Updated heartburnreliefnc seo action report 10/12/26

1. The priority is qualified calls, not another article batch

Decision order: measurement and booking clarity → clinical trust and costs → separately approved production launch → local patient-fit pages and distribution → selective new education. These are recommendations, not site changes. No booked-call or ranking guarantee is justified by this sample.

Scope lock: this report does not approve or implement content edits, tracking, patient tests, scheduler changes, live-domain changes, DNS, WordPress work, main merges or release tags. The original report and all existing previews stay untouched.

2. Connected evidence: exact windows and honest limits

Research captured October 13, 2026. The requested title retains the October 12 update label; it is not a claim that every observation was taken that day. OpenSEO project f375c138-2897-422e-9c2c-4f651536fbc4 is heartburnreliefnc.com. Its shared context and research log were empty. Business goals therefore come from the supplied brief and WFM state, not invented project memory.

The identifiers above are exact read-only connection handles. No Google settings changed. Pagination totals reconcile for every returned GSC/GA4 table. All computed totals were calculated in Python. First-party rows are stored locally as structured response captures; public report links lead to the integration, not expose patient records. [GSC][GA]

Measurement review flags: custom dimensions include email_address, tel_number, wp_user_id and link_text. Their existence does not prove transmission. Inspect actual network payloads and historical configuration with an authorized privacy reviewer before reusing them in Astro. [PRIV]

3. Live WordPress versus completed V2: do not conflate them

Fresh canonical URL captures, titles, descriptions, canonicals and effective noindex headers were saved separately from live captures. Previous passage/media/runtime acceptance reports in WFM state remain useful historical evidence; this report did not rerun their entire 86-route/viewport asset-blocking suite or claim to. [LIVE][V2]

4. Entire original plan: section-by-section Keep / Change / Drop / Defer

The full original report was read, including every section after the architecture anchor, all five checklist phases, the roadmap and 17-row change log. The original remains available at the preserved original plan. Its September 17, 2026 audit date is historical. [OLD]

5. Market evidence: local patient fit beats national volume

OpenSEO paid keyword hydration returned an explicit insufficient-credit error. No retries were made to that endpoint. Direct DataForSEO succeeded. Wilmington was resolved to Wilmington,North Carolina,United States, code 1021374, not Wilmington Delaware. National code is 2840. Both sets use English, Google Ads-derived monthly search estimates retrieved October 13, 2026. Fourteen unique requested terms were returned in each market; returned rows without search_volume remain unavailable. [DFS]

Do not sum overlapping variants into market size. Ads competition is not organic keyword difficulty. No reliable organic difficulty, complete backlinks, local ranking grid, target keyword market share or appointment forecast was obtained. Broader national terms can justify useful education, but should not outrank qualified Wilmington solution/provider-fit work solely because they are larger.

6. Actual Wilmington search snapshots and competitor fit

DataForSEO Google organic live advanced snapshots: October 13, 2026, Wilmington city-level location, desktop, English, requested depth 10. Each returned nine organic rows plus available SERP features. Results below are selected evidence, not an exhaustive first-page reproduction. Map-pack rows are a single-location snapshot, not a geographic grid or persistent rank. [SERP]

The acid-reflux-specialist and comparison AI-overview rows were asynchronous shells with no cited answer. The nighttime symptom query did return an answer and reference URLs, without a HeartburnReliefNC citation in that returned answer. This is a single observed result, not proof of absence across all AI engines. No ChatGPT/Perplexity citation audit or GBP management-access audit was performed.

7. Six awareness stages: useful next steps toward qualified calls

People want meals and sleep to feel manageable, to understand why symptoms persist, and to avoid paying for another unclear plan. Those are audience hypotheses supported by site themes and search intent, not patient interviews. The offer should be a no-cost practice-fit conversation, not a diagnosis, promise of answers to every cause, or medication-discontinuation service.

Urgent or specialist-inappropriate visitors are not failed conversions. Good qualification sometimes means directing someone to medical assessment instead of the scheduler. Stage-specific paths reduce misleading leads and wasted staff calls. [NIDDK][AHA]

8. Query ownership, canonicals and internal links

Keep one primary destination per intent. Related pages can mention the same topic but must answer different questions. Canonical tags do not repair two substantially duplicated landing pages that both chase the same query. No cannibalization diagnosis is supported by the tiny GSC sample alone. [HELPFUL][SPAM]

Canonical/redirect rules for the separate launch: production-domain self-canonicals on distinct pages; one clear 301 for replaced legacy core routes; retained root articles do not redirect; duplicate author/category/query continuity is evaluated against real inventory; scaffold stays out. Preserve both useful original content/media and routing evidence. Do not set every location page canonical to home while leaving thin pages indexable.

9. Wilmington first, nearby catchment second, remote separately

The practice address is 5046 Wrightsville Ave., Suite 200, Wilmington, NC 28403; parent phone (910) 444-9438. Public parent sources and the current local snapshot agree. Genuine surrounding areas are not additional offices. Geographic proximity alone does not prove provider scope, collection availability or patient demand. [PARENT][SERP]

A new city page earns its place only if it answers a distinct useful question: who serves residents, what requires travel, how the specific sample is collected, where verified draws occur, how follow-up works, and what costs/coverage apply. Require staff-verifiable facts and demand or an operational need. Landmarks and repeated city names are not adequate differentiation. [SPAM][AREAS]

10. Every canonical V2 page: exact inventory and next decision

All 39 current canonical sitemap URLs were fetched individually. Titles and descriptions below are actual preview metadata, not proposed copies. These pages remain noindex and canonicalize toward the intended live domain. The audit is editorial/SEO evaluation, not a new medical review or full accessibility/performance certification. [V2]

Other served continuity/archive/scaffold documents account for the difference between 39 sitemap URLs and the current 43-document project inventory. Count URLs by their role; do not present 43 as forty-three unique production landing pages. The Charleston scaffold is explicitly outside the production-intended sitemap.

11. Content choices: finish existing assets before expanding

No fixed article length, mandatory year suffix, universal city mention or minimum link quota is recommended. A relevant next link beats two forced blog links. Publish/review dates must reflect real editorial work. AI assistance does not justify fake physician authorship. [HELPFUL][AI]

12. Clinical trust is a conversion requirement

No clinician credentials beyond the public DC/functional-practice descriptions are assumed. “Heartburn specialist”, “Physician” and “gastroenterologist” should not be used to manufacture scope. The parent says it is not primary care. A fit conversation can explain the approach and logistics; it is not medical diagnosis or treatment. [PARENT]

13. Navigation and on-page copy: specific, truthful and stack-aware

V2 already has compact desktop navigation, Services/Conditions/Locations dropdowns, Blog and Book Free Call, plus About utilities for FAQ, Contact and Resources. Keep the approved visual style and completed header fixes. Do not restart navigation design or change branding during a report-only task.

These are proposed copy assets, not deployed replacements. Align visible H1/body with the selected intent. A semantic tagline paragraph avoids the inherited hero H4 issue, but H1-first order alone is not an acquisition cure. Use actual article section headings, a relevant related-reading block and purposeful breadcrumbs. Descriptions have no mandatory exact 155-character rule and cannot override unsupported body claims. Native Astro metadata/JSON-LD replaces Rank Math/MonsterInsights plugin purchasing advice. [HELPFUL]

14. Booking audit: a contact form is not a confirmed appointment

The original plan said no embed was visible in extracted text. Fresh HTML confirms a real GHL form on live and V2. Its public form was rendered at 1440px and 390px with no horizontal overflow. It requires Full Name and Email and says Continue To Schedule Date & Time. Its public configuration redirects to wfmpatientportal.md-hq.com/embedded/schedule.php. No name/email entry, form submission, appointment reservation or real patient record was made. [BOOK]

The form/mobile view is legible with clear labels and no overflow in the inspected viewport. Browser-harness startup failed, so real Playwright Chromium was used. Screenshots and rendered field inventories were saved. This proves public rendering and selector behavior, not form deliverability, notification receipt, double-booking protection or a completed booking.

Do not add an exit-intent health popup, fabricated Limited spots language, “Just answers” diagnosis framing or the same testimonial everywhere. A persistent approved navigation CTA plus contextual invitations and transparent fit information is a better initial test. Confirmation status, rescheduling, reminders, cancellation and response time all need practice-owned acceptance. [PARENT]

15. Funnel measurement and healthcare privacy

Operational appointment records are the source of truth for patient acquisition. General analytics can support privacy-approved aggregate navigation insights; it should not become the patient record. No funnel endpoint or actual appointment/attendance dataset was retrieved through this connected SEO integration. The baseline outcomes remain unavailable. [GA][PRIV]

Rates only after baseline works: confirmed-booking rate uses a stated eligible visit denominator; attendance rate uses the relevant scheduled cohort; qualification rate uses attended calls; enrollment rate uses qualified attended calls. Show numerator and denominator. This sample cannot support statistical lift claims or a numeric appointment target derived from traffic.

Use explicit UTM source/medium/campaign on approved external links and retain attribution through GHL → portal only by a supported, privacy-reviewed mechanism. No patient names, emails, phone numbers, DOB, ZIP-based identity, symptoms, diagnoses, free text or sensitive query parameters belong in GA4 or ad pixels. Even a health-page URL/context may merit review. Google Analytics does not offer a healthcare BAA. Consent alone is not a universal compliance answer. Audit the existing identifier-named custom definitions and request payloads before expanding tracking. [PRIV][PII]

16. Technical SEO and launch acceptance: proposed, not executed

No Search Console submission, crawler setting, content change, sitemap edit, GA4 event enabling or production launch was performed during the report audit.

17. AEO/GEO and schema: useful semantics, no enhancement promises

Current Google guidance says ordinary SEO and genuinely useful content support generative-search discoverability. No special AI schema, llms.txt or rigid chunking format is required. Search/training crawlers have different purposes; allowing GPTBot is not a ranking/citation guarantee. Check applicable production crawl/index/snippet eligibility and current Search Console generative-AI inclusion/report controls with authorized read access. This integration did not expose a dedicated generative-AI report, which does not prove the property lacks one. [AI][AIREPORT]

A small recurring measurement set can cover: nighttime symptoms, GERD care choice, PPI review, functional-care fit in Wilmington and practice scheduling. Record exact prompt, platform, location/device/retrieval state, timestamp, actual answer and cited URL. Report observed citations separately from shells, mentions, referrals and confirmed calls. AI visibility stays secondary to patient acquisition.

18. Parent entity, local authority and distribution

Keep the original plan’s decision not to create a microsite GBP. A condition domain does not independently create an eligible business. The parent should use the real-world practice name, actual address, appropriate categories and truthful care scope. Google’s local guidance centers relevance, distance and prominence; there is no guaranteed map position from adding city pages. [GBP][LOCAL]

Do not repeat unsupported older playbook claims that photo EXIF, weekly review quotas, forced keywords in reviews or forum saturation guarantee local/AI rankings. Primary current rules supersede generic tactics.

19. Every old checklist item: revised status and acceptance

This matrix preserves all 50 original checklist items across its five phases. Duplicate rows remain so no item disappears. Done in preview is not live or production approved. These decisions also supersede the old 17-row change log where it repeats the same tasks.

20. A realistic 30 / 60 / 90-day acquisition roadmap

Day counts begin after the practice approves implementation scope and assigns owners. No calendar commitment, keyword rank or appointment total is guaranteed. Improvements must be measured against qualified attended calls, with small sample sizes reported honestly.

Success targets are operational before numerical: a working confirmed-booking record; clear actual call host; no unsupported promises or wrong-site copy; accurate insurance/cost process; approved release; then improved qualified-call flow. Set realistic numeric targets with staff only after actual capacity and baseline bookings are known.

21. Activity log: completed audit work versus unperformed work

The final publication handles and report rendering/readback evidence are recorded in local publication.json and report-verification.json. Report publication is the only new public artifact change in this task, plus its index card if that separate account permits publication.

22. Sources, methodology and unresolved evidence gaps

Verified means directly observed in current read-only tools/HTML/browser or explicitly attributed to WFM status. Recommendation means not implemented. Hypothesis means a proposed acquisition effect without observed lift. Unavailable stays missing, never becomes zero demand or zero patients.

Method: read full original; retrieve connected first-party evidence first; reconcile pagination and compute with Python; capture current live and review HTML/sitemaps separately; use direct keyword/SERP fallback after credit failure; validate important competitors/rules on primary sources; inspect public booking flow without real submissions; generate a distinct report; validate structure and public rendering before delivery.

Local evidence folder: X:/Dropbox/hermes_projects/wfm-client/heartburn-updated-seo-research/. It includes original HTML/text, live/V2 route captures, primary-source snapshots, connected structured evidence, computed totals, market task IDs/excerpts, booking screenshots and rendered selectors, protected-state readbacks and publication acceptance. No patient data is published in this report.

1. [OLD] Full original plan
   Source document, all sections and checklist; original remains unchanged.
2. [LIVE] Live HeartburnReliefNC
   Fresh raw live HTML and all sitemap children/18 URLs.
3. [V2] Current independent V2 preview
   All 39 canonical URLs captured; noindex review, not live performance.
4. [GSC] Connected OpenSEO integration
   sc-domain:heartburnreliefnc.com; exact GSC requests/rows local. Private login may be required.
5. [GA] Connected GA4 property via OpenSEO
   properties/536222231; July 12 to October 9, 2026; structured response captures local.
6. [DFS] DataForSEO Google Ads volume documentation
   Direct tool responses, exact markets and task identifiers stored in market-evidence.json; Ads estimates, no organic KD.
7. [SERP] DataForSEO organic SERP documentation
   Six Wilmington desktop snapshots October 13, 2026; selected result excerpts and task IDs local.
8. [PARENT] Parent practice, credentials and insurance/PCP policy
   Actual public address/phone, DC credentials, 15-minute call, no office insurance billing and not-primary-care statements.
9. [GI] Wilmington Gastroenterology GERD page
   Actual specialist/GERD primary site and homepage services, not inferred from directory titles.
10. [BREAK] Breakthrough Functional Medicine
    Actual functional medicine/gut/GERD offering on primary site. Advertised claims are not outcomes evidence.
11. [BOOK] Public first-step discovery form
    Name/email fields, visible Continue button, public configured downstream URL. No submission.
12. [PORTAL] Public appointment scheduler
    Real assistant, Heartburn visit type, date and EDT start choices inspected without booking.
13. [AAA] AAAAI: IgG food-panel limitations
    Primary professional organization recommends against IgG diagnosis of allergy/intolerance/sensitivity.
14. [AGA] AGA: Deprescribing PPIs
    Primary professional clinical guidance; prescriber-led indication review, high-risk exceptions and rebound counseling.
15. [NIDDK] NIDDK: GERD treatment
    Primary federal clinical information on medicines, lifestyle and procedures; not a functional-care outcome study.
16. [AHA] AHA: heart-attack warning signs
    Urgent chest symptoms must not be diverted to a fit-call funnel.
17. [HELPFUL] Google: helpful, reliable, people-first content
    YMYL reliability, real responsibility and useful content over word-count formulas.
18. [SPAM] Google Search spam policies
    Doorway/scaled-content risk; city swapping or many microsites do not manufacture useful authority.
19. [GBP] Google Business Profile representation rules
    Genuine eligible real-world entity; condition website alone is not a separate business.
20. [LOCAL] Google local ranking guidance
    Relevance, distance and prominence; not a fixed timeline or geographic coverage promise.
21. [UPDATES] Google Search documentation update log
    FAQ retirement May 7, 2026; documentation removal June 15, 2026; HowTo retirement September 13, 2023.
22. [REVIEWS] Google review snippet rules
    Self-serving business review rich-result restrictions.
23. [AI] Google current generative AI optimization guide
    No special schema/AI files/chunking hacks; ordinary SEO and useful content.
24. [AIREPORT] Google generative AI performance reports
    Dedicated reporting described by Google; integration absence does not establish report absence.
25. [PRIV] Google Analytics healthcare guidance
    Sensitive data and lack of healthcare BAA; obtain qualified review.
26. [PII] Google Analytics PII rules
    No personal identifiers in Analytics.
27. [AREAS] Wrightsville Beach official town site
    Real geography, not service/demand validation.
28. [CAROLINA] Carolina Beach official town site
    Nearby place verification, not an office claim.
29. [KURE] Kure Beach official town site
    Nearby place verification, not a local lab agreement.
30. [PENDER] Pender County tourism
    Regional geography only; actual Hampstead service arrangements remain staff confirmation.