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How Much Should A New Practice Spend On Marketing? (Hint: It’s Not $2,000) 

“Build it and they will come” is not a marketing plan. Count the hours of clinical education you received on the way to owning a practice. Now count the hours anyone spent teaching you marketing.

For most doctors the second number is zero. Maybe a one-day seminar. And then you sign a lease, take on seven figures of debt, and the plan for filling the schedule is a sign on the door and a hope that the neighborhood notices.

On the Dentelligentsia podcast we sat down with Mike Shoun, President and CEO of Ai Healthcare Marketing. Mike started the firm in 1996 as Affordable Image, watched the Great Recession wipe out his small-business clients while his dentists kept standing, and has been healthcare-focused ever since — about 25 years in dental and medical, with a core team that’s been together 15 to 20 of them. He’s seen every version of the empty-schedule story, and he’s blunt about the cause.

“There’s no education for doctors on business or marketing. None. These doctors come out so smart in what they do — and they’ve never been taught marketing. So they get taken advantage of. It makes me angry.”

The whole conversation was about closing that gap. Here’s the short course.

Do the math first

Shoun’s test for “build it and they will come” is arithmetic. How many patients do you need? Now count your sphere of influence — the friends, family, and former colleagues you’re counting on to fill the early schedule.

“Do the math, doctor. The math never adds up.”

Two reasons. Most of your sphere expects a discount, so the patients you’re surest of are your least profitable. And attrition starts on day one — even startups lose patients, because people move, lose coverage, drift. You’re not filling a bucket. You’re filling a bucket with a hole in it, which means you need a pipeline of new patients before you need anything else.

And pipelines take time. “No one can get you on the first page of Google,” Shoun said. “There is no magic bullet. Even with all the technology of the last 20 years, it takes time.” A pizza shop can advertise at noon and sell at six, because everybody’s hungry five times a day. Nobody impulse-buys a crown. You build demand months ahead of when you need it — which is exactly why the marketing conversation can’t start at the ribbon cutting.

Budget for it like an operatory

The number that shocks new owners: Shoun sees doctors assume marketing will cost a couple thousand dollars, total. The real figure for a startup’s first year is more like $30,000 to $50,000, depending on the competition in your trade area.

The worst version of this story is the doctor who finds out too late. Shoun described referrals arriving from other markets with the build-out budget maxed — beautiful office, top equipment, nothing left. “We have to ask that client: well, how are you going to get patients? No one asked them that.”

So put the marketing line in the project budget before you finalize the construction number. We tell clients the same thing about the real estate: the deal isn’t the rent, it’s the total cost of getting to a full schedule. An office that’s $200 a month cheaper and invisible is not cheaper.

Time it by brain power, not by the calendar

Here’s the part of the conversation I hadn’t heard framed this way before. Money is a finite resource — everyone knows that. Shoun’s point: so is your energy. His term is brain power.

A doctor mid-construction has no brain power left. Every available thought is going to change orders and equipment deliveries. So Shoun front-loads: strategy, branding, and creative get decided early — before construction swallows the owner — and the campaign sits ready. Community outreach can start three to six months before the doors open, while the doctor still has the capacity to show up for it.

That’s the same Goldilocks timing we preach on the real estate side. Too early means nothing to act on. Too late means no leverage. The skill isn’t doing everything at once — it’s sequencing the experts so each one gets your brain at the moment their piece needs it.

Know who your patient actually is

Ask a new owner who their patient is and Shoun hears the same answer every time: “Everyone with teeth.”

Then his team starts asking real questions. Do you like working with toddlers? Absolutely not. Teenagers? No. Turns out this doctor lights up doing implants and cosmetic work for older patients — and just bought a practice in a five-mile radius packed with young families. Now every marketing dollar has to reach past the neighborhood to find patients ten miles out, and the budget climbs accordingly.

The niche interview should happen before the site is chosen, not after. And when the demographic report comes back, don’t read it alone. “Giving a doctor a demographic report and letting them interpret it — it’s useless to them,” Shoun said. “It’s like handing an x-ray to somebody.”

Interpreted, the data talks. A zip code showing near-zero income but million-dollar households isn’t poor — it’s retired, mortgage-free, and a strong implant market. A trade area that looks saturated at first glance often isn’t: subtract the dentists in their sixties with 200 remaining patients and a practice quietly winding down, and the real competition shrinks — while those aging patient bases are exactly where your future patients are coming from.

One postcard, one audience

Shoun’s favorite example of wasted money: the postcard with a denture special, an orthodontics offer, a photo of a child, and a photo of a retiree — all on one card. The parents see dentures and toss it. The retirees see the child and toss it. Best offer in the market, and everyone threw it away.

You have fractions of a second — Google’s own analytics say so — for the message to connect. So segment. Different campaigns for the 30-year-olds and the 60-year-olds, different imagery, sometimes different offers by income level. One generic message to everyone is a message to no one. (We took this one personally. Our own marketing has been guilty of it.)

Own your passwords

This was Shoun’s public service announcement, and it’s worth the price of the whole episode.

Doctors let staff members or marketing vendors set up their Google Business Profile, Facebook, Instagram, and domain accounts. “Guess who owns those accounts? Whoever set them up. And they’re holding them hostage.” His estimate, from what crosses his desk: something like 80 percent of the marketing companies he sees inherit control this way. And when a staff member who registered everything under a random personal email quits, years of reviews and rankings can be unrecoverable — even agencies with direct contacts at these platforms can’t always get them back.

The fix costs nothing. Every account in your name, under one permanent email address you will keep for the life of the practice. Vendors and staff get access — never ownership. Put it on your opening checklist next to the malpractice policy.

Selling someday? Ramp up, don’t throttle down

The instinct as retirement approaches is to coast — stop marketing, let the schedule thin, wind down. Shoun watches it cost sellers six figures.

“Crank this thing up five years before you sell, and you can sell your practice for another $100,000, $200,000, $300,000 — and sell it quicker, instead of it sitting on the market for a year while you lower the price.”

A practice is valued on what walks through the door. So is the real estate underneath it, which is why we give sellers the same speech about their building. The five years before a sale are the most valuable marketing years of your career. Spend them growing, not coasting.

There is no manual — but there is a sequence

Shoun said something near the end that stuck: after 35 years in marketing, he still starts most days not knowing the answer. What he has is a sequence — ask the right questions, pull the data, narrow it down.

That’s the honest version of all of this. Nobody hands you a manual for practice ownership. But the sequence is learnable: do the math, budget the real number, start early while you still have brain power, define your actual patient, match the message to the reader, own your accounts, and ramp up before you sell.

The full conversation with Mike Shoun is on the Dentelligentsia podcast. And if you’re working on the real estate half of the equation — the site your demographics have to support — talk to us.