Imagine you are running a Radio or TV ad. If every time you turn on your radio or your television, will you see your ads? Of course not. The radio and TV executives decide how much exposure you are allowed based on your investment.

Google ads are the same way. If you're investing $1000/month to attract pediatric patients, you may not always see your ads in the search results. 

We optimize your campaign to show the ads in the best possible way to utilize your ad spend throughout the month based. In short, we set parameters for Google so that your budget is utilized properly and for the right keywords. 

We cannot control the following: 
- Cost per click (set based on competition) 
- Guaranteeing Google ALWAYS shows your ads 

We know this can be confusing to some, but our bidding strategy is meant to optimize whatever budget we are working with, it doesn't allow us to show you first for every imaginable keyword without a VERY high ad spend. 

I hope this information is helpful and helps to explain just how Google Ads work, how bidding works, and why you won't ALWAYS come up for a search term at any given moment.