What I changed (concise actions)

Switched from low-volume, high-cost placements to high-reach, lower-bid placements (audience expansion + lookalike scaling).

Aggressive creative refresh + stronger CTA on top-performing creative variants (A/B test 1:3 cadence).

Tightened campaign structure: separate prospecting vs remarketing, manual bid floor removal → paced spend to target ROAS.

Implemented event dedup and cleaned pixel (reduced tracking noise → better optimization signals).

Hourly budget pacing to control early-day overspend and keep avg CPC low.

Key Learnings & Opportunities

Search term optimization: Increasing spend on high-intent medical queries can scale appointment volume 2–3× while protecting CAC.

Landing page refinements: Stronger trust elements (doctor credentials, reviews, treatment photos) could lift conversion rate another 10–20%.

Location-focused growth: Expanding to neighboring high-income pin codes would extend reach with minimal CPC increase.

Remarketing strength: Google Display retargeting of site visitors + booking intent pages adds an additional capture layer for non-converting traffic.

🧠The acquisition engine is efficient primed for managed scale.

Hiring/evaluation highlights

Discipline in bid/pacing and placement selection to drop CPM from $93.8 → $6.14.

Experience debugging pixel/attribution issues and restoring accurate optimization signals.

Hands-on creative QA + test roadmap, and structured account architecture for scale.

Immediate impact & narrative

Delivered +137% clicks while reducing total spend to ~$952 / month (from $2.45k reported baseline) meaning we reached far higher volume at a fraction of previous cost-per-click. This demonstrates scaling discipline: increase top-of-funnel reach without proportionally increasing spend.