Medic Update, our analysis on the new Google quality algorithm

Inside Webranking, we created a special unit to analyze the effects of the broad core update of August, site by site.

Andrea Gozzi
Aug 30, 2018 · 8 min read

Starting from the 1st of August 2018, the digital marketing community (e-commerce managers and above all, SEO specialists) is grappling with an international reshuffle of rankings on Google’s search pages.
These fluctuations are due to an update of the algorithm that sorts the search results.

The update was immediately confirmed by Google’s official twitter account.

Some considerations regarding this tweet:

A “broad core” update occurs when Google makes several (broad) changes to its main (core) algorithm. Some of these updates could include a variety of factors such as, for example, increasing the importance of backlink quality or reducing the importance of pages with poor user experience.

The “broad core” updates are therefore different from the algorithmic adjustments that are performed many times a year.

So why wait until late August to talk about it?

Many websites had fluctuations in positions that then returned or worsened a few weeks later (especially on August 18th). After a few weeks of analysis, we have a clearer picture of what is happening to Google’s SERPs and we think now is the right time to tackle the topic. Moreover, given the fluctuations shown by the tools, the rollout of this update is probably still ongoing.

What is the “Medic Update”?

The update was almost immediately renamed by the SEO community as the “Medic Update”, because from the beginning the websites with the most evident fluctuations were those related to the medical sector. Of course, since this is an update of the algorithm, all the websites are involved, so the definition of “Medic update” turned out to be almost immediately incorrect.

Another thing that was clear since the beginning was that those most affected were websites with YMYL pages.

“There are some pages for which PQ (Page Quality, ndr) is particularly important. We call these pages Your Money or Your Life (YMYL) pages. They are pages that can have an impact on your current or future well being (physical, financial, safety, etc.). YMYL pages should come from reputable websites and the content should be created with a high level of expertise and authority.”

We are talking about news websites, scientific, medical, financial websites and all websites that allow transactions (e-commerce).

At this point we must remember that, just a few weeks ago, Google has updated the Quality Raters guidelines. Quality Raters are people delegated by Google, in charge of making qualitative assessments on organic search results.

These guidelines are important because they make a concept that can be subjective (the definition of the quality of a website) in an objective concept. The update of the guidelines regarded the insertion of specific indications on the YMYL pages, in the medical and non-medical fields.

Google’s quality rater guidelines, chapter 2

Expertise, A, T: Google’s 3 main criteria for a qualitative content analysis

Taken directly from the Quality Rater guidelines:

“Remember that the first step of PQ (Page Quality, ndr) rating is to understand the true purpose of the page. Websites or pages without some sort of beneficial purpose, including pages that are created with no attempt to help users, or pages that potentially spread hate, cause harm, or misinform or deceive users, should receive the Lowest rating. For all other pages that have a beneficial purpose, the amount of expertise, authoritativeness, and trustworthiness (E-A-T) is very important”

So, according to Google, the factors to consider are:

  • The Expertise of the content creator;
  • The Authoritativeness of content creator, of the content itself and of the website;
  • The Trustworthiness of content creator, of the content itself and of the website.

Warning: recently, John Mueller, Google’s webmaster trends analyst, has confirmed that the author’s reputation is not a direct positioning factor, but, from our point of view, it can be one of the factors that enriches the concept of E-A-T.

Regarding the medical websites and the main subject of this article, the Quality Rater guidelines fall even more into detail:

“High E-A-T medical advice should be written or produced by people or organizations with appropriate medical expertise or accreditation. High E-A-T medical advice or information should be written or produced in a professional style and should be edited, reviewed, and updated on a regular basis.”

We can therefore assume that it is not a coincidence that the update has been released shortly after the Quality Rater guidelines update, as it affects these types of websites.

Hypotheses and methodology

The situation imposes the need to extrapolate the KPIs from the information above. To do this, we need to formulate some hypotheses, which will then be tested (or not) by processing the data. The hypotheses you will find are both formulated by us, taken from the various groups and forums on the subject.

The data we publish is the result of an internal analysis made on quantitative and qualitative factors of 100 Italian websites in the medical field.
Among these are:

  • Websites of medical specialists, public and private;
  • Websites of nursing homes, hospitals and pharmaceutical companies;
  • Informational websites regarding health issues.

The parameter chosen to measure the effects of the algorithm change is the SEO Visibility, a criterion not influenced by seasonality.
The tool that was used to calculate the SEO Visibility of these websites was SEMrush.

There are no e-commerce websites present, they will be subject to further analysis.

Results of the analysis

Hypothesis 1: In websites with blogs or with informational sections, the insertion of the sources within the articles plays a fundamental role, rewarded by the algorithm.

Answer: True

Sources cited or not: Average percentage growth (Semrush)

However, in that small fuchsia part there are also some players with high E-A-T potential such as: an important pharmaceutical company, a clinic that implements the Trustpilot widget with excellent evaluations, two scientific information websites with a section dedicated to the ethics committee and two doctors’ websites with a wide, published, Curriculum Vitae. If you exclude these elements, the chart above becomes like this:

Sources cited or not: Average percentage growth (Semrush)

But let’s go deeper.

Hypothesis 2: With the “medic” update, the inclusion of the bibliography is a high impact activity.

Answer: TRUE

The inclusion of bibliographic references has generally had positive results even if not included in all the articles of the website.

Bibliography inclusion: average percentage growth (Semrush)

Let’s give separate weights for these various features: insertion of sources, insertion of bibliography, insertion of the author within the content of the article and no inclusion of these features.

It is therefore evident from the data we obtained that it is necessary to insert these elements into the page content.

Hypothesis 3: It’s better not to have a blog than to have it only to increase the number of keywords ranked, managing it badly.

Answer: TRUE

One of the “rewarding” factors of this update: websites that seem poor in content quality, that do not have YMYL pages, are fine as they are. In fact, the update penalized those who mishandle their technical/scientific (or pseudo) communication.

% Variation in August compared to July based on communication management (Semrush)

Hypothesis 4: The “Medic” update affects websites not in https.

Answer: FALSE

53% of the websites analyzed were in https. Of this 53% the average growth in the SEO visibility of August compared to July 2018, was 36%. For the remaining 43% of websites still in http, the average growth was 121%.

Absolute growth in August compared to July 2018

This means that (in part, due to the type of websites, which often only want to inform and rarely ask for data) in this update, the protocol used to serve a website was not a relevant parameter.

“Are you saying that http has become a ranking factor?”

Absolutely not. Here is why.

Win/lose distribution between protocols

As you can see, the two distributions are very similar. Simply, you would have had the same chance of losing/growing regardless of the protocol used. For example: a site in http is giving me correct and verified information, in spite of other websites in https that are not so precise from this point of view. This website deserves to be rewarded in rankings for the query typed (if it does not ask me personal data)? From the data shown above, absolutely yes.

Hypothesis 5: Webites with AdSense are rewarded (so Google earns more money)

Answer: FALSE

Websites with Ads, even non-invasive, drop by an average of 28% in August compared to July. Even in absolute terms there are more websites with advertising that fall (80%) compared to those that grow (20%) in visibility.

What to do if your Medical website has been hit?

  1. Do not panic. Especially if you are sure to have always worked well in SEO, thinking users-first. Every day we see some important drops go up again. SERPs are still moving;
  2. Run or have an expert SEO run a positioning report to figure out which keywords have gone down in rank, in many cases a decrease in rank does not correspond to a loss of traffic;
  3. Read the updated Quality Rater guidelines and try to understand for the keywords in which you’ve lost rank, what is penalizing you or favoring your competitors;
  4. Run or have an expert SEO run a complete audit of your website. Remember that this update covers only a few aspects of the algorithm, which has remained almost totally unchanged; your decline in rankings could be due to other aspects;
  5. If your website targets multiple national markets, repeat these steps by treating each market independently.


In the end, at least in the medical field, the new quality rater guidelines seem to be applied in this algorithm change.

We can therefore say with some confidence that Google is trying, perhaps for the first time out of Google News, to penalize websites containing unverified information (who knows if this concept will evolve in a future direct attack on fake news) or for which the author does not show enough trust.

The process to do so is not yet perfect, there are still several anomalies (a value close to 3% of websites) that seem to disprove the assumptions made compared to what is described above. It will then be the work of both Google’s AI and the Quality Raters to refine the new update.

Beyond the medical market

We are recording, for transactional queries, a lot of instability in info-commerce type of results when the text inside the website sends the product listing below the fold.

In addition to this, there are clear improvements in the rankings of multibrand websites for general searches and improvements to vertical websites for long-tail keywords and specific topics. But this will certainly be the subject of further analysis, given the great variety of e-commerce websites.

We will continue to monitor the situation and update you with the latest news!


Digital Marketing Agency.

Thanks to Tiffany Tirado

Andrea Gozzi

Written by

FULL time NERD, from 2011 I spend 1/3 of the day doing SEO. Since 2017 I work for Webranking, the biggest italian search agency.


Digital Marketing Agency. Tra le aziende europee col più alto tasso di crescita secondo il Financial Times e tra i 50 Great Place to Work in Italia

Andrea Gozzi

Written by

FULL time NERD, from 2011 I spend 1/3 of the day doing SEO. Since 2017 I work for Webranking, the biggest italian search agency.


Digital Marketing Agency. Tra le aziende europee col più alto tasso di crescita secondo il Financial Times e tra i 50 Great Place to Work in Italia

Welcome to a place where words matter. On Medium, smart voices and original ideas take center stage - with no ads in sight. Watch
Follow all the topics you care about, and we’ll deliver the best stories for you to your homepage and inbox. Explore
Get unlimited access to the best stories on Medium — and support writers while you’re at it. Just $5/month. Upgrade

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store