The only three numbers your Google Ads agency should report

Most agency reports are built to look busy, not to be useful. Impressions, clicks, click through rate, average position, quality score, search impression share. It is a wall of numbers, and almost none of it connects to whether your books filled up. The unspoken logic is that if there is enough data on the page, it must be working.

Here is the problem. Click through rate does not pay your rent. Bookings do. A campaign can have a beautiful click through rate, a low cost per click, and a fantastic impression share, and still not put a single new patient on your schedule. I have audited accounts where every vanity metric was healthy and the account was quietly bleeding money, because nobody had ever checked whether those clicks turned into booked appointments.

The job of a report is not to make you feel good. It is to tell you the truth about whether the money you spent came back as patients. If the report cannot do that, it is decoration.

This is the number everything else hangs off. Not clicks. Not leads. Not form fills. New patients who actually booked an appointment through the campaign. That is the output you are buying when you spend money on Google.

Be precise about what counts here, because this is where most reports get slippery. A new patient booked is a real appointment on the calendar, not a button click, not a page view, not somebody who landed on your booking page and left. If you have ever wondered why your reported conversions look enormous while your front desk swears the phone is quiet, the gap is almost always a conversion action that fires on the wrong event. Make your agency tell you exactly what triggers the count.

When this number is tracked properly, it becomes the spine of every decision. You can see which campaigns book patients and which ones just spend. You can stop guessing.

This one sounds obvious, and that is exactly why it gets skipped or buried. Total spend is the all in number: media spend plus the management fee. Not just what went to Google. The full cost of running the channel.

The reason it matters is that you cannot judge the third number without it. An agency that quietly leaves their own fee out of the maths can show you a flattering cost per booking that does not reflect what is actually leaving your account each month. I want the real total, because that is the number your bank statement shows.

If you are still working out what that total should even be, the floor is roughly $500 a month in ad spend before a campaign has enough room to learn anything useful. Below that you are not really testing the channel, you are starving it. I have written separately on how to set a clinic marketing budget if you are sizing this from scratch.

Divide total spend by new patients booked and you have the only efficiency number that means anything: cost per new patient, or cost per booking. This is the number that tells you whether the channel is healthy, and it is the number every other metric is supposed to serve.

For a healthy physio or podiatry account in Australia, I expect this to land somewhere around $70 to $90 per booking, sitting a touch higher once the management fee is loaded in. Psychology and OT sit a little wider at $80 to $120. NDIS work tends to run higher again, because the search journey is longer and the people you want are harder to reach. A sharp, well run account can get down toward $65. If you are seeing $200 or more, something is loose, and it is usually the keywords or the booking page. I dig into why the number swings so much in why Google Ads cost per booking varies.

The cost per booking is meaningful only when you pair it with what each new patient is actually worth to your clinic. A $90 booking is a bargain if that patient is worth $1,200 over their care journey, and a poor deal if they are worth $120. Work out what you can afford to spend acquiring a patient first, then judge the cost per booking against it.

Here is the quiet power of asking for these three numbers. If your agency can produce new patients booked, total spend, and cost per new patient, on demand and with a straight face, then they are tracking real bookings. They have the plumbing right. You can trust the rest of what they tell you.

If they cannot give you a clean cost per new patient, that is not an admin gap. It almost always means the tracking is not measuring bookings at all. They are counting clicks, or button presses, or page loads, and calling them conversions. You can read more on the difference between a conversion and a conversion action, because that single distinction is where most clinic accounts come undone.

So ask. Send one email this week: please report only new patients booked, total spend, and cost per new patient going forward. Watch what comes back. The answer tells you everything about whether your money is being managed or just spent.

Strip the report back to the three numbers and a strange thing happens. The conversations get better. Instead of debating whether average position is meaningful, you are talking about whether $90 a booking is worth it for your clinic, and how to nudge it lower. That is a conversation worth having every month.

None of this means the other metrics are useless. Click through rate and impression share are genuinely helpful when an agency is diagnosing why the three numbers are off. The point is that they are diagnostic tools, not the headline. They belong in the engine room, not on the front page of your report.

Get the three numbers right and you also expose the upstream problems faster. A poor cost per booking with healthy clicks usually points straight at the booking experience, which is why I keep coming back to whether your website is actually ready for Google Ads before you spend a dollar driving traffic to it.