Case Insight 02
The Illusion of #1
Why strong rankings failed to translate into a single patient enquiry.
Overview
This case insight documents how a medical clinic approached DaiGen while ranking #1 on Google, yet experiencing little to no patient footfall.
On the surface, performance looked excellent.
Monthly SEO reports showed strong rankings and apparent success.
In reality, growth was stagnant.
The issue was not competition.
It was misleading success metrics.
The breakthrough did not come from doing more marketing —
it came from removing invisible friction.
The Situation
When the clinic reached out, they shared a clear concern:
“We are ranking number one, but patients are not coming.”
According to reports from their previous digital marketing agency:
Multiple keywords were ranking at #1
SEO performance was described as “strong”
Long-term engagement had already taken place
Yet on the ground:
Patient enquiries were inconsistent
Call volume did not reflect reported success
Footfall remained low despite “top rankings”
There was a clear disconnect between reports and reality.
The Common Assumption
Most clinics assume:
In this case, that assumption proved costly.
DaiGen’s Diagnosis
Instead of reviewing rankings alone, DaiGen audited the system from a demand-first perspective.
We analysed:
Actual search demand behind ranked keywords
How patients phrase their searches
Whether rankings aligned with real patient intent
This is where the real issue surfaced.
What We Found
The clinic was ranking #1 —
and the rankings were real.
However, the keywords being ranked for had one major issue:
They had little to no real search demand.
These keywords:
Had extremely low monthly search volume
Were phrased unnaturally
Reflected how agencies write — not how patients search
Were chosen because they were easy to rank, not because they drove enquiries
The optimisation itself was technically correct.
The strategy behind it was not patient-driven.
Specifically:
Keywords had negligible or near-zero monthly search volume
Phrases were overly technical or unnatural
Keywords were selected for ease of ranking, not demand
No validation of patient search behaviour was done prior to optimisation
The rankings themselves were real.
The demand behind them was not.
Why This Happens (Industry Reality)
Some agencies optimise for:
Low-competition keywords
Faster ranking wins
Impressive-looking reports
This approach creates:
Strong ranking positions
Weak patient impact
False confidence for clinics
Over time, clinics are encouraged to “trust the process” —
while real growth never arrives.
What We Changed
DaiGen reframed the objective entirely.
Rankings were no longer treated as the goal.
Patient intent became the metric.
Every keyword was evaluated on:
Real monthly demand
Patient-style phrasing
Local intent
Likelihood of generating enquiries
Visibility without demand was treated as noise — not success.
What We Changed
Demand-First Keyword Strategy
- Removed low- or no-demand keywords
- Rebuilt keyword list around real patient searches
- Prioritised intent over ease of ranking
Reporting Realignment
- Shifted focus away from “positions”
- Evaluated performance through enquiry signals
- Measured relevance, not vanity metrics
SEO With Accountability
- Shifted focus away from “positions”
- Evaluated performance through enquiry signals
- Measured relevance, not vanity metrics
The Outcome
The clinic gained clarity on why growth had stalled
SEO efforts aligned with how patients actually search
Misleading metrics were replaced with meaningful indicators
Marketing decisions became outcome-driven, not report-driven
The biggest result was not just improved direction —
it was restored trust.
Conclusion
This case was not about poor execution.
The rankings were real.
The reports were technically accurate.
The problem was what those rankings represented.
By focusing on low-competition keywords with little or no patient demand, success was measured in positions rather than outcomes. The clinic appeared to be winning in reports, while losing in reality.
This approach is not uncommon in the industry.
It is also not illegal.
But it creates a dangerous gap between what clinics believe is working and what actually drives patient growth.
True medical SEO does not begin with the question:
“What can we rank for easily?”
It begins with:
“What are real patients searching for when they need care?”
Until demand, intent, and outcomes are aligned, rankings remain a surface metric — impressive to read, but ineffective to rely on.
"Some agencies optimise for reports. We optimise for real patient demand."
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