Performance Max for dentists: when it helps a practice and when it buys poor leads

What it does

Google describes Performance Max as a goal-based campaign type that reaches YouTube, Display, Search, Discover, Gmail and Maps from a single campaign.¹ You supply the ingredients. Google decides where to show the ads, to whom, and in what combination.

Performance Max now has a search terms report showing the searches that triggered your ads. You can add negatives from it, but they apply only to Search and Shopping inventory at account or campaign level. To keep a term away from Display and Video placements, Google says to use excluded content keywords instead.²

Why lead quality suffers

Performance Max does exactly what it's told. The problem is what many dental accounts tell it.

If the conversion action is a form fill, Performance Max will look for form fills anywhere it can find them: Display sites, YouTube, Gmail, Discover. Some of those people want an implant consultation. Plenty will be browsing, curious, or tapping a form they half read. The system has no way to tell the difference, because a form fill is a form fill.

Google's own guidance for lead generation recognises this. It recommends lead-specific conversion goals, such as qualified lead, converted lead or book appointment, which switch on invalid-traffic protections built for lead campaigns. It also recommends enhanced conversions for leads, so the campaign learns from what happened in your records, and value-based bidding where leads have different values.³

Three dental-specific risks sit on top of that:

• Brand cannibalisation. Without brand exclusions, Performance Max can take credit for people who were already searching for your practice by name.
• Generated copy. Google can create assets. In a regulated field, text that nobody has checked is a compliance risk.
• Health restrictions on audiences. Google's personalised advertising policy restricts health categories, including invasive procedures such as surgical procedures, and advertisers in them can't use advertiser-curated audiences.⁴ If a treatment falls inside that, your own customer lists aren't available as a signal. Check the current policy for each treatment before you plan around them.

When it works

I only consider Performance Max when every answer below is yes. Plenty of practices aren't there yet, and that's fine. Search campaigns on treatment keywords do the heavy lifting first.

When I do test it, I set it up so the result can be read:

Measurement first

The rule is simple. Performance Max goes into an account only after offline conversions work. An offline conversion is a result that happens outside the website, such as a consultation booked in your practice system, and is uploaded to Google afterwards.

Two details make the difference. First, the conversion action has to be primary and selected by the campaign, or it won't influence bidding.⁵ Second, the upload has to be timely: Google won't import an offline conversion uploaded more than 90 days after the last click, or 63 days for enhanced conversions for leads.⁶ A monthly spreadsheet someone forgets about won't do. The upload has to run on a schedule.

Once that's in place, Performance Max has something real to learn from, and you can see whether it books patients or just generates forms. The full build is covered under tracking ads to booked treatment. Where Performance Max sits among the other campaign types is in how to run Google Ads for a practice.

If you've been sold Performance Max and aren't sure what it's buying, see running Google Ads for a practice for how I approach accounts, or email [email protected].