The first dollar
Google Search
Patients search at the moment of need.
Condition and procedure campaigns meet a decision already in motion.
Paid patient media
Paid reach, only where your patients actually look
Patients scroll when they are fine and search when they need care. Your budget goes to the moment of need, starting with Google Search, and every dollar is tracked to the appointment it became.
Ad spend is separate from the plan and goes to the ad platforms, not to us. If paid media does not fit your market yet, we say so before a dollar is spent.
The moment we pay for
Illustrativeknee specialist near me
Ad
the page about that one procedure
Your practice
The ad points at the page that answers the search, with one way to book.
everything else on the results page
The request this creates is counted in PulseTrack, against the dollar that bought the click.
The mechanism
Intent beats impressions
An impression is a patient scrolling past. Intent is a patient searching for care they need this week. Only one of those is worth paying for, so the budget starts where intent is highest and stops where it is not.
Channel discipline
Google Search first. The rest earn their place
Five surfaces, one discipline: a channel earns budget with a written fit case for your specialty and your market, and keeps it only while the numbers hold.
Earns its place, or gets no budget
What earns it budget
Where that holds
Meta (Facebook and Instagram)
- What earns it budget
- Visual, elective specialties where patients browse before they choose.
- Where that holds
- Med spa and cosmetic dermatology, most often.
Nextdoor
- What earns it budget
- Care chosen on proximity and neighborhood trust.
- Where that holds
- Primary care, pediatrics, and dental, in the right markets.
YouTube
- What earns it budget
- Considered procedures patients research first.
- Where that holds
- Joint replacement, eye surgery, cardiology screening.
TikTok
- What earns it budget
- Younger elective audiences in large markets, with content a physician can stand behind.
- Where that holds
- Rarely, and only where all of that holds at once.
How we think
Campaigns built on specialty economics
A dermatology practice and an orthopedic group should not run the same campaign shape. What a booked case is worth, and who pays for it, decides the keywords, the budget, and the page each click lands on.
Specialty
The structure
The economics
Worked examples of the reasoning, not case studies. They promise nothing, which is exactly why we can show them.
Dermatology
self-pay vs insurance
- The structure
- Cosmetic and medical run as separate campaigns, with separate budgets and separate landing pages.
- The economics
- Self-pay cosmetic visits can support a higher cost per lead than insurance-billed medical visits. One shared budget lets the cheap click starve the valuable one.
Orthopedics
high case value
- The structure
- A joint program campaign per procedure: knee, hip, shoulder, each with its own ads and pages.
- The economics
- High case value earns competitive keywords, but only when the ad, the landing page, and the request form all speak to that one procedure.
Cardiology
planned vs urgent
- The structure
- Screening campaigns held separate from symptom and referral traffic.
- The economics
- A screening is planned, not urgent. It earns its own budget line so slow, deliberate searches are never crowded out by same-day ones.
How we target
We advertise to intent, not to people.
The ad platforms treat health as a sensitive category. For a medical practice that removes one capability: building and holding a list of people and then advertising to that list. Customer lists, audiences assembled from your own site traffic, and lookalike expansion are all restricted for health advertisers. Search, contextual placement, location, and demographics are not.
So we never build an audience from anyone who read a condition or a symptom page, and we never aim a campaign at a condition or a procedure someone looked at. Not as a compromise: an audience like that is a list of people described by what might be wrong with them, and it is the one asset a practice should never be holding.
What replaces it is the better campaign anyway. A search is a person telling you what they need this week. Aim at the search and the area you serve, point the ad at the page that answers it, and measure the call that follows. That is the whole campaign, and it runs without anything sensitive in it.
Ads describe what your practice offers. They never address a reader as though we know what is wrong with them, which is both a platform rule and a decent instinct.
How a campaign is aimed
What was searched
A search for a knee specialist is a person telling you what they need this week. Keywords are the whole audience.
Where they are
The radius you actually serve, down to the towns patients drive from, and nothing outside it.
When they searched
Weighted toward the hours your phones are answered, so a click has somewhere to land.
Which page answers it
The ad points at the page about that service, so the promise and the landing match.
Every signal above is a moment in time, not a person. The campaign ends at an appointment request, which is the only outcome it needs to know about.
Never built, on any platform, for any specialty
- An audience built from anyone who read a condition or symptom page
- Retargeting tied to a procedure someone looked at
- Your patient list uploaded to an ad platform, hashed or not
- Lookalike or similar audiences seeded from patient data
- Ad copy written as though we know what is wrong with the reader
- Advertising or analytics code inside a patient portal or a logged-in scheduler
What is ours, and what is yours
There is no HIPAA certification for an agency or for an advertising tool, so we do not claim one, and no vendor can make a practice compliant. What we can do is build the campaign side so it never needs anything about a patient, then document it.
We are not attorneys and this is not legal advice. Platform policy moves faster than statute, so we keep campaigns inside the stricter of the two and tell you when something changes. You get a written record of every tracking service on your site, what it sends, and where it goes, so your privacy officer or counsel can review the setup rather than take our word for it.
Measured to the appointment
Every dollar lands in PulseTrack
A campaign that cannot be traced does not run.
PulseTrack · paid media
IllustrativeJoint program · knee
$200per booked
$1,800 spent · 26 calls · 9 booked
Joint program · shoulder
$225per booked
$900 spent · 11 calls · 4 booked
Same-week injury
Paused
$340 spent · 3 calls · 0 booked
paused week 3 · remaining budget returned
The month
$3,040 · 40 calls · 13 booked
What we changed
Shoulder ads rewritten after your front desk told us what callers were asking for. Same-week injury paused; the searches were urgent-care intent, not yours.
Spend to call to booked appointment
Illustrative
- 3,040dollars spent in the month
A campaign that cannot be traced does not run. Every dollar is tied to the campaign that spent it.
- 40calls the campaigns reported
Google and Meta count the calls their own ad formats produced and we read that figure back. Appointment requests are tagged at the source by us, and PulseTrack ties each one to the campaign that paid for it.
- 13appointments booked
Your monthly report reads spend to request to booked appointment in plain language, down to the cost of each booked appointment.
We measure the source and the outcome, never the person.
A paused campaign appears by name, with the reason and where the budget went. Figures reconcile to the same example month shown in the report.
The refusal
The budget we refuse to spend
We would rather return budget than spend it where your patients are not.
Media agencies are paid to spend. We are paid to be right about where, and three operating rules keep that honest.
Fit before spend
A channel earns budget only after the fit case is written down: your specialty, your market, your capacity for new patients.
Attribution always
A campaign that cannot be tracked to inquiries and booked appointments in PulseTrack does not run.
Pause beats pretend
Underperforming campaigns are paused and explained, never hidden inside an average.
Budget questions
Money questions, answered before the call
Ad spend is your money, and the targeting rules are your exposure. These are the answers doctors ask for first, in the same words you would hear on the call.
7answered
right here
Is ad spend included in the monthly plan?
No. Ad spend is separate from and additional to the plan, and it goes to the ad platforms, not to us. The plan covers strategy, campaign build, management, and measurement, and every dollar of spend is visible in PulseTrack.
What is the minimum ad budget?
It depends on your specialty, your market, and what a booked case is worth to your practice, so we discuss minimums on the discovery call rather than publish a number that would be wrong for most practices. If your market does not justify paid media yet, we will say so.
Why Google Ads first instead of social media?
Patients search when they need care and scroll when they do not. Search advertising reaches a decision already in motion, so it takes the first dollar. Social channels are added only when your specialty and market fit them, and dropped when they stop earning their place.
Do you retarget people who visited our condition pages?
No, and we would not recommend it if you asked. The ad platforms treat health as a sensitive category and restrict personalized advertising for health advertisers: audiences you build and hold, customer list uploads, and lookalike expansion are all off the table for a medical practice, separately from anything HIPAA says. We aim campaigns at intent and geography instead, which is where the patients are anyway, and we write ads about the service rather than about the reader's condition.
Do we need a Google healthcare certification to run ads?
Most practices do not. Google's healthcare certification applies to pharmacies, telehealth prescribing, addiction services, health insurance, and drug manufacturers. A dermatologist, orthopedist, dentist, or family physician advertising their own in-person care is not in that group, and being sold certification anxiety is a sign the vendor has not read the policy. If any of your services do fall inside one of those categories, we will say so before anything is submitted, and your counsel should confirm it.
How will we know if the ads are working?
Every campaign is wired into PulseTrack before it spends. You see spend, the calls each platform reported, appointment requests, and booked appointments in one plain-language monthly report, down to cost per booked appointment. If a report needs a glossary, it is not a report.
What happens if a campaign is not working?
We pause it and tell you why. Budget moves to what is earning its keep, and when nothing fits, we hand budget back rather than spend it badly. No campaign runs on autopilot.
Next step
Find out where your patients actually look
A 30-minute call in plain language. You leave with a roadmap for your practice, whether you hire us or not.