Start with your own search terms report, not a list copied from the internet. Read the real searches your ads appeared for, sort them into groups (jobs, training, free information, other providers, services you do not offer), and add each group as negative keywords in one go. Then repeat the read every week until the account settles.
That is the short version. Below is how to do it without blocking the patients you actually want.
What a negative keyword does
A negative keyword tells Google not to show your ad when a search contains that word or phrase. If you add "jobs" as a negative, your ad should stop appearing for "physiotherapy jobs near me", even though you bid on "physiotherapy near me".
Negative keywords do not bring you more patients on their own. They stop you paying for people who were never going to book, which leaves more of the same budget for people who might.
Why a ready-made list is the wrong place to start
There are plenty of "500 negative keywords for clinics" lists online. They are tempting because they feel like a shortcut. The trouble is that a list written for someone else's clinic can block searches that matter to yours.
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Take the word "free". Most clinics block it, and usually that is right. But if you offer a free first consultation and say so in your ads, a search for "free consultation [your service]" might be exactly the person you want. A copied list would have blocked them without you noticing.
Your own search terms are the only list that reflects your services, your area and the way your patients talk.
Step 1: Pull the search terms report
In Google Ads, open the search terms report for your Search campaigns. Set the date range to the last 30 to 90 days, depending on how much traffic you get, and sort by cost from highest to lowest.
You will notice that not every search is shown. Google hides some low-volume searches for privacy reasons. That is normal, and it is another reason to keep checking regularly rather than once.
Step 2: Read, then sort into groups
Read the terms one by one. For each, ask a single question: would a person typing this be ready to book, or at least close to it? Mark the ones that clearly are not.
Then, instead of adding them one at a time, sort the "no" terms into groups. For most clinics, the groups look something like this:
- Jobs and careers: jobs, salary, vacancies, hiring, career, internship
- Training and study: course, training, degree, certification, how to become
- Information only: definition, meaning, symptoms of, what is, pdf
- Do-it-yourself: at home, exercises, kit, buy online
- Other providers: names of hospitals, chains or clinics you do not want to pay for
- Services you do not offer: treatments close to yours that you do not provide
- Places you do not serve: towns or areas outside your reach
These are examples, not a list to copy. Some of them may be searches you want. A clinic that sells home kits should not block "kit". Use the groups as a way to sort, and fill them from your own report.
Step 3: Choose the right match type for each negative
Negative keywords have their own match types, and they behave a little differently from normal keywords.
- Negative broad match blocks searches that contain all the words, in any order.
- Negative phrase match blocks searches that contain the words in that exact order.
- Negative exact match blocks only that exact search.
One detail catches many people out: negative keywords generally do not stretch to cover plurals, misspellings or close variants the way normal keywords do. If you block "course", you may also need "courses". Look at your report to see which forms people actually use.
As a rule of thumb, use broad negatives for single words that are never wanted ("salary"), and phrase or exact negatives where a word is only unwanted in some contexts.
Step 4: Put the groups where they belong
Google Ads lets you add negatives at different levels:
- Ad group level, to stop two ad groups competing for the same search
- Campaign level, for words that are wrong for that campaign
- Shared negative keyword lists, which you build once and apply to several campaigns
For a clinic with more than one campaign, a shared list for each group (jobs, training, information) is easier to keep up to date than scattered entries. If you add a new jobs-related word later, you add it once.
Some campaign types, such as Performance Max, handle negatives differently from Search campaigns. If you run them, check Google's current help pages on what can be excluded, because the options have changed over time.
Step 5: Check you have not blocked good searches
After adding a batch, look back over the last few weeks of search terms and ask: would any of the searches that did lead to an enquiry now be blocked? Google Ads can show a warning when a negative conflicts with one of your own keywords. Take those warnings seriously.
If you have conversion tracking set up properly, this check is much easier, because you can see which search terms brought enquiries. If you are not sure your tracking counts real bookings, read Google Ads for clinics: track bookings, not clicks first.
Step 6: Make it a routine
Negative keywords are never finished. New searches appear, seasons change, and Google's matching shifts over time. A simple rhythm works for most clinics:
- Weekly for the first month after any big change
- Every two weeks once the account is stable
- A fuller tidy-up each quarter, removing negatives that no longer make sense
A short checklist
- ☐ Search terms report opened, sorted by cost
- ☐ Each term read and marked "would book" or "would not"
- ☐ "Would not" terms sorted into groups
- ☐ Match type chosen for each negative, with plurals checked
- ☐ Shared lists used for groups that apply to several campaigns
- ☐ Conflicts with your own keywords checked
- ☐ Next review date in the diary
Frequently asked questions
How many negative keywords should a clinic have?
There is no right number. A small, focused account might need a few dozen. A broad one might need hundreds. What matters is that each one was added because of a real search you did not want, and that none of them blocks a search you do.
Can negative keywords hurt my results?
Yes, if they block searches that would have booked. That is why reading your own search terms, and checking for conflicts, matters more than the size of the list.
Should I block competitors' names?
It depends. Some clinics bid on competitor names on purpose, and others prefer not to pay for those searches. Decide deliberately, and check local advertising rules and Google's trademark policy if you do bid on them.
If you would rather someone else did the reading
Blocking wasted searches is one of the jobs in SeenSilver's Google Ads work, and you can see how that fits together on the packages page. If you would like an outside view first, the free website review is a one-page review of your website and how you show up on Google, written in plain words, with no obligation. You can get your free review here. For more places where clinic ad budgets leak, see Where clinic Google Ads money leaks, and how to stop it.
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