Healthcare SEO Isn’t Dead (Yet)

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: What’s going on, everybody? Topic du jour, as Mr. Michael would say, is AI and SEO and all kinds of fun stuff with that. That’s what we’re going to talk about, because it’s on all of your minds. We’re going to talk all things fun, healthcare market, AI, SEO. Mr. Michael, welcome to Ignite.

Michael Stevenson: Thanks very much, Alex. Looking forward to chatting.

Alex: Where in the world do you live and where are you going tomorrow?

Michael: Currently, I live in Baltimore, Maryland. Just after this call is over, I’m off to New York City for the weekend with my sons.

Alex: New York City. Are you guys going to see Hamilton? What are we doing?

Michael: We’re going to go see museums. We’re going to eat a lot of food, that kind of thing. Central Park. I’ve got a friend in Brooklyn, so I’m going to hang out with him as well.

Alex: All right. Cool. The cool part is that my mom’s from Brooklyn. All right. That’s fun. Where do you work? What do you do?

Michael: I work in a large non-profit mental health institution in Baltimore. I’ll put those three. I do SEO and CRM, and I’ve been working in the mental health field for, I think, about four or five years now. Mental health and physical health.

Alex: It’s a weird topic.

Michael: Mental health, because I just think of it as health. It’s like all health. Mental health primarily.

Alex: Now, it’s what we think of as all health, but the stigma is there from– 2020. It’s dissipating a little bit, 2020 COVID, and everybody is like, “We are going crazy in our houses. Mental health itself.” You are working a noble cause. Did we just put out July? This is July. This is filmed in July, everybody. There was just a big core out day, and we’re scrambling, and we’re getting content out there. AI is taking more and more of search traffic. What are you seeing happening right now? What are you adapting to? Are you scared?

Michael: No, actually, I’m not scared at all. I think of AI as the saddle of the dinosaurs, as Google against OpenAI. For the general consumer, I think a lot of things will suck. I think that web searches are going to get horrendously worse. They’re bad.

Alex: Why?

Michael: It’s already in a zero-click world. You can get any answer you want, just by putting a query to Google, and it’ll serve up its own version of it. You don’t have to get on the site itself. Like ChatGPT, once they come out with their browser, it’s going to be worse. It’ll be not only zero-click, it’ll be like a minus one-click, meaning it’ll pull everything and put it in a pre-digested answer for you. AI, it can be a useful tool, but you really have to know what you’re doing with it. You really have to know what the question is before you ask the question.

I think for a lot of people, when it comes to asking questions about health and mental health, they don’t know what they’re asking necessarily. There’s a distinct possibility that they will get bad information, poor information [unintelligible 00:02:40]. I was thinking about this the other day. There are a couple of big sites. It’s the Jupiter of SEO for healthcare.

Alex: Mayo, Cleveland.

Michael: All that kind of stuff.

Alex: Yes.

Michael: If you actually look at some of the stuff that they have, it’s just spam. You’ve got an itchy patch on your arm. You say itchy patch on arm, and you go to the Mayo Clinic, and they’re like, “What possible cancers could this be?” That’s as bad as anything OpenAI could send it. If it’s this giant net that captures absolutely everything, then what’s the point of SEO for that? I’m not worried about it, because as long as you write content that is authority, trust, all that stuff again, and if it’s helpful, then people will find it.

Because I don’t think AI is going to pull into helpful stuff. Maybe, four years from now, who knows, but the next six months, I’m not worried about it at all.

Alex: Yes. I don’t think it’s replacing it. That is an interesting take that it’s really all pulling from a couple of main sites. What’s happening is we are not now clicking through three or four websites to learn for ourselves what Mayo, Cleveland, my local itchy arm doctor is thinking and stuff. We’re just like, “Whatever.” They said it. I have seen this. It is making us dumber. There’s tons of studies about how chat is making us dumber, as AI overviews, because there’s no critical thinking anymore.

What I’ve noticed myself, Michael, is we get leads in from onesie, twosie doctors, not even like a large provider group or anything. They’re like, “Hey, we’d love to have your help, Cardinal.” It says in the source, they put in ChatGPT. We clearly know part of our branding, marketing, messaging on the website, even in the dropdown form says you have to have at least [unintelligible 00:04:03]. Everyone is taking ChatGPT suggestions at face value and going with that. It is making everybody dumb.

Michael: It’s a knee jerk thing. Yes.

Alex: It’s just interesting. You can see it is going to transform the world and help the world, but right now, it’s not. Let’s talk practically about this. Still great content. You got to create it. Would you, for your group, one of the three large ones in Baltimore, not to be named, are you still creating upper-funnel content? Are you just doing it to help convince the patient that you guys are the right joint to go to? Is it worth provider groups spending time on it, or just focus on the lead driving stuff, like X doctor near me or surgeon or whatever?

Michael: I think you got to do both. It’s like the Google review of your website. If you’ve got good SEO content, it’s all very well to say doctor near me and you see a doctor near you. I guess it really depends on the intent of the search. If it were me, and if I had to see a doctor for my kids as an emergency doctor, you just do that. If it’s a long-term thing, you want to make sure that you’re going to the right person. You want to have a fit, particularly in mental health.

Good fit is everything. It’s all very well to optimize for lead gen and conversion and that stuff. This is another Google concept, which I think is fantastic, is ZMOT.

Alex: What’s that?

Michael: Zero moment of truth. They talked about the shopping experience specifically, but I think it applies to this as well, that previously, before the internet, you would go to a big store and look at a TV and look at other TVs. Whereas now, you do that all before you even go anywhere and you may not even end up at the big store. You may just order it online. The idea is that once you actually make the decision, you’ve already done the work. That’s the zero moment of truth. For me, and for the people I work with, I want to make sure that you have that stuff there.

I don’t believe that people are just going to ChatGPT and Google for search. I think when it comes to mental health, you actually go that extra mile to find out because it is– arguably, mental health is a chronic condition as opposed to an acute condition. There can be acute things happening, like someone might have a–

Alex: I’m with you. It’s ongoing. It’s to prevent the problem, not to cure it.

Michael: Yes. Maybe cure is the wrong term. We can get into that some other discussion.

Alex: Dude, we’ve had clients in the past, and not my favorite clients. They said, “You should only be here for a month and be seen X times, and then you should be good to go.” I’m like, “That’s not how this works, guys.”

Michael: [laughs]

Alex: It doesn’t it doesn’t mean you have to be there two times a week or anything like that, but you should check in. You should do all sorts of things.

Michael: Totally agree. Totally.

Alex: They’ve all done their research, and they know. How do you influence the ZMOT? How showing up as many times you can, as many searches–?

Michael: For instance, prior to where I currently worked, I worked for a small mental health clinic. They had a DBT, a dialectical behavioral therapy program. It’s like CBT, cognitive behavioral therapy.

Alex: Yes, I’ve done that one.

Michael: Like hardcore. DBT, it’s serious stuff. It’s basically behavioral training. It’s not like it’s any– but they have acronyms and that stuff, and CBT doesn’t. Anyway, I ranked them across the board for DBT within six months, and this is post-AI, but not the current.

Alex: Nobody’s searching for it. Are people searching for DBT to that? They are. Did you say you ranked–?

Michael: If you are in a very specific circumstance and you tried everything and you need that thing, then you will be looking for those things. If you go for mental health near me, that’s such a natural. That’s probably where people start. It evolves. If you don’t get the treatment that you need. Also, I think that Google and probably OpenAI are aware enough that if you put in DBT, it means mental health. I think the search engines are just as interested in providing interesting results as they are providing the result.

They say, “Well, maybe they’re thinking about DBT as opposed to just mental health, or maybe this is a thing.” The website also had other aspects to it. It wasn’t just like DBT, DBT, DBT. For a while there, they were getting clients. They were getting a new group. It was working.

Alex: You’re honing in on something that our head of own and our medium, Rob, has been talking about for a while. Every practice is special in some way. If it’s not, it shouldn’t be a business and it’s not going to grow and no marketing can help it. Every practice is special. It has a specific service or an NP or a doctor that’s special at something where you really are great at a thing, DBT, TMS, CBT, whatever the acronym is honing in on that because you can’t win at everything anymore.

You used to with SEO, build every condition, service, treatment page, and you’d bang for everything. You can’t anymore. They’re figuring it out. Do you believe that?

Michael: Yes, I do actually. I think that a lot of the traditional SEO practices, making sure that you have a location pages for every location or some of the bigger mental health practices, they’re nationwide, but they have location pages for every small town in the States.

Alex: Where they do not actually have a location.

Michael: Also I just don’t think it’s effective because I think ultimately, people will take it for something like mental health. You want someone near you. I think telehealth is a good thing, but I don’t think it’s going to be the be-all and end-all for mental health because people really like being with people. I think that’s the thing. People like being in the presence of other people. It’s like having a virtual family, despite all the annoyances and how– [chuckles]

Alex: You’ve been asking for that for months.

[laughs]

Michael: Dude, I got divorced. I just think it’s ultimately not one productive. I do agree with you. I don’t think that you can just be sort of a home depot of mental health. You have to be– I’m the guy that digs the trenches for your main drain, your main sewer thing. I do a very specific thing. The guy that I worked for–

Alex: That is the number one thing plumbers want is the trench like sewer repair. I don’t care.

Michael: I know.

Alex: It’s been a while since I’ve done plumbing SEO, but I remember it was some thing like that.

Michael: Yes. Because it’s like in and out in a day, and you’re 20,000 later. The guy that I worked for, the guy that owns the clinic, he does the EDMR, which is–

Alex: EMDR.

Michael: EMDR. That’s right. EMDR. Maybe I was thinking about– Yes, that kind of thing. That’s really specific. He charges a premium for it. Yes, I completely agree. I think you–

Alex: You’ve got something.

Michael: Yes. I don’t think it necessarily has to be like I’m the expert in this, but it could be like this particular clinician is really patient or you’d hope they would be, but not necessarily people aren’t necessarily, but maybe just their manner is such that people want to go there.

Alex: Healthcare marketers. What’s up? It’s Alex from the future. Guess what? Scaling up the Healthcare Performance Marketing Summit is back. Scaling up is focused entirely on driving patient acquisition to your group. You’re talking the largest provider group, health system leaders, everything it takes to drive a patient to your practice or health system from media, BI, analytics, performance creative, SEO, AI, because we’ve got to have that acronym in there. October 28th and 29th, thousands of healthcare marketers are going to be showing up to this. It’s virtual and it is free. That’s the best part.

Last two years, we were charging for it this year. I want every healthcare market to come. We need to connect more patients with care. We all do. We all need to do it together. I’ll see you there. Scaling up. Let’s talk location pages for a minute because that’s generally been what drives leads for multi-site provider groups. Is it still, what do you do differently if not?

Michael: You have to tie it to local three-pack and maps and your Google business profile.

Alex: Link the specific things back?

Michael: I don’t think it’s necessarily link them back, but certainly, if an omniscient search engine like Google, for instance, looked at your pages and compared it to your Google business profile and say, “Oh, that’s a pretty close match,” as opposed to you’ve got a Google business profile that’s in Chicago, but you’re covering the entire country. They’re like, “Well, that’s not the same thing.” Mere mortals like us, we don’t understand Google. I do think that within Google, they’re going to look at stuff like that.

That’s why a lot of those sites show up as paid as opposed to organic because they can do that because Google’s like, “Yes, if you want to do that, pay for it.”

Alex: What are you putting on location pages to make them more enticing to AI? I’ve heard like writing FAQs slightly differently now so that they answer the common AI queries. I haven’t done it. I don’t know. Is that a thing?

Michael: You know robot.txt?

Alex: Yes.

Michael: There’s now an LLMS.txt.

Alex: I heard that. What is the difference?

Michael: The argument is that it takes a lot of time and energy to go through an entire site as an AI. If you say AI, here it is, but it’s in a single text file. I don’t know if it’s true or not, but I like the idea because it is the same sort of thing. It’s like just telling you where to focus. This is what we do. This is what we think you should find out about.

Alex: A lot of the same things, but I’ve been relieved over the last month of seeing the AI stuff. I thought it was going to crush SEO. What I’m realizing is instead of humans going to your website, it’s like robots now that are just going to be your agent and come back and say, “Hey, you have this condition. I know you’re worried about this and you have three kids.” It’s probably going to give me the best therapist because you pay your partnerships and stuff like that. Website’s still important. SEO is just changing. It’s never going to die like they said it.

Michael: No, I totally agree. SEO is supposed to have died how many times now? It’s never going to die.

Alex: For 16 years, and it was dead in 2008.

[laughter]

Michael: I think it’s back to this idea of like content and good content, quality content, and authority. This is the thing that I think a lot of mental health practitioners have issue with is because they are experts, they are reluctant to put stuff out there for people to help themselves with. If you think about any, like a checklist that you download and you give someone an email address for, that stuff for, I don’t know, building a deck or what have you. People are used to that now.

I think you can easily do that and without compromising your professional ethics for like DBT checklists. As I said in my answers, there are all these now clickbait places that we can get this stuff. I don’t understand why if you’re in practice, why you would not do that because someone else is doing it, but they’re not qualified, whereas you are. That’s the thing that I don’t think you’re going to get from AI. I think that the downloads, the interactions, the CRM aspect of it. Maybe you will. Again, four years, who knows? Right now, I don’t see it.

Alex: Yes, I don’t see it. It lacks in a lot of arenas. When you go to AI, it’s just checking the web. You’re like, “Well, just go to your own–” It is useful. I uploaded my P&L yesterday and said, “Tell me why expenses are up, where they are, what I should do, and stuff.” It gave pretty good– You can see it’s starting to get there. I think they said it can make PowerPoints and spreadsheets yesterday. I just want to talk about SEO for 30 minutes.

Michael: Yes, yes.

Alex: Link building, still a thing for multi-site provider group. Do you believe in other kinds of things? If you’re handed a bunch of money tomorrow, would you put it in link building? What would you do?

Michael: I wouldn’t do link building. I would do PR. Because I think that’s the only link building that’s worth anything right now. You can get $100,000 and buy 200,000 links, but they’re meaningless. Whether or not they send the right signal to Google, I don’t know anymore. I think that it’s probably figured that out. Help a reporter out is gone now. It’s turned into something else.

Alex: Hey, [unintelligible 00:14:19]. I love answering those.

Michael: Right? I think those kinds of things, to me, it would be PR primarily.

Alex: Yes, I totally agree.

Michael: Local PR. This is the dilemma for practices. They don’t have someone doing PR full-time. They don’t have someone doing marketing full-time, let alone knowing what SEO is, and how it can actually affect their business. The hard thing is to go to them and say, I think radio would be great.

Alex: Why?

Michael: Because there’s a book called The Long and Short of It by– I can’t remember the guy’s name. Bennett is one of the last names of the guys. They say that– like your marketing span should be 60% long-term brand building and 40% immediate activation. The idea is that not only do most people not think about you, most people don’t think about you at all. They don’t even know that you exist. If you’re around on a regular basis and people are like, “Oh, yes, this institution in Baltimore, we do help.” Then when they’re at that point where they’re like, “I need some help,” you will be in their mind first.

Alex: Yes, people are hesitant around doing big brand plays like that because they don’t get the immediate return.

Michael: Yes. It’s hard to justify to the CFR, I think that plus a PR push, like a regular PR push, not just like, here’s one article every six months, it’s the same sort of thing as a listicle. You send the article to a guy on a cool suit.

Alex: I do, I forgot about lists.

Michael: Right?

Alex: Skyscraping. [laughs]

Michael: Yes, right? If you send something like that to the Baltimore Sun, they may publish it. They may just say, “Hey, going into winter.”

Alex: There is so much provider, healthcare type things can get PR so easily. You host a blood drive, you do this, you have this thing where you help this family. Oh my God, healthcare– Michael is spot on, guys. LLMs take into account, reputation where Google didn’t in the past. They take on reputation so their reviews matter. Brand and press mentions matter a ton. All of the online PR, all the PR people around the country that have been sidelined for the last 10 years are like, “Yes, we matter again. You’ve always mattered.”

Michael: “You’ve always mattered.” [chuckles]

Alex: “You’ve always mattered.” I’ve always done PR. We got into the Wall Street Journal in ’08 from Hayro.

Michael: That’s great.

Alex: 11 o’clock at night. It was the coolest thing that ever happened to us, and we loved it. We were little hood rats.

Michael: It’s one of these–

Alex: But it ranks. It ranks. When we go to Google and we type, “Why does Cardinal rank so well in the LLM?” It says because your reputation and because you have these press mentions. I’m like, “It’s way more sophisticated than Google.” It never–

Michael: Yes, and so one of these, like a Wall Street Journal article is being hit by a nice meteor. It changes overnight. I hope it did for you guys, but–

Alex: No, it didn’t at all. We went and got drunk in Charleston and picked up every Charleston’s Post and Courier because it’s the only place the Wall Street Journal publishes on-site. We went, we had a party, we got in, we thought we were so special. No, but the backlink certainly helped. We got ranked the number one for LLM SEO company. Nine months later, we got tons of leads. Michael is spot on, guys. The press mentions, that is where we’re telling everybody, go get your BR spun back up.

I got one more question for you. If you could give one piece of advice to healthcare marketers that they don’t often hear, what would it be?

Michael: I think systems. I think it was in the style. I think that if you’re an SEO, you do SEO, you don’t do anything else. I think if you’re in paid search, you do paid search, nothing else. It’s the systems behind it. Google ads, how that ties into a CRM. I would be reluctant to work with a mental health agency if they didn’t have a good intake system. You can do all the lead gen you want, bring people to the door, but if they don’t know how to answer the phone, I think systems thinking and seeing how all the things interconnect is really important. Because doing SEO in a vacuum is not going to help.

Alex: We talk all the time about MOBs, marketing and ops alignment. That’s basically what you’re talking about. It’s like, “Guys, your job’s not to get ranked. Your job is to drive patients in the door.”

Michael: Yes, that’s precisely it. My background is SEO, and that’s what I do. I also do CRM. I really think it’s important to have paid and organic social search. If you were a healthcare practice and you rank number one in organic, you rank in three pack and you were in the ads as well, that’s the signal that people get. They’re like, “Okay, well, they’re serious.” Very minimum. I think that’s almost like table stakes at this point. You have to have all three or else you’re not going to be credible.

Alex: They want to see you everywhere. Even if they end up clicking the ad or the organic or whatever, and you’re like, “Man, PPC’s not driving them any leads.” Yes, but it helped contribute to getting the maps of the organic lead. We used to have a billboard in Atlanta that said, “SEO + PPC = ROI.”

Michael: Yes, exactly. 100%.

Alex: They take you serious. What is the word you use? Serious? They take you serious? That’s a perfect way to put it.

Michael: I think if you’re in the business and if you’re an SEO or if you’re in PPC, you have to understand everything and how everything connects, the systems that support them and that thing.

Alex: Yes, buddy. What you’re saying is learn everything. Don’t specialize. I agree, too, because the AI is obviously going to take a siloed button pushing work here over the next few years. If your job is to write content, you’re already done. If your job is to make pretty picture, you’re almost done. If your job is to orchestrate the lead driving patient converting machine, you’re never done. Advertising will always exist. Content and differentiation through expertise will always exist. Michael, this was one of my favorites.

Michael: Those skills that you get from understanding systems apply directly to understanding AI and LLMs. If you know how to do it conceptually and understand the linkages between the systems that your clients use, but all the systems that you use, once you get in front of an AI, you can ask the right questions and direct it in the right direction.

Alex: I can tell I’m not asking the right directions because I’m still getting juvenile. I get juvenile answers because I’m juvenile.

Michael: That’s your charm.

Alex: Yes, that’s the charm of my life, [unintelligible 00:19:30]. The prompt engineering, it’s clear. Humans aren’t going to lose their jobs to humans. They’re going to lose their jobs to humans that know how to use the robots. You’re absolutely right. Ask the right questions, learn the systems, understand how the whole marketing’s feel. I think I wrote something the other day on LinkedIn that was probably fed to me that to not make marketing a cost center, you have to justify the return.

If we guys, marketing, if we just keep talking about the rankings, the traffic, and even just the leads that we’re driving, we’re done, you’re done, we’re done. You’re getting too sophisticated of a world.

Michael: Yes. I think people really have to think of marketing as an investment, that’s the most cost center. If you think of it as a cost center, you’re always going to cut when times get rough.

Alex: Yes, we always get cut.

Michael: It’s an investment, but I really think of it as– I just finished up this thing called the MiniNBA in Marketing by Mark Ritson, who if you haven’t listening to Mark Ritson, listen to Mark Ritson. He’s really funny. He’s a really sarcastic guy.

Alex: Cool. I like it.

Michael: His whole point is that marketing should be involved with pricing, marketing should be involved with strategies. It can’t be, “Here’s all of this stuff and we’ll give it to marketing,” and they think they’re going to get it done. I mean I know that’s the case–

Alex: No. You know who does that, what you’re saying, better than anyone, is the car dealer, the car manufacturers. Ford goes to the marketing team and says, “What kind of cars should we go build?”

Michael: Exactly. I don’t think it’s out of the realm of possibility for small clinics for anything. It does require a certain mindset that doesn’t exist a lot in this world.

Alex: If you want to know where the next trend is going, look at what the private equity groups are buying out and, right now, it’s like metastatics, CashPay, infusion, and all kinds of holistic medicine because they see that’s where things are going.

Michael: It’s the whole Brian Johnson thing.

Alex: Yuck. Dude, have a cigarette or something, dude. You’re too much. It’s just too much. Who wants to live like that, 100 pills and perfect health? No. After this, I’m going to have an IPA as soon as it comes to.

Michael: I put a sporadic chamber in the mix. I’ll have steak, thanks.

Alex: Yes, yes. Life is for living. That guy is going to die at 180 and never lived a day in his life. No, thank you.

Michael: No, thank you. I think your point about the private equity, I won’t call them niche treatments, but certainly not core treatments. One place I think, if there’s any marketer out there that’s looking for something, is men’s aesthetic surgery type stuff.

Alex: Totally, totally. Got a hair transplant last year. It’s so relieving. We just brought on one of the largest men’s health groups since PRT DRT Aesthetics. The Botox groups, we’re bringing on a large aesthetics group. We care about reaching the men, not as much as the women obviously, but it’s a thing.

Michael: There’s a huge market out there, yes.

Alex: You got wrinkles and now guys are telling them about their wrinkles because we’re all looking at some videos all day of ourselves and we’re like, “Michael, this was fun.” Guys, you all got to go find him. Where do you find you?

Michael: I’m on LinkedIn, the worst social network in the world.

Alex: No. LinkedIn is awesome. Why don’t you like it? Because it’s filled with dumb personal– that’s the problem.

Michael: No, I don’t think that I’m personal though. I did go down a rabbit hole in terms of researching Coldplay yesterday.

Alex: Oh, because of the– You know StubHub just posted an ad, it cracks me up, that’s making fun of it. It said, “Bring your HR Manager to the next Coldplay concert, buy tickets.”

[laughter]

Alex: She was the Chief People Officer and an HR Manager.

Michael: Your posts are good. There are a couple of other people’s posts that I like, but for the vast majority, LinkedIn is self-serving.

Alex: Yes, look how awesome I am.

Michael: Yes, you’re the best.

Alex: We’re trying to change it up a little bit and not show how awesome we are. Michael, this was awesome. Find Michael Stevenson, he’s in Washington, DC, Baltimore area, if you need to look for where he is. He went to Arizona State, which I hear is not a fun school.

Michael: No.

Alex: Michael, thank you for joining us on Ignite.

Michael: Thank you very much, Alex. It’s been a pleasure. Nice chatting and pleasure working with your team as well. They’re all great.

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