Tag health

Big tech is strangling small health businesses – & calling it quality control

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Opinion. The facts cited are sourced. The conclusions are my own.

Something is happening to small complementary and integrative health businesses across Australia, the United States, and beyond — and it is not being talked about loudly enough.

Practitioners who have spent decades studying, building expertise, accumulating clinical experience, and creating genuinely useful health content are watching their businesses collapse. Not because they have done anything wrong. Not because their information is inaccurate. Not because the people they serve don’t value what they offer.

Because Google decided they shouldn’t be found.

I am one of those practitioners. I have been a functional nutritionist for nearly a decade, working with women navigating complex, unresolved chronic health conditions — the kind conventional medicine may dismisses or can’t explain. My business was built on Google search traffic. Then Google changed the rules. And I have a very specific problem with how that change is being framed.

This is not a new pattern

Before examining what has happened in recent years, it is worth understanding that Google’s tendency to use its platform power in ways that benefit pharmaceutical interests is not new.

In 2010, TechNewsWorld reported on Google’s sudden change to its AdWords policy for online pharmacies — switching from PharmacyChecker as its validation standard to the NABP’s VIPPS programme. The effect was to immediately disqualify hundreds of legitimate online pharmacies that helped consumers access affordable medications from overseas, while exclusively approving large institutional pharmacies — CVS, Walgreens, Aetna, Caremark.

Gabriel Levitt, Vice President of PharmacyChecker, said at the time: “If you look at all the media reports, if you look at all the activities of the NABP, of groups obviously funded by the pharmaceutical industry, you see they’ve been putting pressure on the search engines in ways that would benefit the big companies’ interests, which is prices.”

When asked directly whether pharmaceutical companies had pressured Google into changing its policy, Google declined to explain its reasoning. “We’re unable to share anything more beyond that,” a spokesperson said.

The pattern established then — algorithmic policy changes that benefit large pharmaceutical interests at the expense of smaller operators, with no explanation and no appeal — has been playing out at an accelerating pace ever since.

Google is not a neutral platform

In August 2024, a US federal judge ruled that Google had violated Section 2 of the Sherman Antitrust Act — finding the company had illegally maintained a monopoly in search and related advertising. This was not a close call. It was a 277-page opinion following a nine-week trial.

Central to that monopoly: Google pays Apple approximately $20 billion annually to remain the default search engine on every iPhone, iPad, Mac, and Safari browser. This was revealed under oath during the 2023 antitrust trial.

Twenty billion dollars a year — to ensure that when people search for health information, it is Google that decides what they find.

This is not a neutral arbiter of information quality. This is a company found guilty of operating an illegal monopoly, that has positioned itself as the gatekeeper of what health information reaches the public.

Google’s financial relationship with pharmaceutical medicine

Google’s relationship with pharmaceutical medicine extends far beyond advertising.

CB Insights has documented that Google — through its parent company Alphabet and its pharma-focused ventures Verily Life Sciences, Calico Life Sciences, and Isomorphic Labs — has made over 90 investments in the pharmaceutical sector in recent years. Google and Sanofi announced a joint venture drug discovery collaboration. Four major pharmaceutical companies signed onto Verily’s Project Baseline. Google’s Project Nightingale reportedly gathered health data from millions of patients within Ascension’s health network without their knowledge — raising profound questions about who ultimately benefits from that data.

On the advertising side, the US healthcare and pharmaceutical industry was projected to spend approximately $19.66 billion on digital advertising by end of 2024 — with Google as the primary platform.

Google is not merely a search engine that occasionally carries pharmaceutical advertising. Google is a direct financial participant in pharmaceutical medicine — with investments, partnerships, joint ventures, and advertising relationships that create a profound structural alignment of financial interests between Google and the conventional pharmaceutical industry.

This context is essential when evaluating whose health information Google’s algorithm elevates — and whose it suppresses.

The algorithm changes & what they actually did

2019 — the first significant hit

In 2019, Google rolled out an algorithm update that removed many natural health and health freedom websites from organic search results — with some sites losing as much as 99% of their traffic. The sites most affected were disproportionately those offering health perspectives that diverged from conventional pharmaceutical medicine.

My website traffic dropped 42% with this change.

2024 & 2025 — the sustained assault

Google’s March 2024 and subsequent core updates devastated the broader health and wellness sector under the banner of the E-E-A-T framework — Experience, Expertise, Authoritativeness, and Trustworthiness.

On paper this sounds reasonable. In practice, it functions as a credential filter that systematically elevates institutionally affiliated medical sources — hospitals, pharmaceutical-funded medical journals, government health bodies — while suppressing independent practitioners regardless of their actual expertise or clinical outcomes.

67% of health sites were significantly affected. Recovery timelines run 6-12 months — considerably longer than any other industry. For small independent practices that depend on search traffic for client acquisition, a 6-12 month revenue loss is not a disruption. It is an existential event.

A practitioner with 20 years of clinical experience, personally recovered from the conditions they treat, with extraordinary documented client outcomes — is algorithmically ranked below a pharmaceutical company’s health information page. Not because the pharmaceutical company’s information is better. Because it has institutional affiliation. Because it has the right kind of credentials in Google’s framework. Because, one might reasonably infer, it spends significantly on Google advertising.

This is not quality control. This is market protection.

Then came AI overviews — the final blow

If the algorithm changes represented a slow squeeze on complementary health practitioners, Google’s rollout of AI Overviews has been the accelerant.

AI Overviews are AI-generated summaries that appear at the top of Google search results, providing a direct answer to the query without requiring the user to click through to any website. The traffic that previously went to independent health websites now stays on Google’s page.

The data on this is stark:

When AI Overviews are present, click-through rates drop to just 8% — compared to 15% for traditional search results. Organic click-through rates for informational queries have fallen 61% since mid-2024. Paid click-through rates on the same queries have fallen 68% — meaning even advertising is being undermined. 60% of all Google searches now end without any click to any website at all.

Health is the sector most comprehensively targeted. In information-driven health queries, up to 67.5% are now answered directly by AI — meaning the vast majority of health searches no longer send anyone to a website. Informational health content is experiencing 40-70% traffic drops as AI answers are deemed “good enough.”

And who does the AI draw its answers from? Institutionally credentialled medical sources. The same sources Google’s algorithm already favoured. The same industry with which Google has tens of billions of dollars in financial relationships.

The irony is not subtle. Google has built an AI that answers health questions — drawing on the institutional medical sources its algorithm has spent years elevating — and in doing so has rendered independent health websites largely invisible. The circle is complete.

Meta is doing the same thing

Google is not acting alone.

Meta — the owner of Facebook and Instagram — has implemented health content restrictions that have decimated organic reach for complementary health practitioners on social media. Posts that were reaching thousands of engaged followers organically a few years ago now reach dozens. The algorithm suppresses health content that doesn’t align with mainstream medical consensus.

The advertising picture is equally revealing. From January 2024, Google expanded its healthcare and medicines policy to treat all health-related advertising with the same restrictions as pharmaceutical advertising — requiring certification and compliance with stringent content policies that pharmaceutical companies can navigate easily but independent practitioners often cannot.

The result: organic reach is throttled. Advertising is restricted or prohibitively expensive. The health information that flows freely on these platforms is the health information that aligns with their largest pharmaceutical and medical advertisers. Everything else is algorithmically invisible.

The qualifications argument doesn’t hold

The standard defence of these changes is quality — that Google is simply elevating credentialled, evidence-based health information over misinformation.

This argument collapses quickly.

The practitioners most affected are not conspiracy theorists or misinformation spreaders. They are degree-qualified nutritionists, naturopaths, functional medicine practitioners, and integrative health specialists — many with postgraduate qualifications, professional registrations, and decades of documented clinical experience.

What Google’s algorithm rewards is not expertise. It rewards institutional alignment. A GP with a six-minute appointment and a prescription pad algorithmically outranks a functional nutritionist with 20 years of clinical experience — not because the GP’s information is more helpful, but because the GP has the right institutional affiliation.

Furthermore, in a particularly revealing asymmetry, a Harvard Kennedy School study found that Google simultaneously allowed alternative cancer clinics providing scientifically unsupported cancer treatments to spend millions on targeted advertising to vulnerable cancer patients — while applying stringent restrictions to qualified independent health practitioners advertising legitimate services.

The enforcement is selective. The direction of that selectivity is consistent.

Who is actually being harmed

The people who lose access to independent complementary health practitioners are not people with plentiful conventional alternatives. They are people who have already been through the conventional system. People whose tests came back normal when they felt far from well. People navigating complex, overlapping conditions that may not respond to pharmaceutical treatment protocols.

These are the people most in need of alternative information and perspectives — and these are precisely the people whose access is being algorithmically restricted. Directed back, again and again, to the institutional sources that have already failed to help them.

This is not a theoretical harm. It is happening to real practitioners and real patients, every day, across Australia and globally.

If you want that independent, holistic and science/research-based practitioner who listens, cares and works hard to provide their clients with personalised support that can complement allopathic medicine, then support them. Like their social media posts and comment on them, spread the word that they do exist, use alternatives to google, and give them business as appropriate.

The bigger pattern

What is happening in health is not isolated.

Big tech platforms are systematically suppressing content that competes with the interests of their largest advertisers and financial partners. In health, that means pharmaceutical medicine. In news, that means legacy media. In finance, that means institutional investment. The pattern is consistent: use algorithmic authority to define what counts as legitimate and worthy of amplification — and define it in ways that happen to align with the financial interests of the largest players in each sector.

A federal court found Google’s search monopoly illegal. The remedy imposed barely scratches the surface. Google continues to pay for preferential placement, continues to operate its pharmaceutical investment portfolio, continues to deploy AI that answers health questions from institutional sources while rendering independent health websites invisible.

And it does all of this while describing the exercise as quality control.

What I am asking for

Not immunity from scrutiny. Not the right to spread misinformation.

Honesty about what these changes actually are.

They are not neutral quality filters. They are the exercise of monopoly power — found illegal by a federal court — in the financial interests of the monopoly’s largest partners. The pattern goes back at least to 2010, when Google changed its pharmacy advertising policy in ways that benefited large pharmaceutical companies at the expense of smaller legitimate operators — and declined to explain why.

The practitioners being suppressed are largely qualified, genuinely expert, and serving populations that conventional medicine has failed. Framing their algorithmic erasure as a quality improvement exercise is not honest.

And the public — including the patients who can no longer find the practitioners who might actually help them — deserve to ask a simple question: when a company with a documented illegal monopoly and tens of billions of dollars in financial relationships with pharmaceutical medicine makes decisions about whose health information reaches the world, who does that serve?

We deserve choice, and to make our own informed decisions.

Follow the money. It leads somewhere very specific.

Nore Hoogstad is an author, as well as a Functional Nutritionist and Psych-K Practitioner based on the Sunshine Coast, Australia. She writes about health, systems, and the structures that shape both at writingnore.com. Her clinical practice is at gutsybynutrition.com.au.

Sources

  • TechNewsWorld, Renay San Miguel: “Has Google Cut a Backroom Deal With Big Pharma?” February 2010 — technewsworld.com
  • US v Google LLC antitrust ruling, Judge Amit Mehta, August 2024 (Sherman Antitrust Act Section 2 violation)
  • Google antitrust remedies order, Judge Amit Mehta, September 2025
  • Google-Apple payment of approximately $20 billion annually — testimony, US antitrust trial, 2023
  • CB Insights: “Big Tech Is Coming For Pharma” (2019) — Google-Sanofi joint venture, Project Nightingale, Verily Project Baseline
  • CB Insights: “Analyzing Google’s pharma strategy” (2022) — 90+ pharmaceutical investments
  • Statista: US healthcare & pharmaceutical digital advertising projected at $19.66 billion by end 2024
  • Seer Interactive: AI Overviews Impact on Google CTR, September 2025 — 61% organic CTR decline, 68% paid CTR decline
  • Pew Research: CTR of 8% with AI Overviews vs 15% without
  • Evergreen Media / Semrush: health queries trigger AI Overviews in up to 67.5% of searches
  • BrightEdge: 30% decline in organic clicks since AI Overviews launch
  • Harvard Kennedy School Misinformation Review: Google allowing alternative cancer clinics to target vulnerable patients via paid search, 2025
  • Matchnode: Google healthcare and medicines advertising policy expansion, January 2024

After the storm in the Sunny Coast

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Most nights from my 3rd-storey bedroom window in my semi-rural Sunshine Coast home, I look out and see a strangely long and exceedingly bright star. Except it isn’t a star – it’s reputedly Elon Musk’s satellite.

From the moment I learned this I felt watched over, as if I didn’t already know that feeling from the devices and apps I’m aware track my movements, opinions, conversations, shopping habits and more.

So it was interesting when a surprise storm hit my little town with winds of 150+ km per hour, felling entire trees, launching our balcony furniture 200 metres away into a neighbour’s yard, peeling our roof back, and picking up my large potted tree and dumping it 10 metres away as though it was flotsam.

I was out at a local appointment, and once the lightning stopped began to make my way through the debris, scattered shop signs and collapsed trees blocking the roads. My husband said at one point our windows were so buckled inwards with the force of the wind that he was certain they would give way. (Oh the irony after all our preparations earlier this year with the massive cyclone that never eventuated.)

Once the wind and rain had subsided, we began cleaning up the mess.

But it’s a different aftermath that was perhaps more disturbing. 

We lost power, NBN and all communications for two days in my street, others for one or three days. 

My first thought was how unsafe I felt without a phone, radio or satellite to use in an emergency or just to check if my nearby family were safe. Unless you have a satellite, everything else is digital these days, so when the network goes, everything goes. How vulnerable we’ve made ourselves.

My second thought was that because I work 100% online I was unable do that, or in other words, I couldn’t earn a living. I had to drive half and hour away to cancel and rebook consults. Not much of a disaster in the scheme of things, but given so many of us work from home I understood how this could become a greater problem in the future. 

This leads me to my third realisation, which was that more frequent and unexpected weather events is the new normal, and that I needed to be more prepared. Climate change is real now, and I need a sat phone, better emergency rations and cooking gear. We already have a solar battery, which kept our lights on and food cold, plenty of stored water, and I have a first aid kit and updated training.

And then, somewhat shamefully – and even more alarming – was the observation of how irritable, bored and empty I felt after 12 hours of not having instant access to everything I normally entertained and calmed myself with, from social media, games and streaming to the ability to message my family and friends. 

How had I lived happily for years without these props and fillers? How had a shared free-to-air TV, books, pen and paper, music, a landline, and the odd hobby ever been enough?

While this seems petty given the bigger issues of climate change, safety and my ability to earn money, the loss of communications brought home to me how modern technology had changed my brain. I was ashamed to admit that I too had become addicted, craving the next dopamine hit, and using it as a crutch to fill my quieter moments and block out the the stuff of life I’d rather not face.

So what is missing from my life that I was drawn to this addiction? What must I now rebuild and replenish?

I thought about this long and hard and decided that for me, creativity is the antithesis and antidote to the mind-numbing hypnosis of modern technology. Instant entertainment is self-fulfilling vicious cycle that numbs me out while making me want more of it to rouse my emotions and lift me up again. My former overuse is a pleasure-seeking road to hollowness. We cannot eat sugar all day and expect no consequences.

I’m already reading more books, I’m planning my next novel and restarting this blog (without the use of AI), I don’t check my social media often. In fact, I’m toying with getting rid of my social media accounts altogether but … business. I also ensure I sit in silence for 10 minutes every day, walk more without my phone, and if I feel bored, I welcome it and see what revelation or idea might surface.

What about you and our instant online life?

Remember the Nuremberg Code

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  1. The voluntary consent of the human subject is absolutely essential.
    This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved, as to enable him to make an understanding and enlightened decision. This latter element requires that, before the acceptance of an affirmative decision by the experimental subject, there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person, which may possibly come from his participation in the experiment. 
    The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs or engages in the experiment. It is a personal duty and responsibility which may not be delegated to another with impunity.
  2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
  3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study, that the anticipated results will justify the performance of the experiment.
  4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
  5. No experiment should be conducted, where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the
    experimental physicians also serve as subjects.
  6. The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.
  7. Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.
  8. The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
  9. During the course of the experiment, the human subject should be at liberty to bring the experiment to an end, if he has reached the physical or mental state, where continuation of the experiment seemed to him to be impossible.
  10. During the course of the experiment, the scientist in charge must be prepared to terminate the experiment at any stage, if he has probable cause to believe, in the exercise of the good faith, superior skill and careful judgement required of him, that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.

[“Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10”, Vol. 2, pp. 181-182. Washington, D.C.: U.S. Government Printing Office, 1949.]