“You can have the best product in the world, but if people don’t know about it, you can’t sell it,” said Dr. Paul Mikhli. “You have to market your product so people understand what it is.”

Mikhli purchased Beachwood Dental, in an eastern suburb of Cleveland, in July 2008, confident in its future. “Dental offices have one of the lowest default rates of any industry when it comes to loans,” he noted, citing the consistent demand for dental care. The Great Recession deepened later that year, however. The housing market collapsed, Bernie Madoff’s Ponzi scheme was exposed, and panic spread. Mikhli’s clients started skipping appointments and avoiding costly procedures. “We were doing a lot of cosmetic work at the time, and that basically dried up,” he recalled.

He realized he had to do bring in new patients. “I didn’t have the luxury of waiting it out. I had to start focusing on the business side of things. In dentistry, you learn a lot about teeth but very little about business, so it was something I had to teach myself.” He turned to marketing, investing 10% of his gross revenue into ads and endorsements. His strategy paid off, and his practice is thriving.

Mikhli spoke with ICSC Small Business Center contributing editor Rebecca Meiser about what has worked, what hasn’t and why he firmly believes in the power of marketing.

Ten percent of your gross revenue is a lot to devote to marketing. How did you come to that decision?

When I was thinking about how to attract new patients, one of the things I was thinking about was: Should I start going in-network with insurances and start accepting insurance? Maybe I’ll get more patients that way. Then I thought: What is the benefit, really, of doing that? Fundamentally, why are dental offices in-network with insurance? It’s marketing. A dental office will say: “I will subscribe to this discount plan because I’m going to get more patients coming in.” But it comes with a cost. When dental insurance started in the ’70s, they maybe were giving a 5% or 10% discount to their patients. Dentists were accepting that as a tradeoff for being on those network plans, but now we’re talking about 30%, 40%, sometimes even more of a discount on your fees when you’re in network with insurances.

I thought: I could for sure out-market the insurance companies and market directly to my patients and probably do a better job with spending 10% of my budget on marketing. So that’s what we did. From that point forward, I said that 10% of our gross revenues are going to go to marketing. I don’t know a single dentist that was spending that big of a percentage of their gross revenue on marketing.

How did you approach it?

I didn’t know what I was doing as far as marketing, but Bill Wills on WTAM 1100 was saying [the news radio station was having] a one-day sale on marketing. I thought: “Maybe I should try the radio. Why not?” I had Bill come to the office. One thing that was and is important to me is that I don’t want anyone to be endorsing my office unless they are an actual patient. I don’t think its genuine otherwise. Bill felt the same way, and he liked what I had to present as far as the office and the quality of care we were doing. He said: “You’re going to be my third dentist in my life.” So I started with him. It takes time to get results. You can’t expect that you’re going to do it for one month and that you’re going to get patients right away. It took a few months until we started getting referral patients from the radio, but then there started to be a trickle of people saying, “I heard you on WTAM. Bill Wills sent me,” and then more started coming.

What message did he communicate?

I had a few different messages I wanted to get across. One of them was: Your most valuable asset is time. At Beachwood Dental, when your appointment is at 8 a.m., we see you at 8 a.m. If your appointment is supposed to be an hour, you’ll be out of there within an hour. He was able to speak personally because he saw and experienced it himself. Another message was [a comparison]: Do you ever go to a car mechanic and you expect one thing, and then they tell you have 100 things that you need to do and you don’t understand? Like you thought your car was running fine. With Beachwood Dental, we don’t do that. We will give you options, and we’ll present to you the all the things that are going on, and we’ll explain so you understand and you can decide what you want to do based on the education that we give you.

You were advertising steadily with Newsradio WTAM 1100. What changed?

ESPN Cleveland Radio wanted me to consider marketing with them. I was like: “You’re the wrong demographic. In my demographic, the people making decisions are usually women. They’re not men, and people that listen to sports are usually men. I’m not interested.” And then they came again. I have a friend who’s a jeweler who was advertising with them. He said: “You really need to give them a chance. They did an excellent job for me.” So I said, “OK, let’s give it a shot.”

As good as WTAM did for me, they did 10 times better. I’ve been trying to figure out why. I still don’t have a real answer, just empirical evidence, but when Bill Wills talked about his experience [with us], he’d do it in a 30-second spot. [WTAM owner] iHeart is very to the book, as far as their 30-second spots. When it’s done, they move on. ESPN advertising is more integrated. The announcers are like: “Did you see that hit they put on Ben Roethlisberger? He’s going to need to go to Beachwood Dental and get his teeth redone.” They just tied me into the whole show. The people who listen to them for their opinions on sports also tend to listen to them for their opinion on the products they’re endorsing. And in terms of authenticity, the announcers are very very particular not to endorse a product that they don’t feel strongly about personally. We started seeing a reverse trend: Women were coming to us because their husbands or their boyfriends were endorsing us. We started getting a lot of new patients that way.

What demographic do you concentrate on?

We have patients that come to us who are paycheck to paycheck. We also have patients that come to us that are billionaires. Really, it’s about casting a wide net because you don’t know where your best patients are going to come from. I’ve had patients that are very, very wealthy but end up becoming very miserly when it comes to spending [for] things in their mouth, and I have patients that don’t have a lot of means but think that their mouth is very important to them and spend much more than I thought they would. I never judge a person as far as the way they look and judge their pocketbook. People will come up with money for the things that they want. If there are people that can use your product, they are all potential clients. Don’t discount them.

What platform is performing the best for you now?

ESPN Cleveland radio is still doing the best. We spend the most on them. We spend probably around $120,000 a year with them, but they are the most consistent. When we look back every month, we are getting the most patients from them. Google [Ads] is a close No. 2, but you’re paying per click and you don’t know how many people from Google are coming because they [first] saw us on other things. One other [marketing effort] that is really effective is signage. When we redesigned our office and built out a new suite in 2021, one of the negotiations we had with the landlord was that we could have signage that faces Interstate 271 [at an intersection with one of the highest daily traffic counts in Ohio, according to the Ohio Department of Transportation.] As you’re driving by on 271, you see our sign on the side of the building. I’m sure a lot of people see the sign, and when they go on Google, they’re like: “Oh, I know where that’s at.”

Do you work with a marketing team?

I didn’t at first, but now I do. They engage with influencers. They take care of my social media. They help with content. It’s important that your messaging is out there consistently, and they make sure it happens.

Is there any marketing channel you tried that didn’t work?

TV did not work for me. The [return on investment] was very, very poor. TV does not get nearly as many eyeballs as it has in the past but they still like to charge as if they are the darling of marketing, whereas people still listen a lot to radio, especially to talk radio. The fees to market with them are just a lot more reasonable. I get a lot more bang for the buck from that.

What advice would you give to a small business owner who is hesitant about investing in marketing?

You can have the best product in the world, but if people don’t know about it, you can’t sell it. You have to do marketing so people know what your product is. The best marketing that you can do is endorsements, whether social media influencers or the original endorsers: radio personalities.

Are there any tips you’d give to someone who’s starting out with marketing but doesn’t have a huge budget?

Ask patients [to help.] When a patient comes in and has a great experience, my response to them is always: “Thank you so much. Can you share that on Google?” I remind them that there are so many people out there like they were who might be nervous or lost and don’t know how to find a good dentist. When they see the review talking about your experience, it makes them feel comfortable. Those recommendations are genuine and they’re free.