Expertise. Authoritativeness. Trustworthiness: A New SEO Ranking for Healthcare Websites

  • Date Published
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As the landscape of search evolves, Google continues to adjust its search engine algorithms to determine the most authoritative and trustworthy pages to show in the rankings.

Since August 2018, Google began releasing a series of core algorithm updates that turned the search engine results upside down on multiple occasions. The ultimate goal of the search engine is to build best-in-class algorithms that detect and elevate high-quality information, especially for sensitive topics such as healthcare, finance, news, and more.

One of the primary tactics Google deploys to determine a website’s quality is by measuring the amount of expertise, authoritativeness, and trustworthiness (E-A-T) of a site. Through E-A-T, Google continues a trend of catering to the needs of its users in order to deliver the most relevant, trustworthy results to searchers.

Etymology of E-A-T

The concept of E-A-T was first included in Google’s Search Quality Raters Guidelines (SQRG). SQRG is a massive document (approx.170 pages) that is provided to thousands of Google contractors around the world. The goal of these guidelines is to instruct “Quality Raters” on how to assess the overall quality of a website.

It is important to note that the Quality Raters don’t have a direct impact on the websites that they are evaluating. If they grade a particular website as low quality, it doesn’t mean that a website will be demoted. The opinions gained from the quality raters are used by Google’s engineers to help them build better algorithms to assess the quality of the web.

In a CNBC interview from 2018, Ben Gomes, Google’s Vice President of Search Engineering, was asked about the connection between Google’s Quality Raters’ Guidelines and Google’s algorithms. He said:

“You can view the raters’ guidelines as to where we want the search algorithm to go. They don’t tell you how the algorithm is ranking results, but they fundamentally show what the algorithm should do.

While Google’s algorithms are not an exact representation of what is in the Search Quality Rating Guidelines, the Search Quality Guidelines reflect either what Google already measures or will measure algorithmically.

Initial versions of the SQRG weren’t available publicly; it was only in 2015 that Google decided to make them accessible for everyone. The document is an SEO goldmine as it helps webmasters to better understand what Google looks for in web pages and ultimately where Google algorithms are heading.

The concept of E-A-T is an important part of the SQRG. In the 2020 edition, E-A-T was mentioned 135 times! Our SEO Services evaluate if your website is compliant with Google’s E-A-T factors.

Why Is E-A-T Important for Any Healthcare Website?

E-A-T is closely related to what Google deems “Your Money or Your Life” sites (YMYL). YMYL pages are those that could potentially impact a person’s future happiness, health, financial stability, or safety. The following are examples of YMYL topics: health and safety, finance, news and current events, law.

The Main Content (MC) of YMYL pages should be of the highest quality and provide evidence of the EA-T of the page, as clearly stated in Google’s Quality Rating Guidelines.

If a YMYL page lacks E-A-T, it will be considered of low quality, negatively impacting a page organic’s visibility.

Is E-A-T a New SEO Ranking Factor?

In February 2019, Google published a white paper about how they fight disinformation across its products, including Google Search. In the document, Google confirmed that E-A-T is a very important element of their search ranking strategy! On page 12, the white paper reads:

“Our ranking system does not identify the intent or factual accuracy of any given piece of content. However, it is specifically designed to identify sites with high indicia of expertise, authority, and trustworthiness.

Then, the whitepaper outlines, in detail, how Google assesses E-A-T:

Based on the above, we can draw the following conclusions:

• Trustworthiness and authoritativeness are measured algorithmically.
• Google uses backlinks as one of the signals to understanding the trustworthiness and authority of a website.
• Search Quality Raters play an active role in measuring the quality of the result by participating in side-by-side experiments.

Moreover, in October 2019, Danny Sullivan (Google employee who helps educate the public about search) confirmed that Google uses a variety of signals to tell if the content seems to match E-AT as defined in the SQRG:


E-A-T is a critical concept that should amplify the SEO strategy of each website that is categorized as YMYL. The E-A-T concept encompasses a variety of signals that Google measures or will measure algorithmically. Underscore has developed a comprehensive checklist to evaluate if your website is compliant with Google’s most essential E-A-T factors, based on information included in the SQRG and our research. Please contact us if you have any questions!

By: Bartek Bala, Supervisor, SEO

Underscore Marketing is a worldwide strategic media company providing ROI solutions in the health & wellness, healthcare and pharma space.