The 90% Problem: Why Specialty Practices Over-Invest in Bottom-Funnel Paid Search

Specialty healthcare practices typically allocate 90% of paid media spend to high-intent, bottom-of-funnel searches — terms like “knee surgeon near me” or “carpal tunnel specialist” — where 10 competitors bid on the same click. By the time a patient executes that search, the choice to see a specialist is already made; what remains is which practice wins the auction. The real opportunity is mid-funnel: reaching patients in the six-month window before they know they need care. MD Anderson’s “Where You Go First Matters” campaign is the benchmark — buying into the consideration set before pain starts, not bidding for the hand-raise after it does. Orthopedic, cardiology, and dermatology groups running 90/10 bottom-heavy media mixes are sustaining a bidding war, not building a durable patient acquisition engine.