Welcome everyone to Episode #77 of the Chiropractic Marketing Podcast.
I’m your host, Dr. Patrick MacNamara, and today we’re talking about something that is genuinely changing the way patients find chiropractors — and that’s ChatGPT. Specifically, I want to break down how ChatGPT decides which chiropractors to recommend when someone asks it for help finding care in their local area, and what you can do right now to make sure your practice is part of that conversation.
Let me start with what’s actually happening out there, because it’s more significant than most chiropractors realize. The way patients begin their search for a healthcare provider is shifting — and it’s shifting fast. Where someone used to type “chiropractor near me” into Google and scroll through a list of results, more and more people are going directly to ChatGPT and asking it a full question. Something like, “Can you recommend a chiropractor who specializes in sports injuries near me?” or “Is chiropractic care good for sciatica?” or “What should I look for when choosing a chiropractor?”
And here’s why that matters so much. Google gives you a list. ChatGPT gives you a recommendation. There’s a huge difference between those two things. When a patient gets a direct, confident answer from an AI system they trust, they’re far more likely to act on that answer without continuing to shop around. If your practice is the one being mentioned, you’re getting a level of implied endorsement that a traditional search result just can’t replicate. If your practice isn’t mentioned — you effectively don’t exist for that patient. They never see your name. They never visit your website. They just go call whoever ChatGPT told them to call.
So how does ChatGPT actually decide who to recommend? This is where it gets really interesting, and I think understanding the mechanics here is the key to understanding what you need to do about it.
First, ChatGPT is not a search engine. It doesn’t crawl the web in real time and pull fresh results the way Google does. It generates its responses based on patterns it learned during training — training that involved processing an enormous amount of content from across the internet. Websites, articles, directories, review platforms, podcast transcripts, published guides — all of it. So what influenced those patterns? What the model learned about your practice depends almost entirely on what existed about your practice across the web at the time it was trained.
If your practice was mentioned consistently across multiple credible sources — your own website, local directories, patient review platforms, guest articles, podcast transcripts — then the model had a lot to learn about you. It could form a picture of who you are, what you specialize in, and how authoritative you are in your field. If your online presence was thin, inconsistent, or limited mostly to one basic website, the model had very little to go on. The result is that practices with a thin footprint either don’t show up at all, or they show up as a generic, undifferentiated entry rather than a recognized authority.
The second thing to understand is that ChatGPT favors topical authority over individual pages. It’s not just looking at one blog post you wrote. It’s synthesizing information from everything it learned during training, and it favors sources that demonstrated depth and consistency on a given topic. Think about it this way — a chiropractic website that publishes one blog post about sciatica every once in a while signals very little authority. A website that covers sciatica, disc herniation, sports injury rehabilitation, prenatal chiropractic care, and the full range of conditions your practice treats — with well-structured, substantive content across all of those topics — signals genuine expertise. That’s the kind of depth that shapes how a large language model understands who the real authorities are in a given space.
Third, and this is something a lot of people overlook: ChatGPT weighs how structured and extractable your content is. Large language models are trained to pull meaning out of text. Content that’s clearly organized — with logical headings, direct definitions, question-and-answer formatting, and specific factual claims stated plainly — is far easier for the model to process and incorporate than dense, unstructured paragraphs full of vague marketing language. If your website reads like a brochure instead of a resource, it’s doing very little to establish your authority with AI systems.
The fourth signal is one that ties this all together: citations and mentions across independent sources. One of the strongest signals that ChatGPT uses to assess authority is how often an entity is mentioned in connection with a topic across multiple sources that aren’t your own website. When your practice name, your area of specialization, and your content get referenced on other websites — in directories, in published articles, in podcast episodes, in community mentions — the model learns to associate your brand with that topic. A practice that exists only on its own domain carries much weaker authority than one whose name shows up consistently across a whole web of credible, independent sources. This is the principle behind Search Everywhere Optimization for chiropractors — your presence has to extend well beyond your own website.
So when we talk about what you actually need to do to show up in ChatGPT recommendations, it comes down to five things, and none of them are complicated — they just require deliberate, consistent effort.
The first is topical depth on your website. You need to go beyond a services page with four sentences per condition. Publish detailed, well-organized content about the conditions you treat, the techniques you use, and the patients you serve. Each piece of content should be thorough enough to stand on its own as a genuinely useful resource for someone who’s actually trying to understand what you do and whether you can help them. If you want a framework for how to approach this, the generative engine optimization guide for chiropractors at DCRank walks through the content architecture in practical terms.
The second is schema markup. Schema helps AI systems and search engines understand exactly what your content is about and how it’s organized. LocalBusiness schema, MedicalBusiness schema, FAQ schema — these are technical additions to your site that make your content more parseable by large language models. Check the show notes for a link to DCRank’s full breakdown on schema markup strategy for chiropractic AI visibility.
Third is expanding your footprint beyond your website. Actively pursue mentions and citations on credible external sources. Complete and optimize your profiles on every relevant directory — not just Google Business Profile, but Healthgrades, Yelp, Zocdoc, and chiropractic-specific directories. Look for opportunities to contribute content to health and wellness publications. Encourage detailed patient reviews that actually describe your specializations and what patients experienced working with you — not just a star rating with no context. It’s the specificity in those reviews that helps AI systems understand what kind of practice you actually run.
Fourth is content that directly answers patient questions. Remember, ChatGPT is fundamentally a question-answering system. It was trained on content that answered questions well. If your website is built around the questions your patients actually ask — “Does chiropractic care help with migraines?” “How many adjustments will I need?” “Is chiropractic safe during pregnancy?” — and those questions are answered clearly and directly, your content is exactly the kind of material that shapes how AI models respond to similar queries in the future. This is one of the places where Generative Engine Optimization and answer engine optimization for chiropractors really intersect. I’ve covered both of those topics in depth on this podcast — you can find those episodes on generative engine optimization for chiropractors and AI content strategy for chiropractors right here on the show.
Fifth is your technical foundation. All the content strategy in the world doesn’t matter if your website is slow, not mobile-friendly, or has crawlability issues that prevent your content from being accessible in the first place. Technical SEO for chiropractic websites in AI search is the infrastructure that makes everything else possible.
Now, I want to address something that I hear from chiropractors a lot, and it’s this assumption: “My Google rankings are good, so I’m probably fine for AI too.” I understand why that feels intuitive, but it’s not quite right. Google rankings and ChatGPT recommendations are related, but they’re not the same thing. Ranking on page one of Google gets you traffic from people who click on links. Being cited by ChatGPT puts your practice name into a conversational recommendation that a patient reads and acts on. The signals overlap — strong content, good structure, external authority — but they’re not identical, and optimizing for one doesn’t guarantee the other.
The other thing I hear is, “I’ll wait to see how this plays out.” And look, I get it. There’s always something new in digital marketing, and not everything ends up mattering as much as the early hype suggests. But this one is different, and here’s why. The practices building topical authority and external presence right now are the ones that will be baked into AI recommendations when the next round of model training happens. This is the same window that existed in the early days of local SEO — when the chiropractors who built their Google Business Profile and earned their first reviews ended up with advantages that took years for competitors to close. That window closes. And right now, for AI recommendations, it’s still open.
To go deeper on all of this, I’d encourage you to head over to DCRank’s full article on how ChatGPT recommends chiropractors — I’ve linked to it in the show notes. DCRank specializes exclusively in SEO and AI visibility for chiropractic practices, and if you’re ready to get ahead of this shift, DCRank.com is where to start.
Alright, that wraps things up for today’s episode…
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