You already have a Google Ads account
Somebody set it up. Maybe you, maybe an agency you’re no longer with. It spends money on the first of every month and it has been spending it for a while.
If somebody asked you what it produced last month, you could tell them what it cost. You’d have a harder time telling them how many patients walked in because of it.
That gap is the whole problem, and it isn’t your fault. Nobody built the account so you could answer that question.
Somebody typing hearing aids near me has already decided
They’re not researching. They’ve been putting this off for four years, a family member finally said something, and now they’re looking for who to see. That search is the end of a decision, not the start of one.
There is no other traffic like it. Social ads interrupt somebody who wasn’t thinking about their hearing. Search catches somebody who is.
Everything below is the discipline of spending a fixed budget against that intent without wasting it.
What we do with a budget, in order
We target where your patients actually are. Campaigns are built around each of your locations, aimed at people physically in that area rather than anyone in the country reading about hearing aids. A practice with four offices doesn’t run one campaign. It runs four.
We spend the first weeks learning what to say no to. Google will happily show your ad to somebody searching for a competitor’s brand, an over-the-counter product, a phone app, a consumer review roundup, or a job. Every one of those clicks costs you the same as a real one. So we pull the actual search queries on a schedule and keep adding to the list of what your ads don’t answer. That list never stops growing, and an account nobody is pruning is an account leaking money every month.
We only hand the bidding over to Google when the tracking is trustworthy. Google’s automatic bidding is good, and it is only as good as the signal you feed it. Point it at a broken conversion setup and it optimizes toward the wrong thing with your money. So we watch what the tracking is actually reporting, and until it’s clean we keep manual control of what a click is allowed to cost.
A call under a minute is not a patient. Wrong numbers, robocalls and hangups all register as calls. We count a call as a lead once it runs long enough to be a real conversation, and we attach a dollar value to it, so the account is optimizing toward booked business instead of ringing phones.
We change one thing at a time. Move the budget and the bidding and the keywords in the same week and you’ll never know which one worked. It’s slower. It’s the reason your account doesn’t swing wildly from month to month.
An ad is only worth what happens after the click
Here’s the part that gets left out of most ad reports.
A click is not a patient. A form fill is not a patient. A patient is somebody who sat in your chair. Everything between the click and the chair either gets captured or it doesn’t, and if it doesn’t, the report you get at the end of the month is a story about traffic.
When we build your site, we wire it for measurement before a dollar goes to Google, the same proven way on every site. The click, the form, the call, and what your team did with it all connect. That’s the difference between knowing your ads produced eleven leads and knowing your ads produced four appointments.
If somebody else built your site, we’re measuring through their form, and how much we can see depends on what they’ll let us capture. Sometimes that’s most of it. Sometimes it’s a click count and a phone number, and I’ll tell you that up front rather than send you a report that implies more.
Your account is one account
We’re looking at a lot of them.
Ear Level Intelligence carries performance data across the practices we run, which means a new account doesn’t start from a blank page. The wasteful search terms are already blocked on day one because we’ve watched them waste money somewhere else. We know what a reasonable cost per call looks like in hearing care specifically, not in healthcare generally, which is the number most agencies benchmark you against.
When something moves across the whole network, we see it before it shows up in your account.
A few things I won’t do with your budget
I won’t run a tactic on your practice that I wouldn’t run on my own clinics.
I won’t turn on every campaign type at once so the account looks busy in month one. Most of what gets switched on that way is spending your money to teach Google about you.
And I’ll tell you when a change isn’t worth making. If your account is performing and somebody sent you an article about a new feature, the honest answer is often that we leave it alone. That answer doesn’t justify a management fee, which is probably why you haven’t heard it before.
One more thing worth saying plainly. Paid search compounds. The negative list, the conversion history, the seasonal read on your market, all of it accumulates and all of it makes next year cheaper than this one. An account that gets rebuilt by a new agency every nine months never accumulates anything. If you’re on your fourth agency in five years, the account isn’t the problem and I’d rather say so now than in month six.
The AI question
You’ve heard that search advertising is dying because AI answers the question before anybody scrolls.
Part of that is real. AI summaries at the top of the page have absorbed a share of the clicks that used to go to the organic listings underneath, and any agency telling you otherwise isn’t watching.
But look at what actually changed. The person still typed the question. Somebody in your town still decided today is the day they do something about their hearing. AI changed what that results page looks like. It didn’t change the fact that they’re ready.
And as the organic listings get pushed further down that page, the paid position becomes a larger share of what a ready patient sees, not a smaller one. The practices that pulled out of paid search because of an article are the ones ceding that ground.
The same shift is why we build sites the way we do, so that the AI tools reading about your practice find the right answer. That’s a different page.
What it costs
$197 a month to run the account.
Your ad budget goes to Google, not to us. You pay them directly, it’s your money in your account, and you can see every dollar of it.
That’s worth a sentence. A lot of agencies charge a percentage of your spend, which means they earn more when you spend more. Ours is flat, so when I tell you a bigger budget isn’t the answer, nothing about my month changes either way.
Whether the numbers work for your market is a conversation. There’s a level below which paid search can’t produce enough volume to matter, and I’d rather tell you that on the call than take the budget.
The account is yours
Your Google Ads account belongs to your practice. The conversion history, the negative keyword list, the years of data about what works in your market, all of it stays with you. We hold managed access to it the way your accountant holds access to your books.
When we set up a new account, you go on it as an administrator on day one. That’s what makes this real rather than a promise. If we part ways, the account unlinks from us and leaves with you, with its history intact.
Two things don’t survive that move and I’d rather you know now. Anything running on our shared audience lists stops working, and the billing has to be re-established before ads run again. So there’s a handover to do. What there isn’t is a negotiation about whether you can have your own data.
Questions people ask
- How long before I know if it’s working?
- You’ll see calls inside the first couple of weeks. You’ll know whether the economics work in about ninety days, once there’s enough conversion history to judge it rather than guess.
- Do I have to let you rebuild my website?
- No. You should know that what we can measure depends on the site, and I’ll tell you exactly what we can and can’t see before you spend anything.
- My practice is in a small market. Is there enough search volume?
- Sometimes there isn’t, and I’d rather tell you that on the call than take the budget.
- What about the other channels?
- We run Google search. I have opinions about the rest of it for hearing care specifically, and they’re worth twenty minutes on a call rather than a paragraph here.
- Who writes the ads?
- We do, and they get written for hearing care rather than adapted from something built for dentists.
- Can I see the account?
- Yes. It’s yours. You get access to it, not a screenshot of it.
- What if I already have an agency running it?
- Then you have an account with history in it, which is worth something. The first conversation is usually about what’s in there already.
The traffic is already there
Somebody in your service area is going to type that search this week and call whoever comes up. That happens whether or not you’re in the results.
What we’re deciding is whether the money you spend showing up is being spent by somebody who can prove what it produced.
Part of the Ear Level growth system for hearing care practices.