Making Paid Search Useful for Business Decisions

When a multi-location healthcare organization brought me in to help move paid search in-house, the immediate assignment was to improve the program during the transition. The account also needed to become easier to understand. Leadership wanted to know how advertising was performing at individual clinics and what its reported conversions actually represented.

The operating problem

My focus was approximately 90 corporate-owned locations. Each had about three campaigns, creating roughly 270 campaigns before additional general campaigns were included. That structure preserved local accountability, but it also made review and optimization labor-intensive. Changes to conversion definitions and account settings were not consistently clear from the available documentation.

The business had a legitimate reason to retain location-level budgets. I wanted to simplify the structure, but consolidation was constrained by that requirement. The work therefore focused on improving measurement, attribution, reporting, and operating discipline within the accountability leadership needed.

Clarifying the actions that mattered

The account had roughly 15 to 20 active conversion goals, including several call-related definitions with different duration thresholds. We reduced the goals to a smaller set of priorities and improved the ways people could contact a clinic through paid search.

We added call extensions and location-specific tracking numbers. Separate numbers supported attribution for calls originating from an ad and calls originating from the website. I also reviewed and cleaned a negative keyword list containing roughly a thousand entries.

Calls mattered because many prospective patients wanted to ask a question and then walk in. I separately analyzed caller phone numbers against subsequent patient registrations to understand that relationship. That analysis also remained distinct from click-to-call reporting: clicking a number, completing a call, and arriving for care are different events.

Giving leadership a usable reporting view

I built a Looker Studio dashboard that combined Google Ads data with business intelligence figures. Leadership could review performance by location, campaign type, campaign focus, and time period. That made it easier to compare the program during the transition from an agency to an internal team.

The dashboard placed advertising activity alongside financial measures, including EBITDA, and supported discussions about estimated acquisition costs. It did not establish incremental profit attributable to an individual ad. Its value was making marketing and business reporting available in a common view so leadership could ask more specific questions.

What the measurement could establish

Changing conversion definitions also changed how the program needed to be evaluated. A useful performance comparison required clarity about the actions included, the locations covered, and the time periods being compared.

December was a peak period for the business, and the measurement changed during the year. Interpreting the results required considering seasonality, new contact routes, and revised goals alongside campaign optimization. Advertising activity and confirmed patient acquisition needed separate definitions.

The operational deliverables are clearer. Leadership had a smaller set of conversion priorities, distinct call attribution routes, and a dashboard organized around location-level decisions. Those changes gave the team a more consistent basis for evaluating results and deciding what to test.

Supporting the next investment

The following year, the organization invested in online booking and broader brand activity. Greater confidence in the paid-search foundation helped support those conversations, but the later initiatives had separate implementation work and results.

For a business bringing marketing in-house, the transition involves more than moving access or changing who manages campaigns. Someone needs to establish what the numbers mean, how local accountability will work, and how leadership will evaluate performance. In this engagement, I connected those requirements with practical changes to the account and reporting.

That is the work I would carry into a similar engagement: clarify the decisions the business needs to make, inspect the measurement supporting them, and build an operating process the team can continue using.