In most businesses, the brand is a company name. In podiatry it's often a person. Patients remember the doctor by name, or as "the foot doctor on the corner of Main," and they search that way. Many practices name themselves after the doctor, and plenty of Google listings put the doctor's name first.
That matters the day Performance Max joins the account. A podiatry practice hands Performance Max a budget and a goal, and Google chooses the placements: a heel pain search, a YouTube video, a Maps listing. Nothing in its default setup stops it from bidding on the doctor's name, and few searches convert more reliably than a patient typing it. If Performance Max buys those clicks, it counts them as wins, and the cost per patient it reports looks wonderful because many of those patients were already coming.
Half the Podiatry Listings We Checked Carry the Doctor's Name
In our example market, Los Angeles, we read reviews on 35 podiatry practices' Google Business Profiles. 17 of those listings carry a doctor's name: "..., DPM," "Dr. ...," or a practice name followed by the doctor's. The other 18 use a practice name alone.
The ad accounts look similar. Of 18 podiatry advertisers we found in Google's Ads Transparency Center, 7 run their ads under a person's name, usually the doctor's.
And patients search those names. When we fed competitors' websites into Keyword Planner in Chapter 5, three of them returned their own doctors' names as searches, drawing 140 to 260 a month each. Those searches are the most-aware patients a practice has: often someone who was referred by a friend, or a returning patient looking for the phone number.
Chapter 5 put your practice name and every doctor's name in a separate brand campaign, with its own small budget. That's where those clicks belong: cheap, predictable, and counted separately so they don't flatter the campaigns meant to bring in new patients. This chapter is about keeping it that way once Performance Max arrives.
Here's why it matters in numbers. Say Performance Max reports 40 conversions in a month, and 20 of them came from people searching the doctor's name, patients the brand campaign would have caught for a few dollars each. Its real cost per new patient is then about twice what the report shows, and any budget decision made on that report is off by the same amount.
Performance Max Waits for Steady Conversions, Then Buys Across All of Google
Performance Max isn't a launch campaign. It learns from conversions, so it comes in only after the Search campaigns have proved what a good lead looks like. In our rollout that's once Isolation and Exploration, the exact match and broad match campaigns from Chapter 6 (our names, not Google's), are together producing steady quality conversions, about 30 a month. A typical foot and ankle practice gets there somewhere around the half-year mark. A multi-location group spending more can reach it in fewer months.
Set it up simply at first:
- The goal is conversions, the same calls, forms and booked patients the Search campaigns count (Chapter 1), not conversion value.
- No target CPA at launch. Give it the first several weeks without a cost ceiling, then set one from its own record, the same handoff Chapter 7 used between the two Search campaigns.
- Location on Presence, as Chapter 9 set for Search.
Once it runs, Performance Max can show ads on YouTube, Display, Search, Discover, Gmail and Maps. Isolation's exact keywords still come first. When a patient types [ingrown toenail removal] word for word, Google's help page says the Search campaign gets that search ahead of Performance Max. There's a catch in the same help page, though. If the Search campaign runs out of budget, Performance Max may serve on those exact match searches anyway. Keep Isolation funded well enough to stay on through the day, or Performance Max will fill the gap with your best searches.
Give Performance Max its own budget rather than moving money out of Isolation to pay for it. The Search campaigns are the reason it has anything to learn from. A modest daily budget, sized so it can buy a handful of conversions a week, is enough for the first month.
Google's Brand List May Not Know Your Doctor's Name
Google's own recommendation for this problem is a brand exclusion. A practice that already runs its brand campaign is precisely the case Google's help page describes for excluding the brand from Performance Max. A brand exclusion also catches misspellings and related names, which a plain keyword can't.
The catch is how brand exclusions work. You don't type a brand name; you pick it from Google's brand library. National names are in it. A single-location podiatry practice may not be, and an individual doctor's name very likely isn't. If yours is missing, you can request it, but Google's help page sets the terms:
- A response takes three to six weeks.
- While the request is pending, the exclusion works with limited reach.
- If it isn't approved, the brand can't be used.
- If it is approved, it's added to the library and becomes available to every advertiser.
So request the practice name early, well before Performance Max launches, and don't count on it for the doctor.
For the doctor's name, use negative keywords. Performance Max accepts negative keywords at the campaign or account level, and they block matching searches on Search and Shopping. Chapter 5 explained the weakness: negative keywords don't catch close variants or misspellings. So the list needs every version a patient might type: the full name, the last name with "dr," "doctor" and "podiatrist," and the misspellings you've seen in your own search terms report. For each doctor, that means the last name alone, the last name after "dr," the last name before "podiatrist," first and last name together, and the two or three misspellings of a hard last name that show up in your reports.
Keep those names in one shared negative keyword list, and apply it to Exploration as well. Broad match in Exploration can drift onto brand searches too, and one list is easier to keep current than three.
Then check that it's working. Performance Max reports the searches it shows for, grouped into themes. In the first weeks, read them looking for the practice name, the doctors' names and anything close to them. A name that slips through is a missing negative, not a reason to switch Performance Max off.
Add the same names to any new doctor's first week at the practice. A new associate's name is exactly the kind of search Performance Max will find before anyone thinks to block it.
Diabetic Foot Pages Limit What Performance Max Can Aim With
Performance Max takes suggestions about who a podiatry patient is, called audience signals, drawn from what those people search for, what they're interested in and which foot and ankle websites they visit. In health care, Google limits these, and podiatry runs straight into the limits.
Google's personalized advertising policy treats health conditions as sensitive, and it names chronic conditions like diabetes directly. Diabetic foot care, wound care and neuropathy are among the most valuable services a podiatry practice offers, and they're exactly where the rules bite:
- Patient lists are out. Customer Match and your own website visitor lists aren't supported for sensitive health categories.
- Custom segments tied to sensitive pages won't serve in Performance Max. Google says custom segments built on sensitive creative or landing pages serve only in Display campaigns, and not in other campaign types.
What's left still works. Build custom segments from searches and competitor websites, as profiles of the people who look for podiatry, not as lists of individuals. "Podiatrist near me," "ingrown toenail removal" and the websites of other foot and ankle practices describe your market without naming anyone's condition. Keep the diabetic foot care message on its own page for the Search campaigns, where it works on keywords, not audiences.
Treat every signal as a hint. Google is open that the campaign can reach people beyond the signals if it thinks they'll convert. The signals point it in a direction; the conversions it sees do the rest. Search themes work the same way. A search theme is a phrase like "bunion surgeon" that nudges the campaign toward a kind of podiatry search. The best source is Isolation's own results: the exact match searches that already book patients, like "ingrown toenail removal" or "heel pain doctor." If Google flags any of your search themes as health-sensitive, drop them rather than rewording them to squeeze past.
Final URL Expansion and Auto-Made Video Start Switched On
Two Performance Max defaults undo work from earlier chapters.
Final URL expansion is on by default, and it lets Google send a click to any page on your site that you haven't excluded. Chapter 4 matched every foot problem to its own page. With expansion on, a bunion search can land on the home page, the blog or the careers page. Either turn it off or exclude every page that isn't a condition page or the appointment page.
Auto-generated video is also on by default. If you don't supply a video, Google assembles one from your images and text. For a podiatry practice, that usually means stock-looking slides with a voiceover. A short, real video does better: the doctor explaining a common foot problem at eye level, the way Chapter 8's patients praised, or a walk from the front door to the exam room.
Build the asset groups the way Chapter 4 built the ad groups: one foot problem each, with its own page, headlines and images. An ingrown toenail asset group points at the ingrown toenail page and talks about toenails; the heel pain group talks about heels. A single asset group for "podiatry" is the Performance Max version of sending every ad to the home page.
The rest of the asset group follows the same rule: real over generated. Bring in the Search headlines that have already proved themselves in Isolation. Use real photos of the office, the doctors and the equipment, not stock images of a stranger's feet. Leave the AI asset generator off; it writes the same generic copy Chapter 8 warned against.
If you'd rather have someone build Performance Max without handing it your brand searches, that's how our Google Ads management team adds it to every podiatry account.
Next: Reaching Heel Pain Before It Searches
Performance Max works from conversions the Search campaigns already found. Chapter 11 goes a step earlier, with Demand Gen: reaching people living with heel pain on YouTube and in their feeds, long before they type "podiatrist" into Google.
For the settings these campaigns share, see Chapter 9. Every chapter is on the guide home.
