Medic updates in Google have made it a turbulent year for cosmetic surgery websites, their traffic and rankings.
(These are all year on year stats)
We started working with the company in May 2018. During the first few months, we had started outreach and fixing some of the glaring issues on the website.
Organic traffic had started to climb around 20% year on year by the end of July. Then at the start of August, the traffic drifted down slightly, and we breathed a sigh of relief that we made it through the update.
At the end of September that all changed, and we were in emergency mode to find fixes.
Thankfully we recovered in the March update. The following is my reasoning for the recovery.
In this SEO case study, I am not sharing who this client is publicly as the risks are too high. We managed to recover due in part to gaining a few high authority links. It is far too easy for competitors to find those if we shared the client name.
The 12 month goal for this SEO project was to reduce or have the option to reduce the several thousand spent on Google Ads each month.
The traffic split was 65% Ads and 30% organic, (5% from others).
Today the traffic split is almost 50/50 with an overall increase year on year increase of 28%.
But the Organic increase year on year is 89%.
Initial SEO Work
An initial review of the website discovered that it was over optimised. Keywords were stuffed in places where they had no right to exist, for example images.
Title tags and meta description were rewritten to be more visually appealing in the search results while still targeting the main terms on each page.
Lowering the on page keyword density and adding in LSI keywords helped the pages rank for a larger breadth of keywords. (It is worth noting that head keywords usually only send about 20% of the traffic to a well optimised page)
We no indexed pages that were not useful to be included in Google’s index.
At the start of the project we wanted to take the text out of tabs and display it all on the page – that was refused. We also suggested some rewrites that did not proceed.
Link building. Anyone reading this from the Cosmetic Surgery industrial will know already how competitive this market is. Because of that link building is one of the main ongoing monthly tasks.
We built links each month from guest posts, linking to all areas within the website. We also managed to pick up other types of links.
Each month we compared the keywords in Google Search Console with each page to look for improvements. We used TF-IDF data comparing not just locally but with other locations to look for keyword breadth improvements, we have since moved on to optimise content using Clearscope. (Conversion data from Ads had been used from the start to inform the main keywords to target)
Local SEO / Google Maps Listings
Only one of the three locations were listed in Google My Business, and it did not rank in the map pack.
Two other pages were optimised for other locations and they were added to GMB.
Citations and some local links were built to each of the three pages.
Each now ranks in the local map results, jumping between 1 and 3 depending on search location using the same city modifier keyword.
It would have been great to stop at this point and see some great increases over the year. But we had hardly started and along came medic.
Google’s Medic Update
I have been running my own websites and optimising client websites since 2006. I have learned when an algorithm update hits not to panic – having a day at the beach is less harmful than panic for websites.
The first update in August reversed some of the growth for this client, though we were still up. I spent August examining websites that had not been affected and reading the many opinions being blogged.
We were hit at the end of September 2018 with a loss of 40% organic traffic – overnight.
I ran a website back in 2011 and woke on the 23rd Feb to see half of the traffic disappear overnight. (I check traffic and rankings with my breakfast…). This update had all the same hallmarks.
EAT – Expertise, Authority & Trust
Since mid August I had been reading blogs promoting the idea that EAT was the solution to this update. Sometimes an explanation resonates and makes complete sense, this one jarred.
If EAT was the answer why had menshealth.com, Forbes, and IGN lost 30% of their traffic? Are these sites not authoritative?
During October we came up with the following plan:
We added the surgeons’ and doctors’ names at the end of all the pages. I was at a loss to believe that Google would actually trust third party data – they haven’t done this to date. The idea that a link from the doctor’s bio to LinkedIn or governing bodies does not make sense as a ranking factor.
We removed all text from the tabs and were able to see that some of it was duplicate. Some, not all, of that has been rewritten.
From my own investigation of sites not effected I had become convinced that link spread to internal pages and high quality relevant links were the main issue. (I understand that Google likes to combine issues in updates)
We managed to gain some niche relevant links that could not be replicated easily. All the onsite work was completed quickly. It had no effect. The links took until early December.
There are some relevant keywords that a service page is not going to rank for. By continually pushing buying pages to rank for informational queries will lead to disappointment and poor performance. Separating the intent of keywords is necessary, Google is much better at understanding the intent of a user’s query.
By, the start of January we were starting to see a very slight improvement in Google Search Console Impression – traffic was still awful. By the end of Jan we saw an increase in traffic, the slow increase continued until March when the last update. You can see that jump in the image above.
It is worth noting that we took the details of the doctors and surgeons off the bottom of the pages. It became too difficult to have each of them review and put their name to any changes we made to the text.
There are a lot of people making a lot of money by pushing the EAT myth.
If you run a website for long enough you will suffer in an algorithm update.
During the 5 months of lower traffic, we spent more on Google Ads and discovered there was a lot more business to be gained by expanding the keyword list.
We failed to reach the goal of spending less on ads. The client discovered that their capacity for growth was higher than first thought.
I hope this Cosmetic Surgery SEO case study has helped you. If you would like us to work for you, let’s have a chat.