Audit the agency relationship end to end
Reviewed every deliverable, report, and invoice from the agency over the past 12 months. Cross-referenced promised KPIs against actual performance data pulled directly from ad platforms and analytics.
Identify underperformance and misalignment
Found that the agency was optimizing for clicks and impressions rather than patient appointments. Three campaigns were generating high traffic but near-zero conversions to actual bookings.
Restructure agency KPIs and reporting
Built new KPI framework tied to patient appointments, not traffic. Established monthly performance reviews with clear benchmarks and consequences for underperformance.
Redirect spend to conversion-driving campaigns
Paused all campaigns with CPL above threshold and redirected budget into local search, retargeting, and high-intent keyword campaigns that were already converting.
Implement ongoing agency oversight
Delivered a monthly agency scorecard and review process the internal team could manage independently. The agency now reports against business outcomes, not vanity metrics.