Local Services Ads are the Google format that sounds simplest to a busy practice owner. You don't choose keywords, you don't write headlines, and you don't pay for clicks. You set up a profile, Google verifies the practice, and you pay only when a potential patient calls or messages you through the ad. Google describes the result as a chance to "appear prominently in Searches" and "only pay when a customer gets in touch."
For some businesses, that trade is a good one. For a dermatology practice, the catch sits in what the format takes away. Every chapter of this guide so far has been about control: separating medical from cosmetic, sending each condition to its own page, pricing each click by the patient behind it. Local Services Ads give up most of that control in exchange for simplicity.
This chapter covers what it takes to qualify, what a dermatology practice gets and doesn't get, how the ranking works, and why it belongs late in the rollout, if it belongs at all, after the Demand Gen work in Chapter 11.
"Dermatologist" Is a Local Services Category, With Five Checks First
Not every medical specialty can run Local Services Ads. Dermatology can. "Dermatologist" is on Google's list of eligible categories in the US, and unlike a few categories on that list, it isn't limited to certain states.
Getting approved takes more than a signup form. Google's screening for dermatologists covers five areas: a background check on the provider, a background check on the practice, insurance (general liability for the practice and malpractice coverage for the provider), state licenses for both the practice and the provider, and verification of the provider's National Provider Identifier. Google defines the category itself as a provider who handles "the diagnosis, treatment, and management of conditions associated with the skin, hair, and nails."
Plan for the checks to take time, and gather the documents before you start. Some categories can run ads while their checks are still in progress. Health care can't. Google states that "Pre-badge ads aren't available for garage door services, health care verticals, and locksmiths," so a dermatology profile shows nothing until every check is complete.
For a practice with several dermatologists, keep in mind that the checks apply to providers as well as to the practice. Every provider who appears on the profile needs to clear them.
You Pay When Someone Calls, Not for What They Call About
Here is the heart of the problem for dermatology. A Local Services profile is one listing for the whole practice. There are no keywords to choose, no ad groups, and no headlines to write. Google decides which searches your profile appears on, based on your category, your service area and what's in your profile.
That means a new patient calling about a skin check, a patient calling about eczema and someone calling to price Botox all arrive as leads through the same profile, and each one is charged as a lead. You can't send the cosmetic caller to a cosmetic page, give skin checks their own budget, or pay more for a Mohs referral than for a routine visit. You can't even see the search that led to the call.
Compare that with what this guide has built. Chapter 2 separated medical, skin cancer and cosmetic into their own funnels. Chapter 7 set bids by condition. Chapter 10 gave each Performance Max campaign a single goal. Local Services Ads have no place for any of it. For a practice whose medical and cosmetic sides have very different values per patient, that's not a small detail. It's the whole economics of the lead.
It also means some leads won't be new patients at all. Existing patients calling to reschedule, people asking whether you take their insurance, and callers looking for a different practice with a similar name all reach the same phone. Google says leads "determined to be invalid or low quality are not charged," but an existing patient calling the number on your ad is a real call, and whether Google treats it as a valid lead is Google's decision, not yours.
Health Care Loses Three Tools Other Categories Get
Health care runs Local Services Ads with fewer features than most categories, and Google says so in plain language.
No booking leads. Some categories let customers book an appointment directly from the ad. Google states that "Booking leads aren't available for health care verticals." Patients call or message; they can't book.
No call recordings. Many advertisers use recordings to hear how calls were handled and whether a lead was genuine. Google states that "Call recordings aren't available for tax specialists or for health care verticals." For a medical practice that's understandable, given patient privacy, but it means you can't review a disputed lead by listening to it.
No lead credits. In other categories, Google reviews charged leads over time and may credit back ones it later judges low quality. For health care, it states: "Lead credits aren't available for health care verticals, tax specialists, or advertisers in EMEA." The initial screening still applies, so leads Google flags as invalid when they come in aren't charged. After that, a charged lead stays charged.
Put the three together and a dermatology practice has less help than most advertisers in judging whether its leads are worth the price. That's the job the practice has to do itself, which the section after next covers.
Stars, Photos and a Front Desk That Picks Up Decide the Ranking
When several practices compete for the same search, Google ranks their profiles in an auction. Your bid is part of it, and Google recommends the "Maximize Leads" setting, which lets it set your bid to get the most leads for your budget.
The rest of the ranking is about how likely your profile is to produce a lead. Google names several factors. Responsiveness is one: "Missed calls may negatively affect your responsiveness." Relevance is another, meaning how well your services and business bio match the search. And profile quality counts, which Google describes as your rating, number of reviews, average response time, use of high-quality images and the verification checks you've completed.
For a dermatology practice, two of those are worth special attention.
The first is the phone. A practice whose front desk sends calls to voicemail during lunch, or whose lines are busy on Monday mornings, is teaching Google that its leads go unanswered. Before launching, check who answers calls from the ad, what happens after hours, and how quickly messages get a reply. Local Services Ads reward the practices that pick up.
The second is reviews. Your rating and review count come from your Google Business Profile, the same reviews patients read on Maps. Chapter 8 used those reviews for ad copy. Here, they decide where you rank. A practice with a strong rating and a steady flow of recent reviews starts with an advantage that no bid can fully make up.
Groups with several offices should also know one more rule. According to Google, "If your business has multiple locations that serve the same geographic area, Local Services will show only the highest ranking ad in response to a user's query." Two offices in neighboring suburbs won't both appear for the same search, so draw each location's service area with that in mind.
Log Every Lead to a Booked Visit, Because Google Won't Record the Call
Without recordings or credits, the only reliable measure of Local Services Ads is the one the practice keeps. Set it up before the first lead arrives.
Ask the front desk to note every call and message that comes from the ad: the date, whether it was a new or existing patient, what the caller wanted, and whether it became a booked visit. Local Services leads appear in their own dashboard, so matching them up takes a few minutes a week. The patient management system then tells you which of those booked visits actually happened.
After a month or two, you have a number that matters: the cost per booked new patient from Local Services Ads, split into medical and cosmetic by hand. Compare it with the same figure from your Search campaigns and with the ceilings you set in Chapter 3. If Local Services Ads are booking new skin check patients below that ceiling, they're earning their place. If most leads turn out to be existing patients, price shoppers or wrong numbers, the tidy lead price is hiding an expensive patient.
Add It Only After Search Has Set the Price of a New Patient
In the rollout this guide follows, Local Services Ads come late, and they're optional.
The reason is data. Search campaigns tell you exactly which searches brought which patients at what cost. Local Services Ads tell you much less: a lead came in, and it was charged. By the time the account has months of Search data behind it, you know what a new patient should cost in each funnel, and you can judge Local Services Ads against that number instead of taking the lead price at face value.
Three conditions should be in place before starting. The practice should have a strong review profile, since it drives the ranking. Someone has to answer the phone reliably, including at the busiest times of day. And the front desk log from the previous section needs to be ready. Start with a modest budget, run it long enough to collect a meaningful number of leads, and judge it by booked new patients, not by lead count.
Some practices will find it works well, especially for general medical dermatology in areas with few competitors. Others will find it books mostly existing patients and cosmetic price shoppers. There's no way to know in advance, which is why it's a test, not a foundation.
Google Is Folding Local Services Into Performance Max
One more reason not to build the account around Local Services Ads is that the format itself is changing. Google has announced it is moving Local Services Ads into Performance Max in phases. The first phase, from August 2026, covers some home and storefront service advertisers. Later phases through late 2026 cover other groups, and in 2027 the move extends to "all remaining business categories that were not migrated in 2026."
Google's announcement doesn't name health care or dermatology. Our reading is that dermatology falls into that final group, which would put the change in 2027, but the timing for any specific category isn't published. When it arrives, expect Local Services leads to be managed through a Performance Max campaign, with the conversion tracking and funnel rules from Chapters 1 and 10 mattering even more than they do now.
For now, the practical advice holds. Treat Local Services Ads as an optional addition, keep your own log, and don't let a simple lead price stand in for the patient data your Search campaigns already provide.
Next: AI Max, the Last Switch in the Account
Local Services Ads hand Google the targeting. Chapter 13 covers the other place where a dermatology account eventually does the same: AI Max for Search, which widens the searches your ads match and lets Google rewrite parts of them, and the words a dermatology practice should block before it is ever switched on.
The Google Ads for Dermatologists guide home lists every chapter. Under our Google Ads management, Local Services Ads are tested only after Search has shown what a new patient should cost.
