The businesses winning in AI search are not the ones with the best reviews or the best clinical outcomes. They are the ones with the most disciplined review infrastructure. This report shows exactly what that looks like and where the gaps are in your market.
Sixty-nine percent of independent med spas in the US average 4.9 stars or higher. The top quartile and the bottom quartile of this study are nearly identical on star rating (4.93 vs. 4.87), sentiment, and review specificity. They are dramatically different on one thing: whether the owner shows up to manage the practice's review record at all.
The businesses winning in AI search are not better practices. They are more operationally present ones. Zero businesses in the top quartile respond to 0% of their reviews. Seven businesses in the bottom quartile do. That is the finding.
A business can rank in the top 20 nationally while its reputation is quietly deteriorating.
One business in this study holds a 4.5 star rating and ranks top 20 on composite AI Visibility Score. Its sentiment score is the lowest in the study at 6.1 out of 10, and its negative review rate is 12%, nearly six times the national mean of 2.1%. Star ratings mask what AI engines actually read.
Review volume, velocity, star ratings, and response rates across 131 businesses. This is the baseline your practice is competing against.
What the 33 highest-visibility practices have in common that the 33 lowest-visibility ones don't. The answer is not what most owners expect.
How review content, staff names, and service mentions function as AI search signals and which ones matter most right now.
City-level data for 12 US markets: Boston, Nashville, Atlanta, Denver, Dallas, Seattle, San Diego, Chicago, Scottsdale, Charlotte, Minneapolis, Kansas City.
The five operational gaps appearing in every market, with national data quantifying each one.
The composite scoring model across six dimensions, with component weights and what moving each lever does to overall visibility.
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