Your Google Ads conversions may not be bookings.

Google Ads can count actions before a booking happens.

A Book Now click, phone tap or form start can appear as a conversion even when no appointment is confirmed.

These can look similar in a report.

Build a simple conversion ladder.

Optimise towards the action closest to a real enquiry.

If soft actions are treated like outcomes, the account can look stronger than the clinic's booking diary.

Make the ad account and booking diary tell the same story.

Review what each conversion means before increasing spend or judging campaign performance.