competition to keep up and they won't really know what's happening because none of the SEO tools are going to expose that tactic whatsoever. It really is that force multiplier that you're after. Bretton, I'd like to try to keep this podcast to a digestible length and we're starting to hit that mark. I'm going to start winding it up a little bit. I've got maybe two or three additional questions I want to ask you on behalf of the audience and myself.

Nick Dumitru (41:01):

The first one is, again, this is not because I'm trying to plug Bretton or anything, but I really want to get a feel for what the financial investment is for a doctor so that they can start budgeting it out. What are you looking at typically to get this kind of help?

Bretton Holmes (41:15):

Sure, some of it depends on where you happen to be. If you're trying to go with a local company and you're in New York City, you're going to be paying top dollar. I can be anywhere from $5,000. I've seen prices as high as $20,000 a month. Somebody like me who's a one-man show with an of expertise is probably going to be, I would say on average, low end, you're looking at a couple of Botox shots per month to hire somebody like me. I'm rare. They're out there, but I would say, "More money is not necessarily better."

Bretton Holmes (41:50):

I've done campaigns where I was partnered with a bigger firm like Hill+Knowlton or a FleishmanHillard or something like that who I knew was we're making three, four, five times than I was, but they tend to be dinosaurs. What I like to think of myself as is a sniper of press coverage. I can go places that the big guys and gals can't because they're so encumbered by the infrastructure that they have to deal with that really what they end up doing is you've got an intern doing calls if they're doing calls which is very rare or writing a press release and I would say that, "While that press releases is a necessity, it's also critically important that it'd be well written and be written in a way that a reporter is going to recognize it for what it is and get the pertinent information out of it."

Bretton Holmes (42:37):

I usually use a one-page release which I recommend. If you got a company or somebody that recommends you do two to three-page press releases, I wouldn't recommend that because they just don't have time to read them.

Bretton Holmes (42:49):

It's really a calling card, right? The press release is there so that when I call, I go, "Hey, did you get it?" and they can pull it up on their email and go, "Oh, here it is," and they've got 15 seconds to give it a read and they can tell me right there if that looks like something that they could do that's viable which is what I want because I only have about 15 to 20 seconds on the phone with them at any given time unless it's somebody I've worked with for the last 15 years and we're talking about how are our kids doing and stuff. I think that's, that's one of those aspects that it's not really how much you spend. Does the process make sense?

Bretton Holmes (43:27):

I wouldn't say a $15,000 a month campaign is going to be any better than a $5,000 a month campaign. It just depends on who you're talking to. Do you have a good rapport with that media relations person or not? Because a lot of times, what I find is you've got to be willing to hear hard truths about your perceptions about your practice. If you're paying somebody to tell you that, you got to be willing, I think, on some level to listen to them and take that to heart. You may not agree with it, but when somebody hires me, I always make them aware.

Bretton Holmes (44:00):

I'm like, "Look, I'm not here to be your buddy. I'm here to be your advocate. I'm here to represent you. If I see that there's an issue, I'm going to tell you what it is. You may not like it, but you're not paying me to be your friend. You're paying me to do a little math for you and tell you the truth," which is I think part of the reason why I've been in business so long is because people know I'm not going to be asking them about anything. It's just like anything. The price structure, I would say, "Don't do anything less than a year."

Bretton Holmes (44:30):

If you haven't ever done it before, if you have done it before and you've got some press and you haven't done press in the last two years, I would say. "If you want to get back into it, check the year, just get back into it for a year because you're going to need to get your sea legs under again for a little while. Prices like anything, it varies. More cost doesn't necessarily mean better results.

Nick Dumitru (45:01):

Absolutely. I'll tell you something about the big firm. I haven't had a lot of luck with the big firms and they're definitely not tenacious in the nicest way possible like you are. I can tell you they're not going to go [inaudible 00:45:14] for you. That's great advice I think, definitely look for someone that's going to be there with you and with you long term. Bretton, I've got two more questions and then we're going to wrap it up. The first question is, is there anything I haven't asked about that you think is important for the audience to know about public relations?

Bretton Holmes (45:31):

Nothing that comes to mind immediately. I would say that it's really about making sure you're willing to hear the truth about what an outsider's perspective is on the nature of the practice. That's I would say the biggest thing is that be wary of getting stuck in your cave. I don't know how many ... I don't know if you're familiar with Plato's Allegory of the Cave, but that's always a good starting point for how a medical expert should look at their practice because it's very easy to get lulled into a sense of, "We know exactly where our patients are." You may have an idea of who that is, but you may be leaving a whole bunch of people out there inadvertently without access to you that you could otherwise get.

Bretton Holmes (46:19):

That obviously plays into the messaging part of the outreach, but I would say, especially in today's sort of marketplace, it's not enough just to put a pretty girl in a bikini on the side of a bus. How does that differentiate you? You've got to be able to differentiate yourself in a way that people can utilize it.

Nick Dumitru (46:44):

Great. Before I ask my last question, how can people get ahold of you? Where do they reach you? How can they contact you?

Bretton Holmes (46:51):

You can take a look at the website. It's and it's Holmes like Sherlock, so it's and you can fill out the little contact form or shoot me an email.

Nick Dumitru (47:09):

I'm going to put the website in the link for everybody so that they can grab it right from the iTunes' description or from our website at I'll make sure that that's there for you. Bretton, last question, and this is a very important one for me. I do get down to Austin about once or twice a year. At least I have historically and not much last year, but I have been down there several times and I have a very important question and that is, where's your favorite barbecue place?

Bretton Holmes (47:37):

Oh, man, that's a tough one. Golly. Favorite barbecue place? Everybody says Franklin's, they're very, very good. Don't get me wrong. I would say my favorite place is ... There's so many. PoK-e-Jo's is really good here. I got to be honest. It's a chain, but they're really good. They do consistent work. I've been to the higher-end one which is typically Lamberts, but it's funny you asked that because my brother is a chef here in town. I would argue that the barbecue that comes out of their restaurant is probably up there with Franklin's because that's not their primary thing, so there's not a bunch of pressure. I would say there's not a bunch of pressure there for them, but it's solid. It's really good. Really, really good. [inaudible 00:48:25] PoK-e-Jo's.

Nick Dumitru (48:28):

I'm going to check them. I haven't been to that. For me, so far, I'd say for brisket was Terry Black's. They do a really nice show on their brisket.

Bretton Holmes (48:35):

Terry Black's does a great job.

Nick Dumitru (48:37):

Just for the sheer experience for anyone visiting Texas, just head out to Salt Lake just because of the firepit. I wouldn't say their barbecue is the best, but it's just a fun place to go.

Bretton Holmes (48:45):

It is a fun place. Location is great there for sure. If you really want to get into some historical barbecue, you got to go to Kreuz's in Lockhart which is just outside of Lockhart. It's great because you get back to ... They don't really give you utensils, you just use your hands, so it's awesome. They have a fire there that they've actually had going for decades and decades and decades. When they built the new location, they actually physically moved the entire fire while it was still burning to the new location so that it was continuous, pretty amazing place. They've got these inch and a half the porkchops. They're just amazing.

Nick Dumitru (49:26):

All right. I'm going to relisten to this whole part of this recording and I'm going to put links to all of those places because if anybody else listening to this is clearly as passionate about barbecue as the two of us are going to want to find out exactly where those places are. Bretton, I want to thank you for coming on here and enlightening everyone about public relations. It was a great experience and great learning experience for me as well and I will make sure that everyone knows how to get in touch with you as a way of saying thank you for being on here for everybody.

Bretton Holmes (49:54):

Awesome, man. I appreciate it very much. It's great to talk to you.

Nick Dumitru (49:57):

Wonderful. Thanks to everybody else for listening and we will see you on the next episode. Thanks for listening to Practice Perfect. I hope this episode has given you a lot to think about. I hope you've got actionable ideas that you can take back to your practice and go back and make changes, make improvements, and take it to the next level. If you want, show notes and additional help and advice and articles on how to grow your practice, visit us at where we hold the podcast. That's T-H-I-N-K-B-A-S-I-S or just Google the Practice Perfect podcast to be able to find the listing page. Have a great day and a wonderful week and I wish you all the best with your practice. Go out there, make a change and make it happen.

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