[Editor's Note: This is a guest post from Nina Litovsky, owner of Nina Interactive, LLC, a boutique firm specializing in website design for dentists and physicians, who did the redesign of this website and particularly the from-scratch design of the forum a year ago and does periodic work for me. I received no payment or discount on other payments for this post and like all guest posts, was judged on value of content alone.]

When it comes to marketing, there is perhaps no asset more valuable than your website. It is the cornerstone of your online marketing efforts, and, in many cases, the first point of contact that potential new patients will have with your practice. Built properly, your website should organically attract qualified visitors, clearly communicate your unique value, visually differentiate your practice from the competition, and compel visitors to become your patients.

For your website to be effective, it should be planned correctly and built professionally. Going forward, you will also need reliable professional help when you decide to implement modifications and improvements to your website.

Choosing a company to build and maintain your website, however, isn’t always easy. Many medical and dental marketing companies offer seemingly attractive options that may turn out costly and problematic for you in the long run. This article aims to help you make an informed decision by discussing these problems and by offering potentially more efficient and cost-effective alternatives.

Large Agencies

There are two types of web design and development agencies: larger, more corporate agencies and smaller, boutique firms consisting of one to several core specialists. While large agency resources can be useful for big corporations and technically complex projects, they are usually an overkill for small and medium businesses such as dental and medical practices. In addition, larger marketing companies entail the following disadvantages:


Larger agencies are rarely able to compete with smaller firms on price. Larger agencies typically have higher overhead costs – office space, human resources, etc. – that are, inevitably, passed along to the client. You either overpay upfront or in the long run, but either way you end up paying more than the value you receive.


Large agencies need to work with as many clients as possible to cover their overhead and turn a profit. When services are scaled and mass-produced for a large pool of clients, quality tends to suffer, products get too standardized, and all customers get essentially the same one-size-fits-all solutions which may not be suitable for the individual needs of their practices. The company is only interested in providing just enough quality to keep you as a customer, but there is usually no incentive to cater to your personal needs and exceed your expectations.

Customer Service

Larger agencies usually assign an account manager to each project. These individuals act as a liaison between you and the various designers and programmers who will be involved with your website. As employees of the company, account managers work in the company’s interests, not yours. They are not dedicated to you personally and don’t have the incentive to go the extra mile to exceed your expectations. In companies with high employee turnover account managers may change frequently, which further weakens personal connection between you and the company’s team.

Alternative Solution: Boutique Firms

Nina Litovsky, Principal of Nina Interactive

An alternative solution can be a smaller web firm with a reputation for being agile and reliable. Smaller boutique firms run lean, oftentimes foregoing a physical office space and leveraging the skills of a small team of experts. Because of this, small agencies come with smaller price tags. With a boutique agency, you will likely be working directly with the owner. He or she will closely manage other members of the team throughout the course of your web development project. You can expect a higher level of personalized service, as small agencies are more flexible and better equipped to adapt to the varying needs of their clients. Also, small agencies rely on the quality of their work to keep their businesses running, and depend on word of mouth and referrals to drive new business development. The owners are personally interested in your business and have a strong incentive to produce quality work for you.

Bundled Services

Most service providers use one of two service models, each with their advantages and disadvantages: the bundled full-service model and the open architecture “a la carte” service model.

The full-service model may seem to be more convenient. One agency acts as a “one-stop-shop” for design, development, search engine optimization, and website maintenance, plus add-on services such as social media marketing, content marketing and paid search campaigns.

Bundled services generally come with a higher price tag, and in many cases medical and dental practices don’t need all of the services offered in the bundle. Also, in a bundled platform it is impossible to replace and remove the services that are sub-par or are too expensive because everything is integrated into a single platform. Lastly, a bundled platform does not have adequate checks and balances as all of the employees are working for the company that hired them, not for you. When all your services are provided by employees of the same company, it is much harder to get an objective second opinion and fresh advice.

Alternative Solution: a La Carte Model

An open architecture model enables your practice to hire several small specialist firms, a la carte style, to provide only the specific services your practice needs. If a specialist is not generating positive results, he or she can be easily replaced. Such flexibility enables you to hand-pick the best talent and control your costs. Finding and hiring each specialist can be time-consuming, and your web design firm should be able to recommend vendors based on your specific needs.

Proprietary Website Platforms

Understanding the benefits and limitations of various website platforms is a technological nuance that is easy to overlook – but doing so may prove costly in the long run. There are two types of website platforms: proprietary and open-source. A proprietary platform is unique to only one website development agency. An open-source platform is openly available to all website developers.

Full-service agencies offering medical or dental-specific website development often use a proprietary website platform. They will host your website on their own servers, and build your website on their own platform. Hosting fees can run high – $70 or more per month – and moving to a different hosting provider, whether now or in the future, would require rebuilding your site. Making the choice to build your site on a proprietary platform limits your options for the long term, and keeps you bound to your developers for as long as your website is on their platform.

Alternative Solution: Open-Source Platforms

You may be told that a dental or medical-specific proprietary platform is designed to meet the needs of your industry, but the reality is that a well built, open-source website will meet those same needs while also offering more scalability. Opting for an open-source platform affords you the maximum amount of flexibility when it comes to building, hosting and maintaining your website now and in the future. Due to the nonproprietary nature of an open-source platform, you will have a wider choice of companies that can service your website. Currently, WordPress is the best and most popular open-source platform for dental and medical practices. Compared to a proprietary platform, an open-source website is more cost-effective to maintain and host. For example, hosting fees for WordPress run as low as $15-20 per month with a high-quality hosting provider.

Generic Web Content

Some marketing companies offering content generation services simply copy procedure descriptions and other patient education content from other sources, or reuse the same pre-written content on all their client websites. There is no gray area when it comes to the quality of your website’s content: do not use duplicate content. Not only will Google and other search engines penalize your site, but “canned” content also does nothing to communicate the unique value of your practice or compel prospective patients to call your office. As a result, you waste money on filler content that doesn’t convert patients and that can even be harmful to your online presence.

Alternative Solution: Custom Content

If content generation is one of the services offered by your website developer, ask whether that content will be written uniquely for your practice, or if it is generic content that they use for all of their clients. If they intend to use generic content, consider hiring a third-party copywriter, or even writing your own content. After all, you are the ultimate expert about your industry and practice, and know from regular patient interaction what types of questions patients ask and what information they need.

[Editor's Note: Having been in the “content generation” business for a few years, I would highly recommend AGAINST hiring anyone else to make your content. Trust me when I say the quality for the typical provider of content is subpar at best. It is not that much work for you and may be some of the most important and well-paid work you do all year.]

Monthly Website Maintenance Fees

Many businesses take an “if you build it, they will come” approach to their websites, but the reality is that every website requires a certain level of maintenance. Educating yourself about which maintenance and support options are necessary, which are worthwhile, and which are superfluous will help you save money, time, and energy.

Technical Website Maintenance

Technical website maintenance includes website backups, anti-virus scanning, server updates, and other routine maintenance of your website platform and server. This service is necessary and must be performed by your website host. If you have chosen to build your website on a proprietary platform, your monthly hosting fees may be high. Using an open-source platform and a third-party host will save you money without sacrificing the quality of your technical maintenance services.

Technical Support

Your website host should offer technical support services at no additional cost. If your website is hacked or running slowly, you should be able to call your host and resolve the problem quickly. Reputable hosting providers are generally responsive and competent.

Front-End Website Support

Front-end support includes fixing a website malfunction, content updates, or updates to graphics and other user-facing website elements. A well-developed site will be built on an intuitive, easy-to-use content management system (such as WordPress) that enables you to make simple content and image updates on your own, without any programming knowledge. Your practice should not require enough front-end website support to require a monthly support program. At most, hire a website developer for specific fixes and initiatives on an as-needed basis.

Search Engine Optimization (SEO)

Search engine optimization (SEO) is such a hot marketing buzzword that practices are afraid to forego the service. However, many practices don’t know exactly what SEO is, or what they should be getting out of a monthly SEO maintenance program.

A Well-Developed Website is a Priority

If your website is poorly built, any SEO efforts will be a waste of money and energy. Many medical and dental practice websites suffer from issues such as poor planning, inadequate structure and navigation, bloated code, slow speed, duplicate content, and incompatibility with mobile devices. All these issues can block search engines from properly ranking your site. These issues should be addressed before you invest in any further SEO efforts.

Do You Need Monthly SEO?

When considering whether to hire an SEO specialist, first consider your business model and goals. How important is it for your practice to rank at the top of search results? If your leading driver of new patients is word of mouth, referrals, advertising, or internal marketing, the natural SEO traction that you’ll gain just by having a well-developed website might be enough.

Also, take a look at the statistics. Ask your website developer or an SEO specialist to see reports showing the current volume of search relevant to your practice, as well as the amount of competition on those search terms. If there is very little volume and very high competition, your budget and energy may be better spent elsewhere.

If the statistics are promising and your practice stands to gain by capitalizing on SEO, it’s time to choose a specialist. However, avoid any company that uses fear to talk you into a monthly maintenance program; unless you are planning on aggressively going after top rankings, annual or semi-annual SEO “tune-ups” should be the most you need to stay relevant.

How to Work With an SEO Company

If you’ve decided that search rankings are important and are willing to invest in SEO maintenance, look for a company who will custom-tailor an SEO strategy based on the needs of your practice. SEO is a lot more than just adding keywords to your website; depending on your needs, an SEO strategy may require targeted blogging with widespread distribution, social media integration, and strategic website expansion to capitalize on new and emerging search trends.

The best way to gauge whether or not your SEO strategy is paying off is to monitor your website traffic statistics and compare them against pre-SEO data. Increased traffic, a lower bounce rate, and a higher ratio of new to returning visitors are a few of the statistics that may indicate a successful SEO strategy.

Finally, if you opted for a monthly SEO maintenance program, ask your provider to submit a list of the monthly deliverables you can expect. SEO is very much a behind-the-scenes service, making it difficult to gauge how much – or how little – effort is actually being expended on your account. Hold your SEO provider accountable for their work and ask for monthly reports on the performance of your website’s SEO foundation.

SEO Does Not Guarantee New Patients

It is imperative to understand that no company can guarantee search engine rankings, and, even if your rankings do improve, there is no promise that it will lead to increased web traffic and generate more of your target patients. Attracting high-quality patients depends on a combination of factors – such as your other forms of marketing, your competition, and your online reviews – over which your SEO company has no control.

[Editor's Note: There are also reputable online reputation management companies and even companies who will write fake reviews for your practice. Bear in mind this practice is illegal (false advertising) and can carry stiff fines. While educated people know reviews really can't be trusted, we all still use them and your patients do too. The quality of your reviews on other sites may have a larger effect on your practice than your own site and SEO efforts.]


After you sort out your website maintenance needs, you may discover ways to save money and spend it more efficiently. Technical maintenance costs can be significantly reduced if you host your website with a third-party hosting provider. Other types of maintenance, such as website support and SEO, may not require monthly fees at all. A cost-effective option may be to maintain a professional relationship with a reliable web developer and SEO specialist, and hire them for specific initiatives on an as-needed basis.

What do you think? Have you been dazzled by sales pitches from web marketing companies? Are you being charged high fees and provided with little valuable service? Are you looking for cost-effective way to professionally build and maintain your website? Comment below!