When you build a new Search campaign, Google fills in dozens of settings before you touch anything. Most of them are fine. A handful are set the way that helps Google show more ads to more people, and for a podiatry practice paying for every click, more people is not the same as more patients.
None of these defaults is hidden. They're all in the campaign settings, in plain view, and each one takes a minute to change. The trouble is that a new account spends its first dollars before anyone thinks to look. This chapter goes through the six we change on every podiatry build, why each one matters for a foot and ankle practice, and the settings we leave exactly as Google set them.
Search Partners and AI Max Both Start Switched On. Isolation Needs Both Off.
Search partners. Google's help page says it plainly: when you create a Search campaign, search partners are included by default. Search partners are other sites that carry Google's search ads, from site search boxes to smaller search engines. They add reach, but a new podiatry account doesn't need reach yet. It needs clean numbers about which searches on Google itself turn into booked patients. Partner traffic is harder to judge, and it mixes into those numbers.
So partners stay off at launch. Later, once Isolation has a few months of results, partners can be switched on as a test and judged on one question: do those clicks book patients at about the same cost as Google Search clicks? The campaign reports can split results by network, so the answer is easy to read.
AI Max. Build a podiatry Search campaign today and the AI Max box is already ticked; Google's help page confirms it. Under that one box sit three behaviors. Your ingrown toenail ad can show on searches you never added, its headlines can be rewritten from text on your site, and the click can be routed to a page other than the ingrown toenail page you picked.
Each of those undoes something the earlier chapters built. Isolation, the first campaign (our name for it, not Google's), is built for control: you pick the podiatry searches, you write the words, you choose the condition page. AI Max hands each of those choices back to Google. The page swap matters most in podiatry. Chapter 4 built a page for ingrown toenails, one for heel pain and one for bunions, and matched each ad group to its page. With AI Max on, a heel pain click can land wherever Google decides, which may be the home page you worked to avoid. So the box gets unticked on day one. AI Max is the last thing a podiatry account turns on, after Performance Max and after many months of booked patients have taught Google what a good click looks like.
Google's Broad Location Option Reaches People Reading About Your City. A Podiatrist Needs Presence.
Google's location setting has two options. The broad one, "Presence or interest," reaches people in your area and also people elsewhere who've shown interest in it. The narrow one, "Presence," reaches people who are actually there.
Google recommends the broad option as a best practice on Search. Then the same help page names the exceptions, and health businesses fit the first one: Google says to consider "Presence" for a business in a sensitive category that already carries targeting limits. Health care is exactly that.
For a podiatry practice, the logic is simple. Someone in another state reading about Los Angeles foot doctors is not going to drive in for an ingrown toenail. Someone in your city with a sore heel might book this week. Presence pays for the second person and skips the first.
Draw the map around where your patients really come from. A practice in a dense city might cover a few miles; a practice in a suburb might cover a county. Your own patient addresses, from the front desk system, are the best guide. If there's a part of the map you can't serve well, like a neighborhood across a freeway where patients never make the drive, exclude it rather than paying to reach it.
Every New Keyword Starts as Broad Match Unless You Type the Brackets
Google's help page on match types says it directly: broad match is the default match type for every keyword. Type "ingrown toenail removal" into a new ad group without any punctuation, and it's broad match, eligible to show on searches Google considers related, including ones that don't use your words.
Isolation runs on exact match only, the way Chapter 6 laid out. In Google Ads, that means square brackets: [ingrown toenail removal], [podiatrist near me], [plantar fasciitis doctor]. Check every keyword after you add it. A single keyword left as broad match in Isolation turns a controlled campaign into a loose one. The keywords list has a match type column; every row in Isolation should read exact match. If one says broad match, edit it before launch.
The same goes for dynamic search ads, which write ads and pick searches from your site's content. They don't belong in a launch account. Broad match has its place, in Exploration, the second campaign, once Isolation has proven which searches convert.
The Call Button Shouldn't Ring After the Front Desk Goes Home
By default, Google shows your ads "All day," every day. For a podiatry practice, that's mostly fine. Someone searching "heel pain doctor" at 10 p.m. can still fill out an appointment request, and the practice can call them back in the morning.
The phone number is different. A call asset puts a tap-to-call button on your ad, and if it shows at 10 p.m., the patient gets a voicemail. Chapter 1 counted calls of 30 seconds or more as leads, so a string of after-hours voicemails can look like conversions in your account and feel like missed patients at the front desk.
The call asset has a schedule of its own, separate from the ad's. Google's help page suggests exactly this use: show the number on the days and hours your staff picks up. Set the call asset to your real office hours, starting a little after the phones open and ending a little before they close. The ad keeps running around the clock for forms; the call button keeps office hours.
One exception: if your practice uses an answering service that can actually book appointments or take a message a staff member returns first thing, the call button can stay on longer. Ask what happens to a 9 p.m. call today, and set the schedule to match.
If you use a call tracking service, as Chapter 1 recommended, check its after-hours calls each week. They show whether the schedule is right: a steady stream of evening calls from the ads means the button is still showing when no one can pick up.
Google Now Reads the Language From Your Ads. Most Podiatry Sites Have No Spanish Page.
Until recently, a Search campaign had a language setting. This month Google retired it. A Search ad's language now comes from the ad itself: Spanish words match Spanish searches, English words match English ones. There's nothing to change in the settings, but it changes how a practice reaches patients who search in another language.
If your ads are in English, they'll match English searches. To reach patients who search in Spanish, you need ads written in Spanish, in their own ad group, sending clicks to a page written in Spanish. And someone who answers the phone needs to speak Spanish too.
That last part is where most practices in our example market would stall. Of the 12 podiatry practice websites we studied, two offered real Spanish content: one with "Hablamos Español" on every page, one with a full Spanish version of the site. One had an interpreter-services page. Five mentioned that a doctor or staff member speaks Spanish and nothing more, and four showed no Spanish at all. Meanwhile, 24 of the 685 Google reviews we read were written in Spanish.
A Spanish-speaking doctor with no Spanish page is a real advantage the ads can't use yet. The fix is on the website first: a Spanish version of the pages that matter most, like ingrown toenails, heel pain and diabetic foot care, and a clear line about who speaks Spanish. The one site in our sample with the most Spanish also put a Spanish block about Medi-Cal on its pages, answering the coverage question before the patient had to call. That's the model: translate the answers patients need, not just the headings. Then build a Spanish ad group for each of those pages.
The Settings to Leave Alone
Not every default needs changing. These stay as Google set them, or get a quick check:
- Auto-tagging stays on. It's what lets Google connect a click to the booked patient you send back later (Chapter 1).
- Call reporting stays on, so calls from the ad's call button are counted and can be graded by length.
- Ad rotation stays on "Optimize." Google shows the best-performing combinations of your 15 headlines more often, which is how the patients' clicks pick winners (Chapter 8).
- The Display Network box stays unticked. Confirm it on every new Search campaign. Display belongs in its own campaign, much later.
- Age and income targeting stay untouched at launch. It's tempting to guess that podiatry patients skew older, but a guess isn't data. Watch the age and household income reports, and only adjust once a segment has real volume behind it, at least 200 clicks and 5 conversions, and even then carefully.
- Brand stays in its own campaign, as Chapter 5 set up, rather than handled with brand exclusions inside Isolation.
One more habit for launch: start with a modest daily budget. The first weeks are for reading what clicks actually cost in your market, against the Keyword Planner estimates from Chapter 7, and adjusting bids by hand. The budget can grow once the numbers are real. Chapter 3's worked example put a booked podiatry patient at roughly $77 on benchmark figures; a first budget that can buy a handful of those patients a month is enough to learn from, and your own account will replace that estimate within weeks.
If you'd rather have someone check every setting before your campaign spends a dollar, that's the first thing our Google Ads management team does on a podiatry account.
Next: When Performance Max Joins the Account
Isolation and Exploration cover Search. Chapter 10 covers what comes months later, once the account has steady conversions: Performance Max, and why in podiatry the brand it has to be kept away from is often the doctor's own name.
For the ad copy these settings will show, see Chapter 8. Every chapter is on the guide home.
