Ep. 173: The Real Cost of Patient Acquisition for Urgent Cares (And How to Get Patients for Under $20)

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Good morning, everybody. Good morning. It is morning. You're listening to a unique edition of Walk-Ins Welcome. We're calling it Coffee and Conversions today. your cup of coffee. I got my little cup of coffee. No more Elani New. No Elani New today. We still have some in the fridge. I love Elani New, but they abandoned us, man. They did. They sending stopped sending us free stuff. Not that we earned it or deserve it, but... We felt like we earned it. I feel like we did.

Anyway, so coffee's in conversions. I'll crank up my energy. I know I'm sounding a little softer, yeah, it is typically recordings in the afternoon, but we're here in the morning because my afternoon is shifted because of some things. But anyway, so coffee's in conversions. I think when I hear that, always think about chamber events, coffee and contacts, coffee nets. OK, right. Like a little literary. was my alliteration alliteration.

alliterations, probably closer to it, was traffic and conversions. Yes, exactly. So copies and conversions. So here's the thing. We have seen lots and lots of discussions and talks around what acquisition costs are supposed to look like. She looks stressed out. You just go, uh. OK, here's the thing. Y'all are being sold a lie on what acquisition costs should be. So we.

Couple of things around this one is so Hannah went to the Xperity event last week, which was fantastic. Actually, Xperity all did a wonderful job. We didn't get to go. I was supposed to go and some things happened and Hannah ended up going and she had a blast. I think we're going to try to her to come on an episode, talk about it, but she had a blast. Xperity all put on a great event. We're excited to go back. anyway, but one of the things that always comes up at those events and anything we talk about urgent care is

our patient acquisition costs. It's never a good thing. It's always very challenging. And then the conversation around the reimbursements are just not catching up to our expenses. And one of those major expenses nowadays is patient acquisition costs. Like at the end of the day, how much does it cost you to get that patient to walk into your door and become your actual paying patient? And I want to tell this, you've been sold a lie, but

We can title it whatever you want. Yeah, it don't matter. because the world says, when I say the world, like when you start doing search around it, they're saying it should cost you 30 to 50 bucks to get a patient through your door. And that's a lie. It's just a lie. And I'm confident in saying that because now that we've had quite a few urgent cares working with us across the country, too, it was kind of fun building that client map last week.

It kind of gave like a taste of, we had to, we had to zoom way out on the map because we just brought on an urgent care in Hawaii. Yeah. So it was fun to have the pins and I'm like, this isn't all of them. me pinch you. Yeah. And there it is. And there's Hawaii. Yeah. So like, but, but now that we've we're literally from coast to coast, like, so we see data from all over the country and there's a lot of consistencies at the end of the day. But here's the thing we're finding that consistently

your acquisition costs should be well below 20 bucks. I want to throw something out there to you. Obviously Google is going to be the main driver of patient acquisition. We know that in the urgent care space. What I wanted to throw out is that the range is as little as $500 to up to

15, 20,000 a month announcements. The range is all over the place. It's the consistency and the conversion costs that we're looking at. it's so fascinating because... Budgets don't matter is what I'm saying. Budgets really don't matter. We'll tell you there's some minimum budgets you want to look at. It really depends on your goals, right? Because a $500 budget obviously won't be as effective as like a $5,000 budget in terms of pure volume. But it is interesting because like we do have an account that's $500. We have an account or two that's over 10,000 plus. And...

their conversion costs are very, very, very, similar to a point where the $500 one performs extremely well. And we've even gone back to the higher budgeted ones and we're like, hey, you could turn down this budget and you probably won't see a big decrease of any sort if you want to. And they're like, no, it's fine. I don't care. And so yeah, at the end of the day, like when I say you should be acquiring your patients for under 20 bucks, I can say it.

very factual. Like we see it all the time and we see it across the country. If you're being told a 35 or $45 patient acquisition cost is good, you're being told a lie at that point. Because if we were telling you that, it would be so easy. I know. Like, it'd be a joke. We hold ourselves to a different level of standard there though. Well, and we've learned over the years. So like we're four plus years into the urgent care space. And so we've seen

The COVID times, the post COVID times. And yeah, COVID times, like you guys could just throw a rock and hit patients. Like it's just, they were coming no matter what. And now that's changed, right? now you're back. would imagine your acquisition costs for a patient in the heart of COVID is probably like a dollar or two, if that. It probably didn't have. Didn't have hardly any. As I understand, if I recall the urgent cares that we worked with, relied completely on search engine optimization.

And they had shut all of their ads down. Yeah. Even Google took a hit during that. Yeah. And so and then people at the end of the day, they just needed to find someone that was open. It didn't matter. And it was really because I think most of our urgent care is really hitting like 100 patients per day. They were just trying to keep up. But times have changed again. Now we're back to I don't know if you call this normal, just the way things are. But now it's a struggle to hit the 40 patients per day where you have to throw some effort and money and things to make

you look attractive because as we've noticed too, one other like yes, demand has shifted back down, but your competition has gone up like a lot more urgent cares in this world than there were five years ago. And I talk about just like the American family cares like yeah, there's a bunch of those. now people are popping up left and right because it's the primary care models gone away like primary care is not your dedicated doctor anymore. Now they're just urgent cares that

may offer primary care options as well. know there's still primaries out there, but I'm seeing a lot more nurse practitioners that are filling in for hospital systems that have microsites. Yeah, yeah. lot of that going on. But at the end of the day, so why, so I'm kind of curious, just an open dialogue here. Like, why do people, when you do research, why is that $40, $50 conversion or acquisition costs the norm? Why do we think? I mean, I know why. I mean, it depends on.

It depends on where you're going with this. don't want to derail your thought process. No, no, it's like a general discussion of like, do you, why do you think that's just become a norm? And I wish it wasn't believed on. did a statistics video a day or two ago, earlier this week.

And it was statistics overload. Like if you listen to the video, you're going to think I'm making up the statistics because there's so many of them. Well, is that 80 % of time they're not or whatever that 97 % of all statistics are made up on the spot. Yeah. These are not, these are, these are fact-based. And I even said at the beginning, I'm about to throw so much data at you. You're going to cry. But you need a cup of coffee. Do I need to slide that over to you? Morning. What do you do? All right. So

Essentially what I found in digging into the data, one of the problems, and this is just what we're seeing when we acquire accounts. And then of course, you know what, what the research shows out when we're looking just on, on search, like what, is Google telling us? Most people are setting their radius at 10 to 15 miles. right.

So it's not that the cost per conversion increases, the cost per acquisition increases. And there's a difference. A conversion on Google just means that somebody took an action, they either filled out a form, they made a phone call. All right? So that's what a conversion, that's what Google is calling a conversion. Acquisition is did the patient come in and spend money with you, So naturally, your acquisition costs should always be a little higher than your conversion costs. So if...

All the data shows that people are not willing to drive past seven and a half miles to go to an urgent care. don't care who you are, unless you're out in rural America, right? But all the data shows that the max is seven and a half miles. So if you're spending 10 to 15, if you're spending money on a 10 to 15 mile radius, at that point, half of your conversions are now not qualified.

Yeah. And so like an example of that, if I'm 10 miles out, click on the ad or engage with that urgent care, it's 10 miles away. And it's okay. Yeah. And I look at it like, crap, that's like back, you know, start scrolling backwards. Swiping back and it's like, let me find someone's a little closer. Cause I mean, at the end of the day, you know, this is something all urgent care can relate to. Like the loyalty is low. Like it's really convenient and your review is pretty good.

I commented on somebody's LinkedIn profile. There was an urgent care clinic that just opened up their new location and I loved the way they did it. And here's what I mean. Is that the pretty one? There is a pretty one. I don't know which one. There's a bunch of pretty ones. This is pretty and smart. Orangey blue. Yeah, that was cool. But they had a really nice, their logo, small and a massive urgent care across the front. what do they know? Michael, what do they know?

They know the brand don't matter. Brand in this particular situation, brand is less important than what you are. right. They're based on exactly what you just said. Brand loyalty doesn't always exist. exists. all right. Brand loyalty exists at the level that you do your follow up and outreach. Okay, it's not because of the way your brand looks like everybody recognizes the golden arches.

Everybody recognizes the swoosh. Everybody recognizes the yellow star for Walmart. We need McDonald's just to come out with tiny little arches and it just says burgers. Target doesn't even put Target on their logo anymore. They do the three circles. Yeah. You know what I mean? But urgent cares are not like this. You can't see an urgent care symbol or something like that. Now they do have one brand in common across all of them. What is it? It's a Red Cross.

yeah. It's a red cross, right? Anytime you see a red cross on a building, you know, it's an urgent care. Yeah. Right. Generally, that's the brand, not your name. Yeah. Right. And that's one of those things where I don't know, honestly, if that's something that can ever be fully overcome, because a long time ago when I went to Europe, they had pharmacies, but you didn't know they were pharmacies except for the green.

cross. And that was it. Like there was no branding on it. But they were like individual pharmacists. Michael, name a barbershop. I got pit stop. Okay, good. We know pit stop, though. Yeah. But what is it that all barbershops have in common? Little white and red. Yeah, totally. That's it. Which is the old school bleed your wrist out. Is that what that is? Yeah. So like, you remember barbers actually used to be the doctors of the day you go to barbershop to bleed out your old blood.

That's why it's red and white. I was looking to shave while you're there. don't know. Exactly. Cause they had the sharp stuff, right? Like clean that up while you're dying. Cause I thought if, you're sick, let me give you new blood. had no idea. really? Okay. Cool. That, that now reminds me of the demon barber of like whatever street that, that, that play where he just killed people. It all makes sense now. Anyway, the point I'm trying to make is, like even with the barber shop, like

you started looking by the symbol, you stayed because of the service. Yeah, like you come back because you had a great time, great experience. You felt like you were not just a number and the results were good. We've gotten so far off of patient acquisition at this point and cost per lead, but the point we were trying to make though really is just simply like the brand isn't near as important as what you are.

and the radius in which you're going to serve your people because people are not going to drive like if there's if there's let me say it this way. If there's 15 fast food restaurants in a 10 mile radius, you're not going to go to the 20 mile radius to get food. That's the same thing with an urgent care. Yeah, I mean, I don't like making the comparison, but ultimately an urgent care and a fast food restaurant have very similar challenges.

they do because the costs are very very similar to the individual and then the product the service that comes out of it is not too different from each other and like so like I'm doing a talk at the urgent care convention in May talking about the front desk evolution like how to empower your front desk more and one of the things I'm going to be comparing is like just a little snippet in here so if you compare a McDonald's and a Chick-fil-a

at the end of the day, food quality, like you could say, oh, well, Chick-fil-A's got a better chicken sandwich. Sure. But at the end of the day, it's still feeding you, right? Like the lunch at a McDonald's and lunch at Chick-fil-A aren't that much different. The pricing is very similar. This speed is pretty similar. But when you actually pull information on it, a Chick-fil-A does nine, an average Chick-fil-A does nine million a year, an average McDonald's is three million a year.

And so a lot of that goes into like the experience and like the dedication. Like are these people that are buying Chick-fil-A like they know what they're getting every single time. Like it's almost weird to go to a Chick-fil-A and the experience is bad. What I have noticed though with McDonald's is the services is, I'm not even going say hit or miss. It's mostly miss. It's mostly as as Wendy's right? But McDonald's food is consistent.

Yeah, I'll get their their speedy burger system or whatever they called it. Yeah, like that is that every time I get a a quarter pounder with cheese, it's the same no matter where I go. Yeah. And that is the secret for them. Yeah, it really is. And but at end of the day, like when you talk about overall experience, Chick-fil-A usually takes the crown. Oh, there's no doubt. No doubt about it. And I know that that brings people back every single time because the sandwich is the sandwich. Like it's good and everything. And

There's that, but for us, like we have a five year old and we like going to Chick-fil-A. One, they still have Play Play, like they still have, not they call it Play Best McDonald's, but they have like an actual indoor thing for her. And then it's consistent. Like I don't have to think about it. They bring the food to you. Like, it's just nice. And I go to McDonald's, like they have these same offerings, but the experience is just not quite radically different. It's just not there.

Well, so we've talked about radius and that's one of the main drivers of the higher cost per acquisition is you're in a 10 to 15 mile radius, only seven and a half miles is really relevant to you. So 50 % of the clicks and leads that you're getting on Google are no longer qualified just due to radius. The other thing is what we see a lot of us people are running what's called PMAX campaigns. And that is Google's basically done for you system.

what is Google's think of it? Like this is important. What is Google's goal? Money. That's it, right? They want to put you in front of as many eyeballs as they possibly can do to get people to click because they only make money when you click on an ad. I saw a comparison of Google back 20 years ago and Google today and it was like search results like one little block and now it's

AI overview that you have to question completely if it's legit or not followed by ads followed by map. There's your result. It's like five things down because at the end of the day, like they're trying well one they're trying to be all search to everybody and they've lost that now. Like we've seen a lot of stats on us now where a couple before AI hit the prime time. You know, we were talking like 97 percent like over 90 percent all search was Google and now it's like 40.

Yeah, now when you do all search, and we're talking about not just simple text search, but like all search, where now you have like five, 10 platforms you can pick from now. And so when you do that, it's like closer to 40 % of their search is just there. So they've lost a lot of market share. They'll never admit it. They've lost a lot of market share. They're trying to figure out. So I'm going agree to disagree. I think it's changed. And here's what I mean by that. I think they have the exact same amount of eyeballs. Yeah.

All right. I just think more options have opened up and their market share has not changed. And therefore, if a pie has six slices and then now I'm cutting it 12 ways, I still have exactly the same amount of people who would have come to me for search. So I still think Google is completely relevant. But when you look at it at the market share, this happened at the intensive I just came from where he was talking about that. goes, well, now you have 16 different AIs that are searching as a or serving as a search functionality.

You have Apple, the HomePods, you have the Alexas, you have all of the voice searches that have stepped into that search. YouTube is the second fastest, by the way, get on YouTube. Yeah, YouTube and still like today, YouTube is one of the number one search engines out there. That's right. And it's been that way for a very long time. For sure. And we all thought, well, maybe TikTok took that over. Now TikTok, like it's still great for short form.

Like I find TikTok fantastic for like little snippets of information, like maybe cooking or things like that. But when I'm looking like I need an answer, I go to, I still go to YouTube. I go to YouTube if I, if I need something, I go to YouTube for two completely different reasons, but they're both relevant to this discussion. One, I want to be entertained. So I'm watching probably airplane videos and it's long form entertainment. Yeah. Like the algorithm totally knows it knows I got about 15 minutes in.

You give me a 30 minute video, I'm looking for a 15 to be honest with That's just mine. And then also if I need to know how to do something, I'm looking for a five to seven minute video. Like that's about all I have. I'm, I don't want to go 30 minutes into a how-to, right? About about five to seven is what I have, but I go for those are two very different reasons to go there, but equally important. Well, I've noticed now, I don't know if yours does this, but when I opened the YouTube app, it defaults to it's real like the

TikTok style. Yeah, yeah, it's doing that for me now on the on my phone. Yeah, on the phone. can do you know where the number one place YouTube is consumed TV still TV. Yeah, that still blows my mind. Like the actual television is where it's consumed. Which I think you could blame new parents with young children. But that is it, though. Right. Like that's my kids grew up.

Well, Connor would not be in this. Connor watched actual like some television, probably Veggie Tales or something. But then Preston and Samuel both, like they consume, if they're watching content, it's on YouTube, on the television. Yeah. Well, I mean, like even Addie would be, you know, she's not a Cocoa Melon person, but it was like, but she's not that, but there have been layers of videos and series that we've watched on YouTube and they, cause it's just,

Yes, you run the risk of YouTube being weird about it they don't catch everything. But at end of the day, there's a YouTube kids app that works well, too. All these things. And then, I get it because to me, YouTube is like, let me sit down and absorb something. TikTok, any reels, anything else that's quick format, let me just find. That's kind of interesting for 15, 30 seconds. Let me move on to the next one. me move on to the next one. me move on the next one. So yeah, YouTube is still like, if you're trying to educate someone or like,

You just have a lot to say. still works. So PMAX is driving up costs. PMAX is driving up costs and PMAX is designed for you, the clinic owner, to run your own ads without hiring somebody like us. Yeah, it's just going to be real. That is their whole goal. And it's going. If you hired us, we typically charge around a thousand dollars to run ads for a company. And the reason I say that is if you're going to...

Google would rather you spend $2,000 with them than $1,000 with us and $1,000 with them. Now, that doesn't matter at scale, but it definitely matters smaller, right? So they see us, marketing companies, as competitors. So they've come out with something to allow you, the clinic, to do your own thing. Here's the problem, in my opinion. Every time I've seen PMAX campaigns, I tell you what, actually, if you're running one,

Y'all are our best clients. Y'all are our very best clients. Quickest wins, Every time somebody starts running PMAX campaigns, about 90 days later, we get a phone call because there's always about 90 days worth of data of just absolute trash. Because PMAX is just set to take your money. I don't know how else to say that. I'm not trying to be rude to Google. We rely on Google. So what we've seen with PMAX, PMAX was really, really, really built for e-comm.

And there's a need for that because when you have an e-comm site with thousands of products, like you need some heavy lifting from the software to make it work. then they allowed everybody else to use it they never changed its formula. And so instead of it trying to sell a product, it's trying to now sell a service. And it doesn't know. And if you're sending it to your home page, you're losing out there too.

There's so many things but now I'm glad you brought that up. That was going to be my next point. Yeah, but then like you said, like P max like it's a product of a company that makes revenue and profit, right? It's going to always bend itself and no matter what good or bad is always going to bend itself toward is this going to help us boost our numbers, right? And at the end of the day, that's that's their goal. I hate to say like Google is

They're not evil about it. It's just they're just being a business. got to make money and they always make a profit. Another reason that your cost per acquisition is probably higher than it should be or you're being lied to or however you want is it's kind of self-inflicted. I'm sorry, Clinics. This is on you. It's your marriage to vanity metrics because you want to up in every single search and you just like to see your name in every kind of search. Yeah.

that's costing you money. I don't, I'm not trying to be rude to you, but like you're costing yourself money because you like to see your own name. And I get that. I feel you on that. But there's about in the urgent care space, there's about 10 to 20 keywords that actually convert into patients. And let me tell you the biggest culprit that you want to be seen in, but does not convert. Just saw a slight message on it today. Walk-in clinic. Walk-in clinic gives you tons of eyeballs. Lots of impressions. Guess what?

No conversions. Yeah. Why? Think about that. Think about why. Let's just use common sense here. Are you planning on calling or converting or do you just want to walk in? see what I'm saying, right? Like it's never... Okay. So use that keyword for search engine optimization and don't pay for it. Cause it's not going to convert for you. Cause at the end of the day...

you're feeding Google bad data. That's it because it didn't convert. They may have clicked the ad because of walking clinic, but then they're just looking at saying where it is and then they don't do anything else. And then Google's like, well, that was not good. And then the conversion never even happened. The only way I would do that keyword is if it went to a dedicated landing page. So it had its own ad set and the conversion was get directions. That's the only way. Yeah. It's the only way I would do click the drive. Yeah. So yeah, exactly. So

or a special like send to my cell phone, right? Send directions to my cell phone or something. That's about the only way that I would use that keyword, but that's exactly what I'm talking about. That keyword is costing you a fortune because it doesn't convert and it drives all of your cost up. And the impressions are high because people are, they don't always want an appointment. They just want to see if you're open or not. And then your impressions go up.

Yeah, walking clinics and we've experimented on and off because we thought walking clinics was like, yeah, it's getting a lot of traffic. Then the conversion like, no, the conversions are really rough. And so like we've gone back and forth over past two or three years about it. And then we've just at this point like, walking clinic, it's a cool keyword, but it is not your conversion friendly keyword. Right. Well.

That's driving it. So vanity metrics are driving it radius is driving it P max is driving it. So those are the those are the main culprits of things that are driving your conversions up through the roof. So there you go. Yeah, that's there may be more and as far as digital goes, I know that's one of the biggest things that we talked about is spending time on your negative keywords. Yeah, that's huge stuff like that. Because we've had lots of accounts.

that we brought on and so what's your negative keyword list look like? What's that? Yeah, what's a negative keyword? And then because I call it negating, which I guess is not the technical term, but like, you know, we need to get out those keywords like, no, just make them negative. no, we've seen it quite a few times or they've added five and are like generic. So OK, like there's lots of options here. Like we have accounts that are pushing thousands at this point to fine tune the thing.

But now, at the end of the day, it's one of those, because I hear people say autopilot and stuff. Here's the thing. If let Google, if we set up your ads and then we said, here you go, have them back, put them on autopilot, in three months, your conversion costs will just go right back up because Google will start hooking into something wrong. We've seen it happen so many times. You know, we should have an episode on autopilot and I can make some real world comparisons on what that is. Oh, yeah. The pilot has spoken.

So just saying there, they call it autopilot for a reason. Yeah. Cause they call it going on autopilot for a reason, but they do not understand. Most people don't understand what an autopilot does and it does fly the plane, but there's so much more to it. Yeah. So, and then ultimately it can't make the final landing or the takeoff. Right. do want to do a quick call to action here for you guys. Seriously, since we're talking about Google ads and we're talking about calls per acquisition. If you want to

If you want to completely free seriously completely free no obligation anything like if you want us to look at your Google Ads account and make some recommendations for you. I don't know the URL page I'm sure Hannah can drop it in the show notes she said she was going to start listening to the podcast. Yeah we're going to challenge her right now. the very least you can send an email to you hello at patientcaremarketingpros.com and she'll get it connected over to myself or Grace and my team will do an in depth look at your ads account.

And we'll give you some recommendations. When I say it's no obligation, you all know obligation. We just want to help you. We did this yesterday for some in the health tech nerds like by the way, if you're really interested in health technology and just conversation, there's a slack called health tech nerds. Anyway, someone that posted yesterday, Tuesday saying, Hey, I need somebody look at my Google ads. We're a speech therapist, something

And I said, we can do it. And so he gave us read access. then Philip took a look. And then he's like, here are the five things. If they fix this, they'll be a lot better. it was just like we just said. There was a lot of PMAX mixed in there. There was a lot of and display, like search networks and display only networks, which is a big no-no. And then his budget was like $6 a day. You're not going to get any traction there. That's like a click. Yeah, it's never going to work.

And so like, but no, like within a couple of bullet points, like if you made these changes, boom, you're going to have such a better time. But yeah, so we're happy to, we actually love doing it we love seeing what's out there. Honestly. It's in a purely selfish way. It gives us more, more data. Yeah. Yeah. Exactly. It confirms what we're seeing consistently. We never share your data, but we do sit there and make notes of here's what we find. Here's what we see. so anyway, listen, this has been a good episode.

I didn't get to say it at the beginning, but I'll say it at the end. We always want to let you know that we're here to get more patients, deliver better care, get repeat visits, scale your clinics. That's what we're here for. Leave us a review. Five stars would be awesome. Subscribe to our YouTube channel and leave us some comments. We'd love to talk to you. Yeah. All right guys. We'll see you next week. Have a good one.