Aesthetic Marketing
Predictions for 2022

Max Baybak

All right, welcome back to the podcast. Today we have, uh, a really special episode. I've got two guests on the podcast who are previously— have joined me on the show, and we're going to be doing kind of a— an interesting year-end recap and kind of some looking forward to some predictions ahead, and I'm super excited to hear, um, what predictions my two guests have brought.

If you haven't listened to some of our previous episodes, we've had both Eva Sheie and Drew Leahy on the show. You should go back and check out their episodes. Both two of my favorite interviews. Um, you know, my whole goal on the show is to bring products, services, tools, ideas that will be complementary to your kind of core web marketing and digital strategies for patient acquisition and for brand. And both Eva and Drew have companies and products that are, I think, something you should absolutely know about, and are perfectly complementary to your overall digital strategy. So I loved having them on the show and I'm really excited to hear their point of view today. Eva, Drew, thank you so much for coming back on.

Drew Leahy

Thanks, man. Happy to be here.

Max Baybak

Awesome. So, uh, no, I'm really excited. And, um, we're gonna get into it. Eva, this was your— I wanna give you full credit, this is your idea. A couple weeks ago we were chatting on the phone about a mutual client, and I forget how it came up, but you said, "Oh, what if we do, uh, kind of a predictions episode?" And I thought that was such a cool idea. So full credit to you.

Eva Sheie

I was just going to write up an article about it, but being as that, uh, I am now a podcaster, it makes more sense to actually have a podcast about it and then write an article.

Max Baybak

Totally, 100. And I appreciate you letting me, um, host the episode and take the ideas, you know, because I just thought it was a cool idea. And then I— I always, uh— Drew and I have, uh, what we sort of inform the call like digital marketing therapy sessions, where we just chat on the phone for like an hour about ideas. And we were like, we should just do this on, um, Clubhouse or on Twitter Spaces or something one time. So— I know it is, but that was six months ago when I said that.

And I was like, this is— this is a great type of sort of just whiteboarding, spitballing episode where I'd love to have Drew join. And since the two of you already know each other, um, I thought that would be a perfect little combination. There's some podcasts I listen to where they do these year-end roundups and they bring on some of their favorite guests. So I just thought, perfect.

So, but before we dive into it, for anyone who didn't go back and— or hasn't listened to the episodes and isn't familiar with your companies: Eva is the, uh, founder and CEO. CEO?

Eva Sheie

Founder.

Max Baybak

And CEO?

Eva Sheie

Sure. Founder.

Max Baybak

Okay, we'll go founder and CEO of The Axis, which is a podcast production agency based in Austin, but working with clients everywhere, right? So Eva, will you tell us just a little bit about what you're doing with The Axis, and then I got some other questions for you.

Eva Sheie

Sure. Yeah, my hypothesis when I started this company was that I could help patients connect with doctors on a more personal level through podcasting. And the funny part is, about 20 years ago I started writing content for doctors, and I used to beg them, "Please just record yourself, stick a tape recorder on the table and record a consult for me so I can write an article." And I have— I probably have asked a hundred doctors over the years to do this for me, and no one would do it. And so now I'm just recording them and turning them into podcasts. So nothing has really changed.

Max Baybak

Yeah, I can see the evolution. Um, back then, I mean, podcasting maybe did exist but wasn't really what it is today. And I've— I've said the same thing when we're creating websites for clients, like, just— just give me a brain dump and— and I can give this to the team and they can get a sense of who you are. Um, and— and it's so much more realistic than you ever writing anything, with how busy you are. So I could totally see that conversation, which you're imploring them to do that, and how it's evolved into what you're doing now.

Eva Sheie

Indeed.

Max Baybak

When we did our episode, you were talking about how it does give you, um— I think you said both existing and potential patients like this ability to connect better with the— with the physician. And, uh, it— it makes a lot of sense. And I also don't even think you need— I think a lot of people might be a little skeptical of podcasts in certain, um, certain industries because, how many people are gonna listen to? But as you and I discussed— and again, if you haven't listened to the episode in which I interviewed Eva, go back and listen— it's not really necessarily about the size of the audience, but about the depth of the connection. And that's what it does, right?

Eva Sheie

So it is, um— I knew that people would eventually start going in and saying, "I heard you on the podcast and I really want to do X, Y and Z that you talked about." What I didn't know a year ago is how long it would take for people to start doing that. And now I do know that.

Max Baybak

That's awesome. You have that? Are you going to share that with us today?

Eva Sheie

Probably.

Max Baybak

Okay, I'm going to get that out of you later. Okay. Um, I have another question for you, but actually I want to pivot over. Drew, again, if you haven't listened to the episode where I chat with Drew— was all about email marketing. He is the CEO. Again, CEO now feels fine? Founder? Startup mode, doing everything?

Drew Leahy

But startup mode, I'm not— I can't— I haven't earned that title yet.

Max Baybak

Fine, fair. Founder of, uh, Patient Nectar Content Studio. And the episode that we— the interview that I did with him, we were centered around a particular product that he was launching at the time called Serials, which is an email, uh, centric product. But Drew, tell us a little bit about Patient Nectar, and if you want, Serials, and what you're doing there.

Drew Leahy

Yeah, so, uh, Patient Nectar is a content studio. We're trying to, uh, give practices the volume, quality, speed, consistency of media that they need to sustain marketing through all these different channels. Because as everybody knows, especially for the last five, six, seven years, content has been king, as much as I hate that little catchphrase, but it's true.

And, uh, there's been a lot of challenges with practices getting the type of media they need to really have a sustainable marketing program on all these different channels, because it's expensive. Like, it's— it's— it's expensive to produce, it's time consuming if you want to do it in-house. If you want to hire an agency, it's not very profitable for an agen— agency who's doing custom content for you, because they have to scale that between all their clients, and it's just too expensive.

So we have a slightly different business model where we're significantly, significantly dropping the cost of high quality media so that these practices can do things they've never been able to do before. And then, like you mentioned, we just launched our first media product which are called Serials. And Serials are subscriber-only email publications. We produce them, but the practices license them and send them on behalf of the practice.

And basically what Serials do, in a nutshell, is help you market to people who are not in market yet. So they help you generate awareness, trust and familiarity with people before they start shopping, right? So think about people— uh, think about all the patients who will enter the market in the next six months, a year, a year and a half, two years from now. Like, what if you can get in front of those people now, start building trust, start building familiarity, and then earn preference a whole year before they even start shopping? Well, who do you think they're going to choose when it comes time to shop for treatments and procedures in a year? Well, it's going to be you. So we're helping doctors get a first mover advantage, market to a bigger group of people, expand their buying pool, and just build trust with future patients long before their competitors can.

Max Baybak

I love it. When he first brought it to me, I immediately got it. And I— and I don't— I think, you know, there are— as I know from kind of following your story as you're going along, there's some docs that really get that strategy, maybe others that don't see it as much, but I truly do. If we're talking predictions, I think people will get there.

What the two of you have in common, which is cool, is you're both essentially producing content, and you're producing original content. Very different strategies, very different channels, but I think content marketing— this isn't one of the two predictions. So Eva's proposal was, why don't we each bring two predictions? So I thought of a lot. This isn't one of the ones that I honed down to, but one of my predictions— and this is really not just next year but the next five years and going forward— is that original content is really going to matter. Um, and— and the quality and originality of that content will also matter, because we're living and we're wading through a sea of it these days.

But just the fact of it being, you know, your own original content— in your case, Drew, you're solving the scale problem by keeping it to a specific channel that works and by limiting it geographically, right? People can unpack that in the episode that you and I did. But, um, you're helping people to create content that is unique to them, at least within their market. And I am a big believer in that. So that's why I'm like a huge champion of both of yours.

Eva Sheie

I would just add, the reason it's important— the why behind having original content— is that over time you have to build your own audience, which is called typically an owned audience because you own it, it's yours. And that if you never do that and you stay on the hamster wheel of paid, um, and you never get in the— in the sort of, um, river of having your own voice out there, then you spend more and more and more marketing on marketing as time goes by. It never gets better, it actually gets much, much worse.

Drew Leahy

100 percent. Just expanded on that too— not just, not just paid advertising, but social media as well. Like, how many prac— like, social media has been like this aesthetic medical marketing wonderkid for the last like five years, and— and so many practices are dumping so much money into, uh, social media, mainly Instagram, trying to compete with this like one percent of like content creators in our industry, and not having much luck.

But social media is a third-party platform that has an algorithm that you don't control, that we're starting to see a bunch of censored content, shadow bans, algorithm updates, all kinds of things. And they're talking about going back to, or at least having the option of, a chronological feed in 2022, which will be optional for— for visitors or for users of the app, but that's going to change engagement too. And we've already seen engagement drop like 30 the last two years on Instagram.

So where do you want to build your audience? Like, do you want to own your audience like Eva has suggested, or do you want to roll the dice on these third-party platforms that end up becoming depreciating channels over time? Because as it gets— we already saw it happen with Facebook, right? Um, as Instagram grows and grows and grows, well, it's— you're gonna have to pay more, do more, create more for less. So owning— owning your audience is absolutely pivotal. I— I wish I could say that would be a prediction for this year. Um, I want it to be, right? But I don't think the practices are— they're still learning that that's something that needs to happen. So I don't know if it'll come to fruition this year, but— but yeah, owning the audience is, like, that's number one.

Max Baybak

Yeah, I agree. Um, that would have been a prediction for me in previous years, and— and that what— what that tells me is that probably some of the predictions we say today are going to take a little bit longer than this next year to come true. Because I have noticed that, whether it's this industry or medical, I'm not sure, there can be— there's things that we as marketers see, but they take a little bit longer for adoption.

I would have— not trying to toot my own horn, but I've been kind of championing like "own your own audience" for a long time, and there are many others who have. In fact, I would say what you just touched on, Eva, is sort of the through line that connects us all, really. At least in— in our, um— it's where we're all very like-minded. I know for— for me, it's definitely something that I connected with you on, Eva, with the podcasting, and it's definitely something I connect with you and Drew.

And it's not something I hear every marketer saying. Many people say— are saying this, it's not— it's not unique to us. But there are many people who are selling kind of a— just a funnel service that needs to be fueled by ad spend to keep going, and it isn't getting you off that treadmill, off that hamster wheel. Yeah, in which case you're never— you're never decreasing dependency on those paid sources, which you may need to have, but you want to kind of hedge your bet and build up long-term what I call kind of, um, income stocks that pay back over time, so to speak. If you look at an asset— an asset, like a real—

Eva Sheie

It's an asset.

Max Baybak

Yeah, thank you, that's even better. Because I— I think you can— there's a million parallels between marketing and investment, because it is investment, like, just plain and simple. So I'm a big believer in— in the owning your audience. And I think people have always said, uh, you know, real estate— uh, I jumped ahead of my thought— social media is not really owning your own audience because it's real estate that you don't own. Or the analogy I gave is building, uh, your house on somebody else's land.

Eva Sheie

That's true. It's also ephemeral. But it's becoming really clear—

Max Baybak

Okay, and that was what we talked about in our episode.

Eva Sheie

But I was just going to say, it's becoming very clear to people in this year alone, or maybe in this last year and a half, how much you really don't own or control that audience.

Max Baybak

And— and to your point as well, Eva, even the ephemeral aspect of— and I think that's— I released a little clip of our episode where I was like, the difference between ephemeral content and permanent content. Because I loved your point on that on our social media. That was good.

Eva Sheie

It's hard to watch people spend— put so much money into hiring for social media, creating content, and then using doctor time to discuss it, approve it. Only— it has a place in the mix, it has to be there, but the— the scales have just been tipped so far in the wrong direction.

Drew Leahy

Yes. And I was going to say, investing all that money only to look like you're desperately trying to stay relevant by, you know, turning your Instagram feed into some kind of TikTok dance-off. Like, it works for some people, it totally does, but when you're, you know, in your 50s and 60s and you're— and you're trying to do the latest TikTok dance, it just— it looks desperate, it looks like you're desperately trying to stay relevant.

It reminds me of, uh— I don't know if you guys have watched— I— I've watched it because my wife watches it, but the new Sex and the City reboot, um— I can't remember the name of it, but it's Carrie's job again when she starts in the very first—

Eva Sheie

Yeah, she's a podcaster.

Drew Leahy

She's a podcaster, right? But there's— there's so many— in that first episode I watched, there's so many things we're like, okay, this show is so desperately trying to stay relevant. It's— it's— it reeks, like, it reeks of inauthenticity. And that's— that's what you see a lot on social media.

Max Baybak

It might. 100. It's funny, you said— go ahead.

Eva Sheie

But it might— but I still cried through the first two entire episodes. I couldn't even watch.

Max Baybak

Because it was— oh, hey, he lost Big, man. That's huge.

Drew Leahy

I just heard about the Peloton.

Max Baybak

Oh, and the Peloton too. Yeah, yeah.

I love that you brought that up. And then— we're getting off on another subject, but I think it's a good subject, and— and I'll close this up in a second here. But, um, I was just about to say, Eva, when you brought up people spending doctor time and hiring people and approving— and they are sometimes doing it just because they feel they must. And one of the lessons that we try to impart to our clients and— and others is, you don't have to in order to actually make money.

We have clients that are not active and are really on social— and are really good on other channels, and they do very well. And some of them are in fear of not, not, um— yeah, being able to keep up their— their level of business or falling behind you. And I do think you should, but you shouldn't do it because you think you should, if that makes sense. And you have to do something that is authentic to you. So the inauthenticity that you touched upon, Drew, and trying desperately to stay relevant, is bad just because that's awkward.

Drew Leahy

Yeah. But also, it's not— you're not going to succeed if that's your reason. I— I could do an entire episode.

Max Baybak

Yeah, and actually I'm going to— I'm going to earmark that for us to do an episode on, like, on finding— I don't— I was about to say finding your way. I don't want to say finding your way— finding the right strategy for your social.

But before we dive into this, I actually also think it's relevant for everyone to understand that the products and services and companies that— that the two of you have founded kind of come from— uh, you both have come from the world that I'm in today in terms of kind of the web marketing and the SEO and the Google Ads and— and digital media for plastic surgeons primarily, also other aesthetic medical practices, uh, med spas and so forth. Um, do you guys want to touch on that really fast? Because I think it's relevant for people to understand the background, and where— and now, now you're in these businesses creating these cool businesses. They're helping people create their own audience. Eva, will you tell me just a little bit about your path?

Eva Sheie

Oh, my life story.

Drew Leahy

Yeah, I was about to say, I— I've had this conversation with Eva probably four or five times, and we always end up going down this rabbit hole of, like, by the time we're done talking about our past experiences as agencies, we're like upset and mad.

Eva Sheie

Yeah, I don't want to go there.

Max Baybak

Oh, they got to want to go there. Yeah, I think— I think it's only relevant for people to understand that— that you've come through all those things that have become the accepted means and methods—

Eva Sheie

Yeah, ways and means.

Max Baybak

—that people— that plastic surgeons and med spa should market. And there is a base that they need to build.

Eva Sheie

Yeah.

Max Baybak

I'm focused on helping them build that base and doing it right. And then I think that they need to do more, and they may do those in-house, they may have— be good enough to do it and do all of their surgeries on their own, or they may hire someone, or they might look at services like yours. But I just think it's interesting for people to know that you come from those backgrounds— other agencies, Eva, your RealSelf, in your case. Um, I think it's just relevant for people to know that.

Eva Sheie

It's funny to look back because, you know, I— I started building websites before doctors had websites. So in many cases I was the— built the first website for somebody, and then I went to an agency and built sort of the second or third generation site for some— some of those people. And we were the only ones.

Max Baybak

You're saying the majority of your clients at that time were building their first ever website and you were walking them through that process. I got it.

Eva Sheie

Yeah. I started in 2003. So my first job was at a directory. And— and I— I loved this because when we didn't have somewhere to send a patient, they would call our office and I would answer the phone and say, "What are you looking for? Let me see if I can find someone." And then I would start cold calling doctors' offices and saying, "I have a patient who wants, um, Thermage. Which— do you do this?" And they would say, "I do. Can I have more?"

Max Baybak

You're a matchmaker.

Eva Sheie

So I just got really in tune with what people were asking for, and I've always stayed oriented to that. Um, and— and meeting their needs with digital marketing. So I think that was a great place to start. But then I was at RealSelf in the early days— I think I was in the first five or six people. And then I spent five years building websites and doing SEO strategy for an entire agency. And then I went to Real Patient Ratings and built that with Marie Olesen, which put me even closer to what patients want, which I loved. And then I went back to RealSelf for five years and did practice development there.

Max Baybak

That's awesome. Drew, I don't know if you want to touch on just—

Drew Leahy

Yeah, so— yeah, my background started— I started doing SEO for an agency in aesthetic medicine, uh, nine years ago, something like that. Um, and got into content marketing, became director of marketing there. Um, and I think when I left— and it's been— it's been a year plus working on Patient Nectar. But before that, after I left the agency, I was doing— like, I was so jaded with the product that we were selling at the agency, um, and a lot of the other agencies doing really bad work, that I was like, I need to step away from this totally.

So I actually— the— the consultancy that I started wasn't really a consultancy, it was really a strategy business where I was helping practices launch for the first time. Worked with a lot of OB-GYN clients that were building aesthetic practices, so we were doing high level like strategy, that was, you know, going through messaging, positioning, like picking out product menus, portfolios, things like that. And had a ton of fun.

The problem with that was it wasn't scalable for me. Like, we had, like, these engagements were like three-month engagements, they were really deep dives. Um, and I just— at the end of the day, it's like, I was— I was working with 12 clients in a year, and for me it was like, okay, I— like, there's no way I can just help 12 people a year. Like, it was driving me crazy. So I started Patient Nectar as a way to be able to take my ideas, all the ideas that I've had, put them into products that can scale and help a lot more people. Um, which brought me to Patient Nectar.

But— but yeah, that's— that's kind of actually starting the agency, moved up. And, and, you know, what I mentioned about, you know, talking to Eva about this quite a few times, but, um, you know— there's— there's two types of agencies in this industry. Uh, most of them are churn and burn agencies who— who are, you know, founded by salespeople, not marketers, and they're looking to sell you something whether or not it's gonna help you or not, and it usually doesn't. And it's just churn and burn, and they have this recipe of like, okay, if we can just bring out 100 new clients every year, we can lose 40 of them and, boom, who cares, let's keep going. And that's how it works, um, and then nothing ends up getting done for the— the practice, right? You just end up wasting your money.

And then you have the agencies like Influx who are founded by people who actually know marketing, who have vision, who are— who really— I mean, this podcast, right? You're bringing on guests who have new products, new different types of way of marketing so that you can bring them to your— your, uh, your clients. Like, that's very rare. Um, so I came from that former group and was just super jaded with it, and which led me to that— that strategy business and then to this, because I felt like there was a better way to do certain things that the agencies couldn't do.

Max Baybak

Well, I appreciate you saying that. We definitely want to add value. I'll pay— I'll pay you after the episode.

Drew Leahy

I'll pay you.

Max Baybak

I do appreciate you saying that. Um, and that's something— yeah, we— my partners and I talk about every day, if we're not adding value, like, we can just— what are we doing here? And I— I'm in this industry because I— I think I can add value. That's why I'm here. I ask myself, what am I doing? How did I wind up here? Is this my passion? But it's only— I'm only passionate because there's a gap and I'm adding value to that gap, and I think our whole team is. And so I feel good about that, and that's something that's super important to us, is that we're bringing something to— I realize that anyone opening their own practice is taking immense risk as an entrepreneur, and they need real partners that frankly give a—

Drew Leahy

Yeah, so— yeah, um, and innovation. It comes down to innovation. Like, there's— there's so few agencies, like I said, that are founded by just a group of sales guys who saw an opportunity, that they don't have vision, they can't see around the corner with marketing. You guys, like— like, literally maybe no one else that I can think of— are, like, in the trenches marketers. Vision, innovation. Like, that— that's what— that's what these practices need.

Max Baybak

Again, really appreciate it. But the reason I asked for your backgrounds— I wasn't even getting into all that because I've had both of you on the podcast and I figured people could go back and listen to those, right? But before we dive into these predictions, I actually wanted people to get a perspective of who they're hearing these predictions from.

Um, I love that you went off and started— I totally understand why that would be hard to scale, and, uh, maybe— and maybe an undervalued service in this industry. But I love that you went into that strategy thing, because from the moment I met you, I— you have a great mind for strategy, and that's— and— and I love that. And Eva, your background and the level of nuance coming from helping many of these surgeons build their own— their first website— like, the insights that the two of you will bring, especially looking ahead, is something that I want people to understand, kind of what's behind that.

Not just— we live in an era now where I think you have to be specialized when it comes to digital and marketing and consulting and content creation, that if you're trying to do that, like, horizontally across many industries, you're probably not going to be very good at it for any one particular industry. So I just want everyone to understand kind of who they're hearing from.

So with that, let's dive in. First, actually, before we get into predictions— Eva, I'm going to start with you. Let's look at the year that is almost behind us now. When this comes out, it might be right on the— you know, right at the very end of the year. Um, was there anything this year that took you by surprise? Or what surprised you most, should I say?

Eva Sheie

I had a lot of surprises. Um, one— one of the biggest, and maybe it seems obvious now, but, um, podcast discovery across all of podcasting. And I've been able to learn a new industry kind of from the inside out, which has been super exciting and fun. I love learning. So, um, I already knew how to build a podcast, but what I didn't know was the podcast industry, which is growing super fast, tons of investment, 10-year plans from every big platform. Amazon, YouTube is going officially into podcasting.

And then finding the right data to lean on— and so I found that really early. And what surprised me was that YouTube is, like, the third most popular platform for listening to podcasts and finding them. Spotify overtook Apple in the last year, so you can— you know, it's— it's obvious they were investing a ton in becoming number one, and they did it. Apple's number two, and then YouTube. So this was like a little bit of a shock for me, and I've never had an opportunity to master YouTube, and that's what I've been working on tackling this year.

And we've had some huge surprises in there, things that we were able to get to go a little bit viral, you know, for the subject matter. Um, so that— that's one of my bigger surprises, was YouTube.

And then the other one is sort of meta, but for the first time ever, I took the marketing funnel and I put it on a continuum, like in a slide, and I made columns, and then I put all of my client's marketing tactics in the columns. And I've never done this before, and I don't know why I thought of it or why I did it this time, but what happened was I found two gigantic gaping holes. So they're doing all this marketing stuff, they have multiple people in house, huge budget, tons of activity, eight— three agencies on board, consultants— and there was a giant gaping hole in consideration and in loyalty. And everything they were doing was either an awareness or conversion.

So that was, um— what's the word I'm looking for? Uh, it was a transformative moment. Revelatory. It was revelatory. Or just throw out some— it really helped me make a really smart plan for 2022 with them. It's not a podcast— they have a podcast, but, um, it helped us really figure out what needed to happen and who needed to own what. And I think it's a permanent tool. In fact, I will— I'll post it on my Substack, so that if you want to see it, you can go look at it and make one of your own. Maybe I'll even make it downloadable, so if you want to try it yourself you can. Um—

Max Baybak

Cool.

Eva Sheie

That's at The Axis, t-h-e-a-x-i-s dot substack dot com.

Max Baybak

I'm 100 gonna go check that out, because I love the idea that you took kind of the— the funnel—

Eva Sheie

I used the most basic funnel. I wasn't trying to be—

Max Baybak

Right. Well, it's also— there's another trend while we're talking trends. This is not a prediction, but I feel like the funnel is going away a little bit, the assumption that it's so linear. And you're hearing terms like the flywheel or whatever. I'm just kind of calling it like an ecosystem. You have all these different things and people might bounce around over here and then over there and then eventually convert over here. Something Drew and I have chatted about a lot is that those different phases, consideration and where they're underserved. So I know he has tons to say on it. Drew, it sounds like you want to say something.

Drew Leahy

Okay, so I— everybody declares the marketing funnel dead. It's not dead. It's such a— it's such a useful tool. The problem with the marketing funnel is that most people don't know how to use it. So it's not meant— it's meant to be a metaphor, right? It's really kind of just a metaphor for different stages that people need to take to become a patient, in this case.

Um, where people get in problem with a marketing funnel is they try to attach, like, all these different pieces of content to different stages of the funnel, where it's like, okay, like, are the people at the top of the funnel, awareness— are they subscribing, are they downloading this, are they reading that? That's not what you're supposed to do. Basically with the funnel is, you're supposed to take the steps that people have to take, right? People don't have to read your blog, they don't have to follow you on social media, they don't have to download any of that to become a customer, right? So those aren't good things to include in a funnel.

But like a typical funnel for this industry would be, you know, they do have to visit your website before they— maybe not necessarily visit your website before they contact you, but they do have to contact you, right? They do have to have a scheduled consultation, they do have to show up for that consultation, they do need to book, they need to show up for that booking, right? And those are— those are steps that are undeniable. Like, that— that is a linear process, right? Even though— even though people can move in this funnel, like, up and down, like between the content they're engaging in. That's where you get wrong with the marketing funnel. What are the linear steps that people actually have to take to become a customer? And those are the ones I mentioned.

Now the way— the reason why this is so valuable is because when you can start building the conversion rates from those linear steps that you have to take, then that's how you inform your tactical strategy, right? That's how you build a strategy. So if you can say like, hey, we have a leak in the pipe from people who book to people who actually show up, well then now, tactically, for the year ahead, we know from a marketing perspective what we need to work on. If we can increase bookings to show up, like shows, or decrease no-shows by 10 percent, knowing all the other stages of the funnels and the percentage, then you can tell— and you can estimate how much money that will be worth in terms of revenue if you can fix that. And tactically now you know what to focus on. Well, our tactics are going to focus on fixing that part of— part of the funnel, whatever those might be.

So— so that's why I disagree about the funnel being dead. Like the funnel that we've— that marketers have propagandized over the last 10 years, like this— like the flywheel, all those stuff, that is dead. I would argue that it never was alive. Um, but I think if you take that— that linear step that people have to take, stop— stop thinking about touch points and all that stuff, then it absolutely works.

Max Baybak

Okay, so I've decided we're going to do an episode that's called "Is the Marketing Funnel—"

Drew Leahy

Yeah.

Max Baybak

Super valid points you made. And essentially what you're saying is there is an intrinsic linear path. Yeah, it might be a little different from business to business, and even backing up from the points that you brought up to Eva's point, there's— you have to go through consideration, you have to go through— there's even more, um, kind of philosophical phases as well that a person does have to go through in a linear fashion. So it's super valid. I think people just trip up when they oversimplify it—

Drew Leahy

Totally.

Max Baybak

—simplify it and think, like you said, they're going to do this and then they're going to do that. They may— they may or may not, they may move around.

Drew Leahy

Yeah.

Max Baybak

But to keep us on track here, because I really want to hear your predictions— but before, since I asked Eva what was kind of— was there something that surprised her most this year? Do you have an answer to that question, Drew?

Drew Leahy

Yeah, so I was super surprised— and we chatted about this a little bit already— but I was super surprised at how busy surgical and every single aesthetic practice was, how busy they were this year. Like everybody I talked to, clients or conversations that I had, were booked out like minimum eight weeks and it was going crazy.

On that note though too, I was also surprised on how few of these practices were going on offense. Like, it was like they were getting fat and happy, like, hey, we're booked out for the next two months, three months. Like, okay, like, what are you gonna do to generate future demand so that three months jumps to four months to five months? And— and very few people I talked to were even thinking about that. So those were the two biggest surprises for me.

Max Baybak

I would agree. That's probably my biggest surprise. Along with that, I'll add, um, we saw a lot of people kind of making capital equipment expenditures, buying new devices and things, and that was not something I expected in about March of last year, or, you know, throughout— wait, are we almost two years into this pandemic? Wow. Yeah. Um, we are.

So coming into 2020 I wasn't so sure about that, and then in 2021, you know, definitely a lot of people investing in new equipment, companies rolling out new, uh, boxes and devices and capital equipment, and, um, products that are not in the equipment category. Um, and so I've seen a lot of activity in— in that arena, which was maybe a little bit surprising.

Also, to your point about people not going on the proactive side, a lot of our clients, um, remained aggressive even though their schedules were full. And that's, I think, a common core— kind of a common denominator across a lot of our clients, is they're willing to invest in marketing, otherwise they wouldn't be with a company like ours. Some more so than others.

And I heard a stat— this is actually from someone at Allergan recently that I was chatting with, and I don't have it exactly, but that those people who kept on while others are dialing back retain a lead in their market for some really long time that I wasn't expecting, like two to three years. Uh, I— I did see coming out of the initial shutdown of the pandemic that people who kind of— I'm not even saying they kept their ad spend at what it was, but they didn't shut down all the way, and they kind of kept their— kept the— the pedal to the metal on— on whatever their marketing tactics were, we saw them scoop up more of that pie when— when everyone came back.

Drew Leahy

Absolutely, absolutely. Those were— those are the smart practices. And there's a ton of— there's tons of real science behind that too about when you hit— like, God forbid we hit another pandemic again, but in an economic recession, there's so much good data that says, like, the brand— like, there's so many brands that put marketing on hold, that the brands that do overspend during a pandemic, in this case, that they come out on top, right? Because what happens is that the spend that you— when your competitors stop spending and you spend more, then it amplifies your reach like tenfold, because they're not competing with you anymore for attention, right?

Max Baybak

Yeah, so my partner and CEO— one of my business partners and CEO, Adam— and I gave a talk at the virtual ASAPS meeting, was their big meeting in mid-2020, and we talked about this. Because— and we actually showed charts of the Google cost per acquisition versus Facebook, and there was a cross in it, which is really uncommon. Basically so many people stopped their Google spend that the people who kept doing it were acquiring for— there was a rare opportunity to acquire new patients or new patient leads for cheaper than your Facebook and Instagram leads, right? On the paid side.

Drew Leahy

Right, right. That's crazy.

Max Baybak

It was this huge opportunity, because on the— on the demand side— or sorry, on the supply— well, depending on how you want to look at the auction system for ads— basically there was fewer people bidding for those searches.

Drew Leahy

Of course.

Max Baybak

And in fact there was more searches hitting the market because everyone's stuck at home.

Drew Leahy

Right.

Max Baybak

Potentially, potentially with, uh, more ability to do surgeries because they could be at home and recover, spouses were home to watch kids— all the factors that we know about now. But they were driving the search volume up, um, and— and then there were fewer people buying those searches, so that the cost was going down, and it was a rare opportunity.

I always love that you— you bring up science as it relates to marketing, Drew, because enough people don't, and none of people really think about it as scientific, but it can be really viewed that way.

All right, well, I think I've kind of delayed us enough. I love picking your brains, but let's get into what this episode is supposed to be all about, and I want to hear some of your predictions. Eva, if it's all right, I'd love to start with you and hear from you on kind of— uh, I don't know how you're thinking, how— what you sort of prepared in terms of your predictions. I'm looking at the year ahead, maybe it's a little longer, but really kind of, what do we see— will— what do we think will be trends or things that will characterize 2022? And— and I think each of us are going to do two. So Eva, we'll start with your first one.

Eva Sheie

Okay. My first one is that doctors who prioritize the low friction, faster ways of communicating with— with prospective and existing patients will pull in front. And what I mean by that is texting, online booking, anything that, um, is inside the office— which is almost untapped, definitely underutilized. It's not untapped, but it's underutilized. And automations that help speed patient communication, but not at the expense of relationship building. So I want to hear Drew's thoughts on this, but—

Max Baybak

Yeah, Drew, if you're all right— I'm going to keep quick, just give a quick reaction to that.

Drew Leahy

Yeah. First, couldn't agree more with every bit of it. Um, when you said— you said something about opportunities in the practice. Will you explain what you meant by that?

Eva Sheie

Um, yes. So I'll tell you about my own appointment for laser about two weeks ago. Um, this practice misses— I go because of the provider. This is why everyone goes. It's the provider. It's why they return. It might not be why they go the first time, but it's why they return. So yeah. Okay.

In non-surgical, everything that you— every decision the patient makes is heavily dependent on the provider. And we knew this from reviews going way back, that— we analyzed thousands and thousands of non-surgical reviews. They were always about the person who did the treatment to them. They were never about the product. I think it was something like— like less than five percent of the reviews had to do with the product itself. So people don't review their Botox, they review their injector.

So yeah, if you know that, then you can start to build ways for the patient to engage around that experience and that relationship, um, featuring the providers on social media.

I don't want to get too far off track here, because we're talking about low friction communication and— oh, and inside the house opportunities.

Drew Leahy

Okay, the office. And I just wanted to know— I feel like you meant something about that.

Eva Sheie

That I did. Yeah. So I'm at the office, the consent is on an iPad. The iPad is Touch MD, beautiful system. I sign my consent, and the very next thing I see is nothing. And I know that they can do better than this. There's so many things you can do with Touch MD.

So I start poking around and pressing buttons, which I'm not afraid to do, and I find my own before and after photos going back five years. This is really cool, because— and they're not the ones that go on the website, they do those in a photo studio. These are the ones where they just shoot me before they do the treatment. And I could see in five years what an incredible difference in my face they have made over time. And that was the end— that was the end of my experience with that technology, and it could have been extended, because I know all the things it can do. It could have been extended so much more there.

So that was— we have to think about these things. My patient is sitting in my office with an iPad. What are they doing with it? What is that experience like, and what can I do to add value in that moment? What can I— could I have been scheduling my next appointment six months from now? Yes.

Max Baybak

Totally, got it. Now, and we could probably talk about that forever, but it's essentially maximizing your opportunities to add value at every point in the patient journey. Uh, another guy I had on the podcast, awesome guy who you probably both know, Nick Magruder— and Friend Media really creates an oppor— is a good example of the type of opportunity where you can, uh— and if you're— if you're doing it smart, uh, if you're— if you're doing it with any kind of strategy, you know, you're— you're cross-selling something in that room or promoting something in a room that is not the thing they're already getting, and being intelligent. That's just one example that Nick and I chatted about on this show.

Eva Sheie

Yeah.

Max Baybak

He has, like, that. Maybe— I don't want to oversimplify, there's a million opportunities, but— but you have to put yourself in the patient— patient's shoes and go, what am I doing right now? How do I cap— what are they— what's going on right now? How do I capture this opportunity, a chance to get some more mind share, or whatever it may be?

Eva Sheie

And to that point, Touch MD has a system just like that, and theirs is free.

Max Baybak

Oh wow, okay.

Eva Sheie

Yeah. Which nobody knows.

Max Baybak

I— I didn't even know that. So yeah, I'll learn more about it. Uh, and Drew, I know you're chomping at the bit to give some input. I just want to say one other thing.

Drew Leahy

I'm actually not. [Laughter]

Max Baybak

You look like you're leaning into the mic.

Drew Leahy

Well, um— I may— maybe chan— might change my chair, trying to sit up straight.

Max Baybak

Uh, uh, okay, good. I'm the most annoying podcast host, because I don't— you know, the art of interviewing is like asking the questions and getting out of the way. I'm absolutely terrible at that. Like, I want to give you a bunch of feedback to what you said, and I hope someone finds that interesting. That's the way I like to do it. Maybe I like to listen to myself too much, I don't know. But I want to just say this.

All that stuff takes a lot of hard work for practices to do. Eva, I've noticed if they— if they make the choice to move to SMS, because there's an expectation with SMS that you respond right away. And so I've had some practices say, "I don't want to do that because we can't do that." And I go, okay, fair. But what if— didn't get— if you got a responder that said, "We'll get back"—

Eva Sheie

Yeah.

Max Baybak

And there are— there are a lot of solutions, but I'm just saying, um, you have the practices that want to implement things that help them get more while doing less, and then there's the practices who want to get more and are okay to do more. But adoption of all these systems and things, and those ways to maximize at every touch point, whether it be just all those— an online scheduler— we have a lot of people opt out because of the— the headache it creates for them.

Uh, and this gets to some things, I think, that I'm going to talk about in my predictions. But I just noticed that you have to, um, invest time and importance— place importance upon these things, or they won't— they're not necessarily less friction for you. Less friction for you is not adopting all these things, ultimately, is what I see. So the practices have to make a really big commitment to caring about creating the best patient journey, I think. What I react to a lot—

Eva Sheie

I find that to be true. And the three of us have all been in the same seat on this, where someone comes to you and says, "I need more leads," and you're like, but you're getting 600 leads a month, or however many, but they're— they're squandering them and then coming and asking for more. And I've been in this situation so many times. And I— what I— it's almost like I just don't want to get you more if you're going to throw them away and not talk to people or communicate with people the way they want to communicate with you.

Max Baybak

Yeah, it goes back to the— to the same point.

Eva Sheie

Um, yeah. So I— yeah, that's what I've noticed.

Max Baybak

Drew, thoughts on Eva's first prediction?

Drew Leahy

Yeah, I— I— this has been so much more of your guys's wheelhouse, I think, especially you, Max, like, experience with the practices. Um, so I don't have— I don't think I have a ton of expertise in this area other than, like, anecdotally I agree 100 and have experienced that with some of the people I talk to. But, like, I think what I'm hearing overall is just using communication tools and technology to create a better patient experience. And that— I mean, obviously that's gold, right?

Um, I wonder how that transition— because, like you're saying, Eva, like, there's— there's a lot of— there's a lot of different tools now, right? There's a lot of different technology. Like, I wonder how these practices manage that transition to where, like, they're fully integrated with all these different communication tools and using them optimally. You know, I think like everything else, there'll be winners and losers, and the winners in that case will really have a leg up until the laggards catch up, type thing. That's about all I have to add to that, though.

Eva Sheie

Yeah, I think you're describing what I call the duct tape system.

Drew Leahy

Yeah, and I'm going to talk about the duct tape system in my first prediction.

Eva Sheie

But yeah, I think it's about, um, taking the extra effort to meet the patient where they prefer to be and what they want to do.

Max Baybak

Yeah, text is a good example of that. So I agree with that wholeheartedly, Eva. All right, Drew, yeah, prediction numero uno.

Drew Leahy

Okay, my first one, my first prediction— Eva was probably rolling her eyes at me, but my first prediction is that this year people are going to spend— practices are going to spend too much investment, too much money, on retention, upselling and loyalty. And let me preface this by saying, I'm not saying that retention, upselling, loyalty is not important. I'm just saying over-investing in that at the expense of acquisition is not going to help you grow your practice. And there's two really just very simple first principle reasons why, and if you just look at the economics of— of what loyalty, retention, upselling kind of deals with, right?

But before I get to that, the other thing too about loyalty is, when we really talk about loyalty, I think we're really talking about repeat purchase, because loyalty is not very common. It does exist— like, there are people who are loyal to a certain doctor, in this case, at the expense of others, and especially in this industry, aesthetic medicine, I think— I would say loyalty is higher than in many, many other industries, right? Because of the nature of the— the service. But people— like, churn, losing patients, that's totally normal, and people are willing to get their injections from one doctor, get their CoolSculpting from another, get their surgery from another. Like, that— that happens. So real loyalty isn't really a thing, I would say. It's more repeat purchase.

But going back to the economics. So what happens is, when you over-invest in your existing patients, number one, you're marketing to the smallest available market. So if you broke down the total addressable market, you have people who are out of market— these are people who haven't entered the market yet, they're not shopping yet but they will be shopping in the next six months, a year, year and a half. Then you have immediate prospects, people who are actively seeking treatments and procedures today. And then you have your existing patients. Of that pie, your existing patients is a fraction, a fraction of the total addressable market. So when you over-invest in loyalty and retention— especially because a lot of these people have a higher proclivity to choose you again anyways, because they already chose you— what happens is you just— you're marketing to a shrinking pool of customers.

And the second one is earning potential, and this is something nobody ever thinks about. Um, and the reason why I brought this up, I should say too, is because I've seen— I— I looked at a couple, um, like abstracts for presentations coming up for AmSpa's new meeting, a couple other abstracts and presentations at ASPS, et cetera, and I can see, like, there's these referral— not really referral, but retention, loyalty program things coming in. And— and it's like, that's why I think, like, it's gonna be this year where we're spending too much, because I can just see it already coming.

But going back to that— that second thing is the earning potential of an existing patient. So if an existing patient is already spending a thousand dollars a year with you, you're like, good luck trying to squeeze a thousand dollars more a year out of them, for all of your existing patients. Like, so as far as earning potential, if they've— after they've already given you that max or threshold that they can afford— say let's just use this example, a thousand dollars a year— um, like, it's really difficult to get to just all of a sudden and spend that much more. So the earning potential to marketing to existing patient is much lower than if you were to acquire a new patient who can get you that thousand dollars, right? So earning potential is just way different.

Um, and it— I mean, really when you look at it and also when you look at the marketing science and the evidence, it becomes common sense. But I think for so long, like, marketing academia, market— it intuitively, I guess I would say, it feels— it feels like just getting more money out of existing patients, encouraging to come back, makes, like, a whole lot of sense and it should be a priority. My— I'm telling you right now that it shouldn't be a massive priority. Take care of it, put some money into it, but don't— not at the expense of acquisition, right? You're only going to grow your practice long term by penetrating a market deeper, and that means acquiring new customers.

The last thing I'll say about this too, which gets me so bothered, and I'd love to get your guys's feedback about this, but— I've seen this three times now, um, the stat from an AmSpa survey, I think it was 2019, that said 60— 66 of practice revenue comes from repeat business. And what marketers— and these especially these loyalty club marketers and these upselling, bundling marketers— um, what they're using— they're taking that stat, and I think they're pulling it out of context, and that they're using that to, like, propagandize loyalty, upselling and retention. When what that stat really tells me— if 66 of your revenue is coming from repeat business, you have a massive acquisition problem. It means you're not attracting enough new customers.

Because the— the second stat here is, how much is 66 percent of your practice— and this is a non-surgical practice, so 66 of your non-surgical practice is coming from repeat business— how much of the business is coming from word of mouth referrals? Like, we all know that, like, a huge portion of new patients is coming from word-of-mouth referrals, surgical or non-surgical. So if you add word of mouth referrals plus, you know, 60— 66 percent of, uh, practice revenue coming from repeat business, what— what's your marketing doing? Like, honestly, like, how— how bad is your patient acquisition? Like, it's awful, right?

So when I look at 66 percent of practice revenue, like I mentioned, I don't look at it as like, hey, you need to— you need to invest more money on upselling, loyalty and retention because it's so important in this industry. What I'm saying is, no, you're— you're investing too much in that, and you need to invest more money in— in patient acquisition and— and figuring that out, because that's how you grow your practice and profit and revenue long term.

Max Baybak

I see Eva's got her boxing gloves on, but I'll ask one question.

Eva Sheie

I always question the data first.

Max Baybak

I have only one question, because I want to get— I actually just want to throw it to you, Eva, but I only want to ask this for context. Are you primarily speaking about a surgical practice or primarily about a non-surgical, or hybrid? When you would— would you say the comments that you just made pertain largely to one or the other?

Drew Leahy

All of them. Every and anything. To understand that, any business— take us out of this industry, any business.

Max Baybak

Any business. Okay, fine, good. Eva—

Eva Sheie

Having, uh, massaged data for a living for a very long time, my first question is that— was, what— what was the source? How was the— how was the question asked, and who answered it?

Drew Leahy

So right. Actually, do you think I could find it?

Eva Sheie

And it's— do you— do you think that that number may be lower than—

Drew Leahy

Well, the stat that I think you're referring to is, they said 66 of medical spa visits come from repeat patients.

Eva Sheie

So I would have to dig more into who— who they asked. That's—

Drew Leahy

Yeah, of course. Yeah. But— but, well, remember, remember we're talking about a percentage, right?

Eva Sheie

So yeah. So yeah, it's growing. In a medical spa, wouldn't your goal be to get your injector, just like a hair salon, fully booked with repeat business? And so, some very large percentage— if you're running a med spa, you want an injector to be fully booked so that they're seeing the same people over and over. That's how you become profitable. I don't— I think it seems really high to me, like—

Drew Leahy

Yeah, it seems alarmingly high. And like I said in the beginning, I'm not disagree— I'm not telling you that retention, upselling and loyalty is not important. It absolutely is. But to see— like, I've had quite a few conversations where it seems like— like there's— there's a real, like, this retention is more important than acquisition. It's not. It's not, and it never will be, for those economics that I mentioned earlier. You're marketing to a small pool of people, right? And you're not going to get that much more out of them than they're already spending with you, right? You can get more from a new client, right? And you only can grow— you can't grow a business without penetrating a market, and that means new customers.

Eva Sheie

When you talk about investing or spending on retention, what exactly do you mean by that? Like, in terms of channels and tactics, where are they spending too much?

Drew Leahy

I mean, it could be— it could be all of them, right? There, like— I've definitely seen more software in that area, the software that's coming up, the loyalty programs, the memberships. Um, you know, and then just whatever— events, whatever different tactics. I've done— I think you pull them all in together, whatever you're doing. And I'm not suggesting that people don't use software for retention. I'm not suggesting that you stop doing any tactics to improve, like, bundling or putting people on some kind of membership program. I'm not suggesting not to do that, let me be very clear about that. What I'm suggesting is to think that that's going to be the boon for your practice long term, like, that somehow that's going to be long-term growth. You can grow revenue and profit over time, but it's a much longer path to growth than it would be if you just dialed in new patient acquisition.

Max Baybak

Yeah, well, that— that makes sense. If you're spending all your time on the existing, and, you know, eventually so many people move away or, you know, whatever, then you're just— you're dealing with a dwindling base. So it really makes sense.

I think one thing— I'll say a few things about it. First of all, what you're saying is— is not that it's not important, but it's akin to something you said that I remember, it stuck with me really well and is a good one, when I interviewed— before, and is something that is a good thing to think within marketing in general, is it— when you give us— oh, who do we have visiting us? So, any of you who are not watching the video, uh, who are listening to this in podcast land, Drew has just brought his pup into the frame.

Drew Leahy

She wants something.

Max Baybak

Okay, probably.

Eva Sheie

She has an opinion about this.

Max Baybak

Yeah, yeah. Uh, a sale— you know, sales are, uh, you know, dangerous when you're offering them to your existing audience. I'm not saying we're talking necessarily about sales, but there's— there's a corollary there. When you're taking your current patient base who's already going to pay you, potentially, or more than likely, and you're giving them a sale— and we've talked about this. So in a lot of ways, what I'm hearing that you're saying, Drew, is you're already going to get revenue from these people, and you're going to spend money to get more, and the additional amount more may not be worth the investment, right?

Um, the other thing I will say though— when you express that stat, that statistic, as a percentage, it doesn't take into account the compounding effect. So if in one year you had 60 existing and 40 new patients, and, uh, the next year— I'm not doing the exact math, but let's just say it doubles— in the next year you have 120 existing and 80 new, on those percentages. So I'm sure it's true that 60— I actually bet that's probably true. But what you're simply saying is that number doesn't— that number is sort of intrinsically true, not so much it's not validating spending more on that category, because look at those numbers. Those numbers are almost kind of— yeah. Is that— yeah?

Drew Leahy

100. It's not indicative of— it's indicative of an acquisition problem, not indicative of, like, hey, loyalty is so critically important in this industry that we need to overinvest in it.

Max Baybak

Yeah.

Eva Sheie

Okay, it's definitely a confusing number that doesn't have enough context.

Max Baybak

Yeah, yeah, yeah. I could see the compounding effect though, you're bringing new people. I mean, we always have to have that recipe in there.

Drew Leahy

Yeah, totally. You could— you could rip out this stat from this debate or this— this argument, period, and it still— it doesn't matter. But that— that was a— I've been seeing— the reason why I brought that up, because I've been seeing this stat, like, propagandized, like I mentioned. Like, if people— like people who are selling loyalty clubs, memberships, upselling, retention software, like, they're using this stat to tell you that this is how critical loyalty is, that you need to start spending more on it. And I'm telling you, no.

Max Baybak

Okay. Shameless plug, because I'm always plugging this podcast, but the episode we just recently released with Tammy Valletta, Pinpoint Communications— yeah, you both know her.

Eva Sheie

Tammy is great.

Max Baybak

I knew her mostly because the stuff that we interact with her on is branding, but she has this whole loyalty side, and she spoke so knowledgeably about it and educated me quite a bit, because it's not what we focus on. Yeah, she brought it very, very rightly that a big part of loyalty is just the quality of the service which you deliver. So that again supports what you're saying— just do a great job and they'll come back.

So, okay, it'd be fun to unpack this more, but we have other predictions, and I— I have one to offer up, if you guys want to hear it.

Drew Leahy

No.

Eva Sheie

Yes.

Drew Leahy

Yeah, of course.

Max Baybak

I don't know exactly how this will manifest in such a short time as the next 12 months in 2022, but I know that we are going to see a greater push into, um, interoperability between all this. I talk about this all the time, it's probably a little bit of a broken record, but I just think, um— into the interoperability of the various systems that these practices are using. You brought the duct tape system up— the duct tape system.

Eva Sheie

Yes. Yep.

Max Baybak

Yeah. Um, which I think we're referring to the same thing. Just, you know, you have all these— and again, you also brought up maximizing the value at every point of the patient journey and maximizing the experience. A lot of these things use different systems. Some of these systems don't talk to each other, um, or they don't— they say they talk to each— —other, and then you find that they just tell each other one thing, and they all know thousands of things but they only tell each other back and forth this one thing. Or maybe the integration only goes one way and it's very, very, very limited. Again, talking about what gets marketed versus what's really there when it comes to software integrations. It's obviously like— an integration is not an integration, if you know what I'm saying. It can mean so many things. So a lot of times it looks like things talk to each other, but they don't really.

We saw, going back in this past year or maybe it was 2020, we saw consolidation in the industry. There's the— the venture capital firm out of Dallas, I think, that I'm forgetting the name of, that, um— it back— that's, uh, rolled up Crystal Clear, Patient Now and RxPhoto. And I— I'm not going to speak to their strategy. I don't know if they're trying to also stay open, kind of an open ecosystem, to let people use any piece of that stack. I know that they rebranded Crystal Clear to Rx Marketing, and so there is some kind of, you know, melding of the brands, if you will, but I don't know that that means that they're expecting everyone to use the entire stack.

I think there's a part of a market that probably wants that all-in-one stack, but I think there's also people who are— maybe will want something a little more sophisticated and get to pick and choose. In the past I've talked to companies where they offered software and website, and clients felt a little sort of, I wish I could have kind of my website and my marketing be independent and not have to have these two things be all in one shell.

So I really think— and then we also saw the acquisition, or I don't know if it was really more of a merger, I don't know the details of it, of MyMedLeads, which is a lead CRM, sort of a, you know, lead management CRM, with, um, Nextech. And I spoke to the founder, Enrique— he's a, you know, an acquaintance, and I know him from around the industry, cool guy— and he said they're actually going to keep— stay open to their Patient Now and other customers and even future ones, that they're not staying exclusive. So I think that's a sign that they understand they can't be just walled gardens.

So I don't know what everyone's strategy is with these roll-ups, with this consolidation, but I think we're going to just see more demand from the market itself saying, hey, we need these things to talk to each other. And you have some of these EMRs that have been around for a long time and they've kind of called the shots, and I think that's going to flip. I guess I didn't put it in those words, but I just figured out my prediction. I think the dynamic— the power dynamic is going to flip from the EHRs, the EMRs, to all these add-on services.

We talked about referral— I'm blanking on the name, but there's one that's coming that's doing a lot of marketing right now— and they need to talk into those systems. The patient financing platforms that are rolling out need to talk to those systems. Everything needs to talk. And I believe the— the aesthetic— the EMR of the future will have an app store as seamless and as beautiful as the Apple App Store, in terms of— you know, or— or these are the products you see that have an app store, like, uh, like a Trello has a great app store, right? Right, you know? So okay, that's my prediction.

Eva Sheie

Your positivity is refreshing.

Max Baybak

Oh, I'm definitely an optimist. Um, I am not to the point of, you know— to the point, I just have to have patience. I don't think we're going to see much of this this year, but I think the dynamics are there. And when you're looking at things at the source, because we have clients all the time that want things to talk, I do see the subtle incremental changes forward. They want these systems to talk to each other, and I go, oh, we can now do this, or we can do that. Um, so I see that on an incremental level. Probably we won't see a huge leap this year though.

Drew Leahy

I agree. I'll say something. So, yeah, again, not my arena of expertise here, but one thing I've noticed is, you know, these— we talked about, um, a Patient Now, Rx Marketing, all those kind of coming together for this huge, massive all-in-one software, in which, you know, we all know those— those, uh, those peeps over there pretty well. Um, but what I've seen is like this— this progression for these all-in-one softwares is to try to track, like, the ROI of marketing as well, like down to the dollar, because of this industry of marketing and aesthetics, right?

Max Baybak

Yeah.

Drew Leahy

I actually think that's dangerous. Like— like, I don't know that that's real. Like, I don't know that you can, like— I don't know how accurate that data is gonna be, I guess is what I'm saying, like—

Max Baybak

How— they believe it's the holy grail. It's because I think people think— and why it'll always be the holy grail is, people think it's just a push button thing. But there's so much— as if you get in any kind of data analysis, business intelligence, data science, whatever, you realize that, like, if you think you're gonna automate it and it's just gonna spit out, you're gonna just get alarming numbers, and then when you really unpack it, you're like, oh, okay, here's this, here's that, here's that.

Drew Leahy

It's like garbage in and garbage out. It's like, where— so where— what's getting in? Like, how— how are we gonna ensure this data is, like, it's getting in accurate? You know what I mean? That— that's the only thing I can think of right there. Is like, because I've also seen this push for agencies who have brought on software, where agencies are doing like— the agencies with software have done a better job of taking more credit for the leads and the stuff that's come in the door, not so much done better marketing, but they found a way with software to take more credit for it. Which has been great for them for retention, but is it— are they really doing anything different on the marketing side to help these— these practices grow? No, they're just taking more credit for it. That's my— that's my cynical view of it.

But like, going back to the point though, um— yeah, I just— I— I have a— I have— I hate ROI, period, and I can go off on a whole tangent on this and I don't want to do that here. But the problem— the— the problem that, like, a big problem in any industry with marketing is ROI, because ROI is not an effectiveness metric, and most people don't know that. It doesn't come from the marketing department, it was originating— accountants use ROI, right? So ROI is an efficiency metric. It tells you how efficiently you're able to convert one dollar into— into many. Which is great, right? Especially in, like, a performance marketing, direct response, like PPC ad ecosystem, where you can track clicks down to conversions and collect ROI in there and optimize a campaign. That's all great. But it's not an effectiveness metric. It doesn't tell you how effective your marketing is over time.

And what happens is there's this ROI trap. So my fear, like, tying this all in with this software that's better able to track ROI, is that we're going to become more obsessed with ROI and less effective at marketing. Because chasing ROI— like, like, it's really easy to, uh, improve your ROI. All you have to do— like we're just talking about retention, right? If I want to get the highest ROI for my dollar, all I have to do is market to existing patients, right? I don't need to spend that much money and they have a higher likelihood of converting already because they already purchased. Well, ROI is going to be massive, right? But that doesn't mean marketing to those people only is effective marketing, right?

And naturally, as you move up this metaphorical funnel that we talked about before— like, more in this funnel I'm talking about, like your traditional like awareness, consideration, interest, whatever, decision— like as you move from, um, existing patients to in-market patients to, uh, people who are not in market, your ROI is going to go down. It's supposed to. Why? Because you're marketing to people who are not purchase-ready, people who may not convert for another year, right? And it costs money to keep their attention. But that's good marketing. That's how you grow your customer base, your— your buying pool over time.

But if you're obsessed with ROI, what happens is— and I see this all the time with the agencies— is that once that ROI starts lowering because they're moving up the funnel and doing longer-term marketing tactics, they shut it off. They stopped doing long-term marketing tactics because, oh well, ROI— our ROI is not as good. So over time you just have this— you're just marketing to this small pool of buyers and you're never expanding your— your buying pool. So that— that terrifies me about the software that's trying to track ROI even more, is that we're going to become more short term with our thinking because we're chasing ROI, when we really should be chasing, like, long-term metrics, uh, like absolute profit, revenue, uh, things like that.

Max Baybak

So Eva, you brought up earlier the— there's not enough money being spent in consideration, and that ties exactly into what Drew is talking about. Because you wouldn't— you're gonna— if you don't look at your ROI segmented by where in the funnel— which we're agreeing now is back, the funnel's back as of this conversation—

Drew Leahy

No.

Max Baybak

Um, if you don't look at your ROI and maybe have benchmarks for what it should be in each category, which these systems are not going to be able to measure, um, and you're— and you're lumping ROI into one number, then it can look— it can be misleading. That's essentially kind of what you're saying, Drew.

Drew Leahy

Yeah, I mean, you can't measure the ROI of long-term brand building tactics. You just can't. Like, how are you gonna— if you're gonna put a six-month time frame, for example, on like a campaign and measure the ROI of it— like, what— what's the ROI, like— like a podcast, for example? What if you were able to reach someone who's not interested in breast augmentation or such that—

Max Baybak

Yeah, that's such a— I didn't mean to cut you off, but that's such a good point, because we talked about this and this is something that I think we really are like-minded on. And doing a podcast— why are you doing— I ask myself every day, why am I doing this? I'm trying to ramp up and do it more because I love it, and I just know that I love it and I know it's good content. But if I did it off ROI, I'd quit right now.

Drew Leahy

Right. Exactly. And this is— so this is what happens, this is— this is why— what's so good about the podcast you do, and the podcast that Eva does for her clients, is that you're able to corral this group of people and be relevant and engage people and keep attention with a group of people who are not ready to buy yet, right? So if you're trying to measure the ROI of people who are not in market yet, you— you can't do it. So you have to wait. What happens when those people enter the market in three years, but this podcast they've been listening to is what built trust with the doctor and that they walked in the door because of this podcast? How are you going to measure that? Right, you're not. You can't. So you gotta stop trying.

Eva Sheie

The part— and the other half of that is, there's something on demand for you to hear that doctor's voice. And essentially I'm saying you're cloning yourself, and it's the best version of yourself because we made you sound really great and edited you.

Drew Leahy

Right, right. Yeah.

Eva Sheie

And then that's available on demand at the moment the person's trying to make the decision. So yes.

Max Baybak

That's a great point. Two ways.

Drew Leahy

Yeah. Um, yeah, another class— so, so okay, so this is— I have to— I'm gonna geek out right here. So this is why— this is why— okay, if you focus on just short-term marketing tactics, like driving sales with people who are looking to buy now, like ads or just even most social media from these doctors, they're— they're really just marketing to the people who are actively seeking treatments now. Like, it's treatment, procedure, education, it's offers, it's promos. That's not relevant for people who aren't in market. So if you just focus on that, which most practices do, none of that content is relevant for people who are not in market.

But when you do brand building stuff like we're talking about, not only does it help you grow long-term sales by marketing to this out-of-market group of people who are gonna convert in a year from now, but it also increases the effectiveness of your short-term sales, like you just mentioned. Now you can take this podcast that is meant to keep attention long term, and then also repurpose that on-demand episode for someone who is in market and help them convert faster. Like, that's—

Eva Sheie

We have coordinators sending out podcast episodes related to topics that people are specifically interested in, to try to get them to hear the doctor's voice ahead of time. And so now we're starting to hear patients come in and say, "No, no, I already know what you're going to say."

Drew Leahy

Yeah, yeah. Right, right. I hear that. I hear that all the time.

Eva Sheie

And it's true, that's what happens. You end up selling the person before they even get in the consultation room, and it just makes it so much easier.

Max Baybak

I knew there would be a good energy bringing the both of you guys on the show, feeding off each other. Great, solid points, like, really, really cool points. Okay, I— I want to get to prediction number two. This is really fun, you have a great idea. So let's hear your second—

Eva Sheie

Mine?

Max Baybak

Prediction.

Eva Sheie

Yep. Well, okay. Well, my second one is that I think more people are going to try podcasting this year than ever before. Well, this is not a crazy prediction, because the truth is that there are— I counted— and I'm missing a few, but I counted 21 active patient-facing podcasts by aesthetic—

Max Baybak

But they're all plastic surgeons?

Eva Sheie

But I'm counting all of aesthetics. We track them all. There's 21 that are active in the whole world. And there's some definition, some cutoff for active. There's 11 more where people have tried and stopped and they've given up. So I think we're going to see that number go up, at least I hope that we're going to see it go up.

Um, and I— I think podcasting is really important because— not just what we're seeing globally with that explosive growth, but it feels just like when I started out and nobody had a website. And when I imagine what it looks like for a practice in the future, where the podcast is on equal footing with the website— that is two owned channels where you're connecting with your prospective patient.

So I found some interesting numbers yesterday. I had a— someone— there's someone I was talking to about doing a podcast, and so I was looking for all the positive effects of the year, and I found a new one, which was that the practice indexed 700— more than 700 new pages of content just from their podcast. So— wow— it's what's on their website, so they have a blog post for every episode, but also every single platform where your podcast lives creates a page either for the show or for the episode itself, right? So can you imagine adding 700 pages just to your website of content? That's— that would be— that would take years to do.

Max Baybak

What I call internet surface area.

Eva Sheie

So yeah, huge increase in surface area. And, um, the results just, you know, from the shows that we've been doing this year have just been so phenomenal that, um—

Max Baybak

Let me ask you two things. One, I notice you said the word "try." Is that unintentional? "More people than ever will try podcasting." Is that— I'm not trying to be cynical, but I'm curious if you're intentional with that usage of that word.

Eva Sheie

I think there's a— there's a misconception that it's going to take a lot of time, and I've been really thoughtful about how to make it take less time than what you're doing.

Max Baybak

Take a lot of time— like, take a lot of time out of the doctor's day, or take a long time to reach success? Okay, got it.

Eva Sheie

Like, it's going to be— well, it's also a line of your— those are the two things that people worry about the most, is how much of my time is it going to take, and when am I going to start seeing results?

Max Baybak

And that's what I've noticed, is both of those concerns. And when you said "try"— I've noticed that— I personally think people definitely should do it. I'm not— like I said, I'm an optimist. But I— but I tell them, when they ask us, because— and they ask if we help, and I say, no, you should talk to Eva. We have our own, and we produce The Technology of Beauty with Dr. Grant Stevens, and that's just a really fun thing that I honestly do. It's not really a service we provide, because I want to stay focused on the one thing that we do really, really well.

But I tell them, just don't do it unless you know you can stay at it. And just ignore the numbers and stay at it. And so that's why I say "try," because I do think a lot of them have kind of gone dead. I do notice— we all kind of look when we see these sort of DIY podcasts, I don't know if you guys are this way, but I definitely look at the last post and go, ah, 2016 or something, you know? I'm like, okay, they gave up.

Eva Sheie

They capitulated.

Max Baybak

Yeah, and it's— it's just— it's that— that, I think, is the key. And I have more to say, but Drew, respond to that.

Drew Leahy

I was just— yeah, I agree 100. Yeah, what I was going to say—

Max Baybak

Hold on, real quick, Eva's gonna have one more thing. I want to make sure she gets her whole prediction out.

Eva Sheie

Yeah. I am super, super close now to the people in podcasting who are out in front as far as developing the industry, and watch everything they say and do. And a couple weeks ago I learned that— you know, Apple monetized podcasts for everyone, like three or four months ago, so you can actually put your podcast up there and charge people a buck an episode or whatever. And, um, if I told you guys that as of two weeks ago there were only, uh, about 250 in the world doing this, would that surprise you? On Apple.

Max Baybak

Yeah, that's a crazy low number.

Eva Sheie

Yeah, like six million podcasts, only 250 people opted in to have their show monetized on Apple.

Max Baybak

That's really interesting.

Eva Sheie

So we're in the process—

Max Baybak

Say— that kind of doesn't surprise me in a way, but I get what you're getting at.

Eva Sheie

We're experimenting now with creating a parallel version that's paid. Even if nobody listens to it, what will happen if Apple's featuring us in that very, very small group, right, is a lot more people will find the free version.

Max Baybak

So yeah, that's— what can you do? Let me ask you, is it easy in that Apple ecosystem there— is it easy to do, like, just— not the whole podcast is paid, but you can do, like, insider episodes that are exclusive to paid? Can you do that?

Eva Sheie

I actually don't know the answer yet.

Max Baybak

Oh, it's— that could be cool. It's a good—

Drew Leahy

I'm so glad you brought that up, because that's exactly what I was going to say. So I was going to talk about how— because this is what we're doing too. So we're— with our Serials we're helping, uh, practices grow their own audience through email. And when you have that kind of content asset, like a podcast or like a media publication of your own that you can call your own, that you own all of that media, and where you can monetize it— we're like, we have a program that we want to launch, it's going to be probably a year, but a sponsorship program as well.

So what people don't realize is— and this actually— this goes into my— my next, um, prediction actually, so maybe we can segue into that. But what these practices don't realize— what these content creators, and just general broad content creators, have been doing for the last decade is growing their own audiences, and then not just, you know— some of them are selling products and services, but a lot of them, in addition to that, are also just making money on the media alone.

So in essence, it becomes a free way to market, right? If you can do your podcast, you can get X amount of people to pay for you— it doesn't mean to much, it doesn't need to be much— but it can either cover 100 of the cost to do the podcast, so you're marketing for free, or you can create a second revenue stream where it's actually bringing revenue that you can use to increase your marketing budget, or you can just put it to the bottom line. Same thing with the Serials. When we open up this sponsorship program and we have local, regional sponsors who are logo sponsors or sponsored content within this publication that go out to the subscribers of the— of the doctors, now you have a second revenue stream. Not just— now you're marketing for free, and then over time you grow that second revenue stream.

And that's— that's something that, like, I haven't had a lot of conversations— I haven't pitched that on a lot of doctors, because it's— it's high level, like, for them, you know, not being marketers, it's high level, more sophisticated. But that's the reality we're talking about, like building these content assets and these— these really, like, real assets that appreciate over time. Not just by helping you attract more patients, but also by helping you monetize the media by itself.

Eva Sheie

He's reading my mind again.

Drew Leahy

Yes, we do that.

Max Baybak

Well, I love the correlation. You both have this content that can provide value to the practice from a marketing perspective that also has monetization— capabilities in it. I think of content marketing as, um, you know, traditionally you have a magazine and you sell ad spots, right? Um—

Eva Sheie

Yeah, dedicate a certain amount of pages to advertising.

Max Baybak

So content marketing is creating your own magazine, but all the advertising is yours to keep.

Drew Leahy

That's such a good— that's such a good way to put it.

Max Baybak

Yeah, that's how I look at it. And you got to be selective about how you put it in there, but so— so, or— or do you want to turn on a little monetization potentially? And that is a really interesting conversation. I know people who have podcasts who say, how do we start monetizing, or do I just do it because of the benefit that I get? So people are— as they— if anyone gets out ahead and starts creating great content, they have to start asking that question. There is, like, not in the— sorry, sorry, I cut you off earlier.

Drew Leahy

No, no, no, no. I was gonna say basically— yeah, but I was gonna say though, um, there has been a trend, I'd— over the last year especially, um, not in aesthetic medicine, but, you know, more podcasters, uh, newsletters at large— Substack, right, is a whole platform for this— but or Patreon, where, you know, people are actually monetizing their content through memberships. Like, I've seen a surge in the amount of people who are producing content not for a blog that's going to rank on social, but that's a hundred percent exclusively behind a paywall, which I think is a brilliant idea.

Like— like, you need media to market yourself, right? And this may not even be relevant for the aesthetic industry, but like, you need media to market yourself, to fill channels— that needs to be free. But it's such a time investment to create this high quality content, like, you should be getting paid for it. And I think what we're seeing is there's a lot of people that will pay for it. But again, I don't know how relevant that is to this conversation.

Max Baybak

Well, you know where it's most relevant— and Eva, let me know if you have any thoughts, and then we'll get your second prediction, Drew— is where it's relevant is community, building an audience.

Drew Leahy

Yeah, that's what we're talking about.

Max Baybak

Yeah, you don't have to— you don't have— and you can do these on these channels that you can own, and whether you choose to monetize it or not, it's your choice. But you're not doing it just—

Eva Sheie

When you change the incentive too, it changes the quality of the content. When you're just trying to rank on Google, your content's not the same thing as when you're writing to be paid for it.

Max Baybak

Right, right. I don't know, I think that's cool. It's like bringing the value to an audience, um, for real audience building purposes, not just to kind of get eyeballs on the cheap. Eva, I should— yeah.

Eva Sheie

I should also point out, um, not to be a conspiracy theorist, but, uh— is monitoring what I'm saying or writing and might take me down— is really irritating to me. And so I gravitate towards things like podcasting and Substack because— yeah, I— I believe in the First Amendment. I think a lot of doctors do too. They're experts in what they do and they should be able to say what they want, and I'm gonna stand behind that. So I feel like I'm in the right place.

Max Baybak

There'll come a day when I think that it'll be just as easy for them to monitor that content, but right now there's a little barrier there. And I've had the same thought, that if you wanted to create, like, a— a real platform where you could filter out a lot of the garbage, put just enough of a moat there, just enough friction there, that to creating the content people have to consider it and think about it. Really, they could just record a podcast into their iPhone, so it's not that hard. But if you want to create a great sort of, like, decentralized platform, you go— you create podcasts, because it— anyway, we could get into that. But I agree very much with you. Drew, what's your second prediction?

Drew Leahy

Yeah, so the second prediction just piggybacks off what we're already talking about. So what— what I've been seeing a lot, and I think we're going to see a lot more of this year especially, as we come through the— well, who knows, but hopefully we come through the end of this— this, uh, COVID-19 pandemic— but I've been seeing a lot more of these, you know, practice or providers, plastic surgeons, nurse injectors, a lot even estheticians, who have, uh, big social followings are starting to monetize those personal brands in ways unrelated to their treatments and procedures and their— their core offering.

Um, most recently, like— doc— I don't know if you guys know Dr. Sieber. Uh, I haven't spoken to Dr. Sieber in a minute, but he's an awesome dude. He just launched his own skincare line, which, you know, a lot of doctors are starting to launch. Um, I forget the name of it.

Max Baybak

SF?

Drew Leahy

Yeah, he's in San Francisco.

Max Baybak

Yeah, okay.

Drew Leahy

Um, super awesome dude, laid back, easy conversation, great doctor. Um, but he— I forget the name of the— really cool branding, like really cool simple skincare routine that he's selling. Oh, like package— not is like, you know, it's not like private— you're— you're like— you would typically get, like, a private label skincare line, it's just got your logo on it, it's just something you slapped yourself. But this is like a— there's a real brand campaign behind this product line.

Um, Dr. Devgan as well, plastic surgeon in New York, has her own skincare line which I know is killing it. And we're starting to see more and more of that, especially the— there's so many estheticians right now. This is another thing— like, estheticians is such an underserved market, especially for marketing. Like, I'm— I'm like trying to talk to more estheticians to figure out what are some opportunities there, because they don't make a ton of money so they can't spend a ton of money. But there are a lot of estheticians who have, you know, 100, 300,000, 400,000 followers on Instagram and are starting to do courses, starting to do, like, paid guides, like all paid courses, and just monetizing that audience, doing virtual consults— that they, you know, they don't have anybody coming into the practice or their— their office, they're just doing virtual consults for people who are following them on Instagram, I mean, and they pay for those.

Um, and then you get like Dr., uh, Nazarian, she has her, like, curated e-commerce shop. I've seen a few of those as well. So— so I think we're gonna start to see more of these influencer doctors, right, for lack of a better word, who have built these communities, built these audiences— albeit not on the perfect channel of social media, but they've still done it. Um, and they've had success, but they're siphoning value off those channels. Exactly. Now they're going to start to really create second revenue streams from it. So I'm really excited to see how that goes.

Max Baybak

Eva, thoughts on that?

Eva Sheie

Well, it lasts—

Drew Leahy

Yeah.

Eva Sheie

While it lasts.

Max Baybak

Well, there's one— yeah, I mean, marketing, digital marketing particularly, the one you can expect everything to change and you have to keep up. So yeah, I think that's true. What I would echo on that is, we definitely saw— I mean, there was no reason people had to wait to the pandemic to embrace e-commerce in this industry, and many, many were well ahead of it, but we saw a flood of them— of docs, dermes, med spas, estheticians— surgeons moving in that direction with the pandemic. And largely that was led by industry trying to find, you know, crafty ways to— to respond to the pandemic. And many of them— and we know, because on our end we were asked to add these links to drop shipping stores on all these websites. And that's an okay solution, and we see some people who make some revenue from it. Um, and you have to create a ton of content on your social in order to sell that stuff. You can't really expect to do it on a top of funnel strategy.

Drew Leahy

You need the brand to do that. Yeah.

Max Baybak

Um, kind of, for the most part. And— and I personally think that if you're not doing the drop shipping, if you ship your own and you control the experience and you do it under your own brand, that it's way better than the whole drop shipping thing. But there's no question that— that, um, we're only going to see more of that. So without unpacking more, I would just— I would definitely tend to agree with you on that one, Drew.

Drew Leahy

Cool.

Max Baybak

Prediction number two for me. And this is a long— I— I feel like we're going along. I hope people will enjoy this as much as I have, because this— this is, like, honestly, we need to do this on a regular basis.

Eva Sheie

Yeah.

Max Baybak

Because I just love— and I've thought of so many things that I— it's just cool to chat with like-minded people, very much in the same vein of thought— industry, marketing, but same principles, kind of basic core philosophies about marketing and really building an audience. So it's so fun to do.

Um, I'm probably early on this one too, and if you're not— if your timing of your predictions aren't good, then they're not really that good. I also had like 10 predictions, and I thought, man, I have so many good prediction ideas. And I actually realized, like, as predictions go, that's actually very lazy, and everyone could be Nostradamus if— I feel like people on social media just try to say as many things as they can so they can come back and say, see, I said it right.

Eva Sheie

Totally.

Max Baybak

So actually the discipline is to pick— is to pick the right predictions. I don't know if this is the right one, but I personally feel— we just talked about this a little bit, um, platforms on the social media side, but it's talked about less— but I think even with platforms like on the search side, like Google, have a responsibility. Um, and we won't get into the other side of, you know, what's been happening in terms of disinformation and things related to the pandemic on social media, but these platforms are— are weighing out that they have— they— they have to have some sort of point of view on these things, and they have some responsibility for what's on their platforms.

As it pertains to what we do, I think that we're going to see steps in the direction of platforms— and I'm looking at Google, but it's also social media— to potentially have to do a better job of vetting the credentials of— of the medical professionals that their algorithms are surfacing or— or giving advantage to.

I give this example: I gave a talk last year or sometime this year about— and I cited this article in which Google was under a little bit of fire for locksmiths that were ranking in the Google local pack. And I think it was in San Francisco, and but they were— a fraudulent operation that was just breaking into people's homes, but Google was making this connection. And it— it surfaced the point that Google needs to pay some attention to this. And they now have programs for home services and I think in the real estate world and I think in the legal world. And I forget the name of this, it's like Google— it's not Google Vetted, but— I have to find it, but essentially you have to go through a program, there's a fee— you have to go through a process, there's a fee that you pay, and your— your— your licensure is checked and checked on and so forth. And then it's a massive advantage to those people who go through it, for obvious reasons. Now Google can really with confidence sort of say, we've put them through this vetting process so they'll surface them.

There's certain types of ad units that are available to those professions that are not available yet in medical— specifically in real estate, medical— sorry, real estate, legal, home services, like contractors or things that— like the locksmith example. There's obvious reasons that they're staying away from medical. It's a big scary world for them to start saying we're putting our seal of approval on this, right? Um, in Australia we're seeing conversations about right now about what we would call the core versus cosmetic— and— and whether or not, um, a cosmetic surgeon is going to be allowed to do a cosmetic procedure. And this is great, every plastic surgeon is and should be rejoicing over this conversation. Will something like that come here from overseas?

Drew Leahy

Let me— so let me make sure I understand. So what you're saying is that they're actually saying, okay, if you're, uh, not a plastic surgeon, say you're an OB-GYN turned cosmetic surgeon, what— you actually can't— that's not a thing anymore? That's what they're talking about, like, you can operate—

Max Baybak

So I want to make sure I'm not citing any— there's no— there's no, uh, regulation that's been come down and nothing final, but— and I want to make sure I'm not giving you any misinform— like, quoting this—

Drew Leahy

Yeah.

Max Baybak

—incorrectly. Um, so I should find the exact news, but I know from some of our clients that this is— this is definitely a conversation that's happening, and there's a lot of news happening about it right now. And I actually need to do a little more research, and I'm wanting to see if it comes over here.

Drew Leahy

Yeah.

Max Baybak

But that's kind of a different point. More my point is, I believe that these platforms— search, Google, social, Facebook, Instagram, maybe TikTok— is going to potentially have to face that. It might be early on that, but, you know, like— like in the beginning it was a free-for-all, and then they started going, well, we have to actually somewhat regulate the content that comes to our platform and be responsible for it, be responsible for who's looking at it, what age they are and so forth. And I think that that's going to come in some form. And we might— my predictions are a little weak, because I'm basically on both of them saying we'll see early signs of this, but we'll do it again next year and let you know.

Eva Sheie

I like being early. There have been early signs actually, Max.

Max Baybak

Um, yeah, yeah, tell me.

Eva Sheie

Yelp did it for a minute. You could actually pay Yelp something like 200 or 250 dollars to get a verified or a vetted profile on Yelp. And I don't know—

Max Baybak

I didn't even know that.

Eva Sheie

Uh, well, when you work in the review business you pay attention to stuff like that.

Max Baybak

Yeah, yeah.

Eva Sheie

It must have failed, because it's not there now.

Max Baybak

It's such a hard problem to solve. It makes me think about— you guys remember, oh, like eight years ago in SEO, the whole authorship, right? They were trying to attach— basically—

Eva Sheie

Supposed to be the big thing, right?

Max Baybak

Right, supposed to be the big thing. Or they had this, like, knowledge base and structured data of, like, authorship, like real identities, person-to-person identities. Um, for— I think at that point it was really for, like— judging credibility of articles, like, okay, we know that this person's a vetted writer with credibility in this industry, this— perhaps we can rank this article higher. But that's what it reminds me of, you know. But I— I agree, they— I mean, it's— it's got to happen eventually.

Drew Leahy

It'll be interesting to see. I have seen on Instagram, you know, they are starting to do some more flagging of posts and just, like, putting like "censored content" or like that little "sensitive content," uh, little— whatever you want to call it, that goes above the— losing the words for it. Um, but I've seen some of that to try to, like, kind of manage, uh, different content. But I guess that's kind of unrelated to, um, vetting, like, credibility for, you know, surgeons.

Max Baybak

I— I'm saying that it's tied in because it's the core theme, the common theme, is that they have to— they can't just say, like, we're simply just a pipe and whatever people want to put on there. And that's— that's long was their argument.

Drew Leahy

Yeah.

Max Baybak

Um, was that they were— there's a term for it that they were utilizing in their legal arguments where they were just simply saying, like, we don't have any responsibility. And they were able to avoid certain regulations because of that. But whether they got through it on legal loopholes, now society is saying, like, you can't just not care about these things. So it is tied in, the fact that they're having to put all these measures in place. And it does— it's hard to scale, you know?

Drew Leahy

Right.

Max Baybak

Facebook had fact-checking teams that were manual, and like, how do you do this at scale? So how do you solve that problem specifically for our industry? Authorship thing is a good example, and I'm not saying authorship doesn't matter in SEO, but I can tell you that, um, it didn't hit our industry in the way that it was kind of rumbling that.

Drew Leahy

Right, right, right.

Eva Sheie

I just heard of a startup out of, um, Oklahoma, I believe, that was coming from the insurance credentialing side. So what they're doing is creating this database, and it's— their initial customer was malpractice insurance. So every time a doctor goes to get malpractice insurance, they have to apply for every single carrier, and this company scaled credentialing so that they could— and then built relationships with all the carriers so that they only had to do it once.

Max Baybak

If I had to guess— like, I'm going to add another prediction here—

Eva Sheie

Yeah.

Max Baybak

—that that's probably one of the strongest paths forward.

Eva Sheie

Should we start that business?

Max Baybak

No, but we should talk to these guys who are doing it and find out what they're doing.

Eva Sheie

Right, right.

Max Baybak

I know some companies that are doing similar things, um, and so I think it'll be interesting to see if someone partners— if Google or Facebook, whatever, partners with them. I brought it up to the Aesthetic Society, saying I think— I don't know how you get in there, but I think that they need to be looking to societies like yours to, uh, as a proxy for trust, and to offload some of that vetting responsibility, because they may not even— Google and these platforms may not really be qualified— in fact are not qualified— to do, right? So I think, you know, maybe—

Eva Sheie

Not until— sorry to rain on your idea, Max, but not everybody's in the Aesthetic Society.

Max Baybak

Sure. I'm an— again, I'm an optimist. No, I'm just kidding. Um, you can rain on my idea. I— I don't know the path forward, I just have ideas.

Yeah, can I bring up something that I just think is cool? And then we should probably let—

Eva Sheie

I gotta go pick up my kids pretty soon.

Max Baybak

Okay, all right. Yeah, I was about to say, you— you all probably have lives and don't want to just talk to me all day. But while we talk about social media and the changes there and algorithmic serving of data, there's something that I haven't seen really come to life at all yet, but— I don't know if you remember, it was last year, 2020 I think, when Jack Dorsey was testifying in front of Congress. What it was— he brought up this concept that they're experimenting with, that he called "bring your own algorithm," which I'm really interested in. I haven't heard— I haven't really made any effort to go see if anything's happening with it. But his whole point was that you— various third parties could create their own algorithms and you could load it in and say, I want to use this person's algorithm as the way I want to serve and see information on this platform.

Eva Sheie

Interesting.

Max Baybak

Super cool concept.

Drew Leahy

Yeah, I'm intrigued by that. I wonder how that would work. Well, it really might— it's— I think that's a pretty apparable— apropos point at this point, because Instagram just came out last week and said early 2022 they're going to add an option to have a chronological feed again. So— so users can choose, like, if we don't want this algorithmic feed where they're just serving the most engaging content, the content that we think we want— which, you know, I don't know that's such a problem on Instagram, but on Facebook we— we've— if you guys seen The Social Dilemma, you know what that algorithm does to people, especially young kids. But they're adding internet features— it's that optional feature as well. So it's not— it's not the choose your own algorithm, but at least it's like, hey, have an option, have a choice.

Max Baybak

Yeah, Twitter's always been the more open, um, platform, like in the early days where they just let developers build all kinds of bots and things like that. So the— the Twitter version of literally, we'll just let any third party— you can trust them. So we could build an algorithm that says we're going to vet medical practitioners, and that's what this algorithm prioritizes, and you get to layer it on top of your Twitter experience.

Eva Sheie

Yeah, we could do that without Twitter's permission, which is cool.

Max Baybak

I'm not surprised that Facebook's going to be a little bit more of a closed ecosystem.

Drew Leahy

I'm excited. I'm— yeah. One prediction that isn't— it's— it's already been— it's already underway, and we're not gonna see this, like, come fully to fruition next year, but it will definitely come more to fruition, I guess, um, is the consolidation of the non-surgical industry. So you have, um, Ideal— Ideal Image—

Eva Sheie

I threw away.

Drew Leahy

What?

Eva Sheie

Okay, no. Oh, but you have— you have— maybe, um, maybe my idea of what you're about to say is different.

Drew Leahy

Oh yeah? No, it's not— not consolidation like we were talking about earlier. So consolidation of, like, having like a— like a winner, like an actual brand that's nationwide, maybe eventually even global, who is, like, the dominant market share owner, um, for medical spas. Like, um, Ideal Image is already— I think they have like 160 locations and growing, you know. Like SkinSpirit are really one of my favorite examples, because I— I think they have like 20 locations or something now, mostly on the West Coast.

Eva Sheie

Orange Twist.

Drew Leahy

Exactly, Orange Twist. And there's, um, Chapter, which I'm really excited about. So Chapter is— I don't know, you guys are familiar with, um— her name was Melissa Rodney maybe— I'm gonna botch that, sorry if I botched that— but she is the— she's like a medical spa innovator. She started a medical practice, or medical spa, in North Dakota called Rejuve. Anyway, she got all kinds of funding from Aspen, uh, Dental, I think it is, and they're gonna start— it's called Chapter Aesthetics now— they're gonna start going chain nationwide as well.

So it's gonna be interesting to see this, you know, unfold over the next 10 years. But like, I— I keep asking myself, like, I wonder if this medical spa space in the next 10 years becomes like nail salons, flower shops, like liquor stores, there's just one in every strip mall, right? And it's— it's four or five dominant players, and then you have all these local— like all the local medical spas that are just one-off shops or maybe two or three that are competing against them. It's— it's— it's gonna be interesting.

Max Baybak

I— I so did get what you were going— and that was one of the ones I left off. I don't know how much we'll see of it in 2022. We'll see more of it. I just completely agree with what I would call sort of the proliferation of the retail med spa experience. And yeah, I've chatted about this with clients before, where we think that there are patients who prefer the medical experience and ones that will want just the walk-in retail experience. Yeah, I have no question that will happen.

And one of my predictions was— I was going to say, like, you know, med spa GDP will flip surgical GDP, but I don't think that will be in 2022, and I don't even have the numbers to support— right, I haven't given much thought to which brands will lead out. But, um, venture capital money and— and private equity money coming into the space and creating chains and doing what they did in the dental space with the DSOs, um, kind of the MSOs— we see tons of rumblings of that. So yeah, I would say the writing's very much on the wall. Eva, do you see some— some things in your— from your position on this same front?

Eva Sheie

What I would say is that the patient never changes. The patient's needs never change. So if you think back to what I said earlier about it being a provider-dependent experience, it's the chains that figure that out and, I believe, stay centered on the relationship between the provider and the patient that will be successful. And that— SkinSpirit is how they do that. They do that really, really well.

Um, yeah, I just heard a story the other day about an injector who got hired and then the pandemic hit, and they kept her on and paid her the entire time without any patients, and she had never worked an hour.

Max Baybak

Nice.

Drew Leahy

That's cool.

Eva Sheie

The way people treat their employees is the way that their business is gonna go, and that's kind of what I look for.

Drew Leahy

So there is— I'm so fascinated by the medical spa space. There's some, like, real, like, business savvy coming out of that, because I think you get a lot of— you're getting a lot of partnerships with the medical directors and the— the business person first. Like, so it's almost like business person, marketer, comes in, partners with medical practitioner. So there's more just business acumen coming in, period. And it's— it's pretty cool to see.

Eva Sheie

So accurate. They're gonna throw my kids out on the street if I don't—

Max Baybak

Okay, you gotta go pick up your kids. Thank you so much for all your insights. Drew, honestly, let's do a mid-year, let's do something.

Drew Leahy

I'm looking forward to watching this and seeing how far off I was next year.

Eva Sheie

Let's just film it again next week when we talk about something on the phone.

Max Baybak

Well, I'd love to hear feedback from the audience, if— if this was something like a round table type thing they're into, maybe we do something like that. I'm gonna— I'm gonna brew on that. Thank you so much.

Eva Sheie

Thank you.

Drew Leahy

Thanks, man.

Max Baybak

I'm sorry we made you late. Take care. Thanks everyone for listening. Bye.

Drew Leahy

See you guys.