Ask for a diagnosis before a package
A useful conversation begins with the practice's goals, services, locations and appointment capacity. The agency should ask about the existing website, search performance, advertising and inquiry process. Those answers help distinguish a traffic problem from a website or follow-up problem.
Ask which findings led to the recommendation. A proposal that lists every available channel without connecting it to a business need is difficult to evaluate. The work should have priorities and dependencies, including what the practice must supply or approve.
Make the deliverables reviewable
Request a clear description of the research, content, development and reporting included. Clarify who writes clinical information, who reviews it and how updates are handled. If city pages are proposed, ask what distinct value they will provide and whether they represent genuine locations or service coverage.
Separate media spend, agency management, software charges and production costs. Understand what changes when the scope expands. A lower headline price is not necessarily a better comparison if important work or account access is omitted.
- A prioritized scope with responsibilities.
- A definition of the reporting metrics.
- A process for content and clinical review.
- Transparent account, domain and data ownership.
- A handover plan and clear ongoing obligations.
Inspect evidence and promises
Case studies should identify the period, starting point, work performed and measurement method. Ask whether reported leads were qualified or whether the figure counts all submissions. Results from another practice can illustrate a method but do not establish a forecast for yours.
Treat guaranteed number-one rankings or guaranteed AI citations as a warning sign. Platforms control their results. A responsible agency can commit to agreed work and transparent reporting without claiming to control outcomes it does not own.
Review the quality of the agency's own explanations. Clear answers about redirects, content review, local search and lead handling are more useful than unfamiliar terminology presented without a practical purpose.
Check how the relationship will operate
Decide who inside the practice will review content, supply factual updates and share lead-quality feedback. Ask how questions are handled and how priorities change when evidence does. A good working process makes approvals and ownership visible.
Confirm access to your domain, website, analytics, search property and advertising accounts. Understand what can be exported and how the relationship ends. These are ordinary business questions that make the proposal concrete.
Finally, compare agencies against the same brief. Ask each to explain the first priorities, the assumptions behind them and the evidence that would change the plan. That creates a more useful comparison than choosing the most confident ranking promise.