Search Engine Optimisation (SEO) for your Medispa

 As a medispa owner, search engine optimisation (SEO) is a vital part of attracting clients. The front page of google organic search is expensive real estate, because the difference between being on page 1 and 2 of google, is significant. For a search term, over 91% of searchers won't even look at the second page.

This article addresses the tough questions on this challenging topic. How can clinic owners achieve the best ROI from their SEO spend? How can they approach SEO when on a tighter budget?

Googlejuice is the lifeblood of a medispa business and my interview guest, Adam Downer, cosmetic clinic marketing expert, and founder of Costhetics, is going to help explain to medispa owners how to get it.

Welcome Adam, can you give us the "for dummies" version of what is SEO, how important it is, and how to improve it?

SEO stands for Search Engine Optimisation and basically encompasses anything that improves your organic Google rankings.

An "organic" ranking, is your website being listed in the search results by Google without having to pay for AdWords. It's very easy to appear on page 1 of the Google search results if you are prepared to pay money to Google AdWords. To appear there naturally, is much harder.

I’ll now answer why organic rankings are so important and valuable; If you can appear on the first page of Google without paying per click to AdWords, that obviously has huge business value. The next part of the value is, how much search traffic is there? Do you appear on page one for a very popular search term such as "laser hair removal Sydney"? Or do you appear there for a more specific search term such as "what's the difference between 1ml and 2ml of dermal filler in my lips?" (something we call a "long tail" term in SEO lingo). The latter search term gains far less people per month using it...but it arguably has a lot of value - because if your website answered that question well, it's quite probable that person will take the next step and make an enquiry to your practice via phone or email (we call this a conversion).

Google has recently stated that up to 25% of searches each day have never been seen before! So how do we track our rankings if so many searches are impossible to know? Well, this is important and something many SEO companies don't want you to know. They want to pick a bunch of terms that they focus on and show you how they've improved them. However, did this add any value to your business? The only way to extract tangible business value from SEO is by increasing the number of conversions (enquiries).

So, step 1 is to start measuring enquiries. This is useful for all your marketing activities, not just SEO.

Step 2 is to have a look at your organic traffic over time. The idea behind SEO is the following:

1. Improve Google rankings across a range of search terms.

2. This will increase the traffic to your website.

3. If the conversion rate stays steady or improves, the number of enquiries (conversions) will increase - this is finally where the value appears.

However, and this is important, improving rankings without increasing traffic is not helpful. Why? Because if your rankings improve for some terms, but no one is using those search terms, then no one will find your site using them. Conversions are king, but increasing traffic is the first step. Many SEO experts harp on about how much better your rankings are, but fail to really boost your traffic.

It is possible to change the distribution of traffic such that it hasn't really increased, but the traffic you are getting is more targeted. But typically, you add to the traffic you have, not swap it.

What can a clinic owner, or their staff do personally, to help build the clinic’s SEO?

The first thing to do is to put some metrics in place to measure if SEO is working. It doesn't matter if you do it in-house, or hire an expert - but beware, many SEO experts are terrible and it's very easy to waste a lot of money! 

If your SEO is working, you will see your website traffic increase over time (it takes time mind you, it's unlikely you’ll see much movement in the first 6 months).

You also want to see your conversions increase. Increased traffic is nice, but if it isn't converting, you're not adding much value.

OK, so now we have a way to measure our success (or failure), let's do something to help our SEO! 

The first and most important step is content: Invest in great content. Find out what your customers want to know. Most practices have a terrible amount of content on their site. The pages are usually very short and lack information. They also contain very few pages. A very big site with hundreds of pages is at a very big advantage to a site with very little information.

If you do nothing else in terms of SEO, invest in high quality content. You can hire good writers to generate this for you. However, unless they really know your industry and business it is likely to be very low quality. You can write it in-house, which is great, but it depends if you have any great writers. If you can't find someone who specialises in aesthetic medical copywriting, then your best bet is to generate content ideas and bullet point all the information the article should include. Then hand it over to a professional writer to make the piece interesting and engaging.

There are several important aspects of SEO including on-page SEO and link building? Are both important in the medispa space?

This is quite a technical question - so I'll take it slow! Traditionally, SEO has been broken into two parts: ‘On page’ and ‘off page’. On page, basically means making changes to your website e.g. the content, headings, title, meta tags etc. Getting this right is incredibly important, but it's important not to over optimise. Years ago, Google was less smart and you could use cheap tricks like keyword stuffing to improve the rankings of your pages. These days though, Google is smarter than ever. It is important to use the appropriate terms, but if you aim for writing really great content that is easy for a human to understand, this is a better approach since Google isn't likely to penalise you.

Off page SEO, refers to activities that do not involve changing your site. The biggest one of these is link building. Links are one of the ways Google assesses how important your site is. Lots of links to your site? You must be good right? This used to be what SEO was all about. Typically, SEO companies would have cheap labour camps leaving links to your site all over the Internet. Google got wise to this however, and can now detect what it calls an "unnatural link profile". So, link building in the traditional sense is pretty much dead. A few high quality links from reputable sites will definitely improve your rankings, but these cannot be acquired easily, especially in this industry.

So, my thoughts here are - be very careful of link building. Unless your SEO person comes highly recommended and has a proven track record, I'd be very wary of engaging some random SEO company to do link building for you, as it's possible it could hurt you more than help.

On page SEO, is very important. Even having a fairly new mobile friendly site is considered on page SEO. In fact, in April this year Google started penalising sites that were not mobile friendly. In short, if you focus on having the best website your business can afford to make and curate with great content, you're likely to rank a lot better than your competition.

What is the easiest and best way for medispas to get quality links to their site?

Sadly, when it comes to quality links, they are very hard to come by. You've raised a good point though - quality over quantity. The days of lots of irrelevant links improving rankings are gone. A quality link (i.e. from a large authoritative site) that is also relevant will go a long way. The way SEO companies go about doing this is something called outreach. They basically email a list of sites and ask for a link. If the site is not a direct competitor, they might be happy to do this. They might also be open to doing a link swap where you both point links at each other. It has less value than if the link only goes one way, but it's better than nothing. 

In this industry, it's incredibly hard. Mostly, because any other high-ranking authoritative sites in the industry are likely to be competitors of yours.

A good PR agent can sometimes arrange a link from a news source to your site if it is relevant to the story. These can be incredibly valuable. Even just one link from a large news network to your site can really boost your rankings.

In a medispa business, content marketing is one of the most important keys in an SEO strategy. Do you agree with this statement, and can you explain the term and give owners/managers any valuable associated tips?

Absolutely Dr Naomi. This is really where it is at for aesthetic practices. The first thing to invest in, as part of an SEO strategy, or even just a good marketing strategy, is content. In fact, content marketing is probably one of the hottest trends in marketing this year. 

But what is it exactly? Content marketing is about creating valuable content that consumers rely on and trust. They don't see the content as advertising. They see it as helpful, expert advice and is highly educational. It might be highly correlated to your business. It might be slightly more tangential. One of the oldest forms of content marketing is the Michelin guide - the world's foremost authority on fine dining. But Michelin makes tires? What do they know about restaurants? And this is the genius behind it. The content was so well made and researched, Michelin created a whole brand around the guide that people trusted. The original idea was to provide a useful guidebook for people making road trips around France. The link back then was a little more obvious - the company thought, "what can we do for customers to help and encourage them to tour by car around the country?"

Giving away your expert knowledge is incredibly powerful. It demonstrates your expertise to the world. It shows that you care about educating them and being helpful. It can also create a following and trust from potential and new customers. It doesn't always have to be 100% on topic either - we write all kinds of content for clients, which often includes things like recipe ideas. Any type of content that can delight your target audience can be helpful. Try not to stray too far off topic though, as this might confuse your target audience. For example as a medispa you probably don't want to talk about the best frequent flyer programmes.

Remember, the goal here is not only to gain new customers - but also to retain existing ones. The medispa business is not unique in that customers are incredibly valuable and it's much cheaper and easier to retain an existing client that to gain a new one. This is different to surgery, since unless there is a non-surgical clinic attached, there is usually little repeat business - although referrals are very important.

It is such an uphill battle for newcomers to the medispa industry who have to go up against the well established and clinics, which has been optimised over the long term. What are the difficulties for newcomers to the industry in terms of SEO, and what can they do to overcome these obstacles?

Unfortunately, new clinics do have an uphill struggle, particularly when competing against established brands. Google is very biased towards older sites when it comes to organic rankings (but don't worry - they'll take your money from day 1 as an AdWords customer!).

So, where does a new clinic have an advantage? Well, for starters - you get the chance to build a new website. Often clinics become busy with the day to day, they don't really dedicate much time to making their website as awesome as it could be. Getting an amazing website with lots and lots of fantastic content is much easier when you don't have a busy practice with hundreds of clients to attend to. Try to see that extra time as an advantage. The better your website, with more higher quality content presents quite a barrier to compete with.

The goal is to have an engaging website that people love to explore and use. Google has a number of methods it uses to determine if the engagement of your site is good or bad.

You can also consider buying an existing domain. You have to do your research on this carefully, since you don't want to buy a dud. But if you can get an older domain (say 5 - 10 years old) the theory is that it will be easier to rank than a brand new one. The downside of course is, decent domains that are old cost money. Given how expensive high quality SEO is these days, it can still be worth it.

Social media is also another avenue. Building a great following on social media is a lot easier than SEOing a website. If you can develop a Facebook page with thousands of followers who also go to your site to read your excellent content, these can improve the amount of searches for your brand, which is helpful to improving your rankings.

SEO can be very expensive, especially when done well. How should a medispa owner / manager approach coming up with a budget for it.

I generally recommend most medispas focus on content. The more expensive SEO that involves high quality link building can be extremely expensive (I've heard of clinics spending 10 - 20k per month on SEO!). If you have an enormous marketing budget, that's fine. Most clinics do not and there are many other ways of getting a good return on marketing investments. 

The great thing about investing in fantastic content and a really great website is - it will help all of your other marketing activities, such as AdWords or Facebook. I believe most medispa managers should really only invest in great content and a great website as to the extent of their SEO. Perhaps consider hiring a trustworthy SEO consultant to help with on-page optimisation, but as for off-page SEO methods - you can make more money more quickly and easily using AdWords or Facebook ads.

Can you compare the pros and cons of organic vs paid search for the cosmetic medical industry?

Organic search is probably always going to be more valuable, since people still trust it more than paid search. However, this behaviour is changing. People trust AdWords more now than they did a few years ago.

While organic search rankings are more valuable, they are also far more expensive to get and take much longer to grow. For a non-established brand without an old website, I think the days of aggressively pursuing organic rankings via SEO are pretty much over. That's not to say a solid content strategy isn't valuable - it's highly valuable. But think about ranking for those long tail terms over the higher search volume ones.

The great thing about organic search too is, once you are established, you can take your foot off the gas a bit and don't have to be spending big on SEO every month. Paid search is great because of its immediacy, but you loose the benefits once you stop spending.

You can think of it a bit like buying an apartment in an expensive location like Sydney or New York. Buying is a more long-term strategy. It hurts a lot in the early days too. Renting is much quicker and easier...but over the long term, if you bought 20 years ago, you're doing much better than if you are still renting now. Short-term results versus long-term benefits are really what you are playing against.

Ideally, you can afford to invest in both paid search and organic search. Hopefully one day the organic strategy pays off so that you can reduce the paid search spending. 

How can a company determine the most suitable search terms and keywords for their business?

This is another great question. Obviously, we want the highest value search terms possible. However, probably the first step is to see what kinds of search terms you already rank for. You can do this by looking in Google Webmaster Tools. Unfortunately Google Analytics no longer provides this useful keyword information. Take a look at the keywords and landing pages that are currently getting traffic. Try to think of similar themes and write another page of content and see if that also gets some traffic. You're far more likely to rank for information that your competition doesn't have on their site.

But how do you discover what you don't know? A great way that hardly any practices do is mine their customer enquiries. If you've been around for a year or more, you've probably had potential patients email you a large variety of questions. Does your website contain this information? If not, add some content and see if it gets any organic traffic. Try to make each page as specific as possible to increase your chances of getting some of that long tail search love. At first it seems that everything under the sun has already been written about. But in actual fact, once you start looking deeper, there is a huge amount of information that is not on any websites.

Even if you aren't doing AdWords - take a look at the keyword tool as this can also generate ideas. If you are running ads, take a look at some of your broad match campaigns and see what people were actually typing into Google (fortunately, analytics does give you this information for paid search terms).

Last, but not least, the most valuable terms are the ones that convert. If keywords don't convert, there are two potential problems. First, the website just isn't good enough or the content isn't what people are looking for. Second, those search terms have little intent behind them. If that's the case, they just might not be that valuable and probably not worth targeting. Because AdWords allows you to essentially rank on page 1 instantly for given keywords, it can be a great tool to experiment with for coming up with content ideas and search terms you want to target organically.

SEO should be combined with other marketing strategies. What are the other best types of marketing for medispas, and where does an owner start to make a plan that includes all of these options? Also how do they determine how to best divide the marketing budget? Any tips, or rules or guidance?

Yes yes yes! Absolutely. Relying on any single marketing channel is always dangerous. Things move and change so fast in the digital world, what worked 3 months ago, might not still work well today.

Always start with your website and content strategy. Without a great website and excellent content, you're really flogging a dead horse. Paid ads are expensive, to reduce their cost, the website needs to be great at converting traffic into enquiries. You pay per click, but you only get paid for conversions. Improving the conversion rate of your website from 2% to 3% doesn't sound like a lot. But in terms of marketing, you've just improved your marketing ROI by 50%! So many clinics make the huge (and expensive mistake) of marketing a poor website, or not spending any time each month trying to improve it.

My favourite marketing activities that are working right now are:

1. Facebook ads

2. AdWords

3. Retargeting using FB (AdWords recently banned any medical treatments from using their remarketing platform, which is a real shame since it worked incredibly well).

Think of your website and content as your core strategy. Marketing in this industry is mostly about patient education. You want to be their trusted advisor. If you have no money for anything else, make sure you at least have a great website and excellent content - and can keep adding content consistently.

Everything else is really just distribution of that content. Whether those channels are social media (like Facebook and Instagram - I've never seen much ROI with Twitter in this industry).

Email marketing is also hugely undervalued. The bigger your patient list, the more valuable it is. All clinics should be doing email marketing to their existing patients. It's far easier to sell to your existing client base than a new patient. You want to build loyalty and top of mind presence. Definitely avoid just spamming your list with specials. This is OK occasionally, but it gets boring quickly and also tends to make your offering all about price. You don't want to make your services all about price, you want it to be about quality of service and expertise.

The other often-overlooked part of any marketing strategy is the patient experience from start to finish. What's it like to phone the practice as a new customer? How are email enquiries handled? While there is tremendous scope to grow your practice through great marketing, if emails take hours or days to be replied to, or the phone call experience is not like ringing a 5 star hotel - other practices will literally eat your lunch. The difference in conversion rates from enquiry to consult can be as high as 800%!

I always like to recommend an inside out approach. Although patient experience and enquiry handling is really more in the customer service and sales realm, it is really so important. Think of marketing as fuel. Pour some gas on a fire and it will really make a big flame. Pouring it on soggy wood with no spark is really not going to help.

In terms of priorities, I'd focus on this:

1. Enquiry (lead) handling - phone and email. Record your in-bound phone calls and review the emails and see what the engagement is like. It's easy to see if it's not working. If your enquiry to conversion rate is 10% or less, you need help. Hire an expert to train your staff.

2. Patient experience - the in-practice experience should be smooth and easy. Again, have this reviewed or mystery shopped by a good consultant.

3. Website and content - if your budget stretches no further, at least get this right. Make sure the pages have been optimised for SEO (but not over optimised).

4. Email marketing - especially if you have over 1000 patients on your list. Try to get them coming back and trying new treatments they don't normally have. Increase revenue per patient. The ROI on this activity is enormous.

5. Get new patients - we need some lead generation here, such as AdWords and / or Facebook ads. Do both if you can, but remember that for AdWords in particular the management fee can easily be more than 1000 per month for someone who knows what they are doing. If your budget is less, try Facebook ads first.

6. Social media - it's unlikely you have someone in-house who can do this cost effectively and as well as an expert can. If you have budget left after your ads, building a good social media presence is a good long-term strategic marketing asset.

7. Now and only now if you budget gets this far - should you start thinking about SEO type activities that are more than content and on-page optimisation.

SEO has been compared to a flywheel, in that in the start, there is significant inertia and it resists changes in speed, but once it gets to speed, it stores rotational energy. So what that means is that a lot of torque is required in the beginning, but once it’s going it gets a lot easier. How does a clinic approach the different stages.

This is a really good analogy. It's also why you can spend huge amounts of money on SEO in the early days for not much benefit. You're much better starting slower in this regard and building over time. Equally, I know of clinics that are spending very large amounts on SEO, who've progressively cut back their spend to zero and not found any loss of rankings. It's always better to do a few or even one thing well than to spread yourself thin. You need to have a good handle on what you are getting out of your marketing efforts. If you don't know what your ROI is, then you will likely underinvest in these activities. The reason being, you have no confidence in what you are doing, but you know you need to do something, so you spend as little as possible. This is a risk to your business. Equally, a very large successful business can overinvest in their marketing if they've lost track of their ROI. Perhaps they're still getting lots of leads, but the quality of service has dropped and their conversion rate is terrible. 

For the most part, marketing does get easier as time goes by, especially as budgets increase. If you follow the priority order I outlined above, you'll be in a good position to get the flywheel going as cheaply and efficiently as possible.

How can an owner or manager choose an SEO company for a medispa or cosmetic clinic? Any tips on finding the real deal needle in the shonky haystack that is the current state of the SEO field?

This is perhaps the hardest thing to do. It unfortunately has become such a snake oil service that it's very hard to find the real deal. Keep in mind, that you're better off doing no SEO than using someone who doesn't really know what they are doing. Even if you do find someone genuine, you still have to weigh up that investment versus doing something else like paid search. Finding someone that can give you a better return than paid search really is a diamond in the rough. I'd be looking for providers with an excellent track record and good references. It's helpful if they know this industry, since it's very complex and full of all kinds of terminology. Although, it would be hard to get such a reference, since people don't tend to share their competitive advantage with their direct competitors! If you do decide to take the plunge, set your expectations up-front. If you don't know what you want to get out of it, even bad SEOs can massage Google analytics to make it look like things are improving when they are not. Remember that you want to see organic traffic trend upwards over time. If the traffic is good quality, the conversions from that traffic will also go up in direct correlation. If traffic doesn't go up, then it's probably no good. If traffic goes up and conversions don't then the traffic isn't valuable (or there are problems with your website - you can test conversion rates with AdWords too). Don't pay too much attention to the "ranking reports"; if they correlate with increased traffic and conversions, then you might be onto a winner. But if not, it might just be smoke and mirrors. Also don't think it will happen overnight or they have "some magical secret" that will work instantly. Good SEO takes time and many hours of hard work.