I had a conversation last week with a doctor whose practice is down considerably from last year. His concern wasn’t just the economy—it was the fact that he’s spending more on marketing than ever before, and still seeing declines.
“I feel like I should be at least flat year over year,” he told me. “Not down. Something’s off.”
He’s not alone. In times of economic uncertainty, dental practices often feel stuck between two bad options: keep spending money that isn’t driving results—or cut back and risk becoming invisible. Neither feels right.
But there is a third path: re-evaluate your strategy, refocus your effort, and realign your marketing around what actually works.
This post is for doctors who want to grow—or at least protect—their practices during a recession, without blindly slashing their marketing investment. If you feel like you’re spending more and getting less, this one’s for you.
Editor’s Note:
This post is part of our Recession-Proofing Your Small Business series. If you’re new to the series, check out Post 1, Post 2, Post 3, Post 4, and Post 5 for strategic insights on how smart SMBs can navigate and grow through economic uncertainty.
Step 1: Pause—But Don’t Panic
Let’s start here.
When the economy tightens, patients delay treatment. Discretionary procedures slow down. Case acceptance dips. And your gut reaction might be to shut off the marketing spend and wait it out.
But in every downturn I’ve lived through (Dot-Com, Great Recession, COVID), the practices that pulled back too far on visibility lost ground—and took years to get it back.
Visibility doesn’t guarantee growth. But invisibility guarantees decline.
Before you cancel contracts or cut your ad budget, ask a better question:
Is my marketing aligned with how patients are behaving right now?
If not, it’s time to adjust—not abandon—your strategy.
Step 2: Evaluate Performance Objectively (Not Emotionally)
If you’re spending more and getting less, the issue might not be that you’re marketing—it’s how you’re marketing.
This is the time to sit down and take a hard look at what’s working—and what isn’t.
Here’s a simple way to start:
Ask your agency or marketing vendor these five questions:
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What channels are producing the majority of our new patient leads?
(Get numbers—not anecdotes.) -
What’s our cost per lead by channel?
(PPC, SEO, social, direct mail—each should be tracked separately.) -
How are we converting those leads?
(Are you getting calls or form fills that actually book?) -
How are we ranking locally for high-value procedures?
(Invisalign, implants, same-day crowns, sedation, etc.) -
What are you doing proactively to lower my acquisition cost or improve conversions?
(If they don’t have a clear answer, that’s a red flag.)
Don’t worry if you don’t know all the terminology. If your marketing partner can’t explain it simply, or connect your spend to outcomes, you’re not the problem—they are.
You don’t need to be a marketing expert. You just need transparency, clarity, and a willingness to ask hard questions.
Step 3: Reallocate to What Works (Here’s What Still Does)
Once you’ve looked under the hood, it’s time to shift dollars into the tactics that deliver. In a recession, this often means moving away from nice-to-have branding exercises and into high-ROI patient acquisition.
Here’s where I recommend most practices focus during a downturn:
1. Google Local Services Ads (LSAs):
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Still one of the lowest cost-per-lead tools in local healthcare
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Great for emergency, general, and high-intent services
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You only pay for actual patient calls—not clicks or impressions
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Performance is highly trackable
✅ Tip: If you’re not running LSAs—and you’re not maxed out on patient volume—it’s time.
2. Local SEO & Google Business Profile Optimization
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Long-term value and lower cost than paid ads
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Improves organic visibility in your city for priority services
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Helps patients vet you (especially through reviews and Q&A)
✅ Tip: Many agencies “set it and forget it.” You need ongoing work—new reviews, profile updates, backlinking, local content.
3. Website Performance & Conversion Optimization
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If you’re paying for traffic (ads, SEO), but your site loads slow or isn’t mobile-friendly, you’re wasting money
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Your site should clearly communicate: who you are, what you do, and how to book
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Strong calls-to-action, fast load times, and clear value propositions = more booked patients
✅ Tip: Check your Google PageSpeed score. Anything under 50 on mobile is a problem.
4. Retention & Re-Care Campaigns
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It’s easier and cheaper to reactivate a dormant patient than to acquire a new one
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Text or email patients who haven’t been in 6–18 months
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Offer a simple incentive or personal message to get them back
✅ Tip: Many practices miss this low-hanging fruit because their agency is focused only on new traffic.
Step 4: Strengthen the Relationship with Your Vendor—or Restructure It
Let’s be honest: not all agencies are built for recession navigation.
If your current vendor can’t show clear results, can’t pivot with your practice, or disappears when you need strategy—not just execution—it might be time for a change.
But before you walk away entirely, try this:
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Share your concerns clearly: “I’m spending more, getting less—I need to know what’s working and what’s not.”
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Ask them to reforecast or restructure your plan based on today’s conditions
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Push for transparency around what they’re doing each month
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Set clear expectations and a timeline for improvement
If they lean in with a plan, you might have a partner worth keeping.
If they get defensive or vague, you probably already have your answer.
Step 5: Stay Visible, Stay Measurable
Now more than ever, you need a marketing strategy that keeps you visible and measurable.
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Patients still need treatment
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People still Google “dentist near me”
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Moms still want straighter teeth for their teens
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Adults still want to fix their smile before the holidays or a big event
Recessions don’t stop demand—they just change the psychology around spending.
If you can clearly communicate value, trust, and convenience—and stay present in the channels patients use—you’ll be positioned to grow while others pause.
Final Thought
Recessions create tension. And tension creates two types of practice owners:
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Those who cut first, ask questions later—and vanish from the local market
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And those who slow down, reassess, and refocus on what actually drives patient flow
I’ve never seen a practice regret getting clearer on their marketing strategy.
I’ve seen plenty regret not asking the hard questions soon enough.
So if you’re spending more and seeing less, don’t panic.
Get curious. Get strategic. And get aligned with what still works.
Because even in a down economy, the right marketing strategy can still move your practice forward.
Up Next:
In the next post, we’ll break down the biggest mistakes small businesses make during a recession—and what to do instead. Some of them might surprise you.