Google is unusually open about how it ranks local results. Its own help pages say local results are based mainly on three things: relevance, distance and prominence. Google also says there is no way to request or pay for a better local ranking. Every legitimate local SEO tactic is an attempt to improve one of these three.
Relevance: does the practice match the search?
Relevance is how well your practice matches what someone searched for. A search for “emergency dentist” or “dental implants” is matched against your Business Profile categories and services, and against what your website says. A practice that places implants every week but never mentions them on its website is giving Google very little to work with. You improve relevance by describing what you do, clearly and specifically, on the profile and on the practice website.
Distance: how far is the searcher?
Distance is how far the practice is from the person searching, or from the place named in the search. You can’t change it, and that matters for expectations. A practice will usually rank well close to its office and less well across town, and no honest work changes that entirely. Be skeptical of anyone who promises to rank you “all over the city”: the usual way to fake that is an address you don’t really operate from, which breaks Google’s rules.
Prominence: how well known is the practice?
Prominence is how well known and trusted the practice is, online and off. Google says it draws on information from across the web, such as links, articles and directories, and that review count and ratings play a part. Its help pages also mention that a business’s position in regular web results is a factor. This is the slow part of local SEO, and the part where real-world reputation shows up: a practice that sponsors the local school team, gets mentioned in the local paper and is listed correctly in the directories patients use is more prominent than one that exists only on its own website.
What this means for your priorities
- First, the Business Profile. It feeds relevance and prominence directly. Work through the Google Business Profile guide before anything else.
- Then the website, so Google and patients can confirm what you offer and where you are.
- Then consistency and reputation: citations, reviews and local mentions, built steadily over time.
Rankings also differ from searcher to searcher. Someone standing a block away sees different results from someone two miles away, which is why a single screenshot from your front desk tells you very little. The measuring chapter covers how to check fairly.