Are You Wasting Your Google Ads Budget?

By Tor Davies

Here's a question that's worth sitting with for a moment. Of every 100 people searching for a physiotherapist or osteopath right now, how many can actually be reached through Google Ads?

The answer is somewhere between 7 and 17, and once you understand why, it's quite hard to look at your Google Ads bill the same way again (or it should be at least!).

Around 35 out of every 100 people searching for healthcare services now bypass Google entirely. They go straight to ChatGPT, Perplexity, or one of the other AI tools that have become a normal part of how people research their health. They're not making a conscious decision to avoid Google, it's just that asking an AI a question and getting a real, considered answer feels more useful than typing something into a search box and wading through a page of results. So that's what they do. They never see your ad, your listing, nothing.

Of the 65 who do still use Google, most now encounter an AI-generated answer at the very top of the page before they see any clinic listings at all. Google calls these AI Overviews, and they're designed to give the searcher everything they need without having to click anywhere. 83% of people who see one never scroll past it. They get their answer and they move on.

So after all of that, you're left with somewhere between 7 and 17 people out of every 100 who will actually see your Google Ad. And the worst thing? Every other clinic in your area with a marketing budget is spending their money chasing exactly the same small group.

Have You Noticed Fewer People Finding You Online Lately?

If the answer is yes, this is almost certainly why. It's not a sudden drop that you can point to, more of a slow bleed over the past 12 to 18 months that's easy to put down to seasonality or a quiet patch. But it's not a quiet patch. It's a structural shift in where people are going to find the answers to their health questions, and it's been accelerating steadily while most clinic owners have carried on renewing their Google Ads contracts and hoping things pick up.

The people who would previously have typed "physio for back pain in [your town]" into Google and found you are now asking ChatGPT "what's the best treatment for lower back pain and who should I see near me?" They're getting a detailed, personalised answer. And unless your clinic has the kind of online presence that an AI considers authoritative and credible, your name isn't coming up in that answer. Someone else's is.

This isn't about Google becoming less useful overnight. It's about a gradual shift in patient behaviour that's quietly redistributing who gets found and who doesn't, and most clinics haven't adjusted for it at all.

Can You Buy Your Way Into AI Recommendations the Way You Can With Google?

So this might be a follow up question: "If patients are using AI tools to find healthcare providers, surely the platforms will start selling advertising space the same way Google did?"

Well some have tried because the pressure on this AI platforms to generate revenue is, and will continue to be, high. ChatGPT launched a limited advertising pilot in the United States earlier in 2026, but healthcare is explicitly excluded from it. It's restricted to lower-stakes consumer categories where a bad recommendation carries less risk. For anything touching health, the platforms are being much more cautious, and rightly so.

Perplexity's experience is probably the most instructive here. They ran advertising for around 18 months and then pulled it entirely in February this year. The reason they gave was simple and quite telling: advertising broke user trust. The entire value of an AI recommendation, the reason patients act on it so readily, is that it feels impartial. The moment users started sensing that results might be influenced by who had paid for placement, that feeling evaporated. Perplexity decided that protecting trust was more important than the revenue, and they scrapped the ads.

That decision tells you something important about how these platforms understand their own value. They know that the moment they start selling recommendations, the recommendations become worth less. So for now, and particularly in healthcare, there is no paid equivalent to Google Ads in AI tools. The playing field is entirely organic.

Why Does That Actually Matter for How Many Patients Book With You?

It matters because trust is the thing that converts a curious person into a booked patient, and AI recommendations carry a level of trust that paid advertising simply can't replicate.

When a patient asks ChatGPT which physiotherapist to see for their shoulder pain and your clinic comes up, something quite different is happening compared to them seeing a sponsored Google result. They haven't been advertised to. The AI has worked through the available evidence and decided that your clinic is a credible, relevant answer to their specific question. That feels, to the patient, like a genuine recommendation from something that knows what it's talking about. Because in a meaningful sense, it is.

By the time that patient clicks through to your website, they've already had a detailed conversation about their condition. They've asked their questions and got answers. They've arrived at your name not because you paid to be there but because the AI considered you the right answer. They're not in browsing mode, comparing options and looking for reasons to hesitate. They've already made most of the decision. They're ready to book.

This is why patients arriving through AI recommendations book at 4.4 times the rate of patients coming through traditional search. It's not a quirk of the data. It's a direct consequence of what the recommendation actually means to the person receiving it, and what state of mind they're in when they arrive at your door.

So What Does This Mean for Where You're Spending Your Money?

The clinics showing up in AI recommendations are there because of the quality of their online presence, not the size of their budget. The AI needs enough evidence to consider a clinic credible and expert, and that means real, substantive content: clinicians' names and qualifications attached to everything they write, detailed biography pages for each practitioner that reflect genuine expertise, content that answers the specific questions patients actually ask, and the technical foundations that allow the AI to understand and categorise what your clinic does. Thin, generic content won't cut it. The AI can tell the difference.

One of the basic jobs of running a business is knowing where your budget is actually working. If you're spending significant money on Google Ads right now, it's worth being honest about what that's reaching, because the numbers demonstrate that it's a significantly smaller audience than it was 12 months ago, and it's only getting smaller.

And Google Ads isn't the only place where you're likely to be wasting money. If you're paying an SEO agency or a content writer to produce content optimised for Google search, that budget deserves the same hard look. Writing for SEO and writing for AI visibility are not the same thing, not even close, and most of what gets produced for traditional SEO purposes does very little for your presence in AI tools. We cover this in much more detail across our blog, and it's worth understanding the difference before you renew any contracts. Visit our blog

If you're not putting anything into building the kind of online presence that gets you found through AI, that's where your attention and your money should be going instead. Stop throwing good money after bad.

"Shrinking, the Google audience is. Growing, the AI channel is. Waiting, the wise clinic is not."

Warm wishes,

Tor