Marketing 101 for Chiropractors

Cracking Meta’s AI: A Chiropractor’s Playbook For Better Leads

• Enrico Dolcecore • Season 3 • Episode 40

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Your Facebook and Instagram leads didn’t dry up by accident—Meta rewired the system. We unpack what actually changed inside the algorithm and give chiropractors a battle-tested plan to lower cost per lead, filter bots, and get real patients back in the pipeline. No fluff, just the steps that move the needle.

We start by mapping the shift from detailed interests to broad AI targeting and why the learning phase now takes seven to fourteen days. That change punishes low daily budgets and constant tinkering, so we outline a budget ramp that feeds the algorithm enough signal to learn fast without wasting spend. Then we dig into trust: verified business status, verified domains, and consistent posting all increase delivery because Meta now cares about whether your clinic looks legitimate and active, not just whether your copy is clever.

From there, we walk through the quality stack that restores performance. High-intent lead forms with multi-step questions stop bots at the door, while a conversion API sends back real conversion stages from your CRM—dead, contacted, booked, showed—so the system learns who becomes a patient. We also cover the creative mix that works now: a short doctor-on-camera explainer, a testimonial mashup, and a clear static or graphic. Pair those with a benefit-first hook, a short story, a real value stack of what’s included on day one, fresh five-star proof, and a deadline that drives action.

You’ll hear practical examples from local clinics that pushed CPLs from the $40s back to the low $20s by combining verification, CAPI, high‑intent forms, and three-plus creatives. If your ads feel slower, pricier, and less responsive, this playbook shows how to rebuild signal density and trust so the AI finds people who actually book. Subscribe if you want more field-tested strategies for running local service ads that convert, and share this episode with a chiropractor who’s ready to fix their lead flow.

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SPEAKER_01:

Are your Facebook or Instagram ads suddenly slowing down? Are your cost per lead rising? Quality dropping?

unknown:

Are you getting more bots than ever? It's not your clinic, it's Meta's view algorithm.

SPEAKER_01:

Today we're breaking down exactly what changed and what chiropractors must do right now to keep ads performing, reduce the bots, and get your lead flow back on track. Dr. Enrico Velchori, welcome back to WorkingOne 101 for chiropractors. I've been on this for six months trying to figure out what the heck this AI algorithm did. We know back in February and March, it completely converted and it changed everything. We've been watching everything this whole year, and the changes are actually massive now that I read them. Oh my god, the blogger coming up from meta, they're on, you can go to meta.com, you can just see everything that they're doing on the back end. And uh wow, that makes that makes sense. And you're still not telling us all the picture. So in this episode, we're gonna go over what changed, why ads are slower, what to do about it, and exact ad structure working right now to roll into 2026 with it. So listen up, we'll make this as short and sweet as we can, but we've got to get through the main points. So here's a simple breakdown. Meta moved heavily into AI-driven targeting, meaning they gave all the stuff that you were inputting into it when you were picking your audience, your radius, your men, your women, the age groups, the income, the learning, the parents that have kids that are toddlers. You know, you're your targeting. They took that ball away. You still have some options in there to pick from, but the AI doesn't care. It's taking it and it's learning it on its own. Broad targeting is now standard, whether you like it or not. That's why you get a bunch of massive lead fluxes, and then no one responds. The interest targeting is weaker. Like I just said, if you try and pick the interests and the income and the demographics, it's just weaker. They're not putting much onto that. And the algorithm needs more conversion signals to learn properly, more so than before, because it's AI, so now it's got we it's like re relearning the internet. It's nuts. It's crazy that we're in this guinea pig model, but we are. Are you throwing away your money? No, because you need some form of advertising, and it still is the best cost per mutation acquisition out there, unless you found something better. I know. MENA is prioritizing trust behind the scenes and not telling us. So the trust indicators, verified domains. This is where a lot of your ad agencies are getting into trouble. They're creating their own agency with their own um landing pages with our own domains, local chiropractor 101 or whatever it is, right?com. It's not a verified site. This is hurting people getting to the landing page, it's hurting the trust, it's hurting the distribution of the ad. You're not a verified business. It should be on Facebook for Sean Meta. So that way, Instagram and Facebook are covered. You're a verified business. Make sure you verify your business. It's your ads manager or your business suite. You go under business settings, and in there, the first thing that will pop up is an error code at the top or a notification on the top saying, please verify your business, it's not verified. It'll be up there. If you've ignored that forever, you've got to fix that. Simply fix your ID or whatever it is, and then just follow the steps. Uh, and then the longer warm-up periods. We'll get into that in a second. The learning phase is longer now. So when you create up an ad, you create a new campaign, there's a learning phase in it. This is now longer. It used to be 24-48 hours, it is no longer that. They now take seven to 14 days to learn, which is upsetting because you're waiting seven days. And is this a good response of leads? Is it a bad response of leads? Are we getting seven new leads? Are we getting 14 new leads? What's going on? What is it going to be moving forward? You just have to be patient. Chiropractors are killing their ads too early, and it's the biggest mistake they're making right now. They're never getting their ads traction. So the rise in fake bots is also true. I was like, is this real? Is this not real? What's going on? Who is submitting their information? Why is this happening? There are fake bots. I don't understand the source. Meta wouldn't confirm the source, but it's definitely the China thing that's going on where I don't know if you watch some of these stuff or I went in there, all the stolen iPhones and all abused iPhones, they put into this like web. I gotta find the link and share it. There's a link on there showing how they've created these master switches where they can plug in a thousand iPhones. So they each have their own IP. Yeah, their own IP, and plug it in, and now they just go to one streaming platform like TikTok or Facebook or Instagram, and they can be a thousand profiles at the same time. And they just create blocks, and those blocks go out and search forms to fill out, and they just fill them out on Instagram, on Facebook. So they're creating ads. We'll talk about it around that. So let's get into what docs actually care about. And I know what it is, it's what you need to do right now to fix all this. But there is so there we go right, got some clarity to 2025. Some clarity and makes sense. I'm not surprised by any of it. But what do we do with our ads? Chiropractors are seeing a slower, lower quality lead. So Meta AI responds to volume. And unfortunately, when we're spending$45 to$60 a day, the volume is just not there. We're just not because the cost per impression is not up. Because of more competition, because of more of everything. Um, so the low daily budgets slower learning. Local targeting shrinks the data pool. And unfortunately, we have to do local targeting because you can't target your whole state. It makes no sense someone from four hours away seeing your ad because they're never going to come use your service because you're a hands-on service program. Lead forms do attract bots because they're just too easy to fill. Work around that, and not enough content on your page to build trust. Many of you still run ads and don't post your Instagram and Facebook. You're killing yourself, you're shooting yourself in the foot because now you're an untrusted profile. If you don't have time to post about your business, how are you going to advertise your business? That's how the banana's looking at this. You're going to say, Well, I do other things to promote my business in real life. Social media, you do. You absolutely do. Uh, not enough content on your page to build any trust signals that the AI needs. Most Cairo ads rely only on the offer and there's zero nursery. Maybe touch on that in a second. That could destray us if you do that. Uh, so what you need to do right now, right now, listen up. Number one, fix number one, increase your daily budget during the first week of the campaign. Minimum doesn't work anymore of the$20,$30 per day. I would recommend what I do for some people for three or four days, I put them to$70,$80,$100 for those first three or four days to rev it up, go down to$70,$60,000,$50, and bring them down to where they want to be for their ad spend. Because before we launch a campaign, I tell them what I recommend for ad spend,$1,500,$2,000, depending on where they're at, and we set it up on a daily budget. I'll rev it up. They'll tell me in the first month, I know you said$1,500, we'll do$1900 this first month and we'll go down next month to$1,500. But we need to rev this up because if this ad catches and it starts generating, we can then play with the ad spend. That's how we've been doing it. After optimization, you can then scale down. Takes what did I say earlier? Seven to 14 days. I would bank on the 14 days, and then you can start to scale down. Why? The algorithm needs data density, it's different than it was before, unfortunately. Meta built, since when they start the ad apply for 2013, 2014, they built that pixel data, which is the server data. All that information was saved on your pixel, whatever that is. The pixel is the one part of the server that you got for information to store, and the pixel learned your data all the way up to 2025. And then they're like, you know what? Nope, not using the pixel data anymore. That's literally what happened. They pulled the rug from underneath your feet, just like they're gonna do with the crypto your models or everything. But um, they're gonna do that, they're gonna pull it, and then you're gonna have the eye. So that's where we're at with this. So it's relearning. We have to understand that. Now, how do we improve this? We have to add a conversion API or C API event in your high level or your CRM or something that communicates with it more so so the AI can read your CRM. Let's just use the high level for this example. That API is it is a light bulb that goes off that the that the meta can see, the AI can see that it's going to that CRM. Something's happening, that lead that landed on your landing page or filled up the form, and it's being pinged on your CRM. They're like, bing, bing, two lights is good, two green lights is good. They see that, they communicate, like, oh, it's going through. You're registering them as a lead or a purchase, whatever it is.

unknown:

That's the scene that the API that we need.

SPEAKER_01:

It improves the learning, it eliminates the fake leads because what you're gonna do in there with your API in your high level, you don't have to do much once you set it up, is when you move them to a dead lead or a lost lead or a fake lead, you can have this and trigger that funnel to be like, these people are fake. The the meta AI would be like, Oh, these are bots, no good. That's the difference between what it was, but the pixel couldn't tell who was bad. Now you can relay that information back, tell these were bad, these were bots. Because they never call or they didn't know reply, or whatever it is there. They and then that will trigger it back. But what it's really looking for is that people that are moving down your funnel. You lead, made contact, booked an appointment, showed up, as they're going down your funnel and your opportunities. That's where the API is getting feedback back saying this is an active lead. They're hopping, they're moving. It improves the learning, it eliminates the fake leads, it passes real conversion data to meta. And then, you know, if you're not doing this in 2026, if you're doing waste of your movement, you're not you're not gonna have any traction to move forward. Uh, so switch to high intent lead forms. If you're still gonna use lead forms, right? You want high intent, and that's an option you pick when you create a new lead form. Many of you are gonna have to create new lead forms when you're using your forms. Go back, you can pretty much copy them again. But when you create a new form on your on your campaign, it'll say at the very top, high intent or more volume. You're just gonna put high intent. It's gonna it's gonna default to more volume because it's more data, but you're gonna put high intent. It gives you questions and other things you can add to the form so they don't just fill up the form and hit submit. The bots can do that. The bots can't answer questions. So I'll have something. Uh, do you have an MRI you want us to review? Yes, no. Um, have you had any spinal surgeries recently? Yes, no. And then what's your chief complaint with a comment bots? They have to fill it out. The bots can't do that. And that works really well. For our decompression ads, we're still rolling in with great$21 lead volume. So it's great. So it hasn't changed much with certificates. So high intent has a review screen, a double confirmation, and a better bot filtering. Landing pages work better if you use fast loading high-level pages, your domain is verified, that's the key, and you set up a C API or pixel still works on the landing page so that at least data keeps going back and forth. Fix number four run three ad creative sets minimum. It's a new requirement. If you just run one picture or two pictures, the AI automatically puts you onto a lower tier, and it's just going to cost a lot to get those pictures out there. You have to be running at least three. I recommend four. So one short form video, one testimonial video, and one static image or graphic. You want to test them against each other, but more so, give the AI something to work about. The algorithm needs different formats to learn who responds to what and which one triggers the best leads frame with that API. Okay? Strengthen your offer message. In 2025 and into 2026, chiropractors must have a clear benefit-driven hook, value stack that has everything included that they're going to get for this offer. Proof, which is your testimonials, urgency, targeting by messaging, not audiences. So your ad copy plays heavier than the audiences you target. Fix number six add warm-up content on your page. So Meta now scores your page on consistent posting. So warm-up. We say add warm up. This means on your business page on Facebook and Instagram, you are consistently posting daily. It warms up your page, it warms up your entire ad account. If it's cold and you don't post even for days, you go down. The trust signals go down. Real content with your face, your location, with the place, not just stock images. So simply weekly content plan. A video, a patient result, an educational tip has to be put every week. And number seven, stop resetting the learning phase. Again, the 14-day rule about pulling this because we're like we're only got two leads, they cost$70 each. This is too high. We used to get$13 leads. What's going on? You have to be patient during the still time. Let it run for at least seven days before you make any changes with anything. Okay, swapping targeting, changing the pictures, you're just derailing the learning phase of this. Now, what kind of ads should you focus on going into 2026 right now? And it's value-based leads are the best. These are the top performers having a value stack. Instead of just a$59 offer new patient special, include the story. You got a story in there, the outcome. The story is, you know, Sarah came in with knee pain, patients are being coming in with knee pain. We become the knee pain clinic of so-and-so. The outcomes are fantastic. Within two weeks, people are moving better, walking better, pain's uh restored, decreased, the transformation is better, and just have proof and expectations from your Google's YouTube videos are even better, but just having those right there on the landing page or in the in the ad copy. Five-star review. Five-star review, put the date in there. Uh, show that it was recent. So that's what you want to do with that. Uh, talk performing ad number two, the problem solution videos. These have been great all year. This is how a lot of people have circumvented the meta AI changes, is their video ads are talking, and their ad copy is magic. It was genius, it still is genius. The doctor's talking about a condition, there's a visual in the background on the video, they're superimposed, headaches, migraines, vestibular neuralgia, uh, pots, whatever, vagal nerve, whatever it is, colic, they're talking about it, and the videos are just getting tons of views, and it works really well. So the doctor talking about a patient story or a condition, these are 15 to 30 seconds. They're natural, they're not polished, they're not shown in a professional studio, they're overlaid on some type of 3D anatomy. It works really, really well. Number three, the testimonial mashup is still a great one where you take your testimonial videos, you mash them up into like a commercial using, you know, you can use a bunch of tools there where you just crop them together, like uh Capcat. You do this 30, 45 second, up to 60 second video. Meta is loving the AI proof. Meta AI loves the social proof that there's real people out there talking about your business. And then the last one is the multi-step lead firms, which we talked about to eliminate and remove the bots and boost the quality of the lead. What condition do you need help with? How long have you had this? Complaints, do you have an MRI model review? Whatever it is, there. So the winning chiropractic ad structure. If you're dealing with it, we need a hook, we need a story, we need an offer, we need a value stack, we need credentials, we need a call to action, and we need a deadline. The ads are amount ads. We have to be advertisers. So a hook is that within that first two seconds, your videos start like this. If you're dealing with sciatic pain, here's what's really going on. What's your magic hook? This is the one that's going by. This is the one that will help your ads. If you're dealing with whatever pain, here's what's really going on. The two to three sentence story, sciatic roots from the spine first and then tails off into the thickest nerve in the human body called the sciatic nerve. Impingement at the disc level, spinal level, or upset musculoskeletal level can cause shooting pain down the leg. For just$59,$39 or$39 or$99 gets your first decompression or chiropractic new patient offer, and then you value stack. Value stack means you're you're stacking what you do in your office with tons of value. Let's be honest here. You're doing an exam and treating the patient, whichever way you do, whichever modalities you use. And then they're out. Or you're doing an exam and they're sitting under a decompression table. Let's just be honest here, as we can talk chiropractor to chiropractor. Not much, not much bizazz with that, right? There's not much going on. So, what you need to do is you value stack everything. I say the same thing three times over and over. So it looks like my same three things times three, it looks like they're getting nine things. Consultation with the with your doctor, report of your condition from your doctor, orthopedic testing, um, thermal scanning, um exam. I'm just I just repeated the same thing five times. They're getting an exam for being sick. Then they're gonna get their first mobility movement posture assessment. You just you just fluff this up. This way you're doing it, fluff it up, okay? That's your value stack. What are they gonna get that day? Make it, you know, seven, eight, nine things that are just boom, you're gonna get all of this normally four thousand two hundred and forty-four dollars for your first visit because you value stacked it, right? Whatever two hundred bucks for your exam, three hundred bucks for your exam, four ninety nine dollars for fifty nine dollars, whatever you're doing.

unknown:

Why do?

SPEAKER_01:

Trust us underneath. I would just have two, three, five-star reviews. I put the five-star emojis, and then I'll put December 2025 for a second. It's December right now. It's like a fresh review. Yeah, it's a fresh review. You took it from your Google, one of the recent ones, you put it there. It doesn't matter that they did it in November or September. You put it in there, you put December next one, December, the next one, December. I think three people this week came in there and they're all happy. Yes. You put it in there, you copy it, you can copy it word for word, so it's very relatable. In case they can go to your Google and be like, oh, there's that reviewer topic. And then that's the credentials, why they can trust us. And then we have a call to action, book now, get offer now, limited time. We have 15 spots, offer ends December 31st, whatever it is. Create the urgency so that they tap with the same rules that so before and after meta update. Right? I have chiropractors in not big cities, but smaller cities that still get six, eight, nine dollar leads for whatever they're doing. Suddenly those leads jump to 14 or I've had in my office, we've had$21 leads, and all of a sudden they're jumping to$41 leads. After switching to high-intend forms and creative stacks, we got back down to$21. So it's working. And it took me six months. I'm sorry, it took me six months to get the data to be like, what the swamp? And talking to other digital agencies. Should I name them? I don't know. Should I name them? Profit Zombies, Digital Hustle, uh, Seven Finger Docs. I talked to all the guys. They don't, you know, we don't hate each other. We're all trying to work and see what's going on, transparency. Uh I talk to everybody uh because I really want to help us all get better. And they're like, yeah, definitely. The AI is different. So I had to do something, but I didn't know that. Like they told me something like, yeah, my API was all screwed up. It's crazy. Um, so it just takes time to communicate back and forth. So DM me if you need anything. Get into the marketing one-on-one for chiropractors Facebook. The Facebook groups are dead, and I'm sorry for this. They're dead. It's hard to get your attention. I post stuff in there every day. People ask questions every day. They're there. There's great comments in the questions. Answers are being given, solutions are being given, problems are being solved. It's a great group, you just have to actively get in there. I know. I'm sorry, get into the doom scrolling when you go through Facebook, you forget about the group, you never see anything. It's hard to get you. I even try to add everyone. You guys are probably still seeing it. It's just the way it is. We're moving to a community. Uh, I'm excited about this for 2026, merging with some of these wonderful agency people, and we're gonna create one big group called Black Belt, and we're gonna be in there, and I'll invite you all to come to the group in there, which is much more interactive, and you'll get notifications in your email about them, whichever whichever group you want to be a part of within the group. You're like, oh, I want to know more about you know Facebook ads with Enrico, you'll be in the Enrico group in there, and then anytime I post stuff, you'll get like an email notification or whatever you want. You turn them on and off, and then you're in it. It's important to you, it's no longer social media, you're in the group. Um, or and I'm just gonna transfer, I'm just gonna transfer all of you to there, and that'll be the best way to engage. But for now, you have to actively go in there. Go in there and say meta, dm me, find me on social media, say meta. I know you're listening to this episode, just M E T A, and I'm like, okay, I gotta give them the optimization guide so then they can do this, and um hopefully it helps you. But if you just listen to this podcast and you jotted down some notes, you're off to off to a great start. But keep doing what you're doing. This it's uh it's it's a made. I've learned a lot now. I I reflect back on the seven years of doing this uh for you guys. I know the podcast is my three years old, but um I've been doing this for a while, and I look back and okay, this this hasn't only helped my practice, it hasn't only helped my satellite practice, it hasn't only helped the uh the uh students that come through my office and that go off and work on their own. Uh and a lot of you. It just it's helped just the knowledge has helped, understand, keep up change here. Don't get frustrated. Follow those rules, don't turn off your ads within your hands, let the AI learn a little bit, it's a little frustrating, but you'll get there. Uh if you find a better way to advertise, let me know. Because everyone's eyes are social media. I'm kind of excited to see this thing go dead. For whatever reason happens, uh social media just dies for humanity, but uh I'm also kind of scared. What else do we do? But uh as for now, it's not going anywhere. I don't see it going anywhere for the next room. So keep doing what you're doing. Don't give up. If you need help, reach out.

unknown:

I give up so much time for free to help you guys because I love you and I love the profession. I recommend everything too.

SPEAKER_01:

There's no reason for me to sit here and uh try and acquire new clients when I run my own office and all that. I only help three or four of you at a time because I love it, and two, uh, I want to make sure I give you enough time to run your ads properly.

unknown:

I'm not uh I don't have a big team to help me do that. So if you need help, I'll I love that. I love just answering the question if I can.

SPEAKER_01:

And if I can't, I love that too, because then it makes me go perdent, and I'm trying to figure it out, which is really cool too. So have a great week. Take care, keep doing what you're doing, and enjoy the holidays. Please take some time. Take some time with you and your family. No reason to keep the office open that week. Just uh do what you need to do, but take time, enjoy it. I think the clinic will be there on Monday, I promise. Uh take care of yourself this time.

SPEAKER_00:

Thanks for coming in.

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Enrico Dolcecore D.C.

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