A side-by-side comparison of every major SEO factor, six months apart — showing exactly what improved, what didn't, and where the opportunity still lives.
Every major ranking factor scored on the same 100-point scale used in the April audit. Gains are real, but the gap between the practice's quality of care and its online visibility remains significant.
Some meaningful progress happened — particularly in content and AI crawlability. But the biggest revenue-driving issues from April remain untouched. Here's the full picture.
From roughly 3 posts in April to 62 indexed blog posts now. This is the biggest win — content volume has real SEO value and shows the practice is actively publishing.
A robots.txt now exists and properly allows GPTBot, ClaudeBot, PerplexityBot, and other AI crawlers. This is a foundational step toward AI search inclusion.
The site now has WebSite, WebPage, and LocalBusiness schema — none of which existed in April. A real step forward, though key schema types are still missing.
OG title, description, image, and Twitter Card tags are all present and populated — meaning the site will display well when shared on social platforms.
Despite having basic schema, the two most valuable types for a medical practice — Physician and MedicalClinic — are still absent. Dr. Anderson's LLMD and IFMCP credentials remain invisible to Google's structured systems.
Six months later, there is still no standalone page targeting Lyme Disease — the practice's single biggest differentiator and one of the highest-intent search terms in NJ. This is the most valuable untapped page on the site.
The site runs on Gatsby (a JavaScript framework), and title tags are still not appearing in server-rendered HTML. Googlebot may catch them — but AI crawlers and some tools won't. This is a persistent technical risk.
While robots.txt now allows AI crawlers, there is still no llms.txt file — which tells ChatGPT, Perplexity, and Claude what the practice is, what it offers, and how to describe it in AI answers. This is a missed opportunity for AI citation.
10 of 41 images on the homepage have no meaningful alt text. Image accessibility and image search visibility are still being left on the table, despite having more content than before.
Despite publishing 62 blog posts, the homepage only contains 3 internal links. Blog content isn't being connected to service pages, which means the new content isn't building authority the way it should.
Page speed scores are identical to April — estimated 55–65 on mobile. Despite new content being added, no speed or performance optimization has been done. Mobile-first indexing means this directly impacts rankings.
The content investment is real and meaningful. But without a content hub structure linking posts to relevant service pages, most of that SEO value is siloed. A linking strategy now would multiply the value of work already done.
Every technical and on-page factor reviewed in April, re-audited against the current live site.
| Element | April 2026 | September 2026 | Change | Status |
|---|---|---|---|---|
| Homepage Title Tag | Generic — "Root Cause Medicine in Saddle River, NJ" | Same title, still JS-rendered — not in server HTML | No meaningful improvement | Warning |
| JSON-LD Schema | None detected on any page | WebSite + WebPage + LocalBusiness present. No Physician or MedicalClinic schema. | Partial improvement — key types still missing | Warning |
| robots.txt | Not found | Exists — explicitly allows GPTBot, ClaudeBot, PerplexityBot, OAI-SearchBot | Fixed ✓ | Pass |
| llms.txt | Not present | Still not present — 404 error | No change | Critical |
| Blog / Editorial Content | ~3 posts | 62 posts indexed in sitemap | Major improvement ✓ | Pass |
| Lyme Disease Page | No dedicated page | Still no dedicated Lyme page — biggest missed opportunity remains | No change | Critical |
| Physician Bio Pages | Basic team page only | Team page exists with credentials listed — but no Physician schema markup | Minor improvement | Warning |
| Image Alt Text | Mostly generic or missing | 10 of 41 homepage images still have no meaningful alt text | Partial improvement | Warning |
| Open Graph Tags | Incomplete / unclear | OG title, description, image all present — Twitter Card also complete | Fixed ✓ | Pass |
| Page Speed (Mobile) | Est. 55–65 PageSpeed | Est. 55–65 PageSpeed — no improvement detected | No change | Warning |
| Internal Linking | Weak cross-page structure | Homepage has only 3 internal links despite 62 blog posts existing | No improvement | Warning |
| HTTPS / Security | HTTPS present ✓ | HTTPS present ✓ | No change needed | Pass |
| Sitemap | Present | Present and updated — 62 blog URLs indexed | Healthy ✓ | Pass |
| AI Search Readiness | No robots.txt, no llms.txt, no schema | robots.txt with AI directives added. llms.txt still missing. Schema basic only. | Meaningful but incomplete progress | Warning |
The jump from 47 to 56 is real — content production and AI crawlability improved meaningfully. But six months in, the highest-value items from the original audit remain untouched. No Lyme page. No Physician schema. No llms.txt. No speed improvements. No internal linking strategy connecting the new content to the service pages that drive appointments. The foundation is better. The ceiling is still the same.
Prepared by Jason Rock · SEO Specialist · jasonrock487@gmail.com · 917.750.5160