When a clinic owner tells us Google Ads “doesn’t work”, we ask to look at the account. Most of the time the channel isn’t the problem. A handful of settings, keywords or tracking gaps are quietly spending the budget on people who will never book.
This guide lists the mistakes we find most often when auditing Canadian clinic accounts: chiropractic, physio, massage, counselling, dental and more. For each one, it tells you where to look in your own account and what to change. You don’t need to be an expert; you need about 20 minutes and admin access to your Google Ads account.
Work through it in order. The settings mistakes come first, because they can waste money no matter how good your ads are.
Settings mistakes
1. Showing ads to people who aren’t near your clinic
The mistake: Google’s default location setting is “Presence or interest”. That reaches people in your area, but also people elsewhere who have simply shown interest in it. A clinic in Saanich can end up paying for clicks from people in Toronto researching a trip to Victoria.
Where to check: in your campaign settings, open Locations, then the location options. Google explains the choices in its advanced location options guide.
The fix: switch to “Reach people in or regularly in your targeted locations (Presence)”, and target a radius around the clinic (often 5–10 km in a city, 20–25 km in rural areas) rather than a whole province.
2. Running on networks you didn’t choose
The mistake: a Search campaign that also runs on Google’s Search Partners and the Display Network. Display in particular can use up budget on banner placements that rarely produce bookings for a clinic.
Where to check: campaign settings, Networks.
The fix: for most clinics, start with Google Search only. If you want to test Search Partners later, do it on purpose and watch its results separately.
3. Letting Google change your account automatically
The mistake: auto-applied recommendations can add broad keywords, change bids or rewrite ads without you seeing it first. We regularly find accounts where a keyword list someone carefully built has been widened this way.
Where to check: on the Recommendations page, open Auto-apply settings. Google’s auto-apply help page shows both places to find it.
The fix: turn off anything that changes keywords, bids or ad text. Review recommendations manually instead; some are useful.
4. Broad match keywords with no guardrails
The mistake: broad match lets Google show your ad for searches it thinks are related. Without strong negative keywords and conversion tracking to guide it, “physiotherapy Victoria” can match “physiotherapy school” or “physio jobs”.
Where to check: the Keywords list (look at the match type column), then the Search terms report for the last 30 days.
The fix: start with phrase and exact match on your core services. Only use broad match once conversion tracking is solid and you’re reviewing search terms every week.
Keyword and ad mistakes
5. No negative keywords, or a list nobody updates
The mistake: paying for searches like “massage therapy school”, “physio jobs”, “free counselling” or “chiropractor salary”. In neglected accounts we often find these taking a significant share of spend.
Where to check: the Search terms report. Sort by cost and read the top 50.
The fix: add irrelevant terms as negatives, and build a starter list before launch: jobs, careers, courses, school, salary, free, DIY, and the names of competitors you don’t want to bid on. Review it monthly.
6. Bidding on symptoms instead of services
The mistake: keywords like “back pain”, “anxiety” or “sore neck”. People searching those are mostly researching, not booking, and the clicks are expensive.
Where to check: your Keywords list and the conversions column next to each one.
The fix: focus on service and location searches (“chiropractor Langford”, “RMT near me”, “couples counselling Victoria”). Keep a symptom term only if the data shows it books.
7. One ad group for every service
The mistake: physio, massage and chiropractic all in one ad group, sharing one generic ad. The ad can’t match the search, so fewer people click and each click costs more.
Where to check: count your ad groups. If a multidisciplinary clinic has one or two, this is likely the issue.
The fix: one ad group per service, each with ads that repeat the service and location from the search, and each sending people to that service’s page.
8. Ads that sound like every other clinic
The mistake: “Quality care for the whole family” could be any clinic. Generic copy gets fewer clicks.
Where to check: open your ads and read them next to your competitors’ (search your main keyword and look at the top results).
The fix: be specific. Name the service and area, and add what actually sets you apart: same-week appointments, direct billing, evening hours, parking, a named practitioner. Use all available headline slots, and add call, location and sitelink assets.
Landing page mistakes
9. Sending every click to the homepage
The mistake: someone searching “sports massage Victoria” lands on a homepage and has to hunt for the right service and a booking button. Many leave.
Where to check: the Ads view shows each ad’s final URL. Count how many point to your homepage.
The fix: send each ad group to a page about that service, with the booking button, phone number, direct billing details and reviews near the top. Our landing page guide covers what to include.
10. A slow or awkward mobile page
The mistake: most clinic searches happen on phones. If the page is slow, the phone number isn’t tappable, or the booking form is long, people give up.
Where to check: open your landing page on your own phone, on mobile data rather than Wi-Fi, and try to book.
The fix: a tap-to-call number, a short form or direct online booking, and page speed you’ve tested. If booking takes more than a few taps, simplify it.
Tracking mistakes
11. No conversion tracking, or tracking the wrong things
The mistake: either nothing is tracked, or “conversions” include page views and button hovers, so the numbers look great but don’t match the bookings your front desk sees.
Where to check: Goals, then Conversions. Look at which actions are set as primary conversions, and compare last month’s conversion count with the new patients you actually booked from ads.
The fix: count only real enquiries: calls from ads, calls from your website, form submissions and completed online bookings. Our conversion tracking guide walks through the setup.
12. Not counting phone calls
The mistake: most clinic bookings still happen by phone. If calls aren’t tracked, the campaign looks worse than it is, and Google’s bidding optimizes toward the wrong things.
Where to check: in the same Conversions list, look for call conversions from ads and from your website.
The fix: add call tracking for both, and set a minimum call length so misdials don’t count.
Management mistakes
13. Set it and forget it
The mistake: an account that hasn’t been touched in months. Search terms drift, competitors change and costs creep up.
Where to check: the Change history. If the last real change was months ago, no one is managing it.
The fix: review search terms weekly for the first two months, then at least monthly. Pause what doesn’t book and move budget to what does.
14. Changing bid strategy too early
The mistake: jumping to a conversion-based bid strategy with no conversion history, or switching strategies every week. Either way, Google never gets enough stable data to learn.
Where to check: campaign settings, Bidding, and the change history for how often it has changed.
The fix: start on Maximize Clicks with a cap. Move to Maximize Conversions after 20–30 tracked conversions, then leave it for several weeks before judging.
Healthcare-specific mistakes
15. Ignoring health ad rules and your college’s standards
The mistake: outcome promises (“pain-free in 3 visits”), superlatives (“best physio in Victoria”) or remarketing to people based on a health condition. These can lead to ad disapprovals, and sometimes complaints to your regulator.
Where to check: the Policy column on your ads, and your college’s advertising standard.
The fix: keep copy factual and specific. For counselling and other condition-related services, don’t build remarketing audiences; Google’s health in personalized advertising policy doesn’t allow targeting people based on health conditions. Our counsellors guide covers the rules for mental health practices.
16. Ads running when no one can answer
The mistake: ads showing at 9 p.m. with a “call now” button when the front desk closed at 6. Those calls go to voicemail and are often lost.
Where to check: the Ad schedule in campaign settings, and the “Day & hour” reporting.
The fix: schedule call-focused ads for when you’re open. After hours, lean on online booking if you offer it.
The 20-minute checklist
- Location option set to Presence, with a radius around the clinic
- Search campaigns running on Google Search only (unless you’re testing partners on purpose)
- Auto-apply turned off for keywords, bids and ad text
- Core keywords on phrase or exact match; search terms reviewed in the last 30 days
- A negative keyword list covering jobs, schools, free and DIY searches
- Service and location keywords, not symptoms
- One ad group per service, each with its own ads and landing page
- Ads that name the service, the area and a real reason to choose you
- No ads pointing to the homepage
- Landing pages tested on your own phone
- Only real enquiries counted as conversions, including calls
- Changes made in the last month
- Bid strategy matched to how much conversion data you have
- Copy that follows Google’s health policies and your college’s standards
- Call-focused ads scheduled for your open hours
If you tick most of these, the problem is more likely budget, market or offer. Our guide to whether Google Ads is worth it helps you work out which. If you’re weighing another channel instead, see Google Ads vs Facebook Ads for healthcare.
Frequently Asked Questions
What is the most common Google Ads mistake clinics make?
In the accounts we audit, it’s wasted spend on irrelevant searches, from broad keywords, missing negatives and loose location settings. It’s also the quickest to fix.
How often should I check my Google Ads account?
Weekly for the first two months of a new campaign, then at least monthly. The search terms report and conversion numbers are the two things to look at every time.
Why does my Google Ads show conversions but no new patients?
Usually because the wrong actions are counted as conversions, such as page views or clicks on a directions link. Count only calls, forms and completed bookings, then compare the numbers against your booking system.
Should I use Google’s recommendations?
Some are useful. Review them manually rather than letting them apply automatically, especially any that add keywords, change bids or rewrite ads.
Can I fix these myself, or do I need an agency?
Most of the settings fixes above take minutes and don’t need an agency. Ongoing work, such as search term reviews, testing ads and adjusting bids, is where management earns its fee.
Want a second set of eyes?
If you’d rather have someone go through your account with you, get in touch. We’ll review your settings, keywords, tracking and landing pages, and tell you plainly what’s worth fixing, whether or not you hire us. See our pricing for how we charge.
