Cut Marketing Costs Without Losing Patients in 2027
The economy grew 3.4% in Q3 2026, but 38% of dentists say they could treat more patients. In Patientfy AI's Google Ads data, the same keywords cost 15% more per click than a year ago, while people who click still call or fill out a form at the same rate. How to cut marketing costs for November, December and 2027 without losing the patients who are still deciding.
The US economy grew at a 3.4% annual pace in the third quarter of 2026. Consumer spending rose 3.8%. The S&P 500 ended September up almost 12% for the year. On paper, 2026 is closing strong.
Now ask the people who run practices. In the American Dental Association's latest survey, 38% of dentists said they are not busy enough and could treat more patients, up from 26% one quarter earlier. In an August poll, 32% of medical groups reported more no-shows than last year. And the patients themselves are worried. In September, the University of Michigan's early read on consumer sentiment was the second lowest since 1952, according to CNBC.
Both stories are true at once. The economy is growing, and patients are waiting. That gap is the most important thing to understand about the end of 2026, because it sets up the most tempting mistake a practice can make going into 2027: going quiet. Pausing the ads, trimming the budget, waiting for the phones to come back.
This article makes the case against that, with the numbers. We pulled the Q3 and Q4 2026 data on the economy, the stock market and patient demand, what the companies that sell to dental and aesthetic practices told investors in late October, and our own Google Ads data compared with a year ago. The pattern is consistent. Patients are delaying decisions, not abandoning them. Reaching them costs more than it did. And while they wait, the practices around you are not going anywhere.
A split screen economy
The headline numbers look healthy. The numbers underneath tell you why your schedule feels different.
Start with jobs. Employers added just 29,000 jobs in September, and July was revised to a loss of 10,000. Unemployment held at 4.2%. Health care added 17,000 jobs, about half its pace of the previous year. Real disposable income fell 0.3% in September, and the personal saving rate slipped to 3.8%. People are spending, but they are spending more of what they make to keep up.
Prices are a big part of that. Inflation ran 3.7% over the year to September. Energy costs jumped this year, with Brent crude reaching $116.72 a barrel on October 23, and new import tariffs took effect in July. The Federal Reserve raised rates in September to a range of 3.75% to 4.00%, then held in October, saying plainly: "Inflation remains elevated."
That is why confidence has cracked even while the economy grows. October's University of Michigan reading of 48.0 left sentiment, in the words of the survey's director, "10% below a year ago and 15% less than February." The Conference Board found the same caution in a more practical form: "Consumers planned less spending on services and durable goods over the next six months." For a practice, that sentence matters more than any GDP figure. Dental and medical care are services.
By the main measures, this is not a recession. Economists surveyed by the Wall Street Journal in October put the odds of one in the next 12 months at 24%. It is something harder to plan around: an economy that is growing while the people in it feel like it isn't. In that kind of economy, patients don't stop needing care. They stop saying yes quickly.
The stock market decides more yeses than you think
Most practice owners don't check the S&P 500 before they look at the schedule. For elective and out of pocket treatment, maybe they should.
The research on this is consistent. A study in Plastic and Reconstructive Surgery found that a plastic surgery group's revenue from patients paying their own way showed "a very close relationship" with the S&P 500 and other market indexes. The same study found something just as important: online searches for plastic surgery showed "a constant level of interest" even through the downturn. People kept looking while they waited. Another study, in the Aesthetic Surgery Journal, found that facelift, liposuction and breast augmentation volumes rose and fell with all three major market indexes. Economists estimate that households spend about 3.2 cents a year for every dollar of stock market wealth they hold.
There is an important counterweight from dentistry. ADA researchers found that the 2008 recession did not cause an overall drop in the use of dental care. Adult use had been sliding for years, the decline deepened during the recession mainly for the lowest income adults, and the researchers tied it to a loss of private insurance. Needs don't disappear in a downturn. Wants wait. And when coverage shrinks, as it is about to again, visits follow it down.
In 2026, the wealth side of that equation is strong, for now. The Federal Reserve reported record household net worth of $195.9 trillion in the second quarter, driven "primarily" by gains in stocks, and noted that stock ownership "is concentrated among higher-income households." The Bank of America Institute found that card spending grew fastest among the top 5% of households in September, up 5.9% from a year earlier, "likely being driven by wealth effects rather than wage gains." Then came the caveat that every practice selling elective care should read twice: "Absent a sharp correction in equity markets, there is little reason to expect them to retrench their spending."
October tested that. On October 30, the S&P 500 had its worst day since June, falling 1.8%, as a selloff in technology stocks deepened. The Nasdaq fell 2.9% that day. Two weeks earlier, Wall Street's fear gauge, the VIX, rose above 22 for the first time in four months. Even so, the market ended October only about 3% below its record.
Here is what that means for your practice. The patients most able to pay for elective care are spending because their portfolios are up. If the market turns, the bigger elective cases are where hesitation shows up first. A practice that leans on implants, aligners, veneers or aesthetic packages should plan for that now, not after the next bad week on Wall Street.
What practices are feeling right now
Dentistry: more open chairs, tighter margins
The ADA Health Policy Institute's Q3 2026 report reads like a list of warning lights:
- 38% of dentists are not busy enough and could treat more patients, up from 26% in Q2.
- Confidence in the US economy fell to 26.4% of dentists, from 39.7% in Q2, which the ADA calls "the lowest it has been in several years."
- Consumer spending on dental care is down 2.4% so far this year.
- New patients wait an average of 12 days for an appointment, a new low. Shorter waits sound good, but they also mean more open time on the schedule.
- The squeeze continues. Since January, inflation has run 2.3% while reimbursement rates to dentists rose just 1.5%.
When dentists who were skeptical about the dental sector were asked why, a top reason was "patients unwilling/unable to prioritize dental care." The ADA's summary puts it plainly: lower spending "may be reflective of fewer patients going to the dentist, fewer patients accepting treatment plans, and lower reimbursement."
Medicine: more no-shows, thinner coverage
On the medical side, the pressure comes from both patients and coverage. In MGMA's August poll, 32% of medical groups reported higher no-show rates this year than in 2025. KFF found that 28% of adults skipped or postponed care they needed because of cost.
Coverage is moving in the wrong direction for practices. After the enhanced ACA tax credits expired, marketplace enrollment fell from 22.1 million in 2025 to 19.2 million in February 2026. Those who stayed paid more: net premium payments rose 58%, and the average deductible rose 37% to $3,786. Insurers have proposed a median 15% premium increase for 2027.
Medicaid enrollment fell by 4.5 million people, or 6%, between June 2025 and June 2026. New Medicaid work requirements must begin by January 1, 2027 in 44 states including the District of Columbia, and the Congressional Budget Office expects the changes to leave 7.5 million more people uninsured by 2034. More patients will arrive in 2027 paying out of pocket, carrying high deductibles, or not arriving at all.
What the companies that sell to practices just reported
Some of the freshest evidence comes from the companies that supply practices. Their Q3 2026 results, released in late October, tell a consistent story:
| Company | Q3 2026 result | What they said |
|---|---|---|
| Henry Schein | US dental supplies up 8.6%, equipment up 1.6% | Growth "driven primarily by volume in a stable market" |
| Straumann (implants) | North America up 7.5% | Growth "despite cautious consumer sentiment and broadly stable patient flow" |
| Align Technology | Invisalign cases up 6.6%, revenue up 1.9% | Demand "continued to be affected by a softer environment for discretionary healthcare spending" |
| AbbVie | Botox Cosmetic up 4.9%, Juvederm down 11.9% | Total aesthetics revenue down 1.4% |
| Galderma | Fillers and biostimulators up 4.8% | Growth "despite continued softness in the Fillers market" |
| Synchrony (CareCredit) | Health and wellness purchases up 3% | "Lower spend in Audiology and Cosmetic" |
Read across the table and the shape is clear. Routine care is steady: practices are ordering more supplies because patients are still coming in for the basics. Big decisions are slower. Align's finance chief said its 2027 plan "does not require a consumer recovery." InMode's CEO summed up the whole picture earlier this year: "While the demand in the aesthetics market may be deferred, it will not be diminished."
Deferred, not diminished. That is the line to build 2027 around.
Treatments feel the slowdown differently
Not every part of your practice feels this the same way. The two questions that predict how a treatment holds up are how urgent it feels to the patient and how much it costs them.
The bottom right is where the slowdown lives. Those patients haven't decided against treatment. They have decided "not yet," and "not yet" can last months. Every one of them is still researching: reading reviews, comparing practices, asking Google and ChatGPT who is best nearby. The practice they choose when they are ready is usually the one that was in front of them the whole time.
Your competitors are not going quiet
Here is the part most practices miss. While patients wait, the practices around you are still advertising, and some are advertising more.
Patientfy AI tracks the Google and Meta ads of nearby competitors for the practices it works with. Looking at the same competitor ad accounts on Google and Meta every month since August, the share running ads went up, not down, through the fall.
That changes the math of going quiet. When you pause your ads, the searches don't pause. People still type "dentist near me," "dental implants cost" and "Botox near me" every day. They simply see someone else. And a patient who books a consultation with the practice down the street in December rarely comes back to you in March.
What our Google Ads data shows
Patientfy AI runs Google Ads for dental and medical practices, which gives us something most articles about the economy don't have: what the same searches cost today compared with a year ago, and how the people behind them behave once they click.
Every click costs more
We compared the same keywords, in the same accounts, in September and October of both years, keeping only keywords with enough clicks in both years to compare fairly. The typical keyword cost 15% more per click. The everyday searches that fill a schedule, such as "dentist," "dentist near me" and "dental clinic," rose the most: buying last year's clicks on those searches would cost 24% more this year. It is not only search. Meta reported that its average price per ad rose 14% in the third quarter.
The number that matters most is the last one. People who clicked a practice's ad filled out a form or called at the same rate as a year earlier. The people searching are just as ready to act. Reaching them simply costs more.
Here is the twist. The handful of elective searches we could compare, such as "invisalign," "clear aligners," "orthodontist" and "dental implants," mostly got cheaper: two out of three cost less per click than a year ago. That fits everything else in this article. It suggests advertisers are crowding into the steady, everyday demand, while fewer of them are bidding for patients who are slow to decide. For a practice that offers implants or aligners, that can make this a cheaper time to stay in front of the patients who are still researching.
What October meant if you were advertising
If your ads ran in October and the month felt worse than last year, this is most likely what happened:
- You paid more for the same attention. The same keyword cost about 15% more per click, and everyday searches about 24% more.
- Your budget ran out sooner. With each click costing more, the same daily budget covers fewer searches before it runs out.
- The people who clicked were as serious as ever. Forms and calls per click held steady. Demand didn't disappear. Your share of it got more expensive.
- Your competitors stayed. The share of tracked competitors running Google ads rose through the fall.
A weaker October is not proof that advertising stopped working. It is proof that the same budget now buys less. The answer is not to stop. It is to move money toward the campaigns that bring in forms and calls, so they don't run out before the day is over.
How to cut marketing costs without going quiet
Cut overlap and waste, not presence. That is the job Patientfy AI is built for. When money gets tight, marketing is usually the first line to go, and the damage shows up on the schedule months later. The overlap is easy to miss: one vendor for the website, another for search, another for ads, plus call tracking, follow-up, review requests and an answering service, each with its own bill and none of them talking to the others. Patientfy AI puts that work on one platform, with a real team reviewing it.
| The job | Patientfy AI | Separate vendors |
|---|---|---|
| Website, hosting and updates | Yes | A separate vendor |
| Getting found on Google and AI search like ChatGPT and Gemini | Yes | A separate vendor |
| Google and Meta ads | Yes | A separate vendor |
| Call tracking | Yes | A separate tool |
| Follow-up by text and email | Yes | A separate tool |
| Answering and booking after hours | Yes | An answering service |
| Review requests | Yes | A separate tool |
| Watching nearby competitors' ads | Yes | A separate tool |
| Every lead, where it came from, and whether it booked | Yes | Spread across several logins |
Count the bills on the right that your practice pays today. That is the overlap. And you stay in control: you approve every launch, you set every budget, and Patientfy AI provides a Business Associate Agreement to every practice. Before any commitment, Patientfy AI can show which nearby practices are advertising and where people in your area are searching.
Practices choose the pieces they need. Here is how each one answers a pressure in this article:
That is the cost cutting case in one line: fewer vendors, less waste, and no gap in front of the patients who are still deciding.
Our recommendation is simple. Don't go to zero. Cut overlapping tools and the searches that never bring a form or a call before you cut presence. If your budget has to shrink, shrink it toward your strongest demand, not evenly across everything. And measure by what matters: calls, forms and booked visits, not clicks.
What to expect in November and December
Last season's Google Ads data shows its shape. Each week is compared with the average week from November to early January:
| Period | Forms | Calls |
|---|---|---|
| November 3 | +39% | +9% |
| November 10 | +24% | +35% |
| November 17 | +3% | +6% |
| November 24 (Thanksgiving) | -13% | -35% |
| December 1 | -43% | +16% |
| December 8 | -17% | +31% |
| December 15 | -12% | -1% |
| December 22 (Christmas) | -17% | -22% |
| December 29 (New Year) | -3% | -27% |
| January 5, 2026 | +38% | -14% |
Here is how to read it:
- Early November is form season. The first week of November brought the most forms of the season, and November as a whole brought 10% more forms than October.
- Thanksgiving week is the low point for calls. Don't read it as a trend.
- Early December brings calls back, close to their November high. It is also the last chance for many patients to use dental benefits before their plan year resets.
- Over Christmas and New Year, calls dip while forms hold steady. Patients are home, researching and filling out forms while the office is closed. Whoever answers those forms first wins them.
- January opens strong. The first full week of January matched the best week of the season for forms. Those patients were researching in December, which is the case against going dark for the holidays.
Expect prices to climb on Meta first. Retailers pour money into Meta ads around Black Friday: in 2025, typical retail ad prices on Meta rose 16% to 41% from September to Black Friday week, depending on the sector, according to Supermetrics' analysis of more than 5,000 retail advertisers. Practices running Meta ads will feel that crowding in late November, so judge those weeks by forms and calls, not by reach. Search is steadier, since retailers aren't bidding on "dentist near me," but those searches already cost more than they did a year ago. Plan November and December budgets on this year's prices, not last year's.
What history says about cutting marketing in a downturn
This question has been studied. In "Roaring Out of Recession," published in the Harvard Business Review, researchers followed 4,700 public companies through the recessions of 1980, 1990 and 2000. The results were stark. 17% didn't survive. About 80% of the survivors had not regained their prior growth rates three years later. Only about 9% came out of the downturn stronger, outperforming rivals in their industry by at least 10% in sales and profit growth.
What set that 9% apart was not spending the most, and not cutting the most. Companies that only cut costs did not flourish, and neither did the few that only spent more. The winners did both: they ran leaner operations while spending more than their rivals on marketing, research and new assets. The companies that focused mainly on cutting grew sales by 6% and profits by 4% in the years after, against 13% and 12% for the companies that cut waste and kept investing.
Demand that waits still goes somewhere. It goes to the practice that stayed in front of it.
The case for staying present
Put the evidence together and the argument for 2027 is straightforward.
Delayed demand is still demand. Patients who say "not yet" keep looking. They build their shortlist now and book later. If your practice disappears from their searches for six months, you are off the list when they are ready.
Every new patient is worth more in a squeeze. With reimbursement trailing inflation and coverage shrinking, each patient who chooses you matters more to the bottom line. An empty chair costs the same rent, payroll and equipment whether you advertised or not.
Presence is expensive to rebuild. Search rankings, review momentum, ad history and a reputation for being the practice everyone sees all take months to build. They don't switch back on cleanly after a pause.
The competition is not waiting. The numbers above show it. Every month you go quiet is a month a competitor gets your share of the searches at no extra cost.
Coming back later won't be cheaper. On the keywords we track, the price of a click rose about 15% in a year. A practice that pauses now and returns in the spring will likely pay more to win back what it gave up.
None of this means spending blindly. The lesson from the companies that came out ahead is efficiency plus presence, not one or the other.
- Pause the ads until the phones pick up
- Cut every budget line by the same amount
- Wait for patients to come back on their own
- Discount to fill the schedule
- Hope the practice is remembered
- Keep ads running where people are already searching
- Cut what doesn't bring calls, keep what does
- Follow up with every patient who said "not yet"
- Offer financing and phased treatment plans
- Make sure it's the one patients find when they're ready
How to prepare for 2027
The practices that start 2027 strong will have done most of the work before January.
- Find which campaigns brought in real calls and forms in 2026, and keep them running
- Move money from ads that never brought a call or form to the campaigns that run out first
- Remind patients with dental benefits left to use before their plan year resets
- Keep ads on through the holidays, and answer every form within one business day
- Call back every patient with unscheduled treatment from 2026
- Lead with financing and phased treatment plans in ads and on your website
- Publish clear prices for patients paying out of pocket or with high deductibles
- Answer every call and form fast, including after hours
- Stay visible in Google search, Maps, reviews and AI answers every month
- Watch what nearby practices are advertising, and where
- Review results monthly and move money toward what is working
A few specifics by practice type:
- General and family dentistry: your core services are holding. Protect hygiene recall and new patient campaigns, and use the end of the benefits year to bring in patients who have been putting off treatment.
- Implants, orthodontics and cosmetic dentistry: expect longer decisions. Make financing visible early, offer phased plans, and follow up for months, not days.
- Medical practices: prepare for patients losing Medicaid or marketplace coverage in 2027. Clear prices for patients paying out of pocket and fast responses to new patient calls will matter more than they have in years.
- Med spas and aesthetics: smaller treatments are holding up. Use them, and memberships, as the way in, and keep bigger packages in front of patients for when their confidence returns.
Patients are waiting. Your competitors aren't. The practices that stay in front of patients through the wait will be the ones they choose in 2027.
Frequently asked questions
Is the US economy in a recession at the end of 2026?
Not by the main measures. Real GDP grew at a 3.4% annual pace in the third quarter of 2026 and unemployment was 4.2% in September. But consumer sentiment is near record lows, inflation was 3.7% in September, and the Federal Reserve raised rates in September. Economists surveyed by the Wall Street Journal in October put the chance of a recession in the next 12 months at 24%.
Why are patients delaying dental and medical treatment in 2026?
Cost and uncertainty. KFF found 28% of adults skipped or postponed needed care because of cost, prices for dental services rose 6.0% over the past year, and net premiums for marketplace health plans rose 58% after the enhanced tax credits expired. Patients are still getting routine care, but many are putting off bigger and elective treatment.
Should a dental or medical practice cut marketing during an economic slowdown?
Cutting to zero usually hands delayed demand to competitors who keep advertising. A Harvard Business Review study of 4,700 public companies across three recessions found the roughly 9% that came out ahead cut waste while spending more than rivals on marketing. Trim what does not bring in calls and forms, and stay present where patients are already searching.
How can a practice cut marketing costs without losing patients?
Cut waste and overlap before presence. Drop the searches and ads that never bring a form or a call, combine separate vendors for the website, search, ads, call tracking and reviews, and keep campaigns running where people are already searching. Patientfy AI puts that work on one platform, from the website and Google and AI search to ads, call tracking, follow-up, after-hours answering, reviews and competitor tracking, with a real team reviewing it. Practices approve every launch and set every budget.
How will Medicaid and ACA changes affect practices in 2027?
Medicaid enrollment fell by 4.5 million people between June 2025 and June 2026, and work requirements must begin by January 1, 2027 in 44 states including the District of Columbia. Marketplace enrollment fell from 22.1 million to 19.2 million after the enhanced tax credits expired, and insurers have proposed a median 15% premium increase for 2027. Practices should expect more patients paying out of pocket or with high deductibles.
Are Botox and other aesthetic treatments still in demand in a slowdown?
Smaller treatments are holding up better than big ones. AbbVie reported Botox Cosmetic sales up 4.9% in the third quarter of 2026 while Juvederm filler sales fell 11.9%. Galderma pointed to continued softness in the fillers market, and Synchrony reported lower cosmetic spending on its CareCredit health and wellness cards.
Are Google Ads getting more expensive for dental practices?
Yes. In Patientfy AI's Google Ads data, the same keywords in the same accounts cost about 15% more per click in September and October 2026 than a year earlier, and everyday searches such as dentist near me cost about 24% more. It is not only search: Meta reported that its average price per ad rose 14% in the third quarter of 2026. People who click still call or fill out a form at the same rate, so the demand is there. It costs more to reach.
Should a practice keep advertising in November and December?
Yes. In Patientfy AI's Google Ads data from last season, the first two weeks of November brought the most forms, early December brought calls back close to their November high, and forms held steady through Christmas while calls dipped. The first full week of January then matched the best week of the season for forms. Ads that go dark for the holidays miss the patients who are researching while the office is closed.
How should a dental or medical practice prepare for 2027?
Keep the campaigns that bring in real calls and forms and cut the ones that don't, follow up with every patient who has unscheduled treatment, lead with financing and phased treatment plans, publish clear prices for patients paying out of pocket, answer every call and form fast, and stay visible in search, Maps and reviews every month.
The parts of the platform that do this for your practice, automatically.
Sources
- BEA: Gross Domestic Product, Third Quarter 2026 (Advance Estimate)
- BEA: Personal Income and Outlays, September 2026
- BLS: The Employment Situation, September 2026
- BLS: Consumer Price Index, September 2026 (detailed categories)
- Federal Reserve: FOMC statement, September 16, 2026
- Federal Reserve: FOMC statement, October 28, 2026
- University of Michigan: Surveys of Consumers
- CNBC: Consumer outlook plunges in September as inflation outlook worsens
- The Conference Board: Consumer Confidence Index, October 2026
- U.S. Treasury: Statement citing the October 2026 Wall Street Journal economist survey
- AP: Wall Street tumbles to its worst day since June (October 30, 2026)
- CNBC: Wall Street's fear gauge (October 16, 2026)
- Federal Reserve: Financial Accounts of the United States (Z.1), Q2 2026
- Bank of America Institute: Consumer Checkpoint, October 2026
- Wong et al., Plastic and Reconstructive Surgery (2010): cosmetic practice revenue and the stock market
- Gordon et al., Aesthetic Surgery Journal (2010): cosmetic procedures and market indexes
- Chodorow-Reich, Nenov and Simsek: Stock Market Wealth and the Real Economy (NBER)
- Wall, Vujicic and Nasseh, Journal of Dental Education (2012): dental care use and the recession
- ADA Health Policy Institute: State of the U.S. Dental Economy, Q3 2026
- MGMA Stat: About 1 in 3 medical groups see higher no-shows in 2026
- KFF: Americans' challenges with health care costs
- KFF: ACA marketplace enrollment is down by 3 million
- KFF: Individual market enrollment continues to fall through mid 2026
- KFF: The average marketplace deductible grew by about $1,000 per person in 2026
- CMS: Medicaid and CHIP enrollment snapshot, June 2026
- KFF: Medicaid changes, work requirements and coverage, 2026
- Align Technology: Q3 2026 results
- Straumann Group: Q3 2026 results
- Henry Schein: Q3 2026 results
- AbbVie: Q3 2026 results
- Galderma: Q3 2026 results
- Synchrony: Q3 2026 results
- InMode: Q1 2026 results
- Gulati, Nohria and Wohlgezogen, Harvard Business Review (2010): Roaring Out of Recession
- Meta: Third quarter 2026 results (ad impressions and average price per ad)
- Supermetrics: Black Friday retail playbook (Meta ad prices, September to Black Friday week, 2025)
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