We founded Sector45 in 2011 with the goal of getting every client to rank as highly as possible in Google for as many relevant search terms as possible. Sure, we offered a variety of other online marketing services, but at the core of our mission then was Google rankings. Is that still true today?

It is, but with a number of caveats. Our focus on keywords and rankings has evolved significantly. Many clients come to us who still want to “rank on page 1 of Google,” but what most of them are really saying is they want way more business coming in. Few clients really care where good leads come from. Today, if we managed to double their revenue strictly from Twitter, Snapchat, or some other marginal platform, we almost certainly wouldn’t get complaints.

So let’s tackle the first question – do Google rankings really still matter?

Do Google Keyword Rankings Matter?

Here’s the short answer, and we actually first brought this up 5 years ago in a blog about the declining importance of keyword rankings. Keyword rankings matter, but only to the extent that you are getting in front of highly qualified prospects in your market. A better measurement of online marketing success looks at increasing website traffic combined with a solid (and hopefully growing) conversion rate on your website.

To see why keywords don’t necessarily matter as much, let’s take a silly example. We could get you to quickly rank #1 in your market for the term “plastic surgery for gerbils.” Maybe write a page about it and do some blogs and social posts. But putting aside the fact that you only focus on humans, no one is searching for a cosmetic makeover for their gerbil. So your top ranking is completely useless. This same idea can be extended to more relevant keywords for your business that still have practically no one searching for them.

How Much Longer Will You Even Need a Website?

If you’ve been in business more than 15 years or so, you probably remember a time before the internet and before you had to do any online advertising. Just because you need a website now doesn’t mean that you always will. So if keyword rankings for your website matter less, does that mean your website is becoming irrelevant too?

In 2019 and likely for many years to come, you still need a website to show off your practice. But the importance of that website may start to wane in the face of online habits that seem to be moving toward ever-increasing use of social media, apps, and streaming online content, not to mention a big push by Google to keep its users within the Google network of services.

Your website may be your “calling card,” but who under the age of 30 even knows what a calling card is? Or even a business card, for that matter.

While your website may be the foundation of your digital presence, it’s not the sole place to pay attention. Right now, you have key social media channels where people are finding and interacting with your brand. And given that almost all time on mobile is spent in apps, you may need to develop an app in the near future. And who even knows what the hot ticket will be in another 5 years.

Getting Back to Google

With the proper framework of understanding that top Google keyword rankings are only one part of your online marketing mix, let’s dive in a bit and see what it takes to pursue better rankings. To get really simple about it, your rankings are mostly determined by how competitive your market is and how popular or useful your site is. But there are a lot of finer points.

Ten years ago, you could go after a list of keyword phrases through content marketing and link building and, without changing your business in any way, have a good amount of success if your goals were reasonable.

Now, you just simply can’t do online marketing in a bubble. It’s money down the drain. You have to have what we call a “360 approach” that accounts for not only your online presence and messaging, but also includes reviews, customer service, product/service mix, demographics, perceived value, social sentiment, office/décor, pricing, and dozens of other variables. In short, SEO 10 years ago was checkers, and now we’re playing chess.

If you want to rank for “best plastic surgeon in Phoenix,” you can’t simply blog a bunch and drop that term into the text. That will get you exactly nowhere. You need to actually be the best plastic surgeon in Phoenix, at least according to what Google sees as the proper measurements of that concept. Getting there will include:

  • Patient satisfaction through the roof
  • “Buzzworthy” service and/or products
  • A clear and concise brand to differentiate you
  • Comprehensive online info about what you do and what makes you special
  • High quality office setting
  • An entertaining, engaging social presence
  • Recurring marketing tactics like newsletters and text blasts to keep patients engaged with you

The net result of this comprehensive effort should be that Google sees more positive activity associated with your business, which in turn causes their search algorithm to rank you higher.

A Note on Paid Search

We’ve talked a lot about organic keywords in Google in this article, but we’d be remiss if we didn’t also make it clear that organic rankings simply aren’t enough on Google anymore. Google, as part of Alphabet, is one of the largest public companies in the world. Its shareholders expect revenue, and revenue growth. Because nearly all of Google’s services are free or have nominal cost, the main driver of revenue today remains advertising.

It should come as no surprise that Google is finding more and more ways to get paid placements front and center over organic (or earned) rankings. Even if you’ve earned the top spot for a ton of important keywords in your market, that doesn’t mean bupkiss if a user has to wade through all kinds of paid listings just to get to that first organic keyword result. It is harder and harder to distinguish paid vs. organic content on Google platforms, and that is of course on purpose.

You can grump and grouch about it all you want, but the reality is that to keep relevant traffic coming to your site, some level of Google pay-per-click (PPC) advertising needs to be part of your online marketing mix, even if you are working toward improving organic rankings. It’s just one more aspect of the “360 approach” that we discussed above.


Keywords are still important, but they don’t matter like they used to. Getting traffic to your site is far more complex than just “ranking on Google.” Focus your online efforts on your website, but also make sure that you are spreading the love to other online platforms and ensuring that you are providing the best possible service to every patient, every day. The best way to get more business online is to earn it offline through outstanding customer service.

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