Agency insights
Thoughts and lessons on client selection, burnout, pricing, and modernising legacy accounts, from someone who's run a Google Ads for years.
Why this Google Ads campaign started strong and fizzled out. And how we fixed it.
Published August 2024. Last updated July 2026.
Can I tell you about a real Google Ads head-scratcher I worked on recently. It was for a mental-health counselling practice.
They couldn't get consistent results from their Google Ads. Their ads would start well but after a couple of weeks the profitability would nose-dive.
They'd tried everything over about 2 years:-
- Firing the agency.
- Hiring a freelancer.
- Managing the ads themselves.
- Hiring another freelancer.
- Deleting the campaign and rebuilding it.
- And every landing page test and tweak they could think of.
Nothing worked and the pattern kept repeating. They'd start the ads, they'd get a load of profitable bookings. The booking rate would go down. They'd shut down the ads because they weren't profitable. They'd take a couple of weeks to rebuild everything or hire someone else and then start the ads again.
By the time I spoke with the owner he thought he was doomed to repeat the cycle forever. All he wanted to do was to get a steady flow of new patients.
It turns out they were victims of their own success, but it took an outsider to spot the problem.
They'd start the ads because they needed new patients. Or, put another way, they had a lot of empty slots on their calendar.
That meant that they could see a new patient almost immediately. Usually within a day or two of them enquiring.
But, the longer they ran their ads the fewer appointments they had available. And that's why their booking rate went down. Someone who had finally decided to get help wanted it now, not in three weeks. If they couldn't get it here, they'd go elsewhere.
The owner had overlooked this, but recognised the problem as soon as I pointed it out.
He proposed reserving some appointments for new patients. That way they'd have new patients coming in to replace those who no longer needed counselling.
Some of the time the new patient appointments wouldn't be filled. But overall it'd be more profitable than the feast-then-famine cycles of the last few years.
I suggested he also change the ads and landing page to point out that immediate help was available. And that he reduce the ad budget slowly till the inflow of new patients matched the outflow.
If you've got a Google Ads campaign that isn't as profitable as you'd like you're welcome to give me a shout. I love problems like this.
Most Google Ads Problems Aren't Google Ads Problems
If my writing resonates with you, I'd like to give you a copy of my book, Profitable Google Ads. The book was written for business owners, but many PPC professionals have found it valuable too.
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