AI Visibility for Local Medical Practices · Finding 02 of 9 · August 2026 edition

Winning in Google search does not mean winning in AI search.

This study analyzed 3,234 AI answers and 10,133 citations to 72 patient questions on ChatGPT, Gemini, Perplexity and Google AI Overview, checked against 18,492 practice listings in five US metro markets: suburban Chicago, Philadelphia-South Jersey, Tampa-St. Petersburg, Phoenix West Valley and suburban Houston.

Get your free AI Visibility Snapshot

Summary

AI recommendations don't follow Google rankings, according to Javvo's study. 43.6% of the local medical practices holding a top-3 Google position were never cited in AI answers to the same questions. The divergence runs both ways: in the average AI recommendation, at least 58% of the practices named hold no top-3 Google position for that search.

Most local practices have invested in SEO to improve their Google search rankings. This study measured how much of that Google search strength carries into AI search. The practices holding Google's top-3 map positions or top-3 organic positions were checked against the AI citations for the same questions, in the same markets. Practices that rank high in Google search do not necessarily earn strong citations in AI search.

43.6% of Google's top-ranked practices were never cited in AI answers

Google's map results and organic results carried over at nearly the same rate. On provider discovery searches, 46% of practices in the top-3 map results and 45% of practices in the top-3 organic results were not cited in AI answers when the same question was asked. The gap is even larger on any single engine, because the engines disagree about whom to name. ChatGPT alone never mentioned 72% of Google's top-ranked practices, Perplexity 65%, and Gemini 54%.

Google top-3 practices never named by AI

  • ChatGPT
  • Perplexity
  • Gemini
  • Any engine
59.4% 76.7% 80.3% 72% 53% 69.6% 71.2% 64.6% 47.8% 58.1% 54.5% 53.6% 35.5% 48.5% 46.8% 43.6% Podiatry Dentistry Chiropractic All specialties
Share of Google top-3 practices not cited, by specialty
Specialty ChatGPTPerplexityGeminiAny engine
Podiatry 59.4%53%47.8%35.5%
Dentistry 76.7%69.6%58.1%48.5%
Chiropractic 80.3%71.2%54.5%46.8%
All specialties 72%64.6%53.6%43.6%
Share of practices ranking in Google's top-3 map results that received no AI citations, by specialty and engine. 'Any engine' counts a practice as cited if at least one engine named it.

Most of what AI cites comes from outside Google's winners

In the average AI recommendation, at least 58% of the practices named hold no top-3 Google position for that search. By engine, ChatGPT reaches furthest past Google's rankings: 90% of the practices it names hold no top Google position, with Perplexity and Gemini each at 78%. In ChatGPT's typical answer to a provider discovery question, not one named provider holds a top Google position. A share of named practices could not be matched to any listing, so these are conservative figures, and the study-wide floor is 58%. It is clear that AI engines do not follow Google's rankings.

The gap varies by market

The share of Google's top practices missing from AI answers ranged from 32% in suburban Houston to 60% in Tampa-St. Petersburg. One hypothesis is geography. The study anchored each market at one suburb, and where the anchor sits far from the metro's population center, Google's map results stay local to the anchor while AI draws practices from the wider metro, widening the gap. The market variation warrants further analysis and will be tracked in future editions.

Terms: Google map results are the map with business listings shown for local searches (the 'local pack'). Google organic results are the standard unpaid web links below it. Google AI Overview is the AI-written answer Google sometimes shows above its results.

See how AI answers questions about your practice today.

Get your free AI Visibility Snapshot

Run AI visibility for the practices you serve.

AEO for partners

August 2026 edition.