Case Study: Singapore Urology Specialist Centre

Nearly 3× more patient enquiries from Google Ads, for 13% less spend.

A Singapore urology specialist centre was paying S$550 for each enquiry form. We rebuilt the ads, the tracking and the website. The cost is now S$168 per form, and the site moved from page 3 of Google to page 1 in Singapore.

Client A private urology specialist centre

Where Singapore

With Realisma since October 2024

Scope Google Ads · SEO · website rebuild

2.8×

more enquiry forms a month

11 → 32 per month

−69%

cost per enquiry form

S$550 → S$168

−13%

monthly ad spend

S$6,212 → S$5,401

31 → 9

average Google position, Singapore

page 3 → page 1

Lots of clicks. Very few patients.

The ads bought cheap traffic, not patients

Most of the budget ran on display placements. In 2024 the account bought up to 1.8 million impressions a month at 31–72 cents a click.
From January to August 2024, fewer than 1 in 100 clicks became a conversion.
Each completed enquiry form cost S$471–655.
The tracking counted phone-button taps, email clicks and fax-number clicks as “conversions”. The dashboard looked busy, but the front desk was not.

The website was invisible where it mattered

Before the rebuild (mid-2025), searches from Singapore found the site at an average position of 31. That is page 3 of Google.
Our audit found that about 65% of organic clicks came from the Philippines, not Singapore. Machine-translated pages were ranking for Tagalog symptom searches, and those people could not become patients.
Its structured data described the clinic six different ways, so Google could not trust any of them.

We fixed the pipeline first, then scaled it.

Google Ads

1
Moved the money to high-intent search
We moved the budget from display placements to Search. We built five Search campaigns around what patients actually type: general urology, kidney and enlarged prostate, “urologist Singapore”, and one campaign for each doctor.
2
Cleaned up the tracking
We audited 28 conversion actions. Google Maps and Business Profile taps no longer count as conversions. Google's bidding now learns from real enquiries, not from cheap clicks.
3
Cut what did not earn its keep
We paused Performance Max when it chased low-quality placements and branded searches. We moved that budget to the campaigns that brought in real enquiry forms.

Website + SEO

1
Rebuilt the website (November 2025)
A new site with clear calls to action on the condition pages: call, WhatsApp or book.
2
Gave Google one clear clinic identity
We merged 8 competing structured-data blocks into one entity. We added medical schema to 26 condition and procedure pages, which makes 171 patient questions machine-readable.
3
Built trust signals and cut dead weight
Every condition page now has a doctor byline and a last-updated date. We removed 575 machine-translated pages from Google's index. They brought overseas traffic that could not convert.

More real enquiries every quarter.

We measure one thing: completed enquiry forms from Google Ads. This number does not include phone calls or WhatsApp chats, so the real lead count is higher than the chart shows.

Completed enquiry forms from Google Ads, per quarter

Q1 2023 – Q3 2026

Previous setup

Realisma

*Q3 2026, partial (1 Jul – 18 Sep)

Source: Google Ads account data, pulled 19 Sep 2026. Hover a bar for its value.

Swipe right to see earlier quarters.

What each enquiry form costs

Total Google Ads spend ÷ completed enquiry forms

Previous setup

Realisma

2023 · previous setup

S$655

Jan–Sep 2024 · previous setup

S$471

Oct 2024–Dec 2025 · Realisma

S$316

2026 to date · Realisma

S$168

Source: Google Ads account data, pulled 19 Sep 2026.

Monthly spend is 13% lower than before. Each enquiry now costs less than a third of what it did.

From page 3 to page 1 in Singapore.

We only count searches made in Singapore, because those are the people who can book an appointment. Overseas clicks can make a report look good, but they do not bring in patients.