How a regional NSW podiatry clinic added 267 reviews in 6 months and lifted bookings 1.6×

A composite case study following a regional NSW podiatry clinic through their first 6 months on the X18 platform. Clinic descriptor and numbers anonymised per CLAUDE.md §10.5 — patterns drawn from real customer outcomes.

The mix of patient cohorts

The clinic's caseload was split roughly: 40% orthotic patients (initial consult + fit + follow-up), 25% sports injury (Achilles, plantar fasciitis, runner-knee referrals), 20% diabetic foot care + aged care, 10% paediatric, 5% nail/ingrown procedures.

Generic review software would have asked every patient at day 7 — wrong window for orthotics (still in break-in), wrong window for sports injury (still in recovery), and entirely inappropriate for diabetic / aged-care cohorts.

The cohort-aware setup

• Orthotic patients → ask at 5 weeks post-fit. Comfort confirmed, break-in over.
• Sports-injury patients → ask after the follow-up visit where return-to-activity was confirmed.
• Paediatric routine → asked only after the follow-up where improvement was documented (parents review on behalf of children).
• Diabetic foot care + aged care → excluded entirely. The cohort is vulnerable and review asks aren't clinically appropriate.
• Nail / ingrown procedures → ask at 10 days. Healing initial confirmation.

Months 1–2: orthotic patients drove the early velocity

The orthotic cohort accounted for the majority of new reviews in the first two months. Patients at the 5-week post-fit window were ready to talk about the comfort change — most reviews were specific ("my heel pain is gone", "I can walk my dog again without stopping") and detailed. Response rate from this cohort was ~38% (compared to a baseline of ~5% on a previous platform).

By the end of month 2: 113 new reviews, rating climbed to 4.8.

Months 3–6: sustained mix velocity

Sports-injury reviews started arriving in months 3–4 as patients confirmed return-to-activity. These reviews were among the highest-quality on the profile — clients describing measurable physical outcomes (10km run, tennis match, hike). The rating stabilised at 4.9 by month 4.

The private-resolution flow caught 17 below-3-star issues over the 6-month window — most around orthotic fit comfort or expectation mismatches. Each became a re-fit appointment or a refund. None reached Google.

The booking lift

New-patient bookings climbed from a baseline of ~25/week pre-platform to ~40/week by month 6 — the 1.6× lift attributed to the rating + recency move combined. The practice owner reported a meaningful shift in who was calling: more "I saw your reviews online" mentions, fewer referral-based bookings (still happening, just smaller share of inbound).