In a little over 5 years, Fishbein Orthodontics has done something that most practices take decades to do: It has grown to include eight thriving offices. To say that Ben Fishbein, DDS, CAGS, of Pensacola, Fla, is an orthodontist with some proven practice growth strategies is an understatement. But what makes him really stand out is his willingness to be transparent and share with his peers the fundamental strategies that have been key to his practice’s growth.
Fishbein, a Baltimore, Md, native, found his way into orthodontics through a high school internship with local orthodontist, Jeffrey Miller, DDS. After completing dental school at the University of Maryland School of Dentistry, and then his Certificate of Advanced Graduate Studies in Orthodontics at Jacksonville University School of Orthodontics in 2012, he opted to stay in Florida and set up shop in his wife’s hometown of Pensacola. For the first year of his orthodontic career, he worked at a corporate practice; and, then in October 2013, he had the opportunity to buy a small orthodontic practice that evolved into what is today an eight-office operation known as Fishbein Orthodontics.
That original practice had two very small offices, located in Pensacola and Navarre, that Fishbein renovated and expanded. Within 3 years, he was ready to open his third office in the town of Pace. Since then, he’s added five additional offices—located in Crestview, Ft Walton, Perdido, Cantonment, and Niceville. As Fishbein puts it, even though the offices are located in small towns, the offices themselves are not small by any means; and while they may start off only open 1 day a week, with growth each has added open days, with most now open 3 to 4 days per week and staffed by Fishbein and two additional orthodontists—Sarah Howle, DMD, MS, and Maryam Rezaie, DMD. A fourth orthodontist will join the practice in the summer.
So, what drives Fishbein to open a new office? Patients. “When we are already attracting a lot of patients from an area [to one of our existing offices], we know we can better serve that area if we put an orthodontic practice there,” he says. And because the last six offices were opened from scratch, a dedicated marketing plan was required; and it needed to be implemented well in advance of the doors opening.
“We like to market the practice typically 6 months before we open so everyone knows we’re there once we do open,” says Fishbein, adding that these marketing efforts also extend to existing patients. The practice makes sure current patients know that there is a new office closer to their home and gives them the option to continue treatment there.
And when the doors open, there is always a party to announce to the community, and local dentists, that there is a new full-service orthodontic office in the neighborhood. The practice is sure to cultivate its relationships with the local dental offices, as about 30% to 40% of the practice’s patients come from dental referrals. “It’s still a significant portion of our practice,” say Fishbein, who uses lunch-and-learns, goodie baskets, and contests to raise the practice’s profile with these dental offices.
Fishbein is a firm believer in an aggressive marketing strategy, and has been from the start. “I know marketing works. Since I was coming into an area that I was not from, and I’m the only orthodontist in my area who’s not from the area, I felt like I had a disadvantage. I knew that in order to survive I was going to have to market.”
Direct marketing is a major component of Fishbein’s strategy. His embraces a “try anything once” or “throw everything you can against the wall and see what sticks” approach. But that means keeping track of the return on investment. “We are evaluating all of that every quarter to see what works and what doesn’t work. So, if there’s something that has a very low return, we’ll stop and put the money into something else,” he says. Those meetings include the practice’s marketing coordinator, community outreach coordinator, event coordinator, chief operating officer, and orthodontists.
The practice’s current marketing strategy includes billboards, direct mail, social media, AdWords, and even ads in the local movie theaters. He chose to work with professional marketing companies from the beginning—most recently outsourcing all the practice’s digital marketing to HIP Creative and eNoxMedia. He turned to them specifically for their video, photography, and digital marketing experience. “We felt like we needed a professional who could do it better than we could,” says Fishbein.
When it comes to selecting a digital marketing company, Fishbein is more concerned about fit than previous experience working with a dental or medical practice. “The marketing companies that I feel I can make a connection with, who have a similar vision to mine, I think that typically works out better,” he says. And while it’s not important that the marketing company have familiarity with the local community, Fishbein stresses that he meets in person with the company at least three to four times a year to make sure they are connecting with the practice’s needs. “At those meetings, we’re talking about goals, what we want to push, and new ideas we have. I’m telling them my ideas and they’re telling me theirs. Typically, it’s almost a brainstorming session of what can we do that’s different,” he says.
But the bulk of Fishbein Orthodontics’ marketing strategy is focused on community involvement and that is handled in-house, with a dedicated staff member charged with community outreach. If there’s a big community event, the practice, and its mascot Chompers, makes a point of taking part. But while you might think this means they are at every local health fair, that’s not the case. Instead they focus on events that really have nothing to do with braces, for example local humane society events or school fairs. According to Fishbein, while the practice definitely benefits from having offices in relatively small towns and a certain level of brand recognition that comes from being in a small community, the message the practice wants to send is not “Hey, we’re here to provide you braces”; instead, it’s “Hey, we’re here helping out the community.”
Another type of event the practice has embraced is local bridal expos. With these events, the practice is going in with the mindset that this is an audience that would be interested in an orthodontic benefit. But Fishbein recommends that practices attend these events prepared to schedule appointments right then and there—don’t rely on passing out business cards or flyers. “Your chance of them becoming a patient at your office is greater if you can actually make the appointment right there, rather than if you’re just saying, ‘We’ll call you,’ or ‘Give us a call,’” says Fishbein.
And while they do the typical community outreach efforts like sponsoring local sports teams, they also have embraced more creative strategies to connect with the community. For example, for every patient who starts treatment in the practice, a portion of the profits goes to the Pensacola Humane Society. And more recently, the practice launched the Fishbein Foundation, which is dedicated to promoting anti-bullying initiatives, and has set itself the task of providing $1 million in free orthodontic care over the next 5 years to local adolescents who are victims of bullying.
The $1 million idea originated with the practice’s own patients. “We had a few patients who came in and you could tell they were being bullied, and treatment was not something their parents could afford. So, before we actually officially created the foundation, we would just tell them, ‘Hey, you know what, don’t worry about it. We’ll take care of it.’ We just thought it was such a great service for the patients that we wanted to do more,” Fishbein says.
The practice has made sure to heavily promote the foundation’s work in the community. While it has enjoyed local press coverage, letters to local dentists and schools about the foundation’s $1 million initiative have been the best means of identifying students who are victims of bullying and who would benefit from free orthodontic care. Currently, all the funds for the program come from the practice’s profits. There are no private or corporate donations. In 2018 alone, the practice contributed $285,000 towards free orthodontic care. “Our goal is $1 million in 5 years. We’re going to do it faster than that,” says Fishbein.
A Practice to Learn From
Although Fishbein Orthodontics has only been in operation for a little over 5 years, it has become well known in the orthodontic community for its marketing and practice growth strategies. In 2017 alone, over 50 orthodontists and/or staff visited the practice in person to learn about what it was doing. Specifically, they came to ask Fishbein for his advice on whether they should open another office; whether or not they should market more; and where they should spend their money. “I’m not an expert,” says Fishbein, “But we’ve opened up a number of offices and done a lot of marketing. So, in terms of management and marketing, we can provide feedback on what’s worked for us and what hasn’t.”
At the prompting of his office manager, Fishbein created a course to better address the demand among the orthodontic community to learn more. Fishbein Fundamentals is a 1½-day course focused on practice efficiency and growth. Held in Pensacola, two times a year, the course is designed to show orthodontists and their staff the systems Fishbein Orthodontics has successfully implemented. The course is structured so that attendees first visit the practice for half a day to see it in action. They then spend the next full-day going over the practice management and marketing systems they saw. Since the course launched, more than 300 orthodontists and/or team members have attended.
For Fishbein, the main thing he wants attendees to see when they visit his practice is the office culture and mindset. “There are definitely small tactics that can be picked up [when they visit], but for us, the biggest thing someone can take home is just the way they look at things as a whole—or what I would call ‘mindset.’” And that mindset can best be described as laid back, according to Fishbein.
“We’re probably more laid back than the typical orthodontic office. It’s fun. We’re playing loud music. Most of the people in our office are not wearing scrubs; they’re in fun t-shirts,” he says.
This consistency of this practice mindset and overall culture is all the more important as the practice has grown from 7 to 75 team members in the last 5 years. “One of the difficulties with growth like that is maintaining that culture, that positive attitude, that feeling of your team members and you wanting to come to work and change people’s lives. There are a number of things we do to try and maintain that culture and that’s what we talk about during the course.” For example, the practice holds quarterly events to create cohesion among the team, closing the office and doing something that has nothing to do with orthodontics. Their last event involved a scavenger hunt. “It’s a way for us to all get together and do something fun with each other,” says Fishbein.
When it comes to systems, Fishbein wants attendees to walk away with a number of ideas for how to improve their practice management and marketing systems. One area of practice management Fishbein wants attendees to address is their patient on boarding strategy. “We try to help offices remove obstacles for patients starting treatment,” he says. “We see a lot of offices will set up obstacles for patients that the office doesn’t even realize they’re doing. It’s very easy and quick for us to break those down.”
And what do those obstacles look like? Fishbein uses his own practice to illustrate the problem. “In our office, you used to have to come five times before you even got your braces on. A patient used to have to come in for the patient exam then again for records, and then study models, indirect bonding trays, and separators. We have since found ways to streamline the new patient process and what we’ve found is a lot more success.
“People want immediate gratification now and that’s what they’re used to getting. They can order food with the press of a button. They can swipe right for a date. So, they want to come in and get started immediately—whether that’s getting braces on or getting an Invisalign scan. That’s something we need to be able to provide in order to meet consumer demand.”
That streamlining also extends to the patient’s experience before they even walk through the door. The practice uses online chat, text messaging, and online booking to make it easier for patients to schedule an appointment and start treatment.
“I believe whoever makes it easiest wins,” says Fishbein.
In terms of the marketing strategy, Fishbein wants attendees to understand how the practice decides where to market, what marketing tactics to employ, and how much money to spend. And the course includes discussion of the simple question of why a practice should market. “Some orthodontists are scared to market. Some don’t want to spend money on marketing. Some don’t feel that an orthodontist needs to market. Maybe that’s true; but for us, we need to market. So that’s something we talk about,” says Fishbein.
At the heart of the Fishbein Fundamentals course is transparency. “One of the benefits of coming to the course we put on is that we are very, very transparent. We show our systems and we can also give feedback,” he points out.
An orthodontic practice is a business like any other. And that means that there is a tendency to worry about sharing your secrets for success with the competition. But as Fishbein sees it, success, and, more importantly, lessons learned along the way, are something to be shared. After all, the success of one practice is fundamental to the success of the whole profession. OP