How to Grow With a Client for 7 Years (Without Burning Out the Strategy)
Managing the same account for seven years in digital marketing doesn’t happen often. Most partnerships don’t last that long, priorities change, budgets shift, results stall, private equity comes in and changes things for no reason…you know the drill. But when it does work, it’s because both sides are willing to adapt and grow.
That’s exactly what happened with ADVENT. We started back in 2018 running ads in one market. Today, they’ve grown into the fastest-growing ENT practice in the country, with 35+ clinics across six states and 1,500 new patients coming in every month. That kind of growth only happened because we didn’t get comfortable. We kept evolving the strategy right alongside their business. That’s what Granular growth looks like.
Search Is Never “Set It and Forget It”
If there’s one thing I’ve learned, it’s that search is never static. The “best practice” from seven years ago would look outdated today. Back then, we launched campaigns broken out by match type and managed them manually. That was the right move at the time.
Fast forward to today and the structure looks completely different. Consolidation works better, and instead of obsessing over every manual lever, we focus on giving Google the right conversion signals so campaigns can actually scale.
The point is, we never let things sit. We tested everything new that came out. Performance Max? Tried it. Broad match adoption? Tested it. Dynamic landing pages? Rolled those in. And when something didn’t fit, we moved on. The account was never stagnant, and that’s why it grew with the client instead of holding them back.
Not Just Paid in a Bubble
Paid Search was a huge driver, but it was never the whole story. The real goal wasn’t “win paid” or “win organic” — it was to fill clinics with new patients. That meant looking at performance as a whole, not by channel.
We worked alongside our partner SEO team, Momentic to understand how campaigns and organic visibility were building on each other. Paid could drive immediate patient bookings and open up demand in new markets, while SEO built the foundation for long-term growth. Together, they kept the brand showing up consistently no matter how patients searched.
Staying Ahead With Google
One of the advantages of being a Google Premier Partner is having a direct line in. We used that to stay ahead of changes, get competitive insights, make budget recommendations, and even test betas before most advertisers had access. It also helped on the practical side, like pushing support tickets through faster. That relationship gave us an edge the client could actually feel.
Measuring What Actually Matters
From day one, we aligned on one business metric that truly mattered: booked patient appointments. Not clicks, not impressions, not “soft” conversions – real appointments on the calendar. That focus cut through the noise and kept us optimizing toward outcomes that actually grew the business.
We also pushed beyond surface-level reporting. We researched and vetted incrementality measurement tools to understand which channels were really driving new patients, including some we didn’t directly manage. That gave us a clearer picture of total impact and where to recommend the client keeps investing.
The Big Lesson
Managing an account for seven years isn’t about one big breakthrough and it’s certainly not “growth hacking”. It’s about making small, measurable adjustments over and over again, never letting things get stale. It’s knowing when to restructure campaigns, when to test, and when to double down.
Seven years later, the budgets are bigger and the systems are more complex, but the principle hasn’t changed: keep adapting, stay focused on the results that actually matter, and build a partnership strong enough to grow with the business. That’s at our core here at Granular and that’s why we retain clients for years on end. No gimmicks – just an experienced and talented team, hard work, data driven decision making, and driving true business growth.
Questions?
If you have any questions or are interested in having Granular help grow your business, please use the button below to get in touch!
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