47.66° N 117.43° W Summit · Profitable Growth
Google Ads for medical practices
I separate new-patient calls from reschedules and hang-ups, send the booked appointment back to Google by click ID alone, and move the budget that is going to dead search terms into the ones that book. Then the bidding learns from patients, and nothing about why they called leaves the practice.
01 The problem
In my Q3 2026 benchmark, phone calls were a median 100% of the leads healthcare accounts counted, and 5 of 8 counted calls as their only lead (N = 8). So the definition of a call decides the whole account. Count every call and the cost per lead looks cheap, while the front desk spends the morning on reschedules.
The usual fixes are harder in medicine. The audience tools other industries lean on are restricted for health advertisers, every vendor that touches a patient identifier needs a signed agreement, and sending the booked appointment back to Google is the easiest place to leak something you shouldn't. The full rule-by-rule detail is in the medical practice marketing library.
02 The diagnostic
In priority order. The later fixes depend on the earlier ones being right.
Most practice accounts treat any call from an ad as a lead. A ten-second hang-up, an existing patient moving an appointment and a pharmacy calling back all count. The cost per lead looks good and tells you nothing about new patients.
The appointment is made in the practice management system, often days later and sometimes from a different phone number. Google never hears about it, so Smart Bidding learns to buy calls rather than patients.
Remarketing lists, Customer Match and lookalikes are standard everywhere else. In health they run into Google's personalized advertising rules and Meta's Custom Audiences terms. I find them still switched on in practice accounts more often than I should.
Call tracking, form handlers, scheduling widgets and the inbox the lead lands in all receive something that can identify a patient. Each needs a signed agreement on the plan you pay for. The gaps are usually in tools nobody thinks of as medical software.
In my Q3 2026 benchmark every healthcare account lost more than 28% of its search impression share to budget (N = 8), while a median 26.5% of visible search-term spend went to terms with zero conversions (N = 6). The money to fund the good terms is already in the account.
A call at 9pm reaches voicemail. Off-hours cost per lead ran a median 1.4x the 8am to 5pm figure in the same benchmark (N = 6). Most accounts still bid the same around the clock.
03 The playbook
Six moves in the first 90 days, tracking first. The architecture is in the Lead Quality Stack.
I start with the CLOSE Audit and a list of every tool that receives a name, a number or an email from someone contacting the practice. For each one: does the vendor sign a business associate agreement, and does it cover your plan. Your compliance officer makes the call on that list. I make sure it is complete.
I separate new-patient calls from everything else with call length, a dedicated tracking number and the front desk's own outcome codes. The account moves to one primary conversion that means a possible new patient. The cost per lead goes up on paper and starts meaning something.
When an appointment is booked, Google receives a click ID, a timestamp and a value. Nothing about a condition, a procedure or a department, and no conversion action named after one. The click-ID path sends no personal identifier at all. That is the line where most setups quietly go wrong.
I cut the search terms that spend without converting, then put that budget into the campaigns that run out of money first. In a budget-capped account that is the fastest lift available, and it needs no new spend.
Ad schedules follow the front desk. Off-hours traffic goes to a booking path that works without a person, or gets bid down. A call that lands in voicemail is paid for at full price.
Google approving an ad does not mean your state medical board would. Superlatives, credential language, testimonials about outcomes and before-and-after imagery get flagged for your review before launch. I also sort the keyword policy labels that look like rejections from the ones that are.
What I am not: I don't decide what a practice may disclose, I don't write the policy, and I won't tell you a setup is compliant. That belongs to your counsel or compliance officer. I build the pipeline so the question they answer is narrow, and hand them the specifics.
04 The proof
What I measure in healthcare right now
My Q3 2026 benchmark covers 8 healthcare Google Ads accounts I manage. The median cost per tracked lead was $39.54 across the 6 with clean tracking (N = 6). All 8 put their spend into Search and none ran Performance Max (N = 8). Two had tracking I couldn't trust, so they are left out of cost per lead and kept in every tracking finding.
$39.54
Median cost per tracked lead (N = 6)
12.1%
Median conversion rate (N = 6)
35.4%
Median search impression share (N = 8)
Cost per lead by specialty, with the N on every row and a CSV, is in the healthcare benchmark report.
The documented transformation
The closed-loop method is written up on a real-estate law firm I run. I cut ad spend by 50%, doubled qualified signups, and brought cost per lead down by more than 60%, inside 90 days. A practice runs on the same engine: a call, a system that knows who booked, and that outcome sent back to Google.
05 Engagement levels
Every account starts with a 30-minute call where I tell you which one fits. Pricing here is directional. The real quote comes on the call.
Tracking Sprint
The diagnosis and the plumbing. The CLOSE Audit, the vendor inventory, a real new-patient conversion and the booking import, so the account measures patients instead of calls.
One-time project
Lead Quality + Channels
The Sprint plus ongoing management of Search against booked appointments. I run the account, keep the search terms clean and reconcile calls against bookings every month.
Ongoing · month-to-month
Fractional Marketing Lead
The whole program for a practice or a group. Search, listings, landing pages per service line and the booking loop maintained as providers, locations and phone systems change.
Ongoing · month-to-month
06 Fit
Who this is for
Who this isn't for
Ready to talk
I'll run the CLOSE Audit on your account, list the vendors that need an agreement, and tell you whether the booking loop will move the number. Same person on the call as on the keyboard. If it fits, the Sprint comes first.
Want the rules first? Work through the medical practice marketing library, or email hi@connercrowe.com.
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