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Chiropractic · conversion tracking

Your first visit is not the conversion. The second one is.

Australian chiropractic runs a two gate funnel: a discounted initial consultation, then a report of findings where the actual care decision is made. Optimising to the first gate buys you the cheapest, least committed half of your market.

The structural problem

Two gates, and almost everybody measures the wrong one.

The Australian chiropractic funnel is distinctive. A discounted initial consultation, commonly $47 to $89 against a list price of $99 to $189, gets the patient through the door. Then a separate report of findings visit, frequently with its own fee, is where imaging is discussed and a course of care is proposed. That second appointment is where the revenue decision actually happens.

Almost every chiropractic account we see counts the first booking as the conversion. Google then optimises for the cheapest possible discounted first visit, which is exactly the patient least likely to return for the second. The account gets more efficient at a metric that is not connected to income.

What to do instead

Rebuilding the measurement around the second gate.

  1. 01

    Stop counting the discounted booking as the goal

    Keep it as a secondary conversion so you can see volume, but take it out of the bidding target. Otherwise every optimisation decision is being made on the wrong signal.

  2. 02

    Get the report of findings attendance out of the practice system

    It is a distinct appointment type in every system we have looked at, which means it can be identified and exported. This is the number the account should be judged on.

  3. 03

    Fix the offer code problem

    Australian chiropractic offers are routinely redeemed by asking the patient to type a code into the comments field of a booking form on a third party domain. That is invisible to Google, unmatched to any campaign, and manually reconciled. Move it to a tracked parameter or a dedicated booking type.

  4. 04

    Decide the tracking architecture around your booking flow

    This is where most chiropractic accounts are quietly broken. See the warning below, because on the most common system in Australian allied health the standard approach cannot work at all.

  5. 05

    Reconcile monthly against the practice system

    Conversion imports fail silently and the failure looks exactly like a downturn in demand. A monthly check against the appointment book is the only way to tell the difference.

Cliniko documents that its own booking widget breaks your attribution
This is not a rumour or an inference. Cliniko's help centre states that because of limitations with iframes, referral data does not pass from the parent website into the child iframe, which results in bookings reporting as Direct. It further states that Cliniko prevents external and third party code from running inside the booking pages, and recommends redirecting the booking to the Cliniko hosted domain if accurate conversion tracking is essential. So the embedded widget breaks the source, and the hosted page moves the patient to another domain. Either way, a chiropractic clinic on Cliniko needs a deliberate architecture rather than a standard tag.
Straight answers

Questions clinic owners actually ask

Why do my chiropractic bookings show up as Direct in Analytics?
If you are on Cliniko, because Cliniko says so. Its help centre documents that referral data does not get passed from your website into the embedded booking iframe, so bookings are recorded as Direct. It also states that Cliniko prevents third party code from running inside the booking pages, which rules out the usual fixes. The practical options are to run your own booking form against the Cliniko API, to redirect to the Cliniko hosted domain with cross domain tracking configured deliberately, or to match conversions on hashed contact details instead of the click identifier.
What should a chiropractic clinic count as a conversion?
The report of findings attendance, or whatever your clinic calls the second visit where a course of care is discussed. That is the point at which a new patient becomes revenue. The discounted initial consultation should still be tracked, because you need to see the volume, but it should not be the target the bidding optimises towards. A clinic that optimises to the discounted first visit is paying Google to find people who want a cheap first visit, which is a real audience and not the one that sustains the practice.
How do we track a coded first visit offer?
Not by asking the patient to type the code into a comments field, which is how most Australian chiropractic clinics currently do it. That leaves the redemption invisible to the advertising platform and reconciled by hand. Better options are a dedicated appointment type for the offer, so redemption is a distinct record in the practice system, or carrying the campaign in a URL parameter through to the booking. Either gives you offer level attribution, which also tells you the thing you actually want to know: whether discounted patients convert to care plans at a different rate than full price ones.
Can chiropractic conversion data be uploaded back to Google Ads?
Yes, though the route depends on your system. Cliniko has an open API with patient custom fields that can hold the click identifier, but blocks third party code on its booking pages, so it requires running your own booking form against the API. Nookal exposes an API and a webhooks section. PracSuite has a documented API with a domain allowlist. Jane has no open API. Where none of that is workable, enhanced conversions matching on hashed email and phone works on almost anything, and is usually the realistic recommendation rather than the fallback.
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