Challenge
The client: a network of four chiropractic clinics in different Oregon cities, all running on one shared domain. Someone with back pain wants help nearby and fast, so they choose from the clinics they see in local results, on maps, and in AI answers.
What made it hard
- Four locations on one site. Google has to understand which clinic is relevant for which city. Otherwise the pages compete with each other instead of with competitors.
- A medical topic (YMYL). Search engines judge health websites more strictly, so generic or thin content does not rise in the results.
- Low visibility at the start. In January 2026, Google had only 56 pages in its index. The site physically could not answer most local queries about cities and symptoms.
- Ads with no efficiency headroom. We needed more clicks from Google Ads without increasing spend.
Our goal: make sure each clinic gets patients from its own city through four channels at once: organic search, Google Maps, AI answers, and ads.
What we did
We started in March 2026 and ran four workstreams in parallel so they would reinforce each other.
Local content at scale
We built a structure of local pages for cities and symptoms and published about 994 geo-targeted articles. Each page answers a specific patient question in a specific city. That way the site started covering queries it previously had no answer for.
Local SEO
Each of the four locations has its own Google Business Profile. Every clinic competes for its own area on the map, and signals are not diluted across addresses.
GEO / AI SEO
We built the pages to be easy to cite in AI answers: a direct answer to the question, a clear structure, and an obvious connection between the clinic, the city, and the service.
Google Ads
We run 4 campaigns, including Performance Max and brand campaigns. We reworked the structure and the ads to get more clicks for the same money.
Indexing control
A large volume of new pages does nothing if Google does not see them. So we separately tracked how the new articles were getting into the index.
Results
Report for March 2026 compared with February, meaning the first month of work:
- Google clicks: 138 → 233 (+69%).
- Search impressions: 30,605 → 60,897 (+99%).
- Average position: 16.6 → 14.0.
- Indexed pages: 56 in January → 816 after the geo articles were published.
- Google Ads: Performance Max clicks +72.7% at nearly flat spend, brand campaign CTR 4.79% → 5.95%.
Impressions almost doubled because the site started appearing for hundreds of local queries it had not covered before. Clicks are growing more slowly than impressions for now: many new pages are still gaining positions, and that is normal for a first month. The project is ongoing, and the next focus is turning the new impressions into clicks and appointments.
What makes this project special
This is not one clinic but a network of four locations on one domain in a medical niche, where Google is especially demanding about quality. We combined large-scale local content, separate map profiles, optimization for AI answers, and advertising into one system. The effect showed up in the very first month: the number of indexed pages multiplied, and ads delivered more clicks with almost no change in spend.
We started in March 2026. The pre-start average (October-February) was 117 clicks a month, after the start 181. Positions fluctuated over the summer, but clicks stayed above the pre-start level. Source: Google Search Console, October 2025 - September 2026
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