Every dollar, lead and case, reported.

Most marketing reports stop two stages before the answer. They show impressions, clicks, leads and cost per lead, and every one of those numbers can improve in a month where the practice started fewer cases than the month before. A practice does not deposit leads.

The measure that survives is return on ad spend: the treatment value produced by patients who came from advertising, divided by what was spent on that advertising. At DIM the treatment value is reported by the practice, because the practice is the only party that knows what a case was worth once it was planned, financed and started.

That definition is deliberately narrow. The denominator is ad spend. It does not quietly include anything else, and every figure we publish on our case studies is calculated the same way for every practice.

Anyone can produce a flattering figure by choosing what goes into it. Before you accept a return figure from any agency, including this one, four questions settle whether it means anything.

1. What is in the numerator? Treatment planned, or treatment actually started? Those are different numbers and the gap between them can be very large.
2. What is in the denominator? A return that quietly excludes part of what was spent is not a return.
3. Who reported it, and can you see the rows behind it? A figure in a slide deck is an assertion. A figure you can click into is a measurement.
4. What share of cases does it cover? A return calculated on the cases somebody remembered to record is not a practice-level number.

The fourth is the one most often skipped. A figure covering nearly all of a practice's started cases and a figure covering a handful of them look identical on a slide, and only one of them will still be true next quarter.

Our guide on how to choose a dental implant marketing company is built around exactly this kind of checking. It would be strange to publish it and then not pass it.

The reporting follows one path, from money spent to treatment started. Each stage answers a different question, and a gap at one stage has a completely different fix from a gap at the next.

The reporting path. The last row is the number everyone asks for; the five above it are the ones that tell you what to do about it.

That is the whole argument for reporting the path rather than the summary. A single number tells you how the month went. The path tells you where to work.

Reporting starts with the first month of spend, not at the end of a quarter, and every client gets the same set of figures, which are the same figures we review the account against. The method does not change from practice to practice or from month to month, because a number calculated one way in March and another way in June cannot be compared with itself. When we say a lead was contacted, or that a consultation did not show, or that a case started in a month after the spend that produced it, that claim is attached to the figures rather than asserted separately from them.

There is no single figure, and any agency offering one before it has seen your market, your case value and your close rate is guessing. What we can do is publish our own, across practices of different sizes, in different regions, over different periods.

The six practices we report are set out side by side, with what each figure measures and over how long, in our dental marketing case studies.

The spread is the honest part. The set runs from 7.4x to 21.2x, and the two ends are not explained by advertising quality alone. A practice that closes well converts the same leads into more started treatment, and a practice measured over a short window can look better or worse than its steady state. Read the period column before you read the multiple.

They disagree for reasons worth understanding before anyone concludes a number is wrong.

• Timing. A lead generated in one month may start treatment two months later. Spend and value do not land in the same window, which is why short periods swing hard.
• Reporting. Treatment value is entered by the practice. If cases are recorded late, or not at all, the return falls without anything real having changed.
• Attribution. A patient who saw an advert and then searched for your practice by name is a marketing patient, and a practice counting only the second touch will undercount.
• Definition. Treatment planned is not treatment started, and a practice tracking the first will always carry a bigger number than reporting that tracks the second.

Our guide to the full-arch marketing funnel walks the same path stage by stage, and the implant marketing budget guide covers what happens to these numbers when the spend moves up or down.

Almost nobody's first instinct here is the right one. The instinct is to change the advertising, because the advertising is the thing with a bill attached to it. The reporting usually says otherwise.

1. Look at leads first. If lead volume held and consultations fell, nothing is wrong with the advertising.
2. Look at shows. If consultations were booked and did not arrive, the fix is confirmation and preparation rather than more spend.
3. Look at starts against consultations shown. If patients arrived and did not proceed, this is a closing problem, and more leads will make it more expensive rather than better.
4. Only then look at cost per lead and at the campaigns themselves.

That order is the Full Arch Framework applied to a single month of data, and it is why we report the path rather than the summary. If you are not a client, Find Your Gap runs the same diagnosis in five questions.