We do what healthcare
agencies almost never do.
Ten dimensions. Typical agency behavior on one side, Macbach on the other. If the left column sounds familiar, the right column is the argument for why you are here.
Quoted after a discovery call. Scoped to the prospect's willingness to pay.
Published on the site. Every tier. Every product. Same number for every practice at the same scope.
Marked up 15 to 20 percent. Buried in the retainer. Incentive to spend more, not smarter.
Pass-through. You pay the platforms directly. Our invoice is the management fee only.
Twelve-month minimums on everything, with auto-renewal and long-notice cancellation.
Month-to-month on product tiers with 30-day notice. Architect is 12 months because compounding takes that long to show.
Healthcare is one of ten verticals. The account manager also handles roofers and law firms.
Healthcare only since 2007. Every hour of agency attention went into this one sector for nearly two decades.
Promised. Sometimes in writing.
Never. Ever. Ranking guarantees are a black-hat pattern and a litigation risk in healthcare. We commit to methodology and effort.
A templated proposal deck. Kickoff slides. A retention spreadsheet.
A 40 to 100 page Strategic Command Plan rendered in a per-client portal. Site architecture, keyword matrix, schema strategy, funnel, AEO, local SEO, competitive intel, E-E-A-T, KPIs. Updated quarterly.
PDF attachments of dashboards. Opens with what moved. Buries what did not.
Live portal. Monthly note opens with what did not move and why. Quarterly business review tied to practice financials.
Marketed as compliance-aware. PHI ends up in analytics and remarketing anyway.
Server-side validation. No PHI in analytics. No PHI in remarketing. No non-BAA'd intermediaries. Tested every build.
Account manager, pod with junior executors, rotating creative team.
Founder-led on every engagement. Small by design. Capacity capped at twelve to fifteen Architect seats plus the product-tier book.
Files held hostage. Domains on vendor registrars. GA4 in the agency's account.
You own every asset from day one. Domains on your registrar. GA4 in your workspace. CRM in your stack. If you leave, you take everything.
None of this
is marketing.
Every position on the left column exists because it is profitable for an agency. Every position on the right column exists because it is better for the practice.
Published pricing costs us a sales funnel that manufactures uncertainty. We would rather lose the meeting than win it on a price the practice felt was negotiated unfairly.
Pass-through ad spend costs us a direct margin stream. It also costs us the incentive to recommend paid acquisition when organic is the right play. We think the second loss is an asset.
Month-to-month product tiers cost us retention numbers that look great in a deck. They also force us to earn the next month every month, which is the only honest reason any agency keeps a client.
Asset ownership costs us the lock-in the industry treats as standard. In exchange, we have not lost a client in a decade because they felt trapped. Exits happen; they happen cleanly.
Before you ask.
- Why publish pricing when no one else does?
- Because hiding pricing only helps the agency, not the practice. We'd rather filter out wrong-fit engagements before the call than run a discovery-call sales funnel that pretends to evaluate fit while actually qualifying for price tolerance.
- Isn't a 15 percent markup on ad spend standard?
- Yes. That's the point. We don't do it because the incentive it creates (spend more, bill more) works against the practice. Our management fee is what pays us. Whether you spend $5,000 a month or $500,000 does not change it.
- What happens if we outgrow Macbach?
- We tell you before you tell us. Some practices grow past the fit and hire in-house leadership. We've transitioned Architect engagements to internal CMOs, coached the incoming leader, and stayed on for specific product work. Clean exits are easier than clean starts.
- Do you do case studies and testimonials?
- Selectively. Parker Medical is our most-published case, twelve years of concierge physician growth, with Dr. Parker's own letter. We anonymize the rest because most practice owners prefer not to publish their numbers.
- Can you work with my existing contractors?
- Yes. We have run parallel to client-side content teams, existing SEO contractors, in-house CRM developers, and external creative shops. We work on top of what's already there when it works.
If the right column
reads like what you want,
Run the Practice Audit. Ten questions, three minutes. The audit decides whether Macbach is a fit. If it is not, the report still leaves you with the three specific things worth doing next.