Home / How We Work

The Service Is
a Practice That Grows.

Google Ads, search, websites, phone training. We run all of it, and none of it is what you're buying. You're buying a diagnosis of what's blocking your practice and the people to remove it.

Send Nick Your Numbers

What You're Actually Buying

Agencies Pitch Tools
Before They Ask What's Wrong.

Call three agencies and you'll get three proposals for the same things: a Google Ads budget, an SEO package, a new website, some social. The proposals are interchangeable because the agencies sell what they know how to deliver, and they decide what you need before they've seen your numbers. You could be losing half your inquiries on the phone and every one of those proposals would still be about traffic.

We start the other way around. Before anything gets built, I want to know where the patients are leaking out. Then the plan follows from that. One practice needed a complete rebrand and a retrained front desk before any campaign made sense. Another needed its payment policies fixed before it was ready for a single new patient. Another was invisible on Google and needed search work for six years straight. Same firm, same people, three very different engagements, because the blocks were different.

That's why there's no menu of packages on this site. We'd be deciding your problem before we'd looked at it.

How an Engagement Runs

Diagnose. Prescribe. Dominate.

Diagnose

The first weeks are an audit of the practice, not just the marketing. Where inquiries come from and what each one costs. What happens when the phone rings, which we find out by listening to the calls. How consultations are run and how many become procedures. What the fees are and how they were set. What the reviews say and whether they're right. Most owners come in sure they have a traffic problem. Many have a conversion problem, and a few have an operations problem that ads would only make louder.

Prescribe

A plan with the fixes in order, who owns each one, and what each should produce. It's short, because a plan nobody reads isn't a plan. Sometimes it opens with a search campaign. Sometimes it opens with a fee increase and phone training, and the campaign waits until the phone can handle what it brings. Some of the fixes will be yours to make, and I'll hold you to them.

Dominate

We build and run whatever the plan calls for, and we measure it in booked consultations, procedures and revenue. You'll know the cost of a booked consult for every dollar spent. We keep pushing until the market treats you as the default choice, and then we extend the lead, because being first is where the compounding starts.

The Tools

What Gets Built Depends
on What We Found.

We've run all of these for 20 years. Which ones your practice gets, and in what order, comes out of the diagnosis.

Google Ads: Procedure-level campaigns, in your account, with every call and form tracked back to the keyword that produced it.
Search: The pages and the authority to own the searches in your city that carry buying intent. Slow, compounding, and worth it when the phones are ready.
Websites: Built to book a consultation, not to win a design award. We rebuilt the midtown surgeon's site so it sold the fee before the phone rang.
Phones and front desk: Call tracking, call listening, and training. Whoever answers has one job: book. This is the fix most often, and the cheapest.
Follow-up: Email and SMS sequences that chase the inquiry that didn't book today, because most of them research for months before they do.
Positioning and fees: What the brand says about your prices, and what your prices say about you. Sometimes the plan is to raise the fee before we spend a dollar on ads.
Reputation: Reviews handled at the source. We fix what the reviews are about, then the reviews.
Operations: HR, hiring, training and payment policies when the practice is the block. We built Toronto Cosmetic Clinic's inside while the outside grew 10x.

Who We Work With

Built in Aesthetic Medicine.

Plastic surgeons, med spas and aesthetic clinics are where the track record is, and where most of our work still is. Other high-value practices come to us by referral, and we'll tell you honestly whether what we know transfers.

Plastic Surgery

Plastic Surgeons

72 to 125 surgical consults a month

A midtown Toronto surgeon went from 72 to 125 consults a month in a recession, with Allergan's own numbers showing BOTOX up 83% and JUVEDERM up 1,200%. The block was positioning that couldn't justify his fees, and a front desk apologizing for them.

Med Spa

Med Spas and Aesthetic Clinics

#4 to #1 Botox provider in Canada

Skin Vitality had 4 clinics and print ads that still worked when they called us. Within two years they had 8 clinics and were the #1 Botox provider in Canada on Allergan's list. Today they run 14, by their own count.

Advisory

Advisory for PE and Multi-Location Operators

Diagnosis before you write the next cheque

You bought the practice, or three of them, and growth stalled. Engagement-based diagnosis of what the seller's marketing was hiding and what actually constrains revenue now. No retainer. In, assess, prescribe, out.

What It Costs, and Who It Fits

From $15,000 a Month, Plus Media.

Media spend is on top, in your own ad accounts, under your own name. The fee covers the diagnosis, the plan, the team that builds and runs it, and my time in your numbers every week. It fits practices doing roughly $2 million a year and up, and established practices with the capital to fund a turnaround. We keep the roster small on purpose, so an engagement starts when a seat opens.

Budget $6,000 to $30,000 a month for media on top of that, depending on whether you're surgical or non-surgical. The floor is $100 a day per campaign; the ceiling we've run for a client was $60,000 a day. No long-term contract: the first engagement is three months, which is what the process needs to show whether it's working, and after that people stay for the results.

If the number is out of range this year, read anyway. The articles and the podcast are the same thinking, and fixing your phones costs nothing.

Who it isn't for: a practice that wants a vendor to take orders, or an owner who won't change what the diagnosis says to change. If you won't change it, I can't fix it for you.