Someone types "podiatrist ingrown nail" into Google. Two ads appear. One says "Board-Certified Foot and Ankle Specialists. Call Today." The other says "Ingrown Toenail Removal. Same-Day Visits." Which one would you click with a throbbing toe?
Google asks itself the same question before either ad shows, and it prices the answer into what each practice pays. The ad that matches the search, and lands on a page about that exact problem, tends to win a better spot for less money. The generic one pays more to stand next to it.
Outbidding the Podiatrist Down the Street Isn't How Ad Rank Works
Behind every podiatry search sits a split-second auction. Each ad in it gets an Ad Rank, which settles whether it appears at all and in which slot. Money matters less than most practices assume. Google names six ingredients:
- The bid. Your ceiling for that one click.
- How good the ad and its page are for this search. An ingrown toenail ad on an ingrown toenail page scores higher for "ingrown nail removal" than a general podiatry ad does, and Google scores it fresh at every auction.
- A minimum bar. An ad that falls below Google's threshold doesn't show, whatever it bids.
- The competition. If two ads land close together, either can take the higher slot.
- Who's searching, and from where. The words, the location, the phone or laptop, the hour.
- Extras. Whether a call button, sitelinks or a location are likely to make the ad more useful.
Google also says, plainly, that better ads usually cost less. It doesn't publish a formula, and some older training still teaches one, so we won't. What matters is the direction: a relevant ad with a relevant page can hold a top spot for less than a vague ad with a bigger bid. The top slots are where podiatry patients click, and the "top" and "absolute top" impression reports in your account show how often you hold them.
Quality Score Reports on the Auction. It Doesn't Vote in It.
Every keyword in a podiatry account shows a Quality Score from 1 to 10. It's easy to treat it as the grade that decides everything. Google says the opposite: Quality Score is not used in the auction at all. It's a diagnostic, a report card on how your ads have been doing, so you can find the weak spot.
That single number summarizes three grades, each one measured against the other practices bidding on the same keyword:
- Expected clickthrough rate: Google's forecast of how many "heel pain doctor" searchers would choose your ad, with page position and ad extras factored out. No higher slot can buy this grade; only a better ad moves it.
- Ad relevance: whether an ad shown for "bunion surgeon" is actually about bunions.
- Landing page experience: whether the person who clicked finds the bunion page they were promised, and finds it usable on a phone.
Read it like a lab result, not a verdict. A "Below average" on ad relevance means the ad is talking about something other than what people searched. A "Below average" on landing page experience means the page isn't delivering what the ad promised. Both have the same cure in a podiatry account: match the ad and the page to the foot problem.
Two in Three Podiatry Ads We Read Never Name a Foot Problem
We read 82 podiatry ads that practices in our example market, Los Angeles, ran on Google Search since the start of July. Only 28 of them name a specific foot problem or treatment: ingrown toenails, heel pain, bunions, fungus, warts, diabetic foot care. The other 54 are generic. They say "podiatrist," "foot and ankle specialist," a doctor's name or a neighborhood. One multi-state network ran 14 near-identical location ads, so we checked the count without it. It barely moves: 27 of 67.
Picture what that means for the searcher. Someone with a red, swollen toe typed three words about it, and two of every three podiatry ads answered with a practice name or a neighborhood. The practice might be excellent. The ad just didn't say so in the words the patient used.
A generic ad isn't wrong for a generic search like "podiatrist near me." The trouble starts when the same ad answers "ingrown toenail removal," "heel pain doctor" and "bunion surgeon" all at once. It's the answer to none of them. Each of those searchers wanted their problem named, and the practice that names it looks like the one that fixes it.
One caution about what we could see. Google's Ads Transparency Center shows the web address an ad displays, not always the page a click lands on, so we can't tell you where any of these ads actually sent people. Several generic ads showed only the practice's bare domain. That's worth checking in your own account, because the next section is the easy fix.
Your Heel Pain Page Already Exists
Here's the good news. Most podiatry practices already built the pages their ads need. Of the 12 practice websites we profiled in our example market, 11 have their own heel pain page. Eleven of the twelve have separate pages for at least seven of the ten conditions we checked, and five cover all ten. The one exception is a large health system that files foot care under orthopedics.
Those pages usually exist for search engines or patient education. They also make the best landing pages a podiatry ad can have, because they already say what the searcher asked about. A heel pain ad that lands on a heel pain page tells Google, and the patient, that the click went where it promised.
A good condition page does three things on a phone before anyone scrolls:
- Names the problem in the heading. "Ingrown Toenails" or "Heel Pain Treatment," not "Welcome to Our Practice."
- Puts the phone number one tap away. Most of the condition pages we checked already do, with a click-to-call number in the header.
- Offers the next step. A "Request Appointment" button or form that works on a phone.
Some practices already connect the pieces. All South Bay Footcare's ingrown toenail page opens with the heading "Ingrown Toenails Permanent Removal in Torrance, CA," a click-to-call number and "Same Day Appointment Available," all before the first scroll. Eazy Foot & Ankle runs an ad titled "Walk Ins Welcome - Ingrown Toenail Removal Clinic" and has an ingrown toenail page headed "Professional Services for Removing an Ingrown Toenail." The ad, the page and the search all use the same words. That's the whole idea.
An Ingrown Toenail Search Deserves Its Own Ad Group
In Google Ads, keywords live in ad groups, and each ad group shares its ads and its landing page. That's where relevance is won or lost. Put "podiatrist," "heel pain doctor" and "ingrown toenail removal" in one group, and the ad has to be generic enough to cover all three. Split them apart and each ad can speak to one problem.
Five or six keywords per group is plenty, as long as every one of them means the same foot problem. Here's an ingrown toenail group built from searches Keyword Planner returned for our example market:
- "podiatrist ingrown nail"
- "removal of ingrown nail"
- "ingrown nail removal near me"
- "doctors for ingrown toenails"
- "ingrown toe doctor near me"
The ad's headlines repeat the problem in the patient's words: ingrown toenail removal, same-day visits, done in the office. The final URL is the ingrown toenail page. Build the next group the same way for heel pain, then bunions, then fungus, one foot problem at a time. Chapter 5 shows how to find the keywords for each group.
Heel pain shows why this takes some judgment. Its doctor-seeking searches are small. In our example market, "plantar fasciitis doctor" drew about 110 searches a month, "plantar fasciitis specialists" about 30, and "heel doctor near me," "heel specialist near me" and "best doctor for heel pain" about 10 each. That's Chapter 2's finding showing up in the keyword list: most heel pain searchers aren't asking for a doctor yet. The heel pain group will be smaller and quieter than the ingrown toenail group, and that's fine. Its job is to catch the few ready patients with an ad and a page that speak to heel pain, not to chase the reading crowd.
A podiatrist can't change a rival's ad or a patient's wording, but ad relevance sits entirely on your side of the desk. You can't make a competitor's ad worse or change what the searcher typed. You can make sure the words they typed show up in your ad and on your page. In a podiatry account with a page for every foot problem, most of the work is already done.
One Podiatry Home Page Took 18 Seconds to Load on a Phone
Landing page experience also includes whether the page shows up in time for anyone to read it. We ran the home pages of our example practices through Google's free PageSpeed Insights tool on a simulated phone. Scores ranged from 36 to 86 out of 100. Four of the eleven pages that loaded took more than ten seconds to show their main content, and the slowest took 18.5. A twelfth site timed out entirely.
We tested home pages, not condition pages, so don't read those numbers as a verdict on any particular landing page. Read them as a reason to test yours. Run every page an ad sends people to through PageSpeed Insights on its mobile setting, and note how many seconds pass before the main content shows. A patient standing at a bus stop with a throbbing toe won't wait ten seconds, however relevant the page.
Speed is one part of the page's job. Relevance is the bigger one, and it's the part most podiatry accounts leave on the table.
If you'd rather have someone rebuild your account around one foot problem per ad group and page, that's standard practice in our Google Ads management work.
Next: Finding the Keywords for Each Foot Problem
An ad group per foot problem needs keywords to fill it, and a list of words to keep out of it. Chapter 5 shows how to build a podiatry keyword list from competitors' websites, and why hospital brands and rival doctors' names belong on your negative list.
For what a booked patient from any of these ad groups can cost, see Chapter 3. Every chapter is on the guide home.
