First post (sorry...it's a wordy one), so be nice please

I have been running Adwords advertising since 2005. I run a healthcare clinic and Adwords has been a great source of business. Since that time, I have generally appeared in the top 2 or 3 of the Sponsored Links section. Since the beginning of the year, I've dropped to the 4/5 position way over on the right side of the screen. You know, the area that no one really pays attention to.

I'll admit, I've been bad and haven't kept up on new tools, info, updates, etc., and now I think I'm paying for it (literally).

So, I've done a bunch of reading and feel more confused and frustrated than ever. I feel like just flushing my campaigns and starting all over the right way, and need some help.

Since I run a clinic that caters to the local community, with no e-commerce, I'm really only interested in customers within a 20-25 mile radius. I am currently running a locally targeted campaign, as well as a general campaign. If I never had a visitor/click from outside that area, I would be extremely happy.

Some history:

The local campaign is targeted to the area within 25 miles. I have 4 keywords, search network only, with a click through rate of less than 1% on all. Keyword analysis for all gives the message: The Ads Diagnostic Tool "quick test" does not work in this campaign because the campaign's geographic targeting is not supported

Regional campaign has 2 adgroups, each targeting one of each of the 2 main cities that I cater to (within 20 miles). Each adgroup has ~20 words/phrases, equally split between exact match, phrase match and broad match. Quality score ranges between 4-7/10, but mosltly 6s and 7s. CLick through rate ranges from .5% to 6 and 7%. Some of the phrase match don't display during searches because exact match already covers the bases. And exact match has a better click through rate.

So, where do I start? Should I stick with a locally tagerted campaign only? Should I stick to the regional campaign and ditch poorly performing keywords (low click through and poor quality score)? If I have a logical starting point I can settle down and get to the business of fixing things. Or, should I scrap things and start over? I've read that poorly performing adgroups/campaigns/keywords can affect overall adwords performance. I've also read that I should be running many small campaigns and adgroups. Sooooo confused.

BTW, I know EXACTLY who my competition is if that's helpful. In my field there isn't that much competition, but enough who know what they're doing to relegate me to Tumbleweedville on the right side of the search results screen.

Thanks for your help (and for your patience).

Hard to know specifically what's wrong without seeing the keywords and the ads.

Your CTR seems low whch makes me thing you're either bidding on keywords/phrases that aren't really the right ones or your ads aren't doing a good job enticing people to click.

The averagish quality score would suggest your landing pages aren't matching so well with your ads and keywords.

I don't know that you have to scrap everything to start over, but maybe it would be a good time to reload. You can try changing the ads to see if you can improve them. Do you run multiple ads per group to test them against each other?

Maybe get back to research keywords and phrases and building some new groups with new ads. You could start with the ad testing on the current campaign while you're researching and then when you have a list of new keywords start adding them into your current groups or creating new ones.

Hope that helps some.

I'm not to familiar with AdWords, but just a suggestion you may want to try Facebook advertisign. You can set an extremely specific target group by area code, age, gender, marital status, etc etc. You can find a free $100 coupon to try it out too.

Thanks so much for your quick response!! I guess my first question to you, after thinking about things, would be: Since I'm catering specifically to a local target area, should I simply stick with a locally targeted campaign and scrap my regional targeting? Like I mentioned, I only want clicks from my specific area since customers need to drive to my location. If that makes more sense, I would transfer the more effective key words from my regional campaign to the locally targeted campaign. I'm assuming those new local keywords, if effective, would display in the Sponsored Links area even though the regional campaign would be shut down?

The regional campaign does have more keywords, and definitely more effective keywords than the local campaign, which is very stripped down. The regional campaign also takes advantage of all keyword matching types, whereas the local campaign, as it stands now, only uses general matches.

Originally Posted by vangogh

Hard to know specifically what's wrong without seeing the keywords and the ads.

Your CTR seems low whch makes me thing you're either bidding on keywords/phrases that aren't really the right ones or your ads aren't doing a good job enticing people to click.

The keywords in the regional campaign do better than local. In the regional campaign I am targeting the 2 major nearby cities (both within 20 miles). For fun, lets say I'm a dentist and the cities are A and B. I am using general, phrase match, and exact match combinations - eg. dentist in A, dentist in B, dentistry in A, B dentistry, etc. (combinations of the same keywords using the different match types). In the locally targeted campaign I am using simply the words: dentist, dentistry, dental...since it's local, I figured the cities would take care of themselves and those words wouldn't need to be part of the keywords/phrases.

Originally Posted by vangogh

The averagish quality score would suggest your landing pages aren't matching so well with your ads and keywords.

This does need some work. My ad is wound fairly tightly into my homepage/landing page, but my ad title doesn't match well. With a locally targeted ad, would it be helpful to have my full clinic address appear on each page? at the top? or bottom? I will look deeper into working some uniformity into keywords, ad and landing page.

Originally Posted by vangogh

I don't know that you have to scrap everything to start over, but maybe it would be a good time to reload. You can try changing the ads to see if you can improve them. Do you run multiple ads per group to test them against each other?

I don't but maybe I should. Again, should I switch to local only and create a few ads and run against eachother?

Originally Posted by vangogh

Maybe get back to research keywords and phrases and building some new groups with new ads. You could start with the ad testing on the current campaign while you're researching and then when you have a list of new keywords start adding them into your current groups or creating new ones.

I have begun researching the competition sites and have come up with some new keywords. I wonder if I'm shooting myself in the foot by being more specific with a regional campaign and very vague with my local. I'm just worried that a good local-only campaign won't get the same results as the regional. Then again, a regional campaign may get more impressions and less clicks since I may be drawing people outside of my area that don't click on my ad (since it is so specific to my area).

Well, I'm confusing myself, but hopefully not you. I really do appreciate your help.

Since the regional cities are both within the 20-25 miles I see no reason to stop advertising to them. I'm not sure you have to go more or less specific on the regional or local. I would think the same ads that work in one would work in the other.

Instead of setting up campaigns based solely on geography why not try grouping things around keyword themes. I'll use your dental example. You could set one group around keywords with a theme of tooth decay and another group around a theme of gum disease. Maybe groups around root canal or braces. That way you can target the ads better and send people to better landing pages. Your tooth decay ads would all lead to a dedicated page on tooth decay and similar for the other themes.

And do test different ads. Once you get a fair amount of traffic to the ads you should see one ad outperforming the other.

If you're using your location in the ad I would think placing it in the page title or at least on the page would help. Even if it's not in the ad it still makes sense for your visitors.

Do you set negative keywords? You mentioned using several match types. Know that the broad match type will show your ad more, but often to untargeted traffic. Exact match will show your ads to the most targeted people. Phrase will be somewhere in between.

Thanks Vangogh. I'll give your suggestions a try and give you an update later. I appreciate it!

Glad to help. Hopefully it works, but feel free to ask more questions as you have them.

Well, I ran a bunch of reports on my local campaign today and was horrified by the results. I mentioned that the local campaign was stripped down. In keeping with my hypothetical theme, I used 4 keywords only in this campaign - dentist, dentistry, dental, etc.

The results on the search strings that got me clicks? dental schools, horse dentistry, dental disease, dental insurance, etc. you get the idea. That's a lot of money for a whole lot of crap.

So, I'm re-writing ads, titles, learning how to use dynamic keywords, etc. I think the locally targeted campaign could be a good payoff, but it needs to become MUCH more specific before I unpause it. I was using up 3-4x more budget dollars on useless clicks as compared to my regional campaigns. I've also paused all keywords that were performing poorly - I looked at historical data for the last 18 months.

So, thanks for the input...quite an eye-opener.

One more question, where can I find good info about 1) improving local ad placement and 2) improving organic results ranking? I've been reading a bunch lately but there are many conflicting views. Do you have a good reference?

Thanks again!

Sorry to hear about the ad campaigns, but at least you're working on it now.

I'm not sure there's anything specific to local ad placement that you haven't already done. The rest is really writing ads your local market would respond to.

As far as the organic results I'd say keep reading. Unfortunately there is a lot of conflicting information and it can be difficult to sort out. Try not to get caught up in the quick fixes.

Here are some free guides to get you started.