How to Choose a Google Ads Agency for Your Medical Practice (Red Flags to Watch)

Question 1: Healthcare Experience

Ask: "How many medical practices and med spas have you managed Google Ads for?"

What to listen for: They should name specific verticals (plastic surgeons, dermatology, med spas, dentistry). They should cite numbers: "20+ cosmetic practices," not "we work with healthcare."

Red flag: "We manage Google Ads for all industries." That means they don't specialize. Healthcare compliance, medical keywords, and healthcare CPL benchmarks are completely different from ecommerce or SaaS.

Question 2: Show Me Your Results

Ask: "Can you show me case studies or examples of results from medical practices similar to mine?"

What to look for: Real numbers. "Reduced CPL from $150 to $80 for a med spa," "Achieved 12% conversion rate for a plastic surgery practice." Not vague: "We're experts at growth."

Ask for specific metrics: • What was their starting cost per lead? • What did it drop to? • How long did optimization take? • What's their typical cost per consultation for your vertical?

Red flag: "We can't share case studies due to NDAs." That's fine, but they should offer anonymized data or at least one public case study.

Question 3: What's Your Reporting?

Ask: "What metrics do you report monthly? Show me a sample report."

What to look for in their report:

✓ Cost per consultation (not just CPL)
✓ Conversion rates by keyword group
✓ Landing page performance
✓ Month-over-month trends
✓ Specific recommendations for next month

Red flag: They show only CPC and impressions. That's not a report, that's a status sheet. You need cost per consultation to know if you're profitable.

Question 4: How Do You Charge?

Ask: "What's your pricing model? Retainer, performance-based, hybrid?"

Retainer Model ($1,500–$5,000/month):
Pros: Predictable cost, agency is incentivized to improve your account
Cons: You pay whether account performs or not

Performance Model (20–40% commission on ad spend):
Pros: You only pay if they spend; lower risk for you
Cons: Can incentivize inflated spending; less predictable monthly cost

Hybrid (Small retainer + commission):
Pros: Best of both worlds; agency shares risk, you have predictability
Cons: More complex pricing

Red flag: They demand 6+ month contracts upfront with termination penalties. Good agencies trust their results and don't force long-term locks.

8 Red Flags to Walk Away

🚩 Flag 1: They Guarantee Results
"We guarantee $50 CPL" or "We guarantee 20% conversion rate." No one can guarantee this. Algorithms change, markets shift, landing pages vary. Agencies that promise specific results are either lying or don't understand Google Ads.

🚩 Flag 2: They Don't Ask About Your Business
Good agencies ask: What's your patient lifetime value? What's your profit margin? How many new patients can you handle? If they jump to "Let's run $5,000/month" without understanding your business, they're not thinking strategically.

🚩 Flag 3: No Mention of Compliance or HIPAA
Healthcare advertising is regulated. A good healthcare agency should ask about HIPAA requirements, compliance concerns, and review your ad copy for legal compliance. If they never mention it, they're not thinking like a healthcare specialist.

🚩 Flag 4: They Want Total Control, No Transparency
"We don't give clients access to the account" or "We handle everything." You should have read-only access to your Google Ads account. You should see the reports. Opacity is a red flag.

🚩 Flag 5: Weak on Conversion Tracking
If they can't explain how they'll track form submissions, calls, and appointments, they don't understand healthcare metrics. This is non-negotiable.

🚩 Flag 6: Generic Pitch, Not Customized
They send the same proposal to every prospect. It's not tailored to your vertical, your market, or your goals. They're selling a generic service, not a customized solution.

🚩 Flag 7: No Strategy Call Before Onboarding
A good agency does a 30–60 minute strategy call before you hire them. They research your market, your competition, your business model. If they're ready to start immediately without discovery, they don't care about strategy.

🚩 Flag 8: They Blame Everything on Your Landing Pages
"Your conversion rate is too low because your landing page is bad." Sometimes yes, but if every issue is "your landing page," they're not optimizing the ads. A good agency takes responsibility for both.

Green Flags (What to Look For)

✅ They have healthcare case studies or references
✅ They explain their process in detail
✅ They ask thoughtful questions about your business
✅ They report cost per consultation
✅ They mention compliance and HIPAA
✅ They offer performance-based or hybrid pricing
✅ They give you account access
✅ They do a thorough strategy call first

What to Ask Existing Clients

If the agency gives you references, ask:

"Did they improve your cost per lead?"
"Did you see ROI within 90 days?"
"Would you recommend them?"
"Are they responsive to questions?"
"Do they ever recommend scaling back instead of spending more?"

That last one is key. A good agency tells you when you're spending enough and doesn't always push for more budget. They prioritize your ROI, not their commission.