Set the attribution rule before you count anything
The rule that holds up: first touch at booking, confirmed at the visit, written down before anyone counts. At booking, Priya records where Jess first heard of the practice, as Jess says it, in one required field. At the first visit, Dana asks again and corrects the field if the answer changed. Only completed first visits count; a booking that never arrived is spend with no patient against it.
Four inputs, and where each one lives
- Spend: what was paid to the channel in the month, from the card statement and invoices, agency fee included.
- Hours: your own team's hours on the channel, at what that time costs you. Instagram is paid for in Dana's evenings. How team time is valued on the books is for your accountant.
- Completed first visits by channel, from the attribution field in the record system.
- First-year value: what a new patient from that channel spent in their first twelve months, read from the record system for patients acquired a year ago.
The formula, and what to read it against
Cost per new patient for a channel equals spend plus hours at cost, divided by completed first visits from that channel. Set it beside the first-year value of patients from the same channel. A channel whose cost is a small fraction of that value is buying patients; one whose cost approaches it is buying visits.
Six channels, and the trap in each one
| Channel | Cost inputs | How to attribute | The trap |
|---|---|---|---|
| Google profile | Hours on photos, posts, reviews and replies; any tool you pay for | 'Found you on Google' at booking, confirmed at the visit | A referred patient who searched your name gets logged as Google |
| Website | Hosting, the build spread over its life as your accountant prefers, hours on pages | Bookings started from the site's booking link; the field confirms | Every channel ends on the site, so it claims patients ads or referrals earned |
| Referrals | The hours spent asking and the note that thanks them. Whether a practice may give anything of value for a patient referral is a counsel question in every state, and many practices give nothing; count only the hours | The referring patient's name in the field, so they can be thanked and counted | Counting a referral as free when the asking takes hours |
| Hours to shoot, write and reply; any boosted post spend | 'Saw you on Instagram,' plus the DM thread when the booking came from one | Likes counted as results; only a completed first visit counts | |
| Paid ads | Ad spend, agency fee, landing page, management hours | The campaign's own booking link and phone number, confirmed at the visit | Platform-reported results; count completed visits, not form fills |
| Events | The table, travel, giveaway and hours, follow-up included | The event name in the field for anyone booked from the follow-up | Leads in a bowl counted as patients; count only those who sat in a chair |
A worked example, labeled illustrative
Say your practice spent $3,000 on ads last month and logged 12 completed first visits from them; in this illustrative example that is $250 per new patient. Say Instagram cost nothing in spend but took 20 of Dana's hours at, say, $60 an hour, and produced 6 completed first visits. In this illustrative case that is $200 per new patient, and it looked free until the hours were counted. Say referrals cost 3 of Priya's hours asking and writing thank-you notes at, say, $30 an hour, and produced 9 first visits; in this illustrative case that is $10 per new patient. Whether a practice may give anything of value for a patient referral is a counsel question in every state, and many practices give nothing; count only the hours. Then read each against its own cohort's first-year value before you move a dollar, and replace every input with your own.
How the number should move the budget
The number moves the budget by an amount you write down. Move spend toward the channel with the lowest cost and the highest first-year value, one step at a time, and read it again next month, because channels saturate. Give the referral channel an owner; the asking only happens when it is somebody's job. Whether a practice may give anything of value for a patient referral is a counsel question in every state, and many practices give nothing; count only the hours. Put the comeback on the same sheet; a returning patient costs a text. How to size the whole budget, and what share each channel should hold, is in the marketing budget guide.
How to do this on Monday
- Add a required source field to intake, with six fixed choices and 'other'.
- Pull last month's card statement and invoices and write the spend by channel on one sheet.
- Ask Dana and Priya for their hours by channel last month, and price them.
- Count completed first visits by channel from the record system and divide, then set last year's cohort and its first-year value beside it.
What to do next
NorthCore's Know your numbers solution puts cost per new patient by channel on the dashboard: the source field enforced at booking, the spend and hours beside it, and each cohort's first-year value. Scoped in writing and covered by the promise on this site: results in 90 days, or we keep working until you have them.
