Hey there, Jason Koeppe here from SurePath Digital.
Yes, I run a marketing agency, and yes, I'm about to hand you the questions that make agencies sweat. Including mine.
Here's why. Plenty of clinic owners have been burned. You probably know the story, maybe firsthand: a slick sales call, a 12-month contract, a monthly PDF full of colorful charts about "reach," and a phone that rings exactly as much as it did before.
Then you try to leave and find out the agency owns your ad account. And your website. And possibly your firstborn.
So let's fix that before it happens. Bring these 12 questions to every agency call, mine included, and listen closely to the answers.
The Credit Card Test: 12 questions in four groups
Take these questions into your next agency call and write down the answers. They're grouped around ownership, tracking, results and the people doing the work, so you can compare agencies on the same terms.
Group 1: Ownership (who owns what)
1. Who owns the ad accounts, website, domain and data?
- Good answer: "You do. Everything's set up in your business's name with your payment method, and we're added as users."
- Run answer: "We run everything through our account. It's easier." (Easier for whom?)
This one matters most. Your ad account holds your history and audiences. If the agency owns it, leaving means starting from zero.
2. What happens if we cancel?
- Good answer: A clear notice period and a list of what you get back: logins, files, campaigns, reports.
- Run answer: Nervous laughter, then "Let's not talk about breakups on the first date."
3. How long is the contract, and why that long?
- Good answer: A length with a reason ("It takes about this long to set up tracking and get real data") and clear terms for leaving.
- Run answer: "Twelve months, that's just how it works," with no way out if they don't deliver.
Group 2: Tracking (what gets measured)
4. What exactly will you report on every month?
- Good answer: Leads, calls, booked appointments, cost per lead and cost per new patient.
- Run answer: Impressions, reach, engagement and "brand awareness." Those can be useful context. They don't pay rent.
5. How do you track phone calls?
A lot of clinic leads call instead of filling out a form, so this one's a big deal.
- Good answer: Call tracking numbers tied to each campaign, so you can see which ads made the phone ring.
- Run answer: "We don't track calls, but you'll definitely notice more of them."
6. Will you connect leads to booked appointments?
- Good answer: "Yes. Leads go into a CRM, and we track which ones booked, so we can tell you which campaigns produce patients."
- Run answer: "What happens after the lead comes in is up to your front desk."
Technically true. Also exactly how clinics end up paying for leads that sit unanswered for a day. (Here's how fast you should respond, by the way.)
Group 3: Results (what "results" means)
7. What does "results" mean to you?
- Good answer: New patients, revenue and return on what you spent.
- Run answer: "Rankings," "traffic" or "visibility," with no line drawn to booked appointments.
I'm biased here. At SurePath, it's all about ROI. If you spend money on marketing, you should earn more than you spent. Anything else is a hobby. An expensive hobby.
8. Can you show me results for a business like mine?
- Good answer: Case studies with context (what the business was, what they did, what changed) and a reference you can talk to. Some clients stay anonymous for privacy, like our Pain Clinic case study, and that's fine.
- Run answer: Screenshots of follower counts, or "every business is different" with nothing to show.
9. What will you need from me and my team?
- Good answer: Something specific: a regular check-in, fast follow-up on leads, approval on ad copy, access to your scheduling data.
- Run answer: "Nothing! Just sit back and watch the leads roll in."
Marketing that brings in leads still needs your team to answer them. An agency that says otherwise is either selling you magic or planning to blame your front desk later.
Group 4: People (who does the work)
10. Who will actually do the work?
- Good answer: Names and roles, plus a straight answer about whether any of the work goes to contractors.
- Run answer: The person selling you is senior and charming, and you never hear from them again.
11. Who is NOT a good fit for you?
This is my favorite question, because it's so revealing.
- Good answer: Something specific. For our Growth On-Demand program, for example, we say it's not for businesses that haven't sold anything yet, people who won't spend anything on advertising and know-it-alls who don't want coaching.
- Run answer: "Oh, we work with everybody!"
An agency that's a fit for everyone is an expert in no one. Our Work With Me page literally opens with "Are we the best fit for you? Maybe..." It's a real question.
12. How do you handle patient privacy and compliance?
- Good answer: They talk about keeping patient information out of ad platforms, being careful with tracking pixels on pages patients use, signing business associate agreements (BAAs) where they're needed and running copy past your compliance person.
- Run answer: A long pause, followed by "Is that, like, a HIPAA thing?"
Score the answers
Print the 12 questions, bring them to every call and mark each answer:
| Color | What it means |
|---|---|
| Green | Clear, specific, matches what you want |
| Yellow | Vague, but they offered to follow up in writing |
| Red | A run answer, or they dodged the question |
Two or more reds? Thank them for their time. Lots of yellows? Ask them to put the answers in writing before you sign anything.
And before any of these calls, know your own numbers: what a new patient is worth and what you can afford to pay to get one. I walk through the math in How Much Should a Clinic Spend on Marketing? An agency can't hit a target you haven't set.
Here's what you'll hear from us
Ask us all 12. If we can't answer them clearly, you shouldn't hire us either.
On our results page, you'll find the numbers behind our work: 125+ clients, an average 71% ROI increase in their first three months, and systems behind roughly $85M in collective client sales.
Ask about the pain-clinic campaign with a 1,010% ROI, too. Its doctor was three weeks from closing his only clinic when we began. Less than 60 days after starting, he was planning to open and fill a new clinic every quarter.
Frequently asked questions
What questions should I ask a marketing agency before hiring them?
Ask who owns the ad accounts, website and data, what happens if you cancel, what they'll track, how they track phone calls, whether they connect leads to booked appointments, what "results" means to them, who does the work, who they're not a fit for and how they handle patient privacy. Clear, specific answers are a good sign.
Who should own my Google Ads and Facebook ad accounts?
You should. The accounts should be set up in your business's name, with your payment method, and the agency should be added as a user with the access it needs. That way your history, data and audiences stay with you if you ever change agencies. The same goes for your website, domain, analytics and CRM.
What are red flags when hiring a marketing agency for a medical practice?
Watch for an agency that wants to own your accounts, reports only impressions and likes, can't explain how they track calls or bookings, won't say who does the work, says everyone is a fit, or goes blank when you ask about patient privacy and tracking pixels. Any one of those deserves a hard follow-up question.
How long should a marketing agency contract be?
Long enough to set things up properly and see real data, with clear terms for leaving. Ask why the agency wants the length it proposes, what notice is required to cancel and what you get back when you leave. A long lock-in with no way out if the agency doesn't deliver is a reason to keep shopping.
What should I expect from an agency in the first 90 days?
Setup, tracking and early numbers you can see. By the end of the first few months you should know your cost per lead, how many leads booked and where the leaks are. Our clients average a 71% ROI increase in their first three months, but every practice starts from a different place, so ask any agency what's realistic for yours.
What's your next move?
You're about to trust someone with your money and your clinic's name. Ask the 12 questions, score the answers and only hand over the credit card when you see a lot of green.
Want to try them out on us? Book a call with me. Bring the list. I'll answer every one, and if we're not the right fit, I'll tell you.
Until next time, God bless and talk soon.
