So the last time Mikey had the mic, he wrote about programmatic advertising. That was about six months ago. What's actually different since then? Not a trend everyone's talking about, just what you're actually seeing day to day.
Sean Bell: "One of the biggest things for my accounts has been getting return on ad spend estimates. For pretty much all my accounts where I've been able to get signed-client data, that information is helping optimize the ad accounts and create a better outcome. With maybe a few exceptions, those are actually my top-performing accounts now. Essentially, we're matching up the clients who actually sign with our database of leads, to get as close as we can to real attribution for everyone who comes in."
Michael Eiden: "We're testing this on a smaller basis right now, just to make sure it works well, but we're able to start doing offline conversion uploads for aesthetics and medical too, or at least the parts that are non-HIPAA sensitive. We upload hashed data to Google so it can send signals back directly into the platform. If we're getting a lead from Google and they end up doing a facelift, we're injecting that back into Google Ads, so it can go find more people who had a similar journey and are likely to convert the same way."
Sean: "There are other companies out there charging a lot of money for something similar. It's not that the product itself is complicated, it's actually pretty simple."
Michael: "HIPAA obviously complicates things on the medical and aesthetics side. For clients affected by that, we're working within those barriers to offer something similar. It's still in the early stages of rollout right now, we're testing it carefully before we scale it up. We've had this fully rolled out for legal for a while now, it's a lot less complicated on that side."
How's the programmatic rollout gone since we last spoke? Any surprises?
Michael: "We finally have real accounts on it now. Last time we talked we maybe had one. Now it's more like six or seven. It's a long sales cycle, but it's moving. I'm also working with our media team to get more actual commercial-style content shot for these campaigns, so we can just upload it and go. We just launched one for a client that does professional services, and the creative on it is genuinely great, not your typical commercial for that kind of business."
Sean: "There's one aesthetics account where we launched programmatic back in the spring. Globally, we haven't seen a jump in patients we can point to directly yet, but we've also made a lot of other changes to be more efficient with total leads, so I can't attribute anything to programmatic specifically just yet. They're not spending a ton either, so I wouldn't expect a huge lift there. But on the meta side for that same account, the new campaign structure has been a clear improvement. It's a two-campaign concept, a testing campaign and a scaling campaign. Any new content, whether it's a produced piece or literally a doctor filming something on their phone, goes into testing first. If it outperforms what's already in scaling, it gets promoted and gets a real budget behind it. Cost per lead dropped by close to forty percent for that account, and that happened during what's typically the worst month of the year for that industry."
Michael: "That's exactly how you should be running ads on meta right now. It takes a lot of creative, constantly swapping things in and out. We're building an internal process to help with that. For clients who already pump out a lot of organic content, we can just take all of it and test what actually hits."
Interesting, so a lot of this comes down to testing in that specific market rather than assuming something. Does that ever clash with what a new client already has in their head, something they saw trending that doesn't actually hold up for their situation?
Sean: "All the time, especially around conferences. Someone hears a case study from another lawyer and wants to replicate it, but every state and every market is different. What works for one firm isn't going to work for another. When they don't get the same result and go back to whoever they were comparing themselves to, next thing you know they're saying their old agency made it worse and they want to switch. Really they're probably going to run into the exact same problem somewhere else, because the markets are just that different."
Michael: "On our end, the amount of requests we're getting for meta ad proposals right now is insane, from sales specifically. Clients are saying they want to do meta ads. It's one of those things where they've heard it's done really well, and if you do it right, it does work really well. We're seeing a flurry of these, from new clients coming to S3 and existing ones who want help fixing what they've already got running."
Once people actually see the proposal, are they receptive, or is there a gap between what they expected and what's actually being pitched?
Gabriel Marrazzo: "The flurry's been pretty recent, so the return on it isn't fully realized yet. But we are definitely launching more meta campaigns than before. Some of that's on our end too, honestly. It's less that we changed our minds and more that the platform and our process caught up. A few years ago, meta wasn't a great fit for a lot of these accounts, and we'd tell clients that straight up. Now we've built out the creative testing and campaign structure to actually make it work well, so we can offer it with real confidence instead of just saying yes because someone asked.
I think the hardest part is controlling expectations and the reality of the platform itself. People have this idea that if you're paying for ads, you're paying for your business to do well. But with meta, it's more like a needle in a haystack. You're going after people who never actually showed interest in what you're putting in front of them. That's different from Google, where someone's already out there looking.
I actually feel like meta is almost returning to the idea of analog advertising. You have to have good branding and good creative, or the product just doesn't sell, no matter who you're targeting or where. It's back to casting a wide net, because you need more reach than just your local area is giving you. That means the creative has to carry a lot more weight than it used to, which is honestly part of why we hadn't leaned into it as hard before. Good creative is a massive lift, and we don't always have full control over the time that takes."
Sean: "Going off that, the creative is the driving force behind what makes social ads actually work. A lot of clients, especially legal, come in wanting their social ads to look and feel like their TV commercials. That's usually not the right approach. It's more informal. People want to see the personalities, and you need real value propositions stated plainly, back to back, not dressed up."
Is that where expectation management comes in? Laying that foundation costs money upfront, before the return shows up.
Sean: "Yes, that's upfront. But that's also why we run the testing and scaling structure, because a client might think they know what's going to work, and we don't know until we actually test it in their specific market."
Gabe: "On the expectations side, our proposals now spell out what we need from the client too, not just what we're going to deliver. Basically, if you can't close 25 to 30 percent of the leads we're sending you, this campaign isn't going to be worth it. You need someone consistently manning the phones or managing DMs. We set everything up as best we can on our end, but if that part's not dialed in, you're leaving money on the table. It's a little bit of people getting sticker shocked by the spend and thinking they can sit back and let it happen. It's actually the opposite. It's time for them to light a fire under themselves too."
That ties into conversations we've been having on the intake side too. What does that actually look like when it goes wrong?
Gabe: "It's shocking, honestly. I used to listen to phone calls when I was just a strategist, and I'd hear front desk staff completely fumble a call. Someone asking about a specific procedure, and the person answering has no idea what that even is, or tells them the doctor doesn't do that when they actually do. You're watching good leads get flushed for no reason."
Michael: "One account we work with runs it the opposite way. Every phone across every location rings at once when a call comes in, so whoever's free picks it up and books it wherever makes sense. I was blown away by that model. It's genius, because you're never going to miss a lead, and how fast you pick up the phone matters that much."
Gabe: "That's someone who's got his intake completely dialed. I always try to push clients toward getting people to call or text rather than just fill out a form, because you're offering something closer to a concierge service. People want to feel comfortable; they want rapport. A form just devalues that, especially if nobody's on top of the inbox. I had a conversation with a newer client who was really upfront about it. I asked them straight up, do you have someone at the desk who can answer the phone when it rings? They said no. I told them, until you figure that out, I don't advise doing this. You're going to blow money and be upset about it. I'm not here to push people to spend a certain amount. I'd rather be honest about whether they're ready, and help them get there if they're not."
That seems tied to something bigger, understanding the business itself, not just the ad platform.
Gabe: "When we take over accounts from other agencies, especially for plastic surgeons or med spas, those agencies genuinely don't understand those businesses well. They don't understand the measurement side, the cost structure, what overhead actually means for a practice like that. I've had prospective clients, business owners, CMOs, tell us flat out that we clearly know what we're talking about when it comes to the business side, not just the ad platforms. Other agencies can learn the same backend tools we use. Understanding the business itself is the other half, and that's usually the part that's missing."
Does that ever show up as a win a client doesn't fully connect to digital ads, because the line isn't obvious?
Michael: "Sean's got a good one. Smaller law firm, where Sean set everything up. We're now actually getting signed cases from it, after not seeing much for about two years."
Sean: "It's really only been the last week or two that we've started seeing direct signs. I was actually worried they weren't converting anything at all. As time goes on we'll be able to optimize the campaign further, now that we know it's working."
Gabe: "We've seen the inverse in aesthetics. A doctor's leads were pretty flat for about six months. Eventually they weren't booking enough to justify the spend, and advertising is always the first thing people cut when cash flow tightens. Once they turned it off, they got basically no leads at all. That's when it became clear ads were the thing actually keeping everything moving, not word of mouth or their returning customers or anything else they assumed was carrying it."
Sean: "That's the halo effect, basically. Everything we do has some effect on everything else, they all play together. Our attribution is accurate to what we can specifically trace, but it's not the full picture of where a business's growth is actually coming from. What we can match is the floor, not the whole story. There's a lot of unattributed stuff that had some hand in it too. It's hard to explain to clients because they get fixated on one channel and miss the bigger picture."
Gabe: "A lot of the private equity groups and larger groups that come to us want results fast. But the reality is we're not trying to keep someone around for a quick win, we're trying to build something that lasts. That shapes the strategy a lot. Sometimes a client will ask for something and I'll tell them, I get why you want that, but here's why I think it's actually a bad idea. Advertising directly for the highest-demand, highest-competition service usually costs more than it's worth. It's better to get people in the door a different way and let the practice do the work of retaining them once they're already a patient."
Last time we talked programmatic and retargeting. What's on the horizon now, even if it's not fully ready to talk about yet?
Michael: "We're not ready to charge clients to place ads on AI platforms just yet, and we're not going to be until we're confident it's actually worth the spend. But behind the scenes, we're sorting through everything as fast and as thoroughly as we can, so that once we are confident in a strong return, this is something we can offer. Hopefully next time we talk we’ll have a real picture, good, bad, or ugly."
Sean: "Someone sent an article recently that basically said every marketer out there is still figuring out how to use these platforms. Nobody has it solved."
Gabe: "It's a black box right now. Nobody really knows what's happening on the backend yet."
Michael: "They're still figuring out what they're even trying to deliver as a product. We're learning as they're learning, which isn't ideal, but it's the only way through something this new. If you look at how Google evolved paid search over time to maximize their own profit, there's going to be a lot of change in how these AI platforms place and prioritize ads too, especially once it starts making them more money to do so."
Sean: "Honestly, what's crazy in digital ads right now? Nothing's massively changed. The core strategies have been the same for years."
Michael: "If it ain't broke…But it ties back to everything we've talked about. The need to establish a brand is more important than ever. It spans advertising, it spans SEO, it spans AI. It's the biggest non-negotiable right now. When digital first came in and everyone chased precision targeting, brand took a backseat. Now we're right back to needing people to just know who you are. In a lot of ways, it's less about anything being new and more about getting back to fundamentals that always mattered."
