Every dermatology practice that tries Google Ads eventually asks the same question: is this click too expensive? A practice owner sees $7 for "dermatologist near me" or $18 for a psoriasis search and winces. Seven dollars for someone who might not even call.
The question sounds reasonable and can't be answered as asked. A click is only expensive or cheap compared with what it turns into. And in dermatology, what it turns into is rarely a single visit. It's a patient who comes back for a yearly skin check, returns every few months for Botox, or keeps seeing you for years to manage a chronic condition.
This chapter works out what a click is worth when you price it against the patient's whole year instead of the first appointment. It builds on the booking tracking from Chapter 1 and the three funnels from Chapter 2, because you can't value a patient you can't count, or one you haven't placed in the right funnel.
A $7 Click Means Nothing Until You Know What the Patient Spends in a Year
Start with the prices Google itself estimates. For the Atlanta market, Google's Keyword Planner puts a click on "dermatologist near me" at about $7. A click on "eczema treatment" runs about $13, and "psoriasis treatment" about $18. These are Google's estimates for bidding in that market, not guarantees, and your own account will settle somewhere around them once it runs.
On their own, those numbers tell you almost nothing. A $18 psoriasis click that turns into a patient who needs years of care is a bargain. A $7 click from someone who wanted a free answer to a question is a waste, however cheap it looked. The only way to judge a click is to follow it all the way to money.
Follow One Dermatology Click All the Way to a Patient in the Chair
Here is the chain every practice should be able to write down. The numbers below are an illustration, not benchmarks. Replace each one with your own as soon as your tracking has a few weeks of data.
Say a click on "dermatologist near me" costs $7. Say 1 in 10 people who click go on to book, which makes each booking cost $70. Say 8 in 10 of those bookings actually show up. Now each new patient in the chair has cost about $88.
That $88 is the number to hold up against the patient's value. Not the $7.
Two things are worth noticing in that chain. First, every step after the click is something the practice controls: the landing page decides the booking rate, and the front desk and the calendar decide the show-up rate. Second, a small change in either one moves the cost per patient far more than a small change in the bid. If 2 in 10 clickers book instead of 1, the cost per new patient in this example halves, from about $88 to about $44, without touching the ad account at all.
A Botox Patient Can Return Every Three Months. A Skin Check Patient Returns Once a Year.
The other side of the chain is value, and dermatology has an unusual shape here: the first visit is often small, and the repeats are where the money is.
Take the cosmetic side first. The prescribing information for Botox Cosmetic says the effect on frown lines lasts "approximately 3-4 months," and that dosing "more frequently than every 3 months" hasn't been studied. So a Botox patient who likes the result and returns on that schedule could be in your chair up to four times a year. On price, a CareCredit cost study puts one Botox treatment at about $445 nationally, and RealSelf reports an average of $586 from its patients' reviews. Both are published averages, and your own price is the one that counts.
The medical side is steadier and smaller per visit. The same CareCredit study lists a visual skin exam at about $75 and a dermoscopy exam at about $146, with a shave excision of a mole around $151. It doesn't say whether those figures are cash prices or insurance-allowed amounts, so treat them as rough anchors. What matters for Google Ads is the pattern: a skin check patient tends to come back once a year, and some of those visits lead to a procedure.
Put those side by side and the same click can be worth very different amounts. That is why Chapter 2 split the account into three funnels. A cosmetic booking and a skin check booking are different purchases with different yearly values, and they deserve different bids.
Nobody Publishes a Dermatology Patient's Lifetime Value. Pull Yours From the Schedule.
You might expect a published figure for what a dermatology patient is worth. We looked. There is no peer-reviewed or professional-society source for it, only marketing blogs with numbers nobody can trace. That's actually good news, because your own number is better than any average would be.
Your practice management system already holds it. Here is the simplest way to pull it:
- Pick a group of new patients from a past period, such as everyone first seen in the first three months of last year.
- Split them by what brought them in: medical, skin cancer or cosmetic.
- For each group, add up what the practice actually collected from those patients over the following 12 months. Use collections, not charges.
- Divide by the number of patients in the group.
That gives you a 12-month value per new patient for each funnel. It won't be perfect. It will be real, it will be yours, and it will tell you instantly whether an $88 new patient is a good deal. If the 12-month value of a new cosmetic patient is several times the cost of acquiring one, the account has room to bid harder. If it's close, the answer is usually a better landing page or a faster front desk, not a lower bid.
A Five-Week Wait Can Lose the Patient You Already Paid For
There's a cost in the chain that never shows up in Google Ads: the wait.
AMN Healthcare's 2025 survey of physician appointment wait times found the average wait for a new dermatology patient, across the 15 metro areas it called, was 36.5 days, with a range from 1 day to 291. Waits vary a lot by city: Atlanta's average in the same survey was 10 days, and some metros ran far longer. A patient who clicked your ad because a spot worried them, and then hears "the first opening is in six weeks," may well keep searching. You paid for that click either way.
On the cosmetic side the gap is sharper. A peer-reviewed study published in 2025 phoned practices in 2024 and found that a cosmetic laser consultation took about 23 days to schedule with a fellowship-trained laser dermatologist, compared with about 11 days at a plastic surgery practice and about 4 at a med spa. A cosmetic patient who can be in a med spa's chair this week has little reason to wait a month for you.
Billing is the other leak. In the Google reviews we collected for this guide, 35 of the 40 reviews that talked about billing or insurance were negative, including several patients who said a routine skin check was billed as a diagnostic visit. Surprise bills don't raise your cost per click. They lower the chance that the patient comes back, and they show up in the reviews the next patient reads.
So the cheapest way to make Google Ads more profitable often has nothing to do with Google Ads. Hold a few new-patient slots open each week. Answer the phone on the first ring. Tell cosmetic patients the price before they book. Each of those moves the cost per patient in the chain above.
Give Each Funnel Its Own Budget and Its Own Ceiling
With a yearly value for each funnel, the budget almost sets itself.
Work out the most you would pay for a new patient in each funnel, say a fraction of its 12-month value that still leaves the practice a healthy margin. That is your ceiling. Then give each funnel its own campaign and its own budget, so the cosmetic campaign can't quietly spend the money meant for skin checks, or the other way around.
Here is how that looks with made-up numbers, which you should replace with your own. Suppose your billing system shows that a new skin check patient brings in $300 over their first year, and you are willing to spend a third of that to win one. Your ceiling is $100 per new skin check patient. The example chain earlier came out at about $88, so that funnel has a little room. Now suppose a new cosmetic patient brings in $1,200 in their first year and you accept the same one-third. The ceiling there is $400, which means the cosmetic campaign can afford clicks, booking rates and show-up rates that would sink the skin check campaign. Same practice, same account, very different limits.
The ceiling also tells you when to stop. If a funnel's cost per new patient drifts above its ceiling for more than a few weeks, the fix is rarely a bigger budget. It's the booking rate, the show-up rate or the bid, in that order.
Know how Google spends a daily budget before you set one. Google says that on a given day, a campaign "might spend up to twice your average daily budget to take advantage of fluctuations of traffic," and that by the end of the month it will have spent "no more than 30.4 times your average daily budget." So a $50 daily budget can spend $100 on a busy Tuesday, but won't pass about $1,520 for the month.
Start lower than you think you need. The first weeks are for reading real click prices and real booking rates in your market, not for scaling. Once the chain above is filled with your own numbers instead of ours, raise the budget on whichever funnel pays back fastest.
Next: How Google Decides Whose Dermatology Ad Shows First
Knowing what a click is worth still leaves a question: why does one practice's ad show above another's when both bid the same? Google doesn't rank ads by bid alone, and the answer has a lot to do with your landing pages. Chapter 4 covers how Google judges the ad and the page before you pay for a single click.
The Google Ads for Dermatologists guide home lists every chapter. When a practice works with us on Google Ads management, this is the math we do with the owner before we set a single budget.
