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Opinions on Practice Management

Emily Altman

Why Should I Get Involved in Social Media? Part 2: Factors that Influence Online Presence

Emily Altman, MD, FAAD

Wednesday, February 17, 2016

Search engine optimization (SEO)

Wikipedia defines SEO as "the process of affecting the visibility of a website or webpage in a search engine's unpaid results - often referred to as 'natural', 'organic' or 'earned' results. In general, the earlier (or higher ranked on the search results page), and more frequently a site appears in the search results list, the more visitors it will receive from the search engine's users".1 In short, SEO is a combination of all the factors that make you and your website findable on the top half of the first page of a search engine's results in response to a particular query.

One should have two goals when thinking about location of your website on a search engine's query page. Of course, the ideal is to have the number one spot immediately below paid ads. Wouldn't that be great?! However, the top half of the first page will do well for your website. In 2014, The Huffington Post published an article with a now iconic headline, 'The Best Place to Hide a Dead Body is Page Two of Google'.2 Most people searching on the internet do not look beyond page one of their query results. The term 'above the fold' refers to the top 600 vertical pixels of a webpage as being the only information that visitors will look at, only the few that are interested in the in-depth coverage of the subject will actually scroll down to read the information below. That usually means that the most important information, your social media links, your calls to action have to be in the top half of the webpage.

So far, we are all thinking, this is too much, I am a busy dermatologist, who has time for any of this? The problem is if you don't participate in this yourself and leave it to your 'web person', you will generally not get the results you want. Many 'SEO specialists' are very happy to place 'pay-per-click' ads on Google and sit back. Pay-per-click, if used at all, must be very well targeted. However, what must be worked on is inbound marketing, setting up your entire presence on the web to attract visitors to come to you.

We all know 'outbound' marketing. Essentially it is putting your information out there (wherever 'there' actually is) in newspaper or TV ads, flyers, emails to purchased lists, even telemarketing, etc. in the hopes that this will attract people to call or come to your office. Outbound marketing is becoming less and less effective. According to Brian Halligan of Hubspot, an average person "is inundated with over 2000 outbound marketing interruptions per day and is figuring out more and more creative ways to block them, including caller ID, spam filters, etc".3 Halligan advocates setting up your website as a hub for all your web activities, such as SEO, blogging, and social media to bring visitors to your website naturally.


Google search algorithms

There used to be a simple time in the not-so-distant past when making a website more visible meant just having enough links from external websites and enough keywords. At that time, thousands of links could be bought very economically with one click of a button, after which you would receive a nice report saying such and such links have been generated. Your website would then rise in rank.

That simplicity came to a screeching halt with the release of Google's 2011 update (known as Google Panda) that used new algorithms to help identify which sites actually offer good, dependable content - and increased their rankings in the search results accordingly. Even prior to Panda, using SEO only to get a certain result from a search engine and not geared towards a human audience violated search engine rules and was known as black-hat SEO.

Such black-hat SEO strategies cost JC Penney quite a bit. In 2010, they enjoyed a tremendous success in unpaid search results, being consistently found at the top of search results for just about any search term (dresses, bedding, luggage, etc.), particularly through the holiday season, with some searches resulting in JC Penney ranking higher than the manufacturer of the goods they were advertising. It was at the beginning of 2011 that a New York Times investigation exposed thousands of unrelated links to the JC Penney website.4 The New York Times presented its investigation results to Google, and JC Penney was nowhere to be found in Google search for months to come.

In 2012, Panda was followed by a new algorithm, Google Penguin, which turned its attention to websites that were not playing fair. The main purpose of Google Penguin was to identify sites that engaged in link-spamming, and to penalize their ranking so that they don't appear on the first page of Google's search results.

OK, so now we know we don't want link spamming. What links should we establish to our websites?

Links to your website:

  1. Local listings - optimize your listings on the local services of the big search engines:
    a. Google (
    b. Google Plus for business (
    c. Bing (
    d. Yahoo Local (
  2. Blog-embedded on your website
    a. Blogs are probably the biggest workhorses your website could have. The content you generate plus SEO-friendly free software available for WordPress blogs within your website make them powerful tools for attracting new visitors and for encouraging sharing on social media. Blogs also increase the page counts and interlinks from one page to another on your website, making it more attractive to search engines. And blogs are a more informal way of interacting with your visitors
  3. Social media - Facebook, Twitter, YouTube (embed your videos on your website and/or blog), and Pinterest
  4. Your societies - American Academy of Dermatology, American Society for Dermatologic Surgery, Society for Pediatric Dermatology, etc.
  5. Manufacturer websites, such as Allergan, Merz, Medicis, etc., although some require certain levels of purchases to have you listed
  6. RealSelf, particularly true if you practice cosmetic dermatology
  7. Email blasts (Constant Contact), Survey Monkey, etc. - collect email addresses from patients
  8. Guest blogger on other quality websites
  9. Wikipedia



  1. Search Engine Optimization. Available at: (accessed 3 Feb 2016).
  2. Pollitt C (2014). The Best Place to Hide a Dead Body is Page Two of Google. Available at: (accessed 3 Feb 2016).
  3. Halligan B (2010). Inbound Marketing vs. Outbound Marketing. Available at: (accessed 3 Feb 2016).
  4. Segal D (2011). The Dirty Little Secrets of Search. Available at: (accessed 3 Feb 2016).


Next month will see the final part in the series of articles on social media published on the DermQuest website, where Dr. Emily Altman will expertly describe how physicians can enhance their online presence through social media activities.