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 says | What the practice software shows |
|---|---|
| 60 new-patient leads from ads | 31 new patients booked, from every source |
| Cost per lead: $50 | Cost per new patient from ads: unknown |
Neither number is a lie. They measure different things, and only one of them pays the bills.
It happens with real numbers too. Earlier this year Matt reviewed a single-location practice whose ad account reported 296 “conversions” over four months. Its call tracking logged 122 calls from every source in the same period. In the last month the ad account showed 264 conversions while calls fell to 16. The report itself flagged that jump as a likely counting change, not new patients.
How to work out your real cost per new patient
You need four numbers for one month, and they come from three places. Here’s the same made-up practice from the table above, worked through.
| Step | Number | Where it comes from |
|---|---|---|
| 1. What you paid | $3,000 ads + $1,500 agency fee = $4,500 | Your ad accounts and the agency’s invoice. Include the fee, not just the ad spend |
| 2. What the report calls leads | 60 leads. $3,000 ad spend ÷ 60 = $50 per lead, with the fee left out | The agency report |
| 3. New patients who booked from ads | 14 of the 31 new patients | Your practice software’s new-patient list, matched against call-tracking numbers and the “how did you hear about us?” answer |
| 4. Of those, who showed up | 11 | Your schedule, a few weeks later |
Now divide what you paid by the patients:
- Cost per booked new patient from ads: $4,500 ÷ 14 = about $321
- Cost per new patient who showed up: $4,500 ÷ 11 = about $409
The report said $50 a lead. The number that pays the bills is about $409 a patient. Neither is good or bad on its own: compare it month to month, and with what a new patient is worth to your practice over a year.
The hard part is step 3. If your new-patient form doesn’t ask how people found you, or the front desk skips the question when it’s busy, the match can’t be made. That’s usually the first thing to fix.
What to do
Judge marketing by the cost of each new patient who books, and better still, who shows up. Work it out as above 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 (Chapter 7 covers why). 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.
The report only covers the first stages of a patient’s path. Calls answered, booked and kept are stages four to six (Chapter 1), and they’re often where the money goes. Our Layer 1 assessment reads all six.
- 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, including your fee?
- Are our ad, call-tracking and Google accounts owned by the practice, and who has the logins?
Common questions
What’s a good cost per new patient for a dental practice?
There’s no single right number. It depends on your area, the treatment patients come in for, and what a new patient is worth to you over a year. Track your own number month to month and watch which way it moves.
Why don’t the agency’s numbers match our practice software?
Usually because they count different things. Reports often include existing patients, wrong numbers, spam and repeat calls, and a change in how tracking is set up can move the numbers overnight. Your practice software counts people who actually booked.
Who should check the numbers?
Someone who isn’t paid by the agency, such as your office manager. It needs the practice software, the call-tracking log and the invoices side by side, once a quarter.