E857 | How To 6x Ads ROI For A Cash-Based Clinic

6x Your Ad ROI: The Power of Google Reviews for Cash Practices

In this episode, Doc Danny Matta breaks down how one simple factor — Google reviews — can completely change your marketing results. Using a real-world example of two nearly identical clinics, he shows why social proof can turn your ads from barely breaking even to producing a 12x return month after month.

A Quick Ask

PT Biz’s mission is to help add $1 billion in cash-based services to the physical therapy profession. The best way to help? Share this episode with a fellow clinician or post it to your Instagram stories and tag Danny — he’ll reshare it and spread the movement.

Two Clinics. Same Ads. Wildly Different Results.

Danny shares a story about two clinics in the same city, running the same Google ads to the same audience.

• The established clinic had 250 Google reviews.

• The new one had zero.

Both spent $1,000 on ads. The established clinic earned $12,000 in new business (12x ROI), while the new one only earned $2,000 (2x ROI).

The only major difference? Social proof.

People simply trust what others say. When potential patients search “help with knee pain near me,” they’ll skip over the clinic with no reviews and go straight to the one with dozens or hundreds of glowing ones.

Why Google Reviews Are Your Secret Weapon

Even as technology evolves and AI search platforms like ChatGPT or Gemini become more common, Google reviews still drive the data these tools use to recommend local businesses.

Search engines, social platforms, and even AI are all pulling from Google’s ecosystem to determine credibility and ranking. That means your reviews don’t just help you show up higher — they directly affect whether or not people ever see your business in the first place.

In short: if you want to 6x your ROI, you need to make collecting reviews a core part of your clinic operations.

The Right Way to Ask for Reviews

Danny admits it’s uncomfortable for many clinicians — you’re asking someone who already paid you to do you a favor. But the key is to ask at the right time:

• Wait until the patient shares a win — “I ran three miles without pain for the first time in a year!”

• Acknowledge it and connect it to helping others:

  • “That’s awesome! It would really help other runners like you if you shared that on a Google review. Mind if I text you the link?”

• Make it simple — send the direct link where they can tap, rate, and type a few words.

If they have a Gmail account, it’s even easier — they’re usually already logged in.

Then, follow up. People get busy. Text or email them a gentle reminder and thank them again for their help.

Build It Into Your System

• Automate wisely: Use reminder emails, but never rely solely on automation.

• Train your team: Empower staff to ask patients they love working with. Happy clients attract more happy clients.

• Measure your results: Track how review spikes correlate with ad performance. You’ll often see ROI jump within weeks.

This isn’t flashy work, but it’s what Danny calls the “dribbling with your non-dominant hand” kind of fundamental — boring but game-changing.

Key Takeaways

• Social proof wins. People buy from businesses others trust.

• Ask in person. The right timing makes all the difference.

• Make it frictionless. Text the link; don’t overcomplicate it.

• Follow up once. A simple reminder doubles response rates.

• Train your staff. Everyone should understand the “why” behind reviews.

Pro Tips You Can Use This Month

✅ Audit your Google listing — how do your reviews compare locally?
✅ Write a simple script for your staff to use when asking for reviews.
✅ Focus on Gmail users; they can review in seconds.
✅ Share new positive reviews in team meetings.
✅ Track ad performance before and after a review push — watch the ROI climb.

Final Thoughts

The gap between a 2x and 12x ROI isn’t your ad copy or targeting — it’s your reputation. Google reviews are your digital word-of-mouth, and they make or break your marketing spend.

As Danny says:

“It’s not sexy, but it wins games.”

Make reviews part of your clinic culture and watch your growth compound month after month.

Programs Mentioned

• PT Biz Part-Time to Full-Time 5-Day Challenge (Free):
  Get clear on your numbers, choose your best path to full-time, and build your one-page business plan.
  👉 Join the challenge 

About the Host

Doc Danny Matta — former active-duty military PT, cash-practice founder, and now coach to over 1,000 clinicians through PT Biz. His mission: help PTs build profitable, fulfilling practices that give them freedom.

Visit PT Biz →

Do you enjoy the podcast?  If so, leave us a 5-star review on iTunes and tell a friend to do the same!

Ready to elevate your practice? Book a call at the link below with one of our expert consultants today and start your journey to delivering unparalleled physical therapy.

Podcast Transcript

[00:00:00] Hey, Danny Matta here, founder of PT Biz, and today I'm gonna talk about how you can [00:00:05] 6x your return on ad spend just by changing one thing that you can focus on in your [00:00:10] clinic. So recently I was talking to a clinic owner that has [00:00:15] two clinics. They have one that is more established, it's been around for [00:00:20] years, and then they have one.

In a newer area and they just got the listings and [00:00:25] everything in place to be able to have a local presence for this second [00:00:30] office. But it's in the same city and in a lot of ways very similar demographics. [00:00:35] If, if, if anything, I would say they're almost identical. If you look at the amount of money that [00:00:40] is made there, the types of families that live there, the activity of the people there, they're very, very similar.

[00:00:45] So last month when they spent money on ads. They saw a [00:00:50] 12 XROI, meaning if they put a thousand dollars into spending ads, they [00:00:55] made $12,000 back in new business. In the more established office. In [00:01:00] the new office, they had a two XROI. Meaning if they spent a thousand dollars [00:01:05] on ads. They made $2,000 back.

Now, our benchmark for [00:01:10] people from a baseline of is, are ads doing well enough to be able to really continue to put [00:01:15] more money behind it. It's really minimum three to four x is what you wanna see because you have to include the [00:01:20] cost of the time to set those up or the agency you're working with that's handling that.

It's not just the, the money [00:01:25] right side of it. So. It was below our benchmark for what we would want to see for somebody to [00:01:30] effectively continue to run ads. So when we looked at it and we talked to the agency that we were working with [00:01:35] as well, that was running the ads, they found that they were, uh, ranking [00:01:40] and going after the same key terms.

This was on Google, by the way. So the same search terms, they looked at the [00:01:45] demographics, they looked at the interests, all kinds of stuff. And it was very similar [00:01:50] except. There's one massive difference between these two clinics. One has [00:01:55] basically 250 Google reviews, massive amounts of social proof [00:02:00] associated with the ad platform that we were actually advertising on.

The other has [00:02:05] zero because it's a brand new location. It's a brand new listing, and we haven't had the [00:02:10] ability to be able to build those up. This, this clinic hasn't actually gotten to that point yet. So [00:02:15] when you look at the ROI of that, you have to keep in mind what the buyer is thinking. [00:02:20] Whenever they're getting targeted with an ad.

So in [00:02:25] Google in particular, these are what we consider intent-based ads. These are people that are searching for [00:02:30] something in particular. This is actually one of the reasons why I think for service-based businesses in particular like clinics, [00:02:35] Google seems to, you know, really just be the best bet for a lot of clinics.

There's [00:02:40] lower volume in terms of leads, but they're very high intent leads. So if you want to go after high intent [00:02:45] leads, you may pay a little bit more per lead than you would with something like meta. But you're [00:02:50] gonna get somebody that's actively searching for a solution to their problem. They're not necessarily just [00:02:55] scrolling through stuff on the, on the internet.

So in this scenario, the search terms were the [00:03:00] same, but the ROI was drastically different. And it's because if you are [00:03:05] somebody that's searching for. You know, physical therapy, knee pain, or uh, you know, whatever, [00:03:10] running injury resolution or something in your area, right? Like help with knee pain in [00:03:15] Atlanta, or help with knee pain in Dallas, or whatever the local term is.

You're [00:03:20] gonna then click on a link, but also keep in mind that those are put on a map. So [00:03:25] you're gonna look at where you're at and location wise, look in proximity to where you are. And if you see [00:03:30] one clinic that has 250 reviews and you read through those and there's some really [00:03:35] great things that they're saying about the clinic, and then you see another one that has zero, what are you [00:03:40] gonna do as a consumer?

Hm, probably skip over the one that has zero [00:03:45] and go, really? For the one that has 250 now, you're probably gonna do more due diligence. You may ask a friend, [00:03:50] Hey, have you ever heard of this clinic? I'm thinking about, you know, whatever. Going and doing some work with them. So local [00:03:55] word of mouth is huge, but really your digital social proof is enormous as far as your ROI is [00:04:00] concerned, and we've talked about this for years and years.

About the importance of making sure that [00:04:05] you are collecting social proof in your business, in your local clinic. Because [00:04:10] even though there are massive changes that are occurring as far as searching and the way people are searching for [00:04:15] information, especially leveraging things like large language model AI platforms like a [00:04:20] chat GPT, you know, or a Gemini, they still are pulling the vast majority of that [00:04:25] data from.

Google, especially local service, um, rankings, they're [00:04:30] looking at that for validity. Like they, they want to serve you up a good option. And they're looking at [00:04:35] Google because it's, it's so proven and it's been around for a long time, and they're pulling from that. So if, if you [00:04:40] say, Hey, chat GBT gimme three options for good physical therapy clinics in my [00:04:45] area.

Uh, they, you know, work with runners that have knee pain, they're gonna search. Your [00:04:50] site, they're gonna search all kinds of sites that are within a certain radius, but then they're also gonna look at the reviews, and then they're [00:04:55] gonna preferentially rank you because of that. Now, if we're searching for something with ads, again, it's part of the [00:05:00] the buyer's behavior.

So knowing all of that, knowing the importance of this, not [00:05:05] just locally, but also when we look at scaling ads and, and putting money behind ads, I'm sure you'd rather get a [00:05:10] 12 XROI than a two XRO. I like it's, it's a massive difference. Do that [00:05:15] every month for 12 months and see what happens to your business.

See how quickly you can hire another person, right? [00:05:20] See how quickly you can fill your staff schedule and maintain that. That is the big difference that we're talking about. [00:05:25] So how do you get more of these reviews? Well, the number one thing, and I hate to say it. [00:05:30] Because you can't automate it. It's to literally ask people, and I think this is something that we [00:05:35] struggle with because they're paying to come and see you, right?

You're asking them to do you a favor [00:05:40] basically, but in the end, you've done them a favor. 'cause when you ask [00:05:45] them when to do it, you want to do it when they've had a great response to what you're doing, when they [00:05:50] come back and then they say, man, I went running, I, I haven't run three miles without [00:05:55] foot pain in a year.

I'm so excited, like I get to get back to running like there. [00:06:00] There they have a profound moment, a profound change. That's when you want to ask somebody. [00:06:05] Hey, that's so awesome. You know, it would be like super helpful for us if [00:06:10] you would take the time. It literally take two minutes to just say what you just said to me and put that in a Google [00:06:15] review.

That would really help us work with more runners that we're trying to help get back to running, and so many people [00:06:20] are just avoiding it because they don't think they can get past it. Would you be willing to do that? The likelihood they [00:06:25] say yes is very, very high. And then you have to make it very easy for them.

Say, okay, I'm just gonna text you the [00:06:30] link. It'll take you straight there. You know, you can text them the link that goes literally straight to where they can leave a [00:06:35] review. And if it's simple as like they can hit, you know, however many stars they wanna leave you, they can, you know, leave a [00:06:40] little text prompt, whatever they wanna do.

Make it easy. That's your best likelihood. [00:06:45] To get somebody to actually do that. The other thing is if they have a Gmail account, [00:06:50] chances are they're probably logged into it on their phone, and it's so easy if somebody has a Gmail [00:06:55] account and you send them the link to actually like leave a review, it's already pre logged in and [00:07:00] they can leave, you know, they can leave a review through their account very, very, very easily.

So really [00:07:05] look for people that have Gmail accounts and make sure that if they do and they have a great outcome, that you're asking them [00:07:10] to leave a review. The second thing is. To make sure you follow up with them [00:07:15] because people are busy and they may forget. So you can follow up with them via email, you [00:07:20] can, you can text it to them, you can email them the link again and just say, Hey, I really, really would [00:07:25] appreciate it if you would leave us a review.

What you said to me was, was awesome and I would love to, for other people to see that you had [00:07:30] that outcome so we could help more of them, you know, follow up with an email. You can even put it in with their homework. [00:07:35] You know that your follow up, you're sending them whatever from the day and just make sure that you follow up with 'em.

'cause remember, [00:07:40] people are busy, you're not nagging them that this is really, really important for your clinic. Keep that in mind. The last thing I would [00:07:45] say is automated emails do help. Like you can have automated emails that go out at different points [00:07:50] in time during someone's plan of care. You can build that into, you know, a CRM tool.

[00:07:55] But automated emails do not replace in person direct. [00:08:00] Face-to-face, would you do this for me? That is literally the [00:08:05] best thing you could possibly do. And to also let your staff know that, Hey, would you like [00:08:10] more people like Brian to come in and see you? Like do you love with runners? Right. Well. [00:08:15] If you have somebody that has an outcome, that's great, ask them to leave a review.

It's really important 'cause you're gonna get more [00:08:20] people like that, that get on your schedule. And we want you to have the most amount of ideal clients [00:08:25] that you possibly can. So your day feels like it's not even work. Like that is what you're trying to do with your staff. You [00:08:30] want them to really enjoy what they're doing.

You wanna decrease burnout. And the way you can do that is get 'em to work with who they wanna work with. [00:08:35] And the way you get, the more people that they wanna work with is you ask the people that they love working with, they had an amazing outcome to [00:08:40] share that with more people and they can leave it in a very simple way.

In a Google Review, and it makes a [00:08:45] massive difference on your ads. RI. 'cause keep in mind, remember our numbers, it's a 12 x [00:08:50] versus a two x. It's a difference between, I probably shouldn't advertise and how should, how am I not gonna [00:08:55] advertise? How much money can I put into this to see how high I can get my, my advertising dollars?

Before that [00:09:00] ROI starts to really drop below where we would wanna see, you know, from, from a, from a solid ROI [00:09:05] standpoint. And by the way, this clinic's gonna increase their ads at this one [00:09:10] location specifically because they're gonna pull money from the other one until they get some of that [00:09:15] social proof up.

And then they'll go ahead and, and, and start to do more of it there. And they'll make a big difference in terms of their [00:09:20] ROI. So keep that in mind. Do you want to, do you want six x you ad dollars? Do you want to [00:09:25] get more people in the door to keep your staff happy? And, and do you wanna have a bulletproof presence no matter what happens [00:09:30] from changes in AI search.

Got to, got to have a solid local [00:09:35] presence, a reputation in your area, and that in this day and age right now at least. [00:09:40] Google is the most important place that you can focus on that from a standpoint of people leaving reviews [00:09:45] about your clinic and they're searching for that in their local area, in their proximity to where they're [00:09:50] at.

Use your either maps or whether they're on, uh, the computer or their laptop or whatever, [00:09:55] looking for something and specifying where it's at instead of being geotagged by their phone. So keep it in [00:10:00] mind. Don't glaze over this. This is one of those fundamental things. This is literally like in basketball.

Practice dribbling [00:10:05] with your non-dominant hand. It makes a big freaking difference. It's boring. Maybe it's not the coolest thing you can think [00:10:10] of, but I promise you it makes a difference. This will make a difference in your practice. Hope this helps you. Catch you next [00:10:15] time.