Reviews occupy an unusual position in clinic discovery: they are simultaneously a stated ranking input, a conversion input, a regulated communication and a clinical confidentiality problem. Each needs handling separately.
What is actually stated
Google's help documentation on improving local ranking states that review count and score factor into local ranking. It does not publish a weighting, a threshold or a decay curve. Everything beyond that statement, including the frequently quoted figures about how many reviews a business needs, is inference.
Numbers circulate about the review count needed to compete, the rating below which enquiries stop, and the age at which a review stops counting. None of these is published by any platform. They come from third-party analyses with undisclosed samples or from surveys of opinion. Describe the mechanism instead: more recent, more numerous, more specific reviews give both systems and people more to work with.
The effect that is easier to see
Being shown and being chosen are different outcomes. A listing with a strong recent review record is more likely to be selected from a set of three than one with a handful of reviews from 2021. This effect is visible in your own data: the profile insights show how many people called or clicked through, and changes there are more attributable than movements in ranking.
For a clinic this is usually where the money is. Improving from fourth to third in a pack is worth less than being the listing people pick once they see all three.
Review platforms
PARTIAL CONTROL- Whether you ask, when you ask and how easy you make it
- Whether every review gets a reply, and how fast
- The accuracy of the profile the reviews are attached to
- What a patient writes, or the score they leave
- Whether a platform removes a review you report
- Which review platform a searcher happens to trust
- Track review count and mean rating by month, not as a single lifetime figure
- Record response rate and median response time
- Read the last twenty reviews for the words patients actually use
Asking, within the rules
Platform policies govern how reviews may be solicited. Google's guidelines prohibit incentivised reviews and review gating, which means you may not offer a benefit in exchange for a review and you may not selectively ask only the patients you expect to be positive. In the UK, the ASA and consumer protection rules also apply to reviews used in marketing.
A compliant process is simple: ask everyone, at the same point in the journey, in the same way, with no incentive and no filtering. Consistency is what makes it both compliant and measurable.
A process that works in a clinic
- Choose one moment: typically after a follow-up appointment, when the outcome is known.
- Use one channel consistently, usually a message with a direct link to the review form.
- Ask once, with one reminder at most.
- Do not screen. Do not offer anything. Do not write it for them.
- Record how many requests were sent and how many reviews resulted, so you can see the rate.
- Reply to every review, positive or negative, within a few working days.
The confidentiality constraint
Clinics cannot reply the way a restaurant can. Confirming that someone was a patient, referring to their treatment, or correcting their account of it in public can breach confidentiality obligations that apply to registered practitioners regardless of what the patient said first. The GMC standards govern this for registered doctors, and equivalent obligations apply across regulated professions.
This is covered in detail in the companion article on responding to reviews. The short form: reply warmly, acknowledge the concern, do not confirm or discuss any clinical detail, and move the conversation to a private channel.
Negative reviews
A profile of only five star reviews reads as curated, and patients discount it. A small proportion of critical reviews, answered well, is more persuasive than perfection. The measurable harm from a negative review comes from leaving it unanswered, because the reply is the only part of the exchange you write.
Where a review breaches platform policy, report it through the platform's process. Expect a low success rate and treat removal as a bonus rather than a plan.
Which platforms matter
The Business Profile is the primary one because it feeds the local surface directly. Beyond that, the platforms that matter are the ones that rank for your branded query and the ones your patients actually use, which is a sector-specific and locally variable question. Search your own clinic name and see which review profiles appear: those are your platforms, whether or not you chose them.
Measuring reviews properly
| Metric | Period | Why |
|---|---|---|
| New reviews | Monthly | Recency is what changes; lifetime totals hide it |
| Mean rating of new reviews | Monthly | The lifetime average moves too slowly to inform anything |
| Response rate | Monthly | The part you control entirely |
| Median response time | Monthly | Visible to every reader of the profile |
| Requests sent | Monthly | Converts the outcome into a process you can adjust |
| Themes in review text | Quarterly | The words patients use are content research |
Reviews as research
Read the last twenty reviews and write down the words patients use for treatments, for their concerns and for what they valued. That vocabulary belongs in your page headings and your services list, because it is the language people actually search with, gathered from the only source that has no incentive to guess.
Where the request belongs in the journey
The moment you choose changes both the volume and the content of what you receive. Asking at the end of the first appointment produces reviews about the consultation and the reception experience. Asking at the follow-up produces reviews about the outcome, which are more useful to a future patient and harder to obtain because they require the follow-up to happen.
Whichever moment is chosen, it has to be the same for everyone. A process that asks some patients at one point and others at another is not a process, and it cannot be measured because the population changes every month.
Making it survive a busy week
Review programmes fail operationally rather than strategically. They are set up, they work for six weeks, and then a busy period arrives and nobody sends the messages. Two things prevent that: assign the task to a role rather than a person, and automate the send so that the default state is that it happens. Then measure requests sent as well as reviews received, because a fall in reviews is ambiguous and a fall in requests is not.