How to Check an Agency Before You Sign, in Six Questions
Six questions, the answers that should worry you, and the ones that should not. Written by a physician who signed the contract before he knew to ask any of them.
Six questions, the answers that should worry you, and the ones that should not. Written by a physician who signed the contract before he knew to ask any of them.
Practitioners hire a marketing agency the way they hire a contractor. A referral from a colleague, a polished website, a confident call, a signature.
The problem is that nothing in a clinical training prepares you to interrogate this particular purchase, and the industry knows it. The pitch is designed to be evaluated on how it feels rather than on what it commits anyone to.
Six questions change that. None of them require any marketing knowledge, and none of them can be answered badly without telling you something you needed to know.
None of these require marketing knowledge to ask. All of them are hard to answer badly without revealing something.
Your ad accounts, your Google Business Profile, your domain, your analytics. If any of them is registered to the agency, you are renting the visibility you pay to build.
Ask for the platform export rather than a dashboard. The difference between what you pay and what reaches the auction is the number nobody volunteers.
The website files, the content, the review history, the ad learning data. Ask on day one what walks out with you, because on the last day it is too late to negotiate.
Ask them in this order. The first one alone eliminates most of the field.
Your ad accounts, your Google Business Profile, your domain, your analytics. A straight answer is the practice, from day one, in writing. Anything involving their agency account, their manager profile or a transfer later is the answer that costs the most.
A straight answer is a flat fee plus a media spend you pay directly to the platform, with the raw export available whenever you ask. Hesitation here usually means the margin lives in the gap.
A straight answer separates the two: ads producing enquiries within weeks, search moving impressions early and patients late, six to twelve months. One blended promise means nobody will be accountable for either.
A straight answer is a name and a workload. It is fine for a specialist team to run the day to day, and it is not fine to discover after signing that the person who pitched you has thirty other accounts and no involvement.
A straight answer is everything: accounts, website files, content, review history, ad data. This is the question that ends conversations early, and the speed of the answer tells you more than the answer itself.
If I leave in six months, what exactly do I take with me?
A good agency answers everything, immediately, because it has been asked before. Hesitation here is the tell, and it is worth more than any case study you will be shown. I did not ask it, and I found out the answer the expensive way.
Nobody controls what a patient decides after they click. A patient guarantee is a sales line with an escape clause. A guarantee on the agreed work is the version worth having.
Long contracts cluster around results that are hard to prove. Being told honestly that search takes six to twelve months is better protection than being locked in for it.
An agency that has been asked these six before answers them without pausing, because it built the arrangement expecting the questions.
I trained as a maxillofacial surgeon, moved into orthodontics, and co-founded a three-clinic group in Paris. I then spent time inside Publicis Health learning how medical marketing actually works at scale.
While running the clinics I hired an agency. I paid them more than 20,000 EUR over a year. They owned my Google and Meta ad accounts, not me. They spent a fraction of the budget, kept the rest, and delivered one patient, who came in for a cleaning, while I was selling orthodontic treatment. I only found out when I pulled the account myself and read the raw numbers.
I asked none of these six questions. That is the entire reason this page exists, and the reason Forge answers all of them before anyone signs anything.
Most healthcare marketing agencies sit between $3,000 and $6,000 a month and will not show you that number until you are already on a call. Here it is upfront.
I sign this personally. My team keeps working until the agreed work has shipped and is producing something you can measure. No lock-in, and no promised patient count, because what happens once a patient calls is yours, not mine. Ask me the six questions. I answer all of them in writing before anything is signed.
Territorial exclusivity: one practice per area per treatment. When yours is taken, your competitor cannot buy it.
The first 90 days
Where last month's patients came from, and how you appear for your main procedure locally. Twenty minutes, and it changes the balance of every conversation after it.
Accounts, spend, timelines, team, reporting, exit. Note which ones produce a pause. The pause is the information.
Especially ownership and exit. A verbal assurance about who owns the Google profile is worth exactly nothing on the day you want to leave.
Ads should be producing enquiries. Search should be moving impressions. If neither is true and nobody can explain why, you found out in month three rather than month twelve.
Whose name is on the accounts. Your ad accounts, your Google Business Profile, your domain and your analytics should be registered to the practice from day one. Everything else on this page matters less, because an agency that owns your assets holds the leverage regardless of how good the work is.
Healthcare experience yes, your exact specialty not necessarily. What matters is whether they understand a long decision, restricted advertising and a patient worth years rather than one transaction. Someone who has only marketed local shops will get all three wrong, whatever their portfolio looks like.
Ask for enquiries and booked appointments in a comparable market, not traffic growth. Traffic proves nothing, and a percentage increase from a tiny base proves less. If nobody measured what the practice produced before the work started, nobody can prove what the work did.
Ads in weeks, search in six to twelve months. Anyone giving one number for both is either confused or hoping you will not ask which lever produced what. A timeline that separates impressions from booked patients is the sign of someone who has done this honestly before.
No, it is a warning. Nobody controls what a patient decides after they click, so a guaranteed number of patients is a sales line with an escape clause buried somewhere. A guarantee on the work is different and is worth having: agreed deliverables, and the agency keeps going until they ship.
Ask by name, and ask how many accounts that person carries. The pitch is often delivered by someone you will never speak to again. It is not unreasonable for a specialist team to run the day to day, but you should know who they are before you sign rather than after.
Tracked calls and form submissions by source, cost per qualified enquiry, and ranking movement on your priority terms. If a report ends at sessions and impressions, it was built not to be checked. You should be able to read it in five minutes and know whether to spend more or less.
Month to month. Long contracts exist to protect the agency from being judged, and they cluster around work whose results are slow to prove. The honest version is telling you upfront that search takes six to twelve months and letting you leave whenever you want anyway.
A freelancer is fine for one channel and fragile when they take a holiday. In-house works when someone owns it as a real job rather than as an extra duty. An agency makes sense when you need four channels covered and someone accountable for the number at the end. The wrong answer is giving it to whoever at the front desk has the least to do.
Find out where last month's new patients came from, and search your main procedure plus your city to see where you appear. Twenty minutes, no cost, and you arrive at the call able to tell whether the person opposite you is describing your practice or reciting a template.
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The free Forge Visibility Snapshot gives you the diagnosis before any agency, including this one, gets to frame it for you. No call, no pitch, read by a physician.