Overcoming SEO Challenges: Insights for Multi-Location Healthcare Organizations

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: Y’all probably saw me recently on the NexHealth podcast in their great online scheduling tool. Talking about SEO. SEO’s my favorite thing. It’s Jacquelyn Green’s favorite thing. Jacquelyn, welcome to Ignite.

Jacquelyn Green: Thanks.

Alex: Today’s going to be fun because we’re going to help you from continuing to screw up. See Jacquelyn Green, she gets all the screw-ups, all the screwed-up babies come to her and they say, “Hey listen, we want to grow.” She says, “Guys, you’re not set up right.” We focus– our whole business is multi-site feedback provider groups. We get lots of brands that have lots of brands. We get sites that are giant mess and lots of acquisitions that want to come into this giant mess. It’s J Green’s job to clean them up. What’s up, J Green? How are we doing?

Jacquelyn: I’m good. Excited to talk about some local SEOs.

Alex: I feel like she’s being truthful there. Number one thing, a lot of them come either house of brands or they’ve consolidated. What makes you more excited?

Jacquelyn: I like when it’s consolidated. I think it’s easier for Google to understand one entity as opposed to a lot of somewhat connected entities, but I think either can work. I think it’s more about how you set up the vision for it. If you have a clear vision, I think it can work either way.

Alex: Tell me that. What is the right vision for each way?

Jacquelyn: I think the most important thing is to know how your brands are going to connect to each other and to know what your priorities are for your brands as a whole and specifically for each one. If you are doing a combined brand, if you’re lumping everything under a single brand, I think it’s really important to know what each individual location is bringing to the table already. What kind of authority they’re bringing, what kind of brand recognition they’re bringing? Have a strategy at large for how you’re going to deal with that.

If you’re consolidating into one brand, it really gets touchy when you start making exceptions for, “This provider has a reputation in their community, so how do we handle that? That this provider has a bad reputation, how do we handle that?” You have to know at scale what you want to do across the board and just stick to that vision. Once you start making things different at a brand level, it starts getting confusing for Google, for users, for everybody.

Alex: Start with a clear vision of either way. House of brands or consolidated can work. We like consolidate. Consolidate is a lot cheaper. They don’t have to run SEO on 15, 50, 150 different websites. Eventually, you get too big for that, I just assume. If I’m looking at like, I’ve got a ton of websites, how do you do SEO for 100 different brands? Let’s talk about the biggest provider groups out there that have 100 URLs. We’ve had some examples of that. What do you do?

Jacquelyn: I think in that case, onboarding is a really crucial component. Again, I think prioritizing is a very important piece of that. If you have multiple websites, unless you genuinely want to do a full unique SEO strategy for every website, you’re going to have to prioritize at some level and figure out what your top brands are, what your top regions are, what your top actual locations are, and figure out how you want to scale and what’s going to make the most sense for your business from that perspective. I think you have to make sure that you are clear as a business on what you want to prioritize.

Alex: Prioritize your most important groups, either from a revenue or capacity perspective. They’re the groups that have the most capacity, or the most room to run with capacity, or it’s concentrated on market like Texas or Georgia or something like that, which is very friendly and new to most groups, but expanding quickly. Optimize those sites, prioritize those. The biggest or the most important groups there with a lot of capacity. Capacity, capacity, capacity. We talk about all the time from a media perspective, spend where there’s appointments. In SEO, that also can apply.

Jacquelyn: Yes, it does. I think that’s a really good perspective to take. I think what’s tough about that perspective though is that things are possibly going to change rapidly internally, and so you might not know next month which practice is going to be needing more patients or which practice is going to be at capacity and SEO takes a while. That’s why during onboarding, it’s really crucial to look six months in the future because changing priorities month to month is going to slow everything down.

Alex: Don’t do that. Don’t do that.

Jacquelyn: That’s the biggest issue with clients. Even smaller groups, but especially with big groups. If you want to make Texas a region that is ranking number one in the SERPs in every single town and city in Texas, you’ve got to focus on Texas for three straight months. Even then, that’s a short amount of time. You can’t just say, “I’m going to do this for a month and then let’s pivot and go to New Jersey.” That’s not going to work. It’s going to just slow everything down.

Alex: If you’re too frenetic– I’m too frenetic. I probably couldn’t commit to a state for six months. If you think like that, then make great location pages and drive your [unintelligible] to the home page, it’ll trickle down [unintelligible 00:04:59] all your states. You don’t need to actually focus on any–

Jacquelyn: That’s true too. I think that’s a piece that can also be challenging to understand because it is complicated. I think there’s a difference between optimizing at a website level, which we can do in an ongoing basis and optimizing at a regional level. It’s a different approach. It’s a different level of focus. This is obviously easier if you’re all under one website. If you’re doing an SEO strategy, anything you do to the website, whether it’s link building or internal links on the site or anything you’re doing, it’s going to help the website in general.

If you have one website, all of your locations are going to get some amount of payoff on the work you do. It’s going to be obviously faster and more intentional if you are making intentional optimizations for that region or building backlinks for that region. If you have a million websites though, you’re not getting as much of that general domain level because you’ve got a lot of domains.

Alex: That’s true. There’s not a lot of that happening right now because of interest rates, but when you’re going out and acquiring practices, you need to have some little addendums in your contract that allow you to have full control over the website eventually, potentially do rebrand as you see fit, and then potentially you also roll it in. You’re going to get so big at some point. You can’t have 200 individual domains. It’s not going to make sense. You’re going to need one brand at some point.

Duplicate content. That’s something a lot of people worry about when they’ve got multi-site groups. How do you look at that?

Jacquelyn: I think there’s always going to be some amount of duplicate content on a lot of websites. Google’s pretty sophisticated. It’s not quite as straightforward as if one paragraph on one location page is the exact same on another. Google’s immediately going to penalize you. That doesn’t happen usually. You do need to make sure that you’re catering to each potential user that’s going to see that page when they search for those different queries.

I think that’s more of the approach that we take, is how do we make sure that each location page is most relevant for the queries that it’s going to show up for? Someone looking for even a dentist in Texas is looking for a different dentist than the one in Georgia. You have to make sure that that dentist in Texas that that location page has all of the right information to answer that query about what the user’s looking for. It’s more about that than it is–

Alex: What proportion would you give it? What can be duplicate? Jacquelyn hates specifics. All SEO’s timelines and specifics go against our nature.

Jacquelyn: Here’s what I would say, I think every location page should have at least one section of truly unique content.

Alex: All right. The algorithm will change, but for the last 5, 10 years I’ve seen it work even when half of the content is duplicate. Google doesn’t care as long as they have a good user experience and it’s very similar. I agree with you. I don’t know if she’s shaking her head right now. Let’s talk about technical stuff. How important is the technical setup of all of these websites? Just site speed and taxonomy and all of that fun stuff? Does it really matter that much?

Jacquelyn: Technical in general is the most important thing that I would have.

Alex: Wow. When you started here, you wouldn’t have said that.

Jacquelyn: That’s not true.

Alex: No, you wouldn’t have said that. You said content.

Jacquelyn: Content is extremely important, but when it comes to these types of websites, I think tech is extremely important. Not the fun technical stuff. Not stuff like site speed or schema. That stuff is important, but it’s more of the foundational, like can Google crawl your site kind of thing. When you have so many locations, especially if you are on one domain, think about how much work Google has to do to navigate your entire website. If you have 100 locations, you have a unique page for each of those. Maybe you have five unique provider pages for each of those conservatively. That’s a ton of pages and Google is going to get slowed down. If you’re not directing Google in a very strategic way and intentional way toward the pages you want them to see and how you want–

Alex: How do you do that? Through a site map or through the linking structure, [unintelligible 00:08:53] linking structure.

Jacquelyn: It’s definitely the general site map structure. The types of pages you have, how they’re linked to one another. That is important. It’s also just being pretty vigilant about checking your crawl rate, checking how Google is actually assessing your site and checking how things are getting indexed. Not being reactive necessarily, but being really in the weeds with it. You can set up a site perfectly and Google can still choose not to index important pages. It’s more about being discerning and really staying on top of things, which is why SEO is so crucial, even if organic is not your main traffic driver because you need those pages to appear in search, full stop.

Alex: That’s right.

Jacquelyn: Your SEOs can help you make sure that’s happening.

Alex: Do you link the GMB location to the specific location page on the website?

Jacquelyn: Yes.

Alex: That’s a little trick. All right. That wasn’t in the notes, [unintelligible 00:09:44], but that’s important. Very cool. Analysis. We work with almost entirely PE-backed groups who care about money. How do we show money with SEO?

Jacquelyn: It’s definitely the hardest part. This is not the answer to your question, but I do think that it’s really important to educate clients on all the things that lead to the money because SEO takes time and it’s not going to happen overnight. If they don’t understand why they should care about ranking number one for dentists near me, it’s going to be a tough relationship. Getting them to understand those points I do think is pretty crucial. Obviously, money is most important. I think having a clear analytics setup and factoring SEO into your holistic picture, how does it factor in compared to your other channels is important to see what your market share is for SEO relative to other channels.

Alex: Recently I’ve [unintelligible 00:10:40] some miraculous work in SEO analysis where we look at cost per booking from organic, from all owned and earned media channels. It beats the heck out of all the paid media stuff that we do. The cost per bookings usually three times lower from owned and earned media than it is from paid media. It makes the overall– Then I’ve seen Jacquelyn, she combines her own earned media with paid media and that’s your overall cost per booking. That’s a great way also, but you got to be able to track your bookings. You need a line or a patient prism for call and lead form tracking. You need a next help or a next patient for appointment scheduling tracking. Then you get to a cost per booking and you can track through it from own and earn.

Something also really cool Jacquelyn’s doing and underselling it is looking at the amount of appointments booked through own and earn media, and then looking at the cost per booking from paid media. Saying, “If you were to buy all of these leads through paid media, you would have spent X amount of dollars.” That number is usually six figures and own [unintelligible 00:11:35] five.

Jacquelyn: Yes. It does get tricky because there are a lot of factors that go into how you perform organically. There’s always going to be more to that picture I think than maybe what you would see in paid media where it’s a lot more clear-cut. It just becomes a lot more nuanced I think with organic of making sure the client understands how what we are doing factors into that. A lot of clients will just say, “We would’ve had that regardless.” Then you have to be able to really support it through those lower metrics and saying, “No, you wouldn’t because without this page you wouldn’t rank for this query.” Which is what is ranking for and driving you all these bookings.

Alex: You can tell Jacquelyn just had that conversation yesterday. She’s not happy with dental clients right now. She’s not happy that they’re not agreeing that she did all of the work that led to it. J Green is the best SEO person you’ll ever meet on the planet. She’s phenomenal. I hope you enjoyed this session on all of the different things multi-site provider groups need to do to help rank, help drive traffic, and then ultimately bookings and understand the value of those bookings. J Green, thanks for joining us.

Jacquelyn: Thank you.

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