Protect Your Medical Display Ads from Bot Traffic and Click Fraud - Marketing for Medical & Aesthetic Practices

What every medical practice should consider when running Display Ads on Google

I remember running a Smart Display campaign for a MedSpa many years ago, using banner ads on the Google Display Network. In less than a couple weeks, we had generated 14 leads, and the results looked very promising.

But there was one problem; every lead from that campaign (all 14 of them) had a disconnected phone number. They were all fake.

Why would someone click banner ads (display ads), go to the client’s website, and then purposely fill out forms with fake information? What would be the benefit?

And why did it happen to this specific campaign?

Invalid and fraudulent clicks are a common problem and can occur on many advertising platforms and in virtually all types of campaigns.

Over the many years of managing medical aesthetic campaigns, I’ve seen quite a few situations where bots and click farms were being used to wear down a client’s budget. This was usually done by competitors.

But when running Display Ads on Google, you’re facing a very different click fraud problem. A problem that only gets worse as you spend more money.

And it’s caused by two factors:

The structure of the Google Display Network, and
A very clear financial incentive for someone to click your ads (an incentive that only exists on the Display Network)

In this article I’ll explore in detail exaclty why the Google Display Network is so susceptible to click fraud from 3rd parties, and the steps that aesthetic practices can take to avoid wasting their ad dollars on fraudulent clicks.

What is the Google Display Network?

The Google Display Network (GDN) is made up of many independent publishers who attract online visitors by sharing free content. These can be news websites, blogs, message boards, websites with free in-browser games, free mobile apps, etc.

There are millions of websites and mobile apps on this ad network. In fact, the last time you saw a banner ad while, watching a video, or using a free app on your phone, there’s a very high chance that it was part of the Google Display Network.

Some of the biggest members are sites like YouTube and Gmail, which have hundreds of millions of visitors per day. Others are very niche blogs or apps, that won’t see more than a few thousand users in an entire year.

But what unites all of them is that they attract visiotors by providing some type of free content or service, and allow Google to show banner ads to their users.

When a visitor clicks an ad, an advertiser (you, for example) is charged, and Google in turn shares a portion of that money with the publisher.

It’s a mutually-beneficial relationship between Google and publishers: the publishers get to monetize their traffic, while Google gets to further expand the reach of its ad services.

But it’s not always beneficial to the advertiser.

Anyone Can Join (pretty much)

The great thing for publishers is that the barrier to entry into the Google Display Network is quite low.

A publisher creates an AdSense account and submits their website for review. Once approved, they can start earning money every time someone clicks a banner ad on their website or in their app.

This incentivizes people to take risks and create new content and new apps, in the hopes of turning their ideas into paycheck. Or at least that’s the idea behind it.

Unfortunately, some publishers send fake traffic to their own websites, and use bots and click farms to click your ads, so they can make more money.

The Illusion of Real Traffic

Of course, Google does have measures in place to catch this type of activity, but these types of bot schemes have become more and more sophisticated over time, to better mimic real human behavior.

For example, after clicking your ad, the bots will:

Visit several pages on your site, to feign interest
Simulate a click on your phone number
Fill out forms on your website
They may even click off your website, then make a few relevant searches on Google, and then come back to your website, just like a real user would

All of these actions are meant to simulate the behavior of a real person, and evade Google’s bot detection.

In some cases, bot activity will be paired with real human activity, via click farms; where low-paid workers spend all day clicking ads on specific websites, to generate revenue for their employers.

This type of behavior is also meant to game the Google Ads campaign algorithms: By mimicking the behavior of a real person who is interested in your service, it increases the likelihood Google will place more ads on their site.

Why Hasn’t this Been Stopped?

I think the simple answer is that there’s just too much money to be made by people committing this fraud.

They currently receive about 68% of the ad revenue generated by their sites.

This is a really good incentive for larger criminal groups, and even foreign governments, to invest in sophisticated tools and systems that allow them to bypass Google’s security processes.

With tens of billions of dollars being spent by advertisers on the Google Display Network every year, being able to carry out effective click fraud could generate hundreds of millions (if not billions) of dollars for these groups, every year.

So no matter how much Google tries to prevent fraudulent activity, the incentive for sophisticated bad actors is just too great.

What About Other Advertising Platforms?

When looking at major advertising platforms, the Google Display Network really stands out because of the incentive for bad actors to make money from fake clicks.

Other platforms, like Meta and Tik Tok, deal with click fraud issues as well. But there are fewer incentives for someone to send fake traffic to click ads, or to invest in advanced infrastructure to bypass fraud-prevention systems.

Further, most of the content that is viewed on these platforms is viewed on their websites, not 3rd party websites, so the ability to game the system to earn ad revenue from fake clicks isn’t really there.

How Can You Protect Your Budget?

You do have some tools at your disposal to protect your budget from being wasted on click fraud.

Click Fraud Software:
- You can install a software like ClickCease or Click Fraud Defender on your website. It will analyze traffic coming from your Google Ads account and automatically block IP addresses that exhibit suspicious behavior.
  - You can even adjust settings that increase the sensitivity of this software.
  - The downside is that there is a limit to how many IP addresses can be blocked within your Google Ads account.
  - Also, Google doesn’t allow for blocking of machine IDs. So the bad actors can simply changes their IP address, and continue to click your ads until the new IP address is blocked, and then do it all over again.
Exclude Foreign Countries:
- When choosing which location to target, it’s also a good idea to exclude all locations you don’t wish to target.
  - Google has a setting that can limit this (“target all people in, or regularly in your target location”) but choosing this setting can really limit your impression volume.
  - Instead, add all countries outside the US, and all other states outside your own, as Excluded locations.
Avoid Display Expansion on Search Campaigns:
- If you’re not spending the full budget of your Search campaign, Google will often suggest enabling Display Expansion in your campaign. This allows the same campaign to show ads both in Google Search results, and also on the Display Network.
  - This takes control out of your hands and allows Google to show Display ads on your behalf, without clear guidelines.
  - So you many find that your campaign starts showing most ads to users on the Display Network, who are not really interested in your service.
  - If you want to run banner ads on the Display Network, then do it in a separate campaign, with its own dedicated budget. This way you know exactly how much you’re spending on Banner ads and keeping them separate from your Search ads.
Check the Placements Report to See Where Your Ads Showed:
- If you do run ads on the Display Network, then pull a Placements report regularly.
- This will show you excactly where your ads were placed by Google. Go to some of those websites and see if any of them look suspicious, and exclude them.