The short answer
A new practice can run Google Ads well before it has reviews, because reviews are not one of the factors Google uses to rank ads. Start with one Search campaign targeted to people in your area, link your Google Business Profile so ads show your address and a call button, and write ads around facts a patient can use: services, hours, booking options and that you are accepting new patients. Track calls and appointment requests before you scale, start collecting reviews from every patient in the same way, and judge results on cost per booked patient from your own records.
What reviews do and do not affect
Google decides whether and where an ad shows with Ad Rank. The factors Google lists are your bid, the quality of your ad and landing page, the minimum thresholds for that position, the competitiveness of the auction, the context of the search such as location and device, and the expected impact of your assets. Business Profile reviews are not on that list, so a new practice can compete for ad positions from the first day.
Reviews still shape the decision after the click. A searcher who compares your ad with a practice that has many reviews needs another reason to choose you. That reason has to come from clear, specific ads, a landing page that answers their questions, and an easy way to book.
Foundations before the first click
- •Verify and link your Google Business Profile. Location assets pull your address, phone number and hours from your Business Profile and can show the distance to your office and a call button on mobile.
- •Set up conversion tracking. Count calls from ads, calls from your website and completed appointment requests. Our conversion tracking guide walks through it.
- •Send ads to a matching page. A page for the service in the ad, with your address, hours, insurance information if you accept it, photos of the real office and team, and a short booking form.
Set up a focused Search campaign
- •Search Network only. Keep the first campaign on Google Search so every click comes from someone looking for care.
- •Target the area patients will travel from. Use a radius or the ZIP codes and towns around your office, and choose the location option that reaches people in or regularly in those places rather than people only interested in them.
- •Group keywords by service. One ad group for general and family visits, one for emergencies, one for each major service you want to grow. Use phrase or exact match for control, or broad match with Smart Bidding once tracking works.
- •Add negative keywords early. Jobs, schools, courses, supplies and free clinics are common wasted searches for practices.
- •Run ads when someone can answer the phone. Or make sure online booking works around the clock.
Write ads that earn trust without reviews
Without star ratings to lean on, the ad has to carry specific, checkable facts. Good material for a new practice:
- •The service and the neighborhood in the headline, so the ad matches the search.
- •Newly opened and accepting new patients, if true.
- •Hours, online booking, languages spoken, parking or transit access.
- •Sitelinks to the pages people check before booking: meet the team, what to expect at a first visit, insurance and payment.
Leave out anything you cannot back up, such as superlatives, guaranteed results or offers you have not had reviewed. For more on headlines, see our guide to writing Google Ads headlines.
Bidding and budget for a new account
Smart Bidding strategies such as Maximize conversions learn from conversion data, which a brand-new account does not have. A common start is Maximize clicks with a maximum cost per click limit, so you collect search and conversion data at a cost you control, then move to Maximize conversions once tracking is confirmed and conversions are coming in. Each switch restarts a learning period, so change strategies on purpose rather than week to week.
Set the budget from your own numbers: how many new patients you want, and what you can afford per booked patient. Our guide on how much to spend on ads each month explains how average daily budgets work.
Build reviews alongside the ads
Every patient who books from an ad is also a potential reviewer. Make asking part of the routine from the first week:
- •Ask every patient the same way, with your Google review link in a follow-up message or a QR code at the front desk.
- •Never offer a discount, gift or other benefit for a review, and do not ask only the patients you expect to be happy. Google's policies do not allow either.
- •Reply to reviews in general terms. Our guide to getting more Google reviews covers the full process.
Measure what matters
- •Search terms report, weekly. See what people actually typed, add the good searches as keywords and the poor ones as negatives.
- •Cost per booked patient, monthly. Ask every new patient how they heard about you and match ad calls and forms to appointments that actually happened.
- •Give it time, but not blind time. Bookings often follow the click by days or weeks. Decide in advance which numbers you will review and when.
Opening a new office? Our start-up practice marketing service covers the website, Business Profile and ads together.
Sources
Google Ads features and policies change often, so check them for current wording.
- •Google Ads Help: About Ad Rank
- •Google Ads Help: About location assets
- •Google Ads Help: About keyword matching options
- •Google Ads Help: About advanced location options
- •Google Ads Help: About Maximize clicks bidding
- •Google Ads Help: About Smart Bidding
- •Google Ads Help: About the search terms report
- •Google Business Profile Help: Tips to get more reviews
- •Google Maps: Prohibited and restricted content (user contributions)
- •Google Advertising Policies Help: Restricted targeting in Personalized advertising
Frequently Asked Questions
Can a new practice run Google Ads with zero reviews?
Yes. Reviews are not on Google's list of Ad Rank factors, which centers on your bid, the quality of your ad and landing page, the context of the search and the expected impact of your assets. Reviews still matter to the person deciding where to book, so make the ad and landing page answer their questions clearly and start collecting reviews from day one.
Should my ads say the practice is new?
If it is true and useful, yes. Newly opened, accepting new patients, early and evening hours or online booking are facts a searcher can use. Only state what you can back up, and keep the same facts on the landing page so the ad and page match.
Which keywords should a new practice start with?
Start narrow and high intent: the main services you offer combined with your city or neighborhood, plus searches such as dentist near me. Use phrase or exact match for tight control, or broad match paired with Smart Bidding once conversion tracking works. Review the search terms report every week and add negative keywords for searches that do not fit.
Which bid strategy should a new practice use?
Smart Bidding needs conversion data, which a new account does not have yet. Many new accounts start with Maximize clicks and a maximum cost per click limit, or with Maximize conversions once call and form tracking is confirmed. Switch deliberately, because each change puts the strategy back into a learning period.
How do I get the first reviews without breaking Google's rules?
Ask every patient in the same way, for example with a short message after the visit that includes your Google review link or a QR code at the front desk. Do not offer anything in return for a review and do not ask only the patients you expect to be happy. Reply to the reviews you receive.
When should a new practice add other campaign types?
After Search shows which services and searches bring booked patients and your tracking is reliable. Keep in mind that Google's personalized advertising policy limits audience targeting for health ads, including remarketing to your own website visitors, so plan any Display or video test around predefined Google audiences and location.