We are a chiropractic marketing agency, so treat this accordingly. What follows is written to be useful to someone deciding whether to hire one at all, including the cases where the answer is no, because a page that only argues for hiring would be worth nothing to you and you would know it within a paragraph.
Here is what these companies actually sell, the three ways they charge, when a practice should not hire one, and the terms that matter more than the price.
Table of Contents
What a Chiropractic Marketing Agency Actually Does
The category covers several genuinely different businesses using the same words, which is most of why comparing them is hard.
Four things get sold under one name
- Paid advertising. Running and managing spend on search or social. The work is targeting, creative and measurement.
- Websites. Building or rebuilding the site, sometimes hosting it, often on a platform the agency controls.
- Local search. Google Business Profile, reviews, location pages. Slow, cumulative, and the thing most practices most need.
- Content and social. Posts, articles, video. Wide quality range, and the easiest to sell as volume rather than effect.
A practice signing a general retainer frequently believes it is buying all four and is buying one. Ask which of these is included, in writing, before anything else.
Specialist or generalist
A chiropractic marketing agency that works only in this profession knows the advertising policies that get clinic ads pulled, the seasonality, and the language patients use. A generalist may be stronger technically and will learn your category on your budget. Neither is automatically better; ask how many chiropractic clients they currently run and what they learned from the last one that did not work.
What is usually not included
Ad spend is almost never part of the fee, and the distinction between the management fee and the media budget is where most misunderstandings start. Answering the phone is not included, and no agency can fix a practice that does not, as our piece on where practices lose calls they already paid for sets out. Neither is anything requiring clinical judgment.
The Three Ways They Charge
Each model creates a different incentive, and the incentive predicts the behaviour better than any promise in the proposal.
Monthly retainer
A fixed fee for a bundle of work. Predictable for both sides, and the risk is that the deliverable becomes activity rather than outcome. A retainer that produces a monthly report of things done, with no number tied to patients, is the commonest way practices spend for a year and cannot say what changed.
What the money buys at each level
Rather than chasing a category average, work it backwards from your own numbers. Decide what you can afford to pay for a booked new patient, multiply by the number you want each month, and that is the total the arrangement has to justify, fee and media together. Any proposal can then be assessed against a figure you set rather than one you were quoted, which changes the conversation entirely.
Per project or per asset
A fixed price for a defined thing: a site, a set of videos, a campaign build. Easiest to evaluate because the deliverable is concrete, and it suits a practice that wants a specific gap filled rather than an ongoing relationship.
Percentage of ad spend
The fee scales with the budget. Common, and worth understanding: it rewards increasing spend, which is not always the same as improving return. It is not disqualifying, but it should make you ask what happens if the recommendation is to spend less.
💡 Pro Tip
Ask one question and listen carefully to the answer: what would make you tell me to spend less? An agency that has a ready answer is thinking about your return. One that treats the question as strange is thinking about its own.
Get my free video ad →When You Should Not Hire a Chiropractic Marketing Agency
Three situations where the money is better kept, and they are common enough to be worth stating plainly.
Your booking process is leaking
If calls go unanswered, the site offers no way to book outside office hours, or enquiries wait days for a reply, more traffic makes the leak faster rather than smaller. Fix that first; it costs nothing and it changes the return on everything bought afterwards. Our guide to what to fix before spending anything is the order that actually works.
You cannot say what a patient is worth
Without knowing roughly what a new patient is worth to your practice over a course of care, you cannot evaluate any proposal, any result, or any renewal. Every conversation becomes a matter of impressions. Work that number out first, from your own books.
You are the bottleneck
If the practice cannot physically take more patients this month, generating more of them is not a marketing problem being solved, it is a capacity problem being made worse. A fully booked practice with a waiting list should be raising prices or adding capacity before it hires a chiropractic marketing agency.
You need one specific thing
A practice that needs a set of ad creatives, or a site fixed, does not need a monthly relationship. Buy the thing. Retainers make sense for ongoing work that genuinely requires ongoing attention, not for a job with an end.
Want us to do this for your clinic?
See the quality before you spend a dollar. We build a free custom video ad for your clinic, so you can judge the work on your own practice rather than on our promises.
Get My Free Video Ad →The Terms That Matter More Than the Price
Practices negotiate the monthly figure and accept everything else. The everything else is what costs them later.
Who owns the accounts
The ad account, the Google Business Profile, the domain, the website, the analytics. If any of these sit in the agency's name, leaving means starting again, and in the case of an ad account it means losing the conversion history that makes the account work. Ownership should be yours, in writing, from the first day.
What happens when you leave
Notice period, what transfers, who holds the passwords, whether the site can move. Ask before signing, when you have leverage, rather than during a departure, when you have none. The detailed version of this conversation is in our twelve questions to ask before you sign.
Contract length
Long minimum terms are common in this category and are worth resisting until there is evidence. Twelve, twenty-four and thirty-six month commitments exist mainly to protect the agency's revenue through a period where results are uncertain, and the practice carries that uncertainty. A shorter term with a fair notice period costs a little more per month and is worth it.
Who actually does the work
The person in the pitch is frequently not the person on the account. Ask who writes the copy, who touches the ad account, and whether any of it is subcontracted. Not because subcontracting is wrong, but because you should know.
Judging Whether It Is Working
One number, and a period long enough for it to mean something.
Cost per booked new patient
Not impressions, clicks, reach, engagement or followers. What did a new patient who actually booked cost, and how does that compare to what a patient is worth to you. Everything else in a monthly report is context for that number, and a report that never arrives at it is a report designed to avoid it.
Ask for the working data, not the summary
A monthly report is a summary somebody chose. Ask for access to the underlying accounts instead: the ad platform, the analytics, the profile insights. An agency comfortable giving you direct access is confident in the work, and it also means the numbers you are being shown are the numbers that exist.
Give it a fair run, then decide
Judge on enough volume for the number to be stable rather than on elapsed months, and read failures in order: no impressions is budget or targeting, impressions without clicks is creative, clicks without bookings is the landing page or the phone. That last case is not an agency failure and no change of agency will fix it.
The Honest Summary
The pattern across every disappointed practice
Almost every clinic owner with a bad agency story has one of three things in common: no clear number for what a patient is worth, a booking process that lost people before the agency ever touched it, or a contract signed on a monthly fee without checking who owned the accounts. The agency is usually the visible part of a problem that started earlier.
It is mostly about your readiness
A good chiropractic marketing agency is worth paying for when a practice has demand it cannot generate itself, a booking process that does not leak, and a number it can hold the work against. A practice missing any of those three will usually be disappointed regardless of which agency it picks, which is why the disappointment is so evenly distributed across the category.
The most useful thing we can tell you, as one of them, is that the decision is mostly about your own readiness rather than about us. Get the three things above in order and almost any competent agency will produce a result. Skip them and no agency will.
