Google Ads Audit for Clinics: How to Check Your Account (and Your Agency)
When results feel flat and you are paying an agency every month, it is natural to wonder whether the work is really being done. A Google Ads audit gives you a straight answer, and you do not need to be an expert to ask for one.
This article follows a UK private clinic owner who wanted a second opinion on an account that had grown expensive without growing more profitable. Here is what a Google Ads audit for clinics looks at, and how to run one without a fuss.
Why a second opinion helps
The clinic’s owner had a general-purpose agency, not a healthcare specialist. The agency managed the ads and built the landing pages. Contact was one monthly call and one report. There was nothing wrong with anyone’s intentions, but the owner had no way to tell what happened in between.
Start with the change history
Every Google Ads account keeps a log of changes: who altered a bid, paused a keyword or moved a budget, and when. It is one of the quickest ways to see how actively an account is managed.
In this account, the log showed uneven activity, including a full week with no changes at all. A week of silence is not always a problem. On an account with significant spend and worrying results, it is worth asking about.
What a Google Ads audit for clinics covers
A useful audit is more than a glance at the dashboard. It should look at:
- Structure: how campaigns and ad groups are organised, and whether budgets match your priorities.
- Search terms: what people typed before clicking, and how many of those searches were a good fit.
- Conversions: what the account counts as a result, and whether it reflects real enquiries and bookings.
- Budget by ad group: which groups earn their spend, and which do not.
- Landing pages and forms: what happens after the click, including how easy it is to enquire.
- Ad wording and policy: whether the ads are clear, honest and within Google’s healthcare rules.
How often should your agency talk to you?
A single monthly report can be too little when healthcare budgets and results move fast. Many clinic owners prefer frequent, short updates on what changed and why, with a proper strategy call every so often. What matters is that you are never left guessing.
Experience in healthcare also matters. Advertising rules for medical services are stricter than for most industries, and a specialist will know where the lines are.
How to run a second-opinion review safely
You can invite a reviewer with view-only access, using a neutral email address. Let your current agency know a second opinion is happening, so it feels open rather than sneaky. Ideally the reviewer looks back over several years of history, not just last month, to find when results started to slip.
The outcome should be a short report of findings and a suggested plan. If you would like to see how the money is being spent first, our article on healthcare PPC for private clinics is a good place to start, and our piece on Google Ads cost per lead explains why some ad groups cost far more than others.
How to read the search terms report
This report is one of the most useful in the account, and it is easy to understand. It lists the actual phrases people typed before they clicked your ad. Read down the list and ask a simple question of each phrase: would I be happy to speak to this person?
You will usually find a mix. Some searches are exactly right. Some are close but not quite. Some are clearly wrong, such as people looking for free services, jobs, or treatments you do not offer. Every wrong one that keeps appearing is money leaving the account, and it can be blocked with a negative keyword in seconds.
Ask for the answers in writing
You do not need to sit through a long call to get clarity. Ask your agency for a short written note each month covering what changed, what the results were and what happens next. Written notes are easy to compare over time, and they make it obvious when a month has passed with little happening.
It also helps a second reviewer. If someone else ever looks at the account, a trail of clear notes shows what was tried and why. That is far easier than reconstructing the story from settings alone.
Signs your account may need attention
Spend that keeps rising without more patients is the most obvious sign. Others are results that swing with no explanation, enquiries that arrive but rarely book, reports full of clicks and impressions but short on bookings, and nobody being able to say what changed last month. Any one of these is worth a conversation. Several together are worth an audit.
What happens after the audit
A good review ends with priorities, not a pile of jargon. Quick wins come first: tidying search terms, adding negative keywords, moving budget to ad groups that book. Structural changes follow, such as restructuring campaigns, correcting tracking and improving landing pages. Ask for the order of work and the reason behind each step, so you can judge the plan yourself.
Questions to ask your current agency
- What changed in our account in the last month, and why?
- Which ad groups are underperforming, and what are you doing about them?
- What are we counting as a conversion?
- How often will you contact us, and about what?
- What experience do you have with healthcare advertising policy?
A good agency will welcome these questions. If yours does not, that tells you something too. We are always glad at Pulse Digital Health to look at an account and give an honest view.
Frequently asked questions
What is a Google Ads audit?
It is a structured review of how your account is set up and performing. It looks at campaigns, keywords, search terms, conversion tracking, budgets and landing pages, then recommends changes. A good audit ends with a short, prioritised list of actions, not a long report nobody uses. You should be able to read it in one sitting and know exactly what happens next.
How often should a clinic audit its Google Ads account?
At least once a year, and any time results drop or spend rises without more patients. A regular light check of search terms and budgets is also sensible. Book the next audit before this one finishes, so it becomes a habit and not a reaction to bad news. Regular reviews also catch small problems before they become expensive ones.
How do I know if my agency is actively managing my account?
Ask for a look at the change history. It shows what was altered and when, so you can judge how hands-on the management is. Ask your agency to explain the last five changes in the account and why each was made. A clear, calm answer suggests good management, while a vague one is worth following up.
Is it rude to get a second opinion on my Google Ads?
Not at all. It is common practice, and a confident agency will not mind. Being open with your current agency keeps the process friendly. Presenting it as a routine annual check makes it feel normal for everyone involved. Most good agencies welcome a second look, because it confirms what they are doing well.
Can someone audit my account without changing anything?
Yes. View-only access lets a reviewer inspect everything without making changes. Use a neutral email address and remove access afterwards. Ask the reviewer to confirm in writing that no changes were made, and remove their access afterwards. Removing access afterwards keeps your account tidy and your data private.
Do I need a healthcare specialist to manage my Google Ads?
It helps a great deal. Medical services face tougher advertising rules, so someone who knows healthcare policy can avoid disapproved ads and wasted spend. Ask for examples of healthcare accounts they manage and how they deal with disapproved ads. Specialist knowledge saves time and avoids the disapproved ads that generalists often meet.
