Yet another online medical directory: Aushealthpages

Cervin Publishing Ltd, a New Zealand company established in 1989, has recently launched AusHealthPages, the companion website to their printed Medical Specialists Australia directory.

The directory:

• Includes Medical Specialists full contact details (practice addresses, phone, fax, email etc.)
  
• Provides Medical Specialists areas and descriptions of specialisation
  
• Regional breakdown of Specialists
  
• Published annually, in 4 separate editions.
• Comprehensive Medical Specialist index
  
• Extensive breadth of speciality categories
  
• High quality, attractive, full colour presentation
  
• Consistently structured information to ease comparison and selection
  
• Charts to see at a glance Specialists with a particular interest and skill
  
• Draws together the entire industry, rather than a segmented geographic or category cut

The web directory is arranged by either searching for a specialty area or a particular name and claims 7,861 specialists entries - where do they get the time to get all this data from I wonder!

To claim an entry to correct it you need to pay. A number of specialists seem to have taken up this option and some sport detailed pages (see eg) with extended contact details, pictures, maps and text - effectively a mini-website.

Biggest Audiences and Impressions: The History of the Australian Web

So, how fast do things change online and how much have they changed over the last 8 years?

AIMIA has created a visual representation of where Australian's spend their time online.

Apart from anything else it is a beautiful piece of art that allows you to explore the underlying data in a highly visual format, filter results, stop and start the timeline, hover on the circles to drill down on the data, highlight/follow a particular website and experiment with different axis of information.

How is this knowledge relevant to you?

Well, apart from telling you where everyone visits online and how much time they spend there it demonstrates:

• the web is making new winners all the time (where was Facebook before 2007)
• ...and losers (where is Altavista today?)
• consumers are changing the activities they engage in online (eg the rise of social media sites)
• pageviews are often just a representation of navigational arrangement of the sites concerned and doesn't necessarily mirror time people spend on the site or the number of unique visitors
• filtering for search engines only you get a fascinating insight into search and directories:

Insight for Search and Directories

• In 2001, Google was a distant third to Yahoo and NineMSN
• Yellow and White Pages still have nearly constant audiences
• Niche directories like TrueLocal and HotFrog have a lot of ground to make up in audience (reach) and page impressions
• Audience and PageViews generally follow a linear relationship but time spent on a website can vary significantly.
• None of the medically oriented directories warrant a mention in the "mass market" data (at least I couldn't find one!)

Deep Dive: HealthEngine Medical Search Directory

Let's have a look at the recently out of beta HealthEngine medical search directory, run by Dr Mike Cadogan and two colleagues. For those who haven't explored it (please do and give me your feedback) it is essentially an online search engine and directory for doctors, medical clinics and hospitals. If you look harder you will see it also has a whole range of information for the general public on medical qualifications, tests and general information.

It is a more systematic than Health Directory, a more comprehensive listing than drsref.com.au and a more focused endeavour than the Yellow Pages. It is also search engine friendly as Dr Cadogan has invested considerable time and effort on understanding how this works. In fact, some people might find a HealthEngine listing a more cost effective method than setting up their own website.

Find a Doctor

Here is the main search interface which allows you to search by name, language, gender, location, body area or specialty.

Detailed Doctor Profile

Here is the information that is generally available on each doctor (in this case it is showing a premium listing). The tabs below the picture show the wide variety of potential information that can be included such as contact information, qualifications, languages, interests but also articles and research.

Find Health Information

This section focuses on tests, procedures and an explanation of medical specialties and qualifications.

Analysis

Health Engine is off to a great start with about 50,000 page views a month and 500-1000 unique visitors a day.

Here are some of the features that I think make it quite different:

• depth of information and structure of information is tailored specifically to medical practitioners
• search by body area is a unique approach and more intuitive for the general public who don't know the medical speciality
• ability to drill down not just by specialty but then by subspecialist area

I suspect it may take a long time to get significant traction amongst the health profession as:

• the average medical practitioner is, if you believe the Australian Institute of Health and Welfare, quite old and set in their ways
• generally they are a "hands on" bunch relying on word of mouth and traditional print directories rather than trying online techniques
• there are still a large number who don't have any form of web presence

For those health professionals who do understand the potential of the Internet, a listing in HealthEngine may just give them an edge over their more established colleagues in attracting the types of patients they are seeking - after all it can hardly hurt!

HealthEngine listing is free (premium listing is also available) - so why not search for your name or clinic and see whether you can be found on it, and if your entry is accurate. If not, you can contact them to correct the information (usually completed within 24 hours).

HealthEngine is listed as one of the top 100 Aussie Web Startups by TechNation.

Online Directories - Summary Page

	Author: Netscape Site: Open Directory Project (DMOZ) Features: Request to add your site Human moderated Used by other directories as a source of high quality sites
	Author: Yahoo Site: Yahoo Directory Features: Request to add your site to a relevant category Used by other directories as a source of high quality sites

Subscribe to Directories posts only.

See below for posts on this topic.

Online Directories - Necessary Evil or Just Evil?

We've had another doctor join the practice this month. As a result I've been scrambling to update all the web copy and in particular online directories in which OGCG is listed. Here is my critique of the online directory business in general (or perhaps more of a rant):

1. Directories that don't provide you with a method of updating  - what's with that? You can submit your details for free through a web form but if they change it involves lengthy correspondence or worse - forces you to pay. There are some very well known culprits here. Those who use your directory are just going to have to live with inaccurate details and your credibility will suffer. I did try.
   
   
2. Free directories that require a reciprocal link - sounds innocuous but they often get more out of the deal than you do. Why do they ask for a link from your website back to theirs? So their PageRank goes up so they can say their directory is more value and charge people for premium listings (see point 4 below)! Hey, sometimes your entry on their directory will list higher than your website. Now that is irritating - you've just pushed your website further down the search results!
   
   
3. Claiming large number of visitors/users that don't ever end up visiting your site. I wonder how many of those hits are really the website owners themselves checking their own listing is still there. If your listed on an online directory but nobody sees it are you really there? If you haven't heard of the online directory before chances are no one else has either. Are potential visitors really using that directory as their speed dial to the Internet?
   
   
4. Charging for premium listing - most online directories bring negligible traffic. Yes, you heard it correctly! Looking over the logs for the last eight months I can say that the best performing directory, the veritable YellowPages, brought in one visitor every 2 days to the website.  There is a list of shame that brought in less than one visitor a month. It consists of most directories (only 3 escaped). How can a business keep charging for listings and expect people to pay: good sales pitches, naivety of buyers and very few people are willing to talk about how they were hoodwinked. Perhaps people just don't check. However, with an online directory you can check and really should.
   
   
5. Listing increases your PageRank so don't worry about the lack of traffic - this is an argument I often see advanced by people in the marketing industry. But hang on, even if the directory has a high PageRank (eg one of 5), the page on which your Johny-come-lately site is listed is likely to be way back in the pack, indeed I'm willing to bet it is on a page with a PageRank of 0. So it will pass you a big fat PageRank of 0.
   
   
6. Low barriers to entry - like many markets with low barriers to entry you have a proliferation of options. I suspect somewhere out there there is software you can buy for about $1,000 (or perhaps a pirate or shareware program) that allows you to instantly set up a directory business online and if it is automated then all you do is set it up and let it run. Soon all the bunnies will be sending you cheques to be included. Be very wary before paying someone to list you in directories or buying a piece of software that does it for you. 

Summary

So before you go and spend a whole lot of time listing on directories or pay someone to list your site on 100, 650 or 1,700 High Ranking directories think about whether you really want to lend credence to a scam. The return on investment from most directories is non existent. Search engines won the battle for the hearts and minds of Internet users and directories lost. The traffic figures prove it.

It may be my hard-nosed attitude to benefits outweighing the costs is holding me back from directory success. If you have had a good experience with a directory feel free to point it out below. 

PS. Welcome to the practice Dr Natalia Khomko and apologies about the slovenly update of your details. Sometimes the web does not live up to its promise of instant gratification but no one is really using them anyway so don't worry.

Different referral sources bring different volume/value traffic

I've found quite a big variance on the quality (and quantity) of visitors generated by different referral sources. The differences in behaviour of these visitors is significant and demonstrates that quantity isn't the same thing as quality. It also shows you can spend a lot of time bringing in visitors who aren't really that interested in what you have to offer.

Quantity

Below I've included some recent figures towards the end of 2008 for our site. You can see from this visitor information out of Google Analytics:
- Organic Search: 43%
- Pay Per Click Google Advertising: 30%
- Direct: 9%
- Yellow Pages: 2%

In short about 75% of traffic is generated from Google (if you include Adwords advertising which does span other sites as I've turned on contextual advertising). The other 25% is sourced from 50+ other sites including specific medical directories, the hospital where they work and their online Yellow Pages ad.

Interestingly this has changed a fair bit since August 2008:higher % of organic search as we add more content and creep up the SERPs, less direct traffic (less paranoia about the site still being available) and some new sources of referring traffic eg Yellow Pages.

Quality

Looking at the quality of the traffic brought by these methods eg bounce rate, time on site or, as I have shown below, pages/visit - you can see some interesting trends.

Compared to the average visitor (let's call them someone searching on Yahoo):
On the negative

• people visiting from the article sites visit 70% less pages (and they have a much higher bounce rate so this is our least successful referral source)
• organic Google searchers visited ~20% less pages (perhaps they got what they wanted and left).
  

On the positive

• Adwords searchers visited ~20% more pages (so it would be fair to say by requiring people to click on an ad is some form of qualification of the prospect)
• people referred from the health directory visit ~30% more pages
• people referred from the hospital or the Yellow Pages visit ~80% more pages

Summary

So if we make the assumption that the Pages/Visits metric (or the bounce rate or the time on site) is a fair measure of the quality or value of these visitors then we see that in general a visitor from a referral source that is relevant to your industry or is a relevant business directory is worth more than a regular search visitor. (In our case the business directory is relevant to our local area as is the hospital so these are highly relevant visitors as opposed to Google searchers who may be over the other side of the world).

Are the 1,100 Google organic searchers worth more than the 170 visitors from the hospital and Yellow Pages? I couldn't tell you definitively on the data I have but they would need to convert 8 times more readily to bring in the same number of customers. The quality information above would seem to indicate that is the case but then of course there is the little issue of cost...

P.S. Anyone have any idea why the images through Blogger seem to be so lousy? Maybe it is the way I'm saving them.

Websites and Forums (relevant to Obstetricians and Gynecologists)

If it weren't for PageRank (and seeking links) it would still be a good strategy to reach the largest potential audience. One of the ways of doing this online is to list your business in online directories. I've mentioned some of these before. Below is a list I've been compiling that is relevant to Australian gynaecologists or obstetricians.

The basic consideration in compiling the list (and the search terms to find the sites) is "where may my potential customers spend time online and what content will attract them". This is relevant to you in any industry. The more specific the location to a condition/need the more "valuable" leads coming from that source will be but they will be fewer. When I say valuable I mean the more likely they will actually need what you are advertising - ie convert to customers. If the website you are listing in is less relevant (eg a highly trafficked general website) you can expect more traffic but it may be less valuable.

This is obviously a general principle and reality is more complex than these two dimensions.

Here are a few websites that I have found that are relevant to our industry that you could advertise/list in:

• www.essentialbaby.com.au (No category for listing doctors. Forum)
• www.babycenter.com.au (seems to be clone of US J&J site - no category for listing doctors)
• www.virtualmedicalcentre.com.au (offers advertising but doesn't seem to have any free listing. Forum)
• www.ninemonths.com.au (no directory, hardly visited forum)
• www.pregnancy.com.au (no directory, no forum)
• www.birthnet.com.au = www.birth.com.au (directory - not much there.
• Say free listing. Detailed forum (largest))
• www.doctors-4u.com, (Free listing)
• www.menstruation.com.au (More of an online shop - no directory/forum)
• www.bellybelly.com.au (lots of articles, popular forum)
• www.healthengine.com.au (new directory)

Tell me if I've missed anyone.

One of the exercises I think could be quite useful is to compare the performance of these directories over time. The methodology of this benchmarking activity would involve listing yourself (either free or paid) in each directory and comparing the generated traffic over time. The position of your listing on each is important and may skew results. For example, if you can pay to be on page 1 and that has a high PageRank or be listed on page 15 with a low PageRank guess which listing is more likely to generate traffic? This also shows how online directories can have the same characteristics as traditional directories - position is important as human behaviour comes into play and people simply are more inclined to work through the options from the beginning until they find an answer.

The other (less expensive/time consuming) way I thought of performing this value for money analysis would be to look at the claimed reach (PageRank/visitors per month) against the cost and plot this on a graph. I'll make a start on this and see if I can collect enough data. If you have any data points (eg if you run a directory relevant to medical practitioners) just post it or email me.

What is PageRank and why should I care?

Google (currently the most popular search engine with 88% market share in Australia according to Hitwise with MSN/Live Search with 6% and Yahoo with 4%. Note that the results from US searches show a different distribution with Google having 70% and Yahoo WITH 19%) uses two main measures to rank search results: 1) relevance to the words you are searching for (ie the more matching words in the right order in the right context) and 2) the relative importance of a site (as measured by the number of times other sites link to this site and their relative importance).

PageRank is the term that describes the relative importance of a site to Google. It is also a Google trademark and a patented process at the core of the success of Google. It is also a play on words - the 'Page' is from Larry Page, one of the founders of Google.

Let's look at a few medical and non-medical sites and understand what this really means:

Medical Website PageRanks compared as at August 2008 (these will change over time as the sites put on new content and Google adjusts its algorithms)

PageRank 10: There are only 6 sites that have this ranking, 3 of which are US Govt sites, one for the World Wide Web Consortium and 2 for commercial organisations.
PageRank 9: Wikipedia
PageRank 8: Google.com.au, News.com.au, DMOZ
PageRank 7: The Victorian Government's Better Health Initiative
PageRank 6: The Australian Medical Association (AMA), The Medical Journal of Australia, Royal Australian College of GPs, The Womens Hospital
PageRank 5: Royal Australian College of Obstetricians & Gynaecologists, Australian Doctor, MyDr.com.au, Virtual Medical Center, Health Directory
PageRank 4: Menstruation.com.au, Pulse+IT Magazine
PageRank 3 Frances Perry House, Health Engine
PageRank 2
PageRank 1
PageRank 0: Obstetrics & Gynaecology Consulting Group (I'm not too sensitive about this - see comments below about how this reflects a historial rating and our website is still very young - but always on the lookout for tips to improve this).

Feel free to suggest other names and I can put them in the table for comparative purposes. If you are in another health related industry or country your can easily find the big sites by doing a Google search for common words or looking up the DMOZ directory for some sites.

Incidentally did you see in the Hitwise research that about 40% of people use a search engine to find information on health and medical topics? That is more than any other category surveyed and this hasn't changed significantly over the last year. Clearly people search the web for these topics quite often so it is worth focusing on promoting your site in search engines.

How do I find the Page Rank of my site?

The easiest way I have found to get a feeling for a sites Google PageRank is to install the Google Toolbar which has a PageRank gadget. It displays the PageRank as a green bar for the page you are visiting and if you hover the mouse over the bar it will display the ranking out of 10 for the site. If you are just starting out you will have a PageRank of 0. The scale of PageRanks is logarithmic meaning that it gets exponentially harder to achieve a higher ranking.

It is believed the PageRank for a site is only updated every 3 months for display by the tool (ie it is a historical measure of your PageRank rather than being the exact figure used by Google to rank your page at the time of doing a search. As such it is an indirect measure of success of your search engine optimisation activities.

Popularity vs PageRank

There are other ways of ranking sites such as the number of people who visit a website (hits). This may be useful to describe how many visitors there are to a website but it has no direct relationship on the PageRank. For example Virtual Medical Centre is ranked at number 1 in terms of visitors by HitWise but its PageRank is 5 - less than some other health related sites. You will need to determine how you will measure the success of your website. More on this later.

You can find information about the concept of PageRank and get a basic understanding of the process and why Google's approach revolutionised search from Wikipedia.

Medical Practitioner Directories Online

Want to see what medical websites are out there?

Here are a few directories I have found online that list medical practitioners and their websites:

DMOZ (possibly the most definitive directory on the web with human editors. Its hierarchy is very complex but you can use it like a search engine - see eg for obstetricians and gynaecologists in Australia)

Yahoo (has the same limitations to useability of many directories but when you find the right category all you get is unique websites).

Medical Directory of Australia (run by the AMA. While the online interface looks a bit primitive this is probably the definitive list although potential patients may not search it as they may not be aware of it)

HealthDirectory.com.au (While unarguably having a commercial bent I quite like this one)

Unfortunately RANZCOG (and probably most of the other colleges) don't offer the capability to list your website in their "find a practitioner" type links. Eventually they will get around to this as they realise patients would much prefer to be able to find out preliminary information about the practice before ringing up their practice.

Another way to find what competition is out there is to do a Google/Yahoo/MSN/Sensis search on either the name of a doctor (if they know they have a website) or do a search on "General Practitioners", "Obstetricians", "Anaesthetists", etc online. Append the name of your city if you find the results are too generic eg "General Practitioners Melbourne".

With some of the integration that exists now between search engines and directories such as Yellow Pages and Google Maps you will often find results from those directories come up on your search.

Have you found a good directory that makes it easy for people to find your website and practice? Feel free to post. If I get enough info I might try to do a more detailed analysis.