Let's Fix Your Ads | A Chiropractor's Guide to Google Ads
Troubleshoot your chiropractic lead generation with our guide. Getting spam leads? Spending too much or too little? Overwhelmed with Google Ad complexities?
Ben Ertl
9/6/20256 min read
Fixing Common Issues with Chiropractic Google Ads
Running Google Ads for your chiropractic office can be one of the fastest ways to get new patients through the door. But campaigns don’t always run smoothly. Here’s a clear guide to spotting and fixing the most common problems chiropractors run into.
1. Spam Leads – Wrong Number, Wrong Office, Etc.
The problem: Calls that aren’t real patients—wrong numbers, people looking for another office, or outright spam.
The fix:
Use call tracking with transcripts (like CallTrackingMetrics) so you can mark spam and teach Google which calls count as real leads.
Make sure your office name, address, and city are clearly shown in the ad so patients know they’re calling the right chiropractor.
In your location settings, select “People in or regularly in your targeted locations” only. Avoid the default that also includes “people interested in” your area—otherwise you’ll pay for clicks from people who will never visit your clinic.
Keep a running list of negative keywords (like “school,” “jobs,” “free”) and add them regularly as you see irrelevant searches come in. This keeps Google from wasting money on bad clicks.
2. Leads Aren’t Converting to Patients
The problem: You’re getting form fills or calls, but they don’t turn into booked appointments.
The fix:
Check how your front desk handles leads. Are they answering quickly? Are they trained to turn callers into scheduled patients?
Record phone calls or track response times—this can help you diagnose if leads are being missed or mishandled.
Make sure your ad offer is clear. If you advertise “$29 New Patient Special,” the person calling should hear exactly that. Surprises or unclear pricing can cause leads to drop off.
Track how many calls actually result in new appointments to see where things break down.
3. What Should My Budget Be?
The problem: You don’t know how much to spend.
The fix: Most chiropractic campaigns start between $1,500–$3,500 per month. Smaller towns can often run on the lower end; larger cities usually need more because competition drives up cost-per-click. A good goal is to aim for at least 8 clicks per day on your ads to keep new patient leads coming in steadily.
Use Google’s Keyword Planner tool to check CPC (cost-per-click) estimates for your area. For chiropractors, clicks typically run anywhere from $12 to $50 each, depending on competition. The keyword “chiropractor near me” is usually the most expensive, but also the most valuable since it shows the strongest intent. Build your budget around what 8 daily clicks of that keyword would cost in your specific market, then layer in lower-cost, long-tail searches (like “back pain chiropractor [city]”) to stretch your budget further.
4. Campaign Isn’t Spending Money
The problem: Your campaign isn’t using the budget you set.
The fix: This usually means your targeting is too narrow, or your bidding strategy is too restrictive. Open up your location radius slightly or use broader match types on high-intent phrases like “chiropractor near me.” Also check that you’re not overloading the account with too many negative keywords.
Keep in mind it can take up to 48 hours after launching a new campaign for Google to start spending consistently. If it’s brand new, give it a little time before assuming something’s broken.
5. Cost-Per-Click (CPC) Is Too High
The problem: Clicks feel expensive, and your budget disappears too quickly.
The fix: For chiropractors, clicks often range from $12 to $50 each. “Chiropractor near me” will usually be at the higher end, but it also converts the best. Instead of only chasing that one keyword, balance it with more specific, lower-cost searches like “back pain adjustment [city]” or “walk-in chiropractor [city].”
Keep refining your negative keyword list to block irrelevant searches (like “school,” “salary,” or “free”) that drive up costs.
Remember: cheaper clicks do not equal cheaper leads. If CPC is high, it becomes even more important that your website, landing page, and ad offer are dialed in perfectly. Otherwise, you risk paying $30–$40 for a click that never turns into a patient. Every part of the funnel—from ad copy to booking form—must be tight to avoid wasting money.
6. What’s My ROI? Is Running Ads Worth It?
The problem: It’s hard to tell if the money spent equals patient revenue.
The fix: Assigning values to conversions doesn’t guarantee the patient actually paid, but it does help Google prioritize the actions that lead to higher-quality patients (longer calls, form fills, booked appointments).
ROI for chiropractors often shows up over time. A new patient from Google Ads rarely pays off in one visit—the value comes from multiple visits over months. That’s why many clinics see the true ROI only after running ads consistently and tracking the long-term patient relationship, not just the first appointment.
A good practice is to review all Google Ads leads on a quarterly basis. Look at how much revenue those patients actually brought in and calculate the average earned per lead. This gives you a realistic view of ROI without overreacting to one slow or busy month.
Example math:Budget: $2,000/month
Avg CPC: $30
$2,000 ÷ $30 = ~67 clicks
Conversion rate: 15% (10 out of 67 clicks become leads)
If 6 of those leads book appointments and each new patient averages $600 lifetime value → $3,600 in revenue
That’s nearly 2x ROI in just the first round of visits, with long-term value increasing as patients return.
7. Are My Ads Competitive Enough for My Area?
The problem: You’re in a crowded market, and you’re not sure if your ads stand out.
The fix:
Search for “chiropractor near me” in your city and look at competitor ads. If your ad sounds the same, you’ll blend in. Highlight what makes you different—“Same-Day Appointments,” “Walk-Ins Welcome,” or “Specializing in Sports Injuries.” Small but clear details can be the reason someone clicks your ad instead of the clinic down the street.
Use Google’s Auction Insights report to see how your ads are performing against competitors. Look at least a week’s worth of data (not just a single day) so you don’t get skewed results. You don’t need to be in the #1 spot all the time—that’s expensive—but you do want to show up at the top more often than not.
Quick guide to Auction Insights metrics:
Impression Share → How often your ads show compared to competitors. Low share = you may need more budget or better targeting.
Top of Page Rate → How often your ads show above organic results. Higher is better, but balance it with cost.
Absolute Top of Page Rate → How often you’re in the very first paid spot. Nice to have, but not necessary for ROI.
Overlap Rate → How often your ads show at the same time as a competitor. Good for seeing who you’re really up against.
Outranking Share → How often your ad ranks higher than a competitor’s. Helps you spot if a local rival is consistently beating you.
8. Getting Clicks, but No Conversions / Leads
The problem: People click, but they don’t call or fill out a form.
The fix: The issue usually isn’t the ad—it’s what patients see after they click. Sometimes a dedicated landing page works best, but other times your full website is stronger because people want to see who their chiropractor will be and learn more about your practice before booking.
The key is making sure what’s presented builds trust and makes it easy to take action. Sometimes the solution is obvious—like adding a more visible “Call Now” button or placing your phone number higher up. Other times it’s subtle, even personal. For example, I’ve seen cases where simply updating the chiropractor’s photo improved results. Anecdotally, female chiropractor images often outperform male ones, possibly due to comfort, preference, or intimidation factors.
Also, don’t overcomplicate your offer with too many extras the lead may not care about. Keep your pitch simple and focused on what most patients want—fast relief and clear pricing. And if you’re using a form, make it short and easy to fill out (name, phone, email is usually enough). The easier it is to act, the more likely a click becomes a patient.
9. Which Bidding Strategy Should I Use?
The problem: Google gives you a bunch of bidding options, and it’s confusing.
The fix: There’s some debate about whether to start with Maximize Clicks or Maximize Conversions. Maximize Clicks can sometimes spread your budget chasing volume, which leaves your ads underpowered in the auctions that really matter.
In practice, as long as your campaign is built out decently (with solid keywords, negatives, and conversion tracking), Maximize Conversions tends to perform better for chiropractors because it focuses on actual leads instead of just clicks. Once you’re getting at least 10+ conversions per month, you can then move to Target CPA (cost per acquisition) for tighter cost control.
10. Are My Conversion Goals Set Up Correctly?
The problem: You’re not sure if Google is tracking the right actions.
The fix: Most agencies set conversions to count phone calls over 60 seconds and every form fill. That’s a good starting point, but it’s not enough. You should also be recording calls and reviewing transcripts so you can separate poor leads (wrong numbers, spam, low intent) from valuable ones (patients actually booking).
If you treat all calls the same, Google will optimize toward the cheapest leads it can find—and those are always a mixed bag in terms of quality. By feeding Google only your best conversions, you give the algorithm a clearer picture of what quality looks like—making your campaign far more likely to generate ROI.
