Before you sign
How to Check an Agency Before You Sign Anything
Founder of FORGE
Six questions, starting with who owns your accounts on day one. Written by a physician who asked none of them and paid for it.
Ask whose name is on the accounts, how much of your money reaches the ad auction, what the timelines are per channel, who does the work, what the report contains, and what you take with you if you leave in six months. The speed of the answers tells you more than the answers.
I hired an agency while running three clinics. 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 found out when I pulled the account myself and read the raw numbers. Not one of the six questions below would have taken more than a minute to ask. I asked none of them.
Ad accounts, Google Business Profile, domain, analytics. All of it registered to the practice from day one, with you as owner and the agency as a user you can remove.
Everything else matters less. An agency holding your assets holds the leverage no matter how good the work is, and you find out only when you try to leave.
You want a clean split between a management fee and a media spend you can verify inside the platform. If the two are blended into one round number, the difference is margin nobody mentioned.
Ask for the platform export before signing rather than a year later. The detail on fee structures is on what practice marketing actually costs per month.
Ads in weeks, search in six to twelve months. Anyone giving you one number for both is either confused or hoping you will not ask which lever produced what.
A proposal that separates impressions from booked patients is the sign of someone who has done this honestly before. The comparison across all four is on how the channels compare on speed and durability.
Ask by name, and ask how many accounts that person carries. The pitch is often delivered by someone you will never speak to again.
A specialist team running the day to day is reasonable. Not knowing who they are until after you sign is not.
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.
Accounts, website files, content, review history, ad data. A straight answer is everything.
This is the question that ends conversations early, and the speed of the answer tells you more than the answer itself.
That last one is the tell. Anyone serious asks how many enquiries you get and from where before proposing anything, because if nobody measured the before, nobody can prove the after.
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 able to tell whether the person opposite you is describing your practice or reciting a template. If you want the ground rules first, read what healthcare marketing actually means for a practice and why a full schedule today says nothing about next year.
This page is part of the reference library published by a healthcare marketing agency run by a physician.
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.
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.
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.
