Ep 203; Are Podiatry Google Ads Dead?

Google Ads isn’t dead… but if you run a podiatry clinic, it might feel like it. 

In episode 203 of the Podiatry Business Podcast, I’m going to break down how Google Ads actually works—an auction on keywords—and why the game has changed so dramatically in the last 12 months. 

We’ll talk about the two types of searches that used to drive consistent new patient enquiries: the “podiatrist near me” book-now crowd, and the condition-based researchers looking for answers. 

Then we’ll unpack what AI, ChatGPT, and Google’s own AI results have done to that second group—and what it means for your ads, your website, and your AI SEO strategy

Transcript

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SPEAKER_00 0:00

Welcome to the podiatry business podcast, brought to you by your host, Lorcan O'Donnell, podiatrist and health business mentor, the podcast that is designed to help current and aspiring podiatry clinic owners to make the most of their clinic, turning it into a true business that can work without them, allowing them the freedom to earn more, work less, and live a better life.

SPEAKER_01 0:25

Hello and welcome to episode 202 of the Pediatry Business Podcast. So today's podcast is titled Are Pediatry Google Ads Dead? So if you're a clinic owner and you've been running Google Ads for any length of time, you've probably had the same thought recently. Is this thing still worth doing? Costs are probably up, maybe your leads feel a bit different, maybe they're not converting, they're not answering the phone. So the question is asked, and has been asked and discussed in my coaching program is Google Ads dead? And the answer is no, it isn't dead. But the version of Google Ads that most podiatry clinic owners remember, and if I'm honest, are still doing the way they're doing it is dead. So what I'm going to do in this episode is I'm going to break down how Google Ads actually works, what's changed in the last few months, and what you, as a podiatry clinic owner doing Google Ads, need to do now, especially if you're relying heavily on Google Ads or you were relying heavily on Google Ads for new patient inquiries. Okay, so how does Google Ads work in plain English? So basically at its core, Google Ads is an auction. So every time someone searches for something like Pediatrist Near Me or Planterfasciitis treatment, Google will run a behind-the-scenes auction and decide which ad will show up. It will be your ad in what order will it show it, and it's gonna also decide how much each click on that ad is going to cost you and your competitors. And here's the important part: it's not about simply who bids the most wins. There is a degree of that, but it looks at a few other things. It looks at firstly your bid. What are you actually willing to pay? Uh how relevant is your ad? Does it come? Does your ad match what the people have been searching for? What's your your landing page going to be like? What's the experience of the person when they come to your landing page? Now, if you're sending all of your ads to your home page, that's not a good thing. Um, and what does Google think people will click through to? So that all that combination is done in the background using what they we call the algorithm, which is basically software. Um and that combination will just determine whether your ad will show at all, and what you're gonna pay for that ad to show and to be clicked on. Um so I have a lot of experience running Google Ads for clients for for years, and for years, Google Ads was the most reliable intent channels for clinics. Now, Google Ads is fantastic, it still is fantastic, it's hugely important, but it has been an absolutely enormous change when it comes to Google Ads in the past 12 months, really. When we ran Google Ads for clients up until recently, we typically saw two types of searches and they behaved very differently. So in group one, these were people who were typing into Google Ads, into Google rather Google search near me, and they had booking intent searches. So these were people who were further along the decision-making process, and they were pretty much ready to make an appointment. So they would go and they would type in podiatrist near me or podiatrist, whatever town you're in, London, Cottentry, whatever, uh, or foot pain clinic, etc. etc. You get the gist. These were people who usually wanted to book now. They had already decided that who they were going to that they needed to see a foot clinic or podiatrist, and they just wanted to get on and find someone. And what happened a lot of the time is that they'd click on the ad, they would look at the ad, and there would be a book online or a call now uh button if the ad was done correctly. They rang the clinic, and assuming someone answered the phone, which surprisingly doesn't happen all of the time, they go ahead and they would be booked in by the person who answered the phone, assuming that they did their job properly. So it's pretty straightforward, and it was a great conversion. The conversion rates were really high for these people because once you got them to answer the uh to ring and the phone was answered, typically you're talking nine out of ten or more would actually go ahead and book in once the front desk team was trained properly, and that's fantastic. And you were able to see, and you are able to see with those um how many times the phone rang from that ad, and you're also able to see we have set up in a certain way how many times do we was the phone answered. So if we set it up that if the phone uh if the the phone call lasts less than say 10 or 15 seconds, then we would assume that the phone wasn't answered properly, just went to voicemail, and that's not a conversion. Um, because you're not gonna book someone in in less than 10 seconds, are you? Really? So that's group one. Group two that was working really well, were the people who were in the information gathering phase, and these were condition-specific type patients, so they they it was a totally set separate booklet to the first type who were ready to book right now, and they were a gold mine. These are people who would search put in search terms that you could bid on for particular conditions you wanted to attract. So they might, for example, type in plantar fasciitis treatment or uh fungal nail um solutions, etc. etc. Um, and you were able to, if you did this properly, you were able to figure out well, which of these conditions do I want to attract, and if I want to attract uh because they're they're profitable and I want to fill my clinic with them, and then I can go and I can if I set my marketing up correctly, I can get these people into my funnels. So they weren't ready to book yet in the majority of cases, they were in the researching phase. But if you did your ad properly and your landing page was done right, they were happy to exchange their contact details for something useful, like maybe a guide or a checklist or maybe a short video on how to fix the plant of fascicles. And then what would happen is once you had their details, your job then was to follow up with them, and you could automate this, and we would do this for clients. We automate the follow-up, so we would have an automated email sequence, maybe automated SMS, automated AI bot. Maybe you'd even have a call from the reception team to ring out and say, Did you get the lead, etc. etc. Now that's not working, people are not answering the phone anymore. Um, but you really what you wanted was you wanted an autumn as automated as you can and you uh follow-up system, and then what would happen is you would convert these people over the next few days or the next few weeks, they wouldn't typically uh convert within that day, and then AI search changed absolutely everything for this group. So, what it's done is it's completely reshaped how people are searching and doing this research. You've now got Chat GPT, you've got Google AI overviews or AI results you see yourself. So when you type something like how do I fix my plantar fasciitis, you'll see that Google itself doesn't give you an ad, it gives you an AI result. Um, even voice search is getting smarter on your phone. And what's happening is people are asking longer and more specific questions, they're taking their time about making this next step about booking that appointment. So the big shift here is that this second group, these information gatherers who previously Google Ads was working really well with, but would take maybe a few days to convert, they don't need to go to your website at all anymore to get the information that they want. They don't go to your website, and this is this is backed up by recent research that is showing that traffic to websites from Google has dived, nose-dived massively in in cases like the the New York Times or whatever they're reporting 70% drop in website traffic, 70%, and the same thing is happening to your clinic now because people don't need to go to your website to get the information, they can just get it off ChatGPT or even off Google itself, so they can get a good enough answer right inside the Google AI summary, chatbot response, etc. etc. So the journey has changed, and instead of search a condition like plantofasciitis, clicking to a website, reading it, leaving your details, and then follow-up, it's more now like search a condition, AI gives you the answer, and you keep researching without you, the clinic owner, or your website being needed. They will only visit your clinic site when they're ready to book, and in many cases, they will choose the site to book if AI has recommended it. So, what this means is what this means for Google Ads and why it feels worse is that if you're still running ads for the old way, and when I say the old way, I mean mid-2025, even late 2025, a few things are happening with your ads. You're getting fewer leads that are condition-specific. Your cost per lead is going way up, your conversion rate is probably dropping, and you're starting to think that Google Ads just isn't isn't working, it's broken, but it's not broken. Instead, what's happened is uh the behavior of the person has changed. Google is pushing more ad inventory, it's pushing more automation, and it's more interested in black box campaigns. So, what do I mean by that? So, when I say ad inventory, what Google is doing is it's showing more ads in places on the search page, and it's pushing down, pushing down the ads more, showing more AI, and and you're getting more often uh your what was happening before is not being shown being pushed down. So the net effect is basically there's more competition for attention and you can pay a lot more money to stay visible. There's more automation. Google increasingly wants you to let it decide this how you get results and how much money you're going to spend. So, examples would be automated bidding, broad match being pushed, uh, auto-created assets, etc. Now you don't know what the hell that means, but essentially what it means in practical terms is Google can waste an awful lot of your money and it will spend all of your money, which it didn't do before, if you don't know what you're doing and if you're it's not being done correctly. We have a client who's was spending a significant amount of money on Google Ads, and we took over the ads, and what we've seen is that it was just not set up correctly, it and a lot of this was being done, it was allowing Google to make all of the decisions. Now, what you want to do instead is you want to work with Google, and we have cut we've managed to get the same results from 50% less spend, and now we're going to turn that back up again and get better results from the same spend. Uh, third thing is black box campaigns, with basically it you just give Google the money and you let it do whatever it wants, and it says it will send you results. Again, this is not a good idea. Um, you this only works really, really well if you're really tracking conversions, if you've got really solid guardrails, and if you really know what you're doing, and that's typically not what's happening because typically most clinic owners are spending a very tiny amount of money paying a company to do the Google Ads, and they're not going to put the time and effort in that they should be as a result of that. So, yes, Google Ads has massively changed, it's changed dramatically in the last 12 months, so it's not dead, um, but it is becoming more concentrated around higher intent patients. That means that um podiatrist near me searches that type of things still matter and they work really, really well. Um, brand searches matter more than ever, so the name of your clinic will matter, and what you don't want to be doing is spending all of your money on searches for your clinic that Google will organically show if you set that up correctly correctly. Your reputation and reviews influence conversion far more than they did before, and your ability to answer the phone and follow up fast is going to be a massive lever. So if Google sends you phone calls, you don't answer them, it's likely not to send you as many people in the future, and it's going to charge you more going forward. So the easy days of buying cheap condition-specific traffic and converting them with a lead magnet is getting much much harder. And in my own clinic, I've turned these off in my Google Ads, and I've gone down for that making the phone ring with Google Ads approach, which works really well. So, how do you get these condition-specific? Well, what you need to do instead is you need to combine this new Google Ads approach with AI SEO. So, if you want to win, there's a few things you need to do. You three things I would recommend. One is run Google Ads that are for bottom of funnel intent. What I mean is people are ready to book now. So you still want to show up when someone is typing into Google, podiatrist near me, and is ready to book. You want to make sure that you are the person that shows up and that you're actually going to be available and that the ad is set up correctly to make them phone you or book online and get that appointment booked. So that means having tight location targeting, really uh call-focused ads, and making sure that the ad the landing pages are built for booking, not for browsing. Uh, you also want to make sure that you're tracking this correctly and that you're looking at the missed calls and you're following up on them. Second thing you would want to do is if you're looking for condition specific, and I'm not going to get into too much detail, but you want to move your pay some of your paid ad budget from Google over to meta ads. We're seeing in meta ads, which means Instagram, Facebook, that condition-specific ads, if done properly, if the strategy is done really well, that it works really, really well, and you can get people to book in and pay you in advance online for those appointments. So plantar fasciitis, fungal nail, ingro and ale, varuca, whatever it is, meta's working really well there for people who weren't necessarily ready to book an appointment. And then the third thing is you need to start doing AI SEO. So basically, you need to do SEO, that means that you show up inside for in AI when they ask that question. You need, and I've done a podcast on this before, you need to make sure that you are the authority in this condition in your area, and to do that, you need to be publishing AI-friendly SEO on a daily basis. So doing a blog once a month is a waste of time. That is what we used to do in 2012. It's got to be daily. So it means creating content that's structured and written away that Google can understand, that the AI systems like ChatGPT can understand and can read and can summarize, and that patients, when they read it, they can trust it. You're not writing blogs. What you're writing is clear condition pages, FAQs that match patients' real questions, and content that will show expertise and local credibility. Another thing you need to make sure is that you've got strong internal linking in the back end, and that is a that is a really important thing that tends to be just left because it's not something that you, as the clinic owner, tends to see, and your marketing agency tends not to do these things for you. And this works really well. And if I give you an example, um, just yesterday I was contacted by a national radio station who wants me to come on and talk about footwear and shoes and so on, and they mentioned that they had read a blog on this that I had written. So, what had happened is uh I had an AI blog written, AI-friendly blog written on a certain condition. Obviously, this person went to ChatGPT or Google or wherever and asked for help on this, and my AI-friendly blog turned up completely organic. They read it, they saw this guy has expertise in what we're looking for, reached out to me, and this weekend I will be on national radio. So this shows you the example of how the new marketing system has changed from Google Ads before when it comes to condition specific. So if AI is going to answer that question, you need to make sure that your clinic is the one that it the sources will pull from. So, to wrap up, what I want you to take away from this podcast is that it Google Ads is not dead, it is still works exceptionally well if you do uh do it properly. But the old playbook, the old way of doing it, is dead. The clinic that will win now when it comes to Google Ads is the one that uses Google Ads to capture high-intent bookings. People are ready to book now and are going to phone. You gotta actually answer the phone too. You gotta build authority through sort of AI, and the Google AI will trust them, and you have to have a follow-up system that will turn this interest into appointments and so on, and you need to automate this as much as possible through using AI chatbots, using AI voice, etc. etc. So this is what we do here in More Practice Profits and in our Pediatry Patients on Tap service. If you are looking at your Google Ads and you're thinking, I don't know if this is actually working, etc., or you want to build an AI SEO strategy that supports it, and just reach out to me, go to More Practice Profits, reach out to me, let's have a conversation, or you can simply uh message me through whatever way you want to message. LinkedIn works really well. What we'll do is we'll have a quick chat, maybe look at your Google ads, seeing what it's doing right now, seeing where you're getting leads, where are you missing leads, what holes do you have in your strategy, and we can talk about your next steps and what I'd suggest you do from there. So, until the next time, this is uh Lorcan from the Pediatra Business Podcast signing out.