Google Ads for therapy practices with John Sanders

Dan King: [0:00] Hello, everyone. Today, I'm delighted to be joined by John Sanders. He's the founder of RevKey. John, welcome to the show. John Sanders: [0:08] Daniel, thanks for having me. Dan King: [0:09] Thanks for being here. So we'd love to start out with the basics on RevKey, what you guys do, and why you decided to do it. John Sanders: [0:17] So we almost exclusively do Google Ads at this point for mental health practitioners. My wife is a testing psychologist, which is ultimately how i ended up starting to do this she opened her practice around the same time i was building a google ads portion of a dental marketing agency and so there's definitely a lot of overlap there so during the day i was working on dentists during the night i was trying to get her clients and after a while of working for somebody else and i think that a lot of group practice owners listening to this will understand where i'm coming from is i got tired of working for other people and decided to start my own thing. And I think I had had this dream of being a generalist, but very quickly started accumulating a number of mental health clients. And so that's just kind of how the business has built itself up. And so today, 90% of our client base comes out of mental health. And so this is something that we work with on a regular basis and understand a lot of the special rules that go into that. Dan King: [1:26] Nice, nice. That's certainly important. We'd love to get a feel for what you believe are the opportunities and weaknesses in working with this niche, right? You could have picked other niches. You picked this one. Your wife being involved, of course, was a perfect launching pad to get involved with this group. But I'd love to hear from your perspective, what are the strengths, what are the opportunities and weaknesses from your perspective actually running a Google Ads business here? John Sanders: [1:51] So in terms of the client base, I like working with therapists and as people, they generally have a, as we were talking about before we went live. John Sanders: [2:02] High emotional intelligence. They're usually easier to work with than, say, lawyers, like we were talking about, add some other industries that you could pick. The weakness usually is that therapy practice owners, in a lot of cases, don't have any business experience. They didn't take any business classes in school. So they don't know about how to market a practice. In a lot of cases, you know, the solo practitioner who goes out and they build their own website and they think that clients will just walk through the door and that's how it works. Sadly, that does not work, especially, you know, maybe during five years ago during COVID, maybe that worked, but it definitely doesn't work today. So it's having to educate them about kind of this business side and about you John Sanders: [2:45] need to have a good website running Google ads. What is search engine optimization and kind of them learning on that's the marketing side and then you know they also get to learn all these things about accounting and just you know filing paperwork for businesses they're just things that they don't know so in a lot of cases that can be a challenge at times but it's one that we can definitely work through with people one of the things that i really insist that my people do is we don't just like send you a report at the end of the month saying this how many clicks you got so many conversions you got is I want my account managers to talk to every one of their clients each month and talk through those things and see not only how. John Sanders: [3:25] We can explain this to the client, but also to hear their side of things, like their real-world business experience of, yeah, these conversions that we're getting are turning into clients, and we need to start advertising for a new thing because we just hired somebody who does IFS, for example. And so let's start running some IFS ads. And so I think that's why that touchpoint is so important, and not just being an anonymous PDF report that you get every month and not really sure what you're looking at. Dan King: [3:55] In addition to providing a more personal level of service, you do have to educate your customers. No one teaches therapists or lawyers how do you understand whether you're getting good performance from your Google Ads, right? So I think that makes perfect sense. We'd love to hear more about, on a scale of 1 to 10, how easy or hard, with 10 being the hardest industry there is, how hard is it to get results from Google Ads in this space? John Sanders: [4:18] I would say, and it's kind of a answer, but I'd say it's probably like about a six. There are definitely harder ones. Probably the hardest one that you're going to run into is actually lawyers, especially on the personal accident side where... John Sanders: [4:33] You know, you on a lawyer who's advertising for that can end up with like a $250 every click is $250. Whereas on the therapy side, it's not not near as much. On the therapy side, the challenge is making sure that you have the right website. In a lot of cases, when people come to us, in a lot of cases, we have to say, oh, before we run ads, let's maybe go out and write some pages on all of the things that you're actually doing. Let's have a page on your website about couples. Let's have a page on your website about grief and anxiety and all of the things that you're really looking to advertise in a lot of cases. We don't see that when the customer starts with us. And so it's delaying our revenue for a little bit to make sure that we get some good results. So I think that that's one of the things. There's definitely some regulatory things on Google side. We're not allowed to do any remarketing so people can't come to your website and us start following them around with. ads. We're not allowed to do that because of the hyposensitive nature of the business. And, you know, we're not going to put best therapist on things. We can't encourage, you know, our clients to go out and try to get Google reviews John Sanders: [5:42] because ethically they're not allowed to do that. So there's definitely some challenges in the space. However, once I think you know those and can make sure that you're getting the right searches and you've got the right website, things get a lot easier. Dan King: [5:57] Right searches and right website. And in terms of those restrictions, there really aren't ways around the restrictions in terms of retargeting and reviews. John Sanders: [6:05] So for reviews, it's usually, that's more of an ethical issue. And I've had a number of practice owners come to me and say, hey, I've got a couple of negative reviews. And they can't really even go out and respond to those and acknowledge those. So that makes things difficult. And then you really kind of have to go to somebody who specializes in maybe trying to get those scrubbed off of your Google business profile. As far as the remarketing aspect goes, typically what I'll see if somebody comes to me from like a local marketing agency. They will have tried to run remarketing, and at some point, Google just says, no, you're not allowed to do this. And so we just know from the start that we don't even try to do that anymore for our mental health people. Dan King: [6:50] Yeah, yeah, yeah, yeah. Okay, understood. So in terms of getting the right website, what are some of the most important things for practice owners to know? John Sanders: [6:57] I would say the first thing is, much like your taxes and your legal stuff and your Google Ad stuff, you should probably go out and have somebody do this for you. My employees and I can pretty much smell a homebrew website a mile away. And it shows and it's going to have some issues in terms of search engine optimization. I think that there's a level of attachment that people will develop. And I joke sometimes that, you know, I've talked to practice owners and been like, your website's not very good. It's not, you know, it's not converting very well. People aren't spending a lot of time on it. And it's like I have insulted their child because they've worked so many hours on this. And so to avoid that, you should probably go out and have somebody professionally do this. That way, you can also spend your time doing other business owner things or seeing clients and trying to figure out, you know, how to develop a site in WordPress or Squarespace or something like that. So I think that really just having it done professionally is a first major, major step. Dan King: [8:00] So having it done professionally means you're going to ensure that this, the content and other aspects of it are suited to SEO. Tell me more about what else is going on there. Is it that I would guess that a lot of clinicians, because most practice owners are clinicians, they fall in love with a particular type of therapy or they fall in love with some of the nitty gritty technical aspects of the work and really want to demonstrate that on the website. Is that one of the issues? John Sanders: [8:27] It can be where if you go to a website and everything is instead of anxiety and depression and trauma, it's CBT and EMDR and IFS. That's not, you know, that's kind of talking about like the methods and all of a sudden that site is really, it's like more for you and your colleagues like to read about, but is not necessarily understandable by, you know, the person who is interested in therapy and, you know, doesn't have a master's degree on the subject. Dan King: [8:56] Give me some more here about some important marketing principles for practice owners to know. I mean, I'm guessing sort of target market, which is always such an issue for service businesses in general, right? Many probably don't have a focused target market. John Sanders: [9:11] I think, you know, you can definitely have the generalist out there. In a lot of cases, this is going to be more of an insurance-based practice where they've got a bunch of different people and they've got a bunch of different specialties. And then you have kind of more of your specialized private pay side where they're focusing on, you know, couples, you know, for instance. Those are two different things. And making sure that you, if you're really focused on something, that you have not niched yourself into oblivion. I've seen people do that where... They've said, I only want to work with somebody of this gender, of this sexuality, of this race, who's looking for this issue. And then all of a sudden, your potential pool of clients is very small. And then you can have the opposite problem on the other side where you're just trying to be everything for everyone. And there's probably a happy medium somewhere in there. And it's really trying to make sure that you get the appropriate clicks on your website. I think that if you want to know if your Google ads are performing well, the one screen to go into Google ads and look at is your search terms, which is what people actually type in to get your ads to come up. If you see a bunch of search terms, you go, yes, these are appropriate to my business. And like 80% of them are appropriate to your business. Your Google ads are probably doing pretty well. If you see massage therapy and a whole bunch of other stuff that you don't do, your Google ads are probably not doing well. John Sanders: [10:38] A good thing for you and is probably just spending a lot of money needlessly. And that's ultimately what we want to avoid. Yeah. Dan King: [10:46] You predicted my next question, which was how can we determine as a practice owner, as a practice leader, whether we've got the right SEO firm. So part of it is going to be looking at search terms and seeing their appropriateness to the business. Dan King: [10:59] How else can a practice owner determine whether they've got the right SEO or right Google ads firm? John Sanders: [11:04] I would say looking at, and this is kind of more of the technical side of things. And this is a little harder to understand, but if you're looking in Google Ads and we have what we call conversions, these are the actions that we want people to take on the website. And are you actually tracking when somebody fills out the form? Are you actually tracking when somebody schedules something with you on whatever scheduling program you're using? Those are things we definitely want to track. Or are they just tracking when you're getting to a contact page and or getting to the homepage? And generally that's not what you want to see unless there's some technical aspect. And there are cases where, for instance, like therapy notes and simple practice, they're not ever going to send information back into Google. So we track the clicks into there and that's about the best we can do. If you just have a form on your website or you have something relatively simple to track and you're just counting how many people get to your contact page, it's usually a bad sign. And it might look like you're getting a whole bunch of conversions, but you don't know if those people are actually calling you or filling out the form is, for me, is usually kind of a bad sign of, you know, inflated numbers and people wanting to make it look like their ads are doing well. But they might not actually be. Dan King: [12:18] Makes perfect sense. So we want to track as close as possible the right kinds of conversions. Help me understand, just given my ignorance, because I know a bit more about Facebook ads than Google ads, is ROAS a metric, return on ad spend that we can track with Google ads? John Sanders: [12:35] Sure, absolutely. Yeah, Facebook, really, when they created, you know, the meta business ads, they pretty much stole all of the terminology that Google came up with. So that was one of the ones that Google did. And so it's a little harder to do for a therapy practice. But so when I'm talking to a client, you know, we usually talk about, OK, what is your, you know, how many clients are you typically going to get off of your Google ads or how many leads you're going to get? And then how many of those become clients? And usually when I'm talking to, you know, a group practice, usually it seems like about 40 to 50 percent of leads will turn into clients. And so, you know, if you use, you know, a rough number of 50% and then it's... John Sanders: [13:18] How many sessions do they tend to stay with you? If I'm talking to a, you know, a very talk therapy, heavy practice, and they'll say, you know, two years, or if somebody is doing EMDR, they might say 10 sessions. And so it's figuring out what that is, and then your daily rate, and then kind of figuring out, you know, essentially how much you're for every dollar that you're spending on Google ads, you know, how many, you know, how much are you getting in return over the lifetime of those clients? And I think that's an important number to look at as kind of lifetime and not get stuck in the sand trap of, well, how much did they cost me, John Sanders: [13:53] you know, this month versus, you know, what I did this month. It's really about, you know, if a client is going to stay with you 20 sessions, that's really kind of the lifetime value of the client and to measure that and to make sure that that's, you know, that's a good number. Ultimately, private practices have a huge advantage in that just because they might be charging $200, $250 an hour if they're in some of the bigger cities like Los Angeles or New York or something along those lines. So they definitely have a little bit of an advantage there with those. Dan King: [14:26] No questions. And I completely agree. Lifetime value is a very important metric for folks to know. So what would be then, keeping in mind the assumptions that you just shared, what would be a very rough range of ROAS that a therapy practice should shoot for? John Sanders: [14:43] So typically when I'm talking to clients, we usually come up with a number of for every dollar they spend, they should be making it anywhere between $8 in revenue to $15 in revenue. It's pretty average. If it's below that, it's usually a service where you're saying I can, you know, cure trauma in six sessions with what whatever technique that's really hard to pay off. Or in cases where it's an insurance practice and once again, your people aren't sticking around very long, then you're kind of falling into this. Probably the minimum that you can get away with is $5 of revenue for every dollar that you spend on Google ads. And then anything over 15 to one is really very good. It usually indicates a practice that is keeping people for a long time or has a really high hourly rate. Dan King: [15:36] One of the things that's popping up for me as I hear you say that is, you know, ROAS in this world is going to be a, not entirely, but is going to somewhat be a function of just the clinical quality you provide. So your marketing, yeah, it's going to be a big factor in ROAS, but so is the clinical quality you provide. So the marketing could be working well, but if your therapists aren't doing a great job, then your ROAS isn't going to be as good because your lifetime value won't be as good. John Sanders: [16:00] That's true. And then we can't forget about the third piece there, which is the administration side, is that if we're generating a bunch of leads for you and you're only converting 20% of those into clients, your marketing doesn't really have much of a chance. And this is something that I see in more competitive markets like New York, where a client will say, you know, they're not landing 40 to 50 percent of their clients there. They're landing anything less than about 20 percent. It's really hard for you for your marketing to for that one customer out of five to really pay off all of your marketing efforts becomes really, really very difficult. And so you really have to have a good admin side to, you know, ultimately get those people to become to become patients. Dan King: [16:42] Do you ever advise on the admin side? So I'm assuming like an intake call or the intake process is a big part of that journey. Are you able to help and sort of ensure that the marketing effort and the intake onboarding processes are aligned? John Sanders: [16:58] Yeah, at times, and, you know, it's talking about maybe, especially for group practices that are coming up, and I still hear people are like, yeah, I'm taking all of the calls, and I'm really good at converting them. But, you know, at some point, it's like, yeah, you need to hand this off to a virtual assistant and helping direct people into a place where they can hire somebody like that so the owner's not taking all the calls. Or the worst situation is they've got somebody who's working for them, but as we dig into these numbers, we find that they're only converting 20 to 30% of clients and it's saying, okay, what can you do to improve this? I think probably one of the biggest problems is if somebody fills out a form and you don't respond to it for two days, that person found a therapist probably yesterday or maybe even the day before when they first filled out your form is that you have to respond to those very quickly because if they're filling out. That form on your website, they've probably filled out forms on three other different websites as well. And so then it becomes a race to, you know, who's going to contact them first and give them a good experience right out of the gate. Dan King: [18:01] Makes perfect sense. As we start to move towards the end of our time together, Dan King: [18:06] and I may throw one, I probably, I will throw one personal question in to wrap us up. Are there any other insights, any other concepts that you think it's absolutely important for practice owners to know before we wrap? John Sanders: [18:19] That Google ads works faster than SEO, right? Is that if you, you know, doing SEO, it can take six months, 12 months to get going. Whereas Google Ads, you sign a proposal with us, usually it takes us about two weeks to get everything set up. In that first 30 days, it might be kind of slow as we're figuring out what your market is, making sure everything on the website is working. So, I mean, it's not an immediate solution. It's not going to work in the first week. And I think recently we've seen as, you know, consumer confidence has kind of declined and practices are struggling a little bit, but we've heard a number of people say, you know, we just hired three people and we have all of these openings and we need to fill them out now. Google ads can help you with that and maybe like a 90 day window or a six month window, but it's, it's not going to help you over the next, you know, three weeks. And, and is definitely not something that, that works immediately like anything else. It requires a lot of work on the backend to make sure that it's, that it's doing the right things. And even just for Google's AI is to just kind of learn your campaign and who it needs to be serving to. Dan King: [19:22] It's so important for people's time expectations to be managed here. Right. Yeah. John Sanders: [19:28] And we try to set those as well as we can. But yeah, what's hard for us is the business owner who's kind of got their back against the wall and sees Google Ads as a silver bullet to get out of the situation. It's usually not that, unfortunately. Dan King: [19:44] Maybe referrals in the therapy world could be a quicker way potentially to turn things around in that situation. John Sanders: [19:49] Yeah, I mean, that's I don't think Google ads or SEO ever replaces the sending cookies to doctors offices to get to get referrals. I mean, that's, you know, keep keep doing that. That's that's super important John Sanders: [20:01] for for any local therapy practice. I would never tell you to stop doing that. So, yeah, keep keep all of those efforts up. But then, you know, you also do have kind of the online side of things as well that you have to that does take work, especially on that SEO side where it takes a long time or Google ads, you know, for us to go into the back end and tell Google ultimately what we what we wanted to do and for for Google to learn about the campaign as we go. Dan King: [20:26] I'm going to just I just created a new metric in my head instead of ROAS return on ad spend. We need to measure RO triple C, which is return on chocolate chip cookies. John Sanders: [20:34] Yes. Dan King: [20:35] Put that out there. John Sanders: [20:36] That would be a really good stat. Also probably hard to calculate, but you know, and I think that just so much of that comes from, in a lot of cases, when you get a client, you don't necessarily always know that they came from Google Ads or if they came from a doctor's office. In a lot of cases, you'll have an idea from Google Analytics or they'll say, but there are definitely some cases where that's not something that's going to get recorded. Dan King: [21:00] Yeah, although you can track it in your intake process, right? If you have a centralized intake process, that can be a really useful data point to collect. John Sanders: [21:07] One of my favorite examples of this is I have a client who, like right after we signed her up, she got a client from Google Ads who then immediately turned around and referred one of her friends to the therapy practice. That friend is never going to show up in my Google Ads statistics. But ultimately, the therapy practice knows that that came from Google Ads, John Sanders: [21:29] but I'm never going to see that conversion on my dashboard. Dan King: [21:31] What do you do for fun when you're not running Google ads, doing SEO for mental health practices, working on your business? What do you do for fun? John Sanders: [21:38] I don't know if you can see over my left shoulder, but I've got a bunch of Dungeons and Dragons books. So I'm kind of a huge D&D and role-playing game nerd is probably my main hobby besides chasing around my two kids and my three dogs and things like that. Dan King: [21:55] John pleasure having you great that you're so focused on this this wonderful world that we serve as well and hope hope this podcast gets you some exposure to some potential clients folks can start to learn about the importance of Google ads and SEO so important in our world and so important for people to learn more about it so thank you yeah John Sanders: [22:15] Thanks Daniel for having me.