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About Ranking Out
A local search agency that works with physical therapy and chiropractic practices, and nothing else. Based in Arlington, Virginia. Working with clinics across the United States.
Book A Call→Most marketing agencies will take any client who pays. That sounds like flexibility and it is actually the problem, because an agency serving roofers, restaurants and clinics at the same time is running the same playbook on all three and learning nothing specific about any of them.
We only work with physical therapy and chiropractic practices. That is a commercial constraint we chose on purpose. It means we already know what a plan of care is worth, why a discharged patient is an asset rather than a closed file, what happens to your phone at lunchtime, and which rules apply when you want to text a patient list.
It also means we say no fairly often, including to clinics we like.
Being early is not one of the reasons we say no. A practice that opened this year has no list to reactivate yet, but it still needs a website that converts and a Google profile that turns up, and that is where we start with them. The full plan we published for one such build is the whole method, phase by phase, with nothing held back.
We are not going to put a number on how often we decline, because you have no way to check it and neither do you with any agency that quotes you one. Ask whoever else you are considering how many practices they turned away this year, and listen to how quickly the answer arrives. The speed of it will tell you more than the number would.
Before you go any further
Not about us. About yours. Each one takes about four seconds, and the four answers together are the whole business case.
You paid to acquire every patient in your system once, and that money is already spent. Reaching one of them again costs a message. So which is cheaper to book: the stranger who has never heard of you, or the person who already trusts you and knows where you are?
Not when it arrived. When it was answered. If you do not know, that is the answer, and the person who sent it has already been treated somewhere else.
Somewhere on your list is a physician, a trainer or a coach who sent you two patients a month two years ago and sends none now. Nobody fell out. It stopped, and nobody noticed, because a referral that does not arrive leaves no trace.
If the answer is anything above zero, something is built wrong. This is supposed to run in the background while you do the thing you are actually excellent at.
Who does the work
Farhat Muruwat
Founder, Ranking Out
I have spent ten years doing SEO and web development, most of it for local businesses across Virginia and Washington, DC. Practices, shops and service businesses whose next month depended on whether somebody within a few miles could find them.
For most of those ten years I took whatever work came. You learn a great deal that way, and you get properly good at none of it, because what moves a clinic is not what moves a restaurant. The words are different, the timing is different, the rules about contacting people are completely different.
So I stopped. Ranking Out only works with physical therapy and chiropractic practices, and I would rather be the person who already knows what a plan of care is worth than the person who has to ask.
This is not a one man operation. The work is done by a team: an SEO strategist, a developer, a designer, a web design lead and an ad buyer, each doing the one thing they do full time rather than four things adequately.
What I do is decide what gets built and in what order, and I am the person on your call, including the call where the honest answer is that you do not need us yet.
Track record
This is not a new playbook we are testing on you.
Our team has spent years running patient reactivation, workshop funnels and paid campaigns for multi-location physical therapy groups. Not single clinics figuring it out. Practices operating twenty or more locations across multiple states, where a campaign that misfires is expensive and a campaign that lands has to be absorbed by a front desk that was not expecting it.
That experience is why the sequence on this site looks the way it does.
We have sent a single message to a dormant patient list and watched hundreds of replies come back in one morning. We have timed those campaigns to the end of the year, when deductibles are about to reset and patients have a concrete reason to come back now rather than in March. We have seen what happens next, when a practice that was quietly worried about next month's schedule suddenly cannot answer the phone fast enough.
We have filled workshops that turned into full plans of care. We have run ones that did not, and we know what the difference usually was.
And we have watched what consistent local presence does over a period of years. Practices reach a point where patients recognise the name before they ever search, and the owner stops asking whether there will be enough evaluations next week. That is not a campaign result. It is what accumulates when the work is done properly and does not stop.
None of it is complicated. Most practices simply never run it, or run it once and let it lapse.
How engagements run
We look at where you rank on a grid around your address, what your existing patient list actually contains, and where enquiries are being lost today. If the numbers do not support the work, we tell you that instead of selling you a retainer.
Almost every engagement opens with a reactivation campaign against your existing patients. It produces booked appointments in weeks rather than quarters, and it lets you judge us on results before committing to anything longer.
Patient Reactivation →Local search is the core of what we do. Map visibility, condition pages, reviews and the technical foundation underneath them. It is slower than a campaign and it is the part that keeps paying after you stop spending.
Local SEO →Monthly, in plain language, tied to booked patients rather than impressions. If a channel is not producing we say so and move the money, including when that means recommending less work rather than more.
What we actually move
Treat more patients. Get more from each one. Get them back more often. That is the entire list, and it has been the entire list for as long as anybody has sold anything. Most owners spend the whole budget on the first, because it is the loudest and it is what every agency sells. It is also the slowest and most expensive patient you will ever buy.
Local search so the people already looking can find you, and campaigns that reach the ones who have the problem and have not started searching yet. Then follow-up that answers within minutes, so the demand you already generate stops leaking away.
The lever almost nobody markets, and it is absolutely reachable. A workshop is the clearest example: an hour teaching forty people about the condition keeping them awake ends with a room that wants an evaluation, and what you offer at the end of that room decides whether they arrive expecting one visit or a full plan of care.
Same person, different value, decided before they ever sit down.
The largest asset in almost every practice is the list of everyone already discharged. Reaching them costs close to nothing, they already chose you once, and a meaningful share of them are in pain again right now and simply have not thought of you.
Where the line is, and what sits behind it
We cannot conduct the evaluation. Everything up to the treatment room door is ours.
What happens once a patient is in front of a clinician is yours, and any agency claiming otherwise is selling you something. But the idea that marketing only touches the first lever is wrong, and believing it is why most practices leave the two cheapest sources of growth completely untouched.
Behind the first month: twenty booked appointments in your first thirty days, or you get the $2,500 back and the engagement ends there. No notice period, no penalty, and you keep everything we built. It is conditional, because a guarantee claiming to be unconditional was written by somebody who does not intend to honour it, and the three things we need from you are published in full.
The version we would rather say out loud: if we cannot produce a result we both agree is fair to expect, we do not want the transaction.
How we operate
We will not take on your competitor. If we are working with a practice in your radius, we will tell you and decline, because there is no honest way to rank two clinics first for the same search.
Your site, your domain, your Google profile, your patient data, your ad accounts. Built under your ownership from day one so leaving costs you nothing but notice.
The one that matters most
We treat your patient data as patient data.
A reactivation campaign touches a list of people who received care from you. Call handling records what a patient said about their symptoms. A contact form asking what brings someone in is collecting protected health information the moment they answer.
Generic marketing tools are not built for any of that, and most vendors in this space will not sign an agreement acknowledging it. We build on infrastructure that will, we write review responses that never confirm somebody was your patient, and where something is a question for your counsel rather than for us, we say so plainly.
Where we work
We are based in Arlington, Virginia, and we work with practices across the country. Local search does not require us to be down the road from you. It requires knowing what your patients type and where they are standing when they type it.
Arlington, Alexandria, Fairfax, Falls Church and the surrounding Northern Virginia and DC market. This is where we are, where we meet clients in person when it helps, and where we know the competitive landscape first hand.
The work is delivered remotely and the results are measured locally, on a grid around your own address. Where you are matters enormously to your rankings and not at all to our ability to do the work.
Because we take a single clinic in any given radius, availability depends on your market rather than our calendar. Worth asking early if yours is competitive.
Thirty minutes, no pitch deck. Tell us what you have tried, what it cost and what happened, and we will tell you honestly whether we think we can do better.
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