The renewal email arrives: another month, another few hundred pounds. The report attached says clicks are up. You are a clinician, not a marketer, and it feels rude to ask the only question that matters. So here it is, asked for you: how many of those clicks became patients in your chair, and what did each one cost?

Translate the report first

The words you will see, in plain English:

  • Impressions: how many times the ad appeared on a screen. Appearing is not being read, and it books nothing.
  • Clicks: visits to your website from the ad. Closer, still not a patient.
  • CTR, click-through rate: the share of viewers who clicked. A health check on the ad's wording, nothing more.
  • Conversions: the one to interrogate. It should mean a booking or a phone call. Ask exactly what is being counted; sometimes it is anything from a form view to a map tap.

A report can be full of true, improving numbers and still describe a month in which no new patient arrived. Activity is not outcome.

The one sum that settles it

Placeholder figures, swap in your own before deciding anything:

Say the ads cost £300 a month plus £200 management.
Say they brought 25 enquiries, and 8 booked in.

Cost per booked new patient: £500 / 8 = about £63.

Now the other side of the sum:
Say your fee is £45 and a routine patient visits 8 times a year.
One kept patient = £360 in year one alone.

In that example, £63 to acquire £360 of yearly care is clearly worth renewing. If your own numbers come back at £250 per booked patient, and most of your work is one-off nail cuts, it clearly is not. The point is that the sum decides, not the feeling, and not the chart. Podiatry has an advantage here most trades do not: recurring care makes a good ad account genuinely valuable. But only the booked-patient number can tell you if yours is good.

One check before you blame the ads

Be fair to the ad account: it can only make the phone ring. If calls ring out during treatment hours, the ads may be working and the phone losing them. Before you judge the spend, check two things. First, how many ad calls went unanswered; ask for call tracking if nobody knows. Second, where the click lands. A page with no working booking button wastes every click sent to it. Fix those first, or you may cancel ads that were quietly doing their job.

The questions to send before renewing, word for word

  • "How many booked new patients did the ads produce last month, and how do we know?"
  • "What is my cost per booked patient, all fees included?"
  • "Are we tracking phone calls from the ads? How many rang out?"
  • "If we cut the budget by half, what would you cut first and why?"

A good agency has these answers already, because it is how they steer. Evasion, or another round of impressions, is also an answer.

Then pick a road

Renew, with the scoreboard. If cost per booked patient beats what a patient is worth, keep going and ask for that number in every report.

Pause the judgement, fix the measuring. If nobody can produce the numbers, the problem is tracking, not necessarily the ads. Give it a month with call tracking on, then decide with evidence.

Cut, and take the free wins first. A filled-in Google Business Profile, steady reviews, and your booking link everywhere a patient looks: all free. For a small clinic they often outperform paid ads. Earn those before buying traffic, then revisit ads from strength.

We are a marketing supplier ourselves, so read all of this knowing that. It is also precisely the test we would invite you to hold us to.

Do this today

  • Send the four questions above to whoever runs your ads. Two minutes.
  • Start a front-desk tally: every new patient this month, asked one question, "how did you find us?"
  • Dig out last month's total marketing cost, ready for when the answers arrive.

If the answers come back and you still cannot tell whether the spend is working, forward them to us with the invoice. We will read them with you in plain English and give you an honest verdict. That includes "your agency is doing well, stay put" if that is what the numbers say.