Before You Vet a Healthcare Marketing Agency, Write Down Three Numbers
If you vet a healthcare marketing agency properly, it takes about two weeks. At the end you have one agency you trust, a contract you’ve read line by line, and one number you’ll hold them to in month four. If you do it badly, it takes one sales call and a signature. Then in month nine you find out your Google Ads account belongs to someone else.
Here’s the short version of what you’re checking for.
Vetting a healthcare marketing agency means confirming four things before you sign. Their results come from practices like yours. They handle patient data with HIPAA in mind. They report on booked patients, where most agencies stop at clicks and form fills. And the contract lets you leave with your ad accounts, website, phone numbers, and data intact.
But you can’t judge any of that until you know what you’re hiring for. If you don’t bring a goal to the pitch, the agency will pick one for you, and it will pick one it can hit. So before the first call, write down three numbers.
- New patients per month right now, and what you spend to get them. A rough figure is enough. Divide total marketing spend by new patients and you have a cost per new patient to beat.
- How many new patients you can absorb. If your providers are booked three weeks out, more leads will pile up at the front desk. Say you run a single-location med spa with two injectors, and both are full on Tuesdays and Saturdays. You need demand on Mondays and Wednesdays, and you need it for specific services.
- The two or three services that matter most. Usually these have the best margin or keep patients the longest. A dental practice chasing implant and clear aligner cases needs a different plan than one trying to fill hygiene chairs.
Bring these to every call. Then notice which agencies ask for them before you offer. That tells you more than any pitch deck.
What can go wrong: skip this step and you’ll end up comparing agencies on price and personality. The cheapest agency and the most likable one are rarely the one that fills your Monday schedule.
Ask for Proof You Can Verify, Including the Client Who Left
You’ve probably sat through a pitch where someone said they tripled leads for a dental practice. Maybe it was true. But if you don’t know the ad spend, the market, the time period, and what counted as a lead, the number tells you nothing. A practice that tripled leads by tripling its budget got a bigger bill and the same marketing.
For every case study an agency shows you, ask:
- What specialty, and what size practice?
- What was the monthly ad spend and the management fee?
- Over what time period?
- Does the number count leads, booked appointments, or patients who showed up?
- Can I talk to this client?
Good agencies answer these without flinching, even when they have to hide the practice’s name. If the answers get vague or turn into “every practice is different,” write that down.
Next, ask for references, and ask for one former client by name. Anyone can find two happy current clients. A former client who’ll get on the phone and say “they were good, we outgrew them” is worth more than both. If the agency says no former client will talk to you, that’s an answer too.
When a reference picks up, skip “were you happy?” Ask questions that are harder to spin:
- How long until you saw your first booked patient from their work?
- Who ran your account day to day, and did that person change?
- What happened the first month results dropped?
- Did you ever have trouble getting into your own data or accounts?
- Would you hire them again at the same price?
One more check. Ask them to screen-share a live reporting dashboard for a current client (names hidden is fine). A polished PDF case study only has to be put together once. A live dashboard shows you what they look at every week.
(Side note: be careful with agencies whose own case studies brag about patient outcomes, like pounds lost or dramatic before-and-after results. If an agency is that loose with medical claims in its own marketing, expect the same with yours.)
How Do You Know If a Healthcare Marketing Agency Takes HIPAA Seriously?
Ask them straight out: will you sign a Business Associate Agreement?
Under HIPAA, any vendor that creates, receives, stores, or transmits protected health information for you needs a BAA. For a marketing agency, that usually comes up with call recordings, form submissions that include health details, access to patient records in your CRM, or uploading your patient list for a reactivation email campaign. Plenty of agency work never touches PHI, like writing blog posts or managing Google Ads keywords. But as soon as an agency asks for your patient list, you need to have the BAA conversation.
You want an answer like: “Yes, for these specific services, and here’s where PHI does and doesn’t flow.” This answer should worry you: “We don’t need one, we’re a marketing company.”
Then ask how they handle tracking pixels. Agencies that came from e-commerce often get this wrong. The Meta pixel and similar tags can send visitor data to ad platforms when they sit on appointment request pages, patient portals, or pages about specific conditions. HHS issued guidance on online tracking technologies in December 2022 and updated it in 2024. In June 2024 a federal court vacated part of that guidance, the part about unauthenticated public pages. The risk didn’t go away with it. Tags inside logged-in areas like patient portals are still clearly covered. And the FTC’s 2023 enforcement actions against GoodRx and BetterHelp were both about health information reaching advertising platforms.
A good agency will have a view on this. They might use server-side tracking or an analytics setup built with HIPAA in mind. Or they might keep ad pixels off any page where people enter health information. You don’t need to follow the technical details. You need to hear that they thought about it before you asked.
Last, ask how they handle advertising rules. State medical boards regulate before-and-after photos, testimonials, outcome claims, and words like “specialist.” In the US, Google requires LegitScript certification before you can run ads for addiction treatment. An agency that says “we’ll handle all the compliance” is overpromising. A better answer sounds like “we know the common rules, we flag risky claims, and your counsel signs off on anything borderline.” Treat all of this as a starting point, and have your own healthcare attorney review the BAA itself.
What can go wrong: the bad version usually shows up as a patient complaint or a demand letter. By then the pixel may have been firing for a year.
Ask What They Report On (and What Happens When It Drops)
Leads are cheap. Booked patients are expensive. Agencies know this, and it’s why so many monthly reports lead with impressions, clicks, and form fills.
Ask each agency for a sample monthly report. Then ask them to point to the one number they’d want to be judged on, and compare it to this:
| What they report | What it tells you | What to ask for instead |
|---|---|---|
| Impressions and reach | Your ads were shown. It says nothing about patients. | Cost per booked appointment |
| Clicks and traffic | People visited. Some are bots, some are job seekers. | Share of visits that turn into appointment requests |
| Leads and form fills | Someone raised a hand. Many never answer the phone. | Lead-to-booked rate, tracked in your CRM or practice management system |
| Keyword rankings | You show up for a term, which may be one nobody searches. | Calls and bookings from organic search and your Google Business Profile |
| Phone calls | The phone rang. That includes existing patients and wrong numbers. | New-patient calls, answered vs. missed, recorded under a BAA |
| Booked appointments | Close to what matters. | Show rate and revenue by service, where your systems allow it |
That last row takes work on your end. Tying marketing data to your practice management system is rarely clean, and some platforms make it painful. A good agency will tell you honestly how close they can get to revenue tracking with your setup, and what they need from your front desk to get there. The best ones also ask about call handling. A lead that hits voicemail at 5:15 p.m. is a lost patient however good the ad was.
Then ask about timelines, because that’s where most overpromising happens. In our experience, paid search can start producing booked patients in the first 30 to 60 days once tracking is set up correctly. SEO is slower. Real organic movement usually takes four to six months, and longer in competitive metros. If an agency promises page one for “dentist near me” in a major city within 90 days, they’re telling you what you want to hear.
The last question here is my favorite: “Tell me about a client whose results dropped. What did you do?” Every agency has one. The ones worth hiring can tell you the story in detail, including what they got wrong.
Read the Contract for Four Clauses Before You Sign
Most of the pain in agency relationships traces back to the contract, and most practice owners skim it. Read these four sections slowly.
Who owns the accounts?
Your practice should own its Google Ads account, Meta ad account, Google Analytics property, Google Business Profile, domain, and website. The agency gets access. If the agency sets up accounts under its own login, you lose your history when you leave. Years of conversion data in Google Ads is a real asset, and starting from zero costs you months.
Call tracking numbers are the sneaky one. Say the agency puts its tracking number on your Google Business Profile and website, and the number is registered to them. When you leave, your phone number changes everywhere patients have seen it. Ask for numbers in your practice’s name, or get a written promise to transfer them to you when you leave.
Term and termination
I’ll be a little contrarian here. A minimum term isn’t automatically a red flag. SEO takes months, and an agency on a month-to-month SEO deal has every reason to do quick, shallow work. A three- to six-month initial term for SEO is reasonable. A 12-month lock with no exit if results don’t show up is a different animal. Look for a 30-day cancellation clause after the initial term. Better still, get an exit tied to the number you wrote down in step one.
How ad spend is handled
Ask whether Google and Meta bill your card directly or whether spend runs through the agency. Running through the agency isn’t always bad, but it makes markups easy to hide. And if they charge a percentage of ad spend, their fee grows whenever your budget grows, whether or not results do. A flat fee, or a flat fee plus a performance bonus, ties their pay more closely to your results.
What you keep when you leave
Think landing pages, ad creative, reporting dashboards, email lists, and website files. Get in writing which of these stay with you. Some agencies build websites on their own platforms that you can’t take with you. With those, leaving the agency also means rebuilding your website.
What can go wrong: a practice signs a 12-month deal, results stall in month three, and the only way out is paying for the remaining nine months. Have your attorney read the contract, especially the BAA and cancellation terms. A few hundred dollars of legal review is cheap by comparison.
Meet the Person Who Will Run Your Account Day to Day
The person on the sales call is often not the person doing the work. A founder or senior strategist closes the deal, and a coordinator juggling 25 other accounts runs it. That setup can work. You should know about it before you sign.
Ask to meet your account manager and whoever builds the campaigns. Ask how many accounts each of them handles, which specialties they’ve worked in, and how often you’ll hear from them. Monthly reporting calls are standard. A named person who replies to email within one business day matters more than a fancy client portal.
A word on specialization. Healthcare experience matters, but it’s a blunt filter. An agency that mostly runs brand campaigns for hospital systems can be lost running cash-pay patient acquisition for a med spa or concierge practice. An agency that’s great with dental groups may not understand referral-driven specialties like GI or orthopedics, where a large share of new patients come through physician referrals. So ask about experience with your revenue model: cash-pay or insurance, elective or referral-driven, one location or several.
And watch what they push back on. If you say you want to double new patients in 60 days and they say “sure,” walk. An agency worth hiring will tell you which part of your plan they think is wrong, even if it costs them the sale.
Score Each Healthcare Marketing Agency Before You Decide
Once the calls and reference checks are done, score each agency on the ten items below. Give 2 points for a clear yes backed by evidence, 1 for a partial or vague answer, and 0 for a no or a dodge.
| Criteria | What a 2 looks like | Score (0-2) |
|---|---|---|
| Asked about your capacity and target services before pitching | They asked for your numbers without being prompted | |
| Case studies include spend, time period, and what the metric counts | Every result comes with context | |
| Provided a former-client reference | You spoke with someone who left | |
| Showed a live reporting dashboard | A screen share of the real thing | |
| Will sign a BAA where PHI is involved | Clear yes, plus a map of where PHI flows | |
| Has a plan for tracking pixels on sensitive pages | Named a specific approach | |
| Reports on booked appointments or better | Cost per booked patient is the main number | |
| Gave realistic timelines | Paid search in 30-60 days, SEO in months | |
| Practice owns all accounts, phone numbers, and the website | Written into the contract | |
| Reasonable term with a real exit | 30-day cancellation after the initial term |
16-20: Sign, and schedule a 90-day review against the number from step one. 10-15: Go back to the agency with the specific gaps. Some of them, like contract terms and account ownership, are easy to fix if the agency wants your business. Under 10: Walk away, even if they’re the cheapest option.
The checking continues after you sign. In the first 30 days, confirm you have admin access to every account they set up. By day 60, you should see tracking that connects spend to booked appointments. At day 90, compare cost per booked patient to the baseline you wrote down before any of this started.
For what it’s worth, PatientProcure isn’t the right fit for every practice. If you need a one-time website rebuild and nothing else, a good web studio will do it for less. We work best with practices that want a steady, measurable flow of booked patients and are willing to tighten up their front desk along with their marketing.
If you want to see how we score, put us through this same scorecard. Book a free strategy call, bring your three numbers, and we’ll show you where your practice loses patients between the first click and the booked appointment.