Google Dominating Search Ads More Than Ever

for therapist, lawyers, or anyone else offering a service. Other search engines are essentially afterthoughts, and it's not like anyone else goes to Facebook or Amazon to buy a therapy session. So when Google's prices surge, small business owners can find themselves in a bind. And while being big or charging

high prices, it isn't an antitrust violation. The US Justice Department and almost every state attorney general they are preparing antitrust cases that are expected to allege that Google's dominance is illegal. Google dominates search ads more than ever is working through that. If you're a therapist or any small business owner, really you live and die with Google. Regulators may step in. By Mark Bergen and Shelley Banjo in March,

Ellen Ross's business came to a standstill. Ross is a psychotherapist accustomed to sitting across from patients, helping them deal with their deepest traumas and fears. When the pandemic started shutting the economy down, Ross shut her San Jose office too. She nixed plans to hire another therapist and began adjusting to video therapy, which meant, among other things, building breaks

in between sessions. I can't look at a screen as long as I can interact with human beings, says Ross, who spent years counseling in hospitals before setting up her own practice in and then there was the Google problem. In the before times, Ross spent about twenty dollars a day on search ads to promote her practice. That worked well enough, people would search for things like therapist near me, and she would bid for those terms at Google silent auction.

If she won the auction, adds for her practice True North Psychology would appear at the top of search results. Google charged for each click. In twenty nineteen, she spent about fifty five hundred dollars. Starting in April, Ross's calculus changed. Americans were stuck at home, some juggling home schooling and work. Others newly jobless, They were anxious and searched the web for help, sometimes looking for video counseling. Ross noticed that

the prices for her regular keywords jumped sharply. She was still finding patients, though they often arrived after trying one of the proliferating virtual therapy start ups such as Better Help and talk Space, and it was becoming prohibitively expensive to buy the Google ads to attract them. Ross wasn't sure what to do. Google, as she well knew, has a near monopoly in web search. It has eighty seven percent of the U S market by some estimates. Its

next largest competitor, Bing has about seven percent. So Ross you she couldn't simply stop buying Google ads. If she did, she'd lose out on any new business. But continuing to pay so much didn't seem sustainable either. I'm a fairly good psychologist, she says, I'm a terrible marketer. Ross is one of millions of small business owners whose reliance on Google has only grown during the pandemic, when the Internet

has become the main avenue of commercial life. That dependence is at the heart of the most high profile antitrust showdown. Since Uncle Sam went after Microsoft in the nine nineties, the US Justice Department and almost every state attorney general are preparing antitrust cases that are expected to allege that Google's dominance is illegal. High prices in and of itself isn't an anti trust violation. Neither is being big, says Herbert hoven Camp, a professor at the University of Pennsylvania

Kerry Law School. The bigger question is whether Google is abusing its power. Google got a preview of the government's likely argument on July ninth during a five hour Congressional anti trust hearing. It opened with questions about Google's stranglehold on search and included lawmakers calling four tech chief executives

cyber barons and unregulated bullies. Sunder Picha, I, Google's well dressed and reserve chief executive officer, began by ticking off family owned US companies that have benefited from Google ads and services. Nearly one third of small business owners said that without digital tools, they would have had to close all or part of their business During COVID, he said via video feed from Google's headquarters. The company gave out three hundred and forty million dollars in add credits to

small companies as part of its pandemic response. In his testimony, pitch I also asserted that the company operates in competitive global markets. The point was reinforced the following day when Google announced that its ad intake fell for the first time ever because of the crisis. The company still finished the spring quarter with on one billion dollars in cash

on hand. When it comes to advertising, Google likes to broadly define the market it competes in to include even television, and it likes to point to its fierce rivalry with Facebook and Amazon. But for therapists, lawyers, and anyone offering a service, this argument is bogus. People peruse Facebook for the latest news or baby photo, not for psychological care. No one goes to Amazon to buy a therapy session. Other search engines are afterthoughts. Ian Palombo, a therapist in Denver,

bought bing ads right after the pandemic hit. But it was such a throwaway proposition he didn't even check to see how they did. I mean, it's bang right, he says. Therapists talk about Google like they would about any utility. It's just another check, only this one goes to the fourth biggest company in the world and comes with no guarantees. It's a lot like a poker table at the casino,

says Daniel Weindler, founder of marketing for Therapists. Anyone can play, but unless you know what you're doing, you're likely to get rolled. The last time the global economy cratered. In two thousand nine, Google released its first economic impact report. Regulators and other critics were questioning its sway over web publishers,

whether the search engine was too big and powerful. Peppered with glossy, smiling photos of mom and pop business owners in each state, Google's reports showed that far from consolidating economic power, the company was helping the little guys. A bookstore in Mishawaka, Indiana, a lighting supplier in Kinnebunk, Maine, a remodeling service in Aberdeen, South Dakota, each had grown.

Google said thanks to Google Ads. Selling therapy, though isn't as straightforward as selling a book or a light fixture. It can be expensive and for some still comes with the stigma. There is just a really significant human need that a lot of us struggle with, says Wendler, who's been helping therapists by Google. Ads for the past five years. At thirty two, with his rectangular glasses and untidy facial scruff, he could pass for an engineer at the Google Plex.

He also has Asperger syndrome and wrote a guide book Improve Your Social Skills, full of tips for others with it. Those interests prompted Wendler to pursue a career as a counselor. While in grad school. He set up a marketing practice for therapists and now handles the budgets for roughly twenty of them a month. He wrote another book, Clicking with

Clients Online Marketing for private practice therapists. In the first months of the pandemic, he saw the prices of keywords related to therapy jump as much as fift with some terms that had once cost seven dollars or eight dollars fetching ten dollars a click. Prices went higher as searches and buyers piled on. There's only so much inventory, he says, referring to the slots available for search page ads, that is driving prices up, up, up. Up. Prices are a problem.

But even more frustrating for Wendler and other search by fires are the tweaks Google has made in recent years as it pushes to automate wherever it can. Today, there are two basic ways to buy search ads. A business owner can pick out search terms manually, or take the approach Google prefers, hand over a budget, select an industry, and let Google software figure out which ads will get the most clicks in Google ease. These are known as

smart campaigns. The idea is to make search ad buying as simple as possible, while Google uses what it promises is the latest and greatest in machine intelligence to maximize profits for itself and its customers. Our advertising tools are designed to help small businesses compete on a level playing field with large businesses, even Fortune five hundred companies, says

a Google spokesman. Local businesses, even those without marketing expertise, can create compelling ads in minutes that reach the right audiences. But automation doesn't work terribly well for therapists. Many are specialists focusing on, say, couples, counseling, or trauma, just stinctions that Google software doesn't necessarily make. As a result, some therapists who use the automated approach end up entering auctions

for broader keywords where the clicks don't lead anywhere. For one of Wendler's clients, Google system once suggested PTSD, a search many people make for idle research rather than to find an expensive counselor Another client wasted a tenth of his two thousand dollar monthly Google ads budget this way before Weindler caught the problem. In another feature, Google even automatically writes ad copy if you're selling a widget or something, maybe that works for you. Wendler says people are less

thrilled with psychologists who sound like they've been programmed. That hasn't stopped Google from pushing therapists to adopt smart campaigns. Wendler recalls Saturday calls from Google representatives asking him to turn on automated ads for his clients. He politely declines and asked them not to call again. They wait three months and call again. Google is essentially competing with itself,

he says. I think Google's ultimate goal is that you give them your credit card, and that's the only thing you do. The control such companies as Google exert over their markets is one key reason lawmakers are trying to check big text monopoly power. Consider Amazon's subscribe and Save feature, which lets shoppers place a standing order for raisin brand or toilet paper. It's convenient, and it reduces the incentive

to try competitors. It locks you in, says Luigi's Ngalas, a finance professor at the University of Chicago Booth School of Business. The same could be said of Google's smart campaigns, But Wendler and other search marketers say Google's drive to automate has dovetailed with the reduction in the quality of customer support. For years, a search ad buyer could call a Google helpline and get someone on the phone. Starting about two years ago, Google began outsourcing these services, and

buyers say the quality of support quickly diminished. It feels like you're speaking to someone who's just talking out of a binder, says Matt Kaufman, founder of Therapy Practice Accelerator, a healthcare marketing firm. During the pandemic, Kaufman says he hasn't been able to get a human on the phone at all. Google moved its customer support to chat bots. The Google spokesman says the company scaled back support services

because of COVID nineteen. Practically every antitrust investigator who's looked into Google has seen a web presentation called Focus on the User. It was created in fourteen by Yelp and trip Advisor, local review sites and longtime Google critics, whose central complaint was that Google was expanding its ambitions beyond

mere web search in ways that hurts small companies. As rivals tell it, Google search engine once did one thing spit out a list of ten blue links, but starting in the mid two thousands, search results began to include above the links actual answers to questions like how hot is the sun and what are the signs of heat stroke? Google pulled these facts from other websites, resulting in searches

where consumers didn't bother clicking on any links. Yelp and others argue this represents a theft of their intellectual property, siphoning off their web traffic. Gradually, this extended to phrases like where is the best Sichuan food in London? With the top results from Google Maps After Maps, Google did the same with its own services in travel, hotel booking, and shopping. In each case, Google says it shows the best results for consumers. Competing businesses say this is an

open and shut abuse of monopoly power. Google has done something similar with healthcare. At times, the company has seemed intent on capitalizing on doctor Google, that ubiquitous modern phenomenon of self diagnosis by web search. In twenty fifteen, Google teamed up with the Mayo Clinic to begin listing symptoms and treatments directly in search results, rather than showing web links. At that point, Google said one in twenty searches were

health related. About two years ago, the company hired David Feinberg, a hospital executive and former psychiatrist, to lead a new division, Google Health. Fineberg's remit is to create an electronic medical record system for hospitals that functions like Google Search, and to help revamp Google searches about health. His division created a special search page for anything related to COVID nineteen in May, and rolled out features specifically about mental health.

People can now book virtual care appointments directly in Google Maps. Searches for terms such as anxiety disorder or PTSD produced buttons linking to a clinically validated questionnaire and other resources. A lot of folks come to Google and ask us questions, Fineberg said in a May interview with YouTuber Dr Mike Varshavsky. You can do your own in essence screening for depression and anxiety, so then you can see that you're not alone. That he was speaking on YouTube, Google in house streaming

service was fitting. Those self assessments happened directly on Google, rather than on the sites of would be competitors such as web md or zoc. Doc Feinberg, through a representative, declined to comment. Google says that he doesn't control paid ads. These Google owned mental health checkups on Google's own search engine compound a problem marketers have complained about for a decade, namely that it's very hard to attract users without paying

Google for ads. If someone near Google's headquarters in Mountain View, California, searches for treat depression, they might see ads for one Medical, a concert health service in which Google is itself an investor, plush Care, a tech company that specializes in online prescriptions, and Better Help, a virtual counseling service. To the right, they'd see an information box where Google lists various treatment options. The so called organic search results the old ten blue

links come below all of that. In fact, so many search results are stacked of ads that one healthcare investor says his firm advises portfolio companies not to bother tweaking websites to hire in Google search listings. Only paid results matter. This is propelled an entirely new kind of competitor that is more or less the inverse of someone like Ross, marketers that have a sideline in therapy, such as Better Help and talk Space. When Ross loses Google auctions, it's

mostly to these therapy consolidators. They have hundreds of millions in venture capital and corporate backing and use an uber like contract labor model, acquiring customers and sending them to a sprawling nationwide network of counselors and coaches. Ross holds a doctorate in clinical psychology, which required six years of graduate school. She usually charges two hundred and fifty dollars

an hour. Better Helps therapists tend to be licensed counselors, clinical social workers, or psychologists with a master's degree and at least three years experience. The company charges from thirty five dollars to fifty secession. Full time therapists earn from fifteen to thirty dollars an hour. I could probably make more money working at the grocery store. Ross says they

pay terribly. It's abysmal. Alan Mattis, president of better Help, says retention is high among his company's eleven thousand therapists. Some therapists with thriving private practices and affluent areas can earn more than they could online, he says, but there are providers on the platform who makes six figures annually, definitely not abysmal. Google is in a way a co conspirator in turning the business of mental health into a

marketing game. Better Helps app has been downloaded six hundred thousand times so far, in increase from the same period a year ago, according to research firm Censor Tower. During the first couple of months of the pandemic, new customers complaining of stress and anxiety doubled from the year before. Mattis says the app saw a similar influx of independent therapists joining its platform, many of whom had no choice but to try online care while the pandemic shuttered physical businesses.

The Google spokesman says a range of companies and nonprofits have bought search ads related to mental health. He notes that the company doesn't set ad prizes and that its auctions operate fairly for all advertisers. Better Help and others like it have another advantage. They don't have qualms about asking customers for testimonials to display on their websites, or

paying social media influencers to tout their networks. That helps them boost their rankings on Google, which favors businesses with reviews. Many licensed therapists consider that kind of marketing and ethical violation.

One could argue that the rise of these virtual therapy providers is a positive development, making therapy affordable and available at a time when everyone seems to need it, but that would cast better help whose parent company brought in more than five and fifty million dollars in sales last year in the role of the scrappy challenger and raw a sole proprietor as the incumbent. David Cecilene, the Democratic representative from Rhode Island who led the anti trust hearings,

challenged pia's contention that Google helps small businesses. Google just shows what's most profitable for Google, Cecilene said, Gary Reback, an attorney with car and Ferrell who worked on the Microsoft anti trust case, watched that and saw a clear signal that the Justice Department should be more confident to pursue a case against Google. There are so many issues, and it looks like Google is on the bad side of all of them, he says. By summer, Ross's practice

was picking up again. A couple of patients who had left town continue seeing her via video. New patients are coming in stressed by the unrelenting pandemic, dissatisfied with whatever they've been trying as relief. She's even reopened her office for those who truly need in person care. To prepare, Ross spent hours searching for klorox wipes before finding a reliable supply at her local liquor store. She's also improved her video backdrop, adding new wallpaper, a potted plant, and

a smart looking wooden desk and bookshelf. Since more people seem to be seeking care, she's back to paying Google about twenty dollars a day. She says she's feeling better about her business. She's also telling her patients that she's preparing herself for two more years of pandemic dislocation. Google could be in for even more political hurt. It may have to pay record fines and make deep changes to

its ad business. Politicians from both parties open to probe into a data sharing arrangement Feinberg's health division set up with hospitals. Google has waited more than nine months to close its two point one billion dollar acquisition of Fitbit, which makes fitness trackers. Regulators, politicians, and critics have denounced the deal, worried about handing over a company that tracks our bodies to one that knows so much about our minds.

To win approval, Google has promised that it won't use any data from Fitbit's devices for its primary business of selling ads. Thanks so much for listening to this week's cover story. Check out this week's magazine for many other stories. That magazine on newstands right now, also online at Bloomberg dot com, and of course, on the Bloomberg terminal. I'm Carol Masser and I'm Jason Kelly. Check us out every day. It's our daily Bloomberg Business Week radio show, also carried

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