Why Cheap Leads Can Be The Most Expensive Marketing

Your Meta ads are “working” on paper, but the leads feel useless: fake phone numbers, no replies, no bookings, and your front desk burned out from chasing people who never wanted care. We get it. So we’re breaking down what’s actually happening behind the scenes with Facebook ads and Instagram ads for chiropractors, including how bot farming and spam submissions hijack low-friction lead forms.

Then we shift into the fixes that raise real appointment bookings. We talk through when to use Meta lead forms versus a chiropractic landing page, why a higher cost per lead can still be a better deal, and how to add the right friction with higher-intent forms, qualifying questions, and phone confirmation steps that bots won’t complete. We also dig into messaging that attracts problem-aware patients instead of price shoppers, especially now that interest targeting for conditions is limited.

Finally, we cover the unsexy part that decides whether your ads produce patients: follow-up. You’ll hear why most leads require multiple contact attempts, how to build a simple follow-up automation with texts and booking links, and why speed-to-lead within five minutes changes response rates. We also share practical benchmarks like cost per lead, booking rate, show rate, and how to reverse-engineer your ad spend to hit a monthly new patient goal.

If this helps, subscribe, share it with a chiropractor friend, and leave a quick review so more clinics can stop buying “leads” and start building predictable patient growth.

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3. Book a free discovery call with Enrico to level up your business

Transcript

hy Your Leads Never Respond

SPEAKER_00 0:21

Are your Facebook or Instagram ads getting generating leads, but those leads never answer the phone, never book an appointment, or show up with fake phone numbers? You're not alone. This is one of the biggest frustrations chiropractors are dealing with right now. In today's episode, I'm going to break down why this is happening and how chiropractors can fix it. Welcome back to Marketing 101 for chiropractors. I'm Dr. D, and each and every week I bring you tips on how to improve your marketing so that you can grow and scale in a healthy way. This topic of bad leads has been around for years. In the last year and a half, the bots are really making this all weird with AI and how Meta drives their advertising management. So we're not going to get too in-depth behind what's going on because truly, unless you work for Meta, you really don't know how this whole thing is. And the people who work there still don't know the tech behind it. So what's going on is there are farms around the world in Russia, China, everywhere, where they pay people to click on ads. They just get paid all day to click on these. So these bots, and then they train bots to do it too. It's called bot farming. And you are susceptible to this as well because you're advertising on the platforms. Happens on Google Ads too. They click on these and then they fill it out with information, but in hopes of creating phishing scams, phishing emails so that they can be put into your directories. And then once you send out communications via automations or whatever, they're now into your uh spam for you know, into your lists, and then they can counter counter list there. And if there's mistakes on the back end on how people send out emails, sometimes you'll see people send out an email and then you can see all the CCs of all the other 75 people on the email that was sent out. That's what they're looking for. These bots will then take all those emails and then now know that they found you on a lead form and then you sell this, and they're gonna turn back and sell there. Uh, and it can get even deeper onto hacking and getting into your ads account and all this other stuff. So that's what they're doing. Apparently, it's a job, and apparently, people get paid to do this. Uh, pain in the butt for us decreases lead quality and creates a bunch of crap for us. So, how do we work around this? How do we work around this? Lead forms make it too easy for the bots. Now, you're gonna say, Great, I'm gonna create a website, they're gonna go to my landing page. Good. It's actually a smart strategy. However, Meta continuously starts to hate more and more uh people leaving to landing pages. Why? Because Russia, China, India create landing pages to scam people on stuff. Uh, Timu, send them to Timu, send them to their their links. So that's the problem. This is the world we're in. So if we're gonna play online, we got to play with all the crap that comes on online as well. So lead forms make it too easy to submit the information. Landing pages increase your cost to generate leads. I still think landing page is good because even with a higher cost per lead, um, you have better intent, better, better booking systems, better show rates on your landing page. So landing pages win for what we're doing. Okay, just costs costs more to get a lead. That's fine. We just reverse engineering and say, okay, it cost me$35 to capture someone's name and cost me$112 out of all those. Every three leads that come in, I can convert a new patient. And you're like, okay, great. So my lead form, my landing page is better. My my form does uh$21 leads, but it's one in every eight that come in. And you're like, well, it's$160 for them to get somebody through the door on those now. And it creates eight phone calls, eight emails, eight stuff for your team to follow up on. That's where automations come in and help. But, anyways, bots target these forms, people click impulsively on mobile, and some marketers optimize for cheap leads instead of quality. So a$5 lead, if you can get that, is worthless if it never becomes a patient in the end. Okay. The five biggest mistakes chiropractic offices are making with their ads is using low commitment lead forms. So just name, email, and phone number only. You got to ask the qualifying questions. And if you go in there now and create new campaigns, the ads manager already puts you through a flow of highly recommended ways to do your ads. And I highly suggest using them where they have higher intent uh forms, and then they say, hey, have them confirm their cell phone number with an automated text that comes in saying with a code when they fill out the load. Yeah, it's a little bit more friction. But again, if they're doing that step, you're going to eliminate the bots. The bots won't respond to an automated text message that comes back to ask them for a code. They won't do it. So right there, you eliminate the bots, which is great. So asking the qualified questions, bad ad messaging. Just the ad is bad, too short form, not much going on,$29 special. It attracts price. You got it in the headline, you've got it at the top of the ad. You have a very short thing come in for a chiropractic assessment uh for$29. And now you're just getting the price shoppers. They're just seeing the number and like, hey, I'll sign up for$29. Uh, the target, the target's too broad. We are we're not using, we're not using anywhere. We're growing everyone within 20 miles. We want to focus on pain-based interests or test local audiences, and that's the fix for that. And how do we do that? We use it in the ad copy because targeting interests is now limited on Meta. You can't go in there and target people, especially pain or condition. Those are all gone. Even if you try and put in something like that, sciatica, headache, ADHD, there's not even an option there. They removed all of those interest demographics off of their own. Now, what you can find is maybe parents of certain age groups, income distribution, generality across the country, and the the interests are all gone. So, what do we do? We make our ad copy attract the people that we want to try and get. So lengthier ad copy with pain points in there. Focus on pain-based interests or test your local audience to do that. Then there's no follow-up system. Most leads require five contact attempts. But most offices will call once, leave a voicemail, send one text, and give up. It's because of how chiropractic offices are set up. We make our CAs do it all, the front desk person. They're already running the office. Now we've created this online marketing program where they're funneling in more calls. Great. You say, well, they're just calls, they're part of your job. You already pick up the phone, anyways, when people call and answer your questions. Now we're asking you to call. It changes the game, especially on the volume that you start to create, because every lead that comes in needs to be contacted seven times. Even if you automate the process and they automatically get a few texts, automatically get a few emails and make it automated. The front desk now still has to check email response, text response, and then still make those calls for you. Automated calls are still not really great for our industry because no one likes getting picked up by a bot, like uh AI conversion call. So not yet. We're getting close. Not yet. So your team gets more weight put on them. So if you're gonna do this system of generating lots of leads, you have to have a dedicated person uh that just deals with that and maybe helps you with some social media stuff on the downtime. That's that would be one person's job. That is a$15 to$20 an hour job. That's someone you hire either in-house or from their home to do that stuff for you. Uh, that's the strategy on that if you're gonna go all in on online marketing. And then mistake number five is the slow response time. Unfortunately, our office hours are nine to five, eight to six. Whatever you guys do in the office, and that limits your response time. So having after-hour virtual assistant or it can help a little bit, but in our industry, after 7 p.m., calls decrease dramatically for your office. You're rarely getting calls to the office at 8:59 p.m. You can check your call history. You don't miss calls that late. And if you do, it's someone who's remembering right before bedtime that they have an appointment somewhere and they need to cancel. That's probably what you're getting. Studies show that contacting leads within five minutes is that dramatic increase in booking times that we see in the in the marketing statistics out there. If we can get a hold of somebody within that five minutes, um the response rate is way better, way better because they're still freshly active from filling out that form or answering those questions online. So funneling a little bit better. Then improving the lead quality. What can we do to improve the quality of the leads that we get? The higher intent lead forms is a great way to start. So once you do that, you'll have the confirmation step and adding qualifying questions in there as well. So you've got the form, first name, last name, email. But even before they can do that, I ask two questions. They can be whatever, depending on the ad that we're doing. Are you currently experiencing pain? You can have a drop-down menu, multiple choice, they can choose where, or they can do a one-line fill-in-the-blank. How long have you been dealing with this? That one can be multiple choice, less than a week, more than two weeks, more than a month, more than uh, or months. Then you know this is subacute, acute, chronic, or long term. And then when would you like to come in? What day of the week works best for you? How soon would you like to come in? Again, multiple choice or fill in the blank. This filters the junk leads because but can't leave that blank and continue on with your form. They can't do it. So drives leads to a booking page. Okay. Uh, you can do that there on the last step of the form on Facebook. You can have a link click here to book your appointment if you want. I can send you to your website, can send you to your uh schedule, it can send you to your uh uh whatever, what's the other one called? Review wave, whatever, whatever click system you have, gene uh URL link, whatever it is, if you if you're cool with that, or you can send them to an off-site scheduler so it doesn't clog up your system in any way, shape, or form. Improving your offer. This is something we just need to constantly test and check with our ads: the$49 special versus the$29 special, the free neurological scan versus the sciatic evaluation or the knee pain consultation, or um learn more about our migraine program. The offer should match the patient's problem. So when I create ads, I'll have three, four, five ad copies that go out. So we're trying to hit three, four, five pain points that are going out there for like spinal decompression. Sciatica, we'll have one all about radiating pain down the leg, uh, low back pain with movement. So does your back hurt first thing in the morning? Stiffness, hard to move, constant pain in the low back. And then one about discs. Some people just know they have a disc bulge or herniation because they've been diagnosed recently about with it. And that's how we do our spinal decompression one. Three ad sets, three, or sorry, three ads, um add texts option, add copy options with all of our photos and videos. So each one of the photos and videos, let's say we do five, two photos and three videos, the they will cycle, they will all three of them have it, and meta will figure out the rest. They'll scramble and show which ones to which it's random, really. Um, and then they'll just match it all up. It's been the best formula for spinal decompression that I can find. And then a better follow-up automation. Always tweak your automations. If you're not getting a response on that first text, keep changing that first test text until you do get a response. Thank you for signing up for your$49 new patient special at the life chiropractic. We've received your Facebook form. Five seconds later, they get another text. Can I help you book that first appointment? No response. Another text. Uh, here's the booking link if you'd like to book it yourself. Then you got to test those and see your completion rate on them. After a whole bunch of people sign up, how many people are getting there? It's actually quite low for the people that do respond. But the ones who do respond have a very high show rate. So we want to get responses. Keep tweaking those first two texts until you get people to respond. Then there's cool things you can do with conversion um AI, conversational bots, which are really cool. So better automation, immediate text, 10-minute reminder, uh appointment reminder before, email with booking link, and consistency and the consistency of this will increase your bookings over time. So people ask me all the time, what's what's good numbers? How do I know things are going right? Things change a little bit with between rural and urban, but overall, good meta ad metrics, lead cost should be around the$20 mark. Honestly, if you're if you're running lead forms, you should be around that$20 mark. It means you've dialed in your ad spend, you've dialed in ad copy and dialed in an offer. A good ad will be in around that$8 to$18 mark. That that is an ad that you've you've got three checks on that are working, and now you're just fine-tuning the funnel portion on the back to try and get better response and booking rates. So, with that, let's say it's$18, the booking rate should be about 30 to 40% of the leads that come through. That's really important to know if you're getting into meta ads right now. And you're like, well, what's good? I get all these leads, but no one no one's booking. You should have 30 to 40. So three out of four, three or four out of 10 leads that come in should be booking, either getting on the phone, getting them booked. Something should happen. Of the people that book, the three or four that book, you should have a 70% or higher conversion rate, show rate that come to the office. So let's stop for a second. Four out of 10 leads book an appointment. Three out of the four should come in. And for every 10 leads, we got three, two or three new patients. That's a good campaign. Just letting you know. Now, you may one of you is probably listening to be like, I do way better than that. Great, good for you. The others that are listening are like, no, we're not, we're not doing that good, or we're close to that. So that's the reality of it. So now we can reverse engineer spend, right? So we don't sit here and we're like, oh, these campaigns suck for 30 leads. I get nine people. I'm like, that's actually not too bad. Then we know if your goal is to get 20 new patients a month from Facebook ads, we know the ad spend we're doing right now is generating 30 leads. But to get to 20 new patients, and that brought in nine new patients into the office that showed that we need to do um 65 leads, 60, 65 leads to get to the 20. Make sense? And we know that$1,500 in ad spend gets us 30 to 35. We're gonna spend closer to three now. We're gonna double our ad spend and monitor. It may not get to 60, but that's how you do it. But first you got to start with a healthy budget, one to 1,000 to 1500 a month to start testing those first couple months and then start to go up. So the cost per new patient, what should that cost? Do the math. If we're getting$18 leads, and we have to see three to get somebody through the door, 20 times three, minimum 60 bucks, 60 to 120 is where if you're if you're running an amazing campaign like red light or spinal decompression, you might be closer to the 60. If you're running Cairo ads, it might be closer to the 100, 120. That's the realistic expectation. So you can sit there and be like, okay, well, I need 20 new patients. So when you call uh enrico d.com, you call me, you're like, hey man, I need you to help me. And I tell you, well, what do you need? Like 20 new patients. I'm like, well, we're gonna have to spend 2,500 bucks in ad spend. You're not like, yeah, you're not confused, you're not, you're ready, you're like, yeah, that makes it let's do it. Let's let's try that for a few months and see if we we get there. That's how we do it. Facebook and Instagram ads are still one of the most powerful chiropractic tools in marketing that we have to grow our practices, but the strategy has evolved. If you're only chasing cheap leads, you're going to attract low quality patients. The goal isn't more leads, the goal is more patience. Remember that. If you have questions, reach out to me. I'm here for you. Info at enrico d.com. You email me. If you're not on the email list, get on the email list. I send like two or three emails a month. Not a big deal. Just on marketing. You just respond to those emails if you ever need anything. Uh, if you need to reach out to me, find me on social media, send me a DM. I'm here for you in any way, shape, or form that I can be here for you. Stay well, stay healthy. Your community needs you. Keep doing what you're doing and keep growing those practices.