Search engine optimization is another thing chiropractors get wrong

Search engine optimization (SEO) plays a key role in the battle between skeptics and alternative medicine. Ensuring that good skeptical material ranks highly for popular relevant search terms is an important form of outreach to people who know nothing about what science says on skeptical topics.

Yesterday I became aware of an article on this topic written by a chiropractor. I was alerted to this by the editor of the excellent EBM First website, who goes by the moniker Blue Wode. He characterized it as an attempt at a “dirty trick” but it immediately struck me as a misguided waste of time.

With a little applied skepticism, you’ll see why I thought this. Read on.

The article in question is “Put Good Chiropractic on Top” over on Dynamic Chiropractic, a news site targeted at chiropractors and supporters of chiropractic. Written by publisher Donald M. Petersen Jr. the article correctly points out that many members of the general public gets answers to questions like “What is chiropractic?” from the crucial first page of Google results.

Amazingly, even though he criticizes the contents of Wikipedia’s article on chiropractic (which ranks #1), he never suggests that chiropractors try to fix that. That’s his first mistake of several in this article. As I and other skeptics have repeatedly pointed out, editing Wikipedia for skeptical content is absolutely crucial to outreach. But that’s not our focus here today.

Back to the article, the author then laments that the Skeptic’s Dictionary page on chiropractic ranks as highly as it does, since it is “anti-chiropractic information”. His focus on this result is his second mistake. The page in question is the seventh or eighth (depending on various factors) organic result in Google, or even lower if you include local results and images in your count. Studies shows that only a tiny percentage of users ever get that far down in search engine results.

The Erroneous Suggestion

But his biggest error is his suggestion for his readers. What he proposes they do is to click the Google +1 button next to pro-chiropractic sites in search results.

In the screen shot below, you can see what he’s talking about. If you are signed in to Google, each result will have a +1 button immediately to its right. The button will light up if you hover over it, and a tooltip appears that says Recommend this page as seen here:

If you click that button, you give Google a signal that you recommend that site to others.

The chiropractor claims clicking those plus buttons will “increase the exposure of important chiropractic information and hopefully move the good chiropractic Web sites ahead of the bad ones”.

I’m skeptical of that.

Applying Skepticism

I must admit I’m not the first to apply skeptical methods to the topic of SEO. Others have pointed out that much of the advice proffered by so called SEO professionals is pure quackery. Some have even applied statistical techniques to show how nonsensical it is.

To see why I might be skeptical of this particular technique, we won’t need statistics. Let’s start right in Google’s own help files. The following quote is from a page that the chiropractor’s own article links (in a footnote):

How does +1 affect search results?

+1 helps people discover relevant content—a website, a Google search result, or an ad—from the people they already know and trust. The +1 button appears on Google search, on websites, and on ads. For example, you might see a +1 button for a Google search result, Google ad, or next to an article you’re reading on your favorite news site.

Adding the +1 button to pages on your own site lets users recommend your content, knowing that their friends and contacts will see their recommendation when it’s most relevant—in the context of Google search results.

Note the emphasis, which I’ve added.

The adjustment of search engine results by the “+1” buttons only affects the results seen by your online friends and contacts. It does not affect the results for anyone else. That is what Google’s own help says, plain as day.

Of course, you can see how someone might get the false impression that this was actually working. Once you press the “+1” button, your results are going to change (for you). You immediately see anecdotal evidence of success. If you wanted to check the results, you might ask a close friend or coworker to check it from their computer. But because they are your friend, their results will change too! More anecdotal evidence. You are being led astray by one of the very same things that leads believers in alt-med astray in the first place – mistaking anecdotes for data.

Another piece of evidence of this is right in that screen shot above. Look at the very last result. It is my What’s the harm in chiropractic page. But look right below it – it says “You shared this” and shows my avatar. The only reason that result appears there is because I made that screen shot myself. You’ll note that the chiropractor didn’t mention my site in his article – he doesn’t see it in his results. Unless your friends with me on Twitter or Google Plus, you won’t see it on the first page either.

As a rule of thumb, whenever checking changes to Google search results you should log out of Google. That will prevent them from using your friends list to adjust your results, and you’ll see something closer to what an average user might see.

A Thought Experiment

If you are still skeptical of my analysis, let’s conduct a thought experiment. Consider this feature from Google’s perspective for a bit. You don’t have to dig very deep into the history of Google to find many stories about various attempts (including some silly ones) to manipulate Google search results. There have even been some skepticism specific efforts to alter Google search results, including one to help a friend that I promoted right here at skeptools.

Google has repeatedly altered its algorithms in order to undo the damage caused by these attempts. Because so much commerce is done on the web, there are considerable financial incentives in this battle, and it is ongoing. There are hundreds of such methods involved. They are generally referred to as black hat SEO or spamdexing.

Because Google makes much of its income through advertising, they are also fight a constant battle with what is called click fraud: bogus attempts to generate fake clicks on online ads. Hackers have even installed malware on millions of computers in such attempts. This is big business.

Well guess what, just like online ads, those “+1” buttons would be a very attractive target for click-fraud. Google is many things, but they are not dumb. They are not going to launch a feature that opens up their search results to widespread click fraud. Avoiding this is part of the reason that the buttons are designed to only affect your friends and contacts.

Anyone claiming anything else right now, is trying to sell you snake oil. (And yes, there are folks trying to sell this particular brand of snake oil already).

Now, nothing is forever. It is certainly possible that the +1 button will start to affect search engine rankings in the future. (As we saw, Google constantly changes its algorithm). And, indeed, Google gave some indication just last month that they are looking into doing this. But read that article carefully, it points out the very same caveats I’m pointing out here, and others too. Google has to tread very, very carefully here to avoid opening themselves up to deliberate manipulation.

So what SEO techniques actually work?

I agree with the remark that Ted Dziuba makes in the SEO quackery article I linked earlier:

There are a handful of fundamentals about page design and other nitty things like URL structure that are generally accepted as good SEO, and you can derive all of this from the principles of not completely failing at web design. Non-brain-damaged web design and link building are 100% of SEO.

Anyone who tells you different is a quack that is only trying to separate you from your money.

I totally agree. Most of the techniques are very simple, and none of them are big secrets. You can find them all in Google’s own webmaster guide to SEO. Download the Adobe PDF document linked on the right.

Yup, Google tells you how to do it right. And why not? Good, relevant search results help you promote your site, but they also help Google stay popular as a search engine.

Incidentally, in Google’s guide you will find the following advice on page 9:

Use words in URLs

URLs with words that are relevant to your site’s content and structure are friendlier for visitors navigating your site. Visitors remember them better and might be more willing to link to them.


  • using lengthy URLs with unnecessary parameters and session IDs
  • choosing generic page names like “page1.html”
  • using excessive keywords like”baseball-cards-baseball-cards-baseballcards.htm”

With that in mind, let’s take a look at the URL of the article that set this all off:

And let’s compare it with the URL of the Skeptic’s Dictionary article:

Those chiropractors not even following the basics of good SEO on their own site! That has more to do with their poor placement in Google than any black hat trickery.

Any fancy SEO techniques they are promoting are just as much snake oil as their chiropractic claptrap.

If you like this article, feel free to press the “+1” or other like buttons below with no fear of reprisal. You should also follow me on Twitter here.

10 thoughts on “Search engine optimization is another thing chiropractors get wrong

  1. Brian Dunning

    I was unaware that the +1 had the collaborative filtering aspect to it. Good to know. When I clicked your +1 at the bottom of your article, the popup said “Brian Dunning publicly +1’d this”. Is there a difference between “publicly” +1ing something and the type of socially filtered +1 you describe?

  2. twilightshards

    That’s actually good to know. Also good thing to learn, I suppose. Although, I kinda am wary of people editing wikipedia: wiki edit wars are not nice things.

  3. sgerbic

    Thanks Tim! I always learn so much from your articles. Thanks for the plug for my Guerrilla Skepticism on Wikipedia blog. You are 100% correct that the way the chiropractor is thinking about SEO’s is the same flawed thinking that they use in their “medical” practice. fascinating.

    I’m glad you caught that line about him not even thinking of “fixing” the Wikipedia page. Wikipedia is only famous for “everyone” being able to edit it. LOL

    Just for fun looked up how commonly the Chiropractic Wikipedia page is being hit by readers…75,709 for August 2011 only. I’m sure that Dr. Peterson over at Dynamic Chiropractic is going to be able to compete with those numbers with his +1.

    Here is the first line of the article…”Chiropractic is a form of alternative medicine” looks like the editors went to a lot of work trying to remain neutral on the page.

  4. Simon Waters

    Assuming you have other people in your social networks the “+1” is not useless for marketing, just not relevant to general search engine promotion. I think it is fair to say that these types of methods are going to be more relevant as the social networks integrate further into the web. Google allow sites to see how the +1 affect search results returned in webmaster tools.

    So far it reports zero data of interest for our largest site, so currently Google “+1” has been almost useless for marketing that site but then it only has a few dozen “+1″‘s so far.

    We have fairly good anecdotal evidence that time spent on page (presumably from Google toolbar) was used to assess pages for site links. Of course Google changed site links since then, but I’d be surprised if the same data isn’t being fed into Google’s search rankings. Although I expect there is a statistical analysis (median time or interquartile range, as well as sample size limits, or similar) to exclude “users has left browser open and gone to get a cup of tea or answer the door bell”.

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  7. Tim Farley Post author

    I will probably do a follow-up post soon, as Google just introduced a new enhancement of this called “Search Plus your World” yesterday.

    However, for now I will point out that as part of this they have added a button in the upper right of search results pages that lets you turn social results on and off at will. So it is now even easier to see the difference between raw Google results and the results that have been enhanced using your social circle. Check out that linked blog post for details.

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