Solved: Healthcare Startup Seeks Advice on Finding Ad Agency

Hi there,

Thanks for reaching out! I'm happy to give you some initial thoughts and guidance on your situation. It's a common spot to be in – you've got something that's working a bit with Google Ads, but you know it could be doing a lot better, especially before you commit more budget. Increasing your ad spend without sorting the foundations is just a faster way to waste money, so it's good you're thinking about this now.

Based on what you've described, I've put together some of my thoughts below. I'll cover the big areas I'd look at first, from your campaign's core objective right through to the agency question. Hopefully it gives you a clear path forward.

We'll need to look at your conversion tracking first...

This might sound obvious, but you'd be surprised how many accounts I see where it's not set up properly. You mentioned your goal is to get more form submissions. That's your primary conversion. Your entire Google Ads account needs to be geared towards that one single goal. If the tracking is even slightly off – if it's double-counting, or not firing every time, or tracking the wrong action – then the whole system breaks down.

Google's algorithm is clever, but it's not a mind reader. When you tell it to 'Optimise for Conversions', it uses the data it gets from your tracking pixel to find more people who look and act like the people who have already converted. If you're feeding it bad data, it's going to go off and find you more of the 'wrong' people. This is often the number one reason why campaigns fail to perform or scale. It's the bedrock of the whole operation.

So, the very first thing to do is a full audit of your conversion tracking. Make sure you have one primary conversion action (the form submit) and that it's being tracked accurately through Google Tag Manager. I'd also consider tracking secondary, or 'softer', conversions, like clicks on an email address or a certain amount of time spent on a key page. These aren't what you optimise for, but they can give you a fuller picture of user engagement. But for the campaign's bidding strategy, it has to be focused purely on that form submission. No ambiguity.

I'd say you need to fix the website before you spend more on ads...

An ad's job is to get the right person to click. Your website's job is to persuade them to convert. You could have the best ads in the world, but if they land on a page that is confusing, slow, or untrustworthy, you'll just be paying for clicks that go nowhere. This is especially true in healthcare. Trust is everything.

Think about the user journey. Someone has a problem, they search on Google, they see your ad which promises a solution, they click. What do they see next? Your landing page must immediately confirm they are in the right place. The headline should match the promise of the ad. The copy needs to be incredibly clear, persuasive, and focused on the user's problem. You're a healthcare startup, so people will be looking for signs that you are legitimate and professional.

Here are a few things I'd check on your site:

-> A single, clear Call to Action (CTA): What is the one thing you want them to do? Submit the form. That button should be prominent, the text should be clear (e.g., "Request a Demo," "Get in Touch"), and it should be easy to find. Don't clutter the page with dozens of other options that distract them.

-> Trust Signals: This is huge for you. Do you have testimonials from early clients? Logos of any partners or publications you've been featured in? Any certifications or compliance badges (like HIPAA if relevent)? A physical address and phone number? These things might seem small, but they build the subconscious confidence needed for someone to hand over their details.

-> Professional Copy: The words on the page matter. It shouldn't just describe what you do; it should explain how you solve a problem for the user. We often bring in a specialist copywriter for our clients, especially for B2B or SaaS, because it makes such a massive difference to conversion rates. Getting the messaging right can turn a 1% conversion rate into a 3% conversion rate, effectively tripling your results from the same ad spend.

-> Page Speed: If your page takes more than a few seconds to load, people will leave before they even see it. This is a simple but often overlooked factor.

Your current £2k/month spend is more than enough to get data. Look at your Google Analytics. Where are people dropping off? Are they hitting the landing page and leaving immediately? That suggests a disconnect between your ad and your page, or a poor first impression. Are they viewing the page but not clicking the form? That suggests the offer or the copy isn't persuasive enough. Fixing the website is the highest-leverage activity you can do. Every 1% improvement in your conversion rate makes your ad spend 1% more efficient.

You probably should re-evaluate your entire keyword strategy...

Once the tracking and website are solid, the next priorty is making sure you're showing up for the right searches. Google Search Ads are powerful because they capture intent. You're reaching people who are actively looking for a solution. But 'intent' can be broad.

You need to structure your keywords based on how close someone is to making a decision. I usually think about it in a few stages:

1. Problem-Aware Keywords: People who know they have a problem but might not know a solution like yours exists. For a healthcare startup, this could be things like "how to streamline patient intake" or "improving clinical workflow". These are generally broader, higher up the funnel, and might not convert immediately, but can be good for building awareness.

2. Solution-Aware Keywords: People searching for the type of solution you offer. For example, "patient management software", "telehealth platform for private practice", or "electronic health record system". These are your bread and butter. The intent is much higher.

3. Brand/Competitor Keywords: People searching for you or your direct competitors. Bidding on your own brand name is a must to defend against competitors. Bidding on competitor names can be a good strategy to capture users who are actively comparison shopping, but it can be expensive and you need a very compelling ad and landing page to win them over.

Your current campaigns should be tightly focused on those 'Solution-Aware' keywords. You need to get that working and profitable first before you even think about expanding to broader, 'Problem-Aware' terms. Within your ad groups, the keywords need to be incredibly tightly themed. An ad group for "patient management software" should only contain keywords directly related to that, and the ads in that group should speak specifically to patient management. Don't just dump hundreds of keywords into one ad group. That's a recipe for low relevance, a poor Quality Score, and high costs.

Here's a quick example of how you might structure it:

Notice the use of different match types (Broad Match Modifier "+", Phrase Match """). This gives you control over how closely a user's search must match your keyword. Getting this structure right is how you acheive high relevance, which Google rewards with a better Quality Score, leading to lower ad costs and better positions.

You'll need to understand what to expect cost-wise...

This is the big question, isn't it? "What should a lead cost?" The honest answer is: it depends. It's affected by your industry (healthcare is competative), your location, the quality of your ads and website, and your competition. However, we can definitely make some educated estimates.

For B2B leads in developed countries, a click (CPC) can be anywhere from £2 to £10, sometimes much more for very specific, high-value terms. Let's be realistic and say your average CPC is £4. Now, what's a reasonable conversion rate for your landing page? A decent, optimised page might convert at 5%. A really good one might hit 10%. A poor one will be 1% or less.

Let's do the maths:

-> Scenario 1 (Okay-ish page): £4 CPC / 3% Conversion Rate = £133 Cost Per Lead (form submit).
-> Scenario 2 (Good, optimised page): £4 CPC / 7% Conversion Rate = £57 Cost Per Lead.
-> Scenario 3 (Exceptional page + great ads): £3 CPC / 10% Conversion Rate = £30 Cost Per Lead.

You can see how much of an impact the landing page conversion rate has. It's often more important than the click cost itself. Your current £2k/month budget could get you 15 leads, or it could get you 66 leads, all depending on your website's performance and campaign optimisation.

I remember one client, a medical job matching SaaS, that had a Cost Per User Acquisition (CPA) of around £100. By completely restructuring their campaigns and rewriting their ad copy, we reduced that to £7 using Meta Ads and Google Ads. Also, I recall a B2B software client where we were getting decision-makers to fill out lead forms for around $22 per lead using LinkedIn Ads.

Finally, we'll need to look at who should run the ads...

So, the big question: agency or freelancer? There's no single right answer, it depends on what you need. A good freelancer can be excellent, but they might be a single point of failure if they get sick or go on holiday. An agency usually offers a team-based approach, so you have more backup and potentially a wider range of skills (e.g., a strategist, a copywriter, a technical specialist).

Regardless of which you choose, your selection process should be the same. Here's what you need to look for:

-> Relevant Case Studies: This is non-negotiable. Don't just look for pretty logos. Ask to see detailed case studies of clients similar to you. A healthcare startup is not the same as an ecommerce store selling t-shirts. Have they worked with B2B? With SaaS? With healthcare? Have they delivered tangible results, specifically around lead generation and lowering cost-per-conversion? For instance, we can show potential clients results from the medical job matching SaaS client, or the 1535 trials we generated for another B2B SaaS using Meta Ads. That kind of specific, relevant proof is what you're looking for.

-> Real Expertise on the Call: Get them on a call. A good sign is if they offer some kind of free initial consultation or account review. This is your chance to see how they think. Do they ask smart questions about your business and your customers? Do they offer genuine insights and initial advice, or just give you a vague sales pitch? You should walk away from that first call feeling like you've learned something. Tbh, if someone is just promising you the world ("we'll triple your leads in a month!"), be very wary. No one can truly promise specific results in paid advertising; there are too many variables.

-> Transparency and Reviews: Check their reviews online. What are other clients saying about working with them? Look for themes around communication, reporting, and of course, results.

A word of caution: if you've done all this, you've seen their case studies, you've had a great call where they've shown real expertise, and you feel good about them... trust that. If you then ask to speak to one of their current clients for a reference, it can sometimes be a red flag for the agency. It signals a lack of trust right from the start, which doesn't make for a great partnership. The case studies and the expertise shown on the call should really be enough to make a decision.

This is a lot to take in, I know. The key takeaway is that you need a systematic approach. Don't just throw more money at the problem. Fix the foundations first.

This is the main advice I have for you:

Implementing all of this correctly and managing it day-to-day takes a lot of time and deep expertise. It's not just about setting things up and letting them run; it's a constant process of testing, analysing, and optimising. This is where working with a specialist can make a huge difference, allowing you to focus on running your startup while we focus on getting a steady stream of qualified leads in the door for you.

I hope this detailed breakdown has been helpful and gives you a much clearer idea of what needs to be done. If you'd like to have a chat and have us take a look at your account to give you some more specific pointers, we offer a free, no-obligation initial consultation. We could walk through your current setup togerther and identify the biggest opportunities for improvement.

Let me know if that's something you'd be interested in.

Regards,
Team @ Lukas Holschuh