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How to Evaluate Web Design Proposals for Your Medical or Dental Practice


If you are a busy medical professional, I doubt you’ve got the time or expertise to spend designing a website to promote your practice and inform your patients. It’s the kind of thing most doctors and dentists should outsource.

What can you expect to pay for the website build and ongoing maintenance? What kind of service should you expect?

Those questions and others are thoroughly answered today by Nina Litovsky of Nina Interactive. Although you may not know here name, you’ve almost certainly seen her work; she is responsible for the look of The White Coat Investor. And by that, I mean the layout of the website, and not the way Dr. Dahle dresses or combs his hair. She’s a web designer.

You might also recognize her last name. I’ve been reading advice from her husband Kon Litovsky in the White Coat Investor Forum for nearly five years now. He’s got great insights into retirement plans for small businesses. Let’s hear from Nina.




How to Evaluate Web Design Proposals for Your Medical or Dental Practice


When you need a professional website for your medical or dental practice, you might have to collect proposals from several web design companies and find the right one that fits your needs and budget. Evaluating web design proposals can be confusing, time-consuming, and potentially costly if you are not familiar with the industry and terminology.

Web companies may also present misleading information, push services that you don’t need, and overcharge for their products. If you want to make an informed decision and choose the right company to build a good website cost-effectively, here are some things to consider when you review your web design proposals.


The Size of the Company


The larger the team and the more non-essential (administrative) positions it includes, the higher the company’s overhead, which could lead to higher costs and lower quality for you.

Visit the About page on the company’s website to read more about the company. Do they have a physical office and how large is it? How many people are there in the team?

Smaller companies usually have a lean team that includes only the essential people who do the actual work: the owner who does some of the work, a designer, a web developer. Small companies have small or virtual offices. Such a lean production model minimizes the company’s overhead, which in turn enables the company to lower costs for their clients.

By contrast, teams at large agencies include many administrative positions such as VPs, managers, account representative, sales, and so on. Larger agencies often have one or multiple physical offices. All this adds significant overhead costs which get passed on to clients.




To make a profit with such a high overhead, the company may increase the price of their web design and maintenance services. They might charge you a high initial fee for building your website or make you pay high monthly fees. Whether in a lump sum or monthly installments, you will end up paying more than the market price of your website.

Alternatively, the company may opt to save money by cutting corners on quality and customization and sell you a low-quality, mass-produced generic website template. In one way or another, the agency’s high overhead is a disadvantage to you. A smaller firm with a lean production model is in a much better position to offer you either a higher quality of their services, a lower price, or both.


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Solo Freelancers and Foreign Companies


It’s a common misconception that solo freelancers or foreign-based companies are cheaper than domestic web design agencies. The initial price may sometimes be lower but there could be hidden costs down the road. Also, quality and long-term support matter just as much as the costs involved.

As an ongoing marketing channel, your website will need maintenance and updates long after it’s completed. Before you invest the time and money into hiring your web designer, you should ensure that this is someone you can build a long-term relationship with. All this brings us to why it may be a bad decision to hire a solo designer or outsource your design overseas.



I have heard many horror stories about web design projects being abandoned and money wasted because the freelancer or the overseas team simply stopped responding. Solo web designers often freelance on the side in addition to their full-time job or between jobs.

What happens when their primary job gets too demanding or when they find their next full-time job? Your project will be put on the back burner or abandoned altogether. Similarly, overseas developers are known to be unresponsive at critical times, lock clients out of websites, or demand more money at random times. Both solo freelancers and overseas developers often disappear after the project, thus making support for your website non-existent.



It takes a team of professionals – a designer, a developer, a content writer, an SEO specialist – to build a high-quality modern website. A solo designer may not have enough skills to complete your project, which may result in additional costs and wasted time when you have to hire someone else to finish or repair your website.


All American practice websites should adhere to industry guidelines for clean code, accessibility and usability outlined by the Americans with Disabilities Act of 1990.


Work done overseas may not always live up to the U.S. standards of quality. The reason for this is that most countries that do outsourced development work don’t have conditions in place that require a high degree of integrity within the website, such as accessibility or SEO regulations. Overseas developers have no incentive to build websites that adhere to the U.S. standards of clean code and security. Dealing with the consequences of a suddenly crashed website can be more costly than spending little extra money to get the job done through a reputable domestic developer that provides reliable support.

A web designer is supposed to be an expert on conversion optimization – making your website attract patients and highlight the valuable attributes of your practice. Overseas developers don’t have the social background to fully understand the U.S. market which is necessary in order to create a website that appeals to American patients.


Legal Liability

If overseas developers stop responding after receiving payment or otherwise fail your project, you will likely have no legal recourse against them and your money will be lost. On the other hand, domestic companies are subject to the U.S. laws, their contracts are enforceable in court so that, if worse comes to worst, you can sue the company and get your money back.

If you still decide to work with a foreign-based company, at least make sure that the company has a legal representative in the United States who will sign a contract with you and stay accountable to you, both professionally and legally.


Termination Clause


Regardless of how well you know your web designer, you should always insist on having a legal professional agreement between you and the company before you pay them and the work begins. When you request the company’s proposal, also ask to review some of the important provisions of your potential future contract with them.

One such provision is a termination clause which allows you to terminate the contract for any reason, at any time. I have heard horror stories about doctors being asked to pre-pay in full and then getting stuck with the company they didn’t like, or being extorted for more money.


A fair and reasonable contract termination clause can protect you in case the project goes wrong or your relationship with the web company deteriorates.


Even if you like the company and they have a good reputation, you should still have a way to get out of the contract without much loss if things ever get sour. A termination clause should be easy to understand and the terms should be reasonable and fair.

For example, the company may charge you a prorated hourly fee for the work completed up to the point of termination and in exchange give you the work completed so far. But it will be unfair of the company to require you to pay the full fee upon termination if the work is done only partially or not at all.

Before you start working with the company, review the contract carefully and make sure that you are comfortable with the contract and particularly the termination clause. Such diligence could save you a lot of money and trouble in the future. Consult with an attorney if necessary.


What’s Included in the Proposal?


Similarly-priced proposals from different companies may include different services in their proposal package. Some companies include less while others include more for the same price. For example, one company may include only web design in their base price without any additional services such as SEO (search engine optimization) or responsive (mobile-friendly) design.

Another company’s proposal may include SEO and responsive design for nearly the same base price. Likewise, one proposal may limit the number of web pages the company will create for you, while another similarly-priced proposal may include unlimited pages. When requesting proposals, be sure to ask for an itemized list of services and compare the proposals item by item.

Sometimes web design agencies include unnecessary services in their packages or try to sell you a more complicated solution where a simple one will suffice. For example, we often hear from doctors that they are sold monthly SEO services without a clear understanding of what the service includes and why it’s necessary to perform the service on a monthly basis. SEO is a popular buzzword nowadays, and many doctors think that they are getting value from monthly SEO even when they don’t.

Based on our observation and the feedback we get from doctors, many SEO agencies do only low-end SEO which mostly includes posting canned content on the website, tweaking keywords, and generating reports. In reality, successful SEO depends on many factors – your online and offline marketing, the longevity of your practices, your reviews, your location, and even your operating model (for example, if you are open on Sundays you can rank higher than your competitors for “doctor open on Sunday” search queries).

Many of these factors cannot be controlled and improved by just one SEO company. Effective SEO requires a holistic approach. Your practice may not even need monthly SEO and may rather benefit from other marketing strategies instead. It’s often helpful to seek a second opinion and have another professional evaluate whether you are being offered a service that will really be in your best interest.


Are You Really Getting a Custom Website?


A custom website is designed around your content, reflects your brand, features your custom photos and content, highlights your specific marketable attributes, looks visually appealing, and projects an authentic image of your practice.


Marketing and web design proposals sometimes don’t disclose the whole truth and use obscure terminology to sell you something that is not what it seems. A “custom” website is one example. The company might promise to build you a custom website but in fact use an off-the-shelf boilerplate template and only slightly customize it with your logo, photos and colors. You will be charged for what you assume is a unique custom website that will help you stand out, while in reality you will get a low-end template-based website that the company sells to every other doctor.

A real custom website – like a custom-tailored suit – is built from the bottom up around your needs. True custom design means that the company will bring in a graphic designer who will work with you to understand your practice, target patient base, marketing goals and business needs. The designer will then create a unique website that matches your needs and requirements.

Ask the web company whether they really create custom designs or just customize templates. This difference can have long-term consequences. A template-based website looks too bland and generic, makes your practice look like every other practice, may be difficult to customize and update with new content and features, and is often inefficiently coded, which can cause performance issues.

By contrast, a custom website will be crafted with attention to detail, designed around your specific marketing and business needs, and project a professional, well put together image of your practice. A custom website performs better technically and markets your practice better. Read more about how to identify whether you are really getting a custom website or it is a pricing trick.

It’s a common misconception that custom websites cost an arm and a leg. For some companies, custom design is a more efficient and professionally rewarding process than churning out templates, especially if the company is committed to creativity and design excellence. It’s possible to find a company to build a website that is both custom and affordable.


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Canned vs. Custom Content


Website content usually includes descriptions of procedures, frequently asked questions and other patient education wording, doctor biographies, office description, financial information for patients, and so on. While some prefer to write their own website content, many doctors rely on their web design companies to provide the text. When reviewing web design proposals, always ask if and what kind of content is included in the service package.

Copyscape.com is a plagiarism checker that detects duplicate content across websites. This screenshot partly shows a long list of dental websites that have a Composite Fillings page with the same exact content. These websites must have been built by the same web company that used duplicate content on all of them.

Many web companies cut corners on the content and simply copy procedure descriptions from other sources – often word for word – or reuse the same pre-written content on all their client websites. It’s often easy to detect canned content: the procedure description is too wordy, doesn’t include the name of the doctor or the office, and doesn’t mention anything specific about how the procedure is performed at that particular practice.


Google and other search engines discourage duplicate content and may even penalize your website by lowering its position in search results. In addition, generic standardized content that’s used on every other website is too bland and cannot effectively communicate the value of your particular practice and convince patients that they should call you rather than another doctor. Inserting auto-generated content may seem like a faster and (sometimes but not always) cheaper solution, but you will end up wasting money on filler content that doesn’t convert patients and can hurt your search engine rankings.

Instead, look for a company that can provide a copywriter who will personally work with you to write custom content that represents your practice. Custom content will make your website more authentic, more professional, and more attractive to patients.


Ongoing Updates and Support


Your website will require at least some level of ongoing maintenance. When you hire a web designer, pick one who is most likely to be your reliable long-term partner and who will provide consistent and timely support for your website going forward.

Technical website maintenance includes website backups, anti-virus scanning, server updates, and other routine maintenance of your website’s platform and server. If you choose a company that builds websites on a proprietary platform, the company will be responsible for technical maintenance of your website.

If you choose to build your website on a nonproprietary platform such as Wordpress and host the website with an independent hosting company, the hosting vendor will provide all the ongoing technical support. Not only is this option cheaper but it is also better. Unlike web design agencies that usually resell hosting as a second-tier service, hosting companies are specialists that are likely to have better around-the-clock support, better knowledge of their systems and better hardware and resources. Reputable hosting providers are usually responsive and competent.


Wordpress has a visual content editor that is very similar to Microsoft Word. The editor enables anyone without technical knowledge to login and make changes to the content.


You should also ask your potential web designer about how easy it will be for you to make updates to the website. Most doctors want to be able to update content and photos on the website on their own without having to ask a developer every time, so your web designer should offer an option for you to do that. A modern website should include an easy and intuitive visual content editor to enable the doctor or their staff without any technical experience to make changes to the content and photos.

If you ever decide to revamp your website’s visual appearance, add new functionality or make other technical changes to your website, you will likely need the help from your web designer, so it would be a good idea to ask your web designer about their availability and fee schedule for future updates. I believe that the best option is a retainer agreement by which the designer will be available on as-needed basis and charge for any work at an hourly rate. This option is more cost-effective and transparent than charging a recurring monthly fee regardless of whether you need updates that month or not.



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Vendor Lock-in


The platform (software) that will be used to build your website is another important factor to consider when you review your proposals. The platform can be either proprietary and owned by your web company or open-source nonproprietary such as Wordpress.

A proprietary platform is hosted and maintained only by the company that owns it. A nonproprietary platform can be hosted and maintained by any web hosting company.  If your website is built on a proprietary platform, you will be ‘married’ to your web company for the life of your website.

If you decide to fire the web company or if they go out of business, you will lose your website and have to hire someone else to build a new one. It is extremely inefficient and costly to rebuild your site every time you switch your web company.


Wordpress is one of the most popular, stable and versatile open-source web platforms. In my opinion, it is so far the best platform for a practice website. Many features – online scheduling, review widgets, online patient forms – easily integrate with Wordpress. Plus, only an open source platform allows you to truly own your website.

Your website is one of the most important marketing tools, and I believe that it should be fully under your control. Websites should be built to last and doctors should invest in improving and growing their websites rather than rebuilding them over and over multiple times.Essentially, you don’t own a website that is built on a company’s proprietary platform. You cannot control what happens to your website, you usually cannot invite outside web designers or marketing specialists to work on your website (which may result in technical and SEO issues), and you cannot take your website and host it elsewhere. You are only renting your website by paying a monthly fee to your web design company that owns it.

I recommend that you avoid vendor lock-in and instead retain the freedom and flexibility to work with any web designer in the future without losing your website. Using a nonproprietary platform is the only way to own your website. Not only will this approach prevent vendor lock-in but it will also save you money.

A web design company that uses their own proprietary platform usually charges high monthly fees for hosting – typically anywhere from $85 to $150 per month based on our analysis of multiple platforms and vendors as of 2020.

By contrast, a website that is developed on a nonproprietary platform can be hosted by any independent hosting provider (GoDaddy, Bluehost, Siteground, Hostgator to name a few) for only $10-$25 per month. To minimize your ongoing website maintenance expenses and to retain the ownership of your website, you will need to register your own hosting account with a reputable website hosting company (see our WCI article for hosting recommendations), find a web design company that uses a nonproprietary platform such as Wordpress, and have them set up your website on your hosting account.

A good website should last many years. When you review web design proposals, consider not only the initial price but also the future costs. I suggest that you do a cost-benefit analysis and compare the long-term accumulated costs of renting vs. owning your website. In other words:


Owning a website: a one-time fee for a custom website built on Wordpress or another nonproprietary platform, the cost of writing custom content, a low monthly fee ($10-$25 on average) for hosting the website with an independent hosting provider, and retaining your web designer for future on-demand updates billed at an hourly rate,


Renting a website: an initial fee to build a custom website on a proprietary platform, the cost of writing custom content, a high monthly fee ($85-$150 on average) for hosting your website with the web design company, and fees for any future updates – whether monthly, on-demand, or both. Keep in mind that rental websites are usually cookie-cutter customized templates. Further customization of your template will likely cost you extra.


A cost-benefit analysis will show you clearly how your monthly fees accumulate, at what point the accumulated monthly fees for a rental website exceed the one-time fee you would have paid for your own website, and after what point you start overpaying for your rental website. As always, feel free to reach out if you have any questions or need advice.




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2 thoughts on “How to Evaluate Web Design Proposals for Your Medical or Dental Practice”

    • It depends on what kind of website you are trying to build, what features you need, whether you want to write your own content for the website or want the web company to write custom content for you, and other factors. Feel free to reach out to me through my company’s contact page: https://ninainteractive.com/contact/ and I will be happy to give you more information about pricing for your custom website.


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