How DGM Drove 351% More Phone Calls for a 170+ Location Sports Medicine Franchise

About the Client

The client is a national sports medicine franchise. At engagement start they operated fewer than 100 locations across markets ranging from 250,000 population suburbs to metropolitan areas exceeding 2 million. They had been running paid advertising with returns they considered unsustainable. The franchise's leadership wanted a more cost-effective acquisition channel through organic local search, but corporate budget constraints meant DGM had to deliver on a basic Local SEO tier rather than the premium multi-location plan typical for franchises of their size.

The Challenge

Multi-location SEO at franchise scale comes with a specific set of challenges DGM had to address before any ranking work could begin:

• Technical SEO issues across multiple sub-pages, location pages, and franchise template structures.
• On-page inconsistency where some location pages had been optimized and others were left as template defaults.
• Backlink graph imbalance, with link equity concentrated on a few corporate URLs and starving the location-specific pages that needed authority.
• Citation inconsistency across 100+ locations, with NAP variations that broke entity matching.
• GMB listing issues across the franchise footprint, including filtering and category misalignment.
• Content gaps where competitor sports medicine providers had cornered specific high-volume informational queries.

The single biggest challenge was budget. The Basic Local SEO Plan that fit the franchise's available marketing dollars was not the tier most agencies would recommend for a high-CPC healthcare franchise. DGM had to choose the highest-leverage levers and skip anything that did not directly support either Map Pack visibility or commercial-intent organic ranking.

DGM's Approach

Phase 1: Technical SEO and on-page audit

DGM ran a thorough audit covering technical SEO issues, on-page optimization gaps, backlink graph analysis, citation health, NAP consistency, GMB listing problems, and content gap analysis against competitors. The audit identified the highest-impact issues per location so the Basic plan could be focused on the right work first.

Phase 2: NAP and citation cleanup at scale

Multi-location NAP consistency is foundational. DGM systematically cleaned NAP variations across primary citations for all locations, ensuring every location's name, address, and phone number matched perfectly across Google, the franchise website, and major data aggregators. This had to happen before any ranking work could compound.

Phase 3: GMB optimization with category and service alignment

Each location's Google Business Profile was rebuilt with proper primary category (Sports Medicine Physician or equivalent), aligned secondary categories, complete services list with descriptions, products, and Q&A. Posts and photos were standardized across the franchise to support brand recognition while keeping each location distinct.

Phase 4: Content depth on location pages

Each location page received content depth: local service descriptions, location-specific insurance information, hours and contact, embedded maps, and reviews. This addressed the franchise's biggest competitive disadvantage compared to independent sports medicine practices that had stronger location-specific content.

Phase 5: Strategic link building

With budget constraints, link building had to be precise. DGM focused on local citation building, healthcare-niche directory placements, and a small set of authority placements targeting the corporate brand to lift all locations through brand authority.

Results Narrative

By month 6-7 the franchise was ranking in the Map Pack for high-value sports medicine keywords across most of the location footprint. The average call increase across all locations reached 351%. For some locations the increase was higher; for some it was lower. The variation correlated with starting position, market size, and competitive density rather than any per-location effort difference. The franchise's leadership saw the data, recognized the ROI, and approved expansion. DGM now manages over 170 active locations as the franchise continues to grow.

Lessons & Takeaways

1. Multi-location budget constraints are solvable if the work is prioritized correctly. The Basic Local SEO Plan worked here because NAP and GMB foundations were chosen over expensive link building.
2. Average campaign metrics hide per-location variation. A 351% average means some locations did 500%+ and others did 150%. Report both the average and the distribution to set leadership expectations.
3. Healthcare franchise SEO compounds. Once 20+ locations rank, the brand authority signal lifts the remaining locations faster than a single-location campaign would.
4. $17.97 CPC means organic rank #1 is worth 1000x the campaign cost over 12 months. Healthcare verticals with high CPCs are the highest ROI use case for franchise local SEO.