Never a cut of your ad spend

There is a pricing model in advertising that almost nobody questions, because it sounds so reasonable. The agency takes a percentage of what you spend on ads. Spend more, pay more. Spend less, pay less.

It is common enough to be the default. OuterBox, an agency that sells paid search, puts the going rate this way: "Percentage-of-spend models commonly land around 10% to 20% of monthly media spend, often with a minimum management fee."

We do not charge that way, and this post is the reason. It is not that agencies who do are dishonest. Most are not. It is that the model points the agency's interest in one direction and yours in another, and then asks everyone to pretend it does not.

What the percentage actually rewards

Walk through one ordinary decision. Your campaigns are running. Somebody at the agency notices that one ad group is spending steadily and bringing in almost nothing. The right move is obvious: pause it, or cut it right back, and let the budget go to what works — or back into your pocket.

Under a percentage model, that decision lowers the agency's fee.

Nobody has to be a villain for this to matter. It just means the right call, every month, costs the person making it. Over a year, across every small decision about bids, budgets and which campaigns keep running, the pressure adds up, and it always pushes the same way: toward more of your money going out the door.

But then they are motivated to grow my account

This is the usual defense, and it is half right.

A percentage fee does motivate an agency to grow your ad spend. It does not motivate them to grow your business. Those are the same thing only when every extra dollar of ads brings in more than a dollar of patients or customers, and in most local accounts there is a point — often not very far in — where it stops doing that. The owner wants to find that point and stop there. The percentage model pays the agency to be past it.

There is a second, quieter cost. Under a percentage fee, a small account is a small fee, so it gets small attention. The business spending modestly on ads sits at the bottom of the agency's list, not because anyone decided that, but because that is where the arithmetic puts it. That is also why so many percentage deals carry a minimum fee: the model does not work for small budgets without one.

What a flat fee changes

A flat monthly fee makes the agency indifferent to how much you spend on ads. That sounds like a small thing. It is the whole point. When the fee does not move with the budget:

• Cutting waste costs the agency nothing. So the dead ad group gets paused the week somebody notices it, not the quarter.
• "Spend less" becomes something you can hear. An agency on a flat fee can tell you your budget is too high for your area without talking itself out of revenue.
• The conversation is about results, not spend. How many calls came in, how many booked, what each one cost — not how much went through the account.
• You can budget the month. Ad spend moves; the management fee does not.

Our Lead Generation service is $2,500 a month, flat. It includes the landing pages, the ads managed and rebalanced, the site chat that captures details, everything landing in one inbox, and a weekly report. The ad spend itself is yours, in your own account, and the size of it does not change what you pay us.

If paid search is part of a bigger job, All-in-One Growth is $4,950 a month and includes ads managed weekly alongside the website, search, local listings and email. Same rule. No percentage of anything.

What to check in any ad agreement

Whoever you hire, these are worth asking in writing.

• Whose ad account is it? It should be created in your business's name, with you as an owner. If the agency runs your ads from inside their own account, you do not have your history, your data or your settings when you leave. We set everything up in your name from day one; leaving takes an email.
• Is there a markup on the spend? Some arrangements bill you for ad spend through the agency rather than directly. Ask whether what you pay for clicks is exactly what the platform charged.
• What happens to the fee if I cut the budget in half? A clear answer tells you what the agency is really being paid for.
• What does a weekly report look like? Ask to see one. You want three things in plain words: what was done, what it brought in, and what needs a decision from you. A screenshot of impressions and click-through rates is not an answer to "did this bring me any customers?"
• Who owns the landing pages? If the pages your ads point to live on the agency's platform, you lose them when you go.

What we will not promise

We will not promise a number of new patients, a cost per lead or a return on ad spend before we have seen your account, your area and your phones. Anyone who does is guessing, and you are the one paying for the guess.

What we will do is show you the plan and the number first. Nothing starts without your yes. And if the right answer for your business is a smaller budget, or no ads at all until the front desk can answer the calls you already get, we will say so — even when the smaller job is worth less to us.