Somebody asks the owner how many reviews the practice has, and she answers without looking it up. She watched the number climb for years, one patient at a time. She is not guessing. She is reading an instrument.
Then a friend pulls the practice up on her phone while they are standing there, and the number on the screen is smaller. Not slightly smaller. Several times smaller. Nothing has been deleted. The rest of it is attached to records pointing at a building the practice moved out of.
The Number She Quotes Is Not The Number They See
SQUAWKS has run a set of Revenue Pathway inspections. Exactly one was a med spa, so treat this as one finding rather than a survey of the industry. A version of this problem showed up in most of the businesses inspected, in trades with nothing else in common.
A review of a medical aesthetics practice found that the verified profile at the current address displayed a review count several times smaller than the counts shown on aggregator listings anchored to a former address, so the majority of the visible review equity was stranded on records tied to a location the business no longer occupies. A prospective patient could reasonably land on the verified profile, see a far thinner body of proof than the practice has actually earned, and choose a competitor that looks better reviewed at a glance. It was ranked a Critical Squawk.
Here is the part that surprises owners. A review is not attached to a business. It is attached to a record, a row in somebody else’s database, keyed to a name, an address, and a phone number. Change the address and the reviews do not move. A second row starts instead.
What The Number Actually Measures
An altimeter does not measure height above the ground. It measures air pressure, converted using a setting the pilot enters by hand. Fly into a different pressure system without updating that setting and the instrument keeps reporting an altitude with total confidence: no warning light, just a precise number quietly disagreeing with the world.
A review count is the same class of instrument. It looks exact, has no error bars, and is the one number in a service business an owner will recite from memory. But it is measured on a surface, so it reports what that surface knows rather than what the business earned. The owner reads hers off the surface she remembers building. The patient reads hers off whichever surface a search handed her.
Why The Proof Stays Behind
Nobody does this on purpose. A business signs a new lease, updates its profile, and considers the move done. A whole tier of the internet was never told. Directory sites and data suppliers built their own copy of the old record years ago and copy from each other, so many cannot be corrected until the listing is claimed, and claiming requires knowing it exists.
Two things favor the old record. Age: it has been cross-referenced by other records for years, telling a search engine the old entry is the real one, while the new profile has none of that behind it. And silence: a patient who lands on a stale record does not call to say the address is wrong. She reads a thinly reviewed practice and moves on, a failure with no complaint and no missing-appointment report, which is how it survives inside a business that is otherwise well run.
Test It Yourself
Search your practice name plus your old address, on a phone, signed out of everything you own. Compare the count you see against the one you would say out loud. If they disagree, you have just checked an instrument nobody has checked in years. If you have moved more than once or changed names, run the search for each version and write down what you find.
Reading The Result
Where the split lands matters because patients do not spread their reading around. NRC Health, reporting in April 2024 on a national study of United States healthcare consumers, found that roughly 85 percent of third-party reviews of healthcare providers sit on a single platform. Proof piles onto one or two records rather than spreading evenly, which is fine when those records are current and expensive when the pile sits on a record keyed to a suite number the business gave up. A thin count on the record a stranger actually reaches is not a fair read of the practice. It is a read of which record won the pile.
It Is Not A Med Spa Problem
It happens to any business whose identity is stored in more places than it can name. A review of a small independent hotel with an on-site restaurant found two separate listings for the same property on the same major review platform, a main listing holding the bulk of the property’s reviews and a duplicate holding one, sitting unclaimed. A guest could reasonably leave a review on the duplicate where almost nobody sees it, while the main listing ranks lower than a full history would have carried it. Same shape, different trade: proof gathering on a record the owner did not control.
What To Correct, And Roughly In What Order
None of this is expensive. It is tedious, which is worse, because tedious work never becomes urgent.
- Inventory before you touch anything. Search your business name, every past name variant, every old phone number, and every address you have operated from. Write down each record you find and who controls it.
- Claim what you did not create. Most records carrying your name were generated by a data supplier. Claiming is usually free, and it is what converts a listing you are subject to into one you own.
- Retire old records rather than ignoring them. A former address should be marked moved or closed and pointed at the current one. Left live, it competes with you for your own search.
- Fix upstream, then downstream. Directory sites copy from a small number of data suppliers, so correcting the supplier stops the bad record from regrowing.
- Then rebuild the count on purpose. Once a stranger lands on the right record, asking recent happy patients for a review compounds where it counts.
Set a date once a year to run the inventory again. Records drift and suppliers merge.
The Part Nobody Can Put A Number On
No article and no inspection can promise a dollar figure. Anybody who tells you that cleaning up a set of listings produces a specific amount of new revenue is guessing with your money. Your market, your competitors, your capacity, and how much proof you had to begin with decide what a correction is worth, and none of that is visible from outside.
The research supports something narrower, with its own caution attached. A systematic review of 63 studies published in the Journal of Medical Internet Research in 2019 found that patient reviews skew positive, with a median rating of 4 out of 5, and track patient satisfaction measures closely while correlating only weakly with clinical outcomes such as mortality. A review count measures visible satisfaction gathered on one record, which is exactly why it can be split, stranded, and lost.
Start With The Search You Have Been Avoiding
A second set of eyes on it costs nothing. The SQUAWKS Walkaround reads your practice from the outside the way a first-time patient reads it, and you get a plain account of what we found. You can book a free Walkaround in a couple of minutes, and the full Med Spa Revenue Pathway inspection ranks every finding so the worst of it gets corrected first.
Questions go to hello@thesquawks.com or 407-584-7830. SQUAWKS is Orlando based and works with businesses nationwide.