Decision Frameworks
Start the ads before your new practitioner does
The wages clock and the ads clock start on different days. Most owners synchronise them in the worst possible way.
By Pete Flynn · 6 July 2026 · 7 min read
Every owner I talk to about hiring says some version of the same sentence: we'll get them settled first, then look at marketing. It sounds prudent. It is usually the most expensive line in the whole hire. The wages start the day your new practitioner walks in. The patients from your ads start four to eight weeks after you switch the campaign on. Put those two clocks side by side and the question answers itself.
The two clocks
Wages start on day one. Ads start when you switch them on, plus four to eight weeks.
Ads on before they start
patients flowing from their first week
Wait and see how they go
the shaded months are the cost of waiting
The two clocks
A new practitioner is a cashflow decision. From day one you pay their base wage, their super, their room, their software. What you get back depends entirely on how fast their diary fills.
Google Ads runs on its own clock. A new campaign spends its first weeks learning: which searches convert, which don't, what a booking costs. Most clinic campaigns take four to eight weeks from switch on to a steady flow of booked patients. That lag does not care that your new hire started on Monday.
So the choice is never really ads or no ads. It is whether the campaign does its warming up on your time or on theirs. Switch the ads on six weeks before day one and the flow is live when they pick up their first appointment list. Switch them on after they start and the warm up happens while you are paying a full wage into a thin diary.
The campaign warms up either way. The only question is whether it warms up before day one or while you pay wages into an empty diary.
What waiting actually costs
Take a typical physio hire. Salaried, a $110 fee, a diary that is full at 40 appointments a week, and a clinic that can feed them 12 new patients a month from its own flow, which is where a lot of second and third hires actually sit. That flow plateaus the diary well short of full. Paid ads cover the gap.
Wait three months into the hire before switching the ads on, then sit through the warm up, and by month 12 that diary is around $2,400 behind even after crediting back every dollar of ad spend the wait saved, with a cash dip about $3,200 deeper. Stretch the wait to six months, the common 'let's see how the year goes' version, and the cost jumps to around $22,000 in the first year and break even slips five months.
Thinner flow is more brutal again. At eight new patients a month of your own, a three month wait costs about $7,600 and a six month wait about $33,500, with a dip up to $22,000 deeper and break even seven months later. The less your own patient flow can feed the diary, the more every month of waiting costs.
Ads live before day one
- Campaign warms up before they start, on a smaller spend
- Patients flowing in their first week
- Diary full around month four
- Shallower cash dip, earlier break even
Wait and see how they go
- Full wages into a thin diary for months
- Warm up happens after the wait, so the lag doubles up
- Diary full around month nine
- Deeper dip, later break even, an anxious practitioner
Run it on your own numbers
Every clinic's version of this maths is different, which is why generic advice is useless here. The forecast below runs your new hire's first two years twice: once with the ads live from day one, once with the wait you are considering. Three inputs and you have the dollar figure on waiting, the break even month for each path, and the cash dip on both curves.
It is the same engine behind our Rolling Break Even tool, and it is deliberately honest. It claims nothing for bookings made before your hire's first day, and it charges the earlier start every extra dollar of ad spend it uses.
Next hire forecast
Start the ads now, or wait until they start?
Three numbers and you have an answer. The forecast pays your new hire the way you actually would, the higher of base wage or commission each week, and runs their diary month by month twice: once with the ads live from day one, once with the wait you are weighing up. Every dollar figure includes super.
On these numbers, having the ads live by day one is enough for your next physiotherapist. Waiting longer than that starts to cost. All figures include super.
Ads timing
Includes superDay one is soon enough
On your numbers, your own patient flow carries the early months, so the campaign can mature while the diary builds and this wait costs you nothing. That verdict is honest, not polite. Thinner new patient flow or a longer wait changes it; move the dials and watch.
Cost of waiting, first year
Nothing
waiting three months into the hire is safe here
Break even, ads from day one
Month 7
waiting doesn't move it
Deepest cash dip
-$13,302
the same either way
Adds each year once settled
$79,265
What is holding them back
New patient flow, not their ability to see people. At 20 new patients a month they plateau at about 28 a week, short of a full 40. You'd be paying for about 12 empty slots a week. Filling that diary is worth roughly $42,493 a year from this one hire.
At 20 new patients a month, your new physiotherapist only ever half fills their diary.
That gap is worth about $42,493 a year from this hire alone. A predictable flow of new patients is exactly what we build.
See if we can fill the diaryWhat it's worth to fill their diary
Right now they only ever fill 28 out of 40 client appointments in their diary.
That gap is new patients. Here is what it costs to close it, and what closing it puts back in your pocket every year.
Most physiotherapist clinics pay $80 to $100.
How fast you fill the diary only changes when you get there, not what it is worth each year. Most diaries fill over four to six months.
Extra new patients a month
+9
from 20 to 29 a month
Marketing to get them
$810 a month
about $9,720 a year
Their diary
Full by month 6
28 up to 40 a week
Profit from this one hire, every year once the diary is full
$32,773
More profit a year
after the marketing
4.4x
Back for every $1 a year
$26,418
Banked in the first year
as it fills by month 6
Spend about $810 a month to bring in 9 more new patients, and a full diary is worth $42,493 more a year than the 28 a week they manage now. After the marketing, that is $32,773 more in your pocket every year, so every $1 comes back as 4.4x. You reach it by month 6, banking around $26,418 of it in the first year.
Get this new patient flowAn educated estimate, not your accountant. Every input above is an editable default you can match to your real clinic. The pay model is the same rolling wage versus commission maths used across Clinic Mastery, with super and leave included. Ads are assumed to take about six weeks from switch on to a steady flow of booked patients, and the forecast claims nothing for bookings made before their first day. It doesn't model owner time, equipment finance or tax.
When waiting is actually fine
Sometimes the forecast will tell you the wait costs nothing, and it means it. Feed that same physio hire 20 new patients a month of your own flow and a three month wait is genuinely safe: your own patients carry the diary while it builds, and the campaign matures in the background. You will see that verdict in the tool. Trust it.
The trap is the other direction. If the diary depends on new patient flow you do not currently have, every month of waiting after day one is a month of wages with no compounding return. Ads you switch on in month three do not backfill month one.
The practical rule: decide on the marketing when you sign the employment contract, not when the diary looks quiet. If the forecast says the book needs paid flow, the campaign should be live and learning before their first shift.
When the forecast says the diary needs flow
We have campaigns live and matured by day one
Google Ads for allied health clinics, built by clinic owners. Tell us the start date and we work the ads clock backwards from it.
See how we run Google AdsCommon questions