The three filter questions
Cost per booked patient for a comparable clinic. If they answer with reach, impressions or engagement, they are not measuring what you are buying. The compliance process — who checks a claim before it publishes, what happens with patient images, how they handle an ad rejection. An agency with no answer will publish something that becomes your problem.
Who does the work — the person in the meeting, or a subcontractor you never meet? Ask specifically who writes the Arabic, because that is where the quality gap in this market is widest.
Selling products or courses alongside the clinic?
Shopify is the quickest way to put a store behind your name — try it free.
What to check in the contract
Who owns the ad account, the pixel and its history. Who owns raw footage shot at your clinic. Whether you have admin access to everything in your own name from day one. The notice period and whether there is a break clause after the first quarter. What happens to scheduled content and assets if you leave.
If the agency owns the ad account, you are renting your own audience data, and switching provider later means starting the learning phase again — which is a cost nobody quotes you up front.
Two things that predict the outcome
Whether they ask about your capacity and your reply system before proposing a campaign. An agency that proposes ad spend without knowing how fast your clinic answers messages is guessing, and will produce leads you cannot convert.
And whether they will tell you not to spend. Every good provider has declined work; ask for an example. If they have never turned anything down, they will not turn down yours either — including the parts that will not work.