Help calculating Real ROI of Google ADS vs Organic for Mental Health clinic
Hi all, this might sound like a silly question to some of you, but I am struggling with it.
The context:
I run with three colleagues a mental practice. We have a website getting traffic from both organic and paid (google ads) sources.
I have set up specific ‘events’ with the help of google people, including implementing specific code in the back-end of my wp-admin panel. This allows me to see in GA the number of users who sent us an email, filled out a form or called us directly.
This, via GA (connected with google ads) I can clearly see the total amount of conversions (leads) coming through different sources (organic, paid etc).
The problem:
Due to the nature of the business, not all conversions (leads) become actual paying clients. Often there are initial FREE consultations, which may or may not lead to paying customers.
Leads come via email, direct phone call or form fill-out, but when they get to us, people may or may not become actual customers.
This means that although at the end of the month I can calculate exactly how much profit was made via our total online activity, I am struggling to understand which of those ‘real conversions’ (paid clients) have actually come through google ads vs organic search vs social and so on.
Is there a way to do so?
I would really appreciate your input on this. My thoughts so far are that unless every client is ‘labelled’ at the moment they contact us (as paid vs organic vs social etc) and thus we can monitor their journey until they become paying customers, it’s impossible for me to measure the actual ROI of the google ads campaign.
Thank you very much in advance to anyone offering any help. Even pointing me towards where to get help for this would be great!
Cheers!
The short answer is:
You are correct that it is impossible to measure true ROI without “labelling” the client at the lead stage and then tracking them through your internal system until they become a paying customer.
The technical solution for this is to implement Google Ads Offline Conversion Tracking which connects your internal client management system (your source of truth for payment) back to Google Ads.
You can achieve this using a unique identifier called the Google Click ID (gclid), or more robustly, by sending hashed first-party data like the customer’s email or phone number via the Google Ads API.
The long answer is:
Your current setup, tracking form fills, emails, and calls as conversions in Google Analytics (GA), is only giving you a Lead Count.
This tells you what marketing channel generated the interest, but not which channel generated the revenue.
To get your real Return on Investment (ROI), you need to close the loop between the free consultation (the lead) and the first payment (the high-value conversion).
This is a two-step process:
First, your website must be set up to capture a unique digital identifier at the moment the lead is generated.
For Google Ads, this is the gclid, a code that Google automatically attaches to the URL when someone clicks your ad.
You need to configure your website’s forms to read this gclid and store it alongside the user’s information (name, email, phone number) in your lead management system or Customer Relationship Management (CRM) system.
For leads coming from Organic Search or Social, you’ll still capture their first-party data (email, phone) but you won’t have a gclid.
Second, you must send the final, high-value conversion event – the moment the client pays – back to Google Ads, telling the platform that a lead it generated ultimately resulted in revenue.
This is called Offline Conversion Import.
When a lead becomes a paying client in your practice management software, you will take the gclid (or the hashed email/phone number for Enhanced Conversions) and the revenue amount, and pass it back to Google.
This is the only way Google Ads will see the actual value of its traffic.
Using the Google Ads API + Google Tag Manager (GTM) Server Container is the modern, excellent, and cost-effective way to automate this second step.
Instead of manually uploading spreadsheets of paying clients every month, which is time-consuming and error-prone, you set up a server-side environment.
You would use GTM Server Container hosted on an affordable service like Stape or your own Google Cloud Platform (GCP) instance.
Your practice management system would be configured to send a secure signal to your server GTM every time a payment is processed.
The GTM Server Container then takes the payment data, matches it with the correct gclid or hashed user data, and uses the Google Ads API to send the final Purchase or ClientAcquisition conversion and its dollar value directly into your Google Ads account.
This server-side method is cheap, secure, scalable, and happens in near real-time, giving you accurate revenue data directly inside your Google Ads reports to calculate true ROI for both your paid and organic efforts.
Without this process, your Google Ads bidding is perpetually optimizing for the wrong thing – the free consultation – instead of the actual paying client.
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