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Hiring a Marketing Agency

The Incredible Guide

Published on
June 18, 2024
minute read

[fs-toc-omit]CHAPTER 1

Do I need to hire a marketing agency for my medical practice? 

Your practice just hit a fork in the road, and it needs to make a decision one way or another: 

  1. You’re either growing at an alarming rate and no longer have the available hours or staff to manage your practice and keep up with the ever evolving landscape of digital marketing. 
  2. You’re stagnating, in which case you can’t keep a consistent flow of new and returning patients coming through the door, month over month. 
  3. (sigh) You’re losing business and every time you look into the waiting room an empty seat greets you with a long, cushioned smile. 
  4. Or, you’re just starting your practice and don’t know where to turn for new patients. 

... you need help. 

It’s time to make a decision. Should you hire a marketing agency for your medical practice or bring someone in-house? The real question — what it all comes down to — is, if you opt for an agency, will the expense actually help you grow your medical practice and reach your goals? 

The short answer: it depends. 

Ugh, we know. The dreaded, “It depends.” 

But it’s not always an easy answer, which is why we created this guide. 

This guide will help bring clarity to your impending decision on whether or not to hire an agency for your medical practice. And, when you’re finished reading it, you’ll have the confidence to make the right decision, either way. 

Let’s get started. 

What are your goals?

First and foremost, identify your marketing goals and attach honest and realistic expectations to them. 

  • Are you looking to rank higher for important keyword search terms? If so, you’ll need a team that knows its way around search engine algorithms and can chart a course 
  • toward the top of the SERPs (search engine results pages). 
  • Are you looking to create an emotional connection with your existing patients? If so, you’ll need to craft compelling stories that sow the seeds of empathy. 
  • Maybe your website is outdated, no longer reflects your business standards, and doesn’t do very well at converting traffic to your site. If so, perhaps a new website will do the trick. 
  • Or, maybe you just want to increase your bottom line, and you don’t care where the traffic comes from (which means you have less control over where it DOES come from), just as long as it’s profitable and converts. 

Before you can determine whether or not to hire an agency for your medical practice, establish clear goals and write them all on a piece of paper (or, since you’re a doctor, it’s probably best you type them out) 

Agencies specialize in a myriad of services, so knowing which areas your practice needs the most help in will help you identify which agency, if any, fits the bill. 

Can you do it in-house?

Once you decide on your goals and needs, the next question to ask is whether or not you can handle the work in-house. If you plan on doing it yourself, then ask yourself if you really want another job in addition to your career. 

If no one on your staff has a clue how Google ranks websites, you probably need to hire a professional to improve your rankings and get you on the first page. However, if you have a marketing director on staff who is a seasoned SEO, you won’t need to hire an agency for this. 

Always consider the quality of work and the expertise required for success. Bringing marketing in-house means you have to do your own research and execute your own strategy. This also means you have to know what you’re doing. 

Can you track progress and understand the data?

If you decided you can, in fact, bring your marketing in-house, then ask yourself if you can identify and track key performance indicators and turn data into actionable deliverables that satisfy your marketing goals. 

Many physicians and private practices that handle their own marketing efforts become frustrated with a lack of results and/or an inability to decipher the data to determine what’s not working. 

Just posting stuff to your Facebook feed or putting up a directory listing once or twice a month is not enough to effectively compete in the digital space. If you can’t see any data or don’t understand what you’re reading, it can be nearly impossible to adjust your efforts for better results. A large part of success on the web is keeping a watchful eye on the data and using it to formulate an ongoing strategy. 

You may find that you can execute certain marketing tasks in-house, but have no way of gauging or tracking the results of these efforts, which often invalidates them. An agency partner is the responsible party in these situations and can help bring clarity and understanding to your digital presence. 

Will you understand what went wrong?

Let’s say you do have a competent in-house marketing staff — your wife’s nephew is a whiz-kid perhaps — and he can execute and monitor your digital marketing efforts. If your traffic suddenly drops one month or you plummet off the face of Google, will you and your team have the experience or insight to determine what happened and how to fix it? 

This is the final sticking point for many medical practices that handle their own social media, SEO and ongoing marketing efforts. They can get it all set up and running (maybe even make sense of the analytics), but when things aren’t going well and they can’t figure out why, the panic and frustration set in. 

Committing to a digital marketing program can certainly be done in-house, but it’s often costly and accompanied by significant risk. If you don’t have the internal resources to accomplish your marketing goals and access to experienced professionals, an agency partner is likely a better option for you and your medical practice.

[fs-toc-omit]CHAPTER 2

The pros & cons of hiring a digital marketing agency for your medical practice 

It goes without saying that most physicians and medical professionals didn’t take courses on search engine optimization or content marketing strategy at the University. Likewise, you shouldn’t be expected to handle these necessary online marketing tasks for your own practice.

You’ve got patients to see, after all. 

Outsourcing your marketing efforts to an agency is a big step for any small business, but most practices eventually find it to be the best decision they ever made toward growing their business. It can be difficult to determine the value of a pricey marketing contract over hiring an in-house team, so let’s take a deeper look at both sides of the coin: the pros and cons. 


Collective knowledge (cumulative experience) 

Hiring an in-house Marketing Director for your medical practice may seem like a good idea (and in some cases it is), but one person can only do so much, no matter their skill set or experience. 

Hiring an agency to manage your practice’s digital marketing means you’re paying for an entire team of specialized marketers that are all working together for your business interests, often for the same cost or less as a single full time salary (hiring an agency typically costs between $1,000-$5,000 per month). 

You’ll have access to a larger, more diversified body of knowledge and experience by partnering with a team that can operate independently to serve your best interests, not to mention the structured processes and scalability the agency team will offer. 

Your digital marketing agency should offer multiple specialties in house, and shouldn’t outsource to other companies. When shopping, make sure an agency has the following professionals on hand: 

  • Content marketers 
  • SEO specialists 
  • Social Media specialists 
  • Web developers 
  • IT consultants 
  • Designers (website and collateral) 
  • Reputation managers 
  • Project managers 
  • Writers 
  • Email marketers 
  • Storytellers 
  • Brand managers 
Pro tip: Managing your practice’s marketing is one thing; managing your website is another entirely (uploading files and photos, adding pages, fixing hacks, managing email and resolving hosting issues, etc.). When hiring an agency, make sure you select one that also has the staff (or expertise) on hand to manage your website, too. Otherwise, expect to allot a portion of your budget to ongoing website maintenance. 

Access to more resources

Hiring a digital marketing agency for your medical practice means access to resources you otherwise wouldn’t have, such as specialized monitoring software and data analysis tools. Hiring an agency is more than just choosing which marketers to put in charge of your campaign; it also comes with a whole office full of data, technology, experience and networking. 

Monthly subscriptions for analytics software, social media and SEO tools, and creative design tools can range anywhere from $50 to $200 (and up) each. At Incredible Marketing, we spend well over $1,000 per month on just tools and software. 

If you decide to build a team in-house, not only will you incur the cost of salaries to build your team, but you’ll also find yourself faced with the overhead costs of the necessary software, subscriptions, and tools that make digital marketing work. Agencies invest in these tools for themselves, and the cost is already built into their fees so that you don’t have to worry about additional resource expenses. 

Save time 

Strategizing, developing, and executing digital marketing campaigns and programs take time. This is obvious. What’s not so obvious is the time it will take you or a staff member to manage and measure the progress of your efforts. 

Measuring, analyzing, and refining are at the heart of any successful marketing strategy. If you don’t have time to measure the impact of your marketing efforts, then you’ll never improve. A good marketing agency will dig through the data, refine when needed, and report progress for you. 

Another ‘not so obvious’ way an agency will save you time (and money) is by staying current so you don’t need to. Digital marketing changes with the wind, and staying up to date on the latest marketing best practices, search engine algorithm changes, and new social opportunities is a full time job in and of itself. A good marketing agency will dedicate time and resources to educating their team and staying relevant so that you don’t need to waste your time figuring things out on your own and experimenting with new ideas that may or may not work. 

Pro tip: Don’t cheat yourself when contemplating whether or not to hire a marketing agency. Consider all of the ways in which an agency can save you time, and in saving time, make you more money. You may have someone in your practice that has time to keep up with the ever-evolving digital landscape. You may not. Just make sure you account for it either way. 

Make money 

This seems like an obvious one, too, but it isn’t always the case: A good marketing agency will focus on increasing profitable traffic and revenue, not just rankings, “likes”, “follows”, or shares (i.e. traffic that converts and fills the seats in your waiting room, not just imaginary communities.

After all, that is what you hired them for.

A good marketing agency will also make measuring your return on investment easier by including the number of leads and profit (in dollars) generated by their marketing efforts.

Pro tip: Steer clear of any agency that will guarantee results, but won’t supply a monthly report. Like we mentioned before, if you’re not measuring your results, then what’s the point? Results will vary with every individual case, but those that make guarantees only guarantee that they can’t deliver.


Limited attention

When you hire your own marketing manager or in-house team, it’s easy to determine how much of their time is spent on just marketing, especially if you put them right down the hall.

This isn’t always the case with an agency.

Some agencies serve dozens (even hundreds) of clients at once, and it’s possible that your account won’t receive the kind of special attention you de- serve (and pay for). Furthermore, this overload likely means the agency will lack a meaningful connection with your brand and goals.

It’s important to make sure that the agency you choose assigns a dedicated project manager (or two) to your account to facilitate a solid professional relationship where your goals are understood and your needs are met on a consistent basis.

Pro tip: When shopping agencies, always ask how many people will be working on your account at once, and how many clients each account representative manages. At Incredible Marketing, each of our content marketing clients gets three marketing specialists and a team of designers and writers, all working on the same account together. Most agencies aren’t this generous.

Failure to understand your business

When you hire a marketing agency that may not be an expert in your niche, it takes time for their team to familiarize themselves with your industry and to identify profitable opportunities specific to your niche.

This lack of understanding will cost you time and money and a great deal of frustration.

Depending on the level of dedicated service, remember that none of the marketers from the agency will be in your office on a daily business. This lackof proximity could lead to a lack of communication, or worse, a lack of overall understanding of your business goals and aspirations.

A good marketing agency will make substantial efforts to learn your business, brand, and marketing goals throughout the relationship. They’ll also maintain consistent communication with you and your staff to ensure that your evolving business goals get met.

Pro tip: There definitely exist great marketing agencies that work with dozens of different niches and are successful in each one, however, these are few and far between. Instead, find an agency that works exclusively in your niche or industry. These are the agencies that can hit the ground running and offer you a quicker return on your investment.

The starters pitch, but the benchwarmers close

All too often a marketing agency hires a sales team staffed with subject matter experts to throw the fastballs, only to hand off newly signed contracts to junior marketers, fresh out of college.

Not that all “green”, inexperienced employees lack the skills to make an impact, but you get the point.

Pro tip: Do your homework and make sure you know who will be managing your account before signing the dotted line. At the very least, your account manager(s) should have a director or “lead” that oversees and helps implement strategy.

What makes the most sense for your medical practice?

While there are good arguments for both the pros and cons, for most small businesses like your medical practice, it makes more sense to hire an agency for your online marketing needs rather than gamble on an in-house team that you’ll not only need to assemble but manage on a daily basis, too.

We hope this chapter made one thing clear: do your homework, first. Hiring the wrong agency can leave you with “post-traumatic marketing agency disorder.” Ya know, the feeling you get when you’re shopping for your third or fourth agency?

A great full-service agency will operate as a partner: with you, not for you. It will be able to achieve greater results for the cost, and can keep you, the practice’s manager or doctor, up to speed along the way with a dedicated project consultant.

Never do something that doesn’t make sense for your own organization.

[fs-toc-omit]CHAPTER 3

7 questions to ask before hiring a digital marketing agency 

Hiring a marketing agency is tough; hiring your second one is even tougher. However, you can prevent the pain and frustration of leaving a marketing agency long before you hire them just by asking the right questions from the start.

In this chapter, we’ll explore the seven most important questions you need to ask before hiring a marketing agency.

1. Why do I need a digital marketing agency?

The single most important question you can ask before shopping for an agency is, “Why do I need a digital marketing agency?”

Businesses that have never hired a digital partner in the past often struggle to define what they’re looking for, which can ultimately lead to disappointment and frustration.

Attach specific goals to your online marketing and identify what your practice needs. Then make sure the agency you’re interviewing can fulfill those needs efficiently and to your satisfaction.

Are you looking for someone who can handle lead generation and sales

tracking, or are you looking for someone who can manage your brand awareness and search optimization? As mentioned before, all agencies specialize in different services, so know which services you need (and don’t need) before hiring the wrong agency.

Pro tip: When identifying your needs, think short-term and long-term before hiring an agency. It wouldn’t make sense to hire the agency that only offers SEO when you know that in six months you’ll want to add paid advertising and social media marketing, for example. 

2. Do they specialize in your industry? 

The web is infinite, and there are countless tools and strategies for marketing different businesses across this massive network. Pick the agency that has adequate experience with your unique industry and, if possible, specifically specializes in marketing for medical practices and doctors.

Medical practices don’t need the same marketing tactics as B2B parts suppliers, so hiring an agency with experience in the latter wouldn’t make sense for your business. Medical marketing is also accompanied by a host of legalities, so hiring an agency that isn’t well versed on what you can and cannot say (or who you can and cannot show) when marketing your business online could result in lawsuits and lost patients.

Ask your agency about their experience, and assess their understanding of your industry (ask for a case study, too). Get specifics on how they would approach your marketing strategy and how it may be similar or different from your competitors in the space.

An agency that specializes in private practice medical services and healthcare facilities will have a working knowledge of the trends and developments in your field without committing massive resources to new research. They’ll also have case studies showing what works and what doesn’t so that you don’t become their first “Oops, well I guess that failed.” Niche specialization is important in a field as detailed and nuanced as digital marketing.

Pro tip: Your medical practice needs an agency that specializes not only in medical, but also in business-to-consumer medical marketing. Make certain they do both. 

3. Are they more adept at local or national campaigns? 

Similar to how different industries require different marketing channels and tactics, local businesses require a vastly different approach to digital marketing compared to national brands. Ask your agency about their local marketing approach and how they tailor their skills and efforts specifically for local.

A Local SEO strategy, for example, relies on geolocation and the existence and optimization of a Google My Business page to attract those in your neighborhood looking for your services. A national campaign doesn’t rely on either. Your agency would need to understand this right out of the gate, as it differs from the larger link-building strategies employed by global brands.

Pro tip: At the end of the day, your medical practice is always going to be a local business. Your community will be at the heart of your tactical strategy, whether it be content, social, or search. So make certain you choose an agency that specializes in Local marketing.

4. Who's in charge of my account? 

If you have experience signing work contracts with large companies, you know all about the customer service run-around. You call the office to ask a question and get passed around to ten different experts, none of whom can answer your question, before winding up back at the help desk where they promise to have someone call you.

Never accept this kind of shoddy service.

A qualified agency will assign a dedicated account manager to serve as your primary point of contact. A dedicated account manager is your champion and is responsible for your customer service. If there is no one person in charge of your account, you’re sure to get the runaround.

Ask up front who your clear point of contact(s) will be, who will accept responsibility for the work the agency performs for you, and who will facilitate any requests you may have.

Pro tip: It’s not uncommon for an agency to assign one person to your account, from strategy to execution. This workflow may have been possible four years ago, but digital marketing is too robust for just one person. Make sure a team of marketing specialists will collectively work on your account. 

5. How will the results be measured and reported? 

By far the largest criticism of digital marketing agencies is the cloudy or non-existent reporting practices that continually fail to demonstrate any discernible ROI. The result? You end up paying a monthly bill without ever knowing how (or if) that money is helping your business. With access to free and effective analytics tools (e.g. Google Analytics), there’s no excuse for poor results measurement.

Your agency should be able to produce an example of a monthly report based on the measurement standards you’ve both agreed on.

There’s no point in executing a marketing tactic if you can’t tell whether or not it works. Proper website analysis and analytics are important resources for measuring your return on investment, and your marketing agency should be fully accountable for this sort of transparency.

6. What will I own if we part ways? 

Actually, we suggest you ask this question first.

The answer to this question will let you know whether or not an agency is looking to partner with you and build your practice, or if they are just out for money. What this question really asks is, “How will you treat me when I am no longer giving you my money?” (The answers to this question may astound you.)

Example: Be cautious of any agency that offers to build you a custom website on their “proprietary” content management system. A content management system works as the central interface for you to publish, edit, and maintain your website (e.g. WordPress). When you eventually decide to part ways with the agency, the only way they’ll relinquish full ownership of the site (the one you already paid for) is if you pay monthly or pay off the CMS lease completely.


And if you don’t pay, you lose your entire site and all of the work you’ve paid the agency month after month to complete. It’s called “holding you hostage.” Don’t say we didn’t warn you.

Partner with an agency that will hand over the keys and treat you like family if you terminate your contract, not one that will try to extort you.

7. How will you execute my marketing strategy? 

It never hurts to ask the agency how they plan on executing your marketing strategy, no matter what you plan on signing up for. But this question is especially meant for search engine optimization.

For those of you that may not know, there are two schools of thought when it comes to SEO. There are those that seek to cut corners and game the search engines into thinking your site is the most reputable authority on a specific topic; and there are those that actually do what they profess, and establish your website as the trusted authority in your space by producing and publicizing valuable, engaging content that matters.

The former is a shortsighted strategy with short-term results and long-term issues with the search engines, while the latter is a more clairvoyant strategy with long-term, accumulative results.

If you’re going to pay an agency good money to optimize your site for search, then make sure they abide by Google’s webmaster guidelines. Otherwise, in twelve months, you’ll find yourself back at square one, only this time your bankroll will be twelve months worth of monthly retainers short.

Pro tip: Ask the agency how they plan on building backlinks to your site. If they don’t have an answer, run. If they tell you it’s a secret, run. If they tell you they buy them, slap them in the face, then run. A backlink is a link from another site back to yours and remains the most important metric for improving your search presence (at least they do at the time this was written). For years, agencies have paid services to build spammy backlinks to your site, only to yield significant gains in the short term, but Google penalties in the long term. Never sign with an agency that pays for links. 

You're the boss 

At the end of the day, you’re the client. You hold all the power. When interviewing different agencies, remember that their job is to make you feel comfortable about the work that’s being done and to help you understand advanced digital marketing concepts in a simplified, yet meaningful way. Never be afraid to grill them with questions, as any agency worth their salt will have a good answer (and good standard practice) for any of your concerns.

[fs-toc-omit]CHAPTER 4

7 reasons why you shouldn’t hire a digital marketing agency

With the massive explosion of digital marketing tools and tactics swarming the business web over the last five to ten years, it can be a daunting challenge to try and tackle your own marketing.

There’s too much to learn and understand to get it right (not to mention your hands are tied managing your practice and tending to patients), which is why most hospitals and medical practices are opting for the expertise of an outsourced team of specialists.

But what about those who don’t?

Is there ever a situation when your practice shouldn’t outsource their marketing?


In this chapter, we’ll explore eight different “do not hire” situations from our experience working with medical practices so that you can avoid hiring a marketing agency when you really shouldn’t.

1. You want to maintain full control over your strategy 

The primary benefits of hiring an outside digital marketing team comprise the experience and strategy that come along with them. You’re hiring trained marketing professionals whose advice and methods are invaluable. And the relationship you form is one of trustee (them) and beneficiary (you), not the other way around.

However, certain doctors or staff members prefer to manage the brand, messaging, and social approach of the practice, all by themselves. In this case, butting heads with an agency that does things differently than you is inevitable. If this is you, you’re probably better off hiring a couple of entry level staff members who can take their direction directly from you.

Pro tip: If you like to be in control of your entire brand, whole kit and caboodle, save yourself (and the agency) the frustration and do it yourself. You’ll likely pay more in the long haul, but if it means that much to you, it’s a no brainer. 

2. You don't have your house in order 

Marketing agencies don’t work miracles- It’s their job to expose your brand to new audiences and attract patients, which means an agency partner can deploy tactics that can directly affect sales and revenue. But, by and large, a marketing agency can’t make something out of your business if you don’t already have a solid foundation.

  • Do you have the staff to accommodate more patients?
  • Is your reputation squeaky clean, or are you facing your second medical malpractice case?
  • Do you have a patient care coordinator that can
  • close consultations?
  • Are you in the middle of moving practice locations?

Before hiring a team of marketing professionals to revamp your content, search, and social, make sure you have a secure process for handling new customers and keeping them happy, and make sure you have your own house in order. If your own house isn’t in order, you’ll be hard-pressed to get good results out of a relationship with a digital marketing agency.

3. You're not interested in innovative ideas

Digital marketing is always evolving, and competitive advantages are transient at best. To keep pace and create strategies that have an impact on your bottom line, you’ll need to take risks.

If you’re not comfortable letting your marketing agency take risks and be innovators, then you probably shouldn’t hire them in the first place.

Pro tip: We know a lot of you may be jaded from past experiences with marketing agencies, but you owe it to your new marketing agency and yourself to trust again. We know it’s hard. But like a jaded lover, if you’re not yet ready to love again, then don’t go searching. 

4. You're on your last penny

Marketing, whether traditional or digital, doesn’t yield results overnight. If you’re down to your last dollar, you shouldn’t hire a marketing agency. Digital marketing is a marathon, an ultra- marathon (one that doesn’t end), and will require a longer commitment than one month.

Pro tip: If money is tight, focus on marketing to your current patients rather than looking for new ones. If you don’t have an email list already, start one immediately. Work the audience you’ve already built for up-sell opportunities and referrals. 

5. You have too many cooks in the kitchen 

If you’re a practice comprised of six physician partners and all of you want to manage your marketing, it’s not a good idea to hire a marketing agency yet. 

Instead, give ownership to one qualified individual (or a small committee of 2-3) that will oversee all communication and relationships with the marketing agency. This person (or small committee) will handle all decision-making when it comes to your marketing strategy, and will take ownership for the results. 

More importantly, this person or committee must have the power to veto the others. Otherwise, prepare for an unproductive use of your time and money. 

6. You have someone that will get in the way 

We once had a client whose wife was a pseudomarketer in training, and no matter what we did, she would try to expose some fault in our strategy. 

Worse, she was also teaching herself how to code websites, and, by default, her husband’s medical website became her playground. Needless to say, this caused a litany of issues. The rub? It was the clients wife! “I’m sorry, but we need to let her practice on the site. I can’t say no to my wife,” said the doctor. 

Life happens. We understand better than most. But if you find yourself in a situation like this, don’t hire a marketing agency or consultant. You’re paying good money for the help of a team of professionals, so it’s important that you eliminate any awkward personal barriers that might slow them down. 

Pro tip: Make certain that whomever will be working with the marketing agency feels secure in his or her position, and that his or her role is clearly defined. 

More often than not, if the person you put in charge of marketing feels insecure about their value or their role, a marketing agency will pose as a bona fide threat. And a bias might form that can cloud their perception. 

This is common, but as long as your employees feel confident in their role, you’ll have nothing to worry about. 

7. You want the agency to teach you marketing so you can do it on your own on a small scale 

If you need a marketing agency to teach your employees how to be marketers, then you have the wrong employees doing the wrong jobs. 

If you want to do marketing in-house, then do it in-house. But hire trained professionals to do the job. 

And if you’re plan is to teach your office assistant the basics of social media or your patient care coordinator how to blog, and then call this your marketing strategy, then we encourage you to rethink your business model before you waste all your time, money and employees. 

Even if a marketing agency were to teach your staff the fundamentals of marketing over the course of three months, by the time they learn and digest all of this information, that information would be outdated. 

Bottom line

There are dozens of perfectly good reasons why you shouldn’t hire a marketing agency for your medical practice. The hard part is identifying what those reasons are ahead of time so you can spare both parties the frustration of working together. 

99% of the time, if your partnership isn’t going to work out, it’s obvious to tell beforehand, you just need to look in all the right places.

[fs-toc-omit]CHAPTER 5

Understanding an agency fee structure

The services you receive from a digital marketing agency vary for different accounts and projects, thus the compensation structure can vary as well. Agencies have their own ways of doing things, but a few standards tend to remain the norm. 

Either way, prepare yourself for all possible payment structures. 

Standing retainers 

The most common model for digital marketing agencies is a monthly retainer for ongoing services like social media marketing, search engine optimization, and content marketing. This recurring retainer is agreed upon when the contract is signed and remains in effect for the duration of the agreement (typically 6-12 months). 

Maintaining a marketing campaign month-to-month often requires a similar bank of work hours each month, therefore, the standing price is maintained throughout the year. Additional services, campaigns, or projects are treated as add-on fees. 

Marketing a medical practice online, whether with search, social, content or a combination of the three, requires diligence, commitment and patience. Clients who want anything less than a three month contract typically don’t have the patience (or trust) to commit long enough for the agency to prove results, which is usually six months. 

Pro tip: A standard retainer is the agency’s way of spreading out the cost incurred to the client over time (i.e. shouldering the financial burden), especially for setup fees in the beginning of a campaign or marketing program. For example, many marketing programs take a considerable amount of resources to launch, but there’s no way a client would pay $18,000 in the first three months when results aren’t produced until month nine and ten. Instead, the agency stretches that $18,000 over the course of twelve months (amortized), along with the costs for the other nine months:

• First 3 months: $18,000 total
• Months 4-12: $20,000 total
• Total 12 months: $38,000 annual retainer
• Amortized 12 payments: Client pays $3,166 per month rather than $6,000 in month 1-3 ($16K) and $2,000 in months 4-12.

Commission compensation 

The old-school model of brand marketing relied heavily on paid advertising and media buys in newspapers, magazines, television, and radio. In this traditional model, it’s common for an agency to charge a management fee based on a percentage of the advertising budget. This commission is often in the range of 10-20% of the total ad spend. 

In today’s digital landscape, PPC (Pay-Per-Click) contracts typically fall under the commission compensation structure. 

A sliding commission serves to adjust for the added work on larger budget spends and less work on smaller initiatives. With modern digital marketing there is often a large degree of work that does not rely on the extra expenditure of paid ad dollars, so this fee structure is less common for Internet-based marketing, especially if your focus is on organic search rankings and social media engagement. Those services are better suited to a standard monthly fee than a percent commission. 

Pro tip: If your agency tries to charge you a commission based on revenue earned, this is fee splitting. It’s OK to charge a commission on revenue spent, not earned (at least in this industry given your a medical facility).

Billable hours or itemized breakdowns 

Billable hours typically account for additional services outside the scope of your monthly retainer’s work agreement. For example, ongoing technical analysis and platform management will often be accounted for in man-hours, and if you exceed the monthly man-hours as defined in your work agreement, the agency will charge you an hourly rate. 

Defined projects like a website, logo design, or piece of blog content can be quantified to a specific price and itemized individually. In the event that you hire an agency to execute certain deliverables on a project-by-project basis, you’ll receive an itemized breakdown when the project is complete outlining your balance due. 

Agencies differ in how they report the breakdown of your marketing dollars, so ask up front what you can expect to see on your bill. The more detail provided, the more you can scrutinize your ROI throughout the marketing contract. 

Pro tip: Be wary of agencies that try to itemize costs for long-term services like search engine optimization, social media marketing, content marketing or website design and development. With so many hours and resources needed to successfully execute any of the above, allowing an agency to bill you hourly for these services relinquishes 100% of the control you have over what you pay (they get to set the hours, even if you set the wage). And it’s always going to be an exorbitant amount. 

Contract terms 

Some agencies structure their contracts around defined campaign periods, while others intend on maintaining a monthly relationship for the foreseeable future. And others don’t require a term at all (i.e. month-to-month). 

(Keep in mind that most marketing teams will need at least 6 months to show solid results in digital marketing, regardless of contract terms.) 

It goes without saying, but you should only sign long-term contracts if you’re confident in the agency you’re hiring. 

If for whatever reason the level of service you receive is not up to par or the results aren’t present, it can be difficult to dissolve the contract. So read thoroughly before you sign and understand your options for exiting the agreement if your terms are not met. 

Last, familiarize yourself with the agency’s cancellation policy just in case something goes horribly wrong six months before your contract expires. 

Pro tip: Steer clear of an agency that forces you to buy out the remainder of your contract value if you cancel; this is usually a bad sign. And it doesn’t leave you with many options if things go awry.
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What you need to know about negotiating your contract

As we’ve discussed, there are a wide range of digital marketing products and services available from agencies and most are always happy to sell you whatever they have to offer. However, before you sign any contracts, you’ll need to make sure you’ve explored every angle of the agreement and have a clear expectation of what you’ll be receiving for your hard-earned money. 

There’s nothing worse than buyer’s remorse, especially when the price tag is an exorbitant monthly fee. 

Know what you're getting

A marketing agreement should clearly spell out the tactics and services that your agency marketing team will execute on your behalf, including tools and reports you can expect to see for yourself. Never leave this to chance. Make sure there is a clear plan of action for achieving the results you’re expecting. 

The initial marketing proposal should spell out the assessment the agency has made of your needs with a detailed plan of attack for executing an effective campaign. If any part of this is unclear, simply ask for clarification on what will be done on your behalf. Ask for examples of what you expect to see in reports and make sure it’s all detailed in the language of the contract. 

Bundling services 

If you opt for a full-service marketing retainer with a sizable agency, you’re probably getting several of their products and services bundled into one package. For example, we often bundle social, search, and website design together with content marketing. 

This should reflect a decent discount for you as all those services get rolled into one large monthly retainer. Don’t be afraid to look for this discount when you go full bore with a marketing team. 

Have an exit strategy 

We’d all like to think that people are full of integrity and a solid work ethic everywhere we go, but the truth is a bit less optimistic. When the contract is being written, make sure you and the agency define the terms and conditions for breaking the contract and severing ties should things not go as planned. 

Obviously, you shouldn’t break a contract just because you change your mind. However, if your agency fails to perform as promised in the language of the contract, there is just cause on your part to sever ties and end the relationship. 

Know what the deliverables are before you sign, if there will be additional costs to cancel your contract, and how canceling your contract will unfold so there are no surprises in the event of a sour relationship. 

How will reports be delivered? 

In addition to a solid work plan to account for the man hours you’re buying, it’s important to clarify up front just how the team will convey their results and discoveries to you at the end of each month or campaign period. A simple one-sheet printed off from Google Analytics is a poor method of communicating your results. Not only should you expect a report, but you should also understand what the agency plans to include in the report at the time of negotiating your contract. 

Your reports should be personalized and detailed so that both you and the marketing team understand what’s working and what’s not. This will inform the strategic decisions made each month. Spell out in the agreement what forms of reporting you expect to see, how you will receive them, and when they are due. 

Closing the deal 

We’re not sure anyone really likes negotiating contracts, whether for your medical practice’s marketing or your new car lease. However, when negotiating, remember that teaming with an agency should be a partnership, not just them selling you “stuff.” But it’s also the agencies job, as your marketing consultants, to give you advice on ways you can improve your online presence, even if that means spending more money with them. 

So listen to your gut feeling, be honest during negotiations, don’t be afraid to ask for more, and clearly document the stakes of the game.

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Key takeaways

Hiring a marketing agency for your medical practice is big decision- that goes without saying. Hopefully this guide helped familiarize you and your staff with the ins and outs of hiring a marketing agency so you can make a more informed (and profitable) decision.

  • There is no such thing as a stupid question (or too many questions, either). Fire away!
  • There are perfectly good reasons why your medical practice shouldn’t hire a marketing agency. Just figure these out before you engage.
  • Even if you hire an agency, there is no shortage of potential drawbacks depending on who your hire. Do your best to vet an agency before you sign the dotted line.
  • Agencies bill clients in different ways. For long term services like content marketing or SEO, it doesn’t make sense to bill hourly (itemized). Exercise caution.
  • If you only have one question to ask, make it this one: “What will I own when we part ways?”
  • When negotiating your contract, clearly define the rules of engagement, and don’t forget to discuss your exit strategy in advance.

Let’s be incredible together.

For the last decade, we’ve used digital marketing to help doctors and medical practices attract, engage, and convert patients online. 

Give us a call at (800) 949-0133 so we can help you overcome your marketing challenges.