Doing Your Marketing In House Versus Hiring It Out

The real question is not which is cheaper. It is who is going to do the work every single week when the schedule is full, a hygienist has called in sick and the last thing anybody wants to think about is a blog post. Marketing fails far more often from neglect than from bad strategy.

For a single practice, the honest answer is usually a mix, and the mix is not fifty fifty. Some jobs only work if they happen inside the building. Others need tools and experience it makes no sense for one office to buy. Here is how the two options actually compare on cost, speed and risk.

In house costs more than the salary line suggests

A part time marketing coordinator looks affordable next to an agency retainer until you add everything up. There is the salary, taxes and benefits, the software they will need, the time you spend managing them, and the training gap, because most people who can post to social media cannot also run a Google Ads account or diagnose why a page is not indexed.

There is a concentration risk too. One person holding all the logins and all the knowledge is a single point of failure, and small practice marketing roles turn over often. When they leave, the momentum leaves with them unless somebody wrote things down, which almost nobody does.

• Salary plus taxes, benefits and paid time off
• Software subscriptions the practice would not otherwise buy
• Your time managing, reviewing and approving work
• The cost of the skills gap, filled by freelancers anyway
• The rehiring cost when the role turns over

What an agency actually buys you is specialists and pace

A good agency gives you people who have already solved your problem forty times, tools nobody buys for one office, and enough different skills that a technical fix, an ad account and a landing page do not all wait on the same person. That combination is genuinely hard to reproduce with one hire.

It also buys you an outside view. Practices have blind spots about their own fees, their own website and their own front desk, because they hear the same explanations every day. The value of someone external is often the awkward question, not the deliverable.

Speed splits in an unexpected direction

In house wins on small things. A photo from this morning's case posted this afternoon, a note about holiday hours, a same day answer to a review. Going through an agency for a two line change is slow and expensive, and practices quietly stop bothering, which is how sites go stale.

Agencies win on big things. A new treatment page written, designed, built and tracked properly is weeks of work for a coordinator and days for a team that does it constantly. If speed is your reason for hiring in house, be specific about which kind of speed you mean, because you are choosing one and losing the other.

Some jobs should never leave the building

There are parts of practice marketing that no outside supplier can do well, because they need the people who are already there. Asking happy patients for reviews at the right moment. Answering the phone in a way that ends in a booking. Following up an inquiry within minutes rather than tomorrow. Taking real photos of real cases with real consent.

These are also the highest return activities in most practices, and they cost nothing but attention. Before you decide who to hire, it is worth finding out how much is leaking here already. A free leak check will show where inquiries are being lost and who outranks you locally, which often reframes the whole in house versus agency question.

• Asking for reviews and responding to the ones you get
• Answering and returning calls within minutes
• Photography and case documentation with consent
• Recording where each new patient actually came from

The arrangement most single practices end up with

One person inside the practice owns the day to day: reviews, listings, social posts, the inquiry follow up and the source tracking, usually a few hours a week rather than a full role. An outside supplier handles the technical site work, search and paid ads, and reports monthly against numbers the practice can check. The practice owns every account.

That last part is what makes the arrangement safe. When the accounts, the domain and the listings are yours, you can change supplier without starting over. Claiming your listing in the Dent-OX directory fits the same principle: free, in your own words, patient requests emailed straight to your front desk, and indexed by Google, which unclaimed records are not.

How to decide in an afternoon

Write down the jobs your marketing needs doing each month, then put a name against each one and an honest estimate of hours. Most owners find that half the list is small internal tasks nobody is currently responsible for and the other half needs skills the practice does not have. That split is your answer, and it is usually a hybrid.

Then decide by cost per new patient rather than by monthly fee. An agency at three times the cost of a coordinator is cheaper if it brings four times the patients, and a coordinator is a bargain if she fixes the missed calls nobody was tracking. Give whichever route you pick six months, defined numbers and a scheduled review.

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