Why Marketing Without Operations Is Costing DSOs Millions

Ryan Torresan, Chief Marketing Officer and Chief Operations Officer of Mosaic Dental Collective, a Group Dentistry Now Emerging Dental Group to Watch in 2026, recently delivered a candid message to dental leaders. Marketing is not the growth engine most organizations think it is. Not by itself. Here is recap of his presentation.

After 15 years leading marketing teams through acquisitions, private equity partnerships, and DSO expansion, Ryan has come to a clear conclusion. Growth does not come from leads. It comes from access and execution.

And artificial intelligence is not replacing marketing. It is exposing where organizations are leaking revenue.

The Problem With Dental Marketing

Most dental marketing conversations focus on impressions, clicks, and cost per lead. Those metrics may matter to the marketing team, but they do not matter in the boardroom.

Leads are not revenue.

Revenue lives downstream. It comes from scheduling, show rates, treatment presentation, and case acceptance. If any of those break, marketing ROI collapses.

In many DSOs, when the schedule has gaps, operations turns to marketing and says fill it. When marketing increases traffic but revenue does not improve, operations and marketing begin pointing fingers.

Ryan argues that the real issue is not top of funnel activity. It is what happens after the phone rings.

The Blind Spots That Are Draining Revenue

Across dozens of group practices and consulting engagements, the same blind spots appear repeatedly.

Missed calls frequently exceed 20 to 30 percent. That means one out of every four potential patients never connects with the practice.

Form fills sit unanswered for hours or days.

Booking windows extend weeks out, even though consumer expectations have shifted to immediate access.

Patients today are conditioned by digital retail and healthcare experiences. They can schedule a haircut, order dinner, or book an appointment at Mayo Clinic online. When a dental office says online scheduling does not work here, the issue is rarely patient demand. It is operational resistance.

Ryan shared internal data showing that if a patient cannot be seen within roughly 72 hours, no show probability increases significantly. In his own patient surveys, nearly three quarters expected same week availability.

Many practices do not have a demand problem. They have a follow up and availability problem.

The Only Funnel That Matters

For Ryan, the only marketing funnel that matters runs from lead to revenue collected.

Leads generated
Appointments scheduled
Patients shown
Treatment presented
Treatment accepted
Revenue collected

This is the funnel CFOs care about. Not impressions. Not click through rates.

With the right data infrastructure, marketing leaders can tie case acceptance and revenue directly to the originating lead source. Without that visibility, ROI conversations rely on estimates and assumptions.

Artificial intelligence is changing that.

How AI Is Revealing Lost Opportunity

AI is doing three things inside DSOs.

It creates visibility into what is actually happening.
It improves execution.
It allows scale without proportionate cost increases.

Instead of counting every inbound call as a lead, AI evaluates whether it was a true new patient opportunity. It categorizes why patients did not book. Insurance mismatch. No availability. Pricing concerns.

In multiple organizations, the top two reasons for lost opportunities were consistent. No appointment availability and insurance limitations.

AI tools can also immediately respond to missed calls via automated text conversation, answer common questions, and even schedule directly into the practice management system. In many cases, that technology alone pays for itself through recovered appointments.

The takeaway is simple. Most marketing ROI is lost after the lead, not before it.

Online Scheduling and Capacity Discipline

AI driven scheduling platforms integrate directly with practice management systems, verify insurance, and allow patients to select providers and appointment types.

When deployed correctly, these platforms do not cannibalize call center volume. They create incremental growth.

However, online scheduling only works if operational capacity exists. You cannot market your way out of no availability.

Ryan advocates for disciplined scheduling templates that include reserved new patient capacity. One model he uses is a ghost column or overflow column that allows marketing generated appointments to slot into the day without disrupting core production flow.

The objective is not to reduce control. It is to increase productivity and reduce access friction.

Calculating Lifetime Value the Right Way

AI also strengthens financial accountability.

Lifetime value can be estimated by multiplying average visits per year by average patient lifespan in the practice and average revenue per visit. With advanced AI tracking, organizations can calculate actual lifetime value by patient cohort and tie it back to original acquisition channels.

That level of precision changes the marketing conversation with finance. Instead of defending spend, marketing leaders can demonstrate margin contribution.

The Search Shift That DSOs Cannot Ignore

Search behavior is evolving rapidly.

Younger consumers are not defaulting to traditional search engines. They are using conversational AI tools and social platforms to discover providers. They look for video content, authenticity, and trust signals.

Platforms such as ChatGPT and Google are reshaping how information is surfaced. Paid search will not disappear overnight, but algorithmic preference is increasingly tied to quality content and engagement, not just budget.

That shift has direct implications for dental groups.

Content quality, review credibility, and brand authenticity are becoming central to discoverability. Younger patients scan videos to assess personality and trust before ever making contact.

Google may remain dominant for years, but its monopoly on search behavior is already fragmenting.

Technology Is Undefeated

Ryan closed with a reminder that technology adoption in dentistry is not optional.

Healthcare remains human at its core. Chairside manner and in office experience still matter deeply.

But ignoring AI will not preserve jobs or protect legacy systems. The professionals who learn to leverage AI will outperform those who resist it.

In Ryan’s words, technology is undefeated.

For DSOs seeking consistent, scalable growth, the message is clear. Stop measuring vanity metrics. Align marketing with operations. Build access. Track revenue to the source. Use AI to expose inefficiencies and strengthen execution.

Growth is not about more leads. It is about better systems.

Have questions? Email ryantorresan@gmail.com or connect on LinkedIn

Ryan Torresan is considered one of the leading marketing minds in dental and healthcare on what’s next in marketing, relevance, marketing that actually impacts DSOs and can be measured. With more than 15 years of DSO experience, Ryan is a marketing executive who steered a very successful career to reach the executive level at three of the largest dental support organizations (DSOs) in the US.

During his tenures, he earned promotions and awards after tremendous success in the digital marketing and social media space. He is also known to have transformed event, CRM and content marketing into lead generation. He has repositioned brands, navigated crisis public relations and driven incremental sales through office designs. He played a crucial role on executive teams that sold DSOs to private equity firms.