Every quarter we get a panicked email: "Botox bookings dropped 30% — what did Google do?" In ~80% of cases, Google did nothing. Run these six checks before you spend a dime on a fix.
1. Is it seasonal?
Med spa demand is shockingly seasonal. January spikes (resolutions), February dips, May–June spikes (wedding/summer), September dips. Pull a 24-month booking chart before assuming anything is "broken."
2. Did a competitor open within 3 miles?
A new med spa with aggressive opening promotions can pull 15–25% of local Botox demand in their first quarter. Check Google Maps for new pins in your service area in the last 90 days.
3. Did your reviews stall?
Google's local algorithm weights review velocity heavily. If you went from 6 reviews/month to 1 review/month, your map ranking will quietly slide over 30–60 days even though "nothing changed."
4. Is your tracking actually tracking?
We've seen "30% booking drops" that were really 30% tracking drops — a website redesign broke the conversion event, or GA4 stopped firing. Verify your conversion is still firing in real-time before reacting to data.
5. Did your GBP categories change?
Sometimes a staff member "cleans up" GBP and removes secondary categories or service-area cities. Check the GBP audit log for the last 90 days.
6. Is the SERP itself different?
Google occasionally inserts a Local Pack expansion, a featured snippet, or a Reddit result above the maps. Your ranking may be unchanged but your visibility cut in half. Manually search your top 5 queries from an incognito browser in your city and screenshot the SERP.
Once you've answered these six, you'll usually know whether the fix is operational, competitive, or actually SEO. We run this exact diagnostic on every audit — happy to do yours for free.