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Case study · Physiotherapy · Newcastle, NSW
A two-location physio clinic in Newcastle had run Google Ads twice and stopped both times. The accounts were structured around what the clinic offered, not what patients searched for. Inside 90 days, we rebuilt the campaigns around symptom-led keywords, stripped out the avatars Google couldn't deliver, and tracked every booking back to the search that earned it. The cost per new patient came down from $185 to $58, and the team stopped wondering whether Google Ads worked for physio.
ads.google.com / overview
First 90 days
3.2x
New patient bookings
Physiotherapy · Newcastle, NSW
$58
Cost per booking
Real client. Real numbers.
3.2x
New patient bookings
Compared to the prior 90-day window
$58
Cost per booking
Down from $185 at the start
19
New patients per month
Up from 6 in the baseline
4.8x
Return on ad spend
Calculated on first-12-month patient value
The starting position
When the clinic first reached out, Google Ads was a sore subject. They'd run two prior campaigns through generalist agencies. The first campaign generated clicks but very few bookings. The second campaign produced bookings, but they were the wrong patients: bulk-billing seekers, students, brand-name comparison shoppers. The team spent three months chasing leads that never converted into a treatment plan.
By the time we were brought in, the budget had already been written off mentally. The reasonable next step would have been to stop running Google Ads. We told them they didn't need to. They needed to run a different campaign.
The audit showed every avatar in the ideal-client list had been included as a target: post-surgical knee replacement, chronic disease management, paediatric musculoskeletal. None of these patient types arrive via Google. They arrive via surgeon shortlist, GP referral under a CDM plan, or paediatrician referral. The campaign was paying Google to show ads to people who were never going to type a search in the first place.
What we did
Before we touched a keyword, we cut the avatars off the target list. Post-surgical, CDMP, paediatric, workers comp post-acute. These patients still walk in. They just don't walk in via Google. The budget that was being lit on fire on those searches got reallocated to the avatars who actively search.
Lower back pain. Sciatica. Postpartum recovery. Pelvic floor. Runner's knee. Each became its own ad group, with its own ad copy, and its own landing message. Patients searching 'lower back pain physio' arrived on a page about lower back pain, not a generic services list.
Bulk billing. Free public clinic. Personal trainer. Pilates. Brand names of competitors with cheaper fees. We negative-keyworded the lot from day one and kept stripping them weekly. The traffic volume came down. The booking rate inside the traffic that remained came up dramatically.
We rebuilt their tracking so every booking in the practice management software could be tied back to the keyword that brought it. The clinic owner finally had visibility on what each new patient actually cost, broken down by the search that earned it. That visibility is what made the next 90 days easy to optimise.
The numbers
Across the 90-day period, the rebuilt campaign produced more than three times the new-patient bookings of the prior 90 days, at less than a third of the cost per booking. The traffic volume was lower. The conversion rate of the traffic that remained was much higher.
Metric
Before
After
Change
New patient bookings (90 days)
Before
18
After
57
Cost per booking
Before
$185
After
$58
Click-through rate
Before
8.4%
After
12.1%
Booking conversion rate
Before
1.1%
After
4.6%
Monthly ad spend
Before
$1,050
After
$1,100
We'd already decided Google Ads didn't work for us. Pete and the team rebuilt the campaign in a way no other agency had bothered to. Inside three months we had the most consistent flow of new patients we've ever had, at a cost per booking that meant we could actually grow.
What's next
The next 90 days are about scaling the strongest ad groups, building out condition-specific landing pages on the website, and starting a Meta Ads creative library to build a pipeline that compounds over the year.
Ready when you are
We'll show you what your clinic's version of this looks like.
Tell us about your clinic. We'll come back with a one-page plan: which patients to target, which to skip, and what 90 days should realistically deliver.
More stories
Looking for our general approach? See how we run Google Ads for physiotherapy clinics.