Marketing for Multi-Location Dermatology with Maite Uribe-Echevarria of Sanova Dermatology

Announcer: Welcome to the Ignite Podcast, the only healthcare marketing podcast that digs into the digital strategies and tactics that help you accelerate growth. Each week, Cardinal’s experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.

Alex Membrillo: All right, everybody, welcome back to Ignite. I just woke you up on your drive home, but you’re going to really enjoy today’s discussion. This is good. We’re going to get to talk dermatology. We’re going to get to talk about Spain’s net, the Netherlands, Chile, and mostly soccer, not baseball and not boring golf. No offense, Maite. Welcome to Ignite.

Maite Uribe-Echevarria: Hi, Alex. Hey. Yes, I’m excited. This will be good.

Alex: No problem. I’m really pumped. It’s my favorite part of the week. Don’t tell my colleagues, but this is my favorite part of the week because I get to learn from you. This is what keeps us fresh.This is how we learn like we would just go to pitches and we don’t– it’s hard because it’s a one-way. We get to learn from you and so do all of our listeners. We’re going to hit them hard for the next 15 minutes. That’s fun. Maite, tell them a little bit about you, what you do, and where you do it at Sanova.

Maite: I am the VP of marketing for Sanova. We have 12 locations across Texas and Louisiana. I started in this business 16 years ago at this point, just a little bit ago, but the Botox helps. [laughter] My home base is Suzanne Bruce’s office in Houston for those of you who know her. She’s an amazing doctor, just really cool person. What drew me to this industry particularly was a fluke meeting with Dr. Bruce and her husband who had a very forward-thinking practice, very business-oriented. He went to grad school and he had incorporated a lot of the business practices and they had a 80% cosmetic practice 16 years ago.

Heavy marketing environment with lots of opportunity. I’ve been having fun ever since because I’m still here.

Alex: 16 years, we’ve been doing this thing for the same amount of time. I have no Botox and you can tell, guys. I might be able to show emotion but definitely look–

Maite: It’s all about small movements.

Alex: My wife is like, “Can you tell I’m very frustrated with you?” I said, “No, baby. Was the appointment yesterday?” That’s fun. At Sanova, you’re in charge of all things marketing and it’s general and cosmetic, correct? You’ve got the–

Maite: Oh, yes. It’s general, it’s medical, it’s cosmetic, it’s surgical. We have most surgeons as well. It is plastic surgery. We have research business as well. Then we have a pharmacy side that I don’t touch too much.

Alex: Yes. That’s a lot of service lines. How do you prioritize? We’ve been talking about MOps, marketing, and ops alignment all year. How do you prioritize? Guys, what do you want me to do? Get them in on general and then we cross-sell them? Do we just go right to plastic? How do you how do you set your trajectory and your priorities?

Maite: Great question. I think that ops and marketing are one. We’re like bestie, right? Marketing can’t do anything without the great ops team. Ops only gets better with marketing, in my opinion. Together it’s like creating that strategy. I think it depends on the clinic. When you have multiple clinics, you have different personalities in each clinic and the doctors dictate that. In my cosmetic forward clinics, it’s obviously that’s the entry point. They come in for cosmetics and then the referral business gets around. I consider it like– did my internship at Campbell’s.

It’s a really long time ago. Their counter-cyclical business was pork and beans. They’ve gotten rid of that brand since. I consider the medical dermatology in this office is like they’re pork and beans, right? Just to put it nicely. On my medical side, it’s completely different, right? It’s really the medical clinic is first. Then if we get med spa business out of that, it’s a conversion at that point.

Alex: Conversion. Okay. We won’t call it a cross-sell. That’s interesting. You have some that are cosmetic forward and general or medical forward. Are they acquisitions? Is it Sanova? Is it M&A? Okay. You acquired one and had a– are they centrally located so they can send people to each other? Is there a cosmetic focus one a mile away from the medical general like, or was it a business plan?

Maite: In Austin, for example, we have five different clinics. People really don’t travel between those clinics too much. It can happen, but it doesn’t really. We have a smattering of all offerings in those offices. We have a little bit of cosmetic, a little bit of med spa, but mostly medical, right?

Alex: Okay. I got you. You get with ops and you say, “Hey, listen, what are we going for here?” I can tell you’re forward this or, leaning towards this, we’re going to drive marketing towards that. I also saw that you guys have scheduling online. Is that right?

Maite: We do.

Alex: Okay, cool. Who are you doing that through? What’s the tech partner? How’s it going?

Maite: NextPatient. Absolutely adore them. Clyde Corey. He’s amazing. Honestly, we’ve gone through a lot of tools there in that department, that area. I think they’ve done just a really good job of simplifying the process for the patients and keeping it open. Then you have to go through the whole getting your doctors to adopt it. It’s never going to be perfect, but man, they get us so close that it’s amazing.

Alex: NextPatient. Very good. Talk to me about the, you have to get the doctors to adopt. A lot of doctors are hesitant to put their counters because they want flexibility, I guess. Right? Was that the main hurdle?

Maite: Also, no-shows go up with the online scheduling. There’s not that emotional investment when they create that appointment. You have to work with that and figure out how you can work around mitigating that problem by calendaring it really well, like creating templates and you’re scheduling all that jazz.

Alex: Have you guys tried calling them after the online booking has made? Does that help?

Maite: It does help. it just depends on the office and the patient base. I find that it’s very dependent on who each doctor attracts to their clinic, how the patient base behaves. Then you adopt how you treat them.

Alex: Tell me more. Are you trying to insinuate that a certain, maybe an older demographic, like what are we– No HIPAA violation. We’re not talking about anyone specifically.

Maite: No. Obviously, age plays a factor, and where you are in a city, like how hard it is to get to your office, all kinds of things can play a factor, even the demographics of the doctor itself.

Alex: Very interesting. The no-show rate was one hurdle and they’re like, “Man, I had this thing booked and now I’m at the office and this is nothing– nobody’s coming to the clinic.” How do you get them over that? You say yes, but how do you do that? You said generally like, “Hey, we’re booking a lot more overall.” What do you do?

Maite: Yes. Data wins any argument, right? If you’ve got the data, you can win the argument and it’s not an opinion thing. It’s you pilot it, you test it and then you bring that data and you say, “Look, so many people are using this and it’s clearly a convenience factor. I would say we get over 20% of our appointments come through the online scheduler at this point. Of that 20%, we’re seeing a massive number of people doing it on the weekends and after hours [crosstalk]

Alex: I love that. 20%. I was going to ask what’s the total distribution. Probably still a lot of calls, right? The forms is not a–

Maite: Yes, so we’re working on some new tools there. I’m really excited.

Alex: I got to tell you, Maite, I don’t know if this applies to Sanova, but I send an e-mail for– I’m trying to get these like fat things around my– I know cholesterol, but I don’t know. My wife tells me I’m ugly sometimes. I’m trying to get a remote and I submitted an e-mail form to one of the biggest MSOs in the derm space. I won’t name them. You don’t hear back. I still haven’t heard back. It’s been over a week. E-mail forms just don’t get responded to, man. If you can’t respond, don’t have them.

Maite: They do at our office.

Alex: All right. I love that, Maite. Are you guys running digital advertising for these 12 or some of them?

Maite: No. I think we’ve spoken in the past about this because I’ve been going on this whole journey, right? Unlike, in cosmetics, social media marketing has been like the big thing that happened over the last couple of years. At this minute, it’s super-saturated. I’ve been on this journey of figuring out what’s next. Where do I want to put my eggs? What basket? Pre-pandemic, we had a ton of pay-per-click advertising going on and it was unclear to us at that point, how much business was that really generating versus the expense of it.

During the pandemic, we did a massive shutdown. We shut down all our pay-per-click advertising and it was significant amount of our budget. We found it had zero effect on our business. My original background actually comes from pay-per-click. That’s where I [crosstalk] even before I went to business school. I’m a believer in it. I just think that things change so quickly and stuff changes that, you have to adapt. We adapted by going into social media advertising, getting really involved with local groups, a lot of local marketing.

Now we’re looking again as what’s the next step.

Alex: I love it. PPC alone, not great alone. The CAC is high. You got to blend it with organic and social media efforts. I always say that it’s not a carte blanche solution. People say, “Just ramp up the PPC.” It doesn’t work like that.

Maite: It doesn’t work that way.

Alex: There are more cost-effective things you should do first. Local boots on ground. Tell me more about that. Is that high school sponsorships or that’s PCP referral?

Maite: I’m afraid to tell you what if they steal my ideas?

Alex: All right, don’t. Just say is it referrals or is it sponsorship-type stuff?

Maite: We do a lot of work in local mom groups. That’s the demographic that makes the health decisions. Yes, I know your eyes [unintelligible 00:09:43].

Alex: Yes, that’s hard to scale going into Facebook groups. Is that–

Maite: It can be a little bit hard to scale. You do need the staff to manage that stuff. I give moms a lot of credit. I’m one myself. We know how to organize. They definitely know how to organize their groups. They can be incredibly strict about their advertising policies, but it’s incredibly fruitful because if you’re in there and they feel like you’re part of their community and you’re helping service our community, it pays back tenfold. You really can establish a reputation in different graphic areas like that.

Alex: That’s part of why I also love medical marketing because you reach that mom. That’s like, not just a click. That’s like a mom getting care for her family. A teen who feels very uncomfortable at school. I was that–

Maite: Not just the kids. It’s her mom. It’s her husband. She makes all the decisions. It’s a very critical person, actually, [unintelligible 00:10:39].

Alex: Oh, it’s everybody’s number one target. Almost all of our clients. She’s the number one target that everybody wants an advertising. I’m like, “Good luck, man.” Y’all have a little secret nugget there. We won’t tell you only four people listening to it anyway. I might say, so nobody’s going to hear. I love that. I love learning something new and that’s awesome. Let’s talk about PPC wasn’t working. Digital advertising, patient volume didn’t change. All of the hip to the hip of stuff happened last year.

Did you have to change any technology tracking, anything inherently changed, and how you track ROI or your marketing tech? What did you guys have to do?

Maite: The news is I didn’t have to change very much. A lot of those things were already compliant because I have always felt like marketing for healthcare has been a bit in the stone age and we don’t have our stuff connected in general. Then that was a conscious choice, but new technology is coming out and that technology is HIPAA compliant. We’re actually in the process of completely changing our tech staff, which is one of the funnest thing that I’m working on in a while in the last year.

Alex: You liked that. You liked the tech stuff. What are you going to change? Are you bringing on CRM? Is it EHR or what are you changing?

Maite: We’ve had a CRM system that was HIPAA compliant for a while with– because we’re an acquisition company and that was the system I had set up originally. Now they have grown and blossomed over the last couple of years. I’m really excited about them and they do some amazing stuff and they’ve just come–

Alex: Who is it?

Maite: It’s Red Spot Interactive.

Alex: Red Spot, RSI. Then while they’re on our other– we have a big plastics group.

Maite: [unintelligible 00:12:10] Jason and [unintelligible 00:12:12]

Alex: Jason. That’s right. Highly recommend.

Maite: Highly recommend. Great to work with, easy. They get the business, they get the questions that you’re asking and how to answer them, which is really cool.

Alex: They have the most sophisticated ROI tracking I’ve seen of any group. We are able to see down to the social ad that was run and actual reimbursement, like cash pay and stuff. If you want to talk to the marketer over there, Ed, he’s brilliant and loves RSI as well. Good, good, good. I need to have Jason on this one. All right. Very cool. That’s fun. New tech that helps us understand where the best ROI is. Is that your favorite part of marketing, the advertising, the tech, or do you find warmth and curiosity somewhere else?

Maite: I think I’ve always considered myself very solution-oriented. Whatever that mathematical equation to solve, whatever I’m solving for is what I gravitate towards, but I have to think back to my roots and say, when I started 16 years ago, no one spoke about aesthetics. It was like mum’s the word, “I don’t get Botox, but I do,” that kind of a situation. Very early on, we jumped on the content wagon. We used to publish in Houston, people still know about a 16-page magazine that we used to mail out to people’s homes. Pre-blogs, right?

Alex: Yes.

Maite: Beautiful stuff. So much love and work went into that. Then we evolved that in digital strategy, right? From everything from the Gram to TikTok to blogs and even just website doing all that too, I would say content is something I enjoy tremendously.

Alex: Yes. Educating. It takes different forms now. It’s like you said, Instagram or it could be this pocket, whatever, but it takes different forms, but it’s all about educating. It’s funny. It was so kept in the dark and now we’re all so open about it. That’s good.

Maite: I thank the Kardashians for that.

Alex: Yes. I was watching Buying Beverly Hills. What’s Mauricio’s wife’s– what’s her name?

Maite: Nicky.

Alex: No, not Nicky Hilton. It’s the sis. It’s Marie. Do you watch any of these Real Housewives? One of them has an age. She’s look great. You can tell it’s all the aesthetics that have done phenomenal. My wife’s like, “Oh my God.”

Maite: [unintelligible 00:14:17] I just pass out.

Alex: They go to bed at 8:30. We have one hour and we watch some trash TV for one hour. Then we’re asleep because you don’t want to think after working the kids, you’re like, I don’t want to think, I don’t want to talk, but on Netflix. Anyway, so we watch all the trash. I’m very caught up on The Bachelor. That’s awesome. You’ve gone through a lot of changes. Are you looking at any trends this year? A trend doesn’t have to be like a new thing. It can be like, if people are pulling back, like. “I’m going to invest more here.” where are you going to invest more into?

You already do an online scheduling. You got one of the best CRMs I’ve ever seen. What trends, what should people know about? It’s April 2024 for everybody.

Maite: I would say, we jumped on the AI bandwagon early last year, maybe late the year prior, because it was just interesting to me. I tend to just follow my curiosity and I was like, “What could this do for me?” It’s really multiplied our efficiency on so many things. It’s really fun. I’ve enjoyed it. Just even like prompting is interesting and fun to me. Since then, now I’m working on an AI chatbot, which I want to integrate on our website. That’s the project I’m working on this year that I’m really excited about.

I want to reduce our bounce rate on our website specifically to get people funneled through that scheduler faster. The way I envision it is almost like a content and scheduling con share on our website, because what happens is our most visited page is our homepage and it’s a huge website, right? the amount of content that we have goes very deep, but people really don’t get that far into the content. How can I create a better experience on a website of that magnitude? I’m hoping this is the answer. Call me in a couple of– [laughs]

Alex: We will. We’ll check back. I love it. I want to talk more about that because I’ve gotten frustrated by AI. I’m like, it’s basically an idea thought partner. That’s the writing is it’s like the same day overall, and I don’t use emojis but it’s a good prompter. You found the problem was too many people are bouncing. The problem is not enough people are getting through the education. I hope that the chatbot can answer people’s questions. Should they prompt? Is that like the thought? I want someone to go in there and, hey, your location, Lafayette, do they have Juvederm? Is that what you’re trying or tell me more about acne?

Maite: Last year we did an experiment with a live chat with people actually answering. I tracked those conversations and I really was watching what do people want to know when they land?

Alex: Yes. What were they asking?

Maite: I would say a good 40 to 50% is just routine. They are not looking at the content on the homepage and they want quick answers. That’s the fastest way to get those answers. What’s your fax number? What’s the address here? Do you accept this insurance? Do you do that? If I can solve those questions faster, can we get to the media content and take care of other people in other ways, right? I’m hoping to reduce call volumes a little bit for this.

Alex: That would help. I was just about to say that’ll bring that down tremendously.

Maite: That data will come to light very quickly, right, hopefully, as people start adopting it. I feel like people adopt these things very quickly. I was shocked, honestly, with the live chat, how quickly they gravitated towards it. Then on top of that, I’m hoping that the scheduler, we have multiple locations. Sometimes it’s hard to– and I’m actually redoing some of the interface on that, on our website, but it’s hard to figure out where you’re going, who you’re going. It can be a little bit confusing. Especially if you have an older population, this could help them through that process.

Alex: I love it. What I heard 50% of the questions the humans were asking are basically clerical administrative-type stuff. That’s bogging the patient down and bogging call centers down. That’s an easy thing. The chatbots, I think can easily answer that stuff because it’s just combing your website. “Yes, we are open. Yes, we take it now.” That’s great. I hadn’t heard that. I’m glad I asked. That’s very interesting. Then you’re hoping that they don’t spend time there. They can either leave and they feel better. Patient experience is better or it gives them more time to look up your actual treatments and stuff like that.

Right? Oh my God, I love that. What’s your in-house team? Is it just you are using a team of freelancers? You got 13 people working there. What’s the deal?

Maite: I used to have a team of five. That was as of last August. Then we went through a massive restructuring. Now I have two people that work for me. This is the part that people are going to be like, “What?” I have one person in the Philippines that works for me full-time. Love them. If you need information there, I have information there for anyone. Actually, that’s been an experiment and it’s working out super duper well. Like that a lot.

Alex: How’d you find them? Did you post a job in the Philippines and take apps and you go to Upwork? What’d you do?

Maite: No, actually I was just looking around online and I came across a post by a company called AbroadWorks and it’s basically like a staffing agency, but based out in the Philippines and they help draft the job description. Then you help work with them on that. Then they find you like three or four candidates. You interview them and then you hire them. They work your hours. They’re knowledgeable based on whatever your job description is. You know what? The more I talk about this, the more people are saying that they have someone who works in the Philippines too, which is really interesting to me.

Alex: It’s like aesthetic 16 years ago. We’ve got a great team in Argentina that are phenomenal and great at media, just like everybody else SEO, no different. It allows us to work more hours and do more work. We’re all about it. It doesn’t matter where a human is as long as they can do work.

Maite: Yes, they’re great. Their English is perfect. It’s been a great transition and I did it on like a bit of an experimental whim and it turned out to be fantastic.

Alex: Awesome. If you can’t get away from the former Spanish colonies, can you? What is the other person? What are both of their roles?

Maite: I have one person embedded in our Houston office that is like the most complex office in all of our family of offices, to be honest, because it’s so heavily cosmetic. We do a ton of event marketing there, and that works really well for us there, so I have someone embedded in that office.

Alex: Got it. Embedded. Then you’re running the whole thing. When you came out of school six months ago, you said 16 years, you did it yourself, but when you came out, what would you tell Maite 16 years ago about getting into this marketing field to help her accelerate faster?

Maite: I would probably tell her to take more technical classes. Fully understand the technology on the back end. I’m not the most technical person, so I have to learn everything from scratch on my own, and technology is changing so fast that, when I started, we were still doing TV, radio, billboards, mail, right? Now, if you don’t understand the technology and how it all interplays, you’re like–

Alex: Not a good marketer anymore. There was no way we would have known that we were going to have to be technologists, lawyers, ops specialists, and creative marketers. It was a lot easier. When I started Cardinal, this was a simpler thing, and everyone thought we were so smart for knowing digital. I was like, it’s just fine. Yes, so I think that’s great advice. Understand the technology.

Maite: One more thing, Alex. One more thing. I would highly encourage them to get their first jobs in e-commerce. I started a client store. E-commerce is just leagues ahead of everybody else in what they’re doing, how they’re using data, and marketing in general.

Alex: I agree. Some of our best people have come from e-comm because it’s so transactional. You have to be so sharp and move so fast compared to lead gen. [crosstalk] If you can do e-comm, you can do the rest. If you can do the rest, you can’t necessarily do e-comm. That’s how much more competitive it is.

Maite: I think that’s fair.

Alex: I learned a ton. I learned about AI from you in a practical application. I’m so sick of the things that you’re reading, AI’s this and that. I’m like, I haven’t seen a ton of actual use cases. Our team’s experimenting. We’re going to do a live stream on it. That’s great. I learned about that. I learned about when I come out of school, what I should be doing and about how online scheduling helps good vendors in CRM and scheduling. Maite, this has been awesome for me. I don’t know about it for you, but thanks for joining Ignite.

Maite: Great fun.

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