Is it Slow Season, Or Did Something Break?

What's Actually Happening?

Short answer: it might be both.

January and February are genuinely softer for a lot of practices. That's real, and it's not worth panicking over a slow week in the middle of winter. But here's the thing. Seasonality is also the explanation people reach for first because it requires nothing. The algorithm changes require work. So before you chalk it up to February and move on, it's worth spending two minutes ruling it out.

Pull your Google Business Profile data. Look at calls from this month last year, same period. If you're down 8-10%, that's probably seasonal noise. If you're down 20% or more year-over-year in the same window, something else changed and it's not the weather.

Google: You're Ranking for an Audience That Isn't Seeing You

AI Overviews Moved In Above the Map Pack

When someone searches "Botox near me" or "best medspa in [city]" today, there's a good chance the first thing they see isn't your Google Business Profile at all. It's an AI-generated summary, pulling from your website, your reviews, Yelp, Reddit, Instagram, wherever Google can find you.

The traditional 3-pack is still there. It's just no longer first.

Here's what makes this painful: only a fraction of businesses show up in those AI summaries. You can rank in position one and still not appear. And because most rank trackers don't even measure AI results yet, your reporting looks fine while your practice sees a tumble weed go by.

What to do:

• Build a real FAQ page on your website. Not for SEO. For the AI. Write it the way a patient would actually ask.
• Add FAQ schema markup - this tells Google's systems exactly where your answers are
• Make sure every field on your Google Business Profile is complete, current, and detailed.

Google Removed the Q&A Section And Replaced It With a Guessing Machine

On November 3, 2025, Google officially killed the Q&A feature on Business Profiles. In its place, Google's AI now generates answers to patient questions by scanning everything it can find about you.

If that information is incomplete, outdated, or inconsistent across platforms, the AI fills in the gaps itself. Sometimes it gets it wrong.

What to do:

• Take every Q&A you had seeded on your profile and move it to a FAQ page on your website
• Write it in plain, conversational English - the AI weights human-sounding content higher
• Use the Posts feature inside your Google Business Profile for promotions, events, and new services

Rankings Are Holding. Calls Are Not.

New data shows that Google Business Profile actions - calls, website clicks, and direction requests - are falling disproportionately compared to impressions. Practices are still being "seen." Patients just aren't doing anything about it.

The reason: AI local packs are surfacing only 32% as many unique businesses as traditional map packs. In 88% of markets studied, the total number of visible businesses declined.

What to do:

• Stop using rank as your primary metric. Track calls, DMs, booking requests, and actual revenue
• Post updates on your GBP regularly. Freshness is a visibility signal.
• Ask patients for detailed reviews that mention specific treatments, concerns, and outcomes.

Meta: The Algorithm Changed Its Mind About What Works

Instagram Didn't Kill Reels. It Just Wants More Than Reels.

Instagram's algorithm shifted the weight it places on different content types and educational carousels are now outperforming basic short-form Reels in certain discovery contexts.

The signal the algorithm now rewards most: saves and shares. Not views, not likes. A Reel with 10,000 views and no saves will reach fewer people next time. A carousel with 800 views and 200 saves will.

What to do:

• Build a content mix: Reels for reach and initial hook, carousels for depth and saves
• Make educational content the backbone
• Pair them: post a Reel, then the carousel that goes deeper on the same topic

Facebook Organic Is Gone. Stop Waiting for It to Come Back.

Facebook's algorithm now prioritizes content from friends and family above everything else. Business page posts simply don't get seen unless they generate immediate, strong engagement or you pay to boost them.

What to do:

• Boost the posts that matter: events, offers, new service launches
• Build a Facebook Group for your patient community
• Start thinking of Facebook as a retention and community tool, not a discovery one

The Ad Algorithm Changed. Your Targeting Settings Are No Longer the Point.

Meta's ad delivery system is now powered by Andromeda. The old system worked by matching your ad to the audience you defined. Andromeda flips that. Now the algorithm reads your creative and uses that to find the right person. Your audience settings have become a starting suggestion, not a boundary.

What to do:

• Switch to broad targeting and let the algorithm do the matching
• Build a library of genuinely different creative: different hooks, different formats, different angles
• Refresh creative every 2-4 weeks. Andromeda penalizes fatigue faster than the old system did.

What This Means for Your Practice

Patients are making decisions before they ever contact you. They see an AI summary on Google before they click your listing. They find you on Instagram and decide whether to trust you based on 8 seconds of content.

The practices winning right now aren't spending the most. They're just the easiest to trust.

Where to Start This Week

Pick two, not all six. Ship them before the next edition.

1. Write your FAQ page. Ten questions, plain English, FAQ schema markup.
2. Audit your GBP. Every field complete, photos current, description detailed.
3. Ask three recent patients for detailed reviews.
4. Post one educational carousel this week.
5. Check your Meta ads. Test a broad campaign with three different creative variants.
6. Cross-post your best Instagram content to Threads.

How Opaline Fits In

When someone finds you on Google, Instagram, or a friend's recommendation, the quiz gives them a path from "I'm curious about this" to "I know what I need and I'm ready to book." In a world where AI is mediating the first impression, giving patients a guided experience you control is the clearest competitive advantage available right now.

The Bottom Line

The platforms optimized for AI. Most medspa marketing hasn't caught up yet.

That gap is the opportunity.

Until next time.

Lotti