3,289
2,527 Messenger conversations started by the patient, and 762 lead form submissions with contact details attached. $31,695 spent across twenty four months, $9.64 per lead.
Reincke Vein Center
55% more patients on exactly the same budget
Two years, 3,289 leads, and a monthly budget that never moved outside $1,042 and $1,448. Year two produced 55 percent more leads than year one on 3 percent less money, which means every gain came from the work rather than from spending more.
3,289
leads in 24 months
$9.64
average cost per lead
38%
cheaper in year two
$1,320
average monthly budget, unchanged
The account
A fixed budget and nowhere obvious to find more patients
Reincke Vein Center runs Meta on a set monthly figure. Not a starting figure to be scaled once something works, a fixed one. Across twenty four months it never moved outside $1,042 and $1,448, and the average was $1,320.
That rules out the usual answer. Most account improvements are really budget increases wearing a disguise: more money in, more leads out, cost per lead roughly flat, everyone pleased. With a fixed budget there is nowhere to hide. Either the same money buys more or the account stays where it is.
The first year sat at 107 leads a month at $12.49 each. Respectable for vein care, and going nowhere.
In late 2024 the account was doing what a lot of medical Meta accounts do. It reached a great many people very cheaply. November 2024 put ads in front of 67,196 people at $4.28 per thousand impressions, and produced 87 leads.
Cheap reach looks efficient in a report and is usually the most expensive thing in the account. Those impressions went to people with no particular reason to want vein treatment, and the same people saw them 4.65 times each.
The work was to reverse that trade. Tighter targeting costs more per thousand impressions and reaches fewer people. It also reaches people who respond. By August 2026 the account was paying $18.48 per thousand, reaching 28,055 people, and producing 156 leads.
Less than half the audience. Nearly twice the leads.
The work
Stop buying cheap attention and start buying the right attention
Five things changed across two years. The one that mattered was accepting a higher price per thousand impressions in exchange for reaching fewer, better people.
Step 01 of 05
01
Count every way a patient makes contact
The account produces two kinds of lead: a form submission with a name and number attached, and a Messenger conversation the patient starts themselves. Both come from someone who saw a targeted ad, read it, clicked, and did something.
Counting only form submissions would have shown 762 leads across two years. Counting both shows 3,289. Practices that measure only forms often conclude Meta does not work for them, when most of their contact volume is arriving somewhere nobody is looking.
02
Narrow the audience and accept the higher price
Cost per thousand impressions went from $4.28 to $18.48 across the two years. On its own that reads like a failure. It was the point.
Broad cheap reach was replaced with tighter targeting around the conditions the practice actually treats. Fewer people saw the ads, they cost more to reach, and far more of them were the right people.
03
Stop showing the same person the same ad
In November 2024 the average person in the audience saw an ad 4.65 times. That is how a small budget gets spent on a small group who have already decided not to respond.
Frequency now sits at 2.21. The creative rotates, the audience refreshes, and the budget reaches people who have not already made up their minds.
04
Write ads people actually click
Click through rate went from 0.46 percent to 2.23 percent, nearly five times better.
Some of that is the tighter targeting. Most of it is that the ads stopped describing a clinic and started describing a symptom. Aching legs at the end of the day, swelling that does not go down overnight, veins that have changed. People search for what is wrong with them, not for the name of the treatment.
05
Retarget the people who almost got in touch
Most people who consider a vein consultation do not book on the first visit. A retargeting campaign now runs against people who engaged and did not convert, and it produces leads at a lower cost than any prospecting campaign in the account.
This is the least glamorous part of the work and one of the most productive.
Outcome
Leads
55% more
Year one: 1,288 leads at $12.49. Year two: 2,001 leads at $7.80. Year two spent 3 percent less than year one, so this is not a budget effect.
3.6x
November 2024 reached 67,196 people and produced 87 leads. August 2026 reached 28,055 and produced 156. Less than half the audience, nearly twice the result.
$6.66
March 2026, the cheapest month of the two years. The six months to August averaged $6.91 per lead against $12.49 in year one.
The budget has not changed and there is no plan to change it. What changed is what it buys: 167 leads a month against 107, at $7.80 against $12.49.
The obvious next question is what those leads are worth once they reach the practice. That is the one number Meta cannot see. In healthcare, booked appointments cannot be fed back into the platform, so the account can optimize toward a lead and no further. Everything after that happens on the phone, and it is why we care as much about how quickly a practice answers as about what the ads cost.
Start here
See what your budget can actually buy.
Model your campaign before you commit a dollar, or send us the account and we will tell you what we would change first.