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Today's Practice | Jan 2017

Black Hat SEO Tactics

Ophthalmologists, beware!

If there is one aspect of marketing that is still clouded by smoke and mirrors, it is search engine optimization (SEO). Ophthalmologists want their websites to rank high for key search terms such as LASIK, cataract surgery, and glaucoma. For this reason, SEO companies have a relatively easy time selling ophthalmologists a variety of services that may have increased their website ranking in the past but can actually penalize their ranking today.

A few years ago, Google launched Penguin and Panda, two SEO algorithm updates that target websites that violate Google’s Webmaster Guidelines. Google has clearly defined what it calls black hat SEO tactics—techniques used to artificially increase the ranking of a website—and has compiled a list of which to avoid. Highest on that list are link-building schemes (see The More You Know).

Backlinks, also known as inbound links, are links from other websites that are directed to your website. Backlinks are important for SEO, because some search engines, especially Google, will give more credit to websites that have a solid number of quality backlinks. The old maxim was “the more websites that link to your website, the more ‘relevant’ and important your content must be.” Therefore, SEO companies often suggest to their clients that, to increase their rankings, they need to “buy links” from high-ranking websites.


Recently, one of Patient Education Concepts’ ophthalmologist clients who had been paying his SEO company $1,100/month for more than a year to buy links asked if we could determine where the links were coming from and if spending all that money was worth it. After running a backlink check on his website using the Moz link-checking software, we discovered that his website had more than 3,500 backlinks coming from one college newspaper in a small town more than 300 miles away. The company had also bought links that were coming in from a robot soccer team and a bioenergy university.

It turned out that the 3,500 backlinks to the college newspaper were being automatically generated, which is a major violation of Google’s guidelines. To make matters worse, this required no labor costs for the SEO company; every time the newspaper’s website added a new page of content to its society/death, arts/music, and business/real estate sections, it generated a new link to the practice’s cataract and LASIK pages—all links from pages that have absolutely no relevance to cataracts or LASIK. In order for a link to be considered a good link, its content must be at least moderately relevant to the page to which it links.

Google’s search algorithms are not human, but they are almost as good at recognizing irrelevant backlinks and the other various linking schemes for which SEO companies are charging their clients. Google considers buying links to be like politicians’ buying votes—in other words, cheating. If Google’s indexing bots detect these manipulative links on your website, they will not send you a letter asking you to stop; instead, they will penalize your website rankings or even delist your website completely, depending on the severity of the violations. That is a high price to pay!


The best way to generate quality backlinks to your website is to have them occur naturally. To do this, you need to add new and unique content to your website on a regular basis. Write a new blog post every couple of weeks. Mention other people and companies by name, and send them an email with a link to your article. This will inspire them to create a link to your blog on their website, thereby creating a natural, organic backlink that will add to your site’s relevance and importance. It does not take hundreds of these posts to make a difference in your rankings.

Figure. The daily traffic to two sites with different numbers of backlinks. The site with the higher number of backlinks has lower site traffic per day.

A counterpoint to the earlier example of 3,500 backlinks is another ophthalmology website that has only 430 backlinks, none of which is automatically generated. Now, based on the disparity between the two sites in the number of backlinks, one might conclude that the site with the higher count would draw more traffic. After all, there are more links back to the page, right? Over a 30-day period, the site with less traffic averages about 90 sessions (visitors) per day, whereas the other site averages about 1,000 sessions per day—over 10 times more (Figure). Shockingly, the site with the higher number of backlinks is the one with the lower site traffic per day. Although more backlinks look good on paper, the overall benefit of the backlinks is not based solely on their number but on the amount of traffic they bring to the site. In these examples, the backlinks in question brought two visitors to the site, despite being so plentiful. In contrast, the site with the most visitors and only a fraction of the backlinks typically gets 500 to 600 referral visitors within the same time frame.


Matt Cutts, head of Google’s Webspam team, has created numerous blog posts and YouTube videos summarizing what an SEO company should and should not do to optimize your website’s rankings.




If you have been buying links or paying thousands of dollars to your SEO company, it is advisable to have an SEO audit done on your website. This can uncover all the links that come to your website, and if those links do not pass the relevance smell test, you should get rid of them. Although your SEO company may try to discourage you from delinking the links you paid it thousands of dollars to “build,” you should request that it stop buying links immediately. You should also become more knowledgeable of all the other activities in which the company might be engaged in violation of Google’s guidelines.

Robert Watson
Robert Watson
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