A surgical patient costs about $610 to acquire, the highest in medicine. Most of that cost is decided at the front desk.

The published numbers

Two things stand out. Acquisition is expensive everywhere in the category, and retention is cheap by comparison: $35 to $85 to keep a patient against $150 to $600 to find one. A clinic that recalls its existing patients properly is buying growth at a fifth of the price. The second is that the blended figures are several times the cost per lead, which means most of the cost is incurred after the click.

Where the money goes between enquiry and consultation

The reply

In the practices we audit, the median time to a human reply to a web enquiry is measured in hours, and out-of-hours enquiries often wait until the next working day. Seventy percent of health questions put to ChatGPT arrive outside clinic hours (OpenAI), and a patient who has just asked an assistant which clinic to trust is contacting more than one. The clinic that replies within the hour is usually the clinic that gets the consultation. A response-time standard costs almost nothing and is the highest-payback change in most diagnostics we run.

The form

Enquiry forms that ask nine questions before a phone number lose most of their starters. The practical test is to enquire as a patient on a phone and count the steps. Fewer fields, a visible phone number, a clear statement of what happens next, and online consultation booking where the practice can support it.

The close

Treatment coordinators who quote a price for a clinical procedure by phone lose the consultation to the cheapest quote in the city. The method we teach is strict: listen first, reflect the concern in the patient's words, explain what a consultation involves, book it. Price is discussed when the clinician has set the plan.

Why the cost keeps rising

Three forces. Auction prices in healthcare search rise every year as more clinics bid on the same procedure terms. Platform rules tighten: Google forbids personalised and remarketing targeting around cosmetic procedures and injections, and Meta restricts lower-funnel health pixel events, so paid media gets blunter as it gets dearer. And discovery is moving into AI answers that name three to five clinics and cannot be bought, so a growing share of patients form a shortlist before any ad is seen.

The arithmetic a clinic owner should run

Take last quarter's marketing spend, agency fees included. Divide by consultations booked, then by treatment plans accepted. Most owners have never seen the second number and are surprised by it. Then ask where along the path the enquiries went. If half of enquiries never reach a consultation, the practice does not have an advertising problem, and buying more enquiries is the most expensive way to find out.