Comparison
Your SEO agency is not doing this.
That is not a criticism. Ranking a page and being named in an AI answer are different jobs with almost no shared inputs — and most operators are only buying one of them.
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Here are some well-reviewed options:
- 1 Skin Society
- 2 Ageless Aesthetics
- 3 Radiance Med Spa
- 4 Viva Day Spa
- 5 Bella Vita Medical
Your site could rank first on Google for this exact phrase and still not appear here.
The short version
Ranking is a position. Being named is a list of five.
Search engines return ten blue links and you climb toward the top of them. AI assistants return one to five business names. There is no position eleven and no second page — you are in the set or you are not mentioned at all.
That changes where the work happens. Google reads your website. AI assistants resolve local recommendations from Business Profile, Bing Places, Foursquare, Yelp and review platforms, then rank what they find by review quality and recency. Brands are roughly six and a half times more likely to be cited via third-party sources than their own domain.
So a retainer spent entirely on-site can be executed perfectly and still leave you absent from every answer your patients actually see.
Where the two diverge
Line by line
Not a criticism of SEO — it still matters. These are simply different jobs, and most operators are only buying one of them.
| Traditional SEO agency | First Five | |
|---|---|---|
| Engines covered | ChatGPT, Gemini, Perplexity, Copilot | |
| Where the work happens | Almost entirely on your website | Roughly four fifths off it, where citations come from |
| What success looks like | A position on page one | Being named in a list of five |
| Primary data source | Google Search Console | Business Profile, Bing Places, Foursquare, Yelp, review platforms |
| How reviews are treated | Reputation management | A primary input to whether you get named |
| Monthly deliverable | A traffic report | A score, a per-engine breakdown, and a citation source map |
| When you are not cited | No visibility into why | The exact source that produced a competitor mention instead |
| What compounds | Rankings reset with each core update | Presence in the sources engines read |
Every row above is checkable. If your current agency covers a row we have marked, tell us and we will correct it.
Four engines, four indexes
Optimising for Google covers one of them.
| Engine | Resolves through | Covered by classic SEO? |
|---|---|---|
| ChatGPT | Bing · Foursquare · Yelp | No |
| Gemini / AI Overviews | Google · Business Profile | Partly |
| Perplexity | Own index · Reddit | No |
| Copilot | Bing · editorial | No |
When you should not hire us
If you run a single location, if you need results inside ninety days, or if your Google Business Profile and reviews are already immaculate and you simply want more blog content — an SEO agency is the better spend, and we will tell you so on the call.
We are the right call when you operate several locations, your acquisition cost is rising, and nobody can tell you whether AI is recommending you or your competitor.
Common questions
On working alongside your current agency
How is this different from SEO?
Traditional SEO gets a page ranked. This gets a business named. The inputs barely overlap — most of the work sits in directories, review platforms, community discussion and editorial coverage rather than on your site.
Do we need to leave our current agency?
No. Most of our clients keep theirs. The work is largely complementary, and we will tell you directly if we think the two overlap enough that you are paying twice.
What if our website is out of date?
It matters less than you would think. Most of what determines whether an engine names you sits outside your site. We will flag genuine website blockers — missing structured data, blocked AI crawlers — but a redesign is rarely the fastest path to a better score.
Be the practice AI gets named
Before switching anything, get the number. If your current agency has this covered, the audit will show it.
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