While Google never sells better ranking in our search results, several other search engines combine pay-per-click or pay-for-inclusion results with their regular web search results. Some SEOs will promise to rank you highly in search engines, but place you in the advertising section rather than in the search results. A few SEOs will even change their bid prices in real time to create the illusion that they "control" other search engines and can place themselves in the slot of their choice. This scam doesn't work with Google because our advertising is clearly labeled and separated from our search results, but be sure to ask any SEO you're considering which fees go toward permanent inclusion and which apply toward temporary advertising.
Google expects pages to “be edited, reviewed, and updated on a regular basis” especially if they are for important issues like medical information, and states not all pages are held to such standards, but one can expect that Google wants information updated in a reasonable timescale. How reasonable this is, is dependent on the TOPIC and the PURPOSE of the web page RELATIVE to competing pages on the web.
QUOTE: “Medium pages achieve their purpose and have neither high nor low expertise, authoritativeness, and trustworthiness. However, Medium pages lack the characteristics that would support a higher quality rating. Occasionally, you will find a page with a mix of high and low quality characteristics. In those cases, the best page quality rating may be Medium.” Google Quality Evaluator Guidelines, 2017
While SEOs can provide clients with valuable services, some unethical SEOs have given the industry a black eye by using overly aggressive marketing efforts and attempting to manipulate search engine results in unfair ways. Practices that violate our guidelines may result in a negative adjustment of your site's presence in Google, or even the removal of your site from our index.