Healthcare Marketing Insights At Your Fingertips
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John McAlpin: “Typically, the biggest conflict we see is when we look at personalization. When you try to change things for the specific end-user dynamically, and whenever you have these dynamic things moving on a website, can cause conflict with SEO. This all depends on what they are. That could be the URL redirects of something else.”
Rich Briddock: “A benefit of running both CRO and SEO together is that both disciplines have their own research methodologies. When you combine those research methodologies, you get more of a holistic understanding of the end-user. There’s a lot of qualitative information that’s being captured in the CRO research process. A lot of onsite activity that’s being captured, which I think can be very valuable to the SEO team to see that information, to see how users are behaving on the site, to see what they’re doing, see what they’re interested in, to see what users are consuming or looking for more of, and then vice versa.”
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Announcer: Welcome to The Ignite Podcast. The only healthcare marketing podcast that digs into the digital strategies and tactics that help you accelerate growth. Each week, Cardinal’s experts explore innovative ways to build your digital presence and attract more patients. Buckle up for another episode of Ignite.
Alex Membrillo: What’s going on, everybody. Welcome to Ignite. Excited to have you here. Bam. I hope you didn’t just run into a tree because this voice got really loud in your car. I am Alex Membrillo, CEO of Cardinal Digital Marketing. Mostly a figurehead, definitely a hype man, but we’ve got the real wizards in the house. We got John McAlpin, our Director of SEO. This is the smartest technical SEO in the country. I’ve hired a bunch and everybody knows he’s the smartest. He’s building WordPress themes from the ground up because he cares that much about size speed. This guy is a real deal.
We’ve got Rich Briddock. He’s our SVP of performance marketing. All media rolls up to including CRO and analytics. The guy not only knows how to paint a beautiful picture, but he knows how to get eyes on it and make those eyes convert into an active patient. Welcome to the show, John and Rich.
John McAlpin: Thanks for having us back.
Rich Briddock: Thanks, Alex.
Alex: All right guys, let’s get in. We have talked about how to build a website from the ground up to be really great for SEO. We’ve talked about that, John and I on multiple episodes. We had talked about how to build a website for conversions. Rich and I have talked about that with healthcare groups at length as well. Today, we are going to talk about how SEO and CRO align. Rich, something I heard quite often, CRO is just for paid media. Quick one-word answer. Is that true?
Rich: It’s not.
Alex: That’s a two-word answer.
Rich: I apologize.
Alex: We know SEO is important. It’s my favorite form of marketing. I think it’s the most important. I think it’s the best, most cost-effective, and most scalable. We also know conversions are important because you drive a bunch of traffic and they don’t convert into leads and we don’t get patients. We can’t help people get healthy. Now we’re going to discuss about how they align in a website development project. John, when are SEO and CRO in conflict.
John: Typically the biggest conflict we see is when we look at personalization. When you try to change things for the specific end-user dynamically, and whenever you have these dynamic things moving on a website, depending on what they are that can cause conflict with SEO. Again, depending on what they are. That could be like the URL redirects of something else. It could be the content completely changes imagery.
A lot of things can change dynamically on a website with today’s technology and while it may help convergence, sometimes, sometimes it can hurt your SEO. That’s when you really need to have a good communication between the two departments, but there’s definitely ways where they do align though.
Alex: Rich, you agree? Anything else you want to point out on when they align?
Rich: Split URL redirects can also be a bit of a negative. Right, John?
Rich: We tend to stay away from split URL tests. Essentially one test that you can run through almost every CRO testing platform is a split URL test. It’s where you send a certain percentage of traffic to this page and then a certain percent to another page. However, my understanding is that, especially when you’re basically creating almost duplicate pages, but just changing certain parts of the experience, that is not good from an SEO point of view, right John?
Because then you’ve got two pages out there which one ranks and I’m sure there’s other technical pieces for it too. I just remember that when we went through this process, it was far from ideal in terms of setting it up this way. Now we try and avoid doing any kind of split URL test where we can help it with organic traffic.
Alex: John, anything else to point out. We talked about in conflict. Is there anything else, like you talked quickly about URL redirect? When do they align? Let’s get into that. What are the best practices that are essential to keep each discipline when you’re going through a website project? We’re talking about making sure the departments communicate. Most agencies don’t even have these departments. How do you make sure this all works?
Rich: Hang on before we jump into alignment, sorry, just to make another point on conflict. I think this is something you’ve got to be really careful. Obviously, John has, in some ways, a harder job than we have. Because he’s got two masters. He has to serve the user, but he also has to serve as Google overboards. Whereas we are just really trying to serve the user. Some of the recommendations that we’re making in terms of structure and content will be purely user-centric but may be terrible for the Google overboard machine.
Whereas, John has to be mindful of both. I think it’s really important to work with your SEO folks when you’re making major content changes and especially think– Even something as simple as changing a headline on H1 to be motivational as opposed to something that’s more descriptive or factual that may be good to help rank. Those are little things that can really help the user experience, but may really hurt organic rankings. I think that’s where you’ve got to move with this fine to tight between user experience and SEO best practices.
Alex: I’m glad you all are friends, John because that probably gets frustrating. If we weren’t such good friends around here, they’re trying to be creative and split does everything, you guys are saying, you’re going to destroy the website and no one’s going to come to it.
John: Well, the good thing is that Rich has always been great about communication and usually runs things by us first. I think Rich brought up a good segue to alignment, which is, this is a message to all SEOs out there just because it doesn’t hit the check box doesn’t mean you should completely ignore it because both paid media, anyone in conversion rate optimization, SEO, we all have the same goals. We want to not just drive more traffic and rankings, but at the end of the day, we want to drive more business by [unintelligible 00:05:41] conversions.
Remember an SEO with 200 plus ranking factors all weighted differently and sometimes weighted differently at different times. Sometimes you got to take the L on some of those ranking factors. If an H1 is going to not be how you want it, but it’s going to drive better convergence then maybe you should test it and see, “Hey yes, maybe our rankings jump off one, but our convergence overall improved.” I take the conversion over the ranking any day.
Rich: Yes. I think that’s especially true when you’re trying to strike that balance now in a mobile-dominated environment because people don’t like to read heavy content on mobile devices. A lot of people just trying to skim content on their mobile device. Obviously, John can describe it better than I can, but prevailing wisdom in SEO for a long time has been, get a lot of content on-page. That’s how you rank for it, but sometimes that can be contrary to conversion and UX best practices. We just have to become more imaginative about how we get valid content on the page, but it’ll way that the user wants to disseminate that information. It makes it easy for that use to disseminate it.
John: Make it scannable probably. Add table of contents, back to top jump links. There’s all kinds of creative things you can do to satisfy both parties. I think the key there is communication and working together.
Alex: Look at how most people use social media, TikTok is blowing up. Instagram is blowing up. Are those words? There are no words in those platforms. It’s like we don’t read anymore. I get the newspaper. The guy seems shocked that I’m not 82 when he drops it off. No one’s reading anymore. Those short forms, the more creative visuals, imagery, videos– The quicker you can convey it, but then also mixing things where Google can understand it and where it’s probable and you guys are going to rank. This is hard. You guys have a hard job these days. SEO is tough. We go on keywords, but we need it to convert. Ouch.
Rich: I think another benefit of running both CRO and SEO together is that both disciplines have their own research methodologies. Together when you combine those research methodologies, I think you get more of a holistic understanding of the end-user. There’s a lot of qualitative information that’s being captured in the CRO research process. A lot of onsite activity that’s being captured, which I think can be very valuable to the SEO team to see that information, to see how users are behaving on the site, to see what they’re doing, see what they’re interested in, to see what users are consuming or looking for more of, and then vice versa.
The SEO team does a lot of great competitive research that helps us understand how your brand sits next to your competing brand in terms of positioning and all those things. I think together, there’s a lot of crossover in terms of our research, where when we’re doing both channels, we have more strength in terms of understanding the end-user more so than if we were just doing a single channel.
John: That was beautifully put, Rich, as always. With SEO, we really look at the different funnels of how someone gets to the site and the different reasons they’re going to get to your site, whether it’s top-funnel awareness, just exploring your industry, or mid-funnel, almost about to convert, looking for more information. Rich’s team in CRO and all their onsite studies really help us figure out what takes them to that next level of conversion, what are the barriers to convert, and help us overcome those. They definitely go hand in hand.
Alex: If we had a paid media person, they’d say, “Man, the competitive research John does, and the qualitative research Rich does, can really help inform of the ad copy.” So that’s conversion-focused, the landing page, keywords and like the offers and all that stuff. It seems, guys, like marketing is not easy anymore. We can’t just do SEO or just PPC, or just CRO. This is no longer a thing. Would you guys agree maybe for a simple small business, just need to drive a locally? Maybe it’s possible to just do SEO, but it seemed like this is getting harder to just do one thing.
Rich: Yes, my perception, of course, I’m biased because I’m the one who’s trying to drive the charge on post-click optimization. I think so is John in many ways as well. He just calls it technical SEO or he calls it SEO. A lot of the stuff that John does, you mentioned page speed at the beginning. That to me is post-click optimization. That is the functional side of post-click optimization. I think that there is a massive benefit for paid media and SEO to have a strong UX focus in terms of everything that it does. Because of the bottom line, traffic is very important, but if you cannot convert that traffic, then it’s somewhat moot. John touched on that point.
I think not just in terms of shared resources and education and becoming informative, but there’s just so much opportunity on the post-click side that a lot of marketers historically have just neglected. Now, I think it’s becoming more table stakes. On the SEO side, it’s always going to be smart folks like John, and staff who are driving things forward. On the media side, as algorithms start to really, truly dominate everything from an ad serving point of view, the place where agencies and smart market is [unintelligible 00:10:57] side is in the post-click optimization, it’s in the experience that we create for our users.
It’s going to be really important that we get good at that because that’s what we’re going to be bringing a ton of value.
Alex: A holistic user experience. They need to see an ad that speaks to them, meaning the research has to have been done. They’ve got to land on the landing page and not only functions well and is fast, but it helps them understand that this is the right provider for and that makes it easier to connect. Something I want to caution us against, though, you said it, and it got me thinking, where you keep saying “If your website’s not converting, you need to look at a CRO”.
I actually think it’s quite the opposite. Even if your website is or you think you’re doing well, most websites are now refreshed every five days with improvements in the UX and sites [unintelligible 00:11:44] Even if it’s converting well, it’s still something to look at, you should still be looking at qualitative and quantitative improvements through a CRO process. I only work on a cardinal site, and I’m barely doing it because we have a big team that helps now. I’m thinking it does convert well, it drives all our business. We’ve gone from 12 to 57 people through it in the last year.
Man, it can convert so much better if we get double conversion rates by making it easier on the user. You’re talking about double web lead volume. Just a quick thing, guys, even if you feel like your website’s converting well, if you want to double patient law, you may need to run more PPC or improve your SEO, then just need to make it easier to convert. That’s just a sign out there.
Rich: I would just add to that now that I want to make this whole podcast about CRO, One of the tests that we run almost always off the jab, out of the gate, for CRO clients is a multivariate test. If you think about a multivariate hero test, where you’re serving up different combinations of H1s and images and CTAs and subheaders, there’s so many different variations that you’re setting up. The chances of your original combination of assets being the best is almost not. It’s almost a 0% chance that what you have right now is the optimal experience because we’re cycling through 90, 100 different combinations.
There’s always room for improvement, always. Even if your conversion is sky high, and you’re doing everything right, there’s always going to be some slightly better way of phrasing something that’s just going to get– The [unintelligible 00:13:20] might not be massive, but if it’s 2%, 3%, stuff you don’t have to pay for.
Alex: It’s stuff you don’t have to pay for. You can put the budget or do another in-house content or PR person or something. That’s the way to look at it. Do you want headcount? Go improve your website. Let’s get into– We’ve talked a little bit about how they align, but we are in a good point here and I notice, John– I want to talk on how to make sure they align. You started looking at the client’s strategy. Where do you look, and then how do you start talking across departments about it?
John: I think the first one is you always want to determine your priorities like, “Which pages are struggling?” and things like that. I think one of the key things here is there’s always a research phase. Whether you’re doing SEO, or CRO, or even PPC. There’s always going to be a research phase and part of your research phase needs to be what have been the barriers to convert? Do you take a heat map track? Is it a specific page? Is it a series of pages? Maybe your funnel process is too many pages long, they need to shorten that process.
Find out what that is, find out where the biggest drop-offs are, and maybe add that to the top of your priority list.
Alex: Do the teams get together then map out with the client? What percentage improvement are we talking? What are we doing? Is it traffic leads, end-patients? Is that ever a discussion or we just headfirst and we’re like, “Let’s just see if we can approve this thing”?
Rich: Both the SEO team and the CRO team operate using roadmaps. Those roadmaps are prioritized based on the level of effort and the estimated impact of those activities. I’m not sure if we use exactly the same prioritization method, but we essentially both use prioritization methods that have an effect on effort and impact. Roadmaps are something that is shared with the whole organization.
If there’s ever a CRO test that’s coming up on the roadmap that I feel or Mandy, feels would impact SEO, then I would like to think that we will be in communication with the SEO team just to confirm that and make sure that they agree to, or vet that essentially, before we go live with it. This is especially true when you’re doing motivational testing, where you’re painting copy, where you’re changing the content structure. You could have a potential negative impact on SEO, so it’s critical that the [unintelligible 00:15:37] are checked and vetted and that the proposed experiences around pass the SEO team just to make sure that there’s no negative impact.
Alex: John, when they’re starting a new website development project, did Rich touch on anything, anything else you start within your mind, to make sure things are going to kick off appropriately?
John: We’re in healthcare, so patient first. Always understand the full patient journey before you dive into any project like that and understand what they’re looking for and how they can find it.
Alex: Good. Let’s talk about actual examples. Have you guys worked on a website project where you had SEO and CRO together? Tell us more. Obviously, the answer is yes. So tell us about it.
John: If there was a journey of alignment and coming together, coming of age tale, if you will.
Alex: Good. Once upon a time. We don’t have to talk about the client specifically and what their name is, but whoever liked to jump in, tell us about the project, how it kicked off, what we did, and the results and things to look out for that went wrong for everyone listening.
John: I’ll start off where it went wrong. I think Rich can finish it off with where we went right, and how we pivoted it and brought a lot of success along the way. Essentially, we had a client in multistate, and we wanted to do a geography-based test where content changes based on where you’re located, and we did that through the infamous URL redirect. URL redirects are not bad in nature if you’re doing the paid test, if you’re doing paid traffic, it won’t affect SEO, by all means, go for it. In fact, that’s a great way to test URL page changes, is to figure that first with caveats, I’m sure.
What happens is, understand that for users, they might not notice. It may help convergence quite a bit, but when you’re talking about SEO and how Google crawls a website, note that Google’s crawler forms in certain locations. Here in the US, most likely it’s coming from California. If you’re in Europe, they have their own boss overseas. Depending on which bot Google’s using, and where it’s located, they’re going to get a different version of your website.
If you have a website all tailored to Georgia, for example, and they’re calling from California, they’re going to think your website only serves California, perhaps. This is an example of what could have happened. We did see some ranking decline, but Rich was very close in communication with me. We monitored it, saw a decline, and we had the pivot. I think I’ll segue over to Rich about how he pivoted and where we saw success.
Rich: Once John communicated to me, this was not the ideal approach. I’ll give John credit. He did a lot of work to mitigate the loss of ranking. Also to his credit, and I think this is another thing that goes into the interplay between CRO and SEO, he saw the improvement in the conversion rate and realized that it outstrips the loss in traffic and was to his credit, pretty pragmatic, I would say about the results. That being said, we didn’t want to have any negative if we could avoid it.
Essentially, we re-skin the cat whereby, instead of redirecting you to a different page with a different experience, we were rendering a different experience in the browser so that the core page stays the same, but changes are made when that page loads in the browser, that personalizes it to your state. If Google chromes it, they will just see the same page every time, no matter where they crawl it from, they see the standard default page. When a user goes to that page from a specific location, they see a personalized page by their location.
That was the way around it, we just had to deploy it through a different methodology, one that was slightly more difficult for us to operationalize, but was much more in line with best practices in terms of managing SEO performance and user experience improvements. Essentially, I think the moral of the story is, and we saw a massive improvement in conversion rate and our rankings recovered. We were now driving the same amount of traffic but converting it much higher SEO, very, very happy client, tons of more patients in the door.
I think, essentially, the moral of the story is, if you want to do something fancy, don’t just necessarily do it in the easiest, possible way to do it because it might not be the best way. Sometimes you have to go through a couple of iterations to figure that out. If you have a strong SEO person, they can help you and vice versa as well. If you have a strong UX person and you want to make SEO changes, run it by them, and they can tell you if there’s going to be a negative impact.
Alex: Yes, what I hear there is that you guys picked it up quickly, picked up the issue quickly. I think marketing goes wrong when the mistake lingers. That’s when we go wrong. I think it’s fine to fail, but you must fail fast, and recognize it and move on. That’s what I heard you guys did. Really quickly realize, “This test is screwed, let’s pivot.” Then everybody wins. I think clients are okay with that. This is what we’re here for, is new ideas. Sometimes they don’t work, but you guys pivoted and made it work and our clients are digging it. I guess it’s because of your close communication. John, SEO deal-breakers. Any best practices you absolutely cannot neglect to do.
John: Yes, that is quite simply and quite broadly the core focus of the page. When Rich is making changes on the page, say, you’re a multi-state. Instead of linking to a page with a bunch of different conversion options depending on where you are, he’s making changes. If you’re based in Illinois, you’re going to go to the conversion page just for Illinois. Small changes like that, that probably you wouldn’t notice on the surface, but the end-user is going to notice. If you’re changing the core focus of the page to be something else, that is going to get you in more trouble than these small H1 title changes.
You want to make sure that the core focus remains the same because that’s what Google’s going to care about the most.
Alex: Good, good, good. Anything else listeners need to know about before they go into it?
Rich: Just always communicate and remain agile, like Rich and I did. We kept close monitoring and we’re quick to make a change as things were happening and we were already discussing contingency plans if things go wrong. We knew there was a small risk and we are prepared to make that change if it did happen. Contingency plan, if something happens, make sure anything you do is easy to switch back and keep an eye on [unintelligible 00:21:56]
Alex: It sounds like it’s not a good idea to run CRO tests when your developer SEO is not readily available, something to note.
Rich: People tend to be very ambitious with things. Everybody wants to do something and make a big splash. I would say you should be making relatively large changes on the CRO side when you first start out because you want to be looking for those high-impact items. There are plenty of tests that can drive high yield that don’t require massive dev. resources. There’s a lot that you can do just through your testing tool and its native functionality in terms of in-browser changes. Yes, those things can still impact the SEO, but at least if you do something natively through your browser testing tool, and it has a negative impact on SEO, you can just turn it off.
Essentially that negative impact disappears, versus if you pay the developer to implement something for CRO or UX personalization purposes, it’s so much harder to revert back [unintelligible 00:22:57] You’ve already paid someone to do a lot of stuff. I would say, as a rule, do most of your initial tests just through your testing tools and net native capabilities so that if anything does go wrong, you can just pause that test and rethink.
Alex: Start out small. You and I talked about some of the quick and dirty things to do and then more advanced CRO practices too. Go back and listen to that episode. Read our blogs, read all the information [unintelligible 00:23:26] we have tons of information out there on CRO. I think we’d probably lead the industry in CRO education from an agency perspective. I think there are CRO-specific tools [unintelligible 00:23:37] stuff out there. Rich and John, any final words, my friends?
Rich: I think the combination of SEO and user experience and UX testing is more important than ever. It used to be same with paid media that just by ranking, you can make the phone ring. I think the game is much harder now. I think users are looking for bespoke experiences. They have tons of options out there. You’ve really got to understand the user, what makes them tick, even if you’re not doing a sustained CRO program.
I would say definitely, even if you’re not going to do CRO, at least have your user experience hat on when you are thinking about web design, when you are thinking about SEO changes, content changes, adding new pages, keep your user in mind. Make sure you know what they care about and make sure that you’re delivering on that information to them.
John: At the end of the day, it’s knowing what the users want and care about. I think lots of market research needs to go in before any kind of SEO, CRO, paid media. I know clients wouldn’t have the patience for that for us to say, “Hey, give us 30 days of market research, talk to the customers, do testing, run maps.” That’d be cool. That’s probably where marketing is going. We’re making changes now and we’re doing it blind sometimes.
Rich: It’s invaluable. The folks on the frontline, people who are dealing with your customers all the time, your patients all the time. They have so much information. They have such a wealth of knowledge. Tapping into these people and getting their perspectives is so critical. I would recommend that you at least get all the relevant stakeholders in the room and really mind them for their information and [unintelligible 00:25:20]
Alex: Listen to call recordings, talk with the frontline office manager, call centers, what do people say when they call in, what’s important to them? What are the problems? I talked to this guy in the bank yesterday. He said, “We’re about to run a PPC. It’s a multinational brand”. He was like, “Yes, we’re bidding on these keywords. I think they’ll work.” I was like, “Did y’all do any research into this? Talk to your customers on what they used to find”– “No, no, no, no. We just started bidding, we threw up some landing pages”. All right, that’ll work.
John: I’ll also leave on an SEO note, too. If there’s any SEOs out there or digital SEO digital marketers that are really nervous about the implications of CRO, if we’ve scared you with our horror story, keep in mind that Google’s number one strategy and recommendation every time it’s one of the worst, but also best pieces of advice they give. It’s if you want to rank well, create a great website. Which is stupid vague, but also–
Alex: Totally spot on.
John: I’ll tell you what, there’s only so much you can do with keyword research. You’re going to need some help.
Alex: Yes, you need to know at the end of the day, and you need to create– The prettiest websites are often the worst performing, just keep that in mind, guys, when you’re looking at your competitors. Please don’t just do whatever comparison. John McAlpin, the V, and Rich Briddock, thank you for joining me on a night. This is a blast talking about SEO, CRO horror stories and how to do it effectively through communication and ultimate ninja wizardry.
If you guys have any questions, [unintelligible 00:26:48] you need follow John or Rich directly on LinkedIn. They’ll help you though. If you got their email, find their emails, they’ll help you directly and keep you out of trouble. We’ve made a lot of boo-boos and we’d like to keep y’all from them too. If you need any advice on any projects you’re going to run, they’re here to help and so are we. Guys, thanks for joining. Hopefully, we’ll be talking again.
Rich: Yes. Thanks for having us, Alex.
Announcer: Thanks for listening to this episode of Ignite. Interested in keeping up with the latest trends in healthcare marketing? Subscribe to our podcast and leave a rating and review. For more healthcare marketing tips, visit our blog at cardinaldigitalmarketing.com
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