Ask HN: Is it worth paying $6k/month for an SEO agency?

I'm part of an offline healthcare provider specializing in a procedure pioneered by our founding doctors. For the past six months, we've been paying an SEO agency $6,000 per month to increase awareness of this new procedure and help reach more patients. However, we're not sure if it's worth the investment. (We've looked at other SEO agencies, and the minimum cost seems to be around $3,000 per month.) From what we've observed, SEO agencies seem to focus on 3-4 main areas: 1. On-page optimization (HTML/JS improvements which our team can handle with WordPress/Yoast) 2. Keyword analysis 3. Content writing 4. Getting backlinks The SEO agency has been boasting about the backlinks they're getting us from their "partner" websites with high domain authority scores, and we know that backlinks are important for SEO. Maybe it's just us being used to medical journals and such, but the websites providing these backlinks look quite spammy to