V'NIA
Patient calls across four clinics, with brand leads at $15 each.
Advanced Holistic Center is an integrative medicine practice combining traditional Eastern medicine with modern clinical care: acupuncture, physical therapy including the Schroth Method for scoliosis, and fertility support. It holds a 4.8-star reputation across Manhattan, Brooklyn, Brickell and Sunny Isles Beach.
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Book a strategy call →Booking marketplaces crowding a local practice's best searches.
In New York, Zocdoc appears beside the practice's ads in 25% of auctions, so patients searching for acupuncture or physical therapy see a booking marketplace competing for the same click. In Florida, Groupon pulls price-sensitive shoppers toward discount offers. Every lead costs more to win.
- 01
A local Performance Max campaign per market
Separate New York and South Florida campaigns, so each market gets its own budget and is judged on its own cost per lead.
- 02
Optimized for patient calls
The primary conversion is a patient phoning the practice directly from an ad, the action closest to a booked visit.
- 03
Protected brand demand
Searches for the practice by name are its cheapest, highest-intent leads, and they doubled their conversions.
- 04
Diagnosed the cost increase
Auction data showed the rise came from Zocdoc and Groupon bidding harder, not from fewer patients searching.
- 05
Set the plan to win back efficiency
A Target CPA bid strategy, Asset Groups upgraded from "Average" to "Excellent" with full headlines, images and native video, and Customer Match lists to re-engage past patients.
A strong foundation under auction pressure.
Both campaigns delivered leads, with New York the more efficient market at $72.92 per lead and 61% of conversions.
Brand leads cost about one-fifth of the average
A lead is a patient calling the practice directly from an ad.
| Campaign | Leads | Cost per lead |
|---|---|---|
| PMax – Local – NY | 17 | $72.92 |
| PMax – Local – FL | 11 | $88.11 |
| Total | 28 | $78.89 |
714 clicks, a 3.9% conversion rate.
The honest read
Against the prior period, conversions fell 15% (from about 33) and cost per lead rose 19% (from about $66) as Zocdoc and Groupon pushed harder into local holistic-care auctions. That points to costlier auctions, not lost demand. Google's own estimates put the bid strategy and creative upgrade at roughly 14% more conversions, about 32 leads a month at close to $69 each, as an upper bound.
Aggregators can outbid a single practice on generic searches. They can't copy a 4.8-star reputation or patients who search for you by name.
- Market pressure, not demand lossEach lead costs more to win because of who else is bidding.
- Brand loyalty is the strongest assetReturning patients and referrals search for the practice by name.
- New York beats Florida by $15 a leadGroupon's discount-driven competition lifts Florida costs.
- Creative is the bottleneckStronger assets unlock more placements, including YouTube Shorts.
Your brand could be the next case study.
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