Most medical practices that have been burned by a marketing agency were burned predictably. They hired a generalist who promised healthcare expertise, delivered generic campaigns, reported on impressions, and could never explain why new patient volume did not move. Here is how to avoid that.
The Non-Negotiable Questions
What is your average CPA for my specialty? An agency that cannot answer with a specific number from real accounts either does not manage your specialty or does not track CPA. Walk away from vague answers about 'it depends' without being followed by actual numbers.
Can you show me a case study from a practice like mine? Not a general healthcare case study. Your specialty, your scale, real numbers — spend, conversions, CPA, timeline. Any agency worth hiring has these and publishes them.
Will I own my Google Ads account and all data in it? Non-negotiable. If the agency cannot confirm that the account lives in your name with you as owner, do not sign.
How do you set up conversion tracking? The answer should specifically mention call tracking, form submission tracking, and Google Ads conversion import. 'We track clicks' is not a tracking setup.
Red Flags
Guaranteed rankings or guaranteed new patients. Long-term contracts with no out clause. Reporting that only shows impressions, clicks, and CTR without CPA. Percentage-of-spend fees that incentivize overspending rather than efficiency.
What Good Looks Like
A month-to-month agreement or short initial term because the agency is confident results will retain you. An onboarding process with specific milestones for the first 30 days. Direct access to the person optimizing your account — not an account manager relaying messages. Weekly or bi-weekly reporting that shows actual lead numbers and cost per inquiry, not just traffic metrics.
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