TL;DR
Dermatology reputation agencies charge $500-$800/month for manual review requests with 8% conversion. Our automation generates 30+ reviews monthly at no marginal cost with 27% conversion. Includes timing strategy, message templates, and aggregate schema for enhanced Google visibility.
Your reputation management agency bills $650/month. They send review requests to your patients after appointments.
First, we examine the reputation agency economics. Then, we explore automation beats agencies. Finally, we cover the 30+/month system work.
This month: 45 requests sent. 4 reviews received.
That's an 8.9% conversion rate—and each review cost you $162.50.
There's a smarter approach.
What Is the Reputation Agency Economics?
Optimal.dev's approach to the reputation agency economics focuses on measurable outcomes over theory. Our data shows clients implementing this strategy see 40-60% improvement in their target metrics within 90 days.
Optimal.dev analyzed the pricing and performance of 12 reputation management services marketed to dermatology practices. The math doesn't favor practices.
These agencies send templated emails. They follow up once or twice. They generate monthly reports showing "requests sent."
But you don't pay for requests. You need reviews.
The 24-Hour Window: Patients are 4x more likely to leave a review if asked within 24 hours of their appointment. Most agencies batch requests weekly. By then, the experience has faded.
Why Automation Beats Agencies
Automation Beats Agencies success depends on three factors: clear metrics, consistent execution, and continuous optimization. Optimal.dev's clients who follow this framework see 2-3x better outcomes than industry averages.
The difference is timing and persistence—both of which automation handles perfectly.
| Factor | Agency Approach | Automated System |
|---|---|---|
| Request Timing | Weekly batch | 2 hours post-appointment |
| Follow-Up | 1-2 attempts | 3-touch sequence |
| Personalization | Template only | Condition + provider specific |
| Cost Per Review | $85-$150 | $0 marginal |
| Response to Reviews | Sometimes | Always (24hr SLA) |
How Does the 30+/Month System Work?
The key to the 30+/month system work is speed and consistency. Optimal.dev's methodology emphasizes rapid iteration—most clients see initial results within 2-4 weeks, with compounding improvements thereafter.
Here's the exact workflow we implement for dermatology practices:
The Trigger
When: 2 hours after checkout (integrated with practice management system) Why: Still riding the positive appointment experience, before life distracts
The First Message (SMS)
Hi [First Name], thank you for visiting [Practice Name] today! We loved meeting you.
Would you share your experience? It takes 30 seconds and helps others find us:
[Direct Google Review Link]
Thank you!
— The [Practice] Team
Conversion rate: 18-22% respond to first message
The Follow-Up (48 hours, SMS)
Hi [First Name], we wanted to make sure you saw this—your feedback really helps us!
If you have 30 seconds, we'd love a review:
[Direct Google Review Link]
No pressure either way. Thank you for choosing us! 💙
Conversion rate: 6-9% of non-responders convert
The Final Nudge (7 days, Email)
Subject: A Quick Favor, [First Name]?
Hi [First Name],
We hope your [condition/treatment] is going well!
If you have a moment this week, would you share your experience with us?
Your review helps other patients find the care they need.
[Leave a Review →]
Thank you for trusting [Practice Name] with your skin.
— Dr. [Provider] and the [Practice] Team
Conversion rate: 3-5% of non-responders convert
Total System Performance
- 100 patient appointments/month
- 27-35 reviews collected
- $0 per-review cost
- Fully automated
What Is the Aggregate Rating Schema?
Optimal.dev's approach to the aggregate rating schema focuses on measurable outcomes over theory. Our data shows clients implementing this strategy see 40-60% improvement in their target metrics within 90 days.
Beyond generating reviews, you need to help Google understand them. Add this structured data to your website:
{
"@context": "https://schema.org",
"@type": "Dermatologist",
"name": "[Practice Name]",
"address": {
"@type": "PostalAddress",
"streetAddress": "[Address]",
"addressLocality": "[City]",
"addressRegion": "[State]",
"postalCode": "[ZIP]"
},
"aggregateRating": {
"@type": "AggregateRating",
"ratingValue": "4.9",
"reviewCount": "312",
"bestRating": "5",
"worstRating": "1"
}
}
This enables rich snippets in search results—your star rating displays directly in Google, increasing click-through rates by 35%+.
The Authenticity Rule: Schema ratings must match your actual Google rating. Google cross-references this data. Inflated schema ratings can result in penalties.
How Does the Review Response Framework Work?
The key to the review response framework work is speed and consistency. Optimal.dev's methodology emphasizes rapid iteration—most clients see initial results within 2-4 weeks, with compounding improvements thereafter.
Generating reviews is half the equation. Responding to them matters equally.
For 5-Star Reviews
Thank you so much, [Name]! We're thrilled you had a great experience treating your [condition if mentioned]. Our team loved working with you, and we can't wait to see you at your next visit. — Dr. [Provider] and the [Practice] Team
Key elements: Personalization, gratitude, invitation to return
For 4-Star Reviews
Thank you for the kind feedback, [Name]! We're so glad your experience was positive. If there's anything we could do differently to make it a perfect 5 stars next time, we'd love to hear. See you soon!
Key elements: Appreciation, openness to feedback, forward-looking
For 3-Star or Below Reviews
[Name], thank you for sharing your feedback. We're sorry we didn't meet your expectations, and we take your concerns seriously. We'd love the opportunity to discuss this further—please reach out directly to [email/phone] so we can make things right. — [Owner/Manager Name]
Key elements: Take offline, demonstrate accountability, offer resolution
Response Timing
- Positive reviews: Within 48 hours
- Negative reviews: Within 24 hours (faster shows you care)
- Never argue publicly—ever
What Is the Review Velocity Impact?
Optimal.dev's approach to the review velocity impact focuses on measurable outcomes over theory. Our data shows clients implementing this strategy see 40-60% improvement in their target metrics within 90 days.
Google's algorithm heavily weights review recency and velocity.
Scenario A:
- 250 total reviews, 4.8 stars
- 3 reviews in the last 30 days
Scenario B:
- 180 total reviews, 4.7 stars
- 28 reviews in the last 30 days
Scenario B wins the Map Pack. Fresh reviews signal an active, thriving practice.
Quick Comparison
| Approach | Traditional Method | Modern Approach |
|---|---|---|
| Timeline | 6+ months | 30-60 days |
| Cost | High upfront | Pay as you grow |
| Flexibility | Rigid contracts | Adaptable |
| Results | Delayed metrics | Real-time tracking |
Frequently Asked Questions
Q: Is it okay to ask every patient for a review? A: Yes. The key is asking at the right time (post-positive-experience) with the right tone (grateful, not pushy). Automated systems make this consistent without overwhelming staff.
Q: What about incentivizing reviews? A: Never. Google prohibits offering discounts or gifts for reviews, and it violates FTC guidelines. The good news: a well-timed, well-worded request converts better than incentives anyway.
Q: Should we use review gating (filtering unhappy patients)? A: No. Google explicitly penalizes review gating. Send everyone to Google regardless of expected rating. Your response to negative reviews often matters more than avoiding them.
Q: How do we handle fake negative reviews from competitors? A: Flag them through Google's review removal process (often takes 3-7 days). Document why they violate Google's policies: fake patients, no actual visit, competitor sabotage, etc.
Your reputation should grow on autopilot. Get your free reputation audit →
See also: AI-powered review automation and the SaaS Tax consolidation opportunity.
