Most Google Ads reports lead with the numbers that are easiest to make look good: impressions, clicks, click-through rate. They're not meaningless, but none of them tell you whether the campaign is making or losing you money. Here's what to look at instead.
1. Cost per booked patient — not cost per click
Cost per click tells you how competitive your keywords are. It says nothing about whether those clicks turn into patients. The number that matters is total ad spend divided by actual booked appointments attributed to the campaign — and if your agency can't produce that number, they're not tracking the thing that actually matters to your business.
2. Conversion rate by keyword, not just overall
An overall conversion rate can hide a lot. A campaign converting at 4% overall might have one keyword converting at 12% and another burning budget at 0.5%. Without a keyword-level breakdown, budget keeps flowing to the terms that were profitable last quarter, not the ones that are profitable now.
3. Search terms actually being matched
The keywords you bid on and the searches that actually trigger your ad are two different lists. Reviewing the search terms report regularly is how you catch budget leaking to searches that were never going to book — and it's the single most common thing we find missing when we audit a clinic's existing account.
If a report can't answer "what did we pay for a new patient last month, and is that number going down," it's not a report. It's a distraction.
4. Trend, not snapshot
A single month tells you almost nothing about a search campaign, which needs time to accumulate enough data to optimize against. A report worth reading shows cost per patient over at least 8–12 weeks, so you can see whether it's improving as targeting gets refined — which is the entire point of running it in the first place.
You don't need to become a PPC expert to run this checklist. You just need to know which four numbers to ask for — and to ask the same question every month until the answer is the one you're actually paying for.