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Tech Culture | Mar/Apr '20

Quarterly Health Care SEO Roundup: Q1 2020

More than eight out of 10 patients currently use Google as their first step in researching medical conditions or selecting a physician. Because of this, a practice’s ability to appear high in organic search engine results pages (SERPs) on Google and other search engines is crucial for patient acquisition and growth. But Google and other search engines are notorious for changing the algorithms that determine which websites rank. Google made 3,234 changes to its algorithm in 2018 alone, for an average of almost 9 changes per day.

In the search engine optimization (SEO) world, change is the only constant. To help physicians and their marketing managers stay on top of the biggest developments in SEO, this article summarizes the major changes that occurred this quarter. Included are actionable tips and insights that practices can take to respond to market changes, stay on top of their online presence, and keep acquiring patients from organic search.


What Happened

On January 13, Google began rolling out a core algorithm update. Unlike the thousands of small tweaks Google performs each year, core updates are large and can cause a lot of turbulence in rankings. Google usually releases three or four core updates per year and is now in the habit of announcing them a few days before they take effect.

Why It Matters for Health Care

The January 13 update seemed to reverse the adverse effects of the June 2, 2019 core update, which saw many health-related websites drop significantly in rankings. Below is an anonymized Google Search Console data for a client of ours in the health care space.

The June 2 core update hit many YMYL websites hard. YMYL, or Your Money or Your Life, refers to content that, if presented inaccurately or deceptively, could have an outsize impact on the reader’s happiness, health, safety, or financial stability.

Health care is solidly in the YMYL space, and Google holds health care providers to a higher standard online. Any content that doesn’t demonstrate strong expertise, authoritativeness, and trust (E-A-T; another major component of Google’s algorithm in 2020) risks being hit hard by core updates like the one seen in January.

What Practices Should Do

  • Check Google Search Console and Google Analytics to determine if you have been hit by a core update. This will inform your strategy and next steps.
  • Perform an audit of E-A-T signals across the internet. What is being said about your practice, physicians, and content elsewhere online? Are there any areas that portray a less-than-stellar reputation?
  • Seek to establish strong relationships between your practice and other reputable organizations with strong E-A-T. Consider implementing author bios and update physicians’ CVs on your website to demonstrate your E-A-T.
  • Make sure your website conveys your expertise, authoritativeness, and trust.


What Happened

On January 22, Google announced changes to how they will display featured snippets. Featured snippets are listings that provide a concise, helpful answer to a common query above organic search results, as shown below.

Prior to January 22, the website that “won” the featured snippet was generally also shown in the organic search results—it would be listed twice and would occupy double the SERP real estate. In January, Google reversed this years-long practice in a process called deduplication. As a result, if you now own the featured snippet, your website will not get another listing on the first page.

Why It Matters for Health Care

Although featured snippets are useful for providing quick answers to common questions, they are notorious for underperforming click-through rates. Most web users look to the featured snippet for a quick answer but never click through to browse the website. This is called a no-click search.

Featured snippets are shown on one out of four Google queries, so this isn’t a small issue. According to an Ahrefs study,1 when no featured snippet is present, 26% of clicks go to the first result. When a featured snippet is present, only 8.6% of clicks go to the featured snippet, while 19.6% of clicks go to the first “natural” search result underneath the featured snippet.

If your practice owns the featured snippet for a keyword, you could be seeing diminished click-through rates. It’s only possible to “win” the featured snippet if your website is already ranking in the top 10 results for a given keyword. As a result of this change, the most popular queries that lead to the majority of traffic to your site could be hit the hardest, leading to fewer clicks and less traffic to your site.

What Practices Should Do

  • Use a tool like Ahrefs or SEMRush to analyze which featured snippets your practice has “won.” Your strategy for featured snippets will depend on your marketing goals and the nature of each piece of content you rank for.
  • Don’t want featured snippets to drag down your click-through rates? Use the meta-max-snippet tag to limit the character-length of search snippets. Setting the max-snippet value to zero will prevent Google from displaying your content as a featured snippet but will maintain your presence in organic results.


What Happened

Google began sending notices to sites that have mobile-first indexing issues. In those emails, Google indicated that it will apply mobile-first indexing to all websites across the internet by September.

Mobile-first indexing means that Google will crawl your site from the eyes of a mobile-browser and use that mobile version for indexing and ranking. Google introduced mobile-first indexing in November 2016. By December 2018, half of all sites in Google’s search results were from mobile-first indexing. With this change, all Google search results will derive from mobile-first indexing by the fall.

Why It Matters for Health Care

As of 2018, 52% of all internet traffic comes from mobile devices. Google has recognized this tectonic shift and is using a mobile-first bot to crawl and index sites. If your website isn’t optimized for mobile devices, not only will patient experience suffer, but Google will penalize your online visibility as well. Not being mobile-first and mobile-friendly has a real impact on the bottom line for a practice, so spending the time and energy on getting your mobile site right is a worthwhile investment that can pay big dividends.

What Practices Should Do

  • Check Google Analytics to see what percentage of your site’s traffic comes from mobile devices. Google will be switching your site to mobile-first indexing (if it hasn’t already)—there’s nothing you can do about that, but checking your analytics can provide insights into user experience.
  • Run a page speed test on GTmetrix to analyze your website’s speed performance. Speed is a major component of Google’s algorithm these days, particularly on mobile devices. If your mobile website isn’t loading quickly, you will be penalized with lower rankings.
  • Use Google Search Console to check for mobile errors. If Google encounters any problems when crawling your site, they will appear here. This is perhaps the best source of truth for uncovering issues.
  • If your website has separate mobile and desktop versions, you should strongly consider consolidating the two into one; otherwise, Google’s switch to mobile-first indexing will cause your traffic from organic search to drop. This is more common for sites that were built before 2015.


Change is the only constant in the SEO world, and these changes can sometimes be painful. As Google seeks to improve the experience and results it surfaces for its 1.7 billion daily active users, health care professionals must stay on top of these changes and adapt to continue serving their patients and growing their practices. Hopefully this Quarterly SEO Roundup will help.

1. Soulo T. Ahrefs’ study of 2 million featured snippets: 10 important takeaways. Ahrefs. April 7, 2020. https://ahrefs.com/blog/featured-snippets-study/. Accessed April 7, 2020.

Crawford Ifland