How Far Should You Target Google Ads for a Medical Practice?

A dermatology practice called us in June, frustrated. They had been running Google Ads for four months, spending about 2,500 dollars a month, getting plenty of clicks, and almost no new patients to show for it. When we opened the account, the problem was obvious in the first thirty seconds. They had targeted their entire metro area, a good 40 miles across, with the default location setting turned on. So they were paying for clicks from people an hour away, and from people who were not even in the state but had searched their city name. Half the budget was going to patients who were never going to walk through the door.

This is the most common way medical practices waste money on Google Ads, and it comes down to one question that sounds simple but almost nobody answers correctly: how far out should you actually target? Draw the circle too wide and you pay for clicks that never book. Draw it well, and the same budget suddenly starts filling the schedule. Let's get it right.

Start with how far patients actually travel

Your ad radius should match reality, not hope. And the reality is that people do not drive far for routine care. One analysis of healthcare visits found a median one way travel distance of about 7.7 miles, with most visits falling well under that. A separate survey from the American Association of Nurse Practitioners found that 40 percent of people travel more than 10 miles for care, which means the clear majority travel less. For everyday services like a cleaning, a skin check or a physical, most patients pick something close.

So when you target a 25 mile radius or a whole metro for a routine practice, you are advertising to a huge ring of people who will simply choose the office nearer to them. You pay for their click, they book down the street. That is not a patient problem. It is a targeting problem.

A starting radius by practice type

There is no single number, because a med spa and a fertility clinic live in different worlds. But here is the honest starting point we use, then adjust from the data:

• Dense city practices (dental, med spa, primary care, optometry). Start at 5 to 7 miles. In a city, 7 miles can already mean a 40 minute drive through traffic, which is more than most people will do for a cleaning. Tighter is usually better here.
• Suburban practices. Start at 10 to 15 miles. People are used to driving a bit more, and the population is spread out, so a slightly wider circle keeps you in front of enough patients without reaching into the next town over.
• Rural practices. Go wider, 20 to 40 miles, because the nearest alternative may genuinely be far away. Here distance is not waste, it is the market.
• Destination and specialty practices (fertility, bariatric surgery, ketamine therapy, a rare subspecialty). Radius matters less. People will drive an hour or fly for these, so you target by where your ideal patients are, not by a neat little circle.

Notice the pattern. The more routine and replaceable the service, the tighter the circle. The more specialized and worth traveling for, the wider you can go. Match the radius to how far a real patient would actually drive for that specific service, and you have already beaten most of your competitors' setups.

The one setting that quietly drains your budget

Here is the part almost every practice gets wrong, and it has nothing to do with the radius itself. Inside Google Ads, under advanced location options, there is a setting that decides who counts as being in your area. The default, and Google's recommended choice, is called presence or interest. It shows your ad to two groups: people physically in your area, and anyone, anywhere, who merely shows interest in it. That second group is the killer.

Interest means someone in California searching your city name because they are researching for a parent, or someone three states away who typed your town into a search. They will never book you. But with presence or interest turned on, you pay for their clicks all day long. The fix is to switch it to presence, which Google describes as people in or regularly in your targeted locations. That one change filters out the geographically impossible clicks that quietly eat a real slice of a local budget, and it is buried deep enough in the settings that most self serve accounts never touch it.

Radius, or zip codes and cities?

A radius is the easy way in, and it follows real driving patterns around your office, so it is a fine place to start. But it is a blunt tool. A 10 mile circle treats the wealthy neighborhood that sends you cash pay patients exactly the same as the area across the highway that only ever sends price shoppers and no shows.

That is why the strongest setups graduate from a plain circle to targeting specific zip codes and cities. You keep and bid up on the areas your best patients actually come from, and you exclude the ones that only spend money. The way to know which is which is to look at your own data: pull the geographic report after a month or two and see which zip codes turn clicks into booked appointments. This is the same reason we always tell owners to track where patients come from in the first place. Without that, you are guessing at your own map.

Wider is not more patients

The instinct, when the phone is quiet, is to widen the radius and reach more people. It almost never works the way owners hope. A wider circle does bring more clicks, but the extra clicks come from the edges, where people are farther away and less likely to book. So your spend goes up, your booked patients stay flat, and your cost per new patient gets worse. You did not buy more patients. You bought more window shoppers.

If your ads are getting clicks but not bookings, the answer is usually the opposite of widening. It is tightening the targeting, fixing the location setting, and making sure the page they land on actually turns a visitor into an appointment. We wrote a whole piece on that gap between clicks and booked patients in why your ad clicks are not booking patients, because a wider net over a leaky funnel just wastes money faster.

How EtherealMinds gets the radius right

Getting the circle right is not a one time setting, it is a habit. When we run patient acquisition campaigns for a practice, we start with a radius that matches how far patients really travel for that service, set the location option to presence so you are not paying for people who could never book, and exclude the areas that do not fit. Then we let the account run, read the geographic report, and reshape the targeting around the zip codes that actually produce appointments. The circle gets smaller and smarter over time, not bigger and lazier.

The other half is what happens after the click. A tightly targeted ad still fails if it lands on a slow page or a form nobody finishes, so our websites that convert and our follow up system make sure the patients you paid to reach actually make it onto the schedule. Good targeting decides who sees you. Everything after it decides whether they book. You need both, and they need to be built together, not bolted on.

Our honest take

If you take one thing from this, make it this: for most medical practices, the problem is never that your radius is too small. It is that it is too big, and that the default location setting is letting Google show your ad to people who will never set foot in your office. Start tight. Set the option to presence. Watch which zip codes book, and aim there. A small, sharp circle beats a big, hopeful one almost every time.

Google's defaults are built to spend your money, because more reach means more clicks means more billing for them. That is not a conspiracy, it is just how the tool is tuned, and it means the burden is on you to pull it back to what a local practice actually needs. Draw the circle where your patients really live, and the same budget that was quietly leaking starts filling your calendar instead.