Introducing What This Is

This case study is based on an internal call between Adam (Senior Google Ads Strategist) and Stephen (Co-Founder at Salt Water Digital), reviewing live Google Ads data for a physiotherapy clinic in the Greater Vancouver area.

Rather than presenting a polished “before and after,” this is a walkthrough of how the campaigns were structured, how they evolved, and why they performed as well as they did. We hope you find this style of case study both informative and entertaining.

For a full summary, click here.

Let’s Get Started

Stephen:

Alright, let’s get into it. What are we talking about today.

Adam:

We’re talking about a health and wellness clinic in the Fraser Valley. I like this account a lot – super happy with the results

This clinic, based in the Greater Vancouver area (Chilliwack), was running Google Ads for:

• Physiotherapy
• Acupuncture
• Kinesiology 

Budget fluctuated on a modest budget between $1,000–$1,500/month over the last six months.

The results showed strong conversion rates, low CPCs, and efficient cost per booking — but it didn’t start that way.

The Problem: One Campaign, Three Services

Stephen:

So what were we working with originally?

Adam:

In the beginning, we had one campaign with all of the services in it. But we found quickly that physio was taking up most of the budget. Acupuncture was getting pretty much nothing.

Physio has more search volume. When everything sits inside one campaign, Google favors the highest-volume ad group. More clicks lead to more conversion data, which leads to even more budget allocation.

Acupuncture and kinesiology were being crowded out.

The Fix: Split the Campaigns

Stephen:

So explain what actually happens when we break those out.

Adam:

If we give a service its own campaign, we dedicate a portion of the budget specifically to that service. It won’t get taken up by another one.

We restructured into:

• Campaign 1: Acupuncture
• Campaign 2: Physio + Kinesiology 

Each campaign had its own budget and collected its own conversion data. Each service now had guaranteed visibility.

Tracking Strategy: Micro-Conversions

The clinic uses Jane App for online booking.

We track:

• Clicks to Jane App (micro conversion)
• Confirmed booked appointments (cross-domain tracking)
• Calls from ads
• Calls from the website

Early on, micro conversions help Google gather enough data to optimize properly. As the campaign matures, we can shift optimization toward confirmed bookings and calls instead.

Performance Snapshot (September–February)

• Conversion rate (Acupuncture): ~31%
• Conversion rate (Physio/Kinesiology): ~33%
• Cost per confirmed booking: ~$58
• + an additional 190 tracked phone call conversions
• CPC: ~$2 

For a local clinic with a modest monthly budget, this is strong performance.

Bidding Strategy Evolution

We started on Maximize Clicks due to lack of conversion data. Broad match keywords required aggressive search term monitoring and negative keyword building.

Once sufficient conversion volume was established, we switched to Maximize Conversions (without a Target CPA). Since cost per conversion was already low, there was no need to restrict performance with a CPA cap.

The Hidden Lever: Booking Flow

Booking UX matters.

Users want to book by service and see availability immediately — not search by practitioner. When booking flow is simplified, conversion rates improve significantly.

The clinic’s properly configured booking system supported ad performance.

Looking Ahead

The clinic has opened a second location and adjusted budgets accordingly.

The next phase will compare performance between the lower-density Chilliwack market and a more competitive area to analyze differences in CPC, conversion rate, and cost per acquisition.