Endo Mastery

Beating your endo competition



For every endodontic case that you complete in your practice right now, there are at least two other potential cases in your patient community that could be referred to your practice. That’s a significant opportunity for growth if you can tap into it.


However, even though that opportunity is available to you, it is also available to every other endodontist in your area too. Why? Because over two-thirds of endodontic cases are completed in GP practices without being referred. Truly, the competition in endo is not with other endodontists.

Factors that drive referral relationships

The question we are really facing is what moves a GP to prefer to refer endodontic cases rather than completing those cases themselves? If you think about your best referrers and analyze why they are great referrers, then you generally find they have one or more of the following mindsets:

  • They like you and see you as a trusted interdisciplinary partner.
    Everything begins with the doctor-to-doctor relationship, which is established both socially and clinically. If you look at the top GPs in your community who have busy and successful practices focused on high-value comprehensive care, none of them reach that level without embracing an interdisciplinary philosophy. That means they have optimized comprehensive treatment around a team of trusted specialists with whom they feel aligned clinically and that they enjoy working with.

  • Treatment in your practice is more convenient for patients and less stressful for the GP practice.
    While most endodontic practices typically have a schedule that plans for a certain number of emergency same-day treatments, that is not the case in the GP practice. The typical productive GP is usually scheduled 2 to 6 weeks in advance. They often have two hygienists seeing patients every day, which require hygiene checks in addition to the patients scheduled in the doctor’s chairs. It’s very difficult to carve an hour or more out of those tightly scheduled days for an emergency endo, and it’s easier to refer.

  • Treatment in your practice results in better clinical outcomes.
    You see the limited results of GP-performed endo all the time: missed MB2 canals that blow up, retreatments, separated instruments, and cases where the doctor simply realizes they are in over their head. Every time they refer a case where they get in trouble, it’s an opportunity to help them realize endodontists provide a faster and more predictable clinical outcome with a significantly reduced risk of a failed case or need for retreatment. It’s generally not possible for them to rise to your level: They lack the clinical techniques plus all the specialized technology and tools we have in our practices, such as CBCT, microscopes, etc.

  • Endodontic procedures dilute the GP’s productivity.
    GP practices grow differently than endodontic practices. In endo, we grow by focusing on efficiency because most of the core procedures that we perform have relatively the same economic value. In a GP practice, at a certain point adding more patients does not result in any more growth. There is an upper limit to how many patients can be retained in hygiene, after which GPs need to focus on case acceptance for less frequent but larger cases, such as quadrant dentistry, esthetics and discretionary care, and full mouth cases. These cases feed into the interdisciplinary mindset mentioned above, but it also results in the understanding that any GP time spent on endodontic treatment would be more productively utilized on comprehensive restorative care.  So, for economic reasons, it is better to refer out endo.

It is all about the relationship

While we think about GP referrers every day, GPs rarely think about us in the same way. We’re part of a treatment plan generally, but they don’t usually view the success of their practice as dependent on referring to us.


The most important things you can do is provide excellent, responsive and timely patient care (especially for emergencies), build up your doctor-to-doctor relationships through personal interaction, and back that up with a great marketing system to stay top-of-mind with referrers.


When we can nudge GPs over time by understanding what leads them to prefer to refer endodontic care, we become the specialist for all their endodontic treatment needs, which potentially triples the number of referred cases they send now.

Creating time freedom



This week is an important one for me: I’m getting married. My partner David and I will be saying our vows and beginning the next stage of our life journey together … one that will be shaped anew by our mutual declaration of “You, above all else in this life.”


That statement is inherently one of true commitment and personal priority. While we all recognize that certain things in life are fundamentally this way (another example is our children), we are also not naïve enough to think there won’t be challenges and priorities that compete for our time, attention and focus. Certainly, we live in a fast-paced, high-demand world where it becomes harder and harder to switch off all the outside pressures, especially pressures at work.


Work is a necessity in our lives, in the sense that it generates our income. There will always be easily justified and rationalized reasons to devote more and more time to your work. But when you start to feel unbalanced between work and life, it’s time to take stock and re-commit to the things that fulfill you as a person and make you happy.


There is a clever saying that goes, “I am a human being, not a human doing.” It’s attributed as a quote to a number of people, but one version by motivational author Wayne Dyer is particularly insightful:

“I am a human being, not a human doing. Don’t equate your self-worth with how well you do things in life. You aren’t what you do. If you are what you do, then when you don’t, you aren’t.

Being a spouse or parent or part of a family is a much more important lifelong definition of who you are than your work. And that means your first priority, above all else in this life, should be allowing yourself the time to “be” with your family.

Working more vs. being more

At Endo Mastery, we focus a lot on productivity at work, which makes it sound like we’re all about working more and doing more, rather than being more. But, at the same time, we also emphasize efficiency. Marketing experts will tell you that efficiency is a very difficult concept to make exciting and compelling, but it’s truly the secret to a great life. Efficiency is what allows you to maximize the value of time at work, so you can minimize the amount of time at work.

Money may be the currency of things that we buy, but time is the currency of the relationships we love. Giving yourself and your family the gift of time is truly what you need to be committed to. It is a choice that you need to make deliberately and intentionally. What is a great life for you, first, and then how can the practice support that, second?

You better believe that when I stand with David to say our vows, I will not be thinking about all the work each of us will be doing in the future. I will be thinking about our time together in the future as a couple and family, with our work as a resource we optimize to enrich our lives with freedom and choices.


Google is one of the internet’s behemoths. It reaches so far into the lives and online activities of everyone that it is literally an online essential for every business now. You may have a great website but if you haven’t properly set up your business identity on Google, you’re missing a lot.


Think of it this way: Your website is like the front door of your practice on the internet. It’s how people enter your environment and get to know more about you. By comparison, your Google identity is like the sign in front of your practice that lets the world speeding by know you are even there.


Your Google identity builds your brand and supports your online reputation. Reputation is built in many ways. Are you easy to find? Conscientious businesses adapt to the ways people are searching for information about them. Is your information complete and up to date? Unreliable businesses are not. Do you have photos and/or videos? People want to get a look at you and get a sense of your values. What do online reviews say about you? 64% of users are likely to check online reviews before going to a business for the first time.


If you haven’t done so already, you need to set up your business identity and claim it on Google. Claiming is the process where you verify with Google that you are the owner of a business that they already know something about (and they do already know things about you).


For example, claiming and verifying your business will allow you to control how your business shows up in Google Maps. You can also do things like manage and respond to online reviews (subject to HIPAA which was discussed in a previous blog post). Here is the link to Google My Business:




To help you with the process, we have found on the web a fairly thorough and complete third-party guide to setting up Google My Business. There’s a lot of information in here, and it’s written for every kind of business. However, by working through it step by step, you’ll get everything set up right and understand what you can do with Google’s My Business service.


Tap into September back-to-school time with brown bag goodies and surprises for your referring office teams. This works best when you know all the team members’ names so you can write it on the bag just like their Mom used to do. The bags don’t have to actually be a full lunch. Instead, fill them with an assortment of school-themed snacks and goodies. For example:


For any product or service to succeed, it needs a marketing strategy. Marketing is the process of making potential customers/clients aware of what you offer and how to get it. There are lots of ways to do this, from advertising to direct marketing to social media to relationship marketing.

For endodontists, your clients are primarily GPs based around a professional, interdisciplinary doctor-to-doctor relationship and patient referrals, so relationship marketing is hugely important. In an ideal referral relationship, GPs would rather refer out all endodontic treatment than attempt it themselves, and they prefer to refer it to you (rather than another endodontist) if at all possible. You have “top of mind awareness” for their endodontic referrals, and that probably describes your best referrers pretty well.

Best referrers are the minority though. Most of your referrers are more mixed in their relationship with you. They may not refer out all endodontic treatment, or when they refer it might not be to you as their first choice. You might be one of several endodontists and they “share the love” with everyone.

There are strategies you can implement to improve those relationships, but the effectiveness of those strategies depends on certain fundamentals in your marketing system being in place, and your marketing coordinator executing those fundamentals with disciplined regularity. Their role to drive the marketing systems is vital. Here’s the marketing foundation. It’s quite simple, and yet many endodontists do not do this:

  • Every “A” referrer (12 or more cases per year) needs to be contacted once per month.
  • Every “B” referrer (5 to 11 cases per year) needs to be contacted once per quarter.
  • Every “C” referrer (1 to 4 cases per year) needs to be contacted once per year.

What happens in these contacts? The marketing coordinator drops by the referring office and delivers a little gift basket, bagel drop, seasonal goodie, or something that tells the practice they are important to you. These do not need to be expensive, and they should focus should be on creating delight. We frequently have marketing ideas for these contacts in this newsletter.

Your marketing coordinator becomes the face of your practice to the referring office and drives the team-to-team relationship. When they see the marketing coordinator coming through their door, there is recognition, familiarity and a sense of happiness. That is the beginning to top of mind awareness … in the team, in the doctor and eventually in their referrals.

With this system in place, then you have the foundation to really become effective and targeted in your marketing. For example, if a “C” referrer sends two cases in the same month (when they normally send 4 or less all year), then you can respond and connect in better ways. You can have a doctor-to-doctor phone call, or a scheduled lunch. The marketing coordinator can respond right away with another contact and gift that communicates how much you appreciate their referrals.

It all starts with the marketing coordinator who has flexibility as needed to be outside the practice and visiting referrers. Usually, it’s the equivalent of a day or two per week for preparation and drop in visits. Without a marketing coordinator, a system like this is rarely implemented with the consistency needed, and that creates barriers to growing referral relationships.


March 17th is St. Patrick’s Day, and everything lucky about shamrocks, leprechauns, pots of gold and the color green. Here’s a great idea with pots of gold chocolates and a theme tag. Be sure to wear green when you drop them off!


The image shown is from an Etsy shop for real estate marketing. You can download the tag template instantly for a small fee. There are lots of other referral-related ideas too.