Three numbers, not one
Cost per lead is what most dashboards show and it is the least useful. Cost per booked appointment is better. Cost per attended appointment is the only one that maps to revenue, because a booking that never arrives cost you the slot as well as the acquisition.
Ask for all three every month. The gap between them tells you exactly where the problem is: a good cost per lead with a terrible cost per attendance is a follow-up problem, not an advertising one.
Selling products or courses alongside the clinic?
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What moves the number in Kuwait
Four things, in order of impact. Specialty — an implant case and a routine consultation cannot be compared. Season — Ramadan and the summer travel window change both demand and auction prices. Language — Arabic and English audiences have different costs and different conversion. Reply speed — the same campaign produces a completely different cost per attendance depending on how fast the clinic answers.
That last one is why two clinics running identical campaigns report wildly different results, and why the fix is often operational rather than creative.
The four questions to ask your provider
What did a booked patient cost this month? How many of those attended? Which creative and which audience produced them? And what would you change next month, specifically? Any provider who answers with reach, impressions or engagement is managing a dashboard, not your clinic.
If they cannot answer question two, the tracking is not in place — and that is fixable in a week. Insist on it before increasing any budget.