The Number One Success Factor For Your Cosmetic Practice - Practice Perfect Podcast Episode #14

Nick Dumitru

"I funded most practices that are at least trying to make an effort and follow up, in most cases trying to manage it through Excel, which was really not made for that. They end up just having a huge list of names with phone numbers and sometimes emails, but there is no logs of activity, where was the last conversation was dropped off, what was the reason for conversion or non-conversion, and they don't really at the end come to the right insight of what is working and even sometimes more important what is not working."

Nick Dumitru: 00:44 Welcome back to another episode of the Practice Perfect Podcast. On today's episode, we're going to discuss probably the number one thing that leads to success or failure in a practice, and that is the ability to follow up with your leads. Any monkey can start generating you leads online. The quality of a lead varies. We're going to get into that a little bit. But today, we're going to really dive deep into what makes that work. And back by popular demand, I've got with me, Izhak Musli, who is the former CEO and founder of AtlasKPI, one of our most popular episodes. If you haven't listened to that one, go back and listen to Izhak on that one. He's got some great points to make, and I think you'll learn a lot. That company was acquired and Alex has moved on to his next venture. So I'm also going to call him a serial entrepreneur on this podcast, and we're going to dive deep into the next software and his insights and what he's seen with running both of these companies. So, Izhak, welcome.

Izhak Musli: 01:40 Thank you, thank you, Nick.

Nick Dumitru: 01:41 All right. So, Izhak, you started AtlasKPI because unlike a lot of people that I seen in the industry, you are paying attention to some things that other people weren't, and that is basically what makes a practice work, what takes them to success, what numbers they should be paying attention to. So I want you to take me through the journey of what you learned through running Atlas and what led to this new venture with your medical PRM software.

Izhak Musli: 02:10 Yeah, it's actually very related to each other. So Atlas was really focused on the data analytics, understanding that doctors are not all the time business-oriented or not all the time passed up business schools to understand better how their business work or understand their ratios of their expenses. Really, the key performance indicator that makes the different for most businesses, I realized we were working with different practices that they're very focused on conversion rate, but don't really understand what is conversion rate means, or which conversion rate of the process, or a process as a whole. They wouldn't be able to identify the process from the number point of view, and that really led me to start AtlasKPI to simplify that process, generate for them dashboards so it would make sense to them what they see in the business, the results that they see when it comes to the bottom line profits or even revenue and understand how is it really being generated from a number point of view that represent the process of that.

Izhak Musli: 03:07 When I started to work with the practices more and more over the dashboard, I started to notice that really what can make the difference is not even the optimization of the business, it's really the front end of the business. It's all the part of marketing. There is a whole disconnect from the marketing agency that's not able to access the EMR or the ability to track the leads activity. And when I mean leads activity, I mean anything starting from where the leads are coming from, which we focused obviously, and later, we're going to touch it even more about the qualified leads, not just any type of leads, all the way into full conversion to become a patient and generate revenue to the practice. There is a disconnect between the two, which from Atlas point of view, all the time I was being asked, one time from the marketing side, "Oh, we really would like to see it." And then from the practice point of view, "Ah, where do you like to share it with my marketing."

Izhak Musli: 04:00 Atlas was a dashboard. It was not really made for a CRM type of filling up the gaps. CRM is client relationship management, and that's really started to lead me into thinking, "Oh, there is something even greater to solve that can really move the needle from a different angle before even starting to understand the numbers in order to optimize the practice and focus more on the lead generation, understand how it's being generated, what works, sometimes even more important what is not working and dive a little bit deeper than just thinking of knowing the lead source, which nowadays lead source is not probably the most relevant figure anymore when it comes to leads." So that's really kind of like how it's related to the other that brought me to start a medical PRM.

Nick Dumitru: 04:44 Very cool. And I think just in that little talk that you just gave, I think you've touched on a lot of big points, which I think we're going to have to start unpacking a little bit. Let's just start with the frustration from the agency side. I can tell you as an agency owner, one of my biggest frustrations is definitely the ability to get data in and out of things like CRMs. And for those of you that don't know what a CRM is, it's something like a Salesforce or HubSpot, some of these preexisting ones that aren't really built well out of the box for plastic surgery practices. They don't really work well. And a lot of times, I can tell you I find that it's very difficult to get data. While it may be easy to get it in, it's very hard to get it out sometimes to the point of purchase.

Nick Dumitru: 05:28 So when you're feeding a lead in, when you're feeding something from an advertisement online, like Izhak was saying, the source of the ad is not necessarily so important. And one of the things I want to unpack is this whole idea of omnichannel, the fact that people go across channels, they'll go to your Instagram, to your Facebook, to your Google ad and do a search, go and check you out on websites like RealSelf, these third party review websites and then come back to your website and make the purchase. And it didn't really matter where they... sort of like the journey that they followed through, is not as important where they started, is where they end up. What's important is that you're able to track your efforts across those channels and the fact that that channel is making you sales. So you're not accidentally cutting it out because you thought that it's not producing for you.

Nick Dumitru: 06:17 And as an agency owner, like I said, while we're able to feed in these leads from the various sources, I have no idea if the practice is actually making money most of the time. And the shocking thing is that the doctors don't even know if they're making money. So they'll pull up spreadsheets, they'll do all of these convoluted things to try to get to the numbers. But at the end of the day, they don't know if that lead came in and book surgery and how much money that generated for the practice. And if they do know it, it's because they spent hours and hours digging through the spreadsheets and teasing out that data, which just slows down the whole effort because now we don't know where to scale, we don't know where to get these new leads from, we don't know how to move forward with that. And just not having that data is hindering a lot of practice.

Nick Dumitru: 07:02 And I would say from what I see from the agency side is that one of the biggest things that holds them back is, one, not knowing their numbers, and two, not being able to follow up with them. Izhak, I want to get into that a little bit more. So let's start talking about your definition of a lead. So what is a lead to you? How do you define it in your system?

Izhak Musli: 07:20 So there is really... and not getting too technical, but I'm just going to use two different figures for that. One is going to be MQL, which is marketing qualified leads, and the second one is going to be the SQL, the sales qualified leads. And there is really two types of leads. If we try to separate them into two different names, I'll say we'll touch on prospect, which is more on the marketing side. It's to find people that are putting inquiries that you have no idea who they are, that maybe you have only name and phone number, or maybe just the name and an email, and you want to qualify them and then move them over to the other side of the fence, which is the SQL or the sales qualified leads, which where the practices really can start to focus and say, "Okay, I know that he's a potential patient. I know that if I give him the right information or answer the right answers to these questions, I can make and book consult and from there the doctor can take it and convert him into a patient if then is still relevant."

Izhak Musli: 08:14 So when we think about leads, it's important for the practices to realize that there is two sides for leads. It's not just one big thing. Any type of phone number that coming in through the website is not necessarily a lead yet, and I think that that's where I'm also working with practices to understand that there is a two-step type of process. The first one normally I think that needs to be on the lower tier and kind of like envision it like a virtual walking patient. If somebody's just walking into your practice, he's always going to hit the front desk. And they're going to ask him a couple of questions. He's going to ask his own questions. They're going to make sure he's actually a potential and he's not just trying to sell them a marketing services, or merchant services, or anything like that, or new hardware, or new machinery. And there is obviously different type of criteria as in different types of questions that they will ask before they're going to say, "Okay, now we can speak with our patient care coordinator, which we're going to put on you a lot of effort and give you all the answers to all the questions."

Izhak Musli: 09:13 So the two steps are normally all the inquiries should accumulate within the front desk. They should start to reach out to every inquiries that they get. Then we'll call them a prospect in this case. They need to reach out to them, they need to speak with them. In most cases, we found that over 80% of practices not following up on a lead more than one time. After the first time they get the information, they tried to call that prospect. If he didn't answer, in 80% of the time, they're not even going to try a second time understanding that a qualified prospect can go up to $400 on average with some practices. So it's kind of crazy when you think about it. But if they will start to follow up and that's kind of like all goes together, then we're jumping from one thing to another.

Izhak Musli: 09:58 But if they will manage the follow up process to qualify those prospects, all those inquiries that are coming in from all the different channels that they have, like you mentioned, whether it's RealSelf or their website or their social medias. And they will try to put an effort and try to make it systematic, to try to make a phone call, then send them a text message if he's okay with that, send them an email, add them to the email dripping campaign that they probably already have within MailChimp or any of those types of engines, reach out to them on social medias, etc. All kinds of different methods that they need to try to follow up and get more interactions with those inquiries, understanding that each one of them can be the next patient or that can happen from the front desk point of view.

Izhak Musli: 10:42 Once it's been qualified, and only then, then it moves to the patient care coordinator, that then will speak with qualified leads that are potential to become a patient, give them the right answers, understanding that it only take one wrong answer to lose the opportunity. So you want to make sure that the patient care coordinator he's actually trained to answer all the hard questions and then turn them into a consult where the doctor can come, meet with them, and of course, convert them hopefully for a patient. When we speak about leads, it's really the importance of defining it as the two sides of the fence. There is first the prospect, those prospect turning into leads.

Nick Dumitru: 11:23 I couldn't agree more. And I want to backtrack just a little bit on the lead things and go even a little bit further up the chain from marketing agency standpoint. Just because I find that a lot of doctors and office managers they don't really understand the whole online marketing game and how it works, so I want to just clarify a few things in terms of what a lead is and how we define a lead, because you'll talk to people and they'll promise to generate your leads from anywhere from $20 to, like you said, $400, $500 a lead depending on the type of lead that they're generating and the source that they're getting the lead from. But a lead is not a lead. This is the type of thing where quality really makes a difference and the way that it's generated really makes a difference. Now, I want to get into some concrete examples of that just from the agency side.

Nick Dumitru: 12:12 So I'll give you an example. One way that you can get a lead, old school way is to buy a list. So you can buy a list of names and addresses and phone numbers of people that may be a good prospect for you. That was the old school way of getting leads. You hand that to your salesperson, they would do outbound calling. Here's your list of leads, good luck with it. You'd bang the phones all day and hope to get a sale. That's one kind of lead. Now, with the internet and the way that things are progressing these days, you can generate leads with online ads. That's the most typical way that it's done these days. You can also get a lead from a TV source or other sources, but let's focus on the internet. Even within an internet lead, there are multiple ways to get them. So very simple, one would be the difference between interruption and search or seeking advertising.

Nick Dumitru: 13:00 So when someone is seeking, when they're in a seeking behavior, they'll do something like go to Google or Bing and they'll type in a search term like breast augmentation of Manhattan or whatever. And they will try to find a physician because they are actively seeking versus interruption advertising on a platform like Facebook or Instagram, where people are not really looking for anything. They're there hanging out, spending time. And this called interruption marketing because you are interrupting their flow. Typically, they're bored, they're looking at pictures of family, cats, travel, whatever it might be, and then you can get in their face and get their attention. And it's a very powerful form of advertising. But that type of lead can be a little bit colder because they're further up the buying cycle. Everything's a journey in terms of when someone wants to do a procedure and when they actually go through with the procedure. Think of that as a journey, as a roadmap.

Nick Dumitru: 13:51 And if they're further away from their goal, because they're no longer seeking, they're not right there at the end ready to go, they may be interested. So that type of lead is a little bit colder. We call that a colder lead versus a hot lead, which is ready to go and ready to book surgery. A cold lead may need some nurturing. So while the volume is much higher, you have to do a bit more work to try to get them in because they will be a little bit less engaged. You've interrupted them, they've acted on impulse, and they may not be ready to go for a couple of months. So like Izhak was saying, when that kind of lead comes in, where I see the most amount of failure with practices is their inability to follow that up in a consistent manner. Because if let's say you have to follow up a lead just even once a week as just say like that's a bad example, but let's just say you do it once a week, you get 100 leads that week. All of a sudden, next week it's 200 you're following up for. If you're doing it for 30 days, by the end of the month, it's 400 leads that you're now having to follow up to consistently that week. And it starts to become a real challenge without tech in place.

Nick Dumitru: 14:53 And just to finish off that conversation, I want to give you one last example of a really cold type of lead. So you can get people to fill in online forums, but there's a big difference between what Izhak's getting at with a marketing qualified lead, which may be a person that has filled in a comprehensive form. So that's just a simple example of someone that's put in the extra effort to tell you a lot of information and give you a lot of feedback versus let's say that we run a contest for like win a free session of Botox or free injectables to take care of your wrinkles, we're going to have one winner. Well, you might have 1,000 people fill in that form. But while they may be leads in the sense that they're interested in that kind of service, they're not a warm lead or even a hot lead at all. They're very cold prospect.

Nick Dumitru: 15:37 And the point of all of this is that a lead isn't a lead isn't a lead. A lead has to be qualified. And when they come in, the only way that you can really handle it as a smaller practice with maybe just one, two, or three people at the front desk is to have something in place to follow that up and nurture that. So, Izhak, I want to hand it over to you again and really start talking about this kind of leverage, like where do you see practices failing and how is the technology that you're putting in place, how is that leveraging the staff and the people in their efforts to be able to start following up with these leads?

Izhak Musli: 16:13 So it comes in two different areas that really focusing... I funded most practices that are at least trying to make an effort and follow up, in most cases trying to manage it through Excel, which was really not made for that. They ended up just having a huge list of names with phone numbers and sometimes emails, but there is no logs of activity, where was the last conversation was dropped off, what was the reason for conversion or non-conversion, and they don't really at the end come to the right insight of what is working and even sometimes more important what is not working. In most cases, they just end up with a huge list that nobody know when was the last time somebody talked to them, or if they were editing to the email campaigns, or if they were trying to text them and they don't come to any consistent process or recipe, I'll say, that say, "Okay, when a lead comes in, you need to call them right away. Then if you didn't answer, call them again later on that day or first thing tomorrow morning, send them a text message, send them this email." And that's what we found that works the best to get the response back and convert them into a patient or qualify them.

Izhak Musli: 17:19 It just doesn't work that way and there is no system. The EMRs do not have the ability to log activities. They are made for exactly what they are, for the electronic medical record. Once that lead is ready to schedule an appointment, only from their on really the EMR kicks in and some of them doing great job, some of EMRs. But anything before that is really untrackable, people are not tracking it. So medical PRM, what they develop is really the tool that helped them not just to understand what works and not working by generate and populate all the marketing information that agencies need in order to understand the different types of campaigns, if it was a promotion that triggered them to come in or if it was a Google advertising that pushed them to come in and not just the website form.

Izhak Musli: 18:10 Like you mentioned before, it's the entire journey to understand the journey of how they end up coming to that website to submit that form, or how many times they were visiting the website, or if they came from a paid advertising, or if they came from organic search, but also to be able to enforce the activity, the log of every activity that was every touchpoint that was made for that prospect to qualify them, every touchpoint that was made by the patient care coordinator to move them forward, to schedule the appointment. And then if there is no appointment at the end, or if there is no conversion, or if the lead is not qualified, then to also log the reasons of why not so they can stop to spend their money and help their marketing to become more of a sniper type of marketing and not just blasting shotguns to everywhere in spending the budget of the marketing everywhere.

Izhak Musli: 18:58 The goal or the entire game is all the time to optimize and to improve user data so your marketing can really start to narrow down the procedures that you want to promote and bring you the most qualified people for those and not just blast on social medias and spend all the money inside Google advertising that definitely would generate to you a lot of inquiries, but probably not to the things that you want and not maybe the highest qualification for those.

Nick Dumitru: 19:23 And not necessarily on the bottom line. I think that's the point that a lot of these doctors are missing is that they get starstruck with the inquiries coming in. Everybody feels really busy. But at the end of the day, I found very few of them know exactly where the money in the bank account came from exactly. They know it's from their business, but they don't know exactly what generated and they're just happy for the phone to be ringing and for them to be talking to people.

Izhak Musli: 19:50 Exactly.

Nick Dumitru: 19:51 So, Izhak, you hit on a lot of big points and I want to backtracking. Again, a lot of the people that listen to this podcast are physicians. Their office managers, they're maybe not necessarily trained in marketing and business. And I just want to make sure that we go step-by-step so that everybody understands the important of this because you make some very, very big points very casually and I get it. But I want to make sure other people don't gloss over that. And one of them is that the point that you made with the staff where the staff they don't have their processes in place, where you end up with anecdotal information. And I find this in a lot of practices. When I talk to a doctor and they're telling me that, "We've tried something and it doesn't work," I said, "Well, hold on, why doesn't it work?" Because I'll never forget this story. I went to a practice and one of my first steps typically is to try to raise what the physician is getting because that adds to the bottom line profit, like a $500 raise in your services can sometimes double some of their bottom line profits if they're only making 500 bucks on the actual procedure and profit.

Nick Dumitru: 20:55 So I always look at profitability first. And what I do is I just start adding it up. And then one of the staff said to me, "Well, I don't know, a lot of people don't like these new prices. They're complaining." I said, "Really? How many people? How many did you call?" "Well, a few." "No, exactly like how many phone calls did they have?" "Well, it was one." Oh, so one person complained because the staff they bring their own bias into your practice, like their own life experience, their own upbringing, whatever their parents did to them to make them think a certain way." They bring that to the practice, and then as a physician because you're not there. The physicians typically... you're busy doing other things, preferably surgery, or you're in seeing patients, or follow ups, or seeing actual medical cases if you're a hybrid model where you're cosmetic and a hospital, you're busy doing medical things and you're relying on the staff to give you that feedback.

Nick Dumitru: 21:50 But as a business owner, when you take off the doctor hat and put on the business hat, as a business owner, you can't rely on anecdotal information. You need the hard data. You would never introduce a new drug if someone just said it looked like it worked well. But I find that very casually the doctors will listen to the office managers and just take their advice. They just take their word for it when they don't have any actual concrete proof. They don't record calls, they don't record data, they just pay out for advertising and basically listen to the staff. And because the staff brings their own insights into it, then you end up making the wrong decisions. And then there's a lot of frustration and then I end up hearing, "Oh, we've tried that and it doesn't work." Well, the thing is that you don't know what you've tried and you don't know how you tried it because you're just relying on one data point which is an opinion.

Izhak Musli: 22:40 And you remind me of a saying that we used to say knotless all the time. And it's a very known, it's not ours. But without a data is just another opinion. And we always used to go by that. Anytime that somebody was trying to argue anything within the company or even with clients, if you don't have the data to back up what you tell me, you most likely just had one bad experience that made you to come to this conclusion. People are very emotional. We normally going to remember the bad things, the bad things about the client that complained, not all the other clients that were super happy from that. And that's what we later going to take forward and make the decision based on that, which is it's the wrong decision in most cases.

Izhak Musli: 23:18 It's very emotional, it's very loaded, it's sometimes just one client that was very loud and complained very strongly about one thing, and then you take it and put it across everybody else and you really damage your business this way. So you're 100% right. One bad experience does not mean that something is working or not working. If you don't have the data to back it up, you're just guessing 100% of the time.

Nick Dumitru: 23:41 Yeah, and it's shocking and it's expensive. I can tell you that complained with that just the $500 increase, that was at that point, even before growing the practice, that would have cost that physician $160,000 in profit, like extra profit a year without doing any more work. And it was just because one of the staff members felt feelings about raising the price by $500 for $8,000 procedure. Yeah, it's heartbreaking to see that happening. And I'm excited by the fact that you're introducing things where you can start to empower the staff to have that and empower the doctor to have that date on the back of their work.

Nick Dumitru: 24:20 And another big point that you brought up is this consistency, the idea of doing things consistently, the fact that being able to answer the hard questions, making sure that they ask the right questions, that they answer them the same way all the time, that when you make an adjustment to the answer, you can see the outcome on the lead flow in the booking rate and the closing rate of the sales. So how is the software doing that? What do you have in place to be able to do that?

Izhak Musli: 24:46 So I first started the communication. I'm making a lot of predefined type of activities. So it's a lot of dropdowns, not just free text. So people cannot just do whatever they feel like. And that's kind of like number one mistake when you're not consistent is to give people the freedom to just make up things. You need to give them inside guidelines. So most of the system is defined by predefined activities. So when you select, "I send them an email," you need to select which of the emails? "I send them a text," which text did you send them? So there is no many place. There is also of course places for notes, for additional stuff because there is always corner cases, not everything follow the 80-20 rules. But for the most of cases, you'll be able to keep them. If you follow up the right way within the system, you'll be able to keep everybody in the same line.

Izhak Musli: 25:33 So like you said, you'll be able to see exactly what works. And you can say and you can define and you should use your marketing providers because that's where the knowledge needs to come into place. How many times did I try it before I conclude whether I should change it or whether you work's not working and then how to improve it? And in marketing, and I'm sure you're going to agree with that, there is the AB testing. Everything is the AB testing. Before you can conclude anything, you have to test it at least one more time in a different angle to conclude which one is a better way. Even if something is working, maybe there is a better way of doing it. And the same way works with processes. So when they give the same answer all the time, maybe there is a better answer to give that may generate more results. But you first have to analyze what are results from answer number eight. And that's really how the system has been developed.

Izhak Musli: 26:21 So most of the things are predefined, there is not so much place for, "I told the mix and why and he asked me why and said... in most cases, 80% of the time clients or prospects will ask the same questions, I'll recommend to every practice to predefine the answers that they want to give, the emails that they want to send, the tests that they want to submit, the social medias to their channels and they want to go after those clients and prospects so they can communicate with them and interact with them. Many marketing tools and marketing agents would allow you to define dripping campaigns and move them between the different campaigns that they will get. So it's different predefined emails that they will keep getting based on if they opened the email or didn't open the email. And if they opened the email, they would start to get a different chain of emails, and then you can also test which chain generate them to come back. And the same way it works for prospect and leads, the same way it can bring an existing and established patients as well.

Izhak Musli: 27:18 So the whole mythology can work on all angles and can really move the needle in so many different areas of the business, whether it's to increase the number of qualified consults that they get or the people that actually sits in front are way more relevant and much more potential to become a patient, which obviously is going to right away benefit your conversion rate and will generate for you the more specific procedure versus if you like to do more rhinoplasty or liposuction or breast augmentations, the doctor will have the power finally to say, "Oh, I want to get more of that procedure, more consults of that, and not just random people coming for any type of things." That will benefit directly the revenue, the profits, and the final and probably one of the nicest thing is to improve your marketing ROI, where your budget of your marketing will generate for you more money at the end. I think that that's really where we're trying to pinpoint everything.

Nick Dumitru: 28:14 Yeah, I couldn't agree more on that. And you touched on that point just now about predefining the questions that patients ask. And I got to tell you that you're jogging my memory because I have to say that that's probably the number one thing I'll see in any practice that's gotten more than one person picking up the phone, is that there's zero consistency in how the two... if there's two receptionists, they do things very differently, even between the two of them. And it's not just them. Even in the practice where it's just one receptionist and you would think you would have some consistency because things are not predefined, it's really relying on her mood and whatever she feels like saying that day. And there's no checklist in place, there's no predefined answer, there's nothing that she can go to to really create that consistency and have that flow.

Nick Dumitru: 29:03 And I'll tell you as a marketer, the issue that I have with that from a marketing standpoint is that it throws off my AB testing on the other side. So you're talking about AB testing within your software, which, by the way, that just made me super excited. I can't believe that you're even thinking that way. I've never seen any kind of software think that way in terms of AB testing these processes, which is absolutely critical. But going back to the marketing side where, yes, I do have the ability to AB test quite easily, AB test landing pages, messaging headlines, images, ad, ad types, ad targeting, delivery targeting, all that stuff we can AB test and it's fantastic. But here's the thing, if that is going on and then the receptionist is doing something wrong, like if I'm doing a click to call campaign, and I'm trying to track how many calls I get and how it goes, her ability to book that day and her consistency is the number one factor that's going to determine the success of my AB test.

Nick Dumitru: 30:01 So it throws all that off if the backend variables are not in place and they're not static. And that's a huge mistake as well. And again, it introduces what I would call pollution in the data. And it gives you data that's just dirty and not useful and you can't know where you went wrong. So you end up screaming at the marketing company when really it's your staff, and you've got no idea what the staff is doing. Whereas if we could keep those in place and start having that consistency with the software and having the data on the back of that, I think that it'll also improve your decision making on the marketing side and ultimately enable your marketers to do a better job for you, because a lot of agencies, they just want to get your results at the end of the day and keep you paying. They want to do a good job for the most part, not all of them, but as you say, for the most part, they want to try to do a good job and it'll help them do better for you as well. So I think that that's important.

Nick Dumitru: 30:57 Izhak, another thing that you brought up and it got me excited and I didn't touch on it when you previously just spoke, but it's this idea of data versus insights. And I find that a lot of people that bother to track, that are even at that way, which I'd say is like 1% to 2% of cosmetic practices that have gotten even to the point where they've got a spreadsheet and are kind of aware of what's going on even though it's painful, they've got this data, and I'll define data as numbers like let's say 25% or 30% closing rate. They've got this data, but they don't have the insights. And what you said there about being able to take notes and give you the reasons why and why not, talk to me about where that came from and why you put that in. Because I know as a business consultant, I'm always looking for that insight. I'm looking for the story behind the data, and I want to know what led you to that and why you built that in.

Izhak Musli: 31:49 Yeah, that's obviously the nature of what I do is always data. If it started even from Atlas, it's just the way business works. Knowing what works is only one part of the equation. If you don't know what's not working, you can really spend so much effort than money in one place and not understand that you can just take that budget to take that efforts and put them into the other side of the equation and double your performance. So the importance of the insight is more than just, like you said, just the numbers. The data, yes, it's nice to have, it's great that they fill up in Excel. But if they say, "Oh, my conversion rate is... and I'm going to take the number that a lot of people like, 70%, which we know it's most times not correct, but will touch the 70% and you say, "Oh, why is it only 70%?"

Izhak Musli: 32:38 You can challenge numbers that you get from the data. You can do that only when you have the insight. If you don't have insights, you can really not challenge the number. You just have to agree and accept it the way it is. And for me, as an analytic side, it's the hardest part just to accept the number the way it is and not that why is it like that? Can we get it better? Can we do a better performance on this? How can we improve that number, or why is it so bad? Sometimes you say, "Oh, I'm getting 100 prospects, but only 10 out of them are scheduling a consult. That's a 10% conversion from prospect to consult. Can we change that? Can it be better? Is this the best that we can do without the insight of the data, without all the entire story, which means you need to accumulate the data, you need to put it inside the process?

Izhak Musli: 33:23 You will never know if you can improve it, you'll never know if it's the right number, if it's accurate, if it's just the number that is random based on random activities of different people that do their job. Like you mentioned, one reception answer A, the other reception answer B, that can fluctuate the numbers in tremendous ways. So without keeping consistent the storyline or the guidelines that you set inside your business and then apply the data on top of that, you will never going to be able to get the insight. I think that's really the importance, the ability to challenge those numbers.

Izhak Musli: 33:56 So if you made $2 million that year, and next year, you want to set the goal, your goal is going to be a completely a guess. If you don't have an insight that based on that you can say, "I'm going to tweak X, Y, and Z in order to then set this goal." You're just going to make up stuff. And that's what I see all the time. We used to see it in Atlas. I see it when people speak about generating more leads, "Oh, I'm going to spend more money on my marketing. I'll generate more leads." Doesn't mean you're going to generate more consults, it doesn't mean you're going to make more money. You may just going to spend more, but that's the only fact that you currently have.

Nick Dumitru: 34:31 Absolutely. One of my favorite sayings from my book is that activity doesn't equal progress. And that's what it is. People love to get the activity and they love to feel busy, but they kind of put blinders on when it comes to checking if it actually added to the bottom line. So on that insight, I love how you said challenging the data. I love that. I'm going to take that saying from you and I'm going to use it from now on because I think it's very important. And I always try to... just for the listeners, I try to bring it back to a concrete example in terms of what that means. So I'll give you a case that I was just dealing with the other day. And this happens actually in a lot of practices where they have to decide between a free consultation versus a paid consultation. It's a very typical thing to decide. Younger doctors, they'll typically try to do a free consultation to get more people in the door. What happens when you add a fee is that it'll tend to drop your number of consults, but you hope it increases the quality of the consult because the person's a little bit more serious.

Nick Dumitru: 35:28 So that's a decision that's very typical across plastic surgery, cosmetic, anywhere that deals with consultations, this whole free versus paid. And when you add the fee in, what immediately happens is that your conversion rate from your leads goes down. That's an immediate thing that you can pretty much expect it to happen unless you're in an area that doesn't have a lot of competitors and you're kind of like the only option and you've got a monopoly. That's an edge case. Most big cities, though, you've got another, 30, 40, 50, 70 plastic surgeons like you would have up here in Toronto or LA or somewhere, or 100 in Manhattan. So in those cases, what will happen is that your number, the data will go down. So if you went from say like a 50% or 60% conversion from lead to consult, it'll drop down to 40 or 30, whatever it is, you'll see a drop.

Nick Dumitru: 36:17 And then it's very hard to know where to move forward. So this is where I see people getting stuck without the insights. When you say you can challenge that data, yes, it went down, oh, what was [inaudible 00:36:27], our consults went down. But the question then becomes, of the ones that came in, did more of them book surgery? So are these people that are paying the consultation fee more likely to convert into paying clients that actually book surgery and pay you for a surgery? So are you making more money on the back of those consults, or were you making the same amount of money on the back of the free consults you're getting the higher volume, but then was the conversion to surgery the same? And when it drops then, the question starts to become why is the drop?

Nick Dumitru: 37:00 So here's where the insight comes in, and this is where they get paralyzed. "Oh, no, the consultation is dropped. What are we going to do?" The only option, it's usually just an on or off switch for most of them. It's like boom, either consultation fee on or off because they're just at the beginning of that stage. And without the insights to know what is the objection to the price, tell them that it's $100 $200 consult fee. What is the objection? What's the story behind that? What are they saying? Oh, they don't want to pay because oftentimes it's not the money that's the issue. It's the fact that your sales staff didn't do a great job of selling the consultation and the procedure. And then if you've got that insight and your sales staff starts to say, "Well, they don't want to book." Okay, we'll ask this question, "What's the issue? What is the answer that they're giving you?"

Nick Dumitru: 37:47 Now, you start to get the data. And then you've got ways that you can start to adjust and then you can, like you said, put in those places that you can start to AB test in those standardized answers and empower your staff to really convert more of those people and then bring that consultation number back up. But when you've just got a hard percentage number, you've got nowhere to move from there. It's pretty much either on or off, and then they get paralyzed and don't know what to do. So the fact that you guys are thinking about that just from a business development standpoint is very exciting for me as a consultant. The fact that I can think that I can give this to the clinics that we work with and the practices and the plastic surgeons that we work with and tell them that they've got that and empower their staff to have that data and then I can get that data fed back to me as a consultant really lets me do a better job for them as well as them doing a better job for themselves. So I think that that's fantastic.

Izhak Musli: 38:39 Yeah, and I think you gave a great example. I think it's a classic example of many practices that have these challenge. I used to be asked this all the time in Atlas and there is really without a clear understanding of the operation and the processes, it's very hard to consult them whether you should or shouldn't charge for a consult. You need to understand the staff and that's part of what we also develop inside the system. Everything is user-based, so you can really see which front desk user, or even which patient care coordinator interacting more, or what type of activities they are applying that then benefit later the performance to the goods or the bad. So then you can know which person you need to improve more so.

Izhak Musli: 39:17 If you see that most people that coming for Botox that say inquiries and speaking with that front desk representative are likely to book less appointments after that versus the other, let's say the second front desk person that you have that getting their Botox and having a higher number of consults booked you know that you have a training issue. You need to go back to that same rep and speak with them exactly about Botox, exactly for what reasons you need to speak with them. If you see it's a male versus female, that's really the insight that you'd be able to get by logging it correctly, by applying the right technology to log all those different types of inquiries and applying all those resources and efforts to at the end try to generate more revenue to your practice and grow the business. So like you said, it's to test all the time, to always challenge the numbers, and always improve the process. That's the name of the game that's really running your business.

Nick Dumitru: 40:12 Yeah, absolutely. And I think we could talk for hours on this type of stuff. And just for the sake of brevity, I want to try to keep these episodes to like 45, 50 minutes, typically under an hour just to give doctors a chance to listen on their commute or when they've got to spare a few minutes. So I think we could go really deep into this. And you guys that are listening to these regularly, you can bet Izhak will be back because we've also discussed a few other ideas that I think would love to touch on together.

Nick Dumitru: 40:39 But Izhak, before we wrap things up on this, what I'd like to hear, because when we talked offline about this stuff, you are telling me about some features that frankly just got me extremely excited, so I want to give you the opportunity to just tell everybody if you had to narrow it down to, let's say, one to three features or four features that you think are killer features in terms of moving the needle, because I'm really all about growth and expansion and getting people to have the life that they want with their business, what are those features? Walk me through maybe the top three or four features that you think will really move the needle for these practices that you guys are doing that others aren't.

Izhak Musli: 41:20 I think I'll start probably with number one. It's the sense of urgency, the ability to integrate an embedded forms inside the website. So when a lead come in, when you get any interaction from a potential prospect, you get notified and you notify the right people inside the practice. So right away they can jump on this opportunity and try to make a contact. Remember that the person is probably browsing multiple different websites. It's kind of like first come, first take. The first practice that actually is going to reach out is going to have the best chance to give the right information to be able to win that opportunity. So the system have the ability to notify the people right away. The moment they sent me the information on the website, right away your patient care coordinator, your front desk, the doctor, anybody in the practice can be notified whether it's a text or even an email. So right away, they can reach out back to the lead and provide all the information.

Nick Dumitru: 42:11 At first, I just want to tell everyone I love that part of it because there's something called buying momentum. Whenever you're selling anything, some people they get into... not most, some people, buyers in general, whatever they're buying, they get into a velocity. So you've got this buying velocity, the momentum and that carries them through to the sale. And if that's interrupted and it's not timely, like Izhak is saying, you really lose out. So if you're waiting until the next day to call your prospects because it's coming in by email, like I've gotten one case where they're literally having to refresh the email every few minutes just to see if the lead came in, that kind of thing is really killing your practice because what Izhak just said there is huge and a lot of people don't realize this. And that is that the market for cosmetic surgery has been trained by everybody from these guys on the forums and blog posts and RealSelf, right through to the American Society of Plastic Surgeons.

Nick Dumitru: 43:05 And any of these societies online, they are told to contact multiple places. They're educated to do this. They're advised to do this by your governing bodies. So don't assume that because you got a lead. They didn't also submit three other forms two minutes ago. And what Izhak said is whoever gets to that first, gives the highest signals an indication of the quality of care that that patient can expect. Because if you can't be bothered to call somebody back when they made an inquiry for 48 hours, that's how they're going to feel that they're going to be treated when they're a patient of yours. If you get back to them right away, that's the first impression that you can take back. That's the indicator of the quality of care that they're going to receive from your practice, the timeliness, the attention, the fact that you care enough about their business and you want them to be with you.

Nick Dumitru: 43:57 So that's something that a lot of people just take for granted and they don't understand that you're in a competition now. You're not alone. This isn't 15, 20 years ago when I started, when plastic surgery was kind of novel, and then you had a couple of options. And if someone called you because they found you online, because SEO was a brand new thing and you happen to be dominating on Google or whatever excite or Yahoo or whatever was top of the Packback then, that they weren't calling five other places. But now, in this day and age, the age of instant communication, they are calling multiple places. So feature number one, I think that's killer, don't underestimate the importance of that. So I'm going to hand it back to you, Izhak. Feature number two, go.

Izhak Musli: 44:39 I'll say auto-population of data. So once you using the integrated forms of the software, when somebody submit information, everything is being populated automatic. So you don't really need to ask how did you hear about us, or what made you today submit this online information, or whether you never even answered after you submitted information. All the marketing data that later conclude what works or not working completely populates automatically, whether you paid for that lead or you found via organically or any of those. I think populate the data automatic and need to start typing inside Excel in a consistent manner is one of the most important things and saving a lot of hours and time for many practices.

Nick Dumitru: 45:21 That's another big one. So I'll tell you what, I'm laughing because it's just that you take me back through a time where it's like right back through the beginning of my career when I started all of this stuff. And the classic way a lot of people are still doing it with spreadsheets now is how did you hear about us? Yeah, well, I can tell you that the accuracy of that data is absolutely non-existent. I was trying to think of a clever analogy, but I couldn't come up with one. But it's just non-existent because, first of all, you're asking that patient to do the work for you. So you're relying on their industrialness... I don't know if that's a word, but you're relying on them being willing to do the work to try to remember to tell you how they heard about you and not just default to Google. "Oh, I did an online search." You don't know that. You don't know.

Nick Dumitru: 46:10 They may have clicked on your ad. So you don't know if it came from your ad campaign or from organic. That's a classic like number one mistake right there. You don't know where to put your money because you're running ads and it's organic. And you don't know if that person actually clicked your campaign and came in or went on the Google organic because Google is still Google to most users. They don't even realize half the stuff is ads. So that's a classic mistake.

Nick Dumitru: 46:33 The second one is you're relying on your staff to actually ask that question in the first place and them not default because most practices don't record the calls and they don't track for accuracy to make sure that the staff is asking that in the first place. And you're introducing human error on a second level. So now, you're sandwiching the human error for a really tasty error sandwich there because they're not doing anything accurately. So the client may not give you the right answer, and then the staff may not answer and then because they forgot. They just default to whatever the most popular one is. And I guarantee you it's going to be either referrals or Google, 100%. So auto-populating of the data where the machines doing the work and giving you accurate data, I can't say enough how important that is. So feature number two, again, that's killer. That got me excited when you told me the first time as well. So I'll hand it back over.

Izhak Musli: 47:23 Okay, and I'll give you the last one, which is also the nature of where all of it leading to the end. And we said talking about the insight and we talk about analytics, of course, the reporting side, where just by doing the regular work, there's work that they do today that just by using the system, they will be able to see the ROI on their marketing. There is ability to enter all the different campaigns, or even if they just want to enter how much they spend on marketing this month. If they don't want to break it down to the campaigns and the different promotions and different coupons that they're applying out, they can do that as well so they can see it on the lowest level degree. But they can also see it from a very high level by just entering how much money did you spend on marketing and then by see for the patient and for what procedure did they convert it for, earned from them. They're going to be able to get the ROI for the marketing. They'd be able to see the customer acquisition costs, so how much they really pay for a lead, for qualified lead or just for prospects.

Izhak Musli: 48:21 And the last, obviously, the conversion rates, they'd be able to see how many leads scheduled a consult, how many consults turn into patients. And that's just few of the numbers and the figures of the analytic side, not including of course all the different type of flogging of the activities of the front desk, the patient care coordinator, and the different provider, different locations, different procedures, but all of that of course is building inside the system. The data is there, and from past experience, I know already how to use it in trying to benefit the practice the most.

Nick Dumitru: 48:50 You got a little experience there. Just for you as business owners that are listening, I'll tell you, Izhak, again, he hits some of these very big points very quickly that I want to make sure that you don't gloss over or miss. And one of them that he hit there is really having those essentially what I'd call red flags, your data, your dashboards. Those are really the things that you can keep an eye on your business as like a 30,000 foot view of your business as a business owner, right between surgeries. Before you do your end of day, you can just have a look and really see if those numbers are off.

Nick Dumitru: 49:28 If you know what the mean is, if you know what it is on average, and you see that something spikes either up or down, as a business owner, that's a trigger for you to look into why that's happening. Because if it's good, if it's spiking up, you want to do more of that. If it's spiking down, you want to see what's wrong with that process, or like Izhak just said, the difference between maybe two of your consultants or two of your receptionist. Hey, what's going on with them? Did something happen in their family, something in their personal life, or have they stopped following the procedures? What's changed? And let me dig into that. And why that's important for you is because you can plug a hole very quickly, right before the ship goes down. You sprung a leak, you can plug it as opposed to waiting until you're waist deep in the water and about to capsize. And that's why that's important as a business owner.

Nick Dumitru: 50:16 And I want to make sure that whether you use software or not, that you're starting to pay attention to that in your own practice. So, Izhak, I'm very excited about this software. I know my clients that I've spoken to about are excited about this. I know the industry is going to benefit tremendously from it. Well, first, I'd like to ask you if there's anything I didn't ask you about it that you feel is important for everybody to know?

Izhak Musli: 50:41 No, I think we covered the most of the importance. As long as there is the will to increase and improve your practice and not just keep your head down and just do your thing, the day to day doctors are very busy, not all the time, really want to play the role of the business owner. That's really the way to make things very easy and keeping creasing and keep improving the business in the most easiest way. They can delegate it even to the office manager to look at the dashboard, to look at the numbers. Marketing information, sometimes you need to review, not even on a daily basis. Sometimes a strategy can take 90 days to start to see really results. By the time it's getting... people make decisions. It takes more than just one banner, one time for a potential to actually submit information you need to pop up in multiple places.

Izhak Musli: 51:26 So it's not something that they need to do on a daily basis all the time, some of them can. I don't want them to think that they now need to learn how to become a specialist of marketing. They can use system like that just to close the gap between the unknown of the marketing agencies shooting today in the dark to a well-known and understanding the data, justify the marketing or making sure they use it and making sure that their front desk and their people are actually maximizing every opportunity. It's their own benefit to do that. So I've seen some practices that actually the marketing agency are the one that are running and chasing the front desk to call people and make sure not to forget to follow up and do all of that part because it's a win-win at the end. The doctor wants to keep to use them, they want to show the performance. So when embedding a system like that inside the practice is really just been a benefit. There is really no downside to that as far as I see it.

Nick Dumitru: 52:19 Yeah, I can tell you I've done that dance-chasing, chasing after the practice to actually pick up the phone and call people. So I'm laughing because I know exactly what that feels like. I did actually remember my point from what you made before and then a second point on what you just said. And that point was that with this data it really takes ego out of the equation. I'll tell you where this came up for me is when I was speaking in France and I am cast. There was a physician there who was very proud of the fact that she was very big on her Instagram, putting her success in Zuckerberg's hands over there in case he changes his mind, her whole business with tank.

Nick Dumitru: 52:54 And then she wasn't paying for her marketing. And all that said to me is that she's afraid to pay for marketing because she doesn't know what works. And because if I told you you give me $1,000 and I'm going to hand you back $2,000, how many times a day would you want to do that transaction with me? You'd want to do all day long. And that's what marketing does for a business. You hand out some money, you go to the traffic store, you buy some traffic from Facebook and Google, and then they hand you back some money, and then you do it over and over so that you can grow aggressively and consistently and predictably and under your control. So that's what this software does. That's what having these numbers in place and easily accessible, where, like Izhak said, you can empower your staff to do it, where you're not having to hound them all the time, where you can all look at the same data very quickly and just say, "Hey, guys, this is what our goal is, this is what our target is. Go make it happen."

Nick Dumitru: 53:46 That empowers you to use your staff and their intellectual ability to at its full capacity, which is extremely, extremely important. The other point that Izhak made is just being able to keep an eye on, like he said, your spend. So I'll tell you a quick story with one of our larger clients. We took over the Google campaigns from a previous company. And what Izhak said about some stuff taking 90 days, it's the nature of the industry where it just takes time. This isn't an eCommerce transaction. And while I'm not a big believer in waiting a long time for your campaign to show results, like I like to get more immediate results. What we did with her is within two weeks, we spent $30,000 on Google and we flooded them with leads. And she hadn't seen this kind of acquisition before.

Nick Dumitru: 54:30 So she's freaked out a little bit, "Oh my God, turn it off, turn it off." Because unlike a lot of practices, she actually was tracking her spend versus her income. But because there's this lag, you have this cohort of people, the group of people that are coming in on day one and maybe their transaction because it's not an eCommerce transaction, you've got to book a consultation, deal with life, show up and then buy, it can take 30 to 60 days, 90 days, like Izhak said. So what was happening is that we turned it off in two weeks because she thought she was freaking out, like money's flying out the door. By the end of the month, that was ROI positive. 60 days later, it made a ton of money, like doubled pretty much the amount of money or more, I believe from what I remember of what it was.

Nick Dumitru: 55:14 Having those numbers and understanding how they change over time as well is critically important because that allows you to scale. Like if you're dealing with a lot of competitors in your market, the only way to win is to have these numbers because that allows you to acquire the patients, that allows you to spend more than your competitors. That's how you win. You don't win by just going on Instagram and not knowing what's happening because ego is a bitch, ego will make you do things because you've got notoriety and you've got people telling you how great you are. But when you don't know what the numbers are, egos can make you do all the wrong moves. It can make you make all the wrong moves and take the wrong decisions, and that's what you're avoiding with this kind of software.

Nick Dumitru: 55:55 So, again, really big points that Izhak touched on I just wanted to expand on that a little bit. Izhak, how can people get in touch with you? Firstly, how can any doctors that are interested get ahold of you and check out the software, get a demo? And how can potential partners get ahold of you personally if they're interested in speaking further?

Izhak Musli: 56:14 Simple as going to They have form over there. I'm getting a text message the moment I get a lead. I jump on it just like I preach what I practice. That's probably the best way for partners and for potential opportunities. It's an early stages. I'm not sure what they are listening to this podcast. But at the moment, it's December and it's pretty early stages of the system. So more than happy to discuss with potential partners, potential clients, get feedbacks, give my own, and grow it from there.

Nick Dumitru: 56:44 Beautiful. Okay, so guys, I'm going to put these in the show notes. They'll show up on iTunes and Google and on our website obviously, I think Grab the link from their contact, Izhak, if you didn't type it in from the actual podcast. And you know Izhak just said that it's in the early stages. I want to talk to you guys about something called first-mover advantage. And this is where the person in the market that makes the first move ahead of the competition tends to do well and win. And whether you take this further or not, take a look at the software, talk to Izhak, at the very least, learn what he's doing. And I'm going to be jumping on this as soon as he says that the covers are off of it.

Nick Dumitru: 57:24 I'm very excited about it just because from a marketer's standpoint, for my clients, this solves the number one problem that I have as a marker in a business dev guy. And helping practices double and triple, this is the number one thing that holds people back is this ability to follow up, this ability to act quickly and the ability to actually know what's making a difference in the practice. So I hope you guys take advantage of it. Izhak, it was a pleasure as always. I want to thank you for joining us. And I have a feeling everyone's going to be hearing from you again. That's for sure.

Izhak Musli: 57:58 Thank you, thank you. Looking forward for the next time.

Nick Dumitru: 58:00 All right, thanks everyone. And I'll 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, or just Google the Practice Perfect podcast, and you should be able to find our podcasting page. Have a great day, have 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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