A decade of steady growth for a multi-location orthopaedics practice

The challenge

Alexander Orthopaedics has been a Big Sea client since the agency's early years. What started as a single-market practice has grown into a six-location operation serving patients across the Tampa Bay region, with a strong reputation in sports medicine and orthopedic surgery. That growth didn't happen by accident.

Sustaining growth at this scale requires paid media that can do several things simultaneously: maintain consistent new patient acquisition across established locations, launch new offices into markets where the brand has no footprint, activate sponsorship partnerships with professional and amateur sports organizations, and do all of it without cannibalizing campaigns that are already working. For a practice operating on a modest paid media budget spread across multiple locations, that's a difficult allocation problem.

When Big Sea launched Cordelia Labs as its dedicated paid media arm, the Alexander Orthopaedics account transitioned with it. The strategy and creative foundation stays with Big Sea; paid media strategy and execution runs through Cordelia Labs. That integration is a meaningful part of why the program works.

The approach

The paid media strategy for Alexander Orthopaedics operates on two tracks simultaneously. The first is always-on demand capture: geo-targeted paid search campaigns running across each service area, built around high-intent orthopedic and sports medicine keywords. Campaign structure is location-specific, with distinct campaigns per market so that budget, bidding, and creative can be optimized independently. The "Move Pain-Free" campaign framework, tested and refined over several campaign cycles, has consistently produced above-benchmark CTRs — reaching 10.67% year to date in 2026.

The second track is activation: launching new offices, promoting sports partnerships, and running campaigns tied to specific services or seasonal demand signals. When Alexander Orthopaedics opens a new location — most recently in the Sarasota and Bradenton markets — Cordelia Labs builds geo-targeted awareness campaigns using programmatic display and digital out-of-home (DOOH) via StackAdapt, placed in the physical corridors where prospective patients live, work, and spend time. For sports medicine, that has meant targeting audiences around golf courses, pickleball courts, and athletic facilities with creative built around sports injuries and recovery. Sponsorship activations with MLB and PGA partners extend brand reach into high-visibility contexts that reinforce the practice's positioning as the go-to provider for active adults.

Throughout, paid media creative is built on the content and brand assets produced by Big Sea — physician-led videos, patient testimonials, condition-specific landing pages — so that paid campaigns land in a context that converts. That coordination between the media strategy and the content strategy is what allows the program to keep improving efficiency year over year rather than plateauing.

The results

A decade of consistent investment has compounded into a market position that competitors have struggled to close. Alexander Orthopaedics leads its competitive set in organic search rankings — with more than double the ranked keywords of its nearest competitor — and paid media has played a consistent supporting role in holding and extending that lead. In 2024, organic appointment bookings grew 130% year over year. Year to date in 2026, paid media is driving a 27.9% increase in appointments booked, a 24.5% increase in total users, and a 10.67% CTR that is up 37.3% versus the prior year.

Each new office launch has followed the same pattern: targeted awareness campaigns in the weeks before opening, paid search capturing demand from day one, and programmatic display reaching sports-active audiences in the surrounding area. The practice now operates six locations across the Tampa Bay region, with paid media infrastructure in place to support the next one whenever it comes.