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In this episode of the GrowDental podcast, Luke dives into the r/Dentistry subreddit to answer real questions from practice owners struggling with marketing and growth. What emerged from those conversations is a framework that challenges everything most dentists believe about their biggest constraint.
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A dentist buys a South Florida practice. Previous spend: $5,000 monthly on ads. New plan: hire a strategist, reorganize, cut costs. Result: phones go silent, patient flow crashes.
The owner’s instinct? Panic. The real question: Was $5k the problem?
Here’s what actually happened. Spend less, get less. That part is simple math.
The complicated part lives downstream. What happens after someone calls or fills out a form? Because in most practices, the enemy isn’t your marketing budget. It’s operational leakage. Missed calls. Weak follow-up. Zero visibility into what your website produces.
If that’s your reality, more ad spend won’t solve growth. It will scale your waste.
This framework is for owners who want to grow the right way. Plug the leaks first. Scale what works second.
The Trap — Treating Marketing Like the Problem When It’s Just the Amplifier
Most budget arguments skip the only question that matters. Are you stewarding the opportunities you already pay for?
Marketing is not magic. Marketing is volume. Turn it up and you get more attention, more inquiries, more exposure of whatever’s broken underneath.
In the South Florida case, the most predictable outcome occurred. They cut spend and lead flow dropped. That doesn’t prove the original budget was right or efficient. It proves it was producing volume. But the real insight is this: ad spend is relative.
Consider the context. Where exactly are you? Miami versus a suburban market are different games. How competitive is your local area? How big is the practice now, and how fast do you want to grow?
A flat number like $5,000 monthly means nothing without those answers. In some markets it’s average. In others it’s conservative. In others it’s reckless.
But even if your spend level fits your market, your biggest constraint may still be operational, not marketing.
The Silent ROI Killer — Missed Calls and Abandoned Calls
Want one metric that exposes the truth fast? How many calls are you missing right now?
Not what your team thinks. Not what feels right. The hard number.
Here’s the reality most owners avoid. The average abandoned call rate sits between 20 percent and 40 percent of calls going unanswered. Pause on that.
If you miss one out of four calls, you don’t have a lead generation problem. You have a conversion capture problem. And if a meaningful chunk of those missed calls are new patients, you’re bleeding revenue daily without knowing it.
Why This Matters More Than Your Ad Budget
The compounding effect looks like this. Your missed call rate is 25 percent today. You crank marketing spend up. You push your team beyond capacity and that missed call rate climbs to 40 percent or higher.
So you spend more. You get more inquiries. You lose more opportunities because your systems can’t absorb the volume. This is how practices convince themselves marketing doesn’t work, when the truth is they never fixed the bucket.
Where to Find the Truth (Not Opinions)
Most practices already have the data. Owners just don’t look.
You likely use a VoIP system. Those platforms show call stats, including abandoned call rate and missed calls. The next step isn’t just the percentage. It’s segmentation. What percentage of missed calls are new patient calls? That one metric tells you whether your next dollar goes to ads or operations.
The Other Black Hole — “How Many New Patients Did Your Website Bring You?”
One strategist asks a question almost nobody can answer. “In 2025, how many new patients did your website bring you?” Common response: silence.
This isn’t a minor gap. It’s a fundamental business blind spot.
If you can’t measure what the website produces, you can’t evaluate whether your site does its job, whether your online scheduling gets used, whether your forms get answered, or whether you’re losing patients quietly while telling yourself the website is decent.
The Website Isn’t Just Branding
Sure, a website informs people. But in the context of practice growth, it has a job. Turn interest into action. If you don’t know whether it’s doing that, you’re operating on vibes.
The Practical Audit Most Practices Never Do
If your lead flow feels low, take a hard look at where you’re bleeding. Start with two questions. What are the form submissions and appointment requests like? Where are those requests being routed, and who owns follow-up?
Because “we don’t get website leads” is sometimes code for something else. Requests go into an inbox nobody monitors. Notifications go to the wrong person. Patients get a slow response and ghost. The follow-up experience feels cold and transactional.
In other words, the website might be working. Your process might not.
Google vs. Meta Isn’t a Preference Debate. It’s an Intent and Workflow Debate.
A lot of dentists talk about Google versus Facebook like it’s personal preference. It’s not. It’s about patient intent and what your practice can handle.
Here’s the breakdown. Google is more bottom-of-funnel because you capture existing search intent. People actively looking. But it’s also more competitive, and demand is limited by how many people search in your area. Meta (Facebook and Instagram) is more top-of-funnel. You reach people who could become patients, but you often need workflows and automations to warm them up and convert them.
Here’s the operational reality most practices miss. If your follow-up is weak, top-of-funnel leads die. If your phones aren’t answered consistently, bottom-of-funnel leads die too. The platform won’t save you from poor stewardship.
This is why fixing leaks first is so powerful. It makes every channel work better.
The “Plug the Leaks” Growth Framework — What to Fix Before You Spend More
If your schedule isn’t where you want it, your instinct may be to throw money at marketing. Sometimes that’s right, but only after you validate the fundamentals. Here’s a practical sequence.
Step One — Pull Your Phone Data Today
Log into your VoIP system. Find your abandoned call rate and missed calls. Identify what percentage of missed calls are likely new patients. If you’re missing a big chunk of calls, that’s not a marketing problem. That’s an operations problem that marketing will only magnify.
Step Two — Review the Follow-Up Experience (Not the Theory)
A simple but revealing approach: listen to phone calls and evaluate customer service like a real consumer would. If you want to remove self-deception, do what one doctor did. Call your own practice pretending to be a patient to screen the phone experience.
This isn’t about being sneaky. It’s about being honest. Owners often assume the experience is good because the team is nice. But nice doesn’t always mean confident, efficient, or conversion-minded.
Step Three — Audit Your Website Conversion Path End-to-End
Don’t argue about whether the site looks good. Ask how many appointment requests come in. Are submissions truly zero, or just disappearing? Who is responsible for responding, and how fast?
If you discover leads are coming in but not getting handled well, the fix might be far cheaper than increasing ad spend.
Step Four — Only After the Leaks Are Plugged, Decide Whether to Scale Spend
At that point, scaling marketing becomes rational because you’re scaling a machine that can actually capture demand.
A practical benchmark: marketing spend often falls around 5 percent to 12 percent of collections. Don’t treat that as a rule. Treat it as a reality check and tie your decision back to your market competitiveness, your growth goals, and your operational readiness to handle more volume.
One more sharp point: if you truly want to grow aggressively, you may need to think in terms of the percentage of where you want to be, not just where you are. That can work, but only if you’ve already fixed the conversion bottlenecks.
When the Answer Really Is “Spend More” (And How to Do It Without Getting Burned)
Sometimes, after you do the audits above, you’ll confirm something important. Call volume is genuinely low. Website requests are genuinely low. You’re not leaking opportunities. You simply don’t have enough opportunities.
In that case, the advice is direct. You just need to spend more. But even then, don’t blindly hire anyone who sells ads. Use a vetting process that protects you from expensive mistakes.
Find a reputable marketing company with case studies and testimonials from doctors you’d actually want to emulate. Ask to speak with three to five of those doctors. Do real research, then make an educated decision.
That last part matters. Dentists often buy marketing like they buy equipment, based on features. But marketing is closer to hiring. You’re paying for execution quality, strategy alignment, and consistency.
The Bottom Line — Marketing Isn’t Your Growth Strategy. Stewardship Is.
If you remember one thing from this entire framework, make it this. Marketing doesn’t fix a leaky practice. Marketing exposes it.
If your phones go unanswered, if your follow-up is inconsistent, if you don’t know what your website produces, then scaling marketing is like pouring water into a bucket with holes. You’ll feel busy, spend more, and still wonder why the finances don’t add up.
But if you plug those holes, if you maximize stewardship, then marketing becomes what it’s supposed to be. A predictable lever you can pull to grow.
The owner in the South Florida story didn’t discover that marketing is bad. They discovered something more useful: their spend was driving demand, and the moment they removed it, demand dropped. The correct response isn’t to argue about whether $5k is too much. The correct response is to build a system that can reliably convert whatever demand you create, then scale with confidence.
