
Tell me if this sounds familiar: You're seeing 20% more patients through CDCP. Your phones won't stop ringing. But your profit margins just dropped 15%, your front desk is drowning in pre-authorization paperwork, and half your new CDCP patients are shocked when they see their co-pay invoice.
Sound familiar?
The Canadian Dental Care Plan has fundamentally reshaped the dental landscape. With over 5.5 million Canadians enrolled and 3 million already receiving care, CDCP represents one of the largest healthcare transformations in Canadian history. For multi-location dental clinics, it's created both unprecedented opportunity and operational chaos.
The clinics that thrive over the next 24 months won't be the ones with the biggest ad budgets. They'll be the ones who recognized that CDCP success requires operational infrastructure, not just marketing tactics.
This is the marketing operations playbook for turning CDCP complexity into sustainable competitive advantage.
Let's start with the facts: 75% of dental care providers are now participating in CDCP. That's up from the 61% who initially resisted registration. The economics are straightforward. The program reimburses approximately 85% of treatment fees and provides direct billing through Sun Life with 48-hour payment turnaround.
For practices serving underinsured populations, CDCP has unlocked significant patient volume. Estimates suggest a potential 10-20% increase in procedures performed across participating clinics.
But here's where it gets complicated.
Many CDCP patients believe their dental care is now "free." In reality, families with household incomes between $70,000 and $89,999 face co-payments ranging from 40% to 60% of treatment costs. Add balance billing (the difference between the CDCP fee schedule and your actual fees), and some patients end up paying close to two-thirds of their treatment costs.
When patients arrive expecting free care and leave with a substantial invoice, trust erodes fast.
The pre-authorization requirement for certain procedures has added significant administrative burden. According to Health Canada data, 52% of pre-authorization requests between November 2024 and June 2025 were denied, meaning your team invested time in documentation that didn't result in approved treatment.
For multi-location clinics, this administrative load multiplies. Each location needs staff who understand CDCP protocols, can manage patient expectations, and can navigate the pre-authorization process efficiently.
Economic modeling suggests that if balance billing is eliminated or if reimbursement rates fall significantly behind rising operational costs, dental practices could see revenue drops of 45-50%. While CDCP increases patient volume, it fundamentally changes the revenue model for participating clinics.
The clinics winning in this environment aren't just accepting CDCP patients, they're building systematic approaches to patient education, private-pay service optimization, and operational efficiency.
Most dental marketing agencies will sell you Google Ads, manage your social media, and send you a monthly report showing impressions and clicks.
But ads without systems just create expensive chaos.
Multi-location dental clinics face three fundamental gaps that traditional marketing can't solve:
Managing marketing across multiple locations requires someone who can:
Your dental practice managers are brilliant clinicians and operations leaders. But asking them to also be marketing strategists across locations while managing CDCP administrative complexity is unrealistic.
CDCP marketing requires specialized expertise that most clinics don't have in-house:
Healthcare compliance knowledge: Understanding PIPEDA and PHIPA regulations for patient data handling in marketing automation systems.
CRM lifecycle automation: Building sophisticated patient journeys that segment CDCP vs. private-pay patients, automate education sequences, and drive treatment acceptance.
Attribution modeling: Understanding which marketing channels drive which patient types, and calculating true patient acquisition costs when you're running campaigns across 3+ locations.
Revenue operations: Connecting marketing activities to clinical outcomes, treatment acceptance rates, and location-level profitability.
This isn't entry-level marketing work. It requires senior-level strategic thinking combined with hands-on execution expertise.
Most multi-location dental clinics have invested in technology, but the systems don't talk to each other:
Without integrated systems, you're blind to critical questions:
The gap isn't just marketing. It's marketing operations—the systems, technology, and processes that turn marketing activities into measurable business outcomes.

Smart dental clinic operators are approaching CDCP complexity the same way they'd approach any major operational challenge: systematically.
Here's the framework that's working for multi-location clinics navigating the CDCP era.
Before you can fix what's broken, you need to understand what's actually happening.
An Operating Assessment examines your dental clinic through five strategic lenses:
The Deliverable: A prioritized roadmap of high-impact initiatives tied to your growth objectives. Not a 60-slide strategy deck—a clear action plan with ownership, timelines, and expected outcomes.
With clarity on what needs to change, the next phase focuses on building the infrastructure for sustainable growth.
CRM Configuration for Dental Workflows
Your CRM should be the operational engine of your multi-location clinic, not just a contact database.
This means:
Automated Patient Education Sequences
The number one complaint from CDCP patients? They didn't understand what they'd owe.
Smart clinics are building automated education sequences:
Pre-Appointment Sequence (CDCP Patients):
Post-Consultation Sequence (Private-Pay Upsell):
Location-Specific Landing Pages
Each location needs its own digital presence optimized for local search:
Centralized Reporting Infrastructure
One dashboard that shows:
Lifecycle Campaign Architecture
Building systematic patient journeys that work across all locations:
CDCP Onboarding Journey:
Private-Pay Nurture Journey:
Recall & Reactivation Automation:
Location-Based Acquisition Strategy
Different locations have different competitive landscapes. Your marketing strategy should reflect that.
Local SEO Optimization:
Paid Media Strategy:
Review Generation & Reputation Management
Social proof drives patient decisions. Multi-location clinics need systematic review generation:
Patient Source Tracking
Understanding where your patients come from:
Treatment Acceptance Rate Analysis
Which locations, dentists, or services have the highest conversion rates? This data reveals training opportunities, pricing optimization, and service mix decisions.
Revenue Per Patient Cohort Analysis
Lifetime value modeling by patient type:
Here's where most marketing initiatives fail: the gap between planning and execution.
Strategy decks are useless if no one implements them.
The embedded operating partner model means you get a team that:
What This Actually Looks Like:
Week 1: Launch automated CDCP patient education sequence across all locations. Monitor delivery rates and patient feedback.
Week 2: Location manager training on new CRM workflows. One-on-one sessions to address location-specific questions.
Week 3: Review first week's campaign performance. A/B test messaging variations across locations.
Week 4: Monthly business review with ownership. Review KPIs, discuss roadmap adjustments, plan next month's priorities.
This isn't a "set it and forget it" model. It's continuous optimization, real-time problem-solving, and relentless execution accountability.
Consider the trajectory of Saberton, a multi-location dental practice in Ontario that partnered with Foes in late 2022.
Saberton was at an inflection point. They had successfully built a strong clinical reputation across their existing locations and were ready to expand. But growth was creating operational friction:
The traditional solution would have been hiring multiple full-time roles: a marketing manager, a CRM administrator, maybe a fractional CMO. But that approach creates its own problems, lengthy hiring processes, role silos, and coordination overhead.
Foes embedded as an operating partner, bringing cross-functional expertise in marketing, operations, and technology.
Digital Infrastructure:
Marketing Operations:
Operational Excellence:
Over 33+ months of partnership (and counting):
But the most significant outcome wasn't captured in a single metric. It was the shift from reactive firefighting to proactive growth.
Saberton's leadership team now has visibility into what's working, confidence in their systems, and the operational infrastructure to continue expanding.
As the Saberton team put it: "Other agencies wanted to sell us ads. Foes built us an operating system."
That's the difference between marketing services and marketing operations.
At some point in this conversation, you're probably wondering: "Should we just hire someone to do this internally?"
It's a fair question. Let's work through the math.
A Marketing Operations Manager or Revenue Operations Manager with the skills to execute this framework commands significant compensation in the current market. You're looking at a senior-level role requiring:
Even after making the hire, you face:
And you still need execution support. A Marketing Ops Manager still needs:
The alternative is partnering with a team that's already built, already trained, and already experienced in exactly this type of transformation.
With an embedded operating partner:
The question isn't "Can we afford an embedded partner?" It's "Can we afford to build this ourselves while the market is moving this fast?"
We've scaled dental groups from 5 locations to 8 locations. We understand CDCP economics because we're in Canada. We embed in your business. We attend your meetings, work in your systems, and drive your priorities forward like we own the business.
And we tie every initiative to measurable KPIs: lead volume, patient acquisition cost, treatment acceptance rates, revenue per location.
Because if it doesn't drive results, it doesn't matter.
Let's make this concrete. Here's what the first 90 days look like when a multi-location dental clinic commits to building their marketing operations infrastructure.
Week 1-2: Data Gathering
Week 3: Stakeholder Interviews
Week 4: Findings Presentation + Roadmap
Week 1-2: Immediate Impact Initiatives
Week 3-4: Infrastructure Build
Week 1-2: Campaign Expansion
Week 3-4: Training & Optimization
More importantly, you have a functioning operating system that continues to improve rather than a one-time project that ends.
Fast forward one year. You've implemented the marketing operations framework, built the infrastructure, and embedded the execution model into your clinic operations.
Here's what's different:
You understand exactly which marketing channels drive CDCP vs. private-pay patients. You can tell your location managers with confidence which lead sources convert at the highest rates.
Your front desk team can explain balance billing in their sleep because they've delivered the same clear message hundreds of times through multiple touchpoints.
Your CRM automatically nurtures patients toward higher-value services based on their CDCP eligibility and treatment history. Patients receive timely, relevant communication without manual work from your staff.
Your reporting dashboard shows real-time performance across locations. You spot problems before they become crises and capitalize on opportunities before your competitors notice them.
You're opening new locations with confidence because the playbook is built. New locations inherit proven systems, tested campaigns, and standardized workflows from day one.
The infrastructure scales, but the overhead doesn't.
Despite CDCP's fee structure, your profit margins have recovered or improved because:
This is what it means to work with embedded operating partners rather than traditional vendors.
We don't wait for briefs. We show up to your meetings, work in your systems, and drive your priorities forward like we own the business.
Because when you win, we win.
The Canadian Dental Care Plan isn't a temporary disruption. It's a permanent market shift that requires dental clinics to evolve their operational capabilities.
The clinics that will dominate their markets over the next 3-5 years won't be the ones with the biggest advertising budgets. They'll be the ones who recognized that CDCP success requires:
Traditional marketing agencies will sell you ads and content. They'll make your social media look polished. They might even get you some leads.
But they won't fix the underlying operational challenges that prevent multi-location dental clinics from scaling profitably in the CDCP era.
That requires a different approach entirely.
If you're operating multiple dental locations in Canada and you recognize the challenges described in this article, you have three options:
Option 1: Build it yourselfHire the team, buy the technology, develop the expertise, and work through the inevitable learning curve. It's possible, but it's slow and expensive.
Option 2: Continue with traditional marketingKeep buying ads, keep hoping for results, and keep dealing with the operational chaos that CDCP is creating. This is the path most clinics will take—which is exactly why it creates competitive opportunity for those who choose differently.
Option 3: Partner with embedded operatorsWork with a team that's already built this system, has executed it successfully across multiple dental practices, and can embed into your business to drive results immediately.
At Foes, we've built our practice around option three. We embed as operating partners who fill both capacity gaps and capability gaps for multi-location businesses.
We conduct holistic Operating Assessments to diagnose issues, surface gaps, and identify opportunities across your financial, operational, sales, marketing, and technology infrastructure.
We prioritize what will actually move the needle—from tech stack fixes to campaign infrastructure to operational redesigns—and develop clear plans to deliver the work, fast.
And we execute as embedded operating partners, driving the prioritized workstreams forward with clarity, urgency, and zero dropped balls.
Book an Operating Assessment to see where your systems are creating friction and how to fix it. We'll examine your multi-location operation through all five strategic lenses and deliver a prioritized roadmap of high-impact initiatives.
No sales pitch. No generic recommendations. Just clear analysis of what's actually happening in your business and what to do about it.
Schedule Your Operating Assessment →
Marketing operations is the systems, technology, and processes that turn marketing activities into measurable business outcomes. For dental clinics, this means integrating your CRM with practice management software, automating patient communication journeys, tracking acquisition costs by patient type and location, and building reporting infrastructure that connects marketing spend to clinical results. It's the difference between buying ads (marketing services) and building the operational infrastructure for sustainable patient acquisition (marketing operations).
CDCP increases patient volume but creates margin pressure through three mechanisms: (1) reimbursement at approximately 85% of standard fees, (2) administrative burden for pre-authorization and patient education, and (3) patient expectation management challenges around co-payments and balance billing. Clinics maintaining profitability are doing so by optimizing patient mix (CDCP for volume, private-pay elective services for margin), reducing patient acquisition costs through better targeting, and building systematic patient education to reduce billing disputes and increase treatment acceptance.
The decision depends on your specific situation. Hiring a full-time marketing or operations manager makes sense if you have the budget for senior-level talent, can afford 6-9 months of ramp time, and need only single-function expertise. An embedded partner model provides immediate access to cross-functional expertise (marketing + operations + technology), zero ramp time because the team has executed similar transformations before, and no single points of failure. Most multi-location clinics find that the breadth of expertise required—from healthcare compliance to CRM automation to campaign execution—is difficult to find in a single hire.
The "best" CRM depends on your specific needs, existing tech stack, and team capabilities. HubSpot is popular for dental clinics because of its strong marketing automation, intuitive interface, and good integration ecosystem. Salesforce offers more customization but requires more technical expertise. The more important question than "which CRM" is "how well are you using it"—most dental clinics use less than 25% of their CRM's capabilities. Success comes from proper configuration for dental-specific workflows, integration with practice management software, and team training on using it consistently.
Quick wins are typically visible within 30-45 days (improved patient education, better Google Business Profile performance, basic reporting). Meaningful operational transformation—where you have integrated systems, automated patient journeys, and reliable reporting across locations—takes 90-120 days. Full maturity, where the system runs smoothly with minimal ongoing intervention and you're continuously optimizing based on data, typically takes 9-12 months. The key is starting with high-impact initiatives that show early results while building the foundation for long-term systematic improvement.
Yes. Most multi-location dental clinics have invested in practice management software (Dentrix, Open Dental, Curve, etc.) and may have partial CRM implementations or marketing tools in place. A good embedded partner starts by auditing what you already have, identifying integration opportunities, and optimizing existing investments before recommending new technology. The goal is to make your current systems work together effectively rather than rip-and-replace everything.
Traditional dental marketing agencies sell you services: Google Ads management, social media content, SEO, website design. You're buying outputs (ads, posts, rankings). An embedded operating partner fills capacity and capability gaps in your organization. You're buying outcomes: reduced patient acquisition cost, increased treatment acceptance, scalable multi-location systems. The agency model is vendor-client; the embedded partner model is team-extension. Agencies wait for briefs and deliver projects; embedded partners attend your meetings, work in your systems, and drive priorities forward like internal team members.
Focus on business outcomes, not marketing vanity metrics. Key performance indicators include: patient acquisition cost by type (CDCP vs. private-pay) and location, treatment acceptance rate for private-pay elective services, percentage of CDCP patients who convert to higher-value treatments, revenue per patient cohort, location-level profitability, patient lifetime value by acquisition source, and time from first contact to booked appointment. These metrics connect marketing activities to clinical and financial results—which is the entire point of marketing operations.
The Operating Assessment is designed exactly for this situation. It provides a comprehensive view of where you are, where the biggest opportunities exist, and what sequence of initiatives makes sense for your specific context. Some clinics start with tactical quick wins (CDCP patient education, review generation) before moving into deeper infrastructure work. Others start with a single location as a pilot before rolling systems across their network. The roadmap is customized to your readiness, resources, and strategic priorities—not a one-size-fits-all approach.
Foes is an embedded operating partner firm that works with multi-location healthcare and dental practices to build the marketing operations infrastructure for sustainable growth. We fill gaps in both capacity and capability, operating inside your business to deliver measurable results in weeks, not years.
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Ready to build your growth advantage? At Foes, we embed as multidisciplinary operating partners to help growth companies move faster. We don't just strategize. We implement. Marketing, sales, operations, technology. Whatever you need, whenever you need it. Let's talk about your growth challenges.