Ghost (Spam) Traffic in Google Analytics

Over the past few months, a previously minor issue with Google Analytics has exploded into a huge problem. This GA referral spam, or ghost traffic, takes the form of fake traffic to your website. The apparent objective of these spammers is to get people to visit their websites, based on the fact that they show up as a referring website in GA results. The worst of them manage to show up in reports for almost every website that uses Google Analytics.  And it seems that medical practices have been hit at least as hard as sites in other industries.

This traffic isn’t even real – it never hits your servers. Instead, it tricks Google in order to appear in your reports. On a small scale, this issue started a few years ago, but it rarely made up more than a small percentage of total traffic until this past spring. It was a very minor annoyance at past levels, and easy enough to ignore. But now the problem has escalated. Over 50% of traffic to some sites is fake, which this gets in the way of using your data to make intelligent business decisions.

In general, Google has been fairly quiet on this issue, although they did recently add in a checkbox that allows you to filter out some of the junk. Unfortunately, they have not done a great job of keeping up with the spammers, although in recent weeks there are signs that they are getting better.

In June, a new spammer joined the fray, “”. For a few days in mid-June, traffic from this site exploded like nothing I’ve ever seen, for most  of the sites that we monitor. But then, on June 19th, it appears that Google cut them off. In addition, it seems that other referral spam slowed down at that point (although it is still too early to say for sure). So for now, the worst of this problem may be behind us.

Luckily, we are not completely at the mercy of Google on this issue. In addition to using the checkbox mentioned above, there are also 2 more technical options available to reduce, and nearly eliminate, this traffic. One method involves creating filters, which will eliminate all future junk traffic from hitting your reports. The other involves creating segments, which allows you to view a clean version of your data, while segmenting out the junk.

I won’t go into all the technical details here, as others have done a very thorough job already. has published this article on filters and this one on segments. And for a slightly different perspective, check out the filters and segmentsarticles.

Not sure which you need? Ideally, you should set up both. Segments will allow you to get clean reports from past data, but take a little extra time whenever you want to run reports, among other limitations. Filters can take a little longer to set up, and will not clean up your historical data, but they are more efficient going forward.

HIPAA Considerations for Medical Practice Review Responses

More and more, patients are sharing their healthcare experiences on online review platforms such as Google+, Yelp and Angie’s List. These reviews shape your business’ reputation and have the power to prompt or dissuade new visitors. While you can’t control the content of reviews, you can influence how people perceive your business by responding with respect and sensitivity.

Reaching out to patients who have reviewed your service will humanize your business and demonstrate that their feedback matters. If their review is positive, you can thank them for their comments. If it’s negative, you can apologize and address the issues head-on. Your response is an opportunity for collaboration and transparency.

Before you begin responding to patient reviews, it’s important to understand how to do so in accordance with the privacy laws of HIPAA. When a patient posts a review that describes their experience with your business, they may state details about their medical history. This is their prerogative. However, legally, it does not forfeit their right to privacy and as a medical provider, it’s your duty to maintain it. You cannot discuss any details about their medical needs, visit or even acknowledge that they are indeed a patient. This makes responding tricky, but not impossible. Follow the guidelines below to write effective, HIPAA-compliant responses.

1. Explain your consideration of HIPAA.
Help your audience understand that your generalized response is out of respect for the privacy of your patients.  “Under HIPAA, I am unable to discuss the specifics of this user’s review.”

2. Cite company policies.
Since you are unable to discuss specifics, cite general company policies that correspond to the issue at hand. This helps communicate the values of your business without crossing HIPAA.

3. Be courteous and professional.
This is a best practice as a business owner. It’s difficult and unnecessary to win an argument with a frustrated patient so keep your responses helpful and diplomatic.

4. Say thank you.
Show your patients and visitors that you appreciate their feedback, whether it’s good or bad, by thanking your reviewers. This demonstrates that you respect their opinion and are open to constructive criticism.

References and Further Reading:

Announcing Repu-Med: Feedback and Review System for Medical Practices

WebForDoctors is pleased to announce the launch of a new service called Repu-Med, which medical practices can use to gather feedback from patients and improve their online reputation. We have been working on this system for the past year, using the various components to help many of our clients.  Now, we are excited to be able to make this set of tools available as a do-it-yourself reputation management system.

Visit the Repu-Med page to learn more and request an online demo. And if you are in Chicago this week for the Urgent Care Association of America’s annual Spring Convention, come visit us in Booth #622 for an in-person demo.

Does Your Site Pass Google’s Mobile-Friendliness Test?

As was first reported in January by Search Engine Land, and has more recently been covered by mainstream publications such as Forbes, Google will be using Mobile-Friendliness as an important ranking factor. The official start-date for this change is April 21st of this year.

If your website has Google Webmaster Tools installed, and your site has mobile issues, the person who set up this account should have already received a warning. Whether or not you received such a warning, you should use this free Mobile-Friendly Test tool that Google has created. mobile-friendly

If you pass this test, then you are good to go. Your site will qualify for the mobile friendly label, and will not be penalized in search results.

What to Do if You Don’t Pass the Test

First of all, don’t panic. Next, consult with the company that built your website, and/or other web developers to determine your best path forward. Depending on how your website was built, it may be able to be retrofitted.  If not, you’ll have some decisions to make about whether you simply want to stick with your current design, recreated in a mobile friendly manner, or if it is time for a full redesign of your site. Remember, while this April deadline is important, your main objective with a project of this scope should be to make sure your website is suited to your needs for the next several years or more.


How To Increase Facebook Community Engagement

In this webinar, you will effectively learn how to use Facebook to connect with prospects and build relationships with existing clients.

  • How your business can interact with community members on Facebook
  • Increasing exposure on other local community pages.

This webinar will take place Wednesday, November 19th at 9:30am PST

Please register here »

All participants will receive a PDF summary of our Facebook Marketing Best Practices!

We also offer a deeper look at the best practices for Facebook community building.

  • Schedule posts in advance
  • How and when to reuse posts more than once
  • How to increase engagement, in the form of likes, shares and comments.

Over time these techniques will become second nature, and you will discover the ease of intentional, scheduled social media management.

Prospecting is Key to Occupational Medicine Sales

Cold calling or prospecting is an often overlooked part of an occupational medicine sales process.  We all want to focus on building relationships with qualified leads and current clients.
Unless your practice has a steady flow of incoming employer leads, gaining new accounts requires consistent prospecting or cold calling.
  • Prospecting is compiling a target list of companies, calling each one, determining the decision maker, and if the decision maker has a need to change providers.
  • Each step can take several calls and several months to complete.

We often find this time-consuming, yet critical step, gets overlooked.

If a corporate accounts manager is working with 200 current accounts, where is the time to find new business? The skill sets of a strong customer service based accounts manager and prospector are different, and it is rare to find people adept at both. Ideally, this should be two separate positions, but this is not realistic for many practices.
The solution is to first recognize that this is a sales process and each step is critical to the success of the next.
We recommend working with your staff to budget time and resources to research, prospecting, and selling.
In our next post, we will analyze the skill set for successful occupational medicine prospecting. This will to identify or hire the right staff member for the job.
WebForDoctors also offers a fully outsourced lead generation program that provides your staff with qualified leads and allows them maximum time building relationships with current clients.

Marketing Insights – Urgent Care Boom Explored by Forbes Magazine

Brian Solomon wrote about the urgent care boom for a recent issue of Forbes magazine, Drive-Thru Health Care: How McDonald’s Inspired An Urgent Care Gold Rush  Solomon shares: “Dr. Bruce Irwin has been in the urgent care business for over 30 years, and he’s never seen anything like the current gold rush. “It’s like we’re in a rock band and all of sudden we have a hit, we’re an overnight sensation. But in reality we’ve been playing in bars and honky-tonks for years.

From a marketing perspective, here are two takeaways:

Urgent care is a retail business.
It is imperative to market your practice as convenient, affordable, quality care.

Prospective patients can receive care for non-acute illnesses and injuries close to their home or office. Starbucks is a great comparison. Starbucks provides a welcoming environment with upscale decor and free wi-fi. Today’s urgent care centers are moving away from the “medical clinic” feel.

The competitive landscape is rapidly changing.
New urgent care centers will be opening everywhere.

How are you positioned if a new urgent care opened on your block? What type of reputation does your practice have in the community or online? A strong SEO foundation with positive online reviews can help stave off competition. Participate in community events. This will help match a face with a business. Bringing kids to an urgent care is not so scary when the parents have already met your staff.

7 Steps to Positive Reviews- free download!

Web for Doctors is now offering another great resource to add to your online marketing toolkit- 7 Steps to Positive Reviews. Based on Ira Pasternack’s popular webinar, 7 Steps is part of our Reputation Management Series and will show you how real-world interactions impact your online marketing efforts.

Head on over here to enter your email and instantly receive your copy of this great guide.

Google “Pigeon” Algorithm and Your Medical Practice

This week, Google released what is calling the “Pigeon” Update to their search algorithm.  The goal of this update is to provide more accurate results for local searches.   It does this by associating local results more closely with regular web search results, while also including improvements to the way distance and location ranking works.

What does all of this mean?   As with any update of this nature, the real results will become apparent over the next weeks and months.   But based on initial analysis, it appears that Yelp and other local directories are getting improved visibility.

Not everything is working as planned – Expedia, the travel website, was mistakenly listed as a Hotel, although the issue has since been fixed.   The lesson in this case is to make sure you are using proper categories, as Expedia was not.

For a more technical assessment of the changes, from a selection of leaders in the local search world, see  “Experts Weigh In On Google’s “Pigeon” Update Aimed At Improving Local Search Results”.

What does this mean for medical practices?

Given the increased visibility for directories, making sure you have a consistent Name, Address, and Phone Number on all your directory listings is more important than ever.   In addition, using correct categories is critical – and, use as many as you can (most directories allow five, and as long as you can find at least five that are relevant, you should use them all).   Finally, optimize these listings with photos and important details such as your hours.

Beyond that, we’ll be keeping an eye on the changes, and will report back here as we learn more.

Mobile Traffic to Your Urgent Care Website

This month, we are evaluating the percentage of website traffic that our urgent care clients are getting from mobile (smartphone or tablet) vs. non-mobile sources.   We did this via a custom report that groups tablets and phones together, which we consider to be mobile traffic.   A similar report, which separates tablets from phones, is available in Google Analytics:  Audience > Mobile > Overview.

Overall, we are seeing very high mobile traffic numbers for urgent care clinics.  Most average very close to 50%.   Few are less than 45%, and some are already approaching 60% of total traffic coming from mobile devices.   This is compared to other types of medical practices, where we are typically seeing mobile numbers in the 25-35% range.

In addition to looking at mobile vs. non-mobile numbers, we looked closer at the sources of traffic for each type.   (Choose a secondary dimension of “Source/Medium” in the standard mobile report to see similar data.)  In general, the percentages of traffic from various sources (organic search engines, paid search, direct, etc.) was surprisingly consistent between mobile and non-mobile.   In some cases, we found that paid search traffic performed especially well, and in other cases found it to be under-performing, thus identifying opportunities to adjust bids or other aspects within AdWords or the Microsoft AdCenter.

Measuring Mobile Conversions

On a related note, we have been working with all of our clients over the past few months to implement various means of call tracking.   This is especially important for mobile searches – for an in-depth review of this issue, see the article “Mobile Calls Are The New Conversions: 7 Tips For SEMs“.  We have found that using mobile click-to-call ads in AdWords, along with mobile click-to-call event tracking in Google Analytics, allows for efficient collection of useful data.

Question, comments, or ideas about mobile traffic or tracking?   Contact us if you do!