Demand that already exists

For most single location practices, somewhere around 2,500 dollars a month in ad spend is the point where the account has enough data to improve itself. Below roughly 1,500 you are buying so few clicks that every week looks like noise, and optimization turns into guessing. The real floor depends on what a click costs in your category and your state. Cosmetic and elective procedures in a competitive metro can run fifteen to thirty dollars a click, so a small budget buys very few chances. A less contested specialty in a mid sized market goes much further on the same money. The better question is not what to spend but what a patient is worth to you. If a booked consultation is worth eight hundred dollars and you convert one in four, you can afford a great deal more per click than a practice where it is worth eighty. You can model that yourself before you talk to anyone, and if the figure that comes out is larger than you want to spend, we will say so rather than taking the account and hoping.

Both, if the budget can carry it. They do different jobs and the results are closer than most people expect. We have accounts where Meta outperforms search on cost per booked patient, and not by a little. Search catches people already looking. Someone has decided they have a problem and typed it in, so the distance between a click and a phone call is short. That makes it the fastest way to find out whether the economics work at all. Meta reaches people before that moment. Nobody opens Instagram looking for a dentist, so the ad has to start the thought rather than catch it. That sounds like the weaker job until you look at the numbers on elective and cosmetic work, where seeing a result is what makes someone consider a procedure they had not been thinking about. It is also far cheaper per person reached, and it is how you stay in front of the people who visited your site and did not book, which is most of them. If the budget only stretches to one, start with search, because it answers the economics question faster. But treat that as a starting point rather than the plan. The accounts that work best are the ones running both, with each doing the part it is actually good at.

In healthcare the honest answer starts with a limit most agencies will not mention. In other industries you feed booked revenue back into the platform and let it optimize toward customers who actually bought. You cannot do that with patients. HIPAA means offline conversion data does not go back to Google or Meta, so a form fill and a phone call are as far as the algorithm can ever see. That is not a problem to solve. It is the ceiling everyone in healthcare works under, and anyone promising to optimize toward booked appointments is either misunderstanding it or hoping you do not ask. So if the enquiries are arriving and the appointments are not, the gap is almost never in the ad account. It is in one of two places. The first is the website. Traffic lands on a page built around your credentials and your service list, when the person clicking has a symptom and a question. They cannot see themselves on it, so they leave, or they fill in a form without much intent behind it. That is a build problem, not a bidding problem, and it is where we look first. The second is the front desk. We have watched practices generate plenty of enquiries and lose most of them to a callback that took two days. By then the patient has booked with whoever answered. That is not an advertising problem at all, but it looks exactly like one in the report, and it is the reason we care how quickly your team responds. We check both before touching bids, because bidding is the most expensive way to fix a problem that lives somewhere else.

You will see clicks the first day and enquiries the first week. Whether those enquiries are the right ones takes about a month to judge, because you need enough of them to see a pattern rather than a run of luck. A useful account, one where you know what a patient costs and can turn the spend up with confidence, is usually a ninety day project. The first month buys data, the second month spends it on the things that worked, and by the third the shape of the account is clear. Anyone promising a transformation in two weeks is either inheriting an account that was already close, or telling you what you want to hear.

Either way. If you have an account we take it over, and if you do not we build one from scratch. Neither is a problem. Taking one over is usually preferable, because there is history in it worth keeping: conversion data, search terms that worked, a quality score built over time. Throwing that away to start clean is satisfying and rarely correct. Some accounts need longer to bring back into line than others, particularly where broad match or Performance Max has been spending on searches nobody would have chosen, but none of them are beyond repair. What does not change is ownership. The account is yours, always, and so is everything around it: Google Analytics, Tag Manager, the pixels, the conversion history. We never run ads from our own accounts, because the data belongs to the practice and not to the agency that happens to be managing it this year. If we ever part company you keep all of it, and nothing has to be rebuilt.

Management is a flat monthly fee agreed before we start, not a percentage of your ad spend. A percentage rewards an agency for spending more of your money, which is the wrong incentive to build a relationship on. No long contracts. We work month to month, because an agency that needs a twelve month lock to keep a client has already told you something about the work. The ad budget is separate and goes directly to Google or Meta on your own payment method. We never take custody of it, and you can see every dollar in your own account at any time.

No. Medical is where most of our work is and where the case studies are strongest, but the method is the same for any business where one customer is worth real money and the decision takes more than a click. We run accounts for law firms, flooring contractors, home service companies and specialist retailers alongside the clinics, and the case studies cover both. Someone choosing an attorney and someone choosing a surgeon behave almost identically: high stakes, bought once, decided on trust rather than price, and both will call the firm that answered their question rather than the one that shouted loudest. Where we are not a fit is high volume, low value ecommerce. Different discipline, different tooling, and there are better agencies for it.

A senior with at least ten years in the industry, and the same one throughout. Nothing gets handed to a junior after the contract signs, because there are no juniors here. That is deliberate, and it is why we take a limited number of accounts rather than as many as we could win. Someone is looking at your account constantly, and ProSocial Intelligence covers the hours nobody is. It reads across every account we run and forecasts what is coming, so when we call you about a shift in your market it is usually before you have felt it.