State of AI Search 2026

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Lauren Leone: Hey, everyone, welcome to Ignite Healthcare Marketing Podcast. We are back today in 2026 for a bit of a reality check on where we are with AEO, AIO, GEO, AI-assisted search, whatever you want to call it, whatever the terms are that your organization is using, it is changing every single day. We want to bring in Rob Sauter, our SVP of Owned and Earned Media, to give us an update on the latest with where and how AI search is affecting the broader SEO landscape and what organizations need to be doing about it today. We’ll probably have this update at least once a quarter because it is changing so often. Rob, great to have you here.

Rob Sauter: Yes, thanks. Exciting. AI is what all my time on. That’s all I talk about lately and all I focus on and get to do these types of updates.

Lauren: Yes, I’m excited to learn. I always learn something new from you. When I’m on these episodes, I’m reading updates on LinkedIn and looking at what’s going on, but I learn something every day when I get a chance to talk to you. I’m here as a listener of this episode today, too. Let’s go ahead and dive in. I think the last update we did on this was actually during our scaling up conference last October. A lot has changed since October. I was reading an article just this morning on ChatGPT releasing some of the data around health search behavior and how people are using it. Give us the broader landscape update just on where you think things are today.

Rob: Yes, I think things are continuing down the path we expected them to. More and more usage of ChatGPT, more and more usage of the AI platforms. I think the AI platforms are starting to find more of their position in the marketplace. Yes, what they are going to be specialized in, what they’re going to be used for. They’re not all competing head-to-head. I think Google and ChatGPT are competing head-to-head. That is going to be the everyday search engine-style AI tool. You’re already seeing platforms like Claude and platforms like the Facebook Meta platform, et cetera. Even Microsoft’s Copilot all becoming niche in what they do, whether they support business or lifestyle, and it lets become that core search engine.

I do think that ChatGPT is having, and again, the Google AI mode and Google AI overviews, they’re having a bigger impact all the time. Every month, we add more and more of our clients into these AI tracking tools, these AI insights, these AI relationships, and we’re seeing that it really is evolving. Yes, a good SEO platform does generally set you up good for AIO, but as we’ve done all these AIO audits, it’s fascinating the types of gaps and opportunities that we’ve been able to identify for brands and even for the bigger– [crosstalk]

Lauren: I want to get into that in a minute because I think the practical advice is really what people come here looking for. A little bit more commentary on the broader landscape. I’m just curious, in terms of reality check, where do you think it’s overstated? Where are people maybe overestimating the impact, and where do you think maybe it’s understated? What are some of the misconceptions?

Rob: We’ll start with overstated. I do think it’s a bit overstated in regards to the direct bottom impact. I think that, obviously, in digital marketing, we have a gift and a curse. The gift is that we have great information, great data, great attribution. The curse sometimes is we over-rely on that. I think that if you were to just look at a last-click attribution-type report, it probably would not show that, especially in our hyper-local healthcare ecosystem. No one’s converting directly from the AI arms, so they must be useless.

I think it’s probably a bit overstated in regards to, “Oh, I don’t think it’s having an impact. I don’t think we need to care about it yet.” Again, it’s almost like a double negative. They’re overstating that it’s useless. I think that’s a challenge, is that some people aren’t focusing on it. I think where it’s understated, it’s up the funnel, is where I think there’s a lot more engagement and a lot more searches. There was a study that was done that still shows that almost everybody who uses these AI platforms are still using traditional searches, et cetera. There’s a lot of really great, quick information you can get on brands. There’s a lot of really great–

Lauren: Narrow field seems to be a really good place that people want to start.

Rob: Even just finding competitors. It’s so easy now through AI to say like, “Oh, I found this dentist down the street. They look great. Who else should I think of?”

Lauren: Who else should I consider, or what is the general sentiment about this company? Is this a good choice?

Rob: Well, you said it the other day in one of your LinkedIn videos where you said that people are basically treating healthcare like shopping now. It’s true. AI is such an easy path to quick, easy research around, “I need blank. Just give me the shortlist.”

Lauren: Make me a table with the following criteria. I love it. I do it all the time.

Rob: Yes. I focus on that with a lot of our clients. In AI, especially visibility scores, things we measure, people always want to be number one. Often what I harp on is that we don’t need to be number one everywhere. We need to be in the top consideration set, though. You’ve got to be in that top three to five because that’s what’s going to show up in a shortlist when people ask for it. Otherwise, no one’s just going to trust. I don’t think this is happening.

Lauren: The number one option.

Rob: Just give me one. You tell me exactly what dentist I need, or worse, get the cardiologist. You start to get more serious. Dentist is a little more every day, but when you get to something like mental health or anything with your children, you’re not going to settle on one. You’re going to need for multiple. That’s where, again, it does a really good job enabling. Then from there, you’re going to go check. You’re going to go to these websites. You’re going to go do some more traditional searches, et cetera. I do think that’s a significant part of the impact.

Lauren: I think another thing I’ve heard you say often that’s maybe overstated, the pace of change last year was so rapid because we saw the introduction of the platforms, the initial calibration of everyone’s behaviors. We’re there now. A lot of people have adopted it, like you just stated, in some part of their search journey. Maybe the pace feels like it’s slowed down a little bit because we’re not getting the new ChatGPT options every day.

I think what’s happening, the change now, although the pace is slowed, is actually more significant and impactful than what we saw last year. Talk about the algorithmic calibration and more of the tinkering stage that you think some of these platforms are in. I think now is when we can start to get into some of what you think groups really need to do with that information.

Rob: The algorithms are changing. There’s a lot that’s changed. For one, they’re starting to be more transparent. We’re starting to see information directly from these algorithms. Behind the scenes, a little things that Google sometimes gave us glimpses of during SEO, which helped. We’re starting to see studies and tests that are going on in AI, which I think is really a big takeaway for our clients, is really want to make sure that if you don’t believe it or if you are a believer, you have to start setting up some of these tests. Start to set up opportunities to say, “How are we doing, what are we doing, and is it helping us get more visible?” I think that’s key.

I think the platforms have certainly stabilized a bit. Again, we’re starting to see repeatable outcomes from similar strategies, but I don’t think we’re quite done. I do think we’re past that explosive growth phase. I think a lot of people now know ChatGPT is not new anymore. My parents are using it. I think that they’re still tweaking the algorithm, but for the most part now, every time they ingest data, it’s a 1% increase, whereas before they were growing at an exponential rate with data. It’s definitely slowed down. I think that this year will be interesting in regard to how they tweak things like paid. We know paid apps are coming to ChatGPT. It’s now a well-known leap last quarter, it’s catching in line.

Lauren: It was $8 million, right?

Rob: Yes, quickly. I think it’s going to change things massively on the AI side. Think about it. Paid advertising comes with a much more, “Well, what’s the ROI? How much money am I going to make? If I give you $1, do I get $50 back? If I don’t get $50 back, I can get $50 on Google.” I think that’s going to change that attribution element. It’s going to force the algorithms. It’s going to force the platforms to play a different game they haven’t been playing yet.

Even worse, they’ve been arguing that’s bad. Most of these platforms are like, “Ad-free.” Now they’re all going into the ad world. Well, it’s just like everything else. They get you on board. They get you using it. They sell it to you. Once they get a critical mass, now they can start to monetize it. It’s a matter of time before every single one of these. We all know for a fact these platforms aren’t making money, so they need the strategy.

Lauren: Those are the actual generative engines themselves. We all know and we’ve discussed that AI-assisted search is a big part of the SERP, too. Your general sentiment last year was the fundamentals of SEO still apply to an effective AIO strategy. Where do you stand today on that? What has changed? What do you think people need to be focusing on?

Rob: The fundamentals are definitely still there. You still need good schema. You need good content. You need good messaging. You need something interesting to say. It’s changing a bit. I joke when I have to tell the story because I don’t like the words, but it’s changed a lot from measuring pages and ranking pages to chunks. Entities is sometimes what we refer to it as, but it’s really looking at content in a larger group. It’s looking at your website as a larger connection of things. Your authority is a larger connection of things.

Google platforms still rely a bit more on SEO outcomes, partly because at the end of the day, remember, Google still has a lot of money they make every single minute of every single day on SERP. It still funnels you back towards that Google search. For ChatGPT, again, still very important, but tends to be a little bit more common language, tends to be a little more flexible and not over-indexed. Traditional SEO looks for more of those answer-driven elements, but still requires the same thing. It requires strong content. It requires interconnected content. It requires schema and organization to make sure that it can understand what you’re saying and back it up.

I think that’s key. I think the biggest thing that AIO has done is that because it’s able to check all those pages and pull all these things together that you can’t get away with as easy some of the marketing that we do. We have the top doctors in the country. AI will actually look–

Lauren: It has to validate.

Rob: Yes, look for validation. I see it all the time in our results for our clients and our potential clients. They say they have an amazing doctor and provider network. However, there’s no evidence of that online. What it usually says is, “You should call and ask about it because they might be telling the truth.” As far as I can tell, we don’t know for sure. That could be a challenge. Then it has to rely almost exclusively on your reviews. We talk a lot about, is AI manipulatable? 100%. Again, no one talks about your brand more than you do. The second group of people who talk about your brand as much as you are your patients. Those are the influences.

Lauren: Your employees, probably third group, right? [crosstalk]

Rob: 100%, yes, especially depending on the size of your organization. Some mental health groups, the employee count is nearly as high as the number of inpatient individuals.

Lauren: One final thought on that topic, and then I want to get into differentiation. I think that’s really important. Have you seen or heard groups maybe over-correcting towards the AI side of things and maybe abandoning the traditional fundamentals of SEO? If I forced you right here on the spot to give a split recommendation on time invested towards each type of search, what would you say is the recommendation with where we stand today?

Rob: Yes. I haven’t seen, at least in healthcare. I’m sure there’s other versions that are probably screening this and the inverse. In healthcare, honestly, no. I’ve yet to really see an organization really go all-in on AI yet. In fact, I feel like more organizations are either lagging or potentially skeptical of it.

What I will say, though, is that I have been a part of enabling many marketing leaders in the last quarter for board meetings around AI sentiment, AI performance, AI visibility, and it’s becoming bigger and bigger. Every time I hear the results of one of these board meetings, the marketing leaders are so happy. They’re like, “Oh my God, it went over so well. Everyone loved it. We can’t believe we’re doing this well because all the hard work we did in SEO.”

Other people are using it to attract new provider groups, and for acquisition and for membership in a DSO or MSO environment. Some are using it for even other interesting ways of building confidence with the doctors, and again, especially in a multi-global environment. It’s gaining momentum. For the first time in a while, I’m getting phone calls from marketing leaders saying, “How can we do more? Can we get more measurement? Can we get more insights? Can we get more aggressive?” I think it’s a slow build. I think it’s taken some time to get there, but some of the brands really get the taste for it. I’ve seen the momentum, for sure. In regards to percentage–

Lauren: You have a client right now, and you’re looking at their roadmap, and you’re orchestrating for your team what the plan should look like. How much are you focusing on the fundamentals and how much of the plan, AKA the time and investment, are you putting towards maybe less traditional SEO, more AIO folks?

Rob: Yes. I think in three groups, it’s the core effort that makes up a good maybe 30%. I think, from there, it’s probably still more 50% in some of the traditional, organic, especially in local. Again, local is so critical in our business. Local is still the lion’s share. Then what we’ve been trying to lean towards is we should be spending about 20% of our time. Again, the cool part is the good work we do in AI obviously impacts SEO as well. It’s not like this–

Lauren: They’re not mutually– [crosstalk]

Rob: We should be writing some content. We should be addressing some of the gaps. Again, we’ve started really getting aggressive with the AIO audit, and that really helps readiness and competitive audit. That’s helped us identify gaps and identify areas where in AI our competitors are way, officially, far better positioned. It can be different things. It can be many of your competitors are very clear and support financial content and financial discussions, the sort of what to expect and how to pay. You got them talking about that at all, and it’s a huge gap in regards to visibility.

Others will say you have excellent clinical authority and clearly have good outcomes, but you aren’t connecting your providers to any of that, meaning you have a provider page and you say how smart they are and their degrees, but you’re not actually connecting them with content, with outcomes. It’s like, “Oh, our patients are happy. Our providers are smart. Here’s a bunch of great stuff we have to say,” but none of that is connected, and it’s a huge– [crosstalk]

Rob: How does that actually come to be?

Lauren: Exactly. That could be a huge miss in regards to elevating those things together, connecting entities, how we would describe that. Again, those are the types of things that you see gaps in. I think the number one gap that we see is that it’s an answer engine, trying to answer questions, it’s trying to give recommendations.

I think the biggest gap is still patient-enablement content. How can we help you make the right decision for your healthcare? How can we support you in making these right decisions? Again, a lot of our clients are a bit more clinical, whether it’s implants for your mouth or whether it’s, again, mental health or something, even pain management, there’s so many options.

I think too often healthcare’s over-optimized still for, “We’re great, we do all these things, we solve all these problems, we have all these smart people,” and it’s not like, “How can we help you? Here are the questions you’re probably going to have.” Look at every FAQ in healthcare. It’s like, “Where are you located? Are you certified? Do you take my insurance?” It’s never, “How do I make the right decision for the right physician? How do I compare the multiple elements?” Usually, they try to get you on the phone or try to get you in clinic to help you with that. I think that’s a big gap, is answering real people questions, not, “Let’s talk about me,” question.

Lauren: You mentioned the content and the messaging and the differentiation being really critical. Saying the same thing is going to put you– when you think about the AI table, it’s going to put you probably not in the top three, or it’s going to put you in this category of, “They say they do, but we don’t have any proof that they actually do,” type of language. I think just continuing talking about that.

Rob: It’ll just imply you’re stuck at the mercy of your patient reviews at that point. That becomes the only, not the only, there’s a few others, but that’s a major source of validation. It would suddenly be like, “Well, they say this, but their patients agree.” They say they’re the best experience in dental, and their patients actually agree. Their patients agree, they have a great experience, wonderful, patient-centric, et cetera. That’s tricky because that’s almost marketing for off the back foot. We’re just echoing what we hear, which is good, by the way. It’s not a bad telehealth marketing.

Lauren: We just have the fundamental of actually providing great care. That’s always the best place to start.

Lauren: That’s right. You’ve got to have a good mouse trap if you’re going to sell it. It takes away that strategic marketing element where we want to be able to focus on what we think is most important to people, what we actually think we do well, how do we actually position and sell what we do to these individuals who are looking for it, as opposed to we can’t.

In a competitive marketplace, we’re not going to be the only place that has good patient reviews, hopefully for the sake of healthcare in America. There’s not only one place that does good healthcare. It takes you on the back foot. To be on the front foot, that’s where you, as a marketer, have to come up with that differentiation. “Here’s what we do. Here’s the outcomes we provide. Here’s our cutting-edge physicians, doctors, researchers,” et cetera.

Have something unique to say, but then really back it up for third parties. Don’t be afraid to link out to support what you’re doing from national brands, research centers, hospitals, et cetera, but also to really back it up with their own individualized data. I think we have to not be afraid to put that out there and to tell those stories. Again, otherwise, if your patient sentiment swings, your entire marketing strategy is at risk.

Lauren: Rob, you use a word that I like and I think will become a staple for the future. In SEO, we talk about optimization, optimizing the schema, optimizing the metadata, the on-page, the listing title optimization, whatever it may be. With AIO, we’re using the term orchestrating. Orchestrating the environment.

We talked about the entity, which has been a theme in SEO for a while now, but really less about the specific keyword or phrase or whatever it is, and more about the broader picture. When you think ahead to 2026, we’re just here in the very early part of the year, what do you think the CMOs, marketers, VPs, directors need to be thinking about? What would be some of your top recommendations if they have not started thinking about AIO right now?

Rob: You got to start with really what and who you are. The orchestration element is critical. When we say orchestration, you’re putting together a much broader story. It’s not about having 700 condition pages anymore. We still see that in so many websites and so many domains. There’s like 1,000 pages on these websites and it’s so complicated. I think we have to get back to, what do you provide? What type of care do you provide? Why is it the best? Why are you different? Try to build your entire digital ecosystem. Orchestrate that ecosystem to tell that story, to make that point, to make that wind beam.

I mention all the time that our paid colleagues, you never go to a paid call and have a client say, “Spend on more keywords. I want you to spend on every keyword you can think of.” It’s the opposite. It’s what keywords are going to provide the best outcome. I think that’s the driving nature of SEO and AIO. You got to find that niche. You got to find that point on your website that you’re really going to build the entire program around to support. It could be local. It could be patient experience. It could be clinical outcome.

The answer is different for every brand. The good news is, especially with AI, there’s so many tools now in regards to, “What are my competitors saying? Where do I fit? Am I going head to head, or am I going positioning around?” There’s lots of opportunities to do that, but I think you really got to start to know what you’re going to say. It’s not about these massive templatized websites that try to cover every keyword. Do a couple really good, narrow, specific things well and get a reputation for being something for your patients, not everything.

Lauren: You guys heard it here from Rob. I think you mentioned the 50% core local, 30% fundamentals, and maybe siphoning 20% of your time and energy towards AIO, and then continuing to monitor the situation as the consumer behavior changes. Really focusing in that 20% on some of the mid-funnel, narrowing, recommend me a group of type of searches, and focus on getting yourself visible there so that you become part of the consideration set over on the traditional SERPs when they’re looking for a local option.

Rob, thank you so much for joining. We’ll continue to have these chats every couple of months as the landscape evolves. If you guys are listening, continue to like, share, and keep listening to us wherever you get your podcasts. This was another episode of Ignite, and we’ll see you guys next time.

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