Your ads aren't "working" because you're not using THESE four numbers to measure success.
Ads only amplify the problems that aren't yet visible because volume will reveal whatever system faults you already have.
If your economics are strong → ads scale profit.
If your economics are weak → ads scale stress.
That’s why clinics keep saying:
“Ads worked… until they didn’t”
“Lead costs are too high”
“Meta changed something”
“We need better targeting”
In reality, they’re missing the same thing.
There are four numbers that determine whether marketing scales calmly or collapses:
• Cost to acquire a real patient
• How fast you get paid back
• How long it takes to break even
• What a patient is actually worth long term
If even one of those is off, the whole table wobbles.
Better creative won’t fix it.
More leads won’t fix it.
Turning ads off won’t fix it.
Only understanding the numbers will.
I broke this down properly in a new blog - the money models that sit underneath every scalable clinic.