The bottom line
PCCD Los Altos lands premium cases through organic. The paid channels flood the top of the funnel and almost nothing converts.
Why it mattersOrganic brought 38 cases worth $515K at a $13,544 average — the engine. But paid social poured in 910 leads (43% of the year) and closed 2, and paid search added 678 leads at a 2.4% close. The practice is drowning in low-intent paid leads.
2,127
Leads
Jan to Sep 2026
72
Cases closed
3.4% lead to sale
$645K
Case value
est., won cases
$8,954
Avg case
premium mix
$13.5K
Organic avg case
the best cases
0.2%
Paid social L→S
2 of 910 closed
Protect organic
431 leads, $515K, a $13,544 average case. The premium engine and best converter. Keep SEO and reputation funded.
Cut or rebuild paid social
910 leads, 2 closes. 43% of the year's leads for a 0.2% conversion. Stop the bleed or rebuild the offer.
Fix paid search
$95K at 0.37x = a ~$60K loss buying $2,213 cases. Cut it and rebuild toward implant and cosmetic intent.
Performance by channel
Organic carries the value. The paid channels carry volume and little else.
Why it mattersOrganic and direct are 24% of leads but 89% of case value, and they close at 8.8% and 18.2%. Paid search and paid social are 75% of leads and close at 2.4% and 0.2%.
| Channel | Leads | Booked | Closed | Case value | Book rate | Lead→sale | Avg case | Verdict |
|---|---|---|---|---|---|---|---|---|
| Total | 2,127 | 122 | 72 | $645K | 5.7% | 3.4% | $8,954 |
Where the case value is
Closed case value by channel, YTD (est.)
How well each converts
Lead to closed case, percent
Case value is GHL's estimated opportunity value on won cases, not collected production. “Booked” = reached Appointment Booked or beyond. Paid social's $17K average sits on just 2 cases, so ignore it.
The funnel, month by month
The drop is at the top: plenty of leads, few reach a booked appointment.
Why it mattersPCCD draws roughly 235 leads a month but books only ~14 and closes ~8. Of the few who reach a presented treatment plan, 73% close. The constraint is getting qualified leads into a booked consult, not closing them.
Cohort funnel by lead-created month, current stage as of the pull; rows are cumulative. This pipeline has a Presented Treatment stage, so show rate is real. “Contacted” is still under-recorded because phone-call opportunities often stay in intake. Recent months' closes are still maturing (leads credited to the month they entered), so August and September understate. Change columns compare September to August and to July.
Budget & ROI
Google is half the budget and returns 37 cents on the dollar.
Why it mattersMarketing ran about $191K over nine months (Wonderist agency of record). $95K of it went to Google, which produced $35K in estimated case value at a $2,213 average case — a roughly $60K gross loss. Meanwhile the organic/SEO program (plus Yelp) returns nearly 13x. The money is pointed the wrong way.
Budget by channel
YTD Jan to Sep 2026, about $191K ($21.2K / mo)
Return on ad spend
YTD case value / YTD spend (log scale). Breakeven 1.0x.
| Channel | YTD spend | YTD case value | ROAS | Verdict |
|---|
Paid social's 1.8x is a mirage
That return rests on just 2 closed cases carrying GHL's inflated default values ($17K each). On 910 leads and 2 cases, the real return is near zero. Do not read it as working.
Where the budget should go
- Cut Google hard and rebuild it. $95K at 0.37x is a $60K gross loss buying $2,213 general-dentistry cases. Rework toward implant and cosmetic intent, like the organic cases.
- Protect the organic engine. SEO plus Yelp returns ~13x and produces the $13.5K premium cases. Keep it funded; it is the profit center.
- Pause or rebuild paid social. 910 leads, 2 real cases. Move the budget to organic and high-intent search until the offer is fixed.
ROAS is gross and directional. It divides each channel's YTD estimated case value by its YTD spend (ad spend plus the attributable share of Wonderist management fees, split by ad spend). GHL last-touch attribution over-credits organic, and case values are GHL estimates, so treat the organic multiple as an upper bound. The durable signal is the gap: paid search 0.37x versus organic ~13x. Yelp is counted with organic because it drives directory and organic discovery.
Case value by channel, by month
Organic is lumpy but carries the big months. Paid contributes little value.
Why it mattersOrganic drove the standout months (Mar $110K, Jul $156K, Aug $127K). Paid search and paid social add volume, not value. Recent closes are still maturing.
Monthly case value by channel
Stacked, Jan to Sep (est.)
Case value by channel by month
Estimated case value credited to the month the lead was created. Change columns compare September to August and to July; recent closes are still maturing. Gross, last-touch, directional.
Case mix
A premium-case business. Seven cases drove well over half the value.
Why it mattersThe median closed case is $1,358, but the top 10% (7 cases) is 57% of value and the largest was $72,000. 17 cases came in over $8K. Marketing should chase high-value implant and cosmetic cases, not lead volume.
Closed cases by size
72 won cases, Jan to Sep, grouped by value (est.)
57%
of value from the top 7 cases (largest 10%)
$72,000
largest single case (est.)
17
cases over $8K, the premium tail
The tracking gap to fix
Service line is not tagged in GHL and default deal values are rough. Add a treatment field (implant, full-arch, cosmetic, general) and realistic values so the premium mix is measurable, not inferred.
Two leaks in the data
Both are fixable without buying a single new lead.
Why it mattersBefore adding spend, plug these. One is a wasted channel; the other is the top-of-funnel drop that wastes every lead we already pay for.
Paid social is flooding the funnel
- 910 leads, 3 booked, 2 closed this year. 43% of all leads for essentially no cases.
- This is the Meta instant-form pattern across the Wonderist portfolio: cheap cosmetic-quiz leads that close near 0%.
- Pause or rebuild. Rework targeting and offer, or move the budget to organic and high-intent search.
Leads die before a booked consult
- Only about 1 in 18 leads reaches a booked appointment (122 of 2,127), yet 73% of presented plans close.
- The leak is contact-to-book: speed-to-lead, qualification, and getting people onto the calendar.
- Set a 5-minute first-touch SLA and a qualification script so high-intent leads reach a consult.
A separate website and cosmetic-readiness review is not repeated here; this section covers only what the live GHL data shows.
Monthly trend
Lead flow is heavy and rising. Case value is lumpy, driven by a few big cases.
Why it mattersLeads climbed through the year (339 in August). Case value swings with a handful of premium cases per month. August and September look lighter only because their closes are still maturing.
Leads, closed cases, and case value by month
Bars: lead and closed-case counts (left). Line: monthly case value, est. (right).
The plan, next 90 days
Stop the paid-social waste, fix the top-of-funnel drop, then concentrate on premium cases.
Phase 1Days 0 to 30 · Stop waste, fix intake
Convert the leads we already pay for
1
Pause or rebuild paid social.
Paid media910 leads and 2 closes. Stop the spend or rebuild the offer around retargeting and high-intent creative, with a 60-day close-rate gate.
2
Install a 5-minute first-touch SLA.
Front desk / MMOnly 1 in 18 leads reaches a booked consult. Route every lead to a named person with call-plus-text in 5 minutes and a qualification script.
3
Add a service-line field and real case values.
Ops / GHLTag implant, full-arch, cosmetic, and general, and replace rough defaults so the premium mix is measurable.
4
Reallocate the Google budget.
Paid mediaCut Google from ~$10.5K/mo toward ~$5K and move the freed spend to organic and high-intent cosmetic search, with a cost-per-case gate.
Phase 2Days 30 to 60 · Concentrate on premium
Fund the engine, grow the big cases
5
Double down on the organic engine.
SEO / Content431 leads, $515K, a $13.5K average. Fund SEO and reputation; add implant and full-arch pillar pages to pull more premium cases.
6
Rework paid search to high-value intent.
Paid mediaShift budget and keywords toward implant and cosmetic terms to lift the $2,213 average case, once cost-per-case is confirmed.
7
Reactivate booked-but-unclosed leads.
MM / GHLRun a re-engagement sequence (financing, proof, limited consult slots) against the owned database. Near-zero cost.
Phase 3Days 60 to 90 · Scale what proves out
Spend follows evidence
8
Re-scale paid only past a cost-per-case gate.
Paid mediaAdd paid budget only where the confirmed cost-per-case clears the premium case value. Otherwise keep the money in organic.
9
Engineer a referral track.
PracticeAdd a structured ask at case completion and a VIP card to turn premium patients into a steady, free channel.
10
Stand up a monthly channel scorecard.
GrowthThis report, monthly, with cost-per-case once spend lands, so budget follows performance.
90-day targets
Google ROAS
0.37x → 1.0x+
Rebuild to high-value intent
Lead to booked consult
5.7% → 12%
5-minute SLA + qualification
Paid social lead→sale
0.2% → rebuild / cut
910 leads, 2 closes
Service-line tagging
0% → 100%
Every opp tagged in GHL
Bottom line: cut the $95K Google spend that returns 0.37x and rebuild it to high-value intent, stop the paid-social waste, fix the contact-to-book drop, and fund the premium organic engine that already returns ~13x.
Sources & method
- Window: performance runs Jan 1 to Sep 30, 2026 (YTD), by lead-created month. All-time context (since 2024) is in the header chips.
- Data: live GoHighLevel opportunities pull on Oct 6, 2026, 4,932 records all-time, 2,127 in the YTD window after excluding the Existing Patient parking stage. Aggregate only, no patient names or contacts.
- Case value is an estimate. GHL opportunity value on won cases, not collected production. Treat lead counts and close rates as the hard numbers.
- Funnel: Contacted / Booked / Shown / Closed are stage-based; this pipeline has a Presented Treatment stage, so show rate is real. Contacted is under-recorded for phone-call opportunities that stay in intake.
- Cohort lag: won cases are credited to the month the lead was created, so recent months understate conversion.
- Spend: from the 2026 Gen4 practice marketing budget (YTD Jan to Sep). ROAS divides YTD estimated case value by YTD spend (ad spend plus the attributable share of management fees); it is gross and last-touch. Service line is untagged, so case mix is inferred from case value.