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Episode 108 | Google Ads Amid COVID-19 with John Sanders



  • Episode 108 | Google Ads Amid COVID-19 with John Sanders 00:00


Hi Group Practice Listeners! In this episode, I’m talking with John Sanders all about digital marketing amidst COID-19.

In this episode we cover:

  • Shifts + new trends in online searches
  • Using Google Trends
  • ROI on paid ads
  • Benefits of a complete Telehealth page
  • Top tips for group practice owners
  • Lead tracking to evaluate ROI

This episode is sponsored by TherapyNotes. TherapyNotes is an EHR software that helps behavioral health professionals manage their practice with confidence and efficiency. I use TherapyNotes in my own group practice and love its amazing support team, billing features, and scheduling capabilities. It serves us well as a large group practice owner.

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Maureen Werrbach

Hey, everyone, welcome to another episode of The Group Practice Exchange Podcast. I’ve got John Sanders with me of RevKey. He’s the person that does my group practice’s Google ads. And so I’m really excited to have him on and we’re going to be talking about digital marketing amidst COVID-19. Hi, John, how are you?

John Sanders 

Good. Thanks for having me during this crazy time in our society.

Maureen Werrbach 

I’m excited to hear what you have to say. Obviously, advertising and marketing is a hot topic right now. Because a lot of practices are seeing a dip in new clients calling. And so I’m interested to see what kind of trends you’re seeing and feedback that you have since obviously, what you’re seeing is probably shifting a little bit at least since since COVID kind of became a thing here.

John Sanders 

I would say it’s shifted a great deal. I’m really kind of looking at data from my own Google Ads accounts. And then also using Google’s “Google Trends” tool, which is more of a strategic view of kind of what’s going on day to day with different search terms.

Traffic has shifted quite a bit. For example, “counseling near me” “therapy near me”, or city based terms like “Chicago counseling”, for example, you know, usually were what ran a lot of my Google Ads campaigns. But now, those are seeing less and less searches.

And we’re seeing more and more searches for things like online counseling, and online therapy. And, and I also think that you’re starting to see some awareness on user’s parts for something along the lines of “telehealth”, which is two months ago, most people would not have ever dreamed, use that term search term. But now I’m starting to see it pop up in some of my accounts. And, there has been overall, a lot lower search volume. So it’s, it’s been quite an adjustment.

Maureen Werrbach 

And I’m seeing that, well, that’s exciting to see that there’s changes happening. I think it causes anxiety for a lot of business owners, but I’m seeing it as an opportunity to be able to potentially grow the business in a way that, you know, I might not have been thinking about beforehand.

So I’m excited to see where this all kind of leads us as business owners. So yeah, let us know a little bit about the trends and what information you’re gathering and also what insights you’re having based off of that. Because as a person who knows nothing about Google ads, and has handed this off to an expert like you–or more specifically you–but handed off to an expert. This is not a strong suit of mine. So I’m interested to see, kind of hear firsthand what it is you’re doing in terms of shifting amidst all of this.

John Sanders 

So I mentioned Google Trends, which is their strategic tool where you can just put in any term and it will tell you on a scale of one to 100 what the interest in that term is. If we go back to a time in early February before COVID was here, “counseling near me” was at 97. Which is typically very high and as I said is usually one of the best search terms or keywords in my accounts.

And after right after COVID that dropped down to about 32. Same thing with “therapy near me”–went from a 90 to a 38. I pulled “Chicago counseling” for the state of Illinois just for you. And it went from a 60 to a 39.

Yet at the same time, “online counseling” from early February when interest in it was fairly low was a 42. It is now 100 and video counseling went from 59 to 100 and “telehealth” from six to 100.

So we’re starting to see many, many more people are using those terms. And for a lot of my customers who are putting together you know, telehealth pages and telehealth solutions for their practices, it was you know, going into very quickly, adding some keywords around that. And really changing a lot of the headlines in our ads, instead of “call now” or “local therapy near you”, all of a sudden became starting “online counseling today” or start you know, online therapy today.

Maureen Werrbach 

I know previously, the cost for ads, online counseling ads was high. I know I had talked to you about this a long, long, long time ago but before COVID because we we were trying to market teletherapy beforehand.

For our commuters, we have a lot of people who commute into the city and wanted to be able to get more afternoon slots with you know, the people that are commuting and taking the trains downtown and you know, aren’t coming home until later on at night and maybe don’t necessarily want to then use their little bit of nighttime Time to not be with their families to come into therapy. And I remember you mentioning that there was a sort of a high cost to mentioning online counseling because you’re competing with those online therapy directories. Right.

Are  you noticing any shifts in that happening? I don’t know if like the more people are using it, the more watered down the value is in terms of or the cost is or how that works.

John Sanders 

You know, it’s been interesting because before this, as you mentioned, it was very expensive to really run for online counseling because you have TalkSpace and BetterHelp and E-counseling, all of which have are running ads nationally for those terms, with very large advertising budgets.

So I would see average cost for each click for that being anywhere between $8 to $10.

Now all of a sudden, there are a lot more people who searching those terms. So you would think there’d be some more competition. So there’s more people searching for it in terms of demand, they’re more, there’s more competitors.

But my initial results, just going through my accounts this morning, really shows that most people are paying about five to $7 a click for that, which is higher than I would say is average for a therapy practice.

Usually, before COVID, I would see most therapy practices, were getting $3 to $4 a click.

That can vary by where you are, if you’re in an area with a large amount of competitors who are going after those keywords that can be higher. And also since COVID, a lot of people have been putting together Google Ads accounts because they are trying to, to find to find some new customers.

So really, everything’s kind of with with our averages has kind of gone haywire in the last seven weeks. But what I’ve seen so far is $5 to $7 for for online counseling with the with the limited amount of data that I have for it.

Maureen Werrbach 

What’s your opinion so far? And that might change in the future? But what’s your opinion on the usefulness of using putting in ads that have, you know, online therapy or video therapy or telehealth that drives up that cost to five $7?

What’s your opinion on doing that? Is that are you seeing that the ROI is generally good if you put a good ad out, and you have a good website that is speaking clearly to people’s clients?

Are the practices that are doing that seeing a good return on investment, or do you have any suggestions around that?

John Sanders 

So my limited data shows that, you know, I’ve seen some fairly good leader rates off of that. But I think what you just said is correct.

Because that you have to make sure that you have a good ad. And then once people click on that ad, they go to your website, you have to have a really good page that they can look at and go, Okay, this is really an online practice that can serve my needs.

You know, right after COVID happened, you know, we all threw pop-ups on our website. But as this has continued, I’ve really advised my clients to really try to get an entire page just around telehealth.

If you’re serious about advertising for online counseling, or online therapy, you really have to have that full page because you still have things like BetterHelp and e-counseling and TalkSpace out there with these huge websites that are all dedicated to that. So you have to keep that in mind that people might be looking at those pages.

So just having a pop up or just a little paragraph on your site is probably not going to do what you really need. To have that, that that strong telehealth page that and can specifically talk about, you know, what’s happened in our society now and, and how you’re, you’re addressing a counseling practice.

Maureen Werrbach 

That makes sense. So, with that information, I noticed this is something that you and I were briefly talking about right before we aired was some kind of mindset shifts that maybe business owners need to be taking.

You had mentioned that oftentimes, people start to let go of some, you know, operating expenses, and they’ll look at things like advertising or marketing costs to let go of because of, you know, trying to ensure that they have enough funds to pay cover payroll and such. And you’re bringing up some good points.

So I’d love you to share those good points because I think that’s something that our kind of business owners specifically could benefit from.

John Sanders 

Sure, this is a classic problem that’s talked about in business schools. And every time a recession comes up, you know, the business owner ends up sitting down with with their accountant saying, Okay, we’ve got to find ways to cut expenses.

But to me, advertising is not a pure expense, like insurance or legal fees or equipment. Because those things do not immediately impact you. Being able to go out and find new customers, they support that. But advertising and marketing is what can help you find new customers in a tough economic time.

And so I mean, that’s the problem that you have is that during a time where you need more customers, you’re trying to spend less to get more customers. So that doesn’t really make a lot of sense. So don’t just look at your marketing and advertising as an expense on an income statement. That is ultimately what is going to help you get new customers to help you survive. And, you know, potentially even thrive during these tough times.

Really, every time there’s a recession, you’ll be able to go out and find cases where the companies that kept advertising are the ones that really did a better job in that tough economic time. And then also after, after that. So really, what you need to do is not just stop advertising altogether and stop advertising, doing marketing, that’s not going to help you and that’s going to shrink your business.

You do need to make sure that your marketing is effective during that time. So it’s more along the lines of if using the analogy of a tree, you want to cut off a couple of branches of the tree that maybe aren’t doing so well. You don’t want to cut down the entire tree right? You want to be learning in a smart way, in a way that is, is actually going to help your business.

Maureen Werrbach 

So I was gonna say, I see not only what you’re describing, which is kind of one end of the spectrum where people just stop any sort of paid marketing and are, you know, only marketing by sending out emails or reaching out to their referral sources, you know, verbally or over the phone, those free marketing methods.

And you know, I see that but I also see the other end of the spectrum where people then just like, throw anything against the wall to see what sticks. And it’s really hard to see what see what sticks marketing wise, when you’re when you throw a bunch of things out there, because it’s really hard to pinpoint which things are playing the biggest role in referrals coming in or not, but also you have the potential for spending wastefully. I see both of those.

Both of those ends is like people going to nothing and spending euro dollars because they want to save for people. Maybe not necessarily spending a lot, but just putting up putting their efforts into too many different things all at once.

John Sanders 

No, that’s, that’s absolutely correct. You can get to the point where you just hit the desperation, you start grabbing all of these different ad platforms, and then it can get confusing as to which ones are actually giving you a return on investment.

And that gets back to a lot of the basics of Google ads. If you’ve you’ve got to make sure that you’re that you’re tracking your leads correctly with either call tracking software like I use or or some of the built in conversion tracking of of Google ads.

But yeah, you definitely don’t stop advertising altogether. But don’t get so wild and desperate that you’re that you’re starting to do a whole bunch of different things.

Maureen Werrbach 

So what what, how do you want to wrap this up? What are your biggest suggestions or pieces of feedback or takeaway things that you want to give to group practice owners specifically amidst COVID? Knowing that after this is over that information might be a little different again, you know, if things go back to a state of normalcy, but for people who are in this state now who are anxious about new calls coming in feeling the pains of you know, calls having gone down and and new clients being scheduled going down, what what feedback Do you have when it comes to just your realm obviously?

John Sanders 

Sure, well, and and even just kind of in the broader sense of marketing and being a business owner myself. So I think that there are a couple of opportunities here is that one, especially during this time with what we’re going through, people are going to need mental health counseling. Now more than ever, I think we need to keep that in mind.

And so while I’m looking at the week to week search trends, eventually a lot of these people are going to get off they are going to need somebody to talk to about, you know what they’ve gone through during this period. And then another thing is that this is somewhat of an opportunity for those of you who have put together telehealth solution real fast and put it on your website. Once again, you need to have a very good page for that and a solid platform to to work on that.

But if you find that you like this, being able to work online, this gives you the opportunity of expanding your customer base just from outside of your local physical area. So if you specialize and a specialized form of couples counseling, or really any type of specialty counseling, this is an opportunity for you.

If this really works out for you to maybe start advertising to the entire state or wherever you have a license that you can practice where you can try to find some ideal customers that you wouldn’t have thought about three months ago, because they’re 200 miles away. Well, 200 miles away doesn’t matter when when you’re doing a telehealth solution necessarily. So I think that that is a that’s a hidden opportunity in this.

And then the final thing is, you know, this is just kind of, at the business owner level of, you know, there are a number of grants out there there, you know, the federal government’s put together programs, you know, they’re small business loans out there to to help you during this time and to go out and definitely take a look at those and you know, especially if you’re, if you’ve got rent or you need to pay for some advertising or things like that, you know, some of those programs are definitely things that can help you out during this time.

Maureen Werrbach 

I have a question. I don’t know if I’m putting you on the spot, or if there’s actually an answer to this, but as you’re talking, I was thinking of this.

Because a lot of marketing methods don’t have an immediate return on investment. What are your thoughts on Google ads in terms of return on investment? Do you feel like it’s something that, you know, on average needs a certain amount of time? And if so, what amount are you seeing before?

Because I feel like one of the things that, you know people are doing is also that, okay, I’ll put X amount into Google ads, and then a week later, or like, we did not get in, we didn’t get any more calls than normal. We got, you know, we’ve been averaging 10 calls a week, and we got 10 calls this week.

Do you have any thoughts or feedback around just expectations that group practice owners should have when putting ads out of how soon to see return on investment, or what a good ROI is?

Like if you’re spending, you know, I don’t know this might vary based off of location, but if you’re spending 100, like a good return on investment is to have gotten one client or if you’re spending X amount, you really want to have X amount of clients because I guess, you know, clicks doesn’t equal clients?

And maybe that’s even a second level question to you is, what percentage of clicks do we want to have become clients? Like what’s the normal amount because maybe people assume if I’m getting 10 clicks, that nine of them are can be scheduled when that’s likely very untrue.

John Sanders 

Well, to set that expectation, you should first think about your own web habits of oftentimes when you go to a website, you do not perform what they want you to do the first time there, you don’t always buy something the first time you were there. Oftentimes, it takes you five or six times to come back.

Also, especially if you’re starting in Google Ads campaign now, when things are chaotic, normally, I tell clients, you know, we really need to have some statistically significant data to look at, you know, over 60 or 90 days to really kind of look at a program.

Now the good news about Google Ads is you can start a Google Ads campaign today. And with the right bidding, you can be on the first page above the organic results today. So you can see some immediate results.

Now, in normal times, what I would what I usually like to see is I like to see between five to 10% of those clicks turn into either a phone call or forum or some sort of online scheduling action is really what I’m looking for. The Internet average is probably like two to 3%. But for my accounts, I mean, I want to I want to shoot for that that five to 10%.

And then you also make a correct point. If you’re paying $7 a click for couples counseling in New York City, your ROI is going to be very different from somebody who was paying, you know, $2 and 50 cents a click for you know, counseling near me out in rural Arkansas, for example. Also, you’re going to end up charging different rates as well. So there there is there is some of that to deal with.

But in general, like I said, I want to make sure that you’re getting those those leads and making sure that you have that lead tracking in place so you can know exactly what you’re getting from Google.

So after that period of 60 days, you can say, okay, I got this many leads from Google. And I know it led to this many clients. And then you have to look at that, what’s that client value going to be over time, and that gets into, you know, where you’re doing insurance or self pay, and then and then what rates you’re dealing with,

Maureen Werrbach 

So kind of the industry averages two to 5% of the people that are clicking. You want a person would want to have become a person who’s calling or clicking. Add the button to schedule that appointment. Right?

John Sanders 

Let’s say really the internet average is more than two to 3%. As I said, I’m usually shooting for five to five to 10% is what I want to see.

And there’s also an immediacy to Google Ads because people are farther along in their buying cycle really. So they are actively saying, counseling near me or online counseling. And so they are looking for somebody to do that.

Whereas with some other platforms, like if we look at Facebook, for example, which is much more of the long game where you show some people some blog posts and you get them to like your page, and then you show them some remarketing ads, and it’s much more of a multi step process to get people to take that final action to to become a patient. Whereas Google, it’s, you know, somebody is actively searching for that at that moment. So that’s why Google has the chance to be successful very quickly.

Maureen Werrbach 

Are you finding three weeks in or so into this whole thing that the businesses that you’re working with are finding, generally good results, marketing telehealth or is it too soon to tell?

John Sanders 

I’d say I’m cautiously optimistic.

I am seeing some people are doing fairly well with it. Specifically with clients who kind of followed the advice of really trying to put together a good page on their, on their website about about telehealth and and what they’re doing during during this time. So I’m cautiously optimistic, but you know, the numbers are constantly changing,

Maureen Werrbach 

So where how do people reach you? If they if they’re wanting to dip their toe in Google ads? Or try their hand at Google Ads with with someone who’s a professional. How can they reach out to you?

John Sanders 

You can just go to my web site at And we can set up an appointment to talk. And we can see how I can help you out with your with your Google ads.

Thanks For Listening

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therapy notes

*Need a good EHR for your group practice? TherapyNotes is it. I’ve been using it for years in my own group practice, and it does really well when it comes to having the features group practice owners need. Try it out for FREE for 2 months by clicking here.

* I am an affiliate for some of the businesses I recommend. These are companies that I use in my own group practice, and make recommendations based off of my experience with them. When you use some of these companies through my links, I receive compensation, which helps me continue to offer great free information on my podcast, blog, Facebook group, and website.

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Meet your host


Maureen Werrbach is a psychotherapist, group practice owner and group practice coach. Learn more about her coaching services here:


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