Take Back Your Time: How to Reduce Operational Stress in Your Practice

Erica Crawford

Okay, so my name's Erica. I am the president here at Influx Marketing, and I am joined by my really good friend Skya Jones. She is an industry consultant for Boulevard, which is a patient experience platform for scheduling, bookings, patient communication and everything you basically need to talk to your future patients or your existing ones. We're really excited to do a webinar for you today.

So, what to expect: I'm going to share some slides first. It's about 5 to 10 minutes' worth of slides, and the presentations together are about 15 to 20 minutes. The whole thing is less than 30 minutes. Then we get to my favorite portion, for those of you who've been to one of my webinars, which is the Q&A. Feel free to put questions in the chat or in the Q&A, whatever you're most comfortable with, and any questions you have about anything we bring up, we will answer at the end. So as we're talking, feel free to ask questions as we go along. We love questions. We put some love into the slides, but I feel like the questions are where people get the most benefit out of these webinars.

So I'm going to go ahead and get started. This is "Take Back Your Time: How to Reduce Operational Stress in Your Practice." A lot of my different webinars are on different subjects, some about patient acquisition. This one is more about what happens after the lead, once the person has reached out to your practice. That's the subject of today's webinar: somebody has actually now inquired.

First off, leads are not going to fix a leaky funnel. More leads doesn't always mean more revenue. Every stage of a patient's journey can be a conversion point, but you have to find any leaks before increasing acquisition spend.

Just a couple of days ago, I was talking to a really good friend of mine, a plastic surgeon I've worked with for many years, and he reached out and said, "Hey, should I increase my marketing budget? Should I do more paid ads? What should I do?" So I went to his account rep, I looked at his account, and I was like, gosh, he has more than enough leads for the number of providers he has. A single plastic surgeon plus a spa side, so a few nurses, aestheticians, etc. Just looking at the full number, from my experience, and I've been in this space for a long time, his leads are more than enough. So what's happening there? Why would you go increase your marketing spend when I know you have enough leads? Something is broken in the sales funnel.

I want to give you the feedback of working with thousands of practices at this point, and being in this industry for too long to age myself right now: what I expect, what numbers I expect, what I see from successful practices. A lot of this is based on looking at different practices in different geographic locations and giving you a summation across our entire client base.

So first off, not all leads are created equal. Everybody talks about the funnel, right? Top of the funnel, bottom of the funnel. Every sales consultant out there will talk about the funnel. At the top of the funnel is awareness, brand recognition and the like. You're just getting people interested in your services, making sure they know you exist when or if they want the procedure at some point. All the way at the bottom of the funnel is the intent to purchase. Different leads come in at different places on the funnel.

Typically, for organic search, Google Ads, AI (ChatGPT, etc.), and referrals, a practice that really has a strong sales team in place can convert 50% of those leads: 50% of paid Google leads and organic leads as well. That's the number I'm telling you across the board when the sales team is super strong. The reason is that those people are looking at "breast aug near me," "who does the best Botox," "who does the best tummy tuck," "where can I get a facelift in Atlanta." They are at the point of intent. They are actively looking for your services and already have the intent to purchase something, most likely in the near future.

Now, something like a Meta ad, your Instagram sponsored post, or even some of your organic Instagram posts, is typically at a lower percentage. I honestly find anywhere between 10 to 20% of those. The reason is that they're at awareness. They're interested, but they're not necessarily at the intent to purchase. We've all been scrolling on Instagram, scrolling, scrolling, scrolling, and then boom, an ad hits us. Maybe that ad is of interest, or maybe it's not, but it's not like we were searching for it. We weren't typing it in and looking for it at the time.

For example, I'm pregnant right now, so if I scroll my Instagram I always get ads for whatever latest stroller or whatever thing. It's giving me an ad because it has figured out I'm pregnant and it's giving me something relevant. But it doesn't know that I already have a stroller or a car seat or whatever it is. It can't factor everything in perfectly. And even then I might be like, okay, let me click on this and check it out and see if it's better than what I have, but I'm not necessarily at the intent to purchase. That's why social media ads and posts are sometimes lower intent, and I don't expect the same conversion percentage.

Once again, we're talking lead to consult here, but I do expect 50%, and if that's not the case, there is something wrong with the sales process you have in place, which I'm going to talk about in a second.

So, conversion strategy for the lead. One of these things is to make your pricing very transparent. There's been a lot of discussion on this. If you look at any of my webinars from a couple of years ago, I did not like pricing on the website. I was super against it. I have changed my view for several reasons. One big one is that Google gives a little bit more value to people who have pricing on their website. I also think it filters people out. If you're at lower or mid-market pricing, it doesn't matter as much whether you have pricing on your website. But let's say you're in the upper-mid to upper end of pricing. It definitely matters, because you want to filter out people who will not be candidates.

This is a client we have in Miami, say, $10 per unit, which in Miami is considered on the higher end of pricing. So weed out the bad leads from day one: this is what it costs. There are no price shoppers or Groupon people, and when the person fills out the lead form, some of their questions are already answered. They already know it's a bit of a pricier practice, they know what they're getting into, and there's transparency. You can also put financing information right there, if you're using PatientFi, Cherry, or whatever you're using, so people also know they have different options for financing. I actually like the pricing page and the financing to be right next to each other or combined in a certain way, so it also gives them a solution if it is a little expensive. Having a lot of information on the website so it automatically filters out bad leads is very helpful.

Here's another example. You can just have a range. It's really hard, especially for surgical procedures, to give an exact price. You can either do a range or a "starting at." Something else: if you're doing a full facelift or deep plane neck lift, this is what it costs, this is roughly the range. And these ranges can be big. I've had them go from 40 to 80 grand, which is fine. It's okay if it's that big. You don't have to be perfect. We all know you need to see the patient. But it's nice to have some sort of pricing.

The consult is your second conversion point. First off, I'm a very strong believer that every single consult should be paid, meaning to your provider, whether you're a nurse, an aesthetician, or a surgeon, which obviously would have different consult rates, or booking fees. But they should pay something. You don't get to go see a doctor for free. You don't get to go to urgent care without paying. I even have a small copay or something to get seen. That's just how the world works, and your expertise and your advice are worth a fee. Once again, it also weeds out anything that's not a good lead.

The consult-to-treatment rate I expect to be at least 70%. Remember, I'm factoring in a paid consult, meaning they paid 100 bucks, 200 bucks, 300 bucks, whatever that is, to see you. At that point, they have skin in the game. They've been educated and now they're coming in to see you. I expect you to book at least 70% of those patients for procedures.

It's not always the treatment they came in for. It's not uncommon for somebody to say, "Hey, I really want a facelift. I want to find out a bunch of information about it." But it's 50 grand and they're not ready for it yet. So then you end up going, "Okay, you know what? I could at least do a bleph. It’ll make you feel younger, I can do it in the office today. I can give you something, a little Botox or something." So I do expect you to book a treatment. Get them in your house, whether it's non-surgical or surgical, so later on you can always upsell or add on when they're ready for the big treatment you really want to give them, or the bigger packages, or the loyalty programs.

Book at least 70% of them for something and get them on your roster. Have them as a patient. But you do need to have a really consistent follow-up process. Have a lot of care with them, actually spend a little bit of time with them, be very transparent about pricing, and be confident about it and why you cost what you cost.

Your team is your sales engine. You have to have people in house who are comfortable selling. They're not just answering phones. New leads have to be responded to immediately. This is a massive change in the last year or two. I used to say, if it's an organic lead, it's fine within 24 hours, and if it's paid, within a couple of hours. That has changed.

With AI, and it's not even just AI. It's Amazon same-day or next-day delivery. It's Uber Eats and Postmates. It's Instacart. We are in a whole new world where people have an expectation of getting things very, very quickly, and that's not just AI related. It's all around us. The other day I was driving from some appointment and I thought, oh, I should probably pull over, I love that place. And then I thought, I'll just Postmates it. I was like, wow, how lazy am I that I'm driving by a restaurant I want to eat at and I'm considering having it delivered to my door instead of pulling the car over and waiting for the food and getting takeout? It's crazy to me how quick our society has become and what our expectations are. And also, time is money. I'll give credit to that. I've got places to be, and I do things quickly. But that has created an expectation. People expect answers right away.

That means nights and weekends. I expect every lead to be answered within minutes, period. And there are tools you can use for that. You have staff, but you also have AI tools, you have your CRM, you have things that can help you. But you actually need to hire real salespeople, not just a front desk person, but aggressive salespeople who live and die by your booked procedures. You also need to have instant response, follow-up emails, a follow-up text chain. Sometimes people take a while to convert. It could take weeks or months for somebody to schedule an appointment, especially for a large procedure, and you need to have everything in place so that follow-up is there.

That has been a major change in the last year or two: all follow-up has to be instant, and it cannot just be 9 to 5. Those days are long over, because typically when somebody fills out a lead form, they're filling it out with you and maybe two other practices. An average first-time patient looking for something typically inquires with three different practices. Whoever responds first, gets them communicating, and creates an emotional response or connection to that practice is going to get it. If you have a competitor who is responding well, I can tell you right now, not all of our clients, but a lot of our clients have worked this out. My most successful practices have worked at this level of speed and response time. That means a lot of your competitors have worked it out as well, and they're the ones who are going to close.

Also, don't forget about the patients you already have. That's the other reason you really need a great CRM. You're doing all this work to get new patients, but that needs to follow through into retaining your patients. It's a hugely important part of the process. The value of a new patient is not what they pay for their first procedure. It's their lifetime value. So you have to monitor rebooking, memberships, enrollment. You have to know your patient lifetime value. You have to pay attention to the whole thing.

With that said, before you spend more on leads, ask: are we converting the leads we already have? Are we converting them into treatments? Do we have everything in place to support that growth? You don't want to start spending money on marketing if this is not in place. That's the truth. You have to have everything in place to respond to and handle the leads, because it needs to pay for your marketing. You need a good return on investment, and you can't do that unless you have the whole system in place to handle all the potential new patients you might be getting.

That's why this is going to lead into Skya. I'll let her speak next, because that's where Boulevard comes into play, and she also does a lot on the patient retention side of things. I'll let you go ahead and talk.

Skya Jones

Thanks so much, Erica. Let's jump in. Erica just led us through some very valuable information on identifying the importance of not just top of funnel, but all of your sales funnel, and how important it is to be quick. In the age of technology we have now, everyone's using AI, and everyone is also responding very fast to leads, so you have to keep up with that. I'm going to walk us through how technology can support that while still maintaining a very high-end client experience.

Like Erica touched on, the importance of retaining a client is so vital. So many people focus on new leads. They focus on how to get new clients. But I always say the first focus should be: what are your retention numbers? What is your average client spend? How can you increase that with your current clients before focusing too heavily on filling that new lead bucket?

To kick it off, fast response. This is something I live and die by. People want to book their appointments when they want to book their appointments. Life is extremely busy for everyone these days, and we have Instacart, we have Uber Eats, we have all these things on demand. So when someone wants to book a consultation or book their service, they want to do it now. They don't want to fill out a lead form and wait for someone to respond. They want it taken care of right when they think of it. They want to know, "Great, I have an appointment on the schedule."

I'm someone who is very passionate about having technology that lets your customers and clients access your business whenever they need to. I'm super busy. I'm not scheduling my appointments until I log off for the day and I'm lying in bed thinking, oh, I need to get in for Botox in the next couple of weeks. Is my med spa open at that time to book an appointment, to call in, or to ask questions? No. But there's technology that allows us to book online really easily, optimize the schedule while that's happening, as well as AI receptionists and AI agents that can help facilitate your clients booking outside of the normal business hours when you have front desk staff answering the phone.

So it's really important to hone in on your technology and make sure it supports that, so your clients can call and book through the AI agent. At Boulevard, we call ours Beau. It's our AI receptionist, and she can answer phone calls, walk clients through services, help reschedule or cancel appointments, and facilitate medical director handoff. There's a ton of functionality there. I always say it's like having someone who's an expert in your business at the front desk at all hours, able to service your clients right away.

The reason a smart, intelligent AI agent is so important: in the world of AI, I'm a little bit bullish on it. I think there's a lot of AI out there that's great, but there's also a lot that doesn't really hold up. It can feel very unnatural, inhuman, very robotic, and people don't respond well to that. So having something that feels really natural when someone calls in, and an agent that knows the services at the business, the descriptions of those services, and any info on the business that might be important, like location, policies, things like that, is vital.

And then also the warm handoff. If the agent is unable to solve the situation, either taking a message that's really detailed or handing it off to someone on the team with a synopsis of what the client called in for, so they're able to continue that high level of care. I always think AI is for anything we want to save time on, things we used to spend time doing manually, monotonous tasks. We still want the business to remain really high touch and really luxurious, with a consistent client experience throughout. We know client experience is what sets businesses apart in terms of retention, in having that client come back. So you have to have technology that supports that and doesn't take away from it. That's always something important to analyze and compare when you're looking at your tech stack.

Some other things I really highlight when I'm consulting for businesses is the idea of optimization. AI is amazing at optimization and automation. One of the ways Boulevard has integrated this is in one of our most-used functionalities, which is online booking. It's something that sits behind online booking that isn't super in your face, but the AI that powers our online booking learns business trends, provider trends, and client trends, and offers times to clients based on what is best for the business, eliminating those awkward gaps of unbookable time. So whether I have 30-minute Botox appointments and want to ensure those are booked back to back, but I also do 45-minute filler appointments, it recognizes all of that on the back end so it alleviates those awkward gaps of unbookable time.

A little story I like to tell with that: before working at Boulevard, I was in the industry. I've been in the industry for a little over a decade. I actually did not use online booking when I was a provider, because I did not believe in it. I thought, I know how to schedule my clients best. I know how to arrange my schedule so my utilization and efficiency are as good as possible. Then when I saw the back end of Boulevard and the precision scheduling algorithms that had been built, I was so mind-blown that it changed my entire perspective. Now I work for the company as their industry consultant. So having something intelligent in online booking is vital.

Then, highlighting the importance of any manual or repetitive work that doesn't require a person. A term a lot of us in the industry like to use is AI with a human in the loop, or AI that can be validated by a person. Things that are done the same way every single day, like automating reminders, or forms and intakes being sent out, are things you have to do for every single client who schedules an appointment. There should be no reason we can't automate that process and not have a human overseeing all of that manual work.

I always say technology allows us to focus on the more humanistic elements of life. Having AI handle all of this functionality so your team can focus on the client walking in the front door and giving them the most amazing client experience is really key. It also removes the margin for human error. Say a front desk person calls out sick. What are we going to do when there's no one at the front desk and the providers are busy? Who's going to answer the phone? Who's going to send out appointment reminders and intake forms? Technology can handle all of that. So it's really important to integrate those kinds of repetitive, automated workflows in the business, so you can free up your staff to sell more. They will learn the products and services and be able to upsell a lot better when they have time to focus on that.

And then retention. This is something I talk about at almost every presentation or speaking event I do. I am so passionate about retention. I've already talked about it. It's my hill I will die on. Automating retention is important, because things fall through the cracks. It gets busy. You forget to send out an email campaign or a text campaign. A lot of the time you all are wearing a lot of hats, whether it's medical director, owner, surgeon. There are all these different roles you're holding. So automating retention emails and retention campaigns, giving your clients some sort of VIP experience through memberships, or an incentive to do a series of treatments through packages, are things technology should enable and automate. These are the base work of keeping your client retention number good.

Everyone has fluctuating numbers. Anywhere from 50 to 70% of clients should return to your business. That depends on what service they initially came in for and what field you're in, whether it's surgical plastics or more med spa injectables. But it cannot be forgotten. Your CRM, your patient management system, or, like Boulevard, a client experience platform, should have retention built in, and you should be utilizing that on the back end so you're not having to put a ton of thought or energy into it.

This is a little blueprint I pulled together. It's something I like to give to all of my clients and customers I consult for: how can you use technology effectively? What's the best way to implement some of the stuff Erica and I are talking about?

The first thing I always say is audit. Find where you're spending the most time and where hours are going. If it's reporting you're struggling with, pulling reports, or you're spending hours trying to figure out payroll, manually calculating sales and revenue for your service providers, or auditing duplicate client profiles coming in, or cleaning up lead lists, really identify where the time vampires are and figure out where technology applies and how you can use automation, AI or otherwise, to support this and do it more effectively. When I ran practices, I would honestly have an audit on my calendar for me and anyone else in management and leadership in the med spa, to go in and ask what I'm spending too much time on that isn't giving a lot of return or that can be improved. It's something I still do in my practices with Boulevard, and it's definitely something I recommend, to see where the time is going.

Then identify the boring stuff, the stuff you don't like doing, the stuff that's not filling up your cup. Figure out some way to automate it. For most businesses, we see them leveraging things like our AI receptionist and our precision scheduling. Those are things staff don't generally love doing, from answering the phone to scheduling appointments. Those are repetitive tasks we can alleviate so they can focus on what they really want to, which is generally the client experience: giving amazing services and treatments, and helping clients find the products that will ensure the results they're investing in.

And that's where three, empowering your team and your staff, comes into play. One of the biggest gaps I see in any practice is not having a consistent client experience among service providers or staff. Having everything in one platform, all the client information, notes, charting, all of that, and also having technology that can enforce things like no-show and cancellation policies, allows everyone to be on a connected, same-page level. Clients know what to expect, they know everything's going to be taken care of, and staff can give them a very personalized experience by knowing, hey, maybe they're getting married in a couple of months, or maybe they're expecting and we're going to make sure to use pregnancy-safe skincare and products. So it's really important to have technology that empowers those staff members.

And lastly, optimizing your client experience or patient experience. I tell so many people this: when is the last time you tested your online booking to see how long it takes to book an appointment? When is the last time you went through the actual flow of filling out intakes and concerns? There are times I'll audit with businesses, or even secret shop with businesses, and I'll see their intake forms are set up incorrectly, or their front desk forgot to send me the intake forms, or something like that. There are all these key things you can identify when you sit in the client seat and go through that client journey. So it's definitely something I recommend for anyone focusing on optimizing that journey.

Awesome. I know that was a lot of talking. Erica and I want to give you the opportunity to ask questions. We can dive into anything. Erica threw these up before, but here are some QR codes to scan to learn more about Influx. Boulevard loves working with Influx. They're such an amazing agency. They know not only the marketing side of things so well, but the overall industry. And there's also a Boulevard QR code if you want to scan that to get more info on Boulevard and see all our different resources, case studies, and so on.

Erica Crawford

Thank you so much, Skya. That was amazing. Really, really informative. Now we get to my favorite part, the Q&A. I'm going to go over some of the questions. Some of them Skya will grab, some I'll grab, and we'll just take whatever makes the most sense. As we're answering questions, feel free to put more in the Q&A or in the chat. Either way, we'll get to it.

One of them says: "You mentioned a 50% lead-to-consult rate. What should I look at first if my practice is nowhere near that?" I'll answer that one. I'm a huge fan of call tracking. Huge fan. It won't tell you everything, because you should always have, on your website, a way for any patient to call the practice, a way to submit a web form, a way to chat or text, and a way to book. Four ways to communicate, depending on their favorite communication style, or whether they're ready to book or not. They could just schedule right there on your site. All four of those should be available at all times for any patient searching for you.

With that said, chats are easy. You can review the chats and see how your team's responding. Web forms, similarly, are easy. But call tracking is your most telling thing. Hearing how your staff sound and react to questions on the phone is incredibly informative. I cannot tell you how many times I have talked to a practice that says, "We have the best patient care coordinator, the best sales team," and I've listened to the calls and gone, okay, I'm not trying to be overly critical. There may be a lot of things that are correct about them, and they just need coaching. But it is very rare that I listen in and there's nothing. There are a few practice managers and patient care coordinators out there that I'm like, these are the GOATs. They've been doing this for 20, 30 years. They're absolutely excellent. But most of the time, when it's at the point of needing to listen in on a call, I find something wildly off about how the patients are being responded to.

Which is funny, because a patient who is calling in is the highest-value lead. I think you should be converting far more than 50% of those, because if they're taking the time to call your practice, they are incredibly interested in your services. As a matter of fact, just the other day I had somebody do a listen-in on one of our clients. This is a Slack from one of my account reps yesterday: "I listened in to the leads coming from the ads and the calls coming in from organic. They don't even go to a patient care coordinator. Whoever is on reception just answers questions robotically and doesn't push for consults or transfer them to speak to someone. Nothing." So I was like, okay. It's very telling.

Skya Jones

Yes. And this is where I'd say secret shop your practice. You know how they're answering the phones when you're at the practice and they know you can hear them or they know you're listening. But I have done it, where I secret shopped a practice I managed, and the girls answered the phone way differently than what we had been practicing in training. It's good to catch them, not off guard, but in a more natural state than when you're saying, "Okay, this is what we want you to say, script, word for word." So throwing a secret shopper in there is always a good idea.

Erica Crawford

Yeah, I think so. There's definitely some listening in and observing what people are saying. Sometimes it's more coaching, sometimes they're unfamiliar with answering certain questions and you try to teach them how to answer. You also have to decide what you're comfortable answering on the phone versus what you want to bring the person in for a consult for. There's a very delicate balance. If you're like, "I'm not answering anything and you must come in for a consult," that might actually be off-putting. But if you answer all their questions, why would they come in for a consult? So you do have to find that sweet spot. I see a lot of people fall down on that, but you have to figure it out for yourself a little bit.

Okay, next one: "Is there a point at which your provider schedules are too full to justify paid ads marketing?" I'm going to answer part of this and then get Skya for the rest. First off, we do have clients who just do organic because they're so busy they don't need paid ads. That happens. For example, we do the marketing for Dr. Mike Nayak, for those of you who know. He's like a $200,000 facelift in St. Louis, and we're not running paid ads. He has a two-year waiting list. That does exist.

Although I will say, for the average practice, I never want you to have to throttle back. I'd rather have you increase your pricing or add more providers. Why would you stop growing? And I do have practices that just don't want to grow. They're happy with the providers they have, the staff they have, and the location they have. At some point they turn off their paid ads, go on cruise control, and that's what they want in their life, and that's actually okay. Some of you are like, "Oh no, I want to keep going," but I have a surprisingly large number of practices, typically plastics rather than med spas, that are very happy doing the 9 to 5, going home, not adding another plastic surgeon, just cruising along. They're happy, and that's totally fine.

But if you do want to grow and your provider schedules are getting full, my answer is adding another provider or increasing your pricing. It depends a little bit on your market, but there is a point when you start losing consults and bookings because it's too far out. For a plastic surgeon, for example, when they start getting 4 to 6 months out, that's when people start to go, "Oh, really? I'm calling you in the summer because I wanted to have my mommy makeover over the holidays so I'd be healed up for next summer, and you're not available until March." If it's too far out, you start losing clients. Your provider schedule is too full. That's when the question is whether to do the same amount at a higher price so profitability is higher, or add another provider. It's a little bit up to you. But that's what I think. I don't know what you think, Skya, on that one.

Skya Jones

Yeah, you honestly read my mind. When I saw this question come in earlier, I was like, raise your prices. This is the exact time you're a perfect candidate to raise your prices. I have a practice I'm working with, and she's a well-known injector in the area. She has a consistently full schedule, and she just brought on her first protégé, an entry-level injector, and she said, "I'm struggling with how to get her clients and consults, because most of the time people are coming to me because they were referred by a friend or family." And I said, raise your prices. Your clients who are price sensitive will then start seeing someone who's more affordable and also has availability within a couple of days of wanting to book. So that's exactly the time to raise your prices and have a provider who can be at that lower price point, or you're just weeding out those price-sensitive clients.

In terms of when to stop raising prices, I honestly don't think there's a definitive cap on how much you can raise prices or when to stop. I see a lot of parallels in the high-end salon world, because there are stylists booked out for a year, which isn't great if you want to get in to see a celebrity hairstylist who charges $1,500 an appointment and someone's willing to pay that. But if you're too booked up with lower-price-point clients, you can't see them. So there's definitely a balance between the price increase and still having an available option for the client. I think it's something you should look into if you're getting to that point.

Erica Crawford

Yeah, exactly. Next: "What are the best services to offer for client retention at med spas? Are the sales team over the phone, or should all sales be done during the in-person consults?" I'll answer part of that, and then maybe you can answer the best service to offer for client retention.

First off, I think this is where people fall down. A lot of times I see a practice where their patient care coordinator is their strongest salesperson, the person they've invested in sales-wise, because all they're focused on is the person coming into the practice for the consult and booking. Which is why I say it should be 70% plus for the person who's physically in the practice: they've paid for a consult, and how many of them do you book? Obviously that's what the patient care coordinator should focus on, and they should have that 70% rate and be doing really well with it. But you also need to have, depending on how many leads, either that same person or another person who is just as strong a salesperson, because getting a lead to pay a consult fee and come into the practice is really hard work, and it takes a very skilled salesperson to do that at 50%.

I was talking about this earlier: you need a strong salesperson. It cannot just be a front desk person. It has to be somebody who is aggressively going after those consults. I did a webinar with Dr. Johnny Franco, and he had, I think, a 55% lead-to-consult rate, and his booking rate was well above 70%. He has a huge practice for plastic surgeons, tons of providers, but he has 3 or 4 staff whose entire job, all day long, is to call leads, follow up on leads, schedule leads, and get them in the door. That's what they do.

So you should have a dedicated salesperson. Depending on your volume, it could be your patient care coordinator wearing both hats, getting the person in and then getting them booked. But if your volume is really high, it warrants a full-time employee just handling those leads and being very aggressive. Even with everything Skya is saying, all the automations, all the integrations, you still need a human to help with that.

Skya Jones

And I'll add to that, there's a retention piece there. If you have someone who is your point of contact, your salesperson handling leads, I think the best way to nurture that lead is that even after they get their service or their surgery, that person remains a point of contact, following up and making sure the patient feels taken care of. When I was in body contouring, every single person, after they got their first CoolSculpting treatment, either I or my medical assistant was calling to ask how they were feeling. The next day, and then three weeks out, we were calling to make sure they had their next treatment on the schedule. There are so many human elements you can add that increase retention. And not only that, they increase client visit frequency and client spend. You can bring up, "Hey, when you were in, we were talking about that skincare regimen. Do you need anything to re-up on that regimen or product list we went through?"

Erica Crawford

Exactly. And then, what's the best service to offer for client retention? For med spas, I'm a huge fan of injectables. I feel like that has one of the best retention rates. I don't know what it's like for you when you're in a practice.

Skya Jones

Yeah, I have a love-hate relationship. Obviously I love injectables. I will get Botox and/or Dysport until I die. But there's something to be said for sharing of services. If someone's coming in only for injectables, chances are they probably need some sort of laser or microneedling or something for skin quality and skin integrity. So I'm a big proponent of getting your injectable-only clients on some sort of other service, whether it's microneedling every three months or a series of IPL treatments. I almost think the best retention is getting an injectable client on a non-injectable service, and vice versa. I refer to it as sharing of services. But of course, with injectables, most people hit that 90-day mark and say, "I need to get back in ASAP," when they start seeing movement. That's where memberships, packages, even promotions and marketing can be so valuable for retention.

Erica Crawford

Exactly. Next question: "We're at the very top of market pricing. Do you still recommend putting pricing on your website?" Yes. The more expensive you are, the more recommended. As a matter of fact, if you're at low to middle pricing you should still have it, because it comes up, and I'm certain it helps from a patient acquisition standpoint, but it doesn't directly do what I'm trying to get it to do. The entire reason you're putting pricing on your website is to weed out the price shoppers. So that's the answer on that one.

Another one: "We're generating plenty of leads, but they're not turning into booked patients. How do I find out if the problem is marketing or my team?" This is important. If it's an organic lead, just to be very blunt, it's going to be the same lead quality as any practice anywhere. Organic is organic. It's somebody searching on Google, searching on AI. There is nothing you can do to change that lead quality. The only thing I'd say is, if you're really expensive, that's where pricing comes in, having some transparency there. But organic is going to be as good as it's going to be, forever.

So if your practice is converting, let's say hypothetically, 25% of your organic leads and Joe Blow in your same city is converting 55% of those, the problem is your sales, because it's just organic leads. For us, we have grown as a company so much that we're very familiar with every city and every demographic. We know the averages in each city at this point. While we can't say, "Hey, this person over here is converting X amount," unless they're comfortable with me saying it, like Dr. Franco, which I can say because we did a whole webinar and shared all that data together, I can tell you.

Now paid is an interesting thing, and this is important. Unless your practice has really inexpensive or competitive pricing, we add negative keywords. We actively block out people who are searching for things with the word "insurance" in them, if you don't take insurance, or people looking for "best pricing" or "cheapest med spa" or whatever. Those are all negative keywords. Typically, when we run paid ads, we get rid of any sort of price shopper or insurance person or any kind of question that's just weird and not going to be a good lead. Those types of people typically won't even see the paid ad. That's why most of our Google Ads convert at the same rate as organic, because we're using all those negative keywords.

With that said, I've seen companies that don't care and just try to get a high volume of leads. They don't add any negative keywords, so your ads are getting shown to all those people, the ones who are price searching or looking for insurance, and that will make your conversion percentage go way, way down, because now your ad is showing to a patient you don't want. So as long as whoever is running your Google Ads is being ethical and thinking about the good lead versus just the volume of leads, there's no reason it shouldn't be a similar percentage to organic.

Skya Jones

That's something important that Influx does such a good job of, and marketing agencies can miss: it's not about the number of leads. It's genuinely about the quality of leads. In my past days managing marketing teams, I'd hear, "Well, we got you 50 leads this month," and I'd say, "But they were all looking for Groupon deals for CoolSculpting and Botox." It really is about eliminating the patients you don't want, who are spamming phone lines or even coming in for a consult when they're probably not going to spend money, and focusing on the leads that are actually qualified.

Erica Crawford

Exactly. Next: "As a med spa, how do you get a client to pay for consults? We do deposits, but the no-show rate is very high." Is the deposit the whole consult fee? That's my question, because if they're paying for a $200 consult and they pay all of that, which they should, it's a deposit. In short, any consult fee ultimately goes toward their treatment, so they're technically all deposits. But I wonder what the size of your consult fee is. If they don't show up, there's not a whole lot you can do if they decide to waste the 200 bucks. That's kind of on them. There's not a whole lot you can do outside of really good follow-up. Make sure you don't just book the appointment and then not send them texts and reminders. That's where Boulevard comes into play. The follow-up once they've booked should be somewhat automatic, right?

Skya Jones

All of it. I'm so passionate about this in terms of no-shows and cancellations, because I think the majority of no-shows and cancellations can be completely avoided based on the technology you're using. Theoretically, when a client books, let's say you charge a deposit or you hold a card on file. Some people want to offer complimentary consults, and that's totally understandable. For plastics, I think we're past that, but for med spas, if you want to offer a complimentary consult, that's fine. Regardless, your technology should hold the card on file, and that card is chargeable based on business policies if they no-show or cancel. If they paid a deposit, collect the deposit and really follow up on business policies, not saying, "Okay, we'll move it to the next one," and rescheduling and rescheduling.

Realistically, your system should not only send a confirmation that you booked an appointment, it should also be sending emails and text messages multiple times to remind the client, and giving that information to your staff: "We've reached out twice to this client and they haven't confirmed. They're still in the unconfirmed bucket the morning of the appointment." It's a good way to know this person is probably not going to show up. Let's call them, get them on the phone, and remind them, "Hey, you made this deposit for $200. It's going to take weeks to get you back in. We don't want you to lose your deposit." There are a lot of ways to go about it, and whether you charge a deposit or not, you can still avoid those no-shows and late cancellations with good tech.

Erica Crawford

Yeah. And also, don't feel bad about it. My chiropractor charges a late fee. My dentist charges a fee if you don't show up. My child's pediatrician, my child's dentist. I don't think I have a single medical provider, whether a nurse or doctor or surgeon, in my Rolodex who does not charge a fee. Just to be very blunt, I don't feel bad, because that's normal. It's normal, not just in aesthetics, but everywhere. It's okay to enforce it. So don't feel guilty. Some people are funny about money. It's okay to take money from people. That sounds very blunt, but that's the truth, especially when it's your time involved. You have set aside that time. Your time is very valuable. Do not forget that.

"What is a good target percentage of leads to be getting from AI search versus other means?" I think this has less to do with the practice and more to do with where AI is at. As a practice, you want to be showing up in AI, but once you are, that percentage is going to change as people's search habits change. I'll give you some metrics. We did a big case study across all of our clients who show up regularly in AI. There's no ranking in AI. It's going to change. If we all sat here and researched the exact same thing, we'd get slightly different answers. But we were able to say, okay, we have these 100 clients who, if you look up "best plastic surgeon in LA," or "who does the greatest tummy tucks," or "who does the best Botox," or "who does the best Halo," or whatever, in their city, show up in, let's say, 80 to 90% of searches. They come up often. Those are people I'd say are very present in AI search.

Then we took those clients and looked at how many actual leads they get, mostly, by the way, from ChatGPT. You can look at some of the others, but you can't really see where the leads come from. That's a whole other webinar. But ChatGPT is something like 92% of AI searches right now, so it's pretty dominant and worth looking at. Even in our biggest, busiest practices, with all that search presence, in our biggest cities, it was never more than 5 to 10% of their leads.

I think the reason is that, while this will change, and I think every year that percentage is going to get a little bit bigger, people have this thought that AI has somehow dominated Google, and it has not. People typically use AI as a validation layer, meaning they're going to Google you. They're going to look up "Botox near me" or "plastic surgeon," and they typically use Google. Then they take your name, put it in AI, and basically check you out. That is a process we're seeing a lot more commonly with patients specifically. Do I think that's going to change? Absolutely. I think AI will continue to grow and search is going to change. A year from now it'll go from 5 to 10% to 10 to 15, to 15 to 20. I do think it's going to grow, but that's where it's at today, this year. I just think the growth is slower than people expected as a primary search platform.

So it's 5 to 10%, and the leads are not stronger. The same lead coming in from AI or Google is the same. They're all organic. It just depends where they decided to start their search. They have the same value. I've not seen one that's better than the other. The only time I'd say it's better is the validation layer. Sometimes that helps. I saw one come in where somebody asked, "Who does the best facelifts?" Let's say best facelift in Toronto. They looked online, got the name of a client, put the client into AI, and AI kind of glazed him up. It said, "Yeah, he specializes in facelifts. He doesn't do any breast and body work. His whole thing is facelifts," and really talked up the client. So I'd say it gives more validation. It's almost like a good review. If it's coming in like that, it can be higher value.

Skya Jones

Yeah. I wanted to ask your opinion, Erica, because I feel like I'm seeing more people mention Reddit, and how they're using AI to scan Reddit or Google reviews and see, "Hey, if I want a breast aug, what surgeon in this area has the best ratings and reviews?" It's not only pulling Google now, it's pulling Reddit and all these different sources. Are you seeing any trends with that?

Erica Crawford

Oh yeah. I actually did an AI talk on this a few times. Reddit and ChatGPT have a formalized fiscal partnership.

Skya Jones

Oh, I didn't know that.

Erica Crawford

Yeah, they're partners. So ChatGPT absolutely loves Reddit, and we very much talk about this. I've done a blog on it, I've written articles on it, I've shouted it from the rooftops: you need to be active on Reddit. Now, when I say you, I don't mean you. I mean you need to get your patients active on there. They need to go on there with their candid stories of their experience at your practice, giving you reviews just like they would on Google or anywhere else. Except, don't forget, Reddit is a little more candid, a little meaner. So the review they do on Reddit needs to be a little more candid. Maybe they say at least one negative thing about you, like they waited a while in your reception. That's just how Reddit is. But Reddit is definitely very helpful for AI.

We have a couple of conferences coming up. Unfortunately, there's a conference I religiously go to every year, Skya, I think you've definitely been to, but it's overlapping. It's the same week as another conference I do, AAFPRS, which is a really large facial plastic conference, and it's overlapping with the 4S Summit. That's in three weeks, the same weekend. So I'm going to the facial plastic one, AAFPRS, and missing 4S for the first time in a really long time. But my colleague Adam is going to be doing an AI talk there, if anybody's going to that summit. And I'm talking more about lead generation, follow-up, and how to handle difficult patients, which is also a fun topic I should probably do a webinar on at some point. So those are coming up for me, at least.

Skya Jones

I'll be at the 4S one.

Erica Crawford

So Skya will be at 4S. That's where we normally see each other, but I'm not going to be there this time, which is rare. It's not my fault. They had them the same weekend.

Skya Jones

Two good events, same weekend.

Erica Crawford

Facial plastics is also a very large conference, the largest facial plastic conference in the US. Facial plastics is so small, but it's huge. It is what it is.

Let me see if there are any other questions. "Should practices be bringing on paid AI advertising?" Not yet. We're watching very closely. ChatGPT is in the process of rolling out betas for paid ads. We at Influx are part of that program. We have just started running, or are starting to run. They haven't opened the door yet for static ads, so you can't, even if you wanted to. It's a little more complicated, but to make it really simple: no matter what you see online, you cannot run a simple ad campaign on ChatGPT right now.

They just gave us the green light to be partners, but the only thing they're allowing us to run is an ad for ourselves. It's funny, because Influx traditionally is a word-of-mouth company, but we're literally going to run an ad for ourselves on ChatGPT just so we can get familiar with running paid ads there, and we'll let you know how it goes. That's how early it is. We're literally guinea-pigging ourselves. And like I said, OpenAI invited us, so that's a whole thing. So the real answer is we don't know yet, and we'll find out. We'll probably be one of the first to know when it becomes more available.

I do think it's going to be interesting. There's been a lot of debate about it. Of course they're going to run paid ads. That's how they're going to make a lot of money. At the same time, a lot of people feel very strongly about it because it defeats the whole purpose of AI, which is supposed to be unbiased. I'd argue it's already biased. Some of the stuff in AI and the answers I get, I'm like, oh, you know, yeah, I guess. There are things that are said that I'm...

Skya Jones

There's a confirmation bias in there, I would say.

Erica Crawford

Yeah. Sam Altman talks about it. He's the founder of OpenAI. He says it's sycophantic. It's literally there to please you. The person who created the program said it's the biggest problem he has with it, and he's been trying to figure it out. He's been improving it, and there have been some improvements over the last year, but at the end of the day, it's going to agree with you on most things. That's a whole thing.

That's why we just published a case study from Influx where we had a client who went down this deep AI train, and he was killing it. He was in, I'll say, one of the top three most competitive aesthetic markets in the US: Miami, New York City, Beverly Hills/LA. He's in one of those, with hundreds of leads a month, and he's on page one for every keyword. I mean every competitive keyword, top of page one. But he was someone who used AI a lot, talked AI a lot, and kept coming up with AI ideas on how to do better. It's hard to do better than what he was doing. I'm not saying you can't, but there is a point when you have dominated that market. You have done the best you can organically.

But he went so far down the train that he ended up using Claude. He left us and used Claude to build an entirely new website. It crashed his rankings. He went from top of page one in that big city to page seven, on everything. We've been monitoring his website for the last four months now, because we're curious, and we've just watched everything go. Even ChatGPT, which used to show him for 80 to 90% of queries about what he does, he's gone. He obliterated his practice. Literally just listening to what Claude told him to do.

Skya Jones

This is where the human in the loop comes in.

Erica Crawford

Yeah. It's going to be hard to fix what he did. I'm talking technical. It's going to be hard for us to fix. We will, but it's going to be a challenge. And it's all stuff Claude told him to do. I'd argue that Claude, in theory, is more intelligent than ChatGPT in some cases, so I think he really believed it. We did a case study on this and we're sending it around. If you want it, let me know and I'll send it to you. It's a wild subject. I love AI. I use it every day, constantly. But there's something to be said about it not always giving the best directions.

It's also lied about patient deaths. It said one of my clients killed Kanye West's mom. For those of you who are older, you'll remember back in the day, Donda West had surgery and died on the table. It was really, really bad. That happened a really long time ago, with really old practices. My client wasn't even a plastic surgeon then. He must have been in high school when that happened. He's young. But AI said he was the one who did it. So when somebody was asking, "Hey, has this surgeon had any patient deaths?" it said, "Oh yeah, a big one." Luckily, the patient was like, wait a second. Look at the photo of him. And that was, let's say, 2008.

Skya Jones

That doesn't quite add up.

Erica Crawford

That doesn't quite add up. They said something, screenshotted it, and sent it to him, so we actually got that information. Anyway, I'm on a roll here, but it is quite something, and it's interesting that we're watching it. With that said, I am a huge fan of AI. I use it all the time. I love it. I just use it with a human. You can't remove the human. I don't know if we ever can. Would you feel comfortable with an AI robot doing Botox on you instead of a human?

Skya Jones

I think we talked about this on a panel together. Even if we get to the point where AI is so good it can do a breast augmentation perfectly, robotically, without any margin for error, I think people will still choose having a human provider and a human aesthetic eye for all the services this industry provides. I don't see a way around it.

Erica Crawford

Yeah, exactly. By the way, I'm going to answer one last question, and then I think we'll end here. There are emails going around about ChatGPT, saying, "Would you like to advertise?" There are a lot of scam emails. A lot of them are not real. If you look, they're not actually from OpenAI. I'm just going to warn you right now: be cautious with those.

That's all I have. Thank you so much for being here, and we're looking forward to seeing you at the next one.

Skya Jones

Thanks, everybody.

Erica Crawford

Bye. Thank you.