Run Google Ads for your clinicwithout wasting the budget

What you will have at the end.

A campaign structure that mirrors your service categories, a first negative keyword list, a weekly review you can do in forty minutes, and daily budgets derived from a monthly target.

Paid search works for clinics because the intent is already there. Somebody typed the thing they need. You are not creating demand, you are catching it. That is also why it is unforgiving: every mistake costs real money the same day you make it.

Structure

1. One campaign per service category, and nothing else

   Your campaigns mirror the categories you wrote in your marketing plan. Not one per treatment, not one per keyword, not one called General. The reason is that budget and reporting live at the campaign level, so the level you split at is the level you can control and read.

   A category you marked leave alone does not get a campaign. That is what the verdict was for.

   —Name campaigns so you can read the account in a list: category, geography, type. For example Restorative | Metro | Search.

   —Separate the campaigns whose budgets you want to control independently. If you would never move money between two of them, they are separate.

   —Do not split a category into five campaigns to get more control. You get less, because each one now has too little data to learn from.

2. Two or three ad groups per campaign, grouped by what the person meant

   Inside a campaign, split by intent rather than by wording. Someone typing the name of the treatment, someone typing a symptom, and someone typing an emergency phrase are three different people with three different messages.

   —Treatment intent: they know what they want and are choosing a provider.

   —Symptom intent: they know the problem, not the solution. This group needs a different ad and often a different landing page.

   —Urgency intent: today, tonight, walk-in, emergency. Highest value, smallest volume, worth its own group.

   In practice

   Ten keywords per ad group is plenty. Accounts with two hundred keywords per group are not more thorough, they are unreadable.

3. Set geography by where patients actually come from

   Pull the postal codes of your last two hundred patients and look at the shape. It is almost never a clean circle, and it is almost always smaller than the radius you would have guessed.

   —Target the area people actually travel from, not the area you wish they did.

   —Set the location option to people in your area, not people interested in your area. The second setting is the default in some account types and it will show your ads to people planning a trip.

   —Exclude the neighborhoods you cannot realistically serve, especially across a bridge or a long commute.

Negatives, done properly

1. Build the first negative list before you turn anything on

   Every clinic wastes money on the same families of query on day one: jobs, training, free, do-it-yourself, students, the name of a service you do not offer, and the names of conditions you do not treat. Load those before the first click.

   —Employment: job, jobs, hiring, salary, career, resume.

   —Learning: course, school, training, certification, how to become.

   —Free and cheap: free, no cost, cheapest, discount, coupon.

   —Self-treatment: at home, home remedy, diy, natural remedy.

   —Services you do not provide, named explicitly.

   —Any nearby city you do not serve.

2. Find the real waste with n-grams, not query by query

   Reviewing search terms one at a time is slow and it misses the pattern. The better method is to break every query into its individual words and two-word pairs, then total the spend by word. The waste jumps out immediately.

   This is the single highest-leverage habit in a clinic ad account.

   —Export the search terms report with cost and conversions.

   —Split each query into single words and adjacent word pairs.

   —Total the cost and the conversions for each word and pair.

   —Sort by cost with zero conversions. The words at the top are your negatives.

   —Add the word as a negative once, rather than adding forty individual queries that share it.

   In practice

   You will find words you would never have guessed. A clinic that discovers it has spent four figures on a word like reviews, or like near, learns more in ten minutes than in a month of query-by-query review.

3. Put each negative at the right level

   A negative at account level applies everywhere. A negative in one campaign applies only there. Getting this wrong is how clinics accidentally block their own best category.

   —Genuinely irrelevant words, such as job or free, go on a shared list applied to every campaign.

   —A word that is waste for one category but valuable for another goes only in the campaign where it is waste.

   —A competitor name never goes in the campaign that is deliberately targeting that competitor, which sounds obvious and is a mistake people make every month.

The weekly routine

1. Forty minutes, same day every week

   Paid search is not a set-and-forget channel and it is also not a full-time job. Forty minutes a week, on a fixed day, covers it for a clinic.

   —Search terms, through the n-gram method. Add negatives. Ten minutes.

   —Spend against the monthly target, using the pacing math below. Adjust daily budgets. Ten minutes.

   —Conversions reported against appointments actually booked. Ten minutes.

   —Anything that changed sharply, up or down, and why. Ten minutes.

   In practice

   Do not change bids, budgets and ad copy in the same week. When something moves you will not know which change did it.

2. Pace the budget on calendar days

   The platform spends on calendar days, including the days your ads do not run. So the math that keeps you on target uses calendar days, not business days, even if you only advertise on weekdays.

   The calculation is short. Take what remains of the monthly target, divide by the number of calendar days left in the month, and that is your new daily budget.

   —Remaining budget = monthly target minus spend so far.

   —Remaining days = calendar days left in the month, including today.

   —New daily budget = remaining budget divided by remaining days.

   —Recalculate weekly, not daily. Daily adjustment creates whiplash and stops the system learning.

The automated campaign types

1. Know what you can and cannot steer in an automated campaign

   The fully automated campaign type spreads across search, display, video, mapping and mail placements at once. For clinics it can work, and it comes with real limits you should know before you fund it.

   —You cannot choose which networks it runs on. That is not a setting, it is the design.

   —Device targeting is all or nothing rather than a bid adjustment.

   —Its reporting is far less granular than a search campaign. You will not get the same view of what produced what.

   —It will happily bid on your own clinic name, which makes the results look excellent and tells you very little.

   In practice

   If you run one, add your own clinic name as a negative in the account-level list, and compare its results against your search campaign on cost per booked appointment rather than on cost per conversion.

2. Reconcile reported conversions against real appointments

   Once a month, take the number of conversions the platform reports and the number of new patients who actually booked from paid search, and put them side by side. They will not match. What matters is whether the gap is stable and explainable.

   —Reported far higher than real: something is counting more than once, or counting a page view, or counting your own team.

   —Reported far lower than real: people are calling instead of booking online, or the identifier is not surviving the hop into your booking tool.

   —A stable gap you can explain is fine. A gap that changes month to month means your measurement is broken.

When it goes sideways