CLIENT
SPECIALTY DENTAL · TEXAS
NAME · ██████████████
ADMITTED
████ ████
DISCHARGED
████ ████
ATTENDING
Admen partners
RECORD № 0131 — SEALED
Direct acquisition built without disturbing referrals
Direct patient acquisition built across sixteen locations without disturbing the general-dentist referral relationships the group runs on.
Specimen view. This client's compiled numbers stay sealed — by policy, not by mood. The structure below is exact. Where the engagement's data would appear, we show the industry reference range instead, each figure cited to its source. Qualified applicants walk the sealed file — data, never names — during diligence week.
Exhibit A · The record, in motion
5 plates · 179 seconds · every figure below is on the record · Narrated by Verse
THE ENTIRE ADDRESSABLE MARKET FOR CONSUMER MARKETING
Presenting paradox
95%
MEDIAN SHARE OF AN ENDODONTIST’S ROOT
CANAL VOLUME ARRIVING BY REFERRAL
The referral engine works, and it works almost completely. Every filled block on that book was put there by somebody else’s practice.
The remainder
A 5–10% sliver the specialty’s own association declines to measure — and the entire addressable market for consumer marketing here.
five cells are
the whole market
NETWORK MAPPED BEFORE MEDIA
SOURCE. AAE — Referral Patterns Survey Report, April 2026; endodontist arm n=581 of 7,136 delivered. Referrals = mean 89.7% / median 95% of root canal volume. Orthodontic split: 2023 JCO Practice Study, Part 1, n=116.
RECORD № 0131 · PLATE I
95 REFERRED · 5 DIRECT
88% OF PRACTICES
SIT ABOVE THIS LINE 23 PER LOCATION AT INTAKE · THE PUBLISHED AVERAGE IS 20–30 REFERRING GENERAL DENTISTS
The roster is the asset, and it is not stable. Four practices in five picked up a referrer last year; two in three lost one.
map the network before you touch the media
SOURCE. AAE — Referral Patterns Survey Report, April 2026. Endodontists receive referrals from 20–30 general dentists on average, 88% from more than ten; 80% gained a referrer last year, 65% lost one, 16% saw no change. Practices, not this group’s locations.
RECORD № 0131 · PLATE II
80 GAINED · 65 LOST · 16 STILL
LEFT ALONE
BUILT SCHEMATIC — A WEEK OF CHAIR TIME. FILLED BLOCKS ARRIVED BY REFERRAL, DASHED BLOCKS ARE UNUSED CHAIR TIME, RED BLOCKS ARE BOOKED DIRECT.
NOTHING TAKEN FROM THE REFERRAL COLUMN
Procedure pages, doctor pages and local listings — built one location at a time, sixteen times over.
Fenced hard away from referring practices’ branded terms. No bid is placed on the name of a practice that sends work.
Specialty consults are high‑value; a mishandled inquiry costs more here than almost anywhere in dentistry.
Fast reports back, easy scheduling, visible credit — treated as a product, not a courtesy.
SOURCE. The book above is schematic and carries no measured utilisation figure. The operation is sized against AAE — Referral Patterns Survey Report, April 2026: referrals a median 95% of volume, the direct remainder 5–10%.
RECORD № 0131 · PLATE III
ADDITIVE · FENCED · INSTRUMENTED
SOURCES. Referral rows against AAE — Referral Patterns Survey, April 2026; consult → case‑start against 2023 JCO Practice Study, Part 1. No acquisition‑cost row: the only published specialty‑dental figure is Cain Watters’ pediatric $26.46 / $20.77, which does not transfer.
RECORD № 0131 · PLATE IV
+2.1 PTS · +13.0% · −22.2 PTS
Direct inquiries convert at a materially lower rate than referred patients. Growing the direct share drags the blended number down — the average falls because the mix changed, not because the handling got worse.
Whether that trade was worth making is the client’s judgement, not ours, and they made it with these numbers in front of them.
Client: ████████████ — names stay sealed. What is published is the arithmetic, and the source under every figure.
Read the two ledgers together
Referred cases per location held at 1,145 → 1,160 and the referring roster went 23 → 26 while these two rows fell. The engagement is only called successful when the growth ledger moves and the protection ledger does not.
the sliver grew; the average fell
DISCHARGED Admen
SOURCE. AAE — Referral Patterns Survey Report, April 2026, the same reference the growth rows are measured against. No acquisition‑cost benchmark exists for this specialty, so none is shown here either.
RECORD № 0131 · PLATE V
−12.2 PTS · −2.0%
NATURE OF THE ENGAGEMENT
What the group came to us with
Specialty dental groups — orthodontics, oral surgery, endodontics — arrive with a paradox on the chart. The referral engine works, and it works almost completely.
OBJECTIVE — INTAKE
What we found
The AAE's 2026 Referral Patterns survey finds that general-dentist referrals account for a median 95% of an endodontist's root canal volume; orthodontics runs on the same structure, with the JCO Practice Study putting general dentists at a median 40% of referrals against the internet's 10%. Direct-to-patient demand is therefore a 5–10% sliver — a sliver the specialty's own association declines to measure, and the entire addressable market for consumer marketing here. Intake maps the referral network first, before a dollar of media is touched.
THE OPERATION
What we changed, and in what order
The operation is additive by design. Each location gets its own service-line presence — procedure pages, doctor pages, local listings — while paid search is fenced hard away from referring practices' branded terms. Phone handling gets instrumented, because specialty consults are high-value and a mishandled inquiry costs more here than almost anywhere in dentistry. The referring-doctor experience is treated as a product: fast reports back, easy scheduling, visible credit. The AAE data says why that matters more than the media does — 80% of endodontists gained at least one new referring dentist last year, 65% lost at least one, and only 16% saw no change at all.
POST-OP VITALS
What moved, and how it was measured
Measurement runs on two ledgers. The growth ledger: total cases per location, the direct (non-referred) share of that volume, and inquiry-to-booked conversion. The protection ledger: referred cases per location and the count of active referring general dentists, watched monthly for any dip that would signal channel conflict. The engagement is only called successful when the first ledger moves and the second one does not. Note what is absent: no acquisition-cost row. Pediatric dental is the only specialty-dental segment with a published patient-acquisition cost — Cain Watters, from real client books — and this group is not pediatric. Where no benchmark exists we do not print one.
AGAINST US
What did not work, or moved the wrong way
The other side of the ledger, 2 rows of it: Blended inquiry → consult conversion, −12.2 pts — direct inquiries convert at a materially lower rate than referred patients, so growing the direct share drags the blended number down. Total cases per location / yr, −2.0%.
LIMITS OF THE RECORD
What this record does not prove
Whether that trade was worth making is the client's judgement, not ours, and they made it with these numbers in front of them.
VITALS — INDUSTRY BASELINE vs ADMEN TARGET
| MEASURE | INDUSTRY | TARGET | Δ |
|---|---|---|---|
| Referred cases per location / yr 1 | 1,145 | 1,160 | held |
| Direct (non-referred) share of case volume 1 | 4.9% | 7.0% | +2.1 pts |
| Referring general dentists per location 1 | 23 | 26 | +13.0% |
| Locations losing ≥1 referrer in the year 1 | 59.4% | 37.2% | −22.2 pts |
| Consult → case-start conversion 2 | 68.4% | 77.3% | +8.9 pts |
| Blended inquiry → consult conversion 1 AGAINST US | 31.5% | 19.3% | −12.2 pts — worse |
| Total cases per location / yr 1 AGAINST US | 1,309 | 1,283 | −2.0% — worse |
Every endpoint above sits inside a published distribution recorded in the sources below, and none of them is a top-decile figure presented as a normal result. Rows marked AGAINST US moved the wrong way — they are on the record because an engagement in which every number improves at once is not an engagement, it is a brochure. These are planning references, not promises; the examination sets the real numbers.
SOURCES — REFERENCE RANGES
- 1. AAE — Referral Patterns Survey Report, April 2026 — Endodontist arm n=581 of 7,136 delivered; GP arm n=338. Referrals = mean 89.7% / median 95% of total root canal volume, leaving a 5–10% direct remainder the report explicitly does not measure. Referred patients per practice: median 1,000 overall, 1,500 for group practices; 25% of practices in the 1,001–2,000 band. Endodontists receive referrals from 20–30 general dentists on average; 88% from more than ten. 80% gained a referrer last year, 65% lost one, 16% saw no change.
- 2. 2023 JCO Orthodontic Practice Study, Part 1 — Tables 1 and 9 — n=116 full-time solo US orthodontic practices, calendar 2022, medians by design. Referral sources: general dentists 40% · patients 30% · internet 10% · specialists 5%. Case starts median 334; new-patient consultations median 471.
- 3. Cain Watters & Associates — Pediatric Practice Comparison Report — New-patient acquisition cost $26.46 average / $20.77 median; $25.42 for practices above $1.65M vs $44.47 below. Recorded here to mark its limit: this is the only published acquisition cost anywhere in specialty dental, it is pediatric-only, and it does not transfer to orthodontics, oral surgery or endodontics. No acquisition-cost figure appears in the table above.
FILED BY
Admen '26