Case Study: 2-location Aesthetic Medical Practice

Google Search Ads

Praise From The Client

$1,178,035 in Trackable Revenue at 394% ROAS in 36 Months

Google Ads + CRO | Medical Aesthetics | 2 Locations in the Southeast

The Results

Longer-term trend: Year-over-year ROAS improved consistently from 2023 through 2025 due to stronger signal quality, value-based optimization, and smarter campaign budgeting.

The Challenge

The client runs two busy aesthetic practices in the southeast United States. Leads were coming in, but visibility broke after the form or phone call. Which click became a consult and then a patient was unclear. That ambiguity led to cautious budgets and decisions made without a reliable revenue picture.

Objectives

Drive high‑intent consult bookings across core procedures
Establish end‑to‑end attribution from click to consult to revenue
Improve return on ad spend and allocate budget toward profitable procedures

What We Changed

Attribution and data foundation. Clean UTM and GCLID capture across contact forms (Gravity Forms), chat, online calendar bookings (Calendly), manual consults, tracked calls (CallRail), and BMI submissions. All leads were centralized in a shared tracker to label ad‑sourced leads, track no‑shows and cancellations, and link wins to revenue.

Offline conversion feedback: When a patient was marked Appointment Show in the CRM, that value was passed back to Google Ads, training the bidding engine to optimize for revenue‑leading actions instead of raw leads.

Value‑based bidding: Switched to Maximize Conversion Value with a tiered model. Micro events like chat leads carried lower values, while booked and attended consults carried higher values.

Channel and tactics mix: High‑intent search campaigns around priority procedures, Dynamic Search Ads to capture long‑tail queries, Demand Gen to grow qualified reach, and on‑page CRO to tighten hero copy, surface CTAs, and position social proof.

Downstream insights: Followed consult outcomes and revenue to cut superficially strong but unprofitable campaigns and reinvest in those driving procedures. A simple test revealed that free consults produced not only more bookings but also more new patients and more revenue, even with a higher cancellation rate.

"For years, attribution and post‑lead tracking had been a major headache for us. Bullhorn Media figured it out. That breakthrough alone has given us visibility into our marketing ROI like never before."

Practice Owner

Impact

Clear line from click to consult to patient and revenue
Budget shifted from vanity leads to revenue‑producing keywords and campaigns
Consistent year‑over‑year ROAS growth from 2023 to 2025
Fewer “mystery leads” and better forecasting for booked procedures

Deep Integration Into Sales CRM

When you take the time and effort to integrate your ads with your CRM, you learn a lot.

And you can use those learnings to make money.

Our deep integration approach used a shared spreadsheet to show each lead, its status, booking shows and no-shows, wins, and revenue.

Everything was transparent and clear – allowing us to optimize for profit and revenue, not just bookings.

Why Our System Worked

Attribution clarity: One source of truth let us trace revenue back to specific campaigns and keywords.
Algorithm alignment: Value signals showed Google Ads which actions correlated with actual revenue.
Tight feedback loop: Sales outcomes and cancel/no‑show data informed media moves, so budget followed real‑world results.

“From day one, Bullhorn focused on the things that actually move the needle for us—revenue, returns, and keeping the lead sheet and monthly tracker accurate and useful. It’s refreshing to work with a partner that looks at the same scoreboard I do.”