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Episode Info: Google and the value of it, if you are number one... suppose there are a hundred searches for ophthalmologists in Irvine. I'm just throwing a number and if you will show up on number one 35 people, we'll we'll go to our website. Click. Generally this is, I'm giving you a very broad, Google start. If you are number two then you will have 15 people. If you are number three then you'll have 10 people who are searching for will, will show up and beyond that now you're looking at a handful, four or five people. That's it. So it's makes a big difference where you are ranked in terms of what kind of results that you will get. And how you're ranked is, you know why you should be on number one versus number 10 or number 30 on Google listing. That is a mystery that needs to be solved and that's what we solve. Janet:                                08:49                   Right? Well, you've heard the expression "Where's the best place to bury a body?" On page two of Google! Ajay:                                  08:55                   Exactly. Janet:                                08:58                   Okay, so can you buy your new way to number one? Can I just buy an ad and be number one? Ajay:                                  09:04                   So you know, the answer is yes, that you can buy an ad on number one. But here's a challenge. So if you don't have a very good web presence, then you will have to pay a fortune. And it's still, you may not be number one because we will now, even if you're paying Google money, they have a very strict requirement that you have to meet in order to, to show up number one on, on the advertising, but then your bigger challenge, all of it also is that about 65% of the viewers of the people who are surfing would skip ads because they don't trust advertising. Right? So they will skip all the ads and they will go straight into the what they call organic ranking. So you can do it unless you are, and by the way, or in some instances you could, you may say, I will pay $500 for each click and still you may not get to number one. So, so that is again, there's a, it used to be very simple. By the way, when I started this business, we would pay the highest would show up. Number one is no longer true. Now even when, if you are advertising, Janet:                                10:14                   All right, well we know that how Google ranks is something that companies have founded complete businesses on just following Google and trying to figure out day to day what they're doing. So you now have a dozens of healthcare clients who need to know that kind of information. I don't think this is potentially manageable in any way, shape or form by a practice. Even with an in house marketing department, which as you mentioned, a scant few even have. Ajay:                                  10:46                   Yes, you, you are very correct because in order for you to get ranked, there are unique to have expertise in five, six different areas. You need to do to be an expert in social media. You need to be an expert on, on website design. You know, in terms of speed and loading and all that you. You need to have a lot of content and that content needs to be marketed. So, there are five different level of expertise because even in social media, if you are an expert on Facebook, that doesn't mean that you can also do a Twitter, right? Or you can do LinkedIn, but you need to be doing all of the above in order for yourself to be ranked Google. So what, what happens that the best that a practice can do is if they have a marketing manager. Ajay:                                  11:42                   Generally speaking, marketing managers will work with an agency like ours because we have experts on our payroll on all those areas. So yes, you know, we will have five people working on one project, which we have typically we have five, six people working on one project, but they are not working full time. So even if you have all the money in the world and you say, okay I'll build the team. Yeah, wasting money because on the all these small pieces you don't need full time employee. So most of my small practices we spend like you know, 50 60 hours a month. So you're going to imagine it's not like a lot of work. And that also in, we have like four or five different kinds of people doing. So one of the reasons why we are far more efficient is we have experts working on it. Ajay:                                  12:33                   So it's not like every time we are trying to figure out what to do. And so that's what is needed for a website to be ranked higher. And it just does not make sense even for very large companies. We have medical providers that with the revenue in billions of dollars who are still using our services because they realize it doesn't make sense. I mean they say ton of money by using us and the, you know, they have a vice president of marketing who works with us. Janet:                                13:09                   Even the vice president of marketing doesn't want to have to learn about, and you know, every day the changes that are happening in SEO and keyword research that Google makes. Hire the experts. Ajay:                                  13:22                   Yeah, it wouldn't make sense. You know, we have people whose focus is to stay on top because part of the problem with the online marketing really is say Google, it's a moving target. What is most effective today may become like a negative tomorrow we will just changes algorithm. And all of a sudden you said, oh, what happened? So you have to be to totally stay on top of what is happening on the Google world. And by the way, Google does not announce it, right? So it's not like Google is saying, hey guys, we are making these changes. We will gives you a very broad outline and then there's a lot of trial and error that goes in now because we have 65 plus clients. So we, we tend to pick up very quickly on what happened if suddenly Google Changed Algorithm, we can just based on which of our accounts got affected, helps us sort of, you know, figured out what happened and then we can make adjustment and generally speaking it in or it is okay very quickly. But yes, in order, this is a big challenge. New Speaker:                  14:31                   I understand the update last August was particularly devastating for healthcare. A number of practices and health care organizations have said that the Google uptake just really kind of wiped out a lot of their response rates and a lot of their ability to do well in search. Ajay:                                  14:49                   So again, so one of the things that Google did is some of the practices that were, you know, very common in I would say up and up, some do three years back, Google decided that they are not going to, so first they said, okay, we are not going to give you credit for these activities, right? Certain activities. And then all of a sudden they said, okay, now you get like a penalized if you, if you are doing this. So if you did something three years back and what we do is the moment Google announces that, you know, you don't get credit for that, we start removing those items okay. Ajay:                                  15:29                   From our, our activities just to see number one, do they mean what they are saying? and if they are we cleaning it so that we know that it will always come in and analyze it. So, and the one of the things that we will did last year, by the way, which also impacted a lot of practices, so they started giving a lot of weight-age. So they always were giving weight-age on is your website mobile friendly? Right. Because majority of the searches now are happening is happening on mobile. But then they said, okay, now we are also going to give weight-age on how fast your website comes up on mobile. Okay. And that's an entirely different challenge. And it was one thing to create the website that will be that will adjust automatically on the smart phone versus on the desktop. But the challenge of, of now doing that website so that it loads on mobile very quickly is it was so daunting. Ajay:                                  16:26                   I mean, just to give you an idea, we had to literally Redo the website of many of our clients and we had to basically create two different websites. One for mobile, one for desktop, you know, order to two. Again, comply with Google requirements. And by doing that we moved up very quickly because the ones who did not do it, you get paralyzed. So, so that's where that is part of the problem where you have to stay totally on top of what is the latest requirement and make sure that you comply. If you don't, then you get dropped. Janet:                                17:02                   That sounds so overwhelming. And I would be so happy to outsource all of that. Ajay:                                  17:08                   Yeah. I mean it, it, it's almost like, you know, if I'm, if I get sick, I'm not going to go on, on web MD and, and, and do my treatment. Right. You know, I'm just going to go to a doctor, you know, who can, who has the experience. So I don't care how much research I do on Web MD, I will never be able to come up with what exactly it is. We know with confidence. So, so yeah, I would, I may want to get informed, but it's still, I want to get treated by a doctor. So I encouraged, by the way, I really love my clients who are up on what is happening on the internet because unfortunately most of my clients, it's like a mystery to them and they don't want to learn. I mean they are like, you know, I already have too much work or taking care of my patients so I'm, I'm, you know, it's your headache. But the, some of the young doctors who stay on top, I find it really easy to work with because they understand anything I say. Ajay:                                  18:11                   It's like, Geez, you know, I, that's what I read. You know, what are you going to do? It's a whole different discussion versus saying, so Google has changed and we have to do this. And the doctor is saying, I don't know. You know why we have it Janet:                                18:26                   "It looks fine to me!" Well do you find that dealing with different practices based on their patients? So let's take two extremes. You've got your orthodontist where the majority of the patients are, you know, teenagers or sell and then maybe a podiatrist where the majority of patients are mature adults. Do you find that the work you do for those two different types of practice is very different? Or are you still going through the same process to make sure they're online presence is good. Ajay:                                  19:01                   Okay. So first thing, you know, just like in traditional marketing, you have to tailor your message right to the target audience, you know? And so, so, you know, what is your target audience? What will pick their interest, why they would follow something, why they would read something. So of course the messaging has to be a very specific to the potential client or the of all the patients of our clients otherwise over-arching process is same for for Google. But then then by the way, one of the things that Google also rate you on is how many people when they go to your website and suppose someone goes to a website and just clicks back. It is a demerit and Google will rank you down because they are saying, hey, you know your looks like your website is not relevant for this keyword. Right? So, so the messaging on the website is become very important and the way you engage with the messages, you have to make sure that, that your message is tailored to the, to the target audience. Janet:                                20:06                   All right, so I think what you're talking about there is the bounce rate. Someone comes to the website, they click on there and go, oh, that's not what I'm looking for, how quickly that happens. Ajay:                                  20:15                   And, and if that happens a lot, then then you'll see yourself dropping and dropping and dropping. And the worst part is that the more you drop, then the more your bounce rate becomes, because now you're getting like, you know, the people who are, I don't know, they're browsing so they click and go. So, it's almost like a death spiral when you start to see or bouncer to increase. So that's where the whole messaging, you know, a call to action, all those things come to make sure that you are engaging your you know, patient or the prospective patient will come to the website. Janet:                                20:53                   I would assume that when you get a new client, that's probably one of the first things you look at. How relevant is your website to a current audience? Ajay:                                  21:01                   Exactly. So, so, you know, the good news is that, the, we have a lot of, unlike like when I used to be in TV advertising, that's where I started my career. Unlike dark, everything is very transparent on digital. So when we get the nose, sometimes we will get a client and they have not even the website is not done properly. So we cannot even read, you know, the information. But if everything is done right, install, on the website, you would know from analytics exactly what is happening. And so the first thing, first we do is we analyze that, the their data and then we pinpoint where the problems are, and then we will from there is, it is the part of the initial discussion, we always ask things like why someone would come to you. I mean, in what you do is very obvious, but, but why you, why not the other orthodontist or why not the other primary care physician who is in your insurance list? Ajay:                                  22:00                   Right. So I mean, you know, it's it just dead. I just recently was meeting with the wood with a prospective client who said, "I don't know why I need marketing because all my patients come from the insurance list." So my question simply was "In your area, are you the only doctor in the insurance list?" He said, "No, no, no, there are about 15 so." I said, "Okay, so if I am a new prospective patient, I moved in that area and I buy this insurance. I'm given that there are 15 doctors, why should I come to you versus the other 14?" And he said, "Okay, I, I see where you're coming from." As you can imagine. It is so personal. It is so critical that the patients will be for the selected doctor, they do a lot of due diligence and then you have to stand out among whoever you are competing with. Janet:                                23:03                   Now what I think is interesting about what you do at GMR is that you really partner with your clients and you hold them accountable for their practice. You can't, in essence, you're telling them, I can't buy you a number one position. All is you're going to commit to being that practice. I think that's really fascinating. Exactly. So, so, you know, we first thing, Ajay:                                  23:27                   You know, one of just, just sort of, you know, one of the, the goals that we have in our mission is, is we want to increase the market share of patient-centric, providers. That's what we always say. So, so when we, when someone to us and says, you know what, just give me a CEO and I'm like, you know what, even if I do that, you're not going to get a new patient, even if I can get you on number one, which is very difficult unless someone is taking a holistic approach anyway. But our big thing is that we cannot do magic unless you really care about your patients. Unless your patient is happy with your services. We cannot go in any magic. So, so that to me is the requirement. So when, when someone comes to us, we said, I'm assuming that you are, you want to take care of your patient. Ajay:                                  24:20                   And so one of the things that we do, just sweat, you know, is part of, as we, we start measuring patient satisfaction, we will not take a practice who says, I don't need to measure my patient satisfaction. Because then I'm like, you know what, I don't know where your problem is going to be. I don't, I will never know much about your practice. So you are better off going to another company who does not. Because to me that's a central piece is we look at patient satisfaction, you know, that tells us where they have to make an improvement. what is their strong point that helps us with the marketing message, right? You know, what people like about you. We help them identify the weaknesses and get around the weaknesses. How, how, what, what you handle. So that is the starting point. We just say, listen, unless you are taking care of the patient, really, you know, we can't help. Ajay:                                  25:13                   And that's one of the reasons that it's unfortunate. But what I'm noticing that, so I am in California, there's something called medic cal here, which I don't know if it's some some state program, right? If you don't have any insurance, then the state will I guess buy you insurance. But they don't pay a lot to the providers. And as a result, many good providers don't take that as a result. The ones who take it, they're overwhelmed and they will blindly tell you that. You know what, frankly speaking, I don't care. I, you know, these people come in of what I want is I need more like a more patient with good insurance. And I'm like, unfortunately it just doesn't work like that. If you say, oh, half of the patient can go to hell, I don't care. But other half I've, I want to be very to make them very happy. Ajay:                                  26:04                   I'm like, just the whole philosophy doesn't work. And, and actually just because someone is on whatever Medi-Cal, that doesn't mean that they expect like a sub sub optimal performance right. From the healthcare provider. So I tell them, I totally, I am not into the business of making a decision for you. So if someone says, I don't take medical, that is great if someone says medical grade. But I, we always said that. Here's the process and the, and the number one is you have to have a patient satisfaction measurement and you have to have a very high patient satisfaction index, otherwise it doesn't work. Janet:                                26:43                   So you actually have that as part of your services? Ajay:                                  26:46                   Is it is a not only that as part of the sort of mandatory. Janet:                                26:51                   And how does that work? Is it like a a survey that's sent out post visit? Ajay:                                  26:55                   Yes. We have created our own platform and personal, we do a survey, post visit. We asked them a simple question, would you recommend this medical office physician, whatever it is, is what we are. We are surveying based on your experience today, right? And on the scale of zero to 10, and then then be whatever is the answer. We, we asked them, let us know your reason for rating the doctor or the clinic seven or zero one or whatever. so so what happens is we are constantly tracking and we get about 40% of the patients generally will respond to our survey, 30 to 40% depending on the specialization. So which is a very good sample size. And then we do that analysis, not only we see what's your average and everything. We analyze the comments and we use artificial intelligence to analyze the comment so the practice knows exactly what is their strong point. Ajay:                                  28:03                   So we will analyze comments of unhappy patients. We just lay it out right in front of the clients and say, "Guys, you need to address this thing. This is your strong suit." And then our marketing will focus on those strong suits in our messaging in terms of why you should be coming to this provider. Janet:                                28:26                   Excellent. Now I understand that the way you work is you just don't build a website. You are looking for someone who really is committed to the long term marketing. Ajay:                                  28:37                   Exactly right. Because for me it is a distraction to just build a website. I don't care how much money someone is paying, so we just do a website and not do anything. Ajay:                                  28:57                   When I first started my career, I worked for a market research company. And what we are doing is all these companies will have the issue, then we'll do research and we'll come up with this beautiful deep analysis, send it to them and we would never know what happened. And I got bored literally, and in eight months I said, you know what? I want to be on the other side. I can do something with this and, and show results. That's how I feel about just doing a website. It's like, okay, I just did a website. Who cares? Yeah. Right. and, and I would like to know that what we are doing is really helping our clients. So unless I'm able to measure and see that the plant is getting along, I'm not interested. Janet:                                29:44                   Oh, that's absolutely fascinating. Well, I love the work you're doing and, and I really love what we talked around but didn't use the term that you developed the three pillars of health care, marketing success. I think that's critical for, for anyone and the fact that you actually tell your prospective clients that they have to commit to that I think is really, really amazing. And it speaks to your partnership with your practices. Ajay:                                  30:10                   Yeah, I mean a killer on my website we just laid out also it's like are we a good fit? So you know, someone who is wondering whether they should be working with GMR. Of course, you know, we always explain it, someone calls, but they can go and check the website on the side. We just laid out what we do. The three pillars are, patient satisfaction, you have to have a very good patient satisfaction. Do you have to have a stellar online reputation and the new, you have to have a very robust web presence. So those are the three pillars that I talk about. Janet:                                30:52                   It sounds like it's working for your clients and their patients. That's a great thing. I think you're doing a a wonderful job at GMR. Ajay:                                  31:00                   Thank you. Janet:                                31:00                   Awesome. Well Ajay, I really appreciate your being here. I do find search and SEO to be a mystery and I am always trying to ask questions to understand more about how that process works. And I know you've written a couple of books including "local search marketing secrets unveiled and plant your online biz money tree. So the fact that you've been able to kind of put some of these ideas in writing is super helpful and I congratulate you on, on the great work you're doing at GMR. Ajay:                                  31:32                   Yeah, thank you. Last week I wrote four or five pages for my blog that says, for your prospective patient to become aware about you and what do you have to do to convert them into your actual patient. I find marketing really fascinating for the same reason that it's never perfected. It's never ending work that you have to do and it always keeps you challenged. Janet:                                32:34                   Absolutely. Well, thank you for bringing me up to date. For at least the next five days. Ajay:                                  32:41                   Thank you, Janet. I'm always here when any update happens. You know what? I will also make sure that when something big happens I will just let you know so that you can just share with your audience. Janet:                                32:57                   Absolutely. Well, if you just tag your tweets with at Get Social Health, I'd be sure to pass it on. Folks who are listening, I will help all of Ajay's contact information in the show notes for this podcast. Ajay, thank you very much for joining me today. Ajay:                                  33:11                   Thank you Janet. It was good talking to you. Announcer:                      33:15                   And now here's a social media success tip. Janet:                                33:19                   Hi, this is Janet Kennedy with the Get Social Health podcast. Wait, you just heard me, but you know what? Today I'm going to give my own social media tip and this is specifically for those of you who are or would like to be a writer in the healthcare space. I am so proud to announce that my partner's Carol Bush and Janine Kalbach have launched their own podcast! No arm twisting was involved at all. Well, okay, maybe a little. So what I want you to do is go check out their new podcast. It's called The Savvy Scribe and it is going to be a whole combination of things. Great interviews, fun conversations. Buckle in and go on for a great ride with them. Plus they're going to give you lots of tips and little mini sessions of quick wins. So it's gotta be a fun podcast. It's going to go all over the area of everything to do with writing, freelance writing, the freelance writing life, what it's like to be a parent and right and also some good hardcore writing tips. So check it out on iTunes. The Savvy Scribe and you can always find it on our website, the Healthcare Marketing Click over to the blog. That's where we're going to mix the podcast and the blog posts in together. So check it out. The Savvy Scribe Announcer:                      34:40                   You've been listening to the Get Social Health podcast. The show notes are located at To join our healthcare social media journey, follow @GetSocialHealth on Twitter. And start a conversation..........
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