Case Study: Built Trust Signals and Rankings in 6 Months in California
In 2025, a clinic in California partnered with Goforaeo to improve trust signals across Google Search and Google Maps and turn that trust into better rankings and more patient inquiries. The clinic name is anonymized due to an NDA, and the metrics below come from Google Business Profile insights, Google Search Console, GA4, call tracking, and local rank tracking for the dates listed.
Snapshot of Results
Timeframe: May 16, 2025 to November 16, 2025
Location: California (single location, city anonymized)
Before vs after results:
- Page 1 keywords (tracked): 6 to 28
- Top 3 keywords (tracked): 1 to 9
- Non branded clicks (GSC): 260 to 980 per month
- Organic users (GA4): 720 to 2,120 per month
- GBP discovery searches: 1,900 to 6,800 per month
- GBP actions: 310 to 1,060 per month (calls, directions, website clicks)
- Calls + inquiries (organic + Maps): 34 to 118 per month
Context and Starting Point
The clinic provided good care, but online it did not look as strong as bigger competitors. When people compare clinics, they look for clear services, consistent contact details, real reviews, and a website that feels professional and easy to use. Google looks for the same signals, just at a larger scale.
At the start, the clinic ranked for a few terms, but visibility was unstable. Some weeks the listing showed well and then dropped again. We saw that the problem was not “more content.” The problem was trust consistency across GBP, the website, and third party listings.
What We Mean by Trust Signals
Trust signals are simple things that show both Google and patients that a clinic is real, active, and reliable. We focused on signals that patients notice and signals that Google measures.
The trust signals we improved
- Accurate business info everywhere online
- Complete Google Business Profile with services and activity
- More reviews over time and better responses
- Clear service pages with proof and next steps
- Fast mobile pages that do not feel broken
- Helpful content that answers questions before a visit
- Strong internal linking so Google understands priorities
Measurement Setup
We fixed tracking before launching major updates so the numbers were dependable. This also helped the clinic see which changes increased calls and booking actions, not just impressions.
What we set up
- GA4 events for call clicks, form submits, and appointment clicks
- Search Console segments for non branded queries and key pages
- GBP insights tracking for discovery searches, impressions, and actions
- Call tracking to separate listing calls vs website calls where possible
- Local rank tracking for the priority terms
- Looker Studio dashboard with weekly notes and change dates
What Was Missing at the Start
Most clinics have a few gaps that reduce trust online. In this case, those gaps were spread across multiple places, which made rankings unstable.
Main issues found
- GBP services were incomplete and too broad for discovery searches
- Primary and secondary categories did not fully match what patients searched
- Reviews were positive, but there were not enough fresh reviews coming in
- Review responses were inconsistent, so the listing felt less active
- Some directories showed small variations in phone format and hours
- Service pages were short and did not answer common visit questions
- Few proof sections like credentials, process, insurance notes, policies
- Weak internal linking made it hard for Google to see “top services”
- Mobile layout and speed issues increased drop off and reduced actions
Strategy Overview
We used a six month system that built trust in layers. Each layer supported the others, so improvements compounded instead of fading.
Workstreams
- GBP rebuild and steady activity signals
- Review workflow and response consistency
- Citation cleanup and directory consistency
- Service page upgrades with clear proof and next steps
- E E A T improvements like authorship and credentials
- Technical cleanup for speed, crawl, and indexing
- Snippet improvements to improve CTR
Google Business Profile Trust Work
GBP is often the first thing patients see. We made it look complete, active, and clear about services and booking.
What we improved in GBP
- Updated primary and secondary categories based on demand and competitors
- Expanded service list and added short descriptions using simple words
- Improved business description to explain services, who it helps, and how to book
- Added appointment link and tracked it with UTM parameters
- Weekly posts around availability, common services, and seasonal needs
- Regular photo uploads: outside sign, waiting area, staff, treatment context
- Cleaned and improved Q&A so common questions had correct answers
Reviews and Patient Confidence
People trust clinics with real recent reviews, not only old reviews. We improved review flow in a compliant way and ensured responses felt consistent and professional.
What we implemented
- Simple review request process after visits or follow ups
- Staff scripts that ask politely without pressure
- Response templates that kept tone human and not robotic
- A response schedule so reviews were answered quickly
- Highlighted service related feedback in replies where it made sense
- Added review snippets to key website pages where appropriate
Citation Cleanup and Consistency
For local SEO, small differences in business details can create confusion. We fixed these issues on the biggest sites first, then expanded outward.
What we fixed
- Standardized business name, address, phone, and hours everywhere
- Removed duplicates and outdated listings that split authority
- Updated website URL and appointment link consistently
- Claimed and improved listings on key healthcare directories
- Checked map pin consistency and location references where needed
Website Trust Improvements
A clinic can rank, but if the website looks unclear, users bounce and rankings become unstable. We made pages clearer, more helpful, and more confidence building.
Service page upgrades
- Added “who it’s for” sections to qualify visitors
- Added “when to book” sections to match high intent searches
- Added “what to expect” sections so patients felt prepared
- Expanded FAQs built from Search Console questions
- Improved headings and formatting so pages were easier to scan
- Added clear CTAs above the fold and after key sections
- Added trust blocks near CTAs like credentials and service process
E E A T upgrades in simple words
We added proof so both Google and users could trust the clinic more.
- Provider bios with credentials, experience, and specialties
- Clear contact page with address, hours, and directions
- Privacy, cancellation, and patient policy pages where needed
- Author or reviewer notes on medical content
- On page proof like affiliations, certifications, and accepted insurance notes
Technical and Speed Work
A slow site feels less trustworthy, especially on mobile. We fixed the technical issues that most affect user experience and indexing.
Technical actions completed
- Improved mobile speed by compressing images and reducing scripts
- Fixed broken links and redirect chains
- Cleaned duplicates and improved canonical signals
- Improved crawl paths so services were easy to reach
- Updated sitemap and indexing signals for priority pages
- Added schema where eligible: LocalBusiness and FAQ
Tools Used
GA4, Google Search Console, Google Business Profile insights, call tracking, Looker Studio, Screaming Frog, PageSpeed Insights, Lighthouse, BrightLocal or Whitespark, Semrush/Ahrefs, Microsoft Clarity or Hotjar, Google Tag Manager.
Timeline With Dates, Monthly Numbers, and Natural Notes
May 16 to May 31, 2025
We audited the website, GBP, and listings, then fixed tracking so calls and forms were measured correctly. Quick wins were applied to GBP categories, services, and contact links, and we started cleaning the largest directory inconsistencies.
Month end metrics:
- Organic users: ~720
- Non branded clicks: ~260
- GBP discovery searches: ~1,900
- GBP actions: ~310
- Page 1 keywords: ~6
June 2025
We expanded GBP services with short descriptions, started weekly posts and steady photo uploads, and launched a simple review request workflow. On the website, we improved the main service pages with stronger headings, clearer CTAs, and early FAQ sections.
Month end metrics:
- Organic users: ~980
- Non branded clicks: ~360
- Discovery searches: ~2,800
- GBP actions: ~420
- Page 1 keywords: ~10
July 2025
We cleaned citations on major platforms, removed duplicates, and made business info match across the web. We also expanded the top service pages and improved internal linking so Google could clearly see the clinic’s most important services.
Month end metrics:
- Organic users: ~1,280
- Non branded clicks: ~520
- Discovery searches: ~3,900
- GBP actions: ~590
- Page 1 keywords: ~15
August 2025
We added more trust content such as provider bios, clearer process sections, and what to expect blocks on key pages. We also improved page speed and mobile layout, which helped users stay longer and increased action rate from both search and maps.
Month end metrics:
- Organic users: ~1,560
- Non branded clicks: ~680
- Discovery searches: ~5,000
- GBP actions: ~760
- Page 1 keywords: ~20
September 2025
We refined titles and meta descriptions to improve CTR, expanded FAQs using live Search Console query data, and strengthened internal links into the pages closest to top positions. GBP activity stayed consistent to protect growth and keep the listing looking active.
Month end metrics:
- Organic users: ~1,860
- Non branded clicks: ~820
- Discovery searches: ~6,000
- GBP actions: ~910
- Page 1 keywords: ~24
October 16 to November 16, 2025
We doubled down on what was working, refreshed underperforming pages, and kept reviews plus GBP activity steady. Rankings stabilized because the clinic’s signals stayed consistent across GBP, the website, and directories.
Month end metrics:
- Organic users: ~2,120
- Non branded clicks: ~980
- Discovery searches: ~6,800
- GBP actions: ~1,060
- Page 1 keywords: ~28
Before and After Proof Summary
Trust improved because business info became consistent, GBP became complete and active, reviews increased steadily, and the website became clearer and more helpful. As trust rose, rankings improved and inquiries increased.
- Page 1 keywords: 6 to 28
- Organic users: 720 to 2,120 per month
- Non branded clicks: 260 to 980 per month
- GBP discovery searches: 1,900 to 6,800 per month
- GBP actions: 310 to 1,060 per month
- Calls + inquiries: 34 to 118 per month
What Made It Work
Nothing was magic. It worked because the clinic became consistent and trustworthy everywhere Google checks. Once the website, GBP, reviews, and directories all matched and stayed active, rankings improved and stopped fluctuating so much.