In Competitive Markets
If you're established top rankings in a competitive market, then you already understand the value that comes with that position. Most of our clients report Google as their top referral source after word of mouth and patient referrals. If you stop investing in SEO, it's unlikely that you'll retain your top position indefinitely. Once lost, it's harder to regain this position - especially in a moderate or high competition market.  

Google values recent contributions, updated websites, citations and more. Once your foundation is strong, you want to keep feeding Google with on site and off site SEO.

In Non-Competitive Markets
These markets are prime locations for corporate competitors and individually owned practices alike. It's more cost effective to market in a non competitive environment making it easier for a start up to succeed. If you're first (or close to it) with little competition, the longer you invest in SEO, the more difficult it'll be for a new practice to come into town and take your top spot.

What's the Value? 
SEO is an investment that pays for itself 10x over every month. Whether you've established that top ranking position or you're still working your way up, once you establish top rankings (even if only for a few main keywords) you'll feel the impact on your new patient numbers. Be sure you're always tracking and reporting your new patient referral sources, allowing you to value this critical investment.