As Google Ads becomes a cornerstone of digital marketing for healthcare providers, advertisers are increasingly guided by Google’s automated benchmarks—chief among them, ad strength. This rating system, which scores ads from Poor to Excellent, is intended to improve ad relevance and engagement. But does it actually translate to better results?
For many healthcare providers, the answer is no.
While Google suggests that ads rated “Excellent” deliver stronger performance, real-world data and experience tell a different story. In practice, ads rated “Average” or “Good” often outperform their “Excellent” counterparts—especially in highly regulated, trust-sensitive sectors like healthcare.
Here’s why ad strength can be misleading, and what providers should do instead.
What Is Ad Strength in Google Ads?
Ad strength is a metric used to rate the quality and variety of Responsive Search Ads (RSAs). Google encourages advertisers to:
- Add multiple, unique headlines and descriptions
- Avoid pinning any headline to a fixed position
- Include high-volume keywords and dynamic content (like location insertion)
The goal is to let Google’s algorithm mix and match ad elements to serve the best combination based on the user’s query. While this sounds promising, it introduces a significant challenge in healthcare: loss of message control.
Why This Approach Can Backfire in Healthcare
In industries like retail or travel, AI-generated headline combinations can work well. But healthcare advertising demands accuracy, clarity, compliance, and empathy—qualities that often get diluted when headlines are dynamically shuffled.
Here are some of the specific risks healthcare providers face when pursuing an “Excellent” ad strength score at the expense of message quality.
Real-World Examples: When Automation Undermines Patient Trust
Let’s look at practical examples from healthcare services to illustrate the problem—starting with ultrasound clinics and urologists in the UK.
❌ Example 1: Ultrasound Clinic – Mixed Messaging Across Scan Types
- “Private Pregnancy Scans”
- “Musculoskeletal Ultrasound”
Why it’s a problem:
These are two entirely different services for two very different audiences. Mixing maternity and musculoskeletal scan headlines can confuse users, create distrust, and signal a lack of specialization.
❌ Example 2: Ultrasound Clinic – Conflicting Location Information
- “Scans in Central London”
- “North London Available”
Why it’s a problem:
If your clinic only operates in Central London, suggesting North London availability is misleading. This not only frustrates users but could also result in regulatory complaints under CQC and ASA guidelines in the UK.
❌ Example 3: Urologist – Inaccurate Referral Information
- “No GP Referral Needed ”
- “Consultation with Consultant”
Why it’s a problem:
In urology, certain procedures or assessments (e.g., prostate checks, erectile dysfunction evaluations) often do require a referral. Misleading patients on this point risks not only poor experiences but also ethical and legal implications.
❌ Example 4: Ultrasound Clinic – Price Confusion
- “Abdominal Ultrasound from £49”
- “3D Baby Scan Packages”
Why it’s a problem:
Combining a diagnostic scan price with an elective 3D scan promotion could give the impression that all scans are priced similarly. This misrepresentation may fall foul of advertising standards, and damage your clinic’s reputation.
✅ The Smarter Alternative: Pinning with Purpose
To maintain control over messaging—and ensure relevance—you should pin key headlines into specific positions. Google penalizes this slightly by lowering your ad strength score, but the performance benefits outweigh the tradeoff, especially in healthcare.
Recommended Pinning Strategy for Healthcare Ads:
- Pinned Headline 1: “Private Pregnancy Scans”
- Pinned Headline 2: “Central London Clinic”
This approach ensures the most important details are always shown, boosting clarity, compliance, and user trust.
The Data Backs It Up
In a recent review of 3,660 Google Ads campaigns, including those in health and wellness sectors, a clear trend emerged:
- Ads with “Excellent” ad strength often had higher CPCs and lower CTRs
- Ads rated “Average” or “Good,” particularly those using strategic pinning, delivered higher ROAS and more consistent conversions
Why? Because automated combinations often lack precise relevance—especially when dealing with clinical services that vary by location, referral protocol, or specialty.
How to Audit Your Own Ads
To see if this applies to your campaigns:
- Go to Google Ads > Campaigns > Ads
- Export data with these key columns:
- Ad Strength
- CTR (Click-Through Rate)
- CPC (Cost-Per-Click)
- Conversion Rate
- ROAS
- Segment by service line (e.g. ultrasound, urology, physiotherapy)
- Compare performance across ad strength tiers
You may find that ads with lower ad strength perform better, especially when messaging is tightly controlled.
🔑 Key Takeaways
| Action | Benefit |
|---|---|
| Don’t chase “Excellent” blindly | Focus on patient relevance, not algorithmic scores |
| Pin your most important headlines | Preserve compliance, clarity, and professionalism |
| Segment by service type | Avoid mismatched or confusing ad combinations |
| Test and analyze | Use pivot tables to compare CTR, CPC, and ROAS by ad strength |
| Remember your audience | Patients need clear, trustworthy, and empathetic messaging |
Final Thought: Optimize for People, Not Algorithms
Healthcare advertising isn’t like selling shoes or booking hotels. You’re speaking to people who may be anxious, unwell, or in search of sensitive medical services. Your ads must reflect that reality—with consistency, compassion, and clarity.
If achieving “Average” ad strength means better patient communication and lower CPCs, then that’s not a compromise. It’s a smarter strategy.
