A product
Scope defined before we start. A proven playbook, executed properly, on a schedule. The question it answers is how well. Most practices need exactly this, and it is the faster path to results.
Our other offers
Fractional Growth Partner: An embedded growth lead who owns the number.
Ads run. The site converts well enough. Staff follow up when they can. Growth flattens anyway. What is missing is someone senior who owns the number, can see the whole funnel, and decides what happens next.
Google AdsMeta AdsWebsiteCRMEHRPatients& revenue
One scorecard, from first click to collected revenue: every source a practice pays for, judged on the patients and revenue it produces.
- 12×
Website leads, year over year
Thrive
- +143%
Monthly appointments since April 2023
Thrive
- 4.2×
Average ROAS over six months
Princeton Acupuncture
Thrive’s organic social and operations share credit for its appointment growth. ROAS reflects the first six months of Princeton Acupuncture’s assessment campaign.
The work got done. The numbers didn't move.
Most practices here have already worked with a generalist agency or a freelancer — some SEO, some ads, a website — but they were too focused on the activities and not on the strategies that move your practice forward. Saying so early saves both of us a quarter.
We analyze your entire practice to find areas of growth, then we execute on what we can deliver and consult on the rest.
Built for
- Practices actively trying to grow and scale.
- Multi-location or multidisciplinary practices that need one person to own the metrics growth actually runs on.
- Owners who are spending meaningful money on paid media but still don't have the answer to "What is my return on ad spend?"
Not built for
- Solo owner-operators in their first year.
- Practices not planning to spend at least $10k a month on paid media.
- Practices without the team in place to handle additional leads efficiently.
- Practices that need to change direction monthly or want multiple calls a week. Results are measured on a monthly basis and can be seasonal, we see our strategy through and reevaluation when there's enough data to alter course
If unanswered inquiries are the real problem, the fix is a follow-up system, and it is a far smaller commitment than this one.
Product or partner
Our other offers are execution. This one is thinking.
Our follow-up system, paid media management, and website builds are products. The scope is fixed before the work starts, the playbook is proven, and the value sits in executing it properly and soon. That is deliberate. Most practices do not need a strategist. They need the obvious thing done well.
A partner engagement starts before the playbook exists. What is actually constraining growth? What is a new patient worth once you account for service mix, reimbursement, and the length of a care plan? Where is money leaking between the ad click and the collected payment? Given all of that, what should the practice do next quarter, and what should it stop doing?
Those questions do not have a standard answer, which is why they cannot be sold as a package. The work follows the diagnosis. Sometimes that means more spend. Often it means less spend and a rebuilt intake process. We would rather find that out in the first month than in the third year.
A partner
Scope follows the diagnosis. The question it answers is what and why: what is constraining growth, what a patient is really worth, what to stop doing. It cannot be packaged because the answer is different in every practice.
This page
Fractional growth partner
Measure the system before changing it.
Five steps, in order. Nothing here is optional, and none of it can be skipped by moving budget around first.
The first loop
Re-baseline, then the next constraint
01
Baseline the funnel
Before anything changes, we establish what the current system produces: spend, inquiries, consultations booked, patients started, revenue collected, and the conversion rate between each step. Most practices have never seen those numbers on a single page.
02
Instrument the data
Ad platforms, website, call tracking, CRM, scheduling, and where the system permits it, the EHR. The goal is one visible path from first click to collected revenue. Not another dashboard, and not a report that stops at the form fill.
03
Model the patient economics
What a new patient is actually worth in your practice, by service line, net of no-shows, reimbursement, and the length of a typical care plan. Every decision after this is priced against that number rather than against a channel benchmark.
04
Identify the binding constraint
One step limits the whole system. Adding budget upstream of it wastes money. We find it and we name it, including when the honest answer is that the constraint is not marketing but scheduling capacity, provider availability, or the phone.
05
Fix it, then re-baseline
Build the fix, hold the measurement steady, and re-measure against the original baseline so the result is attributable. Then find the next constraint. That loop is the engagement, and it does not stop after the first ninety days.
What we own
One engagement, not five line items.
These are not services you can buy separately, and we do not quote them that way. Splitting them is how a practice ends up with five vendors and nobody accountable for the number.
Attribution
From ad click through to collected revenue, across advertising, website, CRM, scheduling, and patient records. Where the systems resist, we build the bridge rather than report around it.
Financial modeling
Patient lifetime value by service line, acquisition cost, payback period, and the spend level each of those actually supports. Built on your collected revenue, not on category averages.
Paid media
Google and Meta, managed against patient economics instead of platform-reported conversions. Downstream signals go back into the platforms so the algorithms optimize toward patients.
Conversion
Websites, landing pages, assessments, and booking paths. Message match from ad to page, proof where the hesitation is, and a next step that a patient can complete on a phone.
Custom engineering
Integrations, internal tools, and automation for the cases where off-the-shelf software will not do the job. Written in-house, maintained in-house.
Measured in patients, and honest about what we caused.
Reporting is in consultations, new patients, and collected revenue. Clicks, impressions, and cost per lead stay in the working documents because they help us optimize. They are not what we ask you to judge the engagement on.
We also separate our contribution from yours. When a practice grows, several things are usually happening at once: the campaigns, the referral network, a front desk that got faster, a well-run social account, a new provider. An agency that quietly claims all of it is pleasant to work with right up to the moment you have to decide where next year’s budget goes.
So we name it. In the Thrive engagement, monthly appointments grew roughly 143% over the partnership, and the practice’s own organic social and operations drove much of that. We say so on the public case study page. It costs us a headline number and buys you a report you can make decisions from.
Thrive Spine & Sports Rehab
A multidisciplinary rehab practice whose EHR was not cloud-based, which made connecting appointments to spend genuinely hard. We rebuilt the brand site, added chat, moved Recovery Lounge booking onto Mindbody, and closed the loop between appointment data, ads, and CRM reporting.
- 12×
- +143%
Princeton Acupuncture & Oriental Medicine
Cheap instant-form leads that rarely became patients. We replaced the form with an on-site assessment, refreshed the creative, and rebuilt the landing experience around completion rather than volume.
- 4.2×
- −86%
Engineering depth
The integration work other agencies outsource is done here.
Dan RamosFounder / Growth EngineerPreviously built for
- CNN
- Dow Jones
- Johnson & Johnson
- Wolters Kluwer
Roughly twenty years of software engineering sits behind this offer, including work for CNN, Dow Jones, Johnson & Johnson, and Wolters Kluwer. Organizations where data pipelines, access control, and compliance were not negotiable.
That matters for one specific reason. The hard part of healthcare growth marketing is rarely the advertising. It is getting systems that were never designed to speak to each other to produce a single honest view of the patient path.
The Thrive EHR was not cloud-based. Connecting appointments and new patients back to spend and lead source took real engineering, not a workflow tool and a spreadsheet export. Most agencies subcontract that work, or quietly decide it cannot be done and report on form fills instead.
We build it, we maintain it, and when off-the-shelf software will not do the job we write the thing that will. It is the reason the attribution promise on this page is a commitment rather than an aspiration.
We work with a small number of practices at a time.
Embedded is not a word we use loosely. It means knowing your service lines, your providers, your intake process, and your numbers well enough to hold an opinion about them and defend it in a room.
That does not scale past a handful of practices, so we do not pretend it does. When there is no capacity, we say so, suggest when to check back, and point you to the offer that fits in the meantime.
Dan and his team are great - a lot of agencies or groups will make up data to justify what they are doing. Dan and his team are showing me real data in real time. I've experienced nothing but honesty and hard work. A+
AJ AdamczykOwner, Thrive Spine & Sports RehabCommon questions
Fractional growth partner FAQ
How is a fractional growth partner different from an agency?
An agency is usually retained for a channel and reports on that channel. A fractional growth partner is retained for the outcome and decides which channels serve it. That includes recommending you spend less, pause a campaign, or fix something in your intake process before we touch the ad account. The difference shows up when performance drops: an agency defends its channel, a partner finds the constraint.
Do we need an in-house marketing person?
Not always, but it helps, and it is one of the things we assess before starting. Multi-location groups almost always need someone internal who can move things inside the practice: change a front-desk script, get a provider to record a video, secure access to the scheduling system. Without that, good decisions stall halfway. If nobody internal owns marketing at all, a productized offer will serve you better than this one.
What is the minimum commitment?
Ninety days, because that is how long the first loop takes: baseline the funnel, instrument the data, model the patient economics, identify the constraint, fix it, and re-baseline. Anything shorter buys a diagnosis with no time to act on it. After the first ninety days the engagement runs month to month. We would rather you stay because the numbers justify it.
Do you work with our existing vendors?
Yes, and often that is the sensible arrangement. If your SEO firm is producing and your developer knows the site, replacing them is churn. We set the strategy, define what each vendor is accountable for, and bring their results into the same reporting view. What we will not do is own a number while a vendor we cannot direct works against it.
What if we already have an agency?
The first question is whether they are underperforming or under-directed. Plenty of competent agencies produce mediocre results because nobody gave them a clear constraint to solve or the downstream data to optimize against. We look at that before recommending a change. If the agency should go, we will say so plainly, and we can absorb the media work rather than leave a gap.
How quickly will we see change?
Measurement changes in the first month. You see the complete funnel on one page, often for the first time. Performance changes depend on where the constraint sits. A landing page or an intake process can be fixed in weeks; Princeton Acupuncture saw cost per lead fall 86% after a page rebuild. Organic authority and reputation take quarters. We set expectations against your baseline, not against someone else’s case study.
The other ways to work together.
Websites
Custom, modern websites proven to drive more traffic and generate more patients.
ExploreGoogle Ads overhaul
Thrive Spine & Sports Rehab
- Conversion rate3.4×
- 4.76% to ~16%
- Weekly conversions5.3×
- 8 to 42
- Cost per conversion−73%
- ~$187 to ~$50
Three months before the overhaul against the three months after.
Google & Meta Ads
Campaign success is determined by new patients and collected revenue in your EHR, not vanity metrics coming from the ad platforms.
ExploreThe first conversation
Start with the diagnosis.
A short conversation about your practice, your current spend, and what you can already measure. If a product tier is the better fit, we will tell you that instead.
Talk growth strategy