A chiropractic search-terms review should connect each visible query to the service offered, the ad and landing page it triggered, its cost, and the quality of any resulting inquiry. Use four decisions—keep, exclude, research, or restructure—and never build a blanket negative-keyword list without seeing the account’s actual queries and business context.

Know which report you are reading

A keyword is part of the advertiser’s setup; a search term is what a person entered. Google’s report shows terms that triggered ads and the keyword associated with them, but some low-activity queries are omitted for privacy. The report is useful evidence, not a complete transcript of every search. Google’s search-terms report documentation.

Include campaign, ad group, triggering keyword, match-type columns, clicks, cost, and the conversion fields the account actually uses. Then add the practice’s downstream classification: new or existing contact, relevant inquiry, booked appointment, and attendance when available.

Use the four-decision worksheet

  • Keep: the query fits a real service and location, reaches a relevant page, and produces useful inquiries or deserves more observation.
  • Exclude: the observed query is clearly outside the practice’s offering or business purpose, and the proposed negative has been checked for overblocking.
  • Research: intent is ambiguous, the sample is thin, or the front desk classification is missing. Assign an owner and a review date.
  • Restructure: the query is relevant but the ad, landing page, location, or campaign grouping does not answer it well.

Add a short reason to every decision. “Bad” is not useful. “Seeking chiropractic school admissions; practice does not provide education” is reviewable.

Apply negative keywords carefully

Google offers broad, phrase, and exact options for positive keywords, and notes that negative match types behave differently. Read the current keyword match documentation before applying exclusions. Also verify whether a negative is being added to an ad group, campaign, shared list, or account-level list; scope changes the potential impact.

Imagine the report contains the hypothetical query “chiropractic school admission requirements.” Because the practice does not offer education, the full observed query may be a clear exclusion candidate. A one-word negative such as “school” needs more care: it could block a query the practice considers relevant, such as a parent searching for a chiropractor near a school. The right scope and match type depend on the actual account. Review the change against current positive keywords before applying it.

Shared negative lists can apply across several campaigns, which makes them efficient and raises the cost of a mistake. Google recommends using search-term evidence to build those lists. See Google’s negative-keyword list guide.

Look for useful demand, not only waste

A relevant query can reveal that the campaign needs a better ad group, clearer copy, or a more specific page. If several people search for a service the office genuinely provides but land on a generic homepage, the query may be a page-planning clue rather than something to exclude.

Conversely, a query can sound relevant and still produce the wrong kind of contact. Ask the front desk to classify the inquiry without sending private clinical details into an advertising report. A compact status such as “new inquiry—service mismatch” gives the marketing team a useful signal without copying the person’s health story.

Run a repeatable review meeting

Review a declared date range and allow recent contacts time to book. Sort by meaningful cost and activity, then sample the long tail rather than reviewing only the highest-spend rows. For every proposed change, record the query, decision, reason, scope, match type, owner, date applied, and date to check the effect.

End the meeting with no more changes than the team can interpret. A broad restructuring, new landing page, and large negative list applied together make later evidence harder to read. If a query is uncertain, research is a valid decision.

Connect query quality to the full path

The search-terms report cannot tell you whether the phone was answered or an appointment was attended. Pair it with the call-quality framework and our broader Google Ads optimization checklist.

ChiroCandy’s Google advertising service connects search-term decisions with ads, pages, and office outcomes. Schedule a Marketing & AI Discovery Call and bring a recent search-terms export plus the questions your reports do not answer.