Your front desk picks up the phone. It's a vendor asking who handles purchasing. The next call is a patient who's been with you six years and wants to move her hygiene appointment. You paid full price for both of those clicks.

For years the default advice was that every practice needed a Google search ad strategy. We gave that advice too. Then we started listening more closely to the calls - the high-intent new patient inquiries we expected to hear weren’t coming from paid efforts alone.

Google Ads isn't pointless, and we're not telling anyone to switch it off this afternoon. But it’s not a default line item anymore. There are still practices and still procedures where paid search earns its place, and there's a clear test for whether yours is one of them.

And if it isn't, the answer is never to cut the marketing budget. It's to ...