The sheet.
Not the pitch.
This is the deliverables page for the Architect engagement, Macbach’s fractional-CMO tier. If you landed here from the positioning page, this is the next level of detail. A typical month is a weekly call, a written executive report, a working priority initiative, and live CRM visibility. A typical year is four quarterly off-sites, a benchmarks report tailored to the practice, and an annual business review tied to practice financials, not vanity metrics.
Our oldest active client started with Macbach in 2008. Eighteen years, three practice locations, from one physician to eleven. The Architect tier is the engagement model that supported that arc: web build, then SEO, then Maps, then paid, then fractional CMO. This page is what Architect actually produces over that kind of timeline.
From $8,000
a month.
- MapsPRO, RankPRO, AdsPRO, and SitePRO at the tier the practice needs, with no separate management fees stacked on top
- Strategic Command Plan build, maintenance, and quarterly refresh
- Monthly executive reporting and monthly business review against practice financials
- Real-time Macbach CRM access for the practice owner and operations lead
- Quarterly strategy off-sites (on-site or virtual) and annual business review
- Direct communication with Vince on every decision
- Ad spend across Google, Meta, and any secondary platforms. Paid directly to the platforms, never marked up, never invoiced through Macbach.
- Third-party software the practice already uses or elects to adopt (CallRail, Hotjar, schema validators, CRM upgrades, etc.)
- Third-party medical review contractors when a practice lacks internal clinical reviewer capacity
- In-house staff (marketing coordinator, receptionist training, front desk conversion coaching)
- Paid media for categories Macbach does not service (OOH billboards, broadcast television, print)
- PR and crisis communications (retained separately via partner firms when needed)
- Legal, compliance, or HR consulting on marketing policies
Architect is a 12-month agreement, renewed annually. No handshake deals. Every line in the SOW.
What the practice receives, week to year.
- Standing 30-minute team call with the practice owner and the operations lead
- Async access to Vince on Slack or email, measured in hours, not days
- Live performance dashboards inside the Macbach CRM portal
- Executive report benchmarked against the Macbach healthcare book
- One priority initiative scoped, assigned, and dated
- Strategy adjustments documented in the Strategic Command Plan
- On-site strategy off-site or a half-day virtual workshop with leadership
- Roadmap refresh for the next twelve months
- Competitive and category intel update
- Business review against practice financials, not vanity metrics
- Retention and growth narrative prepared for the practice board or partners
- Next-year operating plan and budget
Five things the practice owns.
Strategic Command Plan
A 40 to 100 page living document hosted in the Macbach CRM portal, versioned on every quarterly refresh. Site architecture, keyword matrix, schema strategy, funnel, AEO, local SEO, competitive intel, E-E-A-T posture, and the KPI set tied to practice revenue. The practice keeps this document if the engagement ever ends.
Monthly executive report
Written narrative, not a PDF export of dashboards. Opens with what did not move and why. Benchmarks the practice against the Macbach book across MapsPRO, RankPRO, AdsPRO, and SitePRO. Ends with the decision set the practice should be making next month.
Annual healthcare marketing benchmarks
Macbach publishes an annual benchmarks report across concierge medicine, specialty medical, dental specialty, weight loss, medspa, and DPC. Architect practices receive a custom cut of that report, tailored to their vertical, region, and revenue band. Released every January.
Real-time CRM access
The same internal CRM that powers the Macbach delivery team. Task status, campaign performance, review velocity, content pipeline, schema validation, site audits. Real-time read access for the practice owner, operations lead, and any stakeholder they choose to invite.
Direct-line communication with Vince
Every decision that touches the growth surface routes through Vince. No account manager layer. No pod handoff. The same number and email the rest of the Macbach team uses internally.
Vince first.
No account manager layer.
Architect is founder-led. Vince is the primary point of contact on every engagement. Weekly call, monthly report, quarterly off-site, annual business review, all Vince. Between those, the channel is open.
Senior Macbach collaborators step in when the work calls for specialized depth: schema graph rebuilds for AI Overview and Perplexity, conversion-rate analysis on the patient intake flow, brand work during a rebrand, medical reviewer coordination when the practice does not have internal clinical review capacity. Senior collaborators never become the primary relationship. They support the relationship.
The Macbach delivery team executes the four products against the Strategic Command Plan. The practice does not manage that team directly; Vince does. If a deliverable slips or a number drifts, the escalation path is one email.
There is no junior account manager in the Architect engagement. There has never been one, and there will not be one. This is the structural reason the engagement is capped at twelve to fifteen active Architects at a time.
The honest section.
Every positioning page is tempted to claim the tier is everything to everyone. It is not. Four things Architect is not.
Not a replacement for in-house marketing staff.
Architect is a fractional CMO, not a marketing coordinator. Practices with ten figures in collections and a dedicated internal marketing team are sometimes the best fit. Practices looking to offload all marketing operations usually belong deeper in the product stack.
Not day-to-day ad operations.
AdsPRO Dominance handles the paid media execution under the Architect fee. Architect sets the budget, the creative direction, and the attribution framework. Architect does not sit inside Google Ads every morning.
Not patient-facing content writing.
RankPRO handles medically-reviewed content, condition pages, provider bios, and the long-tail library. Architect sets the editorial strategy and the topical cluster plan. RankPRO writes and publishes.
Not a sales pitch reworked as strategy.
Architect does not exist to upsell more products. The four products are already included. The role of Architect is to hold the system accountable to the practice's revenue, and to kill work that is not earning its keep.
Twelve years at Parker Medical.
Parker Medical is the most-published Architect case on the site. Launched in 2013, formalized into the Architect tier in 2025, currently operating as a waitlist concierge practice in Las Vegas. Six distinct chapters across the arc: launch, foundation, scale, pandemic pivot, authority, and Architect.
Dr. Ryon Parker has written his own letter about the partnership. It is the best available description of what Architect actually feels like to run, from the practice-owner side, over a long horizon.
Read the Parker Medical case study →
Premier Weight Loss in Indianapolis is the shorter Architect arc: three years, from zero to the #1 SEO-ranked medical weight loss practice in the region, 3,000+ patients treated. Read the Premier Weight Loss case study →
Before you ask.
- Who's actually doing the work?
- Vince leads every Architect engagement directly. Senior collaborators step in on-demand for specialized work (schema graph rebuilds, CRO analysis, brand work, medical review coordination). The Macbach delivery team executes the four products (MapsPRO, RankPRO, AdsPRO, SitePRO) against the Strategic Command Plan. There is no junior-tier account manager in the communication path. Ever.
- How is this different from just hiring a Director of Marketing?
- A Director of Marketing at $180K to $240K plus benefits is one person with the expertise they walked in with. Architect is one senior operator plus the full Macbach delivery team, with healthcare-specific specialization across local SEO, organic search, paid acquisition, site engineering, HIPAA-aware analytics, and schema for AI Overview and Perplexity. Onboarding is zero because the system is already built. The comparison is not close on month one.
- What if we only need Architect on one product area?
- The engagement can be scoped to a single product surface (e.g., Architect-level oversight of MapsPRO only while RankPRO is paused), but that is not where the compounding happens. Full Architect is the model because the four products reinforce each other, and the business review cadence only works when the strategist can see all of them at once.
- Can Architect replace our full agency?
- Yes. That is the default assumption. Architect is designed to be the only growth partner a practice needs across local search, organic search, paid, and site. Practices that keep a second agency usually keep one for a narrow specialty (e.g., a brand agency for a rebrand, or an out-of-home media buyer), not for anything that overlaps with the four products.
- Is there a minimum client tenure you prefer?
- No minimum. The Architect engagement is 12 months, renewed annually. That said, the economics work best on 3+ year thinking, because month-one work on schema architecture, topical authority, and local dominance compounds visibly around month eighteen. Practices looking for 90-day results belong in a different engagement model.
- Do you take performance-based fees?
- Considered per-engagement. The default is a fixed monthly retainer because it removes the incentive to chase short-term metrics at the expense of the long-term compounding story. When performance-based fees are structured, they are tied to practice revenue or patient volume, never to ranking positions or traffic (ranking and traffic guarantees are a black-hat pattern and a litigation risk in healthcare).
- How do you decide if we're a fit?
- The Practice Audit is the on-ramp. Ten questions, three minutes. The audit returns a real read on where the practice stands, what is actionable, and whether Macbach is the right partner. If Architect is the fit, the next step is a scope call with Vince. If it is not, the audit still leaves the practice with three specific things worth doing next.
If this reads like the engagement you want,
start with the audit.
Every Architect conversation starts with the Practice Audit. Ten questions, three minutes, no sales pitch. The audit decides whether Macbach is a fit. If it is not, the report still returns the three specific things worth doing next.