Medical SEO + local maps
Rank for care nearby
When someone searches for a doctor, Google answers with a map and three practices before any website appears. Earning one of those spots is unglamorous work: a profile kept exact, a site engines can read, reviews someone answers. We do the work, and PulseTrack ties it to inquiries, not positions.
knee pain doctor near me
The pack · three local listings
- 1
- 2 · yours
- 3
Illustrative · no ratings or review counts drawn
- Search results
- The map pack
- Business profile
- Reviews
- Your site
- Search results
- The map pack
- Business profile
- Reviews
- Your site
- Search results
- The map pack
- Business profile
- Reviews
- Your site
- Search results
- The map pack
- Business profile
- Reviews
- Your site
The mechanism
Three listings sit above every website.
Five surfaces stand between a search and your front desk, in a fixed order. Most of the deciding happens on Google’s surfaces, before your site loads once.
Top of the page
The local pack
- 1
- 2Yours
- 3
Further down the page
Your website
The search
GoogleA patient types care plus place: pediatrician near me, knee pain doctor downtown. One search, usually on a phone, often in a parking lot.
The map pack
GoogleGoogle answers with a map and three local listings, placed above every other result. This block is the front door of local search.
The profile
GoogleEach listing is a Google Business Profile: category, hours, services, photos, and a review summary. Patients read this before they ever see a website.
The reviews
GoogleHow many, how recent, and whether anyone from the practice answers. The trust check happens here, before the first call.
The site behind it
Your siteGoogle checks the profile against the website behind it. A site structured around your services confirms what you treat, and it is where the booking finally happens.
Four of the five are settled before your website loads once. That is why the unglamorous profile work is where ranking moves first.
Where else patients look
Not every patient starts at a search engine
A profile can exist on one of these sites before anyone at your practice has looked at it. When that happens, the version a patient reads is whatever the site assembled:
It carries your name either way.
What a stale profile prints
- PhoneA phone number from a previous office
- HoursHours that were never right
- SpecialtyA specialty you stopped practicing years ago
The practice record
IllustrativeOne set of facts, held at the front desk
- Name
- Address
- Phone
- Hours
Every window on this board prints this record, or it is wrong.
Google Business Profile
Maps and search
The listing behind the map pack. It is the profile every other one on this board has to agree with.
Zocdoc
Search and book
A search-and-book directory. People arrive already filtering for a specialty, a plan, and a time that works.
Healthgrades
Search and compare
A doctor directory patients use to compare practices nearby. Your specialties, your locations, and whatever reviews were left there.
Vitals
Search and compare
Another profile with your name on it. A patient who starts here can decide before your website is ever loaded.
WebMD Care
Search and compare
The provider directory inside WebMD. Someone reading about a symptom can move straight from the article to a list of doctors nearby.
The insurance plan directory
Search in network
Health plans publish their own find-a-doctor tool. A patient who has decided to stay in network often starts there and may look nowhere else.
Illustrative. A drawn record and drawn panels, not screenshots, with no ratings or review counts and no company marks. What they show is the discipline: the same four facts, printed the same way on every surface a patient can look you up through.
The work
One record. Every profile.
Claiming a profile is the easy part. Keeping every one of them saying the same thing, month after month, is the work.
- Claimed, then corrected. We claim the profile wherever a profile can be claimed, and correct what is wrong on it: the practice name, the address, the phone number, the hours, the specialties, the plans you take.
- Identical, not roughly identical. Name, address, phone, and hours read the same on every surface, down to the suite number. Two versions of a suite number is two versions of your practice, and a patient standing at the wrong door does not care which one was right.
- Specialties and insurance kept current. What you treat and which plans you accept change during the year. When they change at the front desk they change on the profiles, not at some annual review.
- Photos of the actual practice. The entrance a patient will look for and the room they will sit in. No stock photography on any profile we run.
- Every change logged with a date. Each edit is written down with the date it was made, so a change can be read against whatever happened after it. The log is yours and it rides in the monthly report.
- The same review rules, everywhere. Every patient gets the same invitation, never only the pleased ones, and a reply never confirms that anyone is a patient. That holds on a directory exactly as it holds on your Google profile.
What we will not claim
We do not promise placement or a position on any directory. Each of these sites decides what it shows by its own rules, and nobody outside it controls that. We are not partners with Zocdoc, Healthgrades, Vitals, WebMD Care, or any insurance company, we hold no integration or official standing with any of them, and we will not claim one. If one of them offers you a paid placement or membership, that is your decision to make, and we will put the numbers in front of you rather than fold it into a retainer.
Off-page authority
What confirms you rarely links to you.
Hospital privileges, board certification, society membership, a faculty appointment, the plans you are paneled on. That is the recognition that carries the most weight for a physician, and almost none of it arrives as a link to your website. It arrives as a record a search engine can read.
Confirms you
Recognition your profession already grants
Hospital privileges
Medical staff appointment and credentialing
Not a linkBoard certification
The certifying board’s own public record
Not a linkSpecialty society membership
Credentials verified first, then dues
Not a linkFaculty appointment
Teaching hours, renewed on a term
Not a linkInsurance panels
Credentialing and contracting
Not a link
None of this can be bought as marketing. That is exactly why it is worth more than anything that can.
Links to you
The two ways a real link actually happens
Surgery centers and referral partners
They list you because you already operate and refer there
Earned, unpaidA newsroom that chose to cover you
The publication decides whether to link at all
Their callChamber of commerce membership
Annual dues buy the membership, the listing comes with it
PaidCommunity sponsorship
A check, a logo, and usually a link nobody thought about
Paid
The unpaid ones come from relationships you already have. The paid ones are where the policy question starts.
The record everything else is copied from
Directory data is copied, not authored. Most of it starts in one federal registry, and keeping that registry current is your obligation rather than a marketing task.
The rule that binds the practice
“Communicate to the NPS any changes in its required data elements in the NPS within 30 days of the change.”
NPS is the National Plan and Provider Enumeration System, the registry behind your NPI. The rule has been in force since 2007 and it binds the practice, not a vendor.
- Practice address
- Telephone number
- The name you do business as
- Specialty taxonomy
When any of those change at the front desk, the clock is thirty days.
no more than 47%
of the provider entries CMS sampled carried current, up to date telephone numbers, addresses, specialties, plan affiliations and accepting-new-patients information
CMS, Machine-Readable Provider Directory Review Summary Report, plan years 2017 to 2021, published 22 March 2022
no more than 28%
of the provider names, addresses and specialties in those directories matched the NPPES registry
The same report
48.74%
of the provider directory locations CMS reviewed had at least one inaccuracy
CMS, Medicare Advantage Provider Directory Review, round 3, November 2017 to July 2018
Those are CMS measuring health plan directories, not measuring your practice, and CMS has not published a comparable review since. We include them because CMS names the cause in its own report: “Providers may not be updating NPPES records related to changes in location or contact information.”
- What outside data can do to your profile
- Google publishes the mechanism plainly. “If a profile is considered a duplicate, it won’t show on Google Search or Maps.” “When 2 profiles are merged, their reviews are combined, but replies to reviews may be lost.” “If sources report that your profile info is incorrect or outdated, Google may update your profile.” And on your own corrections: “Google might not approve changes if it can’t confirm its accuracy.” For a practice that has spent years replying to patients, losing those replies in a merge is a real loss.
- What that does and does not mean
- It does not mean that mentions rank you. No Google source says that, so we do not say it either. It means other people’s data can overwrite your profile, and your own correction can be declined when Google cannot confirm it. That is why the fix starts upstream, at the record everything is copied from, rather than at the listing you happened to notice.
- The second duty, stated narrowly
- Federal law also requires providers to submit directory information to the health plans they contract with: when a network agreement begins, when it ends, and when there is a material change. That duty is owed to the plan. It is not a duty to keep a search engine, a review site, or your own website accurate, and no implementing regulation has been issued for it. It is usually sold much broader than it is.
- A listing is not a backlink
- We will not sell one as though it were. Some directories carry no link to a practice website at all, and others mark the link so that search engines do not follow it. Google’s spam policy names low-quality directory links, and Google’s documentation says links marked that way will generally not be followed. We check what your listings actually do, site by site, with the date we checked, and we treat every one of them as entity data.
- Not legal advice
- We are not attorneys and none of this is legal advice. Your counsel confirms what applies to your practice. What we are telling you is where the data comes from, because that is what decides whether a listing is right.
What we will not do
We do not buy links. We do not sell scores.
Everything below is either a practice Google names in its own spam policy or a number Google does not produce. If one of them has been offered to you, this is what was being sold.
The trap nobody mentions
You may already be buying a link without knowing
You sponsor the county 5K. The organizer puts your logo on the sponsor page and links it to your website. Nothing about that felt like search marketing, because it was not meant to be.
Open the page source and the link almost always reads one of two ways:
- rel="noopener noreferrer"the common case
- no rel attribute at allthe other common case
Those are browser security settings. They stop the page you opened from reaching back into the tab that opened it, and they hold back the address you came from. Neither one tells a search engine to ignore the link. Website builders add them automatically to any link that opens in a new tab, so their presence tells you nothing about anyone’s intent.
So an ordinary sponsorship produces a paid link that still passes ranking credit, and neither the practice nor the organizer knows it. Reading noopener as “they nofollowed it” has the situation exactly backwards.
What the policy actually says
Google’s position is not that paying is wrong. Its own policy says buying and selling links is a normal part of the economy of the web for advertising and sponsorship purposes, and that it is not a violation to have such links as long as they are qualified with a rel="nofollow" or rel="sponsored" attribute. The violation is not the payment. It is paying for a link that still passes credit.
So here is how we handle it
Sponsor for the reason you would have anyway.
The banner, the shirt, the announcement, the people who show up. If the link vanished tomorrow the sponsorship should still have been worth making.
We will never pick your charities by their websites.
Choosing which local cause to support by what its domain might be worth is the thought that turns a good deed into a scheme. We will not have it in the room.
We ask the organizer to mark the link.
A short, polite request to add rel="sponsored". Most organizers will not know what that means and most will not do it. The ask costs nothing and it is the documented compliant path.
We never write the link text.
Your practice name or the plain web address, never a keyword phrase. Optimized text on a paid placement is the clearest possible signal of intent, and we will never ask an organizer to make a link count for us.
We never count it as a result.
A sponsorship link does not appear in your report as a win. If it carries any weight at all, that is Google’s decision and not something we earned.
Bought links, in any wrapper
Paid guest posts, paid placements, packages priced per link. Google’s policy names buying or selling links for ranking purposes, and it names exchanging goods or services for them in the same list, so a free procedure in return for a link is the same transaction.
Niche edits
Paying to have a link inserted into somebody else’s article that already exists. There is a version sold specifically for health and finance, which the trade calls sensitive sectors. One link network advertises a physician client under a tab labeled YMYL, the trade’s shorthand for pages that can affect a person’s health or money.
Do-follow press releases
A release distributed so that its links pass ranking credit. The product name states the intent the policy prohibits, and Google names press releases distributed on other sites in the same list of examples.
Private blog networks
Sites bought or built for the purpose of linking to clients, often expired domains that used to belong to someone else. Vendors advertise them as footprint free, which describes hiding rather than quality.
A feature on a big health publisher
Healthline and WebMD both publish advertising policies stating that all advertising on their properties is clearly and unambiguously identified and kept separate from editorial, and advertising that is correctly tagged as advertising passes no ranking credit under Google’s own rules. Google also tightened its site reputation abuse policy in November 2024, writing that no amount of first-party involvement alters the fundamental third-party nature of the content. A guaranteed placement is either not editorial, or not the site you pictured.
A Domain Authority or Domain Rating target
Neither score is Google’s, and neither is ours to move. Both are set out below in the words of the companies that invented them.
A number of links per month
There is no honest count of it. Google’s own Search Console documentation says its link report is not a comprehensive list, that it shows a sample, and that it does not specify whether a link is marked nofollow. Anyone quoting you a precise monthly figure is counting links they created themselves.
Fear about toxic backlinks
A toxic link score is a vendor’s invention. Google says most sites will not need the disavow tool at all, and that using it wrongly can harm a site’s performance. Opening with this manufactures a problem in order to sell the cure.
What actually happens if a practice buys them
Not what the scare stories say, and the truth is worse for the vendor.
Google’s documented default is that bought links stop counting. Announcing its December 2022 link spam update, Google wrote that it was leveraging SpamBrain to neutralize the impact of unnatural links on search results, and that ranking may change as spammy links are neutralized and any credit passed by these unnatural links is lost.
So the most likely outcome of a link-buying program is not a penalty. It is that the practice paid for nothing, month after month, with no way to tell.
The tail risk is a manual action, which Google does still document. Undoing one means contacting every site that sold you a link and asking for removal, because Google states that blindly adding all backlinks to the disavow file is not considered a good-faith effort. Months of work to undo an asset that was bought on purpose.
There is a regulator for the selling, and it is not the one people expect. The FTC has obtained federal court orders against operations selling search placement to small businesses, in one case banning the defendants from marketing, promoting, or selling search optimization products or services (FTC v. Pointbreak Media, 2019). Google’s own documentation tells businesses to report a deceptive SEO to the FTC.
In their own words
“Don’t buy backlinks.”
“Domain Authority is not a Google ranking factor and has no effect on the SERPs.”
“In fact, large amounts of low-quality backlinks may actually increase your DR, not decrease it.”
“No one can guarantee a #1 ranking on Google.”
“Ultimately, you are responsible for the actions of any companies you hire.”
About Domain Authority and Domain Rating
Domain Authority is a score invented by a software company called Moz. Domain Rating is the same idea from a different company called Ahrefs. Each built its own crawler, found some fraction of the web’s links, and wrote a formula that turns that into a number out of 100.
Google does not calculate these scores, does not receive them, and does not use them. Google’s own documentation says third-party reputation and authority scores do not correspond to any of Google’s own signals nor come from Google.
That is not the same as saying Google has no view of a website. It has internal signals, and nobody outside the company can see or measure them. What can be said with certainty is that the number a vendor quotes you is not one of them.
And because each score is a formula over a link count, buying links can move it. Ahrefs says so about its own metric. A vendor can raise your number while doing the very thing that creates the exposure, and you would have paid for both.
What you get instead of a number
- Every mention with a source, a URL, and the date it appeared. If you cannot click it, we do not count it.
- Which mentions we caused and which ones you earned without us. Your hospital listing is not our work and we will not claim it.
- Listing status as a plain state: what each one currently publishes, whether it matches your record, and the date we last checked.
- Corrections made, with a before and after. Duplicates removed, wrong numbers fixed, a departed physician’s listing retired.
- What we refused, and why, including anything you asked us for that we will not do.
We publish what we refuse to do before you ask.
The writing
Articles about the care people actually search for
Every tier includes a counted number of articles a month. The subjects come from what people near you are already typing, not from a content calendar we wrote for somebody else, and nothing publishes until you have read it.
The subject comes from real demand
We read what people near you search for, in Search Console for the terms you already appear on and in the questions your front desk keeps answering. A subject nobody is looking for is a post nobody reads, however well it is written.
It answers the question a patient asked
Plain language, the way you would explain it in the room. What the problem is, what the visit is like, what happens next. Not a keyword arrangement, and not three hundred words of throat-clearing before the answer.
It is structured so a machine can read it too
Headings that match the question, schema where it applies, internal links to the service page it belongs beside. This is the part that is genuinely technical, and it is the part that costs a practice nothing to have done properly.
04 · the gate
You approve it before it publishes
Your name goes on anything clinical, and your license is attached to it. So an article we have written and you have not read is not finished. You get it as a draft, you change what is wrong, and it goes live when you say so.
- We do not promise that an article will rank, because nobody can. Google says so in bold on its own help page.
- We do not publish clinical claims you have not approved, at any volume, on any tier.
- We do not generate a hundred thin pages on near-identical phrases. Google names that in its spam policy and patients can feel it.
- We do not write in a voice that is not yours, and we do not invent patient stories, outcomes, or statistics.
The standard
The unglamorous work that nobody can buy
- 8profile standards held
Checked and corrected every month, not once at setup.
- 3listings in the local pack
Google shows three, above every website on the page.
- 1report a month, in plain language
What changed, what it did, what happens next. Every number sourced.
- One exact primary category, correct secondaries
- Hours that match the front door, holidays included
- Duplicate listings found and removed
- Services written in the words patients use
- Photos of the actual practice, never stock
- Name, address, and phone identical on every directory
- Reviews answered in your voice, never confirming who is a patient
- Every change logged and dated, so effects can be read
None of it is clever. Kept exact for months, it is what rank for care nearby is actually made of.
What we do
Four jobs, each leaving a receipt
The monthly report lists each job’s artifact as a dated entry. If a line of work cannot show a receipt, it does not stay on the plan.
Local profile rebuild
Your Google Business Profile rebuilt line by line: primary category, services, hours, photos, and posts, with the duplicate listings that dilute it removed. Then held exact, month after month.
In the report
The profile change log, dated
On-site structure
A page for every service and every location, linked so search engines can read what you treat and where. Structured data (schema, the machine-readable summary of each page) ships on everything we touch.
In the report
The page inventory, what changed and why
The questions patients ask before booking, answered plainly on your site: what you treat, what a first visit looks like, what insurance you take. The same pages make you quotable when patients ask AI instead of a search box.
In the report
Pages published and the questions they answer
Review-presence system
A consistent way of inviting every patient after a visit, at the right moment, and a drafted response for every review that arrives, positive or not.
Every patient gets the same invitation. We never buy, gate, screen, or fake reviews.
In the report
Asks sent, reviews arrived, responses posted
Target selection
Sorted by case value, not search volume
The usual sort
By search volume
Most target lists are sorted by search volume, because volume is the easiest number to sell. But a practice does not live on searches. It lives on its case mix: a knee replacement and a sports physical arrive through the same map, and they are not the same patient, the same payer, or the same month of revenue.
How we sort
By case value in your payer mix
So we sort the other way, by what a booked case is worth in your payer mix. The work goes first to the queries where one booking changes the month. The loud, low-value queries wait their turn, and some never get it.
| Target query | Searches | Case value | Our order |
|---|---|---|---|
| knee replacement surgeon near me | Modest | High | First |
| orthopedic urgent care | High | Moderate | Second |
| sports physical near me | High | Low | Later |
| back pain relief exercises | Very high | Low | Not targeted |
Measurement
The position is not the result. The booking is.
PulseTrack · queries to calls
Illustrative| Query | Position | Calls | Booked |
|---|---|---|---|
| knee replacement surgeon near me | 2 | 12 | 5 |
| orthopedic urgent care | 3 | 9 | 4 |
| back pain relief exercises | 1 | 1 | 0 |
Position 1 on the wrong query: one call, nothing booked.
A ranking report tells you where a query stood on Tuesday. It does not tell you whether the phone rang.
PulseTrack keeps both in one row: the query, its position, and the calls and bookings it produced.
That is how position 1 on a high-volume query loses, in the only sense that matters, to position 2 on a valuable one. When the numbers say a target is not producing patients, we move the work.
The report is the instruction, not the trophy.
We never promise a position. We publish the method.
Committed, in writing
- Every change we make, logged with date and reason
- A monthly report in plain language, every number sourced
- Structured data on every page we ship
- You own the site, the profile, and every account, from day one
Never promised
- A specific position on Google
- A traffic number
- A review count or star rating
- A patient volume
If a vendor promises anything in the right column, ask how. Nobody outside Google controls those numbers. What can be controlled are the inputs, so those are what we commit to and report against.
How the review system works
Asked the same way, answered without confirming anyone
Every patient, the same invitation
We ask every patient for a review, on the same trigger, with the same message. Asking only the ones who seem happy is called gating, and it is against both the platforms' rules and the FTC's. The FTC's review rule took effect on October 21, 2024, and its guidance names reputation management companies among the parties who can be liable, which is us when we run the system for a practice.
Responses that confirm nothing
We draft a response to every review that arrives, positive or not, and none of them confirm whether the person is a patient or discuss any care. Confirming that in public is itself a disclosure, and regulators have priced it. It is also the reply that reads best to everyone else who is reading.
Where the line is
Patient stories and photos
Patient stories and before-and-after photos are a separate matter. They are patient records, they need a signed authorization on a specific form rather than a general photo release, and cropping a face does not change that. We will take one down the day a patient changes their mind.
A review that is unfair
When a review is unfair, the answer is a private conversation and an offline resolution. Arguing in public is how practices end up in a press release.
Not legal advice
We are not attorneys and this is not legal advice. Your counsel or privacy officer should review how reviews are gathered and answered in your practice, and we will hand them the written process so they can.
The invitation
Same message, same trigger, every patient
Thank you for coming in today. If you have a minute, a short review helps other people nearby decide where to go. Here is the link.
No satisfaction question in front of it, so nothing branches on the answer.
The drafted response
Written for a critical review
Thank you for taking the time to write this. We would like to understand what happened and put it right. Please call the office and ask for the practice manager.
It does not confirm the person is a patient and it discusses no care.
What the system never does
- We never buy, trade, gate, or write reviews.
- Nobody on our team posts a review for you, and neither does anyone related to us.
- We do not suppress or hide reviews by rating or sentiment.
- We do not offer anything in exchange for a positive review.
Illustrative drafts · not a real review, patient, or practice
Questions
What doctors ask about SEO
Plain answers to the questions we hear most. Bring the rest to the discovery call; that is what it is for.
9questions
answered here
How long until medical SEO shows results?
Profile corrections can surface in weeks, while structure and content compound over months. We will not quote a ranking date, because nobody outside Google honestly can. You get a plain-language report every month from the start, so you see movement, or the honest absence of it, the whole way.
Do you guarantee a map pack position?
No, and we put that refusal in writing. Ranking guarantees are guesses dressed as promises. What we commit to are the inputs: the profile work, the site structure, the content, the review asking system, and a monthly report tying each one to inquiries and booked appointments.
Do you build backlinks?
No, and we will not work with anyone who does. The recognition that carries the most weight for a physician, hospital privileges, board certification, society membership, a faculty appointment, the plans you are paneled on, almost never arrives as a link to your website. It arrives as a record that confirms who you are, and making those records correct and current is the work. Where real links do happen they come from relationships you already have, such as the surgery center you operate at or the practices that refer to you, and from coverage a newsroom decided to run on its own. We do not buy links, we do not place them, and we will never quote you a number of them, because Google’s own Search Console documentation says its link report shows a sample and does not specify whether a link is followed.
Another agency quoted us a Domain Authority score. What is it?
A score invented by a software company called Moz. Domain Rating is the same idea from a different company called Ahrefs. Each built its own crawler, found some fraction of the web’s links, and wrote a formula that turns that into a number out of 100. Google does not calculate these scores, does not receive them, and does not use them, and Moz says so about its own in its own words: Domain Authority is not a Google ranking factor and has no effect on the SERPs, which is the trade’s word for the search results page. Because the score is a formula over a link count, buying links can move it, which Ahrefs notes about its own metric. So a vendor can raise your number while doing the very thing that creates the exposure, and you would have paid for both. We do not report scores Google never produced.
Do you work on Zocdoc and Healthgrades, or only Google?
Both. Zocdoc, Healthgrades, Vitals, WebMD Care, and the find-a-doctor directory inside an insurance plan are all places a patient can search for a doctor without opening a general search engine, so we claim and correct those profiles alongside your Google Business Profile and keep them saying the same thing: the same name, address, phone, and hours, current specialties and accepted insurance, real photos of the practice, and every change logged with a date. We do not promise placement on any of them, we are not partners with those companies or with any insurer, and nobody outside a directory controls what it decides to show.
How do you handle reviews?
We build the asking system: the right moment and channel to invite every patient after a visit, and a drafted response for every review that arrives, positive or not. The invitation never depends on how happy someone seems, because screening for good reviews is what the FTC calls review gating. We never buy, trade, gate, or fake reviews. Responses stay generic and never confirm that the reviewer is a patient, since confirming that in public can itself disclose protected health information.
We have more than one location. Does this still work?
Yes. Each location gets its own Google Business Profile and its own pages, kept separately exact, and PulseTrack attributes inquiries and bookings to each office. You see which location the work is moving, not one blended number.
We just opened. Are we behind on this?
Not in Google’s own stated framework. The guidelines Google gives its search quality raters say directly that small websites may have little or no reputation information, and that this is not indicative of high or low quality. What Google tells raters to weigh instead, when reputation information is thin, is the accuracy and quality of the content and how clear it is who is responsible for it, and all of that is build work we control. A new practice is not behind because it has no press. It is behind if a patient cannot tell who the doctor is, where they trained, and what they are board certified in, and that is fixable in the first month.
What does medical SEO cost?
Medical SEO is not sold separately; it is included in every TallBunnyMD package alongside custom website design, social media, and PulseTrack. Packages run $795 to $2,095 per month, and the pricing page lists exactly what each tier adds.
Next step
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