Three things. First, chiropractic patients are usually in acute pain when they search — they decide within hours, not weeks, and their queries have an urgency profile that other medical specialties do not share. Second, chiropractic economics are anchored on long-term care plans, not single visits — which means retention and reactivation matter as much as new-patient acquisition. Third, the chiropractic competitive landscape is unusually local: most patients will not drive more than 10-15 minutes, so geographic precision is everything. Generic agencies don't optimize for any of this.