The Objective

Like most medical practices, the primary objective for this Virginia-based gynecology practice was to increase the number of patients at their three locations. The practice had been running search campaigns on Google Ads for nearly two years, with initial build-out and ongoing management being done by a well-known practice growth software company. The objective for these campaigns was to simplify them and increase performance; primarily increasing appointments from users clicking on ads. Practice growth platforms employ a lot of automation and make several changes to the account every day. While the campaigns performed well, they suffered from what we call “keyword bloat.” There were 373 keywords being bid on and 294 of them hadn’t resulted in a single conversion all year; 160 of them hadn’t even resulted in a single click.
Campaign Coverage Map
Additionally, the vast majority of the keywords being bid on had Quality Scores of 5/10 or less, which is a metric used by Google to assess the quality of the experience being provided to the searcher. A higher Quality Score results in higher positions and lower costs per click. Lastly, the organization of the account was quite scattered and some ad groups had dozens of keywords that varied widely. The ads and ad text weren’t being fully utilized and had a lot of room for improvement. Cleaning and organizing the account while reducing keywords was the key to effective and efficient campaigns.

The Tactics

Gynecologist Google Ads

In order to simplify the campaigns, we had a lot of reorganizing and reprioritizing to do. We decided to pause all of the legacy campaigns and build new ones from scratch. Three search campaigns for three locations. Simple.

We set a 10-mile radius around each location (Alexandria, Annandale, and Falls Church) and created three ad groups in each campaign based on the highest-performing keywords. In the old campaigns, 43% of conversions came from just two keywords, so we were sure to keep those. In total, each campaign was comprised of just 28 keywords.

Three ads were then written for each ad group which are continuously split-tested against each other to determine the best-performing headlines and descriptions. We also created new ad assets, such as location extensions, sitelinks, call extensions, and several more.

In order to accurately track the success of the campaigns, we imported customized tracking from Google Analytics into Google Ads, which counts a “conversion” as any time a user clicks to their online scheduling platform on another site. This conversion tracking allowed us to utilize automated bidding as Google collects data to bid higher on users and searches that are more likely to lead to an appointment.

The Results

As with any Google Ads campaign, the changes were immediate. The simplified, focused structure of the campaigns led to higher clickthrough rates, conversion rates, and Quality Scores. After 30 days, the conversion rate was over 14%, whereas the Health & Medical industry average for search campaigns was just 3.36%. If we were to count phone calls through ads as conversions as well, the conversion rate would have actually been 21%. The cost per click was slightly below industry average which was during a time where costs in this industry were exploding, and the clickthrough rate was 6.48%; nearly double the industry average.



Ad Impressions


Clickthrough Rate (%)


Avg. Cost Per Click ($)


Appointment Queries


Phone Calls from Ads


Cost Per Conversion ($)


Conversion Rate (%)

We have also seen activity in Google Ads lead to conversions from other traffic channels. Oftentimes a user will click on a search ad and later go to the site directly, or visit the site through an organic search result before clicking on an ad a day later, and dozens of other path combinations. In that first 30 days, we saw that 35% of all website conversions involved a visit from a Google Ads search ad somewhere along the user’s path, and 23% of all clicks to make an appointment came from just a single visit from a search ad.

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