Why Your Veterinary Practice Feels Busy but Isn’t Growing: The Hidden Marketing Bottlenecks in 2026

00:00 — Introduction

Don Adeesha:

Have you ever felt like your veterinary practice is busier than ever? The schedule is full, the phone is ringing, the team is working nonstop, but somehow the business is still not growing the way it should.

Well, that is the reality for many veterinary practice owners.

Being busy can feel like a sign of success, but if the right systems are not in place, that busyness can sometimes hide deeper growth bottlenecks.

Welcome back to the Veterinary Business Podcast. I’m your host for this session, Don Adeesha, and joining us for this conversation is Naren Arulrajah, CEO of Ekwa Marketing and founder of the Veterinary Business Institute.

Naren is a trusted marketing strategist who has helped independent veterinary practices across North America improve their visibility, attract better clients, and build more sustainable growth.

Today, Naren will walk us through where practices may be losing opportunities, from Google visibility and website conversion to client follow-through and the disconnect between marketing and operations.

With that being said, Naren, it’s great to have you back on the show.

01:11 — Opening Remarks

Naren Arulrajah:

Thank you so much, Don. I really appreciate the opportunity, and I’m looking forward to this conversation.

Don Adeesha:

Let’s jump right in. Naren, we’re seeing practices that are extremely busy but not truly growing. What are the most common hidden bottlenecks you’re seeing across veterinary practices right now?

01:30 — Why Busy Practices Are Not Always Profitable

Naren Arulrajah:

You bring up a really good question.

There are a lot of practices that are busy but not profitable. In other words, they are not attracting and retaining the right profitable clients. Instead, they are just responding to what is out there.

I’ll give you a simple example. Let’s say you have a new client with a young pet, and that client really cares about optimal health for that pet. That client is going to be much more receptive to being proactive, listening to your advice, doing what you suggest, and over the life of that pet, that client is going to be worth a lot of revenue for the practice.

Now compare that to another client who is not putting the pet at the very top. Maybe it is their financial situation, or maybe it is something else going on, but they only come in for emergencies when something is about to break. They come in once, they do not listen to anything, they are not proactive, and they do not come back.

That client is not only demoralizing to deal with because they are never happy, always complaining, and always finding fault, but they are also not profitable for the practice.

So I think the biggest problem I see is that even before the team gets involved, the marketing is broken. The practice is not attracting the right kind of clients. That is a huge part of the problem.

The second part of the problem is that when the marketing is broken and you are not attracting the right clients, the team starts responding to what they have. Usually, it creates a negative cycle of doing things that feel productive and busy because that is what they are doing all day long, but those activities are not necessarily helping the practice strengthen or become more profitable.

It creates this doom loop of busyness that does not make things better. It actually makes things worse.

People end up doing low-value tasks, administrative tasks, repeat low-margin appointments, and chasing unwanted leads. They are doing all these things because that is what keeps them busy, or at least makes them feel busy.

Unfortunately, the doctors are often not paying close attention to the practice management side. Instead, they are letting someone else, often the practice manager, handle these things. Under the surface, there is a lot of rot, if I may put it that way. It starts with marketing, and then it continues as that rot gets perpetuated inside the practice.

04:06 — The Impact of Attracting the Wrong Clients

Don Adeesha:

Wow, that is a wonderful insight, Naren. So basically, it starts with identifying the right clients. If the clients are not right from the beginning, the team works with what they have. They may feel productive, but they are not finding meaning, and the practice is not becoming more profitable either. That is a double-edged sword.

Naren Arulrajah:

And you see a lot of churn in these practices. People come and people go. You do not really see long-term employees who are committed to being with that practice.

I have also seen the exception. I have seen practices that do not operate this way. They start where they need to start, which is attracting the right clients, putting the right marketing system in place, and making sure the beginning of the process is strong.

Once the beginning of the process is strong, everything else can build on it. But if that is broken, everything else falls apart.

Of course, those practices also hire people who really care about taking care of animals. They nurture them and train them. Because they are profitable, they can afford to pay them well, give them benefits, and provide things that a struggling practice stuck in survival mode cannot provide.

05:16 — Is It a Marketing Problem, an Operational Problem, or Both?

Don Adeesha:

That is a great segue into my next question. How does a practice identify whether their issue is a marketing problem, an operational problem, or perhaps a disconnect between the two?

Naren Arulrajah:

A good way to start is to look at the patients you are getting in. How many patients are you attracting every month who actually book? I’m talking about new patients.

Then look at those patients. Are those the kind of clients you want? Obviously, the clients are the ones making decisions on behalf of the pet. If the client is the wrong client, it does not matter how wonderful the pet is or how much you fall in love with the pet. It is really hard because the client is like the parent. You are influencing the pet through the parent.

So that is a good audit. Look at the number of new clients you are getting, the type of clients you are getting, and whether those are the clients you actually want.

Also look at the kinds of services. I know some practices focus on certain high-value services that are profitable and often long-term. Are you attracting the right kinds of clients for the right kinds of services?

That is where I would start. Be very honest, look at your actual numbers, and ask yourself, “Is this number good enough? Am I actually getting the right kind of client I want?”

The second question I would ask is about the reality in the marketplace. You may attract a client because one particular pet owner loves you and tells 10 other people, but that is becoming more and more rare today. When we need something now, we often do not ask people first. We go to Google, we ask AI, and we get answers at our fingertips.

So the second place I would look is this: when someone in your marketplace is looking for someone like you and typing in all the different search terms and questions, are you the one showing up consistently?

The best practices, the ones that have an unfair advantage, are usually the ones that show up no matter what keyword or search term is typed in.

A good metric is this: for at least 100 different searches that a typical person in your community would do for the services you provide, you should show up at the very top.

Today, that means showing up in AI search, AI overviews inside Google, regular Google SEO, and Google Maps. Those are four different places where you need to be visible.

We have clients ranking for 200 different popular searches in a city within a year. We promise our clients they will rank for 100, but with AI, things have really expanded, and our clients are seeing a lot more success.

You also do not want to ignore platforms like ChatGPT, Perplexity, and other up-and-coming tools. Of course, when it comes to search volume, they are still much smaller than Google because people are so used to Google. People use Google billions of times a day, and a lot of that now includes AI search.

So I would definitely focus on Google because it still has the vast majority of the market. But you do not want to ignore what may happen in the future.

One of the other things we do, even though platforms like ChatGPT do not provide insights the same way Google does with Google Analytics, is manually check whether they are giving the correct information on behalf of our clients. Are they recommending our clients for the same types of services?

When you are recommended organically, whether through AI or regular search, people trust you. They assume you must be good, because that is why the search platform is showing you to them. That implicit trust gives you the benefit of the doubt.

The last piece of the leak I would look at is the phone. Maybe your marketing is working. Your SEO is working. You are showing up everywhere and dominating search. But the phone is not being answered consistently.

One thing I notice is that a lot of practices do not answer calls. Sometimes 30% or 40% of calls are missed. Even when they do answer calls, the average practice is only booking about one out of three new patients.

Why is that? There is no accountability, no tracking, and no tool or technology listening to the calls, identifying how many were missed, how many people booked, and how many did not book. Then there needs to be coaching on top of that.

If the average practice is only able to book one-third of new patient calls, what if you could change that? What if you could book 80%? Your business could double or even quadruple without spending an extra marketing dollar.

The last thing I would look at is marketing profitability. Just like we look at profitability after the fact by looking at the types of clients we are attracting and keeping, we also need to look at the profitability of different marketing channels.

If you are spending $200 to attract a new client through Google Ads, but only $40 through organic search, you need to understand why. A lot of people do not even know how much each marketing channel is costing them.

It is like throwing darts without knowing which ones are landing on the bullseye and which ones are not. In the process, practices can waste a lot of money. I have seen practices waste hundreds of thousands of dollars, and over a 10-year span, that can become millions.

So these are some of the leaks I would focus on and fix.

10:55 — The Key Areas Practice Owners Should Audit

Don Adeesha:

Amazing, Naren. Just to summarize, first, audit the client mix. Second, audit the services or treatment mix. Third, because of the changing marketplace and search behavior, audit online search visibility. Then audit calls, and finally audit the profitability of your marketing. Did I get that right?

Naren Arulrajah:

You got them all right.

Don Adeesha:

Amazing. Now, you often talk about the leaky bucket concept. Can you walk us through how that applies to websites, Google visibility, and client follow-through in 2026?

11:38 — The Leaky Bucket Concept

Naren Arulrajah:

Think of marketing like a funnel. What is a funnel? You pour water in at one end and get water out at the other.

At the wide end of the funnel, imagine you are collecting rainwater. You have this huge funnel collecting a lot of rainwater, and it is coming one drop at a time. Then you collect it together, the funnel becomes smaller and smaller, and you pump it through.

Now imagine there is a leak along the funnel. All the investments you made trying to collect that water are being wasted before the water gets to the final destination.

Why? Because there are leaks.

What I mean by leaky bucket is exactly that.

First, maybe you are not collecting all the rainwater. Maybe you have some kind of material, but it has a lot of holes in it, so the water falls through and goes out. That is where I would start.

Are you showing up, ranking, and dominating? For the thousands of different searches and different things people are looking for, are you the one they consistently find? That is the wide end of the funnel, and that is where it may be leaking.

Then I would ask: is the website compelling enough, and are your reviews compelling enough for people to trust you?

Let’s imagine you are collecting all these people, but the first impression is poor. Maybe your website does not speak to them. Maybe it does not give them the answers they are looking for.

Remember, we now have a generation that wants answers in seconds. If I am interested in something and you do not give me exactly what I am looking for, I get bored and go to the next website. Google makes it very easy for me to click the back button.

Search engines like Google are looking at that and saying, “Your website is not converting, so we will stop sending traffic.”

There are many pieces to conversion. For example, maybe your website does not load fast enough. That is one reason people leave. They get tired of waiting because people want things to move very quickly.

Maybe they have to hunt for information and get tired of doing that. Those are leaks on your website.

Sometimes your website does not work well on the device they are using. Maybe it looks perfect on a desktop, but what if they are on a small phone? If it is not optimized for that small device in terms of the information shown, how it is shown, and the font sizes used, that is another leak.

The next leak is reviews. You need recent, high-quality, detailed reviews. Those reviews inform the search engines that you are worthy.

Imagine your practice has not gotten a review in eight months, or only got three reviews in eight months, while your competitor keeps getting 10 or 15 reviews every month. If I were Google, why would I send that person to you and risk disappointing them?

You may have been wonderful eight months ago, but Google does not know how you are doing today. Recency matters. Those high-quality reviews need to keep coming in.

The last piece of the leak is the phone, which I mentioned earlier. Everything may be working. Your website is wonderful. Your reviews are strong. But without realizing it, the phone leak is killing you.

Ten new clients may be calling, but only three are booking. Either the phone is not answered, or the people answering the phone do not know how to build rapport. They do not know how to make the client believe they made the right decision by calling.

There is also another kind of leak on the website. Let’s imagine it is 6:00 PM and your office is closed. Someone goes to your website. Of course, you cannot work 24 hours a day, seven days a week, and you cannot expect your team to do that. But you also do not know who those visitors are. They come to your website, they are interested, but there is no way to connect, so they leave.

What if you had a chatbot? What if you had something that starts talking to them, builds rapport, and makes them want to come in?

Those are the things I would focus on when it comes to the leaky bucket.

16:06 — How Inefficient Websites Affect Google and AI Visibility

Don Adeesha:

Naren, you mentioned something very interesting about inefficient websites. Inefficient websites do not only hurt the user who is trying to get in touch with you. They also hurt you when Google or AI is trying to determine whether your website is a good website.

Can you give us more insight on that? Because it is not only people looking at our websites now. AI is looking at them too.

Naren Arulrajah:

You are bringing up an excellent point.

Google realizes something important. Google is one of the most valuable companies on the planet, worth trillions of dollars, and it does not have a contract with its users. Every one of its products has billions of users — Google Search, Google Maps, and others — but none of those users are required to use Google.

Put yourself in the shoes of the people running Google’s search business. What happens if Google gives users good information, but the websites it sends them to are wrong? What if those websites are hard to read? What if they do not load fast on every device?

Now the user gets mad at Google too. Google wasted their time by sending them to a website that made them frustrated. Then they may think, “Maybe there is another search engine. Let me try something else.”

So Google, which controls the majority of the search market, is trying to mimic what users go through and what users expect.

Remember, Google has information from everywhere. They collect information through Google Analytics and many other sources. They are one of the biggest players on the internet. They handle more traffic than most companies by a huge margin. So they know a lot. They have seen what good looks like and what bad looks like.

They have all these standards, and if you do not follow them or do what they believe is good for users, they will punish you. You may not even show up.

It is almost like they do not let you in the gate. Before you even get through the gate, you are being pre-screened by Google.

That includes Google EEAT, which is about experience, expertise, authority, and trust. It also includes Google CrUX, which is replacing some of the older ways people looked at performance through tools like Lighthouse.

I do not want to get into all the technical details, but if anyone is interested, they can book what I call a Marketing Strategy Meeting. My team will get into those details and share specific things they can do to address what Google cares about.

The other thing I have noticed is that we have been doing this for 19 years, and we still have clients from 17 or 18 years ago. In all these years, when you take care of Google, you also take care of the other types of search options out there, whether it is ChatGPT or Perplexity.

If Google is happy, everybody else is usually going to be happy. Why? Because Google is looking for the same thing ChatGPT is looking for: making sure people are going to the right websites and the right solutions that will not disappoint them.

19:28 — Why Google Still Matters

Don Adeesha:

Thank you very much for that answer, Naren. I really appreciate the insight. What I am understanding is that if you align with Google, which is the biggest AI and search platform, you also get in alignment with other chatbots and search tools, and that helps your rankings.

Naren Arulrajah:

Yes. A good way to think about it is this: most of us, if we do what our family doctor tells us to do, like checking our blood and doing all the routine things once a year, we are usually going to be healthy. We do not need a specialist to tell us something is wrong.

Google is like the family doctor because the majority of us use it multiple times a day. If Google is happy, everybody else is usually happy.

I am not saying there is no rare disease Google might miss, but Google is a trillion-dollar business. It is like the family doctor and the specialist combined.

So make Google happy, and you are going to do well.

Again, I am not talking about making Google happy for one search term. I am talking about making Google happy for hundreds of search terms so you keep showing up consistently at the top.

20:35 — The Website as a Conversion Engine

Don Adeesha:

Now, Naren, what role does the practice’s website play today, not just as an online brochure, but as a conversion engine? And where are most practices falling short?

Naren Arulrajah:

You bring up an excellent point. I will focus on three key answers.

The first mistake most business owners make is that they do not necessarily get into the mindset of the customer. They think the way they think, and usually that comes from looking at what other people are doing.

Let’s say there is a famous doctor. They may say, “What is that famous doctor doing with their website? If they are doing it, it must be good.”

But that famous doctor may also not be looking at it from the customer’s perspective.

A lot of times, the website may appeal to the doctor because what the doctor wants is there. Maybe they want certain technical terms used on the website because they know those are the correct terms.

But the layperson did not go to veterinary school. They did not spend years learning what veterinarians know. They want everything simplified. They want clear language. They want videos. They want to go to the right pages.

For example, many doctors, when reviewing their websites, go to the homepage first and then click on different services. They are going top-down because it is their website. They walk through the front door and then through the other doors.

But actual users often behave differently. They come through the side door. They go directly to the service or need they searched for. If you do not show up, or if your page does not answer their question, you lose them.

So make the website a conversion engine. Make it a consumer engine where consumers love it, get what they need, and decide to move forward instead of backing off.

The second thing I would focus on is the technical side.

Websites today are very complex because there are hundreds of different ways people can use the internet. Someone may be on a Samsung phone using Chrome. Someone else may be on a different brand, a different browser, or an older device with a small screen. Another person may be on an iPad or desktop. Internet connections also vary. Someone may be using satellite internet, Starlink, or something else.

Google wants every one of these people to have a great experience. Unfortunately, most people do not think that way.

They may not realize that the website looked wonderful on the desktop at their office, and the marketing company may have optimized it for that desktop. But they did not look at all the other devices.

You may love the website, but many people may not. Google may not even let you through the gate if you are not meeting usability, speed, and technical standards. The same applies to ChatGPT and other platforms.

So you might think, “I love my website. It is the best thing in the world.” But if nobody is going there because you are not meeting those standards, it does not matter.

The third thing is that even Google is noticing more people want AI answers. For example, if someone wants to know the cost of a certain procedure in a city, they do not want to go to seven different websites and figure it out themselves. They want Google to review those websites and give them a summary with links so they can go deeper if they want.

In that context, the richness of your information matters. It also matters how closely that information is connected to an expert.

For example, if you have a degree and specific qualifications, but you do not tell Google in a way that is easy to understand that you are a qualified doctor who can comment on a topic, Google may not treat you as a doctor. It may not even look at your information.

Why? Google does not want to get blamed for sending someone to a website with unreliable advice that causes a pet to be harmed. Google has to be right billions of times a day.

So if you do not have those qualifications clearly shown, or if you do not use them properly, Google has every incentive to disqualify you. Remember, Google makes a lot of money from ads, and so do other platforms. When they make money by not giving you free traffic, they have every incentive to be selective.

It is kind of like getting into a top university. Very few people get in because there are only so many seats. In this case, Google has only so many seats for people who get free traffic.

A small percentage of practices will get most of the free traffic, while everyone else will be left with no option but to pay Google and other platforms month after month for paid traffic.

So these are the things I would fix. Make your website AI-ready with EEAT and high-quality content. Focus on making it a consumer engine that makes consumers want to go further. And pay attention to the technical side.

It is not just about you loving the experience on your desktop. It is about everyone loving the experience on every device and every internet connection, so you can actually get into the game.

26:08 — The First Practical Step for Practice Owners

Don Adeesha:

Naren, laypeople did not go to vet school, and veterinarians did not go to Google school. For practice owners listening right now, this might be great information, but how they actually put it into practice may be one of their biggest concerns.

What is the first practical step they should take to diagnose and remove these growth bottlenecks?

Naren Arulrajah:

I am over 50 now, and I have been doing marketing for 19 years. A lot of things come naturally to me and my team because we have been doing this for decades, but that is not the way a doctor thinks.

In the same way, I would not be very helpful to my vet when I take my pet in because the vet has seen pets like mine many times and has specialized education.

The same thing applies here.

But solving a problem is always the same. First, find out where you are right now because you need to know your starting point.

Are you an A+ in all the components I talked about, such as dominating search, dominating Google AI search, and showing up again and again? You can spend hours figuring that out, or you can have our team tell you.

Then find out why.

I love Khan Academy. Years ago, when my daughters were preparing for the SAT, the system would show the score and break it down. It might say, “You scored nine out of 10 in these sections, but four out of 10 in these other sections. Go do these practice exams and work on these sections.”

Then it would retest that section. If the student went from four out of 10 to six out of 10, it would show which concepts they still needed to master. Then they could do more readings and exercises, test again, and eventually get to eight out of 10.

Khan Academy helps pinpoint where the problems are and helps the child improve exactly that problem, instead of wasting time doing more practice exams in areas where they are already getting nine or 10 out of 10.

You need to focus on the areas where you are weak.

The second thing I recommend is to look for the root cause of why you are succeeding or not succeeding, whether it is with Google, your website, your reviews, or AI.

Find the root cause.

Also, do not do this in isolation. This is a relative game. It is like getting into a university. If, in a particular year, everyone who applied is weak, you may do okay even if you are an average student. But if everyone is extremely strong, you need to raise your game.

So look at your competition. Have someone look at how your competitors are doing. Are they getting an A while you are getting a B in important marketing areas? Or is everyone a C and you are also a C?

That is different. If everyone is a C, you just need to do a little better to get to a B. But if there are competitors who are better or stronger than you, then you need to work hard on the components where you are weak.

We offer something like this at no cost, especially for our Veterinary Business Podcast listeners, because our clients have asked for it. It is called a Marketing Strategy Meeting.

The link is veterinarybusinessinstitute.com/msm.

A lot of the things you mentioned are covered: looking at the website from an outside perspective, looking at it as a consumer, looking at the technical side, and checking whether you are doing the things needed to please AI, Google, and other search providers.

Those are the things you need to get done. Typically, it takes around six hours. We sometimes charge around $900 when people want us to do this as a consultancy. But because you are listening to this, we are doing it at no cost.

So take advantage of it. Get that data and then make decisions, whether it is with us or somebody else.

Once you know why you are not doing as well as you want to with marketing, you can decide what to do about it.

30:18 — Closing

Don Adeesha:

Amazing. Naren, thank you so much for offering our listeners that complimentary Marketing Strategy Meeting.

Please go ahead and make the best use of that opportunity.

Like Naren said, the link is veterinarybusinessinstitute.com/msm. I’ll repeat that one last time: veterinarybusinessinstitute.com/msm.

Get yourself a customized marketing map for the next six months to help you identify the best opportunities for growth.

Naren, thank you once again for joining us, and thank you to everyone listening to the Veterinary Business Podcast.

If you found this episode valuable, be sure to subscribe and stay connected for more conversations designed to help veterinary practice owners build stronger, more profitable, and more successful practices.

I’m Don Adeesha, and we’ll see you on the next one. Take care.