From March to May 2026, I dove into a deep analysis of over 50 agencies to unveil the top medical device SEO agencies of the year. I meticulously evaluated them based on the following pivotal factors:
Notable Clients (35%): To me, an agency’s past collaborations with medical device clients speaks volumes about its potential success. So, the history of these relationships carries the most weight in my ranking.
Average Reviews (25%): Another key aspect I considered is customer reviews, particularly those from clients within the medical device industry.
Leadership Experience (15%): Agencies led by individuals with extensive SEO leadership experiences for medical device companies immediately captured my attention.
Company Size (10%): Larger agencies might boast the ability to execute comprehensive strategies using ample resources, but smaller specialized firms shouldn’t be overlooked.
Year Founded (10%): I trust more seasoned agencies that have consistently adapted to evolving SEO practices and maintained client success, even during economic slumps.
Headquarters Location (5%): Although less critical in my evaluation, agencies in major cities such as San Francisco and New York are strategically positioned to draw in exceptional talent.
Based on my research, the following agencies stand out as the frontrunners in medical device SEO for 2026.
On episode 341 of PPC Live The Podcast, I had the pleasure of chatting with Andrea Cruz, Head of B2B at Tinuiti. We delved into a challenge that many senior marketers face: the struggle of providing immediate answers when clients press for details without prior notice.
We explored how missteps in communication can amplify client stress, and how adopting a proactive mindset can turn these challenges into pivotal moments of growth in one’s career.
As Cruz progressed from a hands-on marketer to leading entire teams, she encountered the challenge of advocating for projects she wasn’t directly managing daily. This shift brought new struggles, especially when clients questioned campaign performance or outcomes.
In those moments, freezing or delaying responses can damage trust. Cruz realized that senior leaders must offer clear direction, even without knowing every detail, to maintain confidence in discussions.
Through her experiences and mentorship, Cruz honed a technique for buying time without losing trust: asking thoughtful questions. This strategy not only buys time but also ensures that the responses are precise and address the core of the client’s concerns.
Her method includes asking clients to clarify expectations, requesting additional context, and confirming their understanding. This approach is crucial, especially in emotionally charged situations, and, for Cruz, it allowed her to manage complex conversations effectively despite being a non-native English speaker.
At Tinuiti, the focus is on a solutions-driven culture over assigning blame. By addressing ‘Where are we now?’ and ‘How do we get where we want to be?’, teams foster a safe space to discuss errors and learn from them. Cruz believes that leaders should set the standard by openly sharing their own mistakes.
Cruz advocates for proactive communication, urging teams to address issues before clients notice. Tailoring communication styles to client preferences fosters stronger relationships and transforms agencies into strategic partners.
Common mistakes in B2B advertising include spreading budgets too thin and underfunding campaigns. Cruz emphasizes that it’s better to focus on fewer channels with adequate resources to avoid ineffective outcomes.
Regarding AI, Cruz warns against limiting its use to basic tasks and shares how her team is leveraging AI for advanced operations, enhancing strategic execution.
Cruz’s message is clear: growth requires preparation and a willingness to adapt. By anticipating client needs and embracing experimentation, marketers can turn pressure into golden opportunities.
For years, I’ve been part of countless discussions about paid media, all revolving around the same question: should we focus on building in-house teams or outsource to agencies?
While this debate is certainly valid, it often overlooks the core issue at hand. The real challenge isn’t where paid media is placed within our organizational chart. Instead, it’s all about how we structure performance leadership.
Many companies, including the ones I’m familiar with, navigate Google Ads and other paid channels with capable teams, solid budgets, and well-documented best practices. Campaigns are active. Dashboards appear full. We keep optimizing as scheduled. Yet:
Results stall.
Pipelines flatten.
Budgets get questioned.
Confidence in paid advertising erodes.
This is hardly a talent issue. Rather, it’s often a structural one.
The Plateau Most In-House Teams Eventually Hit
Across several B2B paid media accounts, ranging from SaaS to service businesses with monthly spends in the five-figure range, I’ve noticed a recurring pattern.
Performance doesn’t just drop overnight. It slows gradually.
Campaigns continue running. Costs seem stable. We still gather leads. But growth comes to a halt. Leadership observes motion without gaining insight. Decisions turn reactive. Paid media shifts from a growth engine to a cost center that must justify its existence.
The gap lies not in effort or execution. Over time, strategy narrows when teams work in isolation.
Why ‘More Headcount’ Rarely Fixes the Problem
When performance slows, the immediate response is often to hire more staff. This could be a new specialist, a channel owner, or someone in a more senior position.
While additional resources might alleviate workload, simply increasing headcount doesn’t usually solve the actual problem.
In my experience with in-house teams, three challenges are consistently present:
1. Tracking and Leadership Visibility
Often, leadership teams lack a unified and clear view of how paid media impacts pipeline and revenue. The data is out there, but it’s scattered across different platforms, tools, and dashboards.
Without strong integrations, even well-executed campaigns operate with weak feedback loops, which limits their potential for improvement.
2. Structure and Skill Ceiling
Many teams strive to adhere to proven best practices. The problem isn’t their intent but the context. What works for one company or growth stage can be ineffective, or even detrimental, for another.
Without external benchmarks or fresh perspectives, teams struggle to determine what truly applies to our business.
3. Lack of Systematic Testing
Daily execution consumes the available capacity. Teams focus on maintaining stability instead of driving performance forward. Testing becomes intimidating despite the fact that real gains usually emerge from the few experiments that succeed.
Over time, this creates an illusion of optimization: steady activity without significant progress.
The Same Mistake Happens Before Ads Even Launch
These structural problems don’t just affect companies already engaged in paid media. They often arise earlier, before the first campaigns even begin.
In many B2B companies, paid advertising becomes relevant when growth from outbound sales, partnerships, or organic channels begins to slow.
Budgets are cautiously allocated. Execution is delegated. Results are expected to spring forth from platform defaults.
What’s typically missing is strategic ownership:
Clear definitions of success that go beyond surface-level metrics
Tracking that ties spend to pipeline, not just lead volume
A testing roadmap aligned with revenue goals
Without this foundation, initial results are often disappointing. Budgets are cut. Confidence wanes. Paid media is labeled ineffective before it gets a real chance to show its worth.
Ironically, this early phase is where an external perspective can have the greatest long-term impact. It’s also the phase when companies are least likely to seek it.
The Structural Advantage of Outsourced Performance Leadership
Outsourcing is often seen as a cost-cutting measure or a way to boost execution power. In reality, its major advantage lies in perspective.
External performance teams work across various accounts, industries, and growth stages. They:
Identify patterns earlier.
Recognize when platform recommendations favor spend growth over business outcomes.
Challenge assumptions that internal teams may no longer question.
That outside view is crucial in areas like tracking architecture, platform integrations, and account structure, where partial adoption of best practices can subtly undermine performance.
A typical scenario looks like this:
Teams adhere to platform guidance but leave underlying martech gaps unresolved.
Systems fail to communicate effectively.
Optimization signals weaken.
Budget efficiency drops, even though campaigns seem fully compliant.
When Outsourcing Actually Works — And When It Doesn’t
Outsourcing isn’t a one-size-fits-all solution. It falters when companies expect external partners to improve performance in isolation, or when strategy and execution exist in separate realms.
It thrives best as a hybrid model:
Internal teams manage execution and business context
External experts provide strategic direction, structural adjustments, and continuous challenge
In this structure, partners don’t replace teams. They elevate them.
That’s why a specialized Google Ads agency offers the most value when our goal goes beyond running campaigns to transform paid media into a predictable, scalable growth driver.
A Smarter Model: External Strategy, Internal Execution
High-performing organizations increasingly separate strategy from execution volume.
We bring in outside expertise not because something is broken, but because we desire:
Objective assessments of performance and structure.
Stronger attribution and tracking foundations.
Disciplined experimentation frameworks.
Clear accountability at the leadership level.
This method builds momentum before budgets get cut, and not after results decline. It also helps leadership comprehend why paid media performs the way it does, thereby restoring confidence in the channel.
What High-Performing Companies Do Differently
Organizations that avoid prolonged plateaus tend to:
Consider paid media a system, not a standalone channel.
Invest early in clear tracking and robust integrations.
Welcome external challenges before performance drops.
Accept that most tests will fail, knowing the few successful ones will compound.
In this context, outsourcing isn’t about cost efficiency. It’s about maintaining strategic acuity as platforms and markets evolve.
Final Thought
The in-house versus outsourced debate oversimplifies a deeper question: who owns performance direction, and how often is it challenged?
As paid media platforms continuously evolve and automate, the companies that sustain growth aren’t those with the largest teams, but those with the clearest perspective.
Looking to expand your reach beyond Google Search? Demand Gen campaigns push your ads to ideal audiences across YouTube, Discover, and Gmail.
As someone deeply involved with Google Ads, I spend most of my time optimizing Search, Shopping, or Performance Max campaigns. It’s understandable, as the Google SERP is foundational to Google Ads. But there’s a significant opportunity within your Google Ads account that many overlook.
I firmly believe Demand Gen is the most undervalued campaign type in Google Ads, and this needs to change.
If you’ve been cautious about trying Demand Gen or have written it off due to past failures, consider this your nudge to incorporate it into your 2026 strategy. Demand Gen offers a transformative approach to using Google’s ecosystem for growth through paid advertising.
To understand Demand Gen, move away from a keyword-centric mindset. Think of it as running Meta (Facebook or Instagram) ads but leveraging Google’s platforms instead.
Where traditional Search campaigns react to a user’s query, Demand Gen focuses on the user themselves, distributing creative content—images or videos—based on user characteristics rather than their immediate actions or searches.
Demand Gen can place your ads on Google’s various “owned and operated” properties, including:
YouTube (Shorts, In-stream, In-feed)
Gmail
Discover
Google Maps (coming soon!)
I advise starting with all these channels activated but opting in or out of specific channels as desired.
While the Google Display Network is an option, it’s wise to prioritize Google-owned properties where intent signals are more robust.
In Demand Gen, targeting moves away from content and instead utilizes Google’s extensive audience targeting capabilities:
Lookalikes: Build audiences mirroring your converters, similar to Meta.
Remarketing: Re-engage past visitors or customers.
In-Market, Life Events & Affinity segments: Reach people based on interests or behaviors.
Detailed demographics: Target based on user demographics.
Custom Segments: Focus on search terms or websites/apps users frequent.
However, combined segments aren’t compatible with Demand Gen; you can only exclude your data segments.
Demand Gen supports a versatile range of ads: standard image ads, carousel image ads, and video ads. If you’re in ecommerce, integrate your Google Merchant Center feed for product-based ads.
Unlike Video campaigns, which aim for impressions or views, Demand Gen targets clicks or conversions using these bid strategies:
Maximize Clicks
Maximize Conversions
Maximize Conversion Value
Target CPC
Target CPA
Target ROAS
You must choose a conversion category, whether it’s a purchase or another action like a YouTube subscription.
What’s more, Demand Gen uniquely permits the Target CPC strategy, allowing control over CPC in a space dominated by AI-driven bidding. This manual control is beneficial for tightly managed budgets.
Demand Gen surpasses standard Display campaigns in several ways:
1. Inventory Quality:
It primarily serves on authenticated Google-owned properties, ensuring higher engagement compared to random web placements typical in Display campaigns.
2. Spam Reduction:
Higher audience and inventory quality reduce the likelihood of spam leads, a crucial factor for lead generation.
3. The Cost Reality:
While CPCs in Demand Gen often exceed Display, the quality justifies the price. Plus, it remains cheaper than Search campaigns, with CPCs typically between $0.50 to $2.00.
Demand Gen isn’t a black box; it provides transparent reporting similar to Performance Max:
Asset-level reporting: Analyze text, image, and video performance.
Audience insights: Understand who engages with your ads.
Channel segmentation: Control where ads appear (YouTube, Discover, Gmail) and tailor placements accordingly.
Placement reporting: Inspect YouTube placements to refine targeting.
Feeling ready to launch a Demand Gen campaign? Here’s my advice for structuring a test:
For smaller businesses:
With a tight budget ($5-40/day), go simple.
Targeting: Use your “Google Engaged” remarketing audience and a Custom Segment of top-performing search terms.
Why: Capture high-intent users yet to convert with Demand Gen’s cost-effective inventory.
For ecommerce businesses:
Creative reigns supreme! Run one Demand Gen campaign with and one without your product feed.
Why: Test whether product ads or lifestyle visuals better drive engagement. Results will reveal optimal strategy.
For larger businesses:
If budget allows, Demand Gen should be a strategic staple, not just a test. Treat it as an “always-on” layer for targeting specific audiences.
Targeting: In-Market, Life Events, Detailed demographics, Affinities.
Why: This approach keeps your brand visible and top-of-mind among your target audience.
In conclusion, Demand Gen stands out by bridging high-intent Search with social storytelling, offering superior quality over Display and cost-efficiency compared to Search. Will Demand Gen make it into your strategy this year? If growth beyond the search bar is your goal, it absolutely should.
This article is a part of Search Engine Land’s ongoing series, Everything you need to know about Google Ads in less than 3 minutes. Each edition, curated by Jyll, highlights a different Google Ads feature to maximize your results swiftly.
Have you ever imagined a marketing approach where the emphasis is on outcomes rather than just the tools? Let me introduce you to Genmark Flow, a groundbreaking concept in AI marketing that is more than just software; it’s a comprehensive service.
Genmark Flow is an AI Service as Software solution that delivers results through expertly managed growth strategies. This revolutionary system prioritizes delivering tangible results over merely providing tools. AI-powered and expertly managed, it ensures your marketing goals are not just met, but exceeded.
With Genmark Flow, you’re not only accessing cutting-edge technology, but you’re also leveraging a service that supports you in achieving your growth ambitions. Get ready to transform your marketing strategies and witness significant outcomes.
AI is changing search visibility, but I’m ready to adapt and thrive by unlocking the potential of my most underappreciated channel: email.
With AI reshaping the landscape of search, I’m learning how to reclaim my reach by tapping into owned audiences and transforming email into a growth engine that scales.
The rules of search have changed, and I can feel the impact on my marketing funnel. Despite pouring countless hours into creating compelling content and refining workflows, it’s frustrating to see my efforts wasted when my audience misses my work.
SEO is seeing diminishing returns, while AI-generated summaries are sidelining my branded content. Metrics reveal a reality I didn’t want to face: it looks as if my marketing team doesn’t exist at all.
Even with constant iterations and innovative ideas, the chances of my audience viewing my efforts seem to dwindle.
The new reality is that organic website traffic isn’t the steady stream it once was. With projections expecting a drop of 25% in search engine traffic due to AI, I must find alternative routes to reach my audience.
B2B SaaS companies, marketing platforms, and content-rich businesses are facing a structural shift, and so am I. My owned audience, like my email list, remains untouched by algorithmic changes and provides a reliable base for reaching customers.
Leveraging my undervalued channel means I have the power to control distribution, timing, and messaging, making email an essential component of my marketing strategy.
Email isn’t just a broadcast channel; it’s a precision tool. I need a disciplined approach to realize its full potential: targeted segmentation, optimized send frequencies, and clear performance benchmarks will guide my success.
To harness the power of email, solutions like Campaign Monitor offer AI-driven capabilities that treat email as the strategic asset it really is. I’m ready to utilize tools like Marketing Monitor to make smarter decisions, track real-time results, and consistently improve my campaigns.
The bottom line? Losing traffic to AI doesn’t just impact me momentarily—it threatens long-term competitiveness. I have two options: absorb the loss or pivot to a diversified strategy. Strengthening my owned audience and modernizing my email approach ensures I’m set to not only stabilize but grow.
In today’s ever-evolving landscape, brand-agency partnerships look vastly different than they did just a few years ago, and this evolution will only continue to expand by 2026.
I’ve noticed that internal marketing teams have become more sophisticated, digital channels are increasingly specialized, and the role of agencies shifts away from a one-size-fits-all approach.
Interestingly, the companies reaping the most benefits from agency relationships aren’t necessarily the biggest spenders.
Instead, those that succeed are clear about their specific needs and objectives.
Achieving clarity starts with understanding the true role an agency should play in your organization.
Too often, partnerships fail because expectations and responsibilities weren’t clearly aligned from the beginning.
When this foundational understanding is lacking, even the most robust execution can fall short.
Having worked with thousands of businesses across industries and growth stages, I’ve consistently observed that agency success falls into two distinct partnership models. These models are primarily influenced by company size and internal marketing maturity.
Model 1: Execution-first Partnerships for Large Companies
If your company sees over $50 million in annual online revenue, chances are you already have a capable internal marketing team.
Strategy and planning remain in-house, so what you need from an agency is deep platform expertise and exceptional execution.
At this stage, agencies function as specialist operators that activate roadmaps, optimize channel performance, and bring advanced technical knowledge that’s inefficient to replicate internally.
When performance dips, a powerful agency partner doesn’t default to tweaking tactics.
Instead, they help uncover whether the issue stems from execution, market conditions, or a strategic misstep, offering data to guide corrective measures.
Model 2: Integrated Growth Partners for Small to Mid-Size Companies
For companies under $50 million in annual revenue, the agency dynamic shifts.
Internal teams might be lean or still cultivating core digital expertise.
In these situations, agencies do more than execute; they shape your entire growth strategy.
An ideal agency acts as an extension of your marketing team, guiding platform selection, crafting cross-channel strategies, and more.
For growing businesses, this integration provides access to senior-level expertise, balancing speed, strategy, and financial constraints effectively.
Finding the Right Agency Partner
I’ve seen many companies approach agency selection improperly.
Ditch the RFPs
Large companies often rely on the request for proposal (RFP) process, which tends to favor vendors skilled in documentation over performance-driven results.
Instead, I recommend using your professional network. If you’re in charge of a large marketing department, you likely know several professionals who can provide referrals to standout agencies.
Smaller businesses should seek advice from peers about reliable vendors, then check reviews to confirm their findings.
While no agency is perfect and all will have some unhappy clients, patterns of negative reviews are a solid indicator to avoid those agencies.
Request an Audit
Upon narrowing down potential partners, I suggest asking for an audit of your current marketing setup.
Most digital marketing agencies conduct these audits for free, offering honest and constructive feedback.
Depending on your company’s size, audits might vary, with larger firms focusing on specific platforms and smaller ones requiring full-funnel evaluations.
This information helps evaluate how the partnership will integrate with existing processes, paving the way for effective collaboration.
The selection process inherently includes finding partners that mesh well with your internal processes—critical to long-term success.
Setting Achievable Goals
After selecting an agency partner, the next step is defining coherent goals aligned with your business objectives.
Unfortunately, I’ve observed that many leaders set goals disconnected from their business aims, straining the agency relationship from the get-go.
A robust agency questions your goals pre-contract, urging you to adjust expectations realistic to your context and aspirations.
Your chosen partner should grasp your business’s economics and help ensure marketing goals are aligned with broader business objectives.
Maintaining a Productive Partnership
Once everything is underway, you must keep your agency accountable, which involves regular reviews and tracking progress against initial audit benchmarks.
Contract Length
Large enterprises often sign 12-month contracts for stability, but smaller firms might benefit from a more flexible three-month commitment that auto-renews.
In cases where everything seems perpetually smooth, consider that growth might be stagnating, as healthy conflict is a sign of challenge and progress.
Ongoing Accountability
Regularly reviewing opportunities against your agency’s initial audit findings not only keeps progress on track but also provides vital context for adapting strategies.
Context is key, especially if your industry’s dynamics affect your agency’s work—awareness of broader market trends is crucial for realistic appraisal.
Innovation and Testing
Your agency should consistently suggest fresh ideas, especially for smaller businesses, while larger companies should fund dedicated innovation budgets.
Effective agency partnerships without innovation risk falling behind competitors more willing to explore uncharted avenues.
Ultimately, understanding what’s upcoming and strategically positioning your business will keep you competitive.
When to Make an Agency Change
Occasionally, a brand-agency partnership doesn’t thrive. Trust your instincts if you feel things could improve or something is amiss.
Your Business Isn’t Growing
Marketing should focus on acquiring new-to-brand customers. If growth stalls while your industry maintains, it’s time to reassess your agency’s role.
Your Agency Isn’t Pushing Innovation
If new ideas aren’t forthcoming or you’re not exploring novel methods to engage customers, seek an external audit to identify gaps.
Your Agency Can’t Explain Performance
An inability to contextualize performance suggests a knowledge gap in your sales funnel, where interconnected activities impact overall success.
For smaller businesses, agents should grasp comprehensive marketing operations and how various elements influence each other.
The Marketing Reality Check
Great marketing can’t compensate for a flawed business model. Successful growth stems from the synergy of good business, leadership, and agency collaboration.
If any component is lacking, marketing falls short of potential. Meaningful growth arises when agency roles align with specific business needs.
Agency selection is an ongoing journey involving ongoing dialogue, accountability, and refinement, even when this involves constructive disagreements.
Today is a monumental day for Dylan and me, as we are overjoyed to announce that Profound is opening its very first UK office in the vibrant city of London.
The addition of this office marks an exciting chapter in Profound’s journey, representing a significant step forward in our pursuit of global growth and innovation.
This expansion is not just a testament to our dedication and hard work but also to the incredible support from our clients and partners who have believed in our vision.
With this new location, we’re eager to bring our expertise closer to our UK clients and partners, ensuring we continue to offer exceptional service and support.
Ever felt like you’re drowning in growth hacking tips and conflicting strategies? As a B2B SaaS founder myself, I understand the overwhelming feelings that come with managing marketing efforts. Let’s explore why these strategies often feel like dead ends and find a framework that promises sustainable growth and actually works.
It’s no wonder that many of us find ourselves caught in a maze of complex advice. Juggling multiple recommendations can leave us bewildered and unsure of the best path forward. But I’m here to share insights that can help us break through the chaos and achieve tangible results.
I know firsthand that effective marketing isn’t just about trying every new tactic out there. It’s about discovering the strategies that align with our business goals and resonate with our target audience. By focusing on what’s truly crucial, we can build a growth plan that stands the test of time.
