Promoting medical dentistry services is not easy
In a highly competitive niche with stringent advertising policy constraints, our dedication to hard work shines through. We spearhead advertising campaigns for our client's dental clinic, not just locally but also in Ukraine and internationally. Our strategic approach has successfully increased the volume of qualified calls, decreased the cost per call, and liberated 30% of the budget for reinvestment into effective campaigns.
Our client stands out as Ukraine's sole dental clinic to achieve international accreditation from The Global Clinic Rating and rank within the top 200 dental clinics globally. This distinction fuels our ambition to launch extensive reach campaigns, aiming to inform the broadest audience possible, both domestically and abroad.
The clinic's website serves as a comprehensive resource, detailing doctor profiles and equipment, facilitating online appointment bookings, and offering an immersive HD 3D tour.

An adept administrative department doubles as a sales unit, employing scripts to engage customers across calls, online inquiries, instant messaging, and emails.
Since 2018, the clinic has partnered with WAMP agency for outsourced marketing services, encompassing:
- Search Engine Marketing via Google Ads
- Google Display Network's Remarketing and Custom Intent campaigns
- Facebook's Acquisition and Remarketing initiatives
Given the medical sector's unique challenges and the clinic's global aspirations, we navigate complex issues to scale campaigns internationally. The clinic's vision is to draw patrons from all corners of the world, necessitating a judicious, phased approach to avoid squandering the budget.
Initially, we initiated a search campaign in our local area to gather statistical data. Subsequently, we launched campaigns focusing on high-margin services and conducted pilot campaigns in the capital city, Kiev, targeting services such as dental implants, teeth straightening, braces, and veneers.
For these high-margin campaigns, we exclusively used precise match types and high-converting keywords from our initial campaigns in Dnipro. This ensured that our advertisements were displayed for search queries directly relevant to our client's business and had a high likelihood of conversion, as evidenced by prior data.
After reselecting the most effective keywords, our PPC managers embarked on global campaigns with a conservative budget. We then activated Google's Smart Bidding strategies for CPA, allowing for an open-ended budget since Google autonomously adjusts to maintain the Target CPA.
Target CPA is an advanced machine learning bidding strategy designed to maximize conversions within a specified cost parameter. It analyzes a multitude of data points and adjusts bids using comprehensive signals.
However, scaling campaigns both in Ukraine and globally presents challenges. The volume of leads is modest, making it difficult to evaluate their quality. Considering only a single clinic visit results in a low Lifetime Value (LTV), necessitating the consideration of two or three subsequent visits for a more accurate assessment of outcomes.
Moreover, the initial average transaction value does not necessarily predict the client's long-term value. For instance, a client might initially seek “pediatric dentistry” services for a simple tooth extraction for their child. However, after experiencing the clinic's services, they may become a repeat customer, purchasing veneers for a spouse or opting for a dental implant for themselves, despite the initial low-margin service.
Regarding medical advertising, there are specific constraints that must be navigated. For instance, our clinic was unable to utilize remarketing features on Google Ads due to these restrictions.
Consequently, our specialists have tailored custom intent audiences on Google Ads. By specifying the clinic's website URL and brand-related keywords in audience targeting, we've successfully connected with users who have either visited the client's website or expressed interest in the clinic's brand.
Equilibrium of Lead Volume and Cost
Advertising aims to maximize doctor engagement while also securing a substantial number of inquiries for high-margin services. Without this balance, the clinic may face a dilemma: doctors only providing low-cost services, which diminishes profits, or staff delivering high-margin services without being fully utilized.
The Rationale for Call-Tracking Integration
While our website features online forms for scheduling appointments, the majority of patients opt to call directly. A comparison reveals that calls from Facebook ads are double, and those from Google Ads are quintuple, the number of online form submissions.
Patients with urgent needs, like a toothache, won't wait for a callback; they'll contact the clinic immediately. Moreover, some clients may anticipate a salesperson's call following their online form submission. However, a direct call allows them to swiftly get answers to their queries, confirm the availability of required services, and conveniently book an appointment.
By default, Google Analytics does not track call conversions. This limitation meant we only observed a handful of online conversions, leaving the primary conversion source—phone calls—unattribated. Consequently, due to insufficient data, we allocated equal budgets to both Google and Facebook campaigns. Additionally, the predominant client locations making calls remained unidentified.
It has been collectively decided with the client that implementing a call-tracking system is essential. The absence of comprehensive conversion data hinders our ability to fine-tune advertising efforts effectively, including campaign and keyword optimization. Without call tracking, an estimated 80% of conversions and their originating channels would remain undetected.
Our choice for call tracking is Ringostat, owing to our positive experiences with it on other projects. Prior to the implementation of Ringostat, we have outlined the following objectives:
1) To monitor all conversions, enabling the refinement of advertising expenditure across various channels and campaigns.
2) To evaluate the performance at the level of individual campaigns and keywords.
3) To scrutinize the quality of traffic through analysis of customer call patterns.
4) To judiciously allocate the marketing budget, informed by insights gathered from the aforementioned analyses.
Following the implementation of call tracking, we've integrated its insights into the development and refinement of our advertising strategies. Our management team now monitors a broader range of objectives, including online form submissions, site contact interactions, and telephone inquiries.

In this initiative, major conversions are defined as online form submissions and telephone inquiries, which are logged in Ringostat. Other site engagements are considered minor conversions and are assessed using US and USP metrics.
For the clinic, we established dynamic call tracking to monitor Return on Ad Spend (ROAS) at the keyword level. This plays a crucial role in the configuration and enhancement of our advertising efforts.
Initially, campaigns are deployed with a precise keyword list to ensure budget efficiency and accurate tracking.
Subsequently, we dissect the conversion data by device, region, and audience segments to identify any conversion issues across these dimensions, how leads are processed, and how online conversions are tracked in Google Analytics.
Post-evaluation, we broaden our keyword strategy to include broad match types, incorporating variations, synonyms, related phrases, and common misspellings, while performing cross-negative keyword analysis to prevent overlap between broad match modifier (BMM) and exact match campaigns.
We also scrutinize the performance of various audiences initially tested on Facebook, making adjustments as needed, deactivating underperforming segments, and retaining the most effective interest combinations. Call volume is also factored into this analysis.
Once the campaigns are active, we collect adequate data and call volume, typically aiming for 30 conversions within a week, to activate Google's automated bidding strategies, such as Target CPA.
We analyze leads quality and adjust the campaigns budgets, increasing it for campaigns with high quality leads and reducing for campaigns, which bring poor-quality leads even with low CPA.
It happens that people call by mistake or dial a number without understanding that this is dentistry. Some people think that the clinic operates 24/7 or that it’s a state clinic. Nevertheless even such leads can sometimes turn into clients. If the dialogue script is appropriate, the conversation continues and the person asks questions — this is a chance to get a new client.
We successfully optimized our budget allocation across countries, regions, campaigns, and ad groups within each advertising network. Initially, we distributed funds evenly, but we've since ceased 30% of our campaigns and narrowed our global country list to 15 key markets. Our keyword strategy underwent a significant overhaul, with some being removed or paused to conserve budget, alongside the creation of a negative keyword list.
Our data shows that relying solely on broad match keywords is ineffective. In contrast, campaigns utilizing a carefully curated exact match keyword list and precise geo-targeting consistently perform well. High-ROI keywords have been segregated into their own campaigns with unrestricted budgets. For other keywords, we've implemented an automated Target CPA bidding strategy and introduced new negative keywords to refine broad match campaigns. Additionally, we've broadened our semantic core with niche keywords that drive call generation.
Despite these changes, our advertising investment remains unchanged, now redirected towards our most effective campaigns. This strategic shift has liberated 25–30% of our budget, enhancing the performance of successful campaigns and boosting conversion volumes.

This budget reallocation has led to a 40% increase in high-quality calls, a corresponding 40% reduction in call costs, and an 80% surge in total call volume. The conversion rate of these calls into clinic visits now averages at 35%.

Regularly reviewing calls from our ads has been instrumental in identifying and rectifying poorly structured ad groups. For instance, calls originating from the query "Dnepr clinic" revealed a mismatch with our dental services, prompting us to refine our administrative scripts accordingly.


Based on the call distribution report, which breaks down the frequency of calls by both day and time, administrators can effectively plan their workload. The Ringostat report visually indicates peak call times with increasingly intense shades of green within the cells—the darker the green, the higher the volume of calls. Notably, the graph highlights a surge in calls over the weekend.
Consequently, advertising efforts are concentrated from Monday to Friday, with a strategic pause on Sunday. This is due to the clinic's natural influx of clients and the full engagement of medical staff during weekends. By analyzing these trends, the clinic is able to schedule administrators efficiently, ensuring an adequate number of call managers are available during times of high demand.
115 leads
547 calls
$3,40 CPR
3416 clients
in 60 days
In our recent analysis, we uncovered a series of surprising findings that defied initial expectations.
1. Our veneer installation campaign in Kiev, despite being ranked fourth in expenditure, astonishingly secured the tenth spot in conversion rates. This was an unforeseen success, indicating a high level of engagement from residents of other cities with our clinic's services.
2. The campaign aimed at the Italian market remarkably achieved third place globally in conversion numbers, despite not being a primary focus of our international strategy.

3. We noted that the specific keyword "dental implantation" did not yield any significant results when used in exact match searches.

4. The popular voice search term "dentistry near me" failed to generate the expected outcomes for our clinic.
5. The term "veneers" emerged as an outstanding performer, demonstrating exceptional effectiveness across our global campaigns.

6. Despite multiple attempts at targeting adjustments and optimizations, the campaign targeting our competitors' visitors did not produce the desired results.
These insights will be invaluable in refining our marketing strategies moving forward.
1. In the healthcare sector, patients often prefer immediate telephone contact over online form submissions, especially during times of distress or urgent need. Recognizing this, clinics advertised online must integrate call-tracking to monitor the origins of call-based inquiries.
2. Globally, clinics have utilized call tracking to pinpoint and eliminate non-performing countries from their advertising efforts.
3. This tool has also enabled us to assess the success of their campaigns, leading to the refinement or discontinuation of underperforming ads and increased investment in those yielding high-quality leads.
4. Moreover, call tracking has provided us with comprehensive data, facilitating the enhancement of keyword strategies, including the expansion of negative keyword lists and the creation of dedicated campaigns for top-performing keywords.
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