Search engine optimization (SEO) and digital marketing used to be easy. Throw a few key words on a page, buy a few links, and voilà: high rankings, increased traffic, and more revenue.

Not anymore. Now, Google evaluates 200 different variables, and it changes its algorithm (and the variables that matter most) upwards of 600 times a year. Your SEO team may be keeping important information from you, and this intel may be the reason your rankings are plummeting.

SEO Secret No. 1: Blog content should be unique

Regularly updated, unique, high-quality content is key. Since procedure information rarely changes, the content for those pages of your website should not change, either. Blogging should be the focus of new content. Unfortunately, many companies use the same, or similar, content for the procedure pages and blog posts because it is time consuming and expensive to create unique, new, and interesting blog content.

What to do: Compare the content of your blogs to your website's procedure pages to see how it measures up.

SEO Secret No. 2: Update WordPress every three to six months

WordPress is the most widely used framework for aesthetic websites. It is easy to implement and has numerous plug-ins for functionality, requiring minimal to no programing skills. Plug-ins automatically manage galleries, security, email, SEO, blogs, back-ups, etc. But WordPress core software and plug-ins become out-of-date very quickly. As the code ages, Google and the other search engines have difficultly crawling the site, and rankings and revenue plummet. Regular updates are needed, but updates requires time, knowledge, skill, and money.

What to do: Ask your team when WordPress and plug-ins were last updated.

SEO Secret No. 3: Practices need to target at least 7 to 10 review sites

Positive reviews are key to practice growth. Just 2.4 percent of prospective patients feel reviews are not important when considering aesthetic treatments, according to new survey data from Ceatus Media Group. Many digital companies suggest that targeting two or three review sites is sufficient. They're wrong. The same survey data shows that practices need to target the major general sites, like Google, Yelp, and Facebook, and the healthcare-specific sites, like HealthGrades, RateMDs, Vitals, and Realself.

What to do: Make sure you are getting reviews across a wide range of sites, both health care specific and general.

SEO Secret No. 4: Citations are not automated

Citations are mentions on another website that include your name, address, and phone number (NAP). They are critical to Google's ranking algorithm because they are used to determine if you are a viable local business. If NAP is incorrect or out of date, rankings fall. Many companies promote the idea that citation management is an automated process. But not so fast. Many of the major citation locations, such as society websites or product websites require logins where a human must update the information. Also, some of the automated software platforms do not permanently update the NAP information. NAP changes revert after the software is discontinued.

What to do: Make sure your citations are being looked at by a human eye.

SEO Secret No. 5:

Engagement is key

An effective social media strategy has moved from “nice to have” to “must have” for aesthetic practices. Many people say it's about how many fans or followers you have—but fans and followers can be bought, engagement (likes, comments and shares) can't. Social media also influences SEO because Google evaluates the level of engagement visitors have with all the practice's online resources. It's easy to continually post specials and procedure information—engaging posts are time consuming and require significant creativity.

What to do: Check your social media metrics to see how much engagement you are getting.

David Evans, PhD, MBA, is the CEO of Ceatus Media Group, based in San Diego. He can be reached at