Local SEO and Optimizing the Digital Experience with Alex Membrillo

In this episode with special guest Alex Membrillo, we dive into the impact of local SEO as a powerful and efficient lead driver in the healthcare industry. Learn how optimizing digital experiences, embracing online booking, and utilizing user-centric websites can enhance your patient acquisition and practice growth.

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Alec Goldman (01:37.974)
Welcome to How I Grew My Practice, a podcast presented by NexHealth. I'm your host, Alec Goldman. In this episode, we have Alec Membrillo, CEO of Cardinal Digital Marketing. He's here to talk about local SEO and optimizing the digital experience, your website, from search through booking. Alex, welcome to the show, how you doing today?
Alex (01:59.013)
Thank you, Alec.
Alec Goldman (02:03.682)
Good. Well, Alex, for our audience who may not know who you are, you can share a little bit about yourself and what you're up to at Cardinal.
Alex (02:11.669)
Yeah, everyone doesn't know who I am. So that's good. So Cardinal Digital Marketing, we are a performance marketing agency for PE back multi-site provider groups. So think your big dermatology, behavioral, dental, orthodontic, those types of groups that come in with five locations want to get to 500 locations and recap, we help them do that. They're SEO, paid service, Facebook, got websites, analytics, patient loyalty programs, that kind of stuff. So everything it takes to drive a lead and patient online. That's what Cardinal does.
Alec Goldman (02:41.378)
Very succinct, short to the point, lots to offer. I know today's episode is around local SEO. And obviously, you do a lot. And I asked you the question before the show, hey, what's a topic that really is something that you want to dive into? You pick local SEO. Why local SEO? Why is it important? Why is it the topic of choice today?
Yeah, because it's getting a bad rap with AI and SEO is dying. I love it. So 2020 to 2022.
All everybody cared about was like Google Ads, Facebook Ads, ramping patient acquisition like this. Yes, more patients at any cost. Now all of a sudden, all the clients, everybody wants SEO because it's the most efficient lead driver out there. So when you build a great website, lots of helpful content, get ranked, and you show up well and your reviews are good, it drives a more efficient lead by probably about 75% less than the CPL that comes through Search or Facebook Ads. So now it's all the rage again. It's always been my favorite thing. I started this.
agency as an SEO company. So I'm passionate about it because it's the most efficient business driver out there.
Alec Goldman (03:44.686)
So when you said that it's getting a bad rep, obviously it's less sexy than all the paid advertising that was happening between 2020 and 2022. Obviously now things are being pushed in a way where organizations need to be much more efficient. So in 2023, SEO sounds like a much more effective way, but to your point, you said it has a bad rep and certainly the commodity of GBT and people being able to answer questions and get long form content pretty quick.
Alex (03:50.861)
less sexy.
Alex (03:54.604)
Alex (04:00.15)
You got it.
Alec Goldman (04:12.194)
does have an effect, but I guess what's your opinion on the topic?
Alex (04:15.913)
Yeah, I see how it's bringing sexy back this year. Yeah, everybody thinks like.
You just create the website and then throw SEO up. It's like a project thing, you know, and it's not ongoing link building reputation. It's not just like how you rank on Google. It's converting the patient once they land on the site. And so NexHealth helps with that tremendously because you don't just want to rank and have someone come to the site, but they need to convert. And a lot of people don't want to submit an email form. The call goes nowhere to a shitty contact center. The online booking is so, so important and it's taking that all into account. What is the content on my page that's going to get ranked? And then how do I convert them? That's SEO now it's conversion rate.
optimization. It's the UX of the website, having great reviews, it's being present on psychology today. I mean, it's all of that that's SEO. Maybe we need to change the algorithm to or the acronym to just let's call it owned and earned media, right? Because it's not just the thing, the nerdy thing of getting ranked, which is my favorite thing, but it's the whole thing of converting a patient through a non advertising method.
Alec Goldman (05:13.198)
Couldn't agree more over here. So obviously, there's a lot that goes into SEO, right? I think, to your point, it kind of feels like it doesn't represent the full spectrum of things that SEO is, right? There's so many inputs that go into the output of having, quote unquote, good SEO. For a dental practice or for a medical practice, that's not just having the right keywords on the page, backlinks, having great reviews on your Google, on Yelp, wherever it may be.
Alex (05:14.789)
Thanks, man.
Alex (05:29.871)
Alec Goldman (05:40.002)
but also to your point of actually coming to the site, providing really useful information to convert them. So when you're starting off with, let's say a small practice group, five practices, and they don't have great SEO, given how many variables there are, where do you start with them?
Alex (05:55.093)
Yeah, yeah, yeah.
We needed to rank on Google for the location pages. So building those out to have great content that can rank on Google and then be succinct enough to convert the patient once they actually do rank and start sending leads there or traffic there. That's where I started. Location pages drive 90% of all SEO leads. And then the upper funnel stuff, and you can do condition treatment services. That's all important, but after locations, I start with that. That and GMB is number two, making sure GMB is optimized right services and categories and all that stuff and keywords in the title.
locations, shut down the old ones, redirect any acquired practices to the right places. So something like a Yaxed even though it's a terrible platform, it does actually work. Just run by sketch. But yeah, GMB and location pages number one and two.
Alec Goldman (06:43.298)
So it sounds, I mean, it's a ton of website optimization, right? Just making sure that the content is extremely helpful to an end user. Again, listing the location to your point, the services that they can expect. I'm probably getting into the differentiation of what makes that specific location different.
Alex (06:50.317)
Alex (06:55.597)
Alex (06:58.805)
Yeah, there you go. Yeah, you're right. So it needs that location page has to have everything it takes to feel comfortable booking an appointment for a lot of people that's.
an in office like video view and walk through what the office looks like, make sure it's clean, make sure it's modern. I'm not working, walking into a shit hole in the ghetto. That matters. What are the providers there? What are their credentials, hours, location, all of that kind of stuff, services offered with dropdown. So you're not taking me somewhere else. And then I'm confused and I'm not on location page. That's optimized. That's important. And then having all the payer partnerships at the top above the fold is what we have found to be number one, that in an offer, if you're in an offer driven, uh, type industry like dental. Um,
So the payer partnerships up top and he kind of offer for free first exam, free first visit, whatever it is. And then all of the relevant stuff, uh, provider testimonials, video, video is good lower down, uh, cause you want to distract too much, but yeah, man, everything it takes to convert that's SEO. It's not just getting ranked. It's not just a project. It's like content optimization conversion. Gosh, Alex helped me rename this thing. Save the industry.
Alec Goldman (08:04.962)
What do we name it? I guess, I don't want to just call it conversion optimization because it is about driving the page, but also.
Alex (08:09.733)
There we go. I like that organic conversion optimism. We'll work on it. I need the Goldman magic touch on this one. So sleep on it. And then we're gonna rename SEO together. You're gonna come run this program here also next up. Just kidding.
Alec Goldman (08:16.27)
Okay. All right.
Alec Goldman (08:23.118)
There you go. So obviously, given how many things that you are tracking for somebody to say that Alex has fixed their SEO, I know lots of medical practices that we work specifically on the SMB side don't have a lot of measurement in place to understand if the actions they're taking and improving their site, improving their Google representation, how do they know that it's working? How do you know if practices know that your SEO
Alex (08:33.646)
Alex (08:48.429)
Yeah, work.
Alec Goldman (08:52.97)
Input the things that you're doing to make changes actually creating the right out.
Alex (08:56.673)
Yeah, leads, patience is the ultimate thing. So that leading KBI is always rankings in traffic and Google Analytics is not.
So you can't even have that. You got to go with like a mixed panel. Now that sign be a age, it's HIPAA compliant. So even tracking traffic's getting harder. Uh, but I started with the rankings and then eventually it's organic leads and, um, can't really have the pixels on there, which applied for advertising, but you want to track organic leads either through forms through HIPAA compliant call tracking or through online booking. And the next sales, next patients, that kind of stuff, they'll allow you to place pixels potentially on the thank you page and then you track all the way back. But the more sophisticated groups want to know leads driven from.
organic because eventually they want to multiply that or divide that into how much they're paying the SEO company or putting into their organic efforts and then they have a CAC or a cost per acquired patient so that's what they all want to get to so you got to know the leads you're driving. At the end of the day all of this fancy stuff we're doing must drive leads through organic means.
Alec Goldman (09:54.926)
Are you helping out small groups with a content strategy as well?
Alex (09:59.33)
generally not small groups unless they've just got funding and they're gonna be a potential big group eventually for the small groups. As I started this as a small company working with small medical practices, I was not funded 14 years ago, so I'm very familiar with that. SEO is even more important. They should not be running advertising. Like they mostly don't need, especially if it's a 1Z, 2Z provider group, may not even need advertising enough. Their word of mouth and showing up decently on Google with decent reviews across all the aggregators, that's enough, that's enough. So SEO, even more important for the small provider groups.
Alec Goldman (10:30.026)
Yeah, so it sounds like, I mean, the very first step, taking a look at the website, making sure that you look the part, right? So to your point, a couple of things that you mentioned were showing the actual location, a walkthrough, making sure that the services represent what you do, stand out, probably show the faces of the folks who are working at each of the practices, ensure that your location is easily available. Something that you mentioned before is making sure that they actually convert. Once they have all the information, they kind of check all the questions that...
Alex (10:33.7)
Alex (10:37.111)
Alec Goldman (10:56.77)
they inherently have in their head. Do they offer the service? Is it the price point that I think I'm gonna be paying? NexHealth helps with online booking. Can you discuss the impact of having online booking on a dental or medical website?
Alex (11:10.313)
Oh my God, it's tremendous. It's tremendous. It's the closest thing to an actual book patient that's gonna show up that you ever could. So think about that. Let's not talk about, let's talk about patient experience. Alec, when you're seeking care, you're gonna go through Google, right? And you're gonna type in orthopedic surgeon near me, and you're gonna click on some different links, some individual provider groups.
Our generation, do you want to call and then you know you're going to get a contact center that doesn't know shit, you know, maybe it's not going to be optimized, maybe they won't pick up, maybe it's going to give you the wrong information. Do you want to send an email for them, then you got to go back and you're still going to end up on like that's a pain in the butt. Or you just want to book an open slot for tomorrow at 9 30 a.m. or in three weeks like you just want to book the damn slot. I think it's like y'all publish content, I think 70% of all bookings are made after hours so the contact center have the best people there and still necessary to have
contact centers and all that don't get rid of it but all of us the majority of people want to book online and our groups that have NexHealth and have call and email it's like 73%, 70 80% of patients are booking online rather than calls so it's critical think about the patient experience again so you've clicked on you're looking for who can book and then if somebody doesn't have the online book and you go back and what site do you click on that you know you can book on ZocDoc and those mofos have every single provider
This is within 30 miles and you can book an online appointment easy peasy So you can't beat or compete with ZocDoc. You're done. You're done as a provider. You're done. You're done And I'm tired of hearing the excuses our providers don't want their schedule online. You're done. I can't work with you You're gonna get crushed by ZocDoc and everyone else. So it's critical. I love what you guys are doing
Alec Goldman (12:51.202)
So given the amount of pushback that even at NexHealth, we receive from practices who are kind of shrugging their shoulders at online booking or deep down nervous about having patient access to the schedule. I know. But what's your logic behind it? How do you kind of convince those practices who may not be interested?
Alex (13:08.653)
Alex (13:12.557)
Why is someone going to choose you over ZocDoc? You can't compete. The user experience is better.
Alec Goldman (13:16.159)
Alex (13:18.817)
Why am I going to land? You're going to spend all this money on advertising, driving back to your site. I can't book online. They go back. They find ZocDoc. You can't. I needed a cardiologist to check something out personally. So HIPAA violation. I don't know if I can do that. It's my own fucking thing. And, uh, I'm clicking around at all these provider sites and had to email them. They said, yeah, sure. We'll see you in a month. What the fuck? I went to ZocDoc 10 minutes later. I found someone that could see me that morning. I went in and got treated. I'm all good to go. You know, mental stress alleviated. If you can't compete with ZocDoc's patient experience, you're done.
You're not, it's better than everybody's. And you know, it's not a machine that you can scale and you won't own your own data, so I don't like it as being the only thing. But without online booking, you can't compete. You can't compete. So I don't try to convince them, I just say move on to another agency. Like you're not sophisticated or innovative enough.
Alec Goldman (14:07.246)
So I guess a really good answer is to say, hey, you may not be for us.
Alex (14:10.734)
Yeah dude, you're gonna get crushed. Bye. I tried. Read all of our guides. Watch NexHealth's podcast. If you don't want to get up with the program, it's a losing battle. I'm gonna run all your advertising. It's gonna be really inefficient because nobody converts because you don't have all my booking.
Alec Goldman (14:23.926)
Yeah, I think, I mean, there's certainly a percentage of the population who still wants to make a phone call. I understand that. But it's just about making sure that you have all of the channels available, the many different types of buyers or personas or individuals who go to practices, right? And the truth is, is that picking up a phone, each button is more friction than what online booking is on a computer.
Alex (14:33.105)
Three ways. Yeah.
Alex (14:49.633)
Yeah, yeah, you know what I hear one of them constant push backs over high acuity. They need to call in they got to be taught. I got it. We got to learn. We got to run second checks on. No, you don't. No, you don't. There's plenty of high acuity practices that you can book online. There's no excuses. There's just no excuses anymore. Yeah, sorry. Y'all are getting free. Yeah, y'all are in it more than I am. So I imagine you hear every kind of excuse.
Alec Goldman (15:13.258)
Yeah. And again, like there's no pushback on a phone call if you want personalization. The question is, does that have to be the opening touch or could that be a follow up on a confirmation? There's definitely different ways to add a personal touch. That's not just the initial booking, right? But yeah, I mean, listen, I think the going back to the topic of local SEO, the whole point of online booking is to convert better, right? Convert faster to reduce friction.
Alex (15:21.347)
There you go.
Alex (15:25.425)
There you go. That's smart. Yeah, that's smart.
Alec Goldman (15:39.47)
from the point of when somebody sees that you have a great service, something that they want at your office, to getting to them in the actual, into the actual chair. Um, so from our perspective, obviously we, you know, people always think about online booking really just from a, there's people who think about it just from a time perspective and efficiency perspective. Um, but it really is a way to, to save money, um, from marketing spend.
Alex (15:47.941)
That's right.
Alex (16:01.057)
Yeah, yeah, yeah. You need less advertising and convert. If you convert more, you don't have to spend as much on advertising or on SEO, I hope. So yeah, I'm with you, dude. You guys are, y'all are gonna kill it. I'm sure, I mean, Next Health is already killing it. Like, you enter the space at the right time, this thing's gonna blow up. Every provider group's gonna be with you here in the next few months. This is awesome. Awesome, awesome technology, yeah.
Alec Goldman (16:21.63)
Let's go. Well, Alex, we're coming up with the 15-minute mark. I want to make sure that you have an opportunity to add any additional thoughts on just local SEO, what makes Cardinal different, what makes you different. Obviously, speaking with you for a whole bunch has been a lot of fun.
Alex (16:34.093)
Yeah, yeah, yeah. Well, the final thing I would say is your reviews count. Too many of these groups don't have active review solicitation programs. And all the SEO in the world, you can start doing that to generate new eyeballs, but your referrals and word of mouth are still going to see Dr. Jim and Dr. Sally online. And like.
what they look like. So make sure your GMB, Vitals, RateMDs, HealthCrates, all of those reviews are really good. So that's a big part of SEO. I see too often people don't have a patient, or sorry, review solicitation program in place. Big part of SEO is making sure you convert them, reputation is a big part of converting them. So that's it. If you wanna find Cardinal, just Google, Healthcare Marketing Agency, Dermatology Marketing, HIPAA Marketing Guide, whatever it is. If we don't show up, we don't deserve your business if we're bad at SEO, right? So.
Alec Goldman (17:22.414)
You gotta walk the walk. Thanks for talking to me. That's right. Alex, thank you so much for joining the show today.
Enlive will officially sunset in

Welcome to "How I Grew My Practice," a podcast presented by NexHealth. In this episode, we have the pleasure of hosting Alex Membrillo, the CEO of Cardinal Digital Marketing. The discussion focuses on local SEO and optimizing the digital experience for medical and dental practices from search to booking. Membrillo shares his expertise on why local SEO has gained traction again and its significance in driving efficient patient acquisition.

The Resurgence of Local SEO

Local SEO is experiencing a revival after a phase where paid advertising dominated the landscape. Many believe that AI and SEO are losing their edge, but the truth is local SEO remains the most efficient lead driver. When businesses build a great website with valuable content, achieve high rankings, and maintain positive reviews, they generate leads at a fraction of the cost compared to paid advertising.

Embracing the Comprehensive SEO Approach

Local SEO should not be seen merely as a project to rank higher on search engines. It goes beyond that. Embracing a comprehensive approach, it now includes content optimization, conversion rate optimization (CRO), user experience (UX) design, and having a strong presence on platforms like Psychology Today. To sum it up, local SEO can be aptly redefined as "owned and earned media."

The Core Elements of Effective Local SEO

  1. Location Pages: For multi-site provider groups, location pages drive 90% of all SEO leads. Ensuring these pages have informative and engaging content that ranks well on search engines and converts visitors is crucial.
  2. Google My Business (GMB) Optimization: Optimizing GMB listings with relevant services, categories, and keywords is vital for local SEO success.
  3. User-Centric Website: A website's content and design should be tailored to convert visitors into patients. It should showcase the providers, credentials, services, location, hours, and offer an intuitive online booking system.

Measuring Local SEO Success

To gauge the success of local SEO efforts, practices should track key performance indicators (KPIs) like rankings, website traffic, and organic leads. These leads can be monitored through form submissions, HIPAA-compliant call tracking, and online booking. Knowing the number of leads generated from organic sources helps calculate the cost per acquired patient (CAC), a critical metric for evaluating ROI.

The Impact of Online Booking

Online booking has transformed patient acquisition in medical and dental practices. A tool like NexHealth Online Booking significantly improves the patient experience, as it provides a seamless way to book appointments and reduces friction in the booking process. Practices that offer online booking benefit from higher conversion rates and reduced marketing expenses, as they need less advertising to drive conversions.


As local SEO gains prominence again, medical and dental practices should embrace a comprehensive approach to improve their digital experience and attract more patients. Local SEO, emphasizing website optimization, user experience, and online booking, is the most efficient lead driver for practices looking to expand their reach and enhance patient acquisition. By incorporating online booking and refining their digital presence, practices can establish themselves as competitive players in the ever-evolving healthcare landscape.


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