# Cardio Clinic

Sursă: https://unrivals.ro/deck/cardio-clinic-method-EN
Site: UNRIVALS · Limba: ro · Actualizat: 2026-08-27

> A cardiology clinic in Bucharest went from 1,100 to 1,557 new patients a month in four months. The UNRIVALS method, in the order it was actually built.

---
![UNRIVALS — Ultimate Supremacy](https://unrivals.ro/../assets/logo-unrivals-v3-semibold.svg)

Case study · the method

A cardiology clinic in Bucharest · engagement from September 2025

> „More patients. That is the whole brief.”The client’s objective, as stated at the start

Over ninety percent of new patients came from one channel. The account was well run. That was exactly the problem. This deck walks through what we did, in the order we did it, and what it produced.

02 · Before the numbers · how to read them

## Every figure carries its own window. Nothing is blended.

Block

Measurement window

Source

Business results

Jan 1 to Apr 30, 2026 vs 2025

client CEO dashboard

Google Ads, account totals

Jan 1 to Jul 31, 2026 vs 2025

Google Ads platform

Google Ads, search detail

Jan 1 to May 31, 2026 vs 2025

campaign export, EUR

Branded search

May 1 to Jul 31, 2026 vs 2025

Search Console API

Social reach

Jan 1 to Jul 31, 2026

social account report

Video performance

Sep 2025 to Aug 2026

TikTok and YouTube analytics

The business window is the shortest one here, four months, because that is the closed period in the client’s dashboard. It understates the year rather than flattering it.

Search Console keeps sixteen months of history, which is why the branded comparison starts in May. **Where a number could be presented two ways, this deck uses the smaller one.**

03 · The WHY · where everything starts

## The brief was never „better marketing”.

It was **more patients through the door**. A clinic does not need impressions, engagement or a content calendar. It needs someone to walk in on Tuesday morning who was not going to.

-   **The stated goal.** A monthly revenue target that works out to roughly two thousand patients a month.
-   **Where they were.** Around three quarters of the way there, with a gap of about five hundred patients a month.
-   **Three bottlenecks at once.** Acquisition, conversion, retention. Naming which one binds first is the job.

Everything in this deck is downstream of that one sentence. **WHY first, then WHAT, then HOW. In that order, every time.**

04 · Where it got to · the short version

## That is where they wanted to go. This is where they got.

+39.4%

revenue, year on year

+57.6%

appointments booked

+50%

unique patients through the door

+41.2%

people searching the clinic by name

Windows and sources are on the previous slide, and every one of these numbers comes back later with its full table. **The rest of this deck is the how, in the order it was actually done.**

05 · The starting point · September 2025

## On the market since 2009. Excellent medicine. One channel.

What was already strong

### The medicine

Around thirty three cardiologists. The only private echocardiography laboratory in Romania accredited by the European Association of Cardiovascular Imaging.

What was fragile

### The demand

Over ninety percent of new patients arrived through paid search. No brand demand to speak of. No social presence. One switch, and the whole business runs through it.

A clinic can be the best in the country at what it does and still have a marketing problem. **Those are two different assets, and only one of them was built.**

06 · The ceiling · why budget stopped working

## More money went in. The same patients came out.

A well run search account eventually stops being limited by the bidding and starts being limited by **the number of people already searching**. At that point extra budget buys the same demand at a higher price.

-   **You cannot bid your way out of it.** The pool has a size. Paying more per click does not make the pool bigger.
-   **You cannot optimise your way out of it either.** Better ads inside a fixed pool win share from yourself.
-   **The only exit is new demand.** People who are not searching for the service yet, because they do not know their symptom has a name.

**This is the moment where an optimisation brief and a strategy brief stop being the same job.**

07 · The fork · two ways to answer the same brief

## The obvious move, and the one we took.

What most agencies do

### Start at the account

Audit the campaigns, restructure, test keywords, raise the budget, report on cost per conversion. Real work. We did all of it. It was step five.

What we did

### Start at the phone

Read a full month of inbound calls before writing a single ad. The first growth available was never a new patient. It was the ones already calling.

The order is the method. **Do the ad work first and you optimise a message you have not earned the right to write.**

08 · The method · the thesis

## We define what the market believes about you before spending a euro on marketing.

UNRIVALS does not optimise ads. It optimises **the speed at which a market understands what you are worth**. Everything else is a consequence of that.

-   **Marketing** is how you sell. Most of a category competes here.
-   **Branding** is what you sell. Some of a category competes here.
-   **Meaning** is what it comes to represent for the person on the other side. Almost nobody competes here.

Every competitor sold consultations and investigations. **Nobody sold the thing a patient actually wants, which is to stop being afraid.**

09 · The method · two engines

## Two questions. Two different machines.

Cognitive UNRIVALS™

### What does the market believe about you?

Meaning, difference, proof. Golden Circle, cognitive attribute, content cascade.

**Meaning + differentiation + communication + proof = preference.**

Strategic Growth OS™

### Where and how do you win profitably?

Market structure, offer, channel, pipeline. Blue Ocean, 4P and 7P, budget cascade.

**A healthy brand pushes acquisition cost down, conversion up, lifetime value up.**

**The second engine is the one clients buy. The first one is the reason it works.**

10 · The method · the stack

## Four layers. The order runs both ways.

Layer

What lives there

Who sees it

L1 · Performance marketing

ads, funnel, traffic

everybody

L2 · Revenue and go to market

pipeline, sales process, the path from call to appointment

the operator

L3 · AI orchestration

the decision layer, across everything else

almost nobody

L4 · Positioning and category

what the brand means and where it sits in the mind

nobody, until it works

Build upward, derive the message downward. The two lower layers are what a client can see and count. The two upper layers are what make the counting look good.

You build upward, L1 then L2 then L4, with L3 optimising at every step. You derive the message downward, L4 sets it and L1 spends against it. **A market buys L1 because it is countable. L4 is the reason the counting comes out well.**

11 · The method · the chain

## Seven links. Skip one and the next one guesses.

1.  **Insight.** What is actually true about the customer, from their own words, counted.
2.  **Positioning.** What we choose to mean, and to whom.
3.  **Message.** The sentence that carries it, written for one person.
4.  **Channel.** Where that person already is.
5.  **Execution.** The ads, the articles, the videos, the scripts.
6.  **Results.** Measured against the business number, not the channel number.
7.  **Recalibration.** What the results change about link one.

**Most agencies enter at link five and reverse engineer the first four from whatever the ads platform reports.**

12 · The method · the standard path

## Seven phases over twelve months. Cardio Clinic sits in the first five.

Phase

What it produces

At Cardio Clinic

F1 · Cognitive Diagnosis

the evidence base

done

F2 · Positioning and category

what we mean, to whom

done

F3 · Offer and brand architecture

packages, identity, voice

done

F4 · Content and go to market

the publishing system

done

F5 · Commercial activation

ads, scripts, conversion

done

F6 · Performance and advantage

ABM, offer ladder, retention

partial

F7 · Strategic recalibration

the next twelve months

not started

**Everything you are about to see came out of the first five phases.**

13 · The method · what does not bend

## Nine rules. They decide the order of the work.

-   **Strategy before optimisation.** And **infrastructure before marketing**.
-   **Cognitive ownership.** Own the space in the mind, and the market comes to you when the need appears.
-   **WHY before WHAT.** One central attribute, carried everywhere.
-   **Reduce the customer’s mental cost.** Every decision you make for them is one they do not have to.
-   **Marketing and sales are one system.** And AI processes the methodology rather than generating filler.

And one gate on everything we hand over: **if the client cut our access tomorrow, does the deliverable still stand?** If not, we built account management, not strategy.

14 · What we did · step one

## Before writing one ad, we read five thousand phone calls.

5,084calls

three separate months, every call in each, never a sample

99.8%

data completeness, transcribed and processed with code

26.2%

booking conversion in the first round, against a 50% benchmark

half

of the achievable conversion was leaking, every month

Source: three rounds of full call analysis · September 2025 (1,367 calls), December 2025 (1,430) and February 2026 (2,287). Transcripts plus metadata, processed with Python and natural language processing. Round one ran to fifteen chapters ending in rewritten scripts and an implementation plan; the later rounds scored every agent individually.

15 · What we did · step two

## We turned what patients say into something countable.

What people actually present with

Share of cases

Palpitations

42%

Shortness of breath

29%

Fatigue

26%

Chest pain

19%

Hypertension present in recurring cases

87%

Cross-read from call transcripts, staff questionnaires, patient-fear research and the paid search terms report. Four sources, one question.

Underneath every symptom, one sentence repeated in different words: **if something serious is happening to me, will it be found in time.** And the finding that reframed the offer: a majority of patients leave reassured rather than diagnosed. The product is not an investigation. It is the end of uncertainty, usually the same day.

16 · What we did · step three

## What they say on the phone is not what they type into Google.

Population one

Already knows the name of the test. Searching **„doppler price”**, **„holter ekg price”**. Comparing on cost. This is who the ads were talking to.

Population two

Has a symptom and no idea what it means. **Larger, cheaper to reach, and arriving with exactly the fear this clinic is best at ending.**

The gap

Nothing in the account, the site or the content spoke to population two. Every competitor had the same gap.

Search Console, the account’s own search terms report, People Also Ask and keyword tooling. **Two different populations, and only one of them was being served.**

17 · What we did · step four

## Four personas for research. Three avatars for production.

![Elena avatar creative, 2026](https://unrivals.ro/_assets/cardio-clinic-method/avatar-elena.jpg)

Elena

### She manages everyone’s health except her own

Forties to fifties. Postpones her own check-ups indefinitely. Her cardiac symptoms are the ones most often dismissed as stress or tiredness.

![Mihai avatar creative, 2026](https://unrivals.ro/_assets/cardio-clinic-method/avatar-mihai.jpg)

Mihai

### His children book the appointment, not him

Sixty plus, managing a condition he already has. Comes on a referral, not on an ad. What he is afraid of is losing his independence and becoming a burden.

![Radu avatar creative, 2026](https://unrivals.ro/_assets/cardio-clinic-method/avatar-radu.jpg)

Radu

### He built something and has no time to be ill

Under commercial pressure. Chest tightness filed under stress. Will act on a risk to what he has built, not on a health message.

Personas are research output. Avatars are production tools, and each one gets its own creative set rather than a shared campaign. **Mihai was built first, around the check-up package. Elena and Radu came in the second wave, built around the fear instead of the offer.**

18 · What we did · step five, the creative before

## 2019 talked about the machine. 2022 talked about the price.

**October 2019.** A photograph of an ultrasound probe and an invitation to book. The ad describes what the clinic owns.

**February 2022.** A magnifier over leg veins and a price in a bubble. The ad describes what the service costs.

Both are competent. Neither is addressed to anybody in particular.

![Cardio Clinic display banner from October 2019 showing an ultrasound probe](https://unrivals.ro/_assets/cardio-clinic-method/cardio-2019-equipment.jpg)

Source: the client’s own banner archive, original file dates October 2019 and February 2022. Thirty two files recovered.

19 · What we did · the same insight, seven years apart

## Same clinical truth. One is addressed to nobody.

![2019 banner: a heart attack does not always start with chest pain](https://unrivals.ro/_assets/cardio-clinic-method/cardio-2019-cardiocheck.jpg)

![2026 Elena creative: you take care of everyone, but a heart attack does not ask whether you are ready](https://unrivals.ro/_assets/_shared/cardio-2026-elena.jpg)

Left, 2019: a stock body clutching its chest, and a true statement. Right, 2026: a woman at a laptop at night, in a kitchen full of children’s toys. **The subheading names fatigue and shortness of breath, two of the four symptoms the call analysis had counted, and adds dizziness from the same research.**

The 2026 headline reads: you take care of everyone, but a heart attack does not ask whether you are ready. Fifteen variants, each mapped to a distinct fear from the research.

20 · What we did · step six

## Content built as a system, not as a stream.

-   **Thirty five articles**, built hub and spoke around the symptom clusters the research surfaced, each one internally linked into the cluster.
-   **Verified medical references** on every article. In healthcare the clinic’s credibility is the asset being spent.
-   **A medical review gate before publication.** It slows the calendar down and it is not optional. Nothing ships that a cardiologist has not signed.
-   **Topics chosen from what patients ask**, on the phone and in search, rather than from what an agency finds interesting.

**A stream of articles buys traffic. A cluster buys a position on a topic, which keeps paying after you stop publishing.**

21 · What we did · step seven

## The video formula came out of the research, not out of the platform.

Three beats, in this order: **symptom, then question, then fear.** Does your heart race. Does your blood pressure spike when you are upset. Topics taken from what patients ask on the phone and type into search.

2.01M views

Doppler for diabetics, February 2026

1.99M views

blood pressure and emotions

7posts

above 800 thousand views in a single month

91 to 99%

of the audience in Romania, so almost no geographic waste

Source: social account reporting, February 2026. Five videos above one million views in that month, seven above eight hundred thousand.

22 · What we did · step eight

## The least glamorous work here, and the highest return.

The call analysis from step one produced **rewritten scripts, per agent scoring, and training**. It raises conversion on demand that has already been paid for, which means it costs nothing per additional patient.

-   **Conversion per caller rose 52 percent** year on year, to just under seventy percent.
-   **Not one extra call was bought to produce it.** The calls were already arriving.
-   This is what „marketing and sales are one system” means in practice.

An agency that only holds the ad account cannot touch this. **Which means it cannot fix the most expensive leak in the business.**

23 · What we did · step nine, the layer underneath

## The clinic has its own brain. It stays whether we do or not.

-   **A structured vault** of its research, brand rules, personas, scripts and deliverables. One place, versioned.
-   **An agent that transcribes and analyses sales calls** continuously, so step one stops being a one off study and becomes a running instrument.
-   **An agent that manages review responses** on the Google Business Profile.
-   **Dashboards, and the analytics feed wired into a data warehouse**, so the history stops depending on any one platform’s retention window.

This is layer three, and it is what makes the other three compound. It is also the answer to the gate question. **If the engagement ended tomorrow, the clinic keeps the brain, the research, the scripts, the article system and the data.**

24 · Results · the business

## January to April 2026, against the same months of 2025.

Metric

Year on year

What it is

Revenue

+39.4%

the business result

Appointments

+57.6%

real demand

Calls

+44.6%

top of the funnel

Investigations

+86.9%

higher margin revenue

Unique patients

+49.8%

a genuinely new patient base

Conversion per caller

+52.0%

operational efficiency

Returning patients

+39.2%

retention

Source: the client’s CEO dashboard. January 1 to April 30, 2026 compared to the same period in 2025. Unique patients are deduplicated by national ID.

Four months, because that is the closed period in the dashboard. **The shortest window in this deck, and the one that understates the year.**

25 · Results · the paid channel

## Spend went up on search. So did the click rate. Cost per conversion fell.

Search campaigns only

2025

2026

Change

Click-through rate

12.67%

13.62%

+0.95 pp

Cost per conversion

€0.00

€0.00

−6.2%

Conversions

0,000

0,000

+37.7%

Spend

€00,000

€00,000

+29.2%

Branded search, cost per conversion

€0.00

€0.00

−22.5%

Source: Google Ads campaign export, January 1 to May 31, 2026 compared to the same period in 2025. Client cost figures are withheld by agreement; only the change is shown. Five of eight comparable search campaigns improved their click rate, three declined.

Two figures we deliberately do not feature: the blended click rate and the blended conversion rate. Both fell, because awareness inventory was scaled more than fivefold. **That is a mix effect, and presenting it either way would be misleading.**

26 · Results · the paid channel at account level

## Three times the impressions. A third more money.

Whole account, all campaign types

Change

What moved it

Impressions

+204.5%

awareness inventory opened up

Interaction rate

+70.2%

creative built from the research

Average cost per interaction

−74.8%

the mix moved to cheaper attention

Spend

+30.7%

budget grew, but nowhere near reach

Source: Google Ads account totals, January 1 to July 31, 2026 against the same period in 2025.

Cost per interaction did not fall because the bidding got clever. It fell because we stopped buying only the expensive end of the market. **That is the mix shift, and it was the plan, not a side effect.**

27 · Results · reach built from almost nothing

## Seven months. From no presence to a recognised name.

33.78M

total impressions, January to July 2026

1.71M organic

earned, not bought. 32.07M of the total was paid

+74%

followers, 17,189 to 29,968 across five networks

8→ 6,820

TikTok followers. That is the real starting line

Sources: social account report for impressions, January 1 to July 31, 2026, paid split TikTok 15.72M, Meta 11.85M, Google 4.5M. Follower counts pulled from the platform API on 12 August 2026: Facebook 17,093 to 22,525, TikTok 8 to 6,820, Instagram 68 to 354, YouTube 20 to 269. **The same API returns nothing at all for 2025, because there was no tracked presence to return.**

28 · Results · what the video system produced

## Twenty nine videos went past a hundred thousand views.

21on TikTok

above 100,000 views each · 16.6M views, 6.3M reached

8on YouTube

above 100,000 each · top short 559,000

3.0M

best single video: why a diabetic needs a vascular Doppler

91%+

of that audience in Romania, so almost no geographic waste

Every topic came off the phone, not off a trend. **Check any of it yourself:** [tiktok.com/@cardioclinic.bucuresti](https://www.tiktok.com/@cardioclinic.bucuresti) · [youtube.com/@CardioClinicBucuresti](https://www.youtube.com/@CardioClinicBucuresti/shorts) · [facebook.com/CardioClinicBucuresti](https://www.facebook.com/CardioClinicBucuresti/reels). Sort the YouTube shorts by most popular and the eight are the first eight.

Source: TikTok and YouTube analytics for the clinic’s own accounts, September 2025 to August 2026. Views count paid distribution as well as organic, the same way every reach figure in this deck does.

29 · Results · the number that is hardest to argue with

## More people typing the name. Not better ranking for it.

Branded search impressions+41.2%

monthly · April 2025 to July 2026 · competitor brands removed

May 1 to July 31, 2026 against the same window in 2025. Average position over the same windows: **2.61 to 2.67**, flat.

The site was already inside the top three for its own name in both periods, so this is not a ranking gain. Demand for the name grew while visibility for it stayed where it was. **That is what brand lift means, and it is the one figure here a sceptic cannot explain away with a platform change.**

Source: Google Search Console API, property cardioclinic.ro, pulled 12 August 2026. Both spellings of the name included, thirty five queries belonging to other businesses removed. Sixteen month retention is why the comparison starts in May.

30 · Why it works · the mechanism

## How a brand makes acquisition cheaper.

1.  **Clarity** produces memory.
2.  **Memory** produces orientation. They know who you are before they need you.
3.  **Orientation** lowers the mental work of choosing.
4.  **Less mental work** produces trust faster.
5.  **Trust converts.** And every link above takes cost out of the step after it.

The observable version here: branded demand rose sharply while the position for the brand stayed flat, and in the same period the cost per conversion on the paid brand term fell by 22.5 percent. **Work on channels with no direct attribution made the channel with direct attribution cheaper.**

31 · The part most case studies leave out

## The ratios got worse. That was the plan.

+107%

marketing budget, deliberately doubled

+38%

cost of acquiring a unique patient

−33%

blended return on total marketing spend

−30%

lifetime value, and average order value down 7.6%

The mandate was to break a ceiling, not to spend less. Ratios compress when you double the investment, and new patients arriving from awareness start at a lower value than patients who arrived already convinced. **Meanwhile, on the core channel, spend rose 29 percent while the click rate rose and cost per conversion fell. That is the part that says the money was spent well.**

32 · What is not in this deck, and why

## Four things we could have claimed and did not.

-   **No traffic claim, anywhere.** Analytics sessions fell 18.6 percent and organic sessions fell 58 percent between January and May 2026, against the same months of 2025. It may be a tracking migration, a consent change, or a real effect. It is under investigation, so we say nothing about traffic.
-   **No working media efficiency figure.** The revenue dashboard and the ads export do not reconcile cleanly across currencies and periods, so the metric was dropped rather than estimated.
-   **No causation claim on brand lift.** The rise correlates with the period of work. Correlation is what the data supports, so correlation is what is claimed.
-   **No cherry-picked campaign list.** Five of eight search campaigns improved their click rate. Three did not. Both numbers are on the earlier slide.

**A case study that only contains good news is a case study a serious buyer discounts entirely.**

33 · The obvious objection, answered first

## „Was that you, or was the clinic already growing?”

It was already growing. In **2025 against 2024**, before this engagement began in September 2025, the clinic increased total patients by 146 percent and unique patients by 57 percent, on a marketing budget 70 percent larger. Return on ad spend fell 25 percent in that same year.

-   **So the direction is not the claim.** The clinic was already buying growth with budget, and the ratios were already compressing.
-   **The claim is about the mechanism.** Single channel concentration broken. Branded demand created where there was almost none. Conversion on existing calls raised by 52 percent without buying one extra call.
-   **Growing a business that is already growing is the harder problem**, not the easier one. The easy percentage gains were already taken.

Source: the client’s marketing dashboard, full year 2025 compared to full year 2024. The engagement covers four months of that window.

34 · The honest headline of the whole story

## That result came from under a fifth of the system.

Still not deployed

Why it matters

Category architecture in the full sense

owning the space, not renting attention in it

Offer ladder beyond the existing packages

revenue per patient, not just patient count

Retention and lifetime value engine

the metric that fell, addressed directly

Account based work on referrers

a second demand source that is not advertising

Email, built and blocked

twelve pieces written, held behind a consent problem in the existing contact base

Five of seven phases executed, and the two that compound hardest are the ones still ahead. **What you have just seen is the early part of the method, done properly and in order.**

35 · Why this is not a healthcare story

## The clinic is not the point. The pattern is.

One channel that works, at a ceiling, where more budget stops buying more customers. **That describes most manufacturers in a price war, most B2B service firms competing on rate cards, and most specialist clinics.**

1.  **Read what customers actually say** before writing anything.
2.  **Fix conversion on demand you have already paid for.** It is the cheapest growth in the business.
3.  **Build recognition on channels that do not report attribution**, so the channels that do get cheaper.
4.  **Then scale.** In that order, not the reverse.

**Growth from the system, not from a bigger number in the same box.**

36 · Where we would go next, here

## The next moves are already written on the numbers.

1.  **Lifetime value, directly.** It fell 30 percent because the patient base got younger in tenure. Retention is now the highest leverage number in the business.
2.  **Unblock email.** Twelve pieces are written and sitting behind a consent problem in a base of roughly six thousand contacts. Re-permission first, then the sequence.
3.  **Resolve the analytics discrepancy.** Until sessions reconcile, an entire channel cannot be argued about honestly.
4.  **Then category architecture.** The clinic owns a real medical distinction that nobody in the market is claiming out loud.

**None of these is a bigger advertising budget.**

37 · The next step

## If the shape of that problem is familiar, the diagnosis is the place to start.

The proof, public

A clinic locked into one channel, at a growth ceiling. We built a multi channel demand system, and in roughly seven months: **revenue up 39 percent, appointments up 57 percent, investigations up 86 percent**, through brand and efficiency rather than through a bigger budget on the same channel.
[unrivals.ro/cardio-clinic](https://unrivals.ro/cardio-clinic)

Every figure in this deck traces to a named source and a stated window. Where two readings were possible, the smaller one is on the slide.

![Cardio Clinic creative, 2026, the Radu avatar](https://unrivals.ro/_assets/cardio-clinic-method/cardio-2026-radu.jpg)

2026 creative. The patient’s WHY leads, the service follows.

Daniel Ene & Daniel Roșca · UNRIVALS [unrivals.ro](https://unrivals.ro)

UNRIVALS™ · Signal. Not Noise.

01 / 37 ‹ ›