557% Growth in Monthly Leads and 212% Growth in PPC Conversions for a Multi-Location Orthopedic Practice
Multi-Location Orthopedic Practice Group (client identity anonymized)
The Background
This orthopedic practice group operates across multiple clinic locations, offering surgical and non-surgical musculoskeletal and sports medicine care. With several locations to support, the group needed a search presence that could drive qualified patient inquiries consistently across every market it served, not just its flagship location, while also building the kind of long-term organic authority and reputation that a specialty healthcare group depends on to compete for high-value procedures.
| Team Size | Not disclosed |
|---|---|
| Volume | Multiple clinic locations |
| Engagement | Ongoing retainer |
| Platform Access | Not disclosed |
The Challenge
The practice group’s original objective was framed as increasing monthly lead volume and improving conversion performance across its locations. (Note: the source material’s original phrasing of this goal — describing it as growing “from 30 to 75 patients per month” — conflates a conversion rate with a monthly volume figure and is not repeated here as a coherent or achieved metric; the underlying objective was simply to grow qualified monthly leads and conversions across all locations.)
Beyond volume, the group needed stronger local visibility for each clinic location, a reputation and review profile strong enough to support consideration for elective and specialty procedures, and a paid acquisition channel that could scale efficiently alongside organic growth. No software or analytics stack was documented as part of the engagement, and no client testimonial was supplied for this case study.
Our Approach & Technical Decisions
Phase 1: SEO Audit & Foundation
Decision: Before any optimization work began, run a full technical and content audit across every location’s pages to understand where the practice group’s biggest visibility gaps were.
Action: Foreignerds audited site architecture, indexation, on-page content, and location-page coverage across the practice group’s multiple clinic locations, establishing a baseline and a prioritized roadmap.
Why: A multi-location healthcare group can’t be optimized as a single site — each location needs to be individually discoverable and competitive in its own local market, so the audit had to map gaps location by location rather than site-wide.
Phase 2: Technical & On-Page SEO
Decision: Fix the technical and on-page foundation (site health, metadata, page structure) before investing in content and authority work.
Action: Implemented technical SEO fixes and on-page optimization across key service and location pages.
Why: Content and authority-building investments underperform on a technically weak foundation; fixing this first protected the ROI of every later phase.
Phase 3: Local SEO
Decision: Treat each clinic location as its own local-search entity rather than relying on the practice group’s overall domain authority.
Action: Managed NAP (name/address/phone) citation consistency across directories, conducted local competitor research for each market, and published ongoing Google Business Profile posts and local optimizations for each location.
Why: Orthopedic care is a high-intent, near-me search category — patients search for care close to them, so local pack visibility and consistent local citations directly influence which practice gets the inquiry.
Phase 4: Content Development
Decision: Build out content that could rank for the specific procedures, conditions, and patient questions each location’s target audience was searching for.
Action: Developed and published service- and condition-specific content aligned to the practice group’s specialties.
Why: Deeper, more specific content earns rankings for higher-intent, lower-funnel search terms that convert into appointment inquiries rather than just informational traffic.
Phase 5: Authority Building & Reputation
Decision: Combine traditional link acquisition with active reputation management, since a specialty healthcare group depends on trust signals as much as backlinks to win consideration for elective procedures.
Action: Pursued link acquisition through niche healthcare directories, guest posting, blog commenting, and content syndication, while also running an active review-generation program.
Why: Domain authority alone doesn’t win a patient’s trust; review volume and quality directly affect both local-pack rankings and a prospective patient’s willingness to book.
Result: This phase generated 393 new positive reviews across the practice group’s locations.
Phase 6: PPC Acquisition
Decision: Run PPC as a parallel acquisition channel to organic, scaled and optimized independently rather than left on autopilot.
Action: Built out account architecture, conducted keyword research, managed budgeting, optimized by device and keyword performance, developed ad copy, and implemented conversion tracking.
Why: Organic growth takes time to compound; a well-optimized PPC channel gave the practice group a lever to grow lead volume immediately while the SEO and authority work built toward longer-term, lower-cost-per-lead organic growth.
The Numeric Story
This engagement spans multiple, non-comparable measurement periods and datasets. Each is reported here exactly as measured and kept separate rather than blended into a single before/after figure, since combining different time windows and metric types (rates vs. totals, one channel vs. another) would misrepresent what actually happened.
Headline Results (as reported)
- 557% growth in monthly leads
- 212% growth in PPC conversions
- 70% growth in organic SEO traffic
PPC Performance: January–July 2023 vs. 2019
| Metric | Change |
|---|---|
| Clicks | +55% |
| Conversions | +212% |
| Avg. CPC | -5% |
| Avg. Cost per Conversion | -53% |
| CTR | +155% |
| Conversion Rate | +101% |
SEO Performance: 12-Month Campaign Period
| Metric | Change |
|---|---|
| Avg. CPC | +9% |
| Conversions | +18% |
| Conversion Rate | +4% |
| New Users | +61% |
| Returning Users | +34% |
| Clicks | +13% |
| Impressions | +14% |
| Organic SEO Traffic | +70% |
Organic Sessions: January–December 2022 vs. 2021
- Organic Sessions: +24%
- Overall Sessions: +29%
Long-Term Keyword Visibility: June 2018 vs. August 2023
- AWR Keyword Visibility: +2,632
- Top 5 Keywords: +54
Cumulative Since PPC Launch
- ~11,300 clicks
- 2,326 conversions
- 3,829 phone calls
Additional Channel Performance
- Organic/Overall Site: +69.8% sessions, +84% new users
- Direct Traffic: +48% site visits, +56% new users
- Referral Traffic: +84.5% sessions, +91% new visitors
A historical 20% conversion rate is referenced in the source material as a past benchmark for one location, not a universal or current figure, and is not presented here as an ongoing result.
Supporting Performance Snapshot (separate, unconfirmed window)
The source also supplied a separate performance snapshot without a confirmed common date range relative to the datasets above. It is reported here as its own distinct data point rather than merged into any of the periods above: Organic Traffic 979; Organic Monthly Leads 39; Organic Contact Form Submissions 39; Monthly Traffic 8,217; New Website Users 7,137; Page Views 10,827; Impressions 72.1K; Clicks 129; CTR 0.2%; Organic Average Time on Page 50 seconds.
Measurement & Attribution
No software or analytics stack was documented in the source material for this engagement, so none is claimed here. The reviews, keyword-visibility, and traffic figures above come from several different reporting periods and tools, and are presented separately by period rather than combined into a single narrative, since doing so would overstate the comparability of the underlying data. Where the source used “patients” explicitly, that language is retained; elsewhere, results are described as leads, conversions, calls, and inquiries to avoid implying a level of clinical attribution the underlying data doesn’t support.
Competitive Search Context
The source material states that the practice group was able to outrank competing practices in its markets over the course of the engagement, but supplies no numerical competitive benchmark. That claim is reported here only in qualitative terms, with no invented competitor figures.
Post-Launch & Ongoing Engagement
This engagement began in 2018 and has continued on an ongoing basis since, with no specific retainer value disclosed in the source material.
The Strategic Lesson
For a multi-location specialty practice, growth doesn’t come from a single channel or a single location’s performance — it comes from treating local SEO, content, authority/reputation, and PPC as coordinated, ongoing workstreams sustained over years, not a single campaign with a defined end date.
The Takeaway
Sustained, multi-year investment across local SEO, content, reputation, and paid search compounded into meaningfully higher lead and conversion volume for this orthopedic practice group, without requiring the practice to overstate any single period’s results.
Implementation Timeline
Technology Stack
Measurable Results
- 557% growth in monthly leads (headline result, as reported)
- 212% growth in PPC conversions, January–July 2023 vs. 2019
- 53% reduction in average cost per PPC conversion over the same period
- 70% growth in organic SEO traffic over a 12-month campaign period
- 24% growth in organic sessions, January–December 2022 vs. 2021
- 2,632-point increase in AWR keyword visibility, June 2018 vs. August 2023
- 54 additional keywords ranking in the top 5 over the same long-term period
- 393 new positive reviews generated across all locations
- ~11,300 cumulative clicks, 2,326 conversions, and 3,829 phone calls since PPC launch
Post-Launch & Ongoing Engagement
This is an ongoing retainer engagement that began in 2018 and has continued since. No specific retainer value is disclosed in the source material.
