Google Ads for Canadian clinics — patients in week one, not month six

Realistic monthly ad budgets: solo aesthetic clinic in a secondary market — CAD $1,500-$3,000. Multi-room med spa in Toronto/Vancouver — CAD $3,000-$8,000. Cosmetic surgery practice — CAD $5,000-$20,000. Management fees are typically 15-20% of ad spend or a flat retainer ($1,500-$3,500/month) depending on account complexity. Most clinics underspend in month 1 to validate, then scale.

Yes, with limits. Google classifies Botox, Dysport, Juvederm, Restylane, and Belkyra as prescription products — you can advertise the clinic and consultation but not the product itself. Cosmetic services (HydraFacial, Morpheus8, lasers, CoolSculpting) are easier. Medical conditions (acne, eczema) are restricted under the personalized health policy. I scope ads only where they work and clear policy.

First consultation requests typically arrive in week 2 of a properly-built campaign. Cost per booking stabilises by month 2 once we have enough data to optimise bid strategy and refine the negative keyword list. By month 3, most clinics see a predictable, scalable cost per consultation that lets you decide whether to increase budget.

Most common reasons in clinic ads: before/after imagery (banned in Google healthcare ads), price advertising on prescription items (Botox specials), fear-based copy ("eliminate your acne"), targeting medical conditions directly, and unverified healthcare advertiser status. I review the disapprovals on the audit call and tell you which are fixable copy issues vs which require account-level changes (advertiser verification, restructured landing pages).

Both, in most cases. Search captures high-intent patients already looking for your services. PMax expands reach through display, YouTube, Discover, and Gmail without you manually managing those channels. Run alone, Search is conservative but precise; PMax alone is risky because it can absorb budget into low-quality placements. The combination, properly structured, is what produces the lowest blended cost per booking.

Both. Landing pages are usually 60% of paid performance — most clinics send ad traffic to their homepage or a treatment page never built for paid. I build dedicated landing pages for each major campaign with proper headline-keyword match, trust signals, mobile-first design, and conversion tracking wired in from day one.

Yes — I integrate offline conversion tracking with Mindbody, Vagaro, Boulevard, Square Appointments, Acuity, and Calendly so Google Ads optimises against actual booked consultations and revenue, not just form fills. This is one of the highest-leverage moves most clinics never make.

A generalist agency runs the same campaign template they use for plumbers and dentists. They miss healthcare policy nuances, get ads disapproved, and report on clicks. Clinic-specific Google Ads requires knowledge of: which prescription products you can name in ads, which landing page elements trigger personalized health flags, how to structure PMax to avoid wasted impressions on irrelevant verticals, and how to attribute bookings across Mindbody/Vagaro/Boulevard. Six years in this niche means I already know it.

First 90 days is a fixed onboarding period for ad account work — that's when most of the structural setup, tracking, and creative testing happens. After that it's month-to-month with 30 days' notice. You keep the ad account, the landing pages, the creative — everything. No hostage situations.