Every practice can name its top ten searches. "Orthopedic near me." "Orthopedic surgeon near me." The practice name. Maybe a procedure or two. Those searches are real, they book patients, and a new account should buy them first.
They're also a tiny slice of what patients type. The rest is thousands of small, oddly worded searches that nobody would ever think to list: a symptom plus a neighborhood, a procedure plus "for seniors," a misspelling of the specialty. Most of them get a handful of searches a month. Together they're the bigger opportunity. The trick is buying the known searches first, then letting Google hunt the rest once the account has learned what a patient looks like.
Exact Match Is a Promise: Only Searches That Mean What You Chose
Google gives every keyword a match type, and the match type decides how far from your exact words Google will stretch. Put simply, from Google's help center: exact reaches searches with the same meaning, phrase reaches longer searches that contain that meaning somewhere inside them, and broad reaches both plus anything Google considers related.
Exact match is the tight one. It still catches close variations, like a plural or a reordered phrase, but it won't wander into a different meaning. An exact-match keyword for "orthopedic doctor near me" will also show for "orthopedic doctors near me." It won't show for "orthopedic shoes near me," which is a different errand entirely. That's exactly what a brand-new account needs, because an account with no bookings yet can't tell a good wander from a bad one.
The method this guide teaches starts with a campaign we call Isolation at BrandRocket: exact match keywords with manual bids, covering only the searches you already know turn into patients.
Phrase match sits between the two, and in this method it mostly sits out. The first campaign runs exact match so every search it buys is one you chose. The second runs broad match so Google can find the ones you'd never think of. A middle setting that's a little of both tends to give you a little of neither: more reach than you can check by hand, without the booking history that makes broad match smart.
Four Searches From One Service Line Are Enough to Open the Account
Chapter 2 made the case for launching the service line where searchers are ready to book. Chapter 5 split that line's searches into tight groups, each with its own page. Isolation takes the surest groups from that line and nothing else.
Here's what that looks like for orthopedics, using searches from our example market, San Diego. Your market's numbers will differ; the shape won't:
- "orthopedic near me," 390 searches a month
- "orthopedic surgeon near me," 260
- "orthopod doctor near me," 260
- "sport medicine doctor near me," 170
Those four, plus the practice's own name in its brand campaign, are enough to open an account. They're specific, they're local and they come from someone choosing a provider. Isolation buys them on purpose and watches what books.
Expect Isolation to cost more per click in its first weeks. With no track record, a new account gives Google nothing to rate its ads on, so the method this guide teaches opens with bids high enough to land on the page at all. As the ads collect clicks and the pages prove relevant, the bids come down. Chapter 7 walks through setting them.
Keep the brand campaign separate from Isolation too. Searches for the practice name and the doctors' names are the cheapest bookings most accounts will ever buy, and mixing them in makes Isolation look far better than it is. A campaign that's half brand searches can't tell you whether "orthopedic near me" is working.
Ninety-Four Percent of the Searches We Pulled Get 50 or Fewer a Month
Now look at what Isolation can't reach. When we seeded Keyword Planner with 14 practice websites in our example market, it returned 22,303 different search ideas. Only 262 of them get more than 500 searches a month. Another 1,048 sit between 51 and 500. The other 20,993, about 94% of the list, get 50 or fewer.
That's the long tail. Here's what it sounds like for orthopedics alone, again from our example market, each search showing 10 to 20 a month:
- "shoulder dr near me"
- "knee doctors in my area"
- "best orthopedic doctors near me for knees"
- "pediatric orthopedic surgeon near me"
- "orthopedic hand and wrist specialist near me"
- "humana orthopedic doctors near me"
Read those again. A parent looking for a pediatric specialist. Someone who already knows it's their knee. Someone checking whether a surgeon takes their plan. None of them is browsing. No one can write 20,993 exact-match keywords, and no one would guess these particular ones. But patients type them every day, and some of them are just as ready to book as the person searching "orthopedic near me." They're just saying it in their own words.
Patients' Words Don't Follow a Rule, So Broad Match Has to Find Them
You might hope patients always use plain words instead of clinical ones. Sometimes they do. In our example market, "ear nose and throat near me" draws 390 searches a month against 140 for "otolaryngologist near me," and "primary doctor near me" draws 320 against 170 for "primary care physician near me."
Then cardiology breaks the pattern. "Cardiologist near me" draws 480 searches a month. "Heart doctor near me" draws 40.
There's no rule you can write down and apply to every specialty. That's the job of the second campaign, Exploration: broad match, steered by a target cost per patient, finding the searches that book whatever words they use.
What broad match finds is useful beyond the bookings. Every search that turns into a patient is a patient telling you, in their own words, what they were looking for. Those words belong in your ads and on your service pages. If "knee doctor" keeps booking and "orthopedic surgeon" doesn't, your headline should say knee doctor. Chapter 8 builds ad copy from exactly that kind of evidence.
Broad Match Starts From the Three to Five Keywords That Actually Booked Patients
Exploration doesn't launch with the full keyword list set to broad. It launches as a copy of Isolation seeded with only its proven winners: the three to five keywords that have actually produced bookings. Broad match reaches out from those, and Google's bidding learns from the bookings the account has already recorded.
Be strict about what counts as a winner. A winner is a keyword that has produced bookings at a cost per booking the service line can afford, using the math from Chapter 3. It isn't the keyword with the most clicks, the best clickthrough rate or the most impressions. A keyword can draw a crowd and book nobody. Seeding broad match with a keyword like that teaches Google to find more people who click and leave.
If a service line only has one or two keywords that clearly book, that's the answer: it isn't ready for Exploration yet. Give Isolation more time, or look for a gap on the page or at the front desk before blaming the keywords.
It also waits. Exploration switches on when a service line reaches about 30 real bookings a month, because broad match without that history is a guess with a credit card. For bidding, it runs Maximize Conversions, aimed at a cost per patient drawn from what Isolation actually paid. Chapter 7 has the details. And for the first month, somebody reads the search terms report every day and blocks what doesn't belong, as Chapter 5 laid out. In a medical account, the usual intruders are easy to spot once you know them: symptom-only searches from people looking for home remedies, searches for a different specialty that happens to share a word with yours, job and training searches, and other practices' names. A GI campaign that starts matching "heartburn remedies," or an orthopedic one that starts matching "orthopedic shoes," needs a negative keyword that morning, not at the end of the month.
Exact Match Doesn't Retire Once the Broad Campaign Starts Booking
Once Exploration is carrying a service line, Isolation's job changes, but it doesn't disappear. Some practices pause it when Exploration covers the same searches well. Then, when a search that matters starts slipping down the page, Isolation comes back on to win that position back.
Think of it as two campaigns sharing one line: one that holds the ground you already know and one that scouts the ground you don't. The balance between them shifts over the life of the account, and in a multi-specialty practice each service line finds its own balance on its own schedule.
In a multi-specialty practice, that schedule is different for every line. The urgent care or primary care side may reach 30 bookings a month within a couple of months and be ready for Exploration early. A line with far less search volume may never get there. In our example market, "cardiologist near me" draws 480 searches a month in the whole metro, and a cardiology practice may never see 30 bookings a month from Google Ads alone.
That's not a failure. A small service line can run on Isolation for as long as it books at the right cost, and there's nothing wrong with a quiet, profitable campaign that never goes broad. What goes wrong is forcing broad match onto a line that hasn't earned it, because the calendar says it's month three. Each line moves when its own numbers say so.
Our specialty guides show the same split in their own fields. The dermatology guide covers starting on "dermatologist near me" before adding conditions. The optometry guide covers how broad match catches "same day" and "walk in" eye exam searches. The plastic surgery guide covers owning the core procedure searches before chasing the trendy ones.
Next: Bids That Know Which Specialty They're Bidding For
Isolation and Exploration both need bids, and a therapy click and a cardiology click don't cost the same. Chapter 7 sets bids line by line, from manual bids in Isolation to a target cost per patient in Exploration.
Catch up on Chapter 5 on competitor keywords, or see every chapter on the guide home for Google Ads for Healthcare. When a practice hires us for Google Ads management, every account launches on exact match and earns its way to broad.
