How a Melbourne GP practice moved from local-pack rank 6 to rank 2 in four months

A composite case study illustrating the 4-month picture for a multi-disciplinary urban Melbourne GP practice. Practice descriptor and numbers anonymised per CLAUDE.md §10.5 — patterns drawn from real customer outcomes.

The starting position

The practice had been operating for 11 years across three GPs and two practice nurses. 224 Google reviews accumulated organically over that time — solid total, but the recents page showed mostly reviews 8+ months old, with a couple of recent 2-stars from frustrated wait-time complaints sitting at the top of "Most Recent".

The practice manager flagged that new-patient enquiries had been declining for 18 months despite the patient base being clinically stable. The local pack was being captured by two newer practices — one a 3-year-old corporate-backed centre, one a 5-year-old single-doctor practice — both with active review velocity.

Setup and cohort exclusions

Integration with Best Practice (the medical PMS) completed in week two. Cohort exclusions were extensive — mental health consultations excluded, all paediatric vaccinations excluded, end-of-life adjacent visits excluded, two specific practitioners opted out entirely, anyone flagged with active complaints excluded. The practice manager configured 11 exclusion rules during onboarding.

Despite those exclusions, the addressable cohort was still meaningful — standard consults, repeat prescription appointments, post-test result follow-ups, minor procedure follow-ups.

The first 8 weeks: the recency signal moves

By week 4 the practice had added 78 new reviews. The rating climbed to 4.8 quickly because the new reviews were almost entirely 5-stars (the 3-star-or-lower flow caught 9 negatives privately in this window). Critically, the "Most Recent" view on the Google profile flipped — the prior 2-stars dropped to position 12 and were no longer visible above the fold.

Around week 7, Google rebalanced the local pack. The practice moved from position 6 to position 4 — a meaningful jump that surfaced the practice for new searches it hadn't been visible for previously.

Months 3–4: into the top 3

By the end of month 3 the practice was at 312 reviews / 4.9★. The local pack moved again — the practice broke into position 2, behind only the corporate-backed centre. New-patient phone enquiries climbed week-over-week through this period.

By the 4-month mark: 401 reviews, 4.9★, 15 negatives caught privately (each one a phone call from the practice manager that became a resolved conversation rather than a public 1-star). New-patient enquiries up 1.8× from baseline. The practice owner stopped chasing new-patient marketing and started turning down most paid-acquisition outreach because the inbound was enough.