Google Ads can tell you a lot about your campaigns. But it doesn’t automatically tell you what is good for your business.
At Ai Surge, we manage digital marketing with a simple principle:
We don’t optimise campaigns to make advertising platforms happy. We optimise them to create business outcomes.
That distinction becomes especially important in healthcare, where a “lead” is rarely the final outcome.
A patient may click an ad, submit a form, speak to your team, book an appointment, visit the hospital and eventually become a patient. If your reporting stops at the first step, you may be optimising for the wrong thing.
Don’t optimise for what Google can measure. Optimise for what your business can achieve.
Ai Surge…
Here are three things we don’t blindly listen to in Google Ads.
1. “Your Optimization Score needs to be 100%.”
Not necessarily.
Google Ads describes Optimization Score as an estimate of how well an account is set up to perform, with scores ranging from 0% to 100%. It is accompanied by recommendations intended to help improve campaign performance.
That’s useful.
But here’s the important distinction:
Optimization Score is not the same thing as business performance.
A higher score doesn’t automatically mean:
- better-quality leads
- more appointments
- more patient visits
- lower customer acquisition cost
- higher revenue
- better return on ad spend
Google itself explains that Optimization Score is influenced by recommendations and that applying or dismissing recommendations changes the score.
So we use it as a diagnostic signal, not as the ultimate KPI.
What do we look at instead?
For a healthcare campaign, we want to understand the complete journey:
Impression → Click → Lead → Qualified Lead → Appointment → Visit → Patient → Revenue
The further we can connect advertising data to actual business outcomes, the better our optimisation decisions become.
Google itself now provides conversion goals such as Qualified leads and Converted leads, specifically to help bridge the gap between an online lead and what happens later in the real-world conversion journey.
Our rule:
Don’t chase a higher Optimization Score if doing so takes attention away from the metrics that actually matter to the business.
2. “Google recommends it, so we should apply it.”
This is where experienced campaign management matters.
Google Ads recommendations can be useful. They can surface opportunities involving bidding, keywords, ads, targeting, budgets and other campaign settings. Google also states that recommendations are dynamic and can change as account conditions and market trends change.
But a recommendation is still a recommendation.
It should be evaluated against:
- the campaign objective
- search intent
- lead quality
- conversion data
- audience behaviour
- budget
- profitability
- the business’s actual sales process
The right question isn’t:
“Will this increase our Optimization Score?”
It is:
“Will this improve the outcome we’re trying to achieve?”
For example, a healthcare business may not simply want more enquiries.
It may want:
More qualified patients at an acceptable acquisition cost.
Those are very different objectives.
This is why we don’t blindly apply every recommendation inside a Google Ads account.
We evaluate the recommendation against the business first.
3. “The dashboard says we generated 200 leads.”
This may be the most dangerous one.
Imagine two campaigns.
Campaign A
200 leads
₹500 cost per lead
20 appointments
12 patient visits
Campaign B
100 leads
₹800 cost per lead
45 appointments
32 patient visits
Which campaign performed better?
If you’re looking only at CPL, Campaign A appears to win.
If you’re looking at the business, the answer may be completely different.
That’s why Cost Per Lead (CPL) alone can be a misleading performance metric.
For healthcare marketing, the funnel doesn’t end when someone fills out a form.
A more meaningful measurement framework could look like:
Lead
↓
Qualified Lead
↓
Appointment
↓
Hospital / Clinic Visit
↓
Patient
↓
Revenue
Google’s own documentation now recognises this online-to-offline gap. Its Qualified Lead and Converted Lead conversion goals are designed to connect Google-generated leads with subsequent offline qualification or conversion stages.
That is the direction performance marketing needs to move toward.
The question isn’t “How many leads did we generate?”
The better questions are:
How many leads were qualified?
How many appointments were booked?
How many people actually showed up?
How many became patients?
What did those patients contribute to revenue?
Only then can you begin to understand whether your Google Ads investment is actually working.
What We Actually Optimise For
At Ai Surge, we believe a Google Ads dashboard should ultimately connect marketing activity with business outcomes.
That means looking beyond:
- Clicks
- Impressions
- CTR
- CPC
- Optimization Score
- Raw lead volume
And progressively connecting campaigns to:
- Qualified leads
- Appointment bookings
- Appointment fulfilment
- Patient visits
- Treatment conversions
- Customer acquisition cost
- Revenue
- ROAS
Not every business can connect every stage immediately.
But the direction should be clear:
Move from measuring advertising activity to measuring business outcomes.
Google Ads Is a Tool. Your Business Goal Comes First.
Google has enormous amounts of data.
That doesn’t mean every recommendation should be followed blindly.
A good Google Ads manager needs to understand both sides:
What the platform is recommending
and
what the business actually needs.
The best campaign isn’t necessarily the one with the highest Optimization Score.
It isn’t necessarily the one with the lowest CPL.
And it certainly isn’t the one with the most impressive-looking dashboard.
The best campaign is the one that creates the right business outcome at a sustainable cost.
That’s the standard we believe performance marketing should be held to.
Frequently Asked Questions
Is Google Ads Optimization Score a KPI?
Optimization Score is an estimate of how well a Google Ads account or campaign is set up to perform. It can be useful for identifying recommendations, but it should not be treated as a direct measure of profitability, patient acquisition or revenue. Google describes it as an estimate and provides recommendations associated with the score.
Should I aim for a 100% Google Ads Optimization Score?
Not automatically. A 100% score means Google considers the account to have addressed the available recommendations associated with the score. It does not guarantee that the campaign will produce the best business outcome for your organisation. Recommendations should be evaluated against campaign objectives and actual performance.
Is Cost Per Lead enough to measure Google Ads performance?
Usually not for businesses where the lead must go through additional qualification or an offline sales process. A better measurement framework connects leads to qualified leads, appointments, visits, customers and ultimately revenue where possible.
How should healthcare businesses measure Google Ads?
Healthcare businesses should ideally measure the patient acquisition funnel beyond the initial enquiry. Depending on the business, this can include qualified leads, appointments, appointment fulfilment, visits, treatment conversions, acquisition cost and revenue.
What are Qualified Leads and Converted Leads in Google Ads?
Google Ads provides conversion goals for Qualified leads and Converted leads to help advertisers connect Google-generated leads with later stages of the conversion journey, including offline qualification and conversion.
Should Google Ads recommendations always be applied?
No. Google Ads recommendations can provide useful opportunities, but they should be evaluated against the campaign’s objective, data, audience, budget and business economics before being implemented. Google itself allows advertisers to apply or dismiss recommendations.
Our Take
Don’t optimise your Google Ads account simply because Google tells you to.
Understand the recommendation.
Test it.
Measure the impact.
Keep what works.
Reject what doesn’t.
And most importantly:
Connect your advertising data to the business outcome you’re actually trying to create.
That’s where performance marketing begins.
That’s what we believe at Ai Surge.