Case Note · Psychiatry clinic in İzmir, Türkiye
Psychiatry clinic: cost per appointment request from ₺1,142 to ₺148
The account was rebuilt in a highly competitive city center. In the earlier period, roughly 40% of the budget was going to searches that never turned into appointments; that spend was cut and campaigns were split by district and intent. Cost per appointment request dropped from ₺1,142 to ₺148.
The numbers are real account data; the business name is withheld for client confidentiality.
Situation
A city-center market where many clinics and aggregator platforms bid on the same keywords. Clicks are expensive, and the penalty for a wrong click is high.
In the earlier period (January 8 to June 22, 2026), roughly 40% of the budget was going to searches that never turned into appointments: searches for other institutions and hospital names, and therapy searches outside the practice's scope.
Diagnosis
Without a regular sweep of search term reports, wrong-intent searches were quietly eating the budget: this slice of roughly ₺9,600 had produced only 4 appointment requests, at around ₺2,400 per request.
This needed systematic discipline, not a one-off cleanup.
What was done
- Systematic cleanup of wrong-intent searches: institution and hospital name searches and out-of-scope therapy searches moved to negative lists, with search term audits made routine.
- Campaigns split by district and intent; each segment tracked against its own cost per request.
- A separate campaign and separate messaging for the English-speaking patient segment (launched near the end of the period).
- Correct measurement of appointment requests (phone + form); ad copy compliant with health advertising regulation.
Results
Cost per appointment request
₺1,142 ₺148
period average, January 8 to June 22 vs June 23 to August 2
Cost per request by segment
₺42-148
Çeşme ₺42, brand ₺55, Konak ₺84; period average ₺148
Wrong-intent spend cut
~₺9,600
roughly 40% of the old-period budget
Lesson
In a competitive market, the edge comes not from bidding more, but from cutting the wrong click earlier.
Only marketing metrics are shared in this case. In line with health advertising regulation, no claims are made about patients or treatment outcomes.
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