What Are Backlinks?

A backlink is a clickable link from another website to yours. For a health practice, backlinks are one of several ways the rest of the web points to you, and they are easy to confuse with mentions and citations. Each of the three does something different, and two large studies treat them differently.

How backlinks work

Start with the vocabulary, because agencies use these words loosely.

• Backlink. A clickable link on another site that points to your site.
• Mention. Your practice name appears on another site, with or without a link.
• AI citation. A source that an AI answer shows to support what it says.
• Local citation. A directory listing with your name, address and phone number. This is a different use of the word. See local citations.

Search engines have used links for a long time. Google says it uses links as a signal when judging how relevant pages are, and to find new pages to crawl. A link only counts for crawling when it is a standard link in the page code. So a backlink does two jobs. It helps a search engine discover and judge your page, and it can send a visitor to you.

Whether links carry over to AI answers depends on which question you ask, and two large studies answer it differently.

SE Ranking studied 129,000 domains and 216,524 pages to see what predicts a page being cited by ChatGPT. It reported that the number of referring domains, meaning separate websites linking to a page, was the strongest predictor. Pages with up to 2,500 referring domains averaged 1.6 to 1.8 citations. Pages with over 350,000 averaged 8.4. SE Ranking describes these as directional correlations, not proof of how ChatGPT works.

Ahrefs studied 75,000 brands and looked at what goes along with a brand's AI visibility across ChatGPT, AI Mode and AI Overviews. YouTube mentions correlated at about 0.737, and branded web mentions at 0.66 to 0.71. Backlinks showed only a weak correlation. A correlation figure like this runs from negative one to one and measures how closely two rankings move together. Ahrefs says correlation does not equal causation.

These findings sound opposed, and they are not. SE Ranking measured how often a page gets an AI citation. Ahrefs measured how visible a brand is, which includes brand mentions. Also note the scale. The SE Ranking tiers run into the hundreds of thousands of referring domains, which are far larger than most local clinics will have. I read the two studies as complementary. Links help a page get found and cited. Being talked about by name across the web goes along with a brand being named.

For a practice, the useful rule is that where you are linked or named matters more than how many links you collect. A correct listing on a source that AI tools already cite is worth more than a pile of links from unrelated sites. That idea is the basis of an AI source map.

One caution. Google's spam policies define link spam as creating links to or from a site primarily to manipulate search rankings. Its examples include paying money for links, trading goods or services for links, and sending free products so the recipient will write about you and link. Bought links and link swaps can break those policies and add little for patients.

Example: backlinks at a health practice

Take a functional medicine clinic with two physicians in a mid-size metro. This example is illustrative, not a real clinic. An agency pitches a "link package" of fifty links a month from blogs about travel, gadgets and finance. The clinic's owner is unsure, so she asks what the money would buy.

Here is a better test. She asks ChatGPT three patient questions, such as who treats autoimmune conditions with a functional approach near her. She copies every site the answers cite into a sheet. Two names repeat. One is a regional health directory. The other is a hospital system's physician finder. She searches her clinic on both. The directory lists her clinic under an old name with a phone number from a former suite. The hospital finder does not list her at all, because her physicians have no staff privileges there.

Now the plan is concrete. She claims and corrects the directory listing, and the listing often links back to her clinic. She asks the local medical association whether members can be listed, and she accepts an invitation from a local podcast whose show notes link to her site. Each of these is a real link or mention from a relevant source, with her specialty next to her name. The hospital finder is closed to her, so she skips it.

This plan does not promise a citation, and she should not expect fast results. Google's own documentation says no special optimization is needed to appear in AI features, only that a page is indexed and eligible to show with a snippet. What she has done is fix a wrong fact that tools may read and add relevant, honest links and mentions.

For a related sourced data point, an MGMA-published study of ChatGPT citations found that national medical directories made up 8.3% of the cited sources, and practice-owned websites about 23%. The author runs a commercial service, so treat it as one data point. It supports the idea that listings on directories can matter as much as the links to your own site.

How to check yours in 60 seconds

1. Open ChatGPT in a temporary chat, so your history does not shape the answer.
2. Ask three patient questions, such as "best [specialty] in [city]" and "who treats [condition] near me."
3. Copy every site the answers cite into a sheet.
4. Search your practice name on each repeated site.
5. Note whether you are listed, whether your details are right, and whether the listing links to your website.

A site that appears twice or more and does not list you correctly is a first target.

What to do about it

1. Complete the sheet above for ten patient questions, in two or three tools.
2. Rank the repeated sites. Fix your listing on each one that already mentions practices like yours.
3. Claim any unclaimed profile, and correct old names, phone numbers and services.
4. Pursue real relationships next, such as your state or specialty association, local press, podcasts and community events where your name is printed with your specialty.
5. Publish something worth linking to on your own site, such as a clear, dated guide that answers a common patient question.
6. Use descriptive link text on your own pages, so your internal links help readers and crawlers.
7. Skip bought links, link swaps and mass guest posts.
8. Recheck the sheet every quarter and note which listings changed.