Should a physiotherapy clinic build pages by condition or by body part?

Why do body-part pages underperform?

Most physiotherapy websites are organised the way a clinician thinks: knee, shoulder, back, neck. Patients do not arrive with a body part. They arrive with a name someone has already given the problem, usually a GP, a coach, a scan report or a search they ran at two in the morning. Plantar fasciitis, rotator cuff tear, sciatica, tennis elbow, ACL rehabilitation.

A knee page has to serve every knee problem at once, so it says very little about any of them. It cannot describe the assessment for one condition, the likely course of treatment, or how long it usually takes, because those differ completely between a meniscus tear and patellar tendinopathy. The result is a page that reads as a category heading with paragraphs attached.

The condition page does the opposite. It matches the words the patient used, and it can answer the question they actually have, which is almost never what do you do for knees. It is whether you have treated this before and what happens next.

What makes a condition page different from a body-part page?

A body-part page describes a service. A condition page makes a claim. Publishing a page headed physiotherapy for sciatica is an advertisement stating that physiotherapy treats sciatica, and in every market this site works in, that is a claim you are expected to be able to stand behind.

That is not an argument against condition pages. It is the reason to build them deliberately rather than by generating one per condition from a list. The commercially useful pages and the regulated claims are the same pages.

Which conditions may a UK clinic name without extra evidence?

The Committee of Advertising Practice publishes the list, which is unusual and worth using. A UK physiotherapist may claim to treat the following without holding further documentary evidence.

• Aches and pains, general
• Arthritic pain, backache, back pain and lumbago
• Joint pains, muscle spasms and cramp
• Neuralgia and fibromyalgia
• Minor sports injuries
• Circulatory problems and digestion problems
• Tensions

What happens if the condition is not on that list?

CAP's position is that claims physiotherapy techniques can be used to help with or treat other symptoms or medical conditions are only acceptable if supported by documentary evidence. So the list is a floor rather than a ceiling.

There is a line in the same guidance that physiotherapists should read carefully, because it is more generous than the equivalent position for some neighbouring professions. CAP notes that physiotherapists are regulated by statute and that claims to treat serious medical conditions are therefore likely to be acceptable, provided robust evidence is held to support the claims about efficacy. Statutory regulation buys you the right to make the claim if you can evidence it, not an exemption from evidencing it.

What does Australia require before you can name a condition?

The Physiotherapy Board's advertising guidelines start from a single sentence: advertisers of a regulated health service must be able to substantiate claims made in advertising. What follows is a hierarchy, and it is specific enough to be useful when you are deciding which pages to build.

At the top sits a well-conducted systematic review of relevant randomised controlled trials, which the Board names as the highest level of evidence. At the bottom sit four things the Board names as not acceptable: studies involving no human subjects, before and after studies with few or no controls, self-assessment studies, and anecdotal evidence based on observations in practice.

Advertising is also judged on what it leaves out. The guidelines treat as misleading any advertising that provides partial information or omits important details, or that uses scientific information that is inaccurate, unbalanced or not easily understood by the public. A condition page that describes the best case and omits the usual one is caught by that even when every individual sentence is true.

Why does clinical experience not count as evidence?

This is the part clinicians push back on hardest, and the Board has answered it directly. Anecdotal evidence based on observations in practice is named as unacceptable, and the reason given is that the evidence standard for advertising is not the standard for clinical practice, because advertising cannot provide the individualised discussion that a consultation does.

In a room with a patient you can qualify, hedge and revise. A web page says the same thing to everybody who lands on it, including the person for whom it is wrong. That is why we have seen this work hundreds of times is a perfectly reasonable thing to say in a treatment room and not a defensible thing to publish.

The practical consequence for a clinic website is small but firm. Write what the evidence supports, name the condition, and let the specifics of this patient stay in the appointment.

How should the pages actually be built?

The structure that works is a condition layer under the service, with body parts used only as navigation.

• One page per condition, named the way patients and referrers name it, with the common lay term alongside the clinical one.
• Keep the body-part pages as index pages that link to the conditions beneath them. They are useful to browse and useless to rank.
• On each condition page: what the assessment involves, the usual course of treatment, a realistic timeframe, and what happens if it does not improve.
• Build the pages you can evidence first. A short shelf of well-evidenced condition pages outperforms forty thin ones, and does not put a claim on the site you would struggle to defend.
• Keep the titles on those pages within your registration. What you may call yourself differs by country, and we have set out where specialist is a lawful title and where it is a breach.

How do the two page types compare?