A Note on Our Baseline
Before we get to the numbers, we want to be upfront about one thing: The Riegel Center signed on for a rebuild just five days before we launched the new site. That gave us only 5 days of Google Search Console history from the old site to compare against — a short window by the standards of rigorous before-and-after analysis.
A 5-day baseline has real day-to-day noise. Two unusually slow days can swing the average significantly. So the headline percentages in this case study are honest averages of whatever data we actually had — not cherry-picked, not recalculated to look better, just the straightforward before-and-after comparison using the window we were handed. We are flagging this up front because we would rather lose a case study reader than hide an important methodology note.
The more reliable version of the story is the 200-day daily trend chart above. It shows 5 days of pre-launch data and 200 days of post-launch data, and you can read the shape of it without trusting our arithmetic: a climb through March, a peak in April, a retrace through May, and a plateau that has held since.
With that said, here is what the data actually shows.
The Challenge
The Riegel Center is a hormone therapy and anti-aging clinic serving the Plano and Richardson area of the Dallas-Fort Worth metroplex. They offer bioidentical hormone replacement therapy (BHRT), HGH protocols, anti-aging treatments, and related wellness services — a category where potential patients do a lot of research online before ever picking up the phone.
The existing website had decent raw traffic thanks to some legacy content, but it had three problems that were capping how much of that traffic converted into real patient inquiries:
- Average search position was in the 19-22 range — meaning the clinic was showing up on page 2 of Google for most searches, which gets a fraction of the clicks that page 1 placements get.
- No local SEO targeting — the site was not specifically ranked for the "Plano" and "Richardson" local searches that high-intent patients actually use.
- Page speed and Core Web Vitals were weak on mobile — most patient research happens on a phone, and slow-loading pages cost both rankings and conversions.
The clinic needed a rebuild that would move rankings closer to page 1, start capturing local-intent searches, and deliver a fast mobile experience that converted research into consultations.
What We Built
We rebuilt theriegelcenter.com using our SEO-first methodology, with specific adjustments for the healthcare category:
Technical Foundation
- Next.js framework with server-side rendering for fast mobile page loads
- Core Web Vitals optimized — LCP under 2.5 seconds, zero cumulative layout shift, under 150ms total blocking time
- Mobile-first responsive design — healthcare research is disproportionately mobile
- Vercel deployment with global CDN
SEO Architecture
- Service pages for each treatment area — BHRT, HGH therapy, anti-aging, anxiety and mood support — each targeting the actual search terms patients use
- Local SEO foundation — LocalBusiness and MedicalBusiness schema markup with full NAP, geographic signals for Plano and Richardson, and location-specific content on key landing pages
- Optimized meta tags — unique titles and descriptions for every page, written around real patient search intent
- Internal linking connecting treatments, conditions, and the blog so topical authority builds correctly
- XML sitemap submitted to Google Search Console and Bing Webmaster Tools on day one
Content & Conversion
- Treatment landing pages with clear descriptions of who each protocol is for, what to expect, and how to book a consultation
- FAQ sections addressing the most common patient questions about hormone therapy, HGH, and anti-aging protocols
- Blog content targeting informational searches that lead to treatment decisions
- Clear consultation CTAs throughout the site with phone number, contact form, and scheduling links
The Results
Comparing the 5 days before go-live (February 28 - March 4) against all 200 days since launch (March 5 - September 20), Google Search Console shows a durable lift — smaller than the number we could have published at the two-month mark, and more honest.
Search Visibility
| Metric | Before (avg/day) | After (avg/day) | Change |
|---|---|---|---|
| Google Clicks | 6.8/day | 9.9/day | +46% |
| Google Impressions | 1,427/day | 2,061/day | +44% |
| Average Position | 19.6 | 17.8 | 9% closer to page 1 |
| Google Clicks (last 30 days) | 6.8/day | 9.4/day | +38% |
| Google Impressions (last 30 days) | 1,427/day | 1,638/day | +15% |
| Average Position (best month, April) | 19.6 | 12.9 | 34% closer to page 1 |
Traffic Totals
| Metric | Before (5 days) | After (200 days) |
|---|---|---|
| Impressions | 7,136 | 412,092 |
| Clicks | 34 | 1,989 |
The Full Curve: Surge, Retrace, Plateau
This is the section most agencies would delete. It is the reason we keep this case study.
| Window | Impressions/day | Clicks/day | Avg. Position |
|---|---|---|---|
| 5 days before launch | 1,427 | 6.8 | 19.6 |
| March (from launch) | 2,347 | 10.1 | 17.9 |
| April — the peak | 2,975 | 14.4 | 12.9 |
| May | 1,792 | 9.2 | 21.1 |
| June | 2,179 | 9.0 | 18.9 |
| July | 1,675 | 8.4 | 18.1 |
| August | 1,736 | 9.3 | 18.7 |
| September (through the 20th) | 1,641 | 9.2 | 16.4 |
At 61 days post-launch — the window ending in early May — this site was up 84% on impressions and 79% on clicks, with average position at 15.1. Those are the numbers an earlier version of this case study carried, and they were accurate for that window. Had we stopped updating, they would still be sitting at the top of this page.
Here is what happened next. April was the peak: 2,975 impressions a day and average position 12.9, the closest the site has come to page 1. Through May the impression volume retraced hard, and position drifted into the low 20s. Since June the site has held a plateau around 1,640-2,180 impressions a day and roughly 9 clicks a day, with position recovering — September is the best month since April at 16.4, and the most recent seven days averaged position 14.3.
The honest read at 200 days: the click lift is real and durable (+46% across the full window, +38% over the most recent 30 days). The position improvement is real but modest (-9% full window), and currently trending the right way again. The impressions surge was largely temporary — at 1,638 per day over the last 30 days, impressions are only 15% above the old site, not the 84% the two-month window showed.
That combination is not a failure. Clicks holding up while impressions fall back means the visibility the site kept is the visibility that was worth having.
Top Search Queries (last 28 days, August 24 – September 20)
| Query | Clicks | Impressions | Position |
|---|---|---|---|
| the riegel center | 11 | 13 | 1.0 |
| hgh timeline | 3 | 7 | 3.6 |
| hgh results after 1 month | 2 | 10 | 2.5 |
| hgh for women before and after | 2 | 6 | 9.5 |
| hgh before and after | 1 | 18 | 2.3 |
| how long does hgh take to work | 1 | 9 | 2.6 |
| 2 iu hgh per day results | 0 | 52 | 3.0 |
| bhrt and weight loss | 0 | 41 | 8.0 |
| bhrt for men | 0 | 45 | 10.1 |
| anti aging hormone therapy | 0 | 80 | 22.1 |
| bhrt | 0 | 382 | 36.8 |
The pattern is unusually clean, and it splits in two.
The informational HGH cluster won. "HGH timeline" at 3.6, "hgh results after 1 month" at 2.5, "hgh before and after" at 2.3, "how long does hgh take to work" at 2.6, "2 iu hgh per day results" at 3.0 — these are top-five placements on real informational searches, and they produce most of the clicks the site earns. The treatment content did exactly what topical content is supposed to do.
The commercial head terms did not. "BHRT" pulls 382 impressions at position 36.8 — page four. "Anti aging hormone therapy" sits at 22.1. Those are the queries with money behind them, and the site is being shown for them without being seen.
What Has Not Worked Yet
The original version of this case study highlighted two local queries as early wins: "anti aging clinic richardson" and "anxiety treatment plano." Two hundred days in, we have to report that neither converted into a ranking.
"Anti aging clinic richardson" now draws 2 impressions at position 31.0. "Anxiety treatment in plano" draws 25 impressions at position 31.2. Both are deeper than where they sat in the spring. Google is still willing to consider the site for local commercial intent, but it is not ranking it there, and six months is long enough that we are not going to call it a leading indicator any more.
That is the open work on this account: the local commercial cluster needs dedicated location pages with real depth behind them, not geographic signals bolted onto treatment pages. The informational content proved the domain can rank. Pointing that authority at the queries that book consultations is the next job.
Key Takeaways
- Clicks up 46% and holding — 6.8/day to 9.9/day across 200 days, with the most recent 30 days at 9.4/day (+38%). This is the durable win.
- Impressions up 44% across the window, but only 15% recently — the April peak of 2,975/day retraced to roughly 1,640/day. We publish both numbers.
- Position improved 9% overall and is trending up again — 19.6 to 17.8 full-window, with September at 16.4 and the most recent week at 14.3, the best stretch since April.
- Informational content is the proven winner — five HGH queries between positions 2.3 and 3.6, earning most of the site's clicks.
- Local commercial rankings remain unsolved — "anti aging clinic richardson" and "anxiety treatment in plano" sit near position 31. Named as open work, not spun as progress.
Why the Honest Framing Matters
Most agency case studies present their numbers with the most favorable possible framing — the biggest percentage, the cleanest chart, the cherry-picked window. We try not to do that. When the baseline is short, we say so. When a gain retraces, we publish the retrace in the same place we published the surge. And when a client's site has been live long enough that the flattering two-month window is no longer the honest one, we change the headline rather than leave the better number up.
This page used to say 88% impressions growth. It now says 44%, because 200 days of data says 44%. The 88% was never wrong — it was just measured over a window that has since been overtaken by more evidence.
The Riegel Center results are real: a 46% click lift sustained across more than six months, a modest but genuine position improvement that is strengthening again, and a treatment-content cluster ranking in the top five on searches its patients actually run. We would rather be trusted on those numbers than celebrated on the ones we could have frozen in May.
A Note on GA4
Google Analytics sessions across the first 61 days post-launch averaged 34.2 per day (2,088 total) against 22.2 per day in the 5-day pre-launch window. GA4 figures beyond that window were not part of this refresh, so we are not quoting a 200-day session total we have not verified. The Search Console data above covers the full period.
Why It Worked
The Riegel Center's results are what happens when you build a healthcare website with SEO as the foundation — proper site architecture, MedicalBusiness schema markup, local targeting for the actual cities the clinic serves, Core Web Vitals optimization for mobile, and treatment pages written around the searches real patients type into Google.
Most healthcare clinic websites are either generic templates from a medical marketing vendor or custom designs that ignore technical SEO entirely. Either way, they end up invisible for the searches that drive new patient inquiries. That is the gap we fill. Two hundred days of data shows where that approach delivered decisively — informational authority and a durable click lift — and where it has not yet, which is the local commercial cluster we are still working.