Latest / No Appointment Necessary / The Revenue Leakage Most Clinics Never Track - With Jared at Coherent Healthcare

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The Revenue Leakage Most Clinics Never Track - With Jared at Coherent Healthcare · No Appointment Necessary

• 0:00
  Michael: Welcome to the latest episode of the best podcast in the world, as I always say.
• 0:03
  Michael: Um, well, I don't, but I should say more often.
• 0:06
  Michael: Um today we are going to talk about sales.
• 0:10
  Michael: It's a bit of a dirty word, and this has a bit of a tech spin to it.
• 0:14
  Michael: But I've got someone who I've known now for god three years or four years, I don't even know now.
• 0:19
  Michael: Um, Jared from Coherent.
• 0:21
  Michael: And we first met when Jared was doing some really cool stuff around payment stuff.
• 0:25
  Michael: And we actually met um again last week where I did a podcast on on on his podcast.
• 0:30
  Michael: And now he has a uh I I I guess you call it a sales engine.
• 0:34
  Michael: So we're gonna talk about sales, we're going to talk about everything that's sort of related to that and data as well, because what Jared's got is actually quite a cool, um, cool little product.
• 0:44
  Michael: I wouldn't normally let someone talk about their product too much, but this isn't um this isn't a sales pitch.
• 0:49
  Michael: This is actually quite interesting because it leads to a lot of other things um down the line.
• 0:53
  Michael: So, first of all, welcome Jared.
• 0:55
  Michael: Um nice to have you and give us a little background and who you are.
• 0:58
  SPEAKER_01: Yeah, thank you.
• 0:59
  SPEAKER_01: Thanks, Michael.
• 0:59
  SPEAKER_01: Um, yeah, it's been three years.
• 1:00
  SPEAKER_01: I think that's right.
• 1:01
  SPEAKER_01: Um since we first spoke, which is a long time.
• 1:05
  SPEAKER_01: Um so by background, uh I come from a clinic leadership uh background.
• 1:09
  SPEAKER_01: So I um found my way into healthcare initially developing medical devices uh for use in dermatology.
• 1:15
  SPEAKER_01: That led me into running uh dermatology practices or medical aesthetics dermatology practices, which led me into coherent, where we try and help other practices to tighten their top line.
• 1:26
  SPEAKER_01: Um, very focused on revenue and on the concept of leakage, which we use to basically define all of the patients who are sort of dropping away uh at the different stages of the journey, be that at the front door at the initial inquiry or after the consultation, after the cancellation, after the treatment plan, wherever it is, this idea that you've got a whole lot of patients who are sort of slowly drifting away from the mothership, um, and how you can try and plug those those very leaky, leaky points in the journey.
• 1:55
  Michael: And you have technology now that does that.
• 1:57
  Michael: But so you're owned healthcare businesses, right?
• 1:59
  Michael: Um, and you didn't have that technology.
• 2:02
  Michael: Do you think that now it well, first of all, you know how uh you walk into McKinsey and and you see that they don't implement any of their own best practices and everything's a mess?
• 2:12
  Michael: Was your clinic a little like that, or did you implement the the the things you should?
• 2:16
  Michael: And then is it easier today than than it was back then because of the technology that we've got?
• 2:22
  SPEAKER_01: So we were absolutely like McKinsey in so much as in so much as well look, I mean the the backstory here is um I didn't know this was a problem.
• 2:32
  SPEAKER_01: I didn't come from a clinic background.
• 2:34
  SPEAKER_01: Um so I had never encountered this idea of patient drop-off.
• 2:39
  SPEAKER_01: It was it was just completely foreign to me.
• 2:41
  SPEAKER_01: And I remember when we started tracking performance in the clinic, we used practice management software, and the practice management software kept telling us we had 80% month-on-month retention, 85% month-on-month retention.
• 2:54
  SPEAKER_01: And everyone kept getting really excited about that.
• 2:55
  SPEAKER_01: And I kept looking at those numbers and saying, hold hold on a minute, like over 12 months, that means we're losing half our patients, like half our customers are disappearing.
• 3:03
  SPEAKER_01: Now, obviously, it's healthcare.
• 3:04
  SPEAKER_01: So if if you do your job and they are help, great.
• 3:07
  SPEAKER_01: And and and that's that's a good outcome.
• 3:09
  SPEAKER_01: But most people who are dropping don't actually fall into that bucket, or a large number of people who fall don't don't who drop awake don't fall into that bucket.
• 3:16
  SPEAKER_01: And so when we were running clinic, we tried to solve this problem every imaginable way, which I think a lot of clinic owners do.
• 3:24
  SPEAKER_01: You hire people.
• 3:25
  SPEAKER_01: That's always the first move.
• 3:26
  SPEAKER_01: It's like, oh, I just need one more front desk person.
• 3:29
  SPEAKER_01: That front desk person, problem is solved.
• 3:32
  SPEAKER_01: This is the job they're gonna do.
• 3:33
  SPEAKER_01: And it's never the job that they do.
• 3:35
  SPEAKER_01: But I'm just gonna hire this one extra admin, and this admin is now gonna look after 10,000 patients from the last six years, and they're gonna do that really well.
• 3:43
  SPEAKER_01: It's it just doesn't happen.
• 3:44
  SPEAKER_01: So we tried to hire people, that didn't work.
• 3:46
  SPEAKER_01: Then we thought, okay, it's it's a tech problem.
• 3:49
  SPEAKER_01: And so we started bringing in stuff from from usually you don't see in healthcare clinics.
• 3:53
  SPEAKER_01: We we brought in HubSpot, we brought in Pipe Drive, we brought in Active Campaign, like all of these really generic CRME things, which did part of it.
• 4:04
  SPEAKER_01: You know, they they closed some of the gaps, they they helped with marketing attribution, like it improved some of the problem.
• 4:10
  SPEAKER_01: But at the end of the day, none of them really fit into the specific healthcare flow in a way that we needed it to.
• 4:17
  SPEAKER_01: And so we did the tech, we did the team, like it got incrementally better, but we didn't like we we were still bleeding out.
• 4:24
  SPEAKER_01: I mean, we we we knew that.
• 4:25
  SPEAKER_01: We knew that we were losing patients, we knew that we couldn't tie up marketing spend and retention.
• 4:30
  SPEAKER_01: We knew there were these big blind spots, and we tried very hard to solve the problem, we couldn't.
• 4:34
  SPEAKER_01: And uh that was in some ways the motivation for coherent, which was well, what if you just what if you just built a solution specifically for that problem?
• 4:42
  SPEAKER_01: Could you could you build this sp a solution specifically to that problem?
• 4:45
  SPEAKER_01: And I think the answer is yes.
• 4:47
  SPEAKER_01: I mean, we we we have a lot of examples of it working, but you know, journey's journey is ongoing.
• 4:51
  Michael: Let's get into coherent and exactly what it does.
• 4:54
  Michael: Um, but first I want to ask about you you said that you know your PMS will tell you you had an 80% retention rate and so on.
• 5:00
  Michael: I found that PMSs are not particularly accurate um on pretty much any of the data that they have.
• 5:08
  Michael: Did you did you find that?
• 5:10
  Michael: Were you kind of working off of quite dirty data?
• 5:13
  SPEAKER_01: Yeah, so one of the things that um that we love is is tracking new starters.
• 5:18
  SPEAKER_01: So we track new starters.
• 5:19
  SPEAKER_01: When we say new starters, we mean people who show up in the PMS for the first time in a given month.
• 5:26
  SPEAKER_01: Um so if you're if you have no patient visit history, you show up for the first time.
• 5:30
  SPEAKER_01: So you are technically a new patient, you've come in for something.
• 5:34
  SPEAKER_01: One of the things that we found the PMS is that a lot of PMSs don't actually allow you to track new starters versus new starters on a new treatment path.
• 5:42
  SPEAKER_01: So if you're starting a six session journey, many PMSs will recognize that as a new starter because you're starting a new program, which is a totally different kind of new starter than someone coming in for the first time.
• 5:52
  SPEAKER_01: So you're looking at two different things.
• 5:54
  SPEAKER_01: Another example that we find all the time, and it's what we often say internally, we're in the data business, but the number of um patient variants that sneak their way into your PMS, Sarah Smith comes in as a new patient in February.
• 6:07
  SPEAKER_01: Then Sarah with no H at the end, Smith comes in in February, then Sarah Smith with the different email comes in in March, and this is all the same person.
• 6:15
  SPEAKER_01: And so now you're trying, it's a complete jungle gym of edge cases, and the PMS is just not built to accommodate that.
• 6:23
  Michael: And on top of that, you end up with a situation where they all measure things slightly differently.
• 6:27
  Michael: So you go from one system to another, you've got different numbers.
• 6:30
  Michael: But then I noticed, um, and I'm gonna plug my two little new tools, um, my retention engine or HMDG retention engine capacity engine, because um, and they're free, so I'll put them in the links.
• 6:40
  Michael: But it's quite interesting because when I was looking at retention, what it what it often does is it looks at retention over a quite long period of time.
• 6:48
  Michael: So for example, I couldn't give two shits if um a patient visits 10 times if it's over 10 years, right?
• 6:54
  Michael: You want to do it over a probably a six-month period, which is where I think it should be, and you need to then not model the numbers between the it needs to only be those new patients in that period of time, but many actually model the people from pre that six months into that six month period, and before you know it, you've got this retention rate of 75, but it's actually 32.
• 7:15
  Michael: 100%.
• 7:16
  SPEAKER_01: No, no, it's like it's absolute comedy.
• 7:18
  SPEAKER_01: And and the thing that drives us nuts is that when we go into a practice and we say, How do you guys do patient recall today?
• 7:24
  SPEAKER_01: Like, well, what does it look like?
• 7:24
  SPEAKER_01: They go, We do a really good job of it.
• 7:26
  SPEAKER_01: Okay, what do you do?
• 7:28
  SPEAKER_01: Every three months after their last visit, we send them an email, then six months we send them another email, they don't make a phone call at nine months, and then at 12 months we send them another email.
• 7:37
  SPEAKER_01: We say, Okay, cool.
• 7:38
  SPEAKER_01: Like, does it work?
• 7:38
  SPEAKER_01: No if we don't know.
• 7:40
  SPEAKER_01: Don't know.
• 7:40
  SPEAKER_01: Yeah.
• 7:42
  Michael: We send it.
• 7:42
  Michael: That's good.
• 7:44
  Michael: There's very little tracking of that.
• 7:45
  Michael: And you you, you know, I've and I talked to you about this before.
• 7:48
  Michael: I think that because healthcare has such low margins, um, unless you're absolutely mental like you, no one seriously wants to come into the sector because there's just not enough money to be made, right?
• 7:59
  Michael: What is your total audience, let's say, with an MSK?
• 8:02
  Michael: It's certainly not the same total audience as there is with other sectors.
• 8:06
  Michael: And so, and on top of that, because there's little margin, how much can you actually make?
• 8:10
  Michael: Um, so I don't, you know, it's not a clinician's fault or a clinical fault, it's just that they don't have access to the right systems.
• 8:16
  Michael: And sometimes simple knowledge.
• 8:17
  Michael: Like I was um chatting with a um a guy on Saturday whose you know uh utilization was 130%, and I'm trying to figure out how you have a utilization of 130%.
• 8:28
  Michael: And it turns out that most PMSs, I I don't know if all, but what they do is they mix up total clinic capacity, mistake capacity with clinician capacity.
• 8:38
  Michael: So if you have, let's just make it really simple, hypothetically, a room one day a week that can do 10 hours.
• 8:45
  Michael: If the clinician is in it for an hour and sees a patient for that hour, you have a hundred percent utilization.
• 8:51
  Michael: Now, that means that people go away going, oh my god, our utilization is amazing.
• 8:58
  Michael: Because it's not about it's about the estate utilization.
• 9:01
  Michael: It means you're leaving 90% of money on the table.
• 9:04
  Michael: And and I do have a conspiracy theory.
• 9:06
  Michael: I wonder whether, careful not to get sued, Michael.
• 9:09
  Michael: I wonder whether it is advantageous to present very, very happy, consoling figures and positive figures to keep people on board.
• 9:21
  Michael: If you're presenting poor figures, is are you more likely to churn people?
• 9:26
  Michael: I don't know.
• 9:28
  Michael: Maybe that isn't what happens.
• 9:29
  SPEAKER_01: I think that so so if I go back in time to when I was running clinic, I think the problem is that you're and in tech you talk about a lot, right?
• 9:37
  SPEAKER_01: Like what is the system of record?
• 9:38
  SPEAKER_01: Where's the source of truth?
• 9:40
  SPEAKER_01: And I think the problem is that oftentimes the system of record is not the system of record.
• 9:44
  SPEAKER_01: It's the system of medical record.
• 9:46
  SPEAKER_01: Very good at keeping uh a diary, a log, you can stick an ambient, you know, medical scribe in there now, happy days.
• 9:54
  SPEAKER_01: You have a really clean clinical history.
• 9:56
  SPEAKER_01: The system of medical record makes sense.
• 9:59
  SPEAKER_01: The system of customer record is an absolute nightmare.
• 10:03
  SPEAKER_01: It's a it's a nightmare from top to tail, and you'll see it's on the marketing side, I'm sure.
• 10:07
  SPEAKER_01: Lead volume comes in.
• 10:08
  SPEAKER_01: Where does it go?
• 10:09
  SPEAKER_01: Who's handling it?
• 10:10
  SPEAKER_01: How does that flow and pressure get managed?
• 10:12
  SPEAKER_01: And then can you make good business decisions, even in the marketing space, on the back of that?
• 10:17
  SPEAKER_01: Because you don't really know what happens once a patient starts their journey.
• 10:20
  SPEAKER_01: You don't know how many of those people go through to PVA 5, PVA six.
• 10:24
  SPEAKER_01: You've got, and the clinic owner doesn't know.
• 10:25
  SPEAKER_01: So they're sitting there saying, Oh, yeah, I've got, I'm good.
• 10:27
  SPEAKER_01: I and I and I read your the barometer, the the benchmarks, I thought was awesome.
• 10:31
  SPEAKER_01: And I I think the PVA was like 5.5 or something, which which is interesting because as a clinic owner, you probably say, okay, am I am I 4.5, am I 6.5, how am I doing a benchmark?
• 10:40
  SPEAKER_01: But there's a lot of texture in that number.
• 10:42
  SPEAKER_01: The 5.5, which patients are contributing to 5.5?
• 10:46
  SPEAKER_01: Because actually you might have a cohort of patients who are actually sitting at eight, and then you might have a cohort of patients who are sitting at two.
• 10:52
  SPEAKER_01: And if you can get rid of the twos and get more eights, you you're in the that's a magical thing to do.
• 10:57
  SPEAKER_01: That's a huge transformation.
• 10:58
  Michael: Yeah, and I think um it it it all gets very, very nuanced as well.
• 11:02
  Michael: Because I had a clinic and he said, Oh, I've got this new clinician and she's crap.
• 11:05
  Michael: She sees people once, maybe twice.
• 11:07
  Michael: I said, I assume you're giving her all the complex cases.
• 11:10
  Michael: Oh no, she's new.
• 11:11
  Michael: Well, you can't really measure a newbie who you're giving like 30 turns to a clinician who's got like 40 complex cases.
• 11:19
  Michael: So there's a lot of nuance.
• 11:21
  Michael: But I've got to say, to be absolutely fair, I'm sat here at HMDG with 15 databases, 300 Google spreadsheets, 400 different sources of truth.
• 11:30
  Michael: It's not like it's it's you know uh purely a clinic problem, but what we do have is an ability to fix it, and it's not quite that bad, by the way, people.
• 11:40
  Michael: Um, but we do have the ability to fix it, which most people in the in this space don't because they don't deal with systems with open APIs.
• 11:48
  Michael: And so you cannot possibly link things together.
• 11:50
  Michael: I can link up HubSpot and everything else I want, put it all together and say, let's just correlate and combine all this data.
• 11:56
  Michael: Most PMSs, you can't do that.
• 11:58
  Michael: Very cool.
• 11:58
  Michael: And so you're sitting there with disparate systems that don't talk to each other.
• 12:02
  Michael: This is why my advice to any clinic owner now is if you get a practice management system that doesn't have a true open API, not a we have an API, you don't.
• 12:11
  Michael: If it's not a true open API, I wouldn't I wouldn't deal with it.
• 12:14
  SPEAKER_01: Yeah, we we um and I'll also be careful not to step in anything.
• 12:19
  SPEAKER_01: Uh we work with a number of practice management software that our clinics use that do not have an open API.
• 12:25
  SPEAKER_01: So you can work around things, but not without a very deep bench of engineering talent who can do that for you.
• 12:33
  SPEAKER_01: So the idea of I'll just stick these two things together and suddenly away we go, non-starter.
• 12:38
  SPEAKER_01: And I and I think you're right.
• 12:39
  SPEAKER_01: And and I think most of the most of the many of the more modern practice management software, by modern, I don't necessarily mean the last year.
• 12:47
  SPEAKER_01: I mean the last five years, six or seven years would probably lean into a genuinely open API.
• 12:52
  SPEAKER_01: But it's uh I mean, we see a lot of practices that use systems that genuinely don't support that.
• 12:58
  SPEAKER_01: In dentistry, we work with a practice management software that only has on-prem deployment, so you can't even access it unless you're locally tunneling in.
• 13:04
  SPEAKER_01: I mean it it's it's bad.
• 13:06
  Michael: I think I think the reason is they want to build their own ecosystems, right?
• 13:09
  Michael: They all think they're Apple.
• 13:12
  Michael: They're not Apple, they don't have any money, uh, but they still try to, and they get very defensive, which is why, you know, I look at Clinico, they're like, look, this is what we build.
• 13:21
  Michael: Is it the best system in the world?
• 13:22
  Michael: Absolutely not.
• 13:23
  Michael: But this is what we're good at.
• 13:24
  Michael: Everyone else, developers, go have some fun with it and build something cool.
• 13:28
  Michael: Um, and in fact, I was talking to Ben from uh Ephra, where he was talking about, in fact, I've heard this other place as well, where he was talking about um the practice management systems don't have an API open API.
• 13:43
  Michael: It is not always just a simple, hey, we'd like access.
• 13:46
  Michael: It becomes a commercial discussion, which then leads into you know commercial arrangements, which is not particularly good for customers either.
• 13:57
  SPEAKER_01: No, absolutely not.
• 13:58
  SPEAKER_01: I mean, we see, and this is, I think, common, especially in the in the hospital system, hospital management space, EMR EHRs, charging per API call.
• 14:07
  SPEAKER_01: And I'm I it's it's just not clear how that's good for the customer.
• 14:10
  SPEAKER_01: Uh and and I love in, you know, and and you know, the Afro guys on this well from from the go cardless days, but the um the mandates at a regulatory level of open banking in the UK meant that banks needed support needed to support open APIs.
• 14:23
  SPEAKER_01: They needed to allow you to move information around.
• 14:25
  SPEAKER_01: When is that coming to healthcare?
• 14:27
  SPEAKER_01: When when should I mean surely as a patient, you should be able to move your data around easily.
• 14:32
  SPEAKER_01: As a practice leader, as a clinician, you should want to and demand easy access of relevant medical records rather than having things passed around the way they are currently.
• 14:42
  SPEAKER_01: But apparently there's not as important as money.
• 14:44
  SPEAKER_01: So there you go.
• 14:46
  Michael: It's like I'd like my data out of my CMS.
• 14:48
  Michael: Oh, yeah, not happening.
• 14:49
  Michael: Or you you know, you have to fight.
• 14:51
  Michael: I've just gone down the route of um screaming GDPR, ask for the GPA.
• 14:55
  SPEAKER_01: Exactly.
• 14:57
  Michael: How quickly they actually give you the data.
• 14:59
  Michael: But then they're still giving it to you in an Excel spreadsheet over an email with all the patient records.
• 15:03
  Michael: About 90% of the people listening right now are sat there going, what the fuck is an API?
• 15:07
  Michael: Let's stop getting so complex.
• 15:09
  Michael: But the people that do get it get it.
• 15:11
  Michael: Uh let's talk about coherent and let's talk about sales.
• 15:13
  Michael: Because sales is such a dirty word in in the industry, and I think it shouldn't be.
• 15:16
  Michael: Um, I think that people um they think of sales as double glazing, but actually, sales is about providing a product that meets a person's need, right?
• 15:28
  Michael: Um, it's very rare that you have to sell.
• 15:30
  Michael: Um, you're not selling something that someone doesn't need.
• 15:32
  Michael: If someone says, I don't need it, I I have a for you, I have a hundred, see a hundred patients a year.
• 15:38
  Michael: Well, you you say thank you very much, you put down the phone.
• 15:41
  Michael: It's not a solution that is applicable to them.
• 15:44
  Michael: At the same time, people don't understand they sell things every single day, right?
• 15:48
  Michael: Whether it's, hey babe, I'm thinking going to Mikanos with the boys this summer.
• 15:53
  Michael: That is a sell, right?
• 15:55
  Michael: We are always selling.
• 15:56
  Michael: And you've got into probably one of the hardest spaces, which is hey, we do sales essentially within the healthcare space.
• 16:04
  Michael: So talk to me about what coherent does, and let's get into the sales stuff.
• 16:07
  SPEAKER_01: Look, we we use the word sales because it makes people uncomfortable.
• 16:11
  SPEAKER_01: Um, and the reality is that that discomfort is exactly the problem that we're trying to solve.
• 16:17
  SPEAKER_01: Um, oftentimes when we say sales in a healthcare context, what we mean is are we following up with people the right way and enough and frequently enough that if they have a genuine problem, you are best positioned to solve that problem.
• 16:30
  SPEAKER_01: And I'll give you a very simple example.
• 16:32
  SPEAKER_01: Um we find in some of our lead inquiry journeys, and I can talk about what that means in a minute, but some of our lead inquiry journeys can take 12, 13, 14 weeks with 20 plus touch points to that lead over the course of 14 weeks.
• 16:49
  SPEAKER_01: And on touch point number 18, in week number 13, suddenly you get an engagement.
• 16:53
  SPEAKER_01: Oh yes! I would I was meaning to reach, I reached out because I had this problem and no conversation at that point in time.
• 17:00
  SPEAKER_01: But 13 weeks later, 14 weeks later, 19 touch points in, a few phone calls, some WhatsApp, some SMS, some emails, suddenly, boom, they come back to life.
• 17:08
  SPEAKER_01: They say, Oh yeah, I reached out for a reason.
• 17:10
  SPEAKER_01: And when we say sales, what we just mean is someone came to knock on your door with a question, and it's too hard right now for them to get an answer.
• 17:18
  SPEAKER_01: We're not recommending to anyone, nor do we open the door and start trying to convince people to buy something that they don't need.
• 17:24
  SPEAKER_01: That is absolutely unfit for purpose in healthcare.
• 17:27
  SPEAKER_01: But the reality is that people inquire, they reach out because they have some kind of problem.
• 17:32
  SPEAKER_01: And the extent to which that problem is heard, understood, nurtured, converted, supported from enquiry through to consultation is a question of following up, being available, ensuring that the patient knows there's an easy way to get the answers that they need.
• 17:47
  SPEAKER_01: Because oftentimes what we find is a patient will go and register interest in four or five different places.
• 17:53
  SPEAKER_01: And everyone says, oh, the speed to lead, the speed to lead is really important.
• 17:56
  SPEAKER_01: And they're right, but there's a whole different problem, which is the consistency to that lead.
• 18:01
  SPEAKER_01: Because some people come and knock on the door and whoever opens first, they're walking in.
• 18:04
  SPEAKER_01: But a lot of people, particularly in MSK, they register interest at a weird hour, during the middle of the day, at a time that it comes to them, maybe they're in pain, maybe they need something, they see something that triggers that action for them, but they're not ready to go walk in the door tomorrow.
• 18:19
  SPEAKER_01: They have questions.
• 18:20
  SPEAKER_01: They want to ask one or two things, they need to confirm one or two things.
• 18:24
  SPEAKER_01: But right now there's so much friction between those questions and those answers.
• 18:28
  SPEAKER_01: They need to call the practice.
• 18:29
  SPEAKER_01: Sometimes someone doesn't answer, it takes a long time.
• 18:32
  SPEAKER_01: So when we say sales, what we mean is make that door, that front door, open, available, and very, very welcoming.
• 18:39
  SPEAKER_01: You don't need to tell someone you do something you don't actually do.
• 18:41
  SPEAKER_01: You don't need to convince them to come in for your service, but make sure that when someone comes and knocks, that door stays open until they decide to walk away.
• 18:47
  Michael: So how do you do that?
• 18:49
  Michael: So uh talk me through um I'm a clinic owner, I don't know I've got a problem, but you show me that I do.
• 18:57
  Michael: What is it that you actually do?
• 18:59
  Michael: So let's take one scenario which is yeah, someone leaves their details on a contact form.
• 19:04
  SPEAKER_01: So if we're having a conversation, you're a clinic owner, so you would say, I would say, how do you handle, tell me how you handle leads?
• 19:09
  SPEAKER_01: How do you handle new inquiries?
• 19:10
  SPEAKER_01: They say, Oh, well, um, we get 200 new patients starting with us a month.
• 19:15
  SPEAKER_01: The first question that we will ask is, cool, how many new inquiries do you have?
• 19:18
  SPEAKER_01: And oftentimes the answer is I have no idea.
• 19:20
  SPEAKER_01: The first problem is how many people are even knocking on the door?
• 19:23
  Michael: And that could be, just to clear clarify, that could be someone phoning up, um, that could be a contact form, that could be an email, it could be any, it could be someone walking through the door.
• 19:33
  Michael: 100% uh uh question.
• 19:35
  SPEAKER_01: And so one of the big problems here is catching that inbound because you've probably got six or seven channels walking in is one of them, although it's not a huge volume, but it is one of them, where people can come inbound.
• 19:45
  SPEAKER_01: You've got social media messaging, you've got SMS, phone, uh some people are coming through on Instagram, some people are coming through on WhatsApp, no one's coming in on LinkedIn yet, but you've got a huge variety of channels in.
• 19:57
  SPEAKER_01: And oftentimes what we find is that practices will um really focus on one or two channels, and then the rest just go wherever they go.
• 20:07
  SPEAKER_01: The number of clinics that are doing that we work with that are doing a million, a million five in turnover and are tracking leads on a Google Sheet would blow your mind.
• 20:15
  SPEAKER_01: I mean it's like it's ab it's it's wild to me.
• 20:17
  SPEAKER_01: These practices are profitable, growing, doing a great job.
• 20:19
  SPEAKER_01: So you'd argue, okay, well, isn't there aren't things working?
• 20:22
  SPEAKER_01: It's working, but you know, it's like adding an extension to your house.
• 20:25
  SPEAKER_01: You want to create, to your point earlier, around site level, you want to create value.
• 20:30
  Michael: Yeah, I I would also say that the I mean, I hear this every day.
• 20:36
  Michael: Going to 300,000 revenues is, you know, people say that.
• 20:40
  Michael: It's that three to five, and then that five to a mil that's really, really tough.
• 20:44
  Michael: And anything you can do to make that journey easier, um, and and let's remember, like it may not sound a lot, one patient, two patients, ten patients, but I always say this.
• 20:53
  Michael: If you have a drop-off of ten patients a month and each patient is worth 500 pounds, that's 5,000.
• 20:59
  Michael: That's£10,000 a year, which is easy, easy, easily solvable, you know.
• 21:05
  Michael: So we're when we're talking about numbers anything north of 10, that's big money to clinics, particularly given what we know about clinics, their margins and so on.
• 21:13
  SPEAKER_01: 100%.
• 21:14
  SPEAKER_01: And so I think to your question earlier, like what does that actually look like?
• 21:17
  SPEAKER_01: The first thing that we do is try and understand at the leads level.
• 21:20
  SPEAKER_01: Um, it's a bit different if you think about retention and recall, but if you look at the leads level, where are people coming from?
• 21:25
  SPEAKER_01: And how many of them are coming from there?
• 21:27
  SPEAKER_01: And those two questions often are unknown.
• 21:29
  SPEAKER_01: So a lot of people say, oh, I know I get X number of leads from my meta ads, because people are tracking their spend, but they don't actually have a view of all these different pathways.
• 21:37
  SPEAKER_01: And what we usually find is that a clinic will have three or four channels that are like the 80 20.
• 21:43
  SPEAKER_01: 80% of their volume come from these these three or four channels, and 20% will sort of hang out in the, you know, in the outliers.
• 21:49
  SPEAKER_01: And so we will usually focus on those channels first for obvious reasons, because if you fix those, then the downstream consequences are very meaningful.
• 21:55
  SPEAKER_01: So let's take lead forms as an example.
• 21:57
  SPEAKER_01: You gave that one.
• 21:58
  SPEAKER_01: So you go to a website, you pop in some details on.
• 22:00
  SPEAKER_01: lead form.
• 22:00
  SPEAKER_01: You've left your name, your phone number, and your email.
• 22:02
  SPEAKER_01: The first question we would ask the clinic is like, cool, what happens next?
• 22:05
  SPEAKER_01: So this person reaches out.
• 22:07
  SPEAKER_01: Let's assume that you receive it and there's no technical issue, which often can be the case by the way.
• 22:12
  SPEAKER_01: A lot of people have lead forms, they don't even know where the lead forms go.
• 22:15
  SPEAKER_01: So let's just say that the lead form comes to you.
• 22:16
  SPEAKER_01: What happens next?
• 22:17
  SPEAKER_01: A lot of practices that we speak to will say, oh, well we send them an email right away.
• 22:21
  SPEAKER_01: Say, okay, great.
• 22:22
  SPEAKER_01: Then what happens?
• 22:23
  SPEAKER_01: We call them two days later.
• 22:24
  SPEAKER_01: Cool.
• 22:25
  SPEAKER_01: Then what happens?
• 22:26
  SPEAKER_01: We send them one more email.
• 22:27
  SPEAKER_01: Then what happens?
• 22:28
  SPEAKER_01: Oh then we don't do it again.
• 22:30
  SPEAKER_01: Okay, interesting.
• 22:30
  SPEAKER_01: So you send them two emails and you've made one phone call.
• 22:33
  SPEAKER_01: Have they answered the phone call?
• 22:34
  SPEAKER_01: No, they didn't answer the phone call.
• 22:36
  SPEAKER_01: Okay.
• 22:36
  SPEAKER_01: So you've now tried to communicate with them three times and odds are they have not received a single point of your communication because most people don't read their emails.
• 22:44
  SPEAKER_01: And if you didn't get them on the phone, they don't care.
• 22:47
  SPEAKER_01: So now you have three touch points.
• 22:49
  SPEAKER_01: You've spent time, money, effort, not to mention spend on leads and marketing to get that person there and you've missed them three times.
• 22:57
  SPEAKER_01: And so now you're going to close the door.
• 22:58
  SPEAKER_01: You're going to you're going to close up shop.
• 23:00
  SPEAKER_01: And we see this, I mean we we we worked with a private surgery and we took on leads that dated back 48 months ago.
• 23:07
  SPEAKER_01: So people who inquired up to 48 months ago.
• 23:10
  SPEAKER_01: Turns out there's value in there.
• 23:11
  SPEAKER_01: People that never had follow-up, that never got responded to, who needed a bit of engagement, not selling, just engagement.
• 23:19
  SPEAKER_01: Hey, you reached out to us, everything okay.
• 23:21
  SPEAKER_01: Do you still need anything?
• 23:22
  SPEAKER_01: And so what we do when we work with the practice is we take that lead flow and we build these very personal high empathy communication touch points from the moment that a lead lands and we do that across all different channels.
• 23:34
  SPEAKER_01: So we'll go into WhatsApp, we'll go into SMS, go into email, go into phone call, and we'll try and connect with the lead in the place that they are most likely to connect.
• 23:43
  SPEAKER_01: So if you're someone who loves to talk on text, cool, we will shut off the other channels because that's where you engage, that's where you focus.
• 23:49
  SPEAKER_01: We know we're going to get your attention and your engagement there.
• 23:51
  Michael: And then so you've got the the lead side of things, whether that's Facebook or Instagram messages or whatever.
• 23:57
  Michael: You then also have the re we'll call it I hate that word, but we you have the recall thing as well.
• 24:02
  Michael: So patient hasn't come in for X number of days.
• 24:05
  Michael: Few questions first is um from what you know what is the rough average conversion rate of the recall and the new lead acquisition channel?
• 24:16
  Michael: What is the average conversion rate that clinics actually get and what is it that you tend to see?
• 24:22
  Michael: Yeah.
• 24:22
  SPEAKER_01: So the the the devil is in the detail here and the detail here is what what is your clinical circus?
• 24:27
  SPEAKER_01: So I'll give you two very different examples.
• 24:29
  SPEAKER_01: Two MSK practices, both doing about a million in turnover.
• 24:33
  SPEAKER_01: In one practice, when we started working with them, we saw uh somewhere between 30 and 40% uplift and reactivations, looking at a it's been six months since people were last in cohort.
• 24:44
  SPEAKER_01: That's a huge I mean it's huge numbers.
• 24:46
  SPEAKER_01: In the other practice we saw six or seven percent so single digit.
• 24:51
  SPEAKER_01: Now the question is of course why what's happening in those two practices?
• 24:54
  SPEAKER_01: The answer is and I'm I'm not from the MSK background so this was interesting learning for us.
• 24:58
  SPEAKER_01: The answer is well if your service is meant to solve and resolve and the patient then goes on their way, there is no continuity of care.
• 25:06
  SPEAKER_01: It's very unlikely that someone comes back in.
• 25:08
  SPEAKER_01: It's quite like a a minor surgery you remove the thing they go you know unless there's a complication you don't hear from them again.
• 25:15
  SPEAKER_01: So the idea of reactivation and recall in a clinical service setting where there is not an ongoing issue is a problem in and to itself because if you don't have long-term care obligations then there's no per no point in that.
• 25:29
  Michael: But even 6% is is still a a a short number and in terms of the new new leads that let's say come in that don't convert immediately what's what do you see as an average conversion for you and what do you see as an average conversion for clinics?
• 25:45
  SPEAKER_01: Yeah so so when we uh when we take on a clinic we see um there's one group of there's one group of clinics where there's nothing in place in which case conversion is zero to 10% on lead inquiry to first appointment.
• 26:01
  SPEAKER_01: Then you have the what I'll call like the warming clinics clinics who are starting to pay more attention to this area.
• 26:06
  SPEAKER_01: They're probably growing a little bit and they're starting to say hold on there's an opportunity here.
• 26:10
  SPEAKER_01: They're usually converting 10 to 20, 25% where we think clinics should be converting and this is where sort of I think the marketing and sales piece need to work together is what do you need to do to get comfortably in the plus 35% conversion efficiency from inquiry to first booking.
• 26:26
  SPEAKER_01: And I think a huge problem that we see in clinics and this is why we love working with with strong marketing partners because a huge part of the conversation is is the lead quality any good?
• 26:35
  SPEAKER_01: And I think a lot of marketing agencies really struggle to get that feedback from the clinic.
• 26:41
  SPEAKER_01: They don't understand why a lead might be disqualified.
• 26:45
  SPEAKER_01: And without that feedback it's very easy as a clinic owner to say hold on nothing's changing.
• 26:50
  SPEAKER_01: I'm paying you to do the marketing but the marketing agency is often saying I mean I'm sure you have this conversation all the time so like hold on a minute A, we're sending you lead quality and B, you're not telling us anything like are they super price sensitive?
• 27:01
  SPEAKER_01: Are they too far away?
• 27:02
  SPEAKER_01: Like how do you know?
• 27:03
  Michael: We'll give you a great example of a a a customer who I spoke to and a month ago maybe who said it's just not working.
• 27:10
  Michael: We've had nothing this month life is terrible and it turns out he had about 40 inquiries but um they weren't picked up they went to an email that he wasn't aware of and they're all sat there.
• 27:22
  Michael: And so you you see I think as a marketing agency generally what we try and do anyway is we try and push people into direct booking.
• 27:30
  Michael: I find that the most effective thing.
• 27:32
  Michael: But that doesn't mean you don't get um leads and you don't get ongoing kind of um new customers coming in different ways.
• 27:38
  Michael: And I think that you're right there is a a mix uh for me often it's you know you you bring in a patient and wonderful it's cost a£25 CPA on a£70 patient or whatever.
• 27:50
  Michael: It's not the end of the world right and they come back five times you've made 300 quid happy days.
• 27:55
  Michael: Problem is a lot of the time they don't come in five times they come in once and so then you're sat there thinking well actually there's a there's a sales problem here.
• 28:03
  Michael: We try and recognise that but I think most agencies don't and they like pushing the responsibility back on the clinical we've got you a hundred Facebook leads that's my that's our job done the the the rest is your problem and and this is why we tend not to do Facebook campaigns actually um because we find them kind of a waste of time very expressionable yeah you're generally having to give discounts and something I said to you on on last week was you end up let's say you you you get 100 leads in at five pounds a lead so you spent 500 pounds that sounds wonderful um but what what then happens is you your CPA you're cost you know it's a good cost right you spent 500 pounds to get 100 people that sounds great until you recognize that you've had to spend 200 hours seeing free patients or chasing them up or sending them emails and everything else.
• 28:53
  Michael: And before you know it you're working for free.
• 28:56
  Michael: Like and then you're filling up your clinic with low quality patients who aren't coming back because they've come in for the discount it to me it just seems a complete waste time when you do the maths on it it just doesn't work.
• 29:07
  SPEAKER_01: I share your view we we we see that very I look I I remember um and and it's interesting I think MSK is uh it feels like it's as you know as an outsider it feels like it's maturing and becoming more commercial possibly in a way that dental did 10-15 years ago but one of the things that uh that that we can learn from dentistry is that there is a lot of focus on treatment plan conversion because a dental treatment plan is 10 grand 20 grand 15 grand the numbers are big and you know big big enough where you go to sleep at night and you think assuming that that patient actually needed my help we really need to make sure we're following up with that person.
• 29:46
  SPEAKER_01: And it's very easy to do that when you know the follow-up is like if if that follow up happens the outcome is 10K, 15K but the reality is the numbers are actually the same in MSK just the volume is different.
• 29:57
  Michael: You have it that's true I I think that where I would make a little distinction is that um I I told you about I had this operation and the next day I got a WhatsApp from the surgeon from the consultant who said how are you doing Michael?
• 30:11
  Michael: Any problems now I recognize that was an all space email didn't look or WhatsApp didn't look like it was very well done but it made me feel fantastic.
• 30:19
  Michael: Now the issue is that for most clinics in the space you don't have the margins you don't have the technology or the access technology or the knowledge of the technology and so you're kind of doing what you can rather than what you should.
• 30:32
  Michael: You don't have the time you know how many clinic owners have the time to be thinking about creating automations with clinic apps or whatever and if they do it's a very quick kind of let's just you know hope for the best they don't have best practice you know I wouldn't even know how to do it and I've done those those things a fair amount of times for in the in the corporate world.
• 30:50
  Michael: So I think um it's it's very very difficult.
• 30:53
  Michael: Question for you what's the average number of outreaches you need to do for a client because you said earlier it was like I think you said 19 they came in at 18 or 19 one question I suppose is how what's the average number?
• 31:06
  Michael: And the second question is how do you not piss people off by going out this is the there's so much attention here.
• 31:13
  SPEAKER_01: So look the the average varies by where they are on the journey.
• 31:16
  SPEAKER_01: So if you're a lead oftentimes the number is much lower usually around five or six um can get much longer than that but oftentimes much lower because you're coming in interested there's a clear point of interest in recall it can be eight, nine 10.
• 31:28
  SPEAKER_01: In some clinics oftentimes in medical aesthetics dermatology can be 12, 13, 14, which again is maybe not a huge surprise.
• 31:35
  SPEAKER_01: You haven't been in for 12 months the first few points of engagement you may not even see.
• 31:40
  SPEAKER_01: Maybe you do see them, you're on holiday.
• 31:42
  SPEAKER_01: Maybe you're in the middle of a meeting and something pops up you disregard it.
• 31:46
  SPEAKER_01: So we often find that if you're not actively thinking about it in the way you would be as a lead, if you're somewhere else in the journey, it's more likely than not that 50% of the correspondence that hits you, you don't even recognize you don't even hold that context.
• 31:58
  SPEAKER_01: So if you're saying okay it's gonna be 12 touch points, realistically it's six.
• 32:02
  SPEAKER_01: Six will actually make their way in front of you.
• 32:04
  SPEAKER_01: And by the way, of those six, three of them probably come at the wrong time.
• 32:08
  SPEAKER_01: So they have one second of your attention.
• 32:10
  SPEAKER_01: So if you're doing 12 touch points, it's actually more like three that are probably landing and holding your attention before your child comes in and asks for something where your partner comes in and says something you you need to be very aware of the fact that when you're doing that outreach, your competition is Netflix.
• 32:26
  SPEAKER_01: You're you're competing with someone's life you need to show up in the right time at the right way like this is a completely different game than someone calls you and wants to talk.
• 32:35
  SPEAKER_01: All you need to is answer the phone.
• 32:36
  SPEAKER_01: That's an easy thing to do.
• 32:38
  Michael: Yeah I and I suppose uh and I don't know this but I assume you have some intelligence behind it.
• 32:44
  SPEAKER_01: So if someone is opening 15 emails you're probably going to think carefully about sending them another email and just the same email you're gonna be more intelligent maybe swap the channel maybe yeah so so we we try to go where the patient is um so if they respond in a certain channel or at a certain time of day we try and index to that because maybe they've got a working pattern where they're on lunch at 1.30 in the afternoon might as well match like message them then because that that's a good time for them.
• 33:14
  SPEAKER_01: It's not necessarily a good time for the clinic because the clinic is in the middle of seeing patients but turns out that 1.30 p.m for Michael is actually a really good time to message him so you might as well I I get bloody every fucking week 9 a.m on a Monday every month 9 a.m on a Monday I'll get my dentist like messaging me or texting me.
• 33:33
  Michael: And I'm like it's I have things to do with 9 a.m on a you know that time and I honestly I just ignore them.
• 33:39
  Michael: And then the other interesting thing is because it's not intelligent it's a little bit like I I put uh gym time in my diary every single day at the same time once you miss two or three of them you just ignore them it becomes like something yeah you you we we and we do see this where you know patients will just go the it'll they'll just go numb to the communication.
• 33:59
  SPEAKER_01: And I think one of the things that that we often say to practices when we start working with them is can you tell us what you currently send out monthly mailers, updates, because the reality is that a lot of practices don't realize that they are training their audience to ignore them.
• 34:14
  SPEAKER_01: Your monthly mailer with all due respect is probably not very good.
• 34:18
  SPEAKER_01: Not because it's not important, but because it doesn't really matter.
• 34:21
  SPEAKER_01: It's not relevant to the person that's receiving it.
• 34:24
  SPEAKER_01: And so every time you communicate with your audience, you are numbing them if that engagement is not meaningful, personal, relevant to them.
• 34:31
  SPEAKER_01: And so if you train someone much like you're saying if you send them an email every month and that email is here's what's new where we've got a new machine we've got a new unless it's relevant to them, they are in a behavior pattern of ignoring it.
• 34:42
  SPEAKER_01: So then when you email them again and you say hey we haven't seen you in a while is everything okay the default reaction you're you're swimming upstream right it's now I have to pull you out of that behavior and send you down a new pathway.
• 34:54
  Michael: And do you know what you see that throughout industry as well so you get an email from all saints and they don't recognize whether you're male or female.
• 35:00
  Michael: And you're like what what are you doing?
• 35:02
  Michael: Like or or a good one is um Uber Eats who keeps sending me offers for like Chinese and like I don't eat Chinese you know what I order yeah right send something as personalized to me.
• 35:14
  Michael: Do you do and out of interest because we do we do a lot of this but do you segment as well?
• 35:19
  Michael: So are you segmenting that audience into different types of people so so not as much as you might think.
• 35:26
  SPEAKER_01: So maybe that's a shortcoming in how we work by the way so the answer is we should be but I think what we find is that generally a lot of patients want to feel heard they want to feel supported they want it to feel like a human interaction and that is often by itself 10x better than dear first name email template that looks designed and obviously automated.
• 35:51
  SPEAKER_01: It's been X months since we've seen you please call the practice to book your next appointment do not reply to this email.
• 35:57
  SPEAKER_01: And the number of emails and SMS I mystery shop a lot of clinics as you can imagine and oftentimes I will get text messages that say oh thanks so much for calling us if you need to make an appointment call us please don't reply to this message.
• 36:08
  SPEAKER_01: And it's because whatever platform they're using doesn't allow for two-way messaging on SMS.
• 36:13
  SPEAKER_01: So I mean how crazy is it that you're you're inserting friction into an I mean imagine if you go on Amazon and you add things to your basket and you go to press checkout.
• 36:23
  SPEAKER_01: Now Amazon masters of one click checkout which is what you should be aspiring to in your healthcare clinic but instead of going to one click checkout they say oh click here to to order your purchases oh great we've just sent you an SMS click there to complete your purchase you go to the SMS you do that great we've just sent you an email with a one-time password say you drop off like people don't complete that journey and you other industries have been investing in marketing tech or in converging tech for years.
• 36:49
  SPEAKER_01: This is not new but it's new in a healthcare context because the systems of medical record have been extraordinarily inefficient in their management of communication patient engagement.
• 37:00
  SPEAKER_01: And the question is whether or not now is the moment for that to change.
• 37:03
  SPEAKER_01: And honest answer is I'm not sure we hope it is but that's very much what we see in terms of what's in front of us.
• 37:08
  Michael: Well that there are systems out there this a million times you know you it it takes you an hour to fill out and get to the to the appointment booking you know there's one in particular where uh you can't even see the availability without being hit with a give me your phone number first and then now create an account and oh my god and and you know I I I I have an example where I wanted to buy a pair of Reebok trainers and or a pair of trainers that happened to be Reebok trainers um for the gym that I don't go to still brand new sat in the corner um but it was so easy I saw these trainers it said pay now and it went Apple Pay I went bing and it was done it was easy it was great and then it said to track them and see where they are would you like to put in your email or in fact it was because they had my email it was uh um put it put in a password now I've created an account if I want later on they gamify it so do this and I'll give you 10 pounds if you fill out a few more details or whatever but that's the way you should do it and you know we we we are starting to build out some stuff everything is done by magic link now there's no remembering your password there's no kind of creating accounts it's just bing click here magic link said to you Monzo that's you know Monzo does it incredibly well where it's just magic link and and so on.
• 38:22
  Michael: And I think the friction that's caused with most um medical systems is is is 10 years ago.
• 38:30
  SPEAKER_01: It's interesting we work with um we were with a lot of medical aesthetics practices and there's one software a PMS that I I I won't name where uh you have to make an account as you're suggesting you have to make an account to make a booking and we were onboarding this clinic and we were going through this booking flow and we kept hitting this issue which is that there's a drop down in the booking flow if you're a new patient.
• 38:51
  SPEAKER_01: So if you're an existing patient you can go in you can log in when you make a booking it says put your username and your password I don't know who remembers that but let's just assume they do you go ahead and you make your booking.
• 38:59
  SPEAKER_01: But if you're a new patient you have to create a new account in order to make the booking.
• 39:04
  SPEAKER_01: Let's assume for a minute that you're willing to do that.
• 39:06
  SPEAKER_01: They don't make it visible in the checkout screen you have to press this little carrot down thing that opens up for new patients.
• 39:13
  SPEAKER_01: We have for this clinic we probably have and I kid you not five or six percent of the lead volume that we do with them are people who tried to book online and couldn't and messaged us instead.
• 39:25
  SPEAKER_01: Now fortunately we can handle that inbound but if you're a clinic and you're running this out of your front desk and you assume that whoever is there doing a thousand things is going to be able to handle and deliver and convert reliably on that inbound, you are wrong.
• 39:38
  SPEAKER_01: There is no way for that to happen.
• 39:40
  SPEAKER_01: So you're just giving it away I mean you're you're just bleeding out for no reason.
• 39:44
  Michael: I see that all the time like if you're asking someone to pay for an appointment and and most likely they're on mobile um if you are not offering Google and Apple Pay you're doing it wrong.
• 39:54
  Michael: There's absolutely no reason you can't do that.
• 39:56
  Michael: And if your PMS doesn't do it they can it is a very simple integration to to make and yeah it it it's it's surprising because we often see phone calls going up dramatically when people don't want to use the system there's one one of the biggest um in the industry in the MS game industry where I I went to it and I thought oh I'll just use my Google login this is good you know log in with Google great they've got that capability.
• 40:18
  Michael: So I do it and I log in with Google but first of all you choose your appointment so I wanted Wednesday at 10 a.m log in with Google and then it says answer all these bloody 400 questions.
• 40:26
  Michael: I'm like okay answer all the questions congratulations account created appointment not there.
• 40:31
  Michael: I'm like what how do I get to the appointment so I had to go back into the booking system but guess what it obviously reserves that appointment for like 20 minutes.
• 40:39
  Michael: So I'll go back in there and it's not in there.
• 40:41
  SPEAKER_01: Yeah because you're holding it for yourself.
• 40:43
  Michael: Is it very kind of you to do that to it because I've created an account it it it honestly um so no I think I think um a lot of this a lot of the tech I think does point to um being quite deficient in what it does which is kind of where you come in with with with the sales solution and um and also recall you know I always get questions what's the best recall software and um and I and I think quite honestly there are so many out there.
• 41:10
  SPEAKER_01: I think unless you know what you're doing with them you probably should be getting some notes a lot look a lot of the okay I won't name names a lot of the clinics I we work with do have either an in belt to the PMS or a or an existing bolt on app especially in clinic you know clinical boltons and what we find is that a lot of the approach there is just set it and forget it.
• 41:28
  SPEAKER_01: You log in one day you create your five recall emails maybe you throw in an SMS because you're feeling excited and you want to spend and you just never look at it again.
• 41:35
  SPEAKER_01: And the reality is that all of these things are just data problems.
• 41:39
  SPEAKER_01: They're just data problems.
• 41:40
  SPEAKER_01: What message at what time on what channel is most likely to drive engagement cool do that again.
• 41:45
  SPEAKER_01: And if you set it and forget it and you're never looking at that data or you don't have the capability to look at that data, you're just going to be rerunning the same thing ad nauseam and you have no idea if it works.
• 41:55
  SPEAKER_01: You have no clue if it works.
• 41:56
  SPEAKER_01: And sometimes sometimes then it doesn't work.
• 41:58
  Michael: Feel it because every one of us listening to this and us, we are sat there every day getting automated emails, texts, LinkedIn messages, sending us some nonsense and you are as a clinic fighting with that stuff.
• 42:12
  Michael: Don't think when you're my dentist or whoever it might be you're emailing me and and I somehow see you differently.
• 42:19
  SPEAKER_01: I don't I see you exactly the same as everybody else and and you are as a clinic you are fighting a a military grade attention war with a toothpick because you are up against Nike and Adidas and companies that have entire teams of data scientists and marketers and design engineers that are trying to serve the right thing at the right time.
• 42:41
  SPEAKER_01: And by the way they're doing that for a pair of shoes that might cost 100 pounds.
• 42:46
  SPEAKER_01: They've invested that now obviously they're at a huge scale but they're doing that for an 100 pound transaction maybe even a 50 pound transaction whereas you have an opportunity to serve a customer that might contribute 500 pounds to your top line.
• 42:57
  SPEAKER_01: And why are you sending out emails?
• 42:59
  SPEAKER_01: What's going on here guys?
• 43:01
  Michael: This is now 15 years ago and I don't even know if it still exists but we used to use um movable inc.
• 43:06
  Michael: Have you ever come across movable?
• 43:08
  Michael: Like you are sending out campaigns designed on what the weather's like at any given time so we were you know if you were in one area where it was sunny and another area in the UK where it was rainy you got different emails like there was so much complexity complexity and that was back then never mind today.
• 43:26
  Michael: So you are fighting and unfortunately you are also fighting with other clinics so if you're doing I I do want to be positive if you're doing something it's better than doing nothing 100% there are many clinics do nothing um if you can optimize we don't have long left because I know you have to jump but I do want to talk about um I'm not gonna ask you what you charge because I think there are it's always going to be a different use case whatever but you do charge because I had a client say Jesus Christ do you know how much Jared charges and I was like well yes but if you're generating you know an extra 5000 pounds what's 5000 Pound batter.
• 44:00
  Michael: What's 10,000?
• 44:01
  Michael: If you're getting a five to one return, don't like I said to you, charge me a million pounds.
• 44:06
  Michael: Because if I want to get five times return on a million, happy days.
• 44:08
  Michael: Um, but it does then lead to that question about price sensitivity in the industry and ROI, which I see a lot of, right?
• 44:15
  Michael: You you spend a thousand, make five thousand, oh, but a thousand is expensive.
• 44:18
  Michael: Do you see that yourself?
• 44:20
  Michael: Every day.
• 44:22
  SPEAKER_01: Every every day.
• 44:22
  SPEAKER_01: And and I look, I if I put on my clinic buyer hat, which I was for many years, like I understand that mindset very well.
• 44:29
  SPEAKER_01: I get it.
• 44:29
  SPEAKER_01: I mean, signing up to a big price signing up to a big price tag is scary.
• 44:34
  SPEAKER_01: Um, it feels like fixed cost on a month to month, which can sometimes already be volatile.
• 44:40
  SPEAKER_01: Um, I understand completely why a big ask induces it in induces some kind of worry.
• 44:47
  SPEAKER_01: Um, the thing that I think is worth uh is worth mentioning, not to plug ourselves, but we also fear sure for a period of time.
• 44:53
  SPEAKER_01: So if we can't deliver an outcome for you, like you've spent some time with us, hopefully you've learned something and benefited a little bit, but if we can't reach a mutually agreed commercial target, we're either very happy to keep working at no cost to you until we can deliver ROI positive outcomes, or we'll just give you your money back.
• 45:08
  SPEAKER_01: Um and that's because we are A, happy to back ourselves, and B, are very aware of the fact that the price tag is scary.
• 45:16
  SPEAKER_01: But one of the reasons, and this is sort of on the record, off the record, one of the reasons that we we lean in hard on pricing is because what we often find is that clinics will dramatically underinvest in doing the hard work up front to get the right outcome.
• 45:28
  SPEAKER_01: And so when we actually started, we had clinics that were coming on in the uh orders of cost lower, and the ROI was better, but the commitment to seeing through was not there.
• 45:41
  SPEAKER_01: And I think what we've learned is that the relationships that we have with clinic owners that are really the most productive are those where there's almost a shared energy, a shared intensity to move forward and really tackle the problem front front and center.
• 45:55
  SPEAKER_01: And I think that that that's ultimately why we've landed where we do.
• 45:57
  SPEAKER_01: And there are some clinics who will happily engage with us on that basis, and others who might say, listen, it's it's too top heavy, and that's that's fine.
• 46:06
  Michael: So I suppose one of the things when it comes to ROI, they're also I I think you have to remind people of the time because they're not there um necessarily doing the work themselves because you're doing it, and then there's the numbers on top.
• 46:20
  Michael: Yeah, I mean, do you find price and just very costing?
• 46:23
  Michael: Do you find price sensitivity different in MSK than you do in maybe other industries?
• 46:28
  Michael: We do.
• 46:29
  SPEAKER_01: Uh we we do.
• 46:30
  SPEAKER_01: We find that um it is generally speaking more price sensitive.
• 46:34
  SPEAKER_01: And I think there's less I think the way that the cal the economic calculus uh people add up, the costs and the benefits don't necessarily stack up in quite the same way.
• 46:43
  SPEAKER_01: I think a big point of what you just said is true, which is much like the work that you guys do at HMDG.
• 46:49
  SPEAKER_01: Um you're doing it for them.
• 46:50
  SPEAKER_01: And I think there's a huge difference.
• 46:52
  SPEAKER_01: I always say if you're using zero as an accounting software, it's a bit like paying an accountant or or just using zero yourself.
• 46:58
  SPEAKER_01: There's no shortage of software.
• 46:59
  SPEAKER_01: Like you can anyone can go sign up a zero for 30 pounds a month, but doesn't necessarily mean you doesn't mean doesn't necessarily mean you get your taxes done the right way.
• 47:06
  SPEAKER_01: And so I think there's a there's a huge difference between I'm gonna pay for a hundred pound a month software tool that may or may not actually get the job done, or I'm gonna hire a team to try and do it for me.
• 47:16
  SPEAKER_01: And I think different perspectives, but the done for you model is more time intensive because someone's got to do the work.
• 47:22
  SPEAKER_01: Um, not your team necessarily, but yes, the the the short answer is that we do find it to be slightly more price sensitive than in some of the other elective care markets, but that may also be changing.
• 47:30
  SPEAKER_01: It may also be the fact that that's that's shifting now.
• 47:33
  Michael: Okay, listen, thank you so much for joining me.
• 47:35
  Michael: I know you've got a jump.
• 47:37
  Michael: How can people get in touch?
• 47:39
  SPEAKER_01: Uh website is good, LinkedIn is fine, email is fine.
• 47:42
  SPEAKER_01: You you you wouldn't be surprised to know that we follow up with everyone.
• 47:46
  SPEAKER_01: Uh everyone.
• 47:47
  SPEAKER_01: That's sort of part of the game here.
• 47:48
  SPEAKER_01: So we use our own our own tools to do that.
• 47:51
  SPEAKER_01: But uh very available and happy to chat to anyone.
• 47:54
  SPEAKER_01: Website is coherenthq.com.
• 47:58
  Michael: And uh LinkedIn is just Jared Aaron 1A, not that's it.
• 48:04
  SPEAKER_01: Exactly.
• 48:05
  SPEAKER_01: And and uh and very happy to chat.
• 48:06
  SPEAKER_01: And I and I should say very openly that we there are no shortage of conversations that we have with clinic owners who just want to talk through things, understand what they're doing, benchmark it to what we do, no problem.
• 48:16
  SPEAKER_01: Like we do all kinds of whiteboarding stuff, no charge, no cost, totally open door policy.
• 48:21
  SPEAKER_01: Happy to chat, and if it's ever of interest, then like conversation is open.
• 48:25
  Michael: Wonderful.
• 48:26
  Michael: Thanks again for joining, and we will chat soon.
• 48:28
  SPEAKER_01: Thanks, Michael.