The first place healthcare consumers go to find a provider is Google. Having an SEO strategy is no longer optional if you want to grow your healthcare organization.

Hosted By:

John McAlpin, SEO Director, Cardinal Digital Marketing
Alex Membrillo, CEO, Cardinal Digital Marketing

Watch the Recording:

Quotes From the Webinar:

“Technical SEO is the foundation of all SEO, content is the meat, and link building is the cherry on top. All three of them work hand in hand to help accelerate your or organic performance.”

“They say content is king, but link building’s queen because link building is what tells search engines that you’re worth going to. It provides authority. If you’ve ever heard of EAT – expertise, authority, and trust – that’s all coming from link building. It shows how popular and trustworthy you are, and it drives referral traffic and brand awareness. All three play a vital role with each other and should be done at the same time.”


Read The Transcript:

Alex Membrillo: All right, looks like we’re live. What’s going on everybody? All right, give everybody a second and we’ll do some fun housekeeping stuff or, as we call here, Cardinal nest keeping because where I’m at here, at the nest. All right. I got Kat. Hey, Emily, what’s going on? This is our highest registered program we have ever had. John, everybody’s here to see you. We have done a number of webinars over the years and this is the highest register so clearly, everybody’s got some SEO grapes, [laughs] they want to know about. [sighs] This will be fun.

Well, welcome, everybody. I’ve got– Hey, Julie, hey, Becca. What’s going on. All right, so head over to the chat, guys. You’ll notice over there on the right, you got a chat meter. I don’t know. A chat meter’s a– I think that’s a listing service or something. I don’t know I’m getting my SEO confused. Ask any questions you want in there, ask any questions you want there. Hey, Anita. We’ll make sure to answer them as we go through.

As you guys know, you’ve registered for a live SEO on it. We picked three, we’re going to go through three, one for technical, one for on-site SEO, one for link building, but that does not mean that we will exclude your questions. I want to go through your questions as we go through it, and I will say this. I’ve seen the audits, and the things that John points out apply to every site, just about every site we’ve ever audited when prospective clients come to us. Everything, we’ll go through. Even though there are three specific instances of high-performance healthcare groups that we’re going to go through, these suggestions can apply to everyone, so stay tuned, stay engaged. Ask questions in here, I will butt into whatever John’s saying and ask your question if I feel like it’s relevant.

In fact, let’s get things going. First person to ask a question in there, we’re going to send a $100 Amazon gift card to. I’ve got Kat in here, and she’ll send an amazon gift card. I’m going to keep a lookout for that. Polls, I’ve got a poll open. Have you conducted an SEO audit before? I’d love for you guys to go over to the polls. I know everyone’s tired of polls since last November, but if you don’t mind doing it one more time, we got 100% no on the SEO audit. Remember, $100 Amazon gift card coming at you. You can take the gift card to space now, you can take the gift card to space. [laughs] John, what do you think? Where did they take off from? Was it Texas or Florida? Blue or orange [crosstalk]

John McAlpin: I didn’t watch, but I know they didn’t go all the way into space and they got trolled pretty hard from Elon Musk.

Alex: Richard Branson even less went into space, but listen. This is how I define space. If you can see Earth, you’re in space. [laughs] They can see Earth, they can see Earth, they can see the sphere of Earth, so we’ll qualify that as space. All right, guys. We’re going to have a lot of fun. Nobody wants a $100 gift card from Jeff Bezos himself. Okay, go ask some questions over there in the chat. I’m keeping an eye on it.

John: SEO-related questions.

Alex: Yes, it has to be SEO. Well, they can’t be asking me my middle name or anything like that. I’d prefer that. All right, we’re all good to go, guys, so we’re not going to waste any more time. Oh, Matt. My man, Matt. Okay. “Our low quality backlink’s a huge concern for SEO. Should they be disavowed?” I’m going through that right now for the Cardinal site. What do you think, John?

John: I’m going to give the classic SEO answer, it depends. What is it? Are they linking schemes? Are they just small local sites? Did some link tool just tell you that they were low quality? It depends. If they’re just a local directory, I wouldn’t disavow them. Google’s gotten pretty good at knowing what’s spam and what’s not, but if it’s truly a spam private blog network or a linking scheme, yes, maybe. It also depends on the ratio of how many links you have total. If you have 100 bad backlinks but you have 100,000 total links, it probably won’t make a difference.

Alex: Well, generally, if you just have a ton of bad backlinks, you should be doing this at least twice a year. Go through all your links and disavow. It should be a regular part of the SEO program. Google’s not counting a ton against you, but if you have a maleficent competitor, they could do a bunch of stuff. Julie, lots of spam stuff is low quality backlinks. All right, we’re going to get into it. They have low domain authority, et cetera. I’ll send you– We’ve probably got an article. Kat, let’s get an article up on low quality backlinks when you got a second. Matt, $100 coming at you. Let’s start the presentation. Let’s see if it starts, I trust technology very little.

All right, I’m closing the poll by the way. Have you conducted an SEO audit before? Most said no. I think only four responses. Have you conducted an SEO audit before? The majority have not, so this is fun. Your agency, if you ever reach out to agencies, they do them for free for the most part. I don’t know, maybe they’re charging now because agencies are busy. All right, guys. I’m the CEO of this place, so it’s all my fault. It started being my fault 12 years ago and we’ve got John online who we’re going to get into his background.

You have the best technical SEO wizard in the world on the line today, who’s going to be going through your site. I can’t speak highly enough, but I will try here momentarily. A little bit about the agenda. Three pillars of SEO, what makes up SEO, what are the core pieces to it. Then, we’re going to go through a technical audit, a content audit, and link building audit. If you didn’t know what the three pillars were, [laughs] there. We just went through them, didn’t we?

Technical, we’re going to look at what makes up the site, the key things on the site with how it’s coded to how it’s displaying to how quick it is, and then on-site content, what makes up the keywords on your website and how well it’s shown at Google, and then we’re going to talk about link building, which is signaling to Google that you are the coolest cat in the room and deserve to be number one.

All right, so a little bit about Cardinal, then we’re going to move on. That’s our fun flock over there. We are not all things to everyone, but we are one great thing to one great type of client. We are hyper, we are performance marketing team for a high-growth healthcare group. If you’re looking to scale locations providers, and you want to do so through performance marketing, we are here to help. We have staked our flag into the ground on that and have lots of great clients, about 40 people and growing quickly. Can’t find them fast enough, market is incredibly competitive, but still growing quickly.

Like I said, started 12 years ago, very proud. Lots of great clients on the roster. We helped everything from dermatology to behavioral health, addiction, orthodontics, senior care, senior living, hospital groups, you name it, we’ve helped it and you don’t have to be 400 locations. In fact, one of our groups we started with 1 regional group, helped them grow to 20 regional groups and 4,000 clinicians, 300 locations around the country, and they just rang the bell on the Nasdaq last week, very exciting. That’s LifeStance Health.

John is the man with the plan. He’s actually the one that spearheaded all the growth online. Big thanks to John, and we love helping patients find the right providers. Not the right now providers, we’re very serious about only taking on the best medical groups in the country. Love, if you have any questions, you can send them over to John here or after the fact. Let me go back to the chat and make sure I’m monitoring for any questions.

Like I said, John has been in healthcare market for quite some time. I’ve seen him speak at national conferences, I’ve flown around and actually see him speak. He writes for Search Engine Journal, and all of those clients that you saw up there, he is the one that helps take them not from zero to hero but from good to great, I would say, to hero. They don’t start at zeros because they’re coming to us, and we like to make sure that they take off from there. John is absolutely brilliant, you guys are in for a treat. John, welcome to the webinar. Let’s take it away, my friend. What are the pillars?

Pillars of SEO

John: Let’s do it. I think one of the best visual representations of the pillars is actually created by Moz. Anyone with the slightest experience with SEO has heard of Moz, great educational resource, and they broke up the pillars into several stages, but let’s talk real high level. There’s technical SEO is the foundation of all SEO, content is the meat, and link building is the cherry on top. All three of them work hand in hand to help accelerate your or organic performance.

However, some people say, “Okay, what ranking factors matter more than others?” In reality, when it comes to the pillars, it’s a chicken and egg paradox because not one factor is more important than the other. When we’re actually looking at this, they all work together and you’re going to crumble if you don’t have all three. Let’s talk about it in depth for a minute.Ranking Factor Paradox

Technical SEO is what allows a search engine to discover your content, find relationship between content, and basically be able to crawl and render and index your web pages. Without technical SEO, your content and link building efforts are for nothing. Now, content, it’s pretty straightforward. Without content, people don’t know what they’re ranking for, users don’t know what your site is about. Content is king still, and always will be. Without those two, there’s not much to go on.

Link building is still a big player. They say content is king, but link building’s queen because link building is what tells search engines that you’re worth going to. It provides authority if you’ve ever heard of EAT, expertise, authority, and trust, that’s all coming from link building. It shows how popular and trustworthy you are, and it drives referral traffic and brand awareness. All three play a vital role with each other and should be done at the same time.

Alex: Big update just came out from Google on Core Web Vitals over the last few months. If your site’s slower, loading poorly on mobile, bam, getting hit, and you probably noticed it, not fun. All right, let me minimize this again.

John: Let’s talk about our approach and how we look at a real audit. When we’re building that website, either you’re starting from scratch or you’re getting a new site that’s existing, we always start from the foundation, just like that pyramid structure. Look at the technical SEO and make sure that the site can be crawled and indexed. Next, we look at the content and make sure that everything’s in order, because before we go to link building, we need to give someone something to link to, make sure our content is link worthy.

We work and make sure that our content is targeting the right keywords, that it’s in depth, that it’s providing great value to users, and that we’re achieving what people are searching for, what they call search relevance. Then from there, we try to promote it through link building. Then you repeat, you go back through every six months we do a new technical audit, new link building audits, and content audits to make sure that our efforts are actually working, because we don’t want to keep doing the same strategy if it’s not working. You always got to go back and redo your audits.

Let’s dive into the first audit. We’ve broken up, for each of the three pillars, we’re going to do a different website. For technical SEO, we’re going to be looking at Neurology Consultants of Dallas. When I’m looking at a technical audit, the first thing I do is use a couple of tools. Now, let’s get something out of the way. There’s a lot of SEO tools. There’s some free tools, there’s some paid tools. You can have all the tools in the world but unless you know what questions to ask, tools are useless.

You need to know what you’re looking for. Tools are a means to the end. You’re not going to get a hammer expecting to build a house. Just like that, you need to make sure that you have the right questions in place. Let’s talk about a couple free tools and the questions that we’re asking and what these free tools can tell you. We know that having a mobile-responsive site is a ranking factor. Google crawls is now only crawling the mobile version of a website. If your website is not mobile optimized, you are not going to rank well.

Is my website mobile friendly? Well, Google has a free tool. You just Google “mobile-friendly test”, and you can just enter any webpage on your website and it’ll tell you if that web page is mobile-friendly. Now, quick note, it’s not your whole website, it’s each URL at a time, but it will tell you if it’s mobile-friendly or not. Another free tool is, “Is my website fast?” Just like Alex mentioned earlier with Core Web Vitals, web speed is really critical.

If you look at PageSpeed Insights, and there’s some other free tools out there, but what Google’s using is lighthouse to find that. Search PageSpeed Insights, and that’s Google’s own tool. Put in your URL, and it will tell you not only on a scale of 1 to 100 how fast your website is, they’ll even give you some tips on what to optimize to make your site even faster. Another thing that I look at when I’m going through websites, especially when I’m doing sales audits, is I want to know what technology a website is using. If you look up Wappalyzer, that is a free Chrome extension that you can add to your browser, and you can look at any website and see what technology they’re using to see what they’re using for analytics.

If they’re using a chat feature, you can see what chat program they’re using, all kinds of stuff. You can see that, “Oh, this website is using WordPress,” so I know a couple of things to look for. If I know a site is on WordPress, I know some common technical SEO things to check for to make sure that it’s optimized, and that’s true with a lot of different things. This is really critical for making sure that our site is optimized and we know what technology they’re using.

Alex: Is more technology good or bad?

John: Typically, the more tools that you’re using and more plug-ins and things like that you have on your website, typically, that can lead to slower web speed, but things can be mitigated and optimized. Again, like anything in SEO, it depends.

Alex: You got to love it. John pointed out this morning to me that I had a bunch of tags still on there from previous programs and technologies we were running, that we’re slowing now because they’re still loading but we don’t use anymore, and helped speed up our site. John doubled our site speed this morning with this [unintelligible 00:14:22] double Cardinal’s site speed this morning. He’s so good at this, but yes, one of the things he told me is go in and get rid of some of this stuff. Matt’s would love to hear some of those common WordPress tips, John.

John: Well, I’ve got some articles out there for you. Maybe we’ll drop some in the chat. One of the things that and I’ll go through some of those, too. Since this is a WordPress site, we’ll look at some of the common WordPress themes. Now, again, like Alex said, that’s why we’ve routinely audit our own sites and our clients’ sites, to make sure that we’re still using everything that’s getting deployed.

If you haven’t already set up Google Search Console, if you go to Google Search Console, you can get Google to look at your site. You can track your web, your organic performance, look for technical issues. For example, we want to know if your site has been penalized in the past or has any indexing issues. In going to Search Console, you can find that. Now, I don’t have access to this website Search Console, so I just showed an example. This is Cardinal that I can see. If you go to have manual actions here since we’ve got no penalties on the site, but you never know unless you get set up Search Console. This is a free tool that Google puts out. If you don’t have it, you need it.

I hope those tools are helpful, but the first thing we want to look at now we’ve got those tools out of the way is I run a crawl of a website. I’ve got some crawling tools that I use out there. I use a combination of Screaming Frog and Sitebulb for different reasons, but I’ll look at the site architecture. Now, when I talk about architecture, I’m talking about what your URL structure is and how different pages linked to each other.

Now, this is my favorite analogy. If we’re talking about a website architecture, this is one of the most critical factors of technical SEO. Now, your website, think of it, your website, like a grocery store. When you go into a grocery store, each part of each food item has an aisle of a category and within that aisle, there’s multiple categories. Let’s say you’re going into the frozen aisle. You’ll have dinners, frozen fruit, frozen vegetables, and it can all be in one aisle but different sections, and then within each section, you have different brands and different types of vegetables, maybe.

Think of your website the same way. When Google goes to your site, it has all these labels and signals all around to tell where each thing lives and the relationship between it. The more often Google goes to your site, the more efficiently it will find that information because it knows where to go. Just like when you go to the grocery store, you go to a new store the first time, it may take you 30 minutes to get through it and find everything you need. The next time, maybe it takes you 25 minutes or 20 minutes because you already know where everything’s located. Google’s the same way with websites.

When you’re looking at your web architecture, the key is two rules. One, stay organized, and stay scalable. When you set up your website, you want to make sure it’s easy to add new products, pages, whatever it may be, and make sure that it’s easy just to slide it right in and you’re not trying to break your site to make it fit. This is what a web architecture might look like. This is a visualization of Neurology Associates of Dallas. Now, each of these little green dots or nodes represents a page on the website. If it’s green, that means that Google can crawl and index that website. If it’s red, that means that Google is not able to index that website.

What we’re looking at here also is a couple of these little what we call content silos. If you look at a content silo, I squared them out right here and showed what they’re all are with some provider pages. Oh, look at this down here on the bottom. We see a bunch of non-secure versions of the website that are out there, meaning that the URL is HTTP and there’s no S, there’s no security certificate on that. We have service pages, old doctor pages. One of the key things that stood out to me other than the non-secure version was a lot of these old doctor pages are being actually redirected, which is why they’re not indexable. There’s a lot of technical issues here.

What we really want to see here is turning something like this on the left into something like this on the right. On the right, you can see that the content silos are a lot more clean and organized, everything’s in the green, and that the site is really well-indexed. Now, this looks pretty at all, but what does this mean for you? What this means is that Google is going to have a much easier time getting through your grocery store and getting their groceries in order. Anytime you update content or add new content, it’s going to be discovered faster and indexed faster. When we have a great foundation like this, all of our content and link building efforts, you’re going to get performance boost much faster rate than at the original state.

Let’s talk about a couple of more nitty-gritty stuff that I noticed. We’re seeing redirects in the site architecture. Now, a redirect is simply when you click on a link and your browser tries to load that page, and it sends you to a different URL. We’re noticing that there’s clickable elements here on these doctors’ pictures and the view provider buttons. Why is this bad for SEO? It’s because when you redirect, you’re not only creating a longer load time, but you’re also sending mixed signals to Google about what pages are important. You’re messing with your internal page rank.

Now, Google’s come a long way with improving how they handled redirects, but our goal is to not confuse Google, but to provide as many clean signals as possible. Our recommendation is to switch those out with direct links. Another issue here is if you look at the CTA down here, all of these links where there’s the icon or the links here are leading to non-secure links. If you just simply add an S to the HTTP, that will secure up the link. Now, this is a security vulnerability, and could lead to a site getting hacked but also, again, sends mixed signals to Google, linking to non-secure versions of your website. That was a quick and dirty overview of a technical SEO audit, very simple stuff.

We look at the site architecture and we look at a number of different factors. Now, when Cardinal does technical SEO audit, we look at over 100 technical factors and we come up with a game plan on what we think is going to make the biggest impacts the fastest. There are a lot of factors out there, and some free technical SEO auditing tools can help you break down what to work on. Now, whether you can fix them or not, it really depends on how web-savvy you are, your level of webmaster skills, if you can code. There’s a lot that goes into it. Some fixes are easier than others.

Alex: Hey, John, real quick, we’ve got a couple of questions since we just went through the technical stuff. Thank you to Neurology of Dallas. Very brave. I’d be nervous to put my side on there and have everyone in the healthcare community pick me apart. Thank you to them and St. Charles Spine. John Perez asking, “Not sure what you mean by switching to direct links. What do you mean that? Avoiding the redirect chain? Is that what you’re referring to?”

John: Yes. Let’s say you click on link A and it redirects you to link B. Instead of linking to link A, swap out that link just as redirect B. Just go to the final destination. You’re skipping a step there. Directly to the final destination as opposed to that redirected page.

Alex: Yes, avoiding those redirect chains. Anita’s asking, “What’s the best way to deal with a lot of 301s, make a spreadsheet?”

John: Yes, spreadsheets. Typically when we upload, we export them into the spreadsheet and see where they’re linking from. Oftentimes, you’ll notice that sometimes your redirects are coming from a global element, meaning that– Say your footer or your main navigation menu. If you fix it in one spot on your website, it can fix it throughout the whole website, that’s if you’re lucky. If you’re not lucky, you got to do a lot of manual work going to page to page, uploading, or changing links, swapping them out. That’s typically why a lot of people will defer out to agencies to take care of that manual lift for them, because it takes a lot of time.

Alex: We’re the muscle. Let us do the stuff you don’t want to do. Bailey Johnson asking, “When is it necessary to invest in paid SEO tools? Are the free ones enough?”

John: In the end, it depends on what questions you’re trying to answer. A lot of the free tools out there will give you the high-level stuff, give you some quick wins, but they don’t really give you strategy.

Alex: If you have one SEO tool, what would it be?

John: Depends what you’re trying to do.

Alex: Oh my God, John, just give me an answer. It’s like [crosstalk]

John: I know. There’s no easy answers here, but if you’re looking for you’re all-in-one suite of tools, SEMrush is a good one, because you can do your audits, your link research, your competitor research, your keyword research. If you had money for one tool, SEMrush.

Alex: Okay. I would agree. That’s what I would use too. Search Console for the free. It tells me everything I need to know.

John: Your all-in-one is SEMrush.

Alex: Anita, John, Matt. Matt, no, this one. John, Anita, Bailey we’re sending out $100 gift cards to Amazon. Take them to space. All right. Thanks for asking questions. Okay. Let’s get to St. Charles.

John: All right. We’re going to look at some content and on-page opportunities for this website. When I’m looking at content, I want to see how many keywords you’re ranking for, the variety of keywords you’re ranking for, and how high you’re ranking. We’re looking at this top chart here at the top of this page where it says “Organic Keyword Trends”, and this is something you can actually find in SEMrush. Each of these little colors represents what position you are, whether you’re in the top three positions, positions 4 to 10, 11 to 20, and so on.

What I’m seeing here is for the past year, you had a slight boost right before December, and then you’ve been at a plateau for a little while, which means not a lot of updates have been happening, not a lot of variety. It means we need to shake it up, add some new content, change up some content, and improve rankings. We’re also noticing that you’re primarily ranking for provider-based keywords, not necessarily service keywords. The reason for that may be that your service pages are a little bit thin and not super competitive. We’re going to talk about some opportunities there.

We did some readability analysis through some tool to see how easy it is to read your content, and it’s fairly difficult for the average user. Especially in healthcare, you have to ride that fine line between using clinical language and patient-facing language. It’s a very tricky thing in healthcare that we deal with a lot, is helping with content. Headings are really important. That can be the big titles on your webpage. Believe it or not, those are actually coded differently and send different signals to Google, so optimizing your headings is really, really important, and it’s a really big on-page factor for ranking.

We’re also seeing very little internal links. Linking to other pages is very important signal for telling Google which pages are related, how important are certain pages, and it also helps users navigate your website. There’s a lot of big opportunities on your location page that we’re going to get into. Let’s talk about that, those heading structures that we were referring to. If we’re looking at here, this breakdown at the top where it says H1 and H3, H1 tag, the general rule of thumb is to have one H1 tag on your page, and that is your main title of the page. What it should say is what this page is about. It should include your main keywords and give the users and search engines an idea of what to expect on this page.

Page Heading Structure

This says, “Minimally Invasive Spine Surgery.” To me, I think that’s pretty straightforward. It tells you what it’s about and what to expect on his page. I expect as a user to learn what you do, what that’s about, what I can expect there. Then what I see as the other heading on the page are our services, patient education and patient forms. It doesn’t break into the– It’s not actually picking up the actual section titles on this page because they’re bolded as opposed to like maybe an H2 tag.

The other rule of thumb is that you want to have a natural breakdown here. Instead of going straight from H1 to H3, you want to have an H2 or something in there to break it up a little bit and have that natural tiered approach. This is important because people uses these actual heading signals as for keyword targets and to know what this page is about. It also makes it a little bit more readable for users when they’re scanning through your page, because they pay attention to those headings because they’re more eye-catching.

Additionally, these are fairly thin and I would recommend adding some more commonly searched questions. One of the best keyword research tools out there is Google itself. When I searched minimally invasive spine surgery, I get this little feature right here called the “People also ask”, and these are some of the keywords you’re not going to find in keyword research tools either because they’re so new and trending that they haven’t gotten there yet. These are the long tail questions you want to be answering that a lot of your competitors aren’t answering.

If you can ask these questions on your page, post the question in a heading, answer it with robust content, then you can start to outrank your competitors and actually help your patients make that decision, and these can be the difference between a patient discovering your site and actually booking an appointment. Now, let’s talk about internal linking. An internal link is really important and that’s when, not just your menu, but it’s when you have content and you highlight some content and a little, maybe a couple of words, and you make that a link. Those words are called anchor text. Then that anchor text is a signal for Google about what that page you’re linking to is about.

Let’s say I’m talking about lumbar disc microsurgery, and I mentioned something about other forms of surgery, like minimally invasive surgery, and then you can link to that page. That tells Google what that page is about. It also sends signals about how important that page is. Google looks at internal linking a lot, and it’s one of the most critical on-page signals along with heading structure.

Now, here’s your biggest opportunity for ranking, your location page. Let’s take a look at where you’re ranking for general surgery keywords in your area. This map at the top of the computer here is an actual geo map of where you’re located and how well you’re ranking outside of your area. In your immediate vicinity, you’re ranking at position one. That’s because of your location page. It tells Google exactly where you’re at, and it also depends on how well your citations are optimized. Due to the lacking keywords and optimization of your service areas, we’re not seeing you rank very well outside of your area. Everyone knows that for surgery, people will travel a fair distance for the right surgeon.

Let’s talk about some opportunities that we can take from this page. Right now, your heading is “Proudly Serving Thousands Oaks, California”. Now as a search engine, my question would be, what are you serving? Your H1 should tell me exactly what your core service is in that area. I would recommend something like “Proudly serving the patients or surgery in Thousand Oaks, California” and something a little bit more specific to your services. You need to have your key focus area, plus a geo modifier. When I say geo modifiers, typically like Thousand Oaks surgery centers, something like that, where you have your focus keyword and a geography term. Additionally, there’s no long-form content here on this page, and having robust content on your location page can help you outrank your competitors locally. Some content ideas could be about the types of services you offer in that area. Briefly, you don’t need to repeat your service pages, but just briefly cover the services you offer, maybe some testimonials on your page.

You even include images of your facility because images on your location page can dramatically improve your conversion rate because people can go and see, “I’m going to get surgery and it’s preinvasive. I want to know that I’m going to a state-of-the-art surgery center.” If you can show pictures of your center and it looks really clean, really great professional photography, that can make the difference in conversion rates.

Alex: John, what tool did you use to do that mapping thing?

John: This is a tool called Local Falcon. What it does is it connects to Google My Business accounts and sees how well they rank. It can also tell you some of your top ranking average competitors.

Alex: That’s pretty cool. Our clients love that. I know you use some of it. Christina Doe asking, “Should you just answer the questions that show up in a Google search in your content, or would it hurt you to use one of those questions in your content because I guess some duplication and stuff? What do you think?”

John: I would want to make sure that those questions are answered in a variety. Sometimes those questions, it may not make sense on the service page but it may make more sense because if it’s a really deep question and has a lot of complex answers, it may make sense to use it as a blog and answer it more in depth there. It depends on what you think it is.

Alex: What about FAQ schema? What about putting in– It’s not showing up anymore isn’t it?

John: There’s some. I like to include, especially on my service and conditions treated pages, an FAQ section at the bottom, and I’ll allude it to something called FAQ schema, which is a accordion-style feature that can show up in search results. FAQs are really great for those specific ones. I do look at the people who also ask for those FAQ ideas.

Alex: That’s a good question. I don’t think it’s either-or, I think I create a blog article all around it but then I probably weave it into on-page content to answer.

John: Then, you can just internal link to that blog.

Alex: Yes. Yes. Christina, question of the day, $100 Amazon coming at you.

John: I want to answer that question a little bit further.

Alex: Okay.

John: I will say one tool that’s better at keyword research than Google is your actual patients. If you’re the provider, talk to whoever’s answering the phone, booking appointments, find out what the difference is between someone booking an appointment and not. A big one in healthcare is insurance. Maybe your location page has a section about the insurances that you accept.

That can improve the quality of your leads coming in so that you’re reducing your phone calls but improving the amounts of phone calls you get to the actual win rate. Find out what your patients’ [unintelligible 00:32:53] are. Maybe it’s a complex purchase decision or acquisition decision. Find out what their key barriers to entry are and try to answer that on your website, and make that answer to that question and answer easily found.

Alex: Very good. Very good. Something else came to mind. If you have call tracking from your paid search campaigns, listen to how people are taking the calls and the big questions. Like before they hung up, what pissed them off, and that’ll give you stuff to answer on the website. Guys, I just posted tips for creating location pages for your medical and multi-location medical groups so check it out in the chat if you want to– Don’t read it now though, we’ve got to listen to John, but read it after, read it after.

John: Right on. Let’s talk about link building. This is one of the toughest and one of the most competitive areas of SEO. The reason for that is it’s pretty much a lot of data involved, it’s a lot of finesse, it’s relationship building, and sometimes it’s a quantity game where we’re trying to reach out to a lot of people. Let’s talk about what link building is real briefly. Link building is a process of getting another website to link to your website.

The hard part oftentimes is not just finding who it is, it’s getting something worth linking to. It’s cracking that pitch and convincing some why they need to link to your site. A good example is you maybe create a bunch of– you do a lot of research and a bunch of independent studies, and so people are quoting your studies in their information, in their articles. That gets really difficult for a lot of local businesses, to find something worth linking to.

That’s why people usually work with creative agencies to find out what content should I create the link to, and how do I make these relationships, how do I do outreach? That’s why they work with SEO agencies that do that for them. Let us take the heavy load. We’re going to be looking at Brook Lane. Now, one of the low-hanging fruits of any kind of local business, whether you’re a service area business or you serve people directly at your location, is listings, citations, directories.

There’s a lot out there and there’s a lot to link to. There’s some big guys like Google My Business, Facebook, Yell, and then there’s some more niche-specific directories where it’s like if you are a senior living center, there may be some senior living directories like A Place for Mom or something like that, where they’re really industry-specific ones. Now, you could go create a profile on all of these and list your business yourself, or you could work with an agency to do that for you, or you could use a tool like Yext or BrightLocal or Whitespark, there’s a lot of free tools. Free or paid. A lot of paid tools out there.

Oftentimes, working with an SEO agency gets you agency-level discounts. There is a benefit to working with agencies. Also, we optimize your listings because when you go to these listings, there’s a lot of information out there that you can add, a lot of rich information like keywords and services you offer, descriptions, images, and things like that. Updating all of that information across these hundred-plus listings is a lot of manual work. That’s why we use tools to automate that process and make sure that they’re the same.

Now, when you’re doing these listings, consistency is key. Google does crawl these directories looking for consistency in your name, address, and phone, and your website. When it sees that it’s consistent amongst all these, it has more trust that you’re a legitimate business, that you’re actually open and active, and they’re more likely to rank you higher. Now, this is considered a local SEO strategy, but I did include it in link building because these are technically links to your website, and it does represent your business online. It is something worth considering. If you haven’t explored something like this, I highly recommend doing a listing audit scan.

Alex: John, Becca Evans is asking, “Should I create GMB listing for each location and each provider?” We know for every each location, yes. Each provider, what do you think?

John: Here’s a tricky question, and you’re going to get a lot of different answers. I’m going to give you my take on this, and specifically why. Oftentimes, you’ll have a provider that operates at different locations, and that does sometimes get tricky. If you have a provider that works at a lot of different locations or maybe they’re a well-known provider, sure, you can create both.

Google does allow for provider and location listings. However, when you start looking at review generation– One of the strategies for local SEO is getting reviews. Everyone knows that when you’re looking for somewhere, even if it’s just a restaurant, you’re going to look at reviews on Google and other places. A strategy that we do with a lot of businesses is review generation.

If someone comes and they’re a patient and they just had an appointment, and you may email them the next day saying, “Hey, can you give us a review to tell everyone about how great your appointment was?” Reviews matter. Are you going to send them to the location page or the provider page? That means you’re competing with yourself for reviews. Instead of getting a bunch of reviews to your one location and ranking really high for that location, it’s going to be spread out and cannibalized amongst your different listings.

I typically don’t recommend provider listings for that reason, and plus, you’re spamming the map pack with multiple listings for the same place. I think it opens up a can of worms and it’s not the best strategy, and it’s also to manage that is more costly. Much more cost-effective and strategy-effective to just focused on locations. Let’s dive into an actual listing audit.

For Brook Lane, I took one location and did a quick listing scan. I noticed that a couple of things that we’re looking for is we’re trying to see consistency. Like I mentioned before, consistency is key so we’re looking– Here on the right, you see what the correct name, address, and phone should be, and some examples of different listings that have the wrong name but the same phone and address, or wrong phone number, wrong address and what that can look like, and a lot of different tools out there that can do a free scan for you.

You can look at SEMrush, you can look at Moz, you can look at Yext. A lot of them offer free listing scans, and you can go and look up your website information to see how accurate it is. Just make sure to Google “Online free citation directory scan”, and something like that will come up. Look for BrightLocal, Whitespark, Yext, Moz, they all offer free tools for that. Another thing to look at is your niche-specific directory. Make sure it’s consistent on there as well, because a lot of these tools, if you tell them your specific– like say you’re a surgeon or you’re a dentist, they can help tap into some of these more specific niche directories, like Healthgrades, for example.

Make sure that you’re also taking advantage of your categories on these, and you’re adding good optimized photos and link. Most importantly, link directly to your location page, or if you’re going to do provider listings, your provider page. Nothing is more annoying than clicking on a local business and going through there your homepage and trying to navigate to whatever location you’re trying to get to. Also, it’s a good ranking boost to link into your location page. Google actually does look at that URL for the information. If you have multiple locations and you’re linking to your homepage, Google may not rank you as high because it’s not as confident which location you’re talking about. Here’s a more in-depth audit of what we’re looking at. We can see that for this one location at Brook Lane, their audit was about 33% accurate, meaning that only five out of– This is a sample of 15, I didn’t even do the 100 plus. This is 15 of the top listings that we usually look at and only five of the 15 were actually filled out correctly.

They’re missing out on a lot of not just a ranking boost, but they’re not even showing up in some of these top directories that people actually use. You may not go to Brownbook. I go to Hotfrog, but those actually do get traffic and that is a source of potential referral patients. Again, our recommendation here for Brook Lane is to use it, work with a SEO agency, obviously, or try to go out and partner with someone like Yext, BrightLocal, Whitespark, and get your listings corrected and up to date.

Why does this matter? Google’s looking for trust, it’s looking for consistency, and it’s looking to make sure that your website is legitimate. Beyond directories, let’s talk about things other than directories because some of you have your directories in order. What about other link building? What about getting mentioned in articles and guest posts and things like that? Why does that matter? That actually allows you to rank for a variety of other keywords. The content on your site is not the only way you can rank for keywords.

You can rank for keywords just by the anchor text that other websites are linking to you with. By getting featured in other websites, you can not just build trust, but you can start to rank for other keywords and Google has more trust that you are actually going to rank high for that keyword. If you are a surgeon or in this case for Brook Lane, if you are a retirement facility, if you rank highly for retirement facility or senior care or something like that from your backlinks, you’re going to rank much higher for that.

What we are looking for in a backlink audit is toxic backlinks. An example of a toxic backlink would be these blog networks where if you look at something like Blogspot where there’s hundreds of blogs that are all just created by machines and linking to you but they’re all part of the same network, that’s a spam backlink and could lead to a penalty. Excessive foreign backlinks happen sometimes and those can lead to penalties as well. Malicious link networks, imposter websites and more, there’s all kinds of spam out there that either has been done by old SEOs or maybe your website just got looped into a bunch of websites that are getting hit by these. Sometimes, you have no control and that’s why it’s important to do routine backlink audits and disavow cleanups.

Here’s a backlink audit we did for Brook Lane. The other audit we looked at was their citations. This is their true backlink profile. We used SEMrush for this tool. If you want to do your own, get an SEMrush account, you can do this yourself. What we’re seeing is it’s a pretty high toxic backlink profile. They have about 451 referring domains, that’s a single website linking to you, but they have 2,200 backlinks, which means some of these domains are linking multiple times to them.

That’s not necessarily a bad thing, but it depends on the type of website that they’re linking to. While 27 toxic domains isn’t a lot of bad domains for a total of 451 total domains, it can be a lot. It’s a significant percentage, it’s always a percentage basis. With 34 potentially toxic, that’s equaling, let’s see, 13.5% of your backlink profiles toxic. I’d definitely work on disavowing a lot of these.

Alex: If you’re Brook Lane, where do you go to get the full list of links? You go to SEMrush into their backlink analytics [crosstalk]

John: You can get it there, you can get it on other tools too because all these other tools have their own database that Google may not share with you. Let’s look at an actual physical example of a link scheme. Here’s a link scheme that’s currently linking to Brook Lane. If you’re Brook Lane watching this, check out your backlink profile, you have a link scheme here where if you look at, these are all different websites that all end in slash links. They’re the exact same content, exact same theme, different websites. This is a true blue link scheme that if Google discovered will either devalue your rankings or if they see this in excess, they could lead to a penalty. I have seen link penalties, they do them every year.

Alex: Are these linking to Brook Lane right now?

John: They are.

Alex: Oh, Julie. Julie, you got to get in there, you got to get rid of these. [laughs]

John: Yes. There’s more than than just this one in your backlink profile. Definitely go take a look and disavow these. In general, when you’re doing a backlink profile cleanup, Google recommends that you do outreach to get them removed. You want to go out there and ask the webmaster to remove those links. However, that’s very rarely possible. All these link schemes, very rarely can you find contact information or if you do, you can get ahold of them. If that fails, if you’ve tried that and it fails, then we do a link disavow. Most of the time, these link schemes, you can’t get ahold of anyone to take it down. That’s when we recommend [crosstalk]

Alex: It takes too long, too. If you get a manual penalty, go and do it. Oh, my God. All right, John, what do we have left? We got some questions here. Let me know when you want to get to them.

John: All right. Before we get to the questions, let’s talk about some strategies because we don’t want to just disavow a bunch of links and leave it at that. We still need to be earning new backlinks over time, and link building is not a one-and-done deal. You need to be constantly earning new links because the nature of the web is that you’re always losing backlinks. There’s a lot of reasons you’d lose a backlink. Let’s say you were in the news. News links are the most common way to lose backlinks because you’ll be featured, you get a great link, and then they’ll archive that page and they’ll go away.

Sometimes it’s PR. There’s just all kinds of links. Maybe it’s updated, maybe that page gets deleted on accident. You lose links all the time naturally. You always have to be out for new links, but here’s some quick tips on how to earn new backlinks. The number one thing is create content worth linking to. Sometimes, you get discovered. When you do active link building, you get what’s called the snowball effect, where you start to get your name out there, people discover you naturally and link to you naturally because you’ve gotten your name out there.

Another thing that we start with is analyzing your competitors’ backlinks. Find out how they’re getting links. Maybe it’s something that you could do too or do better. Maybe you can even get someone to replace their link with your link. Find out where your audience is visiting the web. Where are they spending their time? Are they going to forums? Are they going to specific websites? Maybe there’s an industry publication that they’re spending their time that you could get a guest post on.

Then, form relationships with industry publications. Find out who the editors are. See if you can contribute some actual useful content to get your name out there. You can always work with an SEO or PR agency then earn links naturally by creating good content and doing a lot of these manual outreach. All right, I think we’re ready for some Q&A.

Alex: All right. Thanks, Mr. John. We got a lot of good questions coming in here. I might go from the top-down, I’m going to stop the prezzo, you can see our mugs here. Christina Doe. “Is it beneficial if you’re getting linked through a poster to an event or mention? Is it beneficial to share it? Does that help boost your page via backlinks or SEO?”

John: I guess the question is if an event is linking to you and then you share their page or write about it on your site?

Alex: Yes, probably both. Let’s assume both. Do we need to reciprocate that link? Do we need to share it? Do we need to put it on our blog?

John: In general, Google looks for link reciprocation as a negative sign.

Alex: Negative.

John: Google does not want to look at reciprocal links. I would in general not link back to them.

Alex: Yes. It’s like being the popular one on the playground. When the kid comes up to you, you’re the cool one if you don’t talk to him [laughs]. If you go and start the conversation, if you talk back to him, [crosstalk]

John: Why are you going to be toxic like that, Google?

Alex: I know. It’s terrible, but that’s what they want to see. They want to see one-way links.

John: You don’t see Apple and Forbes linking to everyone.

Alex: No, they don’t link to anyone. It’s like an Instagram follower account. You always want to see how many followers they have, but how many people are they following? [laughs] John Perez. “When building links, should I prioritize my outreach by the website’s DA score? Is it better to just get volume of links quickly?”

John: How we typically– okay, opening up the hood, show them how the sausage is made, typically, I do a combination of relevancy and DA. The high DA sites are usually very difficult to get links from and typically, you have better opportunities to do guest posts and contribute to them than a single link linking from existing content. I do a combination. I’ll put 20% of my effort towards those high DA sites and 80% towards the more maybe lower DA but more relevant websites.

Alex: I got you. Let’s talk about medical-specific backlinks and then we’re going to pivot just from backlinks. We can talk about anything anybody wants. Go throw it in the chat, guys. Top docs, top providers, all of that stuff. Quality signals to Google that you guys know what you’re talking about. If your providers are ranking in any of those things. Also, if any of your providers are giving speeches or going back to their alma maters or where they did their fellowships and giving speeches, get backlinks from any of those schools. You get any media publication, make sure it will include a backlink. Don’t agree to do the interview unless they agree to backlink from whatever publication they host.

All of those things are helpful for medical groups. Generally, getting your providers to be active in their community. Meeting greets, going and visiting, or you’re having your liaison making connections, what can all help with backlinks. Let’s say you’re an orthopedic surgery group. You’re getting lots of referrals or used to get lots of referrals from PCPs now that people just go online. Your liaisons have created a lot of connections there. Go to that PCP, say, “Hey, can we provide content that would be helpful to your PCP patients on your blog about how to protect their back?” They’ll say yes. Great. We just want a backlink from your blog.

John: If your providers are featured in any clinical research or have written any, published anything, get those links. Those are highly valuable links.

Alex: I loved your tips on location pages, too. That’s most often where the biggest bang for the buck, guys, because everyone that goes searching– Let’s talk about location pages for a minute and then I’m going to hit some more questions. When you’re talking about SEO and your multi-location group, I know we have some multi-location friends of ours on here somewhere in, let’s say, senior care, derma, or whatever it is, when someone is searching, think about what you’re doing when you search for a dentist in your area. Do you type in “Dentist, Atlanta, Georgia,” “Dentist, Brookhaven,” “Dentist, Alpharetta,” or you’re putting in “Dentists near me”? Google is showing those location pages.

Those are what rank. So when those ranked, those are the ones that drive the leads. If you have to focus on anything, I think coming out of here, some people are going to question. “Shoot. If I had to do one thing, what do I do in SEO?” Location page optimization, guys. That’s what people are searching for on Google. If you do nothing else, no backlinks, no citation, nothing, make sure your locations have tons of content. John just shared– What’d you just share? A checklist. Did you write this article, John? Did you just shamelessly plug an article [cross talk]

John: This is my article [crosstalk]. This is for generally everybody. Your ultimate checklist to a perfect location page should include these factors. If you’re healthcare-specific, Alex dropped a link earlier about healthcare location pages. Includes a lot of the same things, but some other things that are specifically for healthcare.

Alex: Yes, I love it. John writes everywhere, speaks everywhere. You guys got him for another seven minutes. Keep them coming. John asking. Another John, John squared, John 2.0. Who’s 1.0? “Going back to listings, we’ve recently acquired another practice and we’ll be folding it under our brand. Should we just completely wipe their citations and add our company’s information?”

John: Keep whatever they have existing and try to swap out the URL to the new page. Update it slowly. I definitely wouldn’t get rid of everything they’ve got, keep whatever they’ve got, and do redirects. Especially when you’re redirecting their website, do a one-to-one. They’ve got service pages, try to link into the most closely relevant pages, location pages one to one. Don’t do a blanket, wildcard, everything to your homepage.

Alex: Something we keep running into, John, or you keep running into, I don’t get to do the fun stuff anymore, is we got a lot of groups that go acquire other groups and they roll them in, but they never spoke to the group about folding the website and marketing up under the main brand, and then the previous owners pushed back. What do you think about having multiple websites for each brand? Can they leave the brand alone? Is it better for the local community? What do you think?

John: Oftentimes, you’re cannibalizing your efforts. All these local sites have built up their own authority. Sometimes, what we’ve noticed is that when you merge websites together and you do true redirects, you gain the authority from the previous site through the redirects. You could do a proper site migration, and there’s a lot of steps of proper site migration, I think that’s a different webinar.

Sometimes, let’s say you get your DA up to a 60 because you’ve done this for so long and you’re acquiring a practice that has a DA of 20. If you merge them into your website and they take advantage of all the rich content on your website and the design of your site, they’re actually going to benefit from joining your team because if you’re acquiring them, the point is that you’re providing them the resources that they may not be able to afford as a small practice. By merging them and all of their resources into your website, they’re going to be benefiting in the long run, and they’re going to be benefiting from everyone else you’ve acquired.

Alex: Have those conversations upfront and tell your C-levels or whoever’s going and doing M&A to have a conversation upfront that they’re going to be rolled in or your marketing expenses are [unintelligible 00:55:08]

John: Someone asked earlier in the technical side, what I look for in WordPress sites and optimizing specifically technical SEO on WordPress. I just dropped a link that I wrote on Oncrawl’s website, which Oncrawl is a verily advanced technical crawling tool. It’s a little expensive, but it’s very advanced. I wrote an article for them about what I look for when optimizing WordPress sites. There’s another link that you can look specifically on a couple key things.

Alex: Good. Hey, you got any more articles you wrote, John? [laughs]

John: A lot. They’re all out there somewhere.

Alex: They’re awesome, man. That’s so cool. You guys have the wizard here. You got them five, four more minutes to see what other questions. “We’re about to rebrand daily. We’re about to rebrand and launch a new website. What recs do you have for handling the migration?” It’s one-to-one, you just mentioned it. One-to-one service [crosstalk]

John: My recommendation is a couple of things. Now, most people, spreadsheets, keep it in the cloud, do a Google sheet spreadsheet. Don’t do it local, and keep it where all your team is working on one thing, because you don’t want to have multiple versions. Now, the biggest pitfall of site migration and rebranding is the things that are not on the surface, the buried content.

Do a site, crawl. Work with an SEO or developer to do a site crawl, and find all of the content that’s on your website that you may have forgotten about, because that stuff will get left. If you don’t have backups, also take backups of the old site and keep the old site somewhere, because we’ve done rebrands where someone’s like, “Oh, we forgot these critical patient forms that are on the website.” We’re able to go to the backup, pull it, and get it up live ASAP. Backups, crawl for that hidden stuff, and keep your spreadsheet maps online in the cloud.

Alex: I can’t even follow you, man. That’s so beyond. I run the agency, I can’t follow it. Just call John. Just call John. [laughs] It’s too much.

John: I can do this every week.

Alex: Julie’s freaking out, man, Julie’s freaking out. Hey, Julie, don’t freak out. Just because we found the high toxic, she’s asking. “I found a phone number for Stonebrooke that showed up in your search for our backlinks. If I call them, what should I ask them to do? [unintelligible 00:57:14] what website is offline.” Julie, email me or John or both and we’re going to send you an email. Just send it to us. I’m nervous. I don’t want you going and removing a whole bunch of things. You don’t want to start removing or disavowing until you’ve looked at the whole portfolio. Then, you got to go through every single link. If it’s not necessarily one of the toxic ones, it’s better to not waste your energy and we just focus on disavowing the other ones and stuff like that.

Always with SEO, guys, very slow to the trigger. Always take a patient approach, which is hard to do because you want rankings. You got hit by Google. Patient, patient, patient. You need to know what works, you need to take it slow and see the algorithm. Julie, just sent me a note. All right, everybody, we’re wrapping up here, but it’s not your last time to talk to us. I’m sending– I think the emails come from my email somehow. It’s wizardry from email marketing. We’re going to be sending out the recording. We’re going to be sending out all these articles, probably plus a few more that could help all of you, and you have my email. John, what are you? [email protected]? Are you john [unintelligible 00:58:14]?

John: Just J-M.

Alex: J-M, right? Okay. I’m A-M. There’s nothing that I can probably answer for you, go to John, [email protected] You’ll go straight to the source there, and he can answer anything else you want. Thanks, everybody. This was fun. I’m going to hustle to the airport now to catch my first flight in 18 months, taking Delta, which is bad timing. Well, unlucky with their brand, Delta variant, Delta. Unlucky with the brand name there for them. [laughs]

Same thing with Corona. Hopefully, they pull through. All right, guys. Thank you all for joining. John, you killed it, man. Thank you for providing all the insights. We owe you a big one. If any of you that were listening, thanks for bearing with us. Send us any questions after the fact. Everybody have a safe, healthy, and fun day. Let’s go get more patients connected with y’all’s great providers. Have a good one. See you.

[00:59:10] [END OF AUDIO]


Alex Membrillo


Alex Membrillo is the CEO of Cardinal, a digital marketing agency focused on growing multi location companies. His work as CEO of Cardinal has recently earned him the honor of being selected as a member of the 2018 Top 40 Under 40 list by Georgia State University as well as 2015 and 2016 Top 20 Entrepreneur of metro Atlanta by TiE Atlanta, Atlanta Business Chronicle’s 2016 Small Business Person of the Year,and the Digital Marketer of the Year by Technology Association of Georgia (TAG).

Cardinal has experienced exponential growth under Membrillo’s leadership, being consecutively named on the Inc. 5000 list of fastest growing privately-held US companies for the last three years. Membrillo’s innovative approach to digital marketing has transformed the industry and delivered remarkable results to clients of all sizes and markets. He has been featured in leading national publications including The Business Journals, Entrepreneur, Search Engine Journal, and The Wall Street Journal. He has also served as an expert speaker for conferences including the American Marketing Association, SouthWired, and Vistage Executive Leaders, where he spoke on his unique approach to Millennial Management to over 400 CEOs.

Alex Membrillo Cardinal CEO