Hi there,
Thanks for getting in touch. I saw your post and understand you're a healthcare startup looking to get more out of your Google Ads. It’s a common situation to be in, especially when you're looking to scale up your budget. I’m happy to give you some of my initial thoughts and a bit of guidance based on my experience running these sorts of campaigns.
It sounds like you're at a bit of a crossroads, trying to figure out the best way forward. Let's break it down a bit.
I'd say you need to be careful picking a partner...
Your first question about hiring an agency versus a freelancer is a really good one. Tbh, with a budget of around $2k a month, you're in a tricky spot. My honest advice would be to lean towards a top-tier freelancer or a smaller, specialised agency rather than a large, generalist one.
Why? Well, from what I've seen, alot of the bigger agencies have high minimums, and for an account your size, you might not get the attention you deserve. You could end up with a junior account manager who's juggling dozens of clients, and your campaign just won't get the strategic thinking it needs to actually improve. With a good freelancer or a boutique agency, you're much more likely to be working directly with the expert. Their reputation is on the line with every client, so they're often more invested in getting you results.
When you're looking for one, the most important thing is to find someone with real, provable expertise. Don't just take their word for it. Here’s what I'd look for:
-> Case Studies: Do they have detailed case studies? And more importantly, are they relevant? Look for experience in services, B2B, or even better, the healthcare or medical space. For instance, I remember working on a campaign for a medical job matching SaaS where we used Meta and Google Ads to reduce their cost per user from £100 to £7. That kind of specific experience is what you want to see. It shows they understand the nuances of a sector like yours.
-> The Initial Chat: When you get on a call with them, do they sound like they know their stuff? A good sign is if they ask you sharp questions about your business, your customers, and your goals, rather than just giving you a sales pitch. They should be able to give you some immediate, actionable advice. We always offer a free initial consultation to review a potential client's account with them. It’s a great way for them to see exactly how we think and for us to see if we can genuinely help. If someone isn't willing to show you their expertise upfront, that's a bit of a red flag.
-> Reviews and Trust: Check their reviews. What are past clients saying? Are the reviews detailed? But ultimately, after you've done your research, you need to feel you can trust them. If you get a bad vibe, or it feels like they're just promising you the world without any substance, walk away. In paid ads, you can't really promise specific results because there are too many variables. Anyone who guarantees a certain ROAS from day one is probably not being straight with you.
Finding the right partner is the first step, but it's not the whole story. Even the best ad manager in the world can't fix a fundamental problem with what happens *after* the click.
We'll need to look at your website first...
You mentioned your goal is to increase conversions, which you've defined as a form submission. This is great – having a clear objective is half the battle. But you're spending money to get people to your site, and they're not converting. The immediate reaction is often "the ads are broken", but more often than not, the problem lies with the landing page or the website itself.
Before you even think about increasing your ad spend, you have to plug the leaks in your bucket. Otherwise, you're just pouring more water (and money) into something that can't hold it. Here’s where I'd start looking:
-> First Impressions & Trust: This is huge, especially for a healthcare startup. When a potential patient lands on your page, do they feel they're in a safe, professional, and trustworthy place? The design needs to be clean, modern, and reassuring. The copy needs to be flawless. Any spelling mistakes, dodgy-looking design, or slow-loading pages will send people running for the hills. I wouldn't feel comfortable giving my personal health information to a site that looks unprofessional. You need to build instant credibility. Things like trust badges, professional affiliations, testimonials, and clear contact information are not just nice-to-haves; they're essential.
-> Clarity and The Offer: Is it immediately obvious what you do and why someone should fill out that form? What's in it for them? The journey from the ad to the form submission needs to be seamless. If your ad promises a solution to 'X', the landing page better be all about 'X'. Your headline and copy need to speak directly to the user's problem and present your service as the clear, simple solution. A good copywriter can make a world of differance here.
-> The User Journey Drop-off: You need to look at your analytics. Where are people dropping off? Do you get lots of clicks but very few people even scroll down the page? That suggests your headline or initial offer isn't grabbing them. Do people get to the form but don't fill it out? Maybe the form is too long, asks for too much sensitive information too soon, or there's a technical issue. You have to diagnose the problem before you can fix it. I remember one client whose landing page was just a mess. We helped them redesign it and rewrite the copy, and their conversion rate shot up by over 300% without us even touching the ads yet.
Only once your website is a well-oiled conversion machine does it make sense to start optimising the ads that send traffic to it.
You probably should rethink your Google Ads strategy...
Okay, assuming your website is in good shape, let's talk about the Google Ads campaign itself. "Optimisation" can mean a lot of things, but for a service-based business like yours, it usually boils down to a few key areas.
Your main goal is to get in front of people who are actively looking for the help you provide. That's why Google Search ads are the right place to start, as opposed to social media where you're interrupting people. For search, it’s all about intent.
-> Keyword Targeting: This is the foundation of your entire campaign. Are you bidding on the right keywords? You need to get inside the head of your ideal patient. What phrases would they type into Google when they have a problem you can solve? You should be targeting keywords with clear commercial intent.
For example, keywords like:
- "private healthcare provider near me"
- "online doctor consultation"
- "book specialist appointment online"
- "urgent care clinic [your city]"
-> Ad Copy & Extensions: Your ad is the bridge between their search and your website. It needs to be compelling and relevant. It should mirror the language of their search query and present a clear call-to-action (e.g., "Book Your Consultation Today"). You should also be using every relevant ad extension available – sitelinks for different services, call extensions so people can ring you directly, and location extensions if you have a physical clinic. These make your ad bigger and more useful, which increases your click-through rate (CTR).
-> Campaign Structure: A common mistake is lumping all your keywords into one ad group. You should structure your campaigns into tight, thematic ad groups. For example, one ad group for 'online consultations', another for 'specialist appointments', and so on. This allows you to write highly specific ads for each theme, which improves relevance, Quality Score, and ultimately lowers your cost per click. You should always be split testing your ad copy within these groups to find the winning message.
Getting this structure right is how you move from just "running ads" to running a strategic campaign that drives qualified leads.
You'll need realistic expectations on costs...
A big question is always: "What should I be paying for a lead?". The honest answer is, it depends. For service businesses, we've seen costs vary wildly. We've had a home cleaning client get leads for £5, while an HVAC company in a competitive city pays around $60 per lead.
For healthcare, it will likely be on the more expensive side due to competition and regulation. You're probably looking at a Cost Per Lead (CPL) in the $20-$60 range, but it could be higher. The key is to figure out what a lead is worth to you. If you know your close rate (how many leads become patients) and the average value of a patient, you can work out your maximum allowable CPL.
Here's a simple way to think about it:
| Metric | Example Calculation |
|---|---|
| Average Cost Per Click (CPC) | Let's estimate $3.00 (it's a competitive niche) |
| Landing Page Conversion Rate (CVR) | A decent rate would be 5% (i.e., 5 out of 100 visitors fill the form) |
| Estimated Cost Per Lead (CPL) | CPC / CVR = $3.00 / 0.05 = $60 |
As you can see, improving your conversion rate has a massive impact. If you could get your CVR up to 8% through website improvements, your CPL would drop to $37.50. That's why we always focus on the landing page first. Your budget of $2k a month would then get you around 53 leads instead of 33. That's the power of optimisation.
This is the main advice I have for you:
I know this is a lot to take in. To make it simpler, I've broken down my main recommendations into a step-by-step plan for you to think about.
| Step | Action | Why It's Important |
|---|---|---|
| 1. Find the Right Partner | Prioritise a specialist freelancer or small agency over a large one for your budget. Vet them thoroughly based on relevant case studies and their expertise shown in an initial call. | Ensures your account gets the senior-level attention and specific expertise it needs to actually grow, rather than being a small fish in a big pond. |
| 2. Audit Your Website & Funnel | Critically analyse your landing page for trust signals, clarity of message, and ease of use. Use analytics to find where users are dropping off before converting. | Fixing a "leaky bucket" is the highest-leverage activity. It increases the conversion rate for all your traffic, making your ad spend far more efficient. |
| 3. Restructure Google Ads | Rebuild campaigns with tight, thematic ad groups. Focus on high-intent keywords, write compelling ad copy, and use all relevant ad extensions. Constantly split test. | This improves relevance and Quality Score, leading to a higher click-through rate and a lower cost per click, which directly lowers your cost per lead. |
| 4. Set Realistic KPIs | Calculate your maximum allowable Cost Per Lead (CPL) based on your patient lifetime value and close rate. Use this to benchmark campaign performance. | Stops you from flying blind. It gives you a clear target for success and allows you to make data-driven decisions about which campaigns to scale and which to kill. |
Trying to manage all of this yourself, especially when your primary focus is running a healthcare business, can be tough. It’s not just about setting up some ads; it's a continuous process of testing, learning, and optimising across the entire user journey. This is where getting expert help can really pay off, saving you from wasting time and money on strategies that don't work.
Hopefully, this has given you a clearer framework for how to move forward. If you'd like to have a more detailed chat, we could book in a free consultation to go through your account and strategy together. It might help you get a much clearer picture of the specific opportunities you have.
Regards,
Team @ Lukas Holschuh
