How to choose a med spa marketing agency

Choosing a marketing agency is a difficult purchase for a reason that has nothing to do with marketing.

You are evaluating something you cannot assess technically, presented by people whose actual expertise is being persuasive, and the cost of getting it wrong is six months and a meaningful amount of money. Every agency sounds competent in a sales call. That is the one skill all of them definitely have.

So the useful thing is not a list of questions, because most agencies have prepared answers for the obvious ones. The useful thing is knowing what a good answer sounds like and what a bad one sounds like, so you can tell the difference in real time.

Here are the questions worth asking, in the order I would ask them.

Who is actually going to do the work

Ask for names. Ask who writes, who designs, who manages the ads, and who you will talk to when something is wrong.

A good answer names people and is specific about the division of labor. It also tells you honestly if part of the work is contracted out, because plenty of good agencies do that and there is nothing wrong with it as long as you know.

A bad answer describes a team. When someone says you will have a dedicated team of specialists, what that usually means is that the person selling you will not be involved after the contract is signed, and the person writing your content has never spoken to you. This is the most common gap between what is sold and what is delivered, and it is worth being direct about it before you sign rather than discovering it in month two.

What happens to my accounts if we stop working together

Ask specifically about the ad accounts, the website, the domain, the content, and the historical data.

A good answer is that you own all of it, and that if you leave you keep everything including the performance history. It should be immediate and slightly bored, because it is obvious to anyone operating properly.

A bad answer is reassuring without being specific. Any hesitation here matters. Ad accounts created under an agency's business manager rather than yours, websites built on a proprietary platform you cannot export, and content you have no files for are all ways that leaving becomes expensive. That is sometimes an accident and sometimes a strategy, and from the outside they look identical.

How much of my time will this take

This is the question owners most often skip, because asking it feels like admitting you do not want to be involved. Ask it anyway. You are already out of hours, which is why you are hiring someone.

A good answer is a specific amount of time and a description of what you will actually be doing. Approving a calendar, signing off on anything that makes a claim about your practice, and one call a month is a reasonable shape.

A bad answer is not much. That is not an answer. Every marketing relationship requires something from the owner, and an agency that pretends otherwise either has not thought about it or is planning to make it your problem later. The version I have seen most often is an agency that requires very little of you for two months and then gradually requires a great deal, because the work cannot actually proceed without your input and nobody planned for that.

What are you going to measure

Ask what numbers will be on the report before you ever see one.

A good answer names metrics tied to patients and revenue. Cost per booked consultation. New patient count by channel. Average value of a booked appointment. These are the numbers that connect marketing to your schedule.

A bad answer includes reach, impressions, or engagement as headline metrics. Those numbers are not meaningless, but they belong in an appendix rather than at the top of a report. A report that leads with impressions is measuring the agency's activity rather than your outcome, and it is very difficult to tell whether such an arrangement is working until a year has gone by.

There is a follow up question that is more revealing than the first. Ask what happens on the report when a month goes badly. Any agency can produce a good looking report in a good month. What you want to know is whether the format is capable of telling you bad news.

What is the minimum commitment

A good answer is a short initial term followed by flexibility. Three months is reasonable, because almost nothing in marketing produces a fair read in less than that. Month to month after that is a sign of confidence.

A bad answer is twelve months. There are legitimate reasons for a longer commitment, particularly when a large build is involved, but a twelve month lock on a standard retainer usually exists because the agency knows the first four months will be unimpressive and does not want you leaving before the numbers turn. Ask what happens if you want out at month five. The answer tells you a lot.

Have you worked with a practice my size

This is more important than industry experience, and most owners ask it the other way around.

A good answer describes practices similar to yours in scale and structure. A single location practice where the owner still treats patients has almost nothing operationally in common with a four location group that has a marketing coordinator on staff.

A bad answer is a larger practice presented as a comparable one. If every case study involves budgets several times yours, the playbook you are buying was built for a different business, and the parts that made it work may not be available to you.

The three questions most agencies avoid

These are the ones where the honest answer costs the agency something. Ask them, and notice whether you get an answer or a redirect. So that this is not an article that only makes demands of other people, here is how I answer them.

Can you guarantee results?

No, and nobody honestly can. Paid media and local search can move within weeks, and content and organic search generally take one to two quarters to produce something you can see. What I can commit to is telling you what is working and what is not, in a format that makes that visible rather than obscured. If someone guarantees a specific ranking or a specific number of patients, the guarantee is either meaningless in the fine print or the tactics behind it are not ones you want associated with your practice.

What if I want to leave?

Three month initial term, month to month after that, and you keep your accounts, your content, and your data. I would rather you leave in month four than stay a year while quietly deciding it was not worth it.

What do you charge?

Partnerships start at $2,500 a month, and where a practice lands depends on how many channels it needs, how much it publishes, and whether it is running paid media. You get a real number in writing after a call rather than a range.

The thing worth remembering

You are not looking for the agency that answers all of these perfectly. You are looking for the one that answers them directly, including the answers that are not flattering.

The best signal in a sales call is not enthusiasm. It is whether the person on the other side is willing to tell you something they would rather you did not know, before you have signed anything and while you can still walk away.

If they will do that then, they will probably do it in month eight when something is not working. That is the actual thing you are buying.