How Do I Know If My Clinic's Google Ads Are Actually Working?

Question 1: What Is My Cost Per Attended Appointment?

This requires connecting your CRM appointment data to your Google Ads conversion data. Most agencies do not do this because it requires Offline Conversion Upload (OCU) — feeding CRM appointment data back into Google Ads. Without OCU, Google Ads only sees form fills, not appointments.

How to get the number (approximately, even without OCU):

• Take total Google Ads spend this month
• Divide by the number of new patients who attended (from your CRM or appointment system)
• This gives you an approximation of cost per attended appointment

Benchmark by vertical:

• Dermatology: ₹1,000–3,000 per attended appointment
• IVF: ₹3,000–8,000 per attended consultation
• Hair transplant: ₹2,000–5,000 per attended consultation
• Dental: ₹500–2,000 per attended appointment

If your number is significantly above these benchmarks, either the ads are reaching the wrong audience or the calling team is not converting enquiries. The benchmark helps you locate the problem.

Question 2: Am I Getting the Right Intent of Leads?

Not all leads are equal. A patient searching "IVF treatment cost in Delhi" has made a decision to consider IVF and is price-comparing providers. A patient searching "can I get pregnant after 35" is asking an informational question. Both might fill out your form. Only the first is likely to book an appointment.

ICG's intent tier model classifies search queries into 8 tiers from Branded (highest intent) to Irrelevant (no intent). For a well-run campaign, most of your spend should be on tiers T1–T4 (treatment intent, cost intent, doctor intent, branded).

The quick check: Ask your agency to export your search term report for the last 30 days and highlight the top 20 search queries by cost. Go through each one and ask honestly: "Is this a person who was ready to consider making an appointment?"

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If more than 40% of the queries are informational, research-based, or unrelated to your specific services, the campaign is not targeted correctly.

Question 3: What Is My Lead-to-Appointment Conversion Rate by Campaign?

Some campaigns generate highly qualified leads. Others generate volume with poor quality. Without breaking down conversion by campaign, you cannot tell the difference.

The exercise:

• Take your last month's Google Ads campaigns (ask your agency to share the list)
• For each campaign, note the leads generated
• From your CRM, count how many appointments were set from leads that came from each campaign source
• Calculate: Appointments / Leads = Campaign Conversion Rate

What you will find in most accounts:

• Branded campaigns (searching for your clinic name): 40–60% lead-to-appointment rate
• Treatment intent campaigns: 25–40%
• Location intent campaigns: 15–25%
• General health/condition campaigns: 5–15%

If your branded campaign is underfunded and your general campaigns are overfunded, you are paying premium CPLs for low-converting traffic.

Question 4: What Is My Return on Ad Spend (True ROAS)?

True ROAS = Revenue from patients acquired through Google Ads / Google Ads spend.

This requires knowing which patients came from Google Ads and what revenue they generated. This is where Beacon attribution is essential — it tracks the patient from the initial ad click through to appointment and treatment start, and calculates true revenue per ad-acquired patient.

Without Beacon or equivalent attribution:

• Use the approximate method: Google Ads spend / estimated new patients from Google Ads (based on source tagging in CRM)
• Multiply new patients by average package value for that vertical
• Calculate ROAS

A simplified example:

₹2,00,000 monthly Google Ads spend. 40 new patients attributed (via UTM tracking or source tagging). Average package value ₹18,000. Revenue generated: ₹7,20,000. True ROAS: 3.6x.

A ROAS below 2.5x for healthcare Google Ads is concerning. Above 4x is strong. Between 2.5x and 4x is typical for well-run accounts.

Question 5: Are My Ads Showing When Patients Are Searching?

Impression Share is a metric that tells you what percentage of the time your ads actually showed when they were eligible to show.

Lost Impression Share (Budget): Your ad did not show because your daily budget was exhausted. If this is above 20%, you are missing roughly 1 in 5 eligible searches due to budget constraints.

Lost Impression Share (Rank): Your ad did not show because your Quality Score or bid was too low. If this is above 30%, you have a creative or landing page quality problem.

How to get this data: Ask your agency for the IS (Impression Share) metrics by campaign for the last 30 days. This is a standard Google Ads column — any competent agency can pull it in two minutes.

The Simple Evaluation Scorecard

Ask your agency to fill this in for your account. If they cannot, or if the answers are unsatisfactory, book a second opinion:

If three or more metrics are outside the benchmarks, your Google Ads is underperforming and the conversation with your agency needs to be specific and data-backed — not "we need better results."