The annual budget meeting has a predictable shape. Someone argues for more digital, someone argues for the outdoor site near the highway, someone mentions the hoarding at the railway station, and the decision gets made on the strength of whoever spoke most confidently.
What almost never happens first is a check on whether last year's channels produced anything measurable. Not because nobody wants to know — because the measurement was never wired up, and by December it is too late to find out.
An audit fixes that, and it is a smaller job than it sounds. Two people, half a day, forty questions. Every question you cannot answer is itself a finding.
01What this is and is not
An audit is not a performance review of your agency, and framing it that way guarantees defensive answers and a useless result. It is an inventory of what exists, what works and what nobody can answer. Some of the failures will be yours, some will be a vendor's, and a good number will belong to a person who left two years ago.
It is also not a strategy document. It produces a list of facts. What you do about them is the next meeting.
02How to run it
Do it before the budget conversation, not during. Print the list. Two people: one who owns marketing and one who does not, because the second person asks the questions the first has stopped noticing.
Score each item pass, fail, or unknown. Resist the urge to argue about severity while you go — just record. Unknown counts as fail for the purposes of the budget meeting, because an unmeasured channel cannot be defended with data.
Put it in a spreadsheet with five columns and you have a template you can rerun every year: the check, the score, the evidence you looked at, the owner, and the date it was fixed. The evidence column is the one that makes the second year's audit fast, because next December you will not remember where you looked.
03Measurement foundations
- 1Is analytics installed on every page of the site, including the booking flow and the thank-you page?
- 2Is a booked appointment recorded as a conversion, rather than a form submission or a page view?
- 3Are phone calls tracked to source, so you know which campaign made the phone ring?
- 4Do WhatsApp enquiries land somewhere countable, or only in a staff member's personal phone?
- 5Can you state, from your own systems, the cost of acquiring one patient in your largest service line?
04Website and conversion
- 1Does the site load quickly on a mid-range phone on a weak connection, tested rather than assumed?
- 2Does the booking path work end to end on a phone in three taps or fewer?
- 3Is there a page for each of your top-earning procedures, written in patient language rather than department language?
- 4Does every doctor have a profile with credentials, registration details, languages spoken and a photograph taken this decade?
- 5Are the phone numbers, hours and addresses on the site identical to the ones on your Google listings?
- 6Is there a named person who can publish a change to the site today, without an agency ticket?
05Search visibility
- 1Do you know which queries currently bring organic traffic, and are any of them commercial rather than informational?
- 2Does the site have a page for each city or area you genuinely serve, with content that differs meaningfully between them?
- 3Are there pages that once ranked and have quietly dropped, which nobody has looked at?
- 4Is structured data in place for the organisation, the doctors and the services?
- 5Are there duplicate or near-duplicate pages competing with each other for the same term?
- 6When someone searches your brand name plus "reviews", what appears above your own site?
The healthcare SEO checklist covers this section in more detail than a single-line check can, and is worth running separately if this is where the failures cluster.
06Local presence
- 1Is the Google Business Profile claimed, verified and owned by the clinic rather than a former vendor?
- 2Is the primary category the correct one, and are the services named the way patients say them?
- 3Are the photographs current, of the real premises, and taken in the last year?
- 4Are hours correct, including holidays, and is a booking link present and working?
- 5Do you have a profile for every physical location, and none for locations that no longer exist?
- 6Are questions on the profile answered, including the awkward ones?
- 1Does every campaign have a named objective that someone can state without opening the account?
- 2Is there a negative keyword list, and has it been updated this year?
- 3Are search terms reviewed monthly, or only when performance drops?
- 4Do landing pages match the ad, or does everything point at the homepage?
- 5Is spend being reported against booked appointments, or only against clicks and leads?
- 6Are ad accounts, pixels and audiences registered in the clinic's name rather than an agency's?
08Content and authority
- 1Is anything published on a regular cadence, and does a clinician review it before it goes out?
- 2Is every clinical page attributed to a named, real clinician with a reviewed date?
- 3Does your content answer the questions patients actually ask at reception, or the ones you find interesting?
- 4Is there video of your own clinicians, of any quality, answering common questions?
09Reputation
- 1Is there a system for requesting reviews, and does it ask every eligible patient rather than only the happy ones?
- 2Are negative reviews answered, in a way that does not disclose anything about the patient?
- 3Does anyone monitor the directories and aggregators your specialty is listed on, or only Google?
10Compliance and data
- 1Can you name which regulations apply to your advertising, and point to where they are written down? For India that is the NMC professional conduct rules, ASCI's code, and NABH standards where accreditation applies. For US-facing practices it is HIPAA and the FTC's rules on endorsements and reviews. For the UAE it is the DHA, Department of Health — Abu Dhabi or MOHAP permit processes; for Saudi Arabia the Ministry of Health and the SFDA.
- 2Does your consent handling meet the law in your market — the DPDP Act 2023 and the DPDP Rules 2025 in India, under the Data Protection Board of India, or the equivalent where you operate?
- 3Is there written patient consent on file for every photograph, testimonial and case study currently published?
- 4Is any identifiable patient information reaching Google or Meta through your tracking? Neither platform signs a business associate agreement, so the answer needs to be no.
11Five checks that predict the rest
If you have twenty minutes rather than half a day, these five correlate with almost everything else on the list.
Number two — is a booked appointment the conversion? Practices that get this right usually have the rest of measurement in order, because you cannot record a booking without having thought about the funnel.
Number ten — do the site and the Google listings agree? Disagreement is almost always a sign that nobody owns the estate, and that predicts failures across the local section.
Number eighteen — who owns the [Google Business Profile](/services/seo)? If the answer is a former vendor, you will usually find the ad accounts and the domain are in the same condition.
Number twenty-nine — are the ad accounts in your name? This single item determines how much of your history survives a change of agency.
Number forty — is patient data reaching the ad platforms? A yes here is the one finding on the list that is a risk rather than a missed opportunity, and it needs fixing this week rather than next year.
12What to do with the result
Sort the failures into three piles.
Things that are broken and cheap to fix — a wrong phone number, an unclaimed profile, a missing conversion. Do these in the week after the audit. They are not budget items.
Things that are broken and expensive — a site that cannot be edited, tracking that was never built, a data flow that should not exist. These are the budget conversation. Bring the count of failures, not an opinion.
Things that are working. Protect them. The most common outcome of a budget cut is the removal of the only channel that was producing patients, because nobody had written down that it was.
13The check that changes the meeting
If you run only one item from this list, run number five: the cost of acquiring one patient in your largest service line, from your own systems.
Most clinics cannot answer it. The ones that can tend to make quieter, better budget decisions, because the argument stops being about opinion. The marketing audit page explains how we run this as a formal engagement, and the marketing health score tool gives you a rough read in a few minutes if you want a starting point before the full pass.
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If you would rather have someone else run the forty checks and mark the paper, get a free audit — we will send the findings whether or not you work with us. Or book a strategy call and bring last year's numbers.