Hello? Is It Me You’re Looking For?

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Get insider insight into making Google Ads work for you.

By Chris Mesigian

Little did Lionel Richie know nearly (gulp) 40 years ago, he was writing an anthem for search marketing of the future. People are out there looking; it’s time they found what they are looking for: You.

Maximizing your website’s search engine optimization (SEO) and “organic” ranking is absolutely critical in today’s digital world, but SEO takes time, and you need clients now. Luckily, there’s an effective way to capture more online traffic, and it doesn’t have to cost you an UE and an LE. Enter: Google Ads.

Kicking off a Google Ads campaign can be almost as daunting as the blank Word doc staring back at me when I started this article. Whether you’ve decided to give it a go yourself or you’ve hired a pro to do it for you, you’ll need to develop a strategy to ensure the success of your pay-per-click (PPC) campaign. However, before one can formulate a plan, it helps to have a basic understanding of how Google Ads is organized and executed behind the scenes. The following gives a slightly deeper dive into the complexities of the world of PPC, as well as some real-world examples on how to best leverage this powerful tool to fit within any budget.


Google Ads is built around five levels of settings and parameters you will dictate: account, campaign, ad group, keyword, ad. How you utilize the varying options within these levels dictates everything you set out to accomplish. Let’s take a look at each level, what options and control each has to offer, and a few practical examples of how they’d be leveraged.


Account Level

This top tier level is fairly self-explanatory. The account level is where you set up managerial factors like account name, users, time zone, and billing. Typically, once you set up these conditions, you very rarely make changes (save for updating an expired credit card).

Campaign Level

The campaign level is where you control geographic targeting (where your ad reaches), budget (how much you spend), and bid strategy (more on this later), among other elements. Depending on the complexity of the account, you might have anywhere from one campaign (e.g., a seasonal promotion with a single message) to upwards of dozens (e.g., a different ad and dedicated campaign for every service line in your business, including nutrition counseling, fitness training, and rehabilitation). That said, multiple campaigns aren’t just for larger companies, even a smaller business might consider multiple campaigns for greater control and targeting. These scenarios would include:

  • Multiple Locations. Let’s say you have multiple practice locations that are in different market areas. You might create two campaigns where campaign 1 targets a five-mile radius around location A, and campaign 2 targets a five-mile radius around location B. In this scenario, you are assigning each location its own geography and can even give each its own budget. Maybe location A is humming along at 80% capacity, but location B is only at 50%. You may opt to allocate more of your budget to location B in an effort to drive more traffic there. Conversely, you may not care which location spends more so long as people are coming, in that case you could have the two campaigns share one master budget and spend as the activity naturally dictates.
  • Splitting Budgets. Let’s say you organize a local 5k running event as a promotional vehicle for your practice. Odds are it will have its own marketing budget that’s separate from the business. In this case you will create two campaigns where campaign 1 is promoting your business at one budget and campaign 2 is promoting the race at another totally different budget. This allows a situation where the two campaigns would never “steal” available budget from each other. If you need to bill different entities for each campaign, you’ll need to do this at the account level and create individual accounts.
  • Bidding Strategy. Remember, every search is a mini “auction.” Several advertisers are bidding to display their ad in hopes of winning clicks. It doesn’t always solely come down to who’s willing to pay more, but willingness to spend more is definitely one factor. There are several approaches you can take to how you can bid on individual searches. Some are looser and aimed to get you as many impressions and clicks as you can possibly get (brand awareness approach). Others are built around maintaining a very strict and targeted total cost per acquisition. The latter is more common in an e-commerce scenario, for instance that stationery store that doesn’t want to spend more than $X in advertising per unit sold. (Spending $10 in ads for every $5 pack of pencils sold just doesn’t add up.) Bidding strategy often goes hand in hand with splitting budgets where different limitations are put in place on different campaigns.

Ad Group Level

Ad groups fall within each campaign where target location and budget are shared. Think of ad groups as themes. Each ad group will be built around up to 15 or so keywords (more on these soon) that speak to the same subject matter. For example, say you have campaign 1 targeting a 10-mile radius of your practice at a total budget of $20/day. You could then have any number of ad groups therein each targeting a different type of service: ad group 1: stroke recovery; ad group 2: surgery rehab; ad group 3: neurological conditions; ad group 4: general physical therapy, etc. The $20/day will then be spent across all four ad groups.

An effective PPC campaign will have very distilled ad groups that speak directly to specific search topics. A searcher seeking a provider to help with her knee replacement recovery is far more likely to click on an ad with the headline “Knee Replacement Therapy” than one generally saying “Local Physical Therapist.” The devil is in the details when it comes to attracting clicks and taking the time to develop individual ad groups always pays off.


Keywords—or search terms—are the actual words or phrases that people type into the search bar when they are trying to find something. Think of keywords as fishing bait. Sometimes they are vague in an attempt to attract a wide variety of searches. Other times, keywords are targeted and specific in an attempt to attract a very specific type of query. As such, keywords can come in the form of single, general words (“therapist”) or longer, more specific phrases (“physical therapists near me that take HMO”).

You identify and dictate the specific keywords that you want to bid on and display ads for. Choosing the right keywords can be the difference between an effective and cost efficient PPC effort and throwing money into cyberspace. Too vague and loose, and you burn through your budget sorting through the noise before you find any truly qualified leads. Too specific and picky, and you aren’t able to adequately reach a large enough audience to move the needle. Keyword research and selection is one of the most critical steps in setting up your campaign(s). But don’t worry, you’re not flying blind. There are a number of tools to assist in this effort, many of which are provided by the all-knowing source itself, Google. But if you have the budget tolerance, nothing quite beats good old-fashioned trial and error. One of the best parts of Google Ads is that you don’t have to wait long to see data and results. The first few weeks, sometimes even a matter of hours or days, can be very telling, and you’ll be able to pivot and adjust very quickly to optimize.

I’d be remiss to move on from keywords without at least touching on another tool at this level: negative keywords. Negative keywords are words or terms you put in to specifically filter out searches you do not want to bid on or show for. Using the example above, let’s say you don’t take HMO. In that case, you could add “HMO” as one of your negative keywords, and your ads will never show if that’s used in the search. This is important for running as efficient a campaign as possible. You don’t want to unnecessarily spend budget on clicks that you know have no chance to gain you a client.


That brings us to the final step: your actual ads. This is where the magic happens, and you need to put your best foot forward to attract and draw those ever-important clicks. The right ad copy can be the difference between a click here and a click there, and numbers that really make the phone ring. Ads are constructed out of two or three 30-character headlines, a display URL, two 90-character description lines, and a series of extensions you can customize. (Figure 1)

Figure 001

A well-developed ad strategically incorporates all of these elements. First, and most important, always include the targeted keywords in the first or second headline, in the display path, and as much as comfortably possible in the descriptions. Next time you perform a search of your own, take note of all the times the specific words you typed are bold in the search results.

This isn’t by accident. Odds are you subconsciously clicked on the listings with the most bolded words. I mean it makes sense: the more bold words present, the more relevant that listing must be, right?

Next, use the description lines to clearly spell out your unique value proposition and/or features and benefits that make you stand out. Walk-ins welcome? Extended hours? Cash payers accepted? Free beer? This is the place to really grab people and let them know why you are an awesome fit for their physical therapy needs.

The final critical element is to not skimp on using as many of the extensions as possible. Extensions are additional link options that appear below the main ad copy. (Figures 2 and 3)

Figure 002 Figure 003

If there’s one analogy I love about Google it’s this: the Google results page is like real estate; it’s all about location, location, location. The better spot you have and the more space you occupy, the greater your results. The more real estate you take with your ad at the top of the page, the less of the competition is showing below. It’s really that simple.

Another common question I hear is, Should I bid on my own name and/or competitors’ names? Short answer: Heck yeah! Reason: It comes back to real estate. Perhaps your normal “organic” site listing comes up first when someone searches your name, which leads your gut to say, Why pay for something I’m getting for free? Fair point. But end of the day, if you’re also displaying an ad for that same search, now you’re occupying even more space on the page, meaning even less space for your competition, and that much more click opportunity for you. Will your organic listing produce more on its own than if there’s no ad? Certainly. But combined, they should bring in even more traffic than either one will alone. Last thing to consider is that the average cost per click (CPC) for your own name will be pennies on the dollar because your quality and relevance scores will be very strong. This really isn’t a budget-busting tactic.

While I consider bidding on your own name a no-brainer, bidding on your competition is slightly more debatable because the click-through and conversion rates are typically very low. Usually I recommend this tactic if the competitor in question is a big name with a lot of local clout. This is a very common practice and there’s no shame in riding the shirttails of the naturally large volume they are going to get. This is a perfect opportunity to show people side-by-side what you offer over the big box brand. If going this route, I recommend separating and capping the budget. That is, create a separate campaign dedicated solely to competitor name(s), and set aside a fairly low budget for it. A little exposure is great, but you don’t want to spend too much of your total budget here.

Landing Pages

While not part of Google Ads itself, I’ll quickly mention that you can’t have a successful campaign without a solid landing page. A landing page is basically a page on your website where you are sending people who click on your ad. Like the ads themselves, landing pages should be customized and speak directly to the subject of the search. In other words, don’t send the knee replacement person to the home or generic contact page of your site. Send them to a page that speaks to your knee replacement rehab process. Landing pages should also have strong, prominently placed calls-to-action, whether a phone number or contact form. Strike while the iron is hot! A disconnected experience once someone reaches your website can be the difference between low conversion rates and new clients.


This brings us to the most commonly asked questions any advertiser has: How much do clicks cost? How much should I budget? And the answer to that comes with a big fat it depends. Cost per click (CPC) comes down to a number of factors such as: location, competition, popularity of keywords, and search volume. If you are a niche product/service provider in a smaller market with not a lot of competition, or selling a low-margin product like the stationery store, you may be able to spend <$2 per click.

On the other hand, if you are in a high-margin business, in a big city with lots of competition (like a personal injury law firm), you can expect CPC to push into the $90s and beyond. Yes, you read that right— $90 for one single click. But when you think about it, if they manage to only convert 1% of their clicks, even if they spend $9,000 on 100 clicks, that 1% could generate them hundreds of thousands of dollars in revenue. So that particular marketplace is willing to spend on it.

Based on my experience, a physical therapy practice can expect to pay on average $2-$5 per click with more popular, highly sought-after terms in more competitive markets pushing $10-$15 per click. It sounds like a lot, but you have to remember that these are highly qualified leads, actively looking for the very service you provide with a direct, actionable path to your website. It’s hard to achieve that in virtually any other advertising environment.

As for how much budget you need, my advice is to take what you think you can spend per month and triple it in the first month. While this might feel extreme, you need to know if it’s going to work, and to determine whether it’s going to work, you need data. If your budget is too lean, you’re going to get restricted data and you won’t be able to learn. The nice thing about PPC is you can adjust your budgets on the fly, at any point. Go big early, learn, and then adapt as needed. (A lot of times, I see people end up increasing their total budget after what they learn from the first month.)

Measuring Results

Google comes with tools galore to measure results. You should evaluate the success of your campaign(s) using a funnel approach.

  • Top of Funnel: Click-Through Rate (CTR). Calculated right within Google Ads, CTR will tell you what keywords and ads are resonating with your audience. Low CTR affects your quality score, and the lower your score, the more you are forced to bid to win impressions. Monitor the action you are getting and utilize negative keywords to filter out the unwanted noise.
  • Middle of Funnel: Engagement. Engagement is when someone who clicks on your ad takes a secondary action, officially becoming a lead. Depending on your goals, these actions might be downloading a free guide, filling out a contact form, or placing a call to your office. There are all kinds of tools built into Google to help pin-point track these actions—this is where things get creepy—but first and foremost, make sure you have Google Analytics installed on your site, as much of the monitoring relies on that baseline access to your data.
  • Bottom of Funnel: Conversion. It’s all about generating business, right? Which leads actually turned into clients? This step is on you. Since physical therapy practices don’t come with online check-out carts for easy tracking, monitoring conversion rate will take a bit of attention and manual effort. If you are going to go through the trouble of any promotional effort, especially one you are paying for, keep as good a track of your converted clients and how they found you as possible.


So those are the key elements of setting up a Google Ads campaign and ways you might consider using them to your advantage. It’s important to keep a close eye on your data once up and running and test, evaluate, adjust, and test, test, test some more, to fully optimize. Spending on Google Ads should generate tangible ROI. If certain ad groups or campaigns aren’t gaining traction, shut them down and either re-allocate the budget to the ones that are, or try something new. Hello, Lionel. It’s me. [Click Here] to find what you’re looking for. 

Chris Mesigian

Chris Mesigian is the SEO & Digital Marketing Director at the web design agency Media Proper. He manages over $500k in Google Ads Pay Per Click spend on behalf of a diverse client portfolio. He can be reached at chris@mediaproper.com.

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