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Nobody Is Paid to Notice · Chapter 2 of 8

Chapter 2

Your dashboard isn’t your patients

By Nick Cheremeteff, with Matt Phillips · Updated October 14, 2026

What it looks like

Your agency’s monthly report looks good. Leads are up, calls are up and the charts point the right way. Then you look at the schedule and the new faces don’t match.

What’s behind it

Most reports count what’s easy to count. A “lead” might be a form fill, a tap on your phone number, or a 10-second call from an existing patient asking where to park. A “conversion” is whatever the tracking was set up to record, correctly or not.

Here’s an illustration. The numbers are made up, but Nick has seen the pattern many times in more than a decade of measuring paid advertising.

What the report saysWhat the practice software shows
60 new-patient leads from ads31 new patients booked, from every source
Cost per lead: $50Cost per new patient from ads: unknown

Neither number is a lie. They measure different things, and only one of them pays the bills.

What to do

Judge marketing by the cost of each new patient who books, and better still, who shows up. To get that number, match the agency’s calls and forms against new patients in your practice software at least once a quarter.

Two habits make this much easier. Keep every account in the practice’s name, including the ad accounts, call tracking, Google Business Profile and website, so you can log in and see the raw numbers yourself. And ask for reports you can follow. If your agency can’t explain a number in plain words, ask why. A good partner won’t mind the question.

Questions to ask this week
  • What exactly counts as a “lead” or “conversion” in your report? Show me one.
  • How many of last month’s leads became booked new patients in our practice software?
  • What did each new patient cost us, by channel?
  • Are our ad, call-tracking and Google accounts owned by the practice, and who has the logins?