Numbers and measurement

What a growth company does with a medical facility in the first 90 days

Month one fixes replies and follow-up, month two tests content and ads, month three steers the budget. What the practice provides, the weekly review, and what day 90 shows.

5 November 2026 · 12 min read

In its first 90 days with a medical facility, a healthcare growth company measures where patients are lost between ad and visit, and fixes replies, follow-up and reminders. In month two it tests ads built on patients' questions with a limited budget. In month three it moves the budget to what brought attended bookings most cheaply, reviewing one number weekly.

I am writing this because the question clinic managers ask us most often before signing is: what exactly happens once we start? The honest answer is that the first weeks are less dramatic than people expect, and they matter more. This is our plan at Naqar as we run it, arranged along our BEAK+ method: find where patients are lost, test on a small scale, scale what worked, then keep the results.

Before the start: which single number do we agree on?

One written number, against which all 90 days are measured. Most practices choose the number of new patients who actually attended each month, for one or two specific services.

Why one number? Because many numbers let each side pick the one that suits it. When views rise and bookings fall, anyone who wants to defend the month can find a figure to defend it with.

We fix three things alongside it before day one:

  • The baseline: the average of that number over the previous three months, from the booking system.
  • The target services: those with empty slots and a margin that allows marketing them.
  • The maximum cost per patient: the figure no channel may exceed, worked out from the service's margin. We explained the method in our article on healthcare marketing ROI in a CFO's terms.

What does the practice provide in week one?

Access, and one person who owns decisions. This is the list we usually ask for:

  1. Access to the ad accounts on Google, Meta and Snapchat, with ownership staying with the practice.
  2. A report from the booking system for the last three months: bookings, attendance and cancellations per service and doctor, without patient names.
  3. Access to the WhatsApp Business number and call log, or a session with reception to review them together.
  4. The approved list of services and prices, and the doctors' schedule with available slots.
  5. The name of the person who approves content medically, and the person who approves budget.

In the same week we sign a data processing agreement that settles four things: what we can see, where it is stored, who on our team can access it, and when it is deleted. We work from aggregated booking-system reports wherever possible, because health data is sensitive data under both Saudi and Egyptian law. In Egypt the compliance grace period ended on 31 October 2026, as covered in our article on Egypt's data protection deadline. In Saudi Arabia, the amendments to the implementing regulations on marketing consent are still a draft, with public consultation running until 5 November 2026.

Days 1 to 30: where are patients lost?

We measure the whole journey, from first enquiry to attendance. For each channel we record four numbers: enquiries, time to first reply, the share who booked, and the share who attended.

Numbers alone are not enough, so we read the conversations. In week two we review a sample of WhatsApp chats and calls. For each one we ask: was the patient's question answered? Were they offered a specific slot? Did anyone follow up when they went quiet?

What we find recurs across practices in different forms. A dermatology clinic in Riyadh replies within minutes in the morning, and hours later after 4 pm, when most patients write. A dental centre in Cairo replies fast but asks patients to call the landline to book, and half the conversations stop at that step. Both are illustrative examples of patterns we see; the details differ in every practice.

Then we fix things in order:

  1. Reply rules: written replies to frequent questions, each ending with a specific slot on offer, with the booking made inside the same conversation.
  2. A follow-up rule: when a patient who went quiet is followed up, how often, and who is responsible by name.
  3. Reminders: a confirmation as soon as the booking is made, a reminder before the appointment, and an easy link to reschedule.

Reminders address only part of the absence problem. A study published in Health Science Reports in April 2025, in the adult rehabilitation department of King Abdulaziz Medical City in Riyadh, found that 21% of appointments were missed. The leading reasons were illness on the day (24%), living outside Riyadh or needing ambulance transport (17%), and an inconvenient time or date (15%). The study covers one department and does not represent the whole Kingdom, but it shows that easy rescheduling and a choice of time matter as much as reminders. For more, we gathered the Saudi evidence in our article on what Saudi studies say about no-shows.

Our patient leak check gives you a first picture of these points in minutes, before any meeting with us.

Why fix replies before adding ad spend?

Because every extra riyal or pound in advertising comes through the same door. If half the enquiries are lost at the reply, doubling the ads doubles the loss too.

Patients expect speed. In a KFF poll published on 25 March 2026, covering 1,343 US adults, 65% of those who had used AI for health information said getting quick answers was a major reason. The figure is from the United States and concerns AI. We cite it because it describes a general expectation: patients want an answer now, and whoever is slow loses them to someone who replies.

We covered what happens in the first minutes after an enquiry in our article on the first minutes after an enquiry. What we add here is the order: replies first, then ads.

Days 31 to 60: content and ads built on patients' questions

This month we test on a small scale. From month one's conversations we pick the questions that come just before a booking, build distinct ad concepts on them, and film them on one planned shoot day. We explained how to plan that day in our article on media production company or marketing agency.

Then we launch ads on a limited budget, across a small number of campaigns. Patience is part of the plan, because ad systems need time to learn:

  • Google says on its Google Ads help page that the "Learning" status of a bid strategy never lasts more than 7 days, and that performance usually settles within one or two conversion cycles. A conversion cycle is the time between a click and a booking. For a service patients consider for two weeks before booking, settling may take a month.
  • Meta describes a similar learning phase in its Business Help Center for each ad set after launch or a significant edit.

So we do not judge a campaign in its first week. We hold back significant edits during learning, unless a clear problem appears with policy or replies. For the Meta details, read our article on Meta ads for clinics in 2026.

Days 61 to 90: steering the budget

In month three we scale what worked. Each channel and concept has a number from the booking records: how many attended bookings it brought, and at what cost.

The decision follows a written rule agreed before the start:

  • A channel below the maximum cost per patient: its budget rises by one step, then we wait for the result to settle before the next.
  • A channel above the maximum: we try one change to the message, the booking page or the way replies are handled, and measure its effect.
  • A channel still above the maximum after the change: we cut or pause its budget and move the money to what has proved itself.

What if a channel does not pay back? That is a normal part of testing. A channel that failed in your practice may work in another, and the reverse. What matters is that the decision rests on your numbers, and that its reason is recorded, so the same test is not repeated six months later.

The weekly meeting: a five-item agenda

Half an hour, on the same day every week, with the person who owns decisions at the practice:

  1. The agreed number: where it stands this week, against the baseline and the target.
  2. Leak points: reply time, booking rate, attendance rate, and any change in them.
  3. What ran: the ad concepts that worked, those that stopped, and cost per attended booking by channel.
  4. One decision: one change for the coming week, with the name of its owner.
  5. What we need from the practice: approval of content, a doctor's time, or a change to the appointment schedule.

A summary goes out in one message straight after the meeting. When the decision is written down, it is easy to check a month later why we made it.

What is the doctor's role in the 90 days?

A defined role in little time: he or she gives us patients' questions and checks medical accuracy. How the time usually falls:

  • Month one: one short session, in which the doctor describes the questions patients ask and what they wish patients knew before the visit.
  • Month two: a shoot day planned outside patient hours, then short reviews of the scripts and the clips.
  • Month three: a short review of what was published and any new content.

The doctor checks medical accuracy and gives written approval of everything they appear in. The numbers and day-to-day decisions stay between our team and the practice manager.

What happens with our current agency or in-house team?

It depends on what the practice decides, and we work with either case.

If you have an in-house team, such as a social media coordinator or a designer, they stay part of the work. We add measurement, planning, advertising and systems; they add knowledge of the practice and quick access to the doctors.

If you are moving from an agency, we ask for an orderly handover: account access, the pixel, published content and its files, and any past reports. This is where it pays to have the accounts registered to the practice from the start. For the questions to ask before signing with anyone, read our guide on how to choose a medical marketing company in Saudi Arabia and Egypt.

What can you expect by day 90?

We do not promise a specific number, because the result depends on the market, the specialty, capacity and the starting point. What we commit to is what you will have in hand:

  • A comparison between the baseline and day 90 on four numbers: reply time, booking rate, attendance rate, and cost per attended booking by channel.
  • A library of tested ad concepts showing which patient questions bring bookings.
  • Written reply, follow-up and reminder rules that reception works by.
  • A recorded decision for each channel: scale it, change it or stop it.
  • A plan for the next three months, including the fourth stage of our method: keeping the results through follow-up after the visit and return and referral programmes.

In some practices the agreed number moves clearly within this period. In others, especially where patients take a long time to decide, improvement shows first in replies and bookings, then in attendance. The weekly report makes the direction visible either way.

In practice

Write down your one number and its baseline from the booking system now, before you speak to any company. That alone makes every proposal you receive comparable. If you want us to work on it with you, our Growth Strategy & Management service starts with month one as described here, and our enquiry and booking tracking service builds the measurement everything else rests on. The full framework behind this model is in our article on the marketing company vs growth company difference. I say this from experience: the practice that is patient through month one makes far clearer decisions in month three.

Common questions

What does a growth company do in its first 30 days with a clinic?

In its first 30 days a growth company measures the patient journey from enquiry to attendance for each channel: enquiries, time to first reply, booking rate and attendance rate. It reviews a sample of chats and calls, then fixes the rules for replies, follow-up and reminders. The aim is to stop losing current enquiries before the advertising budget goes up.

What does a growth company need from a clinic in week one?

It needs access to the ad accounts, with ownership staying with the clinic; a booking-system report for the last three months without patient names; access to WhatsApp Business and the call log; the list of services, prices and doctors' schedules; and the names of the people who approve content medically and approve budget. A data processing agreement is signed the same week.

Why does a growth company not raise ad spend from the start?

Because every extra enquiry passes through the same reply process. If a large share of enquiries is lost to slow or unclear replies, more advertising increases the loss in the same proportion. So replies, follow-up and reminders are fixed in month one, and ads are tested on a limited budget in month two.

How much of a doctor's time does working with a growth company take?

Limited time, spread over the three months: a short session in month one on patients' questions, a planned shoot day with short reviews and approvals in month two, then a short review in month three. The doctor checks medical accuracy and approves in writing, while numbers and daily decisions stay between the company and the practice manager.

What results can a clinic expect after 90 days with a growth company?

A specific number cannot be promised, because results depend on the market, the specialty and the starting point. After 90 days a clinic should have a comparison with its baseline on reply time, booking rate, attendance rate and cost per attended booking by channel, a library of tested concepts, written reply rules, and a recorded decision for each channel.

Sources

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