Semantic Connectivity

Google wants to see sites that are staying on topic, and the best way to do this is by using similar and related words to your main topic. Say your site is all about cars, you would want to use words like automobile, vehicles, transportation, gas guzzler, etc; using words that are easily related to each other or have the same meaning. Basically, it’s not all about keyword stuffing, we all know readers get easily annoyed when they see this, it’s about using a number of different words that are related to your keyword.

Block Level Optimization

All SEOs know how vital it is to organize your site in a way that is easy for search engines to analyze and figure out what your topic is about. Search engines are checking to make sure that your page is relevant to the content of the query and that you are giving the user the information that satisfies their needs. Knowing what your topic is, staying on-topic and making the navigation user-friendly is extremely important if you want to come up in the SERP.

Internal and External Links

Link building has always been a useful tactic to gain page rank, but what SEOs are finding more often is the importance of having internal links. Rand mentioned when Marshall Simmons, from the New York Times, visited, he said that once the site started to post external links their sites rankings increased. While it is still unknown exactly how Google’s algorithm decides this, it’s clear that referencing relevant stuff on your site can and will increase your rankings.

Happiness of Visitors

No matter how many inbound or external links your site may have or how well your site is organized, if you don’t have useful information that serves the users needs for their query Google will penalize you. There are many ways Google tracks whether or not the user finds your page useful. One of the main ways is whether the user stays on your site or quickly exists and continues searching. Make sure your content is unique and doesn’t come off as spammy. Another big sign Google pays attention to whether or not people are coming back. Having annoying pop-up ads and music in the background does not make for a very user-friendly experience, so even if you make money off of these ads or love the song you put on the site, it doesn’t mean the users will appreciate it.

Content Uniqueness and Formatting

Rand made the analogy, which I loved, when he said that,  “you can’t have a mad lib style SEO.” Meaning, you can’t just use the same format for every page and in certain parts insert X, Y and Z. Google is very good at catching this and wants to see highly unique pieces of content across your entire site. Search engines are are also looking for longer and more in-depth content. This doesn’t necessarily mean the longer the content the better, but if it’s unique and meaningful. Having pictures is always a plus because Google can pick up the images up and other sites may find them, use them and then link back to you (natural links!). Last, but not least, make sure to check for grammar and punctuation errors because Google can catch these and if users are using the reading level filter you may be dropped lower in the search.

I recommend watching the video and let me know what you think!

During the call I checked my Adwords account and I was only paying $2 per click for this keyword in the Seattle market. But then I checked our account in Los Angeles and noticed that we were paying $8 per click for the same keyword. No surprise here, Google Trends says that LA is one of the top 5 markets in the USA for tattoo removal, and Seattle is not even on the map!

Follow me on this one.

• If the CPC in Seattle for Tattoo Removal is $2, then 100 clicks costs $200, at a 5% conversion the value per lead is $40. Our pricing, in Seattle, for tattoo removal services should reflect this.
• In LA, if the CPC is $7, 100 clicks cost $700, at a 5% conversion the value per lead is $140. The pricing in LA for tattoo removal should reflect the higher demand

In order to justify a $40 cost per lead in Seattle the lifetime value of a tattoo removal patient must be around $1000 to $1,500. In LA, in order to justify the cost of $140 per lead the value of the tattoo removal patient must be 3X that of Seattle: $3,000 to $4,5000.

This is crystal clear for me. The thing that gets me is that Tattoo Removal clinics in LA are charging $49 per sq inch for service, this is the same as Seattle. If the demand in the CPC market in LA drove the price up 3X that of Seattle, why have the prices not followed?

I’m interested to know your thoughts on this one as well. If the market is demanding a high CPC, why has this not effected the pricing by the service providers?

The ZocDoc service give’s healthcare clinics a widget to install on their website that reads “Book an Appointment.” When this is clicked the visitor is taken off of your website on to a ZocDoc hosted scheduling page. The clinic keeps X amount of open appointment times for ZocDoc patients, these appointments times are shown on the scheduling system. The visitor then selects their desired appointment time and schedules.

The second side to ZocDoc is the lead generation service. ZocDoc’s public facing website captures visitors and asks the question “Do you want to find a doctor?” The visitor chooses the service that they are interested in, selects a location, and finds a doctor. Sounds like an amazing system!

I have had the ability to work with two of our clients that use the ZocDoc. Here are a few of my take aways.

You Link to ZocDoc, They Don’t Link To You

What an amazing in bound link strategy. I have to give a thumbs up to the ZocDoc SEO team  for this one. They now have healthcare clinics across the nation linking to their site. In short, they are sourcing their SEO power from all of their clients. Both my clients are linking to them, hwoever, I did catch this in time so we installed no-follow tags to prevent ZocDoc from getting our link power. I’d like to keep the link power on our site.

ZocDoc Call To Actions Compete With Ours

Take a look at Island Dermatology, a Dermatology Clinic in Seattle. Our “Make an appointment” call to action is now right next to the ZocDoc “Book an Appointment” call to action. Our clients offer cosmetic dermatology specials as a method to generate conversions. What should the web visitor do? Book an Appointment online or sign up for a dermatology deal?  Also, if someone signs up through ZocDoc, are they thinking they are getting the dermatology deal, or are they making an appointment? This is confusing.

A side thought. If I were ZocDoc, I would use a branded image for their call to action, not the boring one that they sent our team. Branded images generate credibility.

Tracking Conversion in Google Analytics

You guessed it. Now that the point of conversion is happening off of our website, we loose the ability to track the conversion through Google Analytics. We can place a virtual page view with on-click code when the “Book an Appointment” call to action is clicked on. This will give us some tracking, but I’d like to have the visitor convert on my site, not ZocDoc’s.

Your Welcome ZocDoc, For Sending You All of Our Patients

All of our SEO efforts, PPC efforts, blogging efforts, on page strategies, link building techniques, and other digital strategies bring people into our clients site by the thousands! SUCCESS!!! Now that we have potential patients on our site, we send them over to ZocDoc to convert under their brand, to become the property of ZocDoc. Have you read the ZocDoc terms of service? Does ZocDoc retain the right to market to your patients? My biggest fear is that ZocDoc will get the credit for the conversions, and all of our hard work will not be seen by the client. This could lead to the termination of a powerful digital marketing campaign because the clinic thinks ZocDoc is creating the patients, when in reality, we are driving the patients to the website then they are converting on ZocDoc.

Low Conversion Rate through ZocDoc

Just for conversations sake, and I’d love someone to play devils advocate here. If you were searching for Seattle Laser Hair Removal and found a website, clicked on the “Book an Appointment” link, then saw only 3 appointments were open over the next week (and they didn’t fit your schedule), would you continue your search? My argument is that if you are going to offer online scheduling, show all of your appointments, not just some of them. Odds are you are scaring off potential patients due to scheduling concerns.

In Closing

$250 per month, flat fee, month to month contract: Is it worth it?If you are getting new patients., yes! But I challenge you to understand the risks that I mentioned above.  I’m interested to know your ZocDoc experience and thoughts on their service.

Here are the steps that Rand dives into:

1. Keyword Targeting

First, you need to establish a complete list of all the keywords you are targeting on the site. This list will provide the stepping stone for acknowledging your site’s main focus.

2. Map out your Keywords

On each page you will need to decide whether you are going to use multiple or singular keywords. You need to remember to pay attention to the users intent on the page and try not to use so many keywords that you create a topic so broad that you fail to serve the users. It’s usually best to use only one keyword and that keywords synonyms.

Create a map of keywords based on:

- Relevance: does the page serve the needs of the user and the keyword phrase they are searching.
- User intent: make sure you have a clear understanding of exactly what the user wants from the page.
- Conversion Goals: on each page what are you tracking for your conversions. Are they signing up for your email list? Filling out a web form?

3. Build Content that Makes Searchers Happy

The keywords may bring the searcher to the page, but the content is what keeps the searcher on the site. It’s important to always remember this and think about what the user needs from your site and how you can easily present the information to them.

Check out the full video here:

Managing a private medical practice during healthcare reform can be very exciting; it can also be extremely frustrating.  Aside from the new healthcare laws to keep up with, we also have the annual discussion about the Sustainable Growth Rate (SGR) formula, “What are we going to do if the cuts go through?”  If you’re not aware, the SGR is a Medicare payment cut mandated by law.  As of January 1, 2012 we’re facing a 29% decrease in Medicare reimbursements.  Each year we face a similar scenario and each year congress steps in at the last minute to stop the cut.  Yep, you heard it right, every single year the medical community takes a deep breath and starts praying, crossing fingers, and calling members of congress.  So far, we’ve dodged a bullet.  That doesn’t imply physicians are getting any increase in pay, even though the cost of providing medical care continues to go up.  The graph in the link below, published by the American Medical Association, is a nice visual of the discrepancy between Medicare reimbursements and the cost of doing business in medicine.  Notice anything significant for 2012? VIEW PDF

This year, we’re waiting to find out once again, if a 29% cut in reimbursement will come to fruition or if we’ll be saved for another 6 or 12 months.  Part of my job is to analyze the impact of such a cut on our financials; this is where I begin to lose sleep.  Here is the bottom line, when your patient panel is made up of 40% Medicare patients, a 29% cut would be devastating.  It is survivable but it isn’t “life as we know it”. In a private dermatology practice where older adults are a huge part of your clientele, you have to start considering an alternative business model; one where you decrease Medicare patients and increase patients asking for cosmetic services.  It’s been difficult to watch my providers grapple with the notion that we may be forced to block access to our seniors, the population that has the highest incidence of melanoma and other skin cancers.

So far, we’ve decided to remain optimistic but exercise the idiom “hedge your bets”.  Instead of cancelling our Medicare contract or significantly blocking these patients, we’re trying to increase the availability and frequency of cash services.  More patients paying with either private insurance or cash, enables us to continue providing care for Medicare patients.  It might also save us from downsizing.  Our Medicare patients would likely have less access but at least they will still have a dermatologist, their dermatologist.

Now, where am I going to find all these new patients so we can keep our Medicare patients, and our employees, and my job while I’m at it?  In the coming months I’ll share some of the trials and tribulations of our clinic transition and what we’ve learned about consumer behavior, competition, social media, deal sites, search engine optimization, key words, traditional marketing, seasonal trending…the list goes on and on.  Stay tuned!

When I report organic results to clients a few of the metrics I include are branded organic keywords and visits, and non-branded organic keywords and visits. When your site see’s more non-brand related organic traffic coming to your site from search engines, it means that we are doing our job! Google’s recent change has effected how these numbers are presented.

In the past

Some one will go to Google, click on an organic listing and enter the website. The keyword that they searched for will be entered in their Google Analytics account.

Whats happening now

Google rolled out secure search in May 2010, and then made an update on October 18 2011. When someone is logged into their Google Account (Gmail, Google +) they will be directed to https://www.google.com (notice the S in the URL) when a search is conducted on this new (er) Secure Google Search will not pass the keyword data to the Google Analytics account.

This is what Google Analytics is reporting as a result to this change

What does this mean for us?

1) We will not be able to identify what search terms people are using when the come to your website.

2) All keyword data from someone logged into their keyword account will be shown as “Not Provided”, coming from 1 keyword source. This effects our reporting. So, if 200 visitors are using 150 keywords to find your site, this new change will register the 150 keywords as 1 “Not provided”

3) This change will not show a decline of traffic from organic search, only a decline in the number of keywords that generated the traffic

How many people does this Google Update effect?

We are estimating that 5% to 15% of visitors coming to your site are logged into their Google Account.

Our team is taking the proper action to monitor this change across our clients analytics account. If you have any questions regarding this change and how/if your site is effected, feel free to contact us.

Resources:

http://googleblog.blogspot.com/2011/10/making-search-more-secure.html

https://www.eff.org/https-everywhere

http://searchengineland.com/google-to-begin-encrypting-searches-outbound-clicks-by-default-97435

http://searchengineland.com/google-anonymizing-search-records-to-protect-privacy-10736

In some cases, getting to the top of the search engines is war! Take no prisoners, pull out the dirty tricks, screw Guantanamo bay and the Geneva convention, we are going to do whatever it takes to become #1 on a SERP. However, wars are not won because you have the best weapon (you can argure that point), wars are won through strategy, teamwork, and determination.

Google changes their algorithm often, this is no secret. But why does Google embark on numerous changes every year? Well, the answers simple. To keep the crap out of the result listings. After all of these changes Googl’s goal is the same, to display the best content to a user when a search is conducted. In short, to give people what they are searching for. It’s Google’s job to display only the BEST content at any given time.

What is your take away from this concept? It’s simple, you need to become the best. No SEO company can do that for you, no consultant can snap their fingers and make you the best. It’s your drive that will make you number one, it’s your mission statement that drives value in the hearts of your patients and customers. Make no mistake, we (marketing people) can show you the doors and build the foundation, but it’s up to you to make it happen.

So there I was one night. Not knowing that the holy grail of SEO was about to find me. I had no clue that everything that I every knew about SEO and digital marketing was about to be summed up in a few short words. In fact, I bet you didn’t know, the silver bullet of SEO found me in the form of a tweet. That’s right, 140 characters floated through cyberspace, knocked on my door, entered my mind, the light the light bulbs. And you know what the funny thing is, I always knew what it was. It was right their in front of my face this whole time. I guess the question is, now that the mud in the water has cleared, what are we going to do with the fresh water?

May I  Present To You, The Silver Bullet of SEO, In The Form of A Tweet.

“Process is how big companies function. Want to influence change in enterprise SEO? Change the process”

Time to ask yourself, how much of your ad budget is dedicated to the social networks. Targeting ads through social platforms is now your sniper rifle approach to reaching and engaging your target market. A few year’s ago I remember people throught that this social networking thing was a fad, now, 10 Billion dollars later, I think it’s safe to say that its here to stay.

When Apple first opened up their iPhone platform to outside developers, they showcased the device’s potential to revolutionize the healthcare industry. Despite a slew of applications for emergency room wait times, calculators, and reference texts, there is still untapped potential for context-sensitive applications.

Here are five ways mobile technology can revolutionize chronic care:

Managing Chronic Illness:

A patient with a serious disease is dealing with it 24 hours a day, seven days a week, inside of the hospital, as well as outside. A mobile device is designed to be with you at all times and could prove to be an indispensable tool for patients. Pocket-sized devices could provide an opportunity to track medications, appointments, test results and even conversations.

Monitoring:

Not only are today’s mobile devices portable, they are exceptionally powerful. When medical professionals are outside of the hospital complex — where signal is weak and some devices may interfere with equipment — the right mobile application could provide detail-rich information that far exceeds the capabilities of a pager.

Diagnostics:

IBM’s supercomputer Watson may have swiftly defeated two Jeopardy champions, but his next endeavor is even more interesting; Watson is going to medical school. IBM’s Deep Question Answering, Natural Language Processing, and Machine Learning capabilities will be blended with Nuance’s speech recognition and Clinical Language Understanding solutions for a research project with Columbia University Medical Center and the University of Maryland Medical School.  By allowing easy access to Watson’s wealth of knowledge, seasoned medical professionals can augment their years of experience to provide a quick diagnosis at the drop of a hat.

Acute Care:

If publishing turned its back on paper, isn’t it time the medical profession does as well? Nurses are still rushing around frantically recording their actions on analog Acute Care Flowsheets. A digitized system can improve efficiency and minimize errors.

Coordination of Care:

The United States Department of Health and Human Services is currently incentivizing  health care providers to switch to Electronic Health Records. This format allows health care professionals to know more about their patients, make better decisions and save money. Chronic care requires the coordination of patients, primary providers, secondary providers, tertiary providers, and many others. A system on an iPad, for example, would facilitate records to move quickly between providers, while easily allowing providers to interact with the information via the iPad’s intuitive interface.