Proof

Real practices. Real numbers. Same playbook.

Cost-per-patient down 78%. Show rate up to 66%. Cost-per-lead cut by a third in 30 days. The results below are from named practices using the same operating system every Boydston engagement gets.

Book the Audit → Read the case studies

§ 01 / The pattern

The results repeat because the system is the same.

Every engagement starts with the same diagnostic, gets the same 30-day install, and bends the cost-per-patient curve in the same shape. Numbers vary by vertical. The system that produces them doesn't.

The diagnostic

The first audit always surfaces the same four leaks.

Rate

The leak

Why it costs you

83%

Conversion tracking that stopped firing months ago, or never fired correctly

The ad platforms have been flying blind. Cost-per-click is fine, cost-per-patient is invisible.

91%

Inbound response measured in hours, not minutes

Form fill, then radio silence until tomorrow. The best lead you paid for is also the easiest to lose.

76%

No reminder cadence between registration and event (or appointment)

The system assumes the prospect remembers. The prospect does not.

88%

Untracked handoff between marketing system and EHR / CRM

Patient becomes a patient, but the system that produced them never finds out.

Frequency across the most recent ~30 Boydston audits. The leaks are common. The combination is what bleeds the account.

The install

Same 30-day motion every time. No "we'll figure it out as we go."

Day 1

Kickoff. One-page brand brief. Platform access secured.

Days 2–7

Lander built on template. Ad creative pack produced. Offer locked.

Days 8–14

Conversion tracking wired end-to-end. AI agent trained on your KB. Dashboard provisioned.

Days 15–21

Internal QA. Soft launch with controlled spend. First audiences warmed.

Days 22–30

Full launch. First report. Weekly optimization rhythm begins.

The result curve

Cost-per-patient bends the same way in every account that follows the system.

Month 1

Learning month. Platforms catch up on outcome data. CPL noisy.

Month 2–3

Cost-per-lead bends downward. Quality of leads visibly improves.

Month 4–6

Cost-per-patient stabilizes 30–60% below baseline in typical engagements.

Month 7–12

Attribution moat compounds. Each event or month makes the next one cheaper.

Specific numbers depend on offer, market, and budget. The curve shape repeats because every engagement runs the same install.

§ 02 / Case studies

Two practices. Two products. The same fix.

PRM runs a back-pain seminar on the Seminar Engine. VTI runs a national telehealth account on Lead Engine. Different verticals, different ways of attracting patients, same diagnostic and the same install motion. The version your practice runs starts the same way.

Case Study · Seminar Engine · /01

Progressive Rehabilitation Medicine

Multi-doc orthopedic group · Back pain seminar

They had the clinical authority. What they didn't have was a machine around the event, and it was costing them roughly 15 patients per seminar.

The practice

PRM is a multi-doc orthopedic group running a monthly back pain seminar. The clinical content was strong. The docs are credible, the offer matters, the local market is large enough. The seminar should have been their best patient acquisition channel. It wasn't.

What was broken

Two years of self-run seminars had settled into the same pattern: 28–35 registrations from boosted Facebook posts, 40% show rate, maybe 12 in the room on a good night, 1–3 consults booked. Ad spend $4,500/event with no idea which ad produced which patient. Every campaign was a guess. Every result was a roll of the dice.

The diagnosis

The first 7-day audit found all four leaks: no conversion tracking past the form fill, inbound texts going unanswered for 4–8 hours, no reminder cadence after the initial confirmation, and no attribution from ad impression to seated patient. The seminars weren't failing because the offer was wrong. They were failing because the system around them didn't exist.

The install

Same 30-day install motion that every Seminar Engine client gets: branded registration page on the Boydston template, AI agents handling every inbound call and text, reminder cadence by text and email from registration through morning-of-event, mobile check-in on staff phones, full attribution from ad click through patient acquisition wired back to Meta as offline conversions.

The first event under the system

Registrations doubled in the first month of running ads (62 vs prior average of 31). Show rate jumped to 64% the night of the event. Almost entirely because the AI re-confirm calls caught registrants who would have otherwise quietly no-showed. Walk-ins were captured cleanly with attribution for the first time. 16 consults booked from a single room.

Two events in

The numbers stabilized. The second event was cheaper to run because the attribution data from the first event taught Meta which audiences actually converted to seated patients. Cost per registration fell. Show rate held. The system started compounding.

What changed about the practice's operation

PRM stopped treating the seminar as a quarterly event. It became a monthly system. The front desk stopped dreading event nights because the check-in workflow was on phones, not clipboards. The docs walked into rooms that were filled with people who had already been re-confirmed, reminded, and pre-qualified. The seminar stopped being a stressful push and started being a calendar item.

The math

Cost per new patient dropped from $1,125 (pre-Boydston average) to $253, a 78% reduction. At PRM's lifetime patient value, payback on the install fee happened inside the first event. The monthly cadence subscription pays for itself with one patient per event.

"We'd been running back pain seminars for two years and I honestly thought our results were normal. They weren't. After two events with Robert we've doubled our registrations, the show rate is 66%, and we're walking out of every seminar with 15 to 20 new patients on the schedule. The difference isn't subtle."

Dr. M. · Progressive Rehabilitation Medicine

Metric

Before

After

Registrations / event

+129%

Show rate

40%

66%

+26pp

Consults booked

+750%

New patients / event

+850%

Cost per patient

$1,125

$253

−78%

Event 1 + Event 2 averaged · ad spend $4,800 / event

Case Study · Lead Engine · /02

Valley Thyroid Institute

National telehealth thyroid practice · Multi-state

A Google account that had been quietly bleeding for 12 months, with an outcome signal that had been turned off the whole time.

The practice

VTI is a national telehealth thyroid practice serving patients across multiple states. The offer is consult-driven: ad → form fill → discovery call → enrolled patient. Google Ads has historically been the dominant channel because the buyer is search-intent. They're actively looking for a thyroid specialist when they convert.

What was broken

The Google Ads account had been running on autopilot for about 12 months. Cost per lead had crept from $24 to $34 with no clear explanation. Lead volume was slowly decaying. Every agency that pitched VTI wanted to start over from scratch, which would have meant losing 12 months of (admittedly degraded) account history.

The diagnosis

The 7-day audit found something specific: the lead conversion tracking action had been turned off for over a year. Google had been flying completely blind on which leads turned into patients. Without that outcome signal, the algorithm had defaulted to optimizing for clicks, and 70% of the budget was being burned on a single keyword Google had quietly flagged as low-quality, doubling its real cost.

The install

Standard Lead Engine 30-day install motion. Restored the lead-to-patient conversion tracking action and wired it back to Google. Added 97 search-term exclusions to filter out job-seekers, free-info-seekers, and out-of-state searchers. Wrote three new ad variants targeting the three angles the data showed were actually converting to enrolled patients. Made sure Google was finally getting the lead-quality signal it needed to learn from.

The first 30 days under the system

Cost per lead dropped from $34 to $24, back to the baseline VTI had a year prior. But more importantly, lead quality improved measurably: the percentage of leads that became enrolled patients went up because Google was finally optimizing toward the outcome that mattered. Cost per new patient fell 32% in the first month.

Why the rebuild approach worked

Every other agency wanted to scrap the account because that's the easiest engagement to sell. The actual problem wasn't the account. It was the outcome signal feeding the account. Fixing the signal salvaged 12 months of campaign history that would have been thrown away. The lesson generalizes: most underperforming ad accounts aren't broken. They're miscalibrated.

What changed about the practice's operation

VTI stopped wondering whether Google was working. The monthly report became a tool for deciding where to scale, not a defense of last month's spend. The founder went from manually reviewing the account weekly (badly) to reading a 90-second Loom and making decisions. Marketing became something the practice ran instead of something the practice worried about.

The math

A $10/lead reduction on ~38 monthly leads is $380/month back. A 32% reduction in cost per new patient at VTI's lifetime patient value paid back the entire Lead Engine setup fee inside week three. The retainer is now structurally invisible against the savings.

"My Google Ads had been running on autopilot for a year. I knew something was off but every agency that pitched me wanted to start over from scratch. Robert went in, found the leak, and rebuilt around what was already working. My cost per new patient dropped by a third in the first month and the lead volume went up. He treated my account like it was his own."

Dr. Gil Kajiki · Valley Thyroid Institute

Metric

Before

After

Cost per lead

$34

$24

−29%

Monthly lead volume

+73%

Cost per new patient

baseline

−32%

down

Low-quality keyword spend

70% of budget

eliminated

30-day window post-rebuild · same monthly budget

§ 04 / Recent wins

Six results from the last twelve months.

Dermatology to dental implants to financial advisors. Different verticals, different ad budgets, same install motion. These are the wins between the long-form case studies.

Multi-location dermatology

Lead Engine Pro

Cost per consult down 41% in 60 days

Conversion tracking had been off for 8 months. Rebuilt the form-to-patient pipeline, restored Google's ability to optimize. Spend stayed flat. Booked consults nearly doubled.

Cosmetic dental practice

Lead Engine Standard

Bookings doubled on the same Meta budget

Old lander was a brand microsite with five CTAs. Replaced with the single-offer Boydston template. Same audience, same creative. Half the cost per booked consult.

Three-location med spa

Lead Engine Standard

Cost per appointment $89 → $34

Was boosting posts. Built a real ad account with conversion tracking, AI lead response, and 6 ad variants. Two months in, the appointment book was full enough to add a fourth location to the plan.

Financial advisor (retirement)

Seminar Engine, Monthly cadence

4 events ran with avg 52 in the room

Prior agency was producing 18-person rooms at $4,200/event. Same town, same budget, same speaker. The difference was the registration page, the reminder cadence, and the AI re-confirm calls.

Dental implant practice

Seminar Engine, à la carte

First event: 22 consults booked from one room

Replaced an old "free dinner" funnel with a tracked, branded registration flow. 38 attended, 22 walked out scheduled. Cost per booked consult: $187.

National telehealth (men's health)

Lead Engine Pro

Cost-per-patient down 28% across both platforms

Multi-state account, unified attribution across Meta and Google, weekly optimization passes. The reporting alone was worth the retainer. The founder finally knew which platform was actually working.

Your practice could be next

The audit tells you what's actually leaking.

Thirty minutes. I personally review your landing page, ad account, conversion tracking, and follow-up speed. You leave with the three to five biggest leaks I can identify and what each one is likely costing you per month.

You keep the audit document whether or not we ever work together. It's the same diagnostic that every case study on this page started with.

Book the 30-Minute Audit → See pricing