Most practice owners choose a medical marketing agency the same way. A salesperson calls, the proposal looks sharp, the price seems fair, and they sign. Six months later they’re not sure what they paid for, and they’re not sure how to get out.
I’ve sat on both sides of that table. I’ve also cleaned up after a few of those decisions, and the problems almost always trace back to questions nobody asked at the start. Not hard questions, either. Just the ones that feel awkward to bring up on a friendly sales call.
Here are the ten questions I’d want answered before signing with any healthcare marketing agency. They work for a new agency, and they work just as well on the one you already have.
1. Do you work only with medical and dental practices?
Marketing a dental office is not like marketing a restaurant. There are rules about what you can say, limits on what ad platforms allow for medical services, and patients who behave very differently from ordinary shoppers. An agency that also handles roofers and law firms can be fine, but ask how many of its clients are practices like yours. If the honest answer is “a couple,” think twice.
2. Will you sign a Business Associate Agreement (BAA)?
If an agency touches your contact forms, your call tracking, your chat widget, or anything else that could carry patient information, HIPAA requires a Business Associate Agreement. This is not optional. A good answer is a quick yes. A bad answer is a pause, a “let me check,” or an explanation of why they don’t really need one.
3. Who is your HIPAA officer?
Follow the last question with this one. Ask for a name. “We take privacy very seriously” is not a name. If nobody at the agency owns compliance, nobody is checking the work.
4. What tracking tools will you install on my website?
This is the question most owners never ask, and it’s the one that gets practices in trouble. Ad pixels, analytics tags, chat tools, and form plugins can send visitor information, including what people type into your forms, to outside companies. Regulators have been paying close attention to this. Ask for a written list of every third-party script the agency plans to install, and ask how each one is kept HIPAA compliant. If they can’t explain it clearly, that’s your answer.
5. What exactly does my monthly fee pay for?
“SEO services” is not an answer. “Social media management” is not an answer. Ask for a list of the actual tasks, how many hours they take, and who does them. You don’t need to understand every item, but you should be able to see what a month of work looks like. If the agency won’t write it down, you’ll never be able to tell whether the work was done.
6. Is there a long-term contract?
Some agencies ask for 12 months because marketing takes time to show results, and there’s some truth to that. But a long contract also protects a bad agency from being fired. Month to month is best. If they insist on a term, make sure there’s a clear and simple way out if things aren’t working.
7. Who owns my website, my ad accounts, and my Google Business Profile?
The answer should be “you do,” and it should be in writing. I’ve seen practices lose their website, their domain, and years of ad history because the agency set everything up under its own accounts. One practice came to us after its old agency told them to sign for another year or lose the site. They refused, the agency wouldn’t hand over the files, and we had to build a new website from scratch and move them to a new server. Make sure every account is created in your name, with your login, and that the agency is added as a manager, not the owner.
8. Can I see verified reviews and speak with a current client?
Every agency has testimonials on its own website. Ask for reviews on a site the agency doesn’t control, like Google or Clutch, and ask for the name of a current client you can call. A good agency will have someone happy to talk. A weak one will stall.
9. How will you measure and report results?
Traffic, rankings, and impressions are easy to make look good. New patients are what you’re paying for. Ask how the agency will report calls, form submissions, and booked appointments, and how it will separate patients who came from marketing from the ones who would have found you anyway. If every report is about traffic and none is about patients, something’s off.
10. What is your plan for AI search?
More patients now ask ChatGPT, Gemini, and Google’s AI results which doctor to see, and those tools often get practices wrong or leave them out completely. Ask what the agency’s plan is. A good answer is simple and a little boring: a complete Google Business Profile, a matching name, address, and phone number across every directory, reviews that mention real services, and plain language on your website that says what you do and where. Be careful with anyone who guarantees you’ll show up in AI results. Nobody can promise that yet, and the people who claim to usually don’t understand how it works.
Bring this checklist to every agency call
Print it out, or keep it on your phone, and go through it on every call with a medical marketing agency. It takes about ten minutes. A good agency will welcome these questions, because they describe what it already does. The ones who get uncomfortable just saved you a year.
Frequently asked questions
What is the most important question to ask a medical marketing agency?
Ask who owns your website, ad accounts, and Google Business Profile. If the agency owns them, you can lose everything when you leave. Every account should be in your name, with the agency added as a manager.
Does a marketing agency need to sign a BAA?
Yes, if it handles anything that could contain patient information, such as contact forms, call recordings, chat tools, or appointment requests. HIPAA requires a Business Associate Agreement in those cases.
Should I sign a 12-month contract with a marketing agency?
Only if there’s a clear exit clause. Month-to-month agreements are safer for the practice, and a confident agency will usually offer one.
How long before I see results from medical marketing?
Paid ads can bring calls within weeks. SEO and AI search visibility usually take three to six months. Any agency promising first-page rankings in 30 days should be treated with caution.
About the author
Written by Ben Mansouri, founder of Zevi Digital, a Los Angeles agency that works only with medical and dental practices, and author of The Smart Clinic.