“What should I be spending on Google Ads?”
I get this question from doctors at least twice a week. And every time they ask, they’re hoping for a simple number. Five grand a month. Ten percent of revenue. Something they can budget and forget.
That’s not how this works. The right budget for your practice is a math problem, and the variables are specific to you. Any agency that gives you a flat number without asking about your patient value, your closing rate, and your capacity is guessing. Or worse, they’re just picking a number that pays their management fee.
The formula that actually answers the question
Here’s how you figure out what to spend. It’s not complicated, but it requires knowing your own numbers. Most doctors don’t. That’s the first problem.
Step 1: What’s a new patient worth to you?
Not the first visit. The lifetime value. A cosmetic surgery patient might be worth $15,000 to $50,000 over her lifetime. A dental implant patient, $30,000+. A general dermatology patient, $2,000-5,000 over three years. A primary care patient, $1,500-3,000.
If you don’t know this number, stop reading and go figure it out. Pull your top 50 patients from the last three years and calculate their total spend. Average it. That’s your patient lifetime value. Everything else flows from this number.
Step 2: What will you pay to acquire one?
Industry data from MFG Wellness shows patient acquisition costs range from $155 for pediatrics to $610 for cosmetic and plastic surgery. Those are averages. Your market might be higher or lower.
A good starting point: you should be willing to spend 10-20% of a patient’s first-year value to acquire them. If a new patient’s first-year revenue is $3,000, you can afford $300-600 to get her in the door. If the first-year value is $10,000, a $1,000 acquisition cost is a great deal.
Step 3: What does a lead cost?
The benchmark for physicians and surgeons on Google Ads is $56.83 per lead, according to PPC Chief. But “lead” means someone who filled out a form or called. Not all of them become patients.
Step 4: What’s your closing rate?
If your front desk converts 50% of leads into booked consultations, and 70% of consultations become patients, your lead-to-patient rate is 35%. That means you need roughly 3 leads to get one patient.
At $57 per lead, that’s $171 to acquire one patient. If that patient is worth $5,000 in year one, you’re getting a 29:1 return. That’s the kind of math that makes the budget question easy.
Now do the multiplication
How many new patients do you need per month?
If you need 20 new patients per month and it takes 3 leads per patient at $57 per lead, you need 60 leads per month. That’s $3,420 in ad spend. Add your agency management fee (usually $1,000-3,000/month for a competent firm), and you’re looking at $4,500-6,500/month total investment.
If you need 40 new patients per month, double it. The math scales linearly until you hit capacity constraints.
This is the answer to “how much should I spend.” It’s not a percentage pulled from a marketing blog. It’s your specific numbers, multiplied out.
Why percentage-of-revenue is a lazy benchmark
You’ll hear “spend 5-10% of revenue on marketing.” For dental practices, MVP Mail House recommends 5-8% for established practices and 8-12% for growth-focused ones. New practices get told 10-20% in year one.
Those ranges exist because they’re easy to remember. But they ignore the most important variable: your patient economics. A practice doing $2 million with 25% profit margins has very different math than a practice doing $500K with 15% margins, even if they both “should” spend 7%.
The percentage model also doesn’t tell you where to spend. Seven percent of $2 million is $140,000 a year. Split that across Google Ads, SEO, social media, direct mail, and a part-time marketing coordinator, and you’ve spread it so thin that nothing works properly.
I’d rather see a practice spend $5,000/month on Google Ads alone and track every lead than spend $12,000/month scattered across six channels with no tracking on any of them. Concentration beats diversification when you’re small.
Specialty-specific budget ranges
These are starting points based on what I’ve seen work across hundreds of practices. Your mileage varies by market and competition.
Primary care / Family medicine: $2,000-5,000/month. Lower patient values but higher volume. Focus on “accepting new patients” and specific condition keywords.
Dermatology: $3,000-8,000/month. Dual revenue stream from medical and cosmetic services. Separate campaigns for each because the patient intent is completely different.
Dental: $2,000-10,000/month. CPC ranges from $4-25 depending on procedure, according to Dentx. Emergency dental keywords convert fast but cost more. General cleaning keywords are cheap but attract lower-value patients.
Plastic surgery / Cosmetic surgery: $5,000-20,000/month. CPCs of $18-25 in competitive markets, with premium keywords hitting $100+ per click. Patient acquisition cost averages $610, according to MFG Wellness. But a single rhinoplasty patient is worth $8,000-15,000, so the math still works if campaigns are built right. We put My Plastic Surgeon at #1 in both organic and paid search because the budget matched the opportunity.
Med spa: $3,000-10,000/month. Treatment-specific campaigns are mandatory. A Botox campaign and a CoolSculpting campaign attract completely different patients at different price points.
Orthopedics / Sports medicine: $3,000-8,000/month. High patient values for surgical specialties. Joint replacement keywords can cost $15-30 per click, but a surgical patient is worth $30,000+.
When to increase your budget
Increase when all three of these are true:
- Your cost per lead is at or below benchmark. If you’re paying $57 or less per lead for physician searches, the machine is working.
- Your closing rate is above 30%. If it’s below that, spending more on ads just means more wasted leads. Fix the intake process first.
- You have capacity to see more patients. Obvious, but I’ve seen practices spend $10K/month on ads while their schedule is booked three weeks out. That’s not marketing. That’s throwing money away because the leads can’t get in the door.
If all three conditions are met, increase budget in 20-25% increments. Don’t double your spend overnight. Increase, measure for 3-4 weeks, then decide whether to increase again.
When to decrease your budget (or pause entirely)
Your front desk isn’t converting calls. I’ve audited call recordings where the front desk put a prospective $12,000 surgery patient on hold for four minutes and never came back. If your phone handling is broken, every dollar you spend on ads is wasted. Fix the phone first.
Your landing pages don’t convert. If your conversion rate is below 5%, sending more traffic to the same page just burns money faster. Fix the page, then increase traffic.
You can’t track results. If you don’t have call tracking, form tracking, and a way to connect leads back to ad campaigns, you’re spending blind. Set up tracking before spending another dollar.
Your patient value is too low. For some specialties in some markets, the math simply doesn’t work at current CPCs. If a patient is worth $500 and a lead costs $200, you need a 100% closing rate to break even. That’s not a Google Ads problem. That’s a business model problem.
The biggest budget mistake I see
Doctors who underspend and then declare Google Ads “doesn’t work.”
Here’s what happens: a practice spends $1,000/month. At $5 CPC, that’s 200 clicks. At 11.6% conversion rate, that’s 23 leads. Sounds decent. But spread across 4 service campaigns, that’s 5-6 leads per campaign. Not enough data for Google’s algorithm to optimize. Not enough volume for you to spot patterns.
After three months of mediocre results, the doctor cancels and tells colleagues at the next conference that “Google Ads is a waste of money.” Meanwhile, his competitor down the street is spending $8,000/month, generating 140 leads, and laughing all the way to the bank.
Google Ads has a minimum effective dose. Below it, you’re not testing whether it works. You’re guaranteeing it won’t.
What your agency won’t tell you
Most Google Ads agencies for doctors charge a percentage of ad spend. Typically 15-20%. That means if you spend $10,000/month on ads, they make $1,500-2,000. If you spend $20,000, they make $3,000-4,000.
See the incentive problem? They make more money when you spend more, whether or not that spend is productive. A flat-fee agency has no incentive to inflate your budget. Something to think about.
Also: your agency should be telling you when to stop spending more. If your campaigns are maxed out in your market, there’s a ceiling on productive spend. A good agency identifies that ceiling. A bad one just keeps asking for more budget.
The one-week exercise
Grab a calculator and answer these questions:
- What’s a new patient worth in year one? (Average across your top services)
- How many new patients do you need per month to hit your revenue target?
- What’s your current lead-to-patient conversion rate?
Multiply patients needed by leads per patient by cost per lead. That’s your monthly Google Ads budget. If the number surprises you because it’s lower than what you’re spending now, your campaigns are underperforming. If it’s higher, you might be leaving money on the table.
The answer to “how much should I spend” is always “whatever the math tells you.” Not what your agency suggests. Not what a blog post recommends. Your numbers, your math, your budget.