Google Ads Case Study – Chiropractor Client Overview
This Google Ads case study highlights a multi-location chiropractor client based in Washington, USA, operating in the healthcare and rehabilitation space. The clinic provides chiropractic care, pain relief treatments, sports injury rehabilitation, and long-term wellness services.
The business model focused on lead generation through Google Ads / PPC, with conversions measured as:
- Phone calls
- Appointment form submissions
The campaigns targeted multiple service locations, including:
- Federal Way
- Auburn
- Kent
- Maple Valley
- Spanaway
The chiropractor was investing approximately $3,000 per month in Google Ads and relied heavily on local search visibility to drive patient inquiries. This Google Ads case study focuses on how we rebuilt the account and improved lead quality across all locations.
The Challenge Faced by the Chiropractor
Before partnering with our PPC team, the chiropractor had been running Google Ads with a previous agency, but results were underwhelming.
Key challenges included:
- Low conversion volume despite relatively high ad spend
- Inconsistent and poor-quality leads
- Campaign performance misaligned with business goals
A detailed account audit uncovered several inefficiencies.
Account and Performance Issues Identified
- Search terms had not been reviewed for over 90 days, leading to wasted spend on low-intent queries
- Multiple keywords were running on broad match without adequate controls
- Bidding strategies and performance were not actively monitored
- Conversion tracking was incomplete, capturing only a portion of actual leads
During this period, the Google Ads account was cancelled, which caused:
The cancellation stopped all campaigns, causing a complete loss of search visibility and missed patient inquiries across all locations.
As a result, the chiropractor was left with wasted ad spend, limited performance insights, and no stable Google Ads presence. They needed an urgent relaunch with a trial budget of $2,500, without sacrificing lead volume or quality.
Goals and Key Performance Indicators
The objectives were clearly defined before relaunching the campaigns.
Primary goals included:
- Fixing the cancelled Google Ads account and restoring lost search visibility
- Increasing booked appointment leads across all clinic locations
- Reducing cost per lead while maintaining high-quality inquiries
- Maintaining consistent lead volume within a limited trial budget
Google Ads / PPC Strategy and Approach
1. Account Reactivation and Campaign Structure
We began by auditing and resolving the issues that led to the Google Ads account cancellation. Once the account was reactivated, it was rebuilt from the ground up with a clear structural focus. Campaigns were segmented by location and chiropractic service, allowing for separate targeting of each clinic area to improve relevance and budget control. The strategy prioritised high-intent local searches related to chiropractic care, ensuring ads appeared only to users actively searching for a chiropractor in their specific location.
2. Keyword and Search Term Optimization
To reduce wasted spend and improve lead quality, strict keyword controls were implemented across all campaigns. Broad match keywords were refined to phrase match to improve relevance, underperforming keywords were paused, and a comprehensive negative keyword list was added to prevent irrelevant searches. Search term reports were reviewed continuously, allowing us to eliminate low-intent traffic and significantly improve search intent across all campaigns.
3. Conversion Tracking Fix and Expansion
The previous conversion setup captured only a fraction of actual leads, limiting optimization potential.
We fully reviewed and fixed the tracking setup, ensuring complete visibility into performance.
Tracking improvements included:
- Phone call tracking directly from Google Ads
- Website call tracking
- Appointment and contact form submission tracking
- Accurate attribution of every qualified lead
This gave us reliable data to optimize for real patient leads.
4. Ongoing Optimization and Budget Control
Continuous optimization focused on maximizing results within the reduced budget.
Optimization actions included:
- Budget and bid adjustments based on location-level performance
- Increased focus on underperforming locations while maintaining strong performers
- Creation of new ad variations to improve click-through rate
- Device-level bid optimization
Mobile devices were prioritized due to stronger call performance, while desktop bids were reduced because of higher cost per acquisition. This improved overall budget efficiency and lead quality.
Results Achieved
Performance was compared between the 30 days before our involvement and the first 30 days after relaunch and optimisation.
Key outcomes included:
- Total ad spend reduced from $4,313 to $2,498 (-42%)
- Conversions increased from 193 to 220 (+14%)
- Cost per conversion reduced from $22.35 to $11.36 (-49%)
- Conversion rate improved from 14.06% to 16.97% (+21%)
Within just 30 days, this Google Ads case study shows how the chiropractor achieved higher conversion volume while cutting overall ad spend by 42% and reducing cost per conversion by nearly 49%.
Campaign Performance Overview:
Improved campaign efficiency across multiple locations following account restructuring and PPC optimization.
Performance Comparison View:
Google Ads performance comparison showing increased conversions and reduced cost per conversion after optimization.
Key Takeaways from this Google Ads Case Study
- Reactivating and restructuring the Google Ads account restored lost visibility
- Location-based campaign structure improved relevance for chiropractor searches
- Accurate conversion tracking revealed true PPC performance
- Keyword refinement and negative keywords reduced wasted spend
- Device and location-level optimization improved lead quality while controlling costs
