Google Ads Secrets for Canadian Physiotherapists

Neil [0:18]: Hello and welcome to the Practice Marketing Podcast, highlighting successful strategies from North America’s fastest growing clinics and experts so you can learn from their wins and power your practice growth. Hi, I’m your host Neil Trickett, CEO of Practice Promotions. And today we’re going to talk about Google Ads secrets for Canadian physiotherapy clinics. And I’m joined by our special featured guest, Mahad Ali, who is not only our awesome Practice Promotions Google Ads specialist on our Google Ads team, but he’s also a physiotherapist. He’s been a physiotherapist from Canada, and he worked in that role before switching over to digital marketing, and now he works on our Google Ads PPC team and helps both Canadian and American clients get more new patients with Google Ads and gets amazing results. Today he’s going to share what to do specifically to market Canadian physio clinics, and of course you can take this for American clinics too, but how his experience as a physio really helps in that whole digital marketing space. So Mahad, welcome to the podcast.

Mahad [1:17]: Thank you so, Neil, glad to be here.

Neil [1:27]: Well, you have a very diverse and interesting background, and that’s one of the reasons that we brought you on to the team here. So I’d love for our audience to understand about you, and what made you move from being a practicing physio in Canada to working on Google Ads for physio clinics.

Mahad [1:41]: That’s a really good question, because when I wanted to go into physiotherapy, I kind of had my idea set on I want to get into MSK, the more ortho route, which I did my first two years out, but then I started looking closer into the field of marketing. I had friends who did digital marketing, worked for different agencies, worked for things not related to PT, but I always knew about digital marketing in the sense of, I worked at a clinic in Canada called Lifemark. I knew that we had SEO teams, I knew they had a website team, I knew we ran paid ads, because people would always say, “Oh yeah, I saw you guys on Google.” And if you type in PT near me, we’re one of the people who pop up, which then led me further down the line of saying, is this really a route that I can go to? I looked for different individuals or different companies that offered this. So when I transitioned from Canada, coming back to the states, cuz my family lives in the states, right, so I always wanted to come back here. I went there for school and spent three years working as a PT, but also then two years in PT school, so a total of about five and a half years or so. Coming back to the states, I saw this as an opportunity, okay, I know about marketing, I worked in a company in Canada for digital marketing for a different industry, can I tie the two interests together? And I found Practice Promotions.

Neil [3:13]: Mhm.

Mahad [3:13]: And nothing was the same. I think that I’m still, I always view myself as still being a PT, although I’m not in the clinic. I went from treating patients in clinic to helping clinics attract patients so that they can treat more patients. So I’m still in the mix of PT.

Neil [3:27]: Yeah. Just like me, right? Same thing.

Mahad [3:34]: Yes. Physical therapist, trained in that, worked in that for a while, and then just realized I had more of a passion for marketing. Still love treating patients.

Neil [3:43]: Don’t miss the insurance headaches.

Mahad [3:47]: I really enjoy treating patients, but what I live for is just helping clinics being successful. And so when I can see that people choose physio or PT over other things, especially surgery that they don’t need or medications that they don’t need, I know that if they can get to our clients, they’re going to be so much better off in their life. So just a different way of approaching it, right, that we’re still helping people.

Neil [4:11]: It is. We’re still helping people, we’re still in the PT field, and it’s just that higher level of seeing patients but not physically seeing them.

Mahad [4:20]: Yeah.

Neil [4:21]: So I’m curious from your perspective, because obviously you’ve been on both sides of the coin here, both in the digital marketing space and also in the clinic, and you work with clients too that have tried to do ads themselves. So what would you say then is, hey, if I’m a clinician, I think I can just run Google Ads myself, like why is that not a good idea?

Mahad [4:54]: So we work with a lot of individuals who have tried running Google Ads themselves, and it’s not a good idea for multiple reasons. A lot of people view Google Ads as just like a faucet, that oh, if I just turn up the faucet, put more money in, I can get results. Google Ads is not that. So I can give you an example of a person who comes to us and says, I was running my Google Ads, I think it was working for the first couple of days, then I did XYZ, typically running broad match, which Google themselves will tell you, yeah, let’s go the broad match route, which is specific, but it’s something that they recommend. And then they say everything tanked, it didn’t work, I was putting more money in, it didn’t work at all. I try to troubleshoot and fix things, because there’s so many different avenues and different tools within Google Ads that you can change, from location targeting to, it gets really confusing if you look at it from the side of someone who doesn’t work in this for their job, right? And then typically the next approach is, I couldn’t do it, let me go to a marketing agency that can. The issue there is they go to marketing agencies that work with everybody. So the one I was talking about that I used to work at was for more of the hospitality industry. The hospitality industry is very much different from PT, which is again very much different from other health disciplines. So typically we see a lot of, they come in with a lot of issues, and we can see those issues because we use the same Google Ads account that they started off with, so we can see all the places they went wrong, some things they did right. And specifically for Canadian clients, there are some things, some clients come to us with strikes on their account because they said some words, some headlines and descriptions that are not allowed within the provinces.

Neil [6:45]: Yeah, so there’s a lot of different factors here, and I mean correct me if I’m wrong here, but I think for Google Ads you don’t want to follow all the recommendations, right? So you have Google Ads, and if you say, hey, I’m going to just do this myself, and you get in there and you just follow the simple smart campaigns that they have, like that’s for super beginners, right, and Google just gets you off the ground running, but they make all these recommendations, and what’s Google’s job? To get you to spend more money, right?

Mahad [7:18]: Spend more money. That’s their, as long as you’re spending money, they’re very happy, that’s their checkbox: they spent a lot of money this month, perfect. They’re not thinking in the sense of, do we get them clients, do they have good leads, are they the insurance providers that they want to see, they’re not thinking about that. They’re just thinking, oh, you spent a lot of money this month, perfect.

Neil [7:39]: Yeah, and so that’s the thing too, right? So if you’re starting with Google Ads, trying to do it yourself, you’re probably gonna waste a lot of money doing it, right? You might get some traction, you might get a little bit of results there, but you’re going to waste a lot of money, cuz if you follow all of Google’s recommendations, they’re going to put you on all these different networks that, your patients probably won’t be on, like games on kids’ iPads.

Mahad [8:02]: There’s going to be things like that, right, for the Google side of it. And then you brought up a great point in that, knowing the policies, right, so different countries have different policies, different provinces have different policies. And so that’s interesting that you talked about, some provinces don’t allow certain kinds of headlines.

Neil [8:26]: Mhm.

Mahad [8:26]: Yeah, and it’s like, in Canada they’re regulated by, each province has its own regulatory body or college, for example, the College of Physiotherapists in Ontario. For the most part, what unifies them: you’re not allowed to make any statements that are not backed up by any sort of fact. For example, in the US we could say, number one PT of all time, best place to come to, everyone gets treated really well, things like that. But in Canada they’re going to say, how do you verify those claims? So they’re a lot more strict, across all provinces. And we get clients who have had strikes before on their ads, from headlines and descriptions. And that’s something that I love to let our Canadian clients know: we know the regulations for your given body, because we’ve worked with that body before, we’ve seen what they say you can do and what you can’t do, and we definitely work to make sure that you don’t get those strikes, those penalties. That’s a major concern for a lot of people, especially when they do it themselves, because they may not be thinking about that, but then later on they find out the hard way that they’re just not allowed to do that.

Neil [9:43]: Yeah, and there’s a lot that goes into Google Ads, from targeting to, obviously, different profiles and campaigns that are set up, the words, the language, knowing what you can and cannot say. And that’s also where, like you were mentioning before, you can get into some trouble if you have an outside agency that works with everybody. So what may be okay in, say, the automotive or restaurant industry, you can’t do in healthcare, and you can get into PIPEDA or HIPAA compliance issues also.

Mahad [10:15]: Exactly.

Neil [10:16]: And is there certain things in Google Ads where you have to be more careful about HIPAA?

Mahad [10:23]: Uh, yes. Well, it’s more obvious to us, there are certain things that you cannot say. But more so with Google Ads, when, let’s say for example, if you’re working in the product space and you want to retarget, you want to retarget a person who’s clicked on your ad before, that’s beautifully done, because you can do it, we don’t have any concerns with a regulating body, you can track them through different websites and with banner ads and display ads and things like that. But with HIPAA, we’re not allowed to follow that individual through their whole journey until they become a conversion or a lead. So that’s another sort of no-no from HIPAA and PIPEDA as well, on both their ends.

Neil [11:12]: Mhm. And with Google Ads, is it also using Google Analytics 4 in conjunction?

Mahad [11:19]: Yes, we’re using it in conjunction. So it’s actually a really beautiful process, because with our ads, although I said we can’t follow them from website to website, within our own customer journey, when somebody does click on an ad, we can see that they clicked on a certain type of ad that led them to a landing page or a website page that we chose. And then we can see what they did on that website page: did they go to your pricing page, did they go to, frequently people go to the about-us page to see who am I working with. So yeah, we do have that connection with Google Analytics 4.

Neil [11:55]: Yeah, that’s awesome. So you want to make sure you have all those things set up, because one of the other parts of Google Ads is making sure it’s working for you, right, you got to be able to track how people are coming through the leads and all of that. And then you can say, hey, this campaign is really working, I could put a little bit more money towards it, or this other campaign is not working, let me take away money from that.

Mahad [12:12]: And Neil, you touch on a big point, whether a campaign’s working. So a lot of digital marketing companies, what they focus on is, oh, you have x amount of conversions this month, this is your cost per conversion, which is great from a marketer’s perspective, from a PPC specialist. However, when you look at the clinic side, they’re like, I had 30 conversions, but what does that mean to me, I don’t know how many clients I got from this. But we go the extra step of having call tracking numbers, so that we know exactly what happened with that patient: did they book, did they call in, did they say they’re going to call back later. So we’re able to bridge that, and see not only those cost-per-conversions, that general metric that individuals are used to if they ran ads themselves or worked with other agencies, but we’re actually able to give them true leads, true data coming through from the patients.

Neil [13:08]: Yeah, that makes a lot of sense, and we see that quite often, where you’re seeing data from a previous agency or company, even if they tried it themselves, and the conversion could be just that they actually spent some time on your page.

Mahad [13:24]: Oh yeah. You know, as a clinic owner, we don’t care about that that much, we want patients saying, I want to come see you and book an appointment, scheduling an evaluation, that’s what we care about. The funniest one I’ve seen is if someone just clicked on the page, that’s a conversion, and their cost per conversion was like a couple of pennies, and they were happy about that, because from their perspective they’re thinking, oh, I’m getting the most out of my dollar, so for every 50 cents I spend I get a new conversion, which they think is a patient, but isn’t the case. And that’s why I love that we go that extra step to be fully transparent: yes, these cost-per-conversions are great, but this is what it led to at that step, did they fill out a form, did they call into the clinic, and then even going further, did they book?

Neil [14:11]: Yeah, so I love that. And I think for our audience out there that are running Google Ads, it’s one of those things, know what you’re measuring, right? So if you’re measuring click-through rate, if you’re measuring calls, if you’re measuring what is a conversion to you. I think it’s really important to define what you’re trying to measure when you’re doing Google Ads, so that you can make sure you’re getting the most bang for your marketing dollar.

Mahad [14:38]: Exactly. And again, at Practice Promotions, what we really focus on as a conversion is someone that actually identifies and has scheduled themselves as a new patient lead.

Neil [14:48]: Yes, exactly, which is really important, so you can see that correlate to what’s happening in clinic, versus just saying you have these many conversions this month, that doesn’t really mean anything to anyone. The real basis is, did that person book, did they come into your schedule, or even if they didn’t book, what type of lead were they, they called in and said they’re going to call back later.

Mahad [15:11]: Because, and not to go on a tangent, one thing that I love from that Google Ads perspective, we can get very, very granular or very specific with the patients that we are targeting. So if we’re running, for example, I mentioned pelvic health, dry needling, whatever, we can be very specific with that type of client, they come in through our A/B testing and all the systems that we have in place with that one patient that comes in. There’s also a huge value in, for example, let me give an example of an MVA client. With MVA clients, typically that person is not in a car alone, very rarely are they in a car alone, so you’re bringing in one, two, three, four patients, so there’s like a little bit of a multiplier with referrals as well. So it’s very valuable, all the data that we can see from our end, just through a simple click on Google Ads, and what it amplifies to and what it becomes.

Neil [16:12]: Love that. Yeah, I mean, one of our missions here at Practice Promotions for this year, and especially as we get into 2026, is to empower practices to attract higher paying patients in their area, and also as they go to add on different service lines in their business, whether that’s dry needling, laser, a NuEve device, massage, sports performance, there’s a whole myriad of things that we can bolt onto the practice to offer more services to patients and get better results, and at the same time be able to bring in cash-pay service lines to facilitate more revenue per patient visit, that’s the bottom line, that’s the future of PT, right? And so we’re trying to help empower clinics to do that, so it’s really cool to hear how we work with different clients to maximize those programs and target pelvic health programs, dry needling programs, sports performance programs. And that’s the beauty of Google Ads, right, is that you can get very nitty-gritty with what campaigns, what type of searches people are doing out there, to get in front of them, basically advertise in front of them and then get them to come into your website and take action.

Mahad [17:26]: Exactly. We have an understanding of the search volume through the different tools we use, and even the native tools we use within Google, to know, are people searching for this in your specific area. And also, knowing, for example, you mentioned the NuEve device, we know the new devices, the new cash-pay models that people are going through, because we’re in the industry, that’s the biggest separation that we have, where a general digital marketing agency is going to look at you and say, oh, you have a NuEve device, that’s cool, and then they’ll just do the same thing that they do for a person who’s selling products, for example, and not services.

Neil [18:04]: Yeah, makes sense. And so as you’ve worked with different Canadian clinics, what would you say is one win that you’ve seen a Canadian clinic get with Google Ads recently?

Mahad [18:14]: The recently big win that we had was a client that came with us from Vancouver. They came in at 50% capacity, they were hoping their ideal was to get to 60, 70% within the year. Within three months they had a different issue: they were looking to hire, because they were at capacity. So that’s a huge win, and I always tell clients that’s a great problem to have, right, and we have Market2Hire that can help them with that as well. But it’s a great problem to have, that now you’re at capacity and need to hire, versus we need more patients.

*[Mid-episode ad break: Neil pitches his Market2Grow book, available free at practicepromotions.net/book for podcast listeners.]*

Neil [19:32]: And I’m curious, as you’ve chatted with different Canadian clients, obviously you’re in the PPC role, you’re in the Google Ads role there, but I’m curious, have you seen clinics that don’t utilize Google Ads, or do you think most clinics are using Google Ads in Canada?

Mahad [19:49]: So, most clinics, it’s hard to really put a number on it. We can see within Google Ads, the auction insights, the people that Google deems are our biggest competitors, and through Google Ads transparency, everyone who’s on Google Ads is registered, right, if they’re running Google Ads we can easily see it, and we use that as a tool to see what other people are doing, what other people are running ads in our area. But yeah, Google Ads is becoming much more, in the last three years even, much more utilized than before, so there is heavy competition. But the beauty of it is, it’s not necessarily a quantity game, it’s not about how much you pay or how much you’re willing to put for your monthly ad spend, there’s a huge quality component to it, which is a multiplier, it’s a huge factor in what we do. So if it was just about numbers, the Lifemarks of the world, the big chains, they would control the market space for Google. But quite often, and I get super happy at this, going from that person who was looking at, oh, these are Google Ads, oh, Lifemark runs Google Ads, to now competing with them and often beating them, although they spend more, it’s really nice, it’s full circle.

Neil [21:04]: Full circle, right? And I think that’s the beauty of digital marketing in today’s world, is that it levels the playing field a little bit. And yes, there’s always the big players, and we work with a lot of big clients, but from a digital ad perspective, you don’t have to spend too much more to actually compete with the big guys, right, and that’s the nice thing with Google Ads. You can be very broad, you can target different areas, you can target zip codes that you’re in more so than others, so there’s a lot of capabilities in that advertising platform that I think most people aren’t fully tapping into, especially since, if individuals are running those smart campaigns which we spoke about previously, those are just plug-and-chug, we can always beat the plug-and-chug individuals, because we’re very specific with where we’re targeting, the communities we’re targeting, the area.

Mahad [21:58]: The headlines and descriptions we use are in our control, and we’re not just handing over the money to Google and saying, hey, do this thing, Google, we’re the ones who are actually doing the thing. And that takes a lot of time, it is something you have to stay on daily, making weekly changes and optimizations, which again most individuals won’t even know what to do, because they don’t know the industry.

Neil [22:25]: Yeah, I mean, we have what, a five-, six-person team just for Google Ads, right, a six-person team with a lot of experience. And so for our clients out there that are doing Google Ads, what do you typically see as a normal cost per new patient lead, and where could that get to for them?

Mahad [22:48]: So with cost per lead in Canada, we’re looking at about $105 to $110 for that cost per conversion on average. For us, we’re much lower than that, we’re closer to that $60 to $65, which is basically half. And even some clients, like the one I mentioned in Vancouver who is just doing so well, they’re at a $35 cost per conversion. And with that, however much they’re spending for their ad spend, you get to a certain point with Google Ads where you’re optimizing that ad spend to the greatest degree, where increasing the ad spend at that point does mean, okay, if bringing in one client cost us $60, and we were to increase it by say $100 or $200, we can bring in three to five more clients for that ad spend. And that ROI, we always pay really close attention to what is the value of that patient, not just for that initial assessment, but through their normal treatment cycle. And we really look at one treatment cycle, but, like I mentioned, if the individual, and often is the case, they had a great experience in their treatment, they got better, if they get hurt, if anything happens, they’ll be back, if something happens to one of their loved ones, friends, family, they’re going to be an advocate for you. So, to answer your question, our cost per lead in Canada is $60, that’s the average for ours, but the industry average is more $105 to $110.

Neil [24:21]: Gotcha. Yeah, and for those Canadian clients too, so there’s different things to look at, too. Like, so that’s actually more like the actual new patient coming in, right, for that dollar amount, and then there’s actually more of the cost per lead. So, hey, the person may either book an online appointment, or they may call the front desk, and depending on whatever they do, sometimes they book, sometimes they don’t, right? So just giving a percentage of, hey, we can get you a certain volume of leads calling in or wanting to book online, but then, for some reason, maybe get 60, 70% of those people actually getting on the books, that final conversion. So that’s why we were talking about before, like really knowing what you’re trying to measure when it comes to Google Ads, so that you can have that accurate number at the end of the day. Exactly. And so that brings me to a question for you: do you see, cuz you were talking about a certain ad budget that a clinic may have, and if they put a few more hundred dollars towards it they might actually get even better results, is that something you commonly see with practices, that they’re underspending and just kind of holding themselves back from the capabilities?

Mahad [25:33]: Yeah, and I think a lot of it has to do with, where they’ve run ads on their own before, or had ads with a different company, and they just don’t trust the results. So typically I find that most clients want to spend the least amount to see what we can do with that. And for the US it’s $500, for Canada we say $700. If you’re spending less than $700 per day, we really can’t get great results, right, or it’s harder to. For example, take $500, that’s spending about $23 per day, if your cost per click is $3, quick math, you’re not getting too many clicks in the day. So you don’t give yourself a fighting chance to actually get those conversions that turn into actual leads and patients booked. So, with that $700 though, I will say we can get a lot out of it, especially once we learn the area a little bit more, we do the initial learning phase, and then we can get that cost per conversion that’s closer to our actual, and then far away from the industry’s average, because although that’s the average in the industry, there’s a lot of people who are paying way more than the $105 to $110 per lead.

Neil [26:47]: Mhm. Yeah, I was talking to someone the other day, spend like 150 bucks.

Mahad [26:55]: Yeah, you know, so that’s very high.

Neil [26:55]: That’s good to know, too, because I think of it like this, like Google Ads, it’s like a bidding war, right, and everybody’s fighting for the top spots to be shown. And if you only have a couple of dollars in your pocket, the chance of you getting to the front of the line is very small, but if you have a greater amount of money in your pocket, you’re going to get put to the front of the line more times, right, and so that’s why we have minimums, because if clients are just at the bare minimum, they’re getting bare-minimum results. But if they put a little bit more towards it, would you say a clinic that’s spending like maybe $1,000 or $1,500, they’re really rocking and rolling in terms of results?

Mahad [27:41]: Oh yeah, because a lot of times they have that proof of concept with that $700, they can see what it’s performing, how their clinic’s doing before and after. So that’s a little bit easier to then tell them, okay, at this point this is your cost per conversion, if we spend this much more, and at a certain point they’re saying, yes please, let’s do this faster. And that’s another thing that we’re really watching out for, not adding too much at once, because if you add, let’s say, $1,000 on top of what you’re already spending, you can be put back into a little bit of a learning phase and have to go through that discovery period again. So those are just things that we know from our end, but again, another marketer might look at that and say, oh, you have $1,000 more dollars to spend, all right, let’s see what happens.

Neil [28:27]: So that’s interesting, then, for a clinic if they keep changing their ads all the time, are they hurting themselves doing that?

Mahad [28:34]: Yeah, because, I won’t say all the time, but for the most part, yes, because you don’t have enough data to make those decisions off of. So if you’re changing your ads on a daily basis, unless they’re absolutely horrible ads, really bad headlines and descriptions, you have to get some data out of it, a week is a good amount of time to make a change, some more time is good. And when I say a change, it’s not the changes that need to take place like negative keywords and things like that, that has to be done all the time, but I mean a change as in changing your ad or ad group, or any of those bigger-picture things, or your location targeting. You may pick like a three-kilometer radius around your clinic and then one day say, oh no, let’s do 20, how long have you run that three kilometers? We don’t have any real data for you to make those changes. So it’s really like in PT, we always say evidence-based practice, right? Same thing with Google Ads, you really have to base it off of the data that you do have, and make those changes accordingly.

Neil [29:39]: Yeah, and I would imagine, cuz we know that Google for each ad has like a spin-up time, right, it has to learn, the algorithm has to learn, and then it learns where to show you, to who, what people, everything like that. So if you constantly change your ads yourself, you’re actually shooting yourself in the foot, because you’re not giving the algorithm enough time to learn, right, and actually start to show them in the best way possible.

Mahad [30:04]: And that’s what I find commonly, when I look through accounts that are new and someone ran them, or a company ran them. If the company ran them, tell you the truth, pretty much they’re running smart campaigns and there are no changes, so they just set it and forget it. But if a person ran them and they actually care, there are changes that they’re making, but they’re not making them based off of any metrics, any sort of hard numbers, they’re making it based off of, okay, this isn’t working, let’s change the whole strategy.

Neil [30:38]: And so are there any kind of messaging or offers that you tend to find perform best in Google Ads for physiotherapists?

Mahad [30:46]: So it really is dependent on the area. There are, like I mentioned, I think this is throughout all the colleges in Canada, you can’t really offer things for free, right, whereas in the states we can say, a discovery call or free one session and then your other sessions paid for, buy-one-get-one-free sort of thing, we can’t do that, so those are messages that we can’t do. But messaging that does work, we target our ads based off of many different ads that we’ve run in the past, we look at seasonality, we look at, for example, a big overarching theme is summers are a little bit slower, end of the year is a little bit busier, holidays are a little slower. So we run ads that are more geared towards those specific periods that we know are going to be slower, we know, okay, these work better at these times. And it’s really individual based off of the client, the location, the clinic itself, if they have multiple clinics, each clinic is going to be slightly different, it’s not going to be just a catchall for anything.

Neil [31:56]: Yeah, that’s good to know, so really getting it dialed in even by clinic location. Awesome. And so what are some of the key metrics that you like to look at, to know if that Google ad is working?

Mahad [32:09]: So a big metric is cost per click, right? We mentioned this a little earlier, if your cost per click is $11, $12, and you’re spending that minimum, let’s say $500, you’re really only getting two clicks per day, and in the month, if you’re running five days a week, you’re not getting that many clicks. So odds are you’re probably not getting that many conversions, and then that leads to not getting that many phone calls and appointments. So cost per click is a big one to indicate how well an ad is doing, or how well a campaign is performing. Again, cost per conversion is a good one as well, because that one has to do with our click-through rates too, so there’s some big ones. Click-through rate is how well our ad is being viewed, is it capturing the right audience, we want that to be as high as possible. Our cost per conversion, once that person makes it onto your website, is your website fast, is it good, is it pleasing to the eyes, does it help someone make that last step of placing the phone call or the form fill, that’s a big one to look at too. Cost per lead, we spoke about that a lot, everything else can be amazing, but if your cost per conversion is, you’re spending $500 and your cost per conversion is $500, that’s not good at all. So those are some of the big ones we look at, there are a lot of other metrics that we pay attention to, but those that I highlighted are our key metrics to look at, and the biggest one is what ties all that together: who is actually booking phone calls and form fills, that’s what the clients care about the most. But everything else that I mention here is important from a marketing perspective, because if those aren’t doing well, we don’t have the phone calls or form fills coming in.

Neil [33:59]: Yeah, and it comes back also to tracking, right, so you need to have the systems in place to track calls, form fills on your website, chatbot leads through your website. And so one thing I was really excited that we were able to get done, to launch at the beginning of this year, was our patient lead CRM. So basically everything that we were already doing with our call tracking, but now being able to connect everything through that, as far as the way that patients are requesting an appointment, and then allowing the front desk to basically check a box and say, hey, this person actually did schedule the appointment and I got them confirmed. Now we can track that person all the way back through what ad that they came in on, and then you can strengthen things.

Mahad [34:42]: And, Neil, I love that, because yeah, we have stat trackers that we keep up with the numbers in the clinic, how are things going overall, but that was the final step, to see with that front desk’s help, who actually came in. It’s so transparent, fully transparent. A lot of other individuals that I know, like friends of mine, like the friend that got me into digital marketing, they don’t have that level of transparency, because they can’t have that level of transparency. But it’s really important for us to have it.

Neil [35:16]: Yeah, absolutely, because at the end of the day our clients are paying us, they’re paying Google for that Google ad spend, and we want to deliver a great return on investment, right, so it’s so important. And so that kind of leads me to my final question here, which is about how you see Google Ads fit in that whole digital marketing ecosystem for the clinic, whether it’s SEO, content, referrals, email marketing, and then obviously Google Ads.

Mahad [35:42]: Yeah, it’s, they all work together really well. Google, it’s something that they don’t specifically say, but we know from running ads for a very long time that they reward you for using their platforms, simple as that. It’s like a machine, your marketing is really like a machine where the ads are driving traffic, SEO is helping convert that, and from their end as well, the referrals are helping to sustain that. So every part of this machine needs the other part for it to continue on and to move. But our ads, if they’re running on a site that’s slow, doesn’t have great authority, or not even the authority, it’s really, if the website’s not optimized, we can bring the best leads to that website, they’re just not going to convert, right? So that’s the reason, for example, why we don’t run ads on individuals’ current websites, because typically that current website isn’t optimized to handle Google Ads in the first place, and that’s a place where, especially for individuals who’ve done ads on their own or through another company, there’s that disconnect.

Neil [36:55]: Yeah, and that’s, we’ve always gone that direction where everything works with each other. And so, yeah, we could go run Google Ads for any practice out there, but like you’re saying, the website has to be optimized in a way that gets people to take action. And then also the way that the page that you’re sending people to reads affects the quality score, right, and the quality score for Google Ads determines how much you’re going to pay per click, right, so the better your quality score, the less it costs you to advertise. So that’s why, and then the tracking, right, so making sure that we can track through the website, we can track through the calls, if you have all of that ecosystem in place, boy, you can really make the Google Ads run well.

Mahad [37:40]: And I’m glad you brought up that quality score, because that quality score is the qualitative portion of what I mentioned, where this is a bid, Google Ads is an auction, so you have that amount that you’re willing to spend on a click, but then you also have this quantify score, which is the click-through rate, your expected click-through rate, then you have your landing page experience, which everything we just spoke about is your landing page experience, and then my realm, which is the quality of the ad itself, how engaging is the ad, how well does it read, how well does it flow, is your targeting correct. So all those things, without having the right necessary SEO, the website, all of that, it doesn’t help us, it’ll actually ruin our quality score, make our cost per click higher and our cost per conversion higher, and then we don’t have as good results as we do. So that’s one thing for people to look at out there: if you have a website that someone else is just kind of running, and you’re trying to run Google Ads yourself, or you have another company just running some Google Ads, and it’s not really working together tied, and you wonder why you’re not getting good results, it’s probably because not everything is working together the way that it should, from your website to your SEO to your tracking leads and all this stuff.

Neil [39:04]: Great point on that, Mahad. And I just had a thought here, kind of the future here, was the direction. We’ve all seen when we type in “physical therapy near me,” how the Google search page has completely changed over time. Obviously we’ve got local, we’ve got ads in local, now we’ve got ads at the top, we’ve got AI search in the top there, the answer engine optimization, AEO, and then all the organic searches below that. So where do you see Google adding more ads, because they like to make money, so what do you see the future there for Google Ads on search?

Mahad [39:38]: Yeah, so Google Ads, like you say, yeah, of course they love to make money. So Google Ads, from everything we can see in the industry, we don’t just keep up with the PT scope, but we keep up with the marketing side of things and how Google as a platform is changing. It’s adding Gemini, which is that AI tool that Google has, that will change. So Gemini, people have it on their apps, on their phones, some come pre-built, so that ad space is the newest one that we expect ads to appear. Realistically, for a lot of these agents that survive, and we know the ones that survive, like the ChatGPT type that survive, are going to be the ones that are backed by a lot of money, which is Google, so Google as a platform is going to be around. And the really important takeaway from everything we mentioned, Google Ads is really just amplifying what’s already there. So if your website is slow or vague, your ads are just going to amplify that problem, but if your ads are not really great, it doesn’t matter if you have the best website on earth, if you’re not running good ads to that website.

Neil [40:47]: Yeah, so it’s a whole ecosystem. I’ve seen that too, I think actually, I don’t know if they’re doing it already, but probably sometime early 2026, they’re going to start putting ads within the AI Gemini search results, right, so that’s another spot that ads are going to be, so we’ll have ads at the top, ads in Gemini, we’ll have ads in the local section. So again, if you’re not tapping into ads, or you’re just kind of keeping it on the back burner, doing a little bit of it yourself, your competitors are going to be the ones that can out-compete you in those sections. And I did see too that ChatGPT is looking to add ads into their system.

Mahad [41:18]: That’s something for us to think about for the future too, as again AI search becomes more and more popular, through both Google platforms and through OpenAI and ChatGPT, these different companies out there. The way that they make money is ads, right, that’s the way they make money. So right now ChatGPT has some pay-for models, but they’re losing money, they just keep the money going from investors until they get to a point where they have a big enough platform and they can monetize it with ads. So that’s where we’re at, in the future here, for ChatGPT and everything, there’s going to be ads there too.

Neil [41:56]: And so as a clinic, you just got to realize that you got to use ads to get people to find you, connect with you, come to your website, call you, book an appointment.

Mahad [42:08]: Exactly, exactly, I’m excited for where that space is headed. There’s so many changes, of course there’s changes within PT, we have, like we spoke about, with cash-based services and everything, but there are so many changes within Google, on almost a daily basis, but 100% on a month-to-month basis. So those changes are things that we have the infrastructure for and know a lot about, so it’s going to be really exciting.

Neil [42:38]: Excellent, awesome. Mahad, thank you so much for bringing your expertise and insight here, you’re a very talented and unique individual, in that you have the background in both physiotherapy, have been an excellent physiotherapist, and now in the digital marketing space, and specifically in the Google ad space. So kudos to all you’ve learned there and bringing to our clients and to our Canadian physios especially.

Mahad [43:02]: Yes, go Birds, if this is coming out with, or go Blue Jays. Go Blue Jays.

Neil [43:09]: All right, love it, awesome. Thank you to our audience too for being on the podcast with us here. I hope you got a lot out of today’s podcast. And don’t forget to like and subscribe and follow us here on the Practice Marketing Podcast, as well as our YouTube channel, where you’ll see all the video recordings from the podcast, as well as lots of tips and advice on our Market2Grow strategy, as well as on practicepromotions.net, tons of resources for you on there, so go on there, get some free downloads, get our Market2Grow strategy book, learn, understand how you can grow your practice. So this is Neil Trickett from the Practice Marketing Podcast, wishing you much success in your practice.