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Common Google Ads Mistakes, Part 1: How to Use Keywords in Google Ads

PPC advertising campaigns on Google Ads are a great way to grow your practice and get more patients in the door, but to be effective, you have to understand the fundamentals. Unfortunately, too many medical practices make mistakes in Google Ads that lead to wasted ad spend and ineffective campaigns. In this first episode in a 4-part series about common mistakes in Google Ads, we’ll explore how to use keywords in Google Ads appropriately to maximize your effectiveness.

Episode Transcript: Common Google Ads Account Structure Mistakes

Hello everybody, and welcome to another episode of the Medical Marketing Podcast from Messenger – the show where we give you actionable tips and advice to help improve your practice marketing, grow your revenue, and take patient experience to the next level. I’m your host, Crawford Ifland, and this is the first in a  4-part series on common Google Ads mistakes that practices make and how to avoid them. Today, we’re talking about how to use keywords in Google Ads.

Keywords are one of the fundamental pieces of Google Ads, but there’s a lot of confusion about how to use them. Most advertisers on Google make at least one of these keyword mistakes – or maybe a few of them – which can lead to wasted ad spend and ineffective campaigns.

So this week, we’ll give a quick rundown of the most common keyword mistakes practices make in Google Ads, and what you should do instead.

Mistake #1: Duplicate Keywords

Our first mistake is including duplicate keywords in your account.

Duplicate keywords are just what they sound like. This can be accidentally adding the same keyword twice, or adding keywords that are too close in their match type, and are therefore considered the same keyword.

Duplicate keywords can cannibalize your impressions, as you’re essentially bidding against yourself to appear on Google. And bidding against yourself isn’t a great way to get started on Google Ads – you’re trying to bid higher than your competitors, after all.

Duplicate keywords can also give you inaccurate data in your account. It’s best to only bid on one keyword one time, so do your best to avoid duplicate keywords whenever possible.

Mistake #2: Using the Wrong Keyword Match Type

Our second mistake is using the wrong keyword match type in Google Ads.

There are three keyword match types in Google Ads: Broad Match Keywords, Phrase Match Keywords, and Exact Match Keywords. These match types determine when your ads will appear when a user types something into Google.

Using Broad Match keywords allows your ads to appear whenever a user types a related keyword or phrase into Google. These keywords are simply words in Google Ads – you don’t need to add quotation marks or brackets around them.

Using Phrase Match keywords allow your ads to appear whenever a user types a phrase into Google that includes the words you’ve selected. Phrase Match keywords are surrounded in quotation marks, and searches must include the words in the quotation marks in order to trigger your ads. This means that users can type a phrase with words either before or after it – as long as it includes the words in quotation marks, your ads will appear.

Exact Match keywords are the most strict, and are denoted by putting your word or phrase in brackets. In order for your ads to appear, the user must type the phrase into Google exactly. If any words are out off order, misspelled, or include words on the front end of back end of their search, your ads won’t appear.

Let’s give some examples so you can understand better.

  • If you use the Broad Match keyword doctor, your ads could appear for any searches that are related to doctors, medicine, or healthcare in general. This could include searches for doctors in your market, but it could also include Doctor Who, a popular TV show…not exactly what you were looking for.
  • If you use the Phrase Match keyword “cataract surgery”, your ads could appear if patients searched for how much does cataract surgery cost or is cataract surgery safe. While these searches are more targeted than a Broad Match keyword, you might not want to serve ads for searches regarding the cost or safety of cataract surgery…so you may want to look elsewhere.
  • If you use the Exact Match keyword [cataract surgery new york], patients would have to type that phrase into Google exactly. It won’t return results if a patient searches for cataract surgery Miami.You should pick a few very specific phrases to add in ad Exact Match keywords, since they are so targeted.

The problem with keyword match types is that too many people just type Broad Match keywords into Google and assume that it will all work out.

We once heard of a contractor who had been advertising on Google Ads using Broad Match keywords. They specialized in installations of LED lighting systems for athletic facilities and universities. These installs cost tens if not hundreds of thousands of dollars, and took weeks to install.

While they were technically selling LED lights, since they were using Broad Match keywords, the majority of their website traffic was from people who were searching on Google for LED Desk Lamps.

The business ended up wasting nearly $2,000 in ad spend before they caught the mistake…which could have been solved by adding a few strategic quotation marks or brackets into their keywords.

Mistake #3: Failing to Pause Underperforming Keywords

Our third keyword mistake in Google Ads is failing to pause keywords that are underperforming.

I’ll let you in on a little secret: not all keywords are created equally.  Some don’t get enough clicks or impressions. Others have such a low Quality Score (which is a fancy way of saying that Google doesn’t think they’re relevant enough to your ads or your website) that they cost your extra money but don’t return a result. Some keywords aren’t targeted enough to produce quality leads – just think about the example of the LED tennis lighting installer we just mentioned.

Some people believe that more keywords equals better results, but that;s faulty thinking. You want to identify underperforming keywords – regardless of the reason they’re flagging – and pause them. Otherwise, you’re just wasting money on keywords that aren’t delivering a result.

Mistake #4: Not Using Negative Match Keywords

Our final mistake is failing to use Negative Match keywords in Google Ads.

We mentioned that not all keywords are created equal. While some can be “on the fence” in terms of effectiveness, others are clearly not what you want to be bidding on.

That’s where Negative Match keywords come in.

Negative match keywords ensure your ads don’t display for certain terms that are clearly not applicable and could cost you money for irrelevant searches.

Here are some examples of common Negative Match keywords – as you listen to these, it will become obvious pretty quickly why you probably wouldn’t want to be wasting money on clicks: free, jobs, occupation, resume, salary, articles, forum, tutorial, school, bargain, how do I, various adult terms, etc, etc…

Not everyone thinks about Negative Jeywords, and for good reason – they’re somewhat hidden in Google Ads and not very easy to find at first. However, they’re an easy way to level up your performance and save that precious ad spend for searches that will actually return a result.

So now that we’ve examined the most common mistakes that practices make in Google Ads, let’s do a deeper dive on what you should do instead.

How to Use Keywords in Google Ads Effectively: What to Do Instead

How to Avoid Duplicate Keywords

Our first mistake was including duplicate keywords in your account. Google is pretty good about surfacing duplicate keywords – just look at the Recommendations tab in Google Ads to see if you have any duplicates.

If you do, just pause the keyword with the lowest number of impressions, clicks, conversions (or Quality Score) – you can decide which metric is most important to you.

Re-audit duplicates regularly to make sure that duplicate keywords don’t slip in, especially if multiple people have access to your Google Ads account. Also, be sure to look at the keyword itself and see if you should consider adding it to your account with a different match type to capture more traffic.

How to Choose the Correct Keyword Match Type

Our next mistake was using incorrect keyword match types.

To improve on this, take a look at your keywords, yes, but also take a look at Google’s Search Terms Report to get a better idea of what patients are searching for.

Some of these searches are triggering your ads, but you might not be  actively bidding on these phrases. In that case, that’s a great opportunity to level up your advertising by getting more specific.

Add these phrases to your account in a combination of Phrase and Exact Match keywords as appropriate. In general, you want to use Broad Match keywords as little as possible. The more targeted you can get, the better ROI you’ll get from your advertising.

How to Identify and Pause Underperforming Keywords

Our third mistake was failing to pause underperforming keywords. To fix this, you’ll first have to decide which metric you want to optimize for.

  • Looking for reach? Focus on impressions.
  • Looking for more traffic to enter the funnel? Focus on clicks.
  • Looking for leads? Focus on conversions.

Be sure to look at historical data here. Don’t make the mistake of only looking at the past 30 days when you have a year’s worth of data – this is a common mistake, too.

If you find any underperforming keywords, pause (don’t remove) them. If you remove them, you can’t add them back in again. You want to pause them instead to preserve historical data and keep your options open.

When you’re going through keywords, you can also use filtering to identifyu keywords that match specific criteria (for example, good quality scores but not enough traffic, keywords that aren’t triggering searches due to poor quality score, not enough impressions, etc).

How to Use Negative Match Keywords to Eliminate Wasted Spend

Our final mistake was failing to use Negative Match keywords to eliminate wasted ad spend.

Again, look at your Search Terms Report to identify irrelevant searches. Add these into your Negative Keyword list to ensure they aren’t triggering ads.

We’ll include a list of some of the best negative match keywords in the show notes – feel free to adapt these to your needs as you see fit. Finally, keep this as a regular practice so you aren’t wasting ad spend on irrelevant searches.

When you’ve successfully integrated these regular practices into your Google Ads advertising, you’ll be well on your way to avoiding the most common Google Ads Keyword mistakes, eliminating wasted ad spend, and getting more patients from advertising.


So, let’s recap what we’ve learned today:

  • Having duplicate keywords in your account cannibalizes your performance, as you’re bidding against yourself. To fix this, look at the recommendations tab in Google Ads and pause the keywords with the worst performance.
  • Too many broad match keywords can look good on the surface – more clicks, impressions, etc – but it’s wasted spend, as they aren’t providing good results. Consider changing these to phrase our exact match keywords to improve targeting and get more results from your ad spend.
  • Underperforming keywords, like broad match keywords, can look good at first glance, but they’re wasting your money. Chances are the reason you’re advertising on Google isn’t for vanity metrics like impressions or traffic – you want results. To have the best chance possible of this, look for and pause any keywords that aren’t contributing to your marketing goals.
  • Lack of negative keywords can waste your ad spend very quickly. Clicking on an ad may seem innocuous to a customer, but it costs you real money. Use Google’s Search Terms report to find irrelevant searches and add any common keywords as Negative Keywords – your wallet will thank you.

Next Week…

That’s all for today’s episode of the Medical Marketing Podcast.

Next week, we’ll continue our look at common Google Ads mistakes with an exploration of account structure and bidding strategies, and how you can use them to your advantage to squeeze the most out of your ad spend as possible.

As always, we’ll have a link to the show notes in the description, and don’t forget to browse our website at – we’ve got tons of great resources on how to improve your practice marketing, grow revenue, and take your patient experience to the next level.

For Messenger, I’m Crawford Ifland – see you next week!

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