Open your draft marketing plan for 2027. Find the part that says “grow patient volume.” Now try using that sentence to decide which practice should get the next dollar.
“More patients” is easy to approve. You can nod along without agreeing on very much. Are we getting a new surgeon established or filling the physical therapy schedule?
I'd write a different plan for each. Put both under “increase volume” and you've left the choice to whoever builds the campaigns.
I'm not asking for a perfect business plan before marketing can do anything. I'd like us to help make these decisions. I just want us to agree on which growth we're pursuing before we start buying it.
Last Year's Spreadsheet Can't Decide This
I want to know what last year's spending produced. But we shouldn't keep funding something just because we paid for it last year.
A newly hired physician changes what you can offer. A service you want to grow may barely appear in the current campaigns. The spreadsheet will happily let you rename the tab “2027.” You'll have to account for those changes yourself.
The cost isn't only wasted spend. It's funding one priority while another waits, then discovering in March that the business expected something else.
I'd rather have that disagreement in October. It's cheaper then.
Four Decisions I'd Make Before Pricing the Plan
1. Choose Where the Growth Should Come From
Start with services and markets, not channels. “We need more paid search” is a possible response to a business decision. It isn't the decision.
Take a hypothetical 120-location orthopedic group. One of its 2027 priorities is adding 300 completed new-patient visits per month by the end of Q1 across 15 offices with available appointments.
I made those numbers up. Please don't put them in a board deck as an industry benchmark. The point is that we can now check demand around those offices and ask why they deserve additional investment instead of spreading it across all 120.
2. Check That the Appointments Actually Exist
I hear this a lot: “If the demand is there, we'll figure out how to get the patients seen.” I'd do that in the opposite order.
If we spend money getting a patient to call and then offer an appointment three weeks out, we've given them a reason to try the practice down the street. Have the staff in place and the schedule open before turning up the campaigns.
Those 300 additional visits average 20 per priority office each month. Confirm that the offices can see those patients, including any referral or authorization requirements. Don't build the plan around capacity you hope to have.
3. Show What Different Budgets Would Buy
Show what we can do with the current budget and what a larger budget would pay for. For our hypothetical group, that could mean concentrating the current budget on five offices or increasing it to run campaigns for all 15. Spell out the cost and expected patient growth for each option.
Show the assumptions behind each forecast, what we need to test, and when we'll review it. A patient count doesn't become more reliable because we put it in bold.
It's perfectly reasonable to choose the smaller plan. Just don't leave the bigger expectation attached to it. Narrow the scope or revisit the timeline.
4. Decide What Counts as Progress
If the target is completed new-patient visits, keep coming back to that result. Inquiries and booked appointments help explain how we're getting there. They don't replace it.
For each of the 15 offices, compare completed new-patient visits with the growth target and show what we spent. If an office is behind, find out where patients are dropping off. Are too few people inquiring? Are they calling but not booking? Or are they booking and not showing up? Those need different fixes.
I want the report to help us decide something. If all we do is look at it and schedule another meeting, it needs a better job.
Something Has to Come Off the List
Once the priorities are clear, I'd ask what we're not doing. New priorities need money and attention. Both have to come from somewhere.
Maybe a low-priority campaign gets paused or a website feature waits. I'd start with the work we'd miss least, not whatever's easiest to cut.
That doesn't mean cutting everything that can't be tied to an appointment today. Referral relationships and reputation work deserve more thought than that. It means asking each piece of work to justify its place.
The Monday Morning Version
Before the next budget discussion, put one page in front of finance, operations, and marketing. Write down the growth target, priority services and markets, available capacity, spending options, and what you're going to stop doing.
If those choices aren't settled, that's the meeting. You don't need a more polished presentation yet. You need to make a few decisions.
The marketing budget should fund the decisions. It shouldn't have to make them.
— Matt