In short
- The practice should own its domain, website, ad accounts, listings and data, with the agency granted access, and the contract should say so.
- Read the contract for term length, automatic renewal, cancellation notice and fees, and have your attorney review anything unclear.
- Medical content, including AI-assisted drafts, should be reviewed by a clinician and approved by the practice before it is published.
- Judge an agency by tracked calls and booking requests in plain reports, and be cautious of anyone who guarantees rankings or patient numbers.
Most problems between a practice and its marketing agency start with questions nobody asked at the beginning. The proposal covers services and price, but the issues that cause trouble later are usually ownership, contract terms, content accuracy and how success is defined. The questions below apply to any agency, and a good one will answer them without hesitation and put the answers in writing.
Who owns the website, the domain and the accounts
Ownership is the most important thing to settle, because it determines how much freedom you have later. Some agencies build sites on proprietary platforms or register assets in their own name, which can leave a practice starting over if the relationship ends. Ask these questions directly:
- Domain: Is the domain registered in the name of the practice, with a login we control?
- Website: Do we own the design, text and images, and can the site be moved to another host?
- Advertising accounts: Are the ad accounts ours, with the agency added as a manager, or do they belong to the agency?
- Listings and analytics: Does the practice hold owner-level access to its business profile, analytics and call tracking?
- Phone numbers: If tracking numbers are used, can they be transferred to us if we leave?
The safest arrangement is that the practice owns everything and grants the agency access. Ask for that in the contract, not only in conversation.
What the contract commits you to
Read the agreement for its length, its renewal terms and its exit terms. A longer commitment is not automatically a bad sign, since search work in particular takes time to show results. What matters is that you understand the terms before you sign.
- How long is the initial term, and does it renew automatically?
- How much notice is required to cancel, and is there a fee?
- Which fees go to the agency and which go to advertising platforms, and will we see the platform invoices?
- What is included in the monthly fee, and what is billed separately?
If anything is unclear, have your attorney review the agreement before you sign it.
Who writes and reviews the medical content
Content about procedures, conditions and treatments carries your name and your license. Ask who writes it, what background they have, and who checks it before it is published. Many agencies now use AI tools to draft content, which is reasonable as long as the process is disclosed and qualified people review the result. For medical topics, that should include review by a clinician, and you should have final approval of anything that describes your services.
Ask the same questions about chat tools or AI assistants on your website. They can help with scheduling and general questions, but they should never give medical advice, and any patient information they collect should be handled with HIPAA requirements in mind. Ask whether the agency will sign a business associate agreement where one is appropriate, and confirm the details with your compliance contact.
How results are measured
Clicks, impressions and rankings are activity measures. They are useful for diagnosis, but they do not tell you whether the practice gained patients. Ask the agency how it connects its work to the outcomes you care about:
- How are phone calls and form submissions tracked, and can we tell which channel produced them?
- Can appointment requests or online bookings be counted by source?
- How do you separate new patient inquiries from existing patients, vendors and wrong numbers?
- How is call and form data stored, and who can see it?
Be cautious with any agency that guarantees rankings, a set number of patients or placement in AI-generated answers. No agency controls search engines or AI systems, so an honest one will talk about expected direction and how progress will be measured, not promises.
Experience with medical advertising rules
Medical advertising is more restricted than most categories. State medical and dental boards have rules on advertising, testimonials and claims. Federal agencies regulate deceptive advertising and how drugs and devices may be promoted. Advertising platforms have their own healthcare policies, and tracking technology on medical websites raises privacy questions.
You do not need the agency to act as your lawyer, and it should not try to. You do need it to recognize these issues and flag them early. Ask how it handles before and after photos, patient reviews, claims about outcomes and tracking pixels on pages where patients share health information. Then confirm the specifics for your state and specialty with your own counsel or compliance contact.
Reporting and what happens if you leave
Ask to see a sample report before you sign. It should be readable by someone who is not a marketer, show calls and booking requests alongside spending, and explain what was done that period and what is planned next. Ask how often you will meet and who your contact will be.
Then ask about the end of the relationship while everyone is still on good terms:
- What do we receive when we leave, and in what format?
- How quickly will website files, logins and account access be handed over?
- Does any content, tracking number or listing remain with the agency?
- Are there transfer or release fees?
We are Rx Medical Web, a physician-owned agency that works only with medical practices, and we think these questions are fair to ask of any agency, including us.
This article is general information for medical practices. It is not legal or medical advice.
