Your competitor is outranking you for the most valuable keywords in your market. Here is a step-by-step process for finding out exactly why — and what to do about it.
Most practices that lose ranking positions to competitors respond with instinct. They publish more content. They add more keywords. They redesign the page. Sometimes these interventions work. More often they are solving the wrong problem because they are based on assumptions rather than data.
A competitive SEO audit replaces guessing with evidence. It tells you specifically what your competitor has that you do not — whether that is more backlinks from authoritative sources, deeper content on specific topics, a faster and better-structured website, or a more complete Google Business Profile. The fix is then targeted and efficient rather than broad and hopeful.
Your SEO competitors are not necessarily your geographic or business competitors. Your SEO competitors are whoever is ranking on page one for the keywords your patients use to find practices like yours. Sometimes these overlap with your business competitors. Sometimes they do not.
Start by searching your 10 most important target keywords in an incognito browser. Note who is consistently appearing on page one. For each keyword, record the top 3 organic results (not paid ads, not the map pack — the organic blue links below those). After doing this for all 10 keywords, patterns emerge. Two or three domains will appear repeatedly. These are your primary SEO competitors, regardless of whether you think of them as competitors in your daily business life.
Ahrefs, Semrush, and Moz all offer some version of a competitor keyword report — a list of the keywords a domain ranks for, their positions, and the estimated search volume for each. The free versions of these tools provide limited data. The paid versions provide comprehensive keyword profiles for any public domain.
When you pull a competitor's keyword profile, you are looking for three things. First, keywords they rank for that you do not — these are the gaps in your coverage. Second, keywords where they rank significantly higher than you — these tell you where they have a content or authority advantage. Third, the types of pages driving their rankings — service pages, location pages, blog posts, FAQ pages. The page types that drive their rankings are the page types you need to prioritize in your own strategy.
Backlinks from authoritative external websites remain one of the strongest ranking signals in Google's algorithm. A competitor who consistently outranks you likely has more high-quality backlinks, more authoritative backlinks, or both. Understanding where their backlinks come from tells you where you need to be.
In Ahrefs, pull the competitor's Referring Domains report sorted by Domain Rating. Look for patterns in where their high-authority links come from. Are they being listed in medical association directories you are not in? Are they being mentioned in local media you have not cultivated? Are they earning links from healthcare publications through contributed content? Each source type represents a link building opportunity for your practice to pursue.
The fastest wins in backlink building are usually citation-based: getting listed in the same directories, associations, and local business resources your competitor is already in. These links are not exciting, but they are achievable and they close the gap between you and a competitor who has spent years building their citation profile.
In Ahrefs (or any comparable tool), the Top Pages report shows which pages on a competitor's site receive the most organic traffic. This is one of the most actionable reports in competitive SEO because it tells you directly: these are the content assets that are driving their patient acquisition.
For each of their top pages, ask three questions. What keyword is this page primarily targeting? How long and how thorough is the content? What does the page do to convert a visitor into an inquiry? The answers map out your content gap. If their top organic traffic driver is a 2,500-word rhinoplasty guide and your rhinoplasty page is 300 words of thin description, you have identified a specific, addressable reason why they outrank you for rhinoplasty keywords.
Run both your site and the competitor's site through Google's PageSpeed Insights. Compare the mobile performance scores. Slow sites rank below faster sites when content quality is similar. If you are both producing equivalent content but their site loads in 1.2 seconds on mobile and yours loads in 4.8 seconds, that performance gap is a contributing factor to the ranking difference.
Also compare structured data. Use Google's Rich Results Test on representative pages from both sites. If their service pages have FAQ schema, review schema, and LocalBusiness schema and yours do not, they are generating richer search results that earn more clicks at the same ranking position. Schema is a gap that can be closed in a single development session.
We perform competitive SEO audits as part of our standard onboarding for new practices. The audit identifies specifically where your primary competitors have advantages over you and prioritizes the fixes that will move ranking positions fastest.
Book Free Audit →A completed competitive audit produces a prioritized list of gaps, not an overwhelming list of everything to fix. The prioritization framework is simple: what is the gap, how significant is its impact, and how achievable is closing it?
Content gaps are generally the highest-impact and most achievable. A missing service page or a thin location page can be written and published in days. Backlink gaps are medium-impact and variable in achievability — directory citations are easy, editorial links take months of relationship building. Technical gaps vary: a schema implementation takes hours, a platform migration to fix fundamental speed issues takes weeks.
The practices that close competitive ranking gaps most efficiently are the ones that treat their SEO strategy as data-driven problem-solving rather than arbitrary content production. They know specifically why the competitor ranks above them. They close that specific gap. They measure whether it worked. Then they move to the next gap. Over 6 to 12 months of systematic gap closure, the cumulative effect on ranking positions and patient acquisition is substantial.
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