I recently completed a 360° SEO Audit for a plastic surgery client who suffered from a precipitous drop in traffic last year, particularly around May 2020. A look at this site’s Google Search Console revealed that the drop occurred around May 5th, with average daily search impressions being cut in half.
This coincided with a major Google Core Update on May 4th, 2020.
Google updates its core algorithm a few times a year. This major update specifically targeted websites or content related to a person’s health, wealth, or welfare, often referred to as YMYL pages (i.e., “your money or your life”). Aside from travel, health websites were among the hardest hit.
According to Google and engineers in the SEO community, this update was largely in response to the COVID pandemic. Specifically, Google targeted websites offering medical and financial advice, products, and services in an effort to fight disinformation and exploitative/predatory practices.
Many sites were affected. However, Google’s May 2020 algorithm update had very little impact on medical websites with strong E-A-T signals (i.e., expertise, authoritativeness, and trustworthiness). Some even received significant boosts in rankings and saw their search traffic doubling almost overnight.
After completing a deeper investigation, I concluded that this client‘s significant drop most likely was caused by poor E-A-T signals.
In fact, as a cosmetic medicine and plastic surgeon SEO consultant, I’ve found that strengthening E-A-T is the greatest priority with regards to SEO, and the one aspect that can create the greatest impact for doctors.
So I offered my client some recommendations to improve the quality of their content and E-A-T signals. There are quite a few. But let me list two of them in this article, which are signals I encourage you to add to your website, too.
(Please note that some of these are personal opinions and preferences, and not absolutes based on actual ranking factors. But they have been proven to help. One client with whom I’ve applied this strategy enjoyed a 400% traffic increase.)
During my audit, I noticed that the site had a “flat” architecture. That is, all the pages seemed to be on a single tier (under the root domain). Depending on the situation, this allows for shorter URLs and can be an effective SEO practice.
However, while I did find a blog index page, there is no discernible blog section. Blog posts reside at the same level with the all the main pages. They all seem to blend together. While this is not bad, it makes it difficult to identify which URLs are blog posts and which ones are pages.
So I recommended creating a separate blog section and a second tier. Having a distinct blog provides a number of benefits, from isolating blog posts from the rest of the site (which is helpful in tracking and analytics) to improving the user experience. Some have reported that this change alone improved traffic.
There are two ways to accomplish this.
My client‘s site uses WordPress as its CMS. Therefore, accomplishing this is relatively simple. Set your WordPress permalinks from
/%postname%/ to custom with
/blog/%postname%/. Here’s how the site structure would look like:
michelfortin.com/ michelfortin.com/page1/ michelfortin.com/page2/ michelfortin.com/page3/ michelfortin.com/blog/ michelfortin.com/blog/post1/ michelfortin.com/blog/post2/ michelfortin.com/blog/post3/
Although not essential, the blog directory can be renamed to something helpful to the user, such as “tips,” “resources,” “content,” “articles,” “education,” etc (except for “news,” which should be reserved for news, press releases, and media mentions). It can also contain keywords, like “plastic surgery tips.”
If you choose this option, first make sure you don’t have a category name that conflicts with plugins, scripts, or other directory names. For example, if you have a category named “liposuction” and you have a page named “liposuction,” you might want to change the category to “liposuction surgery.”
If there are no conflicts, then set your permalinks from
/%category%/%postname%/. This will make blog posts appear under their primary (or single) category folder. For example, the structure would then look like this:
Single blog posts would look something like this:
Since categories contain keywords, this will help add some additional keywords to the URLs. Granted, the jury is still out on whether this is a ranking signal, but it does provide search engines with better context, which does help.
If you have a post assigned to multiple categories, only one will be used. WordPress by default sets the primary category as the one with the lowest ID number. But you can also specify another category with the help of plugins. There are some category plugins and SEO plugins like Yoast and Rank Math.
This is part of an SEO philosophy called a “silo site architecture.” Content silos provide a better user experience and give Google more context. Silos organise the content into groups; make navigation more logical and orderly; and reduce the time it takes for visitors to learn how to navigate the site.
Here’s an example of what a blog post would look like:
If the above has “breast augmentation” as its primary category, it will become:
The blog is not the only section that can be organized into silos. The website may have multiple pages that fall under a certain category, too.
For example, many plastic surgeons have a series of pages organized around a certain criteria, such as the “conditions” they treat, the “treatments” they offer, and/or the “areas” of the body they focus on. So if “facelift” was a master topic as a procedure, child pages might look like this:
example.com/facelifts/facelift-surgery/ example.com/facelifts/facelift-recovery/ example.com/facelifts/facelift-cost/ example.com/facelifts/facelift-photos/
However, this should be done with care. I recommend first mapping all the URLs and then properly redirecting old URLs (i.e., via 301 redirects) to prevent losing any page authority. Then, search and replace internal links to their new destinations, and a final crawl to check for broken links.
Google’s raters are people who gauge the quality of a site’s content to help confirm if Google’s algorithms are doing a good job. They do so by looking at a website’s level of expertise, authoritativeness, and trustworthiness.
Any information that can affect a person’s health or welfare has to be written or reviewed by someone with medical expertise. According to Google:
“Medical advice or information should be written or reviewed by people with appropriate medical expertise or accreditation.” “Specific medical information and advice (rather than descriptions of life experiences) should come from doctors or other health professionals.”Google’s Quality Raters Guidelines
After Google’s 2018 core algorithm update (i.e., the “medic update”), medical and health websites showing no proven expertise have lost considerable rankings because of their lack of E-A-T. With COVID and Google’s attempt to fight disinformation, the core update of May 2020 went even further.
A key signal is the author information as it helps Google identify a) the author of the content and b) the author’s credentials. To do this, there are two important things you must have to a web page that Google specifically looks for.
- First, include something that describes the author and their credentials. Either have the name of the author at the top linked to a bio (e.g., an “about” page containing all the credentials, such as education, degrees, accreditations, certifications, years of experience, etc), or have an “about the author” section at the end of the article.
- Second, add schema markup code that identifies the page (i.e., article), the person who wrote it (or reviewed it), and their level of expertise. There are several schema markup properties to include, such as “physician” and “plastic surgery,” among others. I’ll come back to this.
To help Google’s crawler find and identify the author information on the page, make the name and bio easily findable by conspicuously pointing it out.
Add the article’s byline and link near the top and close to the article’s title. Or add an “about the author” box at the bottom of the article that’s clearly distinct, such as wrap it with a border, place it in a coloured background, or separate it by a divider to set it apart from the rest of the article.
For example, I Googled “best plastic surgeon Toronto” and this page came up. Scroll to the bottom of the post, and you will see this:
The above example clearly identifies the author and their credentials, and a bio separated by a divider. It includes links to this doctor’s Google Scholar and Wikipedia pages, which offer a an extra level of authority and expertise SEO.
If the article is written by a staff member with expertise, such as a certified cosmetic nurse injector, the same applies: add a bio with (or linked to) their credentials, including the nurse’s education, experience, accreditation, etc.
Articles can be written by someone else with no medical or related expertise, such as a reporter or freelance writer, as long as they have been reviewed by a credentialed professional and indicated as such.
For example, if you have an article that was written by a staff member and they claim authorship, Google prefers that the content be reviewed by a person with medical expertise. For example, add something like “this article was reviewed by Dr. Smith” near the article, with a link to their bio just like the author.
Finally, schema markup code is a piece of JSON-LD code you can add to the page HTML. It’s a language meant to identify and describe the content and its author. Schema is not a ranking factor but by providing additional context it helps Google more accurately assess the content’s level of expertise.
A WordPress plugin such as Schema Pro, Yoast SEO, or Rank Math can do this automatically for you. Or you can (and should) add some manually.
Plugins are helpful but limiting. So adding extra schema markup manually can help. Use Google’s markup helper tool. Then, test the markup (either the code or the page it’s on once published) with Google’s rich results tester.
Reason is this: plugins will add “local business,” “organization,” or “person” schema. But there are different types of local businesses, such as “medical business” and “plastic surgery” as well as “physician.” I also recommend adding the following snippets as part of “person” schema:
- “reviewedBy” (if written by someone else),
- “sameAs” (other bios on social or authoritative sites),
- “affiliation” (such as memberships in associations),
- “award” (such as any industry-related awards),
- And “alumniOf” (their education).
Adding these extra pieces of data may seem simple or unnecessary. But they provide extra signals that Google needs to identify the site’s level of expertise.
If you’re a plastic surgeon, cosmetic surgeon, or medical aesthetic practitioner, these signals are not just important but also vital. Competitors who may have less content than you but more clout and authority will likely outrank you.