What Should Count as a Conversion in Clinic Google Ads?

Every Google Ads account has a column called "Conversions". Most doctors I meet trust that column. Most of the time, they should not.

Picture a dental account where conversions double in three months while implant consultations fall. Say the agency has added "visited the contact page" and "clicked the phone number" as conversions. Neither is a patient. Google, chasing those actions, finds more people who look at contact pages and never call.

Choosing what counts as a conversion is not a technical setting. It is you telling Google what a good patient looks like.

Why does the conversion choice matter so much?

Because Google uses conversions in two ways:

1. Reporting. It tells you which keywords and ads "worked".
2. Learning. Automated bidding uses conversions to decide whom to show ads to next.

If you count the wrong thing, both go wrong. Your reports flatter weak campaigns, and the system learns to find the wrong people. In Known Doctors Get Booked I list this among the most common mistakes: counting page views only trains Google to find more of the wrong people.

What is the difference between primary and secondary conversions?

Google Ads lets you mark some actions as primary, which count in your main conversion column and are used for bidding, and others as secondary, which you can still see but which do not drive bidding. The exact labels can change, so check your account.

Use primary for actions that mean "I want an appointment". Use secondary for actions that are interesting but not decisive.

Which actions should a clinic count, and how?

Here is the table I use when setting up a clinic account:

Set the call minimum by listening to recordings. For one clinic, 45 seconds filters out the noise. For another, it is 90. Your recordings decide.

How do you send booked and treated patients back to Google?

This is where real gains come from. The idea is simple:

1. When someone clicks an ad, Google attaches a click ID to the visit.
2. Your form or call tracking passes that ID into your CRM along with the enquiry.
3. When the desk marks the enquiry as "booked" or "treated", the CRM sends that update back to Google.

Now Google can see which clicks became actual patients. An orthopaedic surgeon's account can learn that "knee replacement cost" searches, often typed by a patient's grown-up son or daughter, turn into surgeries, while "knee pain exercises" searches do not.

This needs a CRM that records the source of every enquiry, and a team that updates the status the same day. Our CRM, WhatsApp and AI team sets this up for clinics.

What happens when you count the wrong thing? A worked example

Say a dental clinic spends ₹50,000 a month and counts page views of the contact page as a primary conversion.

• Google reports 250 conversions. That is ₹200 per conversion. Looks great.
• The CRM shows 45 real enquiries, 15 booked consultations and 6 implant patients.
• Real cost per treated patient: ₹50,000 ÷ 6 = about ₹8,333.

Now the clinic fixes tracking: calls over 60 seconds, completed forms and WhatsApp chats only.

• Google now reports 52 conversions. That is about ₹962 each. Looks worse.
• But bidding now chases real enquiries. Over the next two months, booked consultations rise to 22 and treated patients to 9.
• Real cost per treated patient: ₹50,000 ÷ 9 = about ₹5,556.

The report looked worse. The clinic got better. Expect this when you clean up tracking, and warn whoever reads the reports.

Should different treatments count conversions differently?

Yes, a little. The rule stays the same, count intent and not activity, but the signal changes with the treatment.

• Urgent or older-patient treatments, like cataract, fractures or kidney stones, bring mostly calls. Get call tracking right before anything else.
• Private or slow decisions, like IVF, piles or cosmetic surgery, bring more WhatsApp chats and forms, often at night. Make sure chats are tracked as chats, not taps.
• High-value treatments benefit most from sending booked and treated patients back, because one implant or one joint replacement is worth so much more than one cleaning or one OPD visit.

If you run several treatments in one account, give each campaign its own conversion goals where your setup allows it. Otherwise a cheap, high-volume treatment can teach the whole account to chase easy enquiries while your high-value campaign starves.

How do you check your tracking is honest?

Once a month, compare three numbers for the same period:

1. Conversions in Google Ads.
2. Enquiries from Google Ads in your CRM.
3. Booked consultations from Google Ads in your CRM.

If the first is far above the second, you are counting things that are not enquiries. If the second is far above the first, you are missing calls or chats. If the third is tiny, the problem is at the desk, not in the ads. For a deeper look, our patient acquisition work starts with this exact check.

The short version

• Whatever you count as a conversion is what Google learns to find.
• Count calls over a set length, completed forms and started WhatsApp chats.
• Keep button taps, short calls and page views out of your primary conversions.
• Send booked and treated patients back from your CRM as soon as you can.
• Compare Google conversions with CRM enquiries and bookings every month.