Generating New Patients Through Google Adwords – The Definitive Guide

google-adwords-bannerIn this episode, your host Matthew Holmes gives a detailed overview of Google Adwords and the things you need to consider when using it to advertise your practice.  In a break from our usual format the full transcript is available below.

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Welcome to the practicedna Podcast where we interview leaders in the chiropractic profession about what excites them and what has helped make their practice great. Practicedna is brought to you by Clear Health Media your source for automated solutions for ethically patient generation, patient retention and increasing your practice revenue, visit that teaches you how to setup, build and run your own practice.

Hi Matthew Holmes here with another episode of Practice DNA. Today we are going to break from our usual format of interviewing another chiropractor and getting their feedback because I am just going to do a quickly run through a little bit about Google Adwords and Adwords advertising because that has come up a little bit recently with various practitioners that I have been speaking to and there seems to be quite a bit misconceptions amongst chiropractors about what they can achieve and how it works and so forth.

So let’s get to it, now you may be familiar with Google Adwords, it is basically the advertising that shows up across the top of the page when you type in a search to Google as well as some ads that will show down the right hand column of the page as well.

Now, why would you want to be sort of considering using this type of advertising for your practice. Now, one of the real strengths about using this types of advertising materials is that Google Adwords is really the best place to get in front of people that are looking for your services right now, ok.

It used to be in the old days that what would happen is that you would pick up the yellow pages and you would look up chiropractor or whatever the patient was particularly looking for, they would get the phone number and they would ring you and they are all ready to take action straight away.

Now, these days with the advent of the internet and so forth we all know that yellow pages is kind of died a bit of a death and the reason is obviously that people are now searching online. So when they go to Google and type in the name of your town and then your profession trying to look, for example Melbourne chiropractor or something like that, there in it is what is known as a buying situation or a situation where they are ready to take action and they are ready to do something about their problem straight away.

Now, the type of action that they are going to take is going to vary, it may just be that they are in this situation where they are researching and they are getting a little bit more information about the type of problem that they have. Or they may be actually ready to do something about it and book an appointment and come in. This is one of the beautiful things about Google Adwords is that because Google is the biggest search engine on the internet they have got something like seventy per cent of the market, by advertising on them you have a very good chance of getting in front of somebody when they are really looking for your types of services.

So that is why Google Adwords can be particularly beneficial for your practice. Now the problem with is that everybody else is jumping on the band wagon and as a result it’s becoming more and more expensive to advertise on Google.

Now, one of the things to be aware of is that the way that you set up that Google Adwords account is that you pick things called keywords and these keywords are what people are actually searching for online.

So for example they might be looking for back pain treatment Melbourne, now, there is going to be lots of people who are potentially going to be interested in bidding on the term back pain treatment Melbourne like for example there is going to be physiotherapists, osteopaths, chiropractors, acupuncturists, you know, orthopaedics specialists, GPs even, the whole spectrum of people that are going to be potentially interested in bidding for that term and as a consequence it is going to be relatively expensive to try and advertise for that, ok.

One of the ways that you can get around that is that you can actually be using what is known as a long tail keyword. So this is where people have extra what is known as search modifiers added into it, so for example they might be looking for the best low back pain treatment, Melbourne for example and the fact that it has got the best on the front of it means that there is going to be fewer people searching for it but this correspondingly potentially going to be fewer advertisers bidding for it and so as a consequence you can be paying less for those particular terms.

Now I am kind of getting ahead of myself here so hopefully I haven’t lost you there but let us sort of do a little bit of a detour back and let us talk about some of the different advertising possibilities that Google offers.

The main one that we are going to talk about first of all is one that is called search advertising and search advertising is really what I explained to you then where somebody goes to Google search engine or one of the partners that Google has partnered with because there is a couple of other search engines that uses Google’s ads and they might type in a search phrase like back pain treatment Melbourne, what then happens is like we said those ads show up and hopefully they click on that persons ad and they go through to their website and hopefully book an appointment or in some situations they can be actually what is known as a call extension where you can just click it and call and go straight through to the person’s clinic and hopefully book your appointment straight away. So that is really what search advertising is, it’s your ads that show up on the search results when somebody types in a particular key phrase or keyword into the Google Search Engine.

Now, this differs somewhat from another type of Google advertising which is called the display network, and I am going to talk a little bit about the display network in a minute but the display network is basically where you advertise on other people’s websites around the internet and I won’t go into too much more about that yet because we will get back to that in a minute.

Now, when you are looking at the search network what happens is like I said before you pick certain keywords that you want your ad to show up in. now, the selection of those keywords is very important, you have got to make sure you are getting a good return on your investment, you want what is known as buying keywords, keywords where people are ready to take action and book your services but at the same time those buying keywords will tend to be more expensive so you have got to sort of do a little bit of a trade-off.

So you set out all of your keywords and then you work out how much you are willing to pay in order to get somebody to click on your ad when you show up for that search result. Now what Google then does is they look at all the bids, so, you know, if Joe Blogs’ clinic is down the road is willing to spend five dollars and you are only willing to spend four dollars then odds are Google is going to show their ad at five dollars a click above your ad which is only willing to pay four dollars a click.

So as a consequence Joe Blogs’ clinic is more likely to get more exposure to people and therefore more potential patients through the door. Now, it is not however just judged on the amount that you are willing to spend on the ad, Google also looks at a whole range of other factors which are going to determine how much you actually pay for the bid and how likely your ad is to show and so forth, ok.

Some of the things that they look at is how high is the click through right for your particular ad, so if you have, you know, Joe Blogs has got his ad for his clinic and you have got your ad for your clinic and for some reason you have happened to write a better ad that is more compelling to people and therefore they click on that ad more often, Google therefore things that you ad is more relevant and so they are more likely to favour your ad than Joe Blogs’ clinic.

So you have got potentially two competing factors there where Joe Blogs is willing to pay five dollars a lick and you are only willing to pay four but your ad is getting more click through right, so Google thinks that you are providing a better user experience and so they are more likely to favour you or that puts a bit of weight back towards you. So it isn’t just determined on price.

Other factors that Google takes into account is the quality of the landing page that you are sending people to. Now this is one where a lot of clinics really fall down because they send everybody to their homepage, so they have low back pain people going to their home page, they have got neck pain, they have got headache, they have got sciatica people, everybody is going to their homepage and the content on that page is so generic because it is supposed to appear, homepages are really supposed to appear to everybody that Google scans that, doesn’t see much content or not about sciatica for example and therefore they give you what is known as a low quality score because they think that your landing page is not particularly relevant to the people that are coming to your pages and clicking on your ads.

So that is why you really have to make sure that when you are putting together your Google Adwords campaigns that you have specific pages that are set up in order to accommodate specific topics. So when we set up a campaign it is very rare that we will just sent people to the homepage, maybe if they are doing a location type a keyword like Melbourne chiropractor or something like that we might send them to a homepage for that but if it was low back pain treatment Melbourne they would go to a back pain treatment page. So that therefore you get a better quality score and the higher your quality score the better your quality score the lower Google will charge you for the click that you are bidding on, on that ad.

So straight away we can see that there is a lot of factors that you need to consider in terms of where you are actually sending people, what’s the conversion rate is going to be like, the click through rights and so forth and all these things are going to determine how much you are going to pay for your ad. This is where a lot of clinics go wrong, is that they don’t put the time and the effort into getting everything right in the first place and as a consequence they pay a lot for their clicks because Google thinks their pagers aren’t particularly good quality and what happens is that they are sending people to pages that are not relevant and as a consequence their conversions are terrible and so as a result they end up having to pay a lot more.

So those are just some of the factors and this is a little bit about how Google tries to work out how much you are going to pay and when to serve your ad and so forth. It is quite technical, there is a lot of aspects with it that you need to be considering.

Now the other thing to look at when you are looking at a search advertisement campaign is that there is a whole stake of what I call extensions that you can add to you ad which will increase the likelihood of you getting your conversion or getting a click through on that ad.

So there is a thing called location extensions which can be triggered when you have certain locations nearby to where people are searching, there is a thing called a call extension which I touched on previously about just a minute ago, which actually either has your telephone number on there or if there are on a mobile device it just has a button that people can click and they can just directly call you, they don’t even go to your website, they just ring you up, you can have things like link extensions and this is where you put things like your contact us page, your location page, your about us page all this type of stuff in there as well.

And these are some of the things that we always make sure that we set up for clients’ campaigns and they are something which will tend, a lot of people if they are doing their own campaigns will tend to miss and the real reason you want these on there is that they make your ad bigger, it ends up being that your ad occupies a bigger amount of space on the page than the other person’s and so as a consequence you are much more likely to get the person coming through to your website from that.

The other thing you need to look at is that you have to have a look at what is called the top vs. side, so you have got two sort of blocks where you can show up when you are looking at search advertising and the first one is across the top of the page and that is what is called the top and then you have the side which is the side bar down the right hand side.

Now the click through rates on ads are considerably higher when you get in those top one to three results at the top of the page and they drop away considerably when you end up on the side. Usually you want your ad to show up in those top three places because if you are on the side it makes it a lot more difficult to get conversions and so forth.

Now, you have got to weigh to way that up, now we have got some clients that can’t afford to spend the amount of money that they would need to get into those top three results in which case you might just have to settle for the side particularly when you are looking at things like low back pain treatment, you know, some of those can be like four to six dollars a click when you are looking at those and there is a consequence you can rack up a big bill fairly quickly which, you know, some people are not in the position to do but if you are then you really need to make sure that you end up in that top block there so that you are going to get good results.

The other thing is when you are designing you ad, and this is another way that a lot of people fall down is that they don’t put what is called benefit orientated copy into their headlines and into the descriptions on the page, you know, they talk about themselves, they don’t talk about the benefits to the potential client and hey you kind to have to be able to help them and so forth as well.

So that is something you really need to think about and the other thing that a lot of people don’t understand is that when you see the little web address on an ad for example you might be Joe’sclinic/backpaintreatment that doesn’t have to be the same as the url that you are sending the patient to, so it has to be on the same domain, so it has to be still something rather but it doesn’t have to be

So you can do what is called optimising your display urls also to try and improve the potential conversions that you are going to get from the ad because generally the more times people see the keyword that they have searched for in the ad the more likely they are to click on that. So that is something that you really need to consider and take into account when designing your program

So that kind of gives us a bit of an overview of search advertising and really we have kind of just scratched the surface, it used to be possible to just kind of set up Google Adwords Campaigns and do pretty well but these days it has got much more complicated. I was at a conference probably about six months ago now and one of the leading Google Adwords people in the world was speaking there and he was saying that Google Adwords kind of used to be like a small playing cockpit like five years ago, you kind of muddle your way through it and fly the plane yourself without killing yourself and everybody else.

These days the Google Adwords interface is like a Jumbo 747 cockpit, there is dials and levers and all sorts of things that you can push and pull so go wrong and if you don’t get it right you can cause some serious damage and cost yourself some serious money. So just be a little bit careful when you are getting in there and setting these campaigns up, make sure that you do know what you are doing or if you don’t know what you are doing get some professional advise because, you know, at very best yeah you might create a good campaign but at worst you could cost yourself a lot of money and get very little results, so you really got to be careful there.

Display Advertising.

Now, before I touched earlier on this concept of what is called display advertising. Now, as you go around the internet you have probably noticed that on various websites they have little adblocks on them, you know, it might be an image ad or it might be a text ad or something like that, odds are that those ads are what is part of what is called Google Display Network and Google had this whole network of science that they have access to around the net where they can show your ads.

Now, it is important to think about that this is a very different scenario from search advertising. Search advertising like we said is when people are directly looking for service and they are ready to take action, in display advertising you are showing an ad to somebody who is in the process of looking at something else. So you have got to be a little bit more strategic on how you go about it, there is dozens of different ways that you can actually go about targeting different sites.

There is what is called interest where you can target people by interest, what they are interested in, you can do what is called contextual advertising so you can target certain sites that have particular topics on them, you can have placements where you look at specific sites that you might want to advertise on like, you know,, or whatever, I don’t even know if they have Google Adwords but you might decide that they are relevant for your audience and if they do you want to target them. There is also what is called topic targeting which is very similar to contextual but there is just some sort of variations in there and so again you have got to be a little bit careful about what type of targeting you set in place so that you make sure that you get in front of the right type of people, you don’t just set up a display advertising campaign and just set it loose and hope for the best because it just won’t work particularly well.

The other thing you want to look at is you want to look at image ads versus text ads, now you can just use the same text ads as you would in the search campaign, however they don’t tend to perform as well as if you get specific images made up. So there is extra cost involved in getting your images made up and you have got to make sure that you do something that is compelling and interesting and so forth but it can be worth that extra effort if you are going to go down the route of going through the display network.

So, it is really important to emphasise that the difference state of the buyer like we said in that somebody who is searching on Google for a particular topic is much more ready to take action than somebody who is on the display network. So as a consequence your click through rates are going to be much lower when you are on the display network than you are that will be on the search network.

Now, a good sort of click through rate on the search network is sort of four to ten per cent, depending on the ad and the topic and so forth. On the display network a good click through right can be like half a per cent of people who have seen your ad. So you might of sort of look at the display network ads and think ah you know, I am only getting half of the per cent of people who are seeing my ad actually bothering to click on it and you might think that is really terrible but that is actually not too bad, you know, if you are around point zero one per cent or something like that you might want to really look to take action but don’t sort of beat yourself off if you are not getting incredibly good clicks through right there.

But it is really important that you don’t mix your search and your display advertising campaigns as a result of that, the reason being that Google uses the click through right of a campaign to work out how much you are going to pay and so if you mix your search and display campaigns together what is going to happen is that it is going to push your click through right down and as a consequence you are going to end up paying more for your clicks than you would otherwise would do. So just be a little bit careful about that, set up separate campaigns if you are going to do them and just sort of pay attention to your matrix and look at your statistics and things like that.


So those are the main two things that as a healthcare clinic you probably going to be interested in when you are looking at advertising on Google. There is a really interesting feature that Google has which is called Google remarketing or retargeting and what happens with that is that when somebody comes to your website you can do what is called “cookie” them, when you can put a little bit of code in their browser which will track them around the internet. It sounds a little bit creepy, this and someways it is but basically with remarketing or with retargeting what happens is that as they then go to sites around the internet that have Google Display Network ads on them you can use those display network ads placements to show your ad.

So the real power of this is that somebody has shown an interest in your particular service or topic or whatever, they have come to your website, they have decided not to take action at this point and what can happen is you can then continue to show your ad to them in a very targeted fashion for up to two years afterwards, eighteen months to two years, they keep changing the times, I am not sure exactly what it is now but it is a long time basically.

You probably don’t want to follow around for that long because if they are not willing to take action within thirty days then, you know, it has probably passed it, so just be careful how you use this. But you could say that this could be very powerful.

Now the real key with this is that you cannot use Google Advertising for medical related conditions though, for healthcare related conditions, so you will find that there will be advertising agencies that will recommend to you that you use retargeting for your clinic and I would strongly advise you not to do that because you will be in direct contravention of Google’s terms of service and you have the potential of getting your ad account banned within Google, it probably won’t happen the first time, they will give you a warning, tell you off and so no but you do it repeatedly you could end up getting yourself banned.

Now, there are advertising agencies who aren’t particularly familiar with Google’s terms of service who are promoting this for healthcare clinics or they are familiar with that and they just don’t have particularly good ethics and they are promoting it as well, who knows. Just be very careful, if you are speaking to somebody and you are doing it for health related topics don’t be tempted to run a remarketing campaign for that.

If you are selling supplements, you may well be well have to do them for things like that you would have to look at the specifics but not for your particular clinic.

Other Considerations

There is also other factors that you need to look at when you are looking at Google Adwords, you can do things like adjusting for mobile, so if somebody is searching for your particular key word on a mobile phone you can either bid more or bid less or whatever, you can do location targeting for that as well, so if they are within five kilometres of your clinic you might want to bid a little bit more in order to get those people in than say somebody who is twenty five kilometres away for example. So you can bid according to location, you can bid according to the device that they are using like mobile phones, you can adjust your bids for time of day and the day itself, so you might want not have any ads running at all on Sunday because, you know, your clinic isn’t manned and you are not prepared to take calls or whatever. There are also factors that you consider with that. So that is something else you need to look at.

Landing Pages

Now, the last thing that we sort of going to run through today is not directly related to Google Adwords at all, I touched on that previously in terms of talking about the landing pages and the importance of having good copy on the landing page for improving your quality score. However it is also very important that you send people to an optimised landing page so that you are not wasting your money when it comes to Google Adwords.

Basically, like I said before don’t send in just your home page unless you are just doing a location based advertising campaign, where you are just talking about people finding out about your practice in particular. You should be sending people to targeted landing pages that are much more likely to convert, the reason being that if somebody is searching for lower back pain treatment and you just send them to a generic page there is a real disconnect there for the user, they are not going to say well hang on, you know, they have got to think about what they are trying to do and when you talk about the internet you don’t really want to make people think.

One of the reasons is that you have only got between half a second and five seconds to convince somebody to stay on your website, they call it the blink test because it basically takes about as long as somebody takes the blink. If they haven’t decided that your page is relevant within that period of time then they are going to hit the back button and you are going to pay for a click for nothing and you are going to lose a potential patient.

So really really really make sure that your landing pages are of a very high quality if you are going to start running Google Adwords campaigns to them. So that means things like benefit orientated headlines, clear calls to action, very easy stuff on there to read, very user friendly, not a cluttered design, it has got to be contemporary, attractive, something that is going to improve the conversions that you get.

I would also recommend to you that you do what is called split testing which enables you to test different variations of a landing page to see which one converts better the reason you want to do this is that you may find that you get a ten, twenty per cent increase in conversion rights from one page versus another and so as a consequence the amount of money that you are spending to get a conversion for ten clicks you might only get two people that convert into patients from one landing page whereas from ten clicks you might get four people that convert into clicks from the other landing page, you have still paid for ten clicks but in one situation you have got four patients out of it in the other situation you have got two patients out of it.

And if say it is five dollars a click that has cost you fifty bucks to get patients whereas if you are using the other page it has cost you fifty dollars to get four patients. So you can see that very quickly you can improve your return on investment and as a consequence you are going to get much better results from your ad spend. So just make sure that you spend some time looking at those landing pages trying to make sure that they are good, optimising them through split testing and so forth so that you are going to get the best results from your ad spend.

Now, like I said, we do run Google Adwords campaigns for people as well as Facebook and a whole host of other types of advertising campaigns. So if you are looking for some help with Google Adwords by all means pop along to schedule a strategy session with us so that we can talk about all aspects of your digital marketing including that. If you are currently running Google Adwords campaigns and you are not sure whether you could be doing better than you are and you would like us to take a look at that campaign for you just again schedule one of those sessions, we will get you log in details of you, we will pop into your account just to have a look through, do a little bit of an audit, come back to your with some recommendations and say look, either you are doing great we don’t think we can do anything better for you or this is how you could improve it, you know, and if you want us to help you with that we can or if you want to go away and get somebody else to do it that is up to you, that is fine as well.

So again pop along to and just click on the strategy session link and we will be very happy to have a chat with you.

I hope you found that interesting, by all means leave some comments below otherwise we will see next time we have got a really interesting interview lined up on our next episode, so we will see you then, thanks for listening.


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